Dr Om Prakash Singh
Background-prevalence of new epidemic diseases are rising surprisingly in the 21 st century, though the form of diseases are changed, but they are still the challenges for the medical professions of different systems of medicine. Historical background of prevention is also discussed.
So the aim of this article is to have better understanding regarding the preventive care through the intervention of medical management by Homoeopathic medicine in a broad spectrum and their applicability through various ways.
Conclusion-Homoeopathic treatment is effective in prevention of many diseases.
Key words-Prevention, philosophy, Homoeopathy
We all know – An ounce of prevention is better than a pound of cure
- He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health. (§4)
Prevention- the act of stopping something bad from happening:
Preventive medicine developed as a branch of medicine distinct from public health. By definition preventive medicine is applied to ‘healthy people’, customarily by action affecting large numbers or population .Its primary objective is prevention of disease and promotion of health.
According. To Taber-the branch of medicine concerned with preventing the occurrence of both mental and physical illness and disease.
The healthy condition of man as described in § 9
HISTORICAL BACK GROUND-
FOLK MEDICINE- The use of remedies was not only internal but used to be carried as charms and talismans, as a part of treatment. The skins of snake, patella, of sheep, the nail of coffin etc. were used as charms. Another important aspect is put up coloured hangings in the sick room to prevent small-pox, red flannel used to prevent sore throat and to wear red thread with nine knots to prevent nose bleeding.
Herodotus noted the Egyptian concern with internal sources of decay and reported that three days each month were set aside for purging the body with emetics and enemas. These prophylactic purges were not the only preventive measures taken by the Egyptians in their pursuit of health. Cleanliness of body was even more valued by the Egyptians than by the Greeks. Rules for the disinfection of dwellings and proper burial of the dead sprang from a combination of hygienic and religious motives.
AECULAPIUS of BC1200 was considered the leader Greek medicine. He was considered as the grandson of ZEUS. He had two daughters—Hygeia and Panacea. Hygeia worshiped as the goddess of (preventive medicine) and Panacea as the goddess of medicine (curative medicine). They give rise to two systems of medicine i.e. preventive medicine and curative medicine.
Among the ruins of the temple at Epidaurus is a shrine dedicated to Hygeia, who may have been the original Greek goddess of health. Like the Chinese sages who would not treat the sick, Hygeia taught people to achieve health and longevity by proper behaviour.
Hippocrates—The true physician understood that disease was a natural process,
not the result of possession, supernatural agents, or punishment sent by the gods. Disease could be interpreted as punishment only in the sense that one could be punished for transgressing against nature by improper Behaviours. Thus, to care for his patient, the physician must understand the constitution of the individual and determine how health was related to food, drink, and mode of life. In a fundamental sense, dietetics was the basis of the art of healing.
According to Hippocrates, human beings could not consume the rough
Food suitable for other animals; thus, the first cook was the first physician.
Accord. To Hippocrates “life is short, the art of medicine is long, opportunity fleeting, experience treacherous and judgement difficult”
Hippocrates was also an epidemiologist. Since he distinguished between diseases which were epidemic and those which were endemic ,he was constantly seeking the cause of the disease .He studied such things as climate ,water, clothing ,diet, habits of eating and drinking and the effect they had in the producing disease. His book “airs, water and places” is considered a treatise on social medicine and hygiene. The Hippocratic concept of health and diseases stressed the relation between man and his environment.
BIRTH OF PREVETIVE MEDICINE-
Preventive medicine really dates back to the 18th century.
James Lind (1716-1794), a naval surgeon advocated the intake of fresh fruit and vegetable for the prevention of scurvy in 1753.
Edward Jenner (1749-1823) of Great Britain, a pupil of john Hunter, discovered vaccination against small pox in 1796.These 2 discoveries marked the beginning of a new era, the era of disease prevention by specific measures.
Preventive medicine got a firm foundation only after the discovery of causative agents of the disease and the establishment of the germ theory of disease.
Health for all-
The World health assembly, in may1977, decided that the main social goal of governments and WHO in coming year should be the “attainment by all the people of the world by the year 2000AD of a level of health that will permit them to lead a socially and economically productive life”
WHO’s objective of “attainment by all peoples of the highest possible level of health” it implies the removal of obstacles to health.
MODERN CONCEPT-Modern preventive medicine has been defined as “the art and science of health promotion, disease prevention disability limitation and rehabilitation”
In sum, preventive medicine is a kind of anticipatory medicine.
Levels of prevention-
- Primordial Prevention
- Primary Prevention
- Secondary Prevention
- Tertiary Prevention
-It is prevention of the emergence or development of risk factors in countries of population groups in which they have not yet appeared.
-it is receiving esp. attention in the prevention of chronic disease.
Modes of intervention-
- Individual education
- Mass education
-Example you discourage children on being obese through their life style.
“Action taken prior to the onset of disease, which removes the possibility that a disease will ever occur.”
-Primary prevention is a holistic approach.
-It utilizes knowledge of the pre pathogenesis phase of disease, embracing the agent, host and environment.
Modes of intervention-
- Promotion of health
- Specific protection
Promotion of health-
-“The process of enabling people to increase control over and to improve health.”
-It strengthens the host through variety of approaches.
1. Health Education: A large number of diseases could be prevented with little or no medical intervention if people were adequately informed about them and it they were encouraged to take necessary precautions in time.
2. Environmental Modifications: Like –
- Provision of safe water
- Installation of sanitary latrines
- Control of Insects and Rodents
- Improvement on Housing
3. Nutritional Intervention: Like – Food Distribution and nutrition improvement, Child feeding programmes, food fortification, nutrition education,
4. Lifestyle and Behavioural Changes: It is of paramount importance in changing the views, behaviour and habits of people. Here the physician and in fact each health worker acting as an educator than a therapist.
2. Use of Specific Nutrients
4. Protection against Occupational Hazards
5. Protection against Accidents
6. Protection against Carcinogens
7. Avoidance of Allergens
8. Control of specific hazards in the general environment – air pollution
9. Control of consumer product quality and safety of foods, drugs, cosmetics, etc.
Immunization through the administrations of vaccines has its own benefits and hazards.
– There are many problems which arise because of administration of vaccines.
-Dr Burnnet and other stalwarts have observed many hazards after vaccines which they named as VACCINOSIS.
“Action which halts the progress of a disease at its incipient stage and prevents complications.”
Modes of intervention –
These are early diagnosis and adequate treatment. Thus we can attempt to arrest the disease process, restore health by seeking out unrecognized disease and treating it before irreversible pathological changes have taken place and reverse communicability of infectious disease. (Homoeopathic treatment applicable)
-It signifies intervention in the late pathogenesis phase.
“All measures available to reduce or limit impairments and disabilities, minimise suffering and to promote the patient’s adjustment to irremediable conditions”
-If treatment is undertaken late in the natural history of the disease, it can prevent the sequelae and limit disability. When defect and disability are more or less stabilized, rehabilitation may play a preventable role.
Modes of intervention : Disability limitation & Rehabilitation
DISABILITY LIMITATION-sequence leadng to disability
Disease impairment disability handicap
The intervention in disability will often be social or environmental as well as medical. While impairment which is the earliest stage has a large medical component, disability and handicap which are later stages have large social and environmental components in terms of dependence and social cost
It involves disciplines such as physical medicine or physiotherapy, occupational therapy, speech therapy, audiology, psychology, education, social work, vocational guidance and placement services in the combined and co ordinate way (Palliative homoeopathic treatment more effective)
HOMOEOPATHIC APPROACH- Disease – (in the sense lack of ease; inconvenience): any deviation from or interruption of the normal structure or function of any part ,organ, or system(or combination thereof)of the body that is manifested by a characteristic set of symptom and sign and whose aetiology, pathology and prognosis may be known or unknown.
-here we may see the glimpses of §11.
The unprejudiced observer -…..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) ..
Old school often says to their patients, “Wait a little until your disease shall have become developed, —at present I know not what to do.” Why he does not know what to do? This question touches the weak point in the philosophy of physiological school. It is because the patient, as yet, presents only “subjective symptoms”, which are evidence of “dynamic changes” only,—because he cannot form a theory of the cause of the disease until the disease has progressed far enough to furnish him with some material results of these dynamic changes—.
Hahnemann showed the value of subjective symptoms in the aid which they afford us in individualizing cases of disease, and thereby enabling us to select a specific for each individual case with more absolute precision
LET US KNOW SYMPTOMS AND ITS IMPORTANCE- The word symptoms come from a Greek root and refers to “something that falls together with something else.” symptoms, then, are a sign or signal of something else, and treating them does not necessarily change that “something else”
Homoeopathy maintains that all disease is general and denies the possibility of ‘local’ disease or local treatment. The patient’s symptoms represent the totality of his response to a given morbific stimulus.
Disease is not mere surrender to attack but also fight for health; unless there is a fight there is no disease or we can say disease is not just suffering, but a fight to maintain the homeostatic balance of our tissues, despite damage
In 1942, Walter B.Canon, a medical doctor, wrote The Wisdom of the Body. This book, which is a classic in medicine, details the impressive and sophisticated efforts that the body deploys to defend and heal itself. A growing number of physiologists including Dr. Hans Selye, who is considered to be the father of stress theory, have taken Cannon’s work further, recognizing that symptoms are actually efforts of the organism to deal with stress or infection. Rather than viewing symptom simply as sin’s of the body’s breakdown, these medical doctors see symptoms as defense of the body that attempts to protect and heal it.
Towards the end of Louis Pasteur’s life, he confessed that germs may not be the cause of disease after all, but may simply be another symptom of disease. He had come to realize that germs lead to illness primarily when the person’s immune and defense systems (what biologists call “host resistance”) are not strong enough to combat them. The “cause” of disease is not simply a bacterium or virus but also the factors that compromise host resistance, including the person’s hereditary endowment, his nutritional state, the stress in his life , and his psychological state. In describing one of his experiment with silkworms, Pasteur asserted that the microorganism present in such large numbers in the intestinal tracts of the silkworms were “more an effect than a cause of disease”.
At the health conference in 1976, Jonas Salk noted that there are basically two ways to heal sick people. First, one can try to control the individual symptoms that the sick person is experiencing; and the second, one can try to stimulate the person’s own immune and defense system to enable the body to heal itself. Whereas the conventional medicine’s allegiance is to the first approach, homoeopathy and wide variety of natural healing systems attempt the latter
Of special importance, homoeopathy will help physician and scientist to better understand the nature of healing. Because homeopaths assume that the human organism has basic inherent self healing tendencies, they maintain a deep respect for the vismedcatrix naturae, more commonly known as the healing power of nature. Rene Dubos, Nobel Prize winning microbiologist, acknowledged the importance of really understanding this innate healing intelligence. In his introduction to Norman Cousin’s seminal book Anatomy of an Illness, Dubos said: “modern medicine will become really scientific only when the physicians and their patients have learned to manage the forces of the body and the mind that operate in vismedcatrix nature.
The inimical forces, partly psychical, partly physical…..
APPROACH OF PREVENTION FROM DIFFERENT ANGLES IN HOMOEOPATHY-
DIAGNOSIS AND ITS IMPORTANCE IN HOMOEOPATHY-
Evolution of symptoms-
As nothing can be known of disease except through sign and symptoms, its progress will be made known to us by the changes in the symptomatology.
Symptom of the first stage–
Individual reaction of the person. These symptoms vary individual to individual and hence are extreme importance to the homoeopathic physician.
Some examples are- feeling of uneasiness, a sensation of excessive heat with burning of the palms and soles which is relieved by uncovering and or by cold applications or, we may find inexplicable chilliness with aversion to uncover, or, we may find the person complaining of extreme thirst when normally he is quite thirst less and vice-versa, or some peculiar cravings and loathing in relation to food and drink may develop, or we find ravenous appetite which is difficult to appease. A feeling of malaise, lassitude or run down feeling is also very common at this juncture.
Symptom of the second stage–
It is denoted by disordered functioning of the affected organs and systems. At this stage structural changes cannot be detected.
We find here characteristic concomitant symptoms appear much before the development of the diagnostic group of sign and symptoms, thus allowing definitive homoeopathic treatment in the pre-diagnostic stage of the disease. This enables the homoeopathic physician to abort many diseases.
Symptom of the third stage-
Sign and symptoms indicating structural alterations in the tissues and organs appear and permit a definite diagnosis.
Symptom of the fourth stage-
Gross structural alterations in tissues and organs leading to secondary sign and symptoms.
SO THERE IS A WAST SCOPE HOMOEOPATHY IN PREVENTION
ACCESSORY CIRCUMSTANCES IN PREVENTION-
Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.
It is not necessary to say that every intelligent physician would first remove this where it exists; the indisposition thereupon generally ceases spontaneously. He will remove from the room strong-smelling flowers, which have a tendency to cause syncope and hysterical sufferings; extract from the cornea the foreign body that excites inflammation of the eye; loosen the over-tight bandage on a wounded limb that threatens to cause mortification, and apply a more suitable one; lay bare and put ligature on the wounded artery that produces fainting; endeavour to promote the expulsion by vomiting of belladonna berries etc., that may have been swallowed; extract foreign substances that may have got into the orifices of the body (the nose, gullet, ears, urethra, rectum, vagina); crush the vesical calculus; open the imperforate anus of the newborn infant, etc
Those diseases are inappropriately named chronic, which persons incur who expose themselves continually to avoidable noxious influences, who are in the habit of indulging in injurious liquors or aliments, are addicted to dissipation of many kinds which undermine the health, ……they cannot be called chronic diseases.
PREVENTION IN EPIDEMIC AND ENDEMIC-
GENUS EPIDEMICUS IN HOMOEOPATHY
Homoeopathic genus epidemicus (identified on the basis of common symptoms as well as uncommon or peculiar symptoms presented by a significant number of patients during an epidemic) is administered orally to people at risk of contracting infection. It is repeatedly seen during endemics/epidemics that genus epidemicus prevents disease in people living in close proximity of the patients down with disease and also in the population living in the affected area.
Identified genus epidemicus is that is specific to an endemic/epidemic at a given time. It has to be identified afresh based on the clinical presentation of the disease during an endemic/epidemic.
For example, different homoeopathic medicines were used for the prevention during recent Chikungunya and Dengue epidemics in different parts of the Country viz. Bryonia in Kottayam District and Eupatorium perf. in Calicut in Kerala, Eupatorium perf in Hyderabad, Rhus tox in Rajasthan, Ledum pal and Chamomilla in Chennai and other medicines at other places.
In 1799 – Hahnemann’s landmark article Essay on a New Principle – Samuel Hahnemann achieved fame throughout Europe from his exceptionally effective treatment of a Scarlatina epidemic that was sweeping Germany.
•He wrote: “I resolved in this case of scarlet fever just in the act of breaking out, not to act as usual in reference to individual symptoms, but if possible (in accordance with my new synthetical principle) to obtain a remedy whose peculiar mode of action was calculated to produce in the healthy body most of the morbid symptoms which I observed combined in this disease.
My memory and my written collection of the peculiar effects of some medicines, furnished me with no remedy so capable of producing a counterpart of the symptoms here present, as Belladonna.”
Other aphorisms need to be mentioned here are-
§33 fn, §73-fn(2),§100, §102
ENDEMIC DISEASES- §244
The intermittent fevers endemic in marshy districts and tracts of country frequently exposed to inundations, give a great deal of work to physicians of the old school, and yet a healthy man may in his youth become habituated even to marshy districts and remain in good health, provided he preserves a faultless regimen and his system is not lowered by want, fatigue or pernicious passions. The intermittent fevers endemic there would at the most only attack him on his first arrival; but one or two very small doses of a highly potentized solution of cinchona bark would, conjointly with the well-regulated mode of living just alluded to, speedily free him from the disease. But persons who, while taking sufficient corporeal exercise and pursuing a healthy system of intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever by one or a few of such small doses of cinchona – in such persons psora, striving to develop itself, always lies at the root of their malady, and their intermittent fever cannot be cured in the marshy district without antipsoric treatment. It sometimes happens that when these patients exchange, without delay, the marshy district for one that is dry and mountainous, recovery apparently ensues (the fever leaves them) if they be not yet deeply sunk in disease, that is to say, if the psora was not completely developed in them and can consequently return to its latent state; but they will never regain perfect health without antipsoric treatment.
Pierre Schmidt says that the constitutional remedy given in early childhood is the ideal way to protect the organism from common childhood diseases. Other homoeopaths have suggested the use of the constitutional remedy when there is a threat of exposure to acute infectious epidemics. The remedy selected based on the characteristic mental, physical general and particular symptoms is thought to increase the vitality and offers protection against a wide range of infectious diseases.
In the Sacred Diseases Hippocrates opined that most diseases are based on hereditary predispositions. He noted that the diseases found in the mother and father are often found in the offspring.
Lamarck, who is considered the founder of modern genetics, published his research on inheritance between the years 1809 and 1822.
By 1828 Hahnemann was integrating information about inherited depositions in his dynamic healing system. He speaks of inheritance and predisposition in both the Organon and The Chronic Diseases. Vide aphorism §78 and its note 78.
Hahnemann was the first to suggest a complete theory of susceptibility and infection. He makes it very clear that the miasms are infectious in their primary state. He also taught that the microscopic microorganisms he called “animalcule” were the infectious agents of the contagious miasms. He noted that the process of infection includes susceptibility, a moment of infection, incubation period, prodromal stage and primary, latent and secondary symptoms.
Hahnemann stated that miasms are transmitted by infection or inheritance. Hahnemann notes three means of transmitting miasms
1. Contact with the infected host,
2. congenitally through the mother’s womb or by nursing
Inherited miasms produce predispositions in the offspring to particular disease states associated with the miasms.
Hahnemann records the effects of stress as an activator of inherited and acquired chronic miasms. He points out that mental and emotional stress greatly increases the damaging effects of the chronic miasms. The effects of stress on the human constitution and susceptibility to disease have been discovered by modern medicine but Hahnemann recorded the entire syndrome in 1828 and integrated it into homoeopathic philosophy and treatment.
Prevention before birth by constitutional treatment-
§ 284 Sixth Edition fn.
The power of medicines acting upon the infant through the milk of the mother or wet nurse is wonderfully helpful….. But the case of mothers in their (first) pregnancy by means of a mild antipsoric treatment, especially with sulphur dynamizations prepared according to the directions in this edition (§ 270), is indispensable in order to destroy the psora – that producer of most chronic diseases – which is given them hereditarily; destroy it both within themselves and in the foetus, thereby protecting posterity in advance.
Proving of homoeopathic drug and enhancement of immunity-
1——-. Let it not be imagined that such slight indispositions caused by taking medicines for the purpose of proving them can be in the main injurious to the health. Experience shows on the contrary, that the organism of the prover becomes, by these frequent attacks on his health, all the more expert in repelling all external influences inimical to his frame and all artificial and natural morbific noxious agents, and becomes more hardened to resist everything of an injurious character, by means of these moderate experiments on his own person with medicines. His health becomes more unalterable; he becomes more robust, as all experience shows.
Current scenario– Indian govt programmes like Swachh Bharat Mission, promotion of Yoga and Swastha Rakshan Programme started by CCRH, New Delhi aims the prevention of Disease and fully support the Hahnemannian concept of Prevention of diseases.
Specific measures of treatment-
SOME EXAMPLES- specific diseases nosodes are used in the prevention of corresponding diseases.
Morbillinum – Measles,
Variolinum – Small Pox,
Influenzium – Influenza,
Diphtherium – Diphtheria.
•Their routine use in prophylaxis may be strictly considered more isopathic than homoeopathic, but large success rate is seen and most popular method from
Boenninghausen to H.C. Allen, Clarke, Kent and Modern Homoeopaths.
•The current favourite in the western world, for prophylaxis against influenza is “Anas Barbariae hepatis et cardus extractum” (prepared from the heart and liver of the Barbary duck, popularly known as the Oscillococcinum – it’s a sarcode, though originally thought that it contained the causative agent of influenza.”
•Dr. H. C. Allen used the above mentioned principle for 25 years in his practice and there were no second case of diphtheria recorded in the same family administered.
Following is the list of medicines provided by Dr. Pierre Schmidt for prophylactic against common diseases: —
Scarlet Fever: Belladonna, Scarlatinum
Whooping Cough: Pertussin
Herpes: Hepar Sulph
Diphtheria: Diphtherinum or Diphthereotoxin
Cholera: Choleratoxin, Camphor, Lachesis, Sulphur, Cuprum Met
Malaria: Eupatorium P, Natrum Mur, Malaria Off, China Pure,Terebinth
Tetanus: Ledum Pal, Arnica, Tetanotoxin, Thuja
Erysipelas : Graphitis
Emotional Diarrhea: Gelsemum, Arg Nit
Recurring sore throat: Baryta Carb, Psorinum
Recurrent Styes: Sulphur
Tendency to abortion
Second Month- Kali Carb,
Third Month- Sabina,
Seventh Month- Sepia
Polimyelitis; Lathyrus S, Acid Carbolic, Plumbum Met, Physostigma
The following is a list of common prophylactic remedies noticed by their clinical experience by various pioneers of homoeopathy:
IN Female Diseases:
Arnica: Prevents soreness of parts after labor
Aurum Mur Nat: Prevents habitual abortion and premature labor due to indurated cervix or sterility due to antiversion of uterus
Cimicifuga: Prevents death of children after birth; still born children, ensures living babies in women who have previously born only dead children from no known cause.
Erigeron; Prevents formation of placenta previa
Viscum Album: Primary inertia during labor, promotes labor pains (Puls, KP, Secal Cor) Promotes expulsion of place
Pocket Manual of Homoeopathic Materia Medica And Repertory – ByDr. Oscar E Boericke
- Cholera: Ars; Cup.ac; Ver.a
- Diphteria: Apis (30); Diph (30)
- Erysipelas: Graph(30)
- Hay Fever : Ars; Psor
- Hydrophobia: Bell; Canth; Hyos; Stram
- Intermittant Fever: Ars; Chin. S
- Measles: Acon; Ars; Puls
- Mumps: Trifol. Rep
- Pus Infectionn: Arn
- Quinsy: Bar. C(30)
- Scarlet Fever: Bell (30); Eucal
- Variola: Ant. T; Hydr; Kali Cy; Malandr; Thuja; Vaccin, Variol
- Whooping Cough: Dros; Vaccin
DIFFERENT VIEWS ONHOMOEOPATHIC Prevention:
Dr. Schmidt referred to a French homoeopath who experimentally demonstrated that higher he went up in potency the longer the immunity as proved by Shick test. He further said that 9000th potency would give an immunity of about 8 years;-30th for a few months.
Dr. Grimmer is of the opinion that 10M is a protective potency and the reaction is good at least for the epidemic.
Dr. Tyler of England advocates administration of remedies in successive higher potencies as, 1M, 10M, and CM at an interval of 12 hours.
Dr Sarkar ‘the constitutional remedy is the best protection not only against small pox; therefore it is the higher level of health to which homoeopathy can lift its patients. The right constitutional remedy is worth as an immunizer than the entire specific decoction that could be packed in a ship. It is not vaccination at all but it can be called the ideal
And internal vaccination.
CONCLUSION: Homeopathic medicines are thought to work by stimulating the person’s immune and defense system, which raises his or her overall level of health, thereby enabling him or her to re-establish health and prevent diseases. Such treatment provide more ecological approach to curing infectious diseases, since it aids the body’s natural homeostasis without suppressing the organism’s inherent self protecting responses.
Since the end of the nineteenth century, we have seen a remarkable transition from a period where prevention was expensive (e.g., installation of sewer systems) and therapy was basically inexpensive (e.g., bleeding and purging) to one where therapy is expensive (e.g., coronary by-pass operations)and prevention is inexpensive (e.g., exercise(YOGA) and low-cholesterol diets.
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Dr Om Prakash Singh
B.sc.,BHMS,MD(Organon of medicine)
Lecturer (Guest)-Pt. JLN GOVT HOMEOPATHIC MEDICAL COLLEGE, KANPUR