Homeopathy. 2021 Nov;110(4):236-243.
Analysis of Homeopathic Genus Epidemicus for COVID-19 Patients in Spain
Marc Lluís Clapers (1), Manuela Velat (2), Josep Maria Clapers (3), Joan Vidal-Jové (4), Joan Mora (5)
1 Departamento de Clínica of Academia Medico Homeopática de Barcelona (AMHB), Calle Corcega 370 2° 2ª, Barcelona, Spain.
2 Departamento de Clínica of Academia Medico Homeopática de Barcelona (AMHB), Plaça Mons, 1, Barcelona, Spain.
3 Clapers Homeopatia, Academia Medico Homeopática de Barcelona (AMHB), Calle Corcega 370 2° 2ª, Barcelona, Spain.
4 Institut Khuab. Plaça Mons, 1, Barcelona, Spain.
5 Departamento de Clínica of Academia Medico Homeopática de Barcelona (AMHB), Calle Barcelona 42 2°, Girona, Spain.
Abstract
Background: Homeopathy has had documented success treating epidemics in the last two centuries. We aimed to obtain a clear homeopathic clinical picture of coronavirus disease 2019 (COVID-19) and postulate the genus epidemicus of the disease in order to inform and enhance future treatment and prophylaxis options.
Methods: We conducted a prospective case series study, collecting data from 19 homeopaths in Catalonia, Spain, from patients who presented with fever and/or cough and/or breathlessness and/or confirmed COVID-19 infection or close contact with a confirmed case. We included 107 patients, and data were recorded through a checklist questionnaire on the day of the case analysis and at day 10-15 after commencing treatment. Symptoms were collected and analyzed with the help of homeopathic repertories.
Results: A total of 103 cases were mild or moderate; four were severe. The severe cases were excluded from the analysis and the 103 mild and moderate cases were analyzed and a clear overall clinical picture with mental, general, and particular symptoms was achieved. Eighty-eight cases had a complete recorded follow-up. The most prescribed medicines were Bry, Ars, Phos and Gels, whilst those with the best rates of good response were Sulph, Puls and Bry. Time to full recovery after homeopathic treatment ranged from 3.5 to 14.4 days, depending on the medicine used. The potency 200c was associated with faster rates of full recovery and a lesser need to change remedy.
Conclusion: We have defined the symptomatic homeopathic characteristics of mild and moderate COVID-19 in Spain and established a set of medicines that might be useful to consider as effective genus epidemicus.
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https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0041-1727204Excerpts:
"There are some studies showing that homeopathy could be a good therapeutic tool in epidemic diseases...Hahnemann himself had some experience with the cholera epidemics in the early 19th century in Europe: in the sixth edition of the Organon of Medicine, he explains how to manage epidemic diseases with homeopathic treatment, making it very clear that each of them is different from the previous one, even if it is the same pathogen. Through careful observation of a certain number of cases, the homeopathic physician can analyze the 'genus epidemicus,' an image of the set of symptoms that all the patients present, to select one or more similar homeopathic medicines suitable for the treatment of the majority of people suffering from that epidemic disease.[13] [14] Hahnemann went further and even postulated that this same medicine would also be useful to prevent symptomatic disease in individuals.
"The Clinical Department of the Academia Medico Homeopática de Barcelona (AMHB) launched a study in March 2020 to collect clinical cases of COVID-19 who were treated with homeopathy. The study was conducted by local homeopaths, aiming to determine the homeopathic symptomatic characteristics of the COVID-19 outbreak and to identify a group of epidemic medicines or a genus epidemicus that would be useful to treat most patients. A secondary objective was to analyze the response to the homeopathic treatment."
"Any patient consulting a homeopath member with symptoms of fever, cough, or respiratory distress, and with high clinical suspicion of COVID-19 or close contact with a confirmed diagnosis of COVID-19, or with diagnostic confirmation by PCR, could be included in the study after providing informed consent."
"To evaluate each prescription made, we have used the descriptive term 'good response' if it produced amelioration and no other remedies were prescribed for a full recovery. If a change of remedy was needed, although the first prescription ameliorated some of the symptoms, the prescription was evaluated as 'not good response'."
"On June 6th, 2020, the epidemic curve flattened in our region. The new cases being fewer and having collected more than 100 cases, we decided to finish data collection and start analysis of the data to share them with the scientific community. We present here the findings for medicines used, together with symptoms, sensations, and follow-up of confirmed or highly suspected COVID-19 cases..."
"In order to simplify our data analysis and to enable stronger conclusions on the genus epidemicus or set of homeopathic medicines most likely adequate to treat these patients, we have analyzed the data only from the 103 patients with mild or moderate disease. We have excluded the four patients with severe or critical disease because their small numbers could invalidate the extrapolation of findings."
"The repertorizations presented in [Fig. 1] (Radar Opus) and [Fig. 2] (MacRepertory) provide a synthesis of the symptoms reported by patients who were analyzed and registered in the database, showing: (a) the most peculiar, like the loss of taste and/or smell; (b) the most characteristic (fever, chill, cough, difficult respiration, chest oppression) with its concomitants or its peculiarities; (c) general symptoms; (d) multi-locational sensations, ameliorations, or aggravations, such as itching or tickling sensations all through the airway, dryness over all mucous membranes, a general amelioration with lying down or a general aggravation by talking; and (e) mental symptoms (fear of suffocation and anxiety about health)."
"Eighty-eight cases had a complete follow-up; 15 of the 103 cases were lost to follow-up or the information provided was insufficient to evaluate the prescription...To study better the most prescribed remedies, their effectiveness, in terms of time to full recovery and by first prescription, was evaluated separately for cases of dyspnea and/or chest pain and for all moderate cases.
"Forty-three different homeopathic medicines were prescribed. As shown in [table 1], the most prescribed were Bryonia alba, Arsenicum album, Phosphorus, Gelsemium and Camphora. The remedies that showed better results (with six or more cases collected) were Sulphur (100% 'good response'), Pulsatilla (85%), Bryonia alba (72%), Belladona (67%), Phosphorus (56%) and Arsenicum album (50%). Gelsemium and China officinalis, though being among the most prescribed medicines, each showed a very low response in this same sub-group of cases ratio (20% and 0%, respectively).
"When lower respiratory tract symptoms were prominent (dyspnea, chest pain, and for moderate COVID-19 cases), the most prescribed medicines were Bryonia alba, Phosphorus, Arsenicum album and Camphora. The best responses in this same sub-group of cases were obtained (for six or more cases) with Bryonia alba (60%), Camphora (50%), Arsenicum (43%) and Phosphorus (33%).
"The average time to full recovery of all 88 cases was 13.3 days (range, 1–60 days), with an average of 1.6 homeopathic medicines used per case. Full recovery time after homeopathic prescription ranged from 3.5 to 14.4 days, depending on the remedy used, and the fastest recoveries were obtained with Sulphur, Belladonna, Pulsatilla and Bryonia alba (for remedies used in more than six cases)."
"With regard to potency of remedies, 30c was the most frequently used, followed by 200c and then LM potencies ([table 2]). A change of remedy or potency was needed in more than 50% of the cases that received a 30c potency. On the other hand, 200c potency remedies had the best ratio of good response (62%) among the more frequently used potencies."
"To our knowledge, this is one of the largest reported collections of COVID-19 cases treated with homeopathy.[16] [17] Besides having some methodological, study sample or data collection bias, the results of the study seem strong enough to be extrapolated to other populations infected with a symptomatically mild or moderate COVID-19 disease, enabling us to postulate a valid genus epidemicus with a candidate set of useful homeopathic medicines that could be helpful in treating or preventing further COVID-19 outbreaks."
"Regardless of all those confounders and limitations, we believe that the analysis of more than 100 cases shows a well-defined clinical homeopathic picture of the mild—moderate COVID-19 disease in our region, valid for finding a set of genus epidemicus medicines, or remedies most likely to be useful. As shown in Results, the clinical picture is as follows: presents predominantly fever at night, with a sensation of chilliness, chills, cold or icy hands and/or feet, needs to be covered, perspiration is absent or nightly perspiration appears, with thirstlessness. Dry cough is common. In the respiratory domain, we have seen suffocative sensations, shortness of breath, with tightness of chest, and predominantly nocturnal, with dry, itchy, tickling, and burning sensations in the lungs and the entire respiratory mucous membranes. Mental symptoms such as anxiety at night, fear of suffocation at night or during sleep, and concern or anxiety about their own health were frequent. In the general symptoms section, we found fatigue predominantly, sometimes extreme, with great need of lying down, resting, and sleepiness. Muscle pain and headache (with no clear modalities) were usually described by patients. Diarrhea was also commonly noted. Talking worsens the patient situation generally, and more particularly cough, the suffocative sensation and the dryness. There can be loss of taste and smell and an aversion, disgust or nausea for food, improvement by hot drinks, and desire for fruit or refreshing food.
"With this final breakdown of the symptoms that seem most relevant to us, we would like to emphasize some aspects. Though COVID-19 is a viral disease with clear involvement of the respiratory tract and one of the characteristic symptoms of the disease is cough, we found that cough was not so predominant among our patients, and those who present it were not able to describe any particular characteristics or modalities other than a dry cough that improves when lying down and worsens with speaking."
"On the other hand, dyspnea is expressed as a feeling of suffocation, that air is not inhaled, that the lungs cannot be filled up, etc., but in most cases without tachypnea. In many patients, it seems that the patient is not able to discriminate between anxiety and respiratory distress; subjective and objective symptoms are mixed, and the patient does not know or can differentiate them....Regarding mental symptoms, fear and anxiety predominate, both closely related to the feeling of suffocation, and predominantly at night or sleeping. Fear and anxiety are about death and suffocation. Also, though not so relevant, fear of becoming ill and fear of contagion are worries that perhaps we can attribute in part to the contemporary social situation of 'lockdown,' bad news, uncertain information, etc.
"Other relevant symptoms that we would like to emphasize are the loss (or sometimes alteration) of taste and/or smell, very characteristic and particular to the current epidemic.
"Likewise, about the general symptoms, we underline the tiredness, prostration and weakness expressed by the majority of patients, in some cases extreme fatigue that is a very intense, almost paralytic, weakness manifested as 'I cannot even hold my head up' or 'I cannot hold the phone in my hand'."
"Another symptomatic aspect that seems important to us in the analysis for the genus epidemicus is the sensations expressed by patients. In the cases collected, it seems that they are 'multi-locational': that is, the same kind of sensations is experienced in different places in the body."
"These symptoms—the most frequent and intense but also the most characteristic and particular—are the ones that should guide our analysis in the search for a genus epidemicus, a clear symptomatic picture of the COVID-19 disease in the current epidemic in our region."
"As seen in the repertorizations in [Figs. 1] and [2], the remedies that appear in the first positions have also been used in the prescriptions. We must underline the remedies that appear at the top of each repertorization: Phosphorus, Nux vomica, Pulsatilla, Bryonia alba, Rhus toxicodendron, Arsenicum album, Lachesis, Sulphur."
"Bryonia alba was the most used remedy and offered an acceptably good response ratio of 72%."
"Phosphorus is also a remedy to be considered when treating COVID-19 patients. It appears as first-listed on both repertorizations, Complete and Synthesis, and again its Materia Medica has a good correlate with the symptom characteristics of COVID-19."
"Sulphur has to be also considered in this group of useful remedies for COVID-19. It appears well positioned in the repertorization ranking and has shown best results in the cases collected, with 100% of good response when prescribed in our mild and moderate cases."
"Pulsatilla shows great potential as well. It appears in the top 5 of both repertorizations and it has a high good response ratio, around 85%."
"Arsenicum album, a remedy recommended at the beginning of the epidemic by the AYUSH in India as genus epidemicus,[19] and widely prescribed among our study patients, yielded uneven results: it showed a good response ratio of 50% and 43% in mild and moderate cases, respectively, but it also displayed a long average time to full recovery (13.7 days). It appears well positioned in our repertorizations and it consistently has a good symptomatic correspondence with the clinical picture outlined in the study, but in some cases where it was prescribed it seemed to be highly ineffective and many patients needed a change of remedy. We recommend prescribing it with caution."
"Given the previous repertorizations and the results obtained from the remedies used in our collected cases, which we have summarized above, it is difficult to propose just one homeopathic medicine as the genus epidemicus. However, we could probably agree on a group of remedies, as Kent said,[14] with which we might treat nearly all mild and moderate cases of COVID-19 with success. Those medicines would be Bryonia alba, Phosphorus, Sulphur, Camphora and Pulsatilla.
"Regarding the potencies used, we saw from our results that 30c was the most prescribed, but up to 60% of the times it needed a successive remedy, a higher potency, or a different medicine. 200c was frequently used too, and with better response. With these data, and though 30c is the most easily found potency remedy in pharmacies, it seems that using it could delay the healing process or the search for the best remedy in moderate disease cases. We suggest using, whenever it is possible, 200c remedies from first prescription to reduce as much as possible the need for changing potencies and to obtain a quicker healing response."
"After presenting all the data and conclusions from the collected cases, we firmly believe that we have accomplished our goal, to present a clear symptomatic picture of the mild and moderate COVID-19 disease in our region. We presented also a group of remedies most suitable to treat those cases. Nevertheless, we should reflect that for each case studied and treated, the good homeopathic physician should still always individualize and prescribe the proper homeopathic medicine guided by the Law of Similars, even in treating epidemic disease, as Kent said in his Lectures.[14]
"The importance of publishing this work is that its comprehensive homeopathic clinical information can reach as many homeopaths worldwide as possible, and it can be used to inform about the treatment of COVID-19 patients, taking into account that, at the time of the study, there have been no preventive or effective conventional treatments for the disease. We think homeopathy has much to contribute in reducing deaths and morbidity of this disease. Further studies are needed to investigate the role of homeopathy in severe cases of COVID-19 and in critical stages where the involvement of inflammation and hypercoagulability drive the organism to multi-organ failure."
Comment: the authors examined 103 patients given 43 different remedies (possibly more if different potencies were used for the same remedy), some of them receiving more than one remedy, and some of them getting a change of remedy during the study. There were no controls, and outcomes were self-reported. Since they excluded severe cases, they were examining the courses of an illness which usually resolves by itself in time. It seems that they are simply looking at random outcomes, yet they interpret differences as differences in effectiveness of the administered homeopathic remedies.
