Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Chapter 3: Details of The Homeopathic Philosophy and Proving CHAPTER 3 Details Of The Homoeopathic Philosophy And Proving Abstract: The philosophy of the elements of homeopathic treatments will be detailed in this chapter. These elements are ; disease and totality of symptoms, proving of the artificial disease produced by remedy, the required similarity between the artificial disease produced by the remedy and the totality of the symptoms on the patient and the laws and concepts that should be employed in case taking and applying remedy. In addition, closely related types of remedies such as Bach’s and Biochemical remedies will be also outlined. While it is true that homeopaths presently do not know precisely how the homeopathic micro doses work and skeptic views from modern pharmacologists; some compelling theories about their mechanism of action and evidence that supports efficacy are detailed in this chapter. Furthermore, a review of small body of clinical and cost effectiveness research is given to answer the questions of skeptics’ views about the efficacy and safety of the homeopathic micro doses. Finally, more research is needed to help homeopaths to optimize the homeopathic health care systems and managements. Such system will reduce cost of doctors’ visits and hospitalization. 3.1. Disease and Symptoms1 Hahnemann stressed that a disease can only be recognized by its perceptible signs or symptoms. Furthermore, he believed that it’s the totality of these symptoms to which the physician must address himself. Disease (from the French word ‘disaise’ in this context may be defined as an abnormal condition, constituting a deviation from a sound state of health, characterized by disturbance, derangement or impairment of functions of the body or mind. Thus, a specific disease exhibits characteristic symptoms, which may be accompanied by the presence of specific parasitic organisms in the blood or tissues. Symptom (from the Greek, ’sumptoma‘meaning chance or casualty) is defined as a predictable change or sign, in all organs or organic function due to, and indicating, the presence of disease. ‘A single symptom is no more the whole disease than a single foot of a man’ (Organon, para 7).’Orthodox medicine attempts to suppress only one of many symptoms that diseases present, not only that, they could also be the cause of other appearing symptoms (side effects), and so it’s a short sighted method, which does much harm. The totality of symptoms, the outer image expressing the inner essence of disease must be the main event, which only means by which disease allows us to find the necessary remedy. In every individual case of disease, the totality of symptoms must be the main physician’s principal concern’. To illustrate the suppressive nature of conventional or orthodox treatment, let us consider Inflammation, which is an essential part of the body’s natural immune response to injury or infection. 1 Extracted from http://www.ecn.cz/alternativa/book/hocu13.htm 33 The pain of inflammation is due to the stimulation of the nerve endings by the inflammatory chemicals – histamine and others-which are released. These chemicals increase the blood flow to the damaged tissue and cause an accumulation of white blood cells .the white blood cells destroy the invading microorganisms and are involved in repairing damaged tissue. Thus, by taking conventional drugs to suppress inflammation, like corticosteroids drugs or NSAIDs, the body’s natural immune response will be hindered. As stated in the Organon (para. 8); “we can categorically declare that the totality of symptoms and the circumstances observed in each individual case is the one and only indication that can guide us to the choice of remedy’. Factors that cause and sustain disease are important to the homoeopathic physician; since permanent elimination of a headache is only clarified if the cause of the headache can be determined e.g. a headache caused by a blow to the head is treated differently than a headache caused by stress. This was also clearly stated in the Organon in para.5 as follows; “It will help the physician to bring about a cure if he can determine the most probable exciting cause in an acute disease and the most significant phases in the evolution of a chronic, long lasting disease, enabling him to discover its underlying cause”. Homeopaths look at local diseases as a defense of the organism, as a defense of the governing center against declivity, against developing a chronic constitutional disease, against weakening of the constitution. Remarkably, symptoms of disease also signify a certain level of inner health - ability of the organism to put up a defense against decay. Through tonsillitis the organism prevents the pathology from advancing inwards by allowing the tonsils, a lesser organ on the outer line of defense, to become infected. The organism is able to stop the advance here. If we interfere with antibiotics, the bastion is conquered and the disorganization moves on. The next round of the fight might be fought out on the kidneys, on the lungs or on the heart. Fig.1. loosing control with conventional medicines. 34 Returning to the analogy of the staircase; each step represents a particular line of defense, an obstacle to further descend. If we demolish the step by allopathic drugs, the staircase turns into a slide. Another possibility is that the center is too weak and incapable of placing any steps to bar the natural fall into pathology, and such a person slides right down to the most serious diseases, without any colds or rashes. e.g. some reported appearance of cancers where the pathology advances without obstacles, straight to the most important organs, and so the patient is never on the stair case instead he is always on the slide. Opposed to this we all have our experience with hypochondriacs, people who constantly complain of some pains, who always have some inflammations, whose bodies ever give them warning signals - and such people usually live to a ripe old age. They have a relatively strong governing center, which stubbornly resists any moves towards pathology, constantly displaying some symptoms. There is yet another group of people, unfortunately growing fast. Here belong the regular drug addicts who use heroin and similar things, but also the "legalised drug addicts" - those who take sleeping pills and tranquillisers and all kinds of tablets, if possible as prevention. Their practical approach to our staircase is as follows: They take a run up at the top and jump, evading all the unpleasant encounters with the steps. They want to avoid the suffering, which the staircase (as a painful obstruction) would cause them. And they succeed to a degree. Nevertheless, the harder they crush at the bottom and the sooner it happens. Such a dive might result in the complete destruction of their immunity system (or the ability of their center to combat pathology) and in other and most serious chronic illnesses, i.e. kidney disease, liver disease, heart disease, malignant tumors... From the homeopathic point of view, symptoms (the organism's defense) have another important aspect. They provide us with the main lead for selecting the remedy. Where there are no symptoms there cannot be any treatment. "No symptoms, no cure.", says a distinguished American author. The cases of patients who display only a small number of symptoms or "lesser symptoms" can be more difficult to treat, and sometimes it is necessary to try out several remedies before the target is hit. To a homeopath, the human body and the mind are like windows displaying the patient's inner state. When the display is hazy we learn little. It is sometimes easier to treat the patient with a large number of symptoms than the patient who is almost without symptoms. On the other hand, few people would pass as being healthy, in front of a homeopath, few of those who declare that they are healthy, at any rate. Practically all people display some signs or symptoms that characterize their constitution, either in the mental area, in the general reactions, or in the minor physical pathology. This, of course, is great, as it enables us to give the constitutional remedy even to relatively healthy people, as prevention; so this proves that homeopathy is still not totally against the use of conventional therapy unless misused. Treatment from the Center The pinnacle of health is perhaps characterized by a person whose physical organs are in perfect order, but who also stands on a high level of mental, psychological development. And such a person can be created from a previously diseased one, precisely by the homeopathic method of treatment. The reason is that homeopathic cure affects both the body and the mind at the same time. Whatever is happening within the mind is reflected on the physical organs, and whatever happens in the body also influences the mind. 35 According to Hering's Laws of Cure, when the correctly prescribed remedy is applied, the curative process first affects the mind, which includes the power of our will, evaluation, decision making. The next "envelope" in which the process of treatment, the "curative wave" manifests, is the emotional layer. From here the cure moves onto the physical organs, in order of their importance for the sustenance of life functions (the brain, the heart, the kidneys, etc.), or in the reverse order to how the symptoms first appeared (the former is usually virtually identical with the latter). At the same time during the treatment entirety of the whole being is maintained. As long as pathology exists in the physical organs, the mind cannot be entirely healthy either. Fig.2. Homoeopathic holism considerations. We often hear the allopathic doctors say, particularly after a prolonged unsuccessful treatment, and in cases where the physical cause cannot be exactly pinpointed: "That problem of yours (those pains), it's only psychological. It's a psychosomatic matter." They imply that nothing can be done in this case, and that after all, it is not considered to be very serious. As opposed to that, a homeopath thinks of all diseases, acute or chronic, as being closely related to the mind and psychology. Even though he or she does not believe that the cause would be exactly in the mind. It is higher - in the nonmaterialgoverning center, which can be influenced by the nonmaterial potency of the remedy. 36 3.1.b. Fundamental principles of homoeopathy in The Organon2 Only in 1810 “The Organon of Medicine” was published in Leipzig, in which the entire system of homeopathic treatment is outlined and described. During the lifetime of its author it went through four more editions, which were in passing changed and corrected (2nd edition 1819, 3rd edition 1824, 4th edition 1829, 5th edition 1833). The sixth edition, came out a long time after Hahnemann's death. The Organon, in its 294 paragraphs and with numerous subsequently added notes, offers not only the basics of homeopathic treatment, but also very detailed suggestions on treatment. At the same time it warns against the mistakes in treatment, those made out of ignorance, or even intentionally. A large part of the work, particularly the sixth edition, is formed from the polemics with allopathy, or the orthodox medicine. Hahnemann in his Organon: (a) In the light of the new method offered a thorough criticism of allopathic treatment. (b) Outlined the basic principle of the new treatment, i.e. prescribing the remedy accordingly to its similarity to a particular disease. (c) Designed the course of examinations that determine the effect of remedy on a healthy person. (d) Established that only one remedy should be given at any time, as only one correctly selected remedy can affect the totality of all symptoms of the patient. Thanks to the proving, we know the effects of the remedies described in the Materia Medica (s). If we mixed two or more remedies together, we would get a compound of unknown properties, where the parts interfere with each other. It would be a shot into the dark. The practice has reliably proved that such mixtures have uncertain or suppressive effects, discrediting homeopathy through their results. If the remedy does not work as it should and does not bring about a complete cure, any fine-tuning must always be done through the more accurate prescription of a homeopathic remedy. Hahnemann called the practitioners allured to combining the homeopathic remedies with the occasional use of conventional orthodox drugs, rather than of the correct simillimum, "the homeopathic bastards", and often publicly attacked them. He worried that if such improper practices were to become widespread, homeopathy could cease to exist. (e) Hahnemann's conscientiousness on the one hand assured that homeopathy as a pure idea had survived and progressed further, on the other hand it made him a lot of enemies, not only from the ranks of allopaths, but also in the camp of "lukewarm" followers of homeopathy, who also used the allopathic methods. (f) Hahnemann described the process of manufacturing remedies and how to make them into homeopathic potencies through successive dilution and shaking. (g) He defined the philosophical horizon of the treatment, which at the first sight does not appear to be directly related to the medical practice, but to a deeper and more informed viewer it forms the core of the system. Those unable to perceive this core can never become good and successful homeopaths. They will always be liable to be seduced by the opposing systems of thought and would incline towards using allopathy to suppress an illness. In this context, Hahnemann (and naturally all of his followers), was marked by the allopaths as a dogmatist, insistent on his truth to the letter and incapable of any dialogue. Hahnemann nevertheless pointed out that homeopathy when practiced only partially, with some of its principles rejected, i.e. the product of such a "dialogue", is no longer homeopathy and does not achieve the curative results. The same dogmatic approach can be observed in other fields too. For example, the mathematicians dogmatically insist that 1 + 1 = 2 and no one could talk them out of it; if they abandoned 2 Please refer to chapter 2. 37 their dogma, the whole system of mathematics would collapse. With homeopathy it is the same. When its basic principles are deserted, the system collapses, the treatment becomes haphazard, the results uncertain, it is no longer capable of curing chronic diseases, it may perhaps be of a suppressive character. (h) Hahnemann established how the patient should be examined. (i) He outlined how the case should be followed further, and stated that the remedy should be applied again only when the curative effect of the first dose had ceased, and the disease tends to return to its original state before the treatment. (j) He said that disease is never a single entity, nothing that exists on its own, nothing that could be passed on as an item. Disease is always a fault within the dynamic system of organism. Disease means that something in the organism, either in the psychology or its physical parts, unwinds in a different way than it should. "There are no diseases, there are only diseased people". By this Hahnemann implied that diseases mean nothing to him, that they are no leading strings to therapy. The remedy must always be selected in accordance to the overall state of the organism. (k) Hahnemann established that the organism (including the psyche) is guided by the non-material "animating force", "dynamis", and a non-material organizing principle. In a healthy organism, a healthy organizing principle rules. Such organism cannot be touched by any disease, and from experience we know, that many people do not fall ill during the epidemics, even though they breathe the same air, drink the same water and eat the same food as those who become ill. An inclination towards illness occurs only when the organizing principle has been disturbed. Then there is the inclination towards pathology. When administering a homeopathic remedy, first restored is the organizing principle, it then restores to health the body and the mind. The bacteria, running a riot on the tonsils, disappear in a short while after the remedy was taken, without a need to kill them by antibiotics. They depart, rejected by the healthy organism, which again has a healthful governing center. All disorders come from this center. This is a well-known truth, understood by the economists, as well as the politicians. A bad government means that the country is on the decline. The success of any company depends above all on its management. The company that is well managed with inventiveness and flexibility will survive during a recession. Even if attacked by terrorists, it will repair the damage, dress its wounds, restore its workmen; so long as it has capable managerial staff, who had secured ample financial reserves, who had sent out the rescue workers, who had organized the help to the victims, etc. The far-sighted management may even warn off any terrorists before they strike. An organism with a healthful center will defy any bacteria. The logic of this is quite clear, nevertheless the only problem is that to date no X-ray, no microscope, not even a magnetic resonance, let alone a scalpel, have been able to reveal such a governing center. This is the fundamental problem in the controversy of idealism with materialism. The materialists insist on having some tangible evidence. Why, they have it. There is the health, given to many people by homeopathic remedies. (l) In the context of the above, Hahnemann said that even the smallest dose (or the highest potency) could never be as subtle as the actual cause of the disease. Essentially this means that the disease is always of a spiritual origin. A brave idea? Hardly. A logical one. There is something spiritual in any idealistic system in the first place, and something material as its consequence, in the second place. (m) Hahnemann laid out the dietary rules that the patient should follow. They were a great deal stricter than those held by the contemporary homeopaths. For example, among others, he did not recommend tea or pork meat. Note: For further reference to the Organon please refer to chapter 2. 38 3.1.c. Proving and the Materia Medica Hahnemann, his family and co-workers spent the rest of their lives extensively testing, or "proving," many common herbal and medicinal substances to find out what symptoms they could cause. Apart from the results of homeopathic proving, the remedial picture is also formed by the knowledge of toxicology, information gained from accidental poisonings or from criminal investigations. And, naturally, from experiences gained in homeopathic clinical practice, as the effectiveness of remedies can be verified and the knowledge increased particularly through the study of patients and their reactions to the prescribed remedies. The basic diagnostic tool is a book containing the detailed pictures of individual remedies. The first one was Hahnemann's Materia Medica Pura, Hahnemann’s second major work. It was published in six volumes between 1811 and 1821. The Materia Medica Pura consisted of symptom pictures from proving of 66 remedies, listed alphabetically, with their characteristic symptoms and indications for use. To put this in another way, it consists of a list of the proving symptoms for each remedy .these symptoms were grouped together or categorized, under the following headings: -Mind - Head -Eyes -Ears -Nose -Throat -Stomach -Abdomen -Stool -Urine -Male -Female -Back -Extremities -Respiratory -Sleep -Heart -Fever -Skin Each remedy was listed alphabetically, by its classical Latin name followed by its common English name of the source of the remedy e.g. RHUS TOXICODENDRON (Poison Ivy). This is followed by an introductory account of the general effects, affinities and special characteristics. After the listing of the proving symptoms, follows a list of Complementary Remedies (remedies which act to assist the remedy used, in its action or which follow well), and finally the Modalities. Dozens of other Materia Medica publications followed, all adopting the same format. The reason for the creation of more books was the increased knowledge of the remedial effects. The number of remedies that were tried out has also increased. The various authors had various views of the remedies, some stressed their psychological effects, others preferred the general symptoms, some had concentrated only on the characteristic nature of remedies, omitting the general symptoms, others tried to present a clear view of the symptoms, etc. Such a variety of views is useful, because each individual patient has to be viewed from a somewhat different angle. Therefore, every homeopath should have more Materia Medicas to his or her disposal. 39 3.1.d. Closely related remedies 3.1.d.i. Bach remedies The ‘Bach Remedies’ are closely related or analogous to homoeopathic remedies, although they are not strictly homoeopathic since they are not prepared in potencies. Dr.Edward Bach, (1886 – 1936), practiced as consultant, bacteriologist and homoeopath for more than 16 years in London, before he gave up his homoeopathic practice in 1930 and settled in Oxford shire in England to devote the rest of his life to a search for a more natural method of treatment which, as he explained,’ requires nothing to be destroyed or altered ‘. He came to the conclusion that disease was not primarily due to physical causes, but to deeper disharmony within the patient. He thought that distress of mind, such s fear, worry, anxiety, impatience, depletes the vitality of the individual that the body loses its natural resistance to disease and is then vulnerable to infection or any form of illness. With the help of the healing properties of the wild flowers of the countryside, he found the sufferer could gain strength to overcome his or her anxieties, fears and depressions. Dr.Bach had previously gained fame for his work with Dr.Paterson in introducing the Bowel Nosodes, which are now an important part of the homoeopathic Materia Medica. Dr. Bach’s own interpretation of the action of these remedies was expressed as follows: ‘The action of these remedies is to raise our vibrations and open up our channels for the reception of the spiritual self; to flood our natures with the particular virtue we need and wash out from us the fault that is causing us harm. There is no true healing unless there is a change in outlook, peace of mind and inner happiness.’ His theory was that all diseases are of mental origin, and they are, thus, prescribed on the basis of mental indications only. He developed 38 remedies, prepared from fresh flowers, trees and special waters. Each remedy is associated with a specific set of emotions. The remedies are shown in Table 1 (the key symptoms are the most characteristic symptoms, when energy is blocked and the energy of the flower is needed and, therefore, they enable diagnosis) 40 Table 1. Bach Remedies Remedy Agrimony Aspen Beech Centaury Cerato Cherry Plum Chestnut Bud Chicorv Clematis Crab Appis Elm Gentian Gorse Heather Holly Honeysuckle Hornbeam Impatiens Larch Mimulus Mustard Oak Olive Pine Red Chestnut Rock Rose Rock Water Scleranthus Star of Bethlehem Sweet Chestnut Verrain Vine Walnut Water Violet White Chesnut Wild Oat Wild Rose Willow Symptoms Concealing, torturing thoughts, inner restlessness Fear of unknown things Intolerance, arrogance The inability to say ‘no’, weak willed Lack of trust in one’s own decisions Fear of the mind giving way Failure to learn from mistakes Selfish, possessive love Dreaming of the future without working in the present The cleansing remedy, also for self-hatred Overwhelmed by responsibility Discouragement after a setback Hopelessness and despair Self-centeredness and self-concern Hatred, envy and jealousy Living in the past Procrastination, tiredness at the thought of doing something Impatience Lack of confidence Fear of known things Deep gloom for no reason The plodder who keeps going past the point of exhaustion Exhaustion following mental or physical effort Guilt, self reproach Over-concern for the welfare of loved ones Terror and fright Self-denial, rigidity and self-repression Inability to choose between alternatives Shock Extreme mental anguish, when everything has been tried and there is no light left. Over-enthusiasm Dominance and inflexibility Protection from change and unwanted influences Pride and aloofness Unwanted thoughts and mental arguments Uncertainty over one's direction in life Drifting, resignation, apathy Self-pity and resentment 41 The 39th remedy as it’s often called is, in fact a combination of five Bach remedies and it’s probably the best known. It’s a first aid treatment for emergency situations, whilst waiting for medical assistance. e.g. traumatic situations, after a family row, witnessing an accident, or before an operation. 3.1.d.ii. Biochemic remedies Also known as the Tissue remedies or Schuster’s tissue salt remedies. This is a system of medicine evolved by Dr. Schussler in 1873. Schussler was a homeopath who propounded the theory that disease is caused by the insufficiency of organic salts in the tissues/cells of the body and that the supply of these deficient salt(s) cures diseases. Schussler identified 12 homeopathic medicines as the Biochemic remedies. These twelve basic salts are: 1) Calcarea fluor (Calcium fluoride) 2) Calcium phosphorica (Calcium phosphate) 3) Calcium sulphate 4) Ferrum phosphorica (Iron phosphate) 5) Kali muriaticum (Potassium chloride) 6) Kali phosphorica (Potassium phosphate) 7) Kali sulphurica (Potassium sulphate) 8) Magnesia Phosphorica (Magnesium phosphate) 9) Natrum muriaticum (Sodium chloride) 10) Natrum sulphuricum (Glauber's salt - Sodium sulphate) 11) Natrum phosphoricum (Sodium phosphate) 12) Silicea. They are given in a low potency 1x, 2x, 6x, and 12x, 30x. Table 2 lists out the Biochemic remedies. It also points out the indicators for prescription of these medicines - such as the state of the tongue, the discharges, the aggravations (factors worsening the problems) and ameliorations (factors improving / alleviating the problem). 42 Table 2. Biochemic remedies Medicine Symptoms Occurring Discharges Indicated mainly in State of tongue Calc fluor Bone related problems, lumbago, piles Cracked Calc phos General tonic, cough, skin problems Bad taste in the morning Calc sulph All kinds of suppurations Clay coloured, sour, soapy, acrid taste. Ferr phos First stages of all pains, fever, inflammations Clean & red. Also throat dry. Kali mur Respiratory problems, tonsils/throat problems White or grey coated Kali phos Brain disorders. Nerves & muscles related problems Stale, brownish – mustard like taste. Dry in the morning. Conditions of Aggravations Thick, lumpy yellow discharge from nose, Expectoration yellow mucus. Flooding in menses, yellow pus from ulcers Discharges albuminous (like the white of egg) Damp weather. Rest Discharges of gonorrhea & leucorrhoea / expectoration much bloody - yellow mixed with blood Dryness, burning & scanty expectoration mixed with blood, Menses bright red. Easily coagulates Getting wet. By washing. Water. Thick, white, slime or phlegm. Motion clay coloured, Stools bloody, blood from scales (eczema) Blood thin, black, offensive odour. Burning scalding. Dysentry with pure blood, stoolsoffensive odour. Night. Cold. Getting wet. Ameliorat ions Cold fomentatio n. By rubbing. By Heat Warm room. Warm weather. Warm. Dry environme nt. Heat. Hot drinks. Motion. Shaking of head. Stooping Eating rich & fat food. Motion Cold air. Cold applicatio ns. Noise. Being alone. Exertion. Cold. Cheerful excitement . Gentle motion. Rest. Heat. Hot applicatio n& drinks. 43 Continue… Table 2. Biochemic remedies Medicine Indicated mainly in Kali sulph Headaches, Skin related, asthmatic problems Mag phos Spasms, pains, cardiac related problems. Nat mur Nat phos Symptoms State of tongue Occurring Discharges Yellow, slimy, whitish edges. Taste lost, burning heat in mouth. Peeling of lip skin. Clean / coated white. Dry mouth, sticky saliva at corners of lip. Slimy, yellowish or greenish mucus discharge. Skin hot and dry. Scaling of scalp. Expectoration profuse – shiny, yellow/greenish. Diarrhea watery, menstrual flow – dark, clotted, intermittent. Malarial conditions, gastrobilous problems. Dry, parched, sore throat, salty taste, blisters. Liver & gastric problems. Moist, yellow, creamy at back of tongue. Acid taste. Excess secretions, sneezing, vomiting of clear, watery phlegm (with great thirst). Diarrhea watery. Thin watery blood with menses. Polyuria (diabetes), Leucorrhoea discharge watery, starch like. Creamy discharges (eyes, ears). Vomiting of sour fluids. Morning sickness. Sour smelling stools (with mucus). Yellow discharges (eczema, leucorrhoea. . Conditions of Aggravations Ameliorat ions Evenings. Cool air. Warmth. Open air. Pains move from side to side. Open air. Cold air. Uncovering. Touching. Motion. Cold drinks. Pressure. At Night. Mornings. Cold air. Open air. Thunderstorm. Afternoon. Evening. Open air. After eating. Itching in bed. Headache (morning) Warm room. Warm weather. Hot drinks. Light pressure. Friction. Bending over double. Evenings. Warmth. Pressure. Warmth. Warm room. Pressure. 44 Continue… Table 2. Biochemic remedies Medicine Indicated mainly in State of tongue Nat sulph Diabetes, chills, pains. Dirty green, grey, brown. Bitter taste. Full of saliva. Sil Skin, spine & mental problems Hardening of tongue, ulcers. Symptoms Occurring Discharges Pus changes to green on exposure to light. Diarrhoea green stools, urine red, brick-like. Diabetes, eczema yellow watery. Pustules, yellow pus,loose expectoration, rattling of thick yellow pus. Stools foetid, offensive. Pus & mucus in urine. Foot sweat. Conditions of Aggravations Ameliorations Cold. Dry and warm Wet. room. Cold Weather. Warm weather. Water. Night. Full moon. Open air. Cold air. Winter. Heat. Warm room. Summer. Indicators for Biochemic prescriptions: The following medicines are generally indicated for the specified problems. It is advisable to start the medicine with low potency (1x / 3x)** and proceed to higher potencies (6x,12x,30x and even 200x) in case there is no improvement. However for severe problems, higher potencies may be started off with. Dosage generally is three times a day (4-6 pills at a time), taken dry on the tongue, on an empty stomach. In case of acute problems - the medicine may be taken every 15 minutes or half-an-hour. In case there is no improvement even after 6-7 doses, either change the prescription or consult a competent doctor.(still there is no substitute to the Materia medica / repertory) * Potentised remedies: designated as nX, nXH, nXD 45 Table 3. Biochemic indicators SYMPTOM / PROBLEM / INDICATOR Fever Hair falling - thin hair strands Hair falls due to weakness or ailments suffering from Hair falls in bunches Hair growth - to stimulate Hair loss (bald spots) due to dandruff Impotency Jaundice Leucorrhoea Lumbago - aches worse by cold & better by heat & pressure Lumbago - pain at nape & cervical region Lumbago - pain worse while resting, better by heat. Mania (depressions, mental problems) Mouth ulcers Obesity (overweight) Osteoarthritis Pain - colic, abdominal, stomach Paralysis Piles (Itching, bleeding) Pimples , acne Sinusitis Sleeplessness (Insomnia) Stone in kidney Suicidal disposition (wants to die) Tonsillitis, pharyngitis, sore throat Toothache Typhoid (fever) REMEDY INDICATED Ferr phos & Kali phos Nat mur Cal phos Sil Calc phos & Sil Kali sulph Cal phos / Kali phos Ferr phos, Kali mur, Nat sulph Cal phos / Kali mur / Nat mur Mag phos Calc phos Calc fluor Kali phos Ferr phos, Kali mur, Nat phos Calc phos, Nat mur & Sil Mag phos Mag phos Calc phos, Kali phos, Mag phos Calc fluor Calc phos Kali mur & Sil Kali phos & Ferr phos Mag phos to alleviate Sil & Calc phos to dissolve stone Kali phos Kali mur Kali phos Ferr phos, Kali phos & Kali mur pain 46 Vertigo (giddiness) Weakness, general debility, exhaustion Worms (children) Kali phos Kali phos Nat phos & Kali mur 3.2. Types Of Homeopathy There are different types of homeopathy dealing with classical, constitutional, and complex means; 3.2.a. Classical homeopathy: Classical homeopathy is dr. Samuel Hahnemann’s doctrine and system of healing based on clearly, comprehensible principles. Scrupulous adherence to all of these principles as set out in Hahnemann’s organ on of medicine is the authentic practice of classical homeopathy. Today there are many different theories and ideas about the use of homoeopathic medicines, but the foundation and science of classical homeopathy emanates from Hahnemann, and is distinct. It is based on the recognition that health and disease are a change of state in each individual and depend on the individual’s life force (i.e., vitality, or dynamic energy), state of susceptibility, and inherited predispositions. Classical homeopathy addresses the totality of the imbalanced individual. This involves investigating and evaluating all the subjective and objective symptoms of the patient, in the context of their life circumstances and environment. The individualizing characteristics, which distinguish one individual’s mental, physical, emotional state from another’s, are scientifically analyzed indicating the medicine needed to restore balance. Classical prescribing is based on all the fundamental principles, including the law of similars— giving the medicine, which on proving on healthy humans (the homeopathic equivalent of drug trials) has shown the most similar characteristic symptom picture. One remedy is given at a time in the single, smallest dose required to achieve a curative response. The remedy is never routinely repeated and never combined with other remedies. 3.2.b. Constitutional Homeopathy: Homeopathy is particularly effective in the treatment of long-term health problems. For example, in cases of recurrent ear infections in children, although the child may obtain antibiotic therapy for the acute ear infection, the problem may recur frequently, leading to a general state of impaired health. In such a case, homeopathy can be used to strengthen the system to prevent the future infections. 47 3.2.c. Complex homoeopathy: Complex homoeopathy therapy produces an initial worsening in a small proportion of patient. The most worrying response is no change at all, and a reason must be sought for this. Treatment with complex homoeopathy is rather like peeling an onion; at each consultation another layer is peeled away revealing a slightly different clinical situation underneath. Therapy should be continuously modified to accommodate this changing state of the patient. Most complex homoeopathic preparations are available as drops and this means that it is fairly easy to find the optimal dose by trial and error, in any particular situation. This is more difficult to do with tablets. Complex homoeopathy relies on wasting the toxins released in this way out through the skin, urinary tract and colon .As a consequence it is not unusual for the urine to change color, the bowels to become loose, or for the odor of the sweat to be unpleasant as the toxins are released. In some cases of sinusitis the sinuses may start to stream or when treating inflammation of the external ear (otitis externa) the ear may start to discharge. 3.3. Initiation of cure through artificial disease Hahnemann elaborated on the simillimum principle in stating that the curative power of medicines depends not only on the symptoms they produce, but that they are stronger. Thus, ‘a disease can be cured most surely, thoroughly and swiftly, and permanently only by a medicine producing a totality of symptoms in a person most completely similar, but stronger. Hahnemann termed these stronger, similar symptoms thus induced, artificial disease. (Organon, para 29). The weaker natural disease is then controlled and taken over by the stronger, artificial disease since they cannot co-exist. This gives us another definition of a homoeopathic remedy – an ‘artificial disease including agent’. ‘In selecting the appropriate homoeopathic remedy, the symptom picture of that remedy which most closely matches the totality of the diseases symptoms is chosen. The medicine that has produced upon a healthy human body the greatest number of symptoms similar to those of the disease being treated is the only one that will cure.(Organon, para 25) . Hahnemann recognized that tit is virtually impossible to match the disease symptoms exactly .’Artificial disease brought on by medicine does not only have to be stronger in order to cure the natural disease. Above all, it must have the greatest possible similarity to the natural disease being treated’ (Organon, para 34). Complex disease When two diseases occur simultaneously, however, they may coexist only if they are dissimilar; they cannot mutually cure each other. Hahnemann termed such a condition as a complex disease .He 48 pointed out that even though they could not destroy each other, one disease might be suspended until the other had run its course. By the law of Similars, when two similar diseases occur simultaneously in the body, and one of these diseases is stronger, then cure can occur. In other words, two similar diseases cannot coexist in the same organism. Hahnemann exemplified this by pointing to the similarity between cowpox and smallpox, the former rendering immunity from the latter, (Edward Jenner, 1796), and between measles and whooping cough. 3.4. Mode of action Although the ‘anti-homoeopathy’ groups accuse homoeopathic preparations to be placebo, homoeopathic preparations still proved efficacy. Due to the absence of any biochemical active component in homeopathic medicine we conclude that the changes observed are not due to any direct pharmacological action of a conventional kind. In homeopathy a conventional pharmacological action IS substituted with an enhancement of the self vital force. In an approach to find the action field of medicine, Hahnemann realized that every medicine has its own characteristic and general actions which appeared as a group of symptoms. By matching those symptoms with the corresponding symptom picture caused by a disease, this seems to encourage the inner healing force (vital force) to self regain health and well being. i.e. a medicine which could cure a sick person could cause the same symptom in a healthy person. Hence, proving were made by observing symptoms developing in healthy individuals after giving them the medicine to be proved. Thereby, a medicine given to a healthy individual will produce similar symptoms observed in disease state. Hahnemann showed that the homeopathic medicine is effective because it acts like the disease disturbing the vital force, where the symptoms are produced to queue this disease or spread the energy of disturbance. Hence, the homeopathic principle depends on the opposing action of substance in quantitatively different doses; and so, the action of the homeopathic medicine on the vital force is only visible by its effects. A biphasic homeopathic action arises from a single dose. Primary action represents the usual pathogenic effect of the substance exacerbate acting those features of its drug picture that are present in the patient. This primary action evokes the secondary action, which is a counter action of the organism’s vital healing force. Yet on clinical and even sub clinical bases a primary action might precede the curative counter action and in sensitive patient strong primary reaction could evoke even with the use of extremely high dilution. Therefore a therapeutic aggregation observed as the primary phase of the response to a homeopathic prescription is not necessarily a feature of a good response since this primary action may be sub clinical or a possible exceptional case of a non matching constitutional prescription to the presented clinical picture. Unwanted aggravations may also arise by a prescription similar enough to provoke a primary reaction without stimulating a secondary response, and so no improvement features on any level, during or after the event, will be observed. 49 As a conclusion if there is any dissimilarity between the reaction and the existing clinical picture in the patient it is likely to be approving rather than an aggravation of any kind particularly if the dissimilar features are obviously typical of the medicine given. The time scale of an aggravation is unpredictable. Its onset can vary from few minutes up to few weeks from prescription. As for the duration, it’s from a matter of minutes to, very rarely, matter of months. No matter how aggravation is distressing, once it is identified and explanted it is usually tolerated well than the original symptoms due to improvement in well being. Since it is not guaranteed that aggravations will be entirely benign, it is better to use the simplest possible conventional means to manage the aggravation rather than a new homeopathic prescription. The body can only have one disease, as well as one pattern of disturbance, no matter how many facets there are to this, also there is only one vital force, one organism, and it works as a whole. If a stronger disease is introduced it will substitute the old disease. If the medicine is stronger than the disease it might as well take over, the original pattern of symptoms will only be removed permanently if the medicine is close enough in action to resonate with the original symptoms. If there is not enough resonance, the original stimulus remains untouched and unresolved. The medicine may be strong enough to supplement this with anew pattern, which may be more visible only because it is more dominant. In this case, when the vital force recovers from the action of the medicine, the original symptom pattern may reappear the symptoms were suppressed rather than caused therefore the original disturbance is unresolved. The new rhythm of the medicine may be so different as to exist side by side with the old rhythm, creating a new joint pattern! (Fig. 2) This may be possible when the areas affected by the medicine and by the disease are different, E.g. one affects the respiratory system and the other affects the digestive system. This situation is uncommon, as the disturbance and the medicine both affect the vital force, which reacts as a whole through each level of the organism. In summery the homoeopathic principle of cure is that one similar but stronger pattern is imposed over another, so that it takes over. Cure is aided by the fact that the duration of the medicine is limited, because it is potentized and kept to the minimum dose. Cure is indeed permanent if the remedy chosen is similar enough to include the total symptom picture and the exciting cause. If these are not covered, the disturbance is not truly solved because the predisposition or weakness remains and so there is a recurrence when vitality again drops or the exciting cause is met again. 3.5. The self – limiting action of a medicine In disease the medicine acts because it has a similar field of action to the disease (symptom picture), and resonates on these same areas of the vital force, encouraging the same action of the vital 50 force, which results in the outward movement of symptoms. This outward movement is clearly seen in acute diseases, and gives them their self-limiting nature. In acute disease we can see that the selflimiting nature arises from the ability of the vital force to reach the ‘edge’ i.e. diseases end either in death or elimination, as in the diarrhea and vomit of cholera, or the spots of measles and chicken pox. A well-prescribed remedy following the laws of cure will strengthen the outward movement of the symptoms, enhancing elimination. Thus there is a target to be achieved by the vital force, namely to push symptoms outwards as an elimination. Interference with the action of the vital force and the remedy is self – limiting when prescribed in the single dose because the vital force is further disturbed by a substance whose nature so resembles the disease that it can take over. It is the ability of the remedy to obtain a stronger reaction from the vital force that enables the vital force to complete the action of elimination. It does this because the potency is selected to be stronger than the disease, so the nature of substance is of less physiological level on to the dynamic plane. And because the dose is so minimal there is none left over to continue force. In acute illness we give a remedy and that is the end of the matter. The elimination is complete, and there are no repercussions or correspondence to other factors of health it is a one off situation. This does’nt happen, especially in children, but it is a theoretical situation because the vital force is afflicted by miasmas in such a way that its function is restricted. In the constitutional picture there are weak organs and there are latent states where previous disease was unresolved - this is particularly so in the adult. The result is a lack of vitality and an inability to complete the work of resolution. Aided by a remedy the vital force may restore harmony to a greater degree, but a stronger stimulus may be required, this may be a further, higher dose of the same remedy, or another, different remedy, depending on the symptom picture. We can see that the idea is still to produce enough reaction at the acute level. 3.5.a. Susceptibility Hahnemann and Kent use this term where Vithoulkas uses the word ‘resonance’, in modern allopathic terminology It is used to describe the vitality of a patient, in that he or she is more or less susceptible (weakened) to the germs of a particular disease. In this last context it embraces the content of vitality, or resistance to disease. However, in a homoeopathic context it is only used to imply resonance to the remedy or to the exciting cause. Susceptibility to the remedy determines the degree of reaction to that remedy. One who is most susceptible to the remedy reacts easily to it, even in low potencies, whereas one who is least susceptible will barely react at all and then perhaps only after repeat does, as in the proving. The choice of potency will enforce the reaction to the remedy, so that one who is more susceptible may produce the same results from lower potencies than one who is less susceptible. The least susceptible may not react at all to the higher potencies, which need even greater resonance as there is even more dilution in the higher potencies. 51 Susceptibility can be created by repetition of the dose. This is done in the proving as soon as the vital force is touched it reacts, and that reaction immediately changes the situation. Hence, when disturbed, the vital force accommodates the disturbance and moves on. If the disturbance is an ongoing factor in the environment, i.e. a maintaining cause then part of the vital force’s accommodation is to build a higher threshold of reaction. Thus the second dose must be a stronger stimulus to achieve impact. This is one reason why we go up in potency if we repeat a dose. After the first dose, susceptibility to that remedy or exciting cause may be less. 3.5.b. Susceptibility and required time for cure Time should be given to observe cure after a given remedy to allow the secondary action to occur. When another strong dose or repeated doses are given, the vital force is continually pulled back to the point it left, until the resonating parts of the vital force eventually react and become more sensitive to the stimulus because they are weakened, the process of cure is thus prolonged, because the vital force continues to be irritated without allowing the changes to take place which would lessen the organism’s susceptibility. In the proving we stop taking the pills once the symptoms start to appear and the vital force is left undisturbed. In order to resolve the disturbance the symptoms keep on appearing in the proving. During treatment, this repetition of the dose can be dangerous because it creates greater weakness in areas already vulnerable. This is one of only two occasions when homoeopathy can be unsafe; the other is when too high a potency is used, when there is structural (pathological change expressed in the symptoms. Here we also see why the homoeopath is cautious to accept that a remedy has created no change. If the remedy has struck so deep that symptoms have not yet appeared, then the vital force is reacting at a vulnerable level and has not yet appeared, then the vital force is reacting at a vulnerable level and has not yet been able to begin to correct the disturbance. To create further disturbance in such a case is undesirable. When repeated, doses are given you will often notice that there is no reaction at all until the dosing ceases. There may then be a very violent reaction. By continually stimulating the same point, an artificial disease will be created or the original disease may be worsen. The vital force is not free to act until the dosing ceases. The repeat stimulus may push the disturbance in to a more chronic level if it is resonating on vulnerable weaknesses or, if this is not the case, deeper cure may result when the vital force gets to work with more energy. 3.6. The speed of action of a medicine: The speed of reaction to the medicine depends on: ● The nature of the medicine ● The vitality of the vital force ● The nature of the exciting cause 52 Where the interplay of these three factors will determine what we may expect from our treatment. The nature of the medicine Included in the character of a remedy is the speed with which it acts. Acute remedies such as belladonna, aconite and apis mellifirae work very fast and, as the name acute signifies, they are of use in self limiting situations, where they enhance the outward movement of the symptoms. Other remedies have a slower reaction and are more suited to chronic disturbances. Examples of these might be silica, plumbum or Calcarea, to name some of the slowest. On studying a medicine it is necessary to know the pattern of symptoms it products, and the depth and speed of action of which it is capable. In other words, what is expected when a remedy is given to a patient. Potency Affect Toxicology The strength of a remedy may be enhanced or lessened by the potency used. Higher potencies will act with greater speed than lower potencies, because the lower potencies are working nearer the physiological or physical level. The Vitality Of The Vital Force A strong healthy vital force will react with speed, whereas a weakened vital force will act slowly because its areas of vulnerability are deep in organs and in metabolic process. An indication of the vital force may be gained by looking at the types and levels of symptoms being produced in the total symptom picture. The Nature Of The Exciting Cause The exciting cause acts as a trigger. A patient may be susceptible to large doses, and will react strongly and quickly if the vital force is strong if the vital force is strong. In another patient there may not be a sudden response because the vital force is weaker, but because of the strength of the exciting cause, when the response comes it will be a much deeper illness. Sometimes, even if the exciting cause is mild, the weak vital force will still react on the organ level but this time it produce a milder illness, which is of course serious enough, but less acute than the deeper one, and so it is more chronic. 3.7. Potencies Potencies are unique feature of homoeopathic practice. Potencies are energized dilution (or attenuations) of the mother tinctures of homeopathic remedies. Potency Numbers which follow the name 53 of the homeopathic remedies indicate the number of sequential or serial dilutions and successions (potentisation steps) of the number of the original mother tincture. It follows, therefore, the greater the potency number the greater the dilution. Potency numbers must be qualified by denoting the potency series in terms of the decimal or centesimal series. Suffixes to the Potency Numbers may be: X (or x) denoting serial dilutions in the ratio of 1 part mother tincture to 9 parts of a solution of alcohol and water, that is dilutions in the ratio of 1:10 – the decimal series of potencies. C (no suffix in UK) denoting serial dilution in the ration of 1 part mother tincture to 99 parts of a solution of alcohol and water, that is the ratio of 1:100 - the centesimal series of potencies. Thus for example, we have: 6x the sixth decimal potency = 1x 10-6 or 12x the twelfth decimal potency = 1x 10-12 or 24x the twenty-fourth decimal potency= 1x 10-24 or 6C (or 6) the sixth centesimal potency= 1x 10-12 or 30C (or 30) the thirtieth centesimal potency= 1x 10-60 or 200C (or 200) the two hundredth centesimal potency= 1x 10-400 or 1000C (or1M) the one thousandth centesimal potency = 1x 10-2000 Nature of Potencies ‘Potency’ means literally power or strength, and succession is shaking a serial dilution. In the potentisation procedure, succession energies the dilution and this is stored as potential energy. The view generally held is that this energy is released from the infinitesimally small, catalytic homoeopathic dose as kinetic energy, activating or stimulating the body’s own natural defense mechanism to affect the cure. It might be assumed that the higher the potency (and hence the higher dilution) the greater the (healing) power, but although this often the case, it is not strictly true, as we must consider this power in terms of the correct choice of potency for a particular case. Given the selection of the correct remedy in a case, potencies may modify or enhance the therapeutic activity of the remedy. It is, therefore, a powerful tool in the hands of the practitioner. Whilst potency is important in homoeopathic prescribing, the choice of the correct remedy according to the Law of Similars is of prime importance. Hence, if the correct remedy is chosen to treat an illness it may lead to some improvement in the illness whatever the potency prescribed. On the other hand, an incorrect remedy will be of no value whatever the potency prescribed. As Hahnemann discovered, potencies, through their high dilutions, overcome the often-toxic nature of the concentrated (allopathic) dose. Indeed, this was his original aim. The modifying or enhancing influence of high dilutions on therapeutic activity proved subsequently to be of equal benefit. 54 Common potencies The potencies most commonly prescribed universally are: Dilution VERY HIGH HIGH MEDUIM LOW CM 1 x 10 - 200,000 50M 1 x 10 -50,000 10M 1 x 10 -20,000 1M (1,000C) 1 x 10 -2,000 200C 1 x 10 - 400 30C 1 x 10 - 60 30X 1 x 10 - 30 24X 1 x 10 -24 6C 1 x 10 -12 12X 1 x 10 - 12 6X 1 x 10 -6 (1 in 1 million) 3X 1 x 10 -3 (1 in 1,000) Those underlined are prime potencies and the most used (6X, 6C, 30C, 200C, 1M) in practice. In France, potencies of 4C, 5C, 7C, 9C and 30C are most favored. French law does not permit potencies above 30C. 55 Gemmotherapy preparation and Lithotherapy preparation are prescribed in potencies of 2X and 8X respectively. In order to have supplies of prime potencies freshly prepared and quickly available, it is common practice in homoeopathic pharmacies to hold pre-potencies or stock potencies of potency numbers one less than the prime potencies, that is 5x, 5c, 29c, 199c, etc. Thus only one potentisation step necessary to produce the prime potency. Samuel Hahnemann favored the use of potencies 6X, 12X, up to 30C. He did, however, experiment with potencies up to 50C in the latter part of his career. Cook’s Hypothesis The commonly accepted view that the prime potencies of 6X, 6C, 30C, 200C and 1M correspond to levels of optimum therapeutic activity is borne, out by research and clinical evidence. Jones and Jenkins (RLHH, 1983) research with wheat and yeast growth in the presence of different potencies supported this view. Then why did Hahnemann choose potencies of 3, 6, 12, 24 and 30 in the first place? T.M. Cook has pointed out, (Brit. Hom J. 1982) that these potencies are sub units or multiples of the numbers 6 and 12. Hahnemann was influenced by the duodecimal system of counting as used in his days. The coinage of Saxony (and most other European states at that time) was based on the gold Friedrichs D’Or which had six lesser value coins. In Britain, still we have twelve inches to one foot and, before 1969, twelve pence made one shilling. It may be assumed, therefore, that Hahnemann chose these potency numbers as logical steps, since the numbers 6, 12, 24, etc. were in every day contemporary use. If this is valid, then why are commonly prescribed higher potencies (200, 1M, CM) based on the metric or decimal system in units of tne? Cook has suggested that higher were not introduced until the late 19th and early 20th century, by which time the metric system had been generally adopted in medicine and science. It is logical then that Kent et al would specify these metric numbers for higher potencies into homoeopathic practice. One question remains. If Hahnemann used the old duodecimal system is prescribing, then why did he specify metric dilutions in the preparation of the medicine (1:10, 1:100)? Hahnemann regarded the practice of homoeopathy as an art- his Organon, for example, was entitled The Organon of the Healing Art. On the other hand, he pointed out in the Organon that ht e preparation of homoeopathic medicines was as ‘exact science’. Thus, it is logical that he chose potency numbers in everyday use as an art form, whereas he chose the universal scientific metric system for the scientific preparation of potencies. Potencies in Prescribing We have learned that we view acute disease as a condition with sudden onset, clearly defined, severe symptoms and relatively short duration. Although there is some difference of opinion, as a general rule, these condition are treated with low potencies at a high frequency of dosage,(for example, hourly, three times a day). 56 Chronic disease in this context is viewed as a more deep seated, probably inherited disease, with ill-defined symptoms and time of onset of the disease and long lasting. As a general rule, these conditions are treated with high potencies at a low frequency of dosage (for example, once a week, once a month). However, these high potencies may, in certain circumstances, be preceded by prescribing a low potency. Hughesian and Kentian Approach Followers of Dr. Richard Hughes in England believed approach to prescribing at the physical level on a study of the totality of symptoms, low potencies. On the other hand, devotes of Dr. James Tyler Kent in America prescribed high potencies on a constitutional basis for a wide range of conditions- concentrating on the emotional and psychological levels of the patient (and with very high potencies, even the spiritual level). Thus, the same patient may receive the same remedy (his or her constitutional remedy) for different illnesses. Today, many homoeopaths use either the Hughesian or the Kentian approach most successfully, whilst others take a broader view which encompasses both approaches, depending on individual nature of the case. There is massive clinical evidence of successful treatment with either or both low or high potencies over 150 years. 3.8. Laws of cure Homoeopathy is not simply concerned with the totality of symptoms of a disease, but with the patient as a whole person, constitutionally-physically, mentally and emotionally. The homoeopathic practitioner needs to know the conditions which make the symptoms better or worse (modalities). The patient’s medical history and that of his or her family is also taken into account, with miasmic considerations in mind. The following are the important features of homeotherapy. Hering’s Laws Of Cure Dr. Constantine Hering, a contemporary of Samuel Hahnemann, founder of organized homoeopathy in America, author of Guiding Symptoms of The Homoeopathic Materia Medica, enunciated three principles of homoeopathic healing process. These principles are known as Hering’s Laws of Direction of Cure. They provide useful guidelines for the Homoeopathic practitioner in evaluating a patient’s total state of health and monitoring his or her progress. 57 First Principle Healing progresses from the deepest part of the body-the mental and emotional levels and the organs- to the external parts, such as the skin and extremities. The different ‘depths’ of symptoms, and their effect on health, in descending order, have been given by Vithoulkas (a leading Greek homoeopath) as in table3. Table 3 : Mental and Emotional symptoms for different physical ailments. Physical Ailments Brain Heart Endocrine Liver Lung Kidney Bone Muscle Skin Mental Suicidal Depression Apathy Sadness Anguish Phobias Anxiety Irritability Dissatisfaction ---- Emotional Total confusion Destructive Delirium Paranoid ideas Delusions Lethargy Dullness Lack of Concentration Forgetfulness Absentmindedness This table is also useful guide to evaluating the progress (or otherwise) of the patient during treatment. Second Principle As healing progresses, Herring states that symptoms are cured in the reverse order of their appearance. Third Principle Healing progresses from the upper parts of the body to the lower parts of the body. Homoeopathic aggravations may occur in accordance with Hering’s Law, which is quite acceptable, providing there is a corresponding improvement in the symptoms at deeper levels, most recent symptoms and the upper parts of the body. Healing may be more noticeable in deep seated chronic conditions than in acute conditions of short duration. 58 Biphasic Response Of Drugs (ARNDT-SCHULTZ LAW) There is a recognized principle in pharmacology called the "biphasic response of drugs."1 Rather than a drug simply having increased effects as its dose becomes larger, research has consistently shown that exceedingly small doses of a substance will have the opposite effects of large doses. The two phases of a drug's action (thus the name "biphasic") are dose-dependent. For instance, it is widely recognized that normal medical doses of atropine block the parasympathetic nerves, causing mucous membranes to dry up, while exceedingly small doses of atropine cause increased secretions to mucous membranes. This pharmacological principle was concurrently discovered in the 1870s by two separate researchers, Hugo Schulz, a conventional scientist, and Rudolf Arndt, a psychiatrist and homeopath. Initially called the Arndt-Schulz law, this principle is still widely recognized, as witnessed by the fact that it is commonly listed in medical dictionaries under the definition of "law." More specifically, these researchers discovered that weak stimuli accelerate physiological activity, medium stimuli inhibit physiological activity, and strong stimuli halt physiological activity. For example, very weak concentrations of iodine, bromine, mercuric chloride, and arsenious acid will stimulate yeast growth, medium doses of these substances will inhibit yeast growth, and large doses will kill the yeast. In the 1920s, conventional scientists who tested and verified this biphasic response termed the phenomenon "hormesis," and dozens of studies were published in a wide variety of fields to confirm this biological principle.2 In the past two decades there has again been a resurgence of interest in this pharmacological law, and now hundreds of studies in numerous areas of scientific investigation have verified it.3 Because these studies have been performed by conventional scientists who are typically unfamiliar with homeopathic medicine, they have not tested or even considered testing the ultra-high dilutions commonly used in homeopathy. However, their research has consistently shown very significant effects from such small microdoses that even the researchers express confusion and surprise. Reference to this research on the Arndt-Schulz law and hormesis is important for validating homeopathic research because it demonstrates the evidence for the important biphasic responses and microdose effects that lie at the heart of homeopathy. This research is readily available to physicians and scientists yet is often ignored or not understood. This law confirms Hahnemann’s Homoeopathic principles of the infinitesimal dose, that is the inversion of the effectiveness of a medicine as a function of the dose. Clinical Research: People are often confused by research, not only because it can be overly technical but because some studies show that a therapy works and other studies shows that it doesn't. To solve this problem, a recent development in research is used, called a "meta-analysis," which is a systematic review of a body of research that evaluates the overall results of experiments. 59 In 1991, three professors of medicine from the Netherlands, none of them homeopaths, performed a meta-analysis of 25 years of clinical studies using homeopathic medicines and published their results in the British Medical Journal. This meta-analysis covered 107 controlled trials, of which 81 showed that homeopathic medicines were effective, 24 showed they were ineffective, and 2 were inconclusive. The professors concluded, "The amount of positive results came as a surprise to us." Specifically, they found that: --13 of 19 trials showed successful treatment of respiratory infections, --6 of 7 trials showed positive results in treating other infections, --5 of 7 trials showed improvement in diseases of the digestive system, --5 of 5 showed successful treatment of hay fever, --5 of 7 showed faster recovery after abdominal surgery, --4 of 6 promoted healing in treating rheumatological disease, --18 of 20 showed benefit in addressing pain or trauma, --8 of 10 showed positive results in relieving mental or psychological problems, and --13 of 15 showed benefit from miscellaneous diagnoses. Despite the high percentage of studies that provided evidence of success with homeopathic medicine, most of these studies were flawed in some way or another. Still, the researchers found 22 high-caliber studies, 15 of which showed that homeopathic medicines were effective. Of further interest, they found that 11 of the best 15 studies showed efficacy of these natural medicines, suggesting that the better designed and performed the studies were, the higher the likelihood that the medicines were found to be effective. With this knowledge, the researchers of the meta-analysis on homeopathy concluded, "The evidence presented in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain indications." There are different types of homeopathic clinical research, some of which provide individualization of remedies; which is the hallmark of the homeopathic methodology; some of which give a commonly prescribed remedy to all people with a similar ailment, and some of which give a combination of homeopathic medicines to people with a similar condition. While one can perform good research using any of these methods, there are certain issues that researchers have to be aware of and sensitive to in order to obtain the best objective results. For instance, if a study does not individualize a homeopathic medicine to people suffering from a specific ailment and the results of the study show that there was no difference between those given this remedy and those given a placebo, the study does not disprove homeopathy; it simply proves that this one remedy is not effective in treating every person suffering from that ailment, each of whom may have a unique pattern of symptoms that requires an individual prescription. In describing specifics of the following studies using homeopathic medicines, differentiation has been made between studies that allowed for individualization of medicines and those that did not. Clinical Research with Individualized Care 60 Some people incorrectly assume that research using homeopathic medicines is impossibly complicated because each medicine must be individualized to the patient. The following studies disprove this simplistic belief. A recent clinical trial evaluating homeopathic medicine was a unique study of the treatment of asthma. Researchers at the University of Glasgow used conventional allergy testing to discover which substances these asthma patients were most allergic to. Once this was determined, the subjects were randomized into treatment and placebo groups. Those patients chosen for treatment were given the 30c potency of the substance to which they were most allergic (the most common substance was house dust mite). The researchers called this unique method of individualizing remedies "homeopathic immunotherapy" (homeopathic medicines are usually prescribed based on the patient's idiosyncratic symptoms, not on laboratory analysis or diagnostic categories). Subjects in this experiment were evaluated by both homeopathic and conventional physicians. This study showed that 82% of the patients given a homeopathic medicine improved, while only 38% of patients given a placebo experienced a similar degree of relief. When asked if they felt the patient received the homeopathic medicine or the placebo, both the patients and the doctors tended to guess correctly. The experiment was relatively small, with only 24 patients. As noted, for statistically significant results, small experiments must show a large difference between those treated with a medicine and those given a placebo. Such was the case in this study. Along with this recent asthma study, the authors performed a meta-analysis, reviewing all the data from three studies they performed on allergic conditions, which totaled 202 subjects. The researchers found a similar pattern in the three studies. Improvement began within the first week and continued through to the end of the trial four weeks later. The results of this meta-analysis were so substantial (P=0.0004) that the authors concluded that either homeopathic medicines work or controlled clinical trials do not. Because modern science is based on controlled clinical trials, it is a more likely conclusion that homeopathic medicines are effective. Another recent study, published in the American journal Pediatrics, tested homeopathic medicine for the treatment of a condition recognized to be the most serious public health problem today, childhood diarrhea. Over 5 million children die each year as the result of diarrhea, mostly in nonindustrialized countries. Conventional physicians prescribe oral rehydration therapy (ORT, a salt solution that helps children maintain fluid balance), but this treatment does not fight the infection that underlies the diarrhea. Conducted in Nicaragua in association with the University of Washington and the University of Guadalajara, this randomized double-blind, placebo-controlled study of 81 children showed that an individually chosen remedy provided statistically significant improvement of the children's diarrhea as compared to those given a placebo. Children given the homeopathic remedy were cured of their infection 20% faster than those given a placebo, and the sicker children responded most dramatically to the homeopathic treatment. A total of 18 different remedies were used in this trial, individually chosen based on each child's symptoms. A study of the homeopathic treatment of migraine headache was conducted in Italy. Sixty patients were randomized and entered into a double-blind, placebo-controlled trial. Patients regularly 61 filled out a questionnaire on the frequency, intensity, and characteristics of their head pain. They were prescribed a single dose of a 30c remedy at four separate times over two-week intervals. Eight remedies were considered, and prescribers were allowed to use any two with a patient. While only 17% of patients given a placebo experienced relief of their migraine pain, an impressive 93% of patients given an individualized homeopathic medicine experienced good results. A randomized double-blind, placebo-controlled trial was performed on 175 Dutch children suffering from recurrent upper respiratory tract infections. Children in the treatment group were prescribed a "constitutional medicine" for their overall health as well as acute medicines to treat the acute respiratory infections they developed. The study found that the children given homeopathic medicines had a 16% better daily symptom score than children given a placebo. This study also found that the number of children given a placebo who had to undergo adenoidectomy was 24% higher than for the children given homeopathic remedies. A 54.8% reduction in the use of antibiotics in the children given homeopathic medicines was reported, while the children who received a placebo experienced a 37.7% reduction in antibiotic use. (This reduction in both groups was determined to be the result of the normal growth and development of the child, dietary changes° the study provided written nutritional advice to the parents and the change in expectations as the result of being under medical care.) The statistical possibility of these results happening by chance was 6% (P=0.06). Because statistical significance in science is recognized when there is a 5% or less chance of results happening at random, the researchers concluded that homeopathic medicine seem to add little to the treatment of upper respiratory tract infections. This more conservative conclusion appeared to be influenced by the fact that the authors sought and received publication of their study in the British Medical Journal. They should have more accurately said that homeopathic medicines provided benefit to children with upper respiratory infections, but there is a small chance (6%) that these good results happened at random. Considering the closeness of these results to 5%, considering the other improvements in the homeopathic group's health, and considering the increasingly widespread desire to avoid antibiotics, it makes sense for physicians and parents to consider seeking homeopathic care for children's upper respiratory infections. Another study that involved individualized homeopathic care was in the treatment of rheumatoid arthritis. The study involved 46 patients. Two homeopathic physicians prescribed individually chosen medicines to each patient, though only half of them were given the real remedy, while the other half were given a placebo. The study found that 82% of those given an individualized homeopathic remedy experienced some relief of symptoms, while 21% of those given a placebo experienced a similar degree of relief. One other very interesting trial that utilized semi-individualization of care was in the treatment of primary fibromyalgia (also called fibrositis). Patients with fibrositis were admitted into a trial in which homeopathic physicians chose between three possible remedies, Arnica, Rhus tox, and Bryonia. Half of the patients were given one of these remedies, and the other half were given a placebo. There was no discernible difference between these groups. However, as an integral part of the experiment's design, a panel of homeopaths evaluated the accuracy of each prescription. This analysis found that those patients whom the panel considered to have received the correct remedy experienced a statistically significant improvement in symptoms as compared to those patients given the "incorrect" remedy or the placebo. 62 These same researchers next conducted a more sophisticated trial in the treatment of primary fibromyalgia. This double-blind, placebo-controlled, crossover trial admitted only those patients who fit the symptoms of Rhus tox. The researchers found that this constituted 42% of the patients interviewed. One-half of these 30 patients were given Rhus tox 6c during the first phase of the experiment, while the other half were given a placebo. During the second phase, those patients initially given the medicine were given a placebo, and those patients initially given a placebo were now given the homeopathic remedy. Researchers determined at the beginning of the experiment that improvement in pain and sleeplessness were the outcome measures most important in evaluating the results of this trial, and the results showed that 25% more of the patients experienced pain relief when taking the homeopathic remedy compared to when they were given a placebo and almost twice as many had improved sleep when taking the remedy. This type of crossover design is considered a sophisticated type of research because it compares each person when using a treatment with the same person when using a placebo. Most other research compares two supposedly similar groups of people, but researchers commonly acknowledge that it is difficult and perhaps impossible to get two exactly similar groups of people. The limitation of the crossover design for homeopathic treatment, however, is that most homeopathic medicines provide longterm benefits, so that once a person stops taking a homeopathic remedy he or she may still continue to improve, even in the placebo stage of the trial. Low-potency medicines, such as the 6c used in the above described experiment, generally have short-acting effects, while higher potency medicines generally have increasingly longer-term effects. Clinical Research with Nonindividualized Care In addition to the studies on homeopathy in which individualized remedies are prescribed, there is also a body of research testing single remedies to people given in a non-individualized manner. Such research is potentially problematic because homeopaths acknowledge that the remedies require some degree of individualization to be effective. The results of a nonindividualized study, either positive or negative, can be misunderstood by people who do not know basic principles of the homeopathic method. One study using nonindividualized homeopathic treatment was sponsored by the British government during World War II and was conducted in 1941-42 on volunteers whose skin was burned with mustard gas. The study showed the efficacy of Mustard gas 30c as a preventive or Rhus tox 30c and Kali bichromicum 30c as therapy. The study was double-blind, placebo-controlled, and was conducted at two centers (London and Glasgow), both showing similarly positive results. A more recent analysis of the data further substantiated the statistical significance of this study. It should, however, be mentioned that the researchers also tested the efficacy of Opium 30c, Cantharis 30c, and Variolinium 30c, none of which provided any noticeable benefit. If this trial had tested only these medicines, the researchers might have concluded that homeopathic medicines were ineffective in treating mustard gas burns. Finding the correct remedy is the key to making homeopathy work. Some skeptics and journalists inaccurately report that homeopathy is primarily used to treat minor health problems. Homeopaths today primarily treat various chronic ailments for which conventional medicine has not provided effective treatment. One example of a chronic and serious problem shown by a controlled study to be effective treated by homeopathy is diabetic retinitis (retinitis is a common complication of diabetes in which there is an inflammation of the retina causing 63 impairment of sight, perversion of vision, swelling, discharge from the eye, and sometimes hemorrhages into the retina). This double-blind, randomized, placebo-controlled study on 60 patients used Arnica 5c. The results of this study showed that 47% of patients given Arnica 5c experienced improvement in central blood flow to the eye, while only 1% of patients given the placebo experience this improvement. Further, 52% of patients given Arnica 5c experienced improvement in blood flow to other parts of the eye, while only 1.5% of those given the placebo experienced a similar degree of improvement. The best-selling flu remedy in France is actually a homeopathic medicine. Anas barbariae 200c, commonly marketed under the trade name Oscillococcinum TM , is also popular in the U.S. and is effective primarily at the first signs of influenza. A double-blind, placebo-controlled study with 478 patients suffering from influenza was conducted, making this the largest trial yet performed testing a homeopathic medicine. This trial showed that almost twice as many people who took the homeopathic remedy got over the flu after 48 hours as compared to those given a placebo. Although this remedy was found to work for all age groups, it was considerably more effective for people under 30 than for those over 30. However, it was not found to be effective when subjects had severe flu symptoms. In severe cases of the flu, a more individualized homeopathic remedy may be indicated. In addition to various studies on human health, there have also been some animal studies. British researchers have conducted trials showing that homeopathic medicines, specifically Caulophyllum 30c, could lower the rate of stillbirths in pigs. Pigs given a placebo had 103 births and 27 stillbirths (20.8%), while those given Caulophyllum 30c had 104 births and 12 stillbirths (10.3%). Not all studies show efficacy of homeopathic medicines, not because they don't work but mostly because the studies were poorly designed. One such study tested a single homeopathic medicine in the treatment of osteoarthritis. This study consisted of 36 patients, of whom one third were given Rhus tox 6c, one third were given a conventional drug (fenoprofen, a nonsteroidal anti-inflammatory drug), and one third were given a placebo. Those patients given the conventional drug experienced some relief of symptoms, but those given the homeopathic remedy and the placebo had a similar lack of response to treatment. While some people would erronously conclude that homeopathic medicines are ineffective in the treatment of osteoarthritis, it would be more appropriate and accurate to conclude that Rhus tox 6c is an ineffective remedy when given without individualization to people with osteoarthritis. One of the confounding variables from this trial was that 2 of the 12 patients given the homeopathic medicine were withdrawn from the trial because they experienced an aggravation of symptoms after taking the medicine. Because homeopathic medicines sometimes cause a temporary increase in chronic symptoms before significant improvement, it was disappointing that the researchers did not follow their status. Because this trial lasted only two weeks, it did not allow time for the homeopathic remedy to be adequately evaluated. If, for instance, these 2 patients experienced the significant relief that is common after an initial aggravation of symptoms, the results of the trial would have been different. Further, it is unfair to compare a fast-acting conventional drug that has side effects with a slower acting homeopathic medicine that is considerably safer. Finally and of great significance is the fact that while Rhus tox is a common remedy for rheumatoid arthritis, it is less common for osteoarthritis. 64 Clinical Research with Homeopathic Combination Remedies Homeopathic combination remedies are formulas in which several homeopathic substances are mixed together into one remedy. This untraditional approach to using homeopathic medicine is commercially popular in many countries. While these remedies are not thought by homeopaths to be as effective as individually chosen medicines, they do work and research has verified this. Yet, homeopaths consistently find that single homeopathic medicines have the potential to truly cure a person's disease, while combination medicines at best provide safe but temporary relief of symptoms. The same researchers who conducted the study on asthma earlier described also performed a study on the treatment of hay fever. This double-blind, placebo-controlled study prescribed a 30c potency of a combination remedy made from 12 common pollens. The results showed that those subjects taking the homeopathic remedy had six times fewer symptoms than those given the placebo. Both groups of subjects were allowed to use an "escape" medicine (an antihistamine) if their remedy didn't work adequately. The study showed that homeopathic subjects needed this medicine half as often as did those given the placebo. Another example of significant results from a homeopathic combination remedy was in the treatment of women during their ninth month of pregnancy. Ninety women were given the 5c potency of the following remedies: Caulophyllum, Arnica, Cimicifuga, Pulsatilla, and Gelsemium. They were given doses of this combination remedy twice daily during the ninth month. This double-blind, placebocontrolled study showed that women given the homeopathic medicines experienced a 40% (!) shorter labor than those given a placebo. Also, the women given the placebo had four times (!) as many complications of labor as those given the homeopathic medicines. One of the limitations of research on combination remedies is that the results do not reveal whether the effective treatment came from one specific medicine or from the unique combination of remedies. A recent study of 22 healthy women in their first pregnancies tested Caulophyllum, one of the medicines used in the study cited above, which was administered in the 7c potency during the active phase of labor (one dose per hour repeated for a maximum of 4 hours). The time of labor for those women given the homeopathic medicine was 38% shorter than for women given a placebo. This trial was not double-blind; however, the researchers recently completed a double-blind trial and confirmed their earlier results. A popular homeopathic external application marketed as TraumeelTM has been studied for its efficacy in the treatment of sprained ankles. This combination of 14 remedies in 2x to 6x potencies was given to subjects with sprained ankles. After 10 days, 24 of the 33 patients who were given the homeopathic medicine were pain-free, while 13 of 36 patients given a placebo experienced a similar degree of relief. This same medicine was also used in the treatment of traumatic hemarthrosis (joint swelling) and was shown to significantly reduce healing time as compared to a placebo. Objective measurements of joint swelling and movement and evaluation of the synovial fluid at injury were assessed. A study of 61 patients with varicose veins was performed double-blind and placebo-controlled. Three doses of a popular German combination of eight homeopathic medicines were given daily for 24 days. Measures were venous filling time, leg volume, and subjective symptoms. The study found that 65 venous filling time improved in those given the homeopathic medicines by 44%, while it deteriorated in the placebo group by 18%. Other measures also had significant differences. In addition to the various clinical studies on humans, there has also been some research using homeopathic medicines to improve the health of animals. German researchers have shown that dairy cows given Sepia 200c experienced significantly fewer complications of birth than those given a placebo. Low-potency (1x to 6x) combinations of Lachesis, Pulsatilla, and Sabina, or Lachesis, Echinacea, and Pyrogenium, along with Caulophyllum given to pigs had preventive and therapeutic effects on infections (inflammation of the breasts and the uterus) as well as on diarrhea in the piglets. Not all clinical studies on homeopathic combination medicines find efficacy of treatment, but there are often important factors that explain the failure. A Canadian study on the treatment of plantar warts is one such example. This randomized double-blind, placebo-controlled trial with 162 patients prescribed three medicines to each patient (Because the trial did not mix the remedies together, it is not completely accurate to call the use of these remedies a combination. It is more precise to consider it "polypharmacy," the use of several medicines). The remedies used were Thuja 30c, Antimonium crud 7c and Nitric acid 7c. Thuja was taken once a week, and the other two remedies were taken once a day. The trial lasted six weeks. The results showed that there was no noticeable difference between those subjects given the homeopathic medicines and those given a placebo. Many homeopaths may be initially surprised at the result of this trial because they consider these remedies commonly effective in the treatment of warts. But while the remedies may be effective for treating warts, they are not necessarily effective for all types of warts or in all people. A recent study of homeopathic treatment for various types of warts found that 18 of 19 people with plantar warts were cured in, on average, 2.2 months. The most common remedy was Ruta, prescribed to 12 of the 19 patients. Thuja was prescribed for only 3 patients, and Antimonium crud was prescribed for 2 patients. This study teaches us that individualization and the use of well-chosen remedies are necessary for most effective treatment. One additional note about research using homeopathic combination medicines: The homeopathic literature refers to the fact that some remedies are antidoted by other remedies. While the medicines in the Canadian trial are not known to antidote each other, homeopaths acknowledge that our understanding of which remedies antidote each other is somewhat primitive (for a listing of which remedies antidote each other, see the appendix in Kent's Repertory or in the Indian edition of Boericke's Pocket Manual of Materia Medica with Repertory). Homeopathic research must, therefore, be aware of this possibility so that conclusions from research are not overstated. Efficacy and Cost-Effectiveness Issues: Another factor that will greatly influence the inclusion of homeopathic care within managed care is the scientific evaluation of homeopathic practice. There is a growing body of evidence that suggests that homeopathic medicines are effective, as two comprehensive meta-analyses have shown. The most recent meta-analysis evaluated 89 placebo-controlled and/or randomized trials and found that patients given a homeopathic medicine were 2.45 times more likely to experience a therapeutic benefit than those given a placebo. 66 Although some studies have been successfully replicated two times, three times, and even 11 times, other replications have not shown consistent efficacy. Of those studies that have shown some consistent positive results, only one has been replicated by separate and independent bodies of researchers. Replication of research is absolutely necessary for homeopathy to be taken seriously, both by conventional physicians and by managed care organizations. One of the few studies that compared homeopathic treatment versus conventional medical treatment was recently published in an AMA journal. This study compared results in the treatment of vertigo, with half of the subjects given a homeopathic medicine (a combination of four homeopathic medicine mixed together) and half given a conventional drug (betahistine). The study showed that those given the homeopathic medicine experienced at least as good results as those given the conventional drug, though the homeopathic medicine was considerably safer and less expensive. Besides studies that verify the efficacy of homeopathic medicines, there is also a need for more studies evaluating the cost-effectiveness of homeopathic care. Of the studies that have already been conducted, there is presently positive evidence indicating that homeopathic care is more cost-effective than conventional and other alternative care, though more rigorous work is needed in this area as well. One study conducted by the French government in 1991 showed a significantly reduced cost from homeopathic care versus conventional medical care. The totality of costs associated with homeopathic care per physician was approximately one-half of the totality of care provided by conventional primary care physicians. However, because homeopathic physicians, on average, saw significantly fewer patients due to the more labor intensive tendency of homeopathic care, the overall cost per patient under homeopathic care was still a significant 15% less. It is also interesting to note that these savings appear to increase the longer a physician has been using homeopathy. A follow-up study in 1996 confirmed these results. This survey also noted that the number of paid sick leave days by patients under the care of homeopathic physicians were 3.5 times less (598 days/year) than patients under the care of general practitioners (2,017 days/year). These figures suggest further benefit and savings to the homeopathic approach to care. Homeopathic medicines are reimbursable under the French health care system, in part because they cost considerably less than conventional drugs (on average, the cost of a homeopathic medicine is 7 French francs versus 23.00 French francs for conventional drugs). Although homeopathic medicines in France represent 5% of all medicines prescribed by physicians, they represent only 1.2% of all drug reimbursements due to their lower cost per prescription. Another study in Seattle, Washington, which compared the utilization and cost of homeopathic, naturopathic, and acupuncture services found that homeopathic care was the least costly and that patient visits to homeopaths were less than to other alternative care professionals (this study, however, did not concurrently compare or evaluate patient visits or costs for conventional medical care). The Royal London Homeopathic Hospital conducted an audit of a sample of their patients during a three-week period. A total of 541 questionnaires were handed out, 506 returned, and 499 were analyzed. This survey found that 63% of patients had their complaint for more than five years. Of the patients who were on conventional medications when they initially sought homeopathic care, 29% had 67 stopped and an additional 32% had decreased their medication, while only 4% increased their medication. Sixty-two percent indicated that their main complaint had moderately or very much improved compared to their status before treatment at the homeopathic hospital. This study, like others before it, indicate that the vast majority of complaints seen by homeopaths are for chronic, long-term illness. Because these studies showed significant improvement in patient health and in reduction of medication, this data is of special interest to managed care companies. Additional evidence of good results of successful and potentially cost-effective treatment with homeopathic medicines was shown by the Glasgow Homeopathic Hospital which conducted an audit of 100 consecutive patients. They found that 81% had a condition for which conventional medical treatment was not effective and for which 47% had seen a specialist. After one year, 60% experienced significant improvement in the condition about which they were most concerned, 49% had a sustained improvement in their quality of life, and 37% managed a sustained reduction in their conventional medications. Other smaller studies have also confirmed the cost- effectiveness of homeopathic care. One pilot study in Great Britain suggested that doctors practicing homeopathic medicine issued fewer prescriptions and at a lower cost than their conventional medical colleagues, while another pilot study in Germany evaluated a single homeopathic dentist's practice and suggested that it was more costeffective than conventional dental care . One other example of a cost benefit to homeopathic care was witnessed in a small study of the homeopathic treatment for infertility. This study showed that homeopathic care for infertility was 30 times less expensive per successful delivery than the match comparison group given conventional care. Despite these various large and small studies, managed care organizations tend to remain unfamiliar with these investigations, and even when they become knowledgeable of them tend to demand more evidence. Even when clinical and cost-effectiveness studies suggest benefit from homeopathic medicines, some managed care executives may still remain skeptical until basic science investigations posit compelling evidence on how homeopathic medicines work. Although there has been work in this area too, nothing is yet conclusive. Despite the problem of not knowing with certainly how homeopathic medicines work, it is quite possible that this present lack of understanding will not seriously diminish the acceptance of homeopathy, just as many medical treatments today have been readily accepted even though physicians still remain unaware of how or why they seem to work. While managed care organizations have helped to reduce medical care costs by trimming the "fat" from the medical care system, the cost reductions have been less and less recently, suggesting that there may not be much more fat to trim. Perhaps what is needed is a more significant change in how medicine is practiced. Professional homeopathic care provides one viable alternative. For instance, a child with otitis media may receive round after round of antibiotics and may even have eartubes inserted at a significant cost of several thousand dollars. And yet, it is extremely common for children with otitis to receive homeopathic medicines and not experi.ence another ear infection. One study showed that 70.7% of children with otitis medica showed that those given an individually chosen 68 homeopathic medicine experienced no recurrent ear inflammation and 29.3% had a maximum of three relapses, while 56.5% of children given a placebo were free of relapses and 43.6% had a maximum of six recurrences. Cited References; 1. Margaret Roy, The Principles of Homeopathic Philosophy; Publisher: Longman Group UK 2. Dr. E.A. Maury, Homoeopathic treatment of children’s ailments, Translated from French by Geoffrey A. Dudley B.A.; Publisher: Thorsons Publisher limited. 3. Jeremy Swayne, Homoeopathic method implications for clinical practice and medical science; Publisher: Churchill Livingstone 4. Julian N. Kenyon, 21st century medicine, Publisher; Thorsons publishers limited. 5. Dr. C.H.Sharma edited by David Leland, The international manual of homeopathy and natural medicine, Publisher: Thorsons publishers limited. 6. The international manual of homeopathy and natural medicine by Dr. C.H.Sharma edited by David Leland. Publisher, Thorsons publishers limited. 7. Homeopathy for children Henrietta wells MCH. RSHOM publisher: ELEMENT. 8. Dr. Rupal Shah & Dr. Rajesh Shah, Indiaspace creation.., © 1997, http://www.indiaspace.com/homoeopathy/ 9. How Small Homeopathic Medicine Works Homeopathic Medical Centre & Info Homeopathy Malaysia Http://Www.Geocities.Com/Fakulti/Small.Htm 10. James Tyler KENT, Lectures on homoeopathic philosophy , Presented by Dr Robert Séror An appreciation Preface by Pr James Tyler Kent Introduction par le Dr Robert Séror (French) http://www.homeoint.org/books3/kentlect/ 11. Stuart Close, THE GENIUS OF HOMOEOPATHY (1924), © John Lunstroth2000 http://elm.he.net/~janaka/homeopathy/close/close,genius,index.htm 12. Douglas Hoff ,2001, Classical Homeopathy http://doughoff.com/homeopathy/01_philosophy/01_toc.htm 13. Jiri Cehovsky, 1994, Translation by: Voyen Koreis,1997, Homoeopathy-More Than A Cure, Chapters 2-8 ,10-17. http://www.ecn.cz/alternativa/book/hocu13.htm 14. Diploma coarse of the British institute of Homoeopathy 1992. 15. Diploma coarse of the British institute of Homoeopathy 1988 16. J. Kleijnen, P. Knipschild, G. ter Riet, "Clinical Trials of Homoeopathy," British Medical Journal, February 9, 1991, 302:316-323. 69 17. David Reilly, Morag Taylor, Neil Beattie, et al., "Is Evidence for Homoeopathy Reproducible?" Lancet, December 10, 1994, 344:1601-6. 18. Jennifer Jacobs, L. Jimenez, Margarita, Stephen Gloyd, "Treatment of Acute Childhood Diarrhea with Homeopathic Medicine: A Randomized Clinical Trial in Nicaragua," Pediatrics, May 1994, 93,5:719-25. 19. Bruno Brigo, and G. Serpelloni, "Homeopathic Treatment of Migraines: A Randomized Doubleblind Controlled Study of 60 Cases," Berlin Journal on Research in Homeopathy, March 1991, 1,2:98-106. 20. E. de Lange de Klerk, J. Blommers, D.J. Kuik, et al., "Effect of Homoeopathic Medicines on Daily Burden of Symptoms in Children with Recurrent Upper Respiratory Tract Infections," British Medical Journal, November 19, 1994, 309:1329-32. 21. R.G. Gibson, S. Gibson, A.D. MacNeill, et al., "Homoeopathic Therapy in Rheumatoid Arthritis: Evaluation by Double-blind Clinical Therapeutic Trial," British Journal of Clinical Pharmacology, 1980, 9:453-59. 22. P. Fisher, "An Experimental Double-Blind Clinical Trial Method in Homoeopathy: Use of a Limited Range of Remedies to Treat Fibrositis," British Homoeopathic Journal, 1986, 75:142-47. 23. P. Fisher, A. Greenwood, E.C. Huskisson, et al., "Effect of Homoeopathic Treatment on Fibrositis," British Medical Journal, August 5, 1989, 299:365-66. 24. J. Paterson, "Report on Mustard Gas Experiments, Journal of the American Institute of Homeopathy, 1944, 37:47-50, 88-92. 25. R.M.M. Owen and G. Ives, "The Mustard Gas Experiments of the British Homeopathic Society: 1941-1942, Proceedings of the 35th International Homeopathic Congress, 1982, 258-59. 26. D. Zicari, et al., "Valutazione dell'azione Angioprotettiva di Preparati di Arnica nel Trattamento della Retinpatia Diabetica," Bolletino de Oculistica, 1992, 5:841-848. 27. J.P. Ferley, D. Zmirou, D. D'Admehar, et al., "A Controlled Evaluation of a Homoeopathic Preparation in the Treatment of Influenza-like Syndrome," British Journal of Clinical Pharmacology, March 1989, 27:329-35. 28. Christopher Day, "Control of Stillbirths in Pigs Using Homoeopathy," Veterinary Record, March 3, 1984, 114,9, 216. Also Journal of the American Institute of Homeopathy, December 1986, 779, 4:146-47. 29. M. Shipley, H. Berry, G. Broster, et al., "Controlled Trial of Homoeopathic Treatment of Osteoarthritis," Lancet, January 15, 1983, 97-98. 30. David Reilly, Morag Taylor, C. McSharry, et al., "Is Homoeopathy a Placebo Response? Controlled Trial of Homoeopathic Potency, with Pollen in Hayfever as Model" Lancet, October 18, 1986, 881-86. 31. P. Dorfman, M.N. Lasserre, M. and Tetau, "Preparation a l'accouchement par Homeopathie: Experimentation en double-insu versus Placebo," Cahiers de Biotherapie, April 1987, 94:77-81. 32. P. Eid, E. Felisi, M. Sideri, "Applicability of Homoeopathic Caulophyllum thalictroides during Labour," British Homoeopathic Journal, 1993, 82:245. 33. P. Eid, E. Felisi, M. Sideri, "Super-placebo ou action Pharmacologique? Une Etude en Double Aveugle, Randomisee avec un Remede Homeopathique (Caulophyllum thalictroides) dans le Travail de l'accouchement, Proceedings of the 5th Congress of the O.M.H.I. (International Organization for Homeopathic Medicine), Paris, October 20-23, 1994. 34. J. Zell, W.D. Connert, J. Mau, et al., "Behandlung von akuten Sprung-gelenksdisotrionen: Doppelblindstudie zum Wirksamkeitsnachweis eines Homoopathischen Salbenpraparats," Fortschr. Medicine, 1988, 106:96-100. 35. W. Thiel, and B. Borho, "Die Therapie von Frischen, Traumatischen Blutergussen der Kniegelnke (Hamartros) mit Traumeel N Injectionslogung," Biol. Medizin, 20:506. 70 36. E. Ernst, T. Saradeth, K.L. Resch, "Complementary Treatment of Varicose Veins: A Randomised, Placebo-controlled, Double-blind Trial," Phlebology, 1990, 157-163. 37. A.V. Williamson, W.L. Mackie, W.J. Crawford, et al., "A Study Using Sepia 200c given Prophylactically Postpartum to Prevent Anoestrus Problems in the Dairy Cow," British Homoeopathic Journal, 1991, 80:149. See also by the same researchers: "A Trial of Sepia 200," British Homoeopathic Journal, 1995, 84:14-20. 38. G. Both, "Zur Prophylaxe und Therapie des Metritis-Mastitis-Agalactic: Komplexes des Schweines mit Biologischen Arzneimitteln," Biologische Tiermedizen, 1987, 4:39. 39. M. Labrecque, D. Audet, L.G. Latulippe, et al., "Homeopathic Treatment of Plantar Warts," Canadian Medical Association Journal, 1992, 146(10):1749-53. 40. R. Gupta, O.P. Bhardwaj, and R.K. Manchanda, "Homoeopathy in the Treatment of Warts," British 5. 41. Bellavite P, Signorini A. Homeopathy: a frontier in medical science. Berkeley: North Atlantic; 1995. 42. Berman B, Hartnoll SM, Singh BB, Krishna Singh B., Homoeopathy and the US primary care physician." British Homoeopathic Journal. July 1997;86:131-138. 43. Caisse Nationale de l'Assurance Maladie des Travailleurs Salaris, 1996 study of 130,000 prescriptions. 44. California vs. Gregory Dana Ullman, Municipal Court Oakland Piedmont Judicial District, 98158, March 29, 1977. 45. Carlston M, Stuart MR, and Jonas WB. Alternative medicine instruction in medical schools and family practice residency programs. Family Medicine, October, 1997, 29:559-562. 46. Chapman E. Homeopathy: Moving towards the mainstream in a changing health care system. Journal of the American Institute of Homeopathy. 1995;88,4:172-178. 47. Chapman E. Coding for homeopathic procedures. Journal of the American Institute of Homeopathy. 1995a;88,3:117-119. 48. Cohen MH. Legal ramifications of homeopathy. Journal of Alternative and Complementary Medicine. Winter, 1995;1,4:393-398. 49. Feldhaus H-W. Cost-effectiveness of homeopathic treatment in a dental practice. British Homoeopathic Journal. January, 1993;82,1:22-28. 50. Fisher, P, van Haselen, R., Evidence influencing British Health Authorities' decisions in purchasing complementary medicine. JAMA. November 11 1998;280,18:1564. 51. Food and Drug Administration, Compliance Policy Guide, Conditions Under Which Homeo.pathic Drugs May be Marketed, 7132.15, 1988. 52. Friese K-H, Kruse S, Moeler H. "Otitis media in children: a comparison of conventional and homeopathic drugs." HNO (Head and Neck Otorhinolarynology). 1996;44:462-466. 53. Gerhard I, Reimers G, Keller C, et al., "Weibliche fertiltitasstorungen. Vergleich homoopa.thischer einzelmittel--mit konventioneller hormontherapie." Therapeutikon. 1991;7:309-315. 54. GRECHO, "Evaluation de deux produits homeopathiques sur la reprise du transit apres chirurgic digestive: un essai controle multicentrique." Presse Med 1989;18:59-62. 55. HomInform, Homoeopathy: The Guide (CDRom), (June 1, 1997). 56. "Herbals Hot; Homeopathics Fare Well," OTC Market Report. June, 1996. Nicholas Hall. 57. Jackson S. Alternative medicine: not so alternative anymore. Business Week. June 2, 1997. 58. Jacobs J, Smith N. Charges, utilization, and practice patterns from a pilot insurance program covering alternative medical services. American Public Health Association Conference, New York City, November 18-21, 1996. 59. Jonas WB, Jacobs J, Healing with homeopathy. New York: Warner, 1996. 60. Kleijnen J, Knipschild P, ter Riet G, "Clinical trials of homoeopathy." British Medical Journal. February 9, 1991;302:316- 323. 71 61. Linde K, Clausius N, Ramirez G, et al., "Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo- controlled trials," Lancet. September 20, 1997;350:834-843. 62. Lo S-Y, "Anomalous state of ice," Modern Physics Letters B. 1996;10,19:909-919. 63. Lo S-Y, Lo A, Chong LW, et al., "Physical properties of water with IE structures." Modern Physics Letters B. 1996a;10,19:921- 930. 64. National Center for Homeopathy, 1998 Directory, Alexandria, VA. 65. Nevada State Law, Chapter 630A. 1995;15051-15080. 66. Papp R, Schuback G, Beck E, et al., "Oscillococcinum in patients with influenza-like syndromes: A placebo-controlled double-blind evaluation," British Homoeopathic Journal. April 1998;87:69-76. 67. Piturro MC. The alternative mainstream: managed care beginning to embrace non-conventional medicine. Managed Healthcare News, June, 1996. 68. Reilly D, Taylor M, Beattie N, et al., "Is evidence for homoeopathy reproducible?" Lancet. December 10, 1994;344:1601-6. 69. Settlement agreement between Helen Healy and the Minnesota Board of Medical Practice, September 18, 1996. 70. Sharples F, van Haselen, R, Patients perspective on using a complementary medicine approach to their health: a survey at the Royal London Homoeopathic Hospital NHS Trust (no date, but first made available in 1998). 71. Social Security Statistics. CNAM (National Inter-Regulations System) 61, French Government Report. January 1991. 72. Swayne J, The cost and effectiveness of homeopathy. British Homoeopathic Journal July 1992;81,3:148-150. 73. Ullman D, Implications of a court case, Holistic health handbook. Berkeley: And/Or, 1978. 74. Ullman D. The Consumer's Guide to Homeopathy. New York: Jeremy Tarcher/Putnam; 1996. 75. Walach, H, Hausler, W, Lowes t, et al. "Classical homeopathic treatment of chronic headaches. Cephalalgia 1997;17:119-26. 76. Weiser M, Strosser W, Klein P. Homeopathic vs conventional treatment of vertigo: A randomized double-blind controlled clinical study. Archives of Otolaryngology--Head and Neck Sur.gery 1998;124:879-885. 77. Wetzel MS, Eisenberg, D, Kaptchuk T. Course involving complementary and alternative medicine at US medical schools. JAMA. September 2 1998;280:784-787. 78. Whitmarsh TE, Colestron-Shields SM, Steiner TJ. "Double-blind randomized placebo-controlled study of homoeopathic prophylaxis of migraine. Cephalalgia 1997;17:600-04. 79. Wiesenauer M, Ludtke R, "A meta-analysis of the homeopathic treatment of pollinosis with Galphimia Glauca" (a review of 11 annual studies). Forsch Komplementarmed. 1996;3,230-234. 72