Back To The Future: Bird Flu

by Domenick J Masiello, DO, DHt

We've just gotten through another flu season, that time of year when health concerns revolve around what “bug” is going around and whether you have gotten your flu shot. This year is different, however. We now wonder about scientific predictions regarding the future possibility of avian or bird flu.

Modern technology has allowed researchers to determine the genetic structure of the virus that caused the Spanish Flu pandemic of 1918. We now know that it was a type of bird flu, and worldwide, 30 to 50 million people died from that flu or from its complications.

This recent bird flu virus, H5N1, is not as virulent as the 1918 variety. Currently (2008) the CDC estimates that animal to animal infections are continuing to occur and that the virus is now endemic in most of Asia, Europe, the near East, and Africa. The virus seems to spreading from domestic birds to other species such as pigs in China, domestic cats in the Netherlands, Germany and Thailand. It has even been isolated from tigers and leopards in zoos in Thailand.

There have been hundreds of documented cases of bird-to-human transmission of this latest threat. Human cases of bird flu infections have been reported in Asia, Africa, the Pacific, Europe and the Near East. Indonesia and Vietnam have reported the highest number of H5N1 cases to date. Most alarmingly, however, are WHO and CDC reports of limited human-to-human transmission of bird flu in Thailand (2004) and in Indonesia (2006). Current mortality is estimated at 60% due in part to presentation of patients to hospitals late in the course of the disease.

We do not yet have a vaccine because we do not yet know the final form this virus must take before human-to-human transmission becomes more widespread. Vaccine development is underway using the current form of H5N1 but there is no guarantee of its efficacy.  Drugs like Tamiflu®

have been somewhat helpful in bird-to-human cases but it may prove useless should the virus mutate. Some recent reports have even indicated that H5N1 is resistant to Tamiflu®.

Many experts think that it is not a matter of "IF" we will have a pandemic but "WHEN" that pandemic will come. So if the future seems a bit threatening, perhaps looking to the past may give us some hope and comfort.

During the 1918 pandemic mortality rates from influenza were estimated at between 2.5 % and 15% for those patients receiving conventional treatment. Mortality rates for patients whose flu was complicated by pneumonia were as high as 25%. At that time, practitioners of two competing healing arts reported significantly lower mortality rates. Osteopathic physicians reported rates as low as 0.2% for influenza and 10.1% for flu complicated by pneumonia. Homeopathic physicians reported a mortality rate of only 1% for influenza. Given the differing mortality rates, it would be advantageous to examine these alternative methods and learn from past successes.

Homeopathy is a holistic system of healing discovered by the German physician Samuel Hahnemann in 1796. It is based on the principle of cure, namely, that “likes can be treated by likes”. This means that very small amounts of any substance that causes a disease in a healthy person can be used to treat that very same disease in a sick person. Hahnemann also believed that a spirit-like vital force or energy maintained the body's inner balance or homeostasis. Symptoms are not things to be suppressed but rather are indications of the body's attempt to heal itself by changes in the vital force. Diseases are viewed as patterns of symptoms, the language of the vital force in its attempts at self- regulation. By interpreting a detailed list of the patient’s mental, emotional and physical symptoms, a homeopathic physician prescribes a remedy that is the closest match to the patient’s individual symptom pattern. The energy inherent in the dilute homeopathic drug somehow stimulates the body's vital energy and thereby encourages healing.

At the beginning of the twentieth century, homeopathy was a major player in health care. It has been estimated that by around 1900, there were at least 15,000 homeopathic physicians in the United States. Medical schools such as Hahnemann Medical College in Philadelphia, New York Medical College in New York and Boston University’s Medical School all originated as homeopathic medical institutions. By the 1920s and 1930s, homeopathy had already begun its decline, eclipsed, in part, by the introduction of modern pharmacological agents. Despite this decline homeopathic drugs were recognized and regulated when the FDA was created in 1938, a fact that remains true today. Near extinction in the early 1970s, homeopathy began a worldwide renaissance that continues unabated to this day.

Homeopathy is a labor-intensive method of treatment. Far more attention is paid to the patient’s individualized experience of his or her illness than in conventional or allopathic methods of treatment. An extensive history with close attention to symptom details is required to make an effective prescription. This process is driven more by the patient’s stated experience of their problem rather than by the name we give to the disease entity itself. Different patients suffering from the same disease could receive different homeopathic drugs based on their individual constitution and be cured. One important exception to this custom- tailored approach is the homeopathic treatment for epidemic diseases.

Homeopathy had been practiced continuously for at least 120 years before the discovery of penicillin in the 1920s. During that time homeopathy played a significant role in treating epidemics such as the typhus epidemic in Europe in 1813 when the homeopathic mortality rate was .01% vs. the conventional mortality of around 30%. Likewise, during the Asiatic cholera epidemic of 1830, the homeopathic mortality was 7-10% versus the near 80% mortality for conventionally treated patients.

When an epidemic disease appeared, homeopaths would treat the condition based on the individual's signs and symptoms. After treating many cases, a skilled homeopathic physician could see the pattern of common symptoms emerge and would know what remedy or remedies were necessary to treat most cases of the epidemic. Once this remedy was identified it could be prescribed with confidence in that it would cure a large percentage of the cases without the need to individualize each and every case. This type of remedy is called the epidemicus remedy, the remedy of that specific epidemic at that specific point in time. Once identified, the epidemicus remedy could actually be used as a preventive for persons not yet infected. The next year’s epidemic might require a different remedy since the symptoms might present differently. Hence, what worked in the past might not work in the future. One of the epidemicus remedies during the 1918 Spanish Flu pandemic was Gelsemium (yellow jasmine).

Should a bird flu epidemic emerge in Asia in the near future, homeopathic physicians worldwide will communicate their treatment experiences via the Internet. In Asia, India has the most homeopathic physicians and so that country would be a critical link in the worldwide information chain providing homeopaths around the world with the kind of detailed description necessary to see the remedy pattern. Should the portal of this potential pandemic occur through Turkey, neighboring Greece with its relatively larger number of homeopathic physicians might become our forward outpost. We would also have the benefit of their early attempts at cure as well as the remedies necessary for complications such as pneumonia. Should the epidemic become a pandemic and reach our shores, American homeopathic physicians would then very quickly be able to disseminate their experience including any modifications needed since the virus first emerged.

Most homeopathic remedies are available over the counter so once the epidemicus remedy is known and broadcast through alternative channels, people could self medicate and seek consultations with homeopaths for complications. This parallel medical strategy would exist in addition to whatever government program was instituted at the time since homeopathic remedies could be used in addition to conventional methods. Although not the ideal way to practice homeopathy, using remedies together with conventional drugs has virtually no downside as drug interactions from homeopathic remedies have never been reported. People at risk but not yet infected could protect themselves by taking the epidemicus remedy as a preventive since no vaccine would be available.

There is one other homeopathic practice that might also aid in a fight against this potential pandemic. During the 1918 pandemic some homeopathic physicians would give a remedy made from the nasal secretions of a patient with the flu. This class of remedy is called a nosode, that is, a remedy made from a bacterium, virus or some other disease component. This influenza nosode would not be the major epidemicus remedy, rather it would act as an adjunctive measure in the treatment process. This is not a “homeopathic vaccine” as taking the nosode would not result in the appearance of antibodies to the flu virus. The nosode is too dilute to actually elicit an immune response. Would a nosode from the 1918 flu pandemic be useful against potential bird flu pandemic? It’s hard to tell. However, such a nosode has been discovered in a collection of heirloom remedies from the estate of a homeopath who used to practice in New York City. Efforts are now underway to duplicate and distribute this remedy. We may never need it, and its efficacy is not guaranteed but it is at least comforting to know that it may be available as a curative option.

Homeopathy can be legally practiced by medical doctors (MD), osteopathic physicians (DO) and naturopathic physicians (ND). While there are no longer any homeopathic medical schools in existence in the US, most homeopaths get their training in post-graduate institutes. Naturopaths learn basic homeopathy as part of their curriculum and can then elect to take advanced training after graduation.

American pioneer physician, Andrew Taylor Still, founded Osteopathy in 1874. Dr.Still had lost several children from infectious disease and after his service in the Civil War as an Army surgeon; he began to question the methods of crude drugging, purging, puking and blood letting which were the common treatments at the time. His personal loss and the devastation he witnessed during the war lead him to seek a way to improve medical practice.

His new system, which he called Osteopathy, originated as a holistic and drugless approach to health and disease. It is based on the idea that man is not a collection of parts but a synthetic whole imbued with spirit - a totality not reducible to the sum of its parts. The body functions as a total unit and possesses self-healing and self-regulating mechanisms. Osteopathy maintains that there is a reciprocal relationship between structure and function, i.e., that an alteration in structure (the musculoskeletal system) through injury will result in a change in function (an internal organ) and hence disease. Likewise, a diseased internal organ will result in an alteration in the musculoskeletal system. The osteopathic physician, by his or her intimate knowledge of living anatomy can recognize, even on subtle levels, these deviations from normal and by the application of various manual maneuvers can restore the structure and function and assist the inherent self- healing powers of the body. In the 1870s, in America, this was viewed as lunacy and Dr. Still was immediately branded a medical heretic.

Most people familiar with manipulation think of chiropractic. Osteopathy historically predates chiropractic and there is some historical evidence that the founder of chiropractic was actually a student of Andrew Taylor Still. Osteopathy, however, is not a spinal or musculoskeletal therapy. Osteopathy was intended as a reformation of conventional medicine and as such treats the entire body through the diagnosis and manipulation of the musculoskeletal system - freeing the flow of arterial and venous blood, lymphatic fluid, nerve conduction, cerebral spinal fluid and even various subtle human energy fields. The various manual modalities used in osteopathy can be applied to bone, muscle, fascia, nerve, joints, ligaments, tendons, internal organs and the cranium.

Some of Dr. Still’s early career- launching successes involved not only the cure of a crippled child but also the successful treatment of epidemics of infectious diarrhea using only his hands. During the 1918 Spanish Flu pandemic osteopathic physicians treated the neck and upper back as well the ribs and diaphragm. A maneuver called the lymphatic pump was used to help circulate lymphatic fluid containing antibodies throughout the body. This was done using a gentle pumping action on the upper part of the ribcage.

Since the opening of the first osteopathic school in 1892, osteopathy has enjoyed a steady growth as a profession. Improvement of its schools and its curriculum to include the teaching of modern pharmacology began in the early part of the 20th century and the osteopathic profession now enjoys educational and legal parity with allopathic physicians (MDs). There are more than 20 osteopathic medical colleges in the US and an estimated 50,000 osteopaths in practice today. Sixty-five percent of all osteopathic physicians are involved in the primary care areas of family practice, internal medicine, ob/gyn and pediatrics. Although many osteopaths are indistinguishable from their allopathic colleagues and use drugs as their primary treatment modality, there are many who continue to integrate the traditional osteopathic philosophy and methods with modern pharmacology. A small percentage of osteopaths use the traditional methods almost exclusively.

Without an effective vaccine or antiviral drugs to fight this potential pandemic we might as well be living in 1918. We have better surveillance and instantaneous global communications today but this may actually lead to more panic. As hospitals become filled and emergency rooms overwhelmed, conventional medicine will be left with mass quarantine as its only public health measure.

The long history of these holistic healings arts in the successful treatment of epidemic diseases should give some comfort to those worried about bird flu or any other potential new health risks. One should not forget, however, that these approaches have also been used as non-toxic ways to actually prevent disease. Positive interaction and stimulation of one’s vital force on a regular basis through these and other holistic methods can contribute immeasurably to one’s longevity and quality of life. We have hopefully reached the point in our history when as a society we will allow and support a multiplicity of approaches to peacefully coexist to our benefit, each approach doing what it does best in its own way and on its own terms.