HEALTH HORIZONS : MEDICINE : Taking the Natural Cure : Interest is growing in homeopathy, a practice in which remedies--animal, mineral or vegetable extracts--supposedly act like a vaccine by spurring the immune system to action but is it medicine or quackery?

For as long as she can remember, 35-year-old Virginia Schultz has been plagued by asthma, sinus infections and allergies. For years she survived woozily on cocktails of antihistamines, decongestants and steroids. She endured unusually long regimens of allergy shots, which twice sent her into anaphylactic shock. Then came a hellacious string of sinus infections, which stubbornly resisted antibiotics. Her doctor told her there was nothing else he could do.

“I was desperate,” said Schultz, co-owner of a public relations firm in Albuquerque, N.M. “I felt I didn’t have any options left.”

So she turned to homeopathy, a 180-year-old medical practice now enjoying a resurgence in the United States. During a 1 1/2-hour visit, homeopath and physician Dr. Karl Robinson took a medical history and grilled her with a series of bizarre questions: Did she prefer the beach or the mountains? Did she object to scarves wrapped around her neck, or did tight belts bother her more? Did she like to eat lemons, spicy foods or sweets?

Then he chose a remedy--a tiny dilution of tuberculinum, extracted from the lymph node of a tubercular cow--and slipped it under her tongue. Within three minutes Schultz became violently ill with the first of several sinus headaches. But two weeks later, the clouds parted. Though she still gets an occasional allergic flare-up, her chronic asthma and headaches simply disappeared.

“I feel wonderful, energized,” she says, 15 months after her visit. “I have never felt this good in my whole life.”

Schultz is one of a million homeopathic converts in the United States. Worldwide she is in good company. The British Royal Family, Mother Teresa, Tina Turner, Los Angeles Raider Roger Craig and other luminaries are true believers. Dizzy Gillespie reportedly called homeopathy the second-greatest revelation in his life, next to be-bop.

In India, there are at least 100,000 homeopathic doctors and more than 100 homeopathic medical colleges, and the government runs homeopathic drug-detoxification clinics, according to Dana Ullman, president of the Foundation for Homeopathic Education and Research in Berkeley. In Britain, 42% of physicians refer patients to homeopaths, and 32% of French family doctors prescribe homeopathic medicines.

At one time homeopathy had a much stronger hold in the United States as well. By the turn of the century, there were 22 homeopathic medical schools and more than 100 homeopathic hospitals. Today there are none of either, and only a few hundred MDs (plus some dentists, veterinarians and many lay practitioners) advertise homeopathy on their shingles.

Still, with renewed interest in “natural healing,” homeopathy is on the rebound. The sale of homeopathic drugs is a multimillion-dollar industry. “Our business has been growing at 30% a year for seven years,” said Peter P. Vizel, chief executive officer of the Beverly Hills-based Longevity Co., whose products can be found in drug store chains and 7-Elevens.

At the Hahnemann Medical Clinic in Berkeley, 15,000 patients are cared for by six homeopaths, some of whom have waiting lists months long. Patients ask to be treated for everything from colds and ear infections to arthritis and migraines to sexual abuse and depression.

This alarms consumer health advocates, who contend that homeopathy is quackery repackaged in a New Age veneer. They argue that homeopathy’s clinical evidence is flimsy and that its basic tenets violate scientific laws. They are furious with the Food and Drug Administration for not requiring the proof of safety and effectiveness for homeopathic drugs that it demands for other medications. And they are appalled that insurance companies may unwittingly be paying for homeopathy when physicians fail to report their use of homeopathic treatments.

Proponents retort that conventional doctors are blinded by their own prejudices. “Critics tend to have an unscientific attitude towards homeopathy,” Ullman said. “They don’t know the studies and for a variety of reasons they don’t seem to want to know about them.”

Homeopathy (from the Greek homoios, for similar, and pathos, for suffering) is the brainchild of German physician Samuel Hahnemann (1755-1843) who derided the often-deadly treatments of his time, including bloodletting, leeching and purging. In his hunt for more humane forms of healing, Hahnemann happened upon a curious discovery: when he ingested a large dose of quinine, he developed the symptoms of malaria, the very disease quinine is used to treat. The idea that one substance can both treat a disease (with small doses) and cause its symptoms (at high dosage) is known to homeopaths as the Law of Similars.

Homeopaths believe that in tiny doses, their remedies (animal, mineral or vegetable extracts) act somewhat like a vaccine by selectively spurring the immune system to action. Instead of suppressing symptoms--quenching a fever or drying a runny nose--as conventional doctors do, homeopaths say they work with the symptoms, stimulating the body’s attempts to heal itself and to combat disease.

“Because homeopathic medicines enhance the healing and restorative mechanisms of the individual, they’re much more powerful than conventional drugs,” said Dr. William Shevin, a Connecticut homeopath, MD and president of the National Center for Homeopathy, based in Alexandria, Va. They are also less expensive and much safer since they don’t produce untoward side effects, he said.

Homeopaths believe that each disease manifests differently in different people. If someone complains of a cough, they root out the subtle, idiosyncratic qualities of the cough. Does cold air make it worse? Does lying on the right side make it better? Is it a tickling or dry barking cough, or does it sound like a buzz saw? Is the patient anxious or irritable? Does the patient crave solitude or company?

“In every case, we are trying to find a remedy that fits on all levels, the mental, the emotional and the physical,” says homeopath Karl Robinson, who practices in Dallas and Albuquerque. “You have to be very much a sleuth. The art is in knowing what questions to ask.”

Homeopathic literature details thousands of sets of painstakingly characterized complaints, cravings, behaviors and emotional states. Even suicide is covered. For a person who feels compelled to jump out of a window, the remedy is gold; for people who contemplate self-poisoning, arsenic, in small doses, is indicated.

To all of this, the critics roll their eyes. The Law of Similars, they say, is as silly as the ancient belief that if you eat the flesh of a lion you become brave.

In conventional medicine, “There are perhaps 1,000 illnesses and 5,000 drugs--that’s about 5 million illness-drug combinations,” says Stephen Barrett, co-author of “Health Schemes, Scams and Frauds,” published by Consumer Reports. “Occasionally there will be one drug that will have side effects that indeed produce the symptoms of the disease it’s fighting. But that would merely be a coincidence.”

What really makes the critics’ hair stand on end is the homeopathic idea that the smaller the dose, the more powerful and long-lasting the effect. This runs exactly opposite to orthodox pharmacology. Moreover, homeopathic remedies challenge physical laws because in their most potent form, remedies are so diluted that no molecules of the original substance remain. Homeopaths contend that by shaking the remedy as it is being diluted, the molecules of the medicine impart a kind of long-lasting energy pattern to the surrounding water molecules--thereby strengthening the potency of the remedy.

“Horsefeathers. That’s where the mysticism comes in,” scoffs John Renner, president of Consumer Health Information Research Institute in Kansas City, Mo. “If we were to shake Shirley MacLaine before she channels, maybe she too would be more powerful than she is.”

The alleged potency of microdoses ignited a maelstrom of controversy in the scientific press three years ago when the journal Nature published a paper by renowned French immunologist Jacques Benveniste. Benveniste’s group claimed that highly diluted solutions of antibodies could provoke a reaction in white blood cells even though the solutions had been diluted so many times that no antibodies remained.

The paper triggered such skepticism that Nature sent its editor, John Maddox, along with a scientific-fraud investigator and magician James (The Amazing) Randy to scrutinize Benveniste’s research methods. The team concluded that the work was dogged by statistical errors and couldn’t be replicated. They also implied that a technician sympathetic to homeopathy had thrown out unflattering data.

Ullman, of the Foundation for Homeopathic Education and Research, asserts that the team did not understand how immunological research is conducted. Benveniste charged that the team intimidated his group and based their conclusion on only one set of experiments.

Benveniste has since repeated his experiments, replacing his technician with a computer, Ullman said. In the journal of the French Academy of Sciences, Benveniste claims to have replicated his earlier results. Both Nature and Science turned down his second paper. And critics remain suspicious of Benveniste’s motives.

“I wouldn’t believe a word he said from here on in,” Renner said. “He has done his cold-fusion screw-up. He’s dead as a credible scientist. Every once in a while a brilliant scientist is so open-minded that his brain falls out.”

If, as the critics contend, there is nothing to microdoses and the rest of homeopathy, then what accounts for the many shining testimonials like Schultz’s?

The placebo effect, say the critics; people believe they are getting a real medicine so they think themselves into feeling better. And, said William Jarvis, president of the National Council Against Health Fraud in Loma Linda, never discount the positive psychological role of a good doctor-patient relationship. He added that most people who see homeopaths have ailments that naturally improve over time. Since it can take months for the homeopath to find the “correct” remedy, the illness often gets better on its own. Also, Jarvis contended that some homeopathic remedies may be adulterated with therapeutic doses of standard drugs, since there is at least one documented case to that effect.

Homeopaths counter that people come to them because homeopathy works. A placebo would not work on unconscious people, infants or animals, they say, but homeopathic remedies do.

“If the critics believe so strongly that placebo and relationships are responsible for homeopathic cures, then why don’t they use those to treat their own patients instead of continually plying them with expensive drugs that have side effects?” asked Shevin, the president of the National Center for Homeopathy. “If they applied all these criticisms to their own methods, they would find themselves at great fault as well.”

Homeopaths also point to studies in which homeopathic remedies outperformed placeboes. Critics say many studies are flawed. But in a recent issue of the British Medical Journal, two initially skeptical scientists analyzed the quality of 107 studies and concluded that there is enough good evidence to at least justify continued research.

Homeopathy’s recent upswing owes less to science, though, than to politics. Much to the critics’ chagrin, for example, the Food and Drug Administration has never required proof of safety and efficacy for homeopathic drugs--a requirement that could well run homeopathic companies out of business in the United States. According to a 1988 FDA paper, homeopathic remedies are exempted from federal review by the 1938 Food, Drug and Cosmetic Act, which was shepherded through Congress by New York senator and homeopath Royal Copeland.

But Daniel L. Michels, director of the FDA’s Office of Compliance in the Center for Drug Evaluation and Research, believes that the FDA does indeed have the authority to review homeopathic drugs.

In fact, he says, the FDA may consider an efficacy review for homeopathic, over-the-counter remedies in several years, after it completes its review of other over-the-counter medications. But even then, other priorities, such as speeding up new drug applications for AIDS drugs, will probably take precedent. Evaluating homeopathic drugs “is not on our immediate plate and I’m not certain when it will be,” Michels said.

Homeopathy also faces little organized opposition from conventional doctors. The American Medical Assn., which in its early years worked staunchly to squelch homeopathy, is now resoundingly silent on the subject. Renner said that since it lost a costly antitrust case to the chiropractors, the AMA has shied away from commenting on alternative medicine.

Certainly the AMA is keeping a close watch on events in North Carolina, where the Board of Medical Examiners has moved to revoke the medical license of homeopath Dr. George Guess on the grounds that homeopathy is not an acceptable and prevailing medical practice. The move was recently upheld by the North Carolina Supreme Court, but this summer the American Civil Liberties Union filed suit against the board on behalf of Guess and his patients.

Individually, most doctors don’t condone homeopathy--if they even know what it is. But some have softened their resistance and a few are testing the waters. Dr. Gershon Lesser, a Los Angeles physician and host of a radio talk show called The Health Connection on KCRW-FM and KGIL-AM, invited Dr. Ronald W. Davey, Queen Elizabeth’s homeopath, to speak for 10 minutes on his show. But Lesser extended Davey’s time to 1 1/2 hours because the show was swamped with calls. “There are enough people who seem interested in homeopathy for us to at least take a look,” Lesser said. “I’m beginning to feel that homeopathy does play a complementary role.”

It doesn’t surprise Renner that some physicians are attracted to homeopathy. “I’d guess that 1% to 3% of MDs have a learning disability as far as good science is concerned,” he said. But what worries him more is that maverick physicians and the public will treat homeopathy as a ticket to more extreme quackery. “If you can get someone to believe in homeopathy, the next thing they’re into is crystals, coffee enemas, hair analysis and Mexican cancer clinics. . . . If homeopathy is ever going to amount to anything it’s got to totally separate itself from the rest of organized quackery.”

Perhaps there is a lesson or two in the story of homeopathy for orthodox medicine as well. Like Virginia Schultz, most patients turn to homeopathy because they are desperate and fed up with conventional doctors.

“I gave up on everybody else,” says Albuquerque engineering manager Doug Morris, who went to Robinson for intractable colds. “After spending five minutes with me, the regular doctors would give me antibiotics, but the colds would always come back. They just weren’t dealing with the real problem.”

Unlike Schultz, Morris eventually left homeopathy, but he understands its appeal. “I was very happy that somebody was finally listening to me,” he said.

Homeopaths consistently rate higher than conventional doctors in terms of patient satisfaction because they spend up to two hours with each patient and ask about every facet of the patient’s life. “Medicine drives people toward quackery maybe more than quackery draws patients to itself,” Jarvis said.

And part of the reason for that, added Renner, is that “we have built an expectation that medicine can cure everything. That’s the biggest myth we have ever perpetuated.”