𝗔𝗯𝘀𝘁𝗿𝗮𝗰𝘁 – SARS (severe acute respiratory syndrome) caused by a corona virus has resulted in hundreds of deaths in China in 2003 and presented with a clinical picture of fever, dry cough, difficult breathing etc. To find a suitable homoeopathic remedy on the basis of totality of symptoms, a repertorisation through Kent’s Repertory is done on comparison to other viral diseases as influenza and AIDS also caused by RNA viruses and Arsenicum album seems to be most suitable remedy found being discussed in the following article.
K𝗲𝘆𝘄𝗼𝗿𝗱𝘀 – SARS, corona virus, influenza, AIDS/HIV, repertory, toxicology, homoeoprophylaxis, genus epidemicus, Arsenicum album.
Abbreviations: SARS (severe acute respiratory syndrome), AIDS – acquired immunodeficiency syndrome, HIV – human immunodeficiency virus, RNA – ribonucleic acid, ARC – AIDS related complex, PGL – persistent generalised lymphadenopathy, GIT – gastrointestinal tract, RBCs – red blood cells
SARS (severe acute respiratory syndrome) emerged in Guandong in South China in november 2002.It was at its peak in april 2003 with around 8000 cases and 700 deaths approximately.
SARS is caused by a Corona virus not related to another known classes of corona virus which cause mild respiratory infections esp., common cold, with runny nose, slight fever during winters and change of weather. It is a RNA virus like influenza and HIV (AIDS). Corona virus spreads by inhalation of virus present in droplets or aerosols of respiratory secretions of the patients due to sneezing, coughing etc. Incubation period of SARS is 5 to 7 days.
In this article, the author has tried to find some suitable remedy for SARS considering the disease symptoms only prevalent among the patients of SARS and after repertorising from Kent’s Repertory, 6th american edition ( complete repertory from attached)¹.Symptoms of SARS with corresponding pages of KENT’S REPERTORY are as follows.
The clinical picture of SARS presents with dry cough, fever (sometimes with chills), headache, bodyache, weakness, difficult breathing and atypical pneumonia (sometimes as complication). Atypical pneumonia is one which is not caused by pneumococcus but mycoplasma. Pneumoniae and some other microbes. Clinical picture of this pneumonia includes fever, malaise, sore throat, paroxysmal cough with sputum (sometimes blood – tinged). This disease is characterised by moderately severe respiratory involvement with bronchitis and pulmonary consolidation. The lung changes are usually unilateral with and extend towards lower lobe. Less severe febrile manifestations may occur esp. in children.² Death may occur due to progressive respiratory failure. Referring ‘pneumonia’ in Kent’s Repertory, under section ‘CHEST’ pg 835 under rubric – inflammation and sub-rubric – lungs with remedies as Arsenicum album, Bryonia alba, Phosphorus, Pulsatilla nigricans, Sulphur securing full three marks each.
DIFFERENTIATION OF REPERTORISED REMEDIES.
(1) Arsenicum album
It has covered all the seven symptoms with each symptom having full three marks therefore a total of twenty one marks.
(2) Apis mellifica
It has covered all seven symptoms. Symptom no. 2 has secured only one mark but rest of the symptoms full three marks each.
(3) Bryonia alba, Pulsatilla nigricans and Phosphorus.
These medicines have covered only six symptoms with seventeen marks each. All the three remedies lack the coverage of 4th symptom
i.e “fever with chills”. But the first three symptoms have got full three marks in these remedies.
(4) Kalium iodatum, Kalium carbonicum and Arnica montana
These medicines have covered all seven symptoms but secured 16,15 and 15 marks respectively.
(5) Sulphur and Nux vomica
Both these remedies have covered six symptoms with sixteen marks each. Third and fourth symptoms are missing in these remedies respectively.
CHEST SYMPTOMS OF REPERTORISED REMEDIES
(1) ) Arsenicum album
Arrest of breathing with cough aggravated in cold air, turning in bed, difficult expectoration, scanty or frothy Dry cough, deep, fatiguing and shaking, in the evening, lying down obliging the patient to assume an erect posture. It is predominantly right sided and loves warmth. The predisposing factors are chill in the water, eating ices, poor diet. ³
Suffocative catarrh. Darting pain through upper third of right lung. Haemoptysis with pain between shoulder burning heat all over. Cough dry, as from sulphur fumes.⁴
(2) Apis mellifica
Respiration hurried and difficult (with fever and headache). Aggravation on lying down amelioration on sitting up. Symptoms proceed from right to left.³
Feels as if he could not draw another breath.
Suffocation, short dry cough, suprasternal. Hydrothorax.⁴
(3) Bryonia alba
Cough dry excited by tickling, aggravated by motion talking, laughing, drinking, eating. Cough caused by exposure to cold winds.³
Cough, dry at night; must sit up, with stitches in chest , and expectoration if rust coloured sputa. Pleropneumonia.⁴
(4) Pulsatilla nigricans.
Dyspnoea esp, when lying on back at night. Dry cough disappearing while sitting up in bed and returning as soon as lying down again. Shooting in the chest and sides with difficulty in a full inspiration, inability to lie on affected side.³
Short breath, anxiety and palpitations with lying on left side(Phosphorus). Smothering sensation on lying down.⁴
Exposure to drenching rain. Cough from change in weather, dry cough daily for several hours. Expectoration in morning, frothy, streaked with blood. Aggravation from sitting.³ Inflammation of lung ( left side)⁴
(6) Arnica montana
Stitches in the chest (1) aggravated from a dry cough with oppression of breathing aggravated by motion and ameliorated from external pressure.³
Dyspnoea and haemoptysis.⁴
(7) Kalium iodatum – left sided remedy
(8) Kalium carbonicum – right sided remedy.
(9) Sulphur -Dry cough fatiguing and shaking fits of suffocation especially when lying down during sleep, at night, speaking, walking in open air. Inflammation of lungs.³
(10) Nux vomica -Dry cough with pain in head as if it would burst. Difficult respiration, shortness of breath, aggravated at night and morning, exertion, from cold air, after eating, drinking with humming in ears, quick pulse and sweets.³
𝗔 𝗖𝗢𝗡𝗦𝗜𝗗𝗘𝗥𝗔𝗧𝗜𝗢𝗡𝗦 𝗢𝗙 𝗩𝗜𝗥𝗔𝗟 𝗜𝗡𝗙𝗟𝗨𝗘𝗡𝗭𝗔 𝗔𝗡𝗗 𝗔𝗜𝗗𝗦 / 𝗛𝗜𝗩 𝗜𝗡𝗙𝗘𝗖𝗧𝗜𝗢𝗡𝗦 𝗔𝗦 𝗖𝗢𝗠𝗣𝗔𝗥𝗘𝗗 𝗧𝗢 𝗦𝗔𝗥𝗦.
Influenza virus is a RNA virus. Route of entry is respiratory tract. Incubation period is 1-2 days.² commonest complication is pneumonia. Clinical picture includes fever with chills, cough with little expectoration, coryza, pain in throat, fast pulse, bronchitis and pneumonia .⁵
After repertorisation from Kent’s repertory, Arsenicum album secured 23 marks and Sulphur secured 19 marks covering all the eight symptoms in comparison to Pulsatilla nigricans, Bryonia alba and Phosphorus which are securing 16,15,15 marks for 6,5,5 symptoms respectively (Complete Repertory form attached).
𝗔𝗜𝗗𝗦 (𝗔𝗖𝗤𝗨𝗜𝗥𝗘𝗗 𝗜𝗠𝗠𝗨𝗡𝗢𝗗𝗘𝗙𝗜𝗖𝗜𝗘𝗡𝗖𝗬 𝗦𝗬𝗡𝗗𝗥𝗢𝗠𝗘)
AIDS is caused by human immunodeficiency virus. HIV is also a RNA virus. Incubation period is six months to ten years. Then symptoms of AIDS RELATED COMPLEX (ARC) begin to develop. These include recurrent diarrhoea, fever lasting for three months or longer, night sweets, weakness, weight loss and emaciation and persistent generalised lymphadenopathy (PGL).⁶
In this disease, the patient is predisposed to severe opportunistic infections like fungal candidiasis, histoplasmosis, viral herpes (simplex and zoster) , bacterial atypical mycobacteriosis and pneumocystis. Pneumonia and/or tumours (malignant) like Kaposi’s sarcoma due to depletion of T-helper cells (lymphocytes) as a result of HIV infection from infected semen, contaminated blood and blood products.⁷. After repertorisation from Kent’s repertory, Arsenicum album secured 16 marks covering all the six symptoms having three marks for each symptom except 5th, i.e. swollen glands in which it has secured only one mark, while Arsenicum iodatum secured full three marks in the fifth symptom which belongs to Arsenic group. Lycopodium clavatum secured 16 marks covering all six symptoms (Complete Repertory form attached). Here, Arsenicum album appears on the top along with Lycopodium clavatum.
𝗖𝗼𝗺𝗽𝗮𝗿𝗶𝘀𝗼𝗻 𝗼𝗳 𝗦𝗔𝗥𝗦 𝗮𝗻𝗱 𝘃𝗶𝗿𝗮𝗹 i𝗻𝗳𝗹𝘂𝗲𝗻𝘇𝗮 (s𝗶𝗺𝗶𝗹𝗮𝗿𝗶𝘁𝗶𝗲𝘀)
Both SARS and viral flu are caused by RNA viruses, are epidemics and are transmitted by aerosols of respiratory secretions of the patient and has a common complication i.e., pneumonia.
𝗖𝗼𝗺𝗽𝗮𝗿𝗶𝘀𝗼𝗻 𝗼𝗳 𝗦𝗔𝗥𝗦 𝗮𝗻𝗱 𝗔𝗜𝗗𝗦 (similarities)
Both SARS and AIDS are caused by RNA viruses. Because of the mortality, fear of death (not necessarily) may be a common symptom in SARS and AIDS patient. ” The fear of death is not of Aconite but is an anxiety and a feeling that it is useless to take medicine as they will surely die.³ This symptom is fully covered by Arsenicum album.
TOXICOLOGY OF ARSENICUM ALBUM
Since ancient times, Arsenic has been used in medicine for treatment purpose and by criminal as poison. Because of its marked toxicity, it has been studied extensively early pharmacologists and toxicologists.
Chronic arsenic poisoning results from exposure to industrial arsenic or as medicine . It is insidious in on set. The first symptoms are those which attend many disorders. They consist in weakness, languor, loss of appetite, occasionally nausea, vomiting and diarrhea or constipation. As poisoning progresses, symptoms became more characteristics. Conjunctival congestion catarrhal inflammation of nose, throat and larynx, sneezing, hoarseness and coughing all simulate an acute coryza. Arsenical fever with rash, garlic odour of breath or sweat may be present. Stomatitis and excessive salivation and sweating may be present. Dermatitis, arsenic melanosis (skin pigmentation), keratosis of palms and soles, desquamation and scaling of skin are common features. Vitiligo and alopecia may be present.⁸
The liver may swell due to arsenic, obstructive jaundice and cirrhosis may result from hepatotoxic action. As intoxication advances, the nervous system is prominently involved resulting in arsenical encephalopathy comprising numbness, burning and tingling of extremities, especially legs. Paralysis and pain in joints are common. The bone marrow is seriously injured by arsenic and chronic poisoning is characterised by severe blood dyscrasias, as leukaemia, anaemia, etc⁸.
Arsenicum album is a potent capillary poison in large doses. Arteriolar damage occurs and the blood pressure falls to shock level. The heart muscle is depressed and results in circulatory failure.⁸ Gastrointestinal tract capillary beds dilate greatly. Exudation of Plasma results and the escaping fluid collects in the form of vesicles under the Gastro – intestinal mucosa. These “blisters” eventually ruptures, epithelial fragments are cast off and plasma is discharged into the intestinal tract where it coagulates. The presence of this fluid and irritant action of the arsenic on the bowel lead to increased peristaltic activity and the passage of characterized “rice water “stools which later becomes bloody. Vomitus may also be bloody. This type of dysentery in many ways resembles that associated with various diseases, especially cholera.⁸
The action of arsenic on Kidneys may cause severe renal damage. The urine contains protein, R.B.Cs and casts.⁸
Cytotoxic action – Arsenicum album can arrest cell division and produce nuclear abnormalities (dustin, 1933 ).⁸
Arsenicum album is a potent lung irritant Dr W.H. Burt states, ” through its action upon pneumogastric nerve, this remedy has a specific action upon lungs, producing congestion of all their air passages, the lungs being gorged with blood. Accompanying with this congestion, spasm of muscles of the lungs, with violent dyspnoea and worst form of asthma.⁹
Arsenicum album especially acts on the mucous membranes of the air passages, producing tracheo – bronchial catarrh. The most useful sphere of this remedy in the lung disease will be found in neuro – bronchitic asthma.⁹
It acts as a respiratory depressant confirms Dr A. L. Blackwood.¹⁰ The toxicological symptoms of arsenic are similar to SARS and influenza as it produces a coryza like condition in chronic poisoning. Symptoms of bronchitis, pneumonia are also produced by Arsenicum album. Its effect on G.I.T. causes same as chronic, watery diarrhoea of AIDS with resulting weight loss, emaciation and weakness. Therefore, according to the principal of symptoms similarity, arsenic seems to be the the most suitable remedy for not only SARS but Influenza and AIDS as well.
𝗗𝗿. 𝗛𝗔𝗛𝗡𝗘𝗠𝗔𝗡𝗡’𝗦 𝗩𝗜𝗘𝗪𝗦 𝗔𝗡𝗗 𝗣𝗥𝗜𝗡𝗖𝗜𝗣𝗟𝗘𝗦 𝗢𝗡 𝗛𝗢𝗠𝗢𝗘𝗢𝗣𝗥𝗢𝗣𝗛𝗬𝗟𝗔𝗫𝗜𝗦
In aphorism 73 of “Organon of medicine“, Dr Hahnemann has stated, “… those diseases in which many persons are attacked with very similar suffering from the same cause (epidemically), these disease generally become infectious (contagious) when they prevail among thickly congregated masses of human beings. Thence arise fevers, in each instance of a peculiar nature because the cases of diseases have an identical origin, they set up in all those they affect an identical morbid process, which when left to itself terminate in a Moderate period of time in death or recovery.¹¹
In aphorism 240, Hahnemann has stated, “if the remedy found to be homoeopathic specific for a prevalent epidemic of an intermittent fever do not affect a perfect cure….. in which case antipsoric medicine must be employed until complete relief is obtained.¹¹
In aphorism 241, Hahnemann has stated, “Epidemics of intermittent fever…. each single epidemy is of a peculiar uniforms character common to all individuals attacked and when this character is found in the totality of symptoms common to all, it guides us to the discovery of homoeopathic ( specific) remedy suitable for all the cases….”¹¹
Such a remedy has been called as genus epidemicus in HOMOEOPATHY.
Dr J.H Clarke in his famous work “The Prescriber” has stated, “as prophylactic let all who are exposed to infection or when epidemics are about, take Arsenic……. “¹²
From the above discussion, it can be concluded that Ars.alb. is the most appropriate remedy for SARS as with Influenza and AIDS which are also viral diseases caused by RNA viruses. The toxicity or pathogenesis of Arsenicum album correlates with the clinical picture of SARS, AIDS and INFLUENZA. Apis mellifica stands next to Arsenicum album along with Bryonia alba and Phosphorus. Arsenicum album can be regarded as a homoeopathic (specific) remedy and/or genus epidemicus and as an antipsoric for the SARS and FLU on the basis of the totality of symptoms following completely the rules laid down by Dr Hahnemann’s in aphorism 240 and 241 ‘Organon’. Arsenicum album is a trimiasmatic remedy covering the three miasms, i.e. psora, syphilis and sycosis. As the viruses are subject to mutations and new variants keep appearing trimiasmatic nature of Arsenicum album may be helpful for curative and prophylactic purposes irrespective of the viral variants. Finally, in aphorism 17 of Organon of medicine, Dr Hahnemann has stated that the removal of the symptoms (the disease itself) means the removal of the cause. (13 )However, a more thorough scientific and homoeopathic clinical research is required.
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(2) Cruickshank R. Medical microbiology. Eleventh edition Great Britain. The English language book
society and E and S livingstone Ltd; 1965 pgs. 500,393
(3) Clarke JH. A Dictionary of practical materia medica with reprint edition; New Delhi.
B. Jain Pub (P) Ltd. 2003.Vol 1. pg. 184,143,175,318;2 pg. 626; Vol 3 pgs. 789,922,1318. Vol 1 pg 180
(4) Boericke W. Pocket Manual of homoeopathic material medica. Ninth edition. New Delhi. B.Jain Pub(P) Ltd.pgs.81, 63,134,78,538,509
(5) Mills WS. Practice of medicine. Reprint edition. New Delhi.B.Jain.Pub(P) Ltd. 1994.pg.68.
(6) Sharma V. Selecting A remedy for AIDS. Homoeopathic heritage B. Jain Pub (P) Ltd. Vol 28
July 2003; pg 13.
(7) Crowley LV. Pathologic Basis of disease. First Indian Edition. Chennai. All India Publishers and Distributer Regd. 1999; pgs 173 -4
(8) Goodman LS and Gilman A. The Pharmacological Basis of Therapeutics. Second edition. USA. The MacMilan company 1960.pgs 953-4.
(9) Burt WH. Physiological Materia Medica. Third edition. New Delhi. B.Jain Pub(P) Ltd 2005 pg125.
(10) Blackwood AL. A Manual of Materia Medica Therapeutics and Pharmacology. New Delhi. B. Jain Pub (P) Ltd 2002; pg 145.
(11) Hahnemann S. Organon of Medicine. Sixth ed. New Delhi. B. Jain Pub (P) Ltd 1996;pgs 160,267,104.
(12) Clarke JH. The Prescriber. Reprint ed. New Delhi. B.Jain Pub(p) Ltd 2001;pg.233.
(13) Kent JT. Lectures on Homoeopathic Philosophy Reprint edition. B. Jain Pub (P) Ltd. 1995.Pgs (96-8)
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Disease Name – SARS (severe acute respiratory syndrome)
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Consult Homoeopath: Dr Vatsalya Sharma (B.Sc., BHMS)
About the author
Dr Vatsalya Sharma