Keywords
genus epidemicus - COVID-19 - homeopathy
Introduction
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), has brought about the worst pandemic in recent decades,
with tens of millions having been infected worldwide and over one million associated
deaths. Though the infection is mostly asymptomatic (80%), some individuals present
bilateral viral pneumonia with or without respiratory distress, and a few individuals
present a severe complex virus-mediated systemic disease, with inflammation and hypercoagulability
affecting any organ and whose physiopathology is not yet well established.[1] The high transmission rate of the virus and the severity of symptoms have generated
a global health crisis.
There are some studies showing that homeopathy could be a good therapeutic tool in
epidemic diseases.[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12] Hahnemann himself had some experience with the cholera epidemics in the early 19th
century in Europe: in the sixth edition of the Organon of Medicine, he explains how to manage epidemic diseases with homeopathic treatment, making it
very clear that each of them is different from the previous one, even if it is the
same pathogen. Through careful observation of a certain number of cases, the homeopathic
physician can analyze the “genus epidemicus”, an image of the set of symptoms that
all the patients present, to select one or more similar homeopathic medicines suitable
for the treatment of the majority of people suffering from that epidemic disease.[13]
[14] Hahnemann went further and even postulated that this same medicine would also be
useful to prevent symptomatic disease in individuals.
The Clinical Department of the Academia Medico Homeopática de Barcelona (AMHB) launched
a study in March 2020 to collect clinical cases of COVID-19 who were treated with
homeopathy. The study was conducted by local homeopaths, aiming to determine the homeopathic
symptomatic characteristics of the COVID-19 outbreak and to identify a group of epidemic
medicines or a genus epidemicus that would be useful to treat most patients. A secondary
objective was to analyze the response to the homeopathic treatment.
Methods
The present study is a case series of confirmed and suspected COVID-19 cases collected
in Spain. It is an open, prospective, multi-centered, non-comparative cohort of cases.
The study obtained Institutional Review Board approval by the AMHB on March 30th,
2020. All subjects gave informed consent to data collection and data were anonymized
at source.
Cases were collected from the private practices of homeopathic physicians who are
the members of the AMHB. On March 13th, 2020 (day 0 of our study), all AMHB members (approximately 190) received an email
explaining the study, its objectives, and two checklist documents ([Supplementary Files 1] and [2], available online only) to enable data collection from patients, as well as informing
them about the inclusion and exclusion criteria. An email address was also provided
to every associate to centralize the case data collection (email and AMHB database).
Any patient consulting a homeopath member with symptoms of fever, cough, or respiratory
distress, and with high clinical suspicion of COVID-19 or close contact with a confirmed
diagnosis of COVID-19, or with diagnostic confirmation by PCR, could be included in
the study after providing informed consent.
Two questionnaire checklists have been used: Q1 and Q2 ([Supplementary Files 1] and [2], available online only). Q1 is the initial questionnaire, which collects personal
data and symptoms, preferably completed by the patient, and with a free-text section
to characterize symptoms, sensations, and others. A later section allows the patient
to select the modalities of each of the three predominant symptoms in the clinical
picture (fever, cough, and respiratory difficulty). Finally, there is a section to
specify any risk factors for severe disease and there is also a space to register
homeopathic prescription (medicine, potency, doses). Q2 should be completed at 10–15
days after starting the treatment, whenever the outcome was favorable, or earlier
whenever the patient needed a change of prescription if there had been no improvement
(second homeopathic prescription).
Data obtained from the questionnaires have been transferred to a database from which
the statistical analysis has been done (presented in Results).
To evaluate each prescription made, we have used the descriptive term “good response”
if it produced amelioration and no other remedies were prescribed for a full recovery.
If a change of remedy was needed, although the first prescription ameliorated some
of the symptoms, the prescription was evaluated as “not good response”.
Results
On June 6th, 2020, the epidemic curve flattened in our region. The new cases being
fewer and having collected more than 100 cases, we decided to finish data collection
and start analysis of the data to share them with the scientific community. We present
here the findings for medicines used, together with symptoms, sensations, and follow-up
of confirmed or highly suspected COVID-19 cases ([Table 1]).
Table 1
Homeopathic medicines used
|
Homeopathic remedy
|
Number of prescriptions
|
Good response cases
|
Dyspnea, chest pain, or moderate cases
|
Good response in dyspnea, chest pain, or moderate cases (%)
|
Time to full recovery since prescription (days)
|
Used in first prescription
|
|
Bry
|
29
|
21 (72%)
|
14
|
60%
|
8.2
|
22
|
|
Ars
|
20
|
10 (50%)
|
7
|
43%
|
13.7
|
20
|
|
Phos
|
16
|
9 (56%)
|
9
|
33%
|
14.4
|
10
|
|
Gels
|
10
|
2 (20%)
|
1
|
100%
|
10.5
|
6
|
|
Camph
|
7
|
3 (43%)
|
6
|
50%
|
11
|
2
|
|
Sulph
|
6
|
6 (100%)
|
4
|
100%
|
3.5
|
3
|
|
Bell
|
6
|
4 (67%)
|
1
|
0%
|
5.75
|
4
|
|
Puls
|
5
|
4 (85%)
|
0
|
–
|
6.25
|
4
|
|
Chin
|
4
|
0 (0%)
|
2
|
0%
|
–
|
1
|
|
Nux-m
|
4
|
3 (75%)
|
2
|
50%
|
4.3
|
0
|
|
Nux-v
|
4
|
2 (50%)
|
4
|
50%
|
1.5
|
1
|
|
Ant-t
|
4
|
2 (50%)
|
1
|
100%
|
15
|
3
|
Other remedies prescribed: Sil, Lach, Grin, Nat-m, Lat-m, Thuj, Kali-c, Spong, Rhus-t, Carb-v, Sarcol-ac, Tritic-vg,
Verat, Lyc, Kali-s, Chinin-m, Petr, Bamb-a, Ferr-p, Abrot, Ph-ac, Caps, Mag-c, Cypra-eg,
Moly, Arn, Caust, Sam-ox, Merc, Am-c, Calc.
Data from 107 clinical cases were provided by 19 homeopathic local doctors. All cases
came from Spanish individuals, mostly from Catalonia region (98%). Using the WHO COVID-19
disease severity classification,[1] 90 (84.1%) of our cases could be classified as mild (fever, flu-like symptoms, and
negative radiology test [Rx]), 13 (12.1%) as moderate (same plus Rx positive and mild
hypoxia and dyspnea), two (1.9%) as severe (hypoxia and dyspnea, oxygen needed, and
hospitalization), and two (1.9%) as critical (severe acute respiratory syndrome).
It should be said that 34 of the cases classified as mild (30% of total) were patients
between mild and moderate categories; those patients had dyspnea or breathlessness
with no Rx findings or with no Rx performed. Seven patients (6.5%) required hospitalization
at some point and two patients died (1.9%).
In order to simplify our data analysis and to enable stronger conclusions on the genus
epidemicus or set of homeopathic medicines most likely adequate to treat these patients,
we have analyzed the data only from the 103 patients with mild or moderate disease.
We have excluded the four patients with severe or critical disease because their small
numbers could invalidate the extrapolation of findings.
Most of the patients were women (76; 73%). The average age was 49.2 years (range,
3–72 years). Twenty-five cases (24%) had been confirmed by PCR as COVID-19 and another
50 (49%) had a close contact with a PCR-confirmed patient; at the end, 73% of the
cases collected were confirmed COVID-19 cases or highly susceptible due to a close
contact with a positive patient. Three cases were tested negative, despite highly
compatible symptoms (possible false negative).
Radiology tests (Rx) were conducted in 18 cases: 17 simple chest X-rays and one computed
tomography. Twelve cases (12%) had pathological findings: four bilateral findings
(one in lower lobes); five in the lower lobe right lung; one in the left lung; two
non-specified.
The checklist included the main co-morbidities described as negative factors in COVID-19
prognostics[1]: 11 (10.7%) patients had chronic pulmonary disease, eight (7.7%) obesity, and three
(2.9%) cardiovascular disease; no one had diabetes.
Fever, Cough, and Respiratory Distress
The cases collected showed a fever mostly at night, with two major temperature peak
hours, 7 p.m. and 11 p.m. Most patients reported feeling cold and chilly (60; 58%),
with desire to be covered (49; 47.5%) and worsening when uncovered. Thirty (29%) of
the patients referred to cold body parts, such as feet and hands, with icy coldness
in some cases. Chills were frequent (47%) and it was common to see fever without perspiration
or with night perspiration. Likewise, most referred to thirstlessness and, in fewer
cases, loss of appetite.
In half of the cases there was little cough or no cough (45; 44%). When it was present,
it was dry cough, predominantly at night. As for its modalities, it worsened with
inspiration and deep inspiration, by exposure to cold air and especially when speaking
and with movement; it improved by changing position, sleeping, and by lying down.
Those modalities seem to be more general than specific to the cough itself, and in
most of the cases cough was not unbearable or generating discomfort to the patient
(see also Discussion).
Forty-three patients (41.7% of the cases) presented with respiratory difficulty or
the sensation of suffocation. Similar to fever and cough, it was predominant at night,
worsened especially by movement and talking, but also by standing, eating, coughing,
or by breathing in deeply. It improved when lying down or when changing position.
Concomitants
Regarding the concomitants, we should highlight weakness and fatigue (89%), muscle
pain (62%) and headache (55%) above the rest. Diarrhea (28%) was also a common symptom.
A few patients (3.9%) presented extreme fatigue, with difficulty in holding up their
own head or other parts of the body.
General Symptoms
The most prominent symptoms and general modalities were great desire to lie down in
bed (13%) and sleepiness (10%). Improvement from sleep, as well as extreme weakness,
was also present. There was desire for fruit, juices, or fresh things (8.7%) and improvement
by warm drinks (13%). General worsening from talking was notable, aggravating cough,
and respiratory difficulty. Some patients reported feeling worse by noise or by tight
clothes.
Mental Symptoms
The most relevant symptom in this section is “anxiety about one's own health” (17.5%),
with frequent fear of sickness, death, or hospitalization. Anxiety in general was
worse at night with, in the most symptomatic cases, a very specific and repeated symptom
of fear of suffocation or dying from suffocation (11 cases, 10.7%). Other fears and
concerns have also been collected: anxiety about family members, fear of being alone,
fear of poverty, and fear of insanity or becoming insane.
Other mental symptoms that emerged to a lesser extent were irritability (6%), lack
of concentration, dullness and slow thinking (9% globally), or apathy.
Local Symptoms and Sensations
Due to their frequency and relevance, we must underline loss or alteration of taste
(21%) and loss of smell (20%), or the presence of both (13.6%), as being characteristic
of COVID-19.
With regard to pulmonary symptoms and sensations, the most relevant were chest oppression
or tightness (14.5%), mainly focused on the sternum; chest pain (7.7%), usually stitching
or lancinating; and suffocation (7.7%). Particular sensations described by patients
were internal dryness, itching, heat, tickling in the lungs, air itching when entering
the lungs and, with lesser frequency, burning, tiredness, fullness, soreness, and
“sticky”.
All along the airway path, from the nose, mouth, larynx, throat, to the trachea, the
same sensations were described: dryness, itching, and burning. A cold air sensation
and choking mucus in the larynx were also referred to.
Symptoms in other areas of the body were also described. The most repeated symptoms
were loathing of food (5%), internal dryness (6%), and itching eruptions (5%). Also,
soreness in the eyes, noises in the ears, fullness of stomach, skin sensitive to touch,
trembling weakness, vertigo, and palpitations were seen to a lesser degree.
Symptoms Analysis
The repertorizations presented in [Fig. 1] (Radar Opus) and [Fig. 2] (MacRepertory) provide a synthesis of the symptoms reported by patients who were
analyzed and registered in the database, showing: (a) the most peculiar, like the
loss of taste and/or smell; (b) the most characteristic (fever, chill, cough, difficult
respiration, chest oppression) with its concomitants or its peculiarities; (c) general
symptoms; (d) multi-locational sensations, ameliorations, or aggravations, such as
itching or tickling sensations all through the airway, dryness over all mucous membranes,
a general amelioration with lying down or a general aggravation by talking; and (e)
mental symptoms (fear of suffocation and anxiety about health).
Fig. 1
Synthesis repertory—RadarOpus.[15]
Fig. 2
Complete repertory—MacRepertory.[16]
Homeopathic Medicines Prescribed
Eighty-eight cases had a complete follow-up; 15 of the 103 cases were lost to follow-up
or the information provided was insufficient to evaluate the prescription. We have
evaluated all prescriptions from 88 cases with complete follow-up. As stated in Methods,
the “Good response” category has been given if the prescription produced amelioration
and no other remedies were prescribed for a full recovery. To study better the most
prescribed remedies, their effectiveness, in terms of time to full recovery and by
first prescription, was evaluated separately for cases of dyspnea and/or chest pain
and for all moderate cases.
Forty-three different homeopathic medicines were prescribed. As shown in [Table 1], the most prescribed were Bryonia alba, Arsenicum album, Phosphorus, Gelsemium and Camphora. The remedies that showed better results (with six or more cases collected) were
Sulphur (100% “good response”), Pulsatilla (85%), Bryonia alba (72%), Belladona (67%), Phosphorus (56%) and Arsenicum album (50%). Gelsemium and China officinalis, though being among the most prescribed medicines, each showed a very low response
in this same sub-group of cases ratio (20% and 0%, respectively).
When lower respiratory tract symptoms were prominent (dyspnea, chest pain, and for
moderate COVID-19 cases), the most prescribed medicines were Bryonia alba, Phosphorus, Arsenicum album and Camphora. The best responses in this same sub-group of cases were obtained (for six or more
cases) with Bryonia alba (60%), Camphora (50%), Arsenicum (43%) and Phosphorus (33%).
The average time to full recovery of all 88 cases was 13.3 days (range, 1–60 days),
with an average of 1.6 homeopathic medicines used per case. Full recovery time after
homeopathic prescription ranged from 3.5 to 14.4 days, depending on the remedy used,
and the fastest recoveries were obtained with Sulphur, Belladonna, Pulsatilla and Bryonia alba (for remedies used in more than six cases).
Some of the patients were treated using homeopathy along with conventional medicines
or natural supplementation as follows: azithromycin (five cases), hydroxychloroquine
(4), non-specified antibiotics (3), anti-viral drugs (3), corticosteroids (2), and
vitamin C (4).
With regard to potency of remedies, 30c was the most frequently used, followed by
200c and then LM potencies ([Table 2]). A change of remedy or potency was needed in more than 50% of the cases that received
a 30c potency. On the other hand, 200c potency remedies had the best ratio of good
response (62%) among the more frequently used potencies.
Table 2
Homeopathic potencies used
|
Potency
|
Used
|
Good response
|
Change of potency is needed
|
Change of remedy is needed
|
|
5c
|
1
|
–
|
–
|
1
|
|
7c
|
1
|
1
|
–
|
–
|
|
15c
|
1
|
–
|
1
|
–
|
|
30c
|
89
|
43
|
11
|
35
|
|
200c
|
45
|
28
|
4
|
13
|
|
1MK
|
6
|
4
|
–
|
2
|
|
10MK
|
1
|
|
1
|
|
|
LM
|
19
|
12
|
|
7
|
Discussion
To our knowledge, this is one of the largest reported collections of COVID-19 cases
treated with homeopathy.[16]
[17] Besides having some methodological, study sample or data collection bias, the results
of the study seem strong enough to be extrapolated to other populations infected with
a symptomatically mild or moderate COVID-19 disease, enabling us to postulate a valid
genus epidemicus with a candidate set of useful homeopathic medicines that could be
helpful in treating or preventing further COVID-19 outbreaks.
On the various factors that could somehow limit the validity of the study, we would
like to comment first about the study sample. Even though the study sample is quite
heterogeneous, representing all age ranges and both sexes, it is likely to be representative
only for mild and moderate cases of COVID-19. We attended only four cases of severe
or critical COVID-19. Those latter cases presented with severe respiratory distress
and other characteristic symptoms of advanced stages of the disease, with complex
systemic involvement established. As the analysis of those four cases might have altered
the validity of the results for mild or moderate cases, we decided to exclude them
from this analysis. As commented by Waisse et al,[17] the coronaviruses have a large symptomatic range and affect some age groups differently
from others, so other studies focusing on severe disease are needed to determine its
symptomatic homeopathic characteristics and its genus epidemicus.
Another bias that we may have incurred is in patient selection. In order to be included
in the study, cases needed to meet specific symptomatic criteria (presence of fever,
cough, and/or dyspnea) instead of allowing any symptom related to disease in confirmed COVID-19 cases. It would probably have been
more rigorous if the selection criteria had been only PCR-confirmed COVID-19 cases
with any presenting symptomatology, but due to scarcity of diagnostic tests at that time in
our region, especially for those patients with mild disease, it was difficult to do
so. As the clinically established picture elsewhere was the presence of fever, cough,
or respiratory distress, we decided to focus on patients attending our practices with
those symptoms in order to focus on COVID-19 and trying to exclude other diseases.
This selection might have given importance to these symptoms, thereby underestimating
others. Having quite a large sample size, however, we feel we have reduced the possible
impact of this selection bias.
We recognize it would have been desirable to have all included cases confirmed by
PCR test. At the time of data collection, there was a high community transmission
rate in our region and low availability of diagnostic PCR tests, so Health Authorities'
policies were advising testing only in moderate-to-severe cases of COVID-19, and mostly
attending in hospital facilities. Nevertheless, 29 cases (27%) were confirmed and
another 50 (46.7%) were in close contact with a patient with a positive PCR test.
So, up to 70% of the cases collected were confirmed or were positive symptomatic contacts,
which we believe is high enough to give validity to our study.
As stated in Methods, data were collected through questionnaires that were completed
either by the patient or physician, but although the recommendation was their completion
by the patient, most of them were completed by physicians, probably losing quality
and detail in terms of wording and expressions. Furthermore, whilst the questionnaire
allowed a free-writing section, it was mostly a checklist, which again might not be
the best option for quality and individualization as it induces a form of response,
but it is still a good means of easy collection and systematization of information
about specific symptoms and their modalities.
Regardless of all those confounders and limitations, we believe that the analysis
of more than 100 cases shows a well-defined clinical homeopathic picture of the mild—moderate
COVID-19 disease in our region, valid for finding a set of genus epidemicus medicines,
or remedies most likely to be useful. As shown in Results, the clinical picture is
as follows: presents predominantly fever at night, with a sensation of chilliness,
chills, cold or icy hands and/or feet, needs to be covered, perspiration is absent
or nightly perspiration appears, with thirstlessness. Dry cough is common. In the
respiratory domain, we have seen suffocative sensations, shortness of breath, with
tightness of chest, and predominantly nocturnal, with dry, itchy, tickling, and burning
sensations in the lungs and the entire respiratory mucous membranes. Mental symptoms
such as anxiety at night, fear of suffocation at night or during sleep, and concern
or anxiety about their own health were frequent. In the general symptoms section,
we found fatigue predominantly, sometimes extreme, with great need of lying down,
resting, and sleepiness. Muscle pain and headache (with no clear modalities) were
usually described by patients. Diarrhea was also commonly noted. Talking worsens the
patient situation generally, and more particularly cough, the suffocative sensation
and the dryness. There can be loss of taste and smell and an aversion, disgust or
nausea for food, improvement by hot drinks, and desire for fruit or refreshing food.
With this final breakdown of the symptoms that seem most relevant to us, we would
like to emphasize some aspects. Though COVID-19 is a viral disease with clear involvement
of the respiratory tract and one of the characteristic symptoms of the disease is
cough, we found that cough was not so predominant among our patients, and those who
present it were not able to describe any particular characteristics or modalities
other than a dry cough that improves when lying down and worsens with speaking. These
latter two modalities, rather than being particular to the cough itself, seem to be
general modalities, and they are also referred to in association with respiratory
distress, and general and local symptoms.
On the other hand, dyspnea is expressed as a feeling of suffocation, that air is not
inhaled, that the lungs cannot be filled up, etc., but in most cases without tachypnea.
In many patients, it seems that the patient is not able to discriminate between anxiety
and respiratory distress; subjective and objective symptoms are mixed, and the patient
does not know or can differentiate them. There is likely to be a component of both,
but this perception reported in some cases seems relevant to us. Since we must sub-divide
the symptoms by categories, we have included the feeling of suffocation as a respiratory
difficulty and also as anxiety or fear of suffocation, depending on the emphasis in
the patient story. Regarding mental symptoms, fear and anxiety predominate, both closely
related to the feeling of suffocation, and predominantly at night or sleeping. Fear
and anxiety are about death and suffocation. Also, though not so relevant, fear of
becoming ill and fear of contagion are worries that perhaps we can attribute in part
to the contemporary social situation of “lockdown”, bad news, uncertain information,
etc.
Other relevant symptoms that we would like to emphasize are the loss (or sometimes
alteration) of taste and/or smell, very characteristic and particular to the current
epidemic.
Likewise, about the general symptoms, we underline the tiredness, prostration and
weakness expressed by the majority of patients, in some cases extreme fatigue that
is a very intense, almost paralytic, weakness manifested as “I cannot even hold my
head up” or “I cannot hold the phone in my hand”. Conversely, the headache, whilst
very frequent, does not present any particular characteristics, and so for now it
has not been included in the repertorizations.
Another symptomatic aspect that seems important to us in the analysis for the genus
epidemicus is the sensations expressed by patients. In the cases collected, it seems
that they are “multi-locational”: that is, the same kind of sensations is experienced
in different places in the body. There is predominantly dryness, which is very intense,
at various levels: the mouth, throat, larynx, lungs, but also itching and burning,
expressed as “the air itches on entering” (reported by two patients), “tickling of
the lungs on inspiration”, or “feeling that the lungs are sticking inside”.
These symptoms—the most frequent and intense but also the most characteristic and
particular—are the ones that should guide our analysis in the search for a genus epidemicus,
a clear symptomatic picture of the COVID-19 disease in the current epidemic in our
region. And the in-depth study of this genus must lead us to Materia Medica of the
most similar homeopathic medicines.
As seen in the repertorizations in [Figs. 1] and [2], the remedies that appear in the first positions have also been used in the prescriptions.
We must underline the remedies that appear at the top of each repertorization: Phosphorus, Nux vomica, Pulsatilla, Bryonia alba, Rhus toxicodendron, Arsenicum album, Lachesis,
Sulphur. Going through the Materia Medica, we could exclude some of them, such as Rhus toxicodendron.
Bryonia alba was the most used remedy and offered an acceptably good response ratio of 72%. Also,
it was the most prescribed remedy for the moderate stage and for dyspnea and chest
pain cases, with 60% of good response in those. The average time to full recovery
since prescription was below that for all remedies (8.2 days). Though it is not the
first-listed remedy from the repertorizations, it is always among the top ten and
its Materia Medica is far better correlated with the symptoms gathered from COVID-19
patients.
Phosphorus is also a remedy to be considered when treating COVID-19 patients. It appears as
first-listed on both repertorizations, Complete and Synthesis, and again its Materia Medica has a good correlate with the symptom characteristics
of COVID-19. However, its results after prescription have been less promising than
with Bryonia, showing a good response ratio of 56% only and being the second-most prescribed remedy
in moderate cases, with 33% good response. Average time to full recovery since prescription
was 14.4 days.
Sulphur has to be also considered in this group of useful remedies for COVID-19. It appears
well positioned in the repertorization ranking and has shown best results in the cases
collected, with 100% of good response when prescribed in our mild and moderate cases.
Its average time to full recovery since prescription is also the shortest, at 3.5
days. Nevertheless, half of the Sulphur cases were the ones where this remedy was prescribed to treat persistent or convalescence
symptoms.
Pulsatilla shows great potential as well. It appears in the top 5 of both repertorizations and
it has a high good response ratio, around 85%. It was associated with the second shortest
average time for full recovery, achieved in an average of 6.25 days. However, all
Pulsatilla cases were mild, and so its effectiveness in moderate cases still needs to be evaluated.
The same happened with Belladonna, a remedy that also appears well positioned in repertorization and showed good results,
but only in mild cases. Camphora, a remedy postulated to be useful by Sankaran's group, and even a candidate for genus
epidemicus,[18] does not appear in the top rankings in our study repertorizations but showed 50%
good response rate in moderate cases.
Arsenicum album, a remedy recommended at the beginning of the epidemic by the AYUSH in India as genus
epidemicus,[19] and widely prescribed among our study patients, yielded uneven results: it showed
a good response ratio of 50% and 43% in mild and moderate cases, respectively, but
it also displayed a long average time to full recovery (13.7 days). It appears well
positioned in our repertorizations and it consistently has a good symptomatic correspondence
with the clinical picture outlined in the study, but in some cases where it was prescribed
it seemed to be highly ineffective and many patients needed a change of remedy. We
recommend prescribing it with caution.
Based on the results of the symptoms analysis and the prescription outcomes, Nux vomica and Nux moschata may also be good candidates for genus epidemicus, but their case sample size is too
small to make further conclusions. Other remedies like Gelsemium, widely used and recommended in other studies,[19]
[20]
[21] and China officinalis, showed a very low response ratio, 20% and 0% respectively in our study's sample,
and so their prescriptions should be considered carefully.
Given the previous repertorizations and the results obtained from the remedies used
in our collected cases, which we have summarized above, it is difficult to propose
just one homeopathic medicine as the genus epidemicus. However, we could probably
agree on a group of remedies, as Kent said,[14] with which we might treat nearly all mild and moderate cases of COVID-19 with success.
Those medicines would be Bryonia alba, Phosphorus, Sulphur, Camphora and Pulsatilla.
Regarding the potencies used, we saw from our results that 30c was the most prescribed,
but up to 60% of the times it needed a successive remedy, a higher potency, or a different
medicine. 200c was frequently used too, and with better response. With these data,
and though 30c is the most easily found potency remedy in pharmacies, it seems that
using it could delay the healing process or the search for the best remedy in moderate
disease cases. We suggest using, whenever it is possible, 200c remedies from first
prescription to reduce as much as possible the need for changing potencies and to
obtain a quicker healing response.
Conclusion
After presenting all the data and conclusions from the collected cases, we firmly
believe that we have accomplished our goal, to present a clear symptomatic picture
of the mild and moderate COVID-19 disease in our region. We presented also a group
of remedies most suitable to treat those cases. Nevertheless, we should reflect that
for each case studied and treated, the good homeopathic physician should still always
individualize and prescribe the proper homeopathic medicine guided by the Law of Similars,
even in treating epidemic disease, as Kent said in his Lectures.[14]
The importance of publishing this work is that its comprehensive homeopathic clinical
information can reach as many homeopaths worldwide as possible, and it can be used
to inform about the treatment of COVID-19 patients, taking into account that, at the
time of the study, there have been no preventive or effective conventional treatments
for the disease. We think homeopathy has much to contribute in reducing deaths and
morbidity of this disease. Further studies are needed to investigate the role of homeopathy
in severe cases of COVID-19 and in critical stages where the involvement of inflammation
and hypercoagulability drive the organism to multi-organ failure.
