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Dr. Abdul Quadeer PDF
Dr. Abdul Quadeer PDF
APPROACH
AND HOMOEOPATHIC MANAGEMENT”
By
Dr. ABDUL QUADEER
1
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE
the guidance of Dr. P. SAMPATH RAO, HOD & professor Department of Organon
Hospital Gulbarga.
Signature of the
candidate
Date:
Place: Gulbarga Dr. Abdul Quadeer
2
CERTIFICATE BY THE GUIDE
partial fulfillment of the requirements for the award of the degree of Doctor of
Date:
Place: Gulbarga Dr. P. Sampath Rao
M.D. (Homoeo)
Principal, Professor,guide & HOD
Department of Organon of Medicine &
Homoeopathic Philosophy H.K.E.’S
Homoeopathic Medical College &
Hospital, Gulbarga
3
ENDORSEMENT BY THE HOD, PRINCIPAL/
HEAD OF THE INSTITUTION
4
COPYRIGHT
Bangalore (Karnataka) shall have the rights to preserve, use and disseminate this
5
ACKNOWLEDGEMENT
more valuable than independence. No endeavor can start, continue and complete
without the blessings of almighty god. And I thank him for always being my side. I
I am deeply indebted to my Guide, Dr. Sampath Rao M.D (Hom), and HOD &
dissertation. He has always been available when I needed his advice and has guided
Philosophy, for his unflinching valuable support and advice during the course of my
study.
M.D (Hom), for their unflinching valuable support and constant encouragement during
My heartfelt thanks to our P.G. Co-ordinator Dr.Ashok Patil M.D (Hom). Prof.
I express my gratitude to our teacher Dr.Krishna M.D (Hom), Prof. & HOD,
Department of Repertory.
6
I express my gratitude to our teacher Dr.Rajeshwari K M.D (Hom), Prof. & HOD,
Department of Materia Medica.
I express my gratitude to our teacher Dr.Meena P. M.D (Hom), Prof., Department
of Organon of Medicine..
I express my gratitude to our teacher Dr.C.V.Padashetty M.D (Hom), Prof.,
Department of Organon of Medicine.
I express my sincere thanks to our teacher Dr.Mahadev Pasar M.D (Hom),
7
LIST OF ABBREVIATIONS USED`
HTN Hypertension
MI Myocardial infarction
OA Osteoarthritis
RA Rhermatoid Arthrites
TB Tuberculosis
8
ABSTRACT
Background:
Warts are small circumscribed, epidermal papillary elevations of skin. Various
forms of warts are described as per their shape and their predominant characteristics.
Cause of the warts is human papilloma virus.
There are different types in warts namely, flat warts, Filiform warts, Common
warts, Plantar warts.
Objectives:
1) To study the miasmatic background and its implication in warts.
2) To assess the efficacy of homoeopathic remedies in the treatment of warts.
Methods
The present study consisted 30 patients of Warts who attended the OPD, IPD of
H.K.E.’s Homoeopathic Medical College & Hospital, and Gulbarga. And OPD of
village camp, during my study period.
The cases of warts were selected on the basis of following inclusion & exclusion
criteria:
The cases were recorded according to standard case format. This format was prepared
according to homoeopathic methods of case taking.
The cases were recorded by keeping the Holistic & concept of Individualization in
mind.
The Miasmatic diagnosis was done in each and every case using different books. The
miasmatic diagnosis is done on the basis of totality of symptoms, past history and
family history.
All the cases were diagnosed according to the symptoms and signs and also with the
help of investigations like punch biopsy.
9
All the cases were reviewed once in 7, 15, 30 days as the need arouse & were
followed for a period of minimum 6 months.
Results
The result of this study showed that the miasmatic background in most of the
9 cases (30%) showed improvement and 7 cases (23.33%) did not show improvement.
Keywords:
Common warts; Flat warts: Plantar warts: Filiform warts; Human Papilloma
Virus
10
TABLE OF CONTENTS
1. Introduction 1
2. Objectives 4
3. Review of Literature 5
4. Methodology 58
5. Results 63
6. Discussions 73
7. Conclusion 77
8. Summary 78
9. Bibliography 80
10. Annexures 84
11
LIST OF TABLES
12
LIST OF FIGURES
1. Anatomy of Skin 14
13
Introduction
Types of warts are Flat warts, Filiform warts, Common warts, Plantar
warts.
14
disease Gonorrhea when suppressed alters the susceptibility of the human
beings therefore it is said that the cause of the disease is not from outside
the patient. The true cause of the disease is in the patient himself internal
cause psora, sycosis, syphilis or of any two or of all the three of them.
15
scarring and recurrent 0ccurance of warts often as a ring around the treated
site. Procedure is painful
16
OBJECTIVES
17
REVIEW OF LITERATURE
18
Myrmecia is the name given to warts dwarfer and harder than the
thymion. Their roots are deeper, they are more painful, they are broader
at the base that at the summit, they are less disposed to bleed and they are
hardly ever exceed the dimensions of a lupin in size. They are met in the
palms of the hands and the soles of the feet.
Causation of warts:
19
In 1894 Variot, inoculated warts from a child to an adult there
after Jadassohn confirmed the infective nature of warts by inoculation
experiments
20
Anatomy of Skin
Development of skin.
Epidermis
21
superficial to it. By 11 weeks, cells from the stratum germinativum have
formed an intermediate layer.Replacement of peridermal cells continues
until about the twenty-first week; thereafter, the periderm disappears and
the stratum corneum forms.
Proliferation of cells in the stratum germinativum also forms
epidermal ridges, which extend into the developing dermis; these ridges
begin to appear in embryos at 10 weeks and are permanently established
by the seventeenth week. The epidermal ridges produce grooves on the
surface of the palms of the hands and the soles of the feet, including the
digits. The type of pattern that develops is determined genetically and
constitutes the basis for examining fingerprints in criminal investigations
and medical genetics.
Late in the embryonic period, neural crest cells migrate into the
mesenchyme of the developing dermis and differentiate into melanoblasts.
Later these cells migrate to the dermoepidermal junction and differentiate
into melanocytes. The diffefrntiation of melanoblasts into melanocytes
involves the formation of pigment granules. melanocytes appear in the
developing skin at 40 to 50 days, immediately after the migration of neural
crest cells. The melanocytes begin producing melanin before birth and
distribute it to the epidermal cells. The relative content of melanin in the
melanocytes accounts for the different colors of skin.
Dermis
The dermis develops from mesenchyme, which is derived from the
mesoderm underlying the surface ectoderm. Most of the mesenchyme that
22
differentiates into the connective tissue of the dermis originates from the
somatic layer of lateral mesoderm; however, some of it is derived from the
dermatomes of the somites.
Two kinds of glands, sebaceous and sweat glands, are derived from
the epidermis and grow into the dermis. The mammary glands develop in a
similar manner.
Most sebaceous glands develop as buds from the sides of
developing epithelial root sheaths of hair follicles . the glandular buds
23
grow into the surrounding embryonic connective tissue and branch to form
the primordia of several alveoli and their associated ducts.
The central cells of the alveoli break down, forming an oily
secretion –sebum-that is released into the hair follicle and passes to the
surface of the skin, where it mixes with desquamated peridermal cells to
form vernix caseosa. Sebaceous glands independent of hair follicles
develop in a similar manner to buds from the epidermis.
Sweat glands
Hairs begin to develop early in the fetal period , but they do not
become easily recognizable until about the twentieth week , hairs are first
recognizable on the eyebrows, upper lip, and chin. A hair follicle begins as
a proliferation of the stratum germinativum of the epidermis and extends
into the underlying dermis.
The first hairs that appear- lanugo hairs (L. lana, wool)-are fine,
soft, and lightly pigmented. Lanugo hairs begin to appear toward the end
of the twelfth week and are plentiful by 17 to20 weeks. These hairs help to
hold the vernix caseosa on the skin. Lanugo hairs are replaced during the
perinatal period by coarser hairs. Melanoblasts migrate into the hair bulbs
and differentiate into melanocytes.
25
Development of nails
THE EPIDERMIS
There are several layers of cells in the epidermis which extend from
the superficial` stratum corneum (horny layer) to the deepest germinative
layer. The cells on the surface are flat, thin, non-nucleated, dead cells in
which the protoplasm has been replaced by keratin.
Cells on the surface are constantly being rubbed off and they are
replaced by cells which originated in the germinative layer and have
undergone gradual change as they progressed towards the surface.
26
Figure 1.
The epidermis contains 5 layers. From bottom to top the layers are named:
stratum basale
stratum spinosum
stratum granulosum
stratum licidum
stratum corneum
There are four major layers of keratinocytes (the structural cells) in the
epidermis and one layer that is present only in certain parts of the body.
The bottom layer, the stratum basale, has cells that are shaped like
columns. In this layer the cells divide and push already formed cells into
higher layers. As cells move into the higher layers, they flatten and
eventually die. We will take a closer look at the characteristics of each of
these layers.
27
Stratum basale
Stratum spinosum
Cells that move into the spinosum layer (also called prickle cell layer)
change from being columnar to polygonal. In this layer the cells start
to synthesize keratin.
Stratum granulosum
The cells in the stratum granulosum, or granular layer, have lost
their nuclei and are characterized by dark clumps of cytoplasmic material.
There is a lot of activity in this layer as keratin proteins and water-
proofing lipids are being produced and organized.
Stratum lucidum
The stratum lucidum layer is only present in thick skin where it
helps reduce friction and shear forces between the stratum corneum and
stratum granulosum.
Stratum Corneum
The cells in the stratum corneum layer are known as corneocytes. The cells
have flattened out and are composed mainly of keratin protein which
provides strength to the layer but also allows the absorption of water.
Stratum cornerium
28
The structure of the stratum corneum layer looks simple, but this layer is
responsible for maintaining the integrity and hydration of the skin - a very
important function. There are actually complex processes that are at work
in the stratum corneum and minimal disruptions of any of these processes
can cause a variety of skin problems.3
Melanocytes:
29
Langerhans cells:
Langerhans cells originate from the bone marrow and are found in
the basal, spinous, and granular layers of the epidermis. They serve as
antigen-presenting cells. They are capable of ingesting foreign antigens,
processing them into small peptide fragments, binding them with major
histocompatibility complexes, and subsequently presenting them to
lymphocytes for activation of the immune system. An example of
activation of this component of the immune system is contact
hypersensitivity.
Merkel cells:
Merkel cells, also derived from neural crest cells, are found on the
volar aspect of digits, in nail beds, on the genitalia, and in other areas of
the skin. These cells are specialized in the perception of light touch.4
Dermis:
On its deep surface, the dermis is usually connected to the underlying tela
subcutanea, commonly termed the superficial fascia. The loose texture of
this layer provides easy movement of the skin over the underlying
structures. In some locations, howege, the dermis is bound tightly to
30
underlying deep structures, either over ageneral area . or over localizaed
areas, the attachment of the skin to the tela subcutanea and deeper
structures is through connective tissue bands, the retinacula cutis. Where
these are locally well developed and are attavhed to firm, deepler- lying
tissue, they produce permanent folds and dimples in the skin.
Lymph vessels. These form a network throughout the dermis and the
deeper layers of the epidermis.
Sebaceous glands
Sebaceous glands, or holocrine glands, are found over the entire surface of
the body except the palms, soles, and dorsum of the feet. They are largest
and most concentrated in the face and scalp where they are the sites of
origin of acne. The normal function of sebaceous glands is to produce and
secrete sebum, a group of complex oils that include triglycerides and fatty
acid breakdown products, wax esters, squalene, cholesterol esters, and
31
cholesterol. Sebum lubricates the skin to protect it against friction and
makes the skin more impervious to moisture.
Sweat glands
Sweat glands, or eccrine glands, are found over the entire surface of the
body except the vermillion border of the lips, the external ear canal, the
nail beds, the labia minora, and the glans penis and the inner aspect of the
prepuce. They are most concentrated in the palms and soles and the
axillae.
Apocrine glands are similar in structure, but not identical, to eccrine glands.
They are found in the axillae, in the anogenital region, and, as modified
glands, in the external ear canal (ceruminous glands), the eyelid (Moll's
glands), and the breast (mammary glands). They produce odor and do not
function prior to puberty, which means they probably serve a vestigial
function. The mammary gland is considered a modified and highly
specialized type of apocrine gland.5
Hair follicles
Hair follicles are complex structures formed by the epidermis and dermis.
(See the image below.) They are found over the entire surface of the body
except the soles of the feet, palms, glans penis, clitoris, labia minora,
mucocutaneous junction, and portions of the fingers and toes. Sebaceous
32
glands often open into the hair follicle rather than directly onto the skin
surface, and the entire complex is termed the pilosebaceous unit.
Caucasian hair follicles are oriented obliquely to the skin surface, whereas
the hair follicles of black persons are oriented almost parallel to the skin
surface. Asian persons have vertically oriented follicles that produce
straight hairs. These anatomic variations are an important consideration in
avoiding alopecia when making incisions in the scalp.
The base of the hair follicle, or hair bulb, lies deep within the dermis and,
in the face, may actually lie in the subcutaneous fat. This accounts for the
remarkable ability of the face to re-epithelialize even the deepest
cutaneous wounds. A band of smooth muscle, the arrector pili, connects
the deep portion of the follicle to the superficial dermis. Contraction of
this muscle, under control of the sympathetic nervous system, causes the
follicle to assume a more vertical orientation.6
Hair growth exhibits a cyclical pattern. The anagen phase is the growth
phase, whereas the telogen phase is the resting state. The transition
between anagen and telogen is termed the catagen phase. Phases vary in
length according to anatomic location, and the length of the anagen phase
is proportional to the length of the hair produced. At any one time at an
anatomic location, follicles are found in all 3 phases of hair growth. This is
extremely important for laser hair removal, because follicles in the anagen
phase are susceptible to destruction, whereas resting follicles are more
resistant. This explains why multiple treatments of an area may be
necessary to ensure adequate hair removal.7
33
Physiology of Skin
34
arrector pili muscles. Excessive amount of sebum may become impacted
in the duct and this associated with hyperkeratinisation may lead to it
being blocked to form a comedo.
Secretion of sweat gland is a colorless fluid of slightly salty taste, although
it may alkaline or acidic in reaction. It is 99.05% water with certain
organic acids and number of salts of blood. It is quite volatile, easily
evaporating.
Composition of sebum:
Composition of sebum is not fully known. Sebum has a characteristic
color. Sebum is rich in fatty acids, saponified fats, palmatin, olin, stored
cholesterol, cholesterol esters, triglycerides, wax esters and other aliphatic
components.
Control:
Sebum secretion is controlled by central nervous system, existing probably
in spinal cord and medulla. Hormonal regulation of sebaceous gland is
well established. Experimental evidences suggest that excess
administration of progesterone causes pronounced enlargement of
sebaceous glands. This has given rise to the believe that in females, acne is
insisted by progesterone formed by the corpus luteum of the ovary.
Estrogen—reduces the size of sebaceous gland. Inhibits formation of
sebum in humans. Current evidence suggest that sebum production is
stimulated primarily by androgens secreted either from adrenal gland testis
or ovaries. Contraction of arrectores pilorum helps in expulsion of sebum.
These muscles contract by application of cold, during excitement and in
response to adrenaline.
Functions of Sebum:
1). Acts as bacteriostatic agent. And as a lubricant.
2). Has property of preventing damage of epidermis during hot season and
conservation of heat during cold.
3). Keeps the skin moist.
4). Prevents too much rapid evaporation from cut surfaces.
35
Functions of sebaceous glands:
Lymphatics;
All portions of the skin are provided with a system of lymphatic channels,
which aid in the important processor of absorption. Lymph vessels proper
are relatively few and are commonly mere appendages of blood vessels.
Nerve Supply:
The skin is well endowed with medullated and non medullated sensory
nerve fibres and via non medullated autonomic fibres supplying blood
vessels and appendages. Conspicuous nerve supply consist of plexuses in
the papillae, meissner’s corpuscles, Pacinian’s corpuscles, Merkel’s discs
and nerve endings in the basal of epidermis.
Functions of skin
36
Protect the body against abrupt changes in temperature,
maintain homeostasis
Help excrete waste materials through perspiration.
Act as a receptor for touch, pressure, pain, heat, and cold)
Protect the body against sunburn by secreting melanin
Generate vitamin D through exposure to ultraviolet light.
Store water salt, glucose, and vitamin D.
Maintenance of the body form
Formation of new cells from stratum germinativum to repair minor
injuries
Aid in physical examination as color of the skin may indicate many
conditions e.g.it becomes yellowish in jaundice.8
Verrucae(Warts).
Verrucae are common lesions of children and adolescents, although
they may be encountered at any age. They are caused by human
papillomaviruses. Trasmission of disease involves direct contact between
individuals or autoinoculation.
38
These findings are consistent with previous observations of the
association of HPV types 16 and 18 with carcinomas of the uterine cervix.
The potential relationship of papillomavirus to carcinoma is reinforced by
the rare heritable condition termed epidermodysplasia verruciformis. In
this disorder, patients develop multiple flat warts, some of which evolve to
become invasive squamous cell carcinomas. The genomes of HPV types 5
and 8 have been detected in some of these cutaneous tumors. Thus the
types of papillomavirus differ not only in the morphology of the lesions
they produce but also in their oncogenic potential.11
These three changes are quite pronounced in young verrucae vulgares. The
foci of koilocytes are located in the upper stratum malphighii and in the
granular layer. The koilocytes possess small, round, deeply basophilic
nuclei surrounded by a clear halo and pale staining cytoplasm. These cells
contain few or no keratohyaline granules, even when they are located in
the granular layer. The vertical tiers of parakeatotic cells are often located
at the crests of papillomatous elevations of the rare malpighii over lying a
focus of vaculated cells. compared with ordinary parakeratotic nuclei, the
nuclei of the parakeratotic cells in verrucae vulgaris are larger and more
deeply basophilic, and many of them appear rounded rather than
elongated.
Although no granular cells are seen over lying the papillomatous crests.
They are increased in number and size in the inter vening valleys and
contain heavy, irregular clums of keratohyaline granules. Dilated
39
capillaries and small areas of heamorrahage may be seen in the thickened
horny layer at the tip of the vertical tiers of parakeatotic cells.
Common wart
Figure 2 :
Filiform warts the papillae are more elongated then in verrucae vulgaris.
Histogenesis and viral identification: No difference has been noted in
electron microscopic appearance among the virus particles in the various
types of HPV. However the quantity varies with the different types.
Frequently, Virus particles are absent in verrucae vulgaris on electron
microscope examination.
40
Filifom wart
Figure 3
Plantar wart
Figure 4
41
of the rete ridges, and no areas of parakeratosis. In the upper stratum
malphighii, including the granular layer, there is diffuse vacuolization of
the cells. Some of the vacuolated cells are enlarged to about twice their
normal size. The nuclei of the vaculated cells lie at the center of the cells
and some of them appear deeply basophilic.
The granular layer is uniformly thickened, and the stratum corneum has a
pronounced basket weave appearance resulting from the vacuolization of
the horny cells. The dermis appears normal. In spontaneously regressing
warts, there is often a superficial lymphocytic infiltrate in the dermis with
exocytosis and apoptosis of the cells in the epidermis.
Flat wart
Figure 5
Causes :
Papilloma viruses comprise a large family of small DNA viruses found in
humans and many other species. P
Papilloma viruses are highly host specific, meaning that these from one
species do not induce papillomas in heterologous species.
So HPV infect only to the humans.
42
More than 100 HPV types have been sequenced.
The degree of relatedness of their DNA. Sequence distinguishes between
HPV types.
Cutaneous (non genital ) HPV types are HPV-1, HPV-2, HPV-3, HPV-
4.15
Clinical features :
The typical history is of newly acquired, slowly expanding, persistent, and
often scaly lesions of the skin. Over several weeks to months, the
appearance of additional nearby lesion is suggestive of local spread and
the diagnosis of HPV infections.
Coetaneous lesions: Warts are described by their clinical location or
morphology. The coetaneous of warts are varied.
1).common warts (verruca vulgaris) are scaly, rough, spiny papules or
nodules that can be found on any coetaneous surface. They are often occur
as single or grouped papules on the hands and fingers.
2). Fil form warts: They appear coetaneous horns.
3). Flat warts (Verruca Plana): Are 1-4mm, slightly elevated, flat toped
papules that have minimal scale. These are most frequently occur on the
face, hands, and legs.
4). Plantar and palmar wart: These are thick, endophytic and hyperkertotic
papules which may be painful with pressure, punctuate black dots(seats)
that become evident after saving away of the keratinous surface represent
thrombosed capillaries in the paipilloma.14
Investigation:
Punch Biopsy. : Punch biopsy are performed with round disposable
knives, ranging in diameter 2-10mm but 3mm is the smallest size likely to
give sufficient tissue for consistently accurate histological diagnosis. The
punch is an ideal procedure for diagnostic skin biopsy or removing small
lesions, and often provides a better cosmetic result than a shave biopsy.
Punch biopsies can heal by secondary intention, but punches greater than
43
3mm may produce unacceptable scaring and are best closed with one or
two sutures. Punch biopsies are easily mastered by most practitioners, are
quick, and have a low incidence of infection, bleeding , non healing, or
significant scarring. With a punch biopsy owing to size, depth, or location.
Their main advantage is the amount of tissue that can be excised, allowing
for multiple studies (culture, histopathology, immune fluorescence,
electron microscopy) from one biopsy site.11
Diagnosis:
Table - I
Differential diagnosis:
44
SINGLE LESIONS MULTIPLE
LESIONS
Consider Consider
Verruca vulgaris Arsenical keratosis
Palms and soles Callus, corn Verruca vulgaris
Epidermal Plamnoplantar
inclusion cyst keratoderma
Pyogenic Psoriasis, reactive
granuloma arthritis.
Milkers nodules Pits in basal cell
(Palms) nevus syndrome.
Orf (palms)
Rule out Rule out
Amelanotic Secondary syphilis
acrolentiginous
melanoma
Carcinoma
cuniculatum
Dorsum of hands Consider Consider
and feet
Verruca vulgaris Verruca vulgaris
Periungual Verruca planae
warts
Actinic keratosis Actinic keratosis
Acrokeratosis
verruciformes
Rule out Epidermolytic
hyperkeratosis
Squamous cell Stucco keratosis
45
carcinoma
Keratocanthoma
Tuberculosis
verrucosa cutis
Fish tank
granuloma
Differential
Diagnosis of Plane
Warts
FACE HAND TRUNK,
EXTREMITIES
Perioral dermatitis Acrokeratosis Epidermodysplasia
verruciformis verruciformis
Adenoma Lichen planus Pityriasis
sebaceum(mild) versicolor
Syringoma Stucco keratosis Superficial actinic
poeokeratosis
Flat seborrheic Seborrheic Seborrheic
keratosis keratosis keratosis
Actinic keratosis
Trichoepitheliomas
Differential
Diagnosis of
Genital warts
FLAT OR NODULAR
PAPULAR
Consider Consider
Condylomata Nevi
acuminate
Bowenoid Sebborrheic
46
papulosis keratosis
Sebaceous Angiokeratoma
glands
Pearly penile Skin tags
papules
Lichen planus
Lichen sclerosus
et atrophicus
Rule out
Rule out sSquamous cell
carcinoma
Erythroplasia Amelanotic
melanoma
Extramammary
Paget’s disease
Condylomata
lata of
secondary
syphilis.11
Complication:
47
Treatment:
Prevention:
Homoeopathic review
48
Common warts; growths around nails and the back of hands;
usually have a rough surface; grayish-yellow or brown in color.
Foot warts: Flat growths on the soles of feet (plantar warts) with
black dots (blood vessels feeding them); clusters of plantar warts are called
mosaic warts and may be extremely painful.
Flat warts: Small, smooth growths that grow in groups of 20 to 100
at a tune; most often appear on children’s faces.
Genital warts: Grow on the genitals, are sexually transmitted; are
soft and do not have a rough surface like other common warts.
Now, I say that gonorrhea and all of these latent conditions of the
body are one and the same thing; that primarily they date back to one and
the same source of course, the books will tell you that gonorrhea will
produce warts, and gonorrheal rheumatism, and will last throughout life,
and children be brought into the world with the same disease. Symptoms
of a latent gonorrhea are unknown to the books. you will find nothing of it.
Causes of warts
53
Aphorism 78 the true natural chronic diseases are those that arise
from a chronic miasm which when left to themselves, and unchecked by
the employment of those remedies that are specific for them always go on
increasing and growing worse notwithstanding the best mental and
corporeal regimen, and torment the patient to the end of his life with ever
aggravated sufferings.27
Totality of symptoms.
But when the disease is annihilated the health is restored ; and this
is the highest, the sole aim of the physician who knows the true object of
his mission, which consists not in learned sounding prating but in giving
aid to the sick.
Individualization.
56
of a case no man can practice homoeopathy, for without these no man can
individualize and see distinctions. After gathering all the particulars, one
strong general rules out one remedy and rules in another.
The law of vis inertia teaches that all internal changes of bodies in
nature are the results of an external cause, for without 'this all bodies
would remain in the same state in which they were placed. The state of the
body must be known before any change in it can be known. The cause or
reasons of the state of the body, therefore, are the conditions under which
it can be changed by any external cause.
57
causes of disease but they are the end- results of the morbid vital process,
which is disease perse.
The disease process is manifested primarily by “dynamic
alterations of the sensations and functions of our organism.27
Dhawale M. L. says that “Remove the effects and you remove the
disease, the cause of the effects”. Cessat effectus cessat causa. Empiric
medicine guesses, recommends, tries, hits and misses misses and hits
again. Scientific medicine like any other scientific art compares effects,
sensation and motion with corresponding effects, corresponding sensations
and motions.
It has Hahnemann, who paid sufficient attention, in considering the
cause of disease, to both the:
a. Soil or constitution of the patient and
Concept of susceptibility.
59
CLOSE STAURT ; “Susceptibility we mean the the general
quality or capability of living organism of receiving impressions: the
power to react to stimuli.”
It is well-known fact that the living organism is much more
susceptible to homogeneous or similar stimuli than to heterogeneous or
dissimilar stimuli.24
60
Normal susceptibility leads to a state of good health characterized
by good nutrition and a healthy outlook on life. Abnormal susceptibility,
on the other hand, affect them in the first instances and interferes with the
process of adaptation and there by leads to development of disease. The
normal susceptibility may be increased, decreased or exaggerated in the
disease.
61
manifestations of heal are psora-
unnaturally thickened syphilitic stitch
skin abscess
62
(
63
Phyllis Speight writes as follows:
psora Pseudo-psora syphisis sycosis
Eczema-papular Emzempustule.
eruptions. Herpes. Syphlis Sycosis
Urticaria Condylomata will Warts and warty
Anidrosis. Hyperidrosis and reveal the presence of growths.
Psoriasis variola Bromidrosis. both Skin lesions in
have a syco- Anidrosis. SYPHILIS and tertiary stage, warty
psoric nase. Abscess and ulcers. SYCOSIS, also eruptions or
Freckles. verruca accuminata, Growths-verruca
Fine, smooth, clear Pointed papillary filiformis, verruca
skin. growths, coxcomb and vulgaris, verruca
Goose flesh. warts. plana.
Verruca vulgaris
Abscess and found in children,
ulcerations after suffer from
injuries. Bee or bug hereditary SYCOSIS.
affect these patients Verruca filiformis
badly. comes as a tertiary
Impetigo. lesion in an acquired
The patients often form ofSYCOSIS.
have benign or Verruca plana is
malignant tumours. another hereditary
form, found more or
In tubercular and less upon the backs
syphilitic patients we of hands and faces of
see much scarring and children and young
increase in cicatricial people.
tissue. The filiformis
Leprosy. appears in adults
Th the lymphatic with acquired
temperamint we see SYCOSIS who have
the malignancies –we had it suppressed.
64
find here rich soil for Usually appear on
gonorrhea and sexual organs, trunk
syphilis. The of body-small in
tubercular patients we diameter, one-eighth
have so much of an inch long, often
difficulty in shorter, brownish or
eradicating acquered grayish, pointed with
syphilis or gonorrhea. spindle- like
attachments.
Gonorrhea runs to
gleety discharge and
strictrres, pockets and
metastasis forms, or
we have metastasis to
ovaries, broad
ligaments, tubes,
uterus, rectum and all
such complications. 30
65
Evaluation of warts:
Miasm is a dynamic energy, which cannot be seen, maism is
hostile to the life preserving vital force. It is dynamic, as it affects the
dynamic plane and there by dynamically deranges the life preserving
energy of any living creature. The basic pre-condition of a miasmatic
infection is susceptibility. After entering in the body, it tends to join the
fundamental miasm already existing in the body.
There is ample evidence both in the literature of allopathy as well
as homoeopathy, which says that the skin disorders are nothing but
expression of disturbances in the internal dynamics. The cause for this
disturbance is invariably a miasm, as it had been put-forth by Hahnemann
in ‘Chronic Diseases.37
Psoric warts:
Speight Phyllis says about psoric skin, the skin is dry, rough, dirty
or unhealthy looking as an uneasy appearance, very little suppuration in
psoric skin.30
Benerjea S. K. says :dirty, dry, harsh skin itching without pus or
discharge, sensation of burning, scaly eruptions and tendency of recurring
skin diseases. He writes warts in face, arms, and hands comes under psoric
miasm.29
66
Robert H. A.says Gonorrhea is the acute infection of the
gonococci which takes from 5-10 days to develop a urethritis after and
exposure, during this incubation period it is purely an infection; then the
local manifestations are thrown outward by nature at the point of attack as
a resentment of vital energy to the infection. If the gonorrhea thoroughly
and completely cured, practically no psychosis ever develops. Psychosis is
established after a suppressed gonorrhea. When acute infection is driven in
upon vital energy by external methods of suppressions.19
67
Syphylis:
Condylomata or veneral warts will reveal the presence of both syphilis and
psychosis also Verruca acuminate, pointed papillary growths, Cox comb.
And also gangrene or gangrenous spots could be tubercular and in dry
gangrene syphilis is always present.
Psychosis the miasm which we put in second place was well
recognized by Hahnemann for its characteristic production of
neoformation with dented or pedunculated growth resembling figs.25
Management of warts:
68
Sarkar B.K. writes : Removal of local symptoms of local affection
by tropical administration of unhomoeopathic external remedies leads to
rousing up of the internal disease and other symptoms that previously
existed in a latent stage side by side with the local application.27
Homoeopathic Therapeutics:
Kent’s Repertory enumerates 92 Homoeopathic remedies in the
chapter on Skin under Rubrics and sub-rubrics of ‘Excrescences’ and
‘Warts’, which display a spectrum reflecting all the three miasms.21
69
Thuja: Broad, conical warts easily splitting from their age on their
surface.34
Thuja: Broad, conical warts easily splitting from their edge and on
their surface. 35
70
METHODOLOGY
71
2. Chief complaints with duration: The chief or presenting
complaints of the patient were recorded in brief in chronological order.
73
ii. Repertorization: The symptoms were then taken for
repertorization and were repertorized according to raman lal patel, J. T.
Kent repertories.
iii. Miasmatic Diagnosis: Was done from the family history, past
medical history of the patient, and by miasmatic repertorization using
Ramanlal Patel’s ‘Repertory of Miasms’,Subrata Kumar Banerjea’s
miasmatic diagnosis and Phyllis speight’s a comparison of the Chronic
Miasms.
iv. Selection of the remedy: The selection of the remedy was done
based upon Constitution, Causation, Suppressions, and PQRS/Keynote
symptoms of the patient.
vii. Dosage:
Indicated medicine was prescribed in the 200th potency initially, it
was repeated in plus potency when there was no further improvement or
when there was a relapse of symptoms. Higher potencies were considered
when the lower potencies failed to give relief.
b. Auxillary measures:
14. Follow up: All cases were reviewed once in 7/15 days and
on as needed basis over a period of six months.
15. Parameters:
74
The following parameters were fixed according to the type of
response obtained after the treatment.
75
RESULTS
76
Calcara carb in 3 cases (10.00%), Lycopodium in 3 cases (10.%), Nitric
acid in 3 case (3.33%),
77
Table – III
1. 0-9 6 20%
2. 10-19 14 46.66%
3. 20-29 10 33.33%
The above table shows the incidence in age groups. The study showed
maximum incidence in age group i.e. 14 cases (46.66%) in 10-19 year age group,
where as 10 cases (33.33%) in 20-29 year age group and 6 cases (20%) in 0-9 year
age group.
Chart showing incidence in age groups
78
Table – IV
Table showing sex incidence in the treatment
1. Male 11 36.66%
Female
2. 19 63.33%
Total 30 100%
79
The above table shows the incidence of sex taken in this study, Out of 30
cases, 19 cases (63.33%) have female sex and 11 cases (36.66%) have male sex.
Table – V
Table showing the past history of the patients
1. Cauterization 06 20.00%
2. vaccination 04 13.33%
3. Eruptions 04 13.33%
The above table shows the past history of the patients. In this study, Out of 30
cases, 6 cases (33.33%) gave past history of Cauterization. 4 cases (22..22%) gave
past history of vaccination, 04 cases (22.22%) gave past history of Erutions and 04
cases (22.22%) gave a past history of Chemical
80
application.
Table – VI
Table showing the family history of the patients
2. Hypertension 04 13.33%
3. gonorrhoea 03 10.00%
4. Tuberculosis 03 10.00%
81
The above table shows the family history of the patients. In this study, Out of
30 cases, 04 cases (13.33%) gave a family history of Diabetes mellitus, 04 cases
(13.33%) gave a family history of Hypertension , 03 cases (10.00%) gave a family
history of Gonorrhoea. 03cases (10.00%) gave a family history of Tuberculosis and
03 cases (10.00%) gave a family historyof Osteo arthritis.
Table VII
Table showing different types of warts
Sl no. Different types of Total no of cases percentage
warts
1 Common warts 18 60%
2 Flat warts 4 13.33%
3 Filliform warts 1 3.33%
4 Plantar warts 7 23.33%
5 Total 30 100
The above table shows the different types of warts. In this study, Out of 30 cases, 18
cases (60%) show common warts, 4 cases (13.33%) shows Flat warts , 01 cases
(3.33%) shows Filliform warts. 7cases (23.33%) shows Plantar warts.
82
Table – VIII
2. psora 03 10%
The above table shows the incidence of miasms. In this study, miasmatic
background Psoro-Sycotic showed the highest incidence 27 cases (90%); followed by
Psora miasmatic background in 03 cases (10%).
83
Table – IX
Table showing the constitutional drugs used
84
The constitutional remedies were indicated in 30 cases. Thuja in 05 cases
(16.66%), Antimoniuc crudum in 3 cases (10.00%), Dulcamara in 6 cases (20.00%),
Causticum in 5 cases (16.66%), Sepia in 2 cases (6.66%), Calcara carb in 3 cases
(10.00%), Lycopodium in 3 cases (10.00%), Nitric acid in 3 case (10.00%).
2.5
1.5
1
0.5 No. of Cases
0 Percentage
85
Table – X
1. Recovered 14 46.66%
2. Improved 09 30%
Total 30 100%
The above table shows the results of treatment. The outcome of this study was that out
of 30 cases, 14 cases (46.66%) recovered, 9 cases (30%) showed improvement and 7
cases (23.33%) did not show improvement.
86
Graph showing Results of Treatment
16
14
14
12
10 9
8 7
0
Recovered Improved Not Improved
Result
DISCUSSION
87
warts: Long, narrow, small growths that usually appear on the eyelids,
face, neck, or lips.
The subjects of the study were selected from those patients
with selected from those patients with sciatica attending the OPD and
village camps of H.K.E.’s Homoeopathic medical college Gulbarga as per
inclusion criteria.
A total of 30 cases were selected and presented in standardized
case record. All the cases were diagnosed based on the clinical history.
The result s of various observations is discussed below under
different headings.
Age incidence:
This study establishes that the incidence of warts was more
from the first decade onwards. The study showed maximum incidence in
age group i. e. cases (46.66%) in 10 – 19 year age group, where as 10
cases (33.33%) in 20-29 year age group and 06 cases (20%) in 0-9 year
age group.
Sex incidence
There is no correlation between the sex of the patient and the
incidence of Warts. In the present study, females accounted for 19 i.
e.63.33% and males accounted for 11 i.e. 36.66% each.
Family history
It is observed in the present study 04 cases i. e.13.33 % have the
family history of diabetis mellitus, 04 cases i. e. 13.33% have the family
history of hypertension. 03 cases i.e. 10.00 % have the family history of
88
gonorrhea. 03 cases i. e. 10.00 % have the family history of tuberculosis.
03 cases i.e. 10.00% have the family history of osteoarthritis.
Miasmatic background:
According to Dr. T. P. Chatterjee,’Miasm is a sort of taint
hereditary or acquired which lies dormant in the human system but is
reactivated by circumstantial pathogens and helps to bring about
disequilibrium in vital force which in general parlance is called disease. It
acts by prolonging the disease and or by obstructing the process of cure,
even though a true Similimum has been prescribed.
In the present study, Psoro-sycotic was the predominant miasm in
maximum numbers of cases (27) i.e. 90% and followed by psoric miasm in
3 cases i. e. 10%.
Constitutional remedies.
89
When the action of a well indicated constitutional remedy gets
blocked and the patient fails to respond to further medication, the obstacles
to cure have looked for. When this analysis pointed to a miasmatic block,
an anti-miasmatic prescription has cleared the way for the constitutional
medicine to act in many of the cases.
2) Improved
3) Not improved.
90
CONCLUSION
91
Homoeopathic treatment essentially based on “The
constitutional Approach” targeting the root cause and restoring the
deviated immunity back to normal, there by cure the disease.
Summary
92
The objectives of the study are as follows:
1. To understand the miasmatic background of “warts”.
2. To know the efficacy of the homoeopathic drugs in treating
warts.
The 30 cases of warts were treated on the basis of inclusion
and exclusion criteria. The cases were recorded keeping the holistic
concept in mind.
The study was primarily aimed to understand “A clinical
study on warts its miasmatic approach and homoeopathic management”.
The facts found in the present study summarized below:
Study comprises of 30 different cases of warts.
The patient comprise of both the sexes.
Study showed warts has maximum incidence in above 10 years of
age.
Study showed female predominance in development of warts.
In the present study psora-psycotic was the predominant miasm in
maximum number of cases 27 (90%), followed by psoric miasm in 3
(10%) cases.
Among constitutional remidies Dulcamara, Nitric Acid, Thuja,
Causticum, Sepia, Calcarea Carb happened to be the constitutional
remedies. Tuberculinum, Thuja, are the inter-current remedies
commonly found indicated.
93
Bibliography
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3). http://dermatology.about.com/od/anatomy/ss/epidermis_7.htm
94
6). Roose Cornelius: Hillinshead’s Textbook of Anatomy: Printed by R. R.
Donnelley and Sons Company. Published by Lippincott Raven. 5th edition.
1997.
16). Kumar Vinay et al. Robbins and Cotran. Pathologic Basis of Disease.
Philadelphia, Pennsylvania. Published by Elsevier India Pvt. Ltd. New Delhi.
Reprint 2007.
95
17). Bolognia L. Jean et al. Dermatology. Published by Mosby Elsvier. 2nd
edition. Reprint 2008.
18) Allen J. H. “The Chronic Miasms” New Delhi; B. Jain Publishers Pvt.
Ltd; reprint edition 1998.
20) Journal : Homoeopathy For All. Vol-8. No 12( 96). December 15th 2007
28). Ghatak. N. Chronic Diseases Its cause and Cure. New Delhi. B. Jain.
Publishers Pvt. Ltd; Reprint ed 1931.
96
29). Banerjea S. K. Miasmatic Diagnosis. New Delhi. B. Jain. Publishers
Pvt. Ltd; 2003.
31). Patel R.P. Chronic Miasms in Homoeopathy and their cure with
classification of their rubrics. New Delhi. B. Jain. Publishers.
33). Farokh J. M. Diseases of the skin. New Delhi. B. Jain Publishers. Pvt.
Ltd. 1995.
97
ANNEXURE I
CASE PROFORMA :
PRELIMINARY DATA
98
EDUCATIONAL STATUS :
SOCIO ECONOMIC STATUS :
ADDRESS :
DATE :
b). mode of onset and progress of the lesion (with duration of onset) :
99
l). pain: present / absent. if yes which type of pain.
m). associated with hair fall: yes / no.
n). lesion – generalised /localised.
o). erythema: present/ absent.
p). sensitive to touch: yes/ no.
q). progress of symptom:
r). modelities:
s). concamitant:
Past history:
• Intrauterine life:
• Milestones of life:
• Vaccinations:
• Childhood disorders:
[Eczema / allergy / nutritional deficiency / tonsillitis / congenital deformity /
meningitis / primary complex / any other ENT diseases / other respiratory
disorders / others]
• Adolescent disorders:
[Koch’s / Exanthematous diseases / HTN / DM / any respiratory disorders /
allergies / prolonged medication / any surgery / trauma to head / immune
deficiency syndrome / malignancies / dental infections etc.]
FAMILY HISTORY:
PERSONAL HISTORY :
a). Diet : veg/mixed.
b). Appetite: normal/decreased/increased.
c). Thirst: normal/decreased/increased.
d). Dietetic error : present/absent.
e) Bowels: regular/ irregular.
100
satisfactory/unsatisfactory.
character of stools :
frequency ;
g). PERSPIRATION :
site :
character :
odour :
moderate : profuse/ scanty.
h). DESIRE :
Sweat/salty/bitter.
Pungent/sour/bland.
If any other specify:
i). AVERSION :
sweat/salty/bitter
pungent/sour/bland.
IF ANY OTHER SPECIFY.
j). DISAGREES:
101
l). DREAMS:
n). HABITS:
Character:
Yes no if any other specify.
Staining:
Water:
Stringy:
Clots:
q). CONCOMITANTS:
102
r). OBSTETRICS HISTORY:
G PLAS
Any details sepcify :
GENERALITIES
a.GENERAL MODALITIES :
1. Time of the day
2. Season
3. Meteorological (moon, phases etc)
4. Effect of external impression (light, heat of sun, fire place, bathing,
pressure of clothing, touch, noise, music, odour etc.)
b. AILMENTS FROM
Mental:
Physical:
c.NEVER WELL SINCE
d. THERMAL STATE :
103
f. GENERAL SENSATION AND COMPLICATIONS:
EXAMINATION
4. Height:
5. Weight:
104
6. Anemia/ pallor:
Present / absent.
7. Gyanosis:
presnt / absent.
8. Icterus:
presnt / absent.
9. Clubbing:
Present / absent.
11. Lymphadenopathy
Present / absent.
12. Scalp;
13. Hair;
14. Eyes;
Conjunctiva sclera.
15. Ear:
External pinna : hearing :
External acoustic canal:
If any other specify:
16. Face:
17. Vision:
105
18. Nose:
Yes / no if any other specify.
Dns :
Any discharge
Smell;
19. Mouth:
Tongue:
Lips:
Oral cavity:
Teeth:
Gum:
Basal mucosa- pink pale
20. Neck:
21. extremities-
A). upper limbs:
Oedema: yes / no
Pigmentation: yes / no
axillary lymphadenopathy : yes / no
Any other details:
b). lower limbs:
Oedema: yes / no
Pigmentation yes / no
axillary lymphadenopathy :
popliteal / inguinal : yes / no.
Any other details:
c). joints
106
B. LOCAL EXAMINATION / CUTANEOUS
1. MORPHOLOGY OF LESION:
Localised / generalised / papules / follicles / vesicles / large
patches, dry / moist, with scales/ without scales, oozing / without oozing,
crust formation / without crust formation, oedema / without oedema,
associated with hair loss / with out associated with hair loss. erythematous /
without erythema, itching/ non – itching, infected/ non infected, greasy / non
greasy, pustules / small pustules, swollen / not swollen / fissures / ulen
formation. Exudation / papulo vesicles / waxy.
2. SITE OF LESION:
ADULT TYPE:
scalp / eyebrows / super orbital region / thighs / pubic areas/ eye
lids / nasolabial folds or creases / lips / palms / soles / ears / post curricular
107
areas / sternal area axillae / submammary folds/ inter scapular region /
umbilicus groins / gluteal crease / glabella / checks / paranasal areas / beard
areas / checks / retro-auricular / genitalia.
INFANT TYPE:
Scalp / frontal hairline / face/ forehead / eyebrows / eyelids / nasolabial
folds / pinna / neck / external ear / axillae/ anogenital area / groins.
3. COLOUR OF LESION :
Pink / yellow / dull red / red- brown/ erythematous / brown.
5. SECONDARY CHANGES:
SUPER INFECTIONS
6. EXTEND OF SPREAD:
108
SYSTEMATIC EXAMINATION-
RESPIRATORY SYSTEM –
CARDIO-VASCULAR SYSTEM-
GENITOURINARY SYSTEM-
INVESTIGATIONS
BLOOD-
Hb%
TC :
DC :
109
OTHERS
SKIN:
BIOPSY
CONSTITUTIONAL TOTALITY-
REPERTORIAL TOTALITY-
RESULTS OF REPERTORISATION-
110
MIASMATIC ANALYSIS
111
3.
4.
5.
6.
PARTICUL 1.
AR 2.
SYMPTOMS 3.
4.
5.
6.
TOTAL
ACUTE-
CHRONIC-
MIASMATIC-
112
GENERAL MANAGEMENT-
ANNEXURE II
MASTER CHART
113
114
115
116
117
ANNEXURE III
SYNOPSIS OF CASES
1)A patient by named Miss. R.S. aged 9 years, consulted for 1 to 2
warts on face since 1 year. It appeared on dorsum of hands ,she has applied
chemicals locally and also got them cauterized, but they came back in larger
number each time. Past history of chicken pox in early childhood. Family
history of gonorrhea. From the history, clinical features case was diagnosed
as common warts. miasmatic analysis showed predominant miasm as psoric
background. The remedy given was dul camara 1dose given considering the
individuality of the case. The case was recovered.
118
predominant miasm as psoro-sycotic background. causticum 200was given
as the constitutional remedy. The case was recovered
119
showed miasmatic background was psora. Dul camara 200 was given as
acute remedy Case did not improved
11) Patient named K.W. aged 28 years, consulted for multiple warts
around mouth and nose. family history of asthma, diabetic mellitus . past
history of cauterization. From the history, clinical presentation and family
history, the case is diagnosed as flat warts . miasmatic analysis showed
miasmatic background was psro-sycotic.He was prescribed Nitric acid 200,as
constitutional remedy considering the individuality of the case .The case
improved
120
constitutional remedy, considering the individuality of the case . The case
recovered.
13)Patient named D.O. aged 8 years, was consulted for hard warts
on right foot since 6 months. He had applied salicylic acid locally, but they
had come back. Past history of eczema. family history of strong tendency for
gonorrhea
From the history, clinical features case was diagnosed as plantar
warts. miasmatic analysis showed predominant miasm as psoro-sycotic
background.
The remedy given was antimonium crudum 200,1dose was as
constitutional remedy. The case was recovered.
14)Patient named miss S.E. female aged 24 years. consulted for warts
on his left hand since 8 months. Family history of tuberculosis. Past history
of external application of chemical .From thehistory, slinical presentation ,
and family history the case was diagnosed as common wart. Miasmatic
analysis showed predominant miasm as Psoro-sycotic. On the basis of
constitution calc. carb. 200, 1 dose was given. . The case did not improved
finally.
15) Patient named S.V. aged 25 years ,came with warts on right
finger since 2 years . And gives family history of bronchial asthma, allergic
rhinitis, HTN .and gaves a past history of using some external application
undergone cauterization once with recurrence of the warts . On the basis of
history,clinical features and family history this case was diagnosed as
common warts. Miasmatic analysis showed predominant miasm as psoro-
sycotic background. Since the disease was having the acute clinical picture
lycopodium.was given as the constitutional remedy considering the
individuality of the case. Case recovered finally.
16) Patient named miss V.J. female aged 9 years , consulted for
wart on his right foot since 2 years . . There was a family of allergic rhinitis,
bronchial asthma, HTN and T. B.. There is past history of vaccination, On
121
the basis of history,clinical features and family history this case was
diagnosed as plantar warts. Miasmatic analysis showed predominant miasm
as psoro-sycotic background. Thuja was prescribed as the constitutional
remedy .The case recovered finally.
17) Patient named P. S. aged 24 years, came with warts on his upper
lip and around the mouth since 2 years. family history of gonorrohea. And
past history of cautrization.On the basis of history,clinical features and
family history this case was diagnosed as fillifom warts. Miasmatic analysis
showed predominant miasm as psoro-sycotic background.Causticum was
given as constitutional remedy considering the individuality of the case.
Case recovered finally.
19) Patient named S.K. aged 10 years, consulted for warts on the
hands since 9 months. Family history of asthma. Past history of vaccination
From thehistory, slinical presentation , and family history the case was
diagnosed as common wart. Miasmatic analysis showed predominant miasm
as psoro-sycotic.Based on individualization thuja 200 was given as
constitutional remedy. The case was did not improved finally.
20) Patient named M.I. aged 9 years, consulted for a wart on the left
index finger since 2 years..family history of T.B. Past history of
eruptions.From the history, clinical presentation and family history, the case
is diagnosed as common warts . miasmatic analysis showed miasmatic
background was psro-sycotic.Cal. Carb was given as a constitutional remedy
considering the individuality of the case. Case was improved finally.
122
21) Patient named M.H. male aged 9 years, consulted for wart on
the lower limb since 1 year. Family history bronchial asthma. Past history
jaundice.From the history, clinical features, case was diagnosed as common
warts. miasmatic analysis showed predominant miasm as psoro-sycotic
background. Lycopodium was given as constitutional remedy . Then
tuberculinum was given as intercurrent remedy. The case was recovered
finally.
24) Patient P.B. aged 11 years consulted for a big warts on the fingers
of both the hands for one year. .family history of osteoarthritis, hyper
tension. Past history of worms since childhood, vaccination. From thehistory,
slinical presentation , and family history the case was diagnosed as common
wart. Miasmatic analysis showed predominant miasm as psoro-sycotic. On
the basis of constitution calcarea carb was given constitutional remedy. The
case improved.
123
25)Patient named R.S. male aged 24 years, consulted for wart on the
left foot since one year. there is family history of, bronchial
asthma,hypertensive, R.A .gives a past history of chicken pox ,cauterisation.
On the basis of history,clinical features and family history this case was
diagnosed as plantar wart. Miasmatic analysis showed predominant miasm as
psor-sycotic background. Antimonium crudum was prescribed as the
constitutional remedy. The case recovered finally.
26) Patient named R.G. male aged 16 years consulted for warts
on the right foot since 2 years . family history of , Tuberculosis. Past history
of cauterization of warts. From the history, clinical presentation , and family
history the case was diagnosed as plantar wart. Miasmatic analysis showed
predominant miasm as psoro-sycotic. Thuja was given as the constitutional
remedy on the basis of individualization .tuberculinum was given as
intercurrent remedy.The case did not improved finally.
27) Patient named R.O. female aged 12 years, consulted for warts on
the right foot since 7 months. Family history T.B.. Past history diarrhea,
cholera.
From the history, clinical features, case was diagnosed as plantar
warts. miasmatic analysis showed predominant miasm as psororo-sycotic
background. Thuja 200 was given as constitutional remedy considering the
individuality of the case.
The case was recovered.
28)patient named S.D. ,female aged 15 years ,consulted for warts on
hands . Family history of asthmatic attack . past history of
vaccination.From thehistory, slinical presentation , and family history the
case was diagnosed as common wart. Miasmatic analysis showed
predominant miasm as psoro-sycotic. Based on the individualization Nitric
acid was given as constitutional remedy. After failure thuja was given as
intercurrint remedy.The case was did not improved finally.
124
history of bad effects of vaccination. From thehistory, slinical presentation ,
and family history the case was diagnosed as common wart. Miasmatic
analysis showed predominant miasm as psoro-sycotic. On the basis of
individualization causticum. 200 was given constitutional remedy.. The case
improved finally.
125