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The Efficacy of Arnica Montana 30CH and 200CH to Thrombolise a Blood Clot in an In-Vitro Sample

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The Efficacy of Arnica Montana 30CH and 200CH to Thrombolise a Blood Clot in an In-Vitro Sample The efficacy of Arnica montana 30CH and 200CH to thrombolise a blood clot in an in-vitro sample. A dissertation submitted to the Faculty of Health Sciences at the Technikon Witwatersrand for the partial fulfilment Degree of Master of Technology in the program Homoeopathy by Jarne Stefan van Tonder (Student number: 9476443) Supervisor: _______________ Date ____________ Dr. N. Wolf Co-Supervisor: _______________ Date ____________ Dr. K.E. Sinclaire Johannesburg, 2005 DECLARATION I declare that this dissertation is my own, unaided work. It is being submitted for the Degree of Master of Technology in Homoeopathy at the Technikon Witwatersrand, Johannesburg. It has not been submitted before for any other degree or examination in any other Technikon or University. __________________________ Jarne Stefan van Tonder ____ Day of ____________ ii ABSTRACT Coagulation or the formation of blood clots is the result of several complex interactions between humoral coagulation factors, platelets, and fibrin. Unnatural or excessive coagulation is inhibited by the fibrinolytic system. In normal homeostasis, there is a dynamic state in which thrombi are constantly being formed and removed from the circulatory system. Fibrin being the main component of a blood clot is formed by the activation of the clotting cascade. Its production is followed by the fibrinolytic system, resulting in plasmin generation and subsequent fibrin degradation (Soria et al., 1983). Plasmin is the enzyme responsible for fibrin degradation. It is derived from its inactive precursor, plasminogen, by the action of thrombin and plasminogen activators. Homoeopathic Arnica montana is prescribed for pathological conditions that have a sudden onset, are traumatic in nature, and result from the complications of the initial trauma (Vermeulen, 1997). It has been prescribed for various thrombotic disorders and it is known that it speeds up healing and revascularisation of the surrounding tissue (Savage and Roe, 1977). It is a short acting homoeopathic medication, and needs to be repeated often, but it is quick in its actions (Gordon Ross, 1977). This study aimed to establish if Arnica montana 30CH and 200CH potencies caused thrombolysis of a blood clot within an in-vitro sample. It was hypothesised that Arnica montana in 30CH and 200CH potencies would cause thrombolysis in- vitro. The research sample group consisted of fifteen male participants, between eighteen and thirty years of age. Only male participants were selected to prevent any gender variables that may influence the study. Four blood samples each consisting of five milliliters was taken from each participant. Current and efficient phlebotomy techniques were used and iii the samples were placed in non-treated plastic phlebotomy containers to allow speedy clot formation. One sample was treated with one drop of 30CH Arnica montana and the other with one drop of 200CH Arnica montana. The third sample for each subject was used as a control where one drop of 0.9% sterile saline was added. Thus, consistency concerning diluting effects was maintained. D-dimer levels were measured using the D- DI Test from Diagnostica Stago, which is a rapid latex agglutination slide test. A semi- quantitative testing mode was used to gather the relevant research information. The results of the study showed that in all the samples tested, no agglutination of D- dimers occurred. This indicated that if thrombolysis occurred in the samples, a D-dimer level well below 0.5 micrograms per milliliter of FEU occurred. It has been established that as separate entities homoeopathic Arnica montana 30CH and 200CH have little or no direct effect on a clotted in-vitro sample. This indicates that if the medicine has thrombolytic properties, it has to utilize or activate other endogenous factors in-vivo. As these factors require the presence of vascular endothelium, it makes it potentially difficult to conduct studies due to ethical reasons. iv DEDICATION This dissertation is dedicated to all my loved ones that motivated and supported me through this process. To my Angel, that guided and supported me in times of need and despair. v ACKNOLEDGEMENTS I would like to express my sincere gratitude to the following individuals: Dr. N. Wolf: Supervisor Dr. K. E. Sinclaire: Co-supervisor Dr. G. Ferguson and W. Last Homoeopathics for the preparation and donation of medicine Ms. E. Repenseck and Ampath Laboratories vi TABLE OF CONTENTS DECLARATION ii ABSTRACT iii DEDICATION v ACKNOLEDGEMENT vi TABLE OF CONTENTS vii LIST OF TABLES xi LIST OF FIGURES xii LIST OF GRAPHS xiii 1. INTRODUCTION 1 1.1. Problem statement 1 1.2. The aim of the study 1 1.2.1. Objectives 1 1.2.2. Outcomes 2 1.3. Importance of the study 2 1.4. Hypothesis 2 1.5. Null-hypothesis 3 1.6. Possible methodological limitations 3 vii 2. LITERATURE REVIEW 4 2.1. Introduction 4 2.2. Blood and its functions 4 2.2.1. Introduction 5 2.2.2. Blood functions 5 2.2.3. Plasma constituents 6 2.2.4. Plasma proteins 7 2.3. Coagulation 7 2.3.1. Haemostasis 8 2.3.2. The dynamics of haemostasis 8 2.3.3. Blood vessels 9 2.3.4. The platelet plug 11 2.3.5. The coagulation pathways 13 2.3.5.1.The intrinsic pathway 14 2.3.5.2.The extrinsic pathway 16 2.3.5.3.The common pathway 17 2.4. Fibrinolysis 20 2.4.1. Fibrinogen to fibrin 21 2.4.2. Plasminogen to plasmin 21 2.5. The immune systems inflammatory response during blood coagulation 22 2.6. Coagulopathies 23 2.7. Homoeopathy 25 2.7.1. Principles of homoeopathy 25 2.7.1.1.The vital force 25 2.7.1.2.The law of similars 26 2.7.1.3.Minimum dose 26 viii 2.7.1.4.Homoeopathic potencies 27 2.7.2. The science behind homoeopathy 28 2.7.2.1.The cluster theory 29 2.7.2.2.Homoeopathic human studies: The proving 30 2.7.2.3.The coherent frequencies in living systems and homoeopathic medication. 31 2.7.2.4.The chaos theory and homoeopathy 31 2.8. Arnica montana 32 2.8.1. Classification 32 2.8.2. Description 33 2.8.3. Origin of the herb 34 2.8.4. Parts of the herb used 34 2.8.5. Herbal therapeutic category 34 2.8.6. Uses and properties 35 2.8.7. Active ingredients 35 2.8.8. Pharmacological effects 35 2.9. Homoeopathic Arnica montana 36 2.9.1. The prescription of Arnica montana 36 2.9.2. Indications for homoeopathic Arnica montana 37 2.9.2.1.Angina 37 2.9.2.2.Bruises and blunt trauma 37 3. METHODOLOGY 39 3.1. Sample group 39 3.1.1. Inclusion criteria 39 3.1.2. Exclusion criteria 39 3.2. Research procedure 39 ix 3.3. Analysis of data 42 4. RESULTS 43 4.1. Control Sample 44 4.2. Arnica montana 30CH Sample 45 4.3. Arnica montana 200CH Sample 46 5. DISCUSSION 47 5.1. Control samples 47 5.2. Arnica montana 30CH samples 47 5.3. Arnica montana 200CH samples 48 5.4. The importance of this study 49 6. CONCLUSION AND RECOMMENDATIONS 50 6.1. Conclusion 50 6.2. Recommendations 51 7. REFERENCES 53 8. APPENDICES 8.1. APPENDIX A 59 8.2. APPENDIX B 63 8.3. APPENDIX C 65 x LIST OF TABLES Table 2.1: The functions of blood 5 Table 2.2: The molecular weights of plasma proteins 6 Table 2.3: Coagulation factors 15-16 xi LIST OF FIGURES Figure 2.1 33 Figure 2.2 34 xii LIST OF GRAPHS Graph 4.1: Control samples 44 Graph 4.2: Arnica montana 30CH samples 45 Graph 4.3: Arnica montana 200CH samples 46 xiii CHAPTER 1 INTRODUCTION 1.1 Problem statement Homoeopathic Arnica montana is prescribed for pathological conditions that have a sudden onset, are traumatic in nature, and result from the complications of the initial trauma (Vermeulen, 1997). It has been prescribed for various thrombotic disorders, and it is known that it speeds up healing and revascularisation of the surrounding tissue (Savage and Roe, 1977). Very little is known of the actual homoeopathic pathophysiological pathways involved in resulting in cure in patients. No study has been published either locally or internationally that attempts to establish the thrombolytic properties of Arnica montana 30CH and 200CH. 1.2 The aim of the study The aim of the study is to establish the efficacy of homeopathic Arnica montana in 30CH (Centesimal Hahnemanian) and 200CH to thrombolise a blood clot in an in- vitro sample. 1.2.1 Objectives The study aims to determine if Arnica montana 3OCH and 200CH acts directly on the available plasma plasminogen in-vitro, resulting in thrombolysis. This study will asses this by measuring the D-dimer concentration available post treatment of in-vitro blood samples with Arnica montana 30CH and 200CH. 1 1.2.2 Outcomes • There may be a change in D-dimer level of the samples medicated with Arnica montana 30CH and 200CH. This could either indicate that the Arnica montana acted on the available plasminogen to convert it to plasmin directly or by activating tissue plasminogen activator (tPA) to cause fibrinolysis. • No change may occur to the D-dimer levels. 1.3 Importance of the study The study will enhance our understanding of the action of homoeopathic Arnica montana 30CH and 200CH, and the pathophysiological processes involved in thrombolysis. In creating this study, a new methodology has been designed to isolate the factors that influence thrombolysis in-vitro. This will ascertain if homoeopathic Arnica montana acts directly on the fibrin structure or indirectly by activating the plasminogen in-vitro.
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