Intended for healthcare professionals

Education And Debate

Concerns about immunisation

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7229.240 (Published 22 January 2000) Cite this as: BMJ 2000;320:240

Vaccines - cause celebre or bete noir?

Sir,

I think this article is highly misleading to your readers in two very
important respects. Firstly, for trying to portray support for vaccination
from homeopathy. Secondly, in trying to over-interpret scant figures.

It is not true that all homeopaths, at all times, have supported
vaccination. Far from it. In fact, the majority of them have had profound
difficulty in accepting this technique. I shall offer some reference
material below in support of this statement.

Nor is it true that the Faculty of Homeopathy represents anything
more than a minority of medically qualified doctors, who until the 1970s
never amounted to more than 300 practitioners in the UK, and for most of
this century hovered around the 200 mark. The vast majority of
practitioners today are medically unqualified and are represented by three
different professional bodies and registers: the Society of Homeopaths,
the Institute of Complementary Medicine (ICM) and the UKHMA. Together, they total fast approaching 2000
practitioners, and represent at least three quarters of the entire
profession in the UK. It is significant that not one of these three bodies
supports the use of vaccination, and, indeed, they warn patients that it
can be a dangerous practice.

It is only recently, within the last twenty years or so, that the
Faculty has adopted a pro-vaccination stance. I suspect it is an attempt
to draw them closer to mainstream medicine, by reducing areas of conflict
and friction. Moreover, the Faculty of Homeopathy had previously adopted a
very different attitude on this issue. It was strongly influenced by the
views and techniques of the American homeopath, Dr James Tyler Kent, from
about 1903 until well into the 1970s [see Morrell, 2000; and Winston,
pp.203-4]. Moreover, his metaphysical, anti-bacterial and anti-vaccination
views of homeopathy can be very clearly judged from his writings:

"Man cannot be made sick or be cured except by some substance as
ethereal in quality as the Vital Force.[Kent]

"The tendency for the human mind to run after the visible, that can
be felt with the fingers, leads one to adopt foolish theories like the
Bacteria doctrine and the molecular theory. [Kent]

"Most doctors have gone crazy over the vicious Microbe as being the
cause of disease, and think the little fellows are exceedingly dangerous.
As a matter of fact they are scavengers. Shortly after death, a prick with
a scalpel is a serious matter, but when the cadaver has become green and
is filled with bacteria, it is comparatively harmless. [Kent]

"The microbe is not the cause of disease. We should not be carried
away by these idle allopathic dreams and vain imaginations, but should
correct the Vital Force. [Kent]

"The Bacterium is an innocent feller, and if he carries disease he
carries the Simple Substance which causes disease, just as an elephant
would." [Kent]

"It is not from external things that man becomes sick, not from
bacteria nor environment, but from causes within himself." [Kent]

"Whenever a man settles all things by his eyes, and fingers, pseudo-
science and theories, he reasons from lasts to firsts; in other words,
from himself, and is insane." [Kent]

"If we have material ideas of disease we will have material ideas of
the means of cure." [Kent].

"The doctrine of the Vital Force is not admitted by the teachers of
physiology, yet without the vital force, without simple substance, without
the internal as well as the external, there can be no cause and no
relation between cause and effect." [all the above quotes from Kent's
Aphorisms]

Thus, it is quite simply untrue that homeopaths accept and endorse
vaccination. At its best, it is regarded as a crude example of the ‘law of
similars’, and it is probably that viewpoint which Hahnemann had in mind
when he made approving comments about Jenner and cowpox in the 1790s.
Thus, these authors have chosen deliberately to give a highly simplistic
and misleading impression of the view of most homeopaths towards
vaccination.

“Homeopathy is opposed to the use...of drugs in physiological
doses...to the methods of vaccine and serum therapy...to so-called
‘pathological prescribing’ and to ‘group treatment’ of diseases...It
depends for all its results upon the dynamical action of single, pure,
potentised medicines…administered in minimum dose.” [Close, 1924, pp.20-
21]

‘Hahnemann…refers all the phenomena of health and disease…under two
names: ‘the dynamis’ and ‘the life force’. This is Hahnemann’s greatest
discovery, and the absolute bedrock of his system.’ [Close, p.32]

‘The homeopathic opposition to the use of vaccines has its roots in
the work of Dr James Compton Burnett, who was the first to conceptualize
that a vaccine...could cause a deep-seated illness, vaccinosis...treatable
by the use of homeopathic remedies...so the homeopath, since before the
turn of the century, has viewed vaccines as inherently dangerous to the
human economy.’ [Winston, 1999, pp.247-8]

The ‘law of similars’ was not originally conceived by Hahnemann; it
was mentioned by the early Greeks and Galen and used extensively by
Paracelsus and the English physician, Thomas Sydenham [1624-1689]. It is
also made use of in folk medicine, such as recommending heat for burns and
cold for frostbite. In a crude form, it also manifested in the vaccination
experiments of Edward Jenner [1749-1823]. It is a remarkable fact of
history that Jenner's first experiments with Cowpox in Dorset in the
summer of 1796, coincided with Hahnemann's publication of his Essay On a
New Principle, both concerning the ‘law of similars’.

Hahnemann refers positively and at length to Jenner’s experiments
with cow-pox in paragraph 46 of his Organon [mentioned by Wolff, p.240,
and by Rothstein, p.157], which can be viewed online at:


http://www.homeopathyhome.com/reference/organon/organon.html

However, we should treat these comments with some caution, firstly,
because Jenner was an early medical experimentalist, like Hahnemann, an
approach he greatly admired, and which must have predisposed him towards
Jenner’s work; secondly, though vaccination is a crude example of the law
of similars, it also contravenes the individualisation of disease
symptoms, which is so central an impulse within homeopathic philosophy:

‘…cure is always individual, in the concrete case or patient, never
in the generalised disease; and that such a thing as a specific cure for a
disease does not, and, in the nature of things, cannot exist, since no two
cases of the same disease, are ever the same.’ [Close, 1924, p.94]

I thus fail to see how Hahnemann today could approve of the
widespread and routine immunisation of all children.

‘In Germany, contemporary homeopaths, as well as adherents of
sectarian medicine in general, are known to be critical towards
immunization.’ [Wolff, p.218]

‘...research on the historiography of vaccination recognised the
phenomenon that anti-vaccinationism in the late nineteenth and early
twentieth centuries had a deep response among adherents of non-regular
medicine.’ [Wolff, p.218]

‘Recently, one German homeopath wrote: ‘By now every homeopath knows
what disastrous side-effects vaccinations are able to trigger.’ .’ [in
Wolff, p.219]

By the end of the 19th century, it was becoming clear to physicians
that in the causation of disease, it was not the apparent presence or
absence of ‘germs’ [as had first been thought], which was the main
concern, but the precise level of susceptibility to them possessed by the
individual. According to regular physicians, that level of susceptibility
was entirely due to ‘antibodies’, which could be generated or induced
artificially, on demand, through the inoculation procedure. Moreover,
plainly, according to most homeopaths, that susceptibility was down to the
activity of an immaterial vital force, or life principle, inherent in the
organism, and not to any physical and chemical process per se. On
theoretical grounds, therefore, that clearly divides the two groups of
practitioners. However, having said all that, the matter is slightly more
complex. It is also true that some homeopaths chose, of their own
volition, to accept vaccination as a valid procedure and they did not take
the view that it was harmful at all. This latter interpretation was down
to individuals over which the movement as a whole clearly had little
control.

‘While homeopaths before the Civil War had vacillated over the
question of smallpox vaccination...the use of antisepsis could be clearly
linked to Hahnemann’s call for physicians to prevent disease, and many saw
serums and vaccines as an expression of homeopathic law.’ [Warner, p.44]

‘Van Eden pointed to the interest in homeopathy on the part of
religiously orthodox circles such as a the example of Abraham Kuyper. He
was opposed to vaccination, like Hahnemann, or rather in Kuyper’s case
compulsory vaccination...’ [Hofstra, p.102]

A lot of very useful background historical information about
vaccination and how it first developed is given in Blake’s article in
Leavitt and Numbers.

Regarding the data presented in this article, the vaccination data
supplied in the table looks highly suspect. It looks like a classic case
of massaging figures to get whatever ‘spin’ out of them you like. I would
make the following questions about it:

1. More data is required concerning the number of cases and deaths
BEFORE the years given, in order to draw the type of conclusions from the
data that the authors seem so eager to make.

2. By how much were these diseases in decline BEFORE immunisation was
introduced?

3. By how much did their decline accelerate or slow down AFTER the
introduction of vaccination for these diseases?

4. To what extent can the vaccination programmes truly be causally
connected to the decline of the diseases?

5. Most homeopaths are against vaccination regardless of what the
Faculty say. What is the homeopathic principle that dictates that the
serum of a virus should be inoculated into all people, when homeopathy
contends that all disease is expressed and must be treated upon the sole
basis of utterly individualised symptoms?

6. Is it proven beyond reasonable doubt that homeopathic vaccines do
not work. Can we please see some evidence for this claim?

The article seems to convey to the reader the strong and unambiguous
impression that the figures presented demonstrate conclusively that
vaccination has caused the decline of these diseases. This is certainly
questionable, as many of them were in massive decline before a single
vaccine was introduced. This certainly applies to Diphtheria,
Tuberculosis, Whooping Cough and Measles. Such a graph, for the USA and
TB, is shown in Leavitt and Numbers, p.6, and for Diphtheria on p.8. These
graphs clearly show that TB was all but extinct before vaccination against
it was introduced. The same pattern holds true for Diphtheria. Similar
data can be invoked for the UK and all these infections.

The article also seeks, unashamedly in my view, to give the strong
and unambiguous impression that all homeopaths accept and endorse
vaccination as a safe technique. They do not. And historically, they have
opposed it from its first introduction, regardless of what Hahnemann said:

‘In 1879 William Tebb, the leading British anti-vaccinationist came
to New York, and the Anti-vaccination Society of America was founded.’
[Kaufman, p.465]

Sources

Blake, John, B, 1978, The Inoculation Controversy in Boston: 1721-22, in
Leavitt and Numbers, pp.231-40

Close, Stuart, 1924, The Genius of Homeopathy, Lectures and Essays on
Homeopathic Philosophy, New York

Ernst, Edzard, 1995, Letters, Homoeopaths and Chiropractors are Sceptical
About Immunisation, BMJ 1995; 311: 811

Hofstra, Marijka Gijswijt, 1998, Critics and Converts of Homeopathy: The
Dutch Debate in the Nineteenth Century, in Juette et al, pp.89-110

Juette, Robert, G Risse and J Woodward, Culture, Knowledge and Healing -
Historical Essays On Homeopathy in Europe and North America, EAHMH, Univ.
Sheffield Press, UK, 1998

Kaufman, Martin, 1967, The American Anti-vaccinationists and Their
Arguments, Bull. Hist. Med. 41, pp.463-78
Kent, James Tyler, 1926, New Remedies, Lesser Writings and Aphorisms &
Precepts, Chicago
Leavitt, J, and Numbers, R, 1978, Sickness and Health In America, Univ
Wisconsin, USA

Morrell, Peter, 2000, Kent’s Influence on British Homeopathy, Jnl of Amer.
Inst. of Hom. Jan 2000

Rothstein, William G, 1972, American Physicians in the 19th Century, Johns
Hopkins Univ Press, Baltimore, USA

Warner, John H, 1998, Orthodoxy and Otherness: Homeopathy and Regular
Medicine in Nineteenth Century America, in Juette et al, pp.5-30

Winston, Julian, 1999, The Faces of Homeopathy A History of the First 200
Years, Great Auk Publishing, New Zealand

Wolff, Eberhard, 1998, Sectarian Identity and the Aim of Integration: The
Attitudes of American Homeopaths Towards Smallpox Vaccination in the Late
Nineteenth Century, in Juette, Risse and Woodward, pp.217-250

Competing interests: No competing interests

24 January 2000
Peter Morrell
Hon Research Associate, History of Medicine
Staffordshire University UK