Epidemic Case Taking

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Epidemic Case Taking
Dr. B. Parthasarathy DMO( Homoeopathy)
Thiruvananthapuram Member, State Level Expert
Group Technical Core Group Rapid Action
Epidemic Control Homoeopathy
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1801
The year of birth of the concept of Epidemic
Preventive Medicine in Homoeopathy. Discovered
by our Great Master Dr.C.F.S.Hahnemann First
Preventive Medicine Belladonna First Epidemic
Prevented Scarlet Fever. First Govt. which
implemented homoeopathic prophylaxis for scarlet
fever Prussian Govt in the year 1838
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In 1801, Hahnemann published the secret of the
discovery of the prophylactic properties of
Belladonna in scarlet fever in a small pamphlet
printed at Gotha "Cure and Prevention of Scarlet
Fever". Hahnemann writes 'I reasoned thus, a
remedy that is capable of quickly checking a
disease in its onset, must be its best
preventive. The following occurrence
strengthened me in the correctness of this
conclusion. Some weeks previously three children
of a family lay ill of a very bad scarlet fever
the eldest daughter alone, who, upto that period,
had been taking Belladonna internally for an
external affection, to my great astonishment did
not catch this fever although during the
prevalence of other epidemics she had always been
the first one to take them'
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Epidemic case taking has to be done in the
following situations

• Epidemic where few cases are reported
• During a wide spread epidemic
• When an epidemic is feared

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BACKGROUND
Shortfalls observed in the past epidemic
preventive activities

• Standard epidemic case format.
• Effective training in epidemic case taking.
• Systematic analysis and evaluation of the
  recorded cases.
• Proper documentation at various levels.
• Feedback studies based on scientific protocol.
• Uniformity in preventive medicine distribution
  package.
• Publication of standard epidemic related
  awareness materials
• Effective and speedy distribution network.
• Post epidemic data collection for Research and
  future program
• Effective incorporation of Information Technology.

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Objectives of an Epidemic Investigation in General

• To define the magnitude of epidemic outbreak in
  terms of time, place and person.
• To determine particular conditions and factors
  responsible for the occurrence of the epidemic.
• To identify the cause, source(s) of infection and
  modes of transmission to determine measures
  necessary to control and
• To make recommendation to prevent recurrence.

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Objectives in Particular to a Homoeopathic
Physician
To find a preventive remedy to protect unaffected
group. To give homoeopathic management to the
affected individuals. Finding suitable
similimum Appropriate diet and regimen Give
awareness about the individual, family and social
hygiene
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Required Qualities of Trained Reserve Groups
(TRG) for Case taking

• As Hahnemann says 83
• Freedom from prejudice
• Sound senses
• Attention in observing
• Fidelity (trueness) in tracing the picture of the
  disease

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Thrust Area of Epidemic Case Taking
Hahnemann has brought the epidemics under the
classification of acute diseases. This
presupposes that the manner to be adopted in case
taking, analysis and management is the one
required to be done as in acute disease.

• Particulars of the most probable exciting cause.
• Physical
• Biological
• Onset of each symptoms (Time, lt,gt)
• Pathological data supporting the diagnosis
  including investigations

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Importance of Specific Format for Epidemic Case
taking.

• Epidemiological information
• Collection of data
• Based on current scientific approved parameters
  of community medicine. (Disease diagnosis)
• Considering the fundamentals of Homoeopathy.
  (Patient diagnosis)
• Finding out a similimum for the individual an
  exact preventive for the mass.
• Helps in retrospective studies and effective
  implementation for future health plans.

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GOVT. OF KERALA DEPT. OF HOMOEOPATHY RAPID ACTION
EPIDEMIC CONTROL CELL IN HOMOEOPATHY(RAECH) FORMAT
FOR AN EPIDEMIC CASE TAKING
Reporting Centre

Date  
1.Background
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2.Historical Data
3.Methodology of Investigations

• Suspected
• Probable
• Confirmed

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4.Biodata
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(No Transcript)
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5. Presenting Illness (vide database sheet)
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(No Transcript)
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Place

Name of the Doctor Date
Signature.
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Database Sheet
Common symptoms seen in the prevailing epidemics

• Fever (Chill/Heat/Sweat)
• Respiratory Tract Symptoms(Coryza, cough,
  expectoration)
• Pain in general
• G.I.T eliminations (vomiting. Diarrhea,
  constipation)
• Eruptions/ Rashes in general
• Eye symptoms

As seen in Repertories based on Hahnemannian
Schema.
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DATABASE SHEET FOR FEVER   (CHILL / HEAT /
SWEAT)  
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DATABASE SHEET FOR RESPIRATORY TRACT
SYMPTOMS (CORYZA / COUGH EXPECTORATION)
   
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DATABASE SHEET FOR PAIN IN GENERAL
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(No Transcript)
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DATABASE SHEET FOR GASTRO INTESTINAL TRACT
ELIMINATIONS  (VOMITTING / DIARRHOEA /
CONSTIPATION)
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DATABASE SHEET FOR ERUPTION / RASHES IN
GENERAL
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DATABASE SHEET FOR EYE SYMPTOMS
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Prophylactic Posology

• AIM
• To induce artificial disease at dynamic plane
  similar to the prevailing epidemic.
• POTENCY
• Short acting drug of vegetable orgin lower
  potencies 12 C/30 C
• Deep acting drugs of mineral or animal orgin
  Medium potencies 30 C/ 200C
• Nosodes Higher potencies from 200 C and above

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• DOSE
• Distinct from curative dose
• Curative dose Human body in its optimum
  sensitive state (diseased state) minimum dose
• Prophylatic dose Human body is devoid of
  sensitivity of a particular disease (Healthy
  state) moderate dose

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• DURATION OF INTAKE
• FACTORS TO BE CONSIDERED
• Duration of action of the selected drug
• Period of communicability of the epidemic (Refer
  annexure No. 1)
• Duration of the epidemic

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Miasmatic Perspective Of Epidemics

• Generally an epidemic is an expression of acute
  miasm.
• Miasmatic expression of probable epidemics are
  briefly given in the Annexure No. 6

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Miasmatic Prespective

• Chicken pox-
• In Psoric patients, the infection produce rashes
  followed by blisters all subsides within the
  normal course. Leaving no permanent scars.
• Secondary infection of the skin leaving scars or
  depressed marks shows the sycosis or syphilis of
  the individual
• Cholera
• Moderate vomiting and profuse diarrhoea- Psora
  , Sycosis
• vomitting and diarrhoea out of controll-
  Syphilis
• Fatal dehydration- Syphilis
• Conjunctivitis
• Viral Conjunctivitis- Psora
• Red, gritty, itching eyes- psora
• Bacterial conjuctivitis sycosis
• Yellowish, thick, discharge, sticky lids
  sycosis
• Dengue fever
• Never seen predominantly in psoric individuls
• Severe pain in muscles and joints sycosis
• Recurring fever sycosis
• Red spot in skin Syphilis
• Abnormal bleeding from gums and nose Syphilis
• DHF,DSS Syphilis

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• Diarrhoeal disorders
• Profuse, loose watery stools - Sycosis
• Leading to dehydration, out of control frequency
  and intensity- syphilis
• German measles
• German measles usually do not occur in purely
  psoric patients
• Swollen lymph nodes in the back of neck, behind
  ears, armpits, groin, sometimes throughout the
  body- psora Syphilis
• Pink, non itchy rash psora sycosis
• Reactive arthritis sycosis
• Congenital abnormalities syphilis
• Infective hepatitis
• Fatigue, poor appetite, nausea, vomiting,
  discomfort in right hypochondrium, fever- psora
• Hepatitis A psora
• Carriers, chronically increased serum bilirubin
  Sycosis
• Hepatitis B, Cirrhosis, Malignancy,
  Fatality Syphilis
• Japanese encephalitis
• Mild to severe febrile illness, headache,
  nausea, vomiting psora
• Speech and memory impairment, paralysis hearing
  loss, loss of consciousness, coma, fatality-
  Syphilis
• Leptospirosis
• Fever, intense headache, muscle pain,
  conjunctivitis, flat red rash, symptoms reappear-
  Psora

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• Malaria
• Plasmodium malariae, Plasmodium ovale,
  Plasmodium vivax- Sycosis
• Recurrent attacks of high fever. Shivering and
  chills heavy sweating, fatigue, muscle pain
  Sycosis
• Plasmodium falciparum, continuous fever, kidney
  failure, fatal malaria Syphilis
• Measles
• fever, rashes, watery eyes, stuffy or runny
  nose. Hacking cough etc are all Psoric
• Complication in ear, lings brain etc are decided
  by the Sycosis and syphilis of the patient
• Mumps
• Pain and swelling on one or both sides of the
  face are all psoric
• Complications of testes, brain pancreas, etc
  show the presence of sycosis or syphilis
  depending on the symptoms.
• Very huge or diffuse swelling indicates sycosis.
• Typhoid
• headache, fever, dry cough, abdominal pain-
  psora
• Constipation, diarrhoea- psora sycosis
• Rash of rose coloured spot appearing on chest
  abdomen and back Psora syphilis
• Complication like intestinal bleeding,
  perforation etc. only syphilis
• Viral fever( influenza)
• High fever, sweating, aching muscles, weakness
  sneezing , runny nose, sore throat, cough
  etc.-psoric
• Complications like bronchitis, pneumonia etc
  possible Sycotic or Syphilitic patients depending
  on their presentation.

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Distribution of Preventive Medicine

• Should be under the supervision and guidance of a
  qualified homoeopath.
• Authorized request letter from the agency is
  essential.
• Distribute only through authorized agents such as
  government institutions dispensaries, hospitals
  etc, medical camps / preventive camps organized
  under the auspicious of Local Self-Governments,
  voluntary organizations / institutions etc.

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• During a wide spread epidemic the Preventive
  Medicine declared by the SLEG should only be
  distributed.
• During a wide spread epidemic without the
  knowledge or consent of DLR no preventive
  programme should be organized.

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• The preventive medicine and accessories for the
  prophylactic activities organized by RAECH should
  be purchased from HOMCO only.

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Preventive Medicine Distribution Register

• All the practitioners both Government and
  Private should keep preventive medicine
  distribution records.
• AIMS
• To collect the total no. of individuals received
  the preventive medicine according to the age, sex
  area during an epidemic and in other sporadic
  communicable diseases.
• To measure the quantity of medicine and
  accessories spend and total expenditure,.
• To prepare plans for future epidemic activities.
• To prepare data for scientific feed back studies.
• Model of preventive distribution register is
  given in Annexure No.20

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The next procedure is case analysis, evaluation,
repertorisation and arriving at a genus
epidemicus.
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If an Individual Is Affected by the Epidemic Even
After Taking Preventive Medicine

• Probable reasons
• Not taken the medicine as per the instructions.
• Insufficient dose duration
• Medicine intake during the incubation period
• Intake of strong other medicines
  (immunosuppresents, neurosuppresents, steroids
  etc.) and habit of high consumption of alcohol
  and drugs during the intake of medicine.
• Incorrect selection of Genus Epidemicus

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POINTS TO REMEMBER BEFORE LEAVING THE HALL

• All homoeopaths Govt. and private are obliged to
  work together in the epidemic preventive
  activities
• It starts from
• Epidemic area visit
• Case taking
• Analysis, Repertorisation, Finding out of Genus
  epidemicus, Preventive medicine distribution
  package
• Ends with Feed Back procedure

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• All these activities should only be under the
  sole supervision and control of DLR Chairman that
  is the DMO (H) of the affected district.
• ALL THE PREVENTIVE PROGRAMMES IN THE STATE WILL
  TAKE PLACE ONLY UNDER RAECH HERE AFTER.

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R. A. E. C. H.

• Rapid R Rapidity in the periphery
• Action A Action in DLR
• Epidemic E Evolving preventive medicine
• Control Cell C Collective responsibility
• Homoeopathy H Honor to Homoeopathy and
  Homoeopathic profession from the public

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THANK YOU