A homoeopathic drug, Arsenicum album 30, has become a subject of debate after several states recommended it for prophylactic (preventive) use against Covid-19. This was after the Ministry of AYUSH listed the drug among “preventive and prophylactic simple remedies” against Covid-19.
The debate stems from the fact that there is no scientific evidence that the drug works against Covid-19, a fact stressed not only by medical scientists but also by some homoeopathic practitioners themselves.
Arsenicum album 30 has been recommended by the state governments in Rajasthan, Karnataka, Tamil Nadu, Andhra Pradesh and Kerala. While the Maharashtra government is yet to take a formal decision, Mumbai civic authorities have been distributing the drug to high-risk populations in at least two wards. The Haryana prisons department and Mumbai police too are also distributing the drug to prisoners and officers respectively.
Even in states that have no protocol for using the drug against Covid-19, there have been reports about people flocking to homeopathic clinics to buy Arsenicum album, sometimes at triple the cost. Even local chemists have started stocking this medicine.
Arsenicum album is made by heating arsenic with distilled water, a process repeated several times over three days. The health hazards of arsenic contamination in water are well known: long-term exposure to the metal can cause skin cancer, pulmonary and cardiovascular diseases. The homoeopathic drug has less than 1% arsenic, said Dr Amrish Vijayakar of Predictive Homoeopathy Clinic in Mumbai.
“Arsenicum album is considered to correct inflammation in body. It takes care of diarrhoea, cough and cold,” he said. A small bottle with one course costs Rs 20-30.
Professor G Vithoulkas writes in an article published by the International Academy of Classical Homeopathy that Arsenicum album is used commonly by homeopaths to treat anxiety, restlessness, cold, ulcerations, burning pains. It is taken in powder form or as a tablet.
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The Covid-19 context
On January 28, at its 64th meeting, the Scientific Advisory Board of the Central Council for Research in Homoeopathy (CCRH) opined that “Arsenicum album 30 could be taken as prophylactic medicine against Coronavirus infections”. The CCRH released a fact sheet stating this medicine is only a “possible prevention” against flu. The following day, the Ayush Ministry recommended taking the medicine for three days on an empty stomach and repeating the dose after a month if an outbreak continues locally.
On March 6, by when India had recorded five Covid-19 cases, Rajesh Kotecha, Secretary in the Ayush Ministry, wrote to all chief secretaries listing out preventive and prophylactic measures. His letter recommended a three-day dose of Arsenicum album 30 as a prophylactic. The following day, the Ministry released another notification with “preventive and prophylactic simple remedies” against Covid-19-like illness and listed Arsenicum album 30 as a homeopathic solution.
“Arsenicum album 30, daily once in empty stomach for three days. The dose should be repeated after one month by following the same schedule till Corona virus infections prevalent in the community,” the letter said.
For symptom management, the letter listed Arsenicum album among various homeopathic treatments, including Bryonia alba, Rhus toxico dendron, Belladona and Gelmesium. “Homeopathy has reportedly been used for prevention during the epidemic of cholera, Spanish influenza, yellow fever, scarlet fever, diphtheria, typhoid, etc,” it said.
The letter said during the 2014 Ebola outbreak, an expert committee in the World Health Organization (WHO) recommended “it is ethical to offer unproven interventions with as yet unknown efficacy and adverse effects, as potential treatment on prevention keeping in view no vaccine or anti-virals were available”.
Following the Ministry’s recommendations, various state governments and district authorities have started distributing the medicine, in some cases free.
The Central Drug Standard Control Organisation last month issued a notification allowing private practitioners to try alternative remedies like Ayurveda and homoeopathy to treat Covid-19.
Where’s the science?
Dr Balram Bhargava, director of the Indian Council of Medical Research told The Indian Express, “We have issued no guidelines regarding the medicine.”
The WHO has no guidelines on using Arsenicum album as a Covid-19 treatment either. “No evidence that it works,” WHO chief scientist Dr Soumya Swaminathan told The Indian Express.
The Maharashtra government has set up a task-force to evaluate the homoeopathic drug and decide whether it should be used against Covid-19. Its members said they remain undecided. Dr Archana Patil, joint director in the Public Health Department, said Maharashtra is allowing the drug’s use as an immunity booster, like vitamin C tablets, but not encouraging it as a prophylactic. “There is no scientific evidence that it works as prophylactic. So, we are not encouraging it universally for everyone,” she said.
Mumbai corporator Alpa Jadhav remembered seeing locals roaming around her area one day, although the lockdown was in effect. “They said they had taken Arsenicum album. It was scary; they believe this medicine can save them from coronavirus.”
Concerns within the field
With no clinical trial or large-scale study having been undertaken anywhere to scientifically validate the use of Arsenicum album 30 as a preventive medication, the massive demand has worried some homeopaths, too. Dr Vijayakar said their organisation has written to the Ayush Ministry asking why no trial has been conducted to assess its efficacy before recommending it.
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The Ayush Ministry has based its recommendation on existing use of the medicine for respiratory illness and influenza. Several homeopaths have pointed out that each individual reacts differently to homeopathic medicines and one medicine cannot be universally held as a prophylactic for all. “It can only be a part of the treatment, if at all,” said Dr Bahubali Shah, a homeopathy practitioner.
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