Role of 50 Millesimal Potencies in Primary Dysmenorrhoea Updated PDF

“ROLE OF 50 MILLESIMAL POTENCIES
IN PRIMARY DYSMENORRHOEA”
DISSERTATION
Submitted to
Madhya Pradesh Medical Science University, Jabalpur,

Madhya Pradesh
In partial fulfillment of the regulation for the award
of
Doctor of Medicine
in
Homoeopathic Pharmacy
by
Dr. Parul Jain

Session 2016-19
Under the guidance of
Prof. Dr. Hemant Kumar Soni

DEPARTMENT OF HOMOEOPATHIC PHARMACY
Principal
Prof. Dr. S.K. Mishra
GOVT. HOMOEOPATHIC MEDICAL

COLLEGE & HOSPITAL
AYUSH Campus, Beside Kaliyasot Dam, MACT Hills, Bhopal- 462003
DETAILS OF THE DISSERTATION SUBMITTED BY THE
M.D.(Hom.) SCHOLAR
Name of the College: Govt.Homoeopathic Medical College,Bhopal
Department: Homoeopathic Pharmacy

Name of the Head of the Dr.Chetna Pandey
Department:
(a) College name and address: Government Homoeopathic Medical College &
Hospital,
AYUSH Parisar, Beside Kaliasot Dam, MACT Hills,
Bhopal 462003 (M.P.)
(b) Designation: Head of department
(c) Mobile No: 9425392477
(d) E – mail Id: chetnapandey2010@gmail.com
Name of the Guide/ Co – Guide: Guide- Dr. Hemant Kumar Soni
(a) College name and address: Government Homoeopathic Medical College &
Hospital.
AYUSH Parisar, Beside Kaliasot Dam, MACT Hills,
Bhopal- 462003,(M.P.)
(b) Designation: Professor
(c) Mobile No: 9827204815
(d) E – mail Id: drhemantsoni@gmail.com
Name and address of the post Dr.PARUL JAIN,A-414,SAGAR PREMIUM TOWER
graduate scholars (in block
PHASE 2,SHIRDIPURAM,KOLAR ROAD, BHOPAL
letters)
Date of admission to 19/12/2016
M.D.(Hom.) Course:
Name of the Course: MD (Hom.)
Subject: HOMOEOPATHIC PHARMACY
Title of the topic: “ROLE OF 50 MILLESIMAL POTENCIES IN
PRIMARY DYSMENORRHOEA”
DECLARATION
I hereby declare that the dissertation entitled “Role of 50millesimal
potencies in Primary Dysmenorrhoea” is completed and written by me. It has not
previously formed the basis of award of any degree or diploma or other similar
title of this university or examining body.
Place: Bhopal Dr. Parul Jain
Date:
GOVT. HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL
Ref. No. Date:
CERTIFICATE
This is to certify that the dissertation entitled “Role of 50 millesimal

potencies in Primary Dysmenorrhoea” which is being submitted herewith for the
award of the Degree of Doctor of Medicine (M.D.) in Homoeopathic Pharmacy of
Madhya Pradesh Medical Science University, Jabalpur is the result of original
research work completed by Dr.Parul Jain under my supervision and guidance and
to the best of my knowledge and belief the work embodied in this dissertation has
not formed earlier the basis for the award of any Degree or similar title of this or
any other University or examining body.
Place: Bhopal Name of Guide:

Date: Dr. Hemant Kumar Soni
GOVT. HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL
Ref. No.
Date:
CERTIFICATE
This is to certify that the dissertation entitled “Role of 50 millesimal

potencies in primary dysmenorrhoea” is a bonafide work by Dr. Parul Jain under
the valuable guidance of Dr.Hemant Kumar Soni in partial fulfillment of the
regulations for the award of the degree of Doctor of Medicine in the subject
Homoeopathic Pharmacy. She has fulfilled all the requisites of Madhya Pradesh
Medical Science University, Jabalpur for the preparation and completion of the
dissertation.
I recommend and forward the dissertation to the Madhya Pradesh Medical
Science University, Jabalpur, for the award of the degree of Doctor of Medicine in
Homoeopathic Pharmacy for the session 2016-19
I wish her all success in life.
Place: Bhopal Dr. S. K Mishra

Date: PRINCIPAL & CEO
ACKNOWLEDGEMENT
I express my sincere gratitude to the almighty for the blessings, guidance and
support.
I am privileged to get an opportunity to undertake this M.D. under the valuable guidance
of Dr.Hemant Kumar Soni, Professor, Department of Homoeopathic Pharmacy, Govt.
Homoeopathic Medical College, Bhopal. I am extremely thankful to him for his expert
advice on the subject during the entire course of this work.
It is my honor to express my heartfelt gratitude to the most respected Dr R. S. Sharma.
Vice Chancellor, Madhya Pradesh Medical Science University, Jabalpur, for providing
opportunity to work for my M. D. in Homoeopathic Pharmacy and to Sanjay Kumar
Totade , Registrar, Madhya Pradesh Medical Science University, Jabalpur, for her
support and guidance.
I am thankful to each and every member of management, staff, non-teaching staff, OPD/
IPD in-charge, laboratory in-charge, computer experts and other technical personnel of
Govt. Homoeopathic Medical College & Hospital, Bhopal, for their support and help.
I am also thankful to the most respected Dr S.K.Mishra ,Principal , Govt. Homoeopathic

Medical College, Bhopal ;Dr Chetna Pandey, HOD, Department of Homoeopathic
Pharmacy and Dr. Nivedita Agrawal, Assistant professor, Department of Homoeopathic
Pharmacy for their continuous guidance and support.
I express my gratitude to all that everybody else who helped me in trivial, and it may
appear, but significant ways to complete this work, I thank them most heartily.
I am very thankful to my daughter Anaya Jain for her love and support and for
encouraging me to complete my study on time.
P.G Scholar
Dr. Parul Jain
TABLE OF CONTENTS
CHAPTER PAGE NO.
ABSTRACT
1.INTRODUCTION 1
2.AIMS AND OBJECTIVES 4
3.REVIEW OF LITERATURE 5
4.MATERIAL AND METHODS 22
5.OBSERVATION AND RESULT 24
6.DISCUSSION 36
7.CONCLUSION 37
8.SUMMARY 38
9.REFERENCES /BIBLIOGRAPHY 40
10.APPENDICES
10.A. DEFINITIONS 44
10.B.CASE RECORDING FORMAT 45
10.C.NUMERIC PAIN RATING SCALE 49
10.D.CASE RECORD OF PATIENTS 51
10.E.MASTER CHART 88
10.F.KEY TO MASTER CHART 89
10.G.PATIENT INFORMATION SHEET AND WRITTEN CONSENT 90
FORM
LIST OF FIGURES
S.No. Content Page no.
1. Bar diagram showing age distribution 24
2. Pie diagram showing family history of dysmenorrhoea 25
3. Pie diagram showing family history of other diseases 26
4. Bar diagram showing major clinical features of patients 27
5. Pie diagram showing distribution of predominant miasm 28
6. Pie diagram showing previous system of treatment adopted 29
7. Bar diagram showing indicated medicines 30
8. Bar diagram showing religion of patients 31
9. Bar diagram showing socioeconomic status of patients 32
10. Pie diagram showing result of treatment 33

LIST OF TABLES
S.No. Content Page no.
1. Assessment criteria 19
2. Demographic data 24
3. Family history of dysmenorrhoea 25
4. Family history of other diseases 26
5. Distribution of patients according to major clinical features 27
6. Distribution of predominant miasm 28
7. Previous system of treatment adopted 29
8. Indicated medicines in primary dysmenorrhoea 30
9. Religion of patients 31
10. Socio economic status of patients 32
11. Result of treatment 33
12. Statistical analysis 35
13. Result of assessment criteria 36
14. Master chart 88

LIST OF ABBREVIATIONS
1. NPRS - Numeric pain rating scale
2. FSH - Follicle stimulating hormone
3. LH -Luteinising hormone
4. OCPs -Oral contraceptive pills
5. IUCD - Intrauterine contraceptive device

LIST OF APPENDICES
S.no. Contents Page no.

1. Definitions 44
2. Case recording format 45
3. Numeric pain rating scale 49
4. Case record of patients 51
5. Master chart 88
6. Key to master chart 89
7. Patient information sheet and written consent form 90
ABSTRACT
Background and objectives-
Menstruation is a physiological phenomenon in which some amount of pain is normal but if it
incapacitates the female to do her daily works then it is known as dysmenorrhoea. Primary
dysmenorrhoea is very common and there are no pathological changes in the pelvic organs.
Conventionally, many pain killers are there in the market for the pain relief of primary
dysmenorrhoea but they cannot prevent the recurrence of it. Constitutional homoeopathic
medicines are very effective in treating primary dysmenorrhoea. In this study the
effectiveness of medicine in 50 millesimal potencies for treating primary dysmenorrhoea is
studied.
Materials and methods-
The study is conducted in the OPD of Govt homoeopathic medical college, Bhopal and the
peripheral unit at Gautam Nagar, Bhopal and in various camps organised by the college from
July 2018 to June 2019.In this prospective open label observational study 30 females were
randomly selected, their case taking is done as per the proforma designed for the study. The
case is repertorised by Synthesis repertory and the finally selected medicine is administered
in 50 millesimal potency. The data is collected under numeric pain rating scale as before and
after treatment.
Result:
After applying paired t test it is found that out of 30 female patients 24%were markedly
improved, 73%were moderately improved and 3% of them had no improvement.

Conclusion
50 millesimal potencies are very effective in treatment of primary dysmenorrhoea. The same
constitutional medicine in 50millesimal potency palliates the pain and other complaints
during menses and then act as curative medicine also; thus prevents the occurence of severity
of pain in consequent menstrual cycles.
Keywords- Dysmenorrhoea, 50 millesimal potencies, numeric pain rating scale, paired t test
INTRODUCTION
Homoeopathy is an art, a science and a philosophy which works on the principle of
“similia similibus curenter “ which means let likes be treated by likes. The father of
homoeopathy Dr Hahnemann has a view that disease is the deviation from a previous
healthier state to a lower healthier state and the effect of this deviation is the new
sensitivity. Most of the symptoms are due to the environment interacting with the
new sensitivity. Due to this sensitivity one catches disease and the disease is on the
energy planes so the medicine should also act on the energy plane. The homoeopathic
medicines work on the dynamic energy level. [1]
Menstruation is a physiological phenomenon in which there is shedding of oestrogen and
progesterone primed endometrium through vagina at a regular interval of 28-35 days
in the women of reproductive age except during pregnancy and sometimes during
lactation[2].Some amount of pelvic pain and discomfort is normal but if it
incapacitates a women to do her daily routine works then it is termed as
dysmenorrhoea.45%-95% of menstruating women suffers from dysmenorrhoea
which is a common and debilitating gynaecological condition.[3].Primary
dysmenorrhoea is the menstrual pain which is functional and there is no pathologic
changes in the pelvic organs. Secondary dysmenorrhoea is the menstrual pain in
which there is some pathology in the pelvic organs.
In majority of cases the cause is functional or neurotic, behind which lies some
constitutional dyscrasia.Most of the women consider it as a part of their life and are
living with this monthly pain. Many of them take allopathic medications to relieve
their pain, among which non steroidal anti inflammatory drugs (NSAIDs) and oral
contraceptive pills (OCPs) are the commonly used drugs. Both have many side
1
effects. NSAID produces gastric disorders whereas OCPs produces nausea and
headaches. They also increases the risk of thrombosis.[4]
Dr. Hahnemann was experimenting throughout his life to improve the homoeopathic
system of medicine for the benefit of the patient. He was not satisfied with the
centesimal scale which he discovered because rapid gentle cure was not possible
from it. Even after the administration of the well selected medicine undesirable
medicinal aggravation comes. Also after administration of single dose, one has to
wait for long to watch the action of the medicine. Further frequent repetition is not
possible. On the basis of his experiments he comes to a new method of dynamisation
in 6th edition of Organon of Medicine which he called as new altered but perfected
method. Dr Pierre Schimdt named the potencies prepared under this scale as 50
millesimal potencies. With this new scale of potencies Dr. Hahnemann observed that
the action of the selected medicine is rapid. Medicinal aggravation can easily be
avoided by minimising the quantity of the medicine. In both acute and chronic
diseases the medicine can be repeated frequently. Medicine may be continued even
after the improvement starts. A chronic disease can be cured within shortest period of
time and within 4-5 days after administration of medicine; the physician can ascertain
the action of the medicine. [5]
Since 6th edition of organon of medicine was published after the death of Dr Hahnemann
many physicians looked at it with suspicion. According to Luc de Shepper the use of
LM potency calls for much investigations so that this treasure of the 6th edition is not
lost.[6]
The motive of this study is to make women aware that this pain can be overcome and
to improve their quality of life during their menstrual period through the safest mode
of treatment, homoeopathy. There are constitutional homoeopathic medicines which
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help to treat painful menstruation. In 50 millesimal potencies the same constitutional
medicine may be used both for palliative and curative purpose.These medicines are
deep acting and naturally eliminates the pain or cramps during menses.
Since less work is done on 50 milesimal scale as compared to centisimal scale I have
chosen this topic to see the usefulness of this scale.
The scale which will be considered to assess the pain during dysmenorrhoea is Numeric
Pain Rating Scale (NPRS) [7]
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AIMS AND OBJECTIVES
Focused Aims of the study: – To study the utility of 50millesimal potencies in
Primary dysmenorrhoea
Primary Objective(s) –
1. To identify cases of dysmenorrhoea.
2. To study the utility of 50 millesimal potencies in cases of primary
dysmenorrhoea.
3. To find a group of commonly indicated homoeopathic medicines for primary
dysmenorrhoea.
4. To improve the quality of life of women suffering from primary dysmenorrhoea.
5. To decrease the intensity of pain in subsequent menstrual cycles.
6. To remove the fault in diet and regimen.
7. To minimize chemical intervention.
Secondary Objective(s) -
To spread awareness towards homoeopathic treatment in women suffering from
primary dysmenorrhoea
4
REVIEW OF LITERATURE
The uterus is an internal genital hollow organ for -menstruation, sperm transport and
capacitation, embryo embedding and child bearing. It lies in the centre of pelvic cavity
with urinary bladder in front and rectum behind. The external os lies at the level of ischial
spines while the top of the uterus lies below the plane of pelvic inlet. The size of
nulliparous uterus is -Length - 7.5 cm, Breadth - 5 cm, Thickness - 2.5 cm. The uterus
which has born child measures more. The adult uterus weighs -45-80 gm [2]
It has 2 parts- The upper two third part is called the corpus / body of uterus. The part
lying above the plane of tubal attachment is known as fundus. The lower one third part
called cervix / neck. It is again divided into 2 parts - The upper half which lies above
vagina called supravaginalis. The lower half which lies in the vagina called
portiovaginalis . At the apex of it there is an opening called external os with anterior and
posterior lips.[2]
The shape of external os in nulliparous women is circular or conical. In parous women it
is transverse i.e. more short and square shaped. The junction of corpus and cervix is
called isthmus. During late pregnancy and labour it forms the lower uterine segment.[2]
In nulliparous women -The length of uterine cavity from external os to the fundus is
about6.5cm .In parous women, it is 1 cm more [2]
The position of normal uterus is anteverted and anteflexed .So,the normal uterus lies with
fundus directed to pubic symphysis and cervix looks downward and backward.[2]
The uterus is mobile from side to side and from before backwards. The uterus is a hollow
seromuscular structure with 3 layers-Serous layer / Perimetrium; Muscle layer
/Myometrium ; Mucous layer / endometrium.
The endometrial secretion is scanty, watery and alkaline in nature. Cervical secretions are
alkaline mucus like unboiled white of egg. Around 20-60 mg mucus is secreted by cervix
5
which increases to 700 mg/day during midmenstrual cycle of a woman’s reproductive life.
This secretion contains- 85%-98% water, mucoids and mucins, sialicacid, albumin,
globulin, lipoprotein, immunoglobin, lactoferrin, enzymes, glucose,
cholesterol, NaCl, potassium and prostaglandins. [2]
The uterus is supplied by uterine artery and ovarian artery. The venous drainage is
corresponding to the arterial course. The sympathetic motor nerve of uterus is hormone
dependant. Pain of uterine origin has got a somatic distribution to the lower abdomen by
T10 to L1.The parasympathetic motor and sensory nerves of uterus refers the pain arising
from the cervix is to the midsacral region of back .[2]
The uterus is kept in its position by -Uterine ligaments (Cardinal or Mackenrodt ligament,
Uterosacral ligaments, Pubocervical ligaments, Round ligaments and Broad
ligaments); The vagina; The pelvic floor(Pelvic diaphragm, Small muscles of deep
and superficial perineal pouches with fascial coverings) and the pelvic fascia and
pelvic cellular tissue[2]
MENSTRUATION:
It is the periodical vaginal bleeding from an oestrogen and progesterone primed
endometrium of a sexually matured women during her reproductive life except during
pregnancy and sometimes during lactation,usually at an interval of 28 days(+/- 2
days).The average cycle lasts 28days but may vary from 21-35 days. It starts on the
day of onset of menstruation and ends at the start of next menses. Its duration is of 2-7
days or 3-5 days.The flow consists of blood, mucous, endometrial debris, cervical and
endometrial secretions and other substances from uterus. The menstrual blood does
not clot because of presence of fibrinolysin. Though clotting may occur only if there
is excessive blood loss such that fibrinolysin is unable to dissolve the clots. The
6
amount of blood loss is 5-80 ml, average 70 ml. Menstruation is absent before
puberty , during pregnancy , sometimes during lactation and after menopause.[2]
As puberty approaches, the hypothalamic centres stimulate the release of GnRH which
stimulates the anterior pituitary to release FSH and LH. [8].FSH causes growth and
maturation of a group of graafian follicle. LH induces developing follicle to
synthesise oestradiol. The increasing level of oestrogen is responsible for the growth
and initiation of menarche.[2]After a variable period of time following menarche the
positive feedback mechanism causes cyclic release of gonadotropins.This is the
reason why the first few cycles are anovulatory.[8]. Just before ovulation i.e.at 14th
day the oestrogen level is at peak.So by negative feedback mechanism the level of
FSH decreases and by positive feedback mechanism the level of LH increases. This
increased level of LH causes further oestrogen secretion from follicle, one follicle
becomes dominant and others got atresia, and when LH is at peak ovulation occurs.
LH also initiates and maintains corpus luteum. Corpus luteum has life span of 12-14
days. If ovum is not fertilised it is degenerated on 26th day and so the level of plasma
oestrogens and progesterone decreases. This causes shedding away of secretory
endometrium and menstrual bleeding occurs.[2]
Changes occurs both in ovaries and uterus during the menstrual cycle under the action of
FSH, LH, oestrogen and progesterone.
Dysmenorrhoea:
Word meaning and definition - The term dysmenorrhoea is derived from a greek word:
dys-difficulty, menorrhoea - monthly flow. [9] So dysmenorrhoea is defined as difficult
or painful menstruation which incapacitates a women to do her daily routine works .
It is of 2 types-
7
1. Primary dysmenorrhoea- Synonyms- spasmodic / essential /intrinsic /
functional dysmenorrhoea. This pain is functional and there are no pathological
changes in the pelvic organs.[9]
Membranous dysmenorrhoea is a type of primary dysmenorrhoea in which
there is casting of big pieces of endometrium. This is said to run in families.[2]
2. Secondary dysmenorrhoea- Synonyms- congestive / extrinsic / organic
dysmenorrhoea.In this there are pathological changes in the pelvic organs.
Incidence - Dysmenorrhoea is one of the commonest gynaecological complaints among
women, but the exact incidence is difficult to estimate. Pain is a subjective symptom and
cannot be accurately estimated by an outside observer, since different women may
perceive pain with different severity and tolerance. [9] .A study shows that 45% - 95% of
menstruating women suffers from primary dysmenorrhoea [3].
Etiology -Primary dysmenorrhoea - The definite cause of pain is not known but
following are some important factors which are held to be responsible. The condition is
probably multifactorial [2]
1. The prostaglandin theory - This theory is the most widely accepted theory.
Prostaglandins are derived from arachidonic acid. The three main prostaglandins
concerned with menstruation are - PGF2alpha, PGE2, and PGI2.
PGF2alpha is a potent vasoconstrictor and causes increased myometrial contractility.
PGE2 increases the sensitivity of the nerve endings.
PGI2 causes vasodilatation, decreases prior to menstruation leading to ischemia.
Both PGF2alpha and PGE2 are present in high quantities in the menstrual fluid.
Prostaglandin synthetase inhibitors are found to relieve dysmenorrhoea, decrease
menstrual fluid prostaglandin concentration and decrease uterine contractibility.[9]
8
2. Hormonal or endocrine theory - Dysmenorrhoea is characteristically seen in ovulatory
cycles where progesterone plays a key role. Anovulatory cycles are usually painless and
that is why primary dysmenorrhoea starts 1 to 2 years after menarche.
3. Myometrial ischemia - in a normal menstrual cycle there is vasodilatation during the
secretory phase which increases the torturosity of the spiral artery .The spiral arteries are
the main source of blood supply to the endometrium. Just prior to the menses the spiral
arteries undergo vasoconsriction. The decrease in uterine blood flow causes ischemia.
Ischemia is a known cause of pain.
4. Cervical obstruction - Earlier cervical stenosis was believed to be the most important
cause of dysmenorrhoea.
5. Pshycological cause - Psychological factors modify pain or its intensity rather than
causing it. Girls with lower threshold for pain can be completely incapacitated in
comparison to women with a higher threshold for pain.[9]
Secondary dysmenorrhoea -
It can be due to any of the underlying organic diseases of the genital tract -
Pathogenesis of dysmenorrhoea-
Sympathetic fibres pass from the uterus through the posterior roots of T10 , T11 ,T12 and
L1 and from the cervix through S2,S3 and S4. Thus, uterine pain is referred to the
cutaneous distribution of lower abdominal wall in front, groins, upper and medial aspects
of the thighs nearly to the knees and posteriorly to the sacral area and buttocks while that
from the cervix to the lower sacral area and buttocks.[9]
Risk factors for dysmenorrhoea -
1. Menstrual factors -
a. Early menarche - A study conducted on adolescent girls revealed that early age of
menarche is associated with a higher incidence of dysmenorrhoea.
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b. Long and heavy menstrual flow - It was also seen that women with long and
heavy cycles had more severe dysmenorrhoea.[9]
2. Parity - The incidence of dysmenorrhoea is lower in multiparous women. It was
seen that the incidence of primary dysmenorrhoea decreased after the first
delivery. It was also found to be decreased in terms of severity.
3. Diet - Lower consumption of fish, eggs and fruits are believed to increase the
dysmenorrhoea but the association is not clearly established.
4. Exercise - Various types of exercises were advocated to reduce dysmenorrhoea.
5. Cigarette smoking - Heavy smoking was found to be associated with decreased
duration of bleeding but increased duration of dysmenorrhoea.
6. Psychological - Emotionally dependent and overprotected girls are more likely to
develop dysmenorrhoea. It is also more commonly seen in girls whose mothers
suffered from dysmenorrhoea, since the mother become overzealous and
apprehensive around the
time of menarche of her daughter which makes the young girl more conscious ,aware
and paranoid of her forthcoming menses. Rather than being the cause of the pain, it
is more likely that the psychological factors modify the pain causing depression and
anxiety.[9].Primary dysmenorrhoea is seen more in intelligent and sensitive
women[10]
Clinical features of Primary dysmenorrhoea-
Age - Usually seen among younger women upto 25-30 years.
Time of onset - 2-3 years after menarche thus corresponding to the beginning of
ovulation.
Duration of pain - It starts just prior to the menses lasting for 2 days.
10
Type of pain - Cramping pain in lower abdominal wall, upper and medial aspects of
thighs nearly to the knees and posteriorly to the sacral area and buttocks ,
also in lower sacral area and buttocks.
On examination -
General and abdominal examination - usually normal.
Local examination - essentially normal pelvic organs.[9]
Differential diagnosis:
1. Secondary dysmenorrhoea - commonest. 2. Abdominal trauma. 3. Dysfunctional
uterine bleeding. 4.Endometriosis .5.Ovarian cysts 6.Ovarian torsion.7.Ectopic
pregnancy.8.Vaginitis.9.Vulvovaginitis .10.Sexual assault.11.Inflammatory bowel
disease 12.Irritable bowel syndrome.13.Syphilis 14.Perotonitis 15.Urinary tract
infection 16.Uterine neoplasm 17.Arthritis and disc lesions[11]
Lab Studies:
There are no specific tests to diagnose dysmenorrhoea. The diagnosis is made on clinical
findings. [12]
Complications:
1. Anxiety, depression, or both.
2. Secondary infertility [13]
Prognosis:
1. Prognosis for primary dysmenorrhoea is excellent with the use of
antiprostaglandins.
2. Surgical treatment for primary dysmenorrhoea has had variable success and is
determined by the gynecologist. [13]
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3. Studies show that patients with dysmenorrhoea are improved by homoeopathic
treatment
Medical Care:
According to severity of pain and limitation of daily activity treatment is planned.
In addition to pain relief, reassurance and education plays a major role. [14]
A study named “Effect of homoeopathy on pain intensity and quality of life of students
with primary dysmenorrhoea: A randomized controlled trial” shows that there is no
significant effect of homoeopathy on primary dysmenorrhoea in comparison with
placebo. [15]
Surgical Care:
Surgery is generally not indicated for patients with primary dysmenorrhoea. [13]
In refractory cases of dysmenorrhoea, laparoscopic presacral neuroectomy has been
efficacious for as long as 12 months after treatment [10]
Patient Education:
1. Warm bath or local heat may give some symptomatic relief.
2. Exercise decreases the severity of menstrual cramps.
3. Dietary supplementation with omega-3 fatty acids relieves pain in adolescents.
Both a low-fat vegetarian diet and fish-oil supplements have been reported to reduce
menstrual pain in some women.
4. Advice proper personal hygiene.
5. Adequate rest, but in between she should be pre occupied by some work or study.
6. Encourage patients to stop smoking and decrease alcohol use.
7. Explanation of reproductive physiology and reassurance.[16]
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Management of dysmenorrhoea -
Since primary dysmenorrhoea is more common I will discuss management about it.
Secondary dysmenorrhoea is treated according to the pathology.
General measures -
1. Improvement in nutritional state and dietary changes - A healthy and nutritious
diet is a prime factor in the betterment of general health. Thus including
fruits, eggs and fish in the diet of the patient may help to alleviate the pain of
dysmenorrhoea to some extent. A study “The effect of diet on primary
dysmenorrhoea in university students” shows that diet therapy is very effective in
primary dysmenorrhoea[17]
2. Regular exercise - Various remedial exercises are advocated for dysmenorrhoea
like floor polishing movements, bending, twisting, swaying, and rowing
movements and other similar routines. These must be done atleast 15 mins daily
between and during the periods.These can be done in addition to or instead of
various games.
A study “Comparing the effects of aerobic and stretching exercises on the intensity
of primary dysmenorrhoea” shows that both aerobic and stretching exercises are
effective in reducing the severity of dysmenorrhoea. [18] Another study “The effect
of aerobic exercises on primary dysmenorrhoea” also shows that aerobic exercises
improve primary dysmenorrhoea. [19]
3. Explanation regarding the condition and reassurance - The patient must be
reassured that dysmenorrhoea is not a sign of abnormal reproductive organs or
future infertility. One should explain the normal menstrual cycle, its physiology
and the cause of dysmenorrhoea. She must be told that it is a physiological
13
symptom that could be relieved.A study on dysmenorrhoea shows that sometimes
only reassurance is needed for primary dysmenorrhoea[20]
4. Palliative measures like laxatives and hot baths - These are believed to cause pain
relief by increasing the blood supply and thus taking away the ischemic element as
the cause of dysmenorrhoea.
5. Psychotherapy - It is a vital part and must be offered to all patients of
dysmenorrhoea. In depth analysis of the family history of the patient, her
personality, her home atmosphere, beliefs in the family towards menstruation and
dysmenorrhoea and her attitude towards it should be done and then the patient
should be appropriately counselled.
SPECIFIC MEASURES -
Medical management -
Allopathic view-
1. Hormonal -
The pharmacological basis for the use of hormones is that anovulatory cycles are not
associated with dysmenorrhoea. Thus conversion of an ovulatory cycle into an
anovulatory one is the principle of treatment using hormones. For this either oral
contraceptive pills are used or intrauterine device is inserted. The oral contraceptive pills
causes nausea, headache, acne, bloating etc whereas the intrauterine device increases
the incidence of ectopic pregnancy and its cost is high.[9]
2. Non hormonal -
Non steroidal anti inflammatory drugs (NSAIDs) or prostaglandin synthetase inhibitors
(PSIs) form the main stay treatment of primary dysmenorrhoea. In addition to this
Calcium antagonists and beta adrenergics are also used. Calcium antagonists relax the
14
uterine muscles and reduce pain but they cause bradycardia and hypotension. Beta
adrenergics increases the endometrial flow and thus decrease ischemic pain.[9]
Surgical management - In severe cases conservative or radical surgeries are done.[9]
Homoeopathic view -
A prospective multicentre study was done for evaluating homoeopathic medicines for
dysmenorrhoea and it was found very efficacious.[21]
In homoeopathy there are many medicines for primary dysmenorrhoea, given on the
basis of symptom similarity. Few main medicines are-
Belladonna - Sudden and violent pain in lower abdomen, bearing down feeling,
pain in loin and sacrum. Menses too early, too profuse, bright red, hot and offensive.[22]
Natrium muriaticum - Menses retarded and scanty, proceeded by anxiety and
disposition to faint or nausea with sweet taste and bloody sputa, with constipation. Very
sad and gloomy during the menses, with much palpitation of the heart and morning
headache.[23]
Phosphorus - Menses too early and too scanty. Frequent and profuse metrorrhagia,
pouring out freely and then ceasing for a short time.[23]
Pulsatilla pratensis -Suppressed menses from wet feet, nervous debility. Tardy
menses, too late, scanty, thick dark, clotted, changeable, intermittent. Diarrhoea during or
after menses.[24]
Sepia officinalis - Menses too late and scanty, irregular; early and profuse; sharp
clutching pains.Violent stitches upward in the vagina , from uterus to umbilicus.[24]
Before menses -acrid leucorrhoea, especially in young women, violent colic ,shuddering
all over the body.[25]
15
Repertorial analysis -
Since it’s very difficult to remember the vast symptoms in homoeopathic materia medica,
homoeopathic repertory is used. There are various repertories which are commonly used.
According to Synthesis repertory[26],Complete repertory[27],Repertory of
Homoeopathic Materia Medica by J.T.Kent[28],Boeninghausen’s Characteristics
And Repertory[29],Clinical Repertory[30], there are various rubrics given for
dysmenorrhoea.
Miasmatic background:
Dr. Hahnemann has classified diseases into Acute and Chronic and according to him the
cause of chronic diseases is the three Miasms - Psora, Syphilis and Sycosis. In the chronic
diseases its peculiar nature and cure[31], he explains the important symptoms relating to
dysmenorrhoea under Psora
According to J.H.Allen -
The cause of dysmenorrhoea is functional or neurotic and there is constitutional
dyscrasia behind it. It can be due to Psora, pseudo-Psora, Sycosis, or to Syphilis, or to any
of the combinations of these great central disturbers of life. According to him pseudo
psora is the main miasm behind it. There is rise and fall of the latent tubercular expression
in the organism. In dysmenorrhoea every female presents with different sufferings from
crown of head to sole of foot, all due to the presence of the tubercular element.A woman
should have no suffering at the menstrual period; there should be but a simple
consciousness of its presence.Pain is always a signal of disease.
Pseudo psora-
The flow is always accompanied with exhaustion and weariness. It comes too soon, is
too copious and too prolonged, like haemorrhage. The patient feels badly a week before
the menses and a week afterwards. The menstrual period is accompanied with severe
16
backache, gastric disturbances, neuralgia, headaches, ovarian neuralgia, even diarrhoea
and febrile states.
Sycosis -
In Sycosis the uterine pains are spasmodic, colicky, often extending over the whole
abdomen, and generally felt in the membranes of the ovaries and tubes. The flow
frequently comes in gushes with much pain, and is dark and clotted.
The treatment should be continued until the patient menstruates normally or nearly so,
which may take from three months to a year and in some cases even two years.
Prescriptions made during the inter-menstrual period are the most efficacious, as the acute
expression has quieted down and the latent expression is shown more clearly, and our
prescription should be based on this symptomatology. [32]
According to Dr.H.A.Robert
Psora - All functional menstrual disorders are Psoric. Pain is usually sharp and never
colicy.
Sycosis - Pain due to diseases of uterus are sycotic in nature. It is spasmodic,colicky and
paroxysmal. There is pruritis , painful and frequent urination and mastodynia . The
menstrual flow is offensive, clotted, dark even black, and of fish brine odour.
Syphilis - Depression and fears during menses shows syphilitic nature. There is profuse
menstrual flow.
Psuedo psora - Painful, prolonged, copious and always exhausting diseases feels badly a
week before menses. Flow bright red , thin , watery. Headache, backache, neuralgias,
epistaxis , diarrhoea , nausea ,vomiting , cold extremities , febrile states. Hysterical , sad ,
gloomy , fearful , sensitive , nervous irritability and inclination to weep.[33]
17
A study was done by N.M.Sampatt Kumari with a title ‘A Clinical study on miasmatic
background of primary dysmenorrhoea and its homoeopathic management’ in which she
found homoeopathic medicines very effective in treating primary dysmenorrhoea [34].
50 millesimal scale
History of 50 millesimal sacle -
Dr. Hahnemann had discarded many of his formulations of the 5th edition including
centesimal scale of potencies. The centesimal scale of potency brings undesirable
reactions of the vital energy. So the medicinal aggravations which are the common
features of the centesimal scale no longer exists in the new method incorporated in the 6th
edition of the organon of medicine.[35].A study “Hahnemann’s experiments with 50
millesimal potencies”shows the superiority of 50 millesimal scale over centesimal
scale.[36]
Dr Hahnemann was continuously revising , recasting , experimenting and counter
experimenting his new findings in the 6th edition in all its aspects and finally completed
the manusript in 1842 but because of the bungling of his german publisher he could not
publish it. On 2nd july 1843 the world lost Dr. Hahnemann and the great advancement in
homoeopathy remained unpublished. This manusript remained in the possession of his
second wife Madam Malanie. During her life time it could not be published due to her
unexpected greed for money.[35]
Hahnemann’s close friends and relatives , Dr.Boenninghausen and many other French ,
British , and American friends and admirers tried to publish it but could not get the
manuscript.[35]
Long after the death of Madam Malanie , Richard Haehl managed to procure the german
manuscript from the heirs of Hahnemann in the Boenninghausen’s estate and published it
in original only in 1920.[5]
18
Its english version was published by Dr William Boericke published in1921. During this
period, centesimal scale of potencies was fully established in the homoeopathic world. So
even after the publication of the english version of the 6th edition of organon nobody
gives any importance to this new dynamisation method.[5]
In an article by Dr.Charles Pahud of France in a British journal, the homoeopathic
physicians were made aware of this scale. Again from 1954 to 1956 Dr.Pierrie Schimdt
published his valuable essays and other speeches about the new method of the Organon
6th edition in the british homoeopathic journal, the journal of the american institute of
homoeopathy and such other journals.In this way these two learned and world famous
homoeopaths opened the door of the hidden treasure of the last edition of the Organon.
[35] Dr.Hahnemann termed this new method as ‘Renewed Dynamisation’. in footnote
1,sec 132 , he writes :new altered but perfected method - new dynamisation method.
Dr.Pierrie Schimdt of Geneva named it as fifty millesimal potencies because of the fact
that the material part of the medicine was said to be decreased by 50,000 times for each
degree of dynamisation.[5]
In India it is designated as 0/1, 0/2, 0/3 etc. In Western world it is designated as 1/0, 2/0,
3/0 etc. In Bangladesh it is designated as M/1, M/2, and M/3 etc. [5].
The word LM potency was given by Rudolf Flury where L stands for 50 and M stands
for millesimal [37]. Jost Kunzli Von Fimmelsberg introduced the term Q potency for it.
Views of different stalwarts-
1. Dr.Hahnemann – His highest ideal of cure was mentioned in aphorism 2 of Organon Of
Medicine mentioning that cure should be rapid, gentle and permanent. He was not
satisfied with centesimal scale because the potencies were not acting rapidly, it was
producing violent aggravation and one has to wait for a long time to see the action of the
19
medicine. So he modified the centesimal scale of potencies to achieve his idea of cure.
[38]
2. Dr.C.M.F.Von Boenninghausen - The new simplified method of potentising the
medicines given by Dr Hahnemann is more advantageous and efficient than the former
one. [39]
3. Dr.Charles Pahud - Marvellous results are obtained from these marvellous dilutions.
Selecting the size of dose is very important apart from right remedy and potency. When
single globule is administered in the form of aqueuos solution it acts on a deeper level
[40]
4. Dr.Pierrie Schimdt - termed the LM potencies as forgotten treasure of the 6th
edition.The LM potencies are as gentle as the low potencies and are as powerful as
highest centesimal. [41]
5. Dr.Rajeev Saxena - Dr Hahnemann know the limitations of centesimal scale and hence
he introduced the new method of dynamisation.[42]
6. Dr Harimohan Choudhary - In Organon of Medicine potencies from 0/1 to 0/30 are
recommended.Since the vitality of human is limited so Dr Hahnemann has limited the
medicine upto 30 for treating sick human beings.[35]
A study named “50 millesimal scale potency - A critical study” by Dr N Hari hara Iyer
has given a deep insight into the new scale. [43]
Advantages of 50 millesimal potencies over centesimal scale -
1. Minimum homoeopathic aggravation - is due to less amount of material quantity.[5].If
there is any aggravation then it will disappear within 2 days at the most when the remedy
is stopped and in extremely sensitive people the aggravation occasionally lasts longer.[6]
2. Quick cure of the chronic disease - within the shortest period of time. Only this new
system can face boldly any challenge with the so called modern medicines in regard to
20
quickest recovery. [5] A study by Abarna S, Venugopal J, Sivaranjani T, Poruthukaren K
J,Raj P, Suresh S ,“ Evaluating the usefulness of 50 millesimal potencies in treatment of
chronic diseases” has shown that 50 millesimal potencies are effective in the treatment of
chronic diseases.[44]
3. Frequent repetition possible - Even deep acting medicine can be repeated frequently
and also for months as per the need of the patient. [6]
4. Judgement of appropriate medicine - It can be seen within 2 - 4 days whether the
remedy selected is correct or not. After a single dose patients typically report a sense of
well being and improvement on a deep level, such as having more energy or being able to
sleep better, whether or not their chief complaint has improved. With centesimal
potencies we may see a change quickly but often at the cost of an unwarranted similar
aggravation. [6]
5. Palliative and curative purposes simultaneously - The same constitutional medicine
may be used both for palliative and curative purpose simultaneously. No separate
medicine is essential for palliation when needed. [5]
6. Mental diseases - It is very useful in mental diseases where least aggravation may be
very harmful to the patient and confusing to the physician. This potency can effect the
cure smoothly without the least aggravation. [5]
7. Change from incurable to curable stage - The so called incurable diseases may be
turned to curable after few months of treatment after using this potency. [5]
8. Effective for palliation, in incurable disease - without any aggravation [5]
9. Revival of suppressed symptoms - In case of longtime suppression this potency works
very effectively. 50 millesimal potencies revive the suppressed symptoms better than
centesimal potencies. [6]
21
10. Primary manifestation of miasm - In primary stage of psora ,sycosis and syphilis ,
where Hahnemann advises administration of large and repeated doses ,this potency
proves to be very helpful and efficacious.[5]
11. Highest development of latent power - by 100 succussions. So there is rapid
penetration, gentle impression and permanent restoration of health by 50millesimal
potency. [5]
12. Antidotes are seldom required in 50millesimal potencies.[35]
A study named “Effect of LM potency in homoeopathic general practice by Sumanth B
L ” has shown that 50 millesimal potencies works better than centesimal potencies.[45]
22
MATERIAL AND METHOD
Sources of data – The study was conducted on the outpatient department of

Government homoeopathic medical college and hospital, Bhopal; peripheral unit
of Gautam nagar,Bhopal and in frequently organized camps in rural and urban
areas in and around Bhopal city.
Number of cases – 30 cases were studied from June2018 to June2019
Source of procuring medicine – From the dispensing unit of Government
homoeopathic medical college and hospital.
Study design - An observational prospective clinical study is done on 30 female
patients who are followed up for duration of 6-8 months. Afterwards the result is
analysed statistically to see the effectiveness of the study.
Case selection –
Inclusion criteria:
1. Female Patients under age group 18 – 30 years.
2. Patients having no pathological changes in the pelvic organs
3. Patients of all religion irrespective of socio economic status.
4. Patients who are continuing their treatment till the end of the study.
5. Patients who are coming for regular follow-ups.
Exclusion criteria:
1. Age group below 18 years and above 30 years.
2. Patients suffering from organic pelvic disease.
3. Patients with systemic diseases.
4. Patients using OCPs and IUCDs.
5. Patients who discontinue follow-ups.
Case taking proforma- Designed as per the need of study with detailed case
taking of gynaecological symptoms
Selection of medicine – After detailed case taking, repertorisation is done
through Synthesis repertory using RADAR homoeopathic software10.5 version
and the medicine is selected on the basis of result of repertorisation and through
the knowledge of materia medica.
Potency & Doses – The medicine is prescribed in 50 millesimal potencies
starting from 0/1 in every case and as per the need, the dose is increased to higher.
23
Follow up – every month or as per the need of case for atleast 4-5 monthly
cycles
Records –Maintenance until completion of study
Methods of tests/procedures – Assessment criteria-
The signs and symptoms of the patient are assessed subjectively and objectively
and scored according to the numerical rating scale of pain rating scale.
On the basis of major clinical symptoms like pain in thighs, lower abdominal
pain ,backache ,weakness ,nausea and vomiting ,headache ,diarrhoea and
leucorrhoea the disease criteria is set and scoring is done according to the criteria.
The values are assessed before treatment and after treatment.
Table 1
Criteria Score
No pain / No symptom 0
Mild pain / Mild symptom 1-3
Moderate pain / Moderate symptom 4-6
Severe pain / Severe symptom 7-10
Diet and Regimen -

According to aphorism 259, mode of living and regimen affects the treatment, so
it should be taken into consideration -
1. Maintain personal hygiene.
2. Engage yourself in some activity while pain.
3.Make exercise a daily routine. Daily exercise in open air increases the
threshold of pain.
4. Avoid taking any other medicinal substance or high smelling foods during
treatment.
5. Take appropriate rest.
6. Take balanced diet. Avoid all types of stimulants like tea, coffee, alcohol etc.
24
OBSERVATION AND RESULT
Introduction:
30 female cases under the age group of 18-30 years are included in the study.
Demographic data:
Age Frequency Percentage Mean
18 4 13.3
19 4 13.3
20 2 6.66
21 1 3.33
23 1 3.33 23.3
24 3 10
25 2 6.66
26 3 10
27 2 6.66
30 8 26.66
Total 30 100%
Table 2
Figure 1
25
Table according to family history of dysmenorrhoea:
Family history Frequency Percentage
Present 16 53%
Absent 14 47%
Total 30 100%
Table 3
Figure 2
26
Table showing family history of other diseases:
Disease Frequency Percentage

Asthma 1 3%
Diabetes mellitus 4 13%
Hypertension 5 17%
Haemorrhoids 1 3%
Thyroid 1 3%
Osteoarthritis 2 7%
Osteoporosis 4 13%
Respiratory troubles 3 10%
Skin disease 3 10%
Migraine 1 3%
Mood disorder 1 3%
Table 4
Figure 3
27
Table showing distribution of patients according to major clinical features
Clinical Features Frequency Percentage
Pain in thighs /abdomen/ 29 97%
back
Weakness 9 30%
Nausea,vomiting 4 13%
Headache 5 17%
Irritability 4 13%
Weeping mood 2 7%
Leucorrhoea 16 53%
Table 5
Figure 4
28
Table showing distribution of predominant miasm :
Predominant miasm Frequency Percentage

Psora 17 57%
Syphilis 0 0%
Sycosis 1 3%
Pseudo psora 12 40%
Total 30 100%
Table 6
Figure 5
29
Table showing system of treatment adopted previously
Treatment system Frequency Percentage
Allopathy 26 87%
Ayurvedic 0 0%
Homoeopathic 4 13%
Total 30 100%
Table 7
Figure 6
30
Table showing indicated medicines
Drug administered Total cases Percentage
Sepia 9 30%
Pulsatilla 4 14%
Phosphorous 4 14%
Lycopodium 2 7%
Nux vomica 2 7%
Silicea 2 7%
Nitric acid 1 3%
Sabina 1 3%
Arsenicum album 1 3%
Ignatia 1 3%
Calc carb 1 3%
Natrum mur 1 3%
Zincum met 1 3%
Total 30 100%
Table 8
Figure 7
31
Table showing religion of patients
Religion Frequency Percentage

Hindu 28 93%
Muslim 2 7%
Total 30 100%
Table 9
Figure 8
32
Table showing socio economic status of patients :
Economic status Frequency Percentage

Lower middle class 12 40%
Middle class 17 57%
Upper middle class 01 3%
Total 30 100%
Table 10
Figure 9
33
Table showing treatment result:
Criteria Frequency Percentage Treatment result

No Nil 0% Cured
symptom(PRS=0)
Mild 7 24% Remarkably
symptom(PRS=1-3 improved
)
Moderate 22 73% Moderately
symptom(PRS=4-6 improved
)
Severe 1 3% No change
symptom(PRS=7-10)
Total 30 100%
Table 11
Figure 10
34
Statistical analysis :
On the basis of clinical symptoms of dysmenorrhoea,the data is divided into before
treatment and after treatment using pain rating scale. Using paired t test the significance
of the study is calculated.For this purpose we made 2 hypothesis-
Null hypothesis - There is no significant difference between the values before treatment
and after treatment using 50 millesimal potencies
Alternative hypothesis - There is significant difference between the values before
treatment and after treatment using 50 millesimal potencies.
If the value of tcalculated is greater than the value of ttable ,then the null hypothesis( H0 ) is
rejected and the alternative hypothesis ( H1 ) is accepted.
H0 : 50 millesimal potencies are not effective in treatment of primary dysmenorrhoea
H1 : 50 millesimal potencies are effective in treatment of primary dysmenorrhoea
Case NPRS NPRS X1 - X2 = đ= Ʃ d / n (d-đ) ( d - đ )2

number value value d
before after
treatment treatment(
(X1 ) X2 )
1 8 5 3 94 /30 = -0.13 0.0169
2 7 5 2 3.13 -1.13 1.2769
3 7 5 2 -1.13 1.2769
4 8 4 4 0.87 0.7569
5 9 5 4 0.87 0.7569
6 8 3 5 1.87 3.4969
7 7 5 2 -1.13 1.2769
8 6 4 4 0.87 0.7569
9 10 3 7 3.87 14.9769
10 9 7 2 -1.13 1.2769
11 8 6 2 -1.13 1.2769
12 7 5 2 -1.13 1.2769
13 7 5 2 -1.13 1.2769
14 6 4 2 -1.13 1.2769
15 7 5 2 -1.13 1.2769
35
16 9 3 6 2.87 8.2369
17 7 5 2 -1.13 1.2769
18 7 5 2 -1.13 1.2769
19 8 3 5 1.87 3.4969
20 7 3 4 0.87 0.7569
21 9 3 6 2.87 8.2369
22 8 5 3 -0.13 0.0169
23 7 5 2 -1.13 1.2769
24 8 6 2 -1.13 1.2769
25 8 5 3 -0.13 0.0169
26 8 6 2 -1.13 1.2769
27 7 5 2 -1.13 1.2769
28 7 5 2 -1.13 1.2769
29 9 3 6 2.87 8.2369
30 7 5 2 -1.13 1.2769
n = 30 94 3.13 71.469
Table 12
σ = √ Ʃ (d-đ)2 / n-1
Where σ is standard deviation , d is difference of values before and after treatment , đ is
mean of difference ,n is the number of samples.
So , σ = √ 71.469 / 30-1 = √ 71.469 / 29 = √ 2.46 = 1.57
For calculating t value, t = đ / σ / √n = 3.13 / 1.57 / √30
=3.13 /1.57 / 5.47
= 3.13 / 0.29
= 10.79
So the value of t calculated is 10.79
At 95% confidence interval and at degree of freedom n-1 = 30-1 =29,
The value of t table is 2.04227
Since t calculated is more than t table, we reject null hypothesis (H0) and accept alternate
hypothesis.
So, the result of paired t test shows that 50 millesimal potencies are effective in treatment
of primary dysmenorrhoea.
36
DISCUSSION
The study gives a group of the most indicated medicines which are Sepia in 30%
cases; Pulsatilla and Phosphorous in 14% cases each; Lycopodium, Nux vomica and
Silicea in 7%cases each; Arsenicum album, Calcarea carbonica, Ignatia, Natrum
muriaticum, Nitric acid, Sabina and Zincum met 3% in each case.All of them are deep
acting constitutional medicines which act as both palliative and curative when
administered in 50 millesimal potency.
The study shows that in 57% cases the predominant miasm is Psora and in 40% it is
Pseudo Psora whereas in 3%cases the predominant miasm is Sycosis.
The symptoms are assessed before starting the treatment and after the treatment at
each follow up using numeric pain rating scale.The patients are followed up atleast for
4-5 menstrual cycles and at the last follow up the value of scale is noted as the value of
numeric pain rating scale after treatment.
Criteria Score (PRS) Result

No pain / symptom 0 Cured
Mild pain /symptoms 1-3 Remarkably improved
Moderate pain / symptoms 4-6 Moderately improved
Severe pain / symptoms 7-10 No change / not improved
Table 13
The result has shown marked improvement in 24% cases and moderate improvement
in 73% cases.Only 3% cases show no improvement.
On applying paired t test, the calculated value of t is more than the table value of t, at
confidence interval of 95% i.e.at p = 0.05. This shows that our study is significant and 50
millesimal potencies of well selected constitutional medicine act both as palliative and
curative and markedly reduces the pain and symptoms of primary dysmenorrhoea.There
was no aggravation of symptoms on giving the medicine in 50 millesimal potencies.
37
CONCLUSION
1. 50 millesimal potencies are effective and safe and do not aggravate the complaints
of dysmenorrhoea.
2. Constitutional medicine given in 50 millesimal potency acts both as curative and
palliative medicine.
3. Psora and pseudo psora are the predominant miasm of dysmenorrhoea.
4. Diet and regimen plays an important role in management of dysmenorrhoea.
38
SUMMARY
The study was done on 30 patients who came in the OPD of Govt Homoeopathic college
and hospital,Bhopal ; peripheral unit of Gautam Nagar,Bhopal and in various camps
organised in rural and urban areas.
The patients were mainly suffering from some major clinical symptoms like pain in
back/thighs/abdomen(97%), leucorrhoea before or after menses(53%) , weakness(30%) ,
headache(17%) ,nausea and vomiting(13%), irritability(13%),weeping mood(7%).
Previously 87% have adopted allopathic treatment for the pain relief whereas 13% have
adopted homoeopathic treatment for their complaints.
53% cases have family history of dysmenorrhoea.
The female patients of all religion irrespective of their socioeconomic status are included
in this study.
Detailed case taking of each patient is done according to the case taking proforma
designed according to the study and the case is analysed and evaluated on the basis of the
criteria given by Dr Kent as general symptoms,particular symptoms and common
symptoms.
The cases are repertorised using Synthesis repertory and the medicine which covers
maximum marks and maximum rubrics is selected,then on the basis of knowledge of
materia medica the appropriate medicine is prescribed in 50 millesimal potency starting
from 0/1.As per the requirement of the case the potency is increased.In my study I have
prescribed upto 0/4.
The most indicated medicine in the study are Sepia in 30% cases; Pulsatilla and
Phosphorous in 14% cases each; Lycopodium, Nux vomica and Silicea in 7%cases each;
Arsenicum album, Calcarea carbonica, Ignatia, Natrum muriaticum, Nitric acid, Sabina
and Zincum met 3% in each case.All of them are deep acting constitutional medicines
which act as both palliative and curative in 50 millesimal potency.
The study shows that in 57% cases the predominant miasm is Psora and in 40% it is
Pseudo Psora whereas in 3%cases the predominant miasm is Sycosis.
The symptoms are assessed before starting the treatment and after the treatment at
each follow up using numeric pain rating scale.The patients are followed up atleast for
4-5 menstrual cycles and at the last follow up the value of scale is noted as the value of
numeric pain rating scale after treatment.
39
The result has shown marked improvement in 24% cases and moderate improvement
in 73% cases.Only 3% cases show no improvement.
The calculated value of t is more than the table value of t, at confidence interval of
95% i.e.at p = 0.05. This shows that our study is significant.
The study shows that 50 millesimal potencies of well selected constitutional medicine
act both as palliative and curative and markedly reduces the pain and symptoms of
primary dysmenorrhoea.
40
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dysmenorrhoea:a prospective observational study with 2 years follow up.Arch Gynecol
Obstet2009 Oct;280(4):603-11.Available from Epub2009 Feb20
22.Kedarnath Naik,Obstetrics and gynaecology :Handbook of homoeopathic
therapeutics .2012;1
23.Burt WH. Physiological Materia Medica. B. Jain Publishers; 2003;3
24.Boericke W. Pocket manual of homeopathic materia medica. Homeopathic; 1903.
42
25.Lilienthal S. Homo.eopathic therapeutics. Boericke & Tafel; 1996
26.Schroyens F, editor. Synthesis: repertorium homeopathicum syntheticum.
Hahnemann Institut für homöopathische Dokumentation; 1993.
27.Zandvoort RV. The complete repertory. English (version 2003). Radar. 1994;10.
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B. Jain Publishers Pvt. Limited; 1988.
30.Clarke JH. Clinical Repertory. B. Jain Publishers; 1993.
31.Hahnemann S. The chronic diseases: their peculiar nature and their homœopathic cure.
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33.Robert HA. The principles and art of cure by Homoeopathy. Reprint edition
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dysmenorrhoea and its homoeopathic management:observational study with 9
months.Follow up Oct 08,2014[cited 2014 July]Available
from:https://www.researchgate.net
35.Dr.Harimohan Choudhary:50 millesimal potency in theory and practice,26
36.Adler UC, Adler MS. Hahnemann's experiments with 50 millesimal potencies..
Homeopathy. 2006 Jul;95(03):171-81.
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beginnings to the present day:2007,7
38.R.P.Patel:Evolution of 50 millesimal scale of potencies:My experience with 50
millesimal scale potencies:1986,reprint 5,10
39.C.M.F.Von Boenninghausen:lesser writings:reprint 1998-2000,74
43
40.Charles Pahud: My experience abou Hahnemann’s 50 millesimal scale potency:The
Brtitish Homoeopathic Journalt
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Journal: July -October 1954
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43.Dr N Hari hara Iyer.50 millesimal scale potency - a critical study
44.Abarna S, Venugopal J, Sivaranjani T, Poruthukaren KJ, Raj P, Suresh S. Evaluating
the usefulness of 50 millesimal potencies in chronic diseases.
45.BL S. EFFECT OF LM POTENCY IN HOMOEOPATHIC GENERAL
PRACTICE (Doctoral dissertation).
44
APPENDICES
DEFINITIONS
Definitions used for study purpose-
1. Primary dysmenorrhoea patients
2. 50 Millesimal potencies
3. Patients cured after homoeopathic treatment
4. Patients relieved /improved after homoeopathic treatment
5. Patients in status quo(existing condition)after homoeopathic treatment
6. Patients not cured after homoeopathic treatment
45
CASE RECORDING FORMAT
Department of Homoeopathic Pharmacy
CASE TAKING PROFORMA
Physician In-charge: Dr.Chetna Pandey / Dr.Hemant Kumar Soni
(A) Interrogation :
Opd/Ipd no. Date of Examination :

Name of Patient : Age : Sex:
Guardian’s Name : Religion &Caste :
Occupation : Address :
(B) Chief Complaints which is purpose of consultation :
(C) Present Complaints (Symptoms recorded with regards with regard to : Location,
sensation, modalities, concomitants, causation and duration) :
(D) History of Present Illness :

Onset :
Progress :
Treatment adopted :
Result :
( E ) Past History:(Disease/operation/injury with year in which it occured with

treatment taken and its outcome:
(F) Family History:

Father :
Mother :
Other members :
(G) Personal History:

 Mind &disposition :wills and emotions-
Understanding and intellect:
Memory :
46
 Married / Single /Widow /Divorcee :
 Diet and food habits :
 Desire :
 Disagrees :
 Thirst :
 Tongue:
 Taste:
 Salivation:
 Perspiration:
 Stool:
 Urine:
 Bathing:
 Covering:
 Sexual relations:
 Dwelling place :
 Appetite :
 Aversion :
 Habits / Addictions:
o Tobacco :
o Alcohol :
o Coffee/ Tea :
o Drugs etc :
 Thermal reaction:
 Skin:
 Sleep :
 Dream :
 Tendency to any Pathological conditions:
(Haemorrhages, Tumours, Warts, Cysts, Polyps, Moles, Susceptible to etc.)
 Restlessness, Prostration, Weakness, Sensation, Trembling etc.
Other discharges :
(H) Gynecological History:

 Menarche: Age- Complaints:
47
Menstrual Cycle :
Regular / Irregular : .LMP- .Cycle- .Duration-
Quantity(normal /profuse/scanty) :
Consistency(fluid/clotted/partly fluid and clotted):
Colour and odour :
Character (acrid/bland):
Complaints of menses-
Before:
During:
After :
Numeric Pain rating scale
0 1 2 3 4 5 6 7 8 9 10
(I) Abnormal discharges per vagina :

(II) Obstetrical History:
(J) Observations:
 Built / Nutrition :
 Colour of face, eyes & skin :
 Decubitus:
 Expression/ Facies:
 Anything special related to mind and disposition :
(K) Examination:
1- General Examination
Anaemia: Cyanosis :
Jaundice : Oedema :
Nails – Clubbing : Koilonychia:
Hair : Neck glands:
Neck veins : Teeth :
Gum : Tongue :
Smell from mouth : Hearing :
Pupils : Pulse :
Temperature : Blood Pressure :
Respiration : Skin in general :
48
2- Systemic Examination
A thorough examination of the affected system done under the following heads :-
(a) Inspection:
(b) Palpation :
(c) Percussion :
(d) Auscultation :
Brief examination of other systems :
(L) Laboratory Investigations :

(M) Provisional diagnosis:
(N) Differential Diagnosis :
(O) Analysis and evaluation:
(P) Miasmatic diagnosis :
(Q) Repertorial totality. :
(R) Reportorial result :
(S) Final selection of medicine :
(T) Prescription :
(U) Follow up:
Date Symptoms Prescription
Advice:
49
NUMERIC PAIN RATING SCALE
The Numeric Pain Rating Scale (NPRS) is a unidimensional measure of pain intensity
in adults.Here the patient is asked to mark the intensity of his/her pain from 0 to 10.
Scale -
The scale ranges from ‘0’ to ‘10’ where 0 represents one pain extreme i.e.no pain and
10 represents the other pain extreme i.e.pain as bad as you can imagine or worst pain
imaginable.
Respondents are asked to report pain intensity “in the last 24 hours” or an average
pain intensity.The respondent is asked to indicate the numeric value on the segmented
scale that best describes their pain intensity.
Interpretation of result-
0 score indicates no pain
0-3 indicates mild pain
4-6 indicates moderate pain
50
7-10 indicates severe pain
Merits and demerits -
1. The NPRS takes <1 minute to complete
2. The NPRS is easy to administer and score.
3. It can be used in patients of all cultures and languages as it requires minimal

language translation
4. It is a valid and reliable scale to measure pain intensity.
5. It can be used verbally or in written.
51
Case No. 1
(A) Interrogation :
Opd/Ipd no. 4/2994 Date of Examination : 7/12/19

Name of Patient : ABC Age : 18years Sex: Female
Religion &Caste : Hindu Occupation : Student
(D) Chief Complaints which is purpose of consultation :

Violent colic and backache during menses since 3-4 years
(E) Present Complaints (Symptoms recorded with regards with regard to : Location,
Violent colic and backache during menses since 3-4 years .Colic and leucorrhoea before
menses.Weakness , sleepiness , vomiting during menses. Anxiety and leucorrhoea -
milky , acrid with excessive itching after menses.
(E) History of Present Illness :

Onset : Gradual
Progress : Slow
Treatment adopted : Allopathic
Result : No relief

Recurrent cough and cold.
Pneumonia in childhood.
(F) Family History:

Father : Tuberculosis 5 years ago.Treated by allopathy.
Mother : Dysmenorrhoea in her early age.
Other members : Nothing particular

 Mind &disposition :wills and emotions- Indifferent towards
everything.Oversensitive to noise,light,odours etc.Easily gets angry.
52
Understanding and intellect: not too good
Memory : loss of memory
 Married / Single /Widow /Divorcee : Single
 Diet and food habits : vegetarian
 Desire : cold drinks,cold things
 Disagrees : very hot drinks
 Thirst : for very cold water
 Tongue:dry ,red
 Taste: nothing particular
 Salivation: nothing particular
 Perspiration: nothing particular
 Stool:Constipation .
 Urine:Nothing particular
 Bathing: Daily
 Covering: likes covering.
 Sexual relations: Not applicable
 Dwelling place : Pucca house
 Appetite :Hungry soon after eating.Acidity .Burning in chest when empty
stomach
 Aversion : very hot drinks
 Habits / Addictions: Nil
o Tobacco : Nil
o Alcohol : Nil
o Coffee/ Tea : Tea drinker
o Drugs etc : Nil
 Thermal reaction: chilly
 Skin: healthy
 Sleep : Unable to sleep early.Disturbed sleep.Awakens easily
 Dream : of fire
Nil
53
Weakness during and after menses
Other discharges :
Leucorrhoea before and after menses.milky ,acrid, with excessive itching.

 Menarche: Age-14 years Complaints: lower abdominal pain
Menstrual Cycle :
Regular / Irregular :Regular.LMP-1/12/18.Cycle of 28-30 days.Duration of 4-5
days.
Quantity(normal /profuse/scanty) :Scanty
Consistency(fluid/clotted/partly fluid and clotted): clotted
Colour and odour : Dark,non offensive
Character (acrid/bland):Bland
Before: Colic.Weeping mood. Leucorrhoea - milky,acrid in nature.
During:Weakness,sleepiness.Violent colic as if abdomen is cut with a

knife.Backache.Vomiting
After :Weakness,anxiety.Pain in lower abdomen.Leucorrhoea milky ,acrid, with

excessive itching.
0 1 2 3 4 5 6 7 8 9 10
Abnormal discharges per vagina :Leucorrhoea before and after menses.
(III) Obstetrical History:

Not applicable
(J) Observations:
 Built / Nutrition :Thin built
 Colour of face, eyes & skin : Wheatish complexion
 Decubitus: sitting
 Expression/ Facies:Nothing significant
 Anything special related to mind and disposition : Indifferent
(K) Examination:
Anaemia: Absent Cyanosis :Absent
Jaundice : Absent Oedema : Absent
Nails – Clubbing : Absent Koilonychia: Absent
54
Hair : Black Neck glands: Not palpable
Neck veins : Not prominent Teeth : Healthy
Gum : bleeds on brushing Tongue : dry and red
Smell from mouth : Absent Hearing : Proper
Pupils : Well respond to light Pulse : 74 per minute
Temperature : Afebrile Blood Pressure : 100/70 mm of Hg
Respiration : 16 per minute Skin in general :healthy.
Per abdominal examination is done
(a) Inspection: No abnormality detected
(b) Palpation : No abnormality detected
(c) Percussion : No abnormality detected
(d) Auscultation : No abnormality detected
Brief examination of other systems : No abnormality detected

Abdominal USG reveals no abnormal findings.


1. Secondary dysmenorrhoea
2. Adenomyosis
3. Pelvic inflammatory disease

A) General symptoms-
i)Mental general symptoms -
1.Indifferent .
2.Oversensitive to all external impressions
55
3.Easily gets angry
4.Weeping mood before menses
5.Anxiety after menses
6.Loss of memory
7.Dreams of fire
ii)Physical general symptoms -
1.Thirst for very cold water
2.Desire for cold drinks and cold things
3.Leucorrhoea before and after menses,acrid and milky with excessive
itching
4.Great weakness after stool
5.Hungry soon after eating
6.Aversion to hot drinks
7.Cannot sleep easily.Awakens easily from sleep
8.Violent colic before and after menses
9.Vomiting during menses
10.Weakness and sleepiness during menses
11.Leucorrhoea before and after menses - milky ,acrid with excessive
itching
B) Particular symptoms -
1.Gums bleed on brushing
2.Tongue-dry,red
C) Common symptoms -
1.Colic and backache during menses.
(Q) Miasmatic diagnosis :

Psora -
1.Oversensitive to all external impressions
2.Easily gets angry
3.Anxiety after menses
4.Hungry soon after eating
Pseudo psora-
1. Leucorrhoea acrid and milky before and after menses.
56
2.Weakness and sleepiness during menses.
3.Weeping mood before menses
4.Violent colic before and after menses
5.Vomiting during menses
6.Great weakness after stool
Syphilis -
1. Desire for cold drinks and cold things
2.Aversion to hot things
(Q) Repertorial totality. : From RADAR software
1MIND - ANGER - easily 52
2 MIND - ANXIETY - menses - after 5
3 MIND - INDIFFERENCE 340
4 MIND - MEMORY - loss of memory 68
5 MIND - SENSITIVE - external impressions, to all 48
6 MIND - WEEPING - menses - before 17
7 STOMACH - THIRST - cold - water 2
8 STOMACH - APPETITE - increased - eating - after 69
9 STOMACH - VOMITING - menses - during 53
10 ABDOMEN - PAIN - menses - after 19
11 ABDOMEN - PAIN - menses - before 76
12 FEMALE GENITALIA/SEX - LEUKORRHEA - menses - after 93
13 FEMALE GENITALIA/SEX - LEUKORRHEA - menses - before 70
14 FEMALE GENITALIA/SEX - LEUKORRHEA - acrid, excoriating 43
15 FEMALE GENITALIA/SEX - LEUKORRHEA - itching 39
16 FEMALE GENITALIA/SEX - LEUKORRHEA - milky 54
17 SLEEP - SHORT - catnaps, in 11
18 DREAMS - FIRE 85
19 GENERALS - FOOD and DRINKS - cold drink, cold water - desire 227
20 GENERALS - WEAKNESS - menses - during 87
21 GENERALS - WEAKNESS - stool - after 92
phos. sep. calc. lyc. puls. nat-m. graph. lach. sulph. sil.
39/19 30/13 29/14 27/14 26/13 25/16 25/14 23/14 23/14 21/13
1 2 - 1 3 - - 2 - - -
2 1 - - - - - - - - -
3 3 3 2 2 3 3 2 2 2 2
4 1 - - 1 1 2 1 - 1 1
5 3 - - - - 1 - 1 - 1
6 2 1 - 2 2 - - - - -
7 - - - - - - - - - -
8 3 1 2 3 - 1 - 1 - 1
9 2 1 2 2 2 2 2 2 2 -
10 - - - 1 2 2 1 2 - -
11 2 2 2 2 3 1 1 2 1 2
57
12 2 3 3 2 2 1 2 1 2 2
13 2 3 3 - 2 2 3 2 2 2
14 3 3 2 3 3 2 3 2 2 3
15 1 3 3 - 1 2 - 1 1 1
16 2 3 3 1 3 1 1 2 2 2
17 1 - - - - - - - 1 -
18 2 - 1 - - 2 1 1 2 1
19 3 2 2 2 1 1 2 - 1 1
20 2 3 1 1 - 1 2 2 2 -
21 2 2 2 2 1 1 2 2 2 2
(R) Reportorial result:

1.Phos-39/19 2. Sep- 30/13 3. Calc - 29/14 4. Lyco - 27/14
5.Puls-26/13
(S) Final selection of medicine:

Phosphorous is the well selected medicine on the basis of repertorisation as it covers
maximum rubrics i.e. 19 and covers maximum marks i.e. 39
(U) Prescription :
Phosphorous 0/1 x 1 dose daily for 15 days .Give 10 downward strokes before
taking medicine.After this take 1 dose of it in 3/4th glass of purified water. Stir it well
with a teaspoon. Take 1 teaspoon from it and throw the rest of the solution. Take each
dose in the same manner.
(U) Follow up:

8/1/2019 LMP-2/1/19 .Sleep is better than Phos 0/2 daily for 15
before. Mentally little better. pain days
in abdomen during menses is
little less than before. Numeric
pain rating scale(NPRS) 8
22/1/2019 Sleep pattern is improved. Phos 0/2 daily for 15
Appetite is better now. Does not days
feel hungry after eating.
5/2/2019 Mentally better. Sensitivity is less Phos 0/3 on alternate
Now mixing with days for 15 days
people.LMP-1/2/19.Pain in
abdomen is lesser than before.
Weakness is less. Relief in
overall complaints. NPRS 7
58
19/2/19 Sleep is normal. No fresh Phos 0/3 on alternate
complaints. days for 15 days
5/3/2019 LMP-4/3/19.Complaints during Phos 0/3 1 dose
menses are better than before. weekly
Relief in complaints. NPRS 6
3/4/2019 LMP-3/4/19.Better than before. Sac lac 0/1 weekly 1
NPRS 5 dose for a month
Advice:
2. Engage yourself in some activity while pain.
3. Make exercise a daily routine.
treatment.
59
Case no. 2
(A) Interrogation :

Name of Patient : DEF Age 20years Sex Female
(B) Chief Complaints which is purpose of consultation : -

Severe painful menstrual cramps since 4 months.
(C) Present Complaints (Symptoms recorded with regards with regard to :

Location, sensation, modalities, concomitants, causation and duration):
Severe menstrual cramps in lower abdomen since 4 months.The pain is so severe that she
is unable to do her works.Pain starts 5- 7 days before menses, begin with severe pain on
the 1st day of flow.The pain disappears by the 3rd day.The pain is relieved by heat and
pressure,aggravation by light touch.
(F)History of Present Illness :

Onset : Gradual
Progress : Progressive
Treatment adopted : Meftal spas
Result : temporary relief

treatment taken and its outcome: None
(F) Family History:
Father : Nothing particular
Mother : Nothing particular
Other members : Nothing particular
 Mind &disposition :wills and emotions- Tired all the time.Anxiety off and on
Understanding and intellect: Poor
Memory : very forgetful
 Diet and food habits : Vegetarian
60
 Desire : Nothing particular
 Disagrees :Nothing particular
 Thirst : 7 - 8 glasses of water in a day.likes cold water
 Tongue: slightly yellow coated
 Taste: Bad
 Salivation: Nothing significant
 Perspiration: Profuse sweat after exertion
 Stool:Has to pass stool after meals
 Bathing: Daily with lukewarm water.
 Covering: wants to be covered
 Appetite : Fullness after eating little.Flatulence .Constant passage of flatus.
 Aversion : Coffee
o Tobacco : Nil
o Alcohol : Nil
o Coffee/ Tea : Nil
o Drugs etc : Nil
 Thermal reaction: Chilly patient aggravation from cold air and cold washing
 Skin: healthy
 Sleep : sleeplessness due to indigestion
 Dream : Nothing particular
Nil
 Restlessness, Prostration, Weakness, Sensation, Trembling etc. -
Nervousness.Weakness in arms and hands.General weakness in muscles.
Other discharges :
Nil

 Menarche: Age-14 years Complaints: None
61
Menstrual Cycle :
Regular / Irregular :Regular but always 6-8 days earlier.LMP-5/1/19.Duration of 3
days.
Quantity(normal /profuse/scanty) :Normal
Consistency(fluid/clotted/partly fluid and clotted): partly fluid and partly clotted
Colour and odour : Dark
Complaints of menses-started at the age of 18 years
Before: Cramps in lower abdomen which is ameliorated by heat and
pressure.aggravated by light touch
During:Cramps in lower abdomen
After : Weakness after menses.Bruised feeling all over
0 1 2 3 4 5 6 7 8 9 10
Abnormal discharges per vagina : nil .
(IV) Obstetrical History:

Not applicable
(J) Observations:
 Built / Nutrition :Average
 Colour of face, eyes & skin : wheatish complexion
(K) Examination:
Nails – Clubbing : Absent Koilonychia : Absent
Neck veins : Not prominent Teeth : Decay with pain in it
Gum : Healthy Tongue : slightly yellow coated
62
2. Adenomyosis
(A) General symptoms -
(i) Mental general symptoms -
Anxiety.
Tiredness.
Forgetful.
(ii) Physical general symptoms -
Likes cold water to drink
Has to pass stool after meals.
Fullness of abdomen after eating little.
Constant passage of flatus.
Aversion to coffee.
Sleeplessness due to indigestion.
General weakness of muscles.
Severe cramps in lower abdomen before and during menses.
Amelioration by heat and pressure.
Aggravation by least touch.
Bruised feeling after menses.
(B)Particular symptoms-
63
Tongue is slightly yellow coated
Dental caries with pain in tooth
(C)Common symptoms-
Profuse perspiration after exertion .
(R) Miasmatic diagnosis :
Psora - Anxiety.
Tiredness.
Forgetful
Aversion to coffee
Fullness of abdomen after eating.
Constant passage of flatus
Pseudo psora-
General weakness of muscles.
Cramps in lower abdomen before and during menses.
Bruised feeling after menses
(S) Repertorial totality. :
1MIND - ANXIETY - paroxysms, in 30
2 MIND - FORGETFUL 271
3 STOMACH - COFFEE - agg. 7
4 GENERALS - FOOD and DRINKS - cold drink, cold water - desire 227
5 GENERALS - MENSES - after - agg. 54
6 ABDOMEN - PAIN - menses - during 130
7 ABDOMEN - PAIN - menses - before 76
8 ABDOMEN - FULLNESS, sensation of - eating - after 51
9 ABDOMEN - PAIN - pressure - amel. 43
10 SLEEP - SLEEPLESSNESS - indigestion, from 1
11 RECTUM - URGING - eating - after 23
12 ABDOMEN - PAIN - touching - agg. 19
13 GENERALS - WEAKNESS - Muscular 125
cham. phos. cocc. sep. nux-v. sulph. bell. calc. puls. graph.
18/10 18/10 18/9 18/9 18/8 16/10 16/9 15/8 14/9 14/8
1 2 1 2 1 - 2 1 1 - -
2 1 3 3 1 2 2 2 2 1 2
3 3 - 2 - 3 - - - 1 -
4 3 3 2 2 1 1 2 2 1 2
5 - 2 2 3 3 1 2 2 1 3
6 2 2 2 3 3 3 2 3 3 3
7 2 2 2 2 2 1 2 2 3 1
8 1 2 2 2 3 2 - 1 2 1
9 - - - 2 - - 2 - - 1
10 - - - - - - - - - -
64
11 1 1 - - - 1 - - - -
12 2 1 - - - 1 2 - 1 -
13 1 1 1 2 1 2 1 2 1 1

1.Phos-18/10 2. Cham -18/10 3. Cocc- 18/9 4. Sep - 18/9 5. Nux
vom- 18/8
Phosphorous is the well selected medicine on the basis of repertorisation as it covers
(V) Prescription :
Phosphorous 0/1 x 1 dose daily for 15 days .Give 10 downward strokes before taking
medicine.After this take 1dose of it in 3/4th glass of purified water.Stir it well with a
teaspoon.Take 1 teaspoon from it and throw the rest of the solution.Take each dose in the
same manner.
(U) Follow up:

22/1/19 Relief in tired feeling.Some relief Phosphorous 0/1 1
in gastric complaints. dose daily for 15 days
5/2/2019 LMP-30/1/19 Better than Phosphorous 0/2 1

before.Gastric complaints are dose daily for 15 days
relieved.Pain during menses is
lesser than before.The frequency
of passage of stool after eating is
very less.Numeric Pain rating
scale(NPRS) 7
19/2/19 Relief in gastric Phosphorous 0/2 1
complaints.Feeling some strength dose daily for 15 days
in arms now.
5/3/2019 LMP-28/2/19.Relief in
Phosphorous 0/2 on
complaints. NPRS 5 alternate days for a
month
9/4/2019 LMP-30/3/19.Pain is better than Phosphorous 0/3
before.All other complaints are 1dose weekly for a
also relieved.NPRS 4 month
7/5/2019 LMP-29/4/19.Relief in all Sac lac 0/1 weekly 1
complaints.NPRS 3 dose for a month
65
Advice:
2.Engage yourself in some activity while pain.
3.Make exercise a daily routine.
4.Avoid taking any other medicinal substance or high smelling foods during
treatment.
66
Case No.3
(A) Interrogation :

Name of Patient :GHI Age : 23years Sex: Female
(F) Chief Complaints which is purpose of consultation :

Irregular menses since 1 year
(D) Present Complaints (Symptoms recorded with regards with regard to :

Location, sensation, modalities, concomitants, causation and duration) :
Irregular menses since 1 year. Constipation before and during menses.Unable to pass
stool.As the menses starts body becomes cold,irritability during menses. Eruptions in the
inner sides of the thighs.Very smelly menses.Itching in vulva and acrid , milky
leucorrhoea after menses.
(G) History of Present Illness :

Onset : Gradual
Progress : Slow
Result : No relief
Recurrent boils in the childhood
(F) Family History:
Father : Nothing particular
Mother : Nothing particular
Other members : Sisters also have dysmenorrhoea
 Mind &disposition :wills and emotions- Anxiety.Nervousness. Very sensitive to
light and noise
Understanding and intellect: good
Memory : good
67
 Desire : sweets
 Disagrees : bitter gourd
 Thirst : more.15- 16 glasses of water in a day
 Tongue: clean .Sensation of a hair on tongue
 Taste: Normal
 Salivation: nothing particular
 Perspiration: more on head and neck . Offensive sweat
 Stool: Constipation always before and during menses . Has to strain
 Bathing:Daily
 Covering: wants covering.Cannot tolerate uncovering during sleep.
 Appetite :Poor.Eructations after eating
 Aversion : Nothing significant
o Tobacco : Nil
o Alcohol : Nil
o Coffee/ Tea : Nil
o Drugs etc : Nil
 Thermal reaction: chilly.Wants covering.Catches cold easily
 Skin: healthy
 Sleep : Sleeplessness
 Dream : Anxious dreams
Nil
Nervousness
Other discharges :
Leucorrhoea after menses , acrid and milky
68
 Menarche: Age-16 years Complaints: None
Menstrual Cycle :
Regular / Irregular :Irregular.LMP-02/01/19.Duration of 6-7 days.
Quantity(normal /profuse/scanty) :Profuse
Consistency(fluid/clotted/partly fluid and clotted): fluid
Colour and odour : Dark,non offensive
Before: Constipation . Has to strain much to pass stool
During : Irritability ,coldness of body.Eruptions in inner side of thighs
After :Leucorrhoea after menses,acrid and milky with itching in vulva

0 1 2 3 4 5 6 7 8 9 10
Abnormal discharges per vagina :Leucorrhoea after menses.Acrid and milky in
nature.
(V) Obstetrical History:

Not applicable
(J) Observations:
 Built / Nutrition : Thin built
 Colour of face, eyes & skin : Fair complexion
 Anything special related to mind and disposition : Nervous
(K) Examination:
1.General Examination
Nails – Clubbing : Absent Koilonychia Absent
Gum : Healthy Tongue : clean
69
2. Adenomyosis
(A) General symptoms -
(i) Mental general symptoms - Anxiety .
Nervousness.
Sensitive to all impressions .
Anxious dreams.
(ii) Physical general symptoms - Poor appetite.
Eructations after eating,Desire for sweets,Sensation of hair on tongue.
Perspiration more on head and neck,Offensive sweat,Constipation before
and during menses,Irritability ,coldness of body and eruptions in inner side
of thighs, during menses. Leucorrhoea is acrid and excoriating with itching
in vulva after menses. Cannot tolerate uncovering.Catches cold easily.
Sleeplessness.
(T) Miasmatic diagnosis :
Psora -
Anxiety .
Nervousness.
70
Sensitivity to all impressions.
Poor appetite.
Eructations after eating .
Desire for sweets.
Perspiration more on head .
Irritability .
Eruptions in inner sides of thighs.
Chilly .
Constipation.
Pseudo psora-
Leucorrhoea acrid and excoriating after menses.
Catches cold easily.
(U) Repertorial totality. :
1MIND - ANXIETY 485
2 MIND - SENSITIVE - external impressions, to all 48
3 MIND - IRRITABILITY - menses - during 47
4 DREAMS - ANXIOUS 288
5 STOMACH - ERUCTATIONS - eating - after 124
6 MOUTH - HAIR; sensation of a - Tongue 16
7 PERSPIRATION - ODOR - offensive 122
8 HEAD - PERSPIRATION of scalp - Occiput 19
9 RECTUM - CONSTIPATION - menses - during 39
10 RECTUM - CONSTIPATION - menses - before 17
11 GENERALS - COLD - take cold; tendency to 161
12 GENERALS - UNCOVERING - agg. 86
13 EXTREMITIES - ERUPTIONS - Thigh - menses - during 2
14 FEMALE GENITALIA/SEX - LEUKORRHEA - menses - after 93
15 FEMALE GENITALIA/SEX - LEUKORRHEA - itching 39
sil. sulph. nat-m. kali-c. nux-v. sep. nit-ac. puls. phos. lyc.
32/14 26/13 25/13 25/12 25/12 25/11 22/10 21/11 21/10 21/9
1 2 3 2 3 2 2 3 3 3 3
2 1 - 1 - 2 - 2 - 3 -
3 - 2 1 1 2 1 - 1 - 1
4 3 3 3 3 3 2 3 3 3 3
5 2 3 3 2 2 2 2 3 2 2
6 3 1 2 - - - 1 1 - 1
7 3 3 1 1 3 3 3 3 2 3
8 2 3 - - 1 2 1 - - -
9 3 1 3 3 2 3 - 1 1 -
71
10 3 1 1 3 1 - - - - -
11 3 2 3 3 3 3 3 2 2 3
12 3 1 2 3 3 1 - 1 2 3
13 1 - - 1 - - - - - -
14 2 2 1 1 1 3 2 2 2 2
15 1 1 2 1 - 3 2 1 1 -

1.Sil-32/14 2. Sulph- 26/13 3. Nat mur - 25/13 4.Kali carb - 25/12
5.Nux vom - 25/12
Silicea is the well selected medicine on the basis of repertorisation as it covers
(W) Prescription :
Silicea 0/1 x 1 dose daily for 15 days .Give 10 downward strokes before taking
medicine.After this take 1 dose of it in 3/4th glass of purified water.Stir it well with a
same manner.
(U) Follow up:

19/2/2019 LMP-15/2/19 .Irritability was Silicea 0/1 daily for 15
there during menses.Not much days
relief in complaints.Numeric
Pain rating scale(NPRS) 9
5/3/2019 Relief in gastric Silicea 0/1 daily for 15

complaints.Appetite is better days
now.No eructations after eating.
19/3/2019 LMP-16/03/19.Menses are Silicea 0/2 daily for
regular this time.Complaints are 15 days
little better than before.NPRS 7
2/4/2019 Relief in constipation.Appetite is
Silicea 0/2 on
better than before. alternate days for 15
days
23/4/2019 LMP-18/04/19.Smell in menses Silicea 0/3 1 dose on
was less this time.No eruptions every 3rd day
on thighs before menses.Menses
are more regular now.Patient is
72
feeling better now.NPRS 4
21/5/2019 LMP-18/5/19.Better than Sac lac 0/1 weekly 1
before.Feeling better.No fresh dose for a month
complaints.NPRS 3
Advice:
treatment.
73
Case No.4
(A) Interrogation :
Opd/Ipd No. : Id 17 Date of Examination : 18/02/19

Name of Patient : JKL Age : 25 Sex :Female
Religion &Caste : Hindu Occupation : Housewife
(B) Chief Complaints which is purpose of consultation : -

Backache and pain in legs 2 days before menses since many years.
(C) Present Complaints (Symptoms recorded with regards with regard to : Location,
Backache and pain in legs 2 days before menses and on 1st day during menses since many
years.Backache is aggravated by walking and ameliorated by pressure.Pain in legs is
worse on sitting . Sleeplessness before menses. Irritability during menses.Leucorrhoea off
and on, not much troublesome.
(D) History of Present Illness :

Onset : Gradual
Progress : Progressive
Result : Temporary relief in pain
(E) Past History:(Disease/operation/injury with year in which it occured with treatment

taken and its outcome) :
Hypotension 2-3 months ago.Has to be admitted for this.Fracture of left forearm 15
years ago.Pain in it when rainy or damp weather occurs.
(F) Family History:
Father : Nothing significant
Mother :Expired 2 years ago
Other members : Her cousin sister has dysmenorrhoea
74
 Mind &disposition :wills and emotions- Irritability during menses.Depression
after death of mother.
Understanding and intellect : good
Memory: good.
 Married / Single /Widow /Divorcee : Married
 No. of children : 2
 Health of children : Healthy
 Marital relations : Nothing particular
 Diet and food habits : Vegetarian
 Desire : Nothing particular
 Disagrees : Nothing particular
 Thirst : Drinks 8-10 glass of water in a day.
 Tongue: slightly white coated
 Taste: Nothing particular
 Salivation: Nothing particular
 Perspiration: Nothing particular
 Stool:Passes stool daily .Hard and difficult stool
 Urine: Nothing particular
 Bathing:Bathes daily with lukewarm water
 Covering: likes to be covered
 Sexual relations: Nothing particular
 Appetite : Eats properly and in proper amount
 Aversion : Nothing particular
o Tobacco : Nil
o Alcohol : Nil
o Coffee/ Tea : Nil
o Drugs etc : Nil
 Thermal reaction: Likes covering while sleep in all weather
 Skin: Healthy
 Sleep : Disturbed since the death of mother.Misses mother.
75
 Dream : Nothing particular
Nil

Nil
Other discharges :
Leucorrhoea off and on

 Menarche: Age- 14 years Complaints : None
Menstrual Cycle :
Regular / Irregular: Regular.LMP - 21/1/19. 35 days cycle.Duration - 3 days.
Quantity(normal /profuse/scanty): Normal
Consistency(fluid/clotted/partly fluid and clotted): Clotted on first 2 days
Colour and odour : Dark red
Character (acrid/bland) : Bland
Before :Backache and pain in legs 2 days before menses.Contracted feeling in calf
muscles.
During :Backache and pain in legs for the first day of menses
After : Relieved
0 1 2 3 4 5 6 7 8 9 10
Abnormal discharges per vagina : Leucorrhoea off and on .No relation with menses.
(I) Obstetrical History:

 Total number of Pregnancies: 2
 Abortion /Stillbirth/Live birth/early childhood deaths : None
 Children presently surviving : 2
 Complaints during pregnancy: None
 Delivery (home/hospital;normal/episiotomy/lscs/forceps): Normal
 Nature of puerperium : Nothing significant
 Lactation history :Nothing significant
(J) Observations:
 Built / Nutrition :Slim built
 Colour of face, eyes & skin :Wheatish
76
 Decubitus: Sitting
 Expression/ Facies: Sad
 Anything special related to Mind & Disposition: Irritability due to loss of
mother.Depression.
(K) Examination:
Nails – Clubbing : Absent Koilonychia: Absent
Gum : Healthy Tongue : slightly white coated
Respiration : 17 per minute Skin in general : Pale
2. Adenomyosis
77
(A) General symptoms-
(i) Mental generals - Irritability during menses
Depression after death of mother
(ii) Physical generals -Backache and pain in calf muscles before and during
menses.
Contracted feeling in calf muscles.
Disturbed sleep .
Constipation with difficulty in passing stool
Sleeplessness before menses
(B) Particular symptoms- Tongue slightly white coated
(C) Common symptoms- Backache during menses
(P) Miasmatic diagnosis :
Psora -
Irritability, Depression, Disturbed sleep ,Constipation with difficult stool
Pseudo psora -Backache before and during menses.Pain in calf muscles during menses.
Contracted feeling, Sleeplessness before menses
(Q) Repertorial totality. :
1MIND - IRRITABILITY - menses - during 47

2 MIND - SADNESS - death of mother 1
3 RECTUM - CONSTIPATION - difficult stool 198
4 STOOL - HARD 337
5 BACK - PAIN - menses - before 44
6 BACK - PAIN - menses - during 99
7 BACK - PAIN - pressure - amel. 28
8 BACK - PAIN - walking - while 68
9 EXTREMITIES - PAIN - Leg - menses - during 7
10 EXTREMITIES - PAIN - sitting 7
11 SLEEP - DISTURBED - anxiety, from 68
12 SLEEP - SLEEPLESSNESS - menses - before 8
78
sep. Kali c. caust. sulph. mag-m. bry. nux-v. zinc. lyc. phos.
18/8 15/8 15/7 15/6 14/8 14/6 13/7 12/8 12/7 12/7
1 1 1 1 2 1 1 2 1 1 -
2 - - - - - - - - - -
3 2 3 3 3 3 3 3 3 2 2
4 2 3 2 3 3 3 3 3 3 3
5 3 1 2 - 1 - 2 1 2 1
6 2 1 3 3 2 3 1 1 2 2
7 3 3 - - 1 - - 1 - 1
8 3 1 2 2 2 2 1 1 1 1
9 - - - - - - - - - -
10 - - - - - - - - - -
11 2 2 2 2 1 2 1 1 1 2
12 - - - - - - - - - -

1. Sepia -18/8 2. Kali c -15/8 3.Caust - 15/7 4.Sulph-15/6
5.Mag m -14/8
Sepia is the well selected medicine on the basis of repertorisation as it covers
maximum rubrics i.e.8 and covers maximum marks i.e. 18
(T) Prescription :
Sepia 0/1 x 1 dose daily for 15 days .Give 10 downward strokes before taking
same manner.
(U) Follow up:

2/3/2019 Slight change in mood.Sleep is Sepia 0/1 daily for 15
better now. days
23/3/2019 LMP-22/3/2019.Mental Sepia 0/2 for 15 days

complaints are
relieved.Irritability is better than
before.Pain is slightly
lessNumeric pain rating
79
scale(NPRS) 7
13/4/2019 Better than before.Stool is soft Sepia 0/2 for 15 days
now and there is some relief in
constipation.Sleep is better
29/4/2019 LMP-27/4/19.Intensity of Sepia0/2 on alternate
backache before menses is days for 15 days
less.Mentally quiet.No
sleeplessness before
menses.NPRS 6
15/5/2019 No fresh complaints Sepia 0/2 on every 3rd
day for a month
30/5/2019 LMP-24/5/19.Complaints are Sac lac 0/1 weekly 1
better than before.Irritability and dose for a month
pain in back and lower limbs are
lesser than before.NPRS 5
Advice:
treatment.
80
Case No.5
(A) Interrogation :

Name of Patient :MNO Age : 18years Sex: Female
(B) Chief Complaints which is purpose of consultation :

Abdominal pain and pain in lower limbs during menses since 2 years.
(C) Present Complaints (Symptoms recorded with regards with regard to :

Location, sensation, modalities, concomitants, causation and duration) :
Abdominal pain and pain in lower limbs during menses since 2 years. In each
menstrual cycle there are different complaints.Sometimes there is backache ,sometimes
lower abdominal pain with pain in lower limbs, sometimes sleeplessness a night before
menses.Irritability and weeping mood 2-3 days before menses.
(H) History of Present Illness :

Onset : Gradual
Progress : Slow
Result : No relief
Recurrent skin complaints - boils and acne
(F) Family History:
Father : osteoarthritis
Mother : osteoporosis
Other members : Sisters - elder had dysmenorrhoea at same age which is treated by
homoeopathy
Younger sister has gall bladder stone
 Mind &disposition :wills and emotions- Irritability and weeping mood during
menses.Fear of lizards.Fear of being alone as if someone or ghost will come.Fear
of dark
81
Understanding and intellect: good
Memory : sharp
 Desire :Sweets
 Disagrees : Nothing particular
 Thirst : Less .Drinks 3-4 glasses of water in a day
 Tongue: slightly white coated
 Taste: nothing particular
 Salivation: more on seeing sweets
 Perspiration: on back,on walking much
 Stool:Constipation ,even soft stool is difficult to expel.Passes stool daily
 Bathing: Daily with lukewarm water
 Covering: likes covering
 Appetite :Eats 3-4 times in a day.Cannot tolerate hunger.
 Aversion : Nothing particular
o Tobacco : Nil
o Alcohol : Nil
o Coffee/ Tea : Nil
o Drugs etc : Nil
 Thermal reaction: chilly.Headache and sunstroke in every summers.
 Skin: Acne scars on face.
 Sleep : Disturbed when has pending work of studies.
 Dream : of water -lake and a temple there
Nil
Nil
82
Other discharges :
Leucorrhoea after menses -stringy and thin in nature, for 3-4 days

Menarche: Age-15 years Complaints: None
Menstrual Cycle :
Regular / Irregular : Regular.LMP-7/1/19.Cycle of 28-30 days.Duration of 4-5 days.
Quantity(normal /profuse/scanty) : Normal
Consistency(fluid/clotted/partly fluid and clotted): Fluid
Colour and odour : Bright red,non offensive
Before:Changeable complaints.Irritability.Weeping mood.
During:Changeable complaints.Flow is more when rising after sleep or lying down
position
After :Leucorrhoea stringy and thin in nature ,after menses.
0 1 2 3 4 5 6 7 8 9 10
Abnormal discharges per vagina :Leucorrhoea after menses.
(VI) Obstetrical History:

Not applicable
(J) Observations:
 Built / Nutrition :Fatty built
 Colour of face, eyes & skin : Fair complexion
 Decubitus: Sitting
 Expression/ Facies:Co-operative
 Anything special related to mind and disposition : Irritable
( K) Examination:
1.General Examination
Nails – Clubbing : Absent Koilonychia Absent
Neck veins : Not prominent Teeth : cavity in few
Gum : bleeds on brushing Tongue :slightly white coated
83
A thorough examination of the affected system done under the following
heads :-
2. Adenomyosis
A) General symptoms-
i)Mental general symptoms -
Irritability before menses .
Weeping mood before menses.
Fear of lizard
Fear of being alone
Fear of dark
Fear of ghost
Dreams of water and temples
ii)Physical general symptoms -
Desire for sweets
Thirstless
Constipation ,even soft stool is difficult to expel
84
Cannot tolerate hunger
Sunstroke in every summers
Sleep is disturbed when anxious
Leucorrhoea stringy and thin after menses
Changeable symptoms before and during menses
Flow is more on rising after lying down
C) Particular symptoms -
Tongue-slightly white coated
Teeth-caries
D) Common symptoms -
Lower abdominal pain ,backache ,pain in limbs before and during menses
(V) Miasmatic diagnosis :

Psora -
Irritability before menses .
Weeping mood before menses.
Fear of lizard
Fear of being alone
Fear of dark
Fear of ghost
Dreams of water and temples
Desire for sweets
Thirstless
Constipation ,even soft stool is difficult to expel
Cannot tolerate hunger
Sunstroke in every summers
Sleep is disturbed when anxious
Changeable symptoms before and during menses
Pseudo psora-
Leucorrhoea stringy and thin after menses
Lower abdominal pain ,backache ,pain in limbs before and during menses
Tongue-slightly white coated, Teeth-caries
85
(W) Repertorial totality :
1MIND - FEAR - alone, of being 83
2 MIND - FEAR - dark; of 76
3 MIND - FEAR - ghosts, of 46
4 MIND - FEAR - reptiles; of 1
5 MIND - IRRITABILITY - menses - before 45
6 MIND - WEEPING - menses - before 17
7 STOMACH - THIRSTLESS 179
8 RECTUM - CONSTIPATION - difficult stool 198
9 FEMALE GENITALIA/SEX - LEUKORRHEA - ropy, stringy, tenacious 46
10 FEMALE GENITALIA/SEX - LEUKORRHEA - thin - menses - after 5
11 FEMALE GENITALIA/SEX - MENSES - cease - sitting 1
12 SLEEP - DISTURBED - anxiety, from 68
13 DREAMS - RELIGIOUS 7
14 DREAMS - WATER 97
15 GENERALS - WEATHER - change of weather - agg. 100
16 GENERALS - HUNGER - agg. 38
lyc. phos. kali-c. sulph. puls. caust. sil. sep. graph. merc.
23/11 23/11 21/11 20/11 20/10 19/10 18/9 17/10 17/8 16/10
1 3 3 3 - 2 - 1 2 - 1
2 2 2 1 1 2 2 1 1 - 1
3 3 3 1 2 2 2 - 1 - 1
4 - - - - - - - - - -
5 2 - 1 1 2 2 - 2 - -
6 2 2 - - 2 - - 1 - -
7 2 1 2 1 3 1 - 2 1 1
8 2 2 2 3 2 3 3 3 3 2
9 - 1 - 1 - 2 2 - 2 2
10 - - - - - - - - - -
11 - - - - - - - - - -
12 1 2 2 2 1 2 2 2 2 2
13 - - - - - - - - - -
14 2 - 2 1 - - 2 - 2 2
15 - 3 2 2 2 2 3 1 2 2
16 1 2 3 3 - 2 3 - 3 -
17 3 2 2 3 2 1 1 2 2 2
17 GENERALS - FOOD and DRINKS - sweets - desire 198

1.Lyco-23/11 2. Phos- 23/11 3 . Kali carb - 21/11 4. Sulph - 20/11 5.Puls
-20/10

Lycopodium is the well selected medicine on the basis of repertorisation as it covers
86
(X) Prescription :
Lycopodium 0/1 x 1 dose daily for 15 days .Give 10 downward strokes before taking
same manner.
(U) Follow up:

12/2/2019 LMP-8/2/19 Slight improvement Lycopodium 0/1 daily
in complaints during menses. for 15 days
Numeric Pain rating scale(NPRS)
7
26/2/2019 Relief in constipation.Mentally Lycopodium 0/2 daily

quiet now.Fear is also less than for 15 days
before
19/3/2019 LMP-10/3/19. Intensity of Lycopodium0/2 on
symptoms is less.Relief in gastric alternate days for 15
complaints.Mentally feeling days
better. NPRS 5
2/4/2019 Feeling better now.No fresh Lycopodium0/2 on
complaints. alternate days for 15
days
23/4/2019 LMP-11/4/19. Intensity of Lycopodium 0/3 on
symptoms is less.The complaints every 3rd day for a
are tolerable.NPRS 4 month
21/5/2019 LMP-12/5/19.Relief in Sac lac 0/1 weekly 1
complaints.NPRS 4 dose for a month
Advice:
2. .Engage yourself in some activity while pain.
3. Make exercise a daily routine.
treatment.
87
Table 14
FAMILY
ECONOMIC HISTORY NPRS SCALE ON NPRS SCALE ON PREDOMINANT
REG. NO. AGE SEX HABITAT RELIGION STATUS LAST REMEDY POTENCY RESULT
FIRST VISIT
CASE FOLLOWUP
MIASM
NO.
8 5 LM
1 007/2571 30 F Urban HINDU LMC NO PULSATILLA PSEUDO PSORA IMPROVED
7 5 LM
2 CAMP PATIENT 24 F Urban HINDU UMC NO SEPIA PSEUDO PSORA IMPROVED
7 5 LM
3 001/2939 30 F Urban HINDU MC YES SEPIA PSEUDO PSORA IMPROVED
8 4 LM
4 001/2978 30 F Urban HINDU MC YES LYCOPODIUM PSORA IMPROVED
5 LM
5 004/2994 18 F Urban HINDU MC YES 9 PHOSPHOROUS PSEUDO PSORA IMPROVED
8 3 LM
6 CAMP PATIENT 18 F Urban HINDU LMC YES NUX VOMICA PSEUDO PSORA IMPROVED
7 5 LM
7 003/3067 27 F Urban HINDU LMC YES NITRIC ACID PSEUDO PSORA IMPROVED
6 4 LM
8 001/3065 27 F Urban HINDU LMC YES SEPIA PSORA IMPROVED
10 3 LM
9 002/3091 20 F Urban HINDU MC NO PHOSPHOROUS PSORA IMPROVED
9 2 LM
10 376270/3663 21 F Urban HINDU LMC NO SEPIA SYCOSIS NOT IMPROVED
8 6 LM
11 CAMP PATIENT 26 F Rural HINDU LMC NO PHOSPHOROUS PSORA IMPROVED
7 5 LM
12 003/026 18 F Urban HINDU MC YES LYCOPODIUM PSORA IMPROVED
7 5 LM
13 005/2841 18 F Urban HINDU MC YES SEPIA PSORA IMPROVED
6 4 LM
14 377060/3671 30 F Urban HINDU MC NO SEPIA PSEUDO PSORA IMPROVED
7 5 LM
15 001/060 30 F Urban HINDU LMC NO SILICEA PSEUDO PSORA IMPROVED
9 3 LM
16 008/339 19 F Urban HINDU LMC NO SABINA PSORA MPROVED
7 5 LM
17 009/340 25 F Urban HINDU LMC NO SEPIA PSEUDO PSORA IMPROVED
7 5 LM
18 005/308 24 F Urban HINDU MC NO PULSATILLA PSORA IMPROVED
8 3 LM
19 003/139 26 F Urban HINDU MC YES PULSATILLA PSORA IMPROVED
7 3 LM
20 002/138 30 F Urban HINDU MC YES ZINCUM MET PSORA IMPROVED
9 3 LM
21 004/140 23 F Urban HINDU MC YES SILICEA PSORA IMPROVED
8 5 LM
22 387052/3771 19 F Urban HINDU MC NO IGNATIA PSORA IMPROVED
7 5 LM
23 S.N.32 24 F Urban MUSLIM MC NO PHOSPHOROUS PSORA IMPROVED
8 6 LM
24 S.N.13 19 F Urban HINDU MC YES CALC CARB PSEUDO PSORA IMPROVED
8 5 LM
25 S.N.12 19 F Urban HINDU MC YES PULSATILLA PSEUDO PSORA IMPROVED
8 6 LM
26 S.N.26 26 F Urban MUSLIM MC YES SEPIA PSORA IMPROVED
7 5 LM
27 S.N.39 30 F Urban HINDU LMC YES NUX VOMICA PSORA IMPROVED
7 5 LM
28 S.N.17 25 F Urban HINDU LMC YES SEPIA PSEUDO PSORA IMPROVED
9 3 LM
29 S.N.41 20 F Urban HINDU LMC NO NATRUM MUR PSORA IMPROVED
88
7 5 LM
30 3806/390551 30 F Urban HINDU MC NO ARS ALB PSORA IMPROVED
KEY TO MASTER CHART
Case number , registration number , name , age , sex , habitat , religion , economic status ,
family history , numeric pain rating scale score before treatment ,numeric pain rating
scale score after treatment , remedy , potency , predominant miasm , result.
89
SUBJECT INFORMATION SHEET
Study Title:
“ROLE OF 50 MILLESIMAL POTENCIES IN PRIMARY DYSMENORRHOEA”
Investigator: Dr. Parul Jain
Study site:OPD of Government Homoeopathic Medical College & Hospital, Bhopal ;

peripheral OPD of Gautam Nagar ,Bhopal and camps organised by the college.
You are invited to participate in the clinical study entitled “ROLE OF 50

MILLESIMAL POTENCIES IN PRIMARY DYSMENORRHOEA”
The following information is provided for your persual and understanding in order to
help you to arrive at an informed decision whether you should participate in this clinical
trial. Please feel free to ask any questions relating to this study or the information
provided below. Please sign the form only if you are fully satisfied with the information
given to you and understand the procedures involved in the study.
Drug Information:
Trial medicine (Constitutional Homoeopathic medicines): The medicine will be given in
50 millesimal potency and dose as per requirement.
Control medicine (Placebo): No control medicine is given in the study.
Study Purpose and Procedures:
1. Assessment of effectiveness of 50 millesimal potencies in primary

dysmenorrhoea.
2. Patient will be selected consecutively.
90
3. They will receive constitutional homoeopathic medicine in 50 millesimal potency
after proper fulfillment of inclusion and exclusion criteria.
4. The nature of medicine is known to the investigator and to the patients. (open
label).
5. Follow up will be done in regular intervals.
Possible Discomforts / Risks:

1. Medicine may not give relief .
Possible Benefits:
1. Establish effectiveness of homoeopathic medicines in 50 millesimal potencies in
primary dysmenorrhoea.
2. To minimize side effects of modern medicines by prescribing homoeopathic
medicine.
3. To improve the quality of life of women suffering from primary dysmenorrhoea.
4. To decrease the intensity of pain in subsequent menstrual cycles.
5. To remove the fault in diet and regimen.
Right of Privacy
All data obtained in response to the study medication, during the course of this study, will
be kept confidential and will be accessible only to the investigating physicians and the
reviewer / analyst for the study. If the results of the study are published, you may be
referred to by number or initials but not by name so as to protect you identity.
Finally, please note that you are free to withdraw consent and take you out from this
study any time you choose without having to assign any reasons whatsoever from doing
so. This will not compromise your relations with the physicians involved. You may also
be withdrawn from the study by the investigating physician if he feels that further
continuation is not in the best interests of his patient’s health.
Contacts for Additional or Emergency Information:
Dr. Parul Jain
91
Patient Consent Form
FOR PARTICIPATION IN CLINICAL STUDY
StudyTitle:
“ROLE OF 50 MILLESIMAL POTENCIES IN PRIMARY DYSMENORRHOEA”
Subject’s Initials: ___________________ Age: _____ Sex: ______
1. I confirm that I have read and understood the information sheet for the above study. I
have had the opportunity to ask questions and all my questions and doubts have been
answered to my complete satisfaction.
2. I understand that my participation in the study is voluntary and that I am free to
withdraw at any time, without giving reasons, without my relationship with the
attending physicians being compromised or my legal rights being affected.
3. I understand that my identity will not be revealed in any information released to third
parties or published, unless as required under the law. I agree not to restrict the use of
any data or results that arise from the study.
4. I agree not to withhold any information about my health from the investigator and will
convey the same truthfully.
5. I agree to take part in the above study and to comply with the instructions given
during the study and to cooperate with the study team.
● Signature/thumb impression of the subject:

___________________________________
● Name and address:

______________________________________________________
______________________________________________________________________
● Signature of witness:
____________________________________________________
● Name and address:

______________________________________________________
92
______________________________________________________________________
● Investigator’s name and Signature:

_________________________________________
● Place _________________ Date _________________
93

Role of 50 Millesimal Potencies in Primary Dysmenorrhoea Updated PDF

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“ROLE OF 50 MILLESIMAL POTENCIES

Madhya Pradesh Medical Science University, Jabalpur,

Dr. Parul Jain

Under the guidance of

Prof. Dr. Hemant Kumar Soni

GOVT. HOMOEOPATHIC MEDICAL

Name of the College: Govt.Homoeopathic Medical College,Bhopal

Department: Homoeopathic Pharmacy

I hereby declare that the dissertation entitled “Role of 50millesimal

potencies in Primary Dysmenorrhoea” is completed and written by me. It has not

title of this university or examining body.

Place: Bhopal Dr. Parul Jain

AYUSH Campus, Beside Kaliyasot Dam, MACT Hills, Bhopal- 462003

Ref. No. Date:

This is to certify that the dissertation entitled “Role of 50 millesimal

Place: Bhopal Name of Guide:

AYUSH Campus, Beside Kaliyasot Dam, MACT Hills, Bhopal- 462003

This is to certify that the dissertation entitled “Role of 50 millesimal

Place: Bhopal Dr. S. K Mishra

I am also thankful to the most respected Dr S.K.Mishra ,Principal , Govt. Homoeopathic

S.No. Content Page no.

1. Bar diagram showing age distribution 24

2. Pie diagram showing family history of dysmenorrhoea 25

3. Pie diagram showing family history of other diseases 26

4. Bar diagram showing major clinical features of patients 27

5. Pie diagram showing distribution of predominant miasm 28

6. Pie diagram showing previous system of treatment adopted 29

7. Bar diagram showing indicated medicines 30

8. Bar diagram showing religion of patients 31

9. Bar diagram showing socioeconomic status of patients 32

10. Pie diagram showing result of treatment 33

S.No. Content Page no.

3. Family history of dysmenorrhoea 25

4. Family history of other diseases 26

5. Distribution of patients according to major clinical features 27

6. Distribution of predominant miasm 28

7. Previous system of treatment adopted 29

8. Indicated medicines in primary dysmenorrhoea 30

10. Socio economic status of patients 32

11. Result of treatment 33

12. Statistical analysis 35

13. Result of assessment criteria 36

14. Master chart 88

1. NPRS - Numeric pain rating scale

2. FSH - Follicle stimulating hormone

4. OCPs -Oral contraceptive pills

5. IUCD - Intrauterine contraceptive device

S.no. Contents Page no.

Background and objectives-

Menstruation is a physiological phenomenon in which some amount of pain is normal but if it

effectiveness of medicine in 50 millesimal potencies for treating primary dysmenorrhoea is

Materials and methods-

improved, 73%were moderately improved and 3% of them had no improvement.

of pain in consequent menstrual cycles.

Homoeopathy is an art, a science and a philosophy which works on the principle of

medicines work on the dynamic energy level. [1]

Menstruation is a physiological phenomenon in which there is shedding of oestrogen and

progesterone primed endometrium through vagina at a regular interval of 28-35 days

lactation[2].Some amount of pelvic pain and discomfort is normal but if it

incapacitates a women to do her daily routine works then it is termed as

dysmenorrhoea.45%-95% of menstruating women suffers from dysmenorrhoea

which is a common and debilitating gynaecological condition.[3].Primary

dysmenorrhoea is the menstrual pain which is functional and there is no pathologic