Installment 10 of a series on case analysis
© Will Taylor, MD 2001 (bio)
This installment is adapted from an article published in Bulgarian in the first issue of the journal Homeopathy Almanac (Sophia, Bulgaria); July, 2001.
On the Genus Epidemicus
One of the more overlooked topics in contemporary homoeopathy is the prophylactic treatment of acute epidemic disease. Yet a review of homoeopathy's 200-year history reveals that this is an arena in which we have seen some of the greatest examples of the effectiveness of our art and science.
Homeoprophylaxis vs. homeopathic vaccination
I'd like at the outset to draw a distinction between homoeoprophylaxis - the topic of this paper - and what has been termed homoeopathic vaccination. This latter is too large a topic to consider here, but briefly, involves the use of routine combinations and series of disease nosodes in an effort to confer long-term resistance to a variety of diseases.
In contrast, homeoprophylaxis involves the use of individual remedies, selected in an individualized and non-routine manner, to reduce or eliminate the morbidity of epidemic and sporadic contagious acute diseases 0 in the short term. Homoeopathic vaccination is a relatively contemporary innovation, borrowing on the notoriety of allopathic vaccination; whereas homoeoprophylaxis is well rooted in classical homeopathic practice.
Hahnemann on homeoprophylaxis
We don't have to search far in the historical record to find examples of the effective use of homeoprophylaxis.
In 1799 - 3 years after the "birth" of homoeopathy in 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." 1
Hahnemann published this pamphlet Cure and Prevention of Scarlet Fever in 1801. At the time he promoted Belladonna as a specific prophylactic remedy for Scarlatina - and accompanying each pamphlet sold, was a vial of Belladonna prepared according to his technique at that time.
With increased experience observing and treating epidemic illnesses, Hahnemann recognized the unique nature of each occurrence of an epidemic. Aconite proved to be the specific for a subsequent Scarlatina epidemic sweeping Germany between 1800 and 1808.
In an 1808 paper (Observations on the Scarlet Fever 2), Hahnemann provided a careful description of the individualizing aspects of these two epidemics. This individuality of epidemic occurrences had not escaped other observers.
In one of his rare words of praise for other physicians, Hahnemann wrote:
"Only the honest Sydenham perceived this, for he insists … that no epidemic disease should be taken for any previous one and treated in the same way, since all that break out at different times are different from each other." 3
Three approaches for homoeoprophylaxis
Three approaches may be used to select the remedy for prophylaxis of a prevailing epidemic. All have their roots in classical practice, but it is the selection of a genus epidemicus - an individually selected remedy for this particular outbreak of an epidemic - which is to be sought as the surest and most closely aligned with our guiding principles. Initially though, allow me to describe two other approaches, which may prove of use in particular circumstances.
The first of these is the use of the disease nosode in prophylaxis. Examples would be the use of Influenzinum in flu prophylaxis or Morbillinum in a measles epidemic. Closely related to this would be the use of the sarcode Anas barbare hepatis et cardus extractum (liver and heart of the Barbary duck) for 'flu. 4 Derived from tissues of the native host of influenza, this remedy is prepared from tissue containing and reacting to the influenza virus.
The nosode represents the undifferentiated or generic appearance of an acute miasm, not accounting for individual variability of persons or individual epidemic occurrences. Its routine use in active disease would be considered isopathy rather than homoeopathy; and historical experience reveals the general inadequacy of this approach.
However, in prophylaxis, this may be a successful strategy in a pinch, particularly early in the epidemic of an acute miasmatic illness, before a genus epidemicus - the specific remedy for the individual epidemic - has been identified. Following Hering's introduction of nosodes into our Materia Medica, Boenninghausen experimented early on, with considerable success, at using Variolinum (the smallpox nosode) for the prophylactic treatment of smallpox.
The second approach is to select a remedy deemed central to the undifferentiated or generic nature of the epidemic illness. This is done by taking an anamnesis of the disease-as-named, without specific attention to the individuality of the prevailing epidemic or the individuality of a specific case. Examples might include Drosera for whooping cough or Eupatorium perfoliatum for influenza.
Here again the individual nature of the particular epidemic is not taken into account, and this approach works best with those epidemic illnesses that can be termed acute miasms - ones in which there is less variability in individual expression. Hahnemann in this manner suggested Camphora as the homoeoprophylactic simillimum for the approaching epidemic of Asiatic Cholera. 5 Boenninghausen had some excellent success in using Thuja occidentalis in this manner in the prophylactic treatment of smallpox. 6
This of course can only be done for those diseases that Hahnemann would class as "acute miasms" - diseases that "recur in the same manner and are therefore known by a traditional name". 7 As an example, we could look at Scarlatina (scarlet fever), much as Hahnemann himself did in 1799 in Königslutter.
We know that this acute miasmatic disease - although certainly individually variable to some extent in its individual presentation - commonly presents with a high, dry, continued fever, very often with delirium during the fever; with inflammation of the posterior pharynx with enlarged tonsils and pain on swallowing and hoarseness of the voice; with anterior cervical adenopathy; with a characteristic red sandpaper rash; with cracked lips, fissured tongue, and prominent papillae of the tongue which may form the characteristic strawberry-tongue appearance; and with nasal coryza.
From the Synthesis 8.0 Repertory, we could select the following rubrics to represent these common, or generic symptoms of Scarlatina:
FEVER - CONTINUED fever - eruptive
FEVER - INTENSE heat
FEVER - DRY heat
MIND - DELIRIUM - fever - during
THROAT - PAIN - swallowing
THROAT - SWELLING - Tonsils
LARYNX AND TRACHEA - VOICE - hoarseness
EXTERNAL THROAT - SWELLING - Cervical Glands
SKIN - ERUPTIONS - rash
SKIN - DISCOLORATION - red
SKIN - ERUPTIONS - desquamating
FACE - CRACKED - Lips
MOUTH - CRACKED - Tongue fissured
MOUTH - PAPILLAE of tongue - erect + strawberry etc...
NOSE - CORYZA
Analyzing these results in:
Analyzing these results in:
The striking similitude of Belladonna to the generic / undifferentiated picture of Scarlatina stands out.
Closely following Belladonna in this analysis are Apis, Lachesis, Mercurius, Rhus toxicodendron, and the small remedy Arum triphyllum. These remedies all address the essential characteristics of scarlatina - the genus of the disease - but they do so in their own varied manners, each differing somewhat from the generic, undifferentiated similarity of Belladonna to the scarlatina disease-state.
0. For a definition of acute disease and its variations - sporadic and epidemic disease, and acute miasms - see Hahnemann's Organon of Medicine, aph. 73
1. Cure and Prevention of Scarlet Fever, Samuel Hahnemann (published as a pamphlet, Gotha, 1801); and in The Lesser Writings of Samuel Hahnemann, R.E. Dudgen ed.
2. Observations on the Scarlet-Fever Samuel Hahnemann Allg. Anzeig. der Deutschen, no. 160, 1808; and in The Lesser Writings of Samuel Hahnemann, R.E. Dudgen ed.
3. Organon of Medicine; Samuel Hahnemann; Footnote b to aphorism 81 (quote taken from the Künzli edition)
4. Sold as Oscillococcinum® by Boiron, and Flu Solution® by Dolisos.
5. Cause and Prevention of the Asiatic Cholera; Samuel Hahnemann;
Archiv. f. hom. Heilk., vol xi, 1831; and in The Lesser Writings of Samuel Hahnemann, R.E. Dudgen ed.
6. Concerning the Curative Effects of Thuja in Small-pox; Clemens Maria Franz, baron von Boenninghausen; Allg. hom. Zeit, vol. xxvii, p. 21; and in The Lesser Writings of Boenninghausen, L.H. Tafel trans./ed.
7. Organon; Samuel Hahnemann: aphorism 73