Interviews

The COVID-19 Pandemic and Its Homeopathic Approach – Interview with Dr. Ajit Kulkarni

The COVID-19 Pandemic and Its Homeopathic Approach - Interview with Dr. Ajit Kulkarni 1

Dr. Ajit Kulkarni is interviewed by homeopath Roma Bushimensky about the COVID-19 Pandemic and its homeopathic approach. Analysis based on the pathology, course of the disease, miasmatic influences and likely remedies for prophylaxis and for treatment are discussed.

Ajit Kulkarni

Dr. Ajit Kulkarni

Editor’s Note:  See the comments section below this article for additional questions and answers from Dr. Kulkarni.”

 

Ajit, I hope you are fine. Thank you for talking with us about a very important subject. What can you tell us about the Corona pandemic?

Yes, I am fine. The outbreak of COVID-19 has put the international community in front of an unprecedented global challenge, one that knows no boundary, at least at present.

Coronavirus patients were reported first from China and rapidly it gained a foothold in all continents (except Antarctica). The perilous spread is alarming as we are daily getting new patients afflicted with the virus. There are five stages of the corona pandemic.

  1. Cases mostly imported from affected countries
  2. Local transmission from positive cases
  3. Disease spreads in the community, large areas get affected
  4. Disease takes the shape of an epidemic with no clear endpoint
  5. Resolution stage

We can include China and Italy in the fourth group. It is now a big challenge to halt the onset of stage III in many countries of the world. The fifth stage, it seems has begun in China and it is a natural outcome.

What is typical about Corona virus?

Coronavirus covid-19

CORONAVIRUSES

Coronaviruses are named for the crown-like spikes on their surface. There are four main sub-groupings of coronaviruses, known as alpha, beta, gamma, and delta.

Human coronaviruses were first identified in the mid-1960s. The seven coronaviruses that can infect humans are:

Common human coronaviruses

  1. 229E (alpha coronavirus)
  2. NL63 (alpha coronavirus)
  3. OC43 (beta coronavirus)
  4. HKU1 (beta coronavirus)

Other human coronaviruses

  1. MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
  2. SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
  3. SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)

People around the world commonly get infected with human coronaviruses 229E, NL63, OC43, and HKU1. CoVs are positive-stranded RNA viruses with a crown-like appearance under an electron microscope (coronam is the Latin term for crown) due to the presence of spike glycoproteins on the envelope.

Coronavirus disease is a new strain discovered in 2019 and has not been previously identified in humans. The term COVID-19 is used for the clinical disease caused by SARS-CoV-2. Remember, while transmission of SARS-CoV-2 appears similar to that of the related SARS and MERS coronaviruses, the new virus has a lower fatality rate.

Sars-CoV-2, the virus that causes the Covid-19 disease, is detectable for up to three hours in aerosols, up to four hours on a copper surface, up to 24 hours on cardboard, and up to two-three days on plastic and stainless steel.

By the time I finish this interview (22/3/2020), the breaking news is that the WHO has confirmed COVID-19 as airborne and can remain eight hours in air, depending on factors like heat and humidity.

How does coronavirus attack the human body?

The disease can cast a storm over the whole human body. Coronavirus particles have spiked proteins sticking out from their surfaces, and these spikes hook onto cell membranes, allowing the virus’s genetic material to enter the human cell.

COVID-19 replicates itself in the upper respiratory system, making droplets from coughing and sneezing, the main means of spreading the disease. Infected people produce a large quantity of the virus at the beginning of the infection with an incubation period up to 0-14 days. In a recent study, it is found that the incubation period can be as long as 27 days and it could reflect a double exposure.

Once infected, the body will launch an attack against the virus in which immune cells will target COVID-19. As the virus proliferates, they burst out and infect neighbouring cells.

The symptoms often start in the back of the throat with sore throat and dry cough. Some patients may develop productive or wet cough, which is thick mucus coughed up. The virus then crawls progressively down the bronchial tubes.

“The virus will actually land on organs like the heart, the kidney, the liver, and may cause some direct damage to those organs. As the body’s immune system shifts into high gear to battle the infection, the resulting inflammation may cause those organs to malfunction” – Dr. Schaffner.

Can you discuss the evolution of COVID-19 disease?

The virus causes mild to moderate symptoms after infection in most cases, such as, fever, dry cough, and fatigue. But this is when the infection is limited to the upper respiratory tract – nose and throat. Once the infection involves the lower respiratory tract, complications set in.

The spread of the coronavirus disease is better understood in the following way.

DAY-BY-DAY PROGRESSION OF COVID-19 (from symptomatic point of view)

Day 1-3

  • Cold and flu like symptoms
  • Fever
  • Mild or no throat pain

Day 4

  • Increased throat pain
  • Sore voice
  • Fever 36.5 degree centigrade
  • Mild headache and diarrhoea or cramps

Day 5

  • Throat pain very severe, worse eating or drinking
  • Soreness of voice increases
  • Dry cough
  • Joint pains worse motion
  • Weakness

Day 6

  • Increase in fever, 37 degree centigrade
  • All above symptoms increase in intensity
  • Nausea, vomiting and diarrhoea increase
  • Starts feeling shortness of breath in a mild way
  • Body ache or pain from joints extends to fingers
  • Increase in weakness

Day 7

  • Intensity of fever increases 38 degree centigrade
  • Excessive coughing with sputum
  • All above symptoms worsen

Day 8

  • Cough worsens, usually dry
  • Severe difficulty in breathing
  • Heaviness and pain in chest
  • All above symptoms further worsen
  • Toxic appearance of the patient
  • Fever, intense, above 38 degree centigrade

Day 9

  • All the symptoms become much worse
  • Cyanosis
  • Kidney failure
  • Respiratory failure
  • Multi-organ failure

This is not a strict pattern though many patients follow it. Understanding the day wise evolution will help a homeopath to assess the situation from a miasmatic diagnosis, remedy diagnosis and overall management.

CLINICAL CLASSIFICATION (from Pathological point of view)

Mild to moderate cases

  • Fever, nasal congestion, dry cough, fatigue, sputum formation, shortness of breath, sore throat, headache, body ache, chills, nausea, vomiting, diarrhoea, loss of smell and taste etc.
  • This constitute 80% of patients.
  • The difference in mild and moderate cases is that the above symptoms are mild in the former and there is no pneumonia while in the latter the symptoms are more intense and manifestations of pneumonia are seen in imaging.

Severe cases

  • Adults who meet any of the following criteria: respiratory rate; > 30 breaths/min; oxygen saturations; 93% at a resting state; arterial partial pressure of oxygen (PaO2)/oxygen concentration (FiO2); < 300 mmHg. Patients with > 50% lesions progression within 24 to 48 hours in lung imaging should be treated as severe cases.
  • Pneumonia with fluid accumulation
  • This constitutes 14% of patients.

Critical cases

  • Extensive pneumonia
  • Meeting any of the following criteria: occurrence of respiratory failure requiring mechanical ventilation; presence of shock; other organ failure that requires monitoring and treatment in the ICU.
  • This constitutes 6% patients.

A fact to be noted is that not all people go through all the stages of infection. There may jumping from a mild variety to critical in a rapid way. This jumping is a tubercular miasmatic characteristic and you must think to intervene with Tuberculinum at this stage.  Rather, every patient who has recovered from COVID-10 must be given a dose of Tubeculinum 1M in order to prevent the relapse. More doses of Tuberculinum can be thought of relevant to the individual instance.

Do you regard COVID-19 as another kind of Influenza?

Both spread in similar ways and share many of the same symptoms, but the flu and the coronavirus have key differences.

  • Corona virus is a completely novel virus and humans have a zero pre-existing immunity to it; hence, every person is vulnerable.
  • COVID-19 is caused by one virus, SARS-CoV-2 while flu is caused by any of several different types and strains of influenza viruses.
  • COVID-19 patients may not express a runny nose or sneezing, but these are common symptoms of common influenza. Shortness of breath is very rare in flu cases.
  • COVID-19 might be spread through the airborne route (meaning that tiny droplets remaining in the air could cause disease in others even after the ill person is no longer near) though both can be spread from person to person through droplets in the air.
  • In COVID-19, fever appears on an average of 5-6 days after infection. However, incubation period (the time between exposure and first symptoms) can extend up to 14 days. This period may be extended in the future depending upon the behaviour of the virus.
  • The coronavirus is more insidious and more contagious in comparison to common flu. It is said that COVID-19 kills 2.3 percent of patients, meaning it is currently 23 times more fatal than the seasonal flu.
  • The coronavirus can last up to six weeks in some severe and critical cases.

Comments regarding homeopathy:

For a homeopath, it is not only the label of COVID-19 or influenza. During the virus infection, host factors trigger an immune response against the virus. However, immunopathogenesis is associated with an immune response that goes out of control, and results in pulmonary tissue damage, functional impairment, and reduced lung capacity. Apart from the above host factor, the host i.e. the individual is the most pivotal point in homeopathic philosophical and practical thinking.

COVID-19 is deeper and destructive and it has its specific syndrome, unlike common influenza. A homeopath, therefore, should not focus on Influenzinum or Oscillococcinum.  They are the nosodes for common flu and in view of changes in mutation of the virus, we need a change in the nosode. The symptoms and the pathology are different and we must address the situation which is prevailing now if we want to apply the Law of Similars in an appropriate way. We must accept the destructive potential of coronavirus. Miasmatic assessment will be different, here, in COVID-19. A homeopath doesn’t prescribe on the basis of the name of the disease but on the totality of symptoms and signs as represented by the sick individuals.

Please discuss pneumonia in a COVID-19 patient.

Development of pneumonia is a danger signal for COVID-19 patients.

COVID-19 attacks the lungs in three stages:

  • Viral replication
  • Immune hyperreactivity
  • Pulmonary destruction

COVID-19 first enters the body, then starts replicating itself rapidly in the lungs, creating the viral replication stage, ultimately filling the airways with fluid, pus and debris with consequent impaired flow of oxygen.

Next occurs immune hyperreactivity. This is when the body’s immune system effectively kicks into overdrive and bombards the lungs with immune cells in an effort to repair lung tissue. When this type of response is triggered, immune cells can overreact and damage healthy tissues.

The third phase of pulmonary destruction then begins (like SARS). Here, respiratory failure may occur and patients may require the assistance of ventilators to breathe.

The predisposing conditions for COVID-19 pneumonia tend to be old age and medical co-morbidities (such as chronic pulmonary disease, diabetes, and other chronic diseases), similar to previous viral infections (such as influenza H7N9).

Pneumonia is of two types: Moderate and severe. Unilateral pneumonia is rapidly followed by bilateral, sub-pleural lesions are seen, consolidation with surrounding halo sign is seen, ground-glass opacities, fine mesh shadow and tiny nodules are CT findings.

Typical CT features of C0VID-19

CT scan features of SARS-cov2

Figure 1, Figure 2: Patchy ground glass opacities

Figure 3: Nodules and patchy exudation

Figure 4, Figure 5: Multifocal consolidation lesions

Figure 6: Diffuse consolidation, “white lung”

(Courtesy Handbook of COVID-19 Prevention and Treatment)

Most patients show chest x ray abnormalities, with patchy air space disease. CT scan of the lungs shows “ground glass opacities” (observed more in right upper lobe). With worsening of illness, opaque areas scatter and thicken in places, creating a “crazy paving” pattern on the scan.

Pulmonary pathology is of pleural effusion, pronounced pulmonary oedema, extensive consolidation, focal haemorrhage, small pulmonary thromboembolism and interstitial thickening, with fibrosis of a mild to moderate nature or of honeycomb type.

Histopathological observations of pulmonary lesions not only show nonspecific inflammatory responses such as oedema and inflammatory cell infiltration but also exhibit severe exfoliation of alveolar epithelial cells, alveolar septal widening, damage to alveolar septa, and alveolar space infiltration in a distinctly organized manner. Pathologically, inflammation includes degeneration (necrosis), infiltration, and hyperplasia.

COVID-19 begins and ends in their lungs. There are GIT affections in COVID-19 patients like nausea, vomiting, diarrhoea etc. but they are not as dangerous as lower RT. Hence, pneumonic manifestations are elaborated.

Can Homeopathy work as a prophylactic against COVID-19?

The answer to this question is a long one. You must first understand the Law of Similars. Let us see how immunology and serum therapy are related to Homeopathy. The complete development of immunology and serum therapy is based on the principle of Similia.

It is interesting to read what Emil Von Behring, one of the founders of this discipline in late 19th and early 20th centuries, wrote: “In spite of all scientific speculations and experiments concerning small-pox vaccination, Jenner’s discovery remained an erratic boulder in medicine until biochemically thinking Pasteur, devoid of all classroom knowledge, traced the origin of this therapeutic boulder to a principle, which cannot be better characterized than by Hahnemann’s word ‘Homeopathic’. Indeed, what else causes the epidemiological immunity in sheep vaccinated against anthrax than the influence previously exerted by a virus similar in character to that of a fatal anthrax virus? And by what technical term could we more appropriately speak of this influence exerted by a similar virus than by Hahnemann’s word ‘Homeopathy’?”

The preventive use of homeopathy was first applied in 1799 during an epidemic of scarlet fever in Königslütter, Germany, by Dr. Hahnemann. A single dose of the remedy Belladonna was prescribed as the Genus Epidemicus to the susceptible children in the town with more than 95% success rate.

The question is whether ultra-highly diluted homeopathic remedies have demonstrable anti-viral effects and the answer is a big yes.  I appeal to everyone to read research papers by Anisur Rahman Khuda Bukhsh.

What is the concept of prophylaxis in Homeopathy?

Clinical practice based on the Law of Similars opens new horizons on which homeopathy projects its infinite potentialities, one of which is the field of prophylaxis.“Homeopathic prophylaxis” is adopted against many contagious diseases.  It has the same principle of the Law of Similars, like vaccination (which is followed in mainstream medicine).

Homeopathy is a constitutional therapeutic system and its selective and collective approach takes into account the concept of health as an ongoing process. One of the benefits of homeopathy is that a homeopathic physician can commence treatment at whatever stage the patient is presented to him, even if one is still waiting for the definitive diagnosis to be made on the basis of investigations like serology, culture, x-ray, etc. since the homeopathic treatment never interferes with any diagnostic procedures.

The prevention of disease by using an agent, which may cause or transmit the disease has been known for centuries, and its earliest example was of protection against viral infections. For example, the Chinese used to give protection against smallpox by the compulsory wearing of garments of the patient in full suppuration, or by the introduction of a one-year-old dried pustule into the nostrils.

During the 17th and 18th centuries in Europe, vaccination against smallpox using inoculation with variolic pus was also carried out. Even Hippocrates has recommended the consumption of the slimy saliva (from under the tongue) of a rabid dog, taken as a drink, as protection against rabies. The above examples are of ‘Isopathy’, a form of therapy based on the principle of treating with the same agent that may cause or transmit the disease. Comparing with Isotherapy, Homeopathy is based on the Law of Similars.

Can you elaborate further on homeopathic prophylaxis and the use of vaccinations in conventional prophylaxis?

There are four issues to be discussed.

  • Homeopathic Prophylaxis
  • Homeopathic Vaccination
  • Genus Epidemicus (GE)
  • Vaccination in mainstream medicine

Homeopathic Prophylaxis (HP) and Homoeopathic Vaccination (HV) are not the same. Homeopathic prophylaxis is used when there are sporadic, endemic, pandemic or epidemic outbreaks of contagious acute diseases (like COVID-19).

HP involves the use of homeopathic remedies, selected on the basis of totality of symptoms as manifested by the mass who are affected. The purpose of HP is to reduce or eliminate the morbidity of contagious diseases and thus also save the most people from mortality.

Although it is not a very specific individualized modality, it involves a less individualized and non-routine way of prescription for the short term. HP has been used since the inception of homeopathy.

When a remedy specific to the individual occurrence of an epidemic (Genus epidemicus) is identified, this remedy will act more surely in homeopathic prophylaxis and early treatment of cases also.

Homeopathic vaccination (HV) involves the use of a series of disease products (nosodes) in an effort to confer long-term resistance to a variety of diseases. The long-term time is involved with the concept of HV. However, a nosode as a remedy can become GE, provided it covers the totality of symptoms as suffered by the community from a contagious disease.

In mainstream medicine, each immunization procedure carries some risk of adverse reactions since crude/material amounts of disease agents and several other ingredients are being used which may result in an actual infection or else an immunological reaction. These reactions may deter both a doctor as well as a patient from using these procedures in individual cases. The adverse reactions, acute and chronic, have been recorded over the years and we have now enormous data about it.

Let us take the example of the vaccine against Covid-19 in mainstream medicine. It could take one to two years to prepare the vaccine. Further, less is known about this particular virus and certain viruses behave in an unusual manner. This indicates that developing the vaccine is not an easy task.

In the absence of vaccine from mainstream medicine, should the mankind be subjected to spread of COVID-19? However, more research is required in this field.  Homeopathic prophylaxis is based on the totality of data (the field of semeiology), and not on the causative agent only.

In view of the problem of change/mutation of the strain of the virus and the difficulty in preparing a vaccine, the homeopathic prophylactic drug based on Hahnemann’s’ concept of ‘Genus epidemicus’, is comparatively easy to prepare.

In such cases, nosodes (homeopathic potentized preparations of disease-products), can be used as prophylactics. As a result of many years of clinical use, there seem to be rational grounds for recommending these nosodes due to their efficacy and safety. Nosodes should be used only under strict supervision of expert homeopathic physicians.

In the current set-up, we can’t compare immunization in mainstream medicine and homeopathic vaccination. We need double-blind control studies and a large number of cases to draw the conclusions. Rather, this is the most favourable point in the history of medicine to do research on homeopathic vaccination and all the concerned authorities from government and private institutions should take necessary steps.

The virus is circulating and it is almost everywhere. Millions of people are under its grip and mainstream medicine should not oppose Homeopathy, Ayurveda and alternative therapies. Opposing homeopathic prophylaxis means, in another way, opposing the very principle on which the whole edifice of vaccination is built. Let us be one in our fight, let us be united, let us bury grudges and take up the gauntlet for the sake of humankind.

Can you give some evidence that homeopathy has proved itself as a preventive medicine?

Yes, the history of homeopathy is replete with beneficial results of homeopathic prophylaxis in contagious diseases such as Japanese Encephalitis, Yellow fever, Cholera, Diphtheria, Influenza, Plague etc.

Homeopathic medicines have been used to treat the flu symptoms for centuries in the countries where such illnesses have common recurrences. They can be of valuable help in preventing and treating the present COVID-19 pandemic. They can provide quick relief from symptoms of the flu and its use is inexpensive too.

Homeopathy was 98% successful in treating the Spanish flu epidemic in 1918. Dr. T. A. Mccann, from Dayton, Ohio, reported that 24,000 cases of flu treated allopathically had a mortality rate of 28.2% while 26,000 cases of flu treated homeopathically had a mortality rate of 1.05%. This last figure was supported by Dean W.A. Pearson of Philadelphia (Hahnemann College) who collected 26,795 cases of flu treated with homeopathy with the above result. Of the fifteen hundred cases reported at the homeopathic medical society of the District of Columbia, there were only fifteen deaths. Recoveries in the National Homeopathic hospital were 100%. In Ohio, of 1,000 cases of influenza, Dr. T. A. Mccann, MD, Dayton, Ohio reported no deaths. In Connecticut, 6,602 cases were reported, with 55 deaths, less than 1%.

Gelsemium and Bryonia were used successfully to treat Spanish flu in 1918. According to Dr. Frank Wieland, MD, Chicago, “(with) 8,000 workers we had only one death. Gelsemium was practically the only remedy used. We used no Aspirin and no vaccines.”

The Journal of the American Institute for Homeopathy, May, 1921, had a long article about the use of homeopathy in the 1918 flu epidemic. If we refer to literature about influenza prophylaxis in homeopathy, many remedies have been recommended viz. Influenzinum-hispanicum, Arsenicum album, Bryonia, Carbo-veg, Eup-perf, Gelsemium, Influenzinum, Mucobacter, Nelson’s influenza vaccine, Oscillococcinum, Phosphorus, Sulphur etc. by authorities like Pierce Schmidt, Grimmer, William Gutman, Fergie Woods, Younan, etc. Dr. P. Sankaran’s booklet of “Prophylactics in Homeopathy” is worth referring to in this connection.

The successful stories about Homeopathy’s ability to prevent as well as treat epidemic diseases have been compiled well by Fran Sheffield (www.fransheffieldhomeopathy.com) through “Homeo-prophylaxis: Human Records, Studies and Trials”. The compilation is worth reading.

Can you discuss how Hahnemann developed the concept of Genus Epidemicus?

Hahnemann’s aphorisms 100-102, from ‘Organon of Medicine’(6th edition), give guidelines about the investigation of epidemic diseases and the role of Genus Epidemicus. In aphorism 100, he emphasizes the need to examine each epidemic or sporadic disease as an independent new disease and that the totality of each case must be traced thoroughly by observing the phenomenon in its complete detail and in all its aspects and phases.

In aphorism 102, Hahnemann comments that the whole extent and complete picture of the entire epidemic disease cannot be learnt from examining a single case of the epidemic but can be deduced and ascertained from examining several patients of different constitutions. It is then that the Genus Epidemicus could be found out based on the totality of symptoms.

Hahnemann emphasised, “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”.

Note that the totality of symptoms should not be only quantitative but qualitative.

On the basis of the data provided above, it is possible to find the Genus Epidemicus (GE) for the COVID-19.

The GE should be the one single remedy that covers the contagious disease in a thorough and evolutionary spectrum. The GE can’t change due to stages of COVID-19 but homeopathic treatment based on individualization and totality may get changed. I am not in favour of complex remedies being used as a preventive.

What is your criteria for the selection of a remedy for Genus Epidemicus of the corona pandemic?

There are two distinct divisions: GE as a preventive remedy and the use of homeopathic remedies for the sake of treatment of the disease. If a patient is diagnosed for corona, the role of GE is finished for that individual. Now this patient needs homeopathic remedies according to his presenting totality. However, it is the usual experience that the GE remedy helps in the first stage of the disease as a treatment remedy.

If we want to find GE, we must build up the totality of an evolutionary order from Day 1 onwards and see the pivotal points as the essence of the totality. The long exercise which I have presented above is for this purpose. I have a frank opinion that we shouldn’t use only conceptual and imaginative thinking to select GE. It must be based on hard facts and clinical co-relation. Why am I focusing on evolution and pathology etc.? For us homeopaths, it is very important to understand the course and behaviour of the disease that lead the body through this. This understanding will lead us to the right remedy in both divisions of GE and actual treatment.

We can select appropriate remedies according to the types of coronavirus disease and it will be of great help for both clinic and hospital cases as a part of treatment.

Note that the recommendation for GE may change in the future in view of the changing scenario. GE fits only for masses where time is a crucial issue. Treatment of COVID-19 is a specific individual targeted approach.

How will you select GE? Do you want to give it to everyone?

We have already defined five stages of the corona pandemic.

  1. Cases mostly imported from affected countries
  2. Local transmission from positive cases
  3. Disease spreads in the community, large areas get affected
  4. Disease takes the shape of an epidemic with no clear endpoint
  5. Resolution stage

GE should not be given to everyone on the planet. It should be given to those who are exposed and those that are positive and related to stage I and II. GE should be given to all people who have an exposure, and are in an incubation period (which may be for 14 days) and are asymptomatic. In the third stage, naturally GE must be given to a large community in which Corona has become widespread. In the fourth stage, there is no discrimination. Everyone should be given GE (like Italy at present).  The whole idea of GE is to save the people as much as possible from the corona outbreak.

GE is not a universal cure for all COVID-19 patients. It is for prophylaxis.

GE can’t assume the status of Simillimum. Simillimum is where there is an individualized treatment. There is no life-long immunity for corona and hence, even after resolution stage, GE should be given to prevent further onslaught of COVID-19. Such cases need Tuberculinum as an anti-miasmatic remedy to boost the immunity.

I have interacted with many Corona positive cases and tried to elicit the data. Unfortunately, there are few PQRS symptoms and these are not available in all cases.

The remedy of GE must cover

  • Affinity for respiratory tract, both upper and lower; esp. lungs
  • The remedy must cover the typical pneumonia in its pathogenesis
  • The action must be of destructive character
  • The remedy must have sepsis in its pathogenesis
  • The remedy must cover tubercular and syphilitic miasmatic states
  • The remedy must cover the evolution of COVID-19 as a single spectrum in its pathogenesis
  • The remedy must cover the onset and the speed with which the march of the disease occurs

There are ‘n’ number of remedies and you will find patchy similarity with many remedies in one way or other. For GE, we need a synthetic approach and not a fragmentary one. We should not be driven by imaginations. Otherwise, many remedies will crop up as GE and it will cause only confusion.

It is here that I endorse the views of George Vithoulkas. An attempt is made in my work to evaluate the process of finding out GE in a serious way. There is affinity for the right side of the lung in pneumonia with COVID-19 patients. But as the disease progresses, bilateral affection of the lungs occurs and the whole lung is filled with fluid, debris and pus.

Some authors have given importance to ‘winter’ and ‘days are hot and nights are cold’ as causative modalities. As the corona virus spreads, it is not influenced by weather (it has spread in Iran, Dubai etc. which have hot climates, but the virus has survived and is multiplying). Hence, to select GE on the basis of a certain kind of weather has a limited scope.

The GE which is based on the totality of the current outbreak may be changed if the symptoms change. See the instructions for the prevention of Corona given by WHO and other wise people. They are very important, and everyone must follow them.

Many homeopaths have suggested remedies such as Antim tart, Bryonia, Camphor, Eucalyptus globulus, Eupatorium perfoliatum. Gelsemium, Justicia adhatoda, Merc-sol etc. Do you agree with these suggestions?

The physicians who have suggested these are highly respected and we must salute them for their studies. I think the above remedies are more for the sake of treatment than GE.

Let us begin with Antim-tart. It is slower in onset. Borland gives the pattern of response, “ You expect to find the symptoms of Antim-tart cropping up late in a pneumonia, you do not usually get them in the early stages and by the time the patients have gone on to an Antimony tart state, they are seriously ill”. Coarse, loose rattling cough is characteristic of Ant-tart and most of the patients of COVID-19 have dry cough and the Ant-tart, cough grows less frequent as disease advances and the patient shows signs of ‘carbonised blood’. Further, corona patients are found to > with warm drinks while Ant-tart has cough < warm drinks.

Bryonia matches well at many levels. But it has fibrinous or exudative inflammation. It lacks a pyemic or septic state; the debris and pus with fluid accumulation is not a part of Bryonia action. Bryonia can be a remedy for mild to moderate types when pneumonia has set in and there are joint pains < motion. When the state becomes severe and critical, Bryonia gets ruled out. Bryonia has both incubation and deterioration occurring slowly. Note that Bryonia doesn’t cover the collapse i.e. the failure state of the economy.

Bronchoscopic manifestation of Covid 19 Sars-cov2

Bronchoscopic manifestations of COVID-19: bronchial mucosa swelling and congestion; large amounts of mucus secretions in the lumen (Courtesy Handbook of COVID-19 Prevention and Treatment)

I am giving this figure in order to show that we can’t give importance to dry cough only and that there are mucus secretions inside. The same can be said about other remedies. They are more indicated at some stage of COVID-19 as a part of treatment rather than GE. GE is a broader and different idea. Gelsemium is dull and sycotic and lacks the septic state and destructiveness. Gelsemium is touching  the initial phase of the disease when the state is a mild one.

Eucalyptus globulus covers the miasmatic fevers i.e. caused by polluted environment. It has toxaemia but rarely pyemia and typifies a congestive-catarrhal state. Fever is usually of low type with subnormal temperature. Eucalyptus lacks the gravity with which corona sweeps the economy of the individual and social health. Eucalyptus has more ‘aspiration pneumonia’.

Camphor is an interesting entry. It corresponds to the critical stage when collapse has occurred and there is complete arrest of breathing. Violent dry cough is also covered well. However, the pathogenetic action of Camphor is not that of pus, decomposition and debris that occur as a part of violent destructive inflammation in COVID-19. Rather than for GE, I would prefer to keep it for treatment of the class of severe and critical patients. Camphor is primarily an erethistic remedy (as represented by clonic spasms, convulsions, asthmatic spasm etc.) where the system goes into the abnormal state of irritability leading then secondarily to arrested respiration. It is necessary to perceive the process, the phenomenon behind the result and it is different in each remedy.

Justicia adhatoda is a known immunity booster and it has been suggested in crude form. In Ayurveda, there are many immune boosters. Merc sol has also been suggested as GE. Merc sol is mostly needed when there is severe pain in the throat and there is a big and active battle going on in the throat not to allow the virus to go down into the lungs. Here I will prefer Merc-cyn.

Calc-carb has also been suggested. Calc-carb has a prolonged sycotic phase and a little tubercular phase where we get glandular affections. Calc-c has no intense fever and the type of evolution of a destructive type is not the cup of tea of Calc-c.

Can you give prominent indications of some remedies you think for Genus Epidemicus?

Four remedies come up for consideration: Arsenic album, Carbolic acid, Phosphorus and Sulphur.  Three nosodes come up Hippozaeninum, Tuberculinum and Corona virus nosode.

ARSENIC ALBUM

  • A profoundly acting remedy on every organ and tissue. The action is that of organic decay; it destroys the entire machinery of life.
  • Ailments from crowded close places and also from meat; agg.; spoiled, bad.
  • Nose: Thin, watery, excoriating discharge. Feels stopped up. Sneezing; profound; without relief.
  • High temperature.
  • Collapsed stage of a pneumonic crisis. Complete sinking of vital forces. Multi-organ failure.
  • Rapidly progressing violent inflammations. Sudden intense effects. Sudden, rapid decline. The system goes downhill in spite of well selected remedies.
  • Syncope; almost unconscious, cold sweat, dizzy, complains of thirst, anguish; rattling mucus.
  • Acute respiratory distress syndrome leading to death.
  • Covers the range from mild to critical variety of COVID-19.
  • On the top of what is written, fear and anxiety injected in the minds of the population correspond well with Ars-alb.
  • It is said that corona outbreak occurred after eating animals. We have a rubric, Generalities; food and drinks; meat; agg.; spoiled, bad and we have remedies such as ARS BELL BRY camph carb-an CARB-V CROT-H LACH PYROG VERAT
  • Sulphur doesn’t cover the above rubric though it has meat < and this is one of the reasons to emphasise Ars-alb as GE.
  • New information of loss of taste and smell is also covered by Ars-alb.
  • My colleague from Moscow is collecting symptoms from COVID-19 patients and she found that most of the symptoms develop suddenly.

CARBOLIC ACID

  • A blood poisoning remedy like –Echi.Pyrog., but with a slant for tissue destruction, like Ars. or Sec. A homoeopathic antibiotic against infections, zymotic states, toxemias, esp. intestinal (Bapt., Eucal.).
  • Low resistance. Low vitality. Lack of repair. Old age.
  • Malignant types of diseases especially when there is a tendency to generalized destruction of tissues. Breaking off (Crot-h. breaking down) of tissues: incomplete tissue disintegration. Sloughing.
  • Coryza with watery discharge. Influenza and resulting debility.
  • Fever high at onset, sudden and rapid rise, rapid prostration; pulse rapid and feeble; tending to malignancy and collapse.
  • Pneumonia: Circumscribed pneumonia. Double basal pneumonia. Necropneumonia. Septic pneumonia (, Pyrog.). Pneumonia of right base. Gangrene of lungs.
  • Gasping for breath, unable to lie down, wants hands held. Takes long inspirations, with yawning. Stertor (). Impending respiratory paralysis.
  • Both temperature and pathology develop rapidly.
  • For the critical stage when there is extensive pneumonia, septic shock and failure of the system.

PHOSPHORUS

  • Action on both upper and lower respiratory tract.
  • Usually the speed with which the disease process evolves is rapid, though a few cases can be with insidious onset. Suddenness of symptoms is a strong feature.
  • Violent inflammation which shifts rapidly to other parts of the body.
  • Cough: Dry, choking, short, with hoarseness, violent, tormenting, hacking, hoarse, barking, dry.
  • Hemoptysis is usually a symptom of pneumonia.
  • Destructive and disintegrating processes.
  • The system is overactive though seriously weak.
  • Respiration quickened, oppressed, short, laboured.
  • Complete solidification of lung tissue with dullness of percussion.
  • Pleuro-pneumonia.
  • Third stage of pneumonia: Cheesy degeneration of lungs; purulent infiltration and abscess. “When Bry. and Rhus-t. are insufficient in catarrhal and pneumonic states.”
  • Pleurisy: Dry, high fever; late stages; heart dilated; purulent infiltration.

SULPHUR

  • Everything is dirty: eating of dirty animals, the patient looks dirty and smells horribly offensive.
  • Destruction and decomposition as central pathology. Tendency to suppurate.
  • Action: Absorbs infiltration and prevents suppuration.
  • Continued high grade fever.
  • Violent, fluent coryza and frequent sneezing; profuse discharge of purulent mucus
  • Dry, violent cough, hoarseness, with choking and watery coryza. Scanty sputum.
  • Shortness of breath from talking or walking; intense oppressed feeling; severe dyspnoea.
  • Neglected influenza and Pleuritis. The patient is definitely going to be worse.
  • Pneumonia: Neglected, badly treated; hepatization or abscess; hectic fever; slow solidification; fibrous pleuro-pneumonia; with severe weakness. Extensive dirt has accumulated in the lungs.
  • Acute air hunger, great respiratory distress. Asphyxia, death apparent. Collapse.
  • Weakness, lack of reaction.

NOSODES

HIPPOZAENINUM (From Absolute MM)

  • Auto-infection, with pyemia (Bufo) (without blood poisoning, unlike Echi.); suppurations low, malignant.
  • Purulent inflammations of serous membranes, esp. of linings about joints. Purulent infiltrations.
  • Malignant abscesses in lungs.
  • Putrescence: Destructive tendency to tissue decomposition.
  • Collapse. Repair processes lag behind.
  • Descending catarrh beginning in nose.
  • Pneumonia: Specific process. Nodules larger, forming isolated grey hepatizations and abscesses, Pneumonia malleola.

TUBERCULINUM (From Absolute MM)

  • Rapid and complete physical break-down; after contacting acute infections such as pneumonia, influenza etc., no signs of vital reaction, declining, a running down state.
  • Affinity for respiratory tract esp. lungs
  • Frank inflammatory processes (not mere congestion), in the lungs, pleura or vital organs.
  • Viral infections in patients with tubercular taint (, Eucal., Calc-c.); progressing even to septic condition (cp. Pyrog.).
  • Active proliferations occur to an intense degree causing extensive damage and disintegration of tissues.
  • Sporadic influenza is an outburst of latent tubercular diathesis, says H. C. Allen.
  • Pneumonia: Bronchopneumonia. With symptoms of Ant-t, Bry and Zinc. A clearing up remedy in delayed resolution with lack of response, septic foci, or caseous hepatization appearing.
  • Septic conditions, abscesses; pus copious, thick, greenish. Leucocytosis.
  • is the best general antidote to the chronic effects of influenza toxin.
  • When the well-selected remedies fail, as an intercurrent remedy.

CORONA VIRUS NOSODE

  • Corona virus nosode is an interesting idea and definitely better than Influenzinum. The isopathic principle is followed when one uses the same biological product which is the cause of the disease.
  • The current circulating Coronavirus Nosode is a homeopathic nosode that is made from the current circulating strain that started in late 2019 (now named “COVID-19”).
  • There is no proving data or clinically confirmed data yet, but it can be given on the basis of isopathy.

Can you discuss your Miasmatic assessment of COVID-19 cases?

If we study the coronavirus disease in evolutionary totality, it is possible to see the cleavage. We can split the day wise data, analyse the pathology which is supervening and assess the miasmatic state. This will help us figure out the remedies.

Psoric manifestations

Mild symptoms such as fever, cold, throat pain, sore voice, headache, diarrhoea etc. Return to baseline of health is early and easy. Immunity good. Good response to the treatment. No complications. COVID-19 is limited to upper respiratory tract. Psora applies to Day 1-4.

Sycotic manifestations

The mild symptoms in psora become intense and constant. Lingering response. Weakness and dullness. Fever becomes constant and heaviness of head. Dry cough in bouts, often with expectoration; thick, yellow-greenish. Soreness of voice increases. Joint pains. Yet COVID-19 is limited to URT. Sycotic miasm is mostly for Day-5 status of the patients. 80% mild to moderate cases will be under the dominance of psoric and sycotic miasms.

Tubercular manifestations

There are two types of patterns of response:  1. Acute, sudden onset and rapid pace of the disease. 2. Slow, then rapid pattern. COVID-19 usually follows the second pattern. It is from the Day 6 that we are able to see the tubercular miasmatic dominance and up to day 8.

This phase is characterized by high grade and persistent fever, intense throat pain and development of pneumonia and pleural effusion. Intense heaviness in chest, breathlessness, increased respiration, low oxygen saturation, enteritis, profound debility and toxic appearance are on the screen.

The type of severe disease of 14% of patients is due to the dominance by the tubercular miasm.  Day 6-8 needs careful monitoring and a remedy selected on the basis of totality and that covers the miasmatic state, if given in the right posology is able to help the system from the clutches of death. There are three signals that indicate the increasing influence of tubercular miasm. Very severe throat pain (probably a last-ditch effort on the part of the organism (through throat) to prevent the virus to go down in the lungs), pneumonia which is rapidly increasing and lymphopenia (a critical factor associated with disease severity and mortality).

The three stages of pneumonia represent the tubercular miasm. Don’t misunderstand that the first stage is psoric. It is not only replication but rapid changes of destruction (tubercular miasm is a blend of hyperreactivity of psora and destruction of syphilis).

Syphilitic manifestations

No response to treatment. Disease progresses with high pace. Complications à, hemodynamic state poor. Cyanosis. Kidney failure. Collapse. Comatose condition. Respiratory collapse. Multi-organ failure.

The above miasmatic criteria should be applied to all cases of pandemic COVID-19 for preventive and treatment modality. If we take into account the clinical features of COVID-19 in totality, the tubercular miasm is preponderant over the system right from the Day-4, and if the clinical condition becomes worse, it progresses to the syphilitic miasm.

The most common cause of death is respiratory failure. Other causes of death are pneumonia (leading to sepsis), high fever (leading to neurological problems), dehydration and electrolyte imbalance (from excessive vomiting and diarrhea).

Can you be precise in miasmatic categorization?

Mild to moderate cases: Psoric3. Sycotic1. Tubercular1.

Severe cases: Tubercular3. Syphilitic2.

Critical cases: Syphilitic3.

(The numerical marks denote the activity)

How will you process the data of COVID-19 from a homeopathic standpoint?

TABLE OF ANALYSIS WITH COMMENTS

The points in bold are related to COVID-19 disease

1. Nature of disease

Acute. Requiring preventive measures in view of contagiousness. Requiring immediate attention and treatment. In evolution, it becomes per acute i.e. violently acute

Aetiology: Virus

Diagnosis: COVID-19

Highly contagious, human-to-human transmission. Hence, GE is needed.

·       Acute/Per acute/ acute on chronic (exacerbation).

·       Sub-acute/Chronic/Remission

·       Mixed / Messed: natural + iatrogenic

·       Psycho-somatic

·       Somato-psychic

·       Auto-immune

·       Clinical diagnosis

 

2.    Phase of the Disease

Fully developed: Clinically

Homeopathically: Inadequately

developed (absence of PQRS)

·       Pre/Sub-clinical/Clinical

·       Functional

·       Structural  

·       Fully developed

·       Inadequately developed

 

3.    Affinity

Respiratory Tract: Upper and Lower. Lungs; right lobe

      Cells/ Tissues / Organs/ Systems/Sides

 

4.  Type of Pathology

The immune system becomes a prey and can’t mobilize its resources when the state travels from severe to critical state

On pathological examination of the resected lobectomy specimen of COVID-19 patient, 1.2 cm grey-white nodule adjacent to the pleura was identified.

·       Allergic

·       Atrophic

·       Benign

·       Degenerative

·       Destructive

·       Dysplasia/ Proliferation

·       Hyperplasia / Metaplasia / Hypertrophy

·       Induration / Hardening

·       Inflammatory (serous, fibrinous, catarrhal, eosinophilic, granulomatous, pyogranulomatous, fibronecrotic, lymphocytic, suppurative).

·       Malignant

·       Necrosis / Sclerosis

·       Nodular

·       Ulceration

·       Hemorrhagic

·       Ischemic

·       Venous

·       Calcareous

·       Fibrotic

·       Rheumatic

 

5. State of pathology

All three stages represented.

Reversible in mild cases. Borderline to irreversible in tubercular and syphilitic cases.

·       Reversible

·       Borderline

·       Irreversible

 

Sudden development of symptoms

6. Pattern of response

·       Sudden  

·       Alternating

·       Erratic

·       Regular

·       Irregular

·       Paroxysmal

·       Periodic

·       Lingering

·       Shifting

·       Progressive  

·       Continuous  

·       Recurrent

·       Static

 

7. Pace of disease·       Rapid 

·       Slow

·       First rapid then slow

·       First slow then rapid 

·       Moderately rapid  

·       Moderately slow

 

8. Expressions

No PQRS symptoms available.

(+= scanty, ++ = moderate, +++ = ample)

·       The field of modalities: General   Particular

·       The field of sensations: General   Particular

·       The field of symptoms:  Pathognomonic   Non-pathognomonic

Common

Characteristic

 

9. Miasmatic diagnosis

Already given above

·       Dominant / Active

·       Fundamental

·       Combined

Psora Sycosis Tubercle Syphilis

 

10.  Sensitivity

Fear, anxiety make a person sensitive

At physical level sensitivity increased

·       High

·       Moderate

·       Decreased

At Mind level:

At Nerves (body) level:

 

11.  Susceptibility

Active and progressive disease bringing more symptoms and pathologies but absence of PQRS

·       High

·       Moderate

·       Decreased

 

12. Suppression

Not present

·       Mind

·       Physical

 

13. General vitality

Moderate à low

Sinking of immune forces as the disease advances

·       Good

·       Moderate

·       Low

 

14. Monogram

Inflammatory. Exudative. Putrescent. Slow then rapid. Destructive. Tuberculo-syphilitic.

·       Pathological Generals

·       Behaviour of the system

 

This type of analysis is interesting and deep. Which rubrics you will select for repertorization?

I want to focus on the evolution of COVID-19 and the typical pathology it develops. I don’t want to take common mental symptoms as rubrics. This is not a psycho-somatic case. It’s a contagious disease and fear and anxiety in view of social issues and media hype are common.

I would prefer to perform two types of repertorization, one covering the quantity of rubrics that are related to the disease so that we will have a wide panorama to lay hands on and the another one from the exclusive point of view where I will focus on crucial and determinant rubrics.

Also, note that selection of GE only on the basis of rubrics is not an adequate idea. Let us take an example. The rubric Respiration; arrest, arrested’ contains 244 remedies. Many remedies do possess functional symptoms only. I mean, a rubric assumes importance in strong pathology developing contagious disease like COVOD-19, only if the remedy has the pathogenesis of pathology. Can we apply the same thinking to Ignatia and to Hydrocyanic acid? The rubrics are pieces of documents given by the advocates but the final decision has to be taken by the judge of the supreme court which is Materia medica.

LARGE SET OF RUBRICS

  • Generalities; violent complaints
  • Generalities; progressive diseases:
  • Generalities; reaction; lack of
  • Generalities; vitality decreasing
  • Fever, heat; insidious fever
  • Fever, heat; slow
  • Throat; pain; fever, during
  • Throat; pain; influenza, from
  • Chest; inflammation; lungs, pneumonia; influenza, in or after
  • Stomach; nausea; pneumonia, in
  • Stomach; vomiting; pneumonia, in
  • Rectum; diarrhea; pneumonia, in
  • Chest; inflammation; lungs, pneumonia; apex, upper; right
  • Chest; inflammation; lungs, pneumonia; collapse, with
  • Chest; inflammation; lungs, pneumonia; destruction of tissue, cavities, with
  • Chest; inflammation; lungs, pneumonia; resolution, with delayed
  • Chest; inflammation; lungs, pneumonia; weakness, with
  • Chest; inflammation; lungs, pneumonia; pleura-pneumonia
  • Chest; inflammation; lungs, pneumonia; collapse, with
  • Generalities; collapse:
  • Generalities; blueness of parts, cyanosis:
  • Chest; nodules; lungs: hippoz
  • Clinical; asphyxia, death apparent; paralysis of lungs, in threatening

New information

New signs for detecting COVID-19 in patients

  • The British Association of Otorhinolaryngology (ENT UK) says asymptomatic patients – ones who do not have a fever or a cough – could show a loss of smell or taste as symptoms after contracting coronavirus.

Addition of two rubrics

  • Smell; loss of, wanting
  • Taste; wanting, lost

REPERTORIAL FILTER

The COVID-19 Pandemic and Its Homeopathic Approach - Interview with Dr. Ajit Kulkarni 2

Small set of rubrics

  • Respiration; arrest, arrested
  • Chest; lungs; right
  • Chest; inflammation; lungs, pneumonia; old people
  • Chest; inflammation; lungs, pneumonia; apex, upper; right
  • Chest; inflammation; lungs, pneumonia; pleura-pneumonia
  • Chest; inflammation; acute; lungs
  • Fever, heat; insidious fever
  • Fever, heat; intense heat, 39+ c., 102+f
  • Generalities; collapse
  • Generalities; reaction; lack of
  • Generalities; violent complaints

Repertorial filter

The COVID-19 Pandemic and Its Homeopathic Approach - Interview with Dr. Ajit Kulkarni 3

Dr. Kulkarni, what is your final selection for GE?

  • There is a tussle between Arsenic album and Sulphur. My mind is also thinking of Carbolic acid and Hippozaeninum as both covering the range from cold to severe pneumonia and septic shock.
  • But yet as GE, I suggest ARSENICUM ALBUM as a homeopathic prophylactic remedy for the COVID-19 outbreak.

The AYUSH Ministry of India has already announced Arsenicum album as a homeopathic prophylactic remedy for COVID-19 infection.

I am happy that my independent study and analysis, based on symptoms, signs, pathology, evolution of COVID-19 etc. has come to the same conclusion of Arsenic album. The very meaning of GE is that with concerted efforts of all investigators and researchers, we arrive at the same conclusion. This is in line with the Hahnemannian approach.

I endorse the views of AYUSH and Central Council for Research in Homeopathy (CCRH). I hope that reading my interview and CCRH ‘Homeopathic perspectives in COVID-10 Coronavirus infection, Fact sheet’ will be interesting reading.

What are your reasons for selection of Arsenic-album?

Apart from the homeopathic data obtained through proving and clinical confirmation (indications have been given elsewhere), we have to focus also on toxicological data.

On the respiratory tract, Arsenic poisoning causes

  • Irritation of nasal mucosa, pharynx, larynx, and bronchi
  • Pulmonary edema
  • Tracheobronchitis
  • Severe and very severe pneumonia
  • Pulmonary insufficiency
  • Leucopenia
  • Cough and dyspnoea
  • Reynolds’s observation: Arsenic might play a role in the etiology of many viral diseases as the immunity is depressed with Arsenic poisoning.
  • A new study confirms that exposure to low to moderate amounts of arsenic can impair lung function.
  • “Restrictive lung defects, in those exposed to Arsenic, are usually progressive and irreversible,” said Habibul Ahsan, MD.
  • Acute severe Arsenic poisoning causes acute respiratory failure.
  • A new link between cystic fibrosis and Arsenic poisoning has been found out.
  • In short, a strong similarity exists at the pathological level between Coronavirus disease and Arsenic poisoning and this point shifts in favour of Ars-alb as a prophylactic remedy.
  • That the coronavirus pandemic resulted from human consumption of animals is a point of debate. Many viruses, bacteria and parasites that have caused major diseases in the past have been zoonotic, (meaning they had their origin in animals). This causative modality is also covered by Ars-alb.
  • Profound weakness as experienced by COVID-19 patients points to Ars-alb.
  • Many patients develop restlessness and agitation, and these are classical indications of Ars-alb.

CLINICAL STAGES OF SARS-COV2 FROM  MILITARY MEDICAL RESEARCH IN CHINA

I have more to offer. While I was finishing the interview, I came across the Military Medical Research Journal, China which has presented seven clinical stages. We are getting some “homeopathic symptoms” here.

Stage 1

Early-stage. Clinical manifestations: Aversion to cold without sweating, headache and generalized heaviness, limb pain, glomus and fullness in the chest and diaphragm, thirst with no desire to drink, ungratifying loose stool, yellow urine, frequent micturition.

Stage 2

Early-stage. Clinical manifestations: Aversion to cold with or without fever, dry cough, dry throat, fatigue and hypodynamia, oppression in chest, epigastric fullness, or nausea, loose stool. Tongue: Pale or reddish; fur slimy white. Soggy pulse.

Stage 3

Middle-stage. Clinical manifestations: Persistent fever or alternating cold and heat, cough with less phlegm, or yellow phlegm, abdominal distension and constipation; oppression in chest with shortness of breath, cough with wheezes, panting on exertion; or red tongue, slimy yellow fur or yellow dry fur, slippery and rapid pulse.

Stage 4

Severe stage. Clinical manifestations: High fever, oppression in chest with shortness of breath, purple-black facial complexion, lips dark and swollen, obnubilation, crimson tongue, yellow dry fur, surging and fine rapid string like pulse.

Stage 5

Severe-stage: Clinical manifestations: Dyspnea, panting on exertion or need assisted ventilation, accompanied by coma, and agitation, cold limbs with cold sweating, dark purple tongue, thick or dry thick tongue fur, floating and rootless pulse.

Stage 6

Recovery-stage. Clinical manifestations: Shortness of breath, fatigue and hypodynamia, anorexia, nausea and vomiting, glomus and fullness, weak stools, ungratifying loose stool, pale tender-soft enlarged tongue, slimy white tongue fur.

Stage 7

Recovery-stage. Clinical manifestations: Generalized heat with sweating, chest heat vexation, retching and vomiting, shortness of breath and lassitude, red tongue and thin tongue fur, vacuous pulse.

The COVID-19 Pandemic and Its Homeopathic Approach - Interview with Dr. Ajit Kulkarni 4

This third reportorial filter also points to Arsenicum album in a far more qualitative way.

What is next strategy if Ars-alb fails as GE?

One of the reasons why India is able to contain the spread of virus may be consumption of Ars-alb. by a large number of people, and sincere homeopaths are distributing Ars-alb since the announcement of it as a preventive drug by AYUSH. However, if the spread is alarming, I will recommend Carbolicum acidum.

Will you suggest some remedies for the treatment of COVID-19 patients?

See, when you enter into treatment part of COVID-19, there are many remedies to be discussed. But any remedy you give must augment the immune response towards inhibition of the virus replication, promotion of the virus clearance, induction of the tissue repair and triggering of the adaptive mechanisms. I reiterate, GE is for prophylaxis and it has its limited time zone, though it is extremely important.

When you decide to venture upon actual treatment of corona patients, you have to apply the fundamental principles of case taking, data processing, LSMC (Location, Sensation and Pathology, Modalities and Concomitants) cleavage with due value to the clinical and pathological realm,  the stage in which the patient is and the application of the Law of Similars for the selection of a remedy.  Nothing can replace an adequate and accurate case taking.  I suggest only the list of prominent remedies.

Mild to moderate cases

  • Ars-alb, Bryonia alba, Chelidonium, Eup-perp, Ferrum-phos, Gelsemium, Hepar, Merc-sol, Merc-cy.

Severe cases

  • Apis mel, Ars-alb, Bry, Camphor, Kali c, Kali-i, Lyc, Phos, Pyrog, Sulph, Tub

Critical cases

  • Ars-alb, Antim-tart, Camph, Carb-ac, Carb-an, Carb-v, Hippoz, Kali-c, Kali-iod, Sulph, Ver-alb.

Can you give us more tips for the treatment of pneumonia?

If you want to treat pneumonia in COVID-19 patients, you must ponder over ‘Pneumonias’, a classic and practical book by Borland. Borland classified pneumonia under the following categories:

  • Incipient stage: Aconite, Belladonna, Ferrum phos and Ipecacuanha
  • Frankly developed pneumonia: Bryonia, Phosphorus, Veratrum viride, Chelidonium
  • Complicated pneumonia: Baptisia, Pyrogen, Lachesis, Merc-sol, Hepar-sulph, Rhus-tox
  • Creeping/Definite Bronchopneumonia in adult: Natrum-sulph, Pulsatilla, Senega, Lobelia
  • Late pneumonia: Antim-tart, Carbo-veg, Kali-carb, Lycopodium, Arsenic-album, Sulphur

Let us integrate the above classification with the modern classification of COVID-19 cases. The mild to moderate variety fits in well with incipient and frankly developed stages, while severe and critical types correspond well with the remaining three types as mentioned by Borland.

On the third day of the infection, when consolidation is developing and there is high fever, Borland advocated the use of Ferrum-phos in high potency (1M or 10M) given repeatedly which has the capacity to abort the course of pneumonia.

Let us take Carbo-veg. It’s a remedy for the critical stage where the patient is on his deathbed. There is cyanosis, and oxygen saturation is poor. There is intense air hunger and icy cold sweat with a horrible sense of a weight on the chest and the patient literally gasps for the breath. This data is enough to know the seriousness of the condition. The failing lung (and the heart) and the patient if put on oxygen respond astonishingly well to the administration of Carbo-veg. When the lung is filled with debris, and pus and the patient is in shock, Carb-veg is indicated.

You see, carbons are between living and dying. Hence it is not only Carb-veg that comes, Carboneum sulphuratum also has coryza, loss of smell and taste, collapse, debris and lack of reaction. The same can be said about Kreosote or Naphthalinum.

We have seen that in COVId-19, the lung is filled with fluid and here you must think of Kali carb. Here you get violent chest pains with dry cough. Kali remedies have very little or no fever. Apis mellifica should also find entry here.

Viral myocarditis is a serious complication of COVID-19 and it appears it is developed after pneumonia.

Under the rubric, Heart & circulation; inflammation; heart, carditis; myocardium, myocarditis; influenza, after: crat cur dig. Digitalis can be a big choice as it has broncho-pneumonis; senile pneumonia with dry cough, cyanosis, cold extremities; kidney failure; dropsy; cardiac failure after influenza or pneumonia and most markedly bradycardia. It must be compared with Camphor.

Curare (Arrow poison) is a little understood and a neglected remedy. It is multi-phasic remedy and a cocktail of Bapt, Bell, Bry, Carbn-s, Dulc, Eucal and  Gels. Curare has also miasmatic (polluted environment) fever; toxic; septic.

When do you want to intervene with Hippozaeninum or Tuberculinum?

I will use them when well indicated remedies will do only lip-service. I have already provided the indications.

What posology you will advise for COVID-19 patients as a part of treatment?

I will prefer 1M and more in a frequent repetition schedule, say every three or four hours. In critical condition, I may repeat every 15 minutes too.

Can you suggest any treatment plan?

Yes, it is possible to give a gross treatment plan. It is based on the evolution and totality of symptoms as gathered after innumerable sources.

treatment plan for coronavirus

Do you wish to share any further insights about the coronavirus outbreak?

Humans are paying the price of encroachment upon the earth and not respecting Mother Nature. See how life has changed within a few months and that too from a small invisible organism. It would have been thought impossible to cause so many changes for humans within such a short period.

The truth is that you can possess sophisticated armed forces, but you can’t shoot a virus.  The COVID-19 crisis touches every aspect of our lives, including our existence.  The coronavirus pandemic forces us to look at issues such as self-indulgence, hyper-individualism, narcissism, consumerism, selfishness and spiritualism.

The crisis has reduced the speed and the rather maniacal pace of the human species. The crisis has brought to light through a major health issue, the limitations of mainstream medicine.

Homeopathy, Ayurveda and other complementary therapies have been advocating for holistic approaches and therapies for many years. They need big time entry into the mainstream and not pooh-poohing.

Will we focus only on a tiny invisible virus, or we look at the problem in the larger perspective and prospective way?  The lesson is ‘small is big’. ‘Tiny is powerful’. Invisible causes visible changes. And human beings are highly vulnerable in the prodigious universe.

You can’t mock homeopathy because it is sub-physiological, that it uses infinitesimal potencies. The coronavirus in its all-pervasive pandemonium is a wake-up call, it is a karmic test which we need to pass, so that we as a species can transcend our conduct on this planet, which we have maligned and mistreated for far too long. Humans need wisdom. They need balance and control.

Thank you, Dr. Ajit Kulkarni, for a comprehensive interview.

You’re welcome, Roman and thank you for such relevant questions. The present interview is an outcome of actual observations made by researchers, doctors and patients from our interaction with actual COVID-19 patients since the outbreak of coronavirus November 2019. It is subject to change in view of any new information that is cropping up.

I must mention my colleague, Guy Tydor, Israel for his valuable suggestions.

UPDATES  27th March, 2020

Questions Answered

Dr. Ajit Kulkarni will answer the questions here and will give us the updates about his views. . The question is from a modern medicine doctor who also studies homeopathy. He doesn’t want to disclose his name.

Question

The Cov2 and cov has 73 percent similarity in the receptor binding domain (RBD) of the spike protein that attaches to ACE2 receptor.  So, we have to assume that the antibodies of cov should protect us from cov2 to a greater extend. It happens in immunological reactions. But what is the reality?

The actual interface with in the RBD that clips with ACE2 is highly variable (say 34% overlap, so our actual antibodies fail to recognize the COV2 . This is what happens in Cov2 infection. That trick is in the molecular level. So what is the reliability in aggressively collecting symptom data and putting it on repertory? There is an extremely variable host response. If we try ”influenzinum” it might make more sense. At least we are thinking in a molecular level for similarity. So should we spend time again and again in repertory, or go to the war front to help them by all means?  We could do extensive study about this, once the epidemic is contained. See the graph of Europe. In every country it is increasing.

The questioner is focussing on the mechanism of attaching the spike protein of the virus to the ACE2 receptor and brings out a very important point that the actual interface of RBD that clips with ACE2 is highly variable. This is exactly the concept of ‘individualization’ which is the central tenet in homeopathic prescribing. It is this variability that matters in homeopathy at the Genus Epidemicus and treatment level, and this is the reason why each patient is a unique individual in its form, function and structure. Thus, to follow individualization becomes a scientific and rational way to proceed.

The questioner has brought out one more point, that the actual antibodies fail to recognize COV2. Thus, two problems – ‘recognition’ and ‘surveillance’ play a big role. Homeopathically, a remedy must cover the theme of the above in its pathogenesis.

The whole issue is not of the molecular level, but of the host. Naturally, the thinking in homeopathy is explicitly related to vital force, immunity and organismic wholeness. It is the derangement of the vital force through several known and unknown mechanisms that there is genesis, maintenance and progression of the disease.

The most reliable aspect is gathering the totality out of hosts’ responses at various levels of the derangement of the vital force and apply the natural law of healing i.e. the Law of Similars.  One of the reasons for failure at the preventive and treatment level of mainstream medicine is the reductionist approach which is constantly pushed.

Describing the mechanism of RBD clipping and host variability, and linking it to Influenzinum under the molecular level doesn’t make sense, because even at the molecular level, it doesn’t become relevant. Influenzinum is prepared from the approved seasonal inactivated influenza vaccine (Boiron). We have already given many differences between seasonal influenza and COVID-19 disease. If at all we want consider the molecular base, it should be the Coronavirus nosode. However, we don’t want to push only Isopathic principle.

We endorse the views of the questioner that the use of the repertory as the only device for finding GE or even for treatment is not an adequate idea. However, we differ from the author about his views of collecting the data in an aggressive way. This is the need of the hour from the homeopathic standpoint.

REFERENCES

  • Organon of Medicine, 6th Edition, Samuel Hahnemann
  • Materia medica of some important nosodes, H. C. Allen
  • Coronavirus Covid-19 – Analysis of symptoms from confirmed cases with an assessment of possible homeopathic remedies for treatment and prophylaxis, Bhatia, M, Hpathy.com
  • Pneumonia, D. M. Borland
  • Absolute Homoeopathic Materia medica, P. I. Tarkas and Ajit Kulkarni
  • Homoeopathic Posology, Ajit Kulkarni
  • Homeopathy through Harmony and Totality, Ajit Kulkarni Volume I
  • Objective analysis of the case: 20 points recipe: A blueprint to use Homeopathic Philosophy and Organon into clinical practice, Dr. Ajit Kulkarni
  • Respiratory tract infections and homeopathic perspective, Dr. Ajit Kulkarni
  • Research studies in support of nosodes, Dr. Nancy Malik
  • Handbook of COVID-19 Prevention and Treatment, The first affiliated Hospital, Zhejlang University School of Medicine Compiled according to clinical experience
  • Here’s how corona virus enters, affects the human body, Erin Dobrynz
  • Data shows there are the two most common coronavirus symptoms, Emilee Speck
  • Here’s what coronavirus does to the body, Amy Mckeever
  • Ultra-Highly Diluted Homeopathic Remedies Have Demonstrable Anti-Viral Effects: A Commentary on Our Published Findings Related to Experimental Phage Infectivity in Bacteria, Anisur Rahman Khuda Bukhsh. Biomed J Sci & Tech Res 2018
  • Wu, Zunyou, and Jennifer M. McGoogan. “Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention.” Jama (2020).
  • Homeopathic Clinical Features of 14 patients in COVID-19 outbreaks in China, To Ka Lun Aaron, President of Hong Kong Association of Homeopathy Fok Yuen Ying Yvonne, NCP of LMHI (China)
  • Issac G. The potential value of homeo-prophylaxis in the long-term prevention of infectious diseases, and the maintenance of general health in recipients. Trove
  • Golden I. Large Homoeo-prophylaxis: Brief and Long-Term Interventions. American Journal of Homeopathic Medicine. Winter, 2019; 112(1): 31-36.
  • Golden I. Large Homoeo-prophylaxis Interventions by Government Institutions. Similia. 2019; 31(2)
  • Bracho G. and Golden I. A Brief History of Homeo-prophylaxis in Cuba, 2004-2014. Homeopathic Links.
  • How to boost immunity against coronavirus (COVID 2019), Harry van der Zee
  • Homeo-prophylaxis: Human records, studies and trials, Fran Sheffield (fransheffieldhomeopathy.com)
  • Fact check: Is COVID-19 caused by human consumption of animals? Matthew Brown
  • Lotus Materia medica, Robin Murphy
  • Complete Repertory, Roger Van Zandvoort
  • Radar Opus
  • Webinar on Corona by Jeremy Sherr
  • Homeopathy for Coronavirus Covid-19 Infection: Dr Aditya Kasariyans and Dr Rajan Sankaran
  • Views of Prof. George Vithoulkas on Homeopathy for Coronavirus COVID-19 Infection
  • A Select Homeopathic Repertory, P. I. Tarkas and Ajit Kulkarni (Unpublished)
  • Homeopathic perspectives in COVID-10 Coronavirus infection, Fact sheet, Central Council for Research in Homeopathy, New Delhi
  • A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version) Ying-Hui Jin,Lin Cai, […] , for the Zhongnan Hospital of Wuhan University Novel Coronavirus Management and Research Team, Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care (CPAM) Military Medical Research volume 7, Article number: 4 (2020)
  • Internet websites
  • who.int/health-topic
  • en.wikipedia.org
  • hpathy.com

About the author

Ajit Kulkarni

Ajit Kulkarni

Dr. Ajit Kulkarni M.D. (Hom.) is a veteran homoeopath, an academician and a famed international teacher, known for his innovative ideas. Dr. Kulkarni has presented 70 international seminars around the world and more than 100 seminars in India. He is Director of the Homeopathic Research Institute, Pune, India. He is a prolific writer on homeopathy and his works include co-authoring Absolute Homeopathic Materia Medica, and authoring “Law of Similars in Medical Science”, “Homeopathic Posology”
“Kali Family and Its Relations”, Body Language and Homeopathy”, as well as 22 books in the Russian language. He received the Award of Excellence in Homoeopathy (2011), from the Post-Graduate Association of India, the ‘Homoeo-Ratna’ award (2014) from ‘Homoeo-Friends’, India, and the “Life Achievement Award”, (2018), from the Sontara Bhansali Charitable trust and Indian Homeopahic Forum.” Dr. Kulkarni has represented homeopathy on Bulgarian TV and gave an address at Kachare Classic, Erandwane, near New Karnataka High school, Pune. Visit him at his website: Website: www.ajitkulkarni.com E-mail ID: [email protected]

22 Comments

  • ENLIGHTENING INTERVIEW
    Dr. Sadhana Joglekar

    I have been reading so much about Covid-19 on different media but being a homeopath, I wanted to upgrade myself and see how I will contribute for the ailing patients, but I was unable to get the material. Finally, I shut down myself in the lockdown (actually it is locked up). Dr. Ajit Kulkarni’s interview on Hpathy appeared and I found the contents appealing and updating.
    The questions raised by Roman Buchimensky are relevant and the deep answers from Dr. Ajit Kulkarni reflect the very pulse of homeopathy.
    The interesting part of this interview is the integration of Covid-19 and homoeopathic thinking. In no way, Dr. Kulkarni underestimated the value of Covid-19 and linked five stages of the disease to homeopathic thinking – philosophical and practical.
    I was taking Covid-19 as a flu episode but the differentiation between common Influenza and Covid-19 clarifies many issues.
    Dr. Ajit Kulkarni has clarified many issues on Homeopathic prophylaxis, Genus Epidemicus, Homeopathic Vaccination and Allopathic vaccination. Concept of Genus Epidemicus and the criteria for the selection of GE has been laid down in a convincing manner. I understood that gathering few symptoms from repertory and materia medica doesn’t make GE.
    The best part of the interview is the deep homeopathic analysis as processing of the data and linking the various stages of Covid-19 to four miasms and this superbly throws light on how it is possible to integrate modern thinking with homeopathy.
    Many new clinical tips and bringing out the remedies like Carbolic acid, Hippozaeninum etc. before us, are the superb insights, and I must say, I didn’t think over them.
    I must say that with this interview, many new thinking patterns have been developed. I think, we can apply this thinking to every disease and the therapeutics based on this logical thinking will certainly help the homeopaths to do his worth when the only hope for the ailing humanity appears to be homeopathic.

    • Because in the West people are looking for an allopathic drug and a vaccine. It used to be possible to get homeopathic treatment on the National Health Service in the UK but it has been private only for a long time. That makes it out of reach for many people. Her Majesty the Queen has her own homeopath. That is not wide knowledge. The royals use homeopathy because they know it works well for them.

  • My hat’s off to Dr Ajit Kulkarni for both his superb analysis and synthesis, as also the sheer scope and volume of the information on the subject that he has brought to the fore. By setting out a clear-cut plan of treatment and identifying clearly what he thinks is the GE in this case, he has proved himself not to be in the class of those ‘on the one hand this and on the other hand that’ kind of theoreticians, who are afraid to commit themselves to any particular view. No amount praise and gratitude can really do justice to the value Dr Ajit Kulkarni has added to the conversation on COVID – 19.

  • Corona a history from its evolution and manifestation so well presented in Language of modern medicine, pathology , till the toxicological studies itself says the half battle won .. also Dr Ajit Kulkarni clearly opens each Homoeopathic drugs n explain their metamorphosis why they or they can’t be proper GE .. final conclusion of Elaborate studies concluded well as evidence based things remain forever .. it is and it will help for homoeopaths like me ..

  • I am eternally grateful for this article as I assist my daughter through this. I can affirm her case has followed this assessment. Eupatorium Perf, Phos, and now Sulphur, and Tub have been the key remedies.

  • An interesting article, but I do not understand Dr. Kulkarni’s classification of fever. When I looked at his breakdown of how the Covid-19 virus develops from day to day, I noticed that he classifies a body temperature of 36.5 degrees centigrade as a fever.

    I have never before seen such a low body temperature described as a fever – current thought describes a normal body temperature to be 37 degrees centigrade.
    So if someone develops a temperature of 39 degrees centigrade, for example, are we to classify this as dangerously high?
    No wonder analgaesics are being over-used to suppress fever.
    The homeopathic community, at the very least, should support the healthy expression of the immune system when it runs a fever, and not contribute to erroneous beliefs capable of increasing panic.

  • Overall, this the most thorough and well-reasoned article I have read on this virus. However, the editor in me was puzzled by these lines in the section on the “Day-by- Day Progression of Covid 19”: “Fever 36.5 degree centigrade” “Increase in fever, 37 degree centigrade.” Although I live in a Fahrenheit part of the world, this doesn’t make sense to me. In Fahrenheit this is 97 degrees and 98.6 degrees, respectively, both reasonably normal temperatures. Am I missing something?

  • It is regretful that the homeopaths and for that matter allopaths and administrators are focusing on treatment. The primary step in an epidemic or pandemic is prevention. Treatment must be secondary . This is not like just other diseases as it is rapidly spreading, The plus point is that the virus is short living and it cannot withstand heat and humidity. That may be the reason it is more severe in temperate climate countries and region (only an assumption)
    Nobody is seen to thinking of slumps in Bombay and many other cities, where the close contact and the present hygiene measures suggested are highly impractical, and if the disease spreads there it will be a major catastrophe for our nation. The present control measures has developed a situation of panic and stress in people and this itself will cause hormonal imbalance and reduce the immunity they are already having.
    Having said few things I may repeat that the present stress should be on prevention. Just like we are handling accidents, though we are treating the victims in so many sophisticated ways ,but the government is stressing to prevent the accidents. Every epidemic the approach should be like that. The Govt. Is sincerely and seriously trying to do that, but is fragmental and the result will never be as expected. The professional are not doing their responsibility especially the Homeopaths. The only system of medicine that can act fast and economically in such pandemic situation is HOMEOPATHY. I am not a homeopath, but a veterinarian having experience of more than 50 years in managing animals with homeopathy whenever modern medicine is found to be helpless as it is seen now. I do not understand why we depend so much on modern medicine which they themselves say they do not have immediate solution and they may develop vaccine/drugs in one or two years. By this time the disease may do all the harm that can be done. Still the silver line is that the present virus just many other pandemics of virus origin is short lived and will be fade way within 2 months or so.
    The most discouraging thing that the homeopaths (they may be good practitioners/experts/teachers) are seen to be pessimists and not having any practical solid approach to suggest or are not interested thinking that it is not their work. In spite of having so many Associations in this field they are just watching the show, few are publishing articles if you go through it a common man will reach a conclusion that homeopathy is of not much help. The pity is many such remarks from experienced people, which has to be presumed as they are more experienced in clinical individual case than handling epidemics. But our master has not advised like that. Please do excuse me for these suggestions and consider it as something from an unqualified person and ignore. But it is very discouraging as I was having an experience of more than 50 years in homeopathy, especially with the active support of many Homeopaths and developed good faith in this science.
    Considering these facts, I may be permitted to suggest that
    1. The Homeopaths who have faith in the system should come forward to popularize this system,. Just as the common saying “Make Hay while Sun Shines” You may not get a better opportunity than this to prove your stuff. Make use of it.
    2 .Do away with the negative approach–decide that you can find a solution for prevention. As homeopathy has got a vast latitude. Forget about the pneumonia or other complications which comes in the advanced cases. Focus on the early most common symptoms, the possible miasms, constititution ,the environment influence (as this virus is very sensitive to heat and humidity)
    3. Forget your ego, forget your fragmentalism among yourself fot the cause of public and homeopathy.
    4. The CCH/CCRH are both respected institution of homeopathy their suggestion has to be taken seriously and if you find any valid reason to object inform them and request to revise.
    5 .The Govt, for that ministry of AYUSH can only depend on them and if homeopaths are supporting ,what will be the future of homeopathy. I am mentioning this particularly because the ministry of AYUSH more or less becoming Ayurveda. It is not the fault of Ayurveda ,but the inactiveness or lack of confidence of homeopath. Ayurveda and many other complementary systems are good and every system has got its own merits and limitations but in an epidemic there would not have fast action..
    6. In all states the homeopaths should take up the issue as an urgent issue, and request the respective Governments to incorporate them at least in the prevention aspect, where modern medicine failed miserably. Treatment comes only later.
    7. The association should designate few homeopaths that have experience and have a will to work and request the Govt. to visit the isolation and quarantine stations and suggest treatment.
    8. Few years back the Government has suggested (DEC) and Albandazole to control Filariasis as single dose , the result of which I do not know. Whatever it may be it is a guidance that administration of the remedies as suggested by CCH?CCRH may be supplied to all individuals through out India, the cost is very limited. Monthly 3 days for 1 or 2 months in empty stomach by all classes of people from infant to old is not all an herculean task. (The method of distribution should be worked out)
    9. Arrangements for availability and quality of remedy has to be find out by the Homeopaths as this is a situation where the scope of homeopathy will be recognized.
    10. Let India shall be the first to incorporate the alternative system for the control of pandemics.
    11. Let this be the beginning of a strong Homeopathic association at national level just like IMA
    Excuse me for being the comment a lengthy one. Especially when it comes from a non homeopath.
    Dr Ramankutty.P
    Joint Director(AH) RETD. Kerala, Patron CHARIFABLE SOCIETY FOR HOLISTIC VETERINARY MEDICINE
    PH: 09447062736— E mail: [email protected]

  • Reply from Dr Ajit Kulkarni
    The issues raised by Liz Brynin and Tim Owens are genuine. The day-bay-day progress should be read as follows.
    DAY-BY-DAY PROGRESSION OF COVID-19 (from symptomatic point of view)
    Day 1-3
    • Cold and flu like symptoms
    • Feverishness
    • Mild or no throat pain
    Day 4
    • Increased throat pain
    • Sore voice
    • Fever more than 37 degree centigrade
    • Mild headache and diarrhoea or cramps
    Day 5
    • Throat pain very severe, worse eating or drinking
    • Fever persistent around 38 degree centigrade
    • Soreness of voice increases
    • Dry cough
    • Joint pains worse motion
    • Weakness
    Day 6
    • Increase in fever, 38 or more degree centigrade
    • All above symptoms increase in intensity
    • Nausea, vomiting and diarrhoea increase
    • Starts feeling shortness of breath in a mild way
    • Bodyache or pain from joints extend to fingers
    • Increase in weakness
    Day 7
    • Intensity of fever increases 39 or more degree centigrade
    • Excessive coughing with sputum
    • All above symptoms worsen
    Day 8
    • Cough worsens, usually dry
    • Severe difficulty in breathing
    • Heaviness and pain in chest
    • All above symptoms further worsen
    • Toxic appearance of the patient
    • Fever, intense, 39 or above degree centigrade
    Day 9
    • All the symptoms become very worse
    • Cyanosis
    • Kidney failure
    • Respiratory failure
    • Multi-organ failure

    About other issues mentioned, my views are as follows.
    I know that any body temperature above the normal temperature of 98.6 F or 37 C is considered as fever. Medically, a person is not considered to have a significant fever until the temperature is above 100.4 F or 38.0 C.
    To corroborate the views of Liz Brynin about healthy expression of fever, I give my notes.
    The notion of fever as beneficial persist since thousands of years, and countless patients were treated with ”fever therapy” to aid recovery from syphilis, tuberculosis, mania and even cancers.
    In the mid-1800’s, aspirin & other antipyretic drugs became commercially available and the medical view of fever changed drastically.
    The new findings raise serious questions about the wisdom of taking antipyretics for fevers below 104 degrees i.e. below 40-degree C.
    Pediatricians suggest that moderate fevers be allowed to run their course, for they may shorten the illness and reduce the chances of spreading the infection to others.
    Fever increases the phagocytic and bactericidal activity of neutrophils and the cytotoxic effects of lymphocytes. Fever mobilizes the body’s immunological defenses against infectious organisms and directly inhibits their growth.
    To promote and accelerate the inflammatory response, fever is the body’s first-line defense against infection.
    Immunologically active cells called T-cells are stimulated by fever, and they in turn prompt a direct attack on invaders and provoke the development of antibodies to the foreign organisms.
    Fever combats viral infections by triggering production of the virus-fighting substance ‘interferon’ by infected cells.
    The study showed that those given aspirin, which reduces fever, release significantly more viruses from their noses and throats than those given a placebo.
    To wind up this answer, I quote Thomas Sydenham, the 17th-century English physician, ”Fever is Nature’s engine which she brings into the field to remove her enemy.”

    QUESTION
    Question From Prasad
    What are the contraindications for Genus Epidemicus?

    Dr. Kulkarni’s Answer
    The first thing very important is that GE is not to be given to everyone. I have already given my guidelines when it should be distributed. There are stages and they will guide us when to give.
    There are some contradictions. First contradiction is cases of advanced pathological types where the immunity of the patient is low and GE doesn’t fit in well with the existing similarity. GE in such cases may stir up the vitality and the system may not have the capacity to withstand the medicinal stimulus. The other contradiction is that once the patient has developed the disease Covid-19, no more doses of GE are needed. Now you have to work according to the presenting totality. If at all, GE matches the presenting totality well, you can give it; if other remedy matches well, give that remedy. It is better not to harbour the idea that GE will prevent and cure every case in all stages from prevention to cure.

    QuESTION from From Slava
    Big thank you for your videos and article about Covid-19. Me and my colleagues are studying them with great interest for the last few days. It is very important to get your answer for a few questions. The first is about homeopathic prophylaxis. It is about the choice of the remedy and potency. According to the emotional state of the people, Ars Alb seems more fitting to me.
    We have Influenzinum and Covid-19 (1M only), which are closer to the cause of the disease. I think Covi-19 nosode is more preferable because it is made from the virus that is causing the disease. But the doctor that brought this remedy to Moscow said that it is made from the coronaviruse from previous years. I thought about Ars Alb and then, after a few days, Covi-19. What do you think about it? Also picking potency and frequency for Ars Alb is problematic to me.
    Second question is about your description of pulse in Materia Medica. You use the word ‘Sloggy’. I’ve translated it as «stagnant, dull». Is it the right meaning of the word?
    What do you think about giving the patient Ars Alb and then, after a few days, the nosode?

    Dr. Kulkarni’s Answer
    Arsenic album fits in not only because it covers the emotional state but also the criteria for the selection of GE. I have already given my posology criteria from infants to old people.
    In the current juncture, we require Covid-19 virus nosode from the current strain. We should prepare it from 1. Isolating the virus and prepare the potencies from it. However, it is very difficult but in view of huge economical loss, Govt. must do it. 2. Take the throat swab from a positive corona patient and prepare the potencies. The second preparation is in line with all previous nosode preparations like Psorinum, Tuberculinum, Hippozaeninum etc. It at all we don’t get even the latter way prepared nosode, we must use the coronavirus nosode prepared from the previous year. I am not in favour of Influenzinum.
    It is not sloggy pulse but soggy and the meaning is soft pulse.
    See, there are many options. But we have to define the necessity. Arsenic album is enough in first and second phase, but in third phase onwards, the schedule of Arsenic album followed by Covid-19 nosode may be applied. We should be open. The situation is unprecedented, unpredictable and changeful at present. Tuberculinum may also come after Arsenic album or Covid-19 nosode.

  • DEAR DR.
    THE TALK ON CV IS EXTENSIVE AND NOT INTENSIVE.THE GE ARS ALB POINTED BY CCH IS A ROUTINE REMEDY FOR FLU. IT DOES NOT COVER THE SEVERITY OF CHOKING RESPIRATORY SYSTEM AND SUPPLY OF OXYGEN TO HEART ETC ETC. TO THIS GE CARBOLIC ACID HAS BEEN ADDED. IN SHORT A NOS ODE FROM CV HAS TO BE MADE.. THE FACT IS THAT CV VICTIMS GO TO ALLOPETHIC HOSPITALS AND NOT TO HOMEOPATHIC HOSPITALS, WHICH ARE VERY FEW AND NOT CONSIDERED FIT FOR EMERGENCY CASES. UNLESS THE HOMEOPATHS TREAT A FEW CASES OF CV THEMSELVES , THEY ARE NOT ABLE TO EXPERIENCE THE EXACT PROBLEM FACED BY VICTIMS OF SUFFERING CV.THE THEORETICAL KNOWLEDGE IS NOT SUFFICIENT TO FIND OR MAKE TRUE GE FOR THIS VIRUS
    REGARDS
    C S GUPTA

    • Reply from Dr. Ajit Kulkarni
      I will earnestly wait for “intensive” study of CV from Dr. C. S. Gupta.
      The Law of Similars propounds that when Pulsatilla is indicated, give Pulsatilla. When Arsenic album is indicated, give Arsenic album. Can Arsenic album should be discarded because it is a routinely prescribed remedy? Will Dr. C.S. Gupta be happy if a rare Bird remedy or a Lac remedy is selected? If Dr. Gupta offers his “intensive” study of a rare remedy as GE, I will sincerely read it.
      On which scientific grounds Dr. Gupta conclude that Arsenic album doesn’t cover the severity of Covid-19? Is the rubric, Clinical; asphyxia, death apparent, not enough to perceive the seriousness of Arsenic album?
      Being an international teacher, fortunately I have access to many homeopaths of different countries and they have helped me in providing the data base required for building up the totality. There are less patients in India but could this be a reason to be a silent spectator, just watch how the graph of Covid-19 patients ascend daily in terms of morbidity and mortality? And I am treating many cases and I am able to find the beneficial effect of homeopathic remedies selected according to the presenting totality.
      Regards,
      Ajit

  • Thanks for giving nice information regarding different stages of COVID 19 and it’s homeopathic management, HP, HV, GE etc. it will help the practising Homeopathic physicians for prescriptions to help human mankind in this critical situation..

  • As usual ur boring and giving answers already given by others. No new answers. Rubric selected are disease rubric no any individualized. Taken all ars alb. Symptoms. Selection of rubric gives example of your knowledge of homoeopathy

    • THIS IS A SERIOUS DISEASE WHOLE WORLD IS FIGHTING with and not a matter or joke or a comedy show that it has to be some entertainment
      this article is written with so much hard work, if you have energy ,time and knowledge or some more super added knowledge god is giving you , pls share before commenting .
      And please tell me which book you will get the complete analysis of covid in such detail.
      we can not dance before you to satisfy your needs of boredom,

  • Excellent article. Thank you.

    I also came up with arsenicum based on a strange, rare and peculiar symptom I read that interviewed a hospital respiraratory therapist. He said all the patients on venitlators with Covid had pink, frothy sputum. He said this was a symptom he had never seen in any pneumonia patient before, but ALL of the Covid-19 patients had it. Arsenicum has the rubric of frothy sputum.

  • The symptoms Cough, sore throat, pneumonia, ( though not found in a single patient, constructing the totality by observing several patients is an accepted method in *epidemics* for finding the genus epidemicus).
    Then the most important symptom ” falling to the ground in a swoon” or suddenly falling dead observed in many covid19 victims, all these indicate a rare forgotten remedy “MERCURIOUS CYANATUS”.

    It had helped as an excellent prophylactic in the past against epidemic diphtheria and saved the lives of hundreds of children. This time as everyone can see, all the symptoms are there in the totality of Covid-19 constructed in the afore said fashion.
    Absence of some symptoms like epistaxis doesn’t rule out this remedy since that is a symptom belonging to the disease (diphtheria) and not to the patients in general. It is an accepted principle in remedy selection. Modalities may be missing because we have no means of ascertaining the same due to its unimportance for other mainstream systems treating the cases. But I am of the view that the striking symptoms heard & observable from various videos of the patients on social media, Youtube etc make good this lacuna.

    J H Clarke says in the Generalities section of this medicine: Great weakness; cannot stand up.─Repeated fainting.─Great debility during diarrhœa; at last he fell to the ground in a swoon.

    Boericke: Acute infections, pneumonia, nephritis. Its action is similar to that of the toxines of infections diseases. Great and rapid prostration.

    Henry C Allen: Great weakness; extreme prostration; cannot stand up from weakness. When it corresponds to the genus epidemicus, like every other remedy, is effective as a prophylactic.

    I recommend the 30th 3 globules three times for a single day and repeat after 10 or 15 days.

  • QUESTIONS-ANSWERS UPDATES FROM DR. AJIT KULKARNI

    QUESTIONS FROM DAVID, ANNA AND OTHERS
    One of my patients is suffering from heart disease and he is on daily doses of allopathic and homeopathic treatment. I have a very vulnerable and immuno-suppressed patient, a lady, following kidney transplant. What potency should be given as prophylactic?

    There are a lot of patients that are on daily doses of allopathic, homeopathic or both mixed treatment for their complaints like Parkinson’s disease, Multiple sclerosis, Diabetes, Cancer, heart disease etc. What is the possibility to use a prophylactic method for them?

    Should they use both remedies together- the chronic remedy – every day and the prophylactic daily or two times per week?

    What would you suggest for liver or kidney transplant patients?

    ANSWER FROM DR. AJIT KULKARNI

    We will first categorize the patients.
    1. Chronic patients on exclusive homeopathic treatment
    2. Chronic patients on exclusive allopathic treatment
    3. Chronic patients on mixed homeopathic and allopathic treatment
    4. Patients having transplantation of organs and are on anti-rejection medication
    5. Immuno-compromised patients who had been treated or are now on immune-suppressive agents such as steroids, methotrexate, cyclosporin, Interleukin inhibitors, selective immunosuppressants or TNF alfa inhibitors etc.

    In the first category, we have to define whether the patient is on constitutional/classical, palliative or organotrophic treatment. Actually, if the patient is already under a homeopathic constitutional remedy, he doesn’t need a prophylactic remedy. But it also depends upon stage II, III or IV, human density and if the patient is following strict ‘stay at home’.

    The second category of patients have to be defined. If they are on anti-diabetic or hypotensive drugs, they become vulnerable due both to the disease and drugs. It is better to give them Arsenic album.

    The same about the third category.

    The 4th and 5th category is of immune-compromised patients and it is better to define clearly their immune status and miasmatic activity. The general principle is that if the patient is in the vicinity of community infection with the pandemic, it is better to give Arsenic album. Don’t stop the patient’s regular treatment.

    Arsenic album 30 or 200 as a single dose or once every week can be given depending on the susceptibility and vitality. On the day of Arsenic album, no other homeopathic remedy should be taken by the patient. Otherwise, he can continue with allopathic, homeopathic or mixed treatment.

    9th April, 2020

    QUESTIONS FROM DR. SONIA AND DR. NEHA
    1. You have mentioned Tuberculinum to be given when a case jumps rapidly from mild to critical state. Why Tub? And will it not cause a bad aggravation? Also, you have mentioned Tub 1M for preventing relapse. The reasons? The immune response basically goes out of control. Out of control is the hallmark of syphilitic miasm. So why Tub, why not an anti-syphilitic?
    2. You have mentioned Merc-cyan preferable over Merc sol in throat complaints. Any specific reasons?
    3. You have mentioned Sulphur as an option for Genus E. But we need a remedy covering speed of destruction… does it qualify?
    4. What do you mean when you mention that Genus E must cover the pathogenesis of COVID 19 as a single spectrum?
    5. The symptomatology of COVID 19 is very scattered, with patients in India presenting with differing symptoms. Will Ars Alb as GE be able to help in all cases?
    6. What about pregnant women? How can we help them in this pandemic? Because I have 2 patients who are pregnant… one is in the first trimester, another in final.
    7. Kali-carb and Kali-iod have been mentioned in the pneumonia stage of the disease. However, Lycopodium, Hepar sulph can also be considered in hepatization stages.

    ANSWERS FROM DR AJIT KULKARNI

    QUESTION 1
    You have mentioned Tuberculinum to be given when a case jumps rapidly from mild to critical state… why Tub? And will it not cause a bad aggravation? Also, you have mentioned Tub 1M for preventing relapse… reasons? The immune response basically goes out of control. Out of control is the hallmark of syphilitic miasm. So why Tub, why not an anti-syphilitic?

    ANSWER 1

    The role of Tuberculinum
    In the evolutionary march of the disease, it is not mandatory for the disease process to pass through the miasmatic activity from psora  sycosis  tubercle  syphilis in a rigid chronological way. The pace at which the disease process unfolds itself is dependent on the blend of disease potential and host response. Hence, it is possible that the disease may take its heavy toll by not following the intermingling stage(s). This is the reason why old patients, patients with diabetes, hypertension, immune-compromised types etc. land in pneumonitis, CNS and CVS problems and multi-organ failure in a relentless way.

    EXPRESSIONS OF TUBERCULAR MIASM
    CHARACTERS
    Basic
    • Unpredictable
    • Oscillations. Changeability. Erratic
    • Poor tolerance
    • Erraticism
    • Shortened sycotic phase
    • Debility
    • System becoming a prey
    • Forced mobilization of immune forces and poverty of controls
    Patterns and pathology
    • Pattern of response: Sudden, rapidly spreading pathologies. Slow, then rapid
    • Suppuration
    • Ulceration
    • Repair through fibrosis
    • Hemorrhage
    • Erratic febrile states
    Affinity
    • Blood
    • Lungs
    • Brain
    • Metabolism

    Tuberculinum (Bovinum Kent) is a classic representative of tubercular miasm. It exhibits the characters of the tubercular miasm in a remarkable way. In addition to the characters written above under Tuberculinum, the following characters are noteworthy.
    • Tuberculinum is prepared from the pus (with bacilli) from tubercular abscess. Hence, it covers sepsis and septic shock (which is the chief cause of death in Covid-19).
    • Grave troubles from slight causes i.e. simple cold can cause havoc in the system.
    • Symptoms constantly recurring or relapsing, but every time appearing with a new set of them (different in character and/ or location).
    • Obscure, changeful indications.
    • Rapid breakdown.
    • Erratic, unpredictable development of symptoms.
    • Symptoms appear and disappear suddenly.
    • Rapid and pronounced development of pathology.
    • Martyrs to respiratory catarrhs.
    • Hypersensitivity (which is the host response to develop severe to critical stage in Covid-19).
    • Myocarditis in Covid-19.
    • Necrosis, gliosis, fibrosis, degeneration and destruction as the result of pathology.

    The above indications are sufficient to perceive the role of Tuberculinum.
    The issue of killer aggravation is related to subjectivity of the physician; it has posteriori thinking and hence it has no universal satisfying answer.

    The question of “out of control” is applicable not only to the syphilitic miasm but also to the tubercular miasm. It is the sudden, rapid and progressive pattern in tubercular miasm that makes the system difficult to manage.

    Hence, many pathologies get overlapped in both miasms. Pathologies are of three types: Reversible, Borderline and Irreversible. Tubercular pathologies fall within the category of borderline  irreversible while syphilitic ones are mostly irreversible; in other words, impossible to manage from curative standpoint.

    You see, every nosode is a multi-polychrest remedy and is a blend of the disease-potential and the host-response; hence, it represents the dynamic potential of the germ / host inter-action to become the powerful and complex healing force to meet the inveterate morbific conditions. Every nosode is multi-miasmatic and Tuberculinum also covers syphilitic miasm.

    QUESTION 2

    You have mentioned Merc-cyan preferable over Merc sol in throat complaints. Any specific reasons?

    ANSWER 2

    The role of Mercurius cyanatus
    First see this report, “Sars-CoV-2. The virus that causes Covid-19 replicates in the upper respiratory tract before moving down to infect the lungs, which leads to people shedding huge amounts of the virus through coughing in the first week of symptoms (peak at 7.11 × 108 RNA copies per throat swab), according to a study published in the journal Nature on April 1”.

    “Sars-CoV-2 takes up residence in the throat cells first and from that person’s throat… it can readily spread to others”, Peter Kolchinsky, a virologist. The throat is an important organ, hence next to lungs in Covid-19. We have to contain the virus replication here by giving the right remedy.

    Mercuric cyanide poisoning
    Symptoms of both cyanide and mercury intoxication can occur. Acute poisoning: symptoms include tightness and pain in chest, coughing, and difficulty in breathing; cyanide poisoning can cause anxiety, confusion, dizziness, and shortness of breath, with possible unconsciousness, convulsions, and paralysis. Ingestion causes necrosis, pain, vomiting, and severe purging, plus the above symptoms.

    Cyanide poisoning
    • Cyanide prevents the cells of the body from using oxygen. When this happens, the cells die.
    • Cyanide is more harmful to the heart and brain than to other organs because the heart and brain use a lot of oxygen.

    Immediate signs and symptoms of exposure to cyanide
    • Dizziness
    • Headache
    • Nausea and vomiting
    • Rapid breathing
    • Rapid heart rate
    • Restlessness
    • Weakness
    Exposure to a large amount of cyanide by any route may cause these other health effects as well:
    • Convulsions
    • Loss of consciousness
    • Low blood pressure
    • Lung injury
    • Respiratory failure leading to death
    • Slow heart rate
    See that many poisoning symptoms match with COVOD-19 patients.
    Some differences between Merc sol and Merc Cyan

    Both affect the throat but Merc sol has burning as from hot vapour while Merc cyan has cutting pains; sensation as if something hanging in throat in Merc sol; in Merc-cyan, it is rawness and soreness.

    The mucous membrane is broken down and ulcerated and with a thick and greyish membrane with intense redness of fauces in Merc-cyan, while in Merc sol, there is bluish red swelling with a sensation as if a burnt spot in pharynx.

    Two major points why I prefer Merc-cyan to Merc sol is 1. the necrotic destruction of soft parts of palate and fauces and necrosis is the major pathology of Covid-19 and 2. The appearance of honeycomb in throat that resembles the same appearance in pneumonia in covid-19.

    QUESTION 3
    You have mentioned Sulphur as an option for GE. But we need a remedy covering speed of destruction… does it qualify?

    ANSWER 3

    The question is related to speed of action of Sulphur.
    The following rubrics justify that the action of Sulphur is rapid.
    • Mind; sudden manifestations
    • Generalities; sudden manifestations
    • Generalities; weakness; sudden, paroxysmal
    • Generalities; strength; decreased, diminished; sudden
    • Generalities; progressive diseases
    • Generalities; violent complaints

    Moreover, Sulphur is more tubercular than psoric. Emaciation, in spite of voracious appetite, lean thin constitution, suppurative tendency, glandular affections, tubercular diathesis, spells of weakness, epilepsy etc. typify the tubercular miasmatic activity of Sulphur.

    QUESTION 4
    What do you mean when you mention that GE must cover the pathogenesis of COVID 19 as a single spectrum?

    ANSWER 4

    Totality is one. It is the synthetic whole. It includes merging of cause and effect. There is no duality. It includes the phenomenon from the beginning to the end. In the evolution when the phenomenon is unfolding, it is one spectrum. Noting is fragmented. GE criteria must cover the evolution of the disease as one total unit. To exemplify, ARDS should not be separated from cold, fever and sore throat. The asymptomatic phase of the Covid-19 must become a part of GE and ground-glass opacities that get formed in the lungs must as well become a part of GE.

    QUESTION 5
    The symptomatology of COVID-19 is very scattered with patients in India itself presenting with differing symptoms… will Ars Alb as GE be able to help in all cases?

    ANSWER 5

    The symptomatology is not scattered; it is changing. The response of the human species as humans will use their immuno-modulatory defences, will definitely influence the Form, Function and Structure of Covid-19. Human susceptibility as a part of immunity and as a dynamic property will manifest its alteration. In view of the changing scenario, it is interesting if Arsenic album holds the status of GE.
    Please read my recent updates below to get more elaboration of your question.

    QUESTION 6

    What about pregnant women? How can we help them in this pandemic? Because I have 2 patients who are pregnant… one is in first trimester, another in final.

    ANSWER 6

    A pregnant woman can be affected by COVID-19. Whether a pregnant woman with COVID-19 can pass the virus to her foetus or baby during pregnancy or delivery is not yet clear. To date, the virus has not been found in samples of amniotic fluid or breastmilk. Remember that pregnancy is the most favourable period for the action of the homeopathic remedy. If the pregnant woman has some health issues, the best preventive remedy is the constitutional remedy. However, if she is in the susceptible area, Arsenic album 200c, a single dose is recommended.

    QUESTION 7
    Kali-carb and Kali-iod have been mentioned in the pneumonia stage of the disease. However, Lycopodium and Hepar sulph can also be considered in the hepatization stage.

    ANSWER 7

    There are 51 remedies listed in Complete Repertory against Chest; hepatization, lungs:

    acal ant-ar ANT-T ars bac bapt BROM BRY CACT CALC calc-i calc-s CAMPH CARB-AN carb-v CHEL crot-h ferr FERR-P GRIN HEP hippoz IOD KALI-C KALI-CHL KALI-I KALI-M kali-p LACH LOB LYC MERC MYRT-C NIT-AC NUX-V oena op PHOS plb podo rhus-t SANG sec SENEG sil SPONG stroph SULPH TER TUB zinc

    KALI-CARB covers pleuro-pneumonitis. When there is accumulation of pleural effusion, Kali-carb is a remedy of choice. Indications: Right sided; later stages; with cardiac exhaustion; with cyanosis. Heavy oppression, with hurried or impeded breathing.

    Indications of KALI-IODUM: Pneumonia with: Dilated pupils; catarrh, red face, blue lips and nails; hepatization; metastasis to brain; sepsis in lungs. Constant hacking cough. Exudative pleurisy. Pleuro-pneumonia. Choking spells. With albumin in urine. Severe dyspnoea; strangling or hyperventilating.

    Kali carb is more tubercular; Kali-iod more syphilitic. Kali-carb has more fluid accumulation; Kali-iod has more suppuration, ulceration and necrosis. Due to carbon ion, Kali iod is slower than Kali-iod; Kali-iod has potassium + strong halogen of Iodum which makes the process rapidly destructive.

    LYCOPODIUM: Delayed, unresolved, neglected, continued and typhoid pneumonia. Indications: With great dyspnea; diaphragmatic breathing; unable to lie on back, or affected side, flapping of alae nasi, half open eyes; mouth hangs open, pressure on chest. Loud mucous rales; accumulation of serum in pleura and pericardium, hepatization; old people with weak reaction and weakness of all the functions and who do not tend to convalescence.

    Children wither after pneumonia. Right foot cold, distended abdomen, red sand in urine, circumscribed red chest (left), threatened suppuration; tightness across chest, aching over lungs; deep seated pain or bronchial irritation, weak voice remaining. Lips cyanosed; dusky appearance. Latent pneumonia; slight fever, no pain, little cough, expectoration: salty, grey.

    Pleurisy: Left; intercurrent pleuritic attacks; continued stitches. Exudative, stitches in left chest (typhoid, chest cold or neglected, chronic pulmonary inflammation, pleurisy). Sputum copious and purulent.

    Comments
    Lycopodium has a prolonged sycotic phase followed by the syphilitic phase. The speed is, however, slow and it doesn’t match the sudden onset or rapid deterioration which we see in COVID-19. Lyc is indicated more for the later stage when they are tired and worried.

    HEPAR SULPHURICUM: Respiratory symptoms begin from exposure to cold.
    Dry hoarse; barking, rattling, croaking cough. Constant irritation and oppression of chest, becoming < by long continued and fatiguing coughing; finally gasping for breath.

    Dyspnoea; weakness of larynx and chest. Sudden attacks of suffocation; loud, whistling inspiration; face dark red; lips bluish; bends head back and gasps for breath; sputum frothy. Snoring, hoarse, whistling, and often so short and oppressed that he starts from sleep with violent, dry, hoarse cough, with retching; grasps at larynx in the greatest fear. Involuntary deep inspiration. Choking from mucus in larynx.

    Pneumonia of a septic type. Chronic pneumonia and profuse purulent sputum. Chocking, strangling, spasmodic cough; accompanied by acute dyspnoea. Fever swinging. Acute stabbing pains in chest. < from lying on affected side. Constantly cropping up position in pneumonia.

    Pleurisy, croupous exudation, with yellow or yellowish-brown tint in face, in scrofulous and lymphatic persons. Very ill. With hectic flush. Moist skin surface with sour-smelling sweat. Extreme sensitiveness to cold. Oversensitive. Deep split in the center of the lower lip. Tongue, sensitive. Complain of very hot, burning tongue or burning at tip of the tongue. With aphthous patches scattered about the mouth. Extreme weakness in the chest.

    Comments

    Miasmatically, one may feel that Hepar sulph is psoric and it is right to assume it in the initial phase when the mild to moderate form of Covid-19 but soon the system goes into the tubercular miasmatic phase. The lungs are filled with septic foci and there is constant chilliness and a very sick look of the patient. This phase is indicative of the severe phase and pre-clinical stage of Pyrogen and Carbolic acid where one gets the critical phase of Covid-19.

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