Scientific evidence of the efficacy and effectiveness of Belladonna to prevent scarlet fever—A systematic review with its documentation and narratives
Liga Medicorum Homoeopathica Internationalis Global Colloquium—December 11, 2021
Preface
In the fall of 2019, there was a scare about measles in the states of New York and California, which raised the possibility of mandatory vaccination.
Patients began to ask me, whether it was better or not to vaccinate their children?
I told them that I would research the subject of vaccination in general and of measles in particular to better advice them.
As I was discovering that vaccination was an extremely complex subject, I decided to document this research into a book, Risks and Benefits of Vaccination—A Holistic Perspective, which ended up to be 388 pages long with over 1,000 references.
The main findings of this research on vaccination are:
- For the last two hundred years, the key narrative of the medical establishment regarding vaccination has been that the benefits of vaccination far outweigh the risks.
- However, it was found in this research that no vaccine was safe, despite all the narratives to the contrary, as all vaccines can be associated with serious adverse events, and because the definition of the word “safe” is, “presenting no risk of physical harm; posing no threat, not dangerous,”[1] and, as one of the most fundamental principles of medicine is primum non nocere, “physician, above all, no not harm,” a more safe alternative to conventional vaccines was sought after.
- Another arm of this research was to see if the use of medicines to prevent epidemic diseases, as it has been used in homeopathy since 1799, was not only safer, but, above all, sufficiently effective to be a viable alternative to conventional vaccination.
- I focused this research on one intervention for one specific condition, which was Belladonna, the first medicine to be used to prevent epidemic diseases, which is the subject of this presentation and whose fascinating research into an important chapter in the history of medicine also ended up to be a book, which is about 600 pages long with over 1600 references.
A recall of the events regarding the use of Belladonna to prevent scarlet fever
In September 1798, Dr. Edward Jenner published his findings about the inoculation of cowpox to prevent smallpox.[2]
Only a few months afterward, in January 1799, Dr. Samuel Hahnemann faced a most virulent and very contagious epidemic of scarlet fever in the town of Königslutter where he was then living in Germany.
It is during this epidemic that Hahnemann made an important discovery in the history of medicine, which was the effectiveness of medicines to prevent epidemic diseases.
He observed that the symptomatology of Belladonna corresponded well to the one of first stage of the smooth type of scarlet fever and, that at the same time, Belladonna prevented the further development of the disease when it was in its incipient stage, and as well as to prevent its development in the ones who had been clearly exposed to this highly contagious influence.
Two years later, in 1801, and almost exactly three years after the publication of Jenner’s report, Hahnemann reported his own discovery in a booklet.
One of the most distinguished and better-known academic physicians of Europe, Dr. Christoph Hufeland of Berlin, was one of the first physicians to put Belladonna to the test.
Hufeland confirmed Hahnemann’s observations and, as the editor of one of the most prestigious academic medical journals of the time, induced his colleagues in numerous occasions to put Belladonna to the test.
A great number of trials began to appear in the literature out of many countries over the next century.
A systematic review was conducted by searching through several data banks for these reports of trials.
What should be known about scarlet fever?
Let’s first review what should be known about scarlet fever in order to better appreciate the importance of this subject.
The contagiousness and virulence of scarlet fever can vary from one epidemic to another, from one period of time to another, or from one place to another.
It is interesting to note that the more contagious epidemics tended also to be the more virulent ones, and that the great majority of the trials on Belladonna were conducted during the first half of the nineteenth century when scarlet fever tended to be most virulent and contagious.
Some epidemics were so contagious that not a child that never had scarlet fever would be spared.
And in those most contagious epidemics the mortality rate could easily rise up to 30% and even 50%.
As scarlet fever tended to visit communities every four to six years, it would therefore terrorized populations when it was approaching, as there was no place to hide.
The younger children were always the most susceptible to new epidemics and would fall victims to it in greatest numbers.
Another interesting fact about scarlet fever is that it has been known to appear for a century or so with great virulence and then become mild or almost disappear for another century or so.
The last decline of its great contagiousness and virulence began at the same time in Europe and North America around 1880 and continued to progressively decline throughout the twentieth century to the point that scarlet fever became quite rare and mild.
However in the 1980s, the incidence of infectious conditions associated with strains of the bacterium of scarlet fever, that is the highly invasive group A streptococcus, began to markedly increase and included, aside from the classic scarlet fever, very serious syndromes such as necrotizing fasciitis and toxic shock syndrome with organ failure, which were associated with mortality rates as high as 50%.[3],[4]
Recent outbreaks of group A streptococcus, including scarlet fever, have occurred primarily among otherwise healthy populations, raising concerns about the rise of antibiotic resistance strains.[5]
Further, in the last decade, scarlet fever began to reappear in many countries around the world, including the UK after 2014,[6] and Hong Kong and China after 2011,[7] where over 500,000 cases have been reported between 2011 and 2019.[8]
It is interesting to note that in the 2011 scarlet fever outbreak in Hong Kong the responsible streptococcus strain contained tetracycline and erythromycin resistance genes.[9]
Out of the 900 cases of scarlet fever that were hospitalized in the UK epidemic in 2014, many presented severe complications of scarlet fever, such as cellulitis, sepsis, encephalitis, toxic shock syndrome and glomerular nephritis.[10]
The systematic review
In this systematic review, 192 reports of trials have been found in the literature, which makes this review by far the largest one ever conducted on the subject.
Out of these 192 reports, 155 or 81% presented trials with positive outcomes and 95 or 61% of these 155 reports presented significant findings or about 50% of all the reports.
Quantitative analysis of the evidence
All these trials have been rigorously analyzed and evaluated.
Out of the 155 reports of trials with positive outcomes, 73 of these provided exact numbers, which allowed for a quantitative analysis.
Out of 8,603 people who took Belladonna in the reports of trials with positive outcomes, 8,450 or 98.2% of these people were spared of scarlet fever.
This apparently very high protective rate can only be suggestive of the effectiveness of Belladonna to prevent scarlet fever, as no one can say what would have happened if the remedy had not been administered.
The ultimate test would be of course to have series of randomized placebo-controlled trials (RCTs) conducted in different localities and circumstances.
However, no RCT has been found in the literature on the prevention of scarlet fever with Belladonna, which was not a common clinical tool in the nineteenth century.
The second best tool to a series of RCTs to evaluate the efficacy of a prophylactic intervention would be series of randomized comparative groups of treated and untreated people who were similarly exposed and shared the same environment during the same epidemic.
Outcomes of treated versus untreated cases
In this systematic review, there were twenty-eight reports of positive outcome trials that provided exact numbers of people who were treated and untreated and who shared the same environment and exposure during the same epidemic, such as living in the same household, institution or small community.
Out of 813 people who were equally exposed to scarlet fever, 675 took Belladonna and only seven or 1% of these contracted the disease, versus 83 out of 138 or 60% of the ones who didn’t take Belladonna.
This would mean that in a population of 10,000 people who would be exposed without the intake of a prophylactic medicine to a very contagious type of scarlet fever, 6,014 would fall sick to the disease, but this number would drop to only 104 by simply taking Belladonna preventively.
These numbers are obviously extremely significant in favor of the efficacy of Belladonna to prevent scarlet fever, as the odds ratio for developing scarlet fever in the ones who took Belladonna was 0.0058 versus in the ones not taking it with a p-value of less than 0.0001.
Advantages and disadvantages of homeoprophylaxis
Since the initial trial of Hahnemann in 1799, the methodology of homeoprophylaxis has been further perfected and simplified by Hahnemann and several succeeding generations of homeopaths, and has been extended with the same degree of effectiveness to other infectious diseases, such as cholera, yellow fever, smallpox, diphtheria, whooping cough, measles, influenza, malaria, poliomyelitis, meningitis, Japanese encephalitis, leptospirosis, dengue fever, chikungunya and currently COVID-19.
Overall, homeoprophylaxis has many major advantages, such as:
- It is extremely safe for all, including newborn infants, pregnant mothers and the aged, frail and immunocompromised persons.
- It can be deployed as soon as an epidemic points its nose.
- The specific homeoprophylactic remedy can be quickly changed whenever the genius epidemicus changes in a certain area during an epidemic.
- It is very cost-effective, as very little manpower is needed for its preparation and distribution.
- Remedies have a very long shelf life.
- The effectiveness of the genius epidemicus remedy tends to approach 100% protection rate.
- If the remedy used is not an omnimo genius epidemicus, but only a close fit, it can still be efficacious, but to a lesser degree and will likely reduce the severity of the disease and its mortality.
- It can be given during the incubation period and even in the incipient stage of the disease, which would either stop its development or greatly attenuate its severity.
Homeoprophylaxis also has some minor disadvantages, such as:
- The best remedy for homeoprophylaxis will need to be found in each epidemic.
- The choice and the proper administration of the remedy are dependent on the skills of the local homeopathic practitioners.
- The remedy will need to be repeated weekly or monthly, and sometimes more or less often during prolonged times of exposure.
- No lasting immunity is developed, and therefore in another epidemic of the same disease, homeoprophylaxis will need to be resumed.
- If there is a change in the genius epidemicus, the remedy will need to be changed.
- The genius epidemicus can be different in different regions during the same epidemic.
- The posology of the prophylactic remedy will need to be individualized in certain people with particular circumstances and sensitivities, as in the people with extreme sensitivity to remedies.
Conclusion
In conclusion, the scientific evidence in favor of the effectiveness and efficacy of Belladonna to prevent the smooth type of scarlet fever is indisputable, as it has been found to be overwhelmingly, quantitatively and qualitatively positive, and statistically very significant, which is at the same level of evidence that has been associated with the use of cowpox to prevent smallpox.
Hahnemann’s discovery in 1799 opened a window to an entire new and far reaching field of pharmacology, which is the use of medicines to prevent epidemic diseases.
Homeoprophylaxis is not a perfect method of protection, but it is the best that science has so far found.
It has many major advantages and some minor disadvantages, but overall what should be remembered is, that it is very safe, efficacious, cost-effective, quick to deploy and simple to apply.
And finally, the dictum that the benefits of vaccination far outweigh the risks can now be challenged with robust scientific evidence, as the ultimate and sacred promise of medicine has always been to be most safe and beneficial to all.
References
[1] Oxford English Dictionary. https://www.oed.com/viewdictionaryentry/Entry/169673
[2] Edward Jenner. An Inquiry Into the Causes and Effects of Variolae Vaccinae, a Disease Discovered in Some Counties of England, Particularly Gloucestershire, and Known by the Name of Cowpox. London. 1798
[3] Dennis L. Stevens. “Streptococcal toxic-shock syndrome: spectrum of disease, pathogenesis, and new concepts in treatment.” Emerging infectious diseases 1.3 (1995): 69-78.
[4] Alan C. Swedlund, Alison K. Donta. “Scarlet fever epidemics of the nineteenth century: a case of evolved pathogenic virulence?.” Human Biologists in the Archives: Demography, Health, Nutrition and Genetics in Historical Populations (2003): 159-77.
[5] Samson Sy Wong, Kwok-Yung Yuen. “Streptococcus pyogenes and re-emergence of scarlet fever as a public health problem.” Emerging Microbes & Infections 1.1 (2012): 1-10.
[6] Theresa Lamagni, et al. “Resurgence of scarlet fever in England, 2014–16: a population-based surveillance study.” The Lancet infectious diseases 18.2 (2018): 180-187.
[7] Samson Sy Wong, and Kwok-Yung Yuen. “The comeback of scarlet fever.” EBioMedicine 28 (2018): 7.
[8] Stephan Brouwer, et al. “Scarlet fever changes its spots.” The Lancet Infectious Diseases 19.11 (2019): 1154-1155.
[9] Samson Sy Wong, and Kwok-Yung Yuen. “The comeback of scarlet fever.” EBioMedicine 28 (2018): 7.
[10] Theresa Lamagni, et al. “Resurgence of scarlet fever in England, 2014–16: a population-based surveillance study.” The Lancet infectious diseases 18.2 (2018): 180-187.