The homeopathic management of multimorbidity

The homeopathic management of multimorbidity

The homeopathic management of multimorbidity

It appears the medical profession is beginning to take seriously the complex and inter-related problem of chronic illness, multiple morbidity and polypharmacy; and of course their financial and social cost.

It is not generally understood by those who have not studied and practised it, that homeopathy treats the totality of the symptoms and the whole evolution of the illness: the biography and the biology. Multiple morbidity and chronic illness, with mental well-being as a prerequisite, are not a problem for us; a challenge certainly, but not a problem. They are conditions that we expect to mitigate or resolve; and when confronted early enough, to prevent. You might think a Secretary of State for Health would lick his or her lips at such a prospect.

Many of you will have read the recent editions of the BMJ that have focused on multiple morbidity. Here are some quotes from the editorials:

By middle age, multimorbidity is the new normal.  … When the mix of conditions experienced includes both physical and mental health problems, the poorly stitched seams of professional care are at their most threadbare. … Policy must seek to address multimorbidity by applying the idea that there is “no health without mental health”. … Healthcare systems that have a single disease led focus are no longer affordable. … Research into multimorbidity requires shifts in design, funding, and outcomes of interest. … Research on patients with broader multimorbidity is in its infancy. … Practice needs to develop new approaches to caring holistically for patients with mental-physical multimorbidity. … Professionals need to be mindful of the potential burden on patients when treating multiple problems. … Such enabling care requires empathy, trust, and a therapeutic alliance with healthcare professionals who have sufficient time, training and support.

I think we have something to say about all of that.

One paper on this theme introduces an interesting concept: “synergistic” management strategies or interventions[i]. This means the interaction of different activities towards a common outcome. It suggests that some types of morbidity are appropriate for an integrated approach of this kind because there is a perceived overlap of the physiological or pathological states, whereas others are not because they do not have that degree of “concordance”. What it does not conceive of is the possibility, which for us is a certainty, that all co-morbidity actually has that degree of concordance. Nor does it conceive the possibility of stimulating that synergistic action through the patient’s own resources for self-regulation and self-healing; which of course is our aim and expectation – and our empirical experience – whatever the permutations of co-morbidity.

We have a story to tell about multimorbidity. And we must tell it, which is when the hard work begins!

But – and everything I am saying is of course qualified by a huge “but”– we cannot just say these things, however robustly, and expect them to be taken at face value. We have to have evidence. But it is a very different kind of evidence from the clinical trials that are such a problem. It is more like epidemiology. “Salutogenology”perhaps? And it is not difficult to do. Here’s a brief outline of how we could go about acquiring this evidence in the future.

Take the problem of multimorbidity. All it requires is a simple form on your desk in your clinic, on which you record the barest minimum of data whenever you see a patient who has responded to treatment with change in more than one syndrome, simultaneously or over time – the atopic child whose asthma and eczema are both ameliorated is an obvious example. Then once a week you send the form to a coordinating centre, which could be overseen by our Research Development Adviser, Robert Mathie. At the end of the year we would have a portfolio of empirical clinical data which demands to be taken seriously. And then the new health secretary Jeremy Hunt, who to his embarrassment we know to be sympathetic, might have something to smile about.


1. Mercer S, Gunn J et al. Managing patients with mental and physical multimorbidity. Br Med J 2012;345:e5559.