Monday, May 14, 2012

The Use of Homeopathy: Is It Worth It?

Homeopathic practitioners tend to believe that a combination of treatments for symptom relief as well as for disease progression is the most beneficial for the patient.  Those who do not believe in the effectiveness of homeopathy consider successful treatments a result of the placebo effect or positive thinking.  In the age of scientific positivism, idealistic philosophies generally do not fare well.  This brings us to the question: does homeopathy actually work, or is it just a under-studied, over-hyped philosophy?
Similar to allopathic medicine, homeopathy studies the outcome of the treatment and remedy compared to the placebo, and also relies on prescriptions after the full homeopathic evaluation of the patient.   However, different from allopathic medicine, homeopathy considers the whole constitution of the person as opposed to the sole presentation of symptoms.  Some of the diagnosis rely on examination of mental or emotional symptoms, certain sensations, location of symptoms, direction of symptoms, concomitant symptoms, modalities of sensations, intensity and duration of symptoms, onset and sequence of events leading up to the problem are taken into consideration.  Homeopathic practitioners often spend considerable amount of time with patients, obtaining a detailed history, which helps the homeopathic doctor to match the person and the remedy. Although patients may have the same diagnosis, the homeopathic treatment and/or dose is individualized therefore making it difficult conduct large studies.  There have been clinical trials done in homeopathy; however, since homeopathic treatments are personalized to an individual it is difficult to conduct the strict double-blind scientific studies which are generally used to test the validity of allopathic treatments. Conventional scientific wisdom states that homeopathy should have no effect above and beyond placebo. There are however, some experiments on ultra-high dilutions of solutes together with some clinical data that suggests the possibility that there may be health benefits under some circumstances.   Most of the clinical evidence comes from treating relatively minor self-limiting diseases and little comes from treating life-threatening disorders such as cancer, for example    Patients receiving homeopathic care may feel worse before they become better because homeopathic medicines often stimulate, rather than suppress, symptoms. This seeming reversal of logic is a relevant part of homeopathy because symptoms are viewed as the body's effort to restore health.
The experimental aspects of homeopathy date back to the beginning of the practice with outcome measures based upon improvement of symptoms and/or recovery from illness. Homeopathy began with hypotheses based on finding effective ways to improve caring for patients through less barbaric ways than were in practice in the mid 1700’s, including use of bloodletting, purging, cathartics and cupping.  The Law of Similars, formulated by Samuel Hahnemann puts forth the concept that a remedy can cure a disease if it produces similar symptoms in a healthy person. .  Hahnemann used scientific principles and methods to develop chemical compounds.  Hahnemann believed that the detailed association between patient’s clinical symptoms and the experimental pathogenesis of remedies mirrored a universal law of healing with medicinal substances. He first used himself and his family to experiment with various chemical compounds in healthy people.  Hahnemann was very meticulous about recording his observations and his results which are still the basis of the development of homeopathy today.  More clearly stated, the Law of Similars implies that a substance that can produce symptoms in a healthy person can stimulate self healing in a person with similar psychosomatic responses to an illness.   By definition, the underlying principles of homeopathy include treating “like with like” by remedies which are potentized by serial dilution and succession.
 The aspect of the homeopathic treatment working is measured through improvement, which occurs because the body is able to activate its innate ability to heal, leading to important philosophical principles of the practice.  An important foundational and philosophic concept of homeopathy defines health “as a state of freedom existing on three interrelated levels: the physical, the emotional and mental”.   When symptoms are more serious they are affecting the person more deeply. Hering’s Law of Cures, helps to provide a holistic assessment of individual progress following use of specific provings. The three laws describe progression of healing which begins with the deepest part of the organism; the mental and emotional parts and the vital organs. The second law describes the symptoms appearing and disappearing in reverse chronological order of appearance. The third law is that healing will progress from the upper part of the body to the lower part of the body. When there are exceptions to this, the homeopathic principle of assessing if the patient is improving is the final measure of continuation or change in type of treatment used.  Just as in so many scientific disciplines homeopathy is based upon strong scientific mathematical calculations which are driven by hypothesis to prove or disprove a belief or a question. In the case of homeopathy it is “is the patient getting better”? This yields the philosophy of practice. 
            The National Center for Complementary and Alternative Medicine of the United States’ National Institutes of Health states: “Homeopathy is a controversial area of CAM because a number of its key concepts are not consistent with established laws of science (particularly chemistry and physics). Critics think it is implausible that a remedy containing a miniscule amount of an active ingredient (sometimes not a single molecule of the original compound) can have any biological effect—beneficial or otherwise. For these reasons, critics argue that continuing the scientific study of homeopathy is not worthwhile. Others point to observational and anecdotal evidence that homeopathy does work and argue that it should not be rejected just because science has not been able to explain it.”
            Due to the lack of evidence in research, homeopathy remains controversial. In an evidence report review by British House of Commons Science and Technology Committee it was recommended that because the evidence was lacking in homeopathic treatments, the government should stop funding for research. The committee felt that due to the lack of active ingredients, it was basically placebo treatment and deceptive to consumers and patients. The government’s response included comments that CAM, including homeopathy has a long standing history and because the complexities of the placebo effect are not fully understood that it was not the place of the Department of Health to comment on the ethics of treatment in a particular setting.  They did comment that they expected all practitioners to use treatments that are in the best interest of the patient.

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