– The paradigm dispute in medicine (H. L. Coulter)
 – Harris l. coulter, ph.d.  april, 1997

Stage I: Emergence of the Minority Paradigm; Its Separation and Expulsion Homoeopathy, which had been practiced in Europe for over twenty years, was introduced into the United States in 1826 by a physician who had studied it in Copenhagen. It was rapidly accepted by physicians in both New York and New England and had many adherents among German immigrants in Pennsylvania and the Midwest.
 By the early 1840s this had engendered incessant quarreling within the medical societies which, as a contemporary wrote, “often exhibited scenes of discord calculated to disgust the more liberal and enlightened of their members and lower the character of the profession in the estimation of a scrutinizing public.” (1845) The allopaths soon realized that the homoeopaths were not to be persuaded of the error of their ways. They had to be marginalized and placed under a professional ban; throughout the 1830s and early 1840s local and state medical societies passed resolutions to this effect.
 The ensuing war against homoeopathy was conducted under the slogan, “reform of medical education,” the assumption being that only uneducated physicians would take up homoeopathy.
 This slogan justified formation of the American Medical Association, but no “reform of medical education” ever occurred. The AMA’s first and foremost order of business in 1847 was adoption of a “Code of Ethics” binding upon all local and state societies (individual membership was still for the future), which prohibited any professional contact with a homoeopathic physician.
 In time this led to an informal prohibition even on social contacts between the two bodies of physicians; the prohibition remained in place until 1903.
 For these 56 years the ban was rigorously enforced, its violation leading to immediate expulsion from the local or state medical society and boycotting of the offender by his former colleagues. The consequences were sometimes amusing. In 1867 the medical society of Westchester County, New York, expelled a member for purchasing sugar of milk (the basis of all homoeopathic remedies) at a homoeopathic pharmacy. In 1878 a physician was expelled from a medical society in Connecticut for professional contact with a homoeopathic physician who happened to be his wife. Students at allopathic schools were often forced, as a condition of graduation, to swear never to practice homoeopathy, etc.
 Benveniste, at one time a candidate for the Nobel Prize, was for a time banished from French scientific life for performing an experiment in the late 1980s tending to demonstrate that a substance diluted 10120, far beyond the Avogadro Limit, could still have an impact on a biochemical system-specifically, basophil degranulation.
 This discovery, a commonplace in homoeopathy for the past 200 years, was interpreted as a threat to the doctrinal bases of biology and physics and caused a tremendous commotion in those disciplines. The journal Nature, in which the article appeared, editorialized: “Benveniste’s observations …strike at the root of two centuries of observation and rationalization of physical phenomena.” Accounts of the experiment appeared on the front pages of major newspapers in most countries of the world. The conclusion reached by many representative physicists was that, since the laws of physics are immutable, Benveniste must have perpetrated fraud.
 His marginalization was accomplished through a site visit to Benveniste’s Paris laboratory by a three-man team made up of James Maddox (the editor of Nature), a professional magician named James Randi, and a young associate of the U.S.  National Institute of Health, Walter Stewart, who purported to be a specialist in scientific fraud. None of the three had specialized knowledge of biology, and the makeup of the group revealed that the decision had already been taken to condemn Benveniste on grounds of fraud. On returning to England Maddox retracted Nature’s endorsement of the initial Benveniste article and, in effect, charged that the Frenchman had either made up the data or committed inexcusable statistical blunders of interpretation. Thereafter and for several years until he made a comeback in 1997, Benveniste was shunned in French scientific circles and viewed as a researcher who fudged his data.
 Nature’s change of direction was amazingly rapid. Messrs. Maddox, Stewart and Randi spent all of five days in the Benveniste laboratory, and it was at least presumptuous to attempt to annihilate a major long-term project by one site visit. As Benveniste himself remarked, “Who, with even the slightest research background, would blot out five years of our work and that of five other laboratories on such grounds?”
 If this was presumption, that of Stewart, the self-appointed specialist in scientific fraud, was even more egregious. This rather young man told the writer in a private conversation that their site visit was a “crucial experiment” which disproved the whole of homoeopathy!!
 And, in fact, the subtext of the Benveniste episode was to avoid lending credence to homoeopathy. A Nature editorial accompanying the original article stated that Benveniste’s conclusions should not be used for the “malign [???] purposes to which they might be put …In homoeopathic medicine, for example, …there will be a natural inclination to welcome Benveniste’s article as aid and comfort…” Many letters to the editors of representative scientific and non-scientific publications stated the same.
 Just as the AMA’s Code of Ethics separated homoeopathy from allopathy in 1847, so Nature in July, 1988, was able to repeat the exercise. By blacklisting Benveniste and isolating him from his accustomed environment and colleagues, it hoped to strike a second blow at homoeopathic medicine.
 The two procedures resembled one another also in attempting to resolve a serious scientific issue by press release. Since the majority paradigm by definition has far better access to the press, this technique confers a marked advantage.
 This important aspect of the paradigm dispute also came to the fore in the Krebiozen and Antineoplaston disputes. The point is not to convince scientists of anything-those inside the majority paradigm need no convincing, and those outside it will never be convinced-but to act on public opinion.
 Stage II: Ideological Warfare
 In resisting intrusion by homoeopathy the allopathic majority did not admit that the clash was between competing paradigms but took the high ground of claiming to protect “science” from intrusion by imposters. Admitting that the conflict was merely over differing ways of combining technical inputs to earn a respectable living would have deprived the majority paradigm of moral superiority as a “science.” Even recognizing the minority paradigm as a legitimate partner in scientific controversy was an unacceptable concession, compromising the “scientific” status of the majority paradigm and even the moral integrity of its practitioners.
 Since protecting allopathy’s “scientific” status was the point at issue, the homoeopathic claim to be a science had to be assailed. These doctrines were criticized as “physiologically absurd [and] contrary to the commonest dictates of ordinary intelligence” (1853), full of “the grossest inconsistencies” (1851), etc., etc. Their acceptance was seen as tantamount to the destruction of science generally: “A revolution in science is to follow their reception, and a new system is to be based upon their assumptions” (1846). The German authority, Christian Hufeland, wrote early in the century: “most assuredly …would the whole science of medicine, were it generally cultivated in this manner, degenerate into sheer crude empiricism.”
 Those who accepted the homoeopathic paradigm were defamed and discredited in three ways: a) they were said to lack the necessary educational and scientific attainments, b) if they were obviously educated (i.e. , members of existing medical societies), they were said to possess some obliquity or peculiarity of mind or character which prevented them from seeing the scientific truth, and finally, c) they were said to turn their backs on scientific truth for venal and ignoble reasons, primarily because homoeopathy was a more lucrative mode of practice than allopathy.
 The supposed educational inadequacies of the homoeopaths were a favorite accusation. In particular, they were accused of not knowing anatomy and physiology, and in this way the homoeopathic technique of symptomatic diagnosis was turned against them.
 But many of these homoeopaths were graduates of the same medical schools-Harvard, Dartmouth, Columbia, and Pennsylvania-as all other physicians, and it was ludicrous to accuse them of educational deficiencies. Hence a second accusation-intellectual defect or obliquity-was called into action. “It is in consequence of a constitutional weakness of understanding and obtuseness of intellect” (1847). “Those physicians who are so visionary as to embrace homoeopathy, or similar delusions, have either an imperfect elementary medical education, or …their credulity …outweighs their judgment” (1846), etc., etc.
 But the third accusation-that they did it for money-was the most popular. “A class of minds poorly qualified to judge of the merits of any system, by imperfect education …embrace views more with reference to their value for obtaining their bread.” (1853) “We cannot think so poorly of their intellects as to believe them sincere.” (1853) “Where a deficiency either of ‘moral’ or respectable ‘professional’ standing exists, consultations and familiar professional intercourse with them should not be encouraged.” (1852).
 In this way the homoeopaths were effectively demonized as “immoral,” and the stage was set for their expulsion from the medical societies.
 The public at large never accepted these fanciful ratiocinations. Convinced that the homoeopaths were curing their patients, it flocked increasingly to these physicians, leading the allopaths to criticize them for pandering to the public’s preferences, for “dishonorably” seeking its support.
 “Disappointed of success in an honorable pursuit of their profession [they] have chosen from necessity the fashionable humbug of the day.” (1842). “[They] have taken up this mode of practice to secure patronage, which they would have failed to attain by pursuing a rational course, without regard to the prevailing whims and tastes of the community.” (1844). That homoeopathy was fashionable and popular because it was effective, and that people were willing to pay high prices for the same reason, was never admitted.
 But it was still necessary to explain away the homoeopathic cures.
 First the allopaths warned the public against the “post hoc, propter hoc” fallacy. Recovery or improvement after homoeopathic treatment should not be taken as proof of a causal relationship between the two. “In nothing is a wholesome skepticism more necessary than in judging of the effects of medicines by the progress and results of the cases in which they are employed.” (1846) Instead, the public was entreated to rely on the judgment of the allopathic physicians: “is it not the safest policy to be governed by the verdict of the medical profession?” (1883).
 Many homoeopathic cures were attributed to the inherent healing power of the organism, the vis medicatrix naturae. “Let no man, however much learned, assume the attributes of the Deity and say, ‘I can cure’; and let none rob his Maker by saying ‘I have cured.’ He that indulges in such language is a quack, whatever his name, and wherever you find him.” (1859).
 But this explanation could as well be cited against allopathy, and for that reason was less popular.
 Hence, a third explanation was invoked: patients recovered due to the residual effect of the earlier (allopathic) medication they had received. Oliver Wendell Holmes (the father of Justice Holmes) wrote of a case of croup where “leeches, blistering, inhalation of hot vapor, and powerful internal medication” had all been employed, and yet the whole merit was ascribed to “one drop of some homoeopathic fluid.” (1842).
 A fourth set of explanations hypothesized that the homoeopaths were really prescribing allopathic medicine concealed by the sugar coating.
 And finally, they fell back on coincidence. In the end of his life Oliver Wendell Holmes concluded that all homoeopathic cures could be explained in this way.
 The allopathic physicians could never bring themselves to test homoeopathy officially. The AMA has yet to conduct a trial of homoeopathy, contenting itself with destructive criticism of the efforts of others. Oceans of ink have been expended, and are still being expended today, on “critiques” of homoeopathy when, if it were not a paradigm dispute with far-reaching implications, the issue could speedily have been resolved through a clinical trial. But, while scientifically possible, a clinical trial is politically impossible, for it would risk surrender of the majority to the minority.
 The homoeopaths, being confident of their own superiority, urged them to do just this, one writing in 1838: “[the allopathic physicians] overlook how few of the laws of nature are yet known to us, and that homoeopathy, which claims to be founded upon such a law, could not be judged by doctrines which are rendered nugatory by it, but alone by a series of rigid and impartial experiments.”
 This appeal was repeated over and over again by the many prominent individuals who had adopted homoeopathy, and it constituted a permanent reproach against allopathy. But the challenge was never accepted, and, in any case, a paradigm dispute cannot be settled in this way. Many allopaths (including some, like Constantine Hering, who later became leaders of homoeopathy) did test homoeopathy on their own and adopted it in consequence. In the 1830s and 1840s, before the establishment of homoeopathic schools, the whole homoeopathic profession consisted of such allopathic converts. But they thereupon crossed the line into the new paradigm, and the medical profession remained as divided as before-between those who were willing to test homoeopathy, and who became persuaded of its benefit, and those who never ventured to do so.
 The latter had to develop excuses for their unwillingness to experiment with homoeopathy. A favorite was that wasting time on homoeopathy would deprive the patient of “real medicine” (in those days, bloodletting, quinine, and mercury!!). “Try homoeopathy? Try whether a thing of nought can successfully grapple with an enemy of more than giant strength? Whether a powerless remedy can remove an overpowering disease? The very idea is preposterous.” (1842) Or they claimed that homoeopathy could be judged a priori: “I am acquainted with the laws of medical reasoning and evidence, and if a system contradict these on its face, I am competent to condemn it at once.” (1853). Worthington Hooker, a leader of the Connecticut allopathic profession, wrote in 1851, “Can we not …judge of the truth or falsity of a doctrine by other circumstances-the general character of those who believe, the relations which it has to known and long-established truths, and the character of the observations and reasonings by which it is attempted to be sustained? In this way we often see enough at the very threshold of an investigation to satisfy us without going any farther.” This refusal to employ the homoeopathic medicines and procedures became a refusal to examine, evaluate, or take notice of homoeopathic results or homoeopathic statistics.
 Collegial pressure cannot be ignored as a factor in this refusal of contact with homoeopathy. A physician wrote in 1847: “The educated physician is justified in rejecting homoeopathy without testing it at the bedside …If the medical man who seriously sets about [its] verification does not endanger his reputation for soundness of mind, he at any rate compromises his character as a thoroughly educated physician and a man of well-balanced intellectual faculties.”
 The ideological warfare against Benveniste was less far-reaching than that against nineteenth-century homoeopathy, but the same attempt was made to discredit him.
 His willingness to accept the results of experiment could hardly be ascribed to ignorance, since in 1988 he was already world famous. He had authored dozens of scientific articles, four of them published in Nature-one of the world’s leading scientific journals. According to the Science Citation Index thirteen of his articles have been mentioned in the scientific literature more than 100 times each, and are thus regarded as “classics.” One of his articles, in the Journal of Experimental Medicine, has been cited over 640 times. In 1982 he was a finalist for the Nobel Prize. He had been awarded the silver medal of the French National Research Council for his work on allergy and asthma.
 There was no evidence that he performed this experiment for purposes of self-enrichment, and few, if any, of his colleagues thought he had perpetrated a deliberate fraud. Hence, the “mental impairment” or “mental obliquity” explanation was called into play. A colleague stated what many were thinking: that Benveniste suffered from a “psychotic delirium” leading to “distortion of his perception of reality” and ultimately to “unintentional fraud.” The Nobel Prize winner, Francis Jacob, announced: “It is impossible to have a scientific discussion with Jacques Benveniste.” And those who persisted in accepting his results were described as “sectarians.”
 He was also reprimanded for his extensive public support and in 1989 was ordered to cease publishing articles in the popular press. Marked hostility was directed at the prestigious newspaper, Le Monde, which had always been willing to hear both sides of the controversy. Scientists complained that a newspaper should not make its science columns available to one excluded from the world of science.
 And while his claims were “tested,” the “testing” was superficial and scientifically ridiculous; once it was over, the issue was declared closed.
 Stage III: Professional and Economic Coercion
 In nineteenth-century homoeopathy the mode of coercion adopted was the refusal of all contact, even social, with the homoepaths-now seen as “immoral” physicians-for more than 50 years. This has been copiously described in several works of history, including my own Volume III of Divided Legacy. However, far from being blighted, the New School grew and progressed; by the end of the century homoeopathy encompassed fifteen percent of all the physicians in the United States.
 In the twentieth century homoeopathy has occasionally been subjected to the unwelcome attention of allopathic authorities. In the 1920s and thereafter the American Medical Association was steadily hostile. Morris Fishbein, MD, editor of the AMA Journal from 1925 to 1949, charged homoeopathy with being a type of placebo therapy and repeated this on every possible occasion. At the Cincinnati Centennial Exhibition in 1957 the AMA sent an agent from Chicago to force closure of the homoeopathic exhibit there on the grounds that it was an “obnoxious,” “subversive,” “cult.”
 But allopathic hostility was mitigated by the unanimous feeling that homoeopathy in the United States was disappearing anyway. And after 1968, when the homoeopathic movement started to pick up speed, the allopathic authorities were caught by surprise.
 Medical societies have largely left their homoeopathic members in peace. One exception was the 1985 persecution by the North Carolina Medical Association of one of its homoeopathic members, George Guess, MD, for failure to observe “acceptable and prevailing standards” of medical care. No harm to any patient was alleged, and no patient had registered a complaint, but Guess was forced to relocate to Virginia when the North Carolina Supreme Court found against him. In 1993, however, under pressure from this doctor’s patients, the North Carolina legislature changed the statutes of the (allopathic) medical board, prohibiting it from revoking any physician’s license merely for non-conformity with “prevailing” allopathic practice.
 While there have been occasional scuffles, the relations of homoeopathic physicians with medical organizations have on the whole been peaceable. For the time being the volcano is dormant. However, as homoeopathy continues to grow at breakneck speed, the history of the 1840s and 1850s will probably repeat itself.
 The measures taken against Benveniste were also far-reaching. He was shunned and subjected to a conspiracy of silence. A committee of the French national research establishment concluded that his work was “prejudicial to the image of the French research community.” The question was raised of firing him from his position; and ultimately his contract was not renewed at its expiration in 1992. Colleagues refused to associate with him or even to discuss him and his investigations. His research unit was ordered to stop all work on high dilutions.
 The depth of the almost superstitious feeling against him is seen from the comment of a colleague who went against the current and made his laboratory available to Benveniste at this moment of travail. “He’s not the devil, after all. I don’t have to exorcise the laboratory after he’s left!”
 When Benveniste and his team performed the high dilution experiment successfully several more times, both Nature and Science rejected the article.
 Stage IV: Administrative and Juridical Coercion
 Neither the American homoeopathic profession nor Jacques Benveniste have been subjected to judicial or administrative persecution, at least not in comparison with Krebiozen and the Antineoplastons. But, in the United States at least, the attitude of the FDA is still veiled hostility, as witness a December, 1996, article in FDA Consumer entitled, “Homoeopathy: Real Medicine or Empty Promises?” While that is better than active persecution, as homoeopathy continues to flourish, it should be prepared for intensified hostility by the threatened majority paradigm. 

0 0 vote
Please comment and Rate the Article
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/
Dr.Devendra Kumar MD(Homeo) on EmailDr.Devendra Kumar MD(Homeo) on FacebookDr.Devendra Kumar MD(Homeo) on GoogleDr.Devendra Kumar MD(Homeo) on LinkedinDr.Devendra Kumar MD(Homeo) on RssDr.Devendra Kumar MD(Homeo) on TwitterDr.Devendra Kumar MD(Homeo) on Wordpress
Subscribe
Notify of
guest
0 Comments
Inline Feedbacks
View all comments