Homeopathy Papers

Exemplary Case Histories Under the Aspect of the Placebo-Thesis of Homeopathic Effects

Written by Heinrich Hümmer

Homeopath Heinrich Hümmer addresses the problem of establishing the curative effect of homeopathic treatment in light of objections such as coincidental healing and placebo effect. He suggests ways of overcoming those objections.

Case I: Immediate Remission of an Inguinal Lymph Node Afflicted with Large-Cell B-Non-Hodgkin’s Lymphoma Under Sole Homeopathic Treatment with Conium

Summary

Since the preparation of clinically controlled homeopathic studies is hampered by a variety of problems, homeopathy must increasingly rely on the publication of convincing case reports. The vast majority of these individual case studies cannot invalidate the placebo thesis of homeopathy, the argument of coincidence instead of causality and the classification as an anecdotal individual case.

On the basis of cases, which indicate the mono-causality of homeopathic therapy due to close-meshed clinical diagnostics and/or immediate therapeutic successes, the proof of effectiveness for homeopathic evidence can be improved.

In countless discussions with leading figures in homeopathic criticism [1], the author of this article has tried again and again to refute the thesis that homeopathy has a placebo effect, but this turned out to be problematic in view of the poor data situation of placebo-controlled studies.

In particular, the demand for the replication of studies that found a significantly positive effect for homeopathy [2] remained unanswered. The accusation against homeopaths is also formulated polemically in the film announcement for a film critical of homeopathy [3] that was recently released in arthouse cinemas, in which the author and other protagonists were allowed to comment on all homeopathic topics:

“They studied medicine, but they treat their patients contrary to the current state of science. There is an allegation of deception.”  These points of criticism were also expressed inappropriately in a film interview between the author and the director after a screening.

Why the discussions, why the homeopaths’ desire for recognition by so-called scientific medicine?

On the one hand, doubts about one’s own therapeutic actions, which, in view of the sheer “incredible” healing successes but also unmistakable failures – that afflict every self-critical homeopath from time to time, push for the confirmation that one is still on the right “healing path”.

On the other hand, homeopathy in Germany, as well as in the whole of Europe, is encountering increasing resistance, which is only partially based on supposedly rational arguments. Increasingly polemical and dishonest, skeptics are pushing for homeopathy to be eliminated from the range of medical therapies and from reimbursement by health insurance companies.

Even if the world’s most scientifically experienced expert on homeopathic data, Dr. Aust from Germany, attested to the evidence of homeopathic therapy in a moment of undogmatic honesty [4]

“In addition, you should read my statements and those of the INH again more carefully: Our statement is that there is no robust/reliable/convincing evidence of efficacy beyond placebo. So not “none” but “not meaningful”, which makes a difference in the absolute number. Just like “no beer” is different from “no good beer”. “

and even though the medical protagonist of the skeptics, Prof. Edzard Ernst, had to admit in the face of the publication of a double-blind placebo-controlled study on insomnia [5] that

“A new study of homeopathy suggests that highly diluted remedies are better than placebos (and I cannot fault it)” [6]

the accusation of placebo with the assumption of a sham therapy, which does not work independently and is therefore basically superfluous, remains.

Since homeopaths – as is very impressively revealed in the above mentioned film “Homeopathy  unrefuted?” – fundamentally contradict each other on the one hand with regard to the laws, and on the other hand a compulsive adherence to the axioms formulated by Hahnemann in the Organon can be observed, it is not surprising that the credibility of homeopathy is increasingly suffering, especially in the technocratically oriented modern age.

Only a few attempts are made to subject the dogma-like postulated laws and recommendations for action to an internal review and to bring them into line with today’s scientific knowledge, i.e. to be open to corrections or innovations.

If one disregards the problem of internal dissent on individual procedural points of homeopathic therapy and concentrates on the consensus of all homeopaths on the essential homeopathic principle of action, the simile principle, the question arises as to how we homeopaths working at the grassroots level – who do not have university structures for placebo-controlled studies available – can contribute to the qualitative improvement of the evidence of homeopathic therapy by means of case-studies.

Under what conditions can case-studies also be used as an argument against the placebo thesis of homeopathic healing without being dismissed as an “anecdotal individual case”, a case of accidental coincidence or a case of a placebo effect mainly caused by affection?

Exemplary case 1:

The case report published by the author and co-authors in 2018 of  “Immediate Remission of an Inguinal Lymph Node Afflicted with Large-Cell B-Non-Hodgkin’s Lymphoma Under Sole Homeopathic Treatment with Conium[7] may make this clear.

The case offered itself for presentation by publication in a specialist journal for CAM medicine, since both the exact, conclusive diagnosis and the close monitoring of the course left no doubt about the immediately beginning and lasting healing process and little doubt about the monocausal effect of the given homeopathic remedy.

In the reported case of a 63-year-old patient with biopsy-proven involvement of a left inguinal lymph node with large-cell B non-Hodgkin’s lymphoma, a clear, sonographically objectifiable reduction in size was seen immediately after the start of exclusively homeopathic therapy with Conium 30C.

In the further course of the disease, the lymph node was hardly palpable, and 2 weeks after the start of therapy, the histopathological preparation of the excised lymph node showed no remnants of the previously diagnosed large-cell diffuse B-cell lymphoma, apart from “regressive changes (result of therapy?)”.

The patient has been in complete remission since beginning the daily intake of Conium C 30 on July 18, 2018 for 2 weeks and then Conium C 200 until September 26, 2018 with regular oncological follow-up examinations  without any interim indications of any recurrence . (April 2022)

What criteria should/must a case-study meet in order to be used as a method of proof of effectiveness of homeopathic therapy?

Argument – placebo effect or spontaneous course

The accusation of a pure placebo effect, e.g. due to the intensity of the affection, tends to be supported by

  • Lack of immediate reaction or changes in condition only in a larger context of time
  • missing objective healing parameters
  • Changes in sensitivities that are not primarily related to the disease to be cured
  • Responses proportional to the intensity of attention and duration of session

What speaks against a homeopathic placebo effect is

  • immediate responses toward healing
  • immediate positive reactions to a following prescripion after previous failures (possibly despite intensive attention and duration of the previous sessions)
  • initial reactions that were expected but not previously communicated [as well as by H.v. Müller reported in many of his case-descriptions [8], for the author it is an early indicator of a successful healing process if the patient feels an “overwhelming” tiredness and relaxation soon [hours] after the administration of the remedy ]
  • Reactions that take place according to Hering’s rule
  • Unusual, not to be expected, but plausible accompanying reactions in the sense of the homeopathic effect [i.e. dreams of snakes after the administration of an – not communicated – snake remedy]
  • Cure of diseases where placebo-reaction alone is extremely unlikely [cancer]
  • Prompt healings that are expected to take place according to the preconditions of causa or unusual symptom of the disease and previous experience with remedies specifically designed for this [Opium after trauma]

Coincidence versus causality

There is a tendency towards the (accidental) coincidence of homeopathic therapy and the observation of healing effects if there is

  • lack of immediate reaction
  • Courses of healing in diseases that often show spontaneous healing without any therapeutic intervention (especially in the larger context of time).
  • Comedication with conventional therapy
  • Cofactors with an unpredictable impact on the healing process

It speaks for the monocausal homeopathic healing-effect, if

  • you can perceive temporally close correlation of homeopathic drug administration to initial reactions and healing tendency
  • there is low tendency to spontaneous healing in the clinical picture to be cured
  • there is absence of any kind of cofactors that may have medicinal properties
  • there are reproducible healing effects that confirm empirical experience with specific drugs in defined clinical pictures

But note:

Neither the Pacebo-argument nor the argument of coincidence can be based on the postulated scientific implausibility of homeopathic effects, because this only refers to the current state of scientific knowledge!

So what can we do better in the preparation and presentation of cases and what positive effect can this achieve?

The (self)-critical analysis of one’s own cases under the aspect of “suitability for refuting the placebo-thesis” should be before the decision to publish, since a qualitative improvement of the accompanying clinical diagnosis of published cases can contribute to invalidating the coincidence and placebo-argument.

The verification of the (empirically) effective remedies in defined clinical pictures can be used to prove the reproducibility of homeopathic effects [9] and pave the way for placebo-controlled studies that contribute to further securing the evidence of homeopathic therapy.

Homeopathy can prove to be an adjuvant and – in precisely defined cases – also be successfuly applied solely for curing tumors [10]. In view of the increasing doubts about the claim to sole representation, the honesty and the evidence of the so-called scientific medicine [11], homeopathy can (again) position itself as a serious and healing therapy.

Conclusion

With carefully carried out case-accompanying and demonstrative clinical diagnostics, individual case studies from real practice with sufficient follow-up time can (especially in view of the problems in the preparation of clinical controlled homeopathic studies) represent a suitable method of proof of effectiveness for homeopathic therapy success.

Presentation and discussion of further exemplary cases, which refute the postulated placebo-thesis of the homeopathic effect, are planned in a loose order.

Literature

[1] Norbert Aust, Natalie Grams, Amardeo Sarma: Freiburg Declaration on Homeopathy. In: Information network homeopathy. March 17, 2016, https://netzwerk-homoeopathie.info/freiburger-erklaerung-zur-homoeopathie/ accessed April 21, 2022.

[2] Frass, M., Lechleitner, P., Gründling, C., Pirker, C., Grasmuk‐Siegl, E., Domayer, J., … & Burghuber, O. (2021). Homeopathic Treatment as an Add-On Therapy May Improve Quality of Life and Prolong Survival in Patients with Non-Small Cell Lung Cancer: A Prospective, Randomized, Placebo-Controlled, Double-Blind, Three-Arm, Multicenter Study. The Oncologist, 26(3), e523-e523. https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13548

[3] https://filmfreeway.com/HomeopathyUnrefuted , accessed April 21, 2022

[4] Blog comment by Dr. Aust on October 18, 2019 in http://www.beweisaufnahme-homoeopathie.de/?p=5335 , accessed April 21, 2022

[5] Michael, J., Singh, S., Sadhukhan, S., Nath, A., Kundu, N., Magotra, N., … & Saha, S. (2019). Efficacy of individualized homeopathic treatment of insomnia: Double-blind, randomized, placebo-controlled clinical trial. Complementary Therapies in Medicine, 43, 53-59.

[6] https://edzardernst.com/a-new-study-of-homeopathy-suggests-that-highly-diluted-remedies-are-better-than-placebos-and-i-cannot-fault-it/   retrieved April 21, 2022 [the original content of the blog article has  been deleted for unknown reasons]

[7] Hümmer, H., Wiecken, T., & Pachmann, K. (2019). Immediate remission of an inguinal lymph node affected with large cell B non-Hodgkin lymphoma with homeopathic treatment with Conium alone: When is sole adjuvant homeopathic tumor therapy permissible and useful? Complementary Medicine Research, 26(5), 361-366. https://www.karger.com/Article/FullText/500122

[8] Mueller, H.V. (2000) Homeoquiz: Angina pectoris after myocardial infarction. Allgemeine Homöopathische Zeitung 2000; 245(1): 28-29 DOI: 10.1055/s-2006-936715

[9] Hümmer, H., Pachmann, K., & Pachmann, U. (2005). Adjuvant homeopathic therapy in conventionally treated breast cancer. General Homeopathic Newspaper, 250(04), 127-133.   https://scholar.google.com/scholar?hl=de&as_sdt=0%2C5&q=adjuvante+hom%C3%B6opathische+Therapie+bei+konventionell&btnG=

[10] Classical homeopathy, opportunities and limitations in the treatment of breast cancer, lecture mamazone, Augsburg 2009, Slides: https://studylibde.com/doc/2556536/folies—praxis-dr.-h%C3%BCmmer–dr.-wolf-und-dr.-wiecken

[11] Jureidini, J., & McHenry, L.B. (2022). The illusion of evidence-based medicine. bmj, 376. https://www.bmj.com/content/376/bmj.o702

About the author

Heinrich Hümmer

Dr. med. Heinrich Hümmer, Herrsching Germany, earned a degree in civil engineering with diploma. Following this, he did medical studies and clinical training in paediatrics, surgery, gynecology and internal medicine. He also did homeopathic training with well-known teachers including Georgios Vithoulkas. Since becoming a general practitioner in 1986, he used homeopathic treatment almost exclusively, but with strict consideration of the therapeutic limits inherent in homeopathy. Dr. Hümmer engaged in intensive work, lectures and publications on the subject of cancer and the possibilities of homeopathic treatment. He maintained critical distance from the dogmatic interpretation of Hahnemann's Organon with the intention to integrate a reformed homeopathy into the canon of science.
Website: https://wordpress.com/view/homoeopathiewirkt.wordpress.com

Leave a Comment