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Copeland's Cure: Homeopathy and the War Between Conventional and Alternative Medicine

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We are greatly interested in our health, and are eager to spend huge sums of money on pills to improve it (though we are less eager, it seems, to change our habits of diet and exercise). If there was ever a need to fill, as in "Find a need and fill it," medical treatment holds enormous potential for enriching practitioners. This has always been true, and has been true before medicine was on a strong scientific basis, and is true for "alternative" treatments that have no scientific basis. These days, there is standard medical practice, the usual thing that graduates of medical schools are engaged in, and there are many alternatives: acupuncture, chiropractic, herbal remedies, naturopathy, aromatherapy, and many more. Alternative medicine, to the disgust of many doctors and skeptics, has gotten some official level of approval; there's the Office of Complementary and Alternative Medicine in the National Institutes of Health, and financial approval shown by coverage from many insurance companies. Among the most famous of such therapies is homeopathy, so it is timely to read _Copeland's Cure: Homeopathy and the War between Conventional and Alternative Medicine_ (Knopf) by Natalie Robins. It is mostly a biography of Royal Samuel Copeland, a homeopath, conventional doctor, eye surgeon, Health Commissioner of New York City, and U.S. Senator, but Copeland's constant efforts for his beloved homeopathy encompassed the practice's heyday. The controversies he battled are the same ones that alternative medicines are experiencing today, making Robins's detailed look at Copeland's life useful background for current clashes.

Robins starts with a history of homeopathy, which was invented in 1796 by the German doctor Christian Friedrich Samuel Hahnemann, who was horrified by the high doses of medicine that doctors used at the time. He developed a system of curing by giving highly dilute solutions of medicines, so that only the tiniest amount, or even no amount, of the original drug remained in solution. Copeland, born in 1868, took up homeopathy, was president of the American Institute for Homeopathy, and translated his leadership into the civic arena, always promoting homeopathic treatments without shouting that he was doing so. He was busy promoting homeopathy during the time when medicine really did become scientific and really made cures such as those with penicillin, while homeopathic schools folded. He had frequent battles with the American Medical Association. Copeland died in 1938; he probably simply worked himself to death.

Robins says that she has tried to give both sides of the argument about homeopathy, but admits that "scientific proof is only a distant possibility." Homeopathic claims include that water not only has a memory for teensy amounts of solutes, but that such a memory can be captured, digitized, and sent over the internet to be instilled into another water sample. The claims cannot make logical, scientific sense; if such tiny (even to the point of nonexistence) amounts of chemicals change the water somehow, then think how much even distilled water must change as soon as it touches glass or is exposed to air. Nonetheless, Robins profiles two modern homeopaths at the end of her book, each of whom are convinced not only that homeopathy works but that science will show it to do so. Even so, they have to speak warily of scientific investigations; one admits, for instance, that there was a study for homeopathy for premenstrual symptoms, showing homeopathy improved them, "...but the number of patients was small and the methodological quality was poor." Another says that a cure that is "more spiritual" will work better. Homeopathy does have at least one thing to teach conventional doctors: patients report that they are happy with the amount of time the homeopathic provider spends with them. This is surely no small matter in producing the sort of satisfaction in patients that homeopaths prize. If the homeopaths are going to make extraordinary claims, like memory in water, they can only expect that conventional doctors would like to see some extraordinary evidence that this is so, or at least robust and replicable studies showing real cures. Homeopathy either makes a difference or it doesn't, and clinical tests will show one way or the other, unless excuses are made that they cannot test such things as the "spirituality" of the treatment. Even one of the modern homeopaths profiled here agrees with the editors of the _New England Journal of Medicine_ "...who wrote that there is not alternative and conventional medicine, there is just good and bad medicine." The bustling, energetic, platitudinous, and self-serving Royal Copeland revealed in these entertaining pages would certainly agree; but evidence that homeopathy goes into the "good medicine" category is lacking.

Natalie Robins gives us (at what must have been , judging from her bibliography, an enormous cost in sweated research) three books for the price of one.
The first is a biography of Royal Copeland; the second a history of the relationships between a variety of ancillary health professionals and regular MD's; the third is an investigation of the current standing of homeopathy.
I enjoyed the biography best. Some of the life goes out of the book when Copeland dies (on page 218, in 1938). He was a figure straight out of Sinclair Lewis, naïve in some ways but able to manipulate people and get ahead. He qualified as a homeopathic physician from a mid-western diploma mill. His energy and chutzpah brought him to make it big in New York City and rise to the United States Senate, founding New York Medical College and writing a medical advice column for William Randolph Hearst. Much about his pronouncements and statements was unintentionally comic. Robins cleverly lets him speak for himself. The text is peppered with his wondrous medical claims and hilarious pictures. (The descriptions of his ophthalmic procedures are messed up - it's needling not "kneedling" that was done for cataracts).
The explanation of the varying relationships over the years between doctors of medicine, homeopaths, osteopaths, naturopaths, chiropractors, podiatrists, optometrists, herbalists, acupuncturists, etcetera, and of their different qualifications was the clearest I've ever seen.
Evaluating the claims of these various practitioners obviously treads on touchy ground, and whether she does a fair job of it will be a matter of the reader's opinion, but she is able to make it entertaining as well as instructive.

The main reason I bought this book was because it is about my Grandfather. He died when I was very young, and I don't remember him. I have read alot about him, but Natalie made him "come to life" for me in so many ways, as well as my great grandfather! I love the book for all the biographical information I got out of it. I really appreciate her doing all the research she did to write it! Thanks Natalie! You did a great job!!! Ginger

Copeland's Cure: Homeopathy and the War Between Conventional and Alternative Medicine
by Natalie Robins
Alfred A. Knopf, New York, 330 pages, hardcover
ISBN 0-375410-90-2

Reviewed by Julian Winston

A BOOK ABOUT HOMEOPATHIC HISTORY? Usually I have some inkling that a work like this is coming. The homeopathic grapevine is most reliable, and when someone is writing about history, I usually catch wind of it. That this book appeared, full-blown, as a hardback, and with no review copy sent to the National Center for Homeopathy, was certainly a surprise. What could I do but obtain a copy, read it, and write a review?

The book is ostensibly about Royal S. Copeland, an 1889 MD graduate of the Homeopathic Department of the Univer­sity of Michigan. Copeland went on to gain a modicum of fame as an ophthalmic surgeon, taught at his Alma Mater, became mayor of Ann Arbor, and then moved to New York to become the Dean of the New York Homeopathic Medical College. President of the American Institute of Homeopathy (AIH) in 1908, Copeland eventually became Health Commissioner for the City of New York and, ultimately, a U.S. Senator. It is in the latter capacity that most present-day homeopaths know him: it was his influence that placed the Home­opathic Pharmacopoeia of the United States (HPUS) in the legislation that formed the Food and Drug Administration. And it is the HPUS that allows our homeopathic drugs legal status today.

Mover and shaker
The story of Dr. Copeland, a "mover and shaker" of his day, is fascinating. I was most impressed with the details of his struggle to pull the New York Homeo­pathic College from the doldrums and restore some of its previous glory. His "political nature" was never far beneath the surface, and his ability to play the game on the rough and tumble field of New York City and state politics is a story in itself.

Another fascinating side of Dr. Copeland was his willingness to unabashedly produce testimonials for any number of heath-related products, from mineral waters to baking yeast, and to promote those products through his "Ask Dr. Copeland" radio shows and newspaper columns.

Yet the thrust of this book, as seen from its title, is the battle between homeopathy and conventional medicine (represented by the AMA). To write such a book requires that the author possess a mod­icum of understanding of homeopathy as well as of the context in which it operated during the time-period under discussion. Unfortunately, Robins falls far short in this understanding.

Homeopathy misunderstood
To understand Copeland, one has to understand homeopathy in its fullness. So it was with concern that I read, on page 28: "But some new ideas did appear. In 1877, Repertory of the Homeopathic Materia Medica, by the American homeopath James Tyler Kent, a former eclectic, had been published abroad. This book intro­duced to homeopathy the concept of con­stitutional types and prescribing, and brought into being what is called classical homeopathy. Kent held that people with similar personalities and body types also had similar illnesses, and he said that the remedies should be prescribed according to the individual's physical appearance and emotions, as well as to his symptoms." This is unacceptable scholarship. First, the date is wrong. The repertory was first printed in 1897. Second, it was published in Lancaster, PA, not abroad. Third, the Repertory did not "bring into being what is called classical homeopathy" in any way. Fourth, Robins' description of Kent's homeopathy is not what Kent was teaching. Any homeopath knows that.

After seeing these "red flags,' I watched as the author stumbled through what homeopathy is all about. She was certainly not going to get an understanding of homeopathy from Copeland, because he himself had a minimal understanding of the principle of similars. He was one of those who was using remedies based upon toxicological data and who rarely made a prescription above a 3X potency.

We read on page 38 that "Belladonna was often used for infections and inflam­mations, as well as labor pains and toothaches." This passage is typical of the descriptions of homeopathic remedies that are found throughout the book. On page 275, when discussing possible reme­dies to use for ADHD, Stramonium is described as "made from the poisonous plant also known as Devil's Apple, brings on delusions-as well as sedation-if given full strength." The author appears to describe many remedies based upon their toxicology and shows no understanding of the larger sense of materia medica-the same failing that the homeopathic schools of that time-period had in their instruc­tion and the same reason that AIH mem­bers of that period drifted so far from understanding the essential truth of homeopathy.

Copeland's "fall" into the swamp of trying to justify homeopathy within the context of the model of conventional medicine can only be understood in the larger context of why homeopathy almost died off in the U.S. in the first place-a story well told by Daniel Cook, MD, and Alain Naude in their Journal of the American Institute of Homeopathy (JAIH) article (summer 1996) and reiterated by others over the years. That article, so seminal to the understanding of exactly what caused the "downfall" of homeopathy in the U.S., is not referenced by Robins.

Copeland misunderstood
By not understanding the "wholeness" of homeopathy, the author also misunder­stands Copeland. One might comprehend him a bit better after perusing a small pamphlet he wrote in 1909 entitled "The Scientific Reasonableness of Homeopa­thy;' a work I have on my bookshelf. (I did not find this work among the references in Robins' book.) The pamphlet is a telling statement about Copeland's relationship to homeopathy.

In it, he discusses understanding the remedies from the point of view of select­ing, from the mass of provings, the symp­toms of "minimum practical value." He can readily see that the study of Bel­ladonna will give a mental picture that could point the way to the proper selec­tion of the remedy, and that this can be done through knowledge of the materia medica alone. He says:
"Those of us who have not made use of the repertory, or of a sufficient amount of midnight oil, have said, mentally at least, 'I do not know of any homeopathic remedy for this case and I am justified in resorting to expediency.' With most of us, expedi­ency has meant palliative, certainly mate­rial treatment. But the repertorial advocate says nay to all this. He insists there is still a way to select from the bushels of chaff the grain of wheat which may be made into the loaf of healing. Without present discussion of the details of this system, I wish to give earnest testi­mony to what it has revealed to me of the possibilities and actualities of successfully prescribing in cases heretofore apparently hopeless of other methods of homeo­pathic practice. Personally, I regret the years of active practice without working knowledge of the repertory, and I have promised myself that I shall make future use of the system, limited and circumscribed as here indicated."

A "half-homeopath"
It appears that Copeland was trained in the "name" homeopathy but not at all in its "practice,' other than in keynote pre­scribing based on pathological symptoms. Judging by his other writings, he never kept the promise he made to himself to study the system, slipping further and fur­ther into "expediency."

This was well summed up by home­opath Edwin Lightner Nesbit, MD, in the August 1919 IAIHwhen he spoke about the inevitable decline of homeopathy being brought about by "half-homeopathy." Said Nesbit: "When Copeland says, 'If homeop­athy had strength enough, and vigor enough and old-time stamina enough to fight its battles now as it did in the pioneer days, it could accomplish enough in this generation; etc. I say, 'Yep, attaboy, and me too; meaning 'amen.' Only from this prac­titioner's viewpoint I would say, if our homeopathic leaders-like Copeland had the vision enough ten years ago to see the inevitable trend of their truckling to non-homeopathic 'standards' and to stand for 'standards' of their own devising alone, the homeopathic branch of the medical profession would have had more and better colleges of its own today than our pioneers ever dreamed."

This is a view of Copeland that is not even approached in this book, simply because the author does not understand the internal politics of homeopathy in the U.S. through these troubled years. As the homeopathic schools closed and as the AMA gained political clout, the end was easy to see. Stalwart homeopaths like Rudolph Rabe, MD, chastised such "half­homeopaths" who tried to "curry favor" with the allopaths.

Missing pieces, misapplied references
Missing from this book is also that unique slice of time from Copeland's death to the present, during which, if it weren't for homeopathic stalwarts of the Interna­tional Hahnemannian Association (IHA), homeopathy would have died out, just as the AMA hoped it would. After the pas­sage of the FDA legislation, the book skips ahead 60 or so years to 2000 to describe where homeopathy is today.

Again, there are misapplied references. In a discussion about the use of the word "complementary" to describe alternative or unconventional medical practices (page 244), we find the following: "The word 'complementary' had actually first been used in 1889 by a homeopath when Dr. E.B. Nash wrote in the Transactions of the International Hahnemannian Association that 'in regard to complementaries we often see the reports of cases in our jour­nals, when some marvelous result with some particular remedy have been accom­plished, that this remedy had to be fol­lowed by some other remedy to finish the cure." Robins is misinformed; Nash is referring to the concept of complementary remedies and is not coining a word to describe an "alternative" practice.

Present-day misunderstandings
In describing where homeopathy is today, the author chooses to follow two contem­porary homeopaths, Jennifer Jacobs, MD, and Michael Carlston, MD, as they strug­gle to find acceptance for homeopathy within the conventional medical model. Reading these pages, it was as if I were reading about two strangers rather than people I have known for almost 20 years.

Almost every homeopath I know has treated at least a case or two of otitis media, and has been successful at it. How is that success measured? Generally, the child stops having earaches, the operation to install "tubes" is cancelled, and the child seems healthier overall. So when I see a study about treating otitis media with homeopathy summarized as "unimpres­sive and insignificant;' I worry. And when the author quotes a homeopath as saying, "the study does not convince me otitis media should be treated by homeopathy;' I worry some more.

It is this last part of the book, the author's account of the homeopathic pres­ent, that I find most troubling. Robins chose to accept Stephen Barrett's "Quack­watch, Inc." as a reliable source. Barrett has a large axe to grind, and he's been grinding it for over 25 years. His extreme polemics have been formally discredited in a Supe­rior Court in California, and in a separate court ruling, a three-judge panel described him as "biased and unworthy of credibility." To accept a "quackbuster" as the final word cheapens the whole book and the author's credibility.

Bottom line
Copeland's Cure is well bound, and the illustrative photos are interesting. The footnotes are difficult to check as they are a jumble of sources, sorted as to category. The bibliography is not comprehensive.

The story of Copeland's political life is fascinating. A book like this might get some people interested in looking at this magnificent therapy called homeopathy. But it would have been better if the author had had even the slightest inkling of what homeopathy is about-rather than learn­ing about it from a half-homeopath like Copeland and unreliable sources like the quackbusters.

A final word
To me, the lessons from this are clear. The more you try to sell homeopathy to those steeped in the conventional medical model, the more you will fail. No trial will be large enough. No "cures" will be certain enough. Every outcome can have another explanation. And homeopathy-the real homeopathy that Hahnemann teaches in the Organon-will be the loser. Homeopa­thy will survive, however, because those who do it right know that it works. All it takes is to watch the teething Chamomilla child stop in mid-cry when the remedy is put on the tongue to know the power of this medicine.

Julian Winston

I was interested in the history of homeopathy and this was a place I thought would be good to research. It's primarily about Royal Copeland who came along well after the inception of this field. He does have a bit of influence on homeopathy in the US, but he's not essential. as a bio of him, I thought the book very romanticly written, especially regarding his childhood. He is presented as a true blue upstanding man who worked too hard for the bennefit of the public. His story is noble and facinating, I just thouhgt a bit over polished it seemed. As a historical account of homeopathy in the US, it has its info. I couldn't get over the glaring hole in homeopathies claims versus third party testing validation, something the author (and seemingly the homeopathis community) kind of sweeps right by. But then, this isn't a history of homeopathy, but much more of Copeland himself.