In the wake of recent reports of severe form of pneumonia - Severe Acute Respiratory Syndrome (SARS)- occurring around the world, especially in south east Asia, people are having lots of questions in their mind regarding the possibility of spread of same in our country and what can be done by homoeopaths in that event. People of India have witnessed the success of Homoeopathic treatment in epidemic of Japanese Encephalitis in Andhra Pradesh. The homoeopathic treatment of SARS is not based on causative organism but a homoeopathic (specific) remedy based on the totality of symptoms common to all cases, which is almost universally serviceable in those patients who enjoyed tolerable health before the occurrence of the epidemic.

The World Health Organisation is currently coordinating a global response to the reported outbreak of Severe Acute Respiratory Syndrome (SARS), an atypical pneumonia.

Clinical and Epidemological Update
First recognized at the end Feb'03 in Hanoi, Vietnam in middle-aged businessman with high fever, dry cough of myalgia and mild sore throat. Despite intensive therapy, the victim died on 13/3/03 in Hong Kong.

Clinical Features
Common early symptoms in patients progressing with SARS so far are as follows: Fever (100%), Malaise (100%), Chill (97%), Headache (84%), Myalgia (81%), Dizziness (61%), Rigors (55%), Cough (39%), Sore throat (23%), Running Nose (23%) In many cases, patient is presented with severe headache, dizziness and myalgia. In some cases, there was rapid deterioration as acute respiratory distress. Chest X-ray findings typically begin with a small unilateral, patchy shadowing, progress over 1-2 days to become bilateral and generalized.

Treatment
Hospitalized patients have received multiple antibiotic therapy. Antibiotics used alone or in combination have included azithromycin, aminoglycosides, ceftriaxone, doxycycline and ciprofloxacin. No clinical improvement has been attributed to the use of antibiotics. However, an anti viral agent, ribavirin- given with corticosteroids has shown clinical improvement in critically ill patients in Hong Kong. Intensive and good supportive care, with or without anti viral agents have also improved prognosis.

Causative Organism
Scientists say SARS is caused by new viruses from the family of coronoviruses which also causes common cold.

Spread of Virus
The virus spreads through droplets by sneezing or coughing.

Incubation Period
Between 2-7 days with 3-5 days being more common, before victim starts showing Flu-like symptoms. The virus can survive outside of the human body for 3-6 hours.

Mortality Rate
So far mortality rate appears to be between 3-5%. The virus has tended to spread primarily to healthcare professionals treating victims or close family members of victims due to close contact.

From early nineteenth century, homeopathy has been able to treat epidemic diseases with a substantial rate of success, when compared to conventional treatments. It was these successes that placed the practice of homeopathy so firmly in the consciousness of people worldwide.

One of the earliest tests of the homeopathic system was in the treatment of Typhus Fever (spread by lice) in an 1813 an epidemic, which followed the devastation of Napoleon's army marching through Germany to attack Russia, followed by their retreat. When the epidemic came through Leipzig as the army pulled back from the east, Samuel Hahnemann, the founder of homeopathy, was able to treat 180 cases of Typhus-- losing but two. This, at a time when the conventional treatments were having a mortality rate of over 30%.

In 1830 as the cholera epidemic was reported coming from the east, Hahnemann was able to identify the stages of the illness, and predict what remedies would be needed for which stages. When Cholera finally struck Europe in 1831 the mortality rate (under conventional treatment) was between 40% (Imperial Council of Russia) to 80% (Osler's Practice of Medicine). Dr. Quin, in London, reported the mortality in the ten homeopathic hospitals in 1831-32 as 9%; Dr. Roth, physician to the king of Bavaria, reported that under homeopathic care the mortality was 7%; Admiral Mordoinow of the Imperial Russian Council reported 10% mortality under homeopathy; and Dr. Wild, Allopathic editor of Dublin Quarterly Journal, reported in Austria, the Allopathic mortality was 66% and the homeopathic mortality was 33% "and on account of this extraordinary result, the law interdicting the practice of Homeopathy in Austria was repealed."

The epidemic of Yellow Fever during the 1850s, as well Diphtheria in early sixties reported much laser mortality rate compared to allopathic treatment. Perhaps the most recent use of homeopathy in a major epidemic in western world was during the Influenza Pandemic of 1918. The Journal of the American Institute for Homeopathy, May 1921, reported that 24,000 cases of flu treated allopathically had a mortality rate of 28.2% while 26,000 cases of flu treated homeopathically had a mortality rate of 1.05%.

Closer to our present time, there were the Polio epidemics in the mid-1950s. Dr. Francisco Eizayaga or Argentina, tells of a polio epidemic in Buenos Aires in 1957, where the symptoms of the epidemic resembled those of the remedy Lathyrus sativa. The homeopathic doctors and pharmacies prescribed Lathyrus 30c as a prophylactic, and "thousands of doses" were distributed. "Nobody registered a case of contagion." In a very recent times, almost at the end of 20th century Andhra Pradesh in India was affected by periodic epidemic of Japanese Encephalitis in 1998 with significant mortality rate. However, Belladonna, Calarea Carb, & Tuberculinum worked wonders in not only curtailing morbidity but also brought down the death rate to zero.

Homeopathy has been very effective in treating many of the epidemics during the 19th and early 20th centuries. It is quite likely that rational and scientific use of Homoeopathy in SARS could bring us success in limiting the mortality rate.

Homoeopathy is a natural and safe alternative to conventional medicine, which is suitable for all the family. Modern Homoeopathy has been successfully used by millions of people through out the world. Homoeopathy works by treating the whole person rather than the disease, so it fits in well with today's healthy lifestyle. It can be used by adults and children of all ages. SARS symptoms mimic influenza like symptoms in early phase and progress towards development of atypical pneumonia. Yet there is no vaccine available for SARS. Homoeopathic medicines triggers body's own natural healing process to fight against the disease force irrespective of the causative factor. Based on WHO reported clinical picture & progression of SARS cases following Homoeopathic Medicines based on symptom similarity could be helpful:

Aconite 200:
Onset of symptoms is sudden & violent. Useful in early phase when on set of running of nose, fever, sore throat is very rapid with great fear & anxiety of mind with restlessness. Particularly there is a history of exposure to dry cold air or checked perspiration. Frequent sneezing. Neuralgic pains. Fears that his disease will prove fatal. Mental anxiety, fear, worry accompanies with most trivial ailments. Thirst for large quantity of cold water. Dry, loud, suffocating cough.

Eupatorium Perfoliatum 200:
This remedy is most useful in influenza like symptoms. Affection of broncho mucosal membrane. The leading characteristics symptoms are violent, aching, bone breaking pains along with high fever. Chill precedes thirst with body ache followed by rise in body temperature. Insatiable thirst before and during chill and fever. Coryza with great malaise and sore throat. Cough with difficulty in breathing and inability to lie on left side.

Bryonia 200:
Coryza with headache. Headache while stooping, as if forehead would burst. Dryness of mucus membrane of entire body. Dryness and soreness of throat with constricted feeling. Cough with scanty expectoration & stitching pain in chest. Pain in chest on deep inspiration & coughing. Difficult, quick breathing. Least movement causes aggravation in almost all complaints. Feels better by absolute rest and lying on painful side. High fever with bodyache & headache. Delirium, wants to go home, thinking he is not there. Talks of business in delirium. Great thirst for large quantity of water at long intervals. Patient can not sit up from nausea and vertigo.

Gelsemium 30:
Catarrh of mucus membrane with watery discharge from nose. Malaise. Fever with weakness & trembling of entire body. Headache with blurring of sight and better by profuse urine. Vertigo with dimness of vision or diplopia. Headache preceded by blackout in front of eyes. Dull, dizziness & drowsiness. Fever with much muscular soreness & prostration. Chills up & down back. Fever with dizziness, stupor, faintness. Thisrtless. Dry cough with fluent coryza and sore chest. Difficulty in coughing with oppression about chest. Vertigo spreads from occiput, as if drunk with blurring of vision. Light headed and dizzy worse by sudden movement of head. Nervous diarrhoea. Anticipatory anxiety, fear causing painless diarrhoea.

Ars Alb 200:
Coryza, thin, watery, excoriating discharge from nose. Worse in open air, better indoors. Burning and itching in nose. Soreness, burning in throat. Cough may be dry or with loose expectoration. Feeling as if air passage constricted. Difficult breathing. Unable to lie down, fears suffocation. Intense thirst for cold water, drinks little & often. Marked restlessness but physically too weak to move about. Exhaustion out of proportion to ailment. Burning pain, relieved by heat. Mid day, mid night aggravation of symptoms. High fever. Chills irregular, craves hot drinks during chill, dyspnoea. Sweat with great thirst and exhaustion. Marked restlessness. Changing places frequently. Fear of death & disease. Delirium. Thinks it useless to take medicine, is surely going to die. Diarrhoea after eating or drinking. Watery stools followed by great prostration. Exhaustion is not felt while lying still.

Selecting your remedy:

• Select most suitable remedy by symptom similarity.
• You may not always find all the symptoms listed against a particular remedy. In this case, choose the remedy that has the closest match.
• There could be other remedies to cover your ailment based on your individual response to the disease.
• It is advisable that patient seeks proper medical attention in case of doubt or symptoms not responding to the said homoeopathic remedy, or severity of symptoms getting worse.

  Taking homoeopathic remedies:

• Homoeopathic remedies are always to be taken on a clean tongue, at least 15-30 minutes before or after eating or drinking.
• Never handle homoeopathic remedies directly, take it on clean paper or cap of the container.
• Ensure that mouth is free from any strong flavoured substances such as tobacco, mint, coffee.

  Dosage of homoeopathic remedies:

• Typically in acute severe cases, 4-6 pills every two hourly for 6 dosage.
• Thereafter 4-6 pills 3-4 times a day upto 7days or until the symptoms improve completely or as directed by homoeopathic doctor.
• If symptoms worsen or do not improve, consult a doctor.

No one knows how long someone with SARS can spread the disease, so it is important that SARS patients and members of their household follow the steps below to help stop the spread of the illness.

Limit contact with others
Patients with SARS should stay home and not go to work, school, or other public places until ten days after their temperature has returned to normal (no fever) and they no longer have a cough. During this time, a house with SARS patient should not have visitors.

Wash your hands often
Carefully and frequently wash hands with soap and water or use an alcohol-based hand rub, particularly after taking care of the patient or coming in contact with the patient's body fluids (handling used tissues, surgical masks, changing diapers, etc.)

Use gloves around body fluids
Use disposable gloves when you come in contact with the body fluids of a SARS patient. Immediately after contact with the patient's body fluids, take off the gloves and throw them away. Wash or clean your hands with soap and water or an alcohol-based hand-rub. Do not wash or reuse gloves.

Cover your mouth
Patients with SARS should cover their mouth and nose with a tissue when coughing or sneezing. To prevent spreading the illness, a SARS patient should wear a surgical mask when in contact with anyone who is not sick.

Do not share personal items
Don't share eating utensils, towels, or bedding with someone who has SARS, although these items can be used after washing with regular soap and hot water.

Clean infected areas
Any surfaces soiled by the body fluids of a patient should be cleaned with a household disinfectant.

Discard used items
Throw out tissues, surgical masks, and other disposable items used by a SARS patient with other household trash.

Watch for symptoms in family and close contacts
If a household member or other close contact of a SARS patient gets sick with a fever, cough, or has trouble breathing, they should see their health care provider as soon as possible.

Tips for household members and close contacts
Household members or other close contacts that get sick a fever, cough, or have trouble breathing should follow the same steps listed above for SARS patients. Household members or other close contacts of SARS patients do not need to limit their activities outside the home, if they do not have a fever, cough or trouble breathing.

 

Dr. Shivang Swaminarayan
Honourary Homoeopathic Physician
Civil Hospital, Ahmedabad

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