Cognition-Based Medicine: A new paradigm for medicine - applied to Homoeopathy

The objective of this article is to introduce the concept of Cognition Based Medicine (CBM) as a convincing alternative to Evidence Based Medicine (EBM). CBM was developed on the basis of a refutation of the positivist paradigm through Karl Duncker and Curt J. Ducasse. Contrary to Hume′s ideas, we are well capable to discern causality by observation in single cases. This has been demonstrated by Duncker through some simple examples of causal cognition. He termed this concept “Gestalt-cognition”. “Gestalt” means form, structure and process and stretches from a cause into its effect.Helmut Kiene, a German medical doctor and researcher, introduced CBM in 2001, by publishing his book “Komplement re Methodenlehre der Klinischen Forschung” (Complementary Methodology in Clinical Research).Following Kiene′s arguments, the development of the epistemological foundations for EBM from the 16th up to the 20th century will be depicted, with a special focus on RCTs, and on “placebo” in its role as a surveyor′s rod for measuring the effect of any given therapy.Next, CBM with its focus on single-case-cognition as the basis of progress in medicine will be described. Kiene analyzed the published research of four volumes of ′The Lancet′ to demonstrate the validity of this concept.Hahnemann′s finding of the Law of Similars serves as an example of gestalt-cognition.Practitioners should make the tacit knowledge they are gaining from single-case-cognition available to other colleagues, to improve the bases of clinical judgement. Kiene and his co-researchers propose a structure for the publication of single cases, which contains various important criteria to be fulfilled.This structure will be applied to the special necessities of Homoeopathy. A custom-made questionnaire will be presented.