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Homeopathy: Report of the
Australian Committee of Inquiry (1977)

The founder of homoeopathy was Samuel Christian Friedrich Hahnemann. He was born in 1755 in Saxony; the son of a porcelain painter, he died a millionaire in Paris in 1843. Hahnemann had an orthodox medical training and practised as a physician.

According to Garrison's Introduction to the History of Medicine (4th edition, 1929), the concept of homoeopathy arose largely from theoretical systems of medicine that had carried over from the 17th century. In particular, Hahnemann adopted the 'doctrine of signatures' of Paracelsus, and, like Paracelsus, was strongly critical of the general standard of use of the materia medica of his time. The 'doctrine of signatures' held that diseases or symptoms of diseases are curable by those particular drugs which produce similar pathological effects upon the body (similia similibus curantur). The other two aspects of homoeopathy are: that the desired effect of drugs is heightened by giving them in infinitesimally small doses ("potentization") by dilution (of soluble drugs) or trituration (grinding up insoluble drugs with an inert substance); and that chronic diseases are a manifestation of suppressed itch or "psora." The basis of homoeopathy was expounded in his Organon der rationellen Heilkundel (Agents of Rational Therapeutics), published in 1810, and later books.

Homoeopathy and Orthodox Medicine

The Committee considers that there is in the minds of many practitioners confusion of terminology between allopathy and modern pharmacotherapeutics, and the meaning of these terms should be considered. Medicine in the 18th century lacked specific therapies for all but a very few conditions and treatments were based on the symptoms the patient presented. For the most part, the treatments were violent. Psychopathic patients were beaten, emetics and purging were common, and the success of bleeding and counter-irritation was measured by the pain the patient experienced. The last straw to Hahnemann was the death of Kaiser Leopold II of Austria, who died after four episodes of blood letting. This was allopathy, the treatment by opposites, at its most violent. To attempt to exsanguinate a patient after prolonged diarrhea in the face of repeated failure forced him to seek a more humane approach.

To label modern therapeutics as allopathy is completely inappropriate. Since the turn of the century, a range of drugs with scientifically proven efficacy has been available to medicine, drugs which are for the most part safe and often without side effects of an undesirable character. The use of hormone therapy is a good example, where the competent use of insulin, thyroid hormone, or steroids can restore patients experiencing a miserable life with shortened expectancy to normal or near-normal persons. The boon of anaesthetics, antihistamines, analgesics and antibiotics is universally known, and the terrors of infectious diseases are largely past history since the introduction of immunization. The management of the mentally ill has been revolutionized by the use of antidepressant drugs and tranquilizers, and hypertension can be relieved in a substantial number of cases.

It is true that side effects of drugs can be distressing, disabling and, occasionally, disastrous; but the answer lies in the more competent use of the best drugs of each type, not by a reaction against them and a backward step to ineffective therapies of the past.

Much of the emotive reactions against therapy stems from the news value of adverse reactions, and the enthusiasm of the media to denigrate the general success of therapy by concentrating on the failures that such powerful techniques inevitably include.

Hahnemann made two considerable contributions to modern medicine: firstly, he brought moderation to the practice of using massive doses of drugs at a time when the vogue in medicine was to push dosage to the limits of toxicity; secondly, he strongly advocated the use of single drugs and was strongly opposed to the use of the complex mixtures which were then a feature of pharmacopoeias.

Hahnemann's views were widely promulgated, and were espoused especially in the United States. In Britain, there was initially strong opposition from the orthodox medical establishment, but the empirical success of homoeopathic physicians at the time of a cholera epidemic, and royal patronage, finally won the day and allowed the establishment of homoeopathy in Britain.

Homeopathic Techniques

Hahnemann conceived the idea that "likes should be treated by likes," similia similibus curantur, from observations on.cinchona, the source of quinine, which caused the symptoms of ague and also cured malaria. The concept that disease is a vigorous attempt on the part of the body to throw off an illness was already appreciated, and Hahnemann postulated that the induction of such symptoms must inevitably assist in this process, although he appears to have regarded the quinine-induced fever as competing with the malarial symptoms rather than enhancing them.

Hahnemann followed a rigorous and critical attitude and therefore required all the drugs he used to be subject to "provings" on healthy people to establish the symptoms they would produce before they were used in treating the sick. The "provings" were most detailed observations in which no factor, however small, was to be overlooked.

Hahnemann's remedies were all single uncompounded substances of vegetable or animal origin -- a concept derived from Paracelsus, who preached simplicity in medicine as a reaction against polypharmacy and the search for the ultimate universal remedy which would cure all illness.

In his "provings," Hahnemann found that as he decreased the dose, the efficacy seemed to increase, even when the dilution was so great that the possibility of molecules of the original medicament being present was precluded.

The belief was also held that each patient was different in every way and that therefore there must be individual treatment of the patient, and not the disease, which had been the practice in orthodox medicine and still is largely the case today. Many homoeopaths believe that detailed diagnostic investigations are inappropriate as a patient is recognised immediately as requiring a particular homoeopathic remedy.

The foundation of homoeopathy rests then on three concepts: like cures like, the potentiation of drug action by dilution, and the individualization of treatment.

Until about 1940, homoeopathy was a commonly accepted and respectable form of therapy which might still have been included within the ambit of orthodox medicine if the introduction of modern pharmacotherapeutics had not demonstrated its superiority during the 1930s so clearly.

It is frequently claimed that some of our modern immunological techniques are a vindication of the principles of the Hahnemann system. The adoption of the multiple pressure method for smallpox vaccination is a clear example of microdose techniques and also of "like cures like." The protagonists of homoeopathy quote examples of a number of modern drugs that are therapeutically effective in microgram doses in support of their philosophy.

X-rays, curative in small doses, destructive in large, fluoridation as a preventive of dental caries, the effectiveness of hallucinogens such as LSD in microgram doses, are all cited as confirmation of the homoeopathic theory that small doses are curative and large doses toxic. They claim that future developments in medical science will further vindicate the case for homoeopathy.

The dilution concept of homoeopathy is based on the decimal or centesimal system. Decimal dilutions are denoted as 1X, 2X, 3X, . . . 30X, expressed as first potency, second potency, third potency, . . . thirtieth potency, and meaning one part in 10, 100, 1,000, 1030 (i.e. 1 followed by 30 zeros or one million, million, million, million, million); centesimal dilutions are denoted as 1C, 2C, 3C, . . . 30C, meaning one part in 100, 10,000, 1,000,000, . . . 1060 (i.e. 1 followed by 60 zeros). In the case of dilutions of the order of 20X, or 10C, there will be on the average, only one molecule of the postulated active principle in each litre of the preparation, and higher dilutions, or 'more potent' preparations in the homoeopathic jargon, will not contain the active principle at all. Although the concept of the microdose is acceptable to science without any difficulty, potentiation by dilution is not. The effects of LSD can be seen with doses of as little as 25 micrograms for a man, but the homoeopath finds the expression of this as 1/1,000,000th of an ounce more impressive. The pharmacologist recognises that the more specifically a drug is structured for its purpose or site of action, the smaller is likely to be the dose required.

Pharmacologists recognise a biphasic effect in drugs and chemicals whereby a small dose may cause a therapeutic effect and a large one a depressant or toxic effect, but for each property there is a clearly defined dose-response relationship in which increasing the dose increases the effect. This relationship is usually logarithmic, so that markedly decreasing the dose of a drug often still produces the effect. These observations can be demonstrated simply, and to the non-scientist the way in which an antibiotic such as penicillin may be diluted and its effectiveness still displayed against bacteria in the laboratory gives superficial support to the homoeopathic concept.

There is not one example in the whole area of pharmacology in which simple dilution of a drug enhances the response it produces any more than diluting a dye can produce a deeper hue, or adding less sugar can make food sweeter.

The classical books on homoeopathy examined by the Committee appear superficially to be reputable publications, but in most cases contain much nonsense which is totally unacceptable. For example, The Principles and Art of Cur by Homoeopathy (Roberts, H.A.), which was revised in 1942 (the copy in the Committee's possession being dated 1972 impression), contains material which is not only ridiculous but dangerous. The chapters on syphilis and gonorrhoea, which are referred to as "psora," "the syphilitic stigma" or "sycosis," are dangerous since these conditions respond to modern antibiotic therapy painlessly and certainly without any "allopathic dangers or brutality." The implication that the treatment of disease manifestations causes more serious disorders in other parts of the body is totally unacceptable.

There is a chapter on the "Phenomenological Viewpoint" which attempts to explain the "high potency" (very dilute) preparations of the homoeopath by claiming or implying that succussion or trituration releases some force from drugs analogous to radioactivity. The author displays such ignorance of radiochemistry that surely recent reprintings of the book should have been corrected.

A paragraph from page 267 is reproduced here to illustrate the serious nature of such misinformation:

Consider a patient with a heart condition who cannot endure high altitudes. We recognise this modality and look for the profound reason behind it. We are told that cosmic rays are five and one-half times as destructive at an altitude of 14,000 feet as at sea level. Cosmic rays are essentially destructive to all elements, especially the radioactive. Subjecting a patient hampered through his circulatory system, his vital balance already impaired, to forces known to be destructive might easily fall into the class of these conditions we recognise as being syphilitic or sycotic in origin (using syphilitic and sycotic in the sense of either the acquired disease or the inherited dyscrasia). The remedies applicable in these conditions, as we have pointed out previously, are remedies that in the majority are rated in the radioactive group.' We find the pharmacopoeias of homoeopathy, often termed "repertories," to contain much that is nonsensical and some items that are dangerous. The use of 6C sodium chloride is harmless and useless; the use of mercury or arsenic can only be harmful, even when greatly diluted. The use of nosodes -- preparations of bacterial origin -- such as Leuticum from the primary sores of syphilis or Medorrhinum from gonorrheal infections is probably not current today. Certainly the Committee has seen no acceptance of such preparations in Australia, and yet none of the homoeopaths interviewed made restrictions on such preparations that are found widely in their repertories. It could be argued that the nosodes were, in fact, the forerunners of the vaccines, antitoxins and toxoids of today. It must be understood that modern immunology stands on a very firm scientific foundation. Toxins and antitoxins can be titrated stoichiometrically [in quantitative accordance with the volume (or weight) ratio expected on the basis of the known chemical formulae of the toxins and the titrant] both in vivo and in vitro. Their effects increase with increasing dose. Toxins are attenuated and detoxicated so that their use is safe and highly effective

Mr A. Jacka, a prominent non-medical homoeopathic practitioner, stated:

Approximately 98% of homoeopathic remedies used (according to homoeopathic materia medica) have a vegetable origin. Concerning the other 2% most of these are mineral based, but as you are probably aware by now, there are a few which are derived originally from various disease products. For example, the remedy Bacillinum is prepared from the Tubercular Bacilli. However, the original solution is a sterile (or dead) solution. Furthermore, all homoeopathic remedies which are made from these disease products are never used below the 30th centesimal potency -- no molecules of the original substance can therefore be present. In actual fact, these remedies are mostly used in the two hundredth or higher potencies. On this basis, then, contamination of a patient by live bacteria will he impossible. Few practitioners use these preparations, but nevertheless, they are occasionally used with very great effectiveness in appropriate cases.

The Committee did not find any evidence of the commercial preparation of bacterial nosodes for homoeopaths and if such preparations are made by practitioners, which we doubt, such a practice is sufficiently serious to require punishment with the full severity of the law. Evidence has been brought before the Committee that the importation of 'high potency' remedies (extremely diluted preparations) is prohibited and Mr A. Jacka further states that these are rarely used:

Most homoeopathic remedies used by the profession, as I think I have mentioned before, are low potency ones used as mixtures in quite material doses and because they are mixtures depart from the original concepts of Hahnemann who relied on the single remedy theory. However, experience shows that these low potency remedies do, in many cases, work quite well for physically based complaints. On the other hand, many conditions having a mental or emotional basis or, more particularly, a genetic basis, require the use of a single high potency remedy if one is to obtain successful results.

The Medical Practice of Homoeopathy in Australia and the U.K.

The Register of the Faculty of Homoeopathy (U.K.) in 1972 listed three members and one medical associate in Australia. All four are registered medical practitioners, Drs. Geates, Miller, Winer and Gudenswager. In addition, the Committee had written and/or verbal submissions from a few other medical practitioners who had training in and practised homoeopathy. In general, medically qualified homoeopaths are of the opinion that full medical.training is a necessary prerequisite for the practice of homoeopathy. This matter is discussed below with reference to naturopathic homoeopathy. With respect to medical homoeopathy, the Committee is of the opinion that this would not be used to the exclusion of more appropriate remedies, and to the detriment of the patient. The London Homoeopathic Hospital has been cited repeatedly to the Committee as an example of official recognition of this therapeutic modality in a very mature society. It should be stated that we have ascertained that normal and appropriate therapeutic and surgical procedures are followed in this hospital, although it is likely that in conditions which are not specifically identifiable physicians practising there may use homoeopathic treatment as well. By virtue of the greater population of the U.K. alone, it is to be expected that even the rudimentary interest of medical practitioners in homoeopathy would inevitably involve greater numbers of doctors and patients alike. It is hardly necessary to state that only registered medical practitioners practise in that hospital and their selection of homoeopathy is unlikely to be disadvantageous to a patient.

Homoeopathic Preparations and Research

In Australia, homoeopaths purchase their remedies from commercial manufacturers, and a small amount is imported. Customs control prevents the importation of biological products so that nosodes are not imported, and the Committee understands that only 'low potency' (relatively strong) preparations are given entry. It is claimed that this presents some hardship to the practitioner, as the dilution by trituration and succussion requires ball mills and other devices, although dilution of liquid preparations is simple and, in view of the high dilutions, quite non-critical.

An extensive range of preparations, "oligoplexes," is made by Madaus and Co. of Cologne, and the Committee has examined research papers dealing with certain of these products. The products vary from purely homoeopathic preparations from herbs and chemicals in the "oligoplex" range to more generally acceptable medication such as "Convacard," an oral cardiac glycoside from Convallaria sp. and Aescin, a saponin from horse chestnut. It is on the latter preparations that the research of Madaus and Co. centres, and it is similar to that of other pharmaceutical manufacturers.

The outlook on these products is typically Germanic, where a strong interest in herbal medication is traditional. The Committee has seen no research papers on purely homoeopathic preparations. The logical trend in herbal medicina has been the isolation of the active principle and its use in pure form. For example, digoxin has entirely replaced digitalis in medicine in Australia, with increased precision of dosage and safety for the patient.

Recommendations

The Committee recognises that homoeopathy played an important role in the evolution and development of modern medical practice; however the Committee finds that the practice of homoeopathy cannot be supported by any scientific evidence. It does not believe that the practice is harmful except insofar as it may delay a patient from seeking appropriate medical assistance for a serious condition.

The Committee recommends that some control over the practice of homoeopathy for fee or reward is desirable and that vigilance should be directed to ensure that the standards of the premises in which homoeopathy is so practised, the manner in which such a practice is advertised, the sources of supply, quality and purity of the ingredients of extemporaneously prepared medicine and all other appurtenances relating to homoeopathy are adequate to ensure the public safety.

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Source: Webb EC and others. Report of the Committee of Inquiry into Chiropractic, Osteopathy, Homeopathy, and Naturopathy. Canberra: Australian Government Publishing Service, April 1977.

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This article was posted on December 5, 2001.