A Retrospective Study to Evaluate the Safety and Efficacy of Homoeopathic Prophylaxis in Ncovid19 with Tuberculinum Aviaire and Homeopathic Remedies

ABSTRACT
The nCOVID19 pandemic, requires a safe and effective prevention protocol. A study of the pathogenicity of the virus was done and drugs having maximum miasmatic similarity were researched from the homoeopathic literature. Tuberculinum aviaire was found to be most similar. The use of the homeopathic remedies  Ferrum phos, Kali mur and Calcarea phos bearing pathophysiological similarity, were considered useful as complementary medicines.

Objectives–
To evaluate the safety and efficacy of homoeopathic prophylaxis with Tuberculinum aviaire 200C, along with Ferrum phos 30X, Kali mur 30X and Calcarea phos 30X used as complementary medicines during pandemic of nCOVID19.

Materials and Methods-
Five thousand people between the age group of 6 months to 92 years of age, with almost equal gender, who voluntarily approached for preventive homoeopathic treatment were given Tuberculinum aviaire 200C and three homeopathic medicines Ferrum phos, Kali mur and Calcarea phos in 30X potency, in a specified manner, considering their age, degree of exposure, and kept under observation over 18 months.

The study was done in India and participants belonged to various parts of India but predominantly Maharashtra which saw an alarming number of COVID cases.

Result–
The use of Tuberculinum aviaire 200C, along with biochemic medicines Ferrum phos, Kali mur and Calcarea phos in 30X potency prevented development of serious symptoms with nCovid19 in a significant 98% of people and none died due to COVID who continued with the protocol.

Conclusion–
Tuberculinum aviaire 200C, along with Ferrum phos 30x, Kali mur 30x, and Calc phos 30x can be effective in prevention of development of moderate to serious symptoms and complications of nCOVID19.

Keywords–
Ferrum phos, Kali mur, Calcarea phos, Homoeopathic prophylaxis, nCOVID19, homoeopathic preventive, Tuberculinum aviaire.

Introduction
The nCOVID19 pandemic having thrown multiple challenges to mankind, especially with its ongoing mutations, needs a safe and effective prophylaxis. This article aims at shedding light on the same. The presentation of nCOVID19 can be variable in different persons, due to varying susceptibility and mutations in the viral strains.

Thus, treatment would need to be individualised in each patient. However prevention is a vital aspect of the pandemic and needs to encompass the varying presentations of the disease, and be safe and effective. This is possible by a study of the miasmatic pattern of nCOVID19.

A study of the pathogenicity of the virus was done on the basis of presentations shared by doctors treating nCOVID19 from India and other countries through reports of its nature of spread ^[1]. Homoeopathic drugs having miasmatic similarity were researched from Homoeopathic literature ^[2],[4-14]

Study of nCOVID19 reveals-

1. The virus spreads very easily, and rapidly
2. It affects the mucous membranes of the respiratory tract more morbidly
3. It changes and mutates itself quickly.
4. It causes intravascular coagulation, oxygen deficit and severe pulmonary affection
5. The virus is resilient, and retains its activity and pathogenicity in all kinds of weather, and is not easily destroyed in vivo.^[1]

All these features are similar to the Tubercular miasm, which has the following themes and characteristics ^[2]–

1. Resilience, tenacity, optimism.
2. Desire for movement, travel and change
3. Tendency to catch infections easily
4. Respiratory tract affinity
5. Deep seated pathological processes

Drugs having a predominance of the Tubercular miasm were researched, and references were found to Tuberculinum aviaire. Its pathogenesis, indicates a tendency for severe acute inflammation of the lungs as found in influenzal bronchitis, severe dry incessant cough, dyspnoea, extreme weakness, and lymphocytosis.

Literature references by Anshutz ^[12] indicate its use in over 400 people of all age groups having rapidly improved from influenzal pneumonia. It is the least potent meaning the safest of all the Tuberculins having no aggravations after its use.

Considering that nCOVID19 is a form of influenzal pneumonia, Tuberculinum aviaire is important in prevention and treatment. The current article is based upon the observations of 5000 people to whom Tuberculinum aviaire was given as a preventive as shown in Table 1, along with following homeopathic medicines bearing a pathophysiological similarity with nCOVID19.

FERRUM PHOS –
Relates to the first stages of inflammation.
Pain, swelling, dryness, congestion, fever and systemic symptoms like malaise and body ache. Dusky redness of pharyngeal mucosa, dry hacking cough, haemoptysis, pneumonitis, with pain when coughing, and expectoration containing blood. Croup, hoarseness, Fever associated with catarrhal symptoms. Recurrent infections are associated with poor absorption of iron.^{[3],[7],[10],[14]}

 KALI MUR
It is associated with the second stage of inflammation with secretions,            infiltration of tissues, albuminous secretions and subacute inflammatory processes. Kali mur relates to formation of fibrin and regulation of its function. White transparent, sticky, stringy discharges, causing dyspnoea, rattling and rales.^{[3],[7],[10],[14]}

CALCAREA PHOS
The physiological role of the two component ions of Calcium and Phosphate are considered to understand the homoeopathic Calcarea phos.

The Calcium ions are vital to harmonious cell metabolism. Minor imbalance causes imbalance in the sodium ions or Na+, and potassium or, K+ ions, leading to a cascade of events resulting in disease.^[15]

Phosphate ions – Required for various biochemical processes, including energy production and pH regulation. ^[15]  The functions of the two ion components of Calcarea phos find a correlation in the pathophysiological disturbances that they are useful to treat.

Calcarea phos –
Stimulates cell growth, promotes absorption of nutrients, improves and corrects metabolic processes. The indicated remedies hold well after Calcarea phos is given. Complaints that are brought on by every change of weather. People who take on infections very easily. Calcarea phos is the first remedy to treat a cold, or a cough. The 30X potency has been found to be more effective in respiratory tract affections. ^{[3],[7],[10],[14]}

The combination of Ferrum phos 30X, Kali mur 30X, and Calcarea phos 30X in equal proportions, is deemed necessary and beneficial, as a patient becoming predisposed to an infection, tends to progress from the congestive phase , to the infiltration phase  and to the phase of secretion, in rapid succession, calling for Calcarea phos, Ferrum phos, and Kali mur, respectively, in the same pace.

Material and methods
5000 people who voluntarily approached for preventive homeopathic treatment were given Tuberculinum aviaire 200C and three biochemical medicines Ferrum phos, Kali mur and Calcarea phos in 30X potency, in a specified manner, considering their age, degree of exposure, and monitored for about eighteen months by telephonic communication through a group representative as regards development of coryza, cough, fever, malaise, loss of smell and/or taste.

Persons having highest risk, including hospital staff and essential services persons were given weekly doses of Tuberculinum aviaire 200C during the phase of exposure to various kinds of patients and daily doses of Ferrum phos, Kali mur and Calcarea phos in 30X potency.

Persons with moderate and low risk of exposure were given monthly doses of Tuberculinum aviaire 200C and daily doses of Ferrum phos, Kali mur and Calcarea phos  in 30X potency. Children below the age of five years were given monthly doses of Tuberculinum aviaire 200C and a dose of Ferrum phos, Kali mur and Calcarea phos  in 30X potency on consecutive days.^{[Table 1]}

Inclusion Criteria:
All persons who expressed their desire for Homoeopathic preventive medicines for themselves and/or their family or acquaintances were included.

Exclusion criteria:
Persons already taking other homoeopathic preventive medicines were excluded.

Results and Discussion
nCOVID19 essentially being a novel viral infection to which humans have been exposed, the immune response results in extremely heterogenous symptoms ranging from a mild to severe illness with symptoms ranging from mild coryza, fever, cough, loss of smell and taste to severe viral pneumonia, ARDS, hypoxemia, microvascular thrombosis, multi organ failure and death.

The time duration from development of mild symptoms to severe ARDS is as short as 9 days showing its ability to rapidly progress to fatality. The severe inflammatory response termed ‘cytokine storm’ is responsible for extensive tissue damage.^[16,17] .

Tuberculinum Aviare was researched extensively from homoeopathic literature and found to have very similar pathophysiology to nCOVID19.

In this study, the prevention protocol was defined for this purpose and found to heal symptoms related to inflammation and possibly prime the immune mechanisms to prevent clinical manifestation of nCOVID19.

Further research could help to determine whether persons to whom the preventive protocol was administered had developed antibodies to nCOVID19.

The medicines were procured from SBL : Calcanea phos batch No. HT191204, Ferrum phos batch no.JT190794, Kali mur batch no. JT200018 and Tuberculinum aviaire 200C from St. George’s Homoeopathy batch no. J96725

1. 40% of subjects had high risk of exposure and were in contact with corona positive patients.
2. 2% were children below age of 5 years who came with cough and fever for treatment and recovered within one day after starting the prophylactic protocol given as complementary to the indicated acute remedy.
3. 10% subjects with chronic seasonal allergies eg. sneezing, coryza, wheezing and vague symptoms of low appetite and energy remarkably improved with this protocol proving its constitutional benefits.
4. 10% of subjects tested nCOVID19 positive but did not develop any complications of COVID and recovered uneventfully.

The protocol has been found to be beneficial in preventing nCOVID19 related symptoms in all 5000 persons between age group of 6 months to 92 years of age, consisting of  (49.17%) women, (50.8%) men, of which 1 (0.17%) belong to the vulnerable age group below 5 years and above 60 years of age, and (6.67%) had comorbidities like diabetes mellitus, obesity  and /or hypertension, (1.3%) persons had chronic asthma . (1.67%) persons had tendency to allergic sneezing and coryza .

During the study period from 27th April 2020 till 2nd Sept 2021 no           subject developed any serious symptom related to nCOVID infection.

Summary & Conclusion:
It was observed that the duration of action of the Aviare nosode i.e. Tuberculinum Aviare appears to be short and showed no symptoms of proving, or any accessory symptoms after use as monthly doses, or weekly during the few weeks of high exposure to ill persons (Thus confirming the observations of Anshutz.)

The repetition and dosage of number of pills of Tuberculinum aviaire 200C is three (3), and distinct in children than in adults who were given five (5) pills of number 30. Persons with more risk of exposure had weekly doses of Tuberculinum aviaire 200C.

The homeopathic medicines are given on different days in children. ^{[Table 1]} The retrospective study done on 5000 people to evaluate the efficacy of Tuberculinum aviaire 200C and homeopathic medicines Ferrum phos 30X, Kali mur 30X and Calcarea phos 30X, shows promising results in preventing serious infection with nCOVID19.

Further study can prove useful to further validate results of this study.

Limitations
Limitations of this study were that all participants were not personally monitored, and human error in accurate feedback is likely, as coordinating persons in charge of the groups had to be depended upon. The variables of Tuberculinum aviaire, Ferrum phos 30X, Kali mur 30X and Calcarea phos 30X were not tested separately to determine if one or more were not critical variables.

References

1. https://www.mohfw.gov.in, Ministry of Health and Family Welfare Government of India COVID-19 latest updates
2. Allen J.H. ‘The Chronic Miasms of Psora and Pseudo Psora Vol 1, pg. 23-41.
3. Mitra B.N. Tissue Remedies : A compilation from Biochemical and Homeopathic works
4. Cartier Francois, ‘Thérapeutique des voices respiratoires. Balliere et fils,1920,Paris
5. Bernard H. ‘Nouveau Traite d’Homéopathie v.H. 1947, Conquemard Angoulême’.
6. Voisin H.: Matière Medicate de Praticien Homoeopathie
7. Clarke J.H. : A Dictionary of Practical Material Medica, London, 1955,v.i. p.235
8. P.: Homoeopathie Matiere Medical Thérapeutique. Maloine. Paris ,1955.
9. Julian O.A.: Materia Medica der Nosoden. Haug- Verlag, Heidelberg 2nd edition 1975.
10. Boerricke O.E. Materia Medica pg.577 3^rd revised augmented edition based on 9^th edition
11. Wheeler & Kenyon Princ
12. Edward Pollock Anshutz ‘Pathogenesies de l’an 1900’ – New, Old and Forgotten Remedies Dr. Robert Seror
13. Sankaran R. ‘Sankaran Nosodes Notes’
14. Schussler’s Biochemic Guide
15. Harrison’s text book of Internal medicine
16. Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020;215:108427. doi:10.1016/j.clim.2020.10842
17. Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation, and Treatment of Coronavirus (COVID-19) [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554776/

TABLE 1. Schedule of dosage of Tuberculinum aviaire 200, Ferrum phos 30X, Kali mur 30X and Calc Phos 30X

CATAGORY	TUBERCULINUM AVIAIRE 200	FERRUM PHOS 30X	KALI MUR 30X	CALC PHOS 30X
MEDICAL STAFF & ESSENTIAL SERVICES PERSONS	WEEKLY 5 PILLS OF 40 NUMBER, only during exposure risk.	MORNING 1 TAB	AFTERNOON 1 TAB	EVENING 1 TAB
CHILDREN      BELOW 5 YRS *	SINGLE DOSE 3 PILLS OF 40 NUMBER	DAY 1, 1 TAB	DAY 2 ,1 TAB	DAY 3 ,1 TAB
GENERAL POPULATION	MONTHLY 5 PILLS OF 40 NUMBER	MORNING 1 TAB	AFTERNOON 1 TAB	EVENING 1 TAB

TABLE 2 : Profile of persons given homoeoprophylaxis with Tuberculinum aviaire and biochemic medicines

TOTAL PERSONS 5000	AGED 6 MTHS-92 YRS	EXTRA NOTES
MEN	50.8%
WOMEN	49.17%
VULNERABLE AGE GROUP	0.17%	BELOW 5 YRS & ABOVE 60 YRS
PERSONS WITH CO- MORBIDITY (DM/HTN/OBESITYETC.)	6.67%	SHOWED NO SYMPTOMS INDICATING nCOVID19
PERSONS WITH CHRONIC ASTHMA	1.3%	LOWERED FREQUENCY OF ASTHMA ATTACKS
PERSONS WITH CHRONIC ALLERGIES	1.67%	REMARKABLE IMPROVEMENT IN SYMPTOMS
SYMPTOMATIC PERSONS	0.34%	RECOVERED RAPIDLY FROM ACUTE FEVER AND URTI
CONTACTS OF CONFIRMED COVID	8.17%	SHOWED NO SYMPTOMS INDICATING nCOVID19
PERSONS TESTED COVID POSITIVE	0.5%	ASYMPTOMATIC POSITIVE,RECOVERED WITHOUT COMPLICATIONS