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Abstract

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.
Volume 68, Number 3, March, 2022
SECTIONS
EDITORIAL
275 Minimum minimorum: thyroid minimally invasive FNA,
less is more concept? Volens nolens?
GUIDELINES
277 Endoscopic biliary sphincterotomy: electric current mode
LETTERS TO THE EDITOR
296 The Pulmonary Metastasectomy in Colorectal
Cancer study calls for reconsideration of the clinical
effectiveness of this widespread practice
299 Comment on “Nuances between sedentary behavior
and physical inactivity: cardiometabolic effects and
cardiovascular risk”
301 Comment on “Effect of the Mediterranean diet in
patients with chronic spontaneous urticaria”
302 Doxofylline in acute exacerbation of chronic
obstructive pulmonary disease
303 “Similitude in Modern Pharmacology”: two decades
of studies contributing to the scientific basis of the
homeopathic healing principle
SHORT COMMUNICATIONS
308 Public interest in “early treatments” for coronavirus
disease 2019 in Brazil: insights from Google Trends
ARTICLES
ORIGINAL ARTICLES
313 Prognostic assessment of tumor markers in lung
carcinomas
318 Tocilizumab is useful for coronavirus disease 2019
patients: the key point is timing
323 Association between handgrip strength and body
composition, physical fitness, and biomarkers in
postmenopausal women with metabolic syndrome
329 Follow-up of a cohort of patients with noncystic
fibrosis bronchiectasis for 1 year
337 Anxiety, attitudes-behaviors, coping styles, and social
support among high-risk pregnant women in the
late period of the coronavirus disease 2019 pandemic
344 Prevalence of molecular and serological tests of
the new coronavirus (SARS-CoV-2) in Carlos Chagas
laboratory – Sabin group in Cuiabá
351 COVID-19 infection rates among transportation and
metal workers
356 Correlation between the range of motion of the
tibiotarsal joint and blood circulation in the lower
limbs in diabetic individuals
362 Indoleamine-2,3-dioxygenase-related anti-
inflammatory effects of 3-aminobenzamide and
infliximab in experimental colitis
367 Intra- and inter-examiner reliability of digital images
of skin donor areas in burns
372 Clinical and radiological characteristics of pulmonary
actinomycosis mimicking lung malignancy
377 Comparison of the effects of duloxetine and
pregabalin on pain and associated factors in patients
with knee osteoarthritis
384 The prognostic value of the CHA2DS2-VASc score
in coronary collateral circulation and long-term
mortality in coronary artery disease
389 AnexamınatıonoftheanxıetystatesofTurkısh
healthcareworkersdurıngtheCOVID-19pandemıc:
across-sectıonalstudy
395 Effects of imipenem combined with glutamine in the
treatment of severe acute pancreatitis with abdominal
infection in mainland China: a meta-analysis
400 Wnt3a but not CDX-2 expression is associated with
differentiated thyroid cancer
405 Does focal heterogeneity affect survival in
postoperative ipsilateral multifocal and multicentric
breast cancers?
413 Frequency of Congenital Aortic Arch Anomaly in
COVID-19 Patients
REVIEW ARTICLES
417 Management of ultrasonographic endometrial
thickness in postmenopausal asymptomatic women
422 Civil sentencing in health care and their relation with
blanket consent in rulings from the Court of Appeals
of the State of São Paulo
ERRATUM
426 Erratum
428 Erratum
429 Erratum
Journal of The Brazilian Medical Association ISSN 0104-4320
ISSN 1806-9282 (On-line)
303
Rev Assoc Med Bras 2022;68(3):303-307
“Similitude in Modern Pharmacology”: two decades of studies
contributing to the scientic basis of the homeopathic healing principle
Marcus Zulian Teixeira1*
LETTER TO THE EDITOR
Dear Editors,
Homeopathy is based on the following four scientic pillars1:
principle of cure by similars, proving of medicinal substances on
healthy individuals, use of dynamized doses, and prescription
of individualized medicines. Although great importance was
attributed to dynamized doses (ultra-high dilutions), the rst
two pillars are the fundamental premises of the homeopathic
epistemological model, remaining to individualized medicine
the essential condition to awakening the therapeutic response.
In the systematization of the homeopathic method of treat-
ment, Samuel Hahnemann based the “principle of cure by sim-
ilars” (principle of therapeutic similitude) on the careful obser-
vation of the eects of medicines on human health. Inthe essay2
that inaugurated homeopathy in 1796 and in paragraphs 59
and 65 of the Organon of Medicine3, he describes the pharma-
cological eects of dozens of palliative drugs of his time, dis-
criminating the “direct primary action of drug” and the con-
sequent and opposite “indirect secondary action of the body,”
evidencing the new principle of cure proposed:
[...] Excessive vivacity follows the use of strong coee
(primary action), but sluggishness and drowsiness remain
for a long time afterwards (reaction, secondary action),
if this be not always again removed for a short time by
imbibing fresh supplies of coee (palliative). After the
profound stupeed sleep caused by opium (primary
action), the following night will be all the more sleep-
less (reaction, secondary action). After the constipation
produced by opium (primary action), diarrhea ensues
(secondary action); and after purgation with medi-
cines that irritate the bowels, constipation of several
days’ duration ensues (secondary action). And in like
manner it always happens, after the primary action of
a medicine that produces in large doses a great change
in the health of a healthy person, that its exact oppo-
site, when, as has been observed, there is actually such
a thing, is produced in the secondary action by our vital
force. (Organon of Medicine, paragraph 65)3
In paragraph 63 of the Organon of Medicine3, Hahnemann
suggests a physiological explanation for the principle of thera-
peutic similitude (primary action of the drug followed by sec-
ondary and opposite action of the body), justifying its univer-
sal mechanism of action of drugs (biphasic action of drugs) on
the automatic manifestation of “our life-preserving power” or
“homeostasis” according to modern physiology:
Every agent that acts upon the vitality, every medicine,
deranges more or less the vital force, and causes a certain
alteration 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-preserving power, which
goes by the name of secondary action or counteraction.
(Organon of Medicine, paragraph 63)3
Associating his empirical observations with hundreds of
reports of involuntary homeopathic cures described in the
literature and employing the inductive Aristotelian reason-
ing (modus ponens), Hahnemann enunciates the “principle of
cure by similars” (Organon of Medicine, paragraphs 24-7)3: any
medicine that cause, in their primary action, certain signs and
symptoms in healthy individuals can be used, in their second-
ary action, to cure similar signs and symptoms in sick individ-
uals (similia similibus curentur).
erefore, the homeopathic method of treatment employs
the secondary action or vital reaction of the body for therapeutic
1Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Psiquiatria – São Paulo (SP), Brazil.
*Corresponding author: marcus@homeozulian.med.br
Conicts of interest: the authors declare there is no conicts of interest. Funding: none.
Received on December 27, 2021. Accepted on January 09, 2022.
https://doi.org/10.1590/1806-9282.20211362
Similitude in Modern Pharmacology
304
Rev Assoc Med Bras 2022;68(3):303-307
purposes by administering to ill individuals drugs that cause
similar symptoms in healthy individuals in order to awaken
a healing reaction of the body against their own disturbances
or diseases.
By emphasizing that such secondary action of the body
(vital reaction) is observed “in each and every instance with
no exceptions” with ponderable or innitesimal doses in both
healthy and ill individuals, Hahnemann raised the principle
of therapeutic similitude to the level of a “natural law of cure”
(Organon of Medicine, paragraphs 58, 61, 110-2)3.
In contrast, demonstrating the occurrence of evident wors-
ening of disturbances or diseases after ceasing the palliative
eect of drugs with contrary action to symptomatic manifes-
tations (“principle of cure by contraries”) (Organon, paragraphs
57-61)3, Hahnemann reinforces the validity of homeopathic
treatment according to the deductive Aristotelian reasoning
(modus tollens) or “mode that arms by denial”:
Important symptoms of persistent diseases have never
yet been treated with such palliative, antagonistic rem-
edies, without the opposite state, a relapse - indeed,
a palpable aggravation of the malady - occurring a
few hours afterwards. For a persistent tendency to
sleepiness during the day the physician prescribed
coee, whose primary action is to enliven; and when
it had exhausted its action the day - somnolence
increased;-for frequent waking at night he gave in the
evening, without heeding the other symptoms of the
disease, opium, which by virtue of its primary action
produced the same night (stupeed, dull) sleep, but
the subsequent nights were still more sleepless than
before; […]-weakness of the bladder, with conse-
quent retention of urine, was sought to be conquered
by the antipathic work of cantharides to stimulate the
urinary passages whereby evacuation of the urine was
certainly at rst eected but thereafter the bladder
becomes less capable of stimulation and less able to
contract, and paralysis of the bladder is imminent; -
with large doses of purgative drugs and laxative salts,
which excite the bowels to frequent evacuation, it was
sought to remove a chronic tendency to constipation,
but in the secondary action the bowels became still
more conned; [...] Howoften, in one word, the dis-
ease is aggravated, or something even worse is eected
by the secondary action of such antagonistic (antip-
athic) remedies, the old school with its false theories
does not perceive, but experience teaches it in a ter-
rible manner. (Organon of Medicine, paragraph 59)3
According to the modern pharmacology, the “primary
action” described by Hahnemann corresponds to the “thera-
peutic, adverse, and side eects” of conventional drugs, while
the “secondary action” corresponds to the “rebound eect” or
“paradoxical reaction” of the body, observed after discontinu-
ation of several classes of drugs that act contrary (palliative or
antipathic) to the signs and symptoms of diseases.
By denition, the term “rebound” is dened as the rever-
sal of response upon withdrawal of a stimulus, while “rebound
eect” means the production of increased negative symptoms
when the drug ends or the patient no longer responds to it: if
a drug produces a rebound eect, the condition it was used to
treat may come back even stronger when the palliative drug is
withdrawn (discontinued) or loses eectiveness (development
of tolerance or tachyphylaxis).
e rebound eect manifests itself at dierent intervals
(hours to weeks) after the end of the biological eect of the
drug (pharmacological half-life), and its duration also varies.
erebound eect presents an intensity or frequency a few times
higher than the corresponding baseline symptoms suppressed
by the primary action of the antipathic drug. Althoughthe
rebound eect only occurs in a minority of susceptible indi-
viduals, it becomes an epidemiological concern when consid-
ering the exceedingly broad use of palliative treatments by the
population.
Following the deductive Aristotelian reasoning employed
by Hahnemann to validate the homeopathic healing princi-
ple, since 1998, we have been scientically substantiating the
“similitude in modern pharmacology” through the systematic
study of the rebound eect (paradoxical reaction) of many
classes of drugs4-14, conrming the homeopathic postulate and
the principle of similitude: a universal occurrence of strong
secondary and opposite action of the body after ceasing the
primary action of the drugs (Figure 1).
Illustrating the rebound phenomenon4-14, it is observed
that drugs classically used for the treatment of angina pectoris
(e.g., β-blockers, calcium channel blockers, and nitrates) with
benecial eects through their primary action might trigger
a paradoxical increase of the frequency and intensity of chest
pain after its discontinuation. Drugs used for arterial hyper-
tension (e.g., α-2 agonists, β-blockers, ACE inhibitors, MAO
inhibitors, nitrates, sodium nitroprusside, and hydralazine)
might produce rebound arterial hypertension after the end of
the primary biological eect (half-life). Antiarrhythmic drugs
(e.g., adenosine, amiodarone, β-blockers, calcium channel block-
ers, disopyramide, ecainide, lidocaine, mexiletine, moricizine,
and procainamide) may trigger rebound exacerbation of basal
ventricular arrhythmias. Antithrombotic drugs (e.g., argatroban,
Teixeira, M. Z. et al.
305
Rev Assoc Med Bras 2022;68(3):303-307
bezabrate, heparin, salicylates, warfarin, and clopidogrel) might
promote thrombotic complications as a result of the rebound
eect. Drugs with primary pleiotropic or vasoprotective action
(statins) might cause rebound endothelial dysfunction, result-
ing in predisposition to paradoxical vascular accidents.
Analogously, discontinuation of anxiolytics (e.g., barbitu-
rates, benzodiazepines, and carbamates), sedative-hypnotics (e.g.,
barbiturates, benzodiazepines, morphine, promethazine, and
zopiclone), stimulants of the central nervous system (e.g., amphet-
amines, caeine, cocaine, mazindol, and methylphenidate),
antidepressants (e.g., tricyclic, MAO inhibitors, and selective
serotonin reuptake inhibitors), or antipsychotics (e.g., clozap-
ine, phenothiazines, haloperidol, and pimozide) might cause
rebound aggravation of the original condition after the end of
their primary therapeutic action.
Anti-inammatory agents (e.g., steroids, ibuprofen, indo-
methacin, paracetamol, and salicylates) might trigger a para-
doxical increase of inammation and rebound thrombosis (e.g.,
ibuprofen, indomethacin, diclofenac, salicylates, rofecoxib,
and celecoxib) as a function of their primary platelet anti-ag-
gregation eect.
Analgesics (e.g., caeine, calcium channels blockers, clonidine,
ergotamine, methysergide, opiates, and salicylates) might trigger
rebound hyperalgesia. Diuretics (e.g., furosemide, torasemide,
and triamterene) might cause sodium and potassium rebound
retention, with consequent increase in the plasma volume and
the blood pressure. Bronchodilators (e.g., short- and long-act-
ing β-adrenergic agonists, sodium cromoglycate, epinephrine,
ipratropium, and nedocromil) might promote rebound bron-
choconstriction as a paradoxical reaction to discontinuation.
Anti-dyspeptic (e.g., antacids, H2 antagonists, misopros-
tol, sucralfate, and proton-pump inhibitors) might trigger
rebound increase of hydrochloric acid production and gastrin,
with worsening of the original condition. Antiresorptive drugs
used for the treatment of osteoporosis (e.g., bisphosphonates,
denosumab, and odanacatib) might cause paradoxical atypi-
cal fractures due to the rebound increase of osteoclast activity.
Discontinuation of drugs for the treatment of multiple
sclerosis (e.g., glucocorticoids, interferon, glatiramer acetate,
natalizumab, and ngolimod) might cause rebound increase of
the inammation with exacerbation of clinical symptoms and
increase of demyelination lesions. Immunomodulatory agents
(e.g., recombinant monoclonal antibodies and tumor necro-
sis factor inhibitors) indicated for the treatment of psoriasis
might trigger rebound psoriasis after discontinuation. e list
of examples is much longer4-14.
According to these examples, the rebound eect, a universal
and automatic physiological mechanism to maintain a constant
Principle of Similitude
Primary action of the drug
(Homeopathy)
Secondary action of the body
(Homeopathy)
Therapeutic, adverse and
side effects of the drug
(Pharmacology)
Rebound effect or paradoxical
reaction of the body
(Pharmacology)
Figure 1. Universal mechanism of action of drugs (biphasic action of drugs): primary action of the drug followed by secondary and opposite action
of the body (principle of similitude).
Similitude in Modern Pharmacology
306
Rev Assoc Med Bras 2022;68(3):303-307
internal environment or homeostasis, is liable to be elicited by
all types of palliative drugs. Due to the high intensity of pri-
mary action of drug, such paradoxical reaction might induce
severe and eventually fatal adverse events.
Exemplifying these iatrogenic events, the long-acting
β-adrenergic bronchodilators cause 1 episode of fatal rebound
bronchospasm per 1,000 patient-years of use, corresponding
to 4,000–5,000 deaths in 2004 in the United States alone, and
40,000–50,000 deaths worldwide5,7. Selective serotonin reuptake
inhibitor antidepressants cause 5 rebound suicidal manifestations
per 1,000 patient-years of use among adolescents, corresponding
to 16,500 cases of suicidal ideation or behavior in 2007 in the
United States alone5,8. Bisphosphonates cause 1–3 episodes of
paradoxical atypical fractures per 1,000 patient-years of use11.
Assuming that the principle of therapeutic similitude is a
“natural law of cure,” since 2003, we have been suggesting the
homeopathic use of modern drugs employing the rebound
eect in a therapeutic way15-19, proposing to administer, in
ultra-diluted doses, drugs that present, in their primary action,
a set of signs and symptoms similar to the manifestations of
sick individuals.
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:
“Scientic basis of the principle of similitude in modern phar-
macology,”21 “Homeopathic materia medica of modern drugs,22
and “Homeopathic repertory of modern drugs.”23
To test the clinical and scientic validity of this proposal,
we developed a randomized controlled trial employing poten-
tized estrogen (17-β estradiol) for the treatment of endome-
triosis-associated pelvic pain24, in view of the fact that estrogen
causes as an adverse event a set of signs and symptoms similar
to the endometriosis syndrome, observing signicant improve-
ment compared with placebo in relation to pain, depression,
and quality of life25.
We hope that these studies will be useful to all homeo-
pathic doctors and researchers in the scientic validation of
the therapeutic similitude and enable new applications for the
homeopathic treatment.
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... These scientific pieces of evidence [4][5][6][7][8][9][10][11][12][13][14][15] demonstrate that the properties of the rebound effect of modern pharmacology are similar to the secondary action of homeopathic pharmacology (Organon of medicine, paragraphs 59, 64, 69) 3 : 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 the 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 intensity of the primary action of the drug; and 5) It appears only in susceptible individuals (idiosyncrasy). ...
... In accordance with its idiosyncratic nature, the rebound phenomenon appears in a small proportion of susceptible individuals; nevertheless, scientific pieces of evidence point to the occurrence of severe and fatal adverse events as a result of the paradoxical reaction of the body following the discontinuation of different categories of drugs. [4][5][6][7][8][9][10][11][12][13][14][15] This corroborates the magnitude of the phenomenon, the need to be duly known by health care providers, and the benefits of its therapeutic application according to the similitude principle. ...
... (Organon of medicine, paragraph 60). 3 Bridging between the therapeutic similarity principle and modern scientific reason, hundreds of studies in the medical literature describe the occurrence of secondary reactions following and opposed to the primary actions of many categories of drugs, thus corroborating the homeopathic assumption. [4][5][6][7][8][9][10][11][12][13][14][15] Such secondary action or reaction, which occurs automatically and instinctively to maintain the system homeostasis, is described by contemporary pharmacology and physiology as a rebound effect of drugs or a paradoxical reaction of the body, respectively. ...
... These clinical and experimental pharmacological evidences [4][5][6][7] show that the characteristics of the rebound effect are similar to the homeopathic secondary action or reaction (Organon of medicine, §59, 64, 69) 2 : ...
... Despite this idiosyncratic nature of the rebound effectwhich appears in a small proportion of individuals -scientific evidences point to the occurrence of severe and fatal events as a result of the paradoxical reaction of the body following discontinuation of different categories of drugs [5][6][7] . This corroborates the magnitude of the phenomenon, the need to be duly known by health care providers, and the benefits of its therapeutic application according to the similitude principle. ...
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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.
... Desde 1998, siguiendo la lógica deductiva aristotélica empleada por Samuel Hahnemann para sustentar científicamente el principio de la similitud terapéutica, venimos justificando el principio de cura homeopática (acción secundaria o reacción vital del organismo) frente a la farmacología moderna, a través del estudio sistemático del efecto rebote de numerosas clases de fármacos modernos, descrito en varias publicaciones científicas [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] . ...
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Desde 1998, siguiendo la lógica deductiva aristotélica empleada por Samuel Hah-nemann para sustentar científicamente el principio de la similitud terapéutica, ve-nimos justificando el principio de cura homeopática (acción secundaria o reacción vital del organismo) frente a la farmacología moderna, a través del estudio sistemático del efecto rebote de numerosas clases de fármacos mo-dernos, descrito en varias publicaciones científicas. Desde 2003, de manera similar a la practicada por Hahnemann en la im-plementación de la Homeopatía, venimos proponiendo el uso de fármacos mo-dernos según el principio de la similitud terapéutica (aplicación del efecto rebote curativo de los fármacos modernos), descrito en otras publicaciones científicas y con su eficacia probada en ensayo clínico aleatorizado, doble cie-go y controlado con placebo.
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Homeopathy is based on the law of similarity, which tells us that the use of drugs that produce symptoms similar to those of diseases stimulates the body’s reaction to relieve their own ailments. Homeopathic treatment can use all kinds of substances (natural or synthetic, in weight or infinitesimal doses) provided that this principle is respected. Based on the above, since 2003 we have proposed the use of modern drugs according to the homeopathic healing principle both through research and publications in scientific journals, and the development of a Homeopathic Materia Medica Modern Drugs, which includes the primary effects of 1,250 allopathic drugs, and a Homeopathic Repertory of Modern Drugs. These efforts are part of the New Homeopathic Medicine project: Use of Modern Drugs according to the Principle of Similarity, which can be consulted free of charge, in Portuguese and English, on the website www.newhomeopathicmedicines.com. Now, the clinical and scientific validity of this proposal has begun with the performance of a clinical trial to evaluate the efficacy and safety of energized estrogen in the homeopathic treatment of pelvic pain associated with endometriosis. The result has been positive, but it requires doctors, pharmacists and researchers to join this initiative to strengthen it and boost its growth.//////////// Resumen La Homeopatía se fundamenta en la ley de semejanza, la cual nos dice que el empleo de medicamentos que producen síntomas similares a los de las enfermedades estimula la reacción del organismo para aliviar sus propias dolencias. El tratamiento homeopático puede emplear toda clase de sustancias (naturales o sintéticas, en dosis ponderales o infinitesimales) siempre que se respete dicho principio. Con base en lo anterior, desde 2003 hemos propuesto el uso de fármacos modernos según el principio homeopático de curación tanto a través de investigaciones y publicaciones en revistas científicas, como de la elaboración de una Materia Médica Homeopática de Fármacos Modernos, que incluye los efectos primarios de 1,250 fármacos alopáticos, y un Repertorio Homeopático de Fármacos Modernos. Estos esfuerzos forman parte del proyecto Nuevos Medicamentos Homeopáticos: Uso de Fármacos Modernos según el Principio de Semejanza, que puede consultarse de manera gratuita, en portugués e inglés, en el sitio web www.nuevosmedicamentoshomeopaticos. com. Ahora, la validez clínica y científica de esta propuesta ha comenzado con la realización de un ensayo clínico para evaluar la eficacia y la seguridad del estrógeno dinamizado en el tratamiento homeopático del dolor pélvico asociado a la endometriosis. El resultado ha sido positivo, pero se requiere que médicos, farmacéuticos e investigadores se sumen a esta iniciativa para robustecerla e impulsar su crecimiento.
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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.
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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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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: Employing the secondary action or adaptative reaction of the organism as therapeutic response, homeopathy uses the treatment by similitude (similia similibus curentur) administering to sick individuals the medicines that caused similar symptoms in healthy individuals. Such homeostatic or paradoxical reaction of the organism is scientifically explained through the rebound effect of drugs, which cause worsening of symptoms after withdrawal of several palliative treatments. Despite promoting an improvement in psoriasis at the beginning of the treatment, modern biological therapies provoke worsening of the psoriasis (rebound psoriasis) after discontinuation of drugs. Method: Exploratory qualitative review of the literature on the occurrence of the rebound effect with the use of immunomodulatory drugs [T-cell modulating agents and tumor necrosis factor (TNF) inhibitors drugs] in the treatment of psoriasis. Results: Several researches indicate the rebound effect as the mechanism of worsening of psoriasis with the use of efalizumab causing the suspension of its marketing authorization in 2009, in view of some severe cases. Other studies also have demonstrated the occurrence of rebound psoriasis with the use of alefacept, etanercept and infliximab. Conclusion: As well as studied in other classes of drugs, the rebound effect of biologic agents supports the principle of similitude (primary action of the drugs followed by secondary action and opposite of the organism).
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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.