Block Janice
Merkaz HaBriut, Center for Integrative Medicine, Ramat Beit Shemesh, Israel.
Kupat Cholim Leumit, Beit Shemesh, Israel.
Homeopathy. 2019 Nov;108(4):270-276. doi: 10.1055/s-0039-1691835. Epub 2019 Jul 22.
There are two types of bilirubin: conjugated bilirubin, prevalent in cholestatic jaundice, and unconjugated bilirubin, prevalent in hematologic jaundice. Conjugated bilirubin is water soluble and is excreted in urine, whereas unconjugated bilirubin is neither water soluble nor excreted in urine. Homeopathic repertories published prior to the discovery of the two types of bilirubin in 1913 present an opportunity to test the reliability of homeopathic repertories and associated materia medica. If procedures involved in the collecting of homeopathic observations are reliable, then in repertories published prior to 1913, medicines listed for cholestatic jaundice should exhibit a stronger association with urine bile than medicines listed for hematologic jaundice.
In three repertories published prior to 1913, medicines associated with jaundice were further classified into groups labeled "Cholestatic" or "Infant, mostly hematologic". Medicines were identified as "Cholestatic" if associated with both white/clay-colored stool and liver/gallbladder symptoms. Medicines were identified as "Infant, mostly hematologic" if associated with infant jaundice without meeting criteria for the "Cholestatic" group. Controls were medicines appearing in Hahnemann's . Each category was assessed for green urine-usually reflective of bile in urine.
In Knerr's repertory, the "Cholestatic" group demonstrated a significantly greater association with green urine than controls ( < 0.05, Fisher's exact test), whereas the "Infant, mostly hematologic" group did not differ significantly from controls. For Lippe's and Boenninghausen's repertories, statistical significance was not demonstrated. Across repertories, the overall weighted pooled odds ratio (OR) demonstrated significance in the association between the "Cholestatic" group and green urine (OR, 2.384; 95% confidence interval, 1.234 to 4.607), whereas the "Infant, mostly hematologic" group was similar to that of controls (OR, 0.754; 95% confidence interval, 0.226 to 2.514).
Based on the presence or absence of bile in the urine, homeopathic repertories from the 19th century can distinguish between disease processes involving conjugated bilirubin and disease processes involving unconjugated bilirubin.
胆红素分为两种类型：结合胆红素，在胆汁淤积性黄疸中占主导；非结合胆红素，在血液学黄疸中占主导。结合胆红素可溶于水并经尿液排出，而非结合胆红素既不溶于水也不经尿液排出。在1913年发现这两种类型的胆红素之前出版的顺势疗法药典，为检验顺势疗法药典及相关药物学的可靠性提供了一个机会。如果收集顺势疗法观察结果所涉及的程序是可靠的，那么在1913年之前出版的药典中，列出用于胆汁淤积性黄疸的药物与尿胆的关联应比列出用于血液学黄疸的药物更强。
在1913年之前出版的三部药典中，与黄疸相关的药物被进一步分为标记为“胆汁淤积性”或“婴儿，主要为血液学”的组。如果与白色/粘土色粪便及肝脏/胆囊症状相关，则药物被确定为“胆汁淤积性”。如果与婴儿黄疸相关但不符合“胆汁淤积性”组的标准，则药物被确定为“婴儿，主要为血液学”。对照是出现在哈内曼药典中的药物。对每一类进行绿色尿液评估——通常反映尿中胆汁。
在克内尔药典中，“胆汁淤积性”组与绿色尿液的关联显著大于对照组（<0.05，Fisher精确检验），而“婴儿，主要为血液学”组与对照组无显著差异。对于利佩和博宁豪森的药典，未显示出统计学意义。在所有药典中，总体加权合并比值比（OR）显示“胆汁淤积性”组与绿色尿液之间的关联具有显著性（OR，2.384；95%置信区间，1.234至4.607），而“婴儿，主要为血液学”组与对照组相似（OR，0.754；95%置信区间，0.226至2.514）。
基于尿中胆汁的有无，19世纪的顺势疗法药典能够区分涉及结合胆红素的疾病过程和涉及非结合胆红素的疾病过程。
