THE BOWEL NOSODES

Dr Kasra ChehrazyMD MFHom

IntroductionNosode: Remedies derived from products of disease, diseased tissue or pathogenic organisms.Bowel Nosodes: remedies derived from culture of intestinal bacteria.Nosodes are used to overcome blocks to cure.One significant block to cure is intestinal dysbiosis. Intestinal dysbiosis undermines the patients ability to respond appropriately to homeopathic treatment.Intestinal dysbiosis can generate complex patterns of systemic illness.

Historical overview1796Edward Jenner- vaccination against small pox.1860Joseph Lister- antiseptics in surgery. Reduced the incidence of infections.1864 Louis Pasteur- discovered methods of attenuation necessary for vaccine development.1867Robert Koch- established ethiologic role of bacteria in anthrax. 1882Robert Koch- identified the tubercle bacillus.

Historical overview1919Edward Bach- bacteriologist joins the staff of the Royal London Homeopathic Hospital, begins to investigate effects of autologus vaccines.1925Fleming- identified Penicillin notatum colony that lysed Staphylococci.1927John Paterson- establishes a bacteriology laboratory in Glascow and begins to investigate the bacteriological effects of homeopathic treatment.1960Elizabeth Paterson- collates together the findings of John & Elizabeth Paterson and publishes in the BHJ.

First original articleThe British Homeopathic JournalApril 1920The Relation of Vaccine Therapy to Homeopathy

Dr Edward BachPathologist to the Homeopathic Hospital

Key points of the paper:

The Orthodox ConceptThe Homeopathic Concept1- Microdose Phenomena (vaccines)Principle of the Minimum Dose2- Cross antigenicityPrinciple of Similars3-System effects in illness involving the mindThe Symptom Picture4- Immunology-Infective triggers to illnessThe Aetiological nosode and Miasms5- Use of autologus vaccines in chronic diseaseThe Bowel Nosodes

Key points of the paper:

The Orthodox ConceptThe Homeopathic Concept1- Microdose Phenomena (vaccines)

Vaccines contain an estimated 1/200000 mg of bacterial substance at a concentration comparable to 7x or 8x potency of arsenic-BachIn the pre-antibiotic era, vaccine therapy was used in treatment of acute infection, ISOPATHY ??In typhoid 500 or 1000 million bacilli are given as prophylaxis. But in treating a patient with the disease, a hundredth or even a thousandth of that would be used-BachPrinciple of the Minimum Dose

Key points of the paper:

The Orthodox ConceptThe Homeopathic Concept2- Cross antigenicity

Organisms closely allied to the causative germ of a particular disease may give benefit when used as a vaccine - Bach

Skin of milk-maids showed no signs of small-pox scarring- JennerPrinciple of Similars

Key points of the paper:

The Orthodox ConceptThe Homeopathic Concept3-System effects in illness involving the mind

Individuals having unusual fears, such as dread of fire, heights, crowds, traffic, have almost invariably an organism of the paratyphoid group of bacillus-BachThis is the first documented description of the mental picture in post-infective and/or carrier states.Is it Bach true observation or Kentian preoccupation of his audience??Later: Matria medica of Bowel nosodes.The Symptom Picture

Key points of the paper:

The Orthodox ConceptThe Homeopathic Concept4- Immunology-Infective triggers to illnessHaving saved your patient [with pneumonia] with an inoculation of pneumococci or streptococci made from sputum, after convalescence it is well to find the intestinal organism and give doses which will raise the general resistance against disease in all forms -Bach Isopathic treatment based on post-Infective Aetiology. Girl age five- Asthma (18/12), Rx bronchodilators & inhaled steroids, resolves permanently with Pertussin 30c.Trigger aetiology: PertusisThe Aetiological nosode and Miasms

Key points of the paper:

The Orthodox ConceptThe Homeopathic Concept5- Use of autologus vaccines in chronic disease

The potential role of autologus vaccine in chronic disease was investigated by Bach (bacteriologist) and Wheeler (clinician), who under joint authorship, published a treatise in 1925 entitled. Chronic diseases- a working hypothesis.They selected 500 cases who have been under observation for at least 6 months. Part of the result is:The Bowel Nosodes

Key points of the paper:Result of treatment

No of CasesDiagnosisExcellentGoodModerateFail11Chronic skin-64127Anaemia2196-5Bacilluria221-43Chronic rheumatism732313Lumbago12--1Fibrositis---1

Historical overview Continued1927John Paterson- Thomas Dishington (Clinician) and John Paterson (bacteriologist) made clinical observations on the effects of polyvalent nosode at Scottish Homeopathic Childrens Hospital. After presenting paper Paterson visited Bach and learned his bacteriological technique. He estabilished a bacteriology laboratory in Glascow.

Bacteriology of the BowelNormal flora 99% of the normal bowl consists of anaerobes (10 11/g of faeces).Major bacterial flora are divided into the following three groups:The strict anaerobic group: Eubacterium, Bacteroides, Fusobacterium, & Clostridium.The anaerobic lactic acid producing bacteris including Bifidobacterium, Lactobacillus & Enterococcus.Faculative naerobic bacteria, inc. Enterobacteriaceae, 10 8 /g faeces.

Bacteriology of the BowelPotentially Pathogenic Microorganisms (PPMOs) The pathogenic status of the most important enterobacteria and their corresponding bowel nosode(s) are listed:

EnterobacteriaceaePathogenic statusBowel nosode(s) (by fermentation profile)Shigella spp.PMODysenteria co.Eschrichia coliPMO/PPMO??? MutabileSalmonella spp.PMOGaertner ?? MutabileKlebsiella sppPPMO?Proteus spp.PPMOProteusEnterobacter cloacaePPMO?? Bacillus 7CitrobacterPPMO? Bacillus 7Edwardsiella spp.PPMO? Morgan-p. ??? ProteusMorganellaPPMOMorgan-p. ? Mutabile

Identification of the Bowel Nosodes Bach and Paterson began their investigations in non-lactose fermenting bacteris.They used direct microscopy and four standard sugar-fermentation tests to distinguish between the isolated cultures.The production of acid/gas, on fermentation of glucose, lactose, saccharose and dulcitol is recorded below.

18 hr24-30 hrsLactoseA/G---A/GA/GGlucose-A/GA/GA/GA/GA/GDulcitol---A/G-A/GSaccharose------No.10Morg- co.Morg-p.Morg-g.MutabileNo 10.

Identification of the Bowel Nosodes The nosode was prepared by covering the pure culture isolates with a film of sterile water for 18 hours, collecting the solution and heat-treating it in sealed tubes, and then potentising

18 hr24-30 hrsLactose------GlucoseA/GA/GA/GA--DulcitolA/G-A/GA--SaccharoseA/GA/G----No. 7ProteusGaertnerDys.FaecalisSycotic co.

Limitation of Bach and Patersons methodologyBach and Patersons methodology are insufficient to distinguish between pathogenic and non-pathogenic strains of bacteria.There are considerable uncertainty concerning the bacteriology of the nososdes. e.g.

Reproduced from Alexander, M. Reidentifying the bowel nosodes BHJ April 1998 Vol 77. pp. 67-71

NosodeBacteria conforming to Bach & patersons test typesB.MorganMorganella morganii, Proteus mirabilis (4% sucrose +ve), Salmonella subgroup IV, Aeromonas salmonicida, Edwardsiella tarda, Eschrischia blettae, Haffnia alvei (7% are lactose +VE)

Micro-ecology of the Human GI TractAn estimated 10-14 living bacteria encompassing more than 400 species are present in the human gut.Very complex environment, metabolically active.Wide variation due to close relationship of intestinal ecosystem with the host which is perpetually in contact with xenobiotics, mainly food and drugs.

The microflora of different regions of the GI-tractStomach: small number of predominantly G+ve and aerobic bacteria.Small intestine: a transitional zone between the scarce population of the stomach and the high density population of the colon.Small intestine contains only 10 3 to 10 4 bacteria/g of luminal content.Forceful peristalsis, only bacteria that adhere to the mucosa can persist.A dramatic change at ileo-cecal valve, total number of micro-organisms up to one million fold. Anaerobes outnumber aerobes in ration of 1000:1

The microflora of different regions of the GI-tractColon: peristalsis slower, bacterial population 10 9 to 10 10/ gConcentration of nutrients poor in the lumen, but richer near the epithelial cells where mucus and micronutrients are concentrated.Bacterial factors affect the mucus layer enhanced metabolism and multiplication.Development of the human intestinal floraFoetus: no bacteriaAfter birth: rapid colonization2 years old: similar to adaultsComposition changes with age

Disturbance in the intestinal microfloraHealthy person: composition fairly stableIt changes by:AntibioticsEmotional stressSurgical operation of the GI tractDisorders of peristalsisIBDCADisorders of the cellular and humoral immune system.

Regulation within the intestinal EcosystemOur bacterial population is maintained by a surface immunity based on processes of:RecognitionBiofeedback (immunological and biochemical)Local environmental shift involving synergy/inhibitionModulation of competitive balance between sub-populationsRecognition in GI tract involves the gut-associated lymphatic tissue (GALT) which learns by pinocytosis and perabsorption of bacteria and bacterial products.The stability (and protective capacity) of the immune system as a whole is dependant on the maintenance of dynamic equilibrium within the healthy gut.

Disturbance of the Symbiotic EquilibriumChaos in gut symbiosis (under the influence of toxins, pathogens, drugs or psycho-neuro-endocrine stress) leads to:Immunological chaos in GI tract and elsewhere causeing global lowered resistance to opportunistic infections.changes in environment change in bacterial sub-population. e.g. coliforms degenerate into toxic variants.Eubiosis: balanced steady relationship between the microflora and the host.Dysbiosis: significant shift away from eubiosis.Example: repression of bifido-bacteria by tribes of coliform, enterobacteria, and especially increase of enterococci, proteus, yeasts and clostridiae.

Micro-ecology of the human GI tract-EubiosisIn eubiotic state faecal flora is: 90% obligate anaerobes bifido-bacteria and bacteroides.10% obligate aerobic bacteria (coliform, enteococci, lactobacilli)Less than 1% other enterobacteria (proteus, clostridiae, staphylococci, spores, yeasts)Patters of illness (distinct from illness caused by obvious infection by enteropathogens) are associated with characteristic shifts in the microflora.E.g. ulcerative colitis increase in group D streptococci.Very good fermentors are frequently found in healthy subjectsInhibited or delayed fermentors are frequently found in sick patientsBach & Peterson focused on balance between good fermentors and NLF.Bach & Paterson demonstrated changes in bowl flora under the influence of homeopathic treatment.In chronic cases, bowel flora changes temporarily after homeopathic treatment, to a state which is similar to disease state (Increased NLF) ? Changes in surface adherence of NLF, displacement and expulsion via the stoolAny damage to microvillus structure of endotheliom facilitates adhesion of certain bacteria

The influence of homeopathic remedy on bowel microbiology1927-1932Paterson cultured 8000 stool specimens. Homeopathic potencies are capable of completely altering the bacterial flora of the bowel.Paterson. J. Potentized drugs and its Action on the Bowel FloraTreatment with Sulphur or Calcarea increased Morgan in the stool.Treatment with Lycopodium Morgan-gaertnerLess than 1% other enterobacteria (proteus, clostridiae, staphylococci, aerobic spores and yeastsBacterial adherenceSome adhesive bacteria can recruit a variety of structurally diverse host proteins, adhesive glycoproteins, growth factors, cytokines by initially binding heparin and functionally similar sulphated polysaccharides to their surfaces. G.T.macfarlance Colonuc ecosystem. PROPOSITIONIf homeopathic remedies can alter the surface adherence of any population of bowel organisms, or if it can alter any aspect of their gene expression, VIZ. enzyme function or substance utilisation, there will be systemic consequences.

Some extracts from current reviews of bowel ecologyMetabolic activities of flora and enzyme expressionInvestigation of metabolic activities of flora is a difficult task, as we have to grow microorganism in a medium. Are enzyme expression and metabolic activities in vivo compatible with in vitro activities?

Bacteria/bacteria interactionAvailability of substrates (dietary constituents, mucin, proteins, sloughed cells, host digestive enzymes)Cross feeding (one bacterial population utilises certain degradation products formed by other bacteria as substrate).

Multispecies communities-BiofilmsSome bacteria form antimicrobial substances inhibitory to the growth of certain bacterial groups.Inhibition of one group of bacteria may facilitate the estabilishment of another bacterial group with the same substrate spectrum but not susceptible to antimicrobial compound (multispecies formation)M.BLAUT Assessment of bacteria in the gut microbial ecosystemM.BLAUT Assessment of bacteria in the gut microbial ecosystemM.BLAUT Assessment of bacteria in the gut microbial ecosystem

Some extracts from current reviews of bowel ecologyCell to Cell signalingFormation of multispecies require cell to cell communication to occur. Exchange of information may be brought about by signal molecules. Such signals may influence the behavior and metabolic capabilities of bacteria by way of modulating gene expression.

DNA transferAnother way of communication is transfer of genetic material between bacteria. Gene transfer in GI tract is important because it has possible implications for spread of antibiotic resistance.

Regional availabilityThe large intestinal microbiota is not homogenus. The proximal colon and distal bowel differ markedly in their nutritional availabilities and physiochemical attributes.M.BLAUT Assessment of bacteria in the gut microbial ecosystemM.BLAUT Assessment of bacteria in the gut microbial ecosystemG.T Macfarlane Colonic ecosystem

Some extracts from current reviews of bowel ecologyImplications of non-culturable organismsOnly a small fraction of bacterial species in the gut are culturable, thus the ecosystem contains considerable numbers of polygenetically and physiologically different bacteria. The relative population sizes and types of non-culturable organisms present in the microbiota are largely unknown.

Adherent vs. Non-adherent PopulationBacteria attached to surfaces in gut lumen appear to be phylogenetically similar but physiologically different from non adherent populations.Adherent organisms are more directly involved in the breakdown of complex insoluble polymers than unattached bacteria, which provides a competitive advantage in the ecosystem.

Relationship between mucosal population and health In healthy people it is difficult to gain access to the bowel and study mucosal population. Little information is available concerning composition, metabolism and health-related significance of bacteria growing at or near the mucosal surfaceG.T Macfarlane Colonic ecosystemG.T Macfarlane Colonic ecosystemG.T Macfarlane Colonic ecosystem

The relationship between drug, symtom picture and infected aetiologySymptom PictureInfected aetiologyDrugKochHahnnemanPaterson

Materia Medica of Bowel NosodesB. MORGANKey note: Congestion Source: Non-lactose fermenting bacilliAffinity: Skin, LiverCongestion:Deep internal venous atasis (Carbonated remedies: kali.carb, calc. Graph. Petro. Baryta.carb, carbo. Veg)Appearance: Red face, eruptions, varicose veins.General: CongestionVenous stasisHyperemia of the surface of skinMental: introspective, anxious about health, irritable, avoids company, depression, suicidal tendency.Head: Congestive headache, flushed face,

Materia Medica of Bowel NosodesB. MORGANRespiratory system: Congestion of nasal and bronchial membrane, BronchopneumoniaWhen related remedy fails to clear up the residual infection.esp in children, broncho- and lobar pneumonia (Hx of repeated attacks of congestion of the lungs in children)Digestive system: Congestion gastric mucosa, heart burnLiver, portal HTNIndigestion, hemorrhoids, varicesDirty mouth, billious vomitingcholecystitis, gallstone.ConstipationGU system: Congestioncongestive dysmenorrhea, congestive flushing of menopause

Materia Medica of Bowel NosodesB. MORGANCirculation: Congestion sluggish action of circulatory organs, hemorrhoids, varicose veinsM.S: CongestionCirculatory disturbance of the limbsVaricose veins, varices, edema, chill blainsChronic congestion around the joints causing arthritic conditions.Skin: congestionHeat and itch (sulph, graph, petr, psor)Eczema: red. Itchy. Raw, bleedingMORGAN-PUREIndicated whenMarked skin eruptionLiver disturbanceBillious headacheActual gall stone

Materia Medica of Bowel NosodesMORGAN-GAERTNERIndicated whenAcute inflammatory attack (cholecystitis)Renal colicRenal stone4-8 pm modalityLiver disturbanceBillious headacheActual gall stone

Materia Medica of Bowel Nosodes proteus

Key note: suddenness, violenceSource: Bacillus proteus NLFAppearance: thin, dark hairAffinity: Nervous system

Suddenness, violence

CNSSudden violent temperEpilepsy, petit malhysteriaPNSSpasm of peripheral circulationraynaulds phenomenonintermittent claudicationmeniers

Materia Medica of Bowel Nosodes proteusMental: Brain stormTense, irritable, depressed, outburst of temper, esp if opposed; will throw. Kick or strike. Violence, spasms, particularly the young. Emotional hysteria. Head: Frontal headache,

Materia Medica of Bowel Nosodes proteus

GUS: Urethritis. Loin pain.profuse and offensive leucorrhea. Irregular menses with blood clots for 7 days.MS: Contraction of palms/fingers. Loss of grip strength. Intermittent claudication. cramps legs. Numb feet. Feet feel frozen.Copious perspiration from the axillae, hands clammy.Skin: angioneurotic edema. Herpetic eruptions (sudden, painful)

Materia Medica of Bowel NosodesDysentry Co.Key note: Nervous Tension Source: Bacillus dysentry (shigella ssp.) NLFAppearance: tense facial expressionAffinity: Nervous system

Nervous Tension

Mental AlertnessAnticipatory anxietyEmotional Shy, timidFacial flushing in the presence of strangersTwitching of facial and limb musclesPhysical ChoreaDuodenumadult: duodenal ulcerchild: congenital pyloric stenosis (spasm of pylorus)

Materia Medica of Bowel Nosodes Dysentry. coMental: nervous tensionShy, timidMental uneasiness physical restlessnessFidgets. Twitching face & limbsSensitive to criticismSympathetic unstability hyperemia of the cheekAnticipate misfortune & failure overwork to compensatePerhaps deriven by self-doubt and insecurity.Head: Frontal headacheCV: palpitation before event, anticipatory discomfortGIT:Stomach: Duodenal ulcer (stress)Skin: dry, scaly, circinate lesions

Materia Medica of Bowel Nosodes Sycotic co

Key note: Irritation Source: Cocci, NLFAppearance: pale, flabby, long eyelashes, greasy skin, sweat of headAffinity: Mucous membranes, lymphoid tissue

Irritation

Mucus membranes catarrhPND: nasal sinusitis, asthmaGastroentritisUrethritis, cyctitis, albuminuriaVulvovaginitismeningitisSynovial linings rheumatismLymphoid glandsEnlarged tonsils, adenoids

SkinGreasy skin, warts

Materia Medica of Bowel Nosodes Sycotic co

Mental: Nervous, tense. Cross, restless; weepy; depresseed; shy; sensetoive; fussy.Exhausted. Mostly cold sensetive. Bites nails. Nervous irritability; quick temper; outburst of temper from resentment.Fears: darks, being alone, animals and dogs. Mental very similar to gaertnerOutburst of temper (very similsr to lycopodium) often complementary to this nosode.Mentals of sycotic co and gaertner are similar but bodily features are different.Sweat of head during sleep, chiefly from 12-4 am. Calc. Ca++ has some relations to sycotic co as carbon has to Morgan co.Head: Irritation of meninges, headache from infection of sinuses. Headache in child could be prodromal sign of tubercular meningitis (Helleborus)Weekly headache,

Materia Medica of Bowel Nosodes Sycotic co

Respiratory system: Asthma < dampCough < 2 amSinusitis, PND, catarrh, enlarges tonsils & adenoids.GIT: GastroenteritisdiarrheaGUT: Albuminuria, urethritis, cystitis, vulvovaginitisSkin: Greasy skin, wartsSinusitis, PND, catarrh, enlarges tonsils & adenoids.MS: Irritation of synovial membranes rheumatism

Irritation of mucous membranes

Materia Medica of Bowel Nosodes Gaertner Co.

Childrens nosodeKey note: malnutritionSource: salmonella spp. NLFAppearance: big head, emaciated body, often iteAffinity: GI system

Malnutrition

DietMarasmatic childrenFollowing operation (gastric)AssimilationfatSteatorrheaCeliac diseaseChronic gastro-enteritisThread wormsMetabolismfatketosis

Malignant disease

Materia Medica of Bowel Nosodes Gaertner Co.

Predisposed typesBright active types, often intelligentOften fair hair; blue eyesFreckelesThin, pale, nervy peopleMind:Overactive brain, undernourished mindHypersensitive to all impressionsNose:Polypi, catarrhMouth: salivationStomach:Pain in stomach. Vomits everythingOthers:Chronic gastroenteritis, constipation, night terror, perspiration at night

PhosSilicaMerc Vivus Tuberculinum

Materia Medica of Bowel Nosodes Bacillus No. 7Keynote: fatigueMental, physical fatiguediarrheaAppearance: dark, pale colourMentals:Mental fatigue, sense of extreme physical exhaustionDigestive system:Lack of nerve and muscle tone, sense of fullness, flatulence, distensionGUT:Feeble urine flow, loss of sexual function, premature senilityRespiratory:Asthma, bronchial catarrh, sticky, difficult to raiseCirculation:Slow pulse, low BP, myocardial weaknessNeuromuscular:Relaxed fibrous tissue, tendency to syncopeSkinSensitive to cold, nothing outstanding

Dr Kasra ChehrazyMD MFHom

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