Lynn S. Peck, DVM, MS, Gainesville, FL, USA
2005 SAVMA SYMPOSIUM
INTRODUCTION AND BRIEF HISTORY
Homeopathy is a powerful and effective form of medicine. At the same time, it remains one of the more controversial of the holistic modalities. Many people confuse the word “homeopathic” as being interchangeable with “holistic” and “herbal”: they are not the same thing! Homeopathy is a separate and specific system of medicine developed by the German physician and chemist Samuel Hahnemann over a 50-year period some 200 years ago. Homeopathy can accurately be called a scientific medicine, as its principles and the knowledge of the medicines’ action were developed through controlled experimentation confirmed by extensive and repeated (human) clinical observation.
Homeopathy made its debut in 1810 with the publication of the “Organon of Rational Healing” and quickly earned a reputation for outstanding success in the treatment of epidemics in Europe and in this country. One of its first uses was in a large typhus outbreak in Leipzig, Germany in 1813, following Napoleon’s defeat there. Out of 180 cases treated using his new method, Hahnemann lost only 2 patients: a 1.1 % mortality, compared with 30% in that epidemic.1
Over the next 140 years, similar successes were recorded for cholera, yellow fever, influenza, diphtheria, and other epidemics across Europe and the United States.2 Grateful Americans built a memorial to Hahnemann in Washington, D.C. in honor of the German physician who never set foot in this country. Even the President of the United States was in attendance at the dedication in 1900. Homeopathy was used with great success in U.S. Army field hospitals during the Civil War and WWI. It continued to have a strong presence in the U.S. through the 1930’s. Internal strife, loss of funding for homeopathic medical schools, and the development of antibiotics all played a role in homeopathy’s decline until a resurgence began in the late 1980’s/early 1990s.
Veterinary applications of homeopathy are recorded as early as 1812 or 1813, with the first manuals appearing in the late 1830’s.3 In 1860 Frederick Humphrey’s Manual of Veterinary Specific Homeopathy was published in New York. It was widely used for horses and farm livestock; even up to the 1920s the U.S. Cavalry, U.S. Department of the Interior, the Ringling Brothers Circus, and a number of zoos in this country used them for most of their animal care.4
Homeopathic medicine can have profound healing effects in treating both acute and chronic injuries and disease. Acquiring skill requires a great deal of study and practice, particularly in treating chronic ailments. These should only be treated by an experienced, trained practitioner. A beginner can learn basic principles and some common remedies to use effectively in many acute, “first-aid” type situations; however.
1) “Frozen Jaw” in a 1 1/2 year old Golden Retriever
“Molly” lacerated her tonsil in March 1999 while chewing on a stick. She was treated with Amoxicillin. One month later she was observed to have restricted opening of her mouth (< 3″) due to fibrosis. Under anesthesia her jaw was forced open to break down the scar tissue. She was put on prednisolone for 8 months with no improvement, after which the jaw opened only about ˝ inch. There was no pain or swelling in or around the mouth. Homeopathic treatment was begun after a physical exam, radiographs (normal) and a CBC (WBC 17,000) and blood chemistry (normal). There was minimal response to 2 different remedies given individually, each in a single dose in December and January. A 3rd remedy administered was administered with steady improvement. By the 3rd month “Molly” was back competing in field trials (neck retrieve); after 6 months she was able to do whole body retrieves; won her Junior Hunter certificate, and placed 1st in conformation.
2) Rejecting pups
“Judy”, a 7 yr old Beagle mix bitch with 3 previous litters, was a progressively worse mother with each litter. Although not aggressive, she would initially allow nursing but walked away if the pups crawled on her. By the time her 4th litter arrived, she refused to nurse and her milk started to dry up. She was taken to the veterinary clinic approximately 4 days postpartum. The remedy Sepia was given and within 30 min “Judy” started licking, nursing, and mothering the pups. She was a good mother from then on.
3.) Stillbirths in pigs
A hog farm was posting a 20% incidence of stillbirths in its herd of 130 sows. After extensive management review, no concrete cause was identified; only that the sows “appeared to be taking too long” to farrow. Caulophyllum was prescribed; given twice weekly for the last 3 weeks before the farrowing date. Stillbirths dropped to <3% for the next 6 months, at which time the Caulophyllum was discontinued. Stillbirths rose to 15% in the next 60 days. Upon reinstatement of the remedy, stillbirths dropped again to < 2%.5
LAW OF SIMILARS
Homeopathy is a symptom-based, rather than diagnosis-based, form of medicine. Hahnemann observed that a medicinal substance given to a healthy person produced a certain set of symptoms, or changes from the normal state. For example, Cinchona, a tree bark from which quinine is made, repeatably produced symptoms of weakness, cold extremities, heart palpitations, intermittent fever, and aching bone pain. Hahnemann realized that these symptoms were very similar to those of malaria, which disease quinine treats. Hahnemann tested this relationship between symptoms and medicines over many years and found it to be reliable and effective. He summarized it as “Like cures like,” i.e., the medicine which produces a set of symptoms in a healthy person can cure a sick person with similar symptoms, and from this Law of Similars comes the name “Homeo” = similar; “pathos” = disease or suffering.
Homeopathic “drug trials” or provings, are employed to determine the effects of a medicine (remedy). Groups of healthy people are given a remedy or placebo (blinded) and take repeated doses under a standardized protocol. Any symptoms, or changes from their normal state–physical sensations, aches, pains, food desires or aversions, emotional or mental states, or any other difference are carefully described. It is also noted whether these occur at specific times of the day or after specific activities such as eating, drinking, or exercise. Symptoms are recorded by each person (prover) and compiled with detailed questioning by the doctor conducting the proving. In this way an extensive list of common and uncommon symptoms produced by the remedy is constructed.
Homeopaths standardized testing procedures for studying the actions of the medicines. They also pioneered the routine use of placebo controls in provings in the 1880’s and the use of single blinding in the 1890’s, long before these measures were used in conventional medical research. A number of provings of original remedies were meticulously conducted in the 1930’s by physicians belonging to some of the U.S. homeopathic medical societies. These confirmed the observations and actions recorded a hundred or so years earlier by Hahnemann and his colleagues. New homeopathic remedies are still studied using this same basic system. In an interesting twist, this approach largely precludes the use of animal testing!
The “Law of Provings” states that only by giving a single medicine to a healthy person and observing its effects (symptoms) can one know what the actions of the medicine are.
SYMPTOMS AND HOMEOPATHY
There are thus actually two types of symptoms used in homeopathy. Medicinal symptoms, such as reported in provings, are those resulting from the action of the administered remedy. Disease symptoms are what the patient experiences while in an unhealthy state.
Medicinal symptoms: In conventional medicine, even though a single drug may affect many organ systems, we tend to think in terms of it having a main or primary effect or use; and possibly a secondary effect that is medically useful. The remaining effects not of interest are termed side effects or adverse reactions. In contrast, in homeopathy, a single remedy also affects many organ systems. This likewise can produce many medicinal symptoms, all of which are considered as potentially therapeutic.
Both medicinal and disease origin symptoms can occur at the mental, emotional, or physical level. They may alter physical functions, occur at specific times of day or year, or take the form of cravings or sensations with a specific location and character. For animals, changes in hunger, thirst, temperature and food preferences, social behavior, and activity, as well the appearance, odor, color, and consistency of any discharges can be helpful adjuncts to physical exam findings. Identifying things that make symptoms or the whole animal better or worse, and “strange, rare, or peculiar” symptoms, even if not seeming to fit into the overall condition, can also be of extreme value when it comes to prescribing.
When a homeopathic veterinarian is presented with a sick animal, he or she takes a detailed history about the symptoms surrounding the current complaint, as well as noting the patient’s normal habits, disposition, preferences; and details of past health complaints. The homeopath then studies the compiled provings (called a Materia Medica) to find a remedy whose medicinal symptoms best match the patient’s disease symptoms. The correct remedy stimulates a healing response.
The Single Remedy: Since every medicine can create symptoms, giving multiple medicines simultaneously results in a confusing array of symptoms. For this reason only one remedy is used at a time in classical homeopathy. This approach helps keep a clear picture of the symptoms of the actual illness which are to be matched by the remedy, and more readily allows identification of medicinal symptoms should they occur, so that the treatment may be appropriately altered.
Combination remedies containing anywhere from 2 or 3 to upwards of 15 or 20 remedies are a popular form of clinical and “over the counter” homeopathy. Many are marketed for use in pets. While these initially be can apparently effective, in my experience they may not act deeply enough to bring about real long-term improvement in the whole animal’s health. Few of the combination remedies have undergone provings, so knowledge of their actions is usually limited to use for a single condition, rather than the effects on the entire organism, contrary to the principles of classical homeopathy.
Homeopathic remedies are derived mainly from plant, animal, or mineral sources, and named by the Latin names. For example, Rhus toxicodendron is made from poison ivy; Sepia is from the ink of the cuttlefish, and Silicea is from sand, or silica. Remedies are prepared in a unique manner, which gives them unique properties.
Potentization and the Minimum Dose: Hahnemann, a chemist, searched for many years for ways to make remedies as gentle and effective as possible. Many of the medicines of his time were very strong in crude form, and, when used according to the Law of Similars, caused an initial worsening of symptoms before the patient recovered. He diluted them, but found that after a certain point they were too dilute to have much value. Clinical experience showed him that a combination of dilution and agitation (succussion), produced medicines that were more potent in terms of their medicinal actions than either crude or only diluted forms, yet were gentle and did not cause the severe negative reactions. From this came the Law of the Minimum Dose: using the smallest dose needed to stimulate a healing response.
Preparation of Homeopathic Remedies
Homeopathic medicines usually start as an alcohol and water extraction of the crude substance (usually a plant, animal product, or mineral) to form a tincture. The tincture then undergoes a series of dilutions with a succussion/potentization step in between each dilution. The final product is sprayed on a milk sugar base pill globule [several sizes ranging from poppy seed to peppercorn size] or compressed tablet and allowed to dry. Thus, homeopathic remedies all look quite similar to each other.
Serial dilutions of homeopathic remedies are performed in steps of 1 part in 10 (designated by Roman numeral X), 100 (C), 100,000 (M; = 1000C) or higher. The number of dilution steps is indicated by an Arabic number; thus, a 6X potency has gone through 6 serial dilutions of 1 part in 10, and 6 potentization steps. A 30C has gone through 30 serial dilutions of 1 part in 100, and 30 potentization steps. Common potencies are 6X, 12X, 30X, 6C, 12C, 30C, 200C, 1M, 10M, and 50M.
A 30C (100-30, of 10-60) has been diluted well past Avogadro’s number, indicating that there should be no molecules of the original substance left. Thus the controversy: how can “nothing” produce “something” in the way of medicinal value? It makes no sense in a chemical-receptor model of drug action. A variety of evidence, including NMR studies, and trials with ultrahigh dilutions (”microdoses”), however, supports the clinical experience that this method of preparation does produce “something” that is physically and functionally distinct from the starting substance and from plain water or the water and alcohol extraction mixture.
Homeopathic remedies in the U.S. are included in the Food, Drug, and Cosmetic Act of 1938, which established the FDA. They are prepared according to the Homeopathic Pharmacopoeia of the United States (HPUS), in licensed homeopathic pharmacies. Over 2,000 remedies have undergone provings. New substances are continuing to be studied through provings to learn of their medicinal effects.
The Vital Force
Hahnemann’s studies led him eventually to conclude that there is an energetic basis to life, health and disease. He called it the Vital Force, somewhat similar to the Chinese concept of Qi. By careful observation of his patients, Hahnemann came to believe that disease begins on this energetic level before symptoms are experienced. Symptoms of an illness are the efforts of the Vital Force to correct an energetic imbalance on the physical, emotional or mental level and to initiate healing. The deeper the level of the symptom, the more severe the degree of imbalance is considered to be. Symptoms are indicators, then, of the health status of this energetic force and of imbalances in it. They also are guides to what the vital force needs for healing.
Homeopathic remedies, energetically potentized during preparation, are able to stimulate this energetic Vital Force to move in a healing response. The potency, or energetic strength of the remedy, is matched to the strength of the patient’s vital force. A strong Vital Force produces strong symptoms, such as a high fever in a young kitten, and can heal rapidly; a weak Vital Force produces weak symptoms (geriatric dog with low-level chronic cough, stiffness or pyoderma) and healing progresses more slowly.
The action of the remedy on the Vital Force is evaluated by the changes in the symptoms picture. Is the patient’s overall well being (energy, interest in life, confidence, self care) improved, indicating a strengthened Vital Force? Or are some physical symptoms better but the rest of the patient is weaker, fearful, depressed, withdrawn? Sometimes there will be a temporary worsening of symptoms, which resolves without treatment, leaving a healthier, stronger patient. This is where training and experience are needed to accurately assess the response and know whether the best remedy has been selected.
1. Homeopathy is a 200-year-old system of medicine that uses energetically potentized medicines to stimulate a healing response.
2. The action of a medicine is known by giving it to healthy individuals and recording its effects (symptoms) in a proving. Symptoms are thus a guide to what is needed for healing.
3. Matching the symptom picture of the patient to the single medicine that produces the most similar symptom picture will stimulate a healing response by the Vital Force. The medicine itself does not heal.
4. The Vital Force is the energetic basis to life, health and disease. It produces mental, emotional, and or physical symptoms when an imbalance or disorder is present on this energetic level.
5. The response to the remedy is evaluated by the symptom changes. In a healing or curative response, the overall health and well-being of the patient is improved.
Using Homeopathy in the Clinic
The purpose of this section is to introduce some common remedies and their uses in acute care situations to the beginning veterinary homeopath. Beyond these very basic applications, it is strongly encouraged that anyone interested in using homeopathy professionally get sound, comprehensive training in this form of medicine. A 9-month to a year course is highly recommended as it will provide a comprehensive approach to the system of homeopathy, rather than a patchwork approach as from taking weekend workshops. Some other considerations are listed below.
Multiple Modalities: Mixing conventional and other alternative modalities simultaneously with homeopathy is generally not recommended because this can mask, alter, or create new symptoms, making it difficult to assess the patient’s response to the homeopathic remedy. Bachflowers, and chiropractic/manipulative therapies are probably the most compatible with homeopathy. Strong herbs, such as Chinese herbs; acupuncture, and other energy-based therapies may be especially likely to affect homeopathic treatment.
Chronic Disease vs. Acute Disease:
In homeopathy, a chronic underlying imbalance can erupt from time to time in an acute event, such as a case of cystitis, or a recurrent ear infection. The acute event may initially respond to a remedy, then return later and be treated less and less successfully. New, more serious (deeper level) symptoms may also result. These are good indications that the root of the problem is not being addressed. Further acute treatment can lead to many more difficult problems! Refer these patients to a trained homeopath!
First Steps in Homeopathy
Learn some basic remedies to use in specific clinical situations such as intra-operative or post-operative bleeding; post-operative pain; slow recovery from anesthesia; panicked patients, abscesses, contusions, puncture wounds, lacerations, shock. There are remedies appropriate for these acute conditions; however, if the animal does not respond, more individualization is probably needed in the prescribing. Study the remedies ahead of time to become familiar with them. Write out the most common symptoms associated with each condition then evaluate which remedies best fit specific symptoms. Learn how to evaluate the response to a remedy; how long to wait; how to decide if the symptoms are moving in a curative direction, when to repeat or change remedies.
Homeopathy is a symptom-based form of medicine. As mentioned above, symptoms are described as precisely as possible, which requires good observation skills and question asking. Some symptoms are much more useful than others for helping point to a remedy. For example, most cats with cystitis will usually be urinating small amounts frequently and may have bloody urine and drink lots of water. These are very common symptoms and so are not very useful. Crying when urinating; drinking small amounts of water frequently or large amounts of water at long intervals, seeking warmth or cold, are more specific to the individual and are thus more useful symptoms. A change in behavior from a friendly cat to a “don’t bother me” state; or from an independent sort to a clingy, “hold me and pet me” frame of mind is extremely helpful as it points to the individual way the condition is affecting the patient. Lists of symptoms with their associated remedies are compiled in what is called a “Repertory.” Select a few remedies from the most characteristic individual symptoms, read about them in more detail in the materia medica, and choose the one that best matches the patient.
Administering the Remedy
Remedies are most commonly in the form of a lactose pillule (little pill). The remedy is applied to the pillule in liquid form and allowed to evaporate. The smallest (#10) pillules, about the size of a poppy seed, are very convenient to give, as they tend to stick to the mucous membranes and are difficult to spit out. They also readily evaporate in water (or a little bit of milk) and can be given in volume just large enough to moisten the inside of the mouth or gum and cheek mucosal. Because the remedies only need to contact nerve endings in the mouth rather than having to be swallowed, they can be administered safely even to unconscious animals.
It is best not to handle remedies with bare hands to avoid absorption or contamination of the remedy. Instead, they can be measured out into the bottle lid, and dropped into a small square of folded plain white paper or into a small volume of liquid in a clean glass or cup, and dissolved, then given orally using a syringe, put in a small container for drinking water (and promptly removed after consumption), or even atomized near the animal’s face. For storing a larger quantity in liquid form, refrigerate the water solution or add 20% alcohol in the form of brandy or vodka as a preservative. Cats in particular dislike the alcohol solution.
Remedies that are handled carefully, avoiding exposure to heat over 150 F, strong odors or electromagnetic fields including computers, speakers, and microwave radiation, can retain their activity for many years.
Potencies and Repetition
Which potency to give does not depend on body weight, but on the vitality of the patient and the nature of the condition being treated, i.e., acute or chronic; deep or superficial. For beginners in homeopathy, higher potencies (>30C; available only from homeopathic pharmacies) are most appropriately given to young animals, or generally healthy animals in acute trauma situations. Lower potencies (6X to 30C; available over the counter at most health food stores) are used on older or debilitated animals. However, in an emergency the best potency to use is the one you have!
How often to repeat a remedy depends on the situation and the potency. Higher potencies have a deeper, more prolonged effect than lower potencies. In life-threatening or severe injury situations, higher potencies can be repeated every 15 minutes for up to 3 doses, low potencies can be given every 5 to 10 minutes for 3 doses, or until a response is seen. Once a response is seen, WAIT until it has run its course. Repeat when the symptoms indicate another dose is needed. In less severe or critical situations, repeat less frequently (several hours apart). If no change is detectable at all, a different remedy may be needed. Sometimes one remedy will work to its full extent but not all the symptoms are resolved. A different remedy (or a higher potency) may be needed to finish the work. Look at the remaining symptoms and find the best match in the same way as described above.
Remedies for Common Acute Conditions
1. Painless abscesses, especially if already draining, or not healing, or are recurring, or associated with a foreign body. The patient usually seeks warmth (is chilly), is nice or may be timid, and may be more thirsty than usual: SILICEA.
2. Very painful abscesses, very sensitive to touch; often not draining. Patient is very chilly, especially when sick, and may be irritable or nasty (including normally): HEPAR SULPHURIS. Helps prevent or treat cellulites.
3. Ulcerating, smelly, discharging abscesses, very painful. Tendency to lots of saliva, gum problems, red gums, bad breath odor, sensitive to both heat and cold; very thirsty: MERCURIUS VIVUS (SOL.)
1. Slow to awaken; especially if tend to bleed easily and are sensitive to loud noises and/or tend to be nervous: PHOSPHORUS.
2. Slow awakening and extremities feels cold to touch; gums blue: CARBO VEGETABILIS (the “Corpse Reviver”–when patient is weak, cold; life force seems to be ebbing).
1. Bright red blood from superficial vessels: ACONITUM, PHOSPHORUS.
2. Profuse, gushing, bright red blood: IPECAC.
3. Oozing, passive hemorrhage; or bleeding related to surgical operations, e.g., equine castration: ARNICA.
4. Passive venous or capillary bleeding, with dark blood; also, weakness from loss of blood: HAMAMELIS.
1. First degree burns: URTICA URENS
2. Second degree (burns with blisters): CANTHARIS.
3. See notes under “Wounds,” below, for topical dressings for 1st and 2nd degree burns.
Fear, Terror, Shock
1. Animals who come into the exam or waiting room terrified. Injured animals in shock. Sudden fear before going into the show ring: ACONITUM.
1. Incisional pain; also abdominal pain from surgery, especially if any symptoms of anger: STAPHYSAGRIA.
2. Deep tissue bruising; especially pelvic or abdominal: BELLIS PERENNIS. Also for post-partum pain after a long labor/dystocia.
3. Orthopedic surgery: ARNICA first for muscle pain, then follow with SYMPHYTUM for bone/periosteal pain. Symphytum is also indicated in non-union and comminuted fractures to stimulate healing. HYPERICUM if much nerve involvement or amputation. For bruising type periosteal injuries, fractures, and pain related to the flexor tendons or joints, especially if a great deal of restlessness: RUTA GRAVEOLENS. Pain related to fibrous connective tissues, joints, tendon sheaths, that get better with motion, worse with rest, and is accompanied by great restlessness: RHUS TOXICODENDRON.
4. Pain that gets worse with motion and better with rest; especially if accompanied by irritability, anger, great thirst: BRYONIA.
1. Not accepting puppies (doesn’t want to take care of them or wants to destroy them): SEPIA
2. Lactation: insufficient milk or not drying up after weaning: PULSATILLA.
3. Uterine inertia during labor: CAULOPHYLLUM.
1. ARNICA MONTANA: The first remedy to think of in any type of trauma. Treats physical and emotional shock. Excellent pain relief in bruising injuries but also initial pain from broken bones. Contusions/blunt trauma without lacerations, a first remedy for head or spinal trauma. Aids resorption of blood in bruising or hematomas. Animal may be restless (unable to get comfortable), and may draw back when approached.
2. Injuries to area rich in nerve endings (fingers, toes, nails, coronary band/hooves), especially crushing or puncture injuries or amputations. Head and spinal trauma after Arnica has fully acted. Lumbosacral or coccygeal pain, particularly after a fall: HYPERICUM.
1. Puncture-type bite wounds, especially if the wounded parts are cold: LEDUM. May prevent tetanus if given immediately after puncture wound. HYPERICUM for wounds that are more painful/sensitive than appearance indicates. Ledum will cause puncture wound to gape open, making it easier to clean.
2. Lacerations: Sharp incision-type: STAPHYSAGRIA. Ragged, gaping, torn wounds, especially if inflamed or bleeding or when large pieces of flesh are torn from their attachments: CALENDULA. Will help prevent infection. Do not use in puncture type wounds as can cause the wound to close too rapidly, forming a pocket underneath. [The diluted tincture (1:20 or 1:25) or ointment can be used as a topical dressing. Discourages proud flesh in horses; speeds granulation of wide, open wounds. May initially cause a tingling or burning sensation for a few minutes but then tissue heals rapidly and cleanly. Can combine tincture or ointment with Hypericum tincture or ointment = "HyperCal", for pain].
3. Very painful lacerations: HYPERICUM. Preserves vitality of torn and lacerated members when almost entirely separated from the body. [Tincture or ointment as above make an excellent wound dressing for painful wounds and burns].
Lynn S. Peck, DVM, MS, Gainesville, FL, USA
2005 SAVMA SYMPOSIUM