Homeopathic treatment of multimorbid patients: a prospective outcome study with polarity analysis.

BACKGROUND: The treatment of multimorbid patients who have a combination of three or more concurrent complaints is one of the core competencies of homeopathy. In this article we introduce the application of polarity analysis (PA) in multimorbidity. PA came to prominence through the Swiss homeopathic ADHD double-blind study, which successfully demonstrated a significant difference between highly dilute homeopathic remedies and placebo. PA enables homeopaths to calculate a relative healing probability, based on Boenninghausen's grading of polar symptoms. After its evaluation in the treatment of a variety of acute and chronic disease, which showed improved results compared to a conventional homeopathic approach, it was a challenge to test PA with multimorbid patients. Since such patients almost invariably have a multiple symptoms, the question was whether we can nevertheless successfully use Polarity Analysis or whether the method is rendered ineffective by the multitude of symptoms. METHODS: We treated 50 multimorbid patients with PA and prospectively followed them over one year. RESULTS: 43 patients (86%) completed the observation period, achieving an average improvement of 91% in their initial symptoms. Six patients dropped out, and one did not achieve an improvement of 80%, and was therefore also counted as a treatment failure. The cost of homeopathic treatment was 41% of projected equivalent conventional treatment. CONCLUSIONS: Polarity Analysis is an effective method for treating multimorbidity. The multitude of symptoms does not prevent the method from achieving good results. Homeopathy may be capable of taking over a considerable proportion of the treatment of multimorbid patients, at lower costs than conventional medicine.

Frequently occurring polar symptoms assessed by successful cases.

BACKGROUND: Frequently occurring symptoms with opposite poles like 'Cold ameliorates/aggravates' are regarded valuable for homeopathic practice, but are insufficiently assessed and impossible to handle with conventional repertorisation. METHOD: In a pilot study 30 questions out of a standard questionnaire in 102 cases responding well to five medicines were analysed and compared with a control group of 100 consecutive new cases. Outcomes of a pivot table, Likelihood Ratio (LR) calculations and Multivariate Analysis (MVA) were compared. RESULTS: Some questions were less useful than expected. With an average of 4.8 useful answers per patient and moderate LRs this questionnaire provided substantial information. MVA was useful in emphasising differences between medicines and for differential diagnosis. CONCLUSION: The value of frequently occurring symptoms could be much enhanced by scientific assessment. We propose further research with an improved questionnaire.

Polarity analysis, a new approach to increase the precision of homeopathic prescriptions.

INTRODUCTION: The Swiss randomised controlled trial of homeopathy for attention deficit hyperactivity disorder (ADHD) was a rigorous test of homeopathy. In each of its three phases it delivered evidence for a specific effect of homeopathic treatment, but it also unmasked weaknesses of the method. Misleading reports of sensations and mind symptoms by parents were frequent, while modalities and polar symptoms usually proved to be reliable information for repertorisation. The problem of cases with a paucity of symptoms was resolved by reintroduction of (pathognomonic) perception symptoms into the repertorisation. Additionally polarity analysis, a further development of Boenninghausen's concept of contraindications, was tested and introduced. It allows a precise differential diagnosis of possible homeopathic medicines. Increasing the rate of optimal prescriptions by 20%, polarity analysis turned out to be the most efficient modification to case analysis. This paper describes the transfer of the new insights to the treatment of other diseases and as the evaluation of this process. METHODS: Polarity analysis was tested and applied in acute diseases by completing patient histories with repertory specific checklists, mainly based on modalities and polar symptoms. The checklists encompassed eleven different complaints. Treatment results were compared with results reached by conventional homeopathic case analysis methods. The same procedure was applied in chronic diseases with repertory-specific questionnaires. Again, eleven different areas were covered. Treatment results for chronic diseases were also compared with a conventional case analysis approach. RESULTS: Polarity analysis, checklists and questionnaires led to an increase in optimal prescriptions of 22% in acute diseases and 16% in chronic diseases. In addition, the average improvement rates in chronic disease were 9% higher than with conventional homeopathic procedures. The new method is demonstrated by a case example with a verified clinical cure, and its impacts on homeopathy are discussed. CONCLUSION: The use of polarity analysis as an integral part of case analysis and differential diagnosis of possible remedies together with an increased awareness for assessing the reliability of symptoms in repertorisation lead to a substantial improvement in the precision of homeopathic prescriptions.

Treatment of Chronic Immune Thrombocytopenic Purpura with Homeopathic Dilutions of Patient Blood.

BACKGROUND: Conventional or homeopathic treatment of chronic immune thrombocytopenic purpura (ITP) is often difficult. The use of homeopathic dilutions of patient blood (HPB) for immunomodulation has been described, which inspired us to try the method in an ITP case. CASE REPORT: A 2-year-old girl with chronic ITP was treated with homeopathic dilutions of her own capillary blood, given orally over 5 months. Immediately after treatment onset there was a rapid normalization of the thrombocyte counts. Within 6 weeks, they rose from 15,000/µl to 254,000/µl. After treatment stop, they decreased to 155,000/µl, increased again spontaneously to 270,000/µl and remained within normal range for over 3 years. CONCLUSIONS: Oral administration of homeopathic dilutions of capillary patient blood may possibly be an effective treatment in chronic ITP. If our results can be reproduced, this will revolutionize the treatment of ITP.

Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomised, double blind, placebo controlled crossover trial.

UNLABELLED: An increasing number of parents turn to homeopathy for treatment of their hyperactive child. Two publications, a randomised, partially blinded trial and a clinical observation study, conclude that homeopathy has positive effects in patients with attention deficit hyperactivity disorder (ADHD). The aim of this study was to obtain scientific evidence of the effectiveness of homeopathy in ADHD. A total of 83 children aged 6-16 years, with ADHD diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-IV criteria, were recruited. Prior to the randomised, double blind, placebo controlled crossover study, they were treated with individually prescribed homeopathic medications. 62 patients, who achieved an improvement of 50% in the Conners' Global Index (CGI), participated in the trial. Thirteen patients did not fulfill this eligibility criterion (CGI). The responders were split into two groups and received either verum for 6 weeks followed by placebo for 6 weeks (arm A), or vice-versa (arm B). At the beginning of the trial and after each crossover period, parents reported the CGI and patients underwent neuropsychological testing. The CGI rating was evaluated again at the end of each crossover period and twice in long-term follow-up. At entry to the crossover trial, cognitive performance such as visual global perception, impulsivity and divided attention, had improved significantly under open label treatment (P<0.0001). During the crossover trial, CGI parent-ratings were significantly lower under verum (average 1.67 points) than under placebo (P =0.0479). Long-term CGI improvement reached 12 points (63%, P <0.0001). CONCLUSION: The trial suggests scientific evidence of the effectiveness of homeopathy in the treatment of attention deficit hyperactivity disorder, particularly in the areas of behavioural and cognitive functions.

Non-symptoms: variations of the normal - a pitfall in the repertorisation of infants symptoms

To focus on symptoms which are explainable through the disease is fatal in the process of prescribing. But not only must we know the pathognomonic symptoms of the disease, we need to know what is considered still normal, eg. in an infant