NMT100 Homeopathy Review Notes.docx

NMT100 – HOMEOPATHY REVIEW NOTES History of Homeopathy Hippocrates (c460-c375 BCE) Rejected that Gods cause disease The Hippocratic Oath – oath of ethics taken by physicians Discovery of Law of Similars idea to treat patients with substance that can create the same disease/symptoms Vis medicatrix na...

NMT100 – HOMEOPATHY REVIEW NOTES History of Homeopathy Hippocrates (c460-c375 BCE) Rejected that Gods cause disease The Hippocratic Oath – oath of ethics taken by physicians Discovery of Law of Similars idea to treat patients with substance that can create the same disease/symptoms Vis medicatrix naturae – one of six principles of naturopathic medicine Body is a complex and adaptive system – should work with forces and wisdom of nature Galen (129-c216) Greek physician; creator of the 4 humours/temperaments Blood – sanguine Black bile – melancholic Yellow bile – choleric Phlegm – phlegmatic Ibn Sina (Avicenna) (980-1037) Persian physician – “father of early modern medicine” that influenced medieval medicine in Europe until mid-18th century Believed in natural causes to disease and promoted holistic medicine – ex. physical and psychological factors, environmental factors, hygiene, lifestyle, diet Samuel Hahnemann (1755-1843) German physician First findings of homeopathy proposed in: “An Essay on a New Principle to Ascertain the Curative Powers of Drugs” (1796) Founder of homeopathy; decided that the Law of Similars should be a guide to how to prescribe remedies and medical treatments Aphorisms – concise statements of a scientific principle Age of enlightenment in medicine Scotland center of medical advancements and controversy John Brown Teaching that there were only two diseases – sthenic (strong) and asthenic (weak); two treatments of stimulant and sedative William Cullen – orthodox medicine; opposed John Brown’s views Common treatments included: Polypharmacy (herbs, metals, toxici compounds) Bloodletting Emetics, purgatives, blistering agents Cauterization, amputation, surgery 19th to 20th Centuries 1800’s – homeopathic doctors were popular; make more money than average doctor Development of modern medicine + closure of homeopathic colleges and universities => lead to a death of homeopathy in US and Canada 20th to 21st Homeopathy remained worldwide – in America used between friends and families 1970’s – homeopathy regained strength; trained by George Vithoulkas 21st century – began to thrive again Rational vs. Empirical Schools Rationalist School Empirical School Mechanistic (machine) view of body and its functions Dynamic – body is more than a sum and is adaptive Reductionist and grouping of disease Holistic and individualistic (disease class) Heroical theories and treatments Test and observe phenomena, don’t theorize, use natural/gentle measures Can do better than nature, work to eliminate symptoms Vis medicatrix naturae – follow nature, don’t suppress symptoms Common symptoms are most important Peculiar symptoms are most important Hahnemann’s Discoveries The Law of Similars must guide medical practices Began by experimenting on himself with ingesting Cinchona officinalis (tree bark) Symptoms included rush of ideas in bed, intermittent fevers, preventing sleep, indifferent, disobedient Worse with slight touch – at night – every other day – after eating Better with hard pressure – bending double – with open air – warmth Treatments needed to be highly diluted, potentized remedies serial dilutions Dilution beyond Avogadro’s number Succussions: action of shaking and hitting against a surface to produce a shock wave; required between each dilution for the remedies to retain active properties of the substance (makes it stronger vs. weaker with dilution) Signature of substance impregnated into the liquid and properties are transferred to dilution – lose toxicity but gain activity Theory of chronic miasms Found symptoms were returning after correct treatments – attributed chronic cases to ancestors having a similar disease Controversy in discoveries Very vocal – gained followers Constantine Hering Medical graduate; read Hahnemann’s texts and pursued homeopathy Clemens M.F von Bonninghausen Lawyer; contracted TB – homeopathy saved his life Pioneers in creating the remedy index system Naturopathy and Homeopathy Naturopaths trained in classical homeopathy Companies make complex remedies or specific for treating certain indications and pathologies – NOT classical homeopathy Homeotherapy (homeotherapeutics): use of homeopathic remedies, but not necessarily following the Law of Similars for their indication Prescribed to address a diagnosed condition, pathology and not according to the individual’s set of symptoms Combinations – may increase odds that one ingredient will match symptom picture – odds not good and remedy often fails; risk that combination will affect patient in unpredictable ways 6 principles of Naturopathy and aphorism First, do no harm – aphorism #2 Work with the healing power of nature – many aphorisms Identify and treat the cause – aphorism #3 Treat the whole person – aphorism #5 Doctor as teacher – aphorism #5 and others Prevention – aphorism #4 Classical Homeopathy – Principles Law of Similars Individualize the case unique set of symptoms characteristic symptoms Prescribe accordingly find a matching remedy most similar to the case Single remedy Find the most similar remedy (simillimum or simile) no combinations Minimum dose First do no harm use potentized remedies match the intensity Totality of symptoms Characteristic symptoms relevant symptoms; can’t match every symptom Example case: patient suffering from malaria, symptoms are better in open air and with warmth, tend to feel worse at night and after eating – could they try China (Cinchona) officinalis to treat malaria? Yes – symptoms fit indication for Cinchona (intermittent fevers) and modalities (what makes it better or worse) Similar enough to trigger a healing response Homeopathic Preparation Remedy: homeopathic medicine Potency: the number of serial dilutions and succussions in preparation of the remedy Potentization/dynamization: process by which the dynamic power of the substance is released by serial dilutions and succussions Succussion: vigorous taping of the container which used for potentization of liquid potencies Trituration: process of diluting a non-soluble substance by grinding it to a fine powder and mixing it with lactose powder Used for solid substances up to 3rd centesimal potency, then will continue potentization in liquid form Source of remedies include: Plants Minerals – chemicals, elements, compounds, natural minerals, mineral springs Animals – venom, milks, feathers, diseased tissues, pathological microbial culture (nosodes), healthy tissue (Sarcodes) Synthetics – chemical compounds, allopathic medicines (uncommon) Imponderables – immaterial dynamic energies (uncommon) Remedy carriers used in preparation Solid vehicles – pellets, tablets, globules Saccharum lactis (milk sugar) or cane sugar/sucrose Liquid vehicles Distilled water, alcohol, glycerine, saline, ether, oils Semi-solid vehicles Paraffin, beeswax, lanoline, any topical cream Potencies Decimal (1/10) – first potency contains the one-tenth part of the original medicine 1X or 1D Centesimal (1/100) – first potency contains the one-hundredth part of the original medicine 1C; 1M = 1000, 10M = 10 000, CM: 100 000 Fifty Millesimal-LM or Q potency (1/50 000) – for a rapid, gentle and permanent cure Q1 or LM1 Advantages of homeopathic remedies Ethical trials Sustainable – uses very minimal amount of original substance Cost effective Easy to use (children) Manufacturing causes less harm to nature and humans Homeopathic Dispensing Dispensing: provide medicines or devices for specific treatments Includes packaging, labeling and security to safeguard the substances or devices provided Technical and cognitive components performed by registrants Office based dispensing Advantages Homeopathic medicine not easily available in all pharmacies Can control on quality and efficacy of medicine Convenience for patients which can increase compliance rate Disadvantages ethical concerns Compounding standards Standards include: Cleaning procedures for area, tools and receptacles where substances are compounded Proper sanitary handling of materials Minimum requirements of health and hygienic behaviour Utilizing readily disinfected, non-porous containers for storage Substances stored in controlled-access area to avoid contamination No contaminated, disintegrated or decomposed substances may be used; ensure quality of ingredients Registrant be able to distinguish materials that require specialized handling and storage and demonstrate safe handling techniques Labelling No labels – indicate unreliable system or ineffective medicine; may affect patient’s compliance and lead to inappropriate methods of dispensing Perceived benefit of not informing patient with name of medicines – can lead practitioners to avoid labeling medicines Perceived negative effects include: Patients may dislike the substance Self-prescription by patients and possibility of overdosing May not agree with opinion and selection of medicine Patient’s bias with homeopathic remedy Positive effects of transparent labelling: Build trust Give confidence to patients and empower them to have active role in treatment Educate patients on treatment What is on a prescription? Name and address of patient for whom drug is prescribed Name, strength, and quantity of the prescribed drug Directions for use of the drug; including dose, frequency, route of administration and any special instructions Name, signature, address, phone number and college registration number of Registrant issuing instruction Can also include: Date prescription was issued Number of refills Registrant has authorized Record keeping Must maintain patient record for individuals prescribed a drug This must include: Reasoning for prescribing drug Copy of prescription given to the patient Record of results of any laboratory or other tests that the Registrant considered in deciding to prescribe the drug Contacts of other healthcare providers who were notified and how they were notified Handling precaution Keep out of direct sunlight Do not store beside substances with strong odors or near electromagnetic devices Do not take any other medicine or supplement without consulting a homeopath during treatment period Avoid touching pellets or tablets with hands Do not brush teeth, eat, or drink anything for at least 10 minutes before and after taking remedy; mouth should be clean without any taste Homeopathic manufacturers Boiron Reckeweg Helios (UK) for rare remedies Unda (Seroyal) Homeopathy Resources Repertory: index of symptoms which refers to remedies of the materia medica (compendium of remedies) Materia medica: compendium of remedies with their detailed symptoms, tissue and organ affinity and often their sources Most written in 19th century – new ones combine old and new views of remedies Integration of Homeopathy and Medicine Compatible with all naturopathic modalities and conventional medicine Advantage in using homeopathic treatment in hospital (emergency) settings and with cancer treatments Improve progress, survival rate, less time spent in hospital, etc. Research Proving HPT – Plumbum metallicum; pathogenetic trials Water research to explain activity of homeopathic remedies Surface tension of water may explain mechanisms – not through biochemical reactions Studies show individualized treatment improves health outcomes, but more research is needed Hahnemann’s Aphorism Summary Aphorism 1 Physician’s calling is to make sick people healthy Aphorism 2 Rapidly, gently, permanently remove and destroy whole disease in least harmful way => “first, do no harm” Aphorism 3 A true physician – has knowledge of disease (pathology), knowledge of medicinal powers and what cure is needed (prescription), what obstacles are needed to be cleared to make recovery permanent (prevention) Aphorism 4 and 5 Physician should determine probable exciting cause and know what disturbs health => “treat the cause”; in acute cases it is easier (trigger or agent) and in chronic cases a miasm is identifiable Aphorism 6 No need to come up with theories and explanations about an illness as it won’t bring about healing; only way to cure a patient is to pay attention to totality of symptoms and the pattern of symptoms will indicate the need for one similar remedy Disease is known by its symptoms, which are produced by the imbalance of the body’s vital force; cannot destroy diseases but only help the body restore normal function and balance (health) Aphorism 8 Health will remain once all symptoms and signs of disease are eliminated Aphorism 9, 10 and 11 Vital force (dynamis) animates the human body, without it the material organism cannot feel, act or maintain itself When ill, it is the vital force that is untuned due to the disease agent; this untuned state brings out sensations and abnormal functions that we call disease Aphorism 12 Pathologically untuned vital force causes disease and reveals the whole disease; cessation after treatment implies vital force has recovered integrity Vital force produces both the disease symptoms and the healing; with a strong vital force = more intense symptoms and better chance of quick and full recovery but can also be more life-threatening in acute cases Aphorism 13 Disease is the whole manifestation of symptoms; each unique set of symptoms represents the disease that needs to be treated even – each patient suffering from one disease will need their own unique remedy => individualization of prescription Aphorism 16 Diseases and vital force are dynamic, not material things – a similar influence is needed from treatment to return to normal or optimal function of body Treat disease with similar remedies = treating the vital force and working with it to restore health and balance (better than becoming more damaged with chemicals/interventions) Aphorism 17 Treat the cause => elimination of all signs and symptoms that are influencing the vital force can also mean dealing with psychological problems States physicians only need to follow symptom picture to identify what to treat and how to treat it (did not have lab tests to identify but still able to treat/cure patients) Aphorism 18, 19 and 20 Totality of symptoms and circumstances should be used to guide the choice of the remedy Diseases are deviation from healthy conditions, cure is change from diseased condition back to health, medicines cure disease only if they possess power to alter the way a person feels or functions = need to match the symptoms of the case Changes produced in the body by drugs and remedies => artificial disease Law of Similars – two similar diseases cannot coexist in same organism; producing artificial disease with medicinal produce similar to the illness but stronger will bring return to health (or improvement) Aphorism 21 Remedies cure by ability to alter human health by causing characteristic symptoms => should identify active ingredients in an herb and the action can be due to primary or secondary reactions, and be affected by individuality of individual Trying to predict response to substance by ingredients is bound to be imperfect and fail – should test in healthy volunteers who will exhibit symptoms characteristic to the substance (conduct provings) Pay attention to characteristic symptoms of a substance not vague characteristics – want to see how they differ vs. how they are common Aphorism 22 and 23 Change disease to health you must remove totality of symptoms; substances create artificial disease which can destroy the natural disease Antipathic (remedies that are oppose symptoms), enantiopathic (causes an opposite or palliative effect), palliative (compensates for or temporarily improves condition but does not eliminate => discovered similar remedies worked where opposites only palliated (helped temporarily) Ex. corticosteroids, antipyretics – examples of opposite treatments Aphorism 24 Remedy most similar to the natural disease is known as simillimum – once cause and obstacle are eliminated, have to treat any natural disease with an artificial disease (caused by remedy) Artificial disease – created by a substance prescribed and administered willfully by human hand; symptoms created by treatment, not nature Aphorism 25, 26, 27, 28 Weaker dynamic affection is eliminated by a stronger one that is different in nature but greatly resembles its expression – how physical and moral disturbances are cured Little value is explaining how it works – proof found in experience Can controls strength of the artificial disease through posology – select potency and dosage strong enough to dominate over illness’ intensity; going over just a little bit so the body responds to it and no longer influenced by the illness (can repeat remedy in longer lasting and persistent illness’) Aphorism 29 Vital force frees itself more easily from artificial diseases than from natural ones, although former are stronger, because disease agents (medicines) producing the artificial diseases have a short action Natural diseases are weaker than artificial ones, have a longer action, nearly always as long as life itself, and cannot be overcome by the vital force and must be extinguished with a remedy that can make a stronger, but similar artificial disease Miasms – deeper root cause of chronic illnesses; theory that helps cure chronic disease (came from inherited infectious diseases that probability affected DNA and gene expression) Usually with acute diseases the vital force would recover eventually, but remedies help in recover but for chronic diseases the influence is more gradual and less perceptible by the vital force and body defenses. Since body is always trying to conserve energy, it will respond with just enough to cope, but if chronic disease continues it will become more difficult to compensate and will eventually be caught. Remedies override this and make the vital force react more forcefully Aphorism 30 Can make medicine stronger and persist longer than a natural disease because we can repeat the dose and adjust the strength; effect wears off overtime unlike chronic disease that persists Humans are altered more surely by medicines than by natural disease agents Aphorism 72 Speed and duration of disease processes – rapid and ending quickly for acute diseases; gradual and eventually fatal in chronic (does not trigger the automatic immune response that brings healing) Aphorism 73 Exciting causes related to the six external influences in TCM, and unhealthy lifestyles and physical/psychological traumas can cause acute illnesses; must be removed or dealt with before being cured Can only be affected by these triggers if they have innate susceptibility or weakness (chronic latent disease he called psora) and acute diseases are actually flare-ups Approach to treatment between epidemics (many individuals affected very similarly from similar cause) and acute miasms (recur in own form and similar ways; often once in a lifetime) are treated differently Aphorism 82 Each case is individualized and especially in chronic (psoric) diseases, the physician must take into account all symptoms; must distinguish between acute and chronic Acute diseases require less time (probe less); chronic is more difficult to obtain the symptoms Must be patient and pay attention to what patient says about complains and sensations, using exact expressions; in the words of others can get distorted Aphorism 186 Homeopathy can offer great help in emergency and first aid situations and should be added to mechanical interventions Aphorism 192 Need complete case to find the correct remedy for an acute case; do not pay attention to only symptoms related to chief complaint, need to look at changes that have happened recently (totality of symptoms) and how any chronic symptoms have changed over time Aphorism 193 Justifies why we do what he recommended in Aphorism 192, links this to the presence of an ever present chronic miasm, and tells us to expect a relatively rapid and large response to the correct remedy Explains why we look at other new symptoms in the body and not just of local problem or new illness – why body was susceptible to symptoms in the first place