La Homeopatía y el Método

Germán Guajardo Bernal, 2004 Editorial Malabares: Mexico.

This book is based on a collection of articles published in the British Homeopathic Journal, Homeopathy, La Homeopatía de México, Boletin Mexicano de Homeopatía, Gaceta Homeopática de Caracas and other university journals. The title can be translated as ‘Methodology in homeopathy’, but this work is not a technical ‘how to’ textbook. It is more of an epistemological (relating to the study of knowledge), philosophical and historical analysis of those factors which shape homeopathic thinking and give direction to research. Bernal describes science as a constant process of actualisation based on its historical foundation. In this sense, great scientists stand on the shoulders of the giants who preceded them, who in turn were supported by the richness of the knowledge in their cultures which has been built up over time. The evolution in thought that has resulted is responsible for the shape of homeopathy today. The book is divided into four sections:

• 1. Homeopathy and philosophy

• 2. Homeopathic biophysics

• 3. Historical perspectives

• 4. Semantics

The first section explores homeopathy in the context of its naturalist (vital force) and historicist (Hahnemann and the Organon) traditions. The comparisons which are made with other philosophical perspectives would have benefited from an appendix with a succinct definition of each, eg empiricist, vitalist, materialist, mechanicist, etc to help clarify the narrative for the reader who is not familiar with them.

An important theme in the book is that homeopathy needs to be scrutinised with the same scientific rigour as any other branch of medicine, as only this will make it accessible to all relevant scientific disciplines, eg biology, physics, etc which will be needed to advance research in homeopathy in the future. This should be done irrespective of homeopathy's other vitalist or metaphysical facets. It is worth remembering Hahnemann's own approach—the importance of investigation, which he showed both in theory and practice. To paraphrase the author, the tendency of homeopaths to adopt the posture of the ostrich and stick their heads into the sands of metaphysics is no longer acceptable. Bernal then summarises the theoretical foundations of homeopathy and what is necessary for its validation in terms of biological action, mechanism of action, and clinical effectiveness.

In one chapter in this section, Bernal describes the development of homeopathic thought over the past two centuries by comparing it to the trajectory of a salmon swimming upstream against the local currents of each era, and the various conceptual jumps it has had to make on its journey. He is scathing about the ‘dumbing down’ of homeopathy in the profusion of popular books of low academic level and the alleged self-interests of some metaphysical/non-medical groups and courses. Bernal's views seem unnecessarily polarising, with accusations of ‘educational activism’, and belittling the contributions made by people such as Vithoulkas, Sankaran, etc.

The second section begins with the history of physics in homeopathy, followed by the ideas of vitalism and bioenergy. He touches on bioelectromagnetic fields, Kirlian photography, and biocybernetic feedback models, but asserts that an exact explanation of how homeopathy works is still awaited, just like an explanation of the findings of Jenner on vaccination was only forthcoming 70 years later, with the developments in immunology and bacteriology. In this respect, homeopathy is still a frontier science.

The evolution of ideas and paradigms, and how this colours the attitudes of a particular era are given great importance by the author. The third section is historical, and starts by placing homeopathy within the context of the history of medicine as a whole. This is followed by an outline of homeopathic research, divided into three parts: clinical–therapeutic, experimental science, and theoretical models. The development of Hahnemann's miasmatic model is then described. His initial explanation of how remedies acted involved the effect of an active potentised remedy on a passive organism. With further observation, Hahnemann was able to refine his thinking and this gave rise to the model of a reactive organism. This is a significant change, which allows the body to be studied from various perspectives as an open system, rather than a closed one. The section concludes with an analysis of the various hypothesis of how the remedies actually cure. The author's favoured view is that:

• 1. the organism reacts, and is indeed responsible for the homeopathic cure,

• 2. the dynamised remedy is pathogenetic in all its forms, be it the prover or the person to be cured,

• 3. due to this, healing takes place as the organism reacts against the remedy,

• 4. the remedy works due to its physical properties, namely, because of the structure of the solvent altered by the effects of sucussion. The initial solute or tincture imprints information onto the solvent, and this restructuring is then replicated during the dynamisation process with new alcohol–water solvent.

Bernal asserts that future research in this biomedical/biophysical field needs to be carried out in a multidisciplinary context, as no advances will be possible without specialist input in areas such as electron microscopy, spectrophotometry, spectrofluorometry, thermoluminescence, calorimetry, quantum thermodynamics, etc, and the physicists, chemists, engineers, etc who will be needed to build and handle the required apparatus.

The fourth and last section is about semantics. Bernal suggests that the acceptability of homeopathy by the establishment is based on one criterion, namely, its historical inclusion into the edifice of medicine. ‘Complementary’ or ‘alternative’ sound pejorative and excluding, inadvertently ostracising any disciplines that come under those terms.

‘In the desire to promote homeopathy without medical criteria, it has been kidnapped and taken to its lowest expression, generally towards some corner of the supernatural.’

Bernal sees homeopathy as a branch or specialty of Medicine concerned with treatment, just as allopathy is another branch, and not the entire tree. Allopathy should not be synonymous or confused with conventional/orthodox/rational/official medicine. Bernal argues that ‘homeopathic medicine’ does not exist, in the same way that there is no homeopathic anatomy, homeopathic physiology, etc. To take it further, ‘homeopathic medicine’ referring to the substance that is taken, should be replaced by homeopathic medication, which according to the author, would avoid creating an anti-medical stance.

This book paints a picture of homeopathy within the historic and philosophical landscape of science and medicine, in an attempt to define its future direction. It weaves various strands of thought from a broad range of disciplines. The approach is erudite and well researched. But it would have greatly benefited from an index, as the text is densely packed with ideas and it is easy to get lost in it.

The author's intention is to put homeopathy firmly in the camp of academic medicine, and reject any non-medical associations. I believe this is counter-productive. Firstly, an over-medicalisation of homeopathy could disempower the public from using this wonderful therapeutic modality at grassroots level. Self-prescribing safely for a range of ailments reduces the burden on an already stretched homeopathic health delivery service. In addition, few would argue that scientific validation is absolutely essential, both for homeopathy's credibility in the eyes of the wider scientific community, for the evaluation of efficacy and for advances in research.

However, the author's insistence that homeopathy should only be a medical specialty, and the dismissal of any endeavour made by non-university graduates, exacerbates the controversy between medical and non-medically qualified homeopathic practitioners. It widens the split in the homeopathic community, and weakens rather than strengthens the development of homeopathy as a whole, and the promotion of an integrated and safe provision of homeopathy to the general population. After all, this was Hahnemann's intention: ‘the rapid, gentle and permanent restoration of health’. Having said that, this book would be useful to anyone who wants to gain a wider perspective on the evolution of homeopathy, be it student, researcher or practitioner.