Clinical Cases

Skin Disease and Polarity Analysis

Heiner Frei
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A four month old baby girl with severe eczema is treated using Heiner Frei’s Polarity Analysis method.

Polarity analysis (PA) is a development of Boenninghausen’s concept of contraindications. It serves to determine in individual disease a healing probability for each homeopathic medicine in question. The method leads to an efficient and reproducible choice of remedy and increases the precision of prescriptions as compared to a conventional homeopathic procedure (figure 1) Polarity analysis is based on the revised edition of Boenninghausen’s Therapeutic Pocketbook, an exceedingly reliable repertory. Polarity analysis is generally practiced with computer software.

Figure 1: Treatment course over 1 year with polarity analysis vs conventional homeopathy(50 patients with three or more diseases were homeopathically treated over 12 months using polarity analysis. 86% of them achieve an improvement (based on their personal rating) of at least 80% or more – the average improvement is 91%. In the reference group with one single disease treated by conventional homeopathy, 86% of the patients reach an average personal improvement rating of 78%).

The Polarity Analysis software contains new gradings of polar symptoms derived from many successful cases. The division of the symptoms into three reliability groups (high, medium, low) leads to precise prescriptions. The Polarity Analysis program is available at http://polarity-analysis.com and can be tested free of charge.

Polarity analysis (PA) was invented during the Swiss homeopathic ADHD double blind study, a trial which resulted in a significant difference between highly diluted homeopathic remedies and placebo. PA paved the road to this scientific success. It allows the ability calculate a healing probability for each possible remedy, based on Boenninghausens grading of polar symptoms. In evaluation studies with a variety acute and chronic disease, as well as with multimorbid patients, PA led to clear improvements of the results as compared to a conventional homeopathic approach. It is also our method of choice in skin disease.

Skin diseases are often characterized by a lack of symptoms. If there are no concomitant internal symptoms, it can be difficult to select the correct homeopathic remedy because the skin symptoms are only superficial. Using case studies, this paper demonstrates how remedy selection is facilitated by internal symptoms or – if absent – how the modalities of the skin disease can nevertheless be used to select a remedy. In cases with only a few symptoms and a correspondingly large number of possible remedies, PA plays a decisive role in enabling selection of the remedy that most specifically matches the patient’s symptoms – that is, with the closest fit to the remedy’s genius.

For the most difficult cases of skin disease, those with neither concomitant symptoms nor skin modalities, other possible solutions are discussed.

A Case Study

3.1.1

Eczema in a Young Baby

Sheila is a four month old baby girl, so far unvaccinated, who is suffering from severe eczema. She was born after a normal pregnancy at 42 weeks, and was initially completely healthy. The parents are advocates of complementary medicine and took Sheila when she was between one and two months of age to see a homeopath, who recommended a “hereditary cure,” prescribing Lachesis M, and two weeks later Nux vomica M, and one week later the BCG vaccine nosode M. This was followed by the appearance of eczema over her entire body. The homeopath then prescribed two further doses of Nux vomica M followed by two doses of Pulsatilla M, and finally Arsenicum album M, each at weekly intervals. The rash then became appalling (figure 1), and the pediatrician wanted to treat Sheila with cortisone. It is at this time that the parents came to our practice. The baby’s entire body was covered in a crusty, weeping skin rash.

Sheila scratched herself constantly and could not sleep due to the itch. At the same time she failed to thrive, as can be seen from the dip in her weight curve (figure 2).

 

 

Fig. 1, Sheila, 4 Months Old                    Fig. 2, Sheila’s Weight

 

With  the  Checklist  for  Acute  Illness:  Infants  and  Small  Children,  the  following symptoms can be elicited:

  Skin rash, crusty, scabby, weeping, itching

  Difficulty falling asleep

  Sensitivity to noise (< noises)

  > Open air – P

  < Warm room – P

  < While falling asleep – P

  < Becoming warm in bed – P

  Irritability – P

  Absence of thirst – P

P = polar symptoms, related to the child’s general sense of wellbeing, not the skin.

Repertorization

The  repertorization  with  the  PC  software,  Boenninghausen’s  Therapeutic  Pocket Book  2000,  only uses  the  polar  symptoms  and  the  modality: noises:  worse.  As already mentioned, skin symptoms are superficial and can lead to an incorrect choice of remedy.  The  difficulty  falling  asleep  is  non-specific  and  does  not  help  to differentiate the remedies.

Figure 3:

 First Repertorization for Sheila

remedies sorted by the number of hits

Explanations for figure 3

 

  1. The remedies shown here are sorted by the number of hits. Further remedies are not shown due to a lack of space and because they have lower hit rates and a lower polarity difference.
  2. Signatures of symptoms

< = worse from … ; > = better from …

Polar symptoms are  indicated with (P).

The number next to the symptom in square brackets (for example, > open air (P) [93]) corresponds to the number of remedies matching the symptom. This information is important because it shows to what extent the rubric limits remedy selection.

  1. 3. Patient symptoms are located beneath the blue line and above the red line.
  1. Opposite poles are marked in italics and are below the red line.
  1. Calculation of the polarity difference: the grades of the polar patient symptoms of a remedy are added up. From this, the sum of the grades of the opposite poles is subtracted: the result is the polarity difference (for example: Ipeca 14 – 3 = 11, Arnica 9 – 5 = 4). The higher the polarity difference, the better the remedy fits the patient’s symptoms, assuming there are no contraindications.
  1. Contraindications, CI: The opposite poles in the genius range (grades 3 – 5) are compared to the grading of the patient’s symptoms. If this has a low grade (1 – 2) but the opposite pole has a high grade (3 – 5), this means that the genius of the remedy does not correspond to the patient’s characteristic symptoms; the remedy is therefore contraindicated. For example: with Arnica, the patient’s symptom absence of thirst is found at grade 1 whereas the opposite pole thirst is found at grade 3. Therefore, thirst is a genius symptom of Arnica and this remedy does not perfectly fit the patient’s symptoms.
  2. Columns with contraindications, CI, and relative contraindications, (CI), are shaded gray so they can be easily recognized.

Interpretation

Sixteen remedies cover all the patient’s symptoms. Only five have no contraindications. Ipecacuanha has the highest polarity difference, with Magnetis polus arcticus and Sepia in second place.

Prescription and Progress

Although Ipecacuanha is not a remedy that we normally consider for skin disease, Sheila is given one dose of it in the potency 30C because of its large polarity difference (that is, its specificity to the patient’s characteristic symptoms). Without any initial aggravation, the intensity of the symptoms declines somewhat. Encouraged by this reaction, we now give the child Ipecacuanha 200C.

Three weeks later, her skin is much better (the parents say 80% better), she is itching less, can sleep better, and has become more mild-mannered. Since the healing now stagnates, however, we give her Ipecacuanha 500C. This triggers an initial aggravation then leads to the (temporary) disappearance of the eczema, and her weight returns to the original 50th percentile. At the age of six months, the child starts teething and the eczema returns on the elbows and the backs of the knees.

We retake the case, resulting in the following general symptoms, not related to the skin:

  Increased salivation – P

  > Open air – P

  Open air, desire for – P

  < Warm room – P

  > Rest – P

  < While falling asleep – P

  Absence of thirst – P

Figure 4: Second Repertorization for Sheila

remedies sorted by the number of hits

Interpretation

27 remedies cover all symptoms, 18 of which have contraindications. The remedies Asarum, Sabina, Phosphorus, and Magnetis polus arcticus stand out due to their high polarity difference (see also figure 5).

Prescription and Further Progress

Due to the high polarity difference, Sheila is now given Asarum 200 C, which is also a remedy with few known symptoms affecting the skin and teeth but which perfectly covers the child’s general modalities.

Within four weeks the skin again starts to improve, up to 90%. Further doses in the potencies M and XM have no further effect on her condition. Around 10% of the original symptoms remain. Since the symptoms have not changed since the last repertorization, we switch to Sabina, the second-best remedy (fig. 5).

Figure 5: Second Repertorization for Sheila,

remedies sorted by the size of the polarity  difference

Sabina is also a remedy with only a few skin symptoms. The remaining symptoms disappear  with  the  remedy  in  the  potencies  200C,  M,  XM,  and  LM  at  monthly intervals (figure 6). The skin is practically healed and Sheila is in all other respects completely healthy.

About the author

Heiner Frei

Heiner Frei

Heiner Frei MD is a paediatrician in Laupen, Switzerland. He did his MD at the University of Berne, and a specialization in paediatrics at the university hospitals of Bern and Lucerne. From 1984 -1987 he was head physician in paediatric haematology and oncology at the University Children's Hospital of Bern. Since 1994 he has taught homeopathy in Switzerland, European countries and India. He was President of the Swiss Association of Homeopathic Physicians From 2001- 2005. He has published clinical studies on tonsillitis, otitis media, ADHD, H1N1 influenza, multimorbid patients and homeopathic methodology. From 2001 to 2005 he was study coordinator of the rigorous Swiss RCT on homeopathic treatment of ADHD, which yielded scientific evidence for a specific effect of homeopathic medicines. For this he was honored with the Swiss SNE Research Promotion Prize and the German Research Award of the Karl and Hilde Holzschuh Foundation. In 2001 Dr. Frei developed Polarity Analysis, a new approach to improve the precision of homeopathic prescriptions. He published several books in German and English on different aspects of polarity analysis. For his work on ADD / ADHD Dr Frei received the 2009 Research Award of the Max and Eva Tiedemann Foundation in Germany.

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