VALUE ADDITION

LIST OF ARTICLES BY DR.SUBHASH CHAND

LIST OF ARTICLES BY DR.MANJEET SINGH OBEROI

1.Breathing Technique VS. Flow of Vital Force

LIST OF ARTICLES BY DR. AJAY KUMAR GROVER AND DR. TUSHITA

2.EFFICACY OF ANACARDIUM IN THE TREATMENT OF HYPOTHYROIDISM

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New Perspective – An Introduction

Dr. Subhash Chand* *Chief medical officer , Health department, New Delhi Municipal Council , New Delhi Ex. Asst. Research Officer, Central Council for Research in Homoeopathy

Homoeopathy has completed more than two hundred years of its existence solely because of its effectiveness in treating a variety of diseases that too with least cost yet it has been constantly challenged for its placebo like action. The non reproducibility of results under identical conditions is its biggest drawback. This problem has been addressed with a different approach in the attached article on Homoeopathic law of similars –is it really a law? One is advised to go through the contents of that paper before understanding the concept of this website. It should be clear that Hahnemann was unknowingly digging out several principles of Ayurveda from analysis of his observations and many of his remarks about modes of evaluating curative properities of medicine in Medicine other than drug-proving on healthy human beings has proved contrary in homoeopathic pracitce. We are of the opinion hat Hahnemann’s rules and laws related to the practice of Homoeopathy need to be interpreted and expanded in the light of Indian Ayurveda, modern medicine, Yoga, eclectic herbal literature, chemistry, physics, biochemistry and botany etc. The website www.homoeopathyaddedvalue.com aims to discuss several controversial issues in Homoeopathy with special reference to Ayurveda, eclectic herbal medicine and chemistry so that such issues are resolved through general consensus and certain value could be added to our system. It is out of scope of this site to discuss basic principles of Ayurveda, eclectic medicine as well as chemistry. The reader is advised to go through these subjects through different websites available on net so that the contents of this site are better understood.

Our Materia Medica is a special reference book. It is being prepared to standardize the indications of medicines in homoeopathic practice. Homoeopathic symptoms of a standard homoeopathic Materia Medica are being compared with the available Ayurvedic, eclectic, herbal as well as modern medicine literature. Only those indications are being given which are common to other system also. The site favors the use of more than one medicine at a time in case it is needed. Use of more than one medicine at a time and frequent use of surrogates is an established effective mode of using medicines in Ayurveda. Hahnemann did approve use of more than two medicines at a time. There are definite rules and a strong philosophy to mix medicines in Ayurveda and one should apply that logic before indulging in such practice. Several over the counter homoeopathic products contain multiple medicines and their use and turnover is a strong proof in support of effectiveness of multiple medicines at a time. The process can be definitely hastened as well as certainty of cure can be ensured by using more than one medicine at a time.

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Breathing technique versus the flow of Vital force

Dr. Manjeet Singh Oberoi, M.B.B.S., M.D.(Neurology)

Additional Medical Superintendent, Safdarjung Hospital

drmanjitsinghji@yahoo.com

Breathing is essential to our survival. Normally it is an involuntary act under the control of autonomic nervous system. But it can also be voluntary altered through efforts of the will. It is more than mere exchange of gases through nostrils. Indian Yoga considers it as a way to control the Prana in body. There are two parts of the nose known as nostrils through which air enters the lungs, the left one is known as Chandra Swara and the right one as Surya Swara. Normally breathing takes place through one nostril at a time and it keeps on changing from time to time. These are also termed as alternate cycles of breathing. This pattern of breathing through one nostril at a time is an important natural mechanism to adjust the body metabolism according to changes in internal (emotions, stimulation of senses,

diet) as well as external environment ( heat and cold ) . Maintenance of normal body temperature is crucial to the normal functioning of the body and this is usually achieved at subtle level through this cycle of breathing. It has been scientifically demonstrated in several yoga studies that left nostril breathing reduces the BMR and thereby corresponding consumption of oxygen as well as temperature is reduced and right nostril breathing increases the BMR with corresponding increase in oxygen consumption as well as temperature.

Yoga mentions five levels of energy body in the form of different Koshas or bodies. Annamaya Kosha (physical body), Pranamaya Kosha (Vital body or Pranic body), Manomaya Kosha (Mind), Gyanamaya Kosha (Intelligence) and Anadamaya kosha ( Spirit). Pranamaya Kosha is next to the Annamaya kosha (gross level) and directly controls the functioning of our body. Gyanamaya and Manomaya are more subtle in energy. Each Kosha affects the lower one. The disturbances in the circulation of Prana come under Vata disorders in Ayurveda. Vata disturbance is considered essential to the genesis of any disorder in the body. Together with disturbed Kapha and Pitta, it is the cause of all disorders affecting the mankind.

Importance of the Pranamaya kosha was also recognized by Hahnemann. He termed it as the Vital force or the vital principle. Hahnemann did mention that harmonious flow of vital force is pre requisite for good health. Apart from internal medicines, Hahnemann did mention use of Mesmerism and Magnetism to correct the flow of vital force in diseased persons. Probably the idea of controlling the prana or vital force through breathing was not known to him and the subject of vital force has not been studied in more details after him.

There is a well known shloka in Ayurveda “Yatha shule tatha vayu”. It means –“Wherever there is pain there is stagnation of energy or Prana”. It is also known that pranic circulation can be altered through different breathing techniques like breathing through one nostril at a time or Anuloma Viloma Pranayam (AV Pranayam). The AV pranayam is also known as Nadi shodhan pranayama (Nadi means channels of Pranic flow).

Taking these facts into consideration, we thought of curing pains through different techniques of breathing. Patients suffering form any type of pain were advised to do AV Pranayam or one nostril breathing depending upon the predominant doshas for half an hour morning and evening for few days. It was also observed by us that Left nostril breathing activates energy system or Pranamaya kosha of the left side of the body and has a cooling effect which is bilateral i.e. on the entire body and right nostril activates energy system or Pranamaya kosha of right side of the body and has a heating effect which is bilateral i.e. on the entire body

Patients with predominant complaints on left side of the body or those with excess of fire element in the form of Pitta were advised left nostril breathing and those with predominant complaints on right side of the body or Kapha disorders were advised right nostril breathing. Patients with complicated doshas were advised AV pranayam. Most of the patients reported diminishing of their pains within ten to fifteen days and were completely cured within four to six months without giving any medicines. Patients with unilateral pain were improved slowly than those with bilateral pain.

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Homoeopathic law of similars –is it really a law? Its relation with Ayurveda

Dr. Subhash Chand*
*Chief medical officer ,
Ex. Asst. Research Officer, Central Council for Research in Homoeopathy
Health department, New Delhi Municipal Council , New Delhi

Abstract: The existence of homoeoapathic law of similars has never been questioned by the homoeopathic profession. Fundamental Research studies to evaluate it have yet to be undertaken. Medicines, herbal as well as non herbal are used by other systems of medicine, their use in the triturated form do not make them homoeopathic unless they are applied on this law. Hahnemann’s conclusion of the existence of the law based on similarity between proving symptoms of certain medicines which were known to be specific in certain conditions needs reconsideration. Proving of new drugs failed to generate future specifics for use in orthodox medicine. Occurrence of aggravations forced Hahnemann to reduce the dose in a manner which was called potentisation. Different scales of potentisation failed to control the aggravations especially with repetition of these medicines. Further law could not be effectively applied on the basis of individualization to all types of cases. Hahnemann had to classify cases into different categories with different meanings of similarity in each case of disease. Even this failed to give lasting relief in chronic cases, and concept of chronic miasms was proposed for effective application of law in chronic cases. The law was supposed to operate through dual action of medicines i.e. primary and secondary and the opposite action of small and large doses of such medicines. Such type of dual drug actions is not universal and only very few medicines act on these lines. Primary symptoms hold supreme value in the operation of the law but the Materia medica contains secondary as well as clinical symptoms. The concept of second prescription is unrealistic with the law of similars. Over the time, pathological simillimums have failed to establish themselves as the superior basis of prescription in support of the law. Homoeopathy has failed to clearly identify how the application of law influences the traditional use as many medicines common to both the systems and many a times symptoms are treacherously altered to be used on the law of similar. Inclusion of Biochemic medicines, Bach flower medicines, sarcodes, nosodes, partially or unproved medicines, clinically proved medicines in the homoeopathic materia medica etc. along with use of external applications as well as patent medicines in practice is in violation to the law of similars and indicates existence of other laws operating in the process of cure. Emergence of different schools in homoeopathy with special interpretation of rubrics not observed during proving and their acceptance and effectiveness proves the same. Certain Homoeopathic principles and processes such as three chronic miasms as the root cause of disease, process of trituration, olfaction as a means of administration of medicine, use of metals and non metals are common to Ayurveda. Ayurveda is much more than mere antipathic mode of treatment (shaman chikitsa) as it includes other curative mode known as Panchakarma treatment (shodhan chikitsa). A comparative study of both these systems can provide answers to many questions addressed in this paper related to the law of similars. Probably few of the homoeopathic medicines operate through technique of shodhan chikitsa in Ayurveda.

Discussion:

The existence of law of similars that is let likes be treated by likes as propounded by Hahnemann has never been questioned by homoeopathic fraternity. Most research studies (about 90 %) aim at proving the efficacy of homoeopathic treatment in particular disease condition or isolated cases or at the most demonstrating the action of potentized medicines on human beings or on microorganisms. It is to be clearly understood that demonstration of positive action of potentized medicines alone has nothing to do with the applicability of medicines on the basis of law of similars. It is an entirely separate issue. It is a part of fundamental research. The fundamental research aimed at proving the existence, scope and applicability of law of similars in different animal models has not yet been conceived and has not received due attention of the homoeopathic community. Before we go further, it has to be clarified that application on drugs on the basis of law of similars and identification of action of highly potentized drugs on living forms are two separate issues.

Homoeopathy has been frequently challenged by the scientific fraternity because of its pharmaceutical preparation and usage of potentized drugs. There are enough evidences and studies that homoeopathic medicines in potencies do act but their action is never uniform in a particular condition or case and many a times not repeatable in similar disease conditions even with the same treating physician , here we need to re-look at the principle of similars with an UNPREJUDICED mind.
Medicines derived from difference sources such as plants, animals, minerals, diseased products have been used since the time of Hippocrates and even till today by various other disciplines of medicine. The process of jotting down the symptoms obtained by proving ‘i.e. by applying them on a healthy person’ and compiling them into homoeopathic Materia medica does not make any substance a Homoeopathic medicine. Ideally a usefulness of a particular drug in disease condition is defined before its inclusion in the pharmacopoeia, in case of homoeopathy it is decided by the physician.
In fact it becomes homoeopathic when it is applied on the basic principle of homoeopathy, i.e. for treatment of complaints in the sick individual which they have been able to produce in healthy persons. Drug proving on human beings is also common with certain system of medicine but observed with a different angle.

Hahnemann framed the hypothesis of law of similars on the basis of action of china mentioned in the Cullen’s Materia Medica. He tried to confirm this hypothesis with the proving of few other medicines which were known to be ‘specific’ in certain disease conditions on himself as well as other persons. It is according to him that these medicines produced similar disease conditions in healthy persons. These observations have been taken for granted and till date the type of similarity produced and cured by those medicines has never been challenged. It is not known what constituted the similarity in the action of china or other medicines on human beings and the manifestations of similar disease symptoms in human beings. No principles or guidelines were formed and evaluated to ascertain the meaning of similarity of such medicines with specific diseases. It is to be noticed that dual action of certain drugs with dose variation was known to the medical science much before hahnemann but its occurrence is very rare indeed e.g. that of Ipeacacuanha which is known to act as an emetic in large dose but counteracts vomiting in drop dose. Similar examples do occur in Ayurveda where taste of the medicine is taken as one of the tools to assess the action of medicine. Usually all medicines with sour taste aggravate the acidic complaints but the fruit Amla (Embelica officinalis ) is an exception. On the contrary it is one of the best medicines for acidic complaints. But this is the only exception and for which they have other means of evaluating drug action which justifies its use in such conditions. Apart from these few examples, generally medicines do not show such dual actions. I again repeat that generally medicines do not behave in this way.
All mathematical theorems and scientific laws also hold true in their reverse interpretations. Accordingly all those new medicines that were not specific for any disease condition in traditional Materia medica over the time after thorough homoeopathic proving should have become specific for disease symptoms produced by them even in crude doses. Hahnemann after proving sufficient medicines should have been able to suggest some specific medicines in certain conditions but this dream proposition is yet to be realized in actual practice. Over the time even after proving of thousands of medicines, homoeopathy has not contributed towards the development of even a single specific for any particular complaint that could be used by other systems also. On the contrary, thousands of so called proving symptoms under several medicines are still waiting for their clinical confirmation even on the basis of law of similars. This question needs to be seriously answered by our community
Hahnemann himself experienced various problems in the application of his own hypothesis right from the beginning. Hahnemann has himself cited incidents of aggravation encountered in most of the cases when he started using medicines on this law. Naturally right in the initial stage, the hypothesis should have been re-tested. However, this never happened with Hahnemann. He stuck to his hypothesis considering it to be true and started reducing the dose in accordance with a scale which he devised to reduce such aggravations. This technique of dose reduction was named as potentization by him. It postulated that this technique developed certain new properties which were hidden in crude form. The subsequent dilution of dose and rise in potency from 6 to 12 to 30 or 200 or even LM potency could not solve the problem of aggravation which was later termed in some cases as ‘homoeopathic aggravation’ by him. It is not known exactly and has never been scientifically evaluated as to what new properties are developed after potentization and if it does happen, it raises another question that do these properties require law of similar to operate for their optimum use in diseased individuals.

Shifting of dose from crude to potentized form along with individualization could not help uniform application of medicines on this law in all sorts of cases encountered by him. Hahnemann contradicts his own principle of individualization and moves towards some generalization when he classifies diseases as acute, chronic, epidemic, endemic, fixed miasmatic acute diseases, recurrent miasmatic diseases, pseudo chronic diseases, artificially named chronic diseases, surgical diseases, etc. Each type ended with several subtypes. There is a need to have second thought that is this partial generalization a prerequisite for successful application of law of similars or the principle of individualization should be the rule. A law cannot operate equally well with two exactly opposite presumptions in a given condition. He sites different forms of similarity for different types of diseases. In acute individual diseases, exciting causes are said to overrule all the individual features of the case. The examples of complaints after exposure to dry cold air in Aconite, after injuries to Arnica and after wet cold to Hepar sulph are said to surpass the individual features of the case. This is an attempt towards broad generalization as opposed to the principle of strict individualization. The law is again modified in the treatment of acute epidemic diseases. Hahnemann did not only recommend specific medicines on the basis of symptoms of these diseases but also suggested means of preventing those diseases by Genus Epidemicus. This is again a grand generalization in particular type of disease as opposed to individualization as the basis of treatment.
Later on he further admitted that the laws of similars followed by law of individualization were unable to ensure a long lasting cure in all cases of acute individual cases and almost all sorts of chronic diseases. The concept of miasm as causation in the treatment of chronic diseases added new modalities to the application of law of similars. Now the similarity had to be found at miasmatic level. The use of terms such as acute miasms for measles, chickenpox and smallpox etc. and sub acute for rabies clearly establishes that Hahnemann used the term miasm for fixed causes of diseases. It meant a specific relationship between the cause and the symptoms produced in the human beings as the use of term is extended to the specific effects of venom of the vipers. Even the action of the simple medicinal substance is comparable to that of specific morbific miasmata and therefore one could use the term specific drug miasm. The term miasm later on has been given new definitions by succeeding homoeopaths to suit their own needs to explain the outcome of cases. It is debatable that Hahnemann would have used the same word miasm with different interpretations in acute and chronic cases. The term miasm was also coined to explain the concept of disease by him. The vital force needs to be dynamically affected by a dynamic cause like miasm ( probably the term dynamic meant for something which could not be seen by unaided eye ) and the disturbance needs to be corrected by dynamic power of medicine ( developed after potentization ) on the basis of law of similars. As the vital force being dynamic in nature could only be brought to the stage of disease and cure by dynamic means.

The principles of existence of dual action of medicines on human beings and the existence of opposite action of large and small dose of few medicines were also chosen by him to prove the supremacy of law of similars over other modes of applying medicine in human beings. The principle of dual action states two types of actions of medicine – primary and secondary actions. ( aphorisms 63,64) The existence of such type of drug actions needs to be scientifically evaluated as according to him few medicines mainly metals like arsenic, mercury and lead are exceptions to the rule of producing dual action. He states that these medicines produce only primary action. This principle has been thoroughly confounded and mixed with principle of opposite action of large and small doses of medicines. The typical examples of such medicines producing opposite actions with dose variation include drugs like Opium, Cannabis and Ipeacacuanha. All medicinal substances in their action do not follow these principles; therefore their use could not be generalized on these lines. It was only Hahnemann’s conclusion that the law of similars applied on the basis of primary action of the drugs is the only curative law as opposed to dissimilar and antipathic modes of application of medicines. Accordingly the Primary symptoms should have as a rule held the key position during compilation of proving symptoms and also in the compilation of Materia medica. But this did not happen and the proving data and the Materia medica are full of secondary symptoms as well as clinical symptoms. This is the sole reason one finds all sorts of contradictory or opposite symptoms in nearly every medicine Hahnemann himself admits that he was not sure about the dual action of certain medicines (Conium and Camphor) and arbitrarily stresses some symptoms as primary or secondary as to his own authority to justify their use in certain clinical conditions. Any cure even though based on symptoms mentioned in Homoeopathic Materia medica need not be on basis of law of similars unless it has been executed only on the basis of so called primary symptoms of the medicine. After the publication of Materia Medica Pura, first edition of chronic diseases came in 1828 that contained 22 remedies with introduction of antipsoric remedies like Sulphur and Calcarea carb. A major change was noticeable in the pathogenic symptoms, it included clinical symptoms i.e. those observed at bedside during clinical application of those medicines. Even Hahnemann could not over look the importance of clinical symptoms i.e. symptoms not occurring in proving but relieved in sick individuals Some of them are characteristic of certain polychrest drugs like stitching pains of Bryonia. The acceptance and their inclusion in the homoeopathic Materia medica as well as effectiveness of such symptoms in practice is a direct proof that there are other ways of evaluating the drug action besides the proving on healthy human beings. The clinical symptoms by no means follow the therapeutic presumption of Hahnemann that only that can be cured which can be produced in human beings.

The most difficult question in homoeopathic practice relates to second prescription. As per Hahnemann’s explanation of the mechanism of cure, whereby the natural disease is permanently extinguished by the similar medicinal artificial disease in one go, concept of repeating the same dose if the first dose has been the appropriate one should not exist. But repetition of the same medicine in the same or different potency was advocated by Hahnemann himself. In fact use and supremacy of LM potency over decimal and centesimal is seen in its power to produce no aggravations whatsoever in spite of frequent repetition. This issue raises a question that where did the disease reside inside the body after the first dose of the similar medicine has acted and how could it reappear after certain time and how it could again respond to the same or the different medicine. This phenomenon of recurrence of disease with response to same or different medicine is inexplicable with the current theory of health, disease and cure but is easily explainable with tridosha theory of Ayurveda. The various rules for second prescription initially framed by Boenninghausen were later on upgraded by Kent in the form of twelve observations after the first prescription hardly find enough support in clinical practice and these are more of academic importance than in actual practice.

The greatest support in favor of law of similar would have been the effectiveness of pathological simillimum i.e. a medicine prescribed to a patient with a given pathology is capable of producing similar pathology in healthy persons. Earlier it was thought that we do not have enough pathological simillimums i.e. drugs capable of producing pathology similar to that found in diseased individual because proving with mother tinctures could not be extended up to the level of pathology. Therefore one could not predict those medicines which should prove specific in those disease conditions on the basis of law of causation.. Law of causation holds a strong characteristic place in the evaluation of symptoms for making homoeopathic prescription. On the contrary, at present there are several medicines available which are known to precipitate specific disease conditions in human beings. We should be thankful to the modern medicine literature which provides sufficient number of medicines capable of producing pathology that could be used as pathological simillimums in identical disease conditions. Many clinical studies have been undertaken on this basis but the results of such studies have never been significant enough to draw attention of the profession at large.

On the other hand, comparison of indications of those homoeopathic medicines whose use is shared by other schools of medicine shows striking similarity in their use although they are used on entirely different principles of antipathy (opposite action) or Allopathy (dissimilar action). The list of such medicines is a long one. Few typical examples are Hamamelis in bleeding and piles, Carduus marianus in liver complaints, Sabal serrulata in prostate troubles, Passiflora for sleeplessness etc. The usage of these medicines in such conditions has been supported by various clinical studies published in WHO monographs. Hahnemann as well as succeeding homoeopaths was particularly poor in giving details of prevalent clinical uses of the medicines proved by them and how far their clinical use differed after proving and with application on the basis of law of similar. On the other hand under many remedies, the proving physicians have mentioned that provings have confirmed their traditional use in those conditions. Ideally as per homoeopathic law this should not have happened as per dual action of medicines as well as opposite actions of large and small doses.
One finds various references in homoeopathic literature where symptoms have treacherously been modified in such a way that they could be used on homoeopathic principles. Certain statements in our Materia medica under certain remedies need correction. Syzygium jambolanum, a well known herbal drug for diabetes mellitus in herbal medicine has been depicted to increase the blood sugar level in its primary action, Ficus religiosa a known anti-hemorrhagic drug in Ayurveda has been shown to produce bleeding from various organs during proving. These statements do not find any confirmation in future studies for such type of actions and therefore deserve serious clinical review as well as correction. On the other hand symptoms opposite to the characteristic primary properties of the drugs have been cleverly put as characteristic for use in practice. Bryonia is a known hydragogue cathartic in herbal literature, but constipation instead of diarrhea is depicted as one of the important guiding symptoms of the Bryonia. Pulsatilla is a known emmenogogue or menstrual inducer in herbal medicine, but delayed and scanty menses instead of profuse and early menstruation is taken as keynote.. Crude medicines do operate on the basis of chemistry and their use was permitted by Hahnemann in acute emergencies and Hahnemann outwardly rejected knowledge of chemistry as a means to ascertain the curative virtues of the medicines. It is interesting to note that many homoeopathic remedies derived from mineral kingdom show direct antagonism to the law of similars and their action in potencies supports the basic laws of chemistry and contradicts the law of similars in their action on human being. Many alkaline salts used as homoeopathic medicines do contain acidic symptoms as their keynote symptoms. As per rule, The sourness of Calcarea carb, Natrum carb and Magnesia carb, Kali carb as a characteristic symptom is akin to the antipathic mode of treatment and it should not have been utilized as keynote in Homoeopathy.

A Homeopathic Materia medica contains all sorts of medicines i.e. Proved, unproved (Torula cerev. Kali mur etc.) , partially proved, clinically proved, medicines with only Poisoning symptoms, symptoms of disease pathologies in cases of nosodes, bowel nosodes, bach flower remedies, biochemic remedies and tautopathic medicines. Usually Nosodes and sarcodes are used on hypothetical basis as an inter current remedy instead of proving symptoms . The use of certain polychrests or deep acting remedies such as Sulphur, Merc sol or Thuja as an inter current is also without any sound basis. The application of biochemic medicines, Rademacherian remedies, Bach flower remedies, Bowel nosodes and Organ remedies does not exactly pertain to field of homeopathic law but they find enough support and use by profession for unknown reasons.
The views of Prof. John Scudder, M.D. a reputed eclectic physician about homeopathy as mentioned by him the 15th edition of “Specific Medication,” need a special mention for every homoeopath. He states that “The Homoeopathic law of cure, Similia similibus curanter, is based upon the fact that many drugs have two actions in kind, dependent upon the dose-the action of the small or medicinal dose being the opposite of the large or toxic dose. Drug provings being done with toxic doses, the medicinal influence is the opposite of this, and if in disease we see the symptoms of the toxic action of a medicine. The small dose, giving the opposite effect, will prove curative. Homeopaths may twist and turn as they please, they cannot escape these conclusions. But as these opposite effects, dependent upon quantity, do not pertain to all drugs, and vary greatly with many, Homeopathy has a short leg and must go halt many times. In other instances the action of the drug is the same in kind both in small and large doses, and some of them are quite valuable remedies. There being no danger of mistakes from dose. Homeopaths employ the first class, but have little use for the second.” These views do contain some sort of truth as has been highlighted in this paper.
All sorts of external applications in the form of eye drops, ear drops, toothache drops, ointments, powders, patents as well as oils even though their use is denied by law of similars are still being used and their annual turnover under the name of Homoeopathic medicines overshoots those of dilutions. Emergence, acceptance and continuation of different schools of homoeopathy be it Revolutionized, Predictive, Sankaran’s, Vithoulkaus etc. is a solid proof that there are other ways to select the curative medicine. The special interpretation of rubrics by all these schools with particular emphasis on only few rubrics is indeed deviation from the actual guidelines of application of law as were formulated by Hahnemann.
Some concepts in Homeopathy bear apparent to true similarity to the Ayurveda system of Medicine. Probably Hahnemann had access to some part of Ayurvedic literature or he was unknowingly confirming certain truths known in Ayurveda. Three chronic miasms as the root causes of diseases are partly comparable to the tri doshas theory of ayurveda ( vata, pitta and kapha ) but the Ayurvedic doshas are entirely different and there is pole apart difference between them and the miasms of Hahnemann. Ayurvdic doshas are part of the normal physiology and cause disease when they are disturbed beyond certain level whereas Hahnemann’s miasms are dynamic entities and foreign to the body. Homoeopathic Potentization i.e. the preparation of medicines is akin to Mardnam or Bhavana or Puta method of preparation of bhasma medicines ( special metal preparations ) in Ayurveda. “Mardanam bal vardanam”, i.e. grinding of medicines increases the power of medicines is well known principle for preparation of Ayurvedic medicines. Use of vehicle in the form of alcohol and sugar of milk or water in Homooepathy is akin to anupana in Ayurveda. Ayurveda recognizes that certain substances used along with the main medicine act as Yogawahi or carrier as well as promoter of drug action. Extensive use of different forms of metals and non metals such as Arsenic, Calcium, Iron, Copper, Mica, Mercury, Gold, Silver, Boron, Zincum, Plumbum, Stannum, Aluminium as well as poisonous plants like Nux vomica, Aconite, Cannabis sativa, Camphor etc in homoeopathy finds a corresponding use of all these medicines with more extensive usage in Ayurveda. A separate chapter under the name of Rasa Shasthra ( application of metals in different diseases ) is devoted to the use of metals in Ayurveda. Olfaction in Ayurveda is the preferred mean of administering medicine in all diseases of the nose and head. Hahnemann did approve its effectiveness over oral administration in his later life. The concept of heat and cold medicines is common to both. According to Hahnemann, both these systems operate on entirely opposite laws of healing. But Ayurveda is much more than mere antipathy i.e. palliative or shaman chikitsa and includes other modality for permanent relief under the name of Panchkarma or shodhan chikitsa. Homoeopathy has an edge over Ayurveda as the special mode of preparation of medicines after potentization in pills form is cheap, free of toxic effects, easily palatable and equally effective in most of the cases. The problem is with non uniformity of results with the same medicine in similar type of cases. Probably the answer to several questions related to uniform application of law of similars and its limitations still unanswered in Homeopathy could be had from comparative studies of both these systems.
Ayurveda is much more than mere anitpathic mode of administration of medicines as is being explained in Homoeopathy. The knowledge of medicine in Ayurveda is derived through five principles of assessment of drug action i.e. rasa, gunas, veerya , vipaka and special effects of medicines. Rasa refers to taste of drug substance, guna refers to its karmas or actions on the body, veerya refers to the action of its alkaloid on the body and vipaka refers to end effects of drug action.
The assessment of drug action through its taste was known to Hahnemann also and is being elaborately discussed in his Material Medica Pura/Chronic diseases under few medicines especially so under Menyanthes. It is out of scope of this paper to explain this system and the author has found that its principles can provide answers to many questions related to drug and disease action which are still unexplained in our system.

Acknowledgment:
I am gratefully thankful to Dr. Manjeet Singh Oberoi Neurologist Safdarjung Hospital for giving constant guidance, support and inspiration to write this article , Dr. Ajay grover, private practioner for providing me with the literature and support and all the Ayurvedic physicians of NDMC especially Dr. S.K.Arya who was the first to introduce basics of Ayurveda to me.

References/Sources :

1.   Organon of Medicine
2.   Close, Stuart, 1924, The Genius of Homeopathy: Lectures and Essays On Homeopathic Philosophy
3.   Hahnemann, Samuel, c1930, The Organon, combined 5th/6th edition,
Dudgeon & Boericke
4.   Hahnemann, Samuel, Lesser Writings, Jain, India
5.   Kent, James Tyler, 1900, Lectures on Philosophy
6.   Boger Boenninghuasens materia medica and Repertory
7.   K.N.Mathurs principles of prescribing
8.   European commission for homoeopathy; A strategy for Research in homoeopathy

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AN OPEN CLINICAL STUDY ON THE USEFULNESS OF PRE-DEFINED HOMOEOPATHIC MEDICINES ON TYPHOID FEVER

DR. AJAY KUMAR GROVER, DR. TUSHITA

Datavya Charitable Clinic, 1, Bhagmal Complex, Sector-15, Noida, U.P.

BACKGROUND AND OBJECTIVES

Typhoid fever is an acute infectious disease caused by Salmonella typhi and characterized by a continued fever rising in a step-like curve the first week. It is a systemic illness having an insidious onset, with fever, headache, constipation, malaise, chills, and muscle pain. Diarrhea is uncommon, and vomiting is not usually severe. Confusion, delirium, intestinal perforation, and death may occur in severe cases. The disease is transmitted through contaminated drinking water or food. The average duration is 4 weeks, although aborted forms and relapses are not uncommon; the lesions are located chiefly in the lymph follicles of the intestines (Peyer patches), the mesenteric glands, and the spleen; antibody titer of the Widal test rises during the infection. Human beings are the only known reservoir and host for Typhoid Fever.

Typhoid fever is a common presentation in our charitable clinic; the general population reporting often coming from the nearby slums. Patients reporting with fever of several days duration and other suggestive symptoms were promptly tested in laboratory and were confirmed as suffering from typhoid fever. Different authors have suggested a group of homoeopathic medicines that are suitable at different ‘stages’ of the disease. According to Dr. Richard Huges, Baptisia is the “primary and fundamental remedy” followed if necessary by Arsenicum and Rhus Tox. Bahr and Jahr mention the usefulness of Bryonia, Rhus Tox and Arsenic among others. Allen mentions Arsenic, Baptisia, and Gelsemium. Nash praises Baptisia, Bryonia and Gelsemium along with Arsenicum, Rhus Tox among others. However,

There is practical difficulty in ascertaining the ‘stages’ mentioned in the homoeopathic texts.
The clinical picture also seems to have changed and become varied.
Many times the patient have already taken some anti-pyretic and anti-biotic before reporting to us and being diagnosed as suffering from typhoid.

Therefore, there was a need to ascertain homoeopathic remedies that would promptly relieve these cases. Earlier, a single medicine was prescribed in repeated doses or two medicines were alternated. However it was seen that if we prescribed a combination of the 8 homoeopathic medicines, namely Arsenic, Bryonia, Baptisia, Eupatorium, Gelsemium, Rhus Tox, Kali Mur and Ferrum Phos ; we got the best results. Therefore, an open clinical study on typhoid was started with 8 pre-decided remedies as the choice of prescription.

METHOD

The study was conducted from March 2009- April 2011 with the objective to assess the usefulness of a group of 8 pre-defined homoeopathic medicines in the treatment of Typhoid.

Patients enrolled were of both sexes, ranging from 10-50 years presenting with fever of one weeks duration consisting symptoms of malaise, chills with fever, loss of appetite, evening rise of temperature etc. supported by complete blood count and widal test titer of ‘0’ 1:160 or more and ‘H’ 1:160 or more were included in the study. Patients suffering from pneumonitis and jaundice along with typhoid or any systemic illness were excluded

The first prescription was a combination of the following medicines:

+Ars 200-( Ars.200+ Bry.200+ Eupatorium 200+ Gels.200+ Rhus Tox.200)
Baptisia 30
Ferrum Phos 6X + Kali Mur 6X

In all the cases studied. Follow up was provided every day for one week and every third day the following week. Subsequently patient was asked to visit a once a week for two weeks. Use of boiled water for drinking purpose, light nutritious diet prepared at home, avoidance of outside food, and adequate rest were advised to patients along with medicines. The primary outcome assessment was patient being afebrile and improvement in appetite.

RESULTS

At the completion of the study, the outcome assessment shows 80% improvement. 50 patients who completed their follow up of two weeks at 1, Bhagmal Complex, sector-15 Noida (U.P.) were included in this interim data analysis. Sixty percent of the patients i.e. 30 patients were in the age group of 5-15 years.

CONCLUSION

Typhoid Fever continues to be a major public health problem in many developing countries characterized by rapid population growth, increased urbanization, and limited safe water, and health systems like India.
The data of this interim analysis of the study shows positive effects of the homoeopathic medicines in patients suffering from Typhoid Fever.
In view of the continued high burden of typhoid fever and increasing antibiotic resistance, and given the safety, efficacy, feasibility and affordability of homoeopathic medication; there is a need to verify the results of this study with a bigger sample size and randomized control trails.
Instead of regarding the conclusions of this study with disapprobation, we urge our colleagues to exclude all theoretical prejudice, and apply this finding clinically to see its marvelous results!

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PURE HOMOEOPATHY AS PROPOSED BY DR.HAHNEMANN

Till now different schools in Homoeopathy like Sehgal’s School of Revolutionalised Homoeopathy, Sankaran School, Predictive Homoeopathy & Sholten’s school have tried to explain action of homoeopathic remedies with special interpretation of symptoms especially of mind or through introduction of new theories that incorporate basic laws of Homoeopathy as well as concept of Miasms. We believe in interpretation of such actions in terms of Ayurveda, Herbal or physiology etc.

Pure Homoeopathy as proposed by Dr.Hahnemann = Homoeopathy as practiced today – ( mother tinctures- intercurrent remedies- biochemic remedies- organ remedies- nosodes-bach flower remedies- patent or combination of remedies- unproved and partially proved remedies used in homoeopathy- medicines prescribed on special interpretation of rubrics and miasms other than that proposed by Hahnemann)

= would constitute even less than 5% in all. I have yet to see such physicians who fit this group and if they are found they do not enjoy good and hundred percent result oriented practice as they should.

“The proving confirms the traditional use of the drug and the proving brings out the finer indication for this drug in those diseases”

Although not proven, this remedy has a wide clinical use through its introduction by —

After visiting this site, from this moment onwards, It is our request that you keep on noting the above statement in all the medicines you go through in your daily reading of Materia Medica and do tell us as to the number of medicines that have this statement. These statements taken from classical homoeopathic literature support the very purpose of this website.

A patient with lack of vital heat (chilly patient) having excessive sour perspiration mentioned as key note in certain remedies like Hepar sulph, Calcarea carb etc.

Have you ever applied your mind and thought that can these conditions co-exist as per your knowledge of physiology or Biochemistry.

Sweating is an important mechanism whereby body tries to control temperature by dissipating excess of heat that could be released during evaporation of sweat. Can a really chilly patient (if you leave the emotional sweating) ever perspire and that too with sour smell?

A comparison with other modes of ascertaining drug action proves that both these remedies are very hot and are the greatest coolants of our Materia Medica.

Understanding Gelsemium

(Knowing the curative drug action (on whatever principles it is explainable) helps in understanding the symptoms better, opens new possibilities for its application in other similar conditions and builds up your confidence for further use)

The following lines are quoted from introduction to this drug from Boericke’s Materia medica and are supposed to be the pure homoeopathic indications for this drug as they relate to the action of the drug in physiological doses. The herbal indications are exactly opposite to these indications.

Centers its action upon the nervous system, causing various degrees of motor paralysis.
* General prostration.
* Dizziness, drowsiness, dullness, and trembling.
* Slow pulse, tired feeling, and mental apathy.
* Paralysis of various groups of muscles about the eyes, throat, chest, larynx, sphincter, extremities, etc.
* Post-diphtheritic paralysis.
* Muscular weakness.
* Complete relaxation and prostration.
* Lack of muscular co-ordination.
* Sluggish circulation.
Herbal medicine uses it as sedative, painkiller, antispasmodic, fever reducing drug indicated as the first line drug in all fevers characterized by cerebral excitation due to increased passive congestion to the brain and thereby is the prime remedy to prevent febrile convulsions. It is alsoindicated in spasmodic disorders like whooping cough, asthma and is one of the most important remedies in colic surpassing the use of Colocynth or Dioscorea.
Homoeopathic Materia Medica does contain many more keynotes related to such herbal use unknowingly confirming few of its uses based on its physiological action. Gelsemium produces paralysis by action on the neuromuscular junction at the lower motor neuron level. This action is utilized daily by Homoeopaths in many different conditions. It is the prime remedy in homoeopathic doses for examination funk and ailments from stage fright. Both these conditions stimulate the sympathetic nervous system inducing secretion of adrenaline thereby stimulating the heart rate and trembling of muscles. Gelsemium blocks the action of adrenaline and thereby does not let the body to produce increased heart rate or trembling. Nash has also confirmed its use in trembling without chill that is mentioned as nervous trembling.

The several other typical indications in Boericke’s can be interpreted in terms of its antispasmodic and sedative physiological actions:

* Children fear falling, grab nurse orcrib.
* Nervous affections of cigar-makers.
– Emotional excitement, fear, etc., lead to bodily ailments.
– Wants to have head raised on pillow.
– Corrects blurring and discomfort in eyes even after accurately adjusted glasses.
– Orbital neuralgia, with contractions and twitching of muscles.
Face
– Facial muscles contracted, especially around the mouth.
- Chin quivers.
Stomach
- Hiccough; worse in the evening.
– Diarrhoea from emotional excitement, fright, bad news. [Phos. ac.]
Urine
– Retention.
Female
- Rigid os. [Bell.]
- Vaginismus.
- False labor-pains; pains pass up back.
- Dysmenorrhoea, with scanty flow; menses retarded.
– Sensation as if uterus were squeezed.[Cham., Nux v.; Ustilago.]
Male
- Spermatorrhoea, without erections.
– Gonorrhoea, first stage; discharge scanty; tendency to corrode; little pain, but much heat; smarting at meatus.
Respiratory
– Spasm of the glottis.
- Aphonia; acute bronchitis, respiration quickened, spasmodic affections of lungs and diaphragm.
Heart
– Palpitation; pulse soft, weak, full and flowing.
Extremities
- Cramp in muscles of forearm.
- Professional neuroses.
- Writer’s cramp.
- Excessive trembling and weakness of all limbs.
- Hysteric convulsions.
Sleep
- Cannot get fully to sleep.
- Delirious on falling asleep.
- Insomnia from exhaustion; from uncontrollable thinking; tobacco.
- Yawning.
- Sleepless from nervous irritation.[Coffea.]
Fever
- Wants to be held, because he shakes so.
- Nervous chills.
- Bilious remittent fever, with stupor, dizziness, faintness; thirstless, prostrated.
Stomach
- - Colic, umbilical region sensitive to touch.
An interpretation of these symptoms makes their remembrance as well as use easy. It opens options for its use in diverse clinical conditions characterized by such pathology. The medicine can be frequently and harmlessly combined with other paralyzing drugs like Conium, Actea racemosa, Valeriana, Causticum, Passiflora, Viburnum opulus, Cannabis sativa. Try singly or in combination in all sorts of clinical conditions characterized by spasm e.g. in cervical spondylosis, menstrual cramps and spasmodic colic. You have been unknowingly doing this for many years and now you can prescribe with confidence.

A simple way to understand what we want to convey through this website

What will you prefer?

If out of hundred cases a drug relieves ninety nine % cases of constipation in its routine use and cures one % cases of diarrhoea with special indications. How would you like to use that drug? This exactly happens with every homoeopathic prescription.

We request the entire homoeopathic community to make this simple test with one of the diarrhea inducing drug with at least ten cases under both constipation and diarrhea each and mail us their result and we will put your results on this website and then you will understand as to what we want to convey through this website.

All of us know thatCroton tig. is projected as one of the important Homoeopathic remedies in diarrhea. We request all the readers of this website to just mail us how many of you use this as the first line remedy for diarrhea and mail us all those cases of Acute diarrhea only which had Croton tig indications and were relieved within a short time with the exclusive use of this remedy without any other drug and that too with few doses only. We also ask from now onwards to give the same drug in potencies in constipation on opposite conditions to that of typical croton tig diarrhea that is constipation characterized by dry stool with no urge and compare the results. Look at the percentage of cases of constipation versus diarrhea relieved by this drug and do an unbiased comparison. We will publish your results on this website.

I have personally used this drug both in constipation and diarrhea. It relieves more cases of constipation than diarrhea. The occasional dramatic action of this as well as other diarrhea inducing remedies like Aloes, Podophyllum, Arsenic and Merc sol, Ipeacac can be explained on certain different principle other than law of similars and that will be discussed in due course of time.

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A need to redefine concept and scope of homoeopathic dispensary

Dr. Subhash Chand* *Chief medical officer , Health department, New Delhi Municipal Council , New Delhi Ex. Asst. Research Officer, Central Council for Research in Homoeopathy

It is known that health care facilities in India have seen a tremendous change in their setup over a period of time. Initial primary health care setup is being replaced by multi-specialty setups and general physicians being replaced by specialists in nearly every field of medicine.

In relation to homoeopathy, there has been practically no change in its setup of a dispensary particularly at government or NGO level. In the initial years of the introduction of homoeopathy in India, there was a need to establish the popularity, acceptance and efficacy of homoeopathy in comparison to the other systems of medicine. Therefore many things which are essential to maintain the quality and development had to be compromised because it is true that beggars have no choice. But now after more than forty years of establishment of CCH which controls the standards of education in homoeopathy with introduction of graduation and post graduation courses, there is a need to re- look into the pathetic setup of homoeopathic dispensaries at the government or NGO levels.

There is also a need to redefine the scope of services offered at homoeopathic dispensary. It is known to all that Hahnemann himself an allopath was dissatisfied with the principles of Allopathy and wrote more than 17 pages towards criticism of Allopathy in introductory chapter to Organon of Medicine. On the contrary, it is strange to see that homoeopathic education standards put more emphasis on allopathic subjects than on its own subjects. It is also true that mere teaching of surgery and medicine at homoeopathic college is not sufficient. The scope of surgical services in homoeopathy like stitching of wounds, usage of dressing materials, drip arrangement, oxygen cylinder, and usage of life saving drugs etc. need to be critically evaluated in the current circumstances. The half hearted use of such practices by few of the physicians often put them into legal problems as the issues related to their usage have not been clearly defined. Homoeopaths would have to issue a white paper related to several such issues and most prominent are related to microbiological causes of disease and the usage of immunization. The microbiological approach though taught through allopathic subjects is denied in homoeopathic philosophy. A middle path has to be defined whereby homoeopath can use such approach in emergency. The simple technique of stitching has to be supported by tetanus toxoid vaccination along with antibiotic coverage needed to prevent infection. Both of these practices though practiced in few homoeopathic hospitals under guidance of certain allopathic specialists are not permitted at dispensary level in homoeopathic dispensaries or clinics. These questions relate to policy level as to the usage of certain allopathic drugs in certain circumstances so they can be left to the higher authorities for more clarification. But these will have to be answered by us may be by force from other systems in near future. The use of such practices along with necessary circumstances needs to be supported by deputing corresponding staff in the form of dressor, ANM etc. in homoeopathic dispensaries as is being followed in few of the homoeopathic hospitals.

The usual setup of a typical homoeopathic dispensary is one doctor, one pharmacist and a peon. This three member staff setup is somewhat akin to three legged stool of definition of characteristic symptom by Allen. There may or may not be a sweeper. This is the most common pattern throughout the country. This is the most primitive setup of a primary health care unit. One can take lesson from nature that god did not create any animal with three limbs. This setup puts extreme stress on its workers. Most of the dispensaries as per my knowledge have this setup. In fact homoeopathy has been propagated on this issue that homoeopathic setup requires few resources in the form of land, labor as well as running capital to run the dispensaries. The trend is still continuing whereby officials at policy level use this strategy to open more dispensaries. This trend should be immediately stopped and efforts should be made to put up quality in homoeopathic set up that will in long run improve the quality of homoeopathic practice. The policy makers are more than contended with this setup and are taking no pains to improve this setup. At present, there are no quality standards for homoeopathic dispensary setup fixed by any of the govt. departments as per available information on net. The quality homoeopathic treatment is entirely different from allopathic treatment and takes long hours of interrogation and follow up for individual patient. Therefore, allopathic standards of posting a doctor on the basis of number of patients being treated in a single day (mentioned as between 50-100/ day) cannot be blindly adapted for homoeopathic dispensaries. As stated earlier, Most of the dispensaries operate with single doctor. There may or may not be a regular sweeper. Many a times the Pharmacist may be replaced by a Peon, Nursing Orderly, Watchman, Sweeper, Clerk or an Aya. This is the most dangerous situation where a non qualified person deals with the most sensitive part of distribution of medicines. Distribution of medicines i.e. the work of pharmacist is yet to find proper definition in Homoeopathy. The concept of no side effects with homoeopathic medicines has done great damage to this function in particular. It is known that even if the dispensing person fails to deliver the right medicine there are bound to be no side effects. Even after more than forty years of recognition of Homeopathy, the regular course of Pharmacist has not taken any definite shape and even today pharmacists are recruited with only tenth class plus education and experience certificate from any practicing doctor or pharmacy. At present the number of homoeopathic medicines is too large with many drugs bear similar appearing names. The names and spellings of certain medicines are not known to best of the doctors that includes me also, than how can a tenth pass pharmacist can differentiate closely similar looking medicines. There is no single dispensary that keeps regular updated stock of all sorts of homoeopathic medicines in different potencies with complete range of sundries. The concept of keeping different types of medicines in the orderly way akin to allopathic medicine is yet to be conceptualized in homoeopathic pharmacy. Since in most of the dispensaries, there is only one pharmacist with no clerk or storekeeper, it is foolish to conceive the proper existence and maintenance of a store. The purchase of homoeopathic medicines by the central store and their stock position and supply is never smooth and most of the time the medicines as well as sundries are in short quantity sometimes due to lack of initiative on the part of doctor also. The space too in most cases is as limited as staff and usually consists of a single room divided into parts. In most of NGO setups even the post of pharmacist is denied and doctors themselves do all sorts of works right from registration to the distribution of medicines.

These limitations waste the valuable time of the physician in those practices which could be handled by non technical staff. Therefore he is unable to do justice to his system. He cannot maintain the case records, follow up, consult books for references and cannot contribute towards the development of the system in the long run which is very vital in the current scenario of evidence based therapies. In spite of hundreds of patients suffering from all sorts of acute as well as chronic remedies in each of the dispensaries, there is no proportionate contribution of the physicians in the enhancement of the literature which is very vital to the development as well as continuation of the system. The very structure of the homoeopathic dispensary is one of the basic draw backs in this matter.

In the current setup, even the humanitarian approach is missing. We are all human beings who are also bound to our family and social duties for which leaves are to be taken as well as granted as and when required. Health is also very important aspect and we do fall ill ourselves and take leave. What happens to this type of dispensary setup if any member of the staff falls ill. Each staff is vital whose works are indispensable right from the peon, sweeper, clerk, chowkidar or sweeper. Management becomes extremely difficult in the current setup of three staff and if the pharmacist or the doctor goes on leave the entire setup collapses for that particular day. There are very few chances with most of the govt. setups that provide leave reserve staff in the form of doctor, pharmacist or peon. This concept is yet to be conceptualized and implemented. Usually doctors from the nearby dispensaries are given additional duty for the dispensary with deficit staff. This arrangement disturbs the working of both the dispensaries as the doctor finds it difficult to do justice to the patients in both the dispensaries.

There is a big question as to who can help to improve this setup. At present there are three govt. departments in the form of Central Council for research in Homoeopathy, Central Council of Homoeopathy and the Department of ISM & H under ministry of health and family welfare. In addition there are several state level department of ISM & H. The role of CCH is limited to the setting up of standards of education only and they are least concerned with the standards of practice. The Central Council for research in Homoeopathy has its own vision of achieving its aims and objectives of homoeopathic research through its own network of research units. I had been a part of this organization and I do feel that there is huge communication gap between CCRH and General Homoeopathic practitioners as well as between CCRH and teaching institutions. Education, practice and research are interrelated issues. I personally feel for the proper development of our system there should be a department to coordinate the efforts of teachers, practitioners and research workers. In my opinion, it is impossible to conceive progress in our system unless CCRH makes efforts to establish better links with these resources i.e. teachers as well as practitioners. This could be done by lifting the setup of current dispensaries in the form of staff as well as quality medicines.

It is high time that instead of quantity i.e. the number of patients being treated in dispensaries, the policy makers concentrate on quality of homoeopathic treatment delivered in different dispensaries. It is my request that in future no more dispensaries should be opened with three staff pattern. The most fundamental rules of business management need to be seriously applied after identifying the exact scope of homoeopathic services to be delivered along with the necessary staff for each service.

This is also important for contribution of the dispensaries towards documentation. India has faced a rapid change in its business environment during last few years due to liberalization and privatization. Accordingly all business service providers have changed their practices and policies from mere delivery of services to the customer satisfaction. Therefore there is a need to change the current setup of homoeopathic dispensaries taking into consideration issues raised in this paper so that doctors are able to provide homoeopathic health care at par at least with allopathic dispensaries. There should be minimum staff of two doctors, three pharmacists, a clerk for registration, an ANM, a storekeeper, a dressor, a chowkidar, a peon and a sweeper for each homoeopathic dispensary.

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Homoeopathy as an independent System

Dr. Subhash Chand* *Chief medical officer , Health department, New Delhi Municipal Council , New Delhi Ex. Asst. Research Officer, Central Council for Research in Homoeopathy

The current status of Homoeopathic education and practice in India is due to misinterpretation of definition of knowledge of disease mentioned in aphorism three of 5^th edition of Organon of Medicine. The aphorism identifies essential qualifications needed to become a good homoeopathic physician as explained by our master. It states that a physician should understand what is to be cured in disease i.e. knowledge of disease followed by disease individualization. The knowledge of disease refers to subsequent classification of diseases as proposed by Hahnemann in succeeding aphorisms into acute, chronic, one sided and mental diseases. It does not mean diagnosis of disease as mentioned in the books of modern system of medicine. The entire system of Modern system’s classification of diseases into different types was opposed by Hahnemann. Introduction to Organon is spread over more than 27 pages that is one quarter of the book is against such interpretation of disease and its harmful effects. Hahnemann openly criticized ‘tolle causum’ or materialism in medicine. He was strictly against pathological nomenclature of diseases.

In India, Homoeopathy soon after its introduction in 18^th century became popular among masses because it is beyond doubt that it is not only effective in curing many chronic ailments and so called surgical cases but is equally effective in curing acute diseases also. Cheapness, safety and easy palatability were also important for its popularity. Problems started erupting when certain non allopathic educated persons started practicing homoeopathy. It might have been the need of time as the system could not gain popularity without reaching to the common people and number of converted physicians was much less than the demand. Moreover the easy language of Materia Medica and least side effects of homoeopathic medicines attracted many innovative persons towards this system. On this pattern, gradually a team of so called self qualified practicing homoeopath was created in our own country. Homoeopathic books openly criticize allopathic system and this further promoted the number of self qualified homoeopaths. Homoeopathic practice required no knowledge of essential subjects related to body like Anatomy, Physiology, Pathology, Practice of Medicine, Surgery, Gynecology and Toxicology etc. This little knowledge of Healing system acted as double edged sword, it brought both good and bad name to homoeopathy.

One must understand that human life is precious and it is very difficult to demarcate the seriousness of sickness both for the patient as well as for the self qualified doctor. Many of so called common symptoms are danger signs for serious diseases and the valuable time is wasted if patient approaches such doctors with little knowledge of disease. Therefore a need was felt to control the number of such physicians and streamline the basic education in Homoeopathy. Central Council of Homoeopathy Act of 1973 for providing diploma in homoeopathic education was one such big step in this direction. This act has been further extended to provide degree and post graduate courses in homoeopathy. It is to be understood that the contents of these acts were drafted without considering the long term future of the system.

Hahnemann did not plan his system as an independent system of medicine. Hahnemann introduced homoeopathy through books on two subjects i.e. Organon of Medicine and books on Material Medica in the form of Materia Medica Pura and Chronic Diseases. He had no idea that one day Homoeopathy would be able to achieve the status of an independent separate system of medicine. Several issues related to an independent system were not discussed in these two books and were never raised because he himself was a qualified allopath and did not feel the need to mention them separately in these two books. Clearly these two books alone were not sufficient to establish homoeopathic as a separate system of homoeopathy. Hahnemann’s Organon of Medicine and Materia medica is silent over several subjects like Anatomy, Physiology, Pathology, Surgery, Practice of Medicine, Role of diet etc. In reality, Hahnemann opposed the teachings of pathology in a foot note to aphorism. The Organon of medicine is more of a comparative evaluation of different modes of treatment prevalent during Hahnemann’s time. Most of his views about those systems do not find any support in current scenario. The current allopathic practice is far more advanced and scientific than during Hahnemann’s time. The modern system has seen tremendous growth in terms of technological revolution with time and plays an important role in health care system of every country. Organon of Medicine can be best understood by those who possess good knowledge of Allopathy as well as other systems of Medicine. Hahnemann can also be seen to approve the use of antipathic measures in emergencies as well as use of surgical procedures to remove obstacles to cure. He took it for granted that these procedures are known to each and every physician.

Ideally Homoeopathy could not be set up as an independent system only on the basis of these two subjects i.e. Organon and Materia Medica and it should have been introduced as a post graduate course after M.B.B.S. or any other more perfect system. This approach would have been the ideal one but it could not be executed due to circumstances best known to the persons framing policy at that time. The CCH act proposed homoeopathic education on a new line where all the subjects were same as that in Allopathic College providing MBBS degree without the pharamacology of allopathy system but along with homoeopathic subjects. Even the post graduate courses are being introduced and granted on same line. This combination has worked well in the sense that several weaknesses of the homoeopathic system are covered by knowledge of allopathic subjects but it puts a big question that why a student studying in homoeopathic college and getting education in subjects similar to allopathic subjects cannot practice allopathy as well. Hahnemann advocated use of antipathic measures in cases of emergencies in aphorisms as well as surgical procedures but it has failed to take practical shape in homoeopathic teaching in India as well as abroad. The list of diseases under these two categories is huge and forms a considerable proportion of cases encountered in practice. Hahenemann did not clarify on this subject and presumed that a Homoeopath should have knowledge of such subjects from Allopathy. He never conceived the existence of a pure homoeopath. These two issues should have been solved before framing the policy for homoeopathic education and drug manufacturing. This is the reason that Central Council of Homoeopathy India as well as Homoeopathic pharmacopoeia of India are silent on the use of emergency drugs, food supplements as well as surgical procedures. No efforts were made to seriously interpret the meaning and scope of this aphorism and till today tackling emergencies many a times puts the homoeopathic physician in the most embarrassing situation. There is no protocol about the definition of emergencies where one should resort to antipathy or surgical measures and what are those antipathic/surgical measures and whether as a homoeopath we are authorized to use such measures. Both these subjects have seen enormous growth with time and now a days use of antipathic measures/surgical procedures have their own protocols which are often contrary to homoeopathic principles and demand use of allopathic medicines before and after their application.

A student in homoeopathy is exposed to two different truths related to health and disease right from the first year of homoeopathic medical education. Ideally Homoeopathic Materia Medica and Organon of Medicine are not meant for first year student. Materia medica teaching should start during second year along with subjects like practice of Medicine and Surgery. There should be a comparative evaluation of pharmacology with that of allopathic system. Materia Medica teaching during first year puts great stress on the mind of fresh students. A first year student is expected to mug up several symptoms under different remedies without any background of Medicine and Surgery. More than half of the symptoms under each remedy are nothing but common symptoms of different types of diseases. There are no standards for symptoms as well as books in homoeopathic Materia Medica. Each teacher has his own liking for books as well as separate preconceived list of peculiar symptoms for that remedy. It is very important for the student to know the personal whims of the interviewing physician not only to get good marks but also to pass through the examinations. This type of premature introduction of Materia Medica does not allow the student to make any efforts towards comparative evaluation of the action of medicine with that of other system of medicine. The study of pharmacy in homoeopathy is very rudimentary and premature and there is serious need to introduce some information about pharmacological principles applied in modern system of medicine. It is not strange to find that most of the senior homoeopaths are not aware about the source of certain common medicine that includes me also. There is no demarcation as to the valuation of the books on Materia Medica. The same books are being taught during the entire period of education and even in post graduate courses it holds true. The same thing applies to Organon of Medicine which is being taught through same books throughout the education period.

The second most controversial issue relates to homoeopathic management of several diseases named as per allopathic system of medicine. Hahnemann had his own classification of diseases and did not believe in the separate classification as per allopathic system. On the contrary, a student in homoeopathic education is exposed to modern system classification of diseases in all subjects like Practice of Medicine, Surgery, Gynecology, Pediatrics and Ophthalmology etc. Allopathy teaches that these diseases are due to infective, genetic, traumatic or idiopathic causes and than the homoeopathic teacher teaches that these are due to Acute or Chronic Miasms. This standard comparison is done in almost all sorts of diseases related to different specialization. This puts a great stress on the mind of student as to what is true and what he should even write in examinations. Even homoeopathic teachers are divided in their approach to their own system. Some are pro-Homoeopathic and others are pro-allopathic. A student has to maintain proper balance between two approaches as per taste of the teaching physician. There is a standard answer for homoeopathic treatment of these different types of innumerable diseases under different subjects and that has to be cleverly put in different ways under different diseases in the same paper. The utility of such type of teaching is yet to be defined. The same problem is encountered in Interviews for the selection of Homoeopathic doctors for various government jobs. Many a times doctors with good command of homoeopathic subjects get rejected due to poor knowledge of allopathic subjects.

Even with such an extensive knowledge in allopathic subjects, it is strange to find and that too in our country that Nurses, paramedical staff of tuberculosis DOT centers, Leprosy and Malaria centers, Aayas, ANMs, ASHA’s can handle allopathic medicines as well as vaccines but a more educated homoeopathic doctor is not authorized by the law to prescribe these drugs. There is a huge list of over the counter allopathic medicines along with number of other allopathic drugs advertised through television and radio are beyond the prescription range of homoeopathic doctors. Many a times patients admitted in homoeopathic hospitals develop emergencies and are to be referred to other hospitals. They could be easily managed provided use of certain life saving drugs is allowed to homoeopathic doctors. This question of use of essential medicines by homoeopathic doctor would have to be answered by our seniors sitting at top position in near future. It is being faced individually by all practicing homoeopathic doctors time and again.

Hahnemann’s views about health, disease and cure as well as preservation of health need to be supported with the current developments in medical science. This problem is faced by every homoeopath during interviews by media persons or by patients. Now a day’s patients are more intelligent than even doctors. Homoeopathy is silent over several such issues and homoeopathic doctor uses his knowledge of Allopathy to answer those questions with contradictory statements for treatment of such conditions.

The current CCH act is taking homoeopathic education to a blind end. It has failed to create an intellectual hierarchy in homoeopathy and drug companies with patents and over the counter products is dominating the picture. Many acts in the form of short quantity packing, expiry date on homoeopathic medicines and the latest clinic act are some of them. Drug companies have opened their own colleges and students are forced to believe in the use of patents/ combinations.

It is the need to time to understand and discuss issues raised in this paper through seminars and workshops by various Homoeopathic Organizations. Something should be done seriously and also urgently to amend the CCH act. It should be done either by introducing homoeopathy as a post graduate course after MBBS or the current homoeopathic doctors should be legally allowed to use emergency procedures along with use of certain life saving allopathic drugs through necessary changes in education and pharmacopoeia.

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EFFICACY OF ANACARDIUM IN THE TREATMENT OF HYPOTHYROIDISM

DR. AJAY KUMAR GROVER, DR. TUSHITA

Datavya Charitable Clinic, 1, Bhagmal Complex, Sector-15, Noida, U.P.

BACKGROUND AND OBJECTIVES

Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. Optimum levels of thyroid hormones are required to maintain the metabolic processes of the body. Hypothyroidism can be caused by conditions of the thyroid as well as other disease which may indirectly affect the thyroid. Women are affected by hypothyroidism more than men, especially as they age. The incidence of hypothyroidism increases significantly in the elderly and it is noted that its prevalence is increasing by the day. It often presents as weakness, lethargy, fatigue, dryness of skin, coarse hair, intolerance of cold, constipation, weight gain, muscle cramps, oedema of eyelids, face, legs (non-pitting), menstrual irregularities on females, hoarseness of voice, confusion, and weak memory etc thus affecting the quality of life.

Anacardium is mentioned in the homoeopathic Materia Medicae as a remedy for neurasthenics; having impaired memory, irritability, brain-fag, absent mindedness, and; depression. There is aversion to work and lack of self-confidence. There is weakness of digestion, with fullness and distension. Nervous dyspepsia that is relieved by eating.. The bowels are inactive. There is ineffectual desire to pass stool; rectum seems powerless, as if plugged up; spasmodic constriction of sphincter ani; even soft stool passes with difficulty. Painful hæmorrhoids. Palpitation, with weak memory, with coryza in the aged; stitches in heart region. There is paralytic weakness in the extremities. Knees feel paralyzed or bandaged. Cramps in the calf muscles. There is intense itching, eczema, with mental irritability. Skin eruptions- vesiclular, lichen planus, urticarial, neurotic eczema, warts especially on hands etc. come in its sphere of action. Several of these symptoms cover the symptomatology of hypothyroidism.

Anacardium is also held in high esteem by Ayurveda. Maharsi Caraka has categorized Anacardium as dipaniya an appetizer, bhedaniya – accumulation breaking herb, mutra sangrahaniya – antidiuretic and kusthaghna – anti dermatosis. It has been mentioned as vajikara – an aphrodisiac, especially beneficial in the failure of penile erection and sexual debility (Sarngadhara Samhita). In the ayurvedic texts it is described as anala – a fire. It therefore increases the metabolic rate of the body. It is said to sharpen the memory as it boosts the sadhaka pitta and nourishes the nervine tissue. It also works well as aphrodisiac by its stimulant action and enhances the seminal fluids. It is prescribed with success in dysmenorrhoea and oligomenorrhoea. It is also the best rejuvenative for skin ailments, vata disorders and as a preventive measure to increase the body resistance. It improves the appetile and digestion, eliminates ama and clears up the micro channels of all the systems, hence facilitates the nourishment of all the tissues.

Therefore, an observational study on hypothyroidism was started with Anacardium as the pre-decided medicine of choice.

METHOD

A total of 20 cases of hypothyroidism having different clinical presentations and TSH levels ranging from 6.5 to 22.5 were selected for the study. Out of theses, 14 cases were female and 6 male. All 20 cases were prescribed Anacardium and followed up for 2 years. A thyroid profile test was done every 3 months to assess the improvement.

RESULTS

The results obtained from the study are very encouraging with finding that 70% of the patient improvement clinically with evidence of positive changes in diagnostic parameter.

SYMPTOM OF HYPOTHYROIDISM	NO. OF PATIENTS(Before Treatment)	NO. OF PATIENTS IMPROVED(After Treatment)
SKIN: Dry scaly skin Loss of hair from scalp and body Generalized Oedema(initially pitting) Weight Gain	4	3
	12	8
	2	-
	14	10
GASTROINTESTINAL: Constipation	6	7
CARDIOVASCULAR: Mild diastolic Hypertension Breathlessness	1	1
	4	2
NEUROLOGICAL: Physical and mental Slowness Lethargy & Sleepiness Confusion	8	3
	18	15
	7	4
MUSCULO-SKELETAL: Cramps in Calf-Muscles	9	6
FEMALE REPRODUCTIVE SYSTEM: Irregular Menses Scanty Menses Or Amenorrhoea	10	8
	5	3

The female patients previously having oligo-amenorrhoea reported having regular menses with normal flow. Most patients reported improvement in symptoms of weight gain, constipation, dryness of skin, cold intolerance, confusion, crapms in the calf muscles, hair loss etc.

In case of Ms. X, presenting with dryness of skin, constipation, weight gain and oligomenorrhoea, there was symptomatic improvement as well as the TSH came down from 12 to 2.5 in three month duration.

In case of Mr. Y, presenting with patchy hair loss on legs, confusion and weakness of memory, there was symptomatic improvement as well as the TSH came down from 14.5 to 5.5 in six month duration.

CONCLUSION

Anacardium has a definite role to play in the homoeopathic management of hypothyroidism cases. However, such a study with a bigger sample size and randomized control trails is needed to further validate the usefulness of Anacardium in hypothyroidism cases.