Abstract
Background: Typhoid fever is the result of systemic infection mainly by Salmonella typhi and S. Paratyphi A or B. The disease is clinically characterized by a typical continuous fever for 3 to 4 weeks , relatively bradycardia with involvement of lymphoid tissues and considerable constitutional symptoms . The disease may occur sporadically, epidemically, or endemically. Typhoid fever can easily spread and become a propagated epidemic. The global situation of epidemics needs concerted research from all systems of medicine. In Conventional system morbidity is considerable, and an increasing tendency to antibiotic resistance means that some cases are difficult to treat and end up in complications. There are a number of medicines cited in homeopathic literature which can be used as curative as well as prophylactic for typhoid fever. A study was undertaken to explore the usefulness of selected Genus epidemicus as curative and prophylactic medicine in typhoid fever.
Methodology: In this study 104 patients were screened out of which 30 were enrolled on the basis of clinical history, clinical signs and symptoms and investigations especially widal positive cases. Homeopathic Genus epidemicus "Arsenic album" was selected on the basis of totality of symptoms. Response to treatment was assessed on the behalf of widal test and improvement of symptoms presented.
Result: Arsenic alb (Genus epidemicus) had shown its curative as well as the preventive action.
Conclusion: The findings are encouraging to open avenues for further studies on using genus epidemicus for treatment and prevention of epidemic diseases.
Key words: Typhoid Fever, Homeoprophylaxis, Genus Epidemicus, Arsenicum album.
INTRODUCTION
Infectious diseases are still persisting as major health problem in spite of national programs for control of these diseases for almost half a century now.
Public health is concerned with disease prevention and control at population level, through organized efforts and informed choices of society organizations public and private communites and individuals.
The global situation of epidemics needs concerted research from all systems of medicine, Drug resistant strains of organisms are emerging which are variants of the existing strains of the infectious agents, are more virulent and cause a more severe form of the previous illness.
Homoeopathy is based on natural laws and so capable of preventing and curing all sorts of natural diseases. Homoeopathy stimulates the immune system to become stronger and to fight against disease. The homeopathic remedy will allow the vital force to immediately deal with any exposure to the agent. The remedy removes the impediments that otherwise would prevent the vital force from responding to the energetic challenge of an infectious disease.
In conventional system vaccination is given by introducing the living or weakened microbe in body, but homoeopathic remedies stimulate, arouse and upgrade Vital Force to an active and responsive stage.
Therefore, this study was done with the intention to, show the effectiveness of homoeopathy as both preventive and curative in epidemic diseases, by finding out genus epidemicus and testing this genus epidemicus on cases, as well as on persons who are not completely exposed, to disease but living in that area and are prone to disease.
METHODOLOGY
Patient and Settings
The study was conducted at the out patient department of SIR RONALD ROSS INSTITUTE OF TROPICAL AND COMMUNICABLE DISEASES [ FEVER HOSPITAL], at Nallakunta, HYDERABAD. The patients coming to the OPD were screened for Typhoid symptoms. Male and female patients of all age groups and different socio-economic status and occupation with clinically diagnosed cases of typhoid fever were enrolled in the study.
Patients with complication of enteric fever like bowel complications, septicemia etc. or the patients with any chronic disease on active treatment are excluded from the study. Patients underwent investigational screening (USG-whole abdomen and pelvis, electrocardiogram, kidney function test, liver function test, stool for occult blood, CBC and widal test) for ruling out exclusion criteria. Written informed consent was obtained from each patient before inclusion in the study.
A detailed case history was recorded in predesigned case taking proforma. The symptoms of all 104 patients were collected and recorded for analysis. The symptoms were analysed and repertorized by Boger Boenninghausen repertory. The final medicine was selected in consultation with materia medica. Arsenic album was found as the most suitable genus epidemicus.
Symptoms collected are -
| 1 | Symptoms | Presented in |
|---|---|---|
| 2 | Chills ascending | 16 persons |
| 3 | Chills descending | 43 persons |
| 4 | Chills from back to spine to upper part of body | 22 persons |
| 5 | Chills from abdomen | 03 persons |
| 6 | On drinking water chills | 11 persons |
| 7 | After drinking water chills | 06 persons |
| 8 | On eating food chills | 02 persons |
| 9 | Chills on putting the feet on the floor | 02 persons |
| 10 | Chills ameliorated by covering | 38 persons |
| 11 | Chills more at night time | 14 persons |
| 12 | Fever more at night time | 46 persons |
| 13 | Fever more at evening | 01 person |
| 14 | Fever more at afternoon and at night time | 01 person |
| 15 | Fever more in morning and evening | 01 person |
| 16 | Fever more at afternoon evening | 01 person |
| 17 | Fever more in afternoon | 01 person |
| 18 | Loose stools watery in consistency during fever | 01 person |
| 19 | Passage of stool immediately after eating during fever | 04 persons |
| 20 | Loose stools on drinking water in during fever | 01 persons |
| 21 | No passage of stools during fever | 02 persons |
| 22 | Nausea and vomiting during fever | 45 persons |
| 23 | Pain over head region during fever | 70 persons |
| 24 | Thirst decreased during fever | 32 persons |
| 25 | Thirst increased during fever | 10 persons |
| 26 | Appetite diminished during fever. | 50 persons |
| 27 | Sleep diminished during fever. | 52 persons |
| 28 | Weakness during fever | 55 persons |
| 29 | Pains all over body especially bone pains | 45 persons |
| 30 | Increased pulse during fever | 70 persons |
| 31 | Cough with greenish yellow expectoration during fever | 01 person |
| 32 | Cough with white expectoration during fever. | 08 persons |
| 33 | Cough with green white expectoration during fever | 03 persons |
| 34 | Cough with yellow white expectoration during fever. | 06 persons |
| 35 | Cough without expectoration during fever | 13 persons |
| 36 | Heat from head to down | 80 persons |
Totality of the symptoms constructed from the above data for Genus Epidemicus:
- Chills, descending ; upper part of body to legs to spine to back
- Chills , from back to spine to upper part of body
- Chills > by covering
- chills more at night
- fever more at night
- Pain over abdomen during fever
- pain over head region during fever
- On drinking water chills used to aggravate
- Loose stools watery in consistency
- Vomitings during fever and nausea also
- Thirst decreased during fever
- Appetite decreased during fever
- Sleep decreased during fever
- Weakness severe during fever
- Cough during fever, no expectoration
- Pains all over body sore and bruised during fever
- Pulse rapid
From the above totality following rubrics were selected for the repertorization, using BBCR repertory
- FEVER- Pathological types- typhoid fever
- CIRCULATION- Pulse- Pulse- quick
- CHILL- Chill – descending
- CHILL- Chill , etc – time – night
- CHILL- Partial chill- on back- proceeding from
- CHILL – Shivering – in general
- CHILL- Chills , etc aggravation – drinking
- CONDITIONS OF AGGRAVATION AND AMELIORATION IN GENERAL- Covers – amel, desires etc
- HEAT AND FEVER IN GENERAL- Time-night
- HEAT AND FEVER IN GENERAL- Partial heat – partial heat- head on- proceeding from
- HEAT AND FEVER IN GENERAL – Concomitants –appetite – aversion- food in general
- HEAT AND FEVER IN GENERAL – Concomitants –thirst – thirstlessness
- HEAT AND FEVER IN GENERAL – Concomitants – head –pain , headache
- HEAT AND FEVER IN GENERAL – Concomitants – Stomach- Stomach –pain in general
- HEAT AND FEVER IN GENERAL – Concomitants – nausea and vomiting- vomiting in general
- HEAT AND FEVER IN GENERAL- Concomitants – stool- diarrhoea
- HEAT AND FEVER IN GENERAL – Concomitants – cough – expectoration – without
- HEAT AND FEVER IN GENERAL- Concomitants – sleep - sleeplessness
- HEAT AND FEVER IN GENERAL- Concomitants – Sensations and generalities- exhaustion [weakness]
- HEAT AND FEVER IN GENERAL – Concomitants –bones- bones, pains.
Repertorization Result
| Drug | Rubric covered / total rubrics | Marks obtained |
|---|---|---|
| Arsenic album | 17/20 | 56 |
| Pulsatilla | 17/20 | 52 |
| Rhustox | 16/20 | 53 |
| Sulphur | 16/20 | 41 |
| China | 16/20 | 37 |
| Natrum mur | 16/20 | 35 |
| Nux vomica | 15/20 | 50 |
| Phosphorus | 15/20 | 41 |
| Bryonia | 15/20 | 38 |
Selection of Medicine
Arsenic album was selected as the remedy of choice because not only it scores highest number but covers the totality of typhoid symptoms.
-
Arsenic alb was finalized and administered to 30 patients diagnosed with typhoid fever, from March to May 2019 and follow up had been done.
Prescription: ARSENIC ALB 1M IN DIVIDED DOSES IN WATER WAS PRESCRIBED.
CASES OBSERVATION
Observations and Results
Result of Genus epidemicus (curative) for cases of typhoid
| Condition | No. of Cases | Percentage |
|---|---|---|
| No reappearance of symptoms, after taking genus epidemicus, in no of cases | 27 | 90 |
| Reappearance of symptoms, in spite of, taking genus epidemicus , in no of cases | 3 | 10 |
| Total | 30 | 100 |
Result of Genus epidemicus as a Preventive
| Condition | No. of Cases | Percentage |
|---|---|---|
| Symptoms observed in no of persons after taking genus epidemicus as a preventive | 19 | 82 |
| Symptoms not observed in no of persons after taking genus epidemicus as a preventive | 4 | 17.3 |
| Total | 23 | 100 |
Acute disease follow up (Curative)
3 months follow up was observed and it was found that Fever subsided with no weakness. 90% of cases had not suffered with reappearance of fever, after the administration of Genus Epidemicus, only three cases out of 30 had suffered with reappearance of fever after giving genus epidemicus.
Arsenic album as Preventive
Arsenic Alb was also administered as a preventive to 23 persons in the month of May at Gudarigunta, Kakinada, Andhra Pradesh to the high risk persons considering the family history or past history positive for typhoid or ingestion of contaminated food, water or living at Gudarigunta, Kakinada Andhra Pradesh, typhoid exposed area. ARSENIC ALB 200 3 DOSES HAS BEEN PRESCRIBED IN THE MONTH OF MAY 14/5/19. Follow up had been done for every 7 to 10 days, subtle appearance of cold, slight rise of temp, then sac lac for 10 days, automatically subsided the symptoms.
Since this was a small study, it was proposed to be conducted on a minimum sample of thirty patients. 104 patients were screened and 30 patients (22 males; 12 females) were enrolled (considering 10% drop outs). However, there were no dropouts and the data of all 30 cases is presented here.
Discussion
Homoeopathy can prevent and can also treat Epidemic diseases, by administering Genus Epidemicus. As the observations are obtained from limited number of samples in available time period. Further study should be carried taking larger sample size.
Conclusion
- The study therefore conclude that Hahnemannian suggestions on Genus Epidemicus are quite relevant and effective in present era.
- In view of new and reemerging old infectious diseases in endemic and epidemic forms, homoeopathy can be utilised effectively by the authorities
- The effectiveness of homoeopathic preventive medicines needs further clinical, molecular, biological models invitro studies as well.
- HP appears from the literature to offer a level of protection around 90%, and appears to be an extremely safe method of prevention against infectious diseases
Acknowledgement
The study was carried out under the kind guidance of Dr. G. Srinivasulu, Prof. and H.O.D., Department of Organon of Medicine, JSPS Government Homoeopathic Medical College, Hyderabad.
