Drs. Bipin and Anju Jethani discuss the value of lesser known symptoms of polychrests. Included are various case examples.
ABSTRACT: In
our day to day clinical life, the well known and common indications of
Polychrests, the medicines of many uses, have served as the basis of
their prescribing in a majority of cases. However, in order to realize
the enormous scope of their clinical utility, it is imperative that we
fully appreciate their lesser known indications as well, which have been
scantily emphasized in the works of different authors of Materia
Medica. This paper describes those case studies that clinically verify
the lesser known indications of well known remedies, duly evaluated on
the yardstick of modern medicine’s parameters of Evidence Based
Medicine.KEY WORDS: Polychrest, Materia Medica Pura, LM potencies, Lichen Simplex chronicus, Housemaid’s knee.
INTRODUCTION
‘The Materia Medica of Hahnemann is an enduring monument to the genius of its author, original in its conception and design and unique in its form and contents. Its foundation is on the bedrock of natural law. It is constructed of the cut stones of accurately observed facts, laid up in the cement of irrefragable logic.’
These words of Stuart Close mentioned in his work ‘The Genius of Homeopathy: Lectures and Essays on Homeopathic Philosophy’ 1 very aptly underline the true essence of our Materia Medica, which has stood the test of time through its therapeutic efficacy in wide range of clinical disorders.
In Hahnemann’s time itself, his work on Materia Medica was well appreciated by his contemporaries such as Professor Dr. Riecke who in a dedicatory speech (1833) expressed himself forcibly while appreciating Hahnemann’s Materia Medica Pura:
‘In this matter we stand on a pinnacle of homoeopathy. Whoever has at all realised the wretched state of Materia Medica, whoever has regarded it as a medical romance, will be glad to appreciate the significance of a meritorious effort to give it a better foundation. Nobody before Hahnemann completed the investigation of medicinal potencies by experiments on healthy subject….’2
In fact, the homoeopathic stalwarts of a different era have all relied on the in-depth understanding and logical application of therapeutic tool of our Materia Medica for their clinical success. Dr. M.L. Tyler in her brilliant work “Homoeopathic Drug Pictures’ very well illustrated the profound comprehension of our Materia Medica by the stalwarts in their clinical practice as illustrated in the chapter ‘Chamomilla’:
‘Many years ago, I read a story about Wesselhoeft and Lippe, and when those old boys got together, they had some very good talks on Materia Medica….…….Occasionally they vied with one another and tried to see who used it most…..Old Wesselhoeft thought he had Lippe at a disadvantage. He said, “Dr. Lippe, I had a woman patient who got this peculiar symptom: she felt as though she were walking around on the ends of the bones of her legs and didn’t have any feet, as though the feet were gone. What remedy did I give her?” Lippe said, “You gave her de Chamomilla, by Gott.”3
In today’s era, with the changing patterns of diseases, there is a far greater need to thoroughly grasp our Materia Medica, in which the varying permutations of symptoms produced in each drug enables us to clinically treat the syndromes that have not yet taken shape but may appear in the future generation to come. The need of the hour is to rationally apply and clinically verify the symptoms of medicines recorded in our homoeopathic literature, duly evaluated on the yardstick of modern medicine’s parameters of Evidence Based Medicine. This is all the more significant in case of polychrest medicines – the medicines of many uses. Indeed, the enormous clinical scope and widespread application of polychrests is imbibed in the very definition as stated by Hahnemann in the Nux Vomica chapter of Materia Medica Pura where he described them, as medicines ‘the majority of whose symptoms correspond in similarity with the symptoms of the commonest and most frequent of human diseases, and hence very often find an efficacious homoeopathic employment’.4
However, often it has been the well known and common indications of these medicines that have over the years served as backbone of their prescribing in the majority of cases. The following case studies highlight the efficacy of polychrests with prescribing on the basis of their lesser known symptoms.
CASE STUDIES
CASE I: LICHEN SIMPLEX CHRONICUSA 42 yr. old female presented with complaint of purplish hue eruptions on lower extremities with itching worse in morning and intense desire to scratch (Histopathologically diagnosed as Lichen Simplex chronicus). The peculiarity of eruptions and associated itching was its aggravation with menses and persistence for some days after menses. The other complaints were frequent tendency to sore throat from taking cold drinks and unsatisfactory stools. Desire for fats was well marked. The patient had tendency to Profuse, early menses with severe pain in lower abdomen during menses, accompanied with severe backache.
Referring to Introductory part of Materia Medica Pura
in Nux vomica chapter, we find mentioned: ‘If the menses usually come
on some days too soon, and are too copious, the ailments remaining or
occurring after their cessation are quite suitable for Nux vomica.’5Similarly in ‘The Chronic Diseases: Their Peculiar Nature and Their Homoeopathic Cure’, we find mentioned in chapter on Nux vomica:
‘…. in case the menses previously have been premature or too profuse, or too long-lasting, it is often necessary to give on this fourth day a small dose of nux vomica (one very small pellet, moistened with a high dynamization) to be smelled…….’ 6
Similarly, H.C. Allen in his work on Keynotes states with regards to Nux vomica that:
Menses: too early, profuse, lasts too long; or keeping on several days longer, with complaints at onset and remaining after………… during and after, < of old symptoms. 7 Keeping in mind the foresaid references and concomitance of severe backache during menses, desire for fats as well as hypersensitive nature of the patient, Nux vomica in LM potencies was prescribed which resulted in marked improvement.
CASE II: POLYCYSTIC OVARIAN DISEASE: A 30 year old wheatish complexioned female with sharp features, presented with primary infertility. She had c/o scanty, regular menses since 7-8 yrs and was ultrasonographically diagnosed as large left ovarian cyst (34 ml. in volume). After failure of initial prescriptions, the anamnesis of case revealed that the patient had tendency to ascending nose colds and H/o diarrhoea from taking hot milk. Referring to Dr. P. Sankaran in his works “Elements of Homoeopathy’, we find described a case of a patient who was suffering from long standing gastritis with no help from the ‘usual medicines’. The case analysis revealed the beginning of the complaint since he drank hot milk in a marriage function. On the basis of this etiological factor; he was prescribed Sepia with wonderful result.8
Besides this, C.M. Boger in his ‘Synoptic Key to materia Medica’ has mentioned ‘ASCENDING NOSE COLDS’ as a characteristic feature of Sepia
Thus keeping in mind the anamnestic symptoms of ascending nose colds and H/o diarrhoea from taking hot milk, Sepia 30, in infrequent doses was prescribed and the patient reported marked symptomatic improvement which was corroborated by subsequent ultrasound which showed normal follicles in left ovary. (Serial ultrasound reports appended)
pre-treatment / post-treatment
CASE III: SPASMODIC DYSMENORRHOEA
A 30 year old patient had reported with complaint of irregular menses with tendency to spasmodic pain during menses. She had family history of spasmodic dysmenorrhoea. She reported c/o recurrent tendency to cough which was of such nature that the moment she spoke, it used to come in severe paroxysm. This was to the extent that it compelled her from desisting to speak.
Referring to the work of Lee & Clarke ‘Cough and Expectoration’, we find
SPEAK, every attempt to, excites cough, so that one must desist: CIMICIFUGA. 10
Similarly, N.M.Chaudhary in his work on Materia Medica wrote that:
It has been recommended in incipient tuberculosis when the peculiar “Actea cough” is present.……….. The cough becomes particularly harassing when he attempts to speak.”11 Based on this characteristic concomitance of cough, Actea racemosa was prescribed in 200 potency. The patient reported improvement not only in the complaint of cough but also was relieved of her complaint of spasmodic dysmenorrhoea .
Case IV: HOUSEMAID’S KNEE
A 52 year old male c/o recurrent swelling of knee with pain and difficulty in movement (orthopedic specialist diagnosed it as Housemaid’s knee). The pain was worse with change of temperature and slightly better with hot fomentation. No significant precipitating factor could be elicited. He had been on allopathic treatment since 4 months with no substantial relief. He had past h/o pulmonary Koch for which he had taken due course of ATT and had strong family history of Pulmonary Koch. He also had childhood tendency to spasmodic cough with occasional vomiting and redness of face. There were no further prescribing clues in this case. With this strong tubercular background, character of childhood cough and knee involvement, the drug Drosera came foremost to mind.
Dr. M.L. Tyler’s in ‘Homoeopathic Drug Picture’ wrote of ‘DROSERA’ that:
‘I began to realise what Drosera can do in tuberculous disease of bone, of joint and of gland. I was amazed and I started hunting homoeopathic literature for my warrant in so using it………But so far as bone and joints were concerned, I found my justification in black type in the provings of Hahnemann….. How many homoeopath’s of our day read Hahnemann’s Materia Medica Pura? But I may tell you that Hahnemann gives black type not only to laryngeal symptoms that have made Drosera famous among homoeopaths but he gives the same black type to joints……shafts of long bones and pains in limbs.’12
The patient was prescribed Drosera LM1/ twice daily followed by subsequent administration in up to LM5 potencies with marked relief in joint complaint.
Similarly there are often lesser known symptoms of well known drugs that merit due consideration. For instance, many a case of very small extremely painful boils have been cured by prescription of Arnica on keynotes as outlined by H.C. Allen:
‘Tendency to small, painful boils, one after another, extremely sore.’ 13
Further in Materia Medica Pura is mentioned the following symptom of Arnica Montana: On the side of the nape a pimple that causes shooting and ulcerative pain when touched. (This kind of pimple, so painful when touched, with an inflamed red areola, which Arnica produces specifically, bears the greatest resemblance to the well-known boils (furunculi), and consequently these are homoeopathically cured by Arnica, and in persons who are frequently troubled with them are prevented by the use of Arnica, and their future occurrence warded off, as experience has taught me.) (aft. 48 h.).14
Another drug which is under-utilised in cases of biliary and renal calculi is Calcarea carb. It has been highly appreciated by Richard Hughes in his work ‘A Manual of Pharmacodynamics’ wherein he stated:
‘But it has other uses, which seem independent of its power over assimilation. One of these is of very curious kind; ………. It is its power, when given in repeated doses of 30th dilution, of relieving the pain attending the passage of biliary (Dr. Bayes says also of renal) calculi. It has for me quite superseded the need of chloroform and even of hot bath.’15
Of the lesser known symptoms of Alumina, we find that Boenninghausen has given clinical cases of backache cured with Alumina metallicum on the basis of this guiding symptom in the form of sensation as if BACK WAS PIERCED BY RED HOT IRON. 16
On the same lines, we would like to highlight one important application of Syphilinum in cases of infants who have a tendency to cry unreasonably day and night. J.H. Clarke very well elaborates this indication of Syphilinum in his ‘Dictionary of Practical Materia Medica’. ‘Swan says he gave crying infants, when they developed the propensity immediately after birth and did not cease, one dose of Syph. CM, and it was difficult to make them cry after that.’17
To sum up, we would just like to emphasize that the aforementioned case studies and therapeutic pointers in the form of lesser known symptoms of well known remedies at the most qualify as a humble effort on our part to clinically verify the little avenues of our vast Materia Medica. However there is a need for further case studies and adoption of research design for clinical confirmation of such lesser known prescribing clues of polychrests.
REFERENCES:
- Close Stuart. The Genius of Homeopathy: Lectures and Essays on Homoeopathic Philosophy. New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Haehl, Richard (1992). Samuel Hahnemann: His Life and Work – I, Reprint edition. New Delhi: B. Jain Publishers (Pvt.) Ltd
- L. Tyler, Homoeopathic Drug Pictures, reprint edition, 1996. New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Samuel Hahnemann, Materia Medica Pura (Translated by E. Dudgeon, Edited by Richard Hughes), New Delhi: B. Jain Publishers (Pvt.) Ltd.
- ibid
- Hahnemann, Samuel. The Chronic Diseases – Their Peculiar Nature and Their Homoeopathic Cure, Translated from 2nd enlarged German by Prof. Louis H. Tafel, Reprint edition (1997). New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Allen H.C. Keynotes And Characteristics With Comparisons of some of the Leading Remedies of the Materia Medica (Preface). New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Sankaran, P. (1996). The Elements of Homoeopathy, 1st Santa Cruz (W), Mumbai: Homoeopathic Medical Publishers.
- M.Boger, A Synoptic key of the Materia Medica, 1916, New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Lee & Clarke, Cough and Expectoration, 2001, New Delhi: Indian Books & Periodical Publishers.
- M. CHAUDHARY, A Study of Materia Medica, New Delhi: B. Jain Publishers Pvt. Ltd.
- L. Tyler, Homoeopathic Drug Pictures, reprint edition, 1996. New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Allen H.C. Keynotes And Characteristics With Comparisons of some of the Leading Remedies of the Materia Medica (Preface). New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Samuel Hahnemann, Materia Medica Pura (Translated by E. Dudgeon, Edited by Richard Hughes), New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Richard Hughes, A Manual of Pharmacodynamics, New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Clarke J.H. (2001) Dictionary of Practical Materia Medica. New Delhi: B. Jain Publishers (Pvt.) Ltd.
- Boenninghausen, C.M.F. von. (1994). Brief Directions for Forming a Complete Image of a Disease for the Sake of Homoeopathic Treatment. The Lesser Writings of C.M.F. von Boenninghausen, Compiled by T.L.Bradford. New Delhi: B. Jain Publishers (Pvt.) Ltd.
