Respuesta a la campaña NoSinEvidencia


Elementos para la reflexión seria sobre la Medicina Basada en la Evidencia:


-Sobre la medicina basada en la evidencia (réplica al Profesor Berrios) (http://homeopatiaahora.blogspot.com.es/2011/08/sobre-la-medicina-basada-en-la.html);

-Medicina Basada en la Evidencia: entre la herramienta científica y el paradigma comercial, y de la importancia de no confundir una con el otro (http://homeopatiaahora.blogspot.com.es/2012/12/medicina-basada-en-la-evidencia-entre.html).

-La manipulación de la evidencia científica (http://posmedicina.blogspot.com.es/2013/03/la-manipulacion-de-la-evidencia.html

 
Sobre la eficacia de las prácticas médicas convencionales:

Contradicted and Initially Stronger Effects in Highly Cited Clinical Research
(http://jama.jamanetwork.com/article.aspx?articleid=201218)

What conclusions has Clinical Evidence drawn about what works, what doesn't based on randomised controlled trial evidence?
(http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html)

Over 150 potentially low-value health care practices: an Australian study.
(https://www.mja.com.au/journal/2012/197/10/over-150-potentially-low-value-health-care-practices-australian-study)

A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices(http://www.mayoclinicproceedings.org/article/S0025-6196(13)00405-9/abstract).

How Many Contemporary Medical Practices Are Worse Than Doing Nothing or Doing Less?
(http://www.mayoclinicproceedings.org/article/S0025-6196(13)00403-5/fulltext)

Ups and downs of evidence and practice guidelines
(http://www.cfp.ca/content/59/11/1143.full)

Is evidence-based medicine overrated in family medicine? Yes.
(http://www.cfp.ca/content/59/11/1160)

 
Sobre Homeopatía basada en la Ciencia y en la Evidencia:

-Scientific Framework Homeopathy - Evidenced Based Homeopathy 2013 (http://liga.iwmh.net/dokumente/upload/48b2f_Scientific_Framework_Homeopathy_2013.pdf);



-Science-based Medicine (http://www.scoop.it/t/homoeopathy);

-Evidence Based Homeopathy (http://www.evidencebasedhomeopathy.com/).


Y sobre la eficacia de la Homeopatía (además de lo anterior):







Hering's Law: Law, Rule or Dogma?

Introduction
In homeopathy today, Hering's law is widely recognized as the second law of cure, the first law of cure being similia similibus curantur, or like cures like. Hering's law pertains to the direction in which the symptoms of the patient will disappear during a cure under homeopathic treatment.
In his second lecture on homeopathic philosophy given in 1900 to the Post-Graduate School of Homœopathics, Kent said:
  • "The cure must proceed from centre to circumference. From centre to circumference is from above downward, from within outwards, from more important to less important organs, from the head to the hands and feet."
  • "Every homœopathic practitioner who understands the art of healing, knows that the symptoms which go off in these directions remain away permanently. Moreover, he knows that symptoms which disappear in the reverse order of their coming are removed permanently. It is thus he knows that the patient did not merely get well in spite of the treatment, but that he was cured by the action of the remedy. If a homœopathic physician goes to the bedside of a patient and, upon observing the onset of the symptoms and the course of the disease, sees that the symptoms do not follow this order after his remedy, he knows that he has had but little to do with the course of things." (1)
Here Kent does not differentiate between acute and chronic disease in the application of the law. It is reasonable to assume, because of the lack of precision, that he meant all diseases, acute and chronic of venereal and non-venereal origin, would disappear in the direction described above.

When first studying homeopathy, I listened to the teachers and read the "classic" modern works, and assumed, like my fellow colleagues, that Hering's law had been an irrefutable fact recognized by Hering and the many succeeding generations of homeopaths, and that all patients, (All italics used throughout this paper indicate my own emphasis of pertinent points.) acute and chronic, without an exception, would, at all times, be cured in the afore-mentioned direction under careful homeopathic treatment.
Later as a practitioner, I carefully applied myself to put the general homeopathic training I had received to the test. Since then, I have been able to substantiate most but not all of the rules, principles and laws contained in the homeopathic doctrine promulgated by several generations of homeopaths.
So far, however, I have been unable to substantiate Hering's law. Indeed, very rarely do I see, for instance, in a patient with chronic polyarthritis, the symptoms disappearing from the head first and then to the hands and feet. More often, the pain and other joint symptoms disappear in the reverse order of their appearance, even if it is from below upwards. In other words, if the arthritis manifested itself, as it happens at times, first in the knees and then in the ankles, the ankles would get better before the knees.
Or in a patient affected by a complex of essentially functional complaints such as fatigue, anxiety, irritability, difficult digestion, joint pain and acne, rarely would I see the disappearance of the emotional disturbance first, then the poor digestion followed by the joint pain and lastly the acne. With the simillimum most symptoms begin to improve simultaneously and disappear in the reverse order of their appearance, and not necessarily from above downwards and from inside outwards. In fact it is not uncommon that in such cases the acne, the last to have appeared, would disappear readily and the emotional state (the oldest symptom) would be the last to completely disappear.
While treating a patient with an acute febrile disease that had progressed in the first stage from chills to fever, then to perspiration and lastly to weakness, I would observe a rapid and gentle recovery but without the patient re-experiencing the perspiration, then the fever and lastly the chills. While recovering from acute diseases under homeopathic treatment, the patient does not re-experience the original symptoms one by one in the reverse order of their appearance. Many more troublesome exceptions similar to the above could be cited.
What was wrong with Hering's law as quoted above from Kent's Lectures on Homeopathic Philosophy? Had I misunderstood the law?
According to Webster's dictionary, a law is defined as a sequence of events that occurs with unvarying uniformity whereas a rule permits exceptions, and a dogma rests on opinion. Was this lack of confirmation of the said law due to "suppressive" homeopathic treatment as suggested by a number of theoretical and perhaps dogmatic homeopaths? If so, why have these so called "purists" not stood up and proven that all their cured cases followed the said law? To my knowledge this proof has not been forthcoming.
Was I the only practitioner in this position?
I questioned teachers and colleagues, some with many years of experience. Few could answer my questions and none has been able to substantiate from their own experience without the shadow of a doubt that Hering's law was a true law of nature. It seems that most were in the same situation as me, even the supposed authorities would discuss the matter but in private with the author. It seems that we all had classic cases of cure from above downwards, from within outwards, from more to less important organs and in the reverse order of appearance of symptoms. But these absolutely "perfect" cases were only occasional. The majority of cured cases did not fulfill all the four citedcriteria.
So I decided to go back to the sources.
On one hand, neither Kent, in his Lectures on Homœopathic Philosophy of 1900, nor Stuart Close, in The Genius of Homœopathy of 1924, nor Herbert Roberts, in The Principles and Art of Cure by Homœopathy of 1936 while discussing the above law, refer to it as Hering's law. (1-3) None of these three authors makes any reference to Hering in their lectures on the law of direction of cure. On the other hand, Garth Boericke, in A Compendium of the Principles of Homœopathy of 1929, refers to it as Hering's rule but not as a law. (4) Confusing, isn't it? Did Hering ever formulate a law on the direction of cure? If he did, why was his name not clearly associated with the law and was it as a law or a rule? Why was the literature so ambiguous?
At this point, I realized that the sources had to be explored further. The answers would all have to be within the literature of the nineteenth century. After a thorough examination of this literature I have so far been unable to find any of Hering's famous contemporaries and close colleagues discussing or making any reference to a law of direction of cure. Writings of Boenninghausen, Jahr, Joslin, P.P. Wells, Lippe, H.N.Guernsey, Dunham, E.A. Farrington, H.C. Allen, Nash, etc, were all silent.
When Hering died in 1880, colleagues all over the world assembled to pay tribute to the great homeopath. His many accomplishments were recalled. Strangely, none made any mention of a law of direction of cure promulgated by Hering. (5) Arthur Eastman, a student who was close to Hering during the last three years of the venerable homeopath, published in 1917 Life and Reminiscences of Dr. Constantine Hering also without mentioning a law pertaining to direction of cure. (6) Calvin Knerr, Hering's son-in-law, published in 1940, 60 years after Hering's death, the Life of Hering, a compilation of biographical notes. (7) Again no mention is made of the famous law. Not only confusing, but also puzzling.
Obviously, the sources had to be further explored. Here are the fruits of this exploration.

THE HISTORY RELATED TO THE FORMULATION OF HERING'S LAW
  1. Hahnemann - 1811
    With the first publication of his Materia Medica Pura in 1811, Hahnemann inaugurated a new arrangement of the symptoms: from above downwards, from inside outwards, but also from the parts to the generals.
  2. Hahnemann - 1828
    In 1828, Hahnemann published his first observations and theories on chronic diseases. (8) I summarize here the points most pertinent to the present discussion:
    • "All diseases, acute and chronic of non-venereal origin, come from the original malady, called psora. (page 7)
    • "A skin eruption is the first manifestation of psora. (page 38)
    • "The skin eruption acts as a substitute for the internal psora (page 11) and prevents the breaking out of the internal disease. (page 13)
    • "The more the skin eruption spreads the more it keeps the internal manifestations of psora latent. (page 40)
    • "But when the skin eruption is suppressed with an external application or other influences the latent psora goes unnoticed and its internal manifestation increases. Then "it originates a legion of chronic diseases." (page 12) Incidently, for Hahnemann, a suppressed skin eruption is not driven into the body as it was popularly thought in his time, and even today by most homeopaths, but rather the vital force is compelled "to effect a transference of a worse form of morbid action to other and more important parts." (Introduction of the Organon of Medicine page 62) (9)
    • "Latent psora, an abnormal susceptibility to disease, will manifest itself as severe diseases after exposure to stress (or as he calls it, unfavorable conditions of life) acute infections, trauma and injuries, exhaustion from overworking, lack of fresh air or exercise, frustration, grief, poor nutrition, etc, and by "incorrect and weakening allopathic treatment". (page 48)
    • "During the treatment of chronic diseases of non-venereal origin with antipsoric remedies, the last symptoms are always the first to disappear, "but the oldest ailments and those which have been most constant and unchanged, among which are the local ailments, are the last to give way." (page 135)
    • "If old symptoms return during an antipsoric treatment, it means that the remedy is affecting psora at its roots and will do much for its thorough cure (page 135). If a skin eruption appears during the treatment while all other symptoms have so far improved the end of the treatment is close."
  3. Hahnemann - 1833-43
    In paragraphs 161 and 248 of the fifth and sixth edition of the Organon of Medicine of 1833 and 1843 respectively, Hahnemann says that in the treatment of old and very old chronic disease, aggravation of the original disease does not appear if the remedy is accurately chosen and given in the appropriate small doses, which are only gradually increased. "When this is done, these exacerbations of the original symptoms of the chronic disease can appear only at the end of the treatment, when the cure is complete or nearly complete." The original symptoms of a chronic disease should be the last to aggravate or become more prominent before disappearing. (10)

    In paragraph 253 of the same work, the author states that in all diseases, especially in quickly arising (acute) ones, of all the signs that indicate a small beginning of improvement (or aggravation) that is not visible to everybody, the psychic condition of the patient and his general demeanor are the most certain and revealing.

    In paragraph 225, Hahnemann states that some psychic diseases are not the extension of physical disease but, "instead, with only slight physical illness, they arise and proceed from the psyche, from persistent grief, resentment, anger, humiliation and repeated exposure to fear and fright. In time such psychic diseases often greatly harm the physical health." In other words, Hahnemann had recognized the existence of psychosomatic diseases, those diseases which progress from within outwards and from above downwards.

    This is the background that now leads us to Hering, who, among all Hahnemann's students, was most similar to him. Like Hahnemann, Hering was a true scientist who totally adopted the inductive method in his scientific pursuits.
  4. Hering - 1845
    In 1845, Hering published in the preface of the first American edition of Hahnemann's Chronic Diseases an extract of an essay which was never published elsewhere, called "Guide to the Progressive Development of Homœopathy".

    In this essay, Hering writes:
    • "Every homœopathic physician must have observed that the improvement in pain takes place from above downward; and in diseases, from within outward. This is the reason why chronic diseases, if they are thoroughly cured, always terminate in some cutaneous eruption, which differs according to the different constitutions of the patients.
    • "The thorough cure of a widely ramified chronic disease in the organism is indicated by the most important organs being first relieved; the affection passes off in the order in which the organs had been affected, the more important being relieved first, the less important next, and the skin last. (page 7)
    • "Even the superficial observer will not fail in recognising this law of order.
    • "This law of order which we have pointed out above, accounts for numerous cutaneous eruptions consequent upon homœopathic treatment, even where they never had been seen before; it accounts for the obstinacy with which many kinds of herpes and ulcers remain upon the skin, whereas others are dissipated like snow. Those which remain, do remain because the internal disease is yet existing... It lastly accounts for one cutaneous affection being substituted for another." (11) (page 8)
    Here Hering assumes that all chronic diseases (it is likely that he is referring here to diseases of psoric origin, i.e., non-venereal) progress from less to more important organs and disappear in the reverse order. This is compatible with Hahnemann's theory that all chronic diseases of non-venereal origin manifest themselves first on the skin then internally. (Concerning the theories of Hahnemann, Hering wrote in 1836 in the first American edition of the Organon of Medicine: Whether the theories of Hahnemann are destined to endure a longer or a shorter space, whether they be the best or not, time only can determine; be it as it may however, it is a matter of minor importance. For myself, I am generally considered as a disciple and adherent of Hahnemann, and I do indeed declare, that I am one among the most enthusiastic in doing homage to his greatness; but nevertheless I declare also, that since my first acquaintance with homeopathy, (in the year 1821), down to the present day, I hve never yet accepted a single theory in the Organon as it is promulgated. I feel no aversion to acknowledge this even to the venerable sage himself. It is the genuine Hahnemannean spirit totally to disregard all theories, even those of one's own fabrication, when they are in opposition to the results of pure experience. All thoeries and hypotheses have no positive weight whatever, only so far as they lead to new experiments, and afford a better survey of the results of those already made. (page 17) (12)
  5. Hering - 1865
    It seems that Hering did not further elaborate on this subject, at least in the American literature, until 20 years later. In 1865, he published an article in the first volume of The Hahnemannian Monthly called "Hahnemann's three rules concerning the rank of symptoms". Hering states in this article that:
    • "The quintessence of Hahnemann's doctrine is, to give in all chronic diseases, i.e., such as progress from without inwardly, from the less essential parts of our body to the more essential, from the periphery to the central organs, generally from below upwards - to give in all such cases, by preference, such drugs as are opposite in their direction, or way of action, such as act from within outward, from up downward, from the most essential organs to the less essential, from the brain and the nerves outward and down to the most outward and the lowest of all organs, to the skin... All the antipsoric drugs of Hahnemann have this peculiarity as the most characteristic; the evolution of their effects from within towards without. (page 6-7)
    • "Hahnemann states, in his treatise on Chronic Diseases, American translation p.171: Symptoms recently developed are the first to yield. Older symptoms disappear last. Here we have one of Hahnemann's general observations, which like all of them, is of endless value, a plain, practical rule and of immense importance.
    • "The above rule might also be expressed in the following words: In diseases of long standing, where the symptoms or groups of symptoms have befallen the sick in a certain order, succeeding each other, more and more being added from time to time to those already existing, in such cases this order should be reversed during the cure; the last ought to disappear first and the first last." (page 7-8) (13)
    It is very clear here that Hering makes no mention of a law but rather of a rule, that the symptoms ought to disappear in the reverse order of their appearance during the homeopathic treatment of patients with chronic disease of psoric origin, the ones that progress from without inwardly, from less important to more important organs and generally from below upwards.
  6. Hering - 1875
    In 1875, Hering published the first volume of Analytical Therapeutics of the Mind in which he stated that "only such patients remain well and are really cured, who have been rid of their symptoms in the reverse order of their development". (page 24) (14) Here Hering makes no mention of the three other propositions regarding the direction of cure: from above downwards, from within outwards and from the more important to the less important organs. Why? Were they not considered as important to evaluate the direction of cure as stated in previous years?

    In the same work, Hering also explains that he adopted Hahnemann's arrangement of the materia medica: "First inner symptoms, then outer ones. This order we have now uniformly preserved throughout the whole work." (page 21) In explaining why he adopted this arrangement he says: "The arrangement as well as the style of printing, has the one object especially in view, viz.: to make it as easy as possible for the eye, and through the eye, for the mind to find what is looked for." He makes no mention of this arrangement corresponding to a direction of cure, as it has been suggested by some well wishing homeopaths.

    The origin of the term "Hering's law"
    Where does the term "Hering's law" come from as it seems never to have been mentioned in the literature during Hering's time? The earliest mention I have been able to find in the homeopathic literature dates from 1911, in an article published by Kent in the first volume of the Transactions of the Society of Homœopathicians called "Correspondence of Organs, and the Direction of Cure". Kent writes:
    • "Hering first introduced the law of direction of symptoms: from within out, from above downward, in reverse order of their appearance. It does not occur in Hahnemann's writings. It is spoken of as Hering's law. There is scarcely anything of this law in the literature of homœopathy, except the observation of symptoms going from above to the extremities, eruptions appearing on the skin and discharges from the mucous membranes or ulcers appearing upon the legs as internal symptoms disappear.
    • "There is non-specific assertion in the literature except as given in the lectures on philosophy at the Post- Graduate School." (15)
    It is reasonable to assume that Kent was the one that officialized the term "Hering's law" and so inadvertently popularized the concept of the existence of a clear and precise law of direction of cure. (At least up till 1899, at Kent's Post-Graduate School of Homeopathics, the directions of cure were still called "the Three Directions of cure [given by Hahnemann].) (16) By using the name of Hering it is reasonable to say that Kent thus created false and misleading historical assumptions. Since H.C. Allen had died two years previously (1909), the profession, at least in North America, had no other leaders capable to refute Kent and defend the classic Hahnemannian tradition. (It is to be remembered that in 1908 H.C. Allen had severely criticized the materia medica of the new synthetic remedies that Kent had been publishing since 1904 in The Critique. Kent was at the time the associate editor of this journal in which, almost monthly, he had been publishing the materia medica of a new synthetic remedy, each of very questionable value. During an open session at the annual meeting of the International Hahnemannian Association, Allen and G.P. Waring accused Kent of publishing materia medica that was "without proving or any clinical experience", which would have been completely contrary to the strict inductive method intrinsic to homeopathy. (17)

    Kent then stopped permanently the publication of these synthetic remedies, even the ones that he had previously promised for upcoming publication in The Critique. (18) Although Kent continued to publish regularly in The Critique until 1911 he restricted his articles to reporting clinical cases rather than materia medica. Never was a synthetic remedy ever published by Kent after the initial criticism of Allen even in his own journal, The Homœopathician, that he founded in 1912. Furthermore, when Kent published the second edition of his Lectures on Homœopathic Materia Medica in 1912 [the first edition was in 1904], all the synthetic remedies published between 1904 and 1908 were omitted.)

    In this same article, Kent says that in the course of treatment of a patient suffering with a psychic disease of the will (problems of affections, grief, anger, jealousy, etc), the heart or liver will be affected as the treatment progresses.

    While in a patient suffering from a mental disease (problems of the intellect), the stomach or the kidney will be affected during appropriate homeopathic treatment. Were these comments on the direction of cure and correspondence of organs based on Kent's impeccable and meticulous observations or was he rather formulating hypotheses? He does not explain further but he does mention later in the same paper that "through familiarity with Swedenborg, I have found the correspondences wrought out from the Word of God harmonious with all I have learned in the past thirty years. Familiarity with them aids in determining the effect of prescriptions." (15)

    Nowhere was I able to find in the writings of Kent, including in a collection of not yet republished lesser writings, any other mention of Hering's law as to the direction of cure.

    Discussion and Conclusion
    First let us briefly review the highlights of what has been so far demonstrated:
    • Between 1828 and 1843, Hahnemann enunciated his theories of chronic diseases and described his observations and rules about the progression and resolution of these chronic diseases. One key point of his theory is that a skin eruption is the first manifestation of psora, which is the source of all chronic diseases of non-venereal origin. In chronic disease the presenting symptoms of the patient ("those ailments which have been most constant and unchanged") may aggravate and will disappear in the reverse order of their appearance with the correct antipsoric remedies in the correct posology. Possibly, old symptoms may return during an antipsoric treatment. In all diseases, if after a homeopathic remedy the psychic symptoms are the first to improve or aggravate it is a most certain sign of curative change. For Hahnemann this inside outward improvement was not a law but rather a most certain sign of curative change. Finally not all diseases progress from outside inwards but certain diseases (psychosomatic diseases) can progress from within outwards.
    • In 1845, Hering enunciated the original observations of Hahnemann as a law of order in a work never to be published. In this law he mentions essentially four points, that "the improvement in pain takes place from above downward; and in diseases, from within outward... Chronic diseases if thoroughly cured, always terminate in some cutaneous eruption" and lastly "the thorough cure of a widely ramified chronic disease in the organism is indicated by the most important organs being first relieved; the affection passes off in the order in which the organs had been affected, the most important being relieved first, the less important next, and the skin last". As a reader I do not clearly sense that Hering is officially proclaiming the original observations of Hahnemann as an absolute law but rather that there is a "law of order" during a curative process. Also I was unable to find Hering or any of his contemporaries referring further to this unpublished work or to a law of direction of cure.
    • In 1865, Hering described these observations not as a law but as Hahnemann's general observations or as plain practical rules. Essentially he emphasizes the proposition that the symptoms should disappear in the reverse order of their appearance during the treatment of patients with chronic psoric diseases.
    • In 1875, Hering now discussed only one proposition, that the symptoms will disappear in the reverse order of their appearance. The three other propositions are now not mentioned at all.
    • All the illustrious contemporaries of Hering seems to remain silent on this point, at least from my review of the literature.
    • In 1911, Kent, almost arbitrarily, calls the original observations of Hahnemann "Hering's law".
    Now, with Kent's powerful influence, most modern works and presentations on homeopathy began to declare Hering's law as an established fact and seemingly assumed that it has been thoroughly verified since the beginning of homeopathy, although no author, to my knowledge, has so far been able to substantiate what each is repeating from the other. Here is one clear sign which indicates how profoundly the homeopathic profession of today has been cut off from its original and most essential sources. During the years of its decline in the U.S. the profession experienced a gradual discontinuity from its original foundation and started to rely more and more on a neo-foundation dating back to the turn of the present century. Each new generation of homeopaths has readily accepted Hering's law as a perfect law of cure and so unintentionally perpetuated a misleading assumption. For students it is an attractive concept but we clinicians must stand up and report our observations even if they are contrary to the teaching we have received.

    From reviewing the literature, it seems unlikely that the law formulated by Kent in 1911 is a fair represention of Hering's overall understanding of a direction of cure and that neither Kent nor anyone else has been able thus far to clinically demonstrate that the original observations of Hahnemann constituted in fact a perfect law of nature. But if we assume, for a moment, that the law formulated by Kent is true, would all symptoms then have to disappear, not only in the reverse order of their appearance, but also from above downwards, from within outwards and from more important to less important organs?

    To comply with this law it would mean that all diseases to be curable must proceed from outside inwards, from below upwards and from less important to more important organs. Many acute diseases and a whole list of chronic diseases such as psychosomatic diseases and others that develop from within outwards (for example cases of arthritis followed by psoriasis), or diseases that develop from above downwards, as in certain cases of polyarthritis, would then be theoritically incurable. Or (since we know this not to be the case) they are curable, but represent notable exceptions to Kent's formulation of a law of direction of cure.

    In many cases of chronic disease the direction of disappearance of symptoms will contradict at least one of the four propositions. I assume that we all agree that the enunciation of a law must be based on impeccable observations. A law, if it is to be called a law, must explain all observable phenomena of direction of cure. It is unacceptable to use limited or even selected clinical phenomena to confirm a supposed law.

    This situation appears to exist when certain homeopaths in their attempts to defend "pure" homeopathy subscribe to the position that what is observed as contrary to Hering's law, as formulated by Kent, is only due to poor prescribing, suppressive at times, palliative at best but surely not curative. For them what is wrong, is not the law but the prescription: "the simillimum was not given."

    Personally I use and can daily confirm the original observations of Hahnemann concerning the direction of cure and have found them extremely helpful to evaluate the evolution of diseases or of cure but I have not been able to substantiate these observations as a law and have not yet found a colleague with such substantiation. I use them as plain practical rules.

    Probably by the end of my career, homeopathy will have become widely accepted. I would then resent it if a group of objective scientists clinically investigate the principles of homeopathy, and find numerous exceptions not abiding to our idealistic or dogmatic conception of Hering's law; thus renderiing it only "a plain, practical rule". I would similarly resent having a group of scientists saying that for the last hundred or more years the homeopathic profession has been blindly erring in assuming that Hering's law was an irrefutable fact.

    Five of the many plagues that have hindered the growth of homeopathy are ignorance, egotism, dogmatism, idolatry and the diversion from the inductive method. In his last address to the profession in an article published in the August 1880 (Hering died on July 23, 1880.) issue of the North American Journal of Homœopathy, Hering warned us that "if our school ever gives up the strict inductive method of Hahnemann we are lost, and deserve to be mentioned only as a caricature in the history of medicine." (19) Indeed, since its early beginning the tendency to rationalize the practice of medicine has also constantly threatened homeopathy. Hahnemann, who had a thorough understanding of the history of medicine, knew that the only sure way was based on the experimental method. Hering demonstrated the same rigor. Unfortunatively, we can not say the same of Kent. Let us now start carefully observing and reporting any facts that would help to perfect Hahnemann's original observations. If a direction of cure can be expressed within the context of a law, then so be it. But until demonstrated otherwise, it should remain "a plain, practical rule". The law that we suspect still needs to be rightly formulated.

    At present it seems appropriate to refer to these observations as the rules of the direction of cure. To refer to these as Hahnemann's or Hering's rules may further prolong the confusion. From my personal experience, it appears that the four rules are not applicable to all cases and that there is a hierarchy among them, i.e., they do not have equal value. The first indication that a disease is being cured under homeopathic treatment is that the presenting and reversible (Many symptoms related to irreversible lesions can not be expected to totally disappear; consequently the more a symptom is related to organic changes, the less likely, or more slowly it will disappear. The greater the irreversibility of the pathology the greater the symptoms will linger. The practitioner can easily be confused by these important exceptions, which are often not well perceived. Therefore this rule [of symptoms disappearing in the reverse order of appearance] is generally less applicable to symptoms deriving from organic lesions.) symptoms of the disease will disappear in the reverse order of their appearance.

    This confirms the observations as pointed out originally and plainly by Hahnemann in The Chronic Diseases and later by Hering in 1865 and 1875. This means that during the treatment of patients suffering with chronic diseases of non-venereal origin and also at times with acute diseases, the presenting symptoms of the patient's chronic dynamic disease (as opposed to the symptoms resulting essentially from gross error of living) will disappear in the reverse order of their appearance. So the presenting symptoms that have developed in the order of A B C D E seem to consistently disappear in the order of E D C B A. This rule seems to have supremacy over the other three rules: from more important to the less important organs, from within outwards and from above downwards.

    The word "presenting" is here emphasized in order to state perfectly clearly that the symptoms that will disappear in the reverse order of the their appearance are only the presenting symptoms, and that it is not at all expected that every ailment experienced by the patient in his past will again be re-experienced under homeopathic treatment. In fact only a few of these old symptoms and conditions will reappear during a homeopathic treatment, usually the ones that have unmistakably been suppressed by whatever influences. Beside antipathic treatment that will suppress symptoms and normal functions of the organism (perspiration or menses) there are other measures which will cause suppression of symptoms, first, dissimilar diseases, natural or artificial; second, external influences such as exposure to cold temperature, (i.e., suppressed menses from getting the feet wet); and lastly, internal influences that cause the person to suppress emotions such as anger or grief. This rule concerning cure in the reverse order of appearance of the presenting and reversible symptoms of the disease is the most important of the four as it is observable in almost all cases. The importance of this rule is well emphasized by Hering in 1865 when he mentioned:
    • "This rule enables the Hahnemannian artist not only to cure the most obstinate chronic diseases, but also to make a certain prognosis when discharging a cases, whether the patient will remain cured or whether the disease will return, like a half-paid creditor, at the first opportunity." (12)
    The second most important (applicable) rule in the hierarchy is that cure will proceed from more important to less important organs. Third in importance is the rule that cure will proceed from within outwards. Fourth, least important and least often observable, the cure will proceed from above downwards. Hahnemann's observation thatof all the signs that indicate a small beginning of improvement, the psychic condition of the patient and his general demeanor are the most certain and revealing is seen as the source of the last three rules. "The very beginning of improvement is indicated by a sense of greater ease, composure, mental freedom, higher spirits, and returning naturalness." (paragraph 253) 10 This original observation of Hahnemann, which is verified daily, does not contradict the first rule in any case because the first sign of improvement can be and is often different than the symptom that would first disappear.

    Consequent to Hahnemann's theory, (that all diseases, acute and chronic of non-venereal origin, come from the original malady called psora and its first manifestation is a skin eruption) all cases of chronic disease of dynamic origin must develop a skin eruption to be totally cured. As it seems unfeasible to demonstrate, it should at best be used as a working hypothesis and not as a law. For a law to exist it must be demonstrable without exception. Hahnemann had a clear opinion about the role of the physician as theorist when he wrote in the preface to the fourth volume of The Chronic Diseases:
    • "I furnished, indeed, a conjecture about it [on how the cure of diseases is effected], but I did not desire tocall it an explanation, i.e., a definite explanation of the modus operandi. Nor was this at all necessary, for it is only incumbent upon us to cure similar symptoms correctly and successfully, according to a law of nature [similia similibus curantur] which is being constantly confirmed; but not to boast with abstract explanations, while we leave the patients uncured; for that is all which so-called physicians have hitherto accomplished." (8)
    To end this thesis, I would like to leave you with the spirit of some pertinent thoughts of Constantine Hering. In 1879, in the last two paragraphs to the preface of his last work, The Guiding Symptoms of our Materia Medica, he writes:
    • "It has been my rule through life never to accept anything as true, unless it came as near mathematical proof as possible in its domain of science; and, in the other hand, never to reject anything as false, unless there was stronger proof of its falsity.
    • "Some will say, "but so many things - a majority of all observations - will thus remain between the two undecided." So they will; and can it be helped? It can, but only by accumulating most careful observations and contributing them to the general fund of knowledge." (20)
    And finally he wrote in 1845 in the preface of Hahnemann's Chronic Diseases:
    • "It is the duty of all of us to go farther in the theory and practice of Homœopathy than Hahnemann has done. We ought to seek the truth which is before us and forsake the errors of the past." (page 9) (11)
    References
    1. Kent JT. Lectures on Homœopathic Philosophy. 2nd Ed. Chicago: Ehrhart & Karl, 1929.
    2. Close S. The Genius of Homœopathy. Philadelphia: Boericke & Tafel, 1924.
    3. Roberts HA. The Principles and Art of Cure by Homœopathy. 2nd Revised Edition. Rustington: Health Science Press, 1942.
    4. Boericke G. A compend of the Principles of Homœopathy for Students in Medicine. Philadelphia: Boericke & Tafel, 1929.
    5. Raue CG, Knerr CB, Mohr C, eds. A Memorial of Constantine Hering. Philadelphia: Press of Globe Printing House, 1884.
    6. Eastman AM. Life and Reminiscences of Dr. Constantine Hering. Philadelphia: Published by the family for private circulation, 1917.
    7. Knerr CB. Life of Hering. Philadelphia: The Magee Press, 1940.
    8. Hahnemann SC. The Chronic Diseases. Trans. by LF Tafel. Philadelphia: Boericke & Tafel, 1896.
    9. Hahnemann SC. Organon of Medicine. Trans. by W Boericke. Philadelphia: Boericke & Tafel, 1920
    10. Hahnemann SC. Organon of Medicine. Trans. by J Kunzli. Los Angeles: J.P. Tarcher, 1982.
    11. Hering C. Preface. In Hahnemann SC. The Chronic Diseases. Trans. by CJ Hempel. New-York: William Radde, 1845.
    12. Hering C. Preface to the first American edition. In the Organon of Homœopathic Medicine. New-York: William Radde, 1836.
    13. Hering C. Hahnemann's Three Rules Concerning the Rank of Symptoms. Hahnemannian Monthly 1865;1:5-12.
    14. Hering C. Analytical Therapeutics of the Mind. Vol 1. Philadelphia: Boericke & Tafel, 1875.
    15. Kent JT. Correspondence of Organs, and Direction of Cure. Trans Soc. Homœopathicians 1911;1:31-33.
    16. Loos JC. Homœopathic Catechism. Journal of Homœopathics 1898-1899;2:480-488.
    17. Mastin JM. Editorial. Critique 1908;15:277-278.
    18. Mastin JM. Editorial. Critique 1907;14:228-229.
    19. Hering C. Apis. North American Journal of Homœopathy 1880;29:29-35.
    20. Hering C. The Guiding Symptoms of our Materia Medica. Vol 1. Philadelphia: The American Publishing Society, 1879.

Author: André Saine, 1982 graduate of the National College of Naturopathic Medicine in Portland, Oregon. He is board-certified in homeopathy (1988) by the Homeopathic Academy of Naturopathic Physicians.
Presented at the Second Annual Session of the Homeopathic Academy of Naturopathic Physicians in Seattle, Washington, April 16-17, 1988.
Source: The Canadian Academy of Homeopathy.

La influencia de Emmanuel Swedenborg en la Homeopatía

Los médicos homeópatas norteamericanos del siglo XIX, Gram, Hempel, Boericke, Farrington, Grimmer, Tafel entre otros, y por sobretodo Hering y Kent, concibieron la doctrina médica homeopática a la luz de las enseñanzas filosóficas de Swedenborg y su modelo ontológico de la realidad.
George G. Starkey, discípulo y amigo personal de James Tyler Kent, quizás el gran maestro americano, destaca que no una sino muchas veces el Dr. Kent le decía sustancialmente estas palabras: “Toda mi enseñanza está fundada sobre la de Hahnemann1 y la de Swedenborg; las enseñanzas de uno y otro corresponden perfectamente.
La ley de curación siguiendo diferentes planos de grados y ordenes. El concepto de totalidad, unidad y sustancia simple. La concepción de la enfermedad como un nuevo orden existencial en el hombre enfermo devenido de una susceptibilidad individual predisponente y la consiguiente correspondencia de este orden en alguna de las sustancias experimentadas, son sólo algunas de las similitudes que llevaron a estos maestros de Homeopatía del pasado a profundizar el insondable pensamiento swedenborgiano.
Corresponde a este ensayo ampliar la concepción kentiana respecto de la influencia de los medicamentos homeopáticos y el sentido de la enfermedad y de la curación.

Trabajo completo: http://www.universidadcandegabe.org/files/Trabajos/m_candegabe/emmanuel_swedenborg.pdf
Fuente: Universidad Candegabe de Homeopatía

Las aportaciones de Masi Elizalde


Las aportaciones de Masi Elizalde a la Homeopatía pueden resumirse esquemáticamente así:
1-    Adopción del esquema antropológico tomista como marco de referencia para la mejor comprensión del hombre hahnemanniano sano y enfermo. Básicamente la adopción del concepto de “compuesto sustancial” y todo lo que ello implica.
2-    Dinámica miasmática
3-    Metodología para el estudio de la materia médica.


  1. EL ESQUEMA ANTROPOLÓGICO TOMISTA

A lo largo de su artículo Concepto de enfermedad y curación[1] Masi explica y argumenta su convicción de que el esquema antropológico que Hahnemann sustentaba era el mismo que sustenta la filosofía escolástica, en particular Santo Tomás de Aquino. En primer lugar, la idea de que el hombre es un compuesto sustancial, es decir que sus principios constituyentes (alma racional y cuerpo físico) conforman una nueva realidad (hombre) que no es el resultado de la mera aposición, mezcla o amalgama de los anteriores. Esta noción de compuesto sustancial es la base y fundamento antropológico del concepto psicosomático de enfermedad y curación, propio de la homeopatía.

También que el hombre, degradado por el Pecado Original, ha perdido su privilegiada posición edénica, sufriendo un merma en su naturaleza. En la actual situación el hombre sufre en la profundidad de su inconsciente el dolor de lo perdido. (A esta profunda sensación la llama psora primaria.)[2]

Ese dolor, dice Masi, se argumenta de manera general, como se aprecia en las patogenesias tomadas en su conjunto o en los síntomas de consulta tomados en su conjunto, en unos temas fundamentales, los núcleos,  que recuerdan intensamente el drama de la Caída tal y como se relata en el Génesis:
Núcleo de la transgresión, la falta o la culpa.
Núcleo de la pérdida y el sufrimiento.
Núcleo del recuerdo y la nostalgia.
Núcleo del temor al castigo
Núcleo de la disculpa y la justificación.
Pero cuál sea la naturaleza de esa falta en un caso particular está por determinar para cada medicamento y para cada paciente. De manera que en cada medicamento y en cada enfermo encontraremos de manera más o menos evidente los citados núcleos, argumentados de diversas maneras de acuerdo a la temática particular.
2. DINÁMICA MIASMÁTICA
El concepto de dinámica miasmática es muy sencillo: para Masi los miasmas no son entidades independientes, sino sólo aspectos distintos del sufrimiento, tendencias morbosas, actitudes reactivas. La psora es la única enfermedad, siendo sycosis ysyphilis únicamente modos equivocados de defensa ante el sufrimiento psórico. Estas defensas que se producen en clave de hipertrofia o de destrucción lo mismo en el plano físico que en el psíquico, componen, con el sufrimiento original (psora) un triángulo dinámico cuya comprensión permite, no sólo explicar la sintomatología conocida, sino también “predecir” actitudes que, no apareciendo en la patogenesia (porque las patogenesias son necesariamente limitadas), deben corresponder dinámicamente a lo que sí aparece. Así, si en una patogenesia encontramos síntomas que muestran un gran apego a la riqueza, al dinero, que calificamos de “sycosica”, habremos de admitir que la psora correspondiente a esa sycosis será la del temor de la pobreza, y en syphilis debemos adelantar el hallazgo de una liberalidad desordenada; todo lo cual, naturalmente debe ser confirmado por la clínica. En los medicamentos bien experimentados siempre se encuentran, más o menos desarrolladas, las tres tendencias morbosas (miasmáticas), y sin excepción se corresponden matemáticamente en sus argumentos.
3. METODOLOGÍA PARA EL ESTUDIO DE LA MATERIA MÉDICA
a) La organización de material patogenético
El material patogenético (igual que el clínico) puede organizarse, con vistas a su mejor comprensión, de muy diversas maneras.
-  En primer lugar tenemos el protocolo patogenético, en el que los síntomas aparecen agrupados por experimentadores y ordenados según el momento de su aparición.
-  Hahnemann y sus seguidores no conservaron las patogenesias según los protocolos originales, es decir, los síntomas en su orden de aparición, sino que los redistribuyeron por órganos y sistemas. Esta es ya una primera manipulación que algunos autores han considerado como muy grave, aunque a nosotros no nos lo parece porque creemos que tal distribución ayuda al estudio de la materia médica, y facilita su comparación con los síntomas de la clínica que también solemos recoger por órganos y sistemas.
-  También podemos reagrupar los síntomas, dentro de cada órgano o sistema, por orden alfabético. De ahí los repertorios.
-  Otros autores seleccionan, entre los síntomas patogenéticos, aquellos grupos de síntomas que recuerdan los síndromes de la patología y tratan de establecer la semejanza entre dichos grupos de síntomas y los mencionados síndromes.
-  Finalmente algunos seleccionan, tanto en el paciente como en las enfermedades, grupos de síntomas de acuerdo a su matiz miasmático y establecen la semejanza entre ambos según  determinadas series numéricas.
Ninguno de estos hace especulaciones metafísicas a propósito de la esencia íntima de las enfermedades. Ninguno inventa los síntomas de las patogenesias o del paciente. Todos dicen, y es un hecho cierto, estar aplicando el principio de semejanza. Cada uno de ellos ha utilizado un método para organizar los síntomas de las patogenesias y los síntomas de la clínica de manera que puedan ser comparados entre sí. Todos tratan de cumplir la ley.
En el método de Masi los síntomas se toman de las patogenesias, y se comparan con los de la enfermedad, pero cuando estos síntomas se organizan para su mejor comprensión, no se hace por orden cronológico, ni alfabético, ni sistémico, ni sindrómico, ni por series miasmáticas, ya que los miasmas[3] no son algo estático, sino que se agrupan por temas.
No obstante, Masi y su metodología han sufrido permanentes ataques que, como suele ocurrir, no se centran en los verdaderos errores que pueda haber en sus planteamientos sino precisamente en lo contrario, en lo que es incuestionable: se le acusa de especular en el vacío, de ignorar los hechos, los síntomas. Pero lo cierto es que los síntomas, tanto patogenéticos como clínicos, están en el centro de toda la reflexión, no hay forma de escapar de ellos (ni siquiera hacia la clínica convencional). Constituyen el núcleo de cada fase metodológica, se los estudia desde diferentes puntos de vista: antropológico, simbólico, lingüístico, y es preciso volver a ellos una y otra vez.
Si miráis con detenimiento las materias médicas puras veréis, ¡ay!, con dolor que son un verdadero galimatías, un inventario interminable de síntomas que, salvo unos pocos, se parecen terriblemente entre sí, de tal manera que tras varias páginas de lectura es prácticamente imposible para una mente normal recordar lo que ha leído. No digamos nada si nos adentramos sucesivamente en las páginas de varios remedios distintos. Esta circunstancia vuelve muy difícil la práctica de la homeopatía, y es lo que ha inducido a los distintos autores a intentar reagrupar el material de las distintas maneras que hemos visto anteriormente.
Pues bien, si seguimos mirando con atención esos listados de síntomas patogenéticos, observaremos la recurrencia de ciertos temas, de ciertos argumentos. No me extenderé en este punto que sólo la experiencia mostrará al lector con toda claridad. Así pues, sabemos que los síntomas de una patogenesia suelen mostrar una inusitada tolerancia a ser agrupados en temas, y también sabemos que estos temas suelen ser coherentes, guardar cierta relación entre ellos. Por consiguiente, aquí existe ya un principio de orden que como digo no es cronológico ni alfabético ni anatómico, sino que es temático.
Así, el primer paso en la metodología de Masi para el estudio de las patogenesias es establecer en lo posible un orden temático. Este orden temático no invalida los anteriores. Sólo es un nuevo modo, un modo más de organizar los síntomas. Esto permite, como digo, un principio de comprensión que es coherente con la condición racional del médico y del paciente. Vemos así que el sufrimiento humano se estructura alrededor de determinados argumentos, que se configura argumentadamente. Cada persona (y cada medicamento) muestra un determinado número de temas, siempre los mismos. Esto se refleja en el refranero popular con la frase “cada loco con su tema”. Somos así y es perfectamente razonable que esa condición de recurrencia en ciertos temas, a la que estamos naturalmente inclinados, se refleje en la manifestación de nuestra enfermedad.
Este hallazgo nos permite un nuevo modo de establecer la relación de semejanza, abriendo la posibilidad de valorar ciertas argumentaciones existenciales características del paciente que, no correspondiendo a un síntoma concreto de la materia médica o del Repertorio, no nos era dado utilizar anteriormente para la prescripción.
Así, un paciente nos habla de su necesidad de bastarse a sí  mismo, de lo horrible que sería estar imposibilitado y depender de los demás, y esto lo relaciona con cada uno de sus síntomas,  con sus deseos, con sus proyectos, y sentimos que eso es más importante que un mero síntoma porque impregna toda la vida del paciente. Otros insisten en temas tales como el amor, la muerte, el dinero, el servicio a los demás, la enfermedad, la seguridad, y estos temas cobran un importancia tal que de ninguna manera podrían ser considerados como meros síntomas. Por lo demás, en muchas ocasiones no hay modo de incluirlos en una repertorización al uso.
En los medicamentos encontramos los mismos temas, y en ocasiones con la misma importancia. Esto requiere establecer, como se ha dicho, un nuevo tipo de similitud.
b) La relación entre los temas
Los temas que hallamos en un medicamento pueden ser aparentemente inconexos, pero un estudio más detallado suele mostrar que están relacionados entre sí, resumiendo a menudo uno de ellos, por así decir, la esencia del remedio.
En algún momento de todo este estudio vislumbramos un sufrimiento nuclear que podría explicar toda la patogenesia, y que en sí mismo es inexplicable. A este sufrimiento básico, del que toda la enfermedad va a depender se le llama, en la metodología de Masi, “psora primaria”. También me excusaré de abundar en este tema dado que por otro lado será inexcusable su demostración práctica. Y es aquí donde empezamos a tomar contacto con la antropología tradicional, la antropología escolástica. Para Santo Tomás, la naturaleza humana está mermada, caída. Esta merma, este déficit proviene del  Pecado Original, un acto en el que el hombre, envidiando la naturaleza divina, quiso compararse a Dios, ser como Dios. A partir de ese momento toda la estructura psíquica y orgánica del hombre se vio comprometida, sobrevino el imperativo de la muerte y por lo tanto el de la enfermedad. Y ese acontecimiento radical (por más que simbólico), origen de lo que Masi llama psora primaria se manifiesta, como corresponde a la ortodoxia hahnemanniana, en una sensación que por lo que sabemos se refiere básicamente a una pérdida, a una minusvalía. La sensación de no ser feliz, la sensación de no ser querido, la sensación de no ser comprendido, la  sensación de la proximidad de la muerte, la sensación de ser injustamente tratado, etc.
Masi propone comparar la psora primaria con alguno de los aspectos del relato del Génesis y establecer (simbólicamente) con qué aspecto de la Divinidad se ha querido comparar ese individuo representado en la patogenesia, o en su caso el paciente. A esto es a lo que llama el drama metafísico. Adán quiso compararse con la totalidad de la naturaleza divina, pero cada hombre en particular (o cada medicamento) no tiene tanta capacidad, y se compara únicamente con un aspecto de ésta.
La confrontación entre la naturaleza divina y la humana puede parecer un poco fantástica, pero verdaderamente constituye, desde una perspectiva simbólica, el meollo del drama humano. Hay que pensar en ello sin prejuicios. Más allá de esto, en un terreno meramente práctico, la necesidad de dicha comparación para descifrar el daño, el sufrimiento que supone el drama metafísico, nos obliga al estudio de la teología y de la antropología.
De Dios nada sabemos, salvo que es. Lo que de Él predicamos se lo atribuimos, por eso decimos que son atributos: atributos divinos. Del hombre conocemos sus capacidades. Estas capacidades no siempre se realizan, no siempre están en acto. Por eso las llamamos potencias.
Entre las potencias del hombre y los atributos de Dios no existe sólo una diferencia de grado, sino por encima de todo una diferencia cualitativa: en el hombre se da el movimiento, los mejores logros del hombre requieren una actualización de sus potencias, un cambio, un gasto, un devenir. En Dios todo es acto, sea cual sea el atributo al que nos refiramos está presente en grado sumo sin un antes ni un después, no hay nada que deba ser desarrollado, perfeccionado, o meramente realizado, en Dios no hay devenir, es acto puro. Por eso, el intento del hombre de alcanzar por sus medios la naturaleza divina puede considerarse una locura, una falta de previsión[4]. Y sin embargo es eso precisamente lo que ocurre en cada momento de nuestras vidas.
Adquirir un mínimo de nociones escolásticas sobre los atributos divinos y las potencias humanas requiere un esfuerzo. Es esto lo que ha desanimado a muchos de los que se han interesado por las ideas de Masi. Algunos de éstos proponen un método abreviado, a saber, tomar los temas de la patogenesia y los temas del paciente, y simplemente establecer la posible semejanza entre unos y otros, con lo que obtendríamos todas las ventajas del método sin tanto trabajo. Sin embargo, los temas tal y como los obtenemos de las patogenesias no siempre son útiles, pueden ser equivocados, una simple fantasía del que investiga, una mera coincidencia de algunas palabras. Para que estos temas puedan ser utilizados como elementos de comparación en una homeopatía tan profunda, deben adquirir significado antropológico, deben poder integrarse dentro de una visión del hombre en su drama. No pocas veces he visto a principiantes (y no tan principiantes) enumerar en el estudio de una patogenesia temas sin la menor utilidad y sin el menor sentido. Tal vez una persona que haya profundizado algo más en la naturaleza humana pueda, de entrada, elegir los temas adecuadamente, pero siempre necesitará situarlos en el terreno en el cual el sufrimiento se genera, el hombre en el mundo, para adquirir su últimos significados; quedarse en la superficialidad del enunciado de los temas, por muy bien elegidos que éstos resulten, comporta el mismo peligro que quedarse en el enunciado de los síntomas, a saber que, llegado el decisivo momento de la consulta, el paciente no nos los diga con las palabras con que nosotros los hemos formulado, y no podamos entenderlo.
Una vez establecida la hipótesis de cuál puede ser el drama metafísico que resume el sufrimiento de tal determinado remedio, nos aguarda el trabajo de explicar, con base en esa hipótesis, todos y cada uno de los temas y todos y cada uno de los síntomas significativos del remedio. Para esta tarea nos ayudamos de los conocimientos a los que podamos recurrir, especialmente la simbología, la lingüística y la sabiduría popular, todo ello en el marco de la antropología escolástica, naturalmente. Si la hipótesis es acertada, debe poder explicar a plena satisfacción de cualquiera la totalidad de la patogenesia. La experiencia demuestra que estas explicaciones adquieren tal grado de evidencia que suele arrancar exclamaciones de asombro y alguna que otra risa nerviosa.
Ahora tenemos unos temas, que generalmente son muy pocos, en ocasiones sólo uno, tenemos un hipótesis sobre cuál ha podido ser el sufrimiento básico manifestado en la patogenesia, y que es de índole metafísica[5], y hemos podido explicar con dicha hipótesis la totalidad de la patogenesia, dinámica miasmática incluida. Debemos pues comprobar su utilidad clínica. Para ello será necesario que con los síntomas del paciente realicemos un trabajo análogo hasta que podamos descubrir en su sufrimiento un significado central que explique todo lo demás y que sea semejante al significado que exhibe un determinado medicamento. Generalmente si ello es posible, también lo será establecer la semejanza de los síntomas, y podremos hacer la prescripción con todas las garantías: semejanza de los síntomas repertorizables, semejanza de los temas y semejanza del drama metafísico, del núcleo de sufrimiento, de la psora primaria. Siguiendo un caso así podremos verificar que la curación comporta, además de la desaparición del cuadro clínico que trajo al paciente a la consulta, la desaparición también de ese sufrimiento radical que (como hipótesis) habíamos establecido en la base de todo el edificio morboso.

[1] Alfonso Masi Elizalde. Concepto de enfermedad y curación. Actas del Instituto Internacional de Altos Estudios Homeopáticos “James Tyler Kent”. Nº 1 al 7.
[2] Huelga decir que, en esta imputación de la enfermedad al Pecado Original, Masi no hace (como él mismo lo señala) sino ponerse a la cola de una larguísima tradición religiosa, filosófica y médica, que también han compartido explícitamente, como no podía ser de otro modo, muchos de los grandes clásicos de la homeopatía. Por otra parte, desde un punto de vista puramente clínico, el concepto de psora primariaconstituye el núcleo de la comprensión de la enfermedad psicosomática. La expresión “psora primaria” es original de Masi y, al contrario de lo que algunos piensan, jamás fue utilizada por Hahnemann. Denomina una profunda sensación de sufrimiento, una angustia sin referencias, un desasosiego casi inconsciente, que el método puede, hasta cierto punto, objetivar y relacionarlo con  el conjunto de la enfermedad, reconociéndolo como su causa.
[3] Las relación del autor con el concepto hahnemanniano de “miasma crónico” se ha deteriorado mucho en los últimos años. A este respecto, cfr. Fundamentos de nosología homeopática. Dilema, 2004. “Los errores de Hahnemann en la teoría de los miasmas crónicos”, pp. 237-245.
[4] Al hilo del concepto de “imprevisión” “imprudencia”, es dado recordar que un drama análogo queda recogido en el mito de Prometeo y Epimeteo.
[5] El drama metafísico representa, en última instancia, una equivocada relación del hombre con Dios. Hablando con propiedad, desde el punto de vista de Masi (que es un punto de vista religioso) debería llamarse “drama espiritual”.


Autor: Dr. Emilio Morales.

Vaccination and Homeopathy


Introduction
Vaccination presents a difficult choice. On one hand it is aimed to prevent serious diseases whose mere names terrifiy us, like polio or tetanus; on the other hand we tend to instinctively reject the idea of injecting young babies with pathological material. In 1796 Jenner tried his vaccine against smallpox and in 1799 Hahnemann used homoeopathic Belladonna as a preventive for Scarlet fever. Conventional medicine followed efforts to prevent disease in a manner similar to that used by Edward Jenner. Due to lack of systematic studies, homoeoprophylaxis was never established as a scientific and effective method of disease prevention.
The adverse effects of injecting ‘live’ bacteria and viruses are evident, but due to the huge government support and lack of other alternatives, the experimental work on vaccination continued. Later vaccination attempts were with killed pathogens. Nowadays vaccines are ‘attenuated’ or consist only of ‘antigenic proteins’. But even then, adverse reactions to conventional vaccines are not rare and efficacy of many vaccines is still questioned.
The National Vaccine Information Center (NVIC), in Adverse Effects of Vaccines: Evidence and Causality,reviewed by the Institute of Medicine Committee reported that more than 1,000 vaccines studies foundconvincing evidence of 14 health outcomes — including seizures, inflammation of the brain and fainting — that can be caused by certain vaccines. The Institute of Medicine admitted, “Vaccines are not free from side effects, or “adverse effects”. For the majority (135) of potential vaccine-related side effects reviewed, there was inadequate evidence to conclude whether or not vaccines caused the side effect.
In the last few decades, there has been a dramatic resurgence of homoeopathy around the world. This growth with increasing awareness about the bad effects of conventional vaccination has prompted many people to look for alternatives to conventional vaccination.

 Burnett & his vaccinosis

Burnett was the first Homoeopath to forcefully warned against the dangers of vaccination. He believed that vaccination generated a state of disease, not that of the disease intended to be protected against, but rather a similar low chronic state of ill health; a contracted miasm.
He argued that vaccination, as practiced by Pasteur and Jenner using material doses will eventually end in disaster, because it is temporary protection. It does not individualize the dose to the strength of individual and it brings long term chronic consequences.  Burnett warned against the reaction of individuals to particular vaccines on the basis of individual susceptibility back in 1884. In a recent report in August 2011 of IOM in review of adverse effects of vaccine, they clearly mention under the heading of susceptibility that ‘individuals with certain characteristics are more likely to suffer from cer­tain adverse effects from particular immunizations’. Modern medicine is late to actually realize the importance of individual characteristics for evaluating the adverse events of vaccination.
Burnett also noted that vaccination actually increases the mortality rate, because in addition to the vaccinosis incurred, if a person also catches the disease prophylaxis was intended to prevent, he or she is more likely to die from the disease than if had just caught the disease without vaccination.  Neil Z Miller and Gary S Goldman in their research published in Human and experimental toxicology found the positive correlation between the number of vaccine doses in the first year of life and increasing Infant mortality rates (IMRs)of a nation. The US childhood immunization schedule specifies 26 vaccine doses for infants aged less than 1 year—the most in the world—yet 33 nations have lower IMRs. The author concludes with a note ‘A closer inspection of correlations between vaccine doses, biochemical or synergistic toxicity, and IMRs, is essential’.
What Burnett said in the 18th century and what research reflects currently about adverse effects of vaccination is similar. We must think twice before denying facts in the present situation.

Concept of prevention of disease in Homoeopathy
Even before the field of bacteriology originated, Dr. Hahnemann advised immunization during pregnancy in footnote 164 for aphorism 284 of Organon of Medicine, 6th edition he directs to administer Sulphur during the first pregnancy, in order to protect the fetus from psora. He also mentions that such mothers give birth to children usually healthier and stronger.
The homoeopathic approach to epidemic diseases in general was first employed by Hahnemann in 1799, during an extensive scarlet fever epidemic in the province of Saxony. The principal remedy, which corresponded to the genus epidemicus (the main characteristics of the outbreak as a whole), was then given prophylactically to people exposed to the disease, and also to the patients in early stages of illness–before the critical point, when other remedies would sometimes be needed, was reached. The results were quite dramatic. Those so treated either did not get sick at all or suffered much milder illnesses, on the whole, than their compatriots who were not treated or who received the drugs and other heroic measures in standard practice at the time.
“What will cure a disease according to the law of similars will also prevent that same disease.”
Hahnemann mentioned in ‘on proposed remedy for Hydrophobia’ in his lesser writings, that ‘In like manner there cannot be any prophylactic of hydrophobia that does not prove itself to be at the same time a really efficacious remedy for the fully developed hydrophobia’.
Dr. Boenninghausen clearly wrote about preventive medicines in his lesser writings in a chapter on prevention of cholera, ‘Of course, these are and can be only such remedies as are able to cure the disease after it has broken out, which indeed is the first and most necessary requisite of all prophylactics, and without which they would not deserve the least confidence’.
Since the early years of development of Homoeopathy the concept of prevention of disease was clear in Hahnemann mind. Now we are using it with more confidence and we have evidence to prove it to the scientific world.  Homoeopathic medicines can serve as the best preventives as well as curative for any epidemic disease.

Current literature on Homoeoprophylaxis
‘Prevention is better than cure’
Homoeopathy offers a unique perspective on the treatment and prevention of contagious diseases. Rather than aiming treatment at removal of the offending pathogen, homoeopathy focuses on treating the susceptibility of the individual. With reduction in susceptibility, disease naturally goes away. If an individual susceptibility is treated prior to exposure, the disease will have less impact. The best preventive treatment is constitutional treatment.
Kate Birch in her book on vaccine free prevention of infectious contagious diseases with homoeopathy mentions ‘Preventive remedies could be the nosode of that disease, the nosode of miasmatically related diseases or medicines prescribed on a constitutional basis. Administration of the nosode of particular diseases delivers an energetic form of the disease which is more effective in addressing the underlying susceptibility to the disease and effecting prevention without introducing actual harmful germs or incurring the negative side effects of vaccination. This power of the nosode is proved in a recent study conducted in Cuba for prevention of Leptospirosis using the strains of the causative bacteria as a Nosode for prevention.
  • Leptospirosis epidemic control
Cuba goes through a yearly cycle of a Leptospirosis epidemic, especially after the hurricanes flood the countryside and water pollution reaches its height. Many people are left homeless, flooded out and under the stress of a disaster situation.
A homeoprophylactic formulation was prepared from dilutions of four circulating strains of Leptospirosis. This formulation was administered orally to 2.3 million people at high risk for epidemic in a region affected by natural disaster. The data from surveillance were used to measure the impact of the intervention by comparing with historical trends and non-intervention regions. After the homeoprophylactic intervention, a significant decrease of the disease incidence was observed in the intervention region. No such modifications were observed in non-intervention regions.
An study was published in the international journal ‘Homeopathy’ (2010) which concluded that the homeoprophylactic approach was associated with a large reduction of disease incidence and control of the epidemicThe results suggest the use of HP as a feasible tool for epidemic control, further research is warranted.
  • Prevention of Japanese encephalitis  with miasmatic prescription
A study was conducted by the Government of Andhra Pradesh from 1999 to 2004. This project was named B.C.T, as prophylactic drugs, Belladonna 200 on 1st ,2nd , and 3rd  day one dose each, Calcarea carb 200 on 10th day and Tuberculinum 10M on 25th day were administered in phase manner to all children between the age of 0 -15 in the month of August every year for three consecutive years.
Symptoms similarity, complementary relationship, virulence and underlying miasm were taken into consideration for selection of medicines. After its commencement in 1999 the mortality and morbidity rates of J.E. fell drastically. 343 cases were reported in 2000 with 72 deaths; In 2001 only 30 cases with 4 deaths; in 2002 only 18 cases but no deaths; In 2003 and 2004 no cases were recorded.
  • In-Vitro study on prevention of JE with Belladonna
The in-vitro study was aimed at assessing the prophylactic action of Belladonna in Homoeopathic potencies on Chorioallantoic Membrane (CAM) of chick embryo infected with JE virus. A study published in 2010 in theAmerican Journal of Infectious Diseases by researchers of Kolkata’s School of Tropical Medicine and the Central Council for Research in Homeopathy (CCRH) showed that the homeopathic medicine Belladonna prevented infection in chick embryos infected with the Japanese Encephalitis virus. The study showed significant decrease in the viral load when treated with Belladonna in different potencies, in comparison to placebo.
In 1974, during an outbreak of Meningococcal disease in Brazil, 18,640 children were protected homeopathically against Meningococcal infection, and 6,340 were not. The following results were obtained:
18,640 protected homeopathically – 4 cases of Meningococcal infection.
6,340 not protected – 32 cases of Meningococcal infection.
Based on the infection (attack) rate in the unprotected group, 94 cases of infection would have been expected in the homeopathically protected group. Instead, there were only four cases of Meningococcal infection, showing that the homeopathic option was 95% effective against Meningococcal disease.
The results of the first study led to the Brazilian government funding a larger study in 1998. It was conducted by two Professors of Medicine from the University Foundation in Blumenau, Brazil, and a Blumenau specialist physician and Health City Secretary.
A total of 65,826 people between the ages of 0-20 were protected homeopathically against Meningococcal disease while 23,532 were not. Over a 12 month period, the following results were obtained:
65,826 protected homeopathically – 4 cases of Meningococcal infection.
23,532 not protected – 20 cases of Meningococcal infection.
Based on the infection (attack) rate in the unprotected group, 58 cases of infection would have been expected in the homeopathically protected group. Instead, there were only four cases of Meningococcal infection. Statistical analysis showed that homeopathic protection offered 95% protection in the first six months and 91% protection over the year against Meningococcal disease.
  • Homoeoprophylaxis Research
In 1986, Australian homeopath Dr. Isaac Golden began a formal research study of homeopathic immunization. Over the course of 15 years, between 1988-2003, he gave homeopathic immunization against childhood diseases to 2342 children whose parents participated in his survey. He tabulated the survey responses, and found that the overall effectiveness of homeopathic immunization is 90.4%. Therefore, the effectiveness of homeopathic immunization is the same as, or in some cases even better than standard vaccinations. Unfortunately, neither homeopathic immunization nor standard vaccinations can offer 100% protection from a disease.
Between 2001-2004, Dr. Golden did a study of the relative safety of vaccination vs. homeopathic immunization. He surveyed parents of 781 children; some used vaccinations and some used homeopathic immunization. Dr. Golden found that children who received standard vaccination were 15 times more likely to get asthma, 7 times more likely to get eczema, and 2 times more likely to get allergies than those who used homeopathic immunization.

From the current literature it is evident that homoeoprophylaxis has the scientific data to progress in the future in the field of prevention of infectious diseases. Well designed rigorous clinical trials with good sample size exploring the efficacy of homoeopathic medicine in diseases like diphtheria, tetanus, pertussis is need by the profession. Presently conventional vaccination is dominant and mandatory by government policy for all the children. In this scenario Homoeopathy can serve people by assisting in neutralizing the bad effects of vaccination or vaccine injury. There are many drugs effective in vaccine injury.
  • Role of Homoeopathic Medicines  in Vaccine injury
Homoeopathic medicines were prescribed to strengthen the constitution, to remove the miasmatic influences and to recover from the bad effects of vaccination. Selection of medicine will depend upon the reaction of the individual to vaccination, his state of immunity and the patient’s present state of health.  The most commonly used medicine for bad effects of vaccination is Thuja, king of anti- sycotic remedies. It was used by Burnett for bad effects of vaccination (Smallpox) and he explored its effects in his book on vaccinosis through different case discussions.  Now in practice we are using Thuja, Silicea, Antim tart etc. successfully for bad effects of vaccination.

Thuja Occidentalis:
Thuja is indicated in 22 rubrics in different chapters in the “after vaccination” rubric in ‘Complete repertory’. It is indicated for symptoms after vaccination like anxiety; head pain; inflammation of eyes & conjunctiva; stomach pain; diarrhoea; asthma; emaciation of upper limb & paralysis of lower limb; suppuration of finger nails; felon paronyhia; swelling of shoulder & upper arm. In the Generalities chapter it is indicated for symptoms after smallpox vaccination; as prophylactic and in convulsion after vaccination. Because of this wide coverage of Thuja along with other remedies in our repertory, we have a powerful armamentarium in our hands to deal with vaccine injury.

Silicea:
Indicated in Scrofulous, rachitic children, with large head, open fontanelles and sutures, distended abdomen, slow in walking. For ill effects of vaccination. Symptoms of imperfect assimilation and consequent defective nutrition.

Antim Tart:
Indicated for bad effects of vaccination when Thuja fails and Silicea is not indicated.  Great sleepiness or irresistible inclination to sleep with nearly all complaints.  It has thickly coated tongue and desire for apples.  The child clings to those around; wants to be carried and doesn’t want to be touched.

Malandrinum:
An effective protection against small-pox and ill effects of vaccination.  Dry scaly itching; rhagades of hands and feet in cold weather and from washing.

Hypericum:
Indicated in injuries from needles, pins, splinters, from rat- bite. Prevents lock-jaw. Injury to the parts rich in sentient nerves, which are very painful. Nervous depression following wounds or surgical operations; removes bad effects of shock, of fright, of mesmerism.

Crotalus Horridus:
Indicated in diseases caused by a previous low state of the system. For dissecting wounds, insect stings, bad effects of vaccination. Malignant diphtheria or scaletina; edema or gangrene of fauces or tonsils.
Vaccination is always a controversial topic; we need to think in depth on the bad effects of conventional vaccination on the health of the child. Homoeopathy offers an option for disease prevention and cure.  There is scientific evidence in favour of homoeopathy for prevention of diseases. Detailed research in homoeoprophylaxis will show the positive path for the future.

References:
  1. Neil Z Miller and Gary S Goldman. Infant mortality rates regressed against number of vaccine doses routinely given: Is there a biochemical or synergistic toxicity? Human and Experimental Toxicology, 30(9) 1420–1428.
  2. Little Mountain Homeopathy, Vancouver, BC 604-677-7742  http://www.littlemountainhomeopathy.com
  3. Kate BirchVaccine free prevention and treatment of Infectious Contagious Disease with Homeopathy, 2008, B.Jain Publishers, New Delhi.
  4. Johann Loibner. Vaccination and Homoeopathy, 2008, http:// www.hpathy.com .
  5. AHZ2005; 250;DOI:0.1055/s-2005868696 Available online http://www.thieme-connect.com/ejournals/abstract/ahz/doi/10.1055/s-2005-868696
  6. Gustavo Bracho, Enrique Varela, Rolando Fernandez et.al. Large- sacle application of highly- diluted bacteria for Leptospirosis epidemic control, Homeopathy, 2010, 99,156-166.
  7. Bhaswati Bandyopadhyay, Satadal Das, Milan Sengupta et.al. Decreased intensity of Japanese encephalitis virus infection in chick Chorioallantoic membrane under influence of ultra diluted belladonna extract, American Journal of Infectious Diseases, April 2010.
  8. J.C.Burnett. On Vaccinosis and its Cure by Thuja Occidentalis with remarks on Homoeoprophylaxis,Pratap medical Publishers, New Delhi.
  9. Dr. Isaac Golden. Vaccination & Homoeoprophylaxis? A review of risk and Alternatives, 6th edition.
  10. R.E.Dudgeon. The Lesser writing of Hahnemann, reprint edition 2002, B.Jain Publishers, New Delhi.
  11. William Boericke. Pocket Manual of Homoeopathic Materia Medica & Repertory, B.Jain Publishers, New Delhi.
  12. H.C.Allen. Allen’s key Notes and characteristics, B.Jain Publishers, New Delhi.
  13.  Adverse effects of vaccines evidence and causality. August 2011 www.iom.edu/vaccineadverseeffects

Author: Dr. Rupali Dixit Bhalerao M.D. (Hom) pediatrics, currently works as a Senior Research Fellow, at CCRH, New Delhi. Her articles and studies have been published in Homeopathy, Indian Journal of Research in Homoeopathy, International Journal of Bio-Research, Masod, Homoeopathy For All, The Homoeopathic Heritage, Vital Informer, National Journal of Homoeopathy, Homoeotimes and www.audesapere.in/ejournal . Dr. Bhalerao has been involved in numerous research projects and presented a co-authored paper on HIV at LIGA 2011.
Source: Hpathy.com