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An Evidence Based TREATMENT PROTOCOL of HEPATITIS – B – Dr.S.G.BIJU BHMS, MD (Hom)


Target Groups - Acute Hepatitis – B - Chronic Active Hepatitis-B
HBV Chronic Carriers
Management Protocol for Acute Hepatitis
1. Pathological Prescription
2. Drugs
3. Medicines
4. Plants
• 1. Drugs - ACETIC ACID – Sleeplessness during hepatitis. (Dol.)Diarrhoea during jaundice – LYCOPUS VERG
• TARAXACUM – Weakness during jaundice (PIC AC,FERR PICRICUM)
• Head ache with jaundice – SEPItching during jaundice – HEP
• White coating of tongue with jaundice MERC
• Stupor and Unconsciousness during Jaundice – CHEL
• CORNUS CIRCINATA – Eruptions with jaundice. Aphthae

2. Medicines - CHELIDONIUMChelidonium is not a remedy for chronic hepatitis. ! CARDUUS MARIANUS Predominantly a remedy for diseases affecting the portal systems. Pain in left lobe. Not indicated in HBV Active cases but effective in cases with ascitis and Hepato cellular Carcinoma (where AFP is markedly elevated)
LEPTANDRA Jaundice with black stools or white (clay colored) stools. Doubtful about recovery is an additional indication for leptandra. When frequently questioned about recovery
Kalmegh (“Keezhanelli”)Low potencies – A traditional Indian remedy. It’s potencies can be used as an anti dote in patients who are coming after Ayurvedic Treatment.
LAUROCERASUS– Extreme weakness. When well selected remedies fails (lack of reaction).
PODOPHYLLUM (Symptomatic relief only) – Pt. Holds the liver region
DOLICHOS Carrier gets aggravated during pregnancy, presented as itching. White stools.

Most Effective Medicine
Chelidonium
Kalmegh
Myrica
Cardus Mur
Ceanothus
Nux Vom
Lyc
Bryonia
Digitalis
Podophyllum

All Are Plants………….

• Why Plants ? - Sensitivity is the theme of plant remedies
• Viral Diseases are the occurrence in sensitive patients only.
• Acute stage of viral disease are the expression of sensitivity
• Miasm of Acute HBV - Most of the viral diseases are SYCOTIC in origin Acute stage of all viral disease including HBV shows sensitivity, excitability and Inflammation So Acute HBV viral infection is to be treated with antipsoric medicines
• Conclusion in Acute HBV - Acute HBV and other viral infections are to be treated with Anti Psoric Plant Remedies

• Chronic active
SGPT,SGOT,Alkaline Phosphatase, GGTAFP, S.Ferritin, Should be investigated at time to time.

Treatment Protocol in CAH
1. Pathological Prescription
2. Anti Syphilitics
3. Minerals
4. Animals

1. Pathological prescription based on Investigation Reports
• SGPT – Merc Sol
• SGOT – Merc Cor
• Alkaline Phosphatase – Flouric Acid
• GGT – Aur Mur Nat
• AFP – Cadmium Sulph
• S.Ferritin – Fel Tori
• A/G RATIO ALTERED (SYCOSIS) – Acid picricum 30 Picric acid exists as bright yellow glistening crystals. Like so many other yellow substances, Pic. ac. acts powerfully on the liver, and produces jaundice, cachexia, and cancerous tints.(J.H Clarke dictionary of practical material Medica
PIC ACID - May show a yellow tint. Pruritus may be troublesome, especially at night.(Gibson D M Study of homoeopathic remedies)
Yellow discoloration of skin Vomiting, coming on suddenly and without warning, ejected matter being of bright-yellow color and very bitter;(Hering’s Guiding symptoms of our material Medica). PIC ACID (A remedy for weakness in jaundice).

When Hepato renal failure anticipates Crotalus Horridus An Anti Syphilitic Animal remedy Destruction – Syphilitic (Fight for survival) – Animal
In CAH -Structural changes will occur,Degenerative pathology Develops
• Structure is the theme of Mineral Remedies
• Degeneration is the basic character of Syphilitic Miasm

So CAH Needs Antisyphilitic Mineral Remedies

Effective Antisyphilitic Minerals for CAH
• Nat Sulph
• Merc Sol
• Phos
• Fl Acid
• Aur Mur Nat
• Muriatic Acid
Antisyphilitic Animal Remedies - Are found effective where there is a problem of Survival
Anti Syphilitic Animals - Crotalus Hor, Lach, Vipera,Sepia

Carrier HBV
• No Symptom of Disease

• Only Investigation report, HBs Ag (ELISA), HBe Ag, HBc Ag, DNA PCR, Anti HBs, Anti HBc, & Viral Load
• Treatment protocol - Treat other disease if any (DM, Htn, Hyperlipidemia, Br. Asthma, Allergies etc.)
• If no disease at all treat the negatives if any
• If no negative at all consider the positives of patient except HBsAg!



Some Common Negative Rubrics


Some Common Positive Rubrics


• Miasm - 90% of carrier HBV are in need of anti Sycotic remedies.
• Because of the existing high percentage of Sycosis, system is not able to cry for help. Sycosis Grabbed the system from being responding to the virus. Very low titer of Antibodies confirms sycosis.
As the sensitivity is too low Plants can be avoided (Exception Thuja, Opium, Nux Vom)As in course of disease structural changes happens Minerals Shall be considered with priority.
Treatment protocol in HBV carrier - Anti-Sycotic Mineral Remedies

• Some Effective anti sycotic Minerals
• Ars Alb
• Nat Sulph
• Kali Sulph
• Nat Mur
An Effective plant to develop Vitality - Corydalis Formosa Material Doses Q 8 to 10 Drops

70% cure is guaranteed in HBV Carrier Cases if You can select an
Anti Sycotic mineral Remedy
100% Cure is Guaranteed in CAH if you are able to Select an -Anti syphilitic mineral Remedy
100% Rapid cure is Guaranteed in Active HBV cases if you are selecting
Anti Psoric Plant Remedy

Clinical Case
A cured case of Hepatitis – B Carrier


Mr. Biju Abraham, a 25-year-old young man consulted me on 16/8/2000. He was a HEPATITIS – B Carrier patient. The staff of a local laboratory referred this case to us. He was totally asymptomatic when he reported to our hospital except that he was declared unfit to enter in to DUBAI by the emigration people. (See the UNFIT report – 1). The case was taken in detail to trace out the constitutional medicine of the patient.
Initially he was under Allopathic and Ayurvedic for 3 months. The blood result showed HBsAg + even after those treatments. Allopathic doctors told him that there was no treatment for Hepatitis – B carrier state in any system of medicine. Ayurveda doctors told him that they have treatment only for Jaundice and hepatitis and that the HBsAg will be shown positive even after Ayurveda treatment for the same.

So, before starting the interrogation he asked me whether it is curable.
He repeated this question in a number of times during course of questioning. So we took the Rubric (MIND – DOUBTFUL – recovery, of).
He did not believe that his disease will be cured but what he wanted was to protect his wife and other family members from HEPATITIS – B. He was due to go to DUBAI and earn money to look after the entire family. He was afraid of a cross infection to his family members. He tried to avoid even touching them and took more care about the children in his home. (MIND – ANXIETY – health about – relatives of, MIND – CARES, full of – relatives about.)
He told us thus: “the only ambition in my life is to save and protect my family members from HEPATITIS – B”. But his wife told us “ No it is not like that, he is very much ambitious, especially for getting fame among people. He will do any thing for getting his name printed in notices and publication of his photographs in newspapers etc. (MIND – AMBITION – fame for)

When his wife revealed these things he got agitated and scolded her in front of us. He told us that his wife failed in SSLC and she never go to a college so she didn’t know anything about printing name in notice and all. (MIND – ABUSIVE – husband – insulting, husband is – wife before children or vice versa)

He was totally disappointed and told us that he thought a number of times about committing suicide but while thinking about the pains and other sufferings for committing suicide he postponed the act to another occasion. When he was alone he thought about the easy ways of committing suicide. (MIND - SUICIDAL disposition - thoughts - meditates on easiest way of committing suicide).

Because of depression he lost all spirits and used to lie down frequently. (GENERALS - LIE DOWN - desire to).
There was good appetite yet there was an aversion to food. (GENERALS - FOOD and DRINKS - food - aversion - accompanied by – hunger).
He complained that there would be sensation of heat after taking any thing warm. (GENERALS - HEAT - sensation of - eating - after - warm food).
His wife complained that he was having an offensive smell always. She also said that he was always complaining about his disease, HEPATITIS – B. (GENERALS - ODOR OF THE BODY – offensive, MIND - LAMENTING - sickness, about his).
We observed one more peculiarity in him. He covered his lips with his hands during the entire narration of his symptoms. (MIND - GESTURES, makes - hands; involuntary motions of the - covering - mouth with hands).
Apart from the above symptoms/Rubrics we took the rubric GENERALS – CHRONICITY because he was suffering from a chronic carrier stage of Hepatitis – B.
Under the aforesaid rubrics the emerged remedy in RADAR Software (both in VES and Combined Analysis) was LACHESIS and the same was given in 1M potency 1 dose and SL & BT for 10 days.

He reported on 26/8/2000 (after 10 days) with feeling of anxiety and fear of an impending disease. SL & BT was prescribed for 20 more days. In the next time he reported improved in the mental level. There was an inner feeling of well-being and he was hopeful about recovery. SL and BT was continued and he was sent for a blood examination on 15/9/2000. HBsAg was found negative, (See Lab Report HBsAg – ve) he went for detailed medical examination at MUMBAI and passed all tests and now he is working in DUBAI.

CLINICAL CASE - HEPATITIS – B

Mr. Radhakrishnan a 38 years old man consulted me on 1 – 5 – 1999. He was working at Coimbatore. The company in which he was worked transferred him to it’s branch at USA with a promotion. But when he appeared for emigration clearance, he was declared unfit due to an HBsAg +ve blood result. His promotion was withheld and transfer cancelled due to Hepatitis – B.

He heard about the effectiveness of Homoeopathic treatment in Hepatitis – B through a medical magazine and he requested his doctor (An allopathic doctor) for discontinuing the treatment and try Homoeopathy. His doctor agreed and thus he came to me for treatment. He showed the blood results that he got from the laboratory at Coimbatore. The unfit report of the emigration people was being kept in his office.
When he entered the consulting room he had kicked at the weighing balance placed near the door. He expressed sorry and his wife laughed at him. (MIND - AWKWARD - strikes against things?) He told me that he had tried a lot of allopathic medicines and a number of ‘panaceas’ for curing Hepatitis – B, but they were ineffective to cure this disease. Finally he settled under the impression that it was an incurable disease. He said: “ Doctor I am fed up with all the medicines, and I had tried except Homoeopathy”. (MIND - DESPAIR - recovery, of). He told me that he had heard about me as a ‘specialist’ (?!) in treating Hepatitis - B cases and if I was able to cure him, he will bring a good number of patients to me. There are many patients suffering from Hepatitis – B and other incurable disease at Coimbatore. But I have to cure him then only he will refer such patients to me. (MIND – BARGAINING).
I interfered with his speech mid-way and asked him

“ What are your complaints now?”.
“ No complaints except that my physical built up beginning to lose its tone now a days. I am losing weight and my face become shrunken and muscles are reducing in its bulk.”

His wife interfered, and then told.

“No he is not losing weight; He was 68 Kgs earlier and keeping the same still. It is only a false belief that he is reducing in weight and losing the bulk of muscle etc.”

He responded immediately

“Though the weight is steady, still I am losing flesh and my muscles are shrunken”.
She told that he was the same for the past 10 years.
(MIND - DELUSIONS - emaciation, of)

He said that it was unbearable for him to frequently hear from his acquaints “what happened to you; you looks too lean and weak”. And the most unbearable thing was to hear the words of people who knew that he was suffering from Hepatitis – B. They may say, “it is a pity to see your misfortune” etc.
“I don’t like such words”, he said. (MIND - SYMPATHY from others - aversion to).
Whenever some body showered sympathy over him he became angry and then he will not talk to any body for some time. His wife said that he would not express his anger to any body but keep mum for long. If he was keeping mum, it was a sign of his anger. (MIND - ANGER - taciturnity; with).
He said,
“Ofcourse I kept mum when I become angry but this is not the only occasion I kept mum, I frequently thought about my misfortune, about the missed promotion and about the incurable disease I am put in”. (MIND - DWELLS - disappointments, on).
His wife said further:
“Another thing make him angry is----“ She paused and asked her husband “may I tell it?”.

“Oh yes”, he said.
She continued,
“Spending money for domestic affairs is unbearable for him”.

He retorted
“No, I am spending money than anything for celebrations travels and all”.

To this she replayed,

“Yes it is correct, he is extravagant enough for his friends, that is why I said that he get angry when I spend money for household affairs”.

He laughed and nodded agreeing to what his wife said. (MIND - AVARICE - generosity towards strangers, avarice as regards his family).
While tracing the source of infection he told me that there was a dental surgery for him some 4 months back. Causally I asked him whether there any hospitalization, Injections, Accidents, Falls, Etc; His wife said that minor accidents and falls is a regular occurrence in his life.

She asked
“Doctor did you observe that he strikes to some thing when he entered this room?”

He always strikes against dinning table and chairs in house. Sometimes it become major injuries and 2 times fractures had occurred to his toes, but he never go for injections and surgery.” (MIND - AWKWARD - strikes against things – Confirmed the rubric).


No other striking Physical generals were observed except a desire for spices and eggs that also was told after asking leading questions. So we avoided those physical generals for repertorisation.
But he told that his bowel was moving only once in 3 days. (RECTUM - INACTIVITY of).
Apart from the above observations and their corresponding rubrics we took one more rubric for the chronic carrier stage of Hepatitis – B, GENERALS – CHRONICITY.

MIND - AWKWARD - strikes against things
MIND - DESPAIR - recovery, of
MIND - BARGAINING
MIND - DELUSIONS - emaciation, of
MIND - SYMPATHY from others - aversion to
MIND - ANGER - taciturnity; with
MIND - DWELLS - disappointments, on
MIND - AVARICE - generosity towards strangers, avarice as regards his family
RECTUM - INACTIVITY of
GENERALS – CHRONICITY

The emerged remedy in Repertorisation was NAT MUR in VES (Vithulkas Expert System ) of RADAR and SULPHUR in combined analysis, NAT MUR was prescribe with confidence rating 125 points.

So, on 1/5/1999 I gave NAT MUR 10 M 1 dose, SL and BT for 15 days.


16/5/1999 – He reported with several complaints: feeling of uneasiness, headache after night watching, slight abdominal discomfort, constipation intensified, stools only once in 4 days, scanty stool & vague feeling of ill health. He had to go to Coimbatore for re-joining his job. So he wanted medicine for 40 days

SL 1XBD & BT 5 grain 1XBD was prescribed for 40 days

Later he contacted me over telephone and complained that he was suffering from intense constipation; body pain and severe head ache after every episode of irregular diet, after every exposure of the sun etc. He was asked to continue the medicine.

26/6/2001 – Reported: He was totally disappointed with the treatment. He had made a blood examination at Coimbature. Blood showed HBsAg +ve. (See Lab Report II). Total symptamatology remain worsened. He told me “if things are going like this I have to discontinue your treatment, I will leave you and take treatment from any other system of Medicine. So if it is curable in Homoeopathy, please give me that remedy, Other wise I will tell others that I am HBsAg +ve even after your treatment”.

So, I took one more rubric - MIND - COMPLAINING - threatening, and

I told him,
“OK, you may try other systems of medicine, we can stop the treatment”.

He confessed immediately.

“Sorry Doctor, because of my dejection and anger I told those words. I know there is no treatment in any other system of medicine except Homoeopathy, I want to continue your treatment”.

I took one more rubric, MIND - ANGER - alternating with - repentance; quick



Addition of the above rubrics did not change VES selection.

On 26/6/2001 I prescribed another single dose of NAT MUR 10 M because of aggravation of complaints and feeling of ill health.

SL & BT were also prescribed for 10 more days.

He reported on 6th July with general feeling of well-being; and amelioration for headache, his bowels were moving daily. He appeared very cheerful with full of confidence in his face regarding the cure of his disease.
He asked me
“Doctor can I go for another blood examination?”.

Because of the previous experience of positive blood result and his negative attitude towards me when he got the previous +ve result, I told him

“ No you may go for a blood investigation in the next time ie. after one month”.

“OK”, He agreed.

SL & BT were prescribed for another month.

He contacted me over telephone on 21st July and told, “Doctor, I am HBsAg – ve now I will come to you tomorrow”
22nd July was a Sunday.

On 23rd July he reached my clinic & said
“Doctor, I went for a blood investigation because I got another chance for promotion and USA trip”.

He showed me the result and said

“Doctor I am grateful to your valuable help, now I become HBsAg negative and I am selected for the promotion and transfer to USA. I am ready to continue the medicine for any time under your advice.” (See the Lab Result).

I told him.

“Ok you may discontinue the medicine, there is no need of continue the medicine for months”.

He was regularly contacting me at least once in a month up to 2001 January. He sent me a greeting card in January 2001. The words in the greeting card was as follows -

“Though you are staying miles ago, you are always residing in my heart, in my mind & in my soul”.

Dr.S.G.BIJU.BHMS MD (Hom)
Chief medical Officer
The Homoeopathic Multi Speciality Hospital

Views: 20937

Comment by Debby Bruck on September 27, 2009 at 12:56pm
Thank you Dr Biju for this valuable information. May we all learn many lessons here.
Comment by Dr. Sarfaraz Ahmed on October 1, 2009 at 1:27am
Hi! Very useful information. I am impressed by your ability to convert the symptoms into suitable rurics and selecting the important mentals for repertorization. It would be interesting to know about the ratio of the cases which were cured and which were either partially cured or remained symptom free but with positive HBAg,
BTW what do SL & BT stand for? SL for Sac lac?
Comment by Dr. Wequar Ali Khan on October 1, 2009 at 9:05am
Dr Biju,Thank you for a wonderful article and case analysis.The way you have approached your case and chosen the rubrics will prove to be a milestone for me at least.

Comparing the Homeopathic classical approach, with allopathic approach (lab reports) and finding the homeopathic medicine shows that you have taken great pains to decipher the case and prescribe,another point of interest was that with your conviction of the cases,you did not change the medicine at any stage except the potency. Your sagacity is commendable.

I am also using RADAR10,and your approach will help me to hone my case analysis in future.Specially the way you hunt your rubrics;;;

Will look forward to more of your postings eagerly. Best wishes.
Comment by Dr. Faheem Zulfiqar on July 14, 2010 at 2:25am
nice cases , thanks i really enjoy to read it. you are repertory master, welldone
Comment by Regina Lucia Borges Inforzato on November 12, 2010 at 6:21pm
Dr Biju,
Thank you so much for sharing with us your great experiences. I am really great full for all the information I gained from you. Your ability to analyse and select the right homeopathic medicine is awesome!
Comment by sajjadakram on November 12, 2010 at 8:39pm
Thank you for the valuable information.I wonder how the rubric"GENERALS – CHRONICITY" helped you in the selection of the remedy.
Regards.
sajjad.
Comment by Dr Rajneesh Kumar Sharma MD(Hom) on June 14, 2011 at 11:32pm

Thanks Dr Biju to post this detailed article. Awesome....

Pl. see the following in support of evidence...

http://www.homeopathyworldcommunity.com/forum/topics/a-case-of-hepa...

Comment by Dr. Sayed Tahir Hassan on July 10, 2011 at 10:38am

Thank u for sharing these info.

I have had opportunity of treating HBsAg, but the clarity of your prescriptions are self explanatory.

Comment by Dr.Sharad Shangloo on July 20, 2011 at 12:59am
It is really a very nice and informative article
Comment by Dr. Abdul Ghafoor Chughtai on January 28, 2012 at 7:41am

Thank you Dr. S. G. Biju It is really a very informative article. May we all learn many lessons here.

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