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by Dr Umang Khanna (BHMS)
Preventive medicines occupies a prominent place today and it is logical that it should, because prevention makes cure unnecessary. As the Law of Similars excels in the power to cure, it excels more forcibly and certainly in the art of disease prevention. Especially in the realm of children’s diseases have the attempts at prophylaxis been chiefly directed and with some degree of apparent success. I say apparent because there is need for refinements in the technique of administration and in the preparation of the therapeutic agents employed, as there is still much to be desired in results obtained by present methods. It is true that the agents employed bear a crude similarity to, the homœopathic principle but because of this crudity of preparation and administration we meet with much disappointment and considerable consequential evil effects following their use.
Homœopathic prophylaxis never causes anaphylaxis or shock, never results in secondary infection, never leaves in its wake serum or vaccine disease or any other severe reaction ; it simply protects surely and gently.
One of the more overlooked topics in contemporary homoeopathy is the prophylactic treatment of acute epidemic disease. Yet a review of homoeopathy’s 200-year history reveals that this is an arena in which we have seen some of the greatest examples of the effectiveness of our art and science.
Hahnemann describes the process of determining the genus epidemicus concisely, in his Organon:
Usually the physician does not immediately perceive the complete picture of the epidemic in the first case that he treats, since the collective disease reveals itself in the totality of signs and symptoms only after several cases have been closely observed. Nevertheless, an observant physician can often come so close after seeing only one or two patients that he becomes aware of the characteristic picture of the epidemic and can already find its appropriate homoeopathic remedy.
From writing down the symptoms of several cases of this sort, the outline of the disease picture becomes more and more complete – not more extensive and wordy, but more characteristic, containing more accurately the peculiarity of the particular collective disease. The ordinary symptoms – e.g., loss of appetite, sleeplessness, etc. – become more precisely qualified, and those that are more exceptional, special, and, in the circumstances, unusual, and belong to only a few diseases, reveal themselves and constitute the characteristic picture of this epidemic.
All those who catch an epidemic at a particular time have a disease flowing from the same source and therefore the same disease. But the entire scope of such an epidemic disease, the totality of its symptoms (which we need to know in order to grasp the whole disease picture and choose an appropriate remedy for it) cannot be perceived in any one patient, but can be fully distilled and gathered only from the sufferings of several patients with different physical constitutions.
Potency and dose
Potency and dosage for prophylactic treatment are guided by the same issues that guide the treatment of acute disease; largely, the dynamic nature of the illness, the vitality and sensitivity of the individual patient, and, most importantly, what you happen to have on hand at the time. In general, the lower potencies suffice. Commonly used potencies are 12C or 30C, occasionally 200C, and on rare occasions 1M potencies are used in prophylaxis.
It’s ideal to give the remedy in repeated doses of gradually ascending potency in medicinal solution. A typical regimen for a highly virulent disease such as scarlatina (for the patient of average vitality and sensitivity) would be to put 1 pellet of 12C, 30C or 200C in 1 ounce of distilled water in a small dropper bottle; and dose 2 drops daily, after 4 succussions of the bottle, for the duration of the epidemic in the community. An alternative is to use 1 pellet in 4 oz distilled water in a larger bottle, with a 1/2 tsp dose after 4 succussions. Dosing is reduced in patients judged of lower vitality and/or higher sensitivity.
This frequency of repetition has as much to do with the pace of the disease and the (similar) pace of the remedy as it does with the duration of the epidemic. Scarlatina generally has a rapid and furious pace, calling for a simillimum (e.g., Belladonna) with a matching pace and more limited duration of action. Influenza more often has a more indolent pace, calling for a simillimum of matching slow pace (e.g., Bryonia, Gelsemium) and longer duration of action. There are no recipes here which can be followed in cook-book fashion; rather, consider the dosing directions above as examples, and allow yourself to be guided more by your clinical experience in homoeopathic treatment for the cases at hand.
When the genus epidemicus does not fit the case
The genus epidemicus may fail to act – both prophylactically and in treatment of active epidemic disease – when the reaction of the patient is dictated more by the pre-existing chronic disease of the patient than by the virulence of the acute miasmatic organism.
We might imagine (somewhat simplistically) that the direction a disharmony takes in any particular case of disease is a balancing act between the direction a morbific influence is trying to push us, and the direction in which we are naturally inclined to fall. For most of the population, it seems that the ‘flu’ virus is a virulent-enough agent that we mostly fall ill in the same manner, in relative disregard to our individual situations. But for those whose dynamis is occupied with an active chronic disease, the reaction to the ‘flu’ virus may have more to do with the disharmony of that pre-existing disease of the person than it does with the reaction that the rest of the population experiences to the virus. Consequently, their ‘flu’ is unique, and does not bear similitude to the genus epidemicus that prevails in the larger community. If their chronic disharmony can in its own individual manner embrace the disharmony invited by the ‘flu virus’, the ‘flu’ takes on an individual character in that patient.
If the chronic disharmony of the patient is sufficiently dissimilar to the demands made by the virus, the patient may even be “protected” from this acute illness by their chronic dissimilar disease. We all have seen cases like this, where our patient is impressed that they have avoided colds and flu for the past several years, despite being debilitated by (e.g.) chronic rheumatoid arthritis.
For individuals with active chronic disease, the most effective strategy for epidemic prophylaxis may be to treat with the simillimum for the pre-existing chronic disease of the patient, rather than focusing on the acute disease as it is seen in the remainder of the community.
In 1799 – 3 years after the “birth” of homoeopathy in Hahnemann’s landmark article Essay on a New Principle – Samuel Hahnemann achieved fame throughout Europe from his exceptionally effective treatment of a Scarlatina epidemic that was sweeping Germany. He wrote:“I resolved in this case of scarlet fever just in the act of breaking out, not to act as usual in reference to individual symptoms, but if possible (in accordance with my new synthetical principle) to obtain a remedy whose peculiar mode of action was calculated to produce in the healthy body most of the morbid symptoms which I observed combined in this disease. My memory and my written collection of the peculiar effects of some medicines, furnished me with no remedy so capable of producing a counterpart of the symptoms here present, as Belladonna.”
Hahnemann published this pamphlet Cure and Prevention of Scarlet Fever in 1801. At the time he promoted Belladonna as a specific prophylactic remedy for Scarlatina – and accompanying each pamphlet sold, was a vial of Belladonna prepared according to his technique at that time. With increased experience observing and treating epidemic illnesses, Hahnemann recognized the unique nature of each occurrence of an epidemic. Aconite proved to be the specific for a subsequent Scarlatina epidemic sweeping Germany between 1800 and 1808.
In an 1808 paper (Observations on the Scarlet Fever), Hahnemann provided a careful description of the individualizing aspects of these two epidemics. This individuality of epidemic occurrences had not escaped other observers. In one of his rare words of praise for other physicians, Hahnemann wrote: “Only the honest Sydenham perceived this, for he insists … that no epidemic disease should be taken for any previous one and treated in the same way, since all that break out at different times are different from each other.”
Preventive Medicine is the specialty of medical practice that focuses on the health of individuals, communities, and defined populations. Its goal is to protect, promote, and maintain health and well-being and to prevent disease, disability, and death. Preventive medicine specialists have core competencies in biostatistics, epidemiology, environmental and occupational medicine, planning and evaluation of health services, management of health care organizations, research into causes of disease and injury in population groups, and the practice of prevention in clinical medicine. They apply knowledge and skills gained from the medical, social, economic, and behavioral sciences. Preventive medicine has three specialty areas with common core knowledge, skills, and competencies that emphasize different populations, environments, or practice settings: aerospace medicine, occupational medicine, and public health and general preventive medicine.
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