An attempt to solve controversies in Homoeopathic Prophylaxis

Dr Muhammed Rafeeque
FamilyHomoeopathy.com

Abstract
Homeopathy has been getting more popularity by its success in the prevention and cure of several communicable diseases appearing in various parts of the world. By the wholehearted support of the Government, Homeopaths, NGOs, and our well-wishers, Homeopathic prophylaxis medicines are given during the outbreaks of epidemics, and the response is quite favorable. For many ordinary people, now ‘preventive medicine’ means homeopathy! In spite of the positive results and the popularity, the use of homeopathic prophylaxis is a debatable topic, even among homeopaths. Due to theoretical and practical issues, there are a lot of controversies among us, and the critics of this system of medicine are exploiting the controversies within our community to fight against us. Even many contemporary homeopaths are against giving prophylactic medicines, and they even criticize the master and his concept of Genus epidemicus through the public discussion forums on the Internet. Even the prophylactic activities of AYUSH department and CCRH are criticized by a few of our colleagues! On several occasions, the critics of homeopathy have highlighted a few failures as a result of wrong remedial diagnosis, only to misguide the public. Even the News channels like BBC reported the failures of one or two individuals after taking preventive medicine (a patent product marketed as homeopathic!) for Malaria.

This work is a humble attempt to solve the controversies in homeopathic prophylaxis. With the help of historical data, previous results, reviews from eminent homeopaths, views of the critics, result of a secret opinion poll, and also from my own experience and observations, a final conclusion is given about the scope of homeopathic prophylaxis.

Objectives
The main objective of this paper is to solve the controversies in homeopathic prophylaxis that affect the growth of this system.

Methodology
Historical & statistical methods, observational study, opinion-based study.

Key words
Prophylaxis, genus epidemicus, immunization, vaccination, epidemic, pandemic, antigen, antibody, immunity, nosode.

Introduction
Prophylaxis means the prevention of disease, which may be a disease affecting an individual or many people among the population. Prophylactic treatment is more commonly employed during the outbreak of epidemic diseases. An outbreak of epidemic is a clear indication of the imbalance in the environment, which is often associated with war, environmental issues, poverty, overcrowding, calamities, political insecurities, sudden climatic changes, etc. Epidemics create more negative impact than the diseases affecting the individuals. Hence, the old dictum ‘prevention is better than cure’ is very relevant. Whenever there is an epidemic, immediate preventive measures are essential because an ounce of prevention is worth a pound of cure. For the purpose of prevention of certain diseases, vaccines are employed in spite of side effects and serious after effects. A better alternative to this is homeopathy, which is safe, effective and free from side effects.

Why do controversies arise?

Prophylaxis is the most common controversial topic in our system. Different ways to select the prophylaxis is the main reason for controversies.

1. Constitutional remedy
2. Genus epidemicus
3. Nosodes
4. Drug selected on the common symptoms
5. Isodes
6. Favorite remedy
7. Specific remedy
8. Remedy suggested by some authority
9. Influence of previous results/failures
10. Book reference

Critical views on Homeopathic prophylaxis
The reasons for criticism can be discussed under three headings:

1. Theoretical discrepancies

1. “Homeopathy has become a religion. What the literature says is enough for most of the homeopaths, and we do not go further”
2. “A medicine becomes homeopathic when it is indicated on symptom similarity. Giving a medicine to a person without indication is meaningless”
3. “Genus epidemicus may be a dissimilar drug to the presenting totality of the individual patient”
4. “Giving same medicine to all is not Homeopathic. Instead of that, give the constitutional drug that can prevent all diseases”
5. “The picture of the same disease may be different in each individual patient”
6. “Hahnemann never suggested prophylaxis on hearing about epidemic. He had suggested waiting until the disease reaches the nearby locality”
7. “Prophylaxis in Homoeopathy is an imitation of allopathic immunization program”
8. “The vaccine business lobbies always make use of fear among the people. Similarly, we should not blindly give unnecessary medication when it is not indicated”

2. Practical difficulties

1. “The action of Genus epidemicus is theoretical, not always practical since it can’t produce specific immunity to a specific disease”
2. “Give only short-term protection of an acute disease, and is ineffective in giving life long protection”
3. “Nosodes will have to be taken throughout the life, because we cant find out the effectiveness of dose by assessing the specific antibody levels in the blood”
4. “Now people are mixed together and move from place to place. Hence, during an epidemic, it is difficult to get similar clinical features among the victims in the same area”
5. “Difficult to get the clear picture of the epidemic due to the suppressive mode of treatment”
6. “Various strains of viruses are seen in the same episode of epidemic. It is also difficult to reach the common totality since there is no clear expression of epidemics”
7. “There are also different epidemics occurring at the same time”
8.  “Most of the time, the genus epidemicus is selected by considering the symptoms of doubtful cases, classical cases are not usually considered”
9. “There are no standard protocols for the potency selection, repetition and dosage. Homeopaths arbitrarily choose the doses and repetition. Often, their feedbacks are contradictory to each other” 

3. Side effects and after effects:

1. “Giving a medicine when it is not indicated is harmful”
2. “The nosodes can be dangerous and can lead to incurable diseases”
3. “Incorrect homeopathic medicine can affect the chronic remedy already given. It can spoil the whole case”
4. “If the genus epidemicus given to a person fails to prevent disease, other medicines may not easily work on him”
5. “There are even some patent products to prevent diseases like cancer, which are marketed as ‘homeopathic’. The critics often call these medicines as dummy-medicines, and create bad name for homeopathy”
6. “We often get lot of excuses when we fail to cure a disease. Even some sort of symptomatic relief usually satisfies the patients, whereas, failure of prophylaxis has no excuse.”

Counter points in support of prophylaxis

1. A well-selected genus epidemicus can surely work, but a wrongly selected medicine will not. It is due to the human error, not due to the deficiency of the science.
2. Without knowing the character of diseases prevalent in each area, blindly taking a preventive is meaningless. However, we can try nosodes when the disease picture is not available in emergency situations. The nosodes are used in high potencies; hence there is no toxic effect. Too frequent repetition of nosodes is not advisable.
3. Now the people are very health conscious, but all of them do not want to use vaccines, and they prefer homeopathy. Hence, there is scope for prophylaxis.
4. Giving some specifics as preventive often fails. Whereas, a drug given on the basis of symptoms of the epidemic, the result is much better.
5. I have also noticed some patients coming with the symptoms of the preventive after a few days, which is nothing but the proving of the remedy. Once we stop that particular drug, the symptoms will disappear automatically.
6. Giving a few doses of medicines will not spoil the case as believed by a few homeopaths, only the too frequent repletion can create problems. Above all, the idiosyncrasy of the patient is more important, hence, a violent reaction can be seen even by a single dose!
7. Above all, we should consider the benefits we had from the prevention of various diseases.

History
Hahnemann
1799: Scarlatina epidemic in Germany was managed successfully by Belladonna.

1801:  Hahnemann wrote an article, “The prevention and cure of scarlet fever” in his lesser writings. Also published a pamphlet ‘Cure and Prevention of Scarlet Fever’, along with each pamphlet, a vial containing Belladonna was distributed. In his footnote to § 73, he wrote, “scarlet fever founds its preventive and curative means in Belladonna”.

1808: In the subsequent scarlatina epidemic in Germany, Aconite was proved effective.

1808: Published a paper, “Observation on the scarlet fever,” in which he described the individual features of the two previous epidemics.

1813: Hahnemann mentioned in his ‘Chronic Diseases’ about Bryonia and Rhus tox for the acute miasm of typhus.

1831: Hahnemann selected Camphor, Cuprum and Veratrum album for the prevention and cure of Asiatic cholera.

In aphorisms 100 to 102, He has given directions on the evaluation of group simillimum of a specific epidemic. According to him, a carefully observing physician can easily construct a clear picture of the prevailing epidemic by examining even the first and second patient.

Only recently we have understood the genetic mutations in pathogens, but in those days, Hahnemann identified the unique features of each episode of epidemics, and he suggested observing the same to identify the preventive and curative remedy.

In spite of his strong suggestion, a few followers were against genus epidemicus. He wrote in his lesser writings, “Who can deny that the perfect prevention of infection from this devastating scourge…. discover.” (Page 377)

He did not give a prophylactic remedy unless there was a clear and present danger of contracting the disease, and he had suggested waiting until the epidemic affects the nearby places.

 Apart from the genus epidemicus, he also suggested good healthy diet, hygiene and healthy lifestyles for prophylaxis of diseases.

Boenninghausen He successfully used preventives during the cholera epidemic in Europe (1849). The mortality rate was 54-90% in conventional medicine, whereas Homeopathy had only 5 –16% mortality. In his lesser writings, he had mentioned about his experience on Thuja for the prevention of small pox. Once he said,“variolinum 200 is far supreme to crude vaccinations and absolutely safe”.

Herring In 1833 Hering had suggested Psorinum to prevent an infection of itch miasm.

Burnet  In 1884 Burnet suggested Vaccinum 30 as a preventive for small pox.

Dr H C Allen He used Diptherinum for 25 years as a preventive of Diptheria.

Boericke Under Baptisia, he writes, “Baptisia in lower dilutions produces a form of antibodies to the bacillus typhosus. It raises the natural body resistance to the invasion of bacillary intoxication”.

Dorothy shepherd She confirmed the effectiveness of Pertussin in the prevention of whooping cough.

Frnacisco X Eizayaga His protocol of homeopathic prophylaxis was successfully used for four decades in Buenos Aires.

Statistics
Dr Dudgeon: (1820-1904): He reported that 10 allopathic doctors used homeopathic doses of Belladonna on 1646 children as a preventive for scarlet fever, and only 123 cases had the infection. At the same time, 90% of people who had not taken Belladonna got the infection.

Dr Hufeland:  He supported the use of Belladonna as a preventive against scarlet fever, hence, the government of Prussia made its use mandatory in 1838 during an epidemic of scarlet fever.

Dr Eaton:  In 1907, he collated the results of several doctors in Lowa during a smallpox epidemic. As a prophylaxis to small pox, 2806 persons were given Variolinum 30. Out of these 2806 people, 547 persons had definite exposure to small pox. The response was very encouraging. Only 14 cases got the infection, which means the prophylaxis was 97% effective.

W A Pearson: In 1918, W A Pearson of Philadelphia collected 26795 cases of influenza treated with Gelsemium by various homeopathic physicians. The mortality was only 1.05%, but the mortality of cases treated by conventional medicine was 30%.

Dr Isaac Golden: He conducted a survey among the customers who had purchased his prophylactic kit against diseases like pertussis, diphtheria, mumps, measles, influenza, tetanus, and poliomyelitis. He then conducted a follow-up survey by sending a questionnaire between 1988 to 1994 to each parents. He received 879 replies, out of which, only 2% of children got the infection. Out of 188 children who had definite exposure, only 20 got infected, that too with fewer troubles. There were no adverse effects from the programme. The repeated doses actually helped for the long-term prevention.

Brazil: In the year1974, Guarantingueta in Brazil had faced an epidemic of meningitis. As a prophylaxis, Meningococcinum 10C was given to 18640 children. At the same time another group of 6340 children did not receive the nosode, hence used as control. Out of 18640, only 4 cases developed meningitis. And, among 6340 children, 43 cases developed the disease.

USA: The homeopaths who worked for the public health departments in USA gained great experience by using the nosodes against smallpox epidemics.

Cuba: In October-Nov 2007, researchers at Finlay institute, Cuba, reported on their successful use of homeopathic remedy for the prevention of Leptospirosis. They prepared 200c nosode from various strains of the organism, and given to 2.4 million people. There was dramatic decrease in morbidity and reached to zero mortality of hospitalized patients.

India: In almost all states in India, homeopathic preventive medicines were distributed during the epidemics of Japanese encephalitis, Swine flue, Chinkungunya, Chickenpox, Conjunctivitis, Dengue, etc. The responses from the various sources are quite favorable. The success story of prophylaxis from Andhra pradesh was a much-discussed topic in the public media. The Central Council For Research in Homoeopathy (CCRH) is always vigilant on the outbreak of epidemic. They have special research centers to conduct studies on prophylaxis. CCRH also conducted studies on the efficacy of prevention of Japanese Encephalitis in states like UP, WB, AP, Assam (1986-1999). The result was excellent. In India, homeopathic preventives are also distributed by NRHM, State Government departments, Homeopathic colleges, organizations and practitioners. The Government of Kerala has got a special body called RAECH (Rapid Action Epidemic Control cell Homeopathy), which is under the control of the department of homeopathy. It includes medical officers, members from various organizations and also private practitioners in each area.

Secret survey among the Homeopaths on their attitude towards prophylaxis
100 homeopaths were randomly selected from the facebook, and a message was sent with a list of 9 choices, i.e. from A to I, and asked to reply before 6 PM on 20-9-11 (IST)

Here is the response:

A. I support prophylaxis, and give the same to my patients: 23%

B. I support, but do not give for my patients: 3%

C. I do not support, but do not oppose when others give: 4%

D. I am not interested, but whenever patients request, I give: 4%

E. I do not support, and always oppose in the public media: 0%

F. I do not support, & always oppose, but not in public media: 0%

G. Neither support nor oppose: 1%

H. I have no opinion: 4%

I.  Did not respond within the specified time period: 61%

Result: Out of 39 doctors who responded, 58.9% support prophylaxis and they often give the same to their patients.  61 doctors did not reply since they rarely visit facebook!

Steps to solve the controversies

A. Primary steps before giving prophylaxis:

1. Non-supporters among us should not criticize prophylaxis in public media.
2. Give media reports on the scope of homeopathy.
3. Mouth to mouth publicity through volunteers often works.
4. Welcome the NGOs who can support us.
5. Financial support can be obtained from the Government and private firms.
6. Teamwork and uniqueness is very essential.
7. Be vigilant and proactive on the nature of fresh cases.
8. Give a lecture on homeopathy before the preventive camp.

B. Selection and administration of the remedy

1. There should be a team that includes experts from research centers, medical officers, teachers, association members, local doctors, and they should decide one common remedy.
2. The initial clinical presentation of the epidemic in each locality has to be considered.
3. In case taking, qualified common symptoms and PQRS related with the epidemic has to be considered. The basic characters of the patient may not indicate the acute remedy.
4. Seasonal remedy can act as prophylactic, if the symptoms correspond.
5. When a person approaches for prevention of an individual disease, give his constitutional drug.
6. Preferably avoid the prophylactic patents marketed as ‘homeopathic medicine’
7. Common symptoms of a disease should not be ignored, because they become valuable when qualified by the components of a symptom.
8. While traveling to unknown places, make inquiry with the local homeopaths about the diseases prevalent in that area.
9. The picture of the same epidemic may not be same everywhere. So, the doctors practicing in each area must be involved in the drug selection for that area.
10. Wait for the appearance of clear cases if the disease is not dangerous. If the disease is dangerous, start the nosode or a drug on the basis of the common symptom, and once the disease picture is clear, we can select the genus epidemicus as per the indications.
11. Giving a nosode or an anti miasmatic drug after the administration of the genus epidemicus is also found beneficial.
12. While giving medicines, certain data should be collected and preserved for future reference. The name, age, address and number of people should be noted in a chart. A legal disclaimer signed by the patient is also necessary.
13. Along with the dose, a slip that gives details on the dosage, contact details of doctors is mandatory.

C. Special advice while giving the preventive medicine

1. It is very essential to mentally prepare the clients before giving medicine.
2. Ask them to report in case of any symptoms or reactions after taking the medicine. Also advice them to report in case of failure of prevention.
3. Preventive medicine should be taken before the entry of pathogens into our body. The success rate is less when it is taken during the incubation period.
4. When the virus has already entered the body, the preventive medicine may act as curative when there is similarity.
5. If already one family member is affected, there is chance for infection among others.
6. Giving 100% guarantee is a mistake.
7. Beware of mass hysteria while giving medicines to a huge population. One adverse effect after taking the dose in one person may result in the same situation among others. In order to avoid this situation, ask them to take the dose after reaching home.
8. Those who are taking other homeopathic medicine can stop the dose and take the preventive, and they can start the other medicine again as per the requirement.
9. Also we must teach the public regarding the general precautionary measures such as personal hygiene, environmental cleanliness, use of mosquito nets, good food habits & regular exercise, etc.

D. Feedback and evaluation

1. There must be proper follow-up after the medical camp to assess the effectiveness of preventive medicine.
2. Beware of proving of the remedy on the susceptible people, and sudden reaction among the idiosyncratic.
3. People under incubation period may complain that they got the infection as a result of preventive! Make them understand the time taken for the disease to show its manifestations.
4. Facing the criticism and failures is very essential. By taking utmost care, the failures can be reduced. Even when we fail, there are reasons, which should be told to the public. All cases can’t be cured; hence, naturally, all diseases can’t be prevented. No system in this world is 100% perfect, hence admitting our limitations give more authenticity.
5. In case of failures, it is essential to conduct an investigation to identify the fault, and to take precautions in future.

Results

1. Scientifically selected homeopathic medicine will not fail to work
2. History, statistics and experience prove that preventives are useful
3. Failures are due to errors, obstacles, controversies and clashes
4. Eradication of negatives responsible for failures is a must
5. In India, homeopathy is famous in places where preventives were regularly given during the initial days, for example, during cholera epidemics.
6. Prophylaxis is a great service, which makes us the preservers of health.
7. Medicine can be given to only to the patients, but preventive is given to all, hence useful to introduce homeopathy in areas where it is less popular.
8. Those who do not support preventive concept need not do the same under compulsion.
9. Critics among us should not criticize in public media. True that there are pitfalls on our way, but can be nullified by standardization.
10. From the result of opinion poll conducted among Homeopaths, it is clear that many doctors support homoeopathic prophylaxis.

Conclusion
There is an urgent need for research-based trials, most importantly, with proper documentation of outcome of prophylaxis. There should be more special research centers for conducting research on prophylaxis, and in each areas, there must be a team of experts for drug selection under the guidance of experts from the research centers, and to conduct prophylactic camps with the support of government, organizations and local agencies. A joint venture is needed in this regard, and a scientific approach can definitely alleviate the related issues.

Before I conclude, I would request all homeopaths to join the hands together and work for the popularity of this science. We should interact with the homeopaths allover the world, and try to solve the issues affecting the growth of our system, and resist the attacks we suffer from different corners.

At the end, let me quote and ancient saying – If not now, then when? If not we then who?

Aude sapere!

Bibliography

1. Organon of medicine, Dr Hahnemann, B Jain publishers New Delhi.
2. The Lesser writings, Dr Hanemann, B Jain publishers New Delhi.
3. The Chronic Diseases, Dr Hanemann, B Jain publishers New Delhi.
4. Lectures on Homeopathic philosophy, Dr J T Kent, B Jain publishers New Delhi.
5. The prescriber, Dr J H Clarke, B Jain publishers New Delhi.
6. Quick Bedside Prescriber, Dr J N Singhal, B Jain publishers New Delhi.
7. Article by D P Rathogi, HMAI Souvenir, Bangalooru.
8. IHK News, June 2011 issue, IHK, Kerala.
9. CCRH, Government of India.
10. RAECH (Rapid Action Epidemic Control Cell Homoeopathy), Govt. of Kerala.
11. Medical officers, Govt Homoeo Hospital, North Paravur.
12. Softwares: Radar, Hompath.
13. Wikipedia.
14. Homeopathy world community and Facebook.
15. Articles and blog posts in the Internet by the following physicians:
16. Dr Francisco Eizayaga, Dr Chimthanawala, Dr Isaac Golden, Dr. Guillermo Zamora, Dr John Benneth, Dr David Little, Dr Ravi M Nair, Dr Vishwajith basu
17. Dr Debby Bruck, Dr S G Biju, Dr Moskowitz
18. Dr Smits, Dr Mikhail E W Plettner. 

(Paper presented at LIGA 2011, New Delhi) Article Published in The Homeopathic Heritage