Homeopathy and AYUSH ignored in Covid19 intervention when history points to its documented role and scope in pandemics

Dr Eswara Das

POINTERS

• Irrationality in exploring Covid19 treatment even at critical times ? – AYUSH kept at bay ?
• Prince Charles recovers fast from Covid19 with Homeopathy – Can we do it to the World
• Homeopathy & AYUSH ignored in Covid19 intervention possibilities when history points to its documented role and scope in pandemics ?
• Is Symptom Similarity based remedies by Homeopathy missed out from war against Covid19 ?
• Homeopathy Solution with Symptom Similarity based prescriptions – an upper edge in intervention of Covid19 ignored ?

The news that Prince Charles has recovered from Covid19 with Homeopathy being treated by Dr Issac Mathai of Soukya, Bangalore as quoted by Shri Manish Tewari, Member Of Parliament in his letter to Prime minister Narendra Modi requesting to lay stress on Homeopathy and indegenous treatments and to send policy directions to all state governments to use local Homeopathy and AYUSH doctors to provide appropriate treatment protocols for the quarantined and for general public to boost their immune systems, gives fresh hopes worldwide. Covid19 when treated with Homeopathy therapy early along with the support of conventional therapy could be a huge opportunity to the world in tackling this menace.

The century’s most devastating calamity has engulfed every nook and corner of the world in the sordid form of Covid 19. Irrespective of the status of the health care facilities, both developed and developing countries are prime victims of its onslaught. Every Government is making desperate efforts to contain it through established public health care protocols. The extent these efforts succeed in controlling the challenges thrown out by this minute virus to the very existence of the human race would be judged only after we succeed in its uncontested spread. As per a report, America is reporting above 4000 deaths and over 2 lakh confirmed infections of Novel Coronavirus!. New reports say that even droplet infections are very likely which is going to be all the more challenging. 

The Government of India is taking every possible effort by social distancing, quarantine, putting effective restrictions on air, train and road travel, ban on public movement, converting every hospital, hotels, stadiums, the Indian Railway coaches to ICU and quarantine. On another spectrum there are reports that the medicines like Hydroquinone, that were used on Malaria, BCG Vaccines, HiV etc are being tested for prevention and cure of Corona without any scientific evaluation and as a desperate move to find solutions. Some of these are highly toxic on the already immunocompromised patients and doctors cautioning it should not be used without medical supervision. One report says that even one doctor who used it as a preventive died of cardiac arrest, driving the medical fraternity into a frenzy.

In this context, exploring multi-dimensional possibilities for resolutions from Covid19, it is sad to see that India which beholds the ethos and culture of the country is feared to have ignored and failed in tapping the right resources in the AYUSH sector which has time tested practice in healthcare. When bio-molecular medicine demands in vitro evidence and disease centric treatment, the AYUSH systems proceed to adopt a patient centric approach on the basis of disease expressions. A major treatment paradigm under AYUSH, that evolved centuries ago based on the signs and symptoms are also presently the second largest healthcare fraternity of the world – Homeopathy. The process they follow is exactly the same,  that the present  conventional medicine resorted to until the derivation of disease specific therapeutic modalities are invented. The AYUSH practitioners are demanding opportunities to treat active Corona cases exactly the same symptomatic basis. Some State Govts have enforced the age old Infectious Control Act, thereby effectively curtailing AYUSH practitioners from even seeing an active case to understand the symptomatology or to try their medicines when on the other side it is seen that the mainstream has engaged themselves with extensive risk in experimenting with cases with less caution and has grossly added to the chaos !

Though Covid 19 is a new generation threat, the world has faced several pandemics in the past. Epidemiological evidence on the merit of Homeopathic interventions cannot  be simply  washed  away.  Most of the evidence available happened much before the emergence of the current bio medicine, modern epidemiology and contemporary vaccines.  In 1813,  when the endemic of Typus  hit in Leipzig, Hahnemann the founder of Homeopathy treated 180 people, out of which he lost only 2 patients, whereas with the conventional treatment the mortality was more than 30%. In the Cholera endemics in 1831 with  about 80% mortality, with Homeopathy  it was only 9%,  Again in 1854,  when London was inflicted with the Cholera epidemic the morality with Homeopathy was 9% and with conventional treatment it was 60%. In the case of Yellow fever endemic in the US in 1878, when the whole Mississippi valley was  affected and about 20,000 people died, the people who used Homeopathy recovered  much better ( morality 6%.)  Such evidence exists in Homeopathy on Smallpox, Diphtheria, Scarlet fever and many others. The question in present-day context is when no effective interventions are available in the dominant system, why the Govt is reluctant to encourage the AYUSH systems, which claim to have treatment options either as stand-alone or as an adjunct with the WHO notified safety measures. The misunderstanding is that AYUSH modalities are not scientific when looked through the prism of biomedical research.

Science Art and Philosophy in Medicine
It is seen that every medical system has evolved from different philosophies and civilizations based on the ethos and cultures of its origin. Therefore, to understand the science of a particular medical system, one has to understand the traditions from which it got codified. Those who understand this premise shall easily comprehend the science of that system and those who decline to acquaint with it shall perceive that system to be redundant. Thus, for people who know Indian philosophy accept the tridosha theory of Ayurveda as scientific without any prejudice. Same is the case with Homeopathy; those who believe in vitalism, accept it as a refined medical practice.  The argument as to what is the science in a particular system continues amongst the academia without much significant impact on its public acceptability

Each medical system is self regulated through science to theorize its concepts, art as a means to apply the science on patients and philosophical concepts for the safety and ethics of practice. The AYUSH practices which are based on powerful principles, considered as scientific at its time of origin. These practices follow the approach based on their philosophy in managing illnesses and provide health care services to the patients. Homeopathy evolved principally due to the dogmatic practice prevailing in the western medicine at the time of its origin and was very much a leading medical practice in several countries.  The Allopathy of pre 20^th century, evolved from the Hippocratic aphorisms used unprincipled treatment modalities for over 2000 years, now adopted scientific innovations and transformed as pure biomedicine.  In spite of the fact that whether one medical system is  more scientific or less scientific, public acceptance to treatment from these medical systems co exist  in different countries and is contributing their strength by using the science as they understand to be correct and art as they consider necessary. 

The extent on which one system presupposes the contemporary knowledge of science to explain its basis in a language understandable in a rational way makes it perceivably more scientific than other systems. If the knowledge is contemporary, that system becomes scientific and if not, it becomes unscientific. In all the traditional medical practices or the CAM therapies, their approach towards disease, patient and treatment remained constant.  Therefore, it can be inferred that it is the time of assessment that makes one medical system more scientific or less scientific and not its approach towards the patient. The truth is that science, as it exists at a particular time, has provided the key to intellectual expansion. 

The science in medicine consists of theories and principles that form the basis to rationally understand the system. This includes the process of the disease, its general management and the therapeutic tools and methods to treat illness or preserve health. While art in medicine is considered as  the basis of understanding the patient and  management of  sickness including the  selection of the medicine, the recent trend is to seek explanation more so to satisfy others. The art includes understanding the constitution and temperament of the patient, medical humanities, compassion towards the sick, sensitiveness to his illness, understanding the behavior in emotional distress etc. This varies from individual to individual  based on the circumstance and social aptitudes.  There may be less rationality on the above attributes when scrutinized from a rationalistic view, especially the physical ailments from a modern medicine perspective. However in circumstances dealing with patients, these attributes form a major factor. Thus, the art of medicine  in Homeopathy deals with the whole gamut of doctor-patient relationship  For example, a patient of typhoid, whether he is thirty or not, whether he prefers covering or uncovering, restless or calm is quite insignificant in biomedicine to  understand the patient or  for making prescription. The thrust given there is mainly on changes in bio- chemical parameters, evidenced through laboratory reports. Homoeopathy based on vitalistic philosophy, gives significant importance on the emotion, feelings, understanding etc. to know the patient as also for prescription. Here, there is a definite correlation with mind and body. That is why homoeopathy is considered holistic.

The following are the major factors that decide whether one is sick or  otherwise.

1. The evidence of a disease felt or explained by the patient: a feeling that he is sick (subjective symptoms).
2. The evidence of diseases elicited by the physician and or explained by the attendants: signs and objective observation etc. 
3. The evidence of diseases corroborated by clinical findings such as physical examination and laboratory data.

Unless a physician gets positive information on any two or more of the above in one patient, making a treatment protocol for the disease condition is unethical. 

The Need of the hour
When the scientific community is trying for every possible means to defeat the onslaught of this deadly virus and the practitioners of AYUSH systems are willing to submit their time tested principles are practices for scientific validation, putting an iron barrier  in front of them and denying every single opportunity  to see the active cases of Corona and give their treatment approaches in the name of insufficient evidences or on public safety is sheer nonsense.  This a deliberate attempt to deny an opportunity due to either apathy towards the system or due to hidden pressure from lobbyists. The best option to India where resources are scarce is to utilise whatever is best available  through a system neutral approach  for the welfare of the public. The main concern in this approach should be safety of the interventions, quick adaptability, effectiveness, least side effects, easy distribution channels, cost-effectiveness. The crucial observation that the genomics of the novel Coronavirus seen mutating constantly and assumed to have crossed a couple of hundred times already, points at the likely failure of one vaccine and drug intervention strategies  substantiates the model of approach based on symptomatology generated an its similarity with those of drugs as in Homeopathy. The news that in China, studies as a part of the Covid19 interventions showed that the most efficient results came from the cases which received conventional medicine plus alternative bio-medicine which include TCM – traditional Chinese medicine. This calls for urgency for the world to adopt a new and most efficient direction with no further delay.

Huge unutilised infrastructure and resources in AYUSH
In India there are about 900 teaching institutions in the AYUSH sector with more than 7 lakh practitioners. About nearly 25000 new students join AYUSH streams with the same number of interns and Postgraduate trainees. They are well trained in Community medicine, public health issues, curative, preventive and promotive health as per the standard curriculum at par with that in Allopathy. There are also a number of Public health institutions in the form of hospitals, dispensaries in the sector. The practitioners of AYUSH systems are available in every nook and corner of the country. The public have faith in the therapeutic modalities, practices and principles of these systems.  In the present predicament, neither the Nithi Ayog nor the policy makers seems to have taken this huge resources available in combating the national crisis. The AYUSH fraternity has offered all sorts of support and the research councils in the AYUSH systems have notified their strength on the management of Corona. The  Scientific Advisory Board of the Central Council for Research in Homeopathy ( CCRH), the apex research Council has  notified that Ars alb in 30 potency could be used as a preventive for the present epidemics based on their concept, principles and symptomatology. 30 potency in Homeopathy prepared  by  a method called potentisation , where the original  medicinal substance is highly diluted (min this case  10^{– 60}) and sucussed there by producing nanoparticles making the medicine  free from any toxicity.

Win on the Covid 19, a collective responsibility
The present crisis needs to be effectively contained at the shortest time. One of the best possibilities is to go for an integrated health care approach by polling all available resources.   India follows a pluralistic health care delivery system and therefore it is easy to be implemented scientifically.  One possible integrated approach could be as under:

Options Stage	Target	Symptom	Allopathy	Ayurveda	Homoeopathy	Unani	Siddha
Stage1	Community/ Individual	General apprehension and desire of prevention	vaccines(Under development)	Samshamni Vati 500 mg with warm water for 15 days(aqueous extract of Tinospora cordifolia)	Ars Alb 30 daily once on empty stomach for 3 days to be repeated after one month Or  Nosodes(under development)	Decoction of Behidana,Unnab and Sapistana as recommended by AYUSH	Nilvembu Kudineer decoction 60ml twice a day for 14 days
Stage 2	Individual	flu like symptoms ,cold,cough etc	antiviral ,anti flu ,antibiotics and other suitable medicines as per ROP (Recommendation of physician)	AYUSH 64,Agastya Hariteeka,Anu Thailam /sesame oil as ROP	Ars Alb, Bryonia, GelsemiumEup Perf Rhus Tox etc as per ROP	As per ROP	As per ROP
Stage 3	individual (In hospital or in isolation at home as per ROP or health authorities)	flu like symptoms ,cough,cold etc with more severity	Same as stage2 and as per ROP	As per ROP	As per ROP	As per ROP	As per ROP
Stage 4	Individual	Pneumonia,SARS	Hospitalisation	Hospitalisation	Hospitalisation	Hospitalisation

The above table gives a broad idea on utilising resources optimally and effectively. Every medical system has certain strength in health care. Effective usage optimally shall save the country from peril. Public health is the primary concern of every medical system. Utilising AYUSH along with Modern Allopathy (AYUSHMA) shall be a role model to the world. Homeopathy has already established several successes  in controlling Infectious diseases and epidemics. Few are the Cuban research finding on Leptospirosis,  Rapid Action Epidemic Control Cell ( REACH) under Govt of Kerala on chikungunya, several viral fevers, Flu like diseases, cholera etc, Japanese Encephalitis by Govt of Andhra Pradesh and the CCRH etc.  To see these entire realities one needs to have an unbiased scientific fervour. What is science and what is not science shall be evaluated by the Biostatisticians and epidemiologists. No country can remain locked for long periods. The co-morbid conditions, NCDs, Stress related lock down etc is bound to add more challenges in the Healthcare system. Need of the hour is to effectively use every health care technologies available at the disposal of the Government to overcome the present crisis. This may also shape a new health care model to the world to face the future challenges.

Dr.ESWARA DAS
Chairman, Global Homeopathy Foundation
(Former Director, National Institute of Homeopathy, Kolkata under Ministry of AYUSH, Government of India) (with Input from  Satyanarayan Dangayach, Innovative Thoughts Forum, Ahmadabad, Dr Jayesh Sanghvi, Chennai and Dr Sreevals Menon, Calicut)