WELCOME “WORKSHOP ON EMERGING AND REEMERGING INFECTIOUS DISEASES OF KERALAM” PRESENTATION BY Dr. J.HARIKRISHNA PILLAI MD (Hom) HEAD OF THE DEPT. OF COMMUNITY MEDICINE Dr.PADIAR MEMORIAL HOMOEOPATHIC MEDICAL COLLEGE, CHOTTANIKKARA FIRST OF ALL LET ME APPRECIATE THE HON’BLE VICE-CHANCELLOR AND OTHER OFFICIALS OF THE MEDICAL UNIVERSITY FOR ORGANIZING A PROGRAM LIKE THIS. I STRONGLY BELIEVE THAT THIS EVENT WILL BE A MILE STONE IN THE HISTORY OF THE HEALTH CARE SYSTEM OF KERALA. THIS IS A UNIQUE PLATFORM FOR THE LEGATES OF DIFFERENT SYSTEMS OF MEDICINE TO EXCHANGE THEIR VIEWS . “One of the first duties of the physician is to educate the masses not to take medicines” Sir William Osler- 1849-1919 VIEWS FROM HOMOEOPATHY ON INFECTIOUS DISEASES EPIDEMIC ORIGIN OF HOMOEOPATHY Homoeopathy's roots emerge from the findings, teachings and writings of Dr. Samuel Hahnemann (1755-1843). Hahnemann graduated from medical school in 1779 and started his own medical practice. He soon began his first homoeopathic experiments in 1790, as a result of his disillusionment with such common medical practices of the day as purging, bloodletting, and the use of toxic chemicals. At one point, he gave up his own daily practice to work as a chemist. while translating medical texts, he began a project to translate William Cullen's Materia Medica into German.While working on this project, he became fascinated with a species of South American tree-bark (cinchona) which was being used to treat malariainduced fever. Hahnemann ingested the bark and discovered that it caused symptoms similar to malaria. He continued his research into "cures" and the idea of "similar suffering," and began compiling his findings. Similia similibus curentur, the Latin phrase meaning "let likes be cured by likes," is the primary principle of homoeopathy. A homoeopath searches for a substance that produces in a healthy person those same symptoms a patient experiences. THE PRINCIPLE OF VITAL FORCE EVERY SYSTEM OF MEDICINE HAS ITS OWN THEORIES OF CAUSATION OF DISEASES. IN ADDITION TO THE THEORIES OF CAUSATION DESCRIBED IN MODERN MICROBIOLOGY AND PATHOLOGY HOMOEOPATHY BELIEVES IN THE THEORY OF VITAL FORCE. DEFINITION OF VITAL FORCE BY Dr. HAHNEMANN In the healthy condition of man, the spiritual vital force (autocracy), the dynamics that animates the material body (organism) rules with unbounded sway, and retains all the parts of the organism in admirable harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the highest purpose of our existence. LATEST OBSERVATION ON LIFE FORCE A fundamental but elusive step in the early evolution of life on Earth has been replicated in a laboratory. Researchers synthesized the basic ingredients of RNA, a molecule from which the simplest self-replicating structures are made. Until now, they couldn’t explain how these ingredients might have formed. However, though researchers have been able to show how RNA’s component molecules, called ribonucleotides, could assemble into RNA, their many attempts to synthesize these ribonucleotides have failed. No matter how they combined the ingredients — a sugar, a phosphate, and one of four different nitrogenous molecules, or nucleobases — ribonucleotides just wouldn’t form. Ultra Diluted Medicine Homoeopathy has been mired in controversy due to its concept of drug dynamisation leading to ultra diluted form of medicines. "Since these kinds of medicines do not come under any measurable pharmacological standards, the attention of scientific fraternity has been focused on this apparent lack of existence of material substance in homoeopathic medicine and to its potency concept in the light of Avogadro's law, rather than on its effectiveness," Homoeopathy medicines beyond 12th potency do not contain even a single atom or molecule of the medicinal substance. Yet these medicines are effective in the treatment of large number of diseases and particularly the ones that are considered incurable in modern medicine. Electronic division of BARC has been actively working on this aspect of homoeopathic medicines for the past three decades and their initial experiments with potentised medicines have recorded 50 to 150 per cent increase in the blood flow in affected parts of the body within 30 minutes of the indicated medicine in variety of patients Dr.Srinath Rao- Researcher "The reproducibility of these experiments largely depended upon the choice of indicated medicine, which was determined subjectively," “But with the development of Medical Analyser, BARC scientists, headed by J D Jindal, have shown that physiological variability show change in the spectrum caused by randomly selected potentised medicine and randomly selected control subjects (volunteers) in 2004 and "this opened the door to us for using physiological variability in the field of homoeopathy” Dr.Srinath Rao- Researcher SOCPE AND LIMITATIONS OF HOMOEOPATHIC PREVENTIVE MEDICINE SCOPE 1.HOMOEOPATHIC MEDICINES CAN BE SAFELY USED AS PREVENTIVE MEDICINE 2. THIS MEDICINES CAN BE ADVISED FOR PREGNANT WOMEN 3.DISEASE DIAGNOSIS IS NOT A REQUIREMENT 4. VIRAL AND BACTERIAL DISEASES CAN BE PREVENTED. LIMITATIONS DIFFICULTIES TO SELECT PREVENTIVE MEDICINES IN CERTAIN DISEASES Eg. RABIES HOMOEOPATHIC MEDICINES AND IMMUNITY We get sick not just because of micro organisms. Many micro organisms, both pathogenic and non-pathogenic, are always present in our body or regularly enter our body through the nose, mouth, or other roots of entry or opening. We do not get sick when our immune system is strong enough to fight them, keeping our body healthy. But when our immunity goes down, the micro organisms multiply in our body and cause sickness. So the basic cause of sickness is the decreased or deficient immunity or body resistance. Micro organisms like bacteria and viruses are only secondary factors, except in occasions like epidemics in which a large number of organisms enter the body simultaneously and become the cause of the disease condition. In such a situation, the micro organisms gain dominance and destroy the immunity in the process of their fight for the upper hand. Even Louis Pasteur noted that “Terrain is more important than the seed” HOW HOMOEOPATHIC MEDICINE INCREASES THE IMMUNITY OR RESISTANCE POWER OF THE BODY As mentioned earlier, homoeopathic medicines are able to increase the immunity of our body. But how is this possible?. A homoeopathic physician makes a homoeopathic prescription through the holistic approach by considering the totality of symptoms manifested in a patient. These include the mental, emotional spiritual and physical peculiarities of a patient and also the uncommon peculiar signs and symptoms of the manifestations of the disease in each patient. The same disease has different manifestations in different individuals because the extent of damage to the immunity and other functions in the body are different in different individuals. These manifestations represent the corresponding reflection of their inner abnormality, which is hidden from our perception. Hence, a Homoeopathic physician gets hold of the hidden interior through perceivable expressions like the totality of symptoms of the patient, by looking the patient as a whole. “The good physician treats the disease; the great physician treats the patient who has the disease”. Sir William Osler Significance of Homeopathy in epidemics In a country as large as ours, the occurrence of epidemic is not infrequent and they usually spread like wild fire creating chaos. And it is in this chaos that homeopathy hopes to restore order. When there arises situations where the cause of the disease appears to be an enigma and every other system of medicine is clueless regarding what preventive / curative medicine is to be given, homeopathy has been able to solve the problem. Even when in the course of the epidemic there can be changes in the strains of the causative organism and the new drug cannot be found out in time, homeopathy can overcome the crises. This is possible because unlike the commonly used medicines, which are directed towards the destruction of causative organisms, homeopathic medicines aim to improve the immune system of the individual. Here the basis of selection of remedy is not dependent upon the nature of organism, but on the signs and symptoms of the diseased individual. The age old adage \\ prevention is better than cure" holds good here. When few cases of epidemic diseases are studied carefully in all their aspects a single medicine can be selected which will correspond with the characteristic symptoms of the disease as well as that of the patient. Homeopathy gives importance not only to the symptoms of the disease but also that peculiar symptoms exhibited by the patients and that is why they differ even when the disease is the same. The climatic conditions during the time of epidemic also plays role in remedy selection. In epidemics of such nature that are transmitted only through bites of infected insects, the most important preventive step is vector control. However due to practical problems like large population, poverty, poor hygiene and lack of man power this becomes a long drawn procedure. Hence the best solution is to administer preventive medicines in the fastest and the most extensive way. ROLE OF SOCIAL AND ENVIORNMENTAL FACTORS Homoeopathy is giving utmost importance for personal hygiene, social and environmental factors in the prevention of communicable diseases Reasons for homeopathic preventive medicine becoming one of the best option in epidemics l) Economic viability: Cost of the homeopathic medicine is minimal from the consumer point of view. 2) Distribution of medicine Homeopathic medicines though packaged as medicated globules, which makes the transport distribution and administration easy. HOW Dr.HAHNEMANN DISCOVERED THE PREVENTIVE ACTION OF HOMOEOPATHIC MEDICINES : " I reasoned thus, a remedy that is capable of quickly checking a disease in its onset, must be its best preventive ; and the following occurrence strengthened me in the correctness of this conclusion: Some weeks previously three children of another family lay ill of a very bad scarlet fever; the eldest daughter alone, who, up to that period, had been taking Belladonna internally for an external affection on the joints of her fingers, to my great astonishment did not catch the fever, although during the prevalence of other epidemics she had always been the first to take them. This circumstance completely confirmed my idea. I now hesitated not to administer to the other five children of this numerous family this divine remedy, as a preservative, in very small doses, and, as the particular action of this plant does not last above three days, I repeated the dose every seventy two hours, and they all remained perfectly well without the slightest symptoms throughout the whole course of the epidemic, and amid the most virulent scarlatina emanations from the sisters who lay ill with the disease.“ Dr.Hahnemann Dr.Hahnemann’s guidelines for selecting the effective preventive medicine §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 at any way regard the pure picture of every prevailing disease as if it were something new and unknown and investigate it thoroughly for itself, if he desires to practice medicine in a real and radical manner , never substituting conjuncture 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, it's 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 respect 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 remain the same, such as small pox, measles etc. §l0l 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 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 adopted remedy for it. § l02 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, (eg. Loss of appetite, Sleeplessness etc.) Become precisely defined as to their peculiarities, and on 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 extend of such an epidemic disease and the totality of its symptoms (the knowledge there of, 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 suffering of several patients of different constitutions. The key to finding a specific prophylactic is constructing a clear picture of the prevailing epidemic. Hahnemann did not give a prophylactic remedy unless there was a clear and present danger of contracting the disease. That is why he said to wait until the disease is in the near or in the locality. He did not want the general populace to take preventative remedies out of fear and phobia. FROM HISTORY There are a number of events where Homoeopathy played a vital role in the control and prevention of communicable diseases .Unfortunately controlled studies where not conducted . Eg. Cholera in Russia 1830 Cholera in USA -1849 Spanish Influenza- 1918 LATEST SCENERIO A TRIAL WITH HOMOEOPATHIC MEDICINES CONDUCTED TO PREVENT DENGUE FEVER IN BRAZIL WAS ( 2001&2007) A SUCCESS . THE DOCUMENTS OF RCT ARE ATTACHED HERE. ANOTHER RCT STUDY CONDUCTED TO DETECT THE EFFICACY OF ULTRA DILUTED BELLADONA ( A HOMOEOPATHIC MEDICINE) IN CONTROLING THE GROWTH OF JE VIRUS WAS A SUCCESS . THE DOCUMENTS OF THE STUDY ARE ATTACHED HERE. RAPID ACTION EPIDEMIC CONTROL CELL- HOMOEOPATHY (RAECH) An organization formed by the Dept. of Homoeopathy, Govt. of Kerala, to initiate control measures at the onset of any epidemic of Communicable diseases. During the outbreak of the Epidemic fever in 2007, RAECH distributed Homoeopathic preventive medicines in all districts of kerala . A follow-up study was conducted on the efficacy of the same and observed a protection rate of 73.83% among people who took Homoeopathic preventive medicine. THE HOMOEOPATHS OF KERALA EXPECT TREMENDOUS SCOPE FOR RESEARCH UNDER THE HEALTH UNIVERSITY TO PROVE THE EFFICACY OF HOMOEOPATHIC PREVENTIVE MEDICINE. LET US BE OPTIMISTIC . THANK YOU