EVIDENCE BASED HOMEOPATHY IN DERMATOLOGY

DR.R.K.MANCHANDA
M.D.(HOM), MBA (HEALTH CARE) DEPUTY DIRECTOR (HOMOEOPATHY) DIRECTORATE OF ISM & HOMOEOPATHY GOVERNMENT OF NCT OF DELHI E MAIL: rkmanchanda@gmail.com

Introduction
Evidence-based medicine (EBM) applies the scientific method to medical practice. According to the Centre for Evidence-Based Medicine, "Evidence-based medicine is the

conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients."
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The different types of clinical evidences are ranked according to the strength of their freedom from various biases that beset medical research. The strongest evidence for therapeutic interventions is provided by randomized, doubleblind, placebo-controlled trials involving a homogeneous patient population and medical condition.

Evidence Based Homeopathy

It consists of different types of studies/trials which includes disease oriented research, drug oriented research, individual case reports, double blind placebo control trials, fundamental research, clinical verification and validation of various hypothesis of already proved homeopathic drugs according to the modern criteria.

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Tinea infection
GUPTA RAMJI, BHARDWAJ O.P. and MANCHANDA R.K., Evaluation of Bacillinum in tinea infection ; British Homeopathic Journal, 1990, Vol. 79, pp.1011

Total 36 patients (29 Males and 7 females)

Tinea Corporis 14 cases Tinea Cruris 18 cases Both - 4 cases

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Relief Index with different potencies of Bacillinum

Relief in itching Potency 1M 10M 50M CM No. of Patients 35 6 4 2 100% 2 75% 5 1 50% 10 2 <50% 2 Relief in itching and lesion 100% 3 50% 1 1 3 -

Duration of Treatment
Duration 3-4 weeks 1-3 months 3-6 months No. of Patients 4 27 5

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The present study was undertaken to verify Burnetts claim that tinea is curable by its pathological similimum, i.e. Bacillinum in high potency administered internally and infrequently. The term pathological similimum does not refer to any macroscopic or microscopic resemblance. This hypothesis of similimum was based on Burnetts observation of a high incidence of tinea in tubercular families, in persons living together in closed, damp and dark rooms.

He also recorded cures of tinea with Bacillinum. Since then Bacillinum has been widely used by homeopaths in the treatment of tinea infections and is included in various materia medicas and repertories.

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In the present study Burnetts hypothesis of using Bacillinum in tinea has not been verified and the similarity he claimed was probably due to high incidence of tinea in lower socio economic groups having tuberculosis. Bacillinum had not shown a promising result. The six patients who initially showed improvement deteriorated during follow up. Some relief in itching and lesions could be attributed to the general hygienic measures advised to all the patients.

It may be possible that Burnett included cases that clinically stimulated fungal infection but with different aetiology and probably spontaneous remission.

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WARTS
GUPTA RAMJI, BHARDWAJ O.P. and MANCHANDA R.K., Homoeopathy in the treatment of warts; British Homeopathic Journal, 1991, 80, 108-111

Total number of patients studied = 66 Patients

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33 20

Verruca vulgaris

Verruca plana

Verruca plantaris

Verucca vulgaris & plana

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Verruca vulgaris
Out of the total of 34 cases, 12 cases defaulted.
Out of the 22 cases, warts disappeared in 21 cases. nine with Thuja Oc, two with Ruta, three with Nitric acid, two with Calc carb, two with Nat mur, one each with Causticum, Ant-crud and opium.

Verruca Plana
Out of 13 cases of verruca Plana, only one defaulted. Out of 12 cases, nine showed complete disappearance. Six with Ruta, two with Thuja and one with Ant-crud.

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Verruca Plantaris (Plantar warts)

Out of 20 cases, one defaulted & 18 cases recovered completely. Ruta was initially given successfully in a case of painful, sore verruca. Subsequently it was given to all the 11 cases of verruca plantaris irrespective of symptoms with complete recovery. Three cases improved with Thuja, two with Antim Crud and one with Calc-carb.

Warts on any part of the body responded equally to treatment. No patients reported any scar after recovery, although in few cases hyperpigmentation persisted for some time. In one year of follow-up no patient had reported any recurrence.

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 In the present study, clearance of warts with homeopathy was 90%, In case of verruca vulgaris & verruca plantaris it was 95% and verruca plana 75%. Warts are known to clear spontaneously even without drug. To prove the efficacy of these drugs double blind placebo control trial was undertaken.

Double Blind Placebo Control Trial

Manchanda R.K., Mehan Neena, Bahl Ritu and Atey Rajni; Double Blind Placebo controlled clinical trials of Homoeopathic medicines in Warts and Molluscum Contagiosum; CCRH quarterly bulletin, 19 (3&4)-1997.

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Molluscum contagiosum
Molluscum contagiosum

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Anamnesis
Total number of cases studied 124 ( 81 Male and 43 Females ). Of these, 104 cases were analyzed and 20 cases defaulted. The study design was parallel and randomized. Thuja, Causticum, Calc carb and Ruta in different potencies were used.
DRUG GROUP Types Warts Mollusc. Conta. Total
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PLACEBO GROUP % 78% 87% Given Effec. 30 5 11 1 % 36% 20%

Given 54 15

Effec. 42 13

69

55

80%

35

12

34%
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Clinical Case History GUPTA RAMJI, RK Manchanda, Reiters Disease treated with Nux Vomica, Published in Homeopathy, 2006, Vol 95, Number 2, pp-103-104

35 yrs old male presented with fever joint pain and skin lesions of six month duration Pain in his right knee joint, gradually involved the left knee joint both ankles and subsequently other joints of the body including temporomandibular joints during the next two months He was given analgesic orally without much relief in AIIMS.

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Next two months he developed thick heaped up crusted lesions of 1-2 cms size on his abdomen, which subsequently involved other parts of the body specially, face, scalp, extremities, back and genitalia Next 6 months he started getting fever of 104- 105 F which was more in the evening Pain, burning, redness and discharge in both of his eyes Developed burning micturition History of diarrhoea alternates with constipation with mucous in the stool
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No history of extra-martial sexual contact Emaciated, poorly nourished, irritable and melancholic All swollen joints especially ankle, knee, wrist, elbow, shoulder and swollen hip Tender deformed with restricted movements Total leucocyte count 12000/cmm with 70% polymorphs, 25% lymphocyte and 5% eosinophil Erythrocyte sedimentation rate was 150 mm in the Ist hour Urine showed albumin and few pus and epithelial cells No occult blood found in his stool
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Prescription on symptomatalogy Lycopodium and Nux Vomica Initially Lycopodium 200c, 3 doses at 10 minutes Predominating symptoms were disposition to frown, dictatorial attitude and anger from contradictions, complaints from right to left side and evening aggravation of joint pain
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After 12 days: Lycopodium 1M, 3 doses were given with Aggravation of joint pain No change in other symptoms Prescribing symptoms remained the same After one month: Lycopodium 10 M 3 doses Marked changes in the prescribing symptoms in the next 20 days Evening aggravation was irregular, patient became hypersensitive to noise and wanted to be left alone in peaceful atmosphere. At this stage Nux Vomica appeared to be the drug of choice.

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Nux Vomica in 200 potency was started. There was no change. Even next potency of 1000 potency could not control the symptoms. Patient was still desperate having severe joint pains, skin full of heaped up crusted lesions with fever running 104-105 F. At this juncture we decided to give very high dose of Nux Vomica 50 M, 3 doses at 10 minus interval.
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 In next 15 days, there was marked improvement mentally as well as physically. Fever decreased, erythema reduced, crusts of skin lesion started falling, and pain in joints also reduced Condition became static after 7-10 days when next pulse dose of further high potency of Nux Vom CM was given. In next one week symptoms and signs of eyes cleared completely. Fever became normal in 15 days Skin lesion cleared completely during next 3 months

Pain and swelling in all the joints improved in 3 months. However mild pain, restriction in movement and deformity persisted in hands and knee joints He was given placebo along-with physiotherapy. Placebo was stopped during the next three months with complete disappearance of joint pain also. After 6 months he was able to walk freely with no skin lesions and joint pain
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Discussion
There was no recurrence of any symptom during the next 11 years of follow up .
Disappearance of the sign and symptoms with high potency (50M-CM) of Nux Vomica in the present case who was almost bed-ridded suggest that high potency medication can be curative in chronic diseases. There was no effect of medicine up to 1M potency. However signs and symptoms started showing improvement during the next 15 days with 50M potency of Nux Vomica and almost cleared in 7 days with CM potency.
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Conclusion
There is a need to publish studies in reputed journals as discussed above to establish EBH in respect of different diseases. The studies should be qualitative and reproducible. The existing literature of homeopathy is also required to be reviewed without any bias to form the background for EBH.
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