Homeopathy and the War Between Conventional and Alternative Medicine

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http://www.boston.com/ae/books/articles/2005/02/20/mortal_combat?mode=PF

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BOOK REVIEW

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Mortal combat

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As surgeon, senator, and champion of homeopathy, Royal Copeland battled

disease and the medical establishment

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By Jerome Groopman  |  February 20, 2005

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Copeland's Cure: Homeopathy and the War Between Conventional and

Alternative Medicine

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By Natalie Robins

Knopf, 330 pp., illustrated, $24.95

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For centuries, certain rocks in a remote region of northeastern China

were said to have healing powers. Local shamans would grind these rocks

and administer a powdery brew to the sick. There were anecdotal reports

of improvement, particularly among people with cancer.

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Several years ago a group of Chinese scientists skilled in chemistry,

molecular biology, and oncology left their institute in Harbin and

journeyed into the hinterland to investigate these rocks. They

interviewed villagers who claimed to have benefited from the brew,

approaching their clinical histories with the hard-nosed skepticism of

modern science. The rocks were treated according to the exact

specifications of the folkloric recipes, and the potion was taken back

to Harbin for analysis. After many months of investigation, the

scientific team identified arsenic trioxide as the active principle of

the stones. Further study showed that the arsenic compound was toxic to

certain cancer cells, particularly those from a fatal form of myeloid

leukemia. Carefully designed clinical trials were conducted, first in

China and later in Europe and the United States. A new, highly potent

treatment was identified for a lethal form of leukemia. Arsenic trioxide

is now an agent approved by the Food and Drug Administration and is

being tested against other types of cancers.

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Over the past few years, there has been increased interaction between

so-called conventional and alternative forms of medicine. In some

instances, like the one above, traditional Asian treatments have

provided novel advances in combating serious maladies. The key to the

successful marriage of conventional and alternative medicine is, as for

any type of marriage, mutual respect, open communication, and shared

values. In essence, a common language must be employed by both parties,

articulating a rational basis for cause and effect, and a belief in

experimental reproducibility and measurable outcomes.

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The placebo effect is another example of alternative healing becoming

explicable with the tools of today's research. Placebos were formerly

disparaged, cast as inert prescriptions of a charlatan or fool. But

recent work has shown that the placebo effect results from powerful

changes in the chemistry of the brain and the workings of the body. In

fact, the benefits of a number of alternative and mainstream

conventional therapies are due, in part, to the positive beliefs of the

recipients. But there are types of alternative medicine, such as

homeopathy, that have not yet been married with conventional medicine.

In " Copeland's Cure, " Natalie Robins charts the history of homeopathy

and explores in great detail the friction between its practitioners and

mainstream physicians.

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" Founded in 1796 by Christian Friedrich Samuel Hahnemann, a German

doctor, literary scholar, translator, and uncompromising dreamer with a

bad temper who was appalled by the harsh approaches to treating illness,

homeopathy, a term he coined, expounded the principle of Similia

similibus curantur -- Like cures like. The doctor . . . demonstrated on

himself and many others in a series of what he called 'provings' that

certain substances had a curative effect if used in a special way.

First, the substance had to resemble the very illness it was treating,

and second, the substance had to be given in the smallest possible dose.

These two 'rules' were the exact opposite of the ones that other doctors

followed. These doctors . . . were also referred to as the 'dominant'

practitioners of the time, and they used large doses of substances that

were very different from -- in fact, the opposite of -- the illnesses

they were treating. "

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Hahnemann believed that even poisons, if used in minuscule doses, could

be beneficial in the restoration of health. The dilutions that

homeopaths used could range from one part per thousand to a million or

more. " Sometimes the end product was so much more water or alcohol than

remedy that, in fact, no molecules at all remained of the original

substance. The phenomenon defied the principle of what was called

Avogadro's number, which set the point in the process of dilution where

a molecule of any given substance could theoretically no longer exist, "

Robins writes.

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How then could the tincture work if it no longer contained the

substance? Homeopaths believed the solution " remembered " what once had

been in it, and this memory of the original substance was sufficient to

combat disease.

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It is no wonder that a therapeutic philosophy that defies the laws of

chemistry and physics would become the target of derision and vitriol of

mainstream medicine. Robins uses Royal Samuel Copeland, a homeopathic

physician born in Michigan in 1868, as a vehicle to tell the history of

homeopathy in the United States and its contentious relationship with

conventional medicine embodied within the American Medical Association.

I had never heard of Copeland, and his story is a remarkable one. He

pursued surgery and homeopathy in his native Michigan, and then

transited into a career in public service, as mayor of Ann Arbor,

commissioner of public health of New York City, and US senator from the

State of New York. Copeland was caught up not only in battles with the

AMA, but in internecine struggles within homeopathy itself. Some

homeopathic practitioners were orthodox, subscribing strictly to

Hahnemann's principles, while others sought to practice homeopathy along

with mainstream medicine. As a surgeon, Copeland certainly belonged to

the more accommodating group. His legacy is personified today in

homeopathic physicians like Jennifer Jacobs and Michael Carlston, who

have tried to apply the scientific method in evaluating certain

homeopathic treatments. Their results have largely been unconvincing to

conventional medicine.

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Robins wonders why homeopathy has continued to be embraced by large

numbers of people despite its denigration by mainstream medicine and the

difficulties in proving its principles according to the laws of

chemistry and physics. There is a deep appeal to the idea that

infinitesimal quantities of substances could ramify therapeutically

throughout the body. There is also the fear that conventional drugs have

side effects that may not be detected for several years, like those

recently reported with long-term Vioxx treatment. But most of all, we

understandably wish for something miraculous to help us when

conventional medicine fails to supply cures. Robins subtly shows us the

complexity of the human psyche in this narrative of medical history.

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Jerome Groopman, MD, is a professor at Harvard Medical School and Beth

Israel Deaconess Medical Center. His most recent book is " The Anatomy of

Hope. "  

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