20 years ago:

A strategy for research

Galen Ives, a ‘relative outsider’ to homeopathy, attempted to outline what he saw as important current research issues for homeopathy. He commented that there had been no large-scale, multidisciplinary investigation of homeopathy designed to clarify some of the many unknowns. Most of the research had been inept and piecemeal, with a few notable exceptions. The relative absence of good research, based on sound scientific principles, had resulted in an inability to communicate with the mainstream; while the lack of fundamental research, especially into the nature of potency, further compounded the communication problem. The author stressed that certain experiments needed repeating, such as the finding of altered dielectric properties in potentized solutions. He suggested a co-ordinated research programme, which should contain the following elements: clinical research, conceptual research, and fundamental research.

The difficulties faced by researchers in the clinical field were acknowledged. A parallel could be drawn with research in psychotherapy, a subject which had developed considerably over the last decade. Homeopathy, with fewer methodological problems than psychology, ‘could benefit from the application of some of the techniques developed over recent years to cope with the complexities of the latter field. It is vital that inappropriate research methods are not applied to homeopathy in a Procrustean fashion’. In clinical trials of chronic conditions, the author saw an appropriate design as involving three groups, randomly allocated: (1) homeopathic treatment, involving the use of several remedies (‘any temptation to simplify this process or to reduce it to a single remedy for the sake of methodological simplicity or scientific clarity must be resisted’); (2) homeopathic treatment with placebo substituted for all remedies (must be all or nothing); and (3) allopathic treatment. He also advocated the use of single case studies: ‘A method which has proved useful in psychotherapy research is the intensive single case study using multiple baseline assessment. A modification of the technique to include placebo control might well yield valid and interesting results’. In certain acute conditions, a traditional double-blind trial would be more feasible. The author suggested an approach which might strengthen the scientific validity of such studies. This involved a pilot study to identify different drug pictures; a questionnaire based on the characteristic indications to differentiate the remedies; and assessment by statistical cluster analysis. A further suggestion is the use of experimental models to achieve standardization of both the pathological condition and the remedy. One promising line would be the testing of the isopathic principle, which had already given quite convincing results.

Conceptual research was dealt with next. Constitutional prescribing would be amenable to scientific testing. Cluster analysis again would identify groups showing certain characteristics. A pilot study by the author had yielded positive results. Likewise, the principle of similia could be studied. The hypothesis that the more closely a patient's symptoms resembled the drug picture, the better the response, could be investigated statistically. This kind of study could be built into any clinical trial which used a questionnaire to identify groups.

Fundamental research is a crucial area: potency assay and the physical characteristics of the potency. The author considered the lack of a reliable experimental method as seriously hindering study of the former; and that sensitive measuring techniques would be needed for the latter. He made several suggestions. In conclusion, he hoped that the Blackie Research Fund would rectify the serious lack of funding in the past.