20 years ago: British Homoeopathic Journal, July 1984

Homoeopathy—the end of the beginning

This 10-page article is a reprint of the first Blackie Memorial Lecture, given by Dr RJFH Pinsent. He commented that the lecture commemorated one of the great ladies of British medicine, whose stature was less fully recognized by the traditional medical establishment because of the field she had chosen to make her own.

Dr Pinsent gave a brief outline of Dr Blackie's life, from her birth in 1898, the 10th child of her parents, to her appointment as Honorary Physician to HM The Queen in 1969; receiving the order of CVO in 1979. Her uncle was Dr Compton Burnett, one of the leading homeopathic physicians of the day. Although she did not know him personally, she would have known of his many, often aggressive publications on homeopathic themes. She herself did not write extensively, but, for the many doctors who observed her informal teaching sessions at her rooms in South Kensington, it was privilege to see the medical consultation at its best. ‘The memory of her teaching sessions at 18 Thurloe Street will be imprinted on the minds of many. Sitting at a table to the right of the door, with the window light behind her, a screen around one corner of the room, the scene could have been that of suppliants attending the oracle of Delphi. In the shadows around the room were observing doctors sitting quietly on any convenient furniture. The patient would be ushered in, the story unfolded, the problem considered, quietly discussed, and an appropriate remedy chosen. This would be dispensed by a soft-footed acolyte who disappeared behind the screen for the purpose’. The strong impression was of gentle courtesy, deep insight, wide knowledge of her subject and prodigious memory. Without notes, she recalled clinical details of old patients; previous treatments and responses; and would discuss resemblances and differences with other cases after the patient had gone.

Margery Blackie had an open mind. She saw that the nature of the relief she brought, though substantial, was unsubstantiated. To her it mattered that the nature of the homeopathic response and the mechanism through which it operated were unknown. Unlike many of her contemporaries, she recognized that homeopathy had reached a critical point in its evolution. It had come to the end of the beginning. Dr Blackie sensed that empiricism would no longer suffice to sustain it. The author considered it unfortunate that, at about the same time as Hahnemann was relying on dogmatic assertion to establish the similimum proposition, Pasteur was laying the foundations of what was to become the discipline of pathology. While homeopathy concentrated on symptoms and sensations less capable of accurate description and observation, the spotlight of research and the advance of knowledge were focussed on conventional scientific medicine, with its stress on logical deduction from observed evidence. The apparent safety of homeopathy led to its wide use in the mission field and in turn to lay practice; further diminishing it in the eyes of the orthodox. There was some easing of this situation after the First World War with the development of psychiatry and psychology, looking at symptoms and behaviour patterns rather than slides and specimens; while some experimentation in homeopathy was beginning to be attempted, in order to answer the fundamental question—How does homeopathy work?

Margery Blackie knew all of this work, and was concerned for the future. Professional disregard was leading to political discouragement of homeopathy; while the popular interest and rising demand for homeopathic treatment led to more lay practice, further increasing the disregard of the orthodox profession. Dr Blackie saw that understanding of the mechanism of the homeopathic response was unlikely to come from within homeopathy itself, and so enthusiastically supported the formation of the interdisciplinary Midlands Homoeopathic Research Group, becoming a working member of the group. Dr Alastair Jack, a GP who initiated the teaching of homeopathy in the area, appreciated that the work of the Birmingham Research Unit of the Royal College of General Practitioners might be relevant, and as Research Advisor to the college, working at that unit, Dr Pinsent was happy to join in his work. The group included experienced homeopaths from all over the country; and members from a surprisingly wide range of disciplines. The terms of reference of the group were ‘to encourage and conduct rigorous objective examination of the principles and practice of homoeopathy’.

The group was disturbed to find how pitifully meagre were past attempts to address the problem (with a few gallant exceptions). Kollerstromm, reviewing work, concurred; there was no convincing evidence on which to base a general theory. A number of reasons were suggested for this, but a major factor was lack of finance—grants were available to workers in orthodox medical research but not in homeopathy. The author commented that much of the advance in medical science depended on the finance of the great drug manufacturing enterprises, and that this source was obviously closed to homeopathy. There was a feeling of hopelessness, with practitioners becoming inward-looking, and homeopathy considered part of Fringe Medicine.

It was clear to the Midland Group that the prospects for discovery of the mechanism were greatly increased by the advances made in many scientific fields; and it was encouraged to find that, far from treating homeopathy with disdain, non-medical scientists were not only interested, but anxious to apply their skills to the unknown. Dr Pinsent referred to a few of the relevant advances: the new findings of the properties of water; new tools and instruments for the study of micro-quantities of trace elements; knowledge of the composition of, and interactions between enzymes in the human body; identification and isolation of neuro-regulatory peptides, whose function can be influenced by emotional stimuli. The author concluded with a reminder to present day practitioners of homeopathy of their responsibility if this is not to be the beginning of the end; of the need for awareness that lay homeopathy is waiting in the wings to take over should it cease to be a part of medicine.