Samuel Hahnemann

Ο Δρ Samuel Christian Frederic Hahnemann δημιούργησε τις βασικές αρχές της ομοιοπαθητικής από τις Ελληνικές λέξεις "όμοιο" και "πάθος".

Ιπποκράτης ο Κώος

Ο Ιπποκράτης (Κως 460 π.Χ. - Λάρισα 377 π.Χ.) ήταν αρχαίος Έλληνας γιατρός και θεωρείται ο πατέρας της σύγχρονης ιατρικής σε αναγνώριση της συνεισφοράς του στο πεδίο της ιατρικής επιστήμης ως ο ιδρυτής της Ιπποκρατικής Ιατρικής Σχολής. Ο Ιπποκράτης είναι ο θεμελιωτής της ορθολογικής ιατρικής που κατόρθωσε να την απαλλάξει από τα μεταφυσικά στοιχεία, τις προλήψεις, τις προκαταλήψεις. Πέτυχε το αρμονικό συνταίριασμα της ανθρωποκεντρικής επιστήμης με την ιατρική τέχνη και το φιλοσοφικό στοχασμό, ταυτίζοντας την επαγγελματική της άσκηση με τις ηθικοδεοντολογικές αρχές και τις ουμανιστικές αξίες.

 
 

 

Ιπποκράτης ο Κώος

Ο Ιπποκράτης δεν είναι μόνο ο θεμελιωτής της Ιατρικής, αλλά και βαθύς φιλόσοφος και ανθρωπιστής.

Σάμουελ Χάνεμαν

Ο Κρίστιαν Φρίντριχ Σάμουελ Χάνεμαν (Christian Friedrich Samuel Hahnemann, (10 Απριλίου 1755 – 2 Ιουλίου 1843) ήταν Γερμανός ιατρός, γνωστός ως ιδρυτής της ομοιοπαθητικής. Οι έρευνές του οδήγησαν τελικά στη θεμελιώδη αρχή της ομοιοπαθητικής, σύμφωνα με την οποία «τα όμοια θεραπεύουν τα όμοια» (λατ. similia similibus curantur), προτείνοντας πως οι ασθένειες θεραπεύονται με τη χορήγηση φαρμάκων που όταν χορηγούνται σε υγιείς οργανισμούς προκαλούν τα ίδια συμπτώματα με αυτά των ασθενειών.
Γνωστοποίησε για πρώτη φορά την «αρχή των ομοίων» σε δημοσίευση του 1796.

 
 

Clinical trials in Homeopathy. What are we looking for ?

G. Vithoulkas, S. Kivellos International Academy of Classical Homeopathy
One of the main fields of scientific research in Homeopathy, is clinical studies according to the standards of Medical Science. A lot of effort and progress has been done in this field recently. Many clinical studies for homeopathy have been published in homeopathic and mainstream medical journals. Even meta-analysis have been published, in order to be specified if those studies have given clinical results, in favor or against Homeopathy.          Nevertheless, every single homeopathic doctor who practices classical homeopathy, admits that the results of clinical studies prove poorer positive therapeutic results, than those experienced in everyday clinical practice. Even in patients suffering with chronic diseases, widely acceptably well responded to homeopathic treatment, such as asthma and cephalalgia, clinical studies have failed, so far, to reproduce these positive therapeutic results. We can assume that the  reproducibility failure of therapeutic results, in clinical studies,  indicates a severe deficiency of the clinical studies protocols accepted. The main reason is while in conventional research protocols there are certain rules (patho-physiologicals, pathologo-anatomicals, biochemicals, statisticals, epidemiologicals…) for studying disease, but no laws or principles  for studying the patient. On the contrary in homeopathic research protocols there are certain laws (similia,totality, infinitesimal,Hering’s law). for studying patient, and uncertain rules (appropriate remedy, consequence of remedies, repetition, potencies, wait or act…).for studying disease.
In order to indicate the main reasons for all the above, we have to define again the laws that govern classical homeopathic treatment, understand their action upon modern, mostly chemically treated, chronic diseases, and embody them in clinical studies protocols. The suggested triptych includes:1) reference back to theory of classical homeopathy, 2) embodiment of it in modern pathology of chronic diseases and 3) adjustment of medical clinical protocols to it and not the opposite, as it has been mostly done.
Topics of main importance, while drawing up and conducting a medical clinical protocol concerning homeopathic treatment, are:
1.    The choice of disease and treatments under comparison.
2.    The parameter of time including follow ups and final evaluation.
3.    Homeopathic prescription including potency and repetition.
4.    Management of homeopathic aggravation.
5.    Management of acute diseases during treatment of chronic diseases.
6.    Management of reappearance of old predispositions.
7.    Final evaluation with statistical analysis including topics 4,5 and 6. Evaluation of the accuracy of homeopathic prescription.
 
Management of patients suffering from modern chronic diseases, most of them under chemical treatment currently or in the past, is the most difficult part of medical homeopathy, being the major challenge as well. Every parameter of homeopathic treatment, including those, important for clinical protocols above mentioned, is differentiated according to patient’s level of health. Prof G.Vithoulkas’ contribution to the introduction of the laws of classical homeopathy into medical pathology, has led to the upgraded theory of levels of health. Information derived from this theory, are defining for drawing up and conducting medical clinical protocols, which can prove the real therapeutic results of classical homeopathy.
           
            Talking about therapeutic results, as medical doctors and homeopaths too, it is important to define the difference between “suppression of symptoms with a treatment” and “cure”.  Curing patients with classical homeopathy, presupposes the respect on certain laws, almost unfamiliar to our conventional colleagues. Cure means the dynamic condition of freedom not only of patients’ symptoms but of the disease’s pathology. Furthermore, homeopathic cure means a lot more. Means freedom of the patient’s symptoms, of the disease’s pathology and of the predisposition that let the disease to be expressed, acquired idiosyncrasy included. Human Health Definition should be wonderfully upgraded by G.Vihoulkas’ definition of health. http://www.vithoulkas.com/content/view/39/51/lang,en/
          Patients are waiting for therapeutic results, as well as medical doctors.  In chronic diseases it is not uncommon that a classical homeopath should wait different reactions from the patient, than a conventional medical doctor expects.  Homeopathic aggravation, reappearance of acute diseases of the past medical pathology, reappearance of the immunological ability of the patient to raise again high fever, more recognizable homeopathic “picture” with  clearer symptoms and signs which means stronger and more stable neuro-endocrino-immuno balance and last but not least true proceeding of the healing process according to Hering’s law.  It is not uncommon to see patients symptoms to be really better according to one specialized doctor’s point of view (e.g. suppression of acne symptoms after oral retinoid treatment prescribed by a dermatologist) and other more severe symptoms to be appeared, after a long time according to another specialized doctor’s point of view (suicidal tendency as a long term side effect of oral retinoids, detected by a psychiatrist).  This misinterpretation of what “therapy” or “cure” means is one of the main communicative problems between conventional medicine and Homeopathy, but may be, or seems to be sometimes a severe compatibility problem between homeopaths as well.  Further more, those compatibility problems can create a communicative gap between them, when even the steady theoretical basis of classical homeopathy is uncritically reviewed. Provings create conscious symptoms, signs (and probable equivalent biochemical and neuro-endocrinological changes that may also be detected) and not sub-conscious or meditating speculative feelings or imaginary indications of past lives. http://www.vithoulkas.com/content/view/211/9/lang,en/
          It is obvious that respecting and testing the previously mentioned laws of homeopathy, presupposes the prescription according to objective data coming from Homeopathic Pathogenetic Trials-Provings and not according to the transcendental or meditative ability of a doctor or a “teacher”.
During the daily clinical practice of classical homeopathy, the doctor on the first monthly follow up of the patient, after taking the homeopathic remedy, is looking for evidence, indicating that the homeopathic remedy has started to have a therapeutic effect.  This evidence does not necessarily mean the improvement of the patients’ symptoms.  On the contrary, the possibility of the worsening of patients’ symptoms during the first days under the homeopathic treatment – the phenomenon of therapeutic crisis-aggravation, noteworthy changes of symptoms of the mental and emotional level of the patient, which possibly were present at the initial medical consultation, the reappearance of past predispositions or infections the patient has had  (e.g. the reappearance of past dermatitis, or herpes on the lips), or finally noteworthy changes on the particular physical symptoms of the patient  (e.g. patients with migraines, often experience changes on the characteristics of the pain) are observed.  For example, in cases of chronic cephalalgia, where the patient has undertaken conventional medication for a long time period, the symptoms, the signs and its particularities (key-notes) which would lead the homeopathic doctor, to concluding in the absolute correct remedy – the simillimum, have, more possibly, been suppressed.  In these situations, the following have to be taken into account, when evaluating the results of a clinical trial.  Firstly, it is not expected that this patient will be fully cured with the intake of one and only homeopathic remedy, but with a series of homeopathic remedies which will be prescribed gradually, over a long time period.  Secondly, if a patient shows immediate improvement without the indication of therapeutic crisis, or the reappearance of former predispositions, then the homeopathic remedy might not be the first correct remedy – similimum, but a remedy that palliates the patient’s symptoms, without substantially curing him.  In this case, the response of the patient is not due to a placebo effect, but due to a close similarity of the remedy and not due to the absolute similarity of the remedy with the patient’s symptoms. 
In every clinical trial with conventional medicine, the action on a cellular and biochemical level, of the medicine that is under trial, has been understudied in vitro or in animals.  On the contrary, in classical homeopathy, the homeopathic pathogenic trials – provings, have been undertaken on healthy volunteers who presented a sensitivity to the specific natural substance.  In other words, the healthy individuals, since developing the appearance of symptoms indicating the effect of the specific substance, this means that their organism presents sensitivity to the substance and of which, theoretically the specific homeopathic remedy would be one of the remedies advisable in some stage of there life, as patients.  In the same way, the response of a patient to homeopathic treatment, is dependent on the idiosyncratic sensitivity of the specific remedy at the time of prescription. If the wrong remedy is prescribed, the following may occur: 
a)   The prescription of the absolute wrong homeopathic remedy, resembles the prescription of an inactive remedy and its reaction resembles the action of placebo.
b)   The prescription of a relatively wrong – similar - homeopathic remedy, which resembles the prescription of conventional medication, because it suppresses the symptoms, without provoking the reaction of the human organism.  This translated at a clinical level, means that it palliates the patient without treating him. 
    
          For the above mentioned reasons, in cases of chronic diseases, in which the patients have been under conventional treatment for a long time period and may have a low level of health according to G.Vithoulkas’ Theory of levels of health, http://www.vithoulkas.com it is important for the homeopathic doctor to know if the patient received placebo or not, as it is important in every day practice to know if he has received a well produced remedy or it has been antidoted.   This is essential for the effectiveness of the clinical trials on chronic diseases, in which the possibility of the patient having a clear picture, with clear key-notes, is smaller. In such cases, it is quite difficult for the homeopathic doctor to determine if he gave the correct or false homeopathic remedy, so that he can treat the patient with the best possible way and correct the remedy, if he does not have the knowledge of the above.  For conducting a classical double blind trial, it is legitimate, as Dr Menachem Oberbaum said while talking those problems, that the physician will choose the patients he thinks that are treatable, provided that it is done before randomization. This means that the physician may says “for this patient I have enough symptoms and he can be included in the study” and for another patient he may say “for this patient I do not have enough symptoms and he can’t be included in the study”. After the collecting suitable patient, they will be randomized blind into a treatment and placebo group.
The above is essential for the statistical analysis of the study, as far as, the prescription of incorrect homeopathic remedy resembles the action of placebo, and the prescription of a close incorrect remedy (similar) resembles the action of conventional remedy (palliation).
 
Summarizing the guidelines for classical homeopathic clinical studies protocols
 
 1.      There should not be any restrictions on the homeopathic prescription. The doctor should always be able to prescribe whichever of the 3500 homeopathic remedies, believes, is the appropriate in order to achieve the highest individualization of the patient’s treatment.
 2.      There should exist the claim of the homeopathic doctor to choose patients he thinks that are treatable according to his knowledge and patient’s clear picture of symptoms. This admission in a clinical protocol will be essential especially regarding chronic diseases under conventional treatment.
 3.      There should be foresight for recording patient’s therapeutic aggravation phenomenon, which is remarkable in individualized Homeopathic treatment. If this is not foreseen by the protocol, then, falsely negative results are drawn out.
 4.  There should be foresight for recording of the reappearance of  predispositions of the past medical history of a patient (ex. reappearance of  acute sinusitis) , also for treating them exclusively with Homeopathy, so that the treatment is concluded without the intervention of  other medicine. If this is not foreseen by the protocol, then, different therapeutic interventions antidotes homeopathic treatment of the disease under study, in this case of headaches.
 5.      There should be a long period of following the patients under study, especially the ones  with chronic diseases under conventional treatment, because classical drugs weaken the homeopathic medicine’s effect. This effect  will start to occur strongly, only after having gradually reduced classical medicines. Only then will the patient’s initial symptoms reappear, and will be prescribed with a secondhomeopathic medicine that corresponds to his/her initial symptoms which are now more obvious (ex. topography, period of time, modifying factors of pain). It is by experience estimated that a patient with a ten year headache history, that was, regularly, being treated by classical medicine, will need ten months of Homeopathic treatment in order for those clearer symptoms to appear. In that case it should be compared, as for the time frame, to a patient who follows Homeopathic treatment from the first appearance of the headache’s symptoms.
 
          Finally, we should emphasize, that the results of a study on Homeopathy compared to classical treatment or/and placebo, will note the Homeopathic doctor’s ability to find, each time, the patient’s individual drug, and applying the following rules of therapy in classical Homeopathy, while his qualification is complete unnecessary, in conventional trials. 
 
 
 

  

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