By Dana Ullman MPH
- At what point should a clinician consider using only homeopathic medicines?
- At what point should a clinician not consider homeopathic medicines and use only conventional therapeutics?
- And at what point should a clinician consider using both homeopathic and conventional medicines?
- These are all critical questions that will be increasingly asked as growing numbers of health professionals incorporate homeopathic medicines into their practice. The answers to these questions will not be hard and fast, for each sick person brings his or her own unique illness to the clinic, and each sick person has his or her own desires for how relief or cure should be obtained.
- In addition to what the sick person brings to the therapeutic encounter, each practitioner brings his or her own values, knowledge, competence in homeopathy, and competence in conventional therapeutics to the situation.
- And both patient and practitioner bring the various fears, anxieties, and emotional baggage to the relationship. If the patient or someone close to him or her recently had a bad experience with a conventional physician or with a homeopath, then this experience will affect their feelings about the type of treatment that is preferred. Similarly, if the practitioner recently experienced a malpractice suit, he or she may be more cautious in recommending alternatives or conventional therapeutics, whichever seemed to initiate the lawsuit.
- In other words, this article will not provide easy or quick answers to the above questions.
Practical and philosophical issues
- Hippocrates insisted that physicians “First, do no harm.” One can easily make a compelling case for why safer therapeutics should be considered first, thus leading modern clinicians to use homeopathic and other natural therapies before resorting to conventional medical treatments.
- Such a protocol would instantly make homeopathy and natural therapies into leading primary care treatments. Sadly, however, the biases against these therapeutic strategies have led to their disdain, rather than incorporation within our medical care system. These biases are finally diminishing, though there is still a long way for contemporary clinicians to go to attain a healthy attitude towards natural therapeutics.
- Using homeopathic medicines as a first mode of treatment in non-emergency primary care would lead to its application in a wide, even a very wide, assortment of acute care. At the most extreme extent, one could say that homeopathic medicines can and should be considered whenever some type of heroic medical treatment is not necessary. At the other end, one could say that homeopathic medicines can and should be considered only when there is no evidence that the benefits of a conventional medical treatment outweigh its potential side effects.
- One might think that a middle position is the best way to go. However, finding that middle position is not always easy. For instance, one might ask the seemingly important question: what evidence is there that either homeopathic or conventional medicine is more effective? There are very few studies that provide such a comparison, and even when it has been done, it is an unsound comparison. For instance, while it may be true that a painkiller will decrease the pain in patients more effectively than a homeopathic medicine, it does so with various side effects. And while a person taking a homeopathic medicine may initially have more pain than a person taking a painkiller, the long-term health of the person may be a more appropriate measure of a treatment’s successes.
- The problem with figuring out the costs and benefits of each treatment is that conventional physicians and homeopaths will have different analyses of the costs and benefits to each treatment. For instance, conventional physicians will acknowledge that cortisone has serious side effects, but they generally minimize them when used over a short period of time. Homeopaths, on the other hand, are considerably more cautious due to the fact that their detailed casetaking over the years has led to the frequent observation that cortisone and many other conventional drugs suppress a person’s minor illness into a considerably more serious ailment.
- Conventional physicians insist that a person’s new complaint is not related with the previous one, while homeopathic practitioners assert that nothing comes from nowhere and that disease is often built from previous illnesses.
- This debate will inevitably become more heated as increasing numbers of health professionals use homeopathic medicine in their practice and as these individuals begin to come to grips with the implications of homeopathic principles. This debate will benefit both patients and practitioners because there are important philosophical and therapeutic issues that homeopathy brings out which are not presently being addressed.
- Specifically, conventional clinicians presently do not even consider that their treatments may suppress a person’s disease and lead to a more serious complaint. While psychiatrists are intimately aware of the fact that people can suppress their feelings, which then leads to more serious problems, conventional physicians do not presently consider the possibility that certain drugs can suppress specific physiological responses of the body to infection or stress, thereby providing temporary relief of a problem but sometimes creating a deeper and more troubling condition.
- Most conventional physicians consider side effects to be the worst possible problem of conventional drugs. While the various short-term side effects can indeed be a problem, homeopaths assert that there are also long-term consequences to some pharmacological interventions. These long-term consequences are the result of a drug’s ability to inhibit the normal physiological responses of the body, thereby allowing the disease processes to be pushed deeper into the organism.
- Homeopaths consider the term “side effect” to be inaccurate and propagandistic term that mollifies its real actions. From a purely pharmacological perspective, drugs do not have “side effects” but only have “effects,” and that physicians arbitrarily differentiate those effects that they like from those they don’t like (calling these symptoms “side effects”).
- Ultimately, it will be difficult for clinicians to rely upon homeopathic medicines as the sole treatment modality until they have been adequately trained in its application. While most training programs in homeopathy are three or four years, these programs, as any homeopathic student or practitioner will tell you, are only the beginning of a homeopath’s experience.
- When practitioners have this training and 10 years of experience under their belt, I have little doubt that most practitioners will feel confident enough in homeopathic medicines to be the sole or primary treatment in the vast majority of primary care cases.
- Practitioners who have less training and experience will probably not be as confident in their use of homeopathic medicines as a primary treatment, except in those cases where there is no adequate conventional treatment, as is common in many viral infections, common infant complaints (i.e., teething and colic), premenstrual syndrome, and allergies.
At what point should a clinician not consider homeopathic medicines and use only conventional therapeutics?
- There are numerous clinical situations when conventional therapeutics need to be the primary treatment. However, even in the most dire circumstances that require heroic medical treatment, homeopathic medicines can be used concurrently. The only limitation to this is the limitation of the clinician’s knowledge of homeopathy.
- (An important book to help educate clinicians on how to use homeopathic medicine in emergency situations is: Thomas Kruzel, ND, The Homeopathic Emergency Guide, Berkeley: North Atlantic, 1992.)
- For instance, a person with a heart attack needs to be rushed to an emergency room, but this doesn’t mean that Aconitum, Arnica, Cactus, Glonoine, or another individually indicated remedy can’t help. In fact, the immediate use of homeopathic medicine can be literally lifesaving.
- Another example might be a herniated disk which requires surgical intervention. A homeopath would also recommend this important medical treatment, but might also prescribe Hypericum, Bryonia, Agaricus, Aesculus, or another indicated remedy. Further, after the acute attack has subsided, the homeopath might prescribe constitutional remedies to help strengthen the person’s overall health, potentially reducing the risk of another herniated disk.
- Some homeopaths assert that it is useless to consider using homeopathic medicines if the patient is taking steroid medications. Because these drugs directly suppress immune response, they inevitably inhibit the action of a homeopathic medicine. While this may be true, it does not necessarily mean that the indicated homeopathic medicine is totally useless. In fact, I have talked with numerous homeopaths who have told me that they have seen homeopathic medicines help the healing of people on steroidal medications, though admittedly, such healing tends to be slower than normal.
- The greatest problem that homeopaths experience in treating people who are taking conventional medications is that the drugs mask their normal symptoms, making the correct homeopathic prescription more difficult. This doesn’t mean that it is impossible to find the correct remedy. Admittedly, there is inadequate homeopathic literature on this subject; one good source of information is a two-tape series of lectures by the eminent homeopaths Roger Morrison, MD, and Nancy Herrick, PA, Treating Patients on Conventional Drugs.
- An integrative approach in which conventional treatments and homeopathic medicines are used can be highly beneficial in the treatment of numerous conditions.
- Childbirth presents many opportunities for integrative medicine. There are numerous homeopathic remedies that can prevent complications of pregnancy and labor, and when some type of medical intervention is necessary, whether it be cesarean section, episiotomy, or any other emergency procedure, there are homeopathic medicines that can aid in the healing from these interventions.
- While the use of homeopathic medicines can sometimes prevent the need for surgery, homeopaths acknowledge that surgery is sometimes necessary. When surgery is medically indicated, using homeopathic medicines before, during, and after the procedure can help the patient recover more rapidly.
- One classic example of the successful integration of conventional and homeopathic treatment was demonstrated in the study on Nicaraguan children suffering from diarrhea.(1) The children were given oral rehydration therapy, a special salt solution which keeps children from dying by helping them retain water, but does not cure the underlying infection of which the diarrhea is a symptom. The study showed that the administration of individually chosen homeopathic medicines sped up the underlying healing process.
- Other areas in which homeopathic and conventional therapies can be integrated have great potential but have not yet been adequately tested. Specifically, some homeopaths claim that homeopathically prepared doses of chemotherapeutic drugs can reduce the side effects of these drugs. Also, at least two studies in rats have shown that Ruta 30x and 200x and Ginseng 6x, 30x, and 200x can reduce the side effects of radiation, suggesting that these remedies should be tested as a way to reduce the problems associated with radiation treatment in cancer patients.(2) Some homeopaths also recommend the use of X-ray 30 just before and after getting x-rays.
- One of the more obvious ways that conventional and homeopathic approaches are already being integrated is in the field of diagnosis. Homeopaths presently use conventional medical technologies to diagnose a person’s disease, though their treatment is based on a homeopathic assessment of the totality of symptoms. Homeopathy may be particularly useful after diagnosis when the physician and the patient wish to seek safer, natural methods first and when there are no known medicines for the patient’s unique ailment. Also, the homeopathic approach which utilizes the totality of symptoms, including subtle symptoms, helps to prevent more serious conditions from developing in the future.
- An integrative approach can be helpful in the treatment of asthma. A study published in the Lancet showed that conventional allergy testing was useful in selecting a homeopathic medicine that provided benefit.(3) Researchers used conventional allergy testing to determine what substance people with asthma were most allergic to. They then gave this substance in homeopathic doses to the subjects, and these subjects had significantly fewer symptoms of asthma than those subjects given a placebo. The researchers called this approach “homeopathic immunotherapy.”
- An integrative approach may sometimes mean that homeopathic medicines are used first, and then, only if they were ineffective, would conventional therapies be used. The reverse approach is also possible and is presently more common; most people have already used many conventional treatments without adequate success and are now seeking homeopathic care for their conditions. As people become increasingly familiar with homeopathy, it is likely that they will use these natural and safer medicines prior to the more risky therapeutic interventions offered by conventional physicians.
- Part of the trick to making either homeopathic or conventional treatments work is to seek the care of well-trained professionals and to give their treatments reasonable time to act.
- Sometimes a person is in severe pain, and while it may be possible to find the correct homeopathic remedy, he or she wants a higher degree of certainty that relief will be rapid. In such instances, it makes sense to use conventional medicines at least temporarily, while homeopathic medicines are recommended after the acute crisis is diminished or over. Sometimes a person may receive both homeopathic and conventional medical care for a chronic ailment and not experience any relief. After at least six months of ineffective treatment, it may be necessary to get another opinion from another homeopath or conventional physician, or perhaps to seek another form of alternative care.
- Homeopaths commonly refer patients to various conventional specialists when they feel a specific diagnosis and/or treatment is important. And yet there are relatively few referrals to homeopaths from conventional physicians. Considering how many patients do not receive appropriate diagnoses or effective treatments for their ailments despite long-term conventional care, it is unfortunate that there aren’t more referrals to homeopaths. A significant obstacle to a more cooperative relationship between homeopathic and conventional physicians is conventional physicians’ lack of knowledge of homeopathy.
- Although the concept of integrative medicine makes sense, one should not have a “Pollyannish” viewpoint about the subject. It is not always easy or therapeutically effective to use homeopathic and conventional therapies concurrently or even in sequence. Sometimes a patient, with the advice of his or her physician, must decide to use one approach or the other.
- Ultimately, the role of the clinician is to inform patients of the risks and benefits from the various potential treatments available. Sadly, while there may be a body of research to show that certain conventional medical treatments are effective in treating a specific disease, a symptom, or a laboratory reading, this does not necessarily mean that this treatment actually improves the overall health of people. The same limitation can be said about homeopathic research to date. There is presently inadequate research about real healing.
- It is indeed difficult for clinicians to provide patients with hard and fast data for making easy decisions. Clinicians must, therefore, be humble, and they should remember the words of Hippocrates who insisted that physicians should: “First, do no harm.”
(1)Jennifer Jacobs, L. Margarita Jimenez, Stephen S. Gloyd, “Treatment of Acute Childhood Diarrhea with Homeopathic Medicine: A Randomized Clinical Trial in Nicaragua,” Pediatrics, May 1994, 93, 5:719-25.
(2)David Reilly, Morag Taylor, Neil Beattie, et al., “Is Evidence for Homoeopathy Reproducible?” Lancet, December 10, 1994, 344:1601-16.
(3)A.R Khuda-Bukhsh, S. Banik, “Assessment of Cytogenetic Damage in X-irradiated Mice and its Alteration by Oral Administration of Potentized Homeopathic Drug, Ginseng D200,” Berlin Journal of Research in Homeopathy, 1991, 1, 4/5:254. Also A.R. Khuda-Bukhsh and S. Maity, “Alteration of Cytogenetic Effects by Oral Administration of Potentized Homeopathic Drug, Ruta graveolens in Mice Exposed to Sub-lethal X-radiation,” Berlin Journal of Research in Homeopathy, 1991, 1, 4/5:264.