medicines are manufactured from substances of plant, mineral, animal, or even disease origin. The preparation of each medicine is specified in monographs approved
by the HPCUS.
Preparation of a Homeopathic Medicine
The original substance is initially dissolved in pharmaceutical alcohol. One part of this solution is mixed with nine (decimal, D, or X) or ninety-nine (centesimal, C, or
CH) parts of distilled water or pharmaceutical alcohol and vigorously agitated, or succussed. This process of serial dilution and agitation is carried out until the desired
potency is achieved. The dilution of typical low potency remedies range from 6X (10
-6
) to 12C (10
-24
), intermediate potencies from 30X (10
-30
) to 200C (10
-400
), and
high potencies from 1000C or 1M (10
-2000
) to 100M or CM (10
-100,000
). Substances that are insoluble in water or alcohol are initially triturated—ground in a mortar and
pestle—and then serially diluted using lactose in a manner parallel to the liquid method. At the concentration at which the lactose mixture becomes soluble,
preparation continues using alcohol dilution. The solution in which the medicines are prepared may be used directly, sprayed on sugar pellets of various sizes, or
mixed with lactose and pressed into a tablet form.
A standard dose of a homeopathic medicine is 1 to 5 pellets, taken sublingually, with nothing else in the mouth for 10 minutes before or after the dose. The dose is
repeated when the action of the first dose is exhausted; this can range from minutes to years, depending on the response. During the time a patient is using
homeopathy or the action of the homeopathic dose is continuing, many practitioners recommend that certain exposures, thought to be antidotal to many homeopathic
drugs, be avoided. These recommendations vary but include avoiding coffee, strong aromatic oils such as camphor and mint, invasive dental work, exposure to
electromagnetic fields, MRIs, electric blankets, and ultrasound.
A discussion of the extraordinary dilutions used in homeopathic medicine is given context by referring to the concept of Avogadro's number from basic chemistry.
Avogadro's number is the theoretical number of atoms or molecules in a mole, or the gram molecular weight of a given substance. For example, a mole of sodium,
with a gram molecular weight of 22.99, and platinum, with a gram molecular weight of 195, both have the same number of molecules (6.02 × 10
23
). Therefore, at a
dilution of 12C or 24X (10
-24
), the probability of there being a molecule of the original substance in the solution is 1:10. Given the high level of dilution, the activity of
homeopathic medicines is thought to follow from properties of the solvent water conferred to it by the original substance, not the molecules themselves. For the
scientist grounded in concepts of chemistry and molecular biology, the observation that medicines that contain no molecules could have biological activity defies all
logic, and is frankly unbelievable. But this is precisely what homeopathic proponents claim and is increasing demonstrated in controlled trials (
15
).
Although evidence of the biological activity of SADs is accumulating, the mechanism of action of these medicines is speculative. Theoretical explanations have
revolved around the “memory of water” and a subtle energy system in the living biological systems that can perceive and respond to the information encoded in a
homeopathic solution. The physicist Callinan (
16
) suggests that the process of succussion (i.e., agitation of the solution) produces energy storage in the bonds of the
diluent in the infrared spectrum that downloads in contact with the water in living systems. Perhaps the information then spreads like “liquid crystal” through the body
water, modifying receptor sites or enzyme action. Proponents refer to the observation that nuclear magnetic resonance (NMR) spectroscopy (
17
) of solutions
containing homeopathic medicines differ from the control solvent that has been similarly diluted and succussed.
The recent discovery of
I
E
structures in water may be the clearest evidence to date of a mechanism of action of homeopathic medicines (
18
,
19
).
I
E
structures are
crystalline-like structures of water molecules generated in response to electrical dipoles surrounding ions or proteins in solution. They have a circular symmetry and
are measurable by ultraviolet transmission; they are also visualized by electronmicroscopy and atomic force microscopy. At ion concentrations below 10
-7
, these
structures become stable and when exposed to shearing forces, break apart into three nanometer fragments, but then reaggregate into more stable structures that are
capable of self-replication in more dilute solutions, despite the absence of the original polar molecule. The form that these aggregates take is determined by the
electrical field of the original polar solute around which they formed. The shape of these aggregates may contain information that is communicated to highly specific
receptor sites on cell surfaces, antibodies, and so on.
The extraordinary implications of the homeopathic theory challenges the molecular biological model. Publication of the results of homeopathic trials has led to several
angry exchanges in the scientific press, the most notable being the publication of Benveniste's finding that human basophils degranulated in the presence of
antiserum directed against immunoglobulin E (IgE) at dilutions of 10
-120
(
20
). More recently, after
Pediatrics published research on the homeopathic treatment of
childhood diarrhea (
21
), the journal later printed a five-page critique (
22
). Subsequent letters pointed out that the opinions of these critics reflected lack of knowledge
of research design and basic homeopathic principles as well as reflecting a philosophical and political bias (
23
).
The current evidence for the action of homeopathic medicines in a clinical (
15
) and laboratory setting (
24
) are summarized in two meta-analyses. A number of
high-quality clinical trials have demonstrated the efficacy of homeopathic medicines, but none has ever been independently replicated. Proponents accept this as
adequate information for practice. Skeptics say such extraordinary claims require objective evidence for a mechanism of action. Both critics and proponents agree that
more high-quality clinical and laboratory research is needed.
HOMEOPATHIC PROVINGS
Some of the first double-blind, placebo-controlled experiments in human subjects were performed by homeopaths to test their medicine on healthy subjects. Provings
provide the data on which knowledge of the different homeopathic medicines is based. Standardization in the methodology of provings is a subject of significant effort
among homeopathic physicians and researchers (
25
).
Provings begin by interviewing healthy volunteers, or
provers, to assess their state of health and record for a period of time their baseline symptoms in a diary. The
homeopathic medicine is prescribed to each prover in potency for several days or until symptoms begin to develop. The prover records in detail the symptoms that
develop, including any new thoughts, feelings, changes in sleep, dreams, food cravings and aversions, physical sensations, eruptions, and discharges.
At the end of the proving, each subject is interviewed by the master prover, who is ideally blinded to the substance being proven. The experience of multiple provers is
synthesized by the master prover with input from the provers. A picture of the remedy arises from these discussions of the proving experience. Key symptoms are
indexed for possible addition to the repertory. The provings are published in journals or electronic media, making them readily accessible to prescribing physicians.
The ability to archive and retrieve video images on digital media has made a far richer experience of the provings accessible than the written
materia medicas of the
past could capture.
The provings lead to a detailed understanding of the effect of homeopathic substances in human beings. Although allopathic drug testing focuses on biochemical and
physiologic effects, disease-based therapeutic indications, and side effects, homeopathic provings generate a list of the detailed symptoms experienced across all
organ systems. The provers are used as an instrument through which the symptoms of the medicine are expressed and can be used in healing the sick.
The goal in the development of allopathic medicines is the “magic bullet”—i.e., a drug with very specific therapeutic effects and a narrow range of untoward effects.
The side effect profile of any medicine is an undesirable but necessary byproduct of this therapeutic system. In homeopathy, these symptoms, side effects, are
valued; the experiences of provers tell the homeopath the therapeutic indications of the medicine.
Materia Medica
The knowledge of the remedies gained from provings is supplemented by clinical experience. Symptoms that are cured by a specific remedy in multiple patients are
added to the
materia medica of that remedy. The database of symptoms for some of the better known homeopathic remedies often require 80 or 90 pages of written
text. Access to this information has been dramatically altered by computers. The current database of the homeopathic
materia medica includes information for
approximately 2500 remedies and consumes approximately 700 megabytes. Programs specifically written to assist homeopathic practice have had a profound effect
on the quality of homeopathic prescribing over the past two decades, significantly contributing to the renaissance of homeopathy in this same period.
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