eCAM 2005;2(4)441–452

doi:10.1093/ecam/neh141

Lecture Series

Immunology and Homeopathy. 1. Historical Background

Paolo Bellavite1, Anita Conforti2, Valeria Piasere1 and Riccardo Ortolani3
1
Department of Scienze Morfologico-Biomediche, 2Department of Medicina e Sanità Pubblica and
3
Association for Integrative Medicine ‘Giovanni Scolaro’, University of Verona, Piazza L.A. Scuro,
37134 Verona, Italy

Homeopathy was born as an experimental discipline, as can be seen from the enormous amount of
homeopathic data collected over more than two centuries. However, the medical tradition of homeo-
pathy has been separated from that of conventional science for a long time. Conventional scientific wis-
dom dictates that homeopathy should have no effect above placebo but experiments on ultra-high
dilutions of solutes together with some clinical data suggest the intriguing possibility that it might do
in some circumstances. Today, an osmotic process between disciplines, previously seen as in conflict,
is facilitated because over the last few decades homeopathy has initiated the methods of current medical
science and a substantial number of experimental studies—at molecular, cellular and clinical levels—are
available. One area of dialogue and of common progress is that of inflammation and immunity, probably
because these are closely related to the traditional ‘vital force’ of the body’s self-healing power. In a
series of papers we review the historical origins of homeopathy, the laboratory and animal models
related to the field of immunopharmacology, the clinical evidence in favor and against the use of homeo-
pathy in the inflammatory diseases and the hypotheses regarding its action mechanism(s). Finally, we
will enlighten the specific characteristics of the homeopathic approach, which places great emphasis
on identifying a cure for the whole organism.

Keywords: Hahnemann – Hippocrates – history of medicine – homeopathy – immunotherapy –

isotherapy – nosodes – Paracelsus – similia principle

The majority of substances have more than one action; system, low doses of the same substance can cure these symp-
the first is a direct action, which gradually changes into the toms under certain circumstances (‘similia similibus curen-
second, which I call its indirect secondary action. The tur’). About 200 years have passed since the original
second is generally the opposite of the first C.F.S. Hahnemann, interpretation of the principle of similarity. During this period,
1796 medicine evolved as never before and homeopathic theories
and pharmacopoeias have also been scientifically investigated,
albeit slowly with considerable delay in comparison with those
Introduction
of conventional medicine. However, the fundamental nucleus
The main principle of homeopathy, a unique scientific system of homeopathy has been little discussed. Similarity is fre-
of medicine established by Samuel Hahnemann two centuries quently considered unscientific because the statements of
ago, is that of ‘similia’ or ‘simile’ (similarity), which means Hahnemann or other homeopaths are not supported by docu-
‘let likes be cured by likes’. In other words, when a substance mentary proof. The various principles of similarity, Hahne-
is capable of inducing a series of symptoms in a healthy living mann as a scientist, Hahnemann’s homeopathy, various
‘homeopathic’ innovations such as electro-homeopathy and
various types of alternative therapy including herbal medicine
have been indescribably confused, and this has led to conclu-
For reprints and all correspondence: Paolo Bellavite, Department of Scienze
Morfologico-Biomediche, University of Verona, Piazza L.A. Scuro,
sions being drawn on the basis of summary subjective judg-
37134 Verona, Italy. E-mail: [email protected] ments. Unless these sources of confusion are constantly and

The Author (2005). Published by Oxford University Press. All rights reserved.

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442 Homeopathy and immunology

Figure 1. Jenner vaccinating a child with cow smallpox.

Figure 2. C.F.S. Hahnemann (1775–1843).

completely acknowledged and corrected, little progress can be

made in clarifying the concepts of homeopathy or the principle
of similarity.
Immunology is the study of the structure and function of the
immune system, the complex and integrated group of organs,
tissues, cells and cell products such as antibodies that, by dif-
ferentiating self from non-self, defend the body against infec-
tion or disease and neutralize potentially pathogenic cells or
substances. This branch of biomedicine initially found resist-
ance in differentiating from more traditional medical discip-
lines such as pathology and physiology, recent decades have
witnessed an extraordinary development.
Western immunology and homeopathy both began at the end
of the eighteenth century: the first of Jenner’s smallpox
vaccinations (Fig. 1) were given at the same time that the
German physician Samuel Hahnemann (Fig. 2) was conduct-
ing his first homeopathic ‘provings’. The first organic enunci-
ation of the fundamentals of homeopathy was made by
Hahnemann in 1796: ‘One imitates nature, which sometimes
cures chronic diseases by adding another disease, and then
uses in the (preferably chronic) disease a drug that is capable Figure 3. E.A. Von Behring (1854–1917).
of exciting another artificial disease as similar as possible to
the natural disease to be cured: similia similibus’ (1, cited in
diphtheria and tetanus anti-toxins can be clearly
ref. 2, p. 52).
understood on the basis of Ehrlich’s lateral chain
The profound analogies between homeopathic thought and
theory. (. . .) Despite all of the scientific speculations
immunology are due to the fact that the whole of homeopathic
and experiments of anti-smallpox vaccinations,
theory is substantially based on the principle of regulating
Jenner’s discovery remained a relatively isolated epi-
endogenous systems of healing, the best known of which is
sode in medicine until Pasteur connected its origin
certainly the immune system and its neuroendocrine integra-
with a principle that cannot be better characterized
tions. A significant example of a pioneer of immunology
than by Hahnemann’s word: homeopathic. What else
with an open mind towards the new homeopathic theories
causes epidemiological immunity in a sheep vaccin-
was Emil Von Behring (Fig. 3), who wrote:
ated against anthrax, if not the influence previously
The mechanisms of action of my anti-toxin therapy exercised by a micro-organism having similar
are still unclear, although many authors say that the characteristics to those of fatal anthrax? And what
 eCAM 2005;2(4) 443

technical term appropriately defines this influence also here, the connection is obscure in the light of current
exercised by a similar micro-organism if not the knowledge. It is well known that King Mithridates VI (132–
word of Hahnemann: homeopathy? [Behring, Beit- 163 BC) is said to have taken small quantities of poisons and
rage zur Experimentellen Therapie, H. 2, 26, 1906, toxins to protect himself against the repeated attempts made
cited in (2), p. 125] to poison him. Native Americans wear a headdress of eagle
feathers partly to underline their prowess as hunters and partly
In 1912 he wrote ‘Hahnemann principle, according to our pre- for decorative purposes, but the custom is also based on a
sent way of thinking, was not bad at all’ and ‘The concept that belief that the sight, speed, courage and other desirable charac-
the sick person reacts differently to medications than the teristics of the eagle can be magically acquired. The magical
healthy one, which had to be established empirically by thera- transfer of the courage of a killed enemy to the victor by means
peutic trials, also played a role in Hahnemann’s thinking’ (3). of the ingestion of organs (the heart) also explains some
Hahnemann’s principles of homeopathy were not totally aspects of cannibalism.
new as traces of them can be found throughout the history of
medicine.
The ‘Simile’ of Hippocrates
By means of highly acute observations made without
The ‘Magical’ Simile sophisticated instruments but still valid today, the school of
The principles underlying homeopathy can be traced to roots Hippocrates understood that many of the phenomena of a dis-
dating back even further than those of immunology (2,4,5). ease are attempts at cure and suggested imitating them: this is
Mankind has always wondered how to identify remedies cap- the Hippocratic ‘simile’ (Fig. 4). The most frequently cited
able of curing diseases. In the pre-scientific era, empiricism assertions are:
based on chance observations, and trial and error, was prob-
The pains (complaints) will be removed by means of
ably the most widely used approach, accompanied by various
their opposite, each according to its own characterist-
forms of oral or written tradition. In many other cases, the
ics. Thus, heat corresponds to a hot constitution that
sick relied (and still do among some primitive people) on the
has been made ill by the cold, and so on for the others.
intuition of individuals judged to be particularly endowed
Another way of removing pain is the following: a dis-
with divine or natural powers: healers, shamans, witch-
ease develops by means of its like and is cured by
doctors and so on. However, there was also another line of
means of the use of its like. Thus, what causes urinary
thought that, often in a marginal manner, has accompanied
tenesmus in health cures it in disease. Cough is
various medical cultures in different epochs: the identification
caused and cured by means of the same agent, as in
of particular ‘resemblances’ between remedies and the dis-
the case of urinary tenesmus. Another method: the
eases they were thought to be able to cure. The first examples
fever causing the development of inflammation will
of treating ‘like with like’ can be found in the papyrus of Ebers
be caused and cured by the same agent. At other
(1500 BC): ear diseases treated with ear extracts, headache
with fish heads, blindness with the eyes of a pig.
Attempting to treat a disease by administering the agent cap-
able of causing it or transmitting it is one of the most general
acquisitions of empirical medicine. Numerous primitive medi-
cines used to cure the effects of snake venoms by repeatedly
inoculating them or materials extracted from the venom appar-
ati of snakes. In the Far East the Chinese practiced a form of
preventive smallpox vaccination both by wearing the clothes
worn by a smallpox victim in the full suppuration phase of
the disease and by inhaling dried smallpox pustules after stor-
ing them for 1 year. Pliny claimed that the saliva of a rabid dog
can afford protection against rabies. Dioskurides of Anazarbo
recommended that hydrophobia sufferers eat the liver of the
dog that bit them. Aetius of Antioch recommended eating the
meat of the viper that had just bitten you. In the seventeenth
century the Irishman Robert Fludd cured the victims of con-
sumption with dilutions of their own sputum after suitable
preparation.
Equally primitive and often elaborate applications of
the same principle could be found in many pharmaco-
poeias until the last century. The reasoning is sometimes
elementary: swallow human stones in cases of calculosis but, Figure 4. Hippocrates (470–367 BC).
444 Homeopathy and immunology

times, it will be cured by the opposite of its cause.

[Littre’s Oeuvres Completes d’Hippocrates, VI, 334,
Paris, 1839, cited in (2), p. 9]

It is particularly worth mentioning that Hippocrates did

not adopt a dogmatic or ideological position, but saw both
approaches (‘similarity’ and ‘opposition’) as potentially
useful. Prognostic interest, a great capacity for controlled
observation, the rejection of fanciful tendencies and other
characteristics unmistakably distinguish this from magic.
Without going into the whole of Hippocratic medicine, it
must be said that his doctrine is permeated by the concept of
natural healing. Nature (‘physis’) is the healer of disease.
‘Physis’ is an expression of life, not a special energy; it is
unconscious or similar to instinct; it prevails over physiolo-
gical and mechanical processes; it combats disease; it is fre-
quently incomplete and must be assisted by a doctor. It is
likely that no thought has had a more profound effect on medi-
cine than Hippocrates’ observation that the manifestations of Figure 5. P.T. von Hohenheim (Paracelsus) (1494–1541).
disease consist of two groups of events: the first being the dir-
ect effects of the damage, the second the reaction of repair. The observations that were to form the basis for a large number of
corollary to this is that the direct effects must be removed medical applications in subsequent centuries. For a long time,
whenever possible, but the reparative reaction must be pro- the following citation was considered one of the most signific-
moted in order to imitate nature. Hippocrates considered many ant anticipations of the ‘simile’ as seen by homeopathy: ‘What
pathophysiological phenomena as being fundamentally causes jaundice also cures jaundice. That is, the good and the
‘defensive’: fever, skin eruptions and others. In line with this bad lie in the same thing: the bad causes jaundice but, if you
pathophysiological conception, physicians must make a dis- separate the good, it becomes an efficacious remedy against
tinction between useful and harmful symptoms by stimulating jaundice. . . Since the drugs that cure paralysis must come
the former and blocking the latter. Using typical Greek con- from the substances that cause it. . . This is the way to under-
ciseness, Hippocrates formulated what can legitimately be stand the curative powers of minerals. . . What may be harmful
considered one of the fundamental rules of therapy: nature is in our hands can be transformed into a medicine’ [Paracelsus,
the primary physician and the first duty of medicine is ‘to do Miners Diseases, IX, 481, cited in (2), p. 13]. There is also a
no harm’. certain harmony with the concepts concerning drug doses
that were subsequently adopted by homeopaths, since accord-
ing to Paracelsus medicines must be administered not on the
The ‘Simile’ of Paracelsus
basis of their weight, but according to criteria that go beyond
One further representative of this line of thought was P.T. von simple weight.
Hohenheim, also known as Paracelsus (Fig. 5). His works, In the post-Paracelsian period, the ‘simile’ was often men-
which were first published in Basel in an almost complete ver- tioned, but usually in reference to magical practices. Typical
sion of 11 volumes between 1589 and 1591, contain a mixture authors are Porta, who attempted to apply the doctrine of sig-
of genial intuitions and ingenuities; profound clinical observa- natures to the whole botanic world (examples include the use
tions and strange affirmations concerning the influence of of hairy plants for scalps, beautiful plants to improve personal
celestial bodies; new pharmacological observations and con- appearance, ‘happy’ plants, ‘sad’ plants, etc.), and Schroder
vinced assertions as to the truth of alchemical and magical who presented related ideas, such as the fact that the leaves
concepts (6). Among other things, Paracelsus proposed the of Hepatica triloba resemble the liver [citations in ref. (2),
‘doctrine of signatures’ (‘signa naturae’) according to which p. 16]. One true predecessor of Hahnemann was Stoerck (7)
the therapeutic properties of different remedies were ‘similar’ (1731–1803), who in the 1760s published a series of works
to—and could be deduced from—the external appearance of on the treatment of diseases with poisons according to the prin-
plants and minerals: red remedies for blood diseases, sharply ciple of similars. This author made a highly significant state-
pointed leaves for the pain caused by stab wounds, iris- ment: ‘If stramonium causes illness in someone who is sound
colored Eufrasia for eye diseases, topaz against jaundice in mind by inducing mental confusion, why should we not
(because both are yellow) and so on. In this way, ‘magical try to establish whether it can give mental health to someone
similarity’ was re-exhumed in an empirical and intuitive man- who is confused or whose senses are altered by disease?
ner without any scientific understanding or experimental proof. If it cures someone affected by spasms, why should we
However, not all of the work of Paracelsus was ‘magical’: he not investigate whether it causes the spasms?’ [cited in
had many important intuitions and made a number of empirical ref. (2), p. 19].
 eCAM 2005;2(4) 445

Hahnemann criteria, including the patient’s constitutional and psycholo-

gical characteristics, as well as previous diseases.
Christian Frederick Samuel Hahnemann was born on April 10, Hahnemann interpreted his ‘simile-based’ therapy as the res-
1755 in Meissen, Germany, graduated in Medicine from ult of a reactive process that we would now call homeostatic
Erlangen University in 1779, and died in Paris in 1843 after or, better, homeodynamic: ‘If, in the case of a chronic disease,
a long and adventurous life. Although he worked in many you give a medicine whose primary direct action corresponds
fields of chemistry, pharmacology and medicine, he has passed to the disease itself, its secondary indirect action exactly rep-
into history as the founder of homeopathy, of which he is still
resents the state of the body it is desired to obtain. . .’ (1).
unanimously acknowledged as being the greatest authority.
The fundamental points of Hahnemann’s ‘simile’ can be sum-
The first reflection of Hahnemann concentrated on the fact
marized in Table 1. In other words, according to Hahnemann
that two diseases may interact in very particular ways in the the ‘vital energy’ alone is not sufficient to combat the disease.
same individual, with one temporarily or permanently taking By giving a remedy that resembles the disease, this instinctive
the place of another. One example is the well-known alterna- natural force (in analogy to the hippocratic ‘physis’) is driven
tion of eczema and asthma as chronic expressions of an aller- to increase its energy to a point at which it becomes stronger
gic constitution. Hahnemann studied the less known lasting than the disease itself, which finally disappears.
replacement of one disease by another and, for example,
Hahnemann also claimed that diluting the remedies in a par-
observed that a chronic skin rash disappeared after the onset
ticular manner (‘potentiation’ obtained by the extensive suc-
of measles. He wondered what it was that led to this difference
cussion of serial dilutions) not only reduced or abolished
between temporary and permanent replacement, and became their toxic effects, but also paradoxically increased their curat-
convinced that the latter occurred when the two diseases had ive power, which is still one of the most controversial aspects
similar symptoms. of homeopathy. Another highly criticized aspect is the the-
His next step was to try to apply this finding in a systematic ory of the ‘psora’ and the ‘miasmas’, by means of which
and therapeutic manner. As he was also an expert in chemistry, Hahnemann tried to describe the diseases of his time.
he was familiar with many of the symptoms caused by toxic
However, it is necessary to point out that Hahnemann never
agents and aware of the fact that a number of naturally occur-
claimed that homeopathy was the only guide to therapy, but
ring diseases closely resemble symptoms owing to intoxica-
often said that the primary method of treatment (‘the highest
tion: e.g. the intoxication induced by Belladonna resembles to be pursued’) is to remove the fundamental cause of the dis-
scarlet fever; that induced by quinine resembles malaria; and ease. He called this the ‘real way’ or ‘causal therapy’ and,
that induced by arsenic resembles cholera. It did not take him rather than contesting its value, doubted the possibility of
long to combine the idea of the replacement of similar diseases applying it. It must be remembered that he lived between the
with that of the replacement induced by ‘artificial’ intoxica- end of the eighteenth and the beginning of the nineteenth
tion: for example, he tried to use low doses of Belladonna to
century.
treat patients with scarlet fever and of arsenic to treat cholera.
The application of Hahnemann’s theory of ‘simile’ not
He intuitively understood that it was possible to discover spe-
only requires a scrupulous study of ‘Materia Medica’ (a
cific remedies for a number of diseases, and therefore sought compendium of the symptoms caused by the various sub-
other potentially advantageous drugs and tested their ‘patho- stances in normal human beings), but also of the symptoms
genetic’ power in healthy volunteers. After a long series of and pathophysiological characteristics of each individual
experiments on himself, his family and the medical students patient:
who followed his ideas, Hahnemann arrived at the first gener-
alization of his thought in 1796 and then its overall description We must, on the one hand, first precisely understand
in the treatises called ‘Organon’, ‘Chronic Diseases’ and the essential characteristics and incidental manifesta-
‘Materia Medica’, which were published in various editions tions of the diseases of the human body and, on the
during the first decades of the nineteenth century. other, the effects purely due to the use of drugs: that
Little by little, Hahnemann refined his homeopathic ideas. is, their essential characteristics and the incidental
For example, he discovered that diseases other than cholera symptoms of the specific artificial diseases they
could be cured by small doses of arsenic provided that they induce (as a result of differences in dose, form, etc.).
had other common ‘characteristics of arsenic’. However, not In this way, by choosing a remedy capable of causing
all cholera patients responded to arsenic, but required another an artificial disease that is very similar to a given nat-
remedy depending on their individual symptoms. He thus ural disease, we will be able to cure the most obstinate
changed the current nosological schema of medical thought of diseases (1).
by introducing the concepts of drug-specific pathogenesis
and disease-specific individual status. He then noted that As we have already mentioned and as is only logical, further
patients apparently cured by means of homeopathy could discoveries and applications have gradually added themselves
suffer a recurrence of the same disease or be affected by to the initial concepts and groundrules. Among these, particu-
another, and drew the conclusion that permanent cure could larly worthy of note are ‘isopathy’ and the introduction of the
only be achieved by selecting the remedy on the basis of other use of the so-called ‘nosodes’.
446 Homeopathy and immunology

Table 1. Essential principles of classical homeopathy

Potentially therapeutic substances must be tested carefully in healthy

subjects in order to document their ‘pure’, direct effects: this is the basis
of the medical matter

The remedy capable of causing a similar state in a healthy subject causes a
counter-reaction in a patient that is stronger than the pathological stimulus of
the disease itself

The disease must be studied as a whole (and not only in terms of its main
symptom or pathology) in order to ensure that it and the drug interact in a
global manner; the choice of the remedy must be based on the complex of
individual symptoms rather than on the name of the disease

The dose must be the minimal effective dose and therefore adjusted on the
basis of individual sensitivity

Homeopathy empirically maintains that the dose should be higher in the case
of acute diseases affecting specific organs, whereas chronic diseases that are
more sensitive to pharmacological stimulation should be treated with high
dilutions (‘potencies’) separated by much longer intervals

Isotherapy and Nosodes

One of the earliest and most notable innovations of homeo-
pathy, mentioned even in the later editions of the Organon, is
Figure 6. C. Hering (1800–80).
isopathy or isotherapy. The term was probably coined by the
veterinarian Wilhelm Lux (8) somewhere around 1831–33:
after starting to treat his animals with the homeopathic method, Hering also maintained that products of the human body and
he became convinced that every contagious disease bears the various parts of the body in the healthy state all have a pref-
within itself the means whereby it can be cured. He observed erential action on the corresponding diseased parts, and as
that the technique of dilution and dynamization of a contagious early as 1834 he advised the use of diluted and dynamized
product (bacterium, virus or infected secretions, and organic homologous organs (‘iso-organotherapy’) (9). Finally, he
material) would put such a product in a position to exert a assumed that the chemical elements exerted a particular action
therapeutic action on the disease resulting from the contagion. on those organs in which they were mainly contained. His
The law of similars ‘Similia similibus curentur’ thus becomes studies and papers on minerals and salts preceded the work
‘Aequalia aequalibus curentur’ or the law of sameness. of Schüssler on biochemical salts.
Three authors dominate the history of isopathy (2), and all The second great isopath was the veterinarian Joseph
three were homeopaths: Constantine Hering, Wilhelm Lux Wilhelm Lux, born in Silesia in 1776. Lux was appointed
and Denys Collet. Constantine Hering (Fig. 6) was born in Professor of Veterinary Science at the University of Leipzig
Saxony in 1800 and became an assistant to the surgeon Robbi, in 1806, and his work constituted a landmark in the history
who entrusted him with the task of writing a book for him of veterinary medicine. From 1820 onwards he was familiar
confuting homeopathy once and for all, as had already been with Hahnemann’s works and applied the new method in vet-
requested by the publisher Baumgartner. After taking a closer erinary medicine, becoming a staunch advocate of veterinary
look at Hahnemann’s works, Hering was not only intrigued, homeopathy. In 1831 Valentin Zibrik asked him for a homeo-
but ended up by defending Hahnemann and coming out in pathic remedy for distemper and anthrax. As he knew of no
favor of the new method. Hering contributed a great deal to homeopathic remedies for these epidemics at the time, his
homeopathy, but above all it is to him that we owe some advice was to replace the homeopathic ‘similar’ (i.e. the drug
drug provings and the preparation of homeopathic remedies prescribed on the basis of the symptoms) with a 30c dilution
from pathological excretions and secretions, which he terms of a drop of nasal mucus from an animal with distemper and
‘nosodes’. Originally this term denoted any remedy extracted a 30c dilution of a drop of blood of an animal with anthrax,
from pathological excretions or secretions obtained from and get all the animals suffering from distemper and anthrax,
human subjects or animals. Animal poisons were included in respectively, to take them. He was thus the first to create the
this definition, so much so indeed that Hering was the first to strain called Anthracinum. In 1833 Lux (8) published the res-
‘prove’ ‘Lachesis’ (venom of the bushmaster snake, the first ults obtained in a booklet entitled Isopathik der Contagionen,
nosode in history, later to become a homeopathic remedy to in which he claimed that all contagious diseases bear within
all intents and purposes) and the rabies ‘poison’. Convinced their pathological phenomena and products their own means
that every disease contains within it its own remedy and pro- of cure. Moreover, Lux also extended the principle to sub-
phylaxis, he extended his studies to the scabies ‘virus’, extract- stances that had become iatrogenic as a result of abuse, so
ing the alleged ‘virus’ from blisters from a subject with well that a method which was originally used only in contagious
developed scabies. diseases was also applied to non-contagious illnesses. Isopathy
 eCAM 2005;2(4) 447

provoked endless arguments in the homeopathic circles: other epidemics of typhoid fever, cholera and yellow fever which
nineteenth century relevant physicians who employed isopathy raged across Europe and America in the 1800s (17–19).
were Stapf, Rademacher (founder of ‘organotherapy’), Brown- Homeopathic medicine has undergone substantial ups and
Séquard, Arnold, Veith, while Griesselich, Berridge and others downs in its historical development. The rapid early boom
disapproved this method because the isopathic substancs were throughout the world in the nineteenth century and its immense
rarely subjected to proving and were not prescribed on the popularity were due to the fact that the other modes of medi-
basis of symptom similarity as in the original Hahnemann’s cine practiced at that time often used rather crude and painful
method (9,10). means for a cure. A survey of the periodicals and other literat-
After this early period of expansion, the new method ran into ure of the first decades of the nineteenth century reveals that in
continuous and increasingly severe criticism, so much so that the medical practice among physicians of the orthodox persua-
isopathy went into decline for several years, even within the sion the most common methods of treatment were bloodlet-
homeopathic community. Only a few solitary practitioners ting, sulfur, camphor, calomel and mineral medicines, mostly
went on using isopathic remedies. It was Father Denys mercurial salts (20).
Collet, a doctor and Dominican friar born in 1824, who even- However, this rapid spread was followed by a head-on clash
tually brought isopathy back onto the scene. In 1865 he wit- with orthodox medicine, which stopped homeopathy in its
nessed a homeopathic healing which convinced him to tracks and then led to its progressive decline, particularly
devote himself to the new method. He rediscovered isopathy in Western countries, where in some cases it all but disap-
alone and after several decades of practice published a book peared. Over the past few decades, however, we have been
entitled Isopathie, Méthode Pasteur par Voie Interne at the witnessing a steady recovery of homeopathic practice, even
age of 74 (11). According to Collet, there are three ways of in very advanced countries such as France, Germany, and
healing, namely allopathy, homeopathy and isopathy, all of Italy.
which are useful depending on the clinical indications. In addi- Hahnemann, right from the outset, found himself faced
tion, he distinguishes between three types of isopathy: (i) ‘Pure with stern opposition from colleagues and even more so from
isopathy’, which uses secretion products from the patient to the apothecaries, who felt that he was undermining the founda-
cure the same disease. (ii) ‘Organic isopathy’, which cures tions of their profession: since he was recommending the use
the diseased organs with dynamized derivatives from healthy of small doses and was against multiple prescriptions, this
organs. (iii) ‘Serotherapeutic isopathy’ or ‘serotherapy’ (dilu- new medicine was perceived as a serious threat to their profits.
tions of hyperimmune serum). The book also contains 42 per- Moreover, he was accused of dispensing his own medicines
sonal observations and the rules of isopathic pharmacopraxis, and administering them to his patients, which was illegal at
which is the starting point for a substantial renewal of the the time. He was thus arrested in Leipzig in 1820, convicted
method. and forced to leave the city. He then obtained special permis-
In the twentieth century two works devoted entirely to sion from Grand Duke Ferdinand to practice homeopathy in
nosodes have been published: the first in 1910 by H.C. Allen the town of Köthen, where he continued to work, write, and
(12), entitled The Materia Medica of the Nosodes. The second instruct his followers who were swiftly increasing in numbers
is by the Frenchman O.A. Julian (13), who first published and spreading their wings further afield. At his death (1843),
Materia Medica der Nosoden in German in 1960, later to homeopathy was known in all European countries (except
come out in two French versions, one in 1962 entitled Norway and Sweden), as well as in the United States,
Biothérapiques et Nosodes and the other in 1977 entitled Mexico, Cuba and Russia, and not long after his death it
Traité de Micro-Immunothérapie Dynamisée (14). The reached India and South America. It was first introduced
above-mentioned book by O.A. Julian in 1960 was a into Italy in 1822 thanks to G. Necker who founded the
success in Germany, where it revived the study of nosodes. Neapolitan School.
In particular, R. Voll accorded therapy with nosodes a By the middle of the nineteenth century, there were a large
central role in his diagnostic–therapeutic procedure called number of homeopathic journals, clinics, hospitals, societies
electroacupuncture-organometry, and H.H. Reckeweg (15), and pharmacies; homeopathic physicians could be found
the founder of homotoxicology, made extensive use of nosodes throughout the world; and more than 20 faculties of homeo-
and immunomodulators in his biotherapy. The use of the pathic medicine were founded in the United States. However,
nosode Meningococcinum as prophylaxis of meningitis was there were many controversies between the Hahnemann school
suggested by others (16). and the other trends of twentieth century medicine, particularly
in Germany. Furthermore, homeopathy itself also began to
develop different tendencies and conflicts, such as that
Subsequent Developments of Homeopathy
between physicians who used albeit diluted ponderal doses
The rapid initial spread of homeopathy was probably due, on and those who insisted on extremely diluted/dynamized pre-
the one hand, to the fact that the orthodox medicine of Hahne- parations; that between those who gave only single medicines
mann’s day and age was still extremely backward and lacked and those who gave combinations; or that between those who
truly effective therapeutic remedies, and, on the other, to the combined homeopathic and conventional medicines and those
distinct superiority of homeopathy in treating the various who relied exclusively on homeopathic remedies.
448 Homeopathy and immunology

Homeopaths had separated into two groups even before

the death of Hahnemann: one group considered itself the
representative of pure Hahnemann homeopathy, and recog-
nized the founder as the ultimate authority; the others formed
a group of ‘scientific homeopaths’ who acknowledged
Hahnemann as a brilliant innovator, but did not consider
him infallible or hesitate to question his opinions. The
‘scientific’ conception of homeopathy that developed during
the nineteenth and early twentieth century (2) was largely
due to the efforts of this second group of homeopaths,
who encouraged the greatest theoretical and experimental
progress.
Early attempts to investigate the principle of similarity on
the experimental ground can be traced back to the years around
the end of nineteenth century, when H. Schulz published a ser-
ies of papers that examined the activity of various kinds of
poisons (iodine, bromine, mercuric chloride, arsenious acid,
etc.) on yeast, showing that almost all these agents have a
slightly stimulatory effect on yeast metabolism when given
in low doses (21,22). He then came into contact with the
psychiatrist R. Arndt and together they developed a principle Figure 7. C.W. Hufeland (1762–1836).
that later became known as the ‘Arndt-Schulz law’, stating
that weak stimuli slightly increase biological responses,
medium and strong stimuli markedly raise them, strong many references indicating his openness to homeopathic ideas,
ones suppress them and very strong ones arrest them (23). such as:
Similar observations were reported by several other authors
in the 1920s and from their findings one can conclude that The first reason inducing me to write is the fact that I
the occurrence of inverse, or biphasic, effects of different considered it incorrect and unworthy of science to
doses of the same substance was known before the era of ridicule or persecute the new doctrine of homeo-
molecular medicine (24–27). pathy. . . I find suppression and despotism in science
This phenomenon is now well recognized in cell biology, repugnant; here, the only rule should be freedom of
with a number of explanation at the molecular level (e.g. dif- spirit, basic research, the confutation of hypotheses,
ferent receptors for the same substance having different ligand the comparison of observations, adherence to facts
affinities and triggering transduction pathways) and in and not to personalities. (. . .) Homeopathy must
immunology, where the systemic and local responses are necessarily be contested if it intends to present itself
known to depend on the dose in a complex way (e.g. foreign as a general principle of every therapy. In fact, if
antigens may sensitize the host but low doses of the same this affirmation were to be taken literally, it could
substance may suppress the system if administered by oral seem to be the grave of all sciences and human pro-
route). We will go back to these concepts in a subsequent gress. (. . .) But homeopathy is valid as a field of
paper dealing with the scientific models of the similia observation and, instead of being repudiated, should
principle. The delayed recognition of the possible con- be used as a special method of cure, subordinate to
tribution of homeopathic ideas to mainstream medical science the higher concepts of rational medicine. On the basis
and, insistent attacks of some homeopaths against allopathy of my personal observations, I am convinced that it
are at least partially responsible for the rejection of homeo- can render a service not rarely, but sometimes in a
pathy by the majority of modern physicians and academic highly striking manner, particularly after the failure
circles. of other treatments. (. . .) I am not in favor of homeo-
It is generally agreed that one of the greatest physicians in pathy, but of the inclusion of a homeopathic method
Germany at the time of Hahnemann was Christoph Wilhelm in rational medicine. I would not speak of homeo-
Hufeland (1762–1836), a rich and magnanimous physician pathic physicians, but of physicians that use the
who was a friend of Goethe and Schiller (Fig. 7). He was a homeopathic method at the right time and in the right
pioneer of medical journalism and dedicated his Journal der place. [Hufeland, System der Prakt. Heilkunde, 1830,
Praktischen Arzneikunde (which he edited for 40 years and cited in (2), p. 146]
which subsequently took his name) to the correction of the
medical deviations of his time. Although being a leading rep- Unfortunately, the history of medicine during the second half
resentative of ‘official’ medicine, he also dealt extensively of the nineteenth and, particularly, the twentieth century was
with the developments of homeopathy. His works include characterized by bitter struggles between the ‘official’ and
 eCAM 2005;2(4) 449

‘alternative’ medical worlds that made vain these hopes of homeopathy and it was estimated that there were only about
Hufeland. As a result of an irrational policy of reciprocal a hundred practicing homeopaths, almost all over 50 years of
excommunication, the two disciplines failed to develop any age, throughout the United States. For similar reasons, there
common points for a long time and continued along their own was also a parallel decline in homeopathic practice in Europe
separate and often conflicting ways. With some exceptions in the early decades of the twentieth century.
(e.g. the German school), homeopaths have failed to scrutinize We should not conclude, however, that the decline of
homeopathic concepts and theories in relation to conventional homeopathy was due to only political and economic reasons.
biology and immunology, possibly because they feel that any At least two other factors played a decisive role, namely the
reductionist scientific approach is incapable of interpreting internal struggles within homeopathy itself and the new major
the greatness of their ‘art’. scientific and pharmacological discoveries. As regards the
splits in the homeopathic world, there were disputes between
the various schools over dilutions (high or low potencies),
Opposition to the Development of over single or multiple prescriptions, and over whether pre-
Homeopathy scribing should be based on total symptoms or on the main dis-
ease present. The various different schools developed their
In the nineteenth century homeopathy was immensely popular own organizations, hospitals and journals, thus making it
in the United States where major figures such as Hering, very hard even for doctors seriously interested in learning
Kent and Farrington were practicing. Homeopathy was taught about homeopathy to get their bearings in this field.
at Boston University and at the Universities of Michigan, A severe blow to homeopathic theory was delivered by the
Minnesota and Iowa. By the turn of the century as many as chemical sciences and in particular by the law formulated by
29 homeopathic journals were being published. The year Amedeo Avogadro (Fig. 8), that was published initially as a
1844 marked the founding of the American Institute of hypothesis in 1811 and then tested experimentally by Millikan
Homeopathy, which thus became the first American national in 1909 (29): as is well known, this law establishes that one
medical society. mole of any substance contains 6.02254 · 1023 molecular or
Despite this, strong organized opposition was soon forth- atomic units. As a result, a simple calculation demonstrated
coming from ‘orthodox’ medicine, which viewed the growth that dilutions of any substance beyond 1024 (24· or 12c in
of homeopathy as a major threat: homeopathy was calling homeopathic terms) presented an increasingly remote chance
into question the very philosophical basis, clinical methodo- of containing even only a single molecule or atom of the
logy and official pharmacology of orthodox medicine. Right original compound. From this it was obviously but a short
from the very beginning the new approach embodied a strong step to ridiculing the use of homeopathic medicines, and
critical attitude towards the use of conventional medicines,
which were judged to be harmful, toxic and counterproductive
for the practice of homeopathy, in that they were all based on
suppression of symptoms. What is more, good homeopathic
practice called for a long apprenticeship and individualization
of treatment, both of which demanded more time than physi-
cians were normally prepared to give their patients.
The year 1846 marked the foundation of the American
Medical Association (AMA), one of the first objectives of
which was to combat homeopathy: homeopaths could not be
members of the AMA, and AMA members were not allowed
even to consult a homeopath, the penalty for this being expul-
sion from the Association; legal recognition was denied to
graduates with diplomas from universities with full professors
of homeopathy on their academic boards. In 1910, a classifica-
tion of American medical schools was drawn up (the Flexner
Report) on the basis of criteria which assigned high ratings to
schools which placed the emphasis on a physicochemical and
pathological approach to the human body and strongly penal-
ized the homeopathic approach (9,19,20,28). The homeopathic
colleges obviously obtained poor ratings, and as only the
graduates of schools with high ratings had their qualifications
recognized, this was a mortal blow to the teaching of homeo-
pathy. Of 22 homeopathic colleges operating in 1900, only
two were still teaching homeopathy in 1923. By 1950 there
was not a single school in the United States teaching Figure 8. A. Avogadro (1776–1856).
450 Homeopathy and immunology

homeopaths were branded by their adversaries as being These considerations alone should be enough to justify a
on a par with some kind of esoteric sect. Such opinions greater commitment of official scientific institutions towards
have continued to be voiced virtually unaltered up to the monitoring and clinically verifying the efficacy of therapeutic
present day. agents and measures adopted. A need is also felt for at least
The decisive factor, however, permitting conventional sci- some teaching of the basics of homeopathy to doctors trained
entific medicine to prevail over homeopathy was its own in universities, since, at general practitioner level particularly,
development as a science capable of identifying the causes of patients often tend to be keenly interested in homeopathy and
many diseases and as a source of effective techniques and tech- to ask their general practitioners for information and advice
nologies for curing them. Lister’s discoveries in the antiseptic on the subject.
field and the development of anesthesiology greatly increased There may be any number of reasons for the revival of
the success, indications and popularity of surgery. While homeopathy, despite the lack of university teaching in the field
chemistry, physiology and pathology were making giant and of support on the part of public health authorities (homeo-
strides in the theoretical sphere, the discovery of vitamin and pathic drugs are not available on the NHS), but it can hardly be
hormone replacement therapies and, above all, the advent of accounted for merely on commercial grounds. The main rea-
antibiotics, analgesics and anti-inflammatory drugs enabled son for the success of the so-called ‘alternative’ medicines
orthodox therapy to demonstrate its practical superiority. The lies in the fact that they offer something which today’s physi-
possibility of interpreting pathological phenomena rationally cian is unable to provide. This can be traced, on the one
on the basis of a scientifically validated model of the human hand, to the greater degree of individualization of the treat-
body and the availability of chemical, physical or technolo- ment, attention being paid to the human and psychological ele-
gical means capable of repairing defects detected with the ments, which are becoming increasingly neglected in this era
utmost precision by increasingly sophisticated and reliable of ultra high-tech medicine; on the other hand, it is due to the
instruments was (and is) altogether too attractive and convin- awareness that many of the challenges still facing us today in
cing a prospect to allow scope for exploring alternatives based the fight against disease call for a different approach from
on outdated and mysterious theories. that adopted to date.
In fact, the public at large and also the medical profession
itself are becoming increasingly aware that modern medicine
Homeopathy Revival must come up with new means and new ideas for tackling
problems. These include contamination of the environment
As we have already stated, the enormous progress of conven- by toxic agents, ever-growing numbers of diseases induced
tional medicine in this century has reinforced the opinion by increasingly potent drugs themselves, degenerative diseases
that allopathic treatment by means of ‘opposites’ is the only to which errors of diet or life-style contribute, allergies,
effective form of treatment and, generally speaking, has also autoimmunity and immune deficiency, large numbers of
strengthened the view that it is only a question of time before neurological and psychiatric diseases, psychosomatic dis-
a treatment is found for every disease. The great epidemics orders, and tumors. Despite undoubted progress made over
of infectious diseases have been defeated by a combination the past decades in these crucial fields of medicine, despite
of improvements in living conditions, hygiene, vaccinations the fact that we so often hear of new ‘major breakthroughs’
and antibiotics. Our knowledge of disease due to vitamin, paving the way towards achieving a definitive cure for this or
enzyme or hormone deficiencies has furnished new weapons that disease, and despite the fact that our knowledge of the
in the struggle against diseases such as pernicious anemia, intimate mechanisms of the various diseases has increased
dwarfism and diabetes. If it were not for the problem of finding enormously as a result of techniques of molecular biology, it
donors, transplants would already be routine therapy for a size- has to be admitted that, as far as general practice and the vast
able number of diseases. Cortisone and its derivatives are solv- majority of patients suffering from the above-mentioned
ing many problems of immune hypersensitivity. Recent diseases are concerned, the actual practical benefit of such
developments in molecular biology give us good reason to knowledge is not exactly spectacular!
believe that not even the genetic sphere will be able to escape That this is not merely a commercial phenomenon is also
our manipulative capability. suggested by the fact that we are witnessing a renewed interest
Against this background, one cannot see any real scope for on the part of scientists in experimental trials in this field.
homeopathy, though at present its use is still spreading. This Studies are beginning to appear on the biological effects of
spread of homeopathy is happening in countries such as Italy, homeopathic drugs, as well as studies on the so-called ‘high-
France and Germany, and parallels the renewed interest in dilution effect’, or double-blind placebo-controlled clinical tri-
homeopathy in many other countries throughout the world. als. The debate in scientific circles is becoming increasingly
Homeopathy is even more popular in Asia, most notably in heated, and many researchers are setting themselves the
India, Pakistan and Sri Lanka. In the United States, too, we objective of developing reliable methods for tackling the
are witnessing a revival of homeopathic practice: sales of problem.
homeopathic medicines in the USA have been growing at an Reilly’s group has published a series of trials (30–32)
annual rate of 20–25% during the 1990s. describing randomized and double-blind studies of patients
 eCAM 2005;2(4) 451

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