Indian Journal of Research in Homoeopathy

Vol. 4, No. 2, April-June 2010

EXTRA MURAL RESEARCH

Role of homoeopathic treatment in scabies infection in adivasi children attending
ashram shalas (resident schools)
1* 1 1 1
Chandrasekhar Goda , Prashant Tamboli , Sharmila Patil , Swarda Valimbe Kalyani Mhatre
1
Dr. M.L.Dhawale Memorial Trust, Mumbai, India

Scabies is a frequent skin disease suffered by of the tribal (adivasi) children attending residential
schools. The humid living conditions, crowding, poor personal hygiene, and inadequate nutritional
status of the children poses formidable challenges in the management of this disorder. Prolonged
allopathic treatment often fails to eradicate the infection in this unfortunate population. Infection and
other complications are common.
A prospective, randomized controlled, single blind study was carried out during the period November
2004 to December 2007 to explore the efficacy of homoeopathic treatment in tackling scabies infection
and controlling the spread.
300 cases were enrolled and divided into three treatment groups i.e. constitutional group, acute / sector
group and placebo group. Scabies infection was diagnosed by the dermatologist and graded as per the
severity of infection and children were observed for 2 years. All treatment groups were subjected to
standard hygienic measures during the course of the study.
Results were analyzed at the end of each year. 90% of the children from constitutional group improved
st
at the end of the 1 year whereas 27% from the acute and 4% from the placebo group improved. At the
end of the second year, the rate of improvement of the constitutional group rose to 98% whereas 48%
from the acute and 12% from placebo group improved. The prevalence of scabies in the school dropped
from 52% to 17% at a time when the prevalence of scabies in the residential schools in the area did not
show any reduction.
The results demonstrated statistically significant improvement in the constitutional group as compared
to the response in the acute and the placebo groups. It is concluded that the constitutional approach
holds great promise in the cure and control of treatment of infective skin conditions in a closed group.
The results also highlight the efficacy of homoeopathic medicines at a community level thus opening up
the vast untapped area of community medicine to homoeopathic interventions.
Keywords: scabies; constitutional treatment; randomized controlled study; homoeopathy; community
medicine

Introduction It is extremely common in children and equally

affects both sexes. The incubation period is one
Scabies is an exceedingly common contagious disease
month. Once sensitization occurs, the time taken for
caused by the infestation of a mite- Acarus or 1
the subsequent infection is less. It spreads through
Sarcoptes Scabiei.1 It is also known as ‘seven year
contact with infected individuals or infected clothes,
itch’. It was very common during the First and the
towels, bed linen, etc. It was observed that
Second World Wars but gradually has become rare in
prolonged contact especially during sleep is
most western countries. There has been a hypothesis 2
responsible for the spreading of infection.
that scabies epidemics occur in a 30-year cycle. The
last cycle started in 1960 and ended in 1990.2 In India, The most common symptom of scabies is itching
the incidence in any Dermatology outpatient clinic varies especially at night. It is more during warm and humid
from 10 to 30% of all cases with a seasonal prevalence climate.2 Initially, the itching is localized but gradually
2
and higher incidence in the winter months. becomes generalized. The common sites of infection
are webs of fingers, flexor aspect of wrist, elbow,
*Address for Correspondence: anterior axillary fold, upper thigh portion, buttocks and
Dr. Chandrasekhar Goda, Dr. M L. Dhawale Memorial Trust,
BMC's Mother and hild Holistic care Centre, genitalia. These sites usually get
Harishankar Joshi Marg, Dahisar East, Mumbai 400068.
E-mail:[email protected]

33
Role of homoeopathic treatment in scabies infection in adivasi children attending ashram shalas (resident schools)
Chandrasekhar Goda1*, et al

secondarily infected. Scalp, face, palms and soles Materials and Methods
rarely get the secondary infection.
Randomized, placebo controlled, single blind study
The diagnosis is established mainly from the was carried out during the period Nov. 2004 to Dec
history and examination findings. Presence of a 2007, at the Dr. M. L. Dhawale Memorial Trust's
burrow with a characteristic pattern of the lesions, Community Health Centre, Bhopoli, Taluka
intense itching and history of similar complaints in Vikramgarh, Dist. Thane. Dagadipada and Bhopoli
the past or in the family members are the cardinal residential school of Vikramgrah taluka, Thane
features of scabies. district were selected for conducting the study. 315
children residing in the tribal schools between the
From the homoeopathic angle, this state is
age groups 6 to 15 years having scabies were
seen as a chronic and deep affliction needing the
enrolled for the study. The severity of the disease
use of deep-acting constitutional forces to correct
differs from time to time. Hence, to quantify the
the underlying susceptibility thereby improving the
severity in a uniform way it was graded as shown in
immunity to deal with the chronic infection. The
the Table 1. This was done with the help of
strategy for tackling the illness has been to use the
dermatologist. There is no such ready classification
Constitutional remedy. Occasionally there is a need
available in the textbooks of dermatology.
of acute remedies to take care of severe super-
The children were randomly divided into 3
added skin infections.
groups. The first group received constitutional
Aim treatment, the second group received acute / sector
treatment and the third group which acted as a
To explore and assess the role of homoeopathic control received placebo. Common hygienic
constitutional treatment in treating cases of Scabies measures were maintained for all the three groups.
infection. The baseline observations were taken after one
month of enrollment. In this first month, the hygienic
Objectives measures were standardized across all the groups.
1. To assess the efficacy of homoeopathic treatment They were observed over a 2 year period. Children
were observed for two years with the treatment. In
in the prevention of recurrence of the infection.
the third year the observations were recorded
2. To evolve a general strategy in managing this without any treatment being administered to any of
common paediatric skin infection. the groups. However, the hygienic measures were
continued even in this period.
Table 1-Clinical criteria for grading of scabies

Clinical criteria Grade 0 Grade 1 Grade 2 Grade 3

No Scabies Mild Moderate Severe
No. of sites 0 1 to 3 4 to 7 8 to 13
Itching Absent Mild Moderate Severe
Eruptions Absent Less than 5 5 to 15 More than 15
Follow up observations were done at weekly intervals. times a day till the symptoms disappeared after
Constitutional medicines were prescribed based on the which placebo pills were given four times a day.
totality of symptoms. For prescribing acute / sector Placebo was given 4 times a day in the Placebo
medicines, only the characteristic features of local group. The medicines used in the project were
signs and symptoms were considered. To begin with, a manufactured by M/S Willmar Schwabe India Pvt.
single dose of constitutional medicine was prescribed Ltd. and obtained directly from the manufacturer.
and the patient was observed until improvement
Standard hygienic measures were followed for
ceased. Then as per the state of susceptibility, the next
all the three groups. Teachers, community health
action was taken. To maintain the uniformity of doses
volunteers, and class monitors recruited from the
with other groups, placebo pills were given 4 times a
senior classes, specially trained and motivated,
day on a regular basis. In case of acute medicines, the
monitored this on a regular basis.
indicated medicine was given 4

Indian Journal of Research in Homoeopathy 34

Vol. 4, No. 2, April-June 2010
 Role of homoeopathic treatment in scabies infection in adivasi children attending ashram shalas (resident schools)
Chandrasekhar Goda1*, et al

Outcome assessment 4. Pace of the disease– Gradual / Rapid

The results were assessed by considering changes 5. Progress of the disease – Scabies always
in the grade of the infection. Concomitantly, changes present / Seasonal
in other associated complaints were also noted. For 6. Previous and current medications and its
assessing the recurrence, yearly follow up was
response.
considered. Peak seasons in which infection
exacerbates like rainy and winter were taken for 7. Other associated diseases
comparison. 8. General vitality: Examination findings.
Results On the basis of the above the following three
Out of the 315 registered children, 300 followed categories were formulated:
hygiene regularly. These have been taken up for High Susceptibility: Capacity of the individual to
analysis. throw up a good number of characteristics which
Efforts were made to understand the state of were readily expressed and perceived by the trained
susceptibility of the children. This was categorized observer. .
as low, moderate or high based on the following Moderate susceptibility: Individual throws up only a
parameters: moderate number of characteristics and the
1. Predisposition – Family history of scabies expressions are mainly the common symptoms of
the disease.
2. Qualified Mental Symptoms – Present / Absent
Low Susceptibility: Poor capacity to throw up
3. Character of expressions – Asymptomatic /
characteristics. Even common symptoms like itching
Symptomatic, if symptomatic then characteristic
are not expressed.
/ common symptoms

Table 2-State of susceptibility across the groups

Susceptibility Constitutional Acute Placebo Total

Low 11 08 08 27
Moderate 81 84 84 249
High 08 08 08 24
Total 100 100 100 300

Thus by understanding the susceptibility one this. Various aspects of posology like potency, dose
understands how the person reacts to different stimuli. repetition are dependent on the level of susceptibility.
The characteristics expression and pathology guide in

35 Indian Journal of Research in Homoeopathy

Vol. 4, No. 2, April-June 2010
Role of homoeopathic treatment in scabies infection in adivasi children attending ashram shalas (resident schools)
1*
Chandrasekhar Goda , et al

Graph 1-Change in the susceptibility across the groups at the end of 2 years

Susceptibility After Treatment

95
100
90
80
65
70
60
43
50
34
40
24
30 23
20
4 11
10
1
0
Constitution Acute Placebo

Improved Status Quo Deteriorated

Graph 2-Grade wise changes in constitutional group after treatment

Changes in Constitutional Group

120
90 98 100
100

80

60 47
38
40
15
20
9 1 2
0 0 0 0 0 0 0
0
Before Rx. 1st Year 2nd Year 3rd Year

Grade 0 Grade 1 Grade 2 Grade 3

Graph 3-Grade wise changes in acute group after treatment

Changes in Acute Group

76
80
70
60
48
50
39 38
40 33
28 27 29 31
30
19
20 13
15 11
10
0 2 0
0
Before Rx. 1st Year 2nd Year 3rd Year

Grade 0 Grade 1 Grade 2 Grade 3

Indian Journal of Research in Homoeopathy

Vol. 4, No. 2, April-June 2010
36
 Role of homoeopathic treatment in scabies infection in adivasi children attending ashram shalas (resident schools)
Chandrasekhar Goda1*, et al

Graph 4-Grade wise changes in placebo group after treatment

Changes in Placebo Group

50 45
45 39 39
40 35 36
34
35 28 28
30 26 26
25 21
20
20 12
15
7
10
4
5
0
0
Before Rx. 1st Year 2nd Year 3rd Year

Grade 0 Grade 1 Grade 2 Grade 3

Graphs 2, 3 & 4 clearly show that in the constitutional group, 90% of the
children improved within one year whereas 27% cases in the acute
group and 4% in the placebo group improved.

Graph 5-Rate of improvement across groups after the treatment

Rate of improvement across groups after Rx.

70
62
60
50
40
32
30
20 16 19
12 13
10 9
2 4 3
0 0 0
-10
At Starting Rx. 1st week 2nd week 3rd week 4th week

Constitutional Group Acute Group Placebo Group

Graph 5 shows the rate of commencement of In the acute group, 32% showed changes
improvement across the groups. In the constitutional within the first week. Then from the subsequent
st
group, the response was immediate i.e. from the 1 weeks, rate of improvement was not linear. Placebo
week itself. 62 children had shown improvement by group showed no change in the first week.
st
the end of the 1 week whereas 16% of cases
nd
started improvement from the 2 week.

37 Indian Journal of Research in Homoeopathy

Vol. 4, No. 2, April-June 2010
Role of homoeopathic treatment in scabies infection in adivasi children attending ashram shalas (resident schools)
1*
Chandrasekhar Goda , et al

Table 3-Constitutional & Acute remedies prescribed

Constitutional Number of Acute Remedies Number of

Remedies Children Children
Baryta carb. 03 Arsenic album 12
Calc. carb. 33 Calc. sulph. 08
Calc. phos 08 Graphites 09
Calc. silicate 04 Hepar sulph 25
Kali. carb. 03 Merc. sol. 42
Lycopodium 04 Pulsatilla 04
Nat. mur. 14
Nat. silicata 03
Sepia 02
Silicea 23
Sulphur 03
Total 100 Total 100

Discussion sector level. In such cases, sector / acute remedies are

indicated. This study also explored the role of acute
Efficacy of homoeopathic treatment
remedies in scabies treatment. 27% cases which were

Theefficacy of Homoeopathic treatment can treated through this approach were free of scabies at
be established by comparing the results of the the end of one year. Detailed analysis had shown that
different groups. The response is dependent on the where there was greater similarity, the response was
state of susceptibility and the changes brought about faster. Each remedy has a particular site affinity. This is
in it through our medicines. The results are discussed in the later part.
compared in terms of Hygiene is the most important part of the

Results at the end i.e. presence or absence of treatment of the scabies. Placebo controls helped to
scabies understand its importance. It also helped to verify the
results of homoeopathic treatment. At the end of the

Rateof response to treatment
one year, only 4% cases have improved in the placebo

Recurrence of scabies group pointing out to the statistically significant results.

Results in all the three groups Rate of response to the treatment

This study shows the efficacy of homoeopathic Efficacy of any treatment strategy is also dependent on
medicines in the treatment of scabies infection. the rate of response. In a contagious infection like
Constitutional medicines are prescribed based on scabies, a gradual response is expected when the
the totality comprising of physical as well as mental overall hygienic condition improves. If the response is
symptoms. Scabies, being a chronic disease, has faster, it will not only lessen the suffering of that case
responded promptly to the constitutional approach. but will also reduce the risks of cross infection. The
90% cases improved at the end of one year of improvement in the constitutional group is immediate.
treatment. 62 % cases improved during the 1st week itself. In other
words, we can say that when the similimum is
In some cases where the susceptibility is on the
prescribed, improvement should start within 2 weeks.
lower side the characteristic constitutional symptoms
This will help in judging the remedy response. The
are not available. On the other hand, sometimes the
Acute group has shown a mixed pattern of response in
case presents with characteristics symptoms at the
the rate of improvement. It also responded faster when

Indian Journal of Research in Homoeopathy 38

Vol. 4, No. 2, April-June 2010
 Role of homoeopathic treatment in scabies infection in adivasi children attending ashram shalas (resident schools)
Chandrasekhar Goda1*, et al

the scabies were present in the same area where Observations carried out at the end of the third
the remedy has affinity to that location. It is year were without any treatment to any of the
important to note that none of the children from the groups. None of the children had scabies in the third
Placebo group improved in the first week. year from the constitutional group whereas 24%
Statistical analysis children had recurrence from the acute group. Only
12% children were free of scabies in the third year in
Chi-Square test was applied to assess the statistical the Placebo group. The severity of infection was less
significance of the results. The difference between in both Acute as well as Placebo group.
Constitutional group Vs Placebo group was p < 0.01
and that between the Constitutional group Vs. Acute Collective community susceptibility
group was p < 0.01. The results of both these
This project was carried out in a residential school. It
groups are statistically significant. However, the
was a closed community. In a closed community there
difference of the result between Acute group Vs.
is generally a balance struck between the agent, the
Placebo group was not statistically significant.
host and the environment. When this balance is
Recurrence of scabies disturbed in an unfavorable manner, contagious
Scabies is known to have seasonal fluctuations. It infections like scabies break open. In such instances
becomes dormant during unfavorable the chances of cross infections are very high. When
circumstances. Therefore, results cannot be analyzing the responses at the individual and at the
confirmed until cases are observed over a group level we need to take into consideration the
sufficiently prolonged period. The results of the overall load of scabies infection in that school.
second year show the efficacy more clearly. There is
When the project was started the prevalence of
improvement in all the three groups. More cases as
scabies was 57%. At the end of one year of treatment,
compared to first year are becoming free of scabies
it had come down to 32%. The prevalence further
albeit at different rates across groups. At the same
reduced to 27 % at the end of the second year. The
time the severity of the infection is reducing across
the groups. In the constitutional group only 2% interesting finding was at the end of the third year when
children showed a recurrence and that too of a mild treatment had ceased the prevalence rate had dropped
variety. In the Acute group, 48% children improved to just 17%. That means there was a drastic reduction
whereas 12% children were cured in Placebo group. in the scabies infection in the school.

Graph 6-Prevalence of scabies in the school over the period

Prevalence in the school

60

50

40

30
26
20
17
10

0
Before starting the End of 1st year End of 2nd year End of 3rd year
treatment

Prevalence

39 Indian Journal of Research in Homoeopathy

Vol. 4, No. 2, April-June 2010
Role of homoeopathic treatment in scabies infection in adivasi children attending ashram shalas (resident schools)
Chandrasekhar Goda1*, et al

If we understand this response from the point of b. Homoeopathic constitutional medicines to all
susceptibility, which is the cornerstone concept in scabies affected cases where susceptibility
Homoeopathy, we note that there was moderate was in moderate zone. Cases having low
susceptibility in 83% of the cases at the susceptibility and having severe secondary
commencement of treatment. With treatment and infections do not respond to this mode of
change brought about through hygienic measures treatment.
for three years, 65% of cases showed improvement c. Homoeopathic acute medicines to those
in their level of susceptibility. Therefore, there was
having low susceptibility.
an overall change in all the groups. That means they
have collectively improved. In this study, since the d. After acute treatment, completing the cure
susceptibility of 65% cases had improved with the constitutional medicines

individually the collective impact can be seen. These administering the indicated constitutional
observations suggest the presence of an entity like a medicine.
Collective Community Susceptibility. Acknowledgements
This brings out a different perspective in the Authors thank Department of AYUSH for funding the
homeopathic management of infective conditions in project. Authors also acknowledge the contribution
a closed community i.e. Role of Homoeopathic of Prof. Dr. C. Nayak, Director General, and Dr. Anil
medicines in the area of Community Medicine. Khurana, Asstt. Director, CCRH for close
Homoeopathic treatment not only helps the patient supervision of the project. Authors are grateful to Dr.
who is under treatment but it also prevents others Kumar Dhawale, Hon. Director, Dr. M L Dhawale
not under treatment from being infected. This aspect Memorial Organizations for support and technical
of the preventive action of Homoeopathic medicines guidance in completing and conceptualizing the
as a Community Medicine needs to be verified by project and the results.
further research work.
References
Conclusions
1. Stone S, Stephen P. Scabies. Fitzpatrick's
1. Homoeopathic medicines are effective in the Dermatology in General Medicine. McGraw Hill
management of Scabies. Medical, London, 2003: 2029.
2. Valia R G, Valia A. Text Book of Dermatology, 3rd edition.
2. Homoeopathic medicines prevent the recurrence
Bhalani Publishing House, Mumbai, 2002: 422.
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st
3. Constitutional approach is useful in curing for Homoeopathy, 1 edition. B Jain Pub. Ltd, New
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4. Improvement starts within a week of the 5. Skripkin Yu K, Mlich M V. Skin and Venereal
Diseases. MIR Publisher, Moscow, 1985: 229.
administration of the constitutional medicines. nd
6. Pasricha J S. Treatment of Skin Diseases, 2 edition.
5. Repetition of acute medicine, four times a day, Oxford & IBH Publishing Co., 1980: 84.
has been the most useful posology practice. 7. Markus R. Roxburgh's Common Skin Diseases.
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medicines. 8. Dhawale M L. Concept of disease in Homoeopathy.
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research studies need to be specially designed Genius of Homoeopathy. B Jain Pub. Ltd, 1986: 76.
to delineate this role. 10. Dhawale M L. Susceptibility. Principles & Practice of
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Indian Journal of Research in Homoeopathy 40

Vol. 4, No. 2, April-June 2010
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