Dr Seema Mahesh BHMS, MD (hom), Dip IACH is the Research Head of the International Academy of Classical Homeopathy, Greece and the Director of Centre for Classical Homeopathy, Bangalore. She has been instrumental in consolidating the remarkable cases cured with classical homeopathy by the students of prof George Vithoulkas and publishing them in peer reviewed medical journals. She has also presented the concepts of health and disease as taught by prof Vithoulkas at conventional medical conferences all over the world including the Harvard School of Medicine where her presentation won the Best Abstract Award.
AS: What led you to doing research in homeopathy?
SM: The reason I chose to study homeopathy and not mainstream medicine in the first place, was that I saw conventional medicine couldn’t solve most of the health problems around me, including my own. I saw homeopathy give a great relief to these people. However, when I graduated from BHMS, I was appalled by how little scientific evidence existed in our field.
Yes, we had huge clinical success but this wasn’t enough when I had a dialogue with a conventional medical colleague. They said, “Where is the scientific evidence?”. I was hoping that someday I will be able to do something in this direction.
Meanwhile, we (my husband and I) had taken up to visiting Alonissos and learning under Prof Vithoulkas. He, a scientist himself, encouraged that we all think in this manner too. That we don’t succumb to fantasies and ‘novel ideas’ without testing them first, in the crucible of Hahnemannian principles and clinical effect.
Under his tutelage, our, especially Mahesh’s clinical success soared. Once, professor Vithoulkas told Mahesh that he must be publishing such miraculous cases. Mahesh didn’t know what that meant. He asked professor during a private meeting and professor explained what “publishing” is.
Mahesh was overjoyed because he knew Seema could write! That is when I took up research writing. The first article was about 5 cases of gangrene treated by Mahesh. This was like an enlightening moment for me and I felt myself click into the place I was born to be in.
I haven’t looked back or reconsidered my priorities after that. I taught myself how to become better at research over the years but eventually I joined the higher degrees by a research program at Taylor’s University, Malaysia to train hands on.
AS: What are some of the issues that your research has explored?
SM: My research (isn’t mine really – it is team work) has mainly been in two areas.
1. Writing quality case reports as the basic foundation of evidence-based medicine in homeopathy
2. Exploring the concepts of direction of cure and suppression through clinical studies
I agree most people disregard case reports as the bottom grader of the evidence triangle. However, in a field where RCTs are difficult to design (due to being opposed to the homeopathic paradigm), and observational studies will lack power due to the lesser number of participants, it will help to create a strong enough database of case reports that depict the real world scenario and practice outcomes.
This is the idea behind Prof Vithoulkas encouraging us to document our cases and publish them in mainstream journals as much as possible. I do the job of sifting, collating and scientifically writing these cases treated by the diplomats of IACH who are spread in over 65 countries.
The second one is slower but a more advanced work. In our clinic alone, we have over 20,000 cases. This is a treasure mine for analysing homeopathic concepts. Many of our colleagues from IACH have contributed to these types of studies.
For example, the poster we presented at Harvard Medical School conference on Brain Body Cognition was about the connection between antibiotic abuse in the past for acute diseases and the incidence of multiple sclerosis, with data from our Romanian colleagues. This study was widely accepted and they gave us an award of excellence. On similar lines are a few other studies that we conducted, the culmination of which is a paper under peer review at the moment.
Adding to this, my research here at the university was a systematic review and narrative synthesis inspecting the long-term health effects of antipyretic treatment in the elderly during infections.
AS: Could you mention any research projects where the results surprised you or were beyond your expectations?
SM: That is a very good question. You see, as scientists we are supposed to start out with a neutral outlook and inspect without bias what the evidence is telling us. But at the same time, our conditioning as homeopaths, especially with such a long practice history, has ingrained certain expectations in us. This is a very difficult balance to achieve and my supervisor will tell you about my struggle in doing that. However, when we do put the data out there on the excel sheet and analyse, in every one of the investigations, we were able to see facts as were taught by Prof Vithoulkas.
Let me explain a few results as examples.
1. In the Harvard poster study that I mentioned earlier, we found that
– before the onset of MS, 94% of the people had a history of repeated acute infections.
– of these, 80% had abused antibiotics
– 93% of them did not get high fever anymore, if they did get it at all.
2. In 5 studies involving diabetes mellitus, chronic headaches and asthma, and chronic diseases in general, we found
– the chronic inflammatory disease onset was associated with reduction in acute infections and fever temperature if they did get any fever.
– the past history showed recurrent acute infections mostly but the comorbidities were other chronic inflammatory diseases.
– when the chronic inflammatory disease improved, there was return of acute inflammatory diseases.
In our papers dealing with these ideas clinically, you can clearly appreciate this phenomena on the graph. I was floored because I expected to find some weak connection and not such an obvious in your face association.
Prof Vithoulkas’ Continuum theory states that diseases form a continuum in a person’s life and what has happened before decides the present health status. The Levels of Health Theory states that people are born with different potential for health and longevity. Through our actions and treatments we may improve it or destroy it. Both theories say that efficient acute inflammatory response is the hallmark of an efficient immune system and when we don’t allow it to do its job, the response is warped and a compromised low grade chronic inflammatory state begins, leading to the wide variety of chronic disease that is the leading cause for morbidity and mortality today.
This is corroborated by MANY immunological studies but to see it clinically evident was quite magical.
AS: Can we say that the research has clearly validated Prof. Vithoulkas’ theory that allopathic treatment, by suppressing necessary acute immune reactions, leads to chronic illness? Can you imagine a scenario in which allopaths will ever admit that they’ve been inadvertently harming patients for years?
SM: Yes! It has. Conventional medicine’s paradigm does not allow it to see this connection, which is subtle and involves the whole organism. The Cartesian paradigm that allopaths are conditioned to follow may not allow them to see the bigger picture.
However, having said that, I must tell you about my conversation with a Stanford geneticist I met at the “Autoimmunity, Where Are We Now?” conference in New York. When I explained the continuum theory, he was so excited.
He said, “this is the problem with us that we are so focused on one gene, one pathway or one factor as the cause for disease. But I have always seen that there is so much more to it – the balance of the whole tips before any of these could go wrong. This is my experience – but how to prove this?”
I also got the impression from the greats of the field I met in the “Resolution of Inflammation” conference in Dublin, that they have focused enough on setting the resolving factors right and yet are unable to come out with a product that can do this in the real world.
The reason is that there are simply too many factors involved in the smooth functioning of our immune system. The things that go wrong are different in each person and they are usually multiple things. They seem to be a little out of their depths today. Hopefully, someday, they will see that our approach of stimulating the immune system in the same direction as it is already putting effort in, is the most scientific approach.
AS: In the U.S. drug ads on television often state with pride that a drug will “suppress symptoms”. The concept of suppression as something bad, doesn’t even exist in allopathy. When people you know are being treated allopathically, and knowing the danger of that, how do you react emotionally or socially?
SM: “Suppression” to the allopaths has a very superficial meaning compared to what we perceive with that word. They just mean removal of the symptoms. In that sense, they are truly concerned about the patient’s well-being. Actually, I have come across many homeopathy colleagues saying that it doesn’t matter how you achieve it, as long as you relieve the patient. I agree it is a noble goal, except, I know what homeopathy is capable of when applied in the right manner.
If you look at allopathy or even superficial homeopathic practices, there is reduction of the symptom or complaint that a patient has approached the doctor for. But in the long run, if you look at what has happened, you will see that either they are worse in general than when they first came for treatment or in the same state with a little shuffling of symptoms here and there.
We homeopaths have very specific assessment techniques through which we know where the patient is, after treatment. Unless we see the direction of cure, unless we see the elevation of health, unless we see the general well being established, we cannot claim cure.
Because I have witnessed homeopathic cure, earlier, I would get frustrated and argue with my colleagues about the wrong effect of superficial homeopathy and of course, allopathy. However, with age and maturity, I realised that no one is out there with an intention to harm patients (mostlyJ). It is ignorance and yes you may argue that ignorance is the greatest evil. But this evil is surmountable through education and personal experience.
So I have resorted to educating the public and doctors and researchers rather than simply insisting that I am right. Our work with the Vithoulkas E Learning Program and the research team of IACH is solely directed at providing cutting edge education and investigations into homeopathy for this same reason.
I am now not disturbed if my patient suppresses with allopathic drugs or an “acute remedy” (especially homeopaths who are patients J). But I try and educate them about how drugs disrupt the curative process. I must make them understand that we are not going to treat every symptom as and when it arises but always treat the bigger picture. It works, most of the time.
AS: It seems that much research in homeopathy is what I would term defensive research. It is an attempt to legitimize homeopathy to the allopathic community. Is there much research that has the potential to improve the practice of homeopathy, or that expands our view of what is possible with homeopathy (as with the gangrene case study)?
SM: The biggest bane of homeopathic research is that we try to fit our studies into the evidence paradigm of conventional medicine (round peg, square hole and all that). We are a therapeutic system based on inductive logic and individualisation, as opposed to the generalisation principle of allopathy. This simply won’t work.
However, we have to try and make them understand, for the reasons I stated already – to ensure they realise the damage being caused and the better option in most cases. In fact, my dream is to be able to devise homeopathic research principles that will provide air tight evidence and yet not compromise its principles. So far many people have attempted and come out with very interesting solutions but we still have a lot to do.
So far, IACH has exclusively concentrated upon quality case reports in order to demonstrate not just the possibility with homeopathy but also to demonstrate the need for absolute adherence to the principles. The case reports are mostly of deep pathological conditions and such impressive cures cannot be achieved without applying the principles.
In fact, even the systematic review conducted sometime back comparing the efficacy of homeopathy with placebo demonstrated that individualised homeopathy yielded significantly better results than combinations.
It is my experience with youngsters taking up homeopathy in India that most of them do not have the conviction in homeopathy by the time they graduate. If they do not believe in their science, how can they achieve anything?
They are easily distracted by the easier paths that will lead them to some success but will not amount to much eventually. For such young minds case reports published in conventional journals and portals such as Hpathy, will hopefully provide a firmer ground to stand upon and reach for the hights that our science can elevate them to.
Some case reports from peer reviewed journals:
AS: Are there any plans to review Covid-19 cases to see if a reliable genus epidemicus remedy has emerged?
SM: While the straightforward answer is yes, I would like to elaborate a little about this. Both Hahnemann and Kent have been clear that we should be looking at a few remedies to keep ready during the epidemic by inspecting the initial cases. It wasn’t meant to be one genus epidemicus.
It may happen so that one of them is more indicated than the others. Having said that, in our own experience with past epidemics such as dengue and chikungunya, we saw that each case presented with unique characteristic symptoms and prescribing on these alone could truly help the patient.
In our published dengue paper, you may see that within 24 hours of prescription the platelets increased from 11,000 to 45,000 and the neutrophil/lymphocyte ratio improved, indicating a reduction in infection and improvement of the immune response. Such impressive changes cannot occur with a wrong remedy.
We may make a paper of such mistakes as well I think. The idea behind one or few remedies coming indicated in an epidemic may have been during the times of Hahnemann when the general health was much better, comorbidities were lesser and the hereditary load was lesser and there was a sort of uniformity in a geographical location’s community health.
Today, the immune response varies greatly from person to person due to these factors even during an epidemic. To top this, the virus itself is different in different countries. So far, Indian homeopaths have been allowed to prescribe alongside conventional medication and not exclusively to Covid-19 patients.
They have done a great job and it is our experience too that the time taken for recovery with adjuvant homeopathy is very short and the progression to severe covid is very less compared to those who do not take homeopathy (this needs to be taken at face value at the moment as there is no ‘scientific evidence’ towards this yet).
A few doctors have also suggested some remedies as being indicated as genus epidemicus. Prof Vithoulkas, during one of the international webinars gave a list of remedies that may be kept in the covid kit as they seem to be indicated most. This was a list of 10 remedies and not one.
So, at this moment, we definitely have an idea as to what remedies are coming up most of the time but there is no single genus epdemicus. In future, if we succeed in designing a comparative study, with sufficient statsitical power, we may be able to arrive at the evidence necessary but even then, my own conviction is that we will have to stick to the rules of acute disease prescription rather than focus on one or two as the genus.
AS: Thank you Dr. Mahesh for sharing with us today. You’ve given everyone a lot of food for thought.