– Homeopthy in america : taking the case (R. Stewart)

When I first became professionally interested in homeopathy in the early 70s, a friend declared that the practitioners of holistic medicine were like so many Balkan emperors: each had their own special ‘territory’, each operated out of a kind of religious dogmatism, and each held the other in often flagrant enmity. So total was my enthusiasm for the theoretical possibilities of homeopathy, though, that I dashed directly into the fray. Homeopathy seemed to offer all the right kinds of stimulation to my maverick mind. Besides, then there were very few emperors indeed.
 The last 20 years, however, has seen a veritable rash of new practitioners, exuding greater confidence and knowledge than ever before. Far more educational opportunities abound at every level, and yet consumer demand still far exceeds supply. More “homeopathic” products are reaching more outlets than ever before, and even orthodox pharmaceutical companies are scrambling for market shares. Serious university studies are underway and governmental agencies (NIH) have begun to take an interest. There are even several homeopathic software companies. All of this activity has led some to refer to a homeopathic renaissance in this country at this time.
 That popular sentiment has begun to embrace the idea of alternative medicine is in evidence by the outpouring of media support. Recently, a local Manhattan homeopath was featured on national network television. The response was entirely favorable. The country is said to be caught up in some great “sea change” of shifting priorities. While last year’s debate on health care was largely pomp and politics, a more substantive current stirs just below the surface. The millennium swiftly approaches. But before we become overly optimistic, we should remember that the line in Shakespeare refers, after all, to a drowned father’s face.
 The present interest in homeopathy is not so much coming out of a sober evaluation of its merit as out of the perceived bankruptcy of regular medicine to deal effectively -and cheaply -with chronic illness. Many other alternatives have jumped, much more successfully, into this breach. Behold the spread of chiropractics within this century, acupuncture in the last few decades, and, now, ayurvedic medicine in just a few years. What’s different is homeopathy’s rather checkered past. Occasionally heartily embraced by independent thinkers but more often as heartily reviled by established medicine as a form of “scientific secretarianism,” homeopathy, after more than 150 years, has never gained the prominence it enjoys in other countries. That homeopathy was viewed, for the most part, as an eccentric, sometimes pugnacious, fringe phenomena was understood by the profession itself as a factor of outside forces. The question is: how much did the homeopaths themselves contribute to this outrageous fortune?
 An honest insider’s appraisal would have to own that homeopaths spend an inordinate amount of time and energy either covertly or overtly marginalizing one another. Sometimes the issue is the potency; sometimes it is a specialized technique; sometimes it is the ‘depth’ of vision; sometimes it is just the personalities themselves. Further candor would admit that American homeopaths are not -excepting perhaps Kent *, Close and Hubbard -philosophically refined. We are a “Can-Do” people, and approach ideas a bit naively. As Americans, we are known throughout the world (or used to be) for our good-hearted credulity. As American homeopaths, in the last 20 years, we have been open to ideas streaming in from all directions, and have, by turns, seen a Greek invasion, a French invasion, an Argentinean invasion, an Indian invasion, and a British invasion. Each was taken up, again by turns, with a convert’s unconditional fervor. The True Believers have laid claim to the profession, and since there are as many true believers as there are remedies for biliousness or for a headache, we have marginalized ourselves -not by what constitutes homeopathy -but by what constitutes the practice thereof.
 To the question, what is homeopathy? there is the Organon. To the question, who is a homeopath?: se cannot be given. Certainly the study and mastery of materia medica and philosophy are a necessary but hardly sufficient criterion. In the Hippocratic Oath -(do homeopaths hold to this tradition?) -just after the part about consecration, service, respect and gratitude, professional conscience and dignity, and the maintenance of honor, it reads: “My colleagues will be my brothers/sisters.” For decades, what fraternity there has been has been more in evidence among patients, and not within a concordant profession. That is a sad fact. Some reasons for this are: 1) discord over potency; 2) adherence to specialized techniques; 3) personality cults; 4) fear of allopathic wrath; and 5) licensure.
 From the beginning, the potency question has divided homeopaths quite unnecessarily. The truth is that potency selection is more a matter of experience than anything else. Posology is never an exact science except for the demagogue and the dabbler. But everyone seems to have some very definite idea nonetheless. It is possible, though, to remain fairly open on the issue, and to use every potency, high and low, as the case demands. I have even heard of a homeopath in India who uses CM potencies in daily doses with no aggravations.
 In my own experience, I started as a high potency, centesimal Kentian, appreciating the elegance of giving one, single decisive dose and never having to look back. Of course, that didn’t always happen. (Never mind that it only infrequently did!) Later, I began to reduce the potency and to ‘plus’ doses before going higher, having learned to respect the sensitivity of the patient and the size and intensity of the dose. I also seemed to gain more control of the case in this way, and patients often felt more secure with ‘a remedy in hand.’ I still use primarily ‘high’ potencies with children -one dose and their chronic otitis media is gone forever! (Generally.)
 It took Hanhnemann a lifetime of experience to evolve to the use of the so-called LM potencies. But one needn’t become a book-thumping 6th Editionist for that reason. He did not live long enough to write a 7th, 8th, or 9th edition, in which he would have undoubtably had more to say. What we want from posology is that it provides easy compliance and maximum flexibility, and that it honors our commitment to gentleness. For the rest, after almost 200 years of reliable use, we can afford to be more relaxed and less dogmatic about ‘the potency question’. There is the old adage: art is long but life is short. When it comes to the proper potency, all homeopaths are in the process of writing the 7th, 8th, and 9th edition of the Organon. Besides, Hahnemann also recommended in that same 6th edition that every pregnant lady should be given Sulphur (he didn’t say what potency) to antidote latent psora. Can that be good practice? This cannot really be Hahnemann the homeopath speaking; this is Hahnemann the social eugenicist. Call him: Papa Hahnemann.
 As to specialized techniques, they seem to go hand and hand with the cult of the personality. And because we Americans are so ingenuous, it sometimes takes years to realize that the only sacred thing in healing is the therapeutic relationship itself. Even homeopathy must make room for the special destiny that patients have with their doctors, and vice versa. Think of the many stories patients often tell of their search for homeopathic care. Now think of it the other way around. The difference is this: the patient makes an outer search; the homeopath, an inner one. But the effect is the same: the patient and doctor both find each other in the therapeutic exchange. There are vast ethical issues involved here. Each of us must make homeopathy uniquely our own, and not rely on the personalities of our teachers, past and present, nor on their particular bias in prescribing. A truly unprejudiced observer will have no trouble admitting to this (occasional) bias. This is part and parcel of the art and science of medicine that if honestly pursued, it is self-corrective over time.
 A good example of the inductive procedure outside homeopathy are the stories of Arthur Conan Doyle. They are an excellent teaching tool for case-taking. Sherlock Holmes was a master sleuth not only because he had a special genius, but because he tried to remain open to all the evidence, objective and subjective, reasoning from particulars to generals, and thus avoiding the hasty conclusions -“deductions?” -of his allopathic sidekick, Dr. Watson. Here was a spirit that even Hahnemann would have admired! But don’t think that Sherlock, despite his external inflations, was ever without doubt and hesitation. This, too, is part of the art and science of medicine, and keeps the practice genuine. Our best teachers are always our patients.
 Recently I have been helping some Russian doctors get used to prescribing successfully in this country, and to eventually take and pass the National Certification Exam. Their experiences of homeopathy from Russia were very different from this country. For one thing, under communism, it was considered antisocial to have a private practice, so most doctors worked in clinics, i.e. , dental, oncology, psychiatric, dermatology, etc. -situations were the pathology is clearly distinguishable from personality. In their homeopathic clinics, they were never so exposed, as we are in the West, to all the variety of general practice. Every time the door opens to a new patient, incredible adjustments have to be made as to personality, age, ethnicity, gender, etc. They often express amazement at the excessive individualism (neurosis?) of Americans. The Russian soul is by nature more collective, even before communism. The emphasis in their homeopathic studies was on materia medica as handed down from person to person in a kind of oral tradition. (Did you know that Lac caninum was a great remedy for difficult children?) Very little repertorization was taught. When I began to introduce cases with the idea that someone could be harboring deep resentment over having been a middle child, that another was delusional as to personal identity, that someone else could view the world as hostile and sinister, and on and on, they looked puzzled, until one doctor suddenly exclaimed: “that’s not homeopathy -that’s literature!”
 When the person is their story, why shouldn’t homeopathy resemble literature and still be scientific? But what homeopathy is, is not the question. At least to those who practice it. I believe the question facing homeopathy today, and one that will have to be faced with increasing urgency in the very near future, is a social and a professional one. Leaving aside the legal aspect for the moment, by what criterion do we use to characterize the profession before the world? How do we define a homeopathic practitioner? Who may rightfully call themselves such?
 What is needed -beyond the Organon and materia medica -in the way of a conventional understanding of the physical body in health and disease has been a subject of much debated in the past, and it continues to be a ‘bone of contention’ even today. Some people hold that a complete knowledge of anatomy, physiology and traditional diagnosis is indispensable to a good homeopathic practice. But the question is: by whose standards is this obtained? And in what way is this information made use of? In a word: how much allopathy need one know to be a homeopath?
 In 1897, Dr. Eugene H. Porter, then President of the New York State Homeopathic Medical Society, and later Commissioner of Health for New York State, offered the following definition of homeopathy: “A homeopathic physician is one who adds to his knowledge of medicine a special knowledge of homeopathic therapeutics and observes the law of similars.”
 This definition was then taken up by the American Institute of Homeopathy in 1898, and was the cause of a major controversy between the spirit of homeopathy (obtainable from even a cursory reading of the Organon) and the desire to either placate or fit into the customary notions of what constitutes a medical science. The International Hahnemannian Association and James Tyler Kent * were strongly opposed to the wording of this definition. Kent, speaking as a true Hahnemannian, was scathing in his attack on what such a definition implied. He contended, contrarily, that a homeopath was “one who abandoned traditional absurdities.” Some of his response can be found in The LesserWritings, page 229 in my edition.
 The problem is allopathy claims for itself that which is absurd on two counts: First, anatomy and physiology are studies that may become the possession of anyone who has the time and patience to acquire them; secondly, allopathy makes the fatal mistake of separating knowledge from praxis -that is, there is no inherent connection, in regular medicine, between what constitutes pathology and its treatment. Hahnemann knew far less about the endocrine glands than the proverbial ‘person in the street’ does today, and yet he was a great healer. It’s how one makes use of what one knows that makes the difference. I am not saying that homeopaths have no use for the ordinary knowledge of anatomy and physiology, of diagnostic skills, and even of allopathic drugging. The point is that homeopathy itself should decide to what extent this knowledge is desirable, and not outside agitation. Leaving aside the suspicion that the customary views of anatomical/physiological phenomenon may be entirely inadequate, my own opinion is that all that is really needed in this area can be obtained by anyone in six to ten months of study.
 Some others have taken the proprietary position that only a state license can guarantee a legitimate homeopathic practice. This is a bit self-serving. And it obviously places the criterion, again, outside the profession. Besides, anyone researching the history of licensing laws in this country will find that these laws were never meant for consumer protection as it is usually maintained. They were established to protect the trade from outside competition. Period! The so-called “public interest” claim is bogus, and was advanced by the licensed profession, being more concentrated politically than the consumer, a posteriori.
 Protection from fraud is only possible when a profession is self-regulated. All that licensing laws do is add to the further incursion of the state into matters best left to individual conscience. I hold that all cultural activity -to which medicine belongs -is best pursued in a climate of unmitigated freedom. This does not mean that I am opposed to expertise and knowledge. This, however, can be more than adequately addressed outside state licensing laws, which, when not limited to actual civil situations, invariable cripples the human spirit. The North American Society of Homeopaths (NASH), the Homeopathic Academy of Naturopathic Physicians (DHANP), and other groups have established minimum standards of professional practice and scientific accountability quite outside any governmental obstructionism. More communication between these professional societies should be encouraged. Perhaps the National Certification Committee will begin to address this issue as well. As the conservative economist (and I am no fan) Milton Friedman writes:
 “The usual arguments for licensure, and in particular the paternalistic arguments for licensure, are satisfied entirely by certification alone. If the argument is that we are too ignorant to judge good practitioners, all that is needed is to make the relevant information available. If, in full knowledge, we still want to go to someone who is not certified, that is our business.” (The issue of state licensing has a far more baleful aspect, which was made explicit in a fairly recent sub-statute to the New York State law. After acupuncturists were busted in the 70’s and 80’s for practicing ‘medicine’ without a license, the existing law was reworded to include an extension of what the law was intended to cover: the “non-Western” and “non-allopathic”. Then this clincher was added: “and those not yet even conceived.” Don’t even think about it! Can these be the words that would proport to protect the pursuit of science? Can science actually be licensed and still be called a science?)
One final point 
 That medicine is one of the most inflationary segments of society is known all-to-well by everyone today. Unlike appliances, automobiles, housing, even food, where one can learn to do with less, all of us must eventually avail ourselves to medical services. The insurance industry has obscured the fact from some -(like public schooling is free!) -that we all pay dearly for medicine, even when we don’t use it, as the cost of all goods and services is predicated on the rising costs of medicine. That doctors, laboratories, hospitals, etc. have gauged the system for years, needs no documentation. It is, therefore, disturbing to see homeopaths doing the same thing. Frankly, some are charging what I would call prohibitively high fees for their services in an attitude of professional machismo. I know this is not a popular subject to discuss; that everyone would like to keep this a private affair. But as the public debate about medical costs increases -and it will -it is disheartening to see that homeopaths are part of the problem and not the solution.
 My purpose is not to be divisive nor to give offense. I only intended to address very briefly certain issues neglected in our journals -devoted, as they are, to case analysis and materia medica. Over the years, all of us have been giving a great deal of time, energy and attention to these studies, and, as a result, have now reached a certain level of expertise and finesse in our practices. We have witnessed the appearance of three or four new professional societies, and three or four national conferences occurring yearly. A circle has definitely formed around a growing and very dynamic community. Twenty years ago, the appellation, “homeopath”, was self-obtained: at a certain point, early or late, one would simply bestow the honorary, invisible degree of CH upon oneself (Chutzpah in Homeopathy!). This is no longer appropriate. Now one requires the recognition of one’s peers. This is what I would wish to underline. This is a professional step that shows maturity of vision.
 It is said politically that the 20th century began and is now ending on the same dreary note. Should the same be said of homeopathy? We are in a time of renewed interest in alternative healing. People are looking to homeopathy more respectfully than ever before, and patients are calling with a wonderful anticipation and gratitude. There are signs of growth everywhere. If we can subsume personality, potency and prejudice under the one rubric of professionalism, we can probably avoid the balkanization of homeopathy that has plagued us in the past.
 Robert Stewart, RSHom NA, lives, teaches, and practices homeopathy, in New York. He is the director of the New York School of Homeopathy. 212-206-7432 • 914-679-2875 

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Dr.Devendra Kumar MD(Homeo)
International Homeopathic Consultant at Ushahomeopathy
I am a Homeopathic Physician. I am practicing Homeopathy since 20 years. I treat all kinds of Chronic and Acute complaints with Homeopathic Medicines. Even Emergency conditions can be treated with Homeopathy if case is properly managed. know more about me and my research on my blog https://www.homeoresearch.com/about-me/
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