Fisher and Scott (2001) were affiliated to the Royal Homoeopathic Hospital in London and Kings Hospital in London respectively. In other words, these are individuals who specialise in rheumatology and were therefore aware of the various approaches to rheumatoid arthritis treatment prior to writing the paper. They carried out their research for a period of fifteen years having made sure that they included any objections to research design on homeopathy. After completion of their paper, it was submitted to the British rheumatology journal for peer review and was subsequently approved in 2001.
The second paper by Van der Zee (2007) was a case study carried out in Netherlands by an MD. He is a practicing homeopath and is also editor of Homeopathic links. This particular study was published in the latter publication after approximately one year of trying out the new remedy on a patient. However, this article was not peer reviewed.
Analysis of the Papers
Fisher and Scott’s Findings
The research paper by Fisher and Scott (2001) passes the basic criterion for any good scientific research in that it was a controlled trail so utmost consideration was given to the experimental group and the control group represented by homeopathic medicine and placebo ones respectively. Additionally, the researchers also took into consideration other confounding factors which were generally removed or mitigated in the analysis or the actual procedure. For example, they were aware that the placebo effect could affect even members of the homeopathic groups consequently, only the manufacturer knew the code behind the two categories of pillules administered to the patients.
Also, to mitigate this possible placebo effect of homeopathy, randomisation of the patient’s treatment was done such that the two options for treatment were initiated randomly. Furthermore, they were also aware that research measurements could be affected by perceptions of the physiotherapist so they employed a blinded analyst to assess the rheumatic symptoms. Fisher and Scott (2001) were also not careless about the dilution effects of the medications so patients were given instructions concerning the right dosages as dictated by the dilution of the medication. Given such rigorous research procedures, one would therefore be expected to pass off the paper as valid and accurate. In other words, the researchers appear not have violated any blinding or randomisation protocols prescribed in medically based research. However, a deeper analysis at other similar researches illustrates otherwise. Additionally, a deeper look at their methods still leaves some puzzles/questions unanswered.
Fisher and Scott (2001) chose a very sensitive and controversial area to research i.e. alternative medicine. In many biomedical researches, it is often expected that the person carrying out the research should possess a thorough understanding of the theory behind the procedure under analysis. For example, a research on a groundbreaking surgical procedure would be rendered invalid is the author(s) had modest understanding of surgery. However, the same expectations are not carried forward in alternative medicine. Although the authors to this article were well versed with administration of homeopathic medicine, it is debatable whether they are well trained on the alternative modality itself. This may have undermined other aspects of the therapy that may not have been taken into account when carrying out the research. For instance Brien et al (2004) affirm that during interventions for chronic conditions such as rheumatoid arthritis (RA), other factors other than the actual active medicine may come into play and may alter the results of the therapy. For example, the therapist’s attention and handling of patients, the settings of therapy and patient’s point of view can shift outcomes. This implies that homeopathy needs to be looked at holistically as a package rather than as one treatment intervention.
It is evident that Fisher and Scott (2001) did not pay attention to such dimensions as they carried out their research and this may have led them to their null hypothesis. The conclusion made in this paper differs substantially from most research on homeopathy which states that improvement of symptoms often occurs in patients. There are several studies therefore that refute this study and some of them include Taylor et al (2000)’s randomized study. In this work, a randomized controlled trial was rigorously done and the results were found to be positive. Many other previous works on the subject also countered Fisher and Scott’s (2001) findings (Lancaster and Vickers, 2000 and Brien et al, 2004). Since a large number of trials before and after this particular paper’s publishing found that homeopathy does result in positive outcomes then one is left to question any odd findings. Perhaps the authors went wrong in potentisation or administration of the homeopathy. Usually during administration of homeopathic treatments, it is common to find a worsening of symptoms – an aspect that the latter authors also found in their paper.
This is something that is predicted/ anticipated by homeopathic therapists and is considered an important part of the treatment mechanisms for homeopathy. It is possible that the authors were required to wait longer in order to see whether the symptoms of the diseases actually wore off; failure to carry out a longer trial may have altered their results (Taylor et al, 2000). The authors are therefore validating some of the important insights that can be found only in homeopathy. This research’s authors may discredit the usefulness of homeopathy yet certain solutions can only be found in such kinds of studies. Lastly, one can also oppose the findings from this analysis by looking at the sample size made. In previous analyses, the research required a higher number of patients to come to a conclusion. Fisher and Scott (2001) first selected 112 patients but were left with only fifty eight patients after the rest decided to or were forced to withdraw from the RCT. In this regard the p-value required to authenticate findings was altered dramatically and this therefore brings into question the strength of their outcomes. Lancaster & Vickers (2000) often argued that bigger trials are needed for such studies on homeopathy. Given such objections and the fact that Fisher and Scott (2001) findings are so divergent from previous and subsequent research on homeopathy, I believe their research was flawed.
Van der Zee’s Report
Van der Zee (2007) did his research in a clear and complete manner with a thorough explanation of his methodology. He made a point of showing how primary/first simillimum remained ineffective and how he then combined it with complementary simillimum to produce desirable changes. Furthermore, the philosophy behind the findings was fully explained as the author stated that earlier symptoms in patients often become miasms that then hide behind the actual chronic diseases. A need for complementary disease remedies is therefore necessitated in combination with the constitutional simillimum.
Van der Zee (2007) decisions have been sustained by other researches on chronic patients. For instance Naude et al (2010) assert that homeopathic simillimum works for chronic insomnia and that it should be considered as a plausible modality. Other individuals that supported findings made by Van der Zee (2007) include: Polansky (2003) and Chappell (2005). The latter author asserts that during the development of a disease, it is possible to find that a primary simillimum may stop working and it is at this point that the intervention of secondary simillimum may prevent advancement of disease pathology. Other supporters of the findings in the report state that PC complementary simillimum remedies have worked for epidemic diseases and that this is a prerequisite for their functioning in chronic diseases.
The paper written by Van der Zee (2007) has been criticized by its fair share of practitioners as well. For instance Schepper (2007) asserts that proposing that the simillimum can be complemented in chronic cases is inaccurate and tantamount to taking shortcuts in medicine. In other words, he believes that trying to place more than one remedy in a pill and administering it in a short time span to patients could be tantamount to bringing complications to the respective individual. Van der Zee (2007) may have justified his findings based on the fact that these are groundbreaking and contemporary studies yet Schepper (2007) believes that classical ideas in homeopathy are actually the foundation for any respectable article on the practice and that there are reasons why those classical ideas have worked very well. In this regard, the methodology employed in this process may have missed the actual philosophy of homeopathy because the simillimum may have been compromised. Other objections to the study also explain that every disease is often caused by a central disturbance of the vital forces. Only one simillimum can respond to the disturbances in a patient’s body. Therefore, purporting to offer more than one remedy beats this reasoning.
In my judgment, I believe that Van der Zee (2007) may have been justified in his research by asserting that a simillimum can be complemented in chronic cases. This is because although theoretically only one simillimum can exist for a certain disease, it may be almost impractical to find all the information needed to find it. Usually getting to this simillimum depends on finding the right causation, location and modalities. In instances where modalities and locations are too widespread then it may be impractical to depend on one simillimum. Van der Zee (2007) focused on the analysis of complex chronic diseases i.e. toxoplasmosis and chronic headache. Therefore, it is indeed realistic to employ more than one simillimum and this renders strength to his research. I therefore agree with his findings.
References
Brien, S., Lachance, L. & Lewith, G. Are the therapeutic effects of homeopathy attributed to the remedy, consultation or both? Journal of complementary and alternative medicine. 10(3), 499.
Van der Zee ((2007). Complementing the simillimum in chronic cases. Homeopathic links, 20(36-39).
Polansky, H. (2003). Origin of chronic disease. Center for biology of chronic disease, 21(45).
Chappell, P. (2005). The second simillimum. Harne: Homeolinks publishers.
Naude, D., Couchman, I. & Maharaj, A. (2010). Efficacy of homeopathic simillimum. Journal of Homeopathy, 99(2), 151.
Taylor, M., Reilly, D., Llewellyn-Jones, R., McSharry, C. & Aitchison, T. (2000). Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. British Medical Journal, 321(3), 471–476.
Lancaster, T. & Vickers, A. (2000). Commentary: Larger trials are needed. British Medical Journal 42(3), 54.
Schepper, L. (2007). Achieving and maintaining the simillimum. New Mexico: Full of life publishers.