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The semantics of homoeopathy
British HomoeopathicJournal January 1994,Vol. 83, pp. 34-37
For debate
The semantics of homoeopathy GERMAN GUAJARDO, MD, ROBERTO SEARCY, MSC, OSCAR REYES, MC Abstract H o m o e o p a t h y is often referred to as a form of 'alternative' or ' c o m p l e m e n t a r y ' medicine. This results in the marginalization of homoeopathy and tends to equate allopathy with medicine. I n fact h o m o e o p a t h y is a medical speciality and our semantics should reflect this: There is a need to improve our courses and incorporate interdisciplinary topics. The use of the terms dilution and potency is also discussed. KEYWORDS: Semantics; Alternative; Complementary; Allopathy; Speciality; Medical science.
Studies and discussions concerning homoeopathic medical concepts are an integral part o f homoeopathic research and are the cornerstone of its evolution. Poitevin 1
Introduction
homeopathic drugs in the clinical practice of medicine... If the goal of prescribers of homeopathic medicine in the United States is to develop and maintain homeotherapeutics as a viable therapeutic option, then this definition must be accepted as the present basis of homeopathic practice. This is not just a practical regulatory issue, but is a key component to the lifeblood of homeotherapeutics as a practice. As a medical specialty homeotherapeutics depends on a broad scope of application, a depth of expertise, and the open curiosity of further research in order to be vital and growing. Like any other specialty, there are aspects which other practitioners, with little training, can adopt into their practice. For example, while surgeons train to perfect their art and skill, general practitioners nonetheless repair minor lacerations. Similarly, a nearly untrained prescriber can apply Arnica to an accident victim without being a homeopathic specialist... As a medical specialty, it is part of the practice of medicine, and its viability will depend on the breadth of its scope as well as its depth in quality. Homeotherapeutics is no longer a school of thought set in contradistinction to the 'Old School'. Today there are many philosophies and
Three discussions relevant to the future of homoeopathy have recently b e e n published in North A m e r i c a n newsletters. The following are quotations from these articles, which offer valuable insights. The first is from Julian Winston's: '"Alternative" m e d i c i n e ? ' ) In the last few months, several national magazines have run stories about 'alternative' health care. Homeopathy is always mentioned. But the implication of 'alternative' is that it is somewhat inferior to the 'real thing'. It is for those reasons that England's Prince Charles suggested the use of the term 'complementary medicine' but complementary to what? If homeopathy is complementary to conventional practice, does that not put us in a second class position? Of course, we can look at conventionalpractice as being 'complementary' to homeopathy, but there is still a hierarchy implied. The second, written by G u y Hoagland, MD, appears u n d e r the title: 'Homeotherapeutics as a medical speciality'.3 Simply homeotherapeutics is the application of 34
35
Volume 83, Number 1, January 1994
empiric determinations of practice that are included in the specialty of homeotherapeutics. When held in mutual respect, they provide the dynamic tension of professional challenge that is necessary for growth and excellence. A third commentary appears in Homoeopathic Research Reports:The survey published in the British Medical Journal was financed by a grant from the Dutch Ministry of Welfare, Public Health, and Cultural Affairs, which explains why the article begins with a reference to Dutch physicians, 45% of whom think that homoeopathic medicines are efficacious in treating upper respiratory tract infections or hayfever. It may no longer be appropriate to consider homoeopathy a part of 'alternative medicine', especially when you consider that surveys have determined that 32% of French family physicians and approximately 25% of German physicians prescribe homoeopathic medicines and 42% of British physicians refer to homoeopathic physicians. These are important issues that need to be reflected on, for they question deeply rooted but inadequate semantics. In fact the authors quoted above are not trying to update or modernize anything, it is more an analysis that brings awareness of an old and inadequate terminology.
Another medicine? Medical homoeopaths foster this false interpretation of a 'complementary' or 'alternative' medicine, since we maintain the habit of labelling ourselves as a dissident medicine, when in truth h o m o e o p a t h y is but a method. Because we have repeatedly spoken in terms of homoeopathic medicine, others have in turn reasoned: Well, what have we here? A n o t h e r medicine? A fringe one, maybe? But let's not be too harsh on this one, another name might also be suitable: how about complementary, or, better still, alternative? But look, it's just like herbalism or acupuncture! let's get them all together into a department of complementary medicines! We are thus rounded up, stocked and locked up with the others, and easily put in a different building from the 'real' medical sciences. We should seriously consider referring to h o m o e o p a t h y as a method or system of medical practice, and insisting that we are physicians and have professional postgraduate courses and degrees. There is no such thing as allopathic medicine either. In truth it is plain allopathy--a
pharmaceutical attempt to treat disease--and would be better referred to as allopathic practice, allopathic therapy, allopathic treatment or the allopathic option. If we think in terms of allopathic 'medicine', it will be difficult to perceive the following: students study in faculties of medicine, not in faculties of allopathy. It is medicine which studies diseases and creates specialties, which are not specialties of allopathy. Research is done on a medical paradigm, not on an allopathic paradigm; medical research follows the scientific method, not an 'allopathic procedure'. Physicians are trained in the faculty of medicine, not of allopathy. Unlike lay homoeopaths, medical homoeopaths are in faculties of medicine; and in the edifice of medicine h o m o e o p a t h y has a proud place. Homoeopaths, as the physicians that we are, can and must wander freely through any of the corridors and laboratories of this building of medicine. So let us not confuse the issue by mixing 'allopathic' with ' m e d i c i n e ' - - t h e y are not synonymous. We have no need to be grouped in some parallel therapy community. There is only one medical science, and we should be proud to belong to it. Nonetheless, these days it is c o m m o n to speak about h o m o e o p a t h y as complementary medicine (complementary to what?). To say 'alternative medicine' is a fad, it is trendy. Some colleagues even think that such terminology will help homoeopathy, that it will give a good impression.
Homoeopathy a medical discipline Why not take pride in our status as a speciality, and show the world how professional our degrees are? Maybe it is because there is a misunderstanding and we think we might be mistaken for a reductionist notion of speciality, as in cardiology, neurology, dermatology, for after all, we are holistic. Holistic yes, but not the simple-minded holism of health food stores. There is much more at stake; we have a science here! One cannot do without analysis of certain functions as parts, but exclusive reductionism, as an ideology, is crippling to science. But to analyse by reduction is without question part of the scientific method. Hans Selye was holistic in his conclusions on the general adaptation syndrome, but he could not get anywhere without his preceding pen-
36 etrating analysis of systems, organs, and hormones. Immunologists would not accept being relegated to an 'Alternative speciality'; an epidemiologist would not like to be referred to as 'complementary'. The same indignation should be felt in our medical speciality. This semantic dilemma is very important. It means the difference between communication and failure of the dialogue with academics and health officials. Is there really any sense in saying homoeopathic medicine is different from mainstream medicine, or viewing so-called conventional medicine as a rival to unconventional homoeopathy? In truth what we term as mainstream, regul-ar or conventional medicine encompasses homoeopathy; because mainstream medicine is much broader than allopathy. Is homoeopathy outside conventional medicine? If allopathy is a synonym of rational, official, normal, occidental, technological medicine, homoeopathy must be some sort of abnormal, irrational, irregular, extraterrestrial, nontechnological medicine. In fact homoeopathy is as regular, rational and, in many countries, common, official and conventional as allopathy. How unconventional is homoeopathy when conventional medical doctors have specialized in its practice, and in great numbers, in Britain, France, Germany, Mexico, Brazil and India? There must be ways of fighting official and academic unfairness and not hanging ourselves in the process by separating homoeopathy from the main trunk of medicine. As Fisher once pointed out, we seem to be particularly consistent in throwing the baby out with the bathwater when it comes to contrasting homoeopathy with science, medicine or allopathy. Creating better postgraduate courses is an important task. We should nurture the dignity of our speciality by including lectures on psychoneuroimmunology, clinical genetics (as in miasm theory, and individualization), biostatistics (as in Gibson, Jacobs, Reilly, Fisher), holistic response and homeostasis (as in Selye's stress theory, and immunological regulation), or physical chemistry (polymer model of Stephenson-Smith-Callinan, Del Giudice's dipole research), research method-
British Homceopathic Journal
ology (Poitevin and Benveniste). To acknowledge the value of interdisciplinary studies can do no harm. Allopathy is not the scientific method The 3 sentences that follow are typical of a distorted view of methodology in research, and sadly still common m homoeopathic literature: Dr Somerson began his presentation by saying that although our understanding of viral organisms has been greatly enhanced through allopathic models: The division of primary care has a special interest in researching common conditions for which the traditional paradigm has less than satisfactory treatments. 6 The communications in this homeopathic congress were done with pharmacological parameters and methods, research was mainly based on norms followed by our allopathic colleagues] With 'traditional paradigm' the author really meant 'allopathy'. Thus associations can lead to confusion because homoeopathy can be taken as a tradition and a paradigm. Hahnemann established a certain classical paradigm before Bernard began a tradition in medical research. However, in the above quotation 'traditional paradigm' is just a misleading way of saying 'allopathy'. Because of this confusing use of terms, one of the above authors thinks viral studies are done with an 'allopathic model', while another believes basic research on homoeopathy is done according to 'allopathic norms'. Such semantics spell disastrous failure of communication at congresses, in official and academic dialogues or postgraduate courses. Many specialists in medical science do research using a medical paradigm (which can be called traditional), not an allopathic paradigm; medical research follows the scientific method, it is not based on any one allopathic procedure. Allopathy is not a synonym of the traditional medical paradigm. The above are examples of inadequate terminology which can put pebbles in the shoes of prohomoeopathic academics who won't know why, but suddenly find it difficult to advance those (rare) projects to benefit homoeopathy. Conclusion Even if some flaws in terminology have been corrected with time, others are long overdue
Volume 83, Number 1, January 1994
to be reviewed, and modified. For example following the work of Avogadro and Loschmidt, the famous limit to the division of a substance was recognized in the mid 19th century. At that moment homoeopathy should have dropped the terms microdoses, microdilutions, or infinitesimal dilutions, and stuck to Hahnemann's notion of dynamizations or potencies as something physical: not following chemical laws. Other terms like this should have also been analyzed and defined decades ago. As time passes more and more nations are demanding recognition of homoeopathy as a medical speciality and method of practice in medicine. Let us at last view homoeopathy as part of medical and health science.
Address for correspondence Dr Germfin Guajardo Instituto de Investigaciones en Ciencias Veterinarias Universidad Aut6noma de Baja California Mexicali BC, M6xico
37 References 1 Poitevin B. Scientific bases of homeopathy. 7 Oct. 1988 conference at the Societ6 Fran~aise des Sciences et Techniques Pharmaceutiques, Bordeaux. 2 Wilson J. 'Alternative' medicine? Homoeopathy Today 1992; 12: 6, 2. 3 Hoagland G. Homeotherapeutics as a medical specialty. Homoeopathy Today 1992; 12: 6, 3. 4 The British Medical Journal has published the most significant review of homoeopathic research to date. Homeopathic Research Reports. Winter issue 1991; 92: 2. 5 Arrick S. The Ohio Meeting, Homeopathic answers to virus questions. Homoeopathy Today 1992; 12[,]: 3, 9. 6 Shevin W. Important meetings in Washington. Homoeopathy Today 1992; 12: 7, 3. 7 Sfinchez P. Resefia del XL Congreso de la Liga Medicorum Homeopathica Internationalis. La Homeopatia de Mexico 1985; 480: 2.
For debate
The semantics of homoeopathy GERMAN GUAJARDO, MD, ROBERTO SEARCY, MSC, OSCAR REYES, MC Abstract H o m o e o p a t h y is often referred to as a form of 'alternative' or ' c o m p l e m e n t a r y ' medicine. This results in the marginalization of homoeopathy and tends to equate allopathy with medicine. I n fact h o m o e o p a t h y is a medical speciality and our semantics should reflect this: There is a need to improve our courses and incorporate interdisciplinary topics. The use of the terms dilution and potency is also discussed. KEYWORDS: Semantics; Alternative; Complementary; Allopathy; Speciality; Medical science.
Studies and discussions concerning homoeopathic medical concepts are an integral part o f homoeopathic research and are the cornerstone of its evolution. Poitevin 1
Introduction
homeopathic drugs in the clinical practice of medicine... If the goal of prescribers of homeopathic medicine in the United States is to develop and maintain homeotherapeutics as a viable therapeutic option, then this definition must be accepted as the present basis of homeopathic practice. This is not just a practical regulatory issue, but is a key component to the lifeblood of homeotherapeutics as a practice. As a medical specialty homeotherapeutics depends on a broad scope of application, a depth of expertise, and the open curiosity of further research in order to be vital and growing. Like any other specialty, there are aspects which other practitioners, with little training, can adopt into their practice. For example, while surgeons train to perfect their art and skill, general practitioners nonetheless repair minor lacerations. Similarly, a nearly untrained prescriber can apply Arnica to an accident victim without being a homeopathic specialist... As a medical specialty, it is part of the practice of medicine, and its viability will depend on the breadth of its scope as well as its depth in quality. Homeotherapeutics is no longer a school of thought set in contradistinction to the 'Old School'. Today there are many philosophies and
Three discussions relevant to the future of homoeopathy have recently b e e n published in North A m e r i c a n newsletters. The following are quotations from these articles, which offer valuable insights. The first is from Julian Winston's: '"Alternative" m e d i c i n e ? ' ) In the last few months, several national magazines have run stories about 'alternative' health care. Homeopathy is always mentioned. But the implication of 'alternative' is that it is somewhat inferior to the 'real thing'. It is for those reasons that England's Prince Charles suggested the use of the term 'complementary medicine' but complementary to what? If homeopathy is complementary to conventional practice, does that not put us in a second class position? Of course, we can look at conventionalpractice as being 'complementary' to homeopathy, but there is still a hierarchy implied. The second, written by G u y Hoagland, MD, appears u n d e r the title: 'Homeotherapeutics as a medical speciality'.3 Simply homeotherapeutics is the application of 34
35
Volume 83, Number 1, January 1994
empiric determinations of practice that are included in the specialty of homeotherapeutics. When held in mutual respect, they provide the dynamic tension of professional challenge that is necessary for growth and excellence. A third commentary appears in Homoeopathic Research Reports:The survey published in the British Medical Journal was financed by a grant from the Dutch Ministry of Welfare, Public Health, and Cultural Affairs, which explains why the article begins with a reference to Dutch physicians, 45% of whom think that homoeopathic medicines are efficacious in treating upper respiratory tract infections or hayfever. It may no longer be appropriate to consider homoeopathy a part of 'alternative medicine', especially when you consider that surveys have determined that 32% of French family physicians and approximately 25% of German physicians prescribe homoeopathic medicines and 42% of British physicians refer to homoeopathic physicians. These are important issues that need to be reflected on, for they question deeply rooted but inadequate semantics. In fact the authors quoted above are not trying to update or modernize anything, it is more an analysis that brings awareness of an old and inadequate terminology.
Another medicine? Medical homoeopaths foster this false interpretation of a 'complementary' or 'alternative' medicine, since we maintain the habit of labelling ourselves as a dissident medicine, when in truth h o m o e o p a t h y is but a method. Because we have repeatedly spoken in terms of homoeopathic medicine, others have in turn reasoned: Well, what have we here? A n o t h e r medicine? A fringe one, maybe? But let's not be too harsh on this one, another name might also be suitable: how about complementary, or, better still, alternative? But look, it's just like herbalism or acupuncture! let's get them all together into a department of complementary medicines! We are thus rounded up, stocked and locked up with the others, and easily put in a different building from the 'real' medical sciences. We should seriously consider referring to h o m o e o p a t h y as a method or system of medical practice, and insisting that we are physicians and have professional postgraduate courses and degrees. There is no such thing as allopathic medicine either. In truth it is plain allopathy--a
pharmaceutical attempt to treat disease--and would be better referred to as allopathic practice, allopathic therapy, allopathic treatment or the allopathic option. If we think in terms of allopathic 'medicine', it will be difficult to perceive the following: students study in faculties of medicine, not in faculties of allopathy. It is medicine which studies diseases and creates specialties, which are not specialties of allopathy. Research is done on a medical paradigm, not on an allopathic paradigm; medical research follows the scientific method, not an 'allopathic procedure'. Physicians are trained in the faculty of medicine, not of allopathy. Unlike lay homoeopaths, medical homoeopaths are in faculties of medicine; and in the edifice of medicine h o m o e o p a t h y has a proud place. Homoeopaths, as the physicians that we are, can and must wander freely through any of the corridors and laboratories of this building of medicine. So let us not confuse the issue by mixing 'allopathic' with ' m e d i c i n e ' - - t h e y are not synonymous. We have no need to be grouped in some parallel therapy community. There is only one medical science, and we should be proud to belong to it. Nonetheless, these days it is c o m m o n to speak about h o m o e o p a t h y as complementary medicine (complementary to what?). To say 'alternative medicine' is a fad, it is trendy. Some colleagues even think that such terminology will help homoeopathy, that it will give a good impression.
Homoeopathy a medical discipline Why not take pride in our status as a speciality, and show the world how professional our degrees are? Maybe it is because there is a misunderstanding and we think we might be mistaken for a reductionist notion of speciality, as in cardiology, neurology, dermatology, for after all, we are holistic. Holistic yes, but not the simple-minded holism of health food stores. There is much more at stake; we have a science here! One cannot do without analysis of certain functions as parts, but exclusive reductionism, as an ideology, is crippling to science. But to analyse by reduction is without question part of the scientific method. Hans Selye was holistic in his conclusions on the general adaptation syndrome, but he could not get anywhere without his preceding pen-
36 etrating analysis of systems, organs, and hormones. Immunologists would not accept being relegated to an 'Alternative speciality'; an epidemiologist would not like to be referred to as 'complementary'. The same indignation should be felt in our medical speciality. This semantic dilemma is very important. It means the difference between communication and failure of the dialogue with academics and health officials. Is there really any sense in saying homoeopathic medicine is different from mainstream medicine, or viewing so-called conventional medicine as a rival to unconventional homoeopathy? In truth what we term as mainstream, regul-ar or conventional medicine encompasses homoeopathy; because mainstream medicine is much broader than allopathy. Is homoeopathy outside conventional medicine? If allopathy is a synonym of rational, official, normal, occidental, technological medicine, homoeopathy must be some sort of abnormal, irrational, irregular, extraterrestrial, nontechnological medicine. In fact homoeopathy is as regular, rational and, in many countries, common, official and conventional as allopathy. How unconventional is homoeopathy when conventional medical doctors have specialized in its practice, and in great numbers, in Britain, France, Germany, Mexico, Brazil and India? There must be ways of fighting official and academic unfairness and not hanging ourselves in the process by separating homoeopathy from the main trunk of medicine. As Fisher once pointed out, we seem to be particularly consistent in throwing the baby out with the bathwater when it comes to contrasting homoeopathy with science, medicine or allopathy. Creating better postgraduate courses is an important task. We should nurture the dignity of our speciality by including lectures on psychoneuroimmunology, clinical genetics (as in miasm theory, and individualization), biostatistics (as in Gibson, Jacobs, Reilly, Fisher), holistic response and homeostasis (as in Selye's stress theory, and immunological regulation), or physical chemistry (polymer model of Stephenson-Smith-Callinan, Del Giudice's dipole research), research method-
British Homceopathic Journal
ology (Poitevin and Benveniste). To acknowledge the value of interdisciplinary studies can do no harm. Allopathy is not the scientific method The 3 sentences that follow are typical of a distorted view of methodology in research, and sadly still common m homoeopathic literature: Dr Somerson began his presentation by saying that although our understanding of viral organisms has been greatly enhanced through allopathic models: The division of primary care has a special interest in researching common conditions for which the traditional paradigm has less than satisfactory treatments. 6 The communications in this homeopathic congress were done with pharmacological parameters and methods, research was mainly based on norms followed by our allopathic colleagues] With 'traditional paradigm' the author really meant 'allopathy'. Thus associations can lead to confusion because homoeopathy can be taken as a tradition and a paradigm. Hahnemann established a certain classical paradigm before Bernard began a tradition in medical research. However, in the above quotation 'traditional paradigm' is just a misleading way of saying 'allopathy'. Because of this confusing use of terms, one of the above authors thinks viral studies are done with an 'allopathic model', while another believes basic research on homoeopathy is done according to 'allopathic norms'. Such semantics spell disastrous failure of communication at congresses, in official and academic dialogues or postgraduate courses. Many specialists in medical science do research using a medical paradigm (which can be called traditional), not an allopathic paradigm; medical research follows the scientific method, it is not based on any one allopathic procedure. Allopathy is not a synonym of the traditional medical paradigm. The above are examples of inadequate terminology which can put pebbles in the shoes of prohomoeopathic academics who won't know why, but suddenly find it difficult to advance those (rare) projects to benefit homoeopathy. Conclusion Even if some flaws in terminology have been corrected with time, others are long overdue
Volume 83, Number 1, January 1994
to be reviewed, and modified. For example following the work of Avogadro and Loschmidt, the famous limit to the division of a substance was recognized in the mid 19th century. At that moment homoeopathy should have dropped the terms microdoses, microdilutions, or infinitesimal dilutions, and stuck to Hahnemann's notion of dynamizations or potencies as something physical: not following chemical laws. Other terms like this should have also been analyzed and defined decades ago. As time passes more and more nations are demanding recognition of homoeopathy as a medical speciality and method of practice in medicine. Let us at last view homoeopathy as part of medical and health science.
Address for correspondence Dr Germfin Guajardo Instituto de Investigaciones en Ciencias Veterinarias Universidad Aut6noma de Baja California Mexicali BC, M6xico
37 References 1 Poitevin B. Scientific bases of homeopathy. 7 Oct. 1988 conference at the Societ6 Fran~aise des Sciences et Techniques Pharmaceutiques, Bordeaux. 2 Wilson J. 'Alternative' medicine? Homoeopathy Today 1992; 12: 6, 2. 3 Hoagland G. Homeotherapeutics as a medical specialty. Homoeopathy Today 1992; 12: 6, 3. 4 The British Medical Journal has published the most significant review of homoeopathic research to date. Homeopathic Research Reports. Winter issue 1991; 92: 2. 5 Arrick S. The Ohio Meeting, Homeopathic answers to virus questions. Homoeopathy Today 1992; 12[,]: 3, 9. 6 Shevin W. Important meetings in Washington. Homoeopathy Today 1992; 12: 7, 3. 7 Sfinchez P. Resefia del XL Congreso de la Liga Medicorum Homeopathica Internationalis. La Homeopatia de Mexico 1985; 480: 2.