In a past life, before I became so specialized, I was a general surgeon. Like all surgical oncologists and even breast surgeons, before I became a specialist, I had to do a general surgery residency. In addition to the usual cancer problems a general surgeon faces, the two most common being breast and colon cancer, I learned to deal with the most common non-cancer problems that general surgeons deal with, such as gallbladder problems, hernias, bowel obstructions, and the like. Unfortunately, those problems include anorectal problems (not my favorite!) including hemorrhoids.
Basically, hemorrhoids are swollen veins in the anal canal. There are two kinds of hemorrhoids, external and internal. Because external hemorrhoids tend to be relatively easy to deal with, usually only requiring management when they thrombose (clot), which usually requires incision and drainage of the thrombosis ± removal of the vein. Internal hemorrhoids, too, usually only require surgical intervention when they cause severe symptoms, such as prolapse or bleeding, but the interventions are a bigger deal. The specific surgery, such as hemorrhoidectomy or rubber band ligation, the latter of which is often done as an office procedure, tends to be a bit harder and to have the chance of more complications. For purposes of this discussion, the exact surgery isn’t important. What is important is that the problem is anatomical, and the cure is anatomical. While it’s true that for less severe hemorrhoids nonsurgical management is the first choice, including Sitz baths, stool softeners, a high fiber diet, and sometimes topical agents, for serious hemorrhoids, a surgical procedure of some kind is the answer.
That’s why I’m so amused to have found an article entitled Hemorrhoids and Homeopathic Remedy Indications, so much so that I thought it worth a post. As regular readers know, homeopathy postulates two “laws”: The law of similars, which states that to alleviate a symptom you need to use something that causes that symptom in healthy adults, and the law of infinitesimals, which states that diluting a remedy makes it stronger. Often, remedies are diluted 30C, which basically means thirty 100-fold serial dilutions, or 10-60. Given that Avogadro’s number is on the order of 6 x 1023, that means a typical 30C homeopathic dilution is at least 1036-fold greater than Avogadro’s number, which further means that it’s highly unlikely that a single molecule remains.
So what’s the homeopathic treatment of hemorrhoids? This:
• apply the ointment, as needed: AESCULUS / HAMAMELIS / HYDRASTIS / PAEONIA / RATANHIA / VIBURNUM OPULUS / a.a. p. M.T. , 10%
• alternate 3 granules, as needed :
• one dose, every 2 hours :
NUX VOMICA 9C, and then, AESCULUS 9C, then 12C, then 15C
amel. by cold sitzbaths
— like grapes; intense itching and burning; rectal incontinence; diarrhea :
• 3 granules, as needed : ALOE 4C
— very painful and itching, with ineffectual urging to stool :
• 3 granules, as needed : NUX VOMICA 4C
amel. by warm sitzbaths
— feels full of small needles, itching; lumbosacral pains :
• 3 granules, as needed : AESCULUS 4C
— bluish; hot; extremely sensitive to all touch; during pregnancy :
• 3 granules, as needed : MURIATIC ACID 5C
— rectal constriction and sharp sticks; obstinate constipation; pregnancy :
• 3 granules, as needed : COLLINSONIA 4C
— anal fissure and oozing; great constriction and burning like fire :
• 3 granules, as needed : RATANHIA 4C
Notice something? None of these are diluted anywhere near 30C. Most are diluted around 4C. A 4C dilution is 10-8, which, depending on the amount of starting material, could easily leave enough compound to have a pharmacological effect. Ointments can also, of course, constitute effective local therapy. However, that’s not the hilarious thing. The hilarious thing is that homeopathy is proposed for even hemorrhoids that are getting worse:
— when the general treatment does not quickly improve the patient, increase the general drainage and take 3 granules :
• every hour repeat as needed :
LACHESIS 4C, then ALOE 4C, then PAEONIA 4C, etc
• 3 times a day :
ARNICA / MURIATIC ACID / VIPERA REDI / a.a. p. 4C
• 3 granules, as needed : COLLINSONIA / HAMAMELIS / a.a. p. 4C
Of course, a strangulated hemorrhoid is a surgical disease that is rarely resolved without a procedure, usually a hemorrhoidectomy. Complications can include infection, gangrene, and sepsis, usually due to necrosis of the tissue of the hemorrhoidal tissue and formation of an abscess.
While these homeopathic remedies are clearly insufficiently diluted to be considered nonexistent, the way that most homeopathic remedies are, be assured that homeopaths remain just as delusional as ever. There are most definitely homeopathic remedies for hemorrhoids that are much more diluted. There are also homeopathic treatments for anal fissures:
A combination lifestyle changes and homeopathic treatment can be a great relief to a person suffering from piles, as it eliminates the possibility of surgery. Moreover, a thorough homeopathic treatment can remove the tendency and thereby prevent its recurrence.
Nux Vomica is one of the leading medicines for treating piles that are coupled with constipation. Aesculus is very effective for nearly all kinds of painful piles. Aloes is useful when the piles are swollen and painful and protrude out like a bunch of grape. Calc flour is very important medicine as it treats the tendency to develop piles. Hamemelis and Millefolium can handle bleeding from piles quite well.
Although 30 c potency of the above mentioned medicines can be used in an acute case, but for prolonged use, please consult a professional homeopath.
For those of you who have been fortunate enough not to have an anal fissure, I’ll tell you a bit about them. They’re basically ulcerations that occur, usually in the posterior midline of the anus, that are due to repeated minor trauma, usually from bowel movements and spasm of the internal anal sphincter. Conservative treatments include Sitz baths (of course), as well as a high fiber diet and stool bulking agents. Sometimes a surgical procedure known as partial lateral internal sphincterotomy is required. In any case, the “pile” is a tag of skin at the edge of the anus, with the thickened edges of the fissure observable. Homeopathy isn’t going to get rid of this.
Let me just put it this way. Patients with anal fissures are miserable, because they often have horrible pain when they defecate. They don’t need a professional homeopath. They need a colorectal surgeon or a general surgeon experienced in the management of anal fissures. Actually, no one needs a homeopath, as homeopaths represent the most useless pseudo-profession in existence. Any improvement in symptoms of hemorrhoids or anal fissures that seems to be due to homeopathy is almost certainly due to the other adjunctive measures recommended, not due to the quackery that is homeopathy.