Study on Formic Acid

Overview of the Study on Formic Acid

• This study aimed to clinically verify Formic acid's symptomatology.
• Included were symptoms improved during verification and any new findings.

Methods

• A multicentric observational clinical verification study occurred at nine research centers of the Central Council for Research in Homoeopathy.
• The study verified the proving symptoms of the rarely used medicine, Formic acid.
• 270 participants with symptomatological similarity to Formic acid were included.
• Participants were prescribed 6C, 30C, 200C, and 1M potencies, as needed.
• Data was compiled in a designed Excel spreadsheet for analysis, and presented using descriptive statistics.
• Prevalence of symptoms in responding and non-responding populations was compared using Chi-square or Fisher’s exact test.

Results and Findings

• 215 of 266 followed-up cases responded that is ~81%
• Confidence interval of 0.75–0.85.
• 11 proving symptoms were verified
• 22 new observations were made.
• New general symptoms emerged: clean tongue, disturbed sleep, loose stool, tastelessness, and profuse sweat should be considered when prescribing Formic acid.

Conclusions

• Formic acid's proving symptoms were verified clinically, but interpretation of patient-specific symptoms needs to be cautious.
• Further replication is needed on a larger sample including an estimation of likelihood ratio in real-time clinical practice.

Introduction to Homoeopathy & Formic Acid

• Evidence-based Homoeopathy poses a challenge for the future.
• It is concerned with the clinical verification of symptoms used in homoeopathic practice.
• The drug picture of Formic acid was enhanced by verifying proving symptoms and incorporating new findings.
• Mr. R. Wallace of Richmond first used Formic acid, also known as methanoic acid, as a medicine.
• Dr. John Henry Clarke recommended Formic acid for varicose veins, polypi, and catarrh.

Formic Acid Extended Utility

• Since then, no comprehensive study has been done to extend the therapeutic utility.
• A systematic proving of Formic acid using a randomized, double-blind, placebo-controlled technique was conducted, followed by clinical verification.
• Proving was taken up by the Council in 1980–1981, verification enhanced the therapeutic utility after

Formic Acid Description

• Chemical symbol: HCOOH
• Molecular weight: 46.03
• Synonyms: Formic acid (English), Acide formique (French), Ameisensaure (German)
• Simplest carboxylic acid
• Colorless liquid with a pungent acid odor and burning taste
• Crystallizes at 0°C, boils at 100°C
• Soluble in all proportions in water, alcohol, or glycerin with a specific gravity of 1.23.
• Causes a burning sensation and blisters on the skin.
• Preservative and antibacterial agent in livestock feed.
• Causes histotoxic hypoxia by inhibiting mitochondrial cytochrome oxidase.
• First obtained from distilling ants by Samuel Fisher (Lavoisier).
• Found in certain caterpillars, stinging hairs of nettle (Urtica urens, Urtica dioica), pine tree leaves, blood, bile, urine, perspiration, and muscular tissues of man.
• As tincture of ants (Formica rufa), it has a place in homoeopathic practice.
• Increases muscular strength and resistance to fatigue in small doses
• Treats cases of acute rheumatic fever and acute gonococcal arthritis

Study Objectives and Centers

• The primary objective of the study was to clinically verify the symptomatology of the drug
• Includes symptoms observed during proving or in other literature.
• The secondary objective was to ascertain clinical symptoms that did not appear during proving but were improved in the patients after administration
• Started in June 2010 and continued until March 2014 at 9 research centers of CCRH across India.
• Multicentric observational clinical verification study was conducted at:
  • Central Research Institute, Noida (Uttar Pradesh)
  • Homoeopathic Drug Research Institute, Lucknow (Uttar Pradesh)
  • Regional Research Institute (H), Puri (Odisha)
  • Regional Research Institute (H), Shimla (Himachal Pradesh)
  • Regional Research Institute (H), Gudivada (Andhra Pradesh)
  • Regional Research Institute (H), Imphal (Manipur)
  • Dr. Anjali Chatterjee Regional Research Institute (H), Kolkata (West Bengal)
  • Clinical Research Unit (H), Port Blair (Andaman and Nicobar Islands)
  • Clinical Verification Unit, Patna (Bihar)

Participants and Data Collection

• Participants having symptomatological similarity to Formic acid, from all age groups were included.
• Exclusion criteria: clinical presentations not corresponding with the medicine and patients on regular medication for systemic disease.
• Patients on medication for acute purposes had a 7-day washout period.
• Symptoms were repertorized using a council-prepared repertory and confirmed from Materia Medica.
• Formic acid was prescribed according to symptom similarity and was procured from licensed pharmacy in potencies 6C, 30C, 200C, and 1M.

Follow-Up and Statistical Analysis

• Symptoms were recorded during follow-up visits where medicine was stopped if improvement was noted, then followed by placebo.
• If there was no change in symptoms after up to 7 days, the next higher potency was prescribed.
• Data was analyzed using descriptive statistics.
• Prevalence of symptoms was compared using Chi-square or Fisher’s exact test, with a significance level of P < 0.05.
• The study verified 11 symptoms from the medicine's proving conducted by the Council and also identified some new, clinically associated symptoms.
• Many symptoms showed 75% or higher improvement

Spheres of Action and Improved Conditions

• Main spheres of action of Formic acid were head, stomach, abdomen, male/female genitalia, and extremities.
• The conditions improved were dyspepsia, headache, arthritis, spermatorrhea, varicose veins, and lipoma as well as dysmenorrhea, menorrhagia, amebiasis, and lymphadenitis.
• The new general symptoms may offer help while prescribing Formic acid

Symptom Significance

• Statistical significance of symptoms increases the probability of drug effectiveness.
• Research protocol should address spontaneous recovery issues.
• The causal association can be tested prospectively and systematically using modified Naranjo criteria in future studies.

Acknowledgements & Funding

• The authors acknowledge Dr. Vikram Singh, Dr. Krishna Singh, program officers, Mrs. Maya Padmanabhan, and the patients.
• The study was funded by the Central Council for Research in Homoeopathy.