MESOTHERAPYGeneral aspects, Pharmacological mechanisms, Medicines, Side effects. Homeopathy: Basic of homeopathy, Medicines homeopathics: peculiarities. There are numerous definitions for a technique as young as Mesotherapy. In fact, I am quite convinced that every experienced mesotherapist would try to persuade us of their vision of the new technique, quite possibly, in accordance with their particular manner of understanding the art of Medicine. All of us, however, agree with Pistor, its discoverer, that Mesotherapy is not a new medical philosophy, but “simply” a technique that tries to bring the place of treatment into closer contact with the pathology, and thanks to the superficial – intradermal complex network, it enables the use of the minimal dose of the medication in order to solve the problem being treated. I believe that, more importantly than losing ourselves in a philosophical labyrinth, which although it might lead us to an exact definition of a technique which all of its practitioners might agree with, we should consider the “essential” points that those of us who practice this therapy agree must be shared by all. The basic concepts that I deem to be accepted by all are as follows: The use of the "Medicine mini-dose" concept. This concept is a fundamental aspect of the technique, given the fact that as a result of the characteristics of the superficial intradermal tissue, as we will discuss below, the medicine remains for a long time acting on the area where it has been deposited, without passing into the general circulatory system, and without interacting with other organs or systems, which means that we achieve great effects with minimal doses, and without any undesirable effects that these same medicines, administered in other ways, would cause as a result of gaining direct access to the general circulatory system. The mini-deposits of the medicine must be administered at an intradermal level, not at a subcutaneous or intramuscular one. This is a must as far as mesotherapy is concerned, given the fact that we use the properties of this skin tissue to make the most effective use of the drug in question. The appearance of a small papule confirms that we are acting at the correct depth (a maximum depth of 3 mm - 4 mm). Mesotherapy treats the problem or injury where it is to be found. The true aim of its discoverer was just this, to make the most of the proximity to the injury in order to remedy the problem with the minimum cost of the drug and the least iatrogenic expense. These "Savings", both on medicines, as well as with respect to undesirable side effects produced by same, turn Mesotherapy into, according to Pistor, “a different way of treating people who are ill and/or of introducing medicines into the body”. We are not dealing here with a "parallel medicine", rather a different manner of enabling the same medicines to reach the pathological area, by means of which, I insist, we can avoid the iatrogenic effects that we are aware said medicines cause when administered through “conventional” methods.
PHARMACOLOGICAL MECHANISMS 1. The spreading and distribution of the medicine is accomplished more slowly by mesotherapeutic means than by all the other parenteral avenues. 2. The spreading of the medicine does not depend on the anatomical location of the puncture, but on the perfection of the technique carried out by the Mesotherapist. 3. The speed of diffusion is inversely proportional to the molecular weight of the medicine used. Mesotherapy is a form of administering medicines with its own particular pharmacokinetic technique, which is characterised by a greater availability of the medicine that has been administered with a small dose of same, and with fewer dosages. Consequently, it manages to avoid a large amount of side effects. This serves to confirm KAPLAN’s work, which maintains that locally administered products, in accordance with an intradermal injection technique, reach quite a distance with small doses, as well as the existence of a persistent cutaneous reservoir with weak local diffusion. There is no need for a molecule to be physically present at the level of the organ to be treated, given that it can act by means of receptors that will take charge of triggering off a nervous influx, or of releasing chemical mediators acting remotely. There are numerous receptors of this type, but they vary according to position, and above all to depth. According to Dr. Pistor (Its discoverer): "MESOTHERAPY IS NOT A DIFFERENT PARALLEL MEDICINE, MERELY A DIFFERENT WAY OF TREATING PEOPLE WHO ARE ILL AND/OR OF INTRODUCING MEDICINES INTO THE BODY, CLOSELY EVALUATING WHAT IS TO BE ADMINISTERED ". THE EFFECTS OF MESOTHERAPY: THE LOCAL EFFECT It is quite logical that a product, depending solely on its composition, carries out its action in the place where, or at the level at which, it is injected. LOCAL – REGIONAL EFFECT This refers to the deepest levels in the immediate area where the medicine is injected, duly reflected in the classic experiment of observing high concentrations of a medicine at the knee joint when it is injected superficially – intradermally (Mesotherapy) into the skin of same. REGIONAL EFFECT In some cases, it refers to the effects obtained in the specific metameric region corresponding to the injection area. In other cases, we inject the medicine at so-called "Trigger Points" in order to remedy the problem of a particular area. GENERAL EFFECT Obviously, mesotherapeutically injected medicines end up in the general circulatory system. Notwithstanding, it must be remembered that, on account of the specific characteristics of this method of administration, and its capacity to act as a reservoir, its passage through aforesaid system is minimal, as has been demonstrated by Le Coz. The passing into the general circulatory system of a medicine administered in this manner is four times less than if it had been administered by IM. Therefore, any undesirable side effects are minimised. SELECTION CRITERIA WITH RESPECT TO THE SUBSTANCES TO BE USED IN MESOTHERAPY. The medicines used in mesotherapy are selected empirically, either by simple and original extrapolation from the classic pharmacopoeia, or by clinical experimentation. Even so, before using any medicine mesotherapeutically, we need to make sure that it complies with a series of CRITERIA FOR USE, given that, the simple fact that the medicine or drug in question is marketed in an ampoule format, does not necessarily mean that is can be validly used according to mesotherapeutic practice. In fact, the majority of problems provoked by this technique are either as a result of administering medicines that do not fulfil the essential 10 commandments that we deem to be the “CRITERIA FOR USE”, or because their presentation in the ampoule format sees us drop our guard and simply confide in their condition as steriles for mesotherapeutic application. When we speak of Homeopathic Mesotherapy, we are stressing the large amount of products that are available on the market as “homeopathic medicines in sterile ampoules”, which in no way accredits their capacity to be injected, and which, therefore, we must systematically discard from our therapeutic arsenal, given that they must in no way be used mesotherapeutically. Consequently, all of the medicines that can be used in mesotherapy must comply with the following criteria, validating their fitness for use: 1.- THEY CAN ALL BE DISSOLVED IN WATER. The enable isotonic water solutions. 2.- ISOTONICS. Hypotonic or hypertonic solutions must be prohibited. They give rise to ionic disorders at a cellular level, and possibly tissue damage. 3.- PERFECT TOLERANCE IN SUBCUTANEOUS TISSUE (pH NEUTRAL). We are not speaking here only about the absence of pain, an important question in terms of the acceptance of the technique by the patient, but that the medicines must not cause either local or regional irritation. They must not provoke nodules, as for example in the repeated injections of insulin to which diabetics are subject. The absence of local necrosis. Vasoconstrictor products are prohibited in mesotherapy, given that they produce ischemic areas which give rise to tissue necrosis. They must not provoke tissue lysis, as happens with some corticoids which give rise to muscular and ligament lyses. They must not give rise to abscesses. This can be put down more to an accident due to contamination than due to the medicine itself. If the proper technical measures are taken, this condition is extremely rare in Mesotherapy. 4.- TOTAL INTEGRATION IN THE TISSUE Certain protean compounds cannot be administered mesotherapeutically given the fact that they are rejected by the tissues. 5.- THE COMPLETE ABSENCE OF ALLERGIES AND HYPERSENSITIVE PHENOMENA. Allergies to medicines represent 50% of the iatrogenic pathology in Mesotherapy. In this sense, an in-depth interrogation concerning the patient’s medical history is essential, although in Mesotherapy it is extremely difficult to accurately diagnose the product that gives rise to such sensitivity, given that normally mixtures of several medicines are used, and we might be up against a case of crossed sensitivity among same. 6.- NEVER USE OILY VEHICLES. AVOID GIVING RISE TO " POLYOLIC THROMBOSIS " We are referring here to some types of oily excipients. They are hydrosoluble, but are very dense. We must make sure of their complete miscibility in another product which will act as a vector before the injection, and ensure that no opalescence or iridescence occurs in the syringe on looking into same when held up to the light. 7.- PERFECT MUTUAL COMPATIBILITY: - TOTAL MISCIBILITY - ALWAYS THE SAME pH. - NEITHER PRECIPITACION NOR OPALESCENCE We will systematically discard any mixture in which we observe physical changes, precipitations, the forming of lumps, etc. 8.- THEY MUST NEVER INTERACT ANTAGONISTICALLY. Obviously, substances that cancel out the effects of each other must not be used. 9.- PERFECT SYNERGY OF THE ASSOCIATED MEDICINES. Whenever we use a mixture of medicines we must make sure that the effects of each one of the substances complement or boost that of the others. 10.- ACKNOWLEDGED EFFECTIVENESS.
RULES FOR THE USE OF MEDICINES 1. We will avoid medicinal "cocktails". We must avoid the association of several medicines in the same syringe, given that allergic or other interactive phenomena might appear, and we would not know which one is responsible for such reactions. More importantly, however, these unwanted reactions can arise as a response to the mixture itself, even when the different parts taken separately fail to produce any negative reaction. 2. The amount to be injected must of
necessity be the whole of the mixture prepared in the syringe. It is recommended
that a measure of 4cc. be administered in any given session.
MESOTHERAPEUTIC TECHNIQUES MANUAL MESOTHERAPY: The so-called “Lebel needle” is the needle used in mesotherapy. The most commonly used size is the 4mm. x 0.4mm. ( 27 G ) one, and the 13mm. x 0.3mm. (30 G) one. We do not recommend replacing the cap after the needle
has been used, given that we use safety bins in which we dispose of both
the needles and the syringes after they have been used in order to avoid
any risk to third parties (health care personnel, garbage collectors,
etc.).
MULTI-INJECTION SYSTEMS: There are numerous models and types of automatic, electronic, mechanical guns etc., available to us on the market to facilitate the practice of mesotherapy and to ensure the patient’s comfort. Below we remind you of the most popular ones: Multi-injectors The latter is the one I use in my sessions, given that I deem it to be the easiest to handle, the most robust, reliable and cost effective, in terms maintenance, that is available. MEDICINES IN MESOTHERAPY I am going to provide a short summary of the medicines that are most frequently used in Mesotherapy, their composition, indications and side effects. The majority of the ones mentioned are commonly used in medicine, but administered in other ways, consequently, information is readily available on them in any prescription vademecum. 1st.- SYMPATHICOLYTICS A) PROCAINE 1 and 2 % Properties: SYMPATHICOLYTIC ANALGESIC VASODILATAORY This depresses the release action of acetylcholine giving rise to a sympathetic ganglial block >>> vasodilatation. As an anaesthetic it acts by impeding the depolarisation of the axomal membrane after excitation, thus blocking the nervous pulse. It facilitates a FASTER, MORE COMPLETE, AND LONGER-LASTING diffusion of the antialgic agent. It is deemed to be the most important "THERAPEUTIC VECTOR" ( Le Coz ) It belongs to the Paraaminobenzoic group >>>>>> anaphylactic shock???? Pay special attention to the crossed sensitivities with sulphonamides and penecillins B) XYLOCAINE 0.5, 1 and 2 % Anaesthetic 4 times as powerful as Procaine Less allergenic. It is used as an antiarrhythmic. C) MESOCAINE This is a Lidocaine without the "Parahydroxybenzoate" group Free of allergenic problems. D) ETIDOCAINE Anaesthetic 6 times as powerful as Procaine Exclusively for hospital use. More toxic than Procaine. Without a "Para" molecular group, it does not give rise to allergies WHEN SHOULD WE USE PROCAINE , XYLOCAINE, or MESOCAINE? According to Le Coz: XYLOCAINE: Acute pathologies Expectant mothers Children under 3 years of age PROCAINE: Chronic pathologies MESOCAINE : Faced with any risk of allergy. 2nd.- VASOACTIVES A) PAPAVERINES PRAXILENE ( naftidrofuryl ) ( 6 - 12 amp. 5 cc.) Ordiz : Acrosyndromes, Vertigonous Syndrome, Acuphens B) BETA STIMULANTS Vasodilator effect Produces Tachycardia, increase in contractility and cardiac debt (Ordiz) DUVADILAN (Isoxuprine) For ophthalmologic problems ( Le Coz) C) BETA BLOCKERS PROPANOLOL (Sumial) For migraine crises It can provoke faints and may test positive in athletes ( Le Coz ) D) RYE ERGOT Vasodilator effect by passive mechanism (Ordiz) HYDERGINE (Ergotoxine ) It is used in Algodystrophies ( Le Coz ) ISKEDIL ( Dihydroergocristine + Raubasine ) SERMION and VARSON (Nicergoline) In acuphens and hypoacusias ( Le Coz ) DIHYDROERGOTAMINE Vasoregulator, in I.R.V. and varices. Very painful It is used in a very diluted form. The main side effect of these medicines is "ergotism", a vasoconstrictor effect which can give rise to necrosis in the extremities. ( Ordiz ). E) NICOTINE DERIVATIVES PYRIDYL - HEPARIN ( 4 amp. 3cc.) Monoethanolamide nicotinate 75 mg. Sodium heparinate 50 mg. Procaine 2 mg. Local anaesthetic + Peripheral vasodilator + Local anticoagulant Most frequently indicated for circulatory and rheumatic pathologies Side effects: Intense facial flushes and epigastralgia. It is linked to AINES in mesotherapeutic mixtures ( Ordiz ) F) OTHERS : LOFTON ( Buflomedil ) ( 5 amp. 5 cc.) Papaverine + Alpha adrenergic ?? Restores peripheral microcirculation on opening the precapillary sphincters. Side effects: Intense flushing in the extremities + Fainting ( Aznar ) LIPODISTROFIN : ( amp. 2 cc. ) Placenta + Vein + Secale + Tabacum + Funiculus Umbilicalis + Aesculus + Arteria + Barium + Vipera Berus + Juglans + Fumaria + Sepia + Pulsatilla Regulator of peripheral circulatory disorders. 3º.- VENOTROPES Y LYMPHOTONICS ESBERIVEN ( amp. 2 cc.) Melilotus extract 200 mg. Hydrosoluble rutin 50 mg In a hydrosoluble excipient Actions : Anti-oedematous, Vasoprotector, Vasoconstrictor, Lymphokinetic, Reduces capillary permeability, Activates the return circulation. Indications: It is use a lot on cellulitis, Lymphedemas, Varices. On secondary oedemas to traumatisms ( Le Coz ) Side effects: Local intolerance in 27 % of patients ( Ordiz ) LIPODISTROFIN MULTI-POWERED HAMMAMELIS AESCULUS COMPOSITUM - MYOSOTIS COMPOSITUM 4th.- ANTI-CONTRACTURE NEURIPLEGE ( Clorproetazina ) ( Amp. 5 cc ) (Always dissolved accompanied by another substance. It is very hypertonic.) Neuroleptic phenothiazine Actions: Anti-contracture, Vasodilator, Antidystonic - Neurovegetative, Hypotensor – vagal effect block. Indications: Traumatology, rheumatology. As a micro-relaxant. Dupuytren Used in neuro – vegetative dystonia and somatizations ( Pichard ) Precautions - interactions: Precipitates with Pyridyl – Heparin and with Conjonctyl Precipitates with AINES Allergic reactions to phenothiazines have been described ( Ordiz ) COLTRAMYL ( Thiocolchicoside ) ( 6 amp. 2 cc.) Actions: Powerful myorelaxant. Acts both peripherally and centrally. Indications: Muscular contractions. Lumbalgias. Dysmenorrheas. Precautions - interactions: It can be linked with AINES VALIUM ( Diazepam ) ( 6 amp. 10 cc ) This is hardly ever used because of the fact that it precipitates with numerous mixtures (L. Barri) 5th.- ANTI-INFLAMMATORIES ORUDIS ( Ketoprofen ) ( 6 amp. 2 cc ) Action: Inhibits prostaglandin synthesis Inhibition of platelet aggregation. Indications: More as an analgesic than as an anti-inflammatory One of the AINES ( Anti-inflammatory – Anti-rheumatic - Analgesic – Antipyretic) Precautions - interactions: Mix with 5 cc of Xylocaine to 1 % or Mesocaine 1% VOLTAREN ( Diclofenac ) ( 6 amp. 3 cc ) Action: Prostaglandin inhibition Reduces capillary permeability of the of inflamed tissue Inhibitor of hyaluronidase produced by germs Indications: Those of the AINES ( Anti-inflammatory – Anti-rheumatic - Analgesic ) Precautions - Interactions : Always dilute it. The propylene glycol can cause necrosis. pH incompatibility with Procaine and Lidocaine, given that they precipitate when mixed. It is normally used in a mixture with Pyridyl – Heparin and with Coltramyl (Thiocolchicoside) as an Anti-contracture agent. Do not use in allergies to AAS FELDENE ( Piroxicam ) ( 6 amp. 1 cc ) Actions : Prostaglandin inhibition on inhibiting the cyclooxigenase Reduction of the rheumatoid factor in the synovial liquid. Indications : Those of the AINES ( Anti-inflammatory – Anti-rheumatic - Analgesic ) Precautions - Interactions : Produces itching, dilute it in twice its volume (Le Coz) Incompatibility with Neuriplege. TILCOTIL (Tenoxicam ) ( 20 mg lyophilised) Actions : Inhibitor of the prostaglandin synthesis. Indications : Those of the AINES ( Anti-inflammatory – Anti-rheumatic - Analgesic ) Indicated more for acute post-traumatic complaints: tendonitis, sprains, etc. (Ordiz) Precautions - Interactions : Compatible with Mesocaine 0.5%; Pyridyl - Heparin ; Coltramyl ; Valium Incompatible with Xylocaine, Procaine and Neuriplege ( Le Coz ) INYESPRIN ( lysine acetyl salicylate) ( lyophilised) Actions : Analgesic – Anti-inflammatory Indications : Rheumatic and traumatological processes Precautions - Interactions : Allergic to AAS The injection is very painful. It must be administered with an anaesthetic ( Le Coz ) CONDRODISTROFIN (Homeopathic ) ( Amp. 2 cc ) Composition : Formic Acid D 11, Rhus Toxicodendrum D 4, D 6 ; Bryonia D 4; Arnica D4; Spirea Ulmaria D 4; Cartilage Suis D 8; Aconitum D 4. Actions : Antialgic, Anti-inflammatory, Anti-rheumatic, Anti-oedematous. Anti-contracture. Indications : Rheumatic processes. Painful joint syndromes. Traumatisms. Cuts, Bruises. Chondropathias. Osteochondrosis, Neuralgias. Precautions - Interactions : None 6th.- PROTEOLYTIC ENZYMES THIOMUCASE ( 5 vials of100 TRU ) Actions : Depolymerisation of the mucopolysaccharides Indications : As an adjuvant in the treatment of rheumatological injuries, traumatology, urology, sports medicine, etc. It is used quite frequently in anti-cellulitic cocktails. Precautions - Interactions : Alcohol degrades the product It works well with Voltaren ( Le Coz ) It is related to allergic reactions in 47% of same ( Ordiz ) The may decrease mixing it with Polaramine ( Le Coz ) 7th.- VACCINATIONS DIVASTA ( This can only be obtained in concentrations of 2000 germs in Stallergènes laboratories) RIBOMUNYL ( 1 vial + Procaine or Lidocaine ) Actions : Stimulation immunotherapy Indications : Recurrent infections. Recurrent acne In rheumatology: Ankolysing spondilitis ( Le Coz ) Precautions - Interactions : Local intense reactions Pseudo-flu symptoms lasting from 24 hours to 48 hours. 8th.- BIOLOGICS IODO – GLUTHATHIONE VITAMIN B-1.2 % Actions : Slight but sustained vasodilatation Indications : Osteoparthritis Precautions - Interactions : Painful injection. Extremely unpleasant smell that remains on being eliminated by perspiration It may cause thyroid problems in the medium term ( Ordiz ) ONTOSEIN and PEROXINORM ( Orgotein ) ( 4 and 8 mg / vial ) It is the superoxide dismutase of the bovine liver Action : Neutralises the superoxide radicals in the inflammation. Indications : Joint inflammations of the rheumatic type Stretch marks RUMALON ( Proteoglycans ) Unfortunately, this is no longer being manufactured 9th.- HORMONES PIG CALCITONIN: STAPOROS and CALCITAR SALMON CALCITONIN: CALSYNAR SYNTHETIC EEL CALCITONIN: ELCATONIN SYNTHETIC HUMAN CALCITONIN: CIBACALCIN Actions : Anti-hypocalcemic, Anti-osteoclastic. Antialgic, vasodilatory and anti-inflammatory Indications : Osteoparthritis. Paget’s disease. Osteoporosis. Sports injuries. Precautions - Interactions : It is incompatible with Procaine, Neuriplege, and Coltramyl. Mixture with AINES is not recommended 10th.- EUTROPHICS PLACENTA LUCCHINI Little used nowadays. It is a biologically active product. X - ADN Ampoules containing Procaine + vitamins Vial containing desoxyribonuclease lyophilised sodium 60 mg. (This is what is normally used) Actions : Governs protein synthesis ( Parienti ) Indications : Keloids. Slow healing. Post-traumatic ulcers Fine facial wrinkling. BLASTOESTIMULINA ( Asian crowfoot 25 mg. ) Actions : Stimulates fibroblasts and the healing of conjunctival tissue (Parienti) Indications : Delayed healing. Keloids. Hypertrophic scars Precautions - Interactions : Extremely iatrogenic polyolic excipient: necrosis ( Ordiz ) We must ensure good aa miscibility in another solvent ( Procaine ) 11th.- LIPOLYTICS TIRATRICOL ( TRIAC ) ( amp. 5 cc. ) Action : Phosphodiesterase inhibitor Indications : Localised obesity Precautions - Interactions : Forming of anti-triiodothyronine. Local intolerances CONJONCTYL ( Methylsilanetriol salicylate ) ( Amp. 10 cc.) Actions : Induces fibroblastic proliferation Regenerator of elastin and collagen fibres Lipolytic inducer of the AMP c synthesis. Indications : Anti-cellulitic. Stretch marks. Skin ageing. Precautions - Interactions : Contra-indicated in patients allergic to AAS It must not be mixed with destructuring enzymes (thiomucases) EUFILINA (Aminophylline ) ( Amp. 10 cc.) Actions : Phosphodiesterase inhibitor Indications : Cellulitis. Localised obesity Precautions - Interactions: Precaution in cardiopathic patients. (Corbel) Undesirable digestive effects. ( Corbel ) It used to be used a lot more because of its lipolytic effect At present, it is practically only used topically CHOPHYTOL (Cynara scolymus extract ) ( Amp. 5 cc. ) Action Aids in the synthesis of NADP - NADPH2 coenzymes,
exercising control of lipolysis. ( Corbel ) Indications : cellulitis. Obesity. Constipation. Precautions - Interactions : This is a very safe medicine. METABOLITES ( Graphites D-10, D-30, D-200 / Fucus vesiculosus D-6/
ATP D-8 / Action : Direct lipolytic. Phosphodiesterase inhibitor. Constitutional tendency to adiposis. Indications : General and localised obesity Cellulitis. Constipation. Precautions - Interactions : Given that it is a homeopathic product, it is devoid of contraindications or interactions. COENZYME A : Co - A 1000 Actions : Favours neoglycogenesis Catabolism of the Lipids and degradation of fatty acids ( Corbel ) Cell regenerator Indications : Osteoparthritis. Uric gout ( Corbel ) Cellulitis. 12th.- ANTIBIOTICS GEVRAMYCIN ( Gentamicin sulphate) VIBRACINA ( Doxycycline ) Used in mesotherapeutic treatments of iatrogenic infections ( Ordiz ) Treatment of acne and anthrax ( L. Barri ) CLINDAMYCIN The treatment of microbial alopecia ( L. Barri ) BLEOMYCIN In anti-wart and keratoacanthoma treatments ( L. Barri ) It should not be used on pregnant women or immunodepressive patients 13th.- VITAMINS BENERVA ( Vitamin B-1 ) and B-12 LATINO DEPOT Actions: Analgesics Indications : Neuritis. Pinched nerves. Sciatica Precautions - Interactions : They are very painful. SIDE EFFECTS: PAIN: This has no further consequences than the mechanical pain felt as a result of the puncture or injection itself. Attempts have been to minimise this with numerous superficial anaesthetics, however, the results have not been very satisfactory. We prefer to employ distraction techniques, as well as using the 30 G needle, which is less traumatic. What we are more concerned about, however, is an incorrect
medicinal mixture, either with a non-physiological pH, or one with vasoconstrictor
products, or by a clumsily applied technique. ERYTHEMA : We can come across anything from commonplace erythemas merely provoked by the puncturing, in excessively labile, to cutaneous necrosis, not to mention extremely serious allergic reactions that could trigger of cardio-respiratory failures. Neither is there any justification whatsoever in Mesotherapy for a medicine to provoke any moderately serious erythema. VAGAL REACTIONS: We come across these in very nervous, fainthearted, or jumpy patients. The mere sight of the needle can give rise to profuse perspiration and dizziness. Consequently, it is a good idea to carry out the mesotherapeutic session with the patient lying down. NERVE AND VESSEL INJURIES: In some areas, these occur on account of the anatomical proximity of same, or when we carry out the treatment too quickly, or as a result of the reflex movements of a nervous patient. They can arise in temporal, epitrochlear and peri-varicose areas. HAEMATOMAS: This is quite a frequent phenomenon in mesotherapy. If it is due to the technique, we are being told that the puncture is too deep. If it is due to the medicine, this is dangerous, because it is telling us that some coagulation parameter has been altered. These should not be ignored, no matter how small they are. We should not only focus on the aesthetic consequence produced, but should also bear in mind that they could give rise to serious consequences, given that they are an ideal ground for the cultivation of many germs. No medication must provoke hematomas in Mesotherapy. CUTANEOUS NECROSIS. Along with allergic shock, this is the most feared side effect in mesotherapy. It may have a chemical origin (Very dense products, some AINES, Depolymerising enzymes, Mucopolysaccharidases, Cocktails made up of too many medicines, etc.) or biological, which worsens its consequences. It begins with a grey-brown papule, which ulcerates and a purulent transudate appears where the patient was injected, which later spreads with injuries appearing at a certain distance from this point. Histologically speaking we are dealing here with a tuberculoid granuloma. The best way to avoid such situations is to employ a correct technique, a suitable asepsis, to disinfect the skin and to use medicines that we know to comply with the Criteria for Use for this method of administration.
INTRODUCTION The number of doctors showing an interest in homeopathy
and who are practising it is steadily increasing, as attested to by the
fact that, in Europe alone, nearly 30 million people use homeopathic medicines. A definition of homeopathy: The term "homeopathy", which comes from two Greek words: homeos (similar) and phatos (suffering), defines a therapeutic method based on the principle of similitude, which expresses the possibility of treating illnesses with minute doses of those substances that, in proportioned dosages, can give rise in healthy individuals to pathological symptoms similar to that of the illness being treated. BASIC PRINCIPLES OF HOMEOPATHY The principle of similitude. Treatment according to the similium, expressed in Latin by the phrase "simila similibus curantur" (like cures like), is the homeopathic principle par excellence. Treatment according to the contrarium, is defined by the Latin phrase "contraria contrariis curantur" (opposites cure opposites), which implies treating the illnesses by means of remedies contrary to the symptoms. This form of treatment is also known as allopathy (alos, coming from the Greek word for other or contrary). Oddly enough, even though Hippocrates is considered to be the father of medicine, this has traditionally had a development much more influenced by the principle of contraries. This is why, in homeopathy the term allopathy has been coined to refer to conventional medicinal therapy. In 1790, while Hahnemann was translating the book ‘Materia Medica’ by the Scotsman, Cullen, from English to German, he noticed that in several chapters of this book contradictory information appeared on the action of Peruvian bark. Hahnemann, carrying out an experiment on himself in an attempt to learn of its true action found that this bark, used in the treatment of malaria, produced similar feverish symptoms in him as those suffered by patients with this disease. Relating this fact to the "similia similibus curantur" principle, he put forward the idea that a substance which produces certain symptoms in a healthy person, could cure a combination of similar symptoms in a sick person. In order to verify his hypothesis, Hahnemann had to determine the set of symptoms that several medicinal substances available during his time (aconite, quinine, belladonna, etc.) provoked in healthy individuals, in order to later use said substances as medicines for the diseases that revealed similar disorders to those found in the experiments carried out with these subjects. In other words, Hahnemann carried out two types of experimental
studies: Minute dosage At first, the second group of experiments presented Hahnemann with a difficult problem: the substances corresponding to the symptoms of the patient tended to worsen his or her disorders, sometimes intolerably, before any improvement was produced. These reactions were logical, given that the patient took a substance that could reproduce their symptomatology. In an attempt to overcome the intensity of said reactions
he gradually reduced, by means of successive dilutions, the dosage to
be administered, reaching the conclusion that minimal quantities (minute)
maintained their curative activity without giving rise to any undesirable
effects. In order to understand the latter, it must be explained that, for Hahnemann, the symptoms of a disease expressed the resistance of the body to same. This interpretation does not seem to lack sense, given that it coincides with the present consideration of the symptoms as defences of the body that try to protect and cure it. Therefore, if a substance is known that gives rise symptoms
similar to those of a particular disease in healthy individuals and, consequently,
also induces similar defence or resistance mechanisms, the therapeutic
agent of same can be said substance in a minute dose. Once the basic principles of homeopathy have been explained and have been demonstrated in experiments, as well as Hahnemann’s concept of disease, a more complete definition of homeopathy may be proposed, such as: "a therapeutic method based on the stimulation of the body’s own defence systems and one which employs a microdose of those substances which, in healthy people, can give rise to the same problems as those to be treated". There is a pathogenic, experimental or toxicological symptom described for every homeopathic medicine, which may prove to be similar to certain diseases. This possible similarity is that which must be established by the doctor, after taking an in-depth look at the patient’s medical history, in order to be able to prescribe the most specific medicine. Notwithstanding, quite often the most characteristic set of symptoms of a disease is not described within the pathogenic properties of a single homeopathic medicine. This is the reason why it can be necessary to resort to the prescription of more than one homeopathic medicine, or to the medicinal associations (compound homeopathic medicines). With respect to medicinal associations, it must be remembered that, back in 1910, Emil Bürgi, lecturer of pharmacology at the University of Berne (Switzerland), had already shown that two different medicines, of an equal or similar action, on being combined, produce additive effects, greater than the simple sum of the two medicines individually; that is to say, their effects are boosted even more when their points of action are different. What is more, Bürgi managed to show that minimal doses of virtually inactive individual medicinal substances can show an increase in their effectiveness when they are combined. This latter point can be applied to compound homeopathic medicines.
HOMEOPATHIC MEDICINES Preparation: The raw materials used in the preparation of homeopathic medicines can come from a vegetable, animal, mineral or chemical sources, although it is the vegetable kingdom from which over half of same are obtained. There are two basic processes employed in order to obtain the microdoses: dilution and dynamisation. Dynamisation is defined as the process of endowing a solution with series of succussions or energetic shakings. The dilution process, is explained in a summarised fashion below. The mother tinctures (M.T.) are obtained from vegetable substances and some animals. These tinctures and the products, which are soluble, are later diluted in a hydroalcohol mixture or bidistilled water. - dilutions in a proportion of 1/10, so-called decimals and represented by the abbreviation D, DH. - dilutions in a proportion of 1/100, so-called centesimals, and represented by the abbreviations C or CH. In practical terms: by taking a part of mother tincture (M.T.) and mixing it (dilution) with nine parts of a water or hydroalcohol solution, and subsequently shaking it quite energetically (dynamisation), the first Hahnemann decimal dilution is obtained (1st DH). If a part of this 1st DH is taken and is mixed and dynamised with another nine parts of a water or hydroalcohol solution, we get the second Hahnemann decimal dilution ( 2nd DH ), and thus successively, in order to obtain the following dilutions. The process for centesimals is exactly the same as the one for decimals, the only variation being the obvious difference in the dilution proportions , which in this case will be 1/100 (one part of the M.T. or of the previous dilution to 99 parts of water or alcohol). PHARMACOLOGICAL PECULIARITIES We will be unable to understand the homeopathic therapy if we do not accept a series of peculiarities proper to all homeopathic medicines, which in turn makes them different to conventional allopathic medicines: The homeopathic medicine is completely lacking in toxicity, there is no possibility of allergies or undesirable side effects being provoked. Their action is not of the chemical type, but energetic in nature. We cannot establish Dosage / Response curves. In Allopathy, the response that is provoked by a medicine on an individual is directly influenced by the concentration, given that in all cases there is a Dosage / Response relationship. The activity of homeopathic remedies is produced within the context of the generation in the diseased body of a specific biological stimulation in the patient who, in accordance with his or her response mechanism, reacts against the disease, eliminating the pathological condition along with all of its symptoms. Pharmacodynamic monitoring cannot be carried out on a homeopathic medicine, given the non-chemical character of same. The homeopathic medicine does not act quantitatively, but qualitatively.
|
