20/09/2025
Guidelines for homeopathic treatment in epidemic diseases
Hahnemann
As in the case of acute and chronic diseases, Hahnemann laid down individualizing semiotic and therapeutic guidelines to approach epidemic diseases. Just as each individual patients exhibit a set of characteristic signs and symptoms distinguishing each one from all other patients suffering from the same acute or chronic disease, each epidemic disease “is a phenomenon of unique character” that must be distinguished from previous outbreaks. With this warning Hahnemann criticized the application of information obtained in past outbreaks in future ones without a “careful examination of the pure picture of the prevailing disease”.
“In investigating the totality of the symptoms of epidemic and sporadic diseases it is quite immaterial whether or not something similar has ever appeared in the world before under the same or any other name. The novelty or peculiarity of a disease of that kind makes no difference either in the mode of examining or of treating it, as the physician must any way regard to pure picture of every prevailing disease as if it were something new and unknown, and investigate it thoroughly for itself, if he desire to practice medicine in a real and radical manner, never substituting conjecture for actual observation, never taking for granted that the case of disease before him is already wholly or partially known, but always carefully examining it in all its phases; and this mode of procedure is all the more requisite in such cases, as a careful examination will show that every prevailing disease is in many respects a phenomenon of a unique character, differing vastly from all previous epidemics [...]” (Organon of Medicine, §100) [3].
As in all collective diseases, the image of the pathological picture emerges after observing a considerable number of patients, Hahnemann suggests to observe several cases in order to paint “the full picture of the disease”, “totality of characteristic signs and symptoms” or “epidemic genius”, according to the homeopathic connotation of this term.
“It may easily happen that in the first case of an epidemic disease that presents itself to the physician's notice he does not at once obtain a knowledge of its complete picture, as it is only by a close observation of several cases of every such collective disease that he can become conversant with the totality of its signs and symptoms. The carefully observing physician can, however, from the examination of even the first and second patients, often arrive so nearly at a knowledge of the true state as to have in his mind a characteristic portrait of it, and even to succeed in finding a suitable, homoeopathically adapted remedy for it” (Organon of Medicine, §101) [3].
When searching for the epidemic genius – which will allow through similitude to identify the most suitable remedy among the proven substances – the “characteristic picture of the epidemic” will emerge from the totality of the most peculiar, rare and uncommon signs and symptoms. The thus individualized remedy can then be therapeutically prescribed to all patients affected in a same outbreak.
“In the course of writing down the symptoms of several cases of this kind the sketch of the disease picture becomes ever more and more complete, not more spun out and verbose, but more significant (more characteristic), and including more of the peculiarities of this collective disease; on the one hand, the general symptoms (e.g., loss of appetite, sleeplessness, etc.) become precisely defined as to their peculiarities; and on the other, the more marked and special symptoms which are peculiar to but few diseases and of rarer occurrence, at least in the same combination, become prominent and constitute what is characteristic of this malady. All those affected with the disease prevailing at a given time have certainly contracted it from one and the same source and hence are suffering from the same disease; but the whole extent of such an epidemic disease and the totality of its symptoms (the knowledge whereof, which is essential for enabling us to choose the most suitable homoeopathic remedy for this array of symptoms, is obtained by a complete survey of the morbid picture) cannot be learned from one single patient, but is only to be perfectly deduced (abstracted) and ascertained from the sufferings of several patients of different constitutions” (Organon of Medicine, §102) [3].
Reflecting on the nature and treatment of epidemics of intermittent fever, Hahnemann restates the need to individualize the “specific” homeopathic remedy for the ongoing clinical manifestation according to the “totality of symptoms common to all”. Keeping coherence in thought, Hahnemann emphasizes the epistemological premise of employing simple and single substances and avoiding complex means in the individualization of the homeopathic remedy.
“Epidemics of intermittent fever, in situations where none are endemic, are of the nature of chronic diseases, composed of single acute paroxysms; each single epidemic is of a peculiar, uniform character common to all the individuals attacked, and when this character is found in the totality of the symptoms common to all, it guides us to the discovery of the homoeopathic (specific) remedy suitable for all the cases, which is almost universally serviceable in those patients who enjoyed tolerable health before the occurrence of the epidemic, that is to say, who were not chronic sufferers from developed psora” (Organon of Medicine, §241) [3].
Besides indicating homeopathic remedies as therapeutic means in manifest cases of epidemic diseases, Hahnemann also points to the use of individualized homeopathy as prophylactic.
“A striking fact in corroboration of this is, that whilst previously to the year 1801, when the smooth scarlatina of Sydenham still occasionally prevailed epidemically among children, it attacked without exception all children who had escaped it in a former epidemic; in a similar epidemic which I witnessed in Konigslutter, on the contrary, all the children who took in time a very small dose of Belladonna remained unaffected by this highly infectious infantile disease. If medicines can protect from a disease that is raging around, they must possess a vastly superior power of affecting our vital force” (Organon of Medicine, note of §33) [3].
“Subsequently to the year 1801 a kind of pupura miliaris (roodvonk), which came from the West, was by physicians confounded with the scarlet fever, notwithstanding that they exhibited totally different symptoms, that the latter found its prophylatic and curative remedy in belladonna, the former in aconite, and that the former was generally merely sporadic, while the latter was invariable epidemic. Of late years it seems as if the two occasionally joined to form an eruptive fever of a peculiar kind, for which neither the one nor the other remedy, alone, will be found to be exactly homoeopathic” (Organon of Medicine, note of §73) [3].
Despite acknowledging the benefit of smallpox vaccination – introduced by Edward Jenner in 1796 after careful observation and description of a series of 27 immunized cases – Hahnemann criticizes the indiscriminate use of high dilutions of parts or sub products of a disease or pathogenic agent (nosodes or biotherapics) as prophylactic means or isopathic treatment (principle of identity: aequalia aequalibus curentur) without previous pathogenetic experimentation on healthy individuals and the application of individualizing symptomatic similitude.
“A third mode of employing medicines in diseases has been attempted to be created by means of Isopathy, as it is called - that is to say, a method of curing a given disease by the same contagious principle that produces it.[...] To attempt to cure by means of the very same morbific potency (per Idem) contradicts all normal human understanding and hence all experience. Those who first brought Isopathy to notice, probably thought of the benefit which mankind received from cowpox vaccination by which the vaccinated individual is protected against future cowpox infection and as it were cured in advance. But both, cowpox and smallpox are only similar, in no way the same disease. In many respects they differ, namely in the more rapid course and mildness of cowpox and especially in this, that is never contagious to man by more nearness. Universal vaccination put an end to all epidemics of that deadly fearful smallpox to such an extent that the present generation does no longer possess a clear conception of the former frightful smallpox plague. Moreover, in this way, undoubtedly, certain diseases peculiar to animals may give us remedies and thus happily enlarge our stock of homoeopathic remedies. But to use a human morbific matter (a Psorin taken from the itch in man) as a remedy for the same itch or for evils arisen therefrom is - ? Nothing can result from this but trouble and aggravation of the disease” (Organon of Medicine, note of §56) [3].
It must be reminded that for any substance (simple or complex) to be rated a homeopathic remedy and be able to be used therapeutically or preventively safely and efficaciously according to the principle of similitude it must be subjected to experimentation in human beings for pathogenetic symptoms to be disclosed and described. In this way, any animal product or sub product can be used homeopathically provided it had been subjected to previous pathogenetic experimentation and prescribed according to the similitude of characteristics symptoms.
Therefore, it is worth to emphasize that isopathic or isotherapic treatments or medicines (used according to the principle of identity, dismissing previous pathogenetic trials, analogously to modern vaccination and immunotherapy) do not belong with the epistemological framework of classical and hahnemannian homeopathy and cannot be rated “homeopathic”.
James Tyler Kent
Grounded on Hahnemann‟s premises, Kent described in the third lesson of his Lectures on Homoeopathic Philosophy a semiotic protocol to diagnose the group of medicines of the epidemic genius [26]. Here he proposes to carefully observe 20 patients affected by an epidemic disease recording all symptoms in a schematic way (repertory classification) that when addressed collectively “will present one image, as if one man had had expressed all the symptoms”. By placing before each symptom the number of patients exhibiting them, the homeopath will be able to “find out the essential features of the epidemic” (nature of the disease) through the common (pathognomonic symptoms) and characteristic (peculiar symptoms) symptomatic totalities. With the help of a homeopathic repertory, then he will select 6 or 7 medicines covering the symptomatic totality of the given epidemic (group of remedies of the epidemic genius) defining the individual picture of each remedy through the study of the homeopathic materia medica. Next, proceeding from the general to the particular – as “there is no other way to proceed in homeopathy” – he will adapt the characteristics of each patient to the particularities of each selected remedy (individualization), as even among members of a same family it will be seen “a little difference in each case”. In case none of the medicines is useful, “the physician must return to his original anamnesis to see which one of the other remedies is suitable”. Kent emphasizes that although the application of the epidemic genius in the choice of homeopathic remedies requires hard work it has spectacular results.
“[...] Every remedy has in itself a certain state of peculiarities that identifies it as an individual remedy, and the patient has also a certain state of peculiarities that identifies him as an individual patient, and so the remedy is fitted to the patient. No remedy must be given because it is in the list, for the list has only been made as a means of facilitating the study of that epidemic. Things can only be made easy by an immense amount of hard work, and if you do the drudgery in the beginning of an epidemic, the prescribing for your cases will be rapid, and you will find your remedies abort cases of sickness, make malignant cases simple, so simplify scarlet fever that classification would be impossible, stop the course of typhoids in a week, and cure remittent fevers in a day” (Lectures on Homoeopathic Philosophy, Lesson III) [26].
Evidences of the efficacy of homeopathy in epidemic diseases
There are several studies published in the literature on the use of homeopathic medicines in the treatment and prevention of epidemic diseases; most are reports of healed or immunized cases through the use of epidemic genius medicines [27-30].
In lesser writing “Some Kinds of Continued and Remittent Fevers” [31], published in 1798 in Hufelands Journal der practischen Arzneykunde, Hahnemann describes the use of Ignatia amara in the treatment of a continual and sporadic fever affecting children in January 1797, presenting the following characteristic symptoms: instead of heat on the skin, continual chills and great lassitude; the forehead is covered by cold perspiration; weakness of memory; excessively short and spasmodic breath. Two months later, a similar fever once again affected children but presented different characteristic symptoms: immobility of the pupils; pressing pain around the navel; stupor; decrease of strength; relief by perspiration, etc. This time the healing remedy was O***m. And still the next month, Camphora was the remedy used in an epidemic of influenza, which aggravated by the use of O***m due to a different set of peculiar symptoms. With these examples, Hahnemann highlights the importance of individualizing medicines according to the characteristic symptoms of each similar epidemic (or epidemic stage).
In another lesser writing, “Cure and Prevention of Scarlet Fever” [32], Hahnemann describes the use of Atropa belladona in the prevention and treatment of the initial stage of an epidemic in Königslutter in 1799; the remedy was chosen according to the epidemic genius of this stage of the disease; Hahnemann explains “a remedy that is capable of quickly checking a disease in its onset, must be its best preventive”. Here he also describes the use of O***m and Ipeca in the treatment of two conditions corresponding to the stage of full development of the disease, prescribed alone or in alternation, according to the state of each individual patient and the set of symptoms of each manifestation of disease: “For my own part, when summoned to cases of the fully developed disease (where there was no question of prevention or suppressing its commencement), I found I had to combat two different states of body that sometimes rapidly alternated with one another, each of which was composed of a convolute of symptoms”. He also mentions the use of Matricaria chamomilla for what he describes as “unhealthy skin” and the characteristic suffocating cough that may appear in the course of scarlet fever.
It is worth to emphasize that in the treatment of any epidemic, Hahnemann prescribed different remedies in an individualized way and in different moments, never mixing medicines in one and the same prescription (“homeopathic complexes”).
Other doctors reported high levels of protection following prescription of Belladona to children exposed to a similar epidemic in the 1820s: Dudgeon [28,29,33] tells that 10 conventional physicians employed it prophylactically in 1,646 children, and symptoms appeared only in 123 (7.5%) of them – an acknowledgeable high degree of protection in an epidemic that affected 90% of the exposed population at that time. A review of the prophylactic use of Belladona in scarlet fever published in Hufelands Journal in 1826 [34], made the Prussian government turn mandatory its use during an epidemic in 1838 [28,29,35]. These data show that contemporary conventional doctors used Belladona as “specific prophylatic” against scarlet fever without individualizing the characteristic symptoms of each outbreak, contrary to the indication of Hahnemann.
In “Cause and Prevention of the Asiatic Cholera” [36], Hahnemann describes the use of Camphora, Cuprum metallicum and Veratrum album as medicines homeopathic to the epidemic genius of each stage of the disease (prescribed in an individualized way, according to the similitude to the symptoms of each stage of the disease) for the prevention and treatment of a 1831 epidemic of Asiatic cholera in the German area. He would favor Cuprum as prophylactic, Camphora for the treatment of the initial stages, and Cuprum or Veratrum for the later stage (single or in alternation, as indicated by the symptoms). In a historical review [29], Shalts tells that during this epidemic (1831-32) mortality rate in European homeopathic hospitals was 7-10%, whereas with conventional treatment it varied between 40 and 80%.
After studying systematically the symptoms affecting patients during the cholera epidemic of 1846, Clemens von Bönninghausen [37] suggested lay practitioners to use Camphora as single epidemic genius remedy for the treatment of affected patients: “It is only the use of this remedy, which can and must be entrusted to the hands of a non-physicians”. According to Hoover [28] and Shepherd [38] the mortality rate during that epidemic was 5-16% among patients treated with homeopathy and 54-90% among patients treated conventionally. Homeopathy was also used in the 1854 epidemic in London [28,29,39-41] once again with significant reduction of mortality rates.
In Lesson XI of his Lectures, Kent describes the treatment of some cases of an epidemic of childhood diarrhea with Podophyllum 30c according to the similitude of pathogenetic symptoms and the epidemic genius, “the cures were almost instantaneous, it seemed as if there would be no more stool after the first dose of medicine”, despite he did not always use single doses [26].
Noticeably, a meta-analysis of 3 RCTs of homeopathy in epidemics of childhood diarrhea [20] showed that individualized homeopathic treatment was significantly more efficacy than placebo. Moreover, a RCT carried out by the same authors showed that non individualized homeopathic treatment (complex or association of 5 homeopathic medicines commonly used in the treatment of childhood diarrhea), dismissing the symptoms of the epidemic genius, showed no significant response when compared to placebo.
In a lesser writing “Treatment of the Typhus or Hospital Fever at Present Prevailing” [43], Hahnemann describes the use of Bryonia alba, Hyosciamus niger or Rhus toxicodendron as homeopathic medicines to the epidemic genius (prescribed single or in alternation according to the symptoms in each stage of the disease) in the treatment of an epidemic of typhus in 1813: “Of 183 cases treated by me in Leipzig not one died, which created a great sensation among the Russians, then ruling in Dresden, but was consigned to oblivion by the medical authorities” [44].
Also a severe epidemic of diphtheria was successfully treated with individualized homeopathy: records for 1862-64 at Broome County, NY [29] report 84% mortality rate for conventional treatment and 16% for homeopathy.
In 1918, at the beginning of the Spanish Flu pandemic that infected 20% of the world population and killed about 30 million people, homeopathic physicians met at the British Homeopathic Society of London to discuss possible medicines of the epidemic genius on the grounds on observations of series of cases and their characteristic symptoms. Discussions and conclusions were published in a contemporary scientific journal and recommended individualized treatment of epidemic foci in different areas and countries [45]. Several remedies were used in the treatment of this epidemic, including Arsenicum album, Bryonia alba, Baptisia tinctoria, Eupatorium perfoliatum, Gelsemium sempervirens, among others, according to the epidemic genius observed in the different stages of the disease, times and places [28,29,46]. In estimations published in the Journal of the American Institute of Homeopathy in 1921 [47], McCann tells that 26 thousand cases treated with homeopathy in Ohio presented 1% mortality rate against 28% in 24 thousand cases with conventional treatment. Similar rates were observed in Philadelphia by Pearson, regarding 26,795 cases treated with homeopathy.
A systematic review of 3 RCTs (n=2,265) on the use of Oscilococcinum (nosode prepared from autolysate of heart and liver of infected wild duck, a vector for aviary influenza virus) as “specific preventive” against flu-like syndromes and ignoring the requirement of similitude between pathogenetic and patients‟ symptoms, showed no significant effect when compared to placebo [48].
During an epidemic of conjunctivitis in Pittsburgh, PA [49] a RCT was carried out to assess the efficacy of Euphrasia officinalis 30cH, chosen on the grounds of the epidemic genius of earlier outbreaks on the prevention of disease, once again dismissing the symptomatic totality of the ongoing epidemic. Treatment group included 658 schoolchildren who took the homeopathic remedy during 3 consecutive days; control group was composed by 648 schoolchildren who took placebo with the same dosage system. There was no statistically significant difference in the incidence and severity of the disease between both groups.
In another epidemic of keratoconjunctivitis in Cuba in 1995 [50], 108 patients were distributed in a randomized design into homeopathic (n=48) and conventional (n=50) treatment, the former using Pulsatilla nigricans 6cH as homeopathic medicine to the epidemic genius of the ongoing outbreak. Homeopathic treatment was significantly more effective than the conventional one in eliciting improving of symptoms in less than 72 hours.
In 1830, Constantin Hering was seemingly the first to consider the use of diluted and agitated animal parts or products (nosodes or biotherapics) without previous pathogenetic experimentation or application of similitude of characteristic symptoms in the treatment and prevention of infectious diseases caused by the same etiologic agent (isopathy or isotherapy). However, as also other followers of Hahnemann (Timothy F. Allen, John H. Clarke, James T. Kent, etc.) who had also mentioned the possibility of using biotherapics as prophylactics, he never incorporated isopathy in his actual clinical practice [33].
The notion of universal and indiscriminate use of “isopathic” prophylaxis (that cannot be rated “homeopathic”) began to be spread out by Arthur Grimmer and Dorothy Shepherd [38]; there is a large number of diluted and agitated biotherapics prepared from parts of sub-products of disease or its etiologic agent and prescribed without taking into account the similitude of symptoms (pathogenetic experimentation), but they are commonly prescribed for the prevention of almost all endemic and epidemic current diseases (Table 1), with no scientific evidence whatsoever supporting their efficacy and safety in humans [28,51].
Besides the lack of controlled clinical studies confirming the efficacy and safety of so-called “dynamized isoprophylaxis” (mistakenly known as “homeoprophylaxis”), there are no experimental studies supporting the immunoprophylactic activity of this method, as e.g. production of antibodies against the disease. In spite of promoting global use of so-called dynamized isoprophylaxis, Golden reports rates of adverse effects higher than 10% in children subjected to this method – similar to those of conventional vaccination [28,53].
Reproducing the experimental study by Chavanon in 1932, Patterson and Boys [54] verified negativation of Schick‟s Test (immunologic shift in the production of antibodies against diphtheria) in 60% (20/33) children who took nosode Diphtherinum, whereas modern vaccination gives 95% protection rate [55].
In an experimental model, Jonas [56] tested the isoprophylactic action of a nosode for tularemia prepared from tissues infected by Franciscella tularensis, compared to conventional vaccination and placebo in rats (n=142) contaminated with the bacteria. Whereas conventional vaccination supplied 100% protection against death, the nosode gave only 22% when compared to placebo.
Controlled clinical trials in animals [57,58] could not confirm the efficacy of dynamized isoprophylaxis by comparison to placebo, strengthening the arguments against the validity of this approach in humans.
Marcus Zulian Teixeira
Homeopathy: a preventive approach to medicine?
Article in International Journal of High Dilution Research - ISSN 1982-6206 · December 2009
