Editor's Note
This paper addresses the Role of Homeoprophylaxis in Epidemics. It also enlists the scientific trials confirming the effectiveness in HP with special reference to the contributions made by Central Council of Research in Homeopathy to the field.
Abstract
Homoeopathy, a therapeutic system founded by German physician Dr Samuel Hahnemann, has been used for 200 years in most countries around the world in acute and chronic disease conditions. It has also flourished during the times of epidemic diseases which broke out in different parts of the world. There is vast historical evidence which proves that homoeopathic remedies have been successfully used as genus epidemicus for treatment and prophylactics to prevent these conditions. Homoeopathic treatment as well as prophylaxis during epidemics is found for epidemics of Scarlet fever, Typhus, Cholera, Dysentery, Spanish flu, Diphtheria, Measles, Whooping cough, Small pox, Poliomyelitis, Whooping cough, Japanese Encephalitis, Dengue, Cholera, Influenza, Meningitis, Malaria, Chikungunya. Many clinical trials have also been done during the epidemics of Chikungunya, Influenza like illness, Dengue, Acute Encephalitis Syndrome/Japanese Encephalitis.
Key words: Coronavirus, Epidemic diseases, Prophylaxis, Homoeopathy, Immunity.
Introduction
The epidemic diseases are those diseases in which many individuals are affected very similarly from a similar cause which becomes contagious in crowded areas. These epidemics manifest a similar disease process which, if left to itself, ends either in death or in recovery within a limited time.
A smallpox epidemic in Greece in 430 BC that killed more than 30,000 people was one of the first documented epidemics. And that was not the only epidemic history has witnessed, from then to the present Covid-19 pandemic epidemics have been a scourge for human civilisation.
Hahnemann, founder of homoeopathy, said, "He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health." Homoeopathy advocates that the cause of disease is morbic dynamic agent which invades the dynamicity of a living organism called vital principle to produce the sign and symptoms characteristic of the morbic condition upon the body and mind of the victim. Any disease can be prevented by keeping the life force undisturbed. Thus prevention of disease is the natural function of the vital principle of the organism. Homoeopathy provides a healthy condition by which it prevents and cures the incoming enemy force and thus maintaining health.
Homoeopathic therapy is supremely useful for infectious diseases. For homoeopathic prophylaxis in infectious diseases we need not hunt the bacteria or virus for the vaccination. This is because homoeopathic therapy is symptomatic and not materialistic and emphasis is on ‘totality of symptoms' as patient's disease and not on virus. Also it is very difficult to prepare vaccine against such diseases as the viruses frequently change their genetic pattern each time they appear in the epidemic form. Hahnemann, founder of homoeopathy, himself used prophylactic medicines in Asiatic cholera.
The science of prescribing homoeopathy for epidemic diseases is very interesting. Generally an epidemic requires different remedies when rages in different places. The prophylactic can be found by collecting the symptomatology of few patients of an epidemic in an area. This remedy can act as the curative as well as the preventive medicine during the specified epidemic for that area. A low potency of the preventive medicine is suggested as it works even in patients of unmanifested disease.
Recently, a novel corona virus strain (nCoV) has become a matter of concern for human lives. The 2019-nCoV infection has deeply affected every individual, society, and nations all around the world. In such situations, prophylaxis is the great preoccupation of all physicians and biologists.
Homoeopathic prophylaxis is endowed with harmlessness with no side effects and at the same time supreme efficacy in prevention. Immunity can be assured to patients if we will closely observe the symptomatology and select the epidemic remedy in the early stages of each epidemic, by administering the epidemic remedy as a prophylactic.
In homoeopathy there is no immunisation as such, but there are remedies that can build up immunity to infections. They can also act as curative agents where a disease has developed. These remedies carry no risk of detrimental effects, they are absolutely safe. If medicines can protect us from the contagion of a raging epidemic, they must possess a greater power to alter our vital force than the epidemic.
No disease arises in a human being without an existing predisposition to that disease. It is the absence of the predisposition to any particular disease that makes the person immune to it. Homoeopathy alone is capable of removing these predispositions.
Role of Susceptibility
Dr. J. J. Garth Wilkinson, in Epidemic Man and His Visitations, says:
One man catches scarlet fever from another man, but catches it because he is vis minor to the disease, which to him alone is vis major. His neighbor does not catch it; his strength passes it by as no concern of his. It is the first man's foible that is the prime reason of his taking the complaint. He is a vacuum for its pressure. The cause why he succumbed was in him along before the infector appeared. Susceptibility in organism, mental or bodily, is equivalent to state which involves the attitude of organizations to internal causes and to external circumstances. It is all the resource of defense or the way of yielding. In health we live and act and resist without knowing it and in disease we live but suffer.
Homoeopathy in Epidemic Diseases
The preventive aspect of Homoeopathy is well known, and historically, Homoeopathy has reportedly been used for prevention during the epidemics of cholera, Spanish influenza, yellow fever, scarlet fever, diphtheria, typhoid etc. The approach to prevention in Homoeopathy is two-pronged. Homoeoprophylaxis or, prevention through Homoeopathy, can either be met through Genus Epidemicus, which means a remedy which is found to be curative in the majority of cases of the same disease is also the most likely preventive for that disease; or through nosodes (medicine prepared from biological material of a disease). The former is identified through observation of several cases of an epidemic disease, and analysing the symptomatology of those cases for the most indicated medicine. This medicine, is considered to be the preventive medicine for the ongoing epidemic of that disease. The latter, on the other hand, once prepared through homoeopathic procedure, is considered a preventive for the disease it is prepared from, regardless of the overall presentation of that disease, which happens to change from time to time.
There are distinct advantages if prevention by Homoeopathy could be made possible. These include reduced financial burden, safer means for prevention and easier storage and administration. However, establishing the preventive use of Homeopathy in public health setting is a challenge. High quality safety and pre-clinical studies, as well as robust clinical research is required to be undertaken for establishing role of Homoeopathy in epidemics.
Homoeoprophylaxis
Homoeoprophylaxis (HP) is the use of potentised substances in a systematic manner to prevent the development of the characteristic symptoms of infectious diseases. HP was first described in 1801, and has been used throughout the world since then. It is known to be safe, effective and cost-effective.
The homeopathic literature is very rich in reports on the results obtained in the homeopathic treatment during times of epidemics which consistently reveal an extremely low mortality rate.
The following example establishes the effectiveness of Homoeoprophylaxis :
- Hahnemann suggested Belladonna can be used to prevent Scarlet fever.
- Ten doctors used Belladonna as a preventative against Scarlet Fever on 1,646 children, with only 123 cases of the disease arising, an effectiveness of 92.5%. The disease had a reported attack rate of around 90%.
- During the Smallpox epidemic in the USA in the early 1900's, 2806 persons were given Variolinum 30c, out of which 547 were exposed to the disease and only 14 developed smallpox. This resulted in 97.5% effectiveness of the homoeopathic prophylactic.
The successful use of Variolinum in preventing smallpox led Baron to say "Variolinum 200th is far superior to crude vaccination and absolutely safe". - Taylor-Smith investigated the use of the genus epidemicus remedy Lathyrus sativus in the prevention of poliomyelitis with 100% results.
- In August 1974 there was an epidemic of meningitis in Brazil where Meningococcinum 10c was given as prophylactic with effectiveness of 95.7%.
- Effectiveness of Pertussin 30c showed a range of effectiveness from 95% based on confirmed cases of whooping cough.
- Boenninghausen had excellent success in using Thuja occidentalis in the prophylactic treatment of Small-pox.
- In Brazil, in May 2001, a single dose of the homeopathic remedy Eupatorium perfoliatum 30c was given to 40% of the most highly affected neighbourhood. Thereafter, dengue incidence decreased by 81.5%, a highly significant decrease as compared with neighbourhoods that did not receive homoeopathic prophylaxis.
- A Homoeopathy campaign against Dengue was carried in Brazil in 2007 where distribution of 156000 doses of homoeopathic complex was done resulting in 93% reduction in incidence of disease whereas rest of the state showed increase of 128%.
- After the terrible earthquake in Nepal, homeopathy has been used by a Red Cross team in a camp of about 50,000 earthquake victims, with an advantage in the prevention of epidemic diseases.
- After the introduction of HP in Japanese encephalitis in Andhra Pradesh, the incidence of the disease decreased dramatically.
- In Cuba, in high-risk regions with a population of 2.4 million persons, 2.1 millions received one or two doses of homoeoprophylaxis and the incidence of Leptospirosis was significantly diminished by 84% in the group.
Approach for Genus Epidemicus
The term "genus epidemicus" is used to identify the peculiar characteristic manifestation of an epidemic disease working on the hypothesis that the same cause must be followed by like effects. The genus epidemicus is in apparent conflict within the homeopathic methodology of strict individualization, which is the fundamental key to success in homeopathy, but in epidemics we can try to individualize the collective disease rather than every single case affected by the epidemic disease. The selection of the remedy must be from the totality of the epidemic symptoms, and not from one individual epidemic case. The genus epidemicus tends to change from climatic area to another, from the seashore to the mountains. It may also be different for the different stages of an epidemic in the same locality.
The physician has to write down all the symptoms that have been present in each case. By the aid of a repertory he has to write after each one of these symptoms all the remedies that have produced that symptom. This may be called the group of epidemic remedies for that particular epidemic. With the help of material medica, one remedy seems to be the best suited to the general nature of the sickness. A remedy will not have to be so similar to prevent disease as to cure it, and this remedy in daily use will enable to prevent a large number of people from becoming sick. We must look to Homoeopathy for our protection as well as for our cure.
Central Council for Research in Homoeopathy (CCRH) in Epidemics
CCRH through its network of 26 Institutes/ Units all over India is conducting medical relief camps in communicable diseases since its inception. Council had taken a randomized control trial on Chikungunya in 2007 and Influenza like illness in 2010. The various communicable diseases on which CCRH has conducted medical camps are conjunctivitis, dengue, japanese encephalitis, bacillary dysentery, yellow fever, jaundice, typhoid, measles, meningitis, cholera, viral fevers, kala azar, plague, malaria, chikungunya and recent past swine flu and chikungunya. Homoeopathic medicines were distributed for various disease conditions as mentioned above as per the genus epidemicus for preventive purpose.
Chikungunya
Homoeopathy has been effective in various kinds of fever including chikungunya. The data present in literature mentions several medicines like Belladonna, Eupatorium perfoliatum, Bryonia alba, Phosphorus etc. as effective medicines for the disease. Trials conducted on this disease have been able to validate a few of the medicines which are usually prescribed in Chikungunya. In 2006, a homoeopathic preventive Eupatorium 30c was distributed to 1061 people with significant prevention (p < 0.0001). Another preventive trial was conducted by CCRH in 2007 where homoeopathic medicine Bryonia 30c was distributed as a preventive to 19, 750 people in Kerala and Bryonia alba 30c was found to be better than placebo in decreasing the incidence of Chikungunya in Kerala. Further, a prospective observational study was conducted on 126 patients in Chikungunya Fever (CF) and in Post-Chikungunya Chronic Arthritis (PCCA) in a Delhi Government Homeopathic Dispensary for a period of 6 months. A single homeopathic medicine was prescribed for each patient after case taking with the help of Materia Medica and/or Repertory. The study resulted in complete recovery was seen in 84.5% CF cases in a mean time of 6.8 days. 90% cases of PCCA recovered completely in a mean time of 32.5 days.
Dengue fever
The dengue epidemic is not a country-specific health problem, but a global burden. Eupatorium perfoliatum is one of the most frequently indicated medicines in dengue fever. CCRH also announced Eupatorium perfoliatum 30c as the preventive drug for the outbreak in an Advisory through Ministry of AYUSH.
Studies carried out for evaluating the role of homoeopathic treatment of dengue fever have been encouraging, with evidence reported from Brazil and Cuba. In Brazil, in May 2001, a single dose of the homeopathic remedy Eupatorium perfoliatum 30c decreased the incidence of dengue by 81.5%. Again in early 2007, a homeopathic complex against dengue containing Phosphorus 30c, Crotalus horridus 30c and Eupatorium perfoliatum 30c decreased the incidence of the disease by 93%, whereas in the rest of the state there was an increase of 128%. Further, in 2012, a double blind, placebo-controlled randomized trial was conducted on dengue patients using the same homoeopathic complex, to evaluate the effectiveness of homeopathic intervention in dengue epidemic. The intervention group showed improvement in most symptoms including headache, fever and myalgia. In Cuba, 25,000 patients who tested positive for dengue were treated with homoeopathic complex containing medicines Bryonia alba, Eupatorium perfoliatum, Gelsemium and dengue nosode with significant improvement in clinical condition and reduction in days of stay at hospital.
A study by Nayak et al showed that there was a statistically significantly greater rise in platelet count on day 1 of follow-up in the Homeopathic medicine with Usual Care (H+UC) group compared with UC alone. The time taken to reach a platelet count of 100,000/mm3 was nearly 2 days earlier in the H+UC group. These results suggest a positive role of adjuvant homeopathy in thrombocytopenia due to dengue.
Japanese Encephalitis (JE)/ Acute Encephalitis Syndrome (AES)
CCRH carried out research studies for prevention and treatment of JE during its epidemics in eastern parts of U.P. in 1989, 1991 and 1993. Belladonna 200c, single dose was distributed as preventive to 3,22,812 persons in 96 villages in three districts of U.P. In a follow up of 39,250 persons, none of them reported any signs and symptoms of JE. During the year 1999-2003, the government of Andhra Pradesh adopted Belladonna-Calcarea carbonica-Tuberculinum bovinum (BCT) regimen as preventive and the response was encouraging. The death rate was nil in the BCT distributed areas.
In a study undertaken by CCRH on JE showed that homeopathy as an adjuvant to the Institutional Management Protocol (IMP) decrease death rate by 15% in comparison to those who received only IMP. CCRH has also conducted preclinical studies in collaboration with School of Tropical Medicine, Kolkata in both in vitro and in vivo models. Homoeopathic medicine Belladonna could inhibit JE virus infection in both the models significantly. Another exploratory observational study was undertaken by CCRH in IPD setting (epidemic ward) of Baba Rhaghav Das (BRD) Medical College and Nehru Hospital, Uttar Pradesh (July to November 2012) using convenience sampling, with successful reduction in mortality and morbidity rate. CCRH is continuing the JE treatment study at BRD, Medical College to acquire more data on larger sample.
Further, CCRH has undertaken a study in collaboration with Center for Cellular and molecular Biology, Hyderabad to understand the action of BCT medicines on JE. CCRH is also conducting some preclinical studies on JE at its virology laboratory in Kolkata. The results of preclinical and earlier uncontrolled studies indicate that Homoeopathy can offer a preventive aid to reduce the incidence of JE/AES and also treat the patients to reduce the mortality and sequel of the disease in endemic region.
Lymphatic filariasis
CCRH conducted a multicenter study during 1980-2003 to assess role of homoeopathy in clincial filariasis with recurrent adenolymphangitis and lymphoedema using various indicated medicines with encouraging results. Further, a comparative single blind, placebo controlled study carried out during 1986-1988, observed an improvement of 40.54% in the group treated with Rhus toxicodendron,, Apis mellifica or Rhododendron, depending on their symptomatic presentation. Another observational study was carried out during the period April 1985-March 1989, which found Rhus toxicodendron to be the most effective medicine. The overall improvement with homeopathic medicines was 70.7%. In another single blind follow-up study in an endemic village in Odisha, homoeopathic treatment could effectively reduce the frequency of filarial fevers by 20 per cent (p < 0.05) among amicrofilaraemic cases, with a higher reduction in cases with genital involvement (36%) and mastitis (57%). Further, a study undertaken to show usefulness of homoeopathic therapy in preventing development of irreversible lymphedema concluded that treatment in early stage helped in restricting the further advancement of the disease and improved in quality of life of the patients. The medicines found effective were Rhus toxicodendron, followed by Sulphur, Bryonia alba, Natrum muriaticum, Apis mellifica, Pulsatilla nigricans and Thuja occidentalis.
Malaria
CCRH has undertaken initiatives to prevent and treat malarial cases in endemic and/or epidemic regions. Many drugs have been scientifically tested on in-vitro/in-vivo models in recent studies with promising results, with significant antiplasmodial efficacy against various species of plasmodium parasite.
Researchers evaluated the efficacy of two homeoprophylactics in combination therapy against lethal murine malaria in mice. The combination of remedies showed significant preventive activity with chemosuppression that was higher than the standard drug, pyrimethamine. It also showed a moderate curative activity with complete clearance of parasites in 50% of surviving mice. These findings point to the significant antiplasmodial efficacy of the combination of these homeopathic drugs against Plasmodium berghei. Many homoeopathic drugs have been scientifically tested on in-vitro/in-vivo models in recent studies with promising results, with significant antiplasmodial efficacy against various species of plasmodium parasite. Also a group of predefined homeopathic medicines were studied in the management of malaria.
Conclusion
Homoeopathy has always served in times of epidemics as well in pandemics crisis in old and modern times as prophylaxis and in the treatment of disease outbreaks. There will always be epidemics and humanity will always be susceptible to them. Every epidemic is unique and homeopathy is always ready to face such uniqueness, regardless of its newest or severity.
All flu-like illnesses can evolve into pneumonia, which becomes by far the main cause of mortality from these illnesses, as close to 98% of persons dying from these flu-like illnesses is from pneumonia. The current 2019-nCoV pandemic is also a flu-like illness that severely affects the older and immunocompromised segments of our population.
The epidemiological evidence clearly shows that homeopathy discloses a very consistent and strong prophylactic and therapeutic effect and real-world, long-term effectiveness, while is at the same time safe and cost-effective, and should therefore play a major role in the public health systems. As during the 2014 Ebola epidemic the WHO concluded, "It is ethical to offer unproven interventions with as yet unknown efficacy and adverse effects, as potential treatment or prevention." It is the time to open the door to homeopathy, as morbidity and mortality from influenza and could be dramatically lessened by the simple application of homeopathy in the current 2019-nCoV pandemic.
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