INTRODUCTION
There are many systems of medicine which are discovered and practiced in the world since the primitive ages, for the purpose of maintaining wellnessand treating illness of man. Some of the systems becameobsolete with the advancement of science and technologies, but some have remained till today.
The systems of medicine practiced in the world maybe categorized into (1) Conventional medicine, such as Allopathy. (2) Alternative medicines, such as traditional Chinese medicine (TCM), traditional Indian medicine orAyurveda, Unani/Arabic medicine, naturopathy, osteopathy, chiropractic, and homeopathy.
All the systems of medicine have contributions in the field of therapeutics, and one may be used as a complementary to the others. In most countries, Allopathy is practiced as the conventional medicine along with indigenous, traditional medicines. For example, in China, TCM is practiced besides conventional homeopathy Western medicine in India, traditional Ayurvedic medicine is practiced besides conventional Western medicine. Some of the traditional medicines, for example, TCM and Ayurveda, have gained popularity worldwide, beyond the countries of origin.
Such is the case of homeopathy, the German alternative medicine, which was discovered by German medical scholar Dr. Samuel Hahnemann in the early 19th century. Originally, a conventional physician, Hahnemann could not accept the prevalent practices of allopathic medicine of his time, such as blood-letting, application of leeches, use of strong purgatives, emetics, large doses of mercurial preparations, then in vogue. He also differed on the question of the causation of diseases and therapeutic principles. He started experimenting and at last discovered a new treatment with very small doses of single medicines, selected according to symptoms similarity with the patients. He named it homeopathy, coining the phrase as “similia similibus curentur” or “let likes be cured by likes.”
HAHNEMANN, HIS LIFE, AND WORKS
Early life
Hahnemann was born in a small German town Meissen in the Electorate of Saxony on April 10, 1755. His father was a porcelain painter with modest income and a large family. He studied in Prince's School of Meissen, where he learned many foreign languages. He was extraordinarily talented, but his poor father took him away from the school and wanted him to be employed in some petty jobs to help the family. His teachers prevented this by awarding him free tuition. In 1775, he finished the high school with honors, writing a dissertation in Latin entitled “The wonderful construction of human hand.” He became proficient in a number of foreign languages, including English, French, Italian, Greek, Latin, Arabic, and Hebrew.
Hahnemann decided to study medicine but had no monetary support from the family. At last with a little money from his father, he went to Leipzig University to study medicine. He utilized his great knowledge of languages to help earn his living by translating foreign language books into German. He also gave private tutoring to a rich young Greek in his study of French and German. After studying 2 years in Leipzig, he went to Vienna for further study and at last obtained his “Doctor of Medicine” degree from Erlangen University in 1779. His doctoral thesis was entitled “A view of the causes and treatment of cramp”.
Early medical career and birth of homeopathy
After qualifying MD, Hahnemann started medical practice. He moved to Dessau where his interest in chemistry brought him in contact with local pharmacist Haseler, marrying late on his stepdaughter Johanna Henriette. In 1781, he was appointed Medical Officer of Health of Gommern, later moved to Dresden where he worked in Forensic Medicine for 4 years. He returned to Leipzig to exercise his expertise in scientific pursuits. Leipzig as the seat of a big University and book-selling trade was one of the intellectual centers of Germany. But soon, he was disgusted with the conventional treatment in vogue, such as blood-letting, leeching, purging, vomiting, and blood cleaning so he gave up medical practice. His growing family had to be supported by translated books of medicine, biology, chemistry, etc., from different languages. He was then esteemed as an accomplished translator which earned him honor of being elected as distinguished fellows of many scientific societies of Leipzig.
In 1790, he was translating an English book “A Treatise on Materia Medica” by British physician William Cullen. While discussing the treatment of intermittent fever with Peruvian bark Cinchona, Cullen opined that the efficacy of this bitter remedy was due to its tonic effect on the stomach. Hahnemann criticized this opinion saying that there are many remedies that are bitter and has tonic effect on the stomach, but do not cure intermittent fever. He decided to experiment the effects of Cinchona on his body, he took four drams of its tincture twice daily for a few days. He was surprised to have developed almost all the symptoms of intermittent fever with chill, fever, sweat, etc. From this experiment, he hypothesized that Cinchona cures intermittent fever not due to its bitter taste or tonic effect on the stomach but by its property of producing similar symptoms of intermittent fever in a healthy body. He then started experimenting with other remedies known to cure certain diseases and surprisingly had the same experience as that of Cinchona. He then deduced that a remedy cures a disease by its inherent property to produce similar symptoms in healthy body. He named such experimenting of drugs in healthy human as Drug Proving. He continued further provings with different drugs and recorded the symptoms. He then started applying them in patients with similar symptoms as a way of clinical experiments, deducing at the end a principle of treatment as “Similia Similibus Curentur” or “likes cure likes.”
In 1796, Hahnemann published his new experience in Hufeland's Medical Journal as “Essay on a new principle for ascertaining the curative power of drugs;” he also published “Medicine of Experience.” In 1806, he published “Fragmenta de viribus medicamentorum positivis,” in which he added all the proving reports with a symptoms index. He also devised a unique method of preparation of drugs by serial dilution with liquid vehicle, at the same time, strongly shaking the container. He claimed that this procedure reduced the toxicity of drug, at the same time, potentiating its therapeutic effects more and more. He called it “Potentization of drugs.” In 1810, he officially announced his new system of medicine “Homeopathy,” by publishing the epoch-making book “Organon of Medicine.” As expected, the orthodox medical community fiercely opposed and criticized the principles and practice of the new system.
Homeopathic career
Hahnemann decided to join a University faculty to teach the new system of medicine. He shifted to Leipzig and applied to the Dean of the Medical faculty of Leipzig University to join as a faculty. He was required to submit a dissertation and defend it in front of the faculty members to qualify himself. He did it successfully and joined the faculty in June 1812. He officially started a course of homeopathy and lectured twice weekly. His lectures attracted many students, doctors, even faculty members. Many doctors from the surrounding districts used to travel a long way to listen to his lectures. However, after the initial enthusiasm, the crowd was gradually fading because of (1) Hahnemann's criticism of the prevalent methods of treatment, which the new doctors did not want to give up. (2) Allopathic professors of the faculty did not like the students attending Hahnemann's lecture. (3) Students who followed Hahnemann were ridiculed, mocked and criticized by the others.
However, in spite of this, Hahnemann was able to create a small circle of faithful students around him. He tutored them even in his house and employed them in drug proving. Their devoted work enabled Hahnemann to write the Materia Medica Pura of homeopathic medicines. He also had an ever-growing medical practice in spite of antagonism of the orthodox physicians. This made his opponents jealous, trying hard to discredit him. They instigated the apothecaries (pharmacists) to complain against him to Leipzig Council as he prepared and dispensed his own medicines to the patients. In spite of this rivalry, many royals and high-ranking government officials used to come to Hahnemann seeking his treatment. Even Prince Schwarzenberg, the celebrated Austrian General who fought against Napoleon, when suffered a stroke, sought Hahnemann's treatment, coming all the way from Austria. Then, the orthodox practitioners instigated the pharmacists to file a second complaint to the Saxon government against Hahnemann's homeopathic practice. At last, Hahnemann was compelled to leave not only Leipzig, rather the state of Saxony in 1821.
When Hahnemann was contemplating where to go, the Duke of Kothen Prince Ferdinand extended an invitation to him to serve as a Physician to the Duke. He also allowed him the right to practice homeopathy with self-dispensing. Kothen was a small princely state in the middle of Germany, 50 kilometer from Leipzig. The Duke was suffering from a serious health problem which Hahnemann treated and cured him of. Since then, the Duke and Duchess remained ever faithful to Hahnemann and used to comply to all the privileges he asked for. Hahnemann was elected the Privy Councilor of Kothen. Here, he published a very important medical work “Chronic Diseases, Their Peculiar Nature and Homeopathic Cure,” but it drew fierce criticism and ridicule from his opponents. In Kothen, Hahnemann's wife Johanna Henriette died in 1830. They had 11 children, 2 sons and 9 daughters, one son qualified MD from Leipzig University and practiced homeopathy.
Hahnemann had a busy practice in Kothen, patients coming even from outside Germany. In late 1834, a young French woman named Marie Melanie d’Hervilly came from Paris to consult him for her lung problem. She stayed in Kothen for some time to continue her treatment. Having been cured of her lung problem, she became interested to learn homeopathy, which ended up loving the aging widower Hahnemann and they got married in January 1835. After marriage, they lived in Kothen for 6 months, then decided to shift to Paris in June 1835, so that homeopathy might get a wider exposure to the outside world [Figure 1].
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Figure 1: Samuel Hahnemann (1755–1843) at the age of 87 years
Last life in Paris and death
Homeopathy had already spread in France before Hahnemann arrived. Hence, the German master was welcomed most cordially by the French Homeopathic Association in an extraordinary congregation, where Hahnemann was elected the Honorary President for life. The French Minister of Health appreciated Hahnemann's arrival and awarded him a Royal decree to practice homeopathy in France. Hahnemann started medical practice in Paris which soon became very extensive. Many Royals from France, Britain, and other European countries started coming to Paris to seek his treatment. He was even invited to England to treat Queen Adelaide but Hahnemann sent his German disciple Dr. Johann Ernst Stapf (1788–1860)[1] to England to treat the Queen. Many allopathic doctors from different countries came to him to learn homeopathy. Even in this high profile, busy professional life, Hahnemann continued his literary writing and prepared the 6th edition of Organon of Medicine. However, he could not publish it due to his death next year on July 2, 1843, at the age of 89 years. He was buried in the cemetery of Montmartre hill of Paris. But later, his remains were shifted to the famous Pere Lachaise cemetery of Paris with a magnificent tomb on it by the initiative of Hahnemann Medical College of Philadelphia, USA and International Congress of Homeopathic Physicians in 1898 [Figure 2].[123]
Figure 2: Hahnemann's tomb in Pere Lachaise Cemetery, Paris
HAHNEMANN's LITERARY WORKS
Hahnemann wrote a number of books, booklets, and many essays of which the following are the main ones:
Organon of medicine[4]
Regarded as “Bible” of homeopathy, this is the fundamental book of theories, principles, and practice of homeopathy. First published in 1810, this was edited by Hahnemann up to the 6th edition in 1842. This discusses the mission of a physician, definition of health and disease, comparison of homeopathy with Allopathy with many references from ancient physicians, mechanism of action of remedy, classification and nature of diseases, drug proving, homeopathic case-taking, selection of remedy, preparation of homeopathic medicines, the mode of administration.
Materia Medica Pura[5]
It is a compilation of symptoms collected from proving reports of medicines, systematized, and arranged in anatomical schema into six volumes. The 1st volume containing 12 drugs were published in 1811, the 2nd volume with 8 medicines published in 1816, the 3rd with 8 medicines in 1817, the 4th with 12 medicines in 1818, the 5th with 11 medicines in 1819, and the 6th with 10 medicines in 1821. There are 61 medicines in 6 volumes of Materia Medica Pura.
The chronic diseases, their peculiar nature, and homeopathic cure[6]
This book had two editions, and the first edition consists of four parts while the second comprises five parts. Part I contains the general theoretical principles of the new theory about chronic diseases; Parts II-V contain a detailed description of the most important anti-miasmatic remedies. The 1st edition was published in 1828 and the 2nd edition came out in 1835.
The lesser writings[7]
Hahnemann's important writings in the form of journal articles, letters, booklets, etc., were collected, compiled, and translated into English by British homeopathic physician Dr. R E Dudgeon. It was published in New York in 1852.
SPREAD OF HOMEOPATHY IN THE WORLD
In spite of relentless antagonism from the allopathic practitioners, homeopathy spread from Germany to the whole of Europe, America, and Asia during the lifetime of Hahnemann and afterward throughout the world. Having observed its superior therapeutic efficacy, many conventional practitioners learned and were converted to homeopathy. It earned government recognition in many countries and was practiced as the prime alternative medicine. Hereafter, the development of homeopathy in some countries is described.
United States of America[8]
Homeopathy reached American soil mostly by immigrant German homeopathic physicians, of whom Dr. Constantine Hering (1800–1880)[9] was the foremost. Hering studied medicine in Leipzig University, graduated in 1826. A faithful disciple of Hahnemann, he went to Surinam of South America on a biological exploration in 1827, and later went to Philadelphia, the USA in 1833 and settled down. In 1835 he founded “North American Academy for Homoeopathic Healing” in Allentown which was the first educational institution of homoeopathy in the world. Later, he founded Hahnemann Medical College in Philadelphia in 1848, the largest ever academic institution of homeopathy in the world. He served there as Professor of Materia Medica till 1869. The college had its own hospitals and extensive polyclinics, where more than 70 professors and lecturers were at the disposal of hundreds of students. In the hospitals and polyclinics more than 50,000 patients and 6,000 accident cases were treated every year, which afforded the professors abundant material for clinical instruction to the students. It was so famous that students from other parts of the world came to study. Hahnemann Medical College was followed in 1850 by the homoeopathic college in Cleveland, in 1857 in St. Louis, in 1859 in Chicago, and in 1860 in New York and so on. All the colleges had state grants and were recognized by the Universities.[1]
Before the First World War, there were in the United States 56 homoeopathic general hospitals with 35–1400 beds each, nine hospitals for women (inclusive of midwifery) with 30–100 beds each, 13 mental asylums with 150–2000 beds each, nine children's hospitals with 30–100 beds each, etc.[1] Germany was the birthplace of homoeopathy, but in its propagation in USA had far outpaced Germany. Constantine Hering was regarded as the Father of American Homeopathy. Also at that time, the USA produced many world-famous homeopathic physicians who upgraded the new system by writing many important books and teaching many students from the USA and other parts of the world. They were Drs J T Kent, Carroll Dunham, E A Farrington, T F Allen, H C Allen, E B Nash, Elizabeth Hubbard, etc. [Figures 3 and 4].
Figure 3: Dr. Constantine Hering (1800–1880)
Figure 4: Hahnemann Medical College of Philadelphia (Founded 1848), now Hahnemann University Hospital
Homeopathy in Britain
Homeopathy reached Britain during the lifetime of Hahnemann. He was invited to treat British Queen Adelaide in 1835, but he sent his German disciple Dr. Johann Stapf, medical councilor of Saxony, to England in his stead. Stapf stayed in England for a few months to treat the Queen. When coming back to Germany through Paris, he reported to his master Hahnemann.[1] In 1835, Dr. Harvey Quin (1799–1878)[10] of England came to Paris to learn homeopathy. He stayed with Hahnemann and after learning from the master, went back to England and started practicing homeopathy. He was so famous that he was appointed Homeopathic Physician to King Leopold II of Belgium. Dr. Quin owned a high profile homeopath of Britain, by popular support he founded the London Homeopathic Hospital (LHH) in 1849, one of the largest homeopathic hospitals of the world. LHH was awarded Royal Charter in 1949 and became Royal LHH (RLHH). This hospital became the center of excellence for homeopathic education and training for the medical graduates of Great Britain and other countries of the world.
Homeopathic treatment was favorite in the British royal family since Hahnemann's time. In 1925 King George V appointed British homeopath Weir (1879–1971)[11] as the Royal Court Physician. Since then, the tradition has continued through King Edward VIII, King George VI, and up to Queen Elizabeth II, the present monarch of Britain. The royal family always favored the development of homeopathy in Britain. Hence, there have been many homeopathic hospitals in Britain after the RLHH. Britain also produced some world-famous homeopathic physicians such as Drs J C Burnette, J H Clarke, Margaret Tyler, Thomas Skinner, and Margery Blackie, who contributed by teaching and writing many books on homeopathy which became textbooks of homeopathic colleges [Figures 5 and 6].
Figure 5: Dr. Margery Blakie and Dr. Sir John Weir, Homeopathic Physicians to the British Royal Family
Figure 6: The Royal London Homeopathic Hospital, London
Homeopathy in India[12]
Homeopathy was introduced into British India by John Martin Honigburger, a German disciple of Hahnemann, in 1837. He was invited to India to treat King Ranjit Singh of Punjab for stroke with hemiplegia, which the local Unani and Ayurvedic practitioners failed to improve. He was ordered to prepare the medicines in front of the king. He did the same and administered it to the king, whose health started improving satisfactorily within a few days. The happy king proposed Honigburger to stay in his kingdom as a royal physician. He agreed and stayed in India for a few years. At that time an epidemic of Cholera was raging in Kolkata, the then capital of British India. Honigburger traveled to Kolkata and cured many patients of cholera with homeopathic medicine. This raised the interest of the local people in homeopathy; many learned it from him and started treating others. However, until 1867, no qualified Indian physician came to learn homeopathy, when Sarkar (1833–1904)[13] became interested to learn it. He was the first MD of Kolkata University and President of the Indian Branch of the British Medical Association. He declared allegiance to homeopathy and gave up the allopathic practice. By his influence and encouragement, many medical doctors were converted to homeopathy. Dr. Sarkar died in 1904 but by that time homeopathy had been established on a solid foundation on Indian soil. The Indian government recognized homeopathy as one of the state medicines and established more than 100 University affiliated homeopathic medical colleges and hospitals throughout the country. Now India became the hub of homeopathic medicine in the world. Many doctors from the Western countries come to India every year to learn homeopathy.
CARDINAL PRINCIPLES OF HOMEOPATHIC MEDICINE
Every system of medicine is based on certain principles and rules of practice, so is homeopathy. It is based on the following fundamental principles and rules of practice.
The law of similars
The word homeopathy came from the Greek words “Homoios” meaning like or similar, and “Pathos” meaning suffering. Hence, homeopathy means similar sufferings, that is, to treat the sufferings of a patient by a drug which can produce similar sufferings in a healthy person. That's why, Hahnemann conducted drug provings of many medicinal substances to know what symptoms they could produce in healthy humans, which indicated their inherent capability to cure such symptom complex in patients. This natural law was coined as “Similia Similibus Curentur” (Likes cure likes). This was also known to Hippocrates, who proposed two principles of treatment, namely (i) Similia Similibus Curentur and (ii) Contraria Contraris Curentur (Unlikes cure unlikes). Hahnemann rediscovered and established the 1st principle as the true principle of cure. The 2nd principle was followed by medical stalwart 2nd century Cornelius Galen and his followers and later became the allopathic principle of medicine, treating sufferings by drugs which produce opposite symptoms.
In Organon of Medicine, aphorism 26, Hahnemann stated that “A weaker dynamic affection is permanently extinguished in the living organism by a stronger one if the latter (while differing in kind) is very similar to the former in its manifestations.”[4] By this, he means that each individual case of disease is most surely, rapidly, and permanently annihilated and cured if the symptoms of the medicine chosen are similar to the disease symptoms but superior to it in strength.
The law of simplex or single remedy
This means to treat a patient, only a single medicine should be applied at a time (Aphorisms 272–274, Organon). According to Hahnemann, a person becomes ill by the disorder of his vital force, manifested by symptoms. To cure the disorder, vital force needs to be stimulated by the drug which produces similar symptoms known by proving. Hence, it should be a single, simple, proved medicine, not by a complex mixture of different drugs. So in homeopathy, a patient is always treated with a single remedy at a time.
The law of minimum dose
The curative effect of the medicine does not depend on the crude quantity of drug material, rather on the quality of similarity to the symptoms of the patient. As the homoeopathic medicine acts on the dynamic level of vital force, only a minute quantity of the medicine is enough to stimulate the dynamically deranged vital force to bring the curative response. Moreover, as homeopathic medicines are similar symptoms producers, if applied in larger doses, it will bring medicinal aggravations. Hence, it is needed to reduce the material quantity of the drug by serial dilution process, known as potentization. In this way, medicines become stronger in healing effect without producing medicinal aggravations.
Doctrine of drugs proving
Drug proving is an investigation of the disease-producing ability of a drug, by applying it to healthy human beings until symptoms of illness appear. Drug provers are instructed to carefully observe and note all finer sensations, feelings and emotions, or any subtle deviations in the normal functioning of various organs and parts of the body. After proving is concluded, symptoms reported by the provers are collected, carefully assessed, evaluated, and classified. These proving reports are compiled in a systematic order in the homeopathic Materia Medica. Hahnemann suggested only such proved remedies are to be prescribed to treat patients, as these remedies have confirmed symptoms to treat cases having similar symptoms.
It is a prerequisite, to choose healthy volunteers for conducting drug proving because if a drug is proved on a diseased person, the symptoms of the disease will merge with that of the drug and a mixed picture will emerge. Drug proving also needs to be done exclusively on human beings as they can describe subjective sensations and feelings precisely and in detail. They can describe the exact locations, precise sensations and modalities (aggravation and amelioration) of the produced symptoms. They can also give a vivid picture of changes in mental state during proving and can describe their dreams, which denote the subconscious mind. These symptoms can never be elicited by proving on animals as they are not bestowed with intelligence and ability to communicate in the way a human can. Hahnemann proved 99 drugs in his lifetime and recorded the proving symptoms in Materia Medica Pura. After Hahnemann, his followers proved many more medicines which were compiled in the 12 volumes of Encyclopedia of Pure Materia Medica by Allen.[14] At present, more than 4000 homeopathic remedies are in use.
Theory of vital force
Hahnemann gave a vivid description of vital force in aphorisms 9–10 of Organon as, “In the healthy condition of man, the spiritual vital force, the dynamics that animates the material body (organism), rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purposes of our existence.”[4] “The material organism without the vital force is capable of no sensation, no function, no self-preservation; it derives all sensations and performs all functions of life solely by means of the immaterial being, the vital force which stimulates the organism in health and disease.”[4]
Thus vital force is the intrinsic life principle, the essence of the individual that animates the organism in health and disease. In health, it governs the life, coordinates all the bodily functions and maintains an equilibrium, a homeostasis. When a person becomes ill, it is only this spiritual vital force we call disease. And this vital force is primarily deranged by the dynamic influence on it of a morbific force (disease causing agent) inimical to life that furnishes the organism with disagreeable sensations and incline it to irregular processes, which we call disease. Hence, disease is nothing but a disordered state of vital force which leads to the manifestation of symptoms in various parts of the body. Hence, to cure a disease is to act on the vital force by a medicinal agent which has the capability to produce symptoms similar to the disease symptoms.
Doctrine of potentization of drugs
Hahnemann experienced that giving a drug to the patient according to law of similars, brought aggravation of symptoms of the patient, so he started reducing the dose of the drug by diluting with water along with some shaking. He kept reducing the dose by more and more dilution, which brought an unprecedented experience to him. He found the more he dilutes the drug, the less the aggravation of symptoms but more is healing effect. In this process of serial dilution of drug substance, a point arrived when no drug molecule remained in the solution but still the effect of drug remained. Hahnemann named this ultra-molecular process of preparation of drugs as dynamization or potentization of drug.
This created a controversy in the medical and scientific community that how a preparation of drug without a molecule of the original substance can act on a patient and cure a disease. This controversy continued from the time of Hahnemann till today. Many clinical trials have been conducted by homeopaths, Allopaths, and other scientists with these so-called potentized homeopathic drugs on various diseases, with positive outcomes in many instances. The latest scientific research on Hahnemann's theory of potentization was conducted by a famous French immunologist, Prof. Jaque Benveniste.[15] In this multi-center trial conducted in four countries, Benveniste found that highly diluted and potentized anti-IgE retained its effects in the absence of any molecule in the solution. He hypothesized that when a drug substance is diluted in water with strong shaking, the drug molecules make an impression on the labile molecules of water. These imprinted water molecules then carry the property of the drug in serial dilutions. However, many did not agree to this explanation, and they would rather choose to await an explanation from the scientists of molecular Physics.
Theory of chronic diseases[6]
A few years after starting homeopathic practice, Hahnemann noticed that some diseases recurred after initial cure and would not get cured permanently by the well-selected homeopathic remedies. He began an extended inquiry and research on this problem for 12 years from 1816 to 1828 and in the end published his findings in the book “Chronic Diseases, Their Nature and Homeopathic Treatment.” He said that in the past thousands of years, man had been suffering from chronic diseases caused by infection of some deep acting morbific agents, which he named “Chronic Miasms” as there was no better term in that time to signify these chronic infectious agents. After infecting the body, they manifested first by some eruptions or excrescences, such as itch vesicles, warts, or ulcers on the surface of the body. These, after suppressive local treatment, disappeared from the surface and went inward affecting the vital organs and then continued in different forms of diseases years after years, generation after generation. They often manifested by acute episodes in the name of different diseases and again became suppressed by high doses of allopathic treatment.
He classified these chronic diseases into three categories, such as (i) Psora, (ii) Sycosis, and (iii) Syphilis. He also described the symptoms of these chronic diseases in details and sorted out relevant remedies having similar symptoms complex from the material medica. He classified these remedies also into three groups as (i) anti-psoric, (ii) anti-sycotic, and (iii) anti-syphilitic remedies.
“Totality of Symptoms” as true picture of disease[4]
When the vital force of a person is disordered by a morbific agent, it will manifest symptoms of suffering in every sphere of the organism, such as mental, general and particular organs/parts of the body. According to Hahnemann, the totality of all these symptoms from all spheres of the patient collectively represents the true picture of the disease. This he called the Totality of Symptoms, which should be collected carefully during case-taking. This symptom complex is then to be matched with a drug of the homeopathic materia medica which has similar symptoms complex. It is not necessary to match all the symptoms; at least, the leading prime symptoms are to be similar. This well-matched remedy if administered to the patient will help remove his sufferings and restore the health.
The law of cure[16]
Formulated by Dr. Constantine Hering and published in 1865, the law of cure is regarded as Hering's law of cure. It states that after homeopathic treatment of a patient, the cure will follow certain directions, such as the disappearance of the sufferings from inner to outer spheres, from more vital organs to less vital organs, from above downward and in the reverse order of the appearance of the symptoms, the last ones will disappear first.
COMPARISON OF HOMEOPATHY WITH TRADITIONAL CHINESE MEDICINE
TCM is a system of medicine of at least 23 centuries old that aims to prevent or heal disease by maintaining or restoring yin-yang balance. A person is healthy when harmony exists between these two forces. Illness, on the other hand, results from a breakdown in the equilibrium of yin and yang.[17] One of the earliest known written records of Chinese medicine is the Huang di Nei Jing (The Yellow Emperor's Inner Classic) from the 3rd century BCE. This takes the theories of yin-yang, five elements, zang-fu organs, meridians and collaterals, mentality and spirit, qi, blood, body fluid, seven emotions, and six exogenous pathogenic factors, as the basic knowledge of TCM, and acupuncture and moxibustion as the main therapeutic techniques.[18] TCM may be compared with homeopathy in the following aspects.
Origin of homeopathy and traditional Chinese medicine
Homeopathy is a new system of medicine, discovered and founded by German physician Dr. Samuel Hahnemann in 1810 and has been practiced since a little more than 200 years. On the other hand, TCM practice began more than 3000 years ago by traditional Chinese healers, later on officially launched by the Yellow Emperor. He commissioned to compile an official text on the basis of shorter texts from different medical lineages, which is known as Huang Di Nei Jing (Inner Canon of Yellow Emperor), in the 3rd century BCE.
Basic principles of homeopathy and traditional Chinese medicine
Homeopathic medicine and its practice is governed by certain cardinal principles and doctrines, which are as follows: Law of similars, law of simplex or single remedy, minimum dose of medicine, doctrine of drug proving, theory of vital force, doctrine of potentization of drugs, theory of chronic diseases, totality of symptoms, Hering's law of cure, etc., which have been explained above. On the other hand, TCM is based on certain theories and principles, which may be enumerated as the theory of yin-yang, the theory of five elements, four body humors such as essence, Qi, blood and body fluid; Zang-fu organs, meridians and collaterals, TCM etiology and diagnosis, differentiation of syndromes, etc.[19]
TCM considers humans at the center of the universe as a sensor between celestial and earthly elements. Wood, fire, earth, metal, and water are the five elements of the material world. The world is a single unit and its movement gives rise to yin and yang, the two main antithetic aspects. The actual meaning of the term “yin and yang” is “opposites but interconnected,” such as positive and negative. However, TCM considers that yin and yang is not absolute but relative. Consistent with the modern view of homeostasis, yin and yang is interchanged to meet the view that “yang declines and yin rises” or “yang is raised to produce a decline of yin.” The four body humors (essence, qi, blood and body fluids) and internal organ systems (zang-fu) play an important role in balancing yin and yang in the human body. The proper formation, maintenance and circulation of these energies are essential for health. When the two energies fall short of harmony, the disease gains momentum. The physician takes into account this concept while treating patients. Herbs, acupuncture and moxibustion are usually used to correct this imbalance of yin–yang in the human body.
There are some resemblances between the vital force theory of homeopathy and Qi, essence, and yin-yang theory of TCM. Vital force is the spiritual, intrinsic dynamics that animates the whole organism, retains all the parts in harmonious coordination, controls all the functions, and sensations of the organism, without which it is incapable of self-preservation and existence. When the vital force is disordered by a pathogenic force, a person falls ill manifesting various symptoms. For treatment, it is required to stimulate the vital force by a potentized similar drug, which restores order and removes the sufferings. Qi and essence also act such as vital force, controlling and regulating all the functions of the organism such as promoting function, warming function, and defensive function. As long as, the balance is maintained between yin and yang the organism remains in health, whereas their imbalance leads to disease. The goal of treatment is to bring order and balance between yin and yang, thereby bringing back the Qi in order. In this way, both homeopathy and TCM are holistic medicines, treating the whole patient, not merely a part or organ of the body. Homeopathy's dictum “Treat the patient, not the disease” is also true for TCM.
Etiology of diseases
Homeopathy classifies etiology into the following (1) acute miasms, such as of sporadic diseases, endemic diseases and epidemic diseases; (2) chronic miasms, such as of psora, sycosis, and syphilis. Causation of diseases is also categorized as exciting causes, maintaining causes, and fundamental causes which are the chronic miasms.[4] On the other hand, TCM classifies the etiology of diseases as (1) six external evils such as wind, cold, summer heat, damp, dryness, and fire, that are the six climatic changes found in nature and pestilent qi; (2) Endogenous pathogenic factors, which are seven emotional factors such as joy, anger, melancholy, worry, grief, fear, and fright; (3) improper diet, overstrain, stress, and lack of physical exercise; (4) traumatic injury, insect, or animal bites; and (5) pathological products, such as phlegm fluid and stagnant blood.[17]
Diagnosis
Homeopathic practitioners rely on two types of diagnosis, such as (1) nosological diagnosis or diagnosis of the disease. It is done according to the procedures followed in conventional medicine. (2) Therapeutic diagnosis or diagnosis/selection of the remedy. It is done by detailed case-taking, sorting out thecharacteristic individualistic symptoms to constitute the totality of symptoms, and finding out a remedy from the materia medica, which bears the similar symptoms complex. On the other hand, TCM applies four diagnostic methods, namely, inspection, auscultation and olfaction, inquiring and palpation, to record the clinical data of the patient. These are analyzed to determine the causative factors and nature of the disease, thus providing basis for further syndromic differentiation. This enables the practitioner to determine at which stage the disease has progressed, its location and the degree of opposing force between antipathogenic qi and pathogenic factors, on the basis of which treatment is determined.
Treatment
Homeopathic treatment requires selection of the remedy and its potency, administering the remedy singly in one or divided doses, and the follow-up of the patient to see if there is any aggravation of symptoms, the appearance of new symptoms or no change in the existing symptoms. According to the follow-up observations, the practitioner makes the second prescription and continues as such till full recovery of the patient. In TCM, treatment is given according according to syndrome differentiations. The general principles of treatment are regulation of yin and yang; strengthening antipathogenic qi and eliminating pathogenic factors, distinguishing the primary from the secondary; treatment of diseases according to climatic and seasonal conditions, geographical locations and individual conditions.[17] The modalities of TCM treatment are herbal treatment, usually of multiple herbs; acupuncture and moxibustion; tuina massage therapy; regulation of diet and regimen, etc. All these modalities follow the theories and principles of TCM and may be given alone or in combination.
There are resemblances between clinical indications of many homeopathic remedies and that of acupuncture points. For example, indications of Taiyuan (LU9) resembles that of homeopathic remedies Sanguinaria, Carbo veg, and Ammon carb in respiratory complaints; Shenmen (HT6) resembles homeopathic remedies Crataegus and Aconite napellus in heart and mental complaints etc.[20] However, the indications of TCM herbal remedies and homeopathic remedies are for opposite conditions. Homeopathic remedies are prescribed on the basis of symptoms similarity with the disease, for example, a patient of diarrhea needs a homeopathic remedy which also causes diarrhea, say Podophyllum. However, in TCM, herbs in most cases are applied with opposite properties to the patient. For example, to clear off heat in a patient, TCM needs a cooling herb, say Shi Gao (Gypsum) [Figure 7].
Figure 7: Homeopathic globules and acupuncture needles
CONCLUSION
Homeopathy and TCM, differ vastly from one another as in time span and region of origin, years of practice, principles and philosophy, etiology and diagnosis, preparation of medicines, techniques, and modalities of treatment, yet they have also many aspects in common.
Both homeopathy and TCM are holistic medicines; they treat the patient wholly, not partly or only locally. Both acknowledge that there is an intrinsic and inherent life principle in the organism which controls the functions of all the organs and parts of the body in a unique coordination among them. This intrinsic principle is known as vital force in homeopathy and Qi in TCM. This keeps the organism in health, promotes growth and development, maintains its defensive power against pathogenic agents, but when disordered by morbific, noxious forces, the organism falls ill. In order to cure illness and restore the organism to health, it is the vital force or Qi which needs to be potentiated or balanced by a similar remedy in homeopathy and herbs or acupuncture-moxibustion in TCM.
There is another important aspect where both homeopathy and TCM coincide and it is the individualistic approach to treatment. Homeopathy says the disease is general but the patient is particular, which means a disease has many common symptoms found generally in all patients but still every patient has some individualistic symptoms that belong to him only. Therefore homeopathy selects medicine according to this individualistic aspect, so patients of a viral fever, dysentery, or headache though suffering from the same complaints need different remedies, the same is true for TCM.
In conclusion, it may be added that both of these holistic medicines may act as an adjuvant to each other in treating patients, acting synergistically. There may be randomized clinical trials to evaluate their efficacy alone or in combination in future.
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Conflicts of interest
There are no conflicts of interest.
