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d 2.00 • US $ 2.00 • CAN $ 3.00<br />

Journal <strong>of</strong><br />

<strong>Biomedical</strong><br />

<strong>Therapy</strong><br />

Volume 3, Number 1 ) 2009<br />

Integrating Homeopathy<br />

and Conventional Medicine<br />

Neuroendocrine<br />

Dysfunction<br />

• Psychogenic Factors in Gastrointestinal Pathology<br />

• Bioregulatory Treatment <strong>of</strong> Dysautonomia


)<br />

Contents<br />

In Focus<br />

Applied Bioregulation in Neuroendocrine Disease:<br />

Chronic Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4<br />

What Else Is New? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8<br />

Fr o m t h e P ra c t i c e<br />

Metabolic and Endocrine Disorders Associated<br />

With Pseudarthrosis: Presentation <strong>of</strong> a Clinical Case . . . . . . 10<br />

Around the Globe<br />

Verona – More Than Just Romeo and Juliet ... . . . . . . . . . . . . . 15<br />

Practical Protocols<br />

Bioregulatory Treatment <strong>of</strong> Dysautonomia . . . . . . . . . . . . . . 16<br />

In memoriam<br />

Pr<strong>of</strong>essor Michael F. Kirkman . . . . . . . . . . . . . . . . . . . . . . . . . . 17<br />

Re f re s h Yo u r H o m o t ox i c o l o g y<br />

Psychogenic Factors in Gastrointestinal Pathology . . . . . . . 18<br />

M a r ke t i n g Yo u r P ra c t i c e<br />

Communication in Your Practice . . . . . . . . . . . . . . . . . . . . . . . 20<br />

Specialized Applications<br />

The Acupuncture Approach to the<br />

Hypothalamus-Pituitary-Adrenal Axis . . . . . . . . . . . . . . . . . . 22<br />

Making <strong>of</strong> ...<br />

Manufacturing <strong>of</strong> Traumeel Injection Solution<br />

Part I: From Work Preparation to Filling . . . . . . . . . . . . . . . . . 26<br />

Meet the Expert<br />

Dr. Arturo O’Byrne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29<br />

Research Highlights<br />

Nervoheel N vs. Lorazepam for Mild Nervous Disorders . . . 30<br />

) 2<br />

Published by/Verlegt durch: <strong>International</strong> <strong>Academy</strong> for <strong>Homotoxicology</strong> GmbH, Bahnackerstraße 16,<br />

76532 Baden-Baden, Germany, e-mail: journal@iah-online.com<br />

Editor in charge/verantwortlicher Redakteur: Dr. Alta A. Smit<br />

Print/Druck: VVA Konkordia GmbH, Dr.-Rudolf-Eberle-Straße 15, 76534 Baden-Baden, Germany<br />

© 2009 <strong>International</strong> <strong>Academy</strong> for <strong>Homotoxicology</strong> GmbH, Baden-Baden, Germany<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


)<br />

Stress and the Immune System<br />

Dr. Alta A. Smit<br />

Psychoneuroimmunology (PNI)<br />

has come a long way since Walter<br />

Cannon’s early work with animals.<br />

Cannon observed that any<br />

change in emotional state (such as<br />

anxiety, distress, or rage) was accompanied<br />

by total cessation <strong>of</strong> stomach<br />

movements. Cannon’s research culminated<br />

in his seminal work, Bodily<br />

Changes in Pain, Hunger, Fear and<br />

Rage, published in 1915. 1<br />

Hans Selye then drew on Cannon’s<br />

research for his own animal experiments.<br />

Selye subjected animals to a<br />

variety <strong>of</strong> adverse physical and mental<br />

conditions and observed consistent<br />

adaptations that allow the body<br />

to heal and recover. The General<br />

Adaptation Syndrome Selye described<br />

is still important in bioregulatory<br />

medicine today. 2<br />

Even conventional medicine increasingly<br />

recognizes the mind-brain<br />

connection and psychoneuroendocrinoimmunology<br />

(PNEI). For instance,<br />

stress at work is associated<br />

with cardiovascular risk factors such<br />

as BMI, hypertension, and lipid levels.<br />

The Whitehall studies examined<br />

this possible larger relationship between<br />

work stress and cardiovascular<br />

disease in depth. 3<br />

Bioregulatory medicine recognizes<br />

and tests for autonomic dysfunction<br />

as one <strong>of</strong> the main obstacles to regulatory<br />

ability in patients. For example,<br />

heart rate variability is one <strong>of</strong><br />

the main risk factors for cardiac disease.<br />

4<br />

In this issue, we present a variety <strong>of</strong><br />

articles on the effects <strong>of</strong> stress on the<br />

immune system, which have been<br />

well-known for decades. In the focus<br />

article, Dr. Jesús Agudo gives a<br />

general introduction to the subject.<br />

Dr. Mónica Name presents a case<br />

study demonstrating the effect <strong>of</strong><br />

bioregulatory medicines on bone<br />

healing. Dr. Butch Levy examines<br />

the role <strong>of</strong> acupuncture in the treatment<br />

<strong>of</strong> autonomic dysfunction, and<br />

Dr. Bert Hannosset contributes a<br />

treatment protocol for dysautonomia.<br />

In Research Highlights, we present the<br />

results <strong>of</strong> a study investigating the<br />

effectiveness <strong>of</strong> Nervoheel in mild<br />

nervous disorders, and our marketing<br />

specialist <strong>of</strong>fers tips on successful<br />

communication with your patients.<br />

We also examine how ampoule<br />

medications are manufactured (Part<br />

1) and continue our Meet the Expert<br />

series with an introduction to Dr.<br />

Arturo O’Byrne <strong>of</strong> Colombia.<br />

It is with great sadness that we remember<br />

another expert, Pr<strong>of</strong>essor<br />

Michael Kirkman. His sudden death<br />

this year leaves a huge void in the<br />

world <strong>of</strong> homotoxicology. Dr. Damir<br />

Shakambet, who worked closely<br />

with Pr<strong>of</strong>essor Kirkman in the UK,<br />

contributes a heartfelt obituary.<br />

Dr. Alta A. Smit<br />

References<br />

1. Quick JC, Spielberger CD. Walter Bradford<br />

Cannon: Pioneer <strong>of</strong> stress research.<br />

<strong>International</strong> Journal <strong>of</strong> Stress Management.<br />

1994;1(2):141-143.<br />

2. Selye H. A syndrome produced by diverse nocuous<br />

agents. Nature. 1936;138(3479):32.<br />

3. Marmot M. UCL Department <strong>of</strong> Epidemiology<br />

and Public Health: Whitehall II Study.<br />

2008. UCL web site. http://www.ucl.ac.uk/<br />

whitehallII/. Updated February 27, 2008.<br />

Accessed July 14, 2009.<br />

4. Institute <strong>of</strong> HeartMath Research Staff. Science<br />

<strong>of</strong> the heart: exploring the role <strong>of</strong> the<br />

heart in human performance. Institute <strong>of</strong><br />

HeartMath web site. http://www.heartmath.<br />

org/research/research-science-<strong>of</strong>-the-heart.<br />

html. Accessed July 14, 2009.<br />

) 3<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) In Focus<br />

Applied Bioregulation in Neuroendocrine Disease<br />

Chronic Stress<br />

By Jesús Agudo, MD<br />

) 4<br />

Chronic stress is <strong>of</strong>ten a reaction to the stimuli <strong>of</strong> a more<br />

or less hostile environment, to which most people living<br />

in the 21st century have succumbed. With increasing<br />

clarity, chronic stress is shown to be a causative agent <strong>of</strong><br />

numerous diseases, especially those <strong>of</strong> neuroendocrine<br />

origin. A new cross-functional medical specialization is<br />

appearing, propelled by increasingly detailed knowledge<br />

about the biological foundations <strong>of</strong> the relationship<br />

between stress and a variety <strong>of</strong> diseases: psychoneuroimmunology.<br />

The history <strong>of</strong> medicine has been<br />

a constant struggle between<br />

monism and dualism, between those<br />

researchers who consider the human<br />

being to be a unit and those who see<br />

in the individual the confluence <strong>of</strong><br />

2 separate entities: physical and<br />

spiritual, material and immaterial,<br />

metabolism and emotions, body and<br />

soul.<br />

If we go back some 2,600 years,<br />

Hippocrates had already declared<br />

that health was a state inherent to<br />

the individual, whom nature had endowed<br />

with self-healing abilities.<br />

Furthermore, while a person lived in<br />

harmony with nature, his or her<br />

health would be maintained or, were<br />

it lost, could easily be recovered.<br />

Disease was only an imbalance resulting<br />

from a failure to observe the<br />

rules <strong>of</strong> Hygeia. Thus, the physician’s<br />

mission would be to help individuals<br />

recover the lost equilibrium<br />

and teach them to live in<br />

accordance with the laws <strong>of</strong> nature<br />

(vis medicatrix naturae).<br />

In contrast, students <strong>of</strong> the school <strong>of</strong><br />

Aesculapius believed that for every<br />

disease there was a determined<br />

cause, a separate treatment, and<br />

some organs or systems involved,<br />

and that the most prestigious physician<br />

was the one who made the diagnosis<br />

and prescribed the correct<br />

treatment. This compartmentalized<br />

and highly specialized vision is that<br />

which now dominates “modern”<br />

medicine, one in which the idea <strong>of</strong><br />

the individual is, incorrectly, not<br />

considered to be an indivisible entity,<br />

a single unit with one material<br />

component and another apparently<br />

immaterial component.<br />

Fortunately, in the second half <strong>of</strong><br />

the 20th century, the development<br />

<strong>of</strong> that highly specialized and fragmented<br />

medicine, with an impressive<br />

ability to delve into the core <strong>of</strong><br />

the most subtle physiological processes,<br />

converged with the other,<br />

more humanist medicine descended<br />

from Hippocrates, which pays attention<br />

to the psycho-emotional aspects<br />

<strong>of</strong> humankind. We could say that<br />

the more cartesian-reductionist and<br />

more fiercely material medicine has<br />

discovered the influence <strong>of</strong> the human<br />

soul on physiopathological<br />

processes.<br />

It is, therefore, absolutely fascinating<br />

that more than 2,000 years ago,<br />

the pineal gland was described by<br />

Galen, who credited it with the ability<br />

to regulate the flow <strong>of</strong> thought;<br />

in the 17th century, it was described<br />

by Descartes as the seat <strong>of</strong> the rational<br />

soul. What is surprising is the<br />

insight, from ancient times, that this<br />

area would be the gateway between<br />

body and soul and the approximation<br />

<strong>of</strong> what was being described to<br />

what we know today about the interrelationships<br />

between emotions<br />

and their physical responses.<br />

The study <strong>of</strong> the relationships between<br />

mind and body has been<br />

termed psychoneuroimmunology,<br />

and what we are truly faced with is<br />

the most refined, holistic concept <strong>of</strong><br />

medical science.<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) In Focus<br />

Stress<br />

Brain<br />

A<br />

Adrenaline<br />

ACh+ 5-HT+ IL-1+ CRH+ GABA- NA+/–<br />

+<br />

–<br />

IL-1 RA<br />

NA<br />

ACh<br />

GABA<br />

Noradrenaline<br />

Acetylcholine<br />

γ-Aminobutyric acid<br />

Hypothalamus<br />

CRH+<br />

AVP+<br />

Pituitary<br />

–<br />

–<br />

IL-1, IL-6, TNF-a<br />

Monocytes<br />

Macrophages<br />

5-HT<br />

5-Hydroxytryptamine<br />

IL-1 RA Interleukin 1<br />

receptor antagonist<br />

TNF<br />

IL<br />

ACTH<br />

Tumor necrosis factor<br />

Interleukin<br />

Corticotropin<br />

NA/A+<br />

ACTH+<br />

AVP<br />

Arginine vasopressin<br />

Adrenal gland<br />

Cortisol +/–<br />

CRH<br />

Corticotropinreleasing<br />

hormone<br />

Figure 1: Relationship between the cortex, hypothalamus, pituitary gland,<br />

and adrenal glands (after Lack and Wright 1 )<br />

The hypothalamic-<br />

pituitary-adrenal system<br />

The stimuli generated in the cerebral<br />

cortex by adverse situations such as<br />

stress or various pathological mental<br />

processes will create a response in<br />

the limbic system that triggers the<br />

release <strong>of</strong> several neurotransmitters<br />

(e.g., acetylcholine, 5-hydroxytrypta<br />

mine, interleukin [IL] 1, corticotropin-releasing<br />

hormone [CRH],<br />

γ-aminobutyric acid [GABA], and<br />

noradrenaline). These neurotransmitters<br />

will ultimately activate the<br />

hypothalamic-pituitary-adrenal axis<br />

according to the cascade described<br />

later (Figure 1).<br />

Corticotropin-releasing hormone<br />

and arginine vasopressin (AVP) are<br />

produced in the paraventricular nuclei<br />

<strong>of</strong> the hypothalamus. These substances<br />

are carried to the anterior<br />

pituitary gland, where they regulate<br />

the secretion <strong>of</strong> adrenocorticotropic<br />

hormone (ACTH or corticotropin).<br />

Adrenocorticotropic hormone travels<br />

through the bloodstream to the<br />

cortex <strong>of</strong> the adrenal glands, where<br />

it stimulates the synthesis and release<br />

<strong>of</strong> glucocorticoids (GCs).<br />

In turn, these GCs exert a negative<br />

feedback on several targets, including<br />

the adrenal cortex, inhibiting<br />

their own secretion; the pituitary<br />

gland, inhibiting ACTH production;<br />

and even the hypothalamus itself,<br />

down-regulating the release <strong>of</strong><br />

ACTH and AVP. Glucocorticoids<br />

also act on the hypothalamus<br />

through the production <strong>of</strong> GABA,<br />

which ultimately inhibits this organ’s<br />

synthesis <strong>of</strong> CRH and AVP.<br />

Another intermediate feedback regulator<br />

<strong>of</strong> the release <strong>of</strong> CRH in this<br />

process would be the one exerted on<br />

the noradrenergic and serotonergic<br />

neurons. 2<br />

Finally, we must not forget that the<br />

brain will also exert an influence on<br />

the sympathetic and endocrine system<br />

by means <strong>of</strong> the CRH that regulates<br />

the sympathetic nervous system.<br />

This has nerve endings in the<br />

bone marrow, thymus, and spleen,<br />

which are the cell factories responsible<br />

for cellular and humoral immunity.<br />

The psychoneuroimmuno<br />

logy <strong>of</strong> stress<br />

It is now clear that CRH plays a<br />

fundamental role in the response to<br />

stress. Administration <strong>of</strong> CRH produces<br />

a broad suppression <strong>of</strong> immune<br />

functions similar to that observed<br />

in depression or chronic<br />

stress.<br />

Corticotropin-releasing hormone<br />

regulates immune functions through<br />

a central pathway and a peripheral<br />

pathway. By means <strong>of</strong> the central<br />

pathway, it notably suppresses the<br />

proliferation <strong>of</strong> lymphocytes and<br />

phagocytosis by neutrophils while<br />

increasing the number <strong>of</strong> neutrophils<br />

and cellular aggregation. It also<br />

decreases the quantity and activity<br />

<strong>of</strong> natural killer (NK) cells and<br />

IgG levels. In the peripheral pathway,<br />

its activity is based on the CRH<br />

receptors that exist on macrophages,<br />

monocytes, and helper lymphocytes.<br />

Corticotropin-releasing hormone<br />

reduces the replication and survival<br />

<strong>of</strong> spleen cells while simultaneously<br />

encouraging the migration <strong>of</strong> monocytes.<br />

) 5<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) In Focus<br />

) 6<br />

We have already seen how stress activates<br />

the production <strong>of</strong> CRH directly<br />

in the hypothalamus and indirectly<br />

through noradrenergic and<br />

serotonergic neurons. However, it<br />

also activates the autonomic nervous<br />

system. For these tasks, mediation<br />

by intermediaries such as acetylcholine,<br />

IL-1, and serotonin is required.<br />

Meanwhile, to balance this reaction,<br />

stress-inhibiting substances are also<br />

present, such as GABA; opioid peptides,<br />

whose producing neurons are<br />

closely related to CRH-producing<br />

neurons to establish an equilibrium;<br />

and a third group (e.g., adrenaline/<br />

noradrenaline) that acts on various<br />

senses.<br />

With respect to the sympathetic nervous<br />

system, we could say that in<br />

states <strong>of</strong> stress it will be activated by<br />

CRH, and on being stimulated, it<br />

will produce adrenaline and noradrenaline.<br />

Peripherally, these substances<br />

will trigger a series <strong>of</strong> actions,<br />

such as an increase in blood<br />

pressure, blood glucose, heart rate,<br />

alertness, and vigilance, and inhibit<br />

the sensation <strong>of</strong> hunger and growth<br />

through the suppression <strong>of</strong> growth<br />

hormone (GH).<br />

Stress affects various<br />

vital areas<br />

The immune system<br />

According to recent studies, the role<br />

<strong>of</strong> cortisol in the inhibition <strong>of</strong> the<br />

immune system appears to consist <strong>of</strong><br />

suppressing the ability <strong>of</strong> immune<br />

cells to activate their own telomerase<br />

to reproduce their telomeres each<br />

time the cell divides. The telomere<br />

would, therefore, be shortened, a<br />

characteristic observed in pathological<br />

conditions, such as human immunodeficiency<br />

virus infection, osteoporosis,<br />

coronary heart disease,<br />

and even aging. 3<br />

Cancerous diseases<br />

Stress significantly reduces the activity<br />

<strong>of</strong> NK cells. 4 In laboratory experiments<br />

on animals subjected to<br />

stress, the rate <strong>of</strong> pulmonary metastases<br />

from induced breast cancers<br />

doubled.<br />

Studies <strong>of</strong> women who underwent<br />

surgery for carcinoma <strong>of</strong> the breast<br />

have also shown a significantly reduced<br />

NK cell count in patients with<br />

high stress levels compared with<br />

those who controlled their stress, resulting<br />

from uncertainty about the<br />

treatment or prognosis <strong>of</strong> their disease.<br />

5<br />

Infectious diseases<br />

In laboratory experiments on animals<br />

subjected to stress conditions,<br />

their response to the flu virus decreased<br />

significantly. Along with<br />

high levels <strong>of</strong> plasma corticosterone,<br />

a decrease in the mononuclear cell<br />

population and a 60% to 95% decrease<br />

in IL-2 production in lymphoid<br />

organs were observed.<br />

In preschool-aged children subjected<br />

to various situations <strong>of</strong> environmental<br />

stress, several changes in the<br />

CD4, CD8, and NK cell counts were<br />

observed, which have been correlated<br />

with respiratory diseases. 4<br />

Another experiment conducted on<br />

astronauts found that during periods<br />

<strong>of</strong> stress, there was a decrease in antibodies<br />

to the Epstein-Barr virus<br />

nuclear antigens, along with an increase<br />

in adrenaline and noradrenaline<br />

in the urine and a decrease in<br />

virus-specific T lymphocytes. This<br />

led to the reactivation <strong>of</strong> the Epstein-Barr<br />

virus in 11 <strong>of</strong> 28 astronauts.<br />

6<br />

Wound healing<br />

There also appears to be evidence<br />

from in vitro studies showing that<br />

fibroblasts would be less effective in<br />

matrix repair for recovery from injuries<br />

and wounds in situations <strong>of</strong> psychological<br />

stress, precisely because<br />

<strong>of</strong> the presence <strong>of</strong> high tissue levels<br />

<strong>of</strong> corticosteroids. In one study <strong>of</strong><br />

student volunteers who underwent<br />

small incisions on mucous membranes,<br />

the healing time was 40%<br />

longer during examination periods<br />

than during vacation periods. This<br />

longer duration was associated with<br />

a 30% decrease in IL-1 levels during<br />

examination periods. 7<br />

Stress and allergies<br />

In a joint experiment, physicians<br />

and psychologists studied the relationship<br />

between stressful situations<br />

and an increase in the most common<br />

signs <strong>of</strong> allergies (rhinitis, sneezing,<br />

coughing, and conjunctivitis), along<br />

with the peculiarity that the allergic<br />

symptoms worsened in the following<br />

days while the stress stimulus<br />

continued. Analytically, this translates<br />

to a significant increase in IL-6<br />

and catecholamines in the blood <strong>of</strong><br />

stressed patients with symptoms <strong>of</strong><br />

allergies.<br />

There is another mediator, vasoactive<br />

intestinal polypeptide, that has<br />

been found in increased quantities<br />

in children who have experienced<br />

significant stress (typically parental<br />

separation) and that is closely linked<br />

to sensitization and the onset <strong>of</strong> allergic<br />

phenomena. 9<br />

In another recent experiment performed<br />

in Canada, 10 it was found<br />

that maternal stress in the first 7<br />

years <strong>of</strong> the child’s life has a significant<br />

influence on the rates <strong>of</strong> childhood<br />

asthma because mothers in<br />

this situation are less likely to interact<br />

with and show affection to their<br />

children. This is recognized by the<br />

child’s immune system, which could<br />

be considered an “affective” transmission<br />

<strong>of</strong> stress.<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) In Focus<br />

Systemic lupus erythematosus,<br />

depression, and stress<br />

Distinct immunological changes<br />

have been found in patients with depressive<br />

syndromes <strong>of</strong> various degrees<br />

and clinical manifestations. 11<br />

In contrast to healthy control subjects,<br />

an increase in B lymphocytes,<br />

antinuclear antibodies, and serum<br />

immunoglobulins can be observed<br />

in patients with depressive syndromes.<br />

Thus, depressive illnesses<br />

can demonstrate a certain relationship<br />

to autoimmunity. Also, many<br />

autoimmune diseases are characterized<br />

by major episodes <strong>of</strong> depression,<br />

especially systemic lupus erythematosus,<br />

regardless <strong>of</strong> treatment<br />

with GCs.<br />

With depression in general, prolonged<br />

activity in the adrenal cortex<br />

is a factor that makes recovery notably<br />

difficult. These are patients in<br />

whom the administration <strong>of</strong> corticosteroids<br />

does not exert a negative<br />

feedback on their own cortisol levels.<br />

12<br />

Growth and stress<br />

As previously mentioned, sustained<br />

stress causes high levels <strong>of</strong> CRH,<br />

which in turn inhibits GH and insulinlike<br />

growth factor 1. The circulating<br />

corticosteroids also exert a<br />

negative feedback on GH production<br />

by the pituitary gland. 2<br />

Stress and sleep<br />

Patients experiencing stress have a<br />

poor quality <strong>of</strong> sleep as a cause and<br />

a result <strong>of</strong> stress. 5,13 Failure to follow<br />

circadian rhythms due to a lack <strong>of</strong><br />

sleep reduces the amount <strong>of</strong> melatonin<br />

in the blood to below required<br />

levels. It is, therefore, presumed that<br />

its antioxidant activity cannot be<br />

performed. Also, melatonin’s likely<br />

activity <strong>of</strong> promoting immunity by<br />

inhibiting the production <strong>of</strong> gonadotropins<br />

is inhibited. 1,14<br />

Bioregulatory approach to<br />

stress<br />

A fascinating opportunity remains<br />

open for bioregulatory medicine to<br />

establish treatment protocols consisting<br />

<strong>of</strong> immune regulatory medicines<br />

(e.g., Echinacea compositum<br />

and Engystol), medicines supporting<br />

brain function (e.g., Cerebrum<br />

compositum, Thalamus compositum,<br />

Ypsiloheel, Neuro-Injeel, Tonico-Injeel,<br />

Nervoheel, and Ignatia-<br />

Homaccord), and the classic<br />

organoregulators, such as Ovarium<br />

compositum, Pulsatilla compositum,<br />

Coenzyme compositum, Hepar<br />

compositum, Testis compositum,<br />

Thyreoidea compositum, Galium-<br />

Heel, and Ubichinon compositum.<br />

Neurexan, a medication for nervousness<br />

and insomnia, has recently been<br />

shown in preliminary studies to be<br />

possibly useful in anticipatory anxiety.<br />

15 |<br />

References<br />

1. Lack LC, Wright HR. Chronobiology<br />

<strong>of</strong> sleep in humans. Cell Mol Life Sci.<br />

2007;64(10):1205-1215.<br />

2. Rosales Estrada M. Síndrome de inflamación de<br />

las mucosas: tratamiento antihomotóxico. Colombia:<br />

M. Rosales Estrada; 2005.<br />

3. Choi J, Fauce SR, Effros RB. Reduced telomerase<br />

activity in human T lymphocytes<br />

exposed to cortisol. Brain Behav Immun.<br />

2008;22(4):600-605.<br />

4. Song C, Leonard BE. Fundamentals <strong>of</strong> Psychoneuroimmunology.<br />

Chichester, England:<br />

Wiley & Sons; 2000.<br />

5. Andersen BL, Farrar WB, Golden-Kreutz<br />

D, et al. Stress and immune responses after<br />

surgical treatment for regional breast cancer.<br />

J Natl Cancer Inst. 1998;90(1):30-36.<br />

6. Stowe RP, Pierson DL, Barrett AD. Elevated<br />

stress hormone levels relate to Epstein-Barr<br />

virus reactivation in astronauts. Psychosom<br />

Med. 2001;63(6):891-895.<br />

7. Glaser R, Kiecolt-Glaser JK. Stress-induced<br />

immune dysfunction: implications for health.<br />

Nat Rev Immunol. 2005;5(3):243-251.<br />

8. Stress, anxiety can make allergy attacks even<br />

more miserable and last longer. ScienceDaily<br />

Web site. http://www.sciencedaily.com/<br />

releases/2008/08/080814154327.htm.<br />

Published August 17, 2008. Accessed July<br />

14, 2009.<br />

9. Stress during childhood increases the risk <strong>of</strong><br />

allergies. e! Science News Web site. http://<br />

esciencenews.com/articles/2008/06/18/<br />

stress.during.childhood.increases.risk.allergies.<br />

Published June 18, 2008. Accessed<br />

July 14, 2009.<br />

10. Kozyrskyj AL, Mai XM, McGrath P, Hayglass<br />

KT, Becker AB, Macneil B. Continued<br />

exposure to maternal distress in early life is<br />

associated with an increased risk <strong>of</strong> childhood<br />

asthma. Am J Respir Crit Care Med.<br />

2008;177(2):142-147.<br />

11. Eiguchi K, Soneira SG. Psiconeuroinmunoendocrinología<br />

en enfermedades autoinmunes<br />

(LES). Archivos de Alergia e Inmunología Clínica.<br />

2002;33(suppl 1):S8-S16.<br />

12. McEwen BS. Physiology and neurobiology<br />

<strong>of</strong> stress and adaptation: central role <strong>of</strong> the<br />

brain. Physiol Rev. 2007;87(3):873-904.<br />

13. Zisapel N. Sleep and sleep disturbances: biological<br />

basis and clinical implications. Cell<br />

Mol Life Sci. 2007;64(10):1174-1186.<br />

14. Plant TM. Hypothalamic control <strong>of</strong> the pituitary-gonadal<br />

axis in higher primates: key<br />

advances over the last two decades. J Neuroendocrinol.<br />

2008;20(6):719-726.<br />

15. Dimpfel W. Psychophysiological effects <strong>of</strong><br />

neurexan on stress-induced etropsychograms:<br />

a double blind, randomized, placebo-controlled<br />

study in human volunteers.<br />

NeuroCode-AG Web site. http://www.<br />

neurocode-ag.com/Poster%20Stresskongress%20Teil%20A.pdf<br />

and http://www.<br />

neurocode-ag.com/Poster%20Stresskongress%20Teil%20B.pdf.<br />

Accessed July 14,<br />

2009.<br />

) 7<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


Hearing voices when there is nobody<br />

around? A recent study suggests that<br />

high caffeine consumption may<br />

increase a pre-existing tendency<br />

to hallucinate.<br />

Getting a good night’s sleep reduces<br />

the risk <strong>of</strong> catching a viral infection.<br />

Link between caffeine and<br />

hallucinations?<br />

The more expensive<br />

the better?<br />

For good health,<br />

get enough sleep<br />

) 8<br />

A new research study, conducted at<br />

Durham University, UK, examines a<br />

possible link between high caffeine<br />

consumption and an increased tendency<br />

to hallucinate. The study assessed<br />

typical caffeine consumption<br />

<strong>of</strong> 200 students, along with stress<br />

levels and proneness to common<br />

hallucinatory experiences such as<br />

hearing voices when no one is present.<br />

“High caffeine users” consuming<br />

more than the equivalent <strong>of</strong><br />

seven cups <strong>of</strong> instant c<strong>of</strong>fee a day<br />

were three times more likely to hear<br />

voices than “low users” consuming<br />

less than one cup-equivalent.<br />

What’s the theory behind this research?<br />

As a result <strong>of</strong> traumatic<br />

events in their past, many hallucination-prone<br />

individuals respond to<br />

current stress by producing increased<br />

amounts <strong>of</strong> the stress hormone cortisol.<br />

Caffeine consumption further<br />

increases release <strong>of</strong> the stress hormone,<br />

and this extra cortisol boost<br />

might exacerbate a pre-existing tendency<br />

to hallucinate.<br />

The authors call the findings a first<br />

step in better understanding how<br />

nutrition affects hallucinations. More<br />

research is needed to see if changes<br />

in caffeine intake might help people<br />

to better cope with distressing hallucinations<br />

or reduce the frequency<br />

<strong>of</strong> these experiences.<br />

Personality and Individual Differences.<br />

2009;46(4):562-564.<br />

“If it’s not expensive, it can’t be any<br />

good.” Many people seem to approach<br />

medical care with this attitude. In an<br />

American study, 82 healthy volunteers<br />

were given what they thought<br />

was a new pain reliever. In reality, all<br />

<strong>of</strong> the subjects received identical<br />

placebos, but half <strong>of</strong> them were told<br />

that the price per tablet was $2.50,<br />

while the others were allowed to believe<br />

the medication was very lowpriced.<br />

The analge sic effects <strong>of</strong> the<br />

fake medication were then tested using<br />

mild electrical shocks to induce<br />

pain. Subjective sen sations <strong>of</strong> pain<br />

were significantly reduced in the<br />

group receiving the supposedly<br />

more expensive medication in comparison<br />

to the other group.<br />

JAMA. 2008;299:1016-1017<br />

Enjoy food and lose weight<br />

Eating rapidly to the point <strong>of</strong> satiety<br />

increases the risk <strong>of</strong> obesity. When<br />

3,287 Japanese women and men<br />

were surveyed about their eating<br />

habits, respondents who said they<br />

tended to eat fast until they felt full<br />

were three times more likely to be<br />

overweight than people who ate<br />

slowly and enjoyed their food. It<br />

seems that weightwatchers should<br />

not only pay attention to what they<br />

eat but also to how they eat.<br />

BMJ. 2008;337:a2002<br />

People who sleep well and long<br />

enough are less susceptible to viral<br />

infections, according to a study <strong>of</strong><br />

153 healthy men ranging in age<br />

from 21 to 55 years. The subjects<br />

were surveyed about the quantity<br />

and quality <strong>of</strong> their sleep over a 14-<br />

day period, after which they were<br />

infected by administering nose<br />

drops containing rhinoviruses. Researchers<br />

found that subjects who<br />

slept longer and better got sick less<br />

<strong>of</strong>ten than participants who slept<br />

less. For example, participants who<br />

got eight hours <strong>of</strong> sleep or more<br />

were approximately 2.94 times less<br />

likely to catch colds than those who<br />

slept for seven hours or less. The effects<br />

<strong>of</strong> sleep efficiency (actual sleeping<br />

time as a percentage <strong>of</strong> total time<br />

in bed) were even greater: Participants<br />

with 92 percent efficiency or<br />

less were 5.5 times more likely to<br />

develop a cold than those with 98<br />

percent efficiency or more. The immune<br />

system appears to need adequate<br />

sleep to effectively fend <strong>of</strong>f<br />

germs.<br />

Arch Intern Med. 2009;169(1):62-67<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) What Else Is New?<br />

During a coughing attack, airborne<br />

pathogens will be propelled into the<br />

surrounding air for about four meters.<br />

Sexy women wear red<br />

“Red-light” districts and sexy red<br />

lingerie suggest that the color red<br />

has long been associated with male<br />

sexual drive, but this connection had<br />

never been scientifically confirmed.<br />

To test men’s responses to the color<br />

red in relationship to women’s sexual<br />

attractiveness, participants were<br />

shown photos <strong>of</strong> women in front <strong>of</strong><br />

different colored backgrounds. Other<br />

pictures showed the women wearing<br />

different colored tops. The study<br />

found that men saw women posing<br />

in front <strong>of</strong> a red background or<br />

wearing red tops as sexually more<br />

desirable than the same women in<br />

other photos. Red had no effect on<br />

the men’s assessment <strong>of</strong> the women’s<br />

other qualities such as intelligence<br />

or kindness. Women shown the<br />

same photos seemed to be colorblind<br />

when it came to rating the attractiveness<br />

<strong>of</strong> other women.<br />

J Pers Soc Psychol. 2008;95(5):1150-<br />

1164<br />

Communicating with<br />

patients through positive<br />

images<br />

We humans still think best in images,<br />

and abstract numbers are difficult<br />

for most <strong>of</strong> us to remember. Health<br />

care practitioners should also use<br />

this fact to their advantage and enhance<br />

their communication with patients<br />

by using pictures and graphic<br />

elements. Researchers from New<br />

Zealand recently investigated the<br />

best way to convey important information<br />

about treatments to patients.<br />

Two-thirds <strong>of</strong> the patients questioned<br />

preferred graphically presented<br />

information to pure numbers<br />

and percentages. Positive formulations<br />

were also considered help ful.<br />

In other words, it is generally better<br />

to emphasize the benefits <strong>of</strong> a particular<br />

therapy instead <strong>of</strong> stressing<br />

the possible risks <strong>of</strong> leaving a condition<br />

untreated.<br />

Ann Fam Med 2008;6(3):213-217<br />

Keep your distance to<br />

stay healthy<br />

Many diseases are transmitted by<br />

airborne drops. At work, in the subway,<br />

while shopping – wherever we<br />

meet other people, we are bombarded<br />

with germs. People who are already<br />

sick and coughing are especially<br />

likely to contaminate the air<br />

with germ-filled spray. A recent<br />

study investigated how fast this<br />

cloud spreads around a cougher.<br />

Scien tists from the USA calculated<br />

the speed <strong>of</strong> spread at up to eight<br />

meters per second over a period <strong>of</strong><br />

approximately half a second. This<br />

means that an attack <strong>of</strong> coughing<br />

propels germs into the surroundings<br />

for about four meters. Anyone who<br />

wants to make it through cold season<br />

unscathed would do well to<br />

keep their distance from other people.<br />

N Engl J Med. 2008;359(15):e19<br />

FOR PROFESSIONAL USE ONLY<br />

The information contained in this journal is meant for pr<strong>of</strong>essional use only, is meant to convey general and/or specific worldwide scientific information relating to the<br />

products or ingredients referred to for informational purposes only, is not intended to be a recommendation with respect to the use <strong>of</strong> or benefits derived from the<br />

products and/or ingredients (which may be different depending on the regulatory environment in your country), and is not intended to diagnose any illness, nor is it<br />

intended to replace competent medical advice and practice. IAH or anyone connected to, or participating in this publication does not accept nor will it be liable<br />

for any medical or legal responsibility for the reliance upon or the misinterpretation or misuse <strong>of</strong> the scientific, informational and educational content <strong>of</strong> the<br />

articles in this journal.<br />

The purpose <strong>of</strong> the Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> is to share worldwide scientific information about successful protocols from orthodox and complementary practitioners.<br />

The intent <strong>of</strong> the scientific information contained in this journal is not to “dispense recipes” but to provide practitioners with “practice information” for a better<br />

understanding <strong>of</strong> the possibilities and limits <strong>of</strong> complementary and integrative therapies.<br />

Some <strong>of</strong> the products referred to in articles may not be available in all countries in which the journal is made available, with the formulation described in any article or<br />

available for sale with the conditions <strong>of</strong> use and/or claims indicated in the articles. It is the practitioner’s responsibility to use this information as applicable<br />

and in a manner that is permitted in his or her respective jurisdiction based on the applicable regulatory environment. We encourage our readers to share<br />

their complementary therapies, as the purpose <strong>of</strong> the Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> is to join together like-minded practitioners from around the globe.<br />

Written permission is required to reproduce any <strong>of</strong> the enclosed material. The articles contained herein are not independently verified for accuracy or truth. They have<br />

been provided to the Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> by the author and represent the thoughts, views and opinions <strong>of</strong> the article’s author.<br />

) 9<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) From the Practice<br />

Metabolic and Endocrine Disorders<br />

Associated With Pseudarthrosis<br />

Presentation <strong>of</strong> a Clinical Case<br />

Mónica Name Guerra, MD<br />

Bone fatigue is a considerable risk factor causing fractures<br />

in high-performance athletes, as a result <strong>of</strong> many extrinsic<br />

and intrinsic factors. This article describes a 13-year-old<br />

girl, a pr<strong>of</strong>essional skater with a fracture <strong>of</strong> the femur and<br />

atrophic pseudarthrosis 10 months after initial surgical<br />

treatment. A metabolic disturbance was found at the<br />

biological medical consultation; this was managed<br />

holistically, and the patient’s fracture healed after<br />

2 months <strong>of</strong> antihomotoxic and integrative treatment.<br />

The use <strong>of</strong> unsuitable equipment,<br />

very intensive training schedules,<br />

and inappropriate diets are<br />

among the external risk factors that<br />

predispose towards bone pathology<br />

in athletes. Age; mechanical biophysical<br />

factors arising from the<br />

bone-muscle relationship, which alter<br />

physiological alignment; bone<br />

density; and metabolic or hormonal<br />

imbalances are intrinsic causes <strong>of</strong><br />

stress fractures and pseudarthrosis.<br />

Prepubertal girls and women, as a<br />

result <strong>of</strong> the physiological changes<br />

inherent to their sexual development<br />

and monthly hormonal fluctuation,<br />

are a population especially at risk. 1<br />

In 1986, the US Food and Drug<br />

Administration defined pseudarthrosis<br />

as nonhealing <strong>of</strong> a fracture<br />

9 months after injury. However, depending<br />

on the bone and the site <strong>of</strong><br />

the injury, this period may vary. In<br />

fractures <strong>of</strong> the long bones in the<br />

middle third <strong>of</strong> the femur, a waiting<br />

period <strong>of</strong> 6 months is allowed,<br />

whereas neck fractures should heal<br />

within 3 months after the trauma. 2<br />

Although the exact cause <strong>of</strong> pseudarthrosis<br />

is not clear, it is believed that<br />

local factors (e.g., infection and poor<br />

vascularization) and systemic factors<br />

(e.g., nutritional state and hormonal<br />

balance) contribute to nonhealing <strong>of</strong><br />

fractures. Although there are opposing<br />

opinions, there is considerable<br />

bibliographic evidence implicating<br />

nonsteroidal anti-inflammatory<br />

drugs and corticoids as important<br />

factors in fractures that are not healing.<br />

3<br />

Pseudarthrosis can be hypertrophic<br />

or hypervascularized and atrophic<br />

or avascular.<br />

Figure 1: Fracture<br />

Figure 2: Intramedullary pin<br />

(June 26, 2004)<br />

Figure 3: Pseudarthrosis at follow-up<br />

) 10<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) From the Practice<br />

Figure 4: Second operative procedure<br />

Figure 5: Postoperative view 5 months<br />

after the second operative procedure<br />

Clinical case<br />

The patient is a 13-year-old sportsperson<br />

who, on June 25, 2004, experienced<br />

a displaced fracture in the<br />

middle third <strong>of</strong> the right femur (Figure<br />

1), which required surgical treatment<br />

with an intramedullary pin<br />

(Figure 2).<br />

A 5-month postoperative followup<br />

X-ray showed pseudarthrosis<br />

(Figure 3). Thus, from an orthopedic<br />

viewpoint <strong>of</strong> the mechanical instability<br />

and hypertrophic pseudarthrosis,<br />

a further intervention changing<br />

the pin for one <strong>of</strong> a larger<br />

diameter with double distal locking<br />

was performed on November 17,<br />

2004 (Figure 4).<br />

Five months after the second operative<br />

procedure, the fracture was classified<br />

as atrophic pseudarthrosis<br />

(Figure 5), and the treating orthopedic<br />

surgeon proposed a third intervention.<br />

The patient decided to consult<br />

a biological medicine specialist<br />

to obtain a second opinion.<br />

The consultation on April 13, 2005,<br />

showed that the patient was in pain,<br />

with no support from the lower<br />

right limb, and had a high consumption<br />

<strong>of</strong> nonsteroidal anti-inflammatory<br />

drugs.<br />

The results <strong>of</strong> the Meridian Stress<br />

Assessment (developed by Reinhold<br />

Voll) were pancreatic and splenic<br />

dysfunction (Table 1); therefore,<br />

clinical laboratory tests were performed<br />

to complete the investigation<br />

(Table 2). These test results<br />

showed a state <strong>of</strong> hypercortisolism<br />

with a normal basal insulin level (no<br />

postprandial insulin test result was<br />

available). The postprandial glucose<br />

response at 30 minutes was normal;<br />

however, at 1 hour, it was very low.<br />

The thyrotropin level was in the<br />

normal range, the free thyroxine<br />

level was normal, and the triiodothyronine<br />

level was not obtained. The<br />

parathyroid hormone level was normal;<br />

the result <strong>of</strong> bone densitometry<br />

showed osteopenia.<br />

Organ Right side Left side<br />

Lymphatic deg. 48 46<br />

Lung 54 46<br />

Large intestine 34 56<br />

Central nervous<br />

system deg.<br />

42 46<br />

Circulation 46 48<br />

Allergy deg. 42 42<br />

Parenchyma deg. 34 42<br />

Endocrine 46 46<br />

Heart 52 46<br />

Small intestine 44 58<br />

Pancreas 18<br />

Spleen 16<br />

Liver 44 46<br />

Joint deg. 46 36<br />

Stomach 54 52<br />

Fibroid deg. 58 48<br />

Skin deg. 66 58<br />

Fat deg. 56 58<br />

Gallbladder 70 52<br />

Kidney 54 52<br />

Bladder 48 56<br />

Uterus/prostate 48 54<br />

Laboratory test Patient value Reference value<br />

Urinary cortisol, µg/24 h 60.86 5-55<br />

Basal blood glucose, mg/dL 79 70-105<br />

Postprandial blood glucose at 30 min, mg/dL 125 > 110<br />

Postprandial blood glucose at 1 h, mg/dL 74 120-170<br />

Postprandial blood glucose at 2 h, mg/dL 94 70-120<br />

Thyrotropin, µUI/mL 2.40 0.35-5.50<br />

Free thyroxine, ng/dL 1.06 0.93-1.70<br />

Parathyroid hormone, pg/mL 31.3 11.0-79.5<br />

Basal insulin, µU/mL 5.02 2.60 -24.90<br />

Table 1:<br />

Meridian Stress Assessment results*<br />

Table 2:<br />

Clinical laboratory results<br />

* Normal values, 40-60; Irritation, 61-80;<br />

Inflammation, 81-100; Weakness, 31-39;<br />

Degeneration, < 30<br />

) 11<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) From the Practice<br />

Figure 6: Consolidated fracture (June 23,<br />

2005)<br />

) 12<br />

Treatment was started as follows:<br />

• Osteoheel,<br />

1 tablet 4 times per day<br />

• Strumeel,<br />

1 tablet 4 times per day<br />

• Momordica compositum,<br />

1 ampoule twice weekly,<br />

10 doses<br />

• Placenta compositum,<br />

1 ampoule twice weekly,<br />

10 doses<br />

• Acidum citricum-Injeel,<br />

1 ampoule twice weekly,<br />

10 doses<br />

• Lymphomyosot, 1 ampoule<br />

twice weekly, 10 doses<br />

Nutritional changes reducing the intake<br />

<strong>of</strong> rapidly absorbed carbohydrates<br />

(refined sugars) and avoiding<br />

high-sodium processed foods (ready<br />

meals and fast food) were recommended.<br />

At the 2-month clinical follow-up,<br />

pain was absent, normal electrical<br />

measurements <strong>of</strong> the pancreas (44)<br />

and spleen (48) were noted, and radiography<br />

showed healing <strong>of</strong> the<br />

fracture (Figure 6); therefore, the intramedullary<br />

pin was removed (Figure<br />

7). Laboratory findings at the<br />

end <strong>of</strong> treatment were normal.<br />

Discussion<br />

According to the Meridian Stress<br />

Assessment, this patient had an abnormality<br />

<strong>of</strong> the pancreas. Her low<br />

glucose level, using the result <strong>of</strong> the<br />

oral glucose tolerance test at 60<br />

minutes, indicates hypoglycemia and<br />

a state <strong>of</strong> chronic hypercortisolism.<br />

This state <strong>of</strong> transitory hypoglycemia<br />

leads to a functional imbalance<br />

<strong>of</strong> the hypothalamus-pituitary-adrenal<br />

cortex axis 4-6 ; therefore, the response<br />

is an increase in β-adrenergic<br />

activity in the hypothalamus, with<br />

the release <strong>of</strong> the growth hormones<br />

somatotrophin and corticotropin<br />

and increased secretion <strong>of</strong> cortisol<br />

and epinephrine. 5,6<br />

The cortisol acts like a counterregulating<br />

hormone and induces the<br />

production <strong>of</strong> glucose, activating the<br />

gluconeogenesis pathway. If the hypoglycemia<br />

persists, the level <strong>of</strong> cortisol<br />

rises, conforming a state <strong>of</strong><br />

chronic hypercortisolism.<br />

The increased cortisol levels in this<br />

patient could be secondary to the<br />

hypoglycemia and stress produced<br />

by competitive exercise and the influence<br />

<strong>of</strong> interleukin 6 as a chronic<br />

inflammatory cytokine. 7<br />

Intense exercise by high-performance<br />

athletes suppresses the function<br />

<strong>of</strong> the T cells and natural killer<br />

cells and increases the release <strong>of</strong><br />

cortisol and interleukin 6 proinflammatory<br />

factors. 7<br />

Cortisol causes a reduction in bone<br />

formation and an increase in resorption<br />

by various mechanisms<br />

(Figure 8). 8<br />

Cortisol antagonizes the action <strong>of</strong><br />

1,25-dihydroxyvitamin D 3<br />

or calcitriol,<br />

which acts on the osteoblast by<br />

increasing the synthesis <strong>of</strong> tissue<br />

growth factor β (TGF-β) and raising<br />

the number <strong>of</strong> insulinlike growth<br />

factor receptors, whose anabolic effect<br />

regulates bone growth and tissue<br />

repair. 8-12 Vitamin D 3<br />

increases<br />

the synthesis <strong>of</strong> osteocalcin and osteopontin<br />

by improving the mineralization<br />

<strong>of</strong> the collagen fibrils <strong>of</strong><br />

the bone when they are depleted.<br />

9-12<br />

The formation <strong>of</strong> hydroxyapatite alters<br />

with sodium/calcium interchange<br />

in the renal distal tubules,<br />

where phosphorus and magnesium<br />

are also lost. Each gram <strong>of</strong> sodium<br />

ion in urine corresponds to 26.3 mg<br />

<strong>of</strong> lost calcium; therefore, salty and<br />

fast food diets are not recommended.<br />

13<br />

Ingesting oily seeds and extra virgin<br />

vegetable oils rich in polyunsaturated<br />

fatty acids and conjugated linoleic<br />

acid increases the absorption<br />

rate <strong>of</strong> calcium in the cells and reduces<br />

osteoclastogenesis. 14<br />

Acidification secondary to the ingestion<br />

<strong>of</strong> refined sugar and proteins<br />

with sulfur atoms (methionine and<br />

cysteine) alters the mineralization<br />

and metabolism <strong>of</strong> the bone. 9<br />

The concentration <strong>of</strong> protons in the<br />

plasma and in the extracellular fluid<br />

is about 40 nM, corresponding to a<br />

pH <strong>of</strong> 7.4; to stabilize and alkalize<br />

this, there are systems that include<br />

balancing phosphate with calcium<br />

and magnesium ions originating<br />

from the bone matrix at the expense<br />

<strong>of</strong> weakening the bone. 9<br />

According to the personal analysis<br />

that I have made <strong>of</strong> this clinical case,<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) From the Practice<br />

Figure 7: Fracture without intramedullary<br />

pin (November 28, 2006)<br />

antihomotoxic medications could<br />

hypothetically have acted in the following<br />

manner in healing the fracture:<br />

1. Antihomotoxic medications,<br />

which contain low doses <strong>of</strong> antigens,<br />

could have stimulated the<br />

production <strong>of</strong> TGF-β from the<br />

lymphocyte line T-helper cell 3.<br />

This TGF-β intervenes in the reconstruction<br />

<strong>of</strong> the bone matrix<br />

by inhibiting the activation <strong>of</strong><br />

the osteoclasts and stimulating<br />

the action <strong>of</strong> the osteoblasts,<br />

promoting the healing <strong>of</strong> the tissue<br />

and the resolution <strong>of</strong> the inflammation.<br />

15-18<br />

2. The bioregulatory effect <strong>of</strong> Momordica<br />

compositum in the<br />

pancreas in controlling hypoglycemia<br />

and secondary hypercorti<br />

solism could be the result<br />

<strong>of</strong> a possible improvement in the<br />

expression <strong>of</strong> glucotransporters<br />

in the cells and hypothetically<br />

might increase the secretion<br />

<strong>of</strong> amylin and preptin. These<br />

2 polypeptides are cosecreted<br />

with insulin from the β cells <strong>of</strong><br />

the pancreas; their function is to<br />

stimulate osteoblastic proliferation,<br />

reduce osteoblastic apoptosis,<br />

and inhibit osteoclastic activity.<br />

19-25<br />

3. Possibly, Acidum citricum-Injeel,<br />

a Krebs cycle catalyst and calcium<br />

metabolism regulator that<br />

improves the absorption <strong>of</strong> vitamin<br />

D, could act in the renal tubule<br />

cells by stimulating the mitochondrial<br />

1a-hy droxylase res<br />

pon sible for transforming 25-<br />

hydroxycholecalciferol (in acti ve)<br />

into 1,25-dihydroxy cholecalciferol<br />

(active) or calcitriol.<br />

Figure 8: Effects <strong>of</strong> cortisol on bone 8<br />

GI Ca absorption<br />

Renal Ca absorption<br />

Bone resorption<br />

LH – FSH<br />

Testosterone<br />

Estrogen<br />

Cortisol<br />

Osteoprotegerin<br />

Osteoporosis<br />

Muscle strength<br />

Osteoblastic<br />

apoptosis<br />

GI<br />

Ca<br />

Gastrointestinal<br />

Calcium<br />

Bone formation<br />

LH<br />

Luteinizing<br />

hormone<br />

Growth factors<br />

FSH<br />

Follicle-stimulating<br />

hormone<br />

) 13<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) From the Practice<br />

) 14<br />

Conclusion<br />

Antihomotoxic treatment drains the<br />

matrix (Lymphomyosot), regulates<br />

the endocrine function <strong>of</strong> the pancreas<br />

(Momordica compositum),<br />

regulates thyroid function (Strumeel),<br />

solves the problem <strong>of</strong> avascular atrophic<br />

pseudarthrosis (Placenta compositum),<br />

and re-establishes the<br />

metabolic balance <strong>of</strong> bone, the intrinsic<br />

calcium metabolism, and vitamin<br />

D absorption (Osteoheel and<br />

Acidum citricum-Injeel).<br />

Pseudarthrosis is not an exclusively<br />

mechanical problem. It must be confronted<br />

integrally, from the pr<strong>of</strong>ession<br />

or lifestyle to the metabolism <strong>of</strong><br />

the organism, the diet, the neuroendocrine<br />

system, and immunological<br />

modulation. “The whole organism<br />

suffers with the fracture <strong>of</strong> a long<br />

bone.” 26 |<br />

References<br />

1. DeFranco MJ, Recht M, Schils J, Parker RD.<br />

Stress fractures <strong>of</strong> the femur in athletes. Clin<br />

Sports Med. 2006;25(1):89-103, ix.<br />

2. Cleveland KB. Delayed union and nonunion<br />

<strong>of</strong> fractures. In: Canale ST, Beaty J, eds.<br />

Campbell’s Operative Orthopaedics. 11th ed.<br />

Philadelphia, PA: Mosby; 2007:chapter 56.<br />

3. Koester MC, Spindler KP. Pharmacologic<br />

agents in fracture healing. Clin Sports Med.<br />

2006;25(1):63-73, viii.<br />

4. Fruehwald-Schultes B, Kern W, Born J,<br />

Fehm HL, Peters A. Hyperinsulinemia<br />

causes activation <strong>of</strong> the hypothalamus-pituitary-adrenal<br />

axis in humans. Intern J Obes.<br />

2001;25(suppl1):S38-S40.<br />

5. Arias P, Arzt E, Bonet E. Estrés y procesos de<br />

enfermedad. Buenos Aires, Argentina: Biblos;<br />

1998.<br />

6. Suliman AM, Freaney R, McBrinn Y, et al.<br />

Insulin-induced hypoglycemia suppresses<br />

plasma parathyroid hormone levels in patients<br />

with adrenal insufficiency. Metabolism.<br />

2004;53(10):1251-1254.<br />

7. Rosales Estrada M. Síndrome de inflamación<br />

de las mucosas: tratamiento antihomotóxico.<br />

2nd ed. Colombia: M. Rosales Estrada;<br />

2005.<br />

8. Rubin MR, Bilezikian JP. The role <strong>of</strong> parathyroid<br />

hormone in the pathogenesis <strong>of</strong><br />

glucocorticoid-induced osteoporosis: a reexamination<br />

<strong>of</strong> the evidence. J Clin Endocrinol<br />

Metab. 2002;87(9):4033-4041.<br />

9. Koolman J, Röhm K. Bioquímica: texto y atlas.<br />

3rd ed. Stuttgart, Germany: Panamericana;<br />

2004.<br />

10. Clark R. The somatogenic hormones and<br />

insulin-like growth factor-1: stimulators <strong>of</strong><br />

lymphopoiesis and immune function. Endocr<br />

Rev. 1997;18(2):157-179.<br />

11. Kurtz A, Matter R, Eckardt KU, Zapf J.<br />

Erythropoiesis, serum erythropoietin, and serum<br />

IGF-I in rats during accelerated growth.<br />

Acta Endocrinol (Copenh). 1990;122(3):323-<br />

328.<br />

12. Gómez JM. The role <strong>of</strong> insulin-like growth<br />

factor I components in the regulation <strong>of</strong> vitamin<br />

D. Curr Pharm Biotechnol. 2006;7(2):125-<br />

132.<br />

13. Shortt C, Madden A, Flynn A, Morrissey PA.<br />

Influence <strong>of</strong> dietary sodium intake on urinary<br />

calcium excretion in selected Irish individuals.<br />

Eur J Clin Nutr. 1988;42(7):595-603.<br />

14. Bhattacharya A, Banu J, Rahman M, Causey<br />

J, Fernandes G. Biological effects <strong>of</strong> conjugated<br />

linoleic acids in health and disease.<br />

J Nutr Biochem. 2006;17(12):789-810.<br />

15. Abbas AK, Lichtman AH, Pillai S. Inmunología<br />

celular y molecular. 6th ed. Barcelona,<br />

Spain: Elsevier Saunders; 2008:3-16, 243-<br />

263, 267-301.<br />

16. Heine H. Homotoxicología: Una síntesis de las<br />

orientaciones médicas basadas en las ciencias<br />

naturales. 3rd ed. Baden-Baden, Germany:<br />

Aurelia-Verlag; 2004:79-85.<br />

17. Weiner HL, Mayer LF. Oral tolerance: mechanisms<br />

and applications. Ann N Y Acad Sci.<br />

1996;778:1-451.<br />

18. Weiner HL, Friedman A, Miller A, et al.<br />

Oral tolerance: immunologic mechanisms<br />

and treatment <strong>of</strong> animal and human organspecific<br />

autoimmune diseases by oral administration<br />

<strong>of</strong> autoantigens. Annu Rev Immunol.<br />

1994;12:809-837.<br />

19. Cornish J, Callon KE, Bava U, et al. Preptin,<br />

another peptide product <strong>of</strong> the pancreatic<br />

β-cell, is osteogenic in vitro and in vivo. Am<br />

J Physiol Endocrinol Metab. 2007;292(1):<br />

E117-E122.<br />

20. Dacquin R, Davey RA, Laplace C, et al. Amylin<br />

inhibits bone resorption while the calcitonin<br />

receptor controls bone formation in<br />

vivo. J Cell Biol. 2004;164(4):509-514.<br />

21. Valenzano KJ, Heath-Monnig E, Tollefsen<br />

SE, Lake M, Lobel P. Biophysical and biological<br />

properties <strong>of</strong> naturally occurring high<br />

molecular weight insulin-like growth factor<br />

II variants. J Biol Chem. 1997;272(8):4804-<br />

4813.<br />

22. Buchanan CM, Phillips AR, Cooper GJ.<br />

Preptin derived from proinsulin-like growth<br />

factor II (proIGF-II) is secreted from pancreatic<br />

islet β-cells and enhances insulin secretion.<br />

Biochem J. 2001;360(pt 2):431-439.<br />

23. Alam AS, Moonga BS, Bevis PJ, Huang CL,<br />

Zaidi M. Amylin inhibits bone resorption by<br />

a direct effect on the motility <strong>of</strong> rat osteoclasts.<br />

Exp Physiol. 1993;78(2):183-196.<br />

24. Cornish J, Callon KE, Cooper GJ, Reid IR.<br />

Amylin stimulates osteoblast proliferation<br />

and increases mineralized bone volume in<br />

adult mice. Biochem Biophys Res Commun.<br />

1995;207(1):133-139.<br />

25. Cornish J, Callon KE, King AR, Cooper GJ,<br />

Reid IR. Systemic administration <strong>of</strong> amylin<br />

increases bone mass, linear growth, and adiposity<br />

in adult male mice. Am J Physiol Endocrinol<br />

Metab. 1998;275(4, pt 1):E694-E699.<br />

26. Sodi-Pallares D. Magnetoterapia y tratamiento<br />

metabólico. Publisher unknown; 1994:84.<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Around the Globe<br />

Verona – More Than<br />

Just Romeo and Juliet ...<br />

By Anita Bania, MD<br />

From November 6 to 8, 2008, in<br />

Verona, Italy, the <strong>International</strong><br />

<strong>Academy</strong> for <strong>Homotoxicology</strong> presented<br />

a practice-based training for<br />

Polish doctors whose practices combine<br />

conventional medical training<br />

with elements <strong>of</strong> homeopathy, homotoxicology,<br />

acupuncture, homeosiniatry,<br />

and mesotherapy. The small<br />

group <strong>of</strong> students, all experienced<br />

clinicians, included three internal<br />

medicine specialists and two pediatricians.<br />

The training took place in Dr. Ivo<br />

Bianchi’s private medical practice,<br />

which he runs together with his wife<br />

and daughter. Dr. Bianchi sees patients<br />

<strong>of</strong> virtually all ages, ranging<br />

from infants to geriatric patients.<br />

The group had close contact with<br />

selected patients, had access to their<br />

histories, and was able to examine<br />

them. Each patient was then discussed<br />

in detail to determine individually<br />

optimized therapies and<br />

recommendations.<br />

Dr. Bianchi had invited two guest<br />

speakers to contribute to the training.<br />

Dr. Lugero Graziolli gave a lecture<br />

and practical demonstrations on<br />

“Esthetic Biological Medicine: Diagnosis<br />

and Therapies,” placing particular<br />

emphasis on biochemical and<br />

electromagnetic homeostasis in the<br />

Sightseeing in Verona<br />

human body and the loss <strong>of</strong> normal<br />

matrix functions in the course <strong>of</strong> the<br />

aging process. Pr<strong>of</strong>essor Sergio Serrano<br />

introduced the therapeutic use<br />

<strong>of</strong> biophotons and singlet oxygen<br />

and demonstrated their practical applications<br />

in traditional mesotherapy<br />

and biomesotherapy to the group.<br />

Dr. Bianchi is a seasoned expert on<br />

Krebs cycle catalysts and enthusiastically<br />

endorses their use in therapy,<br />

both in his youngest patients (such<br />

as low birth-weight babies) and in<br />

mature and elderly patients. We analyzed<br />

individual clinical case studies<br />

under Dr. Bianchi’s guidance. From<br />

the perspective <strong>of</strong> conventional<br />

medicine, all <strong>of</strong> these cases were at<br />

least very interesting and <strong>of</strong>ten very<br />

challenging. All <strong>of</strong> Dr. Bianchi’s patients<br />

had undergone very thorough<br />

diagnosis, <strong>of</strong>ten in university hospitals,<br />

and their discharge summaries<br />

and hospitalization information<br />

were available. Dr. Bianchi conducted<br />

detailed repertorization <strong>of</strong> each<br />

individual patient, applying the<br />

rules <strong>of</strong> classical homeopathy and<br />

homotoxicology, and determined<br />

the position <strong>of</strong> each patient’s condition<br />

on a neurovegetative outline he<br />

has developed and enriched with<br />

additional elements drawn from homotoxicology,<br />

Chinese medicine,<br />

and conventional medicine.<br />

The training itself was very intense<br />

but well-organized, and the sessions<br />

were just the right length. Between<br />

sessions, we were also able to enjoy<br />

the charming sights <strong>of</strong> the town <strong>of</strong><br />

Verona and see the international<br />

horse show gala HORSELYRIC, for<br />

which Verona is now famous.<br />

We found participating in this training<br />

to be highly rewarding and recommend<br />

it to all practitioners interested<br />

in homotoxicology and holistic<br />

medicine.|<br />

For more information on<br />

practice-based training in<br />

bioregulatory medicine,<br />

please contact the <strong>International</strong><br />

Society <strong>of</strong> <strong>Homotoxicology</strong><br />

and Homeopathy at<br />

info@isohh.de<br />

At the end <strong>of</strong> the training, the<br />

participants received certificates<br />

(far left and right: Dr. Ivo Bianchi<br />

and his wife Marina).<br />

) 15<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Practical Protocols<br />

Bioregulatory Treatment<br />

<strong>of</strong> Dysautonomia<br />

By Bert Hannosset, MD<br />

Dysautonomia, formerly called<br />

neurasthenia, exists in two<br />

forms: familial dysautonomia and<br />

non-familial dysautonomia.<br />

Familial dysautonomia is an autosomal<br />

recessive genetic disease, the<br />

result <strong>of</strong> mutation in the IKBKAP<br />

gene on chromosome 9. It occurs<br />

exclusively in Ashkenazi Jews; there<br />

are currently 350 known living cases<br />

worldwide. To date, the disease<br />

remains incurable.<br />

Non-familial dysautonomia, a disease<br />

or malfunction <strong>of</strong> the autonomic<br />

nervous system, is much more<br />

common. In this disorder, the human<br />

body fails to properly regulate<br />

blood pressure (e.g., orthostatic hypotension),<br />

heart rate (e.g., postural<br />

orthostatic tachycardia syndrome),<br />

temperature, vascular constriction/<br />

dilation, and blood supply to the<br />

brain. The results are unpredictable<br />

fainting, low blood pressure, lightheadedness,<br />

dizziness, problems<br />

with concentration (“brain fog”),<br />

headaches, fatigue, heart palpitations,<br />

exercise intolerance, insomnia,<br />

hot flashes, chills, weakness, seizures,<br />

pain, and disability. The causes<br />

<strong>of</strong> non-familial dysautonomia are<br />

not fully understood but are thought<br />

to include viral infections, exposure<br />

to toxic chemicals, genetic factors (a<br />

variation in the angiotensin II type I<br />

receptor gene), autoimmune disorders<br />

(antibodies to neuronal nicotinic<br />

acetylcholine receptors <strong>of</strong> the<br />

autonomic ganglia), adrenal disorders,<br />

and trauma (injury or emotional<br />

trauma, which damages the autonomic<br />

nervous system). (See protocol<br />

in Table 1.)|<br />

DET-phase<br />

Basic and/or<br />

symptomatic<br />

Regulation therapy*<br />

Optional<br />

Sympathicodermal<br />

Impregnation<br />

• Ignatia-<br />

Homaccord<br />

D&D<br />

IM<br />

• Advanced supportive<br />

detoxification and drainage<br />

followed by the<br />

• Detox-Kit<br />

• Tonsilla compositum<br />

• Vertigoheel (dizziness)<br />

• Tonico-Injeel (exhaustion)<br />

• Cralonin (cardiac weakness)<br />

• Aurumheel (low blood pressure)<br />

• Traumeel (injury)<br />

OR<br />

• Sympathicus suis-Injeel<br />

if available; if not, use<br />

• Engystol (post-viral)<br />

• Cerebrum compositum<br />

Notes: Ignatia and Moschus = basic homeopathic treatment for dystonia. Advanced supportive detoxification and drainage consists <strong>of</strong><br />

Hepar compositum (liver), Solidago compositum (kidneys), and Thyreoidea compositum (connective tissue; also regulates glandular<br />

functions [e.g., pineal body, thyroid, and adrenals]); Coenzyme compositum and Ubichinon compositum for cellular detoxification and<br />

drainage. The Detox-Kit consists <strong>of</strong> Lymphomyosot, Nux-vomica-Homaccord, and Berberis-Homaccord. Tonsilla compositum downregulates<br />

the Th-2 pathway and supports adrenals. Sympathicus suis-Injeel supports the autonomic nervous system. Cerebrum compositum<br />

supports the central nervous system and improves blood flow.<br />

Dosages: Ignatia-Homaccord: 15 drops 3 times per day. Regulation therapy: 1 ampoule <strong>of</strong> each medication 1-3 times per week. Detox-Kit:<br />

30 drops o f each medication in 1.5 liters <strong>of</strong> water; drink throughout the day.<br />

) 16<br />

Table 1: Protocol for dysautonomia<br />

* Antihomotoxic regulation therapy consists <strong>of</strong> a three-pillar approach: detoxification & drainage (D&D), immunomodulation (IM),<br />

and organ regulation (OR)<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


In memoriam<br />

Pr<strong>of</strong>essor Michael F. Kirkman<br />

died on Saturday, January 18 on<br />

the Isle <strong>of</strong> Wight, United Kingdom.<br />

He had lectured at St. Andrew’s<br />

Medical School; his medical knowledge<br />

ranged from pathology and<br />

tropical diseases to homeopathy, homotoxicology,<br />

and nutrition. He was<br />

one <strong>of</strong> the first doctors to apply an<br />

integrative concept <strong>of</strong> medicine that<br />

included environmental factors and<br />

detoxification.<br />

He had the courage to challenge<br />

medical conventions and found<br />

himself in the first line <strong>of</strong> attack for<br />

his use <strong>of</strong> homeopathic sarcodes and<br />

nosodes. Like Drs. Reich, Gerson,<br />

Bach, and Reckeweg before him, his<br />

dogged persistency, academic ability,<br />

and zeal to advance the “art <strong>of</strong> medicine”<br />

enabled him to carry on with<br />

his mission. He wrote a textbook on<br />

tissue microenvironment and lectured<br />

and published articles worldwide.<br />

He was one <strong>of</strong> the first certified<br />

lecturers <strong>of</strong> the <strong>International</strong><br />

<strong>Academy</strong> for <strong>Homotoxicology</strong> (IAH)<br />

and won an award for the best lecture<br />

at the first IAH rollout in Baden-<br />

Baden, Germany in April 2003.<br />

He founded not only one <strong>of</strong> the first<br />

nutritional colleges in the UK (the<br />

European College <strong>of</strong> Nutrition at<br />

the Royal Society for Public Health)<br />

but also the first College <strong>of</strong> <strong>Homotoxicology</strong><br />

in the UK; with colleagues,<br />

he started the first postgraduate<br />

course in bioregulatory<br />

medicine. Last but not least, he was<br />

involved in teaching a course in bioregulatory<br />

medicine at the Biomedic<br />

Centre in the UK in collaboration<br />

with two colleagues, Drs Shakambet<br />

and Bosh.<br />

Pr<strong>of</strong>essor Michael F. Kirkman<br />

(1936 – 2009)<br />

His guidance and support were crucial<br />

to those following this path,<br />

and he was full <strong>of</strong> warmth and enthusiasm<br />

for new projects. His mentorship,<br />

wise guidance, and friendship,<br />

along with his witty and<br />

creative mind, will be greatly missed.<br />

His funeral was held on February 4,<br />

2009 on the Isle <strong>of</strong> Wight. Pr<strong>of</strong>essor<br />

Kirkman is survived by his wife<br />

Muriel.<br />

Damir A. Shakambet, MD<br />

Hans-Heinrich Reckeweg Award 2010<br />

Join in – have your experience rewarded<br />

Heel annually honors outstanding scientific research in<br />

the field <strong>of</strong> a unique homeotherapeutic system (homotoxicology)<br />

with the Hans-Heinrich Reckeweg Award.<br />

The main award (€ 10,000)<br />

is presented for scientific work <strong>of</strong> fundamental theoretical<br />

and/or practical significance in antihomotoxic<br />

medicine in the fields <strong>of</strong> human and veterinary medicine.<br />

The incentive award (€ 5,000)<br />

is presented for promising results arising from clinical,<br />

case-based or fundamental research in antihomotoxic<br />

medicine in the fields <strong>of</strong> human and veterinary medicine.<br />

The prize money is intended to fund further research.<br />

Both prizes are awarded for research carried out in a<br />

laboratory or registered practice. All results must be<br />

new, convincing and previously unpublished, and research<br />

should not have involved animal testing.<br />

The deadline for submissions is May 31, 2010.<br />

For more information contact:<br />

Biologische Heilmittel Heel GmbH,<br />

Department <strong>of</strong> Research,<br />

76532 Baden-Baden, Germany<br />

Phone +49 7221 501-227,<br />

Fax +49 7221 501-660, info@heel.de,<br />

www.heel.com<br />

) 17<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Re f r e s h Yo u r H o m o t ox i c o l o g y<br />

Psychogenic Factors in<br />

Gastrointestinal Pathology<br />

By Bruno Van Brandt<br />

Medical Education Manager <strong>of</strong> the IAH<br />

) 18<br />

Is half a glass <strong>of</strong> water half full or half empty? Although the<br />

reality remains the same, the way individuals look at it will<br />

definitely change their emotional state. Half full or half<br />

empty makes the difference between positivism and negativism,<br />

between stress and inner peace, between psychogenic<br />

factors that will, over the ideomotorical rule in psychology,*<br />

enhance or inhibit physical condition or strength.<br />

Emotional triggers <strong>of</strong> immune<br />

disorders are very well-known<br />

in modern medicine, especially<br />

where psycho-neuro-endocrino-immunological<br />

(PNEI) effects are seen<br />

as a major trigger within psychosomatic<br />

diseases. 1 Serotonin, adrenaline,<br />

dopamine, and glutamate are<br />

major neurotransmitters in the central<br />

nervous system. Serotonin and<br />

adrenaline especially are secreted in<br />

response to stress and emotion. All 4<br />

neurotransmitters mentioned are<br />

also present in a second, almost prehistorical,<br />

and <strong>of</strong>ten forgotten brain,<br />

called the enteric brain.<br />

This enteric nervous system, located<br />

in the gastrointestinal (GI) tract<br />

(more precisely in the epithelial lining<br />

<strong>of</strong> the esophagus, stomach, and<br />

small and large intestines), is a major<br />

subject in the study <strong>of</strong> neurogastroenterology<br />

and plays an important<br />

role in irritable bowel syndrome<br />

(IBS). According to some researchers,<br />

up to 95% <strong>of</strong> the serotonin<br />

available in the body is located in<br />

the GI tract; <strong>of</strong> this 95%, 90% is in<br />

the enterochromaffin cells, and the<br />

remaining 10% can be found in enteric<br />

neurons. Serotonin plays a key<br />

role in the initiation <strong>of</strong> peristaltic<br />

and secretory reflexes. 2<br />

Although the enteric brain is described<br />

as part <strong>of</strong> the peripheral nervous<br />

system, it is also defined as the<br />

second brain, 3 in addition to the primary<br />

central brain. The central nervous<br />

system can influence the enteric<br />

brain and vice versa. 3 This<br />

could be a possible explanation as to<br />

why an emotional stressor or anxiety<br />

can indirectly induce IBS.<br />

During stress, the brain will induce,<br />

over the brain-gut axis, mast cell degranulation<br />

in the intestinal tract.<br />

By this degranulation, histamine<br />

and phospholipids are set free in<br />

large numbers, inducing inflammatory<br />

pathways. Activation <strong>of</strong> the gut<br />

immune system may disrupt normal<br />

gut motility, leading to common<br />

symptoms such as diarrhea, cramping,<br />

and bloating. 4<br />

The inflamed tissues render the enteric<br />

nerves overly sensitive and<br />

overactive, deregulating the production<br />

<strong>of</strong> serotonin. Both low and<br />

high levels <strong>of</strong> serotonin can cause<br />

problems. The same molecule, when<br />

available in a too low or a too high<br />

concentration, may induce the same<br />

clinical symptom: cramps. As Paracelsus<br />

already stated centuries ago,<br />

“the dose makes the poison.”<br />

Low levels <strong>of</strong> serotonin are not only<br />

associated with depression, shortterm<br />

memory, and concentration<br />

deficits, but also, at the level <strong>of</strong> the<br />

enteric nervous system, with bowel<br />

problems such as constipation with<br />

spasm (IBS-C). Emotional stress,<br />

over the PNEI system, can thus induce<br />

changes within serotonin levels<br />

at the level <strong>of</strong> the GI tract and can<br />

induce spasms (Figure 1). A stressrelated<br />

nervous or anxious state will<br />

increase the prevalence or intensity<br />

<strong>of</strong> intestinal spasm over the braingut<br />

axis. 5<br />

Increased levels <strong>of</strong> serotonin are associated<br />

with intestinal problems<br />

too, such as is seen in diarrhea<br />

accompanied by cramps (IBS-D). 6<br />

Selective serotonin reuptake inhibitor<br />

package inserts <strong>of</strong>ten mention<br />

both symptoms as possible adverse<br />

effects because <strong>of</strong> the medicationinduced<br />

decreased reuptake <strong>of</strong> serotonin<br />

and thus the increased serotonin<br />

availability and activity levels.<br />

* Every thought or idea makes the body gravitate to fulfill that thought or idea. William James, The Principles <strong>of</strong> Psychology (1890)<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Re f r e s h Yo u r H o m o t ox i c o l o g y<br />

The conventional medical approach<br />

to IBS is <strong>of</strong>ten the use <strong>of</strong> antispasmodic<br />

agents, such as hyoscine butylbromide,<br />

to relieve spasms and<br />

cramps. Research in conventional<br />

medicine also reports the symptomrelieving<br />

effects <strong>of</strong> benzodiazepines<br />

in patients with IBS, 7,8 pointing at<br />

the psychogenic factors that increase<br />

the physical symptoms over the<br />

brain-gut axis. A combination therapy<br />

<strong>of</strong> an antispasmodic medication<br />

with a benzodiazepine seems to<br />

have synergic therapeutic effects in<br />

the relief <strong>of</strong> IBS symptoms. 9 Treatments<br />

aimed at the gut-brain interface<br />

are in development, but have<br />

been difficult to establish because <strong>of</strong><br />

adverse effects. 10<br />

Bioregulatory treatment<br />

It is thus interesting to look at a bioregulatory<br />

approach in these patients.<br />

In a comparative study, Nervoheel<br />

was found to be noninferior<br />

to lorazepam, a benzodiazepine prescribed<br />

worldwide, in the treatment<br />

<strong>of</strong> mild nervous disorders. 11 Spascupreel<br />

is a bioregulatory antispasmodic<br />

medication that will induce<br />

symptomatic relief <strong>of</strong> spasmodic<br />

conditions <strong>of</strong> the intestinal tract. In<br />

a comparative study versus hyoscine<br />

butylbromide, it was shown to possess<br />

a noninferior therapeutic effect<br />

in treating intestinal cramps. 12 This<br />

effect <strong>of</strong> Spascupreel can be used in<br />

conditions such as IBS, and, if it is<br />

applied together with a psychogenic<br />

relaxing drug such as Nervoheel, a<br />

synergistic action on the gut-brain<br />

axis may be possible. In this way, a<br />

bioregulatory alternative can be <strong>of</strong>fered<br />

for the combination <strong>of</strong> antispasmodic<br />

agent–tranquilizer in<br />

conventional therapy <strong>of</strong> IBS.<br />

Given the PNEI link between the<br />

central and enteric brain and the experience<br />

in conventional medicine<br />

(i.e., antispasmodic drugs in combination<br />

with tranquillizers have a<br />

stronger symptom-relieving effect in<br />

IBS), it can be stated that Nervoheel<br />

might play an important therapeutic<br />

role in the bioregulatory relief <strong>of</strong><br />

IBS symptoms. Although some benzodiazepines<br />

are known to be addictive,<br />

13 to my knowledge, no such<br />

risk has ever been reported for Nervoheel.<br />

Thus, Nervoheel is a safe alternative<br />

to benzodiazepines. In the<br />

same way, Spascupreel is a safe and<br />

effective alternative to hyoscine butylbromide<br />

in the symptomatic relief<br />

<strong>of</strong> patients with IBS. Known adverse<br />

effects <strong>of</strong> hyoscine butylbromide include<br />

constipation, dry mouth, trouble<br />

urinating, and nausea. Other adverse<br />

effects, which are very unlikely<br />

but reported, include rash, itching,<br />

swelling <strong>of</strong> the hands or feet, trouble<br />

breathing, increased pulse, dizziness,<br />

diarrhea, vision problems, and<br />

eye pain. To my knowledge, none <strong>of</strong><br />

these adverse effects have ever been<br />

reported with Spascupreel.<br />

In conclusion, bioregulatory treatment<br />

may <strong>of</strong>fer a viable alternative<br />

Stress<br />

Mood disturbances<br />

• Anxiety<br />

• Depression<br />

Central nervous system (brain)<br />

Autonomic nervous system<br />

in the management <strong>of</strong> conditions in<br />

which the gut-brain interface causes<br />

deregulation <strong>of</strong> the enteric nervous<br />

system, the second brain.|<br />

References:<br />

1. Sivik T, Byrne D, Lipsitt D, Christodoulou G,<br />

Dienstfrey H, eds. Psycho-Neuro-Endocrino-<br />

Immunology (PNEI). Amsterdam, the Netherlands:<br />

Elsevier; 2002. Excerpta Medica<br />

<strong>International</strong> Congress Series 1241.<br />

2. Grider JR, Kuemmerle JF, Jin JG. 5-HT released<br />

by mucosal stimuli initiates peristalsis<br />

by activating 5-HT4/5-HT1p receptors<br />

on sensory CGRP neurons. Am J Physiol.<br />

1996;270(5 pt 1):G778-G782.<br />

3. Gershon MD. The enteric nervous system:<br />

a second brain. Hosp Pract (Minneap).<br />

1999;34(7):31-32, 35-38, 41-42 passim.<br />

4. Törnblom H, Lindberg G, Nyberg B, Veress<br />

B. Full-thickness biopsy <strong>of</strong> the jejunum<br />

reveals inflammation and enteric neuropathy<br />

in irritable bowel syndrome. Gastroenterology.<br />

2002;123(6):1972-1979.<br />

5. Taché Y. Stress and irritable bowel syndrome:<br />

unravelling the code. <strong>International</strong> Foundation<br />

for Gastrointestinal Disorders Web<br />

site. http://www.iffgd.org/store/viewproduct/211.<br />

Accessed July 14, 2009.<br />

6. Singh RK, Pandey HP, Singh RH. Correlation<br />

<strong>of</strong> serotonin and monoamine oxidase<br />

levels with anxiety level in diarrhea-predominant<br />

irritable bowel syndrome. Indian J Gastroenterol.<br />

2003;22(3):88-90.<br />

7. Tollefson GD, Luxenberg M, Valentine R,<br />

Dunsmore G, Tollefson SL. An open label trial<br />

<strong>of</strong> alprazolam in comorbid irritable bowel<br />

syndrome and generalized anxiety disorder.<br />

J Clin Psychiatry. 1991;52(12):502-508.<br />

8. Leventer SM, Raudibaugh K, Frissora CL, et<br />

al. Clinical trial: dext<strong>of</strong>isopam in the treatment<br />

<strong>of</strong> patients with diarrhoea-predominant<br />

or alternating irritable bowel syndrome. Aliment<br />

Pharmacol Ther. 2008;27(2):197-206.<br />

9. Ritchie JA, Truelove SC. Treatment <strong>of</strong> irritable<br />

bowel syndrome with lorazepam, hyoscine<br />

butylbromide, and ispaghula husk. Br<br />

Med J. 1979;1(6160):376-378.<br />

10. Sanger GJ. 5-Hydroxytryptamine and the<br />

gastrointestinal tract: where next? Trends<br />

Pharmacol Sci. 2008;29(9):465-471.<br />

11. van den Meerschaut L, Sünder A. The homeopathic<br />

preparation Nervoheel N can <strong>of</strong>fer<br />

an alternative to lorazepam therapy for mild<br />

nervous disorders. Evid Based Complement<br />

Alternat Med. Published October 25, 2007.<br />

doi:10.1093/ecam/nem144.<br />

12. Müller-Krampe B, Oberbaum M, Klein P,<br />

Weiser M. Effects <strong>of</strong> Spascupreel versus hyoscine<br />

butylbromide for gastrointestinal cramps<br />

in children. Pediatr Int. 2007;49(3):328-334.<br />

13. Cappell H, Busto U, Kay G, Naranjo CA,<br />

Sellers EM, Sanchez-Craig M. Drug deprivation<br />

and reinforcement by diazepam in a<br />

dependent population. Psychopharmacology<br />

(Berl). 1987;91(2):154-160.<br />

Enteric nervous system<br />

Figure 1: Stress alters the function<br />

<strong>of</strong> the gastrointestinal tract via the<br />

Intestines<br />

brain-gut axis.<br />

Smooth muscle<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1<br />

) 19


) M a r k e t i n g Yo u r P r a c t i c e<br />

Communication in Your Practice<br />

By Marc Deschler<br />

Marketing specialist<br />

) 20<br />

An American study shows that faulty communication is<br />

management’s biggest problem. As a physician, you probably<br />

spend 90 percent <strong>of</strong> your working time communicating,<br />

both consciously and unconsciously. In the long term,<br />

miscommunication that leads to actual misunderstandings<br />

can put your practice at risk.<br />

Review the requirements <strong>of</strong><br />

good communication and make<br />

improvements as needed:<br />

1. Good communicators are made,<br />

not born. Every day brings new<br />

opportunities to practice and refine<br />

this ability.<br />

2. We communicate even when<br />

we’re not saying anything. For<br />

example, if you keep your eyes<br />

fixed on the patient’s chart,<br />

you’re giving him the (mistaken)<br />

impression you are not really interested<br />

in his problem – his most<br />

important problem, otherwise he<br />

wouldn’t be there! Pay careful<br />

attention not only to what you<br />

say, but also to what you do.<br />

3. Most <strong>of</strong> the information that gets<br />

stored in the brain is received<br />

through visual channels, and you<br />

can take advantage <strong>of</strong> this fact by<br />

using written information to<br />

supplement your words. Informational<br />

materials give patients<br />

a second chance – if they didn’t<br />

understand something completely,<br />

they can read about it later.<br />

An additional tip: To reinforce<br />

your competence in your patients’<br />

minds, print all informational<br />

materials on your own letterhead.<br />

4. Assume that anything you’re trying<br />

to say can always be misunderstood.<br />

This will lead to better<br />

communication on your part,<br />

since you will choose your words<br />

differently and observe reactions<br />

more closely.<br />

5. Not everything you say has to be<br />

print-ready and error-free. It’s<br />

more important that your patients<br />

understand what you’re<br />

saying. Avoid pretentious technical<br />

jargon.<br />

6. Defining an illness is no help to<br />

the patient. She wants to know<br />

what it means for her, and she<br />

needs to be able to interpret your<br />

message correctly.<br />

7. It’s not what you say, but how<br />

you say it. Pay attention to how<br />

you say something and to how<br />

you reinforce it with body language<br />

because nonverbal communication<br />

is by far the most<br />

important contributing factor.<br />

8. On the phone, nonverbal communication<br />

is eliminated, so you<br />

and your team should make a<br />

special effort to use visual imagery<br />

when you speak.<br />

Repeatedly monitor the communication<br />

behavior <strong>of</strong> your staff and <strong>of</strong>fer<br />

training and suggestions for improvements<br />

as needed.<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


A clear structure, whether in<br />

communication, documentation, or<br />

filing, will save you time and money.<br />

The answering machine<br />

No one likes talking to a machine.<br />

Not surprisingly, according to one<br />

study, almost 60 percent <strong>of</strong> callers<br />

hang up when they get a machine,<br />

and <strong>of</strong> those who do leave a message,<br />

only 16 percent are identifiable.<br />

Clearly, though, your answering<br />

machine is one <strong>of</strong> the most<br />

important advertisements for your<br />

practice. What do you need to keep<br />

in mind when recording your message?<br />

1. Include your name in your greeting.<br />

For example, “Hello, this is<br />

John Sample at XYZ practice.”<br />

2. Meet the caller halfway: “Thank<br />

you for calling. Even though we<br />

can’t answer the phone right<br />

now, we’re still here for you.”<br />

3. Suggest an action: “Please don’t<br />

hang up, but …”<br />

4. In closing, thank them again for<br />

calling.<br />

Your phone message should be wellprepared,<br />

not just an afterthought.<br />

Write out an appropriate text and<br />

read it in a clear and friendly voice,<br />

quietly and not too slowly. Your message<br />

should flow, so concentrate on<br />

what you’re saying but don’t rush it.<br />

Check your machine now and then<br />

by calling yourself. Your voice will<br />

sound different over the phone than<br />

it does when you’re recording. The<br />

tapes in analog machines eventually<br />

wear out; replace them periodically.<br />

To make sure you get the information<br />

you need from your callers, try<br />

handing out cards to your patients<br />

with the most important “W” questions<br />

you need in order to return<br />

their calls:<br />

• Who is calling? (name)<br />

• What are you calling about?<br />

• Where can you be reached?<br />

(phone number? E-mail address?)<br />

• When is a good time to reach<br />

you?<br />

Even if you choose not to <strong>of</strong>fer patients<br />

the option <strong>of</strong> leaving a message,<br />

your recorded statement should<br />

be appropriate and convincing and<br />

leave them with a pr<strong>of</strong>essional impression<br />

<strong>of</strong> your practice.<br />

Optimizing record-keeping<br />

It’s always worth looking for opportunities<br />

to improve the organization<br />

<strong>of</strong> your practice, including patient<br />

chart management, which can be a<br />

half-time job in itself if poorly designed.<br />

To avoid unnecessary expense<br />

to your practice, follow these<br />

rules for chart management:<br />

1. The fewer files you have, the<br />

faster you can find any individual<br />

chart. Make sure to keep all <strong>of</strong><br />

each patient’s information together<br />

in one place!<br />

2. Sort through the files regularly.<br />

Inactive folders simply slow<br />

down your search.<br />

3. Alphabetization is almost always<br />

the best filing system. Using as<br />

many index cards/tabs as possible<br />

makes it easier to find what<br />

you need quickly.<br />

4. Re-file charts as soon as possible<br />

after adding to them. Don’t leave<br />

them lying around for someone<br />

to deal with later.<br />

5. Formats and labeling should be<br />

kept consistent so you know<br />

where to look for what you need<br />

without searching.<br />

6. More than three identifying characters<br />

(first and second letter <strong>of</strong><br />

last name, first letter <strong>of</strong> first<br />

name) get unwieldy. Color coding<br />

(for example, for year <strong>of</strong><br />

treat ment) can speed up access.<br />

7. File tabs or insert cards should<br />

be used to indicate status.<br />

8. Documentation should be completed<br />

immediately after a service<br />

is rendered. Here, too, a<br />

well-conceived and consistent<br />

structure is important.<br />

9. For preparing patient charts,<br />

you’ll need a date stamp, a stamp<br />

for diagnostic reports, etc. Charts<br />

prepared for house calls must<br />

also include a blank prescription<br />

form.<br />

10. A quick glance before re-filing<br />

the chart should be enough to<br />

ensure that all necessary entries<br />

have been made.<br />

If you have the equipment and technical<br />

know-how, by all means get rid<br />

<strong>of</strong> paper charts a.s.a.p. You will eliminate<br />

a lot <strong>of</strong> administrative work,<br />

and that expensive EDP system will<br />

finally pay for itself ! In many cases,<br />

the improved work flow even makes<br />

additional investment in new EDP<br />

work stations worthwhile.|<br />

) 21<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Specialized Applications<br />

The Acupuncture Approach to the<br />

Hypothalamus-Pituitary-Adrenal Axis<br />

and Its Interaction With the<br />

Sympathetic and Parasympathetic Systems<br />

By Butch Levy, MD, LAc<br />

) 22<br />

In contemplating this article, I was struck by the opportunity<br />

to connect and integrate an approach to a Western<br />

anatomical/physiological concept while reflecting on the<br />

use <strong>of</strong> Chinese medicine and homotoxicology. The sympathetic/parasympathetic<br />

system, or autonomic nervous<br />

system (ANS), can be translated into paradigms <strong>of</strong> activity<br />

and interaction using the Oriental construct <strong>of</strong> acupuncture<br />

tsubos, or holes, and using homeopathic combinations as<br />

therapeutic interventions. This combined usage is called<br />

homeosiniatry*.<br />

In the US perception <strong>of</strong> acupuncture,<br />

points reflect an anatomical<br />

location where a needle is inserted.<br />

Changing the rotation <strong>of</strong> the needle<br />

infers a method <strong>of</strong> enhancing or diminishing<br />

its effect (i.e., clockwise is<br />

tonification and counterclockwise is<br />

sedation).<br />

The Japanese approach to needling<br />

technique views acupuncture locations<br />

as specific holes. The needle is<br />

inserted along a vector, with a direction<br />

and depth. This requires palpatory<br />

acumen that translates into a<br />

precise connection into the path <strong>of</strong><br />

flow desired.<br />

The extracellular matrix (ECM) is<br />

the common conduit for therapy, be<br />

it physiological stimulation <strong>of</strong> the<br />

nervous system, the Yin and Yang<br />

energies <strong>of</strong> Asian medicine, or the<br />

electrical signature <strong>of</strong> natural molecules,<br />

as is seen in homeopathy. 1<br />

Within the ECM lie the biological<br />

features that allow nerve impulses to<br />

signal and transmit information for<br />

homeostasis. Layered on that, the<br />

similar concepts <strong>of</strong> Yin and Yang<br />

theory are reflected within the same<br />

ECM, with cylindrical spirals <strong>of</strong><br />

acupuncture holes acting as a transit<br />

system, via the meridian system, for<br />

similar information transmission<br />

concerning the body’s balance. 2<br />

Within the Oriental system, the<br />

ECM represents an equivalent concept,<br />

expressed as the Triple Heater.<br />

It is said to convey the Qi that is essential<br />

in energy transformation and<br />

metabolism. It is considered to be<br />

the fluid interface surrounding cells;<br />

in modern interpretation, it is considered<br />

to be the extracellular environment<br />

<strong>of</strong> the cell.<br />

The importance <strong>of</strong> these statements<br />

is to act as the starting point to treating<br />

patients with problems <strong>of</strong> the<br />

sympathetic/parasympathetic system,<br />

by being able to act in creative<br />

ways based on the practitioner’s assessment<br />

<strong>of</strong> the patient. It is <strong>of</strong>ten<br />

the situation that a single paradigm<br />

<strong>of</strong> therapy is inadequate to treat the<br />

complexity <strong>of</strong> issues generated within<br />

the body. This certainly is true<br />

regarding the sympathetic/parasympathetic<br />

system influences within<br />

us. To integrate these unique therapies<br />

requires a brief review <strong>of</strong> the<br />

connections that make them compatible<br />

for the treatment <strong>of</strong> sympathetic/parasympathetic,<br />

or ANS,<br />

imbalance.<br />

Autonomic nervous system<br />

The aspect <strong>of</strong> the nervous system<br />

that is involved in our discussion is<br />

the ANS. Originating in the hypothalamus,<br />

fiber tracts from the various<br />

nuclei (e.g., medial, lateral, anterior)<br />

travel from the hypothalamus<br />

into the intermediate brain and<br />

through the lower brain, making<br />

connections with multiple other nuclei<br />

there before descending into the<br />

spinal cord. These other nuclei also<br />

contribute essential information for<br />

ANS regulation. These pathways are<br />

called the hypothalamospinal tract<br />

* “Homeo” from homeopathy, “sin” from sinology = study <strong>of</strong> Chinese culture, and “-iatry” from Greek iatros = healer (figuratively: medicine)<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Specialized Applications<br />

Acupuncture needles are inserted<br />

into specific points on the body in<br />

order to relieve pain and/or restore<br />

health and well-being.<br />

(HST) and carry information that<br />

activates, stimulates, inhibits, or balances<br />

sympathetic and parasympathetic<br />

signals. The sympathetic system<br />

dominates during activity in the<br />

body and is energy consuming. The<br />

parasympathetic system dominates<br />

when the organism is in resting<br />

phases, including digestion and<br />

sleep cycles.<br />

The sympathetic nervous system is<br />

under the direct control <strong>of</strong> corticotrophin-releasing<br />

hormone (CRH)<br />

in the hypothalamus. Its stimulation<br />

creates an excitatory response in the<br />

sympathetic system while turning<br />

<strong>of</strong>f parasympathetic responses, in<br />

preparation for the fight, fright, or<br />

flight response. Some <strong>of</strong> the direct<br />

effects seen via increased norepinephrine<br />

(adrenaline) are stimulation<br />

<strong>of</strong> cardiac muscle, an increase in<br />

heart rate and breathing, an increase<br />

in blood glucose, sweating, and vasoconstriction.<br />

At the same time,<br />

blood volume is expanded via the<br />

CRH activation <strong>of</strong> the renin-angiotensin-aldosterone<br />

system. When<br />

situations <strong>of</strong> perceived threat occur,<br />

anticipatory readiness is also reflected<br />

in increased muscle activity and<br />

visual acoustic startle, reduced appetite,<br />

and an inherent protective anxiety<br />

to “get out <strong>of</strong> town” or leave the<br />

scene quickly. To assist these preparations,<br />

the visceral tissues become<br />

quiescent, until the danger has<br />

passed.<br />

The spinal parasympathetic system<br />

is composed <strong>of</strong> the cranial division<br />

(cranial nerves III, VII, IX, and X)<br />

and the sacral division (S2-S4).<br />

These cranial nerves interconnect<br />

with the HST fibers via their nuclei,<br />

located in the midbrain, pons, and<br />

brainstem. The principal HST parasympathetic<br />

functions include pupillary<br />

and lens adjustments, salivation,<br />

heart rate, movement and<br />

secretions in the gastrointestinal<br />

tract, urination, defecation, and erection.<br />

Specifically, cranial nerve IX<br />

influences the carotid body and sinus<br />

and the pharyngeal mucosa.<br />

Cranial nerve X is related to the larynx<br />

and trachea and the thoracoabdominal<br />

viscera to the level <strong>of</strong> the<br />

splenic flexure. The sacral plexus involves<br />

the colon distal to the splenic<br />

flexure, the rectum, and the bladder.<br />

The HST <strong>of</strong> the sympathetic system<br />

extends from T1 to L2/3. The fibers<br />

exit the spinal cord as preganglionic<br />

fibers that release acetylcholine,<br />

which innervates their nearby<br />

preaortic and paravertebral postganglionic<br />

receptors, which then release<br />

norepinephrine. These chemical<br />

transmitters then affect the pupils,<br />

sweat glands, blood vessels, lungs,<br />

abdominal viscera, and gastrointestinal<br />

tract. The ANS helps coordinate<br />

and regulate stimuli coming<br />

from the external and internal environment.<br />

Asian medicine<br />

The seemingly opposite parts <strong>of</strong> the<br />

ANS imply energies <strong>of</strong> mutual dependence<br />

when considered within<br />

the paradigm <strong>of</strong> Asian medicine. It<br />

is the Yin and Yang that are considered<br />

as the framework <strong>of</strong> movement<br />

and stillness, night and day, light<br />

and dark, with each aspect requiring<br />

a comparison to its counterpart to<br />

make sense. Although the final step<br />

for our consideration <strong>of</strong> homeosiniatry<br />

is specific injection <strong>of</strong> tsubos, or<br />

holes, there are essential constructs<br />

in Asian practice that themselves can<br />

act to create an enhancement <strong>of</strong> energy<br />

or the opposite effect <strong>of</strong> reducing<br />

or dampening energetic effects.<br />

The movement <strong>of</strong> energy, or Qi, is<br />

considered to travel unidirectional<br />

under normal circumstances, along<br />

each specific meridian pathway.<br />

Needling a tsubo along this direction<br />

<strong>of</strong> flow is considered tonifying<br />

or sympathetically stimulating. Needling<br />

techniques that are in the direction<br />

opposite or counter to established<br />

meridian flow will slow or<br />

reduce the energy flow, are considered<br />

sedating or quieting to the system,<br />

and would be considered parasympathetic.<br />

In protocols using electrical stimulation,<br />

a sympathetic or parasympathetic<br />

effect can be created via the<br />

circuits used. Electrical charge travels<br />

from negative (silver needle or<br />

black grip) to positive (gold needle<br />

or red grip), and electrical flows can<br />

be used to augment or diminish energy<br />

solely by adjusting the direction<br />

<strong>of</strong> flow <strong>of</strong> the electricity. Practitioners<br />

can also influence the<br />

activation <strong>of</strong> sympathetic activity by<br />

) 23<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Specialized Applications<br />

Figure 1: Back Shu points used in<br />

treating disorders <strong>of</strong> the hypothalamus-pituitary-adrenal–sympathetic/<br />

parasympathetic system.<br />

low-frequency electrical stimulation<br />

in the range <strong>of</strong> 2 to 10 Hz. These<br />

frequencies are used, for example, in<br />

facial nerve palsies and for historic<br />

treatments that were designed to upregulate,<br />

so to speak, weak energy<br />

systems within the body. To create a<br />

parasympathetic flow, high-frequency<br />

electrical stimulation can be used,<br />

ranging from 100 to 200 Hz for local<br />

my<strong>of</strong>ascial injury to 1500 Hz for<br />

sedation <strong>of</strong> the central nervous system,<br />

thereby affecting higher brain<br />

centers for pain regulation (and a<br />

down-regulation <strong>of</strong> pain).<br />

BL 13 Lung<br />

BL 14 Pericardium<br />

BL 15 Heart<br />

BL 16 Governing vessel<br />

BL 17 Conception vessel<br />

BL 18 Liver<br />

BL 19 Gall bladder<br />

BL 20 Spleen<br />

) 24<br />

Injection sites<br />

The classic choices for acupuncture<br />

holes that may be integrated to synergistically<br />

relate to homeosiniatry<br />

might include the 8 extra vessels,<br />

back Shu points (Figure 1), and<br />

source and auricular points. The extra<br />

vessel meridians <strong>of</strong> Yin/Yang<br />

Wei (Pericardium 6 and Triple Heater<br />

5) connect and distribute all the<br />

Yin and Yang, respectively. The Yin/<br />

Yang Qiao vessels (Kidney 6 and<br />

Urinary Bladder 62) balance all the<br />

Yin and Yang for muscle coordination<br />

in the body. Also, the Du Mai<br />

channel, the source <strong>of</strong> all Yang Qi,<br />

or sympathetic energy, can be augmented<br />

by needling from the lower<br />

spine up and can be quieted or sedated<br />

by needling from the scalp<br />

down. For the sympathetic concept,<br />

this would mean increasing the<br />

movement in the Yang organs; for<br />

the parasympathetic concept, the Qi<br />

energy would be augmented in the<br />

Yin organs.<br />

The use <strong>of</strong> auricular points adds an<br />

essential synergism for balance<br />

within the brain and ANS. Using a<br />

point locator allows exact locations<br />

for treatment. Traditional interpretations<br />

used to imply that when one<br />

BL 21 Stomach<br />

BL 22 Triple heater<br />

BL 23 Kidney<br />

BL 25 Large intestine<br />

BL 27 Small intestine<br />

aspect <strong>of</strong> the ANS was on, the other<br />

was <strong>of</strong>f, and vice versa. Our society<br />

today creates levels <strong>of</strong> continuing<br />

stressors, and <strong>of</strong>ten the continued<br />

pressure on both aspects <strong>of</strong> the ANS<br />

results in imbalances that do not fit<br />

conventional rules. Using such a<br />

testing device, areas such as the pi-<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Specialized Applications<br />

In homeosiniatry, bioregulatory<br />

medications are injected into<br />

acupuncture points.<br />

tuitary, hypothalamus, preganglionic<br />

and postganglionic nerves, vagus,<br />

parasympathetic nerves, and amygdala<br />

can be accessed and therapeutically<br />

used.<br />

The back Shu points represent a<br />

level <strong>of</strong> interaction that would be<br />

used to affect the individual organs<br />

that are influenced by the hypothalamus-pituitary-adrenal–sympathetic/parasympathetic<br />

system. The first<br />

line relates to organ dysfunction,<br />

whereas the second line has great<br />

benefits in emotional issues that affect<br />

its adjacent organ.<br />

Practical application<br />

Some practical examples <strong>of</strong> homeosiniatry<br />

that have application in the<br />

clinic would include the following.<br />

Starting at the hypothalamus, it<br />

would be ideal to directly affect its<br />

function! Tonsilla compositum contains<br />

hypothalamus and can act toward<br />

directly targeting at the hypothalamic<br />

level. Its effect would,<br />

therefore, generalize to the entire<br />

system. Points <strong>of</strong> injection should<br />

be ones that have general regulatory<br />

ability, such as Stomach 36 or Spleen<br />

6. More <strong>of</strong>ten, therapy must be designed<br />

to indirectly affect the system,<br />

at the feedback loop to the hypothalamus<br />

or at the organ itself.<br />

Because hypothalamic CRH controls<br />

the production <strong>of</strong> cortisol, the<br />

negative feedback loop to CRH<br />

is activated when the hypothalamus<br />

senses increased cortisol. Therefore,<br />

using medications that contain<br />

cortisol will reduce the production<br />

<strong>of</strong> CRH and slow or regulate the<br />

fight or flight response (i.e., sympathetic<br />

outflow). Tonsilla compositum<br />

(for overall immune stimulation),<br />

Thyreoidea compositum (for<br />

connective tissue metabolism), and<br />

Pulsatilla compositum (for support<br />

during chronic inflammation) all<br />

contain cortisone in dilution and<br />

can be used to reduce the output <strong>of</strong><br />

CRH and with it sympathetic activity.<br />

Major organs that are activated by<br />

sympathetic stimulation are the<br />

heart, lungs, and the associated circulatory<br />

system. To affect these organs,<br />

especially in chronic conditions,<br />

the back Shu points can be<br />

injected. Because fight or flight is an<br />

excess condition, the points chosen<br />

on the Urinary Bladder line (Urinary<br />

Bladder 14, Pericardium; and Urinary<br />

Bladder 15, Heart) are tight<br />

and tense, indicating overactivity.<br />

Chronic myocardial weakness or<br />

coronary circulatory problems can<br />

be treated with Cactus compositum.<br />

Cor compositum can be used for<br />

palpitations, and Cralonin can be<br />

used for chest pains. The lung area,<br />

Urinary Bladder 13, can receive<br />

treatment for bronchospasm, using<br />

Mucosa compositum for wheezing<br />

and cough, Traumeel for inflammation,<br />

or Engystol for immune stimulation.<br />

In contrast, when sympathetic activation<br />

is quieted down, ideally the<br />

parasympathetic system is activated.<br />

Their innervations primarily involve<br />

smooth muscle contraction and<br />

movement within many hollow organs.<br />

The Master Point <strong>of</strong> the Yin<br />

Qiao, Kidney 6, is considered regulatory<br />

<strong>of</strong> the Vagus, and Atropinum<br />

compositum is very useful for cramping<br />

and imbalanced peristalsis. Point<br />

choices might also include the<br />

source points or back Shu points for<br />

the large and small intestines, the<br />

spleen and stomach, and the urinary<br />

bladder and gallbladder. Spascupreel<br />

is effective for intestinal cramps and<br />

bladder spasm and irritability.<br />

In conclusion, any discussion regarding<br />

the hypothalamus-pituitary-adrenal–ANS<br />

really requires<br />

chapters to credibly explain each <strong>of</strong><br />

the topics mentioned in this brief<br />

discussion. What I have attempted<br />

to relate is that the complexity <strong>of</strong><br />

disease and our rapidly expanding<br />

technology have created a need to<br />

look beyond individual areas <strong>of</strong><br />

focus and embrace a new holism<br />

<strong>of</strong> care. It is necessary to integrate<br />

multiple disciplines, concepts, and<br />

images to achieve results that succeed.<br />

|<br />

References<br />

1. Oschman J. Energy Medicine. Dover, NH:<br />

Churchill Livingstone; 2008:141.<br />

2. Pischinger A. The Extracellular Matrix and<br />

Ground Regulation. Berkeley, CA: North Atlantic<br />

Books; 2007:106.<br />

) 25<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Making <strong>of</strong> …<br />

Manufacturing <strong>of</strong><br />

Traumeel Injection Solution<br />

Part I: From Work Preparation to Filling<br />

By Larissa Wörthwein-Mack<br />

) 26<br />

To minimize the risk <strong>of</strong> contamination with microorganisms,<br />

special requirements apply to the manufacture <strong>of</strong><br />

sterile medications. The standards are high, both for spatial<br />

and technical conditions and for employee qualifications.<br />

For example, manufacturing must take place in so-called<br />

cleanrooms <strong>of</strong> the appropriate classes, and spatial separation<br />

<strong>of</strong> the different production steps is required.<br />

Modern homeopathic combination<br />

products like Traumeel<br />

(which is used to treat inflammation<br />

and injuries) contain multiple ingredients.<br />

In Traumeel injection solution,<br />

there are 14 different active<br />

in gredients, primarily plant substances<br />

such as arnica, chamomile,<br />

and calendula. These raw materials<br />

are processed into mother tinctures<br />

and single potencies in accordance<br />

with current regulations <strong>of</strong> the German<br />

Homeopathic Pharmacopeia<br />

(HAB) and the European Pharmacopeia<br />

(Ph. Eur.).<br />

Production <strong>of</strong> a sterile<br />

dosage form<br />

All manufacturing steps involving<br />

open containers must take place in<br />

Class C cleanrooms, which can be<br />

accessed only through airlocks and<br />

in appropriate protective clothing.<br />

High performance filters reduce the<br />

particulate count in the air, and the<br />

rooms are under positive pressure<br />

with more than 20 air exchanges<br />

per hour. Pressure differentials <strong>of</strong><br />

10-15 Pa between cleanrooms <strong>of</strong><br />

different classes ensure that when<br />

the door <strong>of</strong> a cleaner room is opened,<br />

the air streams out and contaminated<br />

air cannot flow in. The air is tested<br />

at regular intervals for particulate<br />

counts and microbiological loads.<br />

All exposed surfaces in the cleanrooms<br />

must be smooth and easy to<br />

clean. The special requirements that<br />

apply to employees engaged in manufacturing<br />

sterile products include<br />

regular training in sterile manufacturing,<br />

hygiene, and microbiology.<br />

Of course high standards <strong>of</strong> personal<br />

hygiene are also a must, and inside<br />

the cleanroom, employees are<br />

not allowed to wear jewelry or<br />

make-up! Regular medical checkups<br />

are also required.<br />

The steps in the production <strong>of</strong> sterile<br />

ampoules are: work preparation,<br />

bulk production, filtration, filling,<br />

ste ri lization, inspection, labeling,<br />

and packaging. Each individual production<br />

step takes place in accordance<br />

with clearly defined procedures<br />

and current GMP (Good<br />

Manufacturing Practice) guidelines.<br />

Written production instructions for<br />

each product detail all <strong>of</strong> the individual<br />

steps in its production. The<br />

production instructions are based on<br />

the company’s manufacturing specifications,<br />

the CTD-HD (Common<br />

Technical Document – Manufacturing<br />

Documentation), which is submitted<br />

to the regulatory agency.<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Making <strong>of</strong> …<br />

Producing potency mixtures from<br />

individual potencies according to<br />

manufacturing specifications<br />

Specially trained employees conduct<br />

in-process controls (IPC) at regular<br />

intervals during production. These<br />

controls serve to monitor and direct<br />

the production process, ensuring<br />

high quality and compliance with<br />

all requirements at every stage <strong>of</strong><br />

processing.<br />

The production process<br />

The first step takes place in the Work<br />

Preparation department, where<br />

batch-specific production instructions<br />

are drawn up. In these documents,<br />

employees will record every<br />

detail <strong>of</strong> the processes involved in<br />

producing the batch.<br />

In the Bulk Production department,<br />

the 14 active ingredients (mother<br />

tinctures, single potencies, and triturations)<br />

are manufactured in accordance<br />

with the production guide.<br />

Ethanol-water mixtures in varying<br />

concentrations are used as the potentizing<br />

medium.<br />

The next step is production <strong>of</strong> the<br />

so-called bulk solutions. The individual<br />

potencies and triturations are<br />

combined into potency mixtures,<br />

which are then further potentized<br />

with water for injection. The resulting<br />

intermediate products are then<br />

mixed in large stainless steel tanks,<br />

and a specific amount <strong>of</strong> sodium<br />

chloride is added to produce an isotonic<br />

solution.<br />

IPC workers take samples <strong>of</strong> the finished<br />

bulk solution and test for a<br />

variety <strong>of</strong> parameters including pH,<br />

isotonicity, and appearance. The<br />

bulk solution is released for further<br />

processing only if all values fall<br />

within the required ranges. This step<br />

Manual potentization <strong>of</strong><br />

a potency mixture<br />

Stainless steel batching tank for<br />

producing the solution<br />

Filtering the bulk solution through<br />

a sterile membrane<br />

) 27<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Making <strong>of</strong> …<br />

Interim storage <strong>of</strong> the bulk solution<br />

in sterile disposable containers<br />

is followed by bulk filtration, which<br />

removes suspended matter and reduces<br />

germs. The filter is a sterile<br />

membrane filter with a pore size <strong>of</strong><br />

0.22 µm. The filtered solution is<br />

filled into sterile, flexible, disposable<br />

containers.<br />

The used filter is then tested for integrity,<br />

and if it passes the test, the<br />

filtered batch <strong>of</strong> bulk solution is<br />

transported to the filling equipment<br />

in disposable containers with capacities<br />

ranging from 10 to 50 liters.<br />

The containers are connected to the<br />

filling equipment, and the required<br />

quantities <strong>of</strong> glass ampoules are prepared.<br />

Before the actual filling takes<br />

place, a test run <strong>of</strong> a certain number<br />

<strong>of</strong> ampoules is filled to check for accuracy<br />

<strong>of</strong> the fill quantity.<br />

If the fill quantities match the target<br />

value, the machine is cleared for filling.<br />

Precisely measured fill quantities<br />

are then pumped into the sterile<br />

glass ampoules through six filling<br />

nozzles. Finally, a blowpipe is used<br />

to seal the open ampoules by melting<br />

their necks to create a closure.<br />

Each machine can fill up to 18,000<br />

ampoules per hour.<br />

In the next issue, you will learn<br />

about the further steps required to<br />

produce a finished, customer-ready<br />

product.|<br />

) 28<br />

Filling and heat sealing the sterile glass<br />

ampoules<br />

Photos by Sonja Bell<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Meet the Expert<br />

Dr. Arturo O’Byrne<br />

By Catherine E. Creeger<br />

Arturo O’Byrne was born in<br />

1951 in Cali, Colombia, into a<br />

long line <strong>of</strong> medical doctors. He received<br />

his first practical instruction<br />

in surgery from his father in their<br />

family-owned clinic.<br />

Young Arturo was very interested in<br />

photography and designing educational<br />

materials, and in college he<br />

collaborated with many <strong>of</strong> his pr<strong>of</strong>essors<br />

on audiovisual presentations<br />

for classes. This skill in developing<br />

innovative educational tools would<br />

later become one <strong>of</strong> the foundations<br />

<strong>of</strong> his pr<strong>of</strong>essional activities. He<br />

graduated from the Universidad del<br />

Cauca in Popayán, Colombia in<br />

1976 with a diploma in surgery.<br />

During his student years, the climate<br />

in Popayán aggravated the asthma<br />

he had suffered from since childhood.<br />

His search for better health<br />

led him to the Colombian physician<br />

Dr. Germán Duque, who pioneered<br />

biological medicine in South America.<br />

Duque’s treatments produced a<br />

lasting cure within a few months.<br />

This introduction to alternative<br />

therapeutic methods, including homeopathy<br />

and homotoxicology,<br />

marked a radical and irrevocable<br />

turning point in Dr. O’Byrne’s life.<br />

On Duque’s advice, Dr. O’Byrne<br />

travelled to Europe to learn about<br />

integrative biological medicine firsthand.<br />

(Later, as medical director <strong>of</strong><br />

Santa Margarita Hospital in La<br />

Cumbre, he would become the first<br />

to obtain authorization for a pilot<br />

program in biological medicine in a<br />

National Health Service hospital.)<br />

Back in Colombia, he studied sports<br />

medicine and nutrition in Cali,<br />

where he later also held pr<strong>of</strong>essorships<br />

in biology and physiology.<br />

From 1987 to 1989, as medical director<br />

<strong>of</strong> the pr<strong>of</strong>essional cycling<br />

team “Café de Colombia,” he based<br />

the athletes’ training and maintenance<br />

program on biological medicine.<br />

During this time, the team<br />

achieved international standing in<br />

particular in mountain racing, resulting<br />

in first places in the 1987<br />

Vuelta a España and the 1988 Dauphiné<br />

Libéré and a third place in the<br />

1988 Tour de France. His work with<br />

other sports teams had similar results<br />

and generated considerable interest<br />

in biological therapies in<br />

sports medicine in Colombia.<br />

In 1989, Dr. O’Byrne founded the<br />

teaching hospital “Centro de Medicina<br />

Biológica Dr. O’Byrne” in<br />

Cali and began giving courses and<br />

talks for doctors. Since then, his ongoing<br />

efforts in disseminating homotoxicology<br />

and biological medicine<br />

have led him to travel widely,<br />

especially in Latin America. Over<br />

the course <strong>of</strong> seventeen years, he has<br />

logged more than four million flight<br />

miles and given more than 650 seminars!<br />

Throughout this time, he has remained<br />

dedicated to producing<br />

state-<strong>of</strong>-the-art educational material.<br />

In 2007, with his son Daniel, he<br />

founded BioMD-SA, an academic<br />

services center focusing on pr<strong>of</strong>essional<br />

production <strong>of</strong> high-definition<br />

3D animation, medical illustration,<br />

etc. His home workstation has three<br />

LCD screens (internet, PowerPoint,<br />

and Photoshop) in use simultaneously.<br />

For entertainment on his long<br />

trips, he downloads music <strong>of</strong> all<br />

genres to his I-pod. (The airlines<br />

serve vanilla ice cream with Baileys<br />

Irish Cream, which also helps to<br />

pass the time!) Dr. O’Byrne enjoys<br />

playing guitar at family gatherings<br />

and is a natural at salsa dancing, but<br />

he is always eager to get back to his<br />

medical projects as soon as the festivities<br />

are over. This is the mark <strong>of</strong><br />

a true scientist!|<br />

) 29<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Research Highlights<br />

Nervoheel N vs. Lorazepam for<br />

Mild Nervous Disorders<br />

By Mary A. Kingzette<br />

) 30<br />

Introduction<br />

Complementary and alternative<br />

medicine (CAM) is being used more<br />

<strong>of</strong>ten, both in Europe and in the<br />

United States. One <strong>of</strong> the main reasons<br />

for the increase in CAM is the<br />

adverse effects seen with conventional<br />

medications, leading to the<br />

withdrawal <strong>of</strong> some <strong>of</strong> these drugs<br />

from the market. It is believed that<br />

CAM medications are better tolerated<br />

than conventional medications.<br />

One <strong>of</strong> the frequent uses <strong>of</strong> CAM is<br />

for treatment <strong>of</strong> functional nervous<br />

disorders, including insomnia, distress,<br />

anxiety, restlessness, and burnout.<br />

In this study, Nervoheel N, a<br />

CAM medication, was compared<br />

with lorazepam, a conventional benzodiazepine,<br />

for the treatment <strong>of</strong><br />

functional nervous disorders. Specifically,<br />

the effectiveness and tolerability<br />

<strong>of</strong> the 2 medications were<br />

compared. The purpose <strong>of</strong> the study<br />

was to show the noninferiority <strong>of</strong><br />

Nervoheel N vs. lorazepam.<br />

Nervoheel N is a preparation based<br />

on the principles <strong>of</strong> homotoxicology.<br />

Lorazepam has a relatively short<br />

half-life and is favored over longacting<br />

benzodiazepines for the<br />

short-term relief <strong>of</strong> anxiety. Benzodiazepines<br />

are contraindicated for<br />

long-term use because <strong>of</strong> their addictiveness<br />

and adverse effects.<br />

The present study was a preliminary<br />

open-label prospective nonrandomized<br />

cohort investigation. To our<br />

knowledge, it is the first study to<br />

evaluate the effectiveness <strong>of</strong> Nervoheel<br />

N in a clinical setting.<br />

Methods<br />

This study was performed in 39<br />

centers in Belgium and the Netherlands;<br />

these centers <strong>of</strong>fer both conventional<br />

and CAM therapy. Patients<br />

enrolled were18 years or older and<br />

suffered from headache, heart palpitations,<br />

backache, indigestion, lack<br />

<strong>of</strong> appetite, mild sexual dysfunction,<br />

fatigue, listlessness, sleep disturbances,<br />

restlessness, or lack <strong>of</strong> concentration.<br />

Patients excluded were<br />

those who were unable or did not<br />

want to participate in the study and<br />

those taking both Nervoheel N and<br />

lorazepam.<br />

The study duration was a maximum<br />

<strong>of</strong> 4 weeks. Patients were examined<br />

at the start <strong>of</strong> treatment, after 2<br />

weeks <strong>of</strong> treatment, and after 4<br />

weeks <strong>of</strong> treatment.<br />

Physicians decided the treatment<br />

used for each patient (after discussion<br />

with the patient), and any other<br />

medications taken were not changed<br />

during the study. The dose <strong>of</strong> Nervoheel<br />

N given was 1 tablet 3 times<br />

a day; the dose <strong>of</strong> lorazepam given<br />

was 2 to 3 mg daily for sedation and<br />

anxiety and 2 to 4 mg nightly for<br />

insomnia. Variations in the dose<br />

were allowed if determined to be in<br />

the patient’s best interest.<br />

The effects <strong>of</strong> treatment were determined<br />

in conversation between the<br />

practitioner and the patient. The severity<br />

<strong>of</strong> symptoms was evaluated<br />

on a 4-point scale (0 indicates<br />

asymptomatic; 1, mild; 2, moderate;<br />

and 3, severe). The overall effect <strong>of</strong><br />

the therapies was evaluated on a<br />

5-point scale (excellent, good, satisfactory,<br />

no improvement, and worsening<br />

<strong>of</strong> symptoms). Tolerability<br />

was determined by patient-reported<br />

adverse events evaluated by the physician.<br />

Overall tolerability <strong>of</strong> the<br />

treatments was evaluated as excellent,<br />

good, moderate, or poor.<br />

Results<br />

A total <strong>of</strong> 248 patients were included<br />

in this study (136 in the Nervoheel<br />

N group and 112 in the lorazepam<br />

group). After 2 weeks <strong>of</strong><br />

treatment, 128 patients in the Nervoheel<br />

N group and 106 patients in<br />

the lorazepam group were examined.<br />

At the final 4-week examination,<br />

the numbers <strong>of</strong> patients included<br />

were 134 and 111, respectively.<br />

There were several differences between<br />

the 2 groups at enrollment:<br />

Patients in the lorazepam group<br />

were older and were more likely to<br />

be men, to smoke, and to use alcohol<br />

or c<strong>of</strong>fee regularly than patients<br />

in the Nervoheel N group. However,<br />

none <strong>of</strong> these differences were statistically<br />

significant.<br />

There was also no significant difference<br />

in the number <strong>of</strong> nervous disorders<br />

between the 2 groups (predominately<br />

2-4 disorders). In both<br />

groups, the most common com-<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


) Research Highlights<br />

Sepia, one <strong>of</strong> the ingredients <strong>of</strong><br />

Nervoheel N, is prepared from the<br />

secretion <strong>of</strong> the inkgland <strong>of</strong> the<br />

cuttlefish (Sepia <strong>of</strong>ficinalis).<br />

plaints included emotional distress,<br />

jitteriness, and anxiety; and the most<br />

common reasons given for the complaints<br />

included work-related anxiety,<br />

stress, and family-related anxiety.<br />

Most patients in both groups<br />

(> 70%) had not received previous<br />

treatment for their condition.<br />

In both groups, there were significant<br />

differences from baseline: The<br />

sum <strong>of</strong> symptom scores improved by<br />

4.4 points in the Nervoheel N group<br />

and by 4.2 points in the lorazepam<br />

group. However, there was not a<br />

significant difference between the<br />

2 groups.<br />

For both groups, the greatest symptom<br />

improvement was seen at the<br />

2-week examination, with slight<br />

continued improvement until the<br />

4-week examination. Even though<br />

most patients chose to maintain<br />

treatment for longer than 4 weeks,<br />

less than 10% did so for longer than<br />

6 weeks. The average duration <strong>of</strong><br />

treatment was 31 days in the Nervoheel<br />

N group and 29 days in the<br />

lorazepam group.<br />

There was no significant difference<br />

between the 2 groups in overall<br />

therapeutic results (rated as excellent<br />

to good by 72.1% <strong>of</strong> the Nervoheel<br />

N group and 73.7% <strong>of</strong> the lorazepam<br />

group; P = 0.84).<br />

The tolerability <strong>of</strong> both treatments<br />

was very good, with only one patient<br />

in each group experiencing an<br />

adverse event (both considered unlikely<br />

to be treatment related).<br />

Notably, the overall patient-assessed<br />

tolerability was significantly better<br />

for the Nervoheel N group vs. the<br />

lorazepam group: Tolerability was<br />

rated as excellent in 81.9% vs. 45.5%<br />

<strong>of</strong> patients (P < 0.001).<br />

There was no significant difference<br />

between the 2 groups in compliance<br />

scores (P = 0.35), with compliance<br />

ratings <strong>of</strong> excellent or good for approximately<br />

90% <strong>of</strong> both groups.<br />

Discussion<br />

This study showed that Nervoheel<br />

N, a homotoxicological medication,<br />

can effectively treat mild nervous<br />

disorders, including aches, palpitations,<br />

indigestion, lack <strong>of</strong> appetite,<br />

mild sexual dysfunction, fatigue,<br />

listlessness, sleep disturbances, restlessness,<br />

and lack <strong>of</strong> concentration.<br />

The study indicated that Nervoheel<br />

N was better tolerated than lorazepam,<br />

a traditional benzodiazepine<br />

medication used to treat these disorders.<br />

This being an open-label observational<br />

trial, there are limitations to<br />

such a study that are inherent in the<br />

design. First, the enrollment criteria<br />

for mild nervous disorders are somewhat<br />

subjective because there are no<br />

standardized rating scales for these<br />

disorders.<br />

Second, the evaluations were left<br />

mostly to the physician’s discretion,<br />

which could result in greater physician<br />

bias. However, the fact that the<br />

enrolling centers <strong>of</strong>fer both complementary<br />

and conventional medicine<br />

may reduce this factor in this case.<br />

Third, baseline differences between<br />

groups are inherent in the design <strong>of</strong><br />

observational studies, as was also<br />

found in the present study.<br />

There were also other differences<br />

between the 2 treatment groups<br />

(older patients and more male patients,<br />

with different lifestyle habits,<br />

in the lorazepam group), which were<br />

addressed with propensity score<br />

analysis but would not exclude all<br />

bias.<br />

However, the strength <strong>of</strong> observational<br />

studies is not so much to show<br />

efficacy, but to show effectiveness in<br />

a practice-based setting and to demonstrate<br />

tolerability, in which this<br />

study succeeded.<br />

In conclusion, this 4-week study<br />

showed that Nervoheel N (a homeopathic<br />

treatment) was not inferior<br />

to lorazepam (a conventional benzo<br />

diazepine treatment) for the<br />

short-term relief <strong>of</strong> mild nervous<br />

symptoms. In addition, significantly<br />

more patients rated the tolerability<br />

<strong>of</strong> Nervoheel N as excellent compared<br />

with the tolerability <strong>of</strong> lorazepam.<br />

|<br />

Reference<br />

van den Meerschaut L, Sünder A. The homeopathic<br />

preparation Nervoheel N can <strong>of</strong>fer an alternative<br />

to lorazepam therapy for mild nervous<br />

disorders. Evid Based Complement Alternat Med.<br />

Published October 25, 2007. doi:10.1093/<br />

ecam/nem144.<br />

) 31<br />

Journal <strong>of</strong> <strong>Biomedical</strong> <strong>Therapy</strong> 2009 ) Vol. 3, No. 1


IAH Abbreviated<br />

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1 Access the IAH website at www.iah-online.com.<br />

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) 32<br />

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