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Dr. Ajit Kulkarni
M.D.(Hom.)
www.ajitkulkarni.com
dr_ajitkulkarni@rediffmail.com

Resume

Swine flu – a global catastrophe…rising deaths… panic in society…the virus information and it’s spread… advantage of homoeopathy in the past epidemics and pandemics… homoeopathic remedies as prophylactic… miasmatic assessment of swine flu… the concept of Genus epidemicus…importance of selection of a right prophylactic remedy.

Introduction

"The virus is still around and ready to explode” William Schaffner, an influenza expert at the Vanderbilt University School of Medicine who advises federal health officials, was quoted as saying to the The Washington Post.
"We are potentially looking at a very big mess," he said.
“Everybody recognizes that H1N1 is going to be a challenge for all of us, and there are people who are going to get sick in the fall and die," John O Brennan, the Deputy National Security Advisor said.
Dr. Anne Schuchat from CDC writes, “This is a virus that is capable of causing a spectrum of illness that includes severe complications and death.”

These remarks by the renowned authorities of their respective fields are enough to create panic in the society. The death toll is rising unabatedly all over the globe and the health authorities are struggling hard to save the people from the deadly claws of Swine Flu. They have succeeded partially in keeping the spread under control. They have seen people helplessly dying of the severity of the disease when the best of their treatment failed. Ambiguous conclusions about the effectiveness of Tamiflu have worsened the situation.

The virus and its spread

Known as Influenza A (H1N1) meaning that this is a type A influenza which has hemaglutinin type 1 (H1) and neuraminidase type 1 (N1). It is an infection by any one of several types of swine influenza virus (SIV). As of 2009, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2, and H2N3.
The strain contains genes from four different flu viruses:

• North American swine influenza
• NA avian influenza
• Human influenza and
• Two swine influenza viruses typically found in Asia and Europe

With its epicenter in the Mexico, Swine Flu has spread across 168 countries, with at least 1,70,000 confirmed cases. Swine Flu has caused 1,160 deaths including 436 in the United States. Seventeen deaths have been reported so far in India.
As the virus belongs to a new strain and majority of the population is non-immune to it, experts suspect that the second wave of infection could be more severe than an average flu season. Mutations in the virus may increase the mortality and morbidity in the future though no mutation has been reported till now.
The role of homoeopathy
“Homoeopathic Prophylaxis” is adopted against many contagious diseases like the vaccines and both have the same Law of Similars. History of homoeopathy is replete with the beneficial results of homoeopathy in contagious diseases such as Japanese encephalitis, Yellow fever, Cholera, Diphtheria, Influenza, Plague etc.

Homoeopathic medicines are used to treat the flu symptoms since centuries in the countries where such illnesses have common recurrences. They can be of valuable help in preventing and treating the present Swine Flu pandemic. It can provide quick relief from symptoms of the flu and its use is inexpensive too.

Homeopathy was 98% successful in treating the Spanish flu epidemic in 1918. Dr. T. A. McCann, from Dayton, Ohio, reported that 24,000 cases of flu treated allopathically had a mortality rate of 28.2% while 26,000 cases of flu treated homeopathically had a mortality rate of 1.05%. This last figure was supported by Dean W.A. Pearson of Philadelphia (Hahnemann College) who collected 26,795 cases of flu treated with homeopathy with the above result. Of the fifteen hundred cases reported at Homeopathic Medical Society of District of Columbia there were only fifteen deaths. Recoveries in the National Homeopathic Hospital were 100%. In Ohio, of 1,000 cases of influenza, Dr. T. A. McCann, MD, Dayton, Ohio reported no deaths. In Connecticut, 6,602 cases were reported, with 55 deaths, less than 1%.

Gelsemium and Bryonia were used to successfully treat the Spanish flu in 1918. According to Dr. Frank Wieland, MD, in Chicago, "(With) 8,000 workers we had only one death. Gelsemium was practically the only remedy used. We used no aspirin and no vaccines."

The Journal of the American Institute for Homeopathy, May, 1921, had a long article about the use of homeopathy in the 1918 flu epidemic.

The role of homoeopathy as preventive medicine

If we refer the literature about influenza prophylaxis in homoeopathy, many remedies have been recommended viz. Influenzinum-hispanicum, Arsenic album, Bryonia, Carbo-veg, Eup-perf, Gelsemium, Influenzinum, Mucobacter, Nelson’s Influenza vaccine, Oscillococcinum, Phosphorus, Sulphur etc. by the authorities like Pierce Schmidt, Grimmer, William Gutman, Fergie Woods, Younan, etc. Dr. P. Sankaran’s booklet of “Prophylactics in Homoeopathy” is worth referring in this connection.

Recommendations about swine flu

For the current swine flu pandemic, there is no uniformity in recommending preventive medicines. Some physicians advocate Gelsemium as, according to them, it is a remedy par excellence for influenza. Some focus on Influenzinum as it is prepared from the virus that causes the infection. Some emphasize Oscillococcinum as it is claimed to prevent any type of influenza. Someone is sending SMS that all people should take a dose of Eupatorium perfoliatum 30 or Nux vomica 30 to prevent the attack of swine flu. Phosphorus and Tuberculinum have also been recommended. Even some poly-pharmacy users are recommending 4-5 prominent influenza remedies together at a time to be used as preventive.

But we must make a difference between genus epidemicus and any other corresponding remedy. There are more than 30 remedies which are indicated for the treatment of flu. In one way or other they will possess some similarity. That doesn’t mean that all these remedies have to be recommended as preventive.

The concept of Genus epidemicus

Hahnemann’s aphorisms 100-102, from ‘Organon of Medicine’, give guidelines about investigation of epidemic diseases in particular and the role of Genus epidemicus. In aphorism 100, he emphasizes the need for examining each epidemic or sporadic disease as an independent new disease and that the totality of each case must be traced thoroughly by observing the phenomenon in its complete detail and in all its aspects or phases. In aphorism 102, Hahnemann comments that the whole extent and complete picture of the entire epidemical disease cannot be learnt from examining a single case of the epidemic but can be deduced and ascertained from examining several patients of different constitutions. What is important in epidemic or pandemic cases is to find the Genus epidemicus based on the totality of symptoms.

Note that the totality of symptoms should not be only quantitative but qualitative. I would like to enumerate the initial and prominent symptoms of the Swine Flu which will help us to find the Genus Epidemicus.

Symptoms of Swine flu: Fever. Coughing. Sore throat. Runny or stuffy nose. Bodyache. Headache. Chills. Fatigue. Diarrhoea. Vomiting.

Serious symptoms: Children – Signs of respiratory distress, blue lips and skin, dehydration, rapid breathing, excessive sleeping, seizures, irritability. Adults – Shortness of breath, pain in chest or abdomen, sudden dizziness or confusion. Also in all cases, persistent vomiting and return of flu-like symptoms.

Complications: Pneumonia. Bronchitis. Sinus infections. Ear infections.

Miasmatic assessment of Swine Flu

Psoric Manifestations: Mild variety. Good response to treatment. No complications. Onset sudden, fever high but return to baseline early. Immunity good.

Sycotic Manifestations: Lingering response. Tremendous weakness and dullness. Lingering cough. Often with expectoration: thick, yellow-greenish. Poor convalescence.

Tubercular Manifestations: Acute, sudden onset and progress. Rapid pace of illness. High grade, persistent fever. Complications common: pneumonia, enteritis, shock. Profound debility. Careful monitoring essential.

Syphilitic Manifestations: No response to treatment. Disease process continued with high pace. Complications à hemodynamic state poor. Collapse, comatose condition. Respiratory collapse.

The above general criteria should be applied to the cases of pandemic swine flu. If we take into account the clinical features of swine flu in totality, TUBERCULAR miasm is preponderant over the system right from the beginning and if the clinical condition becomes worse, it progresses to SYPHILITIC miasm. The most common cause of death is respiratory failure, other causes of death are pneumonia (leading to sepsis), high fever (leading to neurological problems), dehydration and electrolyte imbalance (from excessive vomiting and diarrhea)

It is imperative for us to know the behavior and characters of Swine flu for arriving at Genus epidemicus.

Processing the data of swine flu from homoeopathic standpoint

1. Nature of disease: Acute. Requiring preventive measures in view of contagiousness.
Requiring immediate attention and treatment
2. Zone of illness: Structural
3. Phase of the disease: Fully developed
4. Affinity: Respiratory system, lungs
5. Pathology: Inflammation. Destruction. Necrosis. Sepsis.
6. State of pathology: Reversible in mild cases. Borderline to irreversible in severe cases.
7. Pattern of response: Erratic. Progressive.
8. Pace of disease: Rapid.
9. Expressions: The field of modalities, sensations and concomitants of more
pathognomonic type
10. Miasmatic diagnosis: 1. Dominant / Active: Tubercular Syphilitic
11. Sensitivity: Heightened
12. Susceptibility: Heightened

Let us study indications of some prophylactic remedies.

1.Influenzinum: The symptoms from Materia medica are: General ill feeling with chill, headache, diffused pains. Leucopenia with mononucleosis. Nasal congestion. Coryza of influenza. Sinusitis.

Note that Influenzinum is not a well proved remedy and its acute symptoms of influenza are also not known. Allen writes under Influenzinum, “This generally prevents the spread of the trouble and clears up the "colds", whether they are of the influenza type or not.”

2. Oscillococcinum: Influenza of all types, esp. in the earlier stages. Bursting headaches and muscle aching. Gastrointestinal troubles with influenza. Given early it cuts shorts the manifestations of influenza. Nasal voice and catarrh. Stuffed nose. Sneezing. Serous discharge from nose then muco-purulent. Temperature - bruised sensation, chill, hyperthermia. Throat- aphonia, dry, painful cough.

This data indicates that it is more used at the beginning of influenza. Hence it has more therapeutic value, although it is recommended as a preventive. Note that Oscillococcinum is not a well proved remedy.

3. Gelsemium: Gelsemium is slow in onset, intense weariness. The patient is very dull and tired, physical lethargy with heaviness of eyes and extreme drowsiness, not wanting to be disturbed but to be left in peace, Acute coryza, with a fluid, watery discharge, accompanied by very violent sneezing and a feeling of intense fullness and pressure just about the root of the nose. Thirstlessness. Gelsemium has no marked sepsis. It is more sycotic than tubercular or syphilitic. Hence, it can’t take the role of Genus epidemicus for the current swine flu. It can, however, be, used in the initial stage of flu.

4. Nux vomica: Nux vomica can’t take the role of Genus epidemicus as it is more psoric and sycotic in nature. It has no sepsis or acute respiratory failure and hence it doesn’t match the totality. It can be used more for the sake of treatment of influenza in the initial phase of treatment when chills are strong and rhinorrhoea is present.

5. Tuberculinum: Rapid and complete physical break-down; generally after acute infections such as pneumonia, influenza, no signs of vital reaction, declining, a running down state. When the well selected remedies fail to augment improvement or impress upon the individual. Frank inflammatory processes (not mere congestions), in brain or lungs. Viral infections in patients with tubercular taint (Echin., Eucal., Calc-c.); progressing even to septic condition (cp. Pyrog.). Sporadic influenza is an outburst of latent tubercular diathesis, says H. C. Allen. Tub. is the best general antidote to chronic effects of influenza toxin. Slow convalescnce.

Tuberculinum can be thought of as an intercurrent remedy in influenza.

6. Arsenic album:
• Its clear-cut characteristic symptoms and correspondence to many severe types of
disease make its homoeopathic employment constant and certain
• A profoundly acting remedy on every organ and tissue. The action of Ars. on body is that of organic decay; it destroys the entire machinery of life
• Influenza: covers more phases of grippe than any other remedy
• Ailments from crowded close places
• Nose: thin, watery, excoriating discharge. Nose feels stopped up. Sneezing; profound; without relief
• High temperature. Delirium
• Collapse: a complete sinking of vital forces
• Violent rapidly progressing inflammation. Sudden intense effects; violence and rapidity. Sudden, rapid decline. The system going downhill in spite of other remedies
• Syncope: almost unconscious, cold sweat, dizzy, complains of thirst, anguish; rattling.
• Acute respiratory distress syndrome leading to death

The above data if viewed in totality clearly points to Arsenic album and hence we recommend Arsenic album as the Genus epidemicus for the current pandemic of swine flu.

I appeal the Homoeopathic community to keep a record of cases for scientific investigation.

Posology

In view of the nature of disease, miasm and susceptibility as described above, we suggest following potencies. In more prone areas we suggest to repeat two doses per day for 3 days. Even in some contagious areas, we suggest repetition every month for one or two months.

1. In adults – 1M
2. In infants upto one year – 30, as a single dose
3. In children – one to five years – 200, a single dose
4. In old age above 65 years – 200, a single dose
5. Pregnant women – 200, a single dose
6. Patients with heart disease, diabetes, asthma – 200, a single dose

References

1. Organon of Medicine, 6th Edition, Samuel Hahnemann
2. Materia medica of some important nosodes, H. C. Allen
3. Bhatia, M, Swine Influenza
4. A Select Homoeopathic Materia medica, P.I.Tarkas & Ajit Kulkarni
5. Homoeopathic Posology, Ajit Kulkarni
6. Lotus Materia medica, Robin Murphy
7. Internet websites
www.tamiflu.com
www. en.wikipedia.org
www.hpathy.com