In 1910 the Carnegie Foundation issued the famous/infamous Flexner Report. The Flexner Report was an evaluation of American medical schools chaired by Abraham Flexner, in cooperation with leading members of the A.M.A. (60) While pretending to be objective, the Report actually established guidelines meant to sanction orthodox medical schools and condemn homeopathic ones. The Report placed the highest value on those medical schools that had a full-time teaching faculty and those schools that taught a pathological and physiochemical analysis of the human body. Homeopathic colleges were faulted because of their preference for employing professors who were not simply teachers or researchers but also in clinical practice. Although homeopathic schools included many basic science courses, they also had courses in pharmacology which the Flexner Report did not consider worthwhile.
As one might easily predict, the homeopathic colleges on the whole were given poor ratings by the Flexner Report. As a result of the report, only graduates of those schools which received a high rating were allowed to take medical licensing exams. There were 22 homeopathic colleges in 1900, but only two remained in 1923. (61)
These schools were not the only ones hurt by the Flexner Report. Of the seven black medical schools, only two survived. The Report also contributed to a 33% reduction in women beinggraduated from medical schools. (62)
As a way of coping with new guidelines and in order to pass the new licensing exams that stressed the basic sciences, homeopathic colleges decided to offer more education on pathology, chemistry, physiology, and other medical sciences. Although they offered better education on these subjects, their homeopathic training suffered greatly. (63) As the result, the graduates from these homeopathic colleges were less able to practice homeopathy well. Instead of individualizing medicines to a person's totality of symptoms, many homeopaths began prescribing medicines according to disease categories. The consequences from this type of care were predictably poor results. Many homeopaths gave up homeopathic practice, and many homeopathic patients sought other types of care.
There were other reasons for the sharp decline of homeopathy after the turn of the century. Orthodox medicine was no longer as barbaric as it was in the 1800s, and because of this, it didn't drive as many patients away. Orthodox physicians also began incorporating several of the homeopathic medicines into their practice. Although they didn't prescribe the same small doses as the homeopaths, their use of certain homeopathic medicines confused the public, who were having increasing difficulty in distinguishing orthodox physicians from homeopathic physicians. (64)
Another factor in the decline of homeopathy was itseconomic viability. Good homeopathic practice required individualization of the patient which demanded more time than most orthodox physicians gave to their patients. Since economics governs the way medicine is practiced more than is commonly recognized, the fact that physicians in the 20th century could make more money practicing orthodox medicine is a significant factor that led to homeopathy's decline.
Perhaps history could have been changed if John D. Rockefeller, a strong advocate of homeopathy, gave the major grants he intended to homeopathic institutions. He had instructed his financial advisor, Frederick Gates, to do so. Since Gates was totally enamored with orthodox medicine, he never complied with Rockefeller's orders (65) This loss of potential funding was tragic, since Rockefeller gave away between $300-$400 million in the early 1900s, most of which went to orthodox medical institutions. (66)
The drug companies' antagonism to homeopathy continuedsignificantly to the collective efforts to suppress this form of medicine. Because the drug companies published medical journals, they could use them as mouthpieces against homeopathy and in support of orthodox medicine. Even the Journal of the American Medical Association acknowledged that "the medical press is profoundly under the influence of the proprietary interests (drug companies)." (67)
Along with the various external factors that hindered homeopathy's growth, there were problems amongst homeopaths themselves. Disagreement within homeopathy has a long tradition. Hahnemann demanded that his followers practice precisely the way he did, "He who does not walk on exactly the same line with me, who diverges, if it be but the breadth of a straw, to the right or to the left, is an apostate and a traitor." (68) As one could predict, many homeopaths did not practice as Hahnemann did.
The most famous homeopaths in the U.S. were primarily Hahnemannians. However, the majority of homeopaths practicing in this country did not prescribe their medicines on the basis ofthe totality of symptoms, but primarily according to the chief complaint. These homeopaths prescribed medicines for specific diseases, and sometimes, they prescribed one medicine for person's headache, another for the digestive disorder, and another for the skin problem. Hahnemann and his followers were particularly adamant about the use of only one medicine at a time, and Hahnemann referred to those practitioners who used more than a single medicine as "pseudo-homeopaths" and other less kind things.
Throughout his life, Hahnemann used primarily medicines that were potentized 3, 6, 9, 12 or 30 times. Towards the end of his life, however, some of his colleagues experimented successfully in using medicines that had been potentized 90, 200, 1,000 or 10,000 times. In 1829 Hahnemann wrote a letter to a friend expressing disbelief in the effectiveness of these medicines. He was also concerned that the public would not place trust in homeopathy if practitioners utilized such extremely dilute medicines. He recommended that homeopaths not use anything more dilute than the 30th potency. (69) Later, Hahnemann acknowledged that these higher potencies* had effect, though there is no record of him ever using a medicine higher than the 1,500 potency.
[* Higher potency medicines are those which have been potentized 200, 1,000, 10,000, 100,000 or more times; lower potencies are potentized 3, 6, 9, or 12 times; a medium potency is one potentized 30 times]
After Hahnemann's death, the vast majority of Hahnemannian homeopaths adopted the higher potencies. The low potency homeopaths, however, were not converted, and the stage was set for yet another opportunity for disagreement between homeopaths. The high and low potency schools of thought developed separate organizations, hospitals, and journals. In 1901, because of the various disagreements among homeopaths, Chicago had four different homeopathic medical societies.
The poor training that the homeopathic schools offered after the turn of the century ultimately discouraged the rigorous approach that the Hahnemann method required.
From 1930 to 1975 there are not many horror stories of the A.M.A.'s oppression of homeopathy, primarily because it seemed that the AMA had already won the war. By 1950 all the homeopathic colleges in the U.S. were either closed or no longer teaching homeopathy. There were only 50-150 practicing homeopathic physicians, and most of these practitioners were over 50 years old.
And yet, it is hard to suppress the truth. Homeopathy has risen again, and this time, history will be rewritten.
The Present Status of Homeopathy
(this was written in 1991 and is therefore a bit dated)
Homeopaths throughout the world experienced varying degrees of opposition from orthodox physicians, but not anywhere near the systematic or intense attacks as those beset upon them by American doctors. When homeopaths have been given a relatively free environment to practice, homeopathy has been able to grow and flourish.
Homeopathy is particularly popular in Great Britain where the Royal Family has been under homeopathic care since in 1830s. (70) The New York Times noted that visits to homeopathic physicians are increasing in England at a rate of 39% per year. (71) A British consumer organization surveyed its 28,000 members and discovered that 80% had used some form of complementary medicine* and that 70% of those who had tried homeopathy were cured or improved by it. (72) Not only is there growing interest from the general public, there is also surprising acknowledgement of homeopathy by conventional physicians. The British Medical Journal recently published a survey of the attitudes of British physicians toward practitioners of complementary medicine. The survey discovered that 42% of the physicians surveyed refer patients to homeopathic physicians. (73) A different study published in The Times of London found that 48% of physicians referred patients to homeopathic physicians. (74) A study published in the British Medical Journal which noted that in a survey of 100 recently graduated British physicians, 80% expressed an interest in being trained in either homeopathy, acupuncture or hypnosis. (75)
(* In Great Britain and to a small extent in the U.S. "complementary medicine" or "complementary therapies" is replacing the term "alternative medicine" or "alternative therapies." Advocates of complementary therapies assert that their therapies are not "alternative" but are a growing part of mainstream medicine.)
This impressive growth in Great Britain is being matched in France. A recent survey of French doctors revealed that approximately 11,000 utilize homeopathic medicines, approximately 25% of the French public have tried or are presently using homeopathic medicines, and over 20,000 French pharmacies now sell homeopathic medicines. (76) This survey also noted that courses in homeopathy leading to a degree are offered in six medical schools. Homeopathy is taught in all pharmacy schools and in four veterinary schools. Homeopathy is growing so rapidly in France that a recent cover story of Le Nouvel Observateur, one of France's leading magazines, noted that President Mitterand and six medical school deans had called for more research on homeopathy. (77) The authored editorialized, "It is a fact that homeopathy obtains results, sometimes spectacular results."
In 1981 the Dutch government published a report on Alternative Medicine in The Netherlands in 1981 which concluded that 20% of the Dutch public utilize alternative healing methods. The report also noted that homeopathy is one the most popular therapeutic modalities. (78)
Homeopathy is widespread in Europe, but it is even more popular in Asia, especially India, Pakistan, and Sri Lanka. Homeopathy spread in India, in part, because of the support it received from Mahatma Gandhi who was reported to have said that it "cures a greater number of people than any other method of treatment," but also because it has been effective in treating many of the acute infectious conditions and the chronic maladies on the subcontinent. As an article in the World Health Organization's journal World Health Forum noted, "Homeopathic treatment seems well suited for use in rural areas where the infrastructure, equipment, and drugs needed for conventional medicine cannot be provided." (79) Homeopathy is also considerably cheaper than conventional medicine, and any person, not just physicians, can learn to use a small number of medicines for simple common complaints.
Presently, there are over 120 four- or five-year homeopathic medical schools in India. Nineteen of the colleges are maintained by the state, most of which are affiliated with universities. (80) It has been estimated that there are over 100,000 homeopathic practitioners in India. An article in the World Health Forum acknowledged that, "In the Indian subcontinent the legal position of the practitioners of homeopathy has been elevated to a professional level similar to that of a medical practitioner." (81) Homeopathy is not as popular in South America as it is in Europe or Asia, but it is still widely utilized. Homeopathy's popularity in Argentina dates back to General San Martin, the country's greatest hero, who was reported to have taken a kit of homeopathic medicines across the Andes in his efforts to free Chile and Peru from Spain in 1816. One of Argentina's most respected homeopathic physicians, Dr. Francisco Eizayaga, has estimated that there are now approximately 2,000 doctors in Argentina who practice homeopathy and approximately 3 million of Argentina's 30 million people have used homeopathic medicines. (82)