Polarity Analysis in Homeopathy Module 1 Basics and

Polarity Analysis in Homeopathy Module 1: Basics and Acute Disease HEINER FREI, M. D.

The Three Ways of homeopathic Remedy Determination 1. Focus on the symptoms of the actual disease (Hahnemann, Boenninghausen, Boger, Polarity Analysis) 2. Focus mainly on Mind Symptoms and Sensations (Kent, Sankaran, Scholten, Mangialovori) 3. Focus on the Subconscious of the Patient (Source method, Divia Chabra, Jayesh Shah)

Each way treats physical and mental symptoms as well. The time required for remedy determination increases exponentially between way 1 and 3. The method has to be adapted to the patients needs. Not every patient can be treated with every method.

This presentation introduces you to 30 years of clinical research aimed at improving remedy determination in general and paediatric practice. The result is polarity analysis.

What is Polarity Analysis? PA is a repertorisation method based on Boenninghausens Therapeutic Pocketbook 1846. It allows precise and reproduceable homeopathic remedy determinations. By calculating a healing probability for each remedy it increases the success of prescriptions.

The Key Elements Modalities and polar Symptoms Preexistent: Boenninhausen’s Contraindications New: The Polarity Difference

Case 1 10 -year old Denise suffers frequently of abdominal pain. At school reading is difficult, and she has an atopic dermatitis since infancy. The abdominal pain is located in the periumbilical region. It is violent, crampy, appears suddenly and lasts up to an hour. Digestion within normal range. No apparent history of food intolerance.

Examination Abdomen soft, no resistance, slight meteorism. 591 k. U/l Severe atopisc dermatitis, especially in the joint regions. Ig. E Dermato. pteronys. 2. 88 k. U/l The mother demands allergy tests (Norm < 0. 35) Dermato. farinae 2. 32 k. U/l (Norm < 70) (Norm < 0. 35) Baby food 0. 52 k. U/l (Norm < 0. 35)

Diagnoses Abdominal migraine Atopic dermatitis (housedust- and flourdust mites, baby food) Reading disability

Checklist Abdominal migraine Reading disability < After eating-P < Reading-P < Warm food and drinks-P < Strained vision-P > Uncovering-P Understanding difficult-P > Movement-P > In open air-P Atopic dermatitis < Weather warm-P Rash dry, itchy < Effort physical-P

Remedy and Progress With Pulsatilla 200 C the abdominal pain disappears for four weeks, then returns in reduced intensity and frequency. The atopic dermatitis is considerably better. Reading and concentration are somewhat improved. We continue with monthly doeses of Pulsatilla in rising potency (XM, LM, CM)

After 6 Months The abdominal pains are practically cured. Reading and concetration are considerably better. LAB-Control Ig. E 121 k. U/l Housedust mites 2. 21 k. U/l The atopic dermatitis has disappeared. The mothers rating of the global improvement is 80%. Due to the reading disability we continue the treatment. Improvement (80%) (23%) Flourdust mites 2. 31 k. U/l (0%) Baby food 0. 40 k. U/l (23%)

Basics of Polarity Analysis Org. § 133 Through the [modalities] “…what is peculiar and characteristic about each symptom becomes evident. ”

Boenninghausens Contribution Rank of Symptoms Main Symptom with characteristics Additional Symptoms Changes in state of mind Grading of Symptoms in Pocketbook (BTB 1846)

How to grade a Symptom?

The Genius of the Remedies The genius includes the modalities, sensations, and clinical findings that have repeatedly appeared in the provings at different localisations and have been healed by this remedy. Genius symptoms are in 3 rd to 5 th grade in BTB 1846. Bönninhausen strived to cover the patients characteristic symptoms with the genius of a remedy, avoiding contradictions

Contradictions may arise from Polar Symptoms Polar are symptoms with an opposite Touch aggravates / Touch ameliorates Desire for open air / Aversion against open air Thirstlessness / Thirst BTB 1846 contains 354 polar symptoms

What is a Contradiction? The patient can only have one pole of a polar symptom: He is either thirsty or thirstless. A remedy can cover both poles because its symptoms have been observed by several provers. The contradiction arises, when a polar patient symptom in in grade 1 -2 and the opposite pole has grade 3 to 5. That means, that the patient symptom does not correspond to the genius of a remedy.

Polar Symptoms in BTB 1846 1 st Grade 2 nd Grade 3 rd Grade 4 th GRADE 5 th GRADE Thirstlessness Thirst …Nit-ac, NUX-M, Nux-v, Olnd, Op, Petr, Phosac, Plat PULS Rheum, Rhod… …Nit-ac, Nux-v, Op, Petr, Phos-ac, Plat, Plb, Puls Ran-b, Ran-s, Rheum, Rhod…

Case 2 Since three days the mother of 8 -year-old Simon realises that his face looks asymmetrical. And on his occiput she notices several small subcutaneous nodes. Because the asymmetry worsens, she comes to our clinic. Upon examination I can confirm her findings. The indurations are lymph nodes. Otherwise he seems healthy.

Procedure 1. Homeopathic casetaking 2. Clarify the cause of the facial paresis

Checklist Paralysis, one-sided < Speaking - P < Drinking, while-P < During sleep - P < Touch - P < Light - P < Eyes closing - P Thirst - P Appetite absent - P

Remedy and Progress Simon is immediately given Belladonna 200 C. For three days nothing happens. On the morning of the fourth day he can close the right eye again, and on the fifth day the paresis of the angle of the mouth also disappears.

Diagnosis: Neuroborreliosis Is the treatment now finished?

Comment ORG § 3: “… if the physician knows the obstacles to cure and how to remove them, that the recovery is permanent, treats thoroughly and efficaciously…”

Polarity Analysis

Polarity Difference The polarity difference indicates the level of congruence between patient symptoms and homeopathic remedy.

Calculate Polarity Difference For each remedy the grades of all polar patient symptoms are added. Then the grades of the corresponding opposite symptoms are subtracted. The result is the polarity difference (PD). (Calculation done by Polarity-Analysis Software)

PD of Belladonna: 25 – 7 = 18

Criteria for Remedy Selection 1. Hight of Polarity Difference, 2. No Contraindications 3. Materia medica comparison

Repertorisation 1. We use only the actually present symptoms (ORG § 6). 2. Highest priority have polar symptoms. and modalities (ORG § 133). 3. We include non polar symptoms only if the result is not conclusive.

Acute Disease: Practical Procedure Case History Physical Examination Diagnosis Checklist Repertorisation Main Remedy C 200 Reserve Remedy C 200 (apply reserve only if improvement is less than 50% after 2 days)

Case 3 History The illness of 50 -year-old Mr. B. began six weeks ago with transitory pain in the right side of the neck, lasting a few days. Since then he suffers from palpitations, outbreaks of sweating and an intractable dry cough. Due to these complaints he dropped out of the Berne Marathon, which greatly upset him.

Physical Examination Mr B. is tall and thin. General condition reduced, dark rings round the eyes. Blood pressure 130/80, pulse 72/min. Neck and throat normal, early mesosytolic click on auscultation, lung examination negative, abdominal wall soft, flow murmur in right lower abdomen. Peripheral pulses normal.

Checklist Warmth: worse - P Desire for open air - P Heat with inclination to uncover - P Quick pulse - P Pressure external: worse - P Tenderness to pressure on neck, right - P P= polar symptoms

Materia medica Comparison for Iodium (GS) Gradual increase in size of neck, especially on right side. Marked increase of the thyroid gland. Acute pain in gland upon pressure or slightest movement of the head. Palpitation of the heart < from least exertion. Cough as from feather in throat.

Iodium – what is the message? TSH: 0. 01 (Normal range 0. 35 -4. 50) Diagnosis? Treatment: Iodium 200 C Referral to endocrinologist

Remedy and Progress After Iodium 200 C he has an immediate improvement of wellbeing. The cough disappears. General condition and physical fitness normalize. Ten days later the hyperthyroidism has disappeared. (TSH 1. 29, f. T 4 is now slightly lowered). Final Diagnosis: Thyroiditis de Quervain

Comment Seemingly common unexiting polar symptoms lead us to Iodium, and the remedy indicates that something is wrong with the thyroid gland. The case is an example of how polar symptoms go straigt to the core of the problem.

Case 4 Ms L. T. , 44 years old Ms T. felt the previous day suddenly a loud whistling in the left ear, followed by severe ear pain and acute hearing loss. The examination reveals normal eardrums and considerable loss of hearing on the left. Otherwise no pathological findings. Diagnosis: Acute hearing loss, left ear

Audiogram L. T. , 24. 11. 08 250 -8000 Hz 0 -10 right ear - d. B -20 -30 -40 -50 left ear

Checklist Left ear - P Noises in ear, whistling, ringing Stabbing, pricking, inward - P Hard of hearing, left Uncovering: worse - P Cold in general: worse - P Lying on painful side: better - P Movement: worse - P Physical exercise: worse - P External pressure: worse - P

MM Comparison Bryonia Intolerance of noise. Roaring, humming in left year, resembling pouring water over a dam. Arnica Great sensitiveness to loud sounds, with pain in ears. Buzzing and humming before ears with difficult hearing … Rushing in ears with deafness of right and stitches through left ear.

Remedy and Progress Ms T receives one dose of Arnica 200 C. The next day she feels better but still has a headache and some pressure in the left ear. By the fourth day, pressure and headache have gone and her hearing is almost normal. When standing up she still feels slightly dizzy. Recovery ratig 85%. On the 11 th day, she returns to the ENT physician for an audiogram, which is now completely normal. All discomfort has vanished.

Audiogram L. T. , 5. 12. 08 250 -8000 Hz 5 -5 -d. B -15 -25 -35 -45 right ear left ear

Comment Is this also a case where the remedy goes straigt to the core? Mrs T. is mother of three teenagers. She works 45 hours/week as a speech therapist. And she has a horse, a dog and cats. She is overworked and exhausted, another reason for Arnica.

Homeopathic Treatment of Acute Otitis Media Treatment Effect or Spontaneous Resolution?

AOM: Paincontrol by Placebo Patients (Percent) 100 80 60 40 20 0 Start 1 2 3 4 5 6 7 days Del Mar C, Glasziou P, Hayem M, et al, Are antibiotics indicated as initial treatment for children with acute otitis media? A meta-analysis. Brit Med J (1997) 315, 98 -102.

If we want to prove an effect of homeopathy, pain must disappear faster than with placebo.

Study Design Prospective Outcome Study with 230 AOM Patients Procedure Case taking, examination, remedy determination. Main remedy C 200 in practice. Reserve remedy C 200 after 6 hours if pain persits. Antibiotic after 12 hours if pain still persists Control after 7 days

Diagnoses Non purulent AOM 200 (87 %) Purulent AOM 10 (4 %) AOM, chronic middle ear effusion 20 (9%)

Time Required for Pain Control with Homeopathic Treatment of AOM 39% 33% 28% Patients 40% 30% 20% 10% 0% 6 hours 1 st remedy 12 hours 2 nd remedy longer antibiotics

Successful remedies (166/230) Pulsatilla Belladonna 28 24 Sulfur Phosphor 22 19 Rhus tox. Mercurius sol. 5 4 Conium 1 Graphites 1 Nux vomica 3 Ignatia 1 Silicea 3 Kalium mur. 1 1 Calcium carb. 14 Bryonia 2 Lachesis Lycopodium 10 Ferrum phos. 2 Natrium mur. 1 6 Hepar sulfur 2 Phosphoric. ac. 1 2 Veratrum 1 China Arsenicum alb. 5 Kalium carb. Chamomilla 5 Sepia 2

Pain Control in acute AOM: Homeopathy vs. Placebo Patients in Percent 80 76 70 Placebo, Del Mar 1997 72 60 50 40 Boenninghausen, 1999 (n=230) 41 39 30 Polarity Analysis, 2005 (n=34) 20 10 0 0 12 24 36 48 Hours 60 72 84

Conclusion Homeopathy leads 2, 1 x times faster to pain control than Placebo.

Complications In about 4800 AOM patients treated in this manner, we observed three complications 1 Chronic central drum perforation 1 Cholesteatoma 1 Mastoiditis Frequency: 0. 625 %o

Case 5: Tendinitis Calcarea Since two days 46 years old Ms RJ, suffers of an acute outbreak of pain in the left shoulder. Local touch and pressure is extremly painful, she can hardyly move the left arm, and has a feeling of numbness in the fingers IV and V. The pain keeps her from sleeping and working as a teacher.

The examination reveals an overheated and extremly tender swelling anterior to the left shoulder. Movements are restricted and painful. No other physical findings. Blood tests normal. X-Ray of left shoulder

Diagnosis: Tendinitis calcarea of left shoulder

Checklist < Touch-P < Pressure-P > Cold-P < Warmly from wrapping up-P < Physical effort-P < raising arm-P < Sitting-P > Standing-P < Movement of affected part-P

MM comparison for Ledum (GS) Severe stitch in shoulder when raising arm. Painful pressure in left shoulder, < from motion. Limbs numb and fall aslleep. Tense hard swelling of affected joints; painful hard nodes and calcareous concretions. Stiffness in joints, could only move them after applying cold water. Affects mainly left shoulder and right hip joint.

Prescription and Progress Mrs J. recives one dose of Ledum C 200. The following night she sleeps soundly. After the XRay pain returns. Ledum C 500 and M cause an improvement for 10 days. Since the effect of single doses is too short we switch to Ledum Q-3 daily. After four weeks she reports an improvement of 80%. With Ledum Q 6, 9, 12, 15, 18, each for a month. she is clinically cured. We make another X-Ray.

Outcome Studies In Acute Disease

Outcome-Parameters 1 st Hit: Improvement over 50% with the 1 st Remedy within 48 hours. Patient is cured, no further treatment necessary. 2 nd Hit: Improvement under 50% after 48 hours. Patient receives reserve-remedy and is cured within another 48 hours. No further treatment necessary. No Reaction: The improvement with both remedies remains below 50%. The patient needs another consultation.

Diagnoses, Patients, Results Diagnosis Number of Patients 1 st Hit 2 nd Hit No Reaction Influenza 52 32 13 7 Hayfever 33 19 9 5 Otitis media 34 14 12 8 Tonsillitis 39 23 12 4 Sinusitis 8 3 4 1 Infection Upper Airways 22 11 11 0 Infection Lower Airways 48 26 14 8 Enteritis 20 15 4 1 Total 256 143 (56%) 79 (31%) 34 (13%)

H 1 N 1 Influenza Epidemic 2011: Healing Time with Homeopathic Treatment (n=52 patients) Percent Patients 80% 62% 60% 25% 40% 13% 20% 0% 1 st remedy (2 days) 2 nd remedy (4 days) No reaction

Duration of Symptoms in H 1 N 1 Influenza under Homeopathy, Oseltamivir and Placebo Homeopathy Oseltamivir Placebo 75 h 139 h 160 h

Preconditions for Good Results Precise observations by patients (Checklist) Symptoms must be correct Discuss unclear points with patient Use if ever possible only highly reliable symptoms for repertorisation

Advantages Remedy determinations are precise and reproduceable. The method is easy to teach and to learn. It allows students to treat patients early in their homeopathic formation. It is efficient and can be used in general practice. Often deep healing effects.

Further Information Checklists www. heinerfrei. ch Software http: //polarity-analysis. com

Thank you for your Attention!