Homoeopathic therapeutic guidelines for the treatment of omicron

Therapeutic guidelines for the treatment of omicron / sars-cov-2 patients with homoeopathy

Wadhwani, G G. ^1* Chadha, A²

Introduction
Nearly 2 years into the pandemic with SARS-CoV-2, and there has been emergence of the alpha, beta, and delta SARS-CoV-2 VoCs (Variants of Concern) being associated with new waves of infections, across the world. [1] Despite the best treatment, management and containing strategies across the globe to control the spread of virus, a new VOC emerged in a COVID-19-weary world – Omicron. [2] This new VOC demonstrates the coronavirus’s highly adaptive capability to significantly change the way to spread and sicken us in the future.

The Delta variant has been associated with greater transmissibility and higher viral RNA loads in both unvaccinated and completely vaccinated individuals. [3] The sequencing revealed first omicron case from Botswana on Nov 11, 2021 and later similar sequencing confirmed its spread to other countries. [4] The principal concern following omicron suspected if it is more infectious or severe than other VoCs and whether it can circumvent vaccine protection. Although immunological and clinical data are not yet available to provide definitive evidence and there are conflicting reports on whether COVID-19 vaccines have consistently retained high efficacy for each of the four VoCs preceding omicron, we can extrapolate from what is known about the mutations of omicron to provide preliminary indications on transmissibility, severity, and immune escape.

The COVID-19 Treatment Guidelines Panel recommended several therapeutic agents for the treatment and prevention of SARS-CoV-2 infection such as treatment of COVID-19 over post-exposure prophylaxis (PEP) of SARS-CoV-2 infection; treatment of COVID-19 in unvaccinated or incompletely vaccinated individuals with clinical risk factors for severe illness and vaccinated individuals who are not expected to mount an adequate immune response and Use of tixagevimab plus cilgavimab (Evusheld) as pre-exposure prophylaxis (PrEP) for severely immunocompromised individuals over moderately immunocompromised individuals. Multiple therapeutic agents are being suggested for the treatment ofcases suspected viz. the use of ritonavir-boosted nirmatrelvir (Paxlovid) in most high-risk, non-hospitalized patients with mild to moderate COVID-19. If ritonavir-boosted nirmatrelvir (Paxlovid) is not available or cannot be used because of drug interactions, use of sotrovimab has been suggested. Remdesivir has been suggested as a substitute for sotrovimab. Molnupiravir should only be administered when the other 3 options are either not available or cannot be used. And for the hospitalized / patients with ventillatory support therapeutic-dose heparin with a D-dimer above the ULN has been suggested [5]

As on 18 January, India reported 8,209 cases of Omicron VOC post sequencing, while the total active SARS-CoV-2 tally stands at 2,58,089 and 385 deaths. [6]

Well recorded cases in clinical practice are important for deciding the future course of management and treatment. Evidence based case studies of homeopathic treatment of COVID-19 cases have already been published by the author, with pre & post treatment serological markers/ radiological investigations during the past 2 years of pandemic. [7-10]

After having treated nearly 6000 COVID-19 cases in 2020-2021, the author has in recent times consulted on/ treated nearly 500 cases of Omicron in India, Singapore, Portugal, South Africa, UK etc., a few of which have already been published. [11]

This paper details with regard to Omicron/ SARS-CoV-2 VoC the prominent clinical features observed thus far, the homoeopathic rationale and philosophical considerations, posology clinically useful rubrics, remedies and their therapeutic indications.

Clinical features of SARS-CoV-2 VoC Omicron

The recorded symptoms of Omicron seem to be remarkably different from the traditional Covid symptoms which included loss of smell and taste and breathing troubles amongst other.

Instead, runny nose, scratchy and painful throat, painful deglutition or odynophagia, night sweats, headache, fatigue and muscle soreness and some other common cold and flu-like symptoms, with or without fever have been observed with SARS-CoV-2 VoC Omicron.

Not many people are progressing towards pneumonia or serious/ terminal complications, but that can be credited to an experience of dealing with the pandemic over last nearly two years with a readily available repertoire of remedies and patient management protocols but some immunocompromised do progress towards that.

Homoeopathic philosophy for treating Omicron/ Covid 19/ any pandemic or epidemic

Organon § 3: If the physician clearly perceives what is to be cured in diseases, that is to say, in every individual case of disease (knowledge of disease, indication), if he clearly perceives what is curative in medicines, that is to say, in each individual medicine (knowledge of medical powers), and if he knows how to adapt, according to clearly defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient, so that the recovery must ensue – to adapt it, as well in respect to the suitability of the medicine most appropriate according to its mode of action to the case before him (choice of the remedy, the medicine indicated), as also in respect to the exact mode of preparation and quantity of it required (proper dose), and the proper period for repeating the dose; – if, finally, he knows the obstacles to recovery in each case and is aware how to remove them, so that the restoration may be permanent, then he understands how to treat judiciously and rationally, and he is a true practitioner of the healing art.

(Note the clinical features in the case (knowledge of disease), but for prescription we require the indications of ‘the sick’, which are usually found in sensations, modalities and concomitants.)

Organon § 6: The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.

(Never let your past experience or other’s past experiences colour your judgment of the case in front of you- nearly 200 years back Hahnemann cautioned about bias in assessing and prescribing)

Organon § 73: ……………….Allied to these are those diseases in which many persons are attacked with very similar sufferings from the same cause (epidemically); these diseases generally become infectious (contagious) when they prevail among thickly congregated masses of human beings. Thence arise fevers, in each instance of a peculiar nature, and, because the cases of disease have an identical origin, they set up in all those they affect an identical morbid process, which when left to itself terminates in a moderate period of time in death or recovery. The calamities of war, inundations and famine are not infrequently their exciting causes and producers – sometimes they are peculiar acute miasms which recur in the same manner (hence known by some traditional name), which either attack persons but once in a lifetime, as the smallpox, measles, whooping-cough, the ancient, smooth, bright red scarlet fever2 of Sydenham, the mumps, etc., or such as recur frequently in pretty much the same manner, the plague of the Levant, the yellow fever of the sea-coast, the Asiatic cholera, etc.

Organon § 73 foot note 1: The homoeopathic physician, who does not entertain the foregone conclusion devised by the ordinary school (who have fixed upon a few names of such fevers, besides which mighty nature dare not produce any others, so as to admit of their treating these disease according to some fixed method), does not acknowledge the names goal fever, bilious fever, typhus fever, putrid fever, nervous fever or mucous fever, but treats them each according to their several peculiarities.

Organon § 73 footnote 2: Subsequently to the year 1801 a kind of pupura miliaris (roodvonk), which came from the West, was by physicians confounded with the scarlet fever, notwithstanding that they exhibited totally different symptoms, that the latter found its prophylatic and curative remedy in belladonna, the former in aconite, and that the former was generally merely sporadic, while the latter was invariable epidemic. Of late years it seems as if the two occasionally joined to form an eruptive fever of a peculiar kind, for which neither the one nor the other remedy, alone, will be found to be exactly homoeopathic.

Organon § 100: In investigating the totality of the symptoms of epidemic and sporadic diseases it is quite immaterial whether or not something similar has ever appeared in the world before under the same or any other name. The novelty or peculiarity of a disease of that kind makes no difference either in the mode of examining or of treating it, as the physician must any way regard to pure picture of every prevailing disease as if it were something new and unknown, and investigate it thoroughly for itself, if he desire to practice medicine in a real and radical manner, never substituting conjecture for actual observation, never taking for granted that the case of disease before him is already wholly or partially known, but always carefully examining it in all its phases; and this mode of procedure is all the more requisite in such cases, as a careful examination will show that every prevailing disease is in many respects a phenomenon of a unique character, differing vastly from all previous epidemics, to which certain names have been falsely applied – with the exception of those epidemics resulting from a contagious principle that always remains the same, such as smallpox, measles, etc.

Organon § 101: It may easily happen that in the first case of an epidemic disease that presents itself to the physician’s notice he does not at once obtain a knowledge of its complete picture, as it is only by a close observation of several cases of every such collective disease that he can become conversant with the totality of its signs and symptoms. The carefully observing physician can, however, from the examination of even the first and second patients, often arrive so nearly at a knowledge of the true state as to have in his mind a characteristic portrait of it, and even to succeed in finding a suitable, homoeopathically adapted remedy for it.

Organon § 102: In the course of writing down the symptoms of several cases of this kind the sketch of the disease picture becomes ever more and more complete, not more spun out and verbose, but more significant (more characteristic), and including more of the peculiarities of this collective disease; on the one hand, the general symptoms (e.g., loss of appetite, sleeplessness, etc.) become precisely defined as to their peculiarities; and on the other, the more marked and special symptoms which are peculiar to but few diseases and of rarer occurrence, at least in the same combination, become prominent and constitute what is characteristic of this malady. All those affected with the disease prevailing at a given time have certainly contracted it from one and the same source and hence are suffering from the same disease; but the whole extent of such an epidemic disease and the totality of its symptoms (the knowledge whereof, which is essential for enabling us to choose the most suitable homoeopathic remedy for this array of symptoms, is obtained by a complete survey of the morbid picture) cannot be learned from one single patient, but is only to be perfectly deduced (abstracted) and ascertained from the sufferings of several patients of different constitutions.

Organon § 103: In the same manner as has here been taught relative to the epidemic disease, which are generally of an acute character, the miasmatic chronic maladies, which, as I have shown, always remain the same in their essential nature, especially the psora, must be investigated, as to the whole sphere of their symptoms, in a much more minute manner than has ever been done before, for in them also one patient only exhibits a portion of their symptoms, a second, a third, and so on, present some other symptoms, which also are but a (dissevered, as it were), portion of the totality of the symptoms which constitute the entire extent of this malady, so that the whole array of the symptoms belonging to such a miasmatic, chronic disease, and especially to the psora, can only be ascertained from the observation of very many single patients affected with such a chronic disease, and without a complete survey and collective picture of these symptoms the medicines capable of curing the whole malady homoeopathically (to wit, the antipsorics) cannot be discovered; and these medicines are, at the same time, the true remedies of the several patients suffering from such chronic affections. [12]

Genius Epidemicus in homoeopathy

John Henry Clarke in introduction to The Prescriber writes, “The doctrine of genius epidemicus is another practical aid in prescribing. Just as one proving gives only a partial idea of a drug, so one case of an epidemic disease gives only a partial idea of the disease. It is perfectly legitimate homœopathy to take a number of cases and having found the drug disease which corresponds most closely to the disease in all its developments, to give that drug in a routine fashion to all cases which do not manifestly call for some other drug. That does not mean that I have given no other remedy, on the contrary, I have had to use in some case or other almost every remedy in the materia medica ; but the knowledge of the doctrine of the genius epidemicus has saved a vast amount of trouble, nevertheless.” [13]

Bönninghausen had also published an article titled, ‘Brief instructions for non-physicians concerning the prophylaxis and treatment of asiatic cholera’ for the 1846 epidemic and recommended the use of Camphora as a Genius epidemicus (both therapeutic and prophylactic) to lay-practitioners and non-physicians for public at large. The homoeopathic practitioners were required to prescribe Camphora or any other remedy after thorough case recording. [14]

In other words, the scope of genius epidemicus is to help non-physicians and the common man before they find access to a homoeopathic physician for individualised treatment. The determination of genius epidemicus does not preclude recording of details of history and symptoms in each case afflicted with the prevailing epidemic, for the homoeopathic physician.

Not everyone who has been exposed to Covid -19 developed the infection

Organon § 31: The inimical forces, partly psychical, partly physical, to which our terrestrial existence is exposed, which are termed morbific noxious agents, do not possess the power of morbidly deranging the health of man unconditionally; but we are made ill by them only when our organism is sufficiently disposed and susceptible to attack of the morbific cause that may be present, and to be altered in its health, deranged and made to undergo abnormal sensations and functions – hence they do not produce disease in every one nor at all times. [12]

Posology

In most of the cases 200 CH potency of the indicated remedy is a fairly sufficient to start with and produces a response. Its best to prescribe it in form of ‘Water potency’- a drop of medicine is added to about 100 ml of water to which 40 drops of alcohol is added. If a few symptoms are remaining even after this mixture has run out, a few doses of 1M potency of the same remedy (after verifying the symptoms) may thereafter be required to cure the case. Its rarely required to change the remedy. In a few cases Spongia was followed by Hepar sulph to resolve the remnants of phlegm in throat.

Sometimes there might be an indication of Psorinum, Syphilinum or Tuberculinum or other such nosodes or sarcodes, which then can be safely administered in repeated doses in ascending LM potencies starting from LM1.

Gauging the therapeutic response of the prescription: The effect of homeopathic medication on the diseased patient can be observed within 12-24 hours of intake of medicines

Organon § 250: When, to the observant practitioner who accurately investigates the state of the disease, it is evident, in urgent cases after the lapse of only six, eight or twelve hours, that he has made a bad selection in the medicine last given, in that the patient’s state is growing perceptibly, however slightly, worse from hour to hour, by the occurrence of new symptoms and sufferings, it is not only allowable for him….

Organon § 253: Among the signs that, in all diseases, especially in such as are of an acute nature, inform us of a slight commencement of amelioration or aggravation that is not perceptible to everyone, the state of mind and the whole demeanor of the patient are the most certain and instructive. In the case of ever so slight an improvement we observe a greater degree of comfort, increased calmness and freedom of the mind, higher spirits – a kind of return of the natural state. In the case of ever so small a commencement of aggravation we have, on the contrary, the exact opposite of this: a constrained helpless, pitiable state of the disposition, of the mind, of the whole demeanor, and of all gestures, postures and actions, which may be easily perceived on close observation, but cannot be described in words.

Footnote § 253: The signs of improvement in the disposition and mind, however, may be expected only soon after the medicine has been taken when the dose has been sufficiently minute (i.e., as small as possible), an unnecessary large dose of even the most suitable homoeopathic medicine acts too violently, and at first produces too great and too lasting a disturbance of the mind and disposition to allow us soon to perceive the improvement in them. I must here observe that this so essential rule is chiefly transgressed by presumptuous tryos in homoeopathy, and by physicians who are converted to homoeopathy from the ranks of the old school. From old prejudices these persons abhor the smallest doses of the lowest dilutions of medicine in such cases, and hence they fail to experience the great advantages and blessings of that mode of proceeding which a thousandfold experience has shown to be the most salutary; they cannot effect all that homoeopathy is capable of doing, and hence they have no claim to be considered its adherents.

Important rubrics to be considered for Omicron cases [15,16,17]

Location- Throat

• Left side, on— , Merc. i. r., Sabad.
• Left to right, on— Lac c., , Sabad.
• Right side, On— Bar. c., , Guaiac., Lyc., Mag. p., Merc. i. fl., Merc., Niccol., Phyt., Pod., Sang., Sul.

Extension

• Downwards— Iod., Kali bich., Lac c., Merc. cy.
• Left to right— Lac c., , Sabad.
• Right to left— Lyc.
• Upward— Brom.
• Upward, pains go :- , Sep.
  • glands of neck : Sep.
    • submaxillary :
  • larynx : Fl-ac.,
  • stomach : Crot-c., lach., sul-ac.

Complaints- Throat     

• Glazed appearance: ,carb-ac., cist., kali-bi., Lac-c.,nat-a., nat-m., petr., phos., phyt.
• Jerking
  • to the pit of stomach : Sep.
• Veins, varicose— Æsc., Aloe,  m., Ham., Phyt., Puls.

Sensations- in throat

• Anesthesia: Gels, Kali br.
• APPLE core had lodged, sensation as if : , Merc., Nit-ac.,Phyt.
• Burning heat— , Æsc., Bell., Canth., Caps., Carb. ac., Gels., Phos., Phyt., Sinap. n., Still.
• Burning, smarting, scalded feeling— Acon., Æsc.,  caust., Apis, Ars., Ars. iod., Arum, Aur., Bar. c., Bell., Camph., Canth., Caps., Carb. ac., Caust., Cocaine, Con., Glycerin, Guaiac., Hydr., Iris, Kali bich., Kali per., Kreos., Lyc., Merc. c., Merc. i. fl., Merc., Mez., Nat. ars., Nit. ac., Phos., Phyt., Pop. c., Quill., Sang., Sang. n., Senec., Sul., Wyeth.
• Coldness:
• Constriction, spasmodic— , Æsc., Agar., Alum., Apis., Arg. n., Ars., Arum, Asaf., Bapt., Bell., Bothrops, Cact., Calc. c., Cajup., Canth., Caps., Cic., Cocaine, Cupr. m., Hyos., Ign., Lach., Merc. c., Mez., Morph., Nux v., Phyt., Plumb. m., Puls., Ratanh., Sang., Sang. n., Sarcol. ac., Stram., Strych., Sumb., Val
• Deglutition painful, difficult— Agar., Ail., Alum., Amyg. pers., Anac., Apis, Ars., Atrop., , Bell., Bothrops, Bry., Cajup., Canth., Caps., Carb. ac., Cic., Cocc., Con., Cocaine, Cur., Dub., Fluor. ac., Grat., Hep., Hydroc. ac., Hyos., Ign., Iod., Kali bich., Kali br., Kali c., Kali chlor., Kali m., Kali perm., Lac c., Lach., Lyc., Lyssin, Merc. c., Merc. cy., Merc. i. fl., Merc. i. r., Merc. s., Merc. v., Nat. p., Nit. ac., Phos., Phyt., Pop. c., Psor., Sang., Sang. n., Senec., Stram., Strych.
  • Can swallow only
    • Liquids— , Bar. c., Cham., Nat. m., Plumb., Sil.
      Solids, liquids descend with difficulty — Alumen, Bell., Bothrops, Bry., Cact., Canth., Crot., Gels., Hyos., Ign., Lach., Lyssin, Merc. c., Sil.
  • Choking when eating, drinking— Abies n., , Cajup., Can. s., Glon., Kava, Merc. c., Mur. ac., Niccol., Nit. ac., Phyt., Santon., Sumb.
• Dryness— , Æsc.,Agar., Alum., Apis, Ars., Asaf., Atrop., Bell., Bry., Canth., Caps., Caust., Cistus, Cocaine, Cocc., Dros., Dub., Ferr. p., Gels., Guaiac., Hep., Hyos.,Jugl. c.,  Justicia, Kali bich., Kali c., Kali chlor., Lach., Lemna m., Lyc., Merc. c., Merc. per., Merc., Mez., Morph., Nat. m., Nat. s., Nit. ac., Nux m., Onosm., Phos., Phyt., Puls., Quill., Rhus t., Sabad., Sang., Sang. n., Sarcol. ac., Senec. Sep., Spong., Strych., Sul., Wyeth.
• HAWKING, Hemming (clearing throat) (See Chronic Pharyngitis.) — Æsc., , Am. m., Arg. m., Arg. n., Arum, Bry., Calc. c., Canth., Carbo v., Caust., Cistus, Cocc., Coccus, Con., Coral., Eucal., Guaiac., Gymnocl., Hep., Hepat., Hydr., Iberis, Justicia, Kali bich., Kali c., Kali m., Lach., Lyc., Merc. i. fl., Merc. i. r., Nat. c., Nat. m., Nit. ac., Nux v., Phos., Phyt., Psor., Selen., Sep., Silph. s., Spong., Stann., Sul., Tab., Trifrol. pr., Vinca m., Viola tr., Wyeth.
  • Cheesy, fetid, lumps [with] (See Follicular Pharyngitis.) — , Kali bich., Kali m., Mag. c., Merc. i. r., Psor., Sec., Sil.
  • Fetid Pus [with]— Antipyr., , Lyc., Sil.
  • Gelatinous, viscid, gluey mucus; difficult raising [with]— Æsc., Aloe, , Am. br., Am. m., Arg. n., Arum, Canth., Carbo v., Caust., Cistus, Coca, Coccus, Euphras., Hydr., Iberis, Kali bich., Kali c., Lach., Merc. i. fl., Merc. i. r., Myr., Nat. c., Nat. m., Nat. s., Nux v., Petrol., Phos. ac., Phos., Phyt., Psor., Rumex, Sang., Selen., Sep., Silph. s., Stann.
• Hollow feeling, as if pharynx had disappeared— Lach., Phyt.
• Inclination to swallow constantly— Æsc., Asaf., , Caust., Lac c., Lach., Lact. ac., Lyssin., Merc. i. fl., Merc., Myr., Phyt., Sumb., Wyeth.
• Inflammation— Ail., Apis, , Ferr. p., Kali bich., Menthol, Merc. i. fl., Merc. s.
• LEAF, sensation in pharynx as if leaf lay before posterior nares, morning after waking : Bar-c.
• Redness (Objective)— , Carb. ac., Ferr. p., Gymnocl., Menthol, Merc. cy., Merc. i. r., Mez., Naja, Puls.
• Roughness, sensitive— Æsc., Coccus, Dros., Nux v., Phos.,
• skin hanging loose in, and he must swallow over it :
• Sticking, Pricking, splinter-like Pains, extending to ears, worse Swallowing yawning, etc.— Agar., Alum.,  n., Dolichos, Ferr. iod., Gels., Guaiac., Hep., Kali bich., Kali c., Lac c., Nit. ac., Phyt., Psor., Sil., Staph.
• Tickling, as from hair— Æsc. gl., Allium s., Ambra.,  n., Caust., Dros., Hepat, Kali bich., Lach., Nat. m., Nit. ac., Nux v., Pulex, Sabad., Sang., Sul., Val., Yucca.
• Tingling— , Echin., Phyt.

Modality- local symptoms and general well being

AGGRAVATIONS

• Cold [from]: Acon., bar-c., bell., cham., Cistus, Fluor. ac., Hep., Lyc.
  • cold, drinks from : Arg-n., ars., canth., lac-c., , merc-c., sabad., sulph.
  • on becoming : , calc-p., calc., dulc., Hep., Kali-c., lyc., merc., nit-ac., phos., phyt., Sil.
• Drinks, warm or hot [from]— , Merc. i. fl., Phyt.
• Menses [during]— Lac c.
• Pressure [from]— Lach., Merc. c.
• Sleep [while going to]—
• Sleep [from]— Lyc.
• Sleep [worst on waking from, reducing with movement & every successive gulp or bite]— Rhus t.
• Swallowing [from]
  • Empty— Antipyr.,  c., Crotal., Dolichos, Hep., Justicia, Lac c., Lach., Merc. i. fl., Merc. i. r., Merc., Phyt., Sabad.
  • Liquids— Bell., Bry., Ign.,
  • Solids— Bapt., Merc. s., Morph.
  • Sweet things— Spong.
  • Intervals of swallowing, in— Caps., Ign.
• Warmth [from]— Coccus, Iod., Lach.,
• Afternoon, in— Lach.
• Bed, in— Merc. i. fl.,

AMELIORATIONS

• Inspiring cold air [from]— Sang.
• Swallowing [from]— Gels.,
  • Liquids— Cistus.
    • Warm— , Ars., Calc. fl., Lyc., Morph., Sabad.
    • Cold:, coc-c., Ind., lac-c., lach., lyc., merc-i-f., onos., phyt.
    • warmth in general amel. : Alum., , cham., hep., rhus-t.
  • Solids— , Lach.

Concomitants- to the local symptoms or in general

• Mouth and throat, dry, with increased saliva: , Aral., Kali-c., Lyc., Mag-m., Merc., Nat-m., Plb.
• Mouth and throat, dry, but no thirst: , Bry., Cocc., Kali-c., Lyc., Nux-m., Nux-v., Pul., Spig.
• Night sweats—  ac., Agar., Agaricin., Aral., Ars. iod., Bar. c., Bell., Bolet., Calc. c., Carbo an., Carbo v., Cham., Chrysanth., Cinch., Con., Corn. fl., Euphras., Ferr. p., Hep., Iod., Ipec., Jabor., Kali c., Kali iod., Lyc., Merc. s., Myos., Nat. tell., Nit. ac., Nux v., Op., Petrol., Phos. ac., Phos., Phyt., Picrot., Piloc., Pop. tr., Psor., Salvia, Sang., Sanic., Sep., Sil., Stann., Staph., Stront. c., Sul., Tarax., Thall., Thuya, Tilia, Zinc. m.

Birds eye view of therapeutics of throat ameliorated by warmth [17 – 19]

As explained above, in most of cases the throat symptoms have been found to be more prominent and persisting clinical features. A few of these have cases presented a modality of improving with cold intake whereby Phytolacca and Pulsatilla have led to a recovery. In most of the cases, however, throat symptoms have been remarkably relieved by warmth. In most of such cases the author has obtained results from Alumina, Spongia, Calcarea ars, Arsenic album, Sabadilla, Baryta carb and Hepar sulph (usually following Spongia), in descending order of frequency of prescriptions. In very few cases Lycopodium was prescribed.

Alumina

• In the evening and at night the throat pains are most intense, by warm food and drink.
• Early in the day, dry, later with expectoration. Short, dry, with arrested breathing.
• Suddenly appearing hoarseness not by hawking, mostly in afternoon and evening.
• Extraordinary lassitude and fatigue, particularly from talking. Many complaints are in afternoon and when sitting. He feels best during moderate exercise, in evening and in open air.
• Fever: Chill: Predominant and mostly toward evening, even in bed and by a warm stove, as well as after eating warm soup, often with heat of face. During day, and heat at night. In evening, following the chill there is Heat which spreads from face, but sometimes only attacks the right side of the body. Evening fever with prevailing chill. Sweat: At night, especially in early morning in bed, most profuse on face, often on right side of face only, with anxiety. Entire inability to.
• Sore throat, which is aggravated in the evening and at night, but which is ameliorated on taking anything warm, and which is less painful in the morning. Contractive, or shooting pains in the throat, chiefly on swallowing. Difficult deglutition, as if the gullet were contracted. Cramp-like pressure and squeezing in the œsophagus.─Sensation, as if the œsophagus were contracted when swallowing a small morsel of food; it is felt until it enters into the stomach.─Pains in throat < evening and night.─Swelling of the tonsils.─Great dryness in the throat.─ Accumulation of a thick and viscous mucus in the throat, with difficult expectoration.─ Painful ulcers in the fauces, secreting a brown, badly-smelling pus.─ Sensation of a splinter in the throat.
• WORSE: WARMTH; ROOM, bed. Foods: Artificial. Potatoes. Speaking. Dry weather. Early on awaking. Sitting. After menses.
• BETTER: Evening. Open air. Moderate: Exertion. Temperature
• Uvula hangs down. Throat feels full of sticks or constricted.

Spongia

• Difficult, as from a stopper or valve in larynx, without rattling. Oppressed, bending upper part of body forward. Whistling, rattling, anxious inspiration with violent exertion of abdominal muscles. Wheezing (not rattling) inspiration. Loss of breath.
• — Deep, Dry, hollow, barking c., during day and night, excited by an irritation like a plug or valve high up in the larynx, in the morning only there is detached a scanty, tenacious yellow or hardened mucus, of a faintly sour taste, which can’t be ejected but must be swallowed. With painful soreness and burning in chest.
• Larynx sensitive to touch. Roughness and burning dryness with sensation of constriction in larynx and trachea. Inflammation of mucus membrane of trachea. Membranous croup. Laryngeal and tracheal phthisis. Hoarseness. Husky, weak voice which fails when talking and singing.
• The slightest exertion causes violent congestion to chest, with obstructed breathing, anxiety and qualmishness. Constriction, with violent oppression of breathing. Burning and soreness in.
• Burning sensation and stinging in throat.─Rawness, swelling, and scraping in throat. Penetrating tickling in throat, toward ear. Sore throat < after eating sweet things. Throat symptoms > lying down. Constantly recurring needle-like stitches above pit of throat, externally, in lower part of goiter. Sticking internally in throat, esp. after eating. Thyroid gland swollen and hard, with suffocative attacks at night; stitching pains and pressure. Bitter taste in throat. In esophagus: heat; relaxed sensation. Swelling in faces projecting from r. to l.─Swallowing difficult. On swallowing: stitches in neck pass off; violent straining pain; pain in goiter; moving sensation in goiter.─(Goiter painful, pain synchronous with cardiac pain.─R. T. C.)
• HOLLOW BARKING, CROWING, SAWING OR TIGHT CROUPY COUGH; wakes child; then burning in chest; < cold drinks or excitement; > eating/ drinking warm things. Voice gives out. Croup; sudden. HOARSENESS. Larynx pains, < touch, singing, talking or swallowing; he grasps it. Diphtheria. Neck; as if a cord about. Choking on falling to sleep
• WORSE: DRY, COLD Wind. Roused from sleep. Exertion. Raising arms. Before 12 P.M.
• BETTER: Lying with head low. Eating a little.

Calcarea Arsenicosa

• Fever: Chilly crawl over back towards arms and chest; it originates always inwardly with a sensation as if skin and adjoining parts were hot.─ Shuddering or shivering running over back; has sometimes gooseflesh, esp. at night, and is sleepless.─ Fever in afternoon with sensation as if abdomen were puffed up; much thirst for cold water and afterwards loss of appetite.─ Heat in chest with palpitation.─ Sweat after 3 a.m.
• It is a chilly medicine, the symptoms being < in cold weather; when out of doors.
• Craves Hot soups.

Arsenicum Album.

• Tightness of chest during motion. Suffocative attacks in evening after lying down. Oppression of chest when ascending and when in cold air. Shortness of, when walking or turning over in bed.
• — Clear, ringing, crowing or whistling, excited by burning tickling as from sulphur vapor in trachea and throat pit, dry at night, by day expectoration of a scanty, mostly foamy, mucus, or in lumps of varying taste and color, sometimes mixed with bright red blood, returning periodically with increasing violence. Without expectoration, especially after drinking. Immediately on lying down. Nightly hemoptysis with heat.
• Larynx and trachea.– Phthisis of, with scanty secretion of mucus. Constriction of larynx.
• Catarrh, with hoarseness, coryza, and sleeplessness.─Voice rough and hoarse.─Voice trembling or unequal; at one time strong, at another weak. Tenacious mucus in the larynx and the chest. Bronchitis, with difficult secretion of mucus. Sensation of dryness and burning in the larynx. Spasmodic constriction of the larynx. Dry cough, sometimes deep, fatiguing, and shaking, principally in the evening after lying down, or at night, obliging the patient to assume an erect posture; also after drinking; on being in the fresh and cool air, during movement, or during expiration, and often with difficulty of respiration, suffocating, contractive pain, or sensation as of excoriation in the pit of the stomach and the chest; pain, as from a bruise in the abdomen, shootings in the hypochondria, in the epigastrium, and in the chest, &c.─Arrest of breathing with cough. Cough excited by a sensation of constriction and suffocation in the larynx, as if by the vapor of Sulphur. Respiration oppressed, anxious, short. Oppressed, labored breathing, esp. when ascending a height; in cold air; when turning in bed. Periodical attacks of cough. Cough with expectoration of sanguineous mucus, sometimes with burning heat over the whole body. Difficult expectoration, or scanty and frothy.
• INSATIABLE BURNING THIRST; CRAVES ICE COLD WATER, BUT IT DISTRESSES STOMACH (Nix-v.) AND IS VOMITED AT ONCE; with anorexia; during heat. DRINKS LITTLE AND OFTEN. As of a vapor in larynx. SHORT BREATH; felt in nose; must sit up; < odors, receding eruptions or ascending. Whistling inspiration. Wheezing breathing. Cough alternately dry and loose; must sit up. Frothy expectoration. Acute pain through upper third of r. lung. Asthma. Pulmonary edema. Cough; dry, nightly; < drinking.
• WORSE: COLD: ICES, DRINKS. FOODS. Air. PERIODICALLY: MIDNIGHT; after. AFTER 2 A.M. 14 days. Yearly. VEGETABLES. DRINKING. TIPPLING. Infections. Bad meat. Eruptions: Undeveloped. Suppressed. Quinine. Lying on part. Tobacco. EXERTION.
• BETTER: HOT: APPLICATIONS (dry). FOOD. Drinks. Wraps. Motion. Walking about. ELEVATING HEAD. Sitting erect. Company. Sweating.

Sabadilla

• Pain in the throat as if caused by a plug or an internal swelling during deglutition and at other times. Constantly obliged to swallow, with pain in mouth and behind larynx as if something lodged there, with scratching roughness; hawks constantly, < morning and during and after eating, < empty swallowing > warm drinks, hot things, sweet, milk. Sensation of a skin hanging loosely in throat, must swallow over it; as if uvula were down. Much tough phlegm in throat, must hawk. Feeling of constriction in the throat (in fauces as from an astringent drink).─Can swallow warm food more easily, in sore throat. Pressure and burning sensation in throat during deglutition and at other times. Dryness in throat. Roughness and scraping in throat, with continued want to swallow or to hawk. Inflammation of uvula.
• Hot breath. Hoarse, rough voice. Hawking up of bright red blood, which comes from the nasal fossa. Short, dry cough, also at night, provoked by a scraping in throat. Cough dry, with perspiration and water in the eyes. Cough with vomiting, shootings in vertex, and pain in stomach. Dull cough, sometimes with hemoptysis. Cough immediately on lying down. Cough with expectoration and lancinations in chest.
• Short, tickling c., excited by roughness and scraping in throat, dry at night, during day, expectoration of tenacious yellowish mucus of a repulsively sweat taste, or else of bright red blood. Immediately upon lying down. Dry, causing heat, sweat and watering of eyes. Asthmatic, with stitches in vertex, Vomiting and pains in the stomach.
• Larynx: Scratching in. Hawking of bright red blood which comes from posterior nares. Hoarse husky voice.
• WORSE:
• COLD; air; drinks.
• PERIODICALLY: Same hour. Forenoon. New and full moon. Odors. Undeveloped exanthema.
• BETTER: Open air. Heat. Eating. Swallowing. 

Baryta carbonica

• Repeated inflammation of throat, after taking the slightest cold, with swelling and suppuration of tonsils. Sense of a plug in. Sore, when swallowing empty. > swallowing warm liquids. Roughness in.
• Excited by roughness and tickling in epigastrium and throat. Dry in evening. Chest full of phlegm with night cough. Difficult expectoration of a yellowish, tenacious, starchy, often a saltish mucus in morning.
• — Hoarseness and loss of voice from tenacious mucus in, and in trachea. Sensation of smoke in.
• — Fullness in. Strong palpitation, when lying on left side or renewed when thinking about it. Soreness in. Feeling as if something had fallen down within. Sore feeling about heart. Violent palpitation.
• Old, sickly, weakened look. Crusty ears. Nose dry, < blowing it. Pendulous lips.
• Weak tongue. Burning soreness or vesicles on tip of tongue.
• Throat (glands) affected by every cold; < menses. Chronic quinsy. Enlarged tonsils (Calc-p.). Spasm of œsophagus.
• WORSE: Company. Thinking of it. Cold: Damp; to feet. To head. Changes. Lying on: Painful part. Left side. Odors.
• BETTER: Warm wraps. 

Hepar sulphuris calcareum

• Follows Spongia tosta.
• Sore throat, as if there were a peg in it, or an internal tumor. Painful scraping in the throat, with difficulty in speaking and in swallowing the saliva. Hawking up of mucus. Shootings in the throat, and even into the ears, as from splinters, on swallowing, coughing, breathing, and on turning the head. Violent pressure on the throat, with danger of suffocation. Deglutition impeded and almost impossible, without great efforts. Dryness in the throat. Swelling of the amygdala.
• Throat: Sensation as though’ a plug or sharp splinter stuck therein, when swallowing. Roughness in. Scratching, when swallowing saliva. Hawking up mucus. Swollen tonsils and glands of neck. Hoarseness with rapid, hasty speech, as from over excitement.
• Boring at root of nose. Stuffed, painful nose. Ripened colds and old catarrhs. Sneezes from every cold wind. Hawks mucus. Rough sticking like a splinter, fish-bone, etc., in throat. Quinsy. The upper jaw projects. Goiter (r); pains into head. Stomach weak; easily upset. Craves acids, condiments or stimulants.
• WORSE: COLD, dry: AIR. WINTER. DRAFTS. WIND. PART BECOMING. LEAST: UNCOVERING. TOUCH. Noise. Exertion. Lying on painful part. Mercury. Night.
• BETTER: HEAT: WARM WRAPS. TO HEAD. Moist. DAMP WEATHER.

Lycopodium

• Sensation of constriction in throat, with obstructed deglutition. Dryness of throat. Pain, as from excoriation, in throat. Burning pain in throat, with nocturnal thirst. Sensation in throat, as if a ball were ascending from the pit of the stomach. Feeling on l. side of a lump moving up and down. Inflammation of throat and palate, with shooting pain, which obstructs deglutition. Swelling and suppuration of tonsils. The ulceration of the tonsils begins on r. side. The pharynx feels contracted, nothing can be swallowed. Hawking of hard greenish-yellow masses; granular; of bloody mucus. Sticking in region of r. parotid. Sticking in throat during cough. Sticking preventing sneezing. Sensitiveness of the submaxillary glands. Ulcers, like chancres, in the tonsils. Goiter.
• Shortness of breath in children, especially during sleep. Every exertion of chest, walking in open air. Threatening paralysis of lungs.
• Cough: Dry, by day and night. At night, which affects the stomach. Excited by irritation as from Sulphur vapor in trachea. Tickling c., from deep inspiration. With expectoration during the day, but not at night. Expectoration copious, purulent, offensive, lemon – yellow, gray, salty, bitter, flat, putrid, etc. Hemoptysis.
• Chest: Continual pressure in. Stitches in left, (in typhoid or neglected) pulmonary inflammations. Shattered feeling and shocks in. Rattling. Roughness, soreness and tension in. Liver spots on. Hydrothorax. Moist nipples. Palpitation, with anxiety, especially during digestion.
• A ball rises and sticks in throat. Sore throat (r); < cold drinks. Diphtheria.
• WORSE: RIGHT, PRESSURE OF CLOTHES. WARMTH. Awaking. Wind. Eating; to satiety; oysters. Indigestion. 4-8 P.M.
• BETTER: WARM DRINKS, food, etc. Cold applications. Motion. Eructations. Urinating.

Conclusion

It may be impertinent on my part to modify the three precautionary rules of Hahnemann explained by immortal Boenninghausen into FOUR, which are detailed below:

1. In no case is it requisite to administer more than one single, simple medicinal substance at one time. (§ 272, 5^th edition)
2. To suppose that the doses indicated in every antipsoric medicine and moderated by me (Hahnemann) after much experience, and compelled by experience, to be too small.
3. The wrong choice of the medicine, and
4. The excessive hurry does not allow every dose to finish its action.

Adherence to the above four precautionary rules is necessary to obtain rapid, gentle and permanent relief of patients symptoms with homeopathy in Omicron cases.

References

[1] Fontanet A, Autran B, Lina B, Kieny MP, Karim SSA, Sridhar D. SARS-CoV-2 variants and ending the COVID-19 pandemic. Lancet. 2021 Mar 13;397(10278):952-954. doi: 10.1016/S0140-6736(21)00370-6. Epub 2021 Feb 11. PMID: 33581803; PMCID: PMC7906631.

[2] WHO. Update on omicron. Nov 28, 2021. https://www.who.int/news/item/28-11-2021-update-on-omicron  Date accessed: 17 January 2022

[3] Chun Huai Luo, C. Paul Morris, Jaiprasath Sachithanandham, Adannaya Amadi, David Gaston, Maggie Li, Nicholas J. Swanson, Matthew Schwartz, Eili Y. Klein. Andrew Pekosz, Heba H. Mostafa. Infection with the SARS-CoV-2 Delta Variant is Associated with Higher Infectious Virus Loads Compared to the Alpha Variant in both Unvaccinated and Vaccinated Individuals. doi: https://doi.org/10.1101/2021.08.15.21262077

[4] GISAID. Tracking of variants.https://www.gisaid.org/hcov19-variants/ Date: 2021. Date accessed: 17 January 2022

[5] NIH. The COVID-19 Treatment Guidelines Panel’s Statement on Therapies for High-Risk, Non-hospitalized Patients with Mild to Moderate COVID-19. https://www.covid19treatmentguidelines.nih.gov/therapies/statement-on-therapies-for-high-risk-nonhospitalized-patients/Date accessed: 17 January 2022

[6] TOI. https://timesofindia.indiatimes.com/india/indias-daily-covid-situation-in-5-charts/articleshow/88958748.cmsDate accessed: 18 January 2022

[7] Wadhwani. GG. Hope, Heart and Homoeopathy: Clinical Experiences in the Pandemic of Covid 19 (Case Series Volume 1). Homeopathy for Everyone 17 (9), 1-50. Hpathy. 19 September 2020. Available from https://hpathy.com/clinical-cases/hope-heart-and-homoeopathy-clinical-experiences-in-the-pandemic-of-covid-19-case-series-volume-1/

[8] Wadhwani. GG. Hope, Heart and Homoeopathy: Clinical Experiences in the Pandemic of Covid 19 (Case Series Volume 2). Homeopathy for Everyone 17 (10). Hpathy. 20 October 2020. Available from https://hpathy.com/clinical-cases/hope-heart-and-homoeopathy-clinical-experiences-in-the-pandemic-of-covid-19-case-series-volume-2/

[9] Wadhwani. GG. Hope, Heart and Homoeopathy: Clinical Experiences in the Pandemic of Covid 19 (Case Series Volume 3). Homeopathy for Everyone 17 (11), 1-20. Hpathy. 18 November 2020. Available from https://hpathy.com/clinical-cases/hope-heart-and-homoeopathy-clinical-experiences-in-the-pandemic-of-covid-19-case-series-volume-3/

[10] Wadhwani GG. Hope, Heart and Homoeopathy: Clinical experiences from frontline during the Covid-19 Pandemic. AJHM. Autumn 2021. 114-3; 10-14

[11] Wadhwani GG. Hope, Heart & Homeopathy: Some Experiences With Omicron, A Variant Of Covid-19; Homeopathy For Everyone – Jan 18, 2022, https://hpathy.com/homeopathy-papers/hope-heart-homeopathy-some-experiences-with-omicron-a-variant-of-covid-19/

[12] Hahnemann, S. Organon of Medicine. New Delhi, India; B. Jain Publishers (P) Ltd.; 5th and 6th edition combined; 2016; §31, pp 42; §73, pp 67; §99-102, pp 78 – 79; §241, pp 121; § 56 footnote,pp 56

[13] Clarke, J.H. Genius Epidemicus. The Prescriber. New Delhi India. Indian Books and Periodicals Publishers. Reprint Edition 2009; pp34

[14] Von Bönninghausen, CMF. Brief instructions for non-physicians concerning the prophylaxis and treatment of asiatic cholera. The lesser writings of C.M.F. von Bœnninghausen; New Delhi, India. B Jain Publishers (P) Ltd; 1990 (Reprint edition); pp 299-308.

[15] Kent, J.T. Repertory of the Homoeopathic Materia Medica. New Delhi India. Indian Books and Periodicals Publishers. Reprint Edition

[16] Boericke W. (2004).  Pocket Manual of Homoeopathic Materia Medica & Repertory. B Jain Publishers Pvt Ltd. Delhi, India. 762-767

[17] Boger, C.M. Boger Boenninghausen Characteristics Materia Medica and Repertory. Indian Books and Periodicals Publishers. New Delhi, India. Reprint edition. 2014

[18] Clarke, J.H. A Dictionary of the Practical Materia Medica. New Delhi India. Indian Books and Periodicals Publishers. Reprint Edition

[19] Boger, C.M. A Synoptic Key of the Materia Medica New Delhi India. Indian Books and Periodicals Publishers. Reprint Edition.

Authors 

1 Gyandas G. Wadhwani. M.D (Hom.).
Consultant Homoeopathic Physician & Independent Researcher, Holistic Homoeopathic Clinic & Research Center, New Delhi. Member Aude Sapere groups, South Africa and New Delhi. Editorial Board Member: American Journal of Homeopathic Medicine. Former: Chief Medical Officer (NFSG) (Homoeopathy), Govt of NCT of Delhi. Senior Lecturer (Organon of Medicine & Homoeopathic Philosophy) Dr B R Sur Homoeopathic Medical College, Hospital & Research Centre, Govt of NCT of Delhi.

2 Aditi Chadha. B.H.M.S.
Program Associate (Homoeopathy). Department of Pharmacovigilance. Drug Standardization Unit, Dr. D.P Rastogi Central Research Institute for Homoeopathy, Noida, (U.P). Ministry of AYUSH, Govt. of India

*Correspondence:
Gyandas G. Wadhwani
Mob: +91-9868146489
Email: homoeopathygyan@gmail.com