In the Hippocratic conception, medicine is a synthesis of technique, philosophy and humanism, but in essence it is nothing more than the expression of the living being to counter predestination. Its foundation is the dose–response relationship that a living organism expresses when perturbed by an external agent. In practice, however, this interpretation is defined by the knowledge, thought, economic means, politics and religious sentiment of the community to which the organism belongs. Homeopathy, too, does not escape these considerations. It is a child of the vitalistic philosophy of the time when it was formulated by a giant of human history, Samuel Hahnemann. At that time, knowledge did not allow for the biological definition of disease, but simply the acceptance or rejection of the Hippocratic view of the symptom as an attempt at self-healing.

As a therapeutic modality, therefore, homeopathy was formulated by its founder as an intervention aimed at promoting the self-healing of an organism, postulating that this act was defined by the response that the organism engaged to counter an anomaly. Consequently, the therapeutic method had a heuristic nature, independent of any knowledge of the nature of the homeopathic remedy or the biological mechanisms underlying the administration of such a remedy. In fact, the therapy implied a personalized intervention that did not necessarily foresee its definition within a general scheme.

These foundations have two unfortunate consequences. The first is that the pursuit of homeopathy involves a self-limiting characteristic, not foreseeing the development of the therapeutic modality. The second is that homeopathy is not easily generalizable, not favoring its uptake in medical practice in places designated for the removal of anomalies in a large number of people, such as in a hospital. But what is more important is the fact that it a priori avoids conceiving a definition of reality, as the scientific method pursues with experiment and reproducibility, assuming as real what is exact and not necessarily what is true. This is the primary reason that causes the potential marginalization of homeopathy, because in a society that bases its evolution on the canons that defined the Scientific Revolution, a therapeutic modality that after two centuries does not strive to justify its foundations, limiting itself to the free subjective interpretation of those who pursued it, questions its own right to existence. Therefore, if Hahnemann promoted a view that was astonishing for its inherent foresight, anticipating many concepts of modern health care, the problem resides in the fact that he was unable to notice the fragility of his own perspective.

The founding of experimental medicine by Claude Bernard, the misinterpretation of Pasteur's discoveries and the exaltation of Koch's discoveries rendered Hahnemann's vitalistic conception obsolete. In fact, they promoted the creation of an orthodoxy rooted in the social pact between public institutions and professional orders, defining an official medicine model that entails the adoption of a certain culture and not proven capability. From this, homeopaths were excluded or at most tolerated. Because if “science” was an inadequate word, it was enough to replace it with the locution “demonstration of efficacy”, which lent itself better to the interested intervention of some, but which the personalization of the homeopathic method did not allow to justify.

Medicine did not consider that by adopting a Cartesian mechanistic model, it justified the absurdity of administering 10 million molecules of a drug per cell of an organism with predictable health damage. But to establish itself, it entrusted pharmacology with the task of establishing an efficacy criterion based on a certain minimum dose of the drug (threshold model), ideologically postulating the non-authentic nature of a methodological approach that envisaged dilutions and the action of infinitesimal doses.[1] [2] Indeed, in postulating the view of the organism as a machine, and valuing the preservation of the structure over maximum function, the disease was attributed to the malfunction of a mechanism, which must be inhibited (or removed). Therefore, the experimental evidence showing the existence of self-healing processes, stimulated by low-dose interference, was consciously disregarded. With this behavior, to affirm itself, biomedicine distorted experimental reality. But this conduct took place because neither the essence of the vital process nor the physiology of biological systems was then known. Their partial elucidation has occurred in the past 80 years.

While homeopaths withdrew—as they still do, entrenching themselves in fideistic positions or displaying “bird of the woods” behavior in Hobbesian terms—homeopathy postulated a view similar to the “immobile motor” (unmoved mover) of the Western metaphysical tradition: “mover” because it is the final goal toward which the organism tends, thus justifying self-healing, and “unmoved” because it is an uncaused cause (i.e., the first primary cause). In this view, homeopathy does not need to improve its identity, being already realized in itself as a pure act in its ontological nature, as Hahnemann intrinsically postulated. Therefore, industries did not promote pleonastic investments for scientific research programs since they believed that the therapeutic modality of homeopathy did not require it. Indeed, homeopaths observed with indifference the fact that scientific progress explained the existence of life, the dimensions and functions of cells,[3] and the fact that the heart must beat.[4] This was achieved, along with biological research,[5] [6] through the Science of Complexity,[7] [8] Information Theory,[9] and the introduction of Far-from-Equilibrium Thermodynamics.[10] In fact, the new approach justifies the dose–response interaction of a living organism in aging, hormesis, premature senescence, apoptosis and necrosis as a function of the increasing intensity of a perturbation, such as the ingestion of a drug.[11]

Having translated the dose–response into a more general framework, the following considerations are obtained. The world moves toward disorder, and the ordered features of living beings can be justified only by assuming that their existence constitutes a tool for facilitating the achievement of a more disordered status. In practice, being healthy means efficiency in exporting disorder, while disease represents a reduced efficiency to do so. The interaction of a xenobiotic with a living being always involves damage, but the software of living beings is programmed to counter this action through existing repair mechanisms and the evolution of more efficient ones. Therefore, therapeutic methods are aimed at stimulating self-repair mechanisms or inhibiting certain biological processes, thus allowing the restoration of optimal health. Premature senescence is a phenomenon that can result from an excess of drug molecules postulated by orthodox medicine to induce the inhibition of a certain biological mechanism that can cause a permanent alteration of cells' metabolic mechanisms, resulting in so-called adverse effects.

Hormesis is the only process that can be beneficial, as it promotes the creation of more efficient modes of cell functioning in metabolizing, synthesizing and storing useful molecules, as well as facilitating the elimination of waste products, unlike biomedicine.[12] [13] [14] In practice, hormesis justifies evolution but also directs the organism to benefit from breathing, proper nutrition and physical exercise, promoting behavior that implies increased lifespan. It practically summarizes the concepts we condense into the word “well-being” but, more importantly, it promotes self-awareness about the meaning of existence and the interaction of a living being with the territory where it lives. Only in the case of a therapeutic modality was it not justified to talk about hormesis, primarily because it justified homeopathy,[1] [2] and therefore it had to be forgotten; but even today, when pharmacology has had to accept it because experimental evidence cannot be hidden for long, hormesis tends to be not talked about within the homeopathy community because many of its practitioners, in pursuing the abovementioned “immobile motor” belief, do not want to accept hormesis and thereby prompt an alliance with the holders of patents for drugs used by orthodox medicine.[15] [16]

Indeed, hormesis entails an enantiodromic effect (stimulatory at low doses, inhibitory at high doses) as a function of the intensity of perturbation, such as the number of molecules of a drug, which, justifying the principle of “Similia similibus curentur”, would provide a specific foundation to a method that, being holistic, is considered not to require specific justification. Therefore, the fact that two groups of researchers have independently demonstrated with DNA arrays that homeopathic remedies have a biological action consistent with that supported by manuals and that this action follows the rules of hormesis,[17] [18] [19] should not constitute proof. Those who hold the patents, on the other hand, see it as “smoke in the eyes” because they might find out that their drugs, due to unfavorable pharmacokinetics, could go from being inhibitors to stimulators, with non-exciting effects for those who use them. But for Dr. Peter Fisher, former Editor of Homeopathy, it was enough to promote interest, and after attending a scientific session dedicated to hormesis, which I organized 12 years ago at an international conference, he decided to ask me to act as Guest Editor for a special issue of this journal dedicated to the topic of hormesis.

For the average homeopathic practitioner, however, the existence of drug molecules in a homeopathic remedy may be acceptable, but there has always been the problem that an effect of ultra-diluted solutions cannot readily be explained because from 12C potency onwards it has been taught that there can be no molecules. Therefore, to justify the action of ultra-diluted homeopathic remedies, there must be another mechanism. Better to think of two homeopathies: one “hormetic” with molecules; and one without, which envisages the existence of another biologically active agent. Nevertheless, the fact remains that the action of a drug is singular and essentially involves the allosteric alteration of the receptor, which triggers a certain response after interaction with a drug. This is true for all living beings, from the amoeba to the elephant, as stated by Monod,[6] because the cell only presents optimal responses.

The objection often made that homeopathy is limited to gene activation is the result of those objectors' personal interpretation of biology. Gene activation involves an interaction between genes and a molecule, exactly as in the case of the drug–receptor interaction: they are different processes, I agree, but they follow the same paradigm, and the distinction is specious. Therefore, the homeopath is inclined to introduce hypotheses, even strange ones, to justify the action of the drug, in most cases keeping an eye on the solvent. But if the solvent plays a determining role, it would not be possible to justify the fact that a homeopathic remedy has the same effect when prepared according to different pharmacopeias; nor would it be possible to understand the effect of dilution, as hormesis justifies.

Of course, there is always the possibility of the existence of paraphernalia properties, invoking electromagnetism, for example, as some hypothesize.[20] [21] Unfortunately, faith can help existence, exemplified in the person who “can't change his mind and won't change the subject” (a Churchillian aphorism). However, it is also true that science is demented like democracy, based on dissent; but science also implies the correctness of the experiment and the measurement. Electromagnetism in homeopathy has not been verified in the experiments publicized so far. Those who conducted them forgot to check Google, and the supposed devices that were assumed to demonstrate such a claim were rejected by the patent offices because they could not work.[22]

Fortunately, however, there are also expressions of wisdom, as summarized by the principle of Ockham's razor, which has led people to argue that the effect of homeopathic remedies does not lie in the solvent but, as with all drugs, in the molecules of the drug.[23] [24] Unfortunately, in the eyes of fundamentalist homeopaths, this is the result of ethically unjustifiable observations, as they result from experimental evidence, in blatant contradiction to the principle that “the holistic approach of homeopathy as healing system goes far beyond any specific information”.

In the past 10 years, three independent research groups (Jayesh Bellare, Iris Bell, and Alexander Konovalov) have convincingly demonstrated that highly diluted drug solutions contain nanoparticles,[23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] [34] much like the drugs used in modern pharmacology to reduce adverse therapy effects and improve membrane transport.[35] [36] [37] These nanoparticles, measuring 100 to 300 nm, start forming from a certain dilution threshold (10−5 to 10−7 M) following succussion, which facilitates the transfer of metasilicates from the container walls and the dissolution of air, thereby requiring a certain gas molecule/drug molecule ratio. Metasilicates are necessary to form a coating around a core of drug molecules,[33] and the air helps create a more structured “cage” compared with the solvent alone. Gases dissolve in water forming clathrates (cages),[38] and these clathrates, along with metasilicates, stabilize the core of the drug particles.

These findings lead me to define a homeopathic remedy as a “clathrate of clathrates of gas molecules”. present as nanobubbles. This is confirmed by the fact that heating to 70 °C causes the nanoparticles to disappear along with the remedy's efficacy,[21] as the gas solubility decreases when heated. It is astonishing that something so elementary had not previously been highlighted in over two centuries of history, underscoring the poverty of scientific research in homeopathy and the superficiality with which production industries have addressed the subject. The chemical–physical characterization of these nanoparticles indicates that their properties are ideal for overcoming the barriers that cells possess to prevent the passage of external agents. The great merit of these studies remains their finally shedding of light on the nature of homeopathic remedies and the key role of succussion, which Hahnemann had introduced, though he misinterpreted its significance (and could not have done otherwise).

Moreover, the use of technology has promoted a new perspective on the significance of ultra-diluted solutions, the primary source of the nightmare that has plagued homeopaths since Avogadro's number was defined approximately 70 years after the founding of homeopathy. Alexander Konovalov, the Russian academic chemist long overlooked by homeopaths, stated that it is practically impossible to obtain a solution with zero concentration by successive dilution.[30] Bellare's research team[23] has shown with high-speed video sequences how gas bubbles developed by succussion lead to the partial levitation of nanoparticles to the surface of the solution, forming a flotation film familiar to those who work in laboratories and commonly used in the extraction industry for processing about a billion tons of minerals annually. Thus, a non-solution is created, as the system is not homogeneous.[39] When the ratio of nanoparticles on the surface to those within the solution reaches a certain value, sampling with usual methods always implies taking a greater number of molecules than expected. Therefore, succussed solutions are always much more concentrated than anticipated.[40] Recently, a study by Dandapat's group on Arsenicum album 30C (10−60 M) showed a significant presence of di-arsenic trioxide nanocrystals of 15 nm size, allowing for structural analysis via diffractometry.[41]

In other words, these studies have shown that ultra-diluted solutions indeed contain drug molecules in the order of nanograms per cubic centimeter, which is several molecules in the same order of magnitude as the cells in our body. This perspective, comprising a drug molecule-based full justification of homeopathy,[42] [43] [44] renders unnecessary the various other hypotheses advanced to explain the action of homeopathic remedies under the assumption of molecule absence. However, many homeopaths cannot accept such justification of their therapeutic modality, and simultaneously they do not realize that this rebuttal induces the marginalization of their role in society.

The aforementioned arguments show that the foundations of homeopathy have a well-defined coherent scientific basis. They implement a view outlined some years ago and, once accepted, may be helpful to promote a new perspective of this therapeutic modality. I am old, but I consider myself fortunate to have spent my life in a laboratory of excellence, surrounded by many intelligent people. I am a chemist whose life led me to interact with homeopathic doctors, who professed ideas that my profession viewed with scepticism. This was a great fortune because homeopathy gave me a valuable lesson, and it saddens me to see how the fundamentalism of some of its proponents leads to the marginalization of the discipline and the loss of an enormous cultural heritage accumulated over the past two centuries. Homeopathy schools have become poorly attended, scientific research is stagnating, eminent researchers have distanced themselves, and some homeopathy industries have had to change their image to be accepted by the community. But what is most disheartening is witnessing that many people have failed to recognize their inadequacy in upholding a cultural paradigm that does not meet the needs of future generations, as evidenced by the fact that young doctors are discouraged from pursuing this discipline.

In summary, homeopathy is at a turning point, having failed to communicate a message that justifies its existence. This failure is due to the fact that many of its followers have adhered to a philosophy that did not consider such communication necessary—an approach that does not help one see far ahead. Additionally, others have not recognized their stagnation in a world made dynamic by the progress of scientific research and information dissemination. In short, the cause of crisis lies in the fact of having postulated an emerging character (i.e., the superiority of the whole over the sum of its parts) in the holistic view, without bothering sufficiently to define the properties of the parts.

Yet I remain optimistic, believing that the progress of humanity began in a place like the ancient Greek city of Miletus, where different worlds met, and was accomplished when people left the isolated fortress to engage in discussions in the agora (the city-center gathering place of ancient Greece). I believe that both Miletus and the agora can be identified with the pages of this journal. I am not afraid to discuss my ideas; nor am I afraid, but rather delighted, at the prospect of having to change them.

Received: 14 June 2024

Accepted: 01 July 2024

Article published online:
20 September 2024

© 2024. Faculty of Homeopathy. This article is published by Thieme.

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