DR. AKB SADBHAVANA MISSION SCHOOL OF HOMOEO PHARMACY versus THE SECRETARY, MINISTRY OF AYUSH & ORS. on 15 December 2020

ADR. AKB SADBHAVANA MISSIONSCHOOL OF HOMOEO PHARMACY

V.

THE SECRETARY,MINISTRY OF AYUSH & ORS.

B

(Civil Appeal No. 4049 of 2020)

DECEMBER 15, 2020

[ASHOK BHUSHAN, R. SUBHASH REDDY ANDM. R. SHAH, JJ.]

C

COVID-19: Homeopathic Medicine System – Writ petition filedbefore High Court by an Advocate praying for direction to theDepartment of AYUSH to ensure that the Homeopathic practitionersare immediately allowed to perform in accordance with advisorydated 06.03.2020 issued by Department of AYUSH – PetitionerDpleaded that to control the spread of COVID-19, advisory dated06.03.2020 was issued in which it was pointed out that interventionsunder AYUSH systems have been varyingly used for making aneffective public health response in similar situations faced in manyStates/Union Territories earlier, however, the State of Kerala andthe Department of AYUSH, Trivandrum did not take steps toEimplement the said advisory – High Court while disposing of writpetition, held that the advisory of the Ministry of AYUSH is beingfollowed by the Government and tablets are given free of cost topeople as immunity boosters; that as per the State Medical Protocol,COVID-19 affected persons should not be treated by anybody otherFthan the Government and those authorised by the Government andthe doctors practising in AYUSH medicines are not to prescribe anymedicines, stating that it is curative for COVID-19 disease and thequalified medical AYUSH practitioners can only prescribe immunitybooster mixture or tablets, as suggested by the Ministry of AYUSH– High Court in paragraph 14 noted that if any qualified doctorGpractising AYUSH medicine, makes any advertisement or prescribesany drugs or medicines, as a cure for COVID-19 disease, exceptthose specifically mentioned in the advisory, it would be open forthe respondents to take appropriate action under the provisions ofthe Disaster Management Act, 2005, and also directed Medical/HPolice Departments to monitor the action of AYUSH medical

DR. AKB SADBHAVANA MISSION SCHOOL OF HOMOEO PHARMACY v.THE SECRETARY, MINISTRY OF AYUSH

Conclusion

practitioners – Appellant-Homeo Pharmacy who is not party in writpetition feeling aggrieved by directions issued by High Court filedinstant appeal – Held: Advertisement by Homeopathic practitionersis clearly prohibited by the Homeopathic Practitioners (ProfessionalConduct, Etiquette and Code of Ethics) Regulations, 1982 – Regn.6prohibits advertisement for solicitation of patients personally oradvertisement in the newspaper by the Homeopathic practitioners– When statutory regulations itself prohibit advertisement, there isno occasion for Homeopathic medical practitioners to advertisethat they are competent to cure COVID-19 disease – When theScientists of entire world are engaged in research to find out propermedicine/vaccine for COVID-19, there is no occasion for makingany observation as contained in paragraph 14 with regard toHomeopathic medical practitioners – Homeopathy does not curethe disease, but it cures the patients – Writ petition was filed in HighCourt only with a limited relief for issuing direction to respondentto implement advisory, there was no occasion for High Court tomake observations and issue direction as it made in paragraph 14– High Court did not fully comprehend advisory dated 06.03.2020and made observations for taking appropriate actions against theHomeopathic medical practitioners, which is not approved – HighCourt, however, was right in its observation that no medicalpractitioner can claim that it can cure COVID-19 – There is nosuch claim in other therapy including allopathy – Homeopathy iscontemplated to be used in preventing and mitigating COVID-19 asis reflected by the advisory and guidelines issued by the Ministry ofAYUSH – The directions issued by High Court in paragraph 14 ofthe judgment modified to that extent – Homeopathic medicalpractitioners to follow advisory dated 06.03.2020 as well asguidelines for Homeopathic medical practitioners for COVID-19issued by Government of India, Ministry of AYUSH – DisasterManagement Act, 2005.

Disposing of the appeal, the Court

HELD: 1. The High Court emphasised that if any qualifieddoctor practising AYUSH medicine, makes any advertisementor prescribes any drugs or medicines, as a cure for COVID-19disease, except as prescribed in letter dated 6.3.2020, it is opento the authorities to take appropriate action under the provisions AB

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Aof the Disaster Management Act, 2005. Insofar as advertisementby Homeopathic practitioners is concerned, it is clearly prohibitedby the regulations framed in Section 33 read with Section 24 ofHomeopathy Central Council Act, 1973 namely the HomeopathicPractitioners (Professional Conduct, Etiquette and Code of Ethics)Regulations, 1982. Regulation 6 prohibits advertisement forBsolicitation of patients personally or advertisement in thenewspaper by the Homeopathic practitioners. When statutoryregulations itself prohibit advertisement, there is no occasionfor Homeopathic medical practitioners to advertise that they arecompetent to cure COVID-19 disease. When the Scientists ofCentire world are engaged in research to find out proper medicine/vaccine for COVID-19, there is no occasion for making anyobservation as contained in paragraph 14 with regard toHomeopathic medical practitioners. [Paras 18, 19][1085-B-D;1086-C-D]

D2. The writ petition, which was filed in the Kerala HighCourt only with a limited relief for issuing direction to respondentto implement advisory dated 06.03.2020 issued by Ministry ofAYUSH, there was no occasion for High Court to makeobservations and issue direction as it has been made in paragraph14. What is permissible for Homeopathic medical practitioner inEreference to COVID-19 symptomatic and asymptomatic patientsis already regulated by the said advisory and guidelines. TheGovernment of India, Ministry of AYUSH has also brought onrecord the guidelines issued subsequent to 06.03.2020 forHomeopathy medical practitioners for COVID-19, where

FHomeopathic approach to COVID-19 has been elaborately dealtwith. The said guidelines, which has been issued after 04.04.2020has been brought on the record as Annexure C by the Ministryof AYUSH. Guidelines dated 04.04.2020 make it clear thatHomeopathy has been envisaged by the Ministry as thetherapeutic aid. The said guidelines refer to HomeopathyGmedicines as medicines for prophylaxis, Amelioration andmitigation. The guidelines, however, specifically provides that“the prescription has to be given only by institutionally qualifiedpractitioners”. The High Court in its impugned judgment hasnot fully comprehended the guidelines dated 06.03.2020 andHtaking a restricted view of the guidelines and have made DR. AKB SADBHAVANA MISSION SCHOOL OF HOMOEO PHARMACY v.

observations for taking appropriate actions against theHomeopathic medical practitioners, which cannot be approved.The High Court, however, is right in its observation that nomedical practitioner can claim that it can cure COVID-19. Thereis no such claim in other therapy including allopathy. The HighCourt is right in observing that no claim for cure can be made inHomeopathy. The Homeopathy is contemplated to be used inpreventing and mitigating COVID-19 as is reflected by theadvisory and guidelines issued by the Ministry of AYUSH.[Paras 20, 21, 22, 23][1086-D-F; 1088-G-H; 1089-A-B]

CIVIL APPELLATE JURISDICTION: Civil Appeal No. 4049of 2020.

From the Judgment and Order dated 21.08.2020 of the High Courtof Kerala at Ernakulam in WP (C) No. 9459 of 2020.

Tushar Mehta, SG, Venkita Subramoniam T.R, Rahat Bansal,Raghvendra S. Srivatsa, Gurmeet Singh Makker, Rajat Nair, KanuAgrawal, Ms. Swati Ghildiyal, Advs. for the appearing parties.

The Judgment of the Court was delivered by ASHOK BHUSHAN, J.

The application seeking permission to file special leave petition isallowed.

1. Leave granted.

2. This appeal has been filed by the appellant Dr. AKB SadbhavanaMission School of Homeo Pharmacy aggrieved by the part of DivisionBench judgment of Kerala High Court dated 21.08.2020 passed in WritPetition (C) No.9459 of 2020. The appellant, who was not party in thewrit petition feeling aggrieved by certain directions issued by the HighCourt have come up in this appeal.

3. We need to notice the contents and prayers of the writ petitionfiled in the Kerala High Court by respondent No.4 (proforma respondent).The writ petition was filed by respondent No.4, an Advocate praying forwrit of Mandamus or for any other writ or order directing the Secretary,Department of AYUSH, Government Secretariat, Trivandrum to ensurethat the Homeopathic practitioners are immediately allowed to performin accordance with the Exhibit-P1 notification (Guidelines dated

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A06.03.2020 issued by Secretary, Department of AYUSH (Ministry ofAyurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa andHomeopathy) (AYUSH, New Delhi).

4. The petitioner’s case in the writ petition is that petitioner is anardent admirer of the Homeopathic medicine system, which system ofBmedicine in India is controlled and regulated by the Ministry of AYUSH.The petitioner pleaded that to control the spread of Coronavirus (COVID-19), notification dated 06.03.2020 was issued by the Secretary, Ministryof AYUSH to the Chief Secretaries of all States in which notification, itwas pointed out that interventions under AYUSH systems have beenvaryingly used for making an effective public health response in similarCsituations faced in many States/Union Territories earlier. The petitioner’sgrievance was that State of Kerala and the Secretary, Department ofAYUSH, Government Secretariat, Trivandrum did not take steps toimplement the advisory dated 06.03.2020 whereas many other StateGovernments have taken steps much earlier. The petitioner pleaded thatDHomeopathic system would have been absolutely able to control thespread of COVID-19 through its immunity boosting medicines. Petitionerfurther stated in the writ petition that if the Homeopathic medicines hadbeen distributed earlier in highly affected pockets and particularly tothose under isolation and quarantine, the explosive situation had nothappened, which has happened in the State of Kerala. The only prayerEmade in the writ petition are to the following effect:-

(i) To issue a Writ of Mandamus or any other Writ or Orderdirecting the third respondent to ensure that the Homeopathicpractitioners are immediately allowed to perform inaccordance with the Exhibit P-1 notification.F

(ii) To grant such other reliefs as this Honourable Court deemsfit and proper in the facts and circumstances of the case.5. The Division Bench of the High Court disposed of the writpetition by judgment dated 21.08.2020. The High Court in its judgmentGhas extracted advisory dated 06.03.2020 of the Government of India,Ministry of AYUSH, the Government Order dated 08.04.2020 and21.04.2020 issued by Government of Kerala and after noticing theaforesaid, the High Court disposed of the writ petition. In paragraphs 13and 14 of the judgment, the High Court has stated as follows:- H

“13. It is the case of the petitioner that Exhibit-P1 has not beenimplemented by the State of Kerala, whereas it is the submissionof learned Senior Government Pleader that Government hasapproved the action plan of Homeo Department for giving Homeomedicines as prophylactic. However, the target population wasnot intended to include COVID-19 patients or their contacts orthose people, under quarantine. Advisory of the Ministry ofAYUSH is being followed by the Government and tablets aregiven free of cost to those persons as immunity boosters. As perthe State Medical Protocol, COVID-19 affected persons shouldnot be treated by anybody other than the Government and thoseauthorised by the Government. As per the medical protocol of theGovernment, doctors practising in AYUSH medicines are notsupposed to prescribe any medicines, stating that it is curative forCOVID-19 disease. However, as per the advisory, there is nothingprohibiting the qualified medical AYUSH practitioners to prescribeimmunity booster mixture or tablets, as suggested by the Ministryof AYUSH, Government of India, New Delhi. When the Centralas well as State Governments have approved prescription of certainmixtures and tablets, as immunity boosters, qualified medicalpractitioners in AYUSH can also prescribe the same, but only asimmunity boosters.

14. We also make it clear that if any qualified doctor practisingAYUSH medicine, makes any advertisement or prescribes anydrugs or medicines, as a cure for COVID-19 disease, except thosespecifically mentioned in Annexure-I advisory to Exhibit-P1 D.O.letter dated 6.3.2020, it is open for the respondents to takeappropriate action under the provisions of the DisasterManagement Act, 2005, and the orders of the Governments, bothCentral as well as the State, issued from time-to-time. Only thosetablets or mixtures shall be given as immunity booster and not ascure for COVID-19. AYUSH medical practitioners are furtherdirected not to violate the Government Order dated 6.3.2020. Inthis regard, Medical/Police Departments are also directed tomonitor the action of AYUSH medical practitioners.

Writ petition is disposed of accordingly.”

6. The appellant, who was not party to the writ petition, has filedthis appeal and the reasons given for filing this appeal by the appellant as A

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Astated in paragraph 4 of the application seeking permission to file specialleave petition, are as follows:- “4. It is respectfully submitted that the Hon’ble High Court hadnot issued any notice either to Ministry of AYUSH, Governmentof India or to Homoeopathy doctors or its organisation beforeBpassing the impugned order. Homoeopathy Doctors are treatingall patients who come for treatment. As is well known, most ofthe Covid-19 patients, are asymptomatic and therefore such blanketorders will cause grave prejudice to the Homoeopathy doctors,who treat the patients. The direction to take action under theDisaster Management Act is very harsh and the said order hasCbeen passed without hearing the doctors, who are affected bysuch orders. The Writ Petition has been filed by a lawyer, who isan ardent follower of homoeopathy medicine. The prayer was toimplement the direction passed by AYUSH on 06.03.2020. TheHon’ble High Court unfortunately went beyond the pleadings andDmade observations which will affect the profession ofHomoeopathy doctors. It is pertinent to mention here that manyof the State Governments have been prescribing Homoeopathymedicines as an immunity booster. Even the Health Minister,Government of Kerala had given a press statement thatHomoeopathy medicines are very good for prevention of Covid-E19. In the State of Gujarat, the Government itself had prescribedthe homoeopathy medicines for its citizens.”

7. The appellant is aggrieved by the directions of the High Courtcontained in paragraph 14 only. The High Court in its judgment dated21.08.2020 itself has extracted the G.O. dated 21.04.2020 of theFGovernment of Kerala where Government of Kerala was pleased toapprove the action plan outlining the Homeopathy Strategies for preventionand management of COVID-19 in Kerala. It is now useful to refer tothe G.O. dated 21.04.2020, which has been quoted in the impugnedjudgment, which is to the following effect:-G“GOVERNMENT OF KERALA

Abstract

AYUSH Dept. – COVID-19 - Action Plan outlining theHomeopathy Strategies for Prevention, and Management ofCOVID-19 in Kerala – Approved - Orders issued.H

------------------------------------------------------------------ Read:- 1. Letter No. DHTVM/2606/2019-P2 dtd. 13.04.2020 ofthe Director of Homeopathy.

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ORDER

In the circumstances explained by the Director of Homeopathyvide letter read above, Government are pleased to approve theAction Plan outlining the Homeopathy Strategies for preventionand management of COVID-19 in Kerala as appended to thisorder.

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(By order of the Governor)

Bhooshan V.,”

8. We have heard Shri Venkita Subramoniam, learned counsel forthe appellant and Shri Tushar Mehta, learned Solicitor General of Indiafor the respondent.

9. An affidavit has been filed on behalf of Ministry of AYUSH towhich rejoinder has also been filed. The appellant being aggrieved onlywith directions in paragraph 14 and no relief having been claimed by theappellant against the State of Kerala, we have not issued notice torespondent Nos. 2 and 3 and we proceeded to decide this appeal afterhearing the learned counsel for the petitioner as well as learned SolicitorGeneral of India for the respondent.

10. Learned counsel for the appellant contends that the directionsissued by the Division Bench of Kerala High Court in paragraph 14 totake actions against Homeopathic doctors, who prescribe any drug as acure for COVID-19 disease should be proceeded with under theprovisions of Disaster Management Act, 2005 was uncalled for andbeyond the scope of the writ petition. Learned counsel submits that even E

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Athe Government of India advisory dated 06.03.2020 permitted COVID-19 like illness to be managed by AYUSH systems. The advisory itselfpermits Homeopathy to be used as preventive, prophylactic, symptommanagement of COVID-19 like illnesses and add on interventions to theconventional care. The High Court has erred in confining right ofHomeopathic medical practitioners to prescribe only as immunity booster,Bwhich direction is not in accord to the Guidelines dated 06.03.2020.

11. Learned counsel for the appellant submits that guidelines forHomeopathic practitioners for COVID-19 has been issued byGovernment of India, Ministry of AYUSH, which clearly permits medicalpractitioners, which permission from local health authorities and MedicalCSuperintendent of the hospital to prescribe medicines for COVID-19.When the guidelines issued specifically permits treatment of COVID-19 patients, the High Court erred in observing that Homeopathypractitioners can only prescribe medicines as immunity booster. It issubmitted that the direction issued by the High Court in paragraph 14Dhas made vulnerable the Homeopathic practitioners from being proceededwith under Disaster Management Act, 2005 and actions by police andother medical staff, which is demoralising the practitioners ofHomeopathy.

12. Shri Tushar Mehta, learned Solicitor General of India appearingEfor Ministry of AYUSH, Government of India has submitted thatGovernment of India keeping in view the unprecedented and unforeseenprecarious situation caused by COVID-19, the Ministry of AYUSHdecided to augment and strengthen the COVID -19 medical response ofthe country by using the traditional healthcare system of the country,which includes AYUSH Organisation, Homeopathic practices as wellFas Unani practices. Learned Solicitor General of India has referred toadvisory dated 06.03.2020, which covers the field and he has also referredto the guidelines issued by Government of India. Shri Mehta has referredto the affidavit filed on behalf of Ministry of AYUSH. He submits thatHomeopathy practitioners are permitted by the Ministry of AYUSH toGprescribe medicines as (i) preventive and prophylactic; (ii) symptommanagement of COVID-19; (iii) add on interventions to the conventionalcare.

13. We have considered the submissions of the learned counselfor the parties and have perused the records.

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14. The advisory dated 06.03.2020 issued by the Ministry ofAYUSH has been relied by the learned counsel for the appellant as wellas learned Solicitor General and was also extensively extracted by theHigh Court in its judgment. The advisory dated 06.03.2020 contains theobject of AYUSH systems. It is useful to extract following (relevant ofHomeopathic only), which is part of advisory dated 06.03.2020:- “i. Preventive and prophylactic:

Homoeopathy:

Arsenicum album 30, daily once in empty stomach for three days.The dose should be repeated after one month by following thesame schedule till Coronavirus infections prevalent in thecommunity.

In one of the studies Arsenic album as one of the constituents in aformulation affected HT29 cells and human macrophages. Also,it showed SNF-KB hyperactivity (reduced expression of reportergene GFP in transfected HT29 cells), tTNF-a release inmacrophages. More over, Arsenic album is a common prescriptionin the cases of respiratory infections in day to day practice.

ii. Symptom management of COVID-19 like illnesses

Homoeopathy

Various medicines which found to be effective in treating flu likeillness are Arsenicum album, Btyonia alba, Rhus toxico dendron,Belladonna Gelsemium Eupatorium perfoliatum. All thesemedicines should be taken in consultation with qualified physiciansof respective AYUSH systems.

iii. Add on Interventions to the conventional care

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Homoeopathy

Medicine mentioned Symptom management of COVlD-19 likeillnesses under subhead Homoeopathy can also be given as addon to conventional care.

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[2020] 13 S.C.R.

AAll these medicines should be taken in consultation with qualifiedphysicians of respective AYUSH systems.

15. The above clearly indicate that Ministry of AYUSH specificallypermits use of Homeopathy for following three ways:-

(i) Preventive and prophylactic;

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(ii) Symptom management of COVID-19 like illness;

(iii) Add on interventions to the conventional care.

16. We may further notice the specific averments made by Ministryof AYUSH in its affidavit dated 23.11.2020 regarding what is permittedCto the Homeopathy Medical Practitioner as per Ministry of AYUSH.Paragraph 16 of the affidavit sworn on behalf of the Ministry of AYUSHis as follows:- “16. In addition to the above, it is respectfully reiterated thatMinistry of AYUSH has clearly permitted the homeopathic medicalDpractitioners to prescribe the chugs, as mentioned in the guidelines,as an add-on drug to the conventional treatment for patients whohave been tested Covid positive and are undergoing conventionaltreatment.

Thus in the respectful submission of the answeringErespondent, prescription of the medication prescribed by theMinistry of AYUSH to Covid positive patients as an add-ontreatment is permitted, and therefore, any contention to the contrarystating that homeopathic medical practitioner cannot prescribe anytreatment to Covid-19 positive patients, even as an add-on toconventional treatment is liable to be rejected. It is stated that theFonly embargo is that the said Medicines should not be administeredor advertised as a cure but should be administered as preventivemeasure/immunity booster or as an add-on to the conventionaltreatment.”

17. It is clear from the advisory dated 06.03.2020 and the specificGstand taken by the Ministry of AYUSH as contained in paragraph 16extracted above that Homeopathic medical practitioners are not onlyconfined to prescribe Homeopathic medicines only as immunity booster.The following observations in paragraph 13 by the High Court does notcorrectly comprehend the guidelines dated 06.03.2020:-H

“13. ……………………………………When the Central as wellas State Governments have approved prescription of certainmixtures and tablets, as immunity boosters, qualified medicalpractitioners in AYUSH can also prescribe the same, but only asimmunity boosters.”

18. The High Court in the impugned judgment has emphasisedthat if any qualified doctor practising AYUSH medicine, makes anyadvertisement or prescribes any drugs or medicines, as a cure forCOVID-19 disease, except as prescribed in letter dated 6.3.2020, it isopen to the authorities to take appropriate action under the provisions ofthe Disaster Management Act, 2005. Insofar as advertisement byHomeopathic practitioners is concerned, i.e., clearly prohibited by theregulations framed in Section 33 read with Section 24 of HomeopathyCentral Council Act, 1973 namely the Homeopathic Practitioners(Professional Conduct, Etiquette and Code of Ethics) Regulations, 1982.The Regulation 6 prohibits advertisement for solicitation of patientspersonally or advertisement in the newspaper by the Homeopathicpractitioners. Regulation 6 is to the following effect:- “6.(1) Advertising Solicitation of patients directly or indirectly by a practitioner ofHomoeopathy either personally or by advertisement in thenewspapers, by placards or by the distribution of circular cards orhandbills is unethical. A practitioner of Homoeopathy shall notmake use of, or permit others to make use of, him or his name asa subject of any form or manner of advertising or publicity throughlay channels which shall be of such a character as to invite attentionto him or to his professional position or skill or as would ordinarilyresult in his self-aggrandisement provided that a practitioner ofHomoeopathy is permitted formal announcement in press aboutthe following matters, namely :-

(i) the starting of his practice;

(ii) change of the type of practice;

(iii) change of address;

(iv) temporary absence from duty;.

(v) resumption of practice

(vi) succeeding to another’s practice.

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A(2) He shall further not advertise himself directly or indirectlythrough price lists or publicity materials of manufacturing firms ortraders with whom he may be connected in any capacity, norshall he publish cases, operations or letters of thanks from patientsin non-professional newspapers or journals provided it shall bepermissible for him to publish his name in connection with aBprospectus or a director’s or a technical expert’s report.”

19. When statutory regulations itself prohibit advertisement, thereis no occasion for Homeopathic medical practitioners to advertise thatthey are competent to cure COVID-19 disease. When the Scientists ofentire world are engaged in research to find out proper medicine/vaccineCfor COVID-19, there is no occasion for making any observation ascontained in paragraph 14 with regard to Homeopathic medicalpractitioners. The homeopathy does not cure the disease, but it curesthe patients.

20. We have already noticed that the writ petition, which wasDfiled in the Kerala High Court only with a limited relief for issuing directionto respondent to implement the advisory dated 06.03.2020 issued byMinistry of AYUSH, there was no occasion for High Court to makeobservations and issue direction as it has been made in paragraph 14.

21. We, however, make it clear that what is permissible forEHomeopathic medical practitioner in reference to COVID-19symptomatic and asymptomatic patients is already regulated by the saidadvisory and guidelines. The Government of India, Ministry of AYUSHhas also brought on record the guidelines issued subsequent to 06.03.2020for Homeopathy medical practitioners for COVID-19, whereFHomeopathic approach to COVID-19 has been elaborately dealt with.The said guidelines, which has been issued after 04.04.2020 has beenbrought on the record as Annexure C by the Ministry of AYUSH. Theguidelines contained following under the heading “Homeopathicapproach”- G“Homoeopathic Approach It is advised that before taking up for homoeopathic medicines forprophylaxis, Amelioration and mitigation, physician must acquainthimself of above sections.

In case of epidemics or pandemics, first approach is to followHpreventive measures and educate people about general measures and to provide such interventions which will keep their immunityenhanced. Homeopathy therefore recommends issuing of publicnotice for Genus epidemics identified by the designated expertsfor immunity enhancement and practitioners may suggest the sameto the people and as per the Advisory issued by Ministry ofAYUSH (6).

Second approach is to provide homoeopathic symptomaticmitigation to affected persons. Homoeopathic medicines are alsouseful in the treatment of communicable diseases like InfluenzaLike Illness (7) (8), dengue (9), acute encephalitis syndrome (10).Several studies are also published which shows the immunemodulatory potential of homoeopathic medicines in preclinicalstudies (11) (12) (13) (14) (15) (16). These medicines can beprescribed in an integrated manner or standalone depending onthe severity on a case to case Therapeutic Aid As a system with wholistic approach medicine were selected basedon the presenting signs and symptoms of each patients (17)(18)(19) (20). The medicines given here are suggestive based on theiruse and studies in the past in diseases of similar presentation likeCOVID-19 (21) (22) (23). Patients of COVID-19 are to be treatedwith adjuvant Homoeopathic medicines with the permission fromlocal health authorities and Medical Superintendent of the Hospital.Homoeopathic doctors must follow all preventive measures (usingPPEs) as are required for dealing with COVID 19 patients.

The remedies according to different stages of disease aregiven below:

Mild Disease (Symptomatic Amelioration and MitigationApproach):

Medicines like Aconite napellus, Arsenicum album, Bryonia alba,Gelsemium sempervirens, Rhus tox. Eupatorium perfoliatum,Ipecacaucunha, Belladonna, Camphora, may be used dependingupon the symptoms similarities.

Severe disease but not in critical condition:

It is defined by following criteria (Dyspnoea, respiratory frequencye” 30/min, blood oxygen saturation (SpO2) d” 93%, PaO2/FiO2ratio < 300, and/or lung infiltrates > 50% within 24 to 48 hours)/)

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A•Suggested medicines are as adjuvant to Standard Managementguidelines in the hospital setting only with the approval ofauthorities and willingness of the patient/guardian.

•The prescription is to be given only by institutionally qualifiedpractitioner.

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•Medicines like Phosphorus, Chelidonium, Veratrum Viride,Iodum, Camphora, Cinchona officinalis, Lycopodium, Ars. iod.,Antim ars., Stannum met, Carbo veg., can be prescribed onsymptomatic indication.

PosologyC

The medicine selected for each patient is tailored to person specific,taking into consideration, his/her mental make-up, physicalsymptoms, and characteristic particulars etc. In case of long termillness, besides the above mentioned factors, age, occupation,previous illnesses and life circumstance unique to that individualDirrespective of the disease which he/she is suffering from, arealso taken into consideration; thus the dictum “Homoeopathy treatsthe patient but not the disease”.

After the appropriate medicine is selected, it is essential to decidethe requisite potency, dose and repetition which is imperative forEoptimum response and faster recovery in each case. Differenttypes of potencies such as decimal or centesimal potencies canbe employed for treatment as are required for acute diseases.However, selection of potency of the remedy is dependent onvarious factors like susceptibility of the patient (high or low), typeFof disease (acute/chronic), seat/ nature and intensity of the disease,stage and duration of the disease and also the previous treatmentof the disease (24).”

22. The above guidelines make it clear that Homeopathy has beenenvisaged by the Ministry as the therapeutic aid.G23. The above guidelines refer to Homeopathy medicines as G23. The above guidelines refer to Homeopathy medicines asmedicines for prophylaxis, Amelioration and mitigation. The guidelines,however, specifically provides that “the prescription has to be given onlyby institutionally qualified practitioners”. The High Court in its impugnedjudgment has not fully comprehended the guidelines dated 06.03.2020and taking a restricted view of the guidelines and have made observationsH

for taking appropriate actions against the Homeopathic medicalpractitioners, which cannot be approved. The High Court, however, isright in its observation that no medical practitioner can claim that it cancure COVID-19. There is no such claim in other therapy includingallopathy. The High Court is right in observing that no claim for cure canbe made in Homeopathy. The Homeopathy is contemplated to be usedin preventing and mitigating COVID-19 as is reflected by the advisoryand guidelines issued by the Ministry of AYUSH as noticed above.

24. We, thus, observe that directions issued by the High Court inparagraph 14 of the judgment need to be modified to the extent as indicatedabove. It goes without saying that Homeopathic medical practitionershave to follow the advisory dated 06.03.2020 issued by AYUSH Ministryas well as guidelines for Homeopathic medical practitioners for COVID-19 issued by Government of India, Ministry of AYUSH, as noted above.The Civil Appeal is disposed of accordingly. The interlocutory applicationsfiled seeking permission for impleadment is rejected.

Devika Gujral

Appeal disposed of.

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