The holistic principle is based on the dictum "the Whole is greater than the sum of its parts", as opposed to the reductionist antithesis "the Whole - its unique properties - can be ultimately and completely reduced to the properties of its parts". The concept of the Whole in biology is usually associated with the morphological level. Then, in the frame of the dominating reductionist analysis, the "macroproperties" of the Whole are totally determined by the "microproperties" of its respective parts (portions, components, constituents, fractions, ingredients, elements etc.) expressed on the corresponding subordinate levels: cellular and, in turn, molecular. Hence, the causation is realized according to the down-up (bottom-top) principle, i.e. the living systems’ manifestations are totally reducible to the physical fundamentals. As opposed to that, according to the holistic principle, there is an unsplittable "something" which is associated only with the "complete" Whole. If the holistic principle is expressed by the vitalistic glossary, such "something" can be considered as an "extra ingredient" additional to the known physical fundamentals. The theory of biological field by A. Gurwitsch, non-reducible to any known physical fields, is an attempt to impart to the concept of Whole the ontological meaning. The strictly defined postulates of the Gurwitschian field have ontological and epistemological meaning and would be a powerful tool for scientific exploration of biological phenomenology (including the enigmatic problem of consciousness) according to the up-down (top-bottom) principle of causation.

DOES AN "ACTIVE" HUMAN EAR REFLEX POINT HAVE ITS SPECIFIC   ULTRASTRUCTURE?
L. Malinovsky, Prof., MD, PhD, E. Dvorkin, MD, R. Stepanov, MD, PhD,
J. Hanzlova, MD, I. Mayer, MD, G. Felman, MD, G. Dubinsky, PhD,
A. Shoutko, Prof., MD, PhD
Reported at the ICCAAAM Conference, Las Vegas, USA, August 12-15, 1999
From the Malinovsky International Research Group for Auricular Points Morphology (In honor of the late Prof. Lubomir Malinovsky who passed away April 1, 1997)
Reprint requests: Dr. E. Dvorkin, P.O.Box 3167 Bat-Yam, 59131 Israel,
e-mail: ijam@netvision.net.il
Tel/Fax: 972-3-5065616

In this report, the results of a study of the "live" ("active") ear reflex points ultrastructure are represented. Small pieces of auricle skin were taken from healthy tissue at the surgical edges of the specimen corresponding to the ear reflex points. Those points were detected before surgery, using vascular autonomic signal and verified by electron detection. The surgical material from the four patients was fixed, treated in the usual way, and examined with light and electron microscopy.
Light microscopy examination of semithin sections of all the studied zones was important in order to gain general information. There were found thick nerve bundles with myelinated and non-myelinated fibers, numerous thick vessels, and hair follicles. In our opinion, Heine's collagen bodies are mere collagen fibers knots without a demarcation from their surroundings.
Electron microscopy examination of ultrathin sections of all the studied zones revealed the following findings:
1. Thick nerve bundles with myelinated as well as non-myelinated nerve fibers resembling "penicillate structures".
2. Solitary thin bundles of non-myelinated nerve fibers.
3. Mast cells were found in all zones, either solitary or in small groups, often related to blood vessels and nerves. Direct innervation of these cells was not observed. The cells contain different forms of numerous dark granules, small clear vesicles, vacuoles and some organelles. Mast cells of all the studied zones do not differ in their ultrastructure.
4. Numerous veins without innervation.
5. Solitary arteries without innervation.
6. A rich occurrence of somatic hairs with assumed sensory innervation.
7. No significant ultrastructural differences were found between active ear reflex points and their nearest surroundings, as well as free skin sample. Our findings agree with those of some animal studies (in rabbits, rats, and dogs). Does a "live" ("active") ear reflex point have its own morphological substratum?
No specific ultrastructure was found in this study. In summation, at the risk of reaching hasty conclusions, our group is uncertain at this time of the existence of a unique ear reflex point ultrastructure, and leans more towards the conclusion that structure of these points are merely a temporary structure. We prefer to continue further research in the field.

NEW WAYS TO DOCUMENT VAS USING NOVEL FDA-APPROVED TECHNOLOGY: Historical view and perspectives.
E. Frinerman, MD, PhD
E. Wolfson Medical Center, Holon, Israel
Reported at the ICCAAAM Conference, Las Vegas, USA, August 12-15, 1999
Reprint requests: Dr. E.Frinerman, 3, Arlozorov Street, Bat-Yam, 59307 Israel

The Autonomic Vascular Signal (VAS) that was discovered by Paul Nogier in 1965 is a cornerstone of the auricular medicine.
There is no doubt, that VAS is an outstanding discovery of the 20th century and if documented and standardized, could change our knowledge both in vascular biology and physiology, as well as in medical practice. Nevertheless, a third of a century has passed, but VAS has not yet been assessed and standardized by FDA-approved technology. There is a paradox:
VAS is an outstanding discovery that is easily palpable, but can not be properly objectivated.

ANALGESIC EFFECT OF AURICULAR ACUPUNCTURE FOR NEOPLASM RELATED PAIN
D. Alimi, MD, E. Pichard-Leandri, MD, S. Fermand-Brule, PhD, C. Rubino, PhD
Reported at the ICCAAAM Conference, Las Vegas, USA, August 12-15, 1999
From the Gustave Roussy Institute, 39, rue Camille Desmoulins 94805 Villejuif Cedex France.
 
Introduction Cancer pain is a difficult problem for clinicians because analgesic drugs do not always relieve pain completely (1, 2). For a decade, auricular acupuncture has been part of the treatment of pain (3, 4). Its recent use for the treatment of cancer pain, as a complementary treatment to analgesic drugs when these are not sufficient is recent and must be evaluated.

We report here the results of auricular acupuncture in a series of twenty patients with cancer pain treated between July and November 1997 in the Service of Analgesia of Institut Gustave Roussy, a large cancer center in France. Patients and methods Twenty patients with cancer, still experiencing pain after a treatment with analgesics, were included in the study. Pain intensity was evaluated by a nurse on a Visual Analogue Scale (V.A.S.) both before the initiation of the drug treatment (initial D) and after at least one month of a stable treatment with World Health Organization level 2 or 3 analgesics (at DO). This stable analgesic treatment was continued after auriculotherapy. They all had to have a pain intensity of 30 mm or more at DO.

An electric chart of the ear was obtained for each patient by measuring the electrical potential of the skin at the points suspected to be pain's projected points on the ear, according to the clinical symptoms of the patient. Auriculotherapy treatment was then performed by inserting single-use sterile needles at points where an electrical potentiel had been detected.

A leaflet was given to each patient including an image of the ear where the points of insertion of each needle had been marked for him to report the dates when needles fell. This leaflet was also used to record the weekly consumption of analgesics used and the pain intensity measured weekly according to the VAS.

Pain intensity was evaluated by a nurse around D60 after auriculotherapy i.e. when the patients came back to the clinic for routine follow-up of their cancer.
The effectiveness of auricular acupuncture was measured by the difference in pain intensity evaluated on the VAS at D60 and at DO, and tested by a t-test. We also measured the correlation between pain intensity at DO and the value of the ear's skin electrical potential at the main auricular projection point of the pain (Spearman coefficient). Results Twenty patients were treated by auricular acupuncture between May and September 1997. Their average age was 54.3 with a standard deviation of 11.3. There were 11 cases of post-mastectomy brachial plexitis, 3 cases of post surgical trigeminus neuralgia, and 1 case each of vesical plexitis, neuropathic lingual neuralgia, superficial cervical plexus neuroma, right sinus neoplasm, cerebellar medulloblastoma with diffuse pain, and lingual neoplasm with radicular pain. The general health status on OMS scale was on "0" for 16 patients and on "1" for the four others. Pain appeared at time of neoplasm diagnosis for four patients and for the other 16 patients pain started after surgical treatment.

The average time between initial analgesic treatment (initial D) and auricular acupuncture (DO) was 4 months, with a range of 1 to 5 months. All the patients were treated with OMS level 2 analgesics and 2 patients received additionally morphin sulfates. At DO, the analgesic treatment had been stable for an average of 1.4 months (range 0.7 to 2.3 months). The initial pain as measured on the VAS was on average 76 mm (SD 16). At DO, pain intensity and the value of the ear's electrical potential at the main auricular projection point of the pain were correlated (r = 0.9, p < 10 -4). Needles used for auricular acupuncture felled between 5 and 35 days after auricular acupuncture. There was no significant variation between the initial pain and the pain at DO: the average at DO was 74 mm, and the variation between D initial and DO was on average 2 mm (standard error = 2, p = 0.16). Pain intensity decreased or remained stable after auricular acupuncture for every patient. The average pain intensity decreased by 33 mm (standard error = 5, p < 10 -5) between DO and D60. It is interesting to note that the improvement was not limited to the diminution of the pain. Patients improved after auricular acupuncture also said that they felt better and some felt well enough to suggest interrupting their analgesic treatment. Discussion The analgesic action of auricular acupuncture observed in this study, associated with the knowledge already acquired on this medical discipline (5-10, 12) encouraged us to design a randomized controlled trial with double placebo and independent observer. The protocol of this trial has been written and accepted by the Official Authorities. Its main objective is to evaluate the effectiveness of auricular acupuncture in the treatment of intensive and persistent neoplasm pains.


RHEUMATIC PAIN TREATMENT WITH WILLOW BARK (SALICIS   CORTEX)
S. Chrubasik, MD, PhD and P. Shvartzman, MD, PhD
From the Department of Family Medicine, Ben-Gurion University of the Negev, POBox 653, Beer-Sheva 84105, Israel

Salicin standardized extracts of Salix species bark are used for the treatment of rheumatic pain. The main active principles (salicylate derivatives) act via the inhibition of the eicosanoid biosynthesis, the cycloxygenase. Preparations from Salix species, the natural NSAID, contain a total of more than 1 % salicylates. Salicylate concentrations in the range causing analgesia are achieved with daily consumption of extract standardized at least on 240 mg Salicilin (ESCOP Monograph). Salicylate side-effects may occur during treatment. However, blood coagulation is less affected than with acetylsalicylate. and the occurrence of allergies is very rare. A randomized double-blind pilot study revealed significant analgesic effectiveness if Salix extract with 240 mg Salicin was consumed compared to placebo. A GCP study is presently running.
Key words: rheumatic pain, phytotherapy, salicis cortex

CELIAC DISEASE, LACTOSE INTOLERANCE AND HOMEOPATHY
D. Greilsammer, MD
Israel Medical College of Homeopathy, Jerusalem, Israel
Reprint requests:D. Greilsammer, MD, Harav Berlin 14/1, 92503 Jerusalem, Israel
 
Celiac disease and lactose intolerance are two multifactorial gastroenterologic diseases: genetic, immunologic and environmental. Evolutive medicine's explanations brings of their occurrence among different populations and environmental facts precise why they occur among homogenous group of people. Homeopathy, by taking into account the huge amount of sodium in our nutrition can add its explanations and its remedies.

Gluten intolerance and lactase deficiency are two diseases, which are usually associated in the textbooks of gastroenterology, first because they are due to two basic foods: bread and milk, secondly because they have in common signs of malabsorption, and finally because they have the same pathologic signs in the intestinal mucosa. 

I looked for more similarities between these two entities: first these two diseases are often associated, the patients suffering from celiac disease have frequently a lactose intolerance, secondly from an homeopathic point of view I was impressed by the fact that the remedies of these two diseases are frequently similar, finally because in the light of evolution cow milk and wheat gluten appeared late in human alimentation.