Homeopathy (2013) 102, 114e122 2013 The Faculty of Homeopathy http://dx.doi.org/10.1016/j.homp.2013.01.003, available online at http://www.sciencedirect.

com

ORIGINAL PAPER

Homeopathy e between tradition and modern science: remedies as carriers of signicance

Yannis Almirantis*
Institute of Biosciences and Applications, National Centre for Scientic Research Demokritos, 15310 Athens, Greece The healing potential and description of homeopathic remedies, as determined in homeopathic pathogenic trials (HPTs) and veried by medical experience, are often found to be meaningfully connected with the symbolic content attributed to the original materials (tinctures, metals etc) through tradition or modern semantics. Such a connection is incompatible with a biomolecular mechanistic explanation of the healing action of remedies. The physiological effects of crude substances are often similar to the symptoms of illnesses cured by the corresponding homeopathic remedy. This is considered a manifestation of the similia principle. Evidence is brought here that in several cases the inverse situation occurs, with the healing properties of the crude substance and those of its homeopathic preparation partially coinciding, the remedy usually having broader healing properties. The existence of these two possibilities in the relationship of medicinal actions of remedy and the crude substance, offers evidence in favor of a direct involvement of the level of signicances in the mechanism underlying the homeopathic phenomenon. Finally, an experimental methodology is proposed, which may bring the result of double-blind randomized studies for homeopathic remedies closer to the reported performance of homeopathy in real life medical practice. If successful, this method would be a further indication of a non-local, signicance-related interpretation of homeopathy. Homeopathy (2013) 102, 114e122.

Keywords: Homeopathy; Synchronicity

Meaning;

Signicance;

Entanglement;

Causality;

Introduction
In the recent literature there is a debate about the existence, in homeopathic therapeutics, of a non-local component similar to quantum-mechanical non-locality. H. Walach1 and L.R. Milgrom2 propose an analogy between the non-local correlations experimentally determined among subatomic particles, which are entangled (in the technical sense that this term is used in quantum mechanics) and a conjectured entanglement among patient, practitioner and remedy during the homeopathic therapy. Reasons proposed for the introduction of this metaphor are:

(i) Difculties met so far, despite long-lasting efforts, in the experimental identication of the imprints left in the solvent after the molecules of the initial substance are removed during the potentization procedure. (ii) Difculties in the formulation of a biomolecular mechanistic explanation of the healing action of remedies at high potentization. (iii) Difculties in the search for reproducible experimental systems showing a biological effect (healing or other) of high potency remedies on cell cultures or plants. (iv) The relatively small differences found so far between remedy and placebo groups in meta-analyses of clinical trials assessing homeopathic treatment in doubleblind, randomized studies. As discussed by H. Walach and co-workers,1,3 a general pattern may be discerned when examining the corpus of experimental evidence. Quoting from reference 1: Taken together, the (experimental) data base poses a double

*Correspondence: Yannis Almirantis, Institute of Biosciences and Applications, National Centre for Scientic Research Demokritos, 15310 Athens, Greece. E-mail: yalmir@bio.demokritos.gr Received 18 July 2012; revised 29 October 2012; accepted 29 January 2013

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challenge to an open-minded observer: It shows too many irregularities which cannot easily be dismissed as chance results. Deviations and effect sizes are too large. Some type of anomaly seems to be clearly present, but the irregularities are too spooky. They are not persistent enough in order to be taken as local, stable or causal effects. Another paradox is the obvious divergence between the recorded relatively poor results of clinical trials in favor of homeopathy (especially when double-blind) and the high rates of successful treatment and satisfaction of the patients during the application of homeopathy in medical practice. Walach suggests that all these apparent contradictions may be expressions of the non-local nature of the homeopathic healing process, because quantum non-local correlations are bound not to bear information, as a consequence of contradictions arising in the framework of relativity theory.4 According to this view, due to the need of information to be conveyed by means of a specic carrier with nite speed, a healing process under the action of non-local factors is expected to have an inherent opposition to reproducibility, which is the principal factor tested in modern double-blind randomized clinical trials. The same author has suggested some lines of experimentation which could avoid the pitfall of the search of strict reproducibility1: . introducing a deliberate element of uncertainty, e.g. by the usage of formula remedies in which one never can be sure which was the curative agent. Also focusing1: . more on open, randomized comparative trials which compare real-life homeopathy to other clinical approaches. In open trials one could always argue that the homeopathic remedies were not at stake, but the whole therapeutic approach. In the nal section of this paper, I return to this matter, proposing a methodology aiming to relax reproducibility of experiments and clinical trials in homeopathy. L.R. Milgrom5,6 has discussed the possibility that homeopathy depends on both local bio-molecular phenomena and a non-local component. This view ts well with the present situation of research in homeopathy, because existing evidence, both theoretical and experimental, points towards a multitude of microscopic phenomena, most of which are related to the amazing properties of water as solvent (see the special issue of Homeopathy dedicated to the memory of water7). Such phenomena, most of them ultimately related to quantum-mechanical properties, may form a bridge between local (bio-molecular) and nonlocal, non-causal aspects of homeopathy, at least at the remedy level. A detailed description of quantum-mechanical aspects of patientepractitionereremedy non-local interactions (entanglement) is formulated by Milgrom8e10 who describes by state functions the three components of the entanglement. However, these state functions are not related to quantiable physical observables as in orthodox quantum theory. They are related to more qualitative observables, such as signs and symptoms of a disease.8 It remains an open problem if this description, especially for human being (patient, practitioner) can be brought closer to a quantum description of organismal

components. We can mention here the suggestion of the mathematical physicist R. Penrose11 that consciousness may be an emergent property of the brain involving quantum entanglement properties of the microtubular component of nerve cells. The phenomenon of quantum entanglement is related to quantum non-locality and to some phenomena of microphysics initially viewed as paradoxical. This line of research was started by a famous article of Einstein, Podolsky and Rosen where the authors attempted to show that quantum mechanics is intrinsically incomplete (the EPR paradox). Later, J.S. Bell formulated what was subsequently named Bell inequalities, which could allow the verication or refutation, on an experimental basis, of the existence of non-local correlations between particles generated under certain very specic conditions (entangled particles). The experiment led by A. Aspect and co-workers and its more recent variations verify that nature, at least at the microscopic level, exhibits spontaneous non-local correlations between remote particles, as long as these particles remain entangled. In the related articles of Aspect12,13 further references may be found. In an early essay addressed to the non-specialist, N.D. Mermin14 has presented the essentials for understanding this conceptually intriguing research subject. In the cited references by Walach and Milgrom a connection between quantum non-locality and specic features of homeopathy is attempted and aspects of quantum theory about non-locality are summarized, and an extended review of the relevant literature is also provided. In Atmanspacher et al.15 a general theoretical framework is exposed, which allows the extension of the concepts of non-locality and entanglement outside the limits of microcophysics. This is done by formulating a modied quantum mechanics, named weak quantum mechanics, where only some of the axioms of the standard theory are retained (see also Lucadou et al.16). By means of this theory, it is suggested that non-locality may be extended at the macroscopic level, through theorems analogue to the Heisenberg uncertainty principle, on the basis of the existence of non-commutable operations. These ideas represent a promising eld, open to further exploration, for the understanding of how homeopathy works. The present study focuses on the examination of two aspects of homeopathy which, as I will attempt to show, both directly involve meaning. Evidence presented in the next two sections is compatible with a non-local (and consequently not exclusively based on biomolecular mechanisms) view for homeopathy. H. Walach1 formulated a meaning-related description of homeopathy, combining the non-local interpretation of homeopathy with the concept of synchronicity, published in 1955 by the founder of analytical psychology C.G. Jung and the eminent physicist W. Pauli in a joint publication.17 There, synchronicity is characterized as an acausal connecting principle. Synchronicity, in its original form, deals with the strange simultaneous occurrence of events which are meaningfully inter-related but lacking any causal connection. More
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generally, it is described as a principle expressed by the coincidence in space or in time of events meaningfully related. In the Jungian sense, this occurs when structures of the deep unconscious, the so-called archetypes, are activated. While initially conceived as an acausal connecting principle, synchronicity may be seen as the expression of a generalized causality, in the spirit of the initial Aristotelian classication of causes. In this scheme, not only the material and the efcient causes but also the formal cause and the nal cause, which have become obsolete in the framework of contemporary mechanistic science, must be included. Nevertheless, in the present article, we continue to call the correlations viewed as synchronistic non-causal, in order to unambiguously characterize descriptions of homeopathy which are non mechanistically causal, thus not belonging in the bio-molecular explanatory framework.

Meaningful coincidences between remedy pictures and symbolic significance of remedies

I will discuss some Homeopathic medicines whose general picture comes remarkably close to the meaning that mother substances (tinctures, metals, etc) have acquired traditionally or through non-traditional semantics. Aurum metallicum is typically prescribed in homeopathy to patients with severe depression. Describing the Aurum patient, Kent states: It is astonishing that one could get into such a state of mind, such horrible depression of spirits that there is an absolute loss of enjoyment in everything. You take away a mans hope, and he has nothing to live for, he then wants to die. .. It is suitable (Aur-m) in the most profound states of melancholy and depression where the patient sits silent and says nothing. The homeopathic literature is unanimous that such patients are often entirely submerged into the deepest possible darkness. G. Vithoulkas18 in his Essences comments on Aurum patients: Everything becomes darker and darker, until there seems to be not one ray of light. To these Aurum patients, it is as if the sun has been completely snuffed out. Parallelism with the symbolisms associated with the couple GoldeSun comes naturally. Ancient Greek Alchemy (Hellenistic period) associated gold with the sun, as a planet and as a deity, mostly identical to Apollo. The subject of the metal e planet correspondences is discussed in depth by M. Berthelot in the introduction of his classical Collection des Anciens Alchimistes Grecs.19 The reader can nd explanations in this treatise for all incidences met in the present study, which involve the traditional symbolism of metals for metal-derived remedies. The association of gold with the concepts of wealth and money is also inscribed in the prole of Aurum. G. Vithoulkas18 writes about these patients: They often are quite wealthy e nanciers, bankers, etc. and later he adds: It is interesting that Aurum patients value gold (money) a lot. I do no attempt here to shrink the Aurum general picture only to its relation with psychological darkness or to the
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occurrence of its symptoms to wealthy patients. The width of application of this remedy certainly goes beyond these associations, but, as we realize here and in several other cases discussed in the following, correspondence of significance between substance connotations and patients idiosyncrasy is a typical feature of homeopathic remedies, not reducible to mere chance. Platinum metallicum (more often female) patients are described by Kent by the following words: She becomes arrogant and haughty. One of the most striking characteristics of this drug is pride and over-estimate of ones self. She imagines that she is of a high born family and that her friends and relatives are of lowly origin and looks down upon them. Her acquaintances are inferior to herself. G. Vithoulkas in his Essences gives a more modern view of Platina idiosyncrasy, free of old-fashioned clich e, where however a similar general picture is emerging: The Platina patient, on the one hand, is driven by a powerful, excessive sexual desire; on the other hand, she is strongly idealistic and romantic in her amorous relationships. The tension, and eventual conict, between these two aspects of her nature, the repeated disappointments, inevitable for a person of such intensity and sensitivity, leads to the pathology which is the essence of this remedy. The correspondence between these descriptions and the contemporary social connotation of the metal in its use in precious jewellery, is obvious. Mercurius solubilis is characterized by G. Vithoulkas18 as follows: In Mercurius . reactive power is weakened, becoming unstable and wavering in its functions. Virtually all stimuli are absorbed by the patient without adequate defense, resulting in a pathological condition. The lack of defensive power results in the Mercurius patient being sensitive to everything. Also: He is a closed (introverted) individual. Several characterizations adopted by this and other authors refer to physical properties of quicksilver (mercury) and some of them to properties of Hermes e Mercury, the ancient god related to agility. One further such correspondence of meaning e this time with a technological use of mercury e is remarked by both Kent and Vithoulkas: The intolerance to heat and cold illustrates the instability which characterizes the particular Mercurius weakness. As mentioned by Kent, the patient is a living thermometer.18 The above incidence depends on the technology of a given era for characterizing a remedys inuence on patients. Thus, its inclusion in our account of parallelisms between meanings may appear risky. Nevertheless, this overdetermination at the level of signicances is typical in synchronistic coincidences.17 Carbo vegetabilis is characterized by an unusual combination in several Materia Medicae. In the words of Kent: . in all these conditions of coldness the patient wants to be fanned. This description matches the condition of fabrication of vegetable charcoal in a strange way: within the wood pile, constant fanning aids the combustion to raise the temperature. Plumbum metallicum as a remedy directly addresses the connotations of the metal and of the corresponding

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godeplanet Saturn (Kronos), according to the symbolisms of late Antiquity19 and of medieval alchemy. In brief, lead was connected to the mythological gure of Kronosechronos (time in Greek), the deity symbolizing, among its other connotations, old age. In Plumbum patients (according to Kent) The activities of the body, the functions of the organs, are slowed down in pace. The nerves do not convey their messages with the usual activity. The muscles are slow in action, sluggish. There is rst paresis and nally paralysis, of parts rst and nally of the whole. The mind is impaired, slow. Perception is slow. He memorizes with difculty. Comprehension is difcult. He cannot recall words to express himself. According to Vithoulkas: The Plumbum patient is one which falls under the modern clinical category of arteriosclerosis. The Plumbum image is very similar to that seen in arteriosclerotic patients. ... On the emotional level as well, there is a kind of paralysis which can best be described by the word apathy. This is very similar to the stilled, apathetic state seen in old arteriosclerotic patients. Several authors characterize the remedys action itself as extraordinarily slow in time: (Plumbum) is very slow in action.18 Ferrum metallicum is the metal traditionally corresponding to Mars (planet and god) in its function as material for the manufacture of weapons. The color of its rust reminds one of the color of blood and the color of the red planet, which is caused by iron oxides on its surface. Through the belief he who has slain the wood will cure it again e Ho trosas kai iasetai e (for a brief historical account of this early expression of the similia principle see reference 3), widespread since remote Antiquity to Middle Ages and beyond, iron, due to its role as cause of pouring blood, has to be the cure for blood deciency. Contrary to conventional medicine, where only irondeciency anemias have to be treated with iron (in a biomolecular explanatory framework), homeopathic use of iron is based on its symptom-related remedy picture and consequently is administrated in a wider range of anemias, independently of the occurrence of iron-deciency. Thus, the above described association between curing capabilities and symbolic meaning of this remedy cannot be reduced to a simple causal explanation mediated by the physiological action of iron. Stramonium. We want to mention here a remark of G. Vithoulkas describing a feature of the psychopathology related to this remedy: There may be unusual fears such as a fear of cemeteries18 and the same author adds about the plant Datura stramonium which provides the mother tincture for the remedy: Stramonium is commonly found growing in cemeteries. Tarentula Hispanica represents a particular case from the point of view of our study. In Southern Italy, for a long time, the bite of the tarantula of Southern Europe (Lycosa tarantula, wolf spider) was believed to cause excitability and restlessness that may be fatal. Traditionally, in order to be cured, the victim, was engaged in frenzied dancing to the music called tarantella. The whole condition

is known as tarantism. However, no substantial evidence has been found that the venom of the tarantula may be a serious threat or at the origin of any of the symptoms related to tarantism. The spider commonly known as the Mediterranean black widow (Latrodectus tredecimguttatus) is frequently met in the same regions with L. tarantula and can provoke some, but not all, of the symptoms of tarantism. The causes of tarantism remain unknown,20 it has been proposed that the whole condition may be understood on sociological and anthropological grounds as a remnant of rituals of the Greco-Roman era (Bacchanalian rites, Maenadism). Moreover, it is viewed as a response to the local proscriptions against dancing and the expression of female sexuality during the sixteenth and seventeenth centuries and later on, period of widespread occurrence of tarantism.21 Tarentula is widely considered a remedy for restlessness and anxiety (Kent). Today it is also considered a remedy for the restless legs syndrome (RLS). It is remarkable that a direct convergence of meaning occurs between social semantics and the remedys action. Note that the tincture at the basis of the remedy (prepared from the spider and its venom) cannot be objectively related to the symptoms of tarantism, which largely coincide with the healing spectrum of Tarantula. Evidence presented in this section challenges the view that homeopathic medicine is based uniquely on biomolecular phenomena, and that it can be consequently explained entirely in the mechanistic, local framework. This does not deny that subtle molecular or supra-molecular phenomena or other types of residual information in homeopathic preparations7 may be involved in the whole homeopathic effect. However, the convergence between meaning and function of several widely used remedies points towards alternative types of causation, which are still not incorporated into our post-scientic revolution thinking. The systematic involvement of meaning, acquired through human history and civilization, is not reducible to the physicochemical identity of the substances. Only a global interconnectedness1 may allow such correlations to emerge. Remedies with this convergence of function and meaning admittedly do not represent the majority of the content of Materia Medica. But they do include several characteristic cases, for instance the majority of metals known to the ancient world. Also, there are cases worth mentioning because meaning is acquired outside the era considered as strictly traditional or viewed as sacred by ancient civilizations. Such are Platina, the social connotations of which have recently been established, and Carbo vegetabilis, where the coincidence seems linked to technical details of its fabrication. The remedies discussed are limited to some cases where the above mentioned convergence is mostly obvious. It could however be extended to include e.g. Magnesium muriaticum: psychological bitterness of Mag-m patients in their perception of the world vs. the physical bitterness of magnesium salts; Aethusa cynapium: very intense and strong emotional world and great irritability are typical of the remedys general picture vs.
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symptoms of heat in the mouth and redness of the mucous membranes of the gullet and windpipe when the plant is taken internally; Phosphorus: persons warm, outgoing, affectionate, friendly extrovert are analogous to the inammable and phosphorescent properties of the chemical element in its form of white phosphorus. Note that in the listed examples, I have included only cases of remedies and mother substances where physiological or other properties converge metaphorically and not directly. By this, I mean that the common property cannot be seen simply as the action of a substance in different ranges of concentration. So, remedies like Agaricus muscarius, where neurological and psychic symptoms in patients may be correlated with the existence of psychotropic substances in the mother tincture have not been considered. On the other hand, cases such as Aethusa, where the correspondence of properties (irritability) is only possible through a metaphor, are included.

forms,7 thus conveying some information to the patient, it is difcult to conceive how these imprints or traces can activate the same bio-molecular mechanisms with the initial substance thus accounting for the same symptoms. Consequently, we cannot imagine why and how the crude substance may have either a similar, or any other specic and causally explained correlation concerning its physiological effect, with the corresponding homeopathic (highly potentized) preparation. The crude materials from which remedies are prepared have physiological actions that vary depending on the substance. They may be clustered in four groups: (i) Substances producing symptoms similar to those that the remedy alleviates or cures. Some examples are: Aethusa cynapium, Agaricus muscaricus, Opium, Coffea cruda, Conium maculatum, Agnus castus. This situation is usually viewed as application of the similia principle. (ii) Substances that have healing properties similar to some of those of the corresponding remedy. (iii) Substances which in their crude form have negligible physiological activity (e.g. Silica, Aurum metallicum, Platina); (iv) Substances which have physiological actions different from the remedys effect (e.g. Natrum muriaticum, Plumbum). The standard view is that the similia principle may be generalized to include all of these. Crude substances are thought to always have homologous physiological effects with the remedy when both act on healthy people. Potentization is thus considered to only strengthen and extend the effect of the crude substance. We challenge the generality of this view, proposing that all the four above mentioned possibilities do exist, and that the similia principle applies invariably only between symptoms appearing in the provings and the picture of the patient to be cured. Homeopathic remedies share with the corresponding original substance/tincture some of their healing properties (group ii above) include: Chamomilla: this is widely used to alleviate the symptoms which are also healed by herbal preparations of the plant (tincture of infusion). Gastrointestinal spasms and inammatory diseases of the gastrointestinal tract are treated by both, homeopathic and non-homeopathic preparations of Chamomilla. Its use is particularly frequent in babies suffering from colic spasms or painful teething. Chamomile infusions are used world-wide in these conditions, and in irritability. An objection was made by Kent, who commented: It is not an uncommon thing, even now-a-days, and especially when practicing in the country, for the young mothers and the nurses to give the baby Camomile tea for colic, and the baby goes into convulsions. No one attributes it to Camomile tea, but the doctor will see at once, if he knows Chamomilla, that these convulsions are due to Camomile. However, a baby with colic may suffer from convulsions with or without taking a chamomile infusion, just due to its condition. It may be that Kent, having in mind the provings

Does the similia principle alwaysreflect the physiologicaleffects of the crude substance of aremedy?
Hahnemanns inspiration for the formulation of the similia principle, as used today in homeopathic therapeutics, comes from the Hippocratic tradition. On the other hand, both the practice of the potentization and the use of homeopathic pathogenic trials (HPTs, provings) for the determination of the spectrum of symptoms of a remedy were introduced by Hahnemann himself. The similia principle dictates (and this seems to be veried by the medical practice of homeopaths) that the more complete the similarity between the patients symptoms and the remedy picture the more effective the remedy is when prescribed to a patient.22 In modern HPTs, the remedy is always administered in potentized form. Its homeopathic therapeutic properties are unfolded and the similia principle applies invariably (as the long experience of homeopaths has shown), even if an explanation for the associated phenomena (expressed in the provings as symptoms and in treatment as alleviation of symptoms) is still lacking. The question I address here is how the physiological effects of the crude substance (tincture or other material) could be correlated with the effects of its imprints in the (potentized) remedy, either in HPTs or the therapy. The preparation administered in both provings and therapy, is of the same type (potentized homeopathic remediesa). On the other hand, it is different from the crude substance, which has a molecular identity and often a known molecular mechanism explaining its action. Even if some form of imprint of the initial material still exists in highly diluted remedies in any of the proposed
a

Here, we do not discuss potencies lower than 12c, where molecules of the initial material are still present. Even there however, the action of a preparation as a homeopathic remedy is principally connected to the procedure of potentization.

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of Chamomilla in which convulsions were observed, inferred that the convulsions of babies taking chamomile tea are caused by it, while in fact the convulsions of the sick baby are part of the condition. Ferrum metallicum: this is another typical case of group (ii), in view of the anti-anemic properties of both the homeopathic remedy and the conventional administration of iron salts. Kent said: The Old School has been giving Iron for anaemia throughout all tradition. They have given it in great quantities, in the form of the tincture of chloride, and the carbonate. Whenever the patient became anaemic, pallid, waxy and weak, Iron was the tonic. It is true that Iron produces anaemia, and it would be astonishing to any one who ever read the provings of Ferrum if the allopaths did not create additional blood-lessness with the doses of Iron they administer. It is true that under the provings, and under those circumstances where Iron has been given in excess, the patient becomes greenish, waxy, yellow and pallid, with a sickly and anaemic countenance. We can understand that physicians contemporary to Kent may have given iron salts not only for iron-deciency anemia but in other forms of anemia too, where high doses of iron might worsen the situation. Such cases, in combination with Ferrum provings that Kent had in mind, may have led him to conclude that iron administration always aggravates anemia. Modern research proves that pharmaceutical administration of iron in anemias caused by iron-deciency is benecial, although it does not inuence the underlying cause. In contrast, homeopathic use of Ferrum metallicum may trigger the self-healing potential of the organism. Arnica montana: Arnica is used to treat symptoms and accelerate healing of bruises, internal bleeding and traumatic conditions. Internal administration of the homeopathic remedy and external use of various pharmaceutical preparations containing the herbal tincture are both widespread. According to Kent, if you take Arnica internally, in large doses, you will have mottled spots, bluish spots, which become yellowish, due to ecchymoses, from extravasations of the smaller capillaries. However, the benecial external (non-homeopathic) use of Arnica preparations seems clear and with no such secondary effects. Thus, Arnica belongs to the group of remedies, which share healing potential for the same pathological condition with the corresponding mother tincture. The switching from one type of effect to its inversion, when we change from low to high doses (or from external to internal use) of a pharmaceutically active substance, is not unique to Arnica, and may be seen as a manifestation of hormesis. Hypericum perforatum: the use of Hypericum in several forms of oily extract is well known in herbal medicine for the treatment of wounds, burns and back, neck and related aches, from Galen and Dioscorides to present-day folk medicine. The use of Hypericum in homeopathy is certainly more extended and nuanced. However the general description of healing and soothing in wounds, traumas and aches is common to for both. Boerickes Materia Medica, Hypericum describes it as a remedy for melancholy, this being close to the contemporary herbal-medicine view of Hypericum as an effective antidepressant.

Calendula: there is a variety of herbal preparations containing Calendula, which are used for treating open wounds, skin infections, gum and tooth infections and related conditions. Kent, writing about Calendula remarked: The proving of Calendula is so nearly worthless that we cannot expect at present to use it as a guide to the internal administration of the remedy and then he continuous with a brief guide of its local use on wounds and injuries. Farringtons Materia Medica presents the use of Calendula as a homeopathic remedy in the chapter on Arnica: Calendula is to be thought of when the injury causes a torn or ragged wound, possibly with loss of substance. Calendula removes the inammatory condition of the part and so permits of healthy granulation. Nash, describing Hypericum, comments about the application of Calendula (in homeopathic form) to lacerated muscular tissue. In several homeopathic Materia Medicae, Calendula is discussed in conjunction with the other homeopathic remedies (Arnica, Hypericum, Rhus toxicodendron etc) related to the treatment of wounds and injuries. Allen in his Materia Medica comments that: (Calendula) acts as well in potency as in tincture, applied locally, and may be administered internally at the same time. Undoubtedly, its homeopathic internal administration targets the same problems as its non-homeopathic local use. Digitalis: compounds isolated from this plant are used in the modern pharmaceutical treatment of congestive heart failure and cardiac dysrhythmias. Overall, the heart rate decreases and digitalis often acts as a rhythm regulator. There are important parallels between the allopathic prescription of digitalis and its homeopathic use: G. Vithoulkas described the action of the homeopathic remedy as follows: Digitalis is primarily a heart remedy. It should be considered when the pulse is abnormally slow and later in the pathology, fast or irregular, intermittent; where there is heart disease, with great weakness, and the patient can hardly talk, and is losing strength to the point that he feels faint.23 Of course, here as in most other cases, Digitalis as a homeopathic remedy has a therapeutic spectrum much larger than in conventional medicine. However, in heart problems there is a clear similarity of application. Kents remarks on the matter of dangers related to the administration of digitalis by physicians of his time: This drug as used by the Old School has done more mischief than any one drug in their Materia Medica. . . It has caused more deaths than any drug are understandable in the light of todays knowledge of cardiac glycoside toxicity. The examples of remedies exhibiting similarity in the healing capabilities between crude substance and homeopathic remedy presented above is in contrast with the standard situation, where similarity between the symptoms produced by the crude substance and the symptoms of the patient to be cured is observed. I suggest the existence of this group of remedies may shed light on the nature of the homeopathic phenomenon. Homeopathy displays, in common with archaic forms of expression (myths, primitive words and dreams), a characteristic ambiguity. This ambiguity is seen in the two possible
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relationships between the therapeutic action of remedies and the physiological effects of mother tinctures. These possibilities form polar opposites. This observation must be assessed in combination with the claim that the action of herbal or chemical preparations explained on biomolecular grounds cannot be trivially extended to the therapeutic effect of their corresponding homeopathic remedies, at least in the high potencies. I propose that the existence of both these possibilities (similarity or opposition between the action of the crude substance and the corresponding homeopathic remedy) indicates that the remedies act at a level directly implicating meaning. Thus, we may understand the remedy as a bearer of signicance rather than of a primarily physiological effect. This is sustained by the observation (in entirely different elds: psychology, ethnological studies and linguistics) that a signier (symbol, word, dream image) often appears to be related indiscernibly either with a signied (object, concept, situation) or with its inversion. Some examples will make this point clearer. Concerning the content of dreams, Sigmund Freud in his classical Introduction to Psychoanalysis,24 states: . Moreover, because of the way in which the dream work combines opposites, it is always uncertain whether a specic dream element is to be taken in the positive or the negative sense, whether it is to be understood as itself or as its opposite. He continues: We already know the inversion of the sense, substitution by the opposite. Besides there are inversions of situations, of relations between two people, and so in dreams we are in a sort of topsy-turvy world. In a dream it is frequently the rabbit that shoots the hunter. Further inversion occurs in the sequence of events, so that in the dream the cause is placed after the effect. ... An element in a manifest dream, capable of having an opposite, may therefore represent itself as well as its opposite, or may do both simultaneously; only the context can determine which translation is to be chosen (emphasis mine). Another similar example stems from linguistics. The 19th century German comparative philologist Carl Abel said: ... in the oldest languages opposites such as strong, weak; light, dark; big, little were expressed by the same root word ... In old Egyptian, ken originally meant both strong and weak. In conversation, misunderstanding in the use of such ambiguous words was avoided by the tone of voice and by accompanying gestures, in writing by the addition of so-called determinatives, that is, by a picture that was itself not meant to be expressed. Accordingly, if ken meant strong, the picture of an erect little man was placed after the alphabetical signs, if ken, weak, was meant, the picture of a cowering man followed. Abel believed that initial blurring of antithetic meanings in primitive words was frequent, and only later different words were introduced for a systematic distinction between them. He also cited examples from modern languages, where a trace of the initial ambivalence is still present, as evidence in favor of his thesis. We owe to Freud one more remark on the importance of representation by the opposite, this time derived from the study of myths.25 In a letter to Pster (18 March 1909), when commenting on a dream of one of Psters patients,
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Freud says that being born can be symbolized both by coming out of water and by entering water, and he adds: Because of the ease of representation by its opposite the symbolism of giving birth and being born are often exchanged. In the well-known exposure myths of Sargon, Moses, Romulus, etc, the exposure in a basket or in water signies the same as the subsequent rescuing out of the water. Both refer to birth. Examples taken from dream, myth and analysis of archaic languages, provide evidence of a frequent use of signs representing polar opposites, where the ambiguity may be resolved only under the light of contextual conditions. In the case of the relation of a remedys healing spectrum with the physiological action of its mother substance, we have seen that it may belong to four categories, with (i) and (ii) representing two opposite relations of signicance: inverse or direct. I proposed that this offers further evidence that the homeopathic healing is a procedure involving not only biomolecular factors but also correlations from the sphere of meaning. The question naturally emerging here is whether there is any systematic way for a given remedy to justify why it belongs in category (i) implying an inverse action between mother substance and remedy (similarity in the symptoms caused by the administration of the substance and in the symptoms to be cured), or in category (ii) implying a direct action (similarity in the healing capabilities of mother substance and remedy). This is equivalent to the determination of the contextual conditions which, in analogy to dream analysis and linguistics, could resolve ambiguity. I formulate here a hypothesis, which seems to be supported by available evidence: cases with the strange (in the sense of deviating from a general similia principle) property of similarity in the healing capabilities between mother substance and remedy are cases where the substance has a strong, well established and commonly accepted picture as a curing agent. Camomilla, Arnica, Hypericum, Calendula and Digitalis were widely used medical plants, well before the appearance of homeopathy. Consequently, they can be seen as locked in a given curing role due to a long lasting experience. Several other remedies t this description, e.g. Borax, used traditionally as well as in homeopathy for sore mouth and for Aphthae in mouth and on tongue according to Kent; also Aconitum napellus, used traditionally as well as in homeopathy for headaches and feverish illnesses.

Discussion
I am not the rst to have noticed correspondences, such as those described in the second section of this paper (Meaningful Coincidences). Experienced homeopaths must have noticed such cases. Some of these strange coincidences may also be found in texts and web publications where, however, homeopathy is considered as part of a perennial tradition which has little (or nothing) in common with science. Here, on the other hand, these occurrences are seen in the perspective of an eventual bridging between modern

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scientic thinking and concepts belonging to the traditional world-view. This attempt may also be justied on the grounds of ndings from the domains of analytical psychology, parapsychology, ethnological studies, cognitive sciences and biological evolution, to mention just a few disciplines where indications for a complementarity between traditional world-views and the present-day scientic conceptual framework are conspicuous. I have treated this evidence autonomously, on the basis of homeopathic Materia Medica. Probably, practitioners of homeopathy, although familiar with strange accordances between healing properties and meaning, are reluctant to publicly discuss the subject, fearing that this could harm the cause of homeopathy. Nonetheless, I believe that the principal factor in favor of homeopathy is its effectiveness as a treatment, which has held for over two centuries. No truth should be hidden because in the long run these truths may contribute to an extension of the contemporary explanatory model (or scientic paradigm, as described by T.S. Kuhn26) as mentioned above. In contemporary scientic thought, assignment of meaning is conceived as an entirely human-dependent activity ultimately related exclusively to cerebral activity. Different opinions have however been expressed, even in the recent past. For instance Paulis psychophysical unity17 which, if sustained by further evidence, may bring meaning to the status of a fundamental concept involved directly in the dynamics of reality.16 Previously, I described a case of interweaving, in a meaningful pattern, of physical quantities with beliefs, historically developed during the Antiquity, which seems very unlikely to have been produced by pure chance.27 Situations making the existence of meaning beyond the separate individuals mental activities plausible were described by C.G. Jung on many occasions, which made him suggest the concept of the collective unconsciousness comprising autonomous complexes e carriers of meaning at a transpersonal level. A somewhat similar concept is formative causation developed by R. Sheldrake,28,29 which suggests that causally unrelated events may be connected, in the sense that a previous development e.g. of a behavioral pattern in animal communities or of a morphological trait in biological evolution may facilitate its reappearance in another environment. It is beyond the scope of this article and the competence of the author to present here a unied framework for all these approaches. However, I want to attract attention to a common ground in all the elds mentioned above. This common ground could be seen as an elusive character, expressed by an inherently low reproducibility of the observations, while on the other hand, effects are more persistent than pure chance could justify.16 This comes very close to the general modality described by Walach1 in view of difculties met in the experimental verications of homeopathy, both on experimental and clinical level. I suggest a modication in research practice, which may be applied both to laboratory experiments and in doubleblind clinical trials investigating the homeopathic phenomenon. The aim of the suggested modication is to make them

genuinely less repetitive, as proposed by Walach,1,3,4 without inuencing the effectiveness of experiments or clinical trials as far as the study of the underlying phenomenon is concerned; or the decisive factor for the success of the homeopathic treatment, the close matching of the patients state with the only (or one among very few) remedy. Firstly, I describe the idea in its implementation in a double-blind randomized clinical trial. Let the clinical trial be designed in the usual way, but, using as a control, not placebo medicines, but different homeopathic medicines drawn from a big pool of several tens or hundreds. For each patient belonging to the control group the treatment must be the same throughout. These quasi-placebos will be assigned randomly and blindly, with no possibility of tracing back the identity of the remedies used as control in each case. This modication of the standard procedure represents a true relaxation of reproducibility, which however is not expected on the basis of standard causality, to modify more than minimally the outcome. This may be justied because the large majority of remedies replacing placebos will not match the symptoms to be alleviated, thus, as homeopathic experience dictates, they practically will act merely as placebos. Reproducibility is truly undermined because a variety of potentially active remedies are administered, whose identities remain unknown. According to the hypothesis that non-local factors prevail in the homeopathic cure, we could expect this procedure to result in higher percentages of improvement than those observed in present-day doubleblind clinical trials in homeopathy, where repeatability is studied in the conventional way. This modication of the standard procedure should be safe for the patients since Homeopathic medicines not matching the patients symptoms are believed to be inactive. Some very specic, potentially harmful remedies can be excluded from the group of remedies used as control. Experiments with cell cultures, plants and physicochemical testing may be designed, on similar lines with, in place of inactive reference solutions, randomly selected active homeopathic preparations. The further understanding of the deep nature of homeopathic therapeutics will be greatly facilitated if methodologies and beliefs widely adopted by the scientic community are not seen as dogmas. Experience has always shown that such predispositions act against the advancement of the understanding of the workings of nature. If global connectedness and meaning are involved in the way nature operates, as hypothesized by Josephson and Pallikari-Viras,30 they may have played a crucial role in the emergence of life and consciousness during biological evolution. And evolution without any doubt is important, even though its reproducibility is notoriously difcult to test.

Acknowledgements
I thank Leto Kyritsi for helpful discussions and for her criticism. I am also indebted to Drs Constantine Kafkalidis,
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Panayotis Triantafyllou and Constantine Tsitinidis for valuable comments and discussions.

References
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