Homeopathic Medicine for the 21st Century
What does homeopathy offer our modern ailing world?
PREFACE
Congratulations to Joseph Prahlow, MD, winner of the Excellence in Homeopathy Award! Here is his winning essay. Special thanks to Hermeet Singh and Boiron for their prize donation.
In his own words: "My biggest “homeopathy” credential is that I’m married to a CCHM grad…Tamara Prahlow but I am currently professor and vice chair of the Dept. of Pathology at Western Michigan University, Homer Stryker MD School of Medicine (WMed) in Kalamazoo, MI, where I am also a forensic pathologist/deputy medical examiner for 12 Michigan counties.
Incidentally, Tamara is on the clinical community faculty at WMed and we’ve been co-teaching an “Introduction to Homeopathy” weeklong elective for first and second year medical students. I’m board-certified by the American Board of Pathology in Anatomic, Clinical, and Forensic Pathology."
INTRODUCTION
When homeopathy first made its entrance onto the world stage, from the late 1700s into the 19th century, the world’s current-day medical system was not very encouraging to those seeking appropriate medical care. Those were the days when common, “mainstream” medical “care” included blood-letting and the prescription of poisons for many, many ailments, with a net result being a situation where, quite literally, “the treatment was worse than the disease.” As such, the arrival of homeopathy was a godsend to those who were seeking kind, compassionate, and efficacious medical care. Throughout the 1800s and well into the 20th century, homeopathy continued to be popular and successful in meeting the medical needs of the Western world. Despite this success, as the “modernization” of traditional Western medicine occurred during the early-to-mid 1900s, and with the aid of some political maneuvering, homeopathy largely fell out of favor amongst the masses. Since then, homeopathy has survived thanks to the efforts of many people, including some within the medical profession, but also many amongst the laity.We are now well into the 21st century, and by some accounts, modern “mainstream” medicine has advanced tremendously, some would say beyond what might have been imaginable only a few decades ago. Yet, many of the health care needs of people worldwide do not seem to be adequately addressed by modern medicine. Furthermore, homeopathy remains there in the background, with many faithful practitioners and patients, and it’s actually gaining in popularity worldwide. How could this be, and what does the future hold for this interesting and formidable form of medicine? In my view, homeopathy represents a branch of medicine that is uniquely positioned to address the health care needs of people in the 21st century. In order for homeopathy to be successful in achieving the goal of addressing these health care needs, two overarching issues must be addressed. First, the homeopathy profession as a whole must recognize, understand, and attempt to address the challenges and obstacles that exist in attaining the goal. Second, the homeopathy profession must recognize, embrace, and coordinate efforts to take advantage of various opportunities that exist within the current health care climate of the 21st century. Table 1 provides a synopsis of the challenges/obstacles and opportunities facing homeopathy.
CHALLENGES and OBSTACLES
Unfortunately, the list of challenges facing homeopathy is extensive, and includes issues that are as old as homeopathy itself. But there are also several newer issues of concern, many of which involve the “information age” in which we now exist.
Definitions
It is somewhat ironic that the term “homeopathy” was actually coined by Samuel Hahnemann, the physician who founded homeopathy as a very specific form of medicine, and yet the term is consistently misused and misunderstood. Strictly speaking, for something to be considered “homeopathic” in the classic sense, it must abide by the basic tenets put forth by Hahnemann in the Organon.1 These include, among others, the employing medicines based on the concept of “likes curing likes,” the use of extremely dilute dosages of potentized medicines, determining the correct medicine by considering the totality of the case, individualized care, and using only one medicine at a time. Unfortunately, for many in today’s world, the terms “homeopathy” and “homeopathic” are used interchangeably with terms such as “natural,” “holistic,” and “herbal.” Also, the terms are applied to situations and/or items that use only certain aspects of the basic tenets as listed above. For example, various products may be “prepared” homeopathically, in ultra-dilute doses, and given based on the general principle of “likes cure likes;” however, they might include multiple medicines prepared in combination, and they are frequently “prescribed” for general “conditions” or symptoms, instead of being individualized. The homeopathy community must make efforts to educate the public and health care professionals about what homeopathy is, and how the definitions regarding true classical homeopathy are frequently misused.
Misinformation
In addition to misunderstandings regarding the terms “homeopathy” and “homeopathic,” there also is a tremendous amount of misinformation related to whether or not homeopathy represents a reputable and legitimate form of “alternative” medicine. A brief look at the internet reveals site after site that designates homeopathy as a“pseudoscience,” a form of quackery, or something even worse.2,3 Although the internet is most representative of the misinformation that exists regarding homeopathy, we cannot ignore the fact that “the media” can also be a source of misinformation, when it comes to homeopathy. The media may work “hand in hand” with government and “big pharma” to spread such misinformation.
Two “subcategories” of misinformation that deserve special mention involve medical professionals and people who have spiritual concerns regarding homeopathy.
Lack of Understanding Amongst Medical Professionals – Despite the fact that medical professionals, in particular physicians, are generally regarded as having a level of intellectual and scientific acumen such that they are recognized by most people, especially their own patients, as being well-informed about medical issues, the unfortunate reality is that many physicians know absolutely nothing about homeopathy….or perhaps even worse, they believe many untruths about homeopathy that other so-called “experts” (colleagues, others) relay to them. Therefore, when asked by their patients about homeopathy, a common response is, “it doesn’t work.” This response is often based on nothing more than what they have read on the internet, or a very limited amount of so-called “research” into homeopathy, which typically involves reading about/listening to other physicians who have no credible knowledge about the topic. Homeopathic practitioners and patients must be vigilant in informing not only the general public but also the general medical community of the true scientific underpinnings of classical homeopathy.
Spiritual Worries – A population of potential beneficiaries of homeopathy that deserves mention are persons who shy away from homeopathy because of their false belief that the discipline involves the occult or other religious proclivities. I have seen this worry particularly amongst persons with traditional Judeo-Christian belief systems; however, if may well exist in other groups as well. Perhaps this cautionary concern is related to Hahnemann’s description of the “vital force” as being “spirit-like” (Aphorisms 9, 15, 16, for example);1 however, it may also be related to the fact that certain followers of “New Age” spiritual movements, or similar transcendentalist practices, have more-or-less incorporated homeopathy into their belief systems. As such, homeopaths should be careful to educate their patients and the public that, although one’s spirituality and religious beliefs certainly make-up part of one’s “totality,” there is nothing within the practice of classical homeopathy that requires or advocates for a specific religious belief system.
Government and Other Powers
The recent (and to an extent, ongoing) worldwide pandemic has revealed the unfortunate reality that certain very powerful people, including many within government at all levels, seem to be consumed with controlling people. This topic, by itself, could be a several page diatribe. Suffice to say that, as long as the powers-that-be desire and actually wield control over the people, for whatever end goal they have, then the people will not have the freedom and liberty to choose for themselves, and this includes their health care choices. The current Federal Drug Administration (FDA) dealings regarding homeopathic medicines represents an unfortunate manifestation of the power-hungry overlords seeking to destroy our liberty and freedoms.4 Homeopathy must stand against such tyranny.
Big Pharma
An example of another powerful group that represents an obstacle to homeopathy in the 21st century is the pharmaceutical industry. This was (and continues to be) displayed during the pandemic. Despite their advertisements and propaganda to the contrary, the health and well-being of the people is not the primary concern of big pharma. Rather, it is power and profit. Why wouldn’t a powerful and well-financed industry want to “snuff-out” a very successful form of alternative medicine (homeopathy) that is diametrically opposed to their methods and motives? I would not be surprised at all to learn that big pharma is behind many of the government-led attempts to stifle homeopathy, be it the ongoing FDA efforts regarding homeopathic medicines,4 or various government-sponsored attempts at denigrating homeopathy.5 Indeed, the combination of big pharma, big government, and big media represents an “unholy trinity” of obstacles to homeopathy in the 21st century.
Artificial Intelligence
As the technological advances of artificial intelligence (AI) continue to expand, it is becoming more and more obvious that AI is here to stay and that “we the people” need to be very cautious as this technology becomes more and more a “part” of our lives. Already, we are hearing reports that AI has apparent “built-in” biases, or perhaps it would be better to describe them as “learned” biases. I know very little about the technology itself, but if it involves, as I suspect, the gathering of “known truths” in the form of readily-available information (for example, from the internet), the “truths” that AI espouse will most certainly be biased based on the amount of information available, whether “for” or “against” any particularly controversial topic. Hence, I do not doubt for a moment that, as AI gains more “intelligence” about homeopathy, it may well come to the conclusion that homeopathy doesn’t work, that it’s a fraud, that it represents a huge form of quackery. I’m not sure how the homeopathy community can address this, except that we must be diligent in publishing the truths we know about homeopathy, wherever and however we can, whether it be in the peer-reviewed scientific and medical literature, within the popular press/media, or via the internet.
Divisions Amongst Homeopaths
Within the world we know as “homeopathy,” there exists a tremendous variability in terms of practitioners, medicines, methods of practice, modes of treatment, etc… Are you a physician homeopath? A naturopath? A chiropractor? A nurse homeopath? A lay homeopath? Do you follow the 5th edition Organon or the 6th edition Organon? Do you use dry doses or watery doses? Do you repeat doses frequently or infrequently? Do you practice traditional classical homeopathy or something that differs from it? Key-note prescribing? Sensation method? Protocols? Homeoprophylaxis? Do you advocate for the use of “combination remedies?” And what in the world are you talking about when you speak of individualizing a cocktail of multiple remedies and then injecting it/them into a patient? Most of you reading this probably vehemently object to at least one of the above options, right? Indeed, credible arguments against some of the options described above exist, and within the world of homeopathy, debate backed by research and experience should continue, so that we can ensure as a community that homeopathy is successful for our patients. However, we as a diverse community need to come together to fight against the “anti-homeopathy” obstacles delineated above. We must form a united front in addressing these obstacles and challenges, and in advocating for homeopathy through the opportunities that are addressed in the next section of this essay.
OPPORTUNITIES
Despite the many obstacles and challenges which face homeopathy in the 21st century, the homeopathic community should be emboldened and encouraged by the fact that there are also many opportunities for the advancement of homeopathy as an alternative choice in health care.
Proclaim the Truth: Homeopathy Actually Works
Notwithstanding the challenges involved (especially for a student) in arriving at the correct simillimum for a case, let alone the appropriate follow-up and case management, the truth of the matter is that homeopathy does, in fact, work! Those of us who have been the beneficiaries of homeopathic care, or who have seen the benefits in others, know with no doubt whatsoever that homeopathy represents a truly amazing form of alternative medicine that is able to successfully treat patients having a wide range of health concerns, including some very ill individuals. And it’s not just based on “experience” or “perception,” although such evidence should not be discounted. Numerous studies show the effectiveness of homeopathy.6-9 The fact that homeopathy actually works represents one of the biggest and most important opportunities for homeopathy. The corresponding challenge relates to “getting the word out” into the general community as well as the medical community. Instead of homeopathy being the “last resort,” it should increasingly become the “first choice” amongst patients. Only by “spreading the word” of its success can this become a reality.
Proclaim Another Truth: Homeopathy Addresses the Basic Tenets of Medicine
During their education, every physician learns, in one form or another, some of the most basic tenets or goals related to medicine. The most famous, perhaps, is “first, do no harm.” Another is to “relieve pain and suffering.” A third is to “cure disease,” or to “return to good health.” A corollary would be to “maintain good health.” I know of no physician who would disagree with these basic tenets or goals within the practice of medicine. When attempting to educate physicians (or medical students) about homeopathy, a very good place to start is at the beginning of the Organon, where Samuel Hahnemann spells-out the tenets on which the system of medicine known as “homeopathy” is based. Aphorism 1 states: “The physician’s highest and only calling is to make the sick healthy, to cure, as it is called.”1 Aphorism 2 goes on to say: “The highest ideal of cure is the rapid, gentle and permanent restoration of health; that is, the lifting and annihilation of the disease in its entire extent in the shortest, most reliable, and least disadvantageous way, according to clearly realizable principles.”1 Clearly, Hahnemann understood what all physicians believe to be the basic tenets of medicine, and the practice of homeopathy is based on and functions to achieve these laudable goals.
Numerous Failures of the Current Health Care System
Many support the claim that the “modern health care system” has had an overall positive impact on our world. One could simply point to the advent of general anesthesia and the corresponding ability of physicians to successfully perform all sorts of surgical procedures as evidence of this basic truth. Because of these advancements, suffering has been reduced and lives have been saved. Others would point to various medicines that have resulted in reduced pain and suffering, as well as the saving of lives. It is not the intent of this essay to suggest that “mainstream modern medicine” has not made a positive impact in our lives. Instead, the point that I’d like to make is that, despite this positive impact, the reality is that, over the past many decades, and indeed, even continuing today, so-called “modern medicine” has had a detrimental effect on many people’s lives, even to the point of causing unnecessary premature death.10 Despite the many positive accomplishments within modern medicine, where physicians and the health care system have admirably addressed the goals of relieving pain and suffering and sometimes even returning patients to seemingly good health, the unfortunate reality is that, in many instances, that goal of returning a patient to good health is not really achieved in its entirety. In other words, instead of curing disease, modern medicine really only manages or palliates disease. In addition, in far too many cases, the concept of “first, do no harm” is unfortunately either ignored, forgotten, or sacrificed altogether. Drug and treatment side effects can represent an incredible “harm” for patients. In addition, especially in chronic pain disorders having no clear “mainstream” treatment options, or those with clear treatment options that do not work for all patients, the “harm” that can result from such inadequate care is ongoing pain/discomfort despite being “treated” within the “world’s most advanced” health care system. It is an unfortunate but true reality that many people eventually turn to homeopathy after they have exhausted all hope in the modern mainstream medical system. Homeopathy represents a more holistic, individualized, and gentle approach, either on its own, or perhaps even in combination with various conventional therapies.
People’s Distrust of the Health Care System
Although there is a relatively high percentage of Americans who trust their own physicians (84%), a somewhat smaller percentage trust hospitals (72%), or the health care system as a whole (64%), with only 56% having trust in government agencies involved in health care, and a mere 34% trusting pharmaceutical companies.11 Despite the fact that 84% of people trust their physicians, the fact that the other 16% of people do NOT trust their physicians is actually quite remarkable, and a bit disheartening. For those persons who state that they do not trust their physician, the top reasons why patients do not trust their doctor include: “they spend too little time with me” (25% of patients), “they do not know me”(14%), “they do not listen to me”(14%), and “they do not give me all the information”(10%).11 In the context of the COVID-19 pandemic, this same study indicated that nearly one-third of all patients surveyed (32%) report a decrease in their trust of the U.S. health care system.11 Similarly, nearly one-third of physicians (30%) report a decrease in their level of trust in the health care system and health care organization leadership during the pandemic.11 These statistics are likely not surprising to most homeopaths. There is a general distrust of the “medical system” and those in charge of health care policies. Homeopathy offers a viable alternative to the status quo. The homeopathic community should embrace this and present itself as a valuable, successful, patient-centered option for those who are distrustful of mainstream medicine.
Shortage of Primary Care Providers
Another aspect of the current climate of medical care in the US involves the continued shortage of primary care physicians.12 As the shortage continues, physician extenders, or “advanced practice providers,” including physician assistants (PAs) and nurse practitioners (NPs), are filling the void.12 Studies confirm the value of these non-physician practitioners in the primary care/acute care setting, and in hospital settings.13 However, there is some evidence that those who utilize PAs/NPs as their primary care provider may not receive as much access to certain exams within the traditional health care model as patients whose primary care provider is a physician.14 Likewise, there is evidence that those who rely on PAs/NPs as their primary care provider are also more likely to seek treatment from chiropractors, compared to those who have physicians as their primary care provider.14 This trend might also apply to other alternative care providers, including homeopaths. As such, the homeopathy community should capitalize on the fact that patients who must rely on “advanced practice providers” may be more likely to seek care from alternative care providers, such as homeopaths.
Acceptance of Complementary and Alternative Care Options
Although the term “complementary and alternative medicine” (CAM) encompasses many wide-ranging disciplines, it has been evident for quite some time that many people use CAM therapies. A 2002 study indicated that 36% of adults in the US had used CAM therapy sometime during the previous 12 months.15 A study from 2005 indicated that certain CAM therapies could be considered “cost-effective.”16 In 2007, adults in the US spent nearly 34 billion dollars out-of-pocket on visits to CAM practitioners and purchases of CAM products, classes, and materials.17 There is also evidence of increased acceptance of CAM amongst traditional medicine. A 2022 systematic literature search of CAM use worldwide revealed that the overall use of CAM among various medical specialists was 45%.18 With increasing use of CAM amongst the patient population, and increased acceptance of its use amongst physicians, the homeopathy community is in a very good position to increase homeopathy’s use, effectiveness, and acceptance.
Complementary and Alternative Medicine Exposure in Medical School
During the past decade-plus, there has been a call for more exposure to CAM options within medical school curricula. In a 2009 report of a survey that was sent to US medical students, a sizeable majority of the respondents agreed that physicians should know more about complementary and alternative medicine options.19 A more recent survey at a single US medical school indicated that over 60% of students and faculty desired more exposure to complementary therapies.20 A 2015 paper reported that about half of all US medical schools at that time offered at least one class, course, or clerkship involving a CAM discipline.21 Thirty-one percent of the schools offered a general overview course of CAM disciplines (which may or may not have included homeopathy), and homeopathy was not listed in a table of other more specific CAM disciplines offered by various medical schools.21 Practicing homeopaths should recognize this trend within US medical education as an opportunity to educate future physicians about the effectiveness of homeopathy. Reaching-out to local medical schools to offer a lecture, or even an elective course, in homeopathy, could go a long way in making homeopathy a recognized and respected alternative care option amongst physicians and their patients.
CONCLUSION
The tried and true principles of classical homeopathy have been in existence for more than 200 years. When it first came upon the scene, homeopathy was recognized by many within the general public as representing a valuable alternative to the destructive and unhelpful common medical practices of the day. Today, in the 21st century, homeopathy is in a similar position, where it can represent a powerful force in the advancement of overall health and wellness. To accomplish this, the homeopathic community must recognize obstacles that exist, including confusion related to terminology, a vast amount of misinformation, the combined forces of big government, big pharma, and big media, potential issues related to artificial intelligence, and the divisions that exist within our own homeopathic community. We must recognize these obstacles and rise to the challenge of addressing them, countering them, and/or removing them. In addition, we must recognize the numerous opportunities that exist in the 21st century, so that homeopathy can become better known, better accepted, and embraced not only by the public, but even by those within mainstream medicine. The truth is on our side. Homeopathy works. It represents a pure form of medical practice that truly addresses the generally-accepted basic goals of “good medicine.” Failures within our mainstream health care system, the public’s general distrust of that same system, and the lack of primary care physicians all contribute to the present situation where homeopathy and other complementary forms of care are being sought-out by patients, and even by those within mainstream medicine. Homeopathy is again in a position to address the health care needs of the nations. The homeopathy community needs to rise to the occasion, overcome the obstacles, and embrace the opportunities that exist so that more and more people can benefit from this truly remarkable form of medical art, where the sick are made healthy, via “the lifting and annihilation of the disease in its entire extent in the shortest, most reliable, and least disadvantageous way, according to clearly realizable principles”(Aphorism 2).1
Table 1 – Challenges & Obstacles, and Opportunities Facing Homeopathy in the 21st Century
CHALLENGES & OBSTACLES | OPPORTUNITIES |
Definitions | Homeopathy actually works |
Misinformation: | Homeopathy Addresses Basic Tenets of Medicine |
Media; Medical professional; Spiritual worries | Failures of the Current Health Care System |
Government and other powers | People’s Distrust of the Health Care System |
Big Pharma | Shortage of Primary Care Providers |
Artificial intelligence | Acceptance of Complementary and Alternative Care Options |
Divisions amongst homeopaths | Complementary and Alternative Medicine Exposure in Medical School |
REFERENCES
- Hahnemann CFS. Organon of the Medical Art, 6th edition. Translated by Wenda Brewster O’Reilly. Palo Alto, CA; Birdcage Books. 1996 (original work by Hahnemann completed in 1842).
- “Homeopathy.” Wikipedia. https://en.wikipedia.org/wiki/Homeopathy accessed February 25, 2023.
- “Homeopathy.” NHS. https://www.nhs.uk/conditions/homeopathy/ accessed February 25, 2023.
- Homeopathic Products. U.S. Food and Drug Administration. https://www.fda.gov/drugs/information-drug-class/homeopathic-products accessed February 25, 2023.
- Homeopathy is not an effective treatment for any health condition, report concludes. BMJ 2015;350:h1478.
- Mathie RT, Lloyd SM, Legg LA, et al. Randomised placebo-controlled trials of individualized homeopathic treatment: systematic review and meta-analysis. Syst Rev. 2014 Dec 6;3:142. doi: 10.1186/2046-4053-3-142.
- Taylor JA, Jacobs J. Homeopathic ear drops as an adjunct in reducing antibiotic usage in children with otitis media. Glob Pediatr Health 2014 Nov 21;1:2333794X14559395. doi: 10.1177/2333794X14559395.
- Sorrentino L, Piraneo S, Riggio E, et al. Is there a role for homeopathy in breast cancer surgery? A first randomized clinical trial on treatment with Arnica montana to reduce post-operative seroma and bleeding in patients undergoing total mastectomy. J Intercult Ethnopharmacol 2017 Jan 3;6(1):1-8. doi: 10.5455/jice.20161229055245.
- Frass M, Lechleitner P, Grundling C, et al. Homeopathic treatment as an add-on therapy may improve quality of life and prolong survival in patients with non-small cell lung cancer: a randomized, placebo-controlled, double-blind, three-arm, multic0-e1955enter study. Oncologist 2020 Dec 25(12):e1930-e1955. doi: 10.1002/onco.13548.
- Anderson JG, Abrahamson K. Your health care may kill you: medical errors. Stud Health Technol Inform. 2017;234:13-17.
- American Board of Internal Medicine. “Surveys of Trust in the U.S. Health Care System.” 2021. https://www.norc.org/PDFs/ABIM%20Foundation/20210520ORC_ABIM_Foundation_Trust%20in%20Healthcare_Part%201.pdf accessed February 13, 2023.
- American Board of Family Medicine; Robert Graham Center; IBM Watson Health. “Primary Care in the United States – A Chartbook of Facts and Statistics.” February 2021. https://www.graham-center.org/content/dam/rgc/documents/publications-reports/reports/PrimaryCareChartbook2021.pdf Accessed February 13, 2023.
- Kleinpell RM, Grabenkort WR, Kapu AN, Constantine R, Sicoutris C. Nurse practitioners and physician assistants in acute and critical care: a concise review of the literature and data 2008-2018. Crit Care Med. 2019;47(10):1442-1449.
- Everett CM, Schumacher JR, Wright A, Smith MA. Physician assistants and nurse practitioners as a usual source of care. J Rural Health. 2009;25(4):407-414.
- Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. Adv Data. 2004 May 27;(343):1-19.
- Herman PM, Craig BM, Caspi O. Is complementary and alternative medicine (CAM) cost-effective? A systematic review. BMC Complement Altern Med. 2005;5:11. doi: 10.1186/1472-6882-5-11
- Nahin RL, Barnes PM, Stussman BJ, Bloom B. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Report. 2009 Jul 30;(18):1-14.
- Phutrakool P, Pongpirul K. Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis. Syst Rev 11, 10(2022). https://doi.org/10.1186/s13643-021-01882-4.
- Abbott RB, Hui K-K, Hays RD, et al. Medical student attitudes toward complementary, alternative and integrative medicine. Evid Based Complement Alternat Med 2011;2011:985243. doi: 10.1093/ecam/nep195.
- Hasler ME, Leggit JC. Complementary and integrative health education in the medical school curriculum: an interest survey. Med Acupunct 2018 Dec 1;30(6):298-307.
- Cowen VS, Cyr V. Complementary and alternative medicine in US medical schools. Adv Med Educ Pract 2015 Feb 12;6:113-7.