Potentiating (homeopathy)

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Potentiating (also dynamizing ) describes a method used in homeopathy for the production of homeopathic medicines . In this preparation method, the drug substance is successively with water or alcohol succussed or milk sugar triturated and thereby partially so extremely diluted, that the starting material is no longer detectable. The desired effect should be enhanced by the preparation process.

The claimed pharmacological effect of dilutions as well as the "high potencies" produced in this way are not tenable from a scientific point of view. The exponentiation process and the Hahnemannian principle of similarity contradict scientific knowledge. The effectiveness of homeopathic medicinal products produced by potentising could not be proven despite extensive studies. According to current knowledge, a perceived effect of homeopathic treatments is based on psychologically explainable placebo effects .

Sources of the regulations

Samuel Hahnemann introduced potentization around 1798. According to his instructions, the drugs should be diluted in increments of one hundred. The dilution 1: 100 was called "C1 potency". The decimal system for potentiation (D1 corresponds to 1:10) was developed in the 19th century by the alternative practitioner and later doctor Arthur Lutze and introduced into treatment by Constantin Hering. This system is the most common today.

Potentiation is usually carried out either according to Hahnemann's regulations or according to those of the European (Ph. Eur.) Or the Homeopathic Pharmacopoeia ( HAB ), some of which differ from one another. Hahnemann's methods can be found in his works Organon der Heilkunst , Pure Medicines and The Chronic Diseases . The HAB regulations form the legal basis for the manufacture of homeopathic medicines in Germany. Both the methods and the substances to be used are described there.

Shaking (dilution)

The starting product is a mother tincture (symbol: Ø), which is initially in a ratio of 1:10, that is 1 part mother tincture and 9 parts solvent (together 10 parts, therefore D-potencies), 1: 100, that is 1 part mother tincture and 99 Parts of solvent (together 100 parts, therefore C potencies) or 1: 50,000, that is 1 part mother tincture and 49,999 parts solvent (together therefore 50,000 parts, therefore LM or Q potencies) diluted and then with a fixed number of strokes is shaken. This combination of dilution and shaking is carried out for each potentization step. A distinction is made between multi-glass and single-glass methods. With the multiple glass method (according to Hahnemann), an unused (new) glass is used for each potentization step. With the single-jar method (Korsakoff method), each potentization step is carried out in the same jar. In Germany, according to HAB, production is only permitted using the multiple glass method.

The production of dilutions (liquid-shaken substances) is described in regulation 5 of the HAB.

Hahnemann believed the essence of potentiating in shaking and not in diluting. The comment on § 269 of the Organon shows that even his contemporaries "call homeopathic medicinal potencies merely dilutions". On the other hand, he also describes shaking without dilution as potentising and uses it with the intention of increasing the potency of the remedy between the individual doses.

Trituration

Substances that cannot be dissolved in alcohol or distilled water (e.g. minerals) are first triturated (triturated) up to the third or fourth power. During the trituration, the starting substance (symbol O) is triturated and scraped up three times with lactose in a mortar for each potentization step. The ratio between the starting substance and lactose generally corresponds to 1: 100 (C-potency) per potentization step.

The production of triturations (triturations) is described in regulation 6 of the HAB . Triturations up to the third or fourth power are also used for the production of drugs whose starting substance can also be dissolved. Many homeopaths assume that medicines that are rubbed initially have a better effect. From the fifth power onwards, there is basically only shaking .

Types of potentiation

The following table shows the common types of potentiation. Homeopathic medicines are usually labeled with the starting material and an indication of the potency. When specifying the power, a distinction is made between D, C and Q (or LM) potencies. The letter is followed by information about the number of exponentiation steps (D6 means 6 exponentiation steps according to the method for D potencies, C30 means 30 exponentiation steps according to the method for C potencies).

Potency type Manufacturing History, application
D powers
decimal powers		 Dilution 1:10
+ 10 shaking strokes 		The method of manufacture was first published by C. Hering in 1833. D-potencies are mainly used in Germany and are produced up to a potency of D1000. Due to their comparatively low dilution, they still contain chemical components of the starting substance up to about D24. In the Anglo-Saxon world, D-potencies are also referred to with 'x' (e.g. 30 ×)
C-potencies
Centesimal potencies		 Dilution 1: 100
+ 10 shaking strokes 		After Hahnemann worked with mother tinctures and diluted substances at the beginning of the development of the homeopathic method , he invented the method for producing C-potencies from around 1810. C-potencies are still most commonly used today. These include the potencies of the so-called Kent series: C6, C12, C30, C200, C1000. Abroad, the single-jar method according to Korsakoff and the machine shaking that this makes possible, higher potentiations are also possible. These are designated with the abbreviation CK (C-potency according to Korsakoff) or simply with Roman numerals: CK1000 (M), CK10.000 (XM), CK50.000 (LM), CK100.000 (CM), CK1.000.000 (MM).
Q-potencies /
LM-potencies
Quinquaginta-Millesimal-potencies 		Dilution 1: 50,000
+ 100 shaking strokes
+ use of an additional carrier substance
 
(Q1 is produced from a C3 trituration using a special process) 		Hahnemann developed Q-potencies towards the end of his life. Their production was first described in the 6th edition of Organon (published 1821). Q-potencies are said to have a particularly gentle healing effect. Q-potencies must be distinguished from LM-potencies. Q-potencies are basically produced from the trituration (C1 to C3) of the respective starting material - called trituration. LM potencies, on the other hand, are largely made from alcoholic extracts of the respective basic substance (C1 to C3). These are called dilutions. For some starting materials, however, the production of the LM and Q potencies is the same. So Aurum (gold) is rubbed in each case for C1 to C3 in order to bring it into solution. Furthermore, the LM potencies should not be confused with the C50,000 potency, which could be called LM as a Latin name.

The concentration of the starting material in a C6 and a D12 potency is the same, namely in each case the starting concentration / 10 12 . According to homeopathic teaching, however, the C6 and D12 potencies have different properties, since a 12-fold potentiated substance is ascribed a greater effect.

Example dilutions

D scale C scale Dilution / mixture Remarks
Ø / O Ø / O undiluted
  • Mother tincture, undiluted (mother tincture consists of half drug and half ethanol )
  • Mother tinctures are pharmacy-only medicinal products, but are available without a prescription, provided they are not subject to a prescription .
D1 - 1:10
1:10 1
  • Low potencies of poisons such as mercury (Mercurius solubilis), deadly nightshade (Belladonna) etc. are toxic. For example, the arsenic (III) oxide (Arsenicum album) used primarily in the form known by homeopaths as “lay homeopathy” as D6 or D12 can be fatal in a dosage of 1 g of the D1 solution.
D2 C1 1: 100
1:10 2
  • Corresponds to a concentration that results from dissolving 1 g of active ingredient in 100 g, i.e. 100 cm 3 of liquid.
D4 C2 1: 10,000
1:10 4
  • Corresponds in volume to approx. One drop per half liter of solvent.
  • In the case of poisons diluted to D4, symptoms of poisoning can occur. For example, Arsenicum album D4, absorbed 5 drops 3 times a day for weeks, leads to chronic symptoms of intoxication.
D6 C3 1: 1,000,000
1:10 6
  • Corresponds to about one drop per 50 liters (about half a bathtub) of solvent
  • From this stage, the amount of impurities in the solvent exceeds the amount of mother tincture still present.
  • The highest dilution used in evidence-based medicine . The most toxic known substance, botulinum toxin , is used in neurology at a dilution of 1: 1,600,000.
D8 C4 1: 100,000,000
1:10 8
  • Corresponds to about one drop per 5 m 3 (5000 liters ≈ 25 filled bathtubs) of solvent
  • Approximately corresponds to the limit value for arsenic in drinking water . From this concentration on, no health risks are to be expected even with long-term consumption.
D12 C6 1: 1,000,000,000,000
1:10 12
  • Corresponds to the dissolution of 1 g of active ingredient in the water volume of 400 Olympic swimming pools or 1,000,000 m 3
D24 C12 1:10 24
  • That would be about one drop in the volume of the Atlantic
  • At this potency, in an idealizing thought experiment, only about half of all 1 liter bottles of D24 solution contain a molecule of a one molar mother tincture; accordingly, from this point onwards, when further solvent is added, no more dilution takes place, but solvent is mixed with solvent.
D26 C13 1:10 26
  • This would roughly correspond to the dilution of one drop in 3 times the volume of all water on earth
  • If pure water is used as a diluent, there is no longer any molecule of the original solution in the water.
D60 C30 1:10 60
  • Here would come a molecule of any substance in a ball of water 150 million kilometers in diameter (the distance from Earth to the Sun) or less than a piece of sugar ... in billions of galaxies .
  • Potency preferred by Hahnemann and recommended for drug proving. High potencies of Belladonna have shown no difference to placebos in homeopathic drug trials.
D80 C40 1:10 80
  • It would correspond to one molecule of the starting substance in the entire observable universe
D400 C200 1:10 400
  • Corresponds to a molecule of the starting substance in 10 320 times the entire observable universe
D1000 C500 1:10 1,000
  • Highest D-potency regularly available from manufacturers
- C1000 1:10 2,000
  • Highest C-potency regularly available from manufacturers

Legend: green = low potencies that can have a toxicological or pharmacological effect; yellow = potentiation and chemical effectiveness are reaching their chemical-physical limits; pink = high potencies. It is unlikely that the starting material will be present in the drug.

Chemically detectable proportion of starting substances

In the potencies D24 and C12 a dilution ratio of 1:10 24 is achieved. According to the Avogadro number , one mole contains around 6 · 10 23 molecules. This means, for example, that the simplest carbon-containing compound contains this number of molecules with an elemental carbon content of 12 g. Based on the definition of the molar concentration , an elemental carbon content of 12 g in one liter corresponds to the one molar solution. In the case of the compound methanol , the molecular formula CH 4 O results in the molar mass of 12 + 4 + 16 = 32, that is 32 g of methanol in one liter of water for the one-molar solution. If this one-molar solution is regarded as the mother tincture, the solution in D23 would only contain six molecules; in D24 the end product would statistically contain 0.6 molecules of the starting material. With the LM or Q potencies, this value is exceeded at the 6th power. With every further potentiation step, the probability of the presence of molecules of the starting substance is reduced by the factor of the dilution, i.e. 10 times, 100 times or 50,000 times.

In a C30 preparation with a dilution ratio of 1:10 60 , the probability of finding a molecule of the mother tincture in one mole of matter, which corresponds approximately to a drug vial, is around 1:10 60 - 24 = 1:10 36 . For comparison, the probability of picking 6 correct numbers out of 49 with a super number with a single betting field in the lottery is just under 1: 1.4 · 10 8 .

The requirement for dilution originally arose because the poisonous effect of the substances used was to be reduced. However, when the theory was first created, no distinction was made between percent by mass and percent by volume . The Avogadro constant is calculated exclusively according to the atomic mass - a procedure that was not known 100 years earlier in Hahnemann's time.

From the point of view of physics, potentization is a pure dilution of the starting substance. An alleged transfer of an effect of substances to the diluent cannot be explained by any known physical or chemical laws. This also applies in particular to attempts at explanations based on quantum physics .

swell

  • Samuel Hahnemann: Organon of the healing art. 6th edition. 1842, published in 1921 (exponentiation from §269)
  • Homeopathic Pharmacopoeia. Deutscher Apotheker Verlag, Stuttgart 2006.
  • Pharmacopoeia of the American Institute of Homeopathy. 2004 (American Homeopathic Pharmacopoeia)

Individual evidence

  1. ↑ Information - Homeopathy is a big mistake. Promed e. V. Association against Unfair Practices in Health Care, archived from the original on October 22, 2007 ; Retrieved February 21, 2010 .
  2. ^ Edzard Ernst : The truth about homeopathy. (PDF; 57 kB). In: Br J Clin Pharmacol . 65 (2), Feb 2008, pp. 163-164. Epub 2007 Sep 13. PMID 17875194
  3. ↑ A. Shang et al .: Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. In: The Lancet . Volume 366 (9487), Aug. 27-2 September 2005, pp. 726-732. PMID 16125589
  4. ↑ Technology Review : Homeopathics are placebos. Interview with Edzard Ernst
  5. ^ Matthias Breidert, Karl Hofbauer: Placebo: misunderstandings and prejudices . In: Deutsches Ärzteblatt . tape 106 , no. 46 . Deutscher Ärzte-Verlag , November 13, 2009, p. 751–755 , doi : 10.3238 / arztebl.2009.0751 .
  6. ^ Dylan Evans: Placebo: the belief effect. HarperCollins, 2003, ISBN 0-00-712612-3 ; (Review)
  7. ↑ R. Barker Bausell: Snake Oil Science: The Truth About Complementary and Alternative Medicine. Oxford University Press, 2009, ISBN 978-0-19-538342-3 . (Review)
  8. ↑ Marburg Declaration on Homeopathy , Department of Human Medicine at the Philipps University of Marburg : Marburg Declaration: Homeopathy as “heresy” and deceiving the patient. In: Deutsche Apothekerzeitung. No. 11/1993.
  9. ↑ Björn Lemmer , Kay Brune: Pharmacotherapy: Clinical Pharmacology. Springer, 2006, ISBN 3-540-34180-3 , p. 19. Restricted preview in the Google book search
  10. ↑ Aijing Shang, Karin Huwiler-Müntener, Linda Nartey, Peter Jüni, Stephan Dörig, Jonathan AC star, Daniel Pewsner, Matthias Egger: Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. In: The Lancet . 366, 2005, p. 731. PMID 16125589
  11. ^ Sarah Brien, Laurie Lachance, Phil Prescott, Clare McDermott, George Lewith: Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial. In: Rheumatology. 49, 2010, doi: 10.1093 / rheumatology / keq234 .
  12. ↑ Anette Huesmann: Healing the gentle way. In: Focus. March 28, 2006 "Scientists and medical professionals (...) call homeopathy a pseudoscience"
  13. ↑ Kathrin Schreiber: Samuel Hahnemann in Leipzig: the development of homeopathy between 1811 and 1821: sponsors, opponents and patients . Georg Thieme Verlag, 2002, ISBN 3-8304-7163-7 ( limited preview in the Google book search).
  14. ↑ Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner: Enzyklopädie Medizingeschichte . Walter de Gruyter, 2004, ISBN 3-11-015714-4 ( limited preview in Google book search).
  15. ↑ Michael Frass : Homeopathy in intensive and emergency medicine . Elsevier, Urban & Fischer Verlag, 2007, ISBN 3-437-57260-1 , p. 79 ff . ( limited preview in Google Book search).
  16. ↑ § 269 f.
  17. ↑ The homeopathic remedy ( Memento of the original from September 7, 2017 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , PDF file, p. 2.  @1@ 2Template: Webachiv / IABot / www.dzvhae.de
  18. ↑ Law on the Marketing of Medicinal Products, Section 43
  19. ↑ see: Medicinal Prescription Ordinance
  20. ↑ Source on the toxicity of arsenic Article on arsenic (III) oxide , low-potency Arsenicum album (up to D3) requires a prescription. lexikon-der-homoeopathie.de
  21. ↑ Norbert Aust: In terms of homeopathy - a record of evidence. 1-2 book, 2nd edition 2013, Ebersdorf, p. 52
  22. ↑ Simon Singh, Edzard Ernst: Healthy without pills - What can alternative medicine, Carl Hanser Verlag, Munich 2009, p. 140
  23. ^ Prokop, O., Prokop, L .: Homeopathy and Science. Enke, Stuttgart 1957
  24. ↑ Max Amann: Arsenic and Antimony in Naturopathy ( Memento of the original from January 19, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.natura-naturans.de
  25. ↑ Simon Singh, Edzard Ernst: Healthy without pills - What can alternative medicine, Carl Hanser Verlag, Munich 2009, p. 140
  26. ↑ Colin Goldner: Alternative diagnosis and therapy methods - A critical inventory, Alibri Verlag, 1st edition 2008, Aschaffenburg, p. 86
  27. ^ Prokop, O., Prokop, L .: Homeopathy and Science. Enke, Stuttgart 1957
  28. ↑ Martin Lambeck: Homeopathy: Where Are the Nobel Prizes? GWUP, May 17, 2010, accessed November 18, 2011 .
  29. ↑ Botulinum Toxin as a Biological Weapon. (PDF) American Medical Association, February 28, 2001, accessed November 18, 2011 .
  30. ↑ Application note : BOTOX (onabotulinumtoxinA) for injection, for intramuscular, intradetrusor, or intradermal use (PDF; 715 kB)
  31. ↑ Simon Singh, Edzard Ernst: Healthy without pills - What can alternative medicine, Carl Hanser Verlag, Munich 2009, p. 140
  32. ↑ Appendix 2 (to § 6 Paragraph 2) Drinking Water Ordinance , Part II: The limit value for arsenic is 0.010 mg / l.
  33. ↑ Council Directive 98/83 / EC of November 3, 1998 on the quality of water intended for human consumption ( web document (PDF) , eur-lex.europa.eu).
  34. ↑ Norbert Aust: In terms of homeopathy - a record of evidence. 1-2 book, 2nd edition 2013, Ebersdorf, p. 54
  35. ↑ Bambridge AD (1989). Homeopathy investigated. Kent, England: Diasozo Trust. ISBN 978-0-948171-20-8 .
  36. ↑ A 12C solution produced using sodium chloride (also called natrum muriaticum in homeopathy) is the equivalent of dissolving 0.36 mL of table salt, weighing about 0.77 g, into a volume of water the size of the Atlantic Ocean, since the volume of the Atlantic Ocean and its adjacent seas is 3.55 × 108 km3 or 3.55 × 1020 L: Emery KO, Uchupi E (1984). The geology of the Atlantic Ocean. Jumper. ISBN 978-0-387-96032-6 .
  37. ↑ The volume of all water on earth is about 1.36 × 109 km3: Earth's water distribution. Water Science for Schools. United States Geological Survey. August 28, 2006. ISBN 978-0-07-825402-4 .
  38. ^ Gleick PH, Water resources, In Schneider SH, ed. (1996). Encyclopedia of climate and weather. 2. New York: Oxford University Press. pp. 817-823.
  39. ↑ Ben Goldacre: The Science Lie . (Original English title: Bad Science ). 2nd Edition. Fischer Taschenbuch Verlag, Frankfurt am Main 2010, p. 58.
  40. ↑ Martin Lambeck: Homeopathy: Where Are the Nobel Prizes? GWUP, May 17, 2010, accessed November 22, 2011 .
  41. ↑ (Walach 1993, Goodyear et al. 1998, Walach et al. 2001, Brian et al. 2003) Belladonna high potencies are not homeopathic remedies
  42. ^ Robert L. Park (2008). Superstition: Belief in the Age of Science. Princeton University Press. pp. 145-46. ISBN 978-0-691-13355-3 .
  43. ^ Robert L. Park (2008). Superstition: Belief in the Age of Science. Princeton University Press. pp. 145-46. ISBN 978-0-691-13355-3 .
  44. ↑ a b FAQ of the homeopathic drug manufacturer DHU ( Memento from March 6, 2013 in the Internet Archive ).