Abstract: The clinical manifestations of COVID-19 are protean, which include asymptomatic carrier, pneumonias, ARD, cardiac abnormalities, renal malfunctions and CNS affections. Our success of prescribing the correct remedy largely depends on our skill to follow the principles of homeopathy and ability to assess accurately the individual and the symptoms at the given time that furnish us with the evidence of disease and its pathological state. In this perspective, homeopathic remedies will be of benefit in Covid19.
Background: The World Health Organization (WHO) declared severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) outbreak a pandemic (1). With COVID-19 spreading like wildfire through the globe, currently, there exist no vaccines or anti-viral treatments officially approved for the prevention or management of the disease. The Indian government’s Ministry of AYUSH, advocates the use of homeopathy and traditional remedies to ward off infections of the newly circulating 2019-nCoV (2).Clinical practice based on the Law of Similars opens new horizons on which homeopathy projects its infinite potentialities in epidemics and pandemics.
Homeopathy In Pandemics:-Severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) is the virus strain that has caused coronavirus disease 2019(COVID 19) worldwide. These acute diseases are sudden with marked intensity of functional and structural alterations, rapid progression and equally rapid termination either in death or in natural recovery. ‘Disease’ in acute stage is disorderly functioning of life force and it retains an inherent capacity to set itself right with or without medicinal help (3). It is the Susceptibility that represents the fundamental quality in humans that maintains harmony by adapting healthily to environmental conditions. Hence organism is enabled to lead relatively normal life even in the face of adverse conditions but when this process of adaptation fails, organism undergoes functional and structural damage in the body (4). This explains that for a homeopath, it is not only the label of COVID-19 or influenza but the host factors that trigger an immune response against the virus. The Host or Individual’s Immunopathogenesis is associated with an immune response that goes out of control, to cause devastating consequences all over the body.
Homeopathic Intervention:-Intervention is any interference that would modify a process or situation. The acute diseases throw up acute symptomatology which guides the acute prescription. In epidemic/ pandemic disease, the disease cause might be identical, giving rise to a general picture of the disease to which all the patients conform. A carefully observing physician after observing several such cases constitutes characteristic malady-Genus epidemicus(GE),that acts as a remedy for homeopathic prophylaxis. (3)
While different masters of homeopathy have recommended the indicated remedies for prevention against corona virus, Ministry of AYUSH with CCRH advised Arsenic alb as a possible preventive, for flu like illness such as coronavirus infection, as it showed effect in reducing TNF-α release in macrophages and that Arsenic album is a common prescription in the cases of respiratory infections in day to day practice (2).
GE should not be given to everyone; it should be given to those who are exposed and those who are at a high risk. Once the patient is diagnosed for corona, the role of GE is finished for that individual. Now this patient needs homeopathic remedies according to his presenting totality.
Pathological consideration in Sars-CoV-2 and Homeopathy (5)
For clinical co-relation and to find the right remedy, it is very important to understand the course and behavior that lead the body through during infection.
SARS-CoV-2 lands in the lungs and can do deep damage there. But the virus, or the body’s response to it, can injure many other organs.Sars-CoV-2 is highly transmissible, it targets the respiratory system and gets transmitted by contact, droplets and fomites.
Incubation period is 2-14 days wherein the response of lungs to virus is slow.
Cytokine Storm In Covid19 (6)
-While respiratory failure from acute respiratory distress syndrome (ARDS) is the leading cause of mortality in covid19 but Secondary haemophagocytic lymphohistiocytosis (sHLH) is an under-recognized, hyperinflammatory syndrome characterized by a fulminant and fatal hypercytokinaemia with multiorgan failure. Cytokine storm starts to attack healthy tissues. Blood vessels leak, blood pressure drops, clots form and catastrophic organ failure can ensue.
Acute Homoeopathic management of COVID-19
(Note on hospitalization: According to an Italian report on symptomatic covid19 patients, it was not necessary to hospitalize the patients and the overall cumulative hospitalization rate was 20 per 100,000 populations. As the transmissibility rate of Sars-CoV-2 is very high, extra hospital home isolation regimen is recommended.) (7)
Homeopathy is the science of definite principles and it is an art to apply these principles to find correct remedy. Acute diseases according to Hahnemann are transient explosion of latent psora that lessen the body resistance and make patient more susceptible to secondary infections with various types of acute miasms. The totality of perceptible symptoms manifested by altered sensation and function at a given time constitutes the disease for treatment purpose. (3)
Prescription for Covid19 patients now depends on the individual clinical course and pathological realm, miasmatic state and the stage of disease.
(Constitutional prescribing in Acute diseases: At times, in acute diseases, the vital force is so weakened by morbific agent that it is unable to throw acute response. This calls for deep acting constitutional remedy which also acts as an abortive when given in prodromal phase) (8)
Miasmatic assessment (9):-
Day1-3 Psora:- sensitivity to environmental Stimuli Inflammation,irritation.Symptoms like congestion.Bland discharges.System defenses are good,return to normalcy without any complication
Day3-Day5 Sycosis:- Aberrant immune response-Fatigue, weakness; Resistance low for germs, Lingering response.Symptoms Like fever constant, irritation with dry cough. very slow, gradual onset and gradual recovery are Sycotic.
Day5-Day7 Tubercular:-Sudden,erratic response-effort to survive Increased activity.Complications of disease,Tardy, protracted recovery.Easy suppuration. Symptoms like productive cough,dyspnoea,hypoxia,vomiting,high grade fever
Day7-Day9 Syphitic:-Widespread destruction of tissue, paralysis, collapse of organs.Symptoms like rapid pace of progression of lung damage,hypoxia,cyanosis,Multi organ involvement- kidney failure,respiratory failure.
=>Stage 1-
Nasal congestion, coryza, conjuctival congestion, headache, mild fever, sore throat, myalgia.We see fever is consistent with or without any symptoms.
Miasm:-Psora++, sycotic+
Indications of remedies (10) (11)
Stage 1
1-RHUS-TOX :- PATHOLGY-Irritation, Inflammation, Congestion, Increased discharges, swellings
SYMPTOMS-Sneezing with fluent coryza. Tip of nose red, sore, ulcerated. Pulse quick, weak, irregular intermittent with numbness of left arm. Headache as of a band strapped across forehead, Heat of the whole body as if burning. Throat soreness, better warm drinks, Hoarseness of the voice. Dry, teasing cough. Influenza with aching in all bones
2-FERR-PHOS :- PATHOLOGY-Oxygenation of RBCs, disturbed circulation, deficiency states, inflammation, congestion
SYMPTOMS- First stage of all inflammatory disorders. Susceptibility to chest troubles. Bronchitis of young children. In pale, anemic subjects with violent local congestion. Common colds. First stage of colds in the head. Predisposition to colds and sore throats. Fevers of unknown origin. Fevers, continued infectious, pneumonia intermittent, measles, hemorrhagic.
3-PULSATILLA:– PATHOLOGY-Irritation, catarrhal inflammation, venous engorgement, greenish, yellow discharges
SYMPTOMS- Pressure and soreness upon the chest. Chest oppressed, as by a load. Anosmia with catarrh. Coryza, better going out in the open air, stoppage of right nostril, yellow mucous, abundant in morning. Nasal bones sore. Hoarseness, comes and goes. Throat; Dry, sore with sense of dysphagia. Sensation of a worm wriggling up.Fever:-During apyrexia, headache, diarrhea, loss of appetite, nausea
4-ARSENIC-ALB:- PATHOLOGY-Inflammation, suppuration, copious serous effusions with induration, burning pains. Sepsis, exanthemata, hemorrhage
SYMPTOMS-Hay fever and coryza, worse in open air,better indoors. Thin, watery,excoriating discharge. Nose feels stopped up. Burning and itching. Sneezing with watery coryza, without relief. Nose colds descend to chest. Throat- constricted, burning, unable to swallow. Everything swallowed seems to lodge in esophagus. Intermittent fever. Paroxysms incomplete with exhaustion. Heat as of hot water in veins or they burn like lines of fire. Sweat with great thirst.
A apparently well indicated drug if fails to relieve the case (correct potency), as the stage progress, fresh indications must be constantly looked for.Then reconsider the case with fresh symptoms and old symptoms to reform totality and change the remedy.
=>Stage 2
Dry cough progress to productive cough with shortness of breath, dyspnoea, throat pain, chest pain, swallowing difficult, high grade fever, nausea, vomiting, headache, fatigue and myalgia. (sHLH), Leukocytosis and chest Xray shows unilateral or bilateral lung infiltrates. This stage marks the beginning of pneumonia to rapid progress of disease causing damage to lung parenchyma, blood vessels and blood.
Miasm: Tubercular++, Syphilitic+
From Borland pneumonias, remedies for incipient to frankly developed pneumonia are Phosphorus, aconite, bryonia, ipecac, veratrum viride.
Indication of remedies (Stage2)
REMEDIES
1-BRYONIA:– PATHOLOGY-Inflammation, serous effusions, Increase heart’s action
SYMPTOMS– Morning rise of temperature with rigors. Increase in temperature in afternoon with delirium and toxic look. Headache from sitting up. Irritation in throat with Right lung involves first. Very sharp, intense pleuritic pain worse by any movement better by lying on affected side.Thick, heavy coating of tongue with intense thirst for large quantities
2-TUBERCULINUM:- PATHOLOGY-Tubercular taint, Exhaustion, catarrhal pneumonia, inflammation, pleurisy
SYMPTOMS-Relapsing states. Always tired, motion causes intense fatigue. Increasing exhaustion and lowered vitality. Rapid breakdown of health. When symptoms are constantly changing and well-selected remedies fail to improve, and cold is taken from the slightest exposure.profuse sweating and loss of weight, rales all over chest. Expectoration thick, easy. Shortness of breath. Sensation of suffocation, even with plenty of fresh air. Longs for cold air
3-VANADIUM:– PATHOLOGY-Hypoxic, Hypoxemic states, degeneration of tissue of lungs, liver and heart
SYMPTOMS-Its action is that of an oxygen carrier. Increases amount of haemoglobin, also combine its oxygen with toxins and destroy their virulence. Increases and stimulates phagocytes. Cough dry, irritating and paroxysmal, sometimes with haemorrhages. Irritation of nose, eyes and throat.
4-VERAT-VIRIDE:- PATHOLOGY-Violent Congestion, delirium, apoplexy, hypotension
SYMPTOMS-Rapid rise of temperature to 104℃-105℃ with intense pulsation. The pulse is full, bounding. Very violent delirium. Despite of high temperature, there is profuse perspiration. Intensely thirsty with nausea. Tongue is coated with bright, red streak down the centre. Chest pain worse from coughing, expectoration difficult to expel worse from sitting up.
5-PHOS:- PATHOLOGY-Inflammation, degeneration of mucus membrane, irriation of nerves, disorganization of blood, hemorrhages
SYMPTOMS-Pneumonia develops quickly than bryonia. Acute sense of tightness in chest after going out in cold. Breathing difficult. Very tiring, tormenting cough with little sputum, rusty and dark sputum. High temperature with full, strong pulse. Intensely thirsty, desires cold drinks. Tongue dry and reddish. Feeling of rawness and burning in chest.
=>Stage 3
High grade fever, productive cough, severe dyspnoea, heaviness in chest and chest pain, hypoxia, tachypnea, tachycardia (Pancytopenia).
CT Scan:- Ground glass opacities with or without consolidation consistent with viral pneumonia. In this stage structural changes in lungs occurs rapidly like Pulmonary edema, Impaired oxygenation, Hypoxemia, Alveolar collapse, sepsis. All leading to Acute respiratory disease syndrome(ARDS), Cytokine storm ultimately leads to Multi-organ failure and death.
From Borland’s Pneumonia, remedies for complicated and late pneumonia are antim-tart, carbo-veg, merc-sol, sulphur.
For impaired oxygenation and resultant ↓Hb, Remedies indicated are Hydrocyanicum acidum, Antim-tart, Carbo-veg, Laurocerasus.
Cytokine storm: clot formation, stroke, cardiac arrest:- Lachesis, crot –h, opium, phosphorus, Zinc-mur
For end stage disease: collapse of the vital force, sepsis, remedies indicated are like carbo-veg, Camphor, Hippozaeninum
Miasm:- Syphilitic
Indications of remedies:-
Complicated pneumonia, ARDS, sepsis (Stage3)
REMEDIES
1.Hippozaeninum:-PATHOLOGY:-Inflammation Enlargement, induration of glands, sepsis
SYMPTOMS-Cough and obstructed respiration, Respiration at first partially impeded. Suffocative dyspnoea. Asthma. Violent, dry, hacking cough Patients cough severely and expectorate profusely. Pulse very frequent and small in volume, 110 to 120. Skin becomes cool with collapse. Putrid fever. Thirst excessive with diarrhoea. perspiration. Congestive chill. Tongue cold, flabby,trembling
2.Carbo-veg:- PATHOLOGY-Sluggish, circulation, relaxation, paralytic states, Imperfect, disintegrated oxygenation. Sepsis
SYMPTOMS:– Blood seems to stagnate in the capillaries, causing blueness. Body becomes blue, icy-cold. Sepsis. pulse imperceptible, oppressed and quickened respiration, and must have air, must be fanned hard. Deep, rough voice, failing on slight exertion. Sore and raw chest. Wheezing and rattling of mucus in chest. Cough, with burning in chest. Spasmodic cough, offensive expectoration, neglected pneumonia. Haemorrhage from lungs.
3.Antimonium-tart:- PATHOLOGY:- Catarrhal inflammation, congestions, epileptiform convulsion,Paralysis.
SYMPTOMS-Intense heat. Copious perspiration.Cold, clammy sweat, with great faintness. Intermittent fever with lethargic condition. Great rattling of mucus, but very little is expectorated. Rapid, short, difficult breathing; seems as if he would suffocate; must sit up. Oedema and impending paralysis of lungs. Much palpitation, with uncomfortable hot feeling.Pulse rapid, weak,trembling
4.Hydcy-acidum:- PATHOLOGY:-Congestions, cyanosis, faintness, convulsions, paralysis, uremia
SYMPTOMS-Intense cerebral congestion. Prolonged faints. Pale or bluish face, Cramps in masseters; in nape.Gasping, irregular, slow breathing. Dry, tickling, night cough.Heart; failure. Mouth dry.Taste metallic; astringent.
Cytokine storm:- chronic inflammation of blood, clot formation, stroke, cardiac arrest.(Stage3)
REMEDIES
1.ZINC-MUR:- PATHOLOGY:-Inflammation, Anemia, convulsion,
SYMPTOMS-Perversion of the senses of smell and taste. Throat; inflamed, painful, constricted. Diarrhoea violent with vomiting and collapse. Breathing difficult and rapid. spasmodic twitchings of face and hands, sprains and convulsions were prominent features
2.OPIUM:- PATHOLOGY:-Congestion, Inflammation, hemorrhages constriction of vessels, apoplexy, convulsion.
SYMPTOMS-Stertorous breathing. Difficult deep, Cough with dyspnea and blue face with bloody expectoration. Cough, tickling with blue face or profuse sweat on whole body, better drinking water. Hemoptysis. Sluggish. Stupid. Paralysis of brain. Burning about the heart. Weakness. Full slow pulse. Palpitations Retained or involuntary urination
3.LACHESIS:– PATHOLOGY:-Decomposition of blood, sepsis, suffocation
SYMPTOMS-When the system is thoroughly poisoned and the prostration is profound. Throat: Feeling as if something was swollen which must be swallowed; worse, swallowing saliva or liquids. Feels he must take a deep breath. Cough; dry, suffocative fits, tickling
Potency selection and Repetition:-Covid19 is a rapid progressing disease with gross pathological changes. In such cases that suggest poor susceptibility, remedies with low potency and with frequent repetitions is selected. Nosodes should not be employed below 200th potency as lower potency may lead to aggravation (4)
Ancillary measures in covid19 (12):-
Minimize crowding.
Frequent washing of hands with soap water and alcohol based sanitizers
Steam inhalation
Immunity boosting measures like drinking warm water throughout the day, daily yogasan, pranayama and meditation.
Conclusion: – Covid19 can inflict almost anything in body, from lungs it extends to brain, kidney, gut and heart. Conventional system with no vaccines is left with immunosuppressive drugs to deal with patients of Covid19. Homeopathic remedies have potentiality to abort the disease when selected on the principle of individualization.
Bibliography
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Author:
Dr Priyanka kewalramani
PG STUDENT (MLDMHI- Mumbai)
