Critical considerations on homeopathy

In 1943 David Karel de Jongh M.D. defended a Ph.D. dissertation on homeopathy, which he ended by concluding that homeopathy should be abolished. He based his judgment on his meticulous examination of many hundreds of articles and books and his experiences while working for quite some time in a homeopathic hospital in Utrecht.

The dissertation is digitised in its entirety, and can be downloaded here. De Jongh’s conclusions are still as valid as ever, as has already been observed by C.P. van der Smagt in his booklet Homeopathie, het wonder van het gelijkende which can be found elsewhere on this site.

Only a few people have any idea of the extent of the messiness and incoherence that is homeopathy. The general public thinks it has something to do with innocuous herbs, and those who know a little more think it is about extreme dilutions.

Similia principle

The core of homeopathy, however, is the similia principle. It was thought up by Samuel Hahnemann in 1796 and went something like ‘if you want to cure a sick person, first you establish their symptoms, and then you search for something that produces the same symptoms in healthy people’. It is unclear how Hahnemann got this idea, but he referred to a 1738 book whose author, Johann Christian Hummel, discusses a Danish army doctor named Stahl, who seemed to be quite famous in Denmark and who explained his own success by stating that the best way to treat the sick was by ‘similia similibus’.

Hahnemann himself claimed that he got the idea after he taking, by way of experiment, a full tablespoon of ground Cinchona bark – which was used to treat malaria – twice daily. That was about five times what is now considered as a safe dose. After his experiment, Hahnemann got a ‘fever’. At that time, the meaning of the word ‘fever’ was rather vague and could also apply to the effects of strong coffee, pepper, strychnine and arsenic. However, Hahnemann did not experience the shaking fever that is typical of malaria. His fever may have been a reaction to one of the many compounds in Cinchona bark. Later it turned out that such a reaction to Cinchona bark is very rare.

Hahnemann never proved his method by trying it out systematically. His research consisted of gathering anecdotes from medical literature, which he interpreted in a very biased way. His system was a typical ‘armchair’ product, but in this respect he was no exception: in his time physicians had very little knowledge and were not in the habit of checking their methods.

Dilution

Initially Hahnemann did not use absurdly small doses, but that soon changed. By 1799, three years after his first article, he was using thousandfold or millionfold dilutions. Such dilutions were also used when he tried out his remedies on healthy volunteers (‘healthy’ being what was considered healthy in those days). One can sympathize with the desire to avoid exposing volunteers to large amounts of poison. However, this could hardly have been the reason for treating a sick person with no more than a few drops of chamomile tea, and diluted a million times at that.

Perhaps he ‘discovered’ that his volunteers kept displaying ‘symptoms’, no matter how strongly diluted the remedies were. The explanation of course would be that these ‘provings’ were not blinded at all. Section 128-142 of the Organon almost reads like a manual for obtaining as many spurious results as possible. Hahnemann’s error has become tradition. Later research has shown that with proper blinding no effects are found with diluted substances, except for doses just below what is generally considered toxic.

This was the moment when Hahnemann could have concluded: this can’t possibly be right. But he didn’t. Even worse, he offered no comment upon or explanation for his switch to high dilutions. Since Hahnemann’s time, homeopaths have attached great value to the shaking the remedies (‘succussion’) after each dilution step. Section 270 of Hahnemann’s Organon specifies vigorous shaking and tapping 100 times against a solid object, and in footnote 3 it is explained that a leather-bound book will best serve this purpose. Hahnemann himself did not provide any proof as to why this would make a difference, and no such proofs have been provided since Hahnemann either. Moreover, physics tells us that it is nonsensical: the molecules in a fluid hit each other violently many million times per second, and only very unstable materials like nitroglycerin feel any effect of these shock waves.

Still diseases!

Another indication that his system was no good was the discovery that Hahnemann’s treatment for the chronically ill did not work. Originally Hahnemann claimed that there are no diseases, only sick people, each with their own highly individual set of ‘symptoms’ – by which he meant everything a patient talks about while visiting the doctor. But when it turned out that his treatment of chronic diseases was unsuccessful, he made up three universal diseases that were the cause of all chronic illnesses: syphilis, gonorrhea and ‘psora’, of which psora was by far the most important.

Psora is simply Greek for scabies. As early as 1687, the Italians Diacinto Cestoni and Giovan Cosimo Bonomo had discovered that scabies (‘the itch’) was caused by a kind of mite digging tunnels in the skin and causing terrible itching. Actually, this was the first discovery ever of a cause for a human disease! Still, physicians did not bother very much about what biologists claimed and hardly ever took the trouble to look through a microscope. Even in 1845, three-quarters of a century after the experiments of Spallanzani, the Viennese homeopathic physician Franz Puffer still thought that this mite spontaneously generated in the itching skin and that other parasites like intestinal worms and head lice were also the result of generatio spontanea!

Hahnemann asked his patients whether they had ever had some kind of itch, eczema, rash, warts or other kind of skin problem in their life. If the answer was yes, this was proof they suffered from psora. According to Hahnemann, psora was originally lepra, but because of better hygiene the lepra had changed. He thought it was a bad thing to control ‘psora’-itch, because it would force the disease to retreat within. In 1828 Hahnemann published an entire book about chronic diseases, with many ‘symptoms’ of highly diluted remedies that might cure the psora.

Hahnemann and his disciples seemed to find some success with their treatment There are several explanations for this. First, many sick people will get better on their own no matter what is done to them, as long as they are not actively made worse. Second, people have a natural tendency to attribute any improvement they experience to the treatment they received, whether it had any effect or not. Selective observation and selective memory are important factors in leading people to attribute any improvement in their symptoms to the treatment, even when the healer is a quack. Last: the treatments given by the homeopaths in fact amounted to doing nothing, and as such they were probably better than what the ordinary physicians of the day were in the habit of inflicting on their patients: bloodletting, administering emetics and purgatives, producing artificial sores and prescribing various herbal mixtures.

Isopathy

During and after Hahnemann’s life, many variants of homeopathy were proposed, but like Hahnemann’s method they all lacked experimental proof. In other words, there was no decent comparison between patients with and without treatment. The most important innovations were isopathy, constitution theory, complex-homeopathy and so-called biochemistry. De Jongh discusses about forty followers, each with their own ideas and viewpoints.

The idea of isopathy stems from the German-American homeopath Constantin Hering, who later abandoned it. It wasn’t until 1833 that the idea was developed further by veterinary surgeon Johan Joseph Wilhelm Lux in his book Isopathik der Contagionen, oder: alle ansteckenden Krankheiten tragen in ihren Ansteckungsstoffe das Mittel zur ihrer Heilung. (Isopathy of Contagions, or: all the Contagious Diseases Carry the Means of Their Recovery in Their Very Own Infecting Matter.) For example, Lux treated anthrax with highly diluted blood of animals suffering from the disease. He treated all kinds of non-contagious diseases as well: sweaty feet with highly diluted foot sweat, epilepsy with highly diluted saliva (i.e. foam around the mouth of someone in the middle of an attack) and kidney stones with highly diluted kidney stones.

The most unsavory products of diseases were used: pus, cancer tumors, intestinal worms and other unimaginably crazy stuff. Another variant of isopathy is the use of diluted organs for the treatment of sick organs, for example hepatinum for diseases of the liver. Many homeopaths followed Lux’s lead, which means they had abandoned the idea that there are no diseases. For example, they used morbillin, obtained from sugar globuli that had been held by a measles patient, to treat measles.

Lux’s idea can of course be generalized to ‘highly diluted vaccine’ to treat diseases that are supposedly caused by vaccines, and in this form it is still very much alive, at least in the Netherlands. The collective name for high dilutions of secretions or excretions from patients and the causes of their diseases – pathogens or otherwise – as a remedy against the corresponding disease, is nosodes. The widely sold remedy oscillococcinum is also a nosode. It is a high dilution of a bacterium called oscillococcus, supposedly the cause of all diseases. Oscillococcus does not exist, and it probably is some kind of microscopic artifact observed by an inexperienced French army doctor named Joseph Roy. However, neither producer nor users of this nostrum seem to care.

Hahnemann was strongly opposed to isopathy. Just read section 56 of the Organon, where he says that by diluting something you change its nature and therefore you must first do provings with healthy people to establish its symptoms. But Lux and his followers thought conducting provings was superfluous.

Constitutions

Constitutional homeopathy is an invention of Dr. Eduard von Grauvogl, who described it in Lehrbuch der Homöopathie (1866). The idea is that certain general characteristics of a person match a homeopathic remedy. The therapist first determines the patient’s constitution and then administers the matching remedy, irrespective of the patient’s actual complaints. Von Grauvogl distinguished hydrogenoid, oxygenoid and carbo-nitrogenoid groups of patients.

Following von Grauvogl various other forms of homeopathic constitutions have been devised. A well-known example is the Pulsatilla constitution which refers to fickle blond women who cry easily, have a tendency toward varicose veins and problems with menstruation, who like fresh air, tepid tea and sweets, and dislike fatty food. The Natrum muriaticum constitution on the other hand describes highly sensitive, rancorous and mean personalities who are morose because of lack of motherly love, etc. (Natrum muriaticum is an old fashioned Latin name for kitchen salt.)

Homeopaths don’t seem to agree among themselves what ‘constitution’ really means and have not been able to give a clear definition. The results of homeopathic provings give no indication as to which remedy corresponds to which constitution. Giving someone pulsatilla won’t change him or her into a weepy woman. However, the concept of ‘constitutional homeopathy’ enables homeopaths to give different remedies to different people all suffering from the same disease, thus creating the illusion of individual treatments. On the other hand, homeopaths often give the same remedy for totally different diseases: all ‘sulfur’ cases get Sulphur, regardless of their disease.

Cell Salts

‘Biochemistry’ or Cell Salts refers to homeopathic remedies that were designed in 1873 by Wilhelm Heinrich Schüßler (1821-1898). Fifteen years earlier, Rudolf Virchow, the ‘father of pathology’, identified the cell as the basis of life, a revolutionary idea at the time. Schüßler (also spelled Schuessler) studied the ashes of cremated people and discovered that they contained a dozen important salts. He simplified Virchow’s idea and claimed that diseases are caused by an imbalance of these salts within the cells. He also simplified homeopathy; to restore the imbalance in their cells, sick people should be given one of these salts diluted a million times or a million times a million times. By order of Himmler, Schüßler salts were used in 1942 in the Dachau concentration camp to investigate whether they could cure blood poisoning. Of course the tests failed and all eighty of the experimental subjects died a horrible death. Schüßler salts are still sold everywhere.

Complex homeopathy

Emanuel Felke was an evangelical village pastor, known as the clay pastor. He practiced iridology and cures in which loam or clay were important ingredients. Towards the end of his career he reasoned that diseases are complex, ‘hence’ should be treated with combinations. One of Felke’s cured patients, Magdalene Madaus, became an ardent disciple, and in 1919 her son, Gerhard Madaus M.D. (1890-1942, photo left), began producing these remedies on an industrial scale. But Hahnemann, who was deeply dissatisfied with contemporary physicians prescribing mixtures containing a hotchpotch of ingredients, always stressed that homeopathic remedies should be simple. In section 273 of the Organon he even dismisses quinine, because even though the original Cinchona bark is ‘simple’, quinine is a chemical extract that can only be obtained by a complicated process. Hahnemann is not very consistent however, for he gives an extremely complicated recipe for Causticum, which is just a weak solution of pure potassium hydroxide.

Such ‘complex remedies’ often carry elaborate fantasy names and are sold over the counter in drugstores. Until recently they formed an important part of all homeopathic sales. Because these over-the-counter remedies are meant for specific, clearly defined conditions, they violate Hahnemann’s ideas. European laws are expected to put an end to these nostrums, at least officially. New regulation essentially requires homeopathic remedies to have no effects. Homeopaths are expected to submit data on the quality of their products and show that they are diluted enough to guarantee safety. The most concentrated dilution to be registered must be at least a 1 in 10,000 dilution of the starting material. If the product is made from a registered drug, it may contain no more than 1/100th of the smallest dose used in mainstream medicine of the drug. Aristolochia, for example, is very dangerous for the kidneys, and aristolochic acid is the most carcinogenic substance known, notwithstanding the fact that it was used in folk medicine for over 2,000 years without anybody noticing its dangers. In the Netherlands it is only available as a homeopathic medicine in D8 dilution, whereas in Germany the limit is D11, i.e. one part in a hundred billion.

Drainage

In Hahnemann’s time many physicians practiced various horrible therapies, aimed at ridding the body of evil substances. It was thought that pus was an excretion consisting of such evil substances, and, among other methods to draw out the bad stuff physicians would use setons (surgically inserted threads; setons still are used nowadays to drain certain types of fistula) to cause artificially purulent wounds. Hahnemann strongly objected to these methods and rightly so. But with so-called drainage therapy, a variant of isotherapy invented by the prominent French homeopath Léon Vannier (1890-1963), things came full circle.

Drainage therapy claims that poisons (more pretentiously called toxins) are the cause of diseases. These toxins make the body more vulnerable to bacteria or cancer, and the homeopathic remedies are supposed to eliminate the toxins. Apart from the fact that of course these toxins have never been proven to exist, no one understands how homeopathic remedies actually bring about this draining. Sadly, this silly idea keeps popping up again and again. Man apparently is filled with poisons, all kinds of metabolic waste, burdens, interferences, sins, complexes, in short all kinds of troubles, and the guru can magically make them go away, and everything will be better.

Many symptoms

The symptoms observed during homeopathic provings were collected in two kinds of handbooks. If the symptoms are sorted first by remedy and subsequently by symptom within each remedy, the book is called a (homeopathic) Materia Medica. If the sorting is done the other way around – first symptom, then remedy –, it is called a Repertory. The homeopath J.T. Kent published a famous Repertory containing over 1400 pages, with each page mentioning 200 to 300 remedies. Eventually Hahnemann recommended that all provings should be done with C30, i.e. dilutions of 10 to the power 60. That is what section 128 of the Organon says. But the Materia Medica also contains ‘symptoms’ from medical case descriptions. For example, the book lists serious reactions to bee stings under Apis mellifica (either ground up honeybee or bee poison). Timothy Allen’s authoritative 1870 Materia Medica (10 vols.), lists 1651 symptoms for Spanish Fly, and almost all are from case descriptions of poisonings by this alleged aphrodisiac. In a homeopathic Materia Medica almost none of the symptoms of any remedy state what level of dilution, if any, was used. Moreover, if a remedy was used for a sick person and that person was cured afterwards, this patient’s symptoms were also added to the Materia Medica. Many of these ‘symptoms’ are absurdly subjective. One example may suffice, symptom 546 of Anacardium in Hahnemann’s book on chronic diseases: ‘After playing on the piano he feels heavy and full in the body’.

Many of these symptoms were observed only once. Donner tells the story of dog’s milk. This remedy was thought to be effective against diphtheria (now please don’t object that homeopathy is for sick people and not for diseases). This belief was based on the experiences of precisely one young American woman who had taken a few globuli Lac caninum CM. For two years after that, she suffered from recurring delirium tremens (not because of the globuli of course). Once during these two years she had a pain in her throat, but it was not so bad that she had to stay in bed. An American doctor diagnosed this as diphtheria. At the time (1870) gaining a doctor’s diploma in America required (in some places) only elementary school followed by one year’s study. One could become a doctor without ever having seen patients.

Extreme dilutions explained

Right from the beginning the high dilutions of homeopathy were a serious problem. Nowadays ‘the memory of water’ is a widespread idea, even though this ignores the fact that most homeopathic remedies are no more than minute sugar balls sprayed with alcohol and allowed to dry. The ‘memory of water’ story only started circulating among the public in 1988 following the experiments of Benveniste. There have been countless efforts to explain the effect of extreme dilutions, but they have all failed because they never went further than mere speculation on the effects of smallest measurable doses.

Hahnemann did not see many problems. For him, every action at a distance was something spiritual. Magnetism, gravity, the effect of the tides, contagion by smallpox or measles, it was all ‘dynamic’ or ‘virtual’ or ‘spiritual’. Vomiting after seeing something horrible or disgusting is a spiritual effect, and in Hahnemann’s view even the fact that one can lift one’s arm by willing it was based on an immaterial influence. In section 11 of the Organon he explicitly says so. He also said that healing power was a spiritual force that could be liberated by rubbing and shaking, and the fact that it is possible to magnetize an iron bar by rubbing it with a dull file (footnote 2 of section 269) was proof for him that it was a valid idea.

Hahnemann died in 1843, a year after the physician Robert Mayer had argued – somewhat clumsily – for the first time that heat was just a form of energy. (In 1845 James Prescott Joule would publish his experiments to determine how much heat could be obtained from mechanical energy, and in 1847 Hermann von Helmholtz went on to explain the principle of conservation of energy much more precisely.) In Hahnemann’s time not only magnetism but also light and heat were thought to be immaterial. Vague and confused ideas about ‘forces’ were ubiquitous in those years. The general term ‘energy’ for all forms of energy only came into use among physicists in the 1850s.

A brief selection of the theories entertained by homeopaths is listed below. It goes without saying that in later times physicians found Hahnemann’s primitive ideas hard to believe.

1. Paul Wolf, 1838: when healthy people get certain symptoms from large doses, sick people with the same symptoms are cured by small doses of the same.

2. Arndt and Schulz: small doses stimulate, large doses inhibit (nothing about healthy and sick). Altschul: small and large doses have opposite effects.

3. Wapler: remedies affect specific organs, and a sick organ is more sensitive to such a remedy.

4. Kötschau: each remedy has its own ‘type of action’, namely an action that is both time-responsive and concentration-responsive.

5. Von Bakody, Stiegele and Schulz: sick organs are much more sensitive, therefore they are responsive to smaller amounts (a minor variation of Wapler’s idea of organ specific remedies).

6. Schimert: the effect of a homeopathic remedy is a kind of allergic reaction.

7. Guttmann: homeopathic therapy is a kind of desensitizing therapy, the same kind that is used for people suffering from allergies.

8. Martiny: homeopathic remedies are a kind of catalyst.

9. Schier: homeopathic remedies are a kind of hormone.

10. Bier: homeopathy is a kind of stimulus therapy.

11. Schömmer: homeopathic remedies are a kind of enzyme-like virus.

12. Schlegel: each disease is a kind of poisoning and in a small dose each poison is its own antidote. Homeopathic dilutions are a kind of electricity.

13. Borliachon: homeopathy works by means of resonance.

14. Leeser (1934): the new quantum physics explains how high dilutions work. Constitutions are related to the importance of various chemical elements in the body.

15. Bercher: high dilutions create a fourth aggregational state.

16. Faré: illness is a metastable state, very small influences can disrupt it, and then a return to stable health follows.

Some of these ideas had an observed phenomenon as experimental basis, but often it turned out that the phenomenon was misunderstood. One also sees how each discovery in medicine and other disciplines was exploited with the aim of turning it into a theory that might serve to explain the purported effects of highly diluted homeopathic remedies. Homeopaths were much impressed by the effects displayed by small amounts of hormones, vitamins, enzymes, viruses, etc. In fact, Schulz is the discoverer of the phenomenon of hormesis, although this name for the phenomenon was only proposed in 1943, the year when De Jongh defended his dissertation. Hormesis means, among other things, that the reaction to weak harmful stimuli produces a protective effect that compensates for the original damage. However, protection against long-term effects of harmful influences is something quite different from curing a disease.

None of these ideas explained how extreme dilutions such as C30 could have any effect and neither could they explain the powerful effects of infinitesimal amounts of charcoal, table salt, chalk and sand. It must be noted that in the past many homeopaths did not set great store by high dilutions. The ideas promulgated by Wolf, Arndt and Schulz are still often used in defense of homeopathy. Homeopaths follow Wolf in giving small doses for the sick, although examining their ideas shows they don’t know which symptoms in the homeopathic Materia Medica correspond with large doses, and Hahnemann never gave any indication that he was of the same mind as Wolf in this respect. Not only does Wolf’s view violate Hahnemann’s ideas, but it also ignores the fact that in Hahnemann’s opinion curative doses should be the same infinitesimal amounts as the ones used in homeopathic provings. All in all, it seems that most homeopaths are not very much interested in amounts, and there is no coherent theory as to which dilution should be given under which circumstances. De Jongh gives an impressive report about the chaotic practices in this respect of the homeopathic physicians of his time.

Since De Jongh’s research the production of fantastic explanations has continued. The ‘memory of water’ explanation is based on the discovery that water does have local structures – that cannot survive though for longer than a few thousandths of a trillionth of a second. In his 1988 paper, Benveniste quoted an article about this from 1981, and there are others, all vying with each other to produce the most fantastic explanation. Experiments designed to investigate the effect – no matter which – of extreme dilutions are another modern development. The most bizarre example is the detection of crystal defects in heavy water ice at the temperature of liquid nitrogen. Also, nowadays we often hear that homeopathy stimulates self-healing or the immune system or that homeopathic remedies contain ‘information’. This is nothing but propaganda, based on a new ‘discovery’ for which there is no experimental justification whatsoever.

Modern developments

Also quite new is so-called clinical homeopathy, which consists of the use of regular diagnoses alongside homeopathic diagnoses and is practiced by homeopathic physicians. They can hardly afford to do otherwise, because a doctor who ignores clear indications for a regular diagnosis risks serious trouble with a disciplinary court.

It was not until long after De Jongh’s dissertation that the first thorough comparative research was done to study the effectiveness of homeopathy as a cure, but De Jongh himself already hints at this possibility on page 429. Over the years quite a lot of research was done on a rather large scale, involving all kinds of homeopathy, and many researchers tried to summarize the results. The answer is what could be expected: homeopathy doesn’t work.

Homeopathic practice

Homeopathic practice is only loosely connected to theory, but as homeopathy consists not of one theory but of many that all contradict each other, this is hardly surprising. The most serious problem is that it is virtually impossible to match a patient’s symptoms to a remedy. Homeopaths subject their patients to endless questions on just about anything, which yields an avalanche of irrelevant details from which the patient’s ‘symptoms’ must be distilled, and yet more details regarding time, place, sensation, modalities and connections of each symptom. Each remedy can often be used for more than a thousand ‘symptoms’, and from this myriad of symptoms and remedies a choice has to be made one way or another.

Hahnemann himself had already encountered this problem. He thought that the most striking symptoms (a purely subjective criterion) were the most important. De Jongh practiced for some time in a homeopathic hospital near Utrecht that opened as early as 1914 and was closed in 1942 by the occupying German forces. During his time in the hospital De Jongh observed in practice that it was impossible to make choices on a rational basis. His extensive research in the available literature, with its numerous case descriptions of homeopathic miracle cures, convinced him that this was a general phenomenon.

Summary: totally nonsense

The similia principle is nonsense, the high dilutions are nonsense, doing homeopathic provings only yields nocebo effects, and the data about low dilutions and case stories of poisonings are useless as well. The homeopathic Materia Medica is useless. Even if the similia principle were correct (quod non), even if high dilutions had some effect (quod non), and even if the Materia Medica were correct and reliable (quod non), it would still be impossible to treat patients correctly due to the overwhelming number of ‘symptoms’ in both patients and homeopathic books. It is evident that homeopathic practice does not correspond with homeopathic theory, and this in fact means that the way homeopaths make their treatment decisions is completely arbitrary.

De Jongh’s conclusion is that homeopathic physicians are primitive thinkers. Their writings abound with fallacies. They are strongly inclined to ascribe any improvement of their patients to homeopathy. Actually they think medicine is too difficult, so they stick to all kinds of ‘rules’. De Jongh writes: ‘If one asks homeopathic doctors why they actually became homeopaths, their reasons often turn out to be astonishingly naïve.’

Homeopathy begone!

I conclude with the De Jongh’s own summary (corrected for language).

This work aims at obtaining an objective judgment of the value of the homeopathic system. It differs from existent writings on this subject in its comprehensiveness, because it is based not only on a complete rendering of the origin of the system but also on its theory and practice.

The course of the investigation was as follows. First the role of the similarity idea in medicine before HAHNEMANN was investigated. It was shown that this role was considerably smaller than many homeopaths assume. This required a historical survey, which moreover showed that HAHNEMANN did not collide with then prevailing scientific ideas when he designed his speculative system.

Next HAHNEMANN’s development was sketched. Originally he was an adherent of conventional medicine, but he became a maker of a system of his own. It is clear that initially in his medical career he had commendable critical faculties, but that he subsequently lost these. Furthermore, he drastically changed his system without explanation. It is nothing but a fantastic speculation in the vein of an old idea. Classical homeopathy is an entirely untenable construction.

Many homeopaths of many different countries introduced further alterations of the principles of their master. These are described in detail. We have tried to bring out clearly how the doctrine was ever changing and to what extent the views of the adherents diverged.

The descriptive part of this study was completed in a chapter that describes in detail all the diverging ideas and methods that constitute homeopathy today. It became evident that also nowadays homeopathy is not a unity, but a complex of ideas and practices that often have only the name homeopathy as a common characteristic. Already at this stage of the investigation we were forced to conclude that criticism should do more than just prove the untenability of certain views or the inaccuracy of special methods. A criticism of homeopathy, if it shall have any value, must necessarily start from a contemplation of the whole material.

In our opinion the criticism given here does just that. All important aspects of homeopathy have been discussed. It has become clear that the homeopathic theory is a hotchpotch of unproved, improbable and incorrect opinions, and as a whole it undoubtedly can be called objectionable. Furthermore, there is no intimate connection between the theory and the practice of the system. Finally, there is no reason at all to follow homeopaths in their treatment of the sick. If the exposition had been incomplete in some sense, this conclusion would not have been possible.

Homeopathy is a system to provide sham medical treatment to its clients. It must be abandoned, and in fact it is abandoned in case of serious illness for which a real therapy exists. The system will only find adherents among physicians who lack a scientific attitude. Homeopathy is indeed not a scientific method, but a complex of articles of faith. We documented both the lack of scientific thinking and religious feelings towards the homeopathic doctrines.

The gist of homeopathy is treatment of the sick with so-called similar remedies. We investigated in how far this idea plays a part in present-day medicine. We showed that in modern scientific medicine only a very modest place can be assigned to similarity therapy. There is no need at all to isolate a similiary principle, no matter how guardedly formulated, from modern medicine.

A conciliation between allopathy and homeopathy therefore is impossible. They are not more or less equivalent partners. The official pharmacotherapeutic medicine recognizes the current standards of scientific thought and can justifiably be proud of its results. One merely has to consider the great advances not only of surgery and epidemiology, but also endocrinology and chemotherapy. They are just a few examples of the extent of medical knowledge and ability. Their significance can hardly be overestimated. Just suppose for a moment that a homeopath would to depend entirely on his own means and not use anything from modern science. It should be clear at once that there is no contest between homeopathy and allopathy. Such a struggle only exists in the homeopathic imagination, not in reality. This imaginary battle will continue in the minds of the homeopaths as long as there are any of these specimens left of that autistically undisciplined way of thinking. [A reference to Bleuler’s 1919 book Das autistisch-undisziplinierte Denken in der Medizin und seine Überwindung, JWN] Even that unreal existence will vanish when the last homeopath wakes up from his dreams. When that happens, scientific medicine will not change in the least. It will go on fulfilling its great task quietly, careful not to waste any energy on things that do not carry it any further. Just for once it seemed necessary to us to clear up matters completely regarding homeopathy. We thought it permissible that we should perform this modest task.

Having come to the end of our studies concerning homeopathy we think it will be well to recapitulate our conclusions in a few points. If torn from their context, they will perhaps seem to be a little abrupt; their motivation has however been amply given in the preceding.

I. The theory of homeopathy consists of a heterogenous complex of untenable, inaccurate and improbable assertions.

II. There is a deep gulf between the theory and the practice of homeopathy.

III. The practice of the homeopaths is a conglomerate of divergent actions that cannot be placed under one real common point of view, and the efficacy of which must be considered as very improbable.

IV. Homeopathy viewed as a whole is an unsuccessful endeavor to let the therapy run along a fixed scheme based on the old similarity-thought. But there is no place for that in present-day medicine.

V. A scientific physician cannot be a convinced adherent of the homeopathic principles.

VI. Objectively, it would be better for homeopathy to disappear from the medical scene altogether.
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Postscript. June 19, 2016. I am immensely grateful to several people who have helped me to improve the English in this article. The most recent extensive corrections date from today.