STEPS TO MANAGE SLEEP DISORDERS
– GENERAL AND HOMOEOPATHIC MEASURES
Sleep is an opportunity for the brain and body to rest and be restored. In addition, many functions important to good health take place during sleep at night. The amount of sleep that people need can vary widely. Infants may need up to twenty hours; many children need from ten to fourteen per night. The average requirement for adults is estimated at six to eight hours, but many people need much more than that feeling chronically stressed and compromised, both physically and mentally, because of insufficient sleep.
A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental and emotional functioning. Polysomnography is a test commonly ordered for some sleep disorders.
Disruptions in sleep can be caused by a variety of issues, from teeth grinding (bruxism) to night terrors. When a person suffers from difficulty in sleeping with no obvious cause, it is referred to as insomnia. In addition, sleep disorders may also cause sufferers to sleep excessively, a condition known as hypersomnia. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.
'SLEEP HYGIENE' SOLUTIONS FOR BETTER SLEEP
From having occasional difficulty sleeping to insomnia, there is a lot can do to get a better night's sleep, feel refreshed when awake, and remain alert throughout the day. It's called "sleep hygiene".
There are four general areas important to sleep hygiene:
Our circadian rhythm, or 24-hour cycle
Aging
Psychological stressors -- those factors can cause difficulty falling asleep and disturb the quality of our sleep
Common social or recreational drugs like nicotine, caffeine, and alcohol
Circadian Rhythm
We all have a day-night cycle of about 24 hours called the circadian rhythm. It greatly influences when we sleep and the quantity and the quality of our sleep. The more stable and consistent our circadian rhythm is, the better our sleep. This cycle may be altered by the timing of various factors, including naps, bedtime, exercise, and especially exposure to light (from traveling across time zones to staring at that laptop in bed at night).
Aging
Aging also plays a role in sleep and sleep hygiene. After the age of 40 our sleep patterns change, and we have many more nocturnal awakenings than in our younger years. These awakenings not only directly affect the quality of our sleep, but they also interact with any other condition that may cause arousals or awakenings, like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. The more awakenings we have at night, the more likely we will awaken feeling unrefreshed and unrestored.
Psychological Stressors
Psychological stressors like deadlines, exams, marital conflict, and job crises may prevent us from falling asleep or wake us from sleep throughout the night. It takes time to "turn off" all the noise from the day. One must develop some kind of pre-sleep ritual to break the connection between all the stress and bedtime.
Social or Recreational Drugs
Social or recreational drugs like caffeine, nicotine, and alcohol may have a larger impact on our sleep than we realize. Caffeine, which can stay in our system as long as 14 hours, increases the number of times we awaken at night and decreases the total amount of sleep time. This may subsequently affect daytime anxiety and performance. The effects of nicotine are similar to those of caffeine, with a difference being that at low doses, nicotine tends to act as a sedative, while at high doses it causes arousals during sleep.
Alcohol may initially sedate us, making it easier to fall asleep; however, as it is metabolized and cleared from our system during sleep, it causes arousals that can last as long as two to three hours after it has been eliminated. These arousals disturb sleep, often causing intense dreaming, sweating, and headache. Smoking while drinking caffeine and alcohol can interact to affect our sleep dramatically. These sleep disturbances may be most apparent upon awakening, feeling unrefreshed, groggy, or hungover.
HOMOEOPATHIC MANAGEMENT FOR SLEEP DISORDERS
Professional homoeopaths do not generally prescribe remedies to treat symptoms individually, as the symptoms are considered to be only the outward sign that your vital force is struggling to overcome disease. Instead a remedy is prescribed for the whole person. Accurate prescribing is essential to the success of homoeopathy. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.
Reportorial rubric
[Kent] Sleep, Sleeplessness
Acon., Argen. Nit, Arsenicum album, Belladona, Bryonia, Cactus, Calcerea, Chamomilla, China, Cicuta v, Coffea, Cyclamen,Hepar sulp, Hyosyamus,Kali ars, Kali Carb, Lachesis, Mercurius, Merc. Cor, Nux.vom, Opium, Phosphorus, Plumbum, Pulsatilla, Rhus.tox, Sepia, Stannum met, Silicea, Staphy, Sulphur, Thuja
[Complete] Sleep, Sleeplessness, night
Arsenicum album, Causticum, China, Cina, Coffea, Conium, Ferrem met, Graphites, Hyosyamus, Mag.carb, Moschus, Nat.mur, Nit.ac, Nux.vom, Olendar, Opium, Phosphorus, Plumbum, Rhus.tox, Silicea, Spigelia, Squilla, Thuja
[Boericke] Nervous system, Sleep, Insomnia (Sleeplessness)
Absin, Acon., Anacardium, Arsen album, Avena, Belladona, Calcerea, Camph, Camph – monobrom, Cann ind, Chammomilla, Cimcifuga, Cinchona, Coca, Cocaine, Cocculus, Coffea, Cypripedium pubescens, Gelsimium, Hyoscyamus, Hyoscyaminum hydrobromatum, Ignasia, Kali brom, Lupulus hum, Nux.vom, Opium, Passiflora, Pulsatilla, Scutellaria lateriflora, Sulphur, Sumbulus ferula
[Boenninghausen’s] Sleep, Sleeplessness
Aconite, Arsenicum album, Bryonia, Calcerea, Chamomilla, Coffea, Hepar sulp, Kali Carb, Mercurius, Nux.vom, Pulsatilla, Sepia, Silicea
Remedy Individualizing Symptoms
Aconite Sleeplessness related to anxiety, shock, fright or grief. The sufferer is frequently troubled by nightmares and insomnia accompanied by physical and mental restlessness. Symptoms are worse from pressure of bedding, during menses and in a warm room. Better in open air.
Arnica Sleeplessness associated with jet lag and overwork, the sufferer’s bed feels too hard and uncomfortable, and they may be overtired. Also useful for insomnia related to recent injury. Worse from least touch or wine. Better for lying with the head low or lying outstretched.
Arsenicum Album feel sleepy during the day but anxious at night. Restless in bed with anxious dreams and nightmares. Also for warmth, warm drinks, moving about, and sleeping propped up in bed.
Chamomilla Sleeplessness related to restlessness, irritability, anger or the overuse of coffee. This is a well-used remedy for children suffering from insomnia who refuse to be calmed. Also handy for insomnia and restlessness during the first part of the night and insomnia related to nightmares. Worse for being covered but better for sweating.
Cocculus Difficulty sleeping due to being overtired or exhausted. People needing this remedy are often emotionally sensitive, suffer from motion sickness and/ or depression. Symptoms are worse for touch, noise or cold, worse during menses and better for lying on the side.
Coffea c. This is an excellent remedy for insomnia, particularly where the person is troubled by unwanted thoughts and the nervous system is over-excited, causing an over activity of the mind and body. Worse for cold and noise and better for warmth. Also useful for insomnia during pregnancy.
Gelsemium Sleeplessness associated with anxiety related to impending events such as stage fright in people who tend to be dull and drowsy, who cannot get fully to sleep, or have a restless or overly heavy sleep. Worse in damp, humid weather or in spring and better for reclining with the head held high.
Ignatia Sleepless from grief or sadness. Those who’ll benefit from this remedy are very light sleepers who often whimper while sleeping and have re-occurring bad dreams. Worse for cold open air and touch and better from pressure and warmth.
Kali phos Sleeplessness related to anxiety, mental strain, muscular fatigue, night terrors, restlessness or sleepwalking. Worse for touch, cold or fatigue and better for leaning against something.
Nux vom Sleeplessness associated with irritability, anger and gastrointestinal complaints in people who are impatient, fastidious and competitive. The person who’ll benefit from this remedy often wakes at around 3am, is worse for cold, dry weather, worse from eating and better for strong pressure and damp, wet weather.
Opium If the person is feeling sleepy but unable to get to sleep, if the bed is too hot, or else sleep comes but it is so heavy that the person snores and cannot be roused.
Pulsatilla The Pulsatilla type is restless in the first part of sleep and can’t decide if they’re too hot or too cold and they may wake up too early. Insomnia may be related to sadness, fear or irritability. Symptoms are worse from eating bread, fatty or rich food before sleep, and symptoms are worse before or during menses. Better in the open air or cool weather.
MOTHER TINCTURES
Absinthium
Sleeplessness due to nervous excitement
Avena sativa
Insomnia with despondency
Passiflora Incarnata
60 drops in a ounce of hot water at 8pm induces sleep
Thea
For nervous sleeplessness with history of tea abuse
Piscidia
Here cause of sleeplessness is mental worries
Hypericum
The key actions are antidepressant, antispasmodic, analgestic, astringent, antiviral, sedative and it stimulates bile flow
References
1. Harrison's Principles of Internal Medicine
2. Wikipedia.com/sleep disorders
3. Repertory of the Homeopathic Materia Medica, Dr.J.T.Kent
4. Complete Repertory by Roger van Zandvoort
5. Repertory to Homeopathic Materia Medica” by Oscar E. Boericke
6. www.webmd.com/sleep-disorders
7. http://www.holisticonline.com/remedies/sleep/sleep_ins_homeopathy.htm
8. Quick Bedside Prescriber – J.N.SHINGHAL.
9. http://hpathy.com/homeopathy-papers/sleep-easy/
10. http://www.homeohome.com/about-swasthya-clinic/articles-patients/46-articles-for-laymen-general/183-insomnia-and-homoeopathy.html
11. Boenninghausen's therapeutic pocket book by Clemens von Boenninghausen
12. Principles of Prescribing, Dr. K.N.Mathur.
13. LILIENTHAL S., Homoeopathic Therapeutics
14. DEWEY W. A., Practical Homeopathic Therapeutics
Dr. S. SABARIRAJAN., M.D. (Hom) (Gen.med)
Dr. S. R. AMEERKHAN BABU., M.D. (Hom) (Gen.med)
Reader, Dept. of Practice of Medicine
Vinayaka Mission’s Homoeopathic Medical College & Hospital,
Salem, Tamilnadu.
Tuesday, 24 January 2012
Tuesday, 27 December 2011
EOSINOPHILIA AND HOMOEOPATHY
EOSINOPHILIA AND HOMOEOPATHY
Dr. S. Sabarirajan., M.D. (Hom).
The term Eosinophilia refers to conditions in which abnormally high amounts of Eosinophils are found in either the blood (more than 600 cells per microliter (μ L))or in body tissues. Several causes are known, with the most common being some form of allergic reaction Eosinophil is a type of white blood cell. Eosinophils are produced in the bone marrow and are normally found in the bloodstream and the gut lining. They contain proteins that help the body to fight infection from parasitic organisms, such as worms. But in certain diseases these proteins can damage the body. Diagnosis is by complete blood count (CBC).
Aetiology
- The exact causative mechanisms of Eosinophilia remain largely unclear
- Very common Causes of Eosinophilia are Asthma, Hay fever, Drug allergies, Allergic skin diseases like Eczema, Sarcoptes scabiei, Scabies
- Common Causes of Eosinophilia are Connective tissue disease, Food allergy, Psoriasis, Systemic lupus erythematosus, Allergic rhinitis
Clinical Features
Sympioms includes
- Skin allergy,
- Cough
- Frequent cold attack
- Throat irritation
- Bone pain or tenderness
- Carpal tunnel syndrome
- Joint contractures
- Muscle weakness
- Tenderness and swelling of the arms and legs (occasionally including joints)
- Thickened skin with puckered appearance
Diagnosis
- Complete blood cell (CBC) count with differential to quantitate the percentage eosinophils and absolute number of eosinophils (AEC).However, in some cases, a more accurate absolute eosinophil count may be needed.
- Medical history is taken, with emphasis on travel, allergies and drug use.
- Patients with allergic symptoms should have a nasal smear for eosinophilia and Gram stain. Patients with asthma symptoms should have sputum examination for eosinophilia.
Prevention
- Avoid exposure to known allergens.
- Do not eat raw or undercooked snails, fish, frogs, slugs, freshwater prawns or other animals that may be contaminated with parasitic worms.
- Thoroughly wash all produce to ensure that they are not contaminated with parasitic worms.
TROPICAL EOSINOPHILIA
Syn: Weingarten syndrome, pulmonary eosinophiliosis.
This condition which is common in tropics is characterized by an absolute eosinophil count of 2000/cmm or more in peripheral blood and associated with respiratory symptoms. Current evidence suggests that eosinophilia is an allergic reaction to helminthic parasites particularly filarial worms.
It is a syndrome characterized by cough dyspnea a raised white cell count with persistent and absolute eosinophilia with systemic manifestations like fever loss of weight and lassitude. Chert X-ray shows ground glass appearance.
Homoeopathic Management for Eosinophilia
- Homeopathic medicines stimulate the immune power to act against the disease. So homeopathic medicines acts well in cases of Eosinophilia. Homoeo medicine controls the Eosinophils level in body and helps to reduce the symptoms with out producing any side effect
- Homoeopathy is highly effective in the treatment of allergies and fully capable of stimulating the organism to heal to the point of complete relief from all allergy symptoms.
- There is a special mention about allergic diseases in Homoeopathic literatures under the heading IDIOSYNCRASY. Dr Samuel Hahnemann, founder of Homoeopathic system of medicine defined idiosyncrasy 200 years ago in his famous book Organon of Medicine as “Idiosyncrasies by which are meant peculiar corporeal constitutions which although otherwise healthy, posses a disposition to be brought into a more or less morbid state by certain things which seem to produce no impression and no change in many other individuals”.
- Manifestations of allergic reactions and idiosyncracies are same. Both are hypersensitive reaction. An idiosyncratic individual is oversensitive to one or few things which doesn’t require treatment as the person in healthy, but allergic disorders are due to morbid susceptibility.
- Successful Homoeopathic prescribing demands a detailed case taking to find out the evolution of disease, relation with life situation, also to find out characteristic symptoms. According to Hahnemann it is the constitution of an individual that becomes sick first. The objective of treatment should be the improvement of the constitution, so that sensitivity, which has gone bad, is corrected or brought within normal range. It has been proved, verified and confirmed that if a proper indicated constitutional treatment is given to the child for sometime, it improves the constitution. In due course, the attacks become lesser in frequency and severity.
- By constitutional approach we can prevent the recurrence of the complaint by modifying the altered susceptibility.
Miasmatic remedy can help to remove any miasmatic block obtained from the familial background, past history of patient and also the presentation.
- Acute prescriptions are required during acute flare-ups.
Thus the concept of totality of symptoms and principle of individualization together enables the homoeopathic physician to perceive the disease in its whole content to make a suitable prescription
- Lachesis is a sure cure for tropical eosinophilia.
- Remedies like Aconite napellus, allium cepa, Anti.tart, Arsenicum album, Bryonia alba, Calc.Carb, Drosera, Phosphorus, Hepar sulph, Veratrum viride, Kali carb, Mercurius sol, Kali bich, Natrum sulph, Sulphur Sambucus nigra, Ipecac, Balsamum peruvianum, Asclepias tuberose, Naphthalinum, Sinapis nigra are very much useful in treating eosinophilia.
References
1. Harrison's Principles of Internal Medicine
2. Wikipedia.com/eosinophilia
3. Quick Bedside Prescriber – J.N.SHINGHAL.
4. http://homeoall.com/eosinophilia-homeopathy-treatment/
5. http://www.homeopathyzone.com/blog/article/the-homeopathic-treatment-of-allergies
6. http://doctorprasanna.com/articles/naso-respiratory-allergies-and-homoeopathy/
7. Principles of Prescribing, Dr. K.N.Mathur.
8. LILIENTHAL S., Homoeopathic Therapeutics
9. DEWEY W. A., Practical Homeopathic Therapeutics
Dr. S. SABARIRAJAN., M.D. (Hom) (Gen.med) (Gold medalist)
Reader, Dept. of Practice of Medicine
Vinayaka Mission’s Homoeopathic Medical College & Hospital,
Salem, Tamilnadu.
Dr. S. Sabarirajan., M.D. (Hom).
The term Eosinophilia refers to conditions in which abnormally high amounts of Eosinophils are found in either the blood (more than 600 cells per microliter (μ L))or in body tissues. Several causes are known, with the most common being some form of allergic reaction Eosinophil is a type of white blood cell. Eosinophils are produced in the bone marrow and are normally found in the bloodstream and the gut lining. They contain proteins that help the body to fight infection from parasitic organisms, such as worms. But in certain diseases these proteins can damage the body. Diagnosis is by complete blood count (CBC).
Aetiology
- The exact causative mechanisms of Eosinophilia remain largely unclear
- Very common Causes of Eosinophilia are Asthma, Hay fever, Drug allergies, Allergic skin diseases like Eczema, Sarcoptes scabiei, Scabies
- Common Causes of Eosinophilia are Connective tissue disease, Food allergy, Psoriasis, Systemic lupus erythematosus, Allergic rhinitis
Clinical Features
Sympioms includes
- Skin allergy,
- Cough
- Frequent cold attack
- Throat irritation
- Bone pain or tenderness
- Carpal tunnel syndrome
- Joint contractures
- Muscle weakness
- Tenderness and swelling of the arms and legs (occasionally including joints)
- Thickened skin with puckered appearance
Diagnosis
- Complete blood cell (CBC) count with differential to quantitate the percentage eosinophils and absolute number of eosinophils (AEC).However, in some cases, a more accurate absolute eosinophil count may be needed.
- Medical history is taken, with emphasis on travel, allergies and drug use.
- Patients with allergic symptoms should have a nasal smear for eosinophilia and Gram stain. Patients with asthma symptoms should have sputum examination for eosinophilia.
Prevention
- Avoid exposure to known allergens.
- Do not eat raw or undercooked snails, fish, frogs, slugs, freshwater prawns or other animals that may be contaminated with parasitic worms.
- Thoroughly wash all produce to ensure that they are not contaminated with parasitic worms.
TROPICAL EOSINOPHILIA
Syn: Weingarten syndrome, pulmonary eosinophiliosis.
This condition which is common in tropics is characterized by an absolute eosinophil count of 2000/cmm or more in peripheral blood and associated with respiratory symptoms. Current evidence suggests that eosinophilia is an allergic reaction to helminthic parasites particularly filarial worms.
It is a syndrome characterized by cough dyspnea a raised white cell count with persistent and absolute eosinophilia with systemic manifestations like fever loss of weight and lassitude. Chert X-ray shows ground glass appearance.
Homoeopathic Management for Eosinophilia
- Homeopathic medicines stimulate the immune power to act against the disease. So homeopathic medicines acts well in cases of Eosinophilia. Homoeo medicine controls the Eosinophils level in body and helps to reduce the symptoms with out producing any side effect
- Homoeopathy is highly effective in the treatment of allergies and fully capable of stimulating the organism to heal to the point of complete relief from all allergy symptoms.
- There is a special mention about allergic diseases in Homoeopathic literatures under the heading IDIOSYNCRASY. Dr Samuel Hahnemann, founder of Homoeopathic system of medicine defined idiosyncrasy 200 years ago in his famous book Organon of Medicine as “Idiosyncrasies by which are meant peculiar corporeal constitutions which although otherwise healthy, posses a disposition to be brought into a more or less morbid state by certain things which seem to produce no impression and no change in many other individuals”.
- Manifestations of allergic reactions and idiosyncracies are same. Both are hypersensitive reaction. An idiosyncratic individual is oversensitive to one or few things which doesn’t require treatment as the person in healthy, but allergic disorders are due to morbid susceptibility.
- Successful Homoeopathic prescribing demands a detailed case taking to find out the evolution of disease, relation with life situation, also to find out characteristic symptoms. According to Hahnemann it is the constitution of an individual that becomes sick first. The objective of treatment should be the improvement of the constitution, so that sensitivity, which has gone bad, is corrected or brought within normal range. It has been proved, verified and confirmed that if a proper indicated constitutional treatment is given to the child for sometime, it improves the constitution. In due course, the attacks become lesser in frequency and severity.
- By constitutional approach we can prevent the recurrence of the complaint by modifying the altered susceptibility.
Miasmatic remedy can help to remove any miasmatic block obtained from the familial background, past history of patient and also the presentation.
- Acute prescriptions are required during acute flare-ups.
Thus the concept of totality of symptoms and principle of individualization together enables the homoeopathic physician to perceive the disease in its whole content to make a suitable prescription
- Lachesis is a sure cure for tropical eosinophilia.
- Remedies like Aconite napellus, allium cepa, Anti.tart, Arsenicum album, Bryonia alba, Calc.Carb, Drosera, Phosphorus, Hepar sulph, Veratrum viride, Kali carb, Mercurius sol, Kali bich, Natrum sulph, Sulphur Sambucus nigra, Ipecac, Balsamum peruvianum, Asclepias tuberose, Naphthalinum, Sinapis nigra are very much useful in treating eosinophilia.
References
1. Harrison's Principles of Internal Medicine
2. Wikipedia.com/eosinophilia
3. Quick Bedside Prescriber – J.N.SHINGHAL.
4. http://homeoall.com/eosinophilia-homeopathy-treatment/
5. http://www.homeopathyzone.com/blog/article/the-homeopathic-treatment-of-allergies
6. http://doctorprasanna.com/articles/naso-respiratory-allergies-and-homoeopathy/
7. Principles of Prescribing, Dr. K.N.Mathur.
8. LILIENTHAL S., Homoeopathic Therapeutics
9. DEWEY W. A., Practical Homeopathic Therapeutics
Dr. S. SABARIRAJAN., M.D. (Hom) (Gen.med) (Gold medalist)
Reader, Dept. of Practice of Medicine
Vinayaka Mission’s Homoeopathic Medical College & Hospital,
Salem, Tamilnadu.
Monday, 12 December 2011
HOMOEOPATHIC IMMUNIZATIONS - ALTERNATIVE TO VACCINATIONS
HOMOEOPATHIC IMMUNIZATIONS
- ALTERNATIVE TO VACCINATIONS
Dr. S. Sabarirajan., M.D. (Hom).
Dr. S. R. Ameerkhan Babu., M.D. (Hom).
Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. The preferred prophylactic method against infectious disease in modern medicine is vaccination but nowadays due to their adverse side effects it become highly controversial and makes the new generation to turn out to Homoeopathy for prevention of many diseases.
Homoeopathic Immunization Schedule
At birth – Sulphur 200 1 Globule in a spoon of water to prevent psoric manifestation
Second day after Birth – give Hypericum 200 - 1 Globule in a spoon of water to protect against Tetanus
At Birth to 2 weeks – give Tuberculinum 1M - 1 Globule in a spoon of water to protect against tuberculosis.
At Birth, 6,10,14 weeks, 15-18 months, 5 years – give Thuja 1M - 1 Globule in a spoon of water to protect against Polio
At Birth, 6 weeks, 6-9 months, 10 years – Give Carduus Marianus-1M - 1 Globule in a spoon of water to protect against Hepatitis B
At 6,10,14 weeks, 15-18 months, 5 years - Give Thuja CM - 1 Globule in a spoon of water to protect against diphtheria,whooping cough, tetanus in morning
At 6,10,14 weeks, 15-18 months, 5 years - Give Ledum Palustre CM - 1 Globule in a spoon of water to protect against diphtheria,whooping cough, tetanus in evening
At 9 months - Give Pulsatilla CM - 1 Globule in a spoon of water to protect against Measles
At 15-18 months - Give Pulsatilla CM - 1 Globule in a spoon of water to protect against Measles, mumps, rubella or German measles
At 10-16 years - Give Ledum Palustre CM - 1 Globule in a spoon of water to protect against tetanus
Vaccine Schedule Medicine Dose
Against tuberculosis Birth – 2 weeks Tuberculinum 1M 1 drop in a spoon of water.
Against Polio Birth, 6,10,14 weeks,15-18 months, 5 years Thuja 1M 1 drop in a spoon of water.
Against Hepatitis B Birth, 6 weeks, 6-9 months, 10 years CARDUUS MARIANUS-1M 1 drop in a spoon of water.
Against diphtheria,whooping cough, tetanus 6,10,14 weeks, 15-18 months, 5 years Thuja CM 1 drop in a spoon of water in the morning.
LEDUM PALUSTRE CM 1 drop in a spoon of water in the evening.
Measles 9 months plus PULSATILLA CM 1 drop in a spoon of water.
Against measles, mumps, rubella or German measles 15-18 months PULSATILLA CM 1 drop in a spoon of water.
Against diphtheria and tetanus 5 years Thuja CM 1 drop in a spoon of water in the morning.
LEDUM PALUSTRE CM 1 drop in a spoon of water in the evening.
Against tetanus 10-16 years LEDUM PALUSTRE CM 1 drop in a spoon of water in the evening.
Homoeopathic Immunization
Homeopathic immunizations have been used successfully for over 200 years. Our master Dr. Samuel Hahnemann, used homeopathic immunization routinely in his practice. In 1799, he used the homeopathic remedy Belladonna successfully to prevent Scarlet Fever. 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%. In 1838 the Prussian Government ordered the use of Belladonna during all scarlet fever epidemics after a report from their chief of physicians, Hufeland, showed it to be an effective prophylactic.
In 1831 Samuel Hahnemann prevented and treated cholera during the 1831 Asiatic cholera epidemic with the remedies Camphor, Cuprum metallicum and Veratrum album. In 1849 Dr Clemens von Boenninghausen treated and prevented untold numbers of cholera infections during the 1849 European epidemic with the above 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%. In the 1800s Clemens von Boenninghausen used Thuja for both the treatment and prevention of smallpox during an epidemic. In 1902 Dr. Eaton reported that during a smallpox epidemic in Iowa, 2806 patients were treated prophylactically with homeopathic Variolinum. Of the 547 patients definitely exposed, only 14 developed the disease. The protection rate on these numbers was 97%.
In 1850 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. Dr Grimmer of Chicago prophylactically treated 5,000 young children with Lathyrus sativus. None developed polio.
In 1957 a severe poliomyelitis epidemic occurred in Buenos Aires. The majority of homoeopathic doctors prescribed Lathyrus sativus as a preventative. Drug stores distributed thousands of doses to the public. None of those who used the prophylactic registered a case of contagion (Eizayaga). In 1975 during another poliomyelitis epidemic in Buenos Aires, 40,000 were given the homeopathic prophylactic Lathyrus sativus. None developed poliomyelitis (Eizayaga).
In 1996 Dengueinum 30 was administered to at least 39,200 people in the Delhi area during an epidemic of Dengue haemorrhagic fever. Follow-up of 23,520 people 10 days later showed only 5 people (0.125%) had developed mild symptoms, with the rest showing no signs or symptoms of the disease (CCRH). (During epidemics of dengue, attack rates among susceptible are often 40-50 %, but may reach 80-90 %, World Health Organization.)
In 1999 the Department of Indian Medicine and Homoeopathy started distribution of homoeopathic immunizations for Japanese Encephalitis in a systematic way throughout the Andhra Pradesh with BCT (Belladonna, Calcarea Carb and Tuberculinum). JE mortality rates had touched a high of 638 deaths from 2038 cases in 1986, but fell to four from 33 cases in 2001, following the implementation of the homeopathic immunization program. Even the World Health Organization and the Medical and Health Department acknowledge that homeopathic immunizations have been a vital factor in the sharp decline of Japanese Encephalitis cases in Andhra Pradesh.
Homoeopathic Prophylaxis
Prophylaxis against Diphtheria - Apis mellifica 30, Diphthirinum 30
Prophylaxis against epilepsy - Kali bromium, Gloninine
Prophylaxis against Influenza – Arsenicum album.
Prophylaxis against Jaundice – Cincona off
Prophylaxis against measles – Aconite nap, Pulsatilla nig., Arsenicum album or Morbillinum.
Prophylaxis against Cholera - Camphor, Cuprum metallicum, Veratrum album
Prophylaxis against Mumps – Trifole-rep, Parotidinum.
Prophylaxis against Tetenus – Ledum pal or thuja or Arnica or Tetanotoxin.
Prophylaxis against Whooping cough – Drosera, Vaccininum, Pertussin.
Prophylaxis against Plague – Buboninum 12 – 13 potency, Ignatia amara., Naja triputans.
Prophylaxis against Chicken pox – Antimonium Tart and Rhus tox
Prophylaxis against Meningitis – Cicuta virosa
Prophylaxis against poliomyelitis - Lathyrus sativus 1M or Carbolic acidum or Plumbum or Physostigma
Prophylaxis against Dengue fever – Eupatorium perf
Prophylaxis against Common cold – Nux vomica
Prophylaxis against Snake poison - Golondrina
Prophylaxis against Typhoid – Baptisia
References
1. Birch, Kate. Vaccine Free Prevention and Treatment of Infectious Contagious Disease with Homeopathy: A Manual for Practitioners and Consumers.Trafford Publishing, 2007
2. Central Council of Research in Homoeopathy. CCRH News 1996-1997.
Currim, A.M. Ed. 1996. The Collected Works of Arthur Grimmer, M.D. Norwalk and Greifenberg, Hahnemann International Institute for Homeopathic Documentation.
3. Dudgeon R. E. 1853. Lectures on the Theory and Practice of Homeopathy, p.541,2. Republished by B. Jain Publishers, 2002, New Dehli.
Eaton, Dr. C. W., Variolinum. (a paper read before the American Institute of Homeopathy), 1907.
4. Eisfelder, HW, “Poliomyelitis Immunization: A Final Report.” Journal of the American Institute of Homeopathy. V. 54, Nov-Dec 1961, pp. 166-167.
Eizayaga, Dr. F. X., Treatise on Homeopathic Medicine. (E. Marecel, Buenos Aires, pp. 282-286).
5. Golden, Dr. Isaac, Vaccination & Homeoprophylaxis? A Review of Risks and Alternatives. 6th ed., Isaac Golden Publications, 2007.
6. Hahnemann, Dr. Samuel. “Cause and Prevention of the Asiatic Cholera.”Archiv. f. hom. Helik., vol. xi, 1831.
7. Hahnemann, Dr. Samuel, “Cure and Prevention of Scarlet Fever.” Lesser Writings. Jain, 1801, p. 369-384.
8. Hufeland. “Prophylactic Power of Belladonna in Scarlet Fever,” Hufeland’s Journal, 1828.
9. Staff Reporter. “Japanese Encephalitis on the Decline in State,” The Hindu, April 1, 2003.
10. Taylor-Smith, A. “Poliomyelitis and prophylaxis.” Br Homeopath J, 1950 Apr;40(2):65-77.
11.Von Boenninghausen, C. Baron. “Vide Concerning the Curative Effects of Thuja in Smallpox.” Lesser Writings, Jain, 1908.
12.http://www.homoeopathynow.com/homoeo-articles/69-homoeopathic-immunization
13. Quick Bedside Prescriber – J.N.SHINGHAL.
14. Pocket manual of Homoeopathic Materia Medica & Repertory by William Boericke.
15. Principles of Prescribing, Dr. K.N.Mathur.
Dr. S. Sabarirajan., M.D. (Hom) (Gen.med) (Gold medalist)
Dr. S. R. Ameerkhan Babu., M.D. (Hom) (Gen.med)
Reader, Dept. of Practice of Medicine
Vinayaka Mission’s Homoeopathic Medical College & Hospital,
Salem, Tamilnadu.
- ALTERNATIVE TO VACCINATIONS
Dr. S. Sabarirajan., M.D. (Hom).
Dr. S. R. Ameerkhan Babu., M.D. (Hom).
Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. The preferred prophylactic method against infectious disease in modern medicine is vaccination but nowadays due to their adverse side effects it become highly controversial and makes the new generation to turn out to Homoeopathy for prevention of many diseases.
Homoeopathic Immunization Schedule
At birth – Sulphur 200 1 Globule in a spoon of water to prevent psoric manifestation
Second day after Birth – give Hypericum 200 - 1 Globule in a spoon of water to protect against Tetanus
At Birth to 2 weeks – give Tuberculinum 1M - 1 Globule in a spoon of water to protect against tuberculosis.
At Birth, 6,10,14 weeks, 15-18 months, 5 years – give Thuja 1M - 1 Globule in a spoon of water to protect against Polio
At Birth, 6 weeks, 6-9 months, 10 years – Give Carduus Marianus-1M - 1 Globule in a spoon of water to protect against Hepatitis B
At 6,10,14 weeks, 15-18 months, 5 years - Give Thuja CM - 1 Globule in a spoon of water to protect against diphtheria,whooping cough, tetanus in morning
At 6,10,14 weeks, 15-18 months, 5 years - Give Ledum Palustre CM - 1 Globule in a spoon of water to protect against diphtheria,whooping cough, tetanus in evening
At 9 months - Give Pulsatilla CM - 1 Globule in a spoon of water to protect against Measles
At 15-18 months - Give Pulsatilla CM - 1 Globule in a spoon of water to protect against Measles, mumps, rubella or German measles
At 10-16 years - Give Ledum Palustre CM - 1 Globule in a spoon of water to protect against tetanus
Vaccine Schedule Medicine Dose
Against tuberculosis Birth – 2 weeks Tuberculinum 1M 1 drop in a spoon of water.
Against Polio Birth, 6,10,14 weeks,15-18 months, 5 years Thuja 1M 1 drop in a spoon of water.
Against Hepatitis B Birth, 6 weeks, 6-9 months, 10 years CARDUUS MARIANUS-1M 1 drop in a spoon of water.
Against diphtheria,whooping cough, tetanus 6,10,14 weeks, 15-18 months, 5 years Thuja CM 1 drop in a spoon of water in the morning.
LEDUM PALUSTRE CM 1 drop in a spoon of water in the evening.
Measles 9 months plus PULSATILLA CM 1 drop in a spoon of water.
Against measles, mumps, rubella or German measles 15-18 months PULSATILLA CM 1 drop in a spoon of water.
Against diphtheria and tetanus 5 years Thuja CM 1 drop in a spoon of water in the morning.
LEDUM PALUSTRE CM 1 drop in a spoon of water in the evening.
Against tetanus 10-16 years LEDUM PALUSTRE CM 1 drop in a spoon of water in the evening.
Homoeopathic Immunization
Homeopathic immunizations have been used successfully for over 200 years. Our master Dr. Samuel Hahnemann, used homeopathic immunization routinely in his practice. In 1799, he used the homeopathic remedy Belladonna successfully to prevent Scarlet Fever. 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%. In 1838 the Prussian Government ordered the use of Belladonna during all scarlet fever epidemics after a report from their chief of physicians, Hufeland, showed it to be an effective prophylactic.
In 1831 Samuel Hahnemann prevented and treated cholera during the 1831 Asiatic cholera epidemic with the remedies Camphor, Cuprum metallicum and Veratrum album. In 1849 Dr Clemens von Boenninghausen treated and prevented untold numbers of cholera infections during the 1849 European epidemic with the above 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%. In the 1800s Clemens von Boenninghausen used Thuja for both the treatment and prevention of smallpox during an epidemic. In 1902 Dr. Eaton reported that during a smallpox epidemic in Iowa, 2806 patients were treated prophylactically with homeopathic Variolinum. Of the 547 patients definitely exposed, only 14 developed the disease. The protection rate on these numbers was 97%.
In 1850 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. Dr Grimmer of Chicago prophylactically treated 5,000 young children with Lathyrus sativus. None developed polio.
In 1957 a severe poliomyelitis epidemic occurred in Buenos Aires. The majority of homoeopathic doctors prescribed Lathyrus sativus as a preventative. Drug stores distributed thousands of doses to the public. None of those who used the prophylactic registered a case of contagion (Eizayaga). In 1975 during another poliomyelitis epidemic in Buenos Aires, 40,000 were given the homeopathic prophylactic Lathyrus sativus. None developed poliomyelitis (Eizayaga).
In 1996 Dengueinum 30 was administered to at least 39,200 people in the Delhi area during an epidemic of Dengue haemorrhagic fever. Follow-up of 23,520 people 10 days later showed only 5 people (0.125%) had developed mild symptoms, with the rest showing no signs or symptoms of the disease (CCRH). (During epidemics of dengue, attack rates among susceptible are often 40-50 %, but may reach 80-90 %, World Health Organization.)
In 1999 the Department of Indian Medicine and Homoeopathy started distribution of homoeopathic immunizations for Japanese Encephalitis in a systematic way throughout the Andhra Pradesh with BCT (Belladonna, Calcarea Carb and Tuberculinum). JE mortality rates had touched a high of 638 deaths from 2038 cases in 1986, but fell to four from 33 cases in 2001, following the implementation of the homeopathic immunization program. Even the World Health Organization and the Medical and Health Department acknowledge that homeopathic immunizations have been a vital factor in the sharp decline of Japanese Encephalitis cases in Andhra Pradesh.
Homoeopathic Prophylaxis
Prophylaxis against Diphtheria - Apis mellifica 30, Diphthirinum 30
Prophylaxis against epilepsy - Kali bromium, Gloninine
Prophylaxis against Influenza – Arsenicum album.
Prophylaxis against Jaundice – Cincona off
Prophylaxis against measles – Aconite nap, Pulsatilla nig., Arsenicum album or Morbillinum.
Prophylaxis against Cholera - Camphor, Cuprum metallicum, Veratrum album
Prophylaxis against Mumps – Trifole-rep, Parotidinum.
Prophylaxis against Tetenus – Ledum pal or thuja or Arnica or Tetanotoxin.
Prophylaxis against Whooping cough – Drosera, Vaccininum, Pertussin.
Prophylaxis against Plague – Buboninum 12 – 13 potency, Ignatia amara., Naja triputans.
Prophylaxis against Chicken pox – Antimonium Tart and Rhus tox
Prophylaxis against Meningitis – Cicuta virosa
Prophylaxis against poliomyelitis - Lathyrus sativus 1M or Carbolic acidum or Plumbum or Physostigma
Prophylaxis against Dengue fever – Eupatorium perf
Prophylaxis against Common cold – Nux vomica
Prophylaxis against Snake poison - Golondrina
Prophylaxis against Typhoid – Baptisia
References
1. Birch, Kate. Vaccine Free Prevention and Treatment of Infectious Contagious Disease with Homeopathy: A Manual for Practitioners and Consumers.Trafford Publishing, 2007
2. Central Council of Research in Homoeopathy. CCRH News 1996-1997.
Currim, A.M. Ed. 1996. The Collected Works of Arthur Grimmer, M.D. Norwalk and Greifenberg, Hahnemann International Institute for Homeopathic Documentation.
3. Dudgeon R. E. 1853. Lectures on the Theory and Practice of Homeopathy, p.541,2. Republished by B. Jain Publishers, 2002, New Dehli.
Eaton, Dr. C. W., Variolinum. (a paper read before the American Institute of Homeopathy), 1907.
4. Eisfelder, HW, “Poliomyelitis Immunization: A Final Report.” Journal of the American Institute of Homeopathy. V. 54, Nov-Dec 1961, pp. 166-167.
Eizayaga, Dr. F. X., Treatise on Homeopathic Medicine. (E. Marecel, Buenos Aires, pp. 282-286).
5. Golden, Dr. Isaac, Vaccination & Homeoprophylaxis? A Review of Risks and Alternatives. 6th ed., Isaac Golden Publications, 2007.
6. Hahnemann, Dr. Samuel. “Cause and Prevention of the Asiatic Cholera.”Archiv. f. hom. Helik., vol. xi, 1831.
7. Hahnemann, Dr. Samuel, “Cure and Prevention of Scarlet Fever.” Lesser Writings. Jain, 1801, p. 369-384.
8. Hufeland. “Prophylactic Power of Belladonna in Scarlet Fever,” Hufeland’s Journal, 1828.
9. Staff Reporter. “Japanese Encephalitis on the Decline in State,” The Hindu, April 1, 2003.
10. Taylor-Smith, A. “Poliomyelitis and prophylaxis.” Br Homeopath J, 1950 Apr;40(2):65-77.
11.Von Boenninghausen, C. Baron. “Vide Concerning the Curative Effects of Thuja in Smallpox.” Lesser Writings, Jain, 1908.
12.http://www.homoeopathynow.com/homoeo-articles/69-homoeopathic-immunization
13. Quick Bedside Prescriber – J.N.SHINGHAL.
14. Pocket manual of Homoeopathic Materia Medica & Repertory by William Boericke.
15. Principles of Prescribing, Dr. K.N.Mathur.
Dr. S. Sabarirajan., M.D. (Hom) (Gen.med) (Gold medalist)
Dr. S. R. Ameerkhan Babu., M.D. (Hom) (Gen.med)
Reader, Dept. of Practice of Medicine
Vinayaka Mission’s Homoeopathic Medical College & Hospital,
Salem, Tamilnadu.
Saturday, 24 September 2011
Menopause
Combined therapy along with Homoeopathic treatment helps in combating Menopause
- Dr. S. Sabarirajan & Dr.S.R. Ameerkhan babu.
Introduction
Menopause is a universal and irreversible part of the overall aging process involving a woman's reproductive system, after which she no longer menstruates. Awareness about these changes is less in our country compared to developed nations. Patients seeking treatment for menopause is less, but we find such patients visiting for their menopause related symptoms like irregular bleeding, fatigue, night sweats, etc. Though we have many rubrics in the repertory for menopause and its symptoms, many a times we fail to provide desirable results. Many physicians find in such cases along with the indicated drug, other managing measures like food modifications, exercise, home remedies and herbs, supplements, micronutrients and vitamins are helpful. This article discusses about such combined therapies along with definition, symptoms, pathophysiology, investigations, rubrics and drugs for menopause.
Definition
The word "menopause" literally means the "end of monthly cycles" from the Greek word pausis (cessation) and the root men- (month), because the word "menopause" was created to describe this change in human females, where the end of fertility is traditionally indicated by the permanent stopping of monthly menstruation or menses. Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining. Menopause typically (but not always) occurs in women in midlife, during their late 40s or early 50s, and signals the end of the fertile phase of a woman's life. It is not uncommon however to see a women menstruate well beyond the age of 50.
Perimenopause refers to the time before menopause when vasomotor symptoms and irregular menses often commence. Perimenopause can start 5-10 years or more before menopause.
Menopause is characterized by a continuation of vasomotor symptoms and by urogenital symptoms such as vaginal dryness and dyspareunia.
The cause of menopause is “burning out” of the ovaries. Throughout a woman’s reproductive life, about 400 of the primordial follicles grow into mature follicles and ovulate, and hundreds of thousands of ova degenerate. At about age 45 years, only a few primordial follicles remain to be stimulated by FSH and LH, and, the production of estrogens by the ovaries decreases as the number of primordial follicles approaches zero. When estrogen production falls below a critical value, the estrogens can no longer inhibit the production of the gonadotropins FSH and LH. Instead, the gonadotropins FSH and LH (mainly FSH) are produced after menopause in large and continuous quantities, but as the remaining primordial follicles become atretic, the production of estrogens by the ovaries falls virtually to zero.
SIGNS AND SYMPTOMS
The menopausal transition can cause
Vascular instability
• Hot flashes or hot flushes, including night sweats and, in a few people, cold flashes
• Possible but contentious increased risk of atherosclerosis
• Migraine
• Rapid heartbeat
Urogenital atrophy
• Thinning of the membranes of the vulva, the vagina, the cervix, and also the outer urinary tract, along with considerable shrinking and loss in elasticity of all of the outer and inner genital areas.
• Itching
• Dryness
• Bleeding
• Watery discharge
• Urinary frequency
• Urinary incontinence
• Urinary urgency
• Increased susceptibility to inflammation and infection, for example vaginal candidiasis, and urinary tract infections
Skeletal
• Back pain
• Joint pain, Muscle pain
• Osteopenia and the risk of osteoporosis gradually developing over time
Skin, soft tissue
• Breast atrophy
• breast tenderness +/- swelling
• Decreased elasticity of the skin
• Formication (itching, tingling, burning, pins and needles, or sensation of ants crawling on or under the skin)
• Skin thinning and becoming drier
Psychological
• Depression and/or anxiety
• Fatigue
• Irritability
• Memory loss, and problems with concentration
• Mood disturbance
• Sleep disturbances, poor quality sleep, light sleep, insomnia
Sexual
• Dyspareunia or painful intercourse
• Decreased libido
• Problems reaching orgasm
• Vaginal dryness and vaginal atrophy
PATHOPHYSIOLOGY
During climacteric, ovarian activity declines. Initially, the ovulation fails, no corpus luteum is formed and no progesterone is secreted by the ovary. Thus the menstrual cycles tend to become anovulatory and irregular (Metropathia haemorraghica).Later oestrogenic activity also diminishes and atrophic endometrium ensues, leading to menopause. As a result of cessation of ovarian activity, and fall in estrogen level, there is a rebound increase in secretion of FSH by the anterior pituitary gland. FSH level may rise as much as 50 fold, thus making menopausal urine a commercial source of Gonadotrophin(HMG). With further advancing years, gonadotrophin activity of the anterior pitiuitary also ceases and a fall in the level of FSH is eventually noticed .
CHANGES IN THE GENITAL TRACT
These changes are of atrophic type and affect the external genitalia as well as the internal organs. They take time to occur – over a number of years. Not only the main pelvic structures reduced in size but, more importantly, the fascial framework and the intra pelvic ligaments supporting the bladder and the genitalia are weakened;this may lead to complications.
Vulva: This shows the flattening of the labia majora, the minor labia becoming more evident. Sexual hair become grey and sparse. The clitoris shrinks.
Uterus: The uterus becomes small with a relatively large cervix- return to infantile proportions.
Tubes and ovaries: These show great shrinkage, the tubes becoming thin, while the ovaries are reduced to small white wrinkled bodies 2-3 cm in length. In addition to the shrinkage of the vaginal introitus, the vagina diminishes in length and its secretions are limited, leading to sexual problems. Changes in the vaginal epithelium increase these problems.
PRINCIPAL CHANGES IN THE SERUM HORMONE LEVELS
Once menopause is well established , the plasma estrogen level may remain low at 10 to 20 pg/ml. Oestrone level varies between 30 and 70 Pg/ml. the ovary also secretes a small amount of testosterone which may be responsible for mild hirsutism noticed after the menopause. The gonadotrophin hormone (FSH) appears in high concentration at menopause, because it is not inhibited by the prevailing low levels of estrogen.
Mensturation may gradually decrease, suddenly cease or become irregular. Oestrogen levels fall over the 5 years preceding ovarian failure which occurs usually between 45 and 50 years of age, with an average around 50 years. The fall in oestrodiol has a positive feedback on the pitiuitary, increasing production of FSH and LH.
The ovaries eventually produce androstenidione, which is also produced by the adrenals, and is converted in peripheral fat into weak oestrogen oestrone
INVESTIGATIONS
Assessment and evaluation prior to initiating treatment:
The following plan is recommended, it helps in finding the actual pathology and progress of symptoms, which helps in finding the constitutional or antimiasmatic remedies and further way of treatment.
1. Detailed family and personal history, physical examination - height , weight and BP.
2. Examination of breast.
3. Pelvic examination.
4. Evaluation of menopausal symptoms and need for medication.
5. Evaluation of the individual risks versus benefits from treatment.
6. Routine screening tests like blood routine, urine routine, Fasting and post prandial blood sugars.
7. Lipid profile and cardiovascular risk assessment. (Plasma lipids have been known to be altered by the with in month variations in the female hormonal system. The early menopausal subjects shows a significant increase in the total cholesterol level and slightly higher in late menopausal subjects.)
8. Transvaginal sonography and assessment of endometrial thickness.
9. Routine mammography.
10. Endometrial histology – in cases of post menopausal bleeding or family history of uterine cancer. Or past history of late menopause, infertility, and PCOD.
HORMONE REPLACEMENT AND ALLIED THERAPY
The basic objective of oestrogen replacement therapy is to increase the circulating levels of oestrogen to physiological levels of 45- 200 pg / ml to alleviate the climacteric symptoms resulting from oestrogen deficiency. Semi- synthetic hormones are used for hormone replacement therapy (HRT) because they are more physiologic in their actions. HRT can be administered in the form of oral medications, dermal patches or gels for local application, depending on the patients needs.
There are many contraindications to HRT as follows:
Conventional therapy majorly depends on the Hormone replacement therapy (HRT). But many studies suggest that HRT has got many unwanted side effects. For example, the results of a major study, called women’s health initiative (established by the Government of United States of America), had explored many health risks. In fact this important study was stopped early because the health risks outweighed the health benefits. Women taking the hormones greatly increased their risk for breast cancer, heart attacks, strokes and blood clots. However all hormone replacement therapies probably do carry some health risks, including high blood pressure, blood clots, and increased risks of breast and uterine cancers.
1. Presence of active endometrial cancer and hormone dependent tumours.
2. Active breast cancer and oestrogen progesterone receptor positive cancers.
3. Presence of or suspicion of pregnancy.
4. Undiagnosed vaginal bleeding.
5. Severe liver disease or abnormal liver function tests.
6. Acute vascular thrombosis.
7. History of thrombo embolism.
8. Estrogen dependent vascular thrombosis.
Other relative symptoms are - Strong family history of breast cancer, History of migraine and severe headaches. Thrombo phlebitis, uterine fibroids, Endometriosis, Gall bladder disease, Glucose intolerance.
HOLISTIC APPROACH TO MENOPAUSE
A holistic approach considering the lifestyle, personal habits, food habits, inclusion of nutrients and herbal diet, etc. along with homoeopathic treatment helps in overcoming menopausal symptoms. Information on each such intervention has been given under respective titles.
I. Life style changes and personal habits:
1. Exercises- Brisk walking fro 40 – 60 minutes atleast 5 times/week.
2. Physical workouts-Weight bearing exercises for limbs and back strengthening.
3. Yoga and meditation- Breathing exercises (Pranayama) beneficial in reducing stress.
4. Simple diet- Containing liberal amounts of vegetables and fruits (fibres and vitamins) lower contents of saturated fats and restricted sugar content.
5. Fluid intake- Consume fluids liberally to maintain tissue hydration.
6. Control or abstain- Smoking , alcohol intake, unrestricted consumption of tea / coffee.
II. Herbs and plant products:
Plants are a source of phyto oestrogens which have mild oestrogenic and some anti estrogenic effects. Soya has been the most extensively investigated plant. Phytooestrogens are a source of aglycones and isoflavones, coumestones and lignans.common Indian foods rich in phytooestrogens- isoflavons are found in Bengal grams, cereals fruits like apples and berries,and red clover. Lignans in whole grain, pulses, legumes and beans, sunflower seeds and saponins in herbs like turmeric fenugreek or methi ginger and also in root vegetables yam and grains.
An intake of 50 mg of isoflavones per day has been beneficial in reducing hot flushes, preventing osteoporosis, reducing ldl cholesterol. Also there is an evidence that soya exerts a protective action against breast cancer. The hot flushes can be managed with Wearing cool clothing, Drinking cold water or juice at the onset of flush, shower with tepid water.
III. Micronutrients and antioxidants:
These are essential to the body and required in very small amounts. These include vitamins minerals, essential amino acids, essential fatty acids. Many of these are antoxidants also. Antoxidants protects against the tissue damage. Menopausal women are vulnerable because of the loss of the protective effects of oestrogens and the age related effects.
IV. Calcium and vitamin D3:
In ageing women, the need for calcium supplementation increases to about 1000- 1500 mg / day Provided the calcium should be properly absorbed and utilized. Thus it slows down the process of age related osteoporosis.
This has been justified by Ried et al in 1993 in their research with supplementation of calcium carbonate and lactate- gluconate to post menopausal women in doses of 1 gm / 24 hours for 5 years and demonstrated significantly slowed axial and appendicular bone loss.
Chapuy et al in 1992 has demonstrated both suppression of bone loss and reduction of fracture.
IV. Calcitonin:
Many clinical studies have produced evidence to suggest that calcitonin is able to prevent bone loss in the spine in post menopausal women. Calcitonin injection has been known to cause side effects like nausea and vomiting , flushing and intertrigo, intranasal administration remains another alternative.
V. Biphosphonates:
These are stable active analogues of pyrophosphate, which act by inhibiting bone resorption. These compounds are worth considering in women in whom oestrogens are contraindicated, or for those averse to Hormone Replacement Therapy.
Aroma therapy, Herbalism, Accupressure, Accupuncture, Nutrition and supplements can be suggested as the supportive line of treatments for menopausal complaints.
HOMOEOPATHIC APPROACH
The advantage of homoeopathy is that it considers the patient as whole. Since the symptoms of menopause are not limited to one system or location, a drug selected on the totality is of more helpful than the “single complaint specific drugs”. Our repertory has covered the menopausal symptoms directory or indirectly. Below is a reportorial analysis on the common symptoms of menopause. Therapeutics of menopause follows the analysis.
THERAPEUTICS
Many authors have discussed about the drugs that are commonly indicated during the time of menopause or the climaxis, as referred to in many of the writings. The commonly indicated remedies for General Menopausal symptoms are Amyl Nitrosum, Belladona, Bellis perennis, Cactus grandiflorus, Calcarea carbonicum., Caulophyllum, Cimicifuga racemosa, Castoreum, Conium ,Crotalus Horridus, Erigeron, Gelsemium, Glonine, Graphitis., Kali-carbonicum, Kreosotum, LACHESIS, Manganum, Mag.phos , Murex., Nux-vomica, Nux moschata, Oophorinum, Psorinum, Pulsatilla , Sabina, Sangunaria, Sepia, Sulphur, Sulphuric acid, Thlasi bursa , Tuberculinum, Ustiligo, Vibrunum opulus and Zincum Valerianum.
Aliments from menopause
Lachesis. (It’s a Well Specific Remedy for Menopause)
Ailments during menopause
For hot flashes and night sweats: Amyl nitrosum, Belladonna, Ferrum metallicum, Lachesis, Pulsatilla, Pilocarpus microphyllus, Sepia and Valeriana.
For sleeplessness (insomnia): Aconitum napellus, Arsenicum album, Belladonna, Chamomilla, Coffea crude, Lycopodium clavatum ,Passiflora incarnata, Sulphur and Viburnum opulus.
For constipation: Hydrastis, Iris versicolor. Magnesia muriatica, Magnesia phosphorica and Sepia
For incontinence of urine: Pulsatilla and Zincum metallicum.
For vaginal dryness: Aconitum napellus, Apis mellifica, Belladonna, Bryonia, Ferrum phosphoricum Hydrophobinum, Lycopodium, Natrum muriaticum and Spiranthes.
For depression, fear, nervous or irritability: Aconitum napellus, Amyl nitrosum, Arum Metallicum, Borax, Chamomilla, Ignatia amara, Lachesis, Nux vomica, Passiflora incarnata, Sepia, Stramonium and Viburnum opulus.
For bone related problems like Osteophorosis: Bellis perennis and Calcarea carbonica
For menorrhagia: Lachesis, Sepia, Argentum mettalicum and Cimicifuga racemosa
For painful and enlarged breast: Sangunaria
For painful breast: Cimicifuga racemosa
For burning, palm, sole and vertex: Sulphur, Sangunaria and Lachesis
For excessive perspiration: Sepia
For earache: Gelsimium
For rheumatic pain: Caulophyllum
For headache: Glonine, Sangunaria, Sepia and Cimicifuga racemosa
- Dr. S. Sabarirajan & Dr.S.R. Ameerkhan babu.
Introduction
Menopause is a universal and irreversible part of the overall aging process involving a woman's reproductive system, after which she no longer menstruates. Awareness about these changes is less in our country compared to developed nations. Patients seeking treatment for menopause is less, but we find such patients visiting for their menopause related symptoms like irregular bleeding, fatigue, night sweats, etc. Though we have many rubrics in the repertory for menopause and its symptoms, many a times we fail to provide desirable results. Many physicians find in such cases along with the indicated drug, other managing measures like food modifications, exercise, home remedies and herbs, supplements, micronutrients and vitamins are helpful. This article discusses about such combined therapies along with definition, symptoms, pathophysiology, investigations, rubrics and drugs for menopause.
Definition
The word "menopause" literally means the "end of monthly cycles" from the Greek word pausis (cessation) and the root men- (month), because the word "menopause" was created to describe this change in human females, where the end of fertility is traditionally indicated by the permanent stopping of monthly menstruation or menses. Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining. Menopause typically (but not always) occurs in women in midlife, during their late 40s or early 50s, and signals the end of the fertile phase of a woman's life. It is not uncommon however to see a women menstruate well beyond the age of 50.
Perimenopause refers to the time before menopause when vasomotor symptoms and irregular menses often commence. Perimenopause can start 5-10 years or more before menopause.
Menopause is characterized by a continuation of vasomotor symptoms and by urogenital symptoms such as vaginal dryness and dyspareunia.
The cause of menopause is “burning out” of the ovaries. Throughout a woman’s reproductive life, about 400 of the primordial follicles grow into mature follicles and ovulate, and hundreds of thousands of ova degenerate. At about age 45 years, only a few primordial follicles remain to be stimulated by FSH and LH, and, the production of estrogens by the ovaries decreases as the number of primordial follicles approaches zero. When estrogen production falls below a critical value, the estrogens can no longer inhibit the production of the gonadotropins FSH and LH. Instead, the gonadotropins FSH and LH (mainly FSH) are produced after menopause in large and continuous quantities, but as the remaining primordial follicles become atretic, the production of estrogens by the ovaries falls virtually to zero.
SIGNS AND SYMPTOMS
The menopausal transition can cause
Vascular instability
• Hot flashes or hot flushes, including night sweats and, in a few people, cold flashes
• Possible but contentious increased risk of atherosclerosis
• Migraine
• Rapid heartbeat
Urogenital atrophy
• Thinning of the membranes of the vulva, the vagina, the cervix, and also the outer urinary tract, along with considerable shrinking and loss in elasticity of all of the outer and inner genital areas.
• Itching
• Dryness
• Bleeding
• Watery discharge
• Urinary frequency
• Urinary incontinence
• Urinary urgency
• Increased susceptibility to inflammation and infection, for example vaginal candidiasis, and urinary tract infections
Skeletal
• Back pain
• Joint pain, Muscle pain
• Osteopenia and the risk of osteoporosis gradually developing over time
Skin, soft tissue
• Breast atrophy
• breast tenderness +/- swelling
• Decreased elasticity of the skin
• Formication (itching, tingling, burning, pins and needles, or sensation of ants crawling on or under the skin)
• Skin thinning and becoming drier
Psychological
• Depression and/or anxiety
• Fatigue
• Irritability
• Memory loss, and problems with concentration
• Mood disturbance
• Sleep disturbances, poor quality sleep, light sleep, insomnia
Sexual
• Dyspareunia or painful intercourse
• Decreased libido
• Problems reaching orgasm
• Vaginal dryness and vaginal atrophy
PATHOPHYSIOLOGY
During climacteric, ovarian activity declines. Initially, the ovulation fails, no corpus luteum is formed and no progesterone is secreted by the ovary. Thus the menstrual cycles tend to become anovulatory and irregular (Metropathia haemorraghica).Later oestrogenic activity also diminishes and atrophic endometrium ensues, leading to menopause. As a result of cessation of ovarian activity, and fall in estrogen level, there is a rebound increase in secretion of FSH by the anterior pituitary gland. FSH level may rise as much as 50 fold, thus making menopausal urine a commercial source of Gonadotrophin(HMG). With further advancing years, gonadotrophin activity of the anterior pitiuitary also ceases and a fall in the level of FSH is eventually noticed .
CHANGES IN THE GENITAL TRACT
These changes are of atrophic type and affect the external genitalia as well as the internal organs. They take time to occur – over a number of years. Not only the main pelvic structures reduced in size but, more importantly, the fascial framework and the intra pelvic ligaments supporting the bladder and the genitalia are weakened;this may lead to complications.
Vulva: This shows the flattening of the labia majora, the minor labia becoming more evident. Sexual hair become grey and sparse. The clitoris shrinks.
Uterus: The uterus becomes small with a relatively large cervix- return to infantile proportions.
Tubes and ovaries: These show great shrinkage, the tubes becoming thin, while the ovaries are reduced to small white wrinkled bodies 2-3 cm in length. In addition to the shrinkage of the vaginal introitus, the vagina diminishes in length and its secretions are limited, leading to sexual problems. Changes in the vaginal epithelium increase these problems.
PRINCIPAL CHANGES IN THE SERUM HORMONE LEVELS
Once menopause is well established , the plasma estrogen level may remain low at 10 to 20 pg/ml. Oestrone level varies between 30 and 70 Pg/ml. the ovary also secretes a small amount of testosterone which may be responsible for mild hirsutism noticed after the menopause. The gonadotrophin hormone (FSH) appears in high concentration at menopause, because it is not inhibited by the prevailing low levels of estrogen.
Mensturation may gradually decrease, suddenly cease or become irregular. Oestrogen levels fall over the 5 years preceding ovarian failure which occurs usually between 45 and 50 years of age, with an average around 50 years. The fall in oestrodiol has a positive feedback on the pitiuitary, increasing production of FSH and LH.
The ovaries eventually produce androstenidione, which is also produced by the adrenals, and is converted in peripheral fat into weak oestrogen oestrone
INVESTIGATIONS
Assessment and evaluation prior to initiating treatment:
The following plan is recommended, it helps in finding the actual pathology and progress of symptoms, which helps in finding the constitutional or antimiasmatic remedies and further way of treatment.
1. Detailed family and personal history, physical examination - height , weight and BP.
2. Examination of breast.
3. Pelvic examination.
4. Evaluation of menopausal symptoms and need for medication.
5. Evaluation of the individual risks versus benefits from treatment.
6. Routine screening tests like blood routine, urine routine, Fasting and post prandial blood sugars.
7. Lipid profile and cardiovascular risk assessment. (Plasma lipids have been known to be altered by the with in month variations in the female hormonal system. The early menopausal subjects shows a significant increase in the total cholesterol level and slightly higher in late menopausal subjects.)
8. Transvaginal sonography and assessment of endometrial thickness.
9. Routine mammography.
10. Endometrial histology – in cases of post menopausal bleeding or family history of uterine cancer. Or past history of late menopause, infertility, and PCOD.
HORMONE REPLACEMENT AND ALLIED THERAPY
The basic objective of oestrogen replacement therapy is to increase the circulating levels of oestrogen to physiological levels of 45- 200 pg / ml to alleviate the climacteric symptoms resulting from oestrogen deficiency. Semi- synthetic hormones are used for hormone replacement therapy (HRT) because they are more physiologic in their actions. HRT can be administered in the form of oral medications, dermal patches or gels for local application, depending on the patients needs.
There are many contraindications to HRT as follows:
Conventional therapy majorly depends on the Hormone replacement therapy (HRT). But many studies suggest that HRT has got many unwanted side effects. For example, the results of a major study, called women’s health initiative (established by the Government of United States of America), had explored many health risks. In fact this important study was stopped early because the health risks outweighed the health benefits. Women taking the hormones greatly increased their risk for breast cancer, heart attacks, strokes and blood clots. However all hormone replacement therapies probably do carry some health risks, including high blood pressure, blood clots, and increased risks of breast and uterine cancers.
1. Presence of active endometrial cancer and hormone dependent tumours.
2. Active breast cancer and oestrogen progesterone receptor positive cancers.
3. Presence of or suspicion of pregnancy.
4. Undiagnosed vaginal bleeding.
5. Severe liver disease or abnormal liver function tests.
6. Acute vascular thrombosis.
7. History of thrombo embolism.
8. Estrogen dependent vascular thrombosis.
Other relative symptoms are - Strong family history of breast cancer, History of migraine and severe headaches. Thrombo phlebitis, uterine fibroids, Endometriosis, Gall bladder disease, Glucose intolerance.
HOLISTIC APPROACH TO MENOPAUSE
A holistic approach considering the lifestyle, personal habits, food habits, inclusion of nutrients and herbal diet, etc. along with homoeopathic treatment helps in overcoming menopausal symptoms. Information on each such intervention has been given under respective titles.
I. Life style changes and personal habits:
1. Exercises- Brisk walking fro 40 – 60 minutes atleast 5 times/week.
2. Physical workouts-Weight bearing exercises for limbs and back strengthening.
3. Yoga and meditation- Breathing exercises (Pranayama) beneficial in reducing stress.
4. Simple diet- Containing liberal amounts of vegetables and fruits (fibres and vitamins) lower contents of saturated fats and restricted sugar content.
5. Fluid intake- Consume fluids liberally to maintain tissue hydration.
6. Control or abstain- Smoking , alcohol intake, unrestricted consumption of tea / coffee.
II. Herbs and plant products:
Plants are a source of phyto oestrogens which have mild oestrogenic and some anti estrogenic effects. Soya has been the most extensively investigated plant. Phytooestrogens are a source of aglycones and isoflavones, coumestones and lignans.common Indian foods rich in phytooestrogens- isoflavons are found in Bengal grams, cereals fruits like apples and berries,and red clover. Lignans in whole grain, pulses, legumes and beans, sunflower seeds and saponins in herbs like turmeric fenugreek or methi ginger and also in root vegetables yam and grains.
An intake of 50 mg of isoflavones per day has been beneficial in reducing hot flushes, preventing osteoporosis, reducing ldl cholesterol. Also there is an evidence that soya exerts a protective action against breast cancer. The hot flushes can be managed with Wearing cool clothing, Drinking cold water or juice at the onset of flush, shower with tepid water.
III. Micronutrients and antioxidants:
These are essential to the body and required in very small amounts. These include vitamins minerals, essential amino acids, essential fatty acids. Many of these are antoxidants also. Antoxidants protects against the tissue damage. Menopausal women are vulnerable because of the loss of the protective effects of oestrogens and the age related effects.
IV. Calcium and vitamin D3:
In ageing women, the need for calcium supplementation increases to about 1000- 1500 mg / day Provided the calcium should be properly absorbed and utilized. Thus it slows down the process of age related osteoporosis.
This has been justified by Ried et al in 1993 in their research with supplementation of calcium carbonate and lactate- gluconate to post menopausal women in doses of 1 gm / 24 hours for 5 years and demonstrated significantly slowed axial and appendicular bone loss.
Chapuy et al in 1992 has demonstrated both suppression of bone loss and reduction of fracture.
IV. Calcitonin:
Many clinical studies have produced evidence to suggest that calcitonin is able to prevent bone loss in the spine in post menopausal women. Calcitonin injection has been known to cause side effects like nausea and vomiting , flushing and intertrigo, intranasal administration remains another alternative.
V. Biphosphonates:
These are stable active analogues of pyrophosphate, which act by inhibiting bone resorption. These compounds are worth considering in women in whom oestrogens are contraindicated, or for those averse to Hormone Replacement Therapy.
Aroma therapy, Herbalism, Accupressure, Accupuncture, Nutrition and supplements can be suggested as the supportive line of treatments for menopausal complaints.
HOMOEOPATHIC APPROACH
The advantage of homoeopathy is that it considers the patient as whole. Since the symptoms of menopause are not limited to one system or location, a drug selected on the totality is of more helpful than the “single complaint specific drugs”. Our repertory has covered the menopausal symptoms directory or indirectly. Below is a reportorial analysis on the common symptoms of menopause. Therapeutics of menopause follows the analysis.
THERAPEUTICS
Many authors have discussed about the drugs that are commonly indicated during the time of menopause or the climaxis, as referred to in many of the writings. The commonly indicated remedies for General Menopausal symptoms are Amyl Nitrosum, Belladona, Bellis perennis, Cactus grandiflorus, Calcarea carbonicum., Caulophyllum, Cimicifuga racemosa, Castoreum, Conium ,Crotalus Horridus, Erigeron, Gelsemium, Glonine, Graphitis., Kali-carbonicum, Kreosotum, LACHESIS, Manganum, Mag.phos , Murex., Nux-vomica, Nux moschata, Oophorinum, Psorinum, Pulsatilla , Sabina, Sangunaria, Sepia, Sulphur, Sulphuric acid, Thlasi bursa , Tuberculinum, Ustiligo, Vibrunum opulus and Zincum Valerianum.
Aliments from menopause
Lachesis. (It’s a Well Specific Remedy for Menopause)
Ailments during menopause
For hot flashes and night sweats: Amyl nitrosum, Belladonna, Ferrum metallicum, Lachesis, Pulsatilla, Pilocarpus microphyllus, Sepia and Valeriana.
For sleeplessness (insomnia): Aconitum napellus, Arsenicum album, Belladonna, Chamomilla, Coffea crude, Lycopodium clavatum ,Passiflora incarnata, Sulphur and Viburnum opulus.
For constipation: Hydrastis, Iris versicolor. Magnesia muriatica, Magnesia phosphorica and Sepia
For incontinence of urine: Pulsatilla and Zincum metallicum.
For vaginal dryness: Aconitum napellus, Apis mellifica, Belladonna, Bryonia, Ferrum phosphoricum Hydrophobinum, Lycopodium, Natrum muriaticum and Spiranthes.
For depression, fear, nervous or irritability: Aconitum napellus, Amyl nitrosum, Arum Metallicum, Borax, Chamomilla, Ignatia amara, Lachesis, Nux vomica, Passiflora incarnata, Sepia, Stramonium and Viburnum opulus.
For bone related problems like Osteophorosis: Bellis perennis and Calcarea carbonica
For menorrhagia: Lachesis, Sepia, Argentum mettalicum and Cimicifuga racemosa
For painful and enlarged breast: Sangunaria
For painful breast: Cimicifuga racemosa
For burning, palm, sole and vertex: Sulphur, Sangunaria and Lachesis
For excessive perspiration: Sepia
For earache: Gelsimium
For rheumatic pain: Caulophyllum
For headache: Glonine, Sangunaria, Sepia and Cimicifuga racemosa
Wednesday, 27 July 2011
COPD
OBSTRUCTIVE AIR WAY DISORDERS
DEFINITION
In this Condition there is chronic obstruction to the alveolar in flow of air either due to chronic Bronchitis and / or emphysema and / or Bronchial Asthma.
Chronic Bronchitis may be complicated with emphysema but there may be predominance of any of them. Bronchial asthma also causes generalized airway obstruction and is dealt with separately. There may be considerable over lapping of these three diseases.
CHRONIC BRONCHITIS
DEFINITION
Ch. Bronchitis may be defined as a disease characterized by cough and sputum for at least 3 consecutive months in a year for more than 2 successive Years.
AETIOLOGY
Smoking
Atmospheric Pollution
Infection
Occupation (Coal miners)
Familial and genetic abnormalities associated with alpha1 , antitrypsin deficiency -may also be present.
Pathology
Develops airway wall inflammation
Hypertrophy of mucus secreting Glands and increases in the number of Goblet cells in bronchi and bronchioles with consequent
Decrease in ciliated cells,
Obstruction of air flow.
Pathology for Cyanosis
Due to uneven distribution of the inspired air
There may be diminished diffusing capacity
Airway obstruction gives rise to ventilation perfusion in equality.
Resulting in increased paco2 and decreased pao2 with severe ventilatory failure there is falling pH together with compensatory decrease in plasma bicarbonate and respiratory acidosis.
Cyanosis
Clinical Features
Gradual onset
Cough with expectoration: It is usually starts as attacks of “winter cough” and “Smoker’s cough”. Gradually increasing in severity and duration, the expectoration is mucoid (or) mucopurulent depending on the presence of infection.
Some time there may be haemoptysis.
Shortness of breath due to airway obstruction.
SIGNS
Respiratory rate is hurried
Central cyanosis may be present.
Chest may show no signs on examinations (or) there may be prolonged expiration with transient rhonchi present.
INVESTIGATION
Blood Count: May show leucocytosis in presence of acute infection.
Polycythaemia may develop in long standing cases.
X Ray Chest
Does not show any characteristics change.
Bronchography
May show irregularities of Bronchial lumen,
Pulmonary function test: May chow some impairment due to development of emphysema, simple measurement of ventilatory capacity and arterial Paco2 may help to determine the severity of airway obstruction.
Complication
- Emphysema
- Bronchiolar Spasm
- Bronchiectasis
- Rt heart failure (ch. Cor pulmonale).
EMPHYSEMA
Def:
It is a condition of generalized over distension of the lung alveoli with Rupture of interalveolar septae, over aeration of the alveoli, loss of alveolar elasticity, impairment of pulmonary function and increased lung volume due to various causes.
Aetiology:
- Chronic Bronchitis and chronic Bronchial asthma are common predisposing causes.
- In association with fibrotic pulmonary disease such as silicosis.
C/F:
- Breathlessness (exertional dyspnoea)
- Cough with expectoration are due to associated chronic bronchitis, they usually develop before the onset of breathlessness.
- Wheezing sound present.
Sign:
- Pink buffer cyanosis is present
- Clubbing of finger present
- Respiration rate hurried.
Examination:
Inspection : Barrel shaped chest
Palpation : Vocal fermitus is diminished
Percussion : Hyper Resonant note present
Auscultation : Rhonchi present
- X Ray Chest:
- Marked radio translucent lung fields with the fine vascular striations particularly at the periphery.
- Low and flat diaphragm.
Lung Function Tests:
Blood gas analysis shows Pao2 less than 50 torr and Paco2 more than 50 torr indicative of Respiratory failure.
Complication:
- Rt heart failure
- Spontaneous pneumothorax
BRONCHIAL ASTHMA
Def:
Asthma is defined as a chronic inflammatory disorder of the airways, characterized by Reversible airflow obstruction causing cough, wheeze, chest tightness and shortness of Breath.
Types:
- Early onset asthma (or) atopic
- Late onset asthma (or) Non-atopic
1. Early Onset Asthma:
- Commonly encountered in child hood.
- Family History of this disorder present.
- These individuals are usually atopic.
- Allergic skin tests positive
- IgE level raised
- H/o Allergy present
2. Late Onset Asthma:
- It occurs in any age.
- No family history disorders.
- Non-atopic individuals
- Extrinsic allergens play no part.
- Skin Hyper sensitivity test negative
- IgE level normal.
Aetiology:
- Infections
- Cigarette Smoking
- Temperature and Humidity
- Psychological factors
- Exercise
- Allergy
Triggers of the Asthmatic Response:
- Cold Air, Tobacco, Smoking, Dust, Acid Fumes, Resp. Viral infection and emotional stress.
- In children and young adults exposure to cold air and excretion.
- Previous exposure to antigents stimulate the formation of IgE antibody in the brochi, further on exposing in the allergens.
C/F:
- Episodic Asthma
- Chronic Asthma
- Severe Acute Asthma
1. Episodic:
- Paroxysms of wheeze and breathlessness may occur at any time and can be of sudden onset.
- Episodic asthma may be triggered by Allergens, exercise and Viral infections.
- The attacks may be mild (or) severe lasting for few hours, days (or) weeks.
- Atopic individuals with episodic asthma are worse in summer, when they are heavily exposed to allergens.
2. Chronic Asthma:
- Symptoms of chest tightness, wheeze and Breathlessness on exertion together with spontaneous cough and wheeze during night.
- Cough with mucoid sputum with recurrent episodes of Resp. infection is common.
- Chronic asthma pt. Are worse in winter due to increased exposure to viral infection.
3. Severe Acute Asthma (or) “Status Asthmaticus”
This term has replaced status asthmaticus which in life threatening at time of asthma.
- The patient often has an unproductive cough.
- Respiratory symptoms such as chest tightness and breadthlessness are accompanied by tachycardia, Pulsus Paradoxis, Sweating, and Central Cyanosis.
- The Pt adopts an upright position fixing the shoulder muscle to assist the accessory muscles of respiration.
Signs:
- During an attack when the chest is held in full inspiration, the percussion note is hyper resonance.
- Broncho vesicular Breath sound present.
- Added sounds – Rhonchi, High pitched polyphonic inspiratory and expiratory Rhonchi.
- In severe asthma airflow may be insufficiency of produce a Rhonchi and chest remains silent – it is a “Ominous Sign”.
INVESTIGATION
X ray chest
In an acute attack the lungs appears hyper inflated.
In between the episodes the chest x ray is normal.
Pigeon shaped deformity can be demonstrated on a lateral view x ray.
In severe acute asthma pneumothorax may be seen.
X ray may show mediastinal (or) subcutaneous emphysema.
Pulmonary Function Test:
- Measurement of force expiratory volume in one second, vital capacity and peak expiratory volume with given indication to the degree of airflow obstruction.
Arterial Blood Gas Analysis:
Measurement of partial pressure of PO2 and PCO2 is required in the management sever acute asthma.
Skin hypersensitivity test: It is depends upon the individuals.
Complications:
- Status asthmaticus
- Secondary infection – Bronchitis, Tuberculosis.
- Emphysema of lung
- Rt. Heart failure
- Bronchiectasis.
Homoeopathic Management (Murphy repertory)
Bronchitis. Chronic
Ant.tart hep
Am.carb hydr
ant .s ipecac
ars.alb kali bic
ars.iod kaliod
bac lyco
bar.m nit.ac
calc puls
canth seneg
carb. v stann
cop sulph
Emphysema
Am.carb calc.s
Ant.ars camph
Ant.Tart carb.veg
Hepar chlor
Lachesis dig
Loblia ip
Sil lyc
Ars merc
aur.m Nat.m
bell phos
brom stry
calc.p
From, smoking
am.c
calad
Bronchial asthma
Ambr lobil
Arg. Nit Nat.s
Ars puls
Ars.iod samb
Baltta sil
Carci spong
Cupr stram
Ip sulph
Kali ars visc
Kali carb Grindilia
Kali Nit
DEFINITION
In this Condition there is chronic obstruction to the alveolar in flow of air either due to chronic Bronchitis and / or emphysema and / or Bronchial Asthma.
Chronic Bronchitis may be complicated with emphysema but there may be predominance of any of them. Bronchial asthma also causes generalized airway obstruction and is dealt with separately. There may be considerable over lapping of these three diseases.
CHRONIC BRONCHITIS
DEFINITION
Ch. Bronchitis may be defined as a disease characterized by cough and sputum for at least 3 consecutive months in a year for more than 2 successive Years.
AETIOLOGY
Smoking
Atmospheric Pollution
Infection
Occupation (Coal miners)
Familial and genetic abnormalities associated with alpha1 , antitrypsin deficiency -may also be present.
Pathology
Develops airway wall inflammation
Hypertrophy of mucus secreting Glands and increases in the number of Goblet cells in bronchi and bronchioles with consequent
Decrease in ciliated cells,
Obstruction of air flow.
Pathology for Cyanosis
Due to uneven distribution of the inspired air
There may be diminished diffusing capacity
Airway obstruction gives rise to ventilation perfusion in equality.
Resulting in increased paco2 and decreased pao2 with severe ventilatory failure there is falling pH together with compensatory decrease in plasma bicarbonate and respiratory acidosis.
Cyanosis
Clinical Features
Gradual onset
Cough with expectoration: It is usually starts as attacks of “winter cough” and “Smoker’s cough”. Gradually increasing in severity and duration, the expectoration is mucoid (or) mucopurulent depending on the presence of infection.
Some time there may be haemoptysis.
Shortness of breath due to airway obstruction.
SIGNS
Respiratory rate is hurried
Central cyanosis may be present.
Chest may show no signs on examinations (or) there may be prolonged expiration with transient rhonchi present.
INVESTIGATION
Blood Count: May show leucocytosis in presence of acute infection.
Polycythaemia may develop in long standing cases.
X Ray Chest
Does not show any characteristics change.
Bronchography
May show irregularities of Bronchial lumen,
Pulmonary function test: May chow some impairment due to development of emphysema, simple measurement of ventilatory capacity and arterial Paco2 may help to determine the severity of airway obstruction.
Complication
- Emphysema
- Bronchiolar Spasm
- Bronchiectasis
- Rt heart failure (ch. Cor pulmonale).
EMPHYSEMA
Def:
It is a condition of generalized over distension of the lung alveoli with Rupture of interalveolar septae, over aeration of the alveoli, loss of alveolar elasticity, impairment of pulmonary function and increased lung volume due to various causes.
Aetiology:
- Chronic Bronchitis and chronic Bronchial asthma are common predisposing causes.
- In association with fibrotic pulmonary disease such as silicosis.
C/F:
- Breathlessness (exertional dyspnoea)
- Cough with expectoration are due to associated chronic bronchitis, they usually develop before the onset of breathlessness.
- Wheezing sound present.
Sign:
- Pink buffer cyanosis is present
- Clubbing of finger present
- Respiration rate hurried.
Examination:
Inspection : Barrel shaped chest
Palpation : Vocal fermitus is diminished
Percussion : Hyper Resonant note present
Auscultation : Rhonchi present
- X Ray Chest:
- Marked radio translucent lung fields with the fine vascular striations particularly at the periphery.
- Low and flat diaphragm.
Lung Function Tests:
Blood gas analysis shows Pao2 less than 50 torr and Paco2 more than 50 torr indicative of Respiratory failure.
Complication:
- Rt heart failure
- Spontaneous pneumothorax
BRONCHIAL ASTHMA
Def:
Asthma is defined as a chronic inflammatory disorder of the airways, characterized by Reversible airflow obstruction causing cough, wheeze, chest tightness and shortness of Breath.
Types:
- Early onset asthma (or) atopic
- Late onset asthma (or) Non-atopic
1. Early Onset Asthma:
- Commonly encountered in child hood.
- Family History of this disorder present.
- These individuals are usually atopic.
- Allergic skin tests positive
- IgE level raised
- H/o Allergy present
2. Late Onset Asthma:
- It occurs in any age.
- No family history disorders.
- Non-atopic individuals
- Extrinsic allergens play no part.
- Skin Hyper sensitivity test negative
- IgE level normal.
Aetiology:
- Infections
- Cigarette Smoking
- Temperature and Humidity
- Psychological factors
- Exercise
- Allergy
Triggers of the Asthmatic Response:
- Cold Air, Tobacco, Smoking, Dust, Acid Fumes, Resp. Viral infection and emotional stress.
- In children and young adults exposure to cold air and excretion.
- Previous exposure to antigents stimulate the formation of IgE antibody in the brochi, further on exposing in the allergens.
C/F:
- Episodic Asthma
- Chronic Asthma
- Severe Acute Asthma
1. Episodic:
- Paroxysms of wheeze and breathlessness may occur at any time and can be of sudden onset.
- Episodic asthma may be triggered by Allergens, exercise and Viral infections.
- The attacks may be mild (or) severe lasting for few hours, days (or) weeks.
- Atopic individuals with episodic asthma are worse in summer, when they are heavily exposed to allergens.
2. Chronic Asthma:
- Symptoms of chest tightness, wheeze and Breathlessness on exertion together with spontaneous cough and wheeze during night.
- Cough with mucoid sputum with recurrent episodes of Resp. infection is common.
- Chronic asthma pt. Are worse in winter due to increased exposure to viral infection.
3. Severe Acute Asthma (or) “Status Asthmaticus”
This term has replaced status asthmaticus which in life threatening at time of asthma.
- The patient often has an unproductive cough.
- Respiratory symptoms such as chest tightness and breadthlessness are accompanied by tachycardia, Pulsus Paradoxis, Sweating, and Central Cyanosis.
- The Pt adopts an upright position fixing the shoulder muscle to assist the accessory muscles of respiration.
Signs:
- During an attack when the chest is held in full inspiration, the percussion note is hyper resonance.
- Broncho vesicular Breath sound present.
- Added sounds – Rhonchi, High pitched polyphonic inspiratory and expiratory Rhonchi.
- In severe asthma airflow may be insufficiency of produce a Rhonchi and chest remains silent – it is a “Ominous Sign”.
INVESTIGATION
X ray chest
In an acute attack the lungs appears hyper inflated.
In between the episodes the chest x ray is normal.
Pigeon shaped deformity can be demonstrated on a lateral view x ray.
In severe acute asthma pneumothorax may be seen.
X ray may show mediastinal (or) subcutaneous emphysema.
Pulmonary Function Test:
- Measurement of force expiratory volume in one second, vital capacity and peak expiratory volume with given indication to the degree of airflow obstruction.
Arterial Blood Gas Analysis:
Measurement of partial pressure of PO2 and PCO2 is required in the management sever acute asthma.
Skin hypersensitivity test: It is depends upon the individuals.
Complications:
- Status asthmaticus
- Secondary infection – Bronchitis, Tuberculosis.
- Emphysema of lung
- Rt. Heart failure
- Bronchiectasis.
Homoeopathic Management (Murphy repertory)
Bronchitis. Chronic
Ant.tart hep
Am.carb hydr
ant .s ipecac
ars.alb kali bic
ars.iod kaliod
bac lyco
bar.m nit.ac
calc puls
canth seneg
carb. v stann
cop sulph
Emphysema
Am.carb calc.s
Ant.ars camph
Ant.Tart carb.veg
Hepar chlor
Lachesis dig
Loblia ip
Sil lyc
Ars merc
aur.m Nat.m
bell phos
brom stry
calc.p
From, smoking
am.c
calad
Bronchial asthma
Ambr lobil
Arg. Nit Nat.s
Ars puls
Ars.iod samb
Baltta sil
Carci spong
Cupr stram
Ip sulph
Kali ars visc
Kali carb Grindilia
Kali Nit
Thursday, 16 June 2011
Nails- Importance in diagnosis
Nails- Importance in diagnosis
Our nails are a sign of our health. The colour shape, contour of our nails can tell us if our body is in a healthy state.
Nail disorders
Changes in nail are generally not diagnostic of a specific systemic or skin disease .all of the nail changes of systemic disorders may be seen without systemic disease.
Examination of nails helps us sometimes to diagnose a case clinically. Simultaneously we should not forget the value of study of nail changes in Homoeopathic practice
Different nail abnormalities Associated conditions
Platynychia (flat nails) Iron deficiency anemia
Koilonychia (spoon shaped nails) Iron deficiency anemia
Leuconychia (white nails) congenital or acquired
Hypoalbuminemea,
Nephrotic Syndrome
Chronic liver disease
Protein loosing enteropathy.
Onycholysis (Separation of nail from bed) Lichen planus, thyrotoxicosis Psoriasis.
Missing nail Nail patella syndrome.
Half & Half nail Proximal half- white and distal half
pink or red seen in chronic renal failure
Beau’s line
(Transverse ridges over the nails) Indicates stoppage of nail Growth temporarily. Affects all nails and appear after few week of illness. As the nail growth ridges also move to the distal part.
Mee’s line single or multiple which transverse bands on the nail- inorganic arsenic poisoning
Muehrcke’s line Narrow, white transverse bands occurring in pairs - associated with hypoalbuminaemia, they may disappear when serum albumin level is normalized
Longitudinal ridges Seen in lichen plannus and rheumatoid arthritis.
Nail bed infarct Vasculitis syndromes
Pitted Nails Psoriasis, Alopecia, eczema, ring worm infestation.
Blue Seen in cyanosis, antimalarial drugs, haematoma
Blue green In pseudomonas infection in chronic paronychia
Brown longitudinal streaks In fungal infections, staining from cigarettes
Red streaks
(Splinter hemorrhages) Infective endocarditis, trauma.
Yellow In psoriasis, fungal infections, trauma, jaundice,
* Clubbing Bulbous enlargements of distal segments of fingers and toes.
Causes;
a) Cardiovascular:
Acquired --- infective endocarditis.
Congenital---cyanotic congenital heart disease.
b) Respiratory;
-Brochiectasis
- Lung abscess.
-Bronchogenic carcinoma.
-Tuberculosis with secondary infection.
-Empyema
-Interstitial lung disease
c) Gastrointestinal;
-ulcerative colitis,
-Crohns’disease.
-Malabsorbtion syndrome.
d) Hepatic
-cirrhosis of liver.
e) Endocrine;
-Myxedema.
- Acromegaly.
-Thyroid acropachy,
f) Congenital & idiopathic clubbing.
Homoeopathic drugs according to the Nail colour, changes.
Discoloration, Nails _ Ant. c, Ars, Graph, Nit.ac, Thuja.
Black - Ars, Graph, Lept, Nat-m.
Blood, settles under Nails _ Apis.
Blueness _ Arg.n, Ars, Aur, camph, Carb.v, Chel,Chin, chin.s, Cupr, Dig, Dros, Ferr, Graph, Mez,
Nat.m, Nit.a, Nux.v, Ox.ac, Pet, Sil, Sulph,Thuja, Verat.
Dark _ Morp, Ox.ac,
Gray _ Mer.c, Sil,
Purple _ Apis, Ars, Op, samb, sec, stram,
Red _ Ars, Crot.c, Lith,
-Then black - Ars.
White - Cup, Nit.ac.
-Spots - Alum, Ars, Nit.ac, Sep, Sil, sulph,
Yellow - Ambr, Bry, Carbo.v, Con, Lyco, mer Nit.ac, Nux.v. Op, Sep, Sil, Sipg, Sulp,
Cracked Nails - Ant.c, Ars, Nat.m, Sil,
Curved finger Nails - Nit.ac.
Distorted, Nails - Alum, Fl.ac, Graph, Merc, Sep, Sil, Thuja.
In growing, Nails - Caust, Graph, Mag-aust, Nat.M, Nit.ac, Ph.ac, sil, Sulph, Teucr, Thuja,
Splinters, Nails - Alum, Ars, Nit.ac, Ph.ac, Sep, Sil, Sulph, Tub.
Spotted, Nails - Alum, Ars, Nit.ac, Ph.ac, Sep, Sil, Sulph, Tub.
Ulcers, fingernails - Bov, Hep, Merc, Nat.M, Sil, sulph, thuja,
Panaritium nails - All.c, Am.c,Am.m, Anac, Anthr, Apis, Benz.ac, Bufo, Calc, Caust, Cist, Dios, Fl.ac, Hep, Hyper, iod, iris, lach, lyc, Merc, nat.c, Nat.m, Nat.s, Nit.ac, Phyt, Rhus.tox, Sang, Sep, sil, Sulph, Tarent.c,
NOTE: Close observation and minute study about the nails is important for clinical diagnosis and also to select a remedy while treating homeopathically
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