Probabilistic Reasoning in Homeopathy Practice and its Implications for Clinical Research

The principle of similitude put forward by Hahnemann has challenging practical consequences in the selection of the right homeopathic medicine for a patient. According to this principle, only the medicines that best fit the totality of the symptoms of a given patient are supposed to really cure: this greatly depends on the homeopath's clinical analysis. In addition, a patient's illness may be more or less curable, depending on the characteristics of the disease. In their daily practice, homeopaths typically apply Bayesian reasoning to deal with uncertainty associated with both medicine and disease. We suggest that clinical research on homeopathy would gain by integrating this kind of prior estimation of (1) the probability of a given medicine being effective for that particular patient and (2) the probability of the patient's disease (or symptoms) being curable. We therefore suggest that future trials of N-of-1 design may gain (1) by testing a small number of "best candidate" medicines (instead of one) for a given patient facing a given disease, and (2) by including careful prior estimations of the probabilities that (a) each selected medicine will be efficient for that patient and (b) the patient's disease will be reversible with the medicine.

A Case of Recurrent Urinary Tract Infection Successfully Treated during Homeopathic Supportive Care in Oncology

INTRODUCTION

A 32-year-old patient with colon cancer consulted for homeopathic supportive care (HSC). She had also suffered from recurrent urinary tract infections (RUTIs) for 20 years. Could homeopathy treat these two very different issues with the same medicine?

THE PATIENT'S MAIN CONCERNS

Though the main reason for the consultation was a fear of the side effects of chemotherapy, the presence of Escherichia coli-induced RUTIs affected the patient's quality of life.

INTERVENTIONS AND OUTCOMES

The repertory listing highlighted Pulsatilla as the patient's homeopathic constitutional medicine. It was prescribed both for HSC and also for RUTI. In association with Arsenicum album and Nerves, Pulsatilla enabled a good tolerance to chemotherapy, with rapid recovery from peripheral neuropathies. In combination with Colibacillinum, Pulsatilla provided relapse-free curing of the RUTIs. The MOdified NARanjo Criteria for Homeopathy (MONARCH) Inventory score was +9.

CONCLUSION

The one individual's two different clinical complaints were treated with a constitutional homeopathic medicine, Pulsatilla, which covered the whole case. However, in HSC, the use of the constitutional remedy alone is rarely sufficient: it was reinforced by individualised symptomatic medication, organotherapy and isotherapy. For RUTI, isopathic and tubercular miasmatic treatments were each helpful. For both complaints, individualised homeopathy gave rapid, long-lasting and effective results.

Integrative Oncology: An International Perspective from Six Countries

In June 2019, a meeting was held in Paris in which experts from different countries (Israel, Spain, Belgium, Italy, USA, and France) met to discuss a selection of topics in integrative oncology (IO). The objectives were to draw on the delegates’ experience and expertise to begin an international collaboration, sharing details of differing existing models and discussing future perspectives to help define and guide practice in IO and define unmet needs. This report presents a summary of the meeting’s main presentations, and also reports on the experts’ responses to a questionnaire examining different aspects of IO service delivery, infrastructure, and utilization.

Use of Homeopathy in Integrative Oncology in Strasbourg, France: Multi-center Cross-Sectional Descriptive Study of Patients Undergoing Cancer Treatment

CONTEXT

 The use of homeopathy in oncological supportive care seems to be progressing. The first French prevalence study, performed in 2005 in Strasbourg, showed that only 17% of the subjects were using it. What is the situation 12 years later?

MATERIALS AND METHODS

 This is a descriptive study, using a questionnaire identical to that used in 2005, on 633 patients undergoing treatment in three anti-cancer centers in Strasbourg. The results of the "homeopathy" sub-group were extracted and studied.

RESULTS

 Of the 535 patients included, 164 used homeopathy: that is 30.7%. The main purpose of its use was to reduce the side effects of cancer treatments (75%). Among the users, 82.6% were "somewhat" or "very" satisfied, against "quite" satisfied for 15.5%, and "not at all" satisfied for 1.9%. The homeopathic treatment was prescribed by a doctor in 75.6% of the cases; the general practitioner was kept informed in 87% of the cases and the oncologist in 82%. Fatigue, pain, nausea, anxiety, sadness and diarrhea were improved in 80% of the cases. However, alopecia, weight disorders and loss of libido were the least improved symptoms. The use of homeopathy was significantly associated with the female sex.

CONCLUSION

 With a prevalence of 30.7%, homeopathy is the most used complementary medicine in integrative oncology in Strasbourg. Over 12 years, we have witnessed an increase of 83% in its use in the same city. Almost all respondents declare themselves satisfied and tell their doctors more readily than in 2005.

My best case: homeopathic management of adverse effects of tamoxifen

BACKGROUND

Nearly half of patients discontinue tamoxifen hormone therapy early because of side effects, thus increasing the risk of breast cancer recurrence. Could a homeopathic treatment improve compliance?

METHODS

A patient suffering from side effects of tamoxifen was seen in consultation every 2 months for 10 months by a senior homeopathic doctor and a registrar.

RESULTS

Case analysis and repertorisation led to the identification of Pulsatilla as the simillimum drug and tamoxifen 7c as the etiological treatment. This treatment resulted in a rapid and lasting improvement of all the symptoms.

CONCLUSIONS

The combination of a homeopathic medicine and a hetero-isotherapic illustrates both the principles of "similarity" and "the identical". It has proved to be an excellent response to the side effects of tamoxifen. By enhancing the patient's quality of life, this combined approach also improved adherence to treatment.

Homeopathic Treatment of Insomnia and Symptom Clusters Related to Cerebral Chemotoxicity in Oncology

BACKGROUND

 During chemotherapy, the correlation between insomnia and fatigue, anxiety, pain, depressed mood, and cognitive disorders makes these subjective complaints a 'symptom cluster' with common biological mechanisms. The theory of cerebral inflammation following the production of pro-inflammatory cytokines (high level of interleukin 1-β [IL1-β], IL6 and tumour necrosis factor-alpha) is currently the most generally accepted. Understanding these mechanisms should allow us to propose a chemoprotective homeopathic treatment of the nervous system.

METHODS

 By retaining the inflammatory aetiology, we combined the rubrics 'Inflammation of the brain', 'Inflammation of the meninges', 'Inflammation of the nerves' with the symptom cluster: insomnia, fatigue, depressive state and memory disorders.

RESULTS

After repertorisation, we propose the following homeopathic protocol: Belladonna 15c, Phosphorus 15c, Cerebral cortex 4c and Nerves 4c, two pills of each medicine to be sucked together before breakfast, lunch and dinner, on each day of chemotherapy and for the following 2 days.

CONCLUSION

 This selected protocol, derived from a physiopathological knowledge of the symptoms, seems to be well suited to the prevention and treatment of post-chemotherapeutic cerebral inflammation. It is essential to start the homeopathic treatment before the chemotherapy session to anticipate the emergence of the 'chemo-brain' side effects. This proposed prevention protocol must be confirmed and quantified by randomised studies.

[The Gardner-Diamond syndrome or painful recurrent ecchymotic purpura]

A case of Gardner-Diamond's syndrome is reported in which the lesions were localized to the face. The syndrome is characterized by the spontaneous onset of recurrent painful ecchymoses mainly in young women. The elective site of the lesions is on the limbs, sometimes on the abdomen or thorax, and only rarely on the face. They are accompanied by a very rich symptomatology contrasting with normal biological test results. An autoerythrocytic sensitization mechanism has been suggested but few biological arguments exist to support this auto-immune hypothesis of its origin. In contrast, the psychological background is hysterical in type, and the affection can be included among the psychogenic purpuras.