THE EFFICACY OF HOMOEOPATHIC SIMILLIMUM IN TREATING

ATOPIC BRONCHIAL ASTHMA WITH AN EVALUATION BASED ON IgE

Synopsis Submitted to
VINAYAKA MISSION’S RESEARCH FOUNDATION
(Deemed To Be University)

Application for the Registration of Subjects for Dissertation of the

Degree of

DOCTOR OF MEDICINE
IN
HOMOEOPATHY
Organon of medicine and homoeopathic philosophy

Submitted By
DR.Y. ARAAFATH

Under the Valuable Guidance of

Prof. Dr. NISHA PAUL.E., MD (Hom)
POSTGRADUATE DEPARTMENT OF ORGANON OF MEDICINE AND
HOMOEOPATHIC PHILOSOPHY
VINAYAKA MISSION’S
HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL,
SALEM – 636308.
2020-2021

1
 VINAYAKA MISSION’S RESEARCH FOUNDATION
(DEEMED TO BE UNIVERSITY)
APPLICATION FOR THE REGISTRATION OF SUBJECTS FOR DISSERTATION

DR. Y. ARAAFATH
NAME OF THE CANDIDATE
AND ADDRESS DEPARTMENT OF ORGANON OF
MEDICINE & HOMOEOPATHIC
PHILOSOPHY.
1. VINAYAKA MISSION’S HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
SALEM

Dr.Y. ARAAFATH
PERMANENT ADDRESS S/O A. YUSUFF AZAD
67, POONGANAGAR STREET, SARAMEDU
KARUMBUKADAI.
COIMBATORE-641008

2. NAME OF THE INSTITUTION VINAYAKA MISSION’S HOMOEOPATHIC

MEDICAL COLLEGE. AND HOSPITAL,
SALEM

3. COURSE OF STUDY AND SUBJECT M.D (HOM), ORGANON OF MEDICINE &

HOMOEOPATHIC PHILOSOPHY.

4. DATE OF ADMISSION TO COURSE 28.12.2020

“THE EFFICACY OF
HOMOEOPATHIC SIMILLIMUM IN
5. TITLE OF THE TOPIC
TREATINGATOPIC BRONCHIAL
ASTHMA WITH AN EVALUATION
BASED ON IgE”
 6 BRIEF RESUME OF INTENDED WORK:
6.1 NEED FOR THIS STUDY:
Bronchial asthma is characterized by chronic airway inflammation and increased airway
responsiveness leading to symptoms of wheeze, cough and dyspnea. The prevalence of
asthma is increasing steadily.1
Asthma ranks amongst the most common chronic ailments of
the globe. It is estimated that 300 million people worldwide suffer from asthma.
Annually 250,000 deaths are attributed to asthma, and its complications.1
In our country, the disease is under recognized and
underrated. The WHO estimates that asthma contributes to the loss of 15 million
disability-adjusted life years.
The prevalence of asthma has increased markedly over the past 30 years. In developed
countries, approximately 10% of adults and 15% of children have asthma. The majority of
asthmatics have childhood onset of disease.
Asthma often starts early in life. The prevalence of asthma is
increasing in all age group, despite major advances in understanding the etiology and
pathophysiology of asthma and development of new therapeutic modalities to control
symptoms and prevent exacerbations, effective therapies are not widely used. 1
Homoeopathy has a vital role in the treatment of asthma. . Hence, I selected the topic
“EFFICACY OF HOMEOPATHIC SIMILLIMUM ON TREATING ATOPIC
BRONCHIALASTHMA WITH AN EVALUATION BASED ON IgE”.
6.2 AIMS AND OBJECTIVES
1.To study the efficacy of Homeopathic Medicines on treating atopic bronchialasthma.
2. To evaluate the serum IgE levels in bronchial asthmapatients.
REVIEW OF LITERATURE
6.3
DEFINITION
Asthma is a chronic inflammatory disorder of the airways that is
characterized by increased responsiveness of the tracheobronchial tree to a variety of
stimuli resulting in widespread spasmodic narrowing of the air passages which may
relieved spontaneously or by therapy. Asthma is an episodic disease manifested
clinically by paroxysms of dyspnea, cough and wheezing. However a severe and
unremitting form of the disease termed status asthmaticus.1

EPIDEMOLOGY

The lifetime prevalence of asthma varies considerably within countries

and between countries. It is more prevalent in developed countries than developing
ones, more in children (15%) than adults (10-12%), more in urban than rural areas,
reason of which are not fully understood. Nearly 8-10% of total population suffers
from it.2
The disease can start at any age, but in majority it starts before 10 years
of age. It is twice more common among boys than girls. Whereas in adults the male to
female ration is usually equals.2
Although the development, course of disease and response to treatment
are influenced by genetic determinants, the rapid rising the prevalence of asthma
implies that environmental factors are critically important in terms of its expression to
date, studies have explored the potential role of microbial exposure, diet, vitamin,
breast feeding, air pollution and obesity. Death due to asthma is uncommon and in
many affluent countries has been steadily declining over the last decades.1
PREDISPOSING FACTORS

1. AGE: There is no age limit but majority of the cases are seen before the age of
25years.
2. HEREDITY: Asthma often runs in families and has got a hereditary
predisposition like migraine, epilepsy andhysteria.
3. CLIMATE: Better in dryclimate.
4. SEASON: Particular allergens may produce asthma in particularseason.
5. REFLUXES FROM THE NOSE AND NASOPHARYNX: Swelling of turbinate,
nasal polyp, adenoids and enlarged tonsils acts as abnormalrefluxes and predispose
toasthma.
6. INFECTION: Other diseases like chronic bronchitis and pulmonary tuberculosis
often predispose to asthma, hemolytic streptococci may actsimilar way.
7. EXCITING FACTORS: Sensation of animal hair and other dustparticles.2
TYPES

1. ATOPICASTHMA:

 It is the most common type of asthma, affecting 70-90% of children and

50% of adult.
 An individual with atopic asthma, will have mast cell bound
IgEmolecules residing in theirairways.
 A positive family history of atopy iscommon.
 The disease is triggered by environmental antigens such as
dusts,pollen, animal dander, and foods, but potentially any antigen
isimplicated.
 Asthmatic attacks are often preceded by allergic rhinitis, urticaria oreczema.2

2. NON ATOPICASTHMA

 It is also known as intrinsic asthma. It makes up between 10 to 30%cases

 There is negative skin test to common inhalant allergens and
normalserum. Women are commonlyaffected.
 Drug induced Asthma: Aspirin and non-steroidal anti-inflammatory drugs
may trigger asthma in somepeoples.
 Occupational Asthma: people with this condition work around
chemicalfumes, dust, or other irritants in theair.2

CLASSIFICATIONS: -

1. Extrinsic Asthma
 Early age usually begins inchildhood.
 External allergens have a strongrole.
 Early age usually begins inchildhood
 External allergens have a strongrole.
 Triggering factors are environmental allergens E.g.: dusts,
pollens,animals, dander andfoods.
 Serum level immunoglobulin E(IgE) isincreased.
 Skin hypersensitivity test to common inhalant allergens ispositive.
 Response to provocation tests ispositive.2

2. Intrinsic Asthma:
 Onset is usually after 30 years ofage.
 There are no precipitating causes or raised antibodylevels.
 The patients show a higher frequency of eosinophilia, aspirinsensitivity.
  Respiratory infections due to viruses E.g.; rhinovirus, para influenzavirus
 Inhaled air pollutants E.g.: smoke,fumes.2

3. MIXEDTYPE
 Patients have mixed features ofboth.
 These patients who develop asthma in early life have strong allergic
component, while those who develop the disease late tend to benon-allergic.3

CLINICAL FEATURES; -

A. SYMPTOMS: Asthmatic patients suffer from episodes of acute exacerbation

interspersed with symptom freeperiods.2
 Cough
 Sneezing
 Expiratorywheeze
 Breathlessness.
 Chesttightness
 Scanty and tenacious mucoidexpectoration
 When the attack occurs continuously it leads to statusasthmaticus.2

B. SIGNS:
 Wheezing
 Bluish discoloration of lips andface.
 Rapidpulse
 Expansion of chest is considerably diminished (less than2cm)2

INVESTIGATIONS

1.SERUMIgE:
Increased serum level of total or allergen – specific IgE
(RADIOALLERGOSORBENT TEST- RAST) may be helpful mainly in atopic
asthma.5

2. BLOOD
Increase in number of eosinophils in peripheral blood (>0.4 * 10 IL) ESR
increased when associated with infection.

3.CHEST X RAY P.AVIEW

Chest X-ray appearances are often normal but lobar collapse is seen if the
mucus occludes large bronchus and if accompanied by the presence of flitting
infiltrates, may suggest asthma has been complicated by allergic bronchopulmonary
aspergillosis.4

4.PULMONARY FUNCTIONTEST:
Measurement of the FEV1/VC ratio or PEF provides a fairly reliable indication
of the degree of airflow obstruction.
i. FEV1 (forced expiratory volume in 1 second) –Low
ii. Vc (vital capacity) –Low
 iii. FEV1/VC - Low
iv. PEF (Peak Expiratory flow rate) – Serial recordings are useful in diagnosis.
There is usually a marked diurnal variation in PEF. The lowest values being
recorded in the morning (morning dipping). Measurement of Bronchial
reactivity by administering increasing concentrations of substances such as
histamine and meta choline by inhalation until there is a 20% fall. This
concentration is called the PC20 and patients with asthma show evidence of
bronchoconstriction at much lowerconcentrations.
v. LungVolumes:
 TLC- Total lung capacity –High
 RV – Residual volume –High.5

5.SPUTUM:
Increased eosinophils, curschmann’s spirals or creola bodies, Charcot -Leyden
Crystals. Estimation of eosinophilic cationic protein for assessment of severity.6

6. EXERCISE CHALLENGETEST:
The use of exercise test is useful when the symptoms are predominantly related to
exercise. E.g.: six-minute exercise test but a negative test does not rule out asthma.4

7. HRCT CHEST (High resolutionCT)

Routinely this investigation is not required in patients with bronchial asthma
unless some associated lung disease is suspected, it shows areas of thickening of the
bronchial wall in patient with severe asthma.6

MANAGEMENT OF ASTHMA

LIFE STYLE MODIFICATIONS:

Avoidance of triggers is a key component of improving control and preventing
attacks. The most common triggers include allergens, smoke, air pollution, on selective
beta blockers and sulphite containing foods.4
House dust mite exposure may be minimized by replacing carpets with floor
boards and using mite impermeable bedding. Many beds are particularly sensitized to
several abiquitous aero allergens, making avoidance strategies largely in practical
measures to reduce easy fungal exposure and eliminate cockroaches may applicable in
specific circumstances, and medications known to be precipitated or aggravated
asthma should be avoided. Smoking cessation is particularly important. Yoga could
provide small improvements in quality of life and symptoms in people with asthma.4

HOMOEOPATHIC APPROACH
Homoeopathy does not seek merely to palliate or to suppress but it goes to
the grass root of trouble and thus it does not give temporarily relief but instead it
restores the ‘whole sick to health permanently and judiciously.

Stuart close says “Homoeopathy does not treat disease. It treats patients.
“In one word, it individualizes. Homoeopathy recognizes the individuality of each drug
and substance in nature. Homeopathy recognizes the individuality of each patient or
case.7
 H.A. Robert says, Homeopathic law of cure is ‘similiasimilibuscurentur’
Potentized medicine, administered according to the law of similia is the true regulator
of vital energy.8

Simillimum is selected from the totality of symptoms by the process of

individualization. Homeopathy is based on individualization7

The Homeopathic physician should always be guided by the totality of

symptoms in each case. Hahnemann states, the totality of symptoms is outwardly
reflected picture of the internal essence of the disease, that is, of the affection of the
vital force.9
Disease can be cured by any potency of the drug provided it is the most
homeopathic remedy to the disease concerned. But the speed with which the cure takes
place depends on the potency of the drug as well.

James Tyler Kent says the totality of symptoms may be considered to be

all that is visible and represents the disease in the natural world to the eye. It enables
the physician to individualize between diseases and between remedies. The entire
representation of disease is the totality of the symptoms and the entire representation of
drug is totality of symptoms.10

Considerations for selection of the potency of drug7

1. The seat of thedisease
2. The susceptibility of thepatient.
3. The stage and duration of thedisease.
4. The nature and intensity of thedisease.
5. The previous treatment of thedisease.

7 MATERIALS AND METHODS

7.1
MATERIALS:

Source of Data:
Patient will be collected from the OPD/IPD. Peripheral health centers of Vinayaka
Mission’s Homeopathic Medical college and Hospital, Salem and medical camps
conducted by college.

Case Proforma:
Pre designed homoeopathic case sheet.

Diagnostic Criteria:
Detailed case history will be taken as per proforma. Proper clinical examination of
patient will be done. Measurement of Serum IgEwill be done on all patients.
 IgE- IMMUNOGLOBULIN E
Immunoglobulin E (IgE) is one of the body’s 5 classes (isotypes) of immunoglobulins
(antibodies). This immunoglobulin was discovered in 1966 by ishizaka during
investigation of atopic regain antibodies
Measurement of serum IgE is often used as a tool in the diagnosis and
management of atopic diseases, such as asthma. It has been used to distinguish atopic
from non-atopic individuals presenting allergy like symptoms.

Prognostic criteria

The prognosis is based on

 Symptomaticimprovement
 Laboratory findings before and aftertreatment.

7. METHODS:
2 Research design
 A prospective clinical study design without controlgroup.

Sampledesign
 Purposive sampling done as per inclusion and exclusioncriteria.
 Sample size will be minimum 30 innumber

Inclusion Criteria
 Patients were selected from all agegroups
 Bothsexes
 Patients having recurrent asthmatic attack and allergic reactions (atopic
dermatitis, allergicrhinitis)
 Patients with strong family history of allergy andasthma.

Exclusion Criteria
 Patients suffering from other respiratory diseases.
 Patients suffering with other systemicdiseases.

Data collection:
Primary and secondary data will be collected will be collected through a pre-designed
case sheet.

Data processing and analysis

 The patients were assessed and treatment was started on the basis of
Homeopathictotality.
 The criteria for evaluation of cases were symptomatic, clinical and by
laboratoryinvestigations.
 Analysis will be done using Paired ‘t’test

Prescription and follow-up:

The approach in each case will be based on individualization and totality of symptoms.
The selection of remedy will be based on constitutional and homeopathic protocol.
Potency and repetition will be determined on the basis of susceptibility of patient and
severity of the complaints. Each case will be followed for a minimum of 6 months
from the commencement of treatment.

LIST OF REFRENCES

1. Harrison TR, Tinsley. Harrison’s Principles of Internal Medicine. 6th ed.

McGraw-Hill; 1999.2108pp

2. Krishna Das KV. Textbook of Medicine. 6th ed. Jaypee Brothers Medical; 2017;.1018-
1019pp

3. Mohan H. Textbook of Pathology. 7th ed. Jaypee Brothers Medical; 2015.,

483- 484pp

4. Ralston SH, Penman ID, Strachan MWJ, Hobson R, eds. Davidson’s Principles
and Practice of Medicine. Volume 1. 23rd ed. Elsevier Health Sciences;
2018.569pp

5. Kasper DL, Braunwald E, Fauci AS, et al. Harrison’s Manual of

Medicine. 19th ed. McGraw-Hill Medical; 2016.712pp

6. Munjal YP, Sharm SK. API Textbook of Medicine, Ninth Edition, Volume
1 . Jaypee Brothers Medical; 2012. 1706 -1707pp

7. Close SM. Genius of Homeopathy: Lectures & Essays on Homoeopathic

Philosophy with Word Index; 2nd Edition. B Jain; 2021.130pp

8. Roberts HA. Principles & Art of Cure by Homoeopathy: A Modern

Textbook with Word Index: 3rd Edition. B Jain; 2021. 91pp

9. Hahnemann S. Organon of Medicine: Sixth Edition. B Jain; 2002. 95pp

10. Homeobook- Totality of symptoms in Homoeopathy. Homeobook.com.

Published December 4, 2012. Accessed September 21, 2021.
http://www.Homeobook.com
09 SIGNATURE OF THE
CANDIDATE

REMARKS OF THE GUIDE

10

11.1 NAME AND DESIGNATION

11 OF THE GUIDE

11.2 SIGNATURE

11.3 HEAD OF THE

DEPARTMENT

11.4 SIGNATURE

12.1 REMARKS OF THE

PRINCIPAL
12

12.2 SIGNATURE