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org (E-ISSN 2348-1269, P- ISSN 2349-5138)

“Study of Thermals used for differentiating the

similar medicines during repertorization through
Synthesis Repertory”.
Dr. Snehal Jayant Patil1, Dr. Arun Bhargav Jadhav2, Dr. Anita S. Patil3.
1
Post - Graduate Scholar, Department of Homoeopathic Repertory, Bharati Vidyapeeth (Deemed to be) University Homoeopathic
Medical College & Hospital, Pune. India.
2
Principal, Bharati Vidyapeeth (Deemed to be) University. Homoeopathic Medical College & Hospital, Pune. India.
3
Head of Department, Department of Homoeopathic Repertory, Bharati Vidyapeeth (Deemed to be) University Homoeopathic
Medical College & Hospital, Pune. India.

Abstract: -

A study was conducted to find out the caliber of Thermals in finding out the final similimum with
the help of Synthesis Repertory. Thermals are part of a human being which helps in forming the complete
constitution of a human being. Master Samuel Hahnemann the father of Homoeopathy has also emphasised
on thermals start from his first proving. Synthesis Repertory by Dr.Fedrick Schroyen’s which is the enlarge
version of 6th American edition of Kent’s Repertoire, is the largest among all the Repertories with all the
information and continuous verification. It contains all the remedies and rubrics. So, this study was taken up
to know the gravity of thermals in selection of similimum. This wasPhaze2-Single blind prospective, single
armed, non-randomised study. Total of 30 patients from 15-70 age group, both gender consisting of either
chronic or acute cases was studied. Out of 30 cases 25 (83.33%) cases which were chronic showed complete
amelioration whereas, 5 (16.66%) cases which were acute remain unaltered.

Keywords: - Homoeopathy, Thermals, Constitutional remedies, Similimum.

Introduction: -

Man is a Homoeothermic animal, i.e., warm blooded; Thermoregulation is managed by the pre-optic
anterior hypothalamus. The mechanism of temperature of body in every individual differs depending upon
his cellular and biochemical reactions. The normal temperature of body is 370 C (98.60 F) in human
beings.(1) There are two types of free nerve endings located in the skin to control the temperature in human
body, i.e. thermo receptors a) Heat receptors which react to warmer temperature b) Cold receptors which
react to cooler temperature. The autogenous nervous system counter to an immediate defence of thermal
neutrality where as endocrine system interferes with the delayed response.(2,1) Discharge of norepinephrine,
thyroxin and sympathetic stimulation is the outcome of autogenous nervous system and is responsible in

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heat production in individuals.(3,1) Dr. Hahnemann while testing cinchona officinalis (china off.) the first
medicine, with his skin observation noted down the thermal sensation (heat sensation) i.e. fever and chill
sensation i.e. rigor. Every remedy that was discovered by the Master manifests its own thermal sensations.
Dr. Hahnemann has comprehended that thermals are important in forming the symptom totality and in
selecting exact similimum. Homoeopathy based on principles of “Similia Similibus Curenter” mentions
about selecting the thermally hot remedy for individuals perceiving warm aggravation, amelioration desire
for open air, cold air and themally chilly desire for warm air vice versa. (4, 5)In aphorism 83-93 (6th edition
of Organon of Medicine), Dr. Hahnemann has explained the importance of individualization of case and
disease. Thermals form the physical generals of a patient, which helps us to individualize the case,
differentiate the remedies and in the final selection of the remedy.(6)There is peculiar symptomatology in
terms of Hot and Cold for almost every remedy in Homoeopathic Materia Medica. During the drug selection
thermal modality of patient forms an important axis. While case taking rubrics like ‘lack of heat, vitality’
and ‘tendency to take cold easily’ are used to denote the chilly patient.(7)Thermals are important for
selection of the similimum. (8) Dr. Gibson Miller has worked in depth on thermal sensations. He explains
thermal modality as, the effect of different temperature upon the patient as a whole.(9) Different stalwarts of
Homoeopathy have guided us in reaching a similimum. Dr. Hahnemann has focused on individualization of
the patient, i.e. more striking, singular, uncommon and peculiar symptom where as Dr. Kent has emphasized
on mental generals, Dr. Boger on generalization of symptom, Dr. M. Sehgal suggested for mental symptoms
as the chief guiding symptom.(10)In Homoeopathic philosophy the trilogy of disease and a trilogy of thermal
reaction holds the trick to Cure.(11)As Homoeopathy law implies that for hot patient hot medicines should be
prescribed and for chilly patient’s chilly medicines. Thermals can be classified as hot, Chilly and ambi-
thermal. Remedies in Homoeopathic Materia Medica have all three types of thermal sensations, but differ
according to atmospheric changes, dietary changes etc. Hot or Cold aggravation makes it a particular. We
are concerned with "GENERALS". Now, we are concerned with the tolerance of that person to heat or cold
as compared with others around him in the same environment.(12) Thermals can be confirmed analysing
sensitivity to environment like decreased tolerance to heat (as compared to others in the same climate) can
safely be taken as HOT, decreased tolerance to cold (as compared to others in the same climate) can safely
be taken as CHILLY, increased tolerance to cold (as compared to others) can safely be taken as HOT,
increased tolerance to heat can be taken as Chilly.Repertory is an index to the Homoeopathic Materia
Medica. The repertory helps us to find out required symptoms, together with the medicine or a group of
medicines having different grades.(13) Synthesis repertory is the printed version of RADAR (Rapid Aid to
Drug Aimed Research) computer program. It is largest among all repertories. It contains all its rubrics and
remedies. The repertory has been improved qualitatively in structure and language to make it more
comprehensible and to facilitate easy reference at the time of need.(13,14)

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Methodology:-

Study design -Single blind, prospective, single armed, non-randomized study was administered in Bharati
Vidyapeeth Homoeopathic Hospital, Pune from 2017-2019(18months).A sum of 30 individual of each
sexes, within age group 15 - 70 years, of all groups were registered in the research.
Case definition- After giving informed consent cases requiring remedy is given on the basis of thermals
whether chronic or acute diseases were as selected for study. Patient of 15-70 ages & both sexes were
considered.

Inclusion criteria-

a) Chronic as well as acute cases were considered.

b) Cases with well illustrated thermals were considered.
c) A patient who was ready to take treatment & were as co-operate with regular follow up.

d) Patients of both sexes and age of 15-70ages.

e) Patients who were fulfilled the case definition.

Exclusion criteria-

a) Patient who we’re requires emergency medical treatment.

b) A patient who was not taken medicines as per direction or not co-operating for follow-up.
c) Systemic diseases with its complications.
d) A patient who was suffering from lethal diseases.
Questionnaire format -
Questions interviewed to the patient for analysing accurate thermals (15)

a)Do you prefer warm covering in winter?

b) How many coverings are required during winter while sleeping?

c) You prefer heated water or cool water for bathing?(in winter or summer)

d) Would you prefer warm room, in open air, closed room?

e) Are you sensitive to cold air or hot air?

f)Are you sensitive to cold exposure or hot exposure?

g)Are you sensitive to getting wet in rain?

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h)Do you require fanning?

i) Are you sensitive to cold draft or open air?

Prescription format –

A standardized prescription was prescribed on the basis of thermals followed with classical homoeopathic
approach. Four pills twice a day for 2/3 weeks, followed with three pills twice a day 2/3 weeks as per need
of case was maintained throughout trial.

Outcome assessment–

The clinical trial was conducted with a total no of thirty participants who had completed their regular follow
ups. The outcome of the research was formed by the structured pro-forma of case taking. Thermals were
abolished on the nine points of the questionnaire.

Outcome analysis was done under three headings -

Marked More than 75% disappearance of symptoms.
Moderate- 50-70% disappearance of symptoms.
Mild- Smaller than 50% disappearance of symptoms.

Analysis of data and statistical techniques –

Statistical analysis was performed as per the outcome evaluated from the questionnaire.The graphs &
figures provided with the help of Microsoft Excel 2007. For the analysis of data participants who had
fulfilled the criteria as per the protocol was added in the research. Data were expressed in percentage (%).
Result: -

In this trial 45 participants were registered within the study. 10 participants were ruled out as per inadequate
follow ups.5participants were excluded in this trial due to negligence in taking medicine. Total 30 patients
registered in the trial.16 were female (53.333%) and 14 males (46.666%)

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Total Patients
Completed Drop Out

33%

67%

Fig. (1) Total no. of participants

Completed 30
Drop Out 15
Total Participants in the study 45

Table (1) Total no. of participants..

Gender Of Patients
Male Female

48%
52%

Fig. (2) Gender-wise distribution of participants.

Gender Number of Patients Percentage (%)

Male 14 46.666%
Female 16 53.333%
Total 30 100%

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Table no. (2) Gender- wise distribution of the included participants.

25
0-20
20
20-40
15 40-60

10 60-80
0-20
5
20-40
0 40-60
No Of patient

Figure (3) grouped age wise distribution of the participants.

Age in Year No Of patient Percentage (%)

0-20 2 6.66%

20-40 21 70%

40-60 6 20%

60-80 1 3.33%

Total 30 100%

Table (3) grouped age wise distribution of the participants.

Response to treatment-

marked moderate mild

Fig (4) Response to the treatment according to result criteria.

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Progress No. of subject Percentage(%)

Marked 17 56.666%

Moderate 7 23.333%

Mild 6 20%

Table no. (4) Response to the treatment according to result criteria

nat
Chart Title
phytollaca sulph
3% 3%
onsmodium
staphysagria euphrasia 3% Phosphorus
3% 3% Ars alb 3%
siliciea
7% 17%
causticum
rhus tox sepia 3%
3% 3%
nitric acid pulsatilla
3% 7%
sulphur nux vom
apis mel 7% aloe nat 3%
3% fer met soc bryonia alba mur mag phos lachesis allium cepa
3% 3% 3% 3% 3% 3% 3%

Figure (5) -Case-wise distribution of the selected remedy

Figure (6)-Summary of Thermals utility in homeopathic prescription with outcome analysis.

Name of Number of Thermals. Cases Percentage Outcome

Medicine. times treated. (%). assessment
prescribed
Arsenic 5 Chilly AGE(2), 17 Mild, Mild,
Album Emesis, Moderate,
Allergic Moderate,
rhinitis, Marked.
URTI+
Lumbar
spondylitis
Phosphorus 1 Chilly Osteoarthritis 3 Moderate.

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Causticum 1 Chilly Myaligia 3 Marked.

Sepia 1 Chilly Metrorrhagia 3 Marked.
Pulsatilla 2 Chilly Pyrexia, 7 Marked,
Gastritis. Moderate.
Nux vomica 1 Chilly Constipation 3 Marked.
Allium cepa 1 Hot URTI 3 Moderate.
Lachesis 1 Hot URTI 3 Marked.
Magnesium 1 Chilly Sciatica B/L 3 Marked.
phos
Natrum 1 Hot Hypotension 3 Mild.
muriaticum
Bryonia alba 1 Hot Pyrexia 3 Marked.
Ferrum 1 Hot Emesis 3 Marked.
metallicum
Aloes 1 Hot AGE 3 Moderate.
socrotina
Apis mellifica 1 Hot Urticaria 3 Moderate.
Sulphur 2 Hot Pruritus, 7 Marked,Marked.
Acne rosacea
Nitric acid 1 Chilly Anal fissure 3 Mild.
Stage 2
Rhus 1 Chilly Myalgia 3 Marked,
toxicodendron
Silicea 2 Chilly Migrain 7 Mild,
Staphysagria 1 Chilly Stye 3 Marked.
Euphrasia 1 Hot Conjunctivitis 3 Marked.
officinalis
Phytollaca 1 Chilly Obesity 3 Mild.
berry
Onosmodium 1 Chilly Migrain+ 3 Moderate.
Acute
gastritis
Natrum 1 Chilly Acne rosacea 3 Moderate.
sulphuricum
Note – AGE – Acute gastroenteritis, URTI – Upper respiratory tract infection, B/L – Bilateral.

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Discussion: -

The primary objective of the study was to see the utility of Thermals in prescribing and differentiating

medicine in clinical cases. The trial showed effective results of homeopathy when prescribed on the basis of

thermals with a classical approach. Total patient screened were 45 and 30 were included with a varied

diagnosis. Dietary intervention was consulted as per the need of case. Remedies mentioned in Figure 6.

Showed a marked improvement in cases when prescribed on the basis of thermals. In the study, my major

intention was to understand the importance of thermal state of patient. I had tried to understand the thermal

state and thermal reactions of patient and prescribed the remedy only by perceiving the reaction of patients

about their diseases and changes in life due to disease.30 patients were studied, in my study each patient is

treated by observing the thermal state of the patient. Gender wise incidences in the study out of 30 patients,

16 were females and 14 were males (Table no-2). Age wise incidence was high between the age group of

20-40 years followed by 40-60 years, 0-20 years and last 60-80 years. Each accounted for 21,6,2,1 cases out

of 30 respectively (Table no-3). Out of total 30 cases, 17 showed Marked (Good improvement), while 7

cases showed moderate improvement and 6 cases showed mild response (Table no-4). In the case study of

30 patients the remedies which were indicated in maximum cases are Arsenicum album, Pulsatilla, Sulphur,

Silicea. Case wise distribution of the selected remedy (Table no-5). Summary of thermals utility in

Homeopathic prescription with outcome analysis is shown in (Table no-6). Dietary advises and Counseling

was initiated in cases wherever necessary. In study of my 30 cases I have seen that the presenting symptoms

is more important than the persistent and predominant symptom. In forming a totality, either on the basis of

thermal or physical level I came to a conclusion that the following pattern may consider i.e.(a). Only on the

basis of presenting symptoms (b). Presenting symptoms + Persistent symptoms + Predominant symptom (c).

presenting symptoms. The best thing I learned that different patho-physiological condition of different

remedies which I never practiced in my clinics as Pulsatilla for fever, Lachesis for URTI. Thermals of

patients are important in gradation of symptoms.(16) Inform to grasp the value of Hot and Chilly it's vital to

check and understand the material system of the Body. There are a unit 2 Temperatures of the Body. a) Core

temperature, b) Surface temperature.(12) Although sometimes thermal is considered to be lesser importance

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as compared to medical conditions. Master Hahnemann was right when he taught that “the remedy must

meet the totality of symptoms.” But with our present knowledge this is impossible except by the aid of

repertories.(17) Homoeopathic treatment has proven the significant impact to patient in prescribing

similimum. A detailed case history was interviewed and repertorized in selecting the group of thermal

medicines which was further selected on the questionnaire and helped in choosing the simillimum. In this

study synthesis repertory played a major role in identifying group of thermal medicines. Homoeopathic

Materia Medica helped to finalize the Similimum according to thermals after repertorization of a case. In

this study questionnaire helped in getting accurate thermals of the patient. Human beings are categorized

into three thermal categories- Chilly, Hot, Ambithermal (towards chilly, towards hot).(7) The most aspects

that effect of thermal convenience are those who confirm heat gain and loss, specific rate, covering

insulation, temperature of air, mean effulgent temperature, speed and ratio of air. Psychological parameters,

like individual expectations, conjointly have an effect on the thermal comfort.(18) Thermal discomfort is

affected by an entire vary by individual and environmental objective and subjective factors. (19) Thermal

discomfort can depend upon the age, health standing, and gender of the individual, they're adaptated to the

native climate, and therefore the period of disclosure to temperatures outside the comfort vary.(19) Thermals

are valuable in the choice of the remedy and find out remedy which seems to be indicated one.(20)

Conclusion: -
The study signifies a precise role of Thermals of patients for the choice of similimum analyzing with

repertorization within the management of cases. The current results are a unit positive which provides

associate degree thrust to the action of Homoeopathic remedy elite once through repertorization. This was

Single blind,prospective, single armed, nonrandomised study. Thermals are a unit a part of a person that

helps in forming the entire constitution of a person. Further trials in more sample size can be a futuristic

approach in various non-communicable disease for testing homeopathy through thermals.

Conflict of Interest –

There was no point of Conflict of Interest between the Authors.

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Acknowledgement: –

The authors are grateful to Bharati Vidyapeeth (Deemed to be) University Homoeopathic Medical
College, Pune for their valuable guidance and providing facility to carry out the study. We are indeed
Thankful to patients for their complete faith and have enthusiastically participated in research work.

References: -

1) Nikam AD, Research in Thermal Materia Medica, Maharashtra: Happy Publications; First Edition, 2007,
15-17 pp.

2 )Hole, Human Anatomy and Physiology, Wm. C. Brown Publishers; Seventh Edition, 1996, 443 pp.

3) Kasper, Braunwald, Fauci, Hauser, et. al., Harrison’s Principles of Internal Medicine, New York: Mc
Graw Hill Publishing Division; Fifteenth Edition, 2001, 108 pp.

4) Vijaykar P, Genetic Materia Medica, Mumbai: Preeti Publications; First Edition, 2008

5)Kent JT, Repertory of Homoeopathic Materia Medica, New Delhi: B. Jain Publishers; Low Priced
Edition, 2005, VII pp.

6) 6th edition of organon and philosophy.

7) Rajeev Saxena, Thermal Reactivity in Homoeopathy include Thermal Therapeutics :B.Jain

publications;Edition 2006

8) Kent JT Lectures on Homoeopathic Philosophy, New Delhi: IBPP; Reprint Edition 2000

9) Gibson’s Symptoms Alone their value and selection – page 13

10) Ritu Kumari, Thermals in Homoeopathy:3 November 2013

11) Miasm-and-thermals: May 31, 2013 in General, Home Remedy, Homeopathy, Yoga, Lifestyle, Diet &
Fitness

12) Vijaykar P, Theory of Acutes, Mumbai: Preeti Publications; First Edition, 2000, 1-58 pp.

13) Essentials of Repertorization by Dr. Shashi Kant Tiwari: B.Jain Publication ; Fifth Edition, 2005, page
8,463

14) SYNTHESIS Repertorium Homoeopathicum Syntheticum By: Dr Frederik Schroyens, Edition 9.1 New
Delhi: B. Jain Publishers; Low Priced Edition, 2005, VII pp.

15) Nikam, Thermals Physiology and Homoeopathy.

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16) Siju PV, Evaluation of the Remedy’s Thermal State, New Delhi: IBPP; First Edition, 2003

17) A.W.Woodward : Constitutional Therapeutics:B.Jain Publication, Reprint Edition 1993,81 pp.

18) Thermal comfort article by Sanglorian

19) David Ormandy1 and Véronique Ezratty2 :Thermal Discomfort and Health: Protecting the Susceptible
from Excess Cold and Excess Heat in Housing

20) Dr Dushyant Kamal Dhari :Thermals - Hot and Chilly on March 10, 2010 at 1:57am in Homeopathy-
Study-Guide

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