“Symptoms,” Continued
Part II of this blog† introduced the homeopathic understanding of “symptoms” as they pertain both to “provings” in healthy subjects (now called “homeopathic pathogenic trials” or “HPTs”) and to histories elicited from patients. Hahnemann conflated “symptoms” and every random itch, ache, pain, sniffle, feeling, thought, dream, pimple or other sign, and anything else that might occur to a subject or a patient. This was amply demonstrated by Oliver Wendell Holmes, Sr., who seemed to doubt that such a morass would yield useful information. As unlikely as it may seem, today’s homeopaths are every bit as whimsical in their elicitation of “symptoms” as was Hahnemann.
The following examples are quoted from Homeopathic Medicine for Children and Infants by Dana Ullman, MPH, a contemporary homeopath who is respected in “integrative medicine” circles. Notice the ambiguous warning in his introduction:
Asthma is a potentially serious and even life-threatening condition. Infants and children with asthma should receive medical attention. Conventional drugs used for treating asthma, particularly steroids, can impair immune function and lead to more serious health problems. Homeopathic constitutional care is necessary to achieve a lasting cure of asthma, while the following remedies can often be helpful in reducing the distress that an acute attack can create.
Aconitum: This remedy is very useful at the very beginning stages of onset of asthmatic breathing. Noticeably present is anxiety, fear, and restlessness with the asthma.
Antimonium tart: The characteristic symptom of children who need this remedy is a rattling cough with an inability to expectorate mucus. Their condition is sometimes precipitated after being angered or annoyed. They feel drowsy, weak, and feeble, and their symptoms are usually worse at 4 a.m. Their difficulty in breathing may cause them to sit up rather than lie down. Concurrent with these breathing difficulties is anxiousness, restless, and irritability. They feel chilly but are averse to stuffy warm rooms and desire cool rooms and open windows. This remedy is rarely given at the beginning of an illness.
Arsenicum: Restlessness and anxiety are prominent with asthmatic children who need this remedy. As the asthma continues, they get more and more frightened and agitated. Their symptoms are worse from midnight to 2 a.m., and they will toss and turn in bed, unable to find a comfortable position. Their breathing is best when sitting erect. Despite their restlessness, they are tired and weak. They are very chilly and better by warmth. They are noticeably thirsty but for only sips of water at a time.
Chamomilla: This remedy should be considered for asthma brought on after a tantrum. Chamomilla children are very impatient during their suffering. They have a hard, dry cough during sleep, and their difficult breathing is relieved from bending their head backwards, being in cold air, or drinking cold water.
Ipecac: Persistent nausea with a loose cough and a rattling in the chest but an inability to expectorate are characteristic of children who need this remedy. They have wheezing and tenacious mucus that is blood-streaked. Vomiting provides some relief of their symptoms because it helps to eliminate some mucus. Their symptoms are worse in hot, humid weather and are aggravated by the least motion. They experience cold perspiration of the extremities. They may also have difficulty sleeping and excessive salivation.
Lobelia: This remedy is known for curing asthmatic breathing concurrent with nausea and vomiting. These children usually have prickling sensations all over, even on the fingers and toes, that precedes the asthma. The asthma is aggravated by exposure to cold. The child may feel weakness in the pit of the stomach and a sensation of a lump above the sternum (the chest bone).
Nux vomica: This remedy is good for treating asthma when children have fullness in the stomach, especially in the morning or after eating. They have asthma with choking, anxiety, pressure in the pit of the belly, humming in the ears, quick pulse, and sweating. Their attack is sometimes incited by hay fever. They feel they must loosen clothing around their waist. Emotionally, they are more irritable than fearful.
Pulsatilla: These children have asthmatic breathing in warm or stuffy rooms, in warm weather, or after eating fatty or rich foods. They want windows opened and cool air. They are more apt to have breathing difficulties in the evening, especially after a meal. They crave sympathy and the company of others. They are very clingy and needy. They are highly impressionable: if parents are anxious about the child, the child becomes more anxious, but if parents are confident in the child’s ability to get healthy soon, the child will be soothed.
Sambucus: These children get their asthma attack during sleep, commonly awakening them at 3 a.m. Their breathing is obstructed when they lie down and partially relieved when they sit up as they gasp for air. Their breathing improves while they sit up, but then is aggravated when they lie back down to sleep, only to rise again gasping for air. They sweat profusely during their waking hours but tend not to perspire during sleep.
Spongia: This remedy is known to be helpful for children with asthma who have a dry, barking, croupy cough. Their air passages are dry, the sputum is absent, and the voice is hoarse. The asthma and coughing can be exacerbated by cold air, warm rooms, tobacco smoke, talking, lying with the head low, drinking cold fluids, or eating sweets. The symptoms also tend to be worse in the early part of the night. Warm food or drinks, even in small doses, provide some relief, as does sitting up and leaning forward.
Homeopaths at the most conspicuous levels of academic “CAM” are no more discriminating. The following excerpts are from a book co-written by a past Director of the NIH Office of Alternative Medicine, who is now President and CEO of the Samueli Institute, which receives millions of dollars of federal grants for its Center for Research on Integrative Medicine in the Military; and by a past President of the American Institute of Homeopathy, who is Clinical Assistant Professor, Dept. of Epidemiology, University of Washington in Seattle:
Pulsatilla: “…indicated for the child who is very weepy and clingy, and wants to be held…the child’s mood is extremely changeable…better in the open air…very little thirst, refusing to drink…often a nasal discharge with thick yellow or green mucus.”
Belladonna: “…for the earache that comes on suddenly and with great intensity. The fever can be as high as 104º with a bright red, hot, flushed face and dilated pupils…there can also be delirium during sleep, with nightmares, especially of animals, causing the child to cry out.”
Chamomilla: “The child is extremely irritable and changeable, not knowing what he wants…the only thing that will calm him down is to be carried back and forth continually…Green stools are a common accompanying symptom, especially in cases of otitis that are associated with teething.”
Hepar Sulphur: “…indicated in a child who is very chilly…the ear pain is…a sticking or poking pain…worse from exposure to cold air…also indicated in cases of earache from referred pain from the throat.”
Mercurius vivius: “This patient has an erratic internal thermostat, alternating from extreme chills to flushes of heat and profuse sweating…Offensiveness is a characteristic that runs through Mercurius…a peculiar symptom is swelling of the tongue with indentation marks from the teeth.”[1]
Only such impressions are important. As previously explained, “the disease consists only of the totality of its symptoms” and “the physician needs only to remove the totality of the symptoms in order to cure the disease.”[2] About half of the 1300 entries in the US Homeopathic Pharmacopoeia are based on “provings” that occurred in the 19th century.[3] About 65 are attributable to Hahnemann himself, including most of those commonly prescribed by homeopaths of today.
Homeopaths claim that “provings” are scientific, but several recent studies have failed to demonstrate that they yield reproducible data. As might be expected from the myriad “symptom” descriptions that homeopaths are likely to hear, agreement among practitioners is also unlikely. Thus there is no reason to predict that different homeopaths would prescribe the same “remedy” even if faced with the same patient presentation.
Pseudoscientific “Innovations”
Some homeopathic “remedies” are “constitutional,” based on the practitioner’s interpretation of the patient’s personality type, physical type, dietary preferences, sleeping patterns, and so forth. Others, “nosodes,” are claimed to be equivalent to legitimate vaccines but much safer. These categories seem to be the bases for homeopathic pretensions to “wellness” and “prophylaxis.” Homeopaths prescribe both these and “acute remedies” to patients but usually not at the same time because, according to Hahnemann, “In no case is it requisite to administer more than one single, simple medicinal substance at one time.”[4]
Nevertheless, some contemporary homeopaths believe otherwise, though not for any reason based in evidence. Similarly, because the practice has existed for over 200 years and has never been subjected to real scientific rigor by its proponents, increasingly fanciful “remedies” have been invented. Examples include “potentized noise,” “potentized moonlight,” and “potentized sunlight.”[5] The pattern of continued adherence to an arbitrary belief system, unchecked by science but prone to increasingly fantastic “innovations,” is a hallmark of pseudoscience.
Paradoxically, homeopaths cite this very phenomenon as evidence for validity:
“[Hahnemann’s] observations, indications, and directions have remained constant for over two hundred years and applied by thousands of homeopaths around the world without any changes; this gives weight to the reliability of his observations.
There is no other branch of medical therapeutics that can claim this degree of stability.”
As we shall see next week, such misleading statements are the norm, whether offered by homeopaths or by their apologists in academic medicine.
[1] Jonas WB, Jacobs J. Healing with Homeopathy: the Doctors’ Guide. New York, NY: Warner Books, 1996. pp. 170-172[2] Hahnemann SC. Organon of Medicine. 5th Edition (1833) translated by Dudgeon. 6th Edition (1842?) translated by Boericke. Available at: http://www.homeopathyhome.com/reference/organon/organon.html
[3] Shelton JW. Homeopathy: How it Really Works. Amherst, NY:Prometheus Books, 2004.
[4] Hahnemann SC. Organon of Medicine. Op cit.
[5] Ransom S. Homoeopathy: What Are We Swallowing? Op cit. pp. 64-68.
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†The Homeopathy Series:
- Homeopathy and Evidence-Based Medicine: Back to the Future – Part I
- Homeopathy and Evidence-Based Medicine: Back to the Future – Part II
- Homeopathy and Evidence-Based Medicine: Back to the Future–Part III
- Homeopathy and Evidence-Based Medicine: Back to the Future Part IV
- Homeopathy and Evidence-Based Medicine: Back to the Future Part V
- Harvard Medical School: Veritas for Sale (Part III)
- The Dull-Man Law
- Smallpox and Pseudomedicine