I was working on a piece about how to respond to anti-vaccination beliefs, when it struck me that, in the absence of the germ theory of disease, vaccination looks a lot like homeopathy – you use a tiny amount of something that causes a mild version of the disease you want to prevent. I wondered whether the success of vaccination in the 18th century had any impact on the development of homeopathy. A very casual search suggests not, though there is something called homeopathic vaccination. Does anyone know more about this?
{ 50 comments }
jen 09.11.13 at 3:38 am
Interesting idea, but more likely the other way around; vaccination was if not completely accepted quite widely known and used before homeopathy got really popular, at least in the U.S. (I know a lot more about vaccination than homeopathy though so I might be wrong on the chronology). The principle of vaccination was not especially strange by the late 18th century contrary to pop medical history versions of Jenner’s discovery, etc.
John Quiggin 09.11.13 at 3:44 am
Jen, I was aware of this, and meant it the way around you suggest/
jen 09.11.13 at 4:05 am
aargh, sorry, read too fast.
Dr. Hilarius 09.11.13 at 4:27 am
One of my hobby horses is pseudo-science with medical quackery being a subset. I’ve read a good deal of homeopathic materials over the years but have never seen any mention of vaccination as a historical antecedent. To the contrary, vaccination largely seems to be rejected as reductionist traditional medicine by the homeopathic community. This is the first I’ve ever heard of homeopathic vaccination.
The false link between vaccinations and autism appears to be a strongly held belief by some homeopaths. Recently, I encountered a medical resident (in psychiatry) at a highly regarded children’s hospital who endorsed vaccinations as a cause of autism. Turns out he obtained his MD from a homeopathic medical school. He was unfamiliar with recent research linking autism with parental age and was uninterested in reading it. Frightening.
With infinite dilution, water is supposed to retain the memory of the solute. Why doesn’t water also retain the memory of all the piss and other nasty stuff it’s been part of?
bad Jim 09.11.13 at 6:43 am
It seems to have been generally understood back in the 18th century that variolation did indeed induce smallpox and was hazardous both to those subjected to the procedure and to anyone in contact with them, and the practice was consequently controversial. Smallpox was already considered something physically contagious, effectively a germ, as evidenced by the use of contaminated blankets to spread the disease to American Indians. (By the way, does anyone know whether that was actually effective?)
In context, homeopathic medicine was arguably an improvement on contemporary practice; water may have been safer than the usual herbal concoction, and would certainly be preferable to bloodletting in most situations.
John Carney 09.11.13 at 7:05 am
Modern vaccination evolved from the much older practice of inoculation. While theories varied, the point of inoculation was essentially to protect against a disease.
The basis of homoeopathy comes from an entirely different direction. It’s not about prevention and it doesn’t treat a disease with a diluted form of the relevant pathogen. Instead it treats a disease with substances that produce the same symptoms as the disease. This was all rooted in Samuel Hahnemann’s observation that a then-popular treatment for malaria produced malarial symptoms when given to a healthy person.
Despite these crucial differences, many supporters of homoeopathy claim that vaccination is proof of the principles of homoeopathic principles. Ironically, this claim is sometimes aired by anti-vaccination campaigners.
As far as I know, inoculation did not inspire the development of homoeopathy. In fact I vaguely recall reading somewhere that Hahnemann decried the practice, though I might be imagining that. The concept of “homoeopathic vaccines” is, I believe, a case of homoeopaths borrowing from vaccination, and I imagine the idea is to treat a healthy client as if they had a given disease. This seems to fly in the face of homoeopathic theory as I understand it.
adam.smith 09.11.13 at 7:24 am
@5 bad Jim – it’s not know whether small pox blankets did spread the small pox, no. Even the fact that they were actually used contested and the sourcing quite thin. Notoriously, Ward Churchill made up stories about this in some of his accounts, though this doesn’t mean it couldn’t have happened elsewhere. The only documented case I could find is summarized on Wikipedia
http://en.wikipedia.org/wiki/Siege_of_Fort_Pitt#Blankets_with_smallpox
Best I can tell, the exchange of letters and the diary entry is the total extent of what we know about this. (disclaimer: I’m not a historian, so this could be wrong. I was just curious about your question and dug around a bit, without any prior expectations what I’d find).
maidhc 09.11.13 at 8:50 am
Wasn’t the origin of vaccination giving people cowpox instead of smallpox? Because Jenner observed that people who had cowpox never got smallpox, and no one ever died of cowpox? Or is this just a myth?
One of the funniest things I ever read was an account of a homeopathic bartender who became famous for his homeopathic martinis that became better the more you diluted them. Unfortunately I don’t remember where I read it.
ajay 09.11.13 at 8:58 am
Smallpox was already considered something physically contagious, effectively a germ, as evidenced by the use of contaminated blankets to spread the disease to American Indians.
See 7 on whether this actually happened or not.
Unquestionably people knew that diseases were contagious – you could catch a disease from being in proximity to someone who had it. But that doesn’t necessarily indicate that they knew it was a germ – a separate physical entity that can be passed on from one person to another and multiplies in the body.
Wasn’t the origin of vaccination giving people cowpox instead of smallpox? Because Jenner observed that people who had cowpox never got smallpox, and no one ever died of cowpox?
Correct – hence the name “vaccination”, from vacca, a cow. Jenner wasn’t the first to come up with inoculation, but inoculating someone with smallpox stood a pretty high chance of causing them to die of smallpox. They didn’t have weakened or dead versions of the virus back then; it was the full single malt version. Vaccination meant that, at worst, you got cowpox, which wasn’t too bad.
One of the funniest things I ever read was an account of a homeopathic bartender who became famous for his homeopathic martinis that became better the more you diluted them. Unfortunately I don’t remember where I read it.
Right here:
https://crookedtimber.org/2010/12/22/the-christmas-sermon/
Fergus 09.11.13 at 8:59 am
maidhc, I’m pretty sure that story is one of dsquared’s Christmas posts on this very site…
maidhc 09.11.13 at 9:17 am
ajay, Fergus: Thank you, I must bookmark that. Quite a classic. It had my mother laughing out loud, which is not an easy thing to do.
John Quiggin 09.11.13 at 9:21 am
I’d also missed it somehow, so thanks to all, especially dsquared
Phil 09.11.13 at 9:35 am
With infinite dilution, water is supposed to retain the memory of the solute. Why doesn’t water also retain the memory of all the piss and other nasty stuff it’s been part of?
This problem has been noted.
herr doktor bimler 09.11.13 at 11:23 am
“Homeopathic vaccination” is indeed a thing, another cargo-cult attempt to snatch the mantle of science. I recommend you to my grown-up sister’s blog for details:
http://sci.waikato.ac.nz/bioblog/2010/11/homeopathic-vaccinations-fail.shtml
Orac is splendidly combative:
http://scienceblogs.com/insolence/2010/11/30/homeopathy-in-cuba/
The list of diseases for which the homeopaths offer a preventative treatment does not include rabies. Imagine my disappointment.
David J. Littleboy 09.11.13 at 11:25 am
“homeopathic martinis”
I grew up in a teetotaler household* and didn’t learn to drink until late in life. One technique I developed to avoid dealing with the issue was to order rum and coke, since it’s pretty much always pretty close to being homeopathic with the run. This failed miserably one time when I was taken to an upscale bar by some folks way more upscale than I, and was served a rum and coke that was homeopathic with the coke.
*: No smoking, no drinking, no car, no TV, no religion.
David J. Littleboy 09.11.13 at 11:34 am
“Why doesn’t water also retain the memory of all the piss and other nasty stuff it’s been part of?”
There are some people who insist on only drinking alcohol because of what fish do in water…
Nick 09.11.13 at 12:27 pm
Homeopathy is one of the best forms of complementary medicine. The treatment is nothing, so it can’t actively kill you. You get a placebo without the risk of being exposed to a toxin. Its faith-healing for a scientistic world.
Barry 09.11.13 at 12:35 pm
Nick, somebody pointed out that in the mid 1800’s most ‘medicines’ would do nothing good for you, so homeopathic medicines were probably better, on average.
Barry 09.11.13 at 12:36 pm
“MD from a homeopathic medical school”
There such things, and their graduates are accepted as residents in real hospitals?
Christiaan 09.11.13 at 2:25 pm
It is true that it is often argued that homeopathy works by strengthening the immune system (even though without evidence). So this seems inspired by vaccination. The weird thing though is that at the same time they are against vaccination, because, as they say, that would not strengthen the immune system, but only makes it lazy, or something. Of course that is completely backwards. As for what you say that it naively looks the same, there is a very crucial difference that makes this nonsense. Perhaps vaccination uses with tiny amounts, homeopathy works with far, far less: it works with less than microscopic amounts, in fact basically with an amount of zero (well, a small chance of ingesting a single molecule).
Bruce Wilder 09.11.13 at 5:54 pm
Nick @ 17: faith-healing for a scientistic world
I suppose that’s right: it’s sold in the U.S. as “holistic”, etc., which seems to me a plea for an almost religious overlay to the practice of medicine. And, complementary care is stressed.
If homeopathy is basically a rhetorical framework for generating hypnotic narratives, it can hardly use more than the slightest resonance with vaccination. Vaccination is not a model of cure or balm — it’s not do-this-prayerful-ritual, and feel better tomorrow — and that, not the de minimis, is what homeopathy is about.
As far as I know, homeopathy has no claim on state licensing, though an M.D. plus “alternative therapies” is probably a ticket to a lot of $400 office visits in prosperous areas of the U.S. I looked for reviews on Yelp! of local MD+homeopathy and I don’t know what to make of the results. Lots of people like the concept, but hate the realization — they don’t get the combination of rational competence and caring attention that they anticipate.
Dingbat 09.11.13 at 7:03 pm
When the germ theory of disease was first being developed, both homeopaths and allopaths (what we now know as “doctors”) tried to lay claim to the research and incorporate it into their worldview.
See Owen Whooley, Knowledge in the Time of Cholera: The Struggle over American Medicine in the Nineteenth Century*, especially pp. 161 ff.
“Taken to their logical therapeutic conclusions, both the germ theory and the law of similars arrived at a similar destination–vaccination.” (p. 163) But as it turned out, germ theory became a site of division within the homeopathic movement between those who wanted to lay claim to the ideas (“This is what we’ve been saying all along!”) and those who said, “This is not orthodox according to Hahnemann!”
Anyhow, the whole book is interesting, and so in brief answer to your question, “Does anyone know anything more about this?” I’d say, yes, Owen Whooley does.
*Disclosure: I work for the U of C Press.
peggy 09.11.13 at 7:28 pm
re #8-I’ll make a small medical point. The topic of smallpox vaccination covers two related but different viruses. Smallpox virus (variola), not too surprisingly, causes smallpox. Cowpox virus (vaccinia) causes a disease in cows which if humans are infected, happens to result in immunity to smallpox and is the modern smallpox vaccine. Edward Jenner invented vaccination in 1796 and and named it from the Latin, vacca for cow.
Before cowpox was discovered, Arabs and other Eastern peoples knew that dripping some liquid from a smallpox vesicle onto a slight scratch on another person would likely give them a mild, nonfatal case of smallpox, and perpetual immunity. This practice, inoculation or variolation, was introduced to England by Lady Montague in 1718. It was used by Washington’s troops during the American Revolution in 1776.
Dr. Hilarius 09.11.13 at 7:29 pm
To be accurate I should have been clear that while there are no accredited homeopathic medical schools there are naturopathic medical schools which incorporate homeopathic medicine in their training. There are also a large number of accredited schools awarding degrees in various flavors of alternative medical treatment. It is worth remembering that not all physicians are scientists. My spouse routinely encounters pre-med students who reject evolution and who trash her in evaluations for incorporating evolution in her human anatomy and physiology classes. Medical training can be reduced to a technical program. You don’t need to understand the scientific method in order to run through a differential diagnosis tree and prescribe treatment.
Some hospitals have been incorporating various forms of alternative medicine as marketing tools, lending credibility to unproven treatment modalities. You can get touchy-feely vibes along with your antibiotics.
Adam 09.11.13 at 8:20 pm
There was a letter to Tape Op magazine a while back criticizing their run of a piece advocating homeopathy: Link.
In her response, the original author draws explicitly on vaccination as a validation:
“Using weakened doses of substances that are dangerous in large amounts to treat or protect a person from illness is far from absurd. In fact, that concept is central to vaccines widely prescribed in conventional Western medicine.”
Neville Morley 09.11.13 at 9:14 pm
Has no one mentioned the Mitchell and Webb sketch yet?
Gene O'Grady 09.12.13 at 12:47 am
Amherst is apparently currently in the midst of a controversy (how serious I don’t know) about changing its mascot from Lord Jeff (who knew?) to God knows what else on the grounds that Jeffrey Amherst was involved in the effort to spread small pox to Indians by blankets in Pontiac’s rebellion. Whether he did more than initial a memo I’m not sure, but someone has found documentation of the intent in British military records. I’ve always been told that it didn’t work.
adam.smith 09.12.13 at 1:06 am
yep, that’s the letter that’s cited in the WP article. It was actually discovered by an Amherst prof (or UMass Amherst, which would be quite funny).
Gene O'Grady 09.12.13 at 2:14 am
On the other hand, this story was in fairly wide circulation in my undergraduate days (1965-), based on I’m not sure what.
bad Jim 09.12.13 at 4:43 am
Regarding blankets and smallpox: it’s generally accepted that North America was considerably depopulated by disease shortly following European contact, with smallpox given a large share of the blame; if so, the remaining Indians had already been exposed, and thus blankets, even if they were capable of transmitting the virus, probably wouldn’t have been very effective.
We’d have to surmise that the tactic (if it was ever employed) was devised by people who weren’t familiar with the practice of variolation, otherwise it might have been regarded as an unlikely means of inducing immunity.
Both friend and foe of homeopathy ought to be able to agree that Oscillococcinum, a homeopathic dilution of duck liver, is by any definition quack medicine.
mab 09.12.13 at 7:56 am
Both friend and foe of homeopathy ought to be able to agree that Oscillococcinum, a homeopathic dilution of duck liver, is by any definition quack medicine.
Oh, no. It’s always worked for me, and now it won’t anymore.
ajay 09.12.13 at 9:27 am
Before cowpox was discovered, Arabs and other Eastern peoples knew that dripping some liquid from a smallpox vesicle onto a slight scratch on another person would likely give them a mild, nonfatal case of smallpox, and perpetual immunity.
But, in 2-3% of cases, it would kill them. That was the real advance that Jenner made: not inventing the idea of inoculation, because as you point out that had been known about for centuries, but in finding a method of immunising someone that would not to cause them to die in agony. The Arabs and Eastern peoples, in their exotic, inscrutable way, had a solution first, but it was – to be frank – a fairly crap solution.
ajay 09.12.13 at 9:30 am
Oscillococcinum, a homeopathic dilution of duck liver, is by any definition quack medicine.
You, sir, are a monster.
peggy 09.12.13 at 3:19 pm
@32
Actually inoculation with live smallpox ONLY killed 2-3%, as opposed to the 30-35% who would otherwise die.
In 1775-6 a smallpox epidemic raged through Boston. The revolutionary troops surrounding the city were afraid of contagion. In a “bottom up” medical decision, they decided to protect themselves by using inoculation, despite the hazards. Since an inoculated soldier is a smallpox carrier until the disease resolves, Washington decided to step in and regularize the process, quarantining the soldiers until they healed.
ajay 09.12.13 at 3:28 pm
Actually inoculation with live smallpox ONLY killed 2-3%, as opposed to the 30-35% who would otherwise die.
Yes, that’s what I said! It’s still a bad solution. Smallpox killed up to 10% of infants before vaccination was brought in. Which presumably means that it infected 30% of them. So you’ve got a choice of either inoculating your child, in which case there’s a 3% chance you’ll kill her, or not, in which case there’s up to a 10% chance that she’ll die of smallpox.
Even if it makes mathematical sense to inoculate, that is a pretty terrible position for a parent to be in. Cowpox, on the other hand, didn’t kill people.
peggy 09.12.13 at 4:14 pm
Smallpox inoculation gives a tenfold decrease in mortality, hardly a “crap solution”. Other early triumphs in medicine were rarely as effective. Semmelweis, through hand washing, observed at best a fourfold decrease in maternal mortality. Treating eyes probably infected with gonorrhoeae with penicillin gave a six fold improvement for the first experiment.
The only treatment I’m aware of that a modern day MD can offer with equal odds (outside of don’t drink directly from a stream in the third world) is don’t smoke, which prevents lung cancer by 23 fold, only twice as good as the “crap solution†to smallpox. None of this relates to homeopathy, except to say that even CT commentators can be mistaken.
John Emerson 09.12.13 at 6:45 pm
I have read that milkmaids were deliberately infecting themselves with cowpox, and that Jenner merely noticed that they were doing this. So basically, vaccination started as an old wives (old milkmaids) tale, or folk medicine.
Smallpox seems to be the default explanation for large groups of dead Indians. Both the Comanches and the Sioux had more than one smallpox epidemic before 1970, but they maintained themselves very will until they met the post-Civil War U.S. Army.
Gene O'Grady 09.12.13 at 8:19 pm
No one seems to have mentioned that Jonathan Edwards, at the time president of Princeton, died from smallpox vaccination which he had undertaken to set a good example. Unless that’s an urban legend.
One of the indicators of living to an advanced age as I have is that you have a small scar on your upper arm from smallpox innoculation.
Bruce Wilder 09.12.13 at 8:23 pm
John Emerson: . . . they maintained themselves very will until . . .
Not really.
Antoni Jaume 09.12.13 at 9:44 pm
Emerson, in Spain there were cantigas that spoke of the beauty of the cowgirls, which I reckon was due to not suffering from pox, that might easily disfigure its sufferers.
ezra abrams 09.12.13 at 11:25 pm
hilarius @5 says
“With infinite dilution, water is supposed to retain the memory of the solute. Why doesn’t water also retain the memory of all the piss and other nasty stuff it’s been part of?”
iirc, it isn’t just the diln, but how you do the dilution; there is a special method, where you bang (shake) the vial or container in a certain way many times…on the other hand, homeopathy is so crazy, why would a little thing like fish pee be a problem ?? surely a left handed sky hook, or some unobtainium would do the trick.
Re the blanket thing…in regard to Syria, people on the “left ” (eg, J St Clair, http://www.counterpunch.org) have brought this up as an example of the US using germ warfare.
I did some googling, and for those who are interested, here are some urls that go a bit further then most:
http://hnn.us/article/7302
http://www.thefurtrapper.com/indian_smallpox.htm
http://www.stanford.edu/dept/HPS/MayorSmallpox.pdf
http://www.h-net.org/~west/threads/disc-smallpox.html
http://quod.lib.umich.edu/p/plag/5240451.0001.009?rgn=main;view=fulltext
gavinf 09.13.13 at 3:11 am
@19, @24 There are dozens of accredited homeopathic medical schools in India, with a significant number supported by the State.
Also a number of schools in South Africa and publicly funded clinics treating thousands each day. Praise be to Placebo, and presumably Hygiene.
Rupert Loxton 09.13.13 at 5:05 am
Homeopathy has two central ideas: the “law of similars” and “potentization” (dilution with lots of shaking). The law of similars is basically sympathetic magic which has a long history as a superstition. Trick or Treatment by Singh and Ernst describes how the saying “hair of the dog” was originally a way to treat bites from rabid dogs by placing hairs from the dog into the wound. Belief in sympathetic magic might be how early inoculation was discovered.
In 1796 (the same year Jenner tested vaccination) Hahnemann published Law of Similars describing his early work. He probably came up with his ideas after a probable allergic reaction to quinine which produce symptoms similar to malaria.
The other part of homeopathy is the belief that dilution dramatically increases the potency of the treatment. Hahnemann developed it after publishing Law of Similars. There does not seem to be any historical precursor to potentization, sympathetic magic required smaller doses but not dramatically smaller doses.
Early vaccination (and inoculation) did not resemble potentization, pus was taken from cow with cox pox or people with cow pox (a much more dangerous method) and put in an scratch made on the skin. They were not over diluting it.
Hahaneman in Organon of the Medical Art published in 1810 cited vaccination as an example of the law of similars. Homeopaths mention some earlier praise in the 1790’s but I can’t find it. Given the Hahnemann was developing homeopathy before Jenner did his work it is unlikely that Jenner had any influence.
In short the similarities between vaccination and homeopathy probably come from the same superstition, however inoculation and eventually vaccination actually worked.
John Quiggin 09.13.13 at 7:51 am
@Rupert “Hahaneman in Organon of the Medical Art published in 1810 cited vaccination as an example of the law of similars. ” Bingo! Is it possible to give a more precise citation?
@Peggy Presumably the 30-35 per cent figure must be multiplied by the probability of catching (or being exposed to?) smallpox, which makes the mortality reduction less impressive, unless you wait until there is an epidemic before vaccinating.
@Antoni The beautiful milkmaid trope was also popular in England. In the version of the story my mother told me, it gave Jenner the idea of using cowpox
ajay 09.13.13 at 8:51 am
Smallpox inoculation gives a tenfold decrease in mortality, hardly a “crap solutionâ€.
Threefold, not tenfold, at best, given some fairly generous assumptions about prevalence. See my earlier comment.
Other early triumphs in medicine were rarely as effective
Except for vaccination!
The difference between inoculation and, say, handwashing is that with inoculation, the mortality is _directly due to your action in getting the child inoculated_. Lots of patients still died even after doctors started washing their hands, but it wasn’t contact with clean hands that actually killed them.
That’s what makes it particularly awful for the parents: they’ve killed their own child (albeit with the best of intentions). Knowing that they’ve done the logically correct thing would, I fear, be pretty cold comfort. It would be for me, anyway.
Rupert Loxton 09.13.13 at 4:35 pm
@John Quiggin http://flusolution.net/Organon%205th%20&%206th.pdf is a translation of the 5th and 6th editions of Organon of the Medical Art. It mentions vaccination only a few times. “Aphorism” 36 says that scurvy can’t prevent “the plague of the Levant” and that Rickets can stop vaccination. Aphorism 46 includes a homeopathic explanation of vaccination without any mention of dilution. Hahnemann says that small-pox and cow pox are similar. A footnote added in the 6th edition has a lot of praise for vaccination.
The footnotes of Aphorism 56 contain some interesting tangents. 56 is critical of “antipathy” or opposite cures opposite. The footnote is critical of “isopathy” which is his term for exact cures exact. Isopathy was a break off from homeopathy in the 1830’s, Hahnemann might have been criticising them. Hahnemann states that promoters of isopathy might based their ideas off vaccination. But vaccination involves cow pox which is similar but not identical to small pox so thus isn’t exact. Besides isopaths apply potentisation and therefore turn it into something which is similar. The footnote is incomplete but the end appears to be a criticism of inoculation and similar ideas, but doesn’t give any reasons why they won’t work.
Rupert Loxton 09.13.13 at 4:58 pm
I have also just discovered that Homeopaths Without Borders has their own copy available: http://www.homeopathswithoutborders.gr/index.php?option=com_content&view=article&id=355292&catid=34:homeopathic-theory&Itemid=554
It appears to be the 6th edition.
peggy 09.13.13 at 10:44 pm
ajay, your sense of personal responsibility for the potential injury to one’s child is a very important point. Vaccination as a public health technique is easily undermined by the “tragedy of the commonsâ€. A well vaccinated population cannot support an epidemic, so individuals who choose not to be vaccinated are still protected (as are those who cannot be vaccinated effectively, such as cancer patients and those with AIDS). This sense of immunity leads to popular resentment of vaccination leading to lowered participation and the current outbreaks of whooping cough and measles.
Medical treatment always carries a risk. Dr. Perri Klass in “A Not Entirely Benign Procedure†describes her dilemma about giving her child the drug fansidar (with a potentially fatal side effect) to prevent malaria (also potentially fatal) during a trip to Asia. She decides to take the boy with her and reasons that because she doesn’t own a car protecting against one common fatality, the other potential harm will balance out. Everyone survived, but YMMV.
Rupert Loxton 09.14.13 at 3:51 am
The story of how Jenner came up with the idea of vaccination is recounted in Vaccine by Arthur Allen. Jenner first encountered the idea that cowpox could prevent smallpox from a milkmaid in 1770. He then found folklore on the subject including the beauty of milkmaids.
By 1778 Jenner was thoroughly investigating cowpox asking questions to everyone who might know something about it. By 1796 he had inoculated more than 15 people who had previously natural acquired cowpox and “none, by his account, became infected with smallpox”. In 1796 Jenner vaccinated James Phipps and then later inoculated him to test whether the vaccination actually worked. When Phipps didn’t present with any symptoms Jenner judged vaccination a success. After further experimentation An Inquiry into the Causes and Effects of the Variolae Vaccinae was published in 1798.
John Quiggin 09.14.13 at 4:02 am
Rupert, thanks for this useful info.
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