Nineteenth-Century Homeopathic Repertories Predict Increased Urinary Excretion of Bile in Cholestasis but Not in Non-Cholestatic Infant JaundiceFunding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
25 February 2019
02 April 2019
22 July 2019 (eFirst)
Introduction 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.
Materials and Methods 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 Materia Medica Pura. Each category was assessed for green urine—usually reflective of bile in urine.
Results In Knerr's repertory, the “Cholestatic” group demonstrated a significantly greater association with green urine than controls (p < 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).
Conclusions 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.
Keywordsconjugated bilirubin - unconjugated bilirubin - homeopathic repertory - jaundice - cholestasis - urine bile
• Nineteenth-century authors were unaware that there are two types of bilirubin, one urine soluble and one not soluble in urine.
• In homeopathic repertories authored in the 19th century, rubrics (or intersections of rubrics) for cholestatic jaundice exhibit greater association with urine bile than control.
• In the same homeopathic repertories, rubrics (or intersections of rubrics) for infant non-cholestatic jaundice do not display greater association to urine bile than control.
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