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The Role of Dietary Restrictions in Homeopathic Treatment

Abstract

From the time of Hahnemann, homeopaths have been very particular about the diet during homeopathic treatment. There is a general belief, sometimes bordering on the level of fear, that the remedies will be antidoted by anything of medicinal nature in the diet. A small survey or homeopathic websites revealed that the majority of homeopaths believe in dietary restrictions to some extent. Nowadays, homeopaths seem to be divided in three groups as far as the question of dietary restrictions is concerned. The first group is comprised of those who restrict all articles of medicinal nature from the diet; the second group are those who restrict some articles depending upon the nature of the disease, remedy and sensitivity of the patient. The third group are homeopaths who usually do not impose any dietary restrictions during the course of homeopathic treatment. The aim of this paper is to study the historical basis of this belief, to present the views of contemporary homeopaths through literature review, and to discuss whether the belief is valid or not.

 

Introduction

Hahnemann said that a patient’s diet must be regulated and nothing of medicinal nature should be taken while on homeopathic treatment. This belief started directly from Hahnemann. In aphorism 259 of Organon of Medicine (2002, p.211), he says:

Considering the minuteness of the doses necessary and proper in homoeopathic treatment, we can easily understand that during the treatment everything must be removed from the diet and regimen, which can have any medicinal action, in order that the small dose may not be overwhelmed and extinguished or disturbed by any foreign medicinal irritant.1

1 The softest tones of a distant flute that in the still midnight hours would inspire a tender heart with exalted feelings and dissolve it in religious ecstasy, are inaudible and powerless amid discordant cries and the noise of day.

 And in the footnote to aphorism 260 (2002, p.212), he gives a long list of things to avoid:

Coffee; fine Chinese and other herb teas; beer prepared with medicinal vegetable substances unsuitable for the patient’s state; so-called fine liquors made with medicinal spices; all kinds of punch; spiced chocolate; odorous waters and perfumes of many kinds; strong-scented flowers in the apartment; tooth powders and essences and perfumed sachets compounded of drugs; highly spiced dishes and sauces; spiced cakes and ices; crude medicinal vegetables for soups; dishes of herbs, roots and stalks of plants possessing medicinal qualities; asparagus with long green tips, hops, and all vegetables possessing medicinal properties, celery, onions; old cheese, and meats that are in a state of decomposition, or that passes medicinal properties (as the flesh and fat of pork, ducks and geese, or veal that is too young and sour viands), ought just as certainly to be kept from patients.

Similar references about regulation of diet during homeopathic treatment can be found in Hahnemann’s Lesser Writings (1990, p.391-409), Chronic Diseases (1978, p.12-13) and Materia Medica Pura (1996)

This idea about strict dietary regulation and removing everything of medicinal nature from the diet, seems to have permeated our belief system so much that we can find it in nearly all the homeopathic literature.

A Small Survey

To assess the extent of this belief among contemporary homeopaths, I made a survey of the top ten relevant sites, chosen randomly from search engine (Google and Yahoo) results for the keywords ‘diet homeopathy antidote’. Only those sites were chosen on which there was some mention about ‘diet’ and possible ‘antidotes’ while taking homeopathic treatment. The following table summarizes the findings:

Website

Avoid Coffee

Avoid medicinal herbs/foods

     

http://www.healthepic.com/homeopathy/static/homeo-Diet.htm

Yes

Yes

http://www.bayareahomeopathy.com/faq/

Yes

Yes

http://www.vithoulkas.com/index.php?option=com_content&task=view&id=81&Itemid=9

Yes

No

http://healthlibrary.epnet.com/GetContent.aspx?token=8e492ed2-40b6-404d-a9d8-14be227b3f77&chunkiid=38314

Yes

Yes

http://www.grayhomeopathy.com/m_FAQs.html

Yes*

Yes*

http://www.homeopathicare.org/aa.phtml

No

No

http://www.healthy.net/scr/Article.asp?Id=446&xcntr=2

Yes

Yes*

http://www.homeopathichealthclinic.com/Instructions.htm

Yes

No

http://www.peacefulmind.com/homeopathy.htm#Avoiding%20the%20Antidotes

Yes

Yes

http://www.homeopathy.com.pk/homeopathy_faq.htm#Precautions%20during%20treatment

Yes

Yes*

While studying the guidelines given on these sites, I recorded the possible antidotes listed. Coffee is a common dietary article with medicinal properties and is often considered a universal antidote. Therefore, the restrictions on coffee and other dietary articles of medicinal nature were recorded separately.

Results

80% of the websites studied, clearly indicated that coffee can antidote homeopathic remedies. An additional 10% (marked with *) websites indicated that coffee may or may not work as an antidote depending upon the dose, patient sensitivity, choice of the remedy and habit.

40% of the websites studied, listed many dietary articles as possible antidotes. Another 30% (marked with *) said that some dietary articles may antidote the effect of remedies, depending upon the patient sensitivity and the remedy given.

Limitations

The sample size of this survey was very small and cannot be considered representative of the whole community, but still it gives us a fair idea that the belief about coffee and other medicinal substances as possible antidotes to homeopathic remedies is widely prevalent in the homeopathic community.

Review of Literature

Homeopathic literature is filled with guidelines about dietary restrictions while taking homeopathic remedies. People have written whole books on this subject and many others devote many pages to this issue. Popular contemporary author, McCabe (2000, p. 566) gives the following guidelines about dietary restrictions:

The following articles of diet should be avoided while under homeopathic treatment, not only on account of the injurious effect which they have upon the system, but because they antidote the effects of the medicine.

DRINKS–All alcoholic and fermented beverages, coffee, green tea, herb teas, and all natural and artificial mineral waters.

FRUITS–Pineapples, cranberries, and all kinds of nuts and fruits not mentioned in the allowed article.

VEGETABLES–Salads, pickles, spices, parsley, celery, radishes, horseradish, onions, and all kinds of peppers, catsup, mustard, nutmeg, ginger should all be avoided.

BREAD–Cakes prepared with much fat or with aromatics, pastry, pies, honey, and all kinds of confectionery. All baked goods that having icing or contain a good deal of sugar.

MEATS–Liver should be avoided. Completely avoid pork and all pork products.  Also dairy products, especially cheese and butter. Ice cream should be avoided, and fruit ices substituted.

FISH–All shellfish should be avoided.

Many others have been very rigid about dietary restrictions.

Sankaran (1996, p.491) states that ‘In the beginning of my homeopathic practice, I, like my colleagues, took such instructions seriously and was very strict in applying them. If a patient refused to abide by these restraints, I would mercilessly refuse to treat him.

Castro (199?) also mentions being rigid about dietary restrictions:

In my early years in practice I embraced enthusiastically everything homeopathic notion, including the concept of antidotes. I wrote a patient information leaflet that forbade everything from mint toothpaste to coffee ice cream and cough lozenges. I believed patients were glad to have something they could do towards their own healing, because this is what I had been taught. I believed that my medicines were rather vulnerable, delicate, easily affected by external influences–by heat and x-rays and strong odors. I wouldn’t even let my patients touch their own remedies … the tablets they were taking. Although I never went to the extremes of some homeopaths who forbade their patients to cook with garlic. My Italian blood simply freaked out at the very thought!

Vithoulkas (2000, p.68) also believes that coffee can antidote homeopathic remedies:

Coffee is another common homeopathic ‘antidote’. Coffee is a stimulant which can have effects as powerful as medicines. Individual sensitivities vary widely, so that for some patients a rare cup of mild coffee may have no effect, while for others even this exposure is enough to interfere. For this reason all homeopathic patients should avoid coffee altogether. Decaffeinated coffee, black tea, and grain-based coffee substitutes are all acceptable.

Treuherz (2007) also recollects many instances when coffee antidoted the remedy:

Coffee is often listed as an antidote to remedies. This is also an individual thing. Some people hold their coffee better than others. I think it has a bad effect on remedies but if we always found the perfect remedy then it would not have such a bad effect in moderation. I recall someone taking Arnica after Major dental work. Feeling better she drank coffee and went back into shock. I recall someone drinking coffee on holiday in Paris, feeling weird for a day and then the remedy carried on working. And another timid patient did not have the courage to refuse hospitality and drank the coffee; she had been well but relapsed and I retook the case and changed the remedy.

On the other hand, there are homeopaths who have always believed that blanket restriction on all dietary articles of medicinal nature is not necessary.

Boenninghausen (1998, p.269-271) writes that ‘Even more important, in this direction is the observation frequently made that, as a rule, only such medicinal substances act in a disturbing manner on substances given before as have homeopathic relation to it, i.e. which have the tendency and virtue of producing similar effects on healthy persons. On this alone, the antidotal virtue rests…

Sankaran (1996, p.495) has quoted Gallavardin as:

Thus we see in the writings of the earliest homeopaths a list of food and drinks allowed or forbidden, and the practitioners used to give this list to their patients.

The strictness of this list was founded on simple supposition and not on experiment. …But these apprehensions, still founded on supposition, have disappeared before a much more careful observation; this has shown in fact, that the attenuated remedy will cure even while the patients live in the midst of these hostile conditions.

Kent (2000, p.286) states:

In accordance with a principle and not by rule …do not have one list of foods for your patients; do not have a list of things for everybody. There is no such thing in homeopathy… When patients are under constitutional remedies, they need caution about certain kinds of food that are known to disagree with their constitutional remedy.

Sankaran (1996, p.491) writes about his later experiences:

On finding that the control group given freedom in diet improved as well as the other group, I permitted all my patients to have al these articles of diet which are usually forbidden by other homeopaths.

Schepper (2007) also echoes similar sentiments:

But if people drink one or two cups I never have seen it stop the action of the remedy! An exception: forbid coffee when it is a black type remedy the patient needs and that remedy is black type under coffee aggravates (generalities)

McCabe (2000, p.567) later states:

A good rule of thumb is this:  the foods, chemicals and what-have-you to which you are very sensitive or to which you know you are allergic, should be avoided during treatment.  Therefore, the person who would be strung out and awake for two days if they had a single cup of coffee should certainly avoid coffee during treatment.  But not the person who is already drinking coffee every morning and has a system that is already infused with caffeine and will have no interference with their remedy.

Discussion

My own teachers used to tell me the same ideas about dietary restrictions during homeopathic treatment. I remember one of my teachers had a long list of ‘things to avoid’ printed at the bottom of his prescription pad so that he doesn’t have to repeat it to everyone verbally. The list included coffee, herbal tea, mint, garlic, onion, ginger, asafetida, any spicy food and scented products etc. I have come across such printed guidelines on the patient card or prescription pad from many other homeopaths.

In reviewing the literature, we find that most homeopaths still carry the belief about dietary restrictions and possible antidotes to some extent. The early homeopaths like Boenninghausen and Clarke (referred in Sankaran, 1996) were not so keen on blanket restrictions on foods of medicinal nature. Although prevalent since the beginning of homeopathy, it seems to me that the idea has come into vogue more after the reemergence of homeopathy in the western world after the 1970’s. One of the reasons for it could be that Homeopathy primarily survived and grew only in India from the 1920’s to 1970’s. Most classical Indian homeopaths followed Hahnemann’s words blindly and many of the early contemporary western homeopaths (even Vithoulkas) learned Homeopathy in India. With each generation, the belief seems to have become stronger, even if it stemmed from anecdotal evidence.

In recent times there appears to be a shift in following the words of Hahnemann blindly. Many homeopaths have experimented by loosening the dietary restrictions and have found that it usually does not have any effect on the overall results in practice.

Another group of homeopaths now sees the need for ‘individualized’ restrictions depending upon the sensitivity of the patient, choice of remedy, dietary habits and aggravating articles in diet. Instead of restricting all articles of medicinal nature from diet, they restrict only those items which are not part of the routine diet of the patient or which have an adverse relation with the disease or the medicine.

Many homeopaths (e.g. Boenninghausen (1998, p.271) also argue that since homeopathic remedies are dynamised, they are not affected by the ‘material’ articles in one’s diet and have even experimented by giving the remedy with food, wine and even coffee!

It is also believed by many that if a remedy is antidoted easily by coffee or any medicinal food item, it reflects that it is not the perfect simillimum. Medicinal substances in material dose do not easily affect a true simillimum.

When I started to practice, I was a bit more liberal and would not restrict so many food items from the diet. If somebody asked, I would probably mention coffee. But after seeing a few thousand patients, I realized that it doesn’t matter much to explicitly avoid everything that has medicinal nature. Only those things should be avoided which have a medicinal effect on the patient. I realized that most dietary items used frequently do not exert medicinal influence on the patient. Their bodies are used to it. In India, it is hard to imagine a meal that is not full of spices that have medicinal properties. Plus there will be lots of garlic, ginger, onion, capsicum and dozens of other ‘medicinal’ herbs. But they do not seem to affect any medicinal influence in people who are accustomed to taking them. Similarly, it is a common habit for people in North India to take at least 2 teas in a day and the people in south India have a similar preference for coffee.

I have to come to the conclusion that it is not necessary to remove every article of medicinal nature from a patient’s diet. Only those items should be restricted to which the patient’s body is not accustomed. So today if a patient comes to me and asks ‘Should I restrict coffee?’ my answer is – ‘If you drink it daily, keep drinking it, but if you use it very occasionally, it’s better to avoid it.’ A similar observation was even made by Boenninghausen (1998, p.270)

The belief about dietary restrictions is so strong that it has not just percolated in our professional community but even to our patients. It’s very common for me to find patients coming from other homeopaths and asking for things to avoid while on homeopathic treatment. And when they realize that they don’t have to avoid twenty things from their diet (which is impractical in India), they are happy and relieved and actually continue the treatment better. Others like P. Sankaran (1996, p.492) and Miranda Castro (199?) have observed the same improvement in patient compliance and happiness.

Foods That Aggravates

Having said that, I must say that I do use dietary restriction in cases where an article is known to have a direct bearing on the disease condition – like restricting oxalate rich food in cases of renal calculi and gout, cold and sour things in cases of recurring cold, bronchitis and asthma etc. 

Where the correlation is well known or understandable, it is wise to avoid things that aggravate the disease condition. But apart from such foods not EVERY medicinal article should be taken away from the patient’s diet. Only those substances, which are not part of the patient’s regular diet and have the potential of exerting their ‘medicinal action’, should be taken away.

Conclusion

After reviewing the literature, reading the experiences of those who have been liberal with dietary regulations and based on my personal clinical experiences, I conclude that blanket dietary restrictions during homeopathic treatment, as prescribed by many homeopaths, are not needed. Just as the remedy selection, posology and case management are individualized in Homeopathy, so the dietary restrictions also need to be individualized, keeping in mind the disease being treated, patient sensitivity, food habits and the remedy prescribed. Foods that aggravate or have a medicinal action similar to the remedy being prescribed may need to be avoided.

                                          #  #

References:

  1. Hahnemann S., 2002. Organon of Medicine. New Delhi: B Jain Publishers.
  2. O’Reilly, W. B., ed. 1996. Organon of the Medical Art. California: Birdcage Books.
  3. Hahnemann S., 1978. Chronic Diseases. New Delhi: B Jain Publishers.
  4. Hahnemann S., 1990. Lesser Writings. New Delhi: B Jain Publishers.
  5. Hahnemann S., 1996. Materia Medica Pura. Available online at http://hpathy.com/materiamedica/hahnemann-materia-pura/index.asp [accessed 5 January 2008]
  6. Boenninghausen, von, 1998. The Lesser Writings. New Delhi: B Jain Publishers.
  7. Kent, J.T., 2000. Lectures of Materia Medica. New Delhi: B Jain Publishers.
  8. Sankaran, P., 1996. Dietetic Precautions in Homeopathy. In Sankaran R, ed. The Elements of Homeopathy. Mumbai: Homeopathic Medical Publishers.
  9. Vithoulkas, G. 2000. Homeopathy: Medicine for the New Millennium. Greece: IACH
  10.  Griffith C., 2005. The Companion to Homeopathy. London: Watkins Publishing.
  11.  Santwani, M T. 2002. Practical Diet Guide Homeopathy. New Delhi: B Jain Publishers.
  12.  Sutaswala, J.D., 1992. Dietetic Restrictions and Recommendations in Homoeopathy. New Delhi: B Jain Publishers.
  13.  Vinton, M., 2000. Practical Homeopathy. USA; St. Martin’s Griffin.
  14.  Castro, M. 199?. The Vexed question of Antidotes [online]. Available at:  http://www.mirandacastro.com/articles/vexed_question_of_antidotes.php [accessed 5 January 2008]
  15.  Morrell, P. 199?. On Hahnemann’s Coffee Theory [online]. Available at: http://www.homeoint.org/morrell/articles/pm_coffe.htm [accessed 5 January 2008]
  16.  Taylor, M. 1998. Homeopathy Antidoting [online]. Available at: http://bringhealth.com/homeopathic_remedies_antidoting.html  [accessed 5 January 2008]
  17.  Treuherz, F. Intercurrent Remedies. Message to Victoria. 19 February 2007 [online]. Available at: http://www.minimum.com/bb/viewtopic.php?=&p=500 [accessed 6 January 2008]
  18.  Schepper, L. Intercurrent Remedies. Message to Victoria. 20 February 2007 [online]. Available at: http://www.minimum.com/bb/viewtopic.php?=&p=500 [accessed 6 January 2008]
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