Genus epidemicus  Dr SANOOP.K.K, B.H.M.S, M.s.c, ND,  DNHE       

Right from the beginning of humanity there were diseases. Historical literature shows that he has to suffer from numerous infectious diseases e.g. plague, malaria, small pox .Right from the beginning there have been attempt to prevent infectious disease particularly the epidemic. Examples corals was worn by infants to prevent colic, dried toad could be worn to ward of plague.

              With introduction of vaccination by jenner  concept of prevention of infectious diseases changed. Jenner developed vaccination theory in 1776 and he used cowpox vaccination in 1778. Hahnemann too was successful in preventing many infectious disease. Many of the infectious disease we see today was successfully managed by Homoeopathy. After Hahnemann successfully  treated many epidemic, he laid bases of epidemic which he published in organon in aphorism 100,101, 102, 103  which form the basis  of  genus epidmicus. Further reading of aphorism 241,242,243,244 also helps one to understand the concept of genus epidemicus.

Epidemic is widespread outbreak of a disease, or a large number of cases of a disease in a single community or relatively small area. The word epidemic is derived  from the Greek "epi-", "upon" + "demos", "people or population" = "epidemos" = "upon the population." . The occurrence of epidemic is within a particular geographical area or population  is usually  in excess of what is normally expected and is usually for a given period of time. Epidemics are commonly thought to involve outbreaks of acute infectious disease, such as measles, polio, or streptococcal sore throat. An Endemic is a disease that is constantly present to a greater or lesser degree in people of a certain class or in people living in a particular location;  A pandemic is an epidemic that is geographically widespread occurring throughout a region or even throughout the world.

Characteristics of  Epidemic

         e.g. chikungunya strikes in  kerala 2006(indian state)

      
             Genus epidemicus
 forms exact guidelines in preventing such an outbreak of epidemic or endemic related to specific area or pandemic which shows its presence throughout the world. Genus epidemicus, is  the process of collecting large number of symptoms of a particular epidemic from the infected populations irrespective of  the diagnosis of that epidemic, and applying the symptoms so collected in prevention of disease/prophylaxis and/or even in treatment of disease in that epidemic, is a unique homoeopathic approach . 

Homeopathy does not consider the diagnosis of some specific disease. When an out break of epidemic occur in specific area, the first thing homoeopathic doctors do is collect symptoms of the epidemic irrespective of the diagnosis or microscopic causative organs (bacteria, viruses) of the epidemic. This is because Homoeopathy is based on individualistic approach in treatment. Here the Homoeopath's consider not the disease  but an individual who is diseased. Homoeopathy holds that microscopic organ( virus, bacteria) is an ultimate result of a disease and not the disease. Homoeopathy  require complete collection of symptoms which include sensation (characteristics of each symptoms, e.g. stitching pain), modality (factors increase or decrease a symptoms e.g. exertion aggravates the pain), causation e.g, seasonal appearance of symptoms, exposure to cold and concomitant( A concomitant symptom rarely appears in connection with the main complaint or it can "belong to another sphere of disease than the chief ailment.) of each of the symptoms

practical application of genus epidemicus

practical of application of genus epidemicus is gernarally two steps

First step (COLLECTING SYMPTOMS)

Epidemic in new area, is first hardly noticed by anyone until large number of persons are having similar symptoms. So in the beginning it may be confusing. From the first few cases the physician has a very faint idea of this disease, for he sees only a bit of it, and gets only a portion of its symptoms. But the epidemic spreads and many patients are visited, and many individuals have perhaps been closely observed we get a better picture. Symptom records of each of the patient is preserved until many case records have been formed. Now  the physician will write down all the symptoms that have been present in each case in a schematic form, arranging the mind symptoms of the different patients under "mind" and the head symptoms under "head," and bowels under "rectum" so on and considered together will present one image, as if one man had expressed all the symptoms, and in this way he will have that particular disease in systematic form. Each of the symptoms must include sensation (characteristics of each symptoms, e.g. stitching pain), modality (factors increase or decrease a symptoms e.g. exertion aggravates the pain), causation e.g. seasonal appearance of symptoms, exposure to cold and concomitant( A concomitant symptom rarely appears in connection with the main complaint or it can "belong to another sphere of disease than the chief ailment.). If he places opposite each symptom a number corresponding to the number of patients in which that symptom occurred, he will find out the essential features of that epidemic. Now we can see many of the symptoms are common to almost all population in that epidemic. This is known as pathogonomic symptoms.

For example, twenty patients had aching in the bones, and at once he sees that that symptom is a part of this epidemic. All the patients had catarrhal affections of the eye, and a measly rash, and these also must be recorded as pathognomonic symptoms.

And so by taking the entire scheme and considering it as a whole, as if one patient had experienced all the symptoms, he is able to comprehend how this new disease, this contagious disease, affects the human race, and each particular patient, and he is able to form logic of  what is general and what is particular. Those symptoms that run through all are the pathognomonic symptoms ; those which are rare are the peculiarities of the different people. Each  new patient has a few new symptoms ; he has put his own cast on that disease. This totality represents to the human mind, as nearly as possible, the nature of this sickness, and it is this nature that the therapist must have in mind.

step 2 ( FINDING OUT GENERAL REMEDY CORRESPONDING TO EPIDEMIC AND INDIVIDUALIZING )

Now let him take the next step, which is to find in general the remedies that correspond to this epidemic. By the assistance of a repertory he will write after each one of these symptoms  all the remedies that have produced that symptom. Having in this way gone through the entire schema, he can then begin to eliminate the remedies that don't give a picture of a remedy for practical purposes, and he will see that six or seven remedies run through the picture, and, therefore, are related to the epidemic, corresponding to its whole nature. This may be called the group of epidemic remedies for that particular epidemic, and with these he will manage to cure nearly all his cases.

which one is the remedy for each individual case ?

When he has worked out the half dozen remedies he can go through the Materia Medica and get their individual pictures so fixed in his head that he can use them successfully. Thus he proceeds from generals to particulars. He is called to a family with half a dozen patients in bed from this epidemic, and he finds  difference in each case so that one remedy is indicated in one patient and another remedy in another patient.

             Forget about the name of disease chikungunya, dengue, japanese encephalitis. Collect the symptoms. If your in epidemic area collect as much as symptoms  as possible from as many people as you can. If you are private practitioner  collect as many symptoms from all those cases coming to your clinic. You can also refer media for the symptoms. When you have finished collecting  as many symptoms as possible. Now study the symptoms with that of remedies. 

              All of your patients in chikungunya affected area may get fever. They may suffer from swelling of joints .Note it down. child may have some symptoms .Female population may have different kind of symptoms in the same epidemic. Note all other symptoms from all age group both sexes, just like proving of a remedy .When an person comes see whether if he has any peculiarities different from most of the symptoms collected in that epidemic. If he is different from most of the symptoms from that epidemic he needs an individual remedy other wise he can be treated with most of the common remedy for that epidemic. If another epidemic breaks you will have to take all the symptoms again. You cannot depend on medicine of previous epidemic even if the diagnosis of each epidemic is same. Each epidemic has its own peculiarity.

Now when  chikungunya strikes in kerala 2006, Malaria in some parts of Rajasthan in October 1994, Plague in Surat in September 1994, Dengue fever in Delhi in October 1996, Japanese Encephalitis in Eastern parts of UP in October - November 1989, October - November 1991 and August 1993, Dropsy in Delhi in 1998,what does Homoeopathic physician do? Publish so called medicines in news papers. Many doctors  reads that come out with their own medicine. Finally there is a mess among physicians, both graduates and post graduates. Each come out with their own  medicines. And efficacy of homoeopathy is questioned by media?

Golden quotes of our masters in genus epidemicus

Herbert A Roberts  " This, too, brings up the question of infectious diseases and the symptomatology attending the so-called contagious diseases. It is the duty of the physician to take very close observation of the first cases he has in an epidemic of infectious diseases, for the symptomatology. Immunity can be assured to patients if we will closely observe the symptomatology and select the epidemic remedy in the early stages of each epidemic, by administering the epidemic remedy as a prophylactic. In this way the symptomatology of epidemic diseases is exceedingly valuable to the homœopathic physician"

"


EXTRACTED FROM TEXT BOOK OF INTERPRETATION OF ORGANON by drSANOOPKK Msc BHMS

REFER APHORISM 100,101,102

§ 100

In investigating the totality of the symptoms of epidemic and sporadic diseases it is quite immaterial whether or not something similar has ever appeared in the world before under the same or any other name. The novelty or peculiarity of a disease of that kind makes no difference either in the mode of examining or of treating it, as the physician must 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, to which certain names have been falsely applied - with the exception of those epidemics resulting from a contagious principle that always remains the same, such as smallpox, measles, etc.

COMMENTARY: This aphorism says when an epidemic breaks, the homoeopathic physician should consider that  epidemic as new one even though if it has appeared in the previous year or some time back, in the same  or different locality. Then collect as much  as totality of symptoms from as many people of different age, sex, temperament. Only after thorough examination of the epidemic, by carefully noting down symptoms of many cases in that epidemic, we can find that epidemic is easily distinguished from other epidemic which has ever occurred. Nomenclature of disease by its name is never recommended in Homoeopathy.

 


§ 101

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.

COMMENTARY: In the first case of epidemic he hardly note that it is a part of epidemic. But many people come with similar symptoms he note that it has become epidemic. Careful  observation of such collective disease (epidemic), the physician become familiar with totality of its signs and symptoms. But a well experienced physician from the very first and second patients can arrive at the conclusion about the epidemic.


§ 102

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.1 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.

1 The physician who has already, in the first cases, been able to choose a remedy approximating to the homoeopathic specific, will, from the subsequence cases, be enabled either to verify the suitableness of the medicine chosen, or to discover a more appropriate, the most appropriate homoeopathic remedy.

COMMENTARY: Taking as many symptoms from as many cases as possible it becomes possible to get more better picture of the epidemic. We can see that more characteristics and peculiarities as well as general symptoms (e.g., loss of appetite, sleeplessness, etc.)  of the epidemic becomes more and more clear after thorough study of each of the many cases of that epidemic. As more and peculiarity  form, we can find characteristic remedy for that epidemic. Even though the epidemic has come from same source (water, air, mosquitoes, animals, birds etc or source can even mean the pathological cause such as bacteria, viruses, parasites etc) whole detail of epidemic and the totality of its symptoms  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.


 

REFER APHORISM 241,242,243,244

 

Intermittent disease: A Morbid state of a fixed type returns at a tolerably fixed period, whilst the patient possesses apparently good health during the interval; they may be of febrile or non febrile character. Former is called intermittent fever.

INTERMITTENT FEVER: FOUR  CLINICAL VARIATIONS

-Epidemics of intermittent fever in situation where none are endemic.

-very pernicious types of intermittent fevers attacking individuals not residing in a marshy district

-intermittent fevers endemic in a marshy district and tracts of country frequently exposed to inundations

-Intermittent fevers prevailing sporadically or epidemically. 

 

NOW READ THE FOLLOWING APHORISM

TITLE:-Epidemics of intermittent fever in situation where none are endemic.

§ 241

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.

COMMENTARY: Epidemic of intermittent fever, not of endemic in nature are classified as chronic disease, and has peculiar uniform character common to all individuals attacked, and when this is found in the totality of symptoms common to all, it serves as guide to discovery of specific remedy suitable for all the cases  around the world, particularly when the person has enjoyed perfect health (that is who are not sufferers from developed psora) before the occurrence of the epidemic.


§ 242

If, however, in such an epidemic intermittent fever the first paroxysms have been left uncured, or if the patients have been weakened by improper allopathic treatment; then the inherent psora that exists, alas! in so many persons, although in a latent state, becomes developed, takes on the type of the intermittent fever, and to all appearance continues to play the part of the epidemic intermittent fever, so that the medicine, which would have been useful in the first paroxysms (rarely an antipsoric), is now no longer suitable and cannot be of any service. We have now to do with a psoric intermittent fever only, and this will generally be subdued by minute and rarely repeated doses of sulphur or hepar sulphuris in a high potency.

COMMENTARY: if however in such an epidemic of intermittent fever the first paroxysms have been left uncured or patient has been maltreated by allopathic drugs then inbuilt psora that is found in most of the patients although in inactive state, now becomes developed and takes on the type of the intermittent fever and takes the role of that epidemic intermittent fever. Now if the medicines (rarely antipsoric) that has been selected from that epidemic and would have been useful in the first instance when the first paroxysms occurred does not serve the purpose of cure now (as the case have been maltreated by allopathic drug or left uncured) because it has become psoric intermittent fever that require antipsoric treatment.


Title:-very exceedingly harmful  (pernicious) types of intermittent fevers attacking individuals not residing in a marshy district

§ 243

In those often very pernicious intermittent fevers which attack a single person, not residing in a marshy district, we must also at first, as in the case of acute diseases generally, which they resemble in respect to their psoric origin, employ for some days, to render what service it may, a homoeopathic remedy selected for the special case from the other class of proved (not antipsoric) medicines; but if, notwithstanding this procedure, the recovery is deferred, we know that we have psora on the point of its development, and that in this case antipsoric medicines alone can effect a radical cure.

COMMENTARY: Exceedingly harmful intermittent fevers which attack a single person, (not residing in marshy district) is psoric orgin. Here like any other acute disease totality of  symptoms is considered and  a suitable remedy   is selected based on the totality and  they should not be antipsoric medicne. But if the patient is not treated  in the begiining then  anipsoric medicines will be useful 


 

Title: intermittent fevers endemic in a marshy district and tracts of country frequently exposed to inundations(flood)

§ 244 Fifth Edition

The intermittent fevers endemic in marshy districts and tracts of country frequently exposed to inundations, give a great deal of work to physicians of the old school, and yet a healthy man may in his youth become habituated even to marshy districts and remain in good health, provided he preserves a faultless regimen and his system is not lowered by want, fatigue or pernicious passions. The intermittent fevers endemic there would at the most only attack him on his first arrival; but one or two very small doses of a highly potentized solution of cinchona bark would, conjointly with the well-regulated mode of living just alluded to, speedily free him from the disease. But persons who, while taking sufficient corporeal exercise and pursuing a healthy system of intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever by one or a few of such small doses of cinchona - in such persons psora, striving to develop itself, always lies at the root of their malady, and their intermittent fever cannot be cured in the marshy district without antipsoric treatment.1 It sometimes happens that when these patients exchange, without delay, the marshy district for one that is dry and mountainous, recovery apparently ensues (the fever leaves them) if they be not yet deeply sunk in disease, that is to say, if the psora was not completely developed in them and can consequently return to its latent state; but they will never regain perfect health without antipsoric treatment.

1 Large, oft-repeated doses of cinchona bark, as also concentrated cinchona remedies, such as the sulphate of quinine, have certainly the power of freeing such patients from the periodical fits of the marsh ague; but those thus deceived into the belief that they are cured remain diseased in another way.

 

§ 244 Sixth Edition

The intermittent fevers endemic in marshy districts and tracts of country frequently exposed to inundations, give a great deal of work to physicians of the old school, and yet a healthy man may in his youth become habituated even to marshy districts and remain in good health, provided he preserves a faultless regimen and his system is not lowered by want, fatigue or pernicious passions. The intermittent fevers endemic there would at the most only attack him on his first arrival; but one or two very small doses of a highly potentized solution of cinchona bark would, conjointly with the well-regulated mode of living just alluded to, speedily free him from the disease. But persons who, while taking sufficient corporeal exercise and pursuing a healthy system of intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever by one or a few of such small doses of cinchona - in such persons psora, striving to develop itself, always lies at the root of their malady, and their intermittent fever cannot be cured in the marshy district without antipsoric treatment.1 It sometimes happens that when these patients exchange, without delay, the marshy district for one that is dry and mountainous, recovery apparently ensues (the fever leaves them) if they be not yet deeply sunk in disease, that is to say, if the psora was not completely developed in them and can consequently return to its latent state; but they will never regain perfect health without antipsoric treatment.

COMMENTARY:COMMENTARY: Healthy man living may not be affected by intermittent fever  endemic in marshy areas and  may remain in good health if he under go faultless regimen, avoiding unwanted mental and physical exertions. But many times he gets the attack of endemic fever on the very first arrival such intermittent fever can be easily removed by potentized medicine, based on similarity and generally cover cinchona. But however persons who, while taking sufficient exercise and pursuing a healthy system of intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever by one or a few of such small doses of cinchona - in such persons psora, striving to develop itself, always lies at the root of their malady, and their intermittent fever cannot be cured in the marshy district without anti psoric treatment. When such patients moves away from marshy area to dry areas they apparently recovers if they did not get affected deeply by disease. Here apparent recovery is due to psora returning to latent state and complete cure here  is possible only after anti psoric treatment .