Homeopathy is the modality most difficult to describe in this series on alternative forms of medical treatment for horses. For one thing, even its most ardent advocates and learned practitioners don't know exactly how it works. For another, there has been little research involving homeopathic treatment of horses.
While homeopathy has been used since ancient times in one form or another, a German physician named Samuel Hahnemann is considered the modern-day founder of this form of medical treatment.
Hahnemann was a physician who was revolted by the medical treatments of his day. Granted, when looked at in the light of modern medicine, some of those treatments were cruel and barbaric. They included blood-letting, administering large doses of toxic materials such as mercury, giving the patient heavy doses of purgatives to clean out the bowels, and heavy sweating to cleanse the system.
Hahnemann spent a good deal of time in translating new and old medical texts in and out of his native German. It was during this work that he developed the "theory of similars" that is basic homeopathic law. Homeopaths maintain that "like cures like."
During the next six years of his life, Hahnemann conducted a number of experiments to prove his theories, often using himself as the test subject. The first experiment, conducted on himself, involved quinine or Cinchona. He found that taking quinine actually produced symptoms similar to malaria, which quinine is used to treat.
In essence, his experiments involved attempting to cause disease, then using the same substance in diluted, potentized form to treat the problem. In 1796, Hahnemann published his findings, and the science of homeopathy as we know it today was born. It is practiced worldwide, sometimes by physicians and veterinarians and, at other times, by people without those credentials who have been trained in the field.
Hahnemann and modern-day homeopaths have taken the stated position that they treat the patient, not the disease.
One veterinarian who utilizes homeopathy in her practice is Susan Wynn, DVM, of Atlanta, Ga.
She gave this description of homeopathy:
"His (Hahnemann's) system of treatment as it stands today utilizes very low doses of substances to resolve syndromes which they might actually cause in higher doses. A very simple example is the use of homeopathic ipecac to treat vomiting. (Taken in larger doses, ipecac induces vomiting)
"Homeopathic remedies, as they are called, are prepared in a very specific manner. The original substance is usually from a natural source, such as plants or minerals, and is progressively diluted and potentized by violent shaking at each step, until the final remedy often, theoretically, contains none of the original substance. Theories for the mechanism of action include some form of electromagnetic 'memory' on the water used to dilute the substance.
"Homeopathic researchers have discussed everything from fractal geometrics involving molecules of water and magnetite, to stress responses to the remedy, where heat shock proteins are used as an example. Although homeopathic research is in its infancy regarding mechanism of action, clinical trials have indicated that the remedies do work despite the fact that the mechanism is unclear.
"Because homeopathy seems to work at the subatomic and, potentially, molecular genetic levels, rather than the pharmacological level, the methods for diagnosing and treating disease are entirely foreign to traditional medical thought.
"For instance, two dogs with parvoviral enteritis may look a little different initially--one may have started with vomiting and increasing depression, while the other broke with hemorrhagic diarrhea. The homeopath views these different manifestations as individual differences in the state of the patient's vital force; therefore, they would receive different prescriptions.
"Homeopathy is said to treat the patient, not the disease. Since the remedies work to assist the vital force in healing the body, one Indian homeopath described the system as 'teaching the body to heal itself.' "
The "vital force" that Wynn mentioned is what the acupuncturist would call chi, which means life force.
In his published works, Hahnemann set forth the theory that the essence of illness is a disorder in the vital force. When there is a disorder of this nature, he contended, people are susceptible to various diseases and afflictions. When the integrity of the vital force is restored, the whole organism recovers health and the disease is cured.
Hahnemann felt that the effects of a single disorder in the vital force could result in many signs and symptoms throughout the patient. By looking at the overall picture, he felt, an understanding of how the vital force had been disturbed would emerge, even though the vital force itself couldn't be directly examined. The administration of homeopathic remedies, he was certain, could correct and set right the patient's vital force.
What this means in practical terms, said Wynn, is that knowing a complete medical history of a patient, be it human or animal, is crucial in determining appropriate homeopathic treatment.
Knowing the animal's history, she said, can result in administering two totally different remedies for the same malady. She used, as a theoretical example, two horses which are being treated for rain scald. If the homeopath found, by examining the medical history of the two equines, that one had been foundered and the other had suffered from strangles as a young foal, the remedies administered might be totally different, although both suffer from rain scald. Because of their differing past medical problems to which each would have responded in a certain way, she explained, each horse would respond to a specific treatment for rain scald in a unique way.
A problem for the homeopath in dealing with horses, she said, is that they often have multiple owners without medical histories being transferred with ownership. It is simpler with dogs, she said, because they frequently have the same owner for life, and the owner knows and remembers the animal's medical history.
This means, of course, that the homeopath must understand each of the remedies available. This can involve some serious studying since about 2,000 remedies are known. As a practical matter, said Wynn, less than 300 of those remedies are used with frequency.
One of the key factors in the preparation of all remedies, she said, is the shaking of the substance during the dilution process. It adds energy, she said, but no one knows how.
Interestingly, although the vital force discussed by the homeopath is similar to that dealt with by the acupuncturist, the two modalities are not compatible. For some reason, said Wynn, the use of acupuncture in conjunction with a homeopathic remedy will mitigate the positive effects of that remedy.
One of the most difficult things for the layman to comprehend about homeopathy is the minute quantity of a given remedy that is involved.
The dilution and potentization of medicines work something like this:
The homeopath starts with a solution of established chemical strength. Then one part of the solution is added to 99 parts of a diluent, such as water. The dilution is shaken violently by a mechanical device. This new dilution is described as being 1C potency because it is a 1:100 dilution of the original solution. The C stands for centesimal.
That initial step, however, is often only the beginning. Next, one part of the 1C solution is further diluted by taking one part of it and adding 99 parts of a diluent. Again, the new dilution is shaken violently. The new solution is then labeled as 2C potency. Its actual strength is l:10,000 of the original solution.
In a number of re-medies, Wynn said,
the original substance might be diluted as many as 30 times or more, until, in a manner of speaking, the original substance no longer exists. Yet, homeopaths maintain, the remedy will have a positive effect, with the dilution being determined by the needs of each individual patient.
Wynn was quick to say that homeopathy is not for every animal patient. For example, she explained, horses which have received heavy dosages of drugs in the past often are not good candidates for homeopathic treatment.
Just as homeopathy and acupuncture are not compatible, so it is with homeopathy and prescription drugs.
At present, Wynn is concentrating on a small animal practice. She is most apt to use homeopathy on patients that manifest inappropriate behavior along with a physical problem.
While Wynn is involved primarily with small animals, she does have an anecdotal example of how homeopathy helped her geriatric horse. The horse, she said, was about 30 years old and had gone off feed. A blood workup indicated the horse was suffering from an infection. She treated it with an antibiotic, but with no positive results. She tried another antibiotic, but it also had little or no effect.
She decided to try a relatively common homeopathic remedy. She administered one dose and the following day, the horse was eating again and appeared to have completely recovered.
While there has been little research on the use of homeopathic remedies with animals, there has been some research in the human field that indicates homeopathy can be a viable modality.
Dana Ullman, M.P.H., who has written extensively on homeopathy, discusses some of this research in the publication Consumer's Guide to Homeopathy, and also makes a case for utilizing homeopathy in treating a variety of ailments.
He began his discussion this way: "Some skeptics insist that research on homeopathy is mandatory since the exceptionally small doses used do not make sense and there is no known mechanism of action for these drugs. While it is true that homeopaths presently do not know precisely how the homeopathic microdoses work, there are some compelling theories about their mechanism of action.
"More important, there is compelling evidence that they do work. And, although homeopaths may not understand how their medicines work, keep in mind that leading contemporary pharmacologists readily acknowledge that there are many commonly prescribed drugs today, including aspirin and certain antibiotics, whose mechanism of action remains unknown, but this gap in knowledge does not stop physicians from prescribing them.
"Many conventional physicians express doubt about the efficacy of homeopathy, asserting they will 'believe it when they see it.' It may be more appropriate for them to acknowledge that they will 'see it when they believe it.' This is not meant as a criticism of conventional physicians as much as of conventional medical thinking.
"The biomedical paradigm has narrowed the view of the thinking about, and the practice of, medicine to the treatment of specific disease entities with supposedly symptom-specific drugs and procedures. An integral aspect of this approach to medicine is the assumption that the larger the dose of a drug, the stronger will be its effects.
"While this seems to make sense on the surface, knowledgeable physicians and pharmacologists know that it isn't true. There is a recognized principle in pharmacology called the 'biphasic response of drugs.' Rather than a drug simply having increased effects as its dose becomes larger, research has consistently shown that exceedingly small doses of a substance will have the opposite effects of large doses.
"The two phases of a drug's actions--thus the name biphasic--are dose-
dependent. For instance, it is widely recognized that normal medical doses of atropine block the parasympathetic nerves, causing mucous membranes to dry up, while exceedingly small doses of atropine cause increased secretions to mucous membranes."
Ullman then went on to discuss some of the research that has in-volved homeopathy. In 1991, he said, three professors of medicine from The Netherlands performed a meta-analysis of 25 years of clinical studies using homeopathic medicines and published their results in the British Medical Journal. Meta-analysis is a systematic review of a body of research that evaluates the overall results of experiments.
This meta-analysis covered 107 controlled trials. Of that number, 81 demonstrated that homeopathic medicines were effective, 24 showed they were ineffective, and two were inconclusive.
Specifically they found that:
* Thirteen of 19 trials showed successful treatment of respiratory infections.
* Six of seven trials showed positive results in treating other infections.
* Five of seven trials showed improvement in disease of the digestive system.
* Five of five showed successful treatment of hay fever.
* Five of seven showed faster recovery from abdominal surgery.
* Four of six promoted healing in treating rheumatological disease.
* Eighteen of 20 showed benefit in addressing pain or trauma.
* Eight of 10 showed positive results in relieving mental or psychological problems.
* Thirteen of 15 showed benefit from miscellaneous diagnoses.
Ullman had this comment on the research:
"Despite the high percentage of studies that provided evidence of success with homeopathic medicine, most of these studies were flawed in some way or another. Still, the researchers found 22 high-caliber studies, 15 of which showed that homeopathic medicines were effective.
"With this knowledge, the researchers of the meta-analysis on homeopathy concluded: 'The evidence presented in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain indications.' "
Another study discussed by Ullman involved a recent clinical trial evaluating the administration of homeopathic medicine for the treatment of asthma. Researchers at the University of Glasgow used conventional allergy testing to discover the substance to which the asthma patients were most allergic.
Once this was determined, the patients were randomized into treatment and placebo groups. Those patients chosen for treatment were given the 30C potency of the substance to which they were most allergic. The most common substance was the house dust mite. The end result, with patients being examined by both homeopathic and conventional physicians, showed that 82% of the patients given the homeopathic remedy improved compared to 38% who experienced relief from the placebo.
There also have been some studies with animals that resulted in a positive outcome when homeopathic remedies were used. In one instance, a herd of 130 sows was exhibiting an unacceptably high rate of stillbirths--around 20%. The death rate remained unaltered despite extensive investigations and management efforts.
The homeopathic remedy, caulophyllum 30C, was used in a test trial because of its reputation in being beneficial in all aspects of parturition, from first stage labor to beyond final stage labor.
Twenty sows were involved in the test--10 in the treatment group and 10 in a control group. The remedy was administered in the food twice weekly three weeks before farrowing.
The control group had eight out of 10 (80%) of the sows having stillbirths, while the treatment group had three out of 10 (30%) with stillbirths.
When treatment of the whole herd was adopted, the piglet mortality fell during the following four months to 2.6%. When the caulophyllum treatment was stopped in the sixth month of the monitoring period, mortality rose steadily until it reached 14.9% by the end of the eighth month. Treatment then was reinstated, and in the ninth and tenth months, mortality fell again--this time to 1.9%.
Homeopathy, said Wynn, appears to be growing in popularity, with many animal owners expressing an interest in this form of healing.
"Homeopathy is a well accepted and popular form of therapy in most parts of the world for all species," she said. "In using homeopathic and other holistic treatment options in addition to any required conventional therapies for a sick pet, you are providing additional, complementary aids that will help an animal become strong again."
Wynn is a strong believer, along with the AAEP and AVMA, that individuals practicing homeopathy should have medical training.
The AAEP addressed homeopathy, herbology, and naturopathy thusly in its pamphlet on therapeutic options: "Although many currently available medications are derived from plant and other natural substances, these modalities refer to the use of such medical substances which have not undergone usual rigorous drug approved processes."
The AVMA, in its Guidelines for Alternative and Complementary Veterinary Medicine, approved in 1996, also issued a word of caution (see sidebar page 50).
So, while there are professionals, veterinarians, and others, who believe in homeopathy, there is practically no scientific research on this therapeutic option. And even those who practice this alternative form of treating animals can't tell you exactly why it works, only that they believe from their experience that it does.
About the Author
Les Sellnow is a free-lance writer based near Riverton, Wyo. He specializes in articles on equine research, and operates a ranch where he raises horses and livestock. He has authored several fiction and non-fiction books, including Understanding Equine Lameness and Understanding The Young Horse, published by Eclipse Press and available at www.exclusivelyequine.com or by calling 800/582-5604.