Historical context
Homeopaths claim that Hippocrates may have originated homeopathy around 400 BC, when he prescribed a small dose of mandrake root to treat mania, knowing it produces mania in much larger doses.[28] In the 16th century, the pioneer of pharmacology Paracelsus declared that small doses of "what makes a man ill also cures him".[29] Samuel Hahnemann (1755–1843) gave homeopathy its name and expanded its principles in the late 18th century.
In the late 18th and 19th centuries, mainstream medicine used methods like bloodletting and purging, and administered complex mixtures, such as Venice treacle, which was made from 64 substances including opium, myrrh, and viper's flesh.[30] These treatments often worsened symptoms and sometimes proved fatal.[31][32] Hahnemann rejected these practices – which had been extolled for centuries[33] – as irrational and inadvisable;[34] instead, he advocated the use of single drugs at lower doses and promoted an immaterial, vitalistic view of how living organisms function, believing that diseases have spiritual, as well as physical causes.[35]
Hahnemann's concept
The term "homeopathy" was coined by Hahnemann and first appeared in print in 1807.[36]
Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist William Cullen into German. Being sceptical of Cullen's theory concerning cinchona's use for curing malaria, Hahnemann ingested some bark specifically to investigate what would happen. He experienced fever, shivering and joint pain: symptoms similar to those of malaria itself. From this, Hahnemann came to believe that all effective drugs produce symptoms in healthy individuals similar to those of the diseases that they treat, in accord with the "law of similars" that had been proposed by ancient physicians.[37] An account of the effects of eating cinchona bark noted by Oliver Wendell Holmes, and published in 1861, failed to reproduce the symptoms Hahnemann reported.[38]:128 Hahnemann's law of similars is a postulate rather than a scientific law.[39] This led to the name "homeopathy", which comes from the Greek: ὅμοιος hómoios, "-like" and πάθος páthos, "suffering")
Subsequent scientific work showed that cinchona cures malaria because it contains quinine, which kills the Plasmodium falciparum parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.[40]
"Provings"
Hahnemann began to test what effects substances produced in humans, a procedure that would later become known as "homeopathic proving". These tests required subjects to test the effects of ingesting substances by clearly recording all of their symptoms as well as the ancillary conditions under which they appeared.[41] He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, Materia Medica Pura, in 1810.[42]
Because Hahnemann believed that large doses of drugs that caused similar symptoms would only aggravate illness, he advocated extreme dilutions of the substances; he devised a technique for making dilutions that he believed would preserve a substance's therapeutic properties while removing its harmful effects.[10]Hahnemann believed that this process aroused and enhanced "the spirit-like medicinal powers of the crude substances".[43] He gathered and published a complete overview of his new medical system in his 1810 book, The Organon of the Healing Art, whose 6th edition, published in 1921, is still used by homeopaths today.[44]
Miasms and disease
In the Organon, Hahnemann introduced the concept of "miasms" as "infectious principles" underlying chronic disease.[45] Hahnemann associated each miasm with specific diseases, and thought that initial exposure to miasms causes local symptoms, such as skin or venereal diseases. If, however, these symptoms were suppressed by medication, the cause went deeper and began to manifest itself as diseases of the internal organs.[46] Homeopathy maintains that treating diseases by directly alleviating their symptoms, as is sometimes done in conventional medicine, is ineffective because all "disease can generally be traced to some latent, deep-seated, underlying chronic, or inherited tendency".[47] The underlying imputed miasm still remains, and deep-seated ailments can be corrected only by removing the deeper disturbance of the vital force.[48]
Hahnemann's hypotheses for the direct or remote cause of all chronic diseases (miasms) originally presented only three, psora (the itch), syphilis (venereal disease) or sycosis (fig-wart disease).[49] Of these three the most important was psora (Greek for "itch"), described as being related to any itching diseases of the skin, supposed to be derived from suppressed scabies, and claimed to be the foundation of many further disease conditions. Hahnemann believed psora to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts.[50] Since Hahnemann's time, other miasms have been proposed, some replacing one or more of psora's proposed functions, including tuberculosis and cancer miasms.[46]
The law of susceptibility implies that a negative state of mind can attract hypothetical disease entities called "miasms" to invade the body and produce symptoms of diseases.[51]Hahnemann rejected the notion of a disease as a separate thing or invading entity, and insisted it was always part of the "living whole".[52] Hahnemann coined the expression "allopathic medicine", which was used to pejoratively refer to traditional Western medicine.[53]
Hahnemann's miasm theory remains disputed and controversial within homeopathy even in modern times. The theory of miasms has been criticized as an explanation developed by Hahnemann to preserve the system of homeopathy in the face of treatment failures, and for being inadequate to cover the many hundreds of sorts of diseases, as well as for failing to explain disease predispositions, as well as genetics, environmental factors, and the unique disease history of each patient.[54]:148–9
19th century: rise to popularity and early criticism
Homeopathy achieved its greatest popularity in the 19th century. It was introduced to the United States in 1825 by Hans Birch Gram, a student of Hahnemann.[55] The first homeopathic school in the US opened in 1835, and in 1844, the first US national medical association, the American Institute of Homeopathy, was established. Throughout the 19th century, dozens of homeopathic institutions appeared in Europe and the United States,[56] and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.[57] Because medical practice of the time relied on ineffective and often dangerous treatments, patients of homeopaths often had better outcomes than those of the doctors of the time.[58] Homeopathic preparations, even if ineffective, would almost surely cause no harm, making the users of homeopathic preparations less likely to be killed by the treatment that was supposed to be helping them.[44] The relative success of homeopathy in the 19th century may have led to the abandonment of the ineffective and harmful treatments of bloodletting and purging and to have begun the move towards more effective, science-based medicine.[32] One reason for the growing popularity of homeopathy was its apparent success in treating people suffering from infectious disease epidemics.[59] During 19th-century epidemics of diseases such as cholera, death rates in homeopathic hospitals were often lower than in conventional hospitals, where the treatments used at the time were often harmful and did little or nothing to combat the diseases.[60]
From its inception, however, homeopathy was criticized by mainstream science. Sir John Forbes, physician to Queen Victoria, said in 1843 that the extremely small doses of homeopathy were regularly derided as useless, "an outrage to human reason".[61] James Young Simpson said in 1853 of the highly diluted drugs: "No poison, however strong or powerful, the billionth or decillionth of which would in the least degree affect a man or harm a fly."[62] 19th-century American physician and author Oliver Wendell Holmes, Sr. was also a vocal critic of homeopathy and published an essay in 1842 entitled Homœopathy and Its Kindred Delusions.[38] The members of the French Homeopathic Society observed in 1867 that some leading homeopathists of Europe not only were abandoning the practice of administering infinitesimal doses but were also no longer defending it.[63] The last school in the US exclusively teaching homeopathy closed in 1920.[44]
Revival in the 20th century
According to Paul Ulrich Unschuld, the Nazi regime in Germany was fascinated by homeopathy, and spent large sums of money on researching its mechanisms, but without gaining a positive result. Unschuld further argues that homeopathy never subsequently took root in the United States, but remained more deeply established in European thinking.[64] In the United States, the Food, Drug, and Cosmetic Act of 1938 (sponsored by Royal Copeland, a Senator from New York and homeopathic physician) recognized homeopathic preparations as drugs. In the 1950s, there were only 75 pure homeopaths practising in the U.S.[65] However, by the mid to late 1970s, homeopathy made a significant comeback and sales of some homeopathic companies increased tenfold.[66] Some homeopaths give credit for the revival to Greek homeopath George Vithoulkas, who performed a "great deal of research to update the scenarios and refine the theories and practice of homeopathy", beginning in the 1970s,[67][68] but Ernst and Singh consider it to be linked to the rise of the New Age movement.[33] Whichever is correct, mainstream pharmacy chains recognized the business potential of selling homeopathic preparations.[69] The Food and Drug Administration held a hearing April 20 and 21, 2015, requesting public comment on regulation of homeopathic drugs.[70] The FDA cited the growth of sales of over-the-counter homeopathic medicines, which was $2.7 billion for 2007.[71]
Bruce Hood has argued that the increased popularity of homeopathy in recent times may be due to the comparatively long consultations practitioners are willing to give their patients, and to an irrational preference for "natural" products, which people think are the basis of homeopathic preparations.[72]
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