Homeopatía: una breve descripción de esta especialidad médica / Homeopathy: a brief description of this medical specialty

La homeopatía es una forma de medicina con 200 años de historia. A lo largo de este tiempo, ha demostrado su capacidad para resolver problemas, a bajo costo, con un amplio alcance y con una aceptación social incuestionable. Según las estimaciones, aproximadamente 500 millones de personas utilizan la homeopatía en todo el mundo, lo que corresponde a alrededor del 7% de la población mundial. Sin embargo, aún existen obstáculos para su integración en la medicina convencional, los cuales deben ser puestos en perspectiva y eliminados. El propósito del presente artículo es contextualizar la homeopatía como una ciencia y un arte tanto en Brasil como en el resto del mundo. Analizamos algunos aspectos relevantes, como el perfil de sus usuarios, las razones para elegir la homeopatía, así como los contextos históricos y sociales para su inclusión en los sistemas educativos y de atención médica. Concluimos que la homeopatía es un sistema medico ético que ofrece un tratamiento sistémico y seguro a los pacientes, con una optima relación costo-beneficio. La homeopatía debe incluirse en las universidades, escuelas de medicina, así como en todos los niveles del sistema de atención médica, asegurando así su naturaleza histórica como especialidad médica.

Homeopathy is a medical approach with 200 years of history. Along this time it demonstrated its ability to solve problems, with low cost, broad scope and unquestionable social acceptance. According to estimates, approximately 500 million people use homeopathy worldwide, corresponding to about 7% of the world population. However, there are still hindrances to its integration into conventional medicine which need to be put into perspective and removed. The aim of the present article is to contextualize homeopathy as a science and an art in Brazil and worldwide. We analyzed some relevant aspects, such as the profile of users, their reasons to choose homeopathy, and historical and social contexts for the inclusion of homeopathy into health care and educational systems. We conclude that homeopathy is an ethical medical system that provides systemic and safe treatment to patients with optimal costbenefit ratio. Homeopathy should be included in universities, schools of medicine and at all levels of the healthcare system, thus ensuring its historical nature as a medical specialty.

Ensaios clínicos de pacientes únicos em homeopatia: aspectos técnicos, educacionais e éticos / Single-case studies in homeopathy: technical, educational and ethical aspects

ensaio clínico de pacientes únicos (ECPU/ensaio n-de-1) consiste na observação sistemática de condutas terapêuticas adotadas para otimizar o restabelecimento da saúde em um único paciente, com múltiplos cruzamentos ao longo do tratamento, podendo ter adicionalmente propósito de pesquisa clínica. Foi proposto há décadas e tem sido mais utilizado nas áreas de psicologia clínica, recebendo maior atenção em estudos médicos nos últimos anos. Embora seja considerado como o tipo de estudo com maior força para tomada de decisões terapêuticas, ainda são escassas as publicações sobre o seu emprego em medicina. Este artigo aborda as possibilidades dos ECPUs na avaliação dos resultados clínicos da homeopatia, explorando seus aspectos metodológicos, éticos e educacionais característicos em comparação aos ensaios clínicos randomizados tradicionais. Em pesquisa clínica, diferentemente dos ensaios convencionais, os ECPUs permitem a participação mais direta do paciente na escolha dos procedimentos e acompanhamento dos resultados, com possibilidade de alterações imediatas e sem que seja necessária sua exclusão do estudo, além de implicações de ordem econômica, política e ética. Podem ser utilizados no teste de medicamentos usados de modo off label, sem as restrições impostas à inclusão de pacientes vulneráveis nos estudos clínicos habituais, com excessiva artificialização no delineamento experimental. Poderiam ser ainda adotados nas diversas fases de teste clínico dos medicamentos, reduzindo a exposição de grande número de participantes aos riscos da pesquisa e baixa margem de extrapolação clínica dos resultados ao conjunto da população. Em homeopatia, podem ajudar a aprimorar o conhecimento dos medicamentos já em uso ou a melhor detectar os efeitos de novas substâncias testadas em ensaios patogenéticos homeopáticos. Em função do seu propósito principal de otimização do tratamento individual ­ e do alinhamento com os princípios éticos da autonomia e beneficência associados à prática da medicina centrada-no-paciente ou de precisão - podem ser desenvolvidos em conjunto com o paciente e familiares, sem a obrigatoriedade de aprovação prévia por Comissões de Ética Médica ou Comitês de Ética em Pesquisa.

The single-patient clinical trial (n-of-1 trial) is primarily designed to systematically observe outcomes from different therapeutic options to optimize the restoration of health in a single patient, with multiple crossovers throughout the treatment. They may additionally have a clinical research purpose. They have been proposed for decades and were mostly used in clinical psychology, receiving greater attention in medical studies in recent years. Although it is considered the type of study with the greatest strength for therapeutic decision-making, there are still few publications with its application in medicine. This article discusses the possibilities of single-patient clinical trials in assessing homeopathy outcomes, exploring their characteristic methodological, educational and ethical aspects compared to traditional randomized clinical trials. In clinical research, unlike conventional trials, single-patient clinical trials allow for more direct patient participation in choosing procedures and monitoring results, with the possibility of immediate changes without the need for their exclusion from the study, in addition to economic, political and ethical implications. They can be used in testing off-label drugs without the restrictions imposed on the inclusion of vulnerable patients in usual clinical studies, with excessive artificiality in the experimental design. They could also be adopted in the various clinical trial phases of drugs, reducing the exposure of many participants to the risks of research and low margin of clinical extrapolation of the results to the entire population. In homeopathy, they can help refine the knowledge of medications already in use or better detect the effects of new substances tested in homeopathic pathogenetic trials. Due to their purpose of optimizing individual treatment ­ and alignment with the principles of patient-centered or precision medicine ­ they can be developed jointly with the patient and her family without the mandatory prior approval by Medical Ethics Committees or Research Ethics Committees.

Homeopatia e racionalidade médica / Homeopathy and medical rationality

A prática racional e integral da homeopatia exige que o profissional médico explique a doença do paciente e ao mesmo tempo o compreenda, sendo portanto necessária a individualização do doente com sua(s) doença(s). Por outro lado, a terapêutica homeopática também tem sido historicamente empregada na prática médica, em diferentes situações e com resolutividade, em casos com parcial similitude e uso de um ou mais medicamentos homeopáticos. A homeopatia tem evoluído ao longo do tempo, com realização de pesquisas clínicas que se valem de métodos clínicos validados à avaliação da efetividade e eficácia da homeopatia e que, em certa medida, levam em consideração as peculiaridades do método terapêutico homeopático, com sua exigência de abordagem individualizada do paciente. Entre a terapêutica homeopática e a alopática há muitas compatibilidades e, a distingui-las, a aplicação de dois princípios de base: O princípio dos semelhantes e o dos contrários. A avaliação clínica da homeopatia que considera os seres humanos semelhantes entre si pode seguir razoavelmente o modelo adotado nos estudos clínicos clássicos, enquanto na perspectiva da unicidade do ser humano são requeridos novos modelos de pesquisa que considerem a competência do médico, a variabilidade humana e a confiabilidade das fontes informativas da matéria médica homeopática.

The rational and integral practice of homeopathy requires that the medical professional explain the patient's disease and at the same time understand it, therefore, it is necessary to individualize the patient with his/her disease(s). On the other hand, homeopathic therapy has also been historically used in medical practice, in different situations and with resolution, in cases with partial similarity and use of one or more homeopathic medicines. Homeopathy has evolved over time, with clinical research carried out using validated clinical methods to assess the effectiveness and efficacy of homeopathy and which, to a certain extent, take into account the peculiarities of the homeopathic therapeutic method, with its requirement of individualized patient approach. There are many compatibilities between homeopathic and allopathic therapy and, to distinguish them, the application of two basic principles: the principle of similars and the principle of opposites. The clinical evaluation of homeopathy that considers human beings similar to each other can reasonably follow the model adopted in classic clinical studies, while in the perspective of the uniqueness of the human being, new research models are required that consider the competence of the physician, human variability and the reliability of homeopathic materia medica information sources.

A clínica da similitude / The clinical practice of similarity

Agradecemos a gentileza do convite para proferir esta conferência no interessante momento em que, por iniciativa da comissão organizadora deste XXII Congresso Brasileiro de Homeopatia, são convidados observadores e palestrantes da área não homeopática com a intencionalidade de nos questionar e quebrar a assim chamada auto referência. Trazemos aqui algumas considerações sobre a Clínica da Similitude, que esperamos possam contribuir para a compreensão do nosso modelo e levantar questionamentos sobre a nossa prática. Foi-nos ensinado que a ciência começa na filosofia clássica como um projeto de conhecimento do homem, valendo-se inicialmente apenas da razão, incorporando posteriormente o trabalho experimental para a sua evolução e aperfeiçoamento. Nesse contexto observamos que, como consequência do resgate acidental de Hahnemann, a Homeopatia nasce bem dentro da proposta de experimentação buscando, a seguir, valer-se da razão para tentar compreender o conhecimento que ali se mostrava. (AU)

O organon da arte de curar de Samuel Hahnemann para o século XXI / The art organon of Samuel Hahnemann's healing for the 21st century

O Organon forma um todo, uma unidade solidamente construída, onde cada palavra, cada um dos 291 parágrafos, tem o seu peso, tudo ai parecendo essencial. Esta obra contém a doutrina da homeopatia, que é a expressão do pensamento de seu fundador, Samuel Hahnemann. Como o Organon da Arte de Curar, nunca nenhuma outra obra em medicina viu o seu conteúdo ser sujeito ao filtro do tempo (200 anos) e dos homens e continuar a ser operante, conseguindo ainda hoje dar uma resposta cabal aos problemas que no dia a dia se apresentam no contato com a doença. E foi assim que Marcelo Pustiglione, objetivando tornar esta obra mais acessível e compreensível, tomou para si a responsabilidade de sistematizar e atualizar seu conteúdo e, enfim, elaborar uma obra moderna, com informações organizadas e inúmeras observações e comentários que facilitam sua consulta e estudo. (AU)

Curación, paliación y supresión. Conceptos y antecedentes / Cure, palliation and suppression. Concepts and background

Desde la creación de la doctrina homeopática los conceptos de curación, paliación y supresión han causado inquietud, ya que en muchos círculos médico homeopáticos se tiene la percepción de que la supresión y la paliación son dos acciones que no se deben realizar, o peor aún, se tiene la idea equivocada de que la supresión homeopática no existe. Por eso, muchos médicos pasan buena parte de su vida profesional tratando de conseguir la “curación” de sus pacientes, por imposible o riesgosa que parezca. Pero, ¿por qué se le teme tanto a la supresión? ¿Por qué se piensa que la paliación es jugar con los pacientes? Quizás a lo largo de los años del desarrollo doctrinario se han malinterpretado las definiciones que Samuel Hahnemann otorgó a estos conceptos. Así, en el presente artículo se describen estos términos de manera general y se profundiza en la forma en que se aplican en el ámbito homeopático, con la finalidad de generar un contexto más amplio al respecto...

Since the creation of homeopathic doctrine, the healing concepts palliation and suppression have caused concern because in many homeopathic medical circles there is a perception that the suppression and palliation are two actions that cannot be performed, or even worse, it has the misconception that homeopathic suppression doesn´t exist. Therefore, many doctors spend much time in their professional lives trying to get the “cure” for their patients, as risky and impossible as it may be. But, why worry about suppression? Why think that palliation is playing with patients? Perhaps over the years of doctrinal development, the definitions that Samuel Hahnemann gave about these concepts have been misinterpreted. So, in this article these terms are described in general and explore in a deep way on how they are applied in the homeopathic field in order to generate a broader context about it...

Una propuesta para el formato de la historia clínica homeopática / A proposal for the format of the homeopathic medical record

La historia clínica homeopática o la toma del caso es un método diagnóstico y de seguimiento de pacientes; debe realizarse con el mayor respeto, compromiso y compresión con el ser humano que está pidiendo ayuda para aliviar y/o curar la expresión de su enfermedad a través de sus síntomas. La misión del médico durante la toma del caso es individualizar al paciente, encontrar lo digno de curar y prescribir el medicamento homeopático más semejante posible para lograr la tan anhelada curación, a través, de una buena relación médico-paciente y unos conocimientos solidos de medicina clásica y medicina homeopática. Por lo anterior se considera, indispensable contar con un buen mecanismo de registro de información del paciente, lo que motiva el presente trabajo en el que se "propone" un formato modelo de historia clínica homeopática, muy completo, sustentado en bases históricas, científicas y legales.

Unicismo, Pluralismo y Complejismo / Unicism, Pluralism and complexism

Durante mucho tiempo se ha discutido a veces acaloradamente acerca de la manera más adecuada de prescribir un medicamento homeopático. El reconocido médico Tarsicio Escalante describe de manera muy clara lo que es la prescripción unicista, la pluralista y la complejista, y acepta que el médico homeópata debe ser reconocido como tal, independientemente de la modalidad que haya elegido, “siempre y cuando tenga el cuidado de administrar como factor curativo al semejante”. El autor expone, asimismo, la posibilidad de que los tres tipos de especialistas mencionados puedan dejar de hacer Homeopatía a pesar de usar el semejante. Si nos referimos a los unicistas, porque existe la duda acerca de la cantidad de veces que se puede dividir la materia y, por lo tanto, incertidumbre acerca de la eficacia del medicamento homeopático. En el caso de los pluralistas, se cuestiona la validez de prescribir varios remedios para cubrir en su totalidad la tipología del paciente; finalmente, cuando se habla de los complejistas se infiere que no hay pruebas contundentes para demostrar que el organismo es capaz de elegir la sustancia más adecuada de entre varios remedios mezclados previamente. El artículo desglosa cómo los unicistas defienden los postulados del doctor Samuel Hahnemann, en el sentido de que recetar más de un medicamento propicia que el efecto de uno de ellos se diluya o desaparezca por completo. Los complejistas, deduce el especialista, podrían acudir al precepto hahnemanniano de la individualidad morbosa y decir que cada enfermo responde de manera diferente y, por tanto, no habría razón para que no surtiera efecto un remedio múltiple. Resulta una realidad, concluye el artículo, que la actitud de los unicistas en contra de los complejistas es tan anticientífica como la que muestran los alópatas que detestan a la Homeopatía. En ambos casos, parecería que se conociera a profundidad el funcionamiento de este método clínico terapéutico.

It has long been discussed, sometimes heatedly, about the best way to prescribe a homeopathic medicine. The renowned doctor, Tarcisio Escalante describes very clearly what the unicist, pluralist and complexist prescription are, and agrees that the homeopath must be recognized as such, regardless of the mode he has chosen, “provided that he has the care of administering the similar as the healing factor”. The author also presents the possibility that the three mentioned types of specialists may stop doing Homeopathy despite using the similar. If we refer to the unicists, because there is doubt about the amount of times you can divide the matter and, therefore, uncertainty about the effectiveness of homeopathic medicine. In thecase of pluralists, the validity of the prescription of several remedies to fully cover the type of patient is questioned; finally, when speaking of complexist it follows that there is no conclusive evidence to show that the body is able to choose the best of the several previously mixed remedies. The articles analyzes how unicists defend the tenets of Dr. Samuel Hahnemann, in the sense that to prescribe more than one drug may cause that the effect of one of them may be diluted or may disappear completely. The complexists, points out the specialist, may look to Hahnemann precepts about morbid individuality and say that each patient responds in a different manner, therefore, there would not be a reason not to take effect a multiple remedy. The article concludes that it is a reality, that the attitude of unicists against complexists is as unscientific as the allopathic attitude of those who detest Homeopathy. In both cases, it seems like it may be known, at a very profound level, the operation of this clinical therapeutic method.

Una evaluación del conocimiento en homeopatía que tienen los usuarios de algunos consultorios y farmacias homeopáticas en Bogotá / An evaluation of knowledge in homeopathy that users of some homeopathic pharmacies and clinics have in Bogotá

Desde los años ochenta del siglo XX se observa en todo el mundo, un aumento tanto en la demanda de atención terapéutica bajo el método homeopático, como en el número de profesionales médicos que ejercen la homeopatía. Actualmente en Colombia no existen publicaciones sobre el conocimiento que de la homeopatía tiene la población que acude a las farmacias homeopáticas y a los consultorios de médicos homeópatas unicistas de Bogotá. Como médico homeópata unicista, considero que es importante evaluar qué conocimiento tienen de la homeopatía las personas que buscan atención médica homeopática unicista y las que acuden a las farmacias homeopáticas en la ciudad de Bogotá, para contribuir a su divulgación. Para llevar a cabo el estudio, se diseñó un estudio cualitativo de tipo descriptivo en donde se realizó una encuesta de respuesta múltiple. Se incluyeron a todos los usuarios mayores de edad que acudieron a cuatro farmacias homeopáticas (n= 226) y seis consultorios de médicos homeópatas (n=96) en la ciudad de Bogotá, durante el todo el mes de Abril del 2015. Para el análisis de los resultados se compararon las dos poblaciones. En el estudio se encontró que las personas que acuden frecuentemente a la consulta homeopática y que utilizan la homeopatía como método terapéutico en la ciudad de Bogotá, son principalmente mujeres (73%) con educación universitaria (36%). Con relación al conocimiento de la homeopatía se observó que existe una buena percepción en cuanto a la seguridad, eficacia y prevención de la homeopatía en ambas poblaciones, a pesar de que se encontró un mayor entendimiento sobre el método terapéutico en los pacientes que acuden a consulta con médico especialista con respecto a los usuarios de las farmacias. Sin embargo, de los pacientes que acuden al médico se observa que menos de la mitad (47%) reconoce que la homeopatía clásica utiliza un único remedio, sólo la mitad conoce de donde provienen los remedios homeopáticos y el 14% de la población no comprende el método terapéutico. En cuanto al grupo de usuarios que acuden a las farmacias homeopáticas, se observó que el 32% no comprende el método terapéutico, sólo el 19% reconoce que la homeopatía clásica utiliza un único remedio y sólo el 44% de los entrevistados conoce de donde provienen los remedios homeopáticos. Para ambos grupos la principal motivación para iniciar tratamiento con homeopatía es para tratar una enfermedad o molestia, la forma más común de conocer la homeopatía es a través de un conocido, familiar o amigo y la gran mayoría recomendaría el tratamiento homeopático dado que se encuentran satisfechos o muy satisfechos con la terapia. En conclusión, ambos grupos evidencian altos niveles de conocimiento con respecto a la homeopatía, no obstante, existe mayor conocimiento de la homeopatía en los pacientes que asisten a una consulta médica en comparación con los usuarios de farmacias homeopáticas

Transition time [Editorial] / Transition time [Editorial]

2013 is going to be an interesting year for the High Dilution research . There is a tendency to revise basic concepts and common beliefs, while refining models and theories. The fundamental research team seems to be open to deeper discussions, aiming to reinforce some hypothesis and discharge others. In somehow, we are stuck in a vicious way of think, trying to manage and describe an informational phenomenon into a molecular framework. The challenge offered to those researchers involved with basic science is to figure out how to deal with such phenomenon, since previous theories and models have not shown to be matched!In the other hand, there is a tendency to explore the HD phenomenon in its technological branch. While basic research is important to describe how things work, the applied research has a more intense social and economic appeal. To develop technology based on HD means to give a different kind of visibility to the , attracting sponsors, companies, entrepreneurs, always committed to the market regulatory laws.I am expecting for this year some important movements, both in the basic and applied research. Of course, it will be only a new beginning, as these changes require a lot of work, discussions and insights. But this transition time is very welcome!

The uncomfortable comfort zone [Editorial] / The uncomfortable comfort zone [Editorial]

Whenever we achieve the satisfaction of our expectations and anxiety dissolves, we feel as if we were in a comfort zone ? safe, complete, free from risks and in peace with ourselves. We might even have a little taste of heaven when we feel that we have fulfilled our duty. And as a fact, scientists are entitled to this kind of reward? but not for too long! In science, to enter a comfort zone can be as pleasant as dangerous. On one hand we may have a safe ground available to develop new modes of reasoning, protocols and theories. And on the other, we may stay stuck in a conventional but fragile ground, missing opportunities to reveal novel secrets or to address edge issues.Fundamental research in High Dilutions is at risk of entering such a state. Recently, nanostructures were found in serially diluted and agitated fluids, which not only raised our expectations as to a novel conceptual framework able to explain the HD phenomenon, but also led us back to mainstream science and the most innovative experimental technology. This has more far reaching consequences: if nanostructures form in HD, then Avogadro?s limit becomes senseless, and the long unexplained clinical and pharmacological properties of HD might be finally elucidated, new experiments may be designed, new theories postulated, and so forth. Shortly, once persuaded we hit the gold vein, we might celebrate this new era in the history of HD research and claim our duly place in mainstream science. The expectation of explaining HD and homeopathy out of nanostructures is not shared by our entire community. Some still prefer to associate this phenomenon with immaterial factors, like the putative vital energy or some still unknown property of matter. Others simply refuse such structural hypotheses because they do not fulfill basic requirements to explain the specificity of homeopathic medicines. Despite personal opinions or beliefs, the presence of nanostructures is, indeed, a consistent hypothesis and experimental evidences might accumulate and make it ever sounder. It is reasonable to posit that the energy released by mechanical agitation induces cavitation in the liquid phase and thus triggers nonlinear effects resulting in new molecular rearrangements. To follow this structural track means to keep us inside mainstream science, since we deal with sound theory, might perform modern experiments and collect data fit to be interpreted within the framework the current data. Nanostructures were identified only very recently and they had not been yet fully investigated. Countless data must still be collected, results organized, and eventually, new methods developed. The required tests are extremely complex, whereas the HD community suffers from a chronic and severe lack of human and material resources. In spite of such shortcomings, slowly and gradually we might become able to formulate a consistent theory both supporting and being supported by experimental evidence. This, as a fact, is the natural time of science. Adjusting for scale, we might judge we are following a track similar to the one that leads us to the atomic and the electromagnetic models, which do not started at quantum mechanics or Maxwell?s equations, but from isolated experimental observations.However, several issues still require thorough investigation: Are such nanostructures truly generated by serial dilution and agitation? Do they actually derive from the starting-material? Are nanostructures altered along serial dilution and agitation, as the clinical results predict? Even assuming that the presence of nanostructures in HD has the full weight of evidence, a very long road must still be travelled before we might be able to attribute biological activity to them. Also, since historically the samples have always been prepared in glass vials, we still must rule out the possibility of them being experimental artifacts due to the presence of contaminants, or results of the drying procedures required to prepare samples for experimental analysis.Few years ago, I challenged some colleagues who were utterly persuaded of the physical-chemical nature of HD to cite one single result correlating the identified physical-chemical properties of HDs and the biological activity of such preparations. There is no need to say that I?m still waiting for an answer. And the same applies to nanostructures: they will not represent an answer until they had not been correlated with biological activity and their mechanism is not shown to fully agree with the well-known characteristics of homeopathic medications, namely dependence on the starting-material and different behavior according to the level of dilution and agitation. The experimental and conceptual difficulties, the lack of a critical mass of researches, and the pressure exerted by the university and scientific milieu on the few existing ones might make us loose from sight the fact that the latest positive experiment is never the ultimate explanation of the HD phenomenon. Conversely, conflict and debate are systematically more fruitful in science than consensus and convergence. The community of HD researchers seems to have entered a new comfort zone when nanostructures were found in HD. Nanostructures have been raised to the level of ultimate evidence doing away with Avogadro?s limit and leading homeopathy and HD research into mainstream science. We really should enjoy this moment and collect more information about the HD phenomenon. However, we must be wary to not fall into a trap.

Biosemiotics and Body Signifier Theory: a way to understand High Dilutions / Biosemiotics and Body Signifier Theory: a way to understand High Dilutions

Since the 80´s Madeleine Bastide and Agnès Lagache have worked on the idea of the Body Signifier Theory, in which the living systems could be defined as ?sensible? systems not only able to self-organize, but also to receive and process non-molecular information according to the Pierce semiotic triad: matrix, receiver and carrier. These ideas were built along 20 years of experimental observations, whose results presented some kind of stereotyped pattern that emerged from cells or animals exposed to high dilutions, according to the similia principle. Curiously, at the same time, classical scientific communities have developed the concept of biosemiotics after the observation that living systems are semiotics entities able to deal with codes and meanings, even in molecule-driven processes. Not only the genetic code, but all regulatory functions in living systems represent coding processes. The development of methodologies to identify and understand these codes and its outputs is the aim of biosemiotic science. Putting both concepts together (body signifiers and biosemiotics), it is possible to recognize strong similarities between their approaches and methodology, allowing logical connections between non-molecular signals and changes in cell interactions patterns. Thus, the general concept of biosemiotic could be a theoretical platform on which the construction of a solid phenomenological description of high dilutions effects could be done.

Clinical Verification of Homeopathy / Clinical Verification of Homeopathy

The world is changing! This is certainly true regarding the homeopathic practice and access to homeopathic medicine. Therefore our first priority at the ECH-LMHI [1] has been to produce a yearly report on the scientific framework of homeopathy. In the 2010 version a new chapter about epidemic diseases has been added including the Leptospirosis survey on the Cuban population. A second priority has been to review the definition of the homeopathic medicines respecting the new framework generated by the official registration procedure and the WHO report. We are working now on a documented (Materia Medica and provings) list of homeopathic remedies to facilitate the registration of our remedies. The new challenges are: first of all more good research proposals and as such more funding (possible through ISCHI + Blackie Foundation as examples) [2]; international acceptance of new guidelines for proving and clinical verification of homeopathic symptoms (Proposals are ready for discussion); total reconsideration of the homeopathic repertories including results of the clinical verification of the symptoms. The world is changing, we are part of the world and changes are needed also for homeopathy! [1] Liga Medicorum Homoeopathica Internationalis (LMHI); 2010 [Access in 2010 Oct 21]. Available from http://liga.iwmh.net/index.php?menuid=1 [2] Clinical Verification of Homeopathy. International Scientific Committee on Homeopathic Investigations; 2010 [Acess is 2010 Oct 21]. Available from http://liga.iwmh.net/index.php?menuid=49&reporeid=198

From the informational paradigm to the paradigm of corporeal signifiers : a topical tool for the researcher on High Dilution / From the informational paradigm to the paradigm of corporeal signifiers : a topical tool for the researcher on High Dilution

The paradigm of corporeal signifiers of Madeleine Bastide and Agnès Lagache is very close to the informational paradigm of Claude Levy-Strauss. We will show that this paradigm is compatible with the main results of the research on High Dilution. It can be a very good tool to locate the differents studies on HD and can be of great help for the researcher. The paradigm shows us that the future must also be part of basic research; but it seems important to differentiate experimental studies and basic research. This basic research has to be organized along with conventional researchers, experts in their own areas.

Sujeitos em terapia: um estudo sócio-antropológico das práticas homeopáticas e psicanalíticas / People in Therapy: a social-anthropological study about Homoeopathics and Psycoanalytics clinical practices

Esta tese é fruto de um trabalho de pesquisa de campo desenvolvido ao longo de uma década. Insere-se no campo das Ciências Humanas e da Saúde através da linha de pesquisa Racionalidades Médicas e Práticas de Saúde, coordenada por Madel T. Luz. A partir de um enfoque sócio-antropológico, realiza-se um estudo comparativo entre a prática clínica da racionalidade médica homeopática e da psicanálise. Buscamos compreender os sentidos e significados atribuídos aos processos de adoecimento erecuperação da saúde; bem como os valores culturais, subjacentes a estas práticas, presentes em segmentos da classe média carioca, que levam determinados sujeitos a procurarem estas formas terapêuticas, para aplacarem seus sofrimentos. Para tanto criamos a categoria sociológica: sujeitos em terapia, que inclui a percepção de estados positivos, que chamamos de saúde e seu estado ideal denominado cura; a percepção de estados indicativos de um movimento desestabilizador, nomeado adoecimento; uma perspectiva terapêutica de respeito às singularidades e à pertinência temporal das intervenções possíveis, de acordo com as circunstâncias globais de cada paciente; e, o que ao nosso ver é a maior distinção destas propostas terapêuticas, uma relação terapeuta-paciente única, desafiadora, instigante, onde a sintonia se faz necessária para que o processo caminhe, numa direção que não se sabe a priori qual é, mas que é fruto desta interação. Trabalhamos com a análise das representações sociais dos homeopatas e psicanalistas acerca do sujeito (ou quem se trata), da saúde (ou o sujeito saudável), da cura(ou momento da alta) e da doença (ou o sujeito doente); agregando a esta análise a percepção da dinâmica das consultas homeopáticas e das sessões psicanalíticas referidas por estes profissionais, bem como aquilo que eles valorizam no processo terapêutico que desenvolvem com seus pacientes...

This thesis results from fieldwork research developed along one decade. It belongs to the domain of Humanities and Health Sciences in the line of research Medical Rationalities and Health Practices, coordinated by Madel T. Luz.From a social-anthropological perpective, a comparative study is carried out involving the clinical practice of the homeopathic medical rationality and psychoanalysis. The aim of the study is to understand the meaning and sense attributed to the processes ofsickening and recovery as well as the cultural values underlying the aforementioned practices, present in segments of Rio de Janeiro’s middle class, which lead certain subjectsto seek these therapeutic modes to ease their suffering. In order to develop such a study, a sociological category was created – people in therapy –, which includes the perception of positive states, which we deem health and its ideal state called cure; the perception ofstates indicative of a destabilizing movement, named sickening; a therapeutic perspective respectful of singularities and of the temporal adequacy of the possible interventions,according to the global circumstances of each patient; and, what in our opinion is the main distinction between these therapeutic proposals, namely, a unique, challenging and instigating therapist-patient rapport, in which being in tune with one another is necessaryfor the process to take place, albeit in a direction which no one knows beforehand which will be, but which depends on this interaction.We have worked with the analysis of social representations of homeopaths and psychoanalysts of the subject (or the one in treatment), of health (or the healthy subject), of healing (or the moment of release) and of sickness (or the sick subject); adding to theseanalyses the observations around the dynamics of homeopathic and psychoanalytic sessions as related by...

Scientific framework of homeopathy: evidence-based homeopathy / Marco científico da homeopatia: homeopatia baseada em evidências

Paper aims at considering all important aspects of the scientific framework of homeopathic practice, looking at the levels of scientific evidence of each aspect in an objective way, through an extensive review of literature. Levels of evidence considered are: I) existence of meta-analyses and/or systematic positive reviews of literature; IIa) multiple positive randomized controlled trials (RCTs); IIb) some positive RCTs; IIIa) positive multiple cohorts studies; IIIb) positive studies with some cohorts; IV) opinion of experts (clinical and daily practice cases). Conclusions are clear: homeopathy must stay within the framework of medical practice, and it is even a necessity for public health.

O presente artigo aborda aspectos importantes do marco científico da prática homeopática, focando os níveis de evidência de cada um deles de maneira objetica, através de uma revisão extensa da literatura. Os níveis de evidência considerados são: I) existência de meta-análises e/ou revisões sistemáticas positivas da literatura; IIa) múltiplos estudos randomizados controlados (RCTs) positivos; IIb) alguns RCTs positivos; IIIa) estudos de coortes múltiplas positivos; IIIb) estudos com algumas coortes positivos; IV) opinião de expertos (casos clínicos da prática cotidiana). As conclusões são claras: a homeopatia deve permanecer dentro do marco da prática médica, sendo, inclusive, uma necessidade para a saúde pública.

El sistema rector y el arte clínico homeopático / The guiding system and the art homeopathic clinic

La palabra Arte proviene del término en latín ARS, que significa habilidad y hace referencia a la realización de acciones que requieren una especialización o dedicación especialmente hacia una cosa, dentro del rubro médico se refiere al que con especial atención cultiva una rama determinada de la medicina o sobresale en ella, en este caso nos referimos a la Homeopatía y por tanto al homeópata.

El placebo y su importancia en la clínica homeopática / Placebo and its importance in homoeopathic clinic

La medicina alopática reporta en muchos estudios doble ciego sobre la eficacia del (placebo = pso) en el alivio del dolor. El pso como analgésico puede ser tan efectivo como la morfina hasta en un 55% de los casos (cifra muy elevada) en otras palabras la reducción del dolor con el pso corresponde un 55% por ciento de lo que se obtiene en la alopatía con la morfina y analgésicos.