15 June 2008

Homeopathy, Medicine, Science and Cognitive Dissonance

Given that more and more people globally are using homeopathy with benefit for all kinds of ill-health; its effectiveness in treating epidemics: cholera, influenza (here and here); its integration into the Indian medical system; and the World Health Organisation reporting that it is the number 2 medical system in the world (but you won’t find that report anywhere, it’s been buried), I can only conclude that the reason why conventional medics and scientists might genuinely (rather than wilfully because of love of science itself, self-interest or pharmaceutical allegiances taking priority over the health of patients) refuse to use and investigate homeopathy is because they are suffering from what is termed ‘cognitive dissonance’. www.learningandteaching.info describes it well:

Cognitive dissonance is a psychological phenomenon which refers to the discomfort felt at a discrepancy between what you already know or believe, and new information or interpretation. It therefore occurs when there is a need to accommodate new ideas, and it may be necessary for it to develop so that we become “open” to them. Neighbour (1992) makes the generation of appropriate dissonance into a major feature of tutorial (and other) teaching: he shows how to drive this kind of intellectual wedge between learners’ current beliefs and “reality”.  
Beyond this benign if uncomfortable aspect, however, dissonance can go “over the top”, leading to two interesting side-effects for learning:

  • if someone is called upon to learn something which contradicts what they already think they know — particularly if they are committed to that prior knowledge — they are likely to resist the new learning. Even Carl Rogers recognised this. Accommodation is more difficult than Assimilation, in Piaget’s terms.             
  • and—counter-intuitively, perhaps—if learning something has been difficult, uncomfortable, or even humiliating enough, people are less likely to concede that the content of what has been learned is useless, pointless or valueless. To do so would be to admit that one has been “had”, or “conned”.

Ordeal is therefore an effective — if spurious — way of conferring value on an educational (or any other) experience. “No pain, no gain”, as they say.

  • the more difficult it is to get on a course, the more participants are likely to value it and view it favourably regardless of its real quality.
  • ditto, the more expensive it is.
  • the more obscure and convoluted the subject, the more profound it must be. This has of course been exploited for years to persuade us of the existence of the emperor’s clothes, particularly by French “intellectuals” and “post-structuralists”. (I recently came across the wonderful phrase “intellectual flatulence” which perfectly describes such rubbish.)

It is not, however, so much the qualities of the course which are significant, as the amount of effort which participants have to put in: so the same qualification may well be valued more by the student who had to struggle for it than the student who sailed through.”

As medicine and science is very hard to get into and arduous to study, it seems to fulfill several of the above criteria.


28 February 2008

History of Homeopathy in Britain

An interesting article on the history of Homeopathy in Britain by the Liga Medicorum Homeopathica Internationalis which also details some of the developments, changes in and disputes over prescribing approaches. Contemporary homeopaths are trained in choosing the appropriate prescribing approach for the patient and their symptoms:

“The Early Years
Homeopathy came to Britain relatively late. Although the Organon was published in 1810 it was not until 1832 that the first full time practitioner established himself in London. During this period many British aristocrats, such as the Marquess of Anglesey, and the Duke of Beaufort crossed the Channel for treatment by Hahnemann. Queen Adelaide, wife of King William IV, was a patient of Dr. Stapf and was visited by him at Windsor Castle. A letter published in the Lancet in 1834 demonstrated the effect of the Queen’s interest upon Sir Henry Halford, President of the Royal College of Physicians and dubbed the ‘eel backed baronet’.

The Duke-Royal Homoeopthicism
Dear Dr. Turner,
I am exceedingly annoyed at the Queen’s not commanding my professional attendance, as it would give me an excellent opportunity of playing an important political game at this crisis. The last accounts I have received from the Pavilion mentions that her Majesty is still persevering in the homoeopathic system and she supposes she has derived advantage from it…
Her Majesty’s confidence in the absurd system arose from one of her maids being put under it when they were in Germany. Her brother, the Duke, sends her these invisible pills from Germany and they are such atoms that a quill filled with them lasts her Majesty a couple of months.
Her Majesty has also an extraordinary bottle which she smells whenever she wants a movement in her royal bowels and my correspondent tells me that the effect of smelling the bottle is so immediate that her Majesty is obliged to leave the room at a moments notice
[Lancet: vol1, 1834-5, p359]

Homoeopathy became increasingly popular among the upper classes and pressure grew for a suitable doctor to be available in London. Dr. Frederic Hervey Foster Quin was practising in Naples when Dr. Neckar in Rome first introduced him to the method. He became physician to Prince Leopold, later King of the Belgians but Quin left his service after two years to study with Hahnemann. His aristocratic friends and patients wrote regularly to him, asking him to move to London, which he finally did in 1832.

Quin’s parentage is unknown but he had the entree to all the great houses and numbered royalty, and aristocrats among his friends and patients, as well as Dickens, Landseer and many others from artistic society. Inevitably his practice was at first restricted to the upper classes. He tried unsuccessfully to open a dispensary for the poor but after that concentrated upon the foundation of a hospital. He formed the British Homeopathic Association, a lay/medical society to collect the necessary funds. The hospital was eventually opened in 1850 in Golden Square, Soho, London.

Opposition to homoeopathy was marked from the moment of Quin’s arrival. The Royal College of Physicians had the ancient power to control all medical practice within seven miles of the City of London, although it had not exercised this right for a century. It called upon Quin, an Edinburgh graduate, to take the college examination. He ignored the summons and eventually the College lost its nerve and desisted. But he was not forgotten. When he was proposed for membership of the Athenaeum, an exclusive gentlemens’ club, the then President of the RCP publicly called him a quack. This slur was only retracted on pain of a duel, but the College still mobilised its supporters to ensure that Quin was blackballed.

In 1844 Quin formed the British Homoeopathic Society, the forerunner of the present Faculty, with the half dozen homoeopathic doctors then in the country. It was this society that was attacked in its turn by the Provincial Medical and Surgical Association, later the BMA. Membership was forbidden to all homoeopathic doctors and members of the PMSA were not to co-operate in any way with homoeopaths.

Unfortunately the homoeopathic profession was not united at that time. Why there was a division is not clear. It may have been due to different attitudes to Hahnemann’s theories but more probably was the result of Quin’s attitude to his colleagues. Certainly his insistence that only members of the British Homoeopathic Society could be appointed to the staff of the hospital in Soho played a part.

In 1835 Mr Leaf, a well to do merchant and supporter of homoeopathy, invited Dr. Paul Curie in 1835 to come from Paris as medical officer to a dispensary, which he founded in Finsbury Square, London. Curie, the grandfather of Pierre Curie of radium fame, was regarded as a brilliant homoeopath and teacher. Unfortunately he had been a follower of Broussais who regarded all disease as deriving from the gastrointestinal system. He believed in strict dieting. A scandal arose when one of Curie’s patients died apparently from starvation. However this did not stop Curie who founded the first school of homoeopathy in Britain. In 1850 several doctors including Curie founded the Hahnemann Hospital in Bloomsbury, London, with its associated medical society the Hahnemann Medical Society and its lay counterpart the English Homoeopathic Association. Unfortunately Curie caught typhus from a patient and died in 1853 and the hospital closed shortly afterwards. This led to the unification of the homoeopathic medical profession.

Although the London Homoeopathic Hospital in Golden Square, Soho, was ready for patients in October 1849, this was too late for the cholera epidemic of that year. In 1854, when another epidemic threatened, the Governors of the hospital decided to devote the hospital solely to cholera, for the duration of that epidemic. As a result 90 patients were treated. In addition Camphor was distributed free to the local population with instructions for its use as a prophylactic and as a first stage treatment.

The Board of Health had issued strict instructions for the notification of all cases of cholera and of diarrhoea together with details of treatment and of the outcome. The homoeopathic hospital duly submitted its returns, but to its surprise its results which were far superior to those of conventional hospitals, were omitted from the official report on the epidemic when published in 1855. The area of London where the hospital was situated was one where the epidemic was at its worst. It was the site of Dr. John Snow’s famous efforts to remove the handle of the pump in Broad Street, resulting in an immediate reduction in cases. Patients from this area went to only two hospitals, the Homoeopathic and the Middlesex. For the 90 cases treated at the Homoeopathic Hospital there was a death rate of 19%. [Of the 61 cases, the subject of the complaint to the House of Commons, see below, the rate was even lower at 16.4%.] In contrast the death rate at the Middlesex was 52.35% and elsewhere it was as high as 65%.

The British Homoeopathic Society sought the help of Lord Robert Grosvenor, a Member of Parliament sympathetic to homoeopathy. Following a question asked by him in the House of Commons, the homoeopathic results were published, demonstrating the superiority of the system of treatment.

The Expansion of Homoeopathy
In that same decade pressure mounted for the registration of medical practitioners. Opponents of homoeopathy hoped to preclude its supporters from registering and therefore from practising. The Registration Bill was drafted in such a way that any degree granting body could refuse graduation to anyone whose views it disliked. Dr. Robert Dudgeon discovered this only two days before the bill was to go through its final stages. He was a polymath, editor of the British Journal of Homeopathy and a prolific writer on the subject. Together with Lord Robert Grovesnor, by then Baron Ebury, and another peer, he was able to draft a clause, which limited the power of colleges. This appeared so innocuous that it went through on the nod. Sir James Y Simpson, the Scottish obstetrician who introduced Chloroform, was homoeopathy’s leading opponent at the time; although sitting in the public gallery he was quite unaware of what had happened.

Despite this opposition homoeopathy spread steadily throughout the country. By 1880 every major town had its dispensary while in many there was a hospital. Homoeopathic hospitals varied in size from the ‘cottage’, with 3 or 4 beds, to the major hospital of 100 or more beds and provision for surgery and the other specialities.

Supporters of homoeopathy were originally the aristocracy but later in the 19th century it was the rich upper middle classes who provided the funds and the political support. Some of the larger hospitals were provided by businessmen. Thus, the Liverpool Hahnemann Hospital was built and paid for by Sir Henry Tate, a millionaire sugar importer. The hospital in Bristol owed its existence to the tobacco manufacturers, Wills.

Royal patronage always played a part. Although, as mentioned Queen Adelaide used homoeopathy, neither Queen Victoria nor her son, King Edward VII, favoured it. This is surprising since Frederic Quin was a personal friend of Edward. However the Duchess of Cambridge, sister in law of William IV was converted and employed Quin as physician to her household. Her granddaughter Princess Mary of Teck became Queen Mary, when she married King George V. He appointed Dr. John Weir as royal physician and later knighted him. Thus homoeopathy was passed to the present Royal family.

The ‘Scientific Homoeopaths’
As the century progressed the attitude of British homoeopaths to Hahnemann’s theories changed; they increasingly refused to accept the psora theory and were very suspicious of high potencies. Robert Dudgeon and later Richard Hughes led the profession in low potency prescribing. There were of course exceptions, notably JHC Clarke and Compton Burnett who remained ‘classical’ homoeopaths. But as early as 1853 Dudgeon gave lectures which decried the idea of dynamic increase of power with dilution and succussion. While these doctors had to accept the 30th potency and even the 200th, they regarded as nonsense the M potencies that were being produced in America.

Alternation of potencies became commonplace. In the clinical records of the London Homoeopathic Hospital, which have fortunately been preserved, Bryonia is frequently shown as being alternated with Aconite or Arsenicum in acute cases, usually in the 1x or 3x potency. Quantity also played a part and if a satisfactory action was not obtained with one globule per dose (usually given every 2 or 3 hours) then two or three might be given before a change of remedy was considered.

These doctors wanted to be united with the conventional profession. They were sympathetic to the new scientific developments of the time and made use of pathological advances as they arrived. Many medicines such as Aconite and Belladonna, which they used in potency, were absorbed into the conventional pharmacopoeia. As a consequence some doctors found it avoided trouble if they ceased to call themselves homoeopaths while continuing to use the remedies. Those who remained loyal had no compunction about prescribing conventional medicines such as Morphine and Iron, although in the latter case this might, illogically, be given in low potency for anaemia.

The Arrival of Kentian Philosophy
All this was to change early in the twentieth century with the arrival of the ideas of James Tyler Kent from America. Within little more than a decade there was a complete alteration in prescribing methods. Instead of low potencies, single doses of M potencies were used, after repertorisation; previously the repertory was almost unused. There was less concern for the conventional profession, for pathology and other medical advances. Dr. Richard Hughes, the great man of the late nineteenth century, was dismissed as a ‘pathological prescriber’ unworthy of consideration. Homoeopathy became a small isolated sect cut off from mainstream medicine, and supported in the main by a cadre of ‘homoeopathic families’ who provided both the doctors and the patients.

But the homoeopathic medical profession had to provide a full medical service. For example at the turn of the century tuberculosis was a major fatal disease. James Compton Burnett claimed to have discovered Tuberculinum, as a treatment for it, fifteen years before Koch introduced Tuberculin. Homoeopaths used Tuberculinum in the form of Bacillinum for their cases with limited success. It seemed to work in acute cases but was of little use in caseous lung disease. However it proved successful in associated conditions such as tonsils and adenoids.

Tuberculin was similarly limited in success and, because it was toxic, the dosage was progressively reduced so that eventually it was being utilised in homoeopathic doses. Homoeopaths started to use Tuberculinum first, but if that failed they turned to Tuberculin. It is difficult to make any real estimate of its efficacy because it became superseded by sanatorium treatment. As this happened, fewer and fewer cases were referred to homoeopaths, the patients’ disposal being controlled by the Public Health regulations.

The advent of Kentian ideas can be said to have been almost solely due to Dr. Margaret Tyler. She induced her parents, who served on the committees of the London Homoeopathic Hospital, to provide money for scholarships enabling doctors to study in Chicago under Kent. She qualified in medicine in 1903 at the age of 44 and served on the staff of the hospital until her death forty years later. She specialised in retarded children but her great contribution was teaching. She lectured, she ran a correspondence course, and edited a journal which could be used as a textbook. But she is best known for her ‘Drug Pictures’, which simplified the materia medica for students.

However she did not entirely succeed in keeping British homoeopathy tied to the Swedenborgian mysticism of Kent. C.J.Wheeler and others accepted his method of selection of the remedy while moving away from his philosophy. But the idea of the single constitutional remedy has remained the norm to this day.

The Faculty of Homoeopathy
In 1943 the British Homoeopathic Society reformed as the Faculty of Homoepathy. It developed an academic organisation and started a diploma in homoeopathic medicine. This became the basis of full membership. The examination increased in difficulty so that it became a specialist qualification. It is now forming the basis of a proposed European qualification. More recently, owing much to the work of the Scottish branch of the Faculty, a new qualification has been introduced for GPs who are interested but do not wish to go on to full specialist training.

Within a short time of its formation the Faculty was faced with the question of how homoeopathy, and particularly the homoeopathic hospitals of which five remained in existence, was to be integrated into the new National Health Service. After protracted discussions with the Ministry it was agreed that these hospitals would be treated in the same way as conventional hospitals. Equally important, it was agreed that homoeopathic remedies would be prescribable by all NHS doctors.

Recent Developments
This agreement did not, unfortunately, cause the conventional profession to view expenditure upon homoeopathy as justified. Of the five hospitals, three have been reduced in size. The Royal London Homoeopathic Hospital, which moved to its present site in Great Ormond Street in 1859, was replaced the end of the 19th century with a purpose built hospital with state of the art medical and surgical departments. It survived as an independent hospital in the NHS but was starved of funds for years. It lost its surgical departments and has had to offer other forms of complimentary medicine in addition to homoeopathy. In contrast the Scottish hospital, by a sustained effort of teaching, research and by demonstrating its value for money, has succeeded in obtaining the funds necessary to have a new building constructed.

But another factor has affected the situation. In the last ten years, the demand from the general public for homoeopathy has noticeably increased. In addition the conventional medical profession is taking a much more favourable view. While some managers seek to employ non- medically qualified practitioners, because they are cheaper than doctors, the risks of so doing have been explained to them. (In Britain, anyone without any training whatever can practise medicine provided there is no claim to be a doctor or attempt to prescribe dangerous drugs.). The future for homoeopathy itself seems secure.”

20 January 2008

Fact or FLACT?

Sceptics like to twist things around, notably Ben Goldacre (junior liaison psychiatrist, of the ‘it’s all in your head’ school of medicine), according to twisted logic.

It feels like this:

I might say ‘I like yellow’.

A sceptic might then claim ‘H4H doesn’t like white, red, blue, green, orange, purple, pink, black or brown.’  This would not be true as I also like blue and purple and I can tolerate all the other colours too.

I have a new term for such logic-derived ‘facts’: ‘FLACT’.

*4th February 2008.  Updated* to incorporate my justification of including Ben Goldacre from responses to Andy Lewis (aka le canard noir):


The low cholera mortality rates under homeopathic treatment: When Cholera finally struck Europe in 1831 the mortality rate (under conventional treatment) was between 40% (Imperial Council of Russia) to 80% (Osler’s Practice of Medicine). Out of five people who contracted Cholera, two to four of them died under regular treatment. Dr. Quin, in London, reported the mortality in the ten homeopathic hospitals in 1831-32 as 9%; Dr. Roth, physician to the king of Bavaria, reported that under homeopathic care the mortality was 7%; Admiral Mordoinow of the Imperial Russian Council reported 10% mortality under homeopathy; and Dr. Wild, Allopathic editor of Dublin Quarterly Journal, reported in Austria, the Allopathic mortality was 66% and the homeopathic mortality was 33% “and on account of this extraordinary result, the law interdicting the practice of Homeopathy in Austria was repealed.’

Ben states:‘Homeopathic pills won’t do anything against cholera.’

So by his logic (and yours) most of the people treated with homeopathy just got better anyway: ‘the homeopaths’ treatments at least did nothing either way’

So logically: If people just got better anyway, by this evidence they should just have been left alone when they got cholera and the death rates would have been much lower. And his other part of Ben’s logic is that cholera death rates were so high because allopathic medicine made them much worse: ‘high allopathic mortality rate was due to dangerous practices’

So my point is why would the population worry so much about cholera then?

But they did:


‘New York was probably the most thoroughly scourged among the states. Each of the thriving towns along the Erie Canal suffered in its turn, despite quarantines and last minute attempts at ‘purifications.’ . . .Small villages, even isolated farms, were stricken. And here the disease was most terrifying; it had to be faced alone, often without friend, minister, or physician. The appearance of cholera in even the smallest hamlet was the signal for the general exodus of the inhabitants, who, in their headlong flight, spread the disease throughout the surrounding countryside.’


‘Asiatic cholera is a very violent intestinal disease, usually running a short course to dehydration and death, often in a matter of hours. Its very violence ensured that it would not be the type of disease which could be overlooked or treated with little concern’

‘The social and economic consequences of cholera were quite significant. Community life was completely disrupted whenever a new pandemic arrived. Usually panic gripped the populace and all persons who could leave the affected area promptly did so. The spectacular deadliness of the pandemic of 1826-37, which was the first to strike Europe and America, set up a psychological conditioning which assured that all subsequent invasions would induce panic. Normal economic and social life came to an end. Governmental activities were carried out with difficulty. Even medical and nursing services were impaired–sometimes to the extent that the sick were left untended and the dead unburied. Travellers and strangers often were treated badly. Gradually, as an epidemic waned, normal routines were resumed. Practically every community added boards of health and sanitation, which were supposed to take preventive measures against new outbreaks of cholera.’

3 December 2007

Forced Vaccinations because conventional medicine is less effective in treating infectious disease

Some states in the US are making vaccinations compulsory:

Forced Vaccinations « What IS Going On?

Why? Conventional medicine does not have the tools to treat the strong symptoms that come with a vigorous natural response to infectious disease.

19th century homeopaths were effective in treating these infectious diseases: Read full article here

 “From its earliest days, homeopathy has been able to treat epidemic diseases with a substantial rate of success, when compared to conventional treatments

In 1900, Thomas Lindsley Bradford, MD, wrote a book called “The Logic of Figures” in which he collected the statistics he could find that would compare the conventional therapeutics with homeopathic ones. Many of the figures cited below are derived from Bradford’s work.

One of the earliest tests of the homeopathic system was in the treatment of Typhus Fever (spread by lice) in an 1813 an epidemic which followed the devastation of Napoleon’s army marching through Germany to attack Russia, followed by their retreat. When the epidemic came through Leipzig as the army pulled back from the east, Samuel Hahnemann, the founder of homeopathy, was able to treat 180 cases of Typhus– losing but two. This, at a time when the conventional treatments were having a mortality rate of over 30%.

In 1830 as the cholera epidemic was reported coming from the east, Hahnemann was able to identify the stages of the illness, and predict what remedies would be needed for which stages. When Cholera finally struck Europe in 1831 the mortality rate (under conventional treatment) was between 40% (Imperial Council of Russia) to 80% (Osler’s Practice of Medicine). Out of five people who contracted Cholera, two to four of them died under regular treatment. Dr. Quin, in London, reported the mortality in the ten homeopathic hospitals in 1831-32 as 9%; Dr. Roth, physician to the king of Bavaria, reported that under homeopathic care the mortality was 7%; Admiral Mordoinow of the Imperial Russian Council reported 10% mortality under homeopathy; and Dr. Wild, Allopathic editor of Dublin Quarterly Journal, reported in Austria, the Allopathic mortality was 66% and the homeopathic mortality was 33% “and on account of this extraordinary result, the law interdicting the practice of Homeopathy in Austria was repealed.”

Homeopathy continued to be effective in the treatment of Epidemic Cholera. In 1854 a Cholera Epidemic struck London. This was a historically important epidemic in that it was the first time the medical community was able to trace the outbreak to a source (a public water pump), and when the pump was closed, the epidemic soon ceased.

The House of Commons asked for a report about the various methods of treating the epidemic. When the report was issued, the homeopathic figures were not included. The House of Lords asked for an explanation, and it was admitted that if the homeopathic figures were to be included in the report, it would “skew the results.” The suppressed report revealed that under allopathic care the mortality was 59.2% while under homeopathic care the mortality was only 9%”

Note: Ben Goldacre would like you to believe (notice the word ‘believe’) that the low mortality rate of homeopathy was due to it’s ‘no effect’ effect and the high allopathic mortality rate was due to dangerous practices: ‘Homeopathic sugar pills won’t do anything against cholera, of course, but the reason for homeopathy’s success in this epidemic is even more interesting than the placebo effect: at the time, nobody could treat cholera. So, while hideous medical treatments such as blood-letting were actively harmful, the homeopaths’ treatments at least did nothing either way.’  Then why was there such fear of such epidemics, all everyone needed to do was ‘do nothing’?  Nonsense again, Ben.

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