An overview, requisites, current scenario, challenges and future
“Research must be the morning breakfast for all of us”.
For the past 200 years or so we are the preferred target for skeptics, for “material existence”, “proof”, “recognition” and “modus operandi” of Homoeopathy. There are some areas where we lack or are being criticized and dragged. It is a heartfelt need to strengthen our science as per the scientific methods applied universally. This is the fundamental challenge in front of us now. Constant onslaught from various agencies has made us a little more sensitize to prove, present (or both) our science on research oriented backgrounds. We must explore the hidden areas, define the flaws, and open new horizons for future research. There are many peer reviewed published studies and meta-analyses supporting basic, fundamental and evidence based character of Homoeopathic researches that have contributed substantially, taking Homoeopathy to newer heights. Such work needs to be replicated at multi-centric levels in larger sample sizes to better understand the depth of Homoeopathic research. We must be able to find the hidden treasures of Homoeopathy and present them to the scientific fraternity in a comprehensible manner. The main aim of research is to look into the matter in a scientific and “rational” attitude and the conclusions and benefits must be used for the development of skills, clinical practices, repositories and growth.
Keywords: evidence based medicine, homoeopathy, meta-analysis, scientific research, review articles, publication
Research Orientation: A must learn process
For the past 200 years or so we are the preferred target for skeptics, the main reasons being our “material existence”, “proof”, “recognition” and “modus operandi”. All of us have a common opinion against these attacks, but the counter approach we adopt may be different. Scientific research, literature review, meta-analysis, criticism, cross allegation, protests, official replies and online discussions are a few of the tools being adopted to counteract the situation. “The need of the hour is research oriented awareness”. It is heartfelt need to strengthen our science up-to the levels of modern scientific methods applied universally.
We have been “in fashion” of research since the inception of Homoeopathy by Hahnemann who himself researched into the history to prove the theory he discovered. There are numerous examples of research activities which one can find while going through ancient writings and teachings (some being available online and a few passed on to generations by words of mouth). The trend of data keeping, searching and analysing is as old as eternity, long before our beloved “computer” was born. For the past few decades or rather less, we are very fond of searching online resources for advancement, theories and proof. There is a gross change in the manner of finding and presenting things but the aim “to explore” is still the same. The resources must be built as well as used with caution as one wrong message given, can change the outlook of researchers.
It would be appropriate to give here the example of Shang et al paper11 (Lancet) on the condemnation of Homoeopathy, comparing it to nothing but placebo. When it was analysed by researchers with an open mind, it was found that it was statistically good, but with bias and lack of standards of reporting trials and meta-analyses 32. The clinical effect of Homoeopathy was reported as placebo on the basis of 8 unspecified homoeopathic studies and 6 unspecified conventional studies. It all happened because either the reporting trials were not adequate and up to scientific standards or they had been taken in a manner to yield “expected results”. Had there not been the research orientation, the study would have harmed us deeply.
Homoeopathy has been a victim of constant onslaught from various agencies all around the globe 4, 11. Such of activities at various levels in the past few years have made us more sensitize to prove, present (or both) our science on research oriented backgrounds.
Research orientation is what we need today; there is a researcher and scientist in every one of us. We must be open minded and “active contributors” to the development of science. We must use every possible resource to explore new things and make Homoeopathy an acceptable and accessible science to all.
Is Research really a “complex of certain things”?
Research is the first basic thing for a science to root and grow. It must support the science as well as explore the hidden areas, define the flaws, and open new horizons for future research. A basic research process can be defined as, “An inquiry process that has clearly defined parameters and involves discovery and creation of knowledge for testing, building, revision, confirmation, refutation of knowledge and theory by means of investigation of a problem for local decision making”1. Research in Homoeopathy is known since antiquity and has been carried in one form or another. The first basic thing Hahnemann did to prove that there exists a science beyond the materials, was by means of experimentation and observation, observing it to the levels of criticism and analysing it to the depths of history1. Hahnemann developed homeopathic pathogenetic trials (HPTs) – often referred as drug provings – and reappraised them in the light of more recent knowledge and protocols for clinical trials involving human subjects. Innovative features and methods introduced by Hahnemann and aimed at reducing bias are noted2. This clearly proves the insight of Hahnemann to accept challenges with a futuristic outlook, and to adopt the facts.
Carrying on with the tradition, researchers, schools, institutions and individuals have been trying to explore different aspects.7, 27, 28, 29, 30, 32 The research related issues are also taken on different grounds considering the efficacy of Homoeopathy, quality of drugs prepared, documentary proofs of existing phenomenon, history of Homoeopathy etc. Although the majority of these findings and studies are available online, many of us find them difficult to comprehend and follow. This may be accounted to reasons such as :
- Something which is hard to understand
- Difficult to follow or replicate (at clinics)
- Something which is inaccessible etc.
The material sometimes is also inaccessible on account of
- Paid studies
- Lack of communication
- Non-indexing of work done
- Limited resources etc.
This gap must be shortened or bridged. The main aim of research is to look into the matter with a scientific and “rational” attitude and the conclusions and benefits must be used for the development of skills, clinical practices, repositories and growth. Research must be made simpler by hard work, intellect, scientific attitude and knowledge.
Why so much of research: What exactly we should aim at?
The purpose of research is not only to discover answers through the application of scientific procedures but also to support us. It is not merely a bunch of papers which is hard to understand but a series of observations, results and conclusions, used in a judgemental way. We cannot lead to a fruitful finding until and unless we are clear about objectives. The objectives may be:
- To gain familiarity with a phenomenon or to achieve new insights into it (Exploratory or Formulative Research).
- To portray accurately the characteristics of a particular individual, situation or a group (Descriptive Research), i.e., drug pictures, disease pictures, individualized case studies, research regarding group studies.
- To determine the frequency with which something occurs or with which it is associated with something else (Diagnostic Research), i.e. action of various remedies in specific conditions and vice versa.
- To test a hypothesis of a causal relationship between variables (Hypothesis-Testing Research), i.e. clinical trials of (new or old) drugs on conditions which did not appear in drug provings but were observed in therapeutics, for e.g. action of certain remedies on cancers.
Areas which must be explored: The clarity must prevail
- Drug standardization: Aphorism 122 quotes, “In these experiments – on which depends the exactitude of the whole medical art, and the weal of all future generations of mankind – no other medicines should be employed except such as are perfectly well known, and of whose purity, genuineness and energy we are thoroughly assured.” The aim of drug standardization is to ensure quality, genuiness, and authenticity of raw drugs and to evaluate the safety and efficacy of drugs. This aspect is of prime importance for all our future confrontations with the scientific fraternity. We must be familiar with the common questions every intellectual asks us- What does this drug contain or is made up of?
- Homoeopathic pathogenetic trials (HPTs): The drug proving or human pathogenetic trial is the core area we aim for. Drug proving techniques were elaborated by Hahnemann some 200 years ago and have been rectified and updated time to time. In recent times, the process and methodology of HPT’s has improved greatly. Recent published guidelines22, 23 on drug proving have strengthened HPT practices around the globe. The technique must be unified to yield and replicate the true symptomatology of drugs.
- Clinical research: Clinical research is one of the growing activities in Homoeopathy in the past few years. The concept of “Evidence based medicine” has evolved in conjunction with clinical research. In the past few years many clinical research papers have been published in peer reviewed journals (references cited elsewhere in article), thus supporting Homoeopathy at a global level.
- Clinical verification: To make clinical provings and research more authentic and scientific, clinical verifications are now carried at multi-centric levels. This helps us to gain finer shades of remedies in terms of ethnicities, climates, populations etc.
- Fundamental or Philosophical research: This is one of the areas of interest for historians and many clinicians. These 200 years of evolution of Homoeopathy have been in turmoil for such a vast concept. Evolution in these years is really an area of interest for many. Hahnemannian writings, case studies, his mode of living etc. are now studied with an in-depth scientific attitude to extract finer information he applied. This will help us to present our concepts in a more audacious manner.
Common types of research in Homoeopathy