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Theory of disease
In Hahnemann's day, the conventional theory of disease was based on the four humours. Mainstream medicine focused on restoring the balance in the humours, either by attempting to remove an excess (by such methods as bloodletting and purging, laxatives, enemas and nauseous substances that made patients vomit) or by suppressing symptoms, such as by lowering the body temperature of patients who were feverish. By contrast, Hahnemann promoted an immaterial, vitalistic view of disease: "...homeopathy...can easily convince...that the diseases of man are not caused by any substance, any acridity...any disease matter, but that they are solely spirit-like (dynamic) derangements of the spirit-like power (the vital principle) that animates the human body."
Vitalism was a part of mainstream science in the 18th century. In the twentieth century, medicine discarded vitalism in favour of the germ theory of disease, following the work of Louis Pasteur, Alexander Fleming, Joseph Lister and many others. Modern medicine sees bacteria and viruses as the causes of many diseases, but Kent and some modern homeopaths regard them as effects, not causes, of disease. Others have adapted to the views of modern medicine by referring to disturbances in, and stimulation of, the immune system, rather than the vital force.
As previously stated, homeopathy stemmed in part from the idea of medical similars, the idea that 'like cures like' while Hahnemann was translating into German the Materia Medica (1789) of William Cullen, the so-called Scottish Hippocrates. On reading that Cinchona bark (which contains quinine) was effective because it was bitter, Hahnemann felt this implausible because other substances were as bitter but had no therapeutic value. To understand the effects of Cinchona bark, he decided to take it himself, and saw that his reactions were similar to the symptoms of the disease it was used to treat. At least one writer has suggested that Hahnemann was hypersensitive to quinine, and that he may have had an allergic reaction.
Yet, this proving experiment by Hahnemann was by no means unique, as others before him had tried the same approach, such as, for example, Anton von Sto"rck (1731-1803), "in the 1760’s, who advocated treatment by cautious use of poisons." Indeed, Hahnemann had studied briefly in Vienna (1777) where Sto"rck eventually became head of the University. The proving idea had also been recommended by the great Swiss medical botanist, Albrecht von Haller, (1708-77), who Hahnemann admired, and whose Materia Medica he translated in 1806. It might be said the proving experiment came to Hahnemann from several previous sources.
For Hahnemann, the whole body and spirit was the focus of therapy, not just localised disease. Hahnemann spent a lot of time with his patients, asking them not only about their symptoms or illness, but also about their daily lives. This gentle approach contrasted with the violent forms of heroic medicine common at the time, which included techniques such as bleeding as a matter of course.
Nearly as important as Hahnemann to the development of homeopathy was James Tyler Kent (1849 – 1921). Kent's influence in the USA was limited, but in the UK, his ideas became the homeopathic orthodoxy by the end of the First World War. His most important contribution may be his repertory, which is still used today. Kent's attempt to rescue an idealized pure homeopathy from what he saw as its degenerate mongrel forms was authoritarian, as he sought to re-emphasize the metaphysical and clinical aspects of Hahnemann's teachings, in particular:
* insistence on the core doctrines of miasm and vital force;
* emphasis on case totality rather than rote prescribing for 'named diseases'
* emphasis on psychological symptoms (to supplement physical pathology) in prescribing; and
* regular use of very high potencies.
Influenced by Swedenborgianism, Kent reputedly emphasized 'spiritual factors' as the root cause of disease.
"...for it goes to the very primitive wrong of the human race, the very first sickness of the human race that is the spiritual sickness... which in turn laid the foundation for other diseases."
Homeopathy around the world
There are estimated[54] to be more than 100,000 physicians practising homeopathy worldwide, with an estimated 500 million people receiving treatment. More than 12,000 medical doctors and licensed health care practitioners administer homeopathic treatment in the UK, France, and Germany. Homeopathy was regulated by the European Union in 2001, by Directive 2001/83/EC.
Britain
Homeopathy was first established in Britain by Dr Frederick Quin (1799-1878) around 1827, though two Italian homeopathic doctors (Drs Romani and Roberta) had been employed two years previously by the Earl of Shrewsbury based at Alton Towers in North Staffordshire; however, they soon returned to Naples as they could not tolerate the cool damp English climate. Homeopathy in the UK quickly became the preferred medical treatment of the upper classes: Regarding Dr Quin, "...with his connections, he was quickly established among the well-known and wealthy. Quin counted the Dukes of Edinburgh and Beaufort among his patients, and became physician to the household of the Duchess of Cambridge." Furthermore, "the principal supporters of the (homeopathic) hospital, until Quin's death in 1878, were members of the aristocracy." Homeopathy in Britain "...retained an elite clientele, including members of the royal family." and "...homeopathy still had much support from people in high places in the mid-nineteenth century..." At its peak in the 1870s Britain had numerous homeopathic dispensaries and small hospitals as well as large busy hospitals in Liverpool, Birmingham, Glasgow, London and Bristol, almost exclusively funded and run by members of the local gentry. For example, the Bristol hospital Image was funded and run by several generations of the W.D. & H.O. Wills tobacco family, while the Hahnemann Hospital Liverpool Image was built by members of the Tate family of sugar importers, who also funded the Tate Gallery in London.
In Britain, homeopathic remedies are sold over the counter. Today Britain has five homeopathic hospitals, funded by the National Health Service, which together with many regional clinics make free homeopathic treatment available on the health service. Homeopathy is not practised by most of the medical profession, but there is public support for it, including from the Prince of Wales and many other members of the royal family.
Rumour has it that it was after homeopathy was used in treating King George V for seasickness in the 1920s or 1930s that the British royal family became firm devotees of this medical system.
The largest organisation of homeopaths in Britain, the Society of Homeopaths, was founded in 1978 and has been growing steadily since then; it now has 1300 members, an increasing proportion of whom are women. The medically qualified homeopaths in Britain are represented by the Faculty of Homeopathy based in London: "The Faculty, which was incorporated by an Act of Parliament in 1950, has over 1,400 members throughout the world and is poised for growth as interest in homeopathy increases both among the public and within the health care sector."
India
Homeopathy arrived in India with Dr John Martin Honigberger (1795-1869) in Lahore, in 1829-30,[65] and is officially recognized. "The first doctor who brought homeopathy to India was Dr. Martin Honigburger, who first came to the Punjab...in 1829." India has the largest homeopathic infrastructure in the world, with 300,000 qualified homeopaths, 180 colleges, 7500 government clinics, and 307 hospitals. The Association of Qualified Homoeopaths in India (IHMA) is the largest of its kind.
Interesting education pattern in India is that homeopathy is taught at the university as a full length medical course which amounts to four and half years of full time medical studies plus one year of ward training; entailing the study of anatomy, physiology, pathology, internal medicine, surgery, gynecology and obstetrics, pediatrics, psychology, besides the homeopathic pharmacopia, philosophy, pharmacy and the repertory. The homeopathic doctors in India are considered medical doctors, unlike in many other western countries; and they are trained to clinically diagnose medical and surgical conditions.
USA
Homeopathy was first established in the USA by Dr Hans Burch Gram (1787-1840)[69] in 1825 and rapidly gained popularity, partly because the excesses of conventional medicine were extreme there, and partly due to the efforts of Dr Constantine Hering (1800-1880): "Dr. Hering immigrated to America in 1833 and later became known as the father of American homeopathy." Homeopathy in the US rose to great prominence. "By 1826 homeopathy had taken root in France, Italy, England and the Scandinavian countries....the doctrine arrived in New York in 1825." "Homeopathy spread first in Germany, then France, and England. Its greatest popularity, however, was in America." "Nowhere did (homeopathy) flourish as luxuriantly as in the United States." "...by the early 1840s American homeopathic practitioners were gaining considerable influence and prestige." The use of homeopathy in America increased still further in the next decade, In the period 1880-1900 they were at the height of their influence. Hardly any city numbering over 50,000 souls was without a homeopathic hospital and many smaller communities could claim them. In 1890 there were 93 regular schools, 14 homeopathic and 8 eclectic. In 1900, there were 121 regular schools, 22 homeopathic and 10 eclectic." "Homeopathy enjoyed wide popularity after 1841...many orthodox physicians gradually embraced homeopathy."
Historical note
In the 1930s homeopathy's popularity waned, especially in the USA and Europe, due in part due to advances in conventional medicine, skepticism, and the active advocacy against homeopathy by the American Medical Association. This led to the closure of virtually all medical schools teaching alternative medicine in the USA.
Homeopathy reached a peak of popularity in 1865–1885 and thereafter declined due partly to recognition by the establishment of the dangers of large doses of drugs and bleeding, and via dissent between different schools of homeopathy. The Carnegie Foundation issued the Flexner Report sponsored by the American Medical Association in 1910 that supported conventional medical schools while condemning homeopathic schools.
The Federation of State Medical Boards voluntarily agreed to base its accreditation policies for all medical schools on academic standards determined by the AMA's Council on Medical Education. Consequently, the CME's decisions "came to have the force of law." By the 1930s, the combined efforts of state licensing boards, philanthropic foundations, and the AMA's CME resulted in the eradication of America's proprietary medical colleges including homeopathic schools.
Classical versus non-classical homeopathy
Hahnemann's formulation of homeopathy is often referred to as classical homeopathy. Classical homeopaths use one remedy at a time, and base their prescription also on incidental or constitutional symptoms. However, homeopathic remedies are often used both by practitioners and by the public based on formulations marketed for specific medical conditions. Some formulations use a 'shotgun' approach of the most commonly indicated single remedies in mixture form, while others, such as those by Heel and Reckeweg, are proprietary mixtures marketed for specific diagnostic criteria based on various systems. Many members of the public are unfamiliar with classical homeopathy, and equate these practices with homeopathy; others are familiar with the classical approach but regard these as legitimate variants; while others consider it a misuse of the term. Use of non-classical approaches is confined mainly to places where over-the-counter preparations are popular and where many doctors use natural medicines in a conventional clinical setting.
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