Venerable Denipitiye Dhammindha of Rajagiriya (42) was brought to Dr. Mass R. Usuf's Holistic Treatment Centre at Pita Kotte, about a month ago, with great prostration, complaining of a highly febrile state, severe frontal headache with vertigo and crippling body pain. Dr. Usuf, upon consultation, noted that the patient suffered much around past midnight, had an aversion to cold drinks and had suffered severely for over 24 hours with no sleep. Dr. Usuf also observed the patient's marked depression of spirit and the severe mental and physical restlessness.

He also found out that the patient had vehemently dashed on the ground all the medicines that he had been taking previously saying 'it is useless taking medicine!' The venerable monk was in a depressed state of mind and was brought to Dr. Usuf's clinic (where he treats patients free of charge) by one of his patients who had become an ardent follower of homeopathic treatment. The monk was in such a despondent state where he believed there was no therapy to salvage him.

Taking the mental aspects into consideration and after an assessment of clinical manifestations common to all patients under the present epidemic that has already affected over one hundred thousand people in Sri Lanka, Dr. Usuf diagnosed it as a case of Chikungunya fever.

He says: Chikungunya fever (CF) is a viral disease that can be very debilitating. It is characterised by symptoms of arthralgia (joint pains typically in the knee, ankle, wrists and small joints of the extremities), myalgia (muscle pain) fever (which can register 39 degrees C), headache, fatigue, nausea, vomiting, mild hemorrhage (especially in children), great prostration, insomnia. The medium of infection is through mosquitoes infected with the virus CHIKV. The time from infection to illness (incubation period) can be 2-12 days, with an average of 3-7 days - following the pattern of most illnesses of viral origin. The mosquito known as the Aedes aegypti is a primary vector of CHIKV transmitted to humans. The same type of mosquito is the primary carrier for viruses that causes dengue fever as well.

When Dr. Usuf noticed a marked debility in the Buddhist monk with low vital power and the slightest exertion causing exhaustion and physical restlessness, it became a challenge to him as a medical man because this left him and the patient with the task of ameliorating the gross, negative mental and physiological symptoms.

Dr. Usuf administered the following homoeopathic drugs to the patient in keeping with symptoms manifested:

ARSENIC ALB 30 - to counter: the great debility with low vital power, the exhaustion after even slight exertion, the mental and physical restlessness, the sense of fear he was fraught with, the depressed spirit, the aversion to food, the propensity to curse, the mental turmoil, the despondent state, the almost weeping state, the bitter/metallic taste in mouth, the state of the tongue - dry and clean, the highly febrile state, the severe frontal headache with vertigo, the thirst for warm water - taken little at a time, the lumbo-sacral pain, weakness in lower extremities, the bilateral oedema in the lower extremities, the cold and clammy sweat , disturbed sleep and the imperceptibly small, weak pulse.

LEDUM PAL 200 - to counter: the origin of the disease owing to puncture by an insect (mosquito), the fever accompanied by severe arthralgia of the extremities, the tearing arthralgia - that had an ascending character (feet/hands upwards), the bilateral oedema of the feet and for any rheumatic diathesis.

EUPATORIUM PERF 30 - to counter: the arthralgia of the extremities, the myalgia (sore and bruised feeling all over), the febrile state, the lumbo-sacral pain, the insatiable thirst.

LECITHINUM 30 - to counter: mental exhaustion, the low vitality, the soreness and aching in the extremities (myalgia), the weakness in lower extremities, the disturbed sleep (insomnia), symptoms of a general breakdown

The initial amelioration of the high fever and the severe frontal headache gave both the doctor and the patient confidence that other symptoms, mainly crippling myalgia (sore and bruised feeling all over) and arthralgia would be subjected to amelioration within the next 24 hours.

The rapid relief the patient obtained from the severe mental symptoms gave him a psychological advantage. With this the patient went to his temple abode and within 48 hours was back to his normal self!!

Soon thereafter, he developed a slight inflammation of the glands in the area of the neck but 03 doses of Belladonna 30 resolved it.

PROGNOSIS:
According to Dr. Mass R Usuf, currently there is no vaccine or anti-viral treatment available to counter Chikungunya. In very acute cases (the acute nature being very characteristic of the disease) symptomatic treatment such as administration of NSAIDS (not aspirin as its anti-coagulant properties is contraindicated), fluids, and bed rest would help reduce fever and bring partial (never total) relief from myalgia and arthralgia.

A great number of patients in a very acute state are admitted to hospitals these days with hospital stay averaging 7 - 10 days. Moreover, the post-hospitalisation period at home generally is marked by persistent myalgia and arthralgia with bilateral oedema of the lower extremities for many days/weeks at end, though not crippling. However, in most patients the absence of any feverish condition and headache is quite noteworthy.

Dr. Usuf says, homoeopathy has an array of wonderful drugs that would act not only as a prophylactic to a great extent but also would act effectively against the derangement and bring about quick relief. "Homoeopathic drugs when administered in time would even preclude complications from setting in, unlike when treated with allopathic drugs. The relief is total and rapid in some cases, with the post-hospitalisation period being virtually free of any serious myalgia, arthralgia or oedema of the lower extremities" he confirms.

What Dr. Usuf has observed from his treatment to many of his patients suffering from Chikengunya is the breaking of the violent grip of the disease within 48 hours under homoeopathic treatment with gradual improvement being very apparent within 24 hours after the administration of the very first dose.

A specific objective of homoeopathic treatment he says is to bring relief to the patient as rapidly as possible by first alleviating his mental symptoms. The amelioration of the gross, negative physiological symptoms will follow thereafter.

It was very evident in this case that the patient's severe mental symptoms were a clear indication of the gradual loss of his normal mental faculties. Rapid alleviation of negative mental symptoms under such a traumatic condition would enable the patient to get hold of himself to enable him to overcome the gross, negative physiological symptoms. With negative mental symptoms rapidly receding, it provided the patient a degree of confidence that he could counter the disease with ease.

POST-HOMOEOPATHIC METAMORPHOSIS OF STATE:
Dr. Usuf says the immediate result in this particular case was both fascinating and challenging. Fascinating, because of the sudden amelioration the patient experienced where the patient's high fever and terrible frontal headache were receding fast and he felt much better. He finally had command of his mental faculties, which were evident by the slight smile that lit his otherwise despondent countenance. Dr. Usuf could not help see a sense of disbelief in his eyes!! " In fact when he walked out of my clinic after treatment he displayed a sprightly step with a smile - compared to a man who came in with an unsteady gait almost bent into two with his face and eyes fraught with fear and despondency,' commented Dr. Usuf.

In respect of the Buddhist monk, the first drug administered was Ars alb 30 (02 drops sublingually). On a personal note Dr. Usuf says he would like to look at Ars alb 30 in this instance as a close simillimum if not the simillimum for the virtually rapid amelioration of symptoms leading to relief, the patient experienced within 20 minutes of administering the drug.

The main guiding symptom was the midnight aggravation of all symptoms. Also the single peculiar symptom of the patient dashing the medicines he was given previously saying 'it is useless taking medicine' also strongly pointed to Ars alb said Dr. Usuf.

However, a most noteworthy observation was that the patient had pains all over the body but not burning pains, which was very characteristic of Ars alb!!

The metamorphosis from one of rapid general breakdowns (mentally and physically) towards rapid amelioration underlines the very important fact that the arrest of negative mental symptoms, particularly when it threatens to subvert one's mental faculties, is vital to enable the patient to face his gross, negative physiological traits with some degree of confidence.

CONCLUSION:
Dr. Usuf concludes that CF and dengue fever (DF) manifest more or less the same set of symptoms. However, in Chikungunya fever the myalgia and arthralgia are crippling - which is not characteristic of dengue fever.

Also, post-episodically the myalgia and arthralgia remains in Chikungunya fever - although to a lesser degree and may persist for even 2 years - which again is not characteristic of dengue fever.

A noteworthy observation Dr. Usuf says is the breaking of the violent grip of the disease within 48 hours under homoeopathic treatment with gradual improvement being very apparent with the administration of the very first dose. "Not a single patient treated by me at my clinic required hospitalisation", he amplifies proudly.

On a humble note Dr. Usuf concluded: "I do venture into an area where angels fear to tread when I say it is possible for a patient to acquire and secure his lost mental state homeopathically and then to successfully get over his gross negative physiological symptoms and be whole again rather than palliatively getting over his gross physiological symptoms but remaining a sick man mentally!!

Dr. Usuf can be contacted by telephone : 2885528 - mobile 0777234922 - e-mail.costrans@zeylan.net