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What is Homeopathy?

 

     Homeopathy is a form of health care that developed in Germany and has been practiced in the United States since the early 19th century. Homeopathic practitioners are commonly called homeopaths [1]. The term homeopathy comes from the Greek words “homeo”, which means similar, and “pathos”, which means suffering. Homeopathy is an alternative medical system [1]. The alternative medical systems are built upon complete systems of theory and practice, and often have evolved very early, even earlier than the conventional medical approach used in the United States. It takes a different approach from conventional medicine in diagnosing, classifying, and treating medical problems [2].

 

     The MeSH1 term for ‘Homeopathy’ describes it as a system of therapeutics founded by Samuel Hahnemann (1755–1843). It is based on two axioms: ‘like cures like principle’ [3] and ‘potentization’ (serial dilution with vigorous shaking) renders a medicine not less and less but more and more powerful [4]. Diseases are treated by highly diluted substances that cause, in healthy patients, symptoms like those of the disease to be treated. Thus, many homeopathic remedies are diluted beyond Avogadro’s number where the likelihood approaches zero that a single molecule of the original substance is contained in the remedy and it is suggested that benefit is from energetic life force of the original substance [5].

Origin and development of homeopathy:

The origin of homeopathy:

 

     The father of classical homeopathy is Dr. Samuel Hahnemann lived from 1755 till 1843 and died in Paris, France. He was a medical doctor, chemist and pharmacist at the same time. The basic similarity rule in homeopathy was stated by him as ‘similia similibus currentur’ which means “likes may be cured by like” [3]. This was at a time when the most common medical treatments were harsh, such as blood-letting, purging, blistering, and the use of sulfur and mercury.  There were few effective medications for treating patients and knowledge about their effects was limited [2].

 

     Hahnemann was interested in developing a less-threatening approach to medicine. The first major step reportedly was when he was translating a herbal text and read about a treatment used to cure malaria. He took some cinchona bark and observed that, as a healthy patient, he developed symptoms that were very similar to malaria symptoms. This led Hahnemann to consider that a substance may create symptoms that it can also relieve. This concept is called the “similia principle” or “like cures like.” The similia principle had a prior history in medicine, from Hippocrates in Ancient Greece—who noted that recurrent vomiting could be treated with an emetic principle such as ipecacuanha that would be expected to make it worse—to folk medicine [6].

 

      Dr. Hahnemann investigated nearly 200 substances before he died and used them all as remedies in this medical practice. Since then, many more substances have been tested and used as medicines and now there are more than 3,000 homeopathic medicines available. These detailed descriptions formed the basis of the first collections of symptom profiles or pictures of remedies which is collectively known as Materia Medica. These pictures of remedies are still used today, although now they have been vastly expanded by further "provings" and information that have been acquired over two hundred years of clinical experience [7].

 

The development of homeopathy:

 

     Hans Burch Gram, a Boston-born physician, studied homeopathy in Europe and introduced it into the United States in 1825. European immigrants trained in homeopathy also made the treatment increasingly available in America [2].

 

     When cholera first invaded Europe in 1831, the mortality throughout Europe was generally between 40% to 60%. To the surprise of many, mortality rates reported by homeopathic physicians was generally below 10% [8]. Similarly pneumonia, whose incidence and virulence has remained fairly uniform for long time. Before the era of antibiotics, the average death rate from pneumonia was 30%. Since the introduction of antibiotics, the death rate has reduced to 18%. On the other hand, the death rate under homeopathic treatment has always been less than 1–3%, even in patients suffering from the different types of pneumonia [8].

 

     The American Institute of Homeopathy was established in 1844, two years before the American Medical Association. The two schools have been in opposition ever since. Even though most homeopathic practitioners were graduates from such schools as Harvard, Dartmouth and Penn State [9]. After the yellow fever outbreak in 1878, when homeopathy proved indispensable and was successful in gaining a healthy following of patients and physicians. By the year 1890 there were 14,000 homeopaths to 85,000 “conventional” physicians [9].

 

     In the late 19th and early 20th centuries, numerous medical advances were made, such as the recognition of the mechanisms of disease, Pasteur’s germ theory, the development of antiseptic techniques and the discovery of ether anesthesia....etc. Homeopathy was negatively affected by these developments [10]. Most of the homeopathic medical schools closed down by the 1930s and others had converted to conventional medical schools. But again in 1960s homeopathy’s popularity began to revive in the United States. According to a 1999 survey of Americans and their health, over 6 million Americans had used homeopathy in the preceding 12 months [10].

 

     The World Health Organization noted in 1994 that homeopathy had been integrated into the national health care systems of numerous countries, including Germany, the United Kingdom, India, Pakistan, Sri Lanka, and Mexico. Several schools of practice exist within homeopathy [11]. By the beginning of 20th century, 8 % of all American medical practitioners were homeopaths and there were 20 homeopathic medical colleges and more than 100 homeopathic hospitals in the United States [9].

Homeopathy worldwide:

 

     Despite its implausibility, homeopathy became popular 200 years ago in Germany and France and later in several other countries, including the USA. Considering that, at the time, many conventional treatments were worse than the disease, the initial success of homeopathy is understandable, being highly dilute, most homeopathic remedies are largely free of adverse effects [12].

 

     Kaul cited estimates that over 500 million people worldwide receive homeopathic treatment. Its persistence is especially striking because of intense skepticism and attacks that it has received since its inception [13].

 

     Homeopathy is among the most popular of complementary and alternative medicine (CAM) therapies and is widely used in western European countries including France, Germany, the Netherlands and the UK. It is also popular elsewhere in the world, notably the Indian subcontinent and Latin America and there has been rapid recent growth of usage in the USA [14]. In Germany there are about 3000 qualified homoeopathic practitioners who have undergone specialist training. It is estimated that 1·5 million patients per year are treated in Germany with homoeopathic drugs [15].

 

     Across Europe approximately a quarter of the population uses homeopathy. A Norwegian observational study suggested recently that 7 out of 10 patients who visited a homoeopath felt improvement in their main complaint 6 months after the initial consultation . According to French survey data, homeopathy is used mainly in mental disorders, infections and rheumatological disorders [16].

 

     Homeopathy is the most frequently used CAM therapy in France, the number of patients using homeopathy has increased from 16%  to 36%  in  1982 to1992 [17-18]. Homeopathy is also the most frequently used CAM therapy in Belgium, the Netherlands, Norway, and Switzerland. A nation-wide Italian study of 30,000 families showed that homeopathy was the most frequently used non-conventional therapy by 8.2% of the population [19]. Homeopathy was also quite commonly used in 7.7% of Italian children [20].

 

Food and Drug Administration (FDA) regulation of homeopathic remedies:

 

     Because of their long use in the United States, the U.S. Congress passed a law in 1938 declaring that homeopathic remedies are to be regulated by the FDA in the same manner as nonprescription, over-the-counter (OTC) drugs, which means that they can be purchased without a physician’s prescription [9].  Today, although conventional must undergo thorough testing and review by the FDA for safety and effectiveness before they can be sold, this requirement does not apply to homeopathic remedies [9].

 

     Remedies are required to meet certain legal standards for strength, quality, purity, and packaging. In 1988, the FDA required that all homeopathic remedies list the indications for their use (i.e., the medical problems to be treated) on the label. The FDA also requires the label to list ingredients, dilutions, and instructions for safe use [21-22].

 

     The guidelines for homeopathic remedies are found in an official guide, the Homeopathic Pharmacopoeia of the United States, which is authorized by a nongovernmental, nonprofit organization of industry representatives and homeopathic experts [23]. The Pharmacopoeia also includes provisions for testing new remedies and verifying their clinical effectiveness. Remedies on the market before 1962 have been accepted into the Homeopathic Pharmacopoeia of the United States based on historical use, rather than scientific evidence from clinical trials [23].

 

How does homeopathic treatment work:

 

     Homeopaths believe that their remedies impart information as a form of individually resonant energy. In contrast, allopaths view drugs only as physical molecular agents, active primarily while present in the body, such that higher doses produce bigger responses in everyone and vice versa [24].

 

     Homeopathic pharmaceutical companies make remedies according to specific standards, e.g., as established by the Homeopathic Pharmacopoeia of the US FDA. Most remedies are from plant, mineral or animal sources. They are prepared by diluting the original material in solvent (typically water or pharmaceutical grade ethanol) in a serial fashion. The dilution factors can be 1:10 (D series), 1:100 (C series), or 1:50,000 (LM series). After each dilution step, the solution is shaken vigorously a fixed number of times (e.g., 100) before the next dilution step is made. Homeopaths consider the remedies that have undergone the greatest dilution and succussion ''power of  ultradilutions'' to be energetically the most “potent” (e.g., a 200C is more potent than a 30C) [25-26] .

 

     Clinically, lower potencies are repeated more often than are higher potencies to achieve comparable results, due to plateaus or relapses in response after relatively short periods of time. Notably, animal studies also indicate that the duration of action of higher potencies is longer than that of lower potencies [27].

 

     The higher potencies beyond 12C (1:100)12 do not contain any material molecules. At that point, a reasonable objection is that there is no active substance in a physical sense left in the treatment dose. If homeopathic remedies have biological and even clinically curative properties, then they must exert their effects by a presently undetermined mechanism. In CAM, most practitioners summarize this mechanism as a type of “energy” that must be carried in the solvent [28]. It is believed that these shakings extract the "vital nature" of the substances, imprinting them on the water [28].

 

     A key feature of any difference between water before and after its use in preparing homeopathic dilutions is likely to be the shaking (succussion) between successive dilutions, and which may produce significantly increased concentrations of silicate, sodium and bicarbonate ions by dissolution of the glass tubes and from the atmosphere, respectively [29].

 

     Succussion involves the effect of pressure changes due to the shock waves produced.  Equally increasing and decreasing (negative) pressure will be encountered so involving the compression and stretching of the hydrogen bonded network. Increasing pressure causes gas dissolution and decreasing pressure causes gas formation. Due to the slow kinetics of bubble initiation, it seems reasonable that such effects will mostly concern pre-existing gas nanobubbles in the bulk and at phase surfaces. Certainly bubbles could both grow and divide during such processing [28].

 

     Mechanically induced hydrogen bond breakage may also give rise to increased hydrogen peroxide formation. Such processes are well-known to produce long term oscillatory behaviour [30]. It may be relevant to note that the presence of hydrogen peroxide can take part in and catalyze further reactions with other reactive species such as molecular oxygen and dissolved ozone (present in nanomolar amounts in ‘pure’ water) which may well vary with the number of succussion steps and their sequences [31]. This may be offer an explanation for the changes in the effects of homeopathic preparations with the number of dilutions. Also of note are the known effects of low concentrations of reactive oxygen species on physiological processes such as the immune response [31].

 

     Studies on cluster–cluster aggregation phenomena in aqueous solutions of fullerene–cyclodextrin conjugates, β-cyclodextrin, sodium chloride, sodium guanosine monophosphate, and a DNA oligonucleotide revealed that there are larger aggregates existent in dilute aqueous solutions than in more concentrated solutions by using laser light scattering (LLS) and scanning electron microscopic (SEM) measurements [32].

   

      In homeopathy, the therapeutic action of the remedy would derive not from the static presence of a physical molecule in solution, but rather from the dynamical memory of the solvent as part of a larger system that has stored information from the source substance, via succussion. The dilution steps would permit a freer path for the circulation and reverberation of the systemic memory information by eliminating the actual physical molecules from impeding flow in what is inherently an energetic system [28].

 

     Davenas et al., 1988 have described the effects of increasing dilutions of antiimmunoglobulin E (IgE) on human basophils. Contrary to expectation, solutions of IgE which were so highly dilute that they could not have contained any of the molecules of the antibody, were still able to activate the basophils [33]. Some investigators have found that techniques such as nuclear magnetic resonance spectroscopy, ultraviolet spectroscopy, and x-ray spectroscopy may be able to differentiate homeopathic remedy potencies from pure solvent [27, 34].

  

     Martin Chaplin, a respected British professor who is one of the world’s experts on water, has verified that “homeopathic water” and “regular water” are not the same, and his review of almost 2,000 references to the scientific literature on water confirm this fact [35].

 

     Homeopathic medicines should be considered to be a type of “nanopharmacology”. Although the word “nano” also means one-billionth of a size, that is not its only definition. In fact, “nano” derives from the word “dwarf,” and “nano” is the only word in the English language that is used on common parlance as denoting extremely small and  yet extremely powerful. Homeopathic medicines are both extremely small in dose and yet extremely powerful in their therapeutic effect [36]. Using a nanodose that is able to penetrate deeply into the body and that is specifically chosen for its ability to mimic the symptoms helps to initiate a profound healing process [26, 37].

    

Understanding symptoms and remedies:

 

     In homeopathy there are four stages of disease. These are physical, emotional, mental and psychotic.  If a disease is to be completely cured, then all four stages have to be considered. “A totality of symptoms” is necessary to find the correct remedy. When the correct remedy is found, it stimulates the body into healing [11].

 

     Most chronic states are the result of generations of disease being passed down from parent to offspring. Damaged or mutated genes from vaccinations, poor nutrition, toxic substances and other environmental pollutants are the major contributors to chronic disease. In order to keep the body disease free we must provide the body with the correct environment and allow the body to regain a healthy state [11].

 

The Vital Force:

 

     Hahnemann had discovered a method for making use of the self-healing power of the body called "vital force". It is an energetic force inherent in the body, which could be compared with the energy force of Chinese and Indian medicines known as chi and yogis respectively. The homeopath's aim is therefore to strengthen the vital force, or the immune system, so that it can resist harmful germs and viruses. The homeopath also believes that all parts of body are interrelated and therefore treats the whole patient, rather than concentrating only on the part of the body that is diseased [27].

 

     The reason for this approach to treatment is the belief in homeopathy that suppression of illness in single part of the individual will simply force the distunement to express itself somewhere else. For instance most allopathic medicine, such as antibiotics or steroids, gives symptomatic relief of a symptom of a disease. This means that in allopathic medicine, the symptom is treated and not the disease itself [24, 38]. For example eczema, is the skin’s way of telling us that there is something wrong. The skin is the largest organ in the body and it will work to protect the vital organs by eliminating toxins from the body. When we apply steroidal creams to the skin, it acts to suppress the symptom not cure the problem. This suppression then compromises the entire system and is a complete contradiction to our body’s natural ability to heal. Suppression of a skin condition may later show up in the form of kidney failure or heart disease [27].

    

     Notably, homeopaths place great importance on mental and emotional symptoms over physical symptoms as the most limiting manifestations of poor health. The mainstream research is consistent with this latter point. Investigators have found that depression and dysthymia in medically ill patients has lead to greater medical care utilization, somatic distress, disability, and higher losses of productivity than do physical ailments alone [27, 39- 40].

Identifying the symptoms:

Choosing a Remedy:

 

     A homeopathic symptom picture attempts to identify everything that is taking place within the patient at the time of the illness. All these things are regarded as symptoms expressing a single mind-body condition. Everything about the patient may be a clue to the remedy. For instance, several remedies such as Aconite, Belladonna, Chamomilla, Mercuric sol, Pulsatilla, Silica, and Sulfur are suggested for ear pain. Further details, more particular, characterizing factors are also needed. For example, is the patient with earache weepy or irritable? Chilly or hot? Red-faced or pale? Is the patient hungry, or gone off food?. Anything that has changed or become exaggerated in the patient since the pain started will be useful to notice. These symptoms will undoubtedly point to different remedies, even though many remedy pictures include earache [41-43].

 

     A child has earache and the area around the ear is hot and red, the child is hot and burning, red in the face, and bad-tempered from the pain. The pain subsides a little if the ear is warmed, this child needs Belladonna.  A child who has restlessness, anxious, afraid rather than bad-tempered, and the pain worsens if the ear is warmed, this child needs Aconite. If the child is tearful and clingy, not wanting to be left alone, uncomfortable from the warmth of the room, and perhaps wanting a window open, Pulsatilla is a remedy of choice [41-42].

 

     Usually, emotional and psychological symptoms, and general physical symptoms, such as temperature preferences and food cravings, give a better indication of the remedy than particular symptoms of the illness itself. The remedy picture of choice should include any important particular symptoms of the illness in order to get a complete picture [41].

 

 

 

 

Psychological Symptoms:

 

     The psychological/emotional picture is extremely important in homeopathy. It gives the strongest indications for the remedy, even when the illness seems to be entirely physical. In acute illness, the psychological response can often show itself in what appears to be a complete change of character, the patient is "not himself". At other times, the patient may indeed be himself. For instance, a patient who is normally quite, shy and reserved will become almost reclusive, so that had been just a character trait becomes overemphasized to the point of disability. Either of these types of change is an important symptom and should be noted [44].

 

     In chronic illness, a habitual mode of being or a long-established patientality pattern can be just as much of a symptom as is long-standing joint pain, how someone's digestion works, or the nature of the patient skin. So, it is important to ask questions in order to build up a complete picture. What is the patient mood usually like? Irritable? Tearful? Cheerful despite the pain? Does the patient want company or to be alone? How does the patient's mood appear now : quieter than usual or more talkative? [45].

 

General Physical Symptoms:

 

     General physical symptoms, states, or changes are very important because they affect the whole patient. How is the patient feeling physically? Hot, chilly, sweaty, dry, thirsty, thirstless?  Is the patient unusually hungry, off food, craving certain foods, disliking others? Over-sensitive to pain or not feeling it as much as you would expect? Things that make the patient  as a whole feel better or worse are very useful clues to the remedy. For example, is the patient better or worse for heat, cold, damp, warmth, fresh air, stuffy rooms, winter, summer, night morning, day, evening, ice cream and butter? [46].

 

     These general physical symptoms, like the psychological ones, may change during the course of disease or may become exaggerated. They are more important for choosing the right remedy than looking at particular symptoms of the complaint itself.

 

Particular Symptoms:

 

     These will usually include the symptoms of the actual illness or complaint. They often affect a particular part of the patient. For example, earache, period pain, colds, and joint pain can all be localized within one part or system of the patient's body. In homeopathy, these symptoms are less important clues to the remedy than the general physical symptoms because particular symptoms are usually not very individual. They relate more to the disease itself than to the patient [41,42].

 

     Diarrhea for example, is a condition with a particular symptoms i.e.,  loose stools. "Diarrhea with headache" makes the symptom a little more useful because not all remedies that might cure diarrhea have diarrhea with headache. "Joint pain" is not a very helpful symptom because it occurs in many remedies. "Joint pain with indigestion" or "with headache" would individualize the condition more [41, 47].

 

Looking for the Unusual:

 

     When you are looking for a suitable remedy, remember that the more unusual a particular symptom is in connection with the complaint, the more important it becomes. It is not unusual for a cold to be accompanied by a cough, but if the cough has markedly different characteristics from the usual ones associated with that complaint, a more precise description of the nature of the cough would be helpful. For example, the patient has a splinter in the throat (a clue for Hepar sulf.), or might hold the ribs when coughing because the movement will hurt (a clue for Bryonia). These apparently small distinguishing features in every sick patient are important clues [41, 48].

 

      In forming a picture of a patient, the homeopath will not just rely on what the patient says, but will also notice how the patient says it, whether the patient is reserved and uncommunicative about their symptoms (Narum mur., kali carb), whether the patient is outgoing and helpful (Phosphorus), irritable and impatient (Arsenicum, Nux vomica), or sceptical but interested, asking questions, for instance, about how homeopathy works (Sulfur), or extremely anxious about the illness (Arsenicum). The homeopath will also note other things, such as color and nature of the skin. Extreme pallor might indicate China, redness sulfur, bluish – purple Lachesis and has the patient got a particular smell? Sourness might indicate Calc. carb., for example, or old cheese might indicate Hepar sulf. All these observations provide valuable clues [41, 48].

 

Dosing and potency:

 

     The word "dose frequency" refers to the number of times a medicine is taken. The more intense a patient's symptoms, the more frequent should be the dose, though the response to treatment also directly affects dosage.

 

     The determining of correct dose is important because in infrequent instances excessive dosages can lead to a "proving" (the experience of symptoms caused by the overdose). However, only rarely a patient will experience a proving because it is difficult to elicit symptoms from a proving while a patient is ill. Even in the rare cases that symptoms of a proving are created, the symptoms dissipate shortly after the remedy is stopped [49].

 

     The word "potency" refers to the number of times a medicine is potentized. Homeopaths have discovered that the more a medicine is potentized, the faster and deeper it acts and the fewer doses of it are generally required for treatment. It is generally recognized in homeopathy that the choice of the correct medicine is significantly more important than the correct potency. Giving the incorrect potency will generally promote healing, but the healing is slightly slower. It is likewise unnecessary to worry about whether to give a "D" or a "C" potency. They are both very similar in action, though the "C" potencies are considered slightly more powerful and therefore require slightly more precision in prescribing [49-50].

 

     In the history of homeopathy many types of dilutions were developed. Although other type of dilutions still exist, the decimal, centesimal and LM potencies are popular, although only used by single remedy classical homeopaths. The procedure to produce a homeopathic dilution is described in the Pharmacopeia, followed precisely by homeopathic Laboratories. There are a few recognized Pharmacopeia worldwide. The most followed are the German (HAB: Homöopathisches Arznei Buch) and the French (PF: Pharmacopée française) one. Heel medications are produced according the German Pharmacopeia. The decimal dilutions is strongly present in the ‘German school’. It is a 1:10 concentration used in every dilution step [51].

 

     Between 2 diluting steps there is a process of dynamisation which means a repeated firmly shaking (Hahnemann: 10 times) of the liquid. Starting from a mother tincture a D1 is a 1:10 dilution, a D2 a 1:100 dilution, a D3 a 1:1000 dilution,…a D9 a 1:1000000000 dilution, and so on. Centesimal dilutions have a 1:100 concentration in every dilution step. Also here between two dilution steps dynamisation takes place. A C1 or 1CH is a 1:100 dilution, a C2 or 2CH is a 1:10000 dilution, a C5 or 5CH is a 1:10000000000 dilution, and so on [49-51]. The C-potencies or dilutions are strongly present in the ‘French school’. D-dilutions are much more dynamized than C-dilutions as on every step of 1:10, there is a 10 times shaking which is only the case in every 1:100 step. So, a D6 might have the same molecular concentration as a C3 (both 1:1000000 dilutions), to produce a D6 the liquid in different steps was shaken 60 times, in the C3 dilution only 30 times. Especially in higher dilutions this difference becomes significant [49-51].

 

     Korsakov dilutions were developed by Korsakov. For D, C and LM dilutions in every dilution step pharmaceutical laboratories need to use another container to make each succeeding dilution, in Korsakov dilutions the same recipient is used from the first to the last dilution. The residual content in adhesion on the wall is about 1:100 part of the liquid that was in the bottle. Korsakov machines aspirate the liquid in the container after dynamisation and fill the recipient again afterwards to make the next dilutions. Korsakov dilutions are abbreviated by the K-symbol. A 6K is the 6th Korsakov dilution, the 200K the 200th one [52].

 

Why did the patients seek homeopathy?

 

     The reasons that led patients to look for homeopathy are dissatisfaction with the results of conventional treatment, family influence, suggestions from others and the harmful effects of allopathic remedies are significant elements in the process of adhering to homeopathic treatment. There are reports of the patients who have been treated with homeopathy since they were children are associated with the family tradition of using homeopathic treatment [53].

 

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