Complementary Alternative Cardiovascular Medicine

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216 Alternative Cardiovascular Medicine homeopathic pharmaceutical, with an emphasis of cardiovascular diseases (CVDs), and Dr. Woodson Merrell presents a critical analysis of the evidence, including relatively recent controlled clinical trials, regarding homeopathy. The editors are pleased with the “combination product” that they believe represents an insightful presentation of homeopathic medicine, PART I. AN EVIDENCE-BASED REVIEW OF HOMEOPATHY AND CARDIOVASCULAR DISEASE by Woodson C. Merrell, MD Introduction Complementary and alternative medicine (CAM) is fast entering American mainstream medical practice. Modalities that were once considered questionable or outright quackery are increasingly achieving an evidence basis and becoming recognized as having value in a more comprehensive approach to patient care. This approach is now more appropriately referred to as integrative medicine (1). Acupuncture, mind–body practice (hypnosis, imagery, biofeedback, etc.), chiropractic practice, botanical medicines, diet, and nutraceutical therapies are now practiced by an increasing number of physicians, demanded by their patients (2), and taught in medical schools. One modality that is still believed to be outside the mainstream is homeopathy, despite that worldwide, homeopathy is one of the most used therapeutic approaches (3), and has recent studies to demonstrate its safety and efficacy against placebo and in some specific conditions (4). Analysis of homeopathy’s role in our health care system requires: knowledge of its historical background, philosophical and scientific tenets, mode of practice, training and education, and research findings. Historical Background Homeopathy was developed by the German physician Samuel Christian Hahnemann in the late 18th century. His work was based on case studies he performed using substances that in full potency would cause symptoms found in certain disease states. Serendipitously he found that when these substances were diluted, they stimulated the body to react against these symptoms. He discovered this initially on research with cinchona bark (containing quinine)—which, in full strength, causes symptoms similar to malaria, but when diluted can reduce a patient’s symptoms, such as fever and toxicity, common to malaria and other illnesses. Hahnemann formulated the two guiding principles of homeopathy in his publication in 1796 in “Essay on the new Curative Princi-
Chapter 14 / Homeopathy and CVD 217 pal” (5). The first principle of homeopathy is called the Principle of Similars, in which a substance that is given in full strength can cause symptoms in a healthy person and can also stimulate self-healing in the same person with the illness. The second principle, the Principle of Dilutions, came from Hahnemann’s discovery that as he diluted (and shook up—or successed) the substances, the more dilute they became and usually the more potent their effects. Interestingly, Hahnemann’s work was done at the same time that Edward Jenner was showing that diluted cowpox conferred immunity to humans for smallpox—a technique using diluted biologically active agents that took a more immediately successful path. However, by 1900, there were 22 homeopathic schools in the United States, including Boston University School of Medicine; Hahnemann Medical College (Philadelphia), and New York Medical College. After Harvard’s Flexner Report and other changes in medical care in the United States, the number dwindled to four in 1922, and the last formal training program (part of Hahnemann Medical College) closed in 1949 (6). PUBLIC USE AND ACCEPTANCE Use, Training, and Regulation There is no doubt that homeopathy is enjoying a renaissance in the United States. After nearly a half century of dormancy, homeopathy’s use and acceptance by patients has grown considerably in the last 20 yr. In one 7-yr study in the 1990s, the use of homeopathy grew approx 500% sales of homeopathic preparations have grown 20–30% per year in the 1980s and 1990s (7). PROFESSIONAL TRAINING After the decline in homeopathy in the United States, Europe and India continued to recognize its ability. This recognition culminated in the 1990s in several formal reports on the usage of homeopathy in medical practice in Europe. In 1996, a Commission of the European Parliament (Homeopathy Medicine Research group) published a report that recommended homeopathy to be a part of medical practice (8). In England in 1997, the Prince of Wales’ Commission also recommended homeopathy’s inclusion in the mainstream health care delivery system (9). It was already part of the system, with one hospital—Glasgow Homeopathic Hospital—having been a part of the National Health Service for more than a decade. In 1998, the French equivalent of the American Medical Association (Conseil National de l’Ordre des Medicines) recommended that homeopathy be a part of undergraduate and postgraduate medical training (10).
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Complementary and Alternative Cardi
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CONTEMPORARY CARDIOLOGY CHRISTOPHER
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© 2004 Humana Press Inc. 999 River
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vi Preface physician or other healt
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viii Contents 10 Massage Therapy an
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x Contributors ERIN L. OLIVO, PhD
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Chapter 1 / CAM and CVD 1 1 Complem
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Chapter 1 / CAM and CVD 3 patients
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Chapter 1 / CAM and CVD 5 The crite
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Chapter 1 / CAM and CVD 7 disease c
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Chapter 1 / CAM and CVD 9 analyses,
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Chapter 3 / Botanical Medicine and
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Chapter 4 / Herb and Dietary Supple
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Chapter 5 / Vitamin Therapy and CVD
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Table 2 Type and Quantity of Dietar
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Table 2 (Continued) Type and Quanti
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Chapter 16 / A Guide for Physicians
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Index 279 INDEX A N-Acetylcysteine
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Index 281 taurine studies, 106 Conj
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Index 283 Homeopathic medicine, see
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Index 285 funding of studies, 148 g
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Contemporary Cardiology COMPLEMENTA
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