2. Homeopathy Introduction to Homeopathy

3. Principles Asystem of medicine based on the principle of “like cures like” -similia similibus curentur Uses Uses the smallest dose possible to produce a response

4. Origins This principle was first described in Hindu writings over 3000 years ago This principle was first described in Hindu writings over 3000 years ago Also mentioned by Hippocrates, Galen in the 2nd century and Paracelsus in16th century Also mentioned by Hippocrates, Galen in the 2nd century and Paracelsus in16th century More recently researched by a German physician Samuel Hahnemann who developed “Homoeopathy” More recently researched by a German physician Samuel Hahnemann who developed “Homoeopathy”

5. Hahnemann Disillusioned physician Disillusioned physician Tried cinchona bark Tried cinchona bark Gave preparations to family and students to prove Gave preparations to family and students to prove Diluted medication Diluted medication Remedies Remedies

6. Examples of the similia principle Peeling an onion leads to sore, runny eyes, itchy nose and sneezing - Allium cepa used to treat hayfever and colds Peeling an onion leads to sore, runny eyes, itchy nose and sneezing - Allium cepa used to treat hayfever and colds nettle stings produce a burning, itchy wheal on the skin - Urtica urens is a good remedy for similar skin lesions nettle stings produce a burning, itchy wheal on the skin - Urtica urens is a good remedy for similar skin lesions arsenic poisoning causes severe vomiting and diarrhoea with burning pains and chilliness - Arsenicum alb. V. effective in gastroenteritis and food poisoning arsenic poisoning causes severe vomiting and diarrhoea with burning pains and chilliness - Arsenicum alb. V. effective in gastroenteritis and food poisoning

7. Examples of the similia principle in medicine Radiotherapy which is used to treat cancer also causes it Radiotherapy which is used to treat cancer also causes it Amphetamines which produce hyperactivity, are used to treat hyperactive children Amphetamines which produce hyperactivity, are used to treat hyperactive children Immunisation Immunisation treatment of erythromelalgia with Praxilene? treatment of erythromelalgia with Praxilene?

8. Basis of Treatment Homeopathy works with the body’s response to illness and remedies are prescibed according to the symptoms Homeopathy works with the body’s response to illness and remedies are prescibed according to the symptoms one remedy can be used to treat several ailments one remedy can be used to treat several ailments one ailment may need to be treated with different remedies in different patients one ailment may need to be treated with different remedies in different patients

9. Materia medica Known symptoms produced by poisonings Known symptoms produced by poisonings Symptoms produced by provings Symptoms produced by provings Symptoms relieved when remedy given for other symptoms Symptoms relieved when remedy given for other symptoms

10. Selecting the remedy Detailed Homeopathic history Detailed Homeopathic history Repertorization Repertorization Materia medica Materia medica

11. Homeopathic history Details of presenting complaint - aetiology, aggravations, ameliorations, modalities Details of presenting complaint - aetiology, aggravations, ameliorations, modalities Aetiology : trauma, bereavement, never well since -pregnancy, menopause, glandular fever Aetiology : trauma, bereavement, never well since -pregnancy, menopause, glandular fever Aggravations : conditions that make symptoms worse Aggravations : conditions that make symptoms worse Ameliorations : improve symptoms Ameliorations : improve symptoms Modalities : conditions qualifying a symptom Modalities : conditions qualifying a symptom

12. Homeopathic history General symptoms - patients’ reaction to their environment, heat, cold, weather General symptoms - patients’ reaction to their environment, heat, cold, weather Food likes or dislikes, e.g. crave pickles,like fat Food likes or dislikes, e.g. crave pickles,like fat periodicity - frequency of symptoms - monthly, weekly, yearly periodicity - frequency of symptoms - monthly, weekly, yearly

13. Mind or Mental symptoms Placid, anxious, Placid, anxious, Anxious on anticipation Anxious on anticipation Depressed Depressed Weepy Weepy Consolation Consolation Easily bored Easily bored Jealous Tidy Fears Company Shy Routine Resentments

14. General appearance Vivacious red-head Vivacious red-head Nervous Nervous Laid-back absent minded professor Laid-back absent minded professor Prim and proper Prim and proper Scruffy Scruffy Extremely neat and colour co-ordinated Extremely neat and colour co-ordinated Weepy blonde Lacks energy Flabby handshake Closed Shy, hides behind mother Anxious to please, maintain eye contact

15. The relevant kingdom Animal, Mineral or Vegetable (Plant) Animal, Mineral or Vegetable (Plant) Animal – hunter/ hunted, victim, prey, pursued, escaping, nurturing, flying, pouncing, caged, free Animal – hunter/ hunted, victim, prey, pursued, escaping, nurturing, flying, pouncing, caged, free Mineral – structural terms, cracking, crumbling, stable/ unstable, falling apart Mineral – structural terms, cracking, crumbling, stable/ unstable, falling apart Plant – sensitive to surroundings e.g light, warmth, smells, cold, damp, Plant – sensitive to surroundings e.g light, warmth, smells, cold, damp,

16. Repertorization Repertory contains details of symptoms produced by remedies listed under bodily systems e.g. mind, vertigo, head, eye, vision, ear, hearing, nose, face etc. Repertory contains details of symptoms produced by remedies listed under bodily systems e.g. mind, vertigo, head, eye, vision, ear, hearing, nose, face etc. e.g. heartburn after eating - Aesc. agar. Am.c. anac. Calc. Calc. p. carl. Chin. Cocc.c. con. Croc. Graph. Iod. Lyc. Merc. Nat. mur. Nit. Ac. Nux v. Sep. Sil. e.g. heartburn after eating - Aesc. agar. Am.c. anac. Calc. Calc. p. carl. Chin. Cocc.c. con. Croc. Graph. Iod. Lyc. Merc. Nat. mur. Nit. Ac. Nux v. Sep. Sil.

17. Repertorisation cont. Strong features of the history in each area - mind, generals and local symptoms Strong features of the history in each area - mind, generals and local symptoms The strength of a symptom in a rubric is indicated by the type, The strength of a symptom in a rubric is indicated by the type, i.e. bold type-strongly present, i.e. bold type-strongly present, italic - moderate, italic - moderate, ordinary type - symptom present for that remedy ordinary type - symptom present for that remedy

18. Further considerations Aetiology Aetiology Peculiar symptoms e.g. Peculiar symptoms e.g. burning sensation > warm applications burning sensation > warm applications asthma > lying down asthma > lying down feels exceptionally well day before headache feels exceptionally well day before headache Symptoms can then be fed into a computer Symptoms can then be fed into a computer

19. Remedies These are prepared from :- These are prepared from :- minerals, minerals, plants, plants, fish, fish, insects, insects, snakes and disease products snakes and disease products

20. Sepia - ink sac of the cuttle fish Irritable, intolerant of contradiction Irritable, intolerant of contradiction Weepy, depressed, easily offended Weepy, depressed, easily offended Can’t be bothered, can’t cope Can’t be bothered, can’t cope Indifferent to family, wants to run away Indifferent to family, wants to run away Brunettes, butterfly rash on face Brunettes, butterfly rash on face

21. Pulsatilla - wind flower Mild, yielding disposition, shy, blush Mild, yielding disposition, shy, blush Fair, fat, forty, blue-eyed Fair, fat, forty, blue-eyed Laughs and cries easily, craves sympathy Laughs and cries easily, craves sympathy fresh air, fresh air, < damp > gentle movement, restless > gentle movement, restless Absence of thirst, dislike and upset by fat, pork, spicy food Absence of thirst, dislike and upset by fat, pork, spicy food

22. Sulphur Absent minded professor Absent minded professor Scruffy with dirty skin Scruffy with dirty skin < heat < heat Desires fat, salt, sweet Desires fat, salt, sweet Skin ailments Skin ailments Lazy, selfish, irritable Lazy, selfish, irritable Hungry 11a.m. Hungry 11a.m.

23. Case History 40 yr old lady 40 yr old lady Depressed, indifferent to family Depressed, indifferent to family lacks affection lacks affection anxious about finances anxious about finances wants to be alone wants to be alone > dancing,walking quickly > dancing,walking quickly craves vinegar premens craves vinegar premens Indifferent to loved ones : Acon. Ars. Fl.ac.Hell. Merc. Nat.p. Phos. Plat. Sep. Fear of poverty:Ambr.Bry.Calc Calc.f.chlor. Meli. Nux v. Psor. Puls. Sep. Sulph. > alone: Bar.c.Lyc. Nat c. Nat m. Plb. Sep.Stann. Staph. > walking fast: Arg n.Canth. Carb ac. Ign. Nat m. Petr. Sep. Stann. Sul ac.Tub. Desires vinegar: Apis.Arn. Ars. Hep. Kali p. Sep. Sulph

24. Preparation of the Remedies Whole plant is macerated in alcohol mother tincture Whole plant is macerated in alcohol mother tincture 1 drop added to 9 or 99 of solution results in 1X or 1C potency 1 drop added to 9 or 99 of solution results in 1X or 1C potency Succussed in between dilutions Succussed in between dilutions Standard potencies :- 6C, 30C, 200C, 1M, 10M, 50M Standard potencies :- 6C, 30C, 200C, 1M, 10M, 50M

25. Prescription 6C for local symptoms e.g. joint pain, skin eruptions 6C for local symptoms e.g. joint pain, skin eruptions 30C for acute illness e.g. influenza, diarrhoea and vomiting, childhood illnesses 30C for acute illness e.g. influenza, diarrhoea and vomiting, childhood illnesses 200C if giving nosodes e.g. glandular fever nosode, pertussis, measles vaccine 200C if giving nosodes e.g. glandular fever nosode, pertussis, measles vaccine 1M or 10M for strong emotional symptoms e.g. grief, P.M.T., depression, anxiety etc. 1M or 10M for strong emotional symptoms e.g. grief, P.M.T., depression, anxiety etc.

26. Instructions for taking remedies Homeopathic remedies are very delicate and should not be handled. Homeopathic remedies are very delicate and should not be handled. They are absorbed from the mouth and so are sucked not swallowed. They are absorbed from the mouth and so are sucked not swallowed. Should not be taken near food or drink as these may interfere with the absorption. Should not be taken near food or drink as these may interfere with the absorption. Store away from strong smells. Store away from strong smells.

27. Direction of cure From top to bottom From top to bottom From inside to outside From inside to outside From an important organ to a lesser one From an important organ to a lesser one May develop “old symptoms” May develop “old symptoms”

28. The clinical place for homeopathy Where there is no effective allopathic alternative Where there is no effective allopathic alternative Where conventional medication is unsafe Where conventional medication is unsafe Where allopathy has unacceptable side- effects Where allopathy has unacceptable side- effects To minimise the use of allopathy To minimise the use of allopathy

29. No effective allopathic treatment Allergies Allergies Anger Anger Bruises Bruises Colic Colic Fear/phobias Fear/phobias Glandular fever Glandular fever Grief Grief Influenza Influenza Mastalgia M.E./chronic fatigue Nightmares Premenstrual syndrome Teething Urethral syndrome Warts

30. Where conventional medication is unsafe Pregnant women Pregnant women Young children and babies Young children and babies The elderly The elderly Anticipatory anxiety Anticipatory anxiety

31. Where the side effects of allopathy are unacceptable Anxiety Anxiety Depression Depression Menopausal symptoms Menopausal symptoms Osteoarthritis Osteoarthritis Situations requiring repeat antibiotics Situations requiring repeat antibiotics

32. To minimise the use of allopathy Asthma/eczema Asthma/eczema Constipation Constipation Dysmenorrhoea Dysmenorrhoea Hypertension Hypertension Migraine Migraine Neuralgias Neuralgias Recurrent otitis media/ U.T.Is/ sore throats Recurrent otitis media/ U.T.Is/ sore throats

33. The rewards of homeopathy Patient satisfaction Patient satisfaction Effects on consultation technique Effects on consultation technique Intellectual achievement Intellectual achievement The joy of detective work The joy of detective work Understanding aetiology Understanding aetiology Personal satisfaction and fulfillment Personal satisfaction and fulfillment

34. Overall Outcome of Treatment with Homoeopathy - GHHOS 1 = No change 2 = Slight change Improvement in wellbeing but not PC 3 = mod improvement 4 = good improvement No symptoms as long as continue with remedies 5 = cure Asymptomatic without remedies 68% range from 3-5

35. Conditions referred for homeopathy in 2004 Asthma/eczema/allergies/hayfever - 17% Asthma/eczema/allergies/hayfever - 17% Menopausal and PMT symptoms – 16% Menopausal and PMT symptoms – 16% Rheumatological symptoms - 13% Rheumatological symptoms - 13% Chronic fatigue syndrome - 10% Chronic fatigue syndrome - 10% ADHD, IBS, UTIs, neuralgia, candidiasis, depression and anxiety, headaches, migraine, etc. ADHD, IBS, UTIs, neuralgia, candidiasis, depression and anxiety, headaches, migraine, etc.

36. 1 – No Change 1 – No Change 2 – Sl Improvement 2 – Sl Improvement 3 = Mod Improvement 3 = Mod Improvement 4= Good Improvement 4= Good Improvement 5 = Complete Cure 5 = Complete Cure Audit of Homeopathic treatment for Rheumatology diseases

37. Outcome of Menopausal Symptoms 20% no change 10% improvement in wellbeing 30% some improvement 34% asymptomatic - on remedies 6% asymptomatic - no remedies

38. The evidence for homoeopathy

39. RCTs - the meta-analyses Kleijnen J, Knipschild P, Ter Riet G. Clinical trials of homeopathy. British Medical Journal 1991; 302 (Feb 9) : 316-323. Kleijnen J, Knipschild P, Ter Riet G. Clinical trials of homeopathy. British Medical Journal 1991; 302 (Feb 9) : 316-323. Linde K, Clausius N, Ramirez G, Melchart D,et al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo- controlled trials. The Lancet 1997; 350 (Sep 20): 834-843. Linde K, Clausius N, Ramirez G, Melchart D,et al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo- controlled trials. The Lancet 1997; 350 (Sep 20): 834-843.

40. Kleijnen’s conclusion They found that of 107 trials with interpretable results, 77 were positive. They found that of 107 trials with interpretable results, 77 were positive. They then looked at a sub-group of the most rigorous trials and discovered that 15 out of 22 found homeopathy to be superior to placebo. They then looked at a sub-group of the most rigorous trials and discovered that 15 out of 22 found homeopathy to be superior to placebo. One of Kleijnen’s conclusions was that the evidence found : would probably be sufficient for establishing homeopathy as a regular treatment for certain conditions. One of Kleijnen’s conclusions was that the evidence found : would probably be sufficient for establishing homeopathy as a regular treatment for certain conditions.

41. Linde’s conclusion Linde’s conclusion is “The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo”. Linde’s conclusion is “The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo”. A reading of the study shows a clearly positive result for homeopathy A reading of the study shows a clearly positive result for homeopathy 42% of the trials were clearly positive and a further 39% showed a positive trend 42% of the trials were clearly positive and a further 39% showed a positive trend

42. Useful Addresses British Homeopathic Association, British Homeopathic Association, Hahnemann House, 29 Park Street, Luton, LU1 3BE. www.britishhomeopathic.org Academic Department, Glasgow Homeopathic Hospital, 1053 Great Western Road, Glasgow, G12 0XQ

43. Why learn homeopathy Your patients will be using it Your patients will be using it Your colleagues will be using it Your colleagues will be using it There is a clinical need for it There is a clinical need for it It is rewarding It is rewarding