Hemophilia, also spelled as haemophilia, is an X-linked
inherited genetic disorder that impairs the body’s ability
to make blood clots, a process needed to stop bleeding.
This is known to be a recessive mutation-based life-long
disorder that is found to be expressed much more
frequently in the males and rarely in females. It has a
great impact on physical, emotional, economic and social
problems for the patients. The disease is recorded since
2nd Century A.D. as a hemorrhagic bleeding disorder
primarily affecting men (termed “Bleeders”)[1]. Because
of a hemorrhagic disposition existing in certain royal
families of England, Germany, Russia and Spain in the
19th and 20th centuries, hemophilia is also called “the
royal disease”[2]. Queen Victoria of England, who ruled
from 1837-1901, is believed to have been the carrier of
hemophilia B, or factor IX deficiency gene. She passed
on the trait to three of her nine children. Her son Leopold
died of bleeding after a fall when he was 30. Her
daughters Alice and Beatrice passed the gene on to
several of their children. Alice’s daughter Alix married
Tsar Nicholas of Russia, whose son Alexei also had
hemophilia. Thus hemophilia was carried through
various royal family members for three generations after
Victoria, and then disappeared[2].
According to Ingram[3], Factor I deficiency was first
discovered in 1920. Factors II and V deficiency were
identified subsequently in the 1940s. The 1950s
witnessed a flourish in the study of some rare factor
deficiencies, and deficiencies of FVII, X, XI and XII
were recognized followed by the discovery of FXIII
deficiency in 1960. However, the clotting impairment in
the majority of hemophiliacs in India is due to the
deficiency of clotting factor VIII (hemophilia A) or
factor IX (hemophilia B). Bleeding episodes may start
from superficial cut, epistaxis, gum bleed from fall of
deciduous teeth, deeper mucosal bleed from
genitourinary tract or gastrointestinal bleed, acute joint
bleed, and so on[4]. The frequency of hemophilia is
reported to be approximately 1 in 10,000 births for factor
VIII deficiency and 1 in 40,000 births for factor IX
deficiency in male births, and is fairly constant in
different parts of the world[5]. India bears second highest
number of hemophilia patients (estimated total cases of
11 580 reported in 2013)[6].
Treatment breakthroughs and current strategy
As per the recorded history of the American Hemophilia
Foundation[2], physicians already learnt before 1926 that
patients responded readily to infusions of whole plasma
when given promptly after they sustained spontaneous
joint and muscle bleeding[3] of patients missing any
coagulating factors. Harvard physicians Patek and
Taylor[7] discovered an anitghlobulin found
in plasma to have ability to decrease clotting time in
patients with hemophilia. Fresh frozen plasma was first
transfused in patients in the hospital in the late 1950s and
1960s. The clotting process was described in detail by
Macfarlane[8]. The interaction of the different factors in
blood clotting was termed the “coagulation cascade,”
now called the clotting cascade. Dr. Judith Graham Pool
and her colleague [9], made a major breakthrough in
hemophilia research when they discovered that
cryoprecipitate left from thawing plasma was rich in
factor VIII. Because cryoprecipitate contained a
substantial amount of the factor in a smaller volume, it
could be infused to control serious bleeding by making
an emergency surgery, helping hemophilia patients much
more manageable during crisis.
Then appeared the freeze-dried powdered concentrates
containing factor VIII and IX in the 1970s. The advent of
the factor concentrates provided a major boon to the
hemophilia care. The concentrates could be stored at
home, and patients could even “self–infuse” the specific
factor products, as and when required. They could now
avoid going each time to the hospital for treatment.
In the second decade of this century, some ultra-highly
diluted remedies of the rather unconventional and
somewhat controversial system of medicine-
homeopathy – based on a holistic model and used in
micro doses, started being used with great economy and
success[4]. Homeopathy was used either as a supportive
medicine along with the conventional medicines, or even
without the conventional medicines, but only with
occasional infusion of factor concentrates, as and when
expressly needed.
The recommended conventional treatment and scope
for supportive therapy
The World Health Organization (WHO) and the World
Federation of Hemophilia recommend infusion of anti-
hemophilic factor periodically as and when required as
a standard and conventional orthodox/western method of
treatment for hemophiliacs. However, management of
hemophilia patients by modern medicines is considered
to be quite expensive for patients in a developing country
like India. Almost 90% of the treatment expenditure is
covered as cost of purchasing clotting factor
concentrates[6]. Therefore in many developing countries
the patients cannot afford to go for such expensive
modern system of medicine if the cost cannot be
considerably reduced by some other means; so they seek
some alternative medical practices like CAM
(Complementary and Alternative Medicines) for
treatment and management of the disease. CAM is
practiced across many continents such as Asia, Africa,
and Latin America and is even considered part of
classical documented heritage and ancient civilization.
Among CAM practices, homeopathy is a very popular
holistic method of treatment, particularly in India. It is
also recognized as a legal system of medicine and
patronized by the Government of India by way of giving
all the benefits of a legitimate system of medicine. In fact,
there is now a separate health ministry for CAM called
AYUSH under Government of India, the abbreviation
denoting Ayurveda, Yoga, Unani, Siddha and
Homeopathy, respectively. This ministry provides quite
generous funding for regulating and improving education,
and research activities. It is also involved in propagation
of these ancient systems of medicines that once catered
to the need of the people in India and in some other
countries. Further, current awareness of the toxic side-
effects of many orthodox medicines and resistance
reported quite often for some commonly used anti-biotics
make people rather hesitant to always use the orthodox
medicines unless expressly called for.
Homeopathy and hemophilia: A new development
Recent research activities involving use of homeopathic
remedies on large scale human trials in India[10-12], and
also in controlled set ups in animals[13] demonstrated
efficacy of some homeopathic remedies bringing
excellent responses to ameliorate various disease
conditions; besides, there are also some great outcome
achieved particularly in treating haemophilia patients,
belonging to both haemophilia A and B groups[4, 14]
exclusively with the use of certain homeopathic remedies.
These research articles very convincingly demonstrated
the efficacy of certain homeopathic remedies in
successfully controlling bleeding of the hemophiliacs,
sometimes even showing greater capability than that of
some modern orthodox medicines in respect of clotting
time, gap between blood transfusion requirement, and in
overall cost and efficiency of management. The
homeopathic medicines which showed most promising
results included: Arnica montana, Hamamelis,
Phosphorus, Calcarea fluorica, Magnesium
phosphoricum, Ferrum metallicum, Ledum palustre,
Causticum, Sulphur, and Hypericum. Sometimes the
patients also needed one constitutional remedy alongside
any one of the symptomatic medicines like Arnica,
Hamamelis, Ledum palustre, Hypericum and Magnesium
phosphoricum, depending on the severity, site, nature of
bleeding and pain[4] to achieve the best results.
The concerns versus the benefits
However, since micro doses of ultra-highly diluted
medicines are often used in homeopathy with great
benefits, the rationalists and many scientists question and
challenge the efficacy of such ultra-highly diluted
remedies on the ground that the apparent effects may be
only due to “placebo effects”[15]. They argue that in these
diluted homeopathic medicines, theoretically speaking,
not even a single molecule of the original drug substance
can be expected to be physically present. However, in
many controlled well designed scientific experiments,
their biological action has been proven and confirmed
beyond any doubt and the possible molecular mechanism
of biological action has also been elucidated on scientific
ground[16– 22].
For More Info
EFFECTIVE MANAGEMENT OF HEMOPHILIA… (PDF Download Available). Available from: https://www.researchgate.net/publication/324862404_EFFECTIVE_MANAGEMENT_OF_HEMOPHILIA_PATIENTS_WITH_A_COMBINED_THERAPY_TO_REDUCE_COST_A_NEW_APPROACH [accessed May 06 2018].
EFFECTIVE MANAGEMENT OF HEMOPHILIA… (PDF Download Available). Available from: https://www.researchgate.net/publication/324862404_EFFECTIVE_MANAGEMENT_OF_HEMOPHILIA_PATIENTS_WITH_A_COMBINED_THERAPY_TO_REDUCE_COST_A_NEW_APPROACH [accessed May 06 2018].https://www.researchgate.net/publication/324862404_EFFECTIVE_MANAGEMENT_OF_HEMOPHILIA_PATIENTS_WITH_A_COMBINED_THERAPY_TO_REDUCE_COST_A_NEW_APPROACH
