Brief history
Homeopathy was the discovery of a German physician, Samuel Hahnemann, over 200
years ago. Hahnemann observed that there were therapeutic substances (i.e., used
in the treatment of disease) which, when given in small doses to a healthy
person, produced symptoms similar to the disease itself. As he explored this
phenomenon, he developed a theory which is still the foundation of homeopathy
today: "Similia Similibus Curentur" or "Like Cures Like," also known as the Law
of Similars. Further experimentation and research by Hahnemann seemed to
indicate that the smaller the dose, the stronger the effect - a counterintuitive
finding which still puzzles physicians and researchers today. (It is thought by
some to resemble the immunization process, but there are several other theories
being postulated.)
Homeopathy was brought to the United States in the 1820s, and in 1835 the
first homeopathic college was founded. Although it was not successful, the
spread of homeopathy was dramatic through the rest of the 19th century.
Estimates of usage by the end of the century indicate 10% of all American
physicians used homeopathy in practice, and there were more than 20 homeopathic
medical schools (as well as courses offered in many regular medical schools).
Even as homeopathy reached its historic peak in the U.S. a hundred years ago,
developments were already under way which would almost wipe it out by 1950.
Chief among these was the successful effort by the American Medical Association
to force medical schools into a uniform approach to teaching medicine, and state
laws into a relatively uniform (and monopolistic) approach to practice. Schools
which did not conform, were unable to survive. Another factor was the appearance
of miracle drugs, making huge advances in treatment, in anesthesia and in
antisepsis. It seemed for a good many decades in mid-20th century that we were
on our way to discovering cures for everything. Many natural medicine
alternatives declined (homeopathy, naturopathy, midwifery, herbalism,
hydrotherapy and others) and their practitioners were harassed and suppressed.
Slowly but inexorably, the awareness spread through professional and consumer
groups alike that heroic interventions such as drugs, surgery and radiation,
while immensely valuable, are not panaceas. In addition, voluminous information
began to accumulate about the cascade of conditions and illnesses that are side
effects of their use. Consumers began to look for gentler, less toxic ways of
treating all those ailments from which civilizations still suffer. Thus was born
the current renaissance of natural health care; homeopathy has experienced a
substantial rebirth in the last 20 years, and continues to grow rapidly today.
Philosophy
Although the "like cures like" philosophy of homeopathy and the inverse
relationship between dilution of the remedy and treatment effect are still
poorly understood by scientists and practitioners at the theoretical level,
there is a growing body of research to demonstrate the philosophy's validity
(see our "Conditions" section for more information). In addition to the Law of
Similars, there are other important philosophic principles. Homeopathy falls
into the vitalist tradition of health care - meaning that practitioners have a
belief in the "vis medicatrix naturae," or the healing power of nature.
Homeopaths believe that their remedies strengthen and activate the body's own
innate healing capacity, which is what finally accomplishes the cure. Homeopaths
also believe that prescribing the correct remedy relies on understanding the
totality of a person's symptoms - not just those that appear to be directly
related to the disease. In other words, this is also a holistic discipline,
whose adherents believe that each individual forms a unique, whole being, and
that the whole person must be treated to create optimal health. Homeopathy's aim
is the cure: "The complete restoration of perfect health," as Dr. Hahnemann
said.
Scope of practice
Homeopathy does not have a well-defined legal scope of practice because it is
used by practitioners in many different professions, and there are no uniform
educational standards. Practitioners are usually able to adapt their clinical
approach to the scope of practice permitted by their own discipline and
regulatory environment. Homeopathy is also practiced by lay homeopaths, who are
often self-taught or minimally trained, and who do not hold a health care
license of any kind. Homeopathy does have a core philosophy and established
methods (see Philosophy below) which, because they don't closely resemble
conventional medicine, can be interpreted to mean it is - or is not - the
practice of medicine. Both interpretations have been applied by states, and
there are still variations in state laws which refer to homeopathy.
In the United States today, consumers may find lay homeopaths, physicians
(medical, osteopathic and naturopathic), nurses, dentists, chiropractors, and
many others offering homeopathy. Consumers should understand that there may be a
wide range in training and expertise among practitioners, and the burden rests
on each consumer to investigate a practitioner's background to his or her
satisfaction. If you choose a practitioner who has a health care license, that
person will be bound to the scope of practice established by that licensing law.
Homeopathic medicines, which may be produced from plants, animals, minerals
and other substances, are classified as drugs by the Food and Drug
Administration. Although most are available over the counter, there are a few
(those using disease materials or controlled substances) which are available
only by prescription. The Homeopathic Pharmacopoeia of the United States was
incorporated into federal law in 1938, making the manufacture and sale of
homeopathic medicines legal in this country, and prescribing accepted
manufacturing standards. Today, there are more than 2000 remedies, and new ones
are still being identified.
Regulatory scope
There are only three states which directly regulate homeopathy: Arizona,
Connecticut and Nevada; in these states MDs practicing homeopathy must be
licensed by the state homeopathic licensing board (and other providers must have
it included in their legislated scope of practice). In those jurisdictions where
naturopathic physicians are licensed, homeopathy is included in their scope of
practice. Other professions and practitioners must determine whether or not
homeopathy is permitted within their existing scope of practice; judging by the
rapidly growing number of schools and practitioners, it appears that most health
care practitioners are finding it possible to add homeopathy to their clinical
practice without incurring regulatory problems. Still, it is always wise for the
consumer to ask what the regulatory situation is for a given practitioner, and
it is imperative that you ask about training, because in the absence of state
laws, education and credentialing are important elements in ensuring
accountability.
Education and credentialing
Naturopathic physicians are the only practitioners today who undergo formal,
medical school training in homeopathy as part of their standard didactic and
clinical curriculum; homeopathy has been included in their scope of practice in
every state where they are licensed since the early 1900s. Other than this one
field with a continuous, well-established standard, it's open season. There is
an astonishing array of programs and schools, for lay people, physicians and a
whole range of other practitioners, both here in the U.S. and abroad.
The Council on Homeopathic Education (CHE) was formed in 1982 to monitor and
approve the quality of courses offered for licensed professionals; the agency is
currently preparing itself to apply for federal recognition as an accrediting
agency. It publishes a list of schools which are recognized and those which are
in the process of obtaining recognition.
There are several certification boards of homeopathic practitioners: Council on
Homeopathic Certification (CHC), North American Society of Homeopaths (NASH),
American Board of Homeotherapeutics, Homeopathic Academy of Naturopathic
Physicians (HANP), and National Board of Homeopathic Examiners. A practitioner
who is serious about offering a high level of expertise in homeopathy should
have obtained significant advanced training, and probably some form of
certification as well.
Typical first office call or visit
If you schedule a first office call with a practitioner who does primarily (or
only) homeopathy, be prepared for a lengthy visit. It is the homeopath's job to
obtain as much in-depth information about you as possible, in order to evaluate
the totality of symptoms and select the remedy which most closely matches the
overall picture. Practitioners whose scope of practice includes diagnostic tests
may perform a physical examination and/or laboratory work; others may refer out
for such tests, or ask that you bring recent records from a primary care
provider with you. It is not unusual for an initial homeopathic work-up to take
1-2 hours. Your practitioner may not give you a remedy immediately, as it may be
necessary to reflect on all the information and research the appropriate remedy.
Even experienced practitioners may sometimes try two or three remedies before
finding the best one. (Since there are over 2000 remedies available, some
homeopaths will use a computerized repertory to do this research.) Return visits
should be no longer than 30-45 minutes, unless an unusual situation has arisen.
When the remedy is selected, it will be administered in the form of tiny
sugar pellets, which have been soaked in a very dilute solution of the
appropriate therapeutic agent and which dissolve quickly under the tongue. The
more dilute the solution, the higher the potency. Over-the-counter homeopathics
tend to be low dilutions, which can safely be used for self-care. Prescribing
higher potencies should be done by a trained practitioner. You may be given a
single dose, or asked to take repeated doses until you start to feel better.
It's important to follow your practitioner's advice about how to take (and
store) the medicine. You may be asked to avoid ingesting other substances while
under homeopathic care, although there is a lot of disagreement about just which
things might antidote a homeopathic remedy. Work with your practitioner on this
issue.
In homeopathy, the action of the remedy is considered the initial stage of
healing; the body's own capacity to heal is activated by the remedy, and can
continue working over many weeks or months. Therefore, homeopaths tend to take a
long view of the healing process. Nonetheless, patients should feel free to
express any concerns they have about whether they are getting better, or how
long it is taking. If not satisfied with the pace of healing, consider asking
for a return visit sooner than originally planned, or request a referral. Do not
let acute or serious chronic symptoms continue unaddressed if no improvement is
noted within a reasonable time frame.
Limitations to be aware of
Many practitioners believe that homeopathics may be inactivated (antidoted) by
certain pharmaceuticals, dental work involving drilling or anesthesia,
acupuncture treatment, chiropractic manipulations, and strongly aromatic
substances such as mint and camphor. Some homeopaths recommend against using
coffee, alcohol or certain medicinal herbs while under homeopathic care. The
evidence on these issues is not strong, and there is disagreement among
practitioners. It is best to find out what your homeopath recommends, and why,
and then work within those parameters.
