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International press abstracts
British Homeopathic Journal (2000) 89, 207±209 ß 2000 Macmillan Publishers Ltd All rights reserved 0007±0785/00 $15.00 www.nature.com/bhj
REVIEWS AND ABSTRACTS
International press abstracts A randomized, double-blind, placebo-controlled trial of a Bach ¯ower remedy NC Armstrong, E Ernst The aim of this randomized, double-blind, placebocontrolled trial was to investigate the ef®cacy of `Five Flower Remedy', also known as `Rescue Remedy', for examination anxiety in healthy university students. One-hundred university students were recruited. They were registered at the University of Exeter, aged between 18 and 65 y, and enrolled to undertake university examinations between May and July 1998. Participants were randomized to take one to four doses of either `Five Flower Remedy' or indistinguishable placebo during days 1 ± 7 of the experiment. Self-reported anxiety was quali®ed using the 40-item Spielberger State-Trait Anxiety Inventory (STAI) as the primary outcome measure. Visual analogue scales were used as the secondary outcome measure to allow the determination of daily anxiety scores. Forty-®ve percent of volunteers completed the study (21 subjects in the experimental and 24 in the placebo group). Reporting of anxiety, as measured by the state component of the STAI at enrolment, was not found to differ between verum and placebo and no gender differences were noted. However, self-reports to trait anxiety were found to be lower in men compared to women at enrolment. Eight days before examination, men reported signi®cantly lower levels of state anxiety but no signi®cant differences were subsequently identi®ed the evening before the examination. No signi®cant differences were identi®ed between or within groups for mean values of the daily VAS scores or indeed the linear contrast variable constructed to determine any trends associated with the weekly VAS reports. It is concluded that `Five Flower Remedy' had no speci®c effects in treating anxiety under these trial conditions. Perfusion 1999; 12: 440 ± 446. English-language Journals reviewed by K Lloyd
Psorinum in paediatrics P Popowski In a special issue of the `Cahiers de BiotheÂrapie' about Psorinum, one of the most interesting articles relates to the prescription of Psorinum to children.
The main symptoms of the new-born who needs Psorinum are: lack of reaction to medicines, ailments from vaccinations, from acute diseases, family history of psora, dermatosis, thrush. The main symptoms of the child are: infectious diseases recurring every winter, every cold turns into bronchitis; ailments from frustration, separation, sorrow; eczema, warts, aphtae; great chilliness; periodicity of symptoms every 3 or 4 days, every 21 days; exhaustion after an acute disease. Psorinum may be prescribed when well-indicated medicines do not work, or in a systematic way, as leader of psora, in a pluralist treatment. Cahiers de BiotheÂrapie; 2000; 162: 33 ± 36.
The parasites and their message Dr Van den Eynde The knowledge of parasites is based on the relation between the living being, between the parasite and its host; parasitism may be favourable (symbiosis or saprophytism), or pathogenic (diseases such as malaria). Homeopathy tries to understand why the parasite can grow in a vulnerable individual: a well-balanced human being is resistant to parasitism. This balance depends on the duality (yin ± yang, male ± female), and depends on two opposite principles: the principle of cooperation, or fusion, and the principle of identity or competition. The presence of parasites shows that the host has lost his vital balance: that is why our role is to restore balance instead of wanting only to kill the parasites. This article ends with a re¯ection about human parasitism in our society. Revue Belge; 1999; 4: 11 ± 29.
What to do during the 13th consultation D Scimema Clinical cases often consist of a small number (three or four) of consultations; longer observations should be published more often. The author asks whether the word cure has a meaning; our task consists in bringing harmony to the patient. But our ®ght is always lost in advance, because this leads always to the death . . . .
Abstracts
208
After 13 consultations (or after the 6th or the 28th consultation . . . ), we can distinguish several types of patients:
The `consulting type' has con®dence in his homeopathic doctor, but he follows his own way outside the patient ± doctor relationship. The `questioner type' uses homeopathy in a quest for himself. The `predictive type' is worried about his current health and is afraid of possible future consequences, for example serious illnesses. The `chronobiological' type is attracted by the rhythm of the day or of the seasons; he consults for preventive treatments.
Each type of patient has a very different behaviour and a very different objective towards his own illness:
The questioner wants to know why he is ill. The predictive wants to know how he will be ill. The chronobiological wants to know when he will be ill. The consulting wants to know nothing, but he wants the disappearance of his illness . . . . Cahiers de BiotheÂrapie; 2000; 161: 49 ± 54.
most outstanding French homeopathic doctors of recent years. He began to practise homeopathy in Mauritania when he was in the forces; then he set himself up in Bordeaux in 1946 and founded with Henri Bernard the `SocieÂte de MeÂdecine HomeÂopathique d'Aquitaine'. He was the author of numerous books, among them: `HomeÂopathie, MeÂdecine de l'ExpeÂrience', `L'HomeÂopathie sans masques', `Techniques homeÂopathiques'. He contributed to promote homeopathy in the French medical and university world. He was also a convinced Christian and his erudition permitted him to talk about St Thomas Aquinas, about the history of medicine or about Greek philosophy. His simplicity and his kindness are sadly missed in France, particularly in Bordeaux and in South-West of France. HomeÂopathie EuropeÂenne; 2000; 1: 5 ± 10. French-language journals are reviewed by P Colin.
Translating experience into rubrics AO Minotti
The Art of Homeopathy or by the year 2000 Dr Millemann 450 years before Jesus Christ, Hippocrates had already de®ned a holistic medicine, taking into account the set of symptoms and environment of the patient. Homeopaths try to follow the way of Hippocrates and are proud to pollute neither the environment nor the patients. The author stresses that homeopathic teaching should be more independent of pharmaceutic laboratories. Teaching should study the various methods of practising homeopathy ie classical and pluralist homeopathy. The laboratories should be more involved in the research on the mode of action of homeopathic medicines. They should also complete the old pathogenesis and establish new pathogenesies. Homeopathy should ®nd a place with other alternative holistic therapies in the health care system. The homeopath may ponder over Hahnemann's saying: `when our art is a matter of saving the life, neglecting to learn is a crime'. Cahiers de BiotheÂrapie; 2000; 161: 39 ± 44.
Tribute to Dr Denis Demarque B Poitevin, C Bourdel, C Bentz, A Sarembaud, Y Saint-Jean, P Demange, P Sirieix Dr Denis Demarque was born on 8th February 1915 and died on 17th October 1999. He was one of the British Homeopathic Journal
The author explains how he translates the mental symptoms given by patients into the language of the repertory Ð a challenge when what the person experiences and expresses does not coincide with the rubrics available in the book. Some interesting distinctions are made. Introversion is described as `involuntary egotism of feelings'. `Egotism' because feelings are kept to oneself; `involuntary' because it is in the person's nature, congenital if you like. By contrast, reserved is the `voluntary egotism of feelings', the difference being that it is entirely volitional. Another comparison is between reproaches others and censorious. The former is the propensity to blame another for something that has happened, while the latter is the propensity to look for faults in what another person says or does. Fastidious is de®ned as the preoccupation with maintaining harmony of the part in relation to the whole. It becomes a symptom if it leads to an aggressive reaction when this is not achieved, or when it causes inconvenience to others. For example, if a child leaves an article of clothing on the ¯oor, Nux vomica may shout in an attempt to restore the harmony of the part (the clothing) in relation to the whole (the arrangement of objects in the room). In Pulsatilla, order has to do with maintaining a timetable, which is a framework within which everything can be kept organized and controlled. In Arsenicum, order is seen in terms of alignment, so that symmetry is maintained. Hence the obsession with pictures that hang squintly. Other examples are given. HomeopatõÂa 1999; 64: 23 ± 26.
Abstracts
Case of MRSA tonsillitis F Goldstein Herman
This article describes a severe case of suppurative tonsillitis in the daughter of a homeopathic colleague. Despite numerous remedies and careful repertorization, the case was becoming progressively worse after 15 days. The causative organism was a multiple antibiotic-resistant Staphyloccocus aureus. The case was retaken for the ®fth time, but on this occasion without the parents being present, and ®nally the aetiology was uncovered. The girl had been scorned by her boyfriend, but was too shy to talk about this in front of her parents. Four key rubrics: ailments from scorn, suppuration of tonsils, restless feet and peeling lips, led to the prescription of Chamomilla, with a resolution of all symptoms in 24 h. The tonsils became normal after 72 h. Her constitutional remedy was Pulsatilla, which is complementary to Chamomilla. Dr Minotti's hierarchy of symptoms for acute case analysis is of interest: 1. 2. 3. 4. 5.
aetiology; diagnosis translated into repertory rubrics; as above, but with modalities considered; new mental symptoms (exclude chronic ones); chronic mental symptoms which are acutely exacerbated; 6. new general symptoms (exclude chronic ones); 7. chronic general symptoms which are acutely exacerbated; 8. chronic local symptoms which are acutely exacerbated. HomeopatõÂa 1999; 64: 233 ± 240.
Anxiety or anguish? F Goldstein Herman
This article aims to clarify the difference between these terms, which are often confused. The DSM-IV of the American Psychiatric Association de®nes anxiety only, anguish is ignored. The distinction, which is arrived at by an analysis of patients' language and the structure of rubrics, is important for remedy selection. Both states share restlessness and agitation in common. Anxiety is characterized by an apparent aetiological certainty (which might be a compensatory mechanism in a person who is full of doubts), eg as if guilty of a crime, from masturbation, etc. By contrast, in patients with anguish there is uncertainty, and `they don't know what is happening to them'. In anxiety there is expectation, eg anticipatory, about the future, if a
time is set, etc. Anguish is unpredictable, the onset is sudden and surprising. The emotional state of anxiety is discontinuous, eg in bed, at night, when alone, with alternations, and many modalities. Anguish is uninterrupted, but can intensify, eg during menses. In Herman's view, anxiety does not produce somatization, but anguish does, often characterized by spasms eg chest oppression, muscular tension, sensation of clothes too tight, etc. The word anguish is derived from the Latin `angustus' meaning narrow.
209
HomeopatõÂa 1999; 64: 273 ± 280. Spanish-language journals reviewed by G Blass.
Homeopathy in Head Injury E Chapman, R Weintraub, M Milburn, T O'Neil Pirozzi and E Woo Mild traumatic brain injury (MTBI) affects 750 000 persons in the United States annually, leaving 5 ± 15% with persistent dysfunction and disability. No effective, standard pharmacological treatment exists for this problem. This is a pilot research project to study the clinical effectiveness of homeopathic medicine in the treatment of persistent MTBI. A randomized, double-blind, placebo-controlled trial of 60 patients, with a 4-month follow-up (n 50), was conducted. Patients with persistent MTBI (mean 2.93 y since injury, s.d. 3.1) were randomly assigned to receive a homeopathic medicine or placebo. The primary outcome measure was the subject-rated SRH-MBTI Functional Assessment, composed of three subtests: a Dif®culty with Situation Scale (DSS); a Symptom Rating Scale (SRS); and a Participation in Daily Activities Scale (PDAS). The SRH Cognitive-Linguistic Test Battery was used as the secondary measure. Analysis of covariance demonstrated that the homeopathic treatment was the only signi®cant or near-signi®cant predictor of improvement on DSS subtests (P 0.009; 95% CI 7 0.895 to 7 0.15), SRS (P 0.058; 95% CI 7 0.548 to 0.01) and the Ten Most Common Symptoms of MTBI (P 0.027; 95% CI 7 0.766 to 7 0.048). These results indicate a signi®cant improvement from the homeopathic treatment vs the control and translate into clinically signi®cant outcomes. This study suggests that homeopathy may have a role in treating persistent MTBI. Our ®ndings require large-scale, independent replication. J Head Trauma Rehabil 1999; 14: 521 ± 542.
British Homeopathic Journal
REVIEWS AND ABSTRACTS
International press abstracts A randomized, double-blind, placebo-controlled trial of a Bach ¯ower remedy NC Armstrong, E Ernst The aim of this randomized, double-blind, placebocontrolled trial was to investigate the ef®cacy of `Five Flower Remedy', also known as `Rescue Remedy', for examination anxiety in healthy university students. One-hundred university students were recruited. They were registered at the University of Exeter, aged between 18 and 65 y, and enrolled to undertake university examinations between May and July 1998. Participants were randomized to take one to four doses of either `Five Flower Remedy' or indistinguishable placebo during days 1 ± 7 of the experiment. Self-reported anxiety was quali®ed using the 40-item Spielberger State-Trait Anxiety Inventory (STAI) as the primary outcome measure. Visual analogue scales were used as the secondary outcome measure to allow the determination of daily anxiety scores. Forty-®ve percent of volunteers completed the study (21 subjects in the experimental and 24 in the placebo group). Reporting of anxiety, as measured by the state component of the STAI at enrolment, was not found to differ between verum and placebo and no gender differences were noted. However, self-reports to trait anxiety were found to be lower in men compared to women at enrolment. Eight days before examination, men reported signi®cantly lower levels of state anxiety but no signi®cant differences were subsequently identi®ed the evening before the examination. No signi®cant differences were identi®ed between or within groups for mean values of the daily VAS scores or indeed the linear contrast variable constructed to determine any trends associated with the weekly VAS reports. It is concluded that `Five Flower Remedy' had no speci®c effects in treating anxiety under these trial conditions. Perfusion 1999; 12: 440 ± 446. English-language Journals reviewed by K Lloyd
Psorinum in paediatrics P Popowski In a special issue of the `Cahiers de BiotheÂrapie' about Psorinum, one of the most interesting articles relates to the prescription of Psorinum to children.
The main symptoms of the new-born who needs Psorinum are: lack of reaction to medicines, ailments from vaccinations, from acute diseases, family history of psora, dermatosis, thrush. The main symptoms of the child are: infectious diseases recurring every winter, every cold turns into bronchitis; ailments from frustration, separation, sorrow; eczema, warts, aphtae; great chilliness; periodicity of symptoms every 3 or 4 days, every 21 days; exhaustion after an acute disease. Psorinum may be prescribed when well-indicated medicines do not work, or in a systematic way, as leader of psora, in a pluralist treatment. Cahiers de BiotheÂrapie; 2000; 162: 33 ± 36.
The parasites and their message Dr Van den Eynde The knowledge of parasites is based on the relation between the living being, between the parasite and its host; parasitism may be favourable (symbiosis or saprophytism), or pathogenic (diseases such as malaria). Homeopathy tries to understand why the parasite can grow in a vulnerable individual: a well-balanced human being is resistant to parasitism. This balance depends on the duality (yin ± yang, male ± female), and depends on two opposite principles: the principle of cooperation, or fusion, and the principle of identity or competition. The presence of parasites shows that the host has lost his vital balance: that is why our role is to restore balance instead of wanting only to kill the parasites. This article ends with a re¯ection about human parasitism in our society. Revue Belge; 1999; 4: 11 ± 29.
What to do during the 13th consultation D Scimema Clinical cases often consist of a small number (three or four) of consultations; longer observations should be published more often. The author asks whether the word cure has a meaning; our task consists in bringing harmony to the patient. But our ®ght is always lost in advance, because this leads always to the death . . . .
Abstracts
208
After 13 consultations (or after the 6th or the 28th consultation . . . ), we can distinguish several types of patients:
The `consulting type' has con®dence in his homeopathic doctor, but he follows his own way outside the patient ± doctor relationship. The `questioner type' uses homeopathy in a quest for himself. The `predictive type' is worried about his current health and is afraid of possible future consequences, for example serious illnesses. The `chronobiological' type is attracted by the rhythm of the day or of the seasons; he consults for preventive treatments.
Each type of patient has a very different behaviour and a very different objective towards his own illness:
The questioner wants to know why he is ill. The predictive wants to know how he will be ill. The chronobiological wants to know when he will be ill. The consulting wants to know nothing, but he wants the disappearance of his illness . . . . Cahiers de BiotheÂrapie; 2000; 161: 49 ± 54.
most outstanding French homeopathic doctors of recent years. He began to practise homeopathy in Mauritania when he was in the forces; then he set himself up in Bordeaux in 1946 and founded with Henri Bernard the `SocieÂte de MeÂdecine HomeÂopathique d'Aquitaine'. He was the author of numerous books, among them: `HomeÂopathie, MeÂdecine de l'ExpeÂrience', `L'HomeÂopathie sans masques', `Techniques homeÂopathiques'. He contributed to promote homeopathy in the French medical and university world. He was also a convinced Christian and his erudition permitted him to talk about St Thomas Aquinas, about the history of medicine or about Greek philosophy. His simplicity and his kindness are sadly missed in France, particularly in Bordeaux and in South-West of France. HomeÂopathie EuropeÂenne; 2000; 1: 5 ± 10. French-language journals are reviewed by P Colin.
Translating experience into rubrics AO Minotti
The Art of Homeopathy or by the year 2000 Dr Millemann 450 years before Jesus Christ, Hippocrates had already de®ned a holistic medicine, taking into account the set of symptoms and environment of the patient. Homeopaths try to follow the way of Hippocrates and are proud to pollute neither the environment nor the patients. The author stresses that homeopathic teaching should be more independent of pharmaceutic laboratories. Teaching should study the various methods of practising homeopathy ie classical and pluralist homeopathy. The laboratories should be more involved in the research on the mode of action of homeopathic medicines. They should also complete the old pathogenesis and establish new pathogenesies. Homeopathy should ®nd a place with other alternative holistic therapies in the health care system. The homeopath may ponder over Hahnemann's saying: `when our art is a matter of saving the life, neglecting to learn is a crime'. Cahiers de BiotheÂrapie; 2000; 161: 39 ± 44.
Tribute to Dr Denis Demarque B Poitevin, C Bourdel, C Bentz, A Sarembaud, Y Saint-Jean, P Demange, P Sirieix Dr Denis Demarque was born on 8th February 1915 and died on 17th October 1999. He was one of the British Homeopathic Journal
The author explains how he translates the mental symptoms given by patients into the language of the repertory Ð a challenge when what the person experiences and expresses does not coincide with the rubrics available in the book. Some interesting distinctions are made. Introversion is described as `involuntary egotism of feelings'. `Egotism' because feelings are kept to oneself; `involuntary' because it is in the person's nature, congenital if you like. By contrast, reserved is the `voluntary egotism of feelings', the difference being that it is entirely volitional. Another comparison is between reproaches others and censorious. The former is the propensity to blame another for something that has happened, while the latter is the propensity to look for faults in what another person says or does. Fastidious is de®ned as the preoccupation with maintaining harmony of the part in relation to the whole. It becomes a symptom if it leads to an aggressive reaction when this is not achieved, or when it causes inconvenience to others. For example, if a child leaves an article of clothing on the ¯oor, Nux vomica may shout in an attempt to restore the harmony of the part (the clothing) in relation to the whole (the arrangement of objects in the room). In Pulsatilla, order has to do with maintaining a timetable, which is a framework within which everything can be kept organized and controlled. In Arsenicum, order is seen in terms of alignment, so that symmetry is maintained. Hence the obsession with pictures that hang squintly. Other examples are given. HomeopatõÂa 1999; 64: 23 ± 26.
Abstracts
Case of MRSA tonsillitis F Goldstein Herman
This article describes a severe case of suppurative tonsillitis in the daughter of a homeopathic colleague. Despite numerous remedies and careful repertorization, the case was becoming progressively worse after 15 days. The causative organism was a multiple antibiotic-resistant Staphyloccocus aureus. The case was retaken for the ®fth time, but on this occasion without the parents being present, and ®nally the aetiology was uncovered. The girl had been scorned by her boyfriend, but was too shy to talk about this in front of her parents. Four key rubrics: ailments from scorn, suppuration of tonsils, restless feet and peeling lips, led to the prescription of Chamomilla, with a resolution of all symptoms in 24 h. The tonsils became normal after 72 h. Her constitutional remedy was Pulsatilla, which is complementary to Chamomilla. Dr Minotti's hierarchy of symptoms for acute case analysis is of interest: 1. 2. 3. 4. 5.
aetiology; diagnosis translated into repertory rubrics; as above, but with modalities considered; new mental symptoms (exclude chronic ones); chronic mental symptoms which are acutely exacerbated; 6. new general symptoms (exclude chronic ones); 7. chronic general symptoms which are acutely exacerbated; 8. chronic local symptoms which are acutely exacerbated. HomeopatõÂa 1999; 64: 233 ± 240.
Anxiety or anguish? F Goldstein Herman
This article aims to clarify the difference between these terms, which are often confused. The DSM-IV of the American Psychiatric Association de®nes anxiety only, anguish is ignored. The distinction, which is arrived at by an analysis of patients' language and the structure of rubrics, is important for remedy selection. Both states share restlessness and agitation in common. Anxiety is characterized by an apparent aetiological certainty (which might be a compensatory mechanism in a person who is full of doubts), eg as if guilty of a crime, from masturbation, etc. By contrast, in patients with anguish there is uncertainty, and `they don't know what is happening to them'. In anxiety there is expectation, eg anticipatory, about the future, if a
time is set, etc. Anguish is unpredictable, the onset is sudden and surprising. The emotional state of anxiety is discontinuous, eg in bed, at night, when alone, with alternations, and many modalities. Anguish is uninterrupted, but can intensify, eg during menses. In Herman's view, anxiety does not produce somatization, but anguish does, often characterized by spasms eg chest oppression, muscular tension, sensation of clothes too tight, etc. The word anguish is derived from the Latin `angustus' meaning narrow.
209
HomeopatõÂa 1999; 64: 273 ± 280. Spanish-language journals reviewed by G Blass.
Homeopathy in Head Injury E Chapman, R Weintraub, M Milburn, T O'Neil Pirozzi and E Woo Mild traumatic brain injury (MTBI) affects 750 000 persons in the United States annually, leaving 5 ± 15% with persistent dysfunction and disability. No effective, standard pharmacological treatment exists for this problem. This is a pilot research project to study the clinical effectiveness of homeopathic medicine in the treatment of persistent MTBI. A randomized, double-blind, placebo-controlled trial of 60 patients, with a 4-month follow-up (n 50), was conducted. Patients with persistent MTBI (mean 2.93 y since injury, s.d. 3.1) were randomly assigned to receive a homeopathic medicine or placebo. The primary outcome measure was the subject-rated SRH-MBTI Functional Assessment, composed of three subtests: a Dif®culty with Situation Scale (DSS); a Symptom Rating Scale (SRS); and a Participation in Daily Activities Scale (PDAS). The SRH Cognitive-Linguistic Test Battery was used as the secondary measure. Analysis of covariance demonstrated that the homeopathic treatment was the only signi®cant or near-signi®cant predictor of improvement on DSS subtests (P 0.009; 95% CI 7 0.895 to 7 0.15), SRS (P 0.058; 95% CI 7 0.548 to 0.01) and the Ten Most Common Symptoms of MTBI (P 0.027; 95% CI 7 0.766 to 7 0.048). These results indicate a signi®cant improvement from the homeopathic treatment vs the control and translate into clinically signi®cant outcomes. This study suggests that homeopathy may have a role in treating persistent MTBI. Our ®ndings require large-scale, independent replication. J Head Trauma Rehabil 1999; 14: 521 ± 542.
British Homeopathic Journal