Acute gastroenteritis Homeopathic perspectives

Dr Mansoor Ali 

Paper  presented by the author  in the national workshop organized by Central Institute of research in Homeopathy Kottayam in association with CCRH & AYUSH  

Now we are going to discuss something in brief about

• History of Homeopathy in relation to gastroenteritis
• Concluded studies related to gastro enteritis around globe
• Remedies  for – diarrhoea & Dysentery
• Best Book of reference in treating gastro enteritis
• Repertorial approach in dysentery, diarrhoea & cholera
• Accessory measures required
• Analysis of literatures
• Need of research in Homeopathy 

History of homeopathy in relation to gastro enteritis

Asiatic Cholera (1830)
Give a drop of camphor spirit every five minute – (Lesser writings of Hahnemann). Even without seeing a single patient Hahnemann treated and saved the life many patients at that time.

Kerala : 100 years back by Missionaries, an epidemic of cholera in southern Kerala effectively controlled by them created faith among people of Kerala

Concluded Studies
An approach to acute Diarrhoeal disorders through Sector and constitutional Homoeopathic treatment in adivasi children attending balwadis  in Palghar & Vikramgarh taluka, Thane District, Maharashtra. by DR. M. L.  Dhawale Memorail Trust

• The cost factor was reduced to 20% of the allopathic line of treatment.
• Immunity of the anganwadi children had increased and they were remaining healthy in spite of epidemic affecting other children in the same village
• The common acute remedies indicated were the following: Colocyn, Merc. Cor., Nux. Vom. Aloe., Croton tig., Jalapa, Podo., Cina, Cham, Ars. alb.
• The common constitutional remedies frequently observed were: Mag. carb., Sulph., Silica, Calc carb.,
• The intercurrent remedies indicated were: Tub. Bov., Dys co.
• Acute sector treatment followed by the Constitutional treatment provides the base to develop the child’s immunity and nutritional status better 

Homeopathic Combination Remedy in the Treatment of Acute Childhood Diarrhea in Honduras
The Journal of Alternative and Complementary Medicine (Published in Volume: 12 Issue 8: October 11, 2006)

Researchers :  Jennifer Jacobs , Brandon L. Guthrie , Gustavo Avila Montes , Laurel E. Jacobs , Noah Mickey-Colman, A. Rose Wilson, Ronald DiGiacomo

Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA

Method : double blind RCT

• A total of 292 children with acute diarrhea was recruited;
• 145 were randomized to the experimental group
• 147 to the placebo group.
• Tablets containing a combined preparation of the five most common single homeopathic remedies used to treat 

Result
The homeopathic combination therapy tested in this study did not significantly reduce the duration or severity of acute diarrhea in Honduran children.

Clinical evaluation of the lesser known/ partially proved homoeopathic medicines in amoebic dysentery

• By CCRH in 7 centres all over India
• Clinical trial was conducted on 6198 patients 

Medicines  : Alstonia constricta, Ambrosia, Asclepias tuberose, Atista indica, Cynodon dactylon, Emetine, Ficus indica, Helleborus niger, Holarrhena antidysenterica, Leptandra, Raphanus, Silphium and Trombidium.

• 2015 cases were followed up regularly.
• The drugs were found to be effective in 1500 cases.

9 medicines have better results : Alstonia constricta (n=68), Atista indica (n=170), Cynodon dactylon (n=373), Emetine (n=52), Ficus indica (n=99), Holarrhena antidysenterica (n=128), Leptandra (n=133), Raphanus (n=54) and Trombidium (n=380) cases. The indicated homoeopathic medicines were found useful in 6, 30 and 200 potencies.

Homeopathy for childhood diarrhea: combined results and meta analysis from three randomized, controlled clinical trials.
JENNIFER JACOBS, MD, MPH, WAYNE B. JONAS, MD, MARGARITA JIME´ NEZ-PE´ REZ, MD, PHD AND DEAN CROTHERS, MD

Three double blind clinical trials of diarrhea in 242 children ages 6 months to 5 years

Results : Combined analysis shows a duration of diarrhea of 3.3 days in the homeopathy group compared with 4.1 in the placebo group.

Conclusion : Homeopathy should be considered for use as an adjunct to oral rehydration for this illness.
The Pediatric Infectious Disease Journal, 22 (3): 229-234, March 2003

Treatment of acute childhood diarrhoea in Nicaragua

• This trial involved 81 children aged from 6 months to 5 years in a randomised
• Double blind trial of intravenous fluids plus placebo versus intravenous fluids plus homoeopathic remedy.
• The treatment group had a statistically significant decrease in duration of diarrhoea. 

Source : Jacobs J. Treatment of acute childhood diarrhoea with homoeopathic medicine: a randomized clinical trial in Nicaragua.
The Journal of the American Board of Pediatrics, 1995,8,361-6

Treatment of acute childhood diarrhoea, repeated in Nepal

• In a replication of a trial carried out in Nicaragua in 1994, 116 Nepalese children aged 6 months to 5 years suffering from diarrhoea were given an individualised homoeopathic medicine or placebo.
• Treatment by homoeopathy showed a significant improvement in the condition in comparison to placebo.
• Source : Acute Childhood Diarrhoea- A Replication., Journal of Alternative and Complementary Medicine, 6, 2000, 131-139. 

Important Remedies for Diarrhoea & Dysentry

Aconite  – When days are warm and nights cold. Stools small, frequent, bloody or slimy ; fever, restlessness, anxiety, fear of death.

Arsenicum : Stools dark, putrid, mixed with blood ; during stool tenesmus and burning in rectum, great anguish, restlessness, fear of death ; extreme thirst, aggravated at night, or after eating or drinking.

Colocynth : Stools bloody mucus or like scrapings ; before stool, cutting and great urging, violent colicy pains about navel, causing the patient to bend double.

Ipecac : Stools bloody or bloody mucus ; fermented like frothy molasses ; nausea and vomiting ; loathing for all food, no thirst.

Mercurius cor : Stools pure blood or bloody mucus. During stool straining and tenesmus. Severe pains in rectum after the discharge. Almost constant cutting pain in the abdomen

Merc. sol : Similar cases to Merc. cor. Where the symptoms are worse at night, and where there are profuse night sweats, especially on the head.

Nit. ac : – This medicine follows the use of the mercurials where they cease to act. There is tenesmus during stool, and spasmodic contraction of the anus. Long-lasting exhausting pains after stool.

Nux vom : Stools thin bloody mucus, sometimes mixed with lumps of fecal matter. Constant urging before stool. Violent tenesmus and cutting in hypogastrium during stool. Relief after stool. Worse in the morning.

Ref :  Cholera, diarrhoea and dysentry – Homeopathic prevention & cure J H  Clarke

Best book of reference ?
The homoeopathic therapeutics of diarrhea, dysentery, cholera, cholera morbus, cholera infantum and all other loose evacuation of the bowels

• Author :  by James.B.Bell
• 141 remedies
• Under each remedy stool, aggravation, ameliaration, before stool during stool, after stool, accompaniments & authors 10 years experience. 

Repertorial Approach

Dysentery

• In Synthesis  repertory  44 rubrics are available
• Rectum – Dysentery  190
• Rectum pain – during dysentery
• Stomach appetite  ravenous – dysentery -NUX-V
• Ailments  after dysentery 

In Murphy’s repertory   53 rubrics related to dysentery

• Clinical – dysentery, infection
• Clinical – emaciation, general – dysentery
• Fevers – DYSENTERIC, fever
• Intestines – DYSENTERY, infection
• Liver – WEAK, liver – dysentery, with, and diarrhea
• Pulse – WEAK, pulse – dysentery, in
• Rectum – TENESMUS, rectum, ineffectual straining – dysentery, during 

Cholera 

In  Synthesis repertory   59 rubrics related to cholera are available

• MIND – FEAR – cholera; of
• MIND – FEAR – death, of – cholera asiatica; during
• FACE – DISCOLORATION – bluish – cholera; during
• RECTUM – CHOLERA
• RECTUM – CHOLERA – asiatica; cholera
• RECTUM – CHOLERA – beginning
• RECTUM – CHOLERA – morbus cholera
• KIDNEYS – SUPPRESSION of urine – cholera; during
• RESPIRATION – ASPHYXIA – cholera
• EXTREMITIES – CRAMPS – Legs – Calves – cholera; during
• GENERALS – COLLAPSE – accompanied by – cholera 

In Murphy’s repertory  97 rubrics related to Cholera

• Brain – HYDROCEPHALUS, brain – cholera, infantum, in
• Children – EMACIATION, children – cholera, infantum, in
• Chills – THERMOMETER, degrees, temperature – increased – 105 – 105 to 107, with slight fluctuations, in cholera infantum
•  Clinical – cholera, infection
• Clinical – cholera, infantum
• Clinical – cholera, morbus
• Fevers – TYPHOID, fever, salmonella – cholera, in
• Kidneys – SUPPRESSION, urine, kidneys – cholera, in
• Rectum – CHOLERA
• Stomach – VOMITING, general – cholera, with
• Weakness – NERVOUS, weakness – sudden – cholera, in 

Diarrhoea  

Synthesis repertory has   316 rubrics related to various aspects of diarrhea which are highly useful in our day to day practice.

• MIND – FEAR – death, of – diarrhea; during
• VERTIGO – ACCOMPANIED BY – diarrhea
• NOSE – CORYZA – accompanied by – diarrhea
• ABDOMEN – COMPLAINTS of abdomen – accompanied by – diarrhea
• RECTUM – DIARRHEA
• RECTUM – DIARRHEA – accompanied by
• RECTUM – DIARRHEA – alternating
• RECTUM – PROLAPSUS – diarrhea; during
• CHEST – PHTHISIS pulmonalis – accompanied by – diarrhea
• SLEEP – SLEEPLESSNESS – diarrhea; during
• FEVER – INTENSE   – accompanied by – diarrhea
• GENERALS – COLLAPSE – diarrhea agg.; after
• GENERALS – CONVALESCENCE; ailments during – diarrhea
• GENERALS – EMACIATION – diarrhea; during 

In Murphy’s  – Diarrhoea 373 rubricsAbdomen – PAIN, abdomen – diarrhea, during

• Back – PAIN, lumbar, pain – diarrhea, with
• Cancer – RECTUM, cancer – diarrhea, with cancer
• Children – CONVULSIONS, children – diarrhea, with
• Children – DENTITION, difficult, teething – diarrhea, with
• Children – DIARRHEA, children
• Children – DIARRHEA, infants
• Children – EMACIATION, children – diarrhea, during dentition
• Children – EMACIATION, children – diarrhea, with
• Children – FOOD, artificial, ailments from – diarrhea, and vomiting
• Food – APPETITE, general – ravenous, appetite, canine – diarrhea, with
• Pregnancy – DIARRHEA, during pregnancy
• Rectum – CONSTIPATION, general – alternating, with diarrhea
• Stomach – VOMITING, general – diarrhea, during
• Vaccinations – DIARRHEA, vaccination, after
• Weakness – DIARRHEA, weakness, from 

Graphical Representation
If we are analyzing the entire homeopathic literature,  we will get the following results

Dysentery
Result : Merc. sol is the most important remedy for dysentery followed by Colchicum and Mecr.cor – as represented in majority literatures. 

Diarrhoea
Result : Ars. Alb is the top ranking remedy for diarrhea followed by Sulphur and Podophyllum – by the majority of authors and case records.   

Cholera
Result :  Veratum album, camphor and Ars. Alb are the top ranking remedies for Cholera 

Difficult terms in our literature

Algid Cholera : Algid: chilly; “a person who is algid is marked by prostration and has cold clammy skin and low blood pressure” [Wordnet]

Asiatic Cholera : A remarkable epidemic disease, consisting in the malignant form of cholera, in which all of the symptoms are much more severe and rapid in their prograss to a too generally fatal issue. [Thomas1875]

Bilious Cholera: Copious and frequent vomiting, at first of the alimentary and fecal matters, with redundancy of bile, and spasms of the legs and thighs. This is nothing more than a form or variety of European Cholera. [Thomas1875]

A form of simple cholera characterized by purging, vomiting of bile, and spasms of the lower extremities. Regarded as real or Asiatic cholera if it occurred during an epidemic of the latter. [Appleton1904].

European Cholera
A name given to cholera as it usually appears in Europe when not epidemic. [Thomas1875].

Indian Cholera : Asiatic Cholera.

Cholera Infantum :  A dangerous disease of infants that occurs, generally, in the Middle States of the Union, in June or July, and continues during hot weather; hence called the ‘summer complaint’. The chief symptoms are vomiting, purging of green or yellow matter, slime, or blood, attended with pain or uneasiness, and swelling of the abdomen, with some pyrexia, generally. [Dunglison1874].

A summer disease, of infants, caused by hot weather, bad air, or poor milk, and especially fatal

Cholera Morbus : A common name of non-epidemic cholera. [Thomas1875].

A disease characterized by vomiting and purging, with gripings and cramps, usually caused by imprudence in diet or by gastrointestinal disturbance. Simple cholera. [Webster].

Cholera Sicca
An old term for a malignant form of disease seen during epidemics of Asiatic cholera in which death occurs without diarrhea. [CancerWEB].

Simple Cholera
A disease most common in hot climates, at the close of summer or early autumn. It generally begins with pain in the bowels, nausea and vomiting, and cramps in the extremities, followed by severe watery diarrhea. [Appleton1904].

Accessory life saving measures
Accessory life saving measures is not the monopoly of the any of the medical system. We must have a full knowledge of emergency handling and to take fullest help of accessory life saving measures.

• Give ORS along with our medicines
• Administer IV if required

Research in Homeopathy – need of the hour
All Homeopaths should attain knowledge about the modern research protocol, methodology, diagnostic tools, follow-up criteria and disease management.

This will help us to be at par with the current medical research practices.

Many of the research works in homeopathic field are done in an unscientific manner. When research is not conducted in proper scientific way and when there are no valid statistical data it becomes unacceptable to the scientific community.   Some scientists often criticize homeopathy claiming that it uses medicines without knowing their action mechanism. This does not happen only in homeopathy. It is known that today there are several conventional medicines which are given by prescription and are effective, but we do not know their action mechanism.

Clinical research is an area where we cannot make a lot of mistakes so each and every step of the research has to be properly planned. Even though Western and European homeopaths utilizing modern research protocols such as meta analysis, double blind and triple blind RCTS – majority Indian homeopaths are still in case series study and not even case control or cohort study.

Although the best proof is the millions of patients that have been helped from the application of homeopathy, we must have great interest in the progress of research on the effectiveness of homeopathic medicine.   That is why www.similima.com – have a separate section on Research aspects of Homeopathy.

Reference :

• The homoeopathic therapeutics of diarrhea, dysentery, cholera, cholera morbus, cholera infantum and all other loose evacuation of the bowels  :  by James.B.Bell
• Cholera, diarrhoea and dysentry – Homeopathic prevention & cure : J H  Clarke
• Repertorium homeopathicum syntheticum 9.2 : Frederick Schroyens
• Homeopathic Medical Repertory  3^rd Edition : Robin Murphy
• Websites : www.similima.com,  http://www.antiquusmorbus.com/
• Softwares : RADAR & HOMPATH