Dealing Chronic Diseases with Homoeopathy

,


Introduction
People with diabetes have a higher risk of developing heart problems, nerve damage, and kidney disease & vision issues.Multiple chronic conditions or multi morbidity can worsen health burden, complicate treatment & increase the risk of adverse outcomes.[1,2] Heart Health is directly related to hypertension.The current picture of hypertension in India is also given in this article through the National Family Health Survey (NFHS).Intakes of salt on a daily basis & the Dietary Approaches to Stop www.cmhrj.comHypertension (DASH) have also been focused in the article.The DASH diet is a healthy 'eating plan designed' to help prevent or treat high blood pressure.It may also help lower cholesterol linked to heart disease called Low Density lipoprotein (LDL) cholesterol.Similarly, World Health Organization (WHO) recommends a slat intake of less than 5 grams or approximately 2 grams of Sodium per person per day for the prevention of Cardio Vascular Diseases (CVD), the leading cause of death globally.[17,25,26] Similarly, for cancer, the data from NFHS is used in the article as NFHS gives data related to oral cancer for men & women where as breast, cervical cancer related data is given for women.The data from National Institute of Health regarding cancer is also cited in the article.[17,24] The article concludes with the way forward approaches & the way homoeopathy can play an active role in the era of medical pluralism.[18,19]

About the epidemiology of chronic diseases
India has the second largest number of diabetics worldwide.According to an estimate, over 74 million Indians were diagnosed with diabetes in 2021 & this is expected to rise to over 124 million by 2045.Type 2 diabetes accounts for over 90% of all diabetic cases in India.[1,5,6] A recent study by the health ministry indicates that around 101 million people in India, comprising 11.4% of the population have diabetes.Additionally, 136 million people or 15.3% may have pre-diabetes, which can progress to diabetes within five years.This situation is alarming & can be described as a 'diabetes epidemic'.Diabetes affects approximately one in every 11 adults globally.[1,5,6] The estimated number of incident cases of cancer in India for the year 2022 was found to be 14,61,427 @ crude rate 100.4/100,000.In India, one in nine people are likely to develop cancer in his/her life time.[24] In accordance with the WHO, India accounts for 1/5 th of CVD deaths worldwide especially in younger population.The results of Global Burden of Disease Study state age standardized CVD death rate of 272 per 100,000 population in India that is much higher than that of global average of 235.[27]

Prevention of chronic diseases
Many chronic diseases can be prevented, reversed or managed through life style changes, early detection, proper medical care & sticking to treatment plans.The process starts with eating healthy foods, staying active, not smoking, not drinking alcohol too much & in addition to that, regular visit to the doctor & get vaccines are also critical.[1,2] Here, eating healthy means to eat a balanced diet on regular basis that has fruits &vegetables, whole grains & lean proteins.Avoiding processed foods, sugary drinks, too much salt on a daily basis is essential.[1,2] Regular physical activity like walking, cycling, swimming & maintaining a healthy weight are also important methods of prevention.[1,2] Quitting smoking is crucial because it increases the risk of chronic diseases such as cancer, heart disease & lung disease.
Regular checkups can detect potential health issues & vaccinations protect against specific diseases & reduce the chances of complications.[1,2] The COVID 19 pandemic has affected our bodies & we have seen increased cases of heart diseases and uncontrolled sugar levels.Similarly, it is crucial not to ignore any symptoms or discomfort & seek medical guidance.Here, heart diseases are critical as some blockages can be asymptomatic ot not easily detected by Electro Cardio Grams (ECG) but can lead to heart attacks [1,2,23]

Prevention of Diabetes, Heart Diseases & Cancer
Diabetes is one of the most hostile chronic conditions that affects how our body processes sugar.Reduction in chances of Type 2 diabetes can be achieved by eating healthy, maintaining healthy weight & being physically active.[1,2,3,4] Heart disease is a leading cause of death.We all can protect our hearts by knowing what can hurt the heart.These are high blood pressure, high cholesterol, obesity & smoking.Regular visits to the doctor to monitor blood pressure, cholesterol levels, high homo-cysteine level, Other risk factors are like heart disease can be addressed through Electro Cardio Grams (ECG), cardiac profile, 'Computerised Tomography (CT) calcium score'.& stress tests helps detect heart problems at an early stage.[1,2,3,4] Cancer can affect many parts of our body.Family history can increase chances of getting cancer that can be reduced with risk reduction.By getting screened regularly for cancer early detection can become easier.Not smoking & avoiding second hand smoke significantly reduce the risk of cancer.Maintaining a healthy weight through a balanced diet & regular exercise reduces the risk of breast, colorectal & kidney cancer.[1,2,3,4] Chronic diseases can be challenging but we all can make a difference.By making healthy choices & receiving regular checkups these chronic diseases can be prevented & the population can prevent these diseases while enjoying better health with longer quality of life.[1,2,3,4]

Way forward
Currently, there is a proposal by the Government of India to address these chronic diseases or the Non-Communicable Diseases is through the concept of the health & Wellness Centers (HWC) on a large scale at the national level.The current proposal of developing the Health & Wellness Centers (HWC) known as the Ayushman Bharat Health Wellness Center (ABHWCC) was launched under the Ayushman Bharat programs.This was done in a bid to move away from selective health care to a more comprehensive range of services that includes preventive, promotive, curative, rehabilitative & palliative care for all ages.National Health Policy, 2017 saw these as the foundation of India's health system.[28] In February 2018, Government of India (GoI) announced the creation of 1,50,000 HWCs by transforming the existing Sub Centers (SC) & Primary Health Center (PHC) as the base pillar of AB.The centers are expected to deliver Comprehensive Primary Health Care (CPHC) bringing health care closer to www.cmhrj.comhomes of people covering both Maternal & Child Health (MCH) services & Non-Communicable Diseases (NCD) including free essential drugs & diagnostic services.[28] The concept of HWC also discusses about the integration of AYUSH to upscale the Universal Health Coverage (UHC) and in this article the integration of homoeopathy into the public health systems & approaches is a step in that direction.[18,19,28]

Homoeopathic approach
A study shows that there is complex interplay between chronic diseases and mental health thus needing a holistic approach to management in chronic diseases addressing both physical and psychological factors.This is where homoeopathy chips in to play an active role.As already mentioned above, all Homoeopathic medicine has physical and mental symptoms as the drugs are proved on human beings.Given below are Homoeopathic medicines that are primarily from four sources.These are H.C. Allen's Key notes, Robin Murphy's Materia Medica, Phatak's Materia Medica & Boericke's Materia Medica.These four text books are used to teach homoeopathic students who become qualified homoeopaths later.The treatment plans for these chronic disorders mentioned above are given below.[7 to 16] The issues like chronic diseases & related disorders can be resolved through the Universal Health Coverage (UHC) where the AYUSH systems like homoeopathy can play an active role.The network of private, public and corporate system can come handy here.The inclusion of the traditional systems like homoeopathy can play a vital role to achieve UHC in India as reinforced by a published article on the issue of UHC.[18,19]

Homoeopathic treatment protocol
In the first portion of this section, the specific medicines that have been found to be therapeutically helpful over two & half centuries have been discussed.These drugs have been serving the humanity since the discovery of the Homoeopathic therapeutic system in 1790.[7 to 16] Besides these, there are 'n' numbers of medicines besides the list mentioned above.Under chronic disorders, homoeopathy has medicines that are prescribed on the basis of generalities.These are the symptoms or factors that affect the individual as a whole.While describing these symptoms, the individual starts with the word 'I'.As the article deals with chronic disorders, the broad component of generalities & the related particulars fall in the purview of the article.[7 to 16] These are chronic cases which usually are on medications for long and subsequently these cases became resistant to treatment post the chronicity of the trio mentioned in the article.Each homoeopath should remember that exercise and diet are the main stay of the treatment.A prescription of exercise of 45 minutes of brisk walking per day and the Indian diet of Sattvic, Tamasik and Rajasik as mentioned in the prognosis coupled with care section are a must along with the homoeopathic medicines.[3,20] The treatment plan is on the lines of the physiology, pathology and symptom pattern of the chronic disease affected patients as mentioned above.The first approach is the miasmatic approach.In homoeopathic system of medicine, miasms are disease causing fundamental dynamic influences that are infectious in nature.[7 to 16] Miasmatically, if the patient has asggravation of complains in morning & evening, anti Psorics are to be prescribed to prevent chronicity in nature.e.g.aggravation during morning & evening-the drug is 'Sulphur'.If at night, anti-Syphilitics like 'Syphilinum' & if during forenoon, noon, afternoon, anti Sycotics like 'Thuja' are to be prescribed.There are two types of diabetes, one is diabetes mellitus & the other is diabetes insipidus.Here, both the types are discussed.[4] The lead author has picked up the drugs that are mentioned in capital letters under diabetes.These are the drugs that act in high sugar levels thereby preventing neuropathy.This neuropathy leads to heart attack.The drugs are Bovista, Helonias, Phosphorus, Phosphoric Acid, Tarentula, Terebinth & Uranium Nitricum.The drugs for diabetes insipidus are 'Abroma' in mother tincture & 'Acid Phos' in potencies.[8] Besides the potency medicines, the mother tinctures of Indian drugs can also be prescribed.Under heart & diabetes, the major drugs are Sepia & Sulphur.[8] There is one constitutional medicine mentioned under heart & it covers palpitation & the drug is Lachesis.[8] Besides, the specific drugs for diabetes like Arsenic Bromide, Alloxan, Phaseolus, Phlorizin can also be prescribed.[6] For prevention of uncontrolled sugar levels & heart issues, miasmatic prescribing should be done based on the predominant miasms as discussed above.[13] Whenever heart attacks occur, emergency medicines like Latrodectus, Glonoin, Haematoxylon, Natrum Iod & Zinc Iod are also to be prescribed.The classic combination of Carbo Veg & Aconite can also be prescribed.Another classis example is the combination of Cactus, Crataegus & Glonoine mother tinctures can be used.The point is that the diabetic & heart patients should carry these emergency medicines with them.This disciplinary habit will save lives.[6 to 14] It is also equally critical to keep the Bach flower remedy known as 'Rescue Remedy' as these patients can be saved from heart attacks as well.[15] Another preventive & curative medicine is the bowel nosode 'Dysentery Compound' which is also a heart nosode.[6 to 14] For cancer, along with the antimiasmatic prescribing, medicines like 'Carcinisin', Scirrhinum', 'Aqua Pura' & 'Carcinoma Foubister' & 'Oxygenium' can be prescribed.Three types of cancer have been discussed through the data from NFHS as mentioned above.This reflects the magnitude of the problem in the country from the perspective of chronic diseases as diabetes is a metabolic disorder with an altered biochemistry & physiology in the body leading to pathology.So males are more diabetic than females in India.

Homoeopathy & GDP of India
The current GDP of India is

Conclusion
As all drugs in homoeopathy have a group of mental symptoms, Homoeopathy is and will be effective against these chronic disorders in general.The current article adds another feather in the Homoeopathic cap as it can deal with the probable upcoming of large number of cases of these trio disorders in view of high stress levels due to the consequences of the ongoing COVID 19 crisis that is still prevalent in the form of long COVID.However, it should be also seen that along with constitutional/deep acting/polychrest Homoeopathic medicines, specific medicines are also required to deal with the cases.Simultaneously, nutrition, counseling and all psychic health modalities like life style modification, diet and stress reduction are adhered in each case.[7 to 16, 23] In fact, the detailed case taking of a case & empathetic hearing are the elements of supportive therapy as such chronic cases are stubborn and resistant.The Homoeopathic approach of casetaking/anamnesis exactly fits into the criteria of supportive therapy.Hence, as a part of treatment, the supportive therapy is inherent in the Homoeopathic system of treatment.[7 to 16] The Homoeopathic fraternity should be ready to cover the masses as there is no other therapeutic system that can cover the masses effectively while being economical, no side effects and to add to it, it is cost effective.Simultaneously, it has a wide range of medicines for these chronic disorders as seen in the contents of the sections mentioned above.[4, 7 to 16]

Declaration of the lead author
Prof. Shankar Das, a co-author of the current article was the Ph.D. guide of the lead author at Tata Institute of Social Sciences, Mumbai.Professor D.P. Singh, another co-author of the article was the teacher of the lead author at Tata Institute of Social Sciences, Mumbai during 1995-1997.The lead author also certifies that he has expressed his personal opinion based upon his public health and clinical experiences.The treatment approach or the medicines suggested are only suggestive in nature.

Table 3 -Cancer related indicators in NFHS 5 2019-21.
[17,18,19]million consist of all age groups i.e. infant to old age.[19]Asectionamong the 15+ age group suffers from diabetes as per NFHS 5. Considering that, it is 2/3 rd of the population in India (15-65+ year age group) or 100 crore or 1000 million.Out of these 100 crores, 27% adults are diabetic or about 27 crores are diabetic.These people are at risk from the rest 73 crore.As 130 million use homoeopathy, 2/3rd of the users will be in 15-65+ year age group or 98 million.So, if homoeopathy in integrated in to the diabetic battle in India, 98 million people can be saved from being complicated diabetic cases.Application of biochemical concepts in homoeopathy will be a boon in this regard.[17,18,19]Usingthe same analogy, the burden of heart disease & cancer can be deduced.The cancer related data shows that about 4% suffer from breast, cervix & oral cancer in both the genders in India.In case of high blood pressure, the data shows that 1/4 th of the population in each of the gender suffer from hypertension in India.
3.75 trillion INR.As per the available data, 10% of population use Homoeopathy currently in India.Hence, integration of homoeopathy will help India to save 0.375 trillion INR per year hypothetically.In the process, the trio of diabetes, heart disease & cancer can be dealt with while saving the population from complications related to excess inflammatory levels.[21]