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 Homeopathy: Homeopathic Remedies vs. the Placebo Effect 
 
The art of homeopathic medicine today is all but unknown to the general public; and I would venture to say that a large majority of those who have heard of it, including most of our patients, believe in their hearts that the tiny granules that taste so sweet are in fact nothing but sugar pills, and that whatever results we may achieve clinically could just as well be attributed to our own personal or shamanistic powers, or to the patient's belief in them, or some combination of the two.

Nor does such a view necessarily imply any hostility to Homeopathy. Quite the contrary, it often reflects a deepening skepticism about all forms of treatment, especially the more aggressive modalities of conventional medicine, and even a humanistic preference for the "placebo effect", i.e., the ancient vis medicatrix naturae, the unassisted healing effort of the patient, as a model of the healing process in general.(1)

Moreover, it is a view that Homeopathy itself has never really refuted, partly because we still do not know how our medicines act, or how our patients are cured, and partly, I suspect, because our history as a persecuted minority makes us almost not want to know, or indeed to do anything else to attract further attention to ourselves. Nor is it by any means a simple matter to demonstrate the effectiveness of the high attenuations even to someone who is prepared to examine the evidence with an open mind.

Nevertheless, while it may be quite difficult to prove that our remedies actually work, there is a very substantial body of evidence that they do so; and, to refute the argument that they are placebos, it is not necessary to prove that they act curatively, which is of course a more complicated matter, but only that they act at all, that something happens as a result of their action, rather than simply on account of the interaction between the physician and the patient. Conversely, it is could be proved that our remedies were in fact nothing but placebos, let us by all means admit it with good grace, since, quite apart from having deluded ourselves all these years, knowingly giving placebos or just saying that we don't know would be incalculably simpler and less expensive than the elaborate rigamarole that we actually practise!

As many of you know, there have been a substantial number of experimental studies demonstrating that the homeopathic remedies in high dilution can stimulate or inhibit the growth of various bacteria, plants, molds, fruit flies, etc., as well as the enzymatic activity of some in vitro or cell-free systems. But, inasmuch as these have already been described fairly extensively in the literature, I will concentrate on the clinical data, where my own experience lies.

It seems to me that there are a considerable number of clinical situations in which we can show quite convincingly, albeit without any formal proof, that the homeopathic remedies act, or a least are capable of acting. In the remainder of this paper, I will try, first, to group these situations into categories, and, second, to give cases from my own records to illustrate them, insofar as possible.

1 . Cases where spontaneous recovery would have been highly improbable, or at least would have required a longer' period of time than was actually observed.


CASE 1. Respiratory distress of the newborn.

8-pound baby girl, full-term, born at home in February, 1976, following a prolonged second stage. The baby was born covered with meconium, took a single gasp, and failed to breathe after that. Suctioning of the oropharynx yielded copious thick meconium; endotracheal intubation was unsuccessful (cords not visualized). Heart rate 60 per min., color pale, almost white; no movement. The baby responded somewhat to mouth-to-mouth resuscitation, but could not sustain normal respiration as soon as it was stopped. Gave ARSENICUM ALBUM 200, 1 dose, dry, on the tongue. Almost instantly, the heart began to beat strongly, at a rate of 140 per minute; the child began breathing normally, with good tonus and normal reflexes, and became pink almost immediately. The whole evolution took at most a few seconds. From that moment on, the child continued to behave perfectly normally in every way, as if nothing had happened. She was hospitalized for further observation, but was discharged after 24 hours without any further distress or evidence of aspiration, and without any further medication being required.

I should say in retrospect that, inasmuch as the child was full-term and well-formcd in every respect, she would most probably have recovered eventually, even if the remedy had not been given; but I have no doubt that it would have required at least 24 to 48 hours in thc Newborn ICU, with oxygen, some form of assisted ventilation, and possibly other drugs as well. What was so unforgettable about this case was the extreme rapidity of its evolution, from a life-threatening emergency into a completely normal, stable pattern, in the space of a few seconds. What perhaps convinced me most was the look on my nurse's face, because she had had her ear glued to the stethoscope the whole time, and had not even seen me give the medication. Less than a second after I gave it, she looked up at me in blank amazement, handed me the stethoscope, and asked, "What happened?" These are the experiences that arc imprinted for life in every practitioner's mind.


CASE 2. Breech presentation.

23- year old primigravida, EDC 8 January 1976. Routine prenatal visits: good health, vertex presentation.

15 December 1975. Routine checkup: complaining of increased pressure and movement in suprapubic region. FHT heard in RUQ at 138 per min Definitely breech. Gave PULSATILLA 6x ii t.i.d.

18 December. Mother noted violent movements on the night of the 16th again on the 17th. Position now definitely vertex; FHT heard in LLQ at 150 per min. No other complaints.

5 January 1976. Delivered 7 lb. 6 oz. baby girl after short labor, ROA; no problems.

This was the first breech presentation I had ever turned with PULSATILLA. I had recently read a number of accounts in the old literature recommending its use prior to engagement, or at lest prior to labor. On the other hand, a fairly high percentage of breeches will revert spontaneously in the final weeks, in spite of our best efforts. It was purely circumstantial evidence that led me (and the patient) to believe that the remedy had acted in this case. I used a low potency because the patient otherwise had no symptoms, and I was looking for what could be described as a physiologic effect.


CASE 3. Breech presentation.

24-year-old primigravida, EDC 8 February 1980. Feeling well; no complaints. 16 November 1979. Routine checkup: fundus 25cm., FHT heard in RUQ. Definitely breech. No treatment.

13 December. No complaints; baby still breech. Gave PULSATILLA 6x ii t.i.d. for 4 days. No change.

11 January 1980. Status quo: position unchanged. Discussed possibility of hospital birth. Gave PULSATILLA 30, I dose, dry t.i.d. for 4 days. No change. 17 January. Ultrasound confirmed breech presentation single fetus.

21 January. Still no change. Gave PULSATILLA 200, I dose, dry daily for 4 days.

25 January. Awoke on morning of the 25th after normal sleep, but baby "felt different." Definitely vertex; no other complaint.

4 February. Delivered 7-pound baby boy, at home, after average labor; position LOA. No other problems.

Here again, the evidence was circumstantial, but quite convincing. I should mention that from November on the patient was also doing special exercises for converting the breech, and was receiving acupuncture treatments for the same purpose. But these measures were going on more or less continuously. It was actually the potency that appeared to make the difference in this case: both the 6 x and the 30th produced markedly increased fetal movements, but no change m position, whereas the 200th had no effect on fetal movement, but the patient awoke from a sound sleep with the abnormal position corrected.

2 . Cases where conventional medicine had been tried unsuccessfully or the pa tient had been recommended for surgery, yet were cured or at least significantly helped with homeopathic remedies.


CASE 4. Epilepsy.

4-year-old boy from Hobbs, N.M., with long history of febrile convulsions, and 7-month history of minor seizures. Parents separated when mother was 5 months pregnant, divorced shortly after the birth; mother promptly remarried. Birth was normal and uneventful. Febrile convulsions at 4 months, followed by rash (possibly roseola), and several time thereafter, in the course of acute tonsillitis, otitis media, etc. The seizures were all of the grand mal type, and treated successfully with phenobarbital. Otherwise, the child appeared to be developing normally and in good health, until March 1976, when in the course of a simple URI, with low fever, he developed persistent grand mal seizures and was hospitalized. The EEG was inconclusive. His seizures were controlled with Dilantin and phenobarbital; he was discharged on maintenance doses of both drugs. After a few weeks, he began having many brief episodes of the petit mal type, in which the body stiffened, the head was thrown back, ,the back arched, and the mind would go blank for a few seconds; about half of the time, he would fall to the ground. Zarontin was then added to the regimen, in place of the Dilantin. At the time of his first visit, he was having perhaps 15 to 20 of these episodes daily; the mother had discontinued all medications for 2 weeks at my request.

5 October 1976. First visit: child extremely hyperactive, continually interrupting; speech slurred. Physical exam normal, but twice interrupted by hyperactive episodes. Gave CALCAREA PHOSPHORICA 200, 1 dose, dry plus CALC. PHOS. 6x ii q.i.d. as needed.

25 November. Mother telephoned. Child much improved for about 2 weeks, then old symptoms returning in force for the past 3 days. Gave HYOSCYAMUS 200, 1 dose.

20 December. Mother telephoned. General condition much improved; speech, appetite, hyperactivity much less troublesome. Still fairly frequent petit mal episodes, approx. 6 per day, plus occasional generalized clonic seizures, without loss of consciousness. Gave OPIUM 200, 1 dose.

18 January 1977. Mother telephoned. Several more clonic episodes, similar to above, with continued improvement in general condition; speech "back to normal." On 10 January, had a severe grand mal seizure, followed by long deep sleep. No seizures at all since then. No treatment.

2 April. By letter: good appetite, doing well in public school; no seizures of any kind.

26 August. By letter: moving to Florida, sent for medical records. Perfectly healthy in every respect; no seizures of any kind.

This case was noteworthy because of the suppressive effect of the anticonvulsant drugs, which abolished thegrandmalactivity but produced petit mal in its place. The treatrnent therefore had to proceed "backward" to the grand mal again, before complete cure could occur.


CASE 5. Renal calculi; obstructive uropathy.
31-year-old surveyor, with long history of kidney stones.

24 January 1976. First visit. History of stone began in 1972, passed spontaneously; intermittent flank pain since then. Complaining of severe, intermittent left CVA pain for 5 days, radiating to and from the bladder, associated with obstructed urination, and large amounts of sediment in the urine, resembling shreds of tissue. IVP showed 2 large calculi completely obstructing the left uretero-pelvic junction, with considerable hydronephrotic enlargement of the left renal pelvis and calyces. His family physician had recommended immediate surgery. Gave BERBERIS VULGARIS 200, 1 dose and 6x ii q.i.d.

26 January. Pain considerably lessened, almost gone: now merely a dull ache. Gave OCIMUM CANUM 200, I dose, followed by CALCAREA RENALIS 6x ii q.i.d.

16 February. Pain mild, now chiefly in the bladder area, with occasional stinging and dysuria at the urethral meatus. No treatment.

26 February. Much better. Still has occasional twinges of pain, but feels that the obstruction has been removed. No treatment.

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 About The Author
Richard Moskowitz MDRichard Moskowitz was born in 1938, and educated at Harvard (B.A.) and New York University (M.D.). After medical school he did 3 years of graduate study in Philosophy at the University of Colorado in Boulder on a U. S.......more
 
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