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Homeopathy Fall 2012 - Healthy Options

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					 Homeopathy
Chester L. Price, PharmD, DHPH
     Decline of Homeopathy
• Peaked in the early 1900’s
• Antagonism from Allopathic medicine
• Development of the modern drugs: Paul Ehrlich: the
  first specific anti-bacterial drug Salvarsan as a
  treatment for syphilis, Sulfanilamide, Penicillin, etc
• Homeopathic disagreements re: pathological
  symptoms and modalities were more important than
  mental symptoms
• Differences in teaching of homeopathy: English System
  vs. American system
• Constitutional approach: differences as to how to
  practice                                               2
    Decline of Homeopathy
• Flexnor Report 1912
• Committee on medical education that was
  funded by the Rockefeller and Foundations
• The report stressed the importance of
  anatomy, physiology and pathology in the
  syllabuses.
• Federal support and funding was given only to
  those medical schools which reflected this
  priority
                                                  3
 Resurgence of Homeopathy
• Began in the 1960’s
• Concern over ADR
   o Sometimes on the market a long time before
     problems occur.
• Increased health awareness
• Growing disaffection with results of traditional
  medicine
   • Disconnect between patient and practitioner
• Interest by MD’s, Nurses and other health
  professionals
                                                     4
                      Origins
• Organized as a system in Europe, but was utilized
  previously
• TCM
• Ayurveda
• Roman
• Dark Ages
• 16th Century
• others cultures that have used the principles:
   o Mayan
   o Greek
   o Asian
   o Native American
   o Indian
                                                      5
What Is Homeopathy
 Homeopathy is a system of medical
 therapy that uses very small doses of
 medicines, or remedies. These
 remedies are prepared from
 substances found in nature.
 Homeopaths use ultra-dilute “micro-
 doses” made from not only plants,
 but minerals or other substances
 found in nature. The word
 "homeopathic" is derived from the
 Greek words homeos meaning
 "similar" and pathos meaning
 "disease" or "suffering."

                                         6
Is Homeopathy New
The Law of Similars has been known and
written about since at least the time of
Hippocrates (ca. 400 B.C.), but it was Samuel
Hahnemann who fully organized the system
now known as homeopathy in the early 1800's.
He was a doctor and a chemist in Germany who
lived from 1755 to 1843. He discovered the
truth of the Law of Similars by testing small
doses of medicine on himself and other
volunteers.
By 1900, about 20 percent of doctors in the
United States were homeopaths. Due to           Samuel Hahnemann
various political and social changes,
homeopathy became relatively unknown in the
United States until recently.

                                                                   7
         Dr. Samuel Hahnemann
• Sought alternatives to therapies such as bloodletting
  and use of arsenic
• Experimented with Quinine
   o Known to cure malaria
   o He took some and developed symptoms of
     malaria
   o Led to his theory that some substances can be
     healthy or harmful depending on quantity taken
• Tested this theory on himself using hundreds of
  substances from: plants, minerals, animals (Provings)

                                                          8
       Definition/Terminology
• Doctrine of Signatures
   o Belief that the external appearance of a plant gave an indication of the ailments it could
     treat

• Herrings Law (Laws of Cure)
   o Explains how disease is cured in homeopathy.

• Constitutional Types (chronic disease)
   o Related to emotions, body shape, personalities

• Miasms (chronic disease)
   o Deep-seated weakness due to a prior familial disease history




                                                                                                  9
    Definitions/Terminology
• Vital Force
   o Remedies strengthen the body’s vital energy
• Aggravations
   o Increase in the disease symptoms being treated
• Succussing
   o Vigorous shaking between potentizations to
     release the “energy” of the remedy
• Potency
   o A term used to describer the dilution, or strength
     of the remedy.

                                                          10
   Principles of Homeopathy
• Law of Similars - “like cures like”; remedies are
  similar to the illness & stimulate body’s own healing
  response
• Law of Infinitesimals - the more a substance is
  diluted, the higher its potency; remedies are diluted
  in water & alcohol & shaken
• Arndt-Schultz Law – For every substance, small
  doses stimulate, moderate doses inhibit, and large
  doses kill

                                                          11
          The Law of Similars
The Law of Similars is a special rule of nature, which
states "like cures like," or that a medicine can cure a sick
person if it can cause similar sickness in a healthy
person. To give an example, if you peel an onion, your
eyes burn, itch and water. You might also have a runny
nose and begin to sneeze. If you had similar symptoms
during a cold or allergic reaction, (e.g., a runny nose,
watery eyes and sneezing), a homeopathic micro-dose
of the remedy Allium cepa (red onion) might be
indicated.

                                                               12
                 How it works
• Tell me how yours works and I will tell you how ours
  works.
   o PDR, Many research articles
       • “while the exact mechanism of action is not
         known, it is believed”…
       • “while the mechanism through which…..lowers
         blood pressure is believed to be primarily
         suppression of the renin-angiotensin-
         aldosterone system, ……has an antihypertensive
         even…..”


                                                     13
           How It Works
•   Information Theory
•   Homeostatic Theory
•   Vital Force
•   Resonance


                          14
            How it Works
• Information Theory
   o“disease is an information disorder”
    and that medicines can act to regulate
    faulty homeostatic mechanisms by
    providing specific information.
   oSomething like rebooting a computer
    whose operating system has crashed.


                                             15
                How it Works
• Homeostatic Theory
  o If the body is pushed in one direction it will
    push back in the opposite direction in
    order to maintain balance
     • By giving a sick person a small dose of a
        substance that can cause similar
        symptoms the person is also suffering
        from we can cause the body to push
        back (fight) against the disease
        symptoms)

                                                 16
               How it works
• Vital Force
  o The Vital Energy exists, and it is the one
    and only that rules the function of the
    body
  o It is based on natural laws and on energy




                                                 17
             How it Works
• Resonance
   o Everything in the universe vibrates at its
     own frequency
   o The vibration will increase when
     stimulated by a similar frequency
         oTuning fork High C - same frequency
         oMiddle C –l but at a lower amplitude



                                                  18
                How it Works
Resonance, continued
• Every stimulus has an affect on the vital
  force and it either can adjust or respond
  to it
   oWithout remarkable symptoms or
    with remarkable symptoms,
    depending on whether the stimulus is
    stronger or weaker than the vital force
    itself.

                                          19
            How it Works
Resonance, continued
o Since the vital force is assumed to be
  electro-magnetic, based on energy, there is
  only one way to strengthen it….that is by
  energetic medicine
o Any other influence will just suppress the
  defense mechanism, and the vital force
  will increase its susceptibility for more
  influences

                                                20
                    Practitioners
• Homeopathy in the US is provided by:
   o   MDs
   o   DOs (Doctor of Osteopathy)
   o   NDs (Naturopaths)
   o   Chiropractors
   o   Veterinarians
   o   Acupuncturists
   o   Nurse practitioners
   o   Physician’s Assistants
   o   Pharmacists
   o   Dentists


                                         21
     Homeopathic Training
• Europe: a professional degree taking 3-6 years
  to complete, or a post professional program
  for physicians
• US: certificates or short programs taken by
  various health providers
   o 3 states (Connecticut, Arizona, Nevada)
     have licensing for doctors to provide
     homeopathy
   o Practiced by naturopaths

                                                   22
               Global Use
• Most popularity in Europe
• In Britain: the national healthcare system includes
  homeopathic hospitals and clinics
• Germany: homeopathy is a required subject in med
  school
• France: law requires pharmacies to sell remedies;
  some are covered by insurance
• Other countries: India, South America, Australia,
  Pakistan, Sri Lanka, Mexico


                                                    23
                 Practice in the US
• By the end of the 19th century, widely
  practiced in US - 22 schools & over 100
  homeopathic hospitals
• declined rapidly in 1900s due to medical
  model
• increase in interest in the last 20 years

Image: http://www.fotosearch.com/photos-images/
homeopathic-medicine.html


                                                  24
   Homeopathic Pharmacy
• Sources
  o Plants, whole, leaves, wood, bark, stems, seeds,
    roots, fruit, aerial parts, buds, shoots, flowers
  o Animals, ants, spiders, bees,
  o Secretions: hormones, etc
  o Chemicals, Minerals
  o Venom, Poisons
  o Nosodes, Sarcodes, Isodes
  o Imponderables (x-ray, electricity

                                                        25
            Pharmacy, con’t
• Process
  o Raw materials cleaned, then made into tinctures
  o Tinctures: water-alcohol solutions. Cleaned
    materials are allowed to soak under conditions
    specified in the HPUS
  o Mother Tincture )
  o Triturations
     • Grind the material in milk sugar/lactose. After
       diluting to 6X all substances should be soluble in
       the water alcohol solution.

                                                            26
         Pharmacy, con’t
• Succussion
   oVigorous shaking between each
    dilution under specified conditions
• Dilution/Potencies
   oLow: 1X -6X; 1C – 6C
   oMedium: 12X – 30X, 12C – 30C
   oHigh: 200X; 200C – 1000C (1M)
   oUltra-high: 10M, 50M, CM (100M)
                                          27
Potentization




                28
           Pharmacy, con’t

• Decimal 1/10 or 1X
  oCentesimal 1/100 or 1C
  oHahnemannian CH
  oKorsakovian CK
• Care of Remedies
  oAvoid strong odors, vapors and
    sunlight
  oAvoid heat more than 110 F       29
 Homeopathic Pharmacies in the US


o Boiron, PA
o Washington Homeopathic Pharmacy, DC 7 WVA
o Standard, CA
o Luyties, MO
o Boericke and Tafel, PA & CA
o Weledra, NY
o Dolosis, NV
o Humphrey’s, NJ

                                              30
       Homeopathic Remedies
• There are thousands of remedies (>3,000)
• Created by repeatedly diluting in alcohol or
  water
• The more dilution, the higher the potency
  (strength)
• Some are so dilute the original substance
  cannot be measured
Image: http://www.care2.com/c2c/groups



                                                 31
          Homeopathic Remedies
• Pharmaceutical Forms
   •   Tablets
   •   Pellets
   •   Liquid
   •   Ointments
   •   Gels,
   •   Creams
   •   Suppositories, rectal and virginal
   •   Injectable
   •   Ophthalmic, Otic and intranasal (drops and sprays)



                                                            32
  Classification of Remedies
• The Single Remedy
• Specific Remedies (for the tx of certain
  strongly indicated Sx
   oe.g. Arnica Montana for bruises
• Constitutional Remedies
• Polycrest Remedies)
   oFrom the Greek for “many uses”
   oe.g. Aconite, Belladonna
• Combination Remedies (Polypharmacy)
                                             33
      Types of Remedies
• Nosodes
• Sarcodes
• Isodes
• Drainage
• Detoxification
                          34
 Therapies Closely Related to Homeopathy

• Biochemic Tissue Salts
   o Schuesler Cell Salts
• Bach Flower Remedies
• Biotherapies (1964)
   o Organotherapies (animal organ tissue)
   o Gemmotherapy (plant buds)
   o Lithotherapy (minerals-needed for biochemical
      processes, enzymatic activity
• Homotoxicology

                                                     35
              Homotoxicology
• Originated by Hans-Heinrich Reckeweg, MD in 1952
• Combined classical homeopathy with modern medical science
• Uses conventional medical indications with homeopathic
  remedies
• “all those processes, syndromes and manifestations which we
  designate as diseases are the expression therof that the body
  is combating poisons and that it wants to neutralize and
  excrete these poisons. The body either wins or loses the fight
  thereby. Those processes which we designate as diseases are
  always biological, that is, natural teleological processes which
  serve poison defense and detoxification”.

                                                                     36
       What

In homeopathy, one does not treat diseases;
instead, we treat the person who is sick. Whether
a person has a chronic or an acute disease, all of
their symptoms, whether physical, mental or
emotional, form a whole, representing a state of
imbalance very specific to this individual. The goal
of the homeopath is to recognize the unique
expression of symptoms the patient presents and
then identify among the great number of
remedies available the one most homeopathic, or
most similar to, the patient's disease.            37
   Homeopathy

Homeopathic treatment is ideal to optimize
the body's natural defenses against
microbes. With the appropriate
homeopathic treatment, people recover
from infectious diseases, even the most
serious ones, gently and rapidly. During past
great epidemics of diphtheria, scarlet fever,
typhoid, cholera, yellow fever, malaria, etc.,
homeopathy decreased mortality by 10 to 30
times versus conventional medicine.
                                                 38
 Can a Pregnant Woman or Newborn Baby
 Benefit from Homeopathy?

Since homeopathic remedies are devoid of all chemical
toxicity, homeopathy is the ideal system of medicine for
people of all ages, even the most sensitive like an
expectant mother or a newborn baby. Difficulties during
pregnancy and the delivery or its aftermath as well as
all the problems experienced by the newborn can be
dealt with very efficiently and without side effects with
homeopathy.


                                                        39
     Which Conditions Are Outside the Scope
     of Homeopathy?

If a patient has a problem that necessitates a surgical intervention, the
homeopath will refer this patient to a surgeon. Given that surgical
interventions are a shock to the organism, homeopathic treatment is
often ideal to prepare the patient for surgery and help them recover
post-surgically. Of course, cases with dislocation or fracture will be
dealt with by an orthopedic doctor. For less serious mechanical
physical problems, patents can be referred to a chiropractor,
osteopath, or other appropriate therapist. Generally, people afflicted
with genetic, congenital, or fixed metabolic diseases or with very
advanced degeneration cannot always expect full recovery, but rather
palliative relief with homeopathy, free of side effects usually expected
when palliation is done with modern drugs.

                                                                       40
 How Do Homeopaths Treat Patients?

During a visit to a homeopath, patients are asked to
describe all of their problems in detail as well as a
complete description of everything that characterizes
them, especially feelings, sensations, sensitivity, psyche,
and all that concerns them in terms of energy, sleep,
appetite, digestion, etc. This thorough and initial interview
requires approximately two to three hours. The better the
homeopath understands the patient and his or her
problems, the better the homeopath can individualize to
find the most similar, most effective remedy for the
patient.



                                                                41
        Clinical Application
• Human
   o Adult, Elderly, Pediatrics
• Veterinary
• Safe
• Non-toxic



                                  42
          Clinical Application
• Remedies are prescribed based on symptoms
• The higher the similarity between the patients
  defense mechanisms and the pathogenesis of
  a remedy, the higher the potency is needed.
• Treatments are tiny quantities of substances
  that cause those symptoms in higher doses
• Example:
   o Rhus toxicodendron (Rhus tox): made from
     poison ivy and is used to treat the rash from
     poison ivy
                                                     43
        Clinical Application
The dose of a particular remedy is dependent on
the severity and acuteness of the symptoms. In
acute cases, a dose of 2-3 pellets, tablets, may
be taken every 15-30 minutes at the onset, with
fewer dosages repeated as treatment is
continued, AND the person is improving
As the person improves, the intervals may be
lengthened until the condition is alleviated. If
there is no improvement within the first 1-2
hours, the choice of the remedy should be
reconsidered.
                                                   44
       Clinical Application

In some acute diseases the dose may be
repeated until improvement begins. At the first
sign of positive response, hold further doses
until you see the progress stop or relapse. If
the remedy only works for a short period of
time, a higher potency may act longer.



                                                  45
          Clinical Application
• If no further improvement is obtained and the
  symptoms are the same, use a higher potency.
  If a higher potency fails to act, then the
  symptoms have changed or your first selection
  was close but incorrect, You must reevaluate.
  In this case, or if the symptoms have changed,
  select another remedy.
• If there is an initial aggravation before
  improvement occurs, you remedy was so
  accurate that the pt is experiencing symptoms
  similar to the proving.
• In general, people should recover at the same
  rate in which they became ill.
                                               46
                 Repertory
• A compilation (listing) of symptoms (organized
  according to homeopathic principles of hierarchy of
  importance, with a corresponding list of the
  remedies/substances/medicines that caused or
  cured those symptoms.
• A repertory is a symptom index to the materia
  medica. The term used is “rubric” or symptom, and is
  followed by a listing of the remedies that caused
  those symptoms. Listing of remedies is graded based
  on the reported effectiveness of the remedy and the
  related symptoms.

                                                         47
         Materia Medica
• A compilation (listing in alphabetical
  order) of medicines, with the
  symptoms that are caused by those
  medicines in provings, or found to be
  cured by those medicines in clinical
  practice

                                           48
49
              First Aid Family
• To be inserted here or provided as a handout




                                                 50
Algorithm for Simple Colds,
       Flu, & Coughs




                              51
               Algorithm for Acute Care



     To be inserted here or provided as a
     handout
52
Regulations for Homeopathy
• Homeopathic remedies are prepared according to
  the guidelines of the Homeopathic Pharmacopeia of
  the United States (HPUS), which was written into law
  in the Federal Food, Drug, and Cosmetic Act in 1938.
  Homeopathic remedies are regulated in the same
  manner as nonprescription, over-the-counter (OTC)
  drugs. However, because homeopathic products
  contain little or no active ingredients, they do not
  have to undergo the same safety and efficacy testing
  as prescription and new OTC drugs.

                                                         53
           Regulations, con’t
• The U.S. Food and Drug Administration (FDA) does
  require that homeopathic remedies meet certain legal
  standards for strength, purity, and packaging. The labels
  on the remedies must include at least one major
  indication (i.e., medical problem to be treated), a list of
  ingredients, the dilution, and safety instructions. In
  addition, if a homeopathic remedy claims to treat a
  serious disease such as cancer, it needs to be sold by
  prescription. Only products for self-limiting conditions
  (minor health problems like a cold or headache that go
  away on their own) can be sold without a prescription.

                                                                54
                  FDA Role
• In 1938 Congress passed a law that remedies be
  regulated by the FDA like over-the-counter meds
• However, OTC meds are subject to testing and review
  not required for homeopathic remedies
• In 1988, FDA required that remedies list indications
  and other info on labels
• FDA reviewed possible side effects of use:
  determined that remedies are safe


                                                         55
     Skepticism and Debate
• Why are the most dilute substances the most
  potent?
   o Causes skepticism by traditional medical
     system
   o Theory: remedies have electromagnetic
     properties that signal body to heal itself
• Home treatment
   o Some homeopaths think remedies should
     be individually prescribed rather than
     bought off the shelf of a grocery store
                                                  56
    Research in Homeopathy
• Provings
• Meta-Analysis
• Human Trials
• Animal Studies
• Difficulty with all clinical studies in CAM
   o Individualized nature of the treatments
   o Uniqueness of the individual
   o Traditional clinical studies are restricted to one substance,
      restriction of variables is necessary to validate the
      outcome of the specific substance tested
• Flaws with that method when testing natural substances
       • beta-carotene study in Denmark on lung cancer
       • Vitamin c and cancer
                                                                     57
            Research, con’t
• Homeopathic Treatment of Acute Childhood
  Diarrhea: Results from a Clinical Trial in Nepal
   o Jennifer Jacobs, MD, Margaret Jimenez, MD, MPH,
     Stephen Malthouse, MD, Elizabeth Chapman, ND,
     et al
   o The Journal of Alternative and Complementary
     Medicine Volume 6, Number 2, 2000, pp 131-139
• A Review of Homeopathic Research in the Treatment
  of Respiratory Allergies
   o Dana Ullman, MPH; Michael Frass, MD
   o The Journal of Alternative Medicine Review,
     Volume 15, Number 1                             58
Some research support has been found for:
• Cancer Tx Side     • Influenza
  Effects            • Respiratory
                       allergies
• Dandruff           • Arthritis
• Sprains &          • Diarrhea
  Strains            • Chest pain
                     • Fibromyalgia
• Mild Brain
                     • Chronic Fatigue
  Injury               Syndrome

                                            59
        NCCAM Conclusions
• Findings of review of research:
   o NCCAM reports that little evidence of benefits of
     use
   o Lack of definitive sign of benefits for any medical
     condition
Image:
  http://www.homeopathypractice.co.nz/homeopathy.
  html




                                                           60

				
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