IMPORTANT-HOMEOPATHIC DRUGS WHICH DO NOT APPEAR IN THE U.S.P. OR

Senator ANDERSON. These are drugs not mentioned in the United States Pharmacopoeia?

Dr. BAKER. Yes, sir.

Senator ANDERSON. Or any of these other books?

Dr. BAKER. Yes, sir.

Senator ANDERSON. All right.

Dr. BAKER. And there are approximately 600 homeopathic drugs which I have listed in the Homeopathic Pharmacopoeia. Some are used both physiologically and homeopathically and others are used only homeopathically.

Senator ANDERSON. Thank you.

The CHAIRMAN. Any further questions?

Senator DIRKSEN. Mr. Chairman, Dr. Baker, your statement doesn't contain a definition to show the distinction between homeopathic as distinguished from physiological therapeutics nor does it contain a definition to show a distinction between homeopathic drugs and physiological drugs. Can't you give us a simple definition?

Dr. BAKER. Yes, sir; I have a statement which I submitted along with my previous statement. Homeopathy is a specialty within the practice of medicine. My education was at Hahnemann Medical College, which at that time provided two degrees: one, doctor of medicine, and the other, doctor of homeopathic medicine.

The information sheet which I supplied with this, I will read briefly so that I can save your time. It is a specialty which employs drugs which are prepared according to the standard of homeopathic pharmacopoeia and prescribed according to the certain basic and precise scientific principles based on the law of similars.

This method of therapy is practical by qualified graduates of medicine who have obtained a degree of doctor of medicine and in addition

have obtained the knowledge of this specialty either in medical college or by intensive postgraduate instruction.

The law of similars was originated or discovered by Samuel Hahnemann about 1795. Samuel Hahnemann was a physician and scholar in Germany. This law states that likes cure likes. That is, drugs which can produce certain symptoms when given in toxic dosage to a healthy person can cure illness or disease which is characterized by similar or identical symptoms. It differs from other schools of healing in the following manner:

The drugs are prescribed according to a definite symptom complex rather than for a disease entity. In other words, if we prescribe for a sore throat we take into consideration the appearance of the throat, whether it happens to be red, purple, has white patches, whether the soreness is on the right side, whether the patient is flushed or pale, whether he is toxic or active, irritable, hysterical, whether he is delirious, whether he has a swelling of the glands, and so forth, whether he is thirsty, and various other things like that are characteristic of that particular person's response to that particular illness.

Not the fact that he has tonsillitis, but the fact that he has a disturbance in his normal health which is characterized by these certain symptoms.

In the case of a pneumonia we think in terms of the patient who is perhaps very dull, toxic, has an appearance as if he had typhoid fever or whether he is very flushed, whether he is violently active or whether he is very depressed and toxic. Whether it is on the right side or on the left side, whether he is aggravated by heat, whether he wishes to be covered or whether he wishes to be uncovered, whether he is walking about the room or muttering in delirium or various other characteristics which this particular patient, by which this particular patient responds to his particular illness.

We do not treat the pneumonia, we are treating the patient who has pneumonia. That is the particular difference from physiological medication which makes use of a drug to treat a particular illness given a diagnosis.

The two schools, however, are coming closer and closer together, the concept of Hahnemann have gradually been absorbed over the years by those who practice in general medicine in the so-called allopathic or physiological field.

Does this give you the answer?

Senator DIRKSEN. You have got me more confused than ever now. [Laughter.]

The CHAIRMAN. Doctor, you have made

Dr. BAKER. That is the unfortunate thing, when we try to explain homeopathy it is very confusing. I have a directory of the homeopathic physicians in the country, approximately 1,500 names which I shall be glad to submit to you.

The CHAIRMAN. Doctor, I don't believe you covered all the points included in the last page of your testimony. Would you like for it to be inserted in the record?

Dr. BAKER. Yes, sir.

The CHAIRMAN. It will be placed in the record at this point. (The material referred to follows:)

INFORMATION CONCERNING HOMEOPATHY

1. Homeopathy or homeo-therapeutics is a specialty in the field of medicine which employs drugs which are prepared according to the standards of the Homeopathic Pharmacopoeia and prescribed according to precise scientific principles based on the law of similars.

2. This method of therapy is employed by qualified graduates of medicine who have obtained a degree, doctor of medicine, and in addition have obtained a knowledge of this specialty, either in medical college or by intensive postgraduate instruction.

3. The Homeopathic Pharmacopoeia is a book containing a list of drugs, chemicals, or medical preparations, with descriptions of them, tests for their identity, purity, and strength, and formulas for making them, which is issued periodically by the American Institute of Homeopathy (in the United States) founded in 1844, as the first national medical society in this country. The most recent edition was published in 1964.

4. It is necessary to have a separate Homeopathic Pharmacopoeia because homeopathic drugs are prepared by different technique and prescribed in different dosage than physiological drugs which are described in the United States Pharmacopoeia, and different drugs appear in the two pharmacopoeias.

5. The law of similars was originated or discovered by Samuel Hahnemann about 1795. It states that likes cure likes; i.e., drugs which can produce certain symptoms, when given in toxic dosage to a healthy person, can cure illness or disease which is characterized by similar or identical symptoms.

6. Homeopathy differs from other methods of healing in this manner:

(a) The drugs are prescribed according to a definite symptom complex, rather than for a disease entity.

(b) They are given in minimal or subphysiologic dosage.

(c) Sensitivity reactions seldom occur; toxic reactions rarely occur; fatal poisoning is unheard of.

(d) Each patient is carefully individualized and the drug is prescribed which is characteristic for him rather than the disease.

7. Homeopathy or homeo-therapeutics is limited in its use by the medical profession for it requires years of study to learn its technique and prescribing for the patient requires detailed and time-consuming study to select the best drug. It is therefore not applicable to empirical or mass prescribing except in a few acute illnesses.

8. It is in general use throughout the world, being particularly popular in England, Germany, France, Mexico, Brazil, Switzerland, Italy, and India. In the United States its spread has been hampered by individualism and pharmaceutical advertising of items having a much higher profit for the manufacturer in trademarked preparations.

Senator LONG. Doctor, let me ask you, I was reading the previous statement when you started on yours so it left me more confused than I was otherwise, but what is the attitude of the American Medical Association generally, that is, those who treat by the more traditional method-what is their attitude toward homeopathy, do they approve of it or

Dr. BAKER. I have been a member of the American Medical Association since 1930. I have been a fellow of the College of Physicians since 1942. Both of which are so-called old school organizations. I have never encountered any opposition. Others may say they have. But my relations have always been most pleasant. I am president of the examining board for the District of Columbia. I have been president of the staff of Hahnemann Hospital until we merged with Sibley Hospital. I now have my staff appointment as vice chairman of the Department of Internal Medicine at Sibley, and I would hardly think that would indicate disapproval.

Senator LONG. Well, you know what their attitude is toward the chiropractors generally.

Dr. BAKER. Yes, sir.

Senator LONG. That is not the same situation here. They perhaps practice a different way but don't quarrel with whether or not you are getting results using your approach?

Dr. BAKER. I think any quarrel would be between individuals. Hahnemann Medical College in Philadelphia has met all of the standards and been more or less taken over by so-called "organized medicine." It is one of the outstanding colleges in the country at the present time. New York Medical College, Flower Hospital in New York, met all of the standards, were taken over. There previously were chairs at Ohio State University, Michigan, Boston University, and a number of others. There were several other medical colleges, but the medical curriculum is such today that it is impossible to ge into the specialties. Just as it is impossible, for instance, to go into orthopedics, otolaryngology, or other specialties in the medical school. There is a basic curriculum which has to be completed and then you have to specialize afterward and that is in my opinion where homeopathy belongs today.

The CHAIRMAN. Thank you very much, Doctor.

Dr. BAKER. Thank you, sir.

The CHAIRMAN. The next witness is Dr. Victor B. Buhler, of the College of American Pathologists.

Take a seat, sir, and proceed.

STATEMENT OF DR. VICTOR B. BUHLER, PRESIDENT OF THE COLLEGE OF AMERICAN PATHOLOGISTS; ACCOMPANIED BY OLIVER J. NEIBEL, JR., EXECUTIVE DIRECTOR AND GENERAL COUNSEL OF COLLEGE OF AMERICAN PATHOLOGISTS

Dr. BUHLER. Mr. Chairman and members of the Committee on Finance, I am Dr. Victor B. Buhler, of Kansas City, Mo., president of the College of American Pathologists. I am accompanied by Mr. Oliver J. Neibel, Jr., of Chicago, Ill., executive director and general counsel of the college.

The College of American Pathologists is a professional society of physicians representing approximately 4,500 doctors of medicine practicing the medical specialty of pathology in hospitals, medical schools, clinics, government, research, and private offices throughout the country. I appear before you today representing these physicians in support of those provisions of H.R. 6675 which provide for the payment for physicians' services in the field of pathology, radiology, anesthesiology, and physicial medicine in the voluntary medical care insurance section of H.R. 6675, title XVIII, part B, which is now before this committee for consideration. By the same token, I am appearing here today in opposition to amendments 79 and 156 to H.R. 6675 and any similar amendments which would define the professional services of pathologists as hospital services under title XVIII, part A, or provide for compensation for the services of pathologists through hospitals or other institutions. My presentation today will be confined to these important matters.

First, I would like to emphasize that pathologists are doctors of medicine. After an individual graduates from medical school he must spend at least 5 additional years in intensive training called a residency

in order that he may be certified to practice the medical specialty of pathology.

Both H.R. 1 and S. 1, as well as similar bills presented to earlier Congresses, specifically excluded "medical or surgical services provided by a physician" from the definitions of "inpatient hospital services" and "outpatient hospital services." On this basis, proponents of such legislation maintained that the bills neither interfered with medical practice, nor covered physicians' services.

This claim was not, however, totally accurate. This is because the professional services of physicians in four specialties of medicine: radiology, pathology, anesthesiology, and physiatry, were excepted from the general exclusion of physicians' services. These doctors were thus set apart from all other physicians, and these medical specialties were by implication excluded from consideration as a part of medical practice.

In passing H.R. 6675, the House of Representatives removed this adverse discrimination against these doctors by treating physicians' professional services in these specialties in exactly the same way as other doctors' services were covered.

Speaking quite frankly, pathologists would have preferred to have the total payment for their professional services placed in the voluntary insurance portion of the H.R. 6675 (pt. B), and then for the pathologist to reimburse hospitals for the space, equipment, supplies, personnel, et cetera, furnished by the institution. We genuinely believe that this would have provided maximum physician control over the medical service rendered to each patient.

However, the House of Representatives chose in enacting H.R. 6675, to provide that the costs involved in the operation of hospital beds, the laboratory, the operating room, the department of radiology, and the anesthesiology service be reimbursable as hospital costs under title XVIII, part A. Fees for the services of physicians in internal medicine, pathology, surgery, radiology, anesthesiology, et cetera, would be all paid under the same part B of the bill.

This legislative disposition is in keeping with the overall economies of the practice of medicine and acknowledges that the professional services of pathologists have been traditionally recognized as a branch of the practice of medicine just as is surgery, general practice, and internal medicine. Pathology, as well as the other three specialties, have sections in the scientific assembly of the American Medical Association; we have a recognized medical specialty examining board, and we are recognized as divisions of medical practice within the armed services, the Veterans' Administration, and the U.S. Public Health Service. State attorneys general in California, Colorado, Florida, Idaho, Illinois, Iowa, Louisiana, Ohio, Pennsylvania, Tennessee, Utah, Washington, and West Virginia have issued opinions the import of which is to deny hospitals the right to practice medicine through employed physicians. These attorneys general were following by far the majority rule that a corporation cannot engage in the practice of medicine. The status of radiology and pathology has been litigated in Iowa and the courts in that State have squarely ruled that radiology and pathology are medical practices, or services, and may not be provided by hospitals-but only by physicians in hospitals. It is for these reasons, and others which I will discuss presently, that the College of American Pathologists accepts and endorses the