During the analysis, five main categories were revealed: homeopathic aggravation, adverse effects, disruption, risk assessment, and benefits of both conventional and homeopathic treatment.
The MHs claimed that aggravation was something they often observed in clinical practice both as a dramatic and subtle event. One of them expressed:
"Yes, patients tell me when the aggravation is very strong and obvious. However, if the character is more subtle, the initial consultation needs to be rather thorough in order for them and me to understand that some symptoms are so-called initial aggravations."
Another MH added:
"I think it is difficult to determine the exact number of patients who experience initial aggravations. However, I have seen some quite severe cases. Patients suffering from rheumatoid arthritis, eczema and sciatica have got much worse following homeopathic treatment. The illness has exploded. I call it initial aggravations because, as you say, they have more energy and they can handle it."
According to the MHs, the worst aggravation the patients may experience is when the eczema gets worse, as expressed by one of the participants:
"Patients suffering from eczema, who have seen other homeopaths, have come to me. The remedy they had been given was too strong, resulting in a severe aggravation of the eczema. Therefore, dermatologists understand and know that homeopathy works, as they meet such patients [when hospitalized as a result of the homeopathic treatment]."
One participant explained how adults may react when treated with the correct homeopathic remedy:
"If children have felt that nobody loves them, [as adults] they will do everything to be loved, at work and everywhere. This is a terrible condition, and they may experience anger. This is positive [reaction from the remedy], as it is caused by suppressed anger. When the anger appears I say to them “OK, don’t take it out on your partner. You need to understand that this is a very important process for you.”"
According to the MHs, a feeling of well-being (sleeping better and feeling more energetic, mentally and emotionally stronger, and more balanced) is a criterion that may be used to distinguish HA from AE. One MH explained: “The reason why people keep up with these aggravations is that they feel better. There is nothing else to it. You feel better.” These quotations demonstrate that conditions such as eczema and suppressed feelings were most prone to aggravation. A true HA must be followed by an improved sense of well-being. If not, it may be an AE.
The participants explained the differences between AE and HA as follows: “When you observe severe aggravations without dynamics [no progression in the patient’s symptoms] that continue over time, I think there is something wrong. You may call it adverse effects.” One female participant said: “I do not like that my patients get depressed. That is a bad sign”. Another stated: “However, I have never seen a serious life threatening event”. A third one expressed:
"To me the distinction between adverse effect and aggravation is defined by the general experience of the patient. If the patient experiences an overall improvement, a general increase in energy, I call the aggravation homeopathic aggravation. If the patient feels generally bad, it is adverse effect. This is the distinction I will make."
One male MH talked about the primary and secondary effect of a remedy, when he referred to AE:
"Hahneman [the founder of homeopathy] claims that medication has two types of reactions. The first is a primary reaction which is the quality of the medication. Then there is the secondary effect, which is equivalent to what is called adverse effects in medicine. That is the body’s reaction to the medication, including all the symptoms that may arise. These adverse effects cause a big problem. I am so happy that I can give my patients remedies which will not cause any adverse effect, as there is no secondary effect of homeopathic remedies. They [the symptoms] disappear and that is why you are cured."
Some of the participants perceived that homeopathy produced AE, described as aggravations with no dynamics, meaning a generally bad feeling without improvement. However, others claimed that there were no AE in homeopathy described as a secondary effect of the remedy. Hence, there were disagreements among the participants whether or not homeopathic treatment produced AE.
A disruptive reaction is a reaction following an incorrect remedy. This causes disappearance of some symptoms and creation of new symptoms, and is frequently seen in clinical practice. In order for this to happen, the patient must be sensitive to the medication. One participant described a personal experience with homeopathy, which was perceived to be a disruptive reaction, as described by one of the participants: “I was extremely depressed over six weeks following a cure of 1
A male participant explained:
"However, this is a good example of an incorrect remedy, but it touches you. So it’s very close. You have had a disruptive reaction. I have no personal relationship to him [the MH], but there was something within him that provoked this reaction. It is too complicated to explain here, but as a therapist you have to consider this."
A female added: “Because he has certain sensitivity to “Sulphur”. Another continued: “However, what you may find from a disruptive reaction is the correct remedy. This gives you a unique possibility to understand, because you know that it [the initial remedy] is incorrect.”When the moderator asked him if he considered this to be AEs, he denied this to be the case.
These statements demonstrate that when an incorrect remedy is administrated, it may create a disruptive or suppressive reaction in the body. The participants did not perceive this to be AE, but a possibility to prescribe a new remedy as new symptoms emerge. A suppressive reaction is when the symptoms move from a more superficial to a deeper level in the patient, for example when the eczema disappears, and is replaced by asthmatic symptoms.
In order to evaluate risk the MHs had to evaluate the patient twice, as one of them explained:
"If you see through the eyes of a doctor you see different things than through the eyes of a homeopath. You look for different things, you ask yourself different questions, and these are two different ways of thinking. It is almost as if you need to think two different thoughts at the same time. These are two different conceptual worlds."
A female explained:
"In my initial consultation there is always a doctor present within me looking for severe symptoms. My way of thinking like a doctor never stops: “Do I ignore something severe, or is this something that needs further examination?”"
"It is not difficult to think two thoughts simultaneously. I can easily perform an initial interview as I’m thinking of what remedy is suitable. Sometimes it strikes me: “Are there any red flags here?” I may prescribe a homeopathic remedy and an X-ray requisition to make sure that I do not ignore anything."
The MHs evaluated risk from both a conventional and homeopathic point of view. Based on this, they organized the patient’s symptoms in a twofold manner.
Benefits of using both conventional and homeopathic treatment
According to the MHs, a reduction of conventional medicine is an advantage for patients visiting them. One female said: “When you start treating a patient on conventional medicine, homeopathy enables you to remove it [the conventional medicine] slowly but surely.” She told about a patient who could reduce her medication for high blood pressure by three-fourths. She explained:
"It is no problem for me that she needs a little bit of her medication. She still needs far less than normal and has fewer adverse effects then she would have had without homeopathic medication. I think it is awesome to have both types of treatment."
The homeopathic consultation allowed the patient to explore her/his entire medical history. According to a MH a new medical diagnosis may be revealed, as the complete picture emerges.
"Sometimes I have diagnosed people who for many years have been visiting several doctors and specialists. However, being both a homeopath and a doctor, I have discovered that I have been the first person to see the complete picture. It is one disease or another, which has been overlooked, and then we do some tests in order to verify my diagnosis."
A moral aspect of this situation was explained by a male participant. “If a person experiences that there are uninteresting sides to my [the patient] story, you may want to avoid telling whatever is decisive to enable you to make a correct diagnosis according to conventional medicine.”
According to the participants, a more comprehensive toolkit was a benefit of practicing two medical systems. One MH explained:.
"That is what is so nice, that we have a toolkit with a greater variety of options. Everyone must understand that it is the best for the patients to have a therapist who master all these options. I am not negative to conventional medicine as lots of it is positive. However, it is far too much of it."
He claimed further that “homeopathy has its advantage when it comes to chronic diseases, especially when psychological events manifest themselves in the body. In such cases homeopathy is absolutely outstanding.” A pleasure of professionalism was something the MHs appreciated. One female said:
"I can only speak for myself and what it has done to me when it comes to mastering two worlds simultaneously. It is the feeling of professionalism that is simply so good. I feel twice as good as a doctor than if I had mastered only one of these worlds."
These data demonstrate that the MHs always looked for severe symptoms. Alertness and awareness were always present, to avoid ignoring serious events or to decide whether further examination was necessary. They gave patients time and space, which enabled the MHs to see the complete picture. When practicing both homeopathy and conventional medicine they felt very competent. A more comprehensive toolkit gave them a feeling of flow in their daily work.