Jacques Imberechts, MD, in memoriam

En nombre de todos los miembros de la Federación Española de Médicos Homeópatas (FEMH), a través de este sucinto y sencillo escrito, queremos rendir un pequeño homenaje a uno de los grandes pedestales -quizás el mayor- de la Homeopatía médica en España, y no sólo en España, sino en muchos otros países de casi todos los continentes.

Su llegada a España fue providencial, para avivar la chispa de la Homeopatía –mantenida casi en clandestinidad y en exclusiva por el Dr. Enric Peiró i Rando, de la Academia Mèdico Homeopàtica de Barcelona- en el corazón de unos inquietos estudiantes de Medicina, que buscaban más allá de las asignaturas impartidas en una de las dos facultades de Medicina de Barcelona que existían en aquella época.

De eso ya hace la friolera de más de 40 años. Así se fundó entonces el primer grupo español de Homoeopathia Europea (H.E.), el grupo Sepia, siguiendo la estela de algunos grupos que ya existían en Europa con nombres de remedios homeopáticos, y siendo liderado por el propio Jacques, que tenía su grupo en Bruselas, donde siempre residió.

Si algo lo caracterizaba de forma muy particular era su don de gentes y su facilidad por aprender idiomas diversos; gracias a lo cual colaboró activamente en cosechar el germen de la Homeopatía allá donde fuere, por muy yermo que fuera el terreno. Viajero incansable, era consciente de la utilidad imprescindible de conocer distintos pueblos, culturas diferentes, perspectivas diversas, para tener menos prejuicios y poder observar al paciente de manera más objetiva.

Su caballo de batalla fue, desde el principio, la investigación. Fundó Homoeopathia Europea, que más tarde se amplió a Homoeopathia Europea & Americana, con el objetivo único y primordial de investigar. Repitió hasta la saciedad que H.E. no era una escuela, sino grupos de investigación: grupos de médicos homeópatas que se reunían para homogeneizar su práctica homeopática, partiendo de unos criterios comunes de aplicación de la doctrina (o teoría) homeopática, con el fin de que los resultados prácticos fueran contrastables, y se pudieran sacar conclusiones válidas para el avance de la ciencia homeopática.

Fundó en 1990, durante el Congreso Internacional de la Liga Medicorum Homoeopathica Internationalis (LMHI) en Barcelona, en consenso con todos los vicepresidentes de la LMHI presentes, el Comité Europeo de Homeopatía (ECH – European Committee for Homoeopathy, por sus siglas en inglés), del que fue su presidente durante varios años, participando muy activamente, desde el principio, en fomentar sobre todo las comisiones de Research (Investigación) y de Provings (Experimentaciones puras), que para él eran la columna vertebral del gran edificio de la Homeopatía,  único camino para asegurar su progreso.

Le gustaba la metáfora de la vaca: investigar era para él la forma de nutrir a la “vaca” (a la Homeopatía), para que creciera y diera sus frutos, y no sólo ordeñarla, evitando así que enflaqueciera y muriera de inanición por sobreexplotación.

Por ello se mantuvo siempre independiente en sus criterios: era un librepensador, antiescolástico por naturaleza. No siguió escuela alguna, pero las aceptaba todas. Eso, a ojos de algunos podía parecer contradictorio o incoherente, cuando era precisamente todo lo contrario: extremadamente riguroso y coherente. Aceptaba todos los puntos de vista, siempre y cuando se le ofrecieran argumentos objetivos válidos. Insistía en la importancia crucial de los hechos, frente a la teoría, frente a las especulaciones. Resumiendo: era un hahnemanniano  estricto, pero no dogmático. Era de mente muy abierta.

Se interesó hasta el final de sus días en conocer diversos modos de aplicar la medicina homeopática. Le interesaban ante todo los resultados, pero no se contentaba con ello: quería saber también el proceso que había llevado a esos buenos resultados, para poderlos reproducir dadas circunstancias similares. Es decir, era un científico nato.

Fue gracias a su personalidad por lo que se codeó con toda la élite de la Homeopatía del siglo XX. Allí donde destacaba alguien, ahí estaba él para aprender algo nuevo. No se cansó de viajar y de aprender. Se consideró siempre un aprendiz de la Homeopatía, enmarcado en la tríada aprendiz-artesano-artista, en la búsqueda de otros aprendices, artesanos y artistas de quienes aprender. Nunca se autoproclamó artista, cuando los que lo conocimos sabíamos que lo era. Eso en él era la forma peculiar de manifestarse la humildad, humildad con dignidad, valentía y arrojo.

Una combinación explosiva cuando echaba mano de su hobby preferido (el gin tonic). Entonces podías descubrir quién había realmente detrás de su fachada aparentemente grandilocuente: era todo un caballero, de los que quedan pocos. Pero su fachada –su fuerte personalidad- generaba odios feroces o amores incondicionales, sin medias tintas. Y no tenía reparo alguno en exponer su criterio allí donde hiciera falta, sin reparar en la audiencia, fuera en petit comité –con su muy personal modo de liderar los grupos de trabajo, fuera en sus intervenciones públicas, vociferando desde el fondo de la sala. Ser un líder nato conlleva esas consecuencias.

Podríamos seguir nombrando otras características de su gran personalidad, pero no es el momento ni el lugar adecuados. Podríamos hablar de su sentido agudo del humor (“negro”), de su elegancia, de su impecable comportamiento, en especial con las mujeres, y así… no acabaríamos nunca.

Para terminar, queremos, desde la FEMH, desearle un caluroso viaje al más allá, sea donde sea. Y asegurarle que brindaremos en su honor por haber dejado un legado inapreciable, y una huella indeleble en nuestros corazones.

Nos quedamos con el compromiso de seguir alimentando a la vaca, para evitar que fenezca.

Allí donde estés Jacques, te mandamos un fuerte abrazo, agradeciéndote de corazón todo lo que has hecho por la Homeopatía, dentro y fuera de España.

Descansa en paz, Jacques, con la tranquilidad de que todos tus esfuerzos en pro de la Homeopatía no han caído en saco roto, que somos muchos los que te tomamos el relevo en la gran misión en este mundo de engordar a la vaca, o, al menos, de ordeñarla en la misma medida que la vayamos alimentando.

Physics of homeopathic medicines

Introduction by Prof. Louis Rey†
(Abstract of a seminar in Rome 20-21 of October 2009:
Ethique et Spiritualité de la Santé – Médecines traditionnelles
et complémentaires. Recherches et orientations
nouvelles)
A persistent issue in the assessment of homeopathy by
classical academics, especially in the field of so-called
“hard sciences”, is the fact that, in high and ultra-high
dilutions, there are no more traces of any original chemical.
Hence, they claim that these different solutions are,
indeed, all the same and no more than the mere solvent
itself. This radical assumption proved to be wrong, at least
in the light of several centuries of careful clinical observations,
which did show evidence, that high dilutions were
not only active in therapeutics but that they also had
distinct personalities, both properties which could not be
found in the solvent used for their preparation. Quite obviously,
this problem has been a definite challenge for all
researchers in physics, chemistry and material sciences.
  

Different physical methods to assess
high dilutions
 
A/ Nuclear Magnetic Resonance (RMN) by Izel Botha
This paper seeks to perform a meta-analysis of the findings
of these studies and to draw a conclusion on the
nature of homoeopathic dilutions as well as the validity
of performing this type of inquiry into the nature of homeopathically
prepared medicines.
From the studies presented, two conclusions can be
drawn, the first dealing with the evolution of the thinking
processes associated with the studies that needed to be
conducted. The initial studies, conducted by Ross (146)
and Power (147), investigated the nature of Q potencies.
These researchers acknowledged that the theories as
to the molecular organization in solutions existed, but
they refrained from conclusively interpreting the results
in terms of those theories. Their research lead to Cason
(148) investigating the influence of the frequency of the
NMR spectrometer on results obtained. Davies (149)
and Malan (150) investigated the role of dilution on the
physico-chemical structure of the homeopathic solutions,
showing that information storage does take place in the
solution, but that different dilution methods result in different
solutions, even when the theoretical dilution level
is equal. Malan’s (150) mention of dilution level and succussion
opened the door for investigation of the effect of
various potentization methods. Hofmeyr (151), Lyell (152)
and Botha (153) each investigated different variables that
may be introduced during the manufacturing process,
particularly looking at the number of succussions and
the effect of trituration. Erasmus (154) took this one step
further by investigating the mechanics of the succussion
process. These researchers interpreted their results
based on the theories of Resch and Gutmann (155) and
Anagnostatos (156).
This body of knowledge has inspired Allsopp (157) to
look into the effect of energy transfer into the solution
– whether it is imperative that the energy is imprinted
mechanically by hand production of the remedies, or if it
can equally be achieved through electromagnetic means.
In comparing the studies, it is evident that both trituration
and serial dilution change the physico-chemical properties
of the solvent to produce distinct medicines.

Conclusions: The meta-analysis supports the conclusion
that different potentization methods result in medicines
with different physico-chemical properties. One can also
conclude that NMR Spectroscopy is a valuable tool in
assessing the physico-chemical effect that potentization
methods have on the lactose and water/ethanol bases
utilized in the manufacture of homeopathic medicines.
It works well to study a single compound and it is not
adapted to the investigation of a complex mix of different
substances. NMR may be used for low potencies and
only with the best available instrument. Other references,
Weingärtner (158), Williams (159), Barnard (160), Young
(161), Sach (162), Bol (163), Aabel (164), Milgrom (165),
Anagnostatos (166), Bellavite (167), Smith (168), Antonchenko
(169), Shaw (170).

New publication in the same area:
Demangeat JL. NMR water proton relaxation in unheated
and heated ultrahigh aqueous dilutions of histamine: Evidence
for an air-dependent supramolecular organization
of water. Journal of Molecular Liquids 2009;144:32-39.

B/ A new Magnetic Resonance method by K. Lenger
The “homeopathic information” in high homeopathic
potencies on sugar globule could be considered as
photons with frequencies in the MHz-region by scientific
evidence. These photons in high homeopathic potencies
were detected by two magnetic resonance-methods (171,
172): firstly by the modified photomultiplier-method and
secondly by the Tesla-coil method. Both methods allowed
determination of physical properties of these photons:
holistic, coherent quantum behavior, damping of the
magnetic field by resonance effect, at least two resonance
frequencies in the MHz-region, frequency spectra after
being excited by one of their characteristic resonance
frequencies, measurability of the degree of potencies by
separation of the photons from their carrier substances
alcohol or sucrose by increasing the electromagnetic
fields of their resonance frequencies. A device for measuring
the degree of the potencies and their resonance
frequencies must be developed for quality control of
them in future. Further investigations about the stability
of the remedies in different media: water, alcohol, sugar,
are still necessary. A physical model must be developed
in which way matter substance could be converted into
energy, into photons by succussion in alcoholic dilutions
and in triturations.
For a patient, the pathological pathways (173, 174) can be
regulated by this treatment.

C/UV – Visible spectrometry
A promising approach was reached when the dilutions
were studied near the upper limit of their ultra-violet
absorption spectrum (200 to 400 nm). Rao, Roy, Bell
and Hoover (175) obtained some interesting recordings
for ultra-molecular solutions of 3 different products selected
in totally different kingdom (Natrium muriaticum,
Pulsatilla, Lachesis) and were able to discriminate them
at the 30C level. Similar results were equally obtained by
Pollack and Wexler working on Havit, Apis mellifica and
Histaminum. This method, however, proved to be highly
sensitive to rather unforeseen parameters, like the time
of the day. Reproducibility has not yet been possible.
In the same area Wolf U, Wolf M, Heusser P, Thyrneysen
A, Baumgartner S, presented at the 65th LMHI Congress
the following study: Homeopathic Preparations of Quartz,
Sulfur and Copper Sulfate assessed by U.V. Spectroscopy.

D/Raman spectroscopy
Different attempts have been done to see whether a
close investigation of the Raman shift could help in discriminating
the dilutions among themselves. Once more
the operating conditions proved to be determinant: the
position of the tube, recording done in a dark room and
the same instrument. Under those conditions Rao (175)
could demonstrate that the spectral peaks corresponding
to different potencies of the same strain or dilutions
of the same potency from different sources are different.
Even if those differences are small, they look reproducible.

E/Dynamic Electrophotonic Capture:
Gaz Discharge Visualization – EPC/GDV
The introduction of the so-called EPC/GDV technique in
the research on high dilutions is a somewhat accidental
and unforeseen event. It results from the pioneering work
of Konstantin Korotkov who developed a completely
new process to analyze “the energy fields” on multiple
targets thanks to the analysis of the electrophotonic glow
stimulated by a train of controlled pulses of a high-tension
electromagnetic field, a technique based upon the Kirlian
effect. Applied to ultra-molecular dilutions by Iris Bell
(176), very small drops of liquid (0,02cc) gave successive
glow images under electric discharge, which could be
further processed thanks to the elaborative software of K.
Korotkov. The triple analysis of their fractality (shape), size
and brightness did show different patterns which, under
well-selected conditions, could be species-specific, and Iris
Bell discovered that a high dilution of Natrium muriaticum
had definitely a different overall finger-print than its original
solvent (ethanol in that particular case). It is most likely
that this innovative technique might open perspectives in
dilution research.

F/Calorimetric and Electric Measurements
In a completely different field, Elia, et al., (177) were able to
show that when a high dilution was mixed with an acid or
a base, the heat release was much more important than
it should be for a standard reference. He claimed that this
was due to the fact that, in the case of high dilutions, an
excess of energy was basically needed to “rupture” intrinsic
structures (so-called dissipative structures) resulting to
their preparation.
Similar discrepancies were also observed by Elia (178)
when he measured the electric conductivity of high dilutions,
an observation which was shared by Zacharias (179)
and his group in Brazil when they compared succused high
dilutions of Vincristine sulfate an inert solvent.
Another interesting approach in the field of electric measurements
is provided by the use of Impedance spectroscopy.
In that particular technique the behavior of a dilution is
assessed as a dielectric medium in low frequencies and
some preliminary research (Monod – Cemagref) did show
that the loss angle (Tg delta) and the dielectric constant are
substantially different from one dilution to its original solvent.
Another team (180) published a paper on the “Effect of
dielectric dispersion on potentised homeopathic medicines”
and concluded that using this method it is possible
to identify each homeopathic remedy in a solution even
above Avogadro’s number. The same observation was
confirmed by another team in India (181).

G/Thermoluminescence
(abstract Prof. Louis Rey) (182, 183)
Low-temperature thermoluminescence is a very sensitive
investigation tool and, for instance, could discriminate very
easily different highly diluted alumina colloids that could
not be distinguished by classical chemical analysis. On
that base this method was used to study inter alia, potassium
dichromate, sodium chloride and lithium chloride
preparations made in D20. For potassium dichromate, the
experiments carried out with Ilse Muchitsch and Michael
Frass showed very clearly that their “finger prints” were
totally different from the one of the heavy water alone even
in dilutions above Avogadro’s number.

Conclusions:
This rapid survey of investigations performed on ultramolecular
dilutions by different physical methods confirms
that it is can be proven that, even beyond Avogadro’s
number, they are different from their pure solvent and
also specific to the precise chemicals dissolved at the
initial state of their preparation. Each dilution has its own
personality and can be identified by its own “finger-print.”
Complex fluids carry much more information than could be
expected and this provides a strong, positive background
for homeopathy.
To explain the clinical facts even in very high dilutions and
potentizations (remember that only 25 % of the daily
delivery of homeopathic medicines in a pharmacy – 75 %
being at molecular level), another scientific paradigm is
needed. For many years another scientific paradigm has
existed, the paradigm of body signifiers (184). With the
existence of such a scientific framework, the nature of
the homeopathic medicine begins to be understood and
even identified.





Editor: Dr Michel Van Wassenhoven, LMHI and ECH Secretary for Research.
Part of chapter VII of the document SCIENTIFIC FRAMEWORK OF HOMEOPATHY. Evidence Based Homeopathy 2012. Revised edition after 66th LMHI Congress, December 2011 (New Delhi, India).
Source: European Committee for Homeopathy web

SCIENTIFIC STUDIES IN HOMEOPATHY

Today I would like to present to you the current evidence base of homeopathy. Is homeopathy based on evidence? You may ask: “Is this important for us to know? We know that homeopathy can be effective!” But outsiders ask us to demonstrate the effectiveness and show the evidence. The concept of evidence-based medicine (EBM) is key in modern medicine. Doctors are expected to be aware of the latest evidence when taking clinical decisions. So, is homeopathy evidence based medicine? To answer that question I would like to start with explaining what evidence based medicine actually is, because I know that there are some misunderstandings about it.

According its founding fathers Sackett and Feinstein evidence based medicine is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”. They emphasise that it is not "cookbook" medicine, but requires a bottom up approach that integrates the best external evidence with individual clinical expertise and patients' choice.

In fact EBM has three pillars: external evidence, clinical expertise and patients’ choice whereas all three are equally important. Our clinical expertise including our expertise in homeopathy is one of the leading factors in clinical decision making. And so is the choice of the patient. It carries substantial weight if the patient prefers homeopathy to conventional medicine.

However, when EBM comes into the picture, the external evidence often receives most attention. So this is also the main subject of my presentation.

Traditionally scientists use a hierarchy of evidence. Case studies are low in the hierarchy, cohort studies or observational studies are placed higher in the hierarchy, randomised controlled trials (RCTs) higher, and systematic reviews are considered to be the top.

Looking at the clinical research in homeopathy, we find hundreds of thousands of case histories, recording successful cases. That is impressive, and still, according to modern EBM standards, this is considered to be very low evidence.

Observational studies are positioned higher in the hierarchy. Several of them have been conducted in thousands of patients in Germany, Switzerland and the United Kingdom. They show consistent positive results in 40-70% of the patients as regards disease symptoms, overall wellbeing and the reduction of the use of conventional medication. And, importantly, we have to take into account that these studies do not concern patients with acute self-limiting diseases. The majority of patients had chronic conditions, many had multiple pathologies and many had not responded to previous conventional treatment.

Several cost-effectiveness studies conducted in Germany, France and Switzerland show that GPs practising homeopathy have better results at comparable costs in comparison with conventionally practising GPs. Although homeopathic medicines are less expensive, consultations often last longer and can therefore be more expensive than conventional consultations.

Some other studies show that from a long-term and large-scale perspective homeopathy is cost-effective because general health (not only the presented symptoms) has improved, future consultations are less frequent, absenteeism is shorter, fewer visits to medical specialists are needed, hospitalisation is shorter, all in comparison with patients who receive conventional treatment only.

Higher in the hierarchy pyramid we see experimental research, i.e. studies in which one group receives the treatment under study and the control group receives a placebo or other treatment that already has proven its effectiveness. These studies are usually randomised and therefore named ‘randomised controlled trials’ (RCTs). Although the concept of evidence is multi-faceted, in recent years it has become progressively reduced to accepting RCTs as the gold standard. RCTs, however, have also drawbacks.

While RCTs can be useful in assessing the effects of a single intervention on a single symptom or outcome, they are far less suitable when studying the overall effects of a holistic therapy in a complex organism with multiple problems.

Notwithstanding this a considerable number of RCTs in homeopathy have been published with far more positive than negative outcomes. 142 RCTs have been published in peer-reviewed scientific journals. From them 120 (85%) RCTs were placebo controlled, 22 RCTs (15%) were controlled by other than placebo. Summary finding in 44% of the RCTs was positive for homeopathy, negative in 8% and statistically non-conclusive in 48%.

Going to the top of the pyramid, 4 out of 5 systematic reviews of all RCTs in homeopathy conclude that homeopathy has an effect that is greater than placebo. The 5th, the well-known 2005 Lancet meta-analysis, concluded that “There was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects”. It was heavily criticised for being biased and not meeting basic (QUOROM) scientific standards. I will go into some more detail about this meta-analysis.

The 2005 Lancet review/meta-analysis was originally a part of the Swiss CAM Evaluation project PEK and was performed by a team led by a very competent opponent of homeopathy, professor Matthias Egger. They started with 110 clinical trials of homeopathy, which were to be matched with 110 clinical trials of conventional medicine. They then reduced these 110 homeopathy trials to 21‘higher-quality trials’ and then to 8 ‘larger higher-quality trials’. The final conclusion was based on these 8 studies.

Interestingly, the authors found that “trials of homeopathy tended to be of higher methodological quality than conventional-medicine trials, although most trials of either type of medicine were of low or uncertain quality”. In fact there they found 21 high-quality trials in homeopathy and only 9 high-quality trials in conventional medicine.

But the problem was that the definition of ‘higher quality’ was based on opaque, unpublished criteria. And the trials on which the conclusion was based, were not mentioned in the publication.

The Evaluation Committee of the Swiss PEK Study criticised the authors for that in April 2005; in the Lancet publication (August 2005) these data were still missing. After publication the authors still refused to disclose these data. After more pressure the data were disclosed in December 2005, but no Odds Ratios, Confidence Intervals, or Standard Errors were given.

After disclosure the data were re-analysed by Luedtke and Rutten. One of the things they found out was that the Lancet study discarded four out of six best studies in Linde's meta-analysis (1997). These studies were: (Reilly 1986, Hofmeyr 1990, De Lange-de Klerk 1994, Reilly 1994). So there was selection bias.

They defined ‘larger trials’ as ‘trials with Standard Error in the lowest quartile’. Using this definition they concluded that there were 8 higher-quality trials, leading to a negative outcome for homeopathy.


INDICATION HOMEOPATHY CONV. MEDICINE
Diarrhoea Jacobs n=116 Kaplan n=256
Treatment of influenza Papp n=334 Nicholson n=319, De Flora n=248
Prevention of influenza Rottey n=501
Plantar warts Labrecque n=162
Weight loss Schmidt n=208
Muscle soreness Vickers n=400
Headache Walach n=98
Sinusitis Weiser n=104
Stroke (venous) Horn n=454
Upper genital tract infection Crowley n=273
Seasonal allergic conjunctivitis Moller n=146

The included homeopathy studies were a positive study of the effect of individualised homeopathy in childhood diarrhoea (Jacobs), a positive study of Oscillococcinum in the treatment of flu (Papp), a positive study of a complex homeopathic medicine containing potencies of various influenza viruses and bacteria all in 200K in the prevention of flu (Rottey), a negative study of a combination of Thuya occidentalis 30C, Antimonium crudum 5C, Acidum nitricum 7C on plantar warts (Labrecque), a negative study of the effect of Thyreoidinum 30C on weight loss in fasting individuals (Schmidt), a negative study of the effect of Arnica montana 30D on muscle soreness in marathon runners (Vickers), and a negative study of individualised homeopathy patients suffering from headache (Walach).

The definition of ‘larger trials’ normally means ‘larger than median (= middle value)’. When Luedtke/Rutten re-analysed the trials using the usual ‘larger than median’ criterion, they found 14 larger higher-quality trials (n > 65), leading to a significantly positive result for homeopathy.

So the meta-analysis results depend on how the threshold for ‘large’ studies was defined. The result was positive for homeopathy if the normal ‘larger than median’ criterion is used, negative if the unusual ‘Standard Error in the lowest quartile’ criterion is used, as Shang et al. did. Intention or coincidence?

Another interesting finding was the effect of including a particular diagnosis in the set of higher-quality trials. 4 of the 21 higher-quality trials in homeopathy dealt with the prevention or treatment of muscle soreness in marathon runners. 3 out of the 4 were negative for homeopathy. 4 matched conventional trials for the same indication were too small and low quality and were not included.

Of course, it is highly doubtful if muscle soreness in - very healthy - marathon runners is a medical condition that can be ‘cured’. When Luedtke/Rutten excluded the studies on muscle soreness and restricted their analyses to the remaining 17 trials, they found an overall statistically significant positive effect for homeopathy.

So, the overall results – and the conclusions drawn from them – change depending on which subset of homeopathic trials is analysed. The choice of other meaningful subsets could lead to the opposite conclusion. Intention or coincidence?

Surprisingly, the authors themselves highlight – but dismiss – the fact that 8 trials of homeopathy in upper respiratory tract infections have strongly positive findings overall.

They state that 8 studies is too few to question their conclusion about the whole set of publications. Their conclusion about the whole set, however, was also based on 8 studies. Is eight enough or not? The authors simply refuse to believe the positive results of clinical trials of homeopathy.

So, four out of five major systematic reviews of RCTs in homeopathy have concluded that homeopathy has an effect greater than placebo. The fact that these meta-analyses showed positive evidence for homeopathy is remarkable because meta-analyses are far from appropriate when trials are extremely heterogeneous – as in homeopathy – not only in results but also in the interventions and health conditions under study (over 80 different medical conditions and different types of homeopathy) and when a therapeutic system works in some but not all indications. The Cochrane Handbook for Systematic Reviews recommends that: "Meta-analysis should only be considered when a group of trials is sufficiently homogeneous in terms of participants, interventions and outcomes to provide a meaningful summary".

That means that the question “Are the effects of homeopathy placebo?” does not make sense. Similarly it does not make sense to ask whether conventional medicine is placebo. It is more important to look at specific diseases or areas of diseases.

There are systematic reviews focused on RCTs of homeopathy in 15 specific areas. And these condition-specific systematic reviews have indicated effectiveness of homeopathy in childhood diarrhoea, post-operative ileus, hay fever, vertigo, allergies, upper respiratory tract infections and rheumatic conditions. In addition, there is a balance of positive RCT evidence for fibromyalgia and sinusitis.

So there is clinical evidence for the effectiveness of homeopathy. And still critics do not accept that and maintain that homeopathy cannot possibly work. They assert that homeopathy is a sort of super-placebo. In their opinion, the long doctor-patient contacts can explain why people experience improvements in their health status. A recent German study , however, demonstrated that the placebo effect in placebo controlled double blind RCTs in individualised homeopathy is not larger than in conventional treatment.

Why do these critics not accept the evidence? A famous epidemiologist stated: “A reflection on the scientific behaviour of adherents of conventional medicine toward one form of alternative medicine — homeopathy — teaches us that physicians do reject seemingly solid evidence because it is not compatible with theory ”.

Dr Iain Chalmers, director of the UK Cochrane Centre and ardent proponent of systematic reviews, said a few years ago: “Critics of complementary medicine often seem to operate a double standard, being far more assiduous in their attempts to outlaw unevaluated complementary medical practices than unevaluated orthodox practices.

These double standards might be acceptable if orthodox medicine was based solely on practices which had been shown to do more good than harm, and if the mechanisms through which their beneficial elements had their effects were understood, but neither of these conditions applies. “

Why exactly do sceptics refuse to accept the effectiveness of homeopathy? They assert that there is no scientific explanation for its effectiveness, that the similia principle lacks all logic, that ultramolecular homeopathic preparations (concentrations < Avogadro) do not contain any molecules, that molecules are necessary for effectiveness, and that therefore all positive clinical evidence for homeopathy is unreliable.

In one sentence: “I cannot understand how it could be possible, so it is not possible.”

What these sceptics do not know is that there is accumulating evidence in basic research for the similia principle and measurable effects of even serially agitated high dilutions.

As to the similia principle, toxicological and pharmacological phenomena such as hormesis, drug rebound effects and paradoxical pharmacology are very widely observed. They have in common the occurrence of secondary, reverse or paradoxical effects of drugs and toxins in living organisms as a function of dose or time and are closely analogous to the homeopathic concept of secondary drug action.

Dutch cell biologists Wiegant and Van Wijk examined the validity of similia principle on a cellular level. They demonstrated that low stress doses (heat, arsenic or cadmium) can stimulate self-recovery if these cells were exposed to high doses of these stressors beforehand. In other words, the similia principle seems to be a biological phenomenon.

In homeopathy various potencies, i.e. serially agitated dilutions, are used, from low to high. Many homeopathic medicines are not in ultramolecular dilutions. Relatively low potencies can have a usual molecular effect; from biology we know that low concentrations down to 10-22 M can be biologically active. But the question is: can ultramolecular preparations have a measurable effect?

Well, there is replicated high-quality basic research in biological experiments on intact animals, plants and isolated cells and cell cultures, as well as in physical experiments, that clearly demonstrate that even ultramolecular preparations have measurable effects.

A recent meta-analysis reviewed 67 in-vitro experiments in 75 publications of research on homeopathic dilutions. A majority of them reported high-potency effects. Positive findings were obtained in nearly three-quarters of all replicated studies. Even experiments with a high methodological standard could demonstrate an effect of high potencies.

To give you a few examples, in biological experiments there has been replicated results in the following areas:
• inhibitory effect of serially agitated high dilutions of histamine on the activation of basophil leucocytes,
• effect of serially agitated high dilutions of acetosal on bleeding time, platelet aggregation and coagulation,
• effect of serially agitated high dilutions of thyroxine on the rate of amphibian metamorphosis,
• protective effect of serially agitated high dilutions of mercury on the mortality of poisoned mice,
• effects of serially agitated high dilutions of arsenic on the toxic effect of material doses of arsenic trioxide on wheat shoot growth.

In physical research most attention has focussed on structural or coherence effects induced in water by the preparation process. Several experiments have demonstrated structural changes of water in ultramolecular homeopathic preparations.

I will just list a few of the methods used: low temperature thermoluminescence, flux calorimetry, conductometry, Raman and Ultra Violet spectroscopy, and NMR (Nuclear Magnetic Resonance).

An international association of around 100 pharmacologists, biologists, physicians, chemists and physicists working in the field of ultramolecular preparations is the GIRI = Groupe International de Recherche sur l'Infinitésimal = International Research Group on High Dilution and Very Low Dose Effects. These scientists have published their papers in conventional scientific journals as well as in the International Journal of High Dilution Research. The Homeopathy Basic Research Experiments (‘HomBRex’) Database contains over 1400 experiments in 1000 publications.

So, as a conclusion we can state that he theory/belief that homeopathy, by its use of ultramolecular preparations, is implausible or impossible, is not correct.

Now we come back to the question: how convincing is the evidence?

Thomas Kuhn in his well-known book “The Structure of Scientific Revolutions” maintains that a paradigm, or shared view, persists for a while but then becomes obsolete because it becomes disturbed by too many ‘anomalies’, which do not fit into, and cannot be explained by, the existing paradigm. It is then replaced by a new paradigm, which is able to explain the anomalies. He calls this phenomenon paradigm shift. And I believe we are close to such a paradigm shift.

I can see that in the near future possible explanatory models will come from emerging sciences, such as systems biology and biosemiotics. System biology considers a biological system such as a human individual as a hierarchically organised network of interactions. Homeopathy has the same perspective on the human being.

In biosemiotics, the sign rather than the molecule is the basic unit for studying life. In homeopathy it is the information of the remedy rather than the pharmacological action that helps the organism to recover from disease.

Dear colleagues, I hope you are now well aware of the actual evidence base for homeopathy. I have also showed you why the sceptics are wrong. They simply do not know the facts. You know the facts. Please tell the whole world about them. Homeopathy is evidence based medicine.

Thank you for your attention.


Notes
1. [Shang A et al. (2005) Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet, 366:726-32]
2. Nuhn T, Lüdtke R, Geraedts M (2010). Placebo effect sizes in homeopathic compared to conventional drugs – a systematic review of randomised controlled trials
3. Vandenbroucke JP, de Craen AJP (2001) Alternative Medicine: A “Mirror Image” for Scientific Reasoning in Conventional Medicine. Annals of Internal Medicine, 135:507-513
4. Witt CM et al (2007). The in vitro evidence for an effect of high homeopathic potencies – A systematic review of the literature. Complementary Therapies in Medicine, 15:128–138


Author: Dr. Ton Nicolai, president of European Committee of Homeopathy (ECH).
Presentation at the IV Congreso Nacional de Homeopatía in Barcelona, 11 June 2010.

Response to UK Parliamentary Committee report against Homeopathy on February 2010

Response by the European Committee for Homeopathy ECH and

the International Homeopathic Medical League LMHI

to Evidence Check 2: Homeopathy by the House of Commons Science

and Technology Committee, published 22 February 2010

In a report published 22 February 2010, the Science and Technology Committee of the United Kingdom House of Commons concludes that homeopathy is not efficacious (that is, it does not work beyond the placebo effect), that explanations for why homeopathy would work are scientifically implausible and that further clinical trials of homeopathy could not be justified. Furthermore, it concludes that the NHS should cease funding homeopathy and that the Medicines and Healthcare products Regulatory Agency (MHRA) should no longer license homeopathic medicines.

Remarkably, just 4 of the 14 members of the Science and Technology Committee voted on this report: 3 for, one against. One of its three signatories has stridently campaigned against homeopathy and continued to do so even in the period between the hearings and the publication of the report.

The European Committee for Homeopathy ECH and the International Homeopathic Medical League LMHI find the conclusions and recommendations of the Science and Technology Committee completely unfounded. The report is highly tendentious and fundamentally flawed, consistently misrepresenting the scientific evidence to the detriment of homeopathy and making unfounded and pejorative allegations against those who advocate or practise homeopathy. The report omits or misrepresents any evidence which challenges the view that homeopathy is a placebo response.

The report ignores large areas of evidence which were mentioned in written submissions and oral evidence such as systematic reviews and meta-analyses of randomised controlled trials of homeopathy for specific conditions and groups of conditions, and systematic reviews of biological models of homeopathic responses. The evidence suggests that homeopathy is effective in a number of specific conditions, and there are a number of reproducible biological models of homeopathy.

The European Committee for Homeopathy ECH and the International Homeopathic Medical League LMHI fully endorse the robust and comprehensive response by the British Homeopathic Association. Their rebuttals are accessible at their website http://www.britishhomeopathic.org/media_centre/press_releases/march_2010_prs.html

Authors:

International Homeopathic Medical League LMHI, secretariat, Am Hofgarten 5, 53113 Bonn, Germany, tel. +49-228-2425330, email: generalsecretary@lmhint.net, http://liga.iwmh.net/

European Committee for Homeopathy ECH, secretariat, Chaussée de Bruxelles 132, box 1, 1190 Brussels, Belgium, tel.+32-2-3453597, email: info@homeopathyeurope.org, http://www.homeopathyeurope.org/

Sources: http://liga.iwmh.net/index.php?menuid=49&reporeid=172

http://www.homeopathyeurope.org/news-and-press/news/ech-rebuffs-uk-parliamentary-committee-report

More info: http://www.britishhomeopathic.org/media_centre/press_releases/march_2010_prs.html

HOMEOPATHY – AN ALTERNATIVE TO ANTIBIOTICS?

Current use and misuse of antibiotics.

After their discovery in the 1940s antibiotics considerably reduced illness and death from infectious diseases that are caused by bacteria. However, over the decades virtually all important bacterial infections throughout the world have been becoming resistant especially due to the increasing and indiscriminate use of powerful, broad-spectrum antibiotics to treat common infections, such as ear infections, and the misuse of antibiotics in situations where they are not appropriate, such as treating viral infections like the common cold.

Tuberculosis, gonorrhoea, malaria, pneumonia, meningitis, and sexually transmitted diseases, that are caused by bacteria were once easily treatable with antibiotics but have now become hard to treat with antibiotic drugs and increasingly deadly due to antibiotic resistance. Antibiotic resistance, which has been called one of the world's most pressing public health problems has led to antibiotic-resistant ‘super bugs’ causing an estimated 37,000 deaths in the EU each year.

Approximately 50% of Europe's total consumption of antibiotics is by animals. Treatment of food-producing animals – for important therapeutic, disease prevention or production reasons – with antibiotics that are important in human therapy may present a public health risk by the transfer of resistant zoonotic pathogens or resistant genes from animals to humans via consumption of contaminated food. Resistant bacteria can diminish the effectiveness of antibiotics and demand the use of more expensive or less safe alternatives.

Until recently, research and development (R&D) efforts have provided new drugs in time to treat bacteria that became resistant to older antibiotics. That is no longer the case. The potential crisis at hand is the result of a marked decrease in industry R&D, and the increasing prevalence of resistant bacteria. Infectious disease physicians are alarmed by the prospect that effective antibiotics may not be available to treat seriously ill patients in the near future.

The pipeline of new antibiotics is drying up. Major pharmaceutical companies are losing interest in the antibiotics market because these drugs may not be as profitable as drugs that treat chronic (long-term) conditions and lifestyle issues.

Combating germs vs reducing susceptibility

Modern Western medicine started to develop rapidly in the late 19th century with the rise of especially the discovery of bacteria as an important cause of disease. Initially there were two opposing views in the germ theory of disease. In Germany it was Robert Koch’s ideas (micro-organisms were the ‘most dangerous enemies of mankind’) versus those of Max von Pettenkofer (poor hygiene as the main culprit). A similar well-known historical argument occurred in France between Louis Pasteur (the microbe as the prime factor) and Claude Bernard (the germ is little, the terrain is all). Eventually Pasteur and Koch’s perspectives, focused on combating disease by killing germs prevailed. Doctors were and still are heroes who battle with the forces of disease conceived of invaders from without, alien bacteria, viruses and other microbes that are bent on our destruction.

In reality, infection is always the result of two factors: exposure to a pathogen and the person's susceptibility. From this perspective, bacteria and viruses are not the cause of disease but at best are a ‘co-factor’ to disease. That also means that taking a conventional antibiotic may get rid of the pathogen, but they do not do anything to strengthen a person's immune system. In addition, there is some evidence that antibiotics actually increase the prevalence of allergy and asthma (Noverr, 2004; Johnson, 2005). Johnson demonstrated that children who receive antibiotics within their first six months of life were three times more likely to develop allergies (to pets, ragweed, grass and dust mites), and in case of broad-spectrum antibiotics even 8.9 times more likely to suffer from asthma.

Research demonstrating that homeopathy can be effective

Antibiotics may provide symptomatic treatment, but often persons given these medical treatments tend to experience recurrent infections. By contrast, homeopathic doctors have the experience that many people with infections can be effectively helped by homeopathy and that it is an important way to strengthen people’s own immune system.

Scientific research has mainly been conducted in respiratory tract and middle ear infections.

Several observational studies consistently show real-world effectiveness of homeopathy. An impressive international study (Riley, et al, 2001) that involved 30 clinicians in 6 clinics in 4 countries enrolled 500 consecutive patients with upper respiratory tract complaints, lower respiratory tract complaints, or ear complaints. The study found 83% of patients receiving homeopathic care experienced improvement, while only 68% of those receiving a conventional medication experienced a similar degree of improvement. The study also found that those people given a homeopathic experienced more rapid relief: 67.3% experienced improvement with homeopathy within 3 days, while only 56.6% of patients given conventional medicines experienced improvement (16.4% of homeopathic patients improved within 24 hours; 5.7% in other group).

Apart from observational studies some more rigorous research projects of the highest scientific

standards have been conducted over the last few decades. In several randomized placebo-controlled double-blind clinical trials, involving between 100 and 200 individuals each, treatment with commercial complex homeopathic medicines have proven its effectiveness in medical conditions that in conventional practice are treated with antibiotics, such as sinusitis, both acute and chronic, and bronchitis (Friese & Zabalotnyi [2007], Zabolotnyi et al. [2007], Weiser & Clasen [1994], Diefenbach [1997]).

A placebo controlled RCT of homeopathy published in a major pediatric journal (Jacobs et al, 2001) involving 75 children ages 18 months to 6 years with middle ear effusion and ear pain and/or fever for no more than 36, found that there were 19.9% more treatment failures in children given a placebo than those given an individualised homeopathic treatment. The study also found a significant decrease in symptoms at 24 and 64 hours after treatment in favour of those given a homeopathic medicine.

In a study by Frei & Thurneysen (2001) 230 children with acute middle ear infection were treated with individualised homeopathy, 72% were pain-free within 12 hours, a resolution rate that is 2.4 times faster than reported in other series. As acute middle ear infection has a high rate of spontaneous resolution, a trial to prove any treatment-effect has to demonstrate very fast resolution of symptoms. The purpose of this study was to find out how many children with acute middle ear infection are relieved of pain within 12 hours after the beginning of homeopathic treatment, making additional measures unnecessary. 230 children with acute middle ear infection received a first individualized homeopathic medicine in the paediatric office. There were no complications observed in the study group, and compared to conventional treatment the approach was 14% cheaper.

Since sinusitis and bronchitis account for millions of missed workdays each year and acute ear infection is the most common infection for which antibacterial agents are prescribed for children in the Western world, it is clear that homeopathy can play a crucial role in this condition. The economic benefit was also demonstrated by Trichard et al. (2005) who compared two treatment approaches (‘homeopathic strategy’ vs. ‘antibiotic strategy’) used in routine medical practice by allopathic and homeopathic GPs in the management of recurrent acute rhinopharyngitis in 499 18-month to 4-year-old children. The GPs using homeopathy had significantly better results in terms of clinical effectiveness, complications, parents' quality of life and time lost from work, for lower cost to social security. GPs who integrated homeopathy in their practice achieved better results for similar cost.

As a conclusion, homeopathic treatment of infections, especially of the respiratory tract, have proven to be effective.

References

1. World Health Organization (2000) Antibiotic resistance: synthesis of recommendations by expert policy groups. Alliance for the Prudent Use of Antibiotics WHO/CDS/CSR/DRS/2001/10

2. Noverr MC, Noggle RM, Toews GB, Huffnagle GB (2004). Role of antibiotics and fungal microbiota in driving pulmonary allergic responses. Infection and Immunity, 72:4996-5003.

3. Johnson CC, Ownby DR, Alford SH, Havstad SL, Williams LK, Zoratti EM, Peterson EL, Joseph CL (2005) Antibiotic exposure in early infancy and risk for childhood atopy. The Journal of allergy and clinical immunology, 115:1218-1224.

4. Riley D, Fisher M, Sigh B, Haidvogl M, Heger M (2001). Homeopathy and conventional medicine: An outcomes study comparing effectiveness in a primary care setting. Journal of Alternative and Complementary Medicine, 7:149–159.

5. Friese K-H, Zabalotnyi DI (2007). Homöopathie bei akuter Rhinosinusitis. Eine doppelblinde, placebokontrollierte Studie belegt die Wirksamkeit und Verträglichkeit eines homöopathischen Kombinationsarzneimittels [Homeopathy in acute rhinosinusitis. A double-blind, placebo controlled study shows the efficiency and tolerability of a homeopathic combination remedy]. HNO, 55:271–277.

6. Zabolotnyi DI, Kneis KC, Richardson A, Rettenberger R, Heger M, Kaszkin-Bettag M, Heger PW (2007). Efficacy of a complex homeopathic medication (Sinfrontal) in patients with acute maxillary sinusitis: a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial. Explore (NY), 3:98–109.

7. Weiser M, Clasen B (1994). Randomisierte plazebokontrolierte Doppelblindstudie zur Untersuchung der klinische Wirksamkeit der homöopathischen Euphorbium compositum-Nasentropfen S bei chronischer Sinusitis [Randomized, placebo-controlled, double-blind study of the clinical efficacy of the homeopathic Euphorbium compositum-S nasal spray in cases of chronic sinusitis]. Forschende Komplementärmedizin, 1:251–259.

8. Diefenbach M, Schilken J, Steiner G, Becker HJ (1997). Homöopathische Therapie bei Erkrankungen der Atemwege. Auswertung einer klinischen Studie bei 258 Patienten [Homeopathic therapy in respiratory tract diseases. Evaluation of a clinical study in 258 patients]. Zeitschrift für Allgemeinmedizin, 73:308–314.

9. Jacobs J, Springer DA, Crothers D (2001). Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatric Infectious Disease Journal, 20:177–183.

10. Frei H, Thurneysen A (2001). Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution? Homeopathy, 90:180–182.

11. Trichard M, Chaufferin G Nicoloyannis N (2005). Pharmacoeconomic comparison between homeopathic and antibiotic treatment strategies in recurrent acute rhinopharyngitis in children. Homeopathy, 94:3–9.

Author: ECH position paper

Source: http://www.homeopathyeurope.org/policies/position-papers

Homeopathy works in eczema and psoriasis

The Spring 2006 Newsletter described a prospective, multicentre cohort study that was conducted by a research team at Berlin’s Charité University (Germany), including 103 primary care practices with additional specialization in homeopathy in Germany and Switzerland. In this study the use and effects of homeopathy under conditions of usual care were investigated (1). The study involved 3981 patients who consulted a physician for classical homeopathic therapy in 103 primary care practices in Germany and Switzerland. Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. The study indicates that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases. In recent publications the results of homeopathic treatment in two subgroups of the above-mentioned study were described, one subgroup of children with atopic eczema (2) and another subgroup of 82 adults with psoriasis (3). The study on atopic eczema included 225 children with a disease duration of 3.6 ± 3.8 years who were followed up for 24 months. Over the course of the study patients received 7.3 ± 6.4 homeopathic prescriptions, most frequently Calcium carbonicum (8.2%), Tuberculinum (7.2%), and Medorrhinum (6.8%). In total, 137 different homeopathic remedies were used. The strongest improvement in diagnoses and medical complaints was seen in the first 3 months, and it continued during the full observation period. After 24 months, the atopic eczema as well as the other baseline diagnoses were considerably relieved, while reductions in use of conventional medicines were observed. The other study was aimed at evaluating details and effects of homeopathic treatment in patients with psoriasis. Fortyfive physicians treated 82 adults, who had had psoriasis for an average of 14.7 years and of whom 96.3% had been treated before. Patients received 6.0 ± 4.9 homeopathic prescriptions. Diagnoses and complaints severity improved markedly with large effect sizes. In addition, the quality of life improved, while conventional treatment and health service use were considerably reduced. It has to be kept in mind that these are not experimental studies (with control group, randomization, and blinding), but observational studies which are, by their character, less rigorous than experimental studies. The aim of these studies was to provide systematic and detailed information about status and effects of homeopathic medical care in usual care. And the results clearly demonstrate that under individualized (‘classical’) homeopathic treatment, patients with atopic eczema and psoriasis improved in symptoms and quality of life. References: 1. Witt CM, Lüdtke R, Baur R, Willich SN. (2005) Homeopathic Medical Practice: Long-term results of a Cohort Study with 3,981 Patients. BMC Public Health, 5:115. 2. Witt CM, Lüdtke R, Willich SN (2009). Homeopathic treatment of children with atopic eczema: a prospective observational study with two years followup. Acta Dermato-venereologica, 89:182-183. 3. Witt CM, Lüdtke R, Willich SN (2009) Homeopathic treatment of patients with psoriasis – a prospective observational study with 2 years follow-up. Journal of the European Academy of Dermatology and Venereology, 23:538-543. Source: E.C.H. Newsletter Spring 2009

Stunning Cuban Experiences on Leptospirosis

An unprecedented research study has been done using homeopathic prophylaxis in Cuba on 2.4 million people to prevent the usual Leptospirosis outbreak after tropical flooding. Only 10 cases were reported after use of the homeopathic nosode instead of the usual several thousand cases of Leptospirosis.

On 10-12 December 2008 at the ‘Nosodes 2008’ conference in Havana (Cuba) the director-general of the Finlay Institute, an advocate of homeopathy herself, Dr. Concepción Campa Huergo, gave a presentation about controlling the local epidemic disease of Leptospirosis by using a Leptospira nosode.

Leptospirosis is an infectious disease caused by the spirochaete Leptospira transmitted to humans from rats. In humans it may cause a wide range of symptoms including high fever, severe headache, chills, muscle aches, vomiting, jaundice, red eyes, abdominal pain, diarrhea, or a rash. If the disease is not treated, the patient could develop kidney damage, meningitis, liver failure, and respiratory distress. Cuba goes through a yearly cycle of Leptospirosis epidemic, especially after the hurricanes flood the countryside and water pollution reaches its height. Many people are left homeless, flooded out and under the stress of disaster situation.

A part of the Ministry of Public Health, the Finlay Institute is the Cuban research institute. It has WHO qualified facilities, produces allopathic vaccinations and acts as supporting institution for research, production and development of high quality homeopathic products. Since Cuba is outcast by the USA government, the Cubans have come to depend on themselves for the production of medicines, health care programs, etc. And since they have no pharmaceutical multi-nationals to stop them, they were able to conduct the leptospirosis project on a massive scale unknown in the history of homeopathy.

On October November 2007, three provinces of the eastern region of Cuba were affected by heavy rainfalls causing floods of big areas and damage to sanitary and health systems. The risk of leptospirosis infection was raised to extremely dangerous levels with about 2 million people exposed to potentially contaminated water.

Considering this situation, the Finlay Institute prepared a leptospira nosode 200 CH using 4 circulating strains and following international quality standards. A multidisciplinary team travelled to the affected regions to conduct the massive administration of the nosode. Coordinated action with public health system infrastructures allowed the administration of a preventive treatment consisting in two doses (7- 9 days apart) of the nosode to about 2,4 million people (4,8 million of doses). The coverage of the intervention rose up to 95% percent of total population of the three provinces at risk. Another dose, at a higher potency (10M), was given after the hurricane Ike hit the island.

The epidemiology surveillance after the intervention showed a dramatic decrease of morbidity two weeks after and a reduction to zero mortality of hospitalized patients. The number of confirmed leptospirosis cases remained at low levels and below the expected levels according with the trends and rain regimens. The usual expectancy of infection even with allopathic vaccination would have been around a few thousand, with some deaths included.

The costs of the leptospirosis project were US$ 200,000, whereas the costs of ‘normal’ vaccination, only for the most at-risk populations, ie children, pregnant women, and the elderly, are about US$3,000.000.

What is remarkable is their application to such a large population, and its dramatic success, with full scientific verification. This experience could be extended to other diseases and other countries. The Finlay Institute is offering their facilities and specialists to spread this alternative to all regions needing emergent alternatives for epidemic control and prevention.

Source: E.C.H. Newsletter Spring 2009

More information can be found in: www.finlay.sld.cu/nosodes/en/ProgramaNOSODES2008Eng.pdf

Switzerland enshrines complementary medicine in the constitution

Press release of 18 May 2009 
On 17 May 2009 the Swiss people voted in favour of a constitutional article for complementary medicine in a national vote. 67 percent of voters supported the new constitutional article. Switzerland is the first country in Europe to set out in the constitution, authority for the state and constituent states (cantons) to take complementary medicine into consideration in the public health service.
During the last few years complementary medicine has been politically marginalized in Switzerland. Therefore, the complementary medicine sector, including doctors, therapists, manufacturers and specialized traders, together launched and brought about a national popular initiative. This enables Swiss voters to obtain a popular vote for a constitutional amendment if they collect 100,000 valid signatures within 18 months. Parliament availed itself of its right to oppose the proposers’ constitutional article and suggest a slightly diluted form. Since parliament’s counterproposal adopted all the core demands on a legal level, the original popular initiative was withdrawn. Therefore, the people only had to vote on a constitutional article, which, experience has shown, increases the chances of them voting in favour. Particularly because parliament and the government support the parliamentary proposal. On 17 May 2009, Swiss voters clearly approved the constitutional article proposed by parliament. The majority of voters per canton also voted in favour, which is likewise a prerequisite for any constitutional amendment.

In accordance with the referendum, the Swiss Federal constitution will be expanded by the following article:

Federal constitution Art. 118a BV (new): The Federal government and cantons shall ensure that, within the scope of their jurisdiction, complementary medicine is taken into consideration.

Definite need for action 
On this constitutional basis, parliament and the authorities have to implement the following requirements: 1. Admission of doctors of complementary medicine in the fields of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and Traditional Chinese Medicine (TCM) into obligatory health insurance.

2. Creation of national diplomas for non-medical therapists.

3. Integration of complementary medicine into teaching and research.

4. Safeguarding of proven remedies.

For questions please contact: Walter Stüdeli, Head of politics & media «The future with complementary medicine» Mobile +41 79 330 23 46, Tel. +41 31 560 00 24 / Fax +41 31 560 00 25 / info@koest.ch

Author: Yes committee «The future with complementary medicine» c/o Köhler , Stuedel i & Partner GmbH, Amthausgasse 18, 3011 Berne phone +41 31 560 00 24 , fax +41 31 560 00 25, info@koest .ch

Source: European Committee for Homeopathy (ECH)

EUROPEAN COMMITTEE FOR HOMEOPATHY

POSITION PAPER The practice of homeopathy Modern homeopathic doctors make a conventional diagnosis like all other doctors. History, examination and investigation are all important in patient management. Conventional diagnosis is essential in order to identify the patient for whom homeopathic treatment is appropriate, and to determine the location and the pathological changes involved. Besides this, it renders inestimable help in planning the homeopathic treatment. It gives an idea of the location (tissues and organs affected), the pathological changes (type, degree and extent), the pathogenic agent, the physiological disturbances induced, the psychological accompaniments, and the pathogenesis. It is obvious that no rational treatment can be planned in the absence of knowledge of the factors mentioned above. Similarly, it will be impossible to give the prognosis with any semblance of accuracy unless the doctor possesses this knowledge. It also enables the doctors to 'choose their case' and to eliminate cases that require primarily surgical or other measures. It also makes assessment of the results possible. Both the pathology presented and the long-term treatments require the homeopathic practitioner to make continual assessments of the indication for treatment. Homeopathic treatment often needs to be prescribed within a broader care plan, which includes an awareness of the need for conventional medical diagnosis, prognosis and treatments. Since, in a number of cases, homeopathy can be applied as a successful alternative to conventional medicine and in other cases can be used to supplement conventional medicine, the regulation and co-ordination of training criteria imposed on the practitioners providing homeopathy should constitute an essential guarantee for citizens. Therefore, it is essential, in the interests of both patients and practitioners, that qualifications be harmonised at the same high level as in conventional medicine. Only a full medical training can ensure the necessary minimum clinical competence required.

By virtue of their medical qualification, all medical doctors are entitled to practise medicine, which in principle may include homeopathy. Owing to a different definition of health, however, the therapeutic objective as well as the practical approach to illness differs widely in homeopathy as compared to conventional medicine. Homeopathy requires specific knowledge and skills. Therefore, not all doctors can be considered as competent homeopathic doctors. Competence depends on the quality of this specific knowledge and skill. Homeopathic doctors should be able to combine the knowledge and skills in homeopathic practice with the knowledge and skills in the practice of conventional medicine. A homeopathic physician will, therefore, be a fully qualified medical practitioner additionally trained in homeopathy, and qualified to integrate homeopathy into patient care within the context of general medical practice, conventional specialist practice or full-time homeopathic practice. S/he will bring to the consultation all the ethical and professional values, competence and responsibility that are expected of a medical practitioner; forming an all round assessment of the patient’s needs, and collaborating with other health care practitioners whose care the patient is already receiving or may need.

Source: http://www.homeopathyeurope.org/pdf/pospaper_pract_hom.pdf

COMITÉ EUROPEO PARA LA HOMEOPATÍA

DOCUMENTO DE POSICIONAMIENTO La práctica de la homeopatía Los médicos homeópatas modernos realizan un diagnóstico convencional como todos los demás médicos. La historia clínica, la exploración y la investigación son todas importantes en el cuidado del paciente. El diagnóstico convencional es esencial para identificar a los pacientes a los que sea apropiado un tratamiento homeopático, y para determinar la localización y los cambios patológicos implicados. Además de esto, presta una ayuda inestimable para planificar el tratamiento homeopático. Da una idea de la localización (tejidos y órganos afectados), los cambios patológicos (tipo, grado y extensión), el agente patógeno, las alteraciones fisiológicas producidas, el acompañamiento psicológico y la patogenia. Es obvio que no se puede planificar un tratamiento racional en ausencia del conocimiento de los factores aquí mencionados. De forma similar, será imposible hacer un pronóstico con visos de exactitud a menos que el médico posea dicho conocimiento. También capacita al médico a ‘elegir su caso’ y a eliminar casos que requieren en primer lugar medidas quirúrgicas u otras. También da una valoración de los resultados posibles. Tanto la patología presente como los tratamientos a largo plazo requieren que el médico homeópata haga valoraciones continuas de la indicación del tratamiento. El tratamiento homeopático necesita a menudo ser prescrito dentro de un plan general de atención sanitaria, que puede incluir la necesidad de un diagnóstico, pronóstico y tratamientos médicos convencionales. Desde el momento en que, en un cierto número de casos, la homeopatía puede ser aplicada como una alternativa exitosa a la medicina convencional, y en otros casos puede ser usada como complemento de la medicina convencional, la regulación y la coordinación de los criterios de formación impuestos a los médicos que practican la homeopatía debería constituir una garantía esencial para los ciudadanos. Por lo tanto, es esencial, en interés tanto de los pacientes como de los médicos, que las competencias sean armonizadas al mismo alto nivel que en medicina convencional. Solamente una formación médica completa puede asegurar la competencia clínica mínima necesaria requerida. En virtud de su competencia médica, todos los médicos tienen derecho a practicar medicina, que en principio puede incluir a la homeopatía. Sin embargo, debido a una concepción diferente de la salud, tanto el objetivo terapéutico como el acercamiento práctico a la enfermedad difiere ampliamente entre la homeopatía y la medicina convencional. La homeopatía requiere unos conocimientos y una capacitación específicos. Por lo tanto, no todos los médicos pueden considerarse como médicos homeópatas competentes. La competencia depende de la calidad de dichos conocimientos y capacitación específicos. Los médicos homeópatas deberían ser capaces de combinar los conocimientos y la capacitación de la práctica homeopática con los conocimientos y la capacitación de la práctica de la medicina convencional. Un médico homeópata deberá ser, pues, un médico totalmente preparado formado además en homeopatía, y preparado para integrar la homeopatía en el cuidado del paciente dentro del contexto de la práctica general de la medicina, de la práctica de una especialidad convencional o de la práctica homeopática a tiempo completo. El médico homeópata aportará a la consulta todos los valores éticos y profesionales, competencia y responsabilidad que se esperan de un médico, formándose una valoración global de las necesidades del paciente, y colaborando con otros profesionales sanitarios cuya atención ya recibe el paciente o puede necesitar.

Traducción del original en inglés.

Fuente: http://www.homeopathyeurope.org/pdf/pospaper_pract_hom.pdf

CLI.FI.COL. Clinical Files Collection

HE & HI Homoeopathia Europea & Internationalis in collaboration with all the homeopathic physicians from Mexico and South America ECH European Committee for Homoeopathy UHB Unio Homeopathica Belgica LMHI Liga Medicorum Homeopathica Internationalis Bruxelles 1 November 2008 Dear colleagues and friends, after many years of work, thanks to the international co-operation of the above-mentioned organisations, finally there is a program (software) that allows to exchange our clinical experiences in Homeopathy on the international level. It is the Program Cli-Fi-Col for “Clinical Files Collections”. It is important to collect our clinical cases in a central site in order to improve our daily practice in Homeopathy. The programme allows to search for special cases treated by our colleagues and to send the most relevant cases by ourselves. You can also use this instrument as a tool for studying Homeopathy in the practice, to collect systematically the clinical cases that allow the clinical verification of the pathogenetic symptoms and consequently the improvement of our basic tools (the Repertory and Materia Medica), and for specific projects. You are all invited to participate in sharing our knowledge. You will be impressed favourably by the simplicity of its use, both on the individual level and as a regional or national association. By means of a very moderate contribution in money (100 euros a year), you will become one of the hinges in the improvement of the future homeopathic practice. Today this revolution is possible thanks to the computer science and Internet. Therefore, please read carefully the information contained in the file here enclosed. In all friendship Michel Van Wasshenoven Jacques Imberecths Why a homeopathic clinical files database By integrating comprehensive and right medical documentation from a scientific point of view, the homeopathic clinical files database CLI.FI.COL. (Clinical Files Collection) § provides the international homeopathic community the benefit of sharing the experience of homeopathic Medical Doctors from all over the world; § allows the homeopathic Medical Doctor of having at its disposal, for personal study or even to be released by the subscriber in support of his/her teaching activities, case histories recorded with the explanation of the methodological process that has conducted to the remedy prescription; § permits homeopathic schools to work together with due respect of their methodological diversities; § offers to the homeopathic Medical Doctors the prospect of discovering the differences and similarities between their different methodological approaches of treating related clinical cases; § provides relevant evidence-based clinical information for developing the homeopathic research field; § verifies and updates the homeopathic Medical Doctor’s operative tools: Materia Medica, Repertory and Philosophy; § supports the homeopathic Medical Doctors in organizing the clinical research to shed light upon aspects of the paradigm not satisfactorily discussed yet; § allows the single homeopathic Medical Doctors the use of updated and detailed clinical data, recorded in an easy-to-use format; § organizes the clinical data in a format that makes homeopathy a more reliable field of knowledge facing the conventional medicine point of view and the governments that intend to make homeopathy an official practice. Benefits The main benefits can be summarized in these points: a. clinical verification of the efficacy of homeopathic remedies. b. construction of a “Materia medica clinica viva” constantly updated and enriched with contemporary medical and “linguistic” terms c. enrichment and verification of repertorial symptoms through the proposals of new repertorial levels d. connection between repetorial symptoms and the “language of the patient” e. comparison between the “clinical” symptomatology and the “experimental” symptomatology (proving). That will allow to overcome the distinction between classical and clinical homeopathy. An arbitrary division that only benefits our opposers. Tools & functions § Centralized Database A powerful centralized database management solution designed to store millions of clinical cases. These cases shall be sent nameless directly to the database through the software client, the WinCHIP clinical file. § The software client: the WinCHIP clinical file (from 3.1.02 version) The Medical Doctor, once has recorded the case, can send it to the database, instantly, just by clicking the mouse. After any follow-up, each case shall be updated. § Internet Accessing to the database through the WinCHIP software client Internet-based service, you can perform the following functions: sending and downloading clinical cases. § Cryptographic writing The case histories will be transmitted nameless recorded, using cryptographic writing, directly from the MD surgery to the central database via any available Internet connection. Common cultural heritage Notwithstanding that the hardware & software structures have been economically supported by single associations, CLI.FI.COL recognizes the homeopathic medical doctors community as owner of every clinical case history nameless recorded in the database. An ethical and scientific affairs commission has been appointed to keep watch on the database management with the mission of assuring that this cultural heritage shall remain a common legacy of the homeopathic community. All physicians and institutions are kindly invited to cooperate with this project opened to the contribution from all the different methodological approaches prevailing in homeopathy. How does CLI.FI.COL work? v How to search case histories All the searches that can be carried out in the personal WinCHIP files can be also carried out with the “search in CLI.FI.COL. function”. The advantage of CLI.FI.COL. database is that you can easily reach the experience gained by quite different homeopathic MD that use various methodologies. By setting off the basic information at the search box and clicking the radio-button “search in CLI.FI.COL.”, you can search case histories of your interest. There are two SEARCH METHODS in CLI.FI.COL., one based on a set of criteria and the other one that allows the homeopathic Medical Doctor to calculate some rates. Ø Searches based on a set of criteria This method of searching permits the homeopathic Medical Doctor to search case histories information solved according to different methods of prescription. For instance, you can search all phosphorus cases prescription regarding the depressive pathology from the point of view of § the classical clinical methodology on Repertory basis (MSMV) § the Argentinean Homeopathic School § Masi’s methodological approach § Ortega’s miasmatic methodology § Josep Reves’s prescription method § Sankaran’s approach § Jan Scholten’s method It also provides access to the Materia Medica of the remedy prescription using one of the above specified methodologies or using criteria like age, potency, etc. While carrying out a search based on criteria, a pointing-out and gathering text elements function allows words searching. The searches can be carried out either by selecting words on the anamnesis and can be made finer by associating other elements to the search, e. g. carrying a search out related to Pulsatilla patients with a determinate pathology. You can even make finer the search by, for instance, carrying out a search on Pulsatilla patients files affected of a determinate pathology and in which the word “mother” has been recorded in the patient’s anamnesis text. Once you have identified the case history you are interested in, you can download the entire case history files in a PDF format. Ø Searches to calculate rates For statistics purpose you can compute the rate of the most significant clinical data of the homeopathic practice. Indeed, you can calculate the frequency of § age connected to some pathologies or to some remedy prescription; § diagnosis during the first examination § diagnosis related to pathologies § pathology and city of residence § kind of check-up (acute, relapses, chronic) § symptoms on the Repertory basis § most prescribed remedies related to a specific pathologic or clinical situation. v The aspects that can be connected within each one of the two searching methods (search based on a set of criteria and on the use of text words and search aimed to calculate rates) can be various. This gives the chance to the homeopathic MD of carrying out researches to collect and analyse facts and information and to try to gain new understanding on the basis of the personal needs; e.g. relating facts regarding vaccination, type of vaccine, dosage, reaction to the administration of a particular remedy, patient age, etc. v How to download case histories files Once you have identified the case history you are interested in, by using the search function based on a set of criteria, you can download the entire case history files in a PDF format just by clicking the icon. To carry a search out in the CLI.FI.COL database you have to set off the basic information at the search box. Then you have to click the radio-button “search in CLI.FI.COL.” Data visualized in-video-format can be exported in different types of formats and prints. The downloaded case histories can be utilized by the CLI.FI.COL. subscriber as support in his/her teaching activities and for personal study purpose but by no means published. For other ways of diffusion, a formal authorization is request. The CLI.FI.COL. subscriber can ask for authorization to the CLI.FI.COL. scientific committee by e-mailing at clificol@hehi.org v How to send a case history file Prior to transmitting a case history to the database, the MD has to get signed the CLI.FI.COL privacy policy consent statement on the patient part. For transmitting children’s personal data, it is necessary to get signed the CLI.FI.COL privacy policy consent statement on the parents part. When the study case concerns pets, it is necessary to get signed the CLI.FI.COL privacy policy consent statement on the owner part. The CLI.FI.COL privacy policy consent statement form is provided in electronic format in the act of buying the WinCHIP software. To transmit a case history to the CLI.FI.COL database, you have to click the icon in the WinCHIP Toolbar and the following window will open: On this window are present the following pieces of information: - Information about previous uploading At this window field, you can verify whether a previous file, regarding the patient you are interested in, has been previously transmitted to the CLI.FI.COL database or not. If the patient file has been already delivered to the CLI.FI.COL database, the related last date in which it has been updated and sent will appear; - Case study definition: compulsory information to transmit a case study to the CLI.FI.COL database At this window part appear the compulsory fields to be filled-in, previous to sending a case study file to the CLI.FI.COL database. At least one of these fields shall be filled-in compulsorily: - Case study file sent for statistics purpose: at this field you shall identify the kind of statistics which the case belongs to (e.g. “general statistics”). At the present this function is not available. - A case study regarding homeopathic philosophy: at this field you shall identify the prevalent study case feature, e.g. chronic disease case related to relapse. - A case study regarding Materia Medica: at this field you shall classify the prevalent study case feature, e.g. arsenicum album case history. - A case study regarding symptoms, syndromes or pathologies: at this field you shall indicate the pathology, e.g. Psoriasis case study. - Research monitoring case: at this field you shall indicate the clinical research you are motoring, e.g. Asthma monitoring, YX procedure. At the present this function is not available. - Compulsory fields to be filled in: - Classification the case study as human or veterinarian: at this field you shall identify whether the file regards a human or a veterinarian case. - Texts language: at this field you shall announce the language in which texts files are written, e.g. Italian. - Pick list language: at this field you shall indicates the Pick List language, e.g. Italian - Optional Clinical Observations At this window field you can enter optional remarks you want to add in order to enrich the case by clicking the icon - Clinical Observations. In case you were working on a case history previously recorded, by clicking the iconyou open the Clinical Observations window so that you can add directly other data to make richer the follow-up case study you have already recorded. Promoters - Supporters – Cultural heritage ownership The international homeopathic community has widely considered as extremely necessary the building of a clinical files database, towards which direct and integrate the experience of homeopathic Medical Doctors from all over the world. Today, using the information technologies these case histories recorded in a database would be easily reached for consultation, with the possibility of downloading entire case histories for personal study or even to be released by the subscriber in support of his/her teaching activities. The CLI.FI.COL project, started to be planned as an aspiration of the Homeopathia Europea & Internationalis Groups in the 1970’s, is now operating and permitting homeopathic schools to work together with due respect of their methodological diversities. The CLI.FI.COL (Clinical Files Collection) has been developed with the Homeopathia Europea & Internationalis and the h.m.s. (health medicine services) involvement and with the national and international groups’ contribution. It has been created by homeopathic Medical Doctors that want to share, in electronic real time, data and case studies from reliable sources all over the world. Notwithstanding that the hardware & software structures have been economically supported by the below listed associations, it is necessary to underlining that CLI.FI.COL. recognizes the homeopathic community as owners of every clinical case history recorded. For this reason CLI.FI.COL. has created a Scientific Committee to manage this legacy and ensure this right to any homeopathic reality existent. All physicians and institutions are invited to cooperate with this project opened to the contribution from all the different methodological approaches prevailing in homeopathy. The files collection anticipate the collaboration of the Argentinean, Austrian, Belgian, Brazilian, French, German, Indian, Italian, Mexican and the Spanish Homeopathic Schools. An ethical and scientific affairs commission is appointed to keep watch on the database management with the mission of assuring that this cultural heritage shall remain a common legacy of the homeopathic community. How to participate to the CLI.FI.COL. project 1. Work with a computer with Windows or Mac operative system with an Internet connection A) Windows: Windows 2000, XP or Vista B) Mac: you have to install a Parallel desktop or a VMWare - Parallel desktop: http://www.parallels.com/products/desktop/?ClickID=al5lstvzylyns9nn05sz5pploat0s5wo5rll - VMWare: http://www.vmware.com/products/fusion/ 2. Install WinCHIP as software Client The access to CLI.FI.COL. database is available through the WinCHIP program, a desktop software, from release 3.1.XX Professional. Through WinCHIP program, the user can either upload (send) data or download (receive) data. 3. Make a subscription to CLI.FI.COL. project To set up a subscription to CLI.FI.COL. database services, send an e-mail to clificol@hehi.org The utilisation of CLI.FI.COL on-line services involves a subscription fee of 100 € to mantaine annual database costs. The user has two possibilities: A) If you already work with WinCHIP you will receive a free update to the last 3.1.03 version as soon as you make the subscription In this case, the subscription costs 100 € and, if you make it before the 31 of March 2009, will last until the end of 2010 B) If you have never used WinCHIP you can buy it by sending an a mail to clificol@hehi.org In this way, you can buy WinCHIP and make a subscription to CLI.FI.COL. . With this “formula” you will have 50% discount on WinCHIP and on the subscription (the final ammount for WinCHIP and the subcription will be € 300) This option, if made before the 31 of March 2009, will make your subscripiton last until the end of 2010. Send an e-mail before the 31/03/2009 to: clificol@hehi.org (copy and paste in your mail these information and text; information with “*” are compulsory) writing: Dear CLI.FI.COL. Coordination Office, - I would like to make a subscription to the CLI.FI.COL project (as option A) starting from the signed data, until the end of 2010 (total cost € 100) - I would like to BUY WinCHIP program and to make a subscription to the CLI.FI.COL project (as option B) starting from the signed data, until the end of 2010, with the promotional price of 300 € (delete the option that you don’t choose) I declare that the information above mentioned are true. In the same way, I declare that my interesting cases will be uploaded to CLI.FI.COL. with the necessary approaches of accuracy and that I (the author) am the only responsible of the case. Likewise, I declare to use the CLI.FI.COL information for my personal studies or for teaching. I will never use these information for lucrative works and I will never publish them or part of them in any form without the authorization of the CLI.FI.COL. Ethical Scientist Committee. I will transfer the amount request (taxes at my expense) to this Bank: - DEXIA-Jette-Belgica Avenue Carton de Wiart, 6 B-1090 Bruxelles Account Number : 068-2029761-63 IBAN : BE40 0682 0297 6163 BIC : GKC CB EBB writing as motivation: “CLIFICOL subscription” I add my personal information: * Name/First Name: * Address: (Street, Town, Zip Code) State, Country: * Phone or Fax: * Mail: Homeopathic School or Association: I will wait some working days to receive by mail the access to CLI.FI.COL. Signature: Date: