Homoeopathy before and after Hahnemann

Dr  R N  Wahi &  Dr Pankaj Aggarwaal

Homoeopathy before Hahnemann
On the auspicious occasion during the month of April, wherein we celebrate the Birth Anniversary of Dr. Samuel Fredricke Christian Hahnemann, the best tribute is to carry his legacy forward.

Generally, Hahnemann is regarded as Founder/ Inventor of Homoeopathy, whereas others would say that he discovered Homoeopathy? But, is that really so? The answer lies somewhere else. We have to go back to the History of Medicine, and then align it with the History of Homoeopathy to understand the true picture. The History of Medicine is broadly divided into the following periods:-

1. Pre-Hippocratic
2. Hippocratic
3. The Alexandrian
4. The Galenic and Post Galenic
5. The Renaissance
6. Eighteenth Century medicine of Theories and speculations, ending with Edward Jenner (1749 to 1823)
7. The Modern Period

The Indian Systems of Medicine, i.e. Ayurveda & Siddha are considered to be oldest systems of Medicine. Ayurveda is practiced throughout India, whereas Siddha is practiced mainly in Tamil Speaking Areas of South India. The origin of Ayurveda is traced back to the Vedic Times, about 5000 years B.C., Dhanvantri having  been considered as the Hindu God of Medicine. As recorded in Charak Samhita, the methods of treatment are two-fold, namely “Vipareetha Chikitsa” (treatment by Contraries), and “Tadarthikari Chikitsa” (treatment by Similars). Each of these methods have been sub-divided as under:-

(A) VIPAREETHA CHIKITSA, or treatment by allopathic in the sense of treatment by contraries, or opposites. This is of 3 kinds, namely:-

(1) Hetu Vipareetham or treatment by measures – Medicine (Aushadh), Diets (Anna), and Life activities (Vihara), which are contrary to  Hetu or cause of the disease, and operate for its removal.

(2) Vyadhi Vipareetham, or treatment by measures which are contrary to Vyadhi or Disease (which is the effect), and operate for its removal.

(3) Hetu-Vyadhi Vipareetham, or treatment by measures which are contrary to both Hetu (cause) and Vyadhi (disease), and operate for its removal.

In certain cases, the cause may disappear only after producing the effect (disease), whereas in other cases it may persist and be responsible for the continuation or recurrence of the disease. In the first case, only the disease has to be dealt with, whereas in the other case both cause and the disease have to be dealt with.

(B)   TADARTHIKARI OR VIPAREETHARTHAKARI CHIKITSA or Treatment by Homoeopathy in the sense of treatment by similars. This again is of three kinds, namely:-

(1) Hetu-Tadarthikari, or treatment by measures which are similar to the cause (Hetu), and operate for its removal.

(2) Vyadhi-Tadarthikari, or treatment by measures which are similar to the Vyadhi (disease), and operate for its removal.

(3) Hetu-Vyadhi Tadarthikari, or treatment by measures which are similar to both Hetu (Cause), and Vyadhi (Disease), and operate for its removal.

All of us know Hippocrates as the Father of Bed-Side Medicine, as has been understood in the Western Countries. In his works, Hippocrates has advocated two modes of therapeutic procedures. According to him, “The complaints of diseases are cured through a method of treatment which opposes it. This holds for every disease…………..A different way (for therapy) is this!  The disease is produced by influences which act similar to the healing process, and the disease condition is removed through remedies which produce similar symptoms to the disease”

Concepts of Man, Health & Disease Amongst Various Cultures, And Their Reflections In/Co-Relation to Homoeopathy

PRE-HISTORIC MEDICINE
The medicine was conceived in sympathy and borne out of necessity; the first doctor was the first man, and the first woman was the first nurse. The man did not understand disease, but knew injuries. The healing used to be on the pattern what we observe in the animals. Thus the healing used to be empirical, and bore no relation to homoeopathy.

INDIAN MEDICINE
Ayurvedic philosophy has many similarities with Homoeopathy. Both the systems consider medicine as a healing art that considers man as a whole in everything, including health and disease. The concepts of Tridoshas, are similar to the concepts of constitutions/temperaments. The individualized construction makes for peculiar strengths and weaknesses. Facing a stress, internal or external, the person breaks down first where he is the weakest. Both the systems recognize that the constitutional tendencies can be inherited.

CHINESE MEDICINE
According to Chinese Philosophy, the world is made up of the Five Elements, namely Earth, Metal, Fire, Water and Wood. Man was considered to be a microcosm of the universe and so his organs correspond to the structure of the elements.

Chinese medicine is the first system of medicine that bears many direct co-relations with the concepts used in Homoeopathy. It is said that Dr. Hahnemann was strongly influenced by Chinese literature, including the works of Confucius. The concept of the individual as a microcosm of the universe is common in both philosophies. Another similarity is that the man should not be considered in isolation, but also viewed in relation to his surroundings. The concept of the vital force is similar to the ancient Chinese concept of Qi as the unseen force that animates the body and is responsible for its well-being. Similarly the idea of the roles and responsibilities of the physician in Chinese medicine is the same as incorporated in Aphorism 4 of the Organon.

EGYPTIAN MEDICINE
The concepts of health and disease in those times were a blend of concepts of magical and religious. People believed in life after death. They believed that the body housed the soul and the Ka (the spiritual double). The soul needed the body to attain immortality, so the body needed to be preserved after death. This belief led to the development of the practice of embalming the dead bodies. From the available literature of the era, the information is very meager, though it is clear that the Egyptian Medicine influenced Greek Medicine, which in turn influenced Roman Medic ine. Excepting the concept of soul, there is hardly anything similar between Homoeopathic, and Egyptian Medicine concepts. — and so on.

HAHNEMANN, THE REBEL AND THE REFORMER
Thus, we find that Hahnemann was not the originator of the Similia Principle, as it finds its roots in the earlier literature both in the Ayurveda, as well as that of Hippocrates. Though Homoeopathy is generally considered to be a rival cult and a rebel child of the orthodox medical system, it need not necessarily be so. Two therapeutic principles viz., Law of Similars and the Law of Contraries may appear to be opposite to each other, this does not mean that the one or the other is absolutely wrong. There are arguments for and against each of these two opposite doctrines. According to Linn Boyd, Homoeopathic Law should not be reckoned as a curative law but only a finding-principle for a remedy which would be curative for a certain disease-condition.

In fact medicine had undergone a change to the extent that all rational approach advocated by old physicians like Charak, and Hippocrates had been dumped by Galen, and his strong advocacy of the Law of Dissimilars effectively neutralized all the principles that existed before it. For almost 15 centuries, the Law of Similars declined markedly in medical practice due to Galen’s influence.

It was the vision, and the rational thinking of Hahnemann that is influenced by Lord Bacon of England who introduced the concept of Inductive Logic, and established the scientific base for medicine. Hahnemann is considered a rebel, as in his article ‘ESSAY ON A NEW PRINCIPLE FOR ASCERTAINING THE CURATIVE POWER OF DRUGS’ in the year 1796, firmly stated that the earlier law used for curing illnesses – Contraria Contraris Curenteur, did not  lead to a lasting cure but only caused suppression of the illness. He claimed instead to have discovered the only true law of healing that had hitherto been hidden or ignored – Similia Similibus Curenteur.

INFLUENCE ON DR. HAHNEMANN
There are many authors who appear to have influenced Dr. Hahnemann. Some of them do find a direct reference, whereas others have not been mentioned specifically in his works. The notable are Alburtus Magnus, Albrecht von Hallor, Agrippa von Nettsheim, and Theophrastus ‘Paracelsus’. Another important influence on Hahnemann was Freemasonry. It is not very well known fact, but Hahnemann was a lifelong Freemason. The inscription at the beginning of his Organon of Medicine – ‘Aude Sapere’, or ‘Dare to be wise’ – is actually the slogan of Freemasons. Thus Hahnemann was influenced by a number of factors, when he discovered Homoeopathy and worked on it to give it a scientific meaning.

CONTRIBUTIONS TO LAW OF SIMILIA BY POST HAHNEMANNIAN STALWARTS

CONSTANTINE HERING  (1800-1880)
Dr. Constantine Hering, MD, the “father” of American homeopathy, was born on January 1, 1800 in the town of Oschatz within the electorate of Saxony. 

MAJOR LITERARY WORKS

• The Condensed Materia Medica,
• The Guiding Symptoms of Our Materia Medica
• The Homoeopathic Domestic Physician,
• Homoeopathic Family Physician,
• Analytical repertory of the symptoms of the mind,
• Analytical Therapeutics: Volume I,
• Repertory to Hering’s Condensed Materia Medica,
• Symptomatic Indications of Typhoid Fever,
• The Treatment of Typhoid Fevers with a Few Editions,
• Heaven of Homoeopathy: An Historical Document.

CONTRIBUTION
Hering characterized all vaccination as a “poisoning of the blood”.

“In Jennerian (Edward Jenner) vaccination,” he says, “there is the production of a real contagious disease, acting by zymosis or fermentation in the blood, thus endangering the organism, and resulting only in making the system less liable to, not proof against, the disease.

“Attention must likewise be called to the possibility of inoculating other diseases, such as itch, scrofula, leprosy, phthisis, syphilis, etc., and thus producing a complication of trouble difficult to be overcome.

He prepared medicines with the saliva of a rabid dog, or powdered smallpox scabs, or any other disease products, viruses, or venom’, in the new Hahnemannian way to give a fail-safe method of curing disease. 

ADOLPH LIPPE(1812-1888)
Adolph Graf zur Lippe-Weissenfield was born on May 11, 1812 near Goerlitz, in Prussia, and died on January 23, 1888 in Pennsylvania. Dr. Lippe was educated in Berlin and came to the United States in 1838. 

MAJOR LITERARY WORKS

• Key to the Materia Medica
• Comparative Pharmacodynamic,
• Keynotes of the Homoeopathic Materia Medica,
• Text Book of Materia Medica,
• Key notes & red line symptoms of the materia medica,
• Cholera; Its Treatment by Homoeopathy

CONTRIBUTION
Vigorously assailed all who advocated what he termed the “Pathologising” of the Materia Medica, those who practiced the alternation of remedies or scoffed at high potencies.

Master in the art of presenting the essential indications with the help of reports of the clinical cases.

CAROLL DUNHAM (1828-1877)
Dunham was born in New York on 29th Oct. 1828. He graduated from Columbia university in 1847.He received M. D. at the college of Physicians and Surgeons of New York in 1850.

MAJOR LITERARY WORKS

• Lectures on Materia Medica
• Science of Therapeutics’

CONTRIBUTION
Forcefully argued that homeopaths remember their own struggle for liberty against restrictive practices which so interfered with free thought and expression and which threatened to shut out all knowledge that differed from elite groups.

Preferred a broad church within which education about homeopathy with a common membership should be the rule, otherwise orthodox physicians, women and homeopaths who wished to try new methods and incorporate new experimental results would be excluded and without guidance, could potentially practice harmful medicine, which could never ‘promote medical science’.

RICHARD HUGHES (1836-1902)
Richard Hughes was born in  London, England.

MAJOR LITERARY WORKS

• Author of Manual of Pharmacodynamics
• Co-authored Cyclopedia of Drug Pathogenesy,
• A Repertory to the Cyclopedia of Drug Pathogenesy,
• The Principles And Practice of Homoeopathy

CONTRIBUTION
Attempted to revise and purify the Homeopathic Materia Medica to compile the Timothy Field Allen’s ‘Cyclopedia of Drug Pathogenesy’.

Did not rely in the Proving of The Materia Medica Pura in the same way as have been carried out in The Chronic Diseases so could not be relied on as accurate descriptions of the effects of the new medicines.

Rejected Samuel Hahnemann’s concept of the Vital Force , his theorizing about how homeopathic medicines worked, and the Psora theory.

Hughesian homeopathy -The essential character of Hughesian homeopathy was that it lay at the “scientific” end of the homeopathic spectrum of opinion. That is, it was pragmatic and anti-mystical.

Debated on the concept of high potency v/s low potency

Relaxed and non-dogmatic attitude towards Similia principle. Similia principle is a rule of thumb – a skeleton key to try in the therapeutic lock. It often gave the right answer but not invariably, nor was it the only key worth trying.

“Pathological Prescriber”. Believed that if you are serious about the Similia idea you must take pathology into account. 

HENRY C. ALLEN (1836-1909)
Dr. Henry C. Allen was born on February 10, 1836 in the village of Nilestown, near London, Ontario. 

MAJOR LITERARY WORKS

• Keynotes of the Materia Medica with Nosodes,
• The Materia Medica of The Nosodes,
• The Therapeutics of Intermittent Fever,
• Therapeutics of Tuberculous Affections

CONTRIBUTION
Actively worked for reinstatement of the Organon in college curricula and passionately defended the inductive method described in the Organon

Disappointed with James Tyler Kent over the publication of unproven remedies and combination of two remedies like Alumina silicata in the Denver Critique illustrates this unwavering commitment to Hahnemann’s principles.

JAMES COMPTON BURNETT (1840-1901)
James Compton Burnett was born on July 10, 1840 and died April 2, 1901. Dr. Burnett attended medical school in Vienna, Austria in 1865.

Alfred Hawkes converted him to homeopathy in 1872 (in Glasgow).

MAJOR LITERARY WORKS 

• THE BEST OF BURNETT.
• CURABILITY OF CATARACT WITH MEDICINES.
• VACCINOSIS AND ITS CURE BY THUJA

CONTRIBUTION
Introduced many nosodes: Bacillinum testium, Coqueluchinum, Carcinosinum, Epihysterinum,Ergotinum, Morbillinum, and also Schirrinum, and possibly Influenzinum…

Homeopathic philosophy of aggravations as part of the curative reaction of the Vital Force

“The fact is we need any and every way of finding the right remedy ; the simple simile, the simple symptomatic similimum and the farthest reach of all – the pathological similimum, and I maintain that we are still well within the lines of Homoeopathy that is expansive, progressive, science fostered and science fostering.” 

JAMES TYLER KENT (1849-1916)
James Tyler Kent was born in Woodhull, New York, on March 31, 1849.

MAJOR LITERARY WORKS

• Kent’s Repertory of the Homeopathic Materia Medica, 1899
• Lectures on Homoeopathic Philosophy, 1900
• Lectures on Homoeopathic Materia Medica, 1905
• Lesser Writings
• What the doctor needs to know

CONTRIBUTION
Prefer to use higher potencies but later in his career began using Hahnemann’s method of starting with low potencies and working up the scale by threes (6, 9, 12 etc.).

Introduced the doctrine of ‘Series in Degrees’ in the treatment of chronic diseases. One potency was not sufficient for chronic cases, though it would generally do for acute illnesses.

In chronic cases Homoeopathic Aggravation is essential from the application of the Simillimum.

Developed “pictures” of constitutional types of patients. For example Sulphur as “the ragged philosopher.”

Discovered the ‘Law of Vital Action and Reaction’ as pointed out by Dr. Hahnemann.

“A medicine is not too high to cure so long as it is capable of aggravating the symptoms belonging to the sickness; in the first hours in acute, and in the first few days of a chronic sickness.”

MARGRET LUCY TYLER  (1875 – 1943)
M. L. Tyler was born in England in 1875, the daughter of Sir Henry Tyler, Director of the London Homeopathic Hospital.

From 1908 to 1913, she lived in Chicago, where she learned homeopathy from the great Kent.

MAJOR LITERARY WORKS 

• How Not to Practice Homeopathy ,
• Homeopathic Drug Pictures ,
• Pointers to Common Remedies . 

CONTRIBUTION
Concept of “constitutional prescribing” in the modern sense is largely due to Margaret Tyler.The writings of Margaret Tyler made homeopathy accessible to people who lacked a medical background

 Made frequent use of the nosodes of vaccines  (Diptherinum, Morbillinum, Varicellinum) to treat for past traumas.

Use Ascending Potencies (30, 200, 1M, 10M) over a several days, or even only a few hours apart

PIERRE SCHMIDT  (1894 – 1987)
Pierre Schmidt was born on 22nd July 1894 in Neuchatel. 

Pierre Schmidt  was a Swiss orthodox physician who converted to homeopathy and who was responsible for reintroducing classical homoeopathy into Europe, and he was one of the main founders of the Liga Medicorum Homeopathic Internationalis (LIGA)

MAJOR LITERARY WORKS
Contributed to – Kent’s Final General Repertory of the Homeopathic Materia Medica,

Writings –

• The Art of Case Taking,
• Defective Illnesses,
• The Art of Interrogation,
• The Privilege of Liberation Through Homeopathy

CONTRIBUTION 

• Translated the Organon into French.
• Brought great changes by Samuel Hahnemann in the 6th Edition of the Organon for the attention of the homeopathic community.
• In 1950, Schmidt restored LM potencies to the World for the first time since 1840.

HARRIS LIVERMORE COULTER (1932 – 2009)
Dr. Coulter was born on October 8, 1932 in Baltimore, Maryland and died on October 28, 2009, at the age of 77. 

MAJOR LITERARY WORKS

• 1972 Published: Homeopathic Medicine
• 1973 Published: Divided Legacy. Volume III. The Conflict Between homeopathy and the American Medical Association, and Homeopathic Influences in Nineteenth-Century Allopathic Therapeutics
• 1975 Published: Divided Legacy. Volume I. The Patterns Emerge: Hippocrates to Paracelsus.
• 1977 Published: Divided Legacy. Volume II. The Origins of Modern Western Medicine: J. B. Van Helmont to Claude Bernard
• 1981 Published: Homeopathic Science and Modern Medicine
• 1986  Published (with Barbara Loe Fisher): DPT: A Shot in the Dark.
• 1987 Published: AIDS and Syphilis: the Hidden Link.
• 1990 Published: The Controlled Clinical Trial: an Analysis, and Vaccination, Social Violence, and Criminality
• December 1994 Published: Divided Legacy. Volume IV. Twentieth Century Medicine: The Bacteriological Era

CONTRIBUTION
Gave a sense how he viewed the medical monopoly in his Divided Legacy Vol. III

“Society today is paying a heavy price in disease and death for the monopoly granted the medical profession in the 1920’s. In fact, the situation peculiarly resembles that of the 1830s when physicians relied on bloodletting, mercurial medicines, and quinine, even though knowing them to be intrinsically harmful. And precisely the same arguments were made in defense of these medicines as are employed today, namely, that the benefits outweigh the risks. In truth, the benefits accrue to the physician, while the patient runs the risks.”

GEORGE VITHOULKAS (1932-)
George Vithoulkas was born in Athens, Greece in 1932. He started studying homeopathy in South Africa in 1960. 

MAJOR LITERARY WORKS 

• Homeopathy – Medicine Of The New Millenium —   Published in May 2000
• The Science Of Homeopathy 1980
• Materia Medica Viva 9 volumes
• A New Model For Health And Disease
• Essence Of Materia Medica

CONTRIBUTION
Establishment of homeopathy on a worldwide basis and foundation of homeopathic medical colleges in the USA and Europe where homeopathy can be taught at the highest level.

CONCLUSION 

EXTENSION OF SIMILIA 

• MAGIC SIMILE – SEE OLD SCRIPTURE
• HIPPOCRATIC SIMILE – SUPERFICIAL SIMILE
• GALENIC SIMILE – THEORETICAL SIMILE
• PARACELSIAN SIMILE – MINERAL SIMILE
• HAHNEMANNIAN SIMILE OR MODERN SIMILE –
• SIMPLE,
• SYMPTOMATIC,
• PATHOLOGICAL.

THE FUTURE ROADMAP
In order that we are able to plan the future roadmap for Homoeopathy, it is essential for us to go identify our strengths and weaknesses. We should not forget the struggle for the recognition of Homoeopathy, and the challenges that are at present and also those that are likely to occur in future. We have to evaluate the present scenario in the health delivery systems, and where we fit in to fill the gap, and carry it forward for our future generation.

HOMOEOPATHY IN INDIA
The name of Maharaja Ranjit Singh is closely associated with the history of homoeopathy in India as the first recorded treatment by Homoeopathy was that of the Maharaja. This was by the Romanian Physician Dr. John Martin Honigberger, who came to India for the first time in 1829. However, the origin of Homoeopathy in India is shrouded with uncertainty as no authenticated data is available regarding the year when it was introduced.

Prof. Dr. Mahendra Singh has given reference to Dr. Henry Westly Voysey, a geologist and the person who first of all brought Homoeopathy to India and practiced it. In 1834 three German Missionaries, namely Rev. Leiner, Greiner and Hebrich landed in Manglore (Karnataka), and treated professionals like teachers, lawyers, engineers, Government officers and others in the art of healing through Homoeopathy. Babu Rajinderlal Dutt is considered to be the father of Indian Homoeopathy, and Dr. Mahender Lal Sircar, an eminent allopath and the 2^nd MD from the Calcutta University, and initially a staunch opponent of Homoeopathy became the first allopath to be converted to Homoeopathy after he witnessed the dazzling success of Babu Rajinderlal Dutt.  Dr. Sircar contributed a lot to the spread of Homoeopathy.

REGULATION & DEVELOPMENT OF HOMOEOPATHY IN INDIA
The seeds to the regulation and development of Homoeopathy in India were sown by Dr. K.G. Saxena, who from the time he entered the profession in the year 1937, and dedicated his life to its cause. It was his untiring effort, which even created a dent in his personal life, and without any financial or political support, he had to face rough weather. It is a common saying that “GOD HELPS THOSE WHO HELP THEMSELVES”. This happened practically in case of Dr. K.G. Saxena. He started as a lone crusader, and the untiring efforts he was able to get patrons and associates. Dr. Saxena started his campaign in the year 1937 itself, and with the help of Shri Ghayasuddin an MLA from Punjab, in the then Central Legislative Assembly, was able to mobilize other members to put a resolution in the assembly for setting up an enquiry committee to judge the merits of Homoeopathy. The Homoeopathic Enquiry Committee submitted its report in the year 1949. Gradually came the establishments of Central Council of Homoeopathy, Homoeopathic Pharmacopoea Committee (Subsequent establishment of the Homoeopathic Pharmacopoea Laboratory), Extending Drugs & Cosmetics Act and Rules, to Homoeopathy, Central Council of Research in Homoeopathy, National Institute of Homoeopathy etc. Gradually, Directorates have been established in various states, and a number of institutions have come up. From a uniform Diploma Course in Homoeopathy, now we have reached to Post Graduate Courses. 

THE OPPOSITION OF HOMOEOPATHY
The recent attack on Homoeopathy appearing in THE LANCET, and the hue and cry for withdrawing Homoeopathy from the National Health Service in UK is not the first of its kind. The attacks on Homoeopathy have been there right from the time of Hahnemann, who had to leave Leipzig, and take asylum in Paris in the later years of his life. The press censorship was used to suppress Homoeopathic writings. Even in the present situations, those of us who have countered the attack on Homoeopathy in Lancet would have observed that this very Journal has not bothered to publish any of such writings, and has not allowed the debate to be carried further. Such attacks would continue to be there even in the future, as it is the economics rather than the scientific logic which is playing an important role.

PRESENT SITUATION IN MEDICINE
There are tremendous advancements in the field of medicine, as it has acquired a vast body of knowledge, and has become highly technical. It has moved from organism to organ, from organ to cell, and from cell to the molecular properties. The discovery of the biological role of Nucleic Acid (DNA), the uncovering of the genetic code and its role in regulating the life process are the recent discoveries. Genetic counseling, Genetic Engineering, prenatal sex determination, prenatal diagnosis of the genetic diseases, in-vitro fertilization, organ transplantation, and the latest being the prospects of cloning (asexual reproduction of unlimited number of genetically identical individuals from a single parent). Now the emphasis is on the early diagnosis, and because of this the focus is now shifting from curative medicine to the preventive medicine. Thus, it has now entered the phase of not merely to solve the problem of sickness, but also it is gradually involving the problem of continued improvements in the medical capabilities to preserve life.

PRESENT FAILURES OF THE HEALTH CARE SYSTEMS

1. Much progress and heavy costs have not changed the life expectancy in the developing countries.
2. The increased medical costs have not improved proportionate health benefits.
3. The iatrogenic diseases have increased, and have come under different labels.
4. The threat posed by Malaria, Filaria, schistosomiasis, leishmaniasis, has not lessened.
5. The vaccinations as practiced, and promoted at present, have not lessened these very conditions.
6. There is no equity in the distribution of health services, resulting in the limited access to health care for the large segment of world population.
7. Historical epidemiological studies show that the actual improvements in longevity have taken place from improved food supplies, better hygiene etc, long before the advent of modern drugs and high technology.
8. Modern medicine is attacked for elitist orientation even in health systems adapted to overcome social disparities.
9. High technology medicine seems to be getting out of hand and leading health systems in the wrong direction i.e. away from health promotion for the many and towards expensive treatment for the few.
10. The present notion taking place is that limit has reached in the health impact of medical care and research. This is labeled as a “failure of success”. 

PRESENT SCENERIO IN HOMOEOPATHY
At present, Indian sub-continent is the place wherein Homoeopathy is a very popular system of medicine. It is this area that puts a responsibility on all of us to remain alert and ensure that what happened in America is not repeated here.  The onslaughts on Homoeopathy have been there right from Hahnemann’s time, and would continue so in the coming era, the latest being the protests in UK, when even Lancet also became a part of the controversy. We need to organize ourselves on the pattern of Indian Medical Association, to have a representative voice to look after the long term interests.

It is for us to evolve the strategies to achieve our objectives. This can be done after assessing the current situation, understanding the impediments, setting our goals, and exploring the ways to meet the targets. Some of these may be summarized as follows:-

1. No doubt that after allopathy, it is the next choice for majority of population, yet it is only 1% of our population that adopts Homoeopathy as its first choice. This needs an introspection and plan strategies to reduce this huge gap.
2. In spite of the fact that some of the fundamental principles of Homoeopathy can be better explained now, because of the advancements in the fields of Science & Technology, yet we are not able to market the scientific basis of the Homoeopathy.  It is not uncommon that it is alleged as a placebo effect/witchcraft etc. etc.
3. Our participation in the community health programmes is fractional.
4. It is a very common sight these days that our graduates, after spending  5-1/2 years in getting the BHMS Degree, are doing jobs in the BPO Industry because we are not geared up to provide them the economic viability. After spending some time in the other jobs, they forget homoeopathy for all time to come. As a result, now a situation has reached that except for few metros the institutions are finding it difficult to get students.
5. The avoidance on the part of established practitioners to train the new generation, leading to a lack of confidence in the younger entrants who try to establish independently.
6. Lack of facilities to handle emergencies.Etc etc

COMING CHALLENGES & NEED TO INTEGRATE HOMOEOPATHY IN THE COMMUNITY HEALTH CARE
It is a universal truth that progress wherever, and whichever field has taken place has been as a result of identifying the failures, limitations, and the adoption of the available techniques to put things in place.

Presently, the Government of India is giving support to the indigenous systems of medicine, and the establishment of department of AYUSH is an important step in this direction. It does not mean that we should be satisfied with this only.  It is our responsibility to involve ourselves in the Community Health Care and establish our system of medicine in firm footing. The new emerging concept is Evidence Based Homoeopathy, and therefore, we are to prove ourselves that our system of medicine is on firm scientific basis. Our failure would expose us to the risk of being eliminated, as the counter lobby is very strong.

We have to explore our drawbacks, and evolve strategies to counter them. Some of the steps needing urgent considerations are:-

1. REGULAR CURRICULUM REVIEWS:–  In the present era, the information technology is developing at a rapid pace. We find that the patients coming to us bring with them lot of laboratory investigations already done. Not only this, with the internet facility now becoming a household, not only in the Metros, but also in smaller towns, the patients come after exploring lot of information before visiting us. The situation has reached a stage when at times the patients are more informed than the physicians, and at times it leads to an embarrassing situation in case the physician is not updated with the information. This increases the necessity of periodical reviews of our curriculum to keep pace with the developments in the field of medicine and allied sciences. 
2. COMPULSORY C.M.Es FOR THE ENROLLED PRACTITIONERS:– Times have changed a lot now. Merely getting the Registration done with the respective State Boards/Councils should not longer remain a license to practice Homoeopathy.  It is important that the physicians should keep themselves updated with the current trends. It should now be made mandatory for the Registered Physicians to attend to a specified C.M.Es in a year to enable them continue with their registrations. My proposal may appear harsh at this stage, but such measures are now being adopted in other professional councils, like Chartered Accountants. There is no reason as to why this system cannot be adopted in our profession.  
3.  PROPER CASE RECORDS:– Now, that Consumer Protection Act has been extended to the medical profession, it is very important the we maintain our case records properly. The best practice would be to keep notes in each case taken, whether acute or chronic; it should be our routine practice to note the observations, reports, and the individualities noticed, or the advice given on each visit. This would not only improve our case taking/follow up, but also is good evidence in case any of us are trapped into litigation. 
4. LABORATORY DIAGNOSIS SUPPORT:- The organized  diagnostic laboratories/centers have a  notion that Homoeopaths  do not generally refer the cases for the laboratory investigations. Now the time has come that we have to shed this image of ours. No doubt the laboratory should not dominate our prescribing, but it is a helpful tool in the case management, differential diagnosis, as also for the evidence based results. 
5. COMMUNITY HEALTH CARE:- To involve our system in the main stream, we have to take a pro-active role in the Community Medicine. This would help promote homoeopathy in the far-flung areas, also we can prove on the statistical basis  that Homoeopathy can play a definite positive role in achieving the goal of “Health for All” 
6. ESTABLISHED PRACTITIONER’S GUIDANCE:-We have observed that in the allopathic system of medicine, the senior and established practitioners are generally helpful to the younger generation in guiding them to tackle cases. We are far behind in this interaction, and what really happens is that the fresher instead of gaining confidence gets demotivated, and a good percentage actually leaves the profession, without actually getting a foot-hold. This is a sad reality, and it is our responsibility to reverse this trend. 
7. INTERACTION WITH OTHER SPECIALISTS:- Whatever the Pharmaceutical lobby of the big multinational companies may try to raise campaign against Homoeopathy from time to time, we should continue improving interaction with the specialists in other systems, and seek their assistance to learn the latest developments in the field of medicine. 
8. AWARENESS AMONGST MASSES:- The department of AYUSH , in the Ministry of Health and Family Welfare is doing a good job in this field, and must be appreciated. We find hoardings at various places in support of indigenous systems of medicine. This has not only to be maintained, but also augmented further.  
9. MINIMISING THE GARBAGE FROM THE EXISTING LITERATURE:–  A ground reality is that there is lot of garbage in the existing literature available in the market. It is high time that the Central Council of Homoeopathy plays an active role in appointing teams for the development of the Text Books in various topics providing the application of Homoeopathic System of Medicine in various branches of Medicine. These teams should be vigilant and review the books frequently, thus constantly updating the topics. There has to be a regular collaboration these teams with the Central Council of Research in Homoeopathy, as well as the Homoeopathic Pharmacopoeia Laboratory. There is no purpose of having the medicines in our standard literature about the medicines which have no backing from the Homoeopathic Pharmacopoeia. A ground reality is that although it is claimed that there are about 2800 medicines, the Pharmacopoeia Committee has not been able to standardize even 1000 of them.   The frequent updated editions of these text books would help in the proper propagation of Homoeopathy. The terminology used in the general medical literature needs to be incorporated in our books. This would enable the practitioners of the dominant system of medicine to understand our literature somewhat. 
10. FULL FLEDGED DEPARTMENT FOR HOMOEOPATHY:- In India, presently Homoeopathy is a part of  the other systems of medicine under AYUSH. Our colleagues at present working there must be finding that there is lot of domination with the other systems, namely Ayurveda, which might even be obstructing the budget allocation to the extent that these persons feel for our system. A fully fledged department of Homoeopathy independent of domination by other branches would be more helpful in the development of this system and establish deeper roots.
11. EQUAL STATUS IN PAY SCALES:- Our colleagues in the Government must be aware of the disparity in the status, if at all, and wherever present. A constant vigilance has to be maintained to ensure equal status for Homoeopaths in status and pay.
12. MAINTENANCE OF STUDENT-BED RATIO:- Although the Central Council of Homoeopathy must be keeping a proper monitoring on this part in our teaching hospitals and colleges, it is very important that we should try our best to keep the beds occupied to the maximum extent. This would not only help in providing better exposure to our students, enable them have more confidence, but also play an important role to develop more Homoeopathic Hospitals.
13. MORE SUBJECTS IN M.D. COURSES:-  More subjects are required to be added in this area. The topics could be Rehabilitation Medicine, Sports Medicine, Cardiology, Emergencies etc.
14. INTRODUCTION AND INTERGRATION OF YOGA as part of curriculum at the Degree Level, to truly understand and application of the concept of Holistic Medicine.
15. PROMOTION AND SUPPORT TO THE N.G.OS:- There is a large number of organizations like Lions clubs, Rotary clubs, charitable trusts under various societies who have floated homoeopathic dispensaries. We have to devise some system to regulate these, and urge the Government to promote these, as they could reduce the financial burden on the Government to provide health care to a large number of masses. With support from the Government these organizations could provide better pay to the doctors and the dispensing staff and continue for a much better length of time, rather than starting and closing down subsequently because of the financial crunch. Their effort to provide health care to the economically weaker sections of the society needs encouragement.
16. A PROPER UNDERSTANDING WITH THE HOMOEOPATHIC PHARMACEUTICAL INDUSTRY:– A proper understanding with the Homoeopathic Pharmaceutical Industry is important  for the proper support to the C.M.Es, and other platforms like national and international conferences.
17. MORE & MORE EXCHANGE OF EXPERIENCES THROUGH REGULAR CMEs, and conferences at the National and International Levels.
18. CLINIC ESTABLISHMENT ACT:- Very soon the implementation of this Act is to start. We have to gear ourselves to adjust to the realities/legalities which are to be enforced. At the same time we have to ensure that we do not face harassment  on account of the Inspector Raj.
19. HUMAN RESOURCES FOR THE HEALTH DELIVERY SYSTEMS:- The Government of India has introduced a Bill in the Parliament in December, 2011, according to which a National Council is to be set up develop the human resources for the health delivery systems. The purpose is to make the health services available to the remotest area. Presently, the proposal is for the Allopathic, Dental, Nursing, and Pharmacy. None of the systems belonging to AYUSH have a place in this bill at present. We have to represent to the  Parliament that we are also incorporated in this.

ACKNOWLEDGEMENTS

1. B.K. SARKAR:-  Essays on Homoeopathy
2. K. PARK:- Park’s Text Book of Preventive & Social Medicine
3. WILHELM AMEKE:- History of Homoeopathy, Its Origin & its conflicts.
4. PROF. DR. DIWAN HARISH CHAND:- History of Homoeopathy in India in the 19^th Century.
5. DR. K.G. SAXENA:- Struggle for Homoeopathy in India.
6. DR. NAVIN PAWASKAR:- History of Medicine and Homoeopathy. 

DR. R.N. Wahi, B.A..D.H.S. (Dli), P.Gr (Bom)  &
Dr. Pankaj Aggarwaal, M.D., Principal & HOD Dept of OrganonNaiminath Homoeopathic Medical College, Agra, & Ex-Vice Principal, Bakson Homoeopathic Medical College & Hospital, Greater Noida

(Presentations Made At The Sdha C.M.E On 8-4-2012)