Colour Of Homeopathic Improvement
CLINICAL
The colour of the homeopathic improvement: The
multidimensional nature of the response to homeopathic therapy
M Oberbaum1,!, SR Singer1 and G Vithoulkas2
1The Center for Integrative Complementary Medicine,
Shaare Zedek Medical Center, Jerusalem, Israel 2International Academy of
Classical Homeopathy, Alonisos, Greece :
Homeopathy differs from conventional medicine in
many aspects. Little recognized to date is the unique, multidimensional nature
of the response to homeopathic treatment. We discuss this ‘colour’ of the
homeopathic response; altered temporal awareness, paucity of language,
selective amnesia, lack of self-awareness, the holistic character of the improvement,
and the development of acute illnesses, all in response to successful
homeopathic treatment. We conclude that, beyond its biological effect,
homeopathic treatment affects the awareness. Homeopathy (2005) 94, 196–199.
Keywords: homeopathic improvement; Hering’s law;
therapeutic response; multidimensional
Introduction Cartesian philosophy has been the
central pillar of scientific discovery, and a great benefit for humanity. From
locomotive to space shuttle and from penicillin to PET scan, this paradigm has
dominated western scientific production for over 400 years. However, the
wholesale adoption of Descartes’s worldview has not been without cost. Lost in
the shuffle have been many of the subtler aspects of our existence. Homeopathy
is a system of medicine based upon the law of similars. It maintains a holistic
philosophy of health and illness. In that vein, homeopathy anticipates a subtle
and qualitative model of cure and improve- ment. Samuel Hahnemann, the founder
of homeop- athy, declared that ‘after careful selection ofysimilar homeopathic
medicine, health, recovery, follow in imperceptible, often rapid transitions’,1
and that ‘commencement of amelioration or aggravationy is not perceptible to
every oney [and] cannot be described in words’.2 We maintain that this ‘multi-
dimensional’ nature of the homeopathic response has
gone largely unrecognized, in no small part due to our prevailing cultural bias
towards Cartesian logic.
Multidimensionality Response to conventional medical
treatment is typically measured along a linear, monodimensional scale. This is
exemplified by the widespread use of visual analogue scores to quantify
subjective response to conventional treatment. Responses are graded by a single
digit, lacking ‘volume’, ‘depth’ or scope. Sub- jective experience, while
possibly of personal interest to the physician, carries no weight in
therapeutic reasoning. The homeopathic response, by contrast, is charac-
terized by subtle changes in the character of symptoms, the patient’s mood,
appetite, energy level, and overall well-being, not just the severity of the
symptom. Moreover, these changes cannot be judged in isolation: only the
overall pattern of changes reveals the nature of the response. The patient’s
rash may be exacerbat- ing, but due to improvement in the patient’s mood,
relationships and sleep pattern, the diligent homeopath will judge that the
patient is proceeding toward cure.
ARTICLE IN PRESS
!Correspondence: Menachem Oberbaum, The Center for
Integrative Complementary Medicine, Shaare Zedek Medical Center, Jerusalem,
Israel. E-mail: oberbaum@szmc.org.il Received 11 October 2004; revised 14 March
2005; accepted 9 May 2005
Homeopathy (2005) 94, 196–199 r 2005 The Faculty of
Homeopathy doi:10.1016/j.homp.2005.05.004, available online at http://www.sciencedirect.com
In contrast to the monodimensional measure of
conventional improvement, the homeopathic response typically carries ‘colour’:
The stitching pain may change to burning, numbness may replace formication,
clarity of vision may ensue. The description, ‘cheerful- ness after stool’,
beyond curiosity value, has no meaning in conventional medicine. Only
resolution of constipation carries therapeutic relevance for the conventional
physician. The homeopathic physician, in contrast, would find such a symptom of
great practical import, possibly indicating a healing process or the need to
change a prescription. The monodimensional dynamics of conventional medicine is
thus traded for a multidimensional one, with appearance of new ‘symptoms’, recurrence
of past symptoms, development of symptoms remote to the main complaint, and
sweeping changes in the general, mental and emotional spheres. The emotional
improvement of a rheumatoid arthritis patient responding to conventional
treatment can only be understood as secondary to the physical improvement. In
contrast, the mental or emotional improvement in a patient treated successfully
by homeopathy is a separate entity, wholly independent of the physical process.
To the contrary: homeopathic patients often improve mentally and emotionally
early on, in spite of aggravation of the main complaint. Hahnemann and Kent
both gave instructions for judging the response to homeopathic treatment 3,4
but ‘Hering’s law’ 5 is widely recognized as the yardstick by which to measure
homeopathic improvement. We wish to discuss several subtle phenomena observed
fre- quently in homeopathic practice but not to the best of our knowledge yet
part of the homeopathic literature. The examples below represent actual
excerpts from patient interviews. Each represents many similar cases seen
during our experience with tens of thousands of patients.
Temporality Following homeopathic treatment, the
patient’s sense of time is frequently impaired. Conventionally treated patients
generally recognize when the improve- ment began, ‘Two hours after taking the
Vioxx’, ‘Ten days after starting the cipramil’. Homeopathic pa- tients, in
contrast, are typically unable to say. ‘When did the headache stop?’ ‘I don’t
know exactly. Some- time between Epiphany and Mardi Gras’. Only on more
thorough interrogation are they often able to reconstruct the process,
frequently with the aid of temporal landmarks.
Metaphor Homeopathic treatment accentuates the
poverty of language. During the homeopathic improvement, patients are typically
unable to articulate the permuta- tions they are undergoing. Frequent is the
resort to metaphor (‘as if’) to explain these changes. In fact,
whole volumes of repertory are devoted to
‘Sensations As If’.6 Conventional medicine also recognizes meta- phor (‘as if a
sack of potatoes was sitting on my chest’), but only in specific, time-honoured
circumstances, not in the spontaneous manner recognized in homeopathy. We
propose that the limitation rests not with the patients, nor their physicians,
but with the inability of language to express such nuances. Whereas conven-
tional medicine is little hindered by this limitation, homeopaths must remain
aware that language is an imperfect conduit for expressing the full gamut of
human experience.
Amnesia Homeopathic patients typically undergo
‘selective amnesia’, particularly toward secondary complaints. These
complaints, well documented in the patient file, are completely forgotten. ‘I
didn’t suffer from nausea before the menses!’ the patient will protest, only to
reconsider, ‘Well, it was getting better anywayy’. The repudiation is so
heart-felt that we sense not only that the complaint has disappeared, but that
all memory of the episode has been obliterated. A corollary to this is what we
term the ‘Oh yeah!’ phenomenon. The patient is asked if anything had been
changed since the remedy. ‘No’ is frequently the answer. ‘And what about the
headaches you com- plained about’? ‘Oh yeah! That went away’. ‘And the ringing
in ears?’ ‘Oh yeah! I’d forgotten about that’.
Holism Conventional patients frequently experience
general or emotional improvement, secondary to improvement in their main
complain. Homeopathic patients often share this interpreta- tion: ‘My mood is
better since my colitis went away’. ‘I have more energy since my blood pressure
rose’. ‘I’m sleeping better because I’m breathing more freely’. No doubt
physical improvement contributes to overall well-being, however homeopaths
frequently observe overall improvement far beyond what could be anticipated
secondary to mere physical amelioration.
‘Changes’ in the environment Patients treated
homeopathically frequent attribute improvements in their general, mental and
emotional well-being to changes in their environment. ‘My asthma improved, but
there’s been no change emo- tionally or mentally’. ‘What about your
relationship with your husband? Last time, you complained that he was driving
you crazyy’—the homeopath will ask. ‘Well, you know, it’s interesting. Since my
last visit, he has totally changed. He’s calmer, kinder, and more attentive to
my needs’. ‘And what about your boss? ‘Now that you mention it, she’s changed
too. She’s more appreciative of my work, and has even offered me a big
project.y’. The patient perceives the change
ARTICLE IN PRESS
The colour of improvement M Oberbaum et al
197
Homeopathy
not in herself but in her environment, unlikely as
it may seem.
Acute Illnesses Chronically ill patients frequently
respond to suc- cessful homeopathic treatment with an acute illness. Even
patients who, though chronically ill, have been free from acute disease for
years will, to their great surprise, suddenly develop fever or other acute
afflictions. ‘You’re right doctor, my arthritis has improved, and I am also much
better emotionally. But I hadn’t had a fever for years! Since I started your
treatment I’ve been sick twice!’ The homeopath must realize that this is not a
negative development but rather a step on the road to cure.
Interpretation We submit that our firm cultural
grounding in Cartesian logic blinds us to subtle alterations in health and
renders us incapable of correlating seemingly disparate processes. Homeopaths
are not immune to this cultural influence, though it would be hoped that
homeopathic training would to some extent mitigate this effect. One may
certainly ask, ‘What is the import of these minutiae?’ The importance lies,
first and foremost, in the homeopathic interaction. Homeopaths unaware of these
subtleties may misinterpret their patients’ reac- tions to therapy and fail to
respond appropriately. Patients frequently present at follow-up declaring that
‘nothing has changed’, only to discover that much indeed has. After receiving
homeopathic treatment, a patient claiming that ‘only my environment has
changed’, or denying ever complaining of a documen- ted symptom, is probably
responding well. A patient with a ‘monodimensional’ aggravation but multi-
dimensional improvement is most likely on the road to cure, though he or his
physician may be concerned. On the other hand, a patient expressing a clinical
improvement but no ‘colour’ is likely to be experien- cing a short-lived
placebo effect. A corollary to this lack of awareness on the part of the
patient is a lack of gratitude. Homeopaths’ greatest successes often go
unrecognized. The second important implication of these observa- tions rests in
their relevance to homeopathic research. We suspect that many of homeopathy’s
failures in clinical trials stem from a lack of attentiveness to this
‘unconventional’ response. Clinical trails measure specific, monodimensional
primary and secondary endpoints, missing many of the more subtle, indivi-
dualized aspects of the homeopathic reaction. Arnica montana is a case in
point. Arnica is homeopathy’s leading anti-traumatic re- medy, and one of the
few which can be applied on the basis of a simple indication, regardless of the
‘totality
of symptoms’. This makes Arnica particularly
suitable for randomized, blinded clinical trials. Anecdotal accounts of
Arnica’s success in trauma are numerous. However, Ernst and Pittler recently
reviewed eight such trials 7 and, to the surprise of many homeopaths, did not
find Arnica superior to placebo. We offer two explanations for the disappointing
study results. One is the flawed experimental model. Arnica is homeopathically
indicated for blunt trauma, not surgical incisions, the model used in most of
these trials. We believe studies examining its utility in blunt injury would
yield more favorable results.8 Our second explanation relates to the subject of
this paper. Monodimensional evaluation, the type most com- monly used in
clinical trials, misses the multifarious nature of homeopathic improvement. A
patient’s swelling may be temporarily exacerbated (monodimen- sional), but his
mood exuberant (multidimensional). The bleeding time may indeed be abnormal,
but function rapidly returning. We submit that holistic measures such as
well-being, mood, energy levels and attitude, in conjunction with traditional
measures such as bleeding and coagulation time would better represent the
multidimensional nature of the homeo- pathic improvement than these traditional
measures alone. In recent years, a growing body of literature has addressed the
question of the scientific evaluation of CAM, with an eye toward
multidimensional out- comes.9–15 We highlight additional burdens to be overcome
in the development of adequate outcome measures of homeopathic therapy.
Conclusion Aphorism 2 of Hahnemann’s Organon of
Medicine describes the highest ideal of cure as ‘rapid, gentle and permanent
restoration of the health’. We extend the interpretation of the word ‘gentle’
to include mildness, subtlety and imperceptibility. Our descriptions of
patients mistiming, inability to explain, forgetting completely, or attributing
changes to the environment, leaves us with the impression that such symptoms
have been ‘deleted from the hard-disc’. In fact, the patient’s complaints have
transmuted, contemporaneous with a change in himself. From his morphed vantage
point, his transfigured health seems natural, unremarkable as the morning sun.
Medicine sees in ‘Restitutio ad integrum’, complete restitution, the highest
ideal of cure. We feel that homeopathy goes one step further, erasing the
disease not only from the organism, but from awareness.
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