British Homoeopathic Journal
July 1998, Vol. 87, pp. 173±177
http://www.stockton-press.co.uk/bhj
Book Review
Homoeopathy: A Critical Appraisal. ed.
Ernst & Hahn. Butterworth Heinemann, 1998.
£25.00, ISBN 0 7506 3564 9
It is refreshing to read a book on homoeopathy
which has no axe to grind; as a result, this one is
sure to have more than its share of detractors.
Falling, as it does, neatly (and deliberately)
between two stools, those who are certain of the
ef®cacy and validity of homoeopathy will
dismiss it for failing unequivocally to endorse
their practice, whilst the orthodox practitioner
will revile it for not concluding that all homo-
eopathy is a sham.
The book is divided into ®ve sections; the
®rst discusses methodology and the gauntlet is
®rmly thrown down by the ®rst author, Walter
Lehmacher of Cologne University. Reminding
readers that clinical studies to date have mainly
been of a poor quality and that the apparent
support for homoeopathy may result from
publication bias, he insists that further rando-
mised controlled trials are urgently needed. It is
not enough to point to the use of homoeopathy
for nearly 200 years ± blood-letting was widely
used for 500 years and this is no vindication of
its clinical ef®cacy.
Nobody wishing to take up this challenge
should do so before reading the next chapter, in
which the requirements of controlled clinical
trials in a homoeopathic context are discussed in
much detail. It is a distillation of the report of the
Research Methodology Subgroup of the Homo-
eopathic Medicine Research Group sponsored
by the European Commission's Directorate
General XII. Harald Walach of Freiburg
University then follows with a useful discussion
of some of the special problems of randomised
trials in homoeopathic medicine, looking parti-
cularly at the effects of randomisation and
blinding on the treatment process and problems
with the attribution of causality.
The bulk of the next section comprises a
systematic review of all provings published
over the last 50 years, carried out by FlaÂvio
Dantas of the University of UberlaÃndia (Brazil)
and Peter Fisher of the Royal London Homo-
eopathic Hospital. This is a meta analysis of
provings, or `homoeopathic pathogenetic
trials' as they prefer to call them, and as far as
173
I know it is the ®rst study of its kind to be
undertaken. The results are not particularly
comforting; most of the 45 reports analysed
were of low methodological quality and there
was an unfortunate trend in the data, that the
better the quality of the study, the fewer effects
were noted. The authors conclude that `Overall
the analysis of the reports revealed methodo-
logical shortcomings which, in our opinion
seriously compromise the validity, reliability
and clinical applicability of the results.'
Next comes a section on ef®cacy and safety,
beginning with an overview of overviews, a
meta meta-analysis, if you like. Noting that
existing meta-analyses have shortcomings, and
at times con¯ict with each other, the seven
authors present their own overview, carried
out to exacting standards and conclude that
`the available trials do not support the hypoth-
esis that all clinical effects of homoeopathic
interventions can be attributed to placebo'.
This is followed by a short review of the
placebo effect by Edzard Ernst of Exeter
University, who dispels a number of common
myths surrounding this. An engaging paper by
David Reilly of the Glasgow Homoeopathic
Hospital, then explores the consequences of
homoeopathy being either wholly attributable
to placebo or not. In either case, there are
exciting challenges for `both the art and science
of medicine'. The section concludes with a
short paper which examines a total of 3447
patients admitted as emergencies to the medi-
cal department of the University of Erlangen.
The three authors conclude that `undesired
clinical events occurring under homoeopathic
treatment would appear to be very rare'.
The most positive view of homoeopathy
comes, curiously enough, not from either of
its traditional areas of healing and provings, but
from laboratory studies. Section four begins
with a paper by Fritz-Albert Popp of the Inter-
national Institute of Biophysics, who argues
from a physical perspective that `there is no
serious argument against the principal validity
of Hahnemann's rules', that is, the similimum
and serial potentisation. Following this, four
researchers from institutes in Greece argue
that clathrate formation, a well-understood
phenomenon in water, could account for the
174
retention of remedy-speci®c information in
potencies. Homoeopathic literature contains
much unsupported speculation; these authors,
unusually, back up their hypotheses with
several experimental studies which support
the model they espouse. Two further papers
in this section deal with various in vivo and in
vitro studies which also lend credence to the
notion that dilutions beyond Avogadro's
number can have demonstrable effects.
The ®nal section deals with socio-economic
aspects of homoeopathy. Three papers show
®rstly that patients who choose homoeopathy
differ from those exclusively using orthodox
medicine, secondly that no suf®ciently rigorous
studies exist, to allow a de®nitive cost-bene®t
analysis of homoeopathy, and ®nally that the
decision makers and service providers of Europe
are surprisingly supportive of homoeopathy.
I felt that there were three notable omissions.
The ®rst was the absence of anything French ±
there has been a good deal of research carried
out in France, some of it very careful and
thorough. For example, the work of Jean
Cambar of the Faculty of Pharmacy, Bordeaux,
on renal tissue cultures and cadmium toxicity,
would have been a useful addition, showing as
it does, clear and reproducible homoeopathic
effects. Secondly, the section on physical
evidence would have bene®ted from a mention
of recent studies using nuclear magnetic reso-
nance (NMR), which seems to show not only
that homoeopathic potencies differ from
controls, but also from each other. Finally,
there was no mention of the increasing body
of veterinary studies involving homoeopathic
treatment of animals. One last issue concerns
the standard of English in some of the papers ±
whilst there were no serious errors, it was
obvious that English was not the ®rst language
of some of the authors and this led in parts to
dense, awkward prose. A little gentle editing by
a native English speaker would have helped.
But quibbles aside, this is an extremely useful
work, which I suspect will become a standard
for years to come.
GALEN IVES
The Spirit of Homoeopathic Medicine:
Essential Insights into 300 Remedies. Didier
Grandgeorge, North Atlantic Books, Berkeley,
California. $20.00, ISBN 155-643-261-5
Didier Grandgeorge is one of France's leading
classical homoeopaths and his book re¯ects his
British Homoeopathic Journal
deep, personal understanding of the remedies
selected. The preface states `know your-
self. . .by listening to others. Ignorance is the
source of all ills'. An apt description of the
sentiment of the book.
Dr Grandgeorge shows `the central psycho-
logical core' of the remedies, in a totally unique
manner. Several homoeopaths including
George Vithoulkas and Rajan Sankaran, have
focused on the psychological pro®le of the
remedies in recent years. None, to my knowl-
edge, have blended Freudian psychology,
miasmatic theory and a deeper spiritual view-
point, as Dr Grandgeorge has in this book.
For this very reason, it will be viewed as
provocative by some, even heretical, and
certainly controversial. The opening paragraph
asks whether illness is a chance event, or
indicative of a deeper, hidden message. Most
can accept the concept of stress-induced
illness, but not all will be fully receptive to
the theories that evolve in the text.
Dr Grandgeorge ®rmly believes that unre-
solved childhood con¯icts lay the foundation of
future illness. `Dis-ease' literally becomes
disease. Using Freudian phases of psychologi-
cal development, he elaborates on them, inter-
twining Hahnemann's miasmatic theory,
religion, mythology and spiritual ideas.
Birth, the struggle of evolving life, is seen as
psora, the oral phase. The development of teeth
marks the transition into the sadistic, or active,
oral phase. One can bite or be bitten.
The anal phase at the time of toilet training is
the choice between law and anarchy, sycosis.
Later the sadistic anal phase begins, and sado-
masochism develops. Dr Grandgeorge
suggests that modern Western society is in
this phase of evolution; concerned totally
with control and materialism. The Oedipal
phase is in evidence with the excessive sexual
liberation. The `less developed' societies are
stuck in psora, struggling for survival.
The Oedipal phase of development, the
con¯ict with the father, relates to the syphilitic
miasm. There is a glorious description of
Aurum metallicum, in which this is more fully
expanded. Moses is credited with using `homo-
eopathic dilutions' of Aurum, when he
pulverises the golden calf, casts the dust into
the waters which the Hebrews then drink. Their
later behaviour con®rms the ®rst homoeopathic
cure!
The issue of right and left-sided symptoms is
explained beautifully, again using Freudian
Volume 87, July 1998
concepts. The left brain, controlling the right
side of the body, is the concentration of math-
ematical thought, strength and the paternal
side. The right hemisphere (left side of the
body) is the artistic, emotional side and that
of the mother. An imbalance between the two,
signi®es deep-seated paternal issues, which
manifest in unilateral physical ailments. The
left brain is that of allopaths, the right brain,
that of (most) homoeopaths.
Using these concepts. Dr Grandgeorge
presents a unique insight into the remedies.
The text is full of information gleaned from
his vast experience, without any great detail on
the symptom pictures. No apologies are made
for this; the reader is referred to other Materia
Medicas which list pathological symtomatol-
ogy, as this is outside the scope and purpose of
the book.
Concise case histories illustrate and expand
the understanding of the remedies.
Each remedy is given a sub-title, which
encapsulates the central issue. Abrotanum is
described as `the Vampire', because those
requiring it seem to drain others physically
and emotionally. Certainly one to remember!
Lachesis is `too far to the left', in other words
the emphasis is too far on the paternal left side.
It is the main remedy for the Oedipal complex,
hence the domination and the deep ingrained
jealousy. Head-lice are prevalent in the chil-
dren of the age group associated with this
emotional phase and Dr Grandgeorge plays
on the French colloquialism `jaloux comme
un pou', as jealous as a ¯ea. The whole nature
of homoeopathy, and the deep division from
`orthodox' medicine may have been very
different had our founder, Samuel Hahnemann,
discovered this snake venom, instead of
Constantine Hering!
Lycopodium, by contrast, is the main remedy
of right-sided complaints and, especially the
liver. A fascinating interpretation is proposed,
using Annick de Souzenelle's view, that the
porta hepatis is symbolic of the narrow gates of
heaven. Once one has passed through, the
spiritual faith achieved will temper the
`biliousness' of human nature. Those requiring
Lycopodium are bound up in their oral/anal
phase and have not yet reached that level of
spiritual enlightenment. Thus their physical
symptoms focus in the gastro-intestinal tract.
Some readers may well ®nd such esoteric
interpretations very dif®cult to stomach!
175
Throughout the book, there are unique
perspectives on polychrests, and lesser known
`rarer' remedies. Natrum muriaticum, for
example, is sub-titled `the father'. Most associ-
ate this remedy with the mother, but Dr Grand-
george challenges this view. The father is the
person who normally causes a rift between
mother and child. It is, therefore, an imbalance
in the father±child bonding which can cause the
well-known Natrum muriaticum state.
Conversely, Pulsatilla takes the place of `the
mother'. Here the mother-child bond is unna-
turally strong and attempts to break it, lead to
the characteristic behaviour patterns and
illnesses associated with that remedy.
Dr Grandgeorge presents an alternative
viewpoint of many remedies, challenging
one's preconceptions. The translation from
the original French is very elegant. Many
puns and witticisms could potentially be lost
in an insensitive translation. An excellent
balance has, however, been struck between a
book that is easy to read and the amusing play
on words. The extremely entertaining French
wording is quoted and explained by means of
footnotes, so that the prose is not laboured or
unnaturally stilted by attempts to provide a
literal translation.
It is very unusual to see such a coherent
analogy between Freudian concepts and mias-
matic theory, and it certainly stimulates deeper
thought. To fully appreciate it, one must
obviously be well acquainted with the remedies.
It is not aimed at beginners in homoeopathy.
Although a few `pathological' remedies are
included, (how could Oscillococcinum be
exempt from a French text!), the main empha-
sis is on a deeper, more spiritual plane. To fully
enjoy it, one must have an open mind.
`Duality reigns on Earth', to quote the
author. The right brain dominant amongst us
will be enthralled by Dr Grandgeorge's ideas,
and will bene®t from his spiritual philosophy.
Those who are bound to the domination of their
left brain, will dismiss it all as pernicious
nonsense. Unless, of course, their mothers
have given them Lycopodium to open their
spiritual portals!
MARYSIA KRATIMENOS
Homoeopathy for the Primary Health Care
Team. Dr Paul Downey, Butterworth-Heine-
mann, Oxford, 1997. £16.99, ISBN 0-7506-
299901
176
This book is written by a GP/homoeopath and
aims to be a comprehensive introductory text
for those working in primary care. It is split into
®ve sections. The ®rst outlines the history and
principles of homoeopathy, its development in
the UK, remedy sources and preparation, and
research. It ®nishes with a brief look at related
therapies.
The second section deals with the process of
taking a full homoeopathic history, repertoris-
ing, remedy and potency selection, follow-up
and the second prescription.
The third section goes through the spread of
conditions seen in primary care, covering a
wide range of illnesses, from respiratory and
musculoskeletal disorders through mental
health and skin, to cardiovascular, gastrointest-
inal and paediatric problems. For each system
there is a list of relevant diseases. For example,
in the respiratory chapter there is croup, hay
fever and asthma, amongst others. Each disease
in turn has a selection of appropriate homoeo-
pathic medicines, along with prescribing indi-
cations.
The fourth section considers homoeopathy
in the context of the practice nurse, the health
visitor, the midwife and the district nurse and
the ®fth comprises a short materia medica and a
brief discussion of the nosodes. Two appen-
dices cover useful addresses, further reading
and some case histories.
The ®rst parts of this book give a broad
overview of the concepts which underpin
homoeopathy. Along with pertinent factual
detail, such as trial data, they also cover how
remedies are made and the historical develop-
ment. There is a ¯avour of the thinking which is
integral to the homoeopathic approach to the
patient. Thus the idea of chronic diseases and
miasms is introduced, along with a step-by-step
guide to the taking of a homoeopathic history
and its subsequent analysis. The danger of this
breadth, rather than length, of discussion, is that
complex subjects (which are likely to be un-
familiar to the reader) are dealt with in a fairly
super®cial way.
The clinical section is comprehensive, both
in the range of conditions and the variety of
homoeopathic medicines suggested. The divi-
sion of the subsequent chapters according to the
relevant professional discipline, is neat and
focused. It would perhaps have been more
thorough to have given exact instructions
regarding administration. The author states,
`For ®rst aid cases, acute cases and keynote
British Homoeopathic Journal
prescribing the 6C or 30C potency repeated
frequently may be appropriate'. `Frequently' in
homoeopathic terms means every ®ve minutes;
in conventional parlance it means four times a
day. For the uninitiated considering moving
into new territory, precise guidance would be
preferable.
The materia medica details the salient points
of forty common medicines, which serves as a
useful reminder to those already familiar with
homoeopathy, and as a reference for the begin-
ner. Suggestions of books to move on to, and
addresses for further information, are helpful.
In conclusion, this book may serve as an
interesting appetiser for those members of the
primary health care team who wish to become
acquainted with homoeopathy. The style is
clear and the author comes across as knowing
what he is talking about whilst remaining
entirely unpretentious. It should be a spring-
board text, from which further exploration and
practical application of homoeopathy will
ensue.
KATHY RYAN
Homeopathy for the modern pregnant
woman and her infant: A therapeutic practice
guidebook for midwives, physicians and prac-
titioners. Sandra J. Perko, San Antonio: Bench-
mark Homeopathic Publications 1997. $59.95
ISBN 0-0653187-0-2
Despite its overly long title, this text is exactly
what it statesÐa homoeopathic guide for use in
practice by those caring for pregnant and child-
bearing women and their babies, although its
hard cover and considerable size probably
preclude its use, on practical terms, as a
`pocket' reference book.
There are several preliminary sectionsÐ
Advisory to the reader, Foreword, Preface,
Acknowledgements, Introduction and an
explanation as to how to use the book, before
an extremely detailed Table of Contents. The
initial pages clearly put the purpose of the
guidebook in context and both the author and
the midwife, Renee Gianopoulos, who has
worked with Sandra Perko, are at pains to
emphasise the need for quali®ed and expert
homoeopathic and obstetric/midwifery care for
the client group. It is indeed refreshing to read
of Renee Gianopoulos' scepticism when she
®rst came in contact with homoeopathy, and to
learn of her increasing fascination with the
bene®ts of the therapy for pregnant and child-
Volume 87, July 1998
bearing women. However, for a textbook of
this magnitude, in size, scope and speci®city, it
would have been more academically credible
to have included some discussion on the avail-
ability, or lack, of research into homoeopathy,
both in general terms and related to maternity
and/or paediatric care. This couldÐand
shouldÐhave complemented the somewhat
super®cial discussion of the safety of homo-
eopathic remedies during pregnancy in Chapter
1.
In Chapter 2, the author has made the
mistake of so many who produce books on
individual therapies and their application to
maternity care, by including general care
guidelines for pregnant women, such as
advice regarding weight gain, blood pressure,
rest and exercise, addictive substances and
environmental hazards. Each section is super-
®cial, occasionally inaccurate or incomplete
and often takes a directive, judgemental or
sensationalist tone. The chapter as a whole is
completely unnecessary, particularly as the
title indicates that the book is geared towards
appropriately trained professionals who should
be well apprised of the relevant research-based
information with which to advise women. The
author should have con®ned herself to her very
considerable expertise in the ®eld of homoe-
opathy and advised readers to refer to other
substantive texts on antenatal, intrapartum,
postnatal and infant care.
However, from Chapter 3 onwards the book
really comes into its own. There is a wealth of
information and extremely comprehensive
coverage of many of the conditions of preg-
nancy and childbirth which may successfully
be treated with homoeopathy. Some of the
more unusual remedies are discussed in order
to give as full a picture as possible of the most
appropriate preparations to use.
The title of Chapter 3, `Morning sickness', is
irritating, especially when symptom pictures
described under some of the remedies relate to
evening or all day nausea and vomiting. The
inaccuracies in professional obstetric terminol-
ogy also include the use of outdated terms such
as `albuminuria' and the totally incorrect
`toxaemia', although this reviewer is not clear
whether these remain acceptable terms in the
USA, for which the book is primarily intended.
Homoeopathically the text is an exception-
ally comprehensive source of accurate, precise
177
information, presented in an eminently read-
able manner, which ®rmly places it in the
realms of core reading for students of homoe-
opathy related to pregnancy and childbirth. The
book certainly compares favourably with the
consumer directed Homeopathy for Mother
and Baby by Miranda Castro (1992, Mac-
millan) and Moskowitz's Homeopathic Medi-
cines for Pregnancy and Childbirth (1992,
North Atlantic Books). Unfortunately,
however, the encyclopaedic wealth of informa-
tion contained here somewhat de®es the
author's intention that it can be used a
ready reference at the bedside. Barbara
Geraghty's Homeopathy for Midwives
(September 1997, Churchill Livingstone)
bene®ts from a tabulated framework which
facilitates quick referral in practice; further-
more, it is more catholic in its range of condi-
tions covered, and includes discussion of
professional midwifery accountability issues
when using homoeopathy, pertinent to both
the UK and the USA. In Perko's defence,
however, it must be stated that the Quick
Keynote Reference section at the end of the
book is probably meant as the short route to
relevant homoeopathic prescribing, although
this has resulted in a degree of repetition.
Several appendices are included, commen-
cing with information for experienced homo-
eopathic midwifes and practitioners and
followed by advice about how to build up the
remedy kit for those who are less experienced.
This reinforces the book's purpose as being
forboth homoeopathic practitioners caring for
pregnant and childbearing women and for
midwives and obstetricians wishing to learn
more about homoeopathy. There are resource
lists (American) of various organisations,
courses and sources of homoeopathic reme-
dies, as well as further reading.
Overall Homeopathy for the modern preg-
nant woman and her infant is good value,
comprehensive and easily readable. With
some reservations regarding this ®rst edition,
this reviewer would recommend it for students
of homoeopathic midwifery, but looks forward
to a second edition in which certain changes
have been made.
DENISE TIRAN