Homeopathy: science or religion?

It was pointed out to me recently that the homeopathy looks more like a religious community than a scientific one.  Yet many homeopaths and their apologists say that they represent a new scientific or medical paradigm; implicit in this claim is that their community is scientific.

Examining this question gives me the chance to talk about my philosophical muse of the moment, T S Kuhn, and show that he sets the bar too high for homeopathy to claim to be a scientific community.

With regards to Kuhn and his philosophy we have seen that far from being an anarchic Feyerabendian “anything goes” relativist; he is much more moderate.  His view is that particular theories prevail for “good reasons“; not arbitrary ones.

Also, the sense in which most people continue to use the term ‘paradigm‘ is not Kuhnian.  For Kuhn these are the universally agreed concrete exemplars of good science; the stuff of textbooks: not a prevailing intellectual structure.

They are the possession of mature communities; characterised by having very few (usually only one) ‘school‘ within them. So, what does a scientific community look like for Kuhn?  Does he really set the bar too high for homeopathy?

Scientific Communities

For Kuhn scientific communities are the fundamental unit in his analysis.  He said of his original text for The Structure of Scientific Revolutions (all numbers in square brackets [ ] refer to the 3^rd Ed., 1996): “…If this book were being rewritten, it would…open with a discussion of the community structure of science…” [p.176]

Talking about scientists and their perception of their community ties he opines:  “Most practising scientists respond at once to questions about their community affiliations, taking for granted that responsibility for the various current specialities is distributed among groups of at least roughly determinate membership…” [p.176]

How is the membership of these communities to be defined?  Outlining his own “intuitive notion” of a scientific community he starts with the obvious definition: “practitioners of a specific speciality” [p.177].  He then elaborates on what the special aspects of a scientific community are; those that are “unparalleled in most other fields“.  These are:

• Members possess similar educations.
• They have experienced similar professional initiations.
• The membership has absorbed the same technical literature.
• Many of the same lessons have been drawn from the literature by the community.
• The boundaries of the technical literature mark the limits of scientific subject matter.
• The membership has shared goals.
• It trains its successors
• Professional communication is relatively full within the community.
• The members’ professional judgements are relatively unanimous.

Kuhn’s scientific communities are nested, breaking down broad scientific disciplines into their constituent specialities.  At the top of his tree there is “The most global…the community of all natural scientists” [p.177].  Next come the main professional groupings: “…physicists, chemists, astronomers, zoologists and the like…”

Membership of these groups is, according to Kuhn, relatively easy to ascertain; key markers are: the subject of highest degree; membership of professional societies and journals read.  He argues that sub-groupings can be identified using the same approach.

Kuhn notes that in the next layer of science it is more difficult to identify the communities.  He suggests looking at other discriminating parameters: attendance at special conferences; who referees the papers produced; communication networks and linkages among citations.

What can we learn about the status of the ‘homeopathic community’ from these markers: does it look like a scientific community or not?

Homeopathy: a scientific community?

Education and Professional Initiation

Let’s start with education.  Kuhn identifies the “subject of highest degree” as a key marker for membership of a scientific community; yet homeopathy is not a wholly graduate community. Some homeopathy colleges even doubt the value of studying the subject to ‘degree’ level

“…A major concern with degree courses is how much the course has had to compromise in order to meet the academic criteria of the accrediting university. “

The Homeopathy College – Birmingham (website accessed 7^th January 2007)

Given the academic betrayal that BSc. Degrees in homeopathy currently represent, this is a worrying opinion; one can only hope that it is not widely held.

Kuhn also lays great emphasis on the similarity of educational experiences within a scientific community, however, for homeopaths this varies greatly.  It ranges from the post-graduate acquisition of homeopathy after a conventional medical training, through specific university degree courses to short “home learning” courses. 

This situation may be remedied by the Council for Organisations Representing Homeopaths (CORH) or, given the organisations current disarray, it may not.  The Natural Healthcare Council may do better, or may not.  Central to be problems both these initiatives face is the sheer number and variety of ‘representative’ institutions.

The number and diversity of these institutions is without parallel among true scientific communities.  For example, the UK physics community has the Institute of Physics.  This is affiliated with other, national and supra-national, representative physics institutions outside the UK.  In contrast, for UK based homeopaths, there are the following institutions to choose from:

• Alliance of Registered Homeopaths (ARH)
• Association of Natural Medicine (ANM)
• British Register of Complementary Practitioners (BRCP Hom. Div)
• Council for Homeopathic Colleges (CHC)
• Embody
• Fellowship of Homoeopaths (FelHom)
• Homeopathic Medical Association (HMA)
• International Register of Consultant Herbalists and Homoeopaths (IRCH)
• International Society for Homoeopathy (ISH[UK])
• National Association of Homeopathic Groups (NAHG)
• Scottish Association of Professional Homeopaths (SAPH)
• Society of Homeopaths (SoH)

(I am indebted to Gimpy’s Blog for this listing)

Now there may be some overlap, but even so, this range of ‘professional’ institutions undermines any claim to be a scientific community.  It is a marker, not just for diverse educational experiences and professional initiations: it calls into question the possibility of shared goals, unified training, full communication and unanimity of professional judgement; more on these later.

Technical Literature

The position on the body of technical literature seems clearer.  The NHS’ National Library for Health “Complementary and Alternative Medicine Specialist Library” provides a good way to assess where the best quality homeopathic trials and research are published.  This database is prepared by the leading members of the UK’s medical and academic homeopathy community.  Therefore it can be taken to include the best research published in the field.

 Aside from publications in mainstream journals there are entries published in: Homeopathy, The Journal of Alternative and Complementary Medicine, and Complementary Therapies in Medicine.

Do the boundaries of the technical literature mark the limits of homeopathy?  No, they do not.  It is absolutely standard practise in homeopathy to transgress the boundaries provided by the literature: the treatments offered by homeopaths go far beyond the evidence contained in the ‘respectable’ literature. 

For example the only positive trial contained in the UK’s NHS database is for the treatment of vertigo with a homeopathic ‘medicine’ called ‘Vertigoheel‘ (an example of Clinical homeopathy).   However, homeopaths (even the medically qualified) do not limit themselves to the treatment of vertigo.

The most egregious examples are offering prophylaxis and cures for malaria as well as treatment of HIV/AIDS.  These fantasies are indulged in by doctrinaire homeopaths in the complete absence of evidence; pushing beyond the bounds of their technical literature.

Another pressing problem is that the technical literature provides no answer to the vexed question of how homeopathy ‘works’.  This also limits its ability to provide bounds for the field.

Learning Lessons and Professional Judgement

The next fundamental problem arises when looking at the question as to whether homeopaths have drawn the same lessons from their literature: it is clear that they have not.

There is no clear agreement on what homeopathy really is or which therapeutic schools are valid.  For example, a substantial body of opinion denies outright the validity of Clinical or Complex homeopathy.  Some accept Isopathy, others do not. 

On considering the literature some apologists deny that fair trials are a fair test of homeopathy; others spend their careers undertaking methodologically conventional trials.

There is no agreement on how homeopathy ‘works’.  For some it is a sort of quantum mechanical effect (or something for which quantum mechanics provides a kind of metaphor, model or analogy; take your pick – the vagueness is theirs not mine). 

Others argue that the solvent remembers the solute in an as yet unknown way.  A vocal minority claim that this memory can be ‘digitised‘ and sent down telephone lines.  This leads to the even wilder proposition that homeopathic remedies can even be embodied in music.

The so-called laws of homeopathy are not uniformly accepted.  The “law of similars” is flouted by Isopaths and their fellow-travellers.  The “law of infinitesimals” is not followed by many Clinical homeopaths.

Some homeopaths claim that conventional medicine stops their potions from working and dissuade their clients from using it; they take homeopathy to be alternative medicine.  Conversely, ‘responsible’ homeopaths offer ‘treatments’ alongside conventional treatment, or for ailments for which it cannot provide relief: for them it’s complementary medicine.

Many homeopaths are virulently against vaccination, as it contradicts the “law of similars“.  Medically qualified homeopaths, at least in the UK, disagree with this position; to some extent.

The conclusion is inescapable: professional judgements vary wildly.

As already noted, homeopath’s education varies wildly.  Thus the training of their successors falls to individual therapeutic schools.  Consequently, homeopaths are disciples of different traditions.

The homeopathy ‘community’ looks nothing like any scientific community that I have seen.  Of conventional scientific communities Kuhn notes:  “Communities of this sort are the units that this book has presented as producers and evaluators of scientific knowledge.  Paradigms are something shared by members of such groups…” [p.178]

Therefore, homeopaths and their apologists are not in a position to be “…producers and evaluators of scientific knowledge…”, neither are they in a position to share paradigms.

Is this important?  Well, if you claim you community to be part of a Kuhnian revolution in science your community must look like a Kuhnian scientific community.  As we have seen, homeopathy does not

Homeopathy: A Religious Community?

As has been noted by others, homeopathy looks more like a religious tradition rent asunder by schism.  This may well be due to the religious and mystical influences on its origin and later development.  It isn’t possible, in this post, to do more than sketch an outline of this pervasive influence.  However, briefly drawing on a fascinating book called “Homeopathy In Perspective: Myth And Reality” (© 1998-2004 by Anthony Campbell.) will provide some telling insights.

Anthony Campbell was a homeopath; a Fellow of the Faculty of Homeopathy and a former consultant physician at The Royal London Homeopathic Hospital.  He is also a past Editor of the British Homeopathic Journal (now renamed Homeopathy). 

He has clearly researched this subject in depth and is well placed to point out the religious influences on the origins of Hahnemann’s conception of homeopathy as well as its subsequent development. (All page numbers in parenthesis () are from “Homeopathy In Perspective: Myth And Reality“)

“…We shall not understand the man unless we realize that for him, homeopathy was much more than a mere medical theory; it was a divine revelation. I am not exaggerating here. We know from his own writings that the idea of homeopathy came to him as the solution to a religious dilemma. This dilemma was the paradox that confronts anyone who believes in a God who is simultaneously all-powerful and all-good; how to account for suffering? Hahnemann was not a Christian but he was a deist. He believed that the universe had been designed by an infinitely wise and loving Father, and such a Father, he reasoned, must have provided his children with a means of relieving their suffering.”

(pp. 27-28)

For Hahnemann, homeopathy was a solution to a pressing theological problem.  Later, more directly mystical influences are evident.  Campbell continues:

“…Swedenborgianism and homeopathy took to each other at once. Swedenborgians found in homeopathy a medical system that perfectly complemented their religious attitude, while homeopaths found in Swedenborgianism a religious framework into which Hahnemann’s ideas could expand freely. Homeopathy thus quickly became the accepted medical system for Swedenborgians, while most of the leading nineteenth century homeopaths, including Hans Gram and Constantine Hering, were Swedenborgians…”

(p.58)

Other mystic influences continued to influence the development of homeopathy, according to Campbell:

“…By linking homeopathy with Swedenborgianism the American high-potency school established a connection with occultism, but this is not the only one of its kind. There is indeed a counterpoint of occultism running through homeopathy right from the beginning…”

(p.79)

The occultist “counterpoint” has also included the alchemical tradition; particularly that espoused by the sixteenth-century physician Theophrastus von Hohenheim (Paracelsus).  It also includes the Golden Dawn movement.

The more recent link with Rudolph Steiner‘s ‘Anthroposophical Medicine‘ is interesting.  Campbell describes the link to homeopathy and gives an insight into this practise.

“…Steiner’s medical ideas are rather similar to those of Hahnemann though they also derive from earlier sources, especially Paracelsus and the alchemists; Steiner placed much more emphasis on symbolism and occultism. Many Anthroposophical medicines are the same as those used in homeopathy but they are often given as mixtures instead of singly. The Hahnemannian method of potentization is sometimes used but Steiner also invented some more complicated procedures. For example, metals are often ‘vegetabilized’ by passage through a plant. A metal is added to the soil in which a plant is growing; next year the plant is composted and used to fertilize a second generation of plants, and the process is repeated for a third year. This is said to dynamize the metal very effectively, while the influence of the metal causes the plants to direct their action to a particular organ or system…”

(p.81)

Anthroposophical Medicine is now accepted as one of the many therapeutic schools within homeopathy.  This shows that far from mystical influences belonging to homeopathy’s past, they are a central part of its present.  This is a difficult problem for any within the homeopathy community who may wish it to develop into a scientific community; or at least be seen by those on the outside as one.

Campbell provides an insiders view of this problem.

“…There has long been an uneasy tension between those homeopaths who wish to make their subject wholly scientific and respectable, and those who have leanings towards the mystical or the occult. Today, naturally, the scientifically minded are in the ascendant; the talk is all of evidence-based medicine, double-blind trials, and the physics of water molecules. Yet there has always been, and still is, a movement within homeopathy (even medical homeopathy) in the opposite direction…

…Some homeopaths are drawn towards unconventional and unscientific means of selecting remedies, such as pendulum-swinging and other forms of dowsing. In this as in other respects, homeopathy harks back to its origins. We tend to think of Hahnemann as a nineteenth-century figure, but we forget that his formative years were spent in the eighteenth century. We don’t need to go much further back than that to reach a time when doctors routinely used astrology to help them make their diagnoses…”

(pp. 81-82)

I think that there is a strong argument that whilst homeopathy may not be a conventionally religious community: it is a community with a strong mystical core.

Is Scientific Homeopathy Possible?

To move towards looking like a Kuhnian scientific community homeopathy would need to turn its collective back on its past (like physics has done with astrology and chemistry with alchemy); instead of harking back to it.  What would this entail?

1. Its occultist and mystic tendencies need to be expunged.  The more ‘scientific’ homeopaths desperately need to cull the competing therapeutic schools. 
2. The practise of homeopathy needs to be bounded by both basic science and a high-quality evidence base. Proper respect for evidence and its methods of collection needs to pervade the discipline.
3. Educational routes into homeopathy need to be fewer and degree based (or the equivalent).  These need to teach solid science.
4. Single national representative institutions need to emerge from the current morass.  These should robustly and transparently police the practise and teaching of homeopathy.  

Perhaps after this is done homeopathy vanishes entirely.  Just maybe a worthwhile scientific discipline rises from the ashes of mysticism (perhaps it will look something like this).  Until something very like it happens: homeopathy is mysticism, not science.

So maybe Kuhn can provide a respectable structural model for homeopathy.  However, at this time, it is a pipe-dream not a description.  Until homeopaths learn the lessons of philosophy, rather than using it as an excuse for failure, this will not change.

Next: Kuhn’s take on the role of anomalies in science.