Whether Homeopathy Is Valid Is a Scientific Question: A Reply to the Bell Tolls Article

This article, Whether Homeopathy Is Valid Is a Scientific Question: A Reply to the Bell Tolls Article, was written in response to another one disparaging homeopathy that was published in 2019 in the Journal of Evidence-Based Integrative Medicine. It is published here on the website of the Canadian Academy of Homeopathy as the above journal refused to publish it.

“The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge.”

Daniel J. Boorstin

A recently published article The Bell Tolls for Homeopathy: Time for Change in the Training and Practice of North American Naturopathic Physicians,[1] makes use of unscientific and long-refuted arguments: that the homeopathic principle is implausible, that the high potency remedies are absurd, and that the placebo effect alone explains the popularity and longevity of homeopathy. It also presents a range of inaccurate statements about the origin, development, and effectiveness of homeopathy, its historical place in naturopathy and its place in the world today.

The claim that homeopathy is implausible is not a scientific argument; it is no nothing more than a belief. And science is interested in facts, not beliefs.

Since homeopathy is based solely on experimentation, and not on a priori reasoning, the first duty of the true scientist in an investigation of homeopathy would be to examine, fairly and fully, its empirical evidence, which consists of a huge amount of experimental, epidemiological and clinical data accumulated over the last two hundred years.

To refuse to examine that evidence because it contradicts one’s understanding of the laws of nature is to claim that all the laws that govern our world have been discovered and fully explained. In fact, it is to reject the scientific method.

For most homeopaths, however, it is a respect for science and scientific investigation that has caused them to adopt homeopathy. That is, they have tested the efficacy of the principle of similars and of the higher potencies by submitting them to a clinical test and impartially observing the results, as it would be done in any other natural science.

In my case, I first tested the principle of similars on a patient in 1977 during the summer after my first year in chiropractic college. I was working as a contractor, and my client owned a three-year old St. Bernard dog that was suffering from advanced cherry eyes covering about two thirds of one eye and almost completely obstructing the other one. I gave the dog a few doses of Staphysagria 30C, and lo and behold, the cherry eyes, which had been growing relentlessly since the dog had been a puppy, began improving. Within a few weeks the tumefactions had regressed by more than 80% from their original size and remained so for the rest of the dog’s life. This sudden regression in a condition that can be remedied only partially and only by surgery made me continue testing the efficacy of the principle of similars with the sick, and I have yet to be disappointed by its amazing power.

After conducting similar trials, or by relying on those of reliable observers that were sufficiently conclusive in terms of their efficacy and consistency, and that could not be explained by the placebo effect, such as when the patient is unconscious or insane, or is an infant, or even an animal, a scientific investigator would be inspired to continue exploring the possibilities of the principle of similars.

I am sorry for the doubters of homeopathy who deny a phenomenon because it doesn’t fit with their worldview, for they have no idea what they are missing. It is sad and astonishing to see intelligent and learned persons deviate so far from the truth. However, I am even more sorry that handful of doubters have been able, with the help of the media, to hide the truth about homeopathy, not only from science and the public, but also from members of the alternative health care movement. The stigma imposed on homeopathy by a small group of skeptics has been damaging, to homeopathy of course, but above all to the sick.

Many refuse to experiment with homeopathy because there is no known mechanism of action. Perhaps a person who needs to be warmed by a fire should wait to use a flint until its mechanism of action has been understood! Hahnemann himself explains in his 1828 treatise, Chronic Diseases, that it is not through comprehension or belief that homeopathy should be apprehended but through experience. He further points out that homeopathy, which is not a theory, but the pure result of experimental science, has to be precisely applied in order to obtain predictable results,

“I demand no faith at all, and do not demand that anybody should comprehend it. Neither do I comprehend it; it is enough that it is a fact and nothing else. Experience alone declares it, and I believe more in experience than in my own intelligence. … But he who will not allow himself to be convinced of this, and who will not, therefore, imitate what I now teach after many years’ trial and experience (and what does the physician risk if he imitates it exactly?), he who is not willing to imitate exactly can leave this greatest problem of our art unsolved, he can also leave the most important chronic diseases uncured, as they have remained unhealed, indeed, up to the time of my teaching. I have no more to say about this. It seemed to me my duty to publish the great truths to the world that needs them, untroubled as to whether people can compel themselves to follow them exactly or not. If it is not done with exactness, let no one boast to have imitated me, nor expect a good result.

“Do we refuse to imitate any operation until the wonderful forces of nature on which the result is based are clearly brought before our eyes and made comprehensible even to a child? Would it not be silly to refuse to strike sparks from the stone and flint because we cannot comprehend how so much combined caloric [energy] can be in these bodies, or how this can be drawn out by rubbing or striking, so that the particles of steel which are rubbed off by the stroke of the hard stone are melted, and, as glowing little balls, cause the tinder to catch fire? [Iron melts at 2,800˚F or 1,500˚C] And yet we strike fire with it, without understanding or comprehending this miracle of the inexhaustible caloric hidden in the cold steel, or the possibility of calling it out with a frictional stroke. Again, it would be just as silly as if we should refuse to learn to write because we cannot comprehend how one man can communicate his thought to another through pen, ink and paper—and yet we communicate our thoughts to a friend in a letter without either being able or desirous of comprehending this psychico-physical miracle! Why, then, should we hesitate to conquer and heal the bitterest foes of the life of our fellow-men, the chronic diseases, in the stated way, which, punctually followed, is the best possible method, because we do not see how these cures are effected?”[2]

Thus the statement by the Bell Tolls authors that “[h]omeopathy was developed from Hahnemann’s principle of infinitesimal doses,” is nonsense, since the phenomenon of the increasing power of the serial dilutions with trituration and succussion is an experimental finding, and not a theory developed by Hahnemann.

If homeopathy is false, it can only be refuted by experience. In fact, many physicians who have tried to disprove homeopathy experimentally ended up adopting it when the facts proved their disbelief to be wrong.[3]

Furthermore, it is antithetical to science to reject a priori evidence that is based on careful observation and meticulous experimentation because of a lack of an explanatory mechanism of action. Newton’s law of universal gravitation, which was derived from purely empirical observations is accepted, despite not having any known mechanism of action.

The authors are again wrong in calling homeopathy  “a Westernized theoretic approach first proposed by Samuel Hahnemann.” As pointed out above, homeopathy was not developed through deductive reasoning, as the authors are suggesting, but is the result of the experimental discovery of phenomena.

Through the same process of experimentation and strict inductive reasoning that was used by Newton, Hahnemann reported having discovered not just a therapeutic principle, but a law of nature, Similia similibus curantur, and like Newton he did not state its nature, reason or mechanism, for it was sufficient just to know the law in itself.

Newton had written in the General Scholium of his Principia,

“I have not been able to discover the cause of those properties of gravity from phaenomena, and I frame no hypotheses; for whatever is not deduced from the phaenomena is to be called an hypothesis; and hypotheses, whether metaphysical or physical, whether of occult qualities or mechanical, have no place in experimental philosophy. In this philosophy, particular propositions are inferred from the phaenomena, and afterwards rendered general by induction. Thus it was that the impenetrability, the mobility, and the impulsive force of bodies, and the laws of motion and of gravitation, were discovered. And to us it is enough that gravity does really exist, and act according to the laws which we have explained, and abundantly serves to account for all the motions of the celestial bodies, and of our sea.”[4]

Similarly, the modus operandi of homeopathy is the law of similars. But, what is the modus operandi of the law of similars? The answer seems as hidden as the modus operandi of the law of gravitation.

Searching for Certainty in Medicine

Early in his career as a physician, when Hahnemann was at the bedside of his dying child, he resolved not to use the medicines and doses recommended by the medical authorities of his time because he believed they would do more harm than good. Convinced of the imperfection of orthodox medicine, disgusted with its endless contradictions, the emptiness of its theories and the dangers inherent in its heroic practice, he renounced the practice of medicine he had learned. At the same time however, he began his quest for certainty in medicine.

Some years later, in 1790, while translating Cullen’s Treatise of the Materia Medica, Hahnemann came to the following passages,

“[Peruvian bark] is in no instance, however, more remarkable than in the cure of intermittent fevers.— That the bark in this case operates by a tonic power exerted in the stomach. … I hold to be established as a fact, that both astringents and bitters, in their simple and separate state, have proved often sufficient to prevent the recurrence of the paroxysms of intermittent fevers … and while it is allowed to be a very safe and powerful, the only questions which remain respecting it are, in what circumstances it may be most properly employed?”[5]

As Hahnemann had had malaria as a medical student and had been successfully treated with Peruvian bark, and had afterward successfully treated many malaria patients with it, he agreed that Peruvian bark was effective in certain cases of malaria. However, Cullen’s explanation of its efficacy was illogical, as many substances were more bitter, astringent or tonic to the stomach, but without having any reported efficacy in malaria. Furthermore, Hahnemann, like many of his colleagues, recognized that not all cases of malaria responded favorably to Peruvian bark, but instead to other medicines that also produce symptoms commonly experienced by malaria patients.

Hahnemann decided then to test this hypothesis on himself. He wrote in a footnote of his translation of Cullen’s Treatise,

“By combining the strongest bitters and the strongest astringents we can obtain a compound which, in small doses, possesses much more of both these properties than the bark, and yet in all Eternity no fever specific can be made from such a compound. The author should have accounted for this. This undiscovered principle of the effect of the bark is probably not very easy to find. Let us consider the following: Substances which produce some kind of fever (very strong coffee, pepper, arnica, ignatia-bean, arsenic) counteract these types of intermittent fever. I took, for several days, as an experiment, four drams of good china twice daily. My feet and finger tips, etc., at first became cold; I became languid and drowsy; then my heart began to palpitate; my pulse became hard and quick; an intolerable anxiety and trembling (but without a rigor); prostration in all the limbs; then pulsation in the head, redness of the cheeks, thirst; briefly, all the symptoms usually associated with intermittent fever appeared in succession, yet without the actual rigor. To sum up: all those symptoms which to me are typical of intermittent fever, as the stupefaction of the senses, a kind of rigidity of all joints, but above all the numb, disagreeable sensation which seems to have its seat in the periosteum over all the bones of the body—
all made their appearance. This paroxysm lasted from two to three hours every time, and recurred when I repeated the dose and not otherwise. I discontinued the medicine and I was once more in good health.”[6]

This was more than just a simple coincidence for Hahnemann who here sensed that a general principle of therapeutics was at play, namely the principle of similars that had been referred to throughout the history of medicine. For instance, we can find in the Places of Man, a book in the Hippocratic Corpus, “Another principle is the following: a disease arises because of similars, and, by being treated with similars, patients recover from such diseases.”[7]

Hahnemann continued testing the principle of similars through series of meticulous experiments with other substances. The first requirement for the clinical application of this principle is to discover experimentally the power of simple medicines to create diseases in healthy persons. The proving of medicines on the healthy was not new, as it had been suggested at least 20 years earlier by the father of modern physiology, the Swiss physiologist Albrecht von Haller, who had written in the Preface to his Pharmacopoeia Helvetica, “At first, namely, the remedy has to be tried (proved) on the healthy body without any foreign admixture. After exploring its odor and taste, a very small dose of it has to be introduced, and all the affections which may belong to it have to be noted, the pulse, the head, the respiration, the excretions have to be attended to. Then, in accordance with the course of the phenomena observed in the healthy body, you may proceed to experiments in the diseased body.”[8]

The second requirement of the principle of similars is to obtain a complete description of all the subjective and objective symptoms of a sick patient. Once this is achieved, we now have two sets of facts, the first consists of all the symptoms of a sick patient; the second is a large, well-structured repertory of all the symptoms experienced by the provers for all the proved medicine. The next step in the clinical application of the principle of similars is to find out from this large repertory which medicine has the greatest similarity to the symptoms obtained from the sick patient.

During six years of proving medicines and testing the principle of similars at the bedside, Hahnemann was thus perfecting a true science of therapeutics, which has since been verified by succeeding generations of very happy and privileged physicians. As in other natural sciences, he had found a principle that defines the relationship between two sets of phenomena, and thereby provides that essential aspect of science—which is predictability. In this case, the two sets of phenomena were disease and the properties of medicines that were obtained through pure experimentation. Hahnemann had found what he had been searching for, namely, certainty in the scientific application of medicines, or the science of therapeutics.

In 1796, he published an article in Hufeland’s Journal der praktischen Arzneykunde und Wundarzneykunst (Journal of Practical Medicine and Surgery), one of the most reputable medical journals of this time: “Essay on a New Principle for Ascertaining the Curative Powers of Drugs, With a Few Glances at Those Hitherto Employed,”[9] in which he presented his experience of the application of the principle of similars in the sick: 

“I now proceed to illustrate by examples my maxim, that in order to discover the true remedial powers of a medicine for chronic diseases, we must look to the specific artificial disease it can develop in the human body, and employ it in a very similar morbid condition of the organism which it is wished to remove. The analogous maxim, that in order to cure radically certain chronic diseases, we must search for medicines that can excite a similar disease (the more similar the better) in the human body—will thereby almost become evident.”[10]

Hahnemann had not yet discovered the phenomenon of the potentizing of the medicines. However, in this essay he pointed out that large doses intoxicate while moderate doses cure, and that too frequent repetition can be counterproductive. He was thus honing on the phenomenon of true healing, which results when the vital principle restores lasting balance through its reaction to a medicine having a high degree of similarity, rather than by being temporarily subjected to the direct action of dissimilar medicines in crude doses.

In his 1826 introduction to the remedy Thuja, Hahnemann describes how he was led to discover how the dynamic power of medicines was enhanced when they were subjected to serial dilutions and triturations and succussions:

“Thus I found that even the higher dilutions, e.g. the decillion-fold [30C] or even the vigintillion fold dilution [60C] (1/xx, made with sixty diluting phials, each of 100 drops), if each diluting phial were succussed ten times and oftener (that is, with ten or more shakes of a powerful arm), was not weaker in power than the less diluted preparations, nor, on account of the enormously diminished arithmetical fraction, had it sunk to complete powerlessness, to nothing, but, on the contrary, it had rather become even more intensely charged with the medicinal virtue of Thuja. Innumerable accurate trials have so completely confirmed this (also with regard to other high fluid medicinal dilutions prepared in a similar way) that I can certify to its truth from conviction. The discovery that crude medicinal substances (dry and fluid) unfold their medicinal power ever more and more by trituration or succussion with non-medicinal things, and in greater extent the further, the longer, and the stronger this trituration or succussion is carried on, so that all their material substance seems gradually to be dissolved and resolved into pure medicinal spirit;—this discovery, unheard of till made by me, is of unspeakable value, and so undeniable, that the skeptics, who from ignorance of the inexhaustible resources of nature in the homeopathic dilutions, see nothing but mechanical division and diminution until nothing remains (therefore, annihilation of their medicinal power), must see their error as soon as they appeal to experiment.”[11]

Here lies the two-hundred year old impasse created by the skeptics of homeopathy: for Hahnemann reported experimental results, whereas skeptics  believe homeopathy to be a theory that is contrary to the laws of chemistry and physics. They have therefore been arguing the absurdity of the theory of homeopathy for over two hundred years, while homeopathy was appealing to experiments and clinical trials.

In an 1825 article, “Nota Bene for my Reviewers,” Hahnemann made that point very clear: “Homeopathy appeals, not only chiefly, but solely to the verdict of 
experience—‘repeat the experiments,’ it cries aloud, ‘repeat them 
carefully and accurately, and you will find the doctrine confirmed at 
every step’—and it does what no medical doctrine, no system of
 physic, no so-called therapeutics ever did or could do, it insists upon 
being ‘judged by the result.’ ”[12]

Despite that challenge by Hahnemann and the absolute requirement of science, the Bell Tolls authors continue to reject the scientific method by approaching homeopathy from an intellectual point of view: “Despite its intellectual absurdities, on one hand, homeopathy—a biologically inert placebo dressed up as a biomedicine.”

The Paradoxical Nature of the Law of Similars and the Potentization of Medicines

Admittedly the phenomena of the law of similars and the potentization of medicines are counterintuitive. It just doesn’t make sense that a substance that causes diarrhea can also be used to cure diarrhea. In fact, common sense suggests that it should make diarrhea worse. Yet, experiments show that what causes diarrhea can, in fact, cure diarrhea; like does cure like whether we believe it or not; and hence, what may a priori appear absurd, may in fact turn out a posteriori to be true. And this is again not a matter of belief, but of experience. Similarly, the phenomenon of drug dynamization was found through pure experimentation.

It is easy to lose sight of the fact that beliefs have nothing to do with the truth. Truth is the truth whether we believe it or not. The discoveries of Hahnemann are the results of pure experimentation that can be tested by anyone who follows his method precisely. As he said, “How insignificant and ridiculous is mere theoretical skepticism in opposition to this unerring, infallible experimental proof!”[13] Yet the skeptics continue to choose belief over experience.

The authors have also followed the path of other skeptics of homeopathy by cherry picking from the literature and relying on false assumptions, distortion of historical facts, misleading hyperboles, discredited evidence and ad hominem arguments.

Cherry-picking from the Literature

The authors refer to an article written by a skeptic in 1846 who argued that “homeopathy is too puerile” to occupy the attention of learned persons and to be “almost of waste of time to endeavour seriously to refute so many absurdities,”[14] to support their point that “By the mid-1800s, the accumulated evidence demonstrated that homeopathy was no better than placebo.”

If the authors had any desire for objectivity they should at least have examined a book published the same year as their quoted reference, 1846, and closer to home (in Montreal), but a much more substantial, broad, weighty and factual source of references because it examined some of the evidence so far accumulated against and for homeopathy. It is called The Comparative Merits of Allœopathy, the Old Medical Practice; and Homœopathy, the Reformed Medical Practice; Practically Illustrated.[15]

The authors write, “There are no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo,” and they quote as reference the 2015 Australian Government National Health and Medical Research Council (NHMRC) report on homeopathy,[16] which is immersed in so much controversy that one would expect them to have avoided it.[17] How could anyone with a scientific mind quote and defend the non-transparent Australian report that was rewritten to reach the desired conclusion, as explained by the Homeopathy Research Institute?

“The NHMRC did the homeopathy review twice, producing two reports, one in July 2012 and the one released to the public in March 2015. The existence of the first report has never been disclosed to the public—it was only discovered through Freedom of Information (FOI) requests.

“NHMRC say they rejected the first report because it was poor quality despite it being undertaken by a reputable scientist and author of NHMRC’s own guidelines on how to conduct evidence reviews.

“FOI requests have revealed that a member of NHMRC’s expert committee overseeing the review process, Professor Fred Mendelsohn, confirmed the first review to be high quality saying: ‘I am impressed by the rigor, thoroughness and systematic approach given to this evaluation [….] Overall, a lot of excellent work has gone into this review and the results are presented in a systematic, unbiased and convincing manner.’

“NHMRC said the results of the second report published in 2015 were based on a ‘rigorous assessment of over 1800 studies.’ In fact, the results were based on only 176 studies.

“NHMRC used a method that has never been used in any other review,[18] before or since. NHMRC decided that for trials to be ‘reliable’ they had to have at least 150 participants and reach an unusually high threshold for quality. This is despite the fact that NHMRC itself routinely conducts studies with less than 150 participants.[19]

“These unprecedented and arbitrary rules meant the results of 171 of the trials were completely disregarded as being ‘unreliable’ leaving only 5 trials NHMRC considered to be ‘reliable.’[20] As they assessed all 5 of these trials as negative, this explains how NHMRC could conclude that there was no ‘reliable’ evidence.

“Professor Peter Brooks, Chair of the NHMRC committee that conducted the 2015 review, signed a conflict of interest form, declaring he was not ‘affiliated or associated with any organisation whose interests are either aligned with or opposed to homeopathy,’ despite being a member of anti-homeopathy lobby group ‘Friends of Science in Medicine.’

“NHMRC’s guidelines state that such committees must include experts on the topic being reviewed, yet there was not one homeopathy expert on this committee.”[21]

The authors again lose credibility by not citing a much more transparent and thorough study, conducted by the Swiss government, which resulted in homeopathy acquiring the same status as conventional medicine for purposes of public health insurance in Switzerland. The report is called Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety, Costs.[22]

Another unreliable reference used by the authors is from The Lancet, “More than a decade has passed since the editorial board of The Lancet announced the ‘end of homeopathy’ (2005)—that is, the end of any notion that it has benefit beyond the placebo.” Citing The Lancet editorial[23] that accompanied Shang’s meta-analysis[24] shows poor judgment and again lack of objectivity because this meta-analysis has since been widely discredited.[25],[26],[27],[28],[29],[30],[31],[32],[33],[34]

Historical Inaccuracies

The Bell Tolls authors stated, “Indeed, ND students may be surprised to learn that Hahnemann dismissed the existence of vis medicatrix naturae in his writings,” and use as a reference an old skeptic treatise.[35] This is an example of poor scholarship, for Hahnemann was the champion of the vital force, or the vis medicatrix naturae. This old accusation against Hahnemann by his enemies has been refuted time and time again by many of his numerous biographers. Here, I will simply refer to two chapters, “Hahnemann’s Attitude to the Healing Powers of Nature (Vis medicatrix naturae) to Pathology and to Diagnosis,” and “Hahnemann’s Statements on the Powers of Nature (Vis medicatrix naturae) from the Publication of the Organon Onwards,”both in the second volume of Richard Haehl’s Samuel Hahnemann: His Life and Work,[36] as well as to the chapter “Hahnemann Denies the Healing Power of Nature,” in Wilhelm Ameke’s History of Homoeopathy, Its Origin, Its Conflicts, with an Appendix on the Present State of University Medicine,[37] and finally to chapter 40, “Hahnemann and the Vis medicatrix naturae,”in Thomas Lindsley Bradford’s Life and Letters of Dr. Samuel Hahnemann.[38]

The repetition of long refuted arguments against homeopathy and its founder shows an unacceptable ignorance on the part of the authors.

The authors add insult to injury with another erroneous statement: “Moreover, [Hahnemann] maintained that no cure had ever occurred but through homeopathy; thus as stated in the 1800s, he disparaged Tollo Causa [sic] (His words were Tolle Causam) and those who sought the root environmental sources of illness.”

That is nonsense, for Hahnemann was interested in all the causes of disease and put great emphasis on lifestyle and environment with his patients.[39] After he had begun his investigation of the principle of similars, he wrote a two-volume book, The Friend of Health, in which he talks about the prevention of disease, lifestyle, diet, exercise, sleep, etc.[40] F.E. Bilz, the well-known German pioneer of nature cure, wrote in his book, The Natural Method of Healing,  “Hahnemann was the first to recognize the importance of diet. Like the Natural Healers of the present day [1898], he laid great stress on nourishment, air, light, exercise, rest, cleanliness, etc. In his writings he discusses fully the use of baths and their duration and temperature, and recognizes the beneficial effect of friction or rubbing the whole body to promote reaction.[41]

To learn Hahnemann’s point of view on the causes of diseases, one need read no further than the third paragraph of his Organon: “If in each case [the physician] knows the obstacles to cure and how to remove them, so that recovery is permanent, then he knows to treat thoroughly and efficaciously, and is a true physician”; or the footnote to paragraph 7, in which he states, “It is obvious that every physician will first of all remove the causa occasionalis; after that the indisposition usually disappears on its own.”[42]

Another Refuted Argument—Placebo Effect Explanation

Like most skeptics, the authors of the Bell Tolls charge that the therapeutic value of homeopathy is due to case taking and the placebo effect, but without offering any proof.

Furthermore, they fail to explain how case taking can be the main therapeutic agent of homeopathy, when no case is taken during epidemics when the genius epidemicus is distributed to an entire population, or when people who had no encounter with the homeopath or a therapeutic environment or are treated without their knowledge, as in the case of animals, babies, or insane or unconscious patients. For instance, Dr. Jean-Pierre Gallarvardin reported having treated 1,471 drunkards through their wives and having cured half of them when their vice was not hereditary, and this without having any contact with the patients or any of them knowing that they were being treated.[43] How could case taking cure patients suffering from acute or chronic intractable diseases, in whom any improvement would be most unlikely, such a patients in the last stage of AIDS or meningitis,[44] or with stage IV cancer?

For almost two hundred years, homeopathy has been used, without case taking  in surgical patients, injured persons and wounded soldiers during wars to deal with shock, diminish hemorrhages and pain, prevent and mitigate infection and speed up recovery time. Remedies are given to surgical patients before, during and after surgery, and unconscious soldiers on the battlefield. For instance, Dr. Len Torok, an orthopedic surgeon who conducted in 2001 a study at Wadsworth Rittman Hospital in Wadsworth, Ohio, demonstrated a significant reduction in blood loss during total knee replacement surgery when Arnica montana 30C or 200C was given to unconscious patients who had not given a homeopathic case history before their surgery. The average blood loss in the control group was 650 cc with a range of 300 cc to 900 cc, which is the expected average blood loss for this type of surgery. However, in the experimental group, the average blood loss was 170 cc, with a range of 50 cc to 530 cc, or a 74% decrease in blood loss. The hospital statistician concluded after seventeen patients that the reduction in blood loss had already reached a level of statistical significance that gave the green light to the surgeons of the Wadsworth Rittman Hospital to use potencies of Arnica montana in surgery because it was safe and efficacious. His research also found that the patients had less pain, less swelling, quicker rehabilitation, shorter hospital stays, less need for narcotics, and subsequently less nausea and vomiting and urinary retention associated with the use of narcotics.[45],[46]

The Myth of the Powerful Placebo Effect

Skeptic Joe Schwarcz wrote a few weeks before a public debate on homeopathy that was held at McGill University in November 2012,[47] “Homeopathic remedies work through the placebo effect. That of course is not negligible. Placebos can have success rates of over 30 per cent!”[48] And some weeks after the debate, he wrote, “The placebo response occurs consistently in 30-40% of cases likely due to expectation of relief by the patient.”[49]

First, this argument is unscientific, as it is based solely on a belief. Second, it is also unscientific to maintain that “the placebo response occurs consistently in 30-40% of cases” with the current state of knowledge on the placebo effect. Third, even if the placebo response occurred consistently 30-40% of the time, it still couldn’t explain the extraordinary success reported by homeopathy in epidemic diseases, such as increasing the odds of surviving community-acquired pneumonia from 3 to 1 under pre-antibiotic allopathy and 6 to 1 under current conventional care to 239 to 1 under genuine Hahnemannian homeopathy.[50]

Schwarcz’s belief about the placebo response, which is used to explain the popularity of homeopathy, comes from Dr. Henry K. Beecher’s 1955 study The Powerful Placebo, which remains the most cited publication on the placebo effect. Beecher, who was a distinguished medical researcher from the Harvard Medical School, reported that in 15 randomly chosen studies (7 of his own and 8 from others) involving 1,082 patients, placebos were “found to have an average significant effectiveness of 35.2 ± 2.2%, a degree not widely recognized.”[51] This means that 35% of the patients, and more particularly the ones suffering from pain,[52] reacted satisfactorily to a placebo.

However, Beecher didn’t define what he meant by “significant effectiveness,” although in one of his larger studies the maximum average relief from severe post-operative wound pain was only 53%.[53] In homeopathy, we couldn’t be satisfied with even 60% relief of the severity of post-operative pain. We would  quickly look for a better remedy, which would typically be followed by relief of at least 90%.

It is interesting to note that researchers on the placebo effect have since not been able to confirm Beecher’s finding. In fact, the Cochrane Collaboration published a review in 2010 on the placebo effect for all clinical conditions that concluded, “We did not find that placebo interventions have important clinical effects in general for all clinical conditions.”[54]

Misinformation about the Memory-of-Water Issue

Because the importance of an explanation for the effectiveness of the high potencies looms so large for the Bell Tolls authors, they devote considerable space to the memory-of-water issue. They make the following claim: “The notion that water has a ‘memory’ or enduring imprint derived from the original substance (and through the dilutions and succussion, a robust shaking at each point of dilution) has been disproven.”

Again, this is simply untrue, for London South Bank University Professor Emeritus Martin Chaplin, who has “developed an evidence-based two-state structural model of water,” reports “an episode [that] reflects badly on the, otherwise respected, journal Nature,” on his website (which was last updated  on January 7, 2019, and which is said to be “the world’s leading resource for the science of water, ice and aqueous systems”):

“He [Jacques Benveniste] reported that when white blood cells with a certain substance on their surfaces are exposed to a certain antibody, they release histamine in a manner that can be visibly monitored using a microscope. This work generated a controversial but ‘in good faith’ paper reviewed and published by Nature,[55] after referees could find no flaws with the experimental procedure and they had held up publication for two years while awaiting independent confirmation from impartial laboratories in Israel, Italy, and Canada. These research teams reported that even if the amount of that antibody was subjected to sequential physical processing and was apparently diluted many billions of times, until there was essentially none left, it still had an observable biological effect different from those apparent using just the water employed for the dilutions (the ‘memory of water’).[56] The subject has drawn much controversy with many ‘scientists’ simply rejecting it outright without studying the evidence. Also, it has not been more generally accepted after the results were reported by Nature, as not reproducible by Nature‘s self-acknowledged biased observers (the Editor of Nature, a magician (!) and a malpractice investigator, none of whom had any relevant scientific experience),[57] and under oppressive, overly-demanding (with over twice the normal weekly load of tests) and unsympathetic, conditions, in a limited and rushed 5-day trial (of 5 years and 5 laboratories work) using poorly responsive basophils, and with negative results from only the one laboratory being cherry-picked from amongst otherwise positive results.[58] The original results[59] were, however, confirmed in a blinded study by the statistician Alfred Spira[60] and also in a rather bizarre Nature paper purporting to prove the opposite.[61] They were subsequently comprehensively confirmed by a blinded multi-center trial,[62],[63],[64] and new results confirm similar phenomena.[65],[66] In spite of this apparent confirmation by these several laboratories, there are still doubts (expressed by some) over whether the experiments are truly reproducible and whether the noted effects may be due to the origin of the biological samples or human operator effects.[67],[68],[69],[70] Further support for an effect has been found using NMR.[71],[72],[73][74]

Misleading Hyperboles

The phenomenon of potentization enables the skeptics to point to the supposed “absurdities” of homeopathy by using misleading hyperboles, such as this one from the Bell Tolls authors, “Even if the mass of the entire Earth was composed of water, it would still not be enough to dilute the original particle in a 30C homeopathic preparation.”

In reality, less than 150 ml of water is necessary to prepare a 30C potency, as 99 drops of water are needed for each potency, and 99 times 30 equals 2,970 drops, or 148.5 ml, which is less than a glass of water.

Ad hominem Argument

By now the authors of the Bell Tolls seem to be grasping at straws as they look for a way to impugn the character of Hahnemann by insinuating that he exploited his patients in order to make a buck. Their source is a vague biographical reference which they seize upon to imply that homeopathy continued to be practiced because it remained a “commercially lucrative” practice.[75]

Who Hahnemann was as a scientist and physician and his ethical values can be better assessed by reading Hahnemann’s own writings and the numerous (no fewer than twenty) biographies of him. Specifically, regarding the collection of fees, I will refer the Bell Tolls authors to a scholarly paper specifically related to this subject by one of Hahnemann’s most recent biographers.[76] In Hahnemann’s day physicians did not collect fees, because they considered it degrading to do so and irreconcilable with their professional honor; instead, they had a third party send reminders to patients. Hahnemann, however, charged his patients directly at the time of his service. This was an innovation for his time, and as another of his biographers reported, “We all know… that Hahnemann had a kind and compassionate heart, and that he often treated the poor and indigent without any charge.”[77]

Hahnemann’s fees were relatively high and more than his allopathic colleagues charged, “arguing that their treatment brought little benefit, while he delivered a masterpiece.”[78] He used a sliding scale according to the patients’ means, whereby the rich would pay for the poor, and encouraged his students to do the same.

A Fringe Medicine? Ignorance of Homeopathy around the World
The authors of the Bell Tolls state that homeopathy “represents a fringe form of alternative medicine.”

What world do they live in? Apparently they don’t realize that it is the second-most-used complementary and alternative health care in Europe, with rates of use that vary from 2% to 29% of the population depending on the country.[79],[80],[81] This is certainly not a trivial number of people, considering that the European population is over 741 million.

In 2007, it was reported that in India, where homeopathy is part of the national medical system, the market is growing at 25% a year, and that more than 100 million people depend solely on this form of therapy for their health care.[82] Homeopathy is included in the national health care systems of a number of other countries, including Brazil, Chile, Mexico, Pakistan and Switzerland. In June 2017, the Government of India announced the founding of 25 new homeopathic medical schools. Dr. Anil Khurana, , Deputy Director General of the Central Council for Research in Homoeopathy for India, told me in November 2018 that all twenty-five programs had opened their doors two months earlier. He said that the 225,000 homeopathic physicians in practice and the 12,000 new ones joining the profession every year were not able to satisfy the demand for homeopathy by the Indian population.

Can  homeopathy be called a fringe form of alternative medicine when worldwide sales of homeopathic products were estimated at 3.1 billion dollars in 2017?[83] And let’s remember that the average cost of a multi-dose homeopathic remedy that can serve a family for generations is about ten dollars.

Homeopathy in Naturopathic Medicine—Factual Errors

The authors of the Bell Tolls make a number of misleading statements about the place of homeopathy in the history of naturopathic medicine. The first two most egregious that I will take the time to discuss are these: “Interestingly, homeopathy was not always a part of naturopathic medicine in North America;” and “Much has changed since homeopathy was introduced into naturopathic education and training in the 1970s.”

The fact, seemingly unknown to the authors, is that the roots of homeopathy go far back into the history of nature cure, naturopathy or naturopathic medicine.

Before the advent of the nature cure movement and naturopathy, many physicians combined homeopathy with other modalities that are now considered an intrinsic part of naturopathic medicine. For instance, the founder of homeopathy, Samuel Hahnemann, practiced lifestyle medicine, hydrotherapy, manual therapy, psychotherapy, magnetotherapy and electrotherapy.

In the early 1850s, American physicians published The American Magazine Devoted to Homoeopathy and Hydropathy, and containing also popular articles on anatomy, physiology, hygiene, movement cure, dietetics and health keeping. The motto on the title page of this magazine is from Hahnemann and is very à propos: “Ignorance is disgraceful only when willful.”[84]

In his 1862 domestic physician, Dr. George E. Allshorn combined homeopathy, hydrotherapy, electrotherapy and diet,[85] a practice which is very similar to that of three generations of famous naturopathic physicians who practiced for over a century in Spokane, Washington, namely Drs. O.G. Carroll, Bill Carroll, Harold Dick, Leo Scott and Letitia Dick.[86],[87]

Dr. Stanley Wilde’s 1884 book, Sleeplessness; Its Treatment by Homoeopathy, Hydropathy, and Other Accessory Means,recommended a similar type of practice, which aside from hydrotherapy and homeopathy, included lifestyle medicine (diet, exercise, relaxation, sun, etc.) and manual medicine.[88]

At the same time, many of the better-known nature cure doctors who preceded Benedict Lust by many decades were also practicing homeopaths. Among them were two of the most influential German pioneers of nature cure, Dr. Arnold Rikli (1823-1906) and Dr. Emanuel Felke (1856-1926).

We can read in Kirchfeld and Boyle’s Nature Doctors: Pioneers in Naturopathic Medicine, “It was not just the perfection of the earth cure that distinguished Felke from the other great European nature doctors, but also that he didn’t limit himself to the classic nature cure of water, light, air, and diet. Like Lust and Lindlahr in America, he used electricity, massage, gymnastics, magnetism, hypnotism, herbal teas and homeopathic remedies.” [89]

Dr. Heinrich Lahmann (1860-1905), another pioneer of nature cure, who was known as the First Scientific Nature Doctor and was often cited by Dr. John Bastyr, had as a goal to create a bridge between homeopathy and nature cure.[90]

Dr. Carl Schultz (1849-1935), known as the Benedict Lust of the West and the Father of Naturopathy in California, was one of the most influential pioneers of naturopathic medicine in America. He had studied orthodox medicine, homeopathy and nature cure in Germany before establishing himself in California in 1885, when Dr. Benedict Lust was still a child. In 1901, Dr. Schultz organized the Association of Naturopathic Physicians of California and began a school, the Naturopathic College of California, from which “nearly every naturopath in California and many in Oregon and Washington” graduated.[91]

We now come to Dr. Benedict Lust (1872-1945), who came to be known as the Father of Naturopathy. In Nature Doctors, Kirchfeld and Boyle wrote, “[Sebastian Kneipp’s] method was originally known as Nature Cure. Transplanted to the United States almost a century ago by his disciple Benedict Lust, who added homeopathy and manipulative therapy, it soon became “naturopathy” and evolved to the naturopathic medicine we know today.”[92]

The name “naturopathy”[93] is said to have been bought by Dr. Benedict Lust from Drs. John and Sophie Scheel, who had been using this term to define their joint practice, he being a water curist and she a homeopath and Lust’s preceptor when Lust was studying at the New York Homoeopathic Medical College from which he graduated with a medical degree.[94]

Another false statement made by the authors of the Bell Tolls regarding the place of homeopathy in the history of naturopathic medicine is, “… Benedict Lust, who founded North American naturopathic medicine—and held the presidency of the American Naturopathic Association from the early 1900s until he died in 1945—avoided the word [i.e., homeopathy] in his books, magazines (Nature’s Path), and official journal of the organization (Herald of Health and Naturopath) [sic].”

That statement is simply wrong, for the 1908 volume of The Naturopath and the Herald of Health contains a favorable article on homeopathy by Rudolf Weil called “Homeopathy and its Relation to Naturopathy.” In it, Weil wrote,

“Among all existing methods of healing, Homeopathy occupies a foremost position. The really learned doctor should know everything that will assist him in restoring the diseased body to health. He can render his patient the greatest assistance by the individual and combined application of all therapeutic methods and means. … The adherents to nature cure are quite opposed to the use of medicine … No one will deny that nature contains herbs and substances that have great healing powers. Why ought not the physician employ these means in the proper cases? Only fanatics firmly devoted to some principle can hold such views. … Homeopathic treatment is entirely in harmony with the water, light and air cure. … It shall not be denied that water, light, heat, diet, etc., alone are capable of curing, but after long experience I believe that Homeopathy combined with the natural healing agents will produce the best and speediest results.”[95]

In one number of the 1915 volume of The Naturopath and the Herald of Health, we can find another positive article on homeopathy by Dr. William Freeman Havard, “The Science of Cure: A Positive Method for the Radical Cure of Disease.”[96] Three years later, in 1918, Lust would hire Havard, a convinced homeopath, as the editor of The Naturopath and the Herald of Health.[97]

In 1925, in the first volume of the Nature’s Path, Lust wrote a favorable article on Hahnemann and homeopathy, in which he said,

“The pilot does not cross the ocean. It is his duty, merely to lead big ship out of the port to the lanes of the great ocean waters.

Samuel Hahnemann may well be known as one of the pilots of the field of Naturopathy. He showed the way to pass from the port of orthodox medicine to the point of homeopathy, a point of unorthodox healing.

Inspired through his radical departure from the policies of the old school of medicine, the new healers had the courage to announce a system of healing in which medicine is altogether abandoned.

“Hahnemann represents one of the first steps on the great stairway to Natural Healing and medical freedom. He is the seed from which have sprung the great philosophies and practice of the pioneers of Natural Healing.”[98]

In a series of articles published in the 1926-1927 volume of The Naturopath, Lust described his “Trip to the Fatherland,” which included visits to the famous birthplaces of nature cure doctors; in one of the articles he wrote, “I told them of the Naturopathic movement now, as it includes all methods of healing that are rational and sane, such as Chiropractic, Osteopathy, the Physical Culture Movement and also the Christian Science Movement, as well as the old Nature Cure, Eclecticism and Homeopathy.”[99]

Edward Earle Purinton, who favored the drugless practice of naturopathy, asked in a 1915 issue of The Naturopath and the Herald of Health, “What is Nature Cure?”[100] Havard, who specialized in homeopathy, answered in the following issue of the periodical: “The employment of every method which is in accord with the natural physiological action of the body in order to bring the complete elimination of disease,”[101] and that is exactly what Dr. Bastyr taught.

The genius of naturopathic medicine consists in the art of combining the synergetic power of different modalities and restorative approaches to enhance and accelerate the healing process and the recovery of health. This is exactly what Hahnemann had in mind when he described in the last paragraph of the Organon the use of hydrotherapy to hasten the recovery of patients with both acute and chronic diseases while being treated with homeopathy.[102]

Naturopathic physicians, like Dr. Bastyr, who are well versed in many therapeutic disciplines of naturopathic medicine, such as hydrotherapy, electrotherapy, manual medicine and botanical medicine, find that homeopathy plays the central role in their practice due to the universality of its application and the vast and profound therapeutic potential in patients with both acute and chronic conditions. This is particularly true for patients with any type of infectious conditions, even the most severe ones.

Homeopathy in Pneumonia Cases

In fact, it has been known for over 150 years that homeopathy offers by far the safest and best results ever obtained by any medical system for patients with community-acquired pneumonia (CAP) and would therefore receive the highest possible recommendation over any other intervention for these patients (1A/strong recommendation with high-quality evidence, applying the evidence-based medicine approach).[103] When combined with other approaches, the results can even be better.

Here are the results obtained by five different approaches, namely homeotherapeutics (i.e., the application of the law of similars in any way),[104],[105],[106],[107],[108],[109],[110],[111],[112] genuine Hahnemannian homeopathy,[113]hydrotherapy,[114] expectancy (limited to only good nursing care and therefore without any “active” treatment),[115],[116] pre-antibiotic allopathy[117],[118],[119],[120],[121],[122],[123],[124],[125],[126],[127],[128],[129],[130] and current conventional care:[131]

  TreatmentNumber of patients with CAPNumber of patients  curedSurvival rate (%)Number of deathsMortality rate (%)
Homeotherapeutics 25,216 24,350 96.6 866 3.4
Genuine Hahnemannian homeopathy  960  956 99.6  4 0.4
Hydrotherapy  568  559 98.4  9 1.6
Pre-antibiotic allopathy148,345112,272 75.736,073 24.3
Expectancy 379 29978.8 80 21.1
Current conventional care 33,148 28,607 86.3 4,541 13.7

The treatment effect of genuine Hahnemannian homeopathy is obviously enormous, with the odds of surviving CAP under its care being 239 to 1, compared to only 6 to 1 under current conventional care.

These numbers also imply that about 32 out of every 1,000 patients with CAP were saved by expectancy or killed by pre-antibiotic allopathy; out of 1,000 cases with CAP, 74 more patients are saved by current conventional care  than under expectancy. However, 177 more patients out of every 1,000 patients with CAP are saved under homeotherapeutics, 195 more are saved under hydrotherapy, and 207 more are saved under genuine Hahnemannian homeopathy.

Incidentally, those favorable results cannot be explained by the 30-40% placebo response referred to by Schwarcz. Nor can they be explained by the homeopathic case taking believed by the Bell Tolls authors to be so powerful, because in some of the results reported under homeotherapeutics a homeopathic case history had not been taken.

The Trial of Homeopathy at the Sainte Marguerite Hospital in Paris

That was the situation between 1847 and 1849 at the Sainte Marguerite Hospital in Paris, where the chief of staff, Dr. Jean-Paul Tessier, conducted an experiment in which he treated with homeopathy all cases with pneumonia that were admitted to his ward without triage. (Those included moribund patients.)

He described every case in detail, including age, sex, constitution, evolution of symptoms, severity of the condition (i.e., one or more lobes affected), complications and circumstances, concomitant conditions (e.g., tuberculosis), remedies and dosage used, course and duration of the disease, and post-mortem examination, but no homeopathic case history.

Dr. Tessier, who was considered “one of the distinguished practitioners of medicine in Paris,”[132] and “known as an allopathic practitioner of most respectable attainments, to say the least of him,”[133] wrote, “I have chosen 
pneumonia [and cholera over other diseases to test homeopathy] on account of its dangerous character, on which 
there is but one opinion amongst the profession.”[134]

He presented himself “neither as a partisan nor opponent of homeopathy but as a scientist guarding himself against the misguiding bias of blind passion,” and that he would “endeavor to strictly adhere to the legitimate demands of a scientific inquiry.”[135]

Dr. Tessier reported three deaths out of a series of 41 cases with pneumonia, of which many were seriously ill patients—that is a 7% mortality rate.[136] Even though the mortality rate in his patients was much higher than the average   rate reported under homeotherapeutics (3.4%), it was much superior to the average obtained under pre-antibiotic allopathy (24.3%) or expectancy (21.1%). Furthermore, Tessier didn’t individualize his treatment, which is fundamental to genuine Hahnemannian homeopathy, but treated his patients routinely and, with few exceptions, with the same three remedies in the same sequence, namely, Aconite, Bryonia and Phosphorus, and without taking a homeopathic case history.

In the conclusion of his experiment, Dr. Tessier asked, “What do the facts which I have related, show?,” to which he answered, “The Hahnemannian treatment of pneumonia seems to
 exercise a most happy influence over the symptoms, course and duration of this disease. Hence I affirm that this mode of treatment should be 
made a subject of scientific analysis and observation.”[137]

However, in naturopathic medicine we could do better by simply combining hydrotherapy and Hahnemannian homeopathy, and even manipulative therapy and electrotherapy, and not only should mortality in all pneumonia patients be close to zero, but the speed of the recovery should also be remarkably accelerated.

An estimated 1.2 million children under the age of five die every year worldwide from pneumonia—more than from AIDS, malaria and tuberculosis combined.[138] In developed countries, mortality from pneumonia in children remains relatively low,  but the World Health Organization estimates that in developing countries, 1 in 3 children die from acute respiratory tract infections or related respiratory ailments.[139]

In view of the impact pneumonia has on human population and the efficacy of homeopathy with other naturopathic means, naturopathic physicians should make it their duty to teach the art of combining these means to the rest of the world.

Other Key Leaders and Pioneers of Naturopathic Medicine Espousing Homeopathy

In order to complete this short review of the part that homeopathy played in the early years of naturopathic medical practice, I will look at the practice of some other key leaders of naturopathic medicine. While Drs. Lust and Schultz were leading the naturopathic movement on the east and west coasts, respectively, Dr. Henry Lindlahr (1862-1924), known as the Founder of Scientific Naturopathy, was its leader in the Midwest. The longest chapter in his 1913 classic book Nature Cure,[140] Philosophy and Practice Based on the Unity of Disease and Cure was on homeopathy.[141]

In a 1910 issue of The Naturopath and the Herald of Health is an article by Dr. Henry Lindlahr on Hahnemann’s psora. In one section of this article, “Homeopathy, A Branch of Nature Cure,” Lindlahr describes in detail the case of a psoric patient whom the famous Dr. Henry Edward Lane, the author of Diagnosis From the Eye, had successfully treated with nature cure. However, as the patient had failed to develop a skin eruption that Lane had predicted was necessary for the completion of the cure, Dr. Lindlahr prescribed one dose of Psorinum CM to Lane’s patient.

“Nine days later he broke out on arms and body with the typical itch eruptions. At the same time he developed a violent intestinal crisis as severe colic and diarrhea. … The treatment during the crisis [which lasted fourteen days] consisted of fasting and the usual cold water treatment, no medicine of any kind being given.” Six months later the patient was given a second dose of Psorinum CM. This time the patient developed pronounced catarrhal expectoration and acne that lasted three weeks. Both crises left the patient “much improved in general health.”

Lindlahr concluded,

“This remarkable case is instructive in many respects. It proves the correctness of the diagnosis from the eye; the efficiency of natural diet and Nature Cure treatments; the truths of Hahnemann’s theory of psora, and the law of Similia similibus curantur. This is only one of many cases which can be cited as positive proof of the laws and principles laid down and demonstrated in these pages.

“After reading this history of a psora case our friend Homeopath will be tempted to say, ‘Why bother with Nature Cure? After all, the Homeopathic remedy had to do the work.’

“No, brother Homeopath, ‘Psorinum’ alone did not do the work. It merely gave the final push and pull to the psora-encumbered cells which aroused them into acute activity. Nature Cure first had to purify and sensitize the organism before the Homeopathic potency could act. We always use the similia together with other natural methods of cure, …

“True, Nature Cure means the harmonious combination of all natural healing factors in accordance with the fundamental laws of Cure and with the individual characteristics of the case. To treat serious chronic ailments with one ‘pathy’ or one method when many others are at our service is too much like pulling a heavy load with one horse when others are idle in the stable.”[142]

Dr. Arno R. Koegler (1898-1991), known as Canada’s International Ambassador for Naturopathy, was the most prominent pioneer of naturopathic medicine in that country. He had come to Canada from Germany in 1923 and was active in obtaining legislation for naturopathy in Ontario in 1925. It is said that he trained the founding members of the Board of the Ontario College of Naturopathic Medicine (OCNM).[143] In fact, OCNM was founded in 1978 by Drs. Robert B. Farquharson, John G. LaPlante, Gordon Smith, Gregory Asa Hershoff, William Morris and Eric Shrubb.[144] All six practiced homeopathy, but the first four used mainly homeopathy with their patients.

Dr. Koegler’s specialties were the combination of iris diagnosis with homeopathy. This should not be a surprise, for after suffering from the effects of a train accident in Germany that threatened his life, he was eventually treated by the famous nature doctor, Emanuel Felke, who restored him “to full health, and this experience led him to become the healer that he was.”[145] Dr. Felke, as mentioned earlier, was a pioneer nature doctor who practiced homeopathy while being also a master in iris diagnosis. Incidentally, the originator of iris diagnosis, Dr. Ignatz von Peczely (1826-1911), was a Hungarian homeopathic physician.[146]

While he was acting president of the International Society of Naturopathic Physicians (ISNP) from 1956 to 1972, Dr. Koegler also held the presidency of the ISNP International Council on Homeopathy and considered that his main task was to encourage his fellow naturopathic physicians to practice homeopathy. He wrote a series of articles, “Homeopathy for the Naturopathic Physicians,” in the Journal of Naturopathic Medicine.[147] In the February 1952 number of this journal, he wrote, “I wonder how many doctors have really tested homeopathic remedies on their patients. If you are one who never has, then I suggest that you do. In spite of much information to the contrary, homeopathic therapeutics has stood the test of time. Did you know that Pneumonia was cured nearly 100% 150 years ago with homeopathy. It would be a simple matter to list disease after disease, which were considered incurable by the allopaths which were successfully handled by the homeopath.”[148]

In a 1979 letter to a fellow homeopath, he explained why he had never found the time to write books: “For 40 years they asked me to write some textbooks, but when you work 16 hours a day there is not much time left. In fact when I started I was on a twenty-four hour call all year round. In the days when M.D.s lost 29% of their pneumonia cases, I never lost one, so I was called on most of these cases.”[149]

Another pioneer of naturopathic medicine in the west, Dr. Alan R. Hedges of Medford, Oregon, who was President of the American Naturopathic Physicians and Surgeons Association, also specialized in homeopathy. After his death, his large library containing the classic texts and journals of the homeopathic literature were given to NCNM. When I was a student at NCNM in the early 1980s, I felt privileged, like many of my fellow students, to have access to Dr. Hedges’ rich library containing the classic works of the homeopathic and naturopathic literature.

Finally, we come to Dr. John Bastyr, also known as the Father of Modern Naturopathic Medicine. Before I left Canada to study at NCNM, I was told by Dr. Leo Roy of Toronto, an ND and MD who had worked with Renée Caisse (famous for the Issiac herbal formula), to make sure to study with Dr. John Bastyr, as he was probably the greatest doctor in our profession.

The first lecture we had from Dr. Bastyr, who was then president emeritus of NCNM, and  was on endocrinology. About three-quarters of the therapeutics he spoke about during this four-hour lecture was homeopathy. Over the next five years, I regularly shadowed Dr. Bastyr in his office on Thursdays and would pick him up early the next morning at his homestead in Kent, Washington, to drive him to the NCNM campus in Portland, where he would lecture to all four classes on those Fridays from 9 a.m. until 4 p.m. Rare were the patients in his practice to whom he didn’t prescribed a homeopathic remedy, even the ones who came for manipulation; and rare were his lectures in which he didn’t talk about homeopathy.

Dr. Bastryr kept reminding us never to forget that we were fifth in a direct line from Hahnemann, as he had learned homeopathy in private Sunday morning lessons from Dr. C. P. Bryant, who was then the Head Surgeon at Grace Hospital, where Dr. Bastyr did his internship. Dr. Bryant, who had been president of the International Hahnemannian Association, had studied homeopathy under Dr. Walter James, who was one of Dr. Adolph Lippe’s main students, and with whom he had practiced for over 20 years. Dr. Lippe had studied homeopathy under Drs. Constantine Hering and William Wesselhoeft, all three of whom were contemporaries of Hahnemann.

Kirchfeld and Boyle wrote in Nature Doctors,

“Bastyr’s conversion to homeopathy was an important move for the modern naturopathic profession. Homeopathy had been part of naturopathic medicine for decades, but its role had been more or less peripheral. The majority of practitioners had not received such intensive, classical instruction as Bastyr. In the 1950s, when Bastyr became involved in establishing and teaching a naturopathic curriculum, his balanced emphasis of homeopathy as a therapeutic modality coequal with nutrition, hydrotherapy and botanical medicine assured its place in the ongoing development of naturopathic science. That’s one of the reasons that naturopathic physicians are in the forefront of the current homeopathic revival in this country.”[150]

The Future of Homeopathy in Naturopathic Medicine

Hippocrates and Hahnemann followed a general principle of medicine that is the very foundation of naturopathic medicine, which essentially is to pay attention to the laws of nature and be guided by them, and that would include the principle of similars.

Remove homeopathy from naturopathic medicine and you remove its very soul and guiding principles: the body’s ability to heal itself (through the vital force or vis medicatrix naturae), the importance of the genius epidemicus, of cure versus palliation and of addressing the primary cause of disease, the removal of the causa occasionalis and obstructions to cure, the use of medicines for the prevention of infectious and other diseases, disease as primarily a dynamic phenomenon, the long-term effects of shocks, infections, intoxication, etc., the danger of suppression of symptoms, the totality of the symptoms, the direction of cure, the return of old symptoms, the healing crisis, the wise combination of modalities to enhance and accelerate the healing process, the treatment of the whole person rather than of symptoms or diseases, the everlasting call of aude sapere, and, not least, the therapeutic ideal of a recovery of health that is gentle, pleasant, certain, rapid, efficacious, complete and lasting.

Since World War II, the American osteopathic profession has been progressively assimilated into the practice of conventional medicine, with only a small minority of its practitioners espousing the philosophy and practice of its founder and early pioneers. That will also be the fate of the naturopathic medical profession, if it abandons homeopathy.

Conclusion

As a medical science based on pure experimentation and observation, homeopathy can be proved or disproved only by repeating the experiments of its founder, i.e. by the scientific method. But the Bell Tolls authors do not cite any evidence from such an investigation nor do they even recognize the need to do so.

By not keeping up with 20th and 21st century science and repeating long refuted arguments, skeptics confuse the debate and mislead the public and the health care professions about the true value of homeopathy.

Instead they present a collection of patently incorrect statements about the origin of homeopathy, its place in the historical development of naturopathic medicine, the extent of the placebo effect, the character of Hahnemann, and the extent to which homeopathy is practiced around the world in the 21st century. In their use of sources they have resorted to cherry picking, citing discredited studies and reports while ignoring those that do not agree with their preconceptions. Moreover, they subscribe to the unscientific belief that a phenomenon does not exist if its mechanism cannot be explained; and finally they ignore the vast body of definitive experimental, epidemiological, and clinical evidence of the truth of the homeopathic principle and the efficacy of the high potencies because those phenomena are implausible and therefore must be untrue and not worthy of their attention. In short, they have rejected scientific investigation and the scientific method.

Naturopathic physicians should be championing homeopathy, not undermining it. Naturopathic medical colleges should offer a uniform and complete training in homeopathy, as well as postgraduate programs for those who want to make a specialty of it. The work of Hahnemann and the great Hahnemannians would provide the necessary base for learning the art and science of homeopathy. Research chairs and programs should be encouraged to apply the highest level of scholarship to this most beneficent healing art.

Acknowledgments

The author is thankful to Peter Gold for his comments, Dr. Lisa Samet for her comments and corrections, Dr. Sussanna Cseranko for providing valuable sources of information about the pioneers of naturopathic medicine, and Freya Godard for her thorough and professional revision of the manuscript.


[1] David H. Nelson, Jaclyn M. Perchaluk, Alan C. Logan, Martin A. Katzman. The bell tolls for homeopathy: Time for change in the training and practice of North American naturopathic physicians. Journal of Evidence-Based Integrative Medicine 2019; 24: 1-11.

[2] Samuel Hahnemann. The Chronic Diseases, Their Peculiar Nature and Their Homœopathic Cure. Translated by Louis Tafel. Philadelphia: Boericke and Tafel, 1904: 212-213.

[3] Benjamin Franklin Joslin. Evidences of the Power of Small Doses and Attenuated Medicines, Including a Theory of Potentization. In The Principles of Homœopathy. In a Series of Lectures. New York: William Rade, 1850.

[4] Isaac Newton. General Scholium. In Newton’s Principia: the Mathematical Principles of Natural Philosophy. Translated by Andrew Motte. To which is added, Newton’s system of the world with a life of the author by N.W. Chittenden. New York: Geo. P. Putnam, 1850: 506-507.

[5] William Cullen. A Treatise of the Materia Medica. Volume II. Edinburgh, 1789: 60-61.

[6] Samuel Hahnemann. William Cullen’s Abhandlung über die Materia medica nach der nunmehr von dem Verfasser selbst ausgearbeiteten Originalausgabe, übersetzt und Anmerkungen von Samuel Hahnemann, der Arzneikunde Doktor. Zweiter Band, Leipzig: Schickertscher Verlag, 1790: 108-109. Translated into English by Mary L. Wheeler. In Richard Haehl Samuel Hahnemann: His Life and Work. Volume I. London: Homoeopathic Publishing Company, 1922: 36-37.

[7] Hippocrates. The Places of Man. Edited and translated by Paul Potter. Volume VIII. Loeb Classical Library. Cambridge: Harvard University Press. 1995; Aphorism 42: 83-85.

[8] C. G. Raue. The discovery of the law Similia similibus curantur. Medical Institute of Philadelphia 1886; 1: 51-55.

[9] Samuel Hahnemann. Versuch über ein neues Prinzip zur Aussendung der Heilkräfte der Arzneisubstanzen, nebst einigen Blicken auf die bisherigen. Journal der praktischen Arzneykunde und Wundarzneykunst 1796; 2: 391-439. (Essay on a New Principle for Ascertaining the Curative Powers of Drugs, With a Few Glances at Those Hitherto Employed. In The Lesser Writings of Samuel Hahnemann. Translated by Robert E. Dudgeon. New York: William Rade, 1852: 249-303.)

[10] Samuel Hahnemann. Essay on a new principle for ascertaining the curative powers of drugs, with a few glances at those hitherto employed. In The Lesser Writings of Samuel Hahnemann. Translated by Robert E. Dudgeon. New York: William Rade, 1852: 267.

[11] Samuel Hahnemann. Materia Medica Pura. Translated from the latest German editions by R. E. Dudgeon. With annotations by Richard Hughes. Volume 2. Philadelphia: Boericke and Tafel, 1880-1881: 650-651.

[12] Samuel Hahnemann. Nota Bene for My Reviewers.InMateria Medica Pura. Translated by R. E. Dudgeon. Vol. 2. Liverpool and London: The Hahnemann Publishing House, 1880: 2.

[13] Samuel Hahnemann. Organon of Medicine. Translated from the fifth edition, with an appendix by R. E. Dudgeon. London: E. Gould and Son, 1893; paragraph 281: 191.

[14] O.B. Bellingham. Observations on homœopathy. Dublin Medical Press 1846; 15: 83-88.

[15] J.G. Rosenstein. The Comparative Merits of Allœopathy, the Old Medical Practice; and Homœopathy, the Reformed Medical Practice; Practically Illustrated. Montreal: Rollo Campbell, 1846.

[16] National Health and Medical Research Council Report on Homeopathy. https://nhmrc.gov.au/about-us/publications/homeopathy Accessed January 23, 2019.

[17] The Australian Report. https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy/. Accessed January 23, 2019.

[18] Australian Report FAQs. https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy/australian-report-faqs/. Accessed January 23, 2019.

[19] Ibid.

[20] Ibid.

[21] The Australian Report. https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy/. Accessed January 23, 2019.

[22] Peter F. Matthiessen, Gudrun Bornhöft. Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety, Costs. 2012. http://www.homeovet.cl/Libros/Homeopathy%20in%20Healthcare%20Effectiveness,%20Appropriateness,%20Safety,%20Costs.pdf. Accessed January 23, 2019.

[23] Editorial. The end of homoeopathy. The Lancet 2005; 366 (9487): 690.

[24] Aijing Shang et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. The Lancet 2005; 366 (9487): 726-732.

[25] Peter Fisher et al. Are the clinical effects of homoeopathy placebo effects? The Lancet 2005; 366 (9503): 2082-2083.

[26] Klaus Linde, Wayne Jonas. Are the clinical effects of homoeopathy placebo effects? The Lancet 2005; 366 (9503): 2081-2082.

[27] Iris R. Bell. All evidence is equal, but some evidence is more equal than others: can logic prevail over emotion in the homeopathy debate? Journal of Alternative & Complementary Medicine 2005; 11 (5): 763-769.

[28] David Peters. Shang et al. carelessness, collusion, or conspiracy? Journal of Alternative & Complementary Medicine 2005; 11 (5): 779-780.

[29] Michael Frass et al. Bias in the trial and reporting of trials of homeopathy: A fundamental breakdown in peer review and standards? Journal of Alternative & Complementary Medicine 2005; 11 (5): 780-782.

[30] Helmut Kiene, Gunver S. Kienle, Tido von Schön-Angerer. Failure to exclude false negative bias: a fundamental flaw in the trial of Shang et al. Journal of Alternative & Complementary Medicine 2005; 11 (5): 783.

[31] The Lancet paper by Shang et al. https://www.hri-research.org/resources/homeopathy-the-debate/the-lancet-paper-by-shang-et-al/. Accessed February 1, 2019.

[32] David Reilly. Sir? Is that bias? Journal of Alternative & Complementary Medicine 2005; 11 (5): 785.

[33] Peter Fisher. Homeopathy and The Lancet. Evidence-Based Complementary and Alternative Medicine 2006; 3 (1): 145-147.

[34] Kim A. Jobst. Homeopathy, Hahnemann, and The Lancet 250 years on: a case of the emperor’s new clothes? Journal of Alternative & Complementary Medicine 2005; 11 (5): 751-754.

[35] James Y. Simpson. Homoeopathy: Its Tenets and Tendencies, Theoretical, Theological, and Therapeutical. Edinburgh: Sutherland and Knox, 1853.

[36] Richard Haehl Samuel Hahnemann: His Life and Work. Volume II—Supplements. Translated into English by Mary L. Wheeler. London: Homoeopathic Publishing Company, 1922: 403-406.

[37] Wilhelm Ameke. History of Homoeopathy, Its Origin, Its Conflicts, with an Appendix on the Present State of University Medicine. Translated by Alfred E. Drysdale; edited by R. E. Dudgeon. London: Gould, 1885: 296-300.

[38] Thomas Lindsley Bradford. The Life and Letters of Dr. Samuel Hahnemann. Philadelphia: Boericke and Tafel, 1895: 204-210.

[39] Hahnemann as a Hygienist and Dietetist. In Richard Haehl Samuel Hahnemann: His Life and Work. Volume II—Supplements. Translated into English by Mary L. Wheeler. London: Homoeopathic Publishing Company, 1922: 51-76.

[40] Samuel Hahnemann. The Friend of Health. In The Lesser Writings of Samuel Hahnemann. Translated by Robert E. Dudgeon. New York: William Rade, 1852: 155-242.

[41] F. E. Bilz. The Natural Method of Healing. A New and Complete Guide to Health. New York: The International News Company, 1898: 643.

[42] Samuel Hahnemann. Organon of Medicine. The first integral English translation of the definitive sixth edition of the Organon by Jost Künzli, M.D., Alain Naudé, and Peter Pendleton. Los Angeles: J. P. Tarcher, 1982; pararagraph 3: 10; footnote to paragraph 7: 13.

[43] Jean-Pierre Gallavardin. The Homoeopathic Treatment of Alcoholism. Translated from the French by Irenaeus D. Foulon. Philadelphia: Hahnemann Publishing House, 1890.

[44] André Saine, Steven Novella. Homeopathy: Great Medicine or Dangerous Pseudoscience? Part I. https://homeopathy.ca/homeopathy-great-medicine-or-dangerous-pseudoscience/. Accessed February 4, 2019.

[45] Leonard J. Torok. Knee Pain! Do you need homeopathy or surgery? Insights from an orthopedic surgeon-homeopath. Homeopathy Today 2006; 26 (4): Homeopathy Today Online July/August 2006 https://www.homeopathycenter.org/homeopathy-today/julyaugust-2006/knee-pain-do-you-need-homeopathy-or-surgery. Accessed on January 23, 2019.

[46] Irene Sebastian. A critique of Ernst’s critique and request for replication of an Arnica study. American Journal of Homeopathic Medicine 2012; 105 (4): 150-152.

[47] Homeopathy: Mere Placebo or Great Medicine? Debate between André Saine and Joe Schwarcz. http://youtu.be/T2uBBU4XT7Y. Accessed on February 3, 2019.

[48] Joe Schwarcz. Homeopathic Remedies Safe—But Not Risk Free. Montreal Gazette, November 5, 2012.

[49] Follow-Up to debate between Andre Saine and Joe Schwarcz: Is homeopathy a placebo effect or is it effective medicine? https://www.mcgill.ca/oss/files/oss/homeopathy_qa_schwarcz.pdf. Accessed February 2, 2019.

[50] André Saine. The American school of homeopathy and the International Hahnemannian Association: The high point of homeopathy. PART III—Liga News 2016; No. 17 (April): 17-23. (https://old.homeopathy.ca/articles_det44.shtml). Accessed February 6, 2019)

[51] Henry K. Beecher. The powerful placebo. Journal of the American Medical Association 1955; 159: 1602-1606.

[52] Of the fifteen studies analyzed by Beecher, five were related to severe post-operative wound pain, three to pain from angina pectoris, one to headache, one to cough, one to experimental cough (only one patient in this study), one to drug-induced mood changes, one to seasickness, one to anxiety and tension, and one to the common cold.

[53] L. Lasagna, F. Masteller, J.M. von Felsinger, H.K. Beecher. A study of the placebo response. American Journal of Medicine 1954; 16: 770-779.

[54] Asbjørn Hróbjartsson, Peter C. Gøtzsche. Placebo interventions for all clinical conditions. Cochrane Database of Systematic Reviews 2010; 1.

[55] E. Davenas, F. Beauvais, J. Amara, M. Oberbaum, B. Robinzon, A. Miadonna, A. Tedeschi, B. Pomeranz, P. Fortner, P. Belon, J. Sainte-Laudy, P. Poltevin and J. Benveniste. Human basophil degranulation triggered by very dilute antiserum against IgE. Nature 1998; 333: 816-818.

[56] Y. Thomas, L. Kahhak and J. l Aissa. The physical nature of the biological signal, a puzzling phenomenon: The critical contribution of Jacques Benveniste. Water and the Cell. Edited by G. H. Pollack, I. L. Cameron and D. N. Wheatley. Springer, Dordrecht, 2006: 325-340. (A related phenomenon may be the occurrence of conductivity oscillations (≈ 0.5 Hz) at similar concentrations of salts at the low concentration limit of obedience to Kohlrauch’s law (Onsager’s formula) Λm = Λmo – αc½, where Λmo is the limiting molar conductivity, α is a constant and c is the molar concentration. (S-Y. Lo, W. Li. Onsager’s formula, conductivity, and possible new phase transition. Modern Physics Letters 1999: B 13: 885-893.)

[57] Although the Editor of Nature, (Maddox) initially stated that the investigation into the data would be by “independent investigators” it was heavily biased including and led by Maddox himself, who had already stated that he did not believe the data, “There is no physical basis for such an activity” and “A journal really has to have an opinion.” The magician that Maddox chose to help his ‘investigation’ was James Randi (“The Amazing Randi”), well-known for his skeptical views concerning complementary medicine in which he later made his living having retired from “magic.” The third investigator was Walter Stewart, a zealot dedicated to uncovering scientific fraud. It was Stewart who found MIT biologist Thereza Imanishi-Kari guilty on 19 charges of research misconduct, only for all these charges to be overturned eight years later by an appeals panel of the U.S. Department of Health and Human Services (D. Kevles. The Baltimore Case: A Trial of Science, Politics, and Character. New York: W. W. Norton & Co., 1998). Stewart was later described as evil by Kevles as determined to find and prove scientific fraud at any cost as a vindication of his own belief that fraud is rampant in the scientific community. Maddox had an exaggerated zealotry for disproving the data, and so was certainly not independent. Maddox stated, “None of us has first-hand experience in the field of work at INSERM 200.” Maybe, he did not wish to risk whether a truly independent review by knowledgeable experts would come up with the result he required.

[58] J. Maddox, J. Randi and W. W. Stewart. “High dilution” experiments a delusion. Nature 1988; 334: 287-290.

[59] E. Davenas, F. Beauvais, J. Amara, M. Oberbaum, B. Robinzon, A. MiE. Davenas, F. Beauvais, J. Amara, M. Oberbaum, B. Robinzon, A. Miadonna, A. Tedeschi, B. Pomeranz, P. Fortner, P. Belon, J. Sainte-Laudy, P. Poltevin and J. Benveniste. Human basophil degranulation triggered by very dilute antiserum against IgE. Nature 1998; 333: 816-818.

[60] A. Spira, recounted in Heretic 1, Jacques Benveniste BBC2 program 15 July 1994.

[61] S. J. Hirst, N. A. Hayes, J. Burridge, F. L. Pearce and J. C. Foreman. Human basophil degranulation is not triggered by very dilute antiserum against human IgE. Nature 1993; 366: 525-527. (This paper was bizarre because the data it produced showed a positive effect (therefore actually supporting the “memory of water” conclusions). The authors dismissed these positive conclusions out of hand as “a source of error for which we cannot account,” so leaving the remaining data (that is, only the data which agreed with their headline disproof). It should be noted that the statistical report upon which this paper was based states that “One interpretation is that there are, after all, differences between the treatments …” 322) (J. Burridge. A repeat of the ‘Benveniste’ experiment: Statistical analysis. Research Report 1992; 100, Department of Statistical Science, University College London, England.) but this statement does not survive into the final version published by the journal Nature. The authors have refused to release their raw data (J. Benveniste, B. Ducot, A. Spira. Memory of water revisited. Nature 1994; 370 for unbiased statistical analysis. Nature, also recently published a paper on “ultrafast memory loss” in water that, perhaps ingenuously, appears to misinterpret this “memory of water” concept, as it only concerns the “memory” of single water molecules, not clusters or larger amounts of water molecules (M. L. Cowan, B. D. Bruner, N. Huse, J. R. Dwyer, B. Chugh, E. T. J. Nibbering, T. Elsaesser, R. J. D. Miller. Ultrafast memory loss and energy redistribution in the hydrogen bond network of liquid H2O. Nature 2005; 434: 199-202). Overall the episode reflects badly on the, otherwise respected, journal Nature).

[62] P. Belon, J. Cumps, M. Ennis, P. F. Mannaioni, J. Sainte-Laudy, M. Roberfroid, F. A. C. Wiegant. Inhibition of human basophil degranulation by successive histamine dilutions: Results of a European multi-centre trial. Inflammation Research 1999; 48 Suppl. 1: S17-S18.

[63] P. Belon, J. Cumps, M. Ennis, P. F. Mannaioni, M. Robertfroid, J. Sainte-Laudy, F. A. C. Wiegant. Histamine dilutions modulate basophil activation. Inflammation Research 2004; 53: 181-188.

[64] J. Sainte-Laudy, P. Belon, Use of four different flow cytometric protocols for the analysis of human basophil activation. Application to the study of the biological activity of high dilutions of histamine. Inflammation Research 2006; 55 Suppl. 1: S23-S24.

[65] S. Chirumbolo M. Brizz,i R. Ortolani, A. Vella, P. Bellavite. Inhibition of CD203c membrane up-regulation in human basophils by high dilutions of histamine: a controlled replication study. Inflammation Research 2009; 58: 755-764.

[66] Y. Almirantis, K. Tsitinidis. Ultra-high dilutions and homeopathy: can they be explained without non-local theory? Homeopathy 2018; 107: 189-195.

[67] B. Poitevin. The continuing mystery of the Memory of Water. Homeopathy 2008; 97: 39-54.

[68] Y. Thomas. The history of the memory of water. Homeopathy 2997; 96: 151-157.

[69] F. Beauvais. Memory of water and blinding. Homeopathy 2008; 97: 41-42

[70] F. Beauvais. ‘‘Memory of Water’’ without water: The logic of disputed experiments. Axiomathes 2014; 24: 275-290.

[71] J.-L. Demangeat. NMR water proton relaxation in unheated and heated ultrahigh aqueous dilutions of 
histamine: Evidence for an air-dependent supramolecular organization of water. Journal of Molecular Liquids 2009; 144: 32-39.

[72] J.-L. Demangeat. NMR relaxation evidence for solute-induced nanosized superstructures in ultramolecular aqueous dilutions of silica–lactose. Journal of Molecular Liquids 2010; 155: 71-79.

[73] J.-L. Demangeat. Gas nanobubbles and aqueous nanostructures: the crucial role of dynamization. Homeopathy 2015; 104: 101-115.

[74] Martin Chaplin. Memory of water. In Water Structure and Science http://www1.lsbu.ac.uk/water/memory_of_water.html#r346. Accessed January 29, 2019.

[75] They fail to explain why patients would choose to go to doctors that charge an exorbitant fee.

[76] Robert Jütte. And [the money] accumulates, without annoyance on the part of the patient, in the doctor’s purse’: Samuel Hahnemann and the question of fees. In Martin Dinges’ Patients in the History of Homoeopathy. European Association for the History of Medicine and Health Publications, 2002: 33-51

[77] Lev Evgenʹevich Brasol. Samuel Hahnemann: A Sketch of His Life and Career. London: Adlard & Son, 1896: 52.

[78] Michael Stolberg. The experience of illness and the doctor-patient relationship in Samuel Hahnemann’s correspondence. In Martin Dinges’ Patients in the History of Homoeopathy. European Association for the History of Medicine and Health Publications, 2002: 75.

[79] Commission of the European Communities. Homeopathic Medical Products. Commission Report to the European Parliament and Council on the Application of Directives 92/73′ and 92/74′

[80] Susan Eardley et al. A systematic literature review of complementary and alternative medicine prevalence in EU. Complementary Medicine Research 2012; 19 (Suppl. 2): 18-28.

[81] Laura M. Kemppainen et al. Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. Scandinavian Journal of Public Health 2018; 46 (4): 448-455.

[82] Raekha Prasad. Homoeopathy booming in India. The Lancet 2007; 370 (9600): 1679-1680.

[83] Homeopathic Products Market 2018: Global Trends, Market Share, Industry Size, Growth, Opportunities, Forecast to 2025 http://www.digitaljournal.com/pr/3848438. Accessed on January 24, 2019.

[84] American Magazine Devoted to Homoeopathy and Hydropathy 1851; 1: title page.

[85] George Edward Allshorn. A Handy Book of Domestic Homoeopathic Practice, or, Hints How to Use a Few of the Principal Medicines in the Absence of Professional Advice: and Directions as to Diet and Regimen, with Short Dissertations on Hydropathy and Galvanism. London: Houlston and Wright, 1862.

[86] Wade Boyle, André Saine. Lectures in Naturopathic Hydrotherapy. Buckeye Naturopathic Press, 1988.

[87] Letitia Dick. The Ultimate Text In Constitutional Hydrotherapy. A 100 Years Tradition of Clinical Practice. Lulu.com, 2012.

[88] F. G. Stanley Wilde. Sleeplessness; Its Treatment by Homoeopathy, Hydropathy, and Other Accessory Means. London, Homoeopathic Pub. Co., 1884.

[89] Friedhelm Kirchfeld, Wade Boyle. Nature Doctors: Pioneers in Naturopathic Medicine. Medicina Biologica, 1994: 139.

[90] Friedhelm Kirchfeld, Wade Boyle. Nature Doctors: Pioneers in Naturopathic Medicine. Medicina Biologica, 1994: 143, 147-148.

[91] Ibid, 212.

[92] Ibid, 73.

[93] Incidentally, the use of the term “naturopathy” was not original to the Scheels. A physician by the name of Jacob W. Crosby practiced “Naturepathy” in Boston from at least 1866 and until at least 1878 (The Boston Directory. Boston, Sampson & Murdock Company, 1866: 118 and The Boston Almanac and Business Director 1878; 43: 363). In 1878 there was a Dr. Sidney J. Darrin that advertised in Rochester, N.Y. “Cures without medicines. Dr. Darrin, naturæpathic physician for the safe, sure and natural treatment of diseases, weaknesses and infirmities, without the uses of poisonous drugs and painful surgery” (The Rochester Directory 1873; 24: 522). In 1886, Dr. A. Berlitz was treating patients with nature cure at his “Naturopathic Institute for Chronic diseases” in Philadelphia and was as well the publisher of a magazine, The Naturopath (Polk’s Medical Register and Directory of the United States and Canada. Detroit: R.L. Polk Publishers.1886: 810).

[94] Friedhelm Kirchfeld, Wade Boyle. Nature Doctors: Pioneers in Naturopathic Medicine. Medicina Biologica, 1994: 189-190, 200.

[95] Rudolf Weil. Homeopathy and its relation to naturopathy. The Naturopath and the Herald of Health 1908; 9 (10): 292-299.

[96] William Freeman Havard. The science of cure: a positive method for the radical cure of disease. The Naturopath and the Herald of Health 1915; 20 (10): 600-604.

[97] Personal communication with Dr. Sussanna Czeranko, editor of the twelve volume Hevert Collection series on the early twentieth history of naturopathic medicine.

[98] Benedict Lust. The homeopathic treatment. Nature’s Path 1925; 1 (6): 268-270.

[99] Benedict Lust. Our Trip to my Fatherland. The Naturopath 1927; 32: 171-172.

[100] Edward Earle Purinton. Efficiency in drugless healing, standardizating the nature cure. The Naturopath and the Herald of Health 1915; 20 (3): 141-147.

[101] William Freeman Harvard. An answer to Mr. Purinton’s article in March Naturopath. The Naturopath and the Herald of Health 1915; 20 (4): 211-215.

[102] Samuel Hahnemann. Organon of Medicine. The first integral English translation of the definitive sixth edition of the Organon by Jost Künzli, M.D., Alain Naudé, and Peter Pendleton. Los Angeles: J. P. Tarcher, 1982; paragraph 291: 213-214.

[103] Gordon H. Guyatt et al. Rating quality of evidence and strength of recommendations: Going from evidence to recommendations. British Medical Journal 2008; 336 (7652): 1049-1051.

[104] André Saine. The Weight of Evidence. The Extraordinary Success of Homeopathy in Times of Epidemics. In preparation, see here: https://homeopathy.ca/publications_det02.shtml

[105] Henri de Bonneval. Considérations sur l’homœopathie. Bordeaux: Imprimerie Adrien Bousin, 1881, 19-22.

[106] Christopher Osmond Bodman. Pneumonia in children; illustrated by fifty consecutive cases treated at the New Orphan Houses, Bristol, without mortality. Journal of the British Homoeopathic Society 1910; 18: 213-244.

[107] Willis A. Dewey. Editorials. Pneumonia and its treatment. Medical Century 1912; 19: 250-253.

[108] R. del Mas. Thirty cases of pneumonia. Homoeopathician 1914; 4: 53-54.

[109] G. Harlan Wells. A study of the comparative value of the homeopathic treatment and other methods of treatment in lobar pneumonia. Journal of the American Institute of Homeopathy 1922-1923; 15: 541-550.

[110] E. Rodney Fiske. A survey of the statistics of the homeopathic treatment of lobar pneumonia. Journal of the American Institute of Homeopathy 1928; 21: 886-993

[111] Alfred Pulford, Dayton Pulford. Homoeopathic Leaders in Pneumonia. Published by the authors: Dayton, Ohio, 1928, 5.

[112] D. M. Foubister. Homœopathy in the treatment of pneumonia and acute bronchitis. British Homœopathic Journal 1956; 45: 65-71.

[113] André Saine. The American school of homeopathy and the International Hahnemannian Association: The high point of homeopathy. PART III—Liga News 2016; No. 17 (April): 17-23. (https://homeopathy.ca/articles_det44.shtml. Accessed February 6, 2019)

[114] Simon Baruch. The Principles and Practice of Hydrotherapy. New York: William Wood Company, 1908.

[115] Jules Le Beuf. Étude critique sur l’expectation. Paris: Adrien Delahaye, 1870, 22, 33, 37.

[116] André Saine. Expectancy in Pneumonia Patients. In André Saine, Steven Novella. Homeopathy: Great Medicine or Dangerous Pseudoscience? Part IV. https://homeopathy.ca/debates_2013-03-22Q1-4ns.shtml. Accessed February 6, 2019.

[117] Charles Henry Routh. On the Fallacies of Homœopathy, and the Imperfect Statistical Inquiries on Which the Results of That Practice Are Estimated. London: I. K. Lewis, 1852.

[118] Willis A. Dewey. Editorials. Pneumonia and its treatment. Medical Century 1912; 19: 250-253.

[119] Henri de Bonneval. Considérations sur l’homoeopathie. Bordeaux: Imprimerie Adrien Bousin, 1881: 19-22.

[120] Krüger-Hansen. Ueber das Heilverfahren bei Pneumonien. Medicinischer Argos 1842; 4: 341-361.

[121] J. Greenwood, R. H. Candy. The fatality of fractures of the lower extremity and of lobar pneumonia of hospital mortality rates, 1751-1901. Journal of the Royal Statistical Society 1911; 74: 363-405.

[122] William Osler. The mortality of pneumonia. University Medical Magazine 1888; 1: 77-82.

[123] Samuel Henry Dickson. Essay on Pneumonia. In Studies in Pathology and Therapeutics. New York: William Hood & Co., 1867.

[124] O. Sturges, S. Coupland. The Natural History and Relations of Pneumonia. 2nd edition. London: Smith, Elder & Co., 1890.

[125] William Osler. The Principles and Practice of Medicine. 8th ed. New York and London: D. Appleton and Company, 1912.

[126] J. P. Barber. Pneumonia in children. Homoeopathic Journal of Pediatrics 1907; 2: 24-26.

[127] L. Emmett Holt. The Diseases of Infancy and Childhood. 5th edition. New York: D. Appleton and Company, 1909: 556, 577.

[128] Russell L. Cecil, Horace S. Baldwin, Nils P. Larsen. Lobar pneumonia: A clinical and bacteriological study of two thousands typed cases. Archives of Internal Medicine 1927; 40: 253-280.

[129] In the statistics of the London Hospital, cases of broncho-pneumonia have been excluded, which tend to have a higher mortality rate particularly in young children. Osler said, “Primary acute broncho-pneumonia, like lobar form, attacks children in good health, usually under two years. … The death rate in children under five has been variously estimated at from 30 to 50 per cent.” (William Osler. The Principles and Practice of Medicine. New York: D. Appleton and Company, 1912, 102, 106.)

[130] L. Emmett Holt. The Diseases of Infancy and Childhood. New York: D. Appleton and Company, 1909: 556, 577.

[131] M. J. Fine et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA 1996; 275: 134-141.

[132] Charles J. Hempel. Preface. In Clinical Remarks Concerning the Homoeopathic Treatment of Pneumonia: Preceded by a Retrospective View of the Alloeopathic Materia Medica, and an Explanation of the Homoeopathic Law of Cure. By Jean-Paul Tessier, M. D., Physician to the Hospital Sainte-Marguerite in Paris. Translated by Charles J. Hempel, M. D. New York: William Radde, 1855: iii.

[133] William Henderson. Homoeopathy Fairly Represented: A Reply to Professor Simpson’s “Homoeopathy” Misrepresented. Philadelphia: Lindsay & Blakiston, 1854, 68.

[134] Jean-Paul Tessier. Pneumonia—Does pneumonia get well of itself, without treatment? British Journal of Homoeopathy 1860; 18: 364-366, 369-370. Translated from the French: La pneumonie: Guérit-elle spontanément et sans traitement? Art Médical 1859; 10: 31-38.

[135] Jean-Paul Tessier. Clinical Remarks Concerning the Homoeopathic Treatment of Pneumonia: Preceded by a Retrospective View of the Alloeopathic Materia Medica, and an Explanation of the Homoeopathic Law of Cure. Translated by Charles J. Hempel, M. D. New York: William Radde, 1855.

[136] Jean-Paul Tessier. Recherches cliniques sur le traitement de la pneumonie et du choléra suivant la méthode de Hahnemann. Précédées d’une introduction sur l’abus de la statistique en médecine. Paris: J.-P. Ballières, 1850.

[137] Ibid, 131.

[138] Pneumonia. WHO April 2013: Fact sheet N°331.

[139] M. Gareene, C. Ronsmans, H. Campbell. The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries. World Health Statistics Quarterly 1992; 45 (2-3): 180-191.

[140] Incidentally, Lindlahr and many other leaders of the nature cure movement could not use the term “naturopathy,” as Lust had copyrighted it. (Friedhelm Kirchfeld, Wade Boyle. Nature Doctors: Pioneers in Naturopathic Medicine. Medicina Biologica, 1994: 190.)

[141] Henry Lindlahr. Philosophy and Practice Based on the Unity of Disease and Cure. Chicago: The Nature Cure Company, 1913.

[142] Henry Lindlahr. Diagnosis from the iris of the eyes, itch or psora spots. The Naturopath and the Herald of Health 1910; 15 (8): 449-454.

[143] The Ontario College of Naturopathic Medicine has since changed its name to the Canadian College of Naturopathic Medicine, the alma mater of three of the Bell Tolls authors.

[144] Canadian College of Naturopathic Medicine.

https://en.wikipedia.org/wiki/Canadian_College_of_Naturopathic_Medicine. Accessed January 23, 2019.

[145] Friedhelm Kirchfeld, Wade Boyle. Nature Doctors: Pioneers in Naturopathic Medicine. Medicina Biologica, 1994: 289.

[146] Ibid, 66, 131-132.

[147] Ibid, 291.

[148] Arno Koegler. Comments on the merits of homeopathic therapeutics. Journal of Naturopathic Medicine 1952; 3 (2): 6-8.

[149] Friedhelm Kirchfeld, Wade Boyle. Nature Doctors: Pioneers in Naturopathic Medicine. Medicina Biologica, 1994: 293.

[150] Ibid, 303-304.

Picture of André Saine, N.D., F.C.A.H.

André Saine, N.D., F.C.A.H.

André Saine is a 1982 graduate of the National College of Naturopathic Medicine in Portland, Oregon. He is board-certified in homeopathy (1988) by the Homeopathic Academy of Naturopathic Physicians and has been teaching and lecturing on homeopathy since 1985. He is considered one of the world’s foremost experts on the subject of homeopathy.