Why does Advil work? Palliation for small, temporary complaints

When I was a student, I was constantly told that “palliation” was bad and to be avoided at all costs. Palliation - defined as giving an anti treatment (antibiotics, anti-inflammatory, analgesic, etc) - would “drive the pathology deeper” or “make someone worse in the long run”, I was warned. With these horrible threats in my mind, I got the hint - never tell my homeopathy teachers that I used advil or any other conventional medications hahah (yes that’s a joke but this, of course, is why scary threats rarely work - the lesson the person learns is not to listen to you, but to hide what they do so they don’t get shamed or yelled at). But the question in my mind, after listening to these long scary rants, was “but painkillers get rid of my headache - and I don’t get some horrible disease after using them, and the headache doesn’t immediately come back when the painkiller wear off”. I would guess that most of us have had this experience - we take a conventional medication (most likely a pain medication) and the complaint goes away and doesn’t come back for a little while. We don’t suddenly develop cancer, asthma, eczema, autism…we just continue our happy life, without our headache, or menstrual pain, or whatever.

Now I was told that the idea of palliation as “dangerous” from Hahnemann (the profession’s founder) himself, which is true if you are talking about chronic disease. If you read his book Chronic Diseases, there are pages and pages of examples of antipathic (palliative) treatment given to people with skin conditions, who soon after develop horrible conditions - asthma, cancer, convulsions, and others (see pages 17-31). This, unsurprisingly, convinced him that palliation was a dangerous choice for chronic diseases. Giving an antipathic treatment to someone with eczema is different than giving antipathic treatment for pain after someone had surgery. Namely, eczema is chronic, and pain after a surgery is self-limiting; it will go away when the trauma has healed sufficiently. If you give antipathic treatment in a chronic case, the secondary action of the medicine will cause an aggravation of your complaint when it wears off, and you will need higher and higher doses of your medication over time (if this doesn’t make sense, read this blog post). He also writes in Chronic Diseases that giving antipathic treatment to these chronic conditions makes the person more ill in the long term.

What’s so bad about taking a couple tablets for your headache?

However, if you read his introduction to Opium in Materia Medica Pura and footnote to aphorism 67(in his Organon), you will see that his views on antipathic treatment for temporary complaints is more nuanced. In the Organon, he writes that “Only in the most urgent cases, where danger to life and imminent death allow no time for the action of a homoeopathic remedy - not hours, sometimes not even quarter-hours, and scarcely minutes - in sudden accidents occurring to previously healthy individuals … is it admissible and judicious… to stimulate the irritability and sensibility (the physical life) with a palliative…for there is here no disease* to be removed, but merely an obstruction and suppression of the healthy vital force.” So he’s arguing that in life threatening accidents, palliation is actually the more apt prescription, because “there is no disease to be removed”. In his introduction to Opium, he adds even more nuance: “If in some few cases opium removes cough, diarrhoea, vomiting, sleeplessness, trembling and so forth, this only happens when these ailments are of recent date or have arisen suddenly in a previously healthy body, and when they are of a slight character…Though opium succeeds in the palliative suppression of these rapid trivial ailments in the few instances indicated above, it by no means follows that it possesses a true curative power of permanently removing such affections in every case and under all conditions even when they are of a persistent character. (p 285 and 286 in the English translation of his Materia Medica Pura).” In other words, something like a painkiller will remove a small, temporary discomfort, but not something that is chronic and serious. I think we all intuitively know this, given our experiences with over-the-counter painkillers. If you have arthritis, ibuprofen will never remove your arthritis, and most people I know who take painkillers for their arthritis know that the pain will return as soon as the painkillers wear off - usually 4-8hours. This is similar for people with very severe menstrual pain (like endometriosis) or migraines. But a tension headache, or the pain after an accident, or slight menstrual cramping are different - they may not return after the 4-8 hours is up.

In short, palliation (aka antipathic treatment), according to Hahnemann, is dangerous in the case of chronic disease, because it will likely make you sicker in the long run - either from needing ever more medications with serious side effects, or because you might develop a more serious chronic disease after using a palliative for a chronic condition. However, palliation is not only ok but sometimes necessary in the case of life threatening accidents (where there is no underlying disease). Palliation may also appear to work in slight conditions, like a tension headache, where there is no real “chronic disease” going on.

Quick caveat: I do, as a homeopath, prefer homeopathy even for slight ailments like tension headaches, soreness after working out, or a small cut or burn in the kitchen; this post is not supposed to be a love-letter to painkillers, rather an exploration into why the law of similars can get rid of your headaches, and why painkillers can also get rid of your occasional tension headache.