The National Academy of Homoeopathy, India conducts biannual workshops in the memory of Late Dr. J.N.Kanjilal of Kolkatta. The Central Secretariat (Nagpur) decided that the theme for Academy’s ninth workshop would be Miasmas and the venue was Dr. Babasaheb Ambedkar Sanskrutik Bhavan, Pune. It was also the moment of installation of “Pune Core Group” of the Academy under the leadership of Dr. Abhijeet Joshi.
Indeed this was a long awaited topic since right from Hahnemann’s times; Miasm has been an ill-understood subject. The scientific program laid out was comprehensive covering the entire panorama of Miasms.
At the outset, the traditional samai was lit by all the Guests and rich tributes were paid to Late Dr. J.N.Kanjilal. Inaugurating the workshop, veteran homoeopath Dr. M. P Arya commented that the concept of Chronic Diseases has divided the homoeopaths into two groups – the non believers and believers. The former only apply the concepts of Similia, minimum and potentization in their practice whilst the latter adhere to all these and that of Miasms in principle & practice. Both senior homoeopaths, Dr. S. Katekari & Dr. S. Phansalkar (Director I.C.R: Pune) agreed with him on this point. They were liberal in their praises for the speakers –Drs. Kasim & Aadil Chimthanawala. Dr. Katekari went on to say that it was the first time that deans of all homoeopathic institutes of Pune had conglomerated on a single dias and the credit goes to the Academy. Dr. P Sethiya (Principal D.S.H.M.C) & Dr. A.Jadhav (Principal Bharathi Vidhyapeeth H.M.C) also shared their views.
The first session was by Dr. Kasim. In his immaculate style he provided an insight of different stages of Dr. Hahnemann’s practice – namely
1. Initially from 1790 – 1810, Hahnemann’s objective was to reduce the dose and prevent the bad effects of crude medicines. The sources of the drugs were from ancient records, herbal medicines, customs and traditions and doctrine of signatures. He gave an example of Thuja for warts because the latter has fruits similar in appearance to warts. Also red chilies with burning taste were given for acute pharyngitis etc.
2. The second stage of Hahnemann’s practice (1811-1827) was on the basis of the three fundamental laws of Similia, dynamization & potentization which he had discovered.
3. When he realized that permanent cure could not be achieved simply on the basis of the 3 fundamental laws, he invented the concept of Chronic Miasms (Aph: 211) and thereafter till death he practiced upon the miasmatic state of disposition.
Dr. Kasim went on to describe vivid details regarding the necessity of the concept, genesis and the retaliation that Hahnemann met upon its introduction, etc.
The subsequent deliberation by Dr. Kasim dealt with what are Miasms, Miasmas are defined as - Natural morbific agents that are invisible, dynamic, disease producing, subversive potens. They are the Prima causa morbii and the Causa causorum. There are different types of miasms with separate attributes. They express on spiritual, mental and physical planes. Discussing about Psora, he commented that episodes are sudden, violent and self-limiting. Psora has functional symptoms, sensations, modalities, concomitants, etc. Psoric pathology is always superficial, reversible and leaves no disease Ultimates. Likewise Syphilitic & Sycotic Miasms were discussed in depth. Concept of elimination was presented with few cases in clinical practice. He gave examples of elimination like confession, seeking pardon, emotions, dreams, mental mechanisms, discharges & eruptions. The subject of relations of different microbial affections in different miasmatic states was totally a new one.
The final lecture was on Tubercular Miasm. He said “Nowadays majority of patients belong to this category of this Miasmatic state. What Psora was at the time of Master Hahnemann is Tubercular Miasm today.” He quoted references from writings of Drs. Robert, J.H.Allen, Phyllis Speight, M.L. Dhawale and J.N.Kanjilal.
Cured cases of Paget’s disease Breast in a 46 years female with Nitric Acid and Primary Infertility & SLE in a 27 years old female with Syphilinum and Natrum Muraticum were presented.
Dr. Aadil Chimthanawala elaborated the role of Miasms in the management of Cardiac cases. He presented homeopathically managed cases of
1. Psoric Angina pectoris treated with Veratrum Album
2. Ischemic Heart Disease, Triple Vessel disease with systemic hypertension – a psoro-syphilitic presentation, managed by Arania and Aurum Met
3. Mucopolysaccharoidosis & VSD in a boy aged 2 years – a psoro-sycotic case that was successfully treated with China. He clearly showed the difference in selection between China and Digitalis.
4. Finally a case of Infective Endocarditis in a girl of 14 years suffering from Rheumatic Heart Disease – a psoro-sycotic presentation where Phosphorus and Medhorrinum were used.
The Pune core group of NAHI comprising of Drs. Abhijeet Joshi, Yashodhar Bhalerao, Amit Tribhovan, Vyankatesh Kulkarni, Rupali Deshmukh, Shailesh & Sarika Doshi and others, accepted the challenge of hosting for the first time a workshop of national level in the city of Pune. They left no stone unturned in making the arrangements for its success so that the homoeopathic fraternity would enjoy the academic feast and their stay at Pune would be left with pleasant memories that will be cherished for a long time.
Sunday, May 10, 2009
STRESS IN CHILDREN
It is a feeling of being threatened,
When one is in distress
Psychologists label it Anxiety,
Or the person has stress.
Stress is a subjective feeling
May it be strong or mild
Depends on the cause of distress,
And coping abilities of the child;
Stress is inevitable when Needs are unfulfilled
Negative feelings dominate
And one’s fate seems sealed
Needs may be oxygen or food
Or just a glass of water
Or material things which
Should not matter
Optimal stress is necessary
To initiate action
Overstress makes one sick
And leads to inaction.
Approach to illness should be Individualistic & holistic altogether
Physician should treat both Psyche & Soma together.
When one is in distress
Psychologists label it Anxiety,
Or the person has stress.
Stress is a subjective feeling
May it be strong or mild
Depends on the cause of distress,
And coping abilities of the child;
Stress is inevitable when Needs are unfulfilled
Negative feelings dominate
And one’s fate seems sealed
Needs may be oxygen or food
Or just a glass of water
Or material things which
Should not matter
Optimal stress is necessary
To initiate action
Overstress makes one sick
And leads to inaction.
Approach to illness should be Individualistic & holistic altogether
Physician should treat both Psyche & Soma together.
RESEARCH IN HOMOEOPATHY
Every Science, if it has to survive and flourish, must evolve according to the times and demands. Homoeopathy being no exception. Being a Scientific Art, it must also follow the dictates of time. Majority of homoeopaths in India and abroad are of the opinion that Homoeotherapeutics being a complete science, it does not require any research; since whatever is required for a rational practice is already enshrined in the trio of Organon, Chronic Diseases, & Materia medica. So, the general homoeopathic practitioner has only to percieve & practice the precepts of the Masters of the pathy as observantly & minutely as possible. As it is, this idea is quite true to some extent. But fortunately a large number of us have now started to realise that the teachings of the Organon & Chronic Diseases as well as the tools of materia medica are solely based on the life-long research work of Hahnemann in collaboration with his direct disciples and that all these teachings would not have been assimilable and applicable for us without the dedicated works of Bonninghausen, Kent, Hering, Allen (s), Roberts, BK Bose, BK Sarkar, JN Kanjilal, and many more devoted souls. Its high time for us to think if we too can do something to further enrich this already enriched science. Orthodoxy & narrow mindedness must not render such an invaluable gift of the Master for the ailing humanity a stale stuff. We cannot only stick to what was concieved and preached by our stalwarts, centuries back. The times of Hahnemann were much different from what we are facing today. Everything is changing. Life & living are not the same as those of primitive times. Diseases of those days were simple et superficial (infective, deficiency disorders, etc). But nowadays they are complex, multiorganismal and lifelong (Pychosommatic, Metabolic, Immunological,etc).
So keeping in mind these basic facts, every reason gifted Homoeopath shall agree that we need changes in certain areas of our rational system. New ideas, concepts, theories, approaches etc. must be introduced inorder to fulfil the lacunaes of today. So we have seen that RESEARCH is one of the most essential limb of every viable system. Another wrong notion is widely prevelent is that any sort of research involves costly & elaborate paraphernalia, gadgets and sophestications which are beyond the reach of an average homoeopathic practitioner. Yes it may be true for some researches as determining the precise nature of potentised medicines beyond the Avogadro’s limit, clinical reseach involving biophysics, biochemisty, cybernetics, etc. But there are a good amount of works that can be done by an average homoeopath too. But as far as the field of Homoeopathy is concerned, we must investigate this million dollar question - Research in which areas ?.
* Do we require newer remedies for effectively combacting newer diseases ?
* Do we need deeper insights in understanding the modes of action of Homoeopathic remedies?
* Do we require to reprove the remedies in todays environment ?
* Do we need to discover newer methods for treating the newer diseases of present times?.
* Do we require to update our Literatures in today’s context?
These and many other areas which require deep pondering if we want Homoeopathy to remain alive and a viable alternative to the traditional mode of Drug Therapeutics. Through this write-up we wish to bring to light the intricacies in the field of Research in Homoeopathy.
First of all, let us throw some light on the subjects of proving newer remedies. Do we really need new remedies when we have not been able to legibly apply all the remedies already exisiting in our chest. Is there a single Homoeopath on this planet who can claim that he has used each and every remedy already proved and documented by our stalwarts for the diseases of the present times? If the answer is NO then where is the rationale in proving fresh ones. Why can’t some possible methods be explored which can assist us for the use of the rarer remedies. Research for newer remedies must be done only after we have failed to produce expected results from those which are already gathering dust in our Almirahs. Will it not be foolish to undertake such a futile exercise. So then which are the areas where we require a fresh look? We are of the opinion that we primarily need to work in the field of Case Taking, symptom extraction et appreciation, Miasms, understanding of the manifestations, drug selection, Posology, Psychotherapy, etc.
AREAS OF-RESEARCH : The National Academy of Homoeopathy, India has undertaken some projects of Clinical and Literary Research, keeping in mind the fundamentals laid down in the Organon of Medicine. The Academy firmly believes that the authenticity of any Research in Homoeopathy is established if it passes through the seive of the Organon of Medicine. Any venture other than this should not be considered as Homoepathy. Otherwise we would also fall in the same trap as the so called modernizers of Homoeopathy. Thus the Research should have the sanction of the Organon. Now we shall dwell upon some areas in which Newer approaches are necessary. They being -
1. Case Taking - Much of the scenario of cases presenting at the Homoeopathic OPD has undergone a sea-change compared to those of Hahnemann’s time. A large number of mixed cases (70%) (a combination of natural symptoms, altered symptoms, suppressed symptoms, drug induced smptoms, secondary symptoms due to ultimates, those due to’environmental influences, etc.) present at the table of a homoepathic practitioner. Hence different methods of case taking have to be evolved for different types of cases. It was this very reason which prompted The National Academy Of Homoeopathy, India, to classify the cases under different case heads and their approach of case taking.
2. Diagnosis - In today’s era, the knowledge of Medicine is equally important as that of the drugs. One has to make both the nosological diagnosis as well as the person diagnosis. Clinical Examination, pathological cum radiological investigations have become essential for diagnosing cases. Research into this area should make Homoeopaths abreast with modern diagnostic technologies & their clinical application in therapeutics. The Academy is presently working extensively in this area.
3.Drug Selection- As mentioned, the varied cases which present to the Homoepaths now demand of him to use even Rare homoeopathic remedies apart from the usual ones. Some form of specialization must be introduced in the curricula so that the Homoeopath has a defined set of patients to work upon. He will then be able to use "the lesser used remedies" often and add clinical symptoms to the Materia medica. The Academy has undertaken such works in the field of Cardiology and Allergic disorders.
4. Posology - Research into posology would be instigated when one answers the question as to why Hahnemann himself felt the need for introducing the 50 millesimal potency in the fading years of his life, in the 6th Edition of Organon. This is because he himself could realise the short comings of the Centisimal scale. Don’t we agree that a good amount of work could be done in this area too.
5. Management - Homeopathy at the time of Hahnemann was considered administration of drugs as the prime mode of treatment. Thus Homeopathic remedies were the only weapons available. Whereas today the patients are required to be Managed (the medicinal part constitutes only 30 - 40% of the lot). More emphasis has to be laid on the auxillary measures, psychotherapy, physiotherapy, counselling & mechanical aids. Thus today we should strive for a Broad based Mangement.
6. Scope of Homoeopathy in Surgery - Very few authenticated researches are there regarding the scope of Homoeopathy in management of pre, peri & postoperative patients. Likewise effective and prompt management of Pain and Anasthesia also demand good amount of Research. The Department of Gynecology, at Shaad Hospital Complex and Research Centre, Nagpur, the working headquarters of the Academy is actively involved in these areas for past 18 years.
7. Scope of Homoeopathy in Emergencies -Medical Emergencies are really a challenge to any physician be it from any pathy. There exist very few authenticated documented papers published in reliable Periodicals on the use of homoeopathic drugs in clinical emergencies. Here, the Department of Cardiology of The National Academy of India, is carrying out a 5 year Clinical research on the Scope of Homoeopathy in Ischemic Heart Disease (Acute & Chronic Coronary syndromes) since January, 2004.
8.Updating the Literature - The Homoeopathic literature has to be updated keeping in view the trends and terminologies of today. Likewise there are areas like Perception of Evolution of Miasms, Publication of well documented clinical works etc.which require special emphasis.
INFINE : Before we close we would like to put a word of caution to the fraternity. Today in name of RESEARCH & progress, new drugs are being proved and applied in the most unscientific manners, not based on Organon, new concepts are being coined, new methods of application of remedies are being practised and preached etc. Unfortunately, it is saddening that majority of these have drifted far away from the basic fundamentals laid down in the Organon. Such so called Researches will bring a doom of Homoeopathy just like it has faced in Germany, United States & United Kingdom.
So keeping in mind these basic facts, every reason gifted Homoeopath shall agree that we need changes in certain areas of our rational system. New ideas, concepts, theories, approaches etc. must be introduced inorder to fulfil the lacunaes of today. So we have seen that RESEARCH is one of the most essential limb of every viable system. Another wrong notion is widely prevelent is that any sort of research involves costly & elaborate paraphernalia, gadgets and sophestications which are beyond the reach of an average homoeopathic practitioner. Yes it may be true for some researches as determining the precise nature of potentised medicines beyond the Avogadro’s limit, clinical reseach involving biophysics, biochemisty, cybernetics, etc. But there are a good amount of works that can be done by an average homoeopath too. But as far as the field of Homoeopathy is concerned, we must investigate this million dollar question - Research in which areas ?.
* Do we require newer remedies for effectively combacting newer diseases ?
* Do we need deeper insights in understanding the modes of action of Homoeopathic remedies?
* Do we require to reprove the remedies in todays environment ?
* Do we need to discover newer methods for treating the newer diseases of present times?.
* Do we require to update our Literatures in today’s context?
These and many other areas which require deep pondering if we want Homoeopathy to remain alive and a viable alternative to the traditional mode of Drug Therapeutics. Through this write-up we wish to bring to light the intricacies in the field of Research in Homoeopathy.
First of all, let us throw some light on the subjects of proving newer remedies. Do we really need new remedies when we have not been able to legibly apply all the remedies already exisiting in our chest. Is there a single Homoeopath on this planet who can claim that he has used each and every remedy already proved and documented by our stalwarts for the diseases of the present times? If the answer is NO then where is the rationale in proving fresh ones. Why can’t some possible methods be explored which can assist us for the use of the rarer remedies. Research for newer remedies must be done only after we have failed to produce expected results from those which are already gathering dust in our Almirahs. Will it not be foolish to undertake such a futile exercise. So then which are the areas where we require a fresh look? We are of the opinion that we primarily need to work in the field of Case Taking, symptom extraction et appreciation, Miasms, understanding of the manifestations, drug selection, Posology, Psychotherapy, etc.
AREAS OF-RESEARCH : The National Academy of Homoeopathy, India has undertaken some projects of Clinical and Literary Research, keeping in mind the fundamentals laid down in the Organon of Medicine. The Academy firmly believes that the authenticity of any Research in Homoeopathy is established if it passes through the seive of the Organon of Medicine. Any venture other than this should not be considered as Homoepathy. Otherwise we would also fall in the same trap as the so called modernizers of Homoeopathy. Thus the Research should have the sanction of the Organon. Now we shall dwell upon some areas in which Newer approaches are necessary. They being -
1. Case Taking - Much of the scenario of cases presenting at the Homoeopathic OPD has undergone a sea-change compared to those of Hahnemann’s time. A large number of mixed cases (70%) (a combination of natural symptoms, altered symptoms, suppressed symptoms, drug induced smptoms, secondary symptoms due to ultimates, those due to’environmental influences, etc.) present at the table of a homoepathic practitioner. Hence different methods of case taking have to be evolved for different types of cases. It was this very reason which prompted The National Academy Of Homoeopathy, India, to classify the cases under different case heads and their approach of case taking.
2. Diagnosis - In today’s era, the knowledge of Medicine is equally important as that of the drugs. One has to make both the nosological diagnosis as well as the person diagnosis. Clinical Examination, pathological cum radiological investigations have become essential for diagnosing cases. Research into this area should make Homoeopaths abreast with modern diagnostic technologies & their clinical application in therapeutics. The Academy is presently working extensively in this area.
3.Drug Selection- As mentioned, the varied cases which present to the Homoepaths now demand of him to use even Rare homoeopathic remedies apart from the usual ones. Some form of specialization must be introduced in the curricula so that the Homoeopath has a defined set of patients to work upon. He will then be able to use "the lesser used remedies" often and add clinical symptoms to the Materia medica. The Academy has undertaken such works in the field of Cardiology and Allergic disorders.
4. Posology - Research into posology would be instigated when one answers the question as to why Hahnemann himself felt the need for introducing the 50 millesimal potency in the fading years of his life, in the 6th Edition of Organon. This is because he himself could realise the short comings of the Centisimal scale. Don’t we agree that a good amount of work could be done in this area too.
5. Management - Homeopathy at the time of Hahnemann was considered administration of drugs as the prime mode of treatment. Thus Homeopathic remedies were the only weapons available. Whereas today the patients are required to be Managed (the medicinal part constitutes only 30 - 40% of the lot). More emphasis has to be laid on the auxillary measures, psychotherapy, physiotherapy, counselling & mechanical aids. Thus today we should strive for a Broad based Mangement.
6. Scope of Homoeopathy in Surgery - Very few authenticated researches are there regarding the scope of Homoeopathy in management of pre, peri & postoperative patients. Likewise effective and prompt management of Pain and Anasthesia also demand good amount of Research. The Department of Gynecology, at Shaad Hospital Complex and Research Centre, Nagpur, the working headquarters of the Academy is actively involved in these areas for past 18 years.
7. Scope of Homoeopathy in Emergencies -Medical Emergencies are really a challenge to any physician be it from any pathy. There exist very few authenticated documented papers published in reliable Periodicals on the use of homoeopathic drugs in clinical emergencies. Here, the Department of Cardiology of The National Academy of India, is carrying out a 5 year Clinical research on the Scope of Homoeopathy in Ischemic Heart Disease (Acute & Chronic Coronary syndromes) since January, 2004.
8.Updating the Literature - The Homoeopathic literature has to be updated keeping in view the trends and terminologies of today. Likewise there are areas like Perception of Evolution of Miasms, Publication of well documented clinical works etc.which require special emphasis.
INFINE : Before we close we would like to put a word of caution to the fraternity. Today in name of RESEARCH & progress, new drugs are being proved and applied in the most unscientific manners, not based on Organon, new concepts are being coined, new methods of application of remedies are being practised and preached etc. Unfortunately, it is saddening that majority of these have drifted far away from the basic fundamentals laid down in the Organon. Such so called Researches will bring a doom of Homoeopathy just like it has faced in Germany, United States & United Kingdom.
Dyslipidemia - A Homoeopathic Insight
INTRODUCTION: Atherosclerotic vascular disease - the epidemic of this century, is a metabolic disease gaining a strong foothold in the human community at large, especially the younger generation. Moreover numerous epidemiological studies have proved beyond doubts that Asian Indians have the highest rates of atherosclerotic coronary artery disease (CAD) of any ethnic group, despite the fact that nearly half of this group are life-long vegetarians. It occurs early in age and generally follows a malignant course.
In this era of Mixed Miasms, atherosclerotic disorders stand out to the fore. Its a process that begins in early childhood continues throughout life and becomes clinically apparent only in early middle age or later as seen in Indians. Although the incidence of classic risk factors are Hypercholesterolemia, high triglyceride and low high-density lipoprotein cholesterol levels, high lipoprotein (a) levels, and apple-type obesity all show a substantial prevalence in our population. At the Shaad Heart Care Centre - the research wing of The National Academy of Homoeopathy India, we measured Serum Total cholesterol levels in 147 young healthy men aged 16 -26 years between March to October, 2001. The values were predictive of the risk of coronary artery disease in 67% of the sample studied.
PLASMA LIPIDS:
The following are Serum lipids, the variation in values of which constitute dyslipidemia
Serum Total Cholesterol
Serum Triglycerides
Serum Low Density Lipoprotein Cholesterol (LDL-C)
Serum Very Low Density Lipoprotein Cholesterol (VLDL-C)
Serum High Density Lipoprotein Cholesterol (HDL - C)
Serum Apolipoprotein B
Serum Apolipoprotein A1
Serum Lipoprotein (a)
The cholesterol levels in the first few months of life increase tremendously due to changes in LDL. Over the next 17-20 years the values stabilize in both sexes between 150 -170 mg/dl. Thus children with high cholesterol levels tend to have higher levels as young adults too and vice-versa. The HDL cholesterol levels remain stable in females but decline significantly in the 2nd decade in Males. Plasma triglycerides stabilize to a mean of 75 mg/dl by 20 years of age. A strong association exists between the presence of coronary artery disease and elevated Lipoprotein (a) concentration (30mg/dL and<). Most series of young coronary patients have shown that obesity is more common than in controls.
Despite the association of obesity with ischemic heart disease there is still considerable debate on whether it constitutes an independent risk factor. Although some children suffer from well-defined familial hyperlipidemia, the majority do not have such syndromes. Also, those with hyperlipidaemia are at increased risk for heart disease yet not all such individuals acquire clinical heart disease. Why?
HOMOEOPATHIC VIEW POINT:
Well! the answer to the above question lies not in hyperlipdaemia alone but the Tendency of Atherogensis due to hyperlipidaemia. This is a Psoro-sycotic phenomenon. The end result or the Disease Ultimate is a Thrombus or an Atheroma (single or multiple). This Atheroma is composed of fatty streaks of Blood lipids, platelets and calcium. All of which find a nidus on the injured intima of the arteries and arterioles. Acute coronary syndromes like Angina pectoris (stable or unstable), myocardial infarction or congestive cardiac failure are the secondary effects of this tertiary sycotic miasm - a useless deposition of lipid-platelet-calcium complex in the coronaries. Likewise, such depositions can occur in any blood vessel of any major organs, thereby exhibiting the respective clinical syndromes as Stroke, Pulmonary thromboemolism & infarction, peripheral arterial disease, arteriolar nephrosclerosis, etc. As the miasmatic schedule shifts deeper from the functional to organic plane, even the veins which are ordinarily free of atheroma develop the lesions when pressure within them is increased.
CLINICAL FEATURES - Depending upon the arterial affection of a particular organ system, the clinical features differ. Majority are asymptomatic till late. Many show early tendency to obesity like children of Antim crudum, or calc carb etc.
When the coronaries are stenosed then we have a spectrum of clinical entities ranging from easy fatiguability, angina pectoris (stable, unstable, prinzmetal), myocardial infarction and its attendent consequences or complications
When the carotid or vertibro-basilar system has clinically significant atheromatous plaques then again we have a different array of stroke syndromes - Transient ischemic attacks, Vertebrobasilar artery insufficiency, Reversible ischemic neurological deficit, Completed Stroke.
When the peripheral circulatory tree is affected then we have clinical entities as Burgers disease leading to Gangrene of the affected part.
MANAGEMENT:
Dietary Management - First approach and mainstay of dyslipidaemia remains dietary modification. The physician should seek to achieve the ideal body weight maintaining normal growth velocities in all cases. Dietary modification is safe in the treatment of hyperlipidemia in adults and children older than 2 years of age but the younger children should be excluded from such modifications because of importance of dietary fat in neural growth and development. In patients with elevated total or LDL cholesterol (Cholesterol = 200 mg/dl and LDL Cholesterol = 130 mg/dl), diet should be designed to reduce total fat intake to less than 30% of total calories (10% each of saturates, mono unsaturates, & poly unsaturates) and to reduce the cholesterol intake to less than 100 mg / 1000 calories/day. The minimum goal is to achieve LDL Cholesterol to less than 110 mg/dl.
Acute Management - Although a constitutional approach is the sublime and true homoeopathic approach, yet at times certain cases require aggressive lowering of plasma lipid levels. The management of clinical emergencies as myocardial infarction or gangrene due to the atherogenesis or dyslipidemia constitutes a seperate entity and requires comprehensive managerial skills, tools and remedies, but the discussion is beyond the scope of this topic. At our set-up, we have extensively used the following drugs with miraculous and reliable results.
a) Vipera
b) Terminalia Arjuna
c) Ferrula Sumbul
3. Constitutional Antimiasmatic management - This ultimately forms the key feature of homoeopathic management of any metabolic disorder -especially atherosclerois and /or dyslipidemia
In this era of Mixed Miasms, atherosclerotic disorders stand out to the fore. Its a process that begins in early childhood continues throughout life and becomes clinically apparent only in early middle age or later as seen in Indians. Although the incidence of classic risk factors are Hypercholesterolemia, high triglyceride and low high-density lipoprotein cholesterol levels, high lipoprotein (a) levels, and apple-type obesity all show a substantial prevalence in our population. At the Shaad Heart Care Centre - the research wing of The National Academy of Homoeopathy India, we measured Serum Total cholesterol levels in 147 young healthy men aged 16 -26 years between March to October, 2001. The values were predictive of the risk of coronary artery disease in 67% of the sample studied.
PLASMA LIPIDS:
The following are Serum lipids, the variation in values of which constitute dyslipidemia
Serum Total Cholesterol
Serum Triglycerides
Serum Low Density Lipoprotein Cholesterol (LDL-C)
Serum Very Low Density Lipoprotein Cholesterol (VLDL-C)
Serum High Density Lipoprotein Cholesterol (HDL - C)
Serum Apolipoprotein B
Serum Apolipoprotein A1
Serum Lipoprotein (a)
The cholesterol levels in the first few months of life increase tremendously due to changes in LDL. Over the next 17-20 years the values stabilize in both sexes between 150 -170 mg/dl. Thus children with high cholesterol levels tend to have higher levels as young adults too and vice-versa. The HDL cholesterol levels remain stable in females but decline significantly in the 2nd decade in Males. Plasma triglycerides stabilize to a mean of 75 mg/dl by 20 years of age. A strong association exists between the presence of coronary artery disease and elevated Lipoprotein (a) concentration (30mg/dL and<). Most series of young coronary patients have shown that obesity is more common than in controls.
Despite the association of obesity with ischemic heart disease there is still considerable debate on whether it constitutes an independent risk factor. Although some children suffer from well-defined familial hyperlipidemia, the majority do not have such syndromes. Also, those with hyperlipidaemia are at increased risk for heart disease yet not all such individuals acquire clinical heart disease. Why?
HOMOEOPATHIC VIEW POINT:
Well! the answer to the above question lies not in hyperlipdaemia alone but the Tendency of Atherogensis due to hyperlipidaemia. This is a Psoro-sycotic phenomenon. The end result or the Disease Ultimate is a Thrombus or an Atheroma (single or multiple). This Atheroma is composed of fatty streaks of Blood lipids, platelets and calcium. All of which find a nidus on the injured intima of the arteries and arterioles. Acute coronary syndromes like Angina pectoris (stable or unstable), myocardial infarction or congestive cardiac failure are the secondary effects of this tertiary sycotic miasm - a useless deposition of lipid-platelet-calcium complex in the coronaries. Likewise, such depositions can occur in any blood vessel of any major organs, thereby exhibiting the respective clinical syndromes as Stroke, Pulmonary thromboemolism & infarction, peripheral arterial disease, arteriolar nephrosclerosis, etc. As the miasmatic schedule shifts deeper from the functional to organic plane, even the veins which are ordinarily free of atheroma develop the lesions when pressure within them is increased.
CLINICAL FEATURES - Depending upon the arterial affection of a particular organ system, the clinical features differ. Majority are asymptomatic till late. Many show early tendency to obesity like children of Antim crudum, or calc carb etc.
When the coronaries are stenosed then we have a spectrum of clinical entities ranging from easy fatiguability, angina pectoris (stable, unstable, prinzmetal), myocardial infarction and its attendent consequences or complications
When the carotid or vertibro-basilar system has clinically significant atheromatous plaques then again we have a different array of stroke syndromes - Transient ischemic attacks, Vertebrobasilar artery insufficiency, Reversible ischemic neurological deficit, Completed Stroke.
When the peripheral circulatory tree is affected then we have clinical entities as Burgers disease leading to Gangrene of the affected part.
MANAGEMENT:
Dietary Management - First approach and mainstay of dyslipidaemia remains dietary modification. The physician should seek to achieve the ideal body weight maintaining normal growth velocities in all cases. Dietary modification is safe in the treatment of hyperlipidemia in adults and children older than 2 years of age but the younger children should be excluded from such modifications because of importance of dietary fat in neural growth and development. In patients with elevated total or LDL cholesterol (Cholesterol = 200 mg/dl and LDL Cholesterol = 130 mg/dl), diet should be designed to reduce total fat intake to less than 30% of total calories (10% each of saturates, mono unsaturates, & poly unsaturates) and to reduce the cholesterol intake to less than 100 mg / 1000 calories/day. The minimum goal is to achieve LDL Cholesterol to less than 110 mg/dl.
Acute Management - Although a constitutional approach is the sublime and true homoeopathic approach, yet at times certain cases require aggressive lowering of plasma lipid levels. The management of clinical emergencies as myocardial infarction or gangrene due to the atherogenesis or dyslipidemia constitutes a seperate entity and requires comprehensive managerial skills, tools and remedies, but the discussion is beyond the scope of this topic. At our set-up, we have extensively used the following drugs with miraculous and reliable results.
a) Vipera
b) Terminalia Arjuna
c) Ferrula Sumbul
3. Constitutional Antimiasmatic management - This ultimately forms the key feature of homoeopathic management of any metabolic disorder -especially atherosclerois and /or dyslipidemia
Sunday, November 2, 2008
CARDIAC REHABILITATION
Cardiac rehabilitation is a medically supervised individualized program designed to improve the quality of life in terms of physical, mental, spiritual and social functioning after a cardiac event. The final goal is to stabilize, slow and when possible to reverse the progression of cardiovascular disease, reducing the possibilities of another cardiac event or early death. Rehabilitation should start as soon as the patient is medically stable. This concept is already established in developed countries but is yet to gain momentum in developing countries including India.
Today, Homoeopathy has achieved its due place in the medical fraternity. It is also seriously attempting to develop itself on scientific lines so as to shoulder its responsibility of catering the Sick in this era of fast changing disease scenario. Apart from its domain of holistic care, it has proved effective in managing cases where advanced pathological changes have effectuated. Although, technological advances have enabled us to precisely localize pathologies, yet the cure for many such disorders remains a dream. It is here that scientific homoeopathy is playing a vital role. Today, an inter-disciplinary approach is the need of the hour. It requires an understanding of the separate contributions made by other disciplines within the ambits of their fundamentals and the integration of that information into a unified whole. This shall reflect on our services to our patients.
The National Academy of Homoeopathy, India is committed to the propagation and advancement of Scientific Homoeopathy. It has already taken a leap towards this goal of Cardiac rehabilitation by establishing a separate department of homoeopathic cardiology in 2004 at Nagpur. Our cardiac rehab program entitled “Dil Ki Seva (A)Dil Se” includes:
1. A detailed history is taken as soon as the patient registers. It includes the causation, onset, modalities, symptoms of heart disease, life-space, mental state (before and after the cardiac event), physical generals and their alterations, past, personal and family history. 2. Initially, if the patient is symptomatic, palliative homoeopathic remedies are used. Once settled then the patient is prepared to receive Constitutional Homoeopathic treatment.
3. Counseling the patient and care takers so that they can understand how homoeopathy can help them to manage the disease process and the patient.
4. Beginning an individualized structured exercise program
5. Diet planning - increased intake of fibers, reduction in saturated fats, change of cooking oil to sunflower or safflower; and reduction of quantum of common salt.
6. Helping the patient modify maintaining factors of heart disorders as mental stress, smoking, alcoholism, other addictions, physical inactivity, obesity, etc.
7. Providing vocational guidance to enable the patient to return to work. Account is taken of the type of work, the environment and patient’s psychological state.
8. Supplying information on physical and sexual limitations
9. Lending emotional support to tackle depression (42%: our centre) and anxiety (31%: our centre) that are the most frequent accompaniment of any heart disease.
10. Educating the patient that almost everyone with heart disease can benefit from some type of cardiac rehabilitation. No one is too old or too young and emphasizing that the most important person in the rehabilitation team is the patient. Patients should be encouraged to take charge of their own recovery.
11. Underlining the fact that feedback is an important requirement for deciding the correctness of the first prescription, to decide the second prescription, potency selection and other auxillary measures that are adopted for management. It should be in the form of a daily dairy or record book.
In our experience, the long-term success of any such program is directly related to patient compliance. Evidence suggests that such a holistic approach is the only sure way that benefits patients. And those who quit smoking and tobacco significantly reduce their risks of another heart attack, sudden death, stroke and total mortality compared with those who continue to smoke.
We have found that when supervised by a homoeopathic physician, cardiac rehabilitation is helpful to patients with
1. Angina pectoris and recent myocardial infarct,
2. Patients who have undergone recent Coronary artery bypass graft surgery or PTCA (Balloon angioplasty)
3. Congestive heart failure (stable),
4. Pacemaker implant candidates for heart blocks,
5. Heart valve replacements
6. Persons with peripheral arterial disease,
7. Patients with congenital heart disease who may or may not have had surgery
8. Heart transplant recipients.(We still have not had any transplant candidates at our centre)
Infine - Combining all aspects of cardiovascular rehabilitation in appropriate patients improves functional capacity, quality of life, reduces or eliminates maintaining factors and curtails the miasmatic evolution of the sickness. This in turn creates not only a sense of well-being but also optimism about the future. So dear homoeopaths, let us start rehabilitating our cardiac patients!
Today, Homoeopathy has achieved its due place in the medical fraternity. It is also seriously attempting to develop itself on scientific lines so as to shoulder its responsibility of catering the Sick in this era of fast changing disease scenario. Apart from its domain of holistic care, it has proved effective in managing cases where advanced pathological changes have effectuated. Although, technological advances have enabled us to precisely localize pathologies, yet the cure for many such disorders remains a dream. It is here that scientific homoeopathy is playing a vital role. Today, an inter-disciplinary approach is the need of the hour. It requires an understanding of the separate contributions made by other disciplines within the ambits of their fundamentals and the integration of that information into a unified whole. This shall reflect on our services to our patients.
The National Academy of Homoeopathy, India is committed to the propagation and advancement of Scientific Homoeopathy. It has already taken a leap towards this goal of Cardiac rehabilitation by establishing a separate department of homoeopathic cardiology in 2004 at Nagpur. Our cardiac rehab program entitled “Dil Ki Seva (A)Dil Se” includes:
1. A detailed history is taken as soon as the patient registers. It includes the causation, onset, modalities, symptoms of heart disease, life-space, mental state (before and after the cardiac event), physical generals and their alterations, past, personal and family history. 2. Initially, if the patient is symptomatic, palliative homoeopathic remedies are used. Once settled then the patient is prepared to receive Constitutional Homoeopathic treatment.
3. Counseling the patient and care takers so that they can understand how homoeopathy can help them to manage the disease process and the patient.
4. Beginning an individualized structured exercise program
5. Diet planning - increased intake of fibers, reduction in saturated fats, change of cooking oil to sunflower or safflower; and reduction of quantum of common salt.
6. Helping the patient modify maintaining factors of heart disorders as mental stress, smoking, alcoholism, other addictions, physical inactivity, obesity, etc.
7. Providing vocational guidance to enable the patient to return to work. Account is taken of the type of work, the environment and patient’s psychological state.
8. Supplying information on physical and sexual limitations
9. Lending emotional support to tackle depression (42%: our centre) and anxiety (31%: our centre) that are the most frequent accompaniment of any heart disease.
10. Educating the patient that almost everyone with heart disease can benefit from some type of cardiac rehabilitation. No one is too old or too young and emphasizing that the most important person in the rehabilitation team is the patient. Patients should be encouraged to take charge of their own recovery.
11. Underlining the fact that feedback is an important requirement for deciding the correctness of the first prescription, to decide the second prescription, potency selection and other auxillary measures that are adopted for management. It should be in the form of a daily dairy or record book.
In our experience, the long-term success of any such program is directly related to patient compliance. Evidence suggests that such a holistic approach is the only sure way that benefits patients. And those who quit smoking and tobacco significantly reduce their risks of another heart attack, sudden death, stroke and total mortality compared with those who continue to smoke.
We have found that when supervised by a homoeopathic physician, cardiac rehabilitation is helpful to patients with
1. Angina pectoris and recent myocardial infarct,
2. Patients who have undergone recent Coronary artery bypass graft surgery or PTCA (Balloon angioplasty)
3. Congestive heart failure (stable),
4. Pacemaker implant candidates for heart blocks,
5. Heart valve replacements
6. Persons with peripheral arterial disease,
7. Patients with congenital heart disease who may or may not have had surgery
8. Heart transplant recipients.(We still have not had any transplant candidates at our centre)
Infine - Combining all aspects of cardiovascular rehabilitation in appropriate patients improves functional capacity, quality of life, reduces or eliminates maintaining factors and curtails the miasmatic evolution of the sickness. This in turn creates not only a sense of well-being but also optimism about the future. So dear homoeopaths, let us start rehabilitating our cardiac patients!
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