Homeopathy is primarily based on the evidence of clinical practice, clinical observation and clinical outcomes — provided by way of treatment, clinical trials, or basic research, and laboratory studies. To state the obvious — most conventional medical scientists have relatively no interest in homeopathic clinical care. This is because homeopathy and conventional [allopathic] medicine developed separately.
However, things are a-changin’ now, thanks to the increasing demand for scientific evidence in homeopathy, not to speak of the growing need for a more humanistic, or holistic approach, on the lines of homeopathic treatment in conventional medicine. This is a huge advance, or paradigm shift — it is slowly bringing the two medical schools to communicate and bridge the yawning gap, scepticism, or inflexibility of either towards each other.
A possible framework for such ongoing interactions is provided by new, ongoing research on homeopathic dilutions, or potencies. This, as some researchers believe, may lead to the development of a new, integrated concept of illness and treatment of disease.
Study Of High Dilutions
Research on high dilutions, used in homeopathy, first began in the 1950s. It is only since the mid-1990s that there has been a steady increase in the number and quality of such published studies.
A rigorous systematic review, or summary, of the total research evidence available — designed to provide more accurate information than single studies — was published in 2007. It assessed the entire evidence base for medicinal effects of high potency homeopathic remedies. 67 experiments published in 75 publications were evaluated. 75 per cent of the studies found that homeopathic high dilutions have actual biological effects. When the experiments were repeated, the same results emerged.
This should set the evidence straight and also reflect homeopathy’s ‘scientific’ basis — in objective terms.
It may also be mentioned that homeopathic prescribing is, likewise, based on investigational data, or medicinal ‘provings.’ This is founded on precise and well-judged scientific observation, meticulousness and validation.
In the recent past, top medical scientists, Dr Iris Bell, MD, PhD, and Dr Mary Koithan, PhD, have proposed a new model to explain how ‘low-dose’ homeopathic dilutions work. This is keyed to the latest scientific theories related to highly reactive nanoparticles.
In a paper published in BMC Complementary and Alternative Medicine, Bell and Koithan suggest what they observe as a novel, new scientific model for homeopathic remedy action on living, or complex systems — one that is logically and rationally based. The model explains why homeopathy is scientifically possible and/or how homeopathic remedies exert their biological effects primarily as nanostructures and why, in their view, physiology, not pharmacology, is the most relevant discipline to understand homeopathic medicinal action.
Homeopathy: ‘Nanomedicine’
Homeopathy stimulates the body’s own innate healing mechanisms, although explanations as to how exactly it excites the organism have expectedly evoked cynicism in conventional [allopathic] medical quarters. In the recent past, homeopathy has been increasingly explained on the basis of quantum physics, bioenergetics, molecular memory and nanopharmacology too. Besides, the use of spectroscopy and thin layer chromatography [TLC], among others, has made it possible to actually ‘figure out’ the minute amounts of the medicinal substance present in homeopathic remedies, while differentiating them in their various dilutions, or potencies.
Drs Bell and Koithan suggest that homeopathic remedies contain nanoparticles evenly dispersed and in suspension — and, [that] the way they work is by helping the body’s stress response system do what it wants to do anyway — ‘get back to a stable state’ — by stimulating the biologically-programmed responses in our bodily systems.
It would be useful to bring home the point that Dr Bell had previously proposed that homeopathy is the therapeutics of and for the dynamics of the person as a whole complex system. This has been confirmed on a regular basis around the world — for the past 200 years — in patients, evidence-based clinical treatment and studies. You may visit the National Center for Homeopathy [www.nationalcenterforhomeopathy.org], US, and the Central Council for Research in Homeopathy [www.ccrhindia.org], India, to read about new research and clinical studies in homeopathy.
Useful Evidence
This is certainly the bright part in the defence of homeopathy — that it works. On the other, there is also a growing need for practicing homeopaths to meet sceptics’ derision head-on. This calls for ‘compelling evidence’ in favour of homeopathy. What’s more, it is no longer a question of homeopaths being optimistically buoyed by their successful cases, or clinical experience. It is also not a question of protesting that one knows for sure that homeopathy works, and this has been proven for over two centuries in the treatment of the sick — or, in innumerable evidence-based treatment outcomes, or ‘incurable’ cases, showcased by homeopaths the world over, from time to time.
The point today is not what homeopathy has achieved, but how homeopathy can, in its full scientific right, help people achieve optimal health and wellness — from verifiable scientific results, or standpoint. For this to happen, it is critically important for homeopathy and homeopaths to attain a much wider acceptance within the portals of medicine — traditional, old, new, or conventional. The best manner in which this can emerge is by way of convincingly — not merely persuasive — advanced and thorough research-based evidence of homeopathy’s clinical effectiveness, not to speak of its accepted safety. This would be best supplemented by facing the challenge of proving the specific clinical effectiveness of homeopathic remedies in specific conditions.
While it may not sound pleasing to the ear, such challenges are best addressed by data obtained from randomised controlled clinical trials [RCTs], where homeopathy can be compared with another treatment interventions, or with placebo [dummy pill]. RCTs, as new schools of ‘medical thought’ suggest, are certainly not ‘perfect,’ but they could well assist new research programmes to expand from observational, or group, studies.
It is agreed that RCTs correspond to the criteria of conventional medicine — they are, therefore, extremely limited to and do not analyse the actual daily practice of a homeopathic physician, because homeopathic clinical practice encompasses more than just focusing on the treatment of a specific disease. It is aimed at the complete treatment of a health concern, or issue of the patient. One useful mode would be a broader framework of treatment of a particular disease, which also takes into consideration factors, such as lifestyle, exercise, diet, emotional state and environment — albeit they all have, for long, been a part of the standard homeopathic treatment plan.
While it is accepted that RCTs are restricted and have inadequate ‘influence’ on the practical choice of homeopathic treatment for a specific patient, it may be mentioned that RCTs are carried out in ‘ideal, artificial situations,’ far from the particular context of the individual patient. Conventional evaluation, therefore, must take this reality into context for RCTs to be able to ‘validate’ and explain homeopathic treatment results.
Future Research
According to Dr R T Mathie, PhD, of the British Homeopathic Association and Faculty of Homeopathy, UK, the key issues that must be addressed in future research development in homeopathy are — the research question, the associated clinical trial design and outcome measures chosen. Fresh, new research, he suggests, should consider carefully whether placebo-controlled trials and physical determinants of health are necessarily the wisest approach.
In a paper published in Homeopathy, he writes, “[Present conventional] approaches may [conversely] be particularly inappropriate in researching homeopathy for chronic illness, or where the treatment does not address a named disease. Conditions of this nature are nearly always treated by individualised homeopathy, where remedy selection is based on the given individual’s ‘constitutional’ character; so, non-placebo-controlled designs using quality of life [QoL] measures, for example, might be the most relevant.”
He adds, “[When you bring in] placebo-controlled trials in homeopathy, the most appropriate place might be the assessment of acute [as opposed to chronic] medical conditions, where any homeopathic treatment effect is likely to be quick acting and, thus, adequately measurable. The fact that prescribing is relatively simple — with a minimal range of indicated remedies — in some acute conditions could also offer useful advantages in the study design.”
It may be mentioned that acute [short-term], rather than chronic [long-standing] health conditions feature prominently among illnesses for which homeopathy has the greatest acceptance of positive research evidence in placebo-controlled clinical trials. The inclusion of such contexts would, in more ways than one, encourage fresh interest in exploring and examining the mind-body, holistic efficacy of homeopathy as a useful adjunct [not first-line of therapy] to conventional treatment, in certain disease states, like diabetes and high blood pressure [hypertension], while confirming and highlighting its complementary strength.
It is also proposed that equivalence trials, likewise, offer yet another promising route forward. Equivalence trials are used to prove that two treatments work equally well, in contrast to traditional ‘superiority trials,’ which set out to show that one treatment is better than the other. This, as researchers suggest, would provide them with a more vigorous model to examine the comparative safety, efficacy and cost-effectiveness of homeopathy with conventional medicine — not only in terms of treatment effectiveness, but also with regard to treatment outcomes in specific clinical conditions.
The inference is obvious. That with the passage of time the number of quality research and clinical papers related to homeopathy will only expand — along with results acceptable to conventional critics and ‘compulsive’ detractors of this avant-garde system of safe, gentle, also effective, healing.
