Abstract
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.
Keywords
conjugated bilirubin - unconjugated bilirubin - homeopathic repertory - jaundice -
cholestasis - urine bile
