An evidence Based Homeo treatment protocol of Hepatitis –B

Dr S G Biju  

Introduction
Hepatitis B is a liver infection caused by the hepatitis B virus. Approximately 40 to 45% of all cases of hepatitis are the result of hepatitis B. Over 300,000 new cases of hepatitis B occur annually. Approximately 1% of pregnant women have either an acute or chronic hepatitis B infection. Homoeopathy was extremely successful in dealing both with epidemic and endemic diseases which enabled Homoeopathy to Spread from Germany across Europe and then to America. So I think It is high time to conduct an intense research and study for the effectiveness of Homoeopathy in curing Hepatitis- B cases which is still a challenge to the medical field. Inculcation of softwares in repertorization and suggestion of a constitutional remedy for each and every patient accelerates the advancement of Homoeopathy for the past few decades. So the Research and Study is planned to be held with the help of repertory. Hepatitis – B is a disease considered with a rank not much less than HIV. When Homoeopaths suggests an effective curative treatment for a global health problem it will be quiet beneficial for the suffering humanity of the entire world.

Recently lot of discussions had been made between Homoeopaths and scientists regarding the scientificity of Homoeopathy on the basis of an article published in the health magazine – Lancet. It is the time for proving the efficacy of Homoeopathy in treating and curing the “so called” incurable disease. The word ‘Homoeopathy’ is Latin, which means similar suffering. (Homoeo = similar and pathy = suffering). Substances possessing poisonous property to produce sufferings in healthy human beings when used in small doses become medicines to cure natural diseases of similar sufferings. This was an old principle stated by Hippocratus, the father of modern medicine. A German allopathic doctor named Christian Friedrich Samuel Hahnemann (1755-1843) verified the above principle convincingly while investigating into the reason for cure of malaria by cinchona. He subsequently continued research with the verification of results on similar experiments made and founded a new system of medicine, to which he gave the name as Homoeopathy. It was he who had named the prevalent western system of medicine as Allopathy because he had proved medicines used in allopathy to treat a particular disease, as producing opposite or indifferent signs and symptoms (Allo = opposite; pathy = suffering) when tested in healthy human beings, than those of the disease treated.

It is only about two hundred and odd years since Homoeopathic system of treatment was first introduced into the world by Hahnemann, its celebrated inventor. For reasons advanced, analyzed and studied in detail regarding the origin and cure of diseases, it is possible to get convinced that Homoeopathy is the only true healing art of the mankind, especially having been carefully designed to ward off any toxic effect of the drug use necessitated by various systems of treatment for the cure of diseases. Unlike any other system of treatment that uses medicine in any form as a tool to abate disease, homoeopathy has an exclusive and refined method of preparation of medicines, to save man from the possibility of drug poisoning. When the extensive and large-scale preparation of poisonous drugs purported as medicines for various technically termed diseases, are used in massive doses, the human race is inadvertently surrendering to the grip of a vicious circle of diseases. This happens in two ways, primarily by the suppression of the natural diseases and secondarily by the poisonous influence of the enormous amount of medicines taken, the latter being called as iatrogenic diseases.

According to the philosophy of Homoeopathy medicinal substance required to cure natural diseases is the barest minimum in quantity. But the substance used for the preparation of medicine ought to have produced similar signs and symptoms as that of the disease to be cured, in healthy human beings when experimentally tested. Substances from animal kingdom, vegetable kingdom, mineral kingdom, gas, fire, electricity, magnet, disease products, secretions, hormones etc. have been tested (technically known as ‘proved’) in healthy human beings in this way in several years’ of effort by the Masters of Homoeopathy beginning from Hahnemann, for the preparation of Homoeopathic Materia Medica. From such a Materia Medica, selection of Homoeopathic medicine is made for the irradiation of natural diseases usually treated by Homoeopathy. When the medicine so selected becomes very similar in signs and symptoms it produced to the signs and symptoms of the disease treated, cure take place smoothly without leaving any squeal (after-effect) behind. This has been verified true in almost all curable diseases time and again since the introduction of Homoeopathy to the world. Even the most stubborn cases labeled and rejected as incurable by other systems of treatment have been found to yield to well selected Homoeopathic medicines easily when the ‘similimum’ of homoeopathy work in a patient for a short period. When erudition become impregnation with the above knowledge of treatment “*Homoeopathy offers a life of service to humanity and it is the only method of healing that surely sets the sick man and sick woman on the permanent road to recovery.”

Diseases are situations created by the desperate attempt of the defensive mechanism of an individual to re-establish health. From among the Homoeopathic material medica, it is possible to select a medicine resembling the signs and symptoms of any disease, old, existing or new because Homoeopathic material medica is the stock of a large variety of tools capable of combating any such situation created by an individual for the purpose of maintaining his health. Unlike in case of the other modern systems of treatments Homoeopathy, therefore, need not wage a war afresh in case of whatever malady man is compelled to face. Homoeopathic physicians only needs to select the most suitable weapon of medicine already available in his armamentarium of medicines in which one will always be available befitting to each individual victim who suffers from whatever diseases. Beware that it is not the disease that matter but the man suffering from the particular disease. Due to the very same reason it is also possible that even a most modern disease hitherto not heard of can also be prevented by Homoeopathic medicine in individuals because the defensive mechanism necessary to work in a situation similar to that of such an impending disease could be created by a medicine that almost always exist in Homoeopathic materia medica.

Homoeopathy maintains a holistic outlook. It treats the man in disease and not the disease in man. Contemporary people on earth are demanding a way to regain their lost health in order to face the challenges that technological civilization has imposed on them. Homoeopathy can help the ailing humanity in this endeavor, because it studies man in all his three levels of existence, the mental level, the emotional level and the physical level.

The mental and emotional levels are primarily involved in the loss of his health rather than the physical level but his primary concern goes to the physical level and the other two are neglected. Thus his imaginations always fall short of understanding the diseases in its proper perspective. His efforts to restore health, therefore, become tedious and ineffective. His desperate attempt to drive away disease from the physical plane ultimately results in the suppression of diseases. Thus diseases become more and more complicated; migrate from less important organs to more important organs; change from less complicated state to more complicated one; shift from a sophisticated phenomenon to become an un-understandable one.

Approaches: Curative, Preventive and Palliative.
Homoeopathic approach, just as explained in the above paragraph is, therefore, holistic and curative in nature while in modern concepts other than that of Homoeopathy, suppression of diseases take place in the name of scientific solutions. In Homoeopathic treatment the patient’s mental and emotional levels are primarily set right so that the sufferings in the physical level follow suit and normal health is restored. In circumstances where modern medicine fail to open-up a way into the encroached innermost parts of the cell in which the disease producing virus easily gain access, Homoeopathic medicines that perform an eccentric work evicts the viruses from their habitat in the interior of the cell and restore primary normalcy there so that rapid cure and restoration of health follows. In the sphere of preventive medicine Homoeopathy is a well known and most effective in situation of viral invasions precipitating an array of health problems ranging from meningitis, encephalitis, viral hepatitis, measles, scarlet fever, chicken-pox, mumps, diphtheria, whooping cough, tetanus, aids, viral endocarditis, leptospirosus, viral pneumonia and so on. The efficiency of Homoeopathic medicines to prevent conditions created by Bacilli (Tuberculosis, Bacillary Dysentery, Typhoid etc.) and Bacterial affections is well known. In advanced cases in which it may not be possible to provide a cure to the patient, most smoothening palliative work is seen undertaken by the selected Homoeopathic medicine.

The socio-economic impact created by adopting Homoeopathic system of treatment is much better than any other system of treatment prevalent in the world.

Manipulations are not permitted in Homoeopathy for the purpose of treatment and hence ailments like transmission of Aids never occur due to Homoeopathic treatment unlike in the dominant system of treatment in which injections, blood transfusions and laboratory manipulations on the body of the patient are frequent carrying the risk of spreading serious ailments from carriers of such diseases. Keeping morale is a pre-requisite for the effectiveness of Homoeopathic treatment and hence the patient also becomes healthy in mind and soul. Because the defensive mechanism is strengthened by Homoeopathic medicines, following the discipline of Homoeopathy controls the invasion of new outbreaks of diseases like SARS. Since the institution of Homoeopathic treatment is on the basis of data collected from the patient and his/her by-standers, treatment can be begun without waiting for costly investigations to fix the disease. This aspect, along with the availability of medicines in cheap rates, makes Homoeopathy cheaper than many other systems of treatment. Homoeopathy is, therefore, most suitable for the developing nations.

Establishing a center for Homoeopathic treatment is cheap and cost-effective wherever it may be. Careful case taking is the most important part of duty of a learned Homoeopathic doctor. Medicines are not much costly but total number of medicines with its different potencies in a full-fledged Homoeopathic pharmacy may range from seven to ten thousand. In a busy homoeopathic dispensary appointment of one or two pharmacist may also be necessary. A sweeper cum peon will be necessary for other assistances. Expenditure on installation of investigative tools when compared to Allopathic system of treatment will be practically zero. Establishment of a laboratory for routine examinations like urine, stool, blood etc. about all of which people are over conscious and wanted to know the position before beginning any medicinal treatment may be advisable. However benefits yielded by a unit of Homoeopathic system of treatment will be invaluable when compared to the investment required for establishing an allopathic hospital of equal yielding in terms of affording relief to the sick folks of the society. Plan for establishing a Homoeopathic hospital attached to an outpatient wing of a homoeopathic dispensary can also be easily worked out on minimum expenditure and maximum cost effective. As a modern tool for effective brainwork and for detailed case analysis in Homoeopathic perspective soft wares are now available for computer study. Computer will be an additional expenditure item essential for optimizing efficiency in Homoeopathic treatment in an establishment. A large number of Homoeopathic literatures are also included in good professional soft wares. Computer is a good assistant and confidence booster for an expert Homoeopathic doctor.

There is only one handicap to Homoeopathy that it is very difficult to master it. It is a Devine Science that unless one dedicate his/her life for its study, it may not be possible for him/her to encompass it fully. Yet in countries like Australia, Belgium, USA, UK, Bangladesh, Pakistan, Canada, Germany, Finland, Netherlands, Holland, Switzerland, Ireland, Austria, Malaysia, Srilanka, Czechoslovakia etc. there are Homeopathic doctors who render exemplary services trying to restore the sick to health using this unique system of treatment. Many a time when diseases become a hard nut to crack to the modern systems of medicines, Homoeopathy steps in with its simple yet wonderful magical capacity to cure diseases in man, has helped to restore the sick to health and has controlled epidemics during their outbreak effectively and independently because preventive medicine was available only in Homoeopathy in many situations. The demand for Homoeopathy, in fact, is increasing day by day in various countries mainly due to the flaws of Allopathic medicine and its characteristic inability to cure diseases except in accidental instances, definitely not due to its merit but due to natures play. Because Homoeopathy is built upon on the rock of natural laws, what was laid down as the cause of production of diseases and the principles of curing them in man always stand flawless and help the mankind to regain his health, lost, of course, because of his own fault!

Homoeopathic treatment is now prevalent in almost all developed and developing countries of the world. It is second in importance and popularity of various systems of treatment available in India. Almost all universities in India conduct Homoeopathic Degree courses and Post-graduate courses in various subjects like Practice of Medicine, Obstetrics & Gynecology, MateriaMedica, Organon of Medicine, Homoeopathic Repertory, and Homoeopathic Pharmacology and so on. There are numerous Homoeopathic Medical Colleges under different universities in all 25 States of India. There is a ministry under the Central Govt. of India by name ‘I.S.M. and Homoeopathy’ under the charge of the Central Deputy Health Minister. The President of India has got a Homoeopathic Physician in charge of his health. The Govt. of India has got a Homoeopathic Advisor to recommend Homoeopathic reforms to be made in the Health Policy of the Govt.

There is a special Council of legislature formed by the Govt. of India for the propagation of Homoeopathy in the country by name ‘The Central Council of Homoeopathy.’ The Act governing Homoeopathic education and practice in India is known as the “Homoeopathic Central Council Act, 1854.” So I think Such a Study on a “so called” incurable disease like hepatitis –B must be from India where Homoeopathy is considered as the first resort for the health problems and the secondly accepted main stream system of the medicine of the country.

If at all Hepatitis – B is a viral disease, according to Hahnemannian concept of Miasms the impact on individual to individual is varying. So the basic criterion for study is decided as “Individualization”.  Entire patients suffering from any disease can be broadly classified in to Psoric, Sycotic and syphilitic according to the Philosophy of Homoeopathy. So it was easy to categorize hepatitis patients in to these 3 categories. The ultimate aim of this study was to reveal the fact that Miasmatic constitutional prescription is the one and only effective remedial measure against Hepatitis – B. I bow my head before all those who co-operated me helped me and contributed to this effort.

Objectives

1.  To Develop a Homoeopathic  Treatment protocol for the Management of Hepatitis-B Cases
2. To test whether the employment of Homoeopathic medicine according to the theory of individualization is effective in the management of Hepatitis – B.
3. To classify HBV cases miasmatically and thus to suggest Homoeopathic prognosis for the same.
4. To find out Certain Chapters/Rubrics in various repertories that can guide       the   Homoeopaths to the right chapter/rubric while repertorising HBV cases.
5. To prove the scientificity of Homoeopathy by a study in the treatment of ‘so called’ incurable disease like Hepatitis-B.
6. To provide a guideline in the treatment of one-sided disease with the help of various repertories.
7. To emphasize the relevance of miasmatic approach in curate treatment of HBV.
8. To prove, if Homoeopathic Medicines are used judicially and follows the principles of Miasm of our master Hahnemann, it can cure the so called incurable diseases. 

Key Words

• HBV – Hepatitis-B virus
• CAH- Chronic Active Hepatitis
• LFT – Liver function Test
• HCV – Hepatitis C Virus

Materials & Methods
The study conducted in the patients attending the Special OP of . The Homoeopathic Multi Specialty Referral Hospital & Research Center, Changanacherry – 1, Kottayam (Dist.) Kerala & It’s Peripheral Dispensary at S.G. Clinic AruvithuraErattupetta.

Patients belonging to different socio economic and age groups were selected for the purpose. Patients who complained of Hepatitis – B within last six month or more duration were selected and send for Lab investigation for liver function and Surface Antigen HBsAg and the cases which showed a positive for HBV were selected for the study. All age group are included in the study.

Detailed histories of the illness were elicited from all the patients according to the Homoeopathic method of case taking. Abdominal palpation and conducted to elicit clinical signs of hepatomegaly. Patients were sent for ultra sound scanning to detect the Hepatomegaly and cirrhotic changes as and when required.

All patients were advised to avoid heavy manual work, 32 patients were included in the study, Medicine were selected and administered in accordance with the Homoeopathic principles.

Each case reviewed every week for clinical evaluation. Each case followed up for 12 months.

Result

• 70% cure is guaranteed in HBV Carrier Cases if one can select an Anti Sycotic mineral Remedy.
• 100% Cure is Guaranteed in CAH if one is able to select an -Anti syphilitic mineral Remedy.
• 100% Rapid cure is guaranteed in Active HBV cases if we are selecting Anti Psoric Plant Remedy  

Discussion
Target Groups – Acute Hepatitis – B – Chronic Active Hepatitis-B

HBV Chronic Carriers

Management Protocol for Acute Hepatitis
1. Pathological Prescription
2.Drugs
3.Medicines
4. Plants

1. Drugs –  Drugs are the substance that can alter the state of health to provide comfort to patient.

ACETIC ACID – Sleeplessness during hepatitis. (Dol.)Diarrhoea during jaundice – LYCOPUS VERGTARAXACUM – Weakness during jaundice (PIC AC,FERR PICRICUM)Head ache with jaundice – SEPItching during jaundice – HEP White coating of tongue with jaundice MERC• Stupor and Unconsciousness during Jaundice – CHEL CORNUS CIRCINATA – Eruptions with jaundice. Aphthae

2. Medicines – Medicines are proven drugs in HBV related Hepatitis

CHELIDONIUMChelidonium is not a remedy for chronic hepatitis. ! CARDUUS MARIANUS Predominantly a remedy for diseases affecting the portal systems. Pain in left lobe. Not indicated in HBV Active cases but effective in cases with ascitis and Hepato cellular Carcinoma (where AFP is markedly elevated)
LEPTANDRA Jaundice with black stools or white (clay colored) stools. Doubtful about recovery is an additional indication for leptandra. When frequently questioned about recovery
Kalmegh (“Keezhanelli”)Low potencies – A traditional Indian remedy. It’s potencies can be used as an anti dote in patients who are coming after Ayurvedic Treatment.
LAUROCERASUS– Extreme weakness.When well selected remedies fails (lack of reaction).
PODOPHYLLUM (Symptomatic relief only) – Pt. Holds the liver region
DOLICHOS Carrier gets aggravated during pregnancy, presented as itching. White stools.

Most Effective Medicine
Chelidonium
Kalmegh
Myrica
Cardus Mur
Ceanothus
NuxVom
Lyc
Bryonia
Digitalis
Podophyllum

All Are Plants
Why Plants ?– Sensitivity is the theme of plant remedies
Viral Diseases are the occurrence in sensitive patients only.
Acute stage of viral disease are the expression of sensitivity
Miasm of Acute HBV – Most of the viral diseases are SYCOTIC in origin Acute stage of all viral disease including HBV shows sensitivity, excitability and Inflammation So Acute HBV viral infection is to be treated with antipsoric medicines

Conclusion in Acute HBV – Acute HBV and other viral infections are to be treated with Anti Psoric Plant Remedies

Chronic active
SGPT,SGOT,Alkaline Phosphatase, GGTAFP, S.Ferritin, Should be investigated at time to time.

Treatment Protocol in CAH
1.Pathological Prescription
2.Anti Syphilitics
3.Minerals
4.Animals

1. Pathological prescription based on Investigation Reports
SGPT – Merc Sol
SGOT – MercCor
Alkaline Phosphatase – Flouric Acid
GGT – Aur Mur Nat
AFP – Cadmium Sulph
S.Ferritin – Fel Tori
A/G RATIO ALTERED (SYCOSIS) – Acid picricum 30 Picric acid exists as bright yellow glistening crystals. Like so many other yellow substances, Pic. ac. acts powerfully on the liver, and produces jaundice, cachexia, and cancerous tints.(J.H Clarke dictionary of practical material Medica

PIC ACID – May show a yellow tint. Pruritus may be troublesome, especially at night.(Gibson D M Study of homoeopathic remedies)
Yellow discoloration of skin Vomiting, coming on suddenly and without warning, ejected matter being of bright-yellow color and very bitter;(Hering’s Guiding symptoms of our material Medica). PIC ACID (A remedy for weakness in jaundice).

When Hepato renal failure anticipates CrotalusHorridus An Anti Syphilitic Animal remedy Destruction – Syphilitic (Fight for survival) – Animal
In CAH -Structural changes will occur,Degenerative pathology Develops

• Structure is the theme of Mineral Remedies
• Degeneration is the basic character of Syphilitic Miasm

So CAH Needs Antisyphilitic Mineral Remedies

Effective Antisyphilitic Minerals for CAH

• Nat Sulph
• Merc Sol
• Phos
• Fl Acid
• Aur Mur Nat
• Muriatic Acid

Antisyphilitic Animal Remedies – Are found effective where there is a problem of Survival
Anti Syphilitic Animals – CrotalusHor, Lach, Vipera,Sepia

Carrier HBV

• No Symptom of Disease
• Only Investigation report, HBs Ag (ELISA), HBe Ag, HBc Ag, DNA PCR, Anti HBs, Anti HBc, & Viral Load
• Treatment protocol – Treat other disease if any (DM, Htn, Hyperlipidemia, Br. Asthma, Allergies etc.)
• If no disease at all treat the negatives if any
• If no negative at all consider the positives of patient except HBsAg!

Some Common Negative Rubrics

• GENERALS – COMPLAINTS – chronic
• GENERALS – REACTION – lack of
• MIND – ANXIETY – health; about – relatives; of
• MIND – ANXIETY – health; about – own health; one’s
• MIND – ANXIETY – future, about
• MIND – DESPAIR – recovery, of
• MIND – DOUBTFUL – recovery, of
• MIND – DOUBTFUL – recovery, of – medicine is useless; thinks
• MIND – DOUBTFUL – skeptical
• MIND – ANXIETY – hypochondriacal – read books; mania to – medical books

Some Common Positive Rubrics

• MIND – HOPEFUL
• MIND – HOPEFUL – recovery, of
• MIND – INDIFFERENCE – suffering; to
• MIND – COURAGEOUS
• MIND – COMMUNICATIVE
• MIND – INDUSTRIOUS
• MIND – ACTIVITY – desires activity
• MIND – REASSURED – easily
• MIND – POSITIVENESS
• MIND – COMPLAINING – never
• MIND – READING – desires – medical books; to read 

Miasm – 90% of carrier HBV are in need of anti Sycotic remedies.
Because of the existing high percentage of Sycosis, system is not able to cry for help. SycosisGrabbed the system from being responding to the virus. Very low titer of Antibodies confirms sycosis.
As the sensitivity is too low Plants can be avoided (Exception Thuja, Opium, NuxVom)As in course of disease structural changes happens Minerals Shall be considered with priority.
Treatment protocol in HBV carrier – Anti-Sycotic Mineral Remedies

Some Effective anti sycotic Minerals

• Ars Alb
• Nat Sulph
• Kali Sulph
• Nat Mur

An Effective plant to develop Vitality – Corydalis Formosa Material Doses Q 8 to 10 Drops 

Acknowledgment:
I am greatly thankful and indebted to Dr.  Sohan Singh MD (Hom)

758 – 1 INSIDE ANDRA JYOTHI LANE ROAD, 3 BANJARA HILLS, HYDERABAD, under whose valuable guidance I conducted this study. I am extremely grateful to him for his valuable advice in preparing this thesis.

I take this opportunity to thank Hon.Dr.Ganjanan Pol, Chairman of Yerala Medical Trust Kharghar Mumbai for starting the P.G.Course in the college enabling me to study the post graduate degree inHomoeopathy.

I am highly obliged to Dr.(Mrs.) Page.MD(Hom), Dean, Principal & Director Member of Board of Studies University of Mumbai and CCH Member, New Delhi. I express my sincere thanks to her for her noble advices.I take this opportunity to thank Board of Study Members, University of Mumbainamely Dr(Mrs.) P.P.Page.MD.(Hom), Dr.A.N.Bhasme, Dr.S.M.Desarada, Dr.J.D.Patil, Dr.K.Kelkar, Dr.J.Patel for their support.I express my gratitude and thanks to Research and Recognition CommitteeMembers, University of Mumbai, P.G.Faculty Homoeopathy namely Dr.(Mrs)P.P.Page.MD(Hom), Dr.J.D.Patil and Dr.(Mrs.)S.M.Bhagwat.A special word of thanks to Mr.Khole, Pro-Vice Chancellor, University ofMumbai.

I express my thanks and gratitude to Dr.A.T.Jagose.MD(Hom),

P.G.Co-ordinator & Asst.Professorof  YMT Homoeopathic Medical college and P.G.Institute, NaviMumbai  who have guided me and helped to complete this work.

I am grateful to Dr.(Mrs)P.P.Page.MD(Hom), Professor & Head of the Department, Dr.A.T.Jagose.MD(Hom), P.G.Co-ordinator& Asst.Professor and staff members of Homoeopathic Repertory Department who helped me and assisted me for this work.

I express my gratitude and thanks to Dr.Kishore Mehta for his guidance in completing this work.

I am thankful to Dr.S.Manilal, Trivandrum for his support he has extended to me for completing this Research.

Last of all I acknowledge all those uncounted personalities who had contributed over 14 years to support me, without whom the study would have been incomplete.

References: 

• Chronic Disease:  Dr. Samuel Hahnemann.
• Clinical Diagnosis of Miasm: Dr.S.K.Banerji
• Theory of Acutes: Dr.PrafulVijaykar.
• Theory of Suppression:Dr.PrafulVijaykar.
• Frequent encounters: Dr.PrafulVijaykar.
• Synthesis repertory: FrederikSchroyens
• Principals & Practice of  Medicine: Davidson
• Internal Medicine: Harrison  

Dr S G Biju BHMS, MD (Hom)
Email :  drbijugnair@gmail.com

Download case reports : www.similima.com/pdf/hepatitisB-cases.pdf