Due to the highly varied nature of pneumococcal disease, and the overlap of its presentation with similar disease involving other pathogens, this discussion needs to center on the presentation of disease, rather than on the presence of S. pneumonia per se.

Ignore the rubric

• _Generals - Laboratory findings - bacteria_ -
  - _pneumococcus_ (1): sulfa. [James Hawley Stephenson]

It’s of no relevance. Delete it from your repertory.

Our remedies act on the dynamic process of the host; they may have some actions on the pathogens per se, but these have not been studied; but most importantly, their appreciated actions in disease are not on the pathogen; we cannot expect them to act as antibiotics & disable or kill bacteria. The explanation that our remedies “strengthen” or “support” the immune system is overly simplistic; there is much to do with healing from disease that transcends the actions of the immune system per se.

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Giardia is a genus of flagellated protozoan parasites that colonize and reproduce in the small intestines of multiple vertebrates, causing the disease giardiasis.

Human and other mammalian, avian, & reptilian hosts become infected by ingesting or coming into contact with environmentally resistant cysts spread via the fecal-oral route in contaminated foods, soil, or water tainted by the feces of an infected carrier. The infectious dose is very low, requiring only 1–10 cysts. Trophozoites multiply in the small intestine and encyst during passage into the large intestine, and are excreted as cysts in the feces.

Semi-aquatic mammals including beavers, muskrats, mink, raccoons, and waterfowl, including ducks and geese, are significant carriers, and contribute to Giardia contamination of most North American surface waters. Coyotes, raccoons, squirrels, rodents, deer, moose, and bear may also serve as natural reservoirs.

Prevalence of human infection is estimated around 2% in some developed countries, and between 20% and 40% in parts of Asia, Africa or Latin America.

Symptoms begin to appear 3–25 days after infection, with mild to profuse, often explosive, foul-smelling (sulphurish), greasy/frothy bilious, greenish, or pale stools, flatulence, abdominal bloating & cramping, and nausea. Morbidity is related to dehydration and nutritional loss. Infected hosts may remain asymptomatic or minimally symptomatic carriers serving in community transmission chains. Giardia relies on bile salts in the duodenum for survival and growth, and may invade the biliary tract & gall bladder leading to persistent infection, in rare cases resulting in biliary obstruction and acute acalculous cholecystitis.

Giardia infestation causes the microvilli of the small intestine to atrophy, resulting in malabsorption, often resulting in persistent lactose intolerance.

Clinical suspicion may be confirmed by microscopic examination of a stool smear for ova & parasites (O & P), often requiring multiple samples collected over several days due to intermittent shedding. Direct fluorescent antibody (DFA) testing or enzyme-linked immunosorbent assay (ELISA) on stool samples are often more sensitive than routine microscopy. In many cases giardiasis is treated empirically based on strong clinical suspicion without waiting for laboratory confirmation.

Treatment involves the antibiotics tinidazole, metronidazole, albendazole, nitazoxanide, quinacrine, nitazoxanide, furazolidone, mebendazole, paromomycin, bacitracin zinc, or auranofin. Refractory giardiasis is seen, in some cases attributable to antibiotic resistance.

For personal use, filtration of water with ceramic, carbon block, or hollow fiber membrane filters with a pore size of 1 micron or smaller (NSF/ANSI Standards 53 or 58), ultraviolet or chlorine dioxide sterilization of water, or boiling are effective in eliminating viable cysts in drinking water. For larger-scale operations, slow sand filtration, a diatomaceous earth filter, reverse osmosis, or ultraviolet water treatment systems can be effective. Chlorine and iodine have low-to-moderate effectiveness against Giardia cysts, requiring much higher concentrations and longer contact times than those used for typical bacterial contaminants.

The value of an analysis such as this is to characterize the common symptoms of the disease, to “complete” the Totality of an individual case. We’re often told that the common symptoms of the disease-as-named are not of interest, but this is inaccurate. They are insufficient for a prescription, but necessary to complete the full picture of any particular case of disease. Conversely, it might be suggested less accurately that this forms the core of a case, to be “completed” by the individualizing symptoms of a particular case; what Kent described inelegantly as the “symptoms of the person.”

Aloe, Sulphur, Calcarea ostrearum (carbonica), Arsenicum album, Phosphorus, Natrum sulphuricum, Podophyllum, and Croton tiglium are prominent. I’ve seen Aloe to be particularly important in practice, followed by Podophyllum, Sulphur, Phosphorus, and Croton tiglium.

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I’m aware that, to many of my readers, these will be unwelcome words; but I feel strongly that, particularly for these, they are words that need to be said.

I’ve been startled to witness the embrace of MAHA and RFK Jr.’s policies by the homeopathy community.

MAHA policy is intimately associated with the general policies of the 47th administration, and with The Heritage Foundation’s Project 2025.

Advocates of food purity might laud the removal of red food dye from Gatorade, which is really a pitifully token gesture (I’ve likened it to painting the 1973 Ford Pinto with fire-retardant paint). We might find cheer in Anne Frank being able to drink a highly processed food-like item, totally devoid of nutritional content, without a daily dose of FD&C Red No. 40. Something for folks to read about in her diary in 2108, should humanity still be around.

Advocates for sustainable local farming might embrace the promotion of raw milk, in truth a novelty item available to those who keep their own small milking herds (who very likely pasteurize their own milk, knowing full well the distance from a cow’s rectum to the udder), and to those privileged to obtain dairy products from these small scale operations, but which does not begin to scale to the demands for dairy products on a national level, or even in the commercial marketplace from mid-scale operations such as Mark McAfee’s Raw Farms, found frequently in violation of food safety standards.

Industrial highly processed foods such as Froot Loops™️ and Trix™️ were never at the top of the USDA-endorsed food pyramid, tho if they were, the tip (representing items to be eaten sparingly, if at all, and certainly not by silly rabbits) is where they belonged. Again, RFK Jr.’s suggestion that Froot Loops be made without synthetic dyes is equivalent to suggesting fire extinguishers be located along the Cuyahoga River. Look at the list of food companies committing to remove artificial dyes from their products, and tell me which of these make products that belong in the human diet in the first place, dyes be damned. At least we won’t need to worry about whether the brown & green M&M’s are gay or trans (sarcasm, for those who are slow).

Similarly, the endorsement of Steak & Shake French fries fried in beef tallow. I do enjoy a good French fry, but it’s important to recognize that these are fundamentally recreational food-like items. The particular oil they’re fried in is not the principal nutritional concern (I’m reminded of a stop at Al’s Fries in Colchester, Vermont, when a vegan friend asked Al what they used for frying oil; he looked at the fryer, responded “looks like 10W-40 to me”). This is not an indictment of potatoes; they have nutritional value, and even kept Mark Watney alive for 18 months; but a critique of anything fried in an excess of oil of any sort.

Removing mercurials from the few vaccines in which they remained in trace amounts sounds like good policy, but HHS has been silent regarding deregulation of industrial mercury emmisions, a far more concerning source of mercury exposure.

Shifting the attention of our public health agencies from acute infectious disease to the complex issues of chronic disease is appealing to many, but it comes at a significant cost. The dismantling of the Foodborne Diseases Active Surveillance Network (FoodNet) when foodborne illness accounts for 9.9 million cases of disease, 53,300 hospitalizations and 931 deaths in the U.S. annually cannot be considered a progressive move, nor can the shuttering of the CDC’s venereal disease surveillance program and STD Reference and Research Branch in the face of increasing incidence and growing antibiotic resistance. Ironically, the most accessible modifiable risk factor for type 1 diabetes mellitus is rotavirus infection, a vaccine-preventable acute illness, and influenza remains a significant risk factor for chronic cardiovascular disease, likely to be joined by COVID-19.

RFK Jr. expresses profound ignorance in his insistence that healthy people don’t die of infectious disease and that “It’s very, very difficult for measles to kill a healthy person”, assertions he makes to justify dismantling our public health agencies’ responses to infectious and communicable disease. His insistence that diet can cure diabetes mellitus, schizophrenia, and bipolar disorder, and that the deaths from measles in the 2025 West Texas outbreak were the result of poor nutrition, are embarrassing distortions of the role that diet might play in addressing disease.

Although RFK Jr. has suggested that the policies he’s implemented regarding vaccination are intended to improve public confidence in vaccination, they have contributed significantly to undermining public confidence, with talking points mirroring those of his vaccine-skeptical colleagues, suggesting he’s either incompetent or disingenuous.

His assertion that primary care physicians peddle vaccines principally for profit has no basis in reality, but plays directly into a broader narrative undermining public trust in physicians.

MAHA’s embrace of an isolationist “America First” policy, along with decreased vigilance regarding acute infectious disease, standing by as USAID was disabled and cutting ties with the World Health Organization while crippling the CDC’s involvement in emerging disease surveillance, research & response, comes at a great cost of sacrificing our preparedness to address emerging diseases affecting the global community, including the recent outbreaks of hantavirus, Ebola, the zoonotic emergence of H5N1 influenza, and the still-ongoing emergence of SARS-CoV-2, as well as the re-emergence of measles, pertussis, potentially other pre-21st century communicable diseases, and the next pandemic, which is a question of what and when rather than if. Hiding our heads in the sand by responding with travel bans does nothing to protect the U.S. homeland.

Requiring nutritional courses in medical school, on its face, seems like a decent policy, but look at the proposed competency framework and imagine how this will fail to impact on clinical application. The curriculum was not developed in consultation with existing programs addressing nutritional training for physicians or the medical school curriculum in general, and relies heavily on representatives of the trillion-dollar meat and dairy industries. Medical students already spend far too much time with their asses in lecture hall seats. Modelling in the clinic of awareness of the importance of nutrition, with referral to allied professional dietitians for detailed information, and clinical training (not lectures) in change facilitation, would be far more appropriate approaches.

HHS is basically tossing meatless (tofu-less for the vegans out there) bones out here & there to the “wellness” community, and sadly, folks are biting.

If this administration were really interested in improving the nutritional health of the U.S. population, some truly effective measures would be to restore SNAP benefits and USDA local food purchasing initiatives, support school lunch programs, cease harassing, kidnapping and extraditing our migrant farmworkers, remove the tariffs driving our farmers out of business, reverse measures that are accelerating the inflation of food costs, restore the American Rescue Plan providing debt relief to Black farmers, restore the professional status of dietitians and ensure educational loans and insurance coverage for their services, and address the various other factors contributing to food deserts and food insecurity in this wealthiest of all nations. None of these are easy to address; it’s far easier to adopt the politician’s syllogism:

• We must do something.

• This is something.

• Therefore, we must do this.

And adopt what appear to be politically expedient measures regardless of their appropriateness or chances for success.

The suggestion that every administration over the last 15 years has ignored America’s health crisis, and that this administration is finally the one doing something about it, represents a remarkable feat of revisionist history that requires either abandoning reality entirely or simply not paying attention to health policy over the past 100 years.

MAHA is not about establishing a new order, but about dismantling the efforts put in place over the past century, as is the case with most of the efforts of this administration.

We can easily find much that’s wrong with our current healthcare system. I’ve watched, over my career, the insertion of 3rd-party bureaucrats into reimbursement & approval of coverage, with approval often involving individuals with a BA in healthcare administration, and recently by “artificial intelligence” second-guessing physician recommendations. More than 260 U.S. billionaires have made their fortunes in healthcare, massively inflating costs to the public; these are notably not practicing physicians. My sister was hospitalized for meningitis in 1954; I came across the bill in my mom’s belongings; $101 in total billing for hospital, medication, procedural, & physician fees (that is $1,242 in 2026 dollars, but that won’t even purchase an ER visit today, let alone 10 days of hospital care, which today goes for ~$3,000/day for basic services alone); even a lumbar puncture [spinal tap] necessary to diagnose meningitis goes for ~$4,000 these days; that is not pocketed by the attending physician, but ends up inflating the pockets of “healthcare” administrators and the medicolegal profession.

“Alternative” practitioners, including professional homeopaths, may be lauding distrust sown in the medical community, believing they’ll profit from an influx of patients from growing distrust of conventional medicine, and that this administration will legitimize their profession. We’d do well to be honest regarding the profit motive involved in embracing MAHA, rather than regarding this as a boon to all mankind, as well as to be aware that RFK Jr. is serving at the pleasure of an authoritarian, self-dealing administration, and relying on the fascist playbook of tossing crumbs - marginal concessions - to control the narrative and to buy the allegiance of the masses. By granting minor privileges or resources to select individuals or groups, authoritarian leaders foster competition and distrust among the oppressed. Groups fight over the crumbs rather than uniting to challenge the system. This is not a case of “the enemy of my opponent is my friend,” but of “the enemy of what I’m told to consider my opponent actually has no regard for any of us.”

We’d do well to attend to Martin Neimöller’s poem:

First they came for the Communists

And I did not speak out

Because I was not a Communist

Then they came for the Socialists

And I did not speak out

Because I was not a Socialist

Then they came for the trade unionists

And I did not speak out

Because I was not a trade unionist

Then they came for the Jews

And I did not speak out

Because I was not a Jew

Then they came for me

And there was no one left

To speak out for me

The MAHA Report

Homeopathy Conference Reflects Erosion of Trust in Conventional Medicine

By Gabrielle Traub, Special to The MAHA Report…

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2 months ago · 360 likes · 40 comments

Dr. Jessica Knurick

The Political Purpose of MAHA

This week, it was reported that HHS will lay off another round of employees as the Trump administration continues its dramatic downsizing of the federal health workforce…

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a month ago · 206 likes · 27 comments · Jessica Knurick, PhD, RDN

Dr. Jessica Knurick

Nobody Cared About Americans’ Health Until MAHA?

A lot of reporting has come out recently suggesting the Republican Party might be losing parts of the MAHA movement after a series of decisions that directly contradict what many of those supporters say they care about…

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2 months ago · 311 likes · 36 comments · Jessica Knurick, PhD, RDN

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The genus Marburgvirus of the family Filoviridae comprises two known enveloped, non-segmented, single-stranded negative-sense RNA viruses, Marburg virus (MARV) and Ravn virus (RAVV), closely related to the Ebolaviruses.

Genomic analysis suggests the Marburg and Ebola viruses diverged from a common ancestor in the Miocene, 16 to 23 million years ago, and that Marburg virus (MARV) and the closely related Ravn virus (RAVV) shared a common ancestor approximately 300 to 500 years ago, representing 2 distinct Marburgvirus lineages.

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February 2016

23 yr/o man cc: testicular swelling, pain

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Seed oils are the “new gluten,” demonized as “toxic” by those currently in charge of Health & Human Services and by a crop of “wellness influencers.” Despite RFK Jr.’s characterization of seed oils as “poison” and major drivers of obesity and chronic inflammation, linoleic acid (the primary 𝜔-6 fatty acid in seed oils) does not increase inflammation markers in the blood, and is recognized as an essential nutrient, one of the essential fatty acids required in our diet.

Seed oils are fats extracted from the seeds of plants, commonly including canola, sunflower, safflower, soybeans, corn, cottonseed, grapeseed, peanut, and rice bran. Industrial processing may involve mechanical pressing or solvent (hexane) extraction, with refining involving degumming with water, steam, or acids to remove phospholipids, hydrolysis with sodium hydroxide to convert free fatty acids into soapstock for extraction, bleaching with activated clays or charcoal to absorb pigments (chlorophyll, carotenoids) and trace metals, high-vacuum steam distillation to remove volatile compounds affecting odor and flavor, and dewaxing.

The issue with commercial seed oils is not their source or primary composition, but (1) their degradation in large-scale commercial industrial processing, altering their composition, exposing them to oxidative degradation, and stripping them of essential nutrients, including vitamins A, D, E, & K, CoQ10, and carotenoid & polyphenol antioxidants, and (2) their excess consumption in the diet, displacing whole foods.

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Streptococcus pneumoniae is implicated as a major pathogen in a range of invasive bacterial disease, along with a variety of other constituents of the normal upper respiratory flora:

Purulent rhinitis, acute rhinosinusitis (not technically “invasive”).

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In the early 1970s, Akira Endo reasoned that certain microorganisms may produce inhibitors of the enzyme HMG-CoA reductase to defend themselves against other organisms, as mevalonate is a precursor of isoprenoids required by organisms for the maintenance of their cell walls or cytoskeleton.

The first statin brought to market was lovastatin, (mevinolin, monacolin K), derived from the fungus Aspergillus terreus or Monascus purpureus, first marketed in 1987 as Mevacor®. (Altocor ®). Mevastatin had earlier, in 1970, been isolated from the mold Penicillium citrinum by Akira Endo, but was never developed for market.

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48 yr/o woman North American, on first visit to northern India

Diarrhea - profuse, watery; abdominal cramps

Think I picked it up 2 days ago; leaving Delhi (en route north to Dharamshala),

I bought coconut water & fruit from a street vendor

knew I probably shouldn’t trust it, but I was parched from the long flight & it looked so good.

I was in for a long ride & didn’t know when l’d be able to find something to drink.

Fresh coconut water, he broke the coconut open right there so I figured it would be safe.

With Pineapple & mango. It was delicious, but I’m paying for it now.

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Streptococcus pneumoniae - the pneumococcus - is a target of vaccine management that deserves careful discussion.

Streptococcus pneumoniae resides as a normal constituent of the upper respiratory mucosal flora. This, in contrast to its role as a pathogen, appears to conflict with Koch’s first postulate as commonly rendered:

The microorganism must be found in abundance in all organisms suffering from the disease, but should not be found in healthy organisms.

It’s important to note that “Koch’s postulates” were not intended to describe laws of nature, but to serve as working guidelines for determining the necessary (not necessarily the sufficient) role of a microbe in causing a particular disease. It appears that Streptococcus pneumoniae’s pathogenicity is highly dependent on being in the wrong place at the wrong time.

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I recently posted a case of asthma treated, in its acute phase, with Blatta orientalis; reminiscent of this anecdote, from Edward Pollock Anschutz’s, New, Old, and Forgotten Remedies.

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In my recent essay on “Classical Homeopathy,” I mentioned some contemporary Neo-Kentian practices deviating far from Hahnemann’s concept of the similar, even adopting concepts of similitude that Hahnemann specifically rejected. I received a response asking to clarify that, so here goes -

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Home on spring break from college in Minnesota (spring 2006)

It’s been going around on campus

Felt like the ‘flu for several days; fever & felt crummy all over

2 days ago my neck swole up

(Obj - firm non-fluctuant, tender swelling below/in front of R ear, overlapping angle of jaw; holding head at angle tilted toward affected side)

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I’ve previously detailed the biosynthesis of cholesterol, which begins with acetyl-CoA as its fundamental building block.

The rate-limiting (bottleneck) step involves the NADPH-dependent conversion of ß-Hydroxy-ß-methylglutaryl-CoA (HMG-CoA) to mevalonate by the enzyme HMG CoA reductase, early in the process; this is the site of action of the statins (“HMG-CoA reductase inhibitors”), currently the primary drugs employed in the pharmacologic management of dyslipidemias. (Importantly, guidelines advanced by the medical community only call for pharmacological lipid-lowering treatment if dyslipidemia persists despite non-pharmacologic “lifestyle” interventions, and in the context of overall cardiovascular risk). As with all functions in a complex system, nothing does only any one thing, and nothing is accomplished in only one manner; iatromechanical explanations lack full explanatory power. Statins exhibit “pleiotropic” (Greek, “many-affecting”) properties impacting on atherogenesis in manners that cannot be fully explained by their impact on cholesterol biosynthesis, despite their specific designation as “HMG-CoA reductase inhibitors.”

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The horrifying image of Ebola as a hemorrhagic fever, the patient bleeding internally and externally from the eyes, nose, gums, mouth, and rectum, certainly grasps the imagination and characterizes this as a dread disease in public perception, but it is not central to the pathophysiology of Ebola virus infection. This was a prominent feature of the initial cases in the 1976 outbreaks of the Zaire Ebolavirus; 48% of cases, and 78% of fatal cases had hemorrhagic manifestations, principally melena (black tarry stools from upper GI bleeding). Hemorrhage has been recorded in only 20% of cases since the first outbreak, with no association observed between bleeding and death, arguing against the commonly held belief that fatal outcomes are principally the result of hemorrhage. In the Western African outbreak of Zaire ebolavirus in 2013-2016, hemorrhagic manifestations were rarely reported, involving only 15% of patients in outbreaks in Liberia and Sierra Leone.

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Hantaviruses primarily infect vascular endothelial cells, dendritic cells, and alveolar and peripheral macrophages. Entry is via the respiratory mucosa, replicating in alveolar epithelial cells, alveolar macrophages and dendritic cells, and endothelial cells of the alveolar capillaries, with transport to other tissues, principally vascular endothelial cells, via migratory macrophages & dendritic cells.

Notably, hantaviruses do not replicate in or shed from the respiratory epithelium or the upper respiratory tract, so are not readily communicable in respiratory secretions. Andes virus is a minor exception, replicating in the lung alveolar epithelium and in the secretory cells of the submandibular salivary glands and shed in respiratory secretions, and is weakly communicable person-person from individuals with significant symptoms of lower respiratory disease and high viral load. Hantaviruses are highly adapted to their rodent hosts and only poorly adapted to humans, so are not likely candidates for epidemic or pandemic disease. The recent outbreak on the MV Hondius represents a zoonotic spillover event with limited spread in an unusual human environment.

Hantaviruses are enveloped segmented single-stranded negative-sense RNA viruses, presenting a spike protein on their surface comprised of 2 glycoproteins, Gn and Gc, embedded in a lipid bilayer envelope derived directly from host cell’s internal cell membranes. Most neutralizing antibodies target exposed epitopes on the Gn glycoprotein head domain. An early and robust neutralizing antibody response is the primary predictor of survival in Hantavirus Cardiopulmonary Syndrome (HCPS).

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Brucellosis results from infection by bacteria of the genus Brucella. Four species potentially infect humans: B. abortus, B. canis, B. melitensis,and B. suis, all previously listed under B. melitensis. Brucella melitensis is the most virulent and invasive species, causing undulant fever in humans; it usually infects goats and occasionally sheep. B. abortus is primarily a disease of cattle, but may cause a milder ‘flu-like illness in humans through consumption of raw milk, cheese, or other dairy products from infected animals. B. canis principally infects dogs, B. suis swine and pigs.

Brucellosis in humans is usually associated with consumption of unpasteurized milk and soft cheeses made from the raw milk of infected animals - most often goats - infected with B. melitensis or one of the other 3 Brucella species.

Brucellosis is relatively rare in the U.S., at 80–140 reported human cases/year, and is more significant in Western Asia, Algeria, and Malta.

Brucellosis in cattle is largely eradicated in North America, with cases now largely restricted to occasional, controlled outbreaks in the Greater Yellowstone Area (WY, MT, ID), where it spreads from wild bison & elk into domestic cattle, with mandatory testing for cattle and routine vaccination of heifers in that region. There have been no reported cases in sheep or goats in North America over the past 15 years. A case of rifampin-resistant brucellosis was reported in 2019 linked to contaminated raw cows’ milk from an Amish farm in Pennsylvania that potentially exposed people in 19 states.

In 1945, the magazine Coronet published a fictitious article, picked up by The Reader’s Digest a year later, titled “Raw Milk Can Kill You,” suggesting that raw milk was responsible for an outbreak of brucellosis in a fictitious Midwestern town identified as “Crossroads, U.S.A.,” killing one-third of its inhabitants. The author, Lt. Harold J. Harris, MD, later admitted his fabrication to Johns Hopkins bacteriologist J. Howard Brown. Raw milk advocates have used this story to discredit the very real, tho far less dramatic, role that raw milk may play in food-borne illness.

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Ptomaine poisoning is a deprecated term for food poisoning presumed to be caused by toxins from decomposing food. In its rare retained use, it typically refers to food poisoning from preformed Staphylococcal enterotoxin.

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