Is Hahnemann’s therapeutic system a mystica?

To the Editor: I refer to the recent editorial by Professor Van Niekerk on traditional healers in which Hahnemann’s system, or homeopathic therapeutics (HTS), is termed a ‘mystica’, a religious belief.1

HTS arose out of therapeutic uncertainty – how to match, akin to a pass word, a therapy with a disease of a particular patient. Hahnemann discovered in 1790 the experimental methodology termed provings, the homeopathic pathogenic trial (HPT), on disagreeing with the Scottish Hippocrates, Cullen, on the action of Peruvian bark. Hahnemann’s intuitive ingestion of bark elicited symptoms and signs of malaria, the HPT. Thus, bark induces a mild similar artificial disease which cures the similar severe disease of the patient – the age-old theory, the similarity. During an HPT, knowledge and experience of a medicine’s specific actions are elicited via the healthy, linking diagnosis and therapy prior to its clinical application; thus, specific therapeutics (SRx). The similarity as guiding principle means matching an SRx with the disease of the patient to achieve a successful clinical outcome, which links the diagnosis, therapy and outcome,2 approximating therapeutic certainty.

The validity of HTS can be analysed conceptually by the sciences, and the applied sciences. Medicine is an applied science like engineering; however, the social acceptance of science is attributed to its powerful engineering products.

A scientific theory, says Lakatos,3 must have ‘positive heuristics’; i.e. ‘problem-solving’; e.g. Einstein’s general theory of relativity solved the planet Mercury’s problematic orbit, while certain theories were verified by ‘dramatic confirming instances’ and not ‘crucial experiments’; e.g. Newton’s laws were accepted after Halley’s Comet’s calculated return 72 years later.3 The high quality of a technology must be designed into it from the outset – it won’t work better than originally designed. And, scientific evidence is depicted by, e.g., the first flight of Airbus A380 aircraft, one assembled aircraft – a high-quality product demonstrated outside the laboratory. Furthermore, it is inept to experiment on a mature product.

HTS has ‘positive heuristics’. They approximate therapeutic certainty, designed into medicines from the outset, so achieving the aim of the profession – a ‘right and good healing action taken in the interest of a particular patient’, one patient, achieved not ‘fortuitously’, otherwise the profession is ‘inauthentic and a lie’.4 Its scientific evidence is its clinical successes, its ‘confirming instances’ or ‘anecdotes’ in, e.g., cholera epidemics. Nevertheless, HTS can’t replace, for example, lignocaine or surgery.

In conclusion, Hahnemann’s system isn’t a ‘mystica’, and this letter is based on an article published elsewhere.5 , 6

Herman Jeggels

MD (VU Ams), MRCP (UK), FBIH (Hon), DHM (Hon)

General Practitioner

hjdj@jeggels.com

1. Van Niekerk JP. Traditional healers formalised? S Afr Med J 2012;102(3):105-106.

2. Ameke W. History of Homoeopathy: Its Origin, Its Conflicts. London: E Gould & Son, 1885.

3. Lakatos I, Feyerabend P. For and Against Method. Chicago: University of Chicago Press, 2000.

4. Pellegrino E. Toward a reconstruction of medical morality: the primacy of the act of profession and the fact of illness. Med Philos 1979;4(1).

5. Jeggels HJD. An Analysis of the concept scientific evidence of technologies as it relates to NASA’s TRLs & technoscience, medicine, and homoeopathic therapeutics, Part 1. The Homoeopathic Heritage 2012;38(1):47-49.

6. Jeggels HJD. An Analysis of the concept scientific evidence of technologies as it relates to NASA’s TRLs & technoscience, medicine, and homoeopathic therapeutics, Part 2. The Homoeopathic Heritage 2012;38(2):23-30.

Is Hahnemann’s therapeutic system a mystica? The managing editor replies

Dr Jeggels’ response is difficult to follow but the main claim is that homeopathy is scientifically valid. However, for acceptance, such claims must meet scientific standards.

At the time that Hahnemann made his ‘discoveries’ his treatment was safer than conventional medicine that prescribed bloodletting, purges and harmful substances in the belief that they worked, usually to the detriment of the patient. But medicine changed its beliefs by embracing science, whereas homeopathy shores up the defences of its beliefs.

Homeopathic claims run counter to science: the claim that ‘like cures like’ has been compared to vaccination, where an attenuated organism or a close relative of the organism imparts immunity. However, vaccination results can be measured by rising antibodies, reducing the outbreaks of disease (e.g. wiping smallpox off this planet) etc., whereas homeopathic treatment has no measurable change. Their claim that ‘the greater the dilution the greater the therapeutic effect’ cannot be substantiated scientifically and, if true, would require a complete rewrite of scientific facts. Ah, but it is the preparation of the dilutions (by shaking the mixture) that changes the water molecules so that the therapeutic message that is supposed to reside in the product being diluted is remembered and enhanced in the water molecules. The scientist who claimed to have proved this has been discredited as others could not replicate his findings (required for scientific validation) and which he could not repeat in his laboratory in the presence of a team of scientists sent to review his work.

Thus, in scientific terms, homeopathic medicines do no harm as they contain no active ingredient (though they are harmful when used in place of medication that has measurable benefits, e.g. insulin in diabetes and antiretroviral drugs for AIDS). Homeopathic medicines do indeed also have beneficial effects – but no different from the placebo effect.

Misquoting science to support a belief is non-science and homeopathy remains firmly in the domain of truth called mystica.

J P van Niekerk

Managing Editor

South African Medical Journal

jpvann@hmpg.co.za

S Afr Med J 2012;102(8):640-641. DOI:10.7196/SAMJ.6078