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Abstract

Homeopathy employs the so-called ‘principle of similars’ as therapeutic method - which consists in administering medicines that cause certain primary symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) – in order to induce a secondary and healing reaction of the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the ‘rebound effect’ of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the ‘principle of contraries’ (contraria contrariis curantur). Since 1998, we have been bridging the gap between homeopathic and conventional pharmacology through the systematic study of the rebound effect of modern drugs, scientifically confirming the homeopathic postulate (primary action of the drug followed by secondary and opposite reaction of the organism) and the homeopathic healing principle. Following the homeopathic premises, conventional drugs can be employed according to the therapeutic similitude principle provided they cause primary symptoms (therapeutic, adverse and collateral effects) similar to the symptomatic manifestations of sick individuals. Since 2003, we are proposing the use of the rebound effect of modern drugs in a curative manner, administering to patients, in ultra-diluted doses, the drugs that cause a set of similar adverse events. Entitled “New Homeopathic Medicines: use of modern drugs according to the principle of similitude”, this proposal are been made available in a database composed of three free-access bilingual digital books.
Volume 67, Number 10, October, 2021
SECTIONS
POINT OF VIEW
1385 Blurred lines for management of thyroid nodules
in the era of atypia of undetermined significance/
follicular lesion of undetermined significance: novel
subdivisions of categories IIIA and IIIB in a possible
forthcoming The Bethesda System for Reporting
Thyroid Cytopathology, 3rd edition; amending
versus unnecessary?
SHORT COMMUNICATIONS
1387 “New Homeopathic Medicines” proposal: a
database made available in three free-access
bilingual digital books
ARTICLES
ORIGINAL ARTICLES
1392 COVID-19 pandemic and exercising: a cross-sectional
study with 1156 patients with fibromyalgia
1397 Hesitation regarding the COVID-19 vaccine among
medical students in Brazil
1403 Immunogenicity after CoronaVac vaccination
1409 COVID-19 findings in chest computed tomography
1415 Decreased ovarian reserve and ovarian
morphological alterations in female rat offspring
exposed to a ketogenic maternal diet
1421 Can blood urea Nitrogen-to-Albumin ratio predict
mortality in patients with moderate-to-severe COVID-19
pneumonia hospitalized in the intensive care unit?
1427 Effectiveness of telemedicine in response to the
COVID-19 pandemic
1432 Lung age and respiratory muscle strength in female
volleyball players
1437 Can serum 8-hydroxy-2'-deoxyguanosine levels
reflect the severity of pulmonary arterial
hypertension?
1443 Role of mean platelet volume in differential
diagnosis of adult-onset Still’s disease and sepsis
1448 Evaluation of the effect of antibiotics used during
parenteral nutrition treatment on Candidemia
1454 Evaluation of the factors predicting the need
for intensive care of patients with COVID-19
aged above 65 years: data from an emergency
department in Turkey
1461 Phobia of COVID-19 on people who aged 18 and older
1466 Outcomes associated with Hydroxychloroquine and
Ivermectin in hospitalized patients with COVID-19: a
single-center experience
1472 COVID-19 in Turkish health care workers practicing
chest medicine
1480 Comparison of samples found positive by anti-
HCV screening test with line immunoassay and
determination of threshold value
1485 Factors associated with postoperative complications
following appendectomy in elderly patients
1491 Evaluation of the olfactory bulb volume and
morphology in patients with coronavirus disease 2019:
can differences create predisposition to anosmia?
1498 C-reactive protein and neutrophil–lymphocyte ratio
as predictors of mortality in coronavirus disease 2019
REVIEW ARTICLES
1503 Use of probiotics in pediatric patients with autism
spectrum disorder: a systematic review
1508 A review of genetic syndromes associated with
hypertrichosis
COMMENTARY
1515 Comment on “Prevalence of hot flashes in women
of 40 to 65 years of age with metabolic syndrome”
1516 Comment on “Expression of long noncoding RNA
NBAT1 is associated with the outcome of patients
with non-small cell lung cancer”
1517 Comment on “Efficacy and safety of
percutaneous transforaminal endoscopic discectomy
in the treatment of lumbar spinal stenosis combined
with osteoporosis”
1518 Comment on “Roles of certain biochemical and
hematological parameters in predicting mortality
and ICU admission in COVID-19 patients”
1519 Comment on “Smoking prevalence and effects on
treatment outcomes in patients with tuberculosis”
Journal of e Brazilian Medical Association ISSN 0104-4320
ISSN 1806-9282 (On-line)
1387
Rev Assoc Med Bras 2021;67(10):1387-1391
“New Homeopathic Medicines” proposal:
a database made available in three
free-access bilingual digital books
Marcus Zulian Teixeira1*
SHORT COMMUNICATION
https://doi.org/10.1590/1806-9282.20210482
INTRODUCTION
Homeopathy, a Brazilian medical specialty since 1980, is
based on four assumptions, with several lines of research attest-
ing its scientic validity1:
(1) principle of therapeutic similitude,
(2) testing of medicines on healthy individuals (homeo-
pathic pathogenetic trials),
(3) prescription of individualized medicines, and
(4) the use of serially diluted and agitated medicines
(ultra-diluted and potentized doses). Although much
relevance is attributed to ultra-diluted doses, the rst
two assumptions represent the proper foundation of
the homeopathic epistemological model.
In the development of the homeopathic approach to treat-
ment, Samuel Hahnemann (1755–1843) had resource to the
phenomenological method of qualitative research to describe
the eects of contemporary drugs on the human physiology and
ground the therapeutic similitude principle. Hahnemann noted
that medicines cause signs and symptoms in healthy individuals
similar to the ones exhibited by patients cured with the same
medicines. He surveyed the literature and found hundreds of
clinical reports by doctors from all times and places, involving
many dierent categories of drugs, which conrmed his nding.
With these evidences and through the application of
Aristotelian inductive reasoning (modus ponens), Hahnemann
outlined the homeopathic healing principle: “for any medicine
to cure symptoms in the sick, it must induce similar symp-
toms in the healthy.” By developing a physiological explana-
tion for such “natural healing law,” he grounded the thera-
peutic similitude principle on the “primary action of drugs”
and the consequent and opposite “secondary action or vital
reaction of the body”:
“Every agent that acts upon the vitality, every medicine,
deranges more or less the vital force, and causes a certain alter-
ation in the health of the individual for a longer or a shorter
period. is is termed primary action. […] To its action our vital
force endeavors to oppose its own energy. is resistant action
is a property, is indeed an automatic action of our life-preserv-
ing power, which goes by the name of secondary action or coun-
teraction” (Organon of medicine, §63)2.
Exemplifying this phenomenon, Hahnemann described
the primary actions of drugs and the consequent secondary
reaction of the body in several physiological systems (Table 1),
characterized by the eects opposite to the primary physiolog-
ical changes (Organon of medicine, §59, 65)2. e latter leads
the body back to the state previous to intervention (“life-pre-
serving power,” i.e., modern homeostasis).
Pointing to the unpleasant results of indiscriminate use
of medicines with contrary action to the symptoms of disease
(Organon of medicine, §59-61)2, Hahnemann called the attention
to the fact that the secondary action (vital reaction) of the body
might cause undesirable eects (“a relapse – indeed, a palpable
aggravation of the malady”), validating homeopathic treatment
(principle of similitude) through resource to Aristotelian deduc-
tive reasoning (modus tollens or armation through negation,
i.e., the null hypothesis of modern biostatistics).
Since the secondary reaction of the body (opposed to the
primary action of the drug) could occur with any category of
drugs independently from the dose (ponderable or ultra-di-
luted), Hahnemann raised the similitude principle to the sta-
tus of “natural phenomenon” (Organon of medicine, §58, 61,
110-112)2.
rough administration to the sick of the very medicines
that induce similar symptoms in the healthy on “homeopathic
pathogenetic trials” (similar to our phase I clinical trials)3, the
1Universidade de São Paulo, School of Medicine – São Paulo (SP), Brazil.
*Corresponding author: marcus@homeozulian.med.br
Conicts of interest: the authors declare there are no conicts of interest. Funding: none.
Received on May 08, 2021. Accepted on August 16, 2021.
“New Homeopathic Medicines” proposal available in free-access digital books
1388
Rev Assoc Med Bras 2021;67(10):1387-1391
aim of therapeutic similitude is to trigger a curative homeo-
static reaction by making the body to react against its own
disorders. It should be noticed that the “secondary or vital
reaction” designate the ability of living beings to maintain
the internal environment constant (“life-preserving power” or
homeostasis) through automatic self-adjustment of the phys-
iological processes, ranging from simple cell mechanisms to
complex mental functions.
SCIENTIFIC BASIS OF THE
PRINCIPLE OF SIMILITUDE IN
MODERN PHARMACOLOGY
In modern scientic terms, Hahnemann’s “primary action” cor-
responds to the “therapeutic, adverse, and side eects” of con-
ventional drugs. In turn, the homeopathic “secondary action
or vital reaction” corresponds to the “rebound eect” or “par-
adoxical reaction” of the body that follows discontinuation of
countless categories of drugs that work in a manner opposed
(palliative or antagonistic) to the symptoms of disease.
“Rebound eect” is dened as the production of increased
negative symptoms when the primary eect of a drug has
passed or the patient no longer responds to the drug; if a
drug produces a rebound eect, the condition that was used
to treat may come back even stronger when the drug is dis-
continued or lost its eectiveness. Analogously, “paradoxical
reaction” is a response opposed to the foreseen eect of a drug.
Briey, we might understand rebound eect as an automatic
and instinctive manifestation of the homeostatic mechanisms
aiming at reestablishing the original state, altered by the pri-
mary action of drugs, resulting in an opposed eect and con-
trary to the expected one.
e rebound eect appears following discontinuation
or withdrawal of drugs, causing manifestations with stron-
ger intensity and/or more frequent than the ones originally
suppressed (which distinguish it from relapse of the original
disease following the end of the primary action of drugs).
esemanifestations appear at variable intervals and also have
variable duration. As a feature intrinsic to the phenomenon,
one should consider a minimum interval of time to have a
sound notion of the true magnitude of the phenomenon;
this minimum interval corresponds to the full metabolism of
drugs or the absence of therapeutic eect (biological half-life).
While discontinuation is a requisite for the rebound eect
to manifest – since the primary action continues as long as
receptors are bounded to the drug – some studies showed that
it might also occur along thecourse of treatment, in cases of
therapeutic failure or development of tolerance, tachyphy-
laxis, or receptor desensitization. In turn, drug tapering avoids
abrupt discontinuation and thus minimizes the occurrence
of the rebound eect.
Given the epistemological relevance of therapeutic simili-
tude vis-à-vis the remainder of homeopathic assumptions, since
1998, following the Aristotelian deductive reasoning employed
by Samuel Hahnemann to scientically support the law of sim-
ilars, we have been bridging the gap between homeopathic and
conventional pharmacology through the systematic study of
the rebound eect of modern drugs4-7, scientically conrm-
ing the homeopathic postulate (primary action of the drug
followed by secondary and opposite reaction of the body) and
the homeopathic healing principle.
Tables 2 and 3 list the examples with various categories of
drugs illustrating the universal nature of the rebound eect
and the principle of similitude4-7.
ese clinical and experimental pharmacological evidences4-7
show that the characteristics of the rebound eect are similar
to the homeopathic secondary action or reaction (Organon of
medicine, §59, 64, 69)2:
(1) it induces a body reaction opposed to and of greater
intensity compared to the primary action of drugs;
(2) it takes place after the end of the primary action of the
drug, and as automatic manifestation of the body;
(3) it does not depend on the type of drug, dose, treatment
duration, or category of symptoms (disease);
(4) its magnitude is proportional to the primary action of
the drug; and
(5) it appears in susceptible individuals only (idiosyncrasy).
Table 1. Hahnemann’s examples of primary action of drug and secondary action (vital reaction) of the body.
Drugs Primary action of drug Secondary action of the body
Coffee Excessive vivacity; sleepiness, or insomnia Sluggishness and drowsiness; somnolence
Opium Profound and stupeed sleep Sleepiness or insomnia
Opium Constipation Diarrhea
Opium Analgesia Hyperalgesia
Purgatives or laxatives Diarrhea Constipation
Cantharides Polyuria Oliguria or anuria
Teixeira, M. Z.
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Rev Assoc Med Bras 2021;67(10):1387-1391
Table 2. Primary action (therapeutic effect) of modern drugs followed by secondary and opposite reaction (rebound
effect) of the body
Primary action (therapeutic effect) of modern drugs Secondary reaction (rebound effect) of the body
Antiarrhythmic action (adenosine, amiodarone, beta-
blockers, calcium channel blockers, disopyramide,
ecainide, lidocaine, mexiletine, moricizine, and
procainamide)
Rebound exacerbation of basal arrhythmia after
discontinuation or withdrawal of drug
Antianginal action (nitrates, beta-blockers, and calcium
channel blockers)
Paradoxical increase of frequency and/or intensity of
angina pectoris
Hypotension action (alfa-2 agonists, beta-blockers, ACE
inhibitors, MAO inhibitors, nitrates, sodium nitroprusside,
and hydralazine)
Paradoxical arterial hypertension
Antithrombotic action (argatroban, bezabrate, heparin,
salicylates, warfarin, and clopidogrel) Rebound thromboembolism
Pleiotropic (vasoprotective) action (statins) Paradoxical endothelial dysfunction
Anxiolytic action (barbiturates, benzodiazepines, and
carbamates) Paradoxical anxiety
Sedative-hypnotic action (barbiturates, benzodiazepines,
morphine, promethazine, and zopiclone)
Increased rebound of agitation, nervousness, restlessness,
and irritability
Antidepressant action (tricyclic, MAO inhibitors, and
selective serotonin reuptake inhibitors) Paradoxical increase of depressive symptoms
Antipsychotic action (clozapine, phenothiazines,
haloperidol, and pimozide) Rebound exacerbation of psychotic manifestations
Table 3. Primary action (therapeutic effect) of modern drugs followed by secondary and opposite reaction (rebound
effect) of the body.
Primary action (therapeutic effect) of modern drugs Secondary reaction (rebound effect) of the body
Analgesic action (caffeine, calcium channels blockers,
clonidine, ergotamine, methysergide, opiates, and salicylates)
Hyperalgesia paradoxical after discontinuation or
withdrawal of drug
Anti-inammatory action (steroids, ibuprofen,
indomethacin, paracetamol, and salicylates) Rebound increase of inammation
Diuretic action (furosemide, torasemide, and triamterene) Paradoxical retention of sodium and potassium with
consequent increase of blood volume and arterial pressure
Bronchodilator action (short- and long-acting beta-
adrenergic agonists, sodium cromoglycate, ipratropium,
and nedocromil)
Rebound bronchoconstriction
Antidyspeptic action (antacids, H2 antagonists,
misoprostol, sucralfate, and protons pump inhibitors)
Paradoxical increase in the production of hydrochloric acid
and gastrin
Antiresorptive action (bisphosphonates, denosumab, and
odanacatib)
Rebound increase of osteoclastic activity causing
paradoxical atypical fractures
Immunomodulatory action (glucocorticoids, interferon,
recombinant monoclonal antibodies, and tumor necrosis
factor inhibitors)
Paradoxical effect on the inammatory and immune
response of drug
Despite this idiosyncratic nature of the rebound eect –
which appears in a small proportion of individuals – scientic
evidences point to the occurrence of severe and fatal events
as a result of the paradoxical reaction of the body following
discontinuation of dierent categories of drugs5-7. is cor-
roborates the magnitude of the phenomenon, the need to be
duly known by health care providers, and the benets of its
therapeutic application according to the similitude principle.
“New Homeopathic Medicines” proposal available in free-access digital books
1390
Rev Assoc Med Bras 2021;67(10):1387-1391
“NEW HOMEOPATHIC
MEDICINES” PROPOSAL: USE OF
MODERN DRUGS ACCORDING TO
THE PRINCIPLE OF SIMILITUDE
e basic assumption underlying the homeopathic healing prin-
ciple is the use of drugs that cause pathogenetic manifestations
(signs, symptoms, and physiological or pathological eect) similar
to the disorders to be cured. A similar use might be made of any
type of drug (natural or synthetic) and in any dose (ponderable
or ultra-diluted), provided the therapeutic similitude principle
is observed. us, modern drugs might be used according to
the homeopathic assumptions, provided they induce primary
eects (therapeutic, adverse, or side eects) similar to the full
set of characteristic signs and symptoms exhibited by patients.
Since 2003, we advocate the use of the rebound eect of
modern drugs with curative intent8-13. For this purpose, patients
are given drugs in ultra-diluted doses, which caused a similar
set of adverse events aiming at stimulating the homeostatic
reaction of the body against its own disorders.
To make this idea feasible, a Homeopathic Materia Medica
of Modern Drugs was prepared, in which all the primary or
pathogenetic eects (therapeutic, adverse, and side eects) of
1,250modern drugs described in e United States Pharmacopeia
Dispensing Information (USPDI)14 are organized according to
an anatomical-functional distribution following the format of
the traditional Homeopathic Materia Medica.
To facilitate the choice of the individualized medicine to
be prescribed, according to the full set of similar symptoms, a
Homeopathic Repertory of Modern Drugs was prepared. Here,patho-
genetic eects and the corresponding drugs are organized accord-
ing to the format of the traditional homeopathic repertories, fol-
lowing the aforementioned anatomical-functional distribution.
e proposal entitled “New Homeopathic Medicines: use
of modern drugs according to the principle of similitude”8-13
was described and systematized in a database composed of
three distinct works:
(1) Scientic Basis of the Principle of Similitude in Modern
Pharmacology,
(2) Homeopathic Materia Medica of Modern Drugs, and
(3) Homeopathic Repertory of Modern Drugs.
“NEW HOMEOPATHIC MEDICINES”
PROPOSAL: A DATABASE MADE
AVAILABLE IN THREE FREE-ACCESS
BILINGUAL DIGITAL BOOKS
In 2010, in order to allow everyone access to this proposal and
its database, these three digital works, totaling thousands of
pages, were freely available on a bilingual website (Portuguese
and English) prepared on the Adobe Flash Player platform,
enabling that this clinical protocol could be analyzed and
used by all homeopaths.
Unfortunately, as of 2021, the Adobe Flash Player plat-
form was blocked without oering an alternative to it, pre-
venting colleagues from continuing to have access to that
proposal and its database.
Offering an alternative to maintaining this proposal, we
have made available the three mentioned works in the for-
mat of free-access digital books (PDF), in Portuguese15-17
and English18-20 editions. These two editions of three
books were indexed in the Virtual Health Library (PAHO,
WHO, and BIREME) and are currently accessible to all
interestedparties:
Content of the Portuguese edition15-17
Fundamentação cientíca do princípio da similitude
na farmacologia moderna15;
Matéria médica homeopática dos fármacos
modernos16;
Repertório homeopático dos fármacos modernos17.
Content of the English edition18-20
Scientic basis of the principle of similitude in modern
pharmacology18;
Homeopathic materia medica of modern drugs19;
Homeopathic repertory of modern drugs20.
CONCLUSIONS
To test this proposal, we recently developed a clinical research
protocol for the use of potentized estrogen (17-β estradiol)
for the treatment of endometriosis-associated pelvic pain,
since estrogen causes endometrial hyperplasia or prolifera-
tion as adverse event21. Reporting signicant improvement
versus placebo in relation to pain, depression, and quality
of life22, this study suggests the validity of this clinical and
scientic proposal.
Nevertheless, for this method to be included in homeo-
pathic standard practice, homeopaths need to unite
around this project: physicians should apply it in clini-
cal practice and describe the results (case reports), phar-
macists should prepare the corresponding homeopathic
potentized medicines, and the researchers should design
clinical protocols.
Teixeira, M. Z.
1391
Rev Assoc Med Bras 2021;67(10):1387-1391
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pesquisa.bvsalud.org/portal/resource/en/biblio-1148219.
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edition. São Paulo: Marcus Zulian Teixeira, 20212nd ed. São
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21. Teixeira MZ, Podgaec S, Baracat EC. Protocol of randomized
controlled trial of potentized estrogen in homeopathic
treatment of chronic pelvic pain associated with endometriosis.
Homeopathy. 2016;105(3):240-9. https://doi.org/10.1016/j.
homp.2016.03.002
22. Teixeira MZ, Podgaec S, Baracat EC. Potentized estrogen in
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pain: a 24-week, randomized, double-blind, placebo-controlled
study. Eur J Obstet Gynecol Reprod Biol. 2017;211:48-55.
https://doi.org/10.1016/j.ejogrb.2017.01.052
... The proposal entitled "New Homeopathic Medicines: Use of modern drugs according to the principle of similitude" encompasses 1,250 modern drugs and has been available, since 2021, in three free-access digital books indexed in the Virtual Health Library (i.e., PAHO, WHO, and BIREME) 20 : "Scientific basis of the principle of similitude in modern pharmacology," 21 "Homeopathic materia medica of modern drugs," 22 and "Homeopathic repertory of modern drugs." 23 To test the clinical and scientific validity of this proposal, we developed a randomized controlled trial employing potentized estrogen (17-β estradiol) for the treatment of endometriosis-associated pelvic pain 24 , in view of the fact that estrogen causes as an adverse event a set of signs and symptoms similar to the endometriosis syndrome, observing significant improvement compared with placebo in relation to pain, depression, and quality of life 25 . ...
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When Samuel Hahnemann systematized homeopathy and the effects of drugs on the state of human health, he described the primary action of drugs and the following secondary and opposite reaction of the body. Seeking to apply this secondary action or vital reaction of the body as therapeutic method, he postulated the “principle of cure by similars”, i.e. the prescription to ill individuals of drugs that cause similar symptoms in the healthy (similia similibus curentur). In modern pharmacology, this secondary action (vital reaction) of the body is known as rebound effect or paradoxical reaction. It has been observed after discontinuation of several classes of palliative drugs, namely those that act according to the “principle of cure by contraries” (contraria contrariis curentur). Since 1998, we have been bridging the gap between homeopathic and conventional pharmacology through the systematic study of rebound effect of modern drugs, scientifically confirming the homeopathic postulate (primary action of the drug followed by secondary and opposite reaction of the body) and the homeopathic healing principle. Following the homeopathic premises, conventional drugs can be employed according to the principle of therapeutic similitude provided they cause primary symptoms (therapeutic, adverse and side effects) similar to the symptomatic manifestations of sick individuals. Since 2003, we are proposing the use of the rebound effect of modern drugs in a curative manner, administering to patients, in ultra-diluted doses, drugs that cause a set of similar adverse events. Since 2021, these two decades of studies are made available in three free-access digital books.
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When Samuel Hahnemann systematized homeopathy and the effects of drugs on the state of human health, he described the primary action of drugs and the following secondary and opposite reaction of the body. Seeking to apply this secondary action or vital reaction of the body as therapeutic method, he postulated the “principle of cure by similars”, i.e. the prescription to ill individuals of drugs that cause similar symptoms in the healthy (similia similibus curentur). In modern pharmacology, this secondary action (vital reaction) of the body is known as rebound effect or paradoxical reaction. It has been observed after discontinuation of several classes of palliative drugs, namely those that act according to the “principle of cure by contraries” (contraria contrariis curentur). Since 1998, we have been bridging the gap between homeopathic and conventional pharmacology through the systematic study of rebound effect of modern drugs, scientifically confirming the homeopathic postulate (primary action of the drug followed by secondary and opposite reaction of the body) and the homeopathic healing principle. Following the homeopathic premises, conventional drugs can be employed according to the principle of therapeutic similitude provided they cause primary symptoms (therapeutic, adverse and side effects) similar to the symptomatic manifestations of sick individuals. Since 2003, we are proposing the use of the rebound effect of modern drugs in a curative manner, administering to patients, in ultra-diluted doses, drugs that cause a set of similar adverse events. Since 2021, these two decades of studies are made available in three free-access digital books.
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In July 2017, to demystify the fallacy – or post-truth – asserting “there are no scientific evidence for homeopathy”, the Technical Chamber for Homeopathy, Regional Medical Council of the State of São Paulo (Cremesp, Brazil) published the Dossiê Especial: “Evidências Científicas em Homeopatia”, available online and in printed editions of the scientific journal of the São Paulo Homeopathic Medical Association (APH), Revista de Homeopatia. After this publication, in view of the request of homeopathic physicians and institutions from other countries, the Technical Chamber for Homeopathy (TC-Homeopathy, Cremesp) produced an English edition of the dossier (Special Dossier: “Scientific Evidence for Homeopathy”), which is also available online at the Revista de Homeopatia webpage. Encompassing nine reviews on several lines of homeopathic research (and two randomized clinical trials developed by members of the TC-Homeopathy), containing hundreds of scientific articles published in various journals, this dossier highlights, to the scientific and medical class, as well as to the general public, the state of the art of homeopathic research.
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The homeopathic treatment is based on the principle of therapeutic similitude, employing medicines that cause certain disorders to treat similar manifestations, stimulating a reaction of the organism against its own ailments. The occurrence of this secondary reaction of the organism, opposite in nature to the primary action of the medicines, is evidenced in the study of the rebound (paradoxical) effect of several classes of modern drugs. In this work, in addition to substantiate the principle of similitude before the experimental and clinical pharmacology, we suggest a proposal to employ hundreds of conventional drugs according to homeopathic method, applying the therapeutic similitude between the adverse events of medicines and the clinical manifestations of patients. Describing existing lines of research and a specific method for the therapeutic use of the rebound effect of modern drugs (http://www.newhomeopathicmedicines.com), we hope to minimize prejudices related to the homeopathy and contribute to a broadening of the healing art.
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Using the empirical or phenomenological research method by observing the effects of drugs in the human physiology, Samuel Hahnemann proposed the homeopathic treatment. He synthesized modern pharmacodynamic in the ‘primary action’ of the drugs and in the consequent and opposite ‘secondary action’ or ‘vital reaction’ of the organism. Noting that drugs with ‘contrary’ primary action to the symptoms of the diseases caused worsening of the symptoms after its withdrawal, as a result of secondary action of the organism, Hahnemann proposed using this vital reaction (secondary action) in a curative way, administering to sick individuals the drugs that caused ‘similar’ symptoms in healthy individuals (therapeutic use of the similitude principle). According to the clinical and experimental pharmacology, this secondary action (vital reaction) of the organism is observed in the ‘rebound effect’ or ‘paradoxical reaction’ of several classes of drugs, which is the scientific basis of the ‘homeopathic pharmacology’. In the last decade, exponents of modern pharmacology have suggested the therapeutic use of the paradoxical reaction (‘paradoxical pharmacology’), proposing the use of drugs that cause an exacerbation of the disease in the short term to treat these same diseases in the long-term. In this review, we compare the various aspects between the ‘homeopathic pharmacology’ and the ‘paradoxical pharmacology’, reinforcing the validity of homeopathic assumptions and expanding the knowledge to optimize both proposals.
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A experimentação ou ensaio patogenético homeopático (EPH) é o método de investigação clínico-farmacológica utilizado pela homeopatia para conhecer as manifestações patogenéticas (sinais e sintomas) que as substâncias despertam nos seres humanos, possibilitando a aplicação do princípio da similitude terapêutica. Instrumento indispensável na assistência, na pesquisa e no ensino da homeopatia, apresenta modelos de aplicação diversos ao longo destes dois séculos de prática homeopática, através dos quais milhares de substâncias foram experimentadas em indivíduos humanos sadios e tiveram suas manifestações sintomáticas descritas nas Matérias Médicas Homeopáticas. Apesar da sua importância no desenvolvimento da episteme homeopática, a Homeopatia Brasileira carece, na atualidade, de protocolos de pesquisa patogenética condizentes com as exigências da metodologia científica moderna, que tornariam os testes mais confiáveis e facilitariam sua aprovação perante os comitês de ética em pesquisa das instituições que pretendam executá-los. Este protocolo de experimentação patogenética homeopática foi desenhado com o intuito de suprir esta demanda, seguindo os passos e as exigências necessárias à elaboração de um projeto de pesquisa clínica em humanos, a fim de disponibilizar uma sistemática que permita a uniformização do procedimento e sua aplicação nas diversas instâncias que se proponham a realizar pesquisa patogenética homeopática. A possibilidade da publicação deste protocolo numa revista indexada e de livre acesso, permitindo a ampla divulgação de um tema imprescindível ao entendimento e ao progresso da homeopatia, facilita o esclarecimento da racionalidade científica homeopática perante a classe médica e a disseminação da proposta perante o movimento homeopático brasileiro.
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When Samuel Hahnemann systematized homeopathy and the effects of drugs on the state of human health, he described the primary action of drugs and the following secondary and opposite reaction of the organism. Seeking to apply this secondary action or vital reaction of the organism as therapeutic method, he postulated the principle of similitude, i.e. the prescription to ill individuals of drugs that cause similar symptoms in the healthy (similia similibus curentur). In modern pharmacology, secondary action (vital reaction) of drugs is known as rebound effect or paradoxical reaction of the organism. It has been observed after discontinuation of several classes of palliative (enantiopathic) drugs, namely those that act according to the principle of contraries (contraria contrariis curentur). Although in this case it is associated with severe and fatal iatrogenic events, rebound effect might awaken a healing reaction when the very same drug is employed according to the principle of similitude. The validity of the principle of similitude is proved by scientific evidence on rebound effect, whereas conventional drugs primary (therapeutic, adverse and side) effects might be equated to pathogenetic manifestations and thus be homeopathically applied. For this purpose a homeopathic materia medica and repertory comprising 1,251 modern drugs was elaborated using the monographs described in The United States Pharmacopeia Dispensing Information as source (www.newhomeopathicmedicines.com). Thus, the therapeutic range of homeopathy is broadened through the addition of hundreds of new medicines that might be employed in every kind of disease including countless modern clinical syndromes.
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RESUMO: O princípio da similitude, alicerce da Homeopatia, encontra correspondência no estudo clínico dos efeitos secundários de uma infinidade de fármacos modernos, através da observação do 'efeito rebote' destas drogas. Desta forma, através da Farmacologia Clínica, componente da racionalidade médico e científica atual, propomos um modelo para fundamentar o cientificismo do modelo homeopático. Assim sendo, estudamos os efeitos das drogas atuais no organismo humano, utilizando compêndios farmacológicos e trabalhos científicos recentes, confirmando o mecanismo de ação dos medicamentos homeopáticos através da verificação da ação primária das drogas e da conseqüente ação secundária do organismo em centenas de fármacos clássicos. O tratamento pelo efeito rebote (reação vital curativa) também pôde ser observado. Com este trabalho, sugerimos uma metodologia de pesquisa dos medicamentos modernos, a fim de embasar cientificamente o princípio terapêutico pela similitude.
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The homeopathic model of treatment of diseases uses the ‘principle of similarity’ as therapeutic method, employing drugs that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curentur), seeking to stimulate a healing reaction of the organism against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the organism is based on the study of the ‘rebound effect’ of modern drugs, iatrogenic event that can cause serious disorders after the discontinuation of several classes of conventional treatments that use the ‘principle of contraries’ as therapeutic practice (contraria contrariis curentur). Although the rebound phenomenon is an adverse event studied by modern pharmacology, it is unknown by health professionals, depriving the medical class of a necessary and fundamental knowledge to the safe management of drugs. Despite expressing itself in a small proportion of susceptible individuals, the rebound effect assumes epidemiological importance in view of the enormous consumption of drugs by the population and the lack of clarity on the phenomenon. This article presents an updated review on the rebound effect of drugs, relating it to the homeopathic healing principle. RESUMO: O modelo homeopático de tratamento das doenças utiliza o ‘princípio da semelhança’ como método terapêutico, empregando medicamentos que causam determinados sintomas em indivíduos sadios para tratar sintomas semelhantes em indivíduos doentes (similia similibus curentur), com o intuito de estimular uma reação curativa do organismo contra os seus próprios distúrbios. Esta reação secundária (vital, homeostática ou paradoxal) do organismo está fundamentada no estudo do ‘efeito rebote’ dos fármacos modernos, evento adverso que pode causar transtornos graves após a descontinuação de diversas classes de tratamentos convencionais que utilizam o ‘princípio dos contrários’ como prática terapêutica (contraria contrariis curentur). Embora o fenômeno rebote seja um evento adverso estudado pela farmacologia moderna, ele é desconhecido pelos profissionais da saúde, privando a classe médica de um conhecimento necessário e fundamental ao manejo seguro dos fármacos. Apesar de se expressar numa pequena proporção de indivíduos suscetíveis, o efeito rebote assume importância epidemiológica em vista do enorme consumo de medicamentos pela população e da falta de esclarecimentos sobre o fenômeno. Este artigo apresenta uma revisão atualizada sobre o efeito rebote das drogas, relacionando-o ao princípio de cura homeopático.
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Objective: To evaluate the efficacy and safety of potentized estrogen compared to placebo in homeopathic treatment of endometriosis-associated pelvic pain (EAPP). Study design: The present was a 24-week, randomized, double-blind, placebo-controlled trial that included 50 women aged 18-45 years old with diagnosis of deeply infiltrating endometriosis based on magnetic resonance imaging or transvaginal ultrasound after bowel preparation, and score ≥ 5 on a visual analogue scale (VAS: range 0 to 10) for endometriosis-associated pelvic pain. Potentized estrogen (12cH, 18cH and 24cH) or placebo was administered twice daily per oral route. The primary outcome measure was change in the severity of EAPP global and partial scores (VAS) from baseline to week 24, determined as the difference in the mean score of five modalities of chronic pelvic pain (dysmenorrhea, deep dyspareunia, non-cyclic pelvic pain, cyclic bowel pain and/or cyclic urinary pain). The secondary outcome measures were mean score difference for quality of life assessed with SF-36 Health Survey Questionnaire, depression symptoms on Beck Depression Inventory (BDI), and anxiety symptoms on Beck Anxiety Inventory (BAI). Results: The EAPP global score (VAS: range 0 to 50) decreased by 12.82 (P < 0.001) in the group treated with potentized estrogen from baseline to week 24. Group that used potentized estrogen also exhibited partial score (VAS: range 0 to 10) reduction in three EAPP modalities: dysmenorrhea (3.28; P < 0.001), non-cyclic pelvic pain (2.71; P = 0.009), and cyclic bowel pain (3.40; P < 0.001). Placebo group did not show any significant changes in EAPP global or partial scores. In addition, the potentized estrogen group showed significant improvement in three of eight SF-36 domains (bodily pain, vitality and mental health) and depression symptoms (BDI). Placebo group showed no significant improvement in this regard. These results demonstrate superiority of potentized estrogen over placebo. Few adverse events were associated with potentized estrogen. Conclusions: Potentized estrogen (12cH, 18cH and 24cH) at a dose of 3 drops twice daily for 24 weeks was significantly more effective than placebo for reducing endometriosis-associated pelvic pain. Trial registration: ClinicalTrials.gov Identifier: NCT02427386.
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Background: Endometriosis is a chronic inflammatory disease that causes difficult-to-treat pelvic pain. Thus being, many patients seek help in complementary and alternative medicine, including homeopathy. The effectiveness of homeopathic treatment for endometriosis is controversial due to the lack of evidences in the literature. The aim of the present randomized controlled trial is to assess the efficacy of potentized estrogen compared to placebo in the treatment of chronic pelvic pain associated with endometriosis. Methods/design: The present is a randomized, double-blind, placebo-controlled trial of a homeopathic medicine individualized according to program 'New Homeopathic Medicines: use of modern drugs according to the principle of similitude' (http://newhomeopathicmedicines.com). Women with endometriosis, chronic pelvic pain and a set of signs and symptoms similar to the adverse events caused by estrogen were recruited at the Endometriosis Unit of Division of Clinical Gynecology, Clinical Hospital, School of Medicine, University of São Paulo (Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP). The participants were selected based on the analysis of their medical records and the application of self-report structured questionnaires. A total of 50 women meeting the eligibility criteria will be randomly allocated to receive potentized estrogen or placebo. The primary clinical outcome measure will be severity of chronic pelvic pain. Statistical analysis will be performed on the intention-to-treat and per-protocol approaches comparing the effect of the homeopathic medicine versus placebo after 24 weeks of intervention. Discussion: The present study was approved by the research ethics committee of HCFMUSP and the results are expected in 2016. Trial registration: ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT02427386.