Classical Homoeopathy Book Four

Classical Homoeopathy
Book Four
By
Dr. Douglas Jesse
D.C.,D.HOM.,M.HOMI.
Electronic Edition 2011
Copyright © Light Pulsations Communications Pty Ltd

Classical Homoeopathy Book Four
This Book is devoted to the study and practice of homoeopathy, and is intended for personal
study only. However, you will also be able to integrate this knowledge applied to the study of
Ionictherapy. You will understand how the Ionictherapy equation will point to those areas of
energy loss in the body, which are disrupting the orderly flow of the vital force. Finally, it must
be pointed out that this book does not attempt to diagnose or treat specific illness. It is written
for students and professionals in the healing arts. It is advisable to seek professional advice in
every case when you are in doubt about your health, particularly when you have persistent pain
or any other continuous symptoms. The Publisher takes no responsibility for the reader’s health
or use or misuse of the information contained herein.
HOMOEOPATHIC NOSODES: A nosode is a disease product obtained from any affected part
of the system in case of illness and is thereafter potentized.
The term "Nosode" is due to the famous homoeopath C. Herring, and was derived from
the Greek word NOSO, which signifies the prefix added to the word to form an idea of disease,
indicating a relation to the disease.
It may be compared with the Latin word NOXA, which means damage (NOXIOUS)
Nosodotherapy is the therapeutic use of organic reactional wastes or some aetiologic factors
which are the sources of "damage" to the disease.
The nosodes are some homoeopathic preparations obtained from microbe cultures, from
viruses. pathological secretions and excretions.
ISOPATHICS: The nosodes of which stocks come from the patient are called isopathics.
The isopathics are prepared from:
- Blood (by puncture of the veins, and in women in some particular cases, the menstrual blood).
- Urine.
- Pathological secretions which may be distinguished as: exudate’s such as liquids from ascites,
hydrocele, leucorrhoea, cephlo-rachidian liquid. Sputum (especially of bronchorrhea). Squares
and transudates of eczemas.
The isopathics are at present of real help to doctors and specially for the interested
person, the patient.
Thus we see that the Nosodes and Isopathics are precisely defined.
HISTORY OF NOSODES: In attempting to treat a disease by the agent which may cause the
disease constitutes one of the most general and valid empirical acquisitions of the art of cure.
Hippocrates wrote, "Vomitus Vomitu Curantur, Est Limus Salivae Sublingua Rabiosi
Canisqui, Datus in Potu, Fieri Hydrophobos Non Patitur". "(There is under the tongue of a rabid
dog a slime formed by its saliva, which when taken in drink, guards against rabies)".
Other first century medical writers recommended that where there is disease, there is also
the remedy. The concept of signatures flowed down through history with such renown
physicians as Paracelsus, Robert Flood and Anthanasius Kircher.
The three great names which dominate the history of Nosodes and Isotherapy are
Constantine Herring, Wilhelm Lux and R.P. Collet.
CONSTANTINE HERRING: Born on 1st January 1800, at Oschatz in Saxony, the son of an
assistant rector, Constantine Herring passed his school years in Zittau. In 1817, he attended the
surgical academy in Dresden and in 1820 Heipzig University, to study medicine.
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In his early years at Saxony he made acquaintance with Hahnemann. He attended his
lectures without entering into any close connection with the students of Hahnemann. They were
mostly older than him and formed an exclusive circle amongst themselves.
In 1833 he travelled to the "New World" and after arrival in Philadelphia, his friends
prevailed upon him to stay there.
In 1835 with Dr. Wesselhoft, he founded the "North American Academy for
Homoeopathic Healing.
It was his study of Lachesis. and his first ideas on the use of Homoeopathic remedies
produced from the excretions or from the pathological secretions, which he termed Nosodes, and
introduced this further extension of homoeopathic treatment.
JOSEPH WILHELM LUX: The second researcher, Lux, was born in Silesie, Germany on the
6th April, 1776. He studied to become a veterinary surgeon, and continued his study of medicine
and natural sciences at Leipzig.
In 1800 he published an article in which he concluded, "The veterinary doctor is the most
important person of the state".
From 1820 he began to read the writings of Hahnemann and applied the new method to
veterinary medicine, which brought him immediately some reputation. From that time he
became and ardent propagator of veterinary homoeopathy.
On the 11th December, 1831 he was requested for a homoeopathic remedy against
glanders and anthrax.
Not knowing any homoeopathic means against these epidemics, his reply was negative,
but he advised to replace the wanting Simile by the 30th dilution of a drop of the nasal mucosa
of an animal attacked by glanders and to give it to animals suffering from that disease.
Thus he created a stock of Anthracinum then Malleinum. In 1833 Lux published his
results in an article entitled "Isopathik der Contagioner" - "All Diseases Carry In Them The
Means Of Their Cure".
The use of the morbid agent itself, diluted and dynamized, because the general method
for therapeutic ends by virtue of the principle according to which "Acqualia Acqualibus
Curenur." Thus not only should be diluted and dynamized the "known" morbid agents as for
example, Scabby of Sheep; Tinea of animals; itch (psora) of man; the blood of the spleen of
animals suffering from Anthrax; pus of syphilis; serum taken from the vesicles of Marochetti in
hydrophobias; lymph of Anthrax and of plague; even of the contagion of cholera; but also, all
sorts of products from secretions and excretions of men and animals (dynamized focal matter, or
humanise, vesicular calculus, sweats of feet, saliva etc.)
Even Lux proposed the use of diluted and dynamized remedies that have become
intogenous because of over dosing (thus diluted Sulphur against the abuse of Sulphur).
The method, one sees will, at first applied also to contagious diseases. Thus he prepared
the most varied nosodes such as Corbyzine, Hominum, Anthraxinum, Leucorrhoea, Scabies,
Equorium, Variola Hominum, Psorian.
FATHERS DENYS COLLET: A religious person of the Order of the Dominican and a Doctor
of Medicine, was born on 21st December, 1824. at Frazi in France. He practiced medicine for 12
years after graduation. In 1865 he began his study of homoeopathy. He re-discovered Isopathy
when he prevented an epidemic of Small pox at Flanigny in 1871 using a dilution of 4ch of
Vaccinum. From that time, being convinced of his method, he took advantage of a sojourn of
many years in Mossoul, a town of Asia Minor, for the application in a large scale of Isopathy.
Later he returned to France where he acted as a physician to a small convent and treated
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that community with the isopathic method.

In 1903 his community being dissolved, he exiled himself at Luscenbourg and died there
in 1909.
His book contains a number of excellent ideas and still more unsupportable opinions.
One such attempt to build a law of therapeutics was: "To cure a diseased organism, it is
necessary that the organism is not universally ill, that there are still some parts that are healthy
and that one uses then an identical or analogous morbid agent, but in relatively minimum dose to
create in the healthy parts of that organism some reactive powers, by the intermediary of
nervous and circulatory system, for being reversed on the diseased part, and help them to dis-
burden themselves on their enemy, the morbid agent.
Further to this he adds, "If the real medicine should be an agent similar to that disease,
and nothing is more similar to the agent of the disease but the disease itself and because the
secretions of man who is diseased are more or less charged with morbid elements which are
naturally expulsed by the outlets, if one knows how to collect these elements from the
secretions, one can surely have in these morbid elements some medicinal agents."
In his second book Collect distinguishes three kinds of Isopathies.
1. Pure isopathy which takes the products of the secretion of the patient as the medicinal
agent to cure the same disease.
2. The organic isopathy (at present organotherapy).
3. Scrotherapic isopathy (dilution of hyper-immune serum).
Collect shows that even the blood may be a source of medicines.
Such is the history of the pioneers of Nosodes which led to a boarding of the scope of
homoeopathic nosodal treatment up to the present time.
In order to clarify substances coming from varied sources, we list the following
classifications.
1. Nosodes.
2. Isotherapies.
3. Allergenologics.
4. Toxicotherapics.
5. Organotherapics.
6. Hormonotherapics.
Generally, in practice, these categories are listed under one heading: MICRO-
IMMUNOTHERAPIES.
We may now see that a Nosode varies from an Isotherapic substance, not in the manner of its
preparation, but in its source. Isotherapics is the product, that serves to get the medicines form
the patient, or supplied by the patient.
THUS ONE DISTINGUISHES:
1. HUMORAL PRODUCTS - Secretions or excretions coming from the patient (Blood, Urine,
Secretions and excretions which are pathogenical).
THESE ARE AUTO-ISOTHERAPICS:
2. MICROBES ISOLATED - From the patient by culture on the appropriate ground. These are
Microbian-auto-isotherapics.
3. ALLERGENOTHERAPICS - They are somewhat particular isopathics because it is the
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question of Allergens, Detergents, pesticides, insecticides, allergen sing medicines etc.

THEY ARE EXO-ISOTHERAPICS:
4. ORGANOTHERAPICS - Dynamised and diluted organotherapics have come to use after the
beginning of Isopathy of Lux.
The word "Sarcode" is sometimes used for the dynamised micro-organotherapics or
according to Tetau and Bergeret - diluted and dynamised organotherapy.
According to P. Schmidt, the Sarcode is a remedy of natural product derived form the
tissues or secretions of animals or human beings, as for example, Cholesterinum, Adrenalinum,
Lac Canimum, Pulmobovis, Urea etc.
Recently a clinical-immunologic study by Bergeret and Tetau (Organotherapie diluee et
dynamiese, Ed Maloine) has given a very good explanation of the question and through their
knowledge raised it to a real autonomous therapeutic discipline within the homoeopathic
framework.
5. HORMONOTHERAPY - Is the particular mode of diluted and dynamised organotherapy.
It is from the work of Louis Frouche', who made a study of homoeopathic clinical
pathology of hormones: parathyroid, thyrotropic hormone, folliculost-imuline and A.C.T.A.
SPECIFIC PHARMACOTAXY
1. SIMPLE BIOTHERAPICS
These are biotherapies prepared from pure microbran cultures, which form the original
stock from which is prepared the "Stock Vaccines", which are then serialised in Hahnemannian
dilutions, viz, Colibacullinum, Eberthinum, Enteroccunum, Pasatyphoidinum,
Staphylococcinum, Streptococcinum, Influenzinum, Serum Anti-Collibacillinum.
2. COMPLEX BIOTHERAPICS
These are complex products for which it is necessary to determine their origin, (the
source from where taken) and its nature described in a protocol giving all the guarantees of the
consistency of the preparations.
The lyophilisation helps to their preservation and assures the permanence of their stocks.
These biotherapics are: Anthracinum, Luesinum, Medorhinum, Morbilinum,
Pertussinum, Psorinum, Pyrogeninum, Tuberculinum and Residnum.
We can see that Micro immunotherapy, which embraces the overall nosodical and
isotherapic system, have grown out of the homoeopathic system of dynamisation. They vary in
that they do not follow "Similia Similibus Curentur" of Hahnemann rather the "Aequalia
Aequalibus Curentur" of Lux.
For Lux his "Aequilia" has an aetiological meaning and even for this reason it will be the
perfect simillinum. This finds the support of Leon Vanner who wrote:
"The true simillum is not what corresponds identically by its pathogenetic symptoms to
the morbid symptoms of the patient, but it is the remedy of the same nature as that of the cause
that has produced the troubles observed. I am sorry that I cannot be exactly of the opinion of the
masters who came before us".
Thus the use of Nosodes although not following the true Hahnemanian tradition have
found their position in the ever widening practice of Homoeopathic Medicine.
If one desires a perennity of homoeopathy, one will paraphrase Heraclite saying:
"HOMEOPATHY IS IN THE CONSTANT BECOMING".
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PRESCRIPTION: The prescription according to an acute and sub-acute condition, or in

chronic cases are to be distinguished for pharmacotherapy.
THE ACUTE STAGE: The prescription of a biotherapic will be done according to the
aetiology of the pathological case in question.
This will be, according to the expression of P. Schmidt, the treatment by the "Iden", the
identical, i.e. to say by the substance pathogenous agent, virus, toxin etc.....which is the probable
cause of the disease.
Thus one will prescribe:
Morbillinum in Measles
Pertussinum in Whooping Cough
Staphylotoxunum in Furuncles etc.
The prescription may require a second biotherapic, or one or two homeopathies.
In fact, a Furuncle will require the prescription of Staphylococcus, or Anthracinum, or
Pyrogenium. But the aetiological prescription requires, according to the pathological condition
and to the evolution of the disease, a homoeopathic prescription of Belladonna, or Hepar Sulph,
Calc, at the beginning: Apis or Tarentula if there is a tendency to phlegms with burning; Merc.
Sol. if the reabsorption is late; Echinacea or Lachesis if the infection aggravates; Calcera Sulph,
to help the evolution, and Silicea to stop suppuration.
Here one perceives the static stage of Isotherapy which surrounds only the aetiological
motivation and the dynamic state of homeotherapy which covers the individual "in progress" of
his pathological evolution.
There is a constant and a variable.
Take the case of an Erysipelas: It requires a constant - Anthracinum of Pyrogenium; and
the variable Belladonna, Apis, Rhus Tox, and Croton Tig.
THE CHRONIC STAGE: In the chronic stage the therapeutic application is to be considered
according to the necessity of a biotherapic prescription of the total person.
The immunotherapic remedy is to be added to the constitutional and temperamental
remedy. The Sulphur patient requires Psorinum, the Phosphoric Tuberculinum, and the Fluoric,
Leusinum.
1. Dr. Poisson reported the case of a patient presenting a grave syndrome of denaturation and
post traumatic depression where all homoeopathic and allopathic treatment failed, and a dose of
Parathyrodium B 9c cured the patient.
2. Dr. Barnard treated a case of chronic bronchitis with sensitiveness to cold, with unhealthy
skin, and lesions because of scratching, with one dose of Psorinum 200K.
With prescribing Nosodes one must look at their indications.
DYNAMISATION: French legislation specifies the use in low dynamisations, such as 4c, 5c,
7c, and 9c.
The high potency 15c or 30c is used when it is a question of inducing typo-
aggressological process in the sphere of important morbid process or anamnestic modality.
The lower and the medium potencies are to be prescribed when it is a question of its use
as a SPECIFIC SIGNAL.
Its action will be directed towards the level of lesion of tissues of organs.
Pertussinum 5c will act in the acute process of Whooping cough and may be prescribed
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in 15c or 30c if one wishes to act on the corticoviscral perturbation.

Medorrhidrium 5c will be prescribed for Gonorrhoeal Articular-Rheumatism, the 30c for
inducing the setting aright the Corticoid-Visceral Rheumatism.
The pharmacopollaxy. which means the repetition of the remedy, is modulated according
to the acute and the chronic stage of the patient.
4c, 5c, 7c, or 5c plus 7c combined are to be repeated every hour and according to the
evolution of the case, the doses are escaped.
The 9c, the 15c or the 30c are to be prescribed in chronic cases once every 7, 15, or 50
days.
There are some clinical situations where the prescription of high dynamisation may be
used daily.
REMEDY STUDIES:
ANTHRACINUM: This nosode has proven a great remedy in epidemic spleen diseases of
domestic animals, and in septic inflammation, carbuncles, and malignant ulcers. In boils and
boil like eruptions, acne.
Induration of cellular tissues, Abscess, Bubo, and all inflammation of connective tissue
in which there exists a purulent focus.
GENERALITIES: Here it is a question of a patient who becomes suddenly septicemic with
asthma, emaciation, intense thirst, developing towards a state or prostration.
High fever with an anxious state, delirium of nearing death.
NERVOUS SYSTEM: Adynamic condition, excessive sensitiveness, Delirium.
SKIN: It is the most characteristic seat Anthracinum ulceration with intense burning. At. first
there is a local induration of subcutaneous tissues. Afterwards a blush, violet coloured vesicle,
which becomes black, and from which there is an ichorous, foetid and irritant secretion.
The ulceration may end in gangrene, having intense putrid smell. This condition is
accompanied corresponding adenopathy with big and painful lymphatic ganglions.
DIGESTIVE SYSTEM: Hard ligneous swelling of parotids and submaxillary glands,
predominantly right side.
Intense thirst.
Diarrhoea with liquid stools having foetid smell.
POSOLOGY: 4C TO 9C. Lower dilutions to be repeated many times daily. High dilutions 7c
and 9c every three days.
RELATIONSHIP: Similar to Ars. Alb. which it often follows.
BACILLINUM OF BURNETT: Bacillinum is especially indicated for the lungs of old people,
with chronic catarrh and enfeebled pulmonary circulation, attacks of suffocation at night with
difficult cough. Suffocative catarrh, Tubercular meningitic, constant disposition to take cold.
NERVOUS SYSTEM: Patient is depressed, sad, irritable, likes movement. Has a frequent chill,
violent deep depressing headache, better by complete rest and is aggravated by the slightest
movement of the head.
EYES AND EARS: Eczema of the eyelids, eczema of the ear passage. Impetigo behind the ears.
RESPIRATORY:
NOSE: Small painful furuncles, situated specially on the nasal orifices. Discharge of foetid pus,
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greenish ozena.
LUNGS: Bronchitis with jerking and fatiguing cough, spasmodic suppression, catarrhal
dysponea, humid asthma, bubbling rales and micro-purulent expectoration, cough whilst
sleeping.
MOUTH: Toothache, teeth sensitive to cold air. Roots of teeth are painful. Abundant dental
Tatar.
STOMACH: Gastric flatulence with pinching pain under the right ribs. Appetite diminished.
ABDOMEN: Abdominal pains, enlarged glands in the groins. Sudden diarrhoea before
breakfast. Obstinate constipation.
SKIN: Impetigo of the head; pityriasis versicolour, squamous eczema, generalised pruriginous
eruptions.
Weeping eczema of the head behind the ears and in the folds of the skin.
Alopecia of the head.
MODALITIES: Aggravation by movement, cold air, at night and in the morning.
Amelioration by change of weather, continued movement.
POSOLOGY: Should not be given below 30c and used only once a week. It is rapid in its action
and no need for frequent repetition.
INFLUENZINUM: Made from various strains of the influenza viruses.
GENERALITIES: General feeling of illness with chill, headache, diffused pains, general
stiffness. Temperature 39-40c .Asthma and Anorexia.
Headache of influenza. Eyes are heavy and sensitive to movements, stiffness.
DIGESTIVE SYSTEM: Pharyngitis, Gastro intestinal pain, weakening diarrhoea, weakness of
the anal sphincter.
RESPIRATORY: Dry painful cough, bronchitis, bronchial asthma.
Nose-oculo-nasal, catarrh, coryza of influenza, polysinusitis.
POSOLOGY: 4C TO 9C every hour until symptoms abate, Treat similia homoeopathic ally.
MORBILLINUM: Stock is prepared from the exudate of the mouth and pharynx of patients
suffering from measles and not yet treated.
GENERALITIES: Temperature up to 39 c. Nasal and ocular catarrh, nasal voice, rough cough,
lacrimation.
Koplik spots. Macular exanthema, beginning on the face and behind the ears thence
extending to the whole body from above downwards, which disappears in 4 to 5 days.
Symptoms follows those outlined in lectures on contagious diseases.
POSOLGY: 4c to 9c.
PERTUSSIN: Taken from the glairy and stringy mucous containing the virus of whooping
cough. Introduced by Dr. Clark for the treatment of whooping cough.
GENERALITIES: Restlessness, tears, anorexia, predisposition to T.B.
DIGESTIVE SYSTEM: Ulceration of the tongue, vomiting.
RESPIRATORY: Spasm of the glottis, dry cough, spasmodic of different intensity, comes
suddenly.
Increasing jerking cough with cyanosis, with a phase of arena followed by the taking of
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respiration.
Repeated fits which end in the rejection of mucositis and vomiting.
MODALITIES: Aggravation by laughing, nervous shock, emotion, effort, rest.
POSOLOGY: In acute affection: 4c to 7c repeated frequently.
High potencies 9 to 15c once every 3 days. In chronic anamnestic conditions 15c or 50c
daily or every 7 to 10 days.
PSORINUM:
MIND: Sad, quarrelsome, anxious, desperate of everything and for nothing. Inferiority complex,
occipital type. Aggravated by air currents, after menstruation.
DIGESTIVE: Dry lips, swelling of the upper lips, teeth are yellow. Distension of the abdomen,
constipation because of rectal atony, involuntary stools occasionally at night.
Abdominal colic, pressure in the epigastrium better by passing stools.
CARDIAC-HEMO VASCULAR SYSTEM: Hyposthenia of the myocardia, palpitations,
hypertension, dysponea after a short walk. Aggravated in the open air.
RESPIRATORY:
THROAT: Pain, difficult to swallow, painful vesicle on the tip of the valva. Tickling in the throat
causing cough.
LUNGS: Cough greenish yellow expectoration. Cough with the sensation of weakness in the
chest. Difficult respiration especially in the evening.
SKIN: Dirty, dingy look, urticaria crusty eruptions all over, ulcers slow to heal
SLEEP: Sleepless from intolerable itching.
MODALITIES: Worse from coffee, changes in the weather, hot sunshine, from cold. Dread of
least cold air or draft. Better from warmth, warm clothing even in summer.
POSOLOGY: Two hundredth - not repeated too often.
PYROGENIUM: This is a great remedy for septic states, with intense restlessness. Offensive
discharges.
MIND: Restless. Feels if crowded with arms and legs. Cannot tell whether dreaming while
awake or asleep.
HEAD: Bursting headache with restlessness.
MOUTH: Tongue red and dry, clean cracked, smooth, nausea and vomiting, bad breath.
STOMACH: Coffee grounds vomiting. Vomits water.
ABDOMEN: Intolerable tenesmus both bladder and rectum. Bloated.
STOOL: Diarrhoea. Stools large and black.
HEART: Tired feeling about the heart palpitation. Pulse abnormally rapid.
FEVER: Coldness and chilliness, septic fevers. Chill begins in the back. Temperature rises
rapidly. Great heat with profuse sweat, but sweating does not cause a fall in temperature.
SKIN: Dry: Small cut or injury becomes swollen and inflamed.
SLEEP: Seems to be in a semi sleep. Dreams all night.
MODALITIES: Worse from motion, before a storm, dampness from draught, after sleep, better
in open air.
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POSOLOGY: 30c and higher. Sometimes frequent dosing.

MODALITIES: Relief from motion.
POSOLOGY: 6C TO 30C and higher potencies. Do not repeat too frequently.
TUBERCULINUM: Used for chronic cystitis; incipient tuberculosis.
MAJOR SYMPTOMS:
MIND: Depressed; fear of dogs, animals especially.
NOSE: Boils in the nose; green, fetid pus.
EARS: Perforation in the membrana tympani, with ragged edges.
FEMALE: Benign tumours in the mammary, dysmenorrhoea.
RESPIRATORY: Enlarged tonsils, hard dry cough, especially during sleep.
SKIN: Chronic eczema.
Today, it is considered that a vast majority of human illness is traceable to the
dysfunction of the endocrine glandular system. Many growth problems and maladjustments to
the environment by both children and adults are related in some degree to endocrine imbalance.
To Hahnemann, the human body is a unit, that of mind, body and spirit, and these are so
correlated that they act freely and without impediment when the vital principle is in equilibrium.
If this equilibrium of health is thrown out of balance by the dysfunction of one member, the
whole is affected to a greater or lesser degree.
Complaints have been made from homoeopathic physicians in general that literature on
homoeopathic endocrinology is very rare and difficult to obtain. Comprehensive text books on
the subject in the English language seem to be unobtainable. This difficulty is given as; The
subject is new to homoeopathy; That there is a lack of definite information to homoeopathic
functions and; The intricate inter-relationships of the secretions of the endocrine glands
themselves.
Also, it has been found that the following reasons are also considered:
1. The difficulty in applying the results of animal experiments to human which aside from the
scientific value of such work, is the ultimate object of these investigations.
2. The variations of strength of the basic substances used.
3. The difficulty in determining individual doses and potency to be used, both being influenced
by the degree of function of the glands of the patient, the individual susceptibilities of the
patient, cellular receptivity, interaction of other endocrine secretions and finally the effect of
general metabolic factors and disease processes in each individual.
Before we can treat any abnormal condition successfully, we must first have knowledge
of the syndrome and aetiology of the disease, and secondly we must have adequate
homoeopathic treatment available.
The diagnosis of endocrine disorders is complicated due to the following factors:
a. Inter-relationships of the endocrine gland.
b. Compensatory mechanisms.
c. Size of lesion versus magnitude of effort.
d. Physiologic versus pathologic states.
e. Multiple non endocrine involvements.
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f. Deficiency of knowledge.
g. Difficulties of laboratory diagnosis.
Therefore, only the most common of the endocrine disorders will be discussed here.
ENDOCRINE FUNCTION: The function of the endocrine glands is to secrete a minute
quantity of specialised product into the system, a secretion that has a vital bearing on the health
of the whole constitution. In many cases, this secretion is so minute that it approaches the
homoeopathic attenuation.
With this concept of the importance of the endocrine glands in maintaining health, and
with the almost infinitesimal amount of some of these glandular secretions, we can hardly fail to
see the important relationship the homoeopathic dose may hold to the manifestation of
endocrine dysfunction, and to the balance of the endocrine glands themselves.
PRINCIPLES: The principles and practice involved in this type of homoeopathic therapy is
called homoeopathic homono-opo therapy and may be summarised as follows:
1. Any disease caused by hyper production of a specific hormone may be treated by giving to
the patient the same hormone in certain calculated homoeopathic potency which will break the
hyper production of that hormone.
2. Any disease caused by a hyper production of a specific hormone may be treated by giving to
the patient either the antagonist hormone in a certain calculated homoeopathic potency, or
extract of the gland producing that hormone, also, in certain calculated homoeopathic potency or
a complex remedy of both, each component being in an accurately calculated proportion and
potency according to various experiments tested.
Certain Hormono-opo complexes may contain more than two simples components. They
will be specially adapted to chronic hormonal disease of long standing. They are specially
formulated and will contain apart from the normal hormones, their triggering control hormones
or even their hypothalamic neuro-endocrine releasing factors.
The following case history is given as an example:
"A woman with undeveloped breasts, hair around her nipples and on her stomach and
with scanty periods is presented. From the symptoms mentioned, it was clear that she suffered
from a hyper-production of Testosterone Versus Oestrogens.(N.B.- that those symptoms plus
others that will be discussed later are also found in Adrenal Tumours in women).
The following treatment was administered.
Testosterone 9c one dose T.D.S.
Ovarinum 30c one dose daily
Folliculinum 4c one dose T.D.S.
After one month of treatment her bust had increased by 5 cm, the hair around her nipples
had turned grey and finally died off and her periods became normal.
DISEASES OF THE PITUTARY GLAND:
HYPOPITUITARISM (SIMMOND'S DISEASE) Important points for diagnosis are:
Weakness, lack of resistance to cold, to infections and sexual dysfunction. (Usually lack
of development of primary and secondary sex characteristics, or regression of function). Short
stature is likely of the onset is during the growth period.
There is a spareness or loss of axillary hair and pubic hair, and there may be thinning of
the eyebrows and of the head hair, which is often silky. The skin is almost always dry, with lack
of sweating, has a peculiar pallor and is sallow.
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Pigmentation is lacking even after exposure to sunlight. Fine wrinkles are seen, and the
face presents a sleepy appearance. The heart is small and the blood pressure is low.
If the hyposecretion starts before puberty a certain form of dwarfism is observed. This
disease is sometimes difficult to differentiate from primary Addison's Disease and Primary
Myxoedema.
The interesting consideration about this disease is that all or several of the tropic
hormones may be involved since the inactivity of the pituitary gland leads to insufficiency of the
target organ.
Homoeopathic treatment consists primarily of the gland extract to trigger the function of
the organ, and then each one in turn of all the negative feedback hormones from the target
organs in homoeopathic dose to stimulate the secreting cells individually.
HOMEOPATHIC DOSE:
PITUITARINUM (Hypopieses-Anterior Lobe) 30c one dose daily.
CORTISONE 9c one dose T.D.S.
HYDROCORTISONE 9c one dose T.D.S.
THYROXINUM 9c one dose T.D.S.
TRIIODETHYROXUM 9C one dose T.D.S.
TESTERTERONE 9C one dose T.D.S.
B-OSETRADIEL 9C one dose T.D.S.
Any of the above may be used with Pituitarinum, any of the results are sluggish you may
add:
HYPTOHALAMUS 30C one dose daily.
It has been proved that the hypothalamus secretes releasing factors towards the pituitary.
When you consider Simmonds’s Disease, you should use a differential diagnosis in
considering the possibility of Sheenan's Disease.
HYPERPITUITARISM: This condition reflects itself mainly on a hyper production of the
growth hormone (GH or STH) but secondarily it also affects the other target organs with hyper
production of their respective hormones. If the secretion of the gland is perturbed before
puberty, giantism results.
GIANTISM: This occurs in childhood or adolescence, since the epiphyses of the bones have not
yet united, tremendous increase in size results, so forming giant persons.
Some of them may attain to 2.75 metres, but most of these giants however lose their
excessive strength and develop signs of increased intracranial pressure such as headaches,
vomiting, blindness and coma.
If the secretion of the gland is perturbed after puberty, acromegaly results.
ACROMEGALY: As in a case such as this, the epiphyses of the bones have already united, the
height is not increased. However, certain characteristic changes occur in the bones. For example,
the lower jaw becomes massive and the whole contour of the face broadens, whilst the hands
and feet become abnormally wide, sometimes called spade.
The skin becomes thick and course and the tongue becomes hypertrophied. If these
problems are caused by a tumour of the pituitary, signs of increased pressure gradually develop
as a result of the growth of the tumour, sometimes the pressure on the optic channel may lead to
a restriction of vision.
12
Positive diagnosis of hyperpituitarism is to be considered if there is rapid growth or

resumption of growth once stopped. (e.g. Change in shoe size or ring size). Suspect the
diagnosis also in unexplained amenorrhoea, insulin resistance diabetes mellitus and certain
goitres which do not respond to antithyroid remedies.
If the problem is definitely caused by a tumour, and if there is not visual field loss, the
more normal approach is radiation therapy. If the visual fields are markedly reduced, x-ray
therapy may be hazardous and surgery is usually the treatment used.
In other cases, the following homoeopathic remedy may be prescribed:
SOMATOTROPINUM 9C one dose T.D.S.
This is the only homoeopathic remedy that has given some results in those conditions. It
is quite possible that the secretion of the growth is controlled by a hypothalamic neuero-
endocronine releasing factor but the mechanism involved is not fully understood,
DIABETES INSIPIDUS: This disease is characterised by an increase in thirst and the passage of
large quantities of urine of a low specific gravity. The urine is otherwise normal.
The decrease is due to inefficiency of the posterior pituitary which regulates the flow of
Vasopressin and as consequence, water metabolism.
We may also find in cases of non responding kidney to the hormone but this is very rare
in practice. The principle symptoms of the disease are:
* An intense thirst, especially with a craving for ice water.
* Polyuria.
Some patients may drink from four to forty litres a day and if fluid is restricted and water
not readily available, the patient will develop weight loss, dehydration, headache, irritability,
fatigue, muscular pains, hypothermia, tachycardia and shock.
If the disease is due to granuloma of the skull, temporary improvement or even complete
sure may be affected with x-ray therapy.
Homoeopathic treatment that may be used especially for the chronic type is as follows:
HYPOTHELAMUS 30c one dose daily.
PITUITARINUM 30c one dose daily.
The main factors which control the release of Vasopressin are changes in osmotic
pressure of the plasma reaching the hypothalamus and also changes in the blood volume. There
is no known antagonist chemical negative feedback available.
It is possible to help trigger the secretion of Vasopressin indirectly by breaking the
production of the hormone Aldosterone. This hormone promotes the excretion of potassium ions
and the reabsorption of sodium ions, which then electrostatically attract chloride ions and cause
their reabsorption throughout most of the tubules.
Aldosterone 9c one dose T.D.S. was prescribed.
A combination of the three above substances into one treatment either given separately
as Simplexes or in a Complex form.
DISEASE OF THE THYROID GLAND:
SIMPLE GOITRE: This is an enlarged thyroid gland most commonly due to iodine lack, and
usually occurring in endemic areas away from the sea coast. Relative insufficiency of the iodine
leads to functional overactivity and hyperplasia of the gland, which becomes filled will colloid
poor iodine. If the deficiency is corrected, the enlargement may subside.
13
DOSE PRESCRIPTION:
THYROXINUM 9C one dose T.D.S.
IODUM 3X six doses daily
CALC. FLUOR. 8X T.D.S. to help if there are indurations of the gland.
JUVENILE HYPOTHYROIDISM AND CRETINISM: With juvenile hypothyroidism, all
degrees of dwarfism may be seen, with delayed skeletal maturation, apathy, physical and mental
torpor, dry skin with coarse, dry brittle hair, constipation, slow teething, poor appetite, large
tongue, deep voice, cold extremities and sometimes yellow skin. The problem may be tackled
homoeopathic ally in various ways. We may help the deficient gland by prescribing:
THYRODIUM 30c one dose daily.
PITUITARIUM 30c one dose daily.
HYPOTHALANIUM 30c one dose daily.
ADULT HYPOTHYROIDISM AND MYXOEDEMA: In adults, the symptoms of this problem
may vary from full blown myxoedema to mild states of hypothyroidism.
The early signs are weakness, fatigue, cold intolerance, lethargy, dryness of skin,
headache and Menorrhagia. Nervousness is very common. At a later stage, the main symptoms
are slow speech, absence of sweating, weight gain, constipation, peripheral oedema, pallor,
pains all over the body, dysponea, and sometimes angina pains, deafness and amenorrhoea.
Externally there is puffiness of the face and eyelids, yellowish skin with rosy cheeks. The
tongue may become thickened and there may be oedema and effusions which may lead to
cardiac enlargement.
The heart rate is slow but the patient is more often normotensive than hypotensive. The
homoeopathic treatment is the same as that used for juvenile hypothyroidism.
HYPERTHYROIDISM: This disease is marked by restlessness, nervousness, irritability, easy
fatigability especially toward the latter part of the day and unexplained weight loss in spite of a
tremendous appetite. These are the early features.
THYROIDITIS: This is a painful swelling of the thyroid gland, causing pressure symptoms in
acute, sub acute forms and painless enlargement in chronic forms. Complications may arise
leading to the suppurative forms of thyroiditis with infection.
For treatment prescribe:
BELLADONNA 6C one dose T.D.S.
IODIUM 9c one dose daily.
WITH SUPPURATION GIVE:
HEPAR SULPH CALC. 9c one dose daily and BELLADONNA 6C
If it is too late to stop the suppuration prescribe:
MERC SOL 6c one dose T.D.S.
BELLADONNA 6c one dose T.D.S.
This will bring the trouble quickly toward a safe end without undue inflammation and
probably surgical drainage will be unnecessary.
HYPOPARATHYRADISM: This is a deficiency of the parathyroid gland to produce
parathomone. This problem is most commonly seen following thyroidectomy but it may also be
familiar or be associated with Addison's Disease. The main symptoms in the acute stage are:
14
Tetany, muscle cramps, irritability, convulsions, wheezing, dysponea, photophobia, diplopia and
abdominal cramps.
In the chronic stage we see lethargy, personality changes, anxiety state, blurring of
visions, due to cataracts and metal retardation. Chvostek's sign (facial contraction on tapping the
facial nerve near the angle of the jaw) is present.
Sometimes it is difficult to differentiate true hypoparathyroidism, which responds to
parathyroid extract from pseudohypoparathyroidism which does not respond. In this case the
Ellsworth-Howard test is measured after the administration of 200 units of parathoromone.
Currently, it has not been found that the parathyroid glands receive a stimulation from the
pituitary and so the only homoeopathic remedies are:
PARATHYROIDIUM 30c one dose daily.
PHOSPHOROUS 3c one dose T.D.S.
HYPERARATHYROIDISM:
The manifestation of this disease may be divided into:
1. Skeletal manifestations which may vary from simple back pain, joint pains and similar
complaints to actual pathological fractures of the spine, ribs or long bones.
2. Urinary tract manifestations may be polyuria and the passing in the urine of sand, gravel, or
stones containing Calcium Oxalate or Phosphate, Secondary infections and obstructions may
cause renal damage leading to uraemia.
3. Manifestations of hypercalcemia such as thirst, nausea, anorexia and vomiting.
The treatment prescribed is:
PARATHORMONE 9c one dose T.D.S.
VITAMIN C 600mg daily.
DISEASES OF THE ADRENAL CORTEX:
ACUTE ADRENAL INSUFFICIENCY:
This is a true medical emergency caused by marked insufficient supply of adrenocortical
hormones The patient complains of headaches, lassitude, nausea and vomiting and often
diarrhoea. Costovertebral pain and tenderness and confusion or coma may be present.
Temperature may rise to 40.6 c and the blood pressure is very low. Other signs include cyanosis,
petechiae, dehydration and abnormal skin pigmentation and sometimes lymphadenopathy. Do
not attempt to treat this condition homoeopathically.
ADDISONS DISEASE - CHRONIC ADRENAL INSUFFICIENCY: The main symptoms are
weakness and tiredness, anorexia, nausea and vomiting, diarrhoea, nervous and mental
irritability and faintness especially after missing a meal. Pigmentary changes consist of diffuse
tanning over non exposed as well as exposed parts of multiple freckles. Black freckles may
appear on the mucous membrane of the tongue.
Other findings include hypotension, a small heart, hyperplasia of lymphoid tissues,
stiffness of the cartilages of the ear (Thorn's Sign), scant to absent axillary and pubic hair
(especially females), absence of sweating and severe dental caries.
HOMEOPATHIC TREATMENT
HYPOTHALAMUS 30c one dose daily.
PITUITARINUM 30c one dose daily.
ADRENAL CORTEX 30c one dose daily.
15
ADRENOCORTICAL HYPERFUNCTION - CUSHING'S SYNDROME The main symptoms

are obesity with protuberant abdomen and then extremities, a plethoric appearance,
oligomenorrhea or amenorrhoea, importance in the male, weakness, backache, headache,
hypertension, mild acne and superficial skin infections, pigmentation mainly on the face,
hirsutism and certain mental disorders such as psychosis.
Prescribe:
CORTICOTROPIC RELEASING FACTOR 9c one dose T.D.S.
ADRENCORTIOTROPIC HORMONE 9c one dose T.D.S.
HYDROCOTISONE 9c one dose T.D.S.
CORTISONE 9c one dose T.D.S.
DISEASES OF THE ISLETS OF CANGERLANS
DIABETES MELLITUS:
This disease affects all age groups and there is a well known hereditary predisposition.
The diagnosis is made usually by finding glycosuria on routine testing and supported by a strong
family history. It is a constitutional disorder in which the power of the muscles and other tissues
to utilize sugar for purposes of nutrition is greatly diminished or lost, as a result of lack of
insulin.
The first symptoms which attract attention are usually failure of strength and loss of
weight, along with great thirst and polyuria. Dryness of the skin and mouth and constipation also
form frequent complaints. The amount of sugar circulating in the blood rises from about 0.1%
which is normal to 0.2, 0.3 or more, and it remains high for several hours after a meal instead of
being rapidly absorbed.
In severe cases, a faint sweetish odour can be recognized at times on the breath, owing to
the escape of acetone and diacetic acid from the blood into the air in the lungs.
Diabetes, as a rule, advances comparatively slowly except in the case of young people, in
whom its progress is usually rapid.
Prescribe:
PANCREATINUM 30c one dose weekly.
GLUCAGON 9c one dose T.D.S.
SYZYGIUM 1x one dose T.D.S.
THE HYPOGLYCAEMIC STATES:
ORGANIC HYPERINSULINISM: The main symptoms which are mostly vasomotor may
include sudden hunger and weakness, especially in the fasting state; headache or faintness,
vertigo, sweating, paresthesia of the face, lips or tongue, visual disturbances, and tumours or
convulsions or coma. Personality and mental changes vary from anxiety or exhilaration to
severe psychotic states, often mistaken for alcoholism.
Patients with long standing hyperinsulinism may be obese as a result of chronic high
carbohydrate intake. This disease is usually due to one or multiple adenomas of the Islets of
Langerhans and they may become malignant with functional metastases.
If the disease is diagnosed early and cured surgically, complete recovery is likely.
Complete excision of hyperplastic or adenomatous islets is indicated in certain cases. Sometimes
total pancreatectomy is required.
FUNCTIONAL HYPERINSULIN: This is the most common type of hypoglycemias. It is
considered to be due to an excess of insulin, although the mechanism of its increases production
16
is not fully understood. The systems, although more or less the same, are much less pronounced
than in the organic form. The disorder remains fairly static and the patient is emotionally
unstable, anxious and tense. They often show evidence of autonomic nervous system
dysfunction such as neurocirculatory asthma and excessive perspiration.
PRESCRIBE:
INSULINUM 9C one dose T.D.S.
KALI PHOS 30c one dose daily.
PHOSPHOROUS 30c one dose daily.
MALE HYPOGONADISM:
The patient is usually short and fails to grow mature. Undeveloped genitals and high
pitched voice; beard does not grow and patient lacks motivation.
Sometimes there is a swelling of the breast and mental retardation.
Prescribe:
HYPOTALAMUS 30c
PITITURINUM 30c
TESTES 30c
PHOSPHOROUS 9c
MALE HYPERGONADISM: Causes are mainly from tumours to the testicles. With children
they are to hypothalamic tumours. Surgical removal is necessary.
FEMALE HYPOGANADISM: Major symptoms is amenorrhoea which is primarily causes by
low hormone production or no hormone production. Diagnosis is usually made before the age of
18 years. If the menses are established and have ceased temporarily or permanently it is the
failure of ovarian function.
Usually it is diagnosed of hypothalamic amenorrhoea due to emotional of psychogenic
cause.
Prescribe:
HYPOTALAMUS 30c one dose daily.
PITUITARY 30c one dose daily.
OVARINUM 30c one dose daily.
FEMALE HYPERGONADISM:
Before puberty there are signs sexual precocity such as breast development and early
growth of pubic hair. In cases where tumours of the ovary cause uterine bleeding through
osteogenic secretions, they do not cause ovulation and these girls are not fertile.
In the case of adults, the osteogenic excess is characterised by menorrhagia rarely
amenorrhoea.
Prescribe:
FOLLICULO RELEASING FACTOR 9c one dose T.D.S.
FULLICULO STIMULATING HORMONE 9c one dose T.D.S.
BETA OESTRADIOL 9c one dose T.D.S.
PLEASE NOTE: - Many of the remedies listed in these two lectures are of European origin and
are not available for sale in Australia. This information has been presented mainly for
17
educational purposes only.

1. GONORRHOEA: Neisseria Gonorrhoeae. An acute infectious disease of the lining of urethra,
cervix and rectum. Other areas of the body may be involved.
INCUBATION: male - 2 - 10 days, female - 7 - 21 days
SPREAD: Usually by sexual intercourse.
SYMPTOMS: Women are frequently symptomless carriers - this happens occasionally in men -
presentation of these cases through contact investigation.
Girls in pre-puberty - may develop a vulvo-vaginitis from contact with affected adult.
a) MALE - Onset accompanied by pricking or tingling in urethra then dysuria with purulent
(greenish yellow) urethral discharge. Increased micturition and frequency develop as disease
spreads up urethra. Meatus, red and swollen.
b) FEMALE - + - 60% symptom free. Those that do develop symptoms present with dysuria,
increased frequency and vaginal discharge, vagina, cervix, urethra, scene’s ducts, Bartholin's
glands involved to a greater or lesser degree. Salpingitis may develop.
c) EITHER SEX - Rectal gonorrhoea common though often symptomless in male but when not,
perianal discomfort and rectal discharge may be present. In women, perianal excoriation may be
present.
d) FEMALE INFANTS - Oedema of vulva with purulent vaginal discharge - with or without
proctitis. There may be vulval and perianal soreness with or without dysuria.
DIAGNOSIS - Confirmed by laboratory analysis.
SEQUELAE:
MALE - Post gonococcal N.S.U. most common sequelae (Discharge returns after 7-14 days).
Epididymitis (May lead to sterility if bilateral).
Orchitis - with testicle being hot, tender and swollen.
Prostatitis.
Para-urethral abscesses.
Hydrocele.
Gonococcal Septicaemia.
FEMALE - Salpingitis.
Parametritis.
Gonococcal Septicaemia.
The treatment still comprises the use of penicillin. The inflammatory stage resolving in a
matter of 48 - 72 hours with a drying up of the urethral discharge.
One must ask - is this the answer??
Isn't it more in keeping with the natural centrifugal action of the body to maintain the
discharge and promote it, not dry it up. By maintaining the discharge over a 10 - 14 day period,
serves to forewarn the owner and allows innate healing mechanisms of the body to fulfil their
true roles. This is a reminder to the owner not to be in a hurry to take on more or pass more on.
To stop a discharge does not necessarily mean cure but gives a false sense of security in
believing that a cure has taken place.
How many G.C's are given laboratory clearance from the acute phase - and because the
18
Neisseria Gonorrhoea are not to be seen - have they not left their mark - their stigma. The
answer must be yes - yes to those who understand the miasmic state of man - particularly the
sycotic miasma.
Is the sycotic state in danger of overtaking the psoric state?
Homoeopathy can play an inestimable role in reducing this post gonorrhoeal stigma and
break the genetic chain.
2. SYPHILIS (LUES) - Treponema Palladum.
A contagious systemic disease characterised by periods of active manifestation and years
of symptomless inactivity.
It can affect any body tissue and can be transmitted by the mother to her unborn child.
May be acquired or is congenital, but more usually acquired through direct contact with
patient primary or secondary lesion.
INCUBATION: - 10 days to 12 weeks (usually 21 days).
PRIMARY SYPHILIS: Chancre appears and develops. Found most commonly in labia majus,
labia minor, fourchette, clitoris or cervix but may be anywhere on lower genital tract e.g. vaginal
wall.
Occasionally more than one lesion present. In male, commencing on glans or shaft of
penis. Inguinal glands enlarge especially when primary lesions on vulva, lower vagina or penis.
Glands are hard, shotty - PAINLESS - do not suppurate.
SECONDARY SYPHILIS: Primary chancre tends to heal spontaneously in 5 - 8 weeks and this
is followed shortly by the secondary stage.
1. General systemic upset with pyrexia - more severe in female.
2. Skin rash develops - typically non-irritant, pleomorphic, bilaterally symmetrical in
distribution and copper coloured.
3. Loss of scalp hair.
4. Ulceration of mouth and pharynx.
5. Generalised adenitis.
6. Iritis.
7. Condylomata Lata on vulva and perianal region (these differ from Condylomata Acuminata in
that they are coarse, flat-topped, moist and neurotic).
Occasionally secondary manifestations develop before primary lesion heals.
TERTIARY STAGE: In untreated or poorly treated cases the invasion of tissues and structure
continues over several years. The blood vessels, bones, joints, eyes, c.n.s. and heart are
involved.
Tertiary syphilis is characterised by formation of localised granulomas (gemmae) in any
part of the body. The gunner is rarely seen in the genital tract and when they do occur are more
often found on the vulva where they break down to form ulcers with a serpiginous outline
surrounding oedema.
Usually not painful unless secondarily infected - this is very similar to Yaws (Treponema
Pertenue).
For other conditions such as :
Soft-sore Chancroid.
19
Lymphogranuloma Inguinale (Venereum).

Granuloma Inguinale.
Non-specific urethritis.
The relevant textbooks should be studied.
SOME FEMALE DISORDERS:
VULVITIS: Local injuries or abrasions resulting from clothing or sanitary towels become
infected and cause pain and tenderness.
Excoriation associated with incontinence of urine and chronic vaginal discharge is
common.
Consider application of Eczema Cream, treat urinary tract infection concomitantly
Detox; Ferrum. and Juniper .
If you suspect F.B's involved refer. Hygiene management should be discussed.
INTERTRIGO: - Smegma Concretions. Lack of cleanliness leads to collection of irritating
sebum and other secretions in skin folds and secondary infection follows. Hygiene management,
Detox and Eczema Cream are usually sufficient.
Inattention to skin area of clitoris can result in collection of smegma concretions
resembling a small stone under clitoral hood or prepuce. Hygiene management and prevention.
FURUNCULOSIS: Infection of vulval hair follicles is common and leads to boils and
carbuncles (tendency of recurrence).
Glycosuria should be excluded in such cases.
Treat as for any boil or carbuncle, .i.e. Detox and Ferrum, Staphylococcunum 30ch,
Eczema Cream, Lachesis, Hepar Sulph, Silica, Juglans Regia, topically, combination of
Hypericum and Calendula.
INFECTION OF SEBACEOUS AND APOCRINE GLANDS:
Single abscesses, often representing a secondary infection of retention cyst of apocrine
or sebaceous gland and has the clinical features of a boil.
Treat as for furunculosis.
HERPES GENITALIS: Infection of genital skin and mucosa with herpes virus hominis Type 2:
is contagious and usually spread by sexual intercourse.
INCUBATION: - 4 - 7 days after contact.
CLINICAL FEATURES: Itching and soreness usually take place before a small patch of
erythema appears on skin and mucous membranes. A small group of vesicles develop which
become eroded leaving several superficial circular ulcers with a red areola. They are painful.
Ulcers have a tendency to heal in 10 days leaving a scar. Inguinal lymphatic nodes
slightly enlarged and tender.
Lesions may occur on prepuce, glans penis, shaft of penis, in male and labia, clitoris,
perineum, vagina and cervix in female. In Homosexual males around anus and rectum.
Patient may also have if\difficulty in urinating and walking and feel "off colour".
There is no known cure for this condition, although the undermentioned remedies are
worth considering: Medorrhinum 1000x, Sarsaparilla - low potency, Merc. Sol, Nitricum
Acidum, Ranunculus Bulbosus, Thuja, Pulsatilla, Eczema Cream and Herpesrhus either alone or
combined. Care should be exercised in involving total symptomology not just particular
20
symptomology for which patient presents.

Recall that Herpes Genitalis when associated with Cyclical stomatitis and conjunctivitis
are part of Behcet's syndrome.
DIABETIC VULVITIS: Glycosuria whether due to diabetes or not causes a diffuse
inflammation, gives the vulva skin a typical purplish, red appearance - intense pruritus.
Although chemical changes in epithelial cells may play a part, the vulvitis is mainly a
result of infection with Candida Albicans (thrive in presence of carbohydrates).
Vulval hygiene following micturition very important in controlling the effects of
glycosuria.
If adult onset or diet controlled diabetes, consideration may be given to Lysopodium,
Syzygium Jambolanum (low potency) and Pancreatinum 4ch.
MONILIAL VAGINITIS (THRUSH): Yeast like organism - Candida Albicans - gram + ve
fungus, thrives in pH of 5.0 - 6.5 especially if carbohydrates ++ present.
Monilial Vaginitis often determined by glycosuria.
Occurs frequently in pregnancy due to :
a) Vagina containing much glycogen.
b) Glycosuria common.
c) High acidity of vagina tends to destroy other bacteria.
CLINICAL FEATURES: Discharge thick, white and cheesy, tendency to form plaques on
vaginal wall. They pull away to leave multiple haemorrhagic spots. Discharge may be atypical
and may be watery or purulent whilst vaginal walls diffusely reddened.
Often Monilia and Trichomonas are present concomitantly.
TRICHOMONAS VAGINITIS: A common form of vaginitis. May be transmitted to female
during sexual intercourse. The Trichomonas being harboured in prepuce, urethra or prostate of
male.
INCUBATION - 3 - 28 DAYS.
Gonorrhoea and Trichomonas co-exist though not every Trichomonas infection is by any
means venereal in origin.
Man may be healthy carrier.
Not common in virgins and older women.
Contact may be direct or indirect.
Optimum pH for Trichomonas Vaginitis is 5.5 - 6.5
CLINICAL FEATURES: Sudden onset of purulent vaginal discharge often dating from
menstruation.
Discharge frothy and cream coloured but varies. May be profuse or scanty. Causes
pruritus (in and around introitus). Vagina tender and congested - may be dyspareunia.. Sensation
of fullness which patent thinks is prolapse. In acute stage labia minor and introitus swollen and
oedematous.
Vagina fiery red with often a strawberry appearance which on the cervix can be confused
with erosion.
Dysuria common in acute stage and recurrent cystitis is often explained by Trichomonas
urethritis.
21
Other conditions affecting vulvo-vaginal regions which should be studied are:

Tinea Cruris
Elephantiasis
Actinomycosis
Tetanus
Bartholinitis
Pediculosis Pubis
Schistosomiasis
Diphtheria
Tuberculosis
Epithelial Dystrophies. i.e. Leukoplakia, Kraurosis, Chronic Dermatitis.
Homoeopathy in general is capable of treating vulvovaginal conditions and has many
remedies, the common ones being: Ambra Grisea, Apis Mel, Belladonna, Caladium Seg,
Capsella-Bursa-Pastoris, Comicifuga, Conium, Helonias, Hydrastis, Kreosotum, Lachesis,
Phytolacca, Pulsatilla, Sepia, Thuja.
CERVICITIS: Infection of stratified squamous covering of vaginal cervix as part of vaginitis is
not usually regarded as cervicitis.
Cervicitis is more the inflammatory lesions in the endo-cervix including glands and
deeper tissues.
ACUTE CERVICITIS: Mainly G.C. or puerperal in origin. Cervix is congested and enlarged
with a swollen mucous membrane pouting at external os. Tender when touched and moved and a
profuse purulent discharge exudes from cervical canal.
CHRONIC CERVICITIS: Diagnosis is usually histological without clinical significance.
CLINICAL FEATURES: Worse premenstrual, mucopurulent discharge, deep-seated
dyspareunia, low backache slightly relieved by rest, aching in lower abdomen and pelvis.
Contact bleeding and congestive dysmenorrhoea.
Treatment as suggested under vulvo-vaginitis and associate problems.
ENDOMETRITIS: Apart from infection introduced at operation by instrumentation or by
insertion of I.U.C.D. or other F.B's - acute endometritis is either G.C. or puerperal in type,
Chronic endometrium is broken down - pre-menarche and post menopausal most significant.
Only really occurs when uterus is permanently injured or frequently re-infected e.g.
F.B's, Malignant disease, Infected polypi, retained products of conception, endometrial burns
from caustics and radium.
Clinical features include:
Purulent discharge from within uterus, Menorrhagia, low back ache, Pelvic ache, Infertility.
SENILE ENDOMETRITIS: After menopause, endometrium loses its resistance and is not
repeatedly shed therefore a dry infection which gains entrance to uterus can persist as senile
endometritis and may be associated with senile vaginitis.
CLINICAL FEATURES: Post menopausal discharge which is purulent and very offensive -
sometimes is blood stained. Uterus small and atrophic.
Care must be taken and patient referred to eliminate possibility of C.A. of uterine body.
22
SALPINGO - OOPHORITIS:
When fallopian tubes infected ovaries usually are also but to a lesser extend.
Salpingitis - Sapling - Oophoritis nearly always bilateral - essentially a disease of young
adult.
In G.C. organisms ascend through uterus and along tube to produce endosalpingitis.
Other types are puerperal and postabortal - Streptococci, B. Coli, Staphylococci.
Spread from uterus by lymphatics and veins to peritoneum as part of pelvic peritonitis.
CLINICAL FEATURES OF ACUTE SALPINGO - OOPHORITIS:
Mainly reflect pelvic peritonitis. Commences with acute lower abdominal pain pyrexia,
Tachycardia, Malaise - sometimes vomiting.
Pain is situated diffusely across lower abdomen or in both iliac fossae.
Menses may be delayed in onset by a few days or occur earlier than due. Menses often
heavy and prolonged. May be symptoms of urethritis also. Often history of recent confinement
or abortion or a discharge suggesting G.C. or previous attacks of salpingitis.
Patient is toxic, flushed and has a dirty mouth, lower abdomen tender with muscle
guarding. The gynaecologist would find P.V. examination very painful for patient and by rocking
cervix from side to side is a good indication of salpingitis if pain is elicited.
Polymorphonuclear Leucocytosis presents with spreading peritonitis, intestinal
distension and constipation likely to occur. Pelvic abscesses cause a swinging temperature,
diarrhoea, pain on defecation, sometimes retention of urine. Pyo-Salpinx cause an acute
abdomen when it ruptures with extreme shock.
Acite salpingitis has to be distinguished from:
a) Acute appendicitis - here pain commences higher in abdomen and becomes unilateral,
Anorexia and vomiting likely, Muscle rigidity localised and more obvious, Menstrual
disturbances and discharges are absent.
b) Ectopic pregnancy - here mainly unilateral and causes collapse or fainting. Little pyrexia if
any. Leukocyte count only slightly raised.
c) Torsion of pedicle of fibroid or ovarian cyst.
d) Rupture of ovarian cyst
e) Ovulation pain
f) Corpus Luteum Haematoma
g) Diverticulitis
h) Intestinal obstruction
I) Pyelitis, cystitis.
OOPHORITIS: On its own is rare and only occurs as a result of blood or lymphbourne infection
from elsewhere.
CLINICAL FEATURES: Only evidence of Oophoritis as a rule is occurrence of lower
abdominal pain for a few days during an acute infective illness, e.g. Mumps.
A single period may be disturbed in its onset.
AMENORRHOEA
FALSE ANENORRHOEA:
23
Menstruation is taking place but patient is unaware of it because the outflow is

obstructed at the level of the cervix, vagina or vulva.
Hidden menstruation of Cryptomenorrhea.
A. PHYSIOLOGICAL AMENORRHOEA:
1. BEFORE PUBERTY Is normal during childhood and is explained mainly by low output of
gonadotrophins. Menses usually established by age 16 but may not appear until the age of 18
(and sometimes later) without abnormality.
2. ADOLESCENCE Periods of amenorrhoea lasting 2 - 12 months during first one to two years
after menarche - normal.
3. PREGNANCY Is most common cause of secondary amenorrhoea. Suppression of
menstruation is leading symptoms of early pregnancy.
Amenorrhoea is caused by continuous production of large quantities of oestrogen and
progesterone by chorion.
4. LACTATION Menses are suppressed for varying periods, after abortion or labour but
especially by lactation when the hypothalamic - pituitary system concentrates on production of
prolactin rather than gonadotrophins.
5. MENOPAUSE: Menopause comes on because ovaries cease to react to gonadotrophic
stimulus and when all graafian follicles have disappeared. Occurs usually between 45 - 55 with
great reluctance before 40. Periods of physiological amenorrhoea lasting 3 - 6/12 often precede
menopause itself.
B. PATHOLOGICAL AMENORRHOEA; Amenorrhoea is a symptom not a disease and has
many possible causes.
1. HYPOTHALAMIC AMENORRHOEA:
1. Diseases of hypothalamus
2. Injuries and disease in region of midbrain, e.g. Encephalitis, Meningitis, Base of skull.
3. Mental disease characterised by depression - Electro-Convulsive Therapy (E.C.T.)
4. Changes of work, travel, abode, love affairs, marriage and separation.
5. Any phase of nervous tension
6. Pseudo cyesis
7. Frohlich's Syndrome (Dystrophia Adiposogenitalis) (Genital Hypoplasia, Amenorrhoea,
Obesity, sleeplessness)
8. Certain drugs, phenothiazine derivatives, reserpine and ganglion blocking agents.
2. PITUITARY AMENORRHOEA Not Common
a) May be seen in other evidence of pituitary malfunction e.g. Acromegaly (Giantism) or
pituitary tumour.
b) Sheehan's (Simmonds’s) syndrome is one of the best examples of primary pituitary fault
causing amenorrhoea. Anterior lobe is largely destroyed due to ischaemic necrosis caused by
spasm in pituitary vessels occurring at time of severe haemorrhage or shock (usually
postpartum) complicating childbirth.
3. OVARIAN AMENORRHOEA
a) Under production of Oestrogen and Progesterone:
1) Removal of ovaries by surgery.
24
2) Exposure to radiation,
b) Ovary though present may never develop a capacity to respond to gonadotrophic stimulus.
c) Overproduction of Androgens - these inhibit endometrial and follicular activity.
Maculating tumours of ovary cause amenorrhoea accompanied by virilism, acne, facial
hirsutes, voice changes and enlargement of phallus (clitoral shaft)
d) Continuous production of Oestrogen and Progesterone.
e) Stein-Leventhal Syndrome
i.e. Amenorrhoea or Oligomenorrhea, is infertile - has slightly enlarged and polycystic
ovaries. Failure to ovulate, follicles becoming cysts, slightly hypertension, obesity, suggestion of
virilism manifested by heavy build and hirsutism.
4. UTERINE AMENORRHOEA
1) Uterus congenitally absent
2) Hysterectomy
3) Grossly under-developed
4) Damaged by radium
5) Seat of disease of T.B. endometritis.
5.OTHER ENDOCRINE DISEASES
1) Hyperthyroidism with exophthalmos present - usually oligomenorrhoea
2) Diabetes Melitis
3) Adrenal Cortex - hyperplasia or tumour formation Cushing's Syndrome plus evidence of
virilism. Addison's Disease.
6. CONSTITUTIONAL UPSET AND DISEASE
Any acute illness can cause a short period of amenorrhoea. Chronic disease causes more lasting
suppression of menstruation e.g. Pulmonary T.B.
Nutrition - dietetic deficiencies during childhood and puberty alleged to cause permanent
amenorrhoea. Obesity - over eating, Anorexia Nervosa (down on face, trunk and limbs).
Environment - changes in climate occupation and living conditions.
Work involving institutional life, long hours of study and worry over examinations.
60% of all amenorrhoea without gross organic basis are psychogenic.
SCANTY MENSTURATION: Uterine bleeding may be slight in amount, short in duration or
both.
Bleeding which lasts two days or less is unusual, if not pathological (Hypomenorrhoea).
CAUSES: In most cases scanty menstruation characterises the whole menstrual life of a female
and is to be regarded as a constitutional trait of no significance.
Bleeding which lasts only a few hours is not incompatible with full fertility, the ovarian
and endometrial cycles usually being normal.
Scanty loss sometimes means that bleeding surface is smaller than normal and is
occasionally seen when endometrial cavity has been reduced too much during myomectomy or
other plastic operations on uterus nervous and emotional - Pseudocyesis.
INFREQUENT MENSTRUATION: Menses may be both infrequent and irregular or may be
regularly infrequent.
25
Error is in ovary and its controlling factors rather than uterus.

CAUSES:
CONSTITUTIONAL AND PHYSIOLOGICAL: In majority of cases it represents a peculiarity
of the individual and is not out of keeping with health and good fertility.
May be familial
Sometimes follows menarche and precedes menopause.
HORMONAL: Hypoplasia of uterus and vagina and a history of late menarche.
Obesity and oligomenorrhea are close companions. So are oligomenorrhoea and hirsutes.
CHROMOSOMAL: Arrangement usually found.
ABNORMAL AND EXCESSIVE HAEMORRHAGE FORM UTERUS AND VAGINA: Is
symptom - not disease.
MENORRHAGIA - (HYPERMENORRHOEA). Cyclic bleeding at normal intervals which is
excessive in amount or duration e.g. 4/28 or 8/28. It occurs of bleeding surface is enlarged
(endometrium) by uterine tumour e.g. fibroids and adenomyosis. May result from active or
passive congestion or uterus or it can be a manifestation of a blood disease characterised by
faulty clogging.
EPIMENORRHOEA (POLYMENORRHOEA) Cyclical bleeding normal in onset but occurs at
too frequent intervals 4/21. Usually die to disturbance (functional) or disease of ovary. Even of
fibroids found it can be taken that they are not direct cause.
METROSTAXIS ( METROPHAGIA) Bleeding of any amount which is a cyclical and which
occurs irregularly or continuously.
Often caused by lesion of genital tract.
Benign or malignant growth with ulceration.
CAUSES OF ABNORMAL HAEMORRHAGE
A) DISEASE OF CARDIOVASCULAR SYSTEM: Any blood disorder characterised by
coagulation defects or excessive capillary fragility.
Heart disease does not affect menstruation until congestive failure is present.
B. PSYCHOLOGICAL UPSETS: Emotional and nervous disorders are as important in causing
excessive bleeding as they are in causing amenorrhoea.
Nervous tension, anxiety states, unsatisfied sex urge, marital upsets and overwork.
C. ENDOCRINE DISORDERS - HYPEROESTROGENISM
Hypothyroidism tends to cause menorrhagia or pimelorrhea.
D. PREGNANCY STATES
Causes of uterine bleeding in early pregnancy are implantation haemorrhage, abortion,
hydatidiform mole and ectopic gestation.
E. ERRORS IN UTERUS DEVELOPMENT
F. LOCAL INJURIES - F.B.'S
Tears to hymen, vaginal wall and septa sustained during coitus, masturbation, insertion
of tampons and attempts to induce abortion.
I.C.U.D. and pessaries (ring) (Hodge).
G. DISPLACEMENTS
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Retroversion, Ovarian Prolapse, Uterovaginal prolapse.

H. INFECTIONS
All forms of pelvic peritonitis, salpingo-oophoritis.
I. ENDOMETRIOSIS
J. TUMOURS
DYSMENORRHOEA: Painful menstruation
1. A pain which is uterine in origin (directly due to menstruation).
a) Primary
b) Spasmodic
c) Intrinsic
d) Essential
e) Functional
2. A pain which arises in organ or tissue other than uterus and which is merely associated with
menstruation - congestive dysmenorrhoea.
True dysmenorrhoea is essentially a first day pain while congestive dysmenorrhoea is
worse premenstrual and is relieved during flow. A pain which is equally severe before, during
and after menstruation is likely to have its origin in C.N.S.
FAMILY OUTLOOK: During and just before menses most women less efficient physically and
are more unstable emotionally - These factors alone lower the pain threshold and lead to
exaggeration of minor discomfort. May be used as excuse for avoiding doing something which
is disliked - over anxious patents and curtailment of normal activities during menstruation.
ENVIRONMENTAL FACTORS CAUSING NERVOUS TENSION
Unhappiness at home and work; fear of losing employment; anxiety over examinations;
unhappy marriage; general ill health; pelvic congestion; sedentary life and an unsatisfied sex
urge.
TRUE DYSMENORRHOEA: Pain sensation arises form uterus and is related to muscle
contraction. Experienced a few hours before and after onset and rarely lasts in a severe form for
longer than 12 hours. Colicky in type - patient may describe constant ache causing her to double
up. pain felt mainly in hypogastrium and is often referred to inner and front aspects of thighs -
never extends below level of the knee and is never experienced in back of leg. May be some low
backache but this is not a dominant sensation. During severe attack patient looks drawn and pale
and may sweat, N & V common - may be diarrhoea and rectal and bladder tenesmus? c.n.s.
upset.
CONGESTIVE DYSMENORRHOEA: Not strictly dysmenorrhoea but a period exacerbation of
a constant discomfort. C/F diffuse dull ache in pelvis, often with backache thought to result from
increasing tension in pelvic tissues associated with premenstrual engorgement.
Pain is at its height during two or three days preceding menses and is slowly relieved as
congestion is reduced with onset of menses.
Due to over-anxiety, emotional instability, inability to cope with domestic difficulties,
sedentary life, marital and sexual upsets.
MENSTURAL PAIN OF OVARIAN ORIGIN: Ovarian dysmenorrhoea is said to occur as a dull
ache in one or both iliac fossae for two to three days premenstrual and to be due to congestion of
ovaries which are often the seat of sclero-cystic disease. - really a form of congestive
27
dysmenorrhoea.
OVULATION PAIN: Mid-cycle pain (Mittelschmerz) is present from time to time during
menstrual life (usually 10th -14th days). Discomfort appears in hypogastrium or in one or both
iliac fossae and is occasionally referred to rectum.
CAUSES: - Contraction of tube or uterus; increased tension in Graafian Follicle or ovary;
irritation of peritoneum by discharge of fluid and blood from follicle. Muscle cramps in caecum
or pelvic colon.
INTESTINAL PAIN ASSOCIATED WITH MENSTRUATION
Most common "dysmenorrhoea" is a pain in the L iliac fossa, present 1 - 7 days premenstrual.
Less commonly pain is R sided and occasionally bilateral.
This pain tends to be blamed on ovary, tube, broad ligament varicocele.
In some cases you will find that the female occasionally experiences pain apart from
menstruation and that she suffers from flatulence, distension and either constipation or
diarrhoea. Typical account is of increased constipation premenstrual and of rather loose stools
during menses.
Usually instability, emotional (appendix usually removed) and has a C.A. phobia.
May be tender spastic colon and its is to there that patient refers to her pain. Functional
disturbances of large bowel in which most important element is spasm of spastic colon.
PREMENSTRUAL TENSION STATE: Most well adjusted females experience minor
psychological and somatic changes premenstrual. This menstrual molimina give way to a
sensation of relief and well being once menstruation is established.
Psychoneurotic females incorporate menses into their disorder with result that general
manifestations become exaggerated to constitute a premenstrual tension state. Very common 30
-45 years - often wrongly attributed to approaching menopause.
C/F onset 7 - 10 days premenstrual - if onset delayed even more intense headache,
irritability, depression, lassitude, insomnia, emotional outbursts, intestinal distension, colonic
spasm, congestive dysmenorrhoea.
Patient aware of nervous tension and has bloated feeling often accompanied by increased
girth and weight. Sometimes oedema.
MENSTRUAL MIGRAINE: Patient ordinarily susceptible to migraine is most liable to attacks
premenstrual and at menstruation. Conditions often familial.
Headache localised to one area and incapacitating severe nausea and vomiting.
Pregnancy usually brings temporary relief but migraine can be troublesome during
lactation.
PREMENSTRUAL MASTALGIA: C/F Slight fullness, tingling and tenderness premenstrual.
Breasts may feel tense, knotty and tender and there is some relationship to chronic mastitis.
VICARIOUS MENSTRUATION: Rare condition in which extra genital haemorrhage occurs at
regular intervals corresponding to periods may be: epistaxis - 30%, alimentary tract, lungs,
breast, gums, lips, kidney, rectum, conjunctiva.
CYCLICAL HAEMOTHORAX: Sudden development of hemothorax during menses with
resolution between periods.
C/F Pain in chest, faintness and respiratory embarrassment - symptoms subside.
CYCLICAL PNEUMOTHORAX: Sudden development of pneumothorax with collapse of lung,
with each period.
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C/F Acute chest pain, dysponea at each onset of menses.

MENSTRUAL EPILEPSY: Idiopathic epilepsy often makes its appearance at puberty and that
its manifestations are much more likely about time of menstruation.
In nearly all cases by careful enquiry it will be noted that fits occur apart from menses.
VAGINAL DISCHARGE: Vaginal discharge may be blood stained or otherwise. Here we are
only concerned with white, cream, yellow or greenish discharge.
Slight discharge usually seen at vulva and in vagina is a mixture derived from:
VULVA- Secretions of Bartholin’s, sebaceous, sweat and apocrine glands. Amounts vary with
ovarian function and with sexual stimulus.
VAGINA- Exudate appears as semi-solid, white fakes, resembling curds of milk and consists of
products of degeneration of superficial epithelial cells. Amount varies with ovarian function.
CERVICAL SECRETIONS: Alkaline, glairy, mucoid discharge rich in fructose which is also
influenced by ovarian activity and vascularity of cervix.
It is increased and less viscous at time of ovulation.
UTERINE SECRETION: Alkaline, watery, colourless with sugars.
FALLOPIAN TUBE SECRETIONS: Alkaline rich, watery fluid.
LEUCORRHOEA: (Running of white) Discharge. Should be restricted to mean an excessive
amount of normal discharge.
White or cream when fresh it dries and leaves a brownish yellow stain on clothing.
Excess may cause soreness and excoriation of vulva. NEVER pruritus or offensive.
More noticeable premenstrual, mid cyclically and during pregnancy.
CAUSES:
NEONATES - Have mucoid discharge 1 -10 days due to stimulation of uterus and vagina
placental oestrogens.
PUBERTY - Leucorrhoea not uncommonly seen in young girls during few years before or after
menarche. Corrects itself.
ACTIVE AND PASSIVE CONGESTION OF PELVIC ORGANS ESPECIALLY CERVIX:
Prolonged ill health, anxiety states and neurosis, sedentary occupation, standing for long
periods in hot atmosphere, prolapse and unsatisfied sex urge cause leucorrhoea.
INCREASE IN GLANDULAR ELEMENTS IN CERVIX: Regular douching.
Vaginal Asenomatosis.
INFLAMMATORY DISCHARGE: Cause of inflammation may be result of F.B., burn, abrasion,
tear, strong antiseptics or and idiosyncrasy to drugs.
INFECTIONS: Discharge caused be infection is muco-purulent or frankly purulent. Colour
varies from cream to yellow or green. Often offensive (especially Coli-Bacilli).
A) - VULVO-VAGINITIS - Gonococcus, Trichomonas Vaginalis, Candida Albicans in adult.
Non specific organisms in childhood and old age.
B) - CERVICITIS - Gonococcal or puerperal, secondary infections or erosion.
C) - ENDOMETRITIS - Puerperal, T.B. senile.
D) - SECONDARY INFECTIONS - Of wounds and neoplasms.
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NEOPLASMS:
Any growth exposed to lumen of genital tract can cause continuous discharge which at first
white or cream and non-offensive. When growth becomes ulcerated and infected the discharge
becomes purulent, offensive and blood stained - characteristic of malignant and benign lesions
such as cervical polyp or a sloughing sebaceous fibroid.
URINARY OR LAECAL FISTULAS: Urinary and feculent discharge recognised easily be its
smell and colour - but may be difficult in distinguishing with slight faecal escape from say a
senile pyometra.
CLINICAL HISTORY - DISCHARGE:
1. Age
2. Amount of discharge - judged by need to wear a sanitary towel and by stained underclothing.
3. Onset - Leucorrhoea gradual. Sudden onset nearly always means infection in moniliasis.
Recent treatment is with antibiotics.
4. Relationship to menstruation, ovulation, pregnancy. Trichomonas tends to be worse for a few
days after each period.
5. Colour of discharge.
6. Offensive.
7. Pruritus - T. Vaginalis or C. Albicans.
PRURITIS VALVAE: Sensation of itching. Different from painful, burning and tender does it
arouse the desire to scratch?
Pruritus valvae always more troublesome at night when woman is in bed.
Caused by chemical substances in body e.g. Histamine, Potassium, 5-hydroxy tryptamine
and plasma kinins.
PRURITIS VULVAE ASSOCIATED WITH DISCHARGE:
Not all vaginal discharges cause pruritus. Purulent, mucopurulent discharges from
neoplasms, F.B's gonorrhoea, cervicitis cause pain and tenderness - never itching.
Only discharges associated with pruritus are Trichomonas Vaginalis or Candida Albicans
(80% of all cases). Itch within introitus as well as vulva.
PRURITIS WITHOUR VAGINAL DISCHARGE:
Occasionally pruritus valvae is only part of general pruritus e.g. Lymphadenoma,
Jaundice, Uraemia and other toxic states.
SKIN DISEASE NOT SPECIFIC TO VULVA:
e.g. Psoriasis, Sevorrhoeic, Dermatitis, Scabies, note, C.A. of vulva causes itching in early stage.
ANIMAL AND VEGETABLE PARASITIS INFECTIONS:
PEDICULOSIS: Causes pruritus pubis then vulvae.
MONILIASIS:
Of vulva not uncommon - may be simultaneous infections of nail beds on hands and feet.
TINEA CRURIS: (Dhobi Itch) Affects groin rather than vulva (rare in women).
DISEASES OF ANUS AND RECTUM: Faecal Incontinence (even if they cause Fissure in ano)
pruritus-ani.
Haemorrhoids can be dismissed as causes of pruritus vulvae.
30
Threadworm (Oxyuris) rarely migrate forward enough to cause vulval itching.

Pruritus-ani in adult appears mostly to be caused be a fungus either Monilia or a form of tinea
(ring worm).
CONDITIONS OF URINARY TRACT:
Bacilluria, never cause pruritus
Pyuria vulvae,
Highly acid urine, they may cause
Incontinence of urine chafing and
Hematologic soreness.
Only urinary condition associated with pruritus vulvae is GLYCOSURIA.
ALLERGY AND DRUG SENSITIVITY: Skin sensitive to various chemical constituents of
toilet preparations, e.g. soap, bath salts and antiseptic containing phenols and cresols
occasionally explain pruritus.
Contact dermatitis from all sorts of cosmetics even nail varnish is a possibility.
Others, arsenicals, mercurials, picric acid used in treatment of vaginitis may cause
pruritus. Sensitivity to rubber or lubricants for coitus, benzocaine.
DEFICIENCY STATES:
Avitaminosis
A and B2 + B12
Folic Acid - Iron
PSYCHOLOGICAL FACTORS.
LOW BACK ACHE:
More of ten affects women than men.
- more so because:
a) Invariably worse before menses.
b) Often dates from labour, pregnancy and puerperium.
CAUSES IN GENITAL TRACT: Backache caused by gynaecological lesion is always diffuse. It
is situated in mid-line or has bilateral distribution. Its level is sacral or lumbo-sacral and never
higher than fourth lumbar vertebrae.
Any backache that can be indicated by a finger point or is associated with tenderness is
not due to an intrapelvic disorder.
PROLAPSE AND RETROVERSION: Vaginal prolapse never backache.
Uterine prolapse and retroversion may occasionally do so by dragging on intersacral and
cardinal ligaments.
Backache caused by a prolapse is immediately relieved by lying down.
CHRONIC CERVICITS: Debatable cause of backache - maybe if scarring around cervix or
cellulitis in adjacent ligaments. Relieved by rest.
TUMORS: May cause backache because of extra weight.
PELVIC CONGESTION, PELVIC VARICOCELE, PRMENSTRUAL TENSION:
31
Slight discomfort low in back is so common premenstrual as to be regarded as one of

normal menstrual molimina. It becomes exaggerated in menstrual tension syndrome.
GYNAECOLOGICAL OPERATIONS: Occasionally cause sacroiliac strain and other forms of
low backache.
EXTRAGENITAL CAUSES: Lumbago, fibrositis, myositis, acute and chronic strain of muscles
and ligaments. Rheumatic condition. Sacroiliac strain.
In all cases pain localised and accompanied by tenderness. Renal pain usually unilateral.
MENSTRUATION (MENSES OR CATEMENIA)
First period may be long or short, thereafter cycle is often irregular. Regular rhythm
achieved in 2 - 3 years. 20% experience amenorrhoea for 2 -12 months in early years. Menses
29 days - each female having own rhythm. And a cycle between three and five weeks normal but
some less frequently than this and still have health and fertility. Cycle usually 28 days + or - two
days. Blood loss usually three to five days but two to seven days is normal and may be extended
in some cases.
MENSES: Begins with pink discharge with cervical mucous and blood - rich in leukocytes.
Heavier second and third day - dark red blood with endometrial and cervical secretions,
endometrial debris and bacteria. Has characteristic odour caused by bacterial action and
degeneration and partly be accompanying secretion of sebaceous and apocrine glands on vulva.
Loss estimate. 5 - 100ml (average 25 - 30ml) = 0.6 to 0.7mg iron each day of menses. Average
three tampons in 24 hours (two day and one night) = total 12 -15 for average menses. Menstrual
efflux mainly fluid although small clots in 50%. Large clots means bleeding heavy so as to
defeat fibrinolysis. Normal cycle 4/28, prolonged loss at normal intervals 8.28, normal loss at
too short intervals 4/21.
GENERAL DISTURBANCES ASSOCIATED WITH MENSTRUATION:
Menses frequently accompanied by minor physical and nervous disturbances. Only 20% of
females free from discomfort. Degree depends on individual's outlook and determination not to
let it interfere with normal life. Well balanced individuals disregard it whilst highly strung,
emotional females exaggerate it.
MANIFESTATIONS
PREMENSTRUALLY: Lethargy and tiredness, Malaise, depression, excitability, irritability,
headache, fullness and tenderness of breasts, inability to cope, impairment to efficiency both
mental and physical.
Bowel changes 50% - constipated premenstrual, frequent motion during menses. Result
of disturbance of A.N.S. and may also give increased premenstrual micturition Nausea and
vomiting also occur - associated with dysmenorrhoea. Skin changes include:
Under eye shadow (M.S.H. stimulation).
Rashes
Few acne spots on face, back or chest (effect of progesterone).
Circulatory errors in lower limbs (V.V's) more obvious premenstrual. Enlargement of
thyroid may be noticed. Sometimes slight hyperglycaemia and B.P. up. B.M.R. and pulse
increased. Tendency to retain sodium and H20 in tissue during last week of cycle, this is though
to be due to high Oestrogen level in blood but peak plasma level of aldosterone and renin at the
time may have some bearing. It accounts for weight increase. Usually one third of women over
25 gain three pounds or more younger women notice little change.
MANAGEMENT: Not taboo - not unclean
32
Function of menses should be explained.

Encourage to live normal life.
Disadvantages of Tampon:
Cannot be used unless hymen torn or stretched aroused unfavourable reactions i.e. Masturbation.
- playing with genital and revulsion
- may be forgotten
- inefficient if flow is heavy.
Contraindication to tampons is when I.C.U.D. fitted. Vaginal douching after period
unnecessary. Some females strong sex desire during menses.
ARTIFICIAL ADVANCEMENT OF MENSTRUATION:
Advise no treatment because:
1. Date of next menstrual period cannot be accurately calculated even in females with regular
cycle.
2. Anticipation of important occasion may itself make period early or late.
3. Hormone therapy necessary may be more upsetting than period itself.
If circumstances warrant - it is better to postpone than advance menses - maintain levels
of ovarian hormone in blood artificially for a time when their natural fall will lead to
menstruation.
MENOPAUSE AND CLIMACTERIC
DEFINITION AND AGE:
Climacteric is counterpart of puberty phase, lasts one to five years with genital organs involute
in response to cessation of gonadal activity.
Menopause refers only to cessation of menstruation - it is merely one manifestation of
climacteric and precedes complete cessation of ovarian by several months or years. Interval
between the two may be explained by secretion of oestrogen by adrenal cortex or by ovarian
stroma.
Menopause peculiar to human race, 10% of males experience climacteric but at later age.
Age of menopause not dependant on age of menarche, number of pregnancies, marriage, climate
or environment. Menopause usually occurs 45 – 52. May come without warning but often
gradual decrease over several months or years.
Excessive and prolonged bleeding is never a feature of normal climacteric or
approaching menopause. Menstrual cycle ceases because ovaries cease to react to stimulus of
Anterior Pituitary (carries on producing F.S.H.).
PHYSICAL CHANGES:
Whole of genital tract wanes i.e. atrophy and inactivity due to waning ovarian function.
Breasts shrivel and flatten - in obese - large pendulous because atrophy affects glandular tissue
only. Becomes coarser in build and appearance (mild suggestion of Acromegaly), shoulders fat -
no waistline, slight facial hair, ancillary or pubic hair not shed (adrenal function) not ovarian,
body hair only becomes sparse in later life - senility, increase in weight.
PSYCHOLOGICAL CHANGES: Depends on outlook, single, married - surrounded by family.
Well adjusted an informed, changes are few and insignificant except for short period of
emotional instability.
33
CLIMACTERIC (MENOPAUSAL) SYMPTOMS:

1. NERVOUS AND EMOTIONAL
Depression, excitability, nervousness, irritability, inability to concentrate. Headaches
common, insomnia, paraesthesia of hands and feet, giddiness and head noises.
Involutional Melancholia - morbid depression may require certification - usually only
happens in the persons with personal and familial mental history.
2. GASTRO-INTESTINAL
Appetite increased or decreased - various forms of dyspepsia especially intestinal
distension and constipation with colonic spasms.
3. CARDIO VASCULAR
Palpitations, precordial pain, functional arrhythmia - hot flushes from vasomotor instability
brought on by excitement, nervousness and hot atmosphere - often with profuse sweats
disturbing sleep.
Vasodilation followed by vasoconstriction, therefore hot flush followed by cold shiver.
4. OTHERS
Painful and tender breasts, joint pains, Osteoporosis, fibrosis, Myosotis, skin pigmentation,
development of warts, naevi, menopausal hypertension.
After climacteric incidence of coronary thrombosis rises.
MANAGEMENT: Exclude organic disease, hypothyroidism, cholecystitis, understanding of
menopause by female. Psychological aspects. Middle age spread, watch diet. Encouragement
and explanation to wife and husband.
Prescribe Homeopathics - simplexes or complexes (see end of chapter).
When hot flushes and sweats troublesome, avoid alcohol, coffee, tea, hot baths, highly
seasoned food and fire side chair, blankets reduced.
ABNORMAL MENOPAUSE:
Premature: Rare before 40 - usually family history. No treatment of any value as ovaries
refractory - eliminate other causes of amenorrhoea. No symptoms should be ascribed to
menopause unless accompanied by amenorrhoea.
Late: Up to 52 not uncommon and of little significance. Beyond is unusual of not pathogenic.
Over 55 specialist advice:
a) Constitutional (familial) (race)
b) Uterine fibroids
c) Diabetes Melitis
d) Oestrogenic tumours of ovary (irregular then cyclic bleeding).
Tendency towards carcinoma (D.D.C. ? Hysterectomy).
ARTIFICIAL MENOPAUSE AND CLIMACTERIC:
SURGICAL: Removal of uterus, ovaries or both. If uterus removed and providing blood supply
of at least one ovary is not disturbed, ovarian function continues to normal age of climacteric
and no symptoms other than amenorrhoea develop. Removal of both in female still menstruating
causes severe climacteric symptoms in 50%.
Surgical climacteric more troublesome than natural because of a sudden ovarian influence being
34
withdrawn. Symptoms 4.24 months after operation but more frequent and of shorter duration in
younger women.
RADIATION MENOPAUSE: Repeated exposure to x-rays. Such treatment likely to be followed
by climacteric symptoms as intense as bilateral oophorectomy. In female less than 40 x-ray
"castration" usually not permanent - effects last 1.5 - 2 years - she may then conceive but there
is a theoretical risk of an abnormal foetus. Conception can occur before woman has any warning
by way of menstruation re-starting.
OVULATION AND MENOPAUSE: Generally asserted that menses frequently anovular during
5 - 10 years before menopause and suggests reason for lowered fertility after 40.
Ovulation continues sporadically up to time of menopause and sometimes afterwards.
Suggest menopause (L.M.P.) + 2 years before contraception stopped, risk then very slight.
DIGNOSIS OF OVULATION
ANALYSIS OF SYMPTOMS: Cyclical bedding - occurrence of regular normal menses strong
evidence of monthly ovulation.
OVULATION PAIN: Many females experience some discomfort in hypogastrium or one other
iliac fossa for 12 - 24 hours just before or after ovulation.
OVULATION BLEEDING OR DISCHARGE: Some females experience slight blood loss or
mucous tinged with blood at time of ovulation. It may occur with pain (ovulation) or
independently. Those females who do not have obvious haemorrhage may notice increased
natural discharge.
PREMENSTRUAL MASTALGIA: Premenstrual pain and tenderness in breasts is some way
related to corpus luteum action so its occurrence is reliably evident that ovulation has occurred
during that particular cycle.
ENDOMETRAL CHANGES: Time of ovulation cannot be determined accurately with
histological endometrial changes but the fact that it has occurred can be deduced.
CHANGES IN CERVICAL MUCOUS: Fern test (effects of oestrogen and progesterone on
physiochemical properties of cervical mucous).
VAGINAL SMEARS: Corpus Luteum formation.
TEMPERATURE CHANGES: Body temperature raised by progesterone and therefore is higher
during luteal phase of cycle and during pregnancy. During follicular phase temperature fairly
low. Ovulation sometimes preceded by low peak followed by rise - may occur within 24 hours
or gradually over four days.
Temperature remains higher than in follicular phase until next period. Temperature
recorded daily under standard conditions before rising, eating or drinking.
- orally, rectally or vaginally, oral usually.
HORMONE ASSAYS: Daily assays of oestrogen, progesterone and gonadotrophin in blood and
urine.
DIRECT OBSERVATION: Finding active corpus luteum by inspecting ovary during
laparotomy, peritoneoscopy and culdoscopy.
SUPPRESSION OF OVULATION: Diseases affecting hypothalamus, pituitary, ovary, thyroid,
pancreas, adrenals, metabolic disorders (starvation/obesity), debilitating diseases.
In these circumstances, ovarian failure usually accompanied by amenorrhoea or
oligomenorrhea.
DRUGS AND OTHER THERAPEUTIC AGENTS: Chlorpromazine and derivatives, reserpine,
35
E.C. therapy.
IRRADIATION
ANDROGENS: Oestrogen and progesterone.
CONCEPTION
FERTILISATION OF OVUM:
Pregnancy results when spermatozoa unites (fertilises) ripe ovum.
SPERM: Takes 2/52 from testicle (tubules of epididymis) and are not motile until they mix with
seminal fluid immediately before ejaculation - they are not stored in seminal vesicles. Until they
enter female tract they do not possess capacity to fertilise ovum. Capacitation is acquired only
after they have been in uterus and tubes 2-4 hours. Seminal fluid alkaline pH 7.5 to 8.0 but when
mixed with vaginal fluid secretion pH 6.2 and may be 5.5 if secretion from cervix and
Bartholin’s are limited.
All sperm remaining in vagina 2 hours or longer are killed. Probably only those entering
cervical cancel (pH8-9) within few minutes retain their fertilising powers of propulsion being
directed by chemotaxis (acid repels, alkaline attracts). They invade mucous plug in cervical
canal which at time of ovulations softened to allow easier penetration. Once through cervix,
sperm ascend rapidly (?uterine contraction and tubes). Chief function of flagellum may be to
allow penetration of corona radiata and capsule of ovum.
Time taken for sperm from vagina to tubes may be one hour - some say 6 - 24 hours.
Many lost on way - ingested by epithelial cells of vagina. Those that reach tube travel against
cilia current and some get into peritoneal cavity.
In ampulla of tube, gamete surrounded by corona radiata approached by many sperm but
fertilisation usually by late comer. Forerunners soften and prepare envelope of ovum by
releasing hyaluronidase and they can be seen in zona pellucida.
Single sperm enters ovum and loses tail. Pronucleus contained in head and fuses with
pronucleus of ovum to form single nucleus with 46 chromosomes - starts cell division for seven
days but does not increase in overall size.
Sperm only survive on female upper genital tract ? not longer than 24 hours.
Ripe ovum can only survive 24 hours and probably 8 - 12 hours after leaving ovary.
Conception therefore, unlikely unless coatis takes place and or two days before or
immediately after ovulation.
Fertile period in 28 day cycle varies between 7th and 19th day. Other days relatively but
not absolutely safe outside this period even during menstruation.
EARLY DEVELOPMENT OF OVUM: First division into two cells occurs in 24 - 30 hours,
morula formed by third or fourth day. Morula covered by zona pellucida - becomes cystic as
result of fluid being secreted by its own cells or absorbed from genital tract. This blastocyst
present by seventh day and consists of single layer of cells surrounding the contained fluid, with
a collection of cells forming a solid area on inner aspect of wall at one point. From this inner
cell mass foetus is formed. Cyst wall of flattened cells is trophoblast - soon two layers - inner
cuboidal Langhans cells (Cytotrophoblast) and outer syncytium (Syncytiotrophoblast).
Trophoblasts function is to attach ovum to wall of uterus and there after to nourish it.
FORMATION OF FOETUS AND MEMBRANES: Inner cell mass proliferate and fluid filled
space appears in their midst on adjacent side to trophoblast - amniotic cavity and its lining cells
become the amnion. A second cyst lined by a single layer of flattened cells appears on other
aspect - yolk sac - a primitive structure in humans. Two cavities separated by double layer of
36
cells. Between these mesoderm develops and grows our to form from body stalk or umbilical
cord.
Now flat plate between amnion and yolk sac with three layers ectoderm, mesoderm and
endoderm (yolk sac cells). Neural canal from invagination of ectoderm. Muscle, B.V's, bones -
from mesoderm. Primitive essentials of body recognisable by sixth week.
Trophoblast develops villous projections - fluffy ball appearance. Mesenchyme invades
each villi as central core. When trophoblast receives its inner layer of mesoderm it is known as
chorion and has villi. Chorion villi - well formed by 14th day, Chorion forms placenta.
IMPLANTATION OF OVUM INTO UTERUS: Fertilised ovum moved along tube by cilia
current and peristalsis - in four days reaches uterine cavity where it lies free for two to three
days during which time it is supported by secretion of pro gestational endometrium - uterine
milk, + 7th blastocyst attaches itself to endometrium - usually upper part then burrows itself
losing its zona pellucida. Site of entry quickly sealed.
Altered endometrium lying deep to the implanted ovum is deciduous basalis and that
which shields it from uterine cavity-decidua capsularis. The lining of remainder of uterus is
decidua vera.
HORMONAL CONTROL OF PREGNANCY: Fertilised ovum embedded + 21 - 22 days of
cycle is beginning to secrete chorionic gonadotrophins which is luteinizing and luteotrophic.
This prevents degeneration of corpus lutem which continues to maintain the progestational
endometrium - amenorrhoea results.
CORPUS LUTEUM OF PREGNANCY: Corpus luteum not only persists but continues to
enlarge slightly up to 60th day of pregnancy. soon after 60th day corpus luteum temporarily
becomes cystic and its activity wanes by 10th week. Shows evidence of celloidal degeneration
by 16th week but remains a recognisable structure throughout pregnancy. In puerperium and
after abortion it occasionally undergoes calcification but is ultimately absorbed.
ENDOCRINE FUNCTION OF PLACENTA: Gonadotrophin found in urine of pregnant females
is chorionic gonadotrophin.
CHANGES ASSOCIATED WITH PREGNANCY
VAGINA (LESSER DEGREE VULVA): Shows early signs of vascularisation, walls congested
appearance and violet colouration (Jaxquiemior's Sign). Becomes softer and more elastic.
Epithelial cells packed with glycogen and secretion is free and highly acid.
Changes due to oestrogen but vaginal smear picture reflects a dominant progesterone
influence.
CERVIX: Congested, bluish and soft - softening more apparent in primigravida than
multigravida.
Sometimes erosion appears.
Endocervix presents honeycombing appearance and is closed by tenacious plug or
mucous which doesn't fern on drying. May be leucorrhoea of pregnancy.
UTERUS: Becomes more globular and enlarges progressively.
FALLOPIAN TUBES: Broad and round ligaments show hypertrophy and increased vascularity
due to oestrogen.
OVARY: Corpus luteum persists throughout pregnancy although not active after third month.
Often cystic between 8th - 12th weeks. Ovulation is arrested but follicular atresia continues.
BREASTS: Show changes very early in pregnancy. Especially prinigravida and brunettes.
37
1. Pain and tenderness.

2. Increased vascularity - engorgement of superficial veins.
3. General enlargement
4. Brown pigmentation of areolas
5. Raised pale areas on areola (Montgomery’s Tubercles).
6. Formation of secondary areola
7. Secretion of small amount of colostrum
8. Increased erectibility of nipples
9. Nodularity of breasts
ENDOCRINE SYSTEM: Introduction of new gland for internal secretion - Placenta produces
Oestrogen, Progesterone, Chorionic Gonadotrophins, M.S.H., Possibly A.C.T.H.,
Corticosteroids.
Placenta activity is basis of most pregnancy reaction of body - failure of adoption to
presence of placenta may explain certain disorders of pregnancy such as toxaemia.
Adenohypophysis shows histological change, Its output of L.H. is increased in early
pregnancy and the F.S.H. - L.H. cycle interrupted throughout.
Alterations in actions of hypothalamic and neurohypophysis explain changes in appetite,
weight, thirst and fluid balance, release of oxytocin plays part in labour.
Thyroid activity doubled - P.B.I. up because oestrogens increase amount of thyroxine
binding protein in plasma by 100%.
URINARY TRACT: Frequency of micturition due to enlarged and acutely ante flexed uterus of
by hypertonicity of bladder wall. Frequency increased night and day - bladder tolerance not
decreased except in last trimester when presenting part crowds the pelvis. Due to dilation of
uterus in 80% urinary stasis results and this explains why females are liable to develop
pyelonephritis during pregnancy.
ALIMENTARY TRACT: Nausea and vomiting 50% first 3/12 then sickness and heartburn
return later in pregnancy and are caused by mechanical pressure form abdominal tumour, by
hiatus hernia which was previously not present or symptomless or by oesophageal reflux due to
relaxed cardiac sphincter.
Achlorhydria is a factor in some dyspepsia cases. Appetite may decrease in early weeks
but then increase. Distaste for cigarettes is a characteristic reaction, ptyalism (excess saliva) not
uncommon.
METABOLISM: Changes profound.
Sodium and fluid retention ten to produce oedema. Vomiting and anorexia frequently cause loss
of weight early on, thereafter progressive gains until last 2 - 3 when weight decreases or
becomes stationary.
Total increase + 9.5kg (5 - 15kg).
Foetus, placenta and liquor = 4.5kg even at term. Increase in breasts and uterus = 1.9kg.
Remainder of increase - fluid retention, increased blood volume and deposition of fat. Fat can
appear early so waistline begins to disappear before uterus is big enough to produce a significant
abdominal tumours.
Lowered renal threshold for sugar resulting in glycosuria. Slightly raised B.M.R. altered
liver blood flow and function due to oestrogen effect.
38
CUTANEOUS STRUCTURES: Deposition of fat.

Increase in tissues fluids
Change of skin texture
Scalp hair becomes greasy
Previous skin diseases may be better or worse
Development of cutaneous hemangiomas not uncommon
Brown pigmentation of skin M.S.H. + oestrogen
a) Increased freckling
b) Primary and secondary areola of breasts
c) Patches on forehead and cheeks or pregnancy rash (Chloasma).
d) Linea nigra from umbilicus to pubis occasionally above vulva
e) Discolouration of vulva
Striae gravidarum seen on abdominal walls, thighs, upper arms and breasts. Are
permanent although purplish red when formed becomes silvery and inconspicuous in later years.
LOCOMOTOR SYSTEM: Joints of pelvis and lower spine more mobile as ligaments softened
by oestrogen, progesterone action and ? relaxin (uterine relaxing factor). This change +
increased body weight accounts for low back ache. Makes for difficulty in walking and
susceptibility to ligamenta strains. In late pregnancy presence of large tumour makes women
develop lordosis and waddling gait.
CARDIAC VASCULAR SYSTEM: Volume of circulating plasma up to one litre resulting in
physiological anaemia. It is usually not more than 80% but can be raised to 100% by
administering iron. Cardiac output increased to maximum at 24th to 30th week.
In late pregnancy large uterus displaces heart slightly to L.
Postural hypotension with faintness and respiratory embarrassment on lying flat due to
pressure of uterus on Inferior vena cava (Vena-Caval Syndrome).
Atony of involuntary muscles in B.V's and alteration in circulation in large B.V's of
abdomen and pelvis are manifested by frequency of V.V. of leg, vulva and vagina. Abdominal
haemorrhoids. Worse mid-pregnancy.
Pregnancy commonly complicated by thrombo-embolic disorders.
NERVOUS SYSTEM: Neuritis can develop - if generalised may be due to Vitamin B deficiency.
If localised to hands, arms or legs usually die to pressure on roots.
Falling shoulder girdle produces acroparesthesia in arms. Increased mobility of spine and
disc displacement = sciatica. Oedema of median nerve in carpal tunnel causes tingling of
fingers.
Pregnancy can temporarily alter outlook of female. Early pregnancy - depression,
irritability, emotional instability, lethargy and apathy all common.
Middle pregnancy - feeling of well being - full of energy later placid, content, quietly
happy, proud.
Prior to labour onset - few days of emotional disturbances orgy of unnecessary house
cleaning.
39
OF PREGNANCY:
1. Amenorrhoea
2. Morning sickness, nausea and changes in appetite
3. Pain and tenderness in breasts
4. Frequency of micturition
LATER:
5. Enlargement of breasts
6. Enlargement of abdomen
7. Foetal movements
N.B. - Foetus moves in utero at 12 weeks. Female not aware of it until 16 - 20 weeks in
multigravida, 18 - 22 week in primigravida.
SIGNS:
EARLY: During first weeks i.e. until menses 2/52 overdue, it is usually impossible to
pregnancy on examination - rarely before six to eight weeks (urine analysis - pregnancy test kit
available to expedite diagnosis at earlier date).
BREASTS: Engorgement of surface veins
Pigmentation of primary areola
Montgomery's tubercles
PELVIC ORGANS: Blue or violet colour of vagina. Pulsation of vaginal and uterine arteries
detected in vaginal fornices. Softening of cervix - often absent in multigravida.
Globular shape of uterus. Irregularity in shape or consistency of uterus.
Uterine contractions palpable of B1-manual examination. Enlargement of uterus.
Hagar’s sign 8th - 12th week.
LATER:
BREASTS:
Enlargement
Striae
Secondary areola
Ability to express Colostrum from nipple.
PELVIC AND ABDOMINAL ORGANS: Enlargement of abdomen by tumour which is cystic,
arises from pelvis, dull on percussion and which hardens from time to time with contraction.
Recognition of foetal parts on palpitation
Foetal movements felt by observer
Auscultation of foetal heart
Internal ballottment
External ballottment
Hearing uterine soufflé (which is noise created by blood rushing through large vessels in or
alongside uterine wall).
40
May be distinguished from placental soufflé because rate of latter corresponds to that of foetal
heart whereas former tallies with maternal pulse.
Appearance of linea nigra and striae gravidarum on abdominal walls and thighs.
THE BREASTS
BREAST FUNCTION AND DISORDERS: Age nine to ten female breasts begin to enlarge -
around nipple at first. Ducts and acini develop within next two to three years. By the time of
menarche, fat deposited to make breasts more round and prominent. Further proliferation of
gland and enlargement of breasts as while until 16 - 18 years. Pre-pubertal development -
oestrogen from ovary, growth hormone and adrenal corticoids. Post pubertal - progesterone and
prolactin, Oestrogen and growth hormone and deoxycortone determines duct development.
Progesterone, prolactin and glucocorticoid are responsible more for gland formation.
Mature breasts undergoes cycle which corresponds with ovarian cycle. Luteal phase
increased epithelial activity (with slight secretion) in ducts and acini - regresses during menses.
breasts as a whole increases in size 1/52 premenstrual. Mainly due to congestion and oedema of
connective tissue between lobules - slight pain, tenderness.
Development of breasts in pregnancy - oestrogen (ducts) progesterone (areola).
Full preparation for lactation is also dependent on adequate diet. Corticosteroids and prolactin.
LACTATION: Milk never produced until placenta delivered or ceases to function.
Lactation inhibited during pregnancy by action of oestrogen on hypothalamus and
anterior pituitary gland. Immediately after delivery inhibition removed and outflow of prolactin
initiates lactation.
More important is establishment and certainty in maintenance is suckling and stimulation
of nipple. Emptying of breasts further lactation. Suckling or handling of breasts cause a strong
contraction of puerperal uterus. After pain are always worse at feeding time.
INHIBITION OF LACTATION: Sometimes necessary to suppress lactation e.g. abortion or
death of baby.
Oestrogen in divided within 24 hours of delivery of placenta - longer delay less efficient
treatment. For homoeopathic treatment see end of lecture.
ABNORMAL LACTATION:
DEFICIENT LACTATION:
CAUSES:
1. Poor development of breast tissue - more fat less glands - small nipples, inverted nipples thus
impedes sucking.
2. General ill health and poor nutrition.
3. Acute illness - shock, haemorrhage, serious infection.
4. Destruction of anterior lobe of pituitary.
5. Failure of baby to suckle efficiently.
6. Failure of baby to empty breast.
7. psychological consideration.
N.B. Regular attention to breasts and expression of colostrum during last few weeks.
After delivery mother takes three litres of liquid per 24 hours. If baby fails to empty breast -
remaining milk removed by pump or expression.
41
BREAST ENGORGEMENT: Breasts often tense, hard and painful three or four days after
delivery. Engorgement primarily with blood.
BLOOD STAINED MILK: Bleeding from cracked nipple is common. Rare phenomenon is
contamination of milk with blood from within breast tissue. May come from only one lobe or
whole breast and can be bilateral. Local lesion e.g. duct papilloma results in bright red blood
distinguishable from milk. A diffuse condition can result in homogenous mixture of the two
fluids to produce "brown milk". Usually clears in a few days - if persistent, location must be
discontinued. Sometimes blood stained colostrum is seen in pregnancy.
GALACTORRHOEA: Continuous secretion of milk in absence of recent pregnancy.
CAUSES: Physiological - in nearly all women who have lactated it is possible to express a little
milk or allied secretion from breasts for years afterwards and especially premenstrual.
SUCKLING: Lactation is known to have occurred in virgins, young and old, when they
repeatedly put a baby to the breasts and have had an overpowering desire to feed it.
DRUGS: Certain drugs - phenothiazine.
- reserpine.
Can cause galactorrhea with or without amenorrhoea.
HYPOTHALAMIC AND PITUITARY CONDITIONS:
Galactorrhea is a symptom of pituitary tumours and of hypothalamic lesions.
Chiari-Frommel Syndrome characterised by lactation and amenorrhoea associated with uterine
superinvolution persisting for years after pregnancy.
OTHER CONDITIONS: Galactorrhea is associated with hypothyroidism and hyperthyroidism
(only when these have pituitary causes).
OVULATION AND MENSTRUATION IN RELATION TO LACTATION: Females who do not
lactate - menstruation appears in six to eight weeks after delivery and is regular within three
months (90-93%).
First period 40% are ovular.
After abortion- first menses generally in four to six weeks and in ovular (75%).
Ovulation and lactation are antagonistic probably because prolactin and gonadotrophins cannot
be produced simultaneously.
Menstruation returns within 3/12 in 10 - 30% of lactating females and 75% partially lactating
females.
Inhibition depends on suckling and disappears quickly once complimentary feeding is
introduced.
Of females who continue breast feeding for 6/12, 50% menstruate while lactating. Cycle
not necessarily regular. Ovulation and conception can occur before menstruation returns and it is
not uncommon to see females who have never menstruated for 8-10 years having been
constantly in state of lactation or pregnancy
AMENORRHOEA:
ANOMALIES OF DEVELOPMENT AND FUNCTION
HYPOPLASIA: Size of bust depends on fat as much as on glandular tissue and the development
of nipple is best guide to latter. Hypoplasia of nipple has same causes and treatment.
42
CAUSES:
1. Deficiency of ovarian hormones - always other evidence of deficiency e.g. amenorrhoea and
genital underdevelopment.
2. Intrinsic defects of gland itself- gland may be absent, rudimentary or insensitive to hormone
stimulus - this is always the cause when ovarian function is normal and female not wasted.
TREATMENT: Oestrogen if clearly deficient. Diet, encourage them to put on weight.
Physiotherapy - limited value. Plastic surgery.
BREAST ASYMMETRY: Rarely equally developed - even if they look same, function is
unequal when they lactate. Different sizes - fault inherent in gland tissue. Endocrine valueless.
Plastic surgery.
INVERTED NIPPLES: Developmental error and should not be treated unless patient pregnant.
Oestrogen ointment is early months, later digital manipulation - periodic suction with breast
pump or "waller type" plastic or glass nipple shield worn regularly beneath bra.
ACCESSORY BREASTS AND NIPPLES: The "axillary tail of spence" in well developed
females may result in axillary pain and swelling premenstrual or during lactation. Accessory
nipples (small papillomas or pigmented moles) on nipple line (anterior axilla to pubic spine) are
extremely common. No treatment usually necessary.
HYPERTROPHY OF BREASTS: True hypertrophy (as distinct from adiposity) is not common.
Affects glandular tissue not nipples. Enlarge further in pregnancy and puerperium but do not
lactate (Support with spinal bra or subtotal mastectomy).
PENDULOUS BREASTS: After childbirth and lactation with advancing age and obesity -
breast loses its firmness and shape - may be so pendulous as to be embarrassing. Treatment
immediately after lactation is support and exercise pectoral muscles.
NEONATAL MASTITIS: Breasts of male and female babies sometimes become enlarged and
hard three or four days after delivery. Witches milk from nipple (oestrogen influence). No
treatment other than assuring mother.
ADOLESCENT MASTITIS: A nodular painful enlargement of breast sometimes occurs at
puberty in both male and female - reflects upsurge in pituitary activity - as a rule subsides on its
own but remove irritating clothing.
CHRONIC MASTITIS: Females in 40 - 50's sometimes complain of an intermittent mammary
discomfort - chronic mastitis - although no infection.
Condition is sometimes described as chronic hyperplastic mastopathy or fibroadenosis
( precursor of C.A.)
Breast tenderness O/E and has ill-defined modularity. Majority of cases complain of painful
breasts - lesion more usually in the psyche than the breast - female frequently unmarried or
sterile and approaching menopause. Tend to be over anxious and have fear of C.A. They
experience premenstrual exacerbation of discomfort and on handling breasts discover what they
wrongly think are tumours. - do not overlook C.A. - in doubt refer, it neoplasm excluded -
reassure, bra, leaving breasts alone - not mastectomy. When it affects younger women
pregnancy can be curative.
ABORTION: Denotes termination of pregnancy before 28th week i.e. before foetus viable by
law. Miscarriage synonymous. After 28th week - still born.
Low folic acid intake increases likelihood to abort. Dietetic deficiencies.
CAUSES:
1. FOETAL ASPHYXIA
43
A) INTERFERENCE WITH PLACENTAL CIRCULATION:

e.g. Infarction through maternal nephritis and hypertension - by placental separation, tumour,
hydatidiform mole, infection of placenta as in syphilis.
B) INTERFERENCE WITH CIRCULATION IN CORD:
Knots, twists, entanglements, Innate anomalies in anatomy if B.V.'s
2. FOETAL ANAEMIA: Incompatibility of blood groups.
A) MATERNAL ASPHYXIA: Heart failure, severe, acute and chronic respiratory diseases,
gross anaemia and anaesthesia.
Due to anaemia by ankylostomiasis in tropics.
3. POISONS AND DRUGS: Barbiturates, sulphonamides, anticonvulsants when given over
long periods.
4. INFECTIONS: Smallpox, Rubella, Syphilis after 20th week.
5. PYREXIA:
6. DIRECT INJURY:
7. ENDOCRINIC DISEASES: Hypothyroidism, Hyperthyroidism, Diabetes Mellitus.
8. FAILURE OF UTERUS TO ACCOMMODATE PREGNANCY SAC: Dependant on
Oestrogens and Progesterone in circulation to prepare uterus to receive fertilised ovum.
9. DEVELOPMENT ERRORS OF UTERUS: Bicornuate malformation.
10. DISPLACEMENT OF UTERUS Not important cause.
11. DISTORTION OF CAVITY OF POSITION OF UTERUS BY FIBROIDS AND OTHER
PELVIC TUMORS:
12. STIMULATION OF EXPULSIVE UTERINE CONTRACTIONS: Nervous shock, fright,
emotional upsets, accidents, operations - only in susceptible females.
13. OXYTOCICS: Ergot only cause abortions in susceptible females as do strong purgatives.
14. OVERDISTENSION OF UTERUS:
15. DIRECT TRAUMA TO UTERUS AND IT'S CONTENTS:
16. RUPTURE OF MEMBRANE: With escape of liquor amnii almost inevitably leads to
abortion.
a) Abnormally high intra-uterine pressure.
b) Abnormally friability of membranes.
c) Cervical incompetence.
DANGERS OF ABORTION: Maternal death through haemorrhage, shock and infection.
CLINICAL TYPES OF ABORTION:
1. Threatened abortion
2. Inevitable abortion (complete or incomplete).
3. Missed abortion (including carneous mole).
4 Septic abortion (applies to 1,2,and 3).
Any female who sustains three or more successive abortions is said to suffer from
habitual recurrent abortion.
44
1. THREATENED ABORTION: C/F Female known to be pregnant - has uterine bleeding.

Regard any bleeding as threatening abortion.
Discharge bright red at first - then dark brown. On P.V. - cervix not dilated but blood
escaping, otherwise uterus is like normal pregnant uterus.
Sometimes pain is significant as expulsion may be taking place. Complains of backache
and lower abdominal discomfort. Even when blood loss is sharp and prolonged, pregnancy may
still continue - but passage of clots denotes abortion is inevitable.
Sometimes discharge from uterus is brown from onset, indicating pregnancy is already
dead and abortion is inevitable or missed.
Persistent, slight pyrexia also means pregnancy is unlikely to continue - it is evidence of
infection of pregnancy or degenerating clot in uterus.
N.B. Persistent or intermittent haemorrhage is also feature of hydatidiform mole or
sometimes multiple pregnancy.
TREATMENT: Bed at least even days after bleeding ceased.
Sedatives.
Treatment of cause, folic acid.
Advice against travel.
Generally lead quiet life and avoid coitus (infection).
2. INEVITABLE ABORTION:
C/F As above plus
Painful uterine contraction.
Dilation of Cervix
Extrusions of some part or pregnancy from Os.
Other signs: Ballooning of upper vagina
Tenderness of uterus
Pyrexia
TREATMENT: Refer to medical attendant.
If aborted keep contents for medical attendant to ascertain whether complete or not.
3. INCOMPLETE ABORTION: Fragments of chorion often remain in uterus after apparently
complete abortion.
C/F bleeding does not get progressively less but varies from day to day becoming heavy
from time to time. Normal menstrual rhythm not re-established.
O/E uterus found to be slightly enlarged and possibly softened. Cervix usually remains open
(this sign always regarded as something within uterus).
4.ABORTION COMPLICATED BY INFECTION: Genital tract especially susceptible to
infection during and after abortion and infection arising in or via the uterus at that time is a form
of puerperal sepsis - complications of abortion can prove fatal or chronic health in future and
fertility.
C. Welchii commonly found - dangerous
B Coli
Haemolytic Strep - most dangerous
45
Anaerobic Strep
Staph Aureus
Others are G.C. Pneumococcus and Tetanus Bacilli
C/F PYREXIA - Severity of infection not always proportionate to height of temperature and a
low temperature can have serious portent.
RIGORS usually denote blood stream spread.
TACHCARDIA rise in pulse rate more important sign than pyrexia. Rate of + 110 pm. usually
means infection is spreading beyond uterus, 12 - 48 hours endometritis and septicaemia, 2/3
days pelvic peritonitis, 3/4 days localised endometritis, 10th day cellulitis and thrombo plebitis.
OFFENSIVE DISCHARGE: Tenderness to Uterus
Leucocytosis
Ileis
General systemic upset
Anorexia
Nausea and vomiting
Joint pains
Headache
Flushed and sweating
Dehydration
Mental disorientation
Coma
5. MISSED ABORTION: Sometimes foetus dies in utero but uterus does not expel it - foetus
then becomes macerated or mummified - liquid amnii is absorbed and placenta pale and thin.
C/F at first signs and symptoms of normal pregnancy. Slight bleeding ensued and
diagnosis of threatened abortion is made. Discharge clears up temporarily and pregnancy os
apparently progressing until it becomes clear some weeks or months after that uterus is not
growing - it becomes harder in consistency and smaller. Sooner or later haemorrhage reoccurs or
there may be brown discharge (intermittent). Breasts signs regress and nausea disappears.
Occasionally female experiences sensation of cold or weight in pelvis or lower abdomen
and sometimes toxic absorption causes malaise and skin rashes. Foetal movement (if present)
ceases.
TREATMENT:
Except for possibility of coagulation failure, missed abortion is unlikely to harm provided no
interference. Uterus generally empties itself spontaneously + 21 days after foetal death. If not
hospital.
RECURRENT OR HABITUAL ABORTION: Three pregnancies (consecutive) ending in
abortion.
Rest
Psychological support
Sedation
Diet - adequate varied, rich in protein, iron, folic acid and A,B,C,D, throughout pregnancy.
46
CRIMINAL ABORTION: Self induced or by other party.

ECTOPIC PREGNANCY: Is one where fertilised ovum is implanted into a site other than that
or uterine cavity.
SITES OF ECTOPIC PREGNANCY:
a) Abdominal cavity
b) Ovary
c) Fallopian tube
d) Broad ligament
e) Rudimentary horn of bicornute uterus
f) Cervix - most common fallopian tube
When twinning occurs there may be simultaneous intrauterine and extra-uterine pregnancies and
simultaneous bilateral tubal pregnancies.
CAUSES: Development errors of tube e.g. hypoplasia
Twisting
Distortion of tube
Previous inflammatory disease.
Tubal disease nearly always bilateral and there is a tendency for ectopic to occur first on one
side then the other.
Cross over external of ovum from one tube to other by which time it has enlarged and gets fasts
in tube and acquired a trophoblast which embeds in tube.
SITES:
1. Fimbriae - usual
2. Ampulla - common least dangerous
3. Isthmus - more dangerous
4. Interstitial - rare
Female reacts to pregnancy in usual way as does uterus. Nausea and vomiting, changes
in appetite, pain and tenderness of breasts.
OUTCOME - Foetus often malformed.
Disaster usually overtakes embryo before 6/52.
1) Complete absorption
2) Complete abortion
3) Incomplete abortion
4) Missed abortion - tubal mole (carneous mole)
FOETUS - Result is death from placental separation.
1) Absorbed
2) Mummification
3) Infected
4) Calcified ( |Lithopedion).
47
C/F presents chronic (common) or acute illness (intraperitoneal bleeding small but recurrent).
Patient has short period of amenorrhoea and sometimes other symptoms of early pregnancy e.g.
nausea, breast pains.
When period overdue by few days (pregnancy of two to three weeks) distension and
contractions of tube cause aching in one or other iliac fossa. Severity of pain depends on amount
of blood loss - NEARLY ALWAYS SYNCOPE. When patient lies down blood tracks to
diaphragm and this is manifested by shoulder tip pain or epigastric pain worse on inspiration.
Slight vaginal bleeding has begun, tends to continue even if only as brown discharge without
intermission (feature). Large pelvic haematocele can cause acute retention of urine. Examination
may or may not reveal early pregnancy, changes in breasts etc. Tenderness and muscle guarding
over lower abdomen, especially affected side - striking feature. Some intestinal distension
common. Hemoperitoneum of 2-3 can cause appearance of bruising around umbilicus (Cullen's
Sign).
O/E blue colouration of vagina
Arterial pulsation in fornix of affected side
Slight enlargement of uterus
Irregular and tender enlargement of appendage on affected side.
Tenderness in pelvis most constant sign
Patient pale - pulse rate likely to be up slight intermittent pyrexia
Blood bilirubin is up
Patient may therefore become jaundiced
E.S.R raised
Slight leucocytosis
ACUTE PICTURE: Short period of amenorrhoea or none. Seized with severe lancinating pain
in one iliac fossa or hypogastrium. Immediately followed by profound collapse, pallor, low B.P.,
subnormal temperature, weak rapid pulse - death ensues quickly.
Usually haemorrhage is temporarily arrested and condition approves within a few hours.
Pain persists being referred to epigastrium or shoulder.
O/E shock/anaemia.
Lower abdomen and sometimes upper, acutely tender. Presence of free blood in
peritoneal cavity is indicated by dullness in flanks and intestinal distension in front. Leading
signs - acute tenderness and production of pain by moving cervix.
DIFFERENTIAL :
1. Abortion of early intra-uterine pregnancy
2. Abortion complicated by salpingitis
3. Early intra-uterine pregnancy complicated by pelvic tumour
4. Retroverted gravid tumour
5. Acute and subacute salpingitis (including T.B.).
6. Dysmenorrhoea
7. Rupture of endometriomata’s cyst
8. Torsion of ovarian and pedunculated fibroid
48
9. Intra peritoneal haemorrhage

10. Acute appendicitis
11. Perforated peptic ulcer
12. Renal colic
13. Reaction to I.C.U.D.
OVARIAN PREGNANCY - very rare
CORNUAL PREGNANCY - rare
ANGULAR PREGNANCY
ABDOMINAL PREGNANCY - rare
INTRALIGAMENTARY PREGNANCY
TROPHOBLASTIC TUMORS:
Malignant or potentially malignant
Relatively benign = vesicular (hydatidiform) mole
Malignant = choriocarcinoma
VESICULAR (HYDATIDIFORM) MOLE:
Female + 40 years
Hydatidiform change can occur in one ovum of twin pregnancy - other develops
normally. It can also complicate ectopic gestation.
OTHER TYPES:
Benign Hydatidiform Mole
Malignant Mole, Invasive mole, chorioadenoma Destruens
Metastasizing Mole
C/F S/S are that of early pregnancy at first
Excessive vomiting common
She feels and looks ill
Pre-eclampsia - 50% cases
Recurrent uterine bleeding and brown discharge
Likely to be threatened abortion - always takes place sooner or later.
Possibility of hydatidiform mole should be considered whenever symptoms of
threatened abortion do not subside quickly or when they recur and especially if patient reacting
badly to pregnancy.
Uterus too large for period of amenorrhoea. Sometimes uterus smaller than normal when
mole dies. Uterus doughy and doesn't contract. Foetal parts, movements and heart sound not felt.
DANGERS: Severe haemorrhages at some stage of expulsion
Infection
Perforation in rupture of uterine wall.
CHORIO-CARCINOMA: Most malignant of trophoblastic tumours.
C/F irregular uterus, haemorrhage coming on sooner or later following pregnancy or
49
expulsion of mole. Haemorrhage intermittent but very heavy while it lasts (arterial). Offensive
discharge develops with cachexia with pyrexia. It metastasizes.
INJURIES
F.B.'s IN GENITAL TRACT
Therapeutic agents - swab post op. instruments (supporting pessaries).
Contraceptive appliances
Articles inserted by patient or accidental entry e.g. bottles, cans, pips - children - toys, hairpins,
sweets.
Instruments for inducing abortion and labour e.g. bougies and catheters.
Articles of toilet and hygiene - tampons, couche nozzles, vaginal calculus e.g. suture material
and cotton wool.
EFFECTS: Plastic and vulcanite may cause little trouble.
Rubber - very irritant
Cotton and woollen fabrics quickly lead to local infection and stinking discharge.
Sometimes F.B. becomes embedded with vaginal closing over it.
C.A. of vagina late sequelae
Infection may spread to produce salpingitis and peritonitis.
In all cases predominant symptom is an offensive discharge which is often blood
stained.
UTERUS: F.B. after operation, gauze packs.
Most common is contraceptive device.
EFFECTS: Endometrial infection, ulceration and possibly C.A.
VAGINAL BURNS:
DOUCHING- with too hot a fluid
Clumsiness and errors in using electric cautery or diathermy.
CHEMICALS - E.G. douching with fluids containing cresols and phenols.
Deliberate insertion of caustics.
RADIUM DEEP X-RAY:
DIRECT TRAUMA OF VULVA AND VAGINA:
Cuts and lacerations - e.g. pelvis, sitting/falling on sharp objects.
COITUS - Defloration, rough coitus.
SPONTANEOUS - cough/sneezing in old females.
CHILDBIRTH -
HAEMATONA OF VULVA AND VAGINA: Results in fall or knock - mostly seen in
connection with childbirth.
IN ALL CASES GENERAL SYSTEMIC SHOCK OUT OF ALL PROPORTION TO BLOOD
LOSS - STRIKING FEATURES.
Treatment is URGENT.
50
DEFECTIVE OR DEFICIENT PERINEUM: Defective perineum is end result of unhealed

obstetrical tear which involves muscle of perineal body and overlying skin.
COMPLETE PERINEAL TEAR: Involves skin, perineal muscles and anal sphincter. Main
complaint is incontinence of faeces and flatus.
LACERATION OF CERVIX - Obstetrical
Stellate laceration
Lateral tear extending into vaginal fornix.
Ectropion of cervix - lips of cervix curl upwards and outwards.
Erosion of cervix
RUPTURE AND PERFORATION OF UTERUS
RUPTURE - May be complete or incomplete, peritoneum ruptured. Peritoneum intact.
Spontaneous rupture of non pregnant uterus is a rare complication of haemometra and
pyometra. Also can be caused by extension of cervical tear during operative dilatation of cervix.
During pregnancy as result of:
1. Severe direct violence
2. Weakness of wall from old scars.
PERFORATION: Easily perforated by a sound, cervical dilation and a curette.
BROAD LIGAMENT HAEMATOMA:
CAUSES:
Haemorrhage from operation sites or from laceration.
Incomplete rupture or perforation of uterus.
Direct injury with penetrating instrument.
Haemorrhage from tumours.
Extraperitoneal tubal rupture of ectopic pregnancy
Spontaneous haemorrhage.
GENITAL TRACT FISTULAS:
1. Vesico-colic (bladder to colon).
2. Utero-colic (uterus to colon).
3. Vesico-uterine (bladder to uterus).
4. Vesico-vaginal
5. Uretero-vaginal
6. Rectal-vaginal
7. Urethro-vaginal
8. Vagino-perineal
CAUSES:
Congenital
F.B's
Obstetrical injuries
51
Operation injury
Extension of disease e.g. pelvic abscess
Radiotherapy
Chemical burns
PATIENT COMPLAINS OF INCONTINENCE OF FAECES AND FLATUS
URETHRAL FISTULAS ALWAYS ENTER VAGINA.
ACQUIRED ATRESIA AND STENOSIS OF GENITAL TRACT:
CAUSE:
SENILITY - senile atrophy may be controlled to some extent by coitus.
OPERATIVE - OTHER INJURIES
VULVA - Over enthusiastic perineorrhaphy female circumcision - infections.
VAGINA - Site of adhesion from burns, lacerations and operations - infections.
CERVIX - Amputation, excessive electrical and chemical cauterisation.
GENITAL PROLAPSE - PROCIDENTIA: Common and disabling condition
Vaginal prolapse may occur without uterine prolapse but uterus cannot descend without carrying
upper vagina with it.
TYPES:
FIRST DEGREE - Slight descent of uterus but cervix remains within vagina.
SECOND DEGREE - Descent to the extent that cervix projects through vulva when women is
standing or straining.
THIRD DEGREE - (Complete procidentia)
Entire uterus prolapses outside vulva. Whole vagina or at least whole of its anterior wall, is
inverted.
C/F Immediately and completely relieved by lying down.
Sensation, swelling or fullness of vagina.
Sensation, something coming outside.
Dragging discomfort in lower abdomen.
Dragging bearing down sensation - desire to evacuate.
Urinary symptoms - depends on displacement of bladder and urethra may be
complicated by cystitis
Difficulty in emptying bladder
Stress incontinence
Difficulty in emptying rectum.
Backache - rare.
Discharge - purulent and occasionally blood stained - may be leucorrhoea.
Menorrhagia.
DIFFERENTIAL Vulva and any polypoid tumour which projects through vulva on straining.
Hypertrophy and elongation of cervix.
52
Vaginal and peri-urethral cysts.

Diverticulosis or prolapse of urethra.
Inversion of uterus.
BALANITIS - Inflammation of glans penis and prepuce - see remedies at end of lecture....But
remember that sexually transmitted diseases should be excluded.
PHIMOSIS - Constriction of foreskin - may develop spontaneously or as result of oedema due
to an inflammation state of the penis. Spontaneous phimosis may require emergency surgery.
PRIAPISM - Is a painful persistent and abnormal penile erection unaccompanied by sexual
desire or excitement.
REMEDIES IN FREQUENT USE:
AMENORRHOEA - Pulsatilla, Calc. Phos, Caulophyllum, Nat. Mur.
EPIMENORRHOEA - Hamemelis, Millefolium,
METRORRHAGIA - Nux Vomica, Sangurinaria, Canadensis, Aloe, Aesculus Hip, Arnica, Fluor
Ac, Pulsatilla,
Erigeron, Sepia, Sulphur, Secale Corn.
ABORTION - (prevention of and threatened)
- Caulophyllum, Viburnum Op, Secale Corn, Sabina.
PREGNANCY - Calc. Phos, Ferr. Met., Arnica, Calendula, Caulophyllum.
BREASTS - Milk production - Ricinis, Communis, Alfalfa.
Milk reduction - Lac Caninum, Calc. Carb.,
Fibro Adenomas - Conium, Phytolacca, Asterias Rubens, Calc. Carb.,
Inflammation - Belladonna, Lact Ac., Hepar Sulph.
ORCHITIS - as for inflammatory disorders - with Pulsatilla, Belladonna, Rhododendron,
Spongia, Aurum Met.,
PROSTATITIS - anti inflammatory plus - Cantharis, Chimaphila, Clematis Erecta, Conium,
Pareira Brava.
PROSTATIC ENLARGEMENT - (Benign) - Populus Tremulus, Pulsatilla, Sabal Serr, Urtica
Dioica, Thuja.
IMPOTENCY - Phos Ac., Agnus Castus, Selenium, Sabal Serr., Damiana.
HYDROCELE - Pulsatilla, Graphites, Rhododendron.
BALANITIS - Anti-inflammatory - Merc, Guaiacum.
PHIMOSIS - refer.
DISEASES OF THE BLOOD.
ANAEMIA- Generally, may be defined as a reduction in the normal amount of either red cells
or haemoglobin or both. The result of this is a lowering of the capacity of the blood to combine
with and transport oxygen to the tissues. Two types of deficiency anaemia may exist. The first is
due to lack of Vitamin B12 or folic acid. The erythroblasts do not develop into normoblasts but
into larger cells known as megaloblasts. In their turn the megaloblasts develop into non-
nucleated red cells which are larger than normal and which are called MACROCYTES. The
second type of deficiency anaemia is due to lack of iron. Development proceeds until the final
stage when the red cells contain less haemoglobin than normal and may also be smaller than
53
normal when they are known as MICROCYTES. Cells of normal size are termed
NORMOCYTIC. The intensity in colour of the red cells is dependent upon the amount of
haemoglobin they contain. If a red cell contains a normal amount of haemoglobin it is fully
coloured, NORMOCHROMIC, otherwise it is paler than normal. In those varieties of anaemia
in which the process of blood formation is interrupted at the erythroblastic stage, each cell
contains a relatively large amount of haemoglobin. This type of anaemia is therefore referred to
as hyperchromic. In the types associated with iron deficiency there is a reduced amount of
haemoglobin in each red cell and they are called HYPOCHROMIC.
CLASSIFICATION OF THE ANAEMIAS:
1. ANAEMIAS DUE TO DEFICIENCY OF FACTORS ESSENTIAL FOR NORMAL BLOOD
FORMATION:
A. IRON
Chronic nutritional hypochromic anaemia
Post-haemorrhagic anaemia
Hypochromic anaemia due to malabsorption of iron.
B. VITAMIN B12 AND FOLIC ACID - THE MEGALOBLASTIC ANAEMIAS
Addisonian pernicious anaemia
Nutritional megaloblastic anaemia
Megaloblastic anaemia complicating pathological conditions of the
gastrointestinal tract.
Megaloblastic anaemia of pregnancy
Megaloblastic anaemia of infancy
Megaloblastic anaemia due to anticonvulsant drugs.
Megaloblastic anaemia complicating haemolytic anaemia or leukaemia.
C. VITAMIN C - The anaemia scurvy
D. THYROXINE - The anaemia of myxoedema
2. ANAEMIAS DUE TO EXCESSIVE BLOOD DESTRUCTION:
(Haemolytic Anaemia’s)
A. Due to congenital abnormalities of the erythrocyte.
A) Congenital spherocytosis
B) Hereditary hemoglobinopathy’s.
B. Due to infective, toxic or allergic factors.
C. Due to erythrocyte antibodies
A) Haemolytic disease of the newborn
B) Autoimmune (acquired) haemolytic anaemia
C) Symptomatic haemolytic anaemia
D) Paroxysmal hemoglobinuria
3. ANAEMIAS DUE TO HYPOPLASIA OR APLASIA OF THE BONE MARROW:
PANCYTOPENIA, Primary and secondary
54
4. ANAEMIAS OF UNCERTAIN ORIGIN:

Due to chronic infection, uraemia, rheumatoid arthritis, liver disease or widespread
malignant disease.
Sideroblast anaemia also may be included under this heading.
N.B. - It must be remembered that the iron deficiency anaemia’s constitute by far the most
important group of anaemia’s. Hundreds of such patients are encountered for every case of
megaloblastic anaemia, haemolytic anaemia or aplastic anaemia.
Certain features however are common to all cases of severe anaemia, irrespective of the
cause of the condition. The skin is pallid and waxy looking. The mucous membrane of the lips,
gums and conjunctiva is seen to be pale.
The superficial veins on the back of the hand and feet have a pink, rather than a bluish
appearance. The patient is weak and languid. He complains of headaches, giddiness and
occasionally fainting attacks. There is breathlessness on exertion. palpitation, loss of appetite
and sometimes oedema of the feet. The pulse rate is usually increased. generally speaking, the
more severe the anaemia and the more acute the onset, the more intense will the symptoms be.
Anaemia may be due to defective blood formation or it may be the result of loss of blood or
excessive blood destruction.
COMMON TYPES OF ANAEMIA:
A) ANAEMIA DUE TO LOSS OF BLOOD:
Haemorrhage externally or internally may occur either as a rapid loss of a large amount
of blood or repeated losses of smaller quantities.
500 ml of blood may be lost rapidly by the healthy adult without producing symptoms. A
loss of one litre must be regarded as a serious haemorrhage and if the amount exceeds two litres,
the result is frequently fatal.
In anaemia due to loss of blood, the body replaces the red cells more rapidly than the
haemoglobin, and it will therefore be an anaemia of the HYPOCHROMIC TYPE.
The treatment will consist of course of finding the cause, whether it is mechanical or
pathological and treating same.
The following homoeopathic remedies have proved most useful to stop the haemorrhage
and prevent shock.
ACONITE - accompanied by fever.
ARNICA - (lower potency i.e. 1X) - after accidents.
CHINA - followed by fatigue and weakness although the loss is very small.
CROTALUS HORRIDUS - Black blood with clots
LACHESIS - usually occurring during menopause. The patient feels better after the loss.
MILLEFOLIUM (1x) - bright red blood, no pain, no fever and no fatigue.
PHOSPHOROUS - accompanied by burning sensation and bad general state. These remedies
may be given one dose every two hours and then tapered down as the patient proceeds
satisfactorily. The anaemia is then treated by:
FERRUM METALLICUM (3ch) - one dose T.D.S. with the adjunctive treatment of Calc. Phos.
6x one dose T.D.S.
2. ANAEMIA DUE TO DEFICIENT BLOOD FORMATION:
The two main types of anaemia resulting from deficient blood formation are:
55
TYPE A - The hyperchromic (macrocytic) type due to deficiency of vitamin B12 or folic acid.
TYPE B - The hypochromic (microcytic) type due to iron deficiency.
In A, the most important type in PERNICIOUS ANAEMIA, then folic acid deficiency
anaemia (vitamin B). These conditions will be discussed in Nutritional diseases. Following is a
concise histological consideration in cell multiplication. In order that normal cell division can
take place De-ox ribonucleic acid (DNA). which is the nucleo-protein molecule of chromosomes
must be doubled. The synthesis of DNA requires the presence of Vitamin B12 and folic acid. If
either substance is deficient the manufacture of nucleo-protein is impaired. The result is that the
megaloblasts (erythroblasts) fail to divide and develop properly. Further, these immature cells
have a shorter span of life than normal cells, hence the development of anaemia of the
macrocytic type.
Type B - in this variety of anaemia there is interference with the proper development of
the normoblast into the mature red cell. Haemoglobin contains iron and it is therefore easy to
understand that if there is iron deficiency, the red cells will contain a diminished amount of
haemoglobin and the anaemia will be of the hypochromic (microcytic type). Iron shortage may
be due to three causes:
Deficiency of iron in the diet.
Imperfect absorption of iron from the alimentary tract.
Excessive loss as a result of haemorrhage.
The iron in the average daily diet is only slightly in excess of the body's needs and the
body is not able to store iron in any quantity. Any factors, such as hypochlorhydria, which cause
diminished absorption, if long-contained foodstuffs, tend to produce anaemia. Iron-deficiency
anaemia is not uncommon in elderly people who live alone and tend to rely on a cheap, mainly
carbohydrate diet. It is seen in premature and artificially fed infants, during pregnancy and after
delivery. Following loss of blood by haemorrhage (acute and chronic) and dietetic deficiency. In
the category, the most common anaemia is the simple achlorhydria anaemia which is a condition
found mainly in women of middle age, associated with absence of hydrochloric acid from the
gastric juice, although the intrinsic factor is present. An important point for diagnostics is the
presence of spoon-chapped nails. A similar type of anaemia is often present in cases of cancer,
nephritis, chronic infective processes, malnutrition and starvation. Anaemia due to haemorrhage
is HYPOCHROMIC because the bone marrow has less difficulty in replacing the lost red cells
than the body has in manufacturing the haemoglobin necessary to fill then. The symptoms are
the same as those described for general anaemia.
Consider the following:
FERRUM METALLICUM 3ch
CHINA 6ch
NATRUM MURIATICUM 6x
CALCAREA PHOSPHORICA 6X
Severe cases may require blood transfusion.
3. ANAEMIA DUE TO EXCESSIVE BLOOD DESTRUCTION:
Blood may be destroyed by the action of various poisons which may be either chemical
or bacterial in origin. In addition, these poisons may also have some effect on the BONE
MARROW and so interfere with blood formation, thereby increasing the severity of the
anaemia. The most common chemical poisons are lead and benzene. Those of bacterial origin
include the toxins of the streptococcus, which may be present in a number of septic conditions,
bacterial endocarditis and septicaemia. Malaria also causes anaemia as a result of blood
56
destruction.
` Anaemia of this type is called haemolytic. Due to the excessive destruction of red cells
and haemoglobin the condition is often associated with HAEMOLYTIC JAUNDICE.
The cause of haemolytic anaemia so far mentioned are all acquired during life. A very
severe haemolytic anaemia also occurs as the result of incompatible blood transfusion. The red
blood cells are destroyed so rapidly that free haemoglobin may appear in the urine
(Hemoglobinuria). A position similar to that of an incompatible blood transfusion may develop
in a baby at the time of birth if its blood group is different from that of its mother. This is called
HAEMOLYTIC DISEASE OF THE NEWBORN.
Almost all cases are due to incompatibility of the "Rhesus Factor". For Example, the
father is Rhesus positive, the mother Rhesus negative and the baby Rhesus positive. So the
baby's cells, while it is still in utero, provoke the formation of Rhesus antibodies in the mother's
serum. When an affected baby is born he rapidly becomes anaemic and jaundiced and is likely
to die if and exchange blood transfusion is not performed.
Sometimes in adults an acquired haemolytic anaemia develops without any discoverable
cause this is called an IDIOPATHIC ACQUIRED HAEMOLYTIC ANAEMIA.
Excessive HAEMOLYSIS may be caused by a spleen which has enlarged die to a
variety of causes and in certain conditions SPLENECTOMY may be beneficial.
4. ANAEMIA DUE TO DEFECTIVE BONE MARROW FUNCTION: There may be absence
of blood forming cells in the bone marrow such as in the case of APLASTIC ANAEMIA, or the
marrow may be filled with tumour cells or other abnormal cells which can be detected when
marrow is obtained by sternal puncture.
APLASTIC ANAEMIA is a rare type of anaemia due to defective blood formation in
which red cells, white cells and platelets are diminished in number. It is due to the failure of the
bone marrow to produce blood cells. In many instances the cause is unknown. In others it may
be due to the action of bacterial toxins, to poisons or to drugs which produce
AGRANULOCYTOSIS (Decreased in GRANULOCYTES in the peripheral blood). Excessive
dosage of x-rays, radium, and the products of atomic fission will produce the same effect. The
following homoeopathic treatment may be considered: In cases of anaemia due to excessive
blood destruction, we must find the cause and treat same. For example if malaria is the culprit,
apply the treatment given in the lectures on tropical diseases. If the trouble is caused by bacterial
toxins or chemical substances, consider using the same substances in the homoeopathic form in
the 9ch or 30ch potency depending on the chronicity of the case.
Also consider adding to the treatment:
ARNICA 3CH
CROTALUS HORRIDUS
MEDULLOS 3CH one dose daily.
In cases of anaemia due to defective bone marrow function, consider:
MEDULLOS 30CH one dose daily
CORTISONE 3CH one dose T.D.S.
X-RAY 9CH one dose daily
POLYCYTHAEMIA - This condition is the opposite of anaemia, since the number of red cells is
increased and varies between six and twelve million per cubic millimetre. The haemoglobin also
rises to 120 per cent or more. It is usually found in persons who live for extended periods (+
8,000 feet) high altitudes and is then the response of nature to the diminished oxygen supply in
57
the rarefied atmosphere. It occurs also in some cases of congenital heart diseases and chronic
pulmonary conditions.
The treatment for consideration is :
X-RAY 1CH one dose every two hours
BUSULPHAN 1CH one dose every two hours
TREMINON 1CH one dose every two hours
DISEASES AFFECTING THE WHITE CELLS: There are two important varieties of white cell,
the Polymorphonuclear or GRANULOCYTE and the LYMPHOCYTE. The former develop in
the bone marrow and the latter are produced in the lymphoid tissue of the body, such as the
lymph glands and spleen.
The normal number of white cells circulating in the blood is 6,000 to 10,000 per cu mm,
of which about 70% are granulocytes and 30% lymphocytes. If the number os white cells is less
than 5,000 per cu mm the condition is called LEUCOPENIA, if more than 10,000 per cu mm, it
is called LEUCOCYTOSIS.
LEUCOPENIA may occur as a result of certain toxins and drugs circulating in the blood
which damage the bone marrow, and is seen in typhoid fever.
LEUCOCYTOSIS is one of the responses of the body to infection and is present in most
cases of inflammation, especially if pus formation results.
A special type of white cell, called an Eosinophil is formed in increased numbers in
certain skin conditions, in asthma, allergic states and in various diseases due to worms and
parasites.
AGRANULOCYTOSIS - The terms Agranulocytosis, Granulocytopenia or Neutropenia are
terms used when almost all the granulocytes disappear from the blood such as in cases of
Leukopenia. The resistance of the body to infection is therefore impaired. It is serious condition
which may prove fatal. It usually follows the administration of certain drugs which poison the
bone marrow in those patients who are over sensitive to them. The risk is greater in individuals
with a previous history of allergic disorders. Some examples are Sulphonamides,
Chloramphenicol, Gold and Bismuth Salts etc. As a rule one of the earliest features is the
development of a severe sore throat which may become ulcerated. Consider in treating:
A) The complete withdrawal of the suspected drug.
B) The drug potentized or dynamised according to the homoeopathic principles e.g.
SULPHATHIAZOLE 9CH one dose T.D.S.
MEDULLOS 30CH one dose daily
PENICILLINUM 3CH one dose T.D.S. or
TETRACYCLINIM 3CH one dose T.D.S.
LEUKAEMIA:
Leukaemia is a neoplastic disorder of the tissues which are responsible for the
production of the white cells. The main change in the blood occurring in this condition is the
presence of a large number of abnormal and immature white cells, which may be increased in
number to 100,000 per cu mm or even more. As a rule, the red cells are not seriously affected
until later in the disease when anaemia develops. There are two main varieties of leukaemia
which depend on the type of abnormal cells present.
1. MYELOID LEUKAEMIA:
In this variety abnormal immature granular leucocytes derived from the bone marrow are
58
increased in number.
2. LYMPHATIC LEUKAEMIA:
In this variety abnormal lymphocytes derived from the spleen and lymph glands are
increased.
We may divide the clinical picture into an acute type and a chronic type. The acute
forms are rapidly fatal often in a few days or weeks. It is more common in the younger age
group, especially in children about five years old. The chronic forms tend to occur among older
age groups and patients may survive as long as five to ten years.
ACUTE LEUKAEMIAS often begin like an ordinary infection with high fever, sore throat and
joint pains. Subcutaneous haemorrhages (purpura), bleeding of gums, enlargement of the spleen,
liver and lymphatic glands follow.
Blood and bone marrow examination confirms the diagnosis. NOTE: Because remedies
are considered for certain serious conditions i.e. Leukaemia and that organotherapy is also
mentioned - it is not intended that members go outside the law and attempt to treat these
conditions. The information is given out of interest in these cases only. No treatment is
suggested or offered in Leukaemia.
HAEMORRHAGIC DISEASES:
PURPURA - is a condition associated with changes in the blood such as diminution in the
number of platelets.
THROMBOCYTOPENIA - or some alteration in the capillary walls so permitting blood to
escape into the surrounding tissues. In some cases splenomegaly is present. Sometimes small
purpuric spots (petechiae) are present, otherwise we see extensive bluish-red areas which look
like bruises and change colour in the same way.
Purpura is mainly a symptom rather than a disease and may be found in the following
problems: Platelet defect, Vitamin C defect, Uraemia, Senility, Capillary abnormality, Infection,
Allergy, Drug abuse such as Sulphonamides, Phenylbutazone and oral anti-diabetic drugs.
In certain specific cases when no explanation can be given for its appearance, the
medical term IDIOPATHIC is used.
The treatment of purpura consists of treating the cause of the problem and if we know
the toxic drug, consider it in the 9ch potency at one dose T.D.S. and also add to the treatment:
ARNICA one dose T.D.S. and
CROTALUS HORRIDUS one dose T.D.S.
In cases of Idiopathic Purpura, consider:
ARNICA one dose T.D.S.
CROTALUS HORRIDUS one dose T.D.S.
HAMAMELIS one dose T.D.S.
AESCULUS one dose T.D.S.
HAEMOPHILIA - This disease consists of the tendency to uncontrollable bleeding at the
slightest trauma. It is due to the absence of a clotting factor in the blood plasma. The factor
V111.(There are at least 13 factors connected with blood coagulation). The platelets are normal
but their disintegration may be delayed.
It is an hereditary and familial disease associated with an abnormal gene transmitted by
the females but only affecting the males. Haemorrhage may occur from minor cuts, after tooth
extraction or into joints (hemarthrosis) or muscles as a result of slight injuries. This disease is
59
very dangerous and proper emergency treatment should be administered in a hospital.

There is no known homoeopathic treatment for this disease.
DISEASES OF THE SPLEEN: The spleen is an organ, which although it fulfils a number of
important functions, may be removed (splenectomy) without any serious effect upon the
individual. In foetal life it is actively engaged in the formation of red cells, a function which
ceases after birth. It also takes an important part in the destruction of diseased and worn-out red
cells. (An example seen before is the case of the red cells destroyed in Malaria). in common
with lymphoid tissues it produces lymphocytes and, in addition is a factor in the defence
mechanism of the body by helping forming anti-bodies and the development of immunity. The
spleen is particularly liable to enlargement in disease. Slight increase in size occurs in a number
of acute specific fevers, in particular typhoid fever. Enlargement is also found in Malaria,
Bacterial Endocarditis, Septicaemia, Cirrhosis of the liver, Banti's Syndrome and Hodgkin's
disease. Great increase in size is found in Leukaemia.
SPLENIC ANAEMIA OR BANTI'S DISEASE: This rare condition is a manifestation of portal
hypertension and consists of progressive anaemia, associated with enlargement of the spleen.
The duration of the disease varies between three and ten years. In the early stages it may be
helped by removal of the spleen or by a portacaval ANASTOMOSIS. The homoeopathic
treatment which may help is:
X-RAYS 1CH one dose every two hours.
FERRUM METALLICUM one dose T.D.S.
BELLADONNA one dose T.D.S.
CHINA OFFICINALIS one dose T.D.S.
DISEASE OF THE LYMPHATIC SYSTEM: The lymphatic system consists of a series of
channels which convey the tissue fluid or lymph. These channels or lymphatics pass to and from
the lymph glands which are situated in various parts of the body. Lymph finally reaches the
blood stream via the thoracic duct which opens into the left innominate vein. The most
important groups of lymph glands are situated in the neck, the axilla, the thorax, the abdomen
and the groin.
There are three main types of conditions which affect lymph glands - adenitis.
THEY ARE:
A) SEPSIS
B) TUBERCULOUS
C) MALIGNANT
A) SEPTIC ADENITIS: This occurs as the result of inflammation in the area drained by a group
of glands. For example, a septic finger may be followed by swelling of the lymph glands in the
axilla (axillary adenitis) If the infection is a severe one, an abscess may form in the glands. The
following treatment may be considered before any abscess formation.
APIS MEL - Sensation of burning and stinging around the ganglionic region. Oedema is present
around the ganglions and this is a typical sign for prescribing.
BELLADONNA - The inflamed zone is shining, red hot and there is intense thirst.
BARYTA CARBONICA - Mainly indicated in submaxillary adenitis. It is usually an Adenitis
following a chronic inflammation of the pharynx and larynx.
If the abscess has been formed consider:
MERUCRIUS SOLUBILIS one dose every two hours.
60
BELLADONNA one dose T.D.S.

Inflammation of the lymph channels is called LYMPHANGITIS.
B) TUBERCULOUS ADENITIS
Lymph glands are sometimes the site of tuberculous disease, especially those situated in
the neck and thorax. The treatment that may help will be ARSENICUM IODATUM if the
ganglions are very big and the breath is fetid.
PHELLANDRIUM - Should be prescribed if everything tastes sweet to the patient.
TUBERCULINUM - Is a Nucleo-protein nosode from tubercular abscesses. Used when the
patient experiences trembling and is very sensitive to weather changes and takes cold from the
slightest exposure. Give one dose weekly.
C) MALIGNANT ADENITIS: Lymph glands draining the sites of a malignant tumour
frequently becomes infiltrated with cancer cells. For example, in cancer of the breast, the
axillary glands may be involved. Lymph glands are also enlarged in leukaemia, in Hodgkin’s
Disease, in the second stage of Syphilis, in Rubella and in Glandular Fever. In these cases we
will have to treat the cause.
GLANDULAR FEVER (INFECTIOUS MONONUCLEOSIS)
Is an acute disease due to a virus which has not yet been demonstrated. It is
characterised by fever, general glandular enlargement and an increase in the number of
lymphocytes in the blood. These may be abnormal in appearance. Rashes, enlarged spleen and a
sore throat with exudate on the tonsils are sometimes present. The infectivity is not high and the
disease is rarely fatal although debility and nervous depression may persist for some months.
The Paul Bunnell agglutination test is used to confirm the diagnosis and to differentiate
the condition from Leukaemia. Two to four weeks may elapse before the test becomes positive.
The remedies that have given positive results in glandular fever.
BELLADONNA one dose every two hours.
Consider also adding
MERCURIUS SOLUBILIS one dose T.D.S.
HODGKIN'S DISEASE: (lymphadenoma)
(Patient must be under Medical supervision).
The cause of this disease is unknown. It is characterised by painless enlargement of one
or more groups of lymph glands, often associated with increase in size of the spleen and
sometimes the liver. The glands in the neck, mediastinum or abdomen may be involved. An
interesting point is that the intake of alcohol may cause pain to the patient.
The disease is a slowly progressive one, the patient becoming weaker and often anaemic
in the later stages.
The diagnosis may be confirmed by biopsy of an enlarged gland. Although the
treatments do not necessarily cure the disease, they may help to prolong life.
Consider:
X-RAYS 9CH one dose T.D.S. and
ARSENICUM IODATUM 5CH if the ganglions are hard and no pain is present.
CARBO ANIMALIS 5CH if there is a violet coloration in the neighbouring region.
SILICEA 5CH if the patient perspires terribly from head and feet.
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MYELOMA: (MULIIPLE MYELONATOSIS)

(Patient must be under medical supervision).
This is a rare neoplastic type of disease usually affecting the over 40's, the cause of
which is unknown. It follows the overgrowth of plasma cells in the bone marrow. Areas of bone
destruction and their replacement by the myelomata’s cells may occur anywhere in the skeletal
system. Fractures of the ribs or long bones or collapse of vertebrae with consequent pressure on
the spinal cord are liable to occur.
Anaemia and renal failure may be present. The malignancy of this condition leads to
death in a few years. The following homoeopathic treatment may be considered:
X-RAYS 9CH one dose T.D.S.
CROTALUS HORRIDUS 6ch one dose T.D.S.
MEDULLOS 30CH one dose daily.
We will look at the recent approach to immunology especially immune deficiency states
associated with human cancer and allograft rejection reaction in human transplantation.
Immunity in man originally defined as a state free of contagion. The term is now a more
complicated one and embraces a mosaic of physiologic mechanisms. They operate in
cooperation to protect and intact human host from matter recognized as foreign. These
mechanisms may be concisely stated as follows:
A) The inflammatory reactions being Chemotaxis, Phagocytosis and Intracellular killing.
B) The antimicrobial substances Lysozyme and Interferon.
C) Cell-mediated immunity i.e. delayed hypersensitivity and Allograft rejection.
D) Humoral immunity being immunoglobulin formation in the series of gamma globulins IgA,
IgD,IgE,IgG, IgM. Lymphoid tissue in man is responsible for the specific immune mechanisms
that make up adaptive immunity. The tissue may be considered as either central or peripheral.
Central lymphoid tissue is that witch originated directly from or lies in close association with
intestinal epithelium. The chief example of central lymphoid tissue is the thymus.
This organ usually consists of two lobes, but they may unite to from single lobe between
them. This organ is situated in the upper chest cavity along the trachea, overlapping the great
blood vessels as they leave the heart. At birth the thymus is large, and it gradually decreases in
size after puberty. Recent research demonstrates that the thymus is essential for the normal
development of immunological function. (In the mouse, if the thymus is removed at birth, it fails
to produce circulating antibodies against foreign substances. For example, a thymectomized
mouse will accept a skin graft from an unrelated animal).
Peripheral lymphoid tissue is found in the spleen and lymph nodes. It is believed that the
thymus sends a messenger substance or factor to the spleen and to all lymph glands triggering
these organs to form lymphocytes.
This messenger substance is believed to be a hormone, which to date appears unnamed.
The principal cell within peripheral lymphoid tissue is the small lymphocyte. Two
functionally distinct populations of small lymphocytes are recognized. One is dependent for its
development on the thymus and effects the cell-mediated immune responses of delayed
hypersensitivity and allograft rejection. It is called thymus dependent lymphoid tissue. The other
responds to antigenic stimulation by manufacturing humoral antibody. It is called
immunoglobulin-producing lymphoid tissue. We see that antibody production(humoral
immunity) and delayed hypersensitivity (cell-mediated immunity) are basically different
immune processes.
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Antigenic stimulation will elicit delayed hypersensitivity or antibody formation or both

types of reactions.
THE IMMUNOLOGY OF TISSUE TRANSPLANTATION:
The tissue cells of animals contain antigens that are specific for the species of origin of
the cell, and which if implanted into an animal of another species will induce an immune
response. This response rapidly destroys the implanted cells and has the characteristics of both
immune responses mentioned. The closer the relationship between two individuals of the same
species the more likely are implanted cells to survive and in the cases of identical twins survival
is assured. Although surgical techniques are available to enable transplantation of many organs
and tissues, a high proportion of organ transplants fail because of rejection by the immune
response or because of the side effects of attempts to surprises the immune response, due to
toxicity of the drugs or their depressive effect on resistance to infection.
Experiments have proved that there are many antigenic differences between tissues of
different strains. However, it was found that, just as in red cell antigenic system, some antigens
were very strong and others very weak.
The strong transplantation or histocompatibility antigens in main are controlled by the
HL-A genetic locus (Homologous Leucocytic Antibodies) carried only by the blood leucocytes.
It is therefore possible to test for the presence or absence of antigens of the system using
leucocyte agglutination and cytotoxicity tests.
There are two main types of graft rejection processes.
A) The so-called first set response which occurs about ten days after a first graft from an
unrelated donor.
B) The second set response occurring in about seven days in an individual who had previously
received a graft from the same related donor. This phenomenon of first and second set rejection
can be compared to primary and secondary immunization.
It has been shown histologic ally that grafts undergoing rejection are heavily infiltrated
with lymphocytes and that there is extensive vascular damage. The ability to reject grafts can
readily be transferred from one individual to another by a process known as adoptive transfer of
lymphoid cells from an immune person to a non-immune recipient of the same strain. So graft
rejection really involves sequence of separate phenomena developing from initial contact of the
foreign antigens with the host immunological system through the rejection itself. The steps
include establishment of lymphatic drainage, antigen release, its contact with cell of the immune
system, proliferation of antibody-forming cells of the lymphoid tissues, then inflammatory
response and release of pharmacological mediators and cytotoxic effects of lymphoid cells
and/or antibody on the graft tissues. Interference with any of these stages would be likely to
interfere with the rejection process. One of the most interesting approaches which is still in the
experimental stage, is interference with what might be termed the afferent are of the process of
rejection, namely the initial sensitization of the lymphoid cells. In practice currently there are
only three main approaches to the problem of immunosuppression:
A) X-irradiation to knock out the lymphoid tissues and abolish the immune response.
B) Immuno-suppressive drugs (antimetabolites and anti inflammatory agents) to prevent
proliferation of antibody forming cells.
C) Immunological methods - antilymphocytic serum (ALS) produced, for example, in the horse,
to attack the lymphocytes directly and destroy them before they attack the graft.
Unfortunately these methods carry with them the considerable risk of infection with
fungi, viruses and bacteria. Regarding the homoeopathic approach to the problem, researches are
being carried out in the main European homoeopathic laboratories and hospitals and it is hoped
63
that in the near future some interesting results will be published.

Finally a brief look at malignancy. Many researchers, have pointed out that in man, in
whom more than 10 -14 cells are constantly reproducing, there is sufficient evidence to make it
likely that an error occurs with a frequency in the range of 10-5 to 10-7 per replication. Means
that in the cell population there must be many millions of errors or mutations occurring every
day of life. So it seems inconceivable that means of dealing with this problem would have not
been developed. In the last fifteen years immunologists have begun to discover the details of the
immunological process underlying the control of tumours, the antigenic changes in tumour cells
themselves and the extent and activities of the immune response arising as a result of these
changes.
Experiments have proved that there is an increased incidence in thymectomies mice of
tumours induced by chemical carcinogen and viruses. This seems likely to be due to a
deficiency of the cell mediated immune mechanisms which lie under the control of the thymus.
A number of ways have been proposed of inhibiting tumour growth by enhancing the immune
response to the tumours antigens either by active immunization with tumour antigens or by non
specifically stimulating the lymphoid tissues.
EXPERIMENTAL IMMUNOTHERAPY: Twenty patients were treated by active immunization
with tumour vaccine within three days after the last injection each patient was admitted to a
clinical research centre.
Initially for four mornings the patients received a tumour injection, were rested two days
and then received an additional four injections. After the last injection the patients were
discharged and seen once a month as out patients to follow the course of the disease by
examination of accessible lesions, Chest x-rays etc.
Peripheral blood was obtained from each patient before immunization. Serum is
harvested from these blood samples and stored at -70 degrees until tested.
As human tumours become available from the operating room, they are utilised to make
primary human cell cultures.
Of the 20 patients with primary carcinoma of the lung considered in this program, seven patients
died before completion of the programme due to rapid progression of their disease.
Of the remainder who had completed the treatment and seen eight months later, only one
patient had a lesion that could be followed objectively. This patient's primary adeno-carcinoma
did not decrease in size following Cobalt but after immuno-therapy his lesion was 25% of the
original size. The remaining patients who completed treatment did not have lesions that could be
followed objectively. Since these patients had all either inoperably primary or metastatic lung
tumours they all died but only after a reasonably long period and this due to a large amount of
disease elsewhere. Nevertheless it was able to prove that these patients have had objective
response to immuno-therapy. Sufficient data now exists to support the theory that man can react
immunologic ally against cancer. Immunotherapy however, is only an experimental method of
treating cancer at this stage but it seems possible that immunotherapy may have an important
role in the future treatment of malignant disease. It seems likely to be most effective when the
tumour mass is small or can be reduced by chemotherapy.
The above method of treatment approaches sharply the philosophy of homoeopathy and
researches are being carried out in homoeopathic laboratories and hospitals in Europe.
DISEASES OF THE ARTICULATORY JOINTS: Diseases affecting joints, bones and muscles.
A. JOINTS:
We use the term Arthritis to describe changes in the joints caused either by inflammatory or
degenerative processes.
64
If only one joint is affected the condition is referred to as monarticular arthritis. If

several joints are involved it is called polyarticular arthritis or polyarthritis.
Any or all of joint structures may be involved, depending upon the type present.
The more common types of arthritis include:
1. Infective.
2. Rheumatic Fever.
3. Rheumatoid arthritis.
4. Gout.
5. Osteoarthritis - degenerative type.
6. Traumatic.
7. Neurogenic, such as the problems associated with neurological disorders (Charcot's joints in
Tabes Dorsalis).
RHEUMATOID ARTHRITIS: This disease is more common in women and often has its onset
between the ages of 20 and 40 years. The cause is not fully understood but it seems that its
progress is not really affected by climate or diet.
Recent discoveries tend to prove that it is a type of auto-immune disease, since the
blood of most patients contains and abnormal type of globulin (the Rheumatoid factor) which
may possible act as an antibody towards the patients connective tissues.
The disease is characterised by painful swelling of the small joints of the fingers which
develop a fusiform (spindle shaped) appearance. Subcutaneous nodules similar to those seen in
rheumatic fever may develop. As the disease progresses other joints such as the wrists, ankles,
elbows and knees become involved. It is therefore a polyarthritis which tends to be symmetrical
in distribution.
The onset is sometimes acute, with fever, malaise and sweating. In other cases, the onset
is more gradual and its course is unpredictable, but eventually a chronic state may supervene
and last for many years, often leaving the patient severely crippled with deformed, stiff joints
and wasted muscles. During the acute stages of the disease, the blood sedimentation rate
(E.S.R.) is raised. There is often loss of weight and anaemia.
OSTEOARTHRITIS: This is a chronic condition which is distinguished by degenerative
changes affecting primarily the articular cartilage and adjacent bone which can usually be seen
on x-ray. Sometimes only one joint is affected, and it usually a large one such as a hip, knee or
shoulder joint.
The disease may follow some injury, but it tends to occur in older people (40 - 60 years).
There is no obvious inflammation present, but the joint becomes deformed and fluid may
accumulate within the capsule. Noises may be heard when the joint is moved, while pain is
variable and tends to be worse in wet weather and at night. We cannot repair the damage done to
tissues, but homoeopathy can stop progress of the disease.
The same homoeopathic remedies may be used in all forms of Rheumatism, Rheumatoid
Arthritis, Osteoarthritis and rheumatic fever according to the various symptomatology
developed in each patient.
B. BONES: Bones may be affected by injury (fracture), inflammation (osteitis and
osteomyelitis) and tumours both benign and malignant. The treatment of these conditions is
surgical.
Deformities of the skeleton occur in rickets and in various forms of dwarfism.
65
ACHONDROPLASIA: Is a skeletal defect associated with dwarfism, seen often in circuses. The
trunk in normal length and the head appears large. The short stature is due to shortness of the
long bones, especially the femora. The humerus is also affected so that the tips of the fingers
only reach the iliac crests instead of over halfway down the thighs.
Mental development is normal and the general health is not affected.
OSTEITIS DEFORMANS (PAGET'S DISEASE) Is a chronic disease of bone occurring in the
latter half of life, the cause of which is unknown and for which there is no treatment. The skull
becomes enlarged and the tibiae thickened and bowed forwards. Other bones may also be
affected.
C) MUSCLES: Diseases affecting the muscles -
MYOSITIS - Is an inflammation of the muscles which may be associated with Fibrositis.
ATROPHY OF MUSCLES - Is due to a number of causes and may be general or local in
distribution.
A) It is often part of a general wasting of the whole body due to chronic conditions such as
cancer, tuberculosis, malnutrition or a prolonged illness.
B) Disuse atrophy occurs if a part is kept at rest for a longer period such as a limb retained in a
splint or plaster.
C) Local muscular wasting may also be due to disease affecting the nerve supply and
consequently the nutrition of the affected part (Peripheral Neuritis and Poliomyelitis).
D) Progressive muscular atrophy (Motor Neurone Disease).
FIBROSITIS: Is a vague term sometimes used to describe painful and tender areas in muscles
and the fibrous tissue of the body, especially fascia, the sheaths of muscles and their ligamentous
attachments. The causes of the condition are presumed to include exposure to damp and cold
and possibly the presence of septic foci.
It may also be associated with minor trauma. The symptoms are tenderness and pain,
particularly on movement of the muscles in the affected area. It is for this reason that the
condition is sometimes referred to as myalgia. Common examples of the condition are lumbagos
where the muscles and fascia of the back are affected, stiff neck (trapezius muscle), and pain in
the chest caused by affection of the intercostal muscles and their attachments (intercostal
myalgia).
There is probably no actual inflammation of the fibrous tissue and the nodules
sometimes felt are due to localised spasm of muscle fibres. The homoeopathic treatment for the
symptomology of the above mentioned conditions:
NECK PAIN :
ACTEA RACEMOSA - The pain runs down form the first cervical and spreads to the superior
half of the back. Indicated mainly in women who sew or knit.
CAUSTICUM - Sensation of tightness in the neck. Pain improves with humidity and in the
warmth of the bed, but it worsens with dry and cold weather.
LEDUM PALUSTRE - Will help if the pain is worse in the warmth of the bed. Pain usually
spreads from bottom to top and from periphery of body towards centre.
RHUS RADICANS - mainly in the posterior region of neck obliging the patient to curb the
head. Worse when lifting head.
RHUS TOX - Worsening by rest, humidity and variation in atmospheric pressure.
RUTA - Mainly for vertebral pain if there is a history of displacement. Appears to work best on
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cervical vertebrae.
BACK PAIN
ACTEA RACEMOSA - already described.
CHELIDONIUM - Pain mainly below the right scapula. Bitter taste in mouth, discoloured
stools, yellowish tongue. Worsening at about 4pm.
ARGENTUM NITRICUM - Pain starting in the epigastrium and spreading towards a
corresponding point in the back. Accompanied by aerophagia.
CHENOPODIUM ANTHEL - Pain is left side localised between the scapula and vertebral
column.
LEDUM PALUSTRE - already described
HYPERICUM - All back pains radiating symmetrically on both sides of the vertebral column.
NATRUM MURIATICUM - Pain improves when patient presses against a hard object like the
back of a chair.
PHOSPHOROUS - any back pain accompanied by a sensation of heat and burning.
RANUNCULUS BULBOSUS - Any back pain situated mainly in the lower half of the thorax.
RHUS TOX - already described.
LUMBAGOS
AMMONIUM MURIATICUM - Pain increases progressively while patient remains seated. The
longer the patient is seated, the worse if the pain. The pain radiates into the thighs.
ARNICA - Sensation of stiffness. The pain appears all of a sudden and immobilises the patient
in a certain position.
CALCAREA PHOSPHORICA - The pain is mainly situated at the level of the Sacro-iliac joint.
The patient suffers more when trying to stand.
COBALTUM - Same modalities as for Ammonium Muriaticum but no radiation of the pain.
GNAPHALIUM - Sudden improvement when sitting down.
KALI CARB. - The pain is accompanied by a sensation of weakness of lumbar region.
NUX VOMICA - The patient must sit up in bed before he can turn around.
RHUS TOX - Same modalities as for the other pains already described.
GOUT - This is an inborn error of uric acid metabolism characterised by hyperuricemia and
recurrent attacks of acute arthritis, most often of the great toe and eventually by tophaceous
deposits of urates.
COLCHICUM 1X - This is the main remedy for this type of arthritis. The patient cannot stand
the odours from the kitchen which gives him nausea.
URICUM ACIDUM - This remedy will help to drain the surplus of Uric acid from the blood.
NERVOUS SYSTEM DISORDERS
TRUE HEADACHES: This condition forms part of the syndrome of many diseases. A wide
range of remedies are available which may help the patient considerably while the cause of the
respective disease is being investigated. In most cases however, the following remedies may
cure the patient since many headaches are caused by stress of modern life.
AESCULUS HIPPOCASTANUM 6ch - Occipital cephalalgia usually of circulatory origin. The
patient has also either varicose veins or haemorrhoids.
67
ALFALFA 6ch - Occipital cephalalgia spreading towards the frontal region but stopping above
the eyes.
ALOE 6ch - Frontal cephalalgia of a peculiar type situated mainly at the back of the eyes.
Improvement when shutting the eyes.
ANACARDIUM OREINTALE 6ch - All types of cephalalgias which improve after eating.
ARGENTUM NITRICUM 6ch - Frontal cephalalgia improving with pressure such as a tight
band around the head. There is sometimes a feeling of increase in the volume of the head.
EUPATORIUM PERFOLIATUM 6ch - Occipital cephalalgia of a type starting when the
patient's head is on his pillow. He has difficulty in finding the right position, and knocks his
pillow with his fist. This is an important sign for prescription. The eyes are also very sensitive to
pressure.
GLONOIN 6ch - Occipital cephalalgia with a pulsating sensation. Excellent remedy for
hypertensive patients with headache, especially if the patient feels a pulsating sensation on each
side of the neck at the level of the Carotid arteries.
IGNATIA 6CH - Unilateral cephalalgia with sensation as if a nail is driven into one side of the
head. It is usually triggered or worsened by bad odours of tobacco smoke.
When this type of headache stops, the patient urinates abundantly. It is usually the
headache of nervous persons who yawn and gasp and take a deep breath and sigh.
LEUSINUM 9ch - Peculiar type of cephalalgia in line and joining together two points of the
head, either in the frontal occipital line or laterally. There is intense intellectual fatigue during
this type of cephalalgia.
MERCURIUS VIVUS 6ch - Cephalalgia appearing usually in the second part of the night, just
after midnight.
NICCOLUM 6ch - Cephalalgia appearing on a fixed point of the vertex of the head.
NUX VOMICA 6ch - Cephalalgia appearing on waking up or after lunch.
PARIS QUADRIFOLIA 6ch - Occipital cephalalgia spreading towards the frontal region
accompanied by a sensation as if the eyes are pulled backwards.
PETROLEUM 6ch - Occipital cephalalgia accompanied by a sensation of heaviness at the base
of the skull as if it is full of lead.
SILICEA 6ch - Occipital cephalalgia spreading anteriorly and affecting both eyes.
ZINCUM 6ch - Occipital cephalalgia remaining on a fixed point and not spreading anywhere.
Various diseases which may be of nervous origin and the appropriate remedy adapted to
each particular case.
SYNCOPE - Swooning or fainting is a temporary suspension of consciousness from cerebral
hypoxia. There is normally arrest of respiration and circulation. Give fresh air to the patient, a
slap on the face with a wet towel, throw some water on him or start artificial breathing. The
following homoeopathic remedies have proved outstanding when a dose is slipped into the
patients mouth. It is better to use drops for this purpose.
NUX MOSCHATA 6ch - May be used if the patient presents a dry skin and dry mucosa.
VERATRUM ALBUM 6ch - May be used if on the contrary the patients forehead is wet with
perspiration. There may be vomiting and diarrhoea.
AMMONIUM CARBONICUM 6ch - May be prescribed as a prophylaxis to patients who are
obese, live a sedentary life and faint easily after a pain, an emotion or after a tiring job.
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COMA - Is a type of unconsciousness from which the patient cannot be aroused. It may be due
to primary intracranial disease, drugs, toxins, hypoxia, metabolic disorder, trauma or circulatory,
respiratory or thermal disturbances. The breathing is heavy, loud and irregular, but the heart beat
is more or less regular.
The Homoeopathic treatment is as follows:
ARNICA 6ch - Given one dose every half hour is our first remedy and the most outstanding one.
It should be alternated with:
OPIUM 6ch - If the face is red, hot, covered with hot perspiration. The pulse is hard and strong.
The patient looks as if he is in a deep sleep and does not moan. Alternate Arnica with:
BELLADONNA 6ch - If the pulse is weak and the patient makes certain sounds resembling
talking.
Another way to differentiate between the two remedies is to look at the pupils of the
patient. The Opium patient has pin-point pupils whilst the Belladonna patient has the dilated
pupils.
CONVULSION: Is an involuntary general paroxysm of muscular contraction which may either
be tonic or clonic or tonic followed by clonic stage. This trouble is frequently seen in children
and is often caused by a reflex action triggered by intestinal worms, whooping cough or other
pathological causes.
There are three very good homoeopathic remedies that have proved outstanding if given
immediately.
BELLADONNA 6ch - May be prescribed if the face is congested and red, the skin is hot, the
eyes are bright, the carotids are beating.
CHAMOMILLA 6ch - may be prescribed if the attack of convulsion follows a capricious act or
and anger and especially if one cheek is red and the other pale.
CUPRUM METALLICUM 6ch - May be prescribed if the patient has spasms and contractions,
the fist is shut with the thumb inside, the face is puffed and dark red, the lips are cyanosed.
HYSTERIA: Is a neurosis resulting from repression of emotional conflicts from the conscious
and is characterised by immature impulsive, dependant and attention-seeking behaviour. The
patient usually uses conversation and disassociation defence mechanisms, usually through a
process of autosuggestion so that the symptoms may take any form and involve any mental or
bodily function.
Another category of hysteria may be due to any excessive emotional response. This is mainly a
problem in women and the first remedy to try is a hard slap on the face with a wet towel, and
then put in the mouth a dose of Moschus 6ch.
TICS AND TWITCHES: Tic is an involuntary, intermittent, spasmodic but habitual movement
such as a twitch of the face or shoulder, occurring without a demonstrable stimulus as an
expression of an unconscious emotional conflict. It may also be repetitive spasmodic muscular
movements that are the result of a neurologic disorder such as in trigeminal neuralgia or in
infantile spasms.
Children are the most affected by this problem. Two homoeopathic remedies among
others have given very good results in this condition.
AGARICUS MUSCARIUS - Is mainly indicated for eyelid movements. It acts also very well on
twitches of groups of muscles. Best results have been obtained by prescribing it in two dilutions
simultaneously. For example 6ch one dose T.D.S. and 9ch one dose daily.
LYCOPODIUM - Has proved also very good for tics in general. It may be given alone in the
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9ch one dose daily, or combined with Agaricus and given on alternate days with the 9ch.
STAGE FRIGHT: A type of fainting sensation that the willpower cannot control and usually
happening at most critical moments of life, for example during an important examination or
interview or when an actor has to go on stage.
This may be differentiated into:
A) If this happens only before a critical moment in life consider:
GELSEMIUM 7ch or 9ch one dose only, one week before the examination or interview and
GELSEMIUM 6ch one dose T.D.S. during the whole preceding week.
B) If the patient has this problem habitually, the same remedy in 9ch should be given one dose
weekly for a few months and in 6ch one dose daily for the same period.
TREMBLING-SHAKING: This problem forms part of the syndrome of many diseases of the
nervous, endocrine or other systems. It may also be caused by types of intoxications such as
alcohol or drugs. The remedies described will not cure serious organic disturbances, but they
will improve and even cure shaking due to benign causes.
CAULOPHYLLUM 9ch - Sensation of internal shaking felt by the patient at the level of the
limbs but not accompanied by visible tangible shaking.
ETHYLICUM 9ch - Valuable remedy for shaking of an alcoholic origin. May be used at any
age, for alcoholic adults or children with and alcoholic heredity.
GELSEMIUM 9ch - Is one of the more useful remedies for internal or external shaking which is
accompanied by migraine, vertigo and visual troubles.
PHOSPHOROUS 9ch - Is prescribed when the shaking gets worse after and effort. There us
usually also vertigo, weakness and a sensation of paralysis of the limbs.
CICUTA VIROSA 9ch - Is one of our good remedies in homoeopathic neurology. It is indicated
for shaking accompanied by convulsions. It has given very good results in certain cases of
Parkinson disease and Sclerosis.
ZINCUM 9ch - Should be prescribed if the shaking is accompanied by gnashing of teeth. The
patient shakes so much that his chair or bed also vibrates.
All the above remedies in the recommended potency should be prescribed one dose
daily.
MEMORY TROUBLES: May be found in young persons as well as in old ones although it is
most common in patients after middle age. In younger patients it is mostly related to intellectual
overwork. Homoeopathy is well armed for these troubles and the following remedies will help
the patients.
ANACARDIUM ORIENTALE - May be used for old patients and for young ones in periods of
intellectual strain. The trouble is often accompanied by tension headache.
BARYTA CARBONICA - A typical type of amnesia in old patients. They do not recognise the
streets of their own town. They are driving their car and all at once they forget where they came
from and where they are going, in women, when they arrive in the shops, they forget what they
were going to buy.
GINSENG - Very good remedy for any form of amnesia. It is like a standard remedy for many
types of the problem especially for patients after middle age.
LYCOPODIUM - A special type of amnesia in which the patient forgets names or the exact
word they need to express themselves. Most often it is the name of persons very close to the
patient and he gets stuck when introducing them.
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PHOSPHORIC ACIDUM - Memory trouble happening at any age and generally caused by a
deficiency in mineral salts. It is usually accompanied by phosphaturia of up to 700/800mg in 24
hours. The urine is milky and murky especially towards the end of the micturition. The hair also
falls and breaks easily. The nails are weak, break easily and divide in two. In young girls or
young women, there is leucorrhoea, without smell but yellowish and thick.
SULPHUR - Is a type of amnesia mainly concentrated on names of persons, towns or countries.
The above remedies should be prescribed first in the 9ch potency one dose weekly and
in the 6ch potency one dose T.D.S.
VERTIGO: Is a sensation that the outer world is revolving about the patient (objective vertigo)
or that he himself is moving in space (subjective vertigo). It is used erroneously as a synonym
for dizziness or giddiness to indicate an unpleasant sensation of disturbed relations to
surrounding objects in space. It is part of the syndrome of many pathological conditions. The
conditions may come from the liver, the middle ear, the nervous or vascular system, the blood, a
cerebral organic disease, a displaced vertebra etc.
The following homoeopathic remedies will help the patient tremendously in benign
cases of vertigo.
ARGENTUM NITRICUM - Vertigo with loss of equilibrium. The patient cannot walk straight
and has a tendency to stagger. He has the impression of being pulled on one side and knocks the
person walking near him. He cannot walk on a straight line.
BORAX - Is a type of vertigo happening when the patient moves vertically and down as in horse
riding or swinging. It is also the vertigo of the child who cries and clings to his parent or any
person who takes him up too quickly from his pram.
BRYONIA - Is a vertigo happening on waking up as soon as the patient moves from the
horizontal to the vertical position.
CHININUM SULPHURICUM - Is a vertigo accompanied by buzzing noises in the ear. It is
therefore a good remedy for troubles originating in the labyrinth and mainly Meniere's
Syndrome. It is sometimes accompanied by vomiting.
COCCULUS - Is a good remedy if the vertigo is accompanied by nausea without vomiting.
CONIUM MACULATUM - Is an all round remedy for a wide variety of vertigo. It is usually the
most faithful remedy when specific modalities cannot be discovered. Its symptomatology is
usually for an hepatic nature.
GELSEMIUM - Vertigo accompanied by shaking, migraine and visual troubles.
TABACUM - Vertigo accompanied by nausea and cephalalgia. All three factors must be present
for the prescription of the remedy.
ANXIETY: Is a feeling if apprehension, uncertainty or tension stemming from the anticipation
of an imagined or unreal threat, sometimes manifested by tachycardia, palpitation, sweating,
disturbed breathing, trembling or even paralysis. We will prescribe various homoeopathic
remedies according to the typical drug picture reflected by the patient.
ACTEA RACEMOSA - Is mainly a woman. She is always anxious, sad and afraid of becoming
crazy. There is always a worsening of her symptoms during menstruation, ovulation or the
menopause period.
ARGENTUM NITRICUM - Has always a feeling of apprehension and is afraid of everything,
of the present, of the future. During a journey this patient is nearly certain that he will make an
accident. If one of his relatives is sick he is sure that it is serious. The Argentum Nitricum girl or
woman is afraid of feeling sick in public i.e. in a church, shop or a party. This sensation may
also happen in the street but every one of the above circumstances when the patient is
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unaccompanied. This patient is usually afraid to go out and only if it is really necessary.
Argentum Nitricum patient is always in a hurry in anything he is doing. He wants to
finish things before he has started them and so makes life miserable for everybody around him
i.e. his family or employees. On the physical side there exists a type of imbalance which gives
him the impression of being pulled on one side and so he walks as if he is drunk.
ARSENICUM ALBUM - Has his anxiety mainly concentrated on disease. This patient thinks
that he has a serious disease the aetiology of which is unknown and that no doctor will be able to
diagnose. This disease is always incurable and no remedies will ever have any effect on it. So
this patient is very difficult to treat and you will have some difficulty in persuading him to take
your treatment. This patient always thinks that death is imminent and this leads him sometimes
to suicide.
CALCAREA CARBONICA - Has an anxious state in which we observe sadness and
melancholia, an irresistible tendency to cry, a disgust for life, a fear of becoming crazy. We will
recognise him by his worrying over things without any importance, things which appear
insignificant to other persons. He is also irritable and gets cross easily. He will never take any
responsible job for he always fears the worst.
CALCAREA FLUORICA - Has a special type of anxiety centred mainly around material
problems. He is worried because he is afraid of the future, He fears that maybe he will not have
enough money to live after retirement. His pension will not be enough or the money he is
putting aside will have lost its value. If he is wealthy he is afraid of being ruined. This patient
has very often the syphilitic stigma and it is good to strengthen the action of Calcarea Fluorica
by giving him also Leusinum in the 30ch or higher once a week.
CAUSTICUM - Is anxious mainly at dusk. As the day gives place to the night he becomes sad
and anxious. His worries and troubles are amplified. If it is a child, he does not want to go to
sleep and will struggle against his sleep to be able to remain longer with his parents. Another
important sign for Causticum is that he is really moved by other people's worries and troubles
sometimes more than by his own.
IGNATIA - Is always living in an anxious state. It is the greatest anxiety remedy of our materia
medica. The Ignatia patient yawns, makes big inspirations and sighs. Ignatia has often a
sensation of a ball in the throat or in the epigastrium or sometimes a sensation as if there is
something partly stuck on the mucous membrane of his pharynx and larynx.
Ignatia is nearly always sad and anxious, although he has absolutely nothing to fear.
This is an important point for prescription. Physically the Ignatia patient is paradoxical, for
example he will digest very well a heavy meal and will get an indigestion with a light meal.
NATRUM MURIATICUM - Is mainly a woman who is usually sad and cries easily. Any story
told to her about other people's problems, either psychically or physically will make her cry.
There are, of course, many other remedies that may be used for anxiety states and you
will find them by studying carefully your patient but the above ones are the most important and
common ones.
THE DIAGNOSIS AND HOMEOPATHIC TREATMENT OF THE DIFFERENT TYPES OF
NEURALGIA: Neuralgia is a term which is frequently employed both technically and popularly
in a somewhat loose manner, to describe pains, the origin of which is not clearly traceable. In its
strict sense it means the existence of pain in some portion of, or throughout the whole of. the
distribution of a sensory nerve, without and distinctly recognisable structural change in the
nerve or nerve centres. This strict definition, if adhered to, however, would not be applicable to
a large number of cases of nerve pain, for in many instances the pain is connected with pressure
on, or inflammation of the nerve. Hence the word is generally used to indicate pain affecting a
particular nerve or its branches, whatever be the cause.
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It may generally be stated that neuralgia rarely occurs when the patient is in perfect
health. Constitutional causes, hereditary or acquired, are among the most powerful of the
predisposing influences in its production. Thus it is often found to affect the rheumatic or gouty.
In weakened condition of the system from unsuitable or insufficient food, or as the result of any
drain upon the body, or in anaemia from any cause, or when certain disease toxins are present,
such as syphilis or malaria, it is common for neuralgia to come on.
Any strain upon the nervous system, such as mental overwork or anxiety, is a powerful
predisposing cause. Among the exciting causes of an attack of neuralgia, by far the most
common is exposure to cold and damp, which appears to excite irritation in a nerve already
disposed to suffer.
Irritation may be produces by numerous other causes, such as bruising of a nerve by a
blow, a decayed tooth, diseased bone, local inflammation in which nerves are implicated, or
some source of pressure upon an nerve trunk, such as swelling on the sheath in its passage
through a bony canal. A foreign body, or even the scar of an old wound, has been found to be
sufficient cause of irritation when situated close to a nerve. Further there are causes of a reflex
character which are capable of setting up neuralgia at a distance, such as intestinal or uterine
derangements.
Those cases in which, after removal of a piece of nerve, inflammatory changes and
thickening of the nerve sheath are found, receive the name of neuritis, but, as regards the
question of pain, there is no difference between neuritis and neuralgia due to other causes,
except that pain caused by neuritis tends to be continuous and is very difficult to treat. Although
the pain is generally localised, it may spread beyond the area where it first occurs. It is usually
of paroxysmal character, and often periodic: i.e. it occurs at a certain time of the day or night. It
varies in intensity, being often of the most agonising character, and again less severe and more
of a tingling kind. Various forms of perverted nerve function may be found along with or
following neuralgia.
Thus there may be over-sensitiveness of the skin, loss of feeling, paralysis, or
alternations of nutrition, such as wasting of muscles, whitening of the hair, etc. Attacks of
neuralgia are apt to recur, particularly when the general health is low. The nature of the disease
will be best described under the names of the forms in which it most commonly occurs. These
are:
A) Facial neuralgias including the famous trigeminal neuralgia or "tic douloureux" in French.
B) Intercostal neuralgias, and
C) Sciatica. Other forms affecting the arm, neck, are of much less frequent occurrence.
1. TRIGEMINAL NEURALGIA: One of the most sever forms of neuralgia in facial neuralgias
is the trigeminal neuralgia. It affects the nerve of sensation in the face (trigeminal nerve), and
may occur in one or more of the three divisions in which the nerve is distributed. It is usually
confined to one side. Females on the whole suffer more frequently than males, and are usually
over the age of 50. The attack is often precipitated by movements of the jaw, as when talking or
eating, or by tactile stimuli such as a cold wind or when washing the face. When the first or
upper division of the nerve is involved, the pain is mostly felt in the forehead and side of the
head. It is usually of an intensely sharp, cutting or burning character, either constant or with
exacerbation, and often periodic, returning at a certain hour each day while the attack continues.
Occasionally the paroxysms are of extreme violence, and are brought on by the slightest
provocation, such as a draught of cool air. The skin over the affected part is often red and
swollen, and even after the attack has subsided it feels stiff and tender to the touch. In this, as in
all forms of neuralgia, there are certain localities where the pain is more intense. These painful
points as they are called, being for the most part in those places where the branches of the nerves
emerge from bony canals or pierce the fascia to ramify in the skin. This is a reason why the pain
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is worse normally above the eyebrow and along the side of the nose. There is also pain in the
eyelid, redness of the eye, and flow of tears. When the second division of the nerve is affected,
the pain is chiefly in the cheek and upper jaw, the painful points being immediately below the
lower eyelid, over the cheekbone, and about the upper lip. This form is accompanied by pain of
similar character to that affecting the first division, and the pain often appears suddenly on slight
provocation, such as by taking a mouthful of hot or cold fluid. When the third division of the
nerve suffers, the pain affects the lower jaw, and the chief painful points are in front of the ear
above the chin.
INTERCOSTAL NEURALGIA: Intercostal neuralgia is pain affecting the nerves which emerge
from the spinal cord and run along the spaces between the ribs to the front of the body. This
form is neuralgia affects the left side more than the right, is much more common in women than
in men, and occurs generally in enfeebled states of health. It might sometimes be mistaken for
pleurisy or some inflammatory affection of the lungs, but the absence of any chest symptoms, its
occurrence independently of the act of respiration and other consideration establish the
distinction. The specially painful points are chiefly at the commencement of the nerve as it
leaves from the spinal canal, and at the extremities towards the front of the body, where it breaks
up into filaments which ramify in the skin. This form of neuralgia is sometimes the precursor of
an attack of Shingles (herpes zoster) as well as a result of it.
3. SCIATICA: Is another of the more common forms of neuralgia. It affects the great sciatic
nerve which emerges from the pelvis and runs down the back of the thigh. It is, in many
instances, traceable to exposure to cold or damp, but there are many other possible causes. Any
source of pressure upon the nerve within the pelvis, such as may be produced by a tumour, may
excite an attack of sciatica. It is often connected with a rheumatic or gouty constitution.
In general, the nerve of one side only is affected. pressure upon a nerve by a prolapsed
inter-vertebral disc between the fourth and fifth lumbar vertebrae is often a common cause of
pain along the course of the sciatic nerve. The pain, which is felt at first a little behind the hip-
joint, steadily increases in severity and extends along the course of the nerve and its branches, in
many instances as far as the toes. The specially painful points are where the nerve leaves the
pelvis at the lower margin of the buttock, and also about the knee and ankle joints. A feeling of
numbness is also sometimes experienced throughout the whole limb. In severe cases all
movement of the limbs, and particularly the motion of stooping forwards, or of bending the hip
with the knee straight, aggravates the pain, and the patient is obliged to remain in bed.
HOMEOPATHIC REMEDIES FOR NEURALGIAS:
1. FACIAL NEURALGIAS
ACONITUM - Pain localised in the right or left side, starting immediately after the patients has
been exposed to a dry cold. The pain is strong and is usually accompanied by a sensation of
numbness and/or pins and needles.
ASA FOETIDA - Pain localised mainly around the eyes on the periphery of the orbits.
KALI IODATUM and KALI BICHROMICUM - May be used in certain forms of facial
neuralgias having their origin at the level of the sinuses.
MAGNESIA PHOSPHORICA - Violent neuralgia with pulsating, brutal pain like electric
discharges superimposed over a permanent dull pain but localised only to the right side.
MAGNESIA CARBONICA - Violent neuralgia with pulsating, brutal pain like electric
discharges superimposed over a permanent dull pain localised only to the left side.
MEZEREUM - Can be either a violent or dull neuralgia occurring in the region of the superior
maxillaries. It is also a good remedy for sinusitis of the same region.
PLANTAGO - All dental neuralgias with inflammation of the gums, the latter being often
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spongy.
By carefully combining some of the above remedies according to their symptomatology
the famous trigeminal neuralgia can be progressively and definitely controlled.
2. INTERCOSTAL NEURALGIAS:
ASCLEPIAS TUBEROSA - Very good remedy for all intercostal neuralgias situated at the level
of the mid-line of the superior sterno-costal segment. Very often a pain is felt in the cardiac
region. It can be either a dull pain, a pulsating pain or a crushing pain resembling the ones of
Angina Pectoris. The pressure of a finger on the nerves of the painful region between the ribs
amplifies the pain.
BRYONIA - Intercostal neuralgias mostly of the lower half of the thorax, mainly upon the ribs
and improving by applying pressure or a tight bandage or also by lying on the affected part.
KALMIA LATIFOLIA - Neuralgias as if a needle or a sharp knife is piercing the cardiac region
so making the patient very anxious. They are not really dangerous although they come from a
nerve in the precordial region or in the cardiac muscle itself.
RANUNCULUS BULBOSUS - Is one of the faithful remedies for intercostal neuralgias. its
neuralgia improves in humid weather or during atmospheric changes. These neuralgias come
generally, from a number of intercostal areas and the pain usually from the lower half of the
thorax.
3. SCIATICAS:
ALLIUM SATIVUM - Is a good and reliable remedy for all sciatica’s of the left side,
accompanied by inflammation of the left hip joint.
AMMONIUM MURIATICUM - For lumbago-sciatica worse when the patient is sitting. The
pain increases progressively as the patient remains seated.
CAUSTICUM - Is indicated for sciatica’s of the right side accompanied by inflammation of the
right hip joint. Two notable points for prescription are that the pain increases with cough, and
also that the patient experiences a sensation of shortened ligament and tension of the limb.
GNAPALIUM - For all sciatica’s getting better when the patient is sitting. The pain is also
accompanied by pins and needles and numbness in the limbs.
KALMIA LATIFOLIA - May be prescribed for a sciatica of the right or left side accompanied
by a sensation of completer numbness in the limbs. But from experience it works best when the
symptoms are on the right side.
OXALIC ACID - Is prescribed when there are pins and needles in both the left upper and lower
limbs accompanying the pain.
PHYTOLACCA - Is a peculiar sciatica with the pain running along a definite line on the
external surface of the thigh on a line corresponding to the seam of the trousers.
RHUS TOX - Is an all round remedy for rheumatisms, and sciatica’s getting worse at rest and on
starting to move but getting better as the patient continues his movements.
DIGESTIVE DISORDERS
ODONTALGIA (DENTAL PAINS)
CHAMOMILLA - Used as a soothing agent in dentition of babies. Although it is not really a
homoeopathic analgesic, by soothing the nervous system the child obtains indirect relief In adult
the sedative action of this remedy is also very useful for dental pains. The main point for its
prescription, is that the pain is triggered by a hot meal or drink.
MAGNESIA PHOSPHORICA - Should be prescribed on the contrary if the pain is relieved by
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keeping a hot drink in the mouth.

KREOSOTUM - Is usually prescribed when the pain comes form a decayed tooth. This remedy
is also very useful for children suffering terribly during teething, especially if no relief has been
obtained by Chamomilla, and the child cannot sleep at all.
MERCURIUS SOLUBILIS - Will sooth pains arising from alveolar abscesses with sensation as
if the tooth becomes longer. When the pain subsides, the remedy should be discontinued, and the
service of a dentist considered.
PLANTAGO - May be dropped into the hole as an external analgesic or rubbed on the gum over
area of pain. In addition Hypericum 0 is also effective.
APIS MEL - Swelling, stinging pains- Patient thirsty.
ARNICA - Should be prescribed after any dental surgery including extraction.
HICCOUGH - HICCUPS: This is a spasmodic in drawing of air to the lungs, ending with a
click, due to sudden closure of the vocal cords. The cause is some irritation of the nerves which
go the diaphragm, producing sudden contractions of the latter. Most cases, especially those
recurring habitually about the same hour of the day, are due to indigestion.
The symptoms also occur in some serious general diseases. like the uraemia of Bright's
disease and Typhoid Fever, being in such cases a grave sign. Hiccough lasting over some days
or weeks is in some cases a symptom of mild encephalitis lethargica.
The simple forms may be treated with the following remedies:
IGNATIA - Is a homoeopathic antispasmodic remedy and will relieve the problem in many
cases.
NUX VOMICA - May be used mainly if there is simple spasm and if the patient is a hard
drinker. Also consider Cajuputum.
GASTRITIS: The main symptoms of acute gastritis are burning pain increased by pressure.
Persistent thirst for cold drinks, with inability to retain either food or drink. Constant nausea
with coated tongue and foul breath and sometimes dyspnoea, faintness, prostration and anxiety.
Chronic gastritis is indicated by dull pain and oppression soon after meals and sometimes
vomiting of acid fluid or mucus.
The tongue is coated or red at the edges and the patient often complains of heartburn,
flatulence, thirst, burning of the hands or feet, constipation and high coloured urine. This type
usually accompanies affections of the liver, heart and kidneys and is frequent in alcoholics.
ACONITUM - Usually sufficient in simple gastritis.
ARSENICUM ALBUM - Burning agonising distress, unquenchable thirst, quick pulse.
ANTIMONIUM CRUDUM - Thickly coated tongue, nausea, eructation with taste of food.
ARGENTUM NITRICUM - Accompanied by belching. Craving for sweets. Radiating pain.
MERCURIUS - Intense thirst for cold drinks. Conditions worse at night.
BRYONIA - Usually nausea and faintness when rising up. Stomach sensitive to touch. Pressure
in stomach after eating, as of a stone.
PHOSPHOROUS - Vomiting water as soon as it gets warn in the stomach. Pain in stomach
relieved by cold food.
THUJA - Is beneficial if the gastritis is believed to caused by the abuse of tea.
NUX VOMICA - If accompanied by spasms.
CHRONIC GASTRIC ULCER: More common in men than women, especially those having
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irregular meals and it becomes more frequent as age increases.

The symptoms are not very clear and in some cases the diagnosis has been first made by
the sudden occurrence of a perforation.
First among the symptoms is pain which is usually worse before food. The pain is
situated either in front, at the lower end of the sternum, or behind, about the middle of the back.
It is often severe, and is usually accompanied with much tenderness to touch, and also with a
sense of oppression and inability to wear tight clothing. Accompanying the pain, there is
frequently vomiting, either very soon after the food is swallowed or at a later period and this
tends in some measure to relieve the pain and discomfort.
Vomiting of blood (Haematemesis) occurs in about 25% of cases and is most important
diagnostically. It may show itself either in small quantity of a brown or coffee-like mixture, or as
a copious discharge of pure blood of dark colour and containing clots. The source of the blood is
some vessel or vessels which the ulcerative process has ruptured. Vomiting of blood however,
does not always indicate the presence of a gastric ulcer.
Blood is also found mixed with the discharges from the bowels, rendering them dark
and tarry looking, and there is usually constipation. X-ray examination gives little evidence of
the presence of an acute ulcer, beyond showing that there is much irritation near the pyloric
opening, with spasm to the rest of the stomach. But in chronic cases, the deep ulcer often fills up
with the barium and its outline can then be readily seen.
The dangers to be anticipated are: Perforation when the contents of the stomach escape
into the abdominal cavity setting up Peritonitis. Haemorrhage which occurs in about four per
cent of cases, generally soon after a full meal or finally exhaustion, consequent to want of
nourishment from defective digestion.
If gastric or duodenal ulcers resist treatment, the patient should be referred to a specialist
who will decide if surgery should be performed.
ARGENTUM NITRICUM - If the symptoms are accompanied by belching. There is a craving
for sweets. The pain radiates all over the thorax.
ARSENICUM ALBUM - Accompanied by burning sensation. The patient is agitated and
worried. There is a terrible thirst and quick pulse.
KALI. BICHROM - Nausea and vomiting after drinking beer (mainly). Strange stitching
sensation in region of liver and spleen and through to spine. This remedy is the best one for
round ulcers.
KREOSOTUM - Accompanied by vomiting of an aqueous clear liquid.
ATROPINUM - If there is nausea, faintness and vomiting of bile.
HYDRASTIS - Bitter taste, pulsation in epigastrium. Atonic dyspepsia. If there is haemorrhage
refer to remedies suggested for Haematemesis.
MUCOUS COLITIS - Is a chronic inflammation of the large intestine (colon) with much
mucous secretion. It is often very obstinate. The following remedies have proved useful.
HYDRASTIS - Thick yellowish ropey secretions. If the patient is old, easily tired and with great
debility.
COLCHICUM - Accompanied by neuralgic tearing pains in the abdomen.
Hospital for surgery which is the only thing to save his life.
In the meantime the following remedies will minimise the trouble.
BELLADONNA - If there is extreme sensitivity, sharp pains, sensation of a grip.
77
OPIUM - If the abdomen is hard and inert.

Those remedies may be given one dose every 20 minutes.
INTESTINAL OCCLUSION: Like strangulated hernia, this trouble requires immediate attention
from the surgeon.
There is complete stoppage of matter and gases, terrible vomiting and paroxysmal pain.
While awaiting proper treatment, the following remedies will prove beneficial.
OPIUM & NUX VOMICA - One dose of each given alternately every fifteen minutes have
minimised the trouble.
ACUTE APPENDICITIS; This is also another problem which will require the service of a
surgeon. The pain is mainly in the right iliac fossa but not always. If palpation is attempted the
reflex action gives a sensation of hardness to the abdominal wall.
The condition is accompanied by vomiting and perhaps a slightly elevated temperature.
Do not give anything to eat or drink to the patient while awaiting surgery.
COLOCYNTHIS AND BELLADONNA - One dose of each given alternately every fifteen
minutes will lower the inflammation and give better chances to the patient at surgery.
NOTE:
Conditions of Hernia, Intestinal Occlusion and Acute Appendicitis are mentioned for
information only.
Referral is essential, Remedies given are for extreme First Aid measures only i.e. in the
bush.
FISTULA IN ANO; This is a narrow pipe-like track, opening by an internal orifice on the
mucous surface of the bowel and by an external one on the cutaneous surface near the anus.
Fistulae originate in abscesses, in the tissues round the anus, or by the ulceration of the
mucous membrane of the rectum.
The external orifice of the fistula is often very small and difficult to find in the folds of
the thin skin near the anus, and it is sometimes concealed by a papilla.
HYDRASTIS OR CALENDULA - May be used in local application.
SILICEA - Sometimes accompanied by fissures and haemorrhoids. Painful with spasm of the
sphincter.
CALC. PHOS - Bleeding after hard stool. The fistula usually alternates with chest symptoms.
BERBERIS - Sensation of tearing around anus. Burning in anus and perineum.
LACHESIS - Anus feels tight. Pain darting up the rectum every time patient sneezes or coughs.
FISSURE IN ANUS:
A longitudinal ulcer at the anal margin. It is similar to the crack which occurs in the lower lip of
the mouth, and, like the latter is very painful.
Fissure of anus is usually single and situated in the middle line posteriorly. Below it
there is a tag of mucous membrane called a sentinel pile. There is severe burning pain during
and after defecation with great spasm of anal sphincter muscle. The faeces may be streaked with
blood.
The bowel must be regulated and ointment of CALENDULA, HAMAMELIS or
AESCULUS applied.
DISEASES OF THE LIVER AND PANCREAS:
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BILIOUS HEADACHE: This is really a headache of indigestion arising from overload to the
stomach and liver. There is foul tongue and breath, pain in the gastric and hepatic region, nausea
and vomiting and deranged bowels.
IRIS VERSICOLOR - If there is copious bilious vomiting.
NUX VOMICA - If the headache is accompanied by constipation instead of diarrhoea.
BRYONIA - Constipation bit also vomiting of clear bitter fluids.
HEPATIC COLICS;
Due to the spasms for expulsion of a biliary calculus from the gall bladder. They are very
painful. the main pains are usually localised on the right side of the upper abdomen under the
false ribs and irradiate towards the epigastrium in front and towards the lumbar region at the
back sometimes also upwards towards the right shoulder.
COLOCYNTHIS - Best remedy if the patient is doubled up.
DIOSCOREA - Pain worse lying down or doubled up. Better for pressure and being erect.
CHELIDONIUM - If the pain is worse in the back at the inferior medial angle of the scapula.
BERBERIS VULGARIS 1X - Very good remedy if the pain is worse on movements and is
localised mainly at the gall bladder - 5 drops in a little water every half hour.
MYRICA CERIFERA 3X - If the patient feels nauseous with a bitter taste. The pain is round the
hepatic region. Signs of jaundice are present - 5 drops in water every two hours.
CIRRHOSIS OF LIVER;
(Cirrhosis is a disease condition of various internal organs, in which the proper tissue is replaced
by fibrous tissue similar to scar tissue).
There are various forms of liver Cirrhosis due to various causes. The most common
form results from chronic alcoholism, but other poisons such as lead, may cause similar changes
in the hepatic cell. Also certain diseases such as gout, diabetes, rickets and especially malaria or
syphilis may lead to the disease.
If seen early and if the use of alcohol is given up, the disease can be arrested.
PHOSPHOROUS - The patient feels cold. He has sharp cutting pains and a weak empty
sensation felt in the whole abdominal cavity.
AURUM MET - Pain going down to the right hypochondrium with a hot sensation. Flatulence
in the abdomen.
LYCOPODIUM - Brown spots on abdomen. Formation of ascites and oedema.
NITRIC ACID - Jaundice and hepatic pain worse at rest. Pain appears and disappears.
BERBERIS - Pain worse on movement and localised mainly around gall bladder area.
MERCURIUS - Stabbing pain with chilliness. Flatulent distension with abdominal pain.
Enlarged lever, very sore on touch and indurated.
LIVER CONGESTION: (SIMPLE ENLARGEMENT OF LIVER).
Fullness on the right side in the region of the false ribs. Sense of weight on assuming the upright
posture. Hypersensitivity of liver. The complexion may be pale, sallow or dusky, the tongue
coated. There may be constipation, faulty appetite, nausea, vomiting, headache, languor,
lassitude and depression. The pulse is usually slow and irregular. This problem may be caused
by a sudden chill, too abundant, highly-seasoned fatty diet, the habitual use of alcoholic drinks,
excessive bodily exercise in the sun.
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This condition is very common today with the lifestyle that has developed and is
accepted by the majority.
BRYONIA - Enlargement and hardness of the liver with shooting, stinging or burning pains
decreased on pressure. Constipation.
MERCURIUS - Dull, pressure pain preventing the patient from lying
down on the right side. Yellow colouring of the eye. Sallow skin. Shivering followed by profuse
perspiration. Loss of appetite. Foul taste in mouth. Constipation with white stools.
NUX VOMICA - Trouble caused usually by the use of intoxicating drinks, excessive stimulating
food, sedentary habits or nervous exhaustion. Constipation, deep red urine. Haemorrhoids in
most cases.
LYCOPODIUM - May be required after Nux Vomica to promote and strengthen its effect.
Constipation with flatulence. Continual pain in the right side and back.
CHAMOMILLA - Bilious attacks in women and children from exposure to cold or from anger.
Nausea or vomiting of bile. Yellow coated tongue. Sometimes bilious diarrhoea.
ACONITUM - Sudden acute bilious attacks following chills. Threatened jaundice.
PODOPHYLLUM - Bilious vomiting and diarrhoea with prolapsus ani. Bitter taste, dark urine,
sallow complexion.
ARSENICUM - Severe and chronic cases, with extreme weakness, burning pain vomiting and
exhausting diarrhoea.
CHELIDONIUM MAJUS - Chronic liver complaints. Thick yellow coated tongue. Nausea. Dull
headache. Deep-yellow and turbid urine. Constipation.
ACID NIT and PHOSPHOROUS - Should be used on alternate days if it is a long-continued
obstinate case, with jaundice, more especially if there is reason to fear organic lesions of the
liver and some ascites.
JAUNDICE; Is a term used to express conditions in which many of the tissues and fluids of the
body become yellow, especially the whites of the eyes and connective tissue. Jaundice is a
symptom of some acute or chronic affection of the liver, not a disease by itself.
Jaundice is due to obstruction of the bile-ducts and absorption of the bile into the blood.
In some diseases without actual obstruction there may be a yellow colouring e.g. Yellow fever,
Phosphorous poisoning. In these cases there is degeneration of the liver cells and destruction of
red blood corpuscles.
Obstructive jaundice is due either to external pressure (such as a growing tumour), or to
internal obstruction of the duct by a gallstone, or as the result of catarrh and swelling of the
mucous lining. The treatment should be directed towards the cause of the trouble in the first
instances.
The following remedies have proved beneficial to ease the problem and may prevent
recurrence of the cause.
ACONITUM - Jaundice with symptoms of inflammation and great pain in the region of the
liver.
MERCURIUS - A valuable remedy, and often helps towards a speedy cure. It is especially
useful after Aconitum.
CHINA - Jaundice from malaria, with bilious diarrhoea, and then the disease is intermittent.
Persistently used, it prevents recurrence of gall-stones.
NUX VOMICA - Jaundice with hypersensitivity in the hepatic region, usually from sedentary
80
habits or indulgence in stimulants.

CHELIDONIUM MAJUS - Jaundice with pain or tenderness in the liver and right shoulder.
Deep red, clean tongue, Bitter taste, Light coloured stools.
PHOSPHOROUS - Brownish-yellow skin and conjunctivae. Frequent whitish-grey stools. Dark
brown urine. Sometimes loss of voice and cough.
ARSENICUM ALBUM - Dyspepsia following an attack of jaundice. Detoxification for jaundice
following Mercury poisoning and for obstinate cases from fever.
Also for jaundice during pregnancy or from tumours of the liver.
PANCREATIC CYSTS: (PSEUDO-CYSTS)
These cysts are formed inside the pancreas and are not covered by any epithelium. They contain
a liquid which is a mixture of pus and blood. They may follow an acute or chronic pancreatitis.
They should be treated surgically but unfortunately they may recur and lead to pancreatic
fistulae.
The following remedies may help before surgery and sometimes avoid the operation.
After the operation, they will prevent recurrence.
ARSENICUM ALBUM - Burning pain in the pancreatic region. Feeling better with hot
compresses.
ECHINACEA - Accompanied by temperature and shivering. Rapid pulse and sometimes mental
confusion.
HEPAR SULFUR - In high dilution will dry the cyst and stop suppuration. This remedy will
also prevent recurrence.
PANCREATIC CYSTS: (TRUE CYSTS)
Also called pancreatic adenoma are mostly in groups and may only be diagnosed when they
have attained a certain size. They are composed of glandular tissue or a combination of tissues.
They may transform into adeno-carcinomas. They should be treated surgically, especially if they
have reached a size so interfering with the functioning of vital organs.
If detected early the following remedies may prove beneficial.
CAUSTICUM - Especially indicated if the patient is thin and weak.
THUJA - Is out best remedy especially if the patient has a tendency to hyper-production of
sebum on scalp and face.
LYCOPODIUM - When the patient feels one foot cold and the other hot. Condition worsens
between 4 and 8pm.
SILICEA - Hyper perspiration of feet and head. This remedy may stimulate the organism to re-
absorb fibrotic conditions and scar-tissue.
SULFUR - Hot and heavy sensation in the abdomen which is also sensitive to pressure.
ACUTE PANCREATITIS: This disease is usually due to influx o bile into the pancreatic ducts.
It is sudden in onset, accompanied by severe pain and causes severe shock and collapse. It is a
dangerous disease which carries a high mortality rate of about 25% to 60%, even when treated
adequately and safely.
It is believed to be due to the auto-digestion of the pancreas by the pancreatic enzymes
hyper activated by the influx of bile or duodenal juice in the canal of Wirsung.
The disease is most often accompanied by nausea and vomiting, sometimes the
temperature rises up to 38c. There is sometimes a muscle reflex in the region of the epigastrium
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and flatulence may exist.

The following remedies may be tried and have sometimes given very good results.
URANII NITRAS or URANIUM NITRICUM;
Very thin patient with big appetite. Patient very thirsty and drinks a lot.
SYZYGIUM JAMBOLANUM - Very good remedy for the pancreas, especially if fat patients.
The remedy in the 1x potency has given good results in Diabetes Mellitus (for information only)
MANGANUM - The patient has difficulty in rising up and wants to lie down.
PANCREATINUM - This remedy will trigger the pancreas to self defence, but it is slow acting.
CHRONIC PANCREATITIS: Chronic inflammation of the organ.
It is a much more indeterminate affection, commonly associated with disease of the gall
bladder, particularly gall stones. This disease may occur as a complication of mumps and may
lead to fibrosis of the organ.
It is found mostly in men between 50 and 60 years of age. It may follow a biliary lithiasis or
an attack of acute pancreatitis. The treatment will be the one used for any type of abdominal
inflammation.
BELLADONNA - If the patient feels warn, his face is bright red. His abdomen is distended and
hot. Pain as if clutched by a hand and worse when coughing.
COLOCYNTHIS - Agonising cutting pain in abdomen causing patient to double up or bend and
press on his abdomen. This act relieves the pain.
PANCREATINUM - This remedy which could be added if available will trigger the pancreas to
self defence.
CONSTIPATION: Constipations means a condition in which the bowels are open too seldom or
incompletely, the motions as a consequence being dry and hard. It should, however, be borne in
mind that, though most healthy persons have one daily movement of the bowels, some persons
perform this act twice, while in others a motion once in two or more days is perfectly natural.
Constipation is a chronic condition, and must be carefully distinguished from acute
obstruction of the bowels, a much more serious condition. The stool of a healthy person, with
good appetite, should be light brown in colour, of about 150 gm in weight and about 15 cm long.
It should cohere in one or two pieces and should be sufficiently light to float in water.
Great variations, however, take place, in colour, in amount and in consistency, according to the
nature and quantity of the food and drink taken. The stools consist of the remainder of the food
after it has passed through the alimentary canal and been subjected to the action of the digestive
juices , and after the nutritious parts have been absorbed by the intestinal mucous membrane.
The stools also contain various other matters, such as pigment derived from the bile, and large
quantities of bacteria.
The amount of stool passed varies considerably but it is normally about one eighth of
the daily food intake, however, when diarrhoea is present, and there is much fluid in the stool, it
is increased in amount, whilst in constipation, it is diminished and hardened, and when
astringents such as iron or tannin are taken, their effect is still further to harden the stools.
Although in a healthy state the stool of adults is cylindrical and forms a cast of the interior of the
rectum, in young children it is a soft mass. The appearance of the stools is also much modified
when any tumour is present in the lower bowel. In this case, they may be very small or may be
squeezed out into a flattened tape-like form.
However, a similar appearance is caused by that form of constipation which is due to
spastic condition of the bowel. The colour of the stools is naturally of a dark brown due to
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pigment known as stercobilin, derived from the bile. This colour may be changed to green by
the action of certain bacteria when decomposition is proceeding to a greater extent than usual in
the bowels, and a deep green colour is also produced by some vegetables, such as spinach.
White stools (are called sometimes alcoholic stools), having an appearance like that of clay or
putty, are found in cases where the outlet of bile into the small intestine is stopped and where
jaundice is consequently present. When an excess of fat is taken in the food, as in the case of
children fed on quantities of cream, the digestive organs are unable to deal with it, and much of
it is passed in the stools, giving the stools in these circumstances also a whitish colour.
Black and slaty-grey stools are produced with certain drugs are taken, as, for example, iron and
bismuth, and a tarry blackness known as melena imported to them when bleeding takes place
from the stomach. The iron in the blood being acted upon by the sulphurated hydrogen always
present in the stools to produce the black sulphide of iron.
Bright yellow stools are produced in diarrhoea, when the bile is passed almost
unchanged, and a similar colour is caused by rhubarb, senna and some other drugs.
Mucus in the stools, whether as strings, or mixed with the food remnants, or in the form
of membranes coating the hardened stools, is almost always a sign of irritation or inflammation
in the mucus membrane low down in the bowel, (colitis). Red blood in the stools signifies some
diseased conditions situated near the lower end of the bowel, such as an ulcer or piles. When the
blood proceeds from a point higher up, such as an ulcer of the stomach, it is changed by the
action of the digestive juices as already explained. Some explanation of the type of stools are
important regarding symptomology and the choice of the treatment.
CAUSES OF CONSTIPATION: The uncommon causes of constipation are mechanical, that is
obstruction by stricture of the bowel, by tumour, by adhesive bands etc. The common causes
are:
1. Habit.
2. A greedy colon which absorbs water too quickly.
3. Aspastic colon, the muscle of which remains in a state of
spasm.
4. Lack of tone of the colon muscle, sometimes because of
too little vitamin B1 in the diet.
5. A diet which has not enough roughage filler substances in
it to stimulate the intestine to activity.
Of these, habit is probably the most important. Constant neglect to respond to the
sensation in the rectum which indicates that it is full and needs emptying leads to retention of
faeces, which become dry and hard. The condition is aggravated by the use of purgatives.
SYMPTONS AND EFFECTS OF CONSTIPATION: The stools are dark, hard and passed with
difficulty and in small amounts. In severe, persistent cases, there may be swelling of the
abdomen, from the retention of large masses of the remnants from digestion. Colic is not
uncommon. Haemorrhoids, which are a cause of increasing constipation, are often brought on
by inattention to the bowels in the beginning so forming a vicious circle. When the condition has
become habitual, the whole digestion may be thrown out of gear, with foul tongue, bad breath,
and loss of appetite. Headache and lassitude may also be present.
Pain at stool is a characteristic symptom of a fissure at the anus or of inflamed
haemorrhoids, and in such cases is of a very sharp nature. Pain of a duller character associated
with the movements of the bowels is often caused by inflammation of other pelvic organs.
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DIARRHOEA: Or looseness of the bowels, is, except in its mildest forms, a serious condition. It
is really a symptom of some disease situated in the bowels, but deserves special mention
because of the possibility of serious consequences.
VARIETIES AND CAUSES: Diarrhoea forms the chief symptom of several serious diseases,
but it would be a great mistake to imagine that, by checking the diarrhoea, the disease is
necessarily successfully treated. For example, the severity of an attack of Chorea or Dysentery is
gauged mainly by the extent to which diarrhoea is present. In typhoid fever persons fed upon
ordinary diet have much diarrhoea, so that this is a usual feature in early stages of this disease.
In Tuberculous ulceration of the intestine, diarrhoea occurs. In some diseases of the liver,
kidneys, lungs or heart, diarrhoea ensues as a result of congestion of the bowels, or through the
bowels taking over partly the eliminating functions of the damaged organs. In such cases
diarrhoea may actually be a good thing. Recurring attacks of diarrhoea occur in some case of
habitual constipation, owing to irritation caused by the presence of hard faecal masses. Catarrhal
diarrhoea is the ordinary form, and in it the intestinal mucous membrane is in much the same
condition of congestion and swelling during a head cold and secretes, in great amount, clear
mucus of a similar nature. This catarrhal diarrhoea may be produced in a slight degree of
indigestible food, by nervous excitement or as the result of a chill. In a severe form, it may be
due to infection by micro-organisms of the food poisoning group (Salmonella) or to drugs such
as Mercury and Arsenic. Atmospheric conditions may also play a part, some persons developing
an attack of diarrhoea upon a change of weather, just as other develop a catarrhal condition in
the air passages.
Diarrhoea in infants is such a serious condition that it requires separate consideration.
One of its features is that it is usually accompanied by vomiting. Some ten per cent case of
diarrhoea are due to the Dysentery organisms.
The remainder constitute the group of cases known as infantile gastroenteritis. This
condition is rare after the age of fifteen months, and the majority of cases occur between the
ages of two and four months. The younger the infant, the higher the morality rate. This is the
type of diarrhoea which was once known as Summer Diarrhoea because of its high incidence in
the late summer, but during recent years this seasonal incidence has tended to disappear. The
precise cause is still obscure, but certain strains of the organism known as Escherichia Coli (E.
Coli) are responsible for some cases, whilst in others a virus may be the cause.
Choleraic diarrhoea is an extremely severe type of diarrhoea, resulting very often in
death. Its symptoms are hardly distinguishable from those of true Cholera.
Lienteric diarrhoea is a chronic form, in which a movement of the bowels occur shortly
after every meal. The condition may become so aggravated that food passes rapidly and
undigested through the body, and the sufferer becomes very thin.
Pancreatic diarrhoea is a form occasionally met in children of imperfect development in
consequence of failure by the pancreas to secrete its digestive fluid.
Ulcerative Colitis is a serious condition characterised by the passage of frequent stools
contain blood.
Diarrhoea may also be a symptom of ulceration or gangrene of the bowels and is then
associated with the passage of blood and mucus or even of shreds of membrane produced by the
destruction of the inner surface of the bowel.
CHILDRENS DIARRHOEA: With babies, before and during dentition, this symptom can
quickly take a very serious turn since it is followed by dehydration of the organism accompanied
by metabolic disturbances of the electrolytes. To avoid these troubles, it is important that the
diarrhoea, which is also accompanied by vomiting, be stopped as soon as possible. Regarding
the diet of the baby all the milky products should be stopped together with fruit juices and
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uncooked vegetables. Any type of food that ferments easily should also be avoided.
In babies, it nay happen that the diarrhoea is linked to an infection of the ear e.g. an
Otitis. We must start by treating the Otitis and then the diarrhoea (if necessary).
COMPLICATIONS OF THE CIRCULATORY SYSTEM:
Although some of these diseases are not true circulatory diseases, in most cases they are
complication of the above.
WE SHALL LOOK AT:
Anal Fissures.
Ankle Cyanosis
Chilblains
Haemorrhoids
Haemorrhoidal Bleeding
Hypertension (Arterial)
Phlebitis
Swollen Legs
Varicose Veins
Varicose Ulcers
ANAL FISSURES: These are small ulcerations situated on the border of the anus and most of
the time posteriorly. They are very painful and sensitive and there is an acute pain following
defecation and lasting between ten and fifteen minutes. Those fissures are provoked mostly by
haemorrhoids.
If the patient is constipated, consider the following remedies.
GRAPHITES - Flatulence accompanying the constipation. Hard and voluminous stool
surrounded by mucous membranes. Very often the patient is obese, hypersensitive to cold and if
a woman, presents history of delayed menstruation.
NATRUM MURIATICUM - Is also a very good remedy for anal fissures accompanied by
constipation.
In this case the stools breakdown into tiny pieces and the anus bleeds after defecation.
If the patient is not constipated the remedy that has given us the best result is:
NITRICUM ACIDUM - Remember that this remedy is also very good for ulcerations of any
other orifice of the body. For example fissures at the commissures, of the lips. A topical
application of Eczema Cream and the Complexes Chelidon, Hem R and Pulsatilla are worthy of
consideration.
ANKLE CYANOSIS: This may present various colours: Red, Violet, Blue and sometimes
Black. It is mainly concentrated around the ankle but may also extend to the leg. It is most
common among young girls or young women and is worse in winter due to the cold. It is due to
a bad venous circulation.
There are three remedies that have given good results, they are:
ACTEA RACEMOSA - Is a young girl or young woman who is very nervous, always in a very
bad mood before her periods and who perspires abnormally from the hands. These are the main
points for prescription.
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CARBO VEGETABILIS - Has a violet or bluish coloration of the ankles and legs. Often it may
go up to the knees and the patient is very sensitive to the touch of a cold object.
PULSATILLA - Is mainly a woman patient with cyanosis of the legs and ankles. Her periods are
always late and insufficient with dark blood and stopping at night. Consider an excellent
complex for venous circulatory deficiencies - Hem R.
CHILBLAINS: Are a painful pruriginous swelling of the teguments provoked by the cold and
sometimes triggered by the cold and sometimes triggered by a general bad health or deficiency
in Vitamin D (Calcium Metabolism) trace elements and bad venous circulation.
The most successful remedies are:
AGARICUS MUSCARIUS - Burning and stinging sensation followed by itching mainly on
hard surfaces such as the top of the toes and the back of the heels at the insertion of Achilles’
tendon.
PETROLEUM - Has proved one of the best known remedies for chilblains. Should be
prescribed when there is a burning feeling, itching all over the body and stinging sensation
around the swelling.
These remedies may be given together on alternate days.
CALENDULA - Ointment has proved beneficial when used externally and together with the
above remedies. Tamnus Communis is also worthy of consideration.
HAEMORROIDS: Are varices and an inflamed condition of the veins about the lower end of the
bowel, known as the haemorrhoidal veins. It is usual to divide haemorrhoids into external,
internal and mixed. To understand this division, it is important to remember that at the margin of
the anus the skin joins the mucous membrane of the bowel in a sharp line, and that the bowel is
kept closed by two circular muscles, the external sphincter is weak muscle situated immediately
beneath the skin, while the internal sphincter is a strong circular band, extending up the bowel
for an inch.
External haemorrhoids are found outside the bowel, and are covered by skin, being
brown or dusky purple in colour. Internal haemorrhoids are within the opening, covered by
mucous membrane, and are bright red or cherry coloured. Mixed haemorrhoids are those
situated just on the margin, and covered half by skin, half by mucous membrane. Even internal
haemorrhoids do not extend more than an inch up the bowel, corresponding to the position of
the internal sphincter muscle. There is always a tendency for the veins in this situation to
become distended, partly because they form the lowest part of the portal system and so are very
apt to become overfilled when there is the least interference with the circulation through the
portal vein, and partly because the muscular arrangements for keeping the rectum closed
interfere with the circulation through the haemorrhoidal veins, and because they are not
provided with valves. Probably most people of middle age are troubled by this condition to
some extent, especially men of sedentary habits who indulge in over-eating and are troubled by
constipation, as well as women who have had many children.
However, it must be remembered, that in a certain number of cases, haemorrhoids are
merely a symptom of disease higher up on the portal system, so causing interference with the
circulation. They are common in heart disease, Liver complaints such as cirrhosis, liver
congestion and any disease affecting the bowels. Homoeopathy has proved very successful for
haemorrhoids and the following remedies are the ones that have given the best results.
ARSENICUM ALBUM - Sensation of burning at the level of the orifice of the anus.]
Ameliorations by warm applications and warm bath.
AESCULUS HIPPOCASTANUM - Also burning sensation, but mainly stinging and pulling
sensation an feeling of a bundle of needles in the rectum without bleeding.
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FUORIC ACID - Haemorrhoids accompanied by Pruritus ano, itching in anus, anal eczema, dry
and suppurating.
HAMAMELIS - Big painless haemorrhoids, which bleed easily. The blood is dark but without
clots.
SEPIA - Usually internal haemorrhoids above the anus giving a heavy sensation with a false
urge to pass stools, sometimes accompanied by a slight yellowish discharge.
SULPHUR - Haemorrhoids with burning sensation of the level of the anal orifice improved by
cold applications or cold bath.
HAEMORRHOID BLEEDING:
ALOE is the most important. The bleeding starts during defecation while pushing and is
accompanied by terrible pain which persists for some time.
HAMAMELIS - Dark blood, without pain from protruding haemorrhoids.
IPECAC - Red blood, accompanied by nausea.
MILLIFOLIUM - Red blood, without clots, without pain, without temperature. Please note that
this remedy is excellent for bleeding from any other part of the body especially metrorrhagia. It
is then used in the 1x of 1c potency.
HYPERTENSION: Is a disturbance of normal body functions affecting the arterial blood
pressure.
The level of arterial pressure is only relatively constant and depends upon the needs of
the organism.
It is only part of the mechanism of tissue perfusion. The body faces a difficult problem
in getting the right amount of blood to the right place at the right time and so must find out from
where the limited amount of blood can be withdrawn without damage to some vital function.
In terms of Hemodynamics and Physiological communications, it is a problem of
wonderful complexity. The body has many mechanisms to control the function of tissue
perfusion. On the primitive level, where sluggish changes are all that are needed, chemical
mechanisms predominate. For example, to raise blood pressure, renin is secreted, which forms
angiotensin, which then acts on the adrenal cortex to liberate aldosterone. It in turn causes
retention of salt, and the salt causes retention of water, which increases blood volume and
extracellular fluid. Cardiac output thus is increased and a rise in blood pressure occurs. This is
often followed by an increase in peripheral resistance. Sudden and precise demands for more
blood are regulated by the autonomic nervous system, which achieves quick vasoconstrictor and
cardiac response. The nervous system also has many sensing devices, such as the carotid sinus,
which have feedbacks and can be set at certain levels just like the thermostat in a house. To add
to the smoothness of the whole regulation process, the nervous and chemical systems are
integrated.
The following homoeopathic remedies have proved valuable in Hypertension.
ACONITUM - Strong thrust of hypertension accompanied by palpitations and anguish. Rapid
and hard pulse.
AURUM METALLICUM - Hypertension usually accompanied by arterial sclerosis mainly if
the aorta is dilated. Improvement with fresh air.
VARYTA CARBONICA - Usually an old patient with arteriosclerosis, memory losses and one
who is very sensitive to cold weather.
BELLADONNA - Hypertension accompanied by a red and hot face. Patient cannot stand the
heat. He has pulsating headache with conjunctivitis and dilated pupils. Belladonna is also very
87
good for arterial spasms.

BERBERIS VULGARIS - The hypertension is accompanied by an excess of urea or uric acid in
the blood. So it should be prescribed whenever we suspect that a renal problem has triggered the
symptom.
GLONOIN - Habitual hypertension of a congestive patient with red face. Aggravation by heat.
In this remedy, the diastolic is usually very high. The patient has usually an occipital headache
with palpitations.
LACHESIS - Usually hypertension of the menopause period accompanied by heat flushes.
PLUMBUM - Hypertension accompanied by chronic constipation. The patient is usually thin,
hypersensitive to cold and his skin is yellowish.
SULPHUR - Hypertension accompanied by sensation of hot feet. This patient cannot stand even
slight heat. He has the urge to get out or open the windows. He cannot cover his feet with the
blanket.
PHLIBITIS or THROMBOPHLEBITIS - Is the term commonly applied to general inflammation
of a vein, while the term PERI-PHLEBITIS is used when the inflammation is limited to the
loose connective tissue immediately surrounding the vessel.
Inflammation of a vein is a condition which is serious mainly on account of the clotting
of blood that usually takes place within the inflamed part (thrombosis), and the risk that such a
clot may break up and portions be swept away be the circulation to lodge in other vessels
(embolism).
Sometimes the inflammation is of a very acute character, the vein becoming filled with a
clot containing bacteria, which are carried to distant parts of the body and there produce
abscesses. This condition, known as PYAEMIA, is an extremely grave one.
As a rule however, phlebitis is of a more chronic type, running a course of three or four
weeks and then improving under careful treatment. Usually the actual cause is probably one or
more of the following three factors:
1. Injury or inflammation of the lining endothelium of the vein.
2. Slowing of the bloodstream in the vein
3. Some alteration in the blood which makes it more liable to clot.
If the affected vein is near the surface, it appears reddish purple. It is hard, swollen and
knotted Severe pains may dart through the limb, especially on movement, and there is stiffness,
with more or less oedema of the part. If suppuration occurs, it may be by means of an abscess,
or it may remain under the surface, producing purulent infection. When the veins of the lower
limbs are involved, the patient should rest in bed with the affected limb elevated and resting on
pillows. Hot we packs are applied to relieve the pain and to help to maintain an adequate
circulation. Within three days of going to bed, the patient should be encouraged to move the
affected limb and foot, as this speeds the process of recovery. It is now recognized that
prolonged rest in bed tends to delay recovery.
ACONITUM - Should be considered if the temperature of the patient rises and the disease is
accompanied by fear or anguish.
HAMAMELIS - If there are also varicose veins present.
PULSATILLA - If the disease is accompanied in women by irregular menstruations.
The above three remedies may also be prescribed alternately
for example one early morning, one during the day and one at bedtime.
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SWOLLEN LEGS: This symptom is associated with various disease which may be of cardiac,
renal or vascular origin and also Cellulitis.
The practitioner must find out the cause and treat same accordingly. We are only going
to deal with swollen legs due to peripheral circulatory problems mainly of the venous
circulation.
AESCULUS HIPPOCASTANUM - Is indicated if the swelling is accompanied by big varicose
veins but only by capillaritis.
AURUM METALLICUM - Is indicated if the swelling is accompanied by a sensation of
heaviness as if the feet were made of lead.
PULSATILLA - Is indicated if the swelling is accompanied by cyanosis around the ankle area.
VARICOSE VEINS: Are veins that have become stretched and dilated out of proportion to the
amount of blood they have to carry. There are usually three positions in which the veins have
special tendency to become varicose.
These are the veins about the lower end of the bowel, producing haemorrhoids or piles.
The vein, within its branches on the inner side of the leg, knee and thigh.
Normally the tendency to varicose veins is often hereditary but work that necessitates
long-continued standing, with little vigorous muscular exertion not only throw a great strain
upon the veins of the legs, but fail to provide the pumping action that muscular contractions
exert in emptying the veins. Pregnancy is another common cause of varicose veins, though the
condition tends to disappear after the child is born. Homoeopathy cannot cure completely
varicose veins but it will prevent the formation of new ones and stop the progression of old
ones.
CALCAREA FLUORICA - Is one of our best remedies when there are big varicose veins with
considerable dilation. This remedy is excellent for softening of elastic tissues such as vascular
walls, ligaments etc. But simply it is a remedy of tissue and temperament, it should be
prescribed for a long period.
FERRUM PHOSPHORICUM - Is a good remedy when there is a sensation of burning of heat
accompanying the varicose veins. This sensation usually arrives after effort and is both an
objective and subjective sensation.
FLUORIC ACID - Is very good for varicose veins accompanied by itching along the venous
path (pruritus and varicose eczema). Very faithful remedy which will suppress the itching and
reduce the volume of the vein. Note that for prescribing, the itching should be improved by cold.
HAMAMELIS - Is of course the typical remedy for varicose veins which are painful or very
sensitive to touch. They are usually big and distended and may burst easily discharging a very
dark blood. This remedy is also very good for varicose veins of pregnant women.
AESCULUS HIPPOCASTANUM - Is very good for capillaritis found on the legs of young
women but it is not really a remedy for varicose veins.
PULSATILLA - Is like Hamamelis a typical varicose veins remedy. The veins are blue, swollen
and troubles the patient. They are painful with sometimes a throbbing sensation.
VARICOSE ULCERS: Generally come on as a result of scratching the skin of a leg which has
been rendered eczematous by bad circulation. They may belong to any of the following types
classified under LOCAL ULCERS. They are:
a) Simple or slowly healing ulcers.
b) Inflamed ulcers.
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c) Weak ulcers and

d) Callous or indolent ulcers.
FLUORIC ACID - Is very good for varicose veins accompanied by itching along the venous
path )pruritus and varicose eczema). Very faithful remedy which will suppress the itching and
reduce the volume of the vein. Note that for prescribing, the itching should be improved by heat.
HAMAMELIS - Is of course the typical remedy for varicose veins which are painless or very
sensitive to touch. They are usually big and distended and may burst easily discharging a very
dark blood. This remedy is also very good for varicose veins of pregnant women.
AESCULUS HIPPOCASTANUM - Is very good for capillaritis found on the legs of young
women but it is not really a remedy for varicose veins.
PULSATILLA - Is like Hamamelis a typical varicose veins remedy. The veins are blue, swollen
and troubles the patient. They are painful with sometimes a throbbing sensation.
VARICOSE ULCERS: Generally come on as a result of scratching of a leg which has been
rendered eczematous by bad circulation. They may belong to any of the following types
classified under LOCAL ULCERS. They are:
A) Simple or slowly healing ulcers
B) Inflamed ulcers
C) Weak ulcers and
D) Callous or indolent ulcers
A.) SIMPLE OR SLOWLY HEALING ULCERS: The floor is moderately red and slightly
sunk, the skin around is healthy up to the margin of the ulcer, and at the edge there is a blue line,
which is of great importance as showing the progress of the healing. Such an ulcer has a very
slight white discharge and is quite free from smell.
B) INFLAMED ULCERS: Those are ulcers which, as the result of the presence of bacteria, or in
consequence of continued irritation are still spreading. The floor is very red and swollen. There
is a thick discharge of pus from the surface, and portions of the reddened skin at its edge or in its
neighbourhood tend to die and thus form new ulcers.
C) WEAK ULCERS: Are really the ulcers of debilitated people. The granulations are soft,
project above the surface, forming what is popularly known as "proud flesh", bleed easily, and
prevent the healing edge of the ulcer from growing inwards.
D) CALLOUS OR INDOLENT ULCERS: This is the type of chronic ulcer most frequently
met. The edge is thick and hard, the colour pale, few granulations are present, and the discharge
in consequence is thin and small in amount, though often very offensive in smell.
Due to the variety of varicose ulcers, we use various remedies for its treatment.
AESCULUS HIPP - Will be prescribed if the ulcer is an indolent one with a dark red edge.
ASA FOETIDA - The ulceration is usually accompanied by terrible pain near and over the bony
region. This sign is the most important one for prescribing.
CARBO ANIMALIS - Ulcer surrounded by a violet epidermis with a coppery pigmentation
typical of this type of ulcer.
KALI BICHROM - Ulcer with the edges so sharp that they look as if punched out.
MERCURIUS CORR - Ulcer with edges irregularly cut as if torn secreting a purulent liquid and
usually developing on bony parts.
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PULSATILLA - Ulcer bleeding easily. The secretion may be dark blood or a mixture of blood
and serum.
The remedies mentioned are given as a guide and should not distract from "taking the
case" under homoeopathic rules of prescribing.
We are going to consider the significance of Mental Symptoms in homoeopathic prescribing and
this lecture consists of a paper given by Dr. William Gutman M.D. delivered in 1941 which is
still appropriate today.
“Paragraph 210 of the Organon, 6th edition, reads: "They (e.g., The mental diseases) do not,
however, constitute a class of disease sharply separated from all others, since in all other so-
called corporeal diseases the condition of the disposition and mind is always altered: and in all
cases of disease we are called on to cure the state of the patient's disposition is to be particularly
noted, along with the totality of the symptoms, if we would trace an accurate picture of the
disease, in order to be able therefore to treat it homoeopathically with success".
“Para 211 states: "This holds good to such an extent that the state of the disposition of the
patient often chiefly determines the selection of the homoeopathic remedy as being a decidedly
characteristic symptom which can least of all remain concealed from the accurately observing
physician".
“With these words Hahnemann a hundred years ago has clearly and simply stated facts which
represent today the most recent discovery of medicine, concerning the inter-relationship of mind
and body, and involving the problem of the psychic origin of many pathological conditions and
even anatomical changes die to emotions.
“This discovery promoted by the development of psychopathology, that emotions can be a cause
of organic pathology may be of far greater importance than we still are inclined to believe. The
research in the field of psychosomatic medicine is in its initial stage and the more we learn the
more we become aware of the important role emotions play in the pathogenesis of many
diseases.
“The vegetative nervous system functions as the pathway between psyche and soma. The
emotional reaction is mediated through the thalamus, and the vegetative nervous system centres
in the diencephalon and reaches the organ by means of the sympathetic and para-sympathetic
fibres, expressing itself in the "Language of the organ", i.e. its particular functions and their
disturbances.
“The disturbances may occur chiefly (a) in the sensory functions, (b) in the motor functions, (c)
in the secretory functions which are all under the control of the sympathetic and para-
sympathetic autonomous system.
“It can be said in general that the emotional impulses of pain and discomfort effect
predominantly the sympathetic and those associated with pleasure, the para-sympathetic. The
emotions of fear, rage, worry, anxiety, anger, may give rise to effects of sympathetic stimulation.
“Every emotion may either disappear after a short time without penetrating into the
physiological level or it may continue in the form of a repeated or steady mental stress which
may lead to disturbances in the organs governed by the autonomous nervous system.
“In the same way a sudden emotional shock can upset the functions of an organ or of several
organs initiating pathological changes. The emotional reaction must not reach necessarily the
level of conscious awareness, but by establishing an unconscious working complex far-reaching
effects in the physiological and even anatomical level may result.
“Preceding from the psychological viewpoint, Lange and James developed a theory of emotions
and their relationship to bodily changes. According to this theory the bodily changes follow
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directly the perception of the existing fact, and our feeling of these changes as they occur is the
emotion.
“We feel sorry because we cry, we do not cry because we are sorry. The bodily manifestation
must first be interposed, otherwise we would have a pale colourless perception without any real
emotion. The discovery of the emotional secretion or adrenalin seemed to strengthen the James-
Lange theory of the emotions.
“Proceeding from this theory we may easier understand the influence of drugs on emotions, and
particularly the effect of homoeopathic remedies on emotions and their consequences.
“Let us bear in mind the Aconite picture and at the same time read the description Darwin gives
in his "Expression of the Emotions in Man and Animals", of the physiological change which
takes place in connection with fear: "The heart beats quickly and violently, so that it palpitates
or knocks against the ribs: but it is very doubtful if it then works more efficiently than usual, so
as to send a greater supply of blood to all parts of the body: for the skin instantly becomes pale
as during incipient faintness.
“This paleness of the surface, however, is probably in large part, or is exclusively due to the
vaso-motor centre being affected in such a manner as to cause the contraction of the small
arteries of the skin. That the skin is much affected under the sense of fear, we see in the
marvellous manner in which perspiration immediately exudes from it.
“This exudation is all the more remarkable, as the surface is then cold, and hence the term "a
cold sweat"; whereas the sudorific glands are properly excited into action when the surface is
heated. The hair on the skin also stand erect, and the superficial muscles shiver. In connection
with the disturbed action of the heart the breathing is hurried.
“The salivary glands act imperfectly; the mouth becomes dry and is repeatedly opened and shut.
I have also noticed that under slight fear there is a strong tendency to yawn. One of the marked
symptoms is the trembling of all muscles of the body; and this is first seen in the lips. From this
cause, and from the dryness of the mouth, the voice becomes husky or indistinct, or may
altogether fail. "Going over the proving symptoms of Aconite, we find a complete resemblance
between Darwin's classical description of the state of fear as expressed by bodily symptoms and
the effect of Aconite, laid down in the provings.
“According to the law of similars, Aconite was always found helpful in ailments due to fear or
sudden fright. I recall a case of severe chronic sleeplessness which could be traced to an extreme
shock due to sudden fright suffered in the World War when the patient was accidentally buried;
the man could be cured by Aconite although the actual incident of shock had taken place many
years ago.
“The chapter Consequences of Emotions plays an important part in homoeopathy, but it was not
before the latest development in modern medicine that experimental proof could be found for
our clinical knowledge. Ever since then ample evidence has been gathered that emotion produce
bodily changes, and a short survey of the facts may illustrate how right the homoeopaths have
been in upholding their experience through a century against the contemptible derision of a
medical majority.
“The heart has been considered by common opinions as the seat of the emotions. True, the heart
and the whole circulatory apparatus particularly express readily the emotions as F.I. by blushing
and becoming pale.
“Suggestion of emotions made partly in hypnosis, produced definite changes of the pulse,
distribution of the blood volume, blood pressure, changes in the heart rhythm, demonstrated by
the electrocardiogram, and changes in the heart configuration of more tan 1cm, controlled by x-
rays.
“Under the repeated influence of emotions a definite change in blood pressure and heart
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configuration may take place. Anxiety can be considered as a sot-to-speak heart specific
emotion. Even slight sensations of the heart as they may occur after over-exertion produce the
feeling of fear and anxiety.
“The strongest expression of fear occurs in the attack of angina pectoris since dolore is
exclusively characterised by strong emotions of undefined fear and apprehension. The feeling of
approaching death and the fear of death is closely connected with the heart and the circulatory
system.
“Homoeopathic provings and clinical experiences have established this connection long ago,
and remedies which produce most clearly the sensation of fear of death, like Aconite and
Arsenicum are drugs which affect primarily the circulatory system.
“The effect of Aconite is directed chiefly towards the arteries; Arsenic owes its symptomology
to the poisoning of the heart and the capillary system. There is no remedy which is more closely
related with death than Arsenic. There is this immense fear of death no other remedy has in such
degree.
“Despair of life, anguish, agony, a face showing genuine fear, finally cachexia and Hippocratic
features are the signs of the deadly intoxication of the heart and of the capillary system which
produces a state of chronic collapse, the underlying pathological conditions of this impressive
picture. Even in the subconscious sphere of dreams the idea of death is prevailing. A patient of
mine suffered from a great many functional disorders, I recall particularly, great loss of hair with
an enormous amount of dandruff.
“After one dose of Arsenic all symptoms disappear but the patient expressed her particular
thankfulness that I freed her from her frightful dreams. She dreamed in regular intervals of
corpses and the terrible nightmares made her sick for days afterwards.
“After administration of Arsenic she no longer had these dreams. This is at the same time an
example of the influence which the homoeopathic remedy has on the emotions, penetrating even
into the level of subconsciousness and the realm of dreams.
“The heart as an organ of expression of emotions also causes many functional or subjective
symptoms. A syndrome of symptoms such as sensation as if the heart were squeezed, oppression
anxiety, palpitations and repeated sighing has been called phrenocardia and was found
particularly as a consequence of unhappy love affairs.
“This state corresponds exactly to the picture of Ignatia. Sighing respiration, however, is also
often the first sign of cardiac failure, and we find it as a symptom in the proving of Digitalis
which is also characterised by extreme anxiety and fear, and fearful dreams.
“It was found (Eichenberger) that in cardiac patients a definite increase in anxiety dreams
appeared as the first sign of cardiac decompensation.
”The mental symptoms in cardiac cases may arrive at a state of a real psychosis, characterised
by delusions, anxiety, restlessness with definite anatomical findings in the brain, probably
caused by an oxygen deficiency; all these mental symptoms are also produced by Digitalis.
“Everywhere we notice the influence of the mental state on the bodily condition and of the
bodily condition on the mental state. The homoeopathic remedy mirrors both mental and
physical conditions and gives a true reflection of the integration of both, which characterises all
processes of life and disease.
“Very considerable is also the influence of emotions on the gastro intestinal tract. The first
classical observation of the influence of fear and anger on the secretion of the stomach was
made by Beaumont.
“Recent experiments by means of hypnotic suggestion showed that the emotions of fear, fright,
worry and joy had an immediate influence on gastric secretions as well as on gastric tonus and
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motility.
“Gastric secretions was increased or checked, sometimes the secretion was completely inhibited,
so that even injection of histamine could not produce any reaction. Gastric peristalsis could be
stopped by hypnotic suggestions of worry and anxiety and the following changes in the mucosal
outline, as demonstrated by x-rays, give the same picture as a gastritis.
“Recent research in the field of the genesis of stomach ulcer leads more and more to the belief
of the psychogenic origin of ulcer. It was found that peptic ulcers cases are characterised by over
compensatory aggressively, hyperactivity and excitability, qualities which give rise to emotions
known to cause hypermotility and hypersecretion of the stomach.
“It is interesting to note that the homoeopathic remedies frequently indicated in stomach ulcer as
Anacardium, Nux Vomica, Natrum Mur., Nitric Acid, Arsenicum represent in their picture
exactly the mentioned mental type. Gastric tomes changes according to emotions and by x-ray
examination of the stomach of manic-depressive mental cases the position of the viscera was
found two inches higher in the manic than in the depressive phase. Schindler considers ptosis,
combined with anacidity and atonic constipation the gastrointestinal correlate of depression.
“This brings to my mind the case of a young lady who came to see me for stomach troubles
from which she had suffered for a year, loss of appetite, gastric pains - feeling of heaviness; she
was in a state of great depression and said; "Doctor, I cry all day long. Suspecting a
psychological background, but without intruding, I gave Ignatia.
“Two weeks later she entered the office smiling; Doctor, what have you done with me, now I
laugh the whole day!". The stomach complaints had disappeared together with the depression.
An after-anamnesis revealed that the beginning of the stomach-troubles coincided with and
unhappy love-affair. Ignatia cured the whole condition definitely.
“The emotional effect on the bile secretions could be studied under hypnotic suggestion. Anger
inhibits the bile secretion entirely, and this experiment justifies an old clinical experience. On
the other hand, chronic jaundice produces a state of great mental irritability, and repeated icteric
attacks are often accompanied by fits of anger and rage.
“The homoeopathic use of anger-remedies such as Chamomilla, Bryonia, Colocynthis, Nux
Vomica in bilious attacks shows how homoeopathy has made practical use of clinical
observations which are now confirmed also by experiment.
“Whereas all these recent findings are of a more or less theoretical interest, as school medicine
cannot make practical use of it. Homoeopathy offers the therapeutic link, combined the mental
and physical influences of drugs in treating the whole person as the only existing clinical reality!
“How much different physical or mental aetiology of a case may influence the choice of the
right remedy - and therefore the cure - may be shown by the following case:
“A 40 year old patient was rushed into my office with an acute attack of neuralgia of both
brachial plexuses. It was the most distressing picture of a pain I have ever seen. The patient was
rolling on the couch crying that ten gall-stones before - are better that this agonising pain.
“The patient had caught a cold while sweating under his arms. One dose of Belladonna 200
finished immediately the attack, after Aconite had failed. However, on pressure, a certain
sensitivity of the nerve branches remained.
“Weeks later the patient again was brought to my office with a new similar attack and attack and
even more horrible pains. Although the symptoms at this time were exactly the same,
Belladonna failed utterly.
“In despair - the pain was so strong that the patient, a World War Veteran, was crying - I gave a
morphine injection which began to have an effect after half and hour, and the patient was taken
home. Some hours later, I was called to his house, the horrible pain had recurred as I had
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anticipated.
“The hard-pressed Doctor's brain works faster, and after having elected that this attack had
coincided with a suppressed fit of anger, I gave a dose of Chamomilla. Within 5 minutes the
pain was gone and did not recur any more.
”Less studied than the influence of the mind on the body is the interesting influence of the sick
body on the mind. I refer in this connection to the morosity and ill humour, often accompanying
disease of the hypochondrium, so typical, that hypochondria became a name for this
characteristic disposition.
“We have already mentioned the disposition in cardiac cases and in icteric patients. Typical for
the pneumonia delirium is a psychometric restlessness with the patient grasping for feathers and
picking at the bed clothes, similar to the delirium found in persons saved from asphyxiation,
both pictures due to lack of oxygen; they are covered by remedies like Hyoscyamus and
Lycopodium. Typical for Grippe was found an anxious-depressive disposition, ranging from
irritability to apathy and stupor, and this is very well in accordance with the angry-apathetic flu-
remedies, such as Bryonia, Gelsemium, Eupatorium. Measles are characterised in their initial
stage by a crying disposition and the tearful Pulsatilla is in fact one of the most successful
remedies in this disease.
“A few words should be said about the queer mental symptoms in homoeopathy, which were so
often derided that sometimes the advice was given to throw them out of our materia medica.
“If we learn about such symptoms as: "Listening to music causes distress on one side of the
body", or "He feels a half-sided amorousness with the wish to caress all things with the hand of
this side", symptoms actually found in cases of thalamic lesions, or, if we go over the numerous
queerest "as if" symptoms in the provings made by Beringer at the Heidelberg Psychiatric Clinic
with Meskalin, then we may realise that these queer mental symptoms of our provings may
represent a good deal of useful clinical reality.
“The sensation of a split of the personality is a well known fact in psycho-pathology and it
appears in a number of our drug pictures too. MacAdam could show that this sensation appeared
in the most various forms in the dreams of Grippe - patients and he derived from these dreams
the hint for a successful prescription of Baptisia. Par.212 and 213 of the Organon draw attention
to the fact that drugs are capable of altering the disposition and that no homoeopathic cure - i.e.
a cure conforming to nature - can be achieved without choosing a remedy which covers a s
closely as possible, both the physical and the mental symptoms.
“In a footnote thereto concerning the adoption of remedies such as Aconite, Nux Vomica,
Pulsatilla, Ignatia to mental state, Hahnemann draws the first outline of a new psycho-
pharmacology which could become the therapeutic key for a future psycho-somatic medicine.
“Cannon states: "In modern life infection have diminished and nervous strains have increased",
and "the medical profession has not recognized in a practical way the recent shift in the
aetiology of disease". i.e. The rising aetiological importance of emotional causes. If we are to
treat patients rationally, considering the aetiology, we have to keep in mind this most important
fact. Von Bergmann says: "Psychic phenomena often give us the earlier, because subtler, finer
clinical signs".
“The modern trend in medicine is directed towards an early diagnosis and treatment constituting
a preventive medicine. If we are to treat patients early we have to pay more and more attention
to the mental symptoms and syndromes.
“Modern medicine takes the patient as a unity of mind and body, and as an individual, tending
towards psycho-somatic medicine and a medicine of the individual. Whereas the organ
symptoms are practically the same in each case, the mental symptoms as an expression of the
highest organised system reveal the individuality. If we are to treat a patient thoroughly, and
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individually, we have also for this reason to observe his mental set-up and his individual
behaviour.
“Homoeopathy, which has always stressed the clinical significance of the mental symptoms, has
recognized in a practical way the importance of emotional factors for the aetiology of diseases.
It also finds itself - as could be shown - in accordance with the modern trend towards a
preventive and a psycho-somatic medicine and demonstrates at the same time the practical
possibility of the most interesting, the pharmacological approach towards the highest goal of
medicine, the therapy of the personality.
“In these misguided days of testing a specific homoeopathic remedy against specific allopathic
drug, it is important to take a step back and look at the question in its entirety.
“In order to gain an insight into homoeopathy it is necessary to begin with a holistic image of
the being of man. Such an image demands that we re-evaluate our conception of the process of
scientific inquiry and suspend the reductionistic dogma of western biological science.
“It further demands that we expand our frame of reference to include a carefully guided
intuition. The noted physician and philosopher M. Polanyi has spoken at great length about the
scientific nature of intuition (tacit knowledge).
“He maintains that intuition is a personal cognitive capacity to integrate ideas into a unified
cohesive entity. Einstein exhibited such person intellectual skill in the development of the theory
of relativity. Newton unified celestial and terrestrial mechanics and Copernicus toppled
Ptolemaic theory, not by pointing to new facts but by creating new visions of reality which
altered the significance of the available empirical data. In the case of biological science this
method of scientific inquiry leads to an understanding of a dynamic physiology. The point is that
the research biologist needs to kindle his own integrative or intuitive abilities before holistic
medicine will make any sense to him.
“The reductionistic approach taken by western description of the chemo mechanical workings of
cells, organs and body. Operating under purely chemo-mechanical assumptions has proven self-
limiting because its own standard of research methods show that living physiological systems
are not in chemical equilibrium but are maintained, while alive, in a steady-state non-
equilibrium metabolism.
“Western science fails to describe the mechanism whereby these living systems are maintained.
For example, knowing that there are differences between the intracellular and plasma
concentrations of iron and copper, and that these levels change rhythmically during the course of
a day, gives little insight into the fact that life does not appear to carry material substances on to
a stronger manifestation of their own inclination.
“On the contrary, life subdues and metamorphosised the inherent physical laws of
biochemical’s. In reality these changing levels cannot be understood from the point of view of
pure biochemistry in that they more accurately reflect the rhythmical changes in consciousness
that occur over the period of a day rather tan any known biochemical process.
“It is interesting to note that changes of consciousness which occur with disease and meditation
are also reflected in these levels.
“Modern science has considered biochemical organisms as living machines. According to the
machine analogy, a living organism can be understood by taking it apart (kill it and analyse it)
and then from the knowledge of its parts attempt to reassemble it into its original form.
“This approach, indeed, still constitutes the backbone of most of contemporary biological
thought and is doomed to failure, since once the organism is dead, its essence can no longer be
described. The biological organism is the comprehensive entity whose purpose (essence) exerts
an influence on the operation of all or its various organs. The whole is indeed greater that the
sum of its parts!
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"No physical or chemical analysis of the body can ascertain by itself any of the operational
principles, since the conceptions of purpose and of the successful functioning of the organs
cannot be expressed in terms of physics or chemistry. A complete physio-chemical topography
of an organism would in fact be quite meaningless.
“Therefore, in the analysis of a given organism's health, the physical and chemical information
derived must be interpreted in accordance with what should be (i.e. pathological process are
merely displaced physiological functions).
“The biotic sciences must, in other words, assess the state of the organism against a concept of
the healthful operation of all its functions, the body's operational principles.
“From a holistic perspective the major operational principle of life may be characterised as that
creative energy which orders the entropic patterns of matter in accordance with its own rhythmic
processes.
“Let us build our understanding of this operational principle of life be reflecting upon a very
basic observation biological organisms are alive. Every organ serves (or has served) some
function in the maintenance of the healthy operation of all activities in the organism.
“Every cell and every molecule has been permeated with the unified aims of the whole
biological being. The most basic molecule of water in a living organism may be chemically
indistinguishable from one in a drop of rain, yet the former is filled with the dynamic energy of
life, while the later remains inanimate. Even in its smallest elements the dynamic energy of the
whole organism is enmeshed.
“Working with a man in a holistic way, we endeavour to understand the unfolding, circulation
and balance of this creative energy within the microcosm that is each of us.
“An imbalance in the reactive functional level (Hahnemann's vital force) of man causes a
skewing of the normal interrelationships and results in a state of disease.
“While this idea seems basic it is a concept of paramount importance, for now we have a way to
account for illness. Illness once recognized and accounted for correctly, leads on to appropriate
therapeutic measures. In the prevailing "orthodox" way of studying biological science, the
mechanistic approach leaves no room for illness other than mechanical illness....trauma (How
can an enzyme be made or react differently than it does?).
“In terms of medical illnesses talking of gene and chromosome switches quickly becomes a
meaningless circular argument. Invading bacteria (alleged germ theory) or environmental
stresses do not account for why the husband, wife or doctor did not become ill. Surely
"psychological stresses" cannot be a factor in a purely mechanical system that obviously does
not allow for a psyche; a basic and most perplexing, albeit ignored, problem or the "orthodox"
physician.
“Holistic physicians have realised that symptoms are merely the body's best attempt at
demonstrating and correcting a super sensibly imbalance. Unless the imbalance is worked with
on the plane from which it originates, and not just suppressed on the physical level with drugs
(drugs may be life saving but are rarely curative), a deeper, more severe illness will result. One
can say that "modern medicine" only acknowledges man's higher energies and source of health
tacitly.
“When one is given aspirin for a headache, the drug works to decrease our awareness of the pain
in the hope that whatever caused the headache would soon be righted by the body's own innate
wisdom.
“Drugs, in a certain way, by separating us from the workings of our body, often act to dull our
consciousness. The danger, in this approach to medicine, is that by decreasing our awareness of
disease and by not treating the underlying imbalance, illness can often progress without our
97
sensing it, hence the symptoms as sinusitis, tonsillitis, bronchitis and finally pneumonia may
come and go, and be separating us from the realisation of disease, by treating the symptoms with
drugs, and by not dealing with the underlying imbalance, we lose the sense that these
progressive changes are all manifestation of the same imbalance process.
“The homoeopathic remedy thus being a rarefied therapeutic, correctly applied, relates to the
creative functional level of man and therefore has the potential to root out the cause and right the
imbalance. This then raises the question of how to correctly apply the medicament.
“Culpable, a 17th century astrologer-physician, echoing earlier masters, stated when referring to
the herb ale hoof: "It is an herb of Venus, and therefore cures the diseases she causes by
sympathy, and those of Mars by antipathy". Hahnemann, a master of late vintage, proclaimed
"Similia Similibus Curentur" and then preceded to outline a system of therapeutics based on this
law of healing. More recently Steiner detailed a hierarchy of the energies of man including their
origins and actions. Through his comprehensive philosophy we can now begin to explain more
accurately how potentized medicines act on the metaphysical energy system of man.
“Later homeopaths have described many different ways to apply the similia idea. a recent text
on this point listed over 20 such ways for applying the of similars and thus building a "three
legged stool", and that list is not complete.
“All of these homoeopathic approaches bear merit depending on what the outstanding and
changed features of the case are (based mostly on the history), and depending on the ability of
the physician to perceive and understand his patient (tacitly) and finally to form a concept and
draw a logical and thus reproducible conclusion.
“As homoeopathy is a clinical science, each problem that a patient presents must be looked at in
the context of the individual affected. Patients being treated homoeopathically must be
managed.
“Homoeopathy is more than any remedy, it is an approach. Any well-designed research project
must test within the sphere of that which is being tested. In the case of homoeopathy that means
following patients over a period of time while they are appropriately treated and managed by the
(homoeopathic) physician.
“The length of time necessary for follow-up would depend upon the type of illness and the
remedies involved, as some are said to take longer than others to begin to work.
“Who can say that a patients good response to a second remedy given was not because the first
remedy, although possibly showing "little" physical evidence of a response, actually prepared
the patient for the improvement (one must obviously take into account the length of time a
remedy is said to work for, once it is no longer given).
“Such problems as "proper clinical trails" are not new to homoeopathy; those who do not study
the past are doomed to repeat its failures, as this quotation from 1852 points out:
"Why will not Allopathists remember, that when the line of direction (by way of potentisation)
of a drug is changed, all the circumstances of the case are so altered, that reasoning by analogy
becomes palpably illogical? Their comparison of the drugs in question, reminds me of the silly
formulae made by little school boys, just commencing the Rule of Three.... such as, if a pound
of soap costs a dime, what will a bushel of corn come to? In which there is no natural relation
between the elements of the problem. When we begin to apply a remedy homoeopathically, we
enter on a new field of observation, in which all previous experience with drugs is
comparatively valueless. It becomes our obvious duty to record the facts and to practice upon
them".
It is a highly questionable scientific practice to dismiss a body of significant imperial evidence
(such as homoeopathy) simply because the underlying philosophy, which rationally interprets
such results, assumes premises foreign to those currently accepted.
98
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Classical Homoeopathy

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that community with the isopathic method.

question of Allergens, Detergents, pesticides, insecticides, allergen sing medicines etc.

PRESCRIPTION: The prescription according to an acute and sub-acute condition, or in

in 15c or 30c if one wishes to act on the corticoviscral perturbation.

POSOLOGY: 30c and higher. Sometimes frequent dosing.

Positive diagnosis of hyperpituitarism is to be considered if there is rapid growth or

ADRENOCORTICAL HYPERFUNCTION - CUSHING'S SYNDROME The main symptoms

educational purposes only.

Lymphogranuloma Inguinale (Venereum).

symptomology for which patient presents.

Other conditions affecting vulvo-vaginal regions which should be studied are:

Menstruation is taking place but patient is unaware of it because the outflow is

Error is in ovary and its controlling factors rather than uterus.

Retroversion, Ovarian Prolapse, Uterovaginal prolapse.

C/F Acute chest pain, dysponea at each onset of menses.

Threadworm (Oxyuris) rarely migrate forward enough to cause vulval itching.

Slight discomfort low in back is so common premenstrual as to be regarded as one of

Function of menses should be explained.

CLIMACTERIC (MENOPAUSAL) SYMPTOMS:

1. Pain and tenderness.

CUTANEOUS STRUCTURES: Deposition of fat.

A) INTERFERENCE WITH PLACENTAL CIRCULATION:

1. THREATENED ABORTION: C/F Female known to be pregnant - has uterine bleeding.

CRIMINAL ABORTION: Self induced or by other party.

9. Intra peritoneal haemorrhage

DEFECTIVE OR DEFICIENT PERINEUM: Defective perineum is end result of unhealed

Vaginal and peri-urethral cysts.

4. ANAEMIAS OF UNCERTAIN ORIGIN:

very dangerous and proper emergency treatment should be administered in a hospital.

BELLADONNA one dose T.D.S.

MYELOMA: (MULIIPLE MYELONATOSIS)

Antigenic stimulation will elicit delayed hypersensitivity or antibody formation or both

that in the near future some interesting results will be published.

If only one joint is affected the condition is referred to as monarticular arthritis. If

keeping a hot drink in the mouth.

irregular meals and it becomes more frequent as age increases.

OPIUM - If the abdomen is hard and inert.

habits or indulgence in stimulants.

and flatulence may exist.

good for arterial spasms.

c) Weak ulcers and

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