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Homoeoprophylaxis: An Historical Snapshot
By Isaac Golden December 17, 2013Introduction:
Homoeoprophylaxis (homeopathic immunisation) has a long and successful history of use from 1798 till today. However it still attracts criticism from within the homeopathic profession as well as from advocates of pharmaceutical medicine. The purpose of this article is to provide readers with a snapshot of use from Hahnemann’s first prescription of Belladonna to both treat and prevent Scarlet Fever, to the latest Cuban interventions against Dengue Fever.
The use of homoeoprophylaxis (HP) for both short-term and long-term protection has been described in detail elsewhere, as well as the philosophical basis of the method and a possible mechanism of action[1]. This summary of references in English is simply to show the type of evidence that is available supporting the use of HP. It is not complete, and there are no doubt many more references in Spanish and Hindi in particular.
An Historical Snapshot of HP
The following review shows the year of reference or use. Some references simply support HP in general, and some describe quantified prophylactic interventions using HP.
1798 Dr. S. Hahnemann. “Who can deny that the perfect prevention of infection from this devastating scourge, and the discovery of a means whereby this divine aim may be surely attained, would offer infinite advantages over any mode of treatment, be it of the most incomparable kind soever?
“The remedy capable of maintaining the healthy uninfectable by the miasm of scarlatina, I was so fortunate as to discover.”
Hahnemann then describes his use of Belladonna to prevent Scarlet Fever[2].
1801 Following Hahnemann’s example, another eleven medical doctors prescribed Belladonna during the same epidemic. They reported that of 1,646 children exposed to scarlet fever after being given Belladonna, only 123(7.4%) developed symptoms of infection. In contrast, the infection rate in those who did not receive the prophylactic was as high as 90%.Total Efficacy 92.9%[3].
1831 Dr S. Hahnemann. Cuprum “has also proved itself indispensable for the prevention of the murderous cholera, or for its cure where it had been already developed”[4]
“Cuprum as a prophylactic against cholera has generally shown itself efficacious wherever it has been employed, and where its action has not been disturbed by gross dietetic faults, or by the smell of camphor (which is its antidote)[5].
1831 Hufeland, the Prussian emperor’s personal physician and close friend of Hahnemann, considered all the results of prophylactic use of Belladonna against scarlet fever. His knowledge had such weight that the Prussian government decided to use Belladonna as a prophylactic agent during an epidemic of scarlet fever in 1838[6].
1831 Hahnemann’s Cholera Experience.”The above preparation of copper, is the most certain preventive and protective remedy; those in health should take, once every week, a small globule of it (Cuprum 30C) in the morning fasting”[7].
1849 “Although the circumstance that thousands of men have through the use of these homoeopathic prophylactics escaped cholera, as has been actually proved, does not incontestably prove that these afford an absolute protection, since it might have been that these very persons might have been the ones who would in any case not have been touched by the disease, nevertheless these facts speak at least very much for the probability of such a salutary action”[8].
Dr Clemens von Boenninghausen treated and prevented untold numbers of cholera infections during the 1849 European epidemic with remedies recommended by Hahnemann. While a death rate of 54-90% occurred with conventional treatment, Boenninghausen’s patients had a mortality rate of only 5-16%
1884 Dr J C Burnett stated “It seems to me that the requirement of the age is to systematise the prevention of disease according to the law of similars, and in dynamic dose.”
“Strewn about in literature there are examples of small-dose homœoprophylaxis; see Hahnemann’s little essay on Belladonna for example, at the very birth of Hahnemannian Homoeopathy.
“The vaccine ‘lymph’ – pus – has been dynamised more homoeopathico and given as a prophylactic against small-pox in epidemic times, and apparently with effect. Thuja Occidentalis has been used in like manner by more than one homoeopathic practitioner, and they claim that it is effective … Speaking for myself, I have for the last nine years been in the habit of using vaccine matter, in the thirtieth homoeopathic centesimal potency, whenever small-pox was about, and I have thus far not seen any one so far treated get variola”[9].
1900 Dr Kent – “We must look to homoeopathy for our protection as well as for our cure.”
“Now you will find that for prophylaxis there is required a less degree of similitude than is necessary for curing. A remedy will not have to be so similar to prevent disease as to cure it, and these remedies in daily use will enable you to prevent a large number of people from becoming sick”[10].
1907 Dr Eaton gives the results of the experience in the smallpox epidemic of a number of Iowa physicians. His instructions to his colleagues were precise. The paper “really gives the basis of what is known as ‘Homoeopathic vaccination’ which was upheld by the supreme court of Iowa”.
“I trust that reference to your case book, ledger, and other records will enable you to make your figures on these three points definite and exact. May I ask that in any uncertain cases, such ones be omitted from your report, to the end that the figure be conservative, and an understatement rather than an overstatement”.
Dr Eaton collected the following figures (from which he deliberately excluded his own experience):
Persons given Variolinum 30 2806
Definite exposures after taking Variolinum 30 547
Smallpox cases after taking Variolinum 30 14
Efficacy 97.5%
Dr Eaton concluded:”We must not do Homoeopathy the injustice of giving this, one of its most successful and useful outgrowths, a partial and equivocal recognition, just because it happens to be strange to us. This splendid piece of practice is not new, it has its roots in the past, though we may not have known it. And we must not injure the cause by refusing to recognise its value just because we happen not to have been conversant with it”[11].
1920 Dr Close – “Homoeopathy is opposed to the methods of vaccine and serum therapy, although it is claimed by many that these methods are based upon the homoeopathic principle. It has been proven experimentally and clinically that such methods are unnecessary, and that the results claimed by their advocates can be attained more safely, more rapidly and more thoroughly by the administration of the homoeopathically indicated medicines in sub-physiological doses, through the natural channels of the body, than by introducing it forcibly by means of the hypodermic needle or in any other way”[12].
1932 Chavanon administered Diphtherinum 4M and 8M and after one to two months the antitoxins were measured in the blood. He noted that a total of 45 children changed from Schick test +ve (no antibodies against diphtheria) to Shick test –ve (antibodies present)[13].
1941 Patterson and Boyd repeated the Chavanon experiment and 20 out of 33 children were quickly observed to produce antibodies to diphtheria by Schick test. All the cases done in this way gave the Schick test a negative result within nine weeks, and some as early as three weeks afterwards[14].
1950 During an epidemic of poliomyelitis, Dr Taylor Smith of Johannesburg, South Africa protected 82 people with homoeopathic Lathyrus sativus. Of the 82 so immunised, 12 came into direct contact with disease. None were infected[15].
1956 Dr Heisfelder immunized over 6,000 children with Lathyrus sativus. There were no side effects and no cases of polio reported in the group[16].
1963 Gutman reported on the use of influenza prophylaxis in 385 people, showing an effectiveness of 86.0%[17]
1967 Dr Dorothy Shepherd – “Inoculation with any type of serum in any of these infectious diseases is harmful and can easily and safely be replaced by a remedy or remedies, proved according to our Law of Similars that “likes cures like” on healthy individuals. Nosodes or disease products of the actual disease are often most active preventatives”.
Dr Shepherd gives many practical examples of how HP reduced attacks of infectious diseases in boarding schools which she attended, and other examples from her long and distinguished career[18].
1968 A survey conducted in Indian factories and offices compared the results of the effectiveness of Influenzinum as a homeopathic prophylactic against seasonal flu with standard allopathic measures. Almost 20 percent of the patients treated by conventional medical physicians contracted the flu. Among the homeopathically treated patients, only 6.5 percent came down with the disease. The homeopathic patients who did become ill, recovered more rapidly than the allopathically treated patients. The number of working days lost by the allopathically treated patients was nearly eight and a half times greater than those lost by homeopathic patients[19].
1972 Dr P Sankaran – “Though the efficacy of the Homoeopathic prophylactic remedies for various conditions has not been proved by controlled studies and statistical records, yet generations of homoeopaths have used these remedies to prevent these conditions and they claim to have done it successfully. So their efficacy may be accepted on the basis of this experience even if it is not proved”[20].Referred to in Chapter 1, this booklet is a very thorough literature review sourcing 92 practitioners and hundreds of examples of HP.
1974 In August 1974 (Guarantingueta, Brazil) there was an epidemic of meningitis. 18,640 children under the age of 15 were given Meningococcinum 10CH, and 6,340 children of similar ages were not covered. The following results were obtained:
18,640 protected homoeopathically 4 cases
6,340 not protected 10 cases.
Efficacy = 86.1%[21].
1976 Dr M Blackie – “The same is true of the homoeopathic oral flu vaccine. Clinical experience proves that protection is given in individuals, yet there is no increase in antibodies to the influenza virus. … One cannot ignore clinical observation but we have no way of measuring true reasons – it just works. The results, therefore, of Homoeopathy in preventative medicine are justifiably based on experience rather than experiment”[22].
1976 Dr K N Mathur – “Dr Hahnemann found that remedies can act as prophylactic medicines, when the homoeopathic remedy in its provings brings out symptoms similar to a particular disease. It was experienced that the genus epidemicus when given to the members of the family were not suffering from the epidemic disease were protected from developing the disease.”
Dr Mathur then quoted Dr Pierre Schmidt from an address given in Geneva on HP:
“The most noble role of medicine is unquestionably prophylaxy. There homoeopathy asserts its superiority over the existing methods. It can prevent disease without endangering the organism, without incurring the disappointments of the prevailing school of medicine.”[23]
1978 Dr Sankaran – “The broad general indications of the nosodes are given hereunder for the prophylaxis of infectious diseases. Wheeler recommends that in epidemics, the corresponding nosode in the 30th potency will protect for at least a fortnight. Others like Grimmer recommend one dose in high potency, once a year.”
Dr Sankaran gives various examples of HP when discussing different Nosodes[24].
1982 L J Speight – “In homoeopathy there is no immunisation as such, but there are remedies that can build up immunity to infections. They can also act as curative agents where a disease has developed. These remedies carry no risk of detrimental effects, they are absolutely safe.
“Dr A. Pulford wrote ‘No disease will arise without an existing predisposition to that disease. It is the absence of the predisposition to any particular disease that makes us immune to it. Homoeopathy alone is capable of removing these predispositions’”.
Ms Speight then gives examples of HP in nine common diseases[25].
1989 Dr Lockie – “Homoeopathic immunisation against the graver diseases of childhood is not usually offered unless a child is particularly at risk; most homoeopaths prefer to take the route of boosting general resistance to disease, rather than exposing a child unnecessarily to the influence of powerful disease organisms. That said, homoeopathic immunisation has never damaged anyone”[26].
1991 Dr Eizayaga – “An ideal socio-medical system should assist all individuals before they contract any disease, whether acute or chronic … In acute diseases: with the remedy of the epidemic genius and with the aetiological nosode of the disease.” In homoeopathy, with the nosode of each of the acute diseases we could fulfil a job similar to the one achieved by the vaccines which are known, without any of their inconveniences. While the non specific resistance of an individual to an infection is increased with the homoeopathic remedy, a higher specific immunity against a given germ is obtained with the nosode.”
“Chauvanon demonstrated that as regards Schick’s reaction, the nosode negatives it or makes it inactive during a first period, as well as immunising without the presence of antitoxins or antibodies. After a short time, one to two months, antitoxins which can be measured in the blood appear and a real vaccination exists … the respective immunisation lasts just the same as the one provoked by the antitoxin in substance, without any of its disadvantages”.
Dr H Roux repeated these same experiences in 1946 and obtained like results.
Dr Eizayaga then quotes his own substantial and successful experience with HP[27].
1991 Dr B Sethi – “Diphtherinum. Allen says that he had used it for 25 years as a prophylactic and has never known a second case of diphtheria to occur in a family after it has been administered. He challenges the profession to test it and publish the failures. …Tyler writes that for nearly three years, Diphtherinum in high potency has been used in the London Homoeopathic Hospital to protect nurses and patients exposed to the infection, with perfect success.”
“Morbillinum. As a prophylactic given to those who are, or may be, exposed to infection.”
“Lathyrus Sativa. Homoeopathic physicians are satisfied that they have a really safe and better polio preventative in Lathyrus Sativa when properly given”.
Amongst the many examples of HP given by Dr Sethi, he then quotes the experience of Drs Smith, Grimmer, Bond, and Foubister:
“Whooping Cough. Dr John H Clarke strongly recommended Pertussin in whooping cough. In practice the results of Pertussin have been verified by Dr Dorothy Shepherd. Children who were given this medicine escaped the disease”[28].
1993 Dr C B Lessell – “Those nosodes utilised for immunisation, correctly given, are immensely safe, virtually free from side effects, and may be given in pregnancy and lactation. Alternatively, a remedy other than a nosode may be given preventively which would be used to treat the disease in question (e.g., malaria). Such remedies are also generally very safe. Safety and lack of side-effects thus characterise the homoeopathic method. Homoeopathic remedies would seem to work by actively stimulating the immune system of the body in some way. The manner in which this occurs, however, has not been totally elucidated.”
Dr Lessell follows with numerous examples of the use of HP remedies against diseases which travellers may face[29].
1996 The Dengue Fever Nosode 30C was administered to people in the Delhi area during an epidemic of Dengue haemorrhagic fever.
39,200 people were given Homeopathic Dengue Fever Nosode. 23,520 were successfully followed up. 5 people developed symptoms. Infection rate = 0.125%. Normal infection rate 50%. Total Effectiveness – 99.875%[30].
1998 Mroninski reported an HP intervention in Brazil against meningococcal meningitis type B in 65,826 children. They followed these children plus another unimmunised group of 23,539 for 12 months. Efficacy was 92.4% after 6 months and 91.0% after 12 months[31].
1999 Andhra Pradesh – Japanese Encephalitis intervention in around 20 million children 14 years and under[32].
2000 Notifications and deaths fell from 1,036 and 203 respectively in 1999, to 0 by 2004, whereas the rates remained high in surrounding provinces without the HP intervention.
2001 In 2001, case numbers of Dengue Fever fell more than in surrounding neighborhoods after the prophylactic use of Eupatorium perfoliatum 30cH[33].
2003 A Malarial Trial conducted by Assie Pittendrigh in Kenya between 2003-2005 used a homeopathic Malaria Nosode in a group of 33 volunteers. Twenty-one of the participants had experienced 1 to 3 malaria episodes in the 18 months prior to the trial. During the trial, one person thought he may have developed malaria but this was not verified by blood test. After a full recovery in a matter of hours, malaria was considered unlikely. All other participants in the trial remained malaria free[34].
2004 Golden studied children using his long-term HP program from 1986 to 2004. Use of national attack rates as a control allowed calculation of HP efficacy for 3 diseases: whooping cough = 86.2%; Measles = 90.0%; Mumps = 91.6%.
2006 Minah & Margai instigated a double blind RCT to assess the efficacy of Tropica Nosodes as a homeopathic prophylaxis in reducing malarial parasitic densities among residents in a low-income community in Freetown, Sierra Leone[35]. They found a clear benefit of the Nosode in the first phase of the trial, but less clarity in subsequent phases.
2007 In April-May 2007 a complex of Phosphorus 30, Crotalus horridus 30 & Eupatorium perfoliatum 30 was used prophylactically in a county of Rio de Janeiro in over 156,000 children. In Jan-March 2008 the disease incidence fell 93% compared with the previous year, and the incidence in the rest of Rio increased by 128%[36].
2007 Finlay Institute – Leptospirosis intervention in over 2.2 million people.
2008 Finlay Institute – Leptospirosis intervention in over 2.2 million people[37].
2009 Finlay Institute – Swine Flu intervention in over 9.8 million people. In 2012 an attempt to quantify the effectiveness of the intervention was unsuccessful because surveillance data showed there were no cases of Swine Flu nationally over the 2009/10 flu season.
2011 Nosodes of potential influenza infecting agents or placebo were given to 600 children age 1-5yrs daily for 30 days. The incidence of respiratory symptoms over the next 12 months was 3 times higher in the placebo group[38].
2012 Finlay Institute – a significant Dengue Fever intervention was commenced in March 2012. Data has not been finalised at time of writing, but early reports suggest a very positive result.
These examples are summarised in Table 1. below
Table 1: Summary of HP Use
| Year | Author(s) | Disease | Type | Numbers | Effectivness % |
|---|---|---|---|---|---|
| 1798 | Hahnemann | Scarlet fever | GE | |
|
| 1801 | Various | Scarlet fever | GE | 1646 | 92.9 |
| 1831 | Hahnemann | Cholera | GE | |
|
| 1831 | Hufeland | Scarlet fever | GE | |
|
| 1849 | von Boenninghausen | Cholera | GE | |
|
| 1884 | Burnett | Smallpox | Nosode | |
|
| 1900 | Kent | Various | GE | |
|
| 1907 | Eaton | Smallpox | Nosode | 2806 | 97.5 |
| 1920 | Close | Variois | GE | |
|
| 1932 | Chavanon | Diphtheria | Nosode | |
|
| 1941 | Patterson & Boyd | Diphtheria | Nosode | 33 | |
| 1950 | Taylor Smith | Polio | GE | 82 | No cases reported |
| 1956 | Heisfelder | Polio | GE | 6000 | No cases reported |
| 1963 | Gutman | Influenza | Nosode | 385 | 86 |
| 1967 | Shepherd | Various | Nosode/GE | |
|
| 1968 | Krishnamurty | Influenza | Nosode | |
|
| 1972 | Sankaran P | Various | Nosode/GE | |
|
| 1974 | Castro & Noguiera | Meningitis | Nosode | 18640/6340 | 86.1 |
| 1976 | Mathur | Various | Nosode/GE | |
|
| 1982 | Speight | Various | Nosode/GE | |
|
| 1989 | Lockie | Various | Nosode/GE | |
|
| 1991 | Eizayaga | Various | Nosode | |
|
| 1991 | Sethi | Diphtheria Measles Polio Pertussis |
NosodeGE | |
|
| 1996 | CCRH | Dengue fever | Nosode | 23250 | 99.8 |
| 1998 | Mroninski | Meningitis type B | Nosode | 65826/23539 | 92.4/91 |
| 1999 | Srinivasulu | Japanese encephalitis | GE | 20 million | Cases reduced to 0 after three years |
| 2001 | Marino | Dengue fever | GE | |
|
| 2003 | Pertington | Malaria | Nosode | 33 | |
| 2004 | Golden | Pertussis Measles Mumps |
Nosode | 2342 child years | 86.2 91.6 90.0 |
| 2006 | Minah & Margai | Malaria | Nosode | 731 | |
| 2007 | Nunes | Dengue fever | GE | 56129 | Significant fall in cases |
| 2007 | Finlay Institute Cuba | Leptospirosis | Nosode + GE | 2.2 million + | Significantly fewer cases |
| 2008 | Finlay Institute | Leptospirosis | Nosode + GE | 2.2 million + | Significantly fewer cases |
| 2009 | Finlay Institute | Leptospirosis | Nosode + GE | 9.8 million + | No cases recorded |
| 2011 | Lyrio | Influenza | Nosode | 600 + | Cases reduced to 1/3rd |
| 20212 | Finlay Institute | Dengue fever | Nosode + GE | |
|
Conclusion
Homoeoprophylaxis was used by Hahnemann who saw prevention of disease being preferable to treatment, even homeopathic treatment. There is always more to do, and more data to be collected. But homeopaths should be aware of the history of HP and recognise that its evidentiary base is considerable.
[1]Golden I (2012) The Complete Practitioner’s Manual of Homoeoprophylaxis.Isaac Golden Publications, Gisborne, Australia.
[2] Hahnemann S, (1801). The Cure and Prevention of Scarlet Fever, Lesser Writings.B.Jain Publishing. New Delhi. P.369ff.
[3]Dudgeon R. E. 1853.Lectures on the Theory and Practice of Homeopathy. p.541,2. Republished by B. Jain Publishers, 2002, New Dehli.
[4]Hahnemann S, (1801). Cuprum Copper. Chronic Diseases.B.Jain Publishing. New Delhi. P.369ff.
[5] Hahnemann S, (1801). Cause and Prevention of the Asiatic Cholera. 1831.Lesser Writings. B.Jain Publishing. New Delhi. P.369ff.
[6]Hufeland CW, Prophylactic Power of Belladonna in Scarlet Fever. Hufeland’s Journal, 1826.
[7]Samuel Hahnemann, MD. 1831. Cause and Prevention of the Asiatic Cholera.Archiv.f. hom. Helik., vol. xi.
[8]von Boenninghausen CMF, Brief Instructions for Non-Physicians Concerning the Prophylaxis and Treatment of Asiatic Cholera,Lesser Writings. B.Jain, 1986 (reprint).p. 303.
[9]Burnett JC, Vaccinosis and its Cure by Thuja; with Remarks on Homœoprophylaxis.W H L, 1992 (reprint), pp. 114, 115.
[10]KentJT,Lectures on Homoeopathic Philosophy.B. Jain Publishers, New Delhi, 5th Edition, 1954, p. 229.
[11]Eaton CW, Variolinum, Transactions of the American Institute of Homoeopathy, 1907.www.whale.to/v/eaton.html
[12]Dr S Close, The Genius of Homoeopathy. B. Jain Publishers, New Delhi, 1991, p. 20.
[13]Chavanon, P. La Dipterie, 4th edition. St. Denis, Niort: Imprimerie 1932.
[14]Patterson, J and Boyd WE.Potency Action: A Preliminary Study of the Alteration of the Schick Test by a Homeopathic Potency.British Homeopathic Journal.1941; 31: 301-309.
[15]Taylor-Smith A. 1950 Apr;40(2):65-77. Poliomyelitis and prophylaxis. Br Homeopath J. PMID: 15420319.
[16]Eisfelder, HW,Poliomyelitis Immunization: A Final Report.Journal of the American Institute of Homeopathy. V. 54, Nov-Dec 1961, pp. 166-167.
[17]Gutman W (1963) Homeopathic oral vaccine against influenza. Homeopathy 13(12); pp. 185, 187.
[18]Shepherd S, Homoeopathy in Epidemic Diseases. Health Science Press, 1981 reprint, p. 15.
[19]Krishnamurty, Report on the use of Influenzinum during the outbreak of epidemic in India in 1968. Hahnemannian Gleanings 1970;37:225-6.
[20]Sankaran P, Prophylactics in Homoeopathy. (The Homoeopathic Medical Publishers, 1961).
[21]Castro D &Nogueira GG, Use of the Nosode Meningococcinum as a preventative Against Meningitis.J.A.I.H. 68: 1975; pp. 211-219.
[22]Blackie M, The Challenge of Homoeopathy. Unwin, 1981, p. 184.
[23]Mathur KN, Principles of Prescribing. B.Jain Publishers, new Delhi, 1987 (reprint), pp. 50, 53.
[24]Sankaran P, Some Notes on the Nosodes. (The Hom.Medical Publishers, p. 5).
[25]Speight LJ, Homoeopathy and Immunisation. Health Science Press, p. 3.
[26]Lockie A, The Family Guide to Homoeopathy. Guild Publishing, p. 17.
[27]Eizayaga FX, Treatise on Homoeopathic Medicine. E Marecel, Buenos Aires, pp. 282-286.
[28]Sethi B, Homoeo Prophylactic Remedies. B.Jain Publishing, New Delhi, pp. 22, 47, 56, 78.
[29]Lessell CB, The World Traveller’s Manual of Homoeopathy. C W Daniel Co Ltd, page 14.
[30]Central Council of Research in Homoeopathy. CCRH News 1996-1997.
[31] Mroninski C, Adriano E, Mattos G (2001) Meningococcinum: Its protective effect against meningococcal disease. Homeopathic LinksWinter Vol 14(4); pp. 230-4.
[32]Srinivasulu G. 60thPoster Presentation, Homeopathic World Medical Congress. Berlin. 4-7/5/2005.
[33]Marino R. Homeopathy and Collective Health: The Case of Dengue Epidemics. Int J High Dilution Res 2008; 7(25):179-185. http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/312/373.
[34]Partington, T. Silent and Deadly: Prophylaxis and Treatment of Malaria. Homeopathy in Practice, 2006, pp.14-19.
[35]MinahJ andMargai FM.The Use of Malaria Nosodes to Reduce the Prevalence of Malariain Depressed Communities.Minah JB: AnfragenachUnterstützungeinerForschungsarbeitan das Sekretariat des DZVhÄ. 20. Oktober. 2006,
[36]NunesLAdeS.Contribution of homeopathy to the control of an outbreak of dengue in Macaé, Rio de Janeiro.Int J High Dilution Res 2008; 7(25):186-192. http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/315/374.
[37]Bracho G, Varela E, Fernández R, et al. Large-scale application of highly-diluted bacteria for Leptospirosis epidemic control. Homeopathy. 2010; 99: 156-
[38]Lyrio C et al. The use of homeopathy to prevent symptoms of human flu and acute respiratory infections: a double blind, randomized, placebo-controlled clinical trial with 600 children from Brazilian Public Health Service. Int J High Dilution Res 2011; 10(36):174-176 http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/view/499/513.