Acute diarrhea: The homeopathic approach

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Acute diarrhea: The homeopathic approach

This paper was presented at the annual conference of the National Center for Homeopathy in San Francisco on March 29, 1992.

Diarrhea is one of the most common, and unpleasant, acute illnesses seen in medical practice. Its existence has been recorded as far back as 3000 BC in hieroglyphics that have been found depicting diarrhea. It can strike anyone at any time. Most commonly it occurs after eating contaminated food or while traveling in exotic places. It can also be part of the "flu," often accompanied by other symptoms such as fever and vomiting, or it can be associated with teething in children.

In the developing world it is the leading cause of death among children under age five, leading to more than five million deaths each year (Walsh, page 967; Snyder, page 605). In many parks of the developing world, children under age live have an average of 5-10 episodes of acute diarrhea per year lasting an average of six days for each episode. In Nicaragua, diarrhea is the primary cause of mortality and the second of morbidity during the first year of life and it constitutes 19% of all outpatient consultations in children one to four years of age.

In the US, modern sanitation and hygiene have made deaths from acute diarrhea extremely rare. However, it continues to be a common cause of morbidity in both adults and children. One recent study showed that diarrhea causes an average of 500 preventable deaths per year in the US.

Acute diarrhea can be caused by a variety of pathogens: bacterial, viral, and parasitic. In the US, the most common enteropathogens are non-typhoid species of Salmonella, Shigella sonnei and enterotoxigenic E. coli, which is often the cause of traveler's diarrhea. Principal viruses associated with childhood diarrhea are rotavirus and Norwalk agent. Giardia lamblia is the most common parasite associated with diarrhea in North America.

Since the majority of cases of acute diarrhea are viral, the use of antibiotics is rarely indicated. The World Health Organization now recommends antibiotics only for Shigella, typhoid fever, and cholera. Oral rehydration therapy, a standardized solution of salts and sugar added to water, has become the treatment of choice in the developing world. This treatment has proved to be effective in preventing death from dehydration, but has done little to reduce the overall length or severity of individual diarrheal episodes.

In the US, treatment is usually supportive, using fluid replacement and a clear liquid diet for about 24 hours, then gradually introducing solid foods, avoiding raw foods until the digestive system is back to normal. Over-the-counter and prescription drugs such as Pepto-Bismol or lomotil may give temporary relief of symptoms, but they do not alter the course of diarrhea.

The practice of homeopathic medicine uses naturally occurring plant, animal, and mineral substances to stimulate the defense mechanisms of the body, including the immune system. It is based on the principal of similars, whereby a substance that can cause symptoms when given in large doses to a healthy person can cure those same symptoms in someone who is ill when given in microdoses. Treatment is individualized. Two or more persons with the same clinical diagnosis may be given different homeopathic medicines depending on the specific symptoms of illness in each person.

Recent clinical research suggests that homeopathy affects the immune system, since homeopathy has been found to be effective in the treatment of such immunologically mediated diseases as rheumatoid arthritis and seasonal allergic rhinitis (Gibson, page 453; Reilly, page 881). Homeopathic drugs also have been found to stimulate the white blood cells and to have antiviral effects, as seen in European laboratory studies by Ferley on influenza-like syndromes (page 329) and by Davenas on mouse macrophages (page 313) and on human basophils (page 816).

Since many of the pathogens associated with acute diarrhea are viral and lowered host immunity also plays a role in its occurrence, homeopathic medicine is often valuable in reducing the severity and length of diarrheal episodes.

Homeopathic remedies have been used to treat diarrhea since the late 18th century. According to Bradford, homeopathy became popular in the mid-19th century in the United States largely as a result of its success in the great cholera and yellow fever epidemics of that time (page 112). A late 19th century homeopathic treatise, The Homeopathic Therapeutics of Diarrhea, Cholera, Cholera Morbus, and Cholera Infantum, listed 141 remedies that could be used for diarrhea. In Kent's Repertory of the Homeopathic Materia Medica, the current standard for homeopathic practice, there are 47 medicines listed specifically for diarrhea in children. A recent study of homeopathic treatment of acute childhood diarrhea showed a significant decrease in symptoms in the treated group compared to those receiving placebo (Jacobs).

Since homeopathic treatment is individualized, different patients with diarrhea will need different remedies, depending on their symptoms. The following is a listing of the most common remedies used for acute diarrhea, along with their indications for use.

Arsenicum album is the most common remedy used for acute diarrhea. The patient is anxious and restless, with a fear of being alone. There is often great weakness and prostration, along with an aggravation of symptoms from 12 to 1 AM. Arsenicum patients are extremely chilly and thirsty for water, but only for small sips at a time. The diarrhea of Arsenicum is acrid and excoriating, with a putrid odor that can smell like rotten eggs. The diarrhea is watery, often containing blood or mucus. Vomiting is often a concomitant symptom, usually occurring immediately after eating or drinking.

The Nux vomica patient is irritable and oversensitive, especially to noise, light, and smells. The diarrhea can come on after overindulgence in food, alcohol, or stimulants, as well as from food poisoning. The person is thirsty, chilly, and lacking in appetite, with symptoms often worse on first waking in the rooming. Cramping abdominal pains are accompanied by a frequent and strong urging for stool. There is often nausea and vomiting with the diarrhea, with much retching and dry heaves. The stool is frequent but scanty, thin, and mucous.

Podophyllin is indicated when the diarrhea is profuse and painless, gushing out frequently in large amounts. The stools are watery, yellow, and very offensive. There is a great thirst for large quantities of cold water. The stools can be so violent that they cause rectal prolapse. This type of diarrhea can be caused by mental excitement, eating too much fruit, or teething in children.

Another remedy for diarrhea during dentition is Chamomilla. The Chamomilla patient is irritable, quarrelsome, and impossible to please. The child may ask for something, then reject it and throw it away once it is given. The child can be comforted only by being carried and is worse in the evening, until midnight. There can be a fever, with one cheek red and the other pale. The diarrhea is green, slimy, and offensive, with white and yellow mucus, which looks like chopped eggs and spinach.

Sulphur is indicated in cases that are worse at 5 or 6 AM, with diarrhea forcing the person out of bed in the morning. The diarrhea of Sulphur is very offensive, smelling of rotten eggs, and acrid, leaving a red ring around the anus.

The Mercurius vivus patient, has slimy, scanty, bloody stools and chills that alternate with heat and perspiration. There is often increased salivation, offensive mouth odor, and swelling of the tongue with indentations from the teeth.

Phosphorus is extremely thirsty for large quantities of ice cold water and is easily startled. There are profuse night sweats. The diarrhea is painless, copious, and oozing out of an open anus. Weakness is an important feature of Phosphorus, along with vomiting of water as soon as it has become warm in the stomach.

These seven remedies, when used properly, will cover the majority of cases of acute diarrhea and are found in most homeopathic first aid kits, available from homeopathic pharmaceutical companies. There are also homeopathic combinations on the market, which combine many of the common diarrhea remedies into one tablet. Since most homeopaths use the single remedy approach, there is not much in the homeopathic literature regarding the effectiveness of combination remedies. Theoretically they should work, and could be a helpful shortcut for those without the training and time needed to individualize the prescription.

References

Bradford, T., The Logic of Figures or Comparative Results of Homeopathic and Other Treatments, Philadelphia: Boericke and Tafel, 1900, pp. 112-146.

Davenas, E., Poitevan, B, et. al., "Effect on mouse peritoneal macrophages of orally administered very high dilutions of silica," European Journal of Pharmacology, 1987, 135: 313-319.

Davenas, E., et. al., "Human basophil degranulation triggered by very dilute antiserum against IgE," Nature, 1988, 333: 816-818.

Ferley, J, et. al., "A controlled evaluation of a homeopathic preparation in the treatment of influenza-like syndromes," British Journal of Clinical Pharmacology, 1989, 27: 329-335.

Gibson, R.G., et. al., "Homeopathic therapy in rheumatoid arthritis: evaluation by a double-blind clinical trial," British Journal of Clinical Pharmacology, 1980, 9: 453-459.

Jacobs, J., "A clinical trial of homeopathic treatment for acute diarrhea in children," unpublished master's thesis, University of Washington School of Public Health, 1990.

Reilly, D., et. al., "Controlled trial of homeopathic treatment of arthritis," Lancet, 1986, 11: 881-885.

Snyder, D.C., Merson, MH, "The magnitude of the global problem of acute diarrheal disease: A review of active surveillance data," Bulletin WHO, 1982, 60: 605.

Walsh, J.A., Warren, KS, "Selective primary health care: an interim strategy for disease control in developing countries," New England Journal of Medicine, 1979, 301: 967-974.

International Foundation for Homeopathy.

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By Jennifer Jacobs

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