BRONCHITIS AND HOMOEOPATHIC APPROACH

BRONCHITIS AND HOMOEOPATHIC APPROACH
Dr. S. Sabarirajan., M.D. (Hom)

Do you have a cold, chest discomfort and an irritating cough that may be lasting for weeks? If these symptoms sound familiar then you possibly have Bronchitis. Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. Bronchitis can be divided into two categories, acute and chronic, Acute Bronchitis is caused by a virus that gives you common cold whereas in Chronic Bronchitis the air passages are continuously red, swollen, become narrow and clogged with mucus which makes it easier for bacteria to settle in the airways and become infected.
Acute bronchitis is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated(coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis, whereas bacteria account for fewer than 10%.
Chronic bronchitis, a type of chronic obstructive pulmonary disease, is characterized by the presence of a productive cough that lasts for three months or more per year for at least two years. Chronic bronchitis most often develops due to recurrent injury to the airways caused by inhaled irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants.
Protracted bacterial bronchitis is defined as a chronic wet cough, with a positive bronchoalveolar lavage (BAL). It is usually caused by streptococcus pneumoniae, haemophilus influenzae, or moraxella catarrhalis.
Causes of bronchitis:
- Allergy (environmental and industrial pollutants, pollen, etc.)
- Tobacco
- Infections (viral, bacterial, fungus
- Immunological
- Exposure to temperature changes (extreme cold, change from cold to heat and vise versa, etc.)
Symptoms:
Cough is the most common symptom. The cough may be either dry (without mucus) or wet (with mucus), depending on the cause and severity. Allergic cough is often dry while infective cough has a tendency to have mucus production. The symptoms of Bronchitis may be listed as under:
 Cough (with or without mucus)
 Fever
 Chest pain,
 Difficulty in breathing. (dyspnea)
 Throat pain
 Nose congestion,
 Body ache, joint pain, tiredness (usually due to infection.)
 Abnormal sounds in the lungs called rales or other abnormal breathing sounds may be heard.
Investigation may include:
• Chest x-ray
• Lung function tests provide information that is useful for diagnosis and outlook.
• Pulse oximetry helps determine the amount of oxygen in blood. This quick and painless test uses a device that is placed onto the end of our finger. Arterial blood gas is a more exact measurement of oxygen and carbon dioxide levels, but it requires a needle stick and is more painful.
• Sputum samples may be taken to check for signs of inflammation or bacterial infection.

Recurrent or long lasting Bronchitis make you vulnerable to recurrent respiratory infections and also promote lung complications. A few of the most common complications are:
• Pneumonia is a viral, bacterial or fungal infection of the lungs where the air sacs get filled with pus and mucus preventing oxygen from reaching your blood stream appropriately.
• Emphysema is a condition when the lungs lose its elasticity due to troublesome breathing causing air to be trapped in the air sacs and impairing the exchange of oxygen and carbon dioxide.
• Respiratory failure occurs when the body fluids become acidic and the lungs are unable to expel all the carbon dioxide that the body produces.


Self – Care Measures:
• Stop smoking and also avoid second hand smoke.
• Avoid triggers of attack such as dust, allergens, etc.
• Avoid contact with persons who have Bronchitis.
• Wash your hands more often.
• Get lots of rest so your body has enough energy to fight the infection.
• Drink plenty of water.
• Try coughing up the mucus.
• Eat a healthy diet.
• Use a humidifier in your room.
• ½ tsp. of Turmeric powder in ½ cup of warm milk is an effective home remedy for Bronchitis.
• 1 tsp. of raw onion juice in the morning has beneficial expectorant properties, it liquefies the mucus and prevents its further formation.
• Include garlic in your diet, it is a natural antibiotic.
• Hot towel application over the chest in 3 consecutive turns for 3 minutes each followed by one cold towel turn is very helpful in Acute as well as Chronic Bronchitis.
• Vitamin C intake like fresh orange juice or fresh lemonade is very helpful in preventing and hastening cure of respiratory infections.
• Fresh air and outdoor exercises are essential for Bronchitis patients.
Homoeopathy Treatment & Homoeopathic Remedies
Homoeopathy, the most efficient solution to conquering Bronchitis, is very successful in managing all the symptoms of Bronchitis, and as well plays a significant role in preventing further complications and improving the general health of the person. Homoeopathic approach concentrates on the body’s natural healing ability for a genuine cure of the condition. Homoeopathic treatment does not treat the disease itself, but is prescribed on the basis of physical, emotional and genetic make up that individualizes a person. The healing response is the most arduous but harmonized activity within the human physiology and often cannot be enhanced appreciably without a comprehensive natural Homeopathic approach.
Homeopathic treatment will clear up the infection, alleviate inflammation in the air passages, relieve discomfort, pain and pressure caused by coughing by opening the airways in your lungs and aid in loosening the bronchial secretions making elimination of mucus easier helping you breathe better and naturally. Its constitutional approach furthermore boosts up the immune system of the patient hence preventing recurring infections. Since Homoeopathic remedies treats in totality, it leads to a long-lasting cure, rather than a temporary suppression of symptoms. Since it is safe and gentle, devoid of all chemical toxicity, it is the ideal medicine for people of all ages, even the most sensitive like a newborn baby.
Antimonium tartaricum: This remedy is indicated when the person has a feeling of wet mucus in the chest, and breathing makes a bubbly, rattling sound. The cough takes effort and is often not quite strong enough to bring the mucus up, although burping and spitting may be of help. The person may feel drowsy or dizzy, and feel better when lying on the right side or sitting up.
Bryonia: This remedy is often indicated when a cough is dry and very painful. The person feels worse from any movement, and may even need to hold his or her sides or press against the chest to keep it still. The cough can make the stomach hurt, and digestion may be upset. A very dry mouth is common, and the person may be thirsty. A person who wants to be left alone when ill, and not talked to or disturbed, is likely to need Bryonia.
Belladonna: Sudden, violent attack of dry cough, which comes in short bouts and causes redness of the face, a sensation of constriction in the throat, the cough is worse when lying down at night. These symptoms require urgent need of the said medicine. The dry cough usually disturbs sleep, it lessens with warm drinks and in a warm room, and there is a dislike for open air also.

Calcarea carbonica: This remedy is often indicated forbronchitis after a cold. The cough can be troublesome and tickling, worse from lying down or stooping forward, worse from getting cold, and worse at night. Children may have fever, sweaty heads while sleeping, and be very tired. Adults may feel more chilly and have clammy hands and feet, breathing problems when walking up slopes or climbing stairs, and generally poor stamina.
Causticum: Bronchitis with a deep, hard, racking cough can indicate a need for this remedy. The person fees that mucus is stuck in the throat and upper chest, and may cough continually to try to loosen it. A feeling of rawness and soreness can develop, or a sensation as if a rock is stuck inside. Chills can occur along with fever. Exposure to cool air aggravates the cough, but drinking something cold can help. The person may feel worse when days are cold and clear, and better in wet weather.
Drosera : The symptoms that confirm the use of medicine Drosera 30 can be mentioned as violent, dry, whooping cough in young persons, bouts of cough follow each other so rapidly that the child gets breathless, turns blue and sweats profusely.Sensation of a feather in the throat that excites cough, the cough is worse from talking, singing, when lying down. These can be said as the other symptoms. At night; the person desires to be in open air.

Dulcamara: When a person easily gets ill after being wet and chilled (or when the weather changes from warm and dry to wet and cool) this remedy may be indicated. The cough can be tickly, hoarse, and loose, and worse from physical exertion. Tendencies toward allergies (cats, pollen, etc.) may increase the person’s susceptibility to bronchitis.
Hepar sulphuris: The cough that fits this remedy is usually hoarse and rattling, with yellow mucus coming up. The person can be extremely sensitive to cold—even a minor draft or sticking an arm out from under the covers may set off jags of coughing. Cold food or drink can make things worse. A person who needs this remedy feels vulnerable both physically and emotionally, and may act extremely irritable and out of sorts.
Ipecacuanha : when the person is suffering from various problems such as dry cough with wheezing and rattling in the chest and accompanied by nausea and vomiting, a bout of vomiting does not relieve nausea, long bouts of cough render the person breathless and blue in face, cough is worse in cold, dry weather i.e. winter but improves by warmth, and thirstlessness.

Kali bichromicum: A metallic, brassy, hacking cough that starts with a troublesome tickling in the upper air-tubes and brings up strings of sticky yellow mucus can indicate this remedy. A sensation of coldness may be felt inside the chest, and coughing can lead to pain behind the breastbone or extending to the shoulders. Breathing may make a rattling sound when the person sleeps. Problems are typically worse in the early morning, after eating and drinking, and from exposure to open air. The person feels best just lying in bed and keeping warm.
Pulsatilla: Bronchitis with a feeling of weight in the chest, and a cough with choking and gagging that brings up thick yellow mucus, may respond to this remedy. The cough tends to be dry and tight at night, and loose in the morning. The fever may be worse in the evening and at night. Feeling too warm or being in a stuffy room tends to make the person worse, and open air brings improvement. Thirst is usually low. A person who needs this remedy often is moody and emotional and wants attention and sympathy. (This remedy is often helpful to children who are tearful when not feeling well and want to be held and comforted.)
Silicea: A person who needs this remedy can have bronchitis for weeks at a stretch, or even all winter long. The cough takes effort and may bring up yellow or greenish mucus, or little granules that have an offensive smell. Stitching pains may be felt in the back when the person is coughing. Chills are felt more than heat during fever, and the person is likely to sweat at night. A person who needs this remedy is usually sensitive and nervous, with low stamina, swollen lymph nodes, and poor resistance to infection.
Sulphur: This remedy can be indicated when a person has had many bouts of bronchitis (sometimes the resistance has been weakened by taking antibiotics too often for minor complaints). The cough feels irritating, burning, and painful; yellow or greenish mucus may be produced. Problems can be worse if the person gets too warm in bed, and breathing problems at night may wake the person up. Redness of the eyes and mucous membranes, and foul-smelling breath and perspiration are often seen when a person needs this remedy.
References

1. Harrison's Principles of Internal Medicine
2. http://en.wikipedia.org/wiki/Bronchitis
3. Homeopathic Materia Medica by Boericke
4. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002078/
5. Lilienthal S., Homoeopathic Therapeutics
6. http://health.hpathy.com/bronchitis-symptoms-treatment-cure.asp
7. http://www.indianetzone.com/24/homeopathy_bronchitis.htm
8. www.homeopathic-cure.com/bronchitis and homeopathy
9. Dewey W. A., Practical Homeopathic Therapeutics
10. http://www.askdrshah.com/app/bronchitis.asp
11. http://truestarhealth.com/Notes/2202000.html#Homeo-Options
12. Principles of Prescribing, Dr. K.N.Mathur.


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.

COMMON EYE AFFECTIONS &HOMOEOPATHY

COMMON EYE AFFECTIONS AND HOMOEOPATHY
When we look at a person, what do we look at first? Obviously, eyes! Also when we speak to someone, we do not feel that the conversation is fruitful unless have good eye contact with that person. No wonder experts always give high priority to eyes when it comes to personal well-being. No one likes haggard, dull-looking eyes that reflect the internal ill-health. And therefore, one should take appropriate care of their eyes and enjoy various colors of life. Any serious trouble in connection with the eyes must always receive the most expert care and attention without any delay. There are, however, some eye conditions to which reference can be made here with advantage.
Homeopathy is the holistic mode of treatment that treats the person as a whole and not merely his external manifestation. Therefore, when there is some problem with the eye (unless it is local injury problem), homeopathy believes that it is due to some internal malady that is reflecting through your eyes. Therefore, detailed history of patient is taken even if he has problem only pertaining to eyes.
EYE PROBLEMS THAT CAN BE DEALT EFFICIENTLY WITH HOMOEOPATHY:
Eye strain
This is a rather vague term and usually refers to a sore, tired sensation in the eyes, attributed rightly or wrongly to over – use. It is, of course, necessary to check the vision for any error of refraction which may need correction by glasses. There may be occupational causes related to the type of work engaged in, or the lighting of the room in which the work is carried out; and it may be possible to make adjustments in respect of such causes of strain.
Remedies which may help in this condition are
AGARICUS – letters seem to swim or above when reading, twitching in lids, eyeballs oscillate from side to side, may be double
CAUSTICUM – vision dim, film before eyes, desire to close eyes, lids feel heavy, eye muscle weak
GELSIMIUM – vision dim, eyeballs sore especially when moving them, eyelids droop, feels very heavy, possibly double vision
JABORANDI – eyes tire easily, sensation of heat and burning, indistinct vision, contracted pupils, white spots before eyes
NATRUM MUR – eyes give out while reading or sewing, letters or stitches run togrther, eyeballs feel too large, objects appear ringed with fiery zig zags, hot tears stream down face when reading, lids feel gritty, spasmodic closure of lids
PHOSPHORUS – vision obscured by mist or veil, red mist or black spots before eyes, eyes tire easily on use, sees better by shading eyes with hand
RUTA – weakness of vision with blurring, eyes ache while in use, eyes feel hot and burning, especially in evening, eyes water, green halo seen round artificial light, spasm of lower lids
Black specks before the eyes
It is not at all an uncommon experience to notice small black specks or twirligigs apparently floating in front of the eyes. Moreover they change position readily with every movement of the eyes or head. They seem obvious some days ans less noticeable at other times. These specks and spirals rejoice in the name of muscae volitantes and have been attributed to various causes without much confirmatory evidence. In any case they are of little significance and can be disregarded. If especially troublesome a few doses of AGARICUS, CHINA, NUXVOMICA or PHOSPHORUS, according to general indications, may afford relief
Bloodshot eye
Inflammations of the eye, whether superficial or deep, are accompanied by redness, often of a dusky hue, as well as by pain and distress. These call for treatment by an eye specialist. But occasionally, often without obvious cause, a flaming patch of red discoloration may be observed to one or other side of the pupils and iris. This is due to a haemorrhage beneath the conjunctiva and outside the actual eyeball. It is somewhat alarming in appearance but more unsightly than serious in significance
A few doses of ARNICA will speed recovery and allay any pain that may be present. If absorbtion of the blood is delayed LEDUM may be substituted for the ARNICA
Lachrymation
A watery or other discharge from the eye calls for expert attention, especially if severe or persistent. As an immediate measure pending fuller investigation, one or other of the following remedies may be given
ARSENICUM ALBUM – much burning in eye, discharge which is hot and excoriating, intense photophobis
ALLIUM CEPA – streaming eyes and nose, associated with much sneezing, discharge makes nose sore but not skin around eye
EUPHRASIA – eyes water all the time, discharge is burning and acrid, constant blinking
PULSATILLA – profuse yellow discharge, which does not excoriate the skin, worse in warm room, lids sore
For bathing the eye either EUPHRASIA or HYPERICUM can be used as lotion (two drops of mother tincture to the eye-bath of water)
Quivering Lids
Sometimes a sudden quivering or twitching is felt in one or other eyelid. This is a distressing sensation and seems to occur for no apparent reason. It usually passes off quite quickly and is not a cause for alarm. Various remedies recommended for this condition, among them AGARICUS, BELLADONA, CALC CARB, CICUTA are very useful
Styes
Recurrent styes on the eyelids will call for careful assessment on constitutional lines by a physician. Various remedies may have to be considered but in many cases GRAPHITIS, PULSATILLA or SULPHUR will give relief, as a local application a compress of HYPERICUM lotion (ten drops of mother tincture to the half pint of water) should be helpful.
Eye Injuries
Eyes must be treated with even more respect than ears. The most expert and skilled attention is called for in almost any type of eye injury. As a temporary measure a moist pad of HYPERICUM lotion (ten drops of mother tincture to the half pint of cold water) may be placed over the eye and ARNICA 200 administered. If there is much pain this can be followed by HYPERICUM 6 in hourly doses till relief is obtained. An alternative remedy is ACONITE, which has been called the Arnica of the eye, give a few doses in 30 potencies
If the pain is felt in the eyeball SYMPHYTUM 6, PHYTOLACCA 6 or COLOCYNTHIS 6 may be given. Pain persisting for a long time after the injury may yield to ARNICA 30, twice daily for a few days. If there ia a speck of dust or other foreign bodies in the eye it should be bathed in HYPERICUM lotion (two drops of mother tincture to the eye-bath of water). If after this the object is still felt to be present the lids may be everted and if the speck is visible an attempt should be made to wipe it off with a wisp of soft hand kerchief dipped in the HYPERICUM lotion. If the object is firmly embedded and cannot be easily wiped off, expert aid must be sought without delay. For persisting pain or discomfort after removal of the object, the eye should be bathed with EUPHRASIA lotion (two drops of mother tincture to the eye-bath of water) and EUPHRASIA 6 given internally. A very useful fluid for the use as an eye-wash is an infusion of tea leaves, warm or cold as preferred
In the black eye the damage is mostly around the orbit and the pain and discoloration and swelling cause both distress and disfigurement. ARNICA 30 should be given hourly upto five or six doses, or, if the relief is obtained by cool applications, LEDUM 30. Further treatment may be with ARNICA 6 or, if the eye is painful then HYPERICUM 6
A pair of lovely black eyes, unless separately administered, may indicate a fracture of the base of the skull and immediate steps must be taken to obtain expert advice. ARNICA should of course be given a dose or two of 200, and 30 or 6 to follow.
For quick control of bleeding in a cut eye apply firm pressure with a pad soaked in equal parts of CALENDULA tincture and cold water.
Glaucoma
Common form of glaucoma is associated with an increase in the fluid pressure inside the eye. This pressure may cause damage to the optic nerve and Vision loss may result.
GELSEMIUM (gels) - Eye signs are eyelids heavy, glaucoma and descemetitis, dim-sighted, pupils dilated and unaware of light, orbital neuralgia, detached retina, hysterical amblyopia. General signs are motor paralysis, dizziness, drowsiness, dullness, and trembling, muscular weakness. Mind signs are dullness, languor, listless, apathy about his illness. Head signs are vertigo, pain in the temple, extending into the ear.
PHYSOSTIGMA (physost) - Eye signs are glaucoma, night blindness, photophobia, contraction of pupils, twitching of ocular muscles, partial blindness, paresis of accommodation, astigmatism, a spasm of ciliary muscle, with irritability after using eyes, increasing myopia. General signs are spinal irritation; head cannot bear to raise eyelids. Mouth signs are tongue feels sore on the tip. Heart signs are fluttering of heartfelt in the throat.
RUTA GRAVEOLENS (ruta) - Eye signs are pressure deep in orbits, pressure over eyebrow, eyestrain followed by headache, disturbances of accommodation, weary pain while reading, and asthenopia. General signs are flexor tendons; all parts of the body are painful, as if bruised, feeling of intense weakness, weakness, and despair.
SPIGELIA (spig) - Eye signs feel too large pressive pain on turning them; Pupils dilated, photophobia, rheumatic ophthalmia, severe pain in and around eyes, extending deep into the socket. Neurological signs are ciliary neuralgia, a true neuritis.General signs are touch sensitive; parts feel chilly, send a shudder through a frame.
CATARACT Any opacity that may occur in the lens or its capsule or both is called cataract.It is one of the commonest forms of interference with vision generally with the advancement of age.some important homoeopathic remedy for cataract are Calcarea fluorica; Calcarea phosphorica; Causticum; Cineraria; Conium maculatum; Fluoricum acidum; Magnesium carbonicum; Natrium muriaticum; Nux vomica; Phosphorus; Santoninum; Silicea.
Mother tinctures effective for eye affections are as follows
EUPHRASIA Q – it is very effective in acute eye affections, traumatic conjunctivitis, blepharitis and corneal ulceration with acrid discharges
ZINCUM SULPH Q – very useful for corneal opacities
ARGENTUM NITRICUM – useful for purulent Ophthalmia, pus is thick, yellow and bland worse in warm room or fire better in open air
CINERARIA MARITIMA Q - it is very effective in cataract one drop 4-5 times a day should be instilled in the eyes for several months. It also useful in corneal opacities after trauma

References

1. Harrison's Principles of Internal Medicine
2. Wikipedia.com/eye afections
3. Homeopathic Materia Medica” by Boericke
4. http://healthy-ojas.com/eye/eye-remedies-homeopathic.html
5. Quick Bedside Prescriber – J.N.SHINGHAL.
6. First aid Homoeopathy in ailments by B.Jain
7. http://onlinehomeopath.hubpages.com/hub/Eyecare-and-homeopathy
8. http://www.medwonders.com/medblogs/general/cataract-and-homoeopathy-2038.htm
9. HOMPATH software
10. Principles of Prescribing, Dr. K.N.Mathur.
11. Mother tincture therapeutics and materia medica by Dr. Vinay jain


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.

STEPS TO MANAGE SLEEP DISORDERS

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.

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.

ROTP Participated at Kulasekaram ,

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.

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