Flu pandemics: homeopathic prophylaxis and definition of the epidemic genius

Abstract

Recent studies on viral genetics establish swine-H1N1 – responsible for the ongoing pandemics – as a remainder or continuation of the agent causing the flu epidemics of 1918. This study aimed at analyzing whether this common etiology also result in significant correlations of clinical manifestations. To do so, data were collected to compare the clinical evolution of cases in the 1918 and 2009 epidemics. This historical revision was the ground for evaluating the response to treatment including homeopathy in the former epidemics. It is discussed the convenience of including homeopathic prophylaxis grounded on the diagnosis of the epidemic genius among public health actions.

Full text

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Original Article
Flu pandemics: homeopathic prophylaxis and
definition of the epidemic genius
Renan Marino
Faculty of Medicine of São José do Rio Preto, FAMERP, São Paulo, Brazil
ABSTRACT
Recent studies on viral genetics establish swine-H1N1 – responsible for the ongoing pandemics –
as a remainder or continuation of the agent causing the flu epidemics of 1918. This study aimed
at analyzing whether this common etiology also result in significant correlations of clinical
manifestations. To do so, data were collected to compare the clinical evolution of cases in the 1918
and 2009 epidemics. This historical revision was the ground for evaluating the response to
treatment including homeopathy in the former epidemics. It is discussed the convenience of
including homeopathic prophylaxis grounded on the diagnosis of the epidemic genius among
public health actions.
Keywords: Homeopathy; Collective health; Epidemics; Influenza A – H1N1.
Introduction
The Italian term Influenza was first used in 1743 to indicate the probable etiology (“Influenza del freddo”:
Influence of coldness) of a respiratory illness that fast affected a large number of people during the winter.
Grippe (French), Greifen (German), Flu (English) and Cripu (Russian) are used to designate this universal,
severe pandemic infectious disease that bursts out after irregular and relatively long periods of time (20-40
years or more). [1]
Recent data indicate that ongoing Hog Flu actually had its epicenter in the United States in 1918 from where
it spread to Europe to become known as Morbus ibericus or Spanish Flu. Its viral etiology could only be
established in 1933, when Smith, Andrews and Laidlaw were able to verify Koch’s postulates reproducing the
picture of flu in ferrets and white mice after nasal instillation of clinical materials of human origin. [2]
The new subtype of Influenza virus A-H1N1 was classified by the CDC (Center for Disease Control) as
A/California/04/2009, a representative of a triple rearrangement of human, aviary and swine genes. [3]
Genetic analysis of isolated California virus showing the direct relationship between swine variant H1N1 and
the 1918 epidemics certainly results in clinical developments and implications that are discussed below. [4]
Characteristic symptoms of Influenza A-H1N1 then and now: piecing the puzzle together
Retrospective studies show that pandemic cycles present high mortality in their remission or second wave,
which appears 6 months – 1 year after the occurrence of the initial, and usually moderated, cases [5].
Regarding the clinical manifestations observed during the Spanish Flu, our reference are the archives
researched by Coutinho [1], which include the detailed description of signs and symptoms that he classified as
described in Table 1.

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The search for common points can be achieved from the comparison of the clinical characteristics of the former
epidemics as described above and the clinical manifestations of the ongoing epidemics as described in June
2009. To do so, data supplied by SINAN (Information System of Disease Notification) of the Brazilian
Ministry of Health (MS) were analyzed, using as sample 378 confirmed cases of severe acute respiratory
syndrome due to Influenza A-H1N1 occurring until the epidemiologic week 29/2009. [6] As relevant, we
highlighted sudden fever of 39oC, with dry and continual cough leading to intense dyspnea and facial
cyanosis, chills, general muscle and joint pain, besides contuse headache, extreme prostration fast progressing
into cardiovascular failure with hypotension and shock.
Table 1: Symptoms of Spanish Flu [1]
Stage/ Organs or
systems affected
Synoptic description of signs and symptoms of human Influenza, 1918
Prodrome
Lassitude, the body feels as after prolonged and exhausting exertion, with physical
and mental depression, sudden high fever and intense headache. Joints and
muscular pain, mainly in the calves and lumbar area, sweating and morbiliform
rash in 30% of cases.
Eyes and
rhinopharynx
Frequent sneezing with nasal obstruction and discharge, dryness and itch in the
throat with dry, whooping, frequent and painful cough. Slight catarrhal
conjunctivitis, pale face and cyanosis around the mouth; frequent epistaxis.
Respiratory and
thorax
Lung congestion especially in the base, bilateral, with dyspnea due to intense
bronchospasm, intense whooping-like cough with hemoptysis.
Gastrointestinal
Hiccups, nausea and incoercible vomiting, sialorrhea, abdominal pain around the
navel with mucous/bloody diarrhea.
Neurological
Headache, vertigo, neuralgia; modification of the level of consciousness in different
degrees, mental confusion, torpor, somnolence.
In order to manage data arising from different sources and to better understand the global dimension of the
clinical parameters of the pandemics, we included the report of 18 Mexican cases from which 7 died (39%),
where there was fever, cough and dyspnea in 100% of cases, sudden onset (72%), hemoptysis (33%),
hypotension and hypoventilation (more than 50%), stressing furthermore the occurrence of diarrhea only in
children (22%). Lymphocytopenia with less than 1,000 cells (61%), increase of CPK (creatine phosphokinase)
(72%) and LDH (lactate dehydrogenase) (100%) were the main laboratory parameters verified. [7]
We also sought to define the 5 main risk factors among the Brazilian population, on the grounds of the 222
patients monitored until epidemiologic week 28/2009/MS/SINAN [8]: 1) pregnancy – representing the group
with higher mortality risk associated with hemorrhagic phenomena, placental abruption, hypoventilation and
shock; 2) lung disease; 3) arterial hypertension; 4) heart disease; 5) immune depression.
The clinical comparison of Spanish Flu (1918), Mexico (2009) and Brazil (2009) makes evident the strict
correlation of symptoms among them, a fact of high relevance as it also allows making a retrospective
evaluation of the outcomes of homeopathic treatment between 1918 and 1920 which can supply reliable
criteria to face the ongoing pandemics.
Foundations of homeopathic prophylaxis
Preventive use of homeopathy was first applied in 1801 during an epidemics of scarlet fever in Königslütter,
Germany, when Samuel Hahnemann – the founder of homeopathy – prescribed a single dose of Belladona, as
the remedy of the epidemic genius to susceptible children in the town with 100% success [9]. Homeopathic

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prophylaxis is grounded on the ability of homeopathic remedies to avoid or attenuate manifestations of
disease when chosen according to the principle of similarity. According to authors such as Trousseau and
Tetau it is also grounded on the notion of “terrain” and inheritance that would include the set of individual
factors related to the constitution, predisposition and refractoriness to disease and metabolism[10]. Eizayaga
sustains that homeopathic remedies increase individual unspecific resistance to infections, whereas nosodes
increase specific immunity regarding definite etiologic agents[11]. Ullman attributes the prestige of
homeopathy in Europe and the United States in the 19th century to its success in the treatment of epidemics.
[12]
Antecedents of the use of homeopathy in the pandemics Influenza A-H1N1 (1918)
Pandemics continued to cause high mortality in the 20th century: the Spanish Flu claimed 20-40 million
victims, the Asiatic Flu – H2N2 (1957), 1 million and the Hong Kong Flu – H3N2 (1968), 700 thousand. [13]
In this study, we restricted historical revision of the use of homeopathy in epidemics to pandemics of human
Influenza. As sources, we employed Winston’s major study on the use of homeopathy in 1918 epidemics [14],
while establishing as criteria the selection of rigorously verified data - through historic and scientific
documents and ratified by official sources – we focused on Dewey’s paper (cited in Winston) [15], published in
1921 in the Journal of the American Institute of Homeopathy with the title “Homeopathy in Influenza: A
Chorus of Fifty in Harmony”.
At that time, Dewey was professor of materia medica and therapeutics at Michigan University, which
acquainted him with academic standards, so that he recorded with utmost care data highly significant for our
research as exhibited in Table 2.
Table 2: Data mentioned by Dewey
Cases of human Influenza treated with homeopathy in 1918
Source
Place
Total number of patients
Mortality rate
Pearson, W. A.
Philadelphia
26.795
1,05%
30 doctors from several cities
Connecticut
6.602
1%
Wieland, F.
Chicago
8.000
0,01%
Sappington, E. F.
(Homeopathic Medical Society)
District of Columbia
(Washington)
50.000
0,01%
McCann, T.A.
Dayton, Ohio
1.000
0%
Outcomes of patients treated with homeopathy are remarkable, especially when compared with those of
patients treated exclusively with conventional remedies, as e.g. a group of 24,000 patients in Ohio, where
mortality was 28.2%. It is particularly noteworthy the comment of F. Wieland, from Chicago, on the use of
Gelsemium during the epidemics, which according to him “was virtually the only remedy prescribed” [16].

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Hughes’ contribution: a map leading to the “eye of the hurricane”, or how to actually find the
epidemic genius
Although to find the epidemic genius repertory analysis of the most remarkable, rare, strange and peculiar
symptoms present in most cases during an epidemics may have some success, it is needed to resist the
seduction of simple arithmetic additions, as this perhaps is the chief reason of mistakes in the diagnosis of the
epidemic genius.
Richard Hughes, a leading representative of 19th century homeopathy believed that the selection of a remedy
ought not to be grounded only on subjective symptoms, but rather on the characteristic nucleus of the
symptomatic picture that was mandatorily expressed in the pathological effects experimentally verified in
human beings and animals [17]. By the same token, he sustained that together with the principle of
similarity, also pathology ought to be taken into account. For this reason, between 1884 and 1890, with the
collaboration of Dake, he subjected the homeopathic materia medica to revision and depuration, which
resulted in his 4-volume A Cyclopaedia of Drug Pathogenesy. Besides excluding purely clinic symptoms he
emphasized provings conducted with low dilutions, i.e. below 6cH in order to obtain highly reliable data [17].
“Hughes’ filter” – a tool seeking to ensure that the selected remedy is necessary and sufficient to
pharmacologically minimize the physiopathology of an illness sought to prevent or heal – is extremely useful
when candidates for epidemic genus are many, as in the case of the ongoing flu epidemics, were possible
remedies include Aconitum napellus, Bryonia alba, Eupatorium perfoliatum, Influenzinum, Phosphorus and
Rhus toxicodendron among others besides Ipecacuanha. Application of “Hughes’ Filter” results in the
peremptory indication of Ipecacuanha, on the grounds of the unmistakable specificity of its pattern of
medicinal dynamics as it is shown below.
Grounds for the diagnosis of Ipecacuanha as epidemic genius in the ongoing Influenza A-H1N1
pandemics
Data on Ipecacuanaha agree among the different sources of the homeopathic materia medica beginning from
Hahnemann’s initial Fragmenta de viribus medicamentorum… published in 1805 [18]. Phatak’s materia
medica was selected as an example to deepen the study of the general action of this remedy, which includes:
continual nausea, hemorrhages and frightening respiratory disturbs always accompanying most symptoms,
such as bleeding gastrointestinal disorders; severe prostration with alteration of the level of consciousness;
seizures and tetanus-like spasms complete the picture of symptoms. [19] It must be highlighted that
aggravation occurs by both cold and heat, whereas this extraordinary hypersensitiveness to extreme
modalities of temperature [20], although uncommon, has a direct relationship to the persistence of cases of
Influenza A-H1N1, even in the lack of low temperatures, which leads us to conclude that these are instances
not only of “Influenza del freddo” but also of “Influenza del caldo”, manifesting a recently acquired ability of
the present time mutant virus.
Regarding the high mortality rate among pregnant women, Phatak highlights profuse hemorrhages gushing
out, with nausea, tachypnea, constant abdominal pain in the hypogastrium, stitches from the navel to the
uterus, placenta previa and uterine prolapse.
The objective sequence of symptoms composing the physiopathologic and pathogenetic picture of Ipecacuanha
must be seen as a dynamic picture, comprehending the extension of symptoms such as intense headache from
the nape to the root of the tongue, with sensation as from a wound, as if the head had been beaten by blows,
with nausea and cold sweating on the face, constriction of the chest and the larynx, with incessant,
exhausting and violent cough at each breath, which makes the patient become stiff and cyanotic on the face,

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with uncontrollable hemoptysis, extenuated and almost unconscious, febrile and often evolving to
bronchopneumonia, shock and death [19].
For reasons we ignore, Ipecacuanha is not listed anymore among the best remembered remedies by
homeopaths. However, it was included in the first list of 24 polycrest remedies made by Hahnemann, i.e.
remedies “which have many indications” [10].
The contribution of experimentation of Ipecacuanha in animals
Uraoga, ou Cephaelis ipecacuanha Swartz (Figure 1) is a plant native to center-west Brazil; a small shrub of
20-40 cm height, its chemical composition includes catechols (ipecacuanic acid), nitrogen heterosides,
glycoproteins with allergenic properties and mainly about 3% isoquinoline alkaloids, among which emetine
(60-75%). Its active principles are mainly concentrated in the dried root, which is the part used in the
preparation of the remedy [21].
Figure 1: Uragoga Ipecacuanha [22]
Records of experimentation of Ipecacuanha in animals (frogs and rabbits) mainly express disorders attributed
to emetine, such as hemorrhage, depression of the myocardium, pulmonary congestion, pneumonia and
vomiting, among others. [23] (Figure 2)

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Figure 2: Records of experimentation of Ipecacuanha in animal [23].

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Validity of the use of homeopathic complexes in epidemics
Use of remedies synergically associated in epidemics constitutes an interesting resource and besides
acknowledged by experienced practitioners, it is justified in order to widen the scope of action resulting in
higher effectiveness [10]. Therefore, in the current circumstance, it seems pertinent to add to Ipecacuanha –
selected as epidemic genius – a second remedy arising from the application of the criterion of etiopathogenic
similarity, viz. nosode Influenzinum – in fact nosode of H1N1 would be better indicated. Despite it is prepared
from antigenic variant H2N2 (Asiatic Flu, 1958), it is still indicated according to Kent’s remark in Lection
XXIX: “prophylaxis requires a lesser degree of similarity than the one needed to heal” [24].
Gelsemium sempervirens can also be added, as a complementary of Ipecacuanha [25] in order to strengthen
the effect of the prescription during the prodrome, increasing in this way the prophylactic value of the
complex.
Moreover, in a paper presented to the I Panamerican Congress of Homeopathy in 1977 dealing with
“Prophylaxis of infectious diseases in the first months of life with homeopathic nosodes”, Castro mentioned
that during the 1918 flu epidemics, Gelsemium was the epidemic genius, whereas during the 1957 epidemics,
Influenzinum prepared by Nelson Laboratory in London was prescribed with success [26].
Table 3 describes more details of the abovementioned remedies.
Table 3: Basic data of the remedies included in the complex [27]
Influenzinum (nosode)
Gelsemium sempervirens
Ipecacuanha
Source:
Flu vaccination prepared by
Pasteur Institute, consisting
in a mixtre of 3 parts of
culture of Asian virus A-
Singapour I-1957 and 1 part
of culture of European virus
APR-8
Source:
Fresh rhizome.
Original habitat:
North America
Famíly: Loganiaceae
Vulgar names: Yellow
Jessamine, Evening
Trumpetflower
Source:
Dry root collected before blossoming.
Original habitat: Brazil
Famíly: Rubiaceae
Scientific name: Cephaelis ipecacuanha
Swartz
Pathogenetic trial [33]
Pathogenetic trial [34]
Pathogentic trial [35]
Regarding indications found in homeopathic repertories related to the use of Influenzinum, Gelsemium
sempervirens and Ipecacuanha in Influenza, we found mentions in Boericke [28] and Farias Dias [29].

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Conclusions
Prejudice or ignorance are not valid reasons to rule out homeopathic prophylaxis as an adjuvant tool in the
fight against resurgent epidemics but conversely, rejection implies in dismissing logic, evidence and scientific
neutrality itself.
The scope and effectiveness of application of homeopathy in collective health has been strongly hinted at,
more recently in the control of dengue in Macaé, Rio de Janeiro and São José do Rio Preto, São Paulo, Brazil
[32].
The Brazilian health system is in state of alert facing the impact of the flu pandemics; to approach
successfully this crisis it is legitimate to include the homeopathic model in the strategy adopted by the
Ministry of Health.
In public health, when a homeopathic remedy is preventively prescribed in single doses, the choice of the
dilution is a significant technical factor, strictly dependent on the projected repetition of the medicinal
stimulus. In the current condition, for the effect of the stimulus to last at least 3 months, the most indicated
dilution is 12cH.
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Pandemia de gripe: homeoprofilaxia e definição do gênio epidêmico
RESUMO
Estudos recentes de genética viral estabelecem o vírus H1N1 suíno – responsável pela atual pandemia – como
remanente ou continuação do agente que produziu a epidemia de gripe de 1918. Este estudo visou analisar se
esta etiologia comum também se acompanha de correlação significativa das manifestações clínicas. Para
tanto, foram coletados dados a fim de comparar a evolução clínica nos casos nas epidemias de 1918 e 2009.
Esta revisão histórica foi a base para avaliar a resposta ao tratamento, incluindo o homeopático, na epidemia
passada. Discute-se a conveniência de incluir homeoprofilaxia entre as medidas de saúde pública, com base no
diagnóstico do gênio epidêmico.
Palavras chave: homeopatia; saúde coletiva; epidemias; influenza A-H1N1.

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Pandemia de gripe: profilaxis homeopática y
definición del genio epidémico
RESUMEN
Estudios recientes de genética viral establecen el virus H1N1 porcino – responsable por la pandemia actual –
como remanente o continuación del agente que provocó la epidemia de gripe de 1918. Este estudio buscó
analizar si esta etiología en común también se acompaña por correlación significativa de las manifestaciones
clínicas. Con este fin, fueron recogidos datos con el propósito de comparar la evolución clínica en casos de las
epidemias de 1918 y 2009. Esta revisión histórica sirvió como base para evaluar la respuesta al tratamiento,
incluyendo homeopatía, en la epidemia anterior. Se discute la conveniencia de incluir profilaxis homeopática
entre las medidas de salud pública, basada en el diagnóstico del genio epidémico.
Palabras llave: homeopatia; salud pública; epidemias; influenza A-H1N1
Licensed to GIRI
Support: authors declare that this study received no funding.
Conflict of interest: authors declare there is no conflict of interest.
Received: 01 September 2009; Revised 25 September 2009; Published: 30 September 2009.
Correspondence author: Renan Marino, renanmarino@uol.com.br.
How to cite this article: Marino R. Flu pandemics: homeopathic prophylaxis and definition of the epidemic genius. Int J
High Dilution Res. 2009 [cited YYYY Month dd]; 28 (8): 100-109. Available from:
http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/view/354/399.