Killer’s Aggravation – Homoeopathic Medicines Can Kill You
Killer’s Aggravation and Homoeopathic Medicines
Now a days we frequently see people buying homoeopathic medicines over the counter without doctors prescription, consodering it to be safe and can be consumed by anyone. Its surprising to see that even parent are buying these medicines for their new born kids.
Most of these medicines are patented mix of multiple medicines which is against homoeopathic principles, as homoeopathic medicines are meant to be taken only one medicine at a time.
Also they are proved by using very low standards of drug provings that too completely contradicting principles of homoeopathy as homoeopathy strictly doesnt allow use of multiple medicine at a time.
If it is single medicine one is consuming it doesnt allow frequent repetition of dose in same potency with exceptions, its a very highly skilled to decide at which potency and how many repetition does a patient require as it varies from person to person in similar conditions, most of the times only one dose is administered to cure the conditions, more of it only complicates the case most of the time.
One should be aware that homoeopathic medicines are effective only if they match the constitution and symptoms of the patient or else it may not act at all and the disease may keep on progressing making it worse on the other hand if the medicinines that are not selected by process for repertorisation for indivudualisation ans similimum dosing and if taken too frequently unhomoeopathically then it produces a new artificial morbid condition in the body which can be so severe so as to cause gross pathological change in the body which may be irreversible damaging the body permenantly.
Its a myth that HOMOEOPATHIC MEDICINES does not have side effects!
The fact is , Its HOMOEOPATHY that does not have side effects! But HOMOEOPATHIC MEDICINES if not taken in accordance with HOMOEOPATHIC PRINCIPLES as mentioned in HOMOEOPATHIC ORGANONof medicine then the recipient may have severe aggravations.
As mentioned in KENT’s 12 observations the very first point says “Prolonged aggravation with final decline of patient” also termed as KILLER’s Aggravation by practitioners , a FATAL CONDITIONwhich we not too frequently encounter and is difficult to handle.
So be careful before self medicating or giving medicines to your kids, always consult a registered homoeopathic consultant first.
ANKYLOSING SPONDYLITIS (AS) / MARIE’s Disease / BEKTEREV’s Disease is a Chronic Autoimmune or Autoinflamatory systemic disease which predominantly affects joints and bones of Spine and Pelvis
It falls under AXIAL SPONDYLOARTHRITIS Category.
CAUSES OF ANKYLOSING SPONDYLITIS
Causes are obscure, though Genetics Environmental Factors and Lifestyle in combination are believed to be involved in causation of Ankylosing Spondylitis (AS)
It falls under Sero-negative Systemic Rheumatic disease where its believed to be mediated by Autoimmune or Autoinflamatory response.
Human Leucocyte Antigen HLA B27 subtypes B2701and B2759are class I antigen encoded by B locus of Major Histocompatibility Complex (MHC) on Chromosome 6 and presents antigenic peptides (derived from self and non self antigens ) to T cells. HLA B27 is strongly associated with Ankylosing Spondylitis as 90% of patient showing symptoms of Ankylosing Spondylitis has a genotype presenting it. and 2% of all having genotype expressing HLA B27 contracts Ankylosing Spondylosis.
PATHOGENESIS OF ANKYLOSING SPONDYLITIS
Pathogenesis of AS is still not clear and many factors associated with the pathophysiology directly or indirectly have been identified
Human Leucocyte Antigen (HLA B27 subtypes B2701and B2759) are class I antigen encoded by B locus of Major Histocompatibility Complex (MHC) on Chromosome 6 and presents antigenic peptides (derived from self and non self antigens ) to T cells. HLA B27 is strongly associated with Ankylosing Spondylitis as 90% of patient showing symptoms of Ankylosing Spondylitis has a genotype presenting it. and 2% of all having genotype expressing HLA B27 contracts Ankylosing Spondylosis.Now this association with HLA B27 suggests possible link with CD8 T cells though not proven to involve self antigen it might also be due to reactive arthritis following infection and the antigen might be derived from intracellular microorganism; HLA B27 has many unusual varied properties also it has ability to interact with CD4 so possible association of CD4 in AS is also a probability.
Tumour Necrosis Factor α (TNF α) is found to b implicated in Ankylosing Spondylitis
Interleukine 1 (IL 1) is also associated in pathogenesis of Ankylosing Spondylitis
Anti-Neutrophil Cytoplasmic Antibodies (ANCAs) are associated with Ankylosing Spondylitis but is not indicator of severity of disease
Autoantibodies Specific to Ankylosing Spondylitis have not been identified
PTGER4 gene codes for prostaglandin EP4 receptor(EP4). which is associated with bone remodeling and deposition and is highly expressed in those sites of vertebral coloumn which are involved in Ankylosing Spondylitis . Single Neucleotide Polymorphism (SNP) of A/G variant rs10440635a close to the PTGER4 gene on human chromosome 5 possibly influences excessive production of EP4 which causes excessive bone remodelling and deposition in Ankylosing Spondylosis; though this type of SNP and its association with increased rate of Ankylosing Spondylosis is found only in few ethnic groups
All these and other unknown factors contribute in pathogenesis of Ankylosing Spondylitis which typically results in Annulus Fibrosus Disci Intervertebralis (fibrous ring) of intervertebral disc to OSSIFY which results in the formation of marginal SYNDESMOPHYTES between adjoining vertebrae giving rise to BAMBOO SPINEtype appearance of spine
SYMPTOMS AND DIAGNOSIS OF ANKYLOSING SPONDYLITIS
Genetic Testing For Ankylosing Spondylitis
HLA B27 is a non specific test For Ankylosing Spondylitis
As although 90% of those who have AS are HLA B27positive(50% in african-americans and 80% in mediterrenean)
But it has seen in many ethnic group ;esp north scandivanian;that Only 2 % of total HLA B27 positive have AS
Blood Test for Ankylosing Spondylitis
There are no specific Blood Tests Available for AS except for general inflamatory indicators like ESR and CRPwhich are elevated and tend to increase further on acute episode
Radiological Investigation For Ankylosing Spondylitis
There are no specific Blood Tests Available for AS So its diagnosed based on typical radiological changes but it takes 8-10 years for the disease to become evident enough to establish diagnosis neither CT or MRI can evaluate the disease in early stages
Typical radiological features are:-
Axial Spondyloarthritis
Early Xray changes include erosion and sclerosis of sacroilliac joints
in later stage that erosion increases resulting in pseudo-widening of joint space and Bony Ankylosis
squaring of vertebrae with spine ossification with fibrous band running longitudinally called syndesmophyte giving a bamboo spine appearance
Now in case where there are no evident radiological signs it becomes difficult to establish diagnosis as there are no specific blood tests for AS. In such cases clinical features signs symptoms and other non specific blood tests are conducted to evaluate the probability of AS; they are :
Chronic backache with insidious onset before age of 40yrs which has peculiar modalities- Aggravates on rest ;at night and Ameliorates on moderate movement ;exercise ; after getting up from bed in morning
History of inflamatory arthritis or tendinitis
Family history of axial Spondylosis
Positive HLA B27
Responds well to NSAIDs
Elevated ESR and CRP
Other accompaning conditions like IBS Uveitis psoriasis
Schober’s test is a clinical performed during physical exam which is measure of flexion of lumbar spine.
BATH ANKYLOSING SPONDYLITIS DISEASE ACTIVITY INDEX
BASDAIindex score is an index which is based on multiple clinical radiological genetic and blood parameters which helps in establishing stage and diagnosis and determine type of management and treatment required
BATH ANKYLOSING SPONDYLITIS FUNCTIONAL INDEX
BASFIindex to acess functional impairment
GAIT
HUNCHED POSTURE is a severe complication of AS resulting due to complete spinal fusion leading to increased spinal KYPHOSIS which results into forwar and downward shift of Center of Mass to compensate it the knee flexes and ankle dorsiflexes.Their gait has a cautious pattern as they have reduced shock absorbing ability and cant see horizon.
INDICATED HOMEOPATHIC MEDICINES FOR ANKYLOSING SPONDYLITIS
RHUS TOX
Rhus tox is the most common homoeopathic medicine which is very valuable in case of Ankylosing spondylitis, and is useful in various kinds of pains. Rhus tox affects the multiple systems of the body indcluding spine, joints, extremities, skin and mucus membrrane. Patient usually presents with stiffness of back associated with restlessness, is the key indication of this remedy. Pains are aggravated after a period of inactivity. There is marked stiffness, lameness, and pain in the lumbosacral area of back and hips to thighs. Rheumatic pains spread over a large surface area at the nape of neck, back, loins extremities. The small of back aches while sitting. Painfull stiffness on rising from seat. We are led to think of this remedy where we find an irresistible desire to move or change the position constantly. After
resting for a while, when he wakes up and takes a first move, a painful stiffness is felt.
CIMICIFUGA RACEMOSA
Cimicifuga racemosa is one of the indicated remedy for ankylosing spondylitis where there is marked stiffness in the neck area. The patient usually presents with excessive stiffness in the neck with severe pain. The neck muscles feel retracted, neck stiffness is worsened by cold air. The muscular and crampy pains are primilarily are of neurotic origin, occuring nearly in every part of the body. Pains of Cimicifuga are like that of electric shock, which come and go suddenly. Violent lightening type of pain in posterior spinal sclerosis, stiff neck from cold air. Sensitiveness of spine especially in cervical and upper dorsal region. Severe aching pain in lumbar and sacral region.
KALMIA LATIFOLIA
Kalmia is a great rheumatic remedy. Dr Hering introduced Kalmia into homeopathic practice, he himself and his friends being the first provers. Kalmia is one of tbe efficient remedy in ankylosing spondylosis cases where pain and stiffness are marked in lower back,lumbosacral region and neck area. The pains are accompanied with heat and burning in affected area. Pain is attended with excessive stiffness in neck. The pain from neck often radiates down the arms or scapula. Violent pains in the upper dorsal vertebrae. Constant pain in spine. Sensation as if spinal column would break with an anterior convexity and feeling of paralysis in saccrum.
GUAIACUM
Guaiacum is one of the Hahnemans antisporics, is one of the beat known remedies in rheumatism, gout, ankylosing spondylitis. There is Pressure on the vertebrae of the neck. Stiffness in the back, extending from neck to small of back and saccrum, intolearable on slightest motion. Indicated when there are contractive pains between the scapulae. Stiffness from neck may extend to shoulder blades and its painful. All pains are aggravated from motion and heat and relieved during rest.
KALI CARBONICUM
Kali carbonicum is very useful in deep seated diseases lime Ankylosing spondylosis. Kali carb patient presents with severe back pain with stiffness. Small of back feels weak. There is marked Stiffeness and paralytic feeling in the back. Marked indication of kali carb is severe backache during pregnancy and after miscarriage. Burning in the spine. Lumbago with sudden, sharp pains extending up and down of back to thighs. Weakness caused by all potassium salts is more pronounced in this typical salt of potassium
group. Sharp stitching, stabbing pain felt in various parts of the body. Severe backache must lie down for relief.
AESCULUS HIPPOCASTANUM
Aesculus is one of the indicated remedy in ankylosing spondylitis. The main feature of Aesculus is matked pain in lumbosacral area of the back and hips with extreme stiffness. Pain from back radiates to thighs. Lameness in neck. Aching pain between the ahoulder blades, region of spine feels weak. Backache affecting saccrum and hips worse walking or stooping. When walking feet turn under. Rising from seat seems difficult, has to make repeated efforts. Severe pain in lumbosacral region making movement impossible.
SILICEA
Silicea is a very valuable remedy in case of spondylitis. The action of silicea is slow. In the proving it takes long time to develop symptoms. It is therefore suited to complaints which develop slowly. Presents with ankylosing spondylitis with stiffness in nape of neck with severe headache. Coccyx painful as after a long carriage ride. Weakness and paralytic stiffness in back, loins and nape of neck. Swelling and distortion of spine.Aching, shooting, burning and throbbing pain in lumbosacral region with contussive pain between shoulder blades.
COLOCYNTH
Colocynth has a long lasting action on the spine and nerves. The main feature of colocynth is severe pain in the back which finally settes down on the upper part of thigh and buttock. Pain usually confines to small spot making the patient limp and finally becomes so severe that he can neither stand nor walk. Severe burning pain along the saccrum, cramps in hip. Feels better by doubling up, hard pressure and warmth.
CONIUM MACULATUM
Conium maculatum is deep acting antisporic remedy, its action disturbs almost all the tissues of the body. Very well indicated in ankylosing spondylitis of back, weakness is the most striking feature with dorsal pains. Effects of bruises and shocks to spine. After injuries especially in lumbar region. Severe rheumatic pains. The pains are relievex by putting feet on chair. Pain between the shoulder blades. Dull aching pain in lumbar and sacral region.
CALCAREA PHOSPHORICUM
Calcarea phos is a great tissue remedy, though it resembles calcarea carb in many aspects but has its own characteristic symptoms. The spher of phosphate of lime includes all bone diseases whether due to some inherited dyscrasia or defective nutrition in osseous and other structures. It is.a bone salt.without this element no bone is formed, hence it is a valuable remedy. Patient usually presents with weakness of spine, there is curvature of spine towards left , lumbar vertebrae bent towards left. Soreness in sacro iliac symphysis. Rheumatic pains from draught of air with stiffness of neck and back.
Arthritis is a term derived from “ARTHRON” means Joint and “ITIS” means Inflamation
Inflamation of joint and surrounding tissue is called ARTHRITIS
Its a general term used to describe pain swelling of joint and its surrounding tissue.
When one joint is involved its called Monoarthritis and when more than one joints are involved its called Polyarthritis
Different types of arthritis have different causative factors like
Mechanical
Immunological
Metabolical
Spetic
Genetics
Lifestyle and Evironmental factors
Though each factor has contribution in certain degree in every type of arthritis; Still it can broadly be classified into 4 major category based on the predominant factor responsible for their Pathophysiolohy/Pathogenesis :
Mechanically mediated type
Immunological mediated type
Metabolical mediated type
Spetic
With Genetics Lifestyle and Environment as Contributory factors in each type.
Further various major subtypes are described in detail in following link:
HOMOEOPATHIC MEDICINES and MANAGEMENT OF ARTHRITIS
Homoeopathic Arthritis Management depends on individualisation of the patient based on present symptoms, past history, family history and constitution of the patient.
In arthritis cases it is necessary to take into account the following points (with constant search for underlying miasm and constitution type):
When it started, that is since how long its been there.
How was the onset when it appeared first time.
Wether the complaints had incidious progression or it was sudden.
Which joint is involved, wether its single joint or multiple, wether its bilateral and symetrical or diagonal.
Particulars like which part was affected first, which side it started first and how much time it took for progression to other side or other joints, sequence in which joints were involved.
How and when it gets triggered, aggravation pattern morning stiffness , aggravation on rest/ motion, relation to climate winter/monsoon/summer, relation to heat and cold, aggravation to any particular type of food.
Wether its constant or intermittant.
The joint is warmer than rest of the body or not.
Wether there is swelling around the joint or not.
Nodes or nodosities on or around any joints. or any other signs of disfigurement.
Movement or other disability in joint.
Patient has fever or not or h/o fever before or during the episode of joint pain started.
Presence of any concomittants or accompanying symptoms and wether those symptoms are of Psychotic, Syphilitic or Psoric nature.
Wether he has any other systemic complaint especially any other autoimmune or metabolic disorder.
History of injury, surgery especially affecting neurons or musculoskeletal structure.
Nature of work the patient does , postural habits, structural anomalies disfigurements.
Diet sleep and exercise routine water intake should also be noted carefully.
It is important to note family history of patient wether first degree relative had any autoimmune or metabolic disorder.
Wether patient was or is under any long term medication.
A careful history of all communicable ailments should be recorded in sequence as they had been contracted by patient, as it helps us evaluate when and how was the vital force deranged in past and wether the present condition is manifestation of some past ailment, that is any deep seated miasm, also it helps to establish wether its some inherited genetic condition or its acquired condition also it helps differentiate between
Vector borne conditions like post viral arthralgia/arthritis and Group A streptococcal borne post pharyngitis systemic autoimmune condition AND
Other Systemic autoimmune conditions like Rheumatoid Arthritis SLE psoriatic arthritis.
These basic question will lead you towards a broader vision in the case and will let you reach upto some conclusion that under what category of arthritis it should be classified and will lead you towards some understanding of miasm and constitution.
As I have mentioned in my other arthritis articles that basically I divide all types of arthritis into four major categories based on their pathogenesis.
Mechanical
Immunological
Metabolic
Septic
After being diagnosed and classified the disease condition from one of the above group we can go further on how to manage each type of case.
Immunologically mediated
Once established that its an immune mediated arthritis its necessary to rule out any damage to other organs like heart, liver, kidney, pancreas, eyes etc, as in most cases autoimmune arthritis is found to involve other system and organs or it is a part of broader systemic autoimmune condition and it is all the more necessary to find out miasmatic background, constitution and individualising symptoms, as such types of arthritis are deep seated having its own sets of aggravating and ammeliorating factors, furthermore its also observed that mental stress and emotional fluctuations have much impact on intensity and frequency of aggravations in almost all types of immunologically mediated arthritis, so its of utmost importance to take proper account of patient’s mental emotional past and present including likes and dislikes aversion and cravings, which helps us to individualise the case.
Once the we have derived constitution , miasmatic background and individuslised the case then comes medicine selection process,
I strongly recomend to go by constitution of patient in immunologically mediated arthritis rather than going theraputic remedy selection.
and it should be kept in mind that the selection procedure of medicine should correspond to degree of mental PQRS , degree of systemic PQRS and degree of musculo-skelatal symptoms of the person in disease should match the degree of pathogenic action on various sphere of the specific medicine.
Though during acute exacerbations of disease it becomes necessary many a times to administer short acting acute medicines theraputically where the new symptoms desnt fall into sphere of the constitutional medicine thats been administered.
Many a times only a single dose of similimum medicine selected may suffice to cure the case but all patients are not the same each has a different constitution and miasmatic background and severity of ailment and other external inimical factors, so in many cases it may take series of medicines one by one as per case demands during progression of treatment before the case is cured. It all depends upon how well the physician is able to find out the similimum and type of case and its requirement.
Mechanical
Under mechanical type of arthritis falls osteoarthritis and other types of arthritis caused due to mechanical injuries in such types the case is usually tale tale and shows basic picture of mechanical wear n tear which might be due to poor constitution inherited or might be acquired later on due to external inimical reasons.
In such cases it is necessary to consider that basically the constitution is lacking the capability to repair regenerate and maintain proper quality of joint cartilage and underlying bone and has tendency towards chronic sub-acute inflamation. in such cases it is important to take complete history of patient and family with details of gestational period and individulisation based on Peculiars should be derived forindividualised remedy selection for complete annihilation of condition; if not done so the patient might find relief for time being but the symptoms might keep relapsing with time again and again.
In many cases the repair and regeneration mechanisms are sufficient but mechanical wear and tear are in greater proportion and on regular basis so damage tends to accumulate, in such cases there is not much need to go deep into deriving constitution and treatment approach should aim towards elimination of maintaining cause that is excessive mechanical wear and tear and suppliment with nutritious diet and rest to affected part and symptomatic homoeopathic medicines based on theraputics will also work well.
Metabolic
Again this type of arthritis is a deep seated genetic in nature and they might accompany other metabolic syndromes and requires a careful case taking to get a broader picture of the person in disease, all aother systems and organs should be evaluated to understand sphere of disease pathology its extent and severity so it helps us to select the most similimum homoeopathic remedy.
The approach in such cases again remains constitutional , miasmatic and remedy should be selected only after proper individualisation of case and repertorisation.
Septic
In septic arthritis pt needs to be administered short acting acute remedies theraputically with support of deep acting constitutional remedy which can be administered intermittently or after the acute symptoms are ammeliorated to rearrange the deranged vital force.
Commonly Used Homoeopathic Medicines for Arthritis and its symptoms and indications:
RHUS TOXICODENDRON Usefull in almost all types of joint and musculoskeletal complaints where the symptom call for the medicine like stiffness of joints aggravatedon rest and ammeleorated on motion in any ailment involving musculoskeletal system, rheumatic joint affections, sprain and injury on joints etc
ARNICA MONTANA blunt injury and trauma, sore lame bruised sensation with swelling concussion and contusion call for this remedy
ACTEA SPICATA Pain stiffness and swelling of small joints especially of hands , good remedy for post viral arthralgia like in chickengyunya where small joints are involved
BRYONIA ALBA Stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure
LEDUM PALUSTURE Gouty arthritis involving small joints of extremities, hot swollen joints with throbbing pain, gouty nodosities, pain in ball of great toe, podagra, swollen ankles and painful soles, aggravation on warmth of bed , rheumatism starting from lower extremities and ascending upwards. right side more involved compared to left.
HYPERICUM PERFOLIATUM Degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbarspondylosis with nerve compression, tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes and fingers, sensation of pressure along the ulnar side if arm.
PLANTAGO MAJOR helps relieve bony snd neuralgic pain in arthritis
BELLIS PERENIS Soreness lameness of joints and muscles, rheumatic joint affections, sciatica where pain radiates down the anterior portion of thigh, sensation as if elastic band is tied around wrist feeling of contration of wrist joint, Railway spine, sprain and bruises of joints and muscles, good remedy where varicose veins complicate case of arthritis or both are coexisting in any patient.
ACTEA RACEMOSA Rheumatism affecting intercostal region back and neck, cervical spondylosis caising nerve compression and electric shock like shooting pain comes suddenly reaches peak and goes suddenly, stiffness and pain in tendo-achilles. sensation of heaviness in lower extremities, heavy aching tensive pain with twitching and jerking of limbs.
APIS MELIFICA swelling of joint with synovitis and synovial effusion, spetic arthritis, red hot swollen joint , pain on sloghtest pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia
CALCAREA CARBONICA osteoarthritis, degenarative changes in any joint , osteomalacia or osteoporosis causing joint degeneration, open sutures and fontanale in children, rickets , kyphosis and other loss of normal curvatures of spine, pigeon chest, fractures injuries of bones and joints
COLCHICUM Gouty arthritis , increased Serum Uric acid and tophus formation in joints. typical pain in great toe aggravated at night, sudden gripping cutting pain with much burning comes at night waking patient up from sleep
CALCAREA PHOSPHORICA osteoarthritis due to calcium deficiency , musculoskeletal complaints of old age, developmental musculoskeletal anomaly of growing children, fractures injuries of bones and joints.
BELLADONNA red hot inflamed joint with much pain and swelling
ACONITUM NAPELLUS Acute onset of pain and swelling , can be used in first 24hours or first stage of any acute inflamatory condition with severe mental restlessness fear fright and anxiety.
CALCAREA FLOURICA
NATRUM SULPH a very good remedy for gouty diathesis.
Caused due to mechanical stress and covert low grade inflamatory process.
Due to excessive mechanical stress there is increased in demand from factors responsible for repair mechanism. Initially this repair mechanism repairs as it normally should but then it becomes insufficient to repair with same mechanism so it starts compensatory mechanism where in, it tries to maintain structural aspect but at cost of quality of structural components which again due to its inferior quality gets damaged soon further due to prolonged regular mechanical stress these damages gets accumulated even further and now even compensatory mechanism fails to keep up with the amount of damage that’s been done , this starts erosion of the cartilage and the underlying bone and there is general degeneration of joint.
WHAT ARE THE RISK AND CAUSATIVE FACTORS FACTORS OF OSTEOARTHRITIS?
Mechanical injury like trauma causing damage to joint or any of its component useful in maintaining strenght structure gait and support to joint.
Mechanical stress due to different length of either legs
Mechanical stress due to neurological muscular disorder of muscles supporting that particular joint
Those who never had habit of running or jogging during their childhood or young age if suddenly starts running in excess on later age, or running along with an injury cuases severe mechanical wear and tear injury to joint.
Abnormal body gait and habitual abnormal postures
Genetics and hereditary
Hormone levels especially sex hormones
Metabolic syndrome and obesity( debated as its not the weight thats causing mechanical damage but rather its fats thats responsible to cause metabolic disorder contributing to osteorthritis)
Diet and Lifestyle
Prolonged regular mechanical stress and insufficient self repair causing accumulation of damages and later resulting into prolonged inflamation causes osteoarthritis.
Prevailing condition in body like Osteoporosis, metabolic disorders, autoimmune diseases, joint infections, congenital joint anomaly, certain syndromes like marfan syndrome, elher danlos syndrome, inflamatory diseases like lyme’s disease perthe’s disease
PATHOGENESIS OF OSTEOARTHRITIS
Chondrocytes are responsible to maintain elastic and tensile strength of cartilage by producing collagen and extracellular matrix which maintains hydration by compressive force driving water out and hydrostatic and osmotic pressure drawing water in.
Constant damage to cartilage puts extra load on chondrocytes ;if they aren’t able to repair the damage by producing sufficient collagen and extracellular matrix ; then they start producing different type of collagen just to maintain the structure as far as possible but then this collagen has a different character of retaining more water then the former which spoils the elastic and tensile strength of cartilage as a whole. This further damages the cartilage to the point where it starts disintegrating and shedding off in synovial space which puts extra load on synovium to clear it off for which synoviocytes triggers inflamatory response and synovitis and general mild inflamatory process in joint which gets prolonged due to constant mehanical stress and accumulated damages and finally inflamatory products accumulates damaging joint even further eroding cartillage and bone causing fibrillations and also reduced bone mineral density at site is observed (causation is in debate); finally there is general degeneration of joint leading to pain inflamation and loss of regular function of the affected joint.
WHAT ARE SYMPTOMS OF OSTEOARTHRITIS?
Low grade inflamation and degeneration causes pain due to which there may be loss of range of movement of a joint along its axis in varing degrees from mild to severe.
This loss of ability of movement further causes dysuse atrophy of muscles related to that particular joint and due to degenerative changes the joint becomes wider which gives typical lean muscle and wide joint looks, like in the Heberden’s Nodes and Bouchard’s Nodes in fingers
Osteoarthritis particularly involves weight bearing joint and joints more prone to mechanical stress like knee joint; lumbar spine cervical spine hip joint joints of fingers and less commonly other joints like ankle joint shoulder joint etc
It may present in one joint or in multiple joints at a time.
Exertion and motion aggravates the complaints and rest ameliorates the complaints.
Morning stiffness of affected joint is present in majority cases though not a specific symptom.
Aggravation in cold climate, high humidity, low atmospheric pressure is seen in many cases tough not consistent every-time.
Crepitation on movement or pressure are observed in affected joint.
Surrounding muscle spasms and when vertebral bodies are affected the spinal nerve corresponding to it may get compressed leading to spasms paraesthesia myalgia and cramps to correrponding musscle the affected nerve supplies.
Joint effusion, especially of knee joint are see not too infrequently.
DIAGNOSIS OF OSTEOARTHRITIS
In most cases sufficient clinical evidence supports the diagnosis but an X ray is required not only to reconfirm diagnosis but also to evaluate to amount of damage within as pain and other clinical symptoms are not indicator of the amount of damage within; in many cases we may also need to exclude other conditions for which further related investigations should be done.
HOMOEOPATHIC MANAGEMENT OF OSTEOARTHRITIS
Once its established that the patient is suffering from osteoarthritis the homoeopathic management of the case will be as follows
As per my classification criteria Osteoarthritis falls under Mechanically mediated type of arthritis
Under mechanical type of arthritis falls osteoarthritis and other types of arthritis caused due to mechanical injuries in such types the case is usually tale tale and shows basic picture of mechanical wear n tear which might be due to poor constitution inherited or might be acquired later on due to external inimical reasons.
In such cases it is necessary to consider that basically the constitution is lacking the capability to repair regenerate and maintain proper quality of joint cartilage and underlying bone and has tendency towards chronic sub-acute inflamation. in such cases it is important to take complete history of patient and family with details of gestational period and individulisation based on Peculiars should be derived forindividualised remedy selection for complete annihilation of condition; if not done so the patient might find relief for time being but the symptoms might keep relapsing with time again and again.
In many cases the repair and regeneration mechanisms are sufficient but mechanical wear and tear are in greater proportion and on regular basis so damage tends to accumulate, in such cases there is not much need to go deep into deriving constitution and treatment approach should aim towards elimination of maintaining cause that is excessive mechanical wear and tear and suppliment with nutritious diet and rest to affected part and symptomatic homoeopathic medicines based on theraputics will also work well.
Homoeopathic Medicines for Arthritis with its symptoms and indications:
RHUS TOXICODENDRONusfull in almost all types of joint and musculoskeletal complaints where the symptom call for the medicine like stiffness of joints aggravatedon rest and ammeleorated on motion in any ailment involving musculoskeletal system, rheumatic joint affections, sprain and injury on joints etc
ARNICA MONTANA blunt injury and trauma, sore lame bruised sensation with swelling concussion and contusion call for this remedy
ACTEA SPICATA pain stiffness and swelling of small joints especially of hands , good remedy for post viral arthralgia like in chickengyunya where small joints are involved
BRYONIA stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure
LEDUM PALgouty arthritis involving small joints of extremities, hot swollen joints with throbbing pain, gouty nodosities, pain in ball of great toe, podagra, swollen ankles and painful soles, aggravation on warmth of bed , rheumatism starting from lower extremities and ascending upwards. right side more involved compared to left.
HYPERICUM PERFOLIATUM degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbarspondylosis with nerve compression, tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes and fingers, sensation of pressure along the ulnar side if arm.
PLANTAGO MAJOR helps relieve bony snd neuralgic pain in arthritis
BELLIS PERENIS soreness lameness of joints and muscles, rheumatic joint affections, sciatica where pain radiates down the anterior portion of thigh, sensation as if elastic band is tied around wrist feeling of contration of wrist joint, Railway spine, sprain and bruises of joints and muscles, good remedy where varicose veins complicate case of arthritis or both are coexisting in any patient.
ACTEA RACEMOSA Rheumatism affecting intercostal region back and neck, cervical spondylosis caising nerve compression and electric shock like shooting pain comes suddenly reaches peak and goes suddenly, stiffness and pain in tendo-achilles. sensation of heaviness in lower extremities, heavy aching tensive pain with twitching and jerking of limbs.
APIS MELIFICA swelling of joint with synovitis and synovial effusion, spetic arthritis, red hot swollen joint , pain on sloghtest pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia
CALCAREA CARBONICA osteoarthritis, degenarative changes in any joint , osteomalacia or osteoporosis causing joint degeneration, open sutures and fontanale in children, rickets , kyphosis and other loss of normal curvatures of spine, pigeon chest, fractures injuries of bones and joints
CALCAREA PHOSPHORICA osteoarthritis due to calcium deficiency , musculoskeletal complaints of old age, developmental musculoskeletal anomaly of growing children, fractures injuries of bones and joints.
BELLADONNA red hot inflamed joint with much pain and swelling
ACONITUM NAPELLUSAcute onset of pain and swelling , can be used in first 24hours or first stage of any acute inflamatory condition with severe mental restlessness fear fright and anxiety.
For understanding of arthritis in general, its case-taking and homoeopathic management visit following link
Achlorhydria or hypochlorhydria is a condition where stomach and other digestive organs stops or has reduced secretion respectively of hydrochloric acid
CAUSES OF HYPOCHLORHYDRIA / ACHLORHYDRIA
It usually is secondary to a primary condition like bacterial overgrowth like helicobacter pylori etc which neutralizes HCl; Gastro-intestinal Metaplasia; Atrophic Gastristis; Reducing Basal Metabolic Rate (BMR); autoimmune conditions where there are autoantibodies formed against gastric parietal cells that produces Gastric Acid ; frequent long-term use of antacids like H2 receptor antagonist or Proton pump inhibitors; mucolipidosis type IV, procedures like Gastric Bypass Duodenal switch RNY; Islet Cells tumors like VIPomas ( Vasoactive intestinal peptides) and Somatostatinomas; Pellagra(niacin deficiency), Pernicious anemia, deficiency of mineral and electrolytes required to produce sufficient Gastric acid like sodium chloride potassium zinc iodine etc.
So its a vicious cycle where pre-existing condition causes achlorhydria and achlorhydria further aggravates that primary cause.
SIGNS AND SYMPTOMS OF ACHLORHYDRIA OR HPOCHLORHDRIA
So along with symptoms of primary disease it will also show Gastro-Oesophageal Reflux Disease, anorexia, Early satiety while eating , weight loss, abdominal discomfort , sensation of fullness and distention of abdomen, frequent diarrhea and constipation, iron deficiency anemia due to lack of HCl, pernicious nemia due to lack of Vit B12 and many other deficiencies like that of vitamin B complex, vitamin k, vitamin C and other micronutrients minerals like magnesium sodium chloride potassium zinc etc; causes many neuro-muscular disorders like general weakness esp. lower limbs with myalgia paraesthesia ataxia and gait disorders ;also psychological disorders like weak memory, mood disorders personality disorders, hallucinations etc. these patients are prone to infection of Vibrio Vulnificus and other usually uncommon infections of organisms found in food ( more commonly from seafood); all these complaints and many other collectively may prove fatal.
DIAGNOSIS OF ACHLORHYDRIA OR HYPOCHLORHDRIA
Oesophageal pH monitoring giving 24-hour profile of gastric acid Secretion
Gastric pH at endoscopy
Extreme low levels of pepsinogen A(PgA) < 17ug/l in blood serum and high serum Gastrin Level >500-1000pg/ml supports the diagnosis
Heidelberg test is an alternate test.
Many other tests like Serum iron, serum calcium, Vit B12, Vit D, Thaimin, CBC tests for various forms of anemia elevation in serum folate level s/o small bowel bacterial growth etc can help to exclude associated conditions.
Once achlorhydria is confirmed a hydrogen breath test should be conducted to exclude bacterial overgrowth.
Acne or Pimples is a chronic skin disorder affecting pilosebaceous units caused due to clogged skin’s hair follicles by dead skin, excess sebum, dust and pollution.
It is also called Acne Vulgaris
SYMPTOMATIC CHARACTERISTICS OF ACNE/PIMPLES
It is characterised by oily skin, comedons, black-heads, white-heads, pimples and scarring and pigmentation.
It usually presents itself in region dense with sebeceous glands, like on face, chest and back.
Strong Genetic and Heredity association is found in 80% cases. During puberty surge in hormones triggers Acne in both sexes. Diet, cleanliness, medication, infections, pollution environmental factors ,sunlight exposure, stress, smoking and other lifestyle factor seems to contribute in not all but many cases in varing degrees. propionibacterium acnes a commonly found on skin which frequently outgrows in number and contribute to acne in most of the cases.
CATEGORISATION METHODOLOGY TO JUDGE SEVERITY OF ACNE/PIMPLES
Acne are categorised based on severity and there are various methods to do this Cook’s photographic scale of 0-8 grades, Leed’s scale of 0-10 with 2 modified versions of 0-11 and 0-12 and Pillsburry’s scale of 1-4 grades. A scale of mild, moderate and severe is commonly used which easily helps to quickly decide line of treatment.
Mild form has only clogged hair follicle called comedones also known as black-head(open mouth comedone) and white-head(closed mouth comedone) and very occasional pimples are found on trunk .
Moderate form has pappules and pustules forming on clogged hair follicles called pimples are found on face and trunk.
Severe form has cysts and nodules its termed severe nodular acne and is present extensively on face and trunk.
PATHOGENESIS OF ACNE/PIMPLES
Acne is a chronic skin disorder affecting pilosebaceous units caused due to clogged skin’s hair follicles due to
Excess sebum production under influence of androgen
Excess keratin deposition in hair follicle
Infection and colonization of the hair follicle by Propionibacterium acnes
Local activation of inflamatory mediators.
Dihydroxytestosterone and increased amount DHEA-S of secreted during adrenarche leads to excessive Sebum production prevents dead cells and debri to clear itself from hairfollicle causing an initial keratin and debri clog within and form microcomedon, excessive skin cell proliferation also contributes in development of clog its further complicated by colonisation of Propionibacterium Acnes which forms a slimy biofilm within the hair folicle and helps forming a comedone.
If comedone is superficial the melanin pigments gets exposed giving it dark colour so its called blackhead also called open comedone.
If the comedone is deep within the hair follicle, unexposed, it is called whitehead also called closed comedone.
Many of the comedones further progress into papules, pustules and nodules, also it may affect deeper tissue and form deep tissue nodule.
HOMEOPATHIC TREATMENT WITH INDICATED HOMEOPATHIC MEDICINES FOR ACNE/PIMPLES
KALIUM BROMATICUM
Kali bromaticum is one of the most indicated remedy in case of Acne. In Kali bromaticum pimples usually begins in the teenage. Reddish pustules on the face causing grooves. Pimples usually have a depressed centre. Face is usually flushed, yellowish, cahetic look with pimples on face. In females the acne are worse prior to the menstrual period and during the time of menstruation. Exhausted look of face, lifeless and expressionless. Inflammation and great redness of face due to pimples.
JUGLANS REGIA
It was said that in the golden age, when men lived on acorns, God lived upon walnuts and hence the name Juglans (Jupitars nut). Juglans regia stimulates the body’s defense mechanism and acts on various skin problems like pimples, eczema etc. Juglans regia is a very beneficial remedy in case of Acne. Indicated comedone of face. Reddish hard painful swelling of cheeks due to pimples. Acne filled with pus. Sharply defined depressed dark red erruptions, pus is seen through the thin skin.
CALCAREA SULPHURICA
Calcarea sulph is a Schussler’s connected tissue salt and most of the indications for its use are derived from his clinical experience. It has been extensively used for acne treatment based upon the biochemic theory. Very valuable remedy in case of pimoles. pimples with pustules on the face. Pale and sick looking face. Severe erruptions on face with itching. Pain in the erruptions after exposure to cold. Cold sweat on face. Useful in severe cystic acne. Lesions usually persists in one place for weeks and do not heal quickly. Yellow creamy pus drains for a long time. Unhealthy skin with yellowish scabs. Pimples on face, near hairline.
MERCURIUS SOLUBILIS
Mercurius solubilis is a powerful remedy which acts on every organ and tissue of the body.Very useful remedy in cases of acne. Earthy, puffy, dirty looking face, with constantly perspiring skin. A big pimple is surrounded by multiple smaller ones. Itchy erruptions, yellowish brown or greenish discharge from pustular pimples, often streaked with blood. Worse from extremes of temperature. Yellowish scabs with purulent pustules. Severe Burning of pimples.
ECHINECEA ANGUSTIFOLIA
Acne is by far the most commonest skin condition. Although prevalent among teens, a number of old people are also struggling with this condition. Echinecea angustifolia is the most effective remedy in case of acne. Echinecea angustifolia plant has its roots from daisy family. It makes the subcutaneous and superficial blood vessel walls stronger. This makes the skin more resistant and less penetrable from either the bacteria or free radicles that promote the development of acne. Echinecia helps to lower the inflammation levels due to its antibacterial properties. Echinecea angustifolia enhances good circulation and hence the skin will be clear and free from dead skin cells that clog the pores. It helps to accelerate the body’s natural defense mechanisms of flushing out the toxins.
AZADERECHTA INDICA
Azaderechta indica has been used since decades as a traditional medicine in treatment of Acne. Azaderchta indica is known commonly as Neem. It is aaociated to Meliaceae family. Azaderchta indica detoxifies the body and acts as a blood purifier. Every part of Neem is useful with number of medicinal properties. It has been used since ancient times to treat many skin problems. It has a soothing effect on irritating skin. Very useful in acne. It acts as a nutritive tonic to skin. The antebacterial properties help to reduce the risk of infections. Azaderachta indica reudces the inflammations and puffiness of acne. Purifies blood thus gives radiance to skin. Pimples with severe redness, pus and tendency to form scars. Painful to touch.
BERBERIS AQUIFOLIUM
Berberis aquifolium has a marked action on the skin producing pimples, dry, rough and scaly erruptions. Acne is the most common and psychologically distressing skin disorder which is very well managed by Berberis aquifolia, it clears acne and hence clears the skin. It also helps to erase scars on skin. Berberis aquifolia is one of the recommended medicine for its cleansing effect and helps in lightening of complexion.
PULSATILLA NIGRICANS
Pulsatilla nigricans is a very effective remedy for acne during puberty. Especially indicated in young girls. Young girls usually suffer from various hormonal changes which lead to formation of pimples. Acne is worse during time of or around the time of menses, eating rich and fatty food. Especially indicated around time of puberty or when pimples breaks out near menstrual periods.
HEPAR SULPHUR
Hepar sulphur is one of the indicated remedies in acne. Usefull in acne in case of adolescents with unhealthy skin. Yellowish complexion. Great sensitiveness to slightest touch. Useful in pimples that are pustular in nature. The pus may be blood stained at times. The pimples are extremely painful. Tendency to form boils or abscess.
SILICEA
Acne like boils on face especially on cheeks. Slow healing acne which leave pitting scars. Silicea face is waxy, tired, anaemic. Pustular and vesicular erruptions spread over the face. Erruptions and crusts peel off with no healing. Useful in cases of pimples with offensive pus formation. Indicated in treating all types of skin problems. Pimples on forehead and cheeks. Silicea is usually chilly with increased sweating of palms and soles.
ACNE BEFORE HOMEOPATHIC TREATMENT AT Dr SHAH’s HOMOEOPATHYACNE CURED AFTER HOMEOPATHIC TREATMENT AT Dr SHAH’s HOMOEOPATHYCASE OF ACNE AFTER HOMEOPATHIC TREATMENT AT Dr SHAH’s HOMOEOPATHY
Vitiligo is believed to be an immune mediate disorder affecting skin.
It is characterized by depigmented spots with sharp well defined margins bilateral in most of the cases , usually patches appears on exposed parts, extremities, body orifices, most common sites involved are hand, wrist, lips, face, feet, umbilicus, eye lids, nostrils mucosa of nose eye and mouth are also involved.
BEFORE TREATMENT: VITILIGO CASE Sept 2015 – At Dr SHAH HOMOEOPATHY- Dr DEEPAN P SHAH
DURING TREATMENT: VITILIGO CASE NOVEMBER 2016 – At Dr SHAH HOMOEOPATHY- Dr DEEPAN P SHAH
DURING TREATMENT: VITILIGO CASE JAN 2018 – At Dr SHAH HOMOEOPATHY- Dr DEEPAN P SHAH
CLOSE UP PIC OF RECOVERY DURING TREATMENT: VITILIGO CASE – At Dr SHAH HOMOEOPATHY- Dr DEEPAN P SHAH
PATHOGENESIS and GENETICS
Its cause is not known, but it’s believed to be multifactorial disease which is genetically predisposed and triggered by Environmental factors. It is frequently accompanied by other autoimmune conditions like Hashimoto’s thyroiditis, psoriasis, systemic lupus erythematoses, pernicious anaemia, alopecia areata etc.It is a non infectious condition. A strong hereditary association is noted.
Tyrosinase the enzyme of melanocyte expressed by TYR genewhich is not the component of immune system but catalyzes melanin synthesis and is a major autoantigen in generalised vitiligo. A genomewide dtudy have found around 36 loci associated with succeptibility towards generalised vitiligo, its usually due to defect in genes related to melanocytes or immune system , its doubted that there might be some autoimmune response towards melanocytes.
SYMPTOMS AND CLASSIFICATION
It can be classified into segmentaland nonsegmental types
In nonsegmental type the depigmentation appear somewhat symetrical and bilateral and usually grow with time and also appears in new areas with somewhat symetrical pattern it can start at any age and can grow to generalised or universalis where very few normal pigmented patches are left behind.
It is further categorised into
Vitiligo Universalis depigmented patches cover almost whole body with very few patches of normal pigmented patches are left behind , Micheal Jackson suffered from this type.
Generalised Vitiligo depigmented patches scattered throughout the body in somewhat symeterical fashion.
Focal Vitiligoone or few small patches in an area, commonly found in children.
Acrofacial vitiligo only fingers and periorificial areas involved
Mucosal Vitiligo only mucosal membranes involved
Segmental type usually affects segments of skin supplied by dorsal root from spinal cord. its usually nonsymetrical and unilateral, it is less frewuently associated with other autoimmune disorders as compared to segmental type, it usually is stable and static and does not grow much in size eith time.
DIAGNOSIS
When patches of affected skin are exposed to UV-A light it glows blue and the normal unaffected skin shows no reaction
Biopsy helps in confirmation of diagnosis
MEDICINES FOR VITILIGO IN HOMEOPATHY
BELOW MEDICINES ARE ONLY FOR QUICK REFERENCE AND THERAPUTIC HINTS.
ITS ALWAYS RECOMENDED TO TREAT SUCH AUTOIMMUNE CONDITIONS CONSTITUTIONALY, AFTER PROPER REPERTORISATION AND HOMEOPATHICALLY INDIVIDUALISED SIMILIMUM REMEDY SELECTION.
THE ABOVE MENTIONED CASE WAS TREATED WITH SINGLE SIMILIMUM DOSE FOLLOWED BY PLACEBO TILL DATE AND IT KEPT ON IMPROVING.
PSORALEA CORYLIFOLIA
Psoralea corylifolia used not only in homeopathy but also is an important plant in Ayurvedic system of medicone. The seeds have a variety of traditional medicinal uses. Psoralea corylifolia is used in Homoeopathy and other system of medicines.
Psoralea corylifolia mother tincture is used therapeutically for various kinds of disorders. Psoralea corylifolia is a vedy valuable remedy in case of Vitiligo. It has a poweful action on the skin as it causes dilatation of arterioles of body leading to pigment formation which diffuses into discolorized leucodermic patches. It contains enormous biological values and is been used to treat various skin diseases from a long time like vitiligo, psoriasis, eczema. Psoralea corylifolia consists main components psoralen and iso psoralen thus it has antibacterial and anti viral properties. Psoralea corylifolea were used thousands of years ago in India for repigmentation of skin in vitiligo patients.
AMMI VISNAGO
Ammi visnago is a natural substance used since a long time in herbal medicine. Ammi visnago is extracted from a plant in carrot family. Ammi visnago is a very beneficial remedy used in treatment of Vitiligo. Marked white patches are seen on the skin, it usually occurs when the melanocytes stop producing melanin. Usually the discoloration first shows on sun exposed areas such as hands, feet, arms, face, lips. Along with skin discoloration, there is permature greying of hair. Ammi visnago helps in repigmentation of vitiligo affected area.
IODIUM
Iodium is one of the indicated remedy in vitiligo. Usually presents with whitish discoloration of skin, whitish spots appear in patches. Melanocytes stop producing melanin, the pigment that gives color to skin, hair etc. Hence the involved patches become lighter. Iodium is usually suited to persons of scrofulous diathesis with dark black hair. Profound debility, great emaciation. Striking feature of iodium is eats ravenously yet emaciates.
ARS SULPH FLAVUM
ARS SULPH FLAVUM is one of the deep acting remedy which has very good results in case of vitiligo. The patient usually presents with discoloration of skin in patches that are pale white in colour. Ars sulph flavum is especially indicated when vitiligo is at the muco cutaneous junctions. Also indicated in other skin disorders such as eczema.
SULPHUR
Sulphur is a great general antipsoric remedy widely used for various kinds of skin diseases. It is often of great use in begining the treatment of any chronic diseases. Erruptions almost of every kind. Useful in case of vitiligo. Whitish discoloration of skin. Skin is usually dry, rough, wrinkled. Unhealthy skin. Every erruption presents with great itching, sometimes itching occurs even without any erruption. Burning is the most characteristic symptom of sulphur.
When solids and particulate metabolites or salts starts depositing at any level of urinary collecting system it forms renal stones or urolithiasis
An organic matrix of mucoprotien is present in all above types of stones which acts as an additional binding matrix and it makes up almost 2.5 % of weight in all stones.
Urolithiasis is more common in males than in females
Increased concentration in urine, of the constituents of stones is associated with stone formation.
COMPOSITION AND INCIDENCE OF DIFFERENT TYPES OF RENAL STONES
1) Calcium Oxalate/Phosphate Stonescomprises 75% of every stones.
Its observed that almost 50 % of cases of Calcium Stones that have idiopathic hypercalciuria and doesn’t have hypercalcemia.
10 % of cases calcium stone cases have both hypercalcemia and hypercalciurea
5% have Enteric(4.5%) or Primary (0.5%) hyperoxaluria
20% have hyperuricosuria
15-20% have unknown metabolic anomaly
2) Struvite Stones (Magnesium, Ammonia, Calcium, Phosphate) usually due to renal infections comprises off 10-15% of all stones.
3) Uric Acid Stones comprises 6% of all stobe cases 50% of which are associated with hyperuricosuria and/or hyperuricemia and 50% are of idiopathic origin.
4) Cystine Stone comprises only of 1-2% of all the cases
5) Other and unknown types of stonescomprises of upto 10% of all the cases
An organic matrix of mucoprotien is present in all above all types of stones which acts as an additional binding matrix and it makes up almost 2.5 % of weight of all stones.
Renal caliculus, while selecting homoeopathic remedy for Kidney stones it is important to make note of all accompanying symptoms, like type of pain , character of urine, and if there are gravels in urine then its colour shape size should be noted, also other miasmatic and constitutional background should be evaluated for proper similimum remedy selection.
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy
14mm Renal Caliculus removed nonsurgically at Dr SHAH’s Homoeopathy
Risk factors
Increases Risk:
Dehydration, Low water intake, excess grapefruit or apple juice intake soft drinks containing phosphoric acid especially areated drinks.
Excess red meat consumption increases concerntration of certain sulfurous amino acids like cystiene and methionine which acidifies urine , decreases citrate excretion through urine and increases excretion of calcium and uric acid through urine thus increasing risk of renal stones.
Calcium suppliment tablets and VitaminD suppliment for long term may cause Calcium Stones
Studies show that low dietary calcium promotes calcium stones:- Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine.
Sodium and fluoridated water increases urinary excretion of calcium thus increases risk of stone formation.
Low urinary excretion of citrate
Decreases Risk:
Unlike supplimental calcium , Natural dietary calcium actually protects you against renal stones. As it binds with ingested oxalate from food in gastro-intestinal tract to form calcium oxalate and thus reducing its absorption and inturn reducing oxalate concentration in urine. Oxalate is 15 times more potent in forming renal stones compared to increased levels of calcium in urine
Studies show that low dietary calcium promotes calcium stones.
Magnesium inhibits stone formation.
Patassium promotes urinary excretion of citrate and citrate inhibits crystallisation of calcium and thus reduces risk of urinary calcium stones
Commonly Used Homoeopathic Remedies For Renal Caliculus
BERBERRIES VULGARIS
Sensation of retention of urine and urge to pass it again soon after passing, patient is thirstless, bright red mealy sediments, bubbling sore sensation in renal region, pain in urinary bladder region, pain radiating from lumbar region to pelvis and down to lower limbs while passing urine, burning in urethra even when patient is not passing urine, feequent micturation, well indicated in patients with renal caliculus with gouty diathesis and elevated uric acid levels and urate crystals in urine. Works well in patients having glomerulonephritis along with Renal Caliculus.
HYDRANGEA ARBORESCENS
white amorphous salt in urine giving urine a turbid colour, white amorphous salt in urine deposits in form of gravel. Sharp pain in loins especially in left side with unquenchable thirst for large quantity water, unlike berberries vulgaris which has thirstlessness. Well indicated in patients with enlarged prostate and also having Renal caliculus.
CANTHERIS
In patients with bleeding due to renal stones, heamaturia and Nephritis, Intolerable constant urge to pass urine with paroxysmal acute cutting and burning from lumbar region to pelvis in front, urinary tract infection due to stone initially causing membranous scales giving appearance of bran in water when passed profuse urine and later on urine mixed with blood passes drop by drop jelly like shreddy urine , membranous scales giving appearance of bran in water, infection of urethra due to damage by renal stone causing irritation in urethra increasing sexual desire.
SARSAPARILLA
Scanty slimy flaky sandy and bloody urine, gravels in urine that passes in thin stream, this medicine should be thought of when sand-like gravels seen on daiper of children and they are cranky before and during passing urine, Kidney stones on right side.
PAREIRA BRAVA / CONDODENDRON TORMENTOSUM
great tenesmus while passing urine, constant urge to pass urine but has to strain much while passing has to bend down on his knees and press head on floor in front to pass urine causing pain to radiating till his thighs, Urine dribbles after micturating, pain in glans penis, renal stones in patient with gonorrhoeal urinary tract affections.
BORAX
Small red particles in urine and on daiper of child who cries while passing urine, hot smarting pain in urethra.
SOLIDAGO
Redish brown thick sediment gravels with offensive albuminuria , pain in renal angle radiating forward and downwards towards abdomen and pelvis.
SILICEA
its a wonderful homoeopathy know for its ability to expel foreign particle from body, for which it is also termed as surgeons knife, Red or Yellow sedimentation prostorrhoea due to tenesmus in patients with retention of urine due to renal caliculus
LYCOPODIUM CLAVATUM
Heavy Red Sand Particle in urine, pain in right hypochondrium and right lumbar region , renal stones in old men with slow feeble urine with stangury, tenesmus and retention of urine.
CALCAREA CARBONICA
Calcium oxalate crystals in urine, sour fetid smelling urine with dark brown colour and white sediments and haematuria.
Rheumatoid arthritis is a chronic systemic auto-immune disorder predominantly affecting synovial joints.
Rheumatoid Athritis may also affect tissues other than those in joint; like blood, skin, pleura, lungs, kidney, nerves, heart, pericardium, blood vessels, eyes, liver etc.
CAUSES OF RHEUMATOID ARTHRITIS (RA)
It is still unclear how it is caused but it is believed to be combination of
1) Genetic Factors
HLA-DR4 – HLADRB1 is storngly associated with Rheumatoid Arthritis but not in all ethnicity it shows the same significance.
MHC class II related allotypes and T-cell Associated Protein PTPN22 are also found to be associated with RA.
2) Environmental and Lifestyle Factors
Environmental factors like radiations, pollution etc. Exposure to fine crystalline form of pure silica i.e. Silicon Dioxide can cause Rheumatoid Arthritis, is an established fact.
Lifestyle factors like addiction to cigarette smoking, mental stress, physical stress and digestive disturbances are also doubted (though unconfirmed).
Hormonal fluctuations during pregnancy, menopause, hormonal medications etc. are also believed to be strong contributing factors.
Still we are not able to link any infectious agent or vector associated to RA.
PATHOGENESIS AND PATHOPHYSIOLOGY OF RHEUMATOID ARTHRITIS (RA)
It has been observed that there is an abnormal immune response, where in, there is a state of persistent cellular activation, due to constant positive feedback (probably due to inhibition of negative feedback pathway or exaggerated positive feedback due to certain factors) causing formation of immune complexes and autoimmunity. This initially shows up in synovial joint and less frequently or later in other organs and tissues as well.
Rheumatoid Arthritis manifests in following phases :-
Initial phase – shows non-specific inflamation
Amplification phase – caused by T-cell activation
Chronic inflamatory Phase– where Cytokines like Interlukine-1 Interlukine-6 Tumour Necrosis Factor-alpha comes in picture causing chronic inflamation and tissue injury
Antibodies to IgGFc are called Rheumatoid Factor (RF/ RA factor) and Antibodies to Citrulinated Peptides (ACPA) are major factors specific in pathology of Rheumatoid Arthritis.
Other nonspecific factors are abnormally Glycosylated Antibodies. These are believed to be the contributing factors in arthritis. Though they are not specific to Rheumatoid Arthritis and are also present in many other Autoimmune conditions.
B lymphocytes → Plasma cells → RA factor and ACPA(of IGg And Igm Classes) + Fc receptors & compliment (binding due to antibody’s altered N glycans) (simultaneously; doubted TNF activation at this Stage) → Macrophage activation → Synovial macrophage & dendritic cells further expresses MHC class II molecules → Synovial oedmatous inflamation with T cell activation(also doubted TNF activation through T cell product IL17) and infiltration(mainly CD4 and CD8) → Intense inflamation – Granulation tissue formation -Angiogenesis – Inflamatory products damaging tissues – Thickening of synovium- Cartilage disintegration -Bone disintegration-Joint degeneration.
It is observed that presence of B-cell and T-cell at site is not necessary for the pathogenesis. So the exact role of B-cell and T-cell is doubted. Also TNF a major foctor responsible for progress of Rheumatoid Arthritis is doubted that wether its predominantly derived through B-cell or T-cell channel or through both as presented in above flow chart.
Other factors like IL1, IL6, IL15, IL17 are also believed to be important in pathogenesis of Rheumatoid Arthritis.
Signs and Symptoms of Rheumatoid Arthritis
General Symptoms
Fatigue
Low Grade Fever not necessarily in all cases.
Malaise
Morning Stiffness
Loss of appetite
Weight Loss
Arthritis
Polyarthritis i.e. multiple joint involvement -small joints of hands, feet and spine are affected more than compared to larger joints like – knee, shoulder, hip joints but not always, in many patients, initially it may present as Monoarthritis ie single joint involvement.
Synovitis and erosion of joint tissue, tendinitis, with surrounding tissue swelling. It presents as swollen, tender, warm joints, causing stiffness and resulting into loss of range of motion of joint.
Morning stiffness difficultly in motion of affected joint with sensation of stiffness and pain. Morning stiffness lasts for more than an hour. Aggravation of pain and stiffness of joints on prolonged rest and ammelioration on motion is a distinguishing character of inflamatory arthritis like Rhuematoid Arthritis in its early stages, compared to non inflamatory conditions like osteoarthritis, where the causes are mechanical so it has motion aggravation and rest ammelioration and morning stiffness is not prolonged for more than an hour, pain is nociceptive and not neuropathic.
Various Deformities
Necrotising Granuloma or Rheumatoid Nodule typically appears over areas where there is excessive mechanical stress, like bony processes or prominencies eg knuckles, wrist, elbow, heel etc, they are few milimeters to centimeter in diameter.
Ulnar deviation of fingers.
Button Hole Deformity or Boutonniere Deformity – proximal interphalangeal joints flexed and distal interphalangeal joints extended.
Z-thumb deformity or Z deformity the interphalengeal joint gets hyperextended and there is subluxation of metacarpo-phalengeal joint with fixed flexion.
Arthritis Mutilans
Atlanto axial subluxation due to erosion of odontoid process and transverse process which initially presents as clumsiness and may progress into quadripelgai and eventually death.
Swan Neck Deformity with Ulnar Deviation of fingers and Rheumatoid Nodules
Multiple Rheumatoid nodules seen on knuckles and wrist
Disfigurement of hand in rheumatoid arthritis
Disfigurement of Toes and feet in Rheumatoid Arthritis
Disfigurement of toes in Rheumatoid Arthritis
Skin Symptoms of Rheumatoid Arthritis
Necrotising Granuloma or rheumatic nodule many a times appears in the skin.
Rheumatic Nodule of Skin in patient with Rheumatoid Arthritis
Mononeuritis Multiplex caused due to severe Rhematic vasculitis and vasculitic nerve infarction of small and medium sized blood vessels also giving rise to skin ulcers
Occasionally the skin may also present with
Pyoderma Gangrenosum
Sweet’s Syndrome
Erythema Nodosum
Lobe Paniculitis
Atrophy of finger skin
Palmar Erythema
Fragile Skin
Few of above complications are due to prolonged allopathic medication.
Lungs involvement
Fibrosis of lungs is well recognised consequence of allopathic treatment for Rheumatoid Arthritis.
Caplans syndrome, when RA pt gets exposed to coal dust it gives rise to rheumatoid lung nodules.
Pleural effusion is associated with Rheumatoid Arthritis.
Cardiac involvement in Rheumatoid Arthritis
Rheumatiod Arthritis may affect heart and cause pericarditis, endocarditis, valvulitis, Left Ventricular Failure, Fibrosis.
Rheumatiod Arthritis significantly increases risk of artherosclerosis, myocardial infarction, stroke.
Most of the RA patients do not develop pain of angina or myocardial infarction so are at high risk to be left undiagnosed.
Rheumatoid Arthritis Affects major components of blood
In blood, Rheumatoid Arthritis causes Hepcidin levels to increase leading to Anaemia of Chronic Disease.
Leucocytopenia in patients with felty’s syndrome.
Neutropenia and Thrombocytosis if inflamation persists.
Rheumatoid Arthritis Affects Kidneys
Renal Amyloidisis is consequence of chronic inflamation of RA.
Allopathic treatment of RA may cause membranous nephropathy.
Eye Manifestation of Rheumatoid Arthritis
Episcleritis, Scleritis, Keratitis Keratoconjunctivitis, Scleromalacia, Keratomalacia, Xeropthalmia are occular complications of Rheumatoid Arthritis.
Liver Complications in Rheumatoid Arthritis
Liver may be affected due to prolonged allopathic treatment of Rhuematoid Arthritis and if there are any other inflamatory Liver complaints or autoimmune conditions affecting liver, coexisting with RA, it can create complications in liver.
Neuronal Complications Due To Rheumatoid Arthritis
RA affects neurons to cause Peripheral neuropathy, Mononeuritis Multiplex, Carpel Tunnel Syndrome, Myelopathy due to Rheumatoid disease of spine. Atlanto-Axial subluxation due to erosion of odontoid process and transverse process which initially presents as clumsiness and may progress into quadripelgai and eventually death.
DIAGNOSIS OF RHEUMATOID ARTHRITIS (RA)
X-rays
X-rays may not show any changes in early stages though sometimes mild soft tissue swelling might be visible in later stages along with soft tissue swelling it may show juxta-articular osteopenia and loss off joint space in advanced stage it may also show nodes bony erosion subluxation of affected joints.
Blood Tests
Test for RA factor
Negative serological tests doesnt exclude the probablity of Rheumatoid Arthritis. As 20-25% of RA patients are negative for RA factor test which is considerably large number. Also during first year of development of rheumatoid factor majority of the patients are usually negative. 10% of healthy person may show positive for RA Factor. Even persons with Hepatitis C and persons with chronic autoimmune diseases like Systemic Lupus erythematosus or Sjogren’s syndrome may show positive RA factor test. So the test is not specific and also not much sensitive.
Test for ACPA (measured as Anti-CCP antibodies)
ACPA with 95% specificity is much more specific compared to RA factor test but has lower sensitivity only 60-70% compared to 80-85% of RA Factor test.
Patients with clinical features and all other investigations pointing towards Rheumatoid Arthritis except their RA Factor and Anti-CCP tests are negative sich patients are called seronegative Rheumatoid Arthritis cases almost 25% cases falls in this category.
New point of care test is introduced where in; RF and anti-MCV are detected which has sensitivity of 72% and specificity of 99.7%
Other non-specific, indirect, additional supportive tests to RA factor and ANTI-CCP tests are :-
ESR; CRP; CBC; RFT; LFT; ANA; Ferritin levels.
DIAGNOSIS AND CLASSIFICATION CRITERIA FOR RHEUMATOID ARTHRITIS
This diagnosis and classification criterion is jointly developed by American College of Rheumatology and European League Against Rheumatism has become widely accepted globally is as follows:
A Score of 1-10 is established by adding scores of following 4 different criteria
Number and type of joints involved
RA factor and ACPA tests
Acute Phase Reactants CRP and ESR
Duration of Disease
1) Score Rating of NUMBER and TYPE of JOINTS involved
1 Large joint = 0 points
2-10 Large Joints =1 point
1-3 small joints(with/ without Large Joint involvement) = 2 points
4-10 small joints(with/without Large joint involvement) = 3 points
Involvement of more than 10 joints including atleast 1 small joint =5 points
2) Score Rating of Specific Serological Tests (RA factor and ACPA)
Negative RA factor and ACPA = 0 points
Low positive RA factor or Low Positive ACPA = 2 points
High Positive RA factor or High positive ACPA = 3 points
3) Score Rating of Acute Phase Reactants
Elevated ESR and CRP = 1 point
4) Score Rating of Duration of disease
Duration of Arthritis if more than 6 months =1 point
A score of 6 or above establish positive Rheumatoid Arthritis as diagnosis.
HOMEOPATHIC ARTHRITIS MANAGEMENT
Homoeopathic Arthritis Management depends on individualisation of the patient based on present symptoms, past history, family history and constitution of the patient.
In arthritis cases it is necessary to take into account the following points (with constant search for underlying miasm and constitution type):
When it started, that is since how long its been there.
How was the onset when it appeared first time.
Wether the complaints had incidious progression or it was sudden.
Which joint is involved, wether its single joint or multiple, wether its bilateral and symetrical or diagonal.
Particulars like which part was affected first, which side it started first and how much time it took for progression to other side or other joints, sequence in which joints were involved.
How and when it gets triggered, aggravation pattern morning stiffness , aggravation on rest/ motion, relation to climate winter/monsoon/summer, relation to heat and cold, aggravation to any particular type of food.
Wether its constant or intermittant.
The joint is warmer than rest of the body or not.
Wether there is swelling around the joint or not.
Nodes or nodosities on or around any joints. or any other signs of disfigurement.
Movement or other disability in joint.
Patient has fever or not or h/o fever before or during the episode of joint pain started.
Presence of any concomittants or accompanying symptoms and wether those symptoms are of Psychotic, Syphilitic or Psoric nature.
Wether he has any other systemic complaint especially any other autoimmune or metabolic disorder.
History of injury, surgery especially affecting neurons or musculoskeletal structure.
Nature of work the patient does , postural habits, structural anomalies disfigurements.
Diet sleep and exercise routine water intake should also be noted carefully.
It is important to note family history of patient wether first degree relative had any autoimmune or metabolic disorder.
Wether patient was or is under any long term medication.
A careful history of all communicable ailments should be recorded in sequence as they had been contracted by patient, as it helps us evaluate when and how was the vital force deranged in past and wether the present condition is manifestation of some past ailment, that is any deep seated miasm, also it helps to establish wether its some inherited genetic condition or its acquired condition also it helps differentiate between
Vector borne conditions like post viral arthralgia/arthritis and Group A streptococcal borne post pharyngitis systemic autoimmune condition.
Other Systemic autoimmune conditions like Rheumatoid Arthritis SLE psoriatic arthritis.
These basic question will lead you towards a broader vision in the case and will let you reach upto some conclusion that under what category of arthritis it should be classified and will lead you towards some understanding of miasm and constitution.
As I have mentioned in my other arthritis articles that basically I divide all types of arthritis into four major categories based on their pathogenesis.
Mechanical
Immunological
Metabolic
Septic
After being diagnosed and classified the disease condition from one of the above group we can go further on how to manage each type of case.
Rheumatoid Arthritis falls under immunologically mediated arthritis.
Once established that its an immune mediated arthritis its necessary to rule out any damage to other organs like heart, liver, kidney, pancreas, eyes etc, as in most cases autoimmune arthritis is found to involve other system and organs or it is a part of broader systemic autoimmune condition and it is all the more necessary to find out miasmatic background, constitution and individualising symptoms, as such types of arthritis are deep seated having its own sets of aggravating and ammeliorating factors, furthermore its also observed that mental stress and emotional fluctuations have much impact on intensity and frequency of aggravations in almost all types of immunologically mediated arthritis, so its of utmost importance to take proper account of patient’s mental emotional past and present including likes and dislikes aversion and cravings, which helps us to individualise the case.
Once the we have derived constitution , miasmatic background and individuslised the case then comes medicine selection process.
I strongly recomend to go by constitution of patient in immunologically mediated arthritis rather than going theraputic remedy selection.
It should be kept in mind that the selection procedure of medicine should correspond to degree of mental PQRS , degree of systemic PQRS and degree of musculo-skelatal symptoms of the person in disease should match the degree of pathogenic action on various sphere of the specific medicine.
Though during acute exacerbations of disease it becomes necessary many a times to administer short acting acute medicines theraputically where the new symptoms desnt fall into sphere of the constitutional medicine thats been administered.
Many a times only a single dose of similimum medicine selected may suffice to cure the case but all patients are not the same. As each case has a different constitution, miasmatic background, severity of ailment and other external inimical factors. So in many cases before it gets cures, it may require series of medicines one after another as per case demands during progression of treatment. It all depends upon how well the physician is able to find out the similimum and type of case and its requirement.
HOMEOPATHIC MEDICINES FOR RHEUMATOID ARTHRITIS
Though the approach should always be constitutional in autoimmune disease like rheumatoid arthritis, there are certain medicines which broadly shows pathological drug picture of rheumatoid arthritis or striking peculiar so could be used as therapeutic guidance.
SILICEA – Rheumatoid Arthritis post exposure to fine crystalline form of silica ie silicon dioxide (an established factor that contributes in development of rheumatoid arthritis).
RHUS TOXICODENDRON – While repertorising I have frequently ended up Selecting this remedy in final roundction during conditional approach. Rheumatoid Arthritis has stiffness of joints on prolonged rest especially in morning last more than an hour and gradually ameliorating on motion. Rhus tox has common symptom of aggravation on rest and amelioration on motion and also this medicine has great affinity towards joints and immune mediated disorders.
LEDUM PALUSTURE – This homeopathic medicine has always given me good results in any type of inflammatory joint complaints with swelling and redness especially around ankles.
APIS MELIFICA – I use this medicine with great results during active phase of disease where patient has developed swelling and redness with severe pain just like Ledum pal but more severe acute and sudden in onset.
CALCAREA CARBONICA – Can be used as complimentary medicine during the course of the treatment of rheumatoid arthritis especially in later stages where patients starts showing symptoms of bone erosion and reduced bone mineral density around articular surface due to prolonged inflammation and chronic autoimmune condition in body.
GUALTHERIA PROCUMBENS – In my experience gaultheria yields good results good results; usually in low potency and mother tincture forms; during active exacerbation of disease where in patients joint pains rheumatoid arthritis aggravates on disturbed digestion and other gastric ailments.
SYPHYLLINUM – indicated in later stages where patient starts showing signs of destruction of tissue, degeneratation and disfigurement and necrotising granulomatous nodules of lungs skin and bones. Especially in cases of rheumatoid arthritis with history of syphilis(treponema pellidum) infection this nosode should be administered
TUBERCULINUM – Patients with rheumatoid arthritis if exposed to coal for longterm, they typically develop necrotizing granulomatous nodule in lungs in such condition this medicines comes in to aid in such rare peculiar symptom. Also it should be thought of in patients with necrotising granulomatois nodule of rheumatoid arthritis on bones and skin.
DULCAMARA – this remedy should be thought of when Rheumatic complaints tend to increase in damp cold weather.
BELLADONNA – inflammation of joints during acute exacerbation of RA.
Lichen Planus (LP) is believed to be autoimmune condition with an unknown causative and triggering factor. It presents itself with skin lesions characterize by 6 P’si.e. Planar [flat topped], Purple, Polygonal, Pruritic, Papules and Plaques;
Although it may present itself with variety of other lesions as well.
The Lesions typically shows interspersed lacy white lines which are called Wicham’s Striae
It can affect anywhere on Skin Nails and Mucous membranes of any region.
The lesion may show any of the following pattern Annular, Linear, Hypertrophic, Atrophic, Bullous, Ulcerative, Pigmented.
Etiopathology
What are the causes?
It is non contagious condition and is not related to any known pathogen; it is believed to be T-cell driven autoimmune reaction which triggers apoptosis of the epithelial cells; It is believed that this process is in response to some unidentified antigenic change in oral mucosa
What is Lichenified Reaction?
There are certain conditions where the skin lesions shows similarity with Lichen Planus lesions , in both clinical appearance to naked eye as well as histopathology under microscope but unlike Lichen Planus there are known underlying causative factors such conditions are termed lichenfied reactions.
Few examples which may cause Lichenified Reaction
In certatin drug reactions esp. due to beta blockers quinine thiazide diuretics furosemide spironolactone metformin and penicillin
Reactions to metal alloy fillings
Graft Versus-Host disease typically presents with chronic lichenified skin lesions on palms soles upper trunk and face after several months
Hepatitis ; esp due to Hepatitis B virus infection ; Hepatitis C virus infection ; primary biliary cirrhosis
stress and lifestyle as major impact on lichen planus it may trigger erruptions
lichen planus may be an accompanying symptom of Grinspan’s Syndrome
Diagnosis
LP can be diagnosed clinically with brief history and character of skin lesions characterize by 6 P’s i.e. Planar [flat topped], Purple, Polygonal, Pruritic, Papules and Plaques; it typically has Lichen-like appearance; always Biopsy is Gold Standard to establish diagnosis.
HOMEOPATHIC Treatment Approach and Homeopathic Medicines for Lichen Planus.
Can LP be Cured?
Allopathy System has no cure the condition it can only relieve symptoms temporarily and does have side effects
Homeopathy is known system of medicines which can cure lichen planus without having any side effects
HOMEOPATHIC TREATMENT FOR LICHEN PLANUS WITH INDICATIONS OF COMMON HOMEOPATHIC MEDICINES.
LICHEN PLANUS
Explanation of indicated remedies on website are as follows.
THUJA OCCIDENTALIS
Thuja has main sphere of action on the skin. Acting on the skin thuja causes painful sensitiveness of skin. Very useful remedy in case of Lichen planus. Thuja is very beneficial for inverterate skin troubles and chronic or stubborn skin conditions like lichen planus, psoriasis eczema, warts. Erruptions occur only on the covered parts of the body. The erruptions burn violently after scratching. Dry sensitive skin with hyperpigmented brown spots. Skin sensitive to touch. The skin usually looks unhealthy all over body. Aggravation of complaints usually at night from heat of bed.
ANTIMONIUM CRUDUM
Antimonium crudum is one of the indicated remedies in case of Lichen planus. Acting on the skin, causes ulcerations and has a tendency to grow warts, callosities, bad nails. Hard horny excrescences grow under the nails and is extremely painful. Pustular erruptions with inflammation. Itching especially on the neck, chest, back and limbs. Erruptions chiefly appear in the evening which itch in the heat of bed and disturb sleep. Formation of thick, hard scabs with oozing. Deformed nails. Degeneration of skin. Burning and itching worse scratching at night.
CALCAREA FLOURICA
Calcarea flour is a powerful tissue remedy. Indicated in case of lichen planus. Patient usually presents with marked whiteness of skin. Cracks and fissures in the palms of hand. The skin seems hard. Useful in hard elevated edges of ulcer, surrounding skin is purple and swollen. Worse during change of weather and better by warmth.
SILICEA
Silicea is one of the frequently indicated remedy in case of lichen planus, psoriasis etc. Suited to complaints that develop slowly. Acting on the skin Silicea causes inflammation. Most scaly erruptions alternating with dry erruptions. There is hyperpigmentation of spots, coppery spots. Erruptions usually itch only in the day time. Silicea usually hastens formation of abscess. There is imperfect assimilation and defective nutrition.
SULPHUR
Sulphur is one of the widely used medicine to treat various kind of skin disorders. It is a very valuable remedy in treatment of lichen planus. Papules and erruptions with extreme dryness of skin. Intense itching of skin. Scratching of skin leads to intense burning of affected parts which is a marked indication of sulphur. Complaints are usually worse at night from warmth of bed. Burning in palms and soles is stricking feature of sulphur. Sulphur is a gneral antipsoric for almost every kind of itch. Unhealthy, dirty filthy individuals are prone to skin infections.
ARSENIC IODATUM
Ars iod is efficient remedy in case of lichen planus. Ars iod is a very good remedy for skin conditions like lichen planus, psoriasis, eczema. Marked exfoliation of skin in large scales, leaving raw exuding surface beneath. The skin is cold touch, dryness of skin. It cures all syphilitic erruptions where the symptoms agree, where erruptions have been suppressed by local treatments. There is marked excoriation, itching, burning and stinging pain with rough skin.
BORAX
Borax is often indicated in case of Oral lichen planus. Presents with ulcers inside the cheeks And on tongue. Excessive heat in the mouth. Dry hot, tender apthous ulcers usually bleed on eating or by touch. Mouth remains extremely dry. Ulcers in mouth extend to throat, even to stomach. Difficult healing of skin. Unhealthy skin, every little injury tends to ulcerate. Itching on back of finger joints. Erruptions on fingers and hands.
MERCURIOUS SOLUBILIS
Every organ or tissue of the body is more or less affected by this powerful remedy. Very often indicated in case of oral lichen planus. Presents with irregular ulcerd inside cheeks. The cheeks give a very unhealthy and dirty appearance. Salivary secretions are greatly increased. Painful raged swollen bleeding gums. Highly offenseive odour from mouth with metallic taste in mouth. Skin is almost constantly moist. Vesicular erruptions with severe itching worse from warmth of bed.
