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Abstract

I have written this essay to deconstruct an aspect of my clinical practice. There is controversy around the use of homeoprophylaxis in preventing disease during epidemics and pandemics. I wanted to see if there was research that could demonstrate the ability to use homeopathy in epidemics/pandemics. If so, what type of research and can it be recognised as valid? If it is not, why not? I explored and gathered information, interviews with practitioners, charts, essays, population studies and randomised controlled trials. These helped see the various levels of ability for homeopathic remedies to be used in order to prevent infectious diseases in a laboratory and in actual contemporary populations. However, these studies are in contrast within the prevailing paradigm to do with how homeopathic remedies work. Because there is an underlying disbelief in the idea that highly diluted substances could work, there is a difficulty in accepting the studies that demonstrate success for homeopathic remedies.
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AUDIENCE: Myself, my professors, other students, other homeopaths, other interested
parties.
PURPOSE: To critically challenge the epistemology of an element of Homeopathic
Practice; specifically the idea that Homeopathy can be successful in preventing disease
amongst a population for epidemic or pandemic disease outbreaks.
ABSTRACT:
I have written this essay to deconstruct an aspect of my clinical practice. There is
controversy around the use of homeoprophylaxis in preventing disease during epidemics
and pandemics. I wanted to see if there was research that could demonstrate the ability
to use homeopathy in epidemics/pandemics. If so, what type of research and can it be
recognized as valid. If it is not, why not? I explored and gathered information, interviews
with practitioners, charts, essays, population studies and Random Controlled Trials.
These helped to see the various levels of ability for homeopathic remedies to be used to
prevent infectious diseases in a laboratory and in actual contemporary populations.
However, these studies are in contrast within the prevailing paradigm to do with how
homeopathic remedies work. Since there is an underlying disbelief in the idea that highly
diluted substances could work, there is a difficulty in accepting the studies that
demonstrate success for homeopathic remedies.
Introduction:
Can homeopathy help for prevention of disease in epidemics or pandemics? I have
been using Dr. Isaac Golden’s (2007) homeoprophylaxis (HP) program for children in my
Homeoprophylaxis Can you believe it? © Elena Cecchetto
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homeopathic clinical practice for 7 years. However, when clients and others ask for the
scientific evidence, my reference to historical accounts of the use of homeopathy during
actual epidemics doesn’t always seem to satisfy them. As I am questioning what is
science and what is knowledge, I am also unsure. The purpose of this essay is to
identify and come to an understanding of the idea behind using homeopathy for the
prevention of illness in epidemic or pandemic diseases and addressing whether there is
valid demonstration of the successful use of homeopathy for epidemics/pandemic
diseases. Ranging from historical references, Random Control Trials (RCTs) and
population studies, and provings; are these sufficient to demonstrate the premise that
homeopathic treatment can be used to have an impact on infectious diseases? Are there
factors limiting the research or use of the information generated?
Important aspects of this essay defined:
According to Webster’s online dictionary (2013), Epidemics and pandemics refer to an
outbreak of an infections disease where many people are affected in a wide geographic
area. A pandemic is the same except it is affecting a larger geographic area that can
occur beyond borders of one region or even country. The founder of homeopathy,
Samuel Hahnemann explains in the Organon (1996), that homeopathy is most simply
defined as a medical art relying on two main principles being the law of minimum dose
and the law of similars. Homeoprophylaxis is the use of homeopathic remedies to
prevent ahead of time a specific disease. A homeopathic remedy proving is a collection
of observed and recorded signs and symptoms conducted according to the instructions
outlined in Hahnemann’s (1996) Organon. The material medica is the resource where
these provings and other useful sources are compiled for organized reference of each
remedy’s therapeutic uses.
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How did the use of homeopathy for epidemics start?
Dr. Samuel Hahnemann and homeopaths inspired by him and his writings in the
Organon have seemed to make good use of homeopathic treatment to help people who
have succumbed to infectious diseases or to help prevent them from succumbing to
them. It was Hahnemann’s discriminating observation in 1789 that began the exploration
of prevention of disease with homeopathic remedies. In his Lesser Writings (1852), he
first described his experience preventing Scarlet Fever by giving them all doses of
Belladonna in addition to the members of the family who had contracted it. Using the
principles of homeopathic medicine combined with knowledge of homeopathic remedies
from provings or other material medica resources has granted the use remedies
homeoprophylactically.
Physician’s records:
Historical references of hospital reports are one way a direct comparison can be made
between homeopathy and non-homeopathic treatment. In the chart below compiled by
Navab (2012), numbers of patient deaths in hospitals are compared to allopathic
numbers of deaths. In these reports the rate of success for homeopaths in specific
hospitals is shown as a mortality rate of less than 10% for the treatment of scarlet fever,
cholera, typhus fever, pneumonia, yellow fever and Spanish influenza. The mortality
rates for the conventional doctors of the time (termed allopaths) are over 10% for each
of these diseases. The treatments the allopaths had for the 1918 flu were limited to
aspirin or acetylsalicylic acid according to Billings (1997) compared to what is available
now. It is also very plausible that the results in charts are simply lower for allopaths
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because the allopathic medicines used between 1798 and 1918 were not as
sophisticated as the ones in the present.
Year
Location
Disease
Treatment by
Homeopathy
Treatment by
Allopathy
Treatment
with No
Medicine
1799
Königslütter,
Germany
Scarlet Fever
Mortality <5%
1830 ~ ‘31*
Russia
Cholera
Mortality 11
%Reported by
Imperial Council &
Foreign Ministry of
Russia.
Mortality 63
%Reported by
Imperial Council &
Foreign Ministry of
Russia.
Not recorded.
1830 ~
1832
Vienna,
Prague,
Hungary and
Moravia
Cholera
Mortality 7 %Reported
by Dr. Kath, appointed
by King of Bavaria.
Mortality 31
%Reported by Dr.
Kath, appointed by
King of Bavaria.
Not recorded.
1836**
Vienna
Cholera
Mortality 33 %Lead
Homeopath in charge
was Dr. Fleischmann
Mortality 66 %
1847
Ireland
Typhus fever
Mortality 2 %Lead
Homeopath in charge
was Dr. Joseph Kidd
Mortality 13 %Lead
Allopath in charge
was Dr. Abraham
Tuckey
Not recorded.
1847
England
Typhus fever
Mortality 2 %
Mortality 13 %
Mortality 10
%
1848
Edinburgh,
Scotland
Cholera
Mortality 24
%Reported by
Edinburgh
Dispensary.
Mortality 68
%Reported by
Edinburgh
Dispensary.
Not recorded.
mid 1800’s
Austria
Pneumonia
Mortality 5 %Lead
Homeopath in charge
was Dr. Fleischmann
Mortality 20 %Lead
Allopath in charge
was Dr. Dietl
Not recorded.
1853 ~
1855
South of
America
Yellow fever
Mortality 5.4 %Lead
Homeopaths in
charge were Dr. F.
Davis and Dr. W.
Holconibe
Not Available.
Not recorded.
1854
London,
England
Cholera
Mortality 16.4
%Reported by Royal
College of Physicians.
Mortality 59.2
%Reported by
Royal College of
Physicians.
Not recorded.
1878
New Orleans,
USA
Yellow fever
Mortality 5.6 %Special
Commission reported
the statistics.
Mortality 17
%Special
Commission
reported the
statistics.
Not recorded.
1918***
Pittsburgh,
USA
Spanish
Influenza
Mortality 1.05
%Reported by Dean,
Pittsburgh Hospital
Mortality 30
%Reported by
Dean, Pittsburgh
Hospital
Not recorded.
In the 1800’s and early 1900’s when homeopaths were working as physicians within the
medical system of society of the day, they had access to a statistically significant
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number of patients. Because these reports were created centuries ago, the information
is open to interpretation. Reading the information in the chart above, different people will
have different perspectives on the information presented depending on a person’s prior
knowledge, beliefs and filters that can affect the conclusions (Fuller, 2003). A person
educated in homeopathy (presumable already believing that homeopathy works) might
ask ‘what remedies did they use?’ while a person not knowing homeopathy might simply
ask the question ‘how’.
The homeopathic physicians had the same or similar access to clinical surroundings and
tools available to the allopathic physicians. During the 1918 Influenza in California, Elsa
Engle was a nurse practitioner using homeopathic remedies under instruction from Dr.
Engle. As Malthouse (2010) wrote from an interview that was conducted by Frances
Kalfus in 1992, the then 97 year old Elsa Engle explains their success at Hahnemann
Hospital; “They all had about the same symptoms. You didn't have to do anything else
but give them a bottle of Gelsemium, followed with a bottle of Eupatorium perfoliatum...
In five days practically all of them were well. Gelsemium and Eupatorium perfoliatum
are homeopathic remedies that are still commonly used for influenza. The CBC report
(Puri, 2009) explained to viewers during the many homeopathic clients were turning to
the remedy Gelsemium that was “used extensively during the Spanish flu epidemic of
1918” for the H1N1 flu. However, with information or data and its style of presentation,
each person will come to a different conclusion depending on prior experiences and
beliefs. In order for something like homeopathy, because it might be in contrast with a
strong belief, even the highest quality of research won’t suffice to change that belief
despite what a study shows. Rutten (2008) describes the problem that “Prior beliefs are
updated in the Bayesian process, but the first prior belief has a special position. This first
prior belief is very strong, we need to consider how strong and why. It is in fact
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paradigmatic and might not be susceptible to Bayes’ theorum”. Perhaps only a strong
personal experience (seeing is believing) might be the only thing that can change a
strong prior belief.
RCTs Japanese Encephalitis (JE):
Looking at two Random Control Trials (RCTs) in a clinical laboratory where studies were
done with the infectious disease Japanese Encephalitis (JE) and doses of the
homeopathic remedy, Belladonna. The authors Bandyopadhyay et al. (2010 and 2011)
found statistically significant success showing that Belladonna is effective in preventing
disease indicators. This is a chart from Bandyopadhyay et al. (2010) showing decreased
viral infection found in the Choriallontoic Membrane (CAM) of unhatched chicks dosed
with Belladonna in the four different potencies of 3, 6, 30 and 200;
For the RCT done on suckling mice by Bandyopadhyay et al. (2011), average survival
rates of the infected suckling mice treated with Belladonna 200C daily for 14 days had
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almost double the survival rate than those not treated with Belladonna 200C. 47%
survival rate for untreated mice versus 79.24% and 80.60% for the Belladonna treated
mice for 7 and 14 days. In the discussion of this successful study, the authors
Bandyopadhyay et al. (2011) state that homeopathic practitioners have historically been
using the homeopathic remedy Belladonna for the prevention of JE without any RCT
experimental proof of how it works and therefore there is further need to test how it is
that the homeopathic remedy Belladonna has showed an ability to prevent JE. This
study has successfully shown a specific outcome. However, the question of the
properties of Belladonna that made it work is what the authors chose to recommend as
required further study.
Population Studies:
Swine Flu in India:
In India 2009 a Swine Flu patient study involving 23 Homeopaths and 1146 patients was
conducted by Mathie et al. (2013) which took a set of previous agreed upon (by the
Centre for Clinical Research of Homeopathy (CCRH)) group of symptoms defining
Swine Flu by Homeopaths working in government approved health centres in India. The
Homeopaths agreed to record their results in a formatted excel chart between October,
2009 and February, 2010. The most frequently prescribed remedy that helped the
patients as the primary care for the Swine Flu was Arsenicum album; the very same
remedy that the CCRH had identified as the as a prophylactic Genus Epidemicus for this
pandemic. Results like this can tempt the enthusiast to proclaim at this as proof that
homeopathy can be used in epidemics.
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However, the overarching challenge in demonstrating the proof that homeopathy can be
successful for epidemics and pandemics through research and information is that it
contrasts the current prevailing paradigm. To express this idea Rutten (2008) quotes
Vandenbroucke (2001) “Accepting that infinite dilutions work would subvert more than
conventional medicine; it wrecks a whole edifice of chemistry and physics”. With this in
mind, the work shown in this study could present to different conclusions to people with
different prior beliefs. If accepting the validity of homeopathic remedies is not a
possibility within the belief system than accepting this study as successfully
demonstrating that homeopathy can help in epidemics is also not a possibility.
Leptospirosis in Cuba:
A study by Bracho et al. (2009) was conducted with 2.3 million people in Cuba. The
population above 1 year of age was given two oral doses of the Leptospirosis Nosode in
the 200C and 10M potencies with an interval of 7-9 days between doses. Then ten to
twelve months later, they were given another two oral doses of the 10M potency 7-9
days apart. These homeopathic remedies were administered by approximately 5000
Cuban public health system personnel using five drops (250-300 µL) under the tongue
(sublingually) 20 minutes away from eating or drinking or smoking. One year of
comparison between the area that received doses (the Intervention Region, IR) and the
Rest of the Country (RC) showed a significant decrease of cases of Leptospirosis in the
IR. This study looked at the numbers generated by the same institutions that are
responsible for managing epidemic disease diagnosis and prognosis in Cuba (the
national weekly report based on provincial data generated by the Trend Analysis Unit
from the Minister of Epidemiology of the Ministry of Public Health of Cuba). According to
Bracho (2009) their prediction of number of cases of Leptrospirosis was 111-461 in the
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Intervention Region in the most precarious 3 week period (weeks 47-52 of 2007 because
of number of days between the start of the increased rainfalls and infection rates) when
only actually 38 confirmed cases showed up. This was a reduction of 91.8% to 65.8% in
the IR. Despite that there were increased risks of Leptospirosis infection that year due to
extreme rainfall in October-November in the IR, the annual number of cases decreased
by 84% while in the RC there was an increase of 21.7%. The authors conclude that
these findings lend to a high degree of confidence that using homeopathic remedies to
prevent disease in populations is a useful tool for epidemics and pandemics.
This study shows successful implementation of homeopathy for a population during an
actual epidemic and demonstrates that homeopathy is successful in preventing illness
during epidemics or pandemics. Whether this study will model a way that homeopathy
can show success in preventing disease amongst a population for epidemic or pandemic
disease outbreaks is still in question (Roniger, 2010). The positive aspect of this study is
that there were millions of Cubans who willingly experienced homeopathy by taking
those remedies in compliance with their predominant health professionals. As Rutton
(2008) points out, changing towards a belief in homeopathic medicine might require a
turning point such as a personal experience. What that has been shown to do is “We
may accept evidence that we did not accept before. We may abandon the first prior,
rearrange and re-interpret the evidence and then the process of sequential updating can
start”. That way a previous belief that contradicts the idea that homeopathic remedies
will not continue to stand in the way of some possible data or information being
presented in research of various types.
Conclusions:
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In this essay I’ve brought to attention various types of demonstrations of the use of
homeopathy for epidemics and pandemics, including some that are the accepted
standard for medical science. Using these examples it seems to be possible to
demonstrate the specific success with RCT studies, population studies plus historical
records on the use of homeopathy during epidemics/pandemics. As Bracho says (2010)
it is also possible to conduct further studies with a significant level of confidence that
homeopathy will prove itself as a valid way to address the health of populations during
epidemics/pandemics. However, the criteria required in order to conduct this type of
research isn’t always easily available to homeopaths in various parts of the world. So far
it seems that there is a facility in Cuba that has opportunity to do this plus certain
homeopaths in certain clinics of India are also already established for these types of
studies.
There are challenges to the understanding and acceptance of use of homeopathic
remedies for epidemics and pandemics. Part of it lies within the current paradigm that
predominates. The disbelief that highly diluted substances such as homeopathic
remedies could have a therapeutic action is the paradigm that limits the acceptance of
studies on homeopathy despite their success in showing specific outcomes. With a prior
acceptance of biochemical medicine combined with an expectation that homeopathy
would act in the same manner, there is not a certain type of research that would qualify
to change that disbelief that homeopathic remedies work because the prior belief is too
many steps away from the new belief. It is recommended from this overview that any
further studies to address the ability to use homeopathy for epidemics and pandemics
should acknowledge that whether the reader concludes the study acceptable or not has
to do with the challenge of the paradigm surrounding how homeopathic remedies work.
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REFERENCES:
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in chick chorioallantoic membrane under influence of ultradilutions of belladonna extract.
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nakayama strain japanese encephalitis virus infection. International Journal of
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Article
Full-text available
In many countries the prevalence of Japanese encephalitis is still increasing producing a significant number of deaths and disability-adjusted life years. Global warming with consequent increase in vector population may accentuate the occurrence of the disease in near future. There is no effective medicine against the disease and vaccination of rural poor population and pig population in a wide endemic zone appears not practicable. Thus we have to venture all possible sources to find out a remedy against this disease. In this experiment suckling mice of “Belladonna 200” fed mothers were challenged with virulent Nakayama strain of Japanese encephalitis virus and statistical analysis of the results indicated a protective role of this medicine when compared with controls. A hypothetic pathway of its action mediated by calystegines involving envelope glycoproteins, synthesis of amino acid residues of E protein and Jak-Stat signaling cascades has been proposed.
Article
Full-text available
Problem statement: No specific antiviral therapy is currently available despite an emergence and resurgence of Japanese encephalitis in South-East Asian Countries. There are only few recent studies, which were aimed to treat Japanese encephalitis with newer drugs. There is thus a real need for study on antiviral agents that can reduce the toll of death and neurological sequelae resulting from infection with this virus. Approach: Optimum dilution of the JE virus was determined which could produce significant number of pocks on Chorioallantoic Membrane (CAM). Then ultradiluted belladonna preparations were used to see their inhibitory action on JE virus infection in CAM. Results: Ultradiluted belladonna showed significantly decreased pock count in CAM in comparison to JE virus control. Conclusion: Ultradiluted belladonna could inhibit JE virus infection in CAM, which may be mediated through glycosidase inhibitory role of calystegines present in belladonna.
Article
We conducted a prospective, multi-centre, data collection survey of homeopathic practice in treatment of influenza-like illness in India during the 2009 pandemic of A/H1N1 influenza ('swine flu', SF). To survey the practice of homeopathic practitioners in India in the management of SF, with respect to: (a) patients' symptoms at presentation and at follow-up (FU) consultation; (b) homeopathic medicines prescribed. Data collection took place from October 2009 to February 2010, at the peak of the pandemic. All patients satisfying the minimum diagnostic symptoms of SF were eligible for inclusion. Data per appointment (in person or by telephone) were recorded by practitioners in spreadsheet format. All records were anonymised and included: whether patient was immunised against A/H1N1; influenza symptoms at consultation; the homeopathic medicine/s prescribed; whether antiviral medicine prescribed. Twenty-three homeopathic physicians contributed to data collection. At the first appointment, 1126 patients had valid SF symptoms. A total of 89 different combinations of SF symptoms was observed, the most common being temperature >38°C + cough + runny nose (n = 170; 15.1%). A total of 44 different remedies (or combinations of remedies) were used at these first appointments, the most frequently prescribed being Arsenicum album (n = 265; 23.5%). For a total of 99 FU appointments with valid SF symptoms, Arsenicum album was prescribed most frequently overall (n = 28; 28.0%). In our sample, the 2009 A/H1N1 influenza pandemic in India was characterised by several prominent symptoms and symptom/medicine associations, particularly temperature >38°C + cough + runny nose, associated with Arsenicum album. Future studies should collect additional keynote prescribing symptoms that influence the choice of homeopathic medicine.
Article
Leptospirosis is a zoonotic disease of major importance in the tropics where the incidence peaks in rainy seasons. Natural disasters represent a big challenge to Leptospirosis prevention strategies especially in endemic regions. Vaccination is an effective option but of reduced effectiveness in emergency situations. Homeoprophylactic interventions might help to control epidemics by using highly-diluted pathogens to induce protection in a short time scale. We report the results of a very large-scale homeoprophylaxis (HP) intervention against Leptospirosis in a dangerous epidemic situation in three provinces of Cuba in 2007. Forecast models were used to estimate possible trends of disease incidence. A homeoprophylactic formulation was prepared from dilutions of four circulating strains of Leptospirosis. This formulation was administered orally to 2.3 million persons at high risk in an epidemic in a region affected by natural disasters. The data from surveillance were used to measure the impact of the intervention by comparing with historical trends and non-intervention regions. After the homeoprophylactic intervention a significant decrease of the disease incidence was observed in the intervention regions. No such modifications were observed in non-intervention regions. In the intervention region the incidence of Leptospirosis fell below the historic median. This observation was independent of rainfall. The homeoprophylactic approach was associated with a large reduction of disease incidence and control of the epidemic. The results suggest the use of HP as a feasible tool for epidemic control, further research is warranted.
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A reflection on the scientific behavior of adherents of conventional medicine toward one form of alternative medicine-homeopathy-teaches us that physicians do reject seemingly solid evidence because it is not compatible with theory. Further reflection, however, shows that physicians do the same within conventional medical science: Sometimes they discard a theory because of new facts, but at other times they cling to a theory despite the facts. This essay highlights the seeming contradiction and discusses whether it still permits the building of rational medical science. We propose that rational science is compatible with physicians' behavior, provided that physicians acknowledge the subjective element in the evaluation of science, as exemplified in the crossword analogy by the philosopher Haack. This type of thinking fits very well with the Bayesian approach to decision making that has been advocated for decades in clinical medicine. It does not lead to complete and uncontrollable subjectivity because discernment between rivaling explanations is still possible through argument and counterargument.
Homeopathy and Influenze; The Spanish Flu experience
  • S Malthouse
Malthouse, S., (2010) Homeopathy and Influenze; The Spanish Flu experience. The Immunity Challenge Conference Presentation. last accessed December 2, 2013 at http://www.cmcgc.com/media/handouts/061035/040_Malthouse.pdf
Organon of the medical art
  • S Hahnemann
Hahnemann, S. (1996). Organon of the medical art (6 th Edition) edited and annotated by W.B. O'Rielly. Redmond, Washington: Birdcage Books.
Vaccination & homeoprophylaxis? A review of risks and alternatives
  • I Golden
Golden, I. (2007) Vaccination & homeoprophylaxis? A review of risks and alternatives (6 th edition), Canberra: National Library Homeoprophylaxis -Can you believe it?