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Homoeopathy in Genetic Disorder Hemophilia

About: Article First Published in ‘The Homoeopathic Heritage’ B. Jain Publishers Pvt. Ltd, New Delhi, India, December 2007.
Details: Haemophilia is a haemorrhagic diathesis caused by the congenital deficiency in the blood of Factor VIII (von Willebrand factor/ antihaemophilic globulin). It is a sex linked characteristic, transmitted by the asymptomatic female carriers, and manifest only in males.
1- If a carrier has a son, he has a 50% chance of having haemophilia, and a daughter has a 50% chance of being a carrier.
2- Although haemophilia is a congenital disorder it is unusual for excessive bleeding to be noticed until babies are about 6 months old, when superficial bleeding or haemoarthrosis may occur.

This apparent delay in presentation is due to the relative inactivity of babies in the first few months of life and it is only when they begin to move about that more trauma results in bleeding.
Although haemophilia is a congenital disorder it is unusual for excessive bleeding to be noticed until babies are about 6 months old, when superficial bleeding or haemoarthrosis may occur. This apparent delay in presentation is due to the relative inactivity of babies in the first few months of life and it is only when they begin to move about that more trauma results in bleeding.
Symptomatic patients usually have factor VIII levels <5%, with a close correlation between the clinical severity of hemophilia and plasma AHF (anti haemophilic factor) level. Patients with <1% factor VIII activity have severe disease; they bleed frequently even without discernible trauma. Patients with levels of 1 to 5% have moderate disease with less frequent bleeding episodes. Those with levels >5% have mild disease with infrequent bleeding that is usually secondary to trauma. Occasional patients with factor VIII levels as high as 25% are discovered when they bleed after major trauma or surgery.

The majority of patients with hemophilia A have factor VIII levels below <5%.3 Hemophilic bleeding occurs hours or days after injury, can involve any organ, and, if untreated, may continue for days or weeks. This can result in large collections of partially clotted blood putting pressure on adjacent normal tissues and can cause necrosis of muscle (compartment syndromes), venous congestion (pseudophlebitis), or ischemic damage to nerves. Patients with severe hemophilia are usually diagnosed shortly after birth because of an extensive cephalhematoma or profuse bleeding at circumcision.
Typically, a hemophilia patient presents with pain followed by swelling in a weight-bearing joint, such as the hip, knee, or ankle. The presence of blood in the joint (hemarthrosis) causes synovial inflammation, and repetitive bleeding erodes articular cartilage and causes osteoarthritis, articular fibrosis, joint ankylosis, and eventually muscle atrophy. Bleeding may occur into any joint, but after a joint has been damaged, it may become a site for subsequent bleeding episodes. Patients suspected of having hemophilia should have a platelet count, bleeding time,prothrombin time(PT), and partial thromboplastin time(PTT).

Typically, the patient will have a prolonged PTT with all other tests normal. Because of the clinical similarity of factor VIII deficiency and factor IX deficiency, any male with an appropriate bleeding history and a prolonged PTT should have specific assays for factor VIII and factor IX.
Management: Tenets regarding the treatment of bleeding in hemophilia patients include the following:
(1) Symptoms often precede objective evidence of bleeding.
(2) Signs of bleeding may not appear until several days after well-documented trauma. Early treatment is more effective, less costly, and can be lifesaving.
(3) Avoid the use of aspirin or aspirin-containing drugs, which impair platelet function and may cause severe hemorrhage. Plasma products enriched in factor VIII have revolutionized the care of hemophilia patients, reduced the degree of orthopedic deformity, and permitted virtually any form of elective and emergency surgery.

The widespread use of factor VIII concentrates has also produced serious complications, including viral hepatitis, chronic liver disease, and AIDS. Homoeopathic Management: This includes confidence in physician himself and taking the challenge of treating a hereditary disease because so many homoeopaths leaves hope upon hearing a genetic disorder. Our literature is full of antihaemorrhagic remedies. Syntheis 9.2 contains following 65 medicines.
GENERALS - HEMORRHAGE - blood - non-coagulable4 Adren. ail. am-c. ancis-p. anthraci. Apis aran. Arn. ars. BOTH. both-ax. bov. calc. calc-lac. calc-p. carb-an. Carb-v. carc. cench. chin. chlol. chloram. cloth. cortico. croc. CROT-C. Crot-h. dig. dor. Elaps Erig. FERR. ferr-m. gal-ac. Ham. HIR. ip. Kali-p. kreos. lac-c. LACH. LAT-M. led. merc. mill. nat-m. nat-n. Nat-s. Nat-sil. NIT-AC. op. ph-ac. PHOS. puls. rad-br. Sec. sil. staphytox. stront-c. Sul-ac. sulph. ter. vip. visc. x-ray.

Case Report: A patient diagnosed severe haemophilic was shown to me on 09/05/2006. Pathological report reveals Factor VIII activity 02 %, Clotting time more than one hour, aPTT 155 sec. Parents were nearly hopeless because they were advised lifelong transfusion of Factor VIII per month which is too costly and two mama( mother’s brother) died of haemorrhage at age of 11 and 13 years (Haemophilia?). I took the case as a challenge and repertorised the case as follows with following symptoms MIND - ACTIVITY - desires activity MIND - ANGER - children; in MIND - CHEERFUL - waking, on HEAD - PERSPIRATION of scalp STOMACH - APPETITE - wanting SLEEP - POSITION - side; on SKIN - ECCHYMOSES SKIN - INDURATIONS, nodules, etc. SKIN - INDURATIONS, nodules, etc. - bluish - spots GENERALS - HEAT - sensation of GENERALS - HEMORRHAGE - blood - non-coagulable GENERALS - HEMORRHAGE - Internally I have chosen Phosphorus as most appropriate remedy after studying its materia medica.

At that time there occurs small bluish nodule under the skin which is due to haemorrhage in muscle and skin due to pressure. I used the method of hair transmission (Sahani Effect vide Transmission of Homoeo drug energy from a distance- B.Jain Publishers)6 .Phos 0/1 was transmitted with patients hair on 09/05/2006.Sac lac also given. Nash says “Under Phosphorus the blood becomes so broken down that it will not clot any more, and we have purpura haemorrhagica”. Hering Guiding symptom says about Phos as “Hemorrhages : profuse; frequent and profuse, pouring out freely, then ceasing for a time; from free surface and from tissues; from various parts of body, haemoptysis, bleeding of gums, hemorrhoids; metrorrhagia, etc.; blood very fluid and difficult to coagulate; vicarious, from nose, stomach, anus, urethra; associated with Bright's disease; from internal organs”.

Follow Up: Induration in bluish nodule began to decrease from first day and disappeared in few days. But they continue to recur from time to time till date. As I have discussed above the problem arises when child began to walk. Pressure cause bleeding in weight bearing joints resulting in haemoarthrosis. This child suffer from haemarthrosis of left ankle causing swelling and pain in joint. He does not put feet on the ground. Arnica 0/3 was transmitted on 08/08/2006, swelling and pain decreased within 3 days as evident in plate2. After few days again Phos 0/1 was transmitted which is continued till date. There occurred minor cut, sometime by own nail of child but bleeding stooped in few minutes. Advised for lab investigation of Factor VIII and BT, CT. Report of 12/09/2007 shows marked improvement in Factor VIII from 02% to 17% and Clotting Time from more than 1hours to 10 minutes.
(Reports enclosed) Interpretation : After one and half year of treatment patient improved from almost severe haemophilic to mild haemophilic. This case also demonstrates efficacy of hair transmission and role of homoeopathy in genetic disorders.

REFERENCES-
1-Short Practice of Surgery – Baily & Love.
2- Principle and Practice of Medicine Davidson.
3- Harrison’s Principle And Practice Of Medicine 15th edition.
4- RADAR homoeopathic Software 9.2 .
5- Encyclopedia Homoeopathica Ver 2.2 .
6- Transmission of Homoeo Drug energy from a distance Dr. B. Sahani.

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Homoeopathic Approach To Jaundice

About: ARTICLE FIRST PUBLISHED IN 1st Issue of ‘R.S. Bharagva Pharmacy Journal’.
Details: Jaundice, or icterus, is a yellowish discoloration of tissue resulting from the deposition of bilirubin. Bilirubin pigment has high affinity for elastic tissue and hence jaundice is particularly noticeable in tissue rich in elastin content.Tissue deposition of bilirubin occurs only in the presence of serum hyperbilirubinemia and is a sign of either liver disease or, less often, a hemolytic disorder.

The degree of serum bilirubin elevation can be estimated by physical examination. Slight increases in serum bilirubin are best detected by examining the sclerae which have a particular affinity for bilirubin due to their high elastin content. Normal serum bilirubin concentration ranges from 0.2-0.8 mg/dL, about 80 % of which is unconjugated. The presence of scleral icterus indicates a serum bilirubin of at least 3.0 mg/dL.
The ability to detect scleral icterus is made more difficult if the examining room has fluorescent lighting. If the examiner suspects scleral icterus, a second place to examine is underneath the tongue. As serum bilirubin levels rise, the skin will eventually become yellow in light-skinned patients and even green if the process is longstanding; the green color is produced by oxidation of bilirubin to biliverdin.Another sensitive indicator of increased serum bilirubin is darkening of the urine, which is due to the renal excretion of conjugated bilirubin. Bilirubinuria indicates an elevation of the direct serum bilirubin fraction and therefore the presence of liver disease.Increased serum bilirubin levels occur when an imbalance exists between bilirubin production and clearance.

Types of Jaundice: Haemolytic Jaundice Results from increased destruction of red blood cells or their precursor in the marrow, causing increased bilirubin production.Hepatocellular Jaundice Results from an inability of the liver to transport bilirubin into the bile, occurring as a result of parenchymal liver diseases. Hepatocellular diseases that can cause jaundice include viral hepatitis, drug or environmental toxicity, alcohol, and end-stage cirrhosis from any cause.Cholistatic Jaundice When the pattern of the liver tests suggests a cholestatic disorder, the next step is to determine whether it is intra- or extrahepatic cholestasis. In the USG the absence of biliary dilatation suggests intrahepatic cholestasis, while the presence of biliary dilatation indicates extrahepatic cholestasis. Intrahepatic causes include primary biliary cirrhosis, alcohol, drugs, viral hepatitis, autoimmune hepatitis, pregnancy etc. Extrahepatic can be caused by choledocholithiasis , pancreatic, gallbladder, ampullary, and cholangiocarcinoma, cystic fibrosis and parasitic infection.

Cholestasis of pregnancy caused probably due to an inherited susceptibility of the patients liver cells to oestrogen. Pruritus is the dominant symptom and jaundice occurs in about half of the patients. Itching almost always starts in the third trimester and remits within about 2 weeks of delivery, condition tends to recur in subsequent pregnancies. Jaundice of newborn children must not be confounded with the slight yellowish discolouration of the skin, which, in most children, is seen a few days after birth and is nothing but a change of colour of the haematin, which, in consequence of the great hypreaemia of the skin after birth, becomes deposited in the skin. In such cases the yellow colour of the white of eye is absent.
A complete medical history is perhaps the single most important part of the evaluation of the patient with unexplained jaundice. Important considerations include the use of or exposure to any chemical or medication, either physician-prescribed or over-the-counter, such as herbal and vitamin preparations and other drugs such as anabolic steroids. The patient should be carefully questioned about possible parenteral exposures, including transfusions, intravenous and intranasal drug use, tattoos, and sexual activity. Other important questions include recent travel history, exposure to people with jaundice, exposure to possibly contaminated foods, occupational exposure to hepatotoxins, alcohol consumption, the duration of jaundice, and the presence of any accompanying symptoms such as arthralgias, myalgias, rash, anorexia, weight loss, abdominal pain, fever, pruritis, and changes in the urine and stool. While none of these latter symptoms are specific for any one condition, they can suggest a particular diagnosis.

Physical Examination The general assessment should include assessment of the patient’s nutritional status. Temporal and proximal muscle wasting suggests longstanding diseases such as pancreatic cancer or cirrhosis. Stigmata of chronic liver disease, including spider nevi, palmar erythema, gynecomastia, caput medusae, Dupuytren’s contractures, parotid gland enlargement, and testicular atrophy are commonly seen in advanced alcoholic (Laennec’s) cirrhosis and occasionally in other types of cirrhosis. An enlarged left supraclavicular node (Virchow’s node) or periumbilical nodule (Sister Mary Joseph’s nodule) suggest an abdominal malignancy. Jugular venous distention, a sign of right-sided heart failure, suggests hepatic congestion. Right pleural effusion, in the absence of clinically apparent ascites, may be seen in advanced cirrhosis. The abdominal examination should focus on the size and consistency of the liver, whether the spleen is palpable and hence enlarged, and whether there is ascites present. Patients with cirrhosis may have an enlarged left lobe of the liver which is felt below the xiphoid and an enlarged spleen.
A grossly enlarged nodular liver or an obvious abdominal mass suggests malignancy. An enlarged tender liver could be viral or alcoholic hepatitis or, less often, an acutely congested liver secondary to right-sided heart failure. Severe right upper quadrant tenderness with respiratory arrest on inspiration (Murphy’s sign) suggests cholecystitis or, occasionally, ascending cholangitis. Ascites in the presence of jaundice suggests either cirrhosis or malignancy with peritoneal spread.

Here are few clinical clues according to symptom for assessing disease and patient condition:
1. Jaundice occurring suddenly in apparent health , and painlessly, is usually of emotional origin and transitory.
2. When it depends on disease or injury of brain, acute atrophy of liver, snake poisoning, or infectious fever, it is always associated with mental disturbances.
3. If it be attended with fever and well marked, it is secondary to inflammation of biliary passages, pneumonia, toxemia, or infective inflammation of the portal vein.
4. If it occurs suddenly and is preceded by paroxysmal pain and vomiting, it is caused nine times out of ten by biliary calculi.
5. Impassable obstruction of the common bile duct is shown by great intensity of jaundice, clay colored stools, and in recent cases by distention of the gall bladder.
6. Jaundice caused by sudden obstruction of the biliary passages is always associated with paroxysmal pain and nausea. In the rare cases of sudden obstruction by cancerous, hydatid and aneurismal tumors, there is almost always a history of impaired health, enlargement and deformity of the liver, ascitis etc. In theses cases USG is must and may pin point the disease.
7. Sudden return of normal colouration of stool confirms the diagnosis of obstruction.
8. Occlusion of the cystic duct may be attended with as much pain, nausea and distension of gall bladder as occlusion of the common duct, but there is no jaundice. In occlusion of the hepatic duct, the same symptoms are present, including jaundice and excluding distension of gall bladder.
9. A history of repeated attacks points to the probability of gall stone.
10. Slight but persistent jaundice may be due to incomplete occlusion of the common bile duct, or the complete occlusion of branch of the hepatic ducts.
11. If ascitis be associated with it, the disease is either cirrhosis or cancer of the liver; if the liver be abnormally small, the disease is cirrhosis; if it be large, the disease is either hypertrophic cirrhosis or cancer.
12. Absence of jaundice does not imply absence of hepatic disease; since the liver may be destroyed by disease or extirpated by operation without jaundice ensuing.

Homoeopathic Approach: A detailed history of patient should be taken including previous illness, mental disposition and general symptoms. Below are some clinical rubrics from Synthesis Repertory 9.1. These are mostly general rubric but must not be utilized as eliminating rubrics. These can be used as additional confirmation of remedy. Besides these rubrics any particular and general rubrics may be considered.
1- EYE – DISCOLORATION – yellow.
2 -MOUTH – DISCOLORATION – Tongue – white.
3 -MOUTH – TASTE – bitter.
4 -MOUTH – TASTE – sour.
5 -EXTERNAL THROAT – SWELLING – Cervical Glands.
6 -STOMACH – APPETITE – wanting.
7 -STOMACH – VOMITING – heat – during.
8-ABDOMEN – ATROPHY – Liver.
9 -ABDOMEN – ENLARGED – Liver.
10-ABDOMEN – ENLARGED – Spleen.
11-ABDOMEN – INFLAMMATION – Liver.
12-ABDOMEN – PAIN – Liver.
13-ABDOMEN – PAIN – Liver – sore.
14 -RECTUM – CONSTIPATION.
15 -RECTUM – DIARRHEA.
16-STOOL – CLAY COLORED.
17-STOOL – GRAY.
18 -STOOL – LIGHT COLORED.
19 -STOOL – WHITE.
20 -URINE – BILE, containing.
21-URINE – SCANTY.
22 -SLEEP – SLEEPINESS – heat – during.
23 -FEVER – CHILL; with.
24 -SKIN – DISCOLORATION – yellow.
25 -SKIN – ITCHING.
26 -SKIN – ITCHING – jaundice; during.
27 -SKIN – NETWORK of blood vessels.
28 -GENERALS – SWELLING – Glands; of Therapeutics Of Jaundice

Acon Great unquenchable thirst, pain changing about from stomach to liver, during pregnancy; in newborn children; after fright. Arsenic In different liver affections, in consequence of intermittent fevers; heat, restlessness, anxiety, irritable mood alternating with low spiritedness. Berberis Spells of icterus. Very valuable for hepatic diseases; with indigestion, eructations, salivation, heartburn, vomiting of food after eating. Soreness in the region of the liver. Bilious colic, colic from gall-stones, with jaundice. Bryonia there are sharp, stitching pains in the liver, worse from motion, relieved by lying on the right side; jaundice from duodenal catarrh or when caused by anger indicates it. Card.Mar.In complication with gall stone. Swelling of gall bladder with tenderness; stools hard, difficult, knotty, alternates with bright yellow diarrhoea. Jaundice with intolerable itching, when lying down at night.

Cham After chagrin, imprudent diet; in newborn children.Chelidonium The jaundiced skin, and especially the constant pain under inferior angle of right scapula, are certain indications. In affections of the liver, where there is a great deal of pain and soreness in the region of that organ; jaundice; yellow tongue, taking the imprint of the teeth; bitter taste and craving for sour things. Fatty liver; painful enlargement of liver; gall stones; bilious condition in general. China Gastro-duodenal catarrh, ending in jaundice, particularly after great loss of animal fluids or after heavy illness. Old liver subjects with jaundice. After meals there is a sensation of weight or of a lump behind the middle of the sternum. Flatulent distension of the belly may be extremes as tight as a drum, and this is accompanied by sour eructations and loud belchings which afford no relief. Nor does the passage of flatus give any relief. Flatulence also accompanies liver and gall-bladder complaints. Jaundice is common. Gall stone colic. Yellow coating of tongue.

Digitalis Excessive jaundice, with slow weak heart and ashy-white stools. Jaundice, with slow pulse, with uneasiness in the liver, pale stool. Jaundice from cardiac troubles, with white, ashy stools; liver enlarged, sore and bruised; bitter taste; tongue clean or whitish yellow; slow pulse; drowsiness; high-colored urine, jaundice due to functional imperfections of the liver. Hydrastis Gastroduodinal catarrh; sense of sinking and prostration at epigastrium. The skin is jaundiced; the stool is light, even white, showing the absence of bile, and there is distress in the region of the liver. Colic, gallstone. Kali Carb Swelling of the liver; stitch pain in the right side of the chest through to shoulder; pressive, sprained pain in the liver; can lie only on the right side.
Lach There is lowered coagulability with liability to sub-cutaneous haemorrhages : Great destruction of red blood corpuscles which may give rise to haemotogenous jaundice. Enlarged liver of drunkards, going on to a low grade of symptoms with inflammation and abscess of liver, jaundice, tenderness to pressure all the time ( Lyco. only after meal), intolerance of clothing; constant urging in anus, but no stool follows or extremely offensive stools. Leptandra Great prostration, stupor, heat and dryness of skin,coldness of the extremities, dark, foetid, tarry, or watery stools mixed with bloody mucus, and a jaundiced skin. Full aching pain in the region of gall bladder. Lyco The remedy is often indicated when the liver is affected with local tenderness in the right hypochondrium and, possibly, evident jaundice. Also when there are recurrent bilious attacks or actual bile duct spasm.Hepatitis, especially of children (? with pneumonia). Jaundice with flatulence. Mag Mur Liver : enlarged; congested and face and eyes yellow, jaundice, stool gray, feet and legs swell, urine scanty and high color, constipation; worse lying on right side; or, sour vomiting, breath offensive, face yellow, constipation; or, abdomen bloated, tongue large and coated yellow Merc Jaundice of newborn children. Flabby tongue with imprint of teeth.Soreness in the region of liver; gall stone.

Myrica These are the distinctive features : Aching pain in liver, fulness, drowsiness, despondency, dull, heavy headache, agg. in morning, dirty, dingy, yellowish white of eyes, lids abnormally red, weakness, ash-coloured stools, slow pulse, pains under scapulae (agg. left), dirty yellow tongue, muscular soreness, aching in limbs, jaundice of all degrees. It is in cases attended with jaundice that Myrica has had the greatest success, cases of black jaundice having been cured with it, and it meets the itching of jaundice as well.
Nux Vom -Jaundice from anger (Cham.), high living. There may even be definite enlargement of the liver with a constant feeling of distension in the upper abdomen; and actual attacks of jaundice and even the development of gallstones, with acute hepatic colic.
Phos Diffuse hepatitis.Hyperaemia and enlargement of liver.Liver hard, large, with subsequent atrophy.Hepatitis when suppuration ensues, hectic fever, night sweats, marked soreness over liver (Hepar, Hipp. Lach., Crot. h., Sil.).Jaundice. Pale stools. Abdomen tympanitic.Hepatic congestion, quantities of bright or dark blood discharged with stool.
Craves cold food and drink: ice cream wine.”Bad effects from excessive use of salt”.
A characteristic symptom : As soon as water becomes warm in stomach it is vomited. Podo In complication with gall stone. Pain extends from region of stomach towards the region of gall bladder. Soreness about the liver. Torpidity of the liver; portal engorgement with a tendency to haemorrhoids, hypogastric pain, fullness of superficial veins, jaundice. Sulph This is one of the most commonly indicated drugs in jaundice of children – acute catarrhal jaundice – particularly with the marked intolerance that SULPHUR has to milk in its acute conditions, intense skin irritation, feeling of burning heat on the surface very often with attacks of colic, frequently with attacks of diarrhoea. In psoric persons with or withot hardness and swelling of liver.

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Article on Swine Flu

About: Article Published in Homeopathic Heritage.

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Approach to Newborn in Homoeopathy with Repertory

About: ARTICLE FIRST PUBLISHED IN VITAL INFORMER – NEW DELHI.
The child comes into this world in trust and innocence. Infants whose needs are met in this critical time are better adjusted, cry less and have fewer symptoms during the first year of life. If the child does not feel this sense of security, symptoms will occur. These symptoms are expressed as need for help through non-verbal communication. Study in paediatircs involves understanding the mute communication, which comes out in very innocent way. Since the observation and perceiving of symptoms are very crucial in constituting the totality for any given case in Homoeopathy it become very much necessary to interpret all the expression of a mute child who is crying for help.
Newborns are special field of interest in homoeopathic paediatric practice because we get very few signs and symptoms and basis of our prescriptions are signs and symptoms rather than name of disease. For practical purpose we divide children into Newborn (0-4 weeks), Nurslings (0-1 year), Infants (1-6 years) and Children (6 years and above).

The most important part is KEEN OBSERVATION, because sometimes-even mother does not know the cause of discomfort or weeping of newborn. The newborn is capable to feel and express anger, sadness and fright, as well as feeling of disgust, distress and abandonment Below are some specific 71 rubrics and remedies from SYNTHESIS 9.1 for newborn. These rubrics are from clinical observations of different physicians. Beside these some general rubrics can also be considered as per case.
MIND – ANXIETY – nursed; when the child is – after being nursed – newborns; in (Cham pg. 23).
MIND – JEALOUSY – children – newborn gets all the attention; when the (Hyos,Ign pg. 158).
MIND – WEEPING – continuously – children; in – newborns (Syph,Thuj pg. 249).
HEAD – BORES head in pillow – children; in – newborns (Cham pg. 273).
HEAD – ERUPTIONS – milk crust – children; in – newborns (Calc, Olnd, Tub pg. 287).
HEAD – ERUPTIONS – milk crust – children; in – newborns – adenitis; with (Am-c, Astac, Bar-c pg. 287).
EYE – DISCHARGES – bloody – watery – children; in – newborns (Cham pg. 428).
EYE – INFLAMMATION – children; in – newborns (Acon, Arn,Kali-s,Merc-c,Puls,Thuj pg. 437).
EYE – INFLAMMATION – Lachrymal ducts – children; in – newborns (Sil pg. 439).
EYE – STRICTURE of lachrymal duct – children; in – newborns (Sil pg. 470).
EYE – TEARS – bloody – newborn; in (Cham pg. 472).
EYE – ULCERATION – Cornea – children; in – newborns (Arg-n pg. 475).

NOSE – CORYZA – children; in – newborns (Dulc pg. 548).
NOSE – SNUFFLING – children; in – newborns; in (Acon, Am-c, Bell, Calc-lac, Cham, Dulc, Elaps, Hep, Lyc, Merc, Merc-I-f, Nux-V, Puls, Samb, Stict, Sulph, Syph pg. 581).
FACE – DISCOLORATION – bluish – newborn infant (Laur pg. 591).
FACE – EXPRESSION – old looking – children; in – newborns (Op pg. 612).
FACE – HIPPOCRATIC – children; in – newborns (Abrot, Aeth pg. 617).
FACE – LOCKJAW – children; in – newborns; in (Ambr, Ang, Camph, Merc pg. 619).
FACE – WRINKLED – children; in – newborns (Abrot, Aeth pg. 644).
THROAT – SWALLOWING – difficult – children; in – newborns (Kali-c pg. 762).
STOMACH – APPETITE – wanting – children; in – newborns (Lyc pg. 784).
STOMACH – VOMITING; TYPE OF – blood – children; in – newborns; in (Acon, Lyc pg. 859).
ABDOMEN – DISCHARGE from umbilicus – bloody fluid – children; in – newborns (abrot, calc-p, pg. 873).
ABDOMEN – DISCHARGE from umbilicus – children; in – newborns (Abrot/, pg. 873).
ABDOMEN – ERUPTIONS – Umbilicus – Around – children; in – newborns; in – accompanied by – appetite; diminished (abrot. pg. 879).
ABDOMEN – ERYSIPELAS – Umbilicus – newborns; in (Apis pg. 879).
ABDOMEN – HERNIA; ABDOMINAL – Umbilical – children; in – newborns (nux-m pg. 888).
ABDOMEN – INFLAMMATION – Small intestine – infants – newborns (Coli pg. 889).
ABDOMEN – INFLAMMATION – Umbilicus – children; in – newborns; ulceration of umbilicus in (Abrot, Apis, Calc-p pg. 890).
ABDOMEN – PAIN – children; in – newborns (Coloc, Mag-p pg. 898).
ABDOMEN – ULCERS – Umbilicus, about – children; in – newborns (Apis pg. 961).
RECTUM – CONSTIPATION – children; in – newborns (Alum, Med, Nux-m, Nux-V, Op, Sulph, Verat, Zinc pg. 969).
RECTUM – DIARRHEA – children; in – newborns (Aeth, Coli pg. 976).
RECTUM – ERUPTIONS – Anus; about – children; in – newborns (Med pg. 982).
RECTUM – ERUPTIONS – Anus; about – children; in – newborns – washing agg (Med pg. 982).
RECTUM – ERUPTIONS – Anus; about – rash – children; in – newborns (Med pg. 982).
RECTUM – ERUPTIONS – Perineum – children; in – newborns (Med pg. 982).
RECTUM – IRRITATION – newborns; in (Med pg. 990).

STOOL – BLOODY – children; in – newborns (Acon pg. 1010).
BLADDER – RETENTION of urine – children; in – newborns (Acon, Apis Ars, benz-ac, camph, canth, erig, hyos, lyc, nux-v, puls pg. 1030).
BLADDER – RETENTION of urine – children; in – newborns – passion of the nurse; after (Op pg. 1030).
URINE – ACRID – children; in – newborns (Med pg. 1065).
MALE GENITALIA/SEX – ERUPTIONS – rash – children – newborns – extending through perineum (Med pg. 1086).
FEMALE GENITALIA/SEX – ERUPTIONS – rash – children – newborns – extending through perineum (Med pg. 1114).
RESPIRATION – ASPHYXIA – children, newborns (Acon, Am-c, Ant-c, Ant-t, Arn, Bell, Camph, Chin, Crot-h, Hydr-ac, Hyos, Laur, Op, Ip pg. 1185).
RESPIRATION – ASPHYXIA – children, newborns – mother; from loss of blood of (Chin pg. 1185).
RESPIRATION – DIFFICULT – children; in – newborns (Ant-t, Laur pg. 1193).
CHEST – NODULES, sensitive – Mammae – children; in – newborns (Cham pg. 1274).
EXTREMITIES – CLENCHING – Fists – children; in – newborns (Cham pg. 1431).
EXTREMITIES – DISCOLORATION – Nates – redness – newborns (Med pg. 1456).
EXTREMITIES – ERUPTIONS – Nates – Between nates – rash in children, newborns; red (Med pg. 1470).
SLEEP – DISTURBED – children; in – newborns (Cham pg. 1715).
SLEEP – SLEEPLESSNESS – children; in – newborns (Bell, Cham, Coff, Cypr, Op, Psor, Sulph pg. 1735).
SLEEP – WAKING – frequent – children; in – newborns; in (Borx pg. 1744).
CHILL – CHILLINESS – children; in – newborns (Coli pg. 1800).
SKIN – ERUPTIONS – children; in – newborns; in (Dulc, Tub pg. 1850).
SKIN – ERYSIPELAS – children; in – newborns (Bell, Camph, Carb-an pg. 1866).
SKIN – INDURATIONS, nodules, etc. – children; in – newborn (Camph pg. 1869).
SKIN – INFLAMMATION – desquamation; with – newborn; in (Viol-t pg. 1869).
GENERALS – CHILDREN; complaints in – newborns (Acon pg. 1902).
GENERALS – CONVULSIONS – children; in – newborns (Art-v, Bell, Cupr, Nux-v pg. 1915).
GENERALS – CONVULSIONS – dentition; during – newborns; in (Strept-ent pg. 1915).
GENERALS – CONVULSIONS – heat; during – children; in – newborns; in (Camph pg. 1918).
GENERALS – DROPSY – general; in – children; in – newborns (Apis, Carb-v, Coffin, Dig, Lach, Sec pg. 1928).
GENERALS – EMACIATION – appetite with emaciation; ravenous – children; in – newborns (Sanic pg. 1931).
GENERALS – EMACIATION – children; in – newborns; in – accompanied by – Umbilicus – discharge from umbilicus (Abrot pg. 1931).
GENERALS – EMACIATION – children; in – newborns; in – accompanied by – Umbilicus – eruption on umbilicus (Abrot pg. 1931).
GENERALS – EMACIATION – children; in – newborns; in – birth trauma; after (Borx pg. 1931).
GENERALS – EMACIATION – children; in – newborns; in – bottle fed (Nat-p pg. 1931).
GENERALS – HISTORY; personal – birth trauma; of (Arn, Borx, Carc, Cic, Hell, Hyper, Nat-m, Nat-s pg. 1970).
GENERALS – WEAKNESS – children; in – newborns; in (Aeth pg. 2072)

Beside these rubrics we must note History of pregnancy of Mother. History of birth related – delivery of the child, Nature of Delivery, Place of Birth: At Home/ Hospital or other place. Attitude of Mother during Pregnancy. Attitude of other family members during pregnancy and after birth. Was the child a welcome one or unwanted. Family History of any Sickness. Family history of any hereditary disorder. Personal Past History of sickness of Child. Whether mother or someone else brings up the child. Breast-feeding, reaction to milk. Non verbal behaviors-Eye Contacts (gaze aversion, strong/staring vacant/ staring at examiner/hesitant eye contact/ normal eye contact, body attitude gesture and sleep position. Any notable fear like downward motion, reaction to light, noise. These informations may point towards some general rubrics We must differentiate each remedy of rubrics with knowledge of materia medica. E.g. For CONSTIPATION IN NEWBORN following remedies are listed.

Constipation of ALUM is with soft stool. In MED. the newborn lie on their bellies in a knee-to-chest position, there is also characteristic rash also known as diaper rash found around anus. NUX-M constipation is due to paralytic weakness of intestines. Enormously distended abdomen Stool is soft, and yet is unable to expel it, even with long straining.In NUX-V there is Irregular, peristaltic action; hence frequent ineffectual desire, or passing but small quantities at each attempt. Alternate constipation and diarrhea. OPIUM has obstinate constipation; Round hard, black balls. Faeces protrude and recede. [Thuj. Sil.]Spasmodic retention of faeces in small intestines. Stools involuntary black, offensive, frothy. In SULPH children hard stool that are passed with difficulty cause burning, stinging and itching of the anus afterwards. The differentiating point is that in CALC the constipation may be painless, and in SULPH it tends to be so painful that the child refuses to move his bowels for fear of the pain it will bring. While examining one may observe that the anus, the perineum, and the area between the buttocks are all very red. VERAT is useful in constipation of babies, and when produced by very cold weather. Stools large, with much straining until exhausted, with cold sweat. ZINC constipation of the newborn-loose, soft evacuations of consistence of pop, of liquid, and often accompanied by a discharge of bright red (or pale) blood.

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Articals-5

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Use Of Repertory In Geriatric Practice – Vital Informer

About: Article FIRST PUBLISHED IN ‘Vital Informer’, Tagore Garden, New Delhi, India ,Vol. 15 No. 6, June 2007
Repertory is an indispensable tool in homoeopathic practice. Use of repertory in elderly patients with specific rubrics may point towards some very important remedies which we might overlook in usual materia medica study. Synthesis repertory 9.1 contains many such rubrics with corresponding remedies. These rubrics have come from many author sources and clinical experiences. Here, I am also giving specific rubrics along with remedies because many readers don’t have latest version of synthesis. These rubrics and remedies are added from various author references which can be viewed in computerized or printed version e.g. Rubric Absentminded, old people in- has addition Am-c from Kent personal addition, Ambr and Bar-c from Vithoulkas, Con and Lyc from Stauffer Karl. One should bear in mind these rubrics and remedies are mostly clinical experiences and should not be used as eliminating rubrics. General or larger rubrics must be utilized for repertorisation.

You can have many more general rubrics e.g. at old age common problems of mind include weakness of memory, forsaken feeling, helplessness feeling of, anger, irritability, audacity, Ailments from- abused being, anger, cares, worries, celibacy, grief, indignation, honor wounded, mortification, neglected being, scorned being, unhappiness etc. Some specific rubrics are as below.
MIND – ABSENTMINDED – old age; in am-c. Ambr. Bar-c. Con. Lyc.
MIND – CHILDISH behavior – old people; in BAR-C.
MIND – CONFUSION of mind – old age, in arg-met. Arg-n. Bar-c. Con.
MIND – DELIRIUM TREMENS – old emaciated persons, in OP.
MIND – DULLNESS – old people, of abel. Abies-n. AMBR. Arg-met. Arg-n. BAR-C. Con. Lyc. PLB.
MIND – FEAR – impotence; of am-f. cob. cob-m. cob-p. fl-ac. lith-f. nat-m. onos. phos. pitu. rhod. stry. tritic-vg.
MIND – FORGETFUL – old people, of am-c. Ambr. anac. Bar-c. coff. Con. Crot-h. lach. Lyc. Ph-ac. rhus-t. sulph.
MIND – FORSAKEN feeling – old people; in aur. psor.
MIND – HIDING – himself – old people, in op.
MIND – INSANITY – old people; in bell. ign. nat-m. nux-v. sep. sulph.
MIND – LEWDNESS – old men; in dig.

MIND – LOATHING – general loathing – old age, in aur. calc.
MIND – MEMORY – weakness of memory – facts, for – past facts; for – old people, in coff.
MIND – MEMORY – weakness of memory – facts, for – recent facts, for – old people, in lach. sulph.
MIND – DEMENTIA – senilis agn. alum. Ambr. anac. ant-c. arg-met. aur. Aur-i. aza. bapt. bar-act. Bar-c. bell. bry. bufo calc-p. carc. Con. Crot-h. Cupr. gaert. ign. lach. lil-t. Lyc. med. nat-i. nat-m. nux-v. op. phos. plb. puls. sec. sep. sulph. thiosin.
MIND – MISTAKES; making – speaking, in – old people; in am-c.
MIND – MISTAKES; making – writing, in – old people; in am-c. Crot-h.
MIND – MOANING – old age, in \Bar-c.
MIND – MUTTERING – old people; in Bar-c.
MIND – PROSTRATION of mind – old age, in BAR-C. sel.
MIND – REFLECTING – inability to reflect – old people; in Ambr.
MIND – SADNESS – old age; in Aur. esp-g.

MIND – SIGHING – old peopleign.
MIND – SLOWNESS – old people, of cact. calc. CON. Hell. Phos. zinc.
MIND – STUPOR – old age, in Bar-c.
MIND – TALKING – sleep, in – old men; in bar-c.
MIND – UNCONSCIOUSNESS – old age, in Bar-c.
MIND – WEARY OF LIFE – old age, in Ars. aur. calc.
MIND – WEEPING – causeless – old people; in caust.
A very common complaint at old age is vertigo. Inquire about its occurrence time, effect of posture and modalities and don’t forget to check blood pressure. VERTIGO – OLD PEOPLE; in alum. Ambr. arn. Ars-i. aur. Bar-c. bar-m. bell. bell-p. bry. calc-p. con. Cupr. dig. fl-ac. galph. glon. gran. Iod. op. phos.
RHUS-T. sec. Sin-n. stroph-h. sulph.
HEAD – BRAIN; complaints of – degenerative – old people; in – men; old bar-c.
HEAD – HEAVINESS – old people; in bar-m.
HEAD – PAIN – chronic – old people, of bar-c. calc-p. iod. phos.
HEAD – PAIN – old people, of am-c. ambr. bar-m. cypr. gels. iod. lach. nat-c. sep. sulph.
EYE – AMBLYOPIA – old people; in bar-c.
EYE – CATARACT – old people; in calc-p. Carb-an. caust. chol. Cine. con. graph. kali-c. lyc. mag-c. merc. napht. nat-m. phos. puls. Sec. sil. sulph.
EYE – INFLAMMATION – old people; in alum.
VISION – DIM – old people Ambr. Bar-c.

HEARING – IMPAIRED – old people bar-c. Cic. kali-chl. kali-m. mag-c. merc-d. Petr. phos.
NOSE – CATARRH – old people; in Alum. am-c. bar-c. eup-per. ictod. kali-s. Kreos. merc-i-f.
NOSE – CORYZA – old people am-c. anac. ant-c. camph.
NOSE – EPISTAXIS – old people Agar. aur. bar-c. bov. Carb-v. chin. con. ferr-p. ham. phos. SEC. sil. sul-ac. verat.
FACE – ERUPTIONS – crusty, scabby – old people; in cory.
MOUTH – CLEAN Tongue – accompanied by – bitter taste – women; in old Carb-v.
THROAT – SPASMS – Esophagus – old people can only swallow liquids Bar-c.
STOMACH – INDIGESTION – old people Abies-n. ant-c. ars. Bar-c. caps. carb-v. chin. Chinin-s. Cic. fl-ac. Hydr. juni-c. kali-c. nux-m. nux-v. pop.
STOMACH – NAUSEA – old people; in Fl-ac.
ABDOMEN – ENLARGED – women; in matrons and old Bell. calc. chin. coloc. nux-v. Plat. SEP.
ABDOMEN – FLATULENCE – old people Carb-ac. Phos.
ABDOMEN – HERNIA; ABDOMINAL – Inguinal – old people nux-v. sul-ac.
RECTUM – CHOLERA – old people aeth.
RECTUM – CONSTIPATION – chronic – old people; in phyt.
RECTUM – CONSTIPATION – old people aloe alum. alumn. ambr. Ant-c. arn. Bar-c. Bry. Calc-p. Con. hydr. hyos. Lach. lyc. Nux-v. Op. Phos. Phyt. rhus-t. ruta Sel. Sulph.
RECTUM – DIARRHEA – accompanied by – heat; lack of vital – old people; in bov.
RECTUM – DIARRHEA – alternating with – constipation – old people; in alum. ANT-C. bry. cycl. nux-v. op. Phos.
RECTUM – DIARRHEA – old people ANT-C. ant-t. ARS. ars-i. bapt. bar-c. bov. Bry. Carb-v. Chin. coff. con. Fl-ac. GAMB. iod. kreos. lach. nat-m. nat-s. NIT-AC. nux-v. op. phos. rhus-t. ruta sec. sul-i. sulph.

We should also differentiate between remedies like in Ant-c Old people with morning diarrhoea, suddenly become constipated, or alternate diarrhoea and constipation; pulse hard and rapid. Ars A In asthma of old people, who have occasional attacks of morning diarrhoea, rheumatism, scanty secretion of urine, and too violent impulse of heart sound. Ars-I – The diarrhoea comes in the morning and after eating; in old people, excoriating stool. In Bapt. Dysentery of old people; diarrhoea of children, especially when very offensive (Allen) Bov- Chronic diarrhoea of old people agg. night, early morning. (Phatak) Bry is indicated in constipation after vexation; in old people; during pregnancy; with retention after delivery; before menses; from sedentary habits, after abuse of drugs; alternating with diarrhea (Vithoulkas).
Carb-v – Painful diarrhoea of old people. (Phatak) Con Chronic diarrhoea of old people, with tremulous weakness; discharges sometimes involuntary; specially indicated by the symptoms that the flow of urine is intermittent. Coff. has Obstinate diarrhoea of old people occurring after an attack of cholera.In Fl-Ac warm drinks brings on diarrhoea, it has also morning diarrhoea (Kent)Gambog. is particularly indicated in diarrhoea of old people; the urging is excessive and the stools are expelled all at once with considerable force followed by a feeling of general relief.
One other feature of IODUM quite frequently met with in rheumatic cases, is a history of an acute diarrhoeic attack immediately preceding the rheumatic attack. (Borland)Kreosote is indicated in diarrhoea of old women.Nat S has diarrhoea in the morning and cheerful or amel after stool. Nit-ac Excessive prostration, with diarrhoea, especially in old people and those who sleep badly. Nux v has frequent ineffectual urging and straining even in diarrhoea and they feel still there is more stool Phos Diarrhoea as soon as anything enters the rectum; profuse pouring away as from a hydrant; watery with sago-like particles; with sensation as if the anus stood open; involuntary; during cholera-time; painless; morning of old people; bloody stool; blood-streaked stool; stool like shreddy membranes.Sulph has well known early morning diarrhoea which is sudden and drives him out of bed.

RECTUM – DYSENTERY – old people; in bapt.
RECTUM – HEMORRHAGE from anus – old people; in – women; old psor.
When bladder condition is assessed one should always note prostate condition as prolonged prostate trouble cause pressure over detruser muscles and sphincter which may result in weakness and incontinence results. Also check for any adhesion, phimosis or any stricture in urethra.
BLADDER – ATONY of – old age ars. stram.
BLADDER – CATARRH, mucopus – old people; in Alumn. Carb-v. kali-p. pop. sulph. Ter.
BLADDER – PARALYSIS – old people; in ARS. bell. camph. Cann-s. canth. Caust. Cic. con. Equis-h. Gels. kali-p. lach. lyc. mur-ac. nat-m. nux-v. op. phos. Sec. sil. Sulph. thuj.
BLADDER – RETENTION of urine – old people; in – men; old Caust. Con. lyc. op. pareir. plb. Puls. sars. sep. sil. Solid. staph. sulph. Ter. Zinc.
BLADDER – URINATION – dribbling – old persons; in all-c. bar-c. cic. con. equis-h. nux-v.
BLADDER – URINATION – dysuria – morning – old men, in Benz-ac. Corn.
BLADDER – URINATION – frequent – old people Bar-c.
BLADDER – URINATION – involuntary – night – old people apoc. benz-ac. kali-p. sec.
BLADDER – URINATION – involuntary – old people; in All-c. aloe am-be. apis arg-n. Ars. Aur-m. bar-c. Benz-ac. bry. cann-s. canth. carb-ac. chlorpr. Cic. con. dam. equis-h. gels. Iod. kali-p. nit-ac. phos. psor. Rhus-a. Sec. seneg. Thuj.

BLADDER – URINATION – involuntary – old people; in – men with enlarged prostate
All-s. Aloe apoc. Cic. dig. Iod. kali-p. nux-v. Pareir. Sec. Thuj.
BLADDER – URINATION – involuntary – old people; in – women Caust.
BLADDER – WEAKNESS – old people; in Ars. Gels.
BLADDER – WEAKNESS – old people; in – men; old alum. Benz-ac. carb-ac. clem. con. Pop. sel. Staph.
MALE GENITALIA/SEX – ERECTIONS – continued – old people; in – men; old arn.
MALE GENITALIA/SEX – ERECTIONS – frequent – old people; in – men; old caust.
MALE GENITALIA/SEX – ERECTIONS – violent – old people; in – men; old Fl-ac.
MALE GENITALIA/SEX – ERECTIONS – wanting – old people; in LYC.
MALE GENITALIA/SEX – INDURATION – Penis – old people; in – men; old Berb.
MALE GENITALIA/SEX – INDURATION – Testes – old people; in bar-c.
MALE GENITALIA/SEX – POLLUTIONS – frequent – old people; in – men; old bar-c. caust. nat-c. sulph.
MALE GENITALIA/SEX – SEXUAL DESIRE – increased – old people; in – men; old arn. Fl-ac. lyc. mosch. sel. staph. sulph.
MALE GENITALIA/SEX – SEXUAL DESIRE – increased – old people; in – men; old – impotent; but lyc. sel.
FEMALE GENITALIA/SEX – EXCORIATION – old people; in – women; old merc.
FEMALE GENITALIA/SEX – LEUKORRHEA – bloody – old women, in arist-cl. Phos.

FEMALE GENITALIA/SEX – LEUKORRHEA – old people; in – women; old ars. Gels. Helon. nit-ac. Phos. sec.
FEMALE GENITALIA/SEX – MENSES – copious – old people; in – women; old crot-h. lach. mag-m. Plat. Sars.
FEMALE GENITALIA/SEX – MENSES – return – ceased; after the regular menstrual cycle has – old women, in Calc. lach. mag-c. mag-m. PHOS. Plat. sep. staph.
FEMALE GENITALIA/SEX – METRORRHAGIA – women – old; in Calc. cham. hydr. Ign. lach. Mag-m. Mang. Merc. phos. sep. FEMALE GENITALIA/SEX – SEXUAL DESIRE – increased – old women, in apis Mosch.
FEMALE GENITALIA/SEX – ULCERS – Uterus – Cervix – old people; in – women; old sul-ac.
LARYNX AND TRACHEA – CATARRH – old people; in Ammc. Ant-t. Ars. BAR-C. Carb-v. CHIN. Hydr. Lyc. SENEG.
LARYNX AND TRACHEA – VOICE – old people; complaints of bar-c.
RESPIRATION – ASTHMATIC – old people; in am-c. Ambr. ant-c. ARS. aur. Bar-c. bar-m. camph. Carb-v. Coca Con. phel. Seneg. sulph.
RESPIRATION – ASTHMATIC – old people; in – athletes coca
RESPIRATION – DIFFICULT – old people ammc. Bac. Bar-c. carb-v. Chin. coca seneg.
RESPIRATION – RATTLING – old people Ammc. Bar-c. HIPPOZ. KALI-BI. LYC. Seneg.
RESPIRATION – SUPERFICIAL – old people; in Bac.
COUGH – OLD people alum. alumn. Am-c. Ambr. Ammc. ant-c. ant-i. Ant-t. Bar-c. bar-m. camph. Carb-v. con. DULC. hydr. hyos. ichth. ip. kreos. myrt-c. Psor. rhus-t. sal-ac. Seneg. sil. stict.
COUGH – RATTLING – old people Ammc. bar-c. Hippoz. Kali-bi. Seneg.

EXPECTORATION – COPIOUS – old people alum. Ammc. Ant-t. Ars. BAR-C. caust. Kreos. senec.
EXPECTORATION – DIFFICULT – old people Ammc. diphtox. Seneg.
CHEST – ARTERIOSCLEROSIS of coronaries – old people; in – men; old bar-c.
CHEST – BRONCHIECTASIS – old people eucal.
CHEST – CATARRH – old people Ammc. Ant-t. Bac. BAR-C. Chin. hydr. Nat-s. phel. SENEG. Tub
CHEST – EMPHYSEMA – old people; in lob.
CHEST – HEART; complaints of the – old people; in ars-i. bar-i. crat.
CHEST – INFLAMMATION – Bronchial tubes – old people all-c. Am-c. Ammc. ant-c. ANT-T. ars. Camph. Carb-v. diphtox. Dros. HIPPOZ. Hydr. kreos. led. Lyc. Nux-v. prot. Seneg. squil. verat.
CHEST – INFLAMMATION – Lungs – old people ACON. ant-ar. Ant-t. ars. Bell. Bry. cham. Dig. Ferr. FERR-P. gels. Hyos. ip. MERC. Nat-s. Nit-ac. Nux-v. Op. Seneg. verat.
CHEST – INFLAMMATION – Pleura – old people Nit-ac.
CHEST – PARALYSIS – Lung – old people Ant-t. Ars. aur. BAR-C. Carb-v. CHIN. con. LACH. lyc. Op. phos. verat.
CHEST – PHTHISIS pulmonalis – old people Nat-s. seneg.
EXTREMITIES – GANGRENE – Toes – old people; in Carb-an. Carb-v. cupr. Ph-ac. SEC.
EXTREMITIES – PARALYSIS – old people; in Bar-c. Con. Kali-c. op.
SLEEP – SLEEPINESS – old people ant-c.
SLEEP – SLEEPLESSNESS – old people; in Acon. ars. Bar-c. carc. op. passi. phos. sulph. SYPH.
SLEEP – SLEEPLESSNESS – restlessness, from – old people; in bar-c.
FEVER – INTERMITTENT – old people, with coma alum. nux-m. Op.
SKIN – DISCOLORATION – spots – dark spots – old people; in ars. aur. bar-c. Carb-an. Con. Lach. Lyc. op. Sec.
SKIN – ERYSIPELAS – old people; in am-c. carb-an. Lach.

SKIN – GANGRENE – old people; in all-c. am-c. ars. Carb-v. euph. euph-re. ph-ac. sars. SEC. sul-ac.
SKIN – ITCHING – old people; in alum. arg-n. ars. bar-act. bar-c. con. dol. dulc. fago. fl-ac. kreos. mag-p. merc. Mez. nat-sil. olnd. op. sul-ac. sulph. urt-u.
SKIN – ULCERS – old people; in tarent-c.
GENERALS – BLACKNESS of external parts – old people; in adren. all-c. am-c. Ars. Carb-v. chin. con. crot-h. cupr. echi. ergot. euph. Kreos. LACH. Ph-ac. Plb. SEC. vip.
GENERALS – CHOREA – old people; in aeth. aven.
GENERALS – EMACIATION – old people; in Ambr. anac. BAR-C. carb-v. chin. chinin-s. Fl-ac. IOD. LYC. nit-ac. op. rhus-t. Sec. Sel. Sil.
GENERALS – HEAT – lack of vital heat – old people; in alum. ambr.
GENERALS – OBESITY – old people; in am-c. AUR. bar-c. fl-ac. KALI-C. op. sec.

GENERALS – OLD AGE – premature Agn. alco. alum. Ambr. ant-c. anthraci. arg-met. arg-n. ars. Aur. Bar-c. berb. bufo carb-ac. carb-v. carc. chinin-s. coca Con. cortico. Cupr. des-ac. esp-g. Fl-ac. gins. hydr. hydrog. Kali-c. kres. LACH. lyc. mag-f. nit-ac. nux-v. op. phos. prot. psor. reser. sars. sec. SEL. sep. staph. stram. sulph. sumb. verat. Vip.
GENERALS – TREMBLING – Externally – old people; in alum. ambr. aur. aven. bar-c. calc. cann-i. cocain. con. kali-c. merc. op. phos. plb. plb-act. sil. stront-c. sulph. zinc.
GENERALS – WEAKNESS – old people; in alum. Ambr. ant-t. aur. BAR-C. carb-v. carc. caust. Con. Cur. eup-per. glyc. hydr. nit-ac. Nux-m. op. Phos. sec. Sel. Sul-ac.
You must also note down relation with heat and cold, food desire, aversion or aggravation, reaction with season or weather changes, any history of personal injury or any disease and corresponding rubrics in generalities chapter must be considered.

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What we should learn from History of Homoeopathy- Souvenier

About: ARTICLE FIRST PUBLISHED IN Souvenir of ‘National Homoeopathic Scientific Conference HOMOEOVISION 2007’ Varanasi, India
Before going to history we should think a while why Hahnemann has discovered homoeopathy. Whether he wanted name and fame, wanted money, wanted to do something new or anything else. No, he was a good practitioner of then allopathic (antipathy) system of medicine, but he was dissatisfied with the mode of treatment prevailing at that time. So he had quitted his practice for many years and began to translate books for bread and butter of his family. While translating the Newtonian thought came in his mind in 1790 about which he writes in ‘Materia Medica Pura’ in China chapter as “As long ago as the year 1790 (see W. Cullen’s Materia Medica, Leipzig, bei Schwickert, ii, p.109, note) I made the first pure trial with cinchona bark upon myself, in reference to its power of exciting intermittent fever. With this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and, indeed, only”. He published his experiment after 6 year in 1796 as an “Essay on a new Principle for ascertaining the Curative Powers of Drugs,” in Hufeland’s “Journal of Practical Medicine”.

For history of homoeopathy we should go to review of teachers and their teachings. The Homoeopaths who really followed Hahnemann in fact we know only about the ones that have left writings. Dr. Constantine Hering was second to Hahnemann in terms of personal delight he took in developing Homoeopathy. He participated in at least 106 provings (only 10 less than Hahnemann), wrote Hering Guiding Symptoms given Hering’s Law of cure, decimal Scale, with William Wasselhoeft he was founder father of the” American School of Homoeopathy”. American School of Homoeopathy consists of P.P.Wells, Carrol Dunham, H.N.Guernsey, Constantine Lippe (Adolph’s son), Nash, H.C. Allen, Earnest &Harvey Farrington (father and son), and Yingling, Alfrred & Dayton Pulford (father and son).

Dr. Adolph Von Lippe about whom Nash says “one of the best prescribers that ever lived” wrote extensively most for the journals, given keynote. In fifty years practice he published more than 600 articles, edited journal “The Hahnemannian Monthly”. In Europe Jahr, Boenninghausen, Thomas Skinner (a student of Berridge), had understood homoeopathy very well. Homoeopathy has become very popular in North America during its early years due to its amazing successes obtained by “old guard” during the epidemics of Diphtheria, Scarlet fever, Cholera, malaria, Yellow fever. For a physician, it was often better to be known to be practicing Homoeopathy than Allopathy Later on, resurrection of good homoeopathy through Pierre Schemidt, who came to America to be trained by two student of Kent, Fredrica Gladwin & Alonzo Eugene Austin. He went back to Europe and inspired a whole generation of homoeopaths throughout the world including Jost Kunjli, Horst Barthel, Will Kunkler, Tomas Paschero, Diwan Harish Chand, Elizabeth Wright Hubbard.

Dr. Hahnemann was a keen observer and experimenter that is why he published different edition of Organon from time to time. At 86 years of age master prepared the sixth edition of Organon after eighteen month’s laborious work and in Febuarary 1842 he informed his publisher, Mr. Schawabe of Dusseldorf, from Paris. But on 2nd July master died without the new edition having seen the light of the world. In 1865 the publication of the sixth edition was announced by Dr. Arthur Lutze which contained arbitrary alterations, particularly Dr. Lutze interposed a section numbered as 274 b, dealing with use of double remedies. Dr. Lutze supported his acceptance of this section on double remedies by reference to master’s own letter, dated 15th June, 1833, written from Cothen to Dr. Kari Julius Aegidi who was experimenting on double remedies.-Haehl’s Samuel Hahnemann-His Life and Work, vol.2, p.85.

But when we see today’s 6th edition the use of double remedies expressly rejected as unpermissible at close of section 273 as “In no case under treatment is it necessary and therefore not permissible to administer to a patient more than one single, simple medicinal substance at one time. It is inconceivable how the slightest doubt could exist as to whether it was more consistent with nature and more rational to prescribe a single, simple medicine at one time in a disease or a mixture of several differently acting drugs. It is absolutely not allowed in homoeopathy, the one true, simple and natural art of healing, to give the patient at one time two different medicinal substances”.
When we trace history we find downfall of Homoeopathy started specifically in America in 1845 with Julius Hempel’s translation of Hahnenann’s works. His mistranslation and interpretation of Hahnemann’s texts, as well as general teaching, led to confusion & he was responsible for introducing into homoeopathy a more reductionist and allopathic way of thinking.
In 1870 Caroll Dunham made his famous speech before the American Institute of Homoeopathy called “Liberty of Medical Opinion and Action: a Vital Necessity and a Great Responsibility”. This speech provided license to pseudo-homoeopaths to practice their eclectism. Four year latter in 1874, the word ‘homoeopathy’ was stricken off as a requirement for membership in the American institute of Homoeopathy.

Dunham said” let them practice as they judge best, and in long term they will be convinced that pure homoeopathy is the only way to practice”. Dunham’s original motive was good but was misinterpreted and misused. What eventually happened was that the pseudo-homoeopaths had greater freedom to call homoeopathy what they practiced, taught and wrote about. In the society and colleges, the fundamental principles of homoeopathy were not even taught.
As the demand for homoeopathic physicians increased, more schools were eventually developed. We can say as a general rule that the greater number of schools, the worse was the education, to the point where few graduates were able to practice homoeopathy successfully. In 1880’s there were about 15 different Homoeopathic colleges and more were opening as per demand. But very few physicians were trained in pure Homoeopathy and able to practice it properly. So most of them practice “mixed” Homoeopathy with Allopathy. So when we are told that at the turn of century, there were 15,000 homoeopaths in United States, it is true but probably only less than 200 trying to practice homoeopathy. The rest were “mixers” or physicians who had degrees from homoeopathic colleges, but did not attempt to practice pure homoeopathy.
Nash, whom we admire for “Leaders” said that when he attended the Western College of Homoeopathic Medicine in Cleveland during the 1860’s not only had he never read Organon, but had never heard of its existence. By 1884 about 600 copies of Organon were sold & there were 6000, graduates of homoeopathic school in America (Large no. had been bought by laymen, because physician like Lippe had their patients read the Organon.).

The real problem was Quality Education. There was no lack of institutions in America, but how could one expect to receive adequate education if none of the teachers themselves had mastered their discipline? So Blind was leading the Blind. There were some other factors for Downfall of Homoeopathy like World War, discovery of Penicillin (antibiotic era) by Alexander Flemming. In the allopathic system itself individual prescription writing started yielding place to a system of patent medicines. The emergence of antibiotics dealt a death blow to individualized treatment. Similar way of prescribing were followed by homoeopaths and resulted in failure.
Meanwhile division between homoeopaths viz. mother tincturist verses High potency and division between homoeopaths as to symptom based or physiological action based prescribing occurred as evident in article of Dr. Lippe in the May number of the Medical Advance, entitled, “The last Departure of Homoeopathy in the Physiological Livery”, and by Pemberton Dudley, M.D., “On the Cimex Question” and reply by E.A. Farrington, M.D. as (1876): “Do medicines make functional changes?”(Refer Farrington Lesser writings). Introduction of patents or combination remedies and above all in search of short cuts therapeutic based or allopathic (nosological) way of prescribing has caused failure and disappointments.
It is said that history repeats itself. The similar situation is happening in India especially in Maharashtra. Some members of Central council from Maharashtra are advocating practicing Allopathy by homoeopathic graduates. Organon and homoeopathic subjects are taught as secondary to allied subjects and as much as to only to pass out in examinations. Good practitioners have no time to teach or contribute literature and bogus teachers are teaching what they have partially learned about homoeopathy. Materia Medica are taught by teachers who themselves have no clinic or practice Allopathy or combinations at their clinic.

The point must be very clearly made that everyone has the liberty to practice medicine as they choose to within the limits of the laws of the land, but honesty obliges that no one has the license to call homeopathy what is not homeopathy. Society is demanding and challenging for chronic diseases to homoeopaths but how can a weak soldier, with poor arms and ammunition and poor knowledge of battlefield fight with enemy (chronic diseases).
Revival of homoeopathy has begun in west with sincere efforts and teachings of contemporary homoeopaths like George Vithoulkas, Roger Morrison, Andre Saine, Robin Murphy, Jeremy Sherr, Frans Vermulen, Will Taylor, Jon Scholten. etc. In India contemporary Homoeopaths like Dr. Prafull Vijayakar, Farookh J Master, R.P.Patel, D.P.Rastogi, M.K.Sahani, Mahendra Singh, Rajan Shankaran etc are reviving good homoeopathy. Remember there are no shortcuts to master homoeopathy other than hard work and dedication. In my opinion our problem starts when we inspect homoeopathy through spects of allopathy or modern science.
Homoeopathy and allopathy are two almost opposite science in its philosophy. Tell any allopath to prescribe his medicine according to totality of strange, rare and peculiar characteristic symptoms rather than diagnosis or lab test, he will definitely call you fool, but we homoeopaths wants to do work according to their rules! Neophyte often joins clinics of good homoeopaths to know some secrets, clues or shortcuts to success but ignore the labor done by them. Mono, mini, simi is the only golden rule and should be followed in its true essence. Suppose you are 100 % sure for giving a remedy in a case, will you mix it with other remedy, probably no. So it is lack of your teachings, knowledge and confidence which force to mix or give many remedies in anticipation at a time. Hahnemann said “follow me, You will cure”.
A last word of caution here, now a days many imposters are trying to modify homoeopathy by the name of classical homoeopathy, remember Classical homeopathy should be the homeopathy of Hahnemann and of the Hahnemannians, or in other words, pure homeopathy. So, we have seen deviations from principles and improper teachings of homoeopathy had wiped homoeopathy from western countries. We should introspect ourselves what we are doing for the name of homoeopathy and not to repeat the similar mistakes as done in history of homoeopathy.

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Infertility and Homeopathy

About: Article On Infertility Published on Homoeopathic ascents

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Articals-8

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Internet the best way of interaction in homeopathic

About: Dr. Ravi practices in Lucknow, India. He has studied homeopathy intensively for eight years.(5 and half year undergraduate and Post Graduation in Pediatric with Homeopathic Specialty)
Dr. Ravi is an nationally acclaimed homeopath Dr. and teacher. Over the years he has conducted & attended seminars and workshops for the practitioners and the students in India.

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Articals-9

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Cheaper Medicine vs. Cheap Homoeopathy

Whenever I attend a scientific homoeopathic conference or Hahnemann’s Birthday celebration our chief guests, ministers and dignitaries on stage says that homoeopathy should be promoted because it is cheaper than allopathic medicine. It seems to them homoeopaths are getting patients because of cheapness of their medicine rather their effectiveness. Naturally they will look at homoeopathic physician as 3rd grade poor fellow. In true senses allopathic medicines are also cheap except few life saving drugs, pathological investigations, and surgery. As you might know many famous allopathic physicians who prescribe very few cheap medicine and patient got relieved but they charges high consultation fees. Physician charges for their mental ability not as per medicine cost.
Many times our patients ask Doctor you are charging so high although homoeopathic medicines are so cheap. They say so because they have came from hands of our brother homoeopaths who charges 10 Rs per week for one drachm vial? Today when I was writing this article one of my patient came and I was giving him medicine, he was carrying old vial which I have given him at first consultation. He said he is carrying this because when he had taken treatment from an old Homoeopath of Varanasi who always insists patients to bring old vials. He said “ homoeopathic ilaaj mein to purani shishi lana padta hai”?. These types of myths and cheapness don’t sound good at lease for me.

I always appreciate and have regards for homoeopathic physicians who charge high, if you want to help poor people you can join or open a charitable dispensary but please don’t loose your dignity by charging so less. In this reference I personally know a very famous homoeopath of Allahabad who has one clinic at middle class or lower socioeconomic area, other air conditioned clinic at posh area and he also visit at a charitable dispensary. This may be a nice example for young homoeopaths.
Yes, definitely as a branch of medicine, we are bound to serve humanity with our system, but we have opted for this science as our profession also, so we have every right to provide it with dignity and respect. Apart from our duties towards society as citizens, we also have our duties towards our family. Sometimes, it is necessary to charge patient with high fee, to make him realize the importance of medicine and severity of his own complaints.
When a student pass his/her intermediate and choose medical science as a profession, he will definitely look at his surrounding physicians and their survival in society. If at that time he sees a homoeopath who is hardly earning something for their bread and butter, then how they will choose homoeopathy as a carrier. I have seen many students of combined pre medical test who instead of qualified for B.H.M.S. have left their seat and again try for other branches. Homoeopaths should think how shameful is this situation and only homoeopaths are responsible because they have created a bad example in society that homoeopaths are poor or cheap doctors. If you leave the metros this is situation in almost every part of our country. For this cheapness at last homoeopathy also suffers because creamy student layer or brain of society are diverting towards other branches of medical science.
I appreciate many new modern clinics of metros who charges high (although I disagree with their multimedicine or patent prescriptions) to raise standard of homoeopathy and homoeopathic physicians in society. Recently I have visited such homoeopathic clinic at Gurgaon who charges Rs. 10000 as consultation fee, a fee very few homoeopaths can dream about. I do not want to comment on his method as in homoeopathy every physician has his own methodology but I salute his confidence and appreciate for raising standard of homoeopathic physician.

I do not mean that you should burgle or rob your patient, but if you are giving patient long lasting, harmless relief in chronic complaint who had invested lot of money in their ailment with side effects and sufferings you can take as much high charges. It will depend on your confidence and believe me if the patient gets cured he will never question you about your charges.
For this we have to start from root. First of all there should be increase of standard of education level at homoeopathic colleges. Colleges should run their OPD and IPD honestly so during graduation students witnesses good cases and develop confidence. At the same time professors and teachers of homoeopathic colleges should practice good homoeopathy in every sense at their personal OPD, because that will be the first and most important impression to neophytes (when I was graduating from Maharashtra most of teachers were practicing either Allopathy or not practicing at all and college OPD and IPD were decorated with false hired patients only during inspections.)
Another most important point during practice is personal competence and knowledge. One should not promise for cases of Carcinoma, or multiple sclerosis, Kidney failure or difficult cases only because these diseases are curable with homoeopathy, yes they are curable but by homoeopaths who have dedication and enthusiasm for homoeopathy and studied hard in their life. (One very bad habit of homoeopaths is not referring or consulting their senior homoeopaths or teachers.) One should promise a patient about his disease after assessing his own capacity because every new case is a new faith in homoeopathy.
At last, I just want to add, that every physician has his own way of treating patients, his own vies about practicing in every aspect, but after all it is our, homoeopath’s duty to upgrade this our own great ‘ Homoeopathic System ‘ and give it the rightful dignity. I want a debate on this topic by readers of vital informer at VITAL INFORMER platform.

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Use of Repertory in Geriatric Practice

Repertory is an indispensable tool in homoeopathic practice. Use of repertory in elderly patients with specific rubrics may point towards some very important remedies which we might overlook in usual materia medica study.
Synthesis repertory 9.1 contains many such rubrics with corresponding remedies. These rubrics have come from many author sources and clinical experiences.
Here, I am also giving specific rubrics along with remedies because many readers don’t have latest version of synthesis. These rubrics and remedies are added from various author references which can be viewed in computerized or printed version e.g. Rubric Absentminded, old people in- has addition Am-c from Kent personal addition, Ambr and Bar-c from Vithoulkas, Con and Lyc from Stauffer Karl.
One should bear in mind these rubrics and remedies are mostly clinical experiences and should not be used as eliminating rubrics. General or larger rubrics must be utilized for repertorisation.

You can have many more general rubrics e.g. at old age common problems of mind include weakness of memory, forsaken feeling, helplessness feeling of, anger, irritability, audacity, Ailments from- abused being, anger, cares, worries, celibacy, grief, indignation, honor wounded, mortification, neglected being, scorned being, unhappiness etc. Some specific rubrics are as below.
MIND – ABSENTMINDED – old age; in am-c. Ambr. Bar-c. Con. Lyc.
MIND – CHILDISH behavior – old people; in BAR-C.
MIND – CONFUSION of mind – old age, in arg-met. Arg-n. Bar-c. Con.
MIND – DELIRIUM TREMENS – old emaciated persons, in OP.

MIND – DULLNESS – old people, of abel. Abies-n. AMBR. Arg-met. Arg-n. BAR-C. Con. Lyc. PLB.
MIND – FEAR – impotence; of am-f. cob. cob-m. cob-p. fl-ac. lith-f. nat-m. onos. phos. pitu. rhod. stry. tritic-vg.
MIND – FORGETFUL – old people, of am-c. Ambr. anac. Bar-c. coff. Con. Crot-h. lach. Lyc. Ph-ac. rhus-t. sulph.
MIND – FORSAKEN feeling – old people; in aur. psor.
MIND – HIDING – himself – old people, in op.
MIND – INSANITY – old people; in bell. ign. nat-m. nux-v. sep. sulph.
MIND – LEWDNESS – old men; in dig.
MIND – LOATHING – general loathing – old age, in aur. calc.
MIND – MEMORY – weakness of memory – facts, for – past facts; for – old people, in coff.
MIND – MEMORY – weakness of memory – facts, for – recent facts, for – old people, in lach. sulph.
MIND – DEMENTIA – senilis agn. alum. Ambr. anac. ant-c. arg-met. aur. Aur-i. aza. bapt. bar-act. Bar-c. bell. bry. bufo calc-p. carc. Con. Crot-h. Cupr. gaert. ign. lach. lil-t. Lyc. med. nat-i. nat-m. nux-v. op. phos. plb. puls. sec. sep. sulph. thiosin.
MIND – MISTAKES; making – speaking, in – old people; in am-c.

MIND – MISTAKES; making – writing, in – old people; in am-c. Crot-h.
MIND – MOANING – old age, in Bar-c.
MIND – MUTTERING – old people; in Bar-c.
MIND – PROSTRATION of mind – old age, in BAR-C. sel.
MIND – REFLECTING – inability to reflect – old people; in Ambr.
MIND – SADNESS – old age; in Aur. esp-g.
MIND – SIGHING – old people ign.
MIND – SLOWNESS – old people, of cact. calc. CON. Hell. Phos. zinc.
MIND – STUPOR – old age, in Bar-c.
MIND – TALKING – sleep, in – old men; in bar-c.
MIND – UNCONSCIOUSNESS – old age, in Bar-c.
MIND – WEARY OF LIFE – old age, in Ars. aur. calc.
MIND – WEEPING – causeless – old people; in caust.
A very common complaint at old age is vertigo. Inquire about its occurrence time, effect of posture and modalities and don’t forget to check blood pressure. VERTIGO – OLD PEOPLE; in alum. Ambr. arn. Ars-i. aur. Bar-c. bar-m. bell. bell-p. bry. calc-p. con. Cupr. dig. fl-ac. galph. glon. gran. Iod. op. phos. RHUS-T. sec. Sin-n. stroph-h. sulph.
HEAD – BRAIN; complaints of – degenerative – old people; in – men; old bar-c.
HEAD – HEAVINESS – old people; in bar-m.
HEAD – PAIN – chronic – old people, of bar-c. calc-p. iod. phos.
HEAD – PAIN – old people, of am-c. ambr. bar-m. cypr. gels. iod. lach. nat-c. sep. sulph.
EYE – AMBLYOPIA – old people; in bar-c.

EYE – CATARACT – old people; in calc-p. Carb-an. caust. chol. Cine. con. graph. kali-c. lyc. mag-c. merc. napht. nat-m. phos. puls. Sec. sil. sulph.
EYE – INFLAMMATION – old people; in alum.
VISION – DIM – old people Ambr. Bar-c.
HEARING – IMPAIRED – old people bar-c. Cic. kali-chl. kali-m. mag-c. merc-d. Petr. phos.
NOSE – CATARRH – old people; in Alum. am-c. bar-c. eup-per. ictod. kali-s. Kreos. merc-i-f.
NOSE – CORYZA – old people am-c. anac. ant-c. camph.
NOSE – EPISTAXIS – old people Agar. aur. bar-c. bov. Carb-v. chin. con. ferr-p. ham. phos. SEC. sil. sul-ac. verat.
FACE – ERUPTIONS – crusty, scabby – old people; in cory.
MOUTH – CLEAN Tongue – accompanied by – bitter taste – women; in old Carb-v.
THROAT – SPASMS – Esophagus – old people can only swallow liquids Bar-c.
STOMACH – INDIGESTION – old people Abies-n. ant-c. ars. Bar-c. caps. carb-v. chin. Chinin-s. Cic. fl-ac. Hydr. juni-c. kali-c. nux-m. nux-v. pop.
STOMACH – NAUSEA – old people; in Fl-ac.
ABDOMEN – ENLARGED – women; in matrons and old Bell. calc. chin. coloc. nux-v. Plat. SEP.
ABDOMEN – FLATULENCE – old people Carb-ac. Phos.
ABDOMEN – HERNIA; ABDOMINAL – Inguinal – old people nux-v. sul-ac.
RECTUM – CHOLERA – old people aeth.

RECTUM – CONSTIPATION – chronic – old people; in phyt.
RECTUM – CONSTIPATION – old people aloe alum. alumn. ambr. Ant-c. arn. Bar-c. Bry. Calc-p. Con. hydr. hyos. Lach. lyc. Nux-v. Op. Phos. Phyt. rhus-t. ruta Sel. Sulph.
RECTUM – DIARRHEA – accompanied by – heat; lack of vital – old people; in bov.
RECTUM – DIARRHEA – alternating with – constipation – old people; in alum. ANT-C. bry. cycl. nux-v. op. Phos.
RECTUM – DIARRHEA – old people
ANT-C. ant-t. ARS. ars-i. bapt. bar-c. bov. Bry. Carb-v. Chin. coff. con. Fl-ac. GAMB. iod. kreos. lach. nat-m. nat-s. NIT-AC. nux-v. op. phos. rhus-t. ruta sec. sul-i. sulph.
We should also differentiate between remedies like in Ant-c Old people with morning diarrhoea, suddenly become constipated, or alternate diarrhoea and constipation; pulse hard and rapid.
Ars A In asthma of old people, who have occasional attacks of morning diarrhoea, rheumatism, scanty secretion of urine, and too violent impulse of heart sound.
Ars-I – The diarrhoea comes in the morning and after eating; in old people, excoriating stool.
In Bapt. Dysentery of old people; diarrhoea of children, especially when very offensive (Allen)
Bov- Chronic diarrhoea of old people agg. night, early morning. (Phatak) Bry is indicated in constipation after vexation; in old people; during pregnancy; with retention after delivery; before menses; from sedentary habits, after abuse of drugs; alternating with diarrhea (Vithoulkas)
Carb-v – Painful diarrhoea of old people. (Phatak) Con Chronic diarrhoea of old people, with tremulous weakness; discharges sometimes involuntary; specially indicated by the symptoms that the flow of urine is intermittent.
Coff. has Obstinate diarrhoea of old people occurring after an attack of cholera.
In Fl-Ac warm drinks brings on diarrhoea, it has also morning diarrhoea (Kent) Gambog. is particularly indicated in diarrhoea of old people; the urging is excessive and the stools are expelled all at once with considerable force followed by a feeling of general relief. One other feature of IODUM quite frequently met with in rheumatic cases, is a history of an acute diarrhoeic attack immediately preceding the rheumatic attack. (Borland) Kreosote is indicated in diarrhoea of old women.
Nat S has diarrhoea in the morning and cheerful or amel after stool. Nit-ac Excessive prostration, with diarrhoea, especially in old people and those who sleep badly.
Nux v has frequent ineffectual urging and straining even in diarrhoea and they feel still there is more stool Phos Diarrhoea as soon as anything enters the rectum; profuse pouring away as from a hydrant; watery with sago-like particles; with sensation as if the anus stood open; involuntary; during cholera-time; painless; morning of old people; bloody stool; blood-streaked stool; stool like shreddy membranes. Sulph has well known early morning diarrhoea which is sudden and drives him out of bed
RECTUM – DYSENTERY – old people; in bapt.
RECTUM – HEMORRHAGE from anus – old people; in – women; old psor.

When bladder condition is assessed one should always note prostate condition as prolonged prostate trouble cause pressure over detruser muscles and sphincter which may result in weakness and incontinence results. Also check for any adhesion, phimosis or any stricture in urethra.
BLADDER – ATONY of – old age ars. stram.
BLADDER – CATARRH, mucopus – old people; in Alumn. Carb-v. kali-p. pop. sulph. Ter.
BLADDER – PARALYSIS – old people; in ARS. bell. camph. Cann-s. canth. Caust. Cic. con. Equis-h. Gels. kali-p. lach. lyc. mur-ac. nat-m. nux-v. op. phos. Sec. sil. Sulph. thuj.
BLADDER – RETENTION of urine – old people; in – men; old Caust. Con. lyc. op. pareir. plb. Puls. sars. sep. sil. Solid. staph. sulph. Ter. Zinc.
BLADDER – URINATION – dribbling – old persons; in all-c. bar-c. cic. con. equis-h. nux-v.
BLADDER – URINATION – dysuria – morning – old men, in Benz-ac. Corn.
BLADDER – URINATION – frequent – old people Bar-c.
BLADDER – URINATION – involuntary – night – old people apoc. benz-ac. kali-p. sec.
BLADDER – URINATION – involuntary – old people; in All-c. aloe am-be. apis arg-n. Ars. Aur-m. bar-c. Benz-ac. bry. cann-s. canth. carb-ac. chlorpr. Cic. con. dam. equis-h. gels. Iod. kali-p. nit-ac. phos. psor. Rhus-a. Sec. seneg. Thuj.
BLADDER – URINATION – involuntary – old people; in – men with enlarged prostate All-s. Aloe apoc. Cic. dig. Iod. kali-p. nux-v. Pareir. Sec. Thuj.
BLADDER – URINATION – involuntary – old people; in – women Caust.
BLADDER – WEAKNESS – old people; in Ars. Gels.
BLADDER – WEAKNESS – old people; in – men; old alum. Benz-ac. carb-ac. clem. con. Pop. sel. Staph.
MALE GENITALIA/SEX – ERECTIONS – continued – old people; in – men; old arn.
MALE GENITALIA/SEX – ERECTIONS – frequent – old people; in – men; old caust.
MALE GENITALIA/SEX – ERECTIONS – violent – old people; in – men; old Fl-ac.

MALE GENITALIA/SEX – ERECTIONS – wanting – old people; in LYC.
MALE GENITALIA/SEX – INDURATION – Penis – old people; in – men; old Berb.
MALE GENITALIA/SEX – INDURATION – Testes – old people; in bar-c.
MALE GENITALIA/SEX – POLLUTIONS – frequent – old people; in – men; old bar-c. caust. nat-c. sulph.
MALE GENITALIA/SEX – SEXUAL DESIRE – increased – old people; in – men; old arn. Fl-ac. lyc. mosch. sel. staph. sulph.
MALE GENITALIA/SEX – SEXUAL DESIRE – increased – old people; in – men; old – impotent; but lyc. sel.
FEMALE GENITALIA/SEX – EXCORIATION – old people; in – women; old merc.
FEMALE GENITALIA/SEX – LEUKORRHEA – bloody – old women, in arist-cl. Phos.
FEMALE GENITALIA/SEX – LEUKORRHEA – old people; in – women; old ars. Gels. Helon. nit-ac. Phos. sec.
FEMALE GENITALIA/SEX – MENSES – copious – old people; in – women; old crot-h. lach. mag-m. Plat. Sars.
FEMALE GENITALIA/SEX – MENSES – return – ceased; after the regular menstrual cycle has – old women, in Calc. lach. mag-c. mag-m. PHOS. Plat. sep. staph.
FEMALE GENITALIA/SEX – METRORRHAGIA – women – old; in Calc. cham. hydr. Ign. lach. Mag-m. Mang. Merc. phos. sep.
FEMALE GENITALIA/SEX – SEXUAL DESIRE – increased – old women, in apis Mosch.
FEMALE GENITALIA/SEX – ULCERS – Uterus – Cervix – old people; in – women; old sul-ac.
LARYNX AND TRACHEA – CATARRH – old people; in Ammc. Ant-t. Ars. BAR-C. Carb-v. CHIN. Hydr. Lyc. SENEG.
LARYNX AND TRACHEA – VOICE – old people; complaints of bar-c.
RESPIRATION – ASTHMATIC – old people; in am-c. Ambr. ant-c. ARS. aur. Bar-c. bar-m. camph. Carb-v. Coca Con. phel. Seneg. sulph.
RESPIRATION – ASTHMATIC – old people; in – athletes coca
RESPIRATION – DIFFICULT – old people ammc. Bac. Bar-c. carb-v. Chin. coca seneg.
RESPIRATION – RATTLING – old people Ammc. Bar-c. HIPPOZ. KALI-BI. LYC. Seneg.
RESPIRATION – SUPERFICIAL – old people; in Bac.

COUGH – OLD people alum. alumn. Am-c. Ambr. Ammc. ant-c. ant-i. Ant-t. Bar-c. bar-m. camph. Carb-v. con. DULC. hydr. hyos. ichth. ip. kreos. myrt-c. Psor. rhus-t. sal-ac. Seneg. sil. stict.
COUGH – RATTLING – old people Ammc. bar-c. Hippoz. Kali-bi. Seneg.
EXPECTORATION – COPIOUS – old people alum. Ammc. Ant-t. Ars. BAR-C. caust. Kreos. senec.
EXPECTORATION – DIFFICULT – old people Ammc. diphtox. Seneg.
CHEST – ARTERIOSCLEROSIS of coronaries – old people; in – men; old bar-c.
CHEST – BRONCHIECTASIS – old people eucal.
CHEST – CATARRH – old people Ammc. Ant-t. Bac. BAR-C. Chin. hydr. Nat-s. phel. SENEG. Tub.
CHEST – EMPHYSEMA – old people; in lob.
CHEST – HEART; complaints of the – old people; in ars-i. bar-i. crat.
CHEST – INFLAMMATION – Bronchial tubes – old people all-c. Am-c. Ammc. ant-c. ANT-T. ars. Camph. Carb-v. diphtox. Dros. HIPPOZ. Hydr. kreos. led. Lyc. Nux-v. prot. Seneg. squil. verat.
CHEST – INFLAMMATION – Lungs – old people ACON. ant-ar. Ant-t. ars. Bell. Bry. cham. Dig. Ferr. FERR-P. gels. Hyos. ip. MERC. Nat-s. Nit-ac. Nux-v. Op. Seneg. verat.
CHEST – INFLAMMATION – Pleura – old people Nit-ac.
CHEST – PARALYSIS – Lung – old people
Ant-t. Ars. aur. BAR-C. Carb-v. CHIN. con. LACH. lyc. Op. phos. verat.
CHEST – PHTHISIS pulmonalis – old people Nat-s. seneg.
EXTREMITIES – GANGRENE – Toes – old people; in Carb-an. Carb-v. cupr. Ph-ac. SEC.
EXTREMITIES – PARALYSIS – old people; in Bar-c. Con. Kali-c. op.
SLEEP – SLEEPINESS – old people ant-c.
SLEEP – SLEEPLESSNESS – old people; in Acon. ars. Bar-c. carc. op. passi. phos. sulph. SYPH.
SLEEP – SLEEPLESSNESS – restlessness, from – old people; in bar-c.
FEVER – INTERMITTENT – old people, with coma alum. nux-m. Op.
SKIN – DISCOLORATION – spots – dark spots – old people; in ars. aur. bar-c. Carb-an. Con. Lach. Lyc. op. Sec.
SKIN – ERYSIPELAS – old people; in am-c. carb-an. Lach.

SKIN – GANGRENE – old people; in all-c. am-c. ars. Carb-v. euph. euph-re. ph-ac. sars. SEC. sul-ac.
SKIN – ITCHING – old people; in alum. arg-n. ars. bar-act. bar-c. con. dol. dulc. fago. fl-ac. kreos. mag-p. merc. Mez. nat-sil. olnd. op. sul-ac. sulph. urt-u.
SKIN – ULCERS – old people; in tarent-c.
GENERALS – BLACKNESS of external parts – old people; in adren. all-c. am-c. Ars. Carb-v. chin. con. crot-h. cupr. echi. ergot. euph. Kreos. LACH. Ph-ac. Plb. SEC. vip.
GENERALS – CHOREA – old people; in aeth. aven.
GENERALS – EMACIATION – old people; in Ambr. anac. BAR-C. carb-v. chin. chinin-s. Fl-ac. IOD. LYC. nit-ac. op. rhus-t. Sec. Sel. Sil.
GENERALS – HEAT – lack of vital heat – old people; in alum. ambr.
GENERALS – OBESITY – old people; in am-c. AUR. bar-c. fl-ac. KALI-C. op. sec.
GENERALS – OLD AGE – premature Agn. alco. alum. Ambr. ant-c. anthraci. arg-met. arg-n. ars. Aur. Bar-c. berb. bufo carb-ac. carb-v. carc. chinin-s. coca Con. cortico. Cupr. des-ac. esp-g. Fl-ac. gins. hydr. hydrog. Kali-c. kres. LACH. lyc. mag-f. nit-ac. nux-v. op. phos. prot. psor. reser. sars. sec. SEL. sep. staph. stram. sulph. sumb. verat. Vip.
GENERALS – TREMBLING – Externally – old people; in alum. ambr. aur. aven. bar-c. calc. cann-i. cocain. con. kali-c. merc. op. phos. plb. plb-act. sil. stront-c. sulph. zinc.
GENERALS – WEAKNESS – old people; in alum. Ambr. ant-t. aur. BAR-C. carb-v. carc. caust. Con. Cur. eup-per. glyc. hydr. nit-ac. Nux-m. op. Phos. sec. Sel. Sul-ac.
You must also note down relation with heat and cold, food desire, aversion or aggravation, reaction with season or weather changes, any history of personal injury or any disease and corresponding rubrics in generalities chapter must be considered.

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