Homeopathy & Conventional Medicine
Difficulties in using Double Blind Clinical Tests
Microbiology and bacteriology came into existence to explain which microbes attacked the organism and what malady they led to, etc. The holistic explanation that a microbe or bacteria cannot attack or take hold of a healthy organism had fallen by the wayside.
Thus one cannot fit a square peg into a round hole. The whole way of thinking in research up till this moment was geared towards this Cartesian paradigm. In order to be able to carry out research in Homeopathy we must also have a Holistic paradigm. There are still researchers today who do not understand and who, although they excel in allopathic research, do not have any idea of how to set up a homeopathic experiment. They use allopathic methods and paradigms to prove something totally alien to these methods. This is well cited in the review on double blind study clinical trials reviewed by Kleinen and Knipshild. In order to carry out research in Homeopathy we must abide by certain laws put forth by classical Homeopathy.
There are many in the world today who, although they call themselves Homeopaths, do not practice Homeopathy in the classical sense. They practice polypharmacy; they mix other disciplines in their therapies which only tend to confuse people and give an unclear idea of what classical Homeopathy is really all about. In research this is only too well apparent. Many times the people carrying out the experiments are not fully aware themselves of what they want to prove or to what aim the experiment has, etc.
There are no hypotheses, no structure of thinking behind the making of these experiments and often times the experiments prove nothing. Thus, instead of a positive effect, they have a rather negative effect on other scientists who might be interested but are swayed by these bad results.
It is only lately in research that Homeopathy is coming into its own. This is partly due to a worldwide turn towards a more holistic viewpoint in the sciences, a turn away from a reductionist paradigm. Other sciences, Physics, Chemistry, Quantum physics, etc. are now delving into the structure and running of whole systems or are studying systems “far away from equilibrium”.
These other disciplines help pave the way towards a new understanding of the organism and its pathology which was not available under the reductionist paradigm.
The myriad of problems caused by the taking of allopathic drugs is another major factor which accounts for people turning more to alternative medicine. This also helps the cause of research in that researchers will turn their attention to alternative therapies to find out how they work, etc. since these new products will also be the new remedies of the 21st century. For what better medicine can there be than a remedy with no major adverse side effects?
Thus, the numerous adverse side effects of allopathic drugs, the dehumanization of the medical practitioner as well as the economic interests of large pharmaceutical companies who dictate what drug remains, and what drug will be taken off the market, are some of the more negative aspects and major reasons why many people are turning to holistic principles and practices.
Research in Homeopathy will also provide information to many more people through the interest of varied scientific groups. In the forefront of Homeopathic research at the present time is Statistical Clinical Research. Unfortunately this has not done as well as it can in proving the efficacy of the homeopathic remedy, because of the specific nature of the homeopathic remedy and the way it is administered. [see Kleijnen J, Knipschilf P, ter Riet G. Clinical trials of Homoeopathy. Br Med J 1991;
302: 316-23.] In conventional medicine double blind clinical trials are used to test the efficacy of drugs. What this entails is having a group of patients that suffer from the same ailment i.e. rheumatoid arthritis. In conventional medicine you would then choose the new conventional drug you want to test and split the group of patients into those taking the placebo and those taking the “real” drug. In double blind clinical trials both the doctor administering the drug or placebo and the patient are not aware of what they have been given. This is done in order to rule out psychological or subliminal bias that the doctor can pass on to the patient unknowingly. In Homeopathy since it is the person and not the disease that we give a specific remedy to, the above double blind clinical trial has to be revised in order to take this into account. We cannot for instance give Rhus toxidodendron, a well known homeopathic remedy that has a therapeutic effect on individuals suffering from rheumatoid arthritis, to all the patients in the group and expect to have a true picture of the efficacy of Rhus toxicodendron because all patients in the group suffering from rheumatoid arthritis might need other idiosyncratic remedies such as Bryonia, Calcarea carbonica. This is ascertained in the homeopathic interview we give to the patient in order to ascertain the correct remedy for that specific patient. Thus what holds for conventional medicine does not hold for Homeopathy. Also another major contention or difference is that, as homeopaths, we expect to monitor the patient to see whether we have chosen the correct remedy. The criteria for this is:
1. A possible therapeutic exacerbation in the beginning. This is seen sometimes but not all the time when we have given a correct homeopathic remedy and it brings to the surface the past symptoms and maybe some of the near future symptoms of the patient. A pitfall here for the homeopath is choosing a remedy that is very similar to the correct homeopathic remedy but is not the exact one. If we do this we see we can have a therapeutic aggravation and thinking that it is a therapeutic exacerbation we wait for the symptoms to subside and to have the organism revert to a healthier state. When we finally see that the symptoms do not subside then we have to give the second possibility that arose as the correct homeopathic remedy when we took the interview. So the choosing of the correct remedy and the reading of the patient’s reactions to this remedy is very important for the homeopath. In this respect it is impossible for the doctor administering the remedy not to be aware of these patient’s reactions to the remedy.
2. Another pitfall for the homeopath is that although he/she has chosen the correct remedy, the potency is off and according to the reactions of the patient and how these are interpreted by the homeopath, we might need to give a higher or repetitive dosage of the same remedy to the patient. This is impossible with the double blind format of conventional medicine.
3. Another pitfall is that depending upon the chronicity of the problem, the individual patient’s genetic and acquired predisposition, how many allopathic drugs he/she has taken for this pathology one patient may get better in one hour and another might get better after one month, etc.
Also other more practical pitfalls come to mind, such as where these trials will be tested. There are few Homeopathic Clinical Centers or hospitals in the world. Most double blind clinical trials were held in conventional medical centers and a type of semi-homeopathic format was upheld. This led to allopathic doctors giving allopathic treatment to patients under homeopathic therapy thus negating the homeopathic results. This was not due to sabotage [although in some cases this too occurred, I am sure] but a discrepancy amongst homeopaths themselves as to what antidotes the homeopathic remedies. Many did not adhere to telling the patients to avoid drugs such as cortisone, antibiotics, psychotropic drugs, antihistamines, hormones or coffee, menthol, etc. while taking the homeopathic remedy.
By not adhering to classical Homeopathy the results of these Statistical Clinical Trials, although held in major hospitals, prove little else but that one cannot put a square peg in a round hole. One must adhere and make double blind clinical trials that obey classical homeopathic tenets. Keeping this in mind when I was Research Director for George Vithoulkas at the Center of Homeopathic Medicine in Athens, my colleagues - Drs. med. P. Arseniou, G. Tsantakis, C. Zervanos, P. Garzonis and L. Vavouraki, with clinical statistician A. Hatziparadissis, had come up with quite a good Double Blind Clinical trial for five major chronic disorders. The five major chronic disorders were migraine headaches, rheumatoid arthritis, epilepsy, phobia/anxiety disorders and allergic asthma. We were going to work with another major homeopathic clinical center in Belgium, the Clinical Training Center for Classical Homeopathy whose director is Dr. med. Alfons Geukens. I was head research coordinator of this project and Dr. med. Jean Louis Smout was the research coordinator in Belgium. Thus we submitted our clinical and physical/chemical research proposal before the closing date of Jan. 31, 1992 to the Commission of the European Communities, Directorate-General for Science, Research and Development DG. I later found out from my colleague Dr med. Michel van Wassenhoven that our project was in the top five but unfortunately we never received any funds. Because our centers were privately run and not government hospitals we could not take it upon ourselves to run the double blind trials. No funding is another unfortunate circumstance in medical research.
Another major factor is that good homeopathic treatment is dependent upon the homeopath that gives the treatment. The choosing of the correct remedy is dependent on the expertise, training and knowledge of the homeopath taking the case. The remedy itself and the way it is made is dependent on the expertise of the pharmacist or chemist doing the potentization procedure. Thus for all the reasons cited above, and many more, we have double blind clinical trials that just do not fit the classical homeopathic paradigm and thus allow for very negative reports being published on the therapeutic value of the homeopathic remedies. Statistical Clinical Trials should be held in centers where Classical Homeopathy is practiced, where the remedy chosen will be approved by a Master Homeopath (a Homeopath having the expertise of at least ten to fifteen years of positive experience and acknowledged results) and where, at certain time intervals while undergoing Homeopathic treatment, the patients will undergo classical diagnostic and lab tests so as to ascertain the progress of Homeopathic therapy.[where this is applicable]
These studies will help prove statistically how well Homeopathic remedies alleviate symptoms of chronic and acute diseases.