Nosodes or autologous inactivated potentized pathogens - Heterologous convalescent plasma antibodies vs. autologous inactivated potentized virus antigen.

The science is virgin for exploration as is disowned by homoeopaths and not recognized by Modern Medicine and Ayurveda.

My interest in generating autologous immune response goes back to my days as a student in medical college. Then, we used to administer 5 ml of patient’s blood to the same patient through the intramuscular route or 2 ml of milk, again intramuscularly, to induce short-term inmate immunity in lepromatous reactions in leprosy patients. We also used to use convalescent plasma from recovered patients in unexplained diseases within a community and today COVID-19 patients are being treated with plasma taken from cured patients (convalescent plasma therapy).

Another answer was to find the treatment in the nature. I read a paragraph in Kamasutra, the gist of which was that leave elephants in forest and the food they eat will have anti-kapha, anti-obesity and anti-diabetic properties. We know elephants do not suffer from diabetes. Today, we can produce COVID infected animals in laboratories, take them to the forests and leave them there and watch what they eat.

My boss, Dr (Col) KL Chopra and his son Dr Deepak Chopra, taught me that no virus or a drug can work in the body without first identifying a receptor. God never created these receptors for viruses or pharma drugs. The very fact I have a receptor means my body has the capacity to produce that drug.

As per Chandogya Upanishad and all Vedas, Food is Brahman and our food should come back through the plants. If that is so, all origin of treatments will lie in some or the other plant.

Coming back to autologous treatments, I first came across autologous Nosodes as a therapy when I read about the role of alternative medicine in epidemics in 1990. At that time, the disease was dengue, which had no specific medicine and was associated with high mortality. I was intrigued and started reading about autologous treatments, including Nosode therapy.

In the late nineties, one day around midnight, I was approached by a friend whose sister was in ICU with sepsis. The doctors had given up on her. He was aware of my interest in autologous nosode therapy in association with my friends in homoeopathy. We prepared an autologous nosode in the night using the blood and urine of the patient (200C) and administered sublingually three times at 15 minutes interval early in the morning. The patient was discharged 12 days later. Being a modern medicine doctor, my first obvious reaction was to term this as sheer coincidence.

Sometime later, I had a patient with acute myeloid leukemia. The husband of the patient did not consent for the chemotherapy. I got prepared autologous blood Nosode and within 12 hours of administration, her counts doubled and in next 24 hours the blood cancer disappeared. Again, I attributed this to spontaneous resolution of the cancer. Her cancer re-appeared after three months and she died.

In the next few years, I saw some success with Autologous Nosodes in ovarian cancer, lung cancer, non-healing septic wounds and severe dengue.

But I was still not convinced as we had not done a double-blind trial. These were anecdotal cases. It’s my belief that whatever I have been thinking about, several people would have already addressed the issue to some extent.

In 2005, I was hospitalized with severe jaundice and fever. We know that in hepatitis, jaundice appears when fever disappears. But, this was not so in my case. The bilirubin was rising day by day. Dr Navin Dang did my repeat test and said this was an unusual presentation of hepatitis E. As fever and liver enzymes were not coming down, I got my autologous blood Nosode prepared and the enzyme levels came down within 12 hours.

A senior gynecologist colleague asked me to try this remedy in a senior gyne resident, who had severe hepatitis E in pregnancy, and it worked dramatically.

My modern medicine instincts always told me these were chance findings but the researcher in me always thought that they could not be just attributed to chance; there was some science behind it.

It was my view that the use of autologous Nosodes in veterinary practice in Germany (on the basis that dogs lick their own wounds) cannot be unscientific. Definitely, modern medicine might have used them in practice.

I started reading about use of cancer cells in treatment of cancers after I saw a good response in one lady with lung cancer and another in ovarian cancer. Both lived for three years after they were told that they had only three months.

I saw GVAX® vaccine composed of whole tumor cells genetically modified to secrete granulocyte–macrophage colony-stimulating factor (GM-CSF).  The initial vaccine used autologous irradiated tumor cells transfected with a non-replicating adenoviral vector engineered to secrete GM-CSF.¹ Irradiated tumor cells are nothing but an infection free tumor cell but still capable of causing an immune response. 

I came across a study, the results of which suggest that the tumor-associated antigen MUC1 is sufficiently immunogenic to elicit strong anti-tumor immunity as a tumor antigen and that dendritic cell vaccines targeting MUC1 are useful for immunotherapy of cancer. Patients with advanced or metastatic breast or lung cancer were vaccinated with dendritic cells loaded with MUC1 peptides or tumor lysate. Seven of nine MUC1-positive patients showed decrease in tumor size and tumor marker levels or disappearance of malignant pleural effusion. Except for one, all MUC1-negative patients did not respond to DC vaccines. Survival of MUC1-positive patients was 16.75 months vs. 3.80 months in MUC1-negative patients. ²

Then, I started reading more about Nosodes.

Nosodes are prepared from inactivated diseased products of human, animal or vegetable origin or cultures of micro-organisms. ³

Similar to a conventional vaccine, an autologous Nosode is made by taking an inactivated disease agent or product and subjecting it to the processes of dilution and succession typical in the preparation of homoeopathic principles. ⁴

The Greek prefix “noso” means disease, thus indicating the pathological root of Nosodes. This term is also connected with the Latin word “noxa”, related to noxious or damaging, which implies the use of noxious materials as a basis for a homoeopathic remedy. ⁵ Nosodes are prepared by serial dilutions of biological material, usually by factors of 100, which is then administered to prevent or treat a disorder. ⁶

Since the source material of nosodes is potentially infectious, there is a perceived potential risk of infection associated with their use. However, according to the European Directive 2001/83/EC as amended, the requirement for the viral safety of Nosode is fulfilled by complying with the manufacturing methods specified in the German Homeopathic Pharmacopoeia or the French patented process of tyndallisation. The Homeopathic Pharmacopoeia of the United States (HPUS) considers both manufacturing methods as valid to guarantee the viral safety of nosodes and their safety for public health. By applying the homoeopathic potentiating procedures alone, the number of infectious particles decreases to zero in all potencies above 24X or 12C. At that level of dilution, theoretically, no molecule of the starting material can be present. ⁷

Homoeopathic preparations use 100% alcohol and therefore are potent enough to kill all pathogens, including coronaviruses.

The Lung vaccine trial used the irradiation method to inactivate any virus associated with the cancer cell.

Nosodes have been widely used in veterinary homoeopathic medicine and are now being used therapeutically in humans. ⁶

In the current homoeopathic practices, more than 45 major Nosodes have been in use since 1830. ^8.9 

The homoeopathic Nosodes are used for treating residual infections (e.g. bacillinum for tuberculosis) and as a prophylactic (e.g. Influenzium for swine flu). ³

Joshi et al developed a method for preparation and standardization of univalent and polyvalent Mycobacterium Nosodes (labeled as Emtact), using different strains of Mycobacterium tuberculosis. In in vitro testing, Nosodes were found to be satisfactory for its handling and utilization. ¹⁰

Nosodes are contraindicated in the active phase (incubation period) of an acute disease, in the explosive stage of a miasm (a supposed predisposition to a particular disease either inherited or acquired), during the active phase of a recurrent attack and in an infectious stage, e.g. do not use Tuberculinum in an established case of Tuberculosis. ³

Nosodes may have some protective effects. Here are few evidences:

Experimental studies 

• Vaccines prevent almost all cases of measles, mumps, rubella, diphtheria, tetanus, polio and hepatitis B. In Canada every year, routine vaccines also prevent a large number of cases of varicella (chickenpox), pertussis (whooping cough), meningitis and invasive bacterial infections. Nosodes have not been studied for the prevention of any of these infections.¹¹
• An experimental laboratory study conducted at a P3 containment laboratory at an infectious disease research facility concluded that if homoeopathic Nosodes can induce protection from infectious agents for which vaccination is not available, they may provide an interim method of reducing morbidity or mortality from such agents. The study using a murine model exposed to a potentially lethal dose of Francisella tularensisdemonstrated a reduced time to death in the group treated with the tularemia Nosode and a modest decrease in mortality compared with controls. ¹² Protection rates averaged 22% over controls compared to 100% protection by standard vaccination.
• A large-scale opportunistic cohort study using a Nosode for a potential Leptospirosis epidemic in Cuba appeared to be associated with reduced infection rates, although there were multiple confounders and the study is yet to be replicated.¹³
• A large-scale homoeoprophylaxis intervention against Leptospirosis in an epidemic in three provinces of Cuba in 2007 showed that the intervention led to a significant decrease in the disease incidence and control of the epidemic. The formulation was prepared using dilutions of four circulating strains of Leptospirosis, which was administered orally to 2.3 million persons in the affected area. The results suggest the use of homoeoprophylaxis as a feasible tool for epidemic control, although further research is necessary.¹⁴
• A re-evaluation of the effectiveness of homoeoprophylaxis against leptospirosis in Cuba in 2007 and 2008 reinstated that homoeoprophylaxis can be used to effectively immunize people against targeted infectious diseases such as leptospirosis.¹⁵
• Animal studies assessing the potential efficacy of nosodes in the context of Plasmodium bergheiinfection also appear to demonstrate longer survival time in a murine model. ^16,17 
• A Cochrane review of an avian nosode preparation for influenza observed that although the review findings do not rule out the possibility that the nosode could have a clinically useful treatment effect, there is insufficient good evidence to enable robust conclusions to be made about its use in the prevention or treatment of influenza and influenza-like illness. No clinically important harms were observed for the nosode.¹⁸

I had written to the Prime Minister on 27^th January to explore this as a treatment modality. An editorial written by me came under criticism from the Central Council for Research in Homoeopathy (CCRH) on 27^th March stating that homoeopathy does not recognize this science. On 29^th April, I raised this issue with Dr NK Ganguly, Former Director General of ICMR, at a round table discussion; he said that scientists should look into this possibility.

Summary

While prophylaxis and vaccine therapy require a long process of isolating the spike protein from the virus and making a vaccine after attenuation it and give to healthy people. Using the patients’ own sputum viruses and potentizing it after inactivating it in 100% alcohol and giving it to the same patient to induce immediate inmate immunity is worth exploring by ICMR or CSIR.

References 

1. Salgia R, Lynch T, Skarin A, et al. Vaccination with irradiated autologous tumor cells engineered to secrete granulocyte-macrophage colony-stimulating factor augments antitumor immunity in some patients with metastatic non-small-cell lung carcinoma. J Clin Oncol. 2003;21(4):624–30].
2. Kontani K, Taguchi O, Ozaki Y, et al. Dendritic cell vaccine immunotherapy of cancer targeting MUC1 mucin. Int J Mol Med. 2003;12(4):493-502]. 
3. Karthik Sankar, Aruna P Jadhav. Nosodes and Sarcodes. Indian Journal of Traditional Knowledge. Vol. 16(1), January 2017, pp. 158-163.
4. Roniger H, Jacobs J. Prophylaxis against Leptospirosis using a nosode: Can this large cohort study serve as a model for future replications? Homeopathy. 2010;99(3):153–5.
5. Saurav Arora, Bharti Arora. Use of nosodes in homeopathic clinical practice: a survey. Revista De Homeopatia 2015;78(1/2): 8-13.
6. Rieder MJ, Robinson JL. Nosodes are no substitute for vaccines. Paediatr Child Health. 2015;20(4):219-22.
7. ECHAMP (2006) Nosodes in homeopathy: Significant and safe. Updated version Spring].
8. Shah R. Hepatitis C nosode: The preparation and homeopathic pathogenetic trial. Homeopathy. 2013;102:207-14.
9. Shah R. Scientific method of preparing homoeopathic nosodes. Indian J Res Homeopath. 2014;8:166-74.
10. Joshi S, Mukerjee S, Vaidya S, et al. Preparation, standardization and in vitro safety testing of Mycobacterium nosodes (Emtact- polyvalent nosode). Homeopathy. 2016;105:225-32].
11. Fisher P. Enough nonsense on immunization. Br Homeopath J. 1990;79(4):198–200].
12. Jonas WB. Do homeopathic nosodes protect against infection? A experimental test. Altern Ther Health Med. 1999;5(5):36–40).
13. Roniger H, Jacobs J. Prophylaxis against Leptospirosis using a nosode: Can this large cohort study serve as a model for future replications? Homeopathy. 2010;99(3):153–5.
14. Bracho G, Varela E, Fernández R, et al. Large-scale application of highly diluted bacteria for Leptospirosis epidemic control. Homeopathy. 2010;99(3):155–66.
15. Golden I, Bracho G. A reevaluation of the effectiveness of homeoprophylaxis against Leptospirosis in Cuba in 2007 and 2008. J Evid Based Complementary Altern Med. 2014;19(3):155–60.
16. Bagai U, Rajan A, Kaur S. Antimalarial potential of Nosode 30 and 200 against Plasmodium berghei infection in BALB/c mice. J Vector Borne Dis. 2012;49(2):72–7.
17. Bagai U, Walter NS. Antiplasmodial potential of homeopathic drugs Chelidonium and nosode against Plasmodium berghei infection. J Complement Integr Med. 2014;11(3):195–201.
18. Malthie RT, Frye J, Fisher P. Homeopathic Oscillococcinum® for preventing and treating influenza and influenza-like illness. Cochrane Database Syst Rev. 2015;1:CD001957].

Dr KK Aggarwal

President HCFI