Provings are the system through which homeopathy determines the curative properties of its medicines. It is difficult to explain the homeopathic tradition of provings without a reference to the history of medicine from which it emerged.

 

At the time of Hahnemann there were two great schools of medicine.

 

The rationalist school of medicine believed that it understood the disease process with its advanced scientific knowledge, deriving from the new fields of physics, chemistry and hydraulics. Thus, the duty of the physician was to determine what disease the person had and, thus, what process within the body was malfunctioning. Knowing this, the physician would administer medicine to oppose the effect of the disease on the body. How instance, if a disease provoked fever, anti-fever drugs were given (antipyretics). This approach has continued essentially to this day. Its descendants are modern day Mds, or allopathic doctors.

 

The second school, or the empirical school, had a different approach. Rather than focusing on the disease to be cured, the empirical school focused on what each individual medicine could cure. Very detailed manuals were created of cured patients symptoms, and what remedies relieved them. An absolutely exquisite pharmacology was developed, and very intricate indications for the various medicines used were developed.

 

However, each school had its weaknesses. The rationalist school of therapy was dependant on its theories about the nature of disease in order for therapy to be decided on. If the theory was incorrect ( for instance, as in the theory that syphilis was due to insufficient stimulation of the body) the resulting therapy ( often mercury) would often not help, and at times when medicines were largely toxic, and used in large doses, would often irrevocably harm or kill the patient.

 

The empirical system, with its emphasis on the actual experience ( ie, remedies that actually had cured things in the past) avoided this problem. However, the process of acquiring this information was painfully slow, due to the need for trial and error in trying out medicines for patients with unusual conditions, or for new diseases. Many times physicians would simply try one remedy after another, with no guide toward what might be useful or not.

 

This however changed with the experience of Samuel Hahnemann. Hanhnemann was an MD who had removed himself from practice in the late 1780’s due to his disgust at the inability of the allopathic practitioners to aid, or even not harm, their patients.

 

He made his living at this time as a translator of medical texts. One day he translated a text on the then commonly used cinchona bark. During the translation, he noticed that the symptoms of overdosing of the bark were identical to the symptoms of malaria, which cinchona bark was indicated to treat.

 

Over a time of pondering this, Hahnemann wondered if these two facts were connected. He began taking doses of cinchona himself, and did indeed experience the symptoms of malaria. Over time, Hahnemann developed the idea that the reason why cinchona was so active against malaria ( which the medical science of his day was unable to explain) was in fact due to this similarity.

Hahnemann suspected that the inherent curative ability of the body (which was a long standing idea within the empirical school of medicine) was aroused by the action of the cinchona bark, and then acted against both the malaria and cinchona bark jointly. The two diseases could be dealt with at once because of their similarity.

 

This idea of similar diseases became stated as “like cures like” that is, a medicine producing a symptom complex that is similar to the symptom complex the body has will provoke the body into reacting, and purging itself of both diseases, the one induced by the medicine, and the one inherent to the body.

 

This doesn’t mean, as is often stated, that medicines producing similar symptoms will cure those symptoms. The symptoms complex, or disease as a whole, is the key term here. Hahnemann found that a medicine caused the whole organism to react. Symptoms of any particular part were simply a manifestation of the state of the whole body ( as has recently been confirmed by teh groundbreaking work of Divya Chhabrha, soon to be discussed). As such, the entire picture of the patient, the whole complex of their symptoms, were significant to determining the curative medicine.

 

Hahnemann began to experiment with more medicines, eventually adopting the term proving for these trials. He indeed began to discover in his restarted clinical practice that these medicines are indeed effective in patients with similar symptom complexes and demonstrated in homeopathic practice, and some of the trials of homeopathy recently published. He named this method Homeopathy, or “similar suffering”, in recognition of the centrality of the law of similars to this practice of medicine.

 

With this idea and method, suddenly empirical physicians could proactively test medicines, and had reliable methods for doing so, and a consistent theory for applying them. This discovery alone would have been enough to ensure Hahnemann’s place in medical history. However, another discovery of his also ensured his fame, as well and the infamy of his system. That discovery was a technology, the infinitesimal dose. This will be the subject of my next blog.

 

Most of the ideas written in this blog are the general knowledge of homeopathic medicine and history. The more specific data come from the excellent analysis of medical history, Divided Legacy, by Harris Coulter, listed below.

 

Take Care of Yourselves!

 

References

 

Coulter, H. Divided Legacy, A history of the schism in medical thought. Volume 3. The Conflict Between Homeopathy and the American Medical Association. 2ed. North Atlantic. 1999.

 .

Hi everybody. Just a quick explanation here about my website being down for a day, and slightly different.

 

It was hacked yesterday, I however backed everything up quite well, and my website is now resurected.
I look forward to continuing our journey together.

 

Take care of yourselves.

 

Dr Paul.

One of the most frequent criticisms of homeopathy is that it lacks a research basis. While perhaps true several decades ago, this criticism is no longer accurate. Homeopathic research has advanced considerably in the past several years. Methodological issues in homeopathic research however continue to distort this debate.

 

Despite these issues however, positive research continues to accumulate in favor of homeopathy.

 

In this blog post I will be going over some issues in homeopathic research, and some of the new homeopathic research taking these issues into account.

 

Methodology:

 

Due to differences in availability of research funding, very little homeopathic research is actually done by homeopaths. It is, quite frequently, conducted by researchers with very little understanding of how homeopathy works, or is practiced.

 

Quite frequently such studies would involve a procedure based on the prevailing pharmacological research model. This usually involves administering a given homeopathic remedy for a given disease. These trials, for the most part, are negative, with a few exceptions (for example arnica for post operative pain). Some examples follow below:

 

http://www.ncbi.nlm.nih.gov/pubmed/20233176

http://www.ncbi.nlm.nih.gov/pubmed/18251757

http://www.ncbi.nlm.nih.gov/pubmed/17362845

http://www.ncbi.nlm.nih.gov/pubmed/17105693

http://www.ncbi.nlm.nih.gov/pubmed/17227743

 

 

 

This research model in now way reflects homeopathic practice. In normal homeopathic practice the clinician will compile an individualized picture of the symptoms of the patient. This individualized picture is arrived at in a very different way from allopathic diagnoses( for a more complete view on this I refer the reader to Divided legacy vol 1-4 By Harris Coulter). More recent research has taken this selection process into account, and this has led to an increase in the positive findings of the trials. Much of modern research ahs also included homeopathics with multiple ingredients, which tend to be more successful, as they have more efficacy for a wider variety of patiens. Examples follow below:

 

http://www.ncbi.nlm.nih.gov/pubmed/20129178

http://www.ncbi.nlm.nih.gov/pubmed/20807867

http://www.ncbi.nlm.nih.gov/pubmed/19647206

http://www.ncbi.nlm.nih.gov/pubmed/19305007

http://www.ncbi.nlm.nih.gov/pubmed/19135954

http://www.ncbi.nlm.nih.gov/pubmed/17310359

http://www.ncbi.nlm.nih.gov/pubmed/17335565

http://www.ncbi.nlm.nih.gov/pubmed/16781624

http://www.ncbi.nlm.nih.gov/pubmed/16338192

http://www.ncbi.nlm.nih.gov/pubmed/16266440

http://www.ncbi.nlm.nih.gov/pubmed/16060203

http://www.ncbi.nlm.nih.gov/pubmed/19091085

 

 

In Vitro research:

 

In vitro research is conducted in a test tube or petri dish, and involves altering the environment of a research organism ( usually bacteria, plants usually) and observing how they react.

 

Very interestingly, in vitro research tends to show an very good efficacy rate for homeopathic medicines, showing alteration of multiple physiological variables in multiple organisms. Some examples follow below:

http://www.ncbi.nlm.nih.gov/pubmed/22489193

http://www.ncbi.nlm.nih.gov/pubmed/22226318

http://www.ncbi.nlm.nih.gov/pubmed/21978221

http://www.ncbi.nlm.nih.gov/pubmed/21962197

http://www.ncbi.nlm.nih.gov/pubmed/21962196

http://www.ncbi.nlm.nih.gov/pubmed/20043074

http://www.ncbi.nlm.nih.gov/pubmed/18066110

 

 

 

And very interestingly, as in human clinical trials, there appears to be an increase in sensitivity to homeopathic interventions when the cells under question are sensitised in some way, or made more responsive to thier environment through disruption of their normal homeostatic ( or balance inducing) mechanisms.

 

For instance, in Benevinistes landmark early study, he discovered that basophils ( a white blood cell type) would react when exposed to what could be described as a homeopathic solution of their triggering chemical. (http://www.ncbi.nlm.nih.gov/pubmed/2455231). This study was replicated, but the replication level remained at about 30%, that is about 30% of attempted replication attempts succeeded ( personal conversation with Dr. Peter Fisher 2009). However when the model was changes slightly, and highly sensitised basophils were used, the reproducibility improved considerably ( http://www.ncbi.nlm.nih.gov/pubmed/19945674)

 

And lastly the shang et al Meta-analysis:

 

The last issue to address in homeopathic research is the shang et al meta-analysis (http://www.ncbi.nlm.nih.gov/pubmed/16125589) . Shang did quite a large meta-analysis comparing trials of homeopathy and allopathic medicine. He obtained 110 trials each of allopathy and homeopathy and obtained a conclusion that that the effects of homeopathy are not statistically greater than those of placebo. However this conclusion is called into question by the methods by which the lancet obtained this statistical conclusion.

 

Firstly, in reaching this final conclusion, the lancet did not compare all 110 trials of allopathic medicine and homeopathy. Shang actually compared 8 studies from each branch of medicine. Moreover, in this comparison he did not identify which studies he used. Shang has, to this day, in personal interviews and public correspondence, refused to identify the trials he used. This precludes any analysis of the methodology of the trials used, as disscussed above. Moreover, it is quite dishonest of Shang to not disclose the full sources of his statistical analysis. It essentially stops any reasonable or rational criticism of the analysis because there is no basis for academic criticism without knowing the exact data Shang bases his meta-analysis on.

 

The purposes of the study become quite clear when one examines the editorial accompanying that metanalysis (http://www.ncbi.nlm.nih.gov/pubmed/16125567). This editorial was entitled “The End of Homeopathy” and proclamation that based on this analysis, homeopathy it was no longer viable or defensible to use homeopathy, or ascribe any effects beyond placebo to homeopathy.

 

I strongly suspect that the editorial and this omission in the meta-analysis were not coincidental and I highly doubt that the editorial was meant to be disputed. I suspect is was intended by the author and lancet editorial committee as the final blow against homeopathy as a medical system in the academic role.

 

However, with great effort, other researchers have managed to reconstruct, or to get the same results that Shang obtained with his analysis (http://www.ncbi.nlm.nih.gov/pubmed/18834714 and http://www.ncbi.nlm.nih.gov/pubmed/19371564). These papers showed that the results of the Shang meta-analysis greatly depended upon which set or clinical trials that were used to obtain the data used in the meta-analysis. Specifically, the inclusion of one study (http://www.ncbi.nlm.nih.gov/pubmed/9758072) caused the meta-analysis to reach a negative conclusion. This study is precisely the type of study I described in the methodology section above, in which a remedy is given in the same manner as an allopathic drug, with no attention payed to the actual methods homeopaths use with their patients. The truly ironic part of this is that one of the researchers in the arnica study which tilted the meta-analysis was Dr. Peter Fisher, the most voracious critic of the Shang meta-analysis. Fishers account of the meta-analysis and the coordinated nature of the intended blow to homeopathy are shown on this website (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375230/)

 

When the fisher study is removed, the Shang meta-analysis is positive.

 

Conclusions:

The broad scope of research, taking into account issues of methodology does overall show that homeopathy has a greater effect than placebo. Very little of this research focuses on how homeopathic remedies work, or their mechanism of action. This mechanism of action remains mysterious.

 

However the actual relevance of all this research to the daily life of someone practicing homeopathy, or someone who chooses it as their system of healthcare is minimal. Almost all homeopathic research is focused on the question of whether or not homeopathy actually works, and not on anything that would helpful in the clinic.

 

However that does not mean that there is no tradition of knowledge gathering in homeopathy. There is, and it is a very large and dynamic one. This tradition is called the proving. It will be the subject of my next blog.

Take care of yourselves!

 

Dr. Paul..

Hi everybody. This month i would like to discuss the basics of the most hated and controversial of the naturopathic modalities, homeopathy.

 

Homeopathy was invented in the 19^th century by a man named Samuel Hahnemann. He was a medical doctor who grew dissatisfied with the medical practice of his day, which was imprecise and involved many harmful practices such as large doses of toxic materials and nihilism regarding the curability of chronic disease.

 

Hahnemann withdrew from medical practice for these reasons. He began translating medical texts for a living. In one text he translated, he noted that the overdose symptoms of a drug used to treat malaria, were in fact almost identical to the symptoms of malaria itself. Hahnemann obtained a sample of this drug ( extract of cinchona officinalis, or the remedy cinchona) and confirmed this observation.

 

He began formulating this idea further, and utilizing it in practice. Over time he refined his ideas, and by the time of his death, the system he created became known as homeopathy. The most important features of this system are:

 

1. An idea: Like cures like. The idea that substances causing similar symptoms to a disease can assist the body in healing that disease. This will be covered in a later post.
2. A second idea: Miasms: Miasms are an early idea of the origin of disease. This set of ideas would later evolve into microbiology. However the miasmic thoery of Hahnemann would later evolve into a fascinating idea of the progression of disease after his death. This too will be covered in another post
3. A technology: Succussion and dilution. This actually was almost an accidental discovery> Hahnemann discovered that by diluting the toxic remedies in common use i medicine of his day, the toxic reactions of his patients could be lessened. He continued this process, finding that the more dilute the remedy, paradoxically the more powerful its therapetuic effect. This too will be covered in a following blog post
4. A methodology: the proving: The logical outgrowth of the idea of like cures like is the idea that substances may be examined, and their medical potential discovered, by giving them to healthy people and observing the resulting effects. Again, this will be disscussed in another blog post.

 

This description only covers the basics of this system. As I say many times, I intend many blog posts to cover various aspects of this system.

 

I would like to thank Harris Coulter and Gerard Geuniot for their education in homeopathy, without which the insights into Hahnemann’s system would be impossible.

 

References:

 

Coulter, H. Divided Legacy. Vol 1-4. North Atlantic Books

Geuniot, G. Seminar disscussion: East meets West: Integrating the Foundations of traditional Chinese Medicine with modern Occidental Natural Medicine. Toronto Nov 7-9 2008.

 .

Hi Everybody!

Thank you so much for following me, and visiting my new website. I look forward to sharing many of the insights I’ve gained in my Naturopathic medical practice here with you all! I am writing this blog both for Naturopathic Doctors, and any other medical practitioners who are interested, and for member of the public. If you have any comments (and please do comment, it helps me write more effectively), please email them to me at drpaultheriault.nd@gmail.com

 

I think the first thing I would like to share is a small discussion of the difference between naturopathic and conventional (or allopathic) medicine. I wont discuss this in terms of which medicine is more effective for what condition (that would take a book, or perhaps a PhD).

 

However the differences in how each of these medical systems approaches disease are quite simple and easy to understand.

 

Allopathic (or conventional) medical doctors diagnose and treat disease. If you go into an MDs office with a problem, your MD will either preform an examination or order some tests, such as X-rays, lab studies or others, in order to determine which disease is present in your body. Once the disease is determined, your MD will prescribe a treatment in order to either cure or control the disease.

 

This approach is so common, that it is often difficult to see exactly what it involves. Like many of the things in our everyday lives, the smaller details of this approach only become apparent when we sit and think about it.

 

The allopathic approach rests on two assumptions.

1. Disease exists, as a thing in and of itself
2. The way to help people, and improve their lives is to treat disease.

 

When you sit down and think about this viewpoint, a number of consequences become apparent. For instance, if a person doesn’t yet have a disease, there is very little that can be done, outside of very general measures, to help the person improve their lives.

 

Secondly, this approach doesn’t directly involve prevention. Many of the preventative measures in allopathic medicine are either the general lifestyle advice mentioned above, or making the assumption that people will develop a disease eventually, and treating them preemptively.

 

Lastly, the approach of controlling disease tend to push practitioners into a rather controlling view of human physiology. Rather than allowing physiology to balance itself out, or achieve homeostasis, there is a temptation to constantly regulate. With advances in pharmacology that allow us to affect nearly every major body system, it is not uncommon for this logic to lead to patients being given many medications to “correct” every physiological function that is outside of the normal range.

Now that we know what allopathic medicine sees disease as, we can clearly examine what naturopathic medical approach to disease and healing is.

Naturopathic medicine does not see disease as a thing, in and of itself. Naturopathic medicine sees disease as physiology that has become twisted in upon itself in a self destructive pattern. The question that has occupied naturopathic medicine since its creation, is “what is causing this disruption”. By removing what is causing this disruption it is thought (and generally seen in practice) to heal the disease in question.

 

This view of disease also has several implications.

 

Firstly, you don’t need to have an advanced disease to deal with what is disrupting your physiology. Over time, naturopathic doctors have developed increasingly precise methods for measuring physiological disruption. Learning that a physiology is disrupted, and what is disrupting it, means that Naturopathic Doctors can treat diseases in very early stages.

Secondly, this viewpoint is less controlling of the physiology than allopathic medicine. Naturopathic treatment may be demanding, but it is unlikely to ever result in the body being micromanaged by a physician.

 

Allopathic medicine and naturopathic medicine both have strengths and weaknesses. Understanding this, and which medicine is better suited to what conditions, is key to making the best choice for your own health. More Posts on this topic will follow..