Dr. Rajan Sankaran shares his method of differentiating three different levels of COVID-19 symptoms. These involve the common symptoms of the virus, the acute symptoms and the constitutional symptoms. He offers numerous case summaries to illustrate.
The government and AYUSH department in India has now allowed homeopaths to treat COVID cases as an adjunct to standard protocol. Many homeopaths are now being invited by hospitals to treat COVID cases. Most of our patients who developed COVID infection have asked to be treated with homeopathy.
Given the current situation, I would like to share some of my experiences that helped in treating COVID positive cases. Neophyte as well as experienced practitioners will be able to gain benefit from this article.
Before proceeding forward, I would like to thank some doctors and colleagues who have been working with me in treating COVID cases. Dr. Shrikant Talari, Dr. Sonali Bhonsale, Dr. Faiza Khan, Dr. Meghna Shah, Dr A K Arun, Dr. Kshiti Mehta, the team from Prana Homoeopathy Yoga Center in Pune and the team of The Other Song Academy in Mumbai.
Some of their cases are included here as we have been working together in treating them. Before proceeding forward, a humble request to the readers to take a look at one of my talks uploaded on the you tube channel: “Perspectives in the treatment and Prevention of COVID19”, as it is the precursor to this article which takes you to the next step:
In the video there was mention of the three levels of symptoms, and one will be able to see one of the three levels more prominently in each individual case. The first level is of the pandemic itself, where there are some common symptoms of the pandemic.
In the second level, some patients exhibit acute symptoms very prominently. Acute symptoms are those symptoms that have come up since the onset of the infection, which was not there in them before but in the onset of this infection that developed this acute totality.
Thirdly, in many of the cases we also get to see the symptoms of the constitutional remedy coming up during this acute phase. One of the three levels exhibits very prominently in each and every case.
The three possibilities:
- Symptoms of the pandemic
- Acute totality of the symptoms
- Symptoms indicating the constitutional remedy
What are the symptoms of the pandemic?
Mainly, great weakness which is described as sudden great weakness especially found in the lower limbs. One can find it difficult to walk. Weakness can be felt in the limbs and the entire body. Loss of smell and taste is also another symptom of COVID. These complaints represent an anaesthetic like state, something like a collapse and an anaesthetic weak state.
One may not be able to see symptoms of aches and pains or restlessness or any active symptoms. Weakness, anosmia and loss of taste are the main characteristic symptoms seen here.
At the level of the mind state, we either see a relative lack of anxiety, which means for example, despite being admitted in a COVID ward, he does not seem to be anxious; which means there can be some chances of complications, maybe leading to mortality also, but he does not seem to be concerned about it.
Or, on the other hand he can be quite cheerful which may appear odd. The other mind state or the opposite of this is panic. Panic and fear of being left alone, a feeling of isolation, of being forsaken. Thinking: “what is going to happen to me”. Either of these manifestations of the mind state with the weakness described above are the indications for the remedy Camphora.
Indications of Camphora
- Loss of taste
- Sudden weakness, weakness of the lower limbs
- Mind state- cheerful without anxiety or
- Panic/fear of isolation and being alone
These indications are found in a large majority of patients because these are asymptomatic cases. Almost 80-85% of the cases are asymptomatic where the patient has the symptoms but has no individualized acute symptoms, almost like an anaesthetic state. These cases will benefit from Camphora.
Coming to the next level, are symptoms of the acute. Here either we get these pandemic symptoms where we can prescribe Camphora or we get a set of acute symptoms derived by forming the acute totality on the basis of the peculiarities of the chill, the heat and sweat stage, time modalities and concomitants, other complaints like headache, dyspnea, bodyache, cough etc.
Along with this the person’s general state is, he is anxious, relaxed, dull and drowsy or active. How is the appetite and thirst, is he sleeping well, is he having any dreams during this acute? All this information is gathered during the interview which may indicate a specific acute remedy.
The third possibility is where the symptoms of the constitutional remedy are seen during the infection. The main symptom seen here is the symptom of the patient that you know from before. That is the chronic state which presents itself in the acute. This has been seen in a large number of cases.
We need to prescribe depending on the level of prominence. Below are a few case examples which demonstrate this technique of prescribing on the basis of the prominent level.
Most of the cases were admitted in the allopathic hospitals and were being treated with homeopathy along with the standard hospital protocols. Three cases are an exception to these. After administering homeopathic medications, the result was significant, and they did very well. Many also turned out to be COVID negative and are symptom free.
This the case of a 27-year-old woman. She said she had to attend too many phone calls as somebody in her house was tested positive with COVID. She decided to not attend to any calls and messages. From the moment she decided this she felt very happy and cheerful, which was also observed by someone who asked her if she was on drugs, like cannabis. Her case was recorded on telephone by one of our doctors who also reported her to be very cheerful and happy. This kind of feeling, “Desire to shut off the world. Don’t want any calls, I am just in my own bubble and I am happy”, is very typical of Camphora.
We can also see the painlessness of Opium which is from the same subclass, i.e. the first subclass- positive and cheerful. This is one presentation. When we put it in the MacRepertory remedy graph, Cheerful, Painlessness and Positiveness”, Camphora is one of the remedies that comes up prominently.
Here we see an exactly opposite picture of Camphora. This lady’’s father contracted COVID and expired. Later she and her mother were tested positive. The mother was hospitalised and this lady was quarantined at home with her six-year-old baby who was also tested positive.
It was at this time that we took her case. We asked her about her main current symptom and she said that she had a lot of anxiety about her daughter as she did not have any place to keep her.
No one agreed to keep her child. When we analyse her case, her state of mind, we see that there is an alone child, who is forsaken, isolated and the lady is in a panic feeling – “What am I going to do with my daughter?”.
She further added that she felt like killing herself and her daughter to stop the harassment. This is an exact opposite state as compared to the previous case. Here we see panic, feeling of not being able to take it – it is too much for me.
She mentioned that everybody is scared about their own life, and her cousins and relatives deserted her. The feeling is of being totally alone and isolated, in panic. This is the exact opposite of “I have no problem, I am cheerful, I am happy” like on a drug.
When we put these in the form of rubrics in the MacRepertory, we see, “the desire to kill, the feeling to be deserted, shrieking for help, the despair, the helplessness and the influenza like symptoms”. We again get Camphora as the remedy. She did very well on this remedy. She was admitted in the hospital and was on standard protocol but she did very well.
We saw the two opposite polarities of Camphora. One was panic, isolation and fear; the other side is “shut the world off and I am happy and cheerful inside.” Like in COVID, we remain isolated in the house, eating and drinking and happy. This kind of state is also seen in Camphora.
This the case of a 22-year-female who presented with complaints of sore throat, headache, heaviness, slight nausea, weakness and dizziness while waking up from the bed. Also, loose motions and pain in the abdomen before motions.
She had to rush to pass stools and passed a little quantity at a time which would make her feel better. She had also taken HCQ tablets. She had nausea but no vomiting, general weakness and droopy eyes.
Despite this she felt positive about her recovery and expressed it to us. She said she did not have any anxiety. Thirst for water was less. This was her state, and she was given Camphora, mainly on the indications of absence of anxiety and presence of weakness. She did good.
Case of a male, 36, who presented only with fever. With 100.6 fever, after three days he was admitted in the ICU. His symptoms were soreness and dryness in the throat with increased thirst and sleepiness.
On questioning him he mentioned that during fever he wanted to remain in bed and sleep. Here we see a different picture. Strong thirst, intense dryness and wanting to be in bed and sleep. These are the exact indication of Bryonia. They don’t like to be bothered or disturbed. Here weakness is not the main symptom, dryness, thirst and wanting to be in bed without being disturbed.
Case of a 36-year-old male who presented with loose motions, distention and fullness of abdomen with offensive stool. Thinking about the illness used to make him feel weak. The main symptoms seen in this case was offensiveness and anxiety about the disease, weakness and palpitations; not the anxiety of being isolated like we saw in Camphor.
Here in the anxiety there is a feeling of what will happen to me, to my health, it will deteriorate, I will die, something will go out of control, worried about work and financial issues with the feeling of losing everything- money, health and job.
He liked keeping his things clean and in order always. He used to feel better by warm water. The aspect of weakness and anxiety, unable to sleep until 3 a.m. (time modality) and the feeling of losing his job, money and health are all specific themes of Arsenicum Album.
In the periodic table, Arsenicum Album lies in the 4th row, which has the theme of money, security, home, job, health and stamina. Arsenicum album is towards the right side; there is a feeling of, “I am losing everything”, whereas in Bryonia, the feeling is of wanting my comfort zone, I don’t want to be disturbed, I want to be in one position, which is found in the fourth subclass of the plant kingdom.
They want to be in one position, no motion or movement and no change, just want to remain in the bed; this is the theme of the 4th subclass- Bryonia.
Coming back to the case, we can see the rubrics, “thinking of complaints aggravates, Diarrhoea during fever, offensiveness, desire to go home, better by talking, anxiety with weakness and palpitation, sleeplessness until 3 am in the morning; all are indications of Arsenicum Album on repertorization too. We got to see the acute manifestation of Bryonia, Arsenic and Camphora. The patient was given Arsenicum Album three times a day
One of my colleagues, Dr. A.K. Arun from Delhi had been attending to many symptomatic and asymptomatic COVID 19 patients. He created an excel sheet of 70 patients which he treated with homeopathic medicines only. Of these cases, 58 patients were Camphor, for two he prescribed Arsenicum, for four he prescribed Bryonia, three received China and two received Eupatorium Perfoliatum. All the patients did very well on the medicines.
Through this data we get to know that we don’t need to give every patient Camphora or Bryonia, and that there is a possibility of many other remedies coming up which we should learn about.
The main indication of Bryonia is great dryness and hence there is thirst for large quantities of water. He does not want to move, does not want any change in his position. This is the opposite of Rhus tox, where there is a desire for constant change in position.
The Bryonia patient does not like to be disturbed and gets irritated when questioned. For example, in one of the COVID positive case, I enquired about the symptoms, and the patient said she liked sleeping all the time and if questioned by anyone she would tell them to go away and not disturb her, which is the primary indication of Bryonia.
In Arsenic Album the feeling is that of losing something. Like for example the patient will report as “my health is going”, “my money is going”, “my job is going”, “my future is very insecure”, restlessness, with “what would happen to me and my life.” Along with this there is midnight aggravation and they feel better by warm drinks and have thirst for little quantities and often. These are the keynote indications.
The keynote indication of China is periodicity, the fever coming up periodically. Along with this a bitter taste in the mouth, which is also a mandatory symptom of China. We also see desire for fruit and juicy, refreshing things.
At the mind state, they are highly stimulated; there is sleeplessness and lots of thoughts and activities of the mind as it belongs to the Coffea family, Rubiaceae. The stimulation is of plans, ideas, continuous thoughts which do not allow the person to sleep.
It has the malarial miasm and hence the course of periodicity and weakness along with the feeling of being unfortunate – “why me?” “Why does everything bad happens to me?” This is one of the mind states of China.
For example, “Why did I get the COVID infection and not others?” “Why does everything bad and unfortunate happens to me?’ “My luck is bad, I am troubled and harassed.” This can also be an important indication of China – a feeling of being troubled by everything. One can also see the rubrics, feeling of being persecuted, the feeling of being unfortunate and obstructed.
The main indications of Gelsemium is drowsiness and thirstlessness. We can also see the feeling of shock or bad news. For example, “I saw the report, I was shocked.” This feeling of shock and surprise is a part of Gelsemium also because it comes from the same family as Ignatia which is called the Loganiaceae family. The main theme of Loganiaceae is shock and surprise.
These are some of the most prominent and frequently indicated remedies that have come up and have been used frequently.
Another important finding in the COVID cases was that many cases actually indicated their constitutional medicine during the COVID infection also. The manifestation of this is illustrated below.
This is the case of a 26-year-old male, doctor by profession, who was questioned by our team doctor about his complaints. He started by saying, “I like martial arts, I like Bruce lee, I like fitness, I train for an hour daily, I make people stand on my abdomen in order to be fit. If I am attacked by 5 people I can handle that and I can hit 5 robbers too at the same time.”
Here we were wanting to know about the COVID infection and symptoms and this person was talking something absolutely different, the prominence is somewhere else.
Even in the COVID his idea is about knowing Martial arts. With the context, he says, “I did more exercises in one day and maybe because of that I developed some swelling on the thighs, which was followed by severe vomiting. I was unable to even drink water. Was vomiting every 2 hours, could not retain anything in the stomach. Felt as if my whole intestine would come out while vomiting. As if there are knots in my intestine”.
This peculiarity is interesting because we are trying to understand what is the peculiarity in the COVID. The complaint is of knots in the intestine, severe vomiting as if the intestines would come out, almost like a severe spasm as if the whole intestine would come out.
Then he spoke about himself and mentioned that he was inspired by Obama and Abdul Kalam as they are remembered even after their death. He wanted his photo to also be there after he dies and be remembered as a man who did something good. He then spoke about Iraq and Syria, which should not have been attacked as innocent people were getting killed.
He wanted to be remembered as a good person who did good work, with a good name and respect. Here we see he is talking about his performance. He wanted to give such a good performance that people would remember him. The themes of his mind seen here are: being attacked, developing strength, developing fighting abilities and performance. These are all themes of the mineral kingdom.
We find themes of wanting to develop one’s ability, attack and defence, and the the spasm and the knot in the intestines, when put in the Reference Works as- ‘Knots within three words of intestine attacked within three words of delusion (the feeling he is going to be attacked) in the same remedy as knots in the intestine (the sensation of knots in the intestine) we get the remedy Cuprum Metallicum.
Knots within three words of intestine in the same remedy as attacked within three words of delusion (2): cann-i., Cupr.
Cuprum is one of the remedies for severe spasms. Everything happens in spasms, convulsions, vomiting; everything is severe and in spasms, which was his main symptom. He was given the remedy Cuprum Metallicum, and he improved immensely.
Here while hearing the story of COVID, his original state came up with the acute symptom of knots in the intestine and severe spasms with vomiting which is indicative of Cuprum and the mineral kingdom. Cuprum is the remedy that wants to do martial arts because he feels that suddenly something can attack him and he must have the ability to defend himself.
This is the case of a 36-year-old male, a ward boy in the hospital who was tested positive for COVID. His main symptom was complete loss of appetite. Normally he used to feel hungry between 10 and 11 in the morning but now he just does not feel like eating.
He also felt weak and feverish with heat on the soles and forehead region. He liked milk products in general. He had consumed 1 kg curd a week prior. Lassi (yogurt drink, butter milk) too was his favourite. He liked milk cream, full fat products, malai ice cream, buttermilk with cream and jaggery. He says he can even have 7 glasses of thick yogurt drink.
He was worried about his family. From the case we understand, he had intense craving for milk and milk products, this we need to consider but also know that this is not his symptom during the acute, as it is there all the time. So here in this case he will most likely need his original remedy and not an acute one. Going further, he mentioned his father had met with an accident and was in the ICU in an unconscious state.
He was supposed to take care of his mother and sister. He felt like weeping but could not because he felt he was responsible and had to control his emotions, so did not express himself. During this grief, he developed coryza and headache with a feeling of hopelessness, and as if his father would die.
While narrating this he started weeping. Also, his grandmother’s health was not good and she felt she would die. He got emotional and started weeping. We see that this person is very sensitive and emotional but is unable to express his grief because of a strong sense of responsibility.
He also mentioned about having an affair with a girl despite that he and she both are married. He felt his reputation in the society would be spoilt. He said, ‘I am not worried about somebody beating me up, that’s not my fear, but when I get scared I get trembling of the legs and then when I have arguments, and I can fight for other people. I fight for my staff. You know one employee in my company committed suicide. They tried to suppress it but I fought with them’.
At the same time, he wanted to be fit and go to the gym also. These were his symptoms and his state. When we analyse the case, we see that this person is very sensitive and responsible, has a strong desire for milk and milk products, and he suppresses his grief.
He wants to fight but he is very sensitive to being embarrassed and also concerned about his reputation which was seen in the situation he narrated, where he had an affair with this girl and he worried that if people found out, what would happen to him.
We took the rubrics, desire for milk, wants to fight, weeping easily, trembling, cannot support injustice, sympathetic, strong sense of embarrassment, strong sense of responsibility and trembling of legs when frightened.
The remedy that came up was Ignatia. Ignatia is a plant remedy. These people are very sensitive and there is a lot of silent grief which they hold inside, and a strong sense of duty and responsibility.
He was given Ignatia because there was not much of a difference between the constitutional remedy and his acute remedy. The potency given was 200ch.
Next we come to the level of severe cases. Until now we have seen asymptomatic cases and cases having the symptoms of the pandemic like weakness, severe and sudden symptoms along with either no anxiety or panic and isolation which were given Camphor with good results.
The second level is when we have acute manifestations where we need to take the totality of the acute and find the remedy. The remedies that came up frequently were Arsenic, Bryonia, China, Gelsemium and Camphor.
In a few other cases, we saw the patient’s main indicating symptoms also indicating his constitutional remedy, his mind state and state of his constitution, his generals, cravings and aversions. In such cases we need to give the constitutional remedy that comes up because here the acute symptoms are not peculiar and the pandemic symptoms are not very prominent. This is how we need to handle such cases.
I don’t have a lot of experience with severe cases, that is cases where the oxygen level has gone below 90 or are on ventilator support. But amongst the few cases that I have seen, I will share one case.
This is a 70-year-lady with full oxygen flow, who had developed breathlessness, profound weakness and was not able to get up. She also complained of burning in the palms and in the stomach with perspiration of the whole body and restlessness of the limbs. She felt very breathless due to the weakness due to which she was unable to even get up and sit.
Along with this she also had bitter vomiting and bitter taste in the mouth with anorexia. She mentioned she was confused and not able to make out where she was, on the ground or somewhere else. She had dryness in the mouth with little thirst.
She was also worried about her grandchildren. Her respiratory rate had increased along with vertigo with weakness. She felt like keeping a cold cloth on her soles and hands on account of a severe burning sensation. She was given Camphora 10 M every 6 hourly. The profound weakness with desire to put something cold on the extremities is a good indication for Camphora. She recovered very well and was also on standard protocol at the same time.
Another very important aspect about cases with individual remedies. We need to be vigilant in such cases because the remedy can change and one may need to change the remedy. I will share a case example where the patient was given Camphora, Arsenic and China.
This is a 26-year-old lady who was COVID positive and had symptoms since 10 days. While she was doing certain sessions in the building, she started feeling tired and used to sweat a lot from the slightest exertion. She had even fainted and was very weak after which she developed palpitations and low-grade fever.
She was taken to the hospital and was suspected of having a urinary tract infection but was diagnosed as COVID positive. She was low emotionally and was not able to understand what was happening to her. Her father was unwell. She had a feeling of “why is this is happening to me?”.
The first remedy given was Camphor due to the weakness and symptoms of the pandemic. She was followed up the next day without any significant change or improvement noted. When the remedy had not produced any improvement we had to think again.
There is no panacea or one size fits all theory in homeopathy and that every case will be cured by that. This remedy is good but no remedy fits every case. If the symptoms are changing, and we are not able to see the relief, then we need to change the remedy. This lady developed severe weakness and she started drinking water in sips. She was also very anxious about her father’s health and her own health. Changes in the oxygen levels made her more anxious. These were good indications for Arsenic and it was given every 6 hours.
The next day she was much better in terms of anxiety and energy and also was able to sleep well. She felt positive and her anxiety reduced, the cough got better and hence we continued with Arsenic Album 1M.
There was one funny incident that took place. Despite saying she was doing better, I had asked her to say more about herself. She said everything was okay but she was not able to sleep the previous night until 4-5 o’ clock in the morning. She said her mind was full of thoughts about the future, thoughts about some ideas and plans due to which she was unable to sleep.
On asking her more about this she said she felt as if her mind would not stop thinking but at the same time it was not unpleasant but there was no stop to the thoughts. I
I asked her to tell a little bit more about herself, and she said she was a very creative person and loved writing books also. On the basis of this additional information, I realized she needed China and not Arsenic. As a result of this we had asked to stop with Arsenic and start with China as the anxiety of Arsenic was not seen any more but rather the stimulation of China.
To this request she responded with “No” because she felt she was better after taking Arsenic. I had to be a little firm with her after which she agreed to take the remedy China. This was because the indications of Arsenic was not seen anymore but that of China were coming up.
When the indications of the remedy goes, we need to change the remedy even if the patient is better, as we need to prescribe on the change of the state that is there at that given moment.
While on China, she said she developed anxiety the next day and said that we should have continued with Arsenic. She said, “I was doing well and you stopped it”. Psychologically her anxiety started coming up, but I still continued with China because I realised that China was her constitutional remedy and this would be the best for her.
The next day she improved and was back to normal. We need to be vigilant in such cases. If the patient is not better, then we need to change the remedy and if the patient is better also and the symptoms are different, the state is different and we need to change the remedy.
Potency Selection and Repetition
- If the emotions and the local symptoms are prominent then we need the 200 potency.
- If the general symptoms, the mind state and the dreams are prominent, then we need 1M potency
- If the symptoms are very intense, for example intense weakness or any other intense symptoms. Which means we get to see the very sensation and energy level manifestations, then we need to give 10M potency
- With regards to the repetition, it depends on the intensity. I normally give it two times a day and if it is more intense, then 3 times a day and in very acute situations every three hours. We reduce the frequency and stop when the symptoms abate and then put the patient on placebo.
If you would like to hear this talk with some more details here is the link: https://bit.ly/COVIDtreatment