Complementary Alternative Cardiovascular Medicine

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218 Alternative Cardiovascular Medicine Formal training programs exist in Europe for physicians in homeopathy affiliated with conventional medical curricula, but they do not yet exist in the United States. Currently, there are also no CME courses and only cursory mention of homeopathy at most medical schools that offer instruction in integrative medicine in the United States. Some of the current independent training centers, such as the National Center for Homeopathy, continue to play a leadership role in quality courses, but currently there is no recognized formal medical certification. However, homeopathy is part of the formal curricula at most accredited American colleges of naturopathy, conferring a professional degree (ND) that is currently licensed in 13 states for primary patient care. Homeopathy is a recognized practice with certification for professionals by three states: Arizona, Nevada, and Connecticut. The lay practice of homeopathy varies from state to state and remains unregulated, except in Minnesota, where unregulated practices by lay practitioners are allowed by the state under specific conditions. SUBSTANCE REGULATION Although homeopathy is not generally an accepted practice, homeopathic remedies have always been a part of the US pharmacopeia, officially recognized and regulated (with regular updates to the Homeopathic Pharmacopeia) as over-the-counter drugs. They were included in this federal compendium when the US Food and Drug Administration (FDA) was first established in 1938, under the Food Drug and Cosmetic Act (FDCA), 21 USC, paragraphs 321 (g-1A), and 351b, e.g., and still remain. Many homeopathic substances are derived from common toxins, although they have been diluted to infinitesimal amounts. Quality control is certainly essential. The largest US homeopathic companies have pharmaceutical-standard manufacturing. As with all supplements (and unfortunately occasionally some pharmaceuticals), there is a potential for substandard manufacture. The FDA and Federal Trade Commission (FTC) are spread too thin to effectively monitor all companies’ products. Having experienced providers who know the quality of the products they recommend is of utmost importance with all health care products, including homeopathy. Practice The heart and soul of homeopathic practice is based on the history. Few patients have ever had a conventional history taken that approaches the detail of that provided in a session with a homeopath. Classical homeopathy, done for the greatest impact for health transformation, is comprehensive in nature, with the totality of one’s influences considered. There are some “cookbook” remedies that can be applied for specific use, such as arnica for bruises, but even this is not simple. The key is that for homeopathy to be maximally effective, it must be individualized.
Chapter 14 / Homeopathy and CVD 219 Many homeopaths use an approach involving finding a patient’s constitutional type. Woven into this essential makeup are the specific symptoms that are causing disease. Often all of this fits a polychrest—a confluence of information that suggests a specific remedy. If the remedy is not apparent, the practitioner will consult a Repertory (11), which is a compendium of all known symptoms and corresponding provings from the homeopathic materia medica. This repertorization of homeopathic toxicology then leads to a remedy. Homeopathy is thus a comprehensive analysis of a patient’s underlying makeup, with the presenting complaints leading to a particular remedy. Remedies are generally taken as sublingual pellets, with the homeopathic remedy on a small ball of lactose (an insignificant amount of lactose for those with lactose intolerance). Occasionally, sublingual liquids or topical preparations are used. Strengths or potencies are based on the amount of the dilution—remedies that have been diluted and shaken (succussed) in a series of dilutions of either: 10 times (X or D); 100 times (C); or 1000 times (M). For example, these dilutions are designated: for a thrice 10-fold dilution (10 –1 × 3 ) = 3X; for a 10 times 100-fold dilution (10 –2 × 10 ) = 10C. Philosophical Tenets As yet, homeopathy has no proven mechanism of action. Although not normally spoken of in this sense, homeopathy can be seen as a form of energy medicine. Many proponents explain its effects as changing the energy of the individual to a state that will promote change to a greater state of wellness. The principles of homeopathy are based on a vitalistic theory. This proposes that in disease states, there is an imbalance of one’s vital force, which is similar to the traditional Chinese medical perspective of Qi, or Ayurveda’s prana. This vitalistic theory is central to the practice of most all indigenous practices. It sees no division between mind and body and is comfortable that the changes coming from its practices are currently not explainable by conventional bioscience. (Western allopathic medicine is one of the earth’s only health care approaches that does not recognize a principle of “energy” at its core.) Because there is no explanation at present of homeopathy’s core “energetic” mechanism of action, an examination of what scientific research there is for its mechanisms and current research on clinical outcomes are important to help to assess homeopathy’s relative credibility. Scientific Principles Homeopathy was developed by Hahnemann by the use of careful clinical observation of patients. Hahnemann was first and foremost a scientist, embarking on some of the first controlled studies. He would
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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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12 Alternative Cardiovascular Medic
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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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Complementary Alternative Cardiovascular Medicine

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