To critically challenge the epistemology of an element of Homeopathic Practice; specifically the idea that Homeopathy can be successful in preventing disease amongst a population for epidemic or pandemic disease outbreaks.
/http://issuu.com/healthactionnetworksociety/docs/2015-spring-health_action-magazine- AUDIENCE: Myself, my professors, other students, other homeopaths, other interested parties.
PURPOSE: To critically challenge the epistemology of an element of Homeopathic Practice; specifically the idea that Homeopathy can be successful in preventing disease amongst a population for epidemic or pandemic disease outbreaks.
ABSTRACT:
I have written this essay to deconstruct an aspect of my clinical practice. There is controversy around the use of homeoprophylaxis in preventing disease during epidemics and pandemics. I wanted to see if there was research that could demonstrate the ability to use homeopathy in epidemics/pandemics. If so, what type of research and can it be recognized as valid. If it is not, why not? I explored and gathered information, interviews with practitioners, charts, essays, population studies and Random Controlled Trials. These helped to see the various levels of ability for homeopathic remedies to be used to prevent infectious diseases in a laboratory and in actual contemporary populations. However, these studies are in contrast within the prevailing paradigm to do with how homeopathic remedies work. Since there is an underlying disbelief in the idea that highly diluted substances could work, there is a difficulty in accepting the studies that demonstrate success for homeopathic remedies.
Introduction:
Can homeopathy help for prevention of disease in epidemics or pandemics? I have been using Dr. Isaac Golden’s (2007) homeoprophylaxis (HP) program for children in my homeopathic clinical practice for 7 years. However, when clients and others ask for the scientific evidence, my reference to historical accounts of the use of homeopathy during actual epidemics doesn’t always seem to satisfy them. As I am questioning what is science and what is knowledge, I am also unsure. The purpose of this essay is to identify and come to an understanding of the idea behind using homeopathy for the prevention of illness in epidemic or pandemic diseases and addressing whether there is valid demonstration of the successful use of homeopathy for epidemics/pandemic diseases. Ranging from historical references, Random Control Trials (RCTs) and population studies, and provings; are these sufficient to demonstrate the premise that homeopathic treatment can be used to have an impact on infectious diseases? Are there factors limiting the research or use of the information generated?
Important aspects of this essay defined:
According to Webster’s online dictionary (2013), Epidemics and pandemics refer to an outbreak of an infections disease where many people are affected in a wide geographic area. A pandemic is the same except it is affecting a larger geographic area that can occur beyond borders of one region or even country. The founder of homeopathy, Samuel Hahnemann explains in the Organon (1996), that homeopathy is most simply defined as a medical art relying on two main principles being the law of minimum dose and the law of similars. Homeoprophylaxis is the use of homeopathic remedies to prevent ahead of time a specific disease. A homeopathic remedy proving is a collection of observed and recorded signs and symptoms conducted according to the instructions outlined in Hahnemann’s (1996) Organon. The material medica is the resource where these provings and other useful sources are compiled for organized reference of each remedy’s therapeutic uses.
How did the use of homeopathy for epidemics start?
Dr. Samuel Hahnemann and homeopaths inspired by him and his writings in the Organon have seemed to make good use of homeopathic treatment to help people who have succumbed to infectious diseases or to help prevent them from succumbing to them. It was Hahnemann’s discriminating observation in 1789 that began the exploration of prevention of disease with homeopathic remedies. In his Lesser Writings (1852), he first described his experience preventing Scarlet Fever by giving them all doses of Belladonna in addition to the members of the family who had contracted it. Using the principles of homeopathic medicine combined with knowledge of homeopathic remedies from provings or other material medica resources has granted the use remedies homeoprophylactically.
Physician’s records:
Historical references of hospital reports are one way a direct comparison can be made between homeopathy and non-homeopathic treatment. In the chart below compiled by Navab (2012), numbers of patient deaths in hospitals are compared to allopathic numbers of deaths. In these reports the rate of success for homeopaths in specific hospitals is shown as a mortality rate of less than 10% for the treatment of scarlet fever, cholera, typhus fever, pneumonia, yellow fever and Spanish influenza. The mortality rates for the conventional doctors of the time (termed allopaths) are over 10% for each of these diseases. The treatments the allopaths had for the 1918 flu were limited to aspirin or acetylsalicylic acid according to Billings (1997) compared to what is available now. It is also very plausible that the results in charts are simply lower for allopaths because the allopathic medicines used between 1798 and 1918 were not as sophisticated as the ones in the present.
Year Location Disease Treatment by Homeopathy Treatment by Allopathy Treatment with No Medicine 1799 Königslütter, Germany Scarlet Fever Mortality <5% 1830 ~ ‘31* Russia Cholera Mortality 11 %Reported by Imperial Council & Foreign Ministry of Russia. Mortality 63 %Reported by Imperial Council & Foreign Ministry of Russia. Not recorded. 1830 ~ 1832 Vienna, Prague, Hungary and Moravia Cholera Mortality 7 %Reported by Dr. Kath, appointed by King of Bavaria. Mortality 31 %Reported by Dr. Kath, appointed by King of Bavaria. Not recorded. 1836** Vienna Cholera Mortality 33 %Lead Homeopath in charge was Dr. Fleischmann Mortality 66 % 1847 Ireland Typhus fever Mortality 2 %Lead Homeopath in charge was Dr. Joseph Kidd Mortality 13 %Lead Allopath in charge was Dr. Abraham Tuckey Not recorded. 1847 England Typhus fever Mortality 2 % Mortality 13 % Mortality 10 % 1848 Edinburgh, Scotland Cholera Mortality 24 %Reported by Edinburgh Dispensary. Mortality 68 %Reported by Edinburgh Dispensary. Not recorded. mid 1800’s Austria Pneumonia Mortality 5 %Lead Homeopath in charge was Dr. Fleischmann Mortality 20 %Lead Allopath in charge was Dr. Dietl Not recorded. 1853 ~ 1855 South of America Yellow fever Mortality 5.4 %Lead Homeopaths in charge were Dr. F. Davis and Dr. W. Holconibe Not Available. Not recorded. 1854 London, England Cholera Mortality 16.4 %Reported by Royal College of Physicians. Mortality 59.2 %Reported by Royal College of Physicians. Not recorded. 1878 New Orleans, USA Yellow fever Mortality 5.6 %Special Commission reported the statistics. Mortality 17 %Special Commission reported the statistics. Not recorded. 1918*** Pittsburgh, USA Spanish Influenza Mortality 1.05 %Reported by Dean, Pittsburgh Hospital Mortality 30 %Reported by Dean, Pittsburgh Hospital Not recorded.
In the 1800’s and early 1900’s when homeopaths were working as physicians within the medical system of society of the day, they had access to a statistically significant number of patients. Because these reports were created centuries ago, the information is open to interpretation. Reading the information in the chart above, different people will have different perspectives on the information presented depending on a person’s prior knowledge, beliefs and filters that can affect the conclusions (Fuller, 2003). A person educated in homeopathy (presumable already believing that homeopathy works) might ask ‘what remedies did they use?’ while a person not knowing homeopathy might simply ask the question ‘how’.
The homeopathic physicians had the same or similar access to clinical surroundings and tools available to the allopathic physicians. During the 1918 Influenza in California, Elsa Engle was a nurse practitioner using homeopathic remedies under instruction from Dr. Engle. As Malthouse (2010) wrote from an interview that was conducted by Frances Kalfus in 1992, the then 97 year old Elsa Engle explains their success at Hahnemann Hospital; “They all had about the same symptoms. You didn't have to do anything else but give them a bottle of Gelsemium, followed with a bottle of Eupatorium perfoliatum... In five days practically all of them were well”. Gelsemium and Eupatorium perfoliatum are homeopathic remedies that are still commonly used for influenza. The CBC report (Puri, 2009) explained to viewers during the many homeopathic clients were turning to the remedy Gelsemium that was “used extensively during the Spanish flu epidemic of 1918” for the H1N1 flu. However, with information or data and its style of presentation, each person will come to a different conclusion depending on prior experiences and beliefs. In order for something like homeopathy, because it might be in contrast with a strong belief, even the highest quality of research won’t suffice to change that belief despite what a study shows. Rutten (2008) describes the problem that “Prior beliefs are updated in the Bayesian process, but the first prior belief has a special position. This first prior belief is very strong, we need to consider how strong and why. It is in fact paradigmatic and might not be susceptible to Bayes’ theorum”. Perhaps only a strong personal experience (seeing is believing) might be the only thing that can change a strong prior belief.
RCTs Japanese Encephalitis (JE):
Looking at two Random Control Trials (RCTs) in a clinical laboratory where studies were done with the infectious disease Japanese Encephalitis (JE) and doses of the homeopathic remedy, Belladonna. The authors Bandyopadhyay et al. (2010 and 2011) found statistically significant success showing that Belladonna is effective in preventing disease indicators. This is a chart from Bandyopadhyay et al. (2010) showing decreased viral infection found in the Choriallontoic Membrane (CAM) of unhatched chicks dosed with Belladonna in the four different potencies of 3, 6, 30 and 200;
For the RCT done on suckling mice by Bandyopadhyay et al. (2011), average survival rates of the infected suckling mice treated with Belladonna 200C daily for 14 days had almost double the survival rate than those not treated with Belladonna 200C. 47% survival rate for untreated mice versus 79.24% and 80.60% for the Belladonna treated mice for 7 and 14 days. In the discussion of this successful study, the authors Bandyopadhyay et al. (2011) state that homeopathic practitioners have historically been using the homeopathic remedy Belladonna for the prevention of JE without any RCT experimental proof of how it works and therefore there is further need to test how it is that the homeopathic remedy Belladonna has showed an ability to prevent JE. This study has successfully shown a specific outcome. However, the question of the properties of Belladonna that made it work is what the authors chose to recommend as required further study.
Population Studies: Swine Flu in India:
In India 2009 a Swine Flu patient study involving 23 Homeopaths and 1146 patients was conducted by Mathie et al. (2013) which took a set of previous agreed upon (by the Centre for Clinical Research of Homeopathy (CCRH)) group of symptoms defining Swine Flu by Homeopaths working in government approved health centres in India. The Homeopaths agreed to record their results in a formatted excel chart between October, 2009 and February, 2010. The most frequently prescribed remedy that helped the patients as the primary care for the Swine Flu was Arsenicum album; the very same remedy that the CCRH had identified as the as a prophylactic Genus Epidemicus for this pandemic. Results like this can tempt the enthusiast to proclaim at this as proof that homeopathy can be used in epidemics.
However, the overarching challenge in demonstrating the proof that homeopathy can be successful for epidemics and pandemics through research and information is that it contrasts the current prevailing paradigm. To express this idea Rutten (2008) quotes Vandenbroucke (2001) “Accepting that infinite dilutions work would subvert more than conventional medicine; it wrecks a whole edifice of chemistry and physics”. With this in mind, the work shown in this study could present to different conclusions to people with different prior beliefs. If accepting the validity of homeopathic remedies is not a possibility within the belief system than accepting this study as successfully demonstrating that homeopathy can help in epidemics is also not a possibility.
Leptospirosis in Cuba:
A study by Bracho et al. (2009) was conducted with 2.3 million people in Cuba. The population above 1 year of age was given two oral doses of the Leptospirosis Nosode in the 200C and 10M potencies with an interval of 7-9 days between doses. Then ten to twelve months later, they were given another two oral doses of the 10M potency 7-9 days apart. These homeopathic remedies were administered by approximately 5000 Cuban public health system personnel using five drops (250-300 µL) under the tongue (sublingually) 20 minutes away from eating or drinking or smoking. One year of comparison between the area that received doses (the Intervention Region, IR) and the Rest of the Country (RC) showed a significant decrease of cases of Leptospirosis in the IR. This study looked at the numbers generated by the same institutions that are responsible for managing epidemic disease diagnosis and prognosis in Cuba (the national weekly report based on provincial data generated by the Trend Analysis Unit from the Minister of Epidemiology of the Ministry of Public Health of Cuba). According to Bracho (2009) their prediction of number of cases of Leptrospirosis was 111-461 in the Intervention Region in the most precarious 3 week period (weeks 47-52 of 2007 because of number of days between the start of the increased rainfalls and infection rates) when only actually 38 confirmed cases showed up. This was a reduction of 91.8% to 65.8% in the IR. Despite that there were increased risks of Leptospirosis infection that year due to extreme rainfall in October-November in the IR, the annual number of cases decreased by 84% while in the RC there was an increase of 21.7%. The authors conclude that these findings lend to a high degree of confidence that using homeopathic remedies to prevent disease in populations is a useful tool for epidemics and pandemics.
This study shows successful implementation of homeopathy for a population during an actual epidemic and demonstrates that homeopathy is successful in preventing illness during epidemics or pandemics. Whether this study will model a way that homeopathy can show success in preventing disease amongst a population for epidemic or pandemic disease outbreaks is still in question (Roniger, 2010). The positive aspect of this study is that there were millions of Cubans who willingly experienced homeopathy by taking those remedies in compliance with their predominant health professionals. As Rutton (2008) points out, changing towards a belief in homeopathic medicine might require a turning point such as a personal experience. What that has been shown to do is “We may accept evidence that we did not accept before. We may abandon the first prior, rearrange and re-interpret the evidence and then the process of sequential updating can start”. That way a previous belief that contradicts the idea that homeopathic remedies will not continue to stand in the way of some possible data or information being presented in research of various types.
Conclusions:
In this essay I’ve brought to attention various types of demonstrations of the use of homeopathy for epidemics and pandemics, including some that are the accepted standard for medical science. Using these examples it seems to be possible to demonstrate the specific success with RCT studies, population studies plus historical records on the use of homeopathy during epidemics/pandemics. As Bracho says (2010) it is also possible to conduct further studies with a significant level of confidence that homeopathy will prove itself as a valid way to address the health of populations during epidemics/pandemics. However, the criteria required in order to conduct this type of research isn’t always easily available to homeopaths in various parts of the world. So far it seems that there is a facility in Cuba that has opportunity to do this plus certain homeopaths in certain clinics of India are also already established for these types of studies.
There are challenges to the understanding and acceptance of use of homeopathic remedies for epidemics and pandemics. Part of it lies within the current paradigm that predominates. The disbelief that highly diluted substances such as homeopathic remedies could have a therapeutic action is the paradigm that limits the acceptance of studies on homeopathy despite their success in showing specific outcomes. With a prior acceptance of biochemical medicine combined with an expectation that homeopathy would act in the same manner, there is not a certain type of research that would qualify to change that disbelief that homeopathic remedies work because the prior belief is too many steps away from the new belief. It is recommended from this overview that any further studies to address the ability to use homeopathy for epidemics and pandemics should acknowledge that whether the reader concludes the study acceptable or not has to do with the challenge of the paradigm surrounding how homeopathic remedies work.
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