Why Arsenicum album 30 Needs to be Supplemented?: an Opinion Letter

Prof. Dr. Ravi M. Nair Thiruvananthapuram, Kerala Prof. Dr. Asok Kumar Das Kolkata, West Bengal

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Editor's Note

Through this open letter Dr. Das asserts on the use of antimiasmatic trio of Arsenicum album 30 –Phosphorus 30-Tuberculinum 200 in series for prevention of recurrence of COVID-19. This paper suggests that long acting complementary medicine(s) with miasmatic consideration should be considered according to the homoeopathic principles to supplement Arsenicum album further for producing more strong and long term beneficial effects.

The Arsenicum album 30 as a homoeopathic preventive for COVID-19 was announced by the Ministry of AYUSH, Govt. of India on 29th January as advisory being recommended by Scientific Advisory Board, CCRH on 28th January, 2020. India reported the first confirmed case of the coronavirus infection on 30 January, 2020 in the state of Kerala.

Considering the available symptomatology of the disease from the authentic sources like WHO, CDC, Chinese report, revised guidelines on clinical management of COVID-19 published by the Government of India (although common), pathogenesis of this disease, the present scenario of non- availability of symptom picture from homoeopathic point of view along with the current situation of fear and anxiety among the population, the selection of Arsenicum album 30 from clinical angle as a pathological similar medicine to prevent COVID-19 by the Scientific Advisory Board of CCRH and thus recommended by the Ministry of AYUSH, Govt. of India is justified, rational and timely.Many people of our country and the homeopathic physicians followed this advisory. It is observed and reported that those who have taken Arsenicum album 30 are not affected by COVID-19. In fact, Homoeopathy become more popularized through Arsenicum album as an advisory to prevent COVID-19 and thus highlighting the scope of Homoeopathy in preventing such a contagious pandemic in its right perspectives and timely decision, for which SAB Chairman, members and DG, CCRH should be appreciated.

Afterwards many new observations regarding the nature of SARS-CoV2 and COVID-19 have published. It is reported that those who have taken Arsenicum album are not affected by COVID-19. But the tremendous increased case of COVID-19 positive cases in our country indicates that Arsenicum album alone will not be sufficient to prevent the present pandemic for a long time. Some long acting complementary medicine(s) with miasmatic consideration should be considered according to the homoeopathic principles to supplement Arsenicum album further for producing more strong and long term beneficial effects. The various reasons are as follows:

1. Arsenicum album was suggested on the basis of symptomatology prevalent at that time in other countries following homoeopathic principles, when the number of COVID-19 positive cases in our country was nil. With the progress of time, many new symptoms (including their prevalence rate) have observed in India. So we need to suggest some medicine(s) which covers the symptomatology of COVID-19 in Indian context.
2. According to Homoeopathy, COVID-19 is an acute disease of epidemic type caused by acute miasm (recurring or nonrecurring/ fixed miasm).
3. We need to live with COVID-19, as remarked by W.H.O.
4. In some patients COVID-19 has recurred.
5. Italian scientist observed that the patients of COVID -19 died from disseminated intravascular coagulation. Phosphorus is a medicine which prevents coagulation. Moreover it is the second indicated drug in repertorization and complementary to Arsenicum album particularly in respiratory diseases.
6. Effects of BCG vaccination on COVID-19

All the above factors led us to think some other homoeopathic approach which may be suitable to prevent the disease. In this context we followed the approach of using complimentary antimiasmatic trio which was successful to prevent Japanese Encephalitis completely in Andhra Pradesh and Kerala. In case of Japanese encephalitis, initially Belladonna alone failed to prevent the recurrence of this disease, but when Belladonna was supplemented by Calcarea carb and Tuberculinum, this complimentary antimiasmatic trio successfully prevented the recurrence of this disease. The same principle/approach is followed to prevent COVID 19 also.

In preventing COVID -19, we suggested Arsenicum album 30 –Phosphorus 30-Tuberculinum 200 in series, all of which are complementary to each other and also fitted the miasmatic nature of this disease. Strong, long lasting beneficial effects along with prevention of recurrence can only be obtained by complimentary antimiasmatic medicines as per homoeopathic principles. Hence there is an urgent need to supplement Arsenicum album by APT in series, a complimentary antimiasmatic trio considering the nature of the causative virus, the disease and symptomatology of COVID-19 in our country.

Repetition is needed in case of Arsenicum album till the problem continues in the community. But no repetition is essential in case of APT trio -another advantage. Moreover, it is reported by the medical scientists that SARS Cov2 is changing their character through mutation.

The homoeopathic antimiasmatic approach of prevention of diseases is not specific to the causative pathogen. So it will be effective not only to prevent COVID-19 itself, its mutated strain, but also to prevent any other new virus yet to come in future by improving health status.

Hence, there is an urgent need to follow APT trio in series supplementing Arsenicum album 30 to prevent COVID-19 in our country as follows:

1. Arsenicum album 30 - 4 globules to be taken at morning in empty stomach for three consecutive days.
2. After 15 days – Phosphorus 30 - 4 globules to be taken at morning in empty stomach for three consecutive days.
3. Then after 15 days Tuberculinum 200 - 4 globules to be taken at morning in empty stomach for two consecutive days.

The above intervention protocol was approved by the CCRH and the "Interdisciplinary AYUSH Research and Development Task Force" consisting of 17 members from various research organizations like ICMR, DBT, CSIR, UGC etc. constituted by the Ministry of AYUSH for research study relating to COVID-19.

But the clinical trial needs a lot of time to complete the different administrative and regulatory formalities initially and then the study, especially in this present pandemic situation. Moreover, homoeopathic practice both preventive and curative is not based on clinical trial, but on homoeopathic principles. The clinical trial in Homoeopathy is essential only to assess the claim scientifically. Even the first advisory of Arsenicum album was recommended not on the basis of clinical trial, but on the basis of homoeopathic principles.

Justification for selecting Arsenicum album, Phosphorus and Tuberculinum as preventive for COVID-19

Points in favour of Arsenicum Album

1. All the available symptomatology of the disease from the authentic sources like WHO, CDC, Chinese report, Indian report as published by the Government of India (although common) – first drug through repertorization
2. Sphere of action, pathogenesis of this disease involving both upper respiratory and lower respiratory tract.
3. Current situation of fear and anxiety among the population
4. Long clinical experience in the use of this medicine in different diseases of respiratory system.
5. In absence of characteristic symptom picture of the present epidemic from homoeopathic angle

On the basis of the above, the Arsenicum album is selected from clinical angle as a pathological similar medicine to prevent COVID-19

Points in favor of Phosphorus

1. Second indicated medicine on the basis of all the available symptomatology of the disease as above.
2. Sphere of action mostly on lower respiratory tract and pathogenesis of this disease.
3. Usually may be indicated at later stage of the disease when complications like pneumonia develop.
4. Tubercular diathesis more prevalent in Indian population– persons of tubercular diathesis is more prone to develop cough and cold with complications (syphilis miasm).
5. In absence of characteristic symptom picture of the present epidemic from homoeopathic angle.
6. Antihaemorragic diathesis.
7. Phosphorus is complementary to Arsenicum album

On the basis of the above, Phosphorus appears to be second indicated medicine which may be used to complement Arsenicum album.

Points in favor of Tuberculinum

1. A deep acting constitutional medicine to prevent different diseases including respiratory diseases, thus boost up the general immunity.
2. From miasmatic point, the symptomatology of the present epidemic of COVID-19 appears tubercular nature of the disease.
3. Persons of tubercular diathesis are more prone to develop respiratory diseases with complications.
4. Tuberculinum is complementary to Phosphorus.
5. Proved efficacy of Tuberculinum in preventing viral diseases like Japanese encephalitis min Andhra Pradesh and Kerala.
6. New finding of US scientists about BCG vaccine. "We found that countries without universal policies of BCG vaccination, such as Italy, Netherlands, and the United States, have been more severely affected compared to countries with universal and long-standing BCG policies" The source material for the preparation of BCG and homoeopathic medicine Tuberculinum is the same, only method of preparation differs.

So Tuberculinum may have the potentiality to be useful in COVID-19 cases by boosting up the general immunity of the person. In the Japanese encephalitis, Govt. of Andhra Pradesh used BCT (Belladonna, Calc. Carb, Tuberculinum) on the same analogy and could successfully control the Epidemic. Many more research findings are being published recently showing the relation between Tuberculosis, BCG vaccination and COVID-19 and thus supports our selection of Tuberculinum as a medicine in our complimentary trio. Today India has recorded 55079 coronavirus cases in the past 24 hours, taking its total past the 2.7 million mark to touch 2703517. With 880 fatalities reported on Monday (17th. August, 20), the country's death toll has surged to 51025. India, the third-most-affected country by total cases and fourth by death toll, has added 431,983 cases in the past 7 days alone. It has left even the US and Brazil behind in seven-day average of daily new coronavirus cases.

Keeping in view the above painful scenario in our country, it is not reasonable to wait for the clinical trial outcome. Life is more precious than science.

The APT protocol, a complimentary antimiasmatic trio is completely based on sound homoeopathic principles, absolutely safe, simple, economic, affordable to all, easily available everywhere, applicable and acceptable to all. Only Rs. 10/- (maximum) as a cost of these three medicines for one person can have the potentiality to prevent COVID-19 and related morbidity and mortality.

Since 27th March, 2020 we have tried heart and soul on humanitarian ground to draw the attention of the Govt. of India, different State Governments and other Health Authorities, CCRH regarding the scope of Homoeopathy in treatment and prevention of COVID-19 to save the lives of our people considering it a moral duty as homoeopathic physician, but ultimately failed.

Under the above situation, we are constrained to file a Writ Petition in the nature of PIL (Public Interest Litigation) having the following prayers before the Honorable Supreme Court of India to save the lives of our people on 5th. August, 2020 having the No W.P. (C) 808/2020.

1. To notify Arsenicum album – Phosphorus – Tuberculinum (APT) in series intervention protocol as second advisory supplementing the Arsenicum album;
2. To allow homoeopathic practitioners to treat mild cases of COVID-19 by homoeopathic medicines stand-alone, and for severe cases to critical cases as add-on therapy with allopathic medicine in hospitals if desired by the patient and/ or the party;
3. To undertake this clinical trial simultaneously on Arsenicum album – Phosphorus – Tuberculinum (APT) in series intervention protocol to prevent COVID-19 as approved immediately and to complete it within a fixed time frame by CCRH having adequate expertise and resources;
4. To prepare a homoeopathic nosode from SARS-CoV2 on urgent basis in collaboration with other scientific organizations having the potentiality of being used in the prevention of COVID-19 and in the treatment of other diseases following homoeopathic principles.

Now we request to all our professional colleagues, students, friends and homoeopathic lovers to follow this Arsenic-Phosphorus-Tuberculinum in series protocol and to disseminate this information of intervention to every corners of our country to save the lives of the people.