1 Homeopathy: Mere Placebo or Great Medicine? Post-Debate Questions I- Questions for André: A) Questions from Joe to André: 1-Homeopaths claim that even after a substance is dissolved in water or alcohol and diluted to such an extent that there is not a single molecule of the original solute left, the solution still retains some memory of the solute. But this solution is then impregnated into a sugar pill and the water is evaporated. What then is left behind? And how does whatever is left behind have anything to do with healing? A: Homeopaths are actually not making such a claim, but have instead been reporting a series of very important experimental observations that are, first, sick people are sensitive to remedies that can produce a similar state as their sickness;1 second, patients usually experience an initial aggravation when remedies are precisely prescribed to them according to this principle of similarity;2 third, to avoid this initial aggravation, Hahnemann did what any logical physician would do, he diminished the dose. At first, he used simple dilutions,3 and only many years later he began using serial succussed dilutions,4 a process he had previously used in chemistry5 and which had 1 Hahnemann reported this phenomenon in great detail and with many observations in 1796 in his Essay on a New Principle for Ascertaining the Curative Powers of Drugs. (In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 249-303.) He confirmed this phenomenon during the 1799 scarlet fever epidemic in an article entitled On the Power of Small Doses of Medicine in General and of Belladonna in Particular. (In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 385-389.) 2 In a five month study in a large clinic, it was estimated that approximatively 75% of patients with chronic diseases experienced an initial aggravation after taking the simillimum homeopathic remedy. (Paterakis S, Bachas I, Vithoulkas G. Statistical data on aggravation after the simillimum. Journal of the American Institute of Homeopathy 1977; 70: 267-269. 3 Already in 1786, four years before his exprimentation with Peruvian bark, he was prescribing very small doses of mercury in his treatment of syphilitic patients compared to the much larger doses commonly prescribed by his contemporaries. 4 Even tough Hahnemman made the experiment with Peruvian bark in 1790 and published the results of the first six years of his experiments by announcing a new therapeutic principle in 1796, he began using serial succussed dilutions (usually of the second or third attenuations) only in 1799 during the epidemic of scarlet fever. He would then mix one part of pulverized Opium with twenty parts of weak alcohol, would let this mixture stand in a cool place for a week and would shake it occasionally to “promote the solution.” A drop of this tincture was mixed “intimately” with five hundred drops of diluted alcohol, and the whole was well shaken; and of this last diluted tincture, one drop was added to another five hundred drops of alcohol. Of this diluted tincture, one drop sufficed for a child of four years of age (particularly during stupefaction marked with convulsions), and two drops for one of ten years. For still younger children, one drop of this dilution was mixed with ten teaspoonfuls of water, and one, two, or more spoonfuls given. He wrote, “It is unnecessary to repeat these doses oftener than every four or eight hours, in some case more than every twenty-four hours, and sometime a couple of times during the whole fever, for which the more frequent or more rare occurrence these symptoms must be our guide.” (Hahnemann S. Cure and Prevention of Scarlet Ferer. In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 375.) 2 been known at least since Paracelsus;6 fourth, Hahnemann noticed that patients responded better and longer the higher the potency was, a fact that is confirmed daily by every practicing homeopath; and fifth, Hahnemann slowly pursued this upward process of serial dilution and succussion over the next forty years as he never stopped observing increasing benefit in the sick.7 To illustrate how slow this process of progressive rise in serial trituration/succussion and dilutions was, Hahnemann recommended prescribing Aurum metallicum in the first and second attenuations in 1820, the 12th in 1825, the 30th in 1835 and by 1840 he was consistently using the 200 centesimal potency.8 5 After abandoning the practice of medicine because of its uncertainty, Hahnemann occupied himself mostly with chemistry and translation. He was soon recognized as an expert chemist. (To appreciate Hahnemann’s work as a chemist see: Bradford TL. Life and Letters of Dr. Samuel Hahnemann. Philadelphia: Boericke & Tafel, 1895: 29-42, and Kleiner) It was said that his accomplishments in chemistry “must be termed remarkable… and [that he can be] added to the list of versatile scientists side by side with Lavoisier, Benjamin Franklin and Pasteur.” (Kleiner IS. Hahnemann as a chemist. Scientific Monthly 1938; 46: 450-454.) In his investigation on the fermentation of wine when put in contact with different gases, Hahnemann would fill vials with different gases and hermetically seal them under water. He would then succuss each vial up and down 30 times on a leather-bound book three times a day for a period of two months in order to increase the contact of the gases with the wine. (Hahnemann S. Ueber den Einfluss einiger Luftarten auf die Gährung des Weins. Chemische Annalen für die Freunde der Naturlehre, Arzneygelahrtheit, Haushaltungskunst und Manufakturen 1788; 1: 141-142.) 6 The following extracts are from Scholiast (believed to be Paracelsus) commentaries to the third section of The Golden Treatise of Hermes, “The dead elements (which a spirit inhabits) are revived; the composed bodies tinge and alter, or are altered; and by a wonderful process they are made permanent. … The bodies of the metals are domiciles of their spirits . when their terrestrial substance is by degrees made thin, extended, and purified, the life and fire hitherto lying dormant is excited and made to appear. For the life which dwells in the metals is laid, as it were, asleep (in sense); nor can it exert its powers or show itself unless the bodies (that is, the sensible and vegetable media of life) be first dissolved and turned into their radical source. …This is the property of our medicine, into which the previous bodies of the spirit are reduced; that, at first, one part thereof shall tinge ten parts of an imperfect body, then one hundred, then a thousand, and so infinitely on by which the efficacy of the Creative Word is wonderfully evidenced; and by how much oftener the medicine is dissolved, by so much the more it increases in virtue; which otherwise, and without any more solution, would remain in its single or simple state of perfection. Here, then, is a celestial and divine fountain set open which no man is able to draw dry.” (Cameron FT. Antiquity of the doctrine of dynamization of medicines by dilution. Organon 1878; 1: 280-281.) This accumulation in UMPs of the applied mechanical force is called “potentization” in homeopathy. 7 It is irrefutable from many authentic historical sources why Hahnemann first diminished the doses, and second how he proceeded very slowly through careful experimentation over many decades from prescribing simple dilutions to a progressive rise in serial trituration/succussion and dilutions, which has nothing to do at all with the skeptics’ belief that Hahnemann “came to the conclusion, somehow nobody can explain how, that less is more.” 8 In 1798, two years after Hahnemann published the results of his experiments on a new therapeutic principle, he was still prescribing crude doses of medicine, such as a half dram dose of Peruvian bark tincture (Some Periodical and Hebdomadal Diseases. In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 341-344.), drop doses of tincture of Opium (Antidotes to Some Heroic Vegetable Substances. In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 322-329.), and grain doses of Arnica Montana and Ignatia amara. (Some Kinds of Continued and Remittent Fevers. In The Lesser Writings of Samuel Hahnemann. Collected and translated by R. E. Dudgeon. New York: William Radde, 1852: 329-341.) By 1840, Hahnemann knew that a limit would unlikely ever be found to the efficacy of the higher potencies, as he kept increasing the potency of his remedies while observing increased remedial responses in the sick. Already in 1827, he suspected the unlimited potential of higher potencies when he wrote, “Medicinal substances are not dead masses in the ordinary sense of the term, on the contrary, their 3 In view of these experimental facts, Hahnemann logically assumed that durable, physical changes were occurring in the vehicles due to this process of serial trituration/succussion and dilutions, a phenomenon that can absolutely not be explained with the theory of Avogadro’s limit.9 In 1825, he wrote, “By the succussion and trituration employed, a change is effected in the mixture, which is so incredibly great and so inconceivably curative, that this development of the spiritual power of medicines to such a height by means of the multiplied and continued trituration and succussion of a small portion of medicinal substance with ever more and more dry or fluid unmedicinal substances, deserves incontestably to be reckoned among the greatest discoveries of this age.”10 In the same article, Hahnemann responded to the skeptic’s arguments about the implausibility of the higher attenuations as followed, “But there are various reasons why the skeptic ridicules these homeopathic attenuations.