Introduction
Epidemics are the scourge of human civilization. A smallpox epidemic in Greece in
430 BC that killed more than 30,000 people was one of the first-documented epidemics.
Throughout recorded history there have been reports of epidemics—from the plague in
Europe in the Middle Ages to the smallpox that killed millions of native peoples in
the Americas after the arrival of Europeans in the new world. Yellow fever struck
America in the late 19th century and the worldwide flu pandemic of 1918 and 1919 is
estimated to have killed 20 to 40 million people. More recently, there have been epidemics
of HIV-AIDS, Ebola, swine flu, bird flu, and Zika virus among others. Cholera and
other infectious diseases continue to be a threat wherever large numbers of people
are displaced into refugee camps.
One of the most important challenges of public health is to control these epidemic
outbreaks, which are diseases that spread rapidly and widely, affecting many individuals
in a population at the same time. Vaccines, anti-viral medications, and antibiotics
are the standard conventional treatments for these diseases. However, difficulties
with developing and disseminating immunizations, viral mutations, and the growing
problem of antibiotic-resistant bacteria are undermining these approaches. The World
Health Organization has recently called for “innovative” approaches for treating communicable
diseases.
The use of homeopathy for epidemic diseases dates back to the time of Hahnemann, who
recommended Belladonna for scarlet fever. It is interesting to note that homeopathy was invented in the
same year as Jenner first practiced vaccination (1796) and that Hahnemann strongly
favored vaccination. Homeopathy first rose to prominence in the 19th century due to
its success in treating epidemic diseases such as cholera, yellow fever, and typhus.
There are several different strategies that have been used by homeopaths to treat
epidemic diseases, including individualization, combination remedies, genus epidemicus, and isopathy. We will look at the evidence for each of these in this article.
Individualization
The gold standard in homeopathic practice is individualization. This requires an interview
by a trained homeopathic prescriber to determine the specific remedy for each person,
based on the totality of physical, emotional, and mental symptoms. We have ample evidence
of the effectiveness of individualized homeopathy for epidemic diseases. With my own
team, we successfully treated children with acute diarrhea in both Nicaragua and Nepal,
using individualized single homeopathic remedies.[1]
[2] In Nicaragua, 18 different remedies were used, while 14 were prescribed individually
in Nepal. Other homeopathic researchers have reported treating other epidemic diseases,
such as Chikungunya fever, pulmonary tuberculosis, and malaria, using individualized
prescribing.[3]
[4]
[5]
The main drawbacks of individualized treatment of epidemic diseases are related to
logistics and cost. Except potentially in a few countries of the world with large
numbers of homeopaths, such as India and Brazil, there are not enough trained prescribers
to treat everyone individually during a full-scale epidemic. The cost of mobilizing
such a force would be considerable. Another problem is the accuracy of the prescription,
which can vary depending on the skill of the prescriber. Because of this, researchers
interested in using homeopathy to treat epidemic illnesses have sought other strategies.
Combination Remedies
Combining several different remedies that are commonly prescribed for a specific disease
into one medication could be a cost-effective way to treat people during an epidemic.
There have been several studies to evaluate this approach, some more successful than
others. Because of the success of the Nepal and Nicaragua childhood diarrhea studies,
our team performed a clinical trial in Honduras using a combination remedy composed
of the five most common single remedies, which were prescribed in 80% of the cases
in Nicaragua and Nepal.[6] These were Arsenicum album, Calcarea carbonica, Chamomilla, Podophyllum, and Sulfur. The results of this study were disappointing—we found no difference between those
who received the homeopathic combination and those who were given a placebo. In retrospect,
it is possible that the symptoms of the children in Honduras or the pathological agents
involved were different than those of the previous studies and required a different
combination of homeopathic remedies. A pilot study to determine the most common remedies
for Honduran children with diarrhea might have led to a combination remedy with better
results.
A team in Pakistan recently reported the results of a trial of a homeopathic combination
remedy for dengue fever.[7] Dengue is a mosquito-borne, flu-like illness caused by a virus and is endemic in
more than 110 countries. It infects 50 to 100 million people each year and causes
as many as 25,000 deaths. The study compared a combination of ten different remedies
known to be indicated for symptoms of dengue fever with standard supportive therapy
as recommended by the World Health Organization. The remedies used were Bryonia alba, Rhus toxicodendron, Gelsemium, Aconitum napellus, Eupatorium perfoliatum,
China boliviana, Hamamelis, Citrullus colocynthis, Crotalus horridus, and Phosphorus. Supportive treatments used were acetaminophen (paracetamol), fluid replacement, and
medications for nausea and vomiting. At the end of 6 days, there were statistically
significant improvements in blood platelet levels, hematocrit, and white blood cell
counts in the homeopathic combination group compared with supportive therapy. No information
was given about the clinical course of the disease in the two treatment groups.
This study is in contrast to another by our group that compared a combination of six
remedies with placebo in patients with symptoms of dengue fever in Honduras.[8] Based on materia medica study, the remedies included in the combination were Aconitum napellus, Belladonna, Bryonia alba, Eupatorium perfoliatum, Gelsemium, and
Rhus toxicodendron. We found no differences in the resolution of pain and fever or the use of analgesics
between the two groups. Viral testing revealed that only 3 of the 60 patients in our
study had laboratory-confirmed dengue. Even so, one would expect that patients with
pain and fever would respond to this combination of remedies that are well known for
treating flu-like syndromes. Again, it is possible that the composition of the combination
remedy did not accurately match the symptoms of the patients treated.
As we can see from these studies, the difficulty with combination remedies is in matching
the correct remedies with the epidemic being treated. The best approach in the future
would be first to treat patients in a specific epidemic with individualized remedies
and then to incorporate the most commonly prescribed of these into a combination remedy.
Genus Epidemicus
The genus epidemicus is the remedy found to be most effective for a particular epidemic once data have
been gathered from several cases. This concept was first put forth by Samuel Hahnemann
in the Organon of Medicine, Aphorism 241, as “…each single epidemic is of a peculiar, uniform character common
to all the individuals attacked, and when this character is found in the totality
of the symptoms common to all, it guides us to the discovery of homoeopathic (specific)
remedy suitable for all the cases….”[9]
There is anecdotal evidence that homeopathy was successful during the Spanish flu
epidemic of 1918 to 1919, in which at least 20 million people died worldwide, more
than 500,000 in the United States alone. According to the historian Julian Winston,
the death rates for patients treated with homeopathy were 1 to 2% compared with a
30 to 60% mortality for those treated by conventional physicians.[10] The genus epidemicus for the Spanish flu, according to Winston, was Gelsemium.
A modern example of the use of genus epidemicus was reported by a group in India that performed a double-blind placebo-controlled
trial using Bryonia alba to prevent Chikungunya fever during an epidemic of this viral disease in 2007.[11] Following the method of Hahnemann, investigators first repertorized the symptoms
of 205 patients with fever and arthralgia, characteristic of Chikungunya. A group
of homeopathic experts then came to a consensus for Bryonia as the genus epidemicus after confirming symptoms in the materia medica.
Family groups of approximately 200 individuals, known as “clusters,” were then randomized
to take either Bryonia 30C or placebo during the time of the active epidemic. Out of nearly 20,000 healthy
individuals in each group, 12.8% of those receiving Bryonia developed the illness compared with 15.8% of those taking the placebo (p = 0.03). This translates into a relative risk reduction of nearly 20% in contracting
Chikungunya. These results are promising and hopefully will encourage more researchers
to evaluate this approach.
Isopathy
Isopathic remedies are made from the actual cause of the illness, or from its byproducts,
to treat that same condition. It is somewhat akin to conventional vaccination, although
the preparation is made in the homeopathic manner of potentization, with repeated
dilutions and shaking (succussion) at each step. The particular agent can be a nosode,
made from diseased tissues or bacteria, such as Tuberculinum from tuberculosis-infected lung tissue, or Anthracinum from anthrax poison. Or, it can be a sarcode, made from a healthy tissue or organ,
such as Oscillococcinum, derived from duck heart and liver. Isopathic remedies can also be made from toxic
chemicals, such as arsenic and mustard gas, allergy-causing agents, such as mixed-grass
pollens, and potentized drugs, such as penicillin, to treat the adverse effects of
that medication.
One of the first experiments in isopathy took place in London and Glasgow during World
War II, using potentized mustard gas as a preventative for chemical injury from mustard
gas.[12] Results of this experiment demonstrated a statistically significant decrease in
deep skin lesions in those given mustard gas 30C prior to applying mustard gas to
their skin compared with those receiving a placebo. Another study, using an isopathic
preparation of mixed-grass pollens to treat patients with allergic rhinitis, also
found significant results.[13]
There are several interesting studies using isopathy to treat epidemic diseases. As
previously noted, Oscillococcinum is a homeopathic preparation made from duck heart and liver, thought by some to be
a reservoir of influenza virus, although this has not been definitively proven. Oscillococcinum has been used successfully in a double-blind study to treat patients with influenza-like
illness.[14] In another experiment, a nosode was made from tissues of mice infected with the
bacterium causing tularemia, a tick-borne disease mostly found in animals but sometimes
in humans.[15] Potencies of 30C, 200C, or 1M were given prophylactically to healthy mice for 30
days. Age-matched animals were treated during the same time with 70% ethanol as controls.
After a challenge with a lethal dose of the bacterium, all those treated with the
nosode, except those receiving the 1M, had statistically significant decreased mortality
and increased mean times to death. The overall mortality rate was reduced by 22% in
those treated with these nosodes.
A striking example of the use of isopathy for disease prevention occurred in Cuba
during an epidemic of leptospirosis from 2007 to 2008.[16] Caused by a gram-negative bacterium, leptospirosis is spread through the urine of
domestic and wild animals and can cause serious infections such as meningitis, hepatitis,
and pneumonitis. It is especially prevalent in areas with poor sanitary conditions
and can reach epidemic proportions after heavy rainfall and flooding from hurricanes
and other natural weather disasters.
During a period of widespread flooding and increased incidence of leptospirosis in
three provinces of Cuba in 2007, 97% of the entire population over 1 year of age was
treated with a nosode that comprised four strains of inactivated Leptospira.[17] Over a 5-week period, more than 2 million people received two oral doses of the
200C potency of this preparation. This was followed nearly a year later with two 10M
doses of the same nosode. Disease surveillance statistics revealed an 84% decreased
incidence of the disease in these provinces in 2008 compared with previous years,
despite the occurrence of three large hurricanes. In contrast, the incidence of leptospirosis
in the other, untreated, provinces of Cuba rose by 21.7%. There is a concern in the
leptospirosis data, however, that the incidence of the disease dropped from the highest
to the lowest in successive weeks: between week 52 of 2007 and week 1 of 2008.
