Scope and Limitations of Homeopathy in Psychiatric Diseases

Abstract: The question of scope and limitations of homeopathy has not only been perturbing but intriguing the homeopathic community as well since the time of its discovery. Hahnemann while writing about the tenets and classification of diseases, experimented upon the diseases with various methodologies and kept refining the same with every edition of Organon. He brought out very clearly that it is only the dynamic diseases that could be dealt with dynamic aspect of medicines per se. This article is an attempt to describe scope and limitations of homeopathy in psychiatric/mental diseases and suggest the ways to make it scientific.
Keywords: dynamic diseases, homeopathy, incurable diseases, limitation, mental diseases, scope
Introduction
Mental illness ranks second in terms of causing disability as per the data developed by the
massive Global Burden of Disease study(1), conducted by the World Health Organization, the World
Bank, and Harvard University. It reveals that mental illness, including suicide, ranks second in the burden
of disease in established market economies, such as the United States.Nearly two-thirds of all people with diagnosable mental disorders do not seek treatment. In developed countries, 8 of
the 10 leading causes of disability are mental illnesses.(2) In developed countries, the ten leading causes of lost years of healthy life at ages 15-44 were: Major Depressive Disorder, Alcohol Use, Road Traffic Accidents, Schizophrenia, Self-Inflicted Injuries, Bipolar Disorder, Drug Use, Obsessive-Compulsive Disorders, Osteoarthritis and Violence.
Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to
370/1000 population in India. These varying prevalence rates of mental disorders are not only
specifi c to Indian studies but are also seen in international studies.
Despite variations in the design of studies, available data from the Indian studies suggests that about
20% of the adult population in the community is af ected with one or the other psychiatric disorder.(3)
With such a widespread arena of mental diseases, it is pertinent to understand the therapeutic
modalities as to whether the present healthcare system is able to deal with this burden and how far
diff erent systems of medicine are equipped to combat this kind ofdisability world over. This can be done by understanding the scope of each modality.
Homeopathic physicians deal with a variety of psychiatric cases these days. There has been a paradigm shift of psychiatric illnesses that were primarily in the domain of modern medicine, that are now being treated by homeopaths largely with variable outcomes. The success or failure depends upon
the ailment, case perceiving, case analysis, deriving at the similimum
and long term follow up of these cases.
According to the Psychiatrist, Jerome D. Frank of Hopkins University School of Medicine ‘The
modern physician should and must know as much about emotions and thoughts as about disease symptoms and drugs’.(4)
Right from the beginning, homeopathy has a holistic approach towards diseases; and
the dynamics of mind and its expressions through emotionsor the mental symptoms were considered as one of the prime areasof importance. Dr Hahnemannwas perhaps the first man who highlighted the importance of mind in the understanding of disease process. His famous wordswere –‘Mind is the key to men’.
Homeopathy, the science of therapeutics, views man as a related body-mind-soul entity. In homeopathy, mind is considered as originator of all psychiatric ailments. Mind’s reflection and actions are influenced solely by miasms; the fundamental cause of the disease. Therefore, without having a clear concept about these fundamental causes, the evolution of the present state of patient cannot be perceived.
The Historical Approach
In the primitive cultures, abnormal behaviour was considered to have been caused by demons, evil spirits
etc. The treatment used to be rituals, prayers, use of extreme measureslike flogging and starvation etc.(5) Hippocrates, the Greek physician,was the fi rst to deny this concept and
regard brain as the organ of intellect.
He recognized that heredity, predisposition, environment and emotional stress can damage both
the mind and body. He gave thefamous Humoural theory saying that the body consists of four humours
– blood, black bile, yellow bile and phlegm. According to him, any imbalance between these humours
lead to abnormality in behaviour. Later thinkers like Plato and
Aristotle and then Galen accepted the Hippocratic theory of abnormal behaviour. Hippocrates’s statement
that ‘the physician and the specialist, whatever his field, should study the entire patient and his environment and should view disease with the eye of a naturalist’ is still applicable as it was 2400 years ago.
Wiliam Tuke, the English Quaker established The York Retreat in 1792 to give humane treatment
of mentally ill. He also reformed Bicetre Asylum in Paris where a French physician in 1793 was made
the director, emphasized that mental patients should be approached with compassion and understanding.(6)
History of Reformation in Psychiatry by Hahnemann
Dr Hahnemann entered the field of psychiatry four years prior to W. Tuke and Pinel in 1788, who
upholded the cause of humane treatment of mentally ill patients in addition to laying foundation of
new medicinal treatment of mental illness. Hahnemann also gave the law of similia, and mentioned a
cure by Hippocrates of his friend’s mania by the use of Hellebore (which can) produce the symptoms of mania. Amongst so many thinkers, philosophers, psychologists and psychiatrists, Hahnemann was the one to have advocated the humane treatment of all the mental diseases including the insane. He stated that these diseases should not be taken as a separate one as they are the part and parcel of the total disease or disharmony of man as a whole.
In some cases, Hahnemann considered psychotherapy to be more useful than homeopathic
medicines, emphasising that patients only require sympathy while the harsh treatments worsen
their condition. Moreover, the physician dealing with such patients must be empathetic so as to inspire them with respect and confi dence. In the year 1792, Hahnemann treated and cured an insane person
– Klockenbring at Georgenthal in Germany without the conventional
treatment baring all the then barbarous methods of chaining, beating and whipping etc. The account of this cure was published in 1796 in Lesser Writings(7) which proves that Hahnemann was one of the earliest, if not the very first to advocate treatment of insane by mildness rather than coercion.
Mental diseases are the one sided chronic diseases of psoric origin affecting whole psychosomatic
entity. In the Organon of Medicine, Hahnemann classified mental diseases into the following
four types (§216, 221, 224, 225). (8)
1. Mental diseases appearing with the decline of corporeal disease which threatens to be fatal. (Somatopsychic) In this type of mental illness, the so-called corporeal disease declines that was previously present with a rapid increase of the psychical symptoms. Finally the corporeal symptoms lose all their dangers and improve.
2. Mental illnesses appearing suddenly due to an exciting cause. For example: Mental diseases
like insanity or mania may suddenly break out as an acute disease in patient’s ordinary
calm state from fright, vexation, the abuse of spirituous liquors etc. These diseases may be
considered as the sudden flaring of latent psora. The exciting factors are fright, vexation or
abuse of spirituous liquors.
3. Mental diseases of doubtful origin.
There are certain mental diseases (not quite developed) where it is difficult to ascertain whether they really arise from a corporeal affection or from psychological factors e.g. Fault
of education, bad practices, corrupt morals, neglect of the mind, superstition or ignorance.
4. Mental diseases arising from prolonged emotional causes. (Psycho-somatic)
There are few emotional diseases which originate and are kept up by some emotional causes, such continued anxiety, worry, vexation, wrong and the frequent occurrence of great fear and fright. In contrast to the first type, they are primarily psychological in origin. Here the body is slightly affected in
the beginning, but in course of time they destroy the corporeal health, often to a great degree.
In § 230, Hahnemann said, ‘Indeed, I can confidently assert, from great experience, that the vast
superiority of the homeopathic system over all other conceivable methods ofthe treatment is nowhere displayed in a more triumphant light than in mental and emotional diseases of long standing, which originally sprang from corporeal maladies or were developed simultaneously with them’.
These diseases are somatopsychic i.e. which arose from the physical diseases and culminated into
psychical diseases.(9) In the homeopathic approach for treating mental diseases theemphasis is given on:
1. A thorough psychiatric  evaluation.
2. Mental status examination.
3. Through understanding of family history, personal history –adjustment and coping patterns
and attention to vocational, social and educational areas.
4. Studying causation/aetiology e.g. ailments from anger, ailments from grief, ailments
from indignation, ailments from disappointed love etc.
5. Understanding of personality – to know the traits.
6. Knowing any adverse early life experiences.
7. Knowing the constitution of the individual.
8. Identifying in the patient the characteristic nucleus of general and mental/ emotional symptoms which reflects the temperamental structure.
9. Individualization
Dr Jahr while writing on Mental and psychical derangements in his book ‘Forty Years of Practice’(10) writes
with conviction on insanity, ‘I confess that I have not yet met with a case of
chronic mania where I could have been certain that it would not break out again in another form. I have seen relapses of this kind occur even among patients who had been regarded as cured for three
years. The only psychical and mental derangements where a cure by artificial, sometimes only by homeopathic means, can be promised, are acute mental diseases that had originated
in accidental circumstances ; all such diseases can be cured by homeopathic
means, not only with comparative speed, but permanently, by whatever names
they may be known as pathological facts : mania, rage, melancholy, hysteria,
hypochondria, craziness, dementia, etc., and no matter how violent and
aggravating the exciting cause may have been ; grief, fright, confinement,
sun-stroke, concussion of the brain, etc.
Dr Jahr gave Indication of a few external causes such as fright, a sudden joy, long-lasting grief and
silent care, abuse of spirits, sexual excesses, menstrual irregularities,pregnancy and confi nement, excessive mental exertions,sunstroke, concussion of the brain etc. and has suggested variouscurative remedies for the psychical conditions that arise from these
individual causes.
Throughout the 19th century homeopathy prospered in America. Before the first world war there were about 56 purely homeopathic general hospitals with upto 1400 beds and 13 mental asylums with
upto 2000 beds each that shows that during the progress of homeopathy in general, cases related to mental diseases were also largely kept in these mental asylums that makes it evident that homeopathy was able to deal with mental diseases
successfully. (11)
What the latest studies
of homeopathy in mental
diseases have to say?
Psychiatrist Dr Zafeiriou(12) called
upon the mental healthcare
community at a Dubai conference to
adopt homeopathy as a tool to treat
psychiatric disorders, and to move
away from conventional medicines
that have severe side eff ects. He
said, ‘In psychiatry there aren’t any
medicines designed to be curative, rather
these relieve symptoms. Homeopathy
can treat all kinds of disorders from
anxiety and phobias to depression and
schizophrenia. In mental hospitals,
homeopathy can treat patients with
severe mental disorders, contributing
considerably to the therapeutic outcome
of conventional psychiatric treatment.’
An analysis of 2148
consultations in a private general
medical homeopathic practice
in France was conducted in 12
periods of 7–10 days of study
over four years.(13) The results
show that homeopathy is mainly
used in mental, infectious and
rheumatologic disorders. It is
suggested that homeopathy is a
useful alternative in these illnesses,
as it avoids the abuse of, and
the adverse eff ects of, sedatives,
antibiotics and anti-infl ammatory.
Davidson JR et al of Department
of Psychiatry and Behavioral
Sciences, Duke University Medical
Center, Durham, NC, USA published
an article on Homeopathic treatment
of depression and anxiety with
the objective to report the use of
homeopathic treatment in patients
with depression and anxiety.
Their results showed 58% overall
response rates according to the
clinical global improvement scale
and 50% according to the SCL-90 or
the Brief Social Phobia Scale. They
concluded that Homeopathy may be
useful in the treatment of aff ective
and anxiety disorders in patients
with mildly to severely symptomatic
conditions. (14)
Morag Heirs and Mike Emmans
Dean of Cochrane Developmental,
Psychosocial and Learning Problems
Group in the Cochrane database
of systematic reviews evaluated
a clinical trial of ‘Homeopathy
for a? ention defi cit/hyperactivity
disorder or hyperkinetic disorder’
 
whereupon they mentioned about
insuffi cient evidence to draw robust
conclusions about the eff ectiveness of
any particular form of homeopathy
for ADHD at present given that
only three randomized controlled
trials have been carried out, and all
were relatively small in size. When
pooled, results do not indicate a
signifi cant benefi t of homeopathy,
but due to the heterogeneity
between homeopathic interventions
being tested there may be scope
for more targeted research to test
diff erent treatment protocols. There
is at present insuffi cient evidence to
recommend the use of homeopathy
for children diagnosed with ADHD.
They recommended Good quality
observational studies documenting
how homeopaths in the country of
an intended trial actually practice,
including time to see benefi t and
adverse events or side eff ects, is
crucial for the development of good
quality trials. (15)
Another study on ‘Homeopathic
management in depressive
episodes: A prospective, unicentric,
non-comparative, open-label
observational study’ was done by
Praveen Oberai et al of CCRH, New
Delhi, India with an objective to
evaluate the role of homeopathic
medicines in the management of
depressive episodes which found
that A course of six months of
homeopathic treatment is associated
with signifi cant benefi ts in patients
suff ering from depressive episodes,
as measured by HDRS. (16)
Various preliminary and pilot
studies have been done in India
and abroad on fi nding out the role
of homeopathy in Autistic spectrum
disorder (ASD) whereupon the
results have been found encouraging
e.g., A pilot study(17) was done
in Brazil to study the ‘Eff ect of
homeopathic medication on the
cognitive and motor performance of
autistic children’ by Geórgia Regina
Macedo de Menezes Fonseca et al of
Brazilian Federation of Homeopathy,
Outpatient Clinic of Neurological
and Development Diseases, RJ,
Brazil and “Mão Amiga” Association
for Support of Autistic Individuals,
RJ, Brazil Results showed a positive
interference of homeopathic
treatment on development and
behavior and results of studies
done by Neeraj Gupta et al on
homeopathic eff ectiveness in ASD
cases have shown that homeopathy
brings out signifi cant positive
results in overall improvement in
ASD syndrome. (18-21)
Discussion
Homeopathy might well be
described as the science of vital
dynamics. Its fi eld is the fi eld of
disordered vital phenomena and
functional changes in the individual
patient, irrespective of the name of
the disease, or of its cause.
Hahnemann says, that every
intelligent physician, having a
knowledge of rational aetiology, will
fi rst remove by appropriate means,
as far as possible, every exciting
and maintaining cause of disease
and obstacle to cure, and endeavour
to establish a correct and orderly
course of living for his patient, with
due regard to mental and physical
hygiene.
The eff ects of dynamical causes
of disease, by which is meant all
those intangible and medicinal or
toxic agents and infl uences which
primarily disturb the vital functions
of mind and body, come legitimately
within the sphere of Similia. These
are very numerous, but they may
be roughly classifi ed as (1) mental
or psychical, atmospheric, thermic,
electric, telluric and climatic, (2)
dietetic, hygienic, contagious,
infectious and specifi c-the last three
including all disorders arising from
the use or abuse of drugs.
Hahnemann admits the utility
and necessity of resorting to
palliation in certain emergencies.
Similarly Psychiatric emergencies
where life of the patient is in
danger should be dealt accordingly
by palliative measures. Each
physician must be governed by his
own individual judgment and the
circumstances of the case.
The physician who is imbued
with the spirit of homeopathy
endeavours always to keep his
mind open and free from prejudice.
While striving always to perfect his
knowledge of homeopathic technic,
he never forgets that the necessities
and the welfare of his patient are
fi rst.
He will not allow either pride
or prejudice to obscure his sense
of his own limitations…. But time
and circumstances are sometimes,
at least temporarily, beyond his
control. It is possible to violate
the spirit by adhering too closely
to the le? er of the law. Victory is
sometimes gained by appearing
to yield, which is quite in accord
with the principle of Similia, a sort
of moral homeopathy. A strategic
retreat to another line of defence
in war o? en gives a stronger base
from which to launch a successful
a? ack.(22)
The wide scope of homeopathy
in dealing with various mental/
emotional/psychiatric illnesses
speaks of itself since it does not
go with the nosological diagnostic
names as in modern treatment
rather with its holistic mind, body
and spiritual correlations which
makes it superior to other systems
of medicine.
The strengths of Homeopathy in
treating and managing psychiatric
illnesses are:
1. Utilization of knowledge of
patient as a whole based on
infallible laws of nature
2. By knowing inheritance,
diathesis and constitution (now
called personality) and chronic
miasms, treatment can be made
eff ective
3. Treatment principles are
Homogenous (Homoio + genos
= similar kind) to the symptoms
of the individual while taking
into account causation, chronic
miasms and the general state of
constitution and temperament.
i. Similar to many Group
therapies (form of
Psychotherapy) where
use of similar greater
suff erings of the group to
cure the smaller individual
suff ering of a person is
used (the basis of Support
groups). These form of
encounter techniques are
also homeopathic (similar
suff erings).
ii. Principles of mesmerism
parallel to Homeopathy-
Suggestology, guided
imagery, trance and altered
state of consciousness.
Mesmerists worked to infuse life
energy and balance the circulation
of vital force and use hypnosis
to induce altered state of
consciousness to release trauma
and guide individual through
diff erent levels of awareness
through suggestion.
4. Homeopathic perspective in
understanding mental diseases:
In the understanding of mental
diseases mental symptoms
which are the expression of
mind, the mental state – a
combination of circumstance,
a? ributes and individual
characteristics and the mental
disposition – basic a? itudes/
nature of being that depend
upon birth, family background,
morals, individuals evolution
and its relationship is to be
thoroughly understood.
Merits of Homeopathy in
the fi eld of Mental health
1. Avoids drug dependence.
2. Makes the individual mentally
and emotionally stronger.
3. It is a non-suppressive mode of
treatment.
4. Treatment is cheaper than the
conventional methods.
5. Homeopathic medicines
are more eff ective for many
psychological illnesses as they
target the weakness in the
immune system causing the
problem and not the weakness
itself.
6. Can eliminate or reduce
unpleasant symptoms—make
people learn to handle diff erent
situations.
7. Has compassionate a? itude
towards mentally ill.
8. Act as Preventive medicine as
prescriptions are made on the
fi rst subtle emotional change
long before any change in the
body chemistry or physical
symptoms appear.
9. Helps reducing the painfulness
of hurts, insults or past
memories etc. leading to
building of confi dence and
strong personality.
Areas in mental health
where Homeopathy is
found useful
In the author’s 15 years of
experience in Psychiatry OPD
at Nehru Homeopathic Medical
College and Hospital, New Delhi,
various conditions from Bedwe
? ing to Anxiety, Depression,
Maniac Depressive Psychosis,
Behavioral disorders, Autism
Spectrum Disorder, ADHD,
A? ention Defi cit Disorder, Post
Traumatic Stress Disorder, Specifi c
Phobias, Somatoform Disorders,
Sleep disorders, Substance abuse
disorders, Stress, Sex related issues
etc have been treated successfully
on the basis of Individualization
while conditions like Obsessive
Compulsive Disorder, Mental
Retardation, Chronic psychotic
states like Schizophrenia, Chronic
Major Depression etc. are found
to be resistant but with long term
treatment quality of life can be
improved.
Although homeopathy has
a vast scope having far be? er
approach in exhaustive case
recording, analysis and curative
treatment of many of the mental
diseases as mentioned above yet
the welfare of the patient should be
placed on the top and never for the
selfi sh motive misguide the patient.
We should be able to know whether
the case in hand is dynamic in
nature and fall under the domain of
curability or not, since homeopathy
is the science of vital dynamics as
stated before and can only treat
and cure the curable diseases. In
chronic drug dependent (allopathic)
cases the exact picture of the case
is obscured and needs time and
patience to thoroughly understand
the depth of the phenomenon of
the illness. The drugs should not
be immediately withdrawn. Only
a? er the constitutional and antimiasmatic
similimum start showing
some benefi t they should be tapered
out gradually.
Conclusion
The various studies on the mental/
psychiatric illnesses show the scope
of Homeopathy in mental diseases.
However some of these studies
commented that controlled studies
are needed to assess the effi cacy and
the results encourage us to continue
the studies with a larger number of
patients.
A large number of scientifi c
studies in varied psychiatric
conditions with large number of
subjects should be undertaken
to prove Hahnemannian dictum
– ‘Indeed, I can confi dently assert,
from great experience, that the vast
superiority of the homeopathic system
over all other conceivable methods of
the treatment is nowhere displayed
in a more triumphant light than in
mental and emotional diseases of long
standing….’
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About the Author
Dr Neeraj Gupta is Reader NFSG
or Asso ciate Professor in Nehru
Homoeopathic Medical College, New
Delhi. He is incharge of psychiatry
OPD at NHMC; PG guide for
psychiatry (Agra University) and
organon (Delhi University). He has
authored several papers in various
national and international journals.
He has presented scientifi c papers
on autism, anxiety, depression,
adolescent mental health, behavioural
disorders, plastic leaching etc. in
various national and international
conferences. He is the panelist
speaker of All India Radio and has
given public talks on various health
related issues on Aakashwani, FM
Gold and Indraprastha channel. He
has been a resource person of CCH
for workshops on Organon and
Homoeopathic Medical Technology.
He has been the recipient of Life
Time Achievement award and Dr
D.P. Rastogi award conferred to him
by Delhi Homoeopathic Board for
recognition of meritorious services
rendered by him.