Homoeopathy: An Integrated System
Dr. Ajit Kulkarni
M.D.(Hom.)

"The Homoeopathic system provides a framework of theory, values and related technology which enables patients and doctors to make sense of their lives, and give meaning to their work."
- Frank Bodman

Preamble:
Homoeopathy, highly salubrious therapeutic method discovered in the early nineteenth century by a German Physician, Dr. Samuel Hahnemann, M.D. (1755-1843) has been practiced by groups of physicians in most countries of the world for the past two centuries.

Misconceptions prevail not only in the society but also amongst the physicians as to the exact understanding of Homoeopathy. Either exaggerated claims are made or in those cases where Homoeopathy really can win laurels are unnecessarily referred to other medical therapies. The precise field of application of homoeopathy and the scope and limitations of that application must be sufficiently cognized. This will help clear up bewildering ideas that are besieging on this really curative medical therapy.

Homoeopathy differs in many ways from other system of medicine in possessing its own methodology - a precise set of principles that govern homoeopathic practice.

The principles on which Homoeopathy is based are natural and fundamental. To know these principles is the first and foremost step towards understanding Homoeopathy.

We shall deal with different aspects of Homoeopathy: Its basic concepts, philosophical substratum, its place in current medical sciences in a succinct way. The precise elucidation of all aspects is beyond the scope of this article.

I. THE LAW OF SIMILARS : SIMILIA SIMILIBUS CURENTURE

The bedrock on which the edifice of Homoeopathy has been built is expressed in the Latin sentence 'Similia Similibus Curenture,' which means 'let likes be cured by likes.' In other words, illnesses are to be cured by medicines that are capable of producing symptoms similar to those of illnesses. By enunciating this epoch-making law, Hahnemann by his fine observation and the inductive method of reasoning, brought into prominence the most neglected aspect of the natural relation that exists between the phenomena of disease and the the drugs.

The perusal of the ancient medical literature shows that ancient Ayurvedic physicians, as also Hippocrates, Paracelsus, Hallu and others were aware of the operation of the Law of Similars. But the credit of evolving and constructing a scientific system of therapeutics and harnessing it for curative purpose goes to the genius, Dr. Hahnemann.
II. PROVINGS ON HEALTHY HUMAN BEINGS: HUMAN PHARMOCOLOGY

Hahnemann's intuitive and searching mind did not stagnate at merely 'perceiving' the nature's law of cure. In order to demonstrate the validity of this doctrine, Hahnemann pursued his investigations and determined to prove the drugs on healthy human beings. He preferred the human experimentation to the animal, as the human being (though animal) is a perfect design in the process of evolution whose mind has been evolved to express the fine effects of the drugs and whose physical body has been explored through faculties of physiology, anatomy etc. On the other hand, animals are unfit to express precisely the effects of drugs and therefore, there will always be limitations in knowing the effects of drugs. Using drugs tested only on animals is a serious issue in terms of treatment of human beings.

The concept and technique of human experimentation is the greatest contribution of Hahnemann to medicine. Dr. James Krauss, M.D., has very rightly put his observation, 'The era of scientific medical experimentation begins with Hahnemann and nobody else.'

To clarify, the powers of medicines are discovered in the homoeopathic system by administering these medicines to healthy human beings for a considerable period of time. This is called 'proving' the medicine. The substances that are used for proving are from all kingdoms-vegetable, animal and mineral. These substances produce groups of symptoms (both subjective and objective) that define precisely how the healthy organism reacts to the specific stimulus by each such substance. And these proving symptoms thereby indicate precisely how the given substance is to be used for treatment. Since the symptoms of the sick person represent his curative reaction to the morbific stimulus, the most effective way to cure him will necessarily be through prescribing the substance which intensifies these curative symptoms.

'Drug Provings' have been carried out very systematically and scientifically. Hahnemann set forth certain rules for proving. He himself said, "proving should exclude every supposition, every mere assertion and fiction." And indeed, homoeopathic physicians all over the world are daily confirming the validity of proving symptoms since a century and a half. Further, when it was suspected that homoeopathic proving method is not scientific, some substances were reproved under control conditions, with the provers not knowing which substance they were proving. The results have only corroborated the original provings.

The record has been complied of provings that are collected mainly in the classic works of Dr. Constantine Hering (Guiding Symptoms: 10 Volumes) and Dr. T. F. Allen (Encyclopaedia : 11 Volumes). The Materia Medica books have been prepared by different authors from the compilation of Dr. Hering and Dr. Allen. These books are used as a fundamental source material in homoeopathic system and therefore, indispensable tools in Homoeopathic clinical practice.

Homoeopathic Materia Medica is subject to continuous development. By elaborate research, new substances are proved that get incorporated in the Materia Medica. There are at present more than 3000 drugs in homoeopathic armamentarium. There are many ways of study of materia medica and this wonderful tool has sharpened enough to meet the disease dragons.

When a homoeopath is confronted with a sick individual after eliciting the thorough 'totality' of sickness (which takes into its purview not only the present symptoms and the personality of the patient, but also the past and family history), he investigates the literature of the provings to ascertain precisely which substance produces a set of symptoms similar with that of the patient. This is the indicated remedy because it will stimulate the incipient curative process.

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III) SINGLE REMEDY:

The Homoeopathic provings that were and are carried out are of single substance - never of medical mixtures. Obviously Hahnemann advocated the use of a single remedy at a time as exclusive action is fully explored through provings. Hahnemann thought that the use of medical mixtures leads to over-drugging of the patient and if several drugs are administered simultaneously, it is impossible to predict the synergistic effect.

A wise homoeopathic, therefore, gives a single remedy at a time which is selected by taking into consideration the thorough case-taking of the patient.

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IV) DOCTRINE OF POTENTIZATION: THE INFINITESIMAL DOSE

After being convinced of the truth of the Law of Similars, Hahnemann started administering medicines in the traditional crude doses. To his dismay, he found undesirable aggravation of the symptoms due to toxic action. So he started progressively reducing the dose by diluting it (with alcohol or sugar of milk by succussion or trituration in a set rhythmic manner) in order to moderate the patient's reaction. By this process of dilution of the doses, he ultimately reached such a stage where no material quantity of the drug could be traced by any means.

At the same time to his amazement, he found that this process of diluting the medicinal substance instead of diminishing the curative effect of the drug rather steadily enhanced it and made it all the more deep and long lasting while minimizing the aggravation of the symptoms. Experimenting along the observation for a number of years, Hahnemann concluded that the curative property of the similar-most remedy does not depend upon its physical or chemical quality, but upon a quality which is far deeper than mundane qualities and called it as 'dynamic' quality with their dynamic properties, belonging to the dynamic plane rather than crude material plane of the remedy.

Hahnemann called this process of dilution as 'potentization' or 'dynamization' and remedies specially prepared as 'potentized' or 'dynamic' remedies.

This principle of potentization has opened a new vista in the understanding of the drug effects on an entirely different plane which was never conceived of before the advent of homoeopathy. In the 19th century, homoeopathy was scoffed at for this doctrine that medicines become more powerful with greater dilution. However, with 20th century discovery of hormones and other substances (which are also effective in microscopically small quantities) deriding the homoeopathic dilution has ceased (to some extent).

Various homoeopathic investigators have sponsored a variety of physical, chemical, botanical and biological experiments to demonstrate the existence of medicinal power in small and infinitesimal doses. Recent concepts in other sciences like Allergology, Immunology etc. have thrown considerable light on the power possessed by the infinitesimal doses.

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V) MINIMUM POSE: CO-OPERATION WITH NATURE AND NOT COERCTION

In contrast with large doses that are given in other systems of medicine, a homoeopathic physician insists on giving the minimum dose. He believes that remedies must be used in the smallest possible amount for the purpose of bringing the diseased state back towards normalcy. The principle behind giving the minimum dose in obvious: when the disease states arise, nature sometimes fails to mobilize its own power. It requires assistance. Such assistance is rendered by homoeopathic remedies. In other words, homoeopathic remedies are immune-stimulant and immune-modulars. Homoeopathy is therefore called as advanced form of Micro-immuno-therapy. Further, drug-sensitization, drug-toxicity, drug-resistance, allergies and anaphylactic shocks are remote possibilities in homoeopathic therapeutics as crude, material doses are not used.

Now we shall turn to some philosophical and practical aspects of homoeopathy. The practice of Homoeopathy is nothing but 'applied' homoeopathic philosophy. Unless we comprehend it, we will not be able to understand the dimensions of homoeopathic practice. Note that it is the only science of homoeopathy which emphasizes the value of philosophy of life in the treatment of sick individuals.

VI) CONCEPTS ABOUT HEALTH, DISEASE AND CURE : HOLISTIC APPROACH

Homoeopathy upholds some basic 'corollaries' about health, disease and cure which have emerged out of its sheer logic and experience. Hahnemann conceived of these concepts in their deeper implication and wider perspective.

HEALTH is a state of dynamic, stable equilibrium, a state of harmony of the human organism within itself, in all its constituents and between man and the cosmos of which he is an integral part. Hahnemann postulated that 'VITAL FORCE' governs, animates and keeps the human organism in healthy harmonious functioning at all the levels of the total human entity: viz. 'the physical, the emotional and the intellectual.

DIS-EASE (ill-at ease), to a homoeopath, is a state of dynamic, unstable equilibrium, imbalance, disharmony, involving at least three different factors: some morbific influence, the susceptibility of the patient affected and the individuality of the patient which modifies the disease form. It is primarily a disturbance of the rhythm of the vital force circulating in the human economy, resulting in the disorganization of sensations and functions and manifesting externally through symptoms and signs. Disease, thus, is essentially intrinsic and not extrinsic, its spread is centrifugal, from within outward, from centre towards periphery.

Homoeopathy believes that it is not the part, or organ or tissues only which are diseased. It is the man as a unit who is sick. 'There are no diseases, only sick patients.' Therefore, all illness is regarded by Homoeopathy as general (i.e. pertaining to the patient as a whole). It denies the exclusive possibility of a 'local' disease or even 'local' treatment. It regards disease as an expression of the 'whole' organism. It regards symptoms as representation of the totality of patient's response to a given morbific stimulus (insult), though the symptoms may be in the localized organs.

The difference between this view point and that of Allopathy can be recapitulated, "Allopathy attempts to treat 'The disease that the patient has' whereas homoeopathy attempts to treat 'The patient that has the disease."

Again, disease is regarded by homoeopathy as an expression of the 'adaptive' effort of the whole organism, as an expression of the 'fight to maintain homoeostasis.' In other words, the patient's symptoms are not the impact of some morbific stimulus on his organism but are the reaction of the organism to the morbific stimulus. Hence, symptoms, however painful and undesirable they may be, are regarded as usefully adaptive phenomena, as they emerge out of organism's protective and defensive mechanism, in its attempt to restore health. Totality concept of homoeopathy incorporates anatomy, physiology, pathology, biochemistry, psychology etc. A homoeopathic physician has to perform two types of diagnoses - disease diagnosis and person diagnosis; the two together is termed as comprehensive diagnosis. Hence, the use of investigations is not a bar for a decisive homoeopath.

The connotation and denotation of the term CURE is wide and comprehensive in homoeopathy. Simply the temporary suspension or removal of the most troublesome symptoms or the outstanding pathological formation (e.g. removal of a tumour by surgery) is not regarded as 'cure' in homoeopathy. The term relates to the patient as a whole. It means permanent restoration of susceptibility of the patient which gets altered in sickness; it means restoration of harmony, balance, equilibrium, within man and between man and his environment. It means reversal of symptoms to the 'no-symptom' state. It means peace within and without; it means blossoming the creativity of a man. Hahnemann wrote in his 'ORGANON OF MEDICINE' (Geeta of homoeopathy) that cure must be gentle, rapid and permanent and it should be based on definite and understandable principles.

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VII) HOMOEOPATHY : A SPECIALITY IN INDIVIDUALIZATION

Homoeopathy places the strongest emphasis on individuality and on individualizing in disease. It is obvious that no two individuals are alike in health or in disease. Despite identity of disease stimuli (exogenous or endogenous), sick individuals react in their own behavioral patterns. Two patients suffering from identical disease vary in their reaction patterns, in their individual characteristics based on their unique susceptible constitutions. This is the concept of individualization in homoeopathy where each patient is considered as a unit separate from every other, having a distinct individuality of its own and therefore, requiring the different remedy for the same disease. The natural corollary to individualization is that several remedies may be indicated in one disease and one remedy may be useful in several diseases.

This concept of individualization is the prerogative central tenet in homoeopathic prescribing. Hahnemann asserted, "No cure can follow unless one rigidly individualizes the case." For a homoeopath, individualization is an integral part of his thinking both as regards causation as well as treatment. This concept and its advantages can better be elucidated by exemplifying 'infectioous' diseases. Homoeopathy emphasizes that the fundamental issue concerns not only the specific agent of the disease (bacteria, fungi, virus, etc.) but also the 'reactive' properties of the organism (the host) because:

1. The so-called causal agent only initiates a process while the subsequent development is governed by 'other' conditions (like susceptibility, idiosyncrasy, hypersensitivity etc.) that are entirely contributed by the individual (the host).

2. The causal agent may not possess fixed, consistent and independent immutable properties as they are subject also to change their physical, biological or morphological nature due to 'certain' conditions (e.g. environmental variance(s); to exemplify, a diplococcus can be turned into a bacillus in 18 hours, dependent upon the media upon which it is grown). In contrast with this, the reactive properties of the individual (i.e. semeiology) appear more immutable (as they are obvious and perceptible to a homoeopathic physician). Hence to chase 'merely' these 'causal agents' without paying attention to the host seems to be treating on a limited exteriorized basis.

3. It may be possible that in this prodigious universe, the human being, that multi-dimensional, composite entity, who is subject to evolution in the time-space continuum under the impact of the environmental circumstance(s), may get afflicted with an entirely new or mysterious infection, the real nature and contour of which may not have been perceived. For a homoeopath, it can be stated emphatically that, there are no new diseases or mystery illnesses. He has the armamentarium to meet any infection as a remedies are given on the basis of totality of sickness and not only on the offending micro-organism. In other words, remedies act primarily on the soil, on the host as a whole.

It is due to this unique concept of individualization that homoeopathy has differed considerably from other systems of medicine. This concept minimizes the specialism, which divides the body into a number of more or less delimited sections each for separate treatment of its ills. It pleads for the specialism which treats the derangement of the particular organ or part as evidence of a diseased state of the WHOLE organism. It pleads for the specialism which individualizes the problems of the organism AS A UNIT and treats altered functions of the part in relation to the whole. Therefore, the words 'specifics,' 'patents,' 'panacea' have very little place in homoeopathic therapeutics.

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VIII) HOMOEOPATHY AND SURGERY:

Quite a deal of misunderstanding and confusion prevail regarding the respective roles of and relationship between homoeopathy and surgery. Homoeopathy has never opposed the genuine surgical intervention. But the word genuine has to be defined thoroughly. Homoeopathic literature amply demonstrates the efficacy of homoeopathic remedies in a host of surgical conditions. As written by Dr. Pulford, the well-known homoeopath, 'every surgeon must have an acquaintance with a homoeopathic physician.' This will help avert many unnecessary surgical operations. Cases like abscesses, adenoids, calculi, carbuncles, chronic otitis, cysts, enlarged tonsils, enlarged prostate, hemorrhoids, fissure, fistula, gangrene, papilloma, sinusitis, peptic ulcer, polypi, tumours (including malignant ones), strictures, varicose veins etc. respond favorably to timely administration of homoeopathy remedies.
Here also, homoeopathy upholds that surgery is needed only when medical therapy fails and that generally a call for surgery is an admission of the failure of medicine. Further, it is to be remembered that surgery deals with the results of the disease and not with the cause. The cause is constitution itself with all its form, function and structure and needs to be treated in with constitutional therapeutics. Hahnemann's contention that a disease evolves from functional to structural or organic changes has to be remembered too.

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IX) PSYCHO - SOMATIC AND PSYCHIATRIC ILLNESSES

The individualistic and holistic approach of homoeopathy towards a particular sick individual enables a homoeopath to pay pivotal attention to the mental state: the emotional and the intellectual. In quite a number of cases in homoeopathic clinical practice, the mental state and its correct appreciation becomes the sole determinant of homoeopathic prescription. A homoeopath considers every patient both from mental and somatic aspects as he believes in mind-body as a coordinate system. This is aptly presented by someone, "Homoeopathy is a hybrid medical rationality which incorporates aspects from a vitalist paradigm in its doctrine and therapeutics, and aspects from the biochemical paradigm, accepting modern anatomy and physiology as part of its system." As a matter of fact, there is far greater emphasis on mind than on physical symptoms. In addition to physical symptoms, a homoeopath takes into consideration patient's emotions, his inter-personal relationships, loves and hates, temperament, fears, peculiar mental traits, conflicts, body language, cravings and aversions of food and even dreams, in short, about everything.

Case like depression, neurosis, psychosis, mania, hysteria, schizophrenia, anxiety states etc. improve with homoeopathic therapy. Proper homoeopathic treatment influences the mental state of these patients so as to lead to a better adaptation to the environment with equanimity.

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SOME MISCONCEPTIONS

Hazy, confused, preconceived ideas prevail in the laymen, physicians of other systems of medicine and even in the homoeopathic physicians themselves. These wrong ideas are as follows:

" Homoeopathic remedies act slowly.
" Homoeopathy is effective only in chronic cases and not in acute cases.
" There is no treatment for emergencies in homoeopathy.
" Too much dietetic restrictions are imposed during homoeopathic treatment.
" There is no research going on in homoeopathic field.

Though all these misconceptions cannot be clarified in detail in this short article, suffice it to say here that these are all erroneous notions that are coming out of ignorance; the reality is different. I quote comments by Gay Gawer Luce, Ph.D., (Twice Winner of the National science Writer's Award), "Homoeopathy is a highly developed health practice that uses a systematic approach to the totality of a person's health. Anyone seeking a full understanding of health and healing will find homoeopathy extremely important and applicable."

The criticism on homoeopathy is a continued feature since its birth. Harper's magazine has published comments of a distinguished personality, Mark Twain, "…. (For) the introduction of homoeopathy, which found the old school doctor to stir around and learn something of a rational nature about his business. You may honestly feel grateful that homoeopathy survived the attempts and the allopaths (the orthodox physicians) to destroy it."

The chief criticism on homoeopathy is about the use of infinitesimal doses of remedies. A question is often asked how it is possible that non-material substances act as remedies. Evidence for the action of the infinitesimal dose has been provided by several researchers through their investigations in fields of biochemical, botanical, bacteriological, zoological, and others. Recent concepts in sub-atomic physics, nano technology and water memory are providing new insights into infinitesimal doses. Dana Ullman, MPH, a leading spokesperson for homoeopathy and author of 'The Consumer's Guide to Homoeopathy' stated after Lancet's most significant and comprehensive review of homoeopathic research in 1997, "This research places homoeopathy squarely in the arena of legitimate medical science. Homoeopathy IS effective, but we now need to know simply how effective it is."

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HOMOEOPATHY: ITS SCOPE AND PRESENT POSITION

Within its sphere, homoeopathy is adequate to meet the field of diseases in its own way, when it is practiced in its purity and entirety. While not perfect, homoeopathy is complete in all essentials as a system. It is supreme within its legitimate sphere because it is the only method of therapeutic medication which is based upon a fixed and definite law of nature. It works in perfect harmony with all necessary rational, non-medicinal and mechanical therapeutic agents. Hygiene, dietetics, sanitary science, psycho-therapy, pathology etc. find in homoeopathy their congenial ally.

Homoeopathy has spread to the nooks and corners of the world by its own intrinsic merit and that too without any advertisement or propaganda. There is renaissance of homoeopathy all over the world today and this is now increasingly recognized. John D. Rockefeller has commented, "Homoeopathy is a progressive and aggressive step in medicine." Homoeopathy needs far wider and extensive application. Unfortunately due to the 'lows' that entered into this highly intricate science and also due to prejudice which has emerged out of ignorance, homoeopathy is still not getting adequate support and appreciation, from the Government and from the physicians of other systems of medicine. Despite the ridicule and pooh-poohing to which homoeopathy is subjected for over a century and half by many physicians, it has still survived to emerge as a potent and decidedly congenial system of therapeutics in the treatment of ailing humanity.

Though such pooh-poohing by the ignoramus physicians continues, homoeopathic physicians will continue to serve by successfully treating the so-called hopeless and incurables. As the time advances the limitations and side effects of the modern medicinal therapy are coming to the force more and more. Iatrogenic illnesses have increased considerably. On this scene homoeopathy can definitely make a positive contribution in terms of rendering right approach to life and living and rendering super-specialty treatment to the ailing human mankind.

Due to the concept of individualization, homoeopathic prescribing is difficult and artistic, requiring an elaborate study of symptomatology of the sick individual. It necessitates meticulous observation, circumspection and high degree of talent on the part of a physician.

A homoeopathic physician has to spend hours together to ruminate over the symptomatology presented by the sick individual to find out the indicated homoeopathic remedy. Unfortunately the dearth of competent homoeopaths has made homoeopathy mutilated and emasculated. Homoeopathy should not be, therefore, judged from many 'quacks' that are prescribing homoeopathy and bringing discredit to this science.

Homoeopathy appeals to everyone to thoroughly investigate its principles and practice.

To quote Isis: "Modern Medicine, while it has gained largely in anatomy, physiology and pathology and even in therapeutics, has lost immensely by its narrowness of spirit, its rigid materialism and its sectarian dogmatism." The author of this paper will feel contented if the physicians of all systems of medicine will a bit reduce this dogmatism by paying attention to this highly salutary, dependable and scientific system of medicine.

REFERENCES

1. Organon of Medicine - 6th Edition - Dr. Hahnemann
2. Homoeopathy and Modern Medicine - Harris Coulter
3. Writings on Homoeopathy - Dr. J. N. Kanjilal
4. 'Physician Heal Thyself' - Dr. Diwan Harish Chand
5. The Genius of Homoeopathy - Dr. Staurt Close
6. Lectures on Homoeopathic Philosophy - Dr. J. T. Kent
7. Homoeopathic Philosophy I & II - Dr. K. N. Kasad
8. Re-discovery of Homoeopathy - Dana Ullman

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