Cover Image: Samuel Hahnemann monument in Washington DC. (Source: Wikimedia)
Everything Is Relative
Homeopathy didn’t start out as a pseudoscience. In the eighteenth and early nineteenth centuries, the most respected physicians practiced something called “heroic medicine.” Internal illnesses were treated by a brutal assortment of remedies that included bloodletting and purgatives. It was common for patients to have a large percentage of their blood drained from their bodies or to be given substances that would cause vomiting, diarrhea, and high fever (Vyse 2016). The famous physician Benjamin Rush (1745–1813), a signer of the Declaration of Independence, was a primary proponent of heroic medicine in the United States, and during the yellow fever epidemic of 1793 he and his colleagues undoubtedly hastened the death of many of the infected. On his death bed, George Washington was given multiple bloodlettings and purgatives. It was undoubtedly these heroic methods, as well as a general disappointment with the state of medical science, that inspired Oliver Wendell Holmes Sr., physician and father of the future Supreme Court Justice, to make his famous assessment: “I firmly believe that if the whole materia medica, as now used, could be sunk to the bottom of the sea, it would be better for mankind and all the worse for the fishes” (quoted in Wolpe 1999, 222).
The whole materia medica was not thrown into the sea, but heroic medicine was eventually supplanted by methods that were not particularly effective but were much more palatable. Samuel Thomson (1769–1843) developed a system of herbal remedies that could be prepared at home, and, despite severe criticism from the medical establishment, his methods became quite popular in the egalitarian, anti-elite era of the Jacksonian period.
Similarly, homeopathy, the medical treatment invented by German physician Samuel Hahnemann (1755–1843) succeeded in large part because it did not kill the patient. Hahnemann’s system was based on two simple ideas: (1) like cures like (similia similibus curentur) and (2) dilution. Homeopathic medicines were based on substances that created the same symptoms as the disease in a healthy person, but before they were used as medicines the active ingredients were diluted to the point that they were effectively placebos. Homeopathic medicine was based on a principle that contradicts modern pharmacology: medicines are more effective when more diluted. However, given that some of the substances used in homeopathic medicines were poisons (e.g., belladonna), the extreme dilution was often a very good thing.
As we now know, placebos can produce real health benefits simply because the patient expects to improve, and in the eighteenth and nineteenth centuries, homeopathic medicines often produced better results than bloodletting and purgatives because they avoided making matters worse. So, relative to the standard treatments, homeopathy was an improvement and was credited with helping to defeat bloodletting and purgatives. Everything is relative.
Today we have better options than homeopathy because we have actual science to help us figure out what works and what doesn’t. In the late nineteenth and early twentieth centuries medicine finally established empirical methods of evaluating treatments, and those methods soon revealed that homeopathy was a pseudoscience based on a faulty theory. Homeopathic medicines are no better than placebos because they are placebos. (For a humorous take on the usefulness of homeopathy, see the entry “List of scientifically controlled double blind studies which have conclusively demonstrated the efficacy of homeopathy,” on the RationalWiki.)
Nonetheless, homeopathy still has many believers, and homeopathic physicians still practice. The British Royal Family has a history of supporting homeopathy, and, although the British government’s chief medical officer has called homeopathy “rubbish,” Prince Charles remains a patron of the Faculty of Homeopathy, a professional organization for homeopaths in the United Kingdom. In the United States, homeopathic treatments can be purchased over the counter at drug stores or ordered over the internet. The Center for Inquiry (CFI), the parent organization of Skeptical Inquirer magazine, has recently sued both CVS and Walmart for selling homeopathic treatments—which are not FDA approved—on the same shelves as FDA-tested medicines.
I am by no means an expert on homeopathy, but some time ago I stumbled upon an interesting fact. In Washington, D.C., there is a large monument to Samuel Hahnemann, the founder of homeopathy—the first monument erected in the District of Columbia in honor of a foreigner who was not associated with the Revolutionary War. The dedication and formal presentation of the monument to the U.S. government was held on June 21, 1900, during a meeting of the American Institute of Homeopathy (AIH), the organization that financed and built the monument. The ceremony was attended by many dignitaries, including President McKinley. Music was provided by the Marine Corp Band, and an address was delivered by the Attorney General, John W. Griggs.
On a recent trip to Washington, D.C., I discovered the monument was just a twenty-minute walk from my hotel, and although I was still recovering from a recent foot injury, I made a pilgrimage to the site. The monument, which includes a statue of Hahnemann and four large bronze relief panels, can be found on a shady triangular piece of land on the east side of Scott Circle, at the confluence of Massachusetts and Rhode Island Avenues with 16th Street NW. At the center of the circle is an equestrian statue of General Winfield Scott (1786–1866), “Old Fuss and Feathers,” who fought in the Mexican-American War and advised Lincoln during the Civil War, and on a plot to the west of the circle is a statue of Daniel Webster (1782–1852). Ironically, the Hahnemann monument is a short walk from the executive offices of CFI, the organization that is suing both CVS and Walmart over their marketing of homeopathic remedies.
Established in 1844, the AIH claims to be “the oldest national medical association in the United States” (American Institute of Homeopathy, n.d.), and the organization is obviously quite proud of the monument. Their website tells the history of the original fundraising effort and of their several restorations of the site, most recently in 2011.
The monument was sculpted by Charles Henry Niehaus of Cincinnati, Ohio, who trained in Munich and Rome and was chosen for the job after winning a competition. The bronze sculpture of a seated Hahnemann is in a recessed niche with the Latin phrase SIMILIA SIMILIBUS CURENTUR, “like is cured by like,” below him. The surface of the niche behind Hahnemann’s head is decorated with a colorful mosaic surface, and the bronze reliefs on either side of the statue show Hahnemann in various settings. The two reliefs to his left as you face the monument show Hahnemann as a scholar (reading a book) and as a chemist (holding a test tube). The inscription below the reliefs states the second principle of homeopathy, DIE MILDE MACHT IS GROSS, “Gentle power is great.”
The two reliefs to the right depict Hahnemann as a professor of medicine and as a physician ministering to a bed-ridden patient. The inscription below these reliefs is IN OMNIBUS CARITAS, “In all things charity.”
One of the most interesting aspects of the monument is a large panel on the back directly behind the central statue (see Figure 6). The inscription gives Hahnemann’s full name, Christian Friederich Samuel Hahnemann, and describes him as the “leader of the great medical reformation of the nineteenth century”—one statement about Hahnemann that is arguably true. Homeopathy was a stage on the way to better treatments. We now know that homeopathy is not medicine—unless you want to call placebos medicine—but it played an important role in defeating a much worse form of medicine.
Old Monuments and Old Ideas
For some time, the United States has been divided over confederate flags and statues honoring confederate soldiers. In 2015, after the killing of nine African American churchgoers by a white supremacist in Charlotte, South Carolina, the state legislature finally voted to remove the confederate flag from the state capitol building. In August of 2017, after the killing of a counter-protester at the Unite the Right rally in Charlottesville, Virginia, there was a growing sentiment that monuments glorifying white supremacy and slavery should not be on public lands. Since then, several confederate monuments in southern states have been removed.
The Civil War was the most divisive episode in American history, and although white supremacy has not been completely eliminated, today there is wide agreement that slavery is an unqualified evil—the original sin of American democracy.
Homeopathy is something else entirely. This aging pseudoscience still has many supporters, and more to the point of the Hahnemann monument, the AIH is still around. It is not clear how many members there are, but the AIH still maintains a website and publishes the American Journal of Homeopathic Medicine, which is described as peer reviewed. Furthermore, homeopathic medicine retains some important support from the world of academia. A video on the AIH website features Dr. John Pan, founder of the Integrative Medicine Center at George Washington University School of Medicine, which is just a mile from the Hahnemann memorial at Scott Circle. The video also includes a presentation by Peter Fisher of the Royal London Hospital for Integrative Medicine. Fisher served as the homeopathic physician to Queen Elizabeth until his death in 2018.
Homeopathic medicine may be rubbish, but it is still endorsed by many users and some physicians and academics. In addition, the AIH continues to be an active organization with a sustained interest in the monument they funded and built. As a result, it will be a long time before the Hahnemann monument inspires the kind of strong feelings evoked by Civil War monuments. In addition, as massive as it is, there appears to be just the one statue in Washington, D.C. Advocates for science and reason will probably be more successful if they leave the Hahnemann monument alone and continue to highlight the lack of evidence for homeopathy.
My best-case scenario for the Hahnemann monument is that it becomes an interesting historical artifact. Sigmund Freud’s psychological theories are no longer widely supported. Psychoanalysis is still useful to academics in the humanities looking for interesting interpretations for novels and plays, but in the psychology department of most universities, Freud is hardly mentioned. It’s not that he isn’t respected. Rather, it’s that Freud’s theory of human behavior was inherently untestable, and other treatments were ultimately more effective. Looking back, Freud’s most important contributions were the recognition that psychological problems were worthy of study and treatment and that they weren’t caused by an imbalance of humors or possession by demons. There are still some psychoanalytic therapists in practice, but scientific psychology has left Freud behind.
Homeopathy has not yet been left behind by too many practitioners, unsuspecting consumers, and members of the British Royal Family, and as a result, CFI’s lawsuits and other efforts to discredit Hahnemann’s theories are still necessary. But perhaps someday homeopathy will be seen as an interesting historical curiosity. Perhaps future visitors to the Hahnemann monument in Washington, D.C., will pay tribute to an antique theory that helped defeat the dangerous medical practices of the nineteenth century but is now no longer accepted. A once valuable innovation that was eventually pushed aside by science.
Let’s hope that day comes sooner rather than later.
- American Institute of Homeopathy. N.d. American Institute of Homeopathy – About AIH. Available online at https://homeopathyusa.org/about-aih-2.html.
- Vyse, Stuart. 2016. Where do fads come from? In Controversial Therapies for Autism and Intellectual Disabilities, edited by Richard M. Foxx and James A. Mulick, 2nd ed. New York: Routledge, 3–16.
- Wolpe, P.R. 1999. Alternative medicine and the AMA. In The American Medical Ethics Revolution: How the AMA’s Code of Ethics Has Transformed Physicians’ Relationships to Patients, Professionals, and Society, edited by R.B. Baker, A.L. Caplan, L.L. Emanuel, et al. Baltimore, MD: Johns Hopkins University Press, 218–239.