son, that its exact opposite, when, as has been observed, there is actually such a thing, is produced in the secondary action Similitude and Rebound by our vital force”. Effect of Drugs (Organon of Medicine, paragraph 65) Based on this postulate or “natural law”, homeopathy makes use of the secondary Scientific Evidence and action of the organism as a therapeutic reaction, and prescribes to ill individuals Therapeutic Application medicines that cause symptoms similar to the disorders they themselves cause (prin- ciple of therapeutic similitude), thus stimu- Marcus Zulian Teixeira, Brazil lating the organism to react against its own disease. In Ancient Greece, Hippocrates classically moted alterations in the different systems taught that there were two approaches to of the human body, and the following sec- Although little was divulged by modern PHILOSOPHY AND DISCUSSION the treatment of disease, namely the princi- ondary action of the organism (vital reaction pharmacology, since it opposes convention- ple of contraries and the principle of simi- or conservation force). The latter acts by al treatment, this same secondary action or lars. Treatment according to the principle neutralising the primary disorders caused homeostatic reaction of the organism has of contraries employs drugs that act con- by drugs, in an attempt to maintain the bal- been observed with the use of several types trary to or by palliating (“anti-”)thesymp- ance of the internal milieu or homeostasis: of modern palliative (antipathic or enantio- toms of the disease (e.g., anti-inflammato- pathic) drugs as a rebound effect or para- ries, antacids, antidepressants, etc.). This is “[…] Excessive vivacity follows the use of doxical reaction of the organism.Wehave the main approach to treatment applied by strong coffee (primary action), but slug- been systematically studying for the last fif- conventional medicine, also known as “al- gishness and drowsiness remain for a long teen years the rebound effect of modern lopathy”. Treatment according to the prin- time afterwards (reaction, secondary ac- drugs, and thus we were able to confirm by ciple of similars is used by homeopathy, tion), if this be not always again removed means of scientific evidence both Hahne- and it employs medicines that cause symp- for a short time by imbibing fresh supplies mannʼs postulate (a drug primary action is toms similars (“homeo”)tothesymptoms of coffee (palliative). After the profound followed by the secondary and opposite re- of the disease (e.g., coffee causes insomnia, stupefied sleep caused by opium (primary action of the organism) and the homeo- and is homeopathically used to treat in- action), the following night will be all the pathic principle of healing [1–11]. somnia; chamomile causes colic, and is ho- more sleepless (reaction, secondary ac- meopathically used to treat colic; belladon- tion). After the constipation produced by To illustrate: drugs classically used in the na causes fever, and is homeopathically opium (primary action), diarrhoea ensues treatment of angina pectoris (β-blockers, used to treat fever, etc.). (secondary action); and after purgation calcium channel blockers, nitrates, etc.) with medicines that irritate the bowels, with beneficial effects in their primary ef- Upon founding homeopathy in 1796, Sa- constipation of several daysʼ duration en- fect (anti-angina), might awaken a para- muel Hahnemann grounded this homeo- sues (secondary action). And in like manner doxical increase of the frequency and inten- pathic therapeutic principle on the careful it always happens, after the primary action sity of chest pain after discontinuation or observation of the drugs used in his time of a medicine that produces in large doses a irregular use of doses, which sometimes on the human body, and postulated a uni- great change in the health of a healthy per- does not respond to any therapeutic means. versal “mechanism of action of drugs”: SUMMARY “Every agent that acts upon the vitality, every medicine, deranges more or less the vital force, and causes a certain alteration Samuel Hahnemann systematised the homeopathic model and the effects This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. in the health of the individual for a longer of drugs on the state of human health, describing a primary action of the or a shorter period. This is termed primary drugs followed by a secondary and opposite action of the organism. In action.[…]. To its action our vital force en- modern pharmacology, this secondary action is known as the rebound ef- deavours to oppose its own energy. This re- fect or paradoxical reaction of the organism, being described after the dis- sistant action is a property, is indeed an au- continuation of several classes of palliative (enantiopathic) drugs, i.e., those tomatic action of our life-preserving power, that act according to the principle of contrary (contraria contrariis curentur). which goes by the name of secondary ac- Besides being able to cause severe and fatal iatrogenic events when appear- tion or counteraction”. ing after the palliative use of modern drugs, the rebound effect might awaken a healing reaction if the very same drugs involved were employed (Organon of Medicine, paragraph 63) according to the principle of similitude (similia similibus curentur).
To illustrate this natural phenomenon, Hah- KEYWORDS Homeopathy, Pharmacology, Adverse effect, Secondary nemann listed the primary actions of the effect, Rebound effect, Paradoxical reaction, Law of similarity medicines employed in his time that pro-
Marcus Zulian Teixeira, Similitude and Rebound – Homœopathic Links Summer 2014, Vol. 27: 105–107 © Thieme Medical and Scientific Publishers Private Ltd. 105 Drugs used for the control of arterial hyper- of gastritis and gastroduodenal ulcers caemia/diabetes. Drugs that cause immu- tension (α‑2 agonists, β-blockers, ACE in- might promote, after the primary decrease nosuppression (cyclosporine, corticoids, hibitors, MAO inhibitors, nitrates, sodium of acidity, a rebound increase of the produc- immunosuppressants, etc.) might be used nitroprusside, hydralazine, etc.) might pro- tion of hydrochloric acid by the stomach, to stimulate the immune system in immu- duce rebound arterial hypertension as a eventually causing perforation of chronic nosuppressed patients. Drugs causing at- paradoxical reaction of the organism to the gastroduodenal ulcers. Bronchodilators (ad- tention/concentration disorders (amanta- primary stimulus; antiarrhythmic drugs renergic drugs, sodium chromoglycate, epi- dine, interferons, topiramate, etc.) might (adenosine, amiodarone, β-blockers, calci- nephrine, ipratropium, nedocromil, salme- be used to improve attention disorder in um channel blockers, disopyramide, flecai- terol, formoterol, etc.) used in the treatment children, and so forth. nide, lidocaine, mexiletine, moricizine, pro- of bronchial asthma may worsen bronchial cainamide, quinidine, digital, etc.) may constriction as a paradoxical response of Grounded in Hahnemannʼs premise, since awaken rebound exacerbation of basal ven- the organism to the interruption or discon- 2003 we systematically propose to employ tricular arrhythmias when treatment is in- tinuation of treatment. Drugs indicated for modern drugs according to the homeopath- terrupted. Anticoagulant drugs (argatroban, the treatment of osteoporosis (bisphospho- ic healing principle [12–16]. To allow for bezafibrate, heparin, salicylates, warfarin, nates, denosumab, odanacatib, among actual application of this proposal, a “Ho- clopidogrel, etc.), employed due to their others) can cause paradoxical atypical frac- meopathic Materia Medica of Modern primary effect in the prophylaxis of throm- tures after the biological effect (half-life) as Drugs” was compiled including all the pri- bosis, can promote thrombotic complica- a result of an increased rebound of the mary (therapeutic, adverse and side) effects PHILOSOPHY AND DISCUSSION tions as paradoxical reaction of the orga- osteoclastic activity. Immunomodulatory of 1250 “allopathic” drugs as described in nism. Drugs that have a vasculoprotector drugs (natalizumab, fingolimod, among The United States Pharmacopeia Dispensing (pleiotropic) primary effect (statins, for ex- others), used in the treatment of multiple Information (USP DI, 2004), following the ample) can wake up stroke paradoxically. sclerosis, can cause paradoxical worsening chapter structure of the traditional works of the disease when treatment is inter- on homeopathic materia medica. In the use of psychiatric drugs such as anxi- rupted. And others [1–11]. olytics (barbiturates, benzodiazepines, car- To facilitate the selection of an individual- bamates, etc.), sedative-hypnotics (barbitu- Although a rebound effect or paradoxical ised homeopathic medicine (similar to rates, benzodiazepines, morphine, prome- reaction of the organism usually occurs the totality of symptoms of the patient), thazine, zopiclone, etc.), stimulants of the in a small number of individuals as a func- which is the essential requirement for central nervous system (amphetamines, caf- tion of idiosyncrasy, its effects can be dra- safety and therapeutic success of homeo- feine, cocaine, mazindol, methylfenidate, matic (both in intensity and duration), thus pathic treatment, the next step was to elab- etc.), antidepressants (tricyclic, MAO inhib- strengthening the rationale for their use in orate a “Homeopathic Repertory of Mod- itors, serotonin reuptake inhibitors, etc.) or homeopathy. ern Drugs”, where symptoms and their cor- antipsychotic (clozapine, phenothiazines, responding medicines are displayed analo- haloperidol, pimozide, etc.), a paradoxical Admitting that the main premise of ho- gously to classic homeopathic repertories. reaction of the organism may be observed meopathic treatment is the use of medi- in the attempt of keeping organic homeo- cines that cause symptoms similar to the Due to the high pathogenetic power of mod- stasis, thus promoting the appearance of disease to be treated, it may apply to any ern drugs it is expected that infinitesimal symptoms contrary to the ones expected kind of medicine, either natural or syn- doses will be sufficient to trigger the heal- from their primary therapeutic use, and thetic, in ponderable or infinitesimal doses ing vital reaction of the organism. For this consequently worsening the initial clinical provided that the principle of similitude is reason, it is suggested to start treatment picture. observed. Consequently, “allopathic” drugs with potency 6C and adjust the potencies may also be employed according to the and the repetition of doses to the individual Drugs with anti-inflammatory primary ac- principle of therapeutic similarity when pattern of susceptibility of each patient. In tion (corticoids, ibuprofen, indomethacin, their primary action (therapeutic, adverse this way it will be possible to evaluate the paracetamol, salicylates, etc.) might trigger and side) effects are similar to the symptoms therapeutic results of these medicines in paradoxical reactions of the organism that of the patient. By acting in this manner, we intermediate concentrations and to relate increase inflammation together with its make profit of the rebound effect of mod- them to the pathogenetic effects of the sub- mediatorʼs serum concentration. Drugs ern drugs for the sake of healing. stantial doses while avoiding aggravation This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. with analgesic primary action (caffeine, cal- and intense adverse events [14–16]. cium channels blockers, clonidine, ergot- To illustrate this possible “off-label” use of amine, methysergide, opiates, salicylates, countless classes of modern drugs accord- Entitled “New Homeopathic Medicines: etc.) may exhibit significant hyperalgesia as ing to the homeopathic principle, tens of Use of Modern Drugs According to the a rebound effect. Diuretics (furosemide, tor- drugs causing blood pressure to increase as Principle of Similitude”, this project com- asemide, triamterene, etc.), enantiopathi- a primary effect (adalimumab, cyclosporine, prises three parts: (1) “Scientific Basis of cally used to diminish the volume of plasma dopamine, anti-inflammatory agents, etc.) the Principle of Similitude in Modern (oedema, arterial hypertension, congestive might be homeopathically used to treat ar- Pharmacology”; (2) “Homeopathic Mate- heart failure, etc.), may cause rebound re- terial hypertension, since the drugʼs other ria Medica of Modern Drugs”; and (3) “Ho- tention of sodium and potassium, thus in- pathogenetic effects show similarity with meopathic Repertory of Modern Drugs”. creasing the basal volume of plasma. Drugs the patientʼs individuality. Drugs increas- primarily used as anti-dyspeptic (antacids, ing blood sugar (amprenavir, corticotropin, To facilitate global access to this project, all œ H2 antagonists, misoprostol, sucralfate, pro- diazoxide, strogens, etc.) might be ho- three works extending along thousands of ton pump inhibitors, etc.) in the treatment meopathically employed to treat hypergly- pages are available at a bilingual (English
106 Marcus Zulian Teixeira, Similitude and Rebound – Homœopathic Links Summer 2014, Vol. 27: 105–107 © Thieme Medical and Scientific Publishers Private Ltd. and Portuguese) website. Access is simple 5 Teixeira MZ. Bronchodilators, fatal asth- 14 Teixeira MZ. New homeopathic medi- and free, registration of e-mail address, ma, rebound effect and similitude. Ho- cines: use of modern drugs according to name and occupation are the only data re- meopathy 2007; 96: 135–137 the principle of similitude. Homeopathy quired to obtain a password. In this way, 6 Teixeira MZ. Antidepressants, suicidality 2011; 100: 244–252 the clinical protocol might be analysed and and rebound effect: evidence of simili- 15 Teixeira MZ. Homeopathic use of mod- used by homeopaths worldwide: www. tude? Homeopathy 2009; 98: 114–121 ern drugs: therapeutic application of newhomeopathicmedicines.com 7 Teixeira MZ. Statins withdrawal, vascu- the organism paradoxical reaction or re- lar complications, rebound effect and bound effect. Int J High Dilution Res For this method to be included in homeo- similitude. Homeopathy 2010; 99: 2011; 10: 338–352 pathic standard practice, homeopaths 255–262 16 Teixeira MZ. “New Homeopathic Medi- need to unite around this project: physi- 8 Teixeira MZ. Rebound acid hypersecre- cines” database: a project to employ con- cians to apply it in clinical practice and de- tion after withdrawal of gastric acid sup- ventional drugs according to the homeo- scribe results (case reports), pharmacists pressing drugs: new evidence of simili- pathic method of treatment. Eur J Integr to prepare the corresponding homeopathic tude. Homeopathy 2011; 100: 148–156 Med 2013; 5: 270–278 medicines, and investigators to design re- 9 Teixeira MZ. Rebound effect of drugs: search protocols. fatal risk of conventional treatment and pharmacological basis of homeopathic Vita treatment. Int J High Dilution Res 2012; PHILOSOPHY AND DISCUSSION References 11: 69–106 Marcus Zulian Teixera is a homeopathic 10 Teixeira MZ. Antiresorptive drugs (bis- physician, researcher and teacher of ho- 1 Teixeira MZ. Semelhante cura semel- phosphonates), atypical fractures and meopathic medicine at the Faculty of hante: o princípio de cura homeopático rebound effect: new evidence of simili- Medicine of the University of São Paulo fundamentado pela racionalidade médi- tude. Homeopathy 2012; 101: 231–242 (FMUSP). ca e científica [Similar cure similar: the 11 Teixeira MZ. Immunomodulatory drugs principle of homeopathic cure based by (natalizumab), worsening of multiple [email protected]/ medical and scientific rationality]. São sclerosis, rebound effect and similitude. www.homeozulian.med.br/ Paulo: Editorial Petrus; 1998 Homeopathy 2013; 102: 215–224 www.fm.usp.br/homeopatia/ 2 Teixeira MZ. Similitude in modern phar- 12 Teixeira MZ. Homeopathic use of mod- www.newhomeopathicmedicines.com macology. Br Homeopath J 1999; 88: ern medicines: utilisation of the curative 112–120 rebound effect. Med Hypotheses 2003; 3 Teixeira MZ. Evidence of the principle of 60: 276–283 Marcus Zulian Teixeira Ph.D. Rua Teodoro Sampaio, 352/43 similitude in modern fatal iatrogenic 13 Teixeira MZ. “Paradoxical strategy for 05406-000 – São Paulo/SP events. Homeopathy 2006; 95: 229–236 treating chronic diseases”: a therapeutic Brazil 4 Teixeira MZ. NSAIDs, Myocardial infarc- model used in homeopathy for more E-mail: [email protected] tion, rebound effect and similitude. Ho- than two centuries. Homeopathy 2005; meopathy 2007; 96: 67–68 94: 265–266
Right Scapula Pain 1 Preliminary Comparative Phytochemical Proving of In Bhutanese medicine the bark and root Screening and Biological Evaluation of Desmodi- um elegans: Rabia Usman, Arshad Khan, Abdur are used in the treatment of peptic ulcers, Rauf; Middle-East Journal of Scientific Research 1 Desmodium and bilious complaints. The roots are car- 01/2012; 11(11):1591–1594. DOI:10.5829/ minative, diuretic and tonic. My desire to idosi.mejsr.2012.11.11.64194. elegans
SUMMARY This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Liz Lalor, Australia Desmodium elegans is a medicinal plant commonly used for the treatment of jaundice, fever, paralysis, oedema, asthma, colds, constipation, cough, Introduction convulsion, cholecystolithiasis and urolithiasis. The present investigation commenced with various phytochemical screenings and biological studies Family: Leguminosae is the botanical group were carried out on the bark of Desmodium elegans. Preliminary phyto- allocated to Desmodium elegans in Bhuta- chemical test of the crude extract and various fractions revealed the pres- nese medicine. ence of steroids, saponins, tannins, reducing sugars, cardiac glycosides and Habitat: open slopes, forests, shrubberies. caumarines. The antimicrobial activity and phytotoxicity activities of crude Distribution: on mountain slopes at eleva- extract and various fractions of Desmodium elegans were investigated. Sig- tions of 1000 to 4000 metres in the Hima- nificant phytotoxic activity was observed at a higher concentration. layas, Bhutan and West China. The shrub can grow to a height of 1.5 metres high KEYWORDS Proving, Desmodium elegans, Leguminosae and 1.5 metres wide.
Marcus Zulian Teixeira, Similitude and Rebound – Homœopathic Links Summer 2014, Vol. 27: 105–107 © Thieme Medical and Scientific Publishers Private Ltd. 107