Medical Ethics

Methods To Avoid In Homeopathic Practice: Ethics

Last modified on December 3rd, 2012

The American veterinarian Dr. Pitcairn describes in this document which he prepared for the homoeopathic education of licensed veterinarians the guidelines for ethical practice in homoeopathy.

This script Ethics was originally writen by Richard Pitcairn for the instruction of veterinary homeopaths, and has kindly been made available to us by the author.

The publication here is with kind permission of the author.

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The American veterinarian Dr. Pitcairn describes in this document which he prepared for the homoeopathic education of licensed veterinarians the guidelines for ethical practice in homoeopathy. He presents different approaches falsely called homoeopathy and explains why they are wrong. These concepts include the use of so-called complex remedies, potency chords and sarcodes, the treatment for diagnostic categories, the favoured description of unproved or so-called small remedies, dream and meditation provings as well as the prescription on the basis of psychological aspects, grouping of remedies or through use of psychic methods like kinesiology.

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Richard Pitcairn

http://www.grundlagen-praxis.de

Samuel Hahnemann developed and perfected homeopathic practice for over 50 years. As a science it was founded on some very important principles which are both a guide to clinical work and a basis for ethical practice.

In a simplified way, these principles are:

1. Medicines can stimulate a healing reaction from the body if they are able to disturb the health of the individual in a way that is very similar to that person’s natural disease, e.g., by establishing an artificial medicinal disease that is much like the natural disease.

2. Medicines, if similar in their effects, have the ability to do this because the patient is abnormally sensitive to their influence. That is, the susceptibility to the similar medicine is equal to the susceptibility to the illness.

3. It follows then that medicines which are not similar to the patient will have effects that are other than curative. These are:

– Palliative – temporary relief of symptoms as long as the drug is continued.

– Suppressive – long term disappearance of a symptom even though the drug is not continued. Surgery is suppressive in a similar way. Usually these patients will worsen emotionally.

These non-curative methods, harmful to the patient, are always to be avoided.

4. Medicines, if highly diluted and succussed, act on an energetic level and not physiologically.

5. Only one medicine is to be used at a time, this medicine to be most similar to the totality of symptoms of the patient. Remedies are never combined or mixed together or given alternately, back and forth between two or more.

6. In treatment of chronic disease, there are certain remedies, primarily the antipsorics, but also the antisycotics and antisyphilitics, which are necessary for eradication of the underlying miasm. If remedies other than these are used in treatment, at best psora will be returned to a latent state but not eliminated. The patient remains uncured and will manifest more severe disease at some later time.

7. Mental and emotional diseases are extensions of a physical condition that has become distorted into a primary one major symptom or condition. Disease does not start out on the emotional level but moves there from a physical manifestation.

8. Localized lesions are expressions of a disturbance of the whole patient and are never to be treated as local isolated events. They are in actuality expressions of defense by the life force of the patient and, as such, are never to be removed artificially but only by curing the patient from within.

9. Only medicines which have been previously studied as to their effects in healthy persons are to be used in treatment of the sick. It is unethical and careless to give medicines for which the practitioner has no knowledge of their effects.

10. Obstacles to the desired counteraction from the patient (subsequent to the initial effect of the medicine) are always to be avoided. For this reason, other modalities, such as use of drugs, acupuncture, herbal mixtures, etc. are to be avoided as these will block or modify the curative response.

11. Selection of the remedy for a patient is determined by careful observation, examination, elucidation of history and comparison of the patient’s symptoms to a materia medica in which the pure action of medicines is described. Psychic methods have no place in homeopathy.

These days there are many practitioners that deviate from these principles in one way or another. Usually, most often, this is because they have not had proper training in homeopathy and still think “allopathically’. Many use homeopathic remedies as if they were drugs.

Unfortunately, there is a modern trend to “be individual” in practice. That is, rather than learn the method of Hahnemann and mastering it, many early on in their careers develop their own idiosyncratic method and this method leaves off some part of what is basic to homeopathy. For example, not recognizing how remedies act and having a different idea “They act by energizing the body”, or ignoring the importance of the miasms and antipsoric remedies “Any remedy is suitable for the treatment of chronic disease”.

It seem to be a uniquely American phenomenon to act from hubris, to discount the past, publish a book, and begin to teach one’s limited experience to others. It is difficult to understand how one can begin homeopathic study and after just a very few years, begin to modify historical practice and introduce new and even contradictory practices into homeopathy. I don’t think this would happen in allopathic medicine. For example, if a doctor decided that antibiotics acted better if applied as a wash to the feet, very few would be caught up in such a strange idea. Yet, in homeopathy the equivalent happens all the time. In my opinion this comes about by a deep belief that homeopathy is not a science but something more subjective and flexible. In other words, the discovered rules of homeopathy are not universally applicable but depend on the practitioner.

The idea of subjectivism is very strong in these times and will be heard in statements like “Well it is true for me” implying that results vary with expectation or perceptual context. Yet, one would never say about gravity “It might be true for you, but I don’ t have to accept it”. Again, one would never want to go over a bridge built by an engineer that felt like engineering guidelines were to be interpreted subjectively.

The mood of the times is in this direction and much experimentation is being published in the contemporary homeopathic journals. It is very easy for the beginner to become confused by the many and contradictory ideas presented at conferences or in the literature and to help you sort out these ideas, the following information is provided.

Improper PracticeWhy It Is Not Correct
Using more than one remedy at the same time in a patient.

Some will refer to this as using “Complex Remedies”.

Examples are the brands “Dr. Goodpet”, “HomeoPet”, “Heel/BHI”1, and “Dr. Reckeweg”.2

Hahnemann specifically teaches that only one remedy is to be used at a time.

Par. 273 – “In no case of cure is it necessary to employ more than a single simple substance at one time with a patient. For this reason alone, it is inadmissible to do so.”

This is referred to as polypharmacy in homeopathy and is not ethical practice.3

Prescribing remedies in multiple potencies to solve the problem of deciding what potency is best for a patient.4In homeopathic practice a higher or lower potency of the same remedy can be used to antidote, e.g., neutralize the effect, of the remedy given before. There is no logical reason to give more than one potency at one time except to avoid the issue of deciding potencies in cases
Treatment of diagnostic categories or named diseases like for example, “flea allergy dermatitis”, with homeopathic remedies against that one part of the patients condition.5The patient is treated on an allopathic basis and is not treated as a whole but according to the named disease condition.

Basic to homeopathy is the use of the totality of symptoms to decide on the single remedy to be used. Treatment is never determined by a diagnostic category or on the basis of pathological classification.

Drainage remedies. The idea is to use one or more “main” remedies and then other, low potency (usually 2X or 3X), “smaller” remedies that act on certain organs to improve their function.6More than one remedy is used at the same time in a patient and often the remedies that are used interfere with each other (e.g., antidotes or inimical remedies).

The basic idea behind the approach is lack of confidence that one remedy can initiate a reaction that will be sufficient, e.g., a rejection of Hahnemann’s teaching of the effect of the similar remedy.

Often, sarcodes (remedies made from normal organ tissue like kidney or heart) are included in formulas with the assumption that the normal tissue will “harmonize with the disease organ” and make it function properly.7Use of sarcodes is the use of unproven medicines in the treatment of disease.

The idea of “harmonizing, resonance” etc., is not in agreement with Hahnemann’s teachings about the action of homeopathic remedies – that they act as an artificial medicinal disease which causes a health disturbance similar to the natural disease.

In homeopathy, there is no concept of remedies “harmonizing” with normal tissues or body parts and is an idea made up by non-homeopathic practitioners.

No distinction made between antipsoric and non-antipsoric remedies. Any remedy will be used if it seems to fit the symptoms.8

Many practitioners treat like this, a level of practice corresponding to Hahnemann’s initial findings, the concept of “similarity” as a basis for medicinal action. It ignores Hahnemann’s later findings of the existence of chronic disease and the approach needed to treat it successfully.

Rejection of Hahnemann’s discovery of the miasms and the applicability of the antipsoric remedies to this state.

Cases become confused and palliated or suppressed because of toggling back and forth between classes of remedies.9

Real curative progress is rarely made by these methods though psora can be brought once again to a latent state and the patient appear improved for some time.

Small remedies deliberately avoiding use of the major, polychrest remedies and instead using only little known or slightly proven remedies. The idea this practice comes from is that success in treatment requires using remedies that have not yet been discovered.; that too much emphasis has been placed on certain remedies like Sulphur, Calcarea, etc., and this is a blindness that has to be corrected. This is extremely popular right now and has not yet played itself out.Hahnemann addressed this early on in his Investigation of chronic disease and concluded that treatment of chronic disease was not helped by finding new remedies but by more accurately applying the important remedies already found to be applicable to chronic disease.10 This method is based on rejection of Hahnemanns teachings on chronic disease. Cases treated this way are palliated or return psora to a latent state without curing.
Prescribing unproven remedies. An example are current books that advocate use of remedies made from elements of the periodic table. The idea is that one can theoretically determine what the effect of the medicine will be from its chemical relationships, its similarity to other elements in the same grouping.11One of Hahnemann’s most important directives was to first determine the effects of medicines by doing provings in healthy human beings before they would be given to the ill. It is unethical to use medicines for which the effect is not known or based on theoretical speculation.
Dream provings. Some teachers give out remedies to those attending their classes for the purpose of doing a proving during the seminar. The symptoms are collected the next day by asking what was dreamed during the night. These dreams are considered to be the proving of the remedy. It is thought that those people in the course that do not take the remedy “give the best provings during their dreams” because of the sharing of the universal subconscious with other members of the class.This has little semblance to the provings that Hahnemann established as the basis for determining the action of medicines. It was one of the most important things, to Hahnemann, that medicines were properly tested in the healthy human body because until then, medicines were used on the basis of very changeable and unconfirmed speculation. Dream provings are a return to speculation in homeopathic medicine.
Meditation provings. This is very similar to”dream provings”. The action of a new substance is decided upon by a group of people that hold the material in their hands and then “meditate upon it”. The ideas, feelings and impressions that come up are the basis for establishing a materia medica for that substance.Like “dream provings”, this is speculative and emphasizes presumed psychological changes and, for the most part, ignores physical effects (though a meditation prover may say that there is a physical sensation in the body at times).

These provings report things like – in the proving of mare’s milk (derived from a horse with probable chronic disease (“some minor arthritis in her hip”): “Impatient, frustrated, ‘Get off my back’ feeling, of being corralled, being reined in. Interruption of flow, every time started going forward, felt the reins pulling me back.

Prescribing on the basis of personality, ignoring or minimizing the physical condition.

This is sometimes called “essence prescribing” meaning the presumed central psychological aspect is to be matched to the personality configuration of the patient.12

Some practitioners use only “mental” symptoms to prescribe for the patient and sometimes say that the physical problems of the patient must be corrected with allopathic medicine.

Hahnemann describes disease as affecting the whole patient always – physical as well as psychological. The entire patient must be taken into account and evaluation of the remedy must include the changes that happen physically.

If this is not done, then palliation and suppression can easily be missed.

Assuming that chronic disease has started with an emotional wound’, that some psychological insult has started the process of continued and progressive disturbance. Some advocates describe this as a very complex phenomenon, an initial wound followed by reactive complex formation that covers this up, etc.13 Some refer to the patient’s condition as consisting of a “wound” and then a “wall” of defense established around it. Treatment then is addressed to this perceived double layer in an attempt to see through the patients defenses to the underlying emotional injury.Hahnemann clearly says that patients with primarily emotional or psychological illness started as physical disease that became focussed at this emotional level as a “type of defective disease”.14 That is, conditions that are primarily emotional do not start as emotional upsets but as extension of a miasm that begins on the physical level. The emotional upsets are”triggers”, factors that activate latent psora. Making the assumption of chronic disease starting on an emotional level bypasses Hahnemanns discovery of the miasms and gives homeopathy a more “psychological” but erroneous orientation.
Prescribing for the patient on the basis of dividing them into one of three groups of remedies – those made from plants, animals or minerals. The idea is that by a person’s behavior and preferences (liking plants, flowery clothing patterns, etc.) signals their inclusion in a group of remedies made from a class of substances – plants, animals, etc.15

These ideas come from India (Sankaran) and the basis for them comes from Indian religious philosophy mixed with homeopathy.

This is a rejection of the importance of the miasms in prescribing. Most of the antipsoric remedies are from minerals, but this is not the determining factor for their applicability, e.g., that all minerals are antipsoric remedies or that all patients should receive mineral remedies.

This idea of patient grouping is based loosely on the “Doctrine of Signatures” the idea that there will be a correspondence between the remedy source material and the behavior of the patient, like snake-like behavior (hissing, striking) would require a snake remedy.

Prescribing through use of psychic methods – use of a pendulum, kinesiology or radionics.16

The assumption is that a higher level of consciousness directs the movement. Actually, it accesses the subconscious, and the answers forthcoming depend on its content

This is an attempt to solve the problem of evaluating a case through interview, examination and analysis of symptoms. The necessary study and development of skill in homeopathy is thought to be unnecessary as a more “accurate” method of prescribing is made available through psychic methods and this does not require intellectual effort.
Sequential Therapy is based on the idea of treating the historical traumas of the patient. “By removing the disturbances in reverse order, then dealing with birth, prebirth and inherited miasms, the client eventually arrives at his or her fundamental constitutional remedy, now clearly evident.” “Sequential Therapy points out that (the basic emotions: grief, fear, jealousy, anger and guilt) can destabilize the vita) force and remain there if untreated at the time of their occurrence….”Once again, this is an avoidance of Hahnemann’s teachings on chronic disease and an attempt to make prescribing based on something other than the patients actual presenting condition. Remedies are given close together in rapid succession with little time for the case to “settle out” into a new pattern. Obviously, this is a method that does not allow proper evaluation of each prescription.
Mixing the practice of homeopathy with acupuncture methods as a presumed hybrid advance in medicine .17These practitioners know very little of homeopathy. They discard all that has been discovered about homeopathy and combine it with the techniques of Chinese medicine which has an allopathic basis for its treatment (treat the cold patient with heating herb, etc.) These cases end up confused and suppressed.

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1. From an article by a veterinarian, included in promotional literature from Heel/BHI: “I treat equine flu as follows – Every second day until an improvement occurs – in severe cases daily – 1 ampule each of Engystol and Traumeel which, for animal use, exist in 5 ml dosages, together with 5 ml Gripp-Heel. These products are always mixed with some milliliters of blood which gives a much higher effect and are injected at the following acupuncture points: small intestine 1 1 behind the shoulder blades, governor 13 behind the withers and triple heater 15 at the upper trapezius border in the middle of the shoulder. I increase cardioactive support with Cactus compositum, depending on the case. In between days I administer Traumeel liquid at triple the human dosage, and in the mornings and evenings, one ampule of Engystol orally together with 5 tablets of Gripp-Heel 3 times daily. Excellent results hove, in addition been achieved with a thymus preparation…..”

Engystol N contains Asclepias vincetoxicum 6X, Asclepias vincetoxicum 1 OX Asclepias vincetoxicum 30X, Sulphur 4X, Sulphur 1 OX in isotonic sodium chloride solution “In an in-vitro test Engystol was shown to increase phagocytic activity which exerts positive influence on defense reactions to viral and related infections.”

Traumeel contains Belladonna 4X, Arnica montana, radix 3X, Aconitum napellus 3X, Chamomilla 3X Symphytum officinale 8X, Calendula officinalis 2X, Hamamellis virginiana 2X, Millefolium 3X, Hepar sulphuris calcareum 8X Mercurius solubilis 8X. “….the exact mechanism of action of Traumeel is not fully understood. However, it appears to be the result of modulation of the release of oxygen radicals from activated neutrophils, and inhibition of the release of inflammatory mediators and neuropeptides.”

Gripp-Heel contains Aconitum napellus 3X Bryonia 3X, Lachesis mutus 1 1 X, Eupatorium perfoliatum 2X, Phosphorus 4X. “Gripp-Heel is a modulator of nonspecific cellular defense mechanisms, indicated for the temporary relief of symptoms associated with viral infections, particularly influenza…”

2. From a recent brochure: “In classical homeopathy, symptoms must be assessed in the context of the individual’s entire life and medical history…..The process of choosing the correct remedy requires experience and the proper information (i.e. etiology, modalities, physical and mental symptoms).”

“It is important to gain the patient’s confidence and most of the time it takes more than one consultation to obtain a complete case history. If the patient expects an immediate relief for a specific condition, Dr. Reckeweg formulas can be very useful and may be the appropriate first prescription especially for the patient who has never used homeopathic products before.”

“The combinations of interrelated preparation produce a synergistic effect and have been successfully employed and favored by many homeopaths when they have a difficult case that requires more time. Then, it is appropriate to administer the constitutional remedy the similimum to obtain a long-lasting cure, not only temporary relief. This approach has become especially popular and it is commonly practiced in Europe.”

3. Polypharmacy is very popular with veterinarians that use homeopathic products in eclectic practices. One can tell from their communications that the basic principles of homeopathy are not understood. An example is a recent book (May 1999), Natural Healing in Animals, in which the veterinarian author discusses the action of homeopathic medicines: “My own sense, based on experience, is that any therapy which works orally, such as glandulars and classic homeopathy, will work even better when injected. Anything delivered more directly into the bloodstream is bound to have a more immediate effect than when it has to work through the cells of the tongue, the lining of the stomach, or the digestive tract and be exposed to the factors of dilution and enzymatic action.” Clearly, this practitioner thinks of homeopathic remedies as acting physiologically; like drugs that have to cross mucous membranes and can be degraded by digestive processes.

The use of combination remedies is advocated on this basis: “Homeopathy is also based on the premise that a single remedy the one that best appears to fit a patient’s needs on every level, should be administered once, then not again until the homeopath can see if it has worked – an interlude of one week, may be two. My problem is that many of my patients don’t have two weeks to wait!” The assumption here is that the single remedy is having no effect for a week or more and during this time the patient is declining. It also makes the assumption that giving combination remedies is effective right away but of course no evidence is given to show that this is so. In fact, the author says that combination remedies and many other modalities are all added to conventional veterinary treatment so that he cannot really know what each individual treatment method is doing.

However, again acting on an assumption that contradicts the basic homeopathic experience that homeopathic remedies are powerful medicines and can cause harm if misused he justifies this practice: “Since the ingredients are benign, I side with the homeopaths who argue that there’s nothing wrong with administering more than one at a time, and that this ‘shotgun’ approach may lead to faster responses.”

4. An example is from the literature of Complimed, Complementary Medical Research Group: “Poten-C-cords implement the principle of what has been termed harmonizing potencies, potency chords, muti-attenuations or multiple potencies. The technique utilizes several potencies of the same homeopathic substance in a single tablet, pillule or liquid preparation.” “The purpose of mixed potencies is to avail patients of the advantages of providing both high and low attenuations at the same time.” “Using a Poten-C-cord takes the guess work out of a selecting a potency.” This approach is done with both single remedies and combination formulas – several remedies together, each in several potencies.

5. From a brochure for Allertox, a product of Apex Energetics: “Allertox homeopathic remedies offer you a revolutionary approach to the treatment of allergies. The result of over ten years of research, the Allertox Line is unique in that it: 1) addresses both single and multiple allergies, 2) offers drainage effects as well as neutralization, 3) provides both short-term symptom relief and long-term resistance to specific allergens, 4) links emotional aspects causing susceptibility, and 5) and most importantly, treats not only the symptom, but the cause as well.” This last refers to using isopathy, using medicines made from the presumed allergen.

As an example: One of their products, Aller-Total, contains potencies of Histamine, House dust, Pollen, Hair, Milk, MSG, Wheat, Peanuts, Juniperus communis gemmae, Ribes nigrum gemmae, Apis mellifica, Formicum acidum, Sabadilla, Solidago virgaurea, Luffa operculata, Berberis vulgaris.

6. Example from a recent brochure: “Under the influence of classical ‘single remedy’ homeopathic prescribing, some practitioners have inadvertently overlooked the importance and efficacy of using combination homeopathic preparations to stimulate detoxification of the organism.” “Homeopathic drainage or detoxification provides stronger stimulation of the elimination processes on all levels g the organs, tissues, and cells. Drainage also allows for the opening of the emunctories – the drainage routes in the organism.”

7. From the book Natural Healing In Animals: “If combinations have all but replaced single remedies in my practice, another kind of homeopathic has come to seem even more critical. Question: What do you get if you cross a glandular with a homeopathic remedy? Answer: One of the most exciting therapies I’ve ever used. Injectable homeopathic dilutions of organ and body tissue concentrates. Or, as we jokingly call them at the clinic, ‘injectable body parts’.

8. From a promotional brochure by a well known teacher of homeopathy: “There is no such thing as a ‘small or less powerful’ homeopathic medicine. Only our knowledge of a homeopathic medicine can be small, and inaccurate prescribing limits the action of our remedies. Every homeopathic medicine has a wide range of action, and every homeopathic medicine can act profoundly.”

9. There are some homeopathic teachers that reject the emphasis on small remedies but they are few. In a seminar by Dr. Faroukh Master, a teacher from India: “Particularly in the U.S. there is too much stress on little known, small remedies. You may only get one or two such cases in your lifetime, and too much interpretation is required to fill in the gaps of knowledge in their drug pictures.” “

10. What was the reason of the thousands of unsuccessful endeavors to heal the other diseases of a chronic nature so that lasting health might result? Might this be caused, perhaps, by the still too small number of Homeopathic remedial means that have so far been proved as to their pure action? The followers of Homeopath have hitherto thus consoled themselves; but the excuse, or so-called consolation, never satisfied the founder of Homeopathy-particularly because even the new additions of proved valuable medicines, increasing from year to year have not advanced the healing of chronic (non-venereal) diseases by a single step….” from the Chronic Diseases by Samuel Hahnemann.

11. From a newsletter presenting this method: “For example giving Muriaticum’s essence, or chlorine’s part as a chloride in remedies such as Nat. Mur., Mag. Mur., Calcarea Mur., Koli Mur., Baryta Mur., Ammonium Mur., and Ferrum Mur., as having singular concepts that it contributes to the remedy with which it is in combination. In the case of Muriaticum, these ideas are explained as issues surrounding concepts such as: Self-pity, care and nurturing, the mother, attention, and self awareness.”

About the author

Richard H. Pitcairn

Dr. Richard Pitcairn graduated from veterinary school in 1965, from the University of California at Davis, California, and worked on a PhD degree emphasizing the study of viruses, immunology and biochemistry. Working in a mixed practice he saw a wide variety of health problems, but to his disappointment, did not see the results that he expected using the treatments learned in veterinary school. He became interested in alternative medicine, nutrition and homeopathy. He found homeopathy to be intellectually complete and satisfying, and after studying and using it for some 20 plus years, has had remarkable success. Since 1992 he has taught a yearly course, The Professional Course in Veterinary Homeopathy, to train animal doctors in homeopathy.
Dr. Pitcairn was a founding member of the Academy of Veterinary Homeopathy and also served as its president. With Susan Pitcairn he wrote two editions of Natural Health for Dogs and Cats, a classic in the field, which sold over 350,000 copies.
http://www.drpitcairn.com/

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