The Miasm Theory of Disease

Living in Denial

In 1828, Hahnemann published his book The Chronic Diseases, in which he described his theory of miasms as the origin of disease. The three “miasms” described in this book “are held to be responsible for all disease of a chronic nature and to form the foundation or basis for all disease in general”1. Miasms are supposedly ways in which a person’s “vital force” can be tainted, and homeopaths maintain that they are heritable2.

This idea of Hahnemann’s both predates and opposes the modern established science of germ theory, stating that all contagious diseases are caused by microorganisms3, which is a fundamental part of modern medical science. Basically, Hahnemann’s opposing theory has been disproven.

However, Hahnemann’s 19th century theory of miasms as the origin of chronic disease is alive and well in the practice of homeopathy, where it is “now generally accepted by most homeopaths without question”1. While actual medical doctors recognise that infectious diseases such as influenza are caused by microorganisms and are able to effectively treat them as such, homeopaths that subscribe to Hahnemann’s outdated miasm theory of disease are still claiming that the predominant cause of all chronic disease is the miasma known as Psora, or “itch”.

Essentially, these homeopaths are living in denial – trying to practise medicine as though germ theory has never even occurred to anyone. Trying to practise medicine, essentially, as though it were still prior to the 1860s.

It is worth noting, however, that at the time of its inception homeopathy appeared to be effective. The reason for this is that contemporary medicine, consisting of practices based on the misguided idea of the four humours (such as bloodletting), tended to do more harm than good.

In contrast, homeopathy had no active effect on its patients, although it would elicit a similar placebo response (a phenomenon unheard of in those times) to the harmful treatments, without the same detrimental effects. As a result, those treated by contemporary medicine would tend to do worse than those left untreated, who would again tend to do worse than those treated with homeopathy. Even though the homeopathy itself had no effect, it seemed to be effective.

Today, however, we know better. When compared against a similarly administered placebo, the effect of homeopathy is shown again and again to be no stronger. While there may be some statistical flukes in which the result is in the favour of one or the other (if you test something enough, occasionally you’ll get a strange result simply by chance) the overall body of scientific evidence points overwhelmingly toward the conclusion that homeopathy is nothing more than a placebo.

References

  1. Morrell, Peter. Hahnemann’s Miasm Theory and Miasm Remedies. Homéopathe International [updated 24 December 2004; cited 04 April 2012]. Available from: http://homeoint.org/morrell/articles/pm_miasm.htm
  2. Modern Homoeopathy. [cited 14 April 2012]. Available from http://www.modernhomoeopathy.com/miasms.htm
  3. WordNet Search. Princeton University [cited 04 April 2012]. Available from http://wordnetweb.princeton.edu/perl/webwn?s=germ+theory

Homeopathic Dilutions

Much Ado About Nothing

After realising that giving sick people substances that caused the very symptoms he was trying to cure, Hahnemann realised that something needed to change. Instead of deciding that his principle of “like cures like” was perhaps wrong, Hahnemann decided that instead what he needed to do was dilute his remedies.

Hahnemann went further than simple dilution, however. His idea involved serial dilutions, with each step punctuated by a vigorous shaking of the dilution container. According to Hahnemann this shaking, known as “succussion”, would activate the “vital energy” of the substance1. It is here that homeopathy essentially became magic.

According to homeopathy, this process of serial dilution and succussion would prevent a substance from causing the symptoms that it could be expected to cause when given to a healthy person but still allow it to cure those symptoms via the (incorrect) principle of “like cures like”.

The claim becomes even more scandalous when you realise just how far homeopathic remedies are diluted. Each step of a serial dilution is generally a dilution of 1 in 10 or 1 in 100. The number of steps, size of each step and sometimes the method used are labelled on the remedy. The number of steps comes first, followed by the size of each step represented by a roman numeral. For example, a dilution of 30C (a common homeopathic dilution) consists of 30 steps of a 1 in 100 dilution.

Let me say that again. A common homeopathic dilution involves diluting the original substance by 1 in 100 30 times. As an example, let’s imagine a homeopathic dilution of gold (which was one of the common remedies listed on ABC Homeopathy – listed as “Aurum Metallicum”), starting with an enormous but simple amount of one mole. From Avogadro’s constant, which was unknown during homeopathy’s inception, we know the number of atoms or molecules in one mole. For gold, this amount would weigh about 200g; if it were a cube would be just over 2cm across.

After 10 dilutions of 1 in 100, we would expect to have just over 6000 atoms remaining. After 12 dilutions, we’re almost just as likely to have a single atom left as we are to have none at all. After all 30 dilutions, the probability that there is even a single atom remaining is astronomically low. So low, in fact, that for all intents and purposes it should be considered to be 0.

Now, let’s take another approach to our thought experiment. We know that the total number of atoms in the visible universe is likely to be somewhere between 1078 and 1082. Taking the liberal estimate of 1082, we can estimate the same dilution of 30 serial dilutions of 1 in 100 on the entire known universe. At the end, we would expect to have around 1022 atoms left, which is about 1/60th of 1 mol – the number of molecules in 0.3 mL of water. And that’s from the entire universe! Homeopathic dilutions that go so far as 200C are far from unheard of, either.

The idea that homeopathic remedies supposedly become stronger as they become more diluted (when dilution is accompanied by succussion) goes directly against the dose-response relationship. There has never been a plausible mechanism put forth by which shaking a solution can impart any properties of the diluted substance to the diluent. What’s more, the claim that such a phenomenon exists at all has not held up to rigorous scientific testing.

However, the fact that homeopathic remedies rarely contain any of the original active ingredient likely won’t bother many homeopaths. The reason for this is that, supposedly, the act of succussion at each dilution step “releases and concentrates the spirit-like, healing essence of the substance derived from its animal, botanical or mineral source”1. Basically, this process of “Dynamization” removes all material trace of the original medicinal substance and leaves behind only its “spirit-like, healing essence”. To quote Hahnemann himself2:

The homœopathic healing art develops for its purposes the immaterial (dynamic) virtues of medicinal substances

It isn’t usually marketed this way, but homeopathy can be placed squarely in the pseudoscientific category of so-called “energy healing”.

References

  1. Glossary of Homeopathic Terms. Omaha: Creighton University School of Medicine [updated 03 August 2009; cited 04 April 2012]. Available from: http://altmed.creighton.edu/Homeopathy/Glossary.htm
  2. Hahnemann, Samuel “§ 11”, “§ 270” Samuel Hahnemann’s Organon of Homœopathic Medicine. New York: William Radde, 1849. 99, 217. Google Books. Web. 04 April 2012.

Homeopathic Provings

Dreams of Robbers

Experiments such as Hahnemann’s with conchina bark, during which a healthy person is dosed with a substance and all subsequent experiences are recorded, became known as “provings” and have since been the method by which homeopaths determine which symptoms a particular substance is supposedly appropriate to treat. The main reference of this information is the Homeopathic Materia Medica, an online version of which is available – Homœopathic Materia Medica.

Of course, because no distinction is made between reactions to the substance being “proved” and unrelated experiences, these tests are incredibly lacking in scientific rigour. To demonstrate this, here are some examples from the entry on “Natrium Muriaticum”1:

Wants to be alone to cry

Aches as if a thousand little hammers were knocking on the brain

Pain in eyes when looking down.

Vesicles and burning on tongue, as if there were a hair on it

Sweats while eating

Craving for salt

Dreams of robbers

Keep in mind that “A proving is the testing of a potentized substance to find out which symptoms that substance is capable of producing, and hence curing.”2, so apparently a homeopathic remedy of this “Natrium Muriaticum” is capable of curing these symptoms, amongst others listed in the Materia Medica.

Homeopaths seem to love using latin names for the substances used to create homeopathic remedies, presumably because it makes them sound scientific yet natural, as latin scientific names generally refer to plants and animals. It also has the convenient side effect of preventing the vast majority of people from having any idea what the substance actually is. This “Natrium Muriaticum” is most commonly known as table salt.

To demonstrate this point, I used Google to search for “Homeopathic Remedies” and found ABC Homeopathy to be the top result. On its home page, 36 homeopathic remedies are listed as the “Top Homeopathic Remedies”, each of which are “widely used in homeopathy”3.

I’ve listed some examples from that list here, first as they are listed on the site and then by a more common name, along with a few examples of the symptoms they’re supposed to treat*. Keep in mind that these symptoms were ascertained via a homeopathic proving, wherein a healthy individual is dosed with the substance in order to find out what symptoms it causes2. Reading through the lists of symptoms, it’s sometimes hilarious to read everything they thought was caused by the substance, and often sickening to read a report of the aftermath of a poisoning. Remember, by the tenets of homeopathy, the symptoms listed for each substance are those that can be cured by a homeopathic remedy of the substance.

  • #6. Pulsatilla Nigricans (A highly toxic flower once used by Blackfoot Indians to induce abortions4)
    • Fears in evening to be alone, dark, ghosts
    • Flatulence
    • Numbness around elbow
  • #8. Sepia (Cuttlefish ink)
    • Indifferent to those loved best
    • Hair falls out
    • Pain in teeth from 6 P.M
  • #9. Rhus Toxicodendron (Poison ivy)
    • Thoughts of suicide
    • Jaws crack when chewing
    • Desire for milk
  • #10. Natrum Muriaticum (Table salt, I mentioned earlier some examples of what it supposedly treats)
  • #11. Mercurius Vivus (Mercury, I’ve also seen this listed as a remedy ingredient under the name Mercurius Sol – short for Mercurius Solubilis)
    • Thinks he is losing his reason
    • Sneezing in Sunshine
    • Sweetish metallic taste
  • #12. Belladonna (Deadly nightshade)
    • Patient lives in a world of his own, engrossed by spectres and visions and oblivious to surrounding realities
    • Loss of consciousness
    • Constant moaning
  • #28. Conium Maculatum (Hemlock, a poisonous plant that was historically used as a method of execution, notably for the Greek philosopher Socrates)
    • Photophobia and excessive lachrymation (Fear of light and excessive crying)
    • Painful spasms of the stomach
    • Heavy, weary, paralyzed; trembling; hands unsteady; fingers and toes numb
  • #34. Petroleum (Okay, this name is honest enough, but still worth mentioning. Petrol is one of the top homeopathic remedies?)
    • Loss of eyelashes
    • Strong aversion to fat food, meat; worse, eating cabbage
    • Herpes

Hahnemann eventually realised that giving a sick person a substance that causes the symptoms they already had tended to exacerbate their illness rather than cure it. Instead of deciding that he was wrong, and realising that “fight fire with fire” actually isn’t particularly appropriate in the field of medicine, he came up with a rather odd idea… Homeopathic Dilutions.

* It’s interesting to note that this site has what’s known as a quack Miranda warning. In this case:

This site is for information only and is not a substitute for professional medical advice.
Nothing on this site is a recommendation as to how to treat any particular disease or health-related condition.
Not all conditions will respond to homeopathic treatment.

You’ll see a warning like this quite commonly on sites that sell unproven, untested or even disproven remedies, such as this one. It’s basically their way of covering their tracks in case a customer realises they’ve effectively been conned and decides to become litigious. It’s a good idea to treat a warning such as this one as a big red flag.

References

  1. Boericke, William. Natrium Muriaticum. Homœopathic Materia Medica [updated 23 December 2004; cited 04 April 2012]. Available from: http://homeoint.org/books/boericmm/n/nat-m.htm
  2. What is a Proving. New York School of Homeopathy [updated 27 August 2011; cited 04 April 2012]. Available from: http://www.nyhomeopathy.com/provings.htm
  3. ABC Homeopathy. ABC Homeopathy [cited 04 April 2012]. Available from: http://abchomeopathy.com/
  4. Pulsatilla. Wikipedia, the free encyclopedia [updated 24 January 2012; cited 04 April 2012]. Available from: http://en.wikipedia.org/wiki/Pulsatilla

The Birth of Homeopathy

Similia Similibus Curantur

Homeopathy was invented in the late 18th century by the German physician Samuel Hahnemann1. Hahnemann was very gifted with languages, and at this point in his life he made a living from writing and translating2. In 1790, while he was translating a medical text – Professor William Cullen’s Materia Medica (Vol. 1, Vol. 2) – into his native German he read a claim about the use of the bark of the Cinchona plant (called Peruvian Bark in Cullen’s text) in treating “intermittent fevers” (it was, in particular, used as a treatment for malaria). Cullen claimed that the bark worked in this case due to its effect on the stomach3:

I consider the Peruvian bark… to be a substance in which the qualities of bitter and astringent are conjoined.

As a bitter and astringent conjoined, I consider the bark as a powerful tonic.

It is in no instance, however, more remarkable than in the cure of intermittent fevers. That the bark in this case operates by a tonic power exerted in the stomach…

Hahnemann did not believe this claim, and decided to test it by dosing himself with the bark and recording its effects on his body. He dosed himself with “four good drams of Peruvian bark, twice a day for several days”, and instead of finding that it affected his stomach as Cullen claimed it would, Hahnemann recognised its effects as being very similar to the symptoms of the fevers which are meant to be treated by this bark*. It is from this experience that he thought up the first homeopathic principle: “similia similibus curantur“, most commonly translated as “like cures like”.

It is from this principle that Hahnemann derived the term homœopathy (it is now usually written “homeopathy”, although you may also encounter “homoeopathy”) from the greek homœ-, meaning “similar” and -pathy, meaning “suffering”. In contrast, he also created the term “allopathy”, which he used to refer to forms of medicine that attempted to treat disease via mechanisms that oppose their symptoms (greek allo-, meaning “other”). Considering its origin, this term is generally considered derogatory, and you’ll rarely see it used today except by homeopaths and their sympathisers.

* It’s worth noting that in 1820, 30 years after Hahnemann’s experiment with conchina bark, French chemists Pierre-Joseph Pelletier and Joseph-Bienaime Caventou isolated the chemical quinine in conchina bark4, which was used as a treatment for malaria until the 1940s5.

References

  1. History of Homeopathy. Omaha: Creighton University School of Medicine [updated 03 August 2009; cited 04 April 2012]. Available from: http://altmed.creighton.edu/Homeopathy/history.htm
  2. Grimes, Melanie. Samuel Hahnemann, Founder of Homeopathy. Knol [updated 07 August 2008; cited 04 April 2012]. Available from: http://knol.google.com/k/samuel-hahnemann-founder-of-homeopathy
  3. Cullen, William “Tonics” A treatise of the Materia Medica, Volume 2. Edinburgh: printed for Charles Elliot, and for C. Elliot & T. Kay, London, 1789. 90-91. Google Books. Web. 31 March 2012.
  4. Quinine. Medical Discoveries [cited 04 April 2012]. Available from: http://altmed.creighton.edu/Homeopathy/history.htm
  5. Quinine – a miracle against malaria. Human Touch Of Chemistry [cited 04 April 2012]. Available from: http://www.humantouchofchemistry.com/quinine-a-miracle-against-malaria.htm

World Homeopathy Awareness Week

This week – from April 10* to April 16 – is World Homeopathy Awareness Week, and I’m going to do my part with a series of posts on what homeopathy is and why it’s a problem. This is probably not what the organisers of the event had in mind, I’ll admit, but of course I plan on only telling the truth, and I think this needs to be said.

In my experience, many people have heard of homeopathy, but few know much about it. The fact that it’s a type of “alternative medicine” seems commonly known, but what separates it from other types of “alternative medicine” not so much.

I see this as a problem, so this World Homeopathy Awareness Week I’m going to do my best to raise awareness of homeopathy and what it is. I will do my best not to misrepresent the practice, as I see the truth of homeopathy as being damning enough. Hopefully, after this week, you will feel the same way.

  1. The Birth of Homeopathy
  2. Homeopathic Provings
  3. Homeopathic Dilutions
  4. The Miasm Theory of Disease

* This April 10 marks what would have been the 257th birthday of the inventor of homeopathy, Samuel Hahnemann.