Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation.

http://www.ncbi.nlm.nih.gov/pubmed/23083226 Langmuir. 2012 Nov 13;28(45):15864-75. doi: 10.1021/la303477s. Epub 2012 Nov 1. Why extreme dilutions reach non-zero asymptotes: a nanoparticulate hypothesis based on froth flotation. Chikramane PS1, Kalita D, Suresh AK, Kane SG, Bellare JR. Author information Abstract

Extreme dilutions, especially homeopathic remedies of 30c, 200c, and higher potencies, are prepared by a process of serial dilution of 1:100 per step. As a result, dilution factors of 10(60), 10(400), or even greater are achieved. Therefore, both the presence of any active ingredient and the therapeutic efficacy of these medicines have been contentious because the existence of even traces of the starting raw materials in them is inconceivable. However, physicochemical studies of these solutions have unequivocally established the presence of the starting raw materials in nanoparticulate form even in these extreme (super-Avogadro, >10(23)) dilutions. In this article, we propose and validate a hypothesis to explain how nanoparticles are retained even at such enormous dilution levels. We show that once the bulk concentration is below a threshold level of a few nanograms/milliliter (ng/mL), at the end of each dilution step, all of the nanoparticles levitate to the surface and are accommodated as a monolayer at the top. This dominant population at the air-liquid interface is preserved and carried to the subsequent step, thereby forming an asymptotic concentration. Thus, all dilutions are only apparent and not real in terms of the concentrations of the starting raw materials.

Homeopathic treatment of multimorbid patients: a prospective outcome study with polarity analysis

Homeopathic treatment of multimorbid patients: a prospective outcome study with polarity analysisHeiner Freiemail University of Berne, Kreuzplatz 6, CH-3177 Laupen, Switzerland Received: March 13, 2014; Received in revised form: August 27, 2014; Accepted: September 2, 2014; Published Online: October 10, 2014 DOI: http://dx.doi.org/10.1016/j.homp.2014.09.001 Publication stage: In Press Corrected Proof

Abstract Full Text Images References

Highlights

•We examined the treatment outcome with polarity analysis in 50 multimorbid patients. •43 patients were successfully treated and reached an average improvement of 91%. •The cost of homeopathic treatment is estimated to be 41% of a conventional therapy. •Thus, homeopathy can play a substantial role in treating multimorbid patients.

Background

The treatment of multimorbid patients who have a combination of three or more concurrent complaints is one of the core competencies of homeopathy. In this article we introduce the application of polarity analysis (PA) in multimorbidity. PA came to prominence through the Swiss homeopathic ADHD double-blind study, which successfully demonstrated a significant difference between highly dilute homeopathic remedies and placebo. PA enables homeopaths to calculate a relative healing probability, based on Boenninghausen's grading of polar symptoms. After its evaluation in the treatment of a variety of acute and chronic disease, which showed improved results compared to a conventional homeopathic approach, it was a challenge to test PA with multimorbid patients. Since such patients almost invariably have a multiple symptoms, the question was whether we can nevertheless successfully use Polarity Analysis or whether the method is rendered ineffective by the multitude of symptoms. Methods

We treated 50 multimorbid patients with PA and prospectively followed them over one year. Results

43 patients (86%) completed the observation period, achieving an average improvement of 91% in their initial symptoms. Six patients dropped out, and one did not achieve an improvement of 80%, and was therefore also counted as a treatment failure. The cost of homeopathic treatment was 41% of projected equivalent conventional treatment. Conclusions

Polarity Analysis is an effective method for treating multimorbidity. The multitude of symptoms does not prevent the method from achieving good results. Homeopathy may be capable of taking over a considerable proportion of the treatment of multimorbid patients, at lower costs than conventional medicine. http://www.homeopathyjournal.net/article/S1475-4916%2814%2900084-8/abstract

A model for homeopathic remedy effects: low dose nanoparticles, allostatic cross-adaptation, and time-dependent sensitization in a complex adaptive system.

BellKoithan2012BMCCAMNanoparticleModelHomeopathyFINAL1472-6882-12-191.pdf http://www.ncbi.nlm.nih.gov/pubmed/?term=2012+BMCCAM+Nanoparticle+Model+Homeopathy+FINAL+1472-6882-12-191.pdf A model for homeopathic remedy effects: low dose nanoparticles, allostatic cross-adaptation, and time-dependent sensitization in a complex adaptive system. Bell IR1, Koithan M. Author information Abstract BACKGROUND:

This paper proposes a novel model for homeopathic remedy action on living systems. Research indicates that homeopathic remedies (a) contain measurable source and silica nanoparticles heterogeneously dispersed in colloidal solution; (b) act by modulating biological function of the allostatic stress response network (c) evoke biphasic actions on living systems via organism-dependent adaptive and endogenously amplified effects; (d) improve systemic resilience. DISCUSSION:

The proposed active components of homeopathic remedies are nanoparticles of source substance in water-based colloidal solution, not bulk-form drugs. Nanoparticles have unique biological and physico-chemical properties, including increased catalytic reactivity, protein and DNA adsorption, bioavailability, dose-sparing, electromagnetic, and quantum effects different from bulk-form materials. Trituration and/or liquid succussions during classical remedy preparation create "top-down" nanostructures. Plants can biosynthesize remedy-templated silica nanostructures. Nanoparticles stimulate hormesis, a beneficial low-dose adaptive response. Homeopathic remedies prescribed in low doses spaced intermittently over time act as biological signals that stimulate the organism's allostatic biological stress response network, evoking nonlinear modulatory, self-organizing change. Potential mechanisms include time-dependent sensitization (TDS), a type of adaptive plasticity/metaplasticity involving progressive amplification of host responses, which reverse direction and oscillate at physiological limits. To mobilize hormesis and TDS, the remedy must be appraised as a salient, but low level, novel threat, stressor, or homeostatic disruption for the whole organism. Silica nanoparticles adsorb remedy source and amplify effects. Properly-timed remedy dosing elicits disease-primed compensatory reversal in direction of maladaptive dynamics of the allostatic network, thus promoting resilience and recovery from disease. SUMMARY:

Homeopathic remedies are proposed as source nanoparticles that mobilize hormesis and time-dependent sensitization via non-pharmacological effects on specific biological adaptive and amplification mechanisms. The nanoparticle nature of remedies would distinguish them from conventional bulk drugs in structure, morphology, and functional properties. Outcomes would depend upon the ability of the organism to respond to the remedy as a novel stressor or heterotypic biological threat, initiating reversals of cumulative, cross-adapted biological maladaptations underlying disease in the allostatic stress response network. Systemic resilience would improve. This model provides a foundation for theory-driven research on the role of nanomaterials in living systems, mechanisms of homeopathic remedy actions and translational uses in nanomedicine.

Nonlinear Response Amplification Mechanisms for Low Doses of Natural Product Nanomedicines: Dynamical Interactions with the Recipient Complex Adaptive System

Belletal2013NonlinearAmplificationMechanismsforHomeopathicNanomedicines.pdfwww.omicsonline.org

Nonlinear Response Amplification Mechanisms for Low Doses of Natural Product Nanomedicines: Dynamical Interactions with the Recipient Complex Adaptive System Iris R Bell1,2, Barbara Sarter3, Mary Koithan2, Leanna J Standish4, Prasanta Banerji5 and Pratip Banerji5

1Department of Family and Community Medicine, The University of Arizona College of Medicine, USA 2College of Nursing, The University of Arizona, Tucson, AZ, USA 3Hahn School of Nursing and Health Sciences, University of San Diego, San Diego, California, USA 4Bastyr University, Kenmore, WA, USA 5PBH Research Foundation, Kolkata, India Abstract The purpose of the present paper is (a) to outline the self-organized, complex adaptive network nature of the organism as recipient of nanomedicines; (b) to propose several nonlinear endogenous amplification processes by which pulsed low doses of traditional, homeopathically-manufactured natural product nanomedicines may stimulate a return toward healthier function; and (c) to discuss their potential relevance to novel, but safer than conventional dosing strategies for contemporary nanomedicines. Homeopathy is an over 200-year-old system of complementary and alternative medicine (CAM) that uses low doses of natural plant-, mineral-, and animal-sourced nanomedicines. Homeopathic manufacturing is “green”, with mechanical grinding in lactose and agitation in ethanol-water as primary reagents. Agitation within glass containers at room temperature may also contribute nanosilica and nanosilicon as drug delivery vehicles and biological amplifiers. The medicine selection is matched to the recipient organism’s systemic patterns of dysfunction and pulsed in the timing of the discrete doses. Endogenous amplification processes within the recipient organism may involve hormesis, time-dependent sensitization, and/or stochastic resonance. Effects are adaptive and systemically diffuse, i.e., causally indirect, rather than pharmacological and local, i.e., direct. All of these nonlinear response processes require interaction of the nanoparticle (NP) dose with the organism as a complex adaptive system. The pulsed NP dose serves as a low intensity salient danger signal for the organism to make network-wide adaptive changes that can lead to healing. The historically safe therapeutic approach of homeopathic nanomedicine dosing avoids risks of high, continuous doses and cumulative toxicity that contemporary nanomedicine researchers are now trying to solve while using NPs as if they were conventional bulk drugs. Integrating the insights, technical procedures, and clinical dosing approaches from modern and homeopathic nanomedicine could lead to major advances in the field for more effective and safer translational applications. Keywords: Nanomedicine; Homeopathy; Nanoparticles; Hormesis; Stochastic resonance; Nonlinear dynamical systems; Complex adaptive systems.

Extreme homeopathic dilutions retain starting materials- A nanoparticulate perspective

Extreme homeopathic dilutions retain starting materials- A nanoparticulate perspective Extreme homeopathic dilutions retain starting materials: A nanoparticulate perspective Prashant Satish Chikramane1, Akkihebbal K Suresh1,2, Jayesh Ramesh Bellare1,2,* and Shantaram Govind Kane1,* 1Department of Chemical Engineering, Indian Institute of Technology (IIT), Bombay, Adi Shankaracharya Marg, Powai, Mumbai 400 076, Maharashtra, India 2Department of Biosciences and Bioengineering, Indian Institute of Technology (IIT), Bombay, Adi Shankaracharya Marg, Powai, Mumbai 400 076, Maharashtra, India Homeopathy is controversial because medicines in high potencies such as 30c and 200c involve huge dilution factors (1060 and 10400 respectively) which are many orders of magnitude greater than Avogadro’s number, so that theoretically there should be no measurable remnants of the starting materials. No hypothesis which predicts the retention of properties of starting materials has been proposed nor has any physical entity been shown to exist in these high potency medicines. Using market samples of metal- derived medicines from reputable manufacturers, we have demonstrated for the first time by Transmission Electron Microscopy (TEM), electron diffraction and chemical analysis by Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES), the presence of physical entities in these extreme dilutions, in the form of nanoparticles of the starting metals and their aggregates. Homeopathy (2010) 99, 231e242. Keywords: Homeopathy; Nanoparticles; Nanocrystalline materials; Transmission Electron Microscopy Introduction Homeopathy, a mode of therapy, was established in the late 18th century by German physician, Samuel Hahne- mann. Hahnemann, during his experiments, prepared medi- cines from a wide variety of natural products. He discerned that the infinite dilutions of these substances carried out in steps and accompanied by vigorous shaking ‘succussion’ (together known as potentization) at each dilution step, elicited some kind of a potent activity to these solutions.1,2 In spite of the various controversies and frequent challenges by the scientific community regarding its efficacy, this mode of treatment has stood the test of time, and is still being used in many countries for treatment of various chronic conditions, with medicines being prepared from a variety of herbal, animal, metal and other mineral sources. *Correspondence: Jayesh Ramesh Bellare and Shantaram Go- vind Kane, Department of Chemical Engineering, Indian Institute of Technology (IIT), Bombay, Adi Shankaracharya Marg, Powai, Mumbai 400 076, Maharashtra, India. E-mail: jb@iitb.ac.in, sgkane@gmail.com Received 6 November 2009; revised 22 April 2010; accepted 22 May 2010 However, a major lacuna has been the lack of evidence of physical existence of the starting material. The main dif- ficulty in arriving at a rational explanation stems from the fact that homeopathic medicines are used in extreme dilu- tions, including dilution factors exceeding Avogadro’s number by several orders of magnitude, in which one would not expect any measurable remnant of the starting material to be present. In clinical practice, homeopathic potencies of 30c and 200c having dilution factors of 1060 and 10400 respectively, far beyond Avogadro’s number of 6.023 1023 molecules in one mole, are routinely used. Many hypotheses have been postulated to justify and elu- cidate their mechanisms of action. While some hypotheses such as the theory of water memory,3e5 formation of clathrates,6 and epitaxy7 are conjectural in nature, others such as those based on the quantum physical aspects of the solutions8,9 have not been sufficiently tested, either due to complexity in validating the hypothesis or due to non-reproducible results. The ‘silica hypothesis’10 is the only model that proposes the presence of physical entities such as siloxanes or silicates resulting from leaching from the glass containers. Following a dearth of credible and test- able hypotheses to identify any physical entity responsible for medicinal activity, most modern scientists continue to believe that homeopathy at best provides a placebo effect. Homeopathy (2010) 99, 231e242 ! 2010 The Faculty of Homeopathy doi:10.1016/j.homp.2010.05.006, available online at http://www.sciencedirect.com ORIGINAL PAPER  232 Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al Despite the extreme dilutions in 30c and 200c potencies, our approach has been to test for the presence of the starting materials in the form of nanoparticles.. Medicines selected were metal-based, and were so chosen that the metals would not arise either as impurities or as contaminants. The six metals and their respective homeopathic medicines were gold (Aurum metallicum or Aurum met), copper (Cuprum metallicum or Cuprum met), tin (Stannum metallicum or Stannum met), zinc (Zincum metallicum or Zincum met), silver (Argentum metallicum or Argentum met) and platinum (Platinum metallicum or Platinum met). Three potencies: 6c, 30c, and 200c were selected. The dilution factor for 6c is 1012 which is less than Avogadro’s number, whereas the dilution factors for 30c and 200c are well above. Market samples of these medicines in 90%v/v ethanol were obtained from two reputable manufacturers: SBL, India, and Dr. Willmar Schwabe India (WSI) Private Limited. We examined the following physico-chemical aspects: a. The presence of the physical entities in nanoparticle form and their size by Transmission Electron Microscopy (TEM) by bright-field and dark-field imaging. b.Their identification by matching the Selected Area Electron Diffraction (SAED) patterns against literature standards for the corresponding known crystals. c. Estimation of the levels of starting metals by a 500-fold concentration of medicines, followed by chemical analysis using Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES). Materials and methods Materials The homeopathic medications used for the purpose of re- search were obtained commercially from authorized distrib- utors of a leading homeopathic drug manufacturer in India (SBL) and an Indian subsidiary of a multi-national homeo- pathic company viz. Dr. Willmar Schwabe India Pvt. Ltd. Random batch number samples were purchased from the market and no special effort was made to get samples from the company. Since we purchased these medicines from the market, only in certain cases were we able to obtain them from a single manufacturing batch. Also no special ef- forts were made to obtain the drugs from a batch. The High- performance liquid chromatography (HPLC) grade ethanol used for the purpose of ICP-AES analyses was procured from Commercial Alcohols Inc., Canada. The TEM grids obtained from Pacific Grid-Tech (USA) were 200 mesh cop- per grids coated with carboneformvar. Methods then allowed to dry completely after which another drop was added. The usual drying time for each drop was ap- proximately 30e60 min in air at room temperature. This procedure was repeated 5 times. After air-drying the sam- ple for further 30e60 min, the grid was kept under an IR lamp for approximately 20 min to ensure complete drying of the sample and thereby preventing the possibility of solvent molecules from adhering to the particles on the grid. The SAED patterns of the particles were taken and the d-spacings were calculated using the camera length (calibrated daily using a standard gold colloid). The dark-field images were also taken by selecting three spots from two inner rings on the SAED pattern. The d-spacing values from SAED patterns and the crystallite sizes from the dark-field images were calculated using the Image-J software. Elemental composition by ICP-AES: The determination of the starting elements in ultra-trace concentrations was performed on Ultima 2, (Jobin Yvon Horiba, Japan). The operating parameters for the ICP-AES instrument were as follows: plasma gas flow rate (Argon gas): 12 l/min; auxil- iary gas flow rate: 0.2 l/min; sample uptake: 2.5 ml/min; integration time: 5.0 s, Spray Chamber: cyclonic chamber. The limit of detection of the instrument was 10 ppb. For the purpose of ICP-AES analyses, the samples were pre- pared by pre-concentrating the solutions (6c, 30c, and 200c potencies) 500-fold in a vacuum rotary evaporator, Roteva Model #8706R (Equitron, India) at 45C and 100 rpm speed. The homeopathic medicines that we purchased were in ei- ther 100 ml or 500 ml capacity bottles. Most of the SBL homeopathic medicine bottles were of 500 ml capacity with a few of 100 ml capacity, while those obtained from Willmar Schwabe India (WSI) Pvt. Ltd. were all 100 ml bot- tles. In the case of medicines obtained as 500 ml bottles, so- lutions from 4 bottles of the same medicine and potency were pooled together for concentration, whereas for medi- cines which were marketed as 100 ml bottles, solutions from 20 bottles of each medicine at the same potency were pooled. The concentration was carried out in a 50 ml clean round bottom flask on a rotary vacuum evaporator. The flask was filled with the solution (approximately 30e35 ml at a time) and the solvent was evaporated. Upon complete evaporation of the solvent, the flask was re- filled with fresh homeopathic solution and the process was repeated till the entire volume of 2000 ml was evaporated. Only one bottle was opened at a time to maintain the integ- rity of the purchased medicines. To prevent contamination, under no circumstances was the solution in the bottle kept exposed. The residues of Cuprum met, Stannum met, and Zincum met were acidified to solubilize the particles of their respective starting metals by addition of concentrated nitric acid. Similarly, aqua regia (concentrated nitric acid and con- centrated hydrochloric acid in the ratio 1:3) was added to residues of Aurum met, Argentum met, and Platinum met. A 1:1 ratio of water: acid was maintained for all the concen- trated samples. The amount of acid and water was adjusted so that the final volume was 4 ml, thus, amounting to a con- centration by a factor of 500. The samples were filtered Nanoparticle characterization by TEM/SAED: analyses were performed on Tecnai G2 120 kV Cryo-TEM (FEI, Hillsboro, USA). All samples were viewed at 120 kV. The TEM analyses were performed for the medicines by placing a drop of the original solution (without pre-concen- tration) on the carboneformvar coated copper TEM grids in a clean environment. The drop of the solution was The TEM Homeopathy through Whatman 40 filter paper to remove the residual mat- ter prior to analysis. The SBL samples were analyzed in trip- licate and samples from WSI were analyzed in duplicate. As a negative control, 90%v/v ethanol samples were also pre- pared using HPLC grade ethanol and Milli-Q water. These ethanolic solutions were also concentrated in the manner similar to that employed for the medicines. The emission lines selected for measuring the concentra- tion of the metals are as follows: Gold: 242.795 nm, Copper: 324.754 nm, Tin: 283.999 nm, Zinc: 213.856 nm, Silver: 328.068 nm, Platinum: 265.945 nm. The instrument re- sponse was calibrated using standards prior to analyses of the samples. Results and discussion Determination of size and morphology by TEM Zincum met, Aurum met, Stannum met and Cuprum met 30c and 200c were analyzed by TEM. The results are given as photomicrographs (Figure 1(a)e(p)), which clearly dem- onstrate the presence of nanoparticles and their aggregates. Due to extreme dilution often only a single nanoparticle or a large aggregate is seen. Hereafter, the term ‘particles’ col- lectively refers to the nanoparticles and their aggregates. We noted a high polydispersity of the particles in the so- lutions with respect to their shapes and sizes for various medicines and potencies. A scrupulous examination of the entire manufacturing process of these medicines sug- gested that two key processes played a vital role in impart- ing the high polydispersity. They are: 1. The dilution steps in the solid phase (till 6 potency) in- volved trituration of the raw materials with lactose. Such a comminution process is expected to generate particles of varied shapes and sizes. The physical characteristics of these particles are dependent on the type of raw mate- rial and the shearing force applied. 2. During liquid dilutions, the succussion process at each potentization step played a vital role. The succussions given to the liquid mass are expected to produce particles of varied shapes and sizes due to three factors including shearing forces generated during the pounding of the liq- uid container against an elastic stop, the properties of the raw materials involved, and variations during pounding of the container, between individuals. The permutations and combinations of the above-men- tioned factors and the possible subtle differences in the manufacturing processes employed by various manufac- turers can explain the findings regarding polydispersity between different medicines and manufacturers. We also made another prominent observation regarding the presence of surface asperities on the particles which were clearly evident from the differences in contrast on sur- faces of these particles along with a substantial difference in their size between different starting metals. Thus, larger aggregates were found in Zincum met (Figure 1(a)e(d)) and Stannum met (Figure 1(i)e(l)) as compared to those Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al observed in Aurum met (Figure 1(e)e(h)) and Cuprum met (Figure 1(m)e(p)) at the same potencies. The mechanism of cavitation or generation of vapor bub- bles caused by ultra-sound irradiation (acoustic cavitation) in the entire liquid mass during manufacturing may explain the observations noted above. We suggest that the process of succussion is the cause of cavitation. As set out in a later section, the extant theories of cavitation11e14 can, in principle, provide an explanation of our findings. The aggregation behavior of the particles seems to be de- pendent on the physical property of the starting metal, spe- cifically its melting point. We observed that the aggregates of zinc in Zincum met and tin in Stannum met were rela- tively larger as compared to the smaller aggregates of gold and copper found in Aurum met and Cuprum met re- spectively. The bulk melting points of tin and zinc are w505 K and w692 K respectively as compared to the higher melting points of gold and copper (w1337 K and w1357 K respectively). A decrease in melting points of metallic and semiconductor particles with decreasing size has also been well characterized.15 A combination of ex- tremely high surface temperatures along with a decrease in the melting point of these particles could facilitate the formation of aggregates that we found. It is probable that during the succussion process, the col- lisions of the particles induce surface temperatures well above the melting points of tin and zinc, thereby facilitat- ing their aggregation. However, the melting points of gold and copper being much higher, the occurrence of melting and fusion of these particles would be relatively less frequent than for tin and zinc. Overall, our data for bright-field TEM do not indicate a major difference in the size or nature of the particles in a particular medicine as we increase potency from 30c to 200c. Therefore, the individual crystallite sizes were deter- mined by dark-field TEM (as shown for Zincum met for both manufacturers in Figure 2(a)e(d)). We observed that the aggregates of all the metals tested had maximum crystal- lites (w40e50%) in the size range of 5e10 nm, and that 70e95% of all the crystallites were below 15 nm (Figure S1 e Supplementary information). Thus, in the case of dark-field TEM also, there was no major potency- dependent difference in size distribution of crystallites. Confirmation of elemental composition of particles by SAED The nanoparticles and aggregates identified in TEM were analyzed by SAED for confirmation of the elemental compo- sition. We took multiple SAED patterns of the same particle at varying intensities so as to focus on the inner and outer rings for calculation of the d-spacings of the respective ele- ments. The SAED patterns of the nanoparticles and their ag- gregates found in the metal-based homeopathic medicines are represented in Figure 3(a)e(p). SAED analyses of all samples showed patterns consis- tent with the starting materials. In particular, Aurum met and Cuprum met from both suppliers (SBL and WSI) in- dexed to gold and copper respectively. Table 1 shows the values of the d-spacings calculated from the diameters of 233 Homeopathy 234 Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al Figure 1 Bright-field TEM images of nanoparticles and aggregates. Zincum met: (a) 30c (SBL), (b) 200c (SBL), (c) 30c (WSI), (d) 200c (WSI). Aurum met: (e) 30c (SBL), (f) 200c (SBL), (g) 30c (WSI), (h) 200c (WSI). Stannum met: (i) 30c (SBL), (j) 200c (SBL), (k) 30c (WSI), (l) 200c (WSI). Cuprum met: (m) 30c (SBL), (n) 200c (SBL), (o) 30c (WSI), (p) 200c (WSI). the ring patterns of particles observed in Aurum met sam- ples. Similarly, in the case of Stannum met from SBL, the observed pattern indexed to a-Sn whereas that from WSI to b-Sn. In the case of Zincum met samples from both sup- pliers, we did not observe pure metallic zinc, but the SAED patterns indexed to zinc hydroxide which is an expected compound derived from zinc (d-spacing data for zinc, tin and copper have been given as Supplementary information e Tables S2eS5). The confirmed presence of these crystalline species of starting materials or those derived from them (as evident from the SAED patterns) despite the ultra-high dilutions Homeopathy such as 30c and 200c was astounding, proving that the starting materials were retained even with extremely high dilutions. The d-spacing values for the particular elements con- formed well to the Joint Committee on Powder Diffraction Standards (JCPDS) data in literature in the range of `2%. However, for some d-spacings corresponding to a few planes in the crystal, the values differed by approximately `4%. The differences in some of the d-spacing values for each metal can be explained on the basis of induction of mi- nor plastic deformations in the crystals. The initial tritura- tion process involving high shearing forces, together with the succussion process involving high-velocity collisions of nanoparticles resulting in the generation of shock waves caused by the imploding cavitations, may have induced minor plastic deformations in the metal crystals. In a few of the SAED patterns for the metals analyzed, the particles also showed presence of diffused ring Figure 1 (continued). Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al 235 Homeopathy 236 Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al Figure 2 Bright-field and corresponding dark-field TEM images of nanoparticles and aggregates observed in Zincum met: (a) 30c (SBL), (b) 200c (SBL), (c) 30c (WSI), (d) 200c (WSI). Inset e SAED patterns of the corresponding nanoparticle/aggregate. patterns similar to that of an amorphous material. The probable reason for presence of amorphous phases on the surface of the nanoparticles and aggregates is de- scribed later in this paper. On the whole, the SAED data indicated that the particles of the starting materials were present in the homeopathic medicines even in po- tencies such as 30c and 200c. In order to quantify the ex- act amounts of these starting metals in ultra-high potencies, we conducted the ICP-AES analyses of these medicines. Estimation of concentration of the starting materials by ICP-AES ICP-AES is an established technique for the estimation of metals and other elements. Our equipment had a mini- mum detectable limit of 10 ppb, thereby necessitating Homeopathy Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al Figure 3 SAED patterns of corresponding nanoparticles and aggregates (shown in Figure 1(a)e(p)). Zincum met: (a) 30c (SBL), (b) 200c (SBL), (c) 30c (WSI), (d) 200c (WSI). Aurum met: (e) 30c (SBL), (f) 200c (SBL), (g) 30c (WSI), (h) 200c (WSI). Stannum met: (i) 30c (SBL), (j) 200c (SBL), (k) 30c (WSI), (l) 200c (WSI). Cuprum met: (m) 30c (SBL), (n) 200c (SBL), (o) 30c (WSI), (p) 200c (WSI). 237 Homeopathy Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al 238 Figure 3 (continued). Homeopathy PS Chikramane et al Table 1 Electron diffraction pattern e comparison of d-spacing for Aurum met 30c and 200c potencies 239 Nanoparticles of starting materials in homeopathic medicines hkl values Relative intensity 111 100 200 52 220 32 311 36 222 12 400 6 331 23 420 22 422 23 333 e 440 e 531 e 442 e 620 e 533 e 622 e 444 e d-spacing Gold [#A] 2.3550 2.0390 1.4420 1.2300 1.1774 1.0196 0.9358 0.9120 0.8325 0.7850 0.7210 0.6890 0.6800 0.6450 0.6220 0.6150 0.5890 Aurum met 30C SBL e Figure 3(e) 2.0300 1.2000 1.0700 0.7600 0.6600 Aurum met 200C SBL e Figure 3(f) 2.0393 1.4389 1.2598 1.1809 1.0072 0.9120 0.7843 0.7179 0.6939 Aurum met 30C WSI e Figure 3(g) 2.3515 2.0213 1.4454 1.1732 1.0152 0.9079 0.8286 0.7196 Aurum met 200C WSI e Figure 3(h) 2.3312 2.0224 1.4418 1.2514 1.1695 1.0211 0.9530 All d-spacing values are in #A units. d-spacing data in ‘bold’ e from JCPDS#04-0784, remaining d-spacing data from Edington.16 concentration of the homeopathic solutions using a tech- nique in which there is absolutely no possibility of adding inadvertently the metal to be detected. The analyses of the metal-based medicines, performed after the concentration of the solutions gave startling re- sults. The starting metals were detected for all potencies (6c, 30c, and 200c) at concentrations of the order of picogram/ml (pg/ml). The measured concentrations are presented in Table 2. The data presented in the table are back-calculated concentrations of the metals in the origi- nal homeopathic medicines. The analyses of the negative control of 90%v/v ethanol did not indicate the presence of either the noble metals or tin, and for metals such as cop- per and zinc, indicated far lower concentrations than those in the medicines. We analyzed several samples of Aurum met, Argentum met, and Platinum met for the presence of their respective starting metals. In the case of Aurum met (SBL), some of the samples tested, including higher potencies such as 30c and 200c indi- cated presence of approximately 60e100 pg/ml of gold; the levels being much higher than the sensitivity of the instrument whereas in the ethanolewater negative controls there was no signal for the presence of gold. However, a few Aurum met (SBL) samples did not show presence of gold. Our results point towards a considerable batch-to-batch variation in the concentrations of the starting material. This is certainly not surprising, considering that the method of preparation in- volved manual processes along with an absence of any at- tempt to estimate the concentrations of the starting materials at the end of the manufacturing process of a partic- ular batch. The Aurum met (WSI) samples did not show gold in detectable quantities. Analogous results were obtained for the Argentum met (SBL) samples wherein silver was detected in one 30c and one 200c sample (30.6 pg/ml and 116 pg/ml respec- tively). The concentrations in the other samples were below the detection limit. Likewise, we discerned detect- able concentration of platinum (w40e220 pg/ml) in the Platinum met (SBL) samples for all potencies. The concentrations of non-noble metals such as copper, tin and zinc in their respective homeopathic medicines viz. Cuprum met, Stannum met, and Zincum met were higher (2e30 times that of noble metals) and easily detectable. In the Cuprum met samples (SBL), we detected w500e2500 pg/ml of copper in the solutions. Similarly, 6c potency of WSI indicated high concentration of copper (w370 and w900 pg/ml respectively in the two samples). However, the concentrations of copper in the higher poten- cies viz. 30c and 200c were very low (w10e40 pg/ml) in some and below detectable limits in the others. Likewise for Stannum met samples (SBL) we detected tin; albeit with very high variations from w70 to 1000 pg/ml. In the WSI homeopathic solutions of Stannum met however, lower concentrations of tin were detected in the range of w20e180 pg/ml. As compared to the other samples of non-noble metals noted above, the concentration of zinc in the Zincum met samples was much higher. In the Zincum met samples we detected presence of zinc with a very high variation in the concentrations between manufacturers from w200 to 2700 pg/ml and w1400 to 4000 pg/ml for SBL and WSI respectively. It was reassuring that there was good reproducibility in terms of the estimated concentrations of the starting mate- rials in the pair of samples of the same medicine, potency, and the manufacturing batch. We observed a variation up to 40% in the samples prepared from the same manufacturing batch as compared to a variation up to 1550% in samples from different batches. These results clearly highlighted the following: 1. Validation of the accuracy of our method involving pre- concentration of the medicines prior to analyses as exemplified by the moderate variation in intra-batch samples (refer data sets for Cuprum met, Stannum met, and Zincum met marked in bold in Table 2). 2. High inter-batch variation in the concentration of the starting materials for a given manufacturer and potency, and between manufacturers. Homeopathy 240 PS Chikramane et al Table 2 Estimated concentration of starting metals in various potencies by ICP-AES (pg/ml) Homeopathic dilution SBL (pg/ml) WSI (pg/ml) 12312 Nanoparticles of starting materials in homeopathic medicines 90%v/v Ethanol ND Aurum met 6c 81.4 Aurum met 30c 64.8* Aurum met 200c ND 90%v/v Ethanol 153.4 Cuprum met 6c 1199.0 Cuprum met 30c 730.2 Cuprum met 200c 485.4 90%v/v Ethanol ND Stannum met 6c 569.4 Stannum met 30c 901.6 Stannum met 200c 877.8 90%v/v Ethanol 208.2 Zincum met 6c 380.0 Zincum met 30c 655.2 Zincum met 200c 357.8 90%v/v Ethanol ND Argentum met 6c ND Argentum met 30c ND Argentum met 200c ND 90%v/v Ethanol ND Platinum met 6c 220.6* Platinum met 30c 41.0* Platinum met 200c 213.6 ND 76.4 ND 104.6 245.0 995.2 703.2 432.2 ND 409.2 889.6 1055.8 210.2 366.0 165.4 191.2* ND ND 116.0 ND ND ND 58.2 ND 149.0 1355.6* 1383.4* 2680.2* ND 195.8* 145.6 63.8* 199.0 1002.8 1224.0 2743.6 ND 30.6 ND ND Samples not obtained ND ND Samples not obtained ND ND ND ND 245.0 149.0 893.4 370.8 38.6* ND ND ND ND ND 180.8 153.0 93.8 76.4 20.8 73.0 208.2 210.2 1432.6* 3989.6 3068.6* 1377.6 2230.2* 2322.8 Samples not obtained Samples not obtained ‘Bold’ against a pair of samples in Limit of Detection (LOD) of the instrument was 10 ng/ml corresponding to 20 pg/ml in the original solutions. All concentrations below this value have been reported as ‘Not Detected’ or ‘ND’. * Data indicate that the bottles used to make up the required quantity (2000 ml) were from the same manufacturing batch. Thus, for each metal-based medicine of a particular po- tency, the estimated values appeared to be within a band of 2 orders of magnitude. These variations could be attributed to the processes employed for manufacturing. A visit to a reputed manufacturer revealed that the initial lactose trit- urations were performed on an automated machine using a mortar and pestle. Apart from the control of particle sizes of the metal powders at 1 potency (wherein 80% of the particles of the starting material should be below 10 mm and none above 50 mm),17 there are no further checks for the distribution of the metals in the triturated 6 mixture, which is the starting material for proceeding to the liquid based succussion steps. This is believed to be the cause of these large variations. The liquid dilutions and the potentization steps (includ- ing succussion) were done manually during manufactur- ing, wherein the entire mass of the liquid in the glass container was pounded against a rubber stop 10 times, with inevitable variation in the force of impact and the ex- tent of cavitation generated during these human powered succussions. Apart from the initial trituration with lactose, succussion per se could also be an important method of generation of nanoparticles of the starting materials, due to intense shearing of these nanoparticles against the walls of the glass containers, by the fluid shear and possibly by particle collision due to the implosion of the cavitations created by the ultra-sound waves generated. Therefore, a difference in the shearing force imparted during succus- sion could result in a large difference in the formation of the nanoparticle fraction of the starting materials, thereby reflecting as inter-batch variation. Once the succussion process was completed, the entire mass of liquid was allowed to settle, prior to transfer of 1% of this dilution to 99 parts fresh 90%v/v ethanol. How- ever, the settling time for the dilutions was not fixed. Also, the removal of one part of the previous dilution for the pur- pose of transferring into a fresh solvent was carried out ran- domly from the container and was a manual process. All the above-mentioned factors combined are expected to im- part a lot of disparity in the concentrations of the starting materials in the final medicines which we observed in our studies. During our analyses we also noted the plateauing effect of the concentrations of the starting metals per se in a partic- ular concentration range in potencies 6c, 30c and 200c, in spite of 30c and 200c potencies being 1048 and 10388 respec- tively more dilute than 6c. It is interesting to note that the plateau for non-noble metals showed a higher metal content than for noble metals. Our ICP-AES results suggested that the asymptote effect commences around 6c potency (Figure 4). Our findings appear to be an extension of the trends noted at lower potencies by Ro ̈der et al.,18 who analyzed the concentrations of a few metals in decimal dilutions from 6 to 8 (corresponding to centesimal potencies of 3c to 4c). Part ‘A’ in Figure 4 explicitly depicts de- crease in the concentrations of starting materials with di- lutions. Only in the case of Au3+ in AuCl3 solutions, the a row for given manufacturer and potency indicates their preparation from same manufacturing batch. The Homeopathy Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al Figure 4 Estimated concentrations of starting elements in homeopathic potencies. Part ‘A’ e estimated by Ro ̈ der et al.18 e solid symbols: expected concentrations, open: estimated concentrations, circles: Au3+, star: Fe3+, left triangle: Hg2+, right triangle: Zn2+. Part ‘B’ e estimated by ICP-AES in our work e squares: zinc concentrations, open: Zincum met (SBL), solid: Zincum met (WSI), open triangles: gold concentrations in Aurum met (SBL) samples. The dotted line at 20 pg/ml indicates the LOD of the instrument. 241 actual concentrations determined were lesser than the expected concentrations (circles, solid: expected; open: estimated concentrations). On the contrary, the concentra- tions of Fe3+ though slightly lower than expected at the 6 potency, did not decrease as expected, and were in fact slightly higher at 7 and 8 potencies (stars, solid: expected; open: determined concentrations). Likewise, the concentrations of Hg2+ and Zn2+ were almost 200% higher than expected at 8 potency. A scrupulous, concurrent analysis of these results suggested the com- mencement of an asymptote formation in the vicinity of the 8 (i.e. 4c) potency. When the data from Part ‘A’ of the graph are compared with our data (Part ‘B’), there appears to be a plateauing effect, reached at 6c potency. While a plateau is reached for each metal, the concentra- tion range varied from one metal to another and between manufacturers. The plateau of Zincum met (WSI) (solid squares) was appreciably higher (between 1300 and 4000pg/ml) than that for Zincum met (SBL) (open squares), albeit with the inherent variation mentioned ear- lier. Similar trends were also observed for all the other metals that were analyzed. Possible key mechanisms at large dilutions Acoustic cavitation, a well studied phenomenon11e14 may explain our TEM findings regarding surface asperities and particle aggregation. Researchers have observed that the vapor bubbles generated due to the high-energy sound waves had temperatures exceeding a few thousand degrees (w5000 K) along with intense pressures (w1000 atm). The bubbles so formed had very short lives before imploding, creating intense shock waves which propel particles in the solution at extremely high velocities resulting in collisions which induced the following morphological changes on the particle surfaces: 1. When the particles collided head-on, localized melting occurred on their surfaces at the point of contact, with the temperatures being w3000 K. With the surrounding liquid at ambient temperature, the melted surfaces instantly cooled at extremely high rates (>1010 K/s), thereby solidifying the melted area instantaneously and fusing the particles at the point of contact to form aggregates. 2. The extremely high rate of cooling, while not allowing for re-crystallization at the point of contact, led to an amorphous phase on the particle surface as evident from the diffused rings obtained in the electron diffraction (ED) patterns. 3. Collision of particles at a glancing angle led to fragmen- tation of the particle surface which may have given rise to surface asperities. The above theories support our observations regarding the presence of the surface asperities we see in TEM, since the forceful pounding of the glass containers during the succus- sion process may have been instrumental in generating the ultra-sound waves, resulting in their formation. Homeopathy 242 Nanoparticles of starting materials in homeopathic medicines PS Chikramane et al Another question that arises from our observations is how in spite of such huge dilutions the particles of the start- ing materials are retained even at 200c potency? The an- swer to this question could lie in the manufacturing process itself. We perceive that during the succussion pro- cess, the pounding of solutions against a rubber stop gener- ates numerous nanobubbles19 as a result of entrapment of air and cavitation due to generation of ultra-sound waves. The particles of the starting material instantaneously get adsorbed on the surface of these bubbles and cavitations. This phenomenon could be similar to the mechanism of formation of Pickering emulsions,20e22 wherein the emulsified phase viz. air bubbles or liquid droplets are stabilized by a layer of particles. This nanoparticleenanobubble complex rises to the sur- face and can be within a monolayer once the total metal concentrations are well below 1ppm (Table S6 e Supplementary information). It is this 1% of the top layer of the solution which is collected and added to the next vessel, into 99 parts of fresh solvent and the succussion process is repeated. This transfer of the top 1% layer in each step will ensure that once we reach below a certain concentration i.e. well within a monolayer, the entire start- ing material continues to go from one dilution to the next, resulting in an asymptote beyond 6c. Conclusion Using state-of-the-art techniques (TEM, SAED, and ICP-AES) we have demonstrated the presence of nanopar- ticles of the starting materials and their aggregates even at extremely high dilutions. The confirmed presence of nano- particles challenges current thinking about the role of dilu- tion in homeopathic medicines. We have found that the concentrations reach a plateau at the 6c potency and be- yond. Further, we have shown that despite large differences in the degree of dilution from 6c to 200c (1012 to 10400), there were no major differences in the nature of the parti- cles (shape and size) of the starting material and their abso- lute concentrations (in pg/ml). How this translates into change in biological activity with increasing potency needs further study. Concrete evi- dence of the presence of particles as found by us could help take the research in homeopathy a step forward in under- standing these potentised medicines and also help to posi- tively change the perception of the scientific community towards this mode of treatment. Conflict of interest There are neither any financial nor any personal conflicts of interest with respect to the work carried out for this article. Acknowledgements We thank the Department of Earth Sciences and the Cryo-TEM central facility at IIT Bombay for ICP-AES and TEM analyses respectively. We also gratefully acknowledge funding by Shridhar Shukla, S G Kane and Industrial Research and Consultancy Center (IRCC), IIT Bombay. We also thank P N Varma for valuable insights. Supplementary data Supplementary data associated with this article can be found in the online version at doi:10.1016/j.homp.2010. 05.006. References 1 Khuda-Bukhsh AR. Laboratory research in homeopathy: Pro. Integr Cancer Ther 2006; 5: 320e332. 2 Khuda-Bukhsh AR. Towards understanding molecular mechanisms of action of homeopathic drugs: an overview. Mol Cell Biochem 2003; 253: 339e345. 3 Davenas E, Beauvais F, Amara J, et al. Human basophil degranula- tion triggered by very dilute antiserum against IgE. Nature 1988; 333: 816e818. 4 Chaplin MF. The memory of water: an overview. Homeopathy 2007; 96: 143e150. 5 Teixeira J. Can water possibly have a memory? A skeptical view. Homeopathy 2007; 96: 158e162. 6 Anagnostatos GS. Small water clusters (clathrates) in the homoeo- pathic preparation process. In: Endler PC, Schulte J (eds). Ultra High Dilution e Physiology and Physics. Dordrecht, the Nether- lands: Kluwer Academic Publishers, 1994, p. 121e128. 7 Rao ML, Roy R, Bell IR, Hoover R. The defining role of structure (including epitaxy) in the plausibility of homeopathy. Homeopathy 2007; 96: 175e182. 8 Walach H, Jonas WB, Ives J, van Wijk R, Weinga ̈rtner O. Research on homeopathy: state of the art. J Altern Complement Med 2005; 11: 813e829. 9 Davydov AS. Energy and electron transport in biological systems. In: Ho MW, Popp FA, Warnke U (eds). Bioelectrodynamics and Biocommunication. Singapore: World Scientific Publishing Co. Pte. Ltd., 1994. Chap 17, pp 411e430. 10 Anick DJ, Ives JA. The silica hypothesis for homeopathy: physical chemistry. Homeopathy 2007; 96: 189e195. 11 Doktycz SJ, Suslick KS. Interparticle collisions driven by ultra- sound. Science 1990; 247: 1067e1069. 12 Suslick KS, Doktycz SJ. The sonochemistry of Zn powder. J Am Chem Soc 1989; 111: 2342e2344. 13 Suslick KS, Price GJ. Applications of ultrasound to materials chemistry. Annu Rev Mater Sci 1999; 29: 295e326. 14 Suslick KS. The chemical effects of ultrasound. Sci Am 1989 (Feb);80e86. 15 Goldstein AN, Echer CM, Alivisatos AP. Melting in semiconductor nanocrystals. Science 1992; 256: 1425e1427. 16 Edington JW. Philips technical library e monographs in practical electron microscopy in materials science 2 e electron diffraction in the electron microscope. Eindhoven: N.V. Philips’, 1975, p 110. 17 Varma PN, Vaid I. Encyclopedia of homoeopathic pharmacopoeia & drug index. New Delhi: B. Jain Publishers, 2007, pp 2722e2745. 18 Ro ̈der E, Pu ̈tz W, Frisse R. Bestimmung von Au, Fe, Zn und Hg in homo ̈opathischen Dilutionen durch zersto ̈rungsfreie Neutronenak- tivierungsanalyse. Fresenius Z Anal Chem 1981; 307: 120e126. 19 Roy R, Tiller WA, Bell I, Hoover MR. The structure of liquid water: novel insights from materials research; potential relevance to home- opathy. Mater Res Innov 2005; 9: 577e608. 20 Pickering SU. Emulsions. J Chem Soc 1907; 91: 2001e2021. 21 Binks BP. Particles as surfactants e similarities and differences. Curr Opin Colloid Interface Sci 2002; 7: 21e41. 22 Binks BP, Lumsdon SO. Influence of particle wettability on the type and stability of surfactant-free emulsions. Langmuir 2000; 16: 8622e8631. Homeopathy

TITLE: Homeoprophylaxis – Can you believe it?

TITLE: Homeoprophylaxis; Can you believe it?AUTHOR: © Elena Cecchetto CCH, NSHom(NA), MSc(cand) AUDIENCE: Myself, my professors, other students, other homeopaths, other interested parties. PURPOSE: To critically challenge the epistemology of an element of Homeopathic Practice; specifically the idea that Homeopathy can be successful in preventing disease amongst a population for epidemic or pandemic disease outbreaks. ABSTRACT: I have written this essay to deconstruct an aspect of my clinical practice. There is controversy around the use of homeoprophylaxis in preventing disease during epidemics and pandemics. I wanted to see if there was research that could demonstrate the ability to use homeopathy in epidemics/pandemics. If so, what type of research and can it be recognized as valid. If it is not, why not? I explored and gathered information, interviews with practitioners, charts, essays, population studies and Random Controlled Trials. These helped to see the various levels of ability for homeopathic remedies to be used to prevent infectious diseases in a laboratory and in actual contemporary populations. However, these studies are in contrast within the prevailing paradigm to do with how homeopathic remedies work. Since there is an underlying disbelief in the idea that highly diluted substances could work, there is a difficulty in accepting the studies that demonstrate success for homeopathic remedies.

Introduction:

Can homeopathy help for prevention of disease in epidemics or pandemics? I have been using Dr. Isaac Golden’s (2007) homeoprophylaxis (HP) program for children in my homeopathic clinical practice for 8 years. However, when clients and others ask for the scientific evidence, my reference to historical accounts of the use of homeopathy during actual epidemics doesn’t always seem to satisfy them. As I am questioning what is science and what is knowledge, I am also unsure. The purpose of this essay is to identify and come to an understanding of the idea behind using homeopathy for the prevention of illness in epidemic or pandemic diseases and addressing whether there is valid demonstration of the successful use of homeopathy for epidemics/pandemic diseases. Ranging from historical references, Random Control Trials (RCTs) and population studies, and provings; are these sufficient to demonstrate the premise that homeopathic treatment can be used to have an impact on infectious diseases? Are there factors limiting the research or use of the information generated?

Important aspects of this essay defined:

According to Webster’s online dictionary (2013), Epidemics and pandemics refer to an outbreak of an infections disease where many people are affected in a wide geographic area. A pandemic is the same except it is affecting a larger geographic area that can occur beyond borders of one region or even country. The founder of homeopathy, Samuel Hahnemann explains in the Organon (1996), that homeopathy is most simply defined as a medical art relying on two main principles being the law of minimum dose and the law of similars. Homeoprophylaxis is the use of homeopathic remedies to prevent ahead of time a specific disease. A homeopathic remedy proving is a collection of observed and recorded signs and symptoms conducted according to the instructions outlined in Hahnemann’s (1996) Organon. The material medica is the resource where these provings and other useful sources are compiled for organized reference of each remedy’s therapeutic uses.

How did the use of homeopathy for epidemics start?

Dr. Samuel Hahnemann and homeopaths inspired by him and his writings in the Organon have seemed to make good use of homeopathic treatment to help people who have succumbed to infectious diseases or to help prevent them from succumbing to them. It was Hahnemann’s discriminating observation in 1789 that began the exploration of prevention of disease with homeopathic remedies. In his Lesser Writings (1852), he first described his experience preventing Scarlet Fever by giving them all doses of Belladonna in addition to the members of the family who had contracted it. Using the principles of homeopathic medicine combined with knowledge of homeopathic remedies from provings or other material medica resources has granted the use remedies homeoprophylactically.

Physician’s records:

Historical references of hospital reports are one way a direct comparison can be made between homeopathy and non-homeopathic treatment. In the chart below compiled by Navab (2012), numbers of patient deaths in hospitals are compared to allopathic numbers of deaths. In these reports the rate of success for homeopaths in specific hospitals is shown as a mortality rate of less than 10% for the treatment of scarlet fever, cholera, typhus fever, pneumonia, yellow fever and Spanish influenza. The mortality rates for the conventional doctors of the time (termed allopaths) are over 10% for each of these diseases. The treatments the allopaths had for the 1918 flu were limited to aspirin or acetylsalicylic acid according to Billings (1997) compared to what is available now. It is also very plausible that the results in charts are simply lower for allopaths because the allopathic medicines used between 1798 and 1918 were not as sophisticated as the ones in the present.

homeopathic immunizations historical success rates for homeopathy and homeoprophylaxis in the medical system

In the 1800’s and early 1900’s when homeopaths were working as physicians within the medical system of society of the day, they had access to a statistically significant number of patients. Because these reports were created centuries ago, the information is open to interpretation. Reading the information in the chart above, different people will have different perspectives on the information presented depending on a person’s prior knowledge, beliefs and filters that can affect the conclusions (Fuller, 2003). A person educated in homeopathy (presumable already believing that homeopathy works) might ask ‘what remedies did they use?’ while a person not knowing homeopathy might simply ask the question ‘how’.

The homeopathic physicians had the same or similar access to clinical surroundings and tools available to the allopathic physicians. During the 1918 Influenza in California, Elsa Engle was a nurse practitioner using homeopathic remedies under instruction from Dr. Engle. As Malthouse (2010) wrote from an interview that was conducted by Frances Kalfus in 1992, the then 97 year old Elsa Engle explains their success at Hahnemann Hospital; “They all had about the same symptoms. You didn't have to do anything else but give them a bottle of Gelsemium, followed with a bottle of Eupatorium perfoliatum... In five days practically all of them were well”. Gelsemium and Eupatorium perfoliatum are homeopathic remedies that are still commonly used for influenza. The CBC report (Puri, 2009) explained to viewers during the many homeopathic clients were turning to the remedy Gelsemium that was “used extensively during the Spanish flu epidemic of 1918” for the H1N1 flu. However, with information or data and its style of presentation, each person will come to a different conclusion depending on prior experiences and beliefs. In order for something like homeopathy, because it might be in contrast with a strong belief, even the highest quality of research won’t suffice to change that belief despite what a study shows. Rutten (2008) describes the problem that “Prior beliefs are updated in the Bayesian process, but the first prior belief has a special position. This first prior belief is very strong, we need to consider how strong and why. It is in fact paradigmatic and might not be susceptible to Bayes’ theorum”. Perhaps only a strong personal experience (seeing is believing) might be the only thing that can change a strong prior belief.

RCTs Japanese Encephalitis (JE):

Looking at two Random Control Trials (RCTs) in a clinical laboratory where studies were done with the infectious disease Japanese Encephalitis (JE) and doses of the homeopathic remedy, Belladonna. The authors Bandyopadhyay et al. (2010 and 2011) found statistically significant success showing that Belladonna is effective in preventing disease indicators. This is a chart from Bandyopadhyay et al. (2010) showing decreased viral infection found in the Choriallontoic Membrane (CAM) of unhatched chicks dosed with Belladonna in the four different potencies of 3, 6, 30 and 200;

For the RCT done on suckling mice by Bandyopadhyay et al. (2011), average survival rates of the infected suckling mice treated with Belladonna 200C daily for 14 days had almost double the survival rate than those not treated with Belladonna 200C. 47% survival rate for untreated mice versus 79.24% and 80.60% for the Belladonna treated mice for 7 and 14 days. In the discussion of this successful study, the authors Bandyopadhyay et al. (2011) state that homeopathic practitioners have historically been using the homeopathic remedy Belladonna for the prevention of JE without any RCT experimental proof of how it works and therefore there is further need to test how it is that the homeopathic remedy Belladonna has showed an ability to prevent JE. This study has successfully shown a specific outcome. However, the question of the properties of Belladonna that made it work is what the authors chose to recommend as required further study.

Population Studies: Swine Flu in India:

In India 2009 a Swine Flu patient study involving 23 Homeopaths and 1146 patients was conducted by Mathie et al. (2013) which took a set of previous agreed upon (by the Centre for Clinical Research of Homeopathy (CCRH)) group of symptoms defining Swine Flu by Homeopaths working in government approved health centres in India. The Homeopaths agreed to record their results in a formatted excel chart between October, 2009 and February, 2010. The most frequently prescribed remedy that helped the patients as the primary care for the Swine Flu was Arsenicum album; the very same remedy that the CCRH had identified as the as a prophylactic Genus Epidemicus for this pandemic. Results like this can tempt the enthusiast to proclaim at this as proof that homeopathy can be used in epidemics.

However, the overarching challenge in demonstrating the proof that homeopathy can be successful for epidemics and pandemics through research and information is that it contrasts the current prevailing paradigm. To express this idea Rutten (2008) quotes Vandenbroucke (2001) “Accepting that infinite dilutions work would subvert more than conventional medicine; it wrecks a whole edifice of chemistry and physics”. With this in mind, the work shown in this study could present to different conclusions to people with different prior beliefs. If accepting the validity of homeopathic remedies is not a possibility within the belief system than accepting this study as successfully demonstrating that homeopathy can help in epidemics is also not a possibility.

Leptospirosis in Cuba:

A study by Bracho et al. (2009) was conducted with 2.3 million people in Cuba. The population above 1 year of age was given two oral doses of the Leptospirosis Nosode in the 200C and 10M potencies with an interval of 7-9 days between doses. Then ten to twelve months later, they were given another two oral doses of the 10M potency 7-9 days apart. These homeopathic remedies were administered by approximately 5000 Cuban public health system personnel using five drops (250-300 µL) under the tongue (sublingually) 20 minutes away from eating or drinking or smoking. One year of comparison between the area that received doses (the Intervention Region, IR) and the Rest of the Country (RC) showed a significant decrease of cases of Leptospirosis in the IR. This study looked at the numbers generated by the same institutions that are responsible for managing epidemic disease diagnosis and prognosis in Cuba (the national weekly report based on provincial data generated by the Trend Analysis Unit from the Minister of Epidemiology of the Ministry of Public Health of Cuba). According to Bracho (2009) their prediction of number of cases of Leptrospirosis was 111-461 in the Intervention Region in the most precarious 3 week period (weeks 47-52 of 2007 because of number of days between the start of the increased rainfalls and infection rates) when only actually 38 confirmed cases showed up. This was a reduction of 91.8% to 65.8% in the IR. Despite that there were increased risks of Leptospirosis infection that year due to extreme rainfall in October-November in the IR, the annual number of cases decreased by 84% while in the RC there was an increase of 21.7%. The authors conclude that these findings lend to a high degree of confidence that using homeopathic remedies to prevent disease in populations is a useful tool for epidemics and pandemics.

This study shows successful implementation of homeopathy for a population during an actual epidemic and demonstrates that homeopathy is successful in preventing illness during epidemics or pandemics. Whether this study will model a way that homeopathy can show success in preventing disease amongst a population for epidemic or pandemic disease outbreaks is still in question (Roniger, 2010). The positive aspect of this study is that there were millions of Cubans who willingly experienced homeopathy by taking those remedies in compliance with their predominant health professionals. As Rutton (2008) points out, changing towards a belief in homeopathic medicine might require a turning point such as a personal experience. What that has been shown to do is “We may accept evidence that we did not accept before. We may abandon the first prior, rearrange and re-interpret the evidence and then the process of sequential updating can start”. That way a previous belief that contradicts the idea that homeopathic remedies will not continue to stand in the way of some possible data or information being presented in research of various types.

Conclusions:

In this essay I’ve brought to attention various types of demonstrations of the use of homeopathy for epidemics and pandemics, including some that are the accepted standard for medical science. Using these examples it seems to be possible to demonstrate the specific success with RCT studies, population studies plus historical records on the use of homeopathy during epidemics/pandemics. As Bracho says (2010) it is also possible to conduct further studies with a significant level of confidence that homeopathy will prove itself as a valid way to address the health of populations during epidemics/pandemics. However, the criteria required in order to conduct this type of research isn’t always easily available to homeopaths in various parts of the world. So far it seems that there is a facility in Cuba that has opportunity to do this plus certain homeopaths in certain clinics of India are also already established for these types of studies.

There are challenges to the understanding and acceptance of use of homeopathic remedies for epidemics and pandemics. Part of it lies within the current paradigm that predominates. The disbelief that highly diluted substances such as homeopathic remedies could have a therapeutic action is the paradigm that limits the acceptance of studies on homeopathy despite their success in showing specific outcomes. With a prior acceptance of biochemical medicine combined with an expectation that homeopathy would act in the same manner, there is not a certain type of research that would qualify to change that disbelief that homeopathic remedies work because the prior belief is too many steps away from the new belief. It is recommended from this overview that any further studies to address the ability to use homeopathy for epidemics and pandemics should acknowledge that whether the reader concludes the study acceptable or not has to do with the challenge of the paradigm surrounding how homeopathic remedies work. Do not use this publication or any part of this publication without permission from the author © Elena Cecchetto CCH, NSHom(NA), MSc(cand)

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Hahnemann, S. (1996). Organon of the medical art (6th Edition) edited and annotated by W.B. O’Rielly. Redmond, Washington: Birdcage Books.

Hahnemann, S. (1852) Lesser writings of Samuel Hahnemann last accessed Dec 2, 2013 at http://books.google.ca/books?id=YwTZzl_fk74C&dq=lesser%20writings%20by%20samuel%20hahnemann&pg=PR7#v=onepage&q=lesser%20writings%20by%20samuel%20hahnemann&f=false

Mathie, R., Baitson, E., Frye, J., Nayak, C., Manchanda, R, and Fisher, P. (2013) Homeopathic treatment of patients with influenza-like illness during the 2009 A/H1N1 influenza pandemic in india. Homeopathy 102, 187-192. http://dx.doi.org/10.1016/j.homp.2013.04.001

Malthouse, S., (2010) Homeopathy and Influenze; The Spanish Flu experience. The Immunity Challenge Conference Presentation. last accessed December 2, 2013 at http://www.cmcgc.com/media/handouts/061035/040_Malthouse.pdf

Navab, I. (2012) Lives saved by homeopathy in epidemics and pandemics. last accessed November 23, 2013 at http://drnancymalik.wordpress.com/2013/01/23/epidemics-and-pandemics/

Puri, B. (2009) Last accessed Dec 12-13 at http://www.cbc.ca/news/canada/british-columbia/some-seek-alternative-swine-flu-therapies-1.833973

Roniger, H & Jacobs. (2010) Prophylaxis against leptospirosis using a nosode: Can this cohort study serve as a model for future replications?. The Faculty of homeopathy 99, 152-155. doi.10.1016/j.homp.2010.06.004

Rutton, A. (2008) How can we change beliefs? A bayesian perspective. The Faculty of Homeopathy 97, 214-219. doi:10.1016/j.homp.2008.09.007

Vandenbroucke, JP & de Crean. (2001) Alternative medicine “a mirror image” for scientific reasoning in conventional medicine. Ann Intern Med 135, 507-513

Webster’s online dictionary. Last accessed November 23rd, 2013 at http://www.webster-dictionary.org/definition/epidemic

Webster’s online dictionary. Last accessed November 23rd, 2013 at http://www.webster-dictionary.org/definition/pandemic Do not use this publication or any part of this publication without permission from the author © Elena Cecchetto CCH, NSHom(NA), MSc(cand)

Homeopathy in the public health system: the experience in Lucca Hospital (1998-2011) Elio Rossi

Homeopathy in the public health system: the experience in Lucca Hospital (1998-2011)Elio Rossi

Homeopathic Clinic, Campo di Marte Provincial Hospital, Lucca (Italy)

E-mail: omeopatia@usl2.toscana.it (E. Rossi)

The Homeopathic Clinic in Lucca, funded by the Region of Tuscany, was originally set up in 1998 as part of a pilot project designed to evaluate the possibility of including complementary medicine (CM) into the public health care system.

The following are the main activities in the field of clinics, research and education carried out in these years.

Outcome: The data have been updated with those collected from September 1998 to December 2010: 2,592 patients visited for a total of 6,812 consecutive visits. The results were assessed using the Glasgow Homeopathic Hospital Outcome Score (GHHOS).

Paediatric patients: An observational longitudinal study was carried out on 551 paediatric patients below or equal to the age of 14 years (mean age 5.9 years), that is 25.7% of 2,141 patients consecutively examined from 1998 to 2008.

Adverse effects: In order to assess the possible risk arising from the use of homeopathy a prospective study was carried out to investigate the adverse drug reactions related to homeopathic medicines. Out of 335 homeopathic consecutive follow-up visits, nine adverse reactions were reported (2.68%).

Clinical risk management: A training course for the health professionals of Tuscan public centres of CM, including homeopathy, was conducted. The aim was to develop a plan for the management of clinical risk starting from the analysis of the activities in the clinics of CM, and a systematic approach aiming at identifying and preventing risks.

Homeopathic aggravation: To evaluate the type, inten- sity and frequency of homeopathic aggravation, in particular with Quintamillesimal dilutions (LM or Q), and its prog- nostic value, a retrospective study was realized on the basis of clinical data. The study examines 1,108 patients consec- utively visited, and 441 cases with follow-up. Sixty-three of them (14%) reported a homeopathic aggravation.

Compliance: In order to understand why the patients did not return for follow-up consultations (drop-out) a tele- phone survey was carried out on each patient visited from 6/1,2002 to 5/31, 2003, who did not return for a follow-up visit. 37 patients out of 73 referred to the effec- tiveness of the treatment and the improvement in their state of health as the reason why they did not return.

Long term outcome of atopic patients: To study the outcome of atopic diseases (AD) in paediatric patients ho- meopathically treated and the clinical evolution of 213 (38.6%) with atopic diseases out of 551 children consecu- tively examined from 1998 to 2008. After 5 years from the first visit, all the children were contacted for long-term evaluation of the disease.

Anti-cancer treatment: An outpatient Clinic of integra- tive medicine applied to oncology was set up in October 2010. In the preliminary stage of activities, 97 patients were visited, with various types of cancer.

Cost-benefit evaluation: A study of the Homeopathic Clinic of Lucca demonstrated cost/effectiveness of home- opathy in respiratory diseases. Cost variation for the spe- cific chemical/therapeutic subgroup recorded a decrease in the first and second year of e 46.29% (p < 0.01, n = 105) and e 47.45% (n = 72) respectively.

All these data demonstrate the validity of the integration carried out in Tuscany and the need to strengthen and consolidate the activities of complementary medicine in public healthcare structures.

Homeoprophylaxis – Can you believe it? © Elena Cecchetto

AUDIENCE: Myself, my professors, other students, other homeopaths, other interested parties. PURPOSE: To critically challenge the epistemology of an element of Homeopathic Practice; specifically the idea that Homeopathy can be successful in preventing disease amongst a population for epidemic or pandemic disease outbreaks.

ABSTRACT:

I have written this essay to deconstruct an aspect of my clinical practice. There is controversy around the use of homeoprophylaxis in preventing disease during epidemics and pandemics. I wanted to see if there was research that could demonstrate the ability to use homeopathy in epidemics/pandemics. If so, what type of research and can it be recognized as valid. If it is not, why not? I explored and gathered information, interviews with practitioners, charts, essays, population studies and Random Controlled Trials. These helped to see the various levels of ability for homeopathic remedies to be used to prevent infectious diseases in a laboratory and in actual contemporary populations. However, these studies are in contrast within the prevailing paradigm to do with how homeopathic remedies work. Since there is an underlying disbelief in the idea that highly diluted substances could work, there is a difficulty in accepting the studies that demonstrate success for homeopathic remedies.

Introduction:

Can homeopathy help for prevention of disease in epidemics or pandemics? I have been using Dr. Isaac Golden’s (2007) homeoprophylaxis (HP) program for children in my homeopathic clinical practice for 7 years. However, when clients and others ask for the scientific evidence, my reference to historical accounts of the use of homeopathy during actual epidemics doesn’t always seem to satisfy them. As I am questioning what is science and what is knowledge, I am also unsure. The purpose of this essay is to identify and come to an understanding of the idea behind using homeopathy for the prevention of illness in epidemic or pandemic diseases and addressing whether there is valid demonstration of the successful use of homeopathy for epidemics/pandemic diseases. Ranging from historical references, Random Control Trials (RCTs) and population studies, and provings; are these sufficient to demonstrate the premise that homeopathic treatment can be used to have an impact on infectious diseases? Are there factors limiting the research or use of the information generated?

Important aspects of this essay defined:

According to Webster’s online dictionary (2013), Epidemics and pandemics refer to an outbreak of an infections disease where many people are affected in a wide geographic area. A pandemic is the same except it is affecting a larger geographic area that can occur beyond borders of one region or even country. The founder of homeopathy, Samuel Hahnemann explains in the Organon (1996), that homeopathy is most simply defined as a medical art relying on two main principles being the law of minimum dose and the law of similars. Homeoprophylaxis is the use of homeopathic remedies to prevent ahead of time a specific disease. A homeopathic remedy proving is a collection of observed and recorded signs and symptoms conducted according to the instructions outlined in Hahnemann’s (1996) Organon. The material medica is the resource where these provings and other useful sources are compiled for organized reference of each remedy’s therapeutic uses.

How did the use of homeopathy for epidemics start?

Dr. Samuel Hahnemann and homeopaths inspired by him and his writings in the Organon have seemed to make good use of homeopathic treatment to help people who have succumbed to infectious diseases or to help prevent them from succumbing to them. It was Hahnemann’s discriminating observation in 1789 that began the exploration of prevention of disease with homeopathic remedies. In his Lesser Writings (1852), he first described his experience preventing Scarlet Fever by giving them all doses of Belladonna in addition to the members of the family who had contracted it. Using the principles of homeopathic medicine combined with knowledge of homeopathic remedies from provings or other material medica resources has granted the use remedies homeoprophylactically.

Physician’s records:

Historical references of hospital reports are one way a direct comparison can be made between homeopathy and non-homeopathic treatment. In the chart below compiled by Navab (2012), numbers of patient deaths in hospitals are compared to allopathic numbers of deaths. In these reports the rate of success for homeopaths in specific hospitals is shown as a mortality rate of less than 10% for the treatment of scarlet fever, cholera, typhus fever, pneumonia, yellow fever and Spanish influenza. The mortality rates for the conventional doctors of the time (termed allopaths) are over 10% for each of these diseases. The treatments the allopaths had for the 1918 flu were limited to aspirin or acetylsalicylic acid according to Billings (1997) compared to what is available now. It is also very plausible that the results in charts are simply lower for allopaths because the allopathic medicines used between 1798 and 1918 were not as sophisticated as the ones in the present.

Year Location Disease Treatment by Homeopathy Treatment by Allopathy Treatment with No Medicine 1799 Königslütter, Germany Scarlet Fever Mortality <5% 1830 ~ ‘31* Russia Cholera Mortality 11 %Reported by Imperial Council & Foreign Ministry of Russia. Mortality 63 %Reported by Imperial Council & Foreign Ministry of Russia. Not recorded. 1830 ~ 1832 Vienna, Prague, Hungary and Moravia Cholera Mortality 7 %Reported by Dr. Kath, appointed by King of Bavaria. Mortality 31 %Reported by Dr. Kath, appointed by King of Bavaria. Not recorded. 1836** Vienna Cholera Mortality 33 %Lead Homeopath in charge was Dr. Fleischmann Mortality 66 % 1847 Ireland Typhus fever Mortality 2 %Lead Homeopath in charge was Dr. Joseph Kidd Mortality 13 %Lead Allopath in charge was Dr. Abraham Tuckey Not recorded. 1847 England Typhus fever Mortality 2 % Mortality 13 % Mortality 10 % 1848 Edinburgh, Scotland Cholera Mortality 24 %Reported by Edinburgh Dispensary. Mortality 68 %Reported by Edinburgh Dispensary. Not recorded. mid 1800’s Austria Pneumonia Mortality 5 %Lead Homeopath in charge was Dr. Fleischmann Mortality 20 %Lead Allopath in charge was Dr. Dietl Not recorded. 1853 ~ 1855 South of America Yellow fever Mortality 5.4 %Lead Homeopaths in charge were Dr. F. Davis and Dr. W. Holconibe Not Available. Not recorded. 1854 London, England Cholera Mortality 16.4 %Reported by Royal College of Physicians. Mortality 59.2 %Reported by Royal College of Physicians. Not recorded. 1878 New Orleans, USA Yellow fever Mortality 5.6 %Special Commission reported the statistics. Mortality 17 %Special Commission reported the statistics. Not recorded. 1918*** Pittsburgh, USA Spanish Influenza Mortality 1.05 %Reported by Dean, Pittsburgh Hospital Mortality 30 %Reported by Dean, Pittsburgh Hospital Not recorded.

In the 1800’s and early 1900’s when homeopaths were working as physicians within the medical system of society of the day, they had access to a statistically significant number of patients. Because these reports were created centuries ago, the information is open to interpretation. Reading the information in the chart above, different people will have different perspectives on the information presented depending on a person’s prior knowledge, beliefs and filters that can affect the conclusions (Fuller, 2003). A person educated in homeopathy (presumable already believing that homeopathy works) might ask ‘what remedies did they use?’ while a person not knowing homeopathy might simply ask the question ‘how’.

The homeopathic physicians had the same or similar access to clinical surroundings and tools available to the allopathic physicians. During the 1918 Influenza in California, Elsa Engle was a nurse practitioner using homeopathic remedies under instruction from Dr. Engle. As Malthouse (2010) wrote from an interview that was conducted by Frances Kalfus in 1992, the then 97 year old Elsa Engle explains their success at Hahnemann Hospital; “They all had about the same symptoms. You didn't have to do anything else but give them a bottle of Gelsemium, followed with a bottle of Eupatorium perfoliatum... In five days practically all of them were well”. Gelsemium and Eupatorium perfoliatum are homeopathic remedies that are still commonly used for influenza. The CBC report (Puri, 2009) explained to viewers during the many homeopathic clients were turning to the remedy Gelsemium that was “used extensively during the Spanish flu epidemic of 1918” for the H1N1 flu. However, with information or data and its style of presentation, each person will come to a different conclusion depending on prior experiences and beliefs. In order for something like homeopathy, because it might be in contrast with a strong belief, even the highest quality of research won’t suffice to change that belief despite what a study shows. Rutten (2008) describes the problem that “Prior beliefs are updated in the Bayesian process, but the first prior belief has a special position. This first prior belief is very strong, we need to consider how strong and why. It is in fact paradigmatic and might not be susceptible to Bayes’ theorum”. Perhaps only a strong personal experience (seeing is believing) might be the only thing that can change a strong prior belief.

RCTs Japanese Encephalitis (JE):

Looking at two Random Control Trials (RCTs) in a clinical laboratory where studies were done with the infectious disease Japanese Encephalitis (JE) and doses of the homeopathic remedy, Belladonna. The authors Bandyopadhyay et al. (2010 and 2011) found statistically significant success showing that Belladonna is effective in preventing disease indicators. This is a chart from Bandyopadhyay et al. (2010) showing decreased viral infection found in the Choriallontoic Membrane (CAM) of unhatched chicks dosed with Belladonna in the four different potencies of 3, 6, 30 and 200;

For the RCT done on suckling mice by Bandyopadhyay et al. (2011), average survival rates of the infected suckling mice treated with Belladonna 200C daily for 14 days had almost double the survival rate than those not treated with Belladonna 200C. 47% survival rate for untreated mice versus 79.24% and 80.60% for the Belladonna treated mice for 7 and 14 days. In the discussion of this successful study, the authors Bandyopadhyay et al. (2011) state that homeopathic practitioners have historically been using the homeopathic remedy Belladonna for the prevention of JE without any RCT experimental proof of how it works and therefore there is further need to test how it is that the homeopathic remedy Belladonna has showed an ability to prevent JE. This study has successfully shown a specific outcome. However, the question of the properties of Belladonna that made it work is what the authors chose to recommend as required further study.

Population Studies: Swine Flu in India:

In India 2009 a Swine Flu patient study involving 23 Homeopaths and 1146 patients was conducted by Mathie et al. (2013) which took a set of previous agreed upon (by the Centre for Clinical Research of Homeopathy (CCRH)) group of symptoms defining Swine Flu by Homeopaths working in government approved health centres in India. The Homeopaths agreed to record their results in a formatted excel chart between October, 2009 and February, 2010. The most frequently prescribed remedy that helped the patients as the primary care for the Swine Flu was Arsenicum album; the very same remedy that the CCRH had identified as the as a prophylactic Genus Epidemicus for this pandemic. Results like this can tempt the enthusiast to proclaim at this as proof that homeopathy can be used in epidemics.

However, the overarching challenge in demonstrating the proof that homeopathy can be successful for epidemics and pandemics through research and information is that it contrasts the current prevailing paradigm. To express this idea Rutten (2008) quotes Vandenbroucke (2001) “Accepting that infinite dilutions work would subvert more than conventional medicine; it wrecks a whole edifice of chemistry and physics”. With this in mind, the work shown in this study could present to different conclusions to people with different prior beliefs. If accepting the validity of homeopathic remedies is not a possibility within the belief system than accepting this study as successfully demonstrating that homeopathy can help in epidemics is also not a possibility.

Leptospirosis in Cuba:

A study by Bracho et al. (2009) was conducted with 2.3 million people in Cuba. The population above 1 year of age was given two oral doses of the Leptospirosis Nosode in the 200C and 10M potencies with an interval of 7-9 days between doses. Then ten to twelve months later, they were given another two oral doses of the 10M potency 7-9 days apart. These homeopathic remedies were administered by approximately 5000 Cuban public health system personnel using five drops (250-300 µL) under the tongue (sublingually) 20 minutes away from eating or drinking or smoking. One year of comparison between the area that received doses (the Intervention Region, IR) and the Rest of the Country (RC) showed a significant decrease of cases of Leptospirosis in the IR. This study looked at the numbers generated by the same institutions that are responsible for managing epidemic disease diagnosis and prognosis in Cuba (the national weekly report based on provincial data generated by the Trend Analysis Unit from the Minister of Epidemiology of the Ministry of Public Health of Cuba). According to Bracho (2009) their prediction of number of cases of Leptrospirosis was 111-461 in the Intervention Region in the most precarious 3 week period (weeks 47-52 of 2007 because of number of days between the start of the increased rainfalls and infection rates) when only actually 38 confirmed cases showed up. This was a reduction of 91.8% to 65.8% in the IR. Despite that there were increased risks of Leptospirosis infection that year due to extreme rainfall in October-November in the IR, the annual number of cases decreased by 84% while in the RC there was an increase of 21.7%. The authors conclude that these findings lend to a high degree of confidence that using homeopathic remedies to prevent disease in populations is a useful tool for epidemics and pandemics.

This study shows successful implementation of homeopathy for a population during an actual epidemic and demonstrates that homeopathy is successful in preventing illness during epidemics or pandemics. Whether this study will model a way that homeopathy can show success in preventing disease amongst a population for epidemic or pandemic disease outbreaks is still in question (Roniger, 2010). The positive aspect of this study is that there were millions of Cubans who willingly experienced homeopathy by taking those remedies in compliance with their predominant health professionals. As Rutton (2008) points out, changing towards a belief in homeopathic medicine might require a turning point such as a personal experience. What that has been shown to do is “We may accept evidence that we did not accept before. We may abandon the first prior, rearrange and re-interpret the evidence and then the process of sequential updating can start”. That way a previous belief that contradicts the idea that homeopathic remedies will not continue to stand in the way of some possible data or information being presented in research of various types.

Conclusions:

In this essay I’ve brought to attention various types of demonstrations of the use of homeopathy for epidemics and pandemics, including some that are the accepted standard for medical science. Using these examples it seems to be possible to demonstrate the specific success with RCT studies, population studies plus historical records on the use of homeopathy during epidemics/pandemics. As Bracho says (2010) it is also possible to conduct further studies with a significant level of confidence that homeopathy will prove itself as a valid way to address the health of populations during epidemics/pandemics. However, the criteria required in order to conduct this type of research isn’t always easily available to homeopaths in various parts of the world. So far it seems that there is a facility in Cuba that has opportunity to do this plus certain homeopaths in certain clinics of India are also already established for these types of studies.

There are challenges to the understanding and acceptance of use of homeopathic remedies for epidemics and pandemics. Part of it lies within the current paradigm that predominates. The disbelief that highly diluted substances such as homeopathic remedies could have a therapeutic action is the paradigm that limits the acceptance of studies on homeopathy despite their success in showing specific outcomes. With a prior acceptance of biochemical medicine combined with an expectation that homeopathy would act in the same manner, there is not a certain type of research that would qualify to change that disbelief that homeopathic remedies work because the prior belief is too many steps away from the new belief. It is recommended from this overview that any further studies to address the ability to use homeopathy for epidemics and pandemics should acknowledge that whether the reader concludes the study acceptable or not has to do with the challenge of the paradigm surrounding how homeopathic remedies work.

REFERENCES:

Bandyopadhyay, B. (2010) Decreased intensity of japanese encephalitis virus infection in chick chorioallantoic membrane under influence of ultradilutions of belladonna extract. American Journal of Infectious Diseases 6 (2): 24-28.

Bandyopadhyay, B. (2011) Suckling mice of “belladonna 200” fed mothers evade virulent nakayama strain japanese encephalitis virus infection. International Journal of Microbiological Research 2 (3): 252-257.

Billings, M. (1997) The Medical and Scientific Conceptions of Influenza. Last accessed December 16th, 2013 at http://virus.stanford.edu/uda/fluscimed.html

Bodman, F. (1975) The quest for specifics. British Homoeopathic Journal. 64 (1): 30-39.

Bracho, G., Varela, E., Ferna ́ndez, R., Ordaz, B., Marzoa, N., Mene ́ndez, J., Garc ́ıa, L., Gilling, E., … Campa, C. (2010) Large-scale application of highly-diluted bacteria for leptospirosis epidemic control. Homeopathy 99, 156-166. doi:10.1016/j.homp.2010.05.009

Fuller, S. (2003) Kuhn vs. Popper. Duxford, Cambridge, UK: Icon Books Ltd.

Golden, I. (2007) Vaccination & homeoprophylaxis? A review of risks and alternatives (6th edition), Canberra: National Library

Hahnemann, S. (1996). Organon of the medical art (6th Edition) edited and annotated by W.B. O’Rielly. Redmond, Washington: Birdcage Books.

Hahnemann, S. (1852) Lesser writings of Samuel Hahnemann last accessed Dec 2, 2013 at http://books.google.ca/books?id=YwTZzl_fk74C&dq=lesser%20writings%20by%20samuel%20hahnemann&pg=PR7#v=onepage&q=lesser%20writings%20by%20samuel%20hahnemann&f=false

Mathie, R., Baitson, E., Frye, J., Nayak, C., Manchanda, R, and Fisher, P. (2013) Homeopathic treatment of patients with influenza-like illness during the 2009 A/H1N1 influenza pandemic in india. Homeopathy 102, 187-192. http://dx.doi.org/10.1016/j.homp.2013.04.001

Malthouse, S., (2010) Homeopathy and Influenze; The Spanish Flu experience. The Immunity Challenge Conference Presentation. last accessed December 2, 2013 at http://www.cmcgc.com/media/handouts/061035/040_Malthouse.pdf

Navab, I. (2012) Lives saved by homeopathy in epidemics and pandemics. last accessed November 23, 2013 at http://drnancymalik.wordpress.com/2013/01/23/epidemics-and-pandemics/

Puri, B. (2009) Last accessed Dec 12-13 at http://www.cbc.ca/news/canada/british-columbia/some-seek-alternative-swine-flu-therapies-1.833973

Roniger, H & Jacobs. (2010) Prophylaxis against leptospirosis using a nosode: Can this cohort study serve as a model for future replications?. The Faculty of homeopathy 99, 152-155. doi.10.1016/j.homp.2010.06.004

Rutton, A. (2008) How can we change beliefs? A bayesian perspective. The Faculty of Homeopathy 97, 214-219. doi:10.1016/j.homp.2008.09.007

Vandenbroucke, JP & de Crean. (2001) Alternative medicine “a mirror image” for scientific reasoning in conventional medicine. Ann Intern Med 135, 507-513

Webster’s online dictionary. Last accessed November 23rd, 2013 at http://www.webster-dictionary.org/definition/epidemic

Webster’s online dictionary. Last accessed November 23rd, 2013 at http://www.webster-dictionary.org/definition/pandemic

Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism.

Singh VK, et al. Show allJournal

J Biomed Sci. 2002 Jul-Aug;9(4):359-64. Affiliation Abstract

Autoimmunity to the central nervous system (CNS), especially to myelin basic protein (MBP), may play a causal role in autism, a neurodevelopmental disorder. Because many autistic children harbor elevated levels of measles antibodies, we conducted a serological study of measles-mumps-rubella (MMR) and MBP autoantibodies. Using serum samples of 125 autistic children and 92 control children, antibodies were assayed by ELISA or immunoblotting methods. ELISA analysis showed a significant increase in the level of MMR antibodies in autistic children. Immunoblotting analysis revealed the presence of an unusual MMR antibody in 75 of 125 (60%) autistic sera but not in control sera. This antibody specifically detected a protein of 73-75 kD of MMR. This protein band, as analyzed with monoclonal antibodies, was immunopositive for measles hemagglutinin (HA) protein but not for measles nucleoprotein and rubella or mumps viral proteins. Thus the MMR antibody in autistic sera detected measles HA protein, which is unique to the measles subunit of the vaccine. Furthermore, over 90% of MMR antibody-positive autistic sera were also positive for MBP autoantibodies, suggesting a strong association between MMR and CNS autoimmunity in autism. Stemming from this evidence, we suggest that an inappropriate antibody response to MMR, specifically the measles component thereof, might be related to pathogenesis of autism. Copyright 2002 National Science Council, ROC and S. Karger AG, Basel PMID 12145534 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/m/pubmed/12145534/

Reducing healthcare costs with homeopathy and anthroposophic medicine: a literature review

Reducing healthcare costs with homeopathy and anthroposophic medicine: a literature reviewAbstract: Background: With an ageing European population and the associated rise in chronic diseases pressuring European health systems, an investigation into the appropriateness, cost-effectiveness and efficacy of various medical systems is needed. ECHAMP carried out a literature review on cost-effectiveness of homeopathy and anthroposophic medicine in order to show how homeopathy and anthroposophic medicine can contribute to a sustainable health system. Methods: An extensive search was carried out in the electronic databases of Medline (Pubmed), Google Scholar and Science Direct. The articles were analysed on direct, indirect and intangible cost reductions. Results: Eight studies showed remarkable direct costs savings by the use of homeopathy while seven studies indicated direct cost reductions with the treatment of anthroposophic medicine. One study showed significant direct cost savings for both homeopathy and anthroposophic medicine. None of the studies performed an exact cost calculation for the indirect cost savings of homeopathy whereas only one study calculated the indirect cost savings due to anthroposophic medicine. The latter estimated that indirect cost savings ranged between 41.5 and 113.1 euros per patient per day. Almost all studies for both homeopathy and anthroposophic medicine showed an increase in Quality of Life and reductions in disease severity. Conclusion: Both homeopathy and anthroposophic medicine can contribute to sustainable health systems by reducing direct, indirect and intangible healthcare costs.

ECHAMP represents the industry for homeopathic and anthroposophic medicinal products in Europe.It endorses the important role that homeopathy and anthroposophic medicine play and can play inhealthcare and seeks to maximise availability of homeopathic and anthroposophic medicinal products for all citizens of Europe. ECHAMP works to ensure an appropriate regulatory status for these safe, effective and high quality products. ECHAMP E.E.I.G. Rue Gray 100B - 1040 Brussels office@echamp.eu Tel: (32) 2 649 94 40 Fax: (32) 2 649 41 77

Using Homeopathy for Treating Symptoms of Anxiety

A lot of people in the United States suffer from anxiety disorders. One in eight children in the country are said to be affected by it. Depression cases are also high, with six percent of the total US population recorded to have been suffering from the condition.

To treat people with anxiety disorders, doctors prescribe the combination of medication and psychotherapy. But not everyone can tolerate the antidepressants and instead they undergo alternative therapies such as yoga, herbs, dietary changes, and homeopathy.

Homeopathy has been claimed to be effective in treating several mental illnesses but there are still some people questioning its safety because some of the remedies have ingredients that are not approved by the FDA.

There are some homeopathy remedies that contain substances that might interact with other medications or high concentrations of toxic materials. It is best to inform a doctor if one is planning to go through a homeopathic treatment.

According to a study that looked into the use of homeopathy to cure anxiety disorders, the remedies didn’t do well. They also looked into the use of homeopathy to treat depression and stated that they can’t make a conclusion on the effectiveness of the treatment.

It has been noted that the important part of the homeopathy treatment is the initial interview where the patient talks about one’s story, talk about the struggles to be better, and what treatments were already tried in the past. Experts have said that the positive response patients got from homeopathy treatment might come from this part of the process, which is similar to talk therapy.

When suffering from anxiety or depression, it is best to talk to the therapist or doctor. Homeopathy options might not be the best one available. There are other options that don’t involve medication, such as helping out at the local library or volunteering at the local shelter.

Photo by Wes Washington (Own work) [CC-BY-SA-3.0], via Wikimedia Commons

http://www.healthaim.com/using-homeopathy-for-treating-symptoms-of-anxiety/

Adaptive network nanomedicine: an integrated model for homeopathic medicine.

Adaptive network nanomedicine: an integrated model for homeopathic medicine.

Abstract

This paper presents an evidence-based model for the nature and mode of action of homeopathic remedies. Recent studies reveal that homeopathic remedies contain nanoparticles (NPs) of source materials formed by "top-down" mechanical grinding in lactose and/or succussion (forceful agitation) in ethanolic solutions. Silica nanostructures formed during succussions in glass and/or biosynthesized by specific plant extract tinctures also may acquire and convey epitaxial information from remedy source materials into higher potencies. NPs have enhanced bioavailability, adsorptive capabilities, adjuvant reactivity, electromagnetic and quantum properties compared with their bulk forms. NPs induce adaptive changes in the organism at nontoxic doses (hormesis), serving as salient, low level danger signals to the biological stress response network. Activation of stress response effectors, including heat shock proteins, inflammasomes, cytokines and neuroendocrine pathways, initiate beneficial compensatory reactions across the interconnected networks of the organism as a complex adaptive system. Homeopathic remedies act by stimulating hormetic adaptive rather than conventional pharmacological effects. Updating terminology from "homeopathy" to "adaptive network nanomedicine" reflects the integration of this historical but controversial medical system with modern scientific findings.

http://www.ncbi.nlm.nih.gov/pubmed/23277079

Dr. Bhatia – Please share with us the most significant findings of your research?

Dr. Isaac – There is so much that could be said, but I would say that the three most significant findings are:

(1)   The consistency of measures of the effectiveness of HP over 200 years, both for long-term and short-term protection – at around 90%.  This is a very strong figure, and very consistent with vaccine efficacy. My own data was collected from 1986 to 2004, and vetted by a Professor of Medicine and a medical epidemiologist during my Swinburne research. So it means we can offer people a safe alternative with a demonstrated effectiveness.

(2)   Evaluation of the overall safety of long-term HP was an important new aspect of my Doctoral research at Swinburne University from 2000 to 2004, and the results were excellent. Some of my colleagues had quite reasonably questioned whether the use of my long-term program could cause any weakening of the Vital Force over time, and the data unambiguously said “no” to that question. It further showed that my long-term HP program was associated with an improvement in general well being– a result that pleased, but also surprised me to some extent.

(3)   How damaging vaccination is over the long-term. Once again, the results are unambiguous, and are fully consistent with the very few long-term studies of the impact of vaccination on overall wellness. The fact that the orthodox community has done so little genuine research into long-term safety of vaccination is to their eternal discredit.

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