Homeopathy For a Changing World: Is there a Remedy for Bioterrorism?

History of Bioterrorism
Even though bioterrorism appears to be new to the world, nothing could be further from the truth. The origins of biological warfare can be traced back to 600 B.C., when Assyrian soldiers poisoned enemy wells using Rye Ergot toxin. Later in 1346, Tartars reportedly hurled the corpses of plague victims into the enemy camp at the Siege of Kaffa. In America, the first recorded use of biological weapons was when the British Army gave blankets from the beds of Smallpox victims to Native Americans in the 1600s.

Modern experimentation with biological weapons began with German development of Anthrax during WWII. American and Soviet facilities quickly expanded this technological development during the Cold War until the 1972 Convention on the Prohibition of Biological Weapons and Toxins was declared.

Risk of Bioterrorism Today
Over the past 30 years, governments and fringe groups alike have demonstrated the willingness to use biological weapons. In the 1970s, there were numerous reports of "Yellow Rain," a suspected Mycotoxin, being dispersed from aircraft in Cambodia and Afghanistan. In 1984, the Rajneesh cult contaminated salad bars in Oregon with Salmonella to influence local elections. Over 700 people became ill. During the recent Gulf War, Iraq deployed weapons including 19,000 liters of Botulinum Toxin and 8,500 liters of Anthrax. The Cult group, Aum Shrinrikyo, responsible for the Tokyo subway Sarin Gas incident, was to have sent members to Zaire in the hope of obtaining samples of Ebola Virus. And in the past few weeks we have seen Anthrax cases emerge in waves throughout the Eastern United States.

Access to these weapons of mass destruction was once limited to very few. In the past two decades the number of countries working on offensive biological weapons has increased dramatically. There is significant concern that former Soviet bio-weapons experts may be vulnerable to financial enticement from nations interested in developing biological agents. The Vector facility in the former Soviet Union was once a 30-building, 4000-employee, high-security bio-weapons research facility with an elite guard force. An inspector in 1997 reported that the facility was only half occupied and protected by a handful of guards that had not been paid for months. The number of countries engaged in biological weapons experimentation has grown from 4 in the 1960s to 11 in the 1990s. And in our age of unlimited access to information, recipes for the development of biological weapons can even be obtained over the Internet free of charge. Morality, which has been a useful deterrent to the use of such weapons in the past, appears to have questionable effect on small fringe groups who have demonstrated the capability and willingness to use biological agents with potentially far reaching effects.

The Weapons
The Centers for Disease Control (CDC) Bioterrorism Readiness Plan for Healthcare Facilities published in April 1999 lists four agents that have a high potential for use in our current situation: Anthrax, Plague, Botulism Toxin, and Smallpox. Other agents include Tularemia, Q Fever, Brucellosis, Ebola and Marburg viruses, and Staphylococcal Enterotoxin B.

Anthrax has become a commonplace word in the news today. Previously a predominantly cutaneous disease of goat hide workers, the current form favors the more aggressive respiratory form that results in much higher death rates from pulmonary collapse. The best current data on a large-scale release comes from Sverdlovsk in Russia. In 1979, an accidental release of Anthrax on a single day from a bio-weapons facility spread over a four-kilometer area. At least 77 people were infected and 66 patients died of confirmed disease. The cases reported during this accidental release stopped occurring after 43 days, suggesting that person-to-person spread is highly improbable.

Plague is a bacterial disease generally transmitted by fleas from rats. Plague still occurs in the U.S., but has a very low frequency of natural occurrence. The bubonic form is generally more common and not easily spread from person-to-person. A pneumonic version, however, could lead to rapid and epidemic spread through a population.

Botulism is a toxin that is 100,000 times more potent than Sarin Gas. Botulism quickly causes paralysis and death. The effects of this toxin are limited to the people who are directly exposed, and there is no infectious spread of disease.

Smallpox is a virus that has a history of devastating entire populations across many sections of the globe. Some of the most recent cases were reported in 1970 in Germany. A single case, isolated from the first day they were admitted to the hospital, led to 19 subsequent infections in that hospital. These infections occurred despite the mass immunization of 100,000 people in an already well-vaccinated population. In 1972, Yugoslavia had one patient that was diagnosed late into the course of the illness. One million people were revaccinated and 10,000 people were quarantined for 16 days. Despite these measures, 175 people developed Smallpox and 35 people died. Immunization for Smallpox was stopped in the U.S. in 1972. It is estimated that only 10-15% of the U.S. population is currently immune to the disease.

The Public Health Response
The CDC and other public health agencies take a measured, stepwise approach to epidemic disease. The rationale is based upon an overall risk assessment of the biological agent in question, with containment of an epidemic as an overarching priority. The current response to Anthrax cases has been a methodical testing of individuals and high risk environments to establish the extent of exposure, combined with prophylactic antibiotic treatment of any individuals considered to be at high risk based on testing results. Since the risk of developing Anthrax still remains exceedingly low, and there is no evidence for person-to-person spread of the disease, antibiotics will be recommended on a voluntary-use basis.

If, however, a potentially epidemic agent (Smallpox, Plague, Ebola virus, etc.) enters a population, I believe the response would be quite different. As in Germany and in Yugoslavia, these epidemic agents require massive quarantine and containment efforts. In this type of scenario, it is probable that antibiotic therapy and/or vaccination will be required for any individual exposed. Because of the high level of contagion (reaching near 100% for Smallpox), public health concerns may override individual freedom of choice. The last epidemic of this type in the U.S. was the Spanish Influenza of 1918. In certain areas of the country, laws were established to require citizens to wear masks. With the medical community so thoroughly entrenched within the government, I believe the power to quarantine and completely control medical treatment would be much more far reaching at this time.

The Homeopathic Legacy
Homeopathy has a rich history of experience with epidemics over the past 200 years. Some of the highlights include Hahnemann's widely acclaimed use of Belladonna during Scarlet Fever outbreaks, Hering's success treating Cholera victims in Europe, and Dr. Eaton's reports of preventing Smallpox. While this data is strong support for the effectiveness of homeopathy in epidemic disease, it is not enough.

When we look at the actual studies of homeopathic medicines given for epidemic diseases, we see a more mixed picture. Only several such studies exist. One report of homeopathic remedies used to prevent Influenza in Britain in 1958 showed no effect from the remedies. In 1974 in Brazil, however, a large study on Meningitis showed that the homeopathic remedy was much more effective than no treatment at all. The best-constructed study to date was preformed by Dr. Wayne Jonas using Tularemia infected mice. He demonstrated a 22% survival rate for the homeopathic medicine. While this study showed a clear effect from the homeopathic medicine, the improvement was significantly less than the 100% protection provided by vaccination in the same study. For more information, you may wish to obtain a recent article I have written for the Autumn issue of the Journal of the American Institute of Homeopathy that goes into much more detail regarding the probable mechanisms and clinical usefulness of homeopathic remedies as prophylactics. [See the AIH website, www.homeopathyusa.org, for journal subscription and single issue rates.]

A Practical Approach for Today
Many people have asked me if they should take homeopathic medicines to be prepared for a potential epidemic. Usually, they are hoping for a very simple answer like: "Just get this list of remedies and take them." While that would be wonderful, I believe the experienced homeopaths of the past would roll over in their graves. When Hahnemann, Hering, and others approached an epidemic, it took careful case-taking and analysis of multiple patients to arrive at the most useful remedy for the general population. Many have suggested that simply taking the nosode, or homeopathically prepared disease organism, should provide protection enough for any outbreak. It is clear from Dr. Jonas's work and others that this is simply not true.

Moreover, if there is truly an epidemic, health and law enforcement authorities will most likely dictate what form of treatment you will be required to undergo. I believe the more pertinent question to ask would be, "Can homeopathy help lower my risk of becoming infected?" and "Can homeopathy help treat or prevent some of the severe side effects seen with treatments like Smallpox vaccination?"

In the current Anthrax crises in the U.S., the situation is actually not an epidemic. These cases represent single episodes of exposure to the same organism. True epidemics that sweep through a population require person-to-person spread. Similarly, the homeopathic treatment for Anthrax would be selected purely on a case-by-case basis in a traditional homeopathic manner.

If an epidemic disease does occur, one of the most vital functions of the homeopathic medical community will be to coordinate prescribers to choose a single remedy, or group of remedies, that best fit the particular nature of the epidemic. The selection of the correct remedy(s) is not as simple as using Franciscella tularensis nosode for Tularemia or Variolinum for Smallpox. For example, at least 12 different homeopathic remedies have historically been found useful for the prevention of Smallpox. Careful observation of multiple cases of the disease in question, as it affects individuals of various constitutions, will lead to a remedy that reflects the nature of that particular epidemic, at that particular time in history. After the selection of these "Genus Epidemicus" remedies, appropriate dosing schedules following a model based on the experience of homeopathic provings should be established. Past experience of provings and prior use of homeopathic prophylaxis would suggest that a low potency repeated in one to two-week intervals would be the correct approach.

The second most important role of the homeopathic medical community will be to help treat or prevent the serious side effects associated with mass vaccination that may be mandated for these diseases. Although Plague and Anthrax vaccines have been associated with both local and general reactions, these side effects tend to be transient compared to the syndrome that follows Smallpox vaccination. Smallpox vaccination was stopped in 1971, due to global eradication of the disease, and the severe side effects sometimes seen in the Vaccinia syndrome that follows for some individuals.

Vaccinia Syndrome
Vaccinia develops after inoculation for Smallpox in approximately 240 out of 1 million patients during primary inoculation, and only 9 out of 1 million during booster doses. An initial eruption over different parts of the body resembles smallpox with papules that turn to vesicles that turn to pustules after five to ten days. Fever, malaise and flu-like symptoms may accompany the rash. Swelling of the axillary glands is frequently present. Some patients become progressively ill with sepsis and occasionally meningitis. Individuals with a history of eczema are at higher risk for developing a milder form of Vaccinia, while those with immunodeficiency diseases like AIDS are at increased risk of developing the severe form of this disease.

During mass vaccinations for Smallpox in the past, homeopaths were somewhat divided on how best to deal with the consequences of Vaccinia. While some promoted routine use of remedies before vaccination, others suggested only treating those who developed symptoms. Some of the remedies that have been most often used to treat Vaccinia are described below.

Thuja occidentalis has been the most frequently prescribed and most highly touted remedy for patients with Vaccinia. On an interesting side note, I once worked with a physician who would inoculate patients with Smallpox vaccine to treat plantar warts: a condition that Thuja occidentalis has proved useful in treating. Thuja occidentalis is useful for diseases that result from a suppressed eruption, or from suppression of the immune system. The eruptions may be papular, vesicular, or pustular. In patients who develop any chronic effects after Vaccinia, such as weakness, fatigue, growths of tumors or infections, Thuja occidentalis should be strongly considered.

Antimonium tartaricum has been very useful for eruptions resembling Chicken Pox. Dr. Arthur Grimmer even reports that when placed onto abraded skin in the third trituation, it will produce a typical vaccination scar. Boericke notes that the eruption may leave a bluish red mark after the pustule resolves. Cough that is typically present in patients needing Antimonium tartaricum may be absent during Vaccinia.

Silicea is a remedy that is complimentary to Thuja occidentalis. Silicea is indicated for diseases that result from suppression of the individual by an external force such as a vaccination. Enlargement of the glands and malaise may be strong features. Pustules do not seem to progress and improve.

Belladonna is useful when the patient progresses toward sepsis or meningitis. The fever is high and there may be delirium due to the effects on the brain. These patients will most likely be in the intensive care unit and should only be treated by a skilled homeopath.

Malandrinum has been mentioned as being the most potent treatment for the septicemia or blood infection that sometimes follows Smallpox vaccination.

Variolinum has been suggested as the foremost treatment of both Smallpox and Vaccinia, but there is only anecdotal evidence from a few prescribers to support its use. No well-performed provings, or even the method by which this remedy was produced, exists at this time. Without guiding symptoms, the selection and use of a remedy like Variolinum can only be made on a purely empiric basis. Homeopathic medicine has continued to exist because it is practiced according to a scientific discipline. Once that discipline is abandoned, the results of practice are unpredictable.

The Best Medicine
I hope I have been able to convey at least a small piece of the immense threat that now looms over the world. We have entered a time when reasonable people must confront a world with an unpredictable future. In the practice of homeopathy, I have seen that external stresses are omnipresent and uncontrollable. Health lies not in our ability to control what is outside of us, but in our desire to love and thrive in relation to all aspects of life. Perhaps the best medicine for this time in history will be open listening, inner fortitude, compassion for all who suffer, and a sustained prayer for peace.

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References

Bioterrorism Readiness Plan: A Template for Healthcare Facilities; APIC Bioterrorism Task Force, CDC Hospital Infections Program Bioterrorism Working Group; 13 April 1999.

Bioterrorism as a Public Health Threat; D.A. Henderson; Johns Hopkins University; Emerging Infectious Diseases; Vol 4:3; Jul-Sep 1998.

Bioweapons and bioterrorism; JAMA 1997; 278:351-70, 389-436.

Medical Management of Biological Casualties Handbook; U.S. Army Medical Research; Institute of Infectious Diseases; Fort Detrick, MD; September 1999.

Homeopathy in Epidemic Diseases; Dorothy Shepherd; The C.W. Daniel Company, LTD; Essex, England; 1967.

The Collected Works of Arthur Hill Grimmer, MD; Ahmed N. Currim, PhD, MD, Ed.; Hahnemann International Institute for Homeopathic Documentation; Norwalk, CT; 1996.