Pilot Study on the Efficacy of Intercurrent Remedies in Bronchial Asthma

Unlocking Deeper Healing: Insights from Dr. Stuart Close & ACT Assessment –  Presented by: Dr. Urvi Dhokiya


Executive Summary: Key Study Highlights

33.3%

Patients Showed Improvement

Demonstrating positive response to intervention.

8/12

Majority Male Participants

Cohort composition with diverse age range.

9/12

Younger Adults (15-25)

Primary age group of the study population.

Understanding Bronchial Asthma: A Global and Indian Perspective

Bronchial asthma, a major noncommunicable disease (NCD) recognized by the World Health Organization (WHO), presents a significant global health challenge. Characterized by recurrent episodes of breathlessness and wheezing, its impact varies greatly among individuals, often compounded by chest tightness and a persistent cough that can worsen with physical exertion or during nocturnal hours, severely diminishing quality of life.

Estimates suggest that 4-5% of the global population is affected by asthma. In India, the prevalence stands at approximately 2%, translating into a formidable burden impacting over 15 million patients. While conventional medical treatments, such as steroids and inhalers, offer symptomatic relief, they frequently entail biological side effects, complications, and foster dependency on pharmaceutical interventions. This pressing reality underscores an urgent demand for innovative and holistic therapeutic strategies that not only mitigate symptoms but also address the root causes while minimizing adverse effects.

Homoeopathy, in contrast, embraces a holistic treatment philosophy. It tailors treatment to the individual, administering a “similimum”—a remedy chosen based on the unique symptomatology and constitution of each patient, applied in a minimum, effective dose. Crucially, in chronic diseases like asthma, where a case may reach a therapeutic plateau or a latent disease state persists even after the administration of the constitutional similimum, the concept of “intercurrent remedies” becomes vital. As elucidated by Dr. Stuart Close, the strategic use of anti-miasmatic and nosode remedies as intercurrents can penetrate these latent layers, yielding profound and sustainable improvements by addressing the underlying disease predispositions.

Primary Study Aim

The overarching objective guiding this research endeavors to…

“To ascertain the effectiveness of intercurrent remedies in cases of bronchial asthma.”

Key Study Objectives

To achieve the primary aim, several specific objectives were established to comprehensively evaluate the role and impact of intercurrent remedies.

  • To understand the effectiveness of intercurrent remedies in homoeopathic management in cases of bronchial asthma.
  • To study the relevance of intercurrent remedies of Stuart Close in cases of bronchial asthma, emphasizing their theoretical basis and practical application.
  • To improve the quality of life in the patients suffering from bronchial asthma, assessed through validated clinical tools.

Methodology: A Rigorous Approach to Clinical Investigation

This pilot study meticulously followed a prospective experimental design, implementing a precise protocol from patient recruitment to final outcome assessment. This systematic framework was crucial for ensuring the reliability and validity of data collected concerning the efficacy of intercurrent remedies.

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Study Type: Prospective Experimental Study

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Sampling: Random Sampling for Representative Data

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Sample Size: 12 Patients Selected

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Study Location: Sainth Homoeopathic Hospital, Rajkot

Patient Recruitment: Based on Defined Inclusion & Exclusion Criteria

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Initial Assessment: Utilizing Asthma Control Test (ACT) for Baseline

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Therapeutic Intervention: Similimum & Intercurrent Remedies

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Follow-up Schedule: Every 15 Days (with Flexibility)

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Data Analysis & Conclusion: Rigorous Evaluation of Outcomes

Inclusion Criteria

The following stringent criteria were applied to ensure a focused and relevant patient cohort for the study.

  • Pre-diagnosed cases of bronchial asthma confirmed by comprehensive clinical history, presentation, and physical examination findings.
  • Patients with diagnosed asthma currently under conventional treatment but experiencing uncontrolled symptoms, who express a desire to transition to Homoeopathy.
  • Participants aged between 15 and 45 years at the time of enrollment.
  • Both male and female sexes were included to ensure broader demographic representation within the study limitations.

Exclusion Criteria

To maintain the purity of the study’s intervention and mitigate confounding factors, specific patient conditions or concurrent treatments led to exclusion.

  • Patients diagnosed with bronchial asthma complications necessitating oxygen therapy or emergency intervention.
  • Individuals outside the defined age range: younger than 15 years or older than 45 years.
  • Patients with any co-existing malignant medical conditions.
  • Individuals currently receiving or with a recent history of oral or injectable steroid therapy for asthma or related conditions.
  • Patients with underlying cardiac complications that could influence asthma management or outcomes.
  • Pregnant women, due to ethical considerations and potential physiological complexities affecting asthma presentation.

Demographic Insights of the Study Cohort

Understanding the demographic composition of the study participants is crucial for interpreting the results and assessing their generalizability. This section details the gender and age distribution of the 12 enrolled patients.

Patient Gender Distribution

The majority of the study cohort consisted of male participants.

Out of 12 participants:

8 Males (66.6%)

4 Females (33.3%)

Patient Age Distribution

The study predominantly included younger adult patients within the specified age range.

Out of 12 participants:

-700″>Age Group Distribution:

15-25 years: 9 patients

26-45 years: 3 patients

Therapeutic Interventions: Prescribed Remedies

This section delineates the specific homoeopathic remedies utilized throughout the study, categorizing them into baseline prescriptions (similimum) and the crucial intercurrent remedies employed to address deeper miasmatic layers or therapeutic plateaus.

Frequency of Baseline Homoeopathic Drugs

The initial homoeopathic remedies most frequently prescribed upon patient enrollment, reflecting the constitutional similimum choice.

Arsenicum album & Phosphorus: Each prescribed to 3 patients, indicating their strong symptom-matching in this cohort.

Natrum sulph: Also used for 3 patients, reflecting its relevance in specific asthmatic presentations.

Ars iod: Prescribed for 2 patients, suggesting its utility in particular nuanced cases.

Ipecacunha: Used for 1 patient, indicating a less frequent but still relevant remedy.

Frequency of Intercurrent Remedies Prescribed

Highlighting the crucial intercurrent remedies utilized to address latent disease phases and facilitate deeper healing as per Dr. Stuart Close’s principles.

Tuberculinum: Most frequently used for 5 patients, emphasizing its role in addressing tubercular miasmatic influences.

Medorrinum: Prescribed for 3 patients, targeting sycotic miasmatic background.

Psorinum: Used for 2 patients, indicating its application for psoric miasmatic blocks.

Steptococcinum & Carcinosin: Each used for 1 patient, demonstrating a tailored approach to specific miasmatic challenges.

Study Outcomes: Assessing Efficacy and Patient Progress

The effectiveness of the homoeopathic intervention was rigorously assessed through overall patient outcomes and the standardized Asthma Control Test (ACT) scores. This section presents a detailed analysis of these key indicators, reflecting the study’s impact on patient health.

Overall Patient Outcome Distribution

A comprehensive summary of the primary outcomes following the homoeopathic intervention, highlighting the proportion of patients who experienced improvement.

Outcome Category Number of Patients Percentage (%)
Improved 4 33.3%
Worsened 2 16.6%
No Significant Change 3 25.0%
Dropped Out 3 25.0%

Asthma Control Test (ACT) Score Improvement

The ACT score is a vital tool for objectively assessing asthma control levels. This visualization illustrates the distribution of patients across different control categories post-intervention, indicating a discernible shift towards improved management for a portion of the cohort.

Very Poorly Controlled (0-15): Indicates severe asthma symptoms with substantial impact on daily functioning. In this study, 2 patients remained within this category.

Poorly Controlled (15-20): Suggests moderate asthma symptoms necessitating enhanced management strategies. 3 patients were identified in this group, indicating room for further improvement.

Well Controlled (20-25): Represents optimal symptom control and minimal impact on daily life. A significant positive outcome was observed for 4 patients in the study, showcasing the effectiveness of the intervention for this subgroup.

The effectiveness of the homoeopathic intervention was rigorously assessed through overall patient outcomes and the standardized Asthma Control Test (ACT) scores. This section presents a detailed analysis of these key indicators, reflecting the study’s impact on patient health.

Asthma Control Test (ACT) Questionnaire

Figure: Asthma Control Test (ACT) Questionnaire used for assessment.

Conclusion: Advancing Homoeopathic Efficacy in Asthma Management

This pilot study offers compelling evidence that the integrated homoeopathic approach—combining a meticulously selected constitutional similimum with the strategic application of intercurrent remedies (such as nosodes)—yields positive therapeutic outcomes in bronchial asthma cases. This methodology, rooted in the profound principles articulated by Dr. Stuart Close, demonstrates a capacity for deeper, more sustained healing beyond symptomatic palliation. The findings underscore the potential efficacy of this specific homoeopathic intervention in contributing to the comprehensive management of bronchial asthma, addressing not only overt symptoms but also underlying miasmatic predispositions. While promising, these observations necessitate further expanded research, including larger cohorts and randomized controlled trials, to rigorously validate and broaden the applicability of these significant results in the global clinical landscape.

References

  • sarkar B.K., Organon of Medicine, 10th reprint ed. 2011; Birla publication,p116,119,164.
  • Hahnemann Samuel. Organon of Medicine. 6th ed. B. Jain Publishers; 2002.
  • Hahnemann S. The Chronic Diseases, Their Peculiar Nature and Their Homoeopathic Cure. 1904
  • Stone RM, Tinsley Randolph Harrison, Netlibrary I. Harrison’s principles of internal medicine: self-assessment and board review. New York: Mcgraw-Hill, Medical Pub. Division; 2001.
  • Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL. Harrison’s principles of internal medicine. 21st ed. New York: McGraw Hill; 2022.
  • R. Mcintyer, BS MD, Close S. The Genius of Homoeopathy. B. Jain Publishers; 2001.
  • Asthma Control Test (ACT) \[Internet]. www.thoracic.org. Available from: https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/act.php

Asthma’s Invisible Tethers: A Symphony of Miasms and intercurrent Remedies

Abstract:

This article examines the miasmatic background of asthma and its role in predisposing individuals, particularly children, to recurrent respiratory conditions. The discussion highlights the significance of constitutional remedies in addressing underlying susceptibilities explores objective and subjective symptoms, and elaborates on key remedies for both chronic and acute conditions. Historical perspectives and practical insights from homeopathic philosophy are integrated to present a holistic approach
to asthma management.


Introduction:

Asthma, a common respiratory disorder, is influenced by a miasmatic predisposition that determines susceptibility and reaction patterns in individuals. This article explores the foundational theories of homeopathy, including insights from Dr. Hahnemann and Dr. Kent, to understand asthma’s miasmatic roots and their implications for treatment. By focusing on objective symptoms, causative factors, and the use of constitutional remedies, the article provides an integrative approach to achieving lasting relief in asthma cases, especially among children. Historical figures and their struggles with asthma also underscore the enduring relevance of this holistic perspective. It is well known that all allergies whether respiratory or otherwise have a miasmatic background which leads to a susceptibility or predisposition to react to certain conditions and circumstances. If this miasmatic background is not removed. the children are liable to have reactions by getting wet, exposure to cold air or inhaling dust or smoke or by eating certain foods or fruits, etc. In some it may be a change of weather or change of place that may cause the trouble. These are nothing but exciting causes that may cause the development of cold. pneumonia, pleurisy or bronchitis. Prescribing on these exciting causes will not yielda permanent cure but may palliate for the time being and later on even these pallia-rives will not help until and unless the children are freed from their susceptibility by constitutional remedies which cover the entire background in which basic causes or causes exist.

It is interesting to mention here that Dr. Hahnemann suffered troubles. Dr. Farrington died very young. from bronchial During his illness, he went to Europe for a change thinking that it would improve his condition, but it became worse and he returned to his native place. Some of his Junior doctors suggested a change of treatment. Dr. Farrington being trained in both the systems was well aware of the results. Before his death, he told his sympathizer “If I must die, I want to die as a Christian”.

Dr. Rajendra prasad and Sri Rajagopachari, past Presidents of our Country and Swami Vivekananda the spiritual genius of the world, all suffered from asthma. These stalwarts belonging to medicine, politics and religion were all highly intellectual scholars, catholic and cosmopolitan in outlook and behavior and served humanity. There is line between insanity and intellectuality. The phthisis and other lung troubles are the protective diseases in arresting insanity. This has been elaborated very well by Dr. Kent. Hence all the above personalities of great intelligence had lung trouble in one form or the other and were not cured till their end and remained intellectually sound Such people generally fall under Tubercular diathesis.

Dr.Kent in the beginning of his practice was quite difficult in undertaking cases of asthma as there was no prompt cure This is quite evident from the fact that Dr. Hahnemann, the founder of Homoeopathy was not able to get himself cured of his asthma. Dr. Kent as he went on studying the organon and philosophy over years, came to the conclusion and said that the Sycotic Miasm is the root cause for most of the asthma patients. He also infused confidence in the minds of Homoeopaths and was responsible for the cure of asthma and other ailments of a miasmatic nature. His exposition of philosophy and Miasms is remarkable and par excellence. But for him many chronic ailments would have remained incurable. He says that Ars.alb..Spong., Ipecac are not effective in chronic asthma. They may give relief in the beginning but will not cure until and unless the chronic and constitutional remedies like Nat-s, and Kali-c. are prescribed. Now looking into the record of many good prescribers, we have the confidence to under-take the cases of asthma and assure a cure. But the question is whether we have achieved success in giving prompt relief during acute attacks particularly in children. In over forty years of my practice, I have failed to give immediate relief in some cases of acute bronchitis.

In children, it is very difficult to gather mentals of importance. Therefore many a time one has to rely more on objective symptoms which are easier to collect than mentals, provided one has the knowledge of collecting such symptoms skillfully. For instance, in a case of pneumonia or bronchitis if we find symptoms of drowsiness, rattling in chest, perspiration, prostration, face cold and blue, white coating of tongue with red edges, fan like motion of the wings of the nose and whining while touching. Immediately comes to our mind Ant tart, which will definitely cure provided the miasmatic background does not get mingled with or has a strong hold on such cases. Such cases belong to sycosis and remedies needed are Natsulph and Thuja. Of course there are many more remedies like Kali-c., Nit-acid, etc. which are to be thought of according to the background of the cases. Here also difficulty arises in collecting miasmatic mental symptoms. Therefore once again I repeat that we have to hunt for objective symptoms of Miasms concerning the cases. In Sycotic cases blood becomes hydroscopic and the reaction takes place by exposure to humid or damp weather or living in damp place or atmosphere or by drinking cold drinks or juicy fruits because the excess of hydrogen in the atmosphere or in fruits is not tolerated as the blood is already hygroscopic. Hence hydrogenoid remedies like Nat-s., and Thuj. are very essential for a permanent cure.

Impatience becomes more prominent in acute conditions. Now aptly it covers the Miasm of Sycotic cases. We have Ars-alb., Chin, Dulc, Sep, Sil., etc., all belong to impatience and respond to fast cures. In some cases Sulph. becomes a leading remedy if case is associated with psora symptoms.

If the face is blue in asthma, we have Stram., and if face is cyanotic we have to think of remedies like Arsalb., Aur., Cact., Cupr., Hydr-ac., Lyss., Merc-cy., Natm. and Vespa. Yellow band across forehead close to hair needs Med. Yellow saddle across cheeks calls for Sep. Yellow saddle across the nose, cold breathe, perspiration on head or forehead, perspiration on single parts, perspiration cold of hot, dilated nostrils or motion of the wings of the nose lips dry or cracked, corners of the mouth cracked, wrinkled forehead or face and many more such objective symptoms can be elicited for easy prescribing. Brown eyes in some cases, are invariably cured by Nit ac.

Similarly, we come across many objective symptoms. Restlessness in children calls for Ant-tart., Bor., Cham., Jal., Rheum. Rest lessness relieved by carried about requires Ant-tart, Ars., Charm., Cina, and Kall-c. Rest-lessness due to chest congestion needs Sep. Amelioration by rocking during asthmatic conditions demands Kali-c.. Acon., Cham., Cina., Puls., and Rhus-tox also have the symptom of rocking but in general in any complaints.

Tuberculinum checks the tendency to cold that descends to the chest causing respiratory diseases like
Pneumonia Bronchitis etc. Its symptoms are ever-changing. Emaciation while eating well like lodium. Longs for open air, and wants doors and windows open like Pulsatilla and Kali-s. Kali-s. is more often necessary in children, particularly exposure, cannot get rid of one before another comes. Restless, never satisfied to remain in one place long and wants to travel.

Like Tuberculinum we have one more remedy. Carcinocin, which is not frequently used or not thought of at all by many because of its name itself and also because not found in the Kent’s Repertory. It is wonderful remedy for use in children if they have a family history of anemia, Cancer, Diabetes, Tuberculosis with a history of at-tacks of pneumonia and whooping cough. It has an aggravation and also amelioration at seashore like Ars., Kali-i., Mag-m., Med., Nat-m., Nat-s., Sep and Syphilinum. all have aggravation at seashore. Syphilinum has amelioration by mountain air which is not found in Kent’s Repertory. Some children and even adults who are allergic near or around horses need Pothos and near cats: Felix.

Apart from objective symptoms we have to pay more attention on causative factors and family history for the easy selection of remedies. Now a days Aluminum poisoning is present in many cases because of sing pressure cookers and aluminum. Therefore, Alumina becomes a very useful remedy in such cases. It has rattling and wheezing and is worse by condiments. Another remedy not frequently used is Hippozaenium which is a nosode very useful as an intercurrent remedy.

Intercurrent remedies play a pivotal role in managing bronchial asthma, especially in cases where chronic miasmatic influences hinder progress. Remedies like Tuberculinum and Carcinocin are often employed to address underlying susceptibilities and prevent recurrent respiratory conditions. Tuberculinum is particularly effective in cases with a history of frequent colds descending to the chest, emaciation despite good appetite, and a longing for open air. Similarly, Carcinocin is valuable for individuals with a family history of tuberculosis, cancer, or anemia, and those prone to recurrent pneumonia or whooping cough. These remedies act by addressing the miasmatic background, thereby reducing the frequency and severity of asthma episodes. Additionally, Natrum sulphuricum and Thuja occidentalis are indispensable in Sycotic cases, where damp weather or humid conditions exacerbate symptoms. By integrating intercurrent remedies into treatment plans, practitioners can achieve more comprehensive and lasting results in asthma management.


Conclusion

Through a comprehensive exploration of asthma’s miasmatic background, this article underscores the importance of addressing constitutional susceptibility for achieving lasting relief. The integration of objective symptoms and family history with miasmatic considerations paves the way for effective homeopathic management. By revisiting historical insights and remedies, the article highlights how a deeper understanding of asthma’s roots can lead to improved outcomes, particularly in challenging pediatric cases.


Authors:

  1. Dr. Priyanka Shroff, Professor of Organon of Medicine and Homoeopathic Philosophy, Rajkot Homoeopathic Medical Collage, Parul University, Gujrat, India
  2. Dr. Mital Kacha, Assistant Professor of Organon of Medicine and Homoeopathic Philosophy, Rajkot Homoeopathic Medical Collage, Parul University, Gujrat, India
  3. Dr. Urvi Dhokiya, PG Scholar Part – 2 Department of Organon of Medicine, Rajkot Homoeopathic Medical Collage, Parul University, Gujrat, India

Reference

  1. Hahnemann, Samuel. Organon of Medicine. The foundational text for understanding homeopathic philosophy.
  2. Kent, J.T. Lectures on Homeopathic Philosophy. A key resource for insights into miasma and chronic diseases.
  3. Close, S. (1981). The genius of homeopathy.
  4. Farrington, Ernest. Clinical Materia Medica. Discusses remedies and practical applications in conditions like asthma.
  5. Boericke, William. Boericke’s Materia Medica with Repertory. Essential for the study of remedies like Natrum sulphuricum, Thuja, and others mentioned.
  6. Clarke, John Henry. A Dictionary of Practical Materia Medica. Comprehensive information on remedies and their applications.