I am certain that this Blog will draw a lot of flak. Even the doctors and others who agree with me till this point, may differ on this. However, I feel this deserves a chapter and hopefully once you read the whole thing, you might agree with me as well.
In the late 18th century, a German physician by the name Dr. Samuel Hahnemann had a starling discovery. One has to remember a context here. Medicine was rudimentary at this time and most of the medications involved dangerous procedures like leeching, bloodletting, purging and other harmful ways that were often more fatal than the disease itself.
He realized that when he drank the extract of Cinchona bark (which was then used to treat symptoms of Malaria and still is used in modern medicine as a drug), he developed symptoms of Malaria although he hadn’t contracted Malaria per say. In the late 18th century, there was no concept of microbes (which were yet to be discovered) and hence it would be hard to say what they described as “Malaria” was truly malaria or not. In the text, it is mentioned as high remittent fever with chills, sweating etc. What Hanhemann could be experiencing, is the side-effects of the bark. Any substance natural or synthetic (if its not food) that has an effect, will also have a side effect. The side effect is a collateral damage which the substance does. These happen due to various reasons like off-target effects, individual variability (now we know as genetic differences), dose-dependent effects, metabolic effects etc. Nevertheless, he then started preparing tinctures of commonly used plants at that time (like cinchona, belladonna atropa for fever, strychnine, etc. which were mostly already being used in herbal medicine as poisonous plants used for various purposes). He then started using them in his patients who were presenting with certain set of symptoms and he saw great improvement. For example, he saw that belladonna, when given to healthy people, cause them to have fever with rashes. So he then prescribed the tincture of belladonna to children with scarlet fever (which is now known to be caused by staphylococcus bacteria) and saw great improvements. He also noticed that the tincture itself was quite strong and hence he started diluting it in a systematic way which is today known as potentization. This process has gotten passed down over the next 200 years. It is to be noted here that what we call today as systematic trials, did not exist at that time and hence were not done.
Here starts the issues with homeopathy. The dilution process removes the primary substance from the liquid to such an extent that there is no substance in it anymore. So, what is actually the medicinal molecule? This question is yet to be answered. Some of the recent research into homeopathic dilution is trying to explain this by using the theory of water memory (which has been debunked and was not replicable).
A recent study in 2010 done in IIT Mumbai (Indian Institute of technology) suggested that even in high dilutions, they discovered nano particles of the started metal. These were done only for metal remedies so it is hard to extrapolate it for plant remedies. There was another study done in Bhopal, India, which said that these remedies have electromagnetic signatures. These studies were also not replicated elsewhere. So now I think you can get an idea of what is missing here.
We still do not know how this modality works and hence there is huge divide within the homeopathic community itself on how to prescribe it. It has crossed the line from medicine into quackery. There are schools of thought within the community itself that base the prescription on modern diagnosis, that base on symptoms (physical) and some who base it on personality of the person. There is utter chaos and as a physician myself, who has studied homeopathy for quite a number of years, I am unable to understand the basics of how it is prescribed. There is a lot of subjective variation which is never good for medicine. Medicine has to be uniform, systematic and protocol driven to some extent. Only then it becomes replicable and have uniform practice throughout the world.
This brings me to the next issue. In the last 100 years, medicine has made great strides in understanding the human body. We know the cause for many illnesses and the body is no longer the black box it used to be. Antibiotics were a major breakthrough in curtailing deaths due to infectious diseases and we then entered what is called an era of chronic diseases which was a side-effect of longer life spans. Our understanding of medicine and diseases have changed; however, if you look at the texts in homeopathy, they still echo the ancient understanding. Words like phlegmatic, humours, sanguine etc. are used to select remedies, which are no longer is used in medical diagnosis. These words occur repeatedly in older pharmacopeias but are no longer relevant. As a clinician, it becomes hard for me to correlate these terms with what we know today. I have also come across homeopathic doctors who prescribe remedies for surgical issues like hernia, undescended testes, prolapse etc. which makes no sense to me. Even chronic diseases like diabetes, hypertension etc. which can be sometimes managed with homeopathy (but never treated and cured) are claimed to be treatable by most of these practitioners. So, all in all what I can see that, homeopaths are unwilling to come to a consensus about how to prescribe the remedy and more so as unwilling to accept the short comings of the therapy itself.
Even with all these problems (and much more), I wouldn’t be quick to dismiss the modality because of my personal (albeit anecdotal) experiences with my family and my patients alike. Personally, I have never used anything other than homeopathy for all my acute problems (tonsilitis, mumps, gastroenteritis etc.). I have given homeopathy for my patients (including children) and seen remarkable recovery in serious conditions like impetigo (which was managed without antibiotics), bacterial tonsilitis, rotavirus diarrhea, allergic rhinitis, asthmatic bronchitis and many more conditions. From what I have seen and experienced, I strongly feel homeopathy shouldn’t be dismissed because it does give us an opportunity to use less antibiotics (especially with the advent of antibiotic resistance), avoid harmful drugs if possible and give more natural ways of healing for patients.
Like me, there are genuine clinicians across the world, who integrate homeopathy into their practice and are continuing to do so because they do see results.
“Lack of evidence doesn’t necessarily mean absence of evidence”.
We need more research to understand how homeopathy works and when this is answered satisfactorily, we can then progress to how to incorporate it in clinical practice. If this doesn’t happen soon, homeopathy will soon be a dead science because it hasn’t kept up pace with the developments of modern medicine. I personally feel it will be a great loss to the medical community as a whole.
Comments