“THE STUDY OF HOMOEOPATHIC REMEDY

PROFILE ON TINEA CORPORIS”

By

DR SHARANENDRA. B. PAGA

Dissertation Submitted to

Rajiv Gandhi University of Health Sciences, Karnataka, Bengaluru

In partial fulfillment

Of the requirements for the degree of

Doctor of Medicine
In
Homoeopathic Materia Medica

Under the guidance of

Prof. DR. SUNNY MATHEW

Department of Homoeopathic Materia Medica

Father Muller Homoeopathic Medical College & Hospital
Deralakatte, Mangalore.

2012

1
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BENGALURU

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation/ thesis entitled “THE STUDY OF HOMOEOPATHIC

REMEDY PROFILE ON TINEA CORPORIS” is a bonafide and genuine research work

carried out by me under the guidance of Dr. SUNNY MATHEW, Professor, Department of

Homoeopathic Materia Medica during the year 2009-2012 in partial fulfillment of regulations of

Rajiv Gandhi University of Health Sciences Karnataka, Bengaluru for the award of ―DOCTOR

OF MEDICINE (HOMOEOPATHIC MATERIA MEDICA)‖

I have not previously submitted this work (partial or full) to any other Degree or

Diploma.

Date: DR. SH ARANENDRA.B.PAGA.

Place: Mangalore

2
 CERTIFICATE BY THE GUIDE

This is to certify that the dissertation entitled “THE STUDY OF

HOMOEOPATHIC REMEDY PROFILE ON TINEA CORPORIS” is a bonafide

research work done by DR.SHARANENDRA B. PAGA during the year 2009-2012 in

partial fulfillment of the requirement for the award of the degree of DOCTOR OF

MEDICINE (HOMOEOPATHIC MATERIA MEDICA).

I have satisfied myself regarding the authenticity of his observations noted in this

dissertation and it conforms to the standards of Rajiv Gandhi University of Health

Sciences, Karnataka, and Bengaluru. It has not been submitted (partial or full) for the

award of any other Degree or Diploma.

Guide
Date: Dr. SUNNY MATHEW
Place: Mangalore BHMS, MD (HOM)

Professor,
Department of Homoeopathic Materia Medica,
Father Muller Homoeopathic Medical,
College and Hospital, Deralakatte, Mangalore

3
 ENDORSEMENT BY THE HOD, PRINCIPAL/
HEAD OF THE INSTITUTION

This is to certify that the dissertation entitled “THE STUDY OF HOMOEOPATHIC

REMEDY PROFILE ON TINEA CORPORIS” is a bonafide research work done by

DR. SHARANENDRA B. PAGA during the year 2009-2012, as a partial fulfillment of the

requirement for the award of the degree of ―DOCTOR OF MEDICINE (HOMOEOPATHIC

MATERIA MEDICA)‖.

I have satisfied regarding the authenticity of his observations noted in this dissertation

and it confirms the standards of Rajiv Gandhi University of Health Sciences, Karnataka,

Bengaluru. It has not been submitted (partial or full) for the award of any other Degree or

Diploma.

Head of the Department Principal

DR. SRINATH RAO DR. SRINATH RAO

B.H.M.S., M.D (HOM) B.H.M.S., M.D (HOM)

Professor Father Muller Homoeopathic Medical

Dept. of Materia Medica College &Hospital
Father Muller Homoeopathic Deralakatte, Mangalore
Medical College& Hospital
Deralakatte, Mangalore

Date: Date:
Place: Mangalore Place: Mangalore

4
 COPYRIGHT

Declaration by the candidate

I hereby declare that Rajiv Gandhi university of Health sciences, Karnataka,

Bengaluru shall have the rights to preserve, use and disseminate this dissertation/ thesis

in print or electronic format for academic / research purpose.

Place: Mangalore

Date: Dr. SHARANENDRA. B. PAGA

 Rajiv Gandhi university of Health Sciences, Karnataka

5
 DEDICATED

TO MY DEAR PARENTS

MR BASAVANAPPA S. PAGA

MRS. SHAKUNTALA B. PAGA,

MY SISTERS & MY BROTHER

MRS RAJESHWARI M.MELAKUNDI

MRS KANCHANA K. KANAKI

MR BANSHANKAR B. PAGA

&

AND TO MY DEAR FIANCE

DR AKSHATA N.J

6
 ACKNOWLEDGEMENT

I consider this as my privilege to thank the Almighty God for helping me to

achieve this humble task through the following persons who have been of immense help

and source of encouragement in my endeavor.

I would like to express my sincere and heartfelt thanks to my respected teacher

and guide Dr. Sunny Mathew, Professor, Department of Homoeopathic Materia

Medica for providing me expert guidance, constructive advice, freedom of thought,

personal attention, timely support and encouragement throughout my post graduate

course and during the dissertation work. It is my good fortune to do this work under his

guidance.

It is my privilege to express sincere gratitude to Director, Rev. Father Patrick

Rodrigues, Father Muller Charitable Institutions, The Administrator, Rev. Father

Wilfred Prakash D’Souza, Father Muller Homoeopathic medical college, Mangalore for

providing me an opportunity and adequate facilities to carry out this work to my

satisfaction in this reputed institution.

I am extremely grateful to Dr.Srinath Rao, Principal and Head of the Department

of Homoeopathic Materia Medica, for his valuable guidance and extending all necessary

facilities to take up this endeavor.

I also express my heartfelt thanks and gratitude to Prof. Dr. Shivaprasad K

Vice Principal, & Head of the Department of Organon of Medicine and Homoeopathic

Philosophy for his constant support, and encouragement.

I have to give my special thanks to Dr M.K. Kamath, our PG Coordinator for his

valuable suggestions. I also thank him for the kind of clinical understanding he imparted

to us, it‘s my good fortune to be his student.

7
 I would like to give special thanks to Dr Praveen Raj, Prof, dept. of organon and

philosophy for his constant support, encouragement, and for Inculcating clinical skills,

which made me confident enough to practice Homoeopathy.

I am failing in my duties if I am not mentioning my sincere gratitude to

Dr Guruprasad and Dr N.M.Dhole for helping me to sharpen my clinical acumen. I

also want to extend my hearty thanks to Dr Prasanna Kumar, Dr Amitha, Dr Girish

Navada, Dr Rajachandra , Dr Ranjan for their constant love and support during my

PG Programme.

I extend my gratitude to all my friends, my classmates especially Dr Sagar S.J,

Dr. Nivedita Dr.Praveen rai, Dr Praveen kulkarni, Dr. Ravi. J and Dr. Anu Joseph.

And to my seniors and juniors whose co-operation and timely help considerably eased

my task.

I must thank my dept mates Dr. Sr.Saritha, Dr vidhya. P, Dr. Subhapradha, Who

showed sisterly attitude and remained as models to share and learn. Their companionship

made my every task easy and I attribute part of success and strength to them.

I thank all the members of non-teaching staff of Father Muller Homoeopathic

Medical College and the staff of outpatient department who has provided me with the

case material required for the study.

Last but not the least, my sincere thanks to all the Patients on whom the study was

conducted and A1 solutions, Kankanady for taking pains to complete this work in time.

Place: Mangalore DR SHARANENDRA. B. PAGA

Date :

8
 LIST OF ABBREVIATION

+ : Present

0 : Absent

< : Aggravation

> : Amelioration

: Decreased

: Increased

& : And

A/F : Ailments from

Agg : Aggravation

Amel : Amelioration

App : Appetite

Av : Aversion

BP : Blood Pressure

Cr : Craving

DO : Dropped out

D/E : Date of examination

DM : Dominant Miasm

eg : Example

F : Female

FM : Fundamental miasm

H.S : Hora Somni- At bed time

9
Kg : Kilogram

Lt : Left side

M : Male

MT : Mother tincture

NS : Nothing significant

NAD : No abnormalities Detected

O/E : On Examination

℞ : Recipio- to take

S : Same

S.L : Saccharum lactis- sugar of milk

Sl. No : Serial Number

10
 ABSTRACT

Background:

Tinea corporis refers to all dermatophytoses of glabrous skin except the palms,

soles, and groin1, which is seen in all age groups, much common in animal workers and

manual laborers, its transmission is usually by autoinoculation from one part of body i.e.,

from tinea pedis and tinea capitis. Contact with animals or contaminated soil, more

common in tropical and subtropical regions.6

The classic presentation is an annular lesion with scale across the entire

erythematous border. The border is often vesicular and advances centrifugally. The center

of the lesion is usually scaly, but may exhibit clearing. Concentric vesicular rings suggest

tinea incognito caused by T. rubrum, whereas the concentric rings of tinea imbricate

demonstrate little to no vesiculation. T. rubrum infections may also present as large,

confluent polycyclic or psoriasiform plaques.8

According to other systems of medicine tinea corporis is a superficial fungal

infection, which is usually treated by external application, which is merely palliating or

suppressing the disease condition, but homoeopathy is having wider and better scope in

giving a gentle and permanent results in cases of tinea corporis.

11
Objectives:

1. To assess the effectiveness of constitutional approach in the treatment of tinea

corporis.

2. To analyze group of remedies effective in the treatment of Tinea corporis.

Methods:

Thirty patients suffering from tinea corporis were selected on the basis of inclusion

and exclusion criteria. Case taking was done according to the scheme of SCR format with

special emphasis on points needed for the homoeopathic treatment. Repertorisation was

done according to the need of the case.

Follow-up criteria: Parameters for evaluating the result for the study was formulated.

Results:

The results of the treatment of 30 cases taken up for the study were as fallows.26

cases were improved i.e.87.00%, 03 cases i.e.10% were not improved during the

treatment and 01 case i.e. 3.00% were drop out.

Conclusion:

Homoeopathic treatment is effective in the treatment of patients suffering from

Tinea corporis.

Key words:

Tinea corporis, constitutional medicines, acute medicines, remedy profile used in

tinea corporis.

12
 TABLE OF CONTENTS

SL. PAGE
TITLE
NO NO.

1. INTRODUCTION 01

2. AIMS AND OBJECTIVES 04

3. REVIEW OF LITERATURE 05

4. METHODOLOGY 44

5. RESULTS 46

6. DISCUSSION 81

7. CONCLUSION 86

8. SUMMARY 87

9. BIBLIOGRAPHY 88

10. ANNEXURES

ANNEXURE – I 92

ANNEXURE – II 93

ANNEXURE -- III 104

ANNEXURE -- IV 113

ANNEXURE -- V 116

13
 LIST OF TABLES

TABLE NO. TITLE PAGE NO.

1. DISTRIBUTION ACCORDING TO AGE INCIDENCE 46

2. DISTRIBUTION ACCORDING TO SEX INCIDENCE 46

3. DISTRIBUTION ACCORDING TO MIASMATIC 47

EXPRESSION

4. DISTRIBUTION ACCORDING TO 47
CONSTITUTIONAL REMEDIES USED IN STUDY

5. DISTRIBUTION ACCORDING TO ACUTE 48

REMEDIES USED IN STUDY

6. DISTRIBUTION ACCORDING TO URBAN AND 49

RURAL AREAS

7. DISTRIBUTION ACCORDING TO OCCUPATIONAL 49

INCIDENCE

8. DISTRIBUTION OF CASE ACCORDING TO 50

RELIGION

9. RESULTS OF THE TREATMENT 50

10. 51
STATISTICAL ANALYSIS

14
TABLE NO. TITLE PAGE NO.

11. REMEDY PROFILE 58

12. SULPHUR- CASES 58

13. ARSENICUM ALBUM- CASES 62

14. NATRUM MURIATICUM - CASES 65

15. TELLURIUM – CASES 68

16. BACILLINUM – CASES 71

17. LYCOPODIUM – CASES 74

18. CALCAREA CARB – CASES 77

19. PHOSPHORUS- CASES 79

15
 LIST OF FIGURES

FIGURE NO. TITLE PAGE NO.

1. SKIN 06

2. TINEA CORPORIS 10

3. DISTRIBUTION ACCORDING TO AGE 54

INCIDENCE

4. DISTRIBUTION ACCORDING TO SEX 54

INCIDENCE

5. DISTRIBUTION ACCORDING TO MIASMATIC 54

EXPRESSION

6. DISTRIBUTION ACCORDING TO 55
CONSTITUTIONAL REMEDIES USED IN STUDY

7. DISTRIBUTION ACCORDING TO ACUTE 55

REMEDIES USED IN STUDY

8. DISTRIBUTION ACCORDING TO URBAN AND 55

RURAL AREAS

9. DISTRIBUTION ACCORDING TO 56
OCCUPATIONAL INCIDENCE

10. DISTRIBUTION ACCORDING TO RELEGION 56

11. DISTRIBUTION ACCORDING TO RESULTS OF 56

THE TREATMENT
12. STATISTICAL ANALYSIS 57

16
Introduction

17
 INTRODUCTION
A healthy skin is a source of pleasure not only to its owner but also to the one

who looks at it. Skin does more than present one‘s ‗Face‘ to the world; it plays a vital

role in the maintenance of physical & mental health.

The skin is the largest organ of the body and is also the most varied organ, since it

adapts itself as the occasion requires.

Skin is tough, resilient & virtually impermeable to aqueous solutions, bacteria or

toxic compounds. Skin varies in thickness & other qualities from one part of the body to

another, which often accounts for the distribution of skin diseases.

The layers of the skin are a lot like the layers of soil in a flowerbed. Each layer

has its use and all the skin layers (or soil) work together to provide nutrients and

protection for the stuff growing in it.

Skin is man‘s front-line protective barrier between internal structures & the

external environment. Because it interfaces with the environment, skin plays a key role

in protecting (the body) against pathogens and thus it is also prone to various diseases.

Tinea corporis is one among them which is commonly seen in population.

Tinea corporis refers to all dermatophytoses of glabrous skin except the palms,

soles, and groin. Although any dermatophyte can cause tinea corporis, but the most

common causes are T. mentagrophytes. T. rubrum. and M. canis. T. rubrum and T.

verrucosum are the most likely candidates in cases with additional follicular involvement.

The classic presentation is an annular lesion with scale across the entire

erythematous border. The border is often vesicular and advances centrifugally. The center

of the lesion is usually scaly, but may exhibit clearing.

18
 At this stage, the other schools trying to combat this condition with their local

treatment by external ointments & medicaments which do nothing but simply suppress or

palliate the state; that later on being followed by the contrary condition, i.e., the return of

the evil, often seriously aggravated. This suppression is the cause of many constitutional

diseases & the source of many functional disturbances.

In Homoeopathy, the concept of a “whole” or “the holistic concept” is taken into

account, rather than the so called ‗Local treatment’. The ‗cause‘ or the ‗stimulus‘ after

passing through this organic whole, thereby becomes completely changed, any action

issuing from it has the stamp of an individualistic whole upon it. So, it is not the mere

‗stimulus‘ or the ‗local part‘ that needs to be treated, but the ‗person‘ as a whole… In

relation to this, Hahnemann once said, “There are no diseases, but sick people”.

Disease, to the homoeopathy, is a state of disharmony involving at least three

different factors, some morbific influence, the susceptibility of the person affected and

the individuality of the person.

The idea that the skin can be improved or cured by outward application is, of

course, held by specialists in skin diseases, by dermatologists. As the diseases &

disorders of the skin are hardly ever restricted to the skin itself but come from within the

body, these disorders must be treated from within. Outward treatments can only do

mischief by depriving the body of the much needed outlet & driving the troubles inside.

Treatment with antifungal and topical application merely suppresses the tinea

(resulting condition) which may occur again and again. In some cases, suppressed tinea

may lead to some systemic diseases.

19
 To treat the cases of tinea, the system of homoeopathy is enriched with several

medicines which are harmless and help the patients to recover from this condition. The

treatment is based on totality of symptom which is obtained after individualizing the case

and finding out characteristics. Homeopathy holds that every individual is unique and

thus needs unique treatment when he is sick. It is possible to handle every case according

to its individual presentation because of special nature of Materia Medica and its

therapeutic application based on the law of similar.

To deal with cutaneous reaction to fungal infection is a challenge to a

Homoeopath. Successful treatment with Potentised & Dynamized diluted doses of

medicine produces dramatic results which are satisfying both to the suffering patient &

the treating Homoeopath.

I thus being a Homoeopath feel it a privilege & wish to take up this clinical

condition of tinea corporis to understand its presentation, constitutional approach, the

utility of Homoeopathic treatment & arrive at a group of medicines to set the vital energy

in order, thus enabling it to function properly.

20
Aims &
Objectives

21
OBJECTIVES

1. To assess the effectiveness of constitutional approach in the treatment of Tinea

corporis.

2. To analyze group of remedies effective in the treatment of Tinea corporis.

22
Review of
Literature

23
 REVIEW OF LITERATURE

Tinea Corporis (Tinea Circinata)

Tinea corporis refers to all dermatophytoses of glabrous skin except the palms,

soles, and groin.1

Historical Aspects

Systematic study of superficial fungal infection began more than 150 years ago

when Remak described the mycelial nature of the clinical disease favus. In 1841, Gruby

isolated the organism of favus in culture and experimentally reproduced the disease with

inoculation in normal skin. However, it was not until 1910 that Raymond Saboraud

published his seminal treatise, Les Tiegnes, classifying the dermatophytes into four genera

based on their microscopic and clinical characteristics. In 1934, Emmons' critical review

of dermatophyte taxonomy resulted in the three genera known today: Epidermophyton,

Microsporum, and Trichophyton.1

ANATOMY OF SKIN:

Anatomy of skin helps for proper understanding about development, involvement,

progress, diagnosis, prognosis of tinea corporis.

The skin is composed of superficial epithelial layer the epidermis and an underlying

connective tissue layer, the dermis or corium and another connective tissue layer, the

Hypodermis or subcutaneous layer.

24
 Fig no: 1.SKIN

EPIDERMIS:

The epidermis is formed of non-vascular stratified epithelium. Its usual thickness

is between 0.07 to 0.12mm .the epidermis is mainly divisible in to 2 main systems

Keratinizing or malphigian system (keratinocytes) which forms the bulk and the

pigmentary system (melanocytes) which produces the pigment melanin. Melanin is

transferred to keratinocytes through the dendrites of melanocytes. The main layers of

epidermis are -

25
. Stratum germinativum

. Stratum Malpighi or prickle cell layer

. Stratum lucidum

. Stratum corneum

. Basal lamina (Basement membrane)

DERMIS:

This layer consists of bundles of collagen and elastic fibers arranged in a reticular

fashion. It is profusely supplied with blood vessels. Superficially dermis is condensed in

to a dense fibrous network, the basement membrane, connected to epidermis. Its deeper

part merges imperceptibly into the hyper dermis. Beneath the basement membrane there

are many blood vessels forming a capillary network. Microscopically in dermis there are

many hair follicles, various type of sebaceous and sweat glands, plain muscle fibers

sensory end organs like pacinian and meissner‘s corpuscles and adipose tissue. There are

few round cells, and occasional fibrocytes and a few pigment carrying histolytic called

melanophores.

SWEAT GLANDS:

They are of 2 types

(1) Eccrine glands. (2) Apocrine glands.

Eccrine glands small sized sweat glands which are distributed all over the skin

except on nail beds, margins of lips and glans penis. They secrete sweat through sweat

ducts in to epidermis.

Apocrine glands are specialized sweat glands in axilla, areola, nipples, umbilicus

etc. Their secretions are odoriferous with secondary sexual significance.

26
HAIR:

Present on every part of body except palms, soles, inner surface of labia, prepuse

and glans penis. Hairs vary in different individuals, nationalities and types. There are 3

types

(1) Fine downy or lungo hairs found upon general surface.

(2) Short, strong or bristly hairs found in eyebrows, eyelashes etc.

(3) Long softer hair of scalp, beard etc.

The portion of hair in skin is root and the part beyond skin is shaft.

PIGMENT:

The shade of color of the skin is partly due to degree of vascularity and partly due

to amount of straining in the cells of the lower strata of the nuclei and due deposit of fine

granules of pigment, melanin, in the cell cavity. The amount of coloring matter in the

layers of epidermis is influenced somewhat by exposure to sun, habits climate, racial and

other differences.

BLOOD:

The epidermis has no vascular supply, but the corium and subcutaneous tissue are

liberally supplied with truncal and capillary vessels. Arterial supply derived from

subcutaneous branches, which passes through fascia and by division from three separate

vascular districts. The deepest variety supply the subcutaneous fat, the middle district

sends off arterioles to form a capillary plexus for the sweat glands and upper districts

supplied from ascending artery for the hair follicles, sebaceous glands and papillae.

27
Venous plexus accompany the arterial in all portions of the skin merge into venous

sinuses which end in subcutaneous veins.

LYMPHATICS:

All the portions of skin are provided with a system of lymphatic channels, which

aid in the important process of absorption. Lymph is so abundantly supplied to the skin

through lymph channels which are so abundantly supplied to the skin through corium,

and coverage near the middle of the base where lymphatic vessels usually begins from

the apices of the papillae lymph flows in to mucus layer of epidermis, then slowly returns

to corium by way of interpapillary depressions of epidermis or ducts of sweat glands and

fat tissue goes by slow infiltration into neighboring veins or lymph vessels. This

facilitates in formation of subcutaneous fat.

NERVE SUPPLY:

The skin is well endowed with medullated and non-medullated autonomic fibers.

Non medullated fibers supply blood vessels and appendages. Conspicuous nerve supply

consists of plexuses in papillae, meissner‘s corpuscles, pacinian corpuscles, Merkel‘s

discs and nerve endings in the basal layer of epidermis.21

SKIN FUNCTIONS

Protection against

Water loss - stratum corneum

Water gain - Stratum corneum

Toxic substances penetration - Stratum corneum

Microbial attack - Stratum corneum

Mechanical injury - Stratum corneum + dermis

28
Thermal regulation

Via heat loss sweat evaporation – eccrine sweat

Vasomotor regulation – vasculature

Via heat conservation Body hair

Insulation provided by body fat

Sensory functions via free nerve endings and end organs

Secondary sexual characteristics

Immune functions – Protections against foreign antigen from epidermal antigen

presenting cells (Langerhans‘s cells)

Metabolic – Vitamin D synthesis

Radiation (IV) protection1

Tinea Corporis (Tinea Circinata)

Fig no 2: Tinea corporis

Tinea corporis refers to all dermatophytoses of glabrous skin except the palms,

soles and groin.1

29
MYCOLOGY

The dermatophytes are a group of taxonomically related fungi whose ability to

form molecular attachments to keratin and use it as a source of nutrients allows them to

colonize keratinized tissues, including the stratum corneum of the epidermis, hair, nails,

and the horny tissues of animals. Superficial infection caused by a dermatophyte is termed

dermatophytosis, whereas dermatomycosis refers to systemic or deep fungal infections.1

EPIDEMIOLOGY:

Tinea corporis may be transmitted directly from infected humans or animals, via

fomites or via autoinoculation from reservoirs such as T. rubrum colonization of the feet.9

Children are more likely to contact zoophilic pathogens, especially M. canis from dogs or

cats. Occlusive clothing and a warm, humid climate are associated with more frequent and

severe eruptions.3 the occlusive clothing, frequent skin-to-skin contact, and minor trauma

(mat burns) of competitive wrestling create an environment in which dermatophytes

flourish. Numerous outbreaks of ―tinea corporis gladiatorum‖ have resulted, mostly caused

by T. tonsurans4. Preliminary evidence suggests a high prevalence of disease even in the

absence of an epidemic. Tinea imbricata, caused by T. concentricum, is largely limited to

areas of the Far East, South Pacific, and South and Central America and is more prevalent

in natives than resident nonnatives. Explanations for this observation include the necessity

to acquire chronic infection in early childhood and genetic susceptibility5.

Age of Onset: All ages

Occupation: Animal (large and small) workers

30
Transmission: Autoinoculation from other parts of the body, i.e., from tinea pedis and

tinea capitis, Contact with animals or contaminated soil.

Geography: More common in tropical and subtropical regions

Predisposing Factors: Most commonly, infection is spread from dermatophytic

infection of the feet (T. rubrum, T. mentagrophytes). Infection can also be acquired from

an active lesion of an animal (T. verrucosum, M. canis) or rarely, from soil (M.

gypseum).6

Incubation Period: Days to months

Duration: Weeks to months to years.6

ETIOLOGY:

Although any dermatophyte can cause tinea corporis, the most common causes are

T. mentagrophytes, T. rubrum, and M. canis. T. rubrum and T. verrucosum are the most

likely candidates in cases with additional follicular involvement. 7

CLINICAL MANIFESTATIONS:

Tinea corporis presents in many variants. The classic presentation is an annular

lesion with scale across the entire erythematous border. The border is often vesicular and

advances centrifugally. The center of the lesion is usually scaly, but may exhibit clearing.

Concentric vesicular rings suggest tinea incognito caused by T. rubrum, whereas the

concentric rings of tinea imbricata demonstrate little to no vesiculation. T. rubrum

infections may also present as large, confluent polycyclic or psoriasiform plaques.

31
INVESTIGATION

The Diagnosis of Pityriasis versicolor can be confirmed by following

investigations

(i) KOH Preparation.

(ii) Cello phone tape Examination and staining with periodic acid Schiff‘s (PAS)

reagent.

(iii) Wood‘s Lamp Examination.

(iv) Culture on Sabouraud‘s medium.8

LABORATORY FINDINGS

Any erythematous, scaly eruption should be scraped for KOH examination.

Obtaining scales by scraping outward from the active border maximizes sensitivity, while

vesicles and bullae harbor the most organisms in their roofs. Because of the high rate of

false-negative KOH preparations, fungal culture of scrapings is often necessary for

diagnosis. However, in cases with dermal granulomata, culturing biopsy material produces

the highest yield.

PATHOLOGY

PAS stains of typical tinea circinata reveal red hyphae within the stratum corneum.

Hyphae are basophilic with hematoxylin & eosin, and stain black with methenamine

silver. If organisms are absent, the histopathology is nonspecific and resembles an acute or

chronic dermatitis with or without spongiotic vesiculation. The nodular perifolliculitis

variant caused by T. rubrum, displays a perifollicular granulomatous reaction commonly

32
accompanied by central necrosis and suppuration. Organisms are present in the hairs &

dermis, and large spores (6 µm) may be found within multinucleated giant cells. 1

DIFFERENTIAL DIAGNOSIS

The differential diagnosis of annular tinea corporis includes erythema annulare

centrifugum, nummular eczema and granuloma annulare.

Erythema annulare centrifugum is distinguished by scale at the trailing edge of

the advancing border instead of over the entire border.

Nummular eczema tends to produce more numerous and symmetric lesions than

tinea corporis, and lacks central clearing.

Granuloma annulare consists of intradermal papules without scale.

A papulosquamous lesion of tinea corporis may resemble psoriasis, lichen planus,

secondary syphilis, seborrheic dermatitis, pityriasis rosea, or pityriasis rubra pilaris.

These are usually readily differentiated by their unique clinical features, otherwise a

biopsy is diagnostic.

Tinea faciei often lacks a distinct raised scaly border and may mimic a

photodermatosis such as lupus erythematosus or dermatomyositis. However, most tinea

faciei lack the follicular plugging and poikiloderma of connective tissue diseases.

Other photodermatoses to consider include polymorphous light eruption, contact

dermatitis and acne rosacea. For inflammatory variants of tinea corporis, other infectious

processes such as bacterial, candidal or deep fungal infections should be considered.

Verrucous and granulomatous lesions can resemble mycobacterial infections or

blastomycosis1

33
 HOMOEOPATHIC APPROACH
Homoeopathy is a science of therapeutics which helps to restore the skin to health

by administering medicine based on the principle of SIMILIA SIMILIBUS CURENTUR

– let like be cured by likes.

Tinea corporis is an external presentation of an internal disorder due to lowered vitality

and immunity. Homoeopathy does not believe in treating any skin diseases by simply

applying ointment or creams.10

HOMOEOPATHIC VIEW ON THE CAUSE OF TINEA

According to Dr P.N.Banerjee

– It is the constitution of an individual that becomes sick first. This sick

constitution renders itself vulnerable to the various environmental influences. Dr.

Hahnemann found that the factor which renders the constitution sick & susceptible is an

invisible dynamic disease producing potential (Aph.16). It deranges the vital force of the

economy. This factor he termed as Miasm (Aph.78). They are three in number viz. psora,

sycosis & syphilis. They are the fundamental causes of all chronic & natural ailments11.

Hahnemann quotes in Aph.5

―Useful to the physician in assisting him to cure are the particulars of the most

probable exciting cause of the acute disease as well as the most significant points in the

complete history of the chronic disease, to enable him to discover its fundamental cause,

which is generally to a chronic miasm. In these investigations, the ascertainable physical

constitution of the patient (especially when the disease is chronic), his moral &

intellectual character, his occupation, mode of living & habits, his social & domestic

relations, his age, sexual function, etc., are to be taken into consideration.12

34
FUNDAMENTAL CAUSES

Dr. Samuel Hahnemann quotes: ―The Psora is the only cause of all the several

diseases of mankind; or in other words, this ―Psora‖ is the only disease, while all the so-

called diseases, having all the different shapes & names, are its different expressions‖.13

Aphorism – 78

The true natural chronic diseases are those that arise from a chronic miasm, which

when left to themselves, & unchecked by the employment of those remedies that are

specific for them, always go on increasing & growing worse, notwithstanding the best

mental & corporeal regimen, & torment the patient to the end of his life with ever

aggravated sufferings. These are the most numerous & greatest sources of the human

race; for the most robust constitution, the best regulated mode of living, & the most

vigorous energy of the vital force are insufficient for their eradication.12

Aphorism – 80

Incalculably greater & more important than the two chronic miasms just named,

however, is the chronic miasm of psora, which, whilst those two reveal their specific

internal dyscrasia, the one by the venereal chancre, the other by the cauliflower-like

growths, does also, after the completion of the internal infection of the whole organism,

announce by a peculiar cutaneous eruption, sometimes consisting only of a few vesicles

accompanied by intolerable voluptuous tickling itching (& a peculiar odors), the

monstrous internal chronic miasm – the psora, the only real fundamental cause &

producer of all the other numerous, I may say innumerable, forms of disease, which

under the names of nervous debility, hysteria, hypochondriasis, mania, melancholia,

35
imbecility, madness, epilepsy & convulsions of all sorts, softening of the bones (rachitis),

scoliosis & kyphosis, caries, cancer, jaundice, fungus hematodes, cyanosis, dropsy,

amenorrhoea, hemorrhages from the stomach, nose, lungs, bladder & womb, of asthma &

ulceration of the lungs, of impotence & of barrenness, of megrim, deafness, cataract,

amaurosis, urinary calculus, paralysis, defects of the senses & pains of thousand kinds,

etc., figure in systematic works on pathology as peculiar, independent diseases.12

Emotional causes

There are three basic miasms affecting the integumentary system: psora, sycosis

& syphilis. Miasmas lie dormant in a person‘s genetic make-up until a pre-encoded

trigger is activated by the occurrence of something contraindicated to that individual‘s

maintenance of well-being. These triggers are most commonly a trauma or intervention

of some kind that affects the person‘s physical or mental status.14

Here it can be seen that the basic emotions of anger & resentment, grief & guilt

and inability to let go, are major keys to the resolution of skin problems

Recent works on emotion has revealed the fact that, it can cause various

psychosomatic illnesses, which has been postulated by Hahnemann long before the birth

of scientific psychology. The importance of emotional reaction has been associated with

a number of illnesses like peptic ulcers, diabetes, hypertension, skin eruption, etc.15

Often, a simple error in diet, a hot bath, a mineral bath, overheat of the sun, wetting the

body or the feet, an undue excitement or over joy, continued grief, disappointment,

failure in business, or life, generally may be the starting point, whereby psora is aroused

from its slumber.16

36
PATHOLOGY AND HOMOEOPATHY

Dr J.H.Allen writes

―The absolute in disease, then, we see to be miasmatic action. There is no other

cause behind it, save a broken law, which has given that we might follow its teaching &

have life, even life in larger sense. As we study these miasms, we see they express

themselves in these degrees of action – acute, chronic & latent. This fact we recognize in

their secondary or tertiary expression or that which comes under what manifestation of

miasms. Primary action has no pathology, it is functional. It is only reaction that gives

expression, physical form or genesis of any kind. A miasm is only made visible in

proportion as we have these stages & degree of action presented in the organism.

The perverted cell of Virchow in any disease is not at first a pathological one, but

a functionally changed cell, only cognizable by symptoms that are not normal or that are

below the standard of life or what is known as true function. So, it can be readily seen,

that cell perversion which in time becomes pathological, must first be functional & that

there may be any intervening time between that functional change & the appearance of

the pathological post mortem changes & pathology are not always the end of miasmatic

action or the end of disease, although they may be the end or death of the patient.

It is only when the miasm has created something that the pathologist recognizes it

as true disease.16

37
Dr J.T.Kent writes;

―That it is a disorder of the activities of the internal man, a lack of harmony or

lack of balance, which gives forth the signs & symptoms by which we recognize disease.

These sensations constitute the language of disorder, we will see in course of time that,

the change in form of a cell is the result first of disorder, that the derangement of the

immaterial vital principle is the very beginning of the disorder & that with this beginning

there are changes in the sensation by which man may know this beginning, which occurs

long before there is any visible change in the material substance of the body.17

Kent writes in his minor writings, while all tissue changes are the results of

disease, with this thought in mind, it must seem strange that men study morbid anatomy

to be able to find means to correct a wrong that is wholly vital. The pathological anatomy

is the intermediate state while the external image, made up of sensations, is a perfect

likeness of the primitive state; the true disease & these only correspond with each other.

The study of morbid anatomy can never reveal the remedy to correct the ills of man.

ABOUT SKIN DISEASES

According to J.H.Allen

All skin eruptions are either secondary or tertiary expressions of miasmatic

actions. The skin is the mirror or the reflector of the internal stress, the internal dynamics

& the internal workings of this human machine. It has, in the skin its reflection, its

kaleidoscope, its kinetoscopic views of its internal movements & its multiple shading of

disease. Its lights & its shadows, that goes to make up a picture thrown upon that human

canvas. The skin shows much of the perverted life action in the organism.
38
 Pathologically speaking, we look upon the outer men for sight, from markings or

penciling that tells the kind of life within the organism itself. Sometimes these penciling

are like shadow-graphs, showing only faint tracing of the presence of a latent miasm &

again they may be well defined & well developed even to physiological changes of

Colour & proportions.

When we look upon these lesions of the skin, local states or changes in it, we

simply ignore that co-operative principle that rules throughout the organism as a whole &

we attribute that power to apart & to what that which governs the whole. Therefore, our

therapeutic efforts are themselves misdirected & instead of directing the perverted life

forces as right, we misguide them & bring about nothing.

It was upon skin that Hahnemann first saw that true psoric vesicle; it was there,

that he became familiar with psora as it came forth or receded under the positive

influence, of the applied law of similars. It was there that the mysterious veil was lifted &

he was meted to look into the psoric mystery & see the etiology of the disease. It was in

his study of disease that he saw the hemorrhage, the menorrhagia, the insistent local pain,

the abnormal growth, the vertigo, the nervous attack, the spasm, the convulsion, the

mania, the moral insanity & a thousand other things that might be sighted, disappear

forever, as an local expression of an eruptive disease presented upon the self-surface of

the skin and as he watched these multiple presentations that appear so often mysteriously

from within, so we today look for relief and for cure through the same natural processes

or metamorphosis of similia.

The skin of the psoric patient is dry, rough, dirty, or unhealthy looking and not

only that but it has an unwashed appearance & the more you bath it the rougher it

39
becomes, as it cannot endure water. In pseudo-psora, this is magnified in such diseases

like eczema, fissures of the skin. Pruritus of the skin is always a psoric symptom.16

T.P.Chatterjee says

Psora prefers the tissues of ectodermal origin, syphilis, mesodermal tissue and

sycosis, endodermal ones. Its importance lies in the fact that it gives prior information of

the parts of the body prone to be affected by disease after birth. It may be said by way of

explanation the ‗ectoderm‘ is the outermost of three primitive germ layers of the embryo;

from it are derived the epidermis & epidermic tissues, such as nails, hair & glands of the

skin, the nervous system, external sense organs and the mucus membranes of mouth and

anus. Psora affects the tissues of these parts in the embryonic stage and makes them

prone to diseases after birth. Similarly, ‗mesoderm‘, the inter-mediary layer is responsible

for all types of muscles, connective tissue, bone marrow, blood, lymphoid tissues, etc.

Finally, ‗endoderm‘, which is the innermost of the three germ layers of embryo, is

responsible for the epithelium of the pharynx, respiratory tract except nose, digestive

tract, bladder & urethra.14

J. Compton Burnett

Gout in the big toe is not a disease of the said toe; acne on the shoulders of young

persons is not a disease of the skin of the shoulders; neither is a yellow-coated tongue a

disease of the tongue.

In regard to ringworm I am of opinion that absolutely healthy children do not and

cannot, catch it. Before they can catch ringworm it is essential that they be in tainted

40
health in some way, for otherwise they could not supply to the parasitic fungi the food

which they need to live and thrive on, and to continue their propagation.

You cannot grow a common mushroom except under given conditions, neither

can you the trichophyton of ringworm. The trichophyton is not the disease itself, but its

organic scavenger. Cure the internal disease, and this scavenger dies. 18

Dr. Hughes, says- in his Manual of Therapeutics

Hughes, in his Manual of Therapeutics, says that Herpes Cincinnatus (ringworm

of the surface) is usually treated, and with fair success, by Sepia, but that when the

proving of Tellurium produced so similar an eruption, he (Dr. Hughes) followed Dr.

Metcalf in prescribing it instead of Sepia for this disorder, and has never failed to cure it

speedily thereby.

Few need to be told that the task of treating ringworm successfully by external

means; i.e., killing the fungi, is so unsatisfactory, so uncertain, so tedious, so often and

entire failure

The external treatment of ringworm is wrong, because it only deals with the

external manifestations of the internal organismic ailment. Ringworm is an Internal

Disease of the organism having for its outward signs the ringworm consisting of fungi

thriving in a certain order: the fungi are the guests of the diseased host; cure the host‘s

diseased state, and the fungus-the ringworm-dies off from lack of a proper medium.18

41
Hahnemann writes in aphorism 185

Among the one-sided diseases an important place is occupied by the so-called

local maladies, by which term is signified those changes & ailments that appear on the

external parts of the body. Till now, the idea prevalent in the schools was that these parts

were alone morbidly affected, & that the rest of the body did not participate in the disease

– a theoretical, absurd doctrine, which has led to the most disastrous medical treatment.

In aphorism 186

Those so-called local maladies which have been produced a short time previously,

solely by an external lesion; still appear at first sight to deserve the name of local

diseases. But then, the lesion must be very trivial, & in that case it would be of no great

moment…..

In aphorism 190

All true medical treatment of a disease on the external parts of the body that has

occurred from little or no injury from without, must, therefore, be directed against the

whole, must effect the annihilation & cure of the general malady by means of internal

remedies, if it is wished that the treatment should be judicious, sure, efficacious &

radical.

In aphorism 198

The mere topical employment of medicines, that are powerful for cure when given

internally, to the local symptoms of chronic miasmatic diseases is for the same reason,

quite inadmissible; for if the local affection of the chronic disease be only removed

locally & in a one-sided manner, the internal treatment indispensable for the complete
42
restoration of the health remains in dubious obscurity; the chief symptom (the local

affection) is gone, & there remains only the other, less distinguishable symptoms, which

are less constant & less persistent than the local affection, & frequently not sufficiently

peculiar & too slightly characteristic to display after that, a picture of the disease in clear

& peculiar outlines.12

In Hahnemann’s Chronic Diseases, page 101 he says: 27

"For, first of all, no cutaneous eruption, of whatever kind it may be, ought to be

expelled through external means by any physician who wishes to act conscientiously and

rationally. The human skin does not evolve of itself, without the co-operation of the rest

of the living whole any eruption, nor does it become sick in any way without being

induced and compelled to it by the general diseased state by the lack of normality in the

whole organism. In every case there is at the bottom a disorderly state of the whole living

organism, which state must first be considered, and therefore the eruption is only to be

removed by internal healing and curative remedies, which change the state of the whole;

then, also, the eruption which is based on the internal disease, will be cured and healed of

itself, without the help of any external remedy, and frequently more quickly than it could

be done by external remedies".19

P.N.Banerjee say‘s

―All methods of suppression, the most common & the most dangerous, is that by

external application of ointment. It has already been made clear that all itches, etc, on the

skin, which appear to the unintelligent eye as mere local disease independent of men, are

but psora reflected on the external body, they are conditions of the whole man expressed

43
in those particular forms in those particular localities. It is therefore extremely silly to

treat them as independent units & to drive them from their seats‖.21

Dr. Stuart Close writes

―Suppression‖ or palliation of disease is the removal of the external symptoms of

the disease by external, mechanical, chemical or topical treatment, or by means of power

full drugs, given internally in massive dose, which have a direct physiological or toxic

effect but no true therapeutic or curative action. The ‗suppressed‘ case always ‗goes

bad‘.22

H.A.Robert’s say‘s

―The palliative effects of medicines in physiological form are a condition that we

see over & over again, & we can observe the sequence of suppression action, the result

being first palliation & then suppression, or an actual aggravation of the first condition.

The immediate effect of this method of treatment is suppression, but it persisted in &

continued over a period of time. It has the effect of driving the vital energy to express

itself in other form & usually in a deeper & more vital organ‖.23

Dr J. Compton Burnett writes

The generally received external treatment of the disease of the skin, whatever,

with lotions or ointment or whatsoever else, is demonstrably shallow in conception,

wrong in theory, harmful in practice, and therefore inadvisable.24

CLASSIFICATION OF DISEASE

In aphorism 187, Hahnemann classified the ailments appearing on the external

parts as local, dynamic chronic disease with internal cause.

44
 Under the homoeopathic system, while isolation of the allergen in the initial stage

is common, the method of desensitizing is wide based & covers all essential factors

including heredity. Indeed homoeopathy is immunology incarnated. Equipped as the

system is with constitutional remedies & nosodes, it has hardly any equal in this field.

―A strict individualization of the patient is done with due regard to his genetic

pattern, to the influences to which he might have exposed during gestation & at the time

of birth to the environment in which he lives & to the type of temperament he possesses‖.

While the treatment of allergy like skin diseases has to be based on heredity with

due regard to their peculiar particulars, concomitants & alternating symptoms where

available, the general method is to treat first the acute symptoms & then the constitution

by prescribing the constitutional & anti-miasmatic remedies on the basis of totality of the

symptoms & psycho-biographical history of the patient.12

Dr Dhawale says

―Many chronic disorders have a constitutional basis & emotional attitudes play an

important role in facilitating their occurrence and continuance, a well selected remedy

affects them favorably & thus homoeopathic treatment offers unlimited potentialities‖ .25

Holistic approach

Most skin diseases are not diseases of the skin, but they are constitutional diseases

which manifest themselves in the skin and try to produce an outlet for the diseased matter

by way of the skin, the skin acting as a kind of safety valve.26

45
 It is dangerous to stop the safety valve of an overcharged boiler, it might explode.

It is equally dangerous to stop the outlet of a disease which seeks an outlet through the

skin by driving the disease back into the body by means of poisonous disinfectant

ointments, washes, etc., which produce healing of the skin to the danger of the body as a

whole. The fact that a skin eruption is a healing process of nature is perfectly obvious.

A skin condition is a reflection of the individual as a whole, & that in most cases internal

treatment is, therefore necessary, and in some cases, it is the only method of treatment.27

The skin being biologically within the organism, being fed from within, having its

life from within, having its health from within, and having its disease from within, it must

also be treated medicinally from within.24

To Speaking in a strictly homoeopathic sense, there should be no skin specialists,

nor specialists in any other organ or part of the body. The patient should be treated as

whole and on visible manifestations of skin or elsewhere be looked upon as results of

disease and not the disease itself 28.

In conclusion, it would probably be true to say that were the afore-mentioned

principle of Nature generally recognized and the external manifestations of inward

disease treated scientifically by treating the patient as a whole, then more than half the

chronic disease in the world would automatically disappear.

CONSTITUTIONAL APPROACH

Skin diseases are most commonly not merely organic, but at the same time

organismic or constitutional. When a person‘s skin becomes diseased, ‗The roots have

got down on clay‘. If disease of the body bubbles up, so to speak, into the skin like water

46
from a spring, to treat this Disease in (of) the skin by washes and ointments, or other

outward applications, is really not treating the diseased state at all, but only preventing its

peripheral expression.

The symptomatology is by no means confined to the skin itself, but may involve

any part or organ of the body. The true homoeopath recognizes all diseases, whether upon

skin or not, as first a disturbance of the life force or the internal dynamis, & that the

symptoms that manifest themselves upon the skin are simply a reflection or external

expression of the internal change; & that the internal economy is usually relieved by such

an expression.

To the homoeopathic physician, the physical and psychical character of the

patient with all inherited and acquired peculiarities of the sickness, and their similarity to

the symptoms of a certain remedy or poison are very important. To him every well-

proved remedy presents a separate case.

For pathological purposes, the objective or external signs upon the skin are

frequently sufficient, but for a higher therapeutic purpose a fuller comprehension of the

true relationship between the pathological & the primary internal disturbances must be

known, in order to be able to cure our cases by the administration of the internal

homoeopathic remedy.

INDIVIDUALIZATION

S.Close say‘s

―It is a characteristic of Homoeopathy that all of its practical processes are

governed by the principle of individualization. In its drug proving, its study of the

47
Materia medica compiled from those proving; its examination of the patient and study of

a case; its selection of the remedy & its conduct of whatever auxiliary treatment is

required, it seek always to individualize‖ .22

H.A.Robert’s say‘s

―No two individuals are alike; the development of the vital energy in one differs

from that in another. Each one possesses a special personality and a special

psychophysical construction, which is determined by the interplay of hereditary

tendencies & factors of disease‖.23

Kanjilal mentions

―The Homoeopathic treatment must never be directed to any of these isolated

clinical entities, but to the whole totality of symptoms, individualized by some peculiar

characteristic symptoms by which a particular disease condition of the vital force of the

individual patient manifest itself‖.

The concept of totality of symptoms and the principle of individualization,

together permit the Homoeopathic physician to perceive the disease in a manner suitable

for Homoeopathic prescribing.30

CONCEPT OF TOTALITY OF SYMPTOMS

―The totality of symptoms is the outwardly reflected picture of the internal

essence of the disease, that is, of the affection of the vital force, must be the principal, or

the sole means, whereby the disease can make known what remedy it requires, the only

thing that can determine the choice of the most appropriate remedy......‖

48
 Totality of symptoms is not the sum total of symptoms but it speaks of the

essence of the disease.

A successful application of the law of similars rests entirely on the ability of the

prescriber to identify and match portrait of the disease with the portrait of the remedy.12

In aphorism 17 – Hahnemann states that, when a practitioner takes away the

totality of the disease signs, he has removed the entire disease. A thorough understanding

of the patient together with the environmental stresses is essential if a homoeopathic

physician is to portray the disease picture effectively. Thus, the development of

conceptual image is one attempt to help the physician to conceptualize the disorder in the

patient, so that law of similars can be effectively applied.

In aphorism 153 – Hahnemann say‘s

―In this search for a homoeopathic specific remedy, that is to say, in which the list

of symptoms of known medicines, in order to find among these an artificial morbid agent

corresponding by morbific similarity to the disease to be cured, the more striking,

singular, uncommon & peculiar (characteristic) signs and symptoms of the case of

disease are chiefly and most solely to be kept in view, for its more particularly these that

very similar one‘s in the list of symptoms of the selected medicine must correspond in

order to constitute it the most suitable for effecting the cure. The more general and

undefined symptoms; loss of appetite, headache, debility, restless sleep, discomfort and

so forth, demand but little attention, when of that vague and indefinite character, if they

cannot be more accurately described as symptoms of such a general nature are observed

in almost every disease & from almost every disease & from almost every drug‖.

49
He further say‘s in aphorism 154

―If the antitype constructed from the list of symptoms of the most suitable

medicine contains those peculiar, uncommon, singular and distinguishing symptoms,

which are to be met with in the disease to be cured in the greatest number and in the

greatest similarity, this medicine is the most appropriate homoeopathic specific remedy

for this morbid state; the disease, if it be not one of not very long-standing, will generally

be removed and extinguished by the first doses of it, without any considerable

disturbance‖.

According to Boenninghausen, this was elucidated to the following seven

considerations.

 Quis – the personality and peculiarity of the disease.

 Quid – nature and peculiarity of the disease.

 Ubi – the seat of the disease.

 Quibis Auxillis – accompanying symptoms.

 Cur – the cause of the disease.

 Quamado – modifying factors.

 Quando – time.31

CONCEPT OF CURE

The diseases are due to the dynamic influences of the natural morbific agents

inimical to life (miasms). The cure, is removing of the dynamic influence of the miasms

by a similar dynamic agent (medicine).

50
 Dr. Samuel Hahnemann writes in his Organon of Medicine.12

Aphorism 17: ―Now, as in the cure effected by the removal of the whole of the

perceptible signs & symptoms of the disease the internal alternation of the vital principle

to which the disease is due – consequently the whole of the disease – is at the same time

removed, it follows that the physician has only to remove the whole of the symptoms in

order, at the same time, to abrogate & annihilate the internal change, that is to say, the

morbid derangement of the vital force – consequently the totality of the disease, the

disease itself. But when the disease is annihilated, health is restored, & this is the highest,

the sole aim of the physician who knows the true object of his mission, which consists

not in learned-sounding prating, but in giving aid to the sick‖.

Aphorism 29: ―As every disease (not entirely surgical) consists only in a special,

morbid, dynamic alteration of our vital energy (of the principle of life) manifested in

sensation & motion, so in every homoeopathic cure this principle of life dynamically

altered by natural disease is seized through the administration of a medicinal potency

selected exactly according to symptom-similarity by a somewhat stronger, similar

artificial disease-manifestation. By this the feeling of the natural (weaker) dynamic

disease-manifestation ceases & disappears. This disease-manifestation no longer exists

for the principle of life which is now occupied & governed merely by the stronger,

artificial disease-manifestation. This artificial disease-manifestation has soon spent its

force and leaves the patient free from disease, cured. The dynamis, thus freed, can now

continue to carry life on in health. This most highly probable process rests upon the

following propositions‖.

51
 Aphorism 2: ―The highest ideal of cure is rapid, gentle and permanent restoration

of the health, or removal and annihilation of the disease in its whole extent, in the

shortest, most reliable, and most harmless way, on easily comprehensible principles‖.

Ghatak says

―It is the patient who has to be cured & not the disease symptoms that have to be

removed. The true cure, therefore, consists in bringing the sick man to health & not in

removing the disease‖.32

B.K.Sarkar writes as

―Cure is alteration of that altered state of health to its previously normal healthy

state, cure is not worth the name if the health is not restored permanently. A temporary

restoration of the health to be followed by suffering of any sort, falls short of the ideal

cure, palliation or suppression of the state of suffering should not be ideal‖.33

Stuart close writes as

―Cure relates to the case as a whole, cure does not refer to the patient, not to some

symptoms of his disease, nor to what may be called ‗one of his disease‘, cure means

complete restoration to health‖.22

52
 HOMOEOPATHIC THERAPEUTICS

Arsenicum album Skin perfectly dry and rough, covered with dry scales and scabs,

extending sometimes even to forehead, face chest and ears; burning-itching eruption,

parts painful after scratching; scales falling off in patches.39

Agaricus muscarius Tinea favosa, with crusts sometimes spreading to other parts of the

body; biting itching in scalp and other parts of body; scalp sensitive as from subcutaneous

ulceration.39

Arsenicum Iod Tinea dry and rough, and covered with dry scales and scabs;

extend to forehead, face and ears; intense itching and burning.39

Baryta carbonica

Pricking or burning needle like pain, Intolerable itching and tingling over the

whole body at night, Excoriation and oozing in several parts of the skin.36

Bacillinum

Bacillinum is important remedy for ringworm. Lesions: The typical appearance

is of many fine white scales. Location: Face, Scalp, Beard and trunk. Falling of hair in

spots on scalp and face.34

Calcarea carbonica Yellow scabs upon vertex, covering nearly entire top of head,

spreading to face; scabs on scalp, thick and bleeding when picked, also itch a little; dry,

thickly encrusted, foul-smelling eruption, commencing at back of head and extending

over whole head to beard, with crawling and sore itching pain, amel. From scratching;

unhealthy ulcerative skin, even small wounds suppurate.37

Calcarea iodata

53
 Copper-colored and papulous eruptions, tinea favus, crusta lactea, swelling of the

glands, skin cracked, falling out of hair. Easy perspiration.35

Clematis erecta

Skin Red, burning, vesicular, scaly, and scabby, Tinea Itches terribly; worse,

washing in cold water; worse face and hands, scalp around occiput, trunk. Glands hot,

painful, swollen; worse inguinal glands.35

Chrysarobinum

This remedy is used successfully in ringworm, acne rosacea, eczema of the lower

extremities that is attended with intense itching, profuse and offensive discharges.37

Dulcamara Typical ringworm, especially of the scalp, Lesions: Thick, brownish crusts

with reddish borders. Hair falls in spots on scalp, especially temples. Location: Scalp.

Temples. Face. Chin. Worse: Change of weather. 34 Graphites

Skin Moist, crusty eruptions or discolored skin with thick borders. Lesions are

Large, brown with raised margin. Spots of falling hair; matted hair comes out at the root.

Thick hard nails, especially toenails Crumbly nails. Location: Scalp. Face. Groin (Sulph,

Med, Nat-M, Rhus-T) Between toes (Sil) and Nail beds. Worse: Heat and perspiration. 34

Hepar sulphur

Humid eruptions on body, feeling sore, of foetid odor, itching violently on rising

in the morning, burning and feeling sore on scratching; falling off of the hair, with very

sore, painful pimples and large bald spots on scalp; scabs easily torn off, leaving a raw

and bleeding surface41

54
Iris versicolor

Eruptions are seen on scalp, face, around mouth and other parts of the body. Tinea

corporis, crusta lacteal, eczema of face. Impetigo capitis with gastric complaints like

nausea and vomiting. Eruption dry, distinct and of dark hue.37

Juglans regia

Farrington says Jug. r. is one of the best remedies in "tinea favus, especially in the

scalp behind the ear, itching is intense at night so that the patient has difficulty in

sleeping." ―Various exanthematous symptoms, which appear late and run a chronic

course.".36

Lycopodium After abuse of mercury; itching and suppurating eruption on head and

face; full of deep cracks; abundant and foetid discharge; foetid and moist scabs behind

ears; humid tinea. 38

Mezereum

Skin is Red which itches violently; agg. In bed, from touch; burning and change

of place after scratching, Skin covered with elevated white scabs. Itching, esp. at night

(when in bed), more violent and painful (and changed to burning) after scratching the

parts, and sometimes with swelling of the part that has been scratched.36

Mercurius Swelling and suppuration of glands; gastric derangement; moist scabs,

with excoriation of the scalp and destruction of the hair; yellowish scabs on face and on

body, with fetid discharge. 38

Natrium muriaticum Scabs on head and in axillae; oozing of a corroding fluid,

which destroys the hair; scabby eruption about occiput; raw eczema; impetigo aggr. on

55
boundaries of hairy scalp, especially about nape of neck; sore nose, interior of wings of

nose swollen, scabs in nose; hair dull-looking, not glossy, of a dry and inferior quality;

pale, sickly-looking, weak children.18

Phosphorus Dandruff copious, falls out in clouds; roots of hair get gray, and hair

comes out in bunches; burning and itching worse after scratching; the denuded scalp

appears clear, white and smooth38.

Phytolacca decandra Tinea, worse washing it, when he is warm; scaly eruption

on scalp; glands enlarged; blotches on face, aggr. P. M. after eating. 18

Psorinum Moist, suppurating, foetid eruption on head; averse to having head

uncovered; hair dry, lustreless, tangles easily; skin dirty, greasy-looking, with yellow

blotches here and there; the whole body has a filthy smell, even after a bath.36

Radium bromatum

Ringworm where the lesions are very red and burn, perfectly round patches on the scalp

or skin.34 Senna

Skin complaints like itching and burning aggravation at night, Bedsore, I

prescribe the drug in Ringworm get very good results, Great remedy of Ringworm.38

Sepia officinalis

Sepia is one of our most important remedies in these affections, for brown spots

on the skin, circular tetters, pustular eruptions, deep cracks or rhagades, worse from

56
washing in the water; itching eruptions, burning after scratching, dirty yellow and scurfy

skin.41

Silica marina constantly sweaty feet leads to tinea corporis. Moist cracks

between the toes. Thickened nails.34

Sulphur Terribly itchy tinea cruris; red and irritated at folds of scrotum and thigh.
Lesions: Fungal nails. Burning athlete's feet - must leave them uncovered. Location:
Face, Feet, trunk, Toenails. 34

57
Tellurium metallicum Tinea lesions may cover the whole body or only single

parts. Lesions: Circular patches; sometimes intersecting circles, Barber's itch, Hair

falling in spots. Offensive garlic or fish-brine odors from skin. Location: Face, Beard,

Head, trunk, Scalp. Ears. Abdomen. Scrotum and Perineum. 34

Tuberculinum bovinum

Tuberculinum is important remedy for ringworm. Lesions: The typical

appearance is of many fine white scales. Location: Face, Scalp, Beard, falling of hair in

spots on scalp and face. 34 Thuja occidentalis Moist corroding eruption on occiput

and temples, worse from touch, better from rubbing; white scaly dandruff, hair dry and

falling off, extending to eyebrows; wants head and face warmly wrapped. 40

Viola tricolor Urine smells like cat's urine; tinea capitis, with frequent

involuntary urination; impetigo on hairy scalp and face; burning stitches in scalp,

especially in forehead and temples; crusta lactea; thick incrustations, pouring out a large

quantity of thick yellow fluid, which agglutinates the hair; scurfs on head unbearable,

burning most at night; skin difficult to heal.37

58
 REPERTORIAL APPROACH

MURPHY’S REPERTORY

Skin - RINGWORM, general

anac. anag. ars-s-f. BAC. Bar-c. Calc. calc-act. chrysar. clem. dulc. dys. equis-h. Eup-

per. Graph. hell. hep. iod. Lith-c. mag-c. med. Nat-c. NAT-M. phos. PHYT. Sanic. SEP.

spong. sulph. syc. TELL. THUJ. tor. TUB.

rings, in intersecting-tell.

Diseases - TINEA, general - tinea, circinate

aesc. ant-c. calc. graph. hep. lyc. merc. mez. psor. rhus-t. sep. sulph. thuj.

SYNTHESIS 8.1V

SKIN - ERUPTIONS - ringworm

anac-oc. anag. ant-t. Ars. Bac. bapt. bar-m. Calc. chim. chrys-ac. chrysar. cupr. dulc. eup-

per. Graph. jug-c. jug-r. lappa lyc. mez. nat-m. oci-sa. ol-j. phyt. psor. rad-br. Sep. sil.

Sulph. Tela tell. thuj. tub. viol-t

SKIN - ERUPTIONS - herpetic - circinate

anac. anag. ars-s-f. BAC. bacls-10. Bar-c. bar-s. Calc. calc-ar. chrysar. clem. dulc. dys.

equis-h. Eup-per. Graph. hell. hep. iod. lach. Lith-c. mag-c. med. morg. morg-p. Nat-c.

NAT-M. parth. phos. PHYT. psor. rad-br. sanic. semp. SEP. spong. sulph. syc. TELL.

THUJ. tor. TUB.

PHATAK. S. R. CONCISE REPERTORY

59
Ringworm all over, the body

psor. ran-b.

BOERICKE, O. REPERTORY

SKIN - Tinea favosa- favus

agar. ars-i. Brom. calc. dulc. graph. hep. jug-r. Kali-c. lappa Lyc. med. Mez. olnd. phos.

Sep. sulo-ac. sulph. ust. vinc. viol-t.

TRICHOPHYTOSIS - ringworm

Ant. c., Ant. t., Ars., Bac., Calc. c., Calc. iod., Chrysar., Graph., Hep., Jugl. c., Jugl. r.,

Kali s., Lyc., Mez., Psor., Rhus t., Semperv. t., Sep., Sul., Tellur., Tub., Viola tr.

Intersecting rings [in] over great portion of body; fever; great Constitutional disturbances

-Tellur.

Isolated spots [in] on upper part of body

- Sep.

VAN ZANDVOORT R, COMPLETE REPERTORY.2003

SKIN - RINGWORM

SKIN - ROUGH

ALUM. ALUMN. AM-C. anag. APISIN. apoc. ars. ARS-I. bar-c. BELL. bry. CALC.

calen. crot-t. fl-ac. granit-m. GRAPH. hep. hyper. IOD. kali-c. kali-i. LAUR. LITH-C.

mang. merc. mez. NAT-C. NAT-M. nit-ac. olnd. PARTH. PETR. ph-ac. phos. phyt. PLB.

psor. RHUS-T. ruta sabad. sapo-so. sars. SEC. SEP. stram. SULPH. tub. zinc. zinc-o.

60
SCHROYENS. F. SYNTHESIS 9.0

SKIN - ERUPTIONS - ringworm

anac-oc. anag. ant-t. Ars. Bac. bapt. bar-m. Calc. chim. chrys-ac. chrysar. cupr. dulc. eup-

per. Graph. jug-c. jug-r. kali-i. lappa lyc. mez. nat-m. oci-sa. ol-j. phyt. psor. rad-br.

semp. Sep. sil. Sulph. Tela tell. thuj. tub. viol-t.

VAN ZANDVOORT. R. COMPLETE REPERTORY 4.5(CR45)

SKIN - TRICHOPHYTOSIS

abr. ant-c. ant-t. Ars. Bac. calc. calc-i. Chrysar. Graph. hep. jug-c. jug-r. kali-s. lyc. mez.

psor. ran-b. rhus-t. semp. Sep. sulph. Tell. ter. tub. viol-t.

SKIN - ERUPTIONS - herpetic - circinate

aegle-f. anac. anag. ars-s-f. BAC. Bar-c. bar-s. Calc. calc-act. carc. chrys-ac. chrysar.

clem. dulc. dys. equis-h. Eup-per. Graph. hell. hep. Hydrc. iod. Lith-c. mag-c. med.

morg-p. mucor Nat-c. NAT-M. oci-sa. ol-j. phos. PHYT. psor. semp. SEP. spong. sulph.

syc. TELL. ter. thuj. tor. TUB.

SKIN - ERUPTIONS - herpetic - circinate - rings, in intersecting

-tell.

SKIN - ERUPTIONS - herpetic - circinate - spots, in isolated

-sep.

61
CLARKE J.H., CLINICAL REPERTORY (ENGLISH)-CLINICAL-R

Ringworm

anac-oc. anag. ant-t. Ars. Bac. bapt. bar-m. Calc. chim. chrys-ac. cupr. eup-per. jug-c.

jug-r. lappa mez. ol-j. phyt. psor. Sep. Sulph. Tell. viol-t

BOGER.C. BOENNINGHAUSEN’S REPORTORY

SKIN AND EXTERIOR BODY - Tetters (including herpes and eczema)

In general

agar. Alum. am-c. Ambr. anac. ARS. aur. Bar-c. Bell. borx. BOV. BRY. bufo calad.

CALC. caps. carb-ac. carb-an. Carb-v. CAUST. chel. cic. CLEM. cocc. CON. Cupr.

cycl. DULC. FL-AC. GRAPH. hell. hep. hyos. kali-c. kali-n. KREOS. Lach. LED. LYC.

Mag-c. mag-m. mang. MERC. mez. mosch. Mur-ac. NAT-C. Nat-m. Nit-ac. nux-v. Olnd.

op. par. PETR. Ph-ac. PHOS. plb. puls. Ran-b. ran-s. RHUS-T. ruta sabad. Sars. SEP.

SIL. spig. spong. squil. stann. STAPH. sul-ac. sulph. tarax. TELL. teucr. thuj. valer.

verat. Viol-t. Zinc.

Ringworm

Calc. clem. graph. iod. mag-c. NAT-C. Nat-m. SEP. Sulph. Tell. ter. thuj.

SKIN AND EXTERIOR BODY - Tetters (including herpes and eczema)

- eating and spreading at the margins

alum. am-c. bar-c. CALC. carb-v. caust. chel. CLEM. CON. GRAPH. hell. Hep. kali-c.

lach. Lyc. mag-c. mang. Merc. mur-ac. Nat-c. Nit-ac. nux-v. olnd. par. PETR. ph-ac.

phos. plb. RHUS-T. SEP. SIL. Squil. Staph. Sulph. tarax. Viol-t.4

62
Methodology

63
 METHODOLOGY

Sources of data

The subjects for this study have been selected from those patients with tinea corporis

who attended the OPD, IPD, peripheral centers and village camps of Father Muller

Homoeopathic Medical College Mangalore, as per the inclusion criteria

Method of collection of data

Total number of 30 cases were selected by purposive sampling technique. The data was

collected based on clinical history, clinical presentation, and clinical examination and recorded in

the Standardized Case Record (SCR). According to guidelines given in the SCR, cases were

analyzed, synthesized and management was instituted.

Inclusion criteria

1. All patients with tinea corporis between the age group 10 years to 60 years were selected.

2. Both male and female were considered for this study.

3. Diagnostic criteria are mainly based on clinical history, presentation and examination

findings.

Exclusion criteria

1. Subjects below the age of 10 and above the age of 60 of both sexes are excluded.

2. Cases associated with systemic disorders and complications.

eg : Myocardial infarction, Renal failure, Hepatic failure and metabolic disorder like

Diabetes mellitus.etc..

Follow ups

Follow ups were watched and interpreted as per criteria set up in each case. Total

duration of study for each case has been kept for 3 months unless the patient shows dramatic

improvement before the scheduled time.

64
Diet and Regimen

All the patients were directed to continue with the same diet as earlier. No specific

supplementary diet advised.

Ancillary measures

1. Avoid going to swimming pools, communal baths.

2. Avoid tight under occlusive garments.

3. Avoid sharing personal items like towels.

4. Intake of nutritious food and maintaining good personal hygiene.9

Assessment of Effectiveness

Effectiveness of the treatment was assessed on the basis of

a) Clinical improvement, disappearance or relief of symptoms, improvement of general

health.

b) For an effective assessment and evaluation, disease intensity scores were given to every

patient. After completion of treatment the post treatment disease intensity scores were

compared with the pretreatment disease intensity scores and statistically evaluated.

c) Note: Disease intensity scores were given in Annexure I

65
Results

66
OBSERVATION AND RESULTS

In this study a total no of 30 cases of tinea corporis were taken in age between 10-

60 years, irrespective of their sex and socio-economic status.

Case distribution:

Table No. 1: Distribution of cases according to age

Sl.no Age group in years No. of patients Percentage

1 10-20 6 20.00

2 20-30 8 26.06

3 30-40 4 13.03

4 40-50 4 13.03

5 50-60 8 26.06
As shown in the above table, the maximum age incidence of 26.06% were

between 20 to 30 and 50 to 60 years in 8 cases and the minimum age incidence of

13.03% were between 30-40 and 40 to 50 years, 6 patients between 10-20 years showing

20.00% incidence. The youngest was 13 years of age and oldest was 60 years of age.

Table No. 2: Distribution of cases according to sex

The table given below shows the statistical study of sex incidence in 30
patients with psoriasis.

Sex No of patients Percentage

Male 17 56.06

Female 13 43.03

67
 As shown in the table the sex incidence was, in male patients i.e. 56.06% and

female patients 43.03% i.e. males are more affected than females.

Table No. 3: Distribution of cases according to miasmatic expression

Miasm No of Patients Percentage

Psora 27 90.00

Sycosis 2 7.00

Tubercular 1 3.00

In the study, 27 cases i.e. 90.00% of the total cases showed psora expression, 2

cases i.e. 7.00% of the total cases showed a purely sycotic manifestation, 1 case showed

tubercular expression i.e. 3.00 % of the cases. It shows psora is the predominant miasm

appearing in this clinical study of 30 cases.

Table No. 4: Distribution of constitutional remedies used in this study

Sl.no Constitutional Remedy No of cases Percentage

1. Phosphorus 2 6.06
2. Natrum mur 5 16.03
3. Sepia 1 3.03
4. Pulsatilla 2 6.06
5. Nux vomica 1 3.03
6. Calcarea carb 2 6.06
7. Sulphur 5 16.06
8. Arsenic album 4 13.03
9. Lycopodium 2 6.06
10. Calcarea Phos 1 3.03

68
 In this 30 case clinical study 3 dominant constitutions were seen i.e. Nat Mur was

given in 16.03%, sulphur was given in 16.03% and Arsenic was given in 13.03% cases.

The second dominant constitution came during this clinical study was 3 drugs i.e.

Phosphorus, Pulsatilla, and Calcarea carb 6.06%. The other few constitutional drugs

given once during this clinical study were Sepia, Nux vom, and Calcarea Phos with

3.03%

Table no. 5: distribution of acute remedies used during study:

Remedy No. of cases Percentage

Bacillinum 5 16.06

Tellurium 4 13.03

Bryonia 1 3.03

Arsenic 1 3.03

Sulphur 3 10.00

In this study, 14 cases were prescribed with an acute remedy, out of which 5 cases

i.e. 16.06% of patients are prescribed Bacillinum, 4 cases 13.03% of patients are given

tellurium, Bryonia and arsenic were given in once 3.03% and sulphur was given 3 times

10.00% as acute medicine.

69
Table No. 6: Distribution according to urban and rural areas:

Place No. of cases Percentage

Rural 24 80.00

Urban 6 20.00

In this clinical study of 30 cases, 24 cases came from rural area 80.00% and 6

cases came from urban area (20.00%) which shows that tinea corporis is much prevalent

in rural areas.

Occupation No. of cases Percentage

Student 6 20.00

Business 8 26.66

Manual laborer 11 36.66

Housewife 2 6.06

Officials 3 10.00
Table No. 7: Distribution of cases according to occupation

Among the 30 case study 6 cases (20.00%) were students, 8 cases (26.66%) where

business class peoples, the maximum cases i.e. 11 cases (36.66%) were manual labors, 2

cases (6.06%) were housewife‘s and 3 cases (10.00%) where officials.

70
Table No. 8: Distribution of cases according to religion

Remedy No. of cases Percentage

Hindu 6 20.00

Muslim 19 63.33

Christen 5 16.66

Out of 30 cases included in clinical study of tinea corporis 20.00% i.e. 6 cases

belong to Hindu religion, 63.33% i.e.19 cases belong to Muslim religion, 16.66 % i.e. 5

cases belong to Christian religion.

Result of treatment No .of patients Percentage

Improved 26 86.06

Not improved 3 10.00

Drop out 1 3.03

Table No. 9: Distribution according to the treatment outcome

In the study 86.06% of the patients showed improvement. The rest 10.00% patients

showed no improvement. Patient who did not return for the first follow-up i.e. dropped

out or discontinued treatment is 3.03%.

71
STATISTICAL ANALYSIS
Table No.10: Distribution of scores before and after treatment

Case No. X Y X-Y= Z Z-Z (Z-Z)2

1 4 0 4 1.5 2.25
2 3 1 2 -0.5 0.25
3 3 1 2 -0.5 0.25
4 3 0 3 0.5 0.25
5 4 1 3 0.5 0.25
6 4 1 3 0.5 0.25
7 3 0 3 0.5 0.25
8 3 1 2 -0.5 0.25
9 3 0 3 0.5 0.25
10 3 3 0 -2.5 6.25
11 3 0 2 -0.5 0.25
12 4 3 1 -1.5 2.25
13 3 0 3 0.5 0.25
14 4 1 3 0.5 0.25
15 3 0 3 0.5 0.25
16 4 2 2 -0.5 0.25
17 3 1 2 -0.5 0.25
18 3 1 2 -0.5 0.25
19 4 0 4 1.5 2.25
20 4 1 3 0.5 0.25
21 3 0 3 0.5 0.25
22 3 1 2 -0.5 0.25
23 3 1 2 -0.5 0.25
24 3 0 3 0.5 0.25
25 4 4 0 -2.5 6.25
26 3 0 3 0.5 0.25
27 3 1 2 -0.5 0.25
28 4 1 3 0.5 0.25
29 3 0 3 0.5 0.25
30 4 0 4 1.5 2.25
T0TAL 75 27.5

72
 A. Question to be answered- Is there any difference between the scores taken before

the treatment and scores after the Homoeopathic treatment?

B. Null hypothesis: There is no difference between the scores before and after the

Homoeopathic treatment.

C. Standard score of the mean of difference

N = 30

X = Score before treatment

Y = Score after treatment

Z = Mean difference

∑ Z = 75

Z = ΣZ//N

= 75/30

= 2.5

∑ (Z - Z) 2 = 27.5

The estimate of population standard deviation is given by

SD = ∑ (Z-Z) 2 / N-1

= 27.5/30-1

= 27.5/29

= 0.9482758

= 0.973794
The estimate of standard error of mean /SD/ n
= 0,973794 /5.47
= 0.1733593

73
 D. Critical ratio ‗t‘ = / SD/ n
= 2.5/ 0.1733593

t = 14.42

E. Comparison with tabled value:

This critical ratio ‗t‘ follows a distribution with N=1 (29) degrees to freedom. The

5% level is 2.045 and 1% level is 2.756 for 29 degrees of freedom. Since the calculated

value 14.42 is greater than tabled value at 5% and 1% level, we reject the null hypothesis.

Inference:

This study provides proof to say that, there is significant reduction in the disease

intensity scores after Homoeopathic treatment.

Therefore, homoeopathic treatment is effective in cases of tinea corporis.

74
Graph

75
76
77
78
79
REMEDY PROFILE

Out of 30 cases included in this study of tinea corporis, there are some

constitutional medicines and few acute medicines which come in two or more than two

cases and those cases are studied in detail and general characters of those cases belonging

to the same remedy been evolved by screening them by this method a drug image is being

obtained which is nothing but a remedy profile.

REMEDY PROFILE
Table no: 11

Sulphur was prescribed as a constitutional remedy in 5 cases

Arsenicum album was prescribed as a constitutional remedy in 4 cases

Natrum muriaticum was prescribed as a constitutional remedy in 4 cases

Lycopodium was prescribed as a constitutional remedy in 2 cases

Phosphorus was prescribed as a constitutional remedy in 2 cases

Calcarea carb was prescribed as a constitutional remedy in 2 cases

Bacillinum was prescribed as a acute remedy in 5 cases

Tellurium was prescribed as a acute remedy in 4 cases

80
SULPHUR
Table no: 12

Case no 3 9 10 17 18
Particulars of Mrs. M U MR. ABL MRS. FZ MR. MUS MR. AM
the patient 44/F 60/M 25/F 32/M 25/M
Appearance Lean, fair Lean Lean and Stocky Lean
dark
Perspiration Increased Decreased Increased Increased Increased
offensive in and
axilla offensive
Appetite Increased Good Increased Decreased Increased
Desire Sweets, veg Tea. Sweets Vegetables Sweets Chicken
Aversion Milk, Milk Fish Vegetables Vegetables
Thirst Increased Reduced Increased Increased Increased
B&B Habits Consternated Consternated Loose stool Constipated Constipated
Thermal Hot NS Hot Hot Hot
reaction
Menstrual Leucorrhoea
function
Mental generals Fear death Travelling Anger Anger Anxious
Extravert Talkative Weeps easily Anger easily
Broods Finance loss Consolation Anxious Company
Anger Hallucination Reserved Conscious Optimistic
Talkative

Characteristic Itching eruption Skin black Skin burning Skin itch Skin
particulars <menses during Itching<night, itching< <sun and eruption
>scratching in rain 5pm washing burn and itch
>scratching Sun, till bleeds.
washing
with hot
water
Miasm Psora Psora Psora Psora Psora

Repetition Infrequent Infrequent Infrequent Infrequent Infrequent

81
SULPHUR

Out of 30 cases, in this clinical study of tinea corporis, sulphur was prescribed in

5 cases (3, 9, 10, 17, and 18). Elemental Sulphur has always been associated with fire.

Sulphur is flammable and burns with a stench, which can be smelt at the site of an

erupting volcano, and brimstone. It is one of the polychrests used in Materia Medica. Out

of 5 (3 and 10) were females and (9. 17 and 18) are male, which shows sulphur is

comparatively more adaptable to male

PHYSICAL GENERALS

Sulphur is suitable for lean thin stoop shouldered people. Out of 5 cases lean

appearance was noted in 4 cases (3, 9, 10, and 18) and stocky in 1 case (17) it is justified

that greatly sulphur act on lean peoples.

Sulphur has increased perspiration in 4 cases (3, 10, 17, and 18) out of 5cases, with

offensive perspiration in two cases (3and 10) and one case shows decreased perspiration

(9) which is justifies that increased and offensive perspiration is one of the significant

feature of sulphur.

Thirst of sulphur is increased and burning thirst. Out of 5 cases 4 cases shows

increased thirst (3, 10, 10, 17 and 18) and 1 case (9) shows decreased thirst, which

justifies sulphur peoples are highly thirsty.

Case (3, 9, 17 and 18) presents with constipation and case (10) shows loose stool

which is suggestive of alternating constipation and loose stool present in sulphur people.

Cravings like sweets is significant in sulphur and aversion to milk is also significant

82
which can be evidently seen in 3 cases showing craving for sweets (3, 9 and 17) and 2

cases showing aversion to milk (3 and 9)

Thermal state of sulphur is hot which evidently seen in 4 cases (3, 10, 17 and 18)

out of 5 cases and 1 case (9) is ambithermal which is suggestive of sulphur adoptability to

hot peoples.

MENTAL GENERALS

Sulphur is extravert, loquacious, anxious, irritable, and lot of illusions seen. This

can be significantly seen in 4 out of 5 cases (3, 9, 17 and 18) and 1 case showing reserved

behavior (10). At the same time fear, anger and irritability was also seen in (3, 9, 17 and

18) which is similar to sulphur peoples.

CHARACTERISTIC PARTICULARS

Sulphur skin complaints are usually dry skin itching and burning aggravation

night and warmth of bed worse by washing and > by scratching, many of these features

are seen in all the cases (3, 9, 10, 17and 18) but 1 case (3) shows aggravation of

complaints during menses, and 2 cases (10 and 17) shows sun aggravation of complaints.

A very marked complaint of washing aggravation and scratching amelioration is seen in

(3, 9, 10 and 17) which is highly suggestive of sulphur skin.

MIASM

Psora is significant in all the 5 cases where sulphur was given, sulphur being one

of the very important antipsoric remedy. Same is justified in all these 5 cases (3, 9, 10, 17

and 18)

REPETITION

Repetition was Infrequent, as sulphur is deep acting constitutional remedy.

83
ARSENICUM ALBUM

Table no: 13

Case no 2 11 15 16
Particulars of the MR. AY MR. MK MR. ABK MR. AR
patient 40/M 52/M 51/M 20/M
Appearance Lean Stocky Lean Lean
Perspiration Normal Increased Increased Increased
Apatite Normal Good Decreased Increased
Desire Egg, cold Rice, fruits Fish, sweets, Vegetables
drinks, fruits fried food
Aversion Nil Oily food Nil Beef
Thirst Increased Increased Increased Increased
B&B Habits Regular Regular Constipated Regular
Thermal reaction Chilly Chilly Chilly Hot
Mental generals Mild Dreams fear Anxious Ambitious
Anxious Fastidious Reserved Company
Family Anger Irritable Fear
oriented Anxious Brooding Industrious

Characteristic Skin itching Skin itch and Skin eruption Skin itching
particulars >hot water burn black, itching, Burning intense
<perspiration Sleep talks burning, <night,
Burning < mid night scratching
retrosternal Cough < early
<ice-cream, morning
milk< spice
Miasm Psora Psora Psora psora

Repetition Infrequent Infrequent Infrequent Infrequent

ARSENICUM ALBUM

This White Oxide of Arsenicum (As2O3) has got General irritability, with

extreme weakness and prostration of mind and body with emaciation. Eruptions of

arsenic are generally dry, white and scaly, painful with burning, Itching aggravated by

scratching, this mineral is very important polycreasts remedy used in our Materia Medica.

And it is especially suitable for male. In this case study all the 4 cases are male.

84
PHYSICAL GENERALS

The appearance of lean is seen in 3 (2, 15 and 16) and stocky in 1(11) the profuse

ness of perspiration is seen in 3(11, 15, 16) and 1(2). Normal moderate sweating on

exertion, 2 cases shows good appetite (2 and 11) 1 case presented with (15) increased

appetite and other presented with decreased appetite.

Desires of given 4 cases, 2cases (2 and 11) shows desire for cold drinks, 2cases (11 and

15) shows desire for fried food. The other 1case (2) shows desire for egg. Aversion for

oily food and beef was noted in (11 and 16) at the same times all 4 cases (2, 11, 15 and

16) presented with increased thirst and 1 case (11) presented with thirst for cold water

which is very typical of arsenic. The bowel and bladder, 3 cases of 4 cases (2, 11and 16)

have regular B/B habits and1 case (15) complained of constipated.

The points which were discussed above justify the features of arsenic.

MENTAL GENERAL

All 4 cases where anxious (2, 11, 15 and 16) fastidious, irritable, ambitious,

industrious, and reserved types seen in (11, 15 and 16) and case (2) is mild and family

oriented. All these are very typical mental features seen in all 4 cases where arsenic was

given.

CHARACTERISTIC PARTICULARS

85
 Skin complaints itching followed by burning was seen in all the 4 cases where

arsenic was given (2, 11, 15 and 16) complaints ameliorated by hot application was seen

in 1 case (2) and aggravation midnight seen in 2 cases (15 and 16). These skin complaints

and presented modalities are suggestive of typical arsenic.

MIASM

All the 4 cases which were given arsenic were psoric as there was no marked

scaling, itching and burning was marked.

REPETITION

Infrequent repetition was done as the given remedy arsenic is deep acting and

constitutionally prescribed

86
NATRUM MURIATICUM

Table no: 14
Case no 14 21 29 30
Particulars of the MS,SS MS SJ MRS. MRM MR. MB
patient 18/F 25/F 55/F 47/M
Appearance Lean Lean Lean Lean
Perspiration Increased Increased Increased Normal
Apatite Decreased Normal Decreased Decreased
Desire Potato, pickle Fish, sweets Fish, salt Coffee, spice
Vegetable
Aversion Milk, onion nil Bread Sweets
Thirst Increased Increased Increased Increased
B&B Habits Constipated Regular Constipated Constipated
Thermal reaction Hot Hot Hot Hot
Menstrual Irregular Regular and
function scanty
Mental generals Reserved Fear snakes Irritable Introvert
Offends Fear alone Anger-easily Anger-easily
Suppressed Mild Reserved Sympathetic
anger Reserved Sympathetic Anxious
Irritable

Characteristic Skin eruptions Skin itching skin red eruptions Skin itching
particulars <morning, night eruptions <scratching burning
Head ache >cold water Hot water bath <sun, heat
<noon, sun <hot weather >cold water Meat

Miasm Psora Psora Psora Psora

Repetition Infrequent Infrequent Infrequent Infrequent

87
NATRUM MURIATICUM

Natrum muriaticum, also called the Chloride of Sodium, is our common table salt.

It is a polychrest amongst polychrests. In the human economy, it plays a very important

part. It is found in almost all the tissues of our body.

PARTICULARS OF THE PATIENT

Out of 4 cases where Natrum muriaticum is given 3 cases (14, 21 and 29) are

females and 2 cases (14 and 21) are young girls and 1 case (30) is a male. This shows

that, this drug is more stable for females and less adoptable for males.

PHYSICAL GENERALS

In 3 cases (14, 21, and 29) where Natrum is given the patients are lean and 1 case

(30) is stocky. 3 cases (14, 21 and 29) shows increased perspiration and 1 case (30)

normal perspiration on exertion. 3 cases (14, 29 and 30) showing decreased appetite and

1 case (21) presenting normal appetite, the desire for salt, pickle and fish is present in 3

cases (14, 21 and 29) and 1 case (30) shows craving for coffee and spice.

1 case (14) shows aversion for milk and onion, 1 case (29) shows dislike for bread and

sweet dislike was seen in case (30), thermally all 4 cases (14, 21, 29 and 30) are hot

Bowel and bladder habits in these 4 cases, 3 cases shows constipation and all 4 cases are

highly thirsty

One case (14) showing irregular menses and 1 case (21) show regular but scanty menses.

All these data indicated above justify the features of Natrum muriaticum.

88
MENTAL GENERALS

These people are highly sensitive at the level of their emotion; impressions are

absorbed deeply and retained tenaciously. This makes them sensitive to another wants,

loyal in affection, strong in attachment they too vividly remember past offences, sorrow,

disappointments etc. suddenly get angry without any reason and they are great vulnerable

to emotional injury.

A/f- anger, weeping usually irritable doesn‘t show anger towards any one.

Usually reserved, doesn‘t show their emotions, doesn‘t share his feelings to any one

which was noticed in case (14, 21, 29 and 30)

CHARACTERISTIC PARTICULARS

As skin complaints in Natrum shows Hives, itching after exertion, Greasy skin

and early morning aggravation of complaints, Eczema; raw, red, and inflamed; worse,

eating salt, and at seashore

In 4 cases where Natrum was prescribed, skin complaints like itching, eruptions

< In the morning and from sun is seen in 2 case (14 and 30) the other 2 cases (21 and 29)

presented with skin eruptions > cold application. Meat and heat < is seen in 1 case (30)

All the above features are suggestive of Natrum muriaticum

MIASM

In all the 4 cases where Natrum is given have got psora in background

REPETITION

Repetition was infrequently done, as this drug is a deep acting polycreasts remedy

and was constitutionally prescribed.

89
 TELLURIUM

Table no: 15

Case no 6 7 8 18
Particulars of the MR. AS MR.H,D‘SO MRS PS MR.AM
patient 13/F 58M 48/F 25/M
Appearance Lean Stocky Lean Lean
Perspiration Increased Normal Increased Increased
Apatite Good Good Good Increased
Desire Sweets, spice Sweets Sweets, fish Chicken
Aversion Nil Nil Nil Vegetables
Thirst Ns Reduced Increased Increased
B&B Habits Constipated Regular Regular Constipated
Thermal reaction Chilly Chilly Ns Hot
Menstrual function Regular
Mental generals Weeps easily Abandoned Anger-easily Anxious
Fear blood Dipsomania Company Anger easily
Timid Reserved desire Company
Active Reserved Optimistic

Characteristic Skin circular Skin itching Skin itch and Skin eruption burn and
particulars patch eruptions eruption with burn. itch till bleeds.
<perspiration scaling <night Hypo-
Perspiration pigmented
>scratching patches with
scaling
<night,
scratching
Miasm Psora Sycosis Sycosis Psora

Repetition Frequent Infrequent Frequent Frequent

90
TELLURIUM

Is an element; (generally considered non-metallic) Te- Atomic weight 125.

Trituration done with precipitated element, Tellurium occurs in combination with gold,

silver, lead, and antimony. It resembles Sulphur and Selenium in its chemical reactions

The most characteristic form of the skin irritation of Tellurium is herpes circinatus

and it has probably cured more cases of ringworm, especially of the face and body, than

any other remedy

PARTICULARS OF THE PATIENT

In 4 Cases where tell is given 2 cases (6 and 8) are females and 2 cases (7 and 18)

are male. The age ranges from 13 to 58

This shows tellurium acts on both sex equally and at any age very young age people to

old age peoples

PHYSICAL GENERALS

3 cases (6, 8 and 18) showing lean appearance and 1 case (7) is stocky. In 3 cases

(6, 8 and 18) perspiration is increased and in 1case (7) perspiration is normal. Appetite is

good in 3 cases (6, 7 and8) and in 1 case (18) shows increased appetite

In 3 cases (6, 7 and 8) showing sweet desire and 1 case (18) showing craving for chicken,

and no specific aversion was seen in any of the above 4 cases

Thirst reduced in 1 case (7) and increased in 2 cases (8 and 18)

2 cases (7 and 8) showing regular bowel movements and 2 cases (6 and 18) showing

Constipation, Thermally 2 cases (6 and 7) showing chilliness and 1 case (18) was hot

91
CHARACTERISTIC PARTICULARS

A skin itching, scaling, circular eruption which burn on scratching and sometimes

bleeds on scratching is seen in all 4 cases (6, 7, 8 and 18) which is very significant in

tellurium skin, the modalities like < on perspiration, night, scratching in most of the cases

MIASM

The miasmatic expression was taken on skin presentation where scaling was

prominent presentation in 2 cases (7 and 8) so they were predominantly Sycotic

And 2 cases (6 and 18) are presenting with itching and burning predominantly which

were psoric in background.

REPETITION

In 3 cases (6, 8 and 18) the remedy was frequently repeated, and in 1 case (7)

infrequent repetition is done were case responded quickly with medicine.

92
 BACILLINUM

Table no: 16

Case no 5 12 16 22 27
Particulars of the MR. MS MRS KSA MR. AR MS. CEN MR. MP
patient 18/M 27/F 20/M 15/F 60/M
appearance Stocky stocky Lean Stocky Stocky
Perspiration Increased Increased Increased Increased Increased
Apatite Good Good Increased Good Good
Desire Salt, spice Rice, fruits Vegetables Vegetables Warm food
Aversion Sweets Oily food Beef Milk Nil
Thirst Increased Increased Increased Increased Increased for
warm water
B&B Habits Regular Regular Regular Loose stool Regular
Thermal reaction Hot Chilly Hot Hot Hot
Menstrual function Regular
Mental generals Mild Dreams fear Ambitious Ambitious Diplomatic
Anxious Fastidious Company Broods Religious
Fear Anger Fear Fear-dog Reserved
Lazy Anxious Industries Company Obstinate

Characteristic Skin Skin itch and Skin itching Skin itch and Skin
particulars Itching burn Burning burn Circular
<night, warmth Sleep talks intense <night, patches
>scratching Burning <night, perspiration <scratching
retrosternal scratching >cold Perspiration
<ice-cream, application
milk< spice
Miasm Psora Psora psora Psora Psora

Repetition Infrequent Infrequent Infrequent Infrequent Infrequent

93
BACILLINUM

Bacillinum Burnett (a maceration of a typical tuberculous lung Introduced by Dr.

Burnett) Ringworm Worse, night, early morning and cold air. This drug is one of the

deep acting nosode which acts more significantly on respiratory system and on skin. It

should not be given below the thirtieth and not repeated frequently. One dose a week

often sufficient to bring about reaction, It is rapid in action, and good results ought to be

seen, otherwise there is no need of repetition says William Boericke.

Out of 30 cases taken for clinical study 5 cases (5, 12, 16, 22 and 27) are given

Bacillinum based on totality and clinical presentation.

The age of the patients ranging from 15 to 60 years, 3 cases (5, 16 and 27) are

male and 2 cases (12 and 22) are female.

PHYSICAL GENERAL

In 30 case clinical study 4 cases (5, 12, 22 and 27) are stocky and 1 case (16) is

lean. The perspiration pattern in all 5 cases shows profuse perspiration, appetite is

increased in 1 case (16) and other 4 cases (5, 12, 22 and 27) shows good appetite, desire

for vegetables is seen in 2 cases (16 and 22) and in other 3 cases desire and aversions

where not significant, the very marked thirst presented in all 5 cases and one case (27)

presents increased thirst for warm water.

MENTAL GENERALS

Mental generals presented in 5 cases, where Bacillinum is given were not

analyzed before giving this medicine, basically this drug is given as acute prescription

and on acute totality and later those cases which are not completely better from this

medicine is followed by other constitutional medicine.

94
CHARACTERISTIC PARTICULARS

The skin complaints in Bacillinum are very characteristic and case (5, 16 and 22)

showing < of itching in night, and > by scratching and cold application was observed in 2

cases (22 and 27) which justifies the skin features of Bacillinum.

MIASM

In all 5 clinical cases where Bacillinum was given, presented with psora in

background.

Repetition

As William Boericke says this medicine should not be repeated frequently. So

infrequent repetition was done with satisfactory result

95
LYCOPODIUM

Table no: 17

Case no 1 19
Particulars of the patient MR. AS MR.L D‘M
39/M 48/M
appearance Lean Lean
Perspiration Increased Increased
Apatite Decreased Decreased
Desire Sweets, spice, veg Sweets, warm food
Aversion Fish, salt Green grams
Thirst Reduced Reduced
B&B Habits Constipated Constipated
Thermal reaction Hot Hot
Menstrual function Regular
Mental generals Religious, anger easily, Irritable, anger, anxious
reserved, sexual desire Industrious
increased
Characteristic particulars Skin circular patch eruptions Skin itching eruption with
<perspiration and cold scaling <4 to 7pm
>pressure, hot water bath Perspiration
>scratching , warm water

Miasm Psora Sycosis

Repetition Infrequent Infrequent

96
LYCOPODIUM

Commonly this is known as club moss or Wolfs-claw, a low creeping perennial

plant that grows almost everywhere but specially in the northern countries.

Lycopodium is the premier remedy of our Materia Medica, from the time it has been

introduced into our Materia Medica by Samuel Hahnemann, it has affected innumerable

cures, some of which are simply marvelous.

They are highly intelligent, precautious and their physical condition is not in

keeping with their mental state, Lean and puny, thin and emaciated, they rarely leave any

strong impression at first sight, Extremely sensitive, they take offence at trifles and are

easily excited to anger, They are discontented, impatient and misanthropic.

Out of 30 cases, in this clinical study of tinea corporis 2 cases required Lycopodium

As constitutional medicine

PHYSICAL GENERALS

In this clinical study 2 cases are given Lycopodium, Both cases are apparently

lean (1 and 19) and both cases presented with profuse perspiration and at same time both

cases (1 and 19) has decreased appetite and desire for sweets and warm food

Case (1 and 19) showing decreased thirst and constipation. These above data of physical

generals justify the features of Lycopodium.

MENTAL GENERALS

In this clinical study, 2 cases are given Lycopodium presented with Anger,

anxious, irritability, reserved in both the cases (1 and 19). Anxiety was the marked

feature in both the cases. 1 case (1) was showing marked increased sexual desire and 1
97
case (19) he was industrious in work, and case (1) was religious. All the above mental

features are suggestive of Lycopodium

MIASM

In this clinical study 1 case (1) was psoric and 1 case (19) was sycotic in

presentation.

REPETITION

In this clinical study 2 cases (1 and 19) are given Lycopodium on constitutional basis, so

infrequent repetition was adopted.

98
CALCAREA CARB

Case no 13 24
Particulars of the patient Mrs. S.I Ms. J. D‘S
45/F 20/F
appearance Stocky Stocky
Perspiration Increased Increased
Apatite Good Good
Desire Sweets, spice, veg Chicken, fish, egg, spice
Aversion Fish, salt Nil
Thirst Reduced Good
B&B Habits Constipated Constipated
Thermal reaction Chilly Chilly
Menstrual function Menopause Regular but scanty
Mental generals Fear of thunderstorm closed Desire consolation and
places, company,
Yielding, reserved indifference to family,
weeps easily,
Characteristic particulars Skin circular patch eruptions Skin itching eruption
in lower abdomen, and trunk with scaling <night,
Scratch till it bleeds Perspiration
Burning< scratching >scratching , warm
< perspiration water
Miasm Psora Psora

Repetition Infrequent Infrequent

Table no: 18

CALCAREA CARB

This great Hahnemannian anti-psoric is a constitutional remedy is of par

excellence. Its chief action is centered in the vegetative sphere, impaired nutrition being

the keynote of its action, the glands, skin, and bones, being instrumental in the changes

wrought. Increased local and general perspiration, swelling of glands, scrofulous and

rachitic conditions generally offer numerous opportunities for the exhibition of Calcarea.

99
Out of 30 cases in this clinical study of tinea corporis, 2 cases required calcarea carb as

constitutional medicine.

PHYSICAL GENERALS

In this clinical study 2 cases are given calcarea, Both cases are apparently stocky

(13 and 24) and both cases presented with profuse perspiration and at same time both

cases (13 and 24) has good appetite and desire for sweets, egg and spicy food

Case (13 and 24) showing decreased thirst, constipation and chilliness; these above data

of physical generals justify the features of calcarea

MENTAL GENERALS

In this clinical study, 2 cases are given calcarea which were presenting fear,

anxious, Desire Company, reserved in both the cases (13 and 24) Anxiety was the marked

feature in both the cases yielding temperament, and fear for closed places was seen in

case (13).And weeps easily was also seen in case (24) which are important features of

calcarea.

MIASM

In this clinical study both the cases (13 and 24) was psoric in presentation.

REPETITION

In this clinical study 2 cases (13 and 24) are given calcarea on constitutional

basis, so infrequent repetition was adopted.

100
PHOSPHORUS

Table no: 18

Case no 6 20
Particulars of the patient Ms. SRF Ms. K. KUMAR
13/F 20/F
appearance Lean Lean
Perspiration Normal Increased
Apatite Good Good
Desire Sweets, spice, veg Chicken, fish, egg, spice
Aversion Nil Nil
Thirst Reduced Good
B&B Habits Regular Constipated
Thermal reaction Chilly Chilly
Menstrual function Menopause Regular but scanty
Mental generals Weeps easily, Fear of blood, Benevolence, helps others,
active in work, timid. never gets anger, desire
consolation and company.

Characteristic particulars Skin itching eruption, circular, Skin itching eruption with
with reddish eruptions scaling <night,
abdomen, and trunk, eruption< Perspiration
scratching >scratching , warm water
< perspiration
Miasm Psora Psora

Repetition Infrequent Infrequent

PHOSPHORUS

Phosphorus irritates, inflames and degenerates mucous membranes, irritates and

inflames serous membranes, inflames spinal cord and nerves, causing paralysis, destroys

bone, especially the lower jaw and tibia; disorganizes the blood, causing fatty

degeneration of blood vessels and every tissue and organ of the body, Easily vexed,

fearfulness, tendency to start, Over-sensitive to external impressions are important

features of phosphorus.

101
Out of 30 cases in this clinical study of tinea corporis, 2 cases required phosphorus as

constitutional medicine.

PHYSICAL GENERALS

In this clinical study 2 cases are given calcarea, both cases are apparently lean (6

and 20) and one case (20) presented with profuse perspiration and at same time both

cases (6 and 20) had good appetite and desire for sweets, chicken and spicy food

Case (6) showing decreased thirst, constipation and chilliness; these above data of

physical generals justify the features of phosphorus

MENTAL GENERALS

In this clinical study, 2 cases are given phosphorus which were presenting fear,

anxious, Desire Company, extravert in both the cases (6 and 20) Anxiety was the marked

feature in both the cases yielding temperament, and fear for closed places was seen in

case (6). And helps others, benevolence, desire consolation was also seen in case (20)

which are important features of phosphorus.

MIASM

In this clinical study both the cases (6 and 20) were psoric in presentation.

REPETITION

In this clinical study 2 cases (6 and 20) are given phosphorus on constitutional basis, so

infrequent repetition was adopted.

102
Discussion

103
 DISCUSSION

Tinea corporis refers to all dermatophytoses of glabrous skin except the palms,

soles and groin. 30 patients with Tinea corporis were taken upon for study and the result

has been discussed below.

All the different modes of treatment have only helped in palliating the disease

merely by external application. At the same time Homoeopathic mode of treatment is

superior to other modes of treatment, since it treats not the effects but the causes. It is the

man who is sick and not his body and as a matter of fact he needs to be treated. It is here

the concept of individualization comes into practice, where the physical as well as the

mental characteristics of the individual is taken.

Therefore a study has been taken to evolve a suitable Homoeopathic approach in

the effective management of Tinea corporis

In this study the majority of cases were between 20yrs to 30yrs and 50yrs to 60

years of age i.e. 8 patients respectively (26.6%). The next incidence was between 10 to

20 years of age i.e. 6 patients (20%). All patients were between 10 years and 60 years.

In this study the youngest patient was 13 years old and the oldest 60 year old.

According to the sex, males were affected more 17 (56.06%) when compared to females

13 (43.03%).

As majority of cases shows, psora as dominant miasm (90.00%), and only

(7.00%) of cases were of Sycotic miasm and (3.00%) only of tubercular miasm

A total of 17 cases (56.67%) were followed up to 6 months, 10 cases (33.33%) up

to 12 months and 2 cases (6.67%) up to 4 months and 1 case (3.33%) up to 15 months.

104
 Out of the 30 cases, constitutional medicine was prescribed for 25 cases. In 18

cases (60%), only constitutional medicine was prescribed. In 9 cases (30%), acute

followed by constitutional was given. In 2 cases (6.67%), constitutional and anti-

miasmatic was given. In two cases (6.66%) only acute medicine was prescribed.

In the study, 11(36.66%) were Manual laborers. Business came next with 8 cases

(26.66%) followed by students in 6 cases (20.00%), Officials in 3 cases (10.00%) which

shows tinea corporis is more prevalent in manual laborers.

The study showed that tinea corporis is a constitutional problem affecting those

who are susceptible when the modifying factors are present. In the study all constitutional

remedies were not only symptomatically similar, but also miasmatically the simillimum.

Out of 30 cases, 22 patients received the first prescription in 200th potency,

constituting 73.33% of total cases, 30th potency in 4 cases (13.33%), 1M potency in 3

cases (10%) and 0/1 in 1 case (3.33%). Thus medium potency 200 was widely used in the

study group.

The study shows constitutional medicines like Natrum muriaticum and sulphur

were indicated in majority of cases 5 (16.03%). Arsenic stands second with indications

seen in 4 cases (13.33%). Phosphorus, calcarea carb and Lycopodium, were indicated in

2 cases (6.67%) each. calcarea Phos, Sepia and Nux vomica were indicated in 1 case

(3.33%) each.

The study also shows acute medicines like Bacillinum was indicated in majority

of cases 5 (16.03%). Tellurium stands second with indications seen in 4 cases (13.33%).

105
And in 3 cases (10.00%) patients were given sulphur and Bryonia and Arsenic once

(3.03) as acute prescription.

Regarding the final outcome of this study, out of 30 cases, 26(87.00%) cases

showed improvement and 3(10%) cases were not improved and 1(3.00) case was drop

out.

Inference: The above study proved that Homoeopathic treatment is the most effective in

cases like tinea corporis. This internal dynamic medicine brings out a rapid, gentle and

permanent relief of complaints without any small terms palliation or suppression of

complaints, which is usually done by other schools of medicine by external application.

106
 LIMITATIONS

1. This is a restricted sample design, in which only 30 cases were studied. So chances

of sampling error are increased with small sample size.

2. No control group was maintained to assess the effectiveness.

3. The exciting or maintaining factors could not be traced or elicited in 6 cases..

Since there can‘t be an effect without a cause, a more thorough search might reveal

the underlying cause.

4. Few of the cases follow up were not regular so assessment of drug action could not

be controlled well.

5. To minimize the variations in physician‘s actions, proper planning on the part of

primary physician is demanded.

6. Since this is a time bound study, the cases could not be studied for longer period.

Some good cases couldn‘t be considered in this study because of discontinuation

of treatment.

7. Since the study was based on subjective evaluation of patients before and after

treatment, objective parameters like skin scraping with 10% KOH mount test,

woods light examination etc. were not done. Hence the improvement was noted

only on clinical parameters and examination so the results were not substantiated

on investigation reports.

107
 RECOMMENDATIONS

1. Universal standardized scale for assessing the symptoms should be used, so that

evaluation of outcome of the study would become precise.

2. Bigger sample with extended time of research would provide better result

3. It will be always scientific to keep control (placebo) group simultaneously to

verify the effectiveness of treatment.

4. Reliable laboratory based diagnosis and evaluation of outcome gives more

credibility for the study.

108
Conclusion

109
 CONCLUSION

 Majority of the cases were aged between 20-30 and 50 to 60years.

 Prevalence of tinea corporis is more common in males.

 Non vegetarian are more prone to get tinea corporis.

 Manual laborer is more affected with tinea corporis.

 Tinea corporis is multifactorial in origin with unhygienic condition and physical

stress as the prominent maintaining cause.

 Psoric expression is well marked and found to be dominating in both fundamental

and dominant miasm.

 The constitutional remedy was given for 25 cases.

 Majority patients showed a good response to constitutional simillimum

 200th potency showed wider indications.

 The statistical analysis used for the assessment of the effect of the treatment also

showed significant improvement after treatment.

110
Summary

111
 SUMMARY

This study was conducted, in the OPD, IPD and peripheral dispensaries of Father

Muller Homoeopathic Medical College and Hospital, Mangalore. A total of 30 cases

were selected for the study based on inclusion and exclusion criteria. These cases were

followed regularly and at the end of the study there were certain conclusions arrived at.

In this study maximum numbers of cases were male and maximum patients who

suffered with tinea corporis were in between the age group of 20 to 30 and 50 to 60 years.

Out of 30 cases selected, manual labors showed more prevalence for tinea corporis. Out

of 30 cases, 24 cases revealed the presence of exciting and maintaining factor.

Out of 30 cases selected, 25 cases treated with constitutional remedy (18 cases

constitutional medicine alone, 7 cases acute followed by constitutional) and they showed

87% cure. The most indicated constitutional remedies were, Natrum muriaticum, sulphur

and Arsenicum album. In this study 200th potency was selected for the first prescription

in maximum cases.

The results of the study bring cheer to the patients suffering with tinea corporis, as

a huge majority of the subjects showed improvement under Homoeopathic treatment.

A study of greater magnitude and longer duration is needed to reinforce the

outcomes derived during this study.

112
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113
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36. Clarke. H. MD., Dictionary of Practical Materia Medica. New Delhi: B. Jain

Publishers (P) Ltd; 1997, vol 1 p98.211.

37. Allen.J.Henry M.D. Disease and Therapeutics of the skin; Reprint Edition; New

Delhi: B. Jain Publishers Pvt. Ltd., 2001p,69.

38. Douglass, M. E. MD. Skin Diseases. New Delhi: B. Jain Publishers (P) Ltd;2006

p162,194

39. Lilienthal S MD., Homoeopathic Therapeutics. Indian books and periodicals

publication New Delhi India. Jan2006 p1026,1039

40. Wadia S.R-―Homoeopathy in Skin Diseases‖, B.Jain Publishers Pvt Ltd, 1921,

Chuna Mandi, Street no.-10,Paharganj, New Delhi-110055.

41. Hoyne T. S., Clinical Therapeutics. New Delhi: B. Jain Publishers (P) Ltd;2006

p69,112

42. RADAR 10. Homoeopathic Software.

117
Annexures

118
 ANNEXURE -1

DISEASE INTENSITY SCORING CHART FOR TINEA CORPORIS

0 1

ITCHING Absent Present

ERYTHEMA Absent Present

BURNING Absent Present

SCALING Absent Present

119
 ANNEXURE – II

CASE PROFORMA

FR. MULLER HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL

STANDARDISED CASE RECORD

PRELIMINARY DATA
Name: Mr. B SCR NO: 22520
Age: 45yrs Date: 12/03/11
Sex: Male.
Religion: Muslim
Education: 5th class
Occupation: Working in Hotel
Address: Belma Mangalore
PRESENT HISTORY
Chief Complaints.

LOCATION SENSATION MODALITY COCOMITANT

(1)Skin Erythematous patches < perspiration2

with elevated margins
Since 1years <sun3
3
Itching
< 2 months <meat2
Burning3
Lower abdomen and <night2
2
Redness and pain <scratching2
thighs bilateral.
>hot water
application3

Pain2
(2) Back
<ascending
Pulling type
Low back
<bending 3

120
 Lf hip Cramps 2 <standing2
Back of knee Stiffness
Calf muscle <on walking
20 years >sitting, rest
< 2 year >hot water
Since 2years
On and off
Back

HISTORY OF PRESENT ILLNESS

20 years back patient was apparently well, complaints started gradually in the left

hip joint. For few years pain was mild and occasional, later because of his occupation and

physical work complaints like pain and stiffness became worse, 5years before his pain

started radiating till calf muscle. Since last 2 years his complaints started coming

recurrently, intervening his daily activities. Pain worse on exertion and better by rest,

stiffness on first motion associated with cramps.

Skin complaints started 1year back, erythematous circular intersecting rings in

lower abdomen and thighs bilaterally which itch and burn on scratching later on which

will burn, aggravation on perspiration, in sun and better by hot water application.

These eruptions are 3 to 5cm intersecting erythematous lesion. With central clearance,

These eruptions first appeared on lower abdomen, later on spreading to thighs bilaterally.

PAST HISTORY

Medical: For his back pain 3years before he took Ayurvadic treatment for 3months and

his complaints where better for few months and again complaints started.

For his skin complaints he took Allopathic treatment before 6months, applied external

application and was better for a month, and complaints restarted.

121
 Surgical: Nil particular

Allergic: Nil particular

FAMILY HISTORY

Father- was healthy

Mother- was healthy

PATIENT AS A PERSON

Appearance: Stocky

Perspiration: generally moderate

Skin: Erythematous patches.

Hair: dry and grey

Digestion

Appetite: good

Thirst: 3-4glasses/day, likes cold water

Flatulence: not present

Cravings: coffee, pickles.

Desire: vegetables

Intolerance- sweets

Elimination:

Stool: one/day (Mostly)

Urine: 4-5/day, 1/Night

122
Sexual function

Marital- Satisfactory

Thermal state: Hot patient3

THE MENTAL STATE

Emotional

Wants to be alone

Grief

Anxiety about health

Contradiction intolerant to

Inferiority feeling

Intellectual

Perception- good

Decision –takes own

Perfectionist

REACTION: A.F., <,>: STATE EFFECTS

Fright –Nil

Decision –takes own

Sleep: refreshing, 10pm-5.30am.

Lying on back or on right side

Dreams: daily activities.

123
LIFE SPACE INVESTIGATION

Patient is from a lower middle class family. He has 2 brothers, 3 sisters and he is

the 5th child to his parents. He studied up to 5th STD. He lost his father when he was 7

yrs old. As they were not financially stable, he couldn‘t continue his studies. He was

helping his mother in Beedi rolling. From the age of seventeen he started working in

super market. He got married at the age of 24 and has 6 children, 2 sons and 4 daughters.

At present he is employed as a supervisor in a hotel. His relation with his wife, children

and other family members is good.

As a person he is reserved by nature and not very communicative. He gets angry

when his children contradict him and when people say bad about him. He never reacts

though he keeps thinking about it. He shares only a few feelings with his wife. He is

sympathetic by nature and helps people in need within his limits. On further questioning

he revealed that he is worried about his daughters who are at the age of marriage.

On observation it was noted that the patient was introverted as he was not

expressing his interpersonal relationships and his financial status, though he was

cooperative throughout the case taking.

GENERAL PHYSICAL EXAMINATION

Well oriented with time, place and person.

Moderately built and moderately nourished.

Hair -graying of hair.

Oral hygiene is good.

Tongue is dry.

No abnormal pulsations, swellings.

124
Skin- erythematous intersecting hyper pigmented patches

Nails-no clubbing

No signs of pallor, cyanosis, icterus, clubbing, edema and lymphadenopathy

B.M.I – 24

VITAL SIGNS

Temperature- afebrile at the time of examination

Pulse-74/minute, regular rhythm, moderate volume, vessel wall not thickened

Respiratory rate -16 breaths per minute

Blood pressure- 130/80 mm of Hg

CUTANEOUS EXAMINATION

1. Morphology of lesions

Multiple intersecting lesions, measuring 4 to 5 cm in diameter, erythematous patches

with scaling and elevated margins.

2. Site of lesion

Lower abdomen/Back/groin/extremities

3. Colour of the lesion

Hyper pigmented erythematous patches

4. Distribution.

Defined elevated margin with scaling scattered lesions.

5. Secondary changes

Spreading patches

6. Sensations preserved.

125
SYSTEMIC EXAMINATION

Respiratory system-NAD

Cardiovascular system-NAD

Central nervous system-NAD

Abdomen-NAD

Genitourinary system-NAD

PROVISIONAL DIAGNOSIS

TINEA CORPORIS

DIFFERENTIAL DIAGNOSIS

NUMULAR ECZEMA

GENERAL MANAGEMENT

INVESTIGATION

URINARY MICROSCOPY-NAD

BLOOD ROUTINE

HB%-13.9gm%

TC-7600/mm3

DC - N59 L35 E05 M05

ESR-18mm/1hr

PLASMA GLUCOSE

Fasting-102mg/dl

Post pranadial-120mg/dl

MIASMATIC EXPRESSION -Miasm-psora

126
PROBLEM STRUCTURALISATION

FAMILY: GOOD FAMILY:NOT GOOD

FM: Psora
SOCIETY: GOOD. SOCIETY: GOOD.
DM: Psora

WORK:GOOD WORK: GOOD

Introvert.
D
M I Anger when contradicted
S
I P
N O Grief
D S
I
T Sympathetic, helps others
I
O
N Family oriented

Mild

Anxiety about health

apparence- stocky
Characteristic particular
D
Thermally- hot Erythematous eruption with
Psora I
A elevated edge <sun, heat,
T
H
Dreams-of daily events, god meat, > hot water
B E Burning and itching in skin
O S Craving: coffee, vegetables, <night, perspiration
D I
S and pungent thinks
Y Aversion :sweets
D
I
Psora S
E
A
S
E

Tinea Corporis

127
First prescription

Dated- 2|03|11

RX

1. Natrum Mur 200 (1 packet) HS

2. No.40 pills. 4-0-4 for 2 weeks

Follow up criteria.

1. Changes in emotional plane-grief feeling

2. Changes in the emotional plane –anger

3. Changes in the dreams

4. Changes in the craving

5. Changes in the skin eruption

6. Reduction of itching

7. Reduction of burning pain

8. Reduction in cramp pains

Follow up

DATE SYMPTOM CHANGES PRESCRIPTION

1 2 3 4 5 6 7 8 9 10 RX
s > s > s > s > 1. Natrum mur 200 -
1P
12/03/11 Generals improving
Size of the lesion same 2. No.40 pills.
( 4-0-4 )
for 2 weeks

128
 DATE SYMPTOM CHANGES PRESCRIPTION
1 2 3 4 5 6 7 8 9 10 RX
G > > > > S S >
1. SL 1p HS
19/04/011 2. No.40 pills.
No fresh complaints ( 4-0-4 )
Generals good for 2 weeks

1 2 3 4 5 6 7 8 9 10 RX

> > > > > > > > 1. SL 1 packet

2. No.40 pills.
10/05/011 ( 4-0-4 )
for 3 weeks

1 2 3 4 5 6 7 8 9 10 RX

1. SL – 1 Packet
> > > >+ > > S >
27/05/11 2. No.40 pills.
( 4-0-4 )
for 3 week

RX
05/06/11
1 2 3 4 5 6 7 8 9 10
1.Natrum mur
(1M)- 1P -HS
> > > >+ > s S > 2. No.40 pills.
( 4-0-4 )
for 3 weeks
Itching still same
Lesion size reduced
Generals good

129
 DATE SYMPTOM CHANGES PRESCRIPTION
1 2 3 4 5 6 7 8 9 10 RX
1.SL – 7 dose
> > > > > S S > (SOS)
18/06/11 2. 3 grain tablet
(1-1-1)
cramp pains reduced
generals good

1 2 3 4 5 6 7 8 9 10 RX
8/07/11 1.SL – 7 dose
> > > I G S > > (SOS)
2. 3 grain tablet
No fresh complaints (1-1-1)

Generals good
Itching better

> > > > G S > > RX

11/08/11 1.SL – 7 dose
(SOS)
2. 3 grain tablet
Generals good (1-1-1)
No new lesions seen

1 2 3 4 5 6 7 8 9 10 RX
> > > > G S > > 1.SL – 7 dose
(SOS)
2. 3 grain tablet
7/09/11 (1-1-1)
Lesion size fully reduced One month

No fresh complaints

Back pain didn‘t appear again

130
 ANNEXURE III

Fr. MULLER HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL

LEARNING SESSION RECORD

CASE CONCEPT FORM
PATIENTS NAME: Mr. B
CLINICAL DIAGNOSIS: Tinea corporis SCR NO: 22520/11.
Date: 02\09\09
REMEDY: 1. ACUTE: Physician: Dr Sharanendra.
2. CHRONIC: Natrum Mur
3. INTERCURRENT:
A. PROBLEM DEFINITION:

1. INTERVIEW TECHNIQUE. 2. CLINICAL RECORD.

As there was no history available, direct Data‘s were recorded simultaneously in

case taking was done. There was good SCR. Importance were given to patient‘s
rapport between the physician and patient. chief complaints and generals.

B. CORRELATIONS:

3. SYMPTOMATIC 4. CLINICO- 5. PSYCHOLOGICAL.

CLASIFICATION AND PATHOLOGICAL.
EVALUATION.

Symptoms were classified

Itching in the skin with Guilty feeling
according to Kent‘s
scaling –burning –no
philosophy. Reserved
discharge from the skin–
Qualified metals. Problems in life
guilty feeling-expression in

Physical generals. the body – Suppression of problems –

tinea corporis
Characteristic particulars Tinea corporis

131
6. HAHNEMANNIAN MIASMATIC PATHOLOGY: CURRENT

INTERPRETATIONS.

Fundamental miasm: Can be derived from patient‘s family history and past history of

complaints- psora.

Dominant miasm: Derived from clinical presentation, associated complaints and mental

symptoms - psora.

7.ACUTE 8. CHRONIC TOTALITIES. 9. INTERCURRENT

TOTALITIES.
TOTALITIES.
Natrum mur was selected according to Kent‘s philosophy and it covers all the three totalities
Mind:
Ailments from –after guilt
Wants to be alone
Grief
Anxiety about health
Contradiction intolerant
Inferiority feeling
Physical generals:
Thermally- hot
Dreams- daily events, god
Craving: coffee, vegetable and pungent thinks
Aversion: sweets
Characteristic particulars:
Erythematous eruption < oily food meat
Burning and itching in skin < night ,cold water application

132
 C. ANALYSIS AND SYNTHESIS.

10. SEQUENTI- 11. SPLIT TOTALITIES. 12. RELATED TOTALITIES.

AL TOTALITIES
pulsatilla comes close to Natrum
mur in the general complaints but
since it was not covering the
patient as a whole, so it is not
given

D.PROBLEM STRUCTURALISATION

A/F – Grief,
Anger

PATIENT

Erythematous patches with scaling Suppressed emotions

Itching3 Burning3 dreams of god, family

Tinea corporis Members

133
 E. PROBLEM RESOLUTION

13. MANAGEMENT: 14. MANAGEMENT: 15. MANAGEMENT:

GENERAL GENERAL GENERAL
ENVIRONMENT. INDIVIDUAL. REPLACEMENT.

Assurance to the patient.

Self-protection from
scratching
Avoid meat and oily food

16. MANAGEMENT: MECHANICAL MEASURES AND ANCILLARY

MEASURES:

Self-protection from scratch injury

Avoid meat and oily food

17. MANAGEMENT: SPECIFIC HOMOEOPATHIC: PLANNING AND

PROGRAMING:

The patient presented with chronic complaints and based on the totality Natrum

muriaticum was prescribed on constitutional basis.

REMEDY SELECTION. POTENCY SELECTION. REPETITION SHEDULE.

Natrum muriaticum 200 Repeated when

(Constitutional) Ascending potency was improvement stops
employed.

PLACEBO ADMINISTRATION: Placebo was given for adequate spacing and

psychological support of the patient.

REMEDY RESPONSE: The totality was clear, hence the constitutional remedy was

administered, gradual improvement of the disease condition.

REMEDY REGULATION: As per response and change in symptom – low to high

potency has been planned.

134
PALLIATION: not needed as the underlining pathology can be reversed back.

CURE: Complaints were relieved significantly.

SUPRESSION:

HERINGS LAW OF CURE:

18. PROGNOSIS: Good. Patient was showing good improvement.

F. EDUCATION AND TRAINING:

1. Shows the efficacy of Natrum Mur as a constitutional remedy

2. Efficacy of Homoeopathic treatment over other modes of treatment in tinea corporis.

CASE CONCEPT EXPOSITION

Natural infection is acquired by the deposition of viable arthorospores or hyphae

on the surface of the susceptible individual

Invasion of the skin at the site of infection is followed by centrifugal spread

through the Horney layer of the epidermis, after this period of establishment (incubation),

which lasts 1-3 weeks, the tissue responses to infection become evident

The characteristic annular appearance of many ringworm infection results from

the elimination of the fungus from the center of the lesion, and subsequent resolution of

the inflammatory host response at that site.

135
1. CLINICAL DIAGNOSIS:

1. Tinea corporis

Natural infection is acquired by the deposition of viable arthorospores or hyphae on the

surface of the susceptible individual

Invasion of the skin at the site of infection is followed by centrifugal spread through the

Horney layer of the epidermis. After this period of establishment (incubation), which

lasts 1-3 weeks, the tissue responses to infection become evident.

The characteristic annular appearance of many ringworm infection results from

the elimination of the fungus from the center of the lesion and subsequent resolution of

the inflammatory host response at that site.

This area usually becomes resistant to re-infection, although a second wave of centrifugal

spread from the original site may occur with the formation of concentric erythematous

inflammatory rings

Some inflammatory cases of animal infection resolve spontaneously in a few months,

while a typical case of T. rubrum, Tinea corporis may persist for years.

2. REMEDY DIAGNOSIS

Constitutional Remedy: Natrum Mur was selected as constitutional remedy which

covers all the three totalities. A constitutional treatment was needed in this type of

chronic diseases where multiple sectors were involved. The dosage schedule adopted and

changes have been done depending on the susceptibility and also on the basis of potency.

136
A.PROBLEM DEFINITION

1. Interview technique: Direct case taking was done as there was no written record of

patient available. The interview began with chief complaints; there was active interaction,

careful observation, listening, questioning, and accurate analysis of case in hand. Patient

was observed as confident and active. Rapport between physician and patient was good.

2. Clinical record: The data were simultaneously recorded in SCR with interview. The

physician noted chief complaints, past history, family history, mental and physical

generals were recorded. There after general physical examination, local examination and

systemic examination was done and recorded.

B. CORRELATIONS

3. Symptomatic classification and evaluation: Symptoms were classified according to

Kent‘s philosophy giving prime importance to generals followed by particulars. In

generals, mental generals were given prior importance than physical generals.

4. Clinico pathological: Anxiety, anger, irritability, grief his environment caused

erythematous patches with scales over the body.

5. Hahnemannian miasmatic pathology:

Fundamental miasm: psora

Dominant Miasm: psora

137
C. ANALYSIS AND SYNTHESIS

6. Chronic constitutional totality:

Mental generals
Mind:
Emotional: Ailments from – A/F suppressed anger, Wants to be alone Grief, Anxiety about
health, and introvert behaviour.
intolerance to Contradiction, Inferiority feeling
Intellectual: Perception- good, Decision - takes own, Perfectionist
Physical generals: perspiration increased craving for pungent and cold drinks aversion sweets
hot patient
Characteristic particulars: Erythematous circular patches with scaling < winter3 <meat2
<sun2 <perspiration2
Itching3, Burning3 <night2 <scratching2 >hot water application3

7. Related Totality: comes close to Natrum Mur but Pulsatilla is differing in its metals.

8. Reportorial technique: Not adopted

D.PROBLEM STRUCTURALISATION

To define and explain the patient as a whole, essential evolutionary totality

considered in which mental generals, physical generals, chief complaints, diagnosis,

fundamental miasm and dominant miasm are included.

E.PROBLEM RESOLUTION

9. General management: Assurance to the patient..

Self-protection from injuries

Avoid meat and oily food

138
10. Specific management: As the complaints are chronic, constitutional remedy Natrum

Mur 200 was selected and administered one packet for two weeks.

11. Potency selection and repletion: 200th potency was selected as patient was presented

with acute exacerbation and was prescribed 1 dose in sugar of milk once in week.

12. Placebo administration: Placebo was given for the satisfaction of the patient.

13. Remedy regulation: Natrum Mur 200, powder dose at bed time weakly once was

given. Since the remedy responded well, frequency was decreased and potency was

increased in subsequent follow up as remedy has to cover all the phases of the disease.

14. Remedy response: Gradual improvement of the symptoms.

F. EDUCATION AND TRAINING

This case gives some idea in the treatment of the cases with reversible pathology.

According to source books cases with reversible pathology should be treated with

infrequent doses of higher potency of some sector remedies. But this case showed scope

of simillimum selected at constitutional and miasmatic level after thorough case taking.

139
 ANNEXURE IV
FATHER MULLER HOMOEOPATHIC MEDICAL COLLEGE& HOSPITAL
STANDARDISED PAPER IN HOMOEOPATHIC PRESCRIBING
MASTER ANSWER BOOK.

PHYSICIAN: Dr S.M CASE REG NO.OPD/22520/11 INDEX NO.

ACTION. REASONS.
I. CLINICAL Tinea corporis
DIAGNOSIS.

II PERCEIVING THE
TOTALITY.
1. ACUTE. Not considered.
(a) Fixed general totality.
(b) Sector totality. Taken when necessary
2. CHRONIC. Family history not
significant
(a) Dominant miasm. psora
Skin itching, burning
Perspiration increased
Craving for pungent things
(b) Acute exacerbation. Nil.
(c) Periodic expression. Nil.
(d) One sided expression.
(e) Suppression.
(f) Mixed miasm. Nil.

(g) Sequence. Nil.

(h) Drug affects miasm. Nil.
Cause: (i)Fundamental Grief
(ii) Precipitating. Winter, mental stress

(j) Aggravations. <winter<sun2 <mutton2

<perspiration3<itching2

140
(k) Ameliorations. >cold water application
(l) Generals. Wants to be alone
Mental. Grief, Anger, Reserved
Anxiety about health
Contradiction intolerant
Inferiority feeling

Physical. Thermally- hot

Dreams-of daily events, god
Craving: cold drinks and
pungent thinks
Aversion: sweets

Characteristic particular
Erythematous patches with
scalingwithItching3and Burning3
Calf cramp pains < walking

III. REPERTORIAL Not required as the totality is

APPROACH. clear

Reading The Analysis.

Potential Differential Field. Mental symptoms mental general

References to Homoeopathic Boericke‘s Materia Medica Referred for selection of a

Materia medica. remedy which covers
Homoeopathic psychology
completely
Philip M Bailey
IV. NON REPERTORIAL Grief, Anger , Reserved
APPROACH.
Consolation aggravation
1. Structuralisation.
Anxiety about health
2. Key Notes.
Desire-spicy food, coffee
Scaly erythematous patches
Thermally-hot

141
 ACTION. REASONS.
V. PLANNING AND
PROGRAMING
THERAPY.
1. Acute RX. Not given as it was not in
acute phase
Potency & Repetition.
2. Chronic RX. Natrum mur 200 one dose/15 As it is a chronic case
days
Potency & Repetition.
3. Intercurrent RX Not given any anti-miasmatic
as there was no miasmatic block
Potency & Repetition.
4. Placebo. No. 40 pills were given For satisfaction of the
Patient.
VI. REMEDY Relief of complaints at sector Since remedy given in low
RESPONSE. level potency, hence it acted at sector
level
(a) Interpretation.
(b) Action. The same remedy was given in More the simillimum higher the
higher potency potency
5.Purpose Chronic case with prominent mental and physical generals so
constitutional remedy was found which at first gave in low potency
Reasoning
with frequent repetition as patient present with acute exacerbation of
Expectations complaints. Later given higher potencies with infrequent repetition
with gradual improvement.
As the disease is having irreversible pathology a permanent cure was
not possible so, relieving of troublesome symptoms has been
expected.
VII.GENERAL This case shows the efficacy of Constitutional remedy in diseases
COMMENTS having reversible pathology. Reversible pathological conditions can
be corrected by the constitutional treatment.

142
 ANNEXURE V - MASTER CHART
Scoring
Sl. SCR Preliminary Age Acute Constitutional Result
Totality Miasm
no no Data sex remedy Remedy B A
1 11203 Mr A. s 39M Mental generals Sycotic Lycopodium 4 0 Improved
Electrician Religious
Muslim Anger-suppresses
Ullala Increased-sexual desire
Reserved
Irritable
Physical generals
Dreams-accidents
Desire-veg, sweets
Aversion-fish, salt.
Characteristic particulars
Skin-itching trunk region
< exposure to air
>pressure, hot water bath.
2 11382 Mr Ay 40M Mental generals psora sulphur Ars alb 3 1 Improved
Business Mild
Muslim Vary anxious
Manjanady Family oriented
Physical generals
Dreams-dead bodies
Desire-egg, cold drinks
Thermal –chilly
Characteristic particulars
Skin-itching, lower abdomen & behind
knee
>hot water bath
<perspiration, evening.

143
3 14977 Mrs. M 44F Mental generals Psora Sulphur 3 1 Improved
Housewife Fear-for death
Muslim Reserved
Uimala Broods-about husband‘s death.
Physical generals
Thirst- increased
Desire- sweets, veg.
Aversion- milk, meat.
Sweet- increased.
Thermal- hot
Characteristic particulars
Itching eruptions,
Abdomen and axilla
<rainy season, menses during
4 17467 Mr Ily 29M Mental generals sycosis Nux vom 3 0 Improved
Welding shop Anger-violent
Muslim Quarrelsome
Derlakatta Guilty of it
Likes company
Physical generals
Desire-cold drinks
Aversion-hot drinks
Thermal-hot
Characteristic particulars
Itching with hair loss
<summer, soap.
Abdomen distension.
<chicken. Spicey food

5 19529 MD sh 18M Mental generals psora Bacillinum 4 1 Improved

Student, Mild
Muslim Anxious-health about
Derlakatta Fear –darkness
Physical generals

144
 Desire-salt, spice
Aversion-sweets
Characteristic particulars
Skin:
Itching thighs, hands, trunk.
<night, warm water >scratching
6 20201 Ms A.SRF 13F Mental generals psora Tellurium phosphorus 4 1 Improved
Student Weeps- easily
Muslim Fear –seeing blood
Mangalore Active- quick in work
Timid
Physical generals
Desire-sweets, spicy
Sweet-increased
Thermal-chilly
Characteristic particulars
Skin-itching, circular patches
Reddish eruptions with raised margins
< sweating
7 20343 Mr H. D‘souza 58M Mental generals psora Tellurium 3 0 Improved
Business Abandoned feeling
Christian Dipsomania
kalathadamme Reserved
Physical generals
Desire-sweets
Thirst-reduced
Appetite-reduced
Characteristic particulars
Skin- lf shoulder and scapular region
Itching eruption
<night, perspiration
> scratching.

145
8 22173 Mrs. P. Shetty 48F Mental generals sycosis Tellurium 3 1 Improved
Sweeper in Anger-gets easily
hospital Reserved
Hindu Company desire
Kumpala Physical generals
Sleep position lt side
Thirst-increased
Desire-fish, sweets
Thermal- hot
Perspiration-increased on face
Characteristic particulars
Skin-itching, burning hypo-pigmented
patch
9 22259 Mr. ADL 60M Mental generals psora sulphur 3 0 Improved
Retired Travelling likes
Muslim Financial loss
Mangalore Physical generals
Perspiration- scanty
Appetite- reduced
Thirst- reduced
Desire-tea
Skin- blackish discoloration
Characteristic particulars
Itching
<night, rainy seasons
>bathing, scratching
10 21348 Mrs F.Z 25F Mental generals psora sulphur 3 3 Not
Muslim Anger-violent beets her children‘s Improved
Housewife Weeps-easily when sad
Kuttar Likes to be alone
Consolation likes
Appetite- decreased
Physical generals
Sleep-disturbed

146
 Thermal-hot
Craving-veg
Aversion- fish
Characteristic particulars
Skin- on neck and back
Burning and itching
<5pm, sun exposure
Urine-involuntary
Female –leucorrhoea
Profuse
11 17632 Mr M. K 52M Mental generals psora Ars alb 3 0 Improved
Coolie worker Anxiety- marked
Muslim Dreams-fearful
karkal Fastidious
Anger-gets easily
Physical generals
Thirst- increased
Craving-rice
Aversion- oily food
Sleep- talks in sleep
Addictions- smocking
Characteristic particulars
Chest-retrosternal burning
>milk, ice cream
<spice
12 15813 MRS.KV 27F Mental generals sycosis Bacillinum Sepia 4 3 Not
Beedi rolling Mind-mild Improved
Muslim Weeps-easily
Ullal Company-desire
Grief
Physical generals
Craving-pungent
Aversion –sweets
Perspiration- scanty

147
 Thermal- chilly
Characteristic particulars
Skin- itching, scratches till it bleeds
Burning> warm application
Eruptions-scaly
13 16134 Mrs. S.I 45F Mental generals psora Calc carb 3 0 Improved
Beedirolling Fear-thunderstorm
Muslim And in closed places
Ullal Yielding temperament
Reserved
Physical generals
Thirst-reduced Perspiration-increased
Neck region Aversion –meat
Characteristic particulars
Skin- lower abdomen and trunk
Circular eruptions scratching till it bleeds
burning< scratching <perspiration
14 16513 Ms. S. S 18F Mental generals psora Bryonia Nat mur 4 1 Improved
Student Mind- disturbed easily
Hindu Reserved
Kasargod Offends easily.
Suppressed mortification
Physical generals
Dreams- daily events
Thirst- increased
Craving- potato
Aversion- milk products, onion
Characteristic particulars
Skin- hands. Thighs
Papular eruptions, reddish itching
<night, warmth, evening
>hot water
Headache< evening. lack of sleep

148
15 22646 Mr AB 51M Mental generals Psora Ars alb 3 0 Improved
Business Anxious
Manjanady Reserved
Suppresses emotions
Irritable
Brooding
Lazy-at work
Tension-financial matters
Physical generals
Perspiration-increased
Thirst- increased
Cr-fish, sweets, fried food
Thermal- hot
Characteristic particulars
Skin-eruption, black discoloration
Itching, burning.
< mid night.
>hot application
Cough <early morning

16 20196 Mr. A.R 20M Mental generals Psora Bacillinum Ars alb 4 2 Improved
Business Ambitious
Muslim Company desire for
Manjeshwar Fear- snakes
Industries
Physical generals
Perspiration-increased
Craving- veg
Aversion- beef
Thermal- hot
Characteristic particulars
Skin-legs and thighs
Itching burning, watery discharge on
scratching

149
 <night, moist, perspiration
>scratching
17 20147 Mr. M 32M Mental generals Psora Sulphur 3 1 Improved
Driver Anger-gets easily
Muslim Company-desire
Baikampadi Conscious- self
Anxiety- health about
Physical generals
Perspiration- increased
Aversion-veg
Bowel- constipation
Thermal- hot
Characteristic particulars
Skin- waist and hands
Itching, burning
<evening, exposure to sun
>cold water application
Back pain
<sitting, exertion
>sleep and rest
18 15305 Mr ABL 25M Mental generals psora Tellurium Sulphur 3 1 Improved
mathalif Anxiety- about future
Cooliworker And about financial loss
Muslim Company- desire for
Deralakatte Anger- gets easily
Physical generals
Aversion-veg, bread
Desire- chicken. salt
Thermal- hot
Characteristic particulars
Skin- eruption with well-defined margin
Itching
Burning till it bleeds

150
19 53969 Mr. l..D‘mello 48M Mental generals psora Ars iod Lyco 4 0 Improved
Agriculture Irritable-trifles at
Neerumarga Anxiety-anticipation
Anger-on contradiction
Memory-weak
Physical generals
Dreams- snakes and animals
Craving- sweets, warm food
Thermal – hot
Characteristic particulars
Skin- trunk and limbs
Itching till it bleeds
<4 to 7pm before full moon and new moon
>warm water
GIT-distension
<spice and milk
20 56024 Mr k.k 29M Mental generals psora Phosphorus 4 1 Improved
Business Benevolence- helps peoples in difficulty
Hindu Anger- never gets
Mangalore Company-likes
Physical generals
Craving- meat
Aversion- chicken
Thermal- chilly
Characteristic particulars
Skin- white circular eruption
<winter, sweets, hot weather, morning
>cold water.
21 50634 Ms S. J 25F Mental generals psora Natrum mur 3 0 Improved
Computer Fear- alone when and snakes
instructor Mildness
Hindu Physical generals
Ullal Bold- in taking decision
Craving- fish, sweets

151
 Thermal-hot
Characteristic particulars
Skin- limbs circular eruption, itching,
scratching
<rainy season, night
>hot application
22 58227 Ms. CLA 15F Mental generals psora Bacillinum Calc phos 3 3 Drop out
Student Ambitious
Christen Company- likes
Kankanady Brooding-weeps
Fear- darkness. Snakes. Dog
Physical generals
Perspiration- increased
Craving- veg
Aversion- milk
Thermal- hot
Characteristic particulars
Skin- itching on chest and trunk
<night, perspiration
>cold application
23 56152 Mr F.lobo 54M Mental generals psora Nux vom 3 1 Improved
Government Mind- memory weak
servant Irritable
Christen Anger- shouts
Jothi nagar Physical generals
Craving- ice-cream, sweets, butter milk
Addictions- alcohol
Characteristic particulars
Skin- itching <hot water
Asthma- <morning
Back pain- <night, perspiration
>warm water bath

152
24 21546 Ms J. D‘Souza 20F Mental generals psora Sulph Calc carb 3 0 Improved
B.E student Mind-consolation desire
Christen Indifference-his family
Thalappadi Company-desire
Weeps-anger after
Physical generals
Desire-chicken, fish, egg, chocolates, spice
Perspiration- on face
Menses- scanty
Thermal-chilly pt.
Characteristic particulars
Skin-lower abdomen and groin region,
tinea itches in night
25 52046 Mrs. N.P 28F Mental generals psora Ars sulp 4 4 Not
Beedirolling Mind- mild disposition improved
Hindu Company- desire
Kuttar Complains- when thinking about it
Physical generals
Craving- sweets, veg, egg
Aversion- spice
Thermal- chilly
Characteristic particulars
Skin- eruption on back
And trunk
<perspiration, summer, >hot water
26 58560 Ms S.b 15F Mental generals psora Puls 3 0 Improved
Student Absorbed- in thoughts
Muslim Laziness- in work
Nandikutta Reckless
Resterved
Physical generals
Craving- cold, fried and funk foods
Aversion- milk, sweets
Thermal- hot

153
 Characteristic particulars
Skin- itching
<night, bathing after
27 15130 Mr. MD. P 60M Mental generals Tubercular Bacillinum 3 1 Improved
Business Diplomatic
Muslim Religious
Manjanady reserved
Obstinate
Physical generals
Addiction-smoking
Perspiration- profuse
Thirst- for warm water
Desire- warm food and drinks
Thermal- hot
Characteristic particulars
Skin- lower limb.
Itching, circular patch.
<scratching
<perspiration
28 17632 Mr. M.K 52M Mental generals Psors Sulphur Ars arl 4 1 Improved
Coolie worker Anxiety –highly
Muslim Dreams- fearful
karkalla Fastidious
Anger-easily gets
Confused- perception
Physical generals
Thirst-reduced
Craving- rice
Aversion- oily food
Sleep- talking in
Characteristic particulars
Skin- leg anterior aspect
Eruptions, itching till bleeds
<touching

154
29 22262 Mrs. MG 55F Mental generals Psora Nat mur 3 0 Improved
House wife Irritable
Hindu Anger-easily gets
Deralakatte And while thinking of complaints
Physical generals
Apatite- reduced
Thermal-hot
Desire- fish, salt
Aversion- milk
Characteristic particulars
Skin- itching, red eruptions
>scratching
>hot water application
<night
30 22520 Mr. .B 47M Mental generals psora Nat mur 4 0 Improved
Muslim Introvert
Working in Anger- easily
hotel Sympathetic
Muslim Family oriented
Belma Grief
Physical generals
Craving- coffee, vegetable, spice
Aversion- sweets
Thermals- hot
Dreams- daily work
Characteristic particulars
Skin itching, burning, scaling< sun, heat,
perspiration, meat, scratching
>hot water application

155