Use of Homeopathy in patiative care

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I) HOMEOPATHY METHODOLOGY

Homeopathy is a therapeutic system based on the principle of similarity and two corollaries: the principle of infinitesimal and globality. Here is the definition adopted by the homeopathy Commission on December 97 to the National Physician Order: "Homeopathy is a therapeutic method based on Hahnemann's conceptual tripod: similarity globality and infinitesimal. It consists of "administrating at very low or infinitesimal doses of active substances to the healthy patient which may lead to similar symptoms presented by the sick. The correct application of the method involves, after diagnosis, the comparison by the doctor of all symptoms of the condition and individual reactions demonstrated by the patient with the pathogenesis of drug use. (ref 1; 2)

• The similarity principle (ref 3)

"Any substance capable of causing in a healthy and sensitive patient a set of symptoms can cure a patient with the same symptoms." Symptoms and remedies are collected in medical materials. They are obtained from poisoning archives, experiments on the "healthy and sensible" patient and by the feedback obtained by the homeopath's experiences. There are several medical materials according to the sensitivity of the authors and their perception of the remedy. It refers to "pathogenesis" the testing of each substance in a volunteer "Healthy and sensible" patient. The research still continues and agglomerates today. Each remedy may be based on several hundred symptoms, the homeopath is using a repertory: the most used is the Kent's repertory or computer software to cross the most appropriate remedy to all of the symptoms presented by the patient. More than 4,000 substances have been used: mineral, plant, animal, or even some from the patient itself. The diversity of the origin of the substances explains the confusion with other forms of exercise including herbal medicine or aromatherapy.

• The infinitesimal principle

Hahnemann found that lowering the dose during his experiments reduces the number of side effects and increases the therapeutic effects. In addition, the infinitesimal principal allowed making active inert substances such as Natrum muriaticum (sea salt) or Calc (oyster limestone). This infinitesimal dilution should be carried out by dynamic to be considered effective. The dynamic is the hundred shaking the tube taken at each dilution during the creation of the drug.

This principle regularly leads controversy because no modern theory is able to explain the action of infinitesimal dilutions as to demonstrate its efficiency.

As for the dynamic, experimental result of accidental discoveries, are not based on a scientific basis.

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i) Dillution principle

• The globality principle (ref 3)

The disease is defined by Hahnemann as an energy imbalance and the drug as an energy force that restores the balance. This is to take the individual in his whole and in its vital force, and not to perform a simple physical palliation of local symptoms.

Homeopathy is based on the premise that the body has in it the strength to generate a natural healing process. It is more important in the mind of Hahnemann to find ways to stimulate the natural healing process inherent in all living things, that to know the specific cause of the disease.

II) THE EVALUATION OF ISSUE AND HOMEOPATHY

EFFECTIVENESS

1. The unsuitability of evaluating tools

In unicist homeopathy, the physicians search an individualized treatment for his patient. However, the therapist symptom analysis based on its sensitivity and cures the patient.

We understand the difficulty of a large-scale study of different patients, though having the same disease, assessed by different homeopaths (unicist, pluralistic, complexiste), using tools from allopathic medicine. The study benefit / risk versus placebo treatment for a disease is not appropriate to the research for a cure for an individual patient. However, research attempts have been made according to the actual scientific methods to assess the superiority of homeopathy compared to a placebo effect. (ref 9)

The different currents of homeopathy

- The unicism: It is directly derived from its founder Hahnemann. The homeopathy aims to find a single remedy that can synthesize different symptoms presented by the patient.

- Pluralism: Near the allopathic reasoning, the homeopath approaches the patient under symptomatic angle. He prescribed several remedies based on the patient's symptoms, considered non-systemic. (This is the common method in France)

- The Complexisme: Homeopathic product contains several remedies in the same bottle. It is a drug ready for use and assumes that of the remedies might be effective for the patient.

2. Four meta-analyzes of correct methodology:

a (ref 10)- In 1991, Kleijnen and other confreres conducted a meta-analysis of 105 trials with analyzable results. They concluded that the evidence was sufficient to indicate a statistically favorable result to homeopathy.

b (ref 11)- The following meta-analysis, conducted in 1997 by Linde and other confreres reviewed 89 trials that the authors considered acceptable. According to the authors' conclusions, it was improbable that the clinical effects of homeopathy were completely due to placebo effect. They did not have enough evidence to conclude that homeopathy was effective against a given disorder. However, the method of selecting studies has been questioned.

c (ref 12)- Another meta-analysis of 1998 by Linde and Melchart, has helped

to compare individualized homeopathy with another treatment, at a placebo or at the absence of treatment. In the 19 trials that provided sufficient data, homeopathy was much more effective than placebo. When the tests were limited to the most robust methodology, no significant results were observed. It was then impossible to draw firm conclusions about the overall effectiveness of homeopathy due to the poor quality of the trials and the unknown role of publication bias.

d (ref 13)- In 2005, a meta-analysis published in the Lancet by a group of eight researchers Swiss and British led by Dr. Shang