Professional Documents
Culture Documents
Ree Ba
Ree Ba
SUBMITTED TO
REPERTORY in partial fulfilment of the regulations for the award of the degree of
This has not been submitted in full or part for the award of any degree or
Dr. V. SATHISH KUMAR M.D (Hom) Dr. N.V SUGUTHAN M.D. (Hom)
Place: Kulasekharam
Date:
CERTIFICATE BY THE GUIDE
All her work has been carried out under my direct supervision and guidance. Her
approach to the subject has been sincere, scientific and analytic. This work is
myself under the direct supervision and guidance of DR. V. SATHISH KUMAR
MEDICAL UNIVERSITY, CHENNAI. This has not been submitted in full or part
INTRODUCTION
affects all age group but especially more in adults.Due to low fibre diet ,strainning
while passing stool ,and prolonged sitting while passing stool these are identified as
the common cause of hemorrhoids.Apart from this females are prone to suffer from
Hemorrhoids and can able to reduce the rate of surgery and helpful for preventing the
METHODS
The present study with sample of 30 cases and age group of 18-65 years suffering
from hemorrhoidal pain were selected from OPD/IPD and rural centres of Sarada
with complaints of Hemorrhoids were Randomly selected and were analaysed for
(CORECTS ) and .History was taken as per the case performa .Case were followed
for a period of 6 months .Observations were recorded and pain before and after
difference in symptom. Sulphur & nuxvomica was the remedy which was most used
and potency was 200.occupation in which people who have to sit for prolonged
periods are at risk of developing hemorrhoids . Case score was analysed before and
after treatment which shows 23 cases of marked impovement and 5 cases of moderate
CONCLUSION
Based on the result of study it is evident that Homoeopathic medicine are very
recurrence
KEYWORDS
Writing this disseration has been fascinating and extremely rewarding would like to
thank a no of persons who have contributed to the final result in different ways.
To commence with I pay obeisance to GOD the almighty to have bestowed upon me
good health,courage ,inspiration zeal and the light .After god I express my sincere and
M.D (HOM),professor & HOD ,Dept of Repertory for providing me expert guidance
,advice ,timely support ,personal attention ,supervision and encourgement through out
my post graduation course and during this disseration work .It is a good fortune to do
valuable thoughts ,guidance and suggestions given through out the period of study .
I Would like to express my special thanks of gratitute and deep regards to our
opportunity to study in this Institution and for providing me with necessary facilities
,MD(Hom)& for their timely support and encourgaement .It is my duty to express my
sincere thanks to all my kind teachers who lit the lamp of knowledge in me.
Iam very much indebted to my family My better half Mr.Sajeev.D ,my son Shawn ,&
my Father in law Mr.Daveed ,Who supported me in every possible way to see the
completion of this work.I would never accomplished my goal with out them .I remain
indebted to them for every thing I have and whatever I have achieved.
Mr.A .Ravi & Mrs A.Jayanthi who made me What Iam ,my brother R.Regin who
Tasnem ,Dr.Libi, Dr. Beulah ,Dr.Fathima mujahitha and Dr.Anjana for their
helping hands .
I don’t have words to pay my love and Thankfulness to my friends Dr.Aparna.S,
I am thankful to all my colleagues ,friends and internees for their kind cooperation
I Convey my thanks to librarians and all college staffs ,hospital and registration staffs
for providing the sample support in the collection of data and towards the preparation
of the work
I would also like to thank all the members of the Ethical committee for their valuable
suggestions
I extend my heart felt thanks to all the patients with out them this work would not
Last but not least ,I thank the non –teaching staff of sarada krishna homoeopathic
medical college & hospital for their immense help in providing me with all the case
Dr.R.Reeba
TABLE OF CONTENTS
1. INTRODUCTION 1
3. REVIEW OF LITERATURE 4
6. DISCUSSION 58
8. CONCLUSION 69
9. SUMMARY 70
10. BIBILOGRAPHY 71
11. APPENDICES 75
LIST OF TABLES
PAGE
TABLE.NO. DESCRIPTION
NO.
FIGUR
DESCRIPTION PAGE NO.
E.NO
1. APPENDIX – I: GLOSSARY 75
“It is a blissful feeling to relieve the pain of a suffering one”. Being a homoeopath,
there are many situation where we can feel this bliss. I am dealing with such a clinical
study, where the patient faces much difficulty even to make his day to day activities
congestion.In modern medicine, they are removing the end product of the disease,
whereas our system of medicine is removing the root cause of disease.The action of
(each stage of this disease pass through different miasms). By treating miasmatically
we are not only curing the disease but also preventing the recurrence, there by
therapeutic book for Hemorrhoids. This repertory mention that “totality of symptom
does not refer to the drug but to the patient, and that it must not be expected that a
case will present all the symptoms of any medicine, on the other hand the remedy
should contain all the prominent medication of patient”. Here the totality can be
BBCR is one among the latest repertory. Boger follow boenninghausen’s method
ie, complete symptom, and the totality is also based on complete symptom.
Boenninghausen repertory and used it, when patient make no connection between
hemorrhoids.one million new cases are reported annually. It can affect both men and
1
women. Literature and experience of homoeopaths provide information that, the
initial signs of the hemorrhoids should be recognized so that the disease can be
brought under control at an early stage with minimum life style modifications and
hence avoid surgery. So the complaint more commonly affects the young adults .So
the impact of disease is more dangerous and can affect the wellbeing and
socioeconomic levels.
There is also a study which reported hemorrhoids are treated with considerable
success rate of 60.3to 82.3 % in homoeopathic hospital in West Bengal. First and
second degrees of hemorrhoids are able to treat successfully with homoeopathy but
in case of third and fourth degree, we can give symptomatic relief and improve
quality of life .
,alcohol etc.Only fewer systematic studies were published. I have seen many cases
medicine have positive results. From my work I not only like to help such people
who suffer from hemorrhoids, and also to prove that Homoeopathic medicine can
surely improve the quality of life of people suffering from Hemorrhoids .With this
study I would like to find out most indicated remedies so that other homoeopathic
practioners also find easy to deal with such condition. Every science develops
chosen.
2
2. AIMS AND OBJECTIVES
3
3. REVIEW OF LITERATURE
DEFINITION
„rhoos‟means flowing or piles.( In latin Pila means a ball).(1) Hemorrhoids are dilated
enlarged veins in the walls of anus and sometimes around the rectum, usually caused
Symptoms start with bleeding after defecation.If untreated, hemorrhoids can get
EPIDEMIOLOGY
estimated that 58% of people added over 40 years have the disease in the US.Current
statistics suggest that nearly half of the world‟s population will experience some form
of hemorrhoids especially when they reach the golden age of fifty.A study carried
out in four hospitals in Austria,for the screening of the colorectal cancer in which
United States regarding the incidence and prevalence of hemorrhoids ,shows that
States of America.
4
In India Approximately 40,723,288 people are reported to have hemorrhoids.
1 million new cases are reported annually in which 47 per 1000 cases shows an
recorded ,making it one of the most common health issue.A study in India shows
that approximately 80% of the cases are in the 21-50 years of age group
another study ,half the population over the age of 50 years have hemorrhoids.
(6).
Patients presenting with hemorrhoids more frequently white ,from higher socio
increase in prevalence after an age of 65 yrs and was more common in blacks and in
Every healthy humanbeing has three inner hemorrhoids they are swollen in the
anus or rectum ,similar to varicose veins .They only become a health issue when they
enlarge or grow deeper .Hemorrhoids can have a number of causes although often the
exact cause is unknown .It can be a low fiber diet ,long hours of sitting ,straining
the people over 50 years of age have hemorrhoids categorized in 4 stages. Men are
5
ANATOMY
Hemorrhoids form when the bundle of veins in the anus and lower rectum
,they are cluster of vascular tissue (8) . hey are classified by their anatomic origin with
in the anal canal and by their position relative to the denate line(9).The denate line it
lies at the inferior most level of the anal column and indicate the junction of the
superior part of the anal canal and the inferior part.Hemorrhoids are abnormally
ETIOLOGY OF HEMORRHOIDS
constipation or diarrhea.It has been said that a standing position cause arise in static
venous pressure,and that pressure from anal spasms and bowel movement causes an
ascites.It has been reported that there are few hemorrhoids patients with portal
hypertension(11)
with in the hemorrhoidal veins , can also leads to excessive vascular pressure and
swelling (13)
6
b) Anatomical-It has been suggested that internal pile is a natural consequence of
Hemorrhoidal veins.The veins passing through the rectal muscultare 10cm above the
anus will cause occlusion of veins and congestion during defecation .The radicals of
superior rectal vein lie unsupported in the loose submucosa connective tissue of the
rectum.
c)Exciting cause or factors - Parks suggested Straining to expel the constipated stool
cause dilation of the venous plexus .(6)..Once dilation of venous plexus as well as the
partial prolapse occured with each bowel movement, then it would stretch the
corpus cavernosum rectum ,which is a normal constituent in the upper third of the
e) Diet – A low fiber diet is found to be the main cause of haemorrhoids.( 6).Action of
passing hard stool through the anal mucosa may cause damage to the anal cushions
and lead to symptomatic hemorrhoids. Intake of fiber or providing added bulk in the
7
PATHOPHYSIOLOGY OF HEMORRHOIDS
pathological disease only when they experience abnormal changes. There are three
main cushions present in the normal anal canal .These are located classically at left
lateral ,right anterior ,and right posterior positions.They are composed of neither
arteries nor veins but blood vessels called sinusoids, which do not have muscle or
tissue in their walls as veins do.This set of blood vessels is known as the
hemorrhoidal plexus.
of anal closure pressure at rest and protect the internal and external anal sphincter
muscles during the passage of stool .When a person bears down ,the intra abdominal
pressure increases and hemorrhoid cushions enlarges in size, helps in maintain anal
closure . Hemorrhoid symptoms are believed to result when these vascular structures
internal and external anal splincter pressure may also be involved in hemorrhoid
symptoms.
8
SECONDARY HEMORRHOIDS
contributory causes are those things that cause to raise the pressure in the abdomen
A) Carcinoma of the rectum- This compress the superior rectal veins causing
Hemorrhoids. (2)
B) Pregnancy –These occur in about 1 in every 3 women and may occur for the first
time during pregnancy(15).. It is also estimated that 35% of women will develop
hemorrhoids during the course of her preganancies risk typically increases with each
.(16
subsequent birth )Hemorrhoids frequent in pregnancy,may cause considerable
The pressure of fetus in the abdomen as well as hormonal changes may cause the
and they revert back to normal after child birth.Surgical treatment is rarely indicated
9
E) Difficulty in micturation –Stricture of urethra or enlarged prostrate will cause
increase in intra abdominal pressure and there by increase in venous pressure to cause
Hemorrhoids.(2)
F) Diet high in processed food and low in fiber(noodles ,cold drinks ,fried food etc)
OTHER CAUSES
Pelvic causes includes gravid uterus, uterine and ovarian neoplasm, bladder
carcinoma
Squatting while defecating may also increase the risk of severe hemorrhoids.
10
CLASSIFICATION OF HAEMORRHOIDS
Depending upon the site of origin, hemorrhoids can be divided in two types
INTERNAL HEMORRHOIDS
EXTERNAL HEMORRHOIDS
INTERNAL HEMORRHOIDS
It develops inside the anus.They are usually painless because not richly supplied by
nerves.Tendency to bulge out of the anal opening in various degrees. They do not
cause cutaneous pain , because they are above the denate line and are not innervated
by cutaneous nerves.
EXTERNAL HEMORRHOIDS
External hemorrhoids are under the skin around the anus, where there are many
pain sensing nerves,which tend to cause pain as well as bleed.It develops at the
margin of the anal opening .They are usually painful, because a rich supply of nerves
hemorrhoids may get prolapsed or get bigger and bulge outside the anal sphincter,
which can be seen as a moist bump and is pinker than the sourrounding area. They
thrombosis, it can be painful and itch a lot and could bleed.When a clot dissolves it
may still have a bit of skin left over ,which could be irritating.
11
SIGNS AND SYMPTOMS
Signs and symptoms may present with pain, bleeding, protusion, or change in
Bleeding
It is the principal and earliest symptoms after moving bowels .It is slight, bright
Prolapsing
degrees
Degree SYMPTOMS
12
Itching
When the hemorrhoids are painful, it may be difficult to keep the area clean,which
Anemia
Rarely, blood loss from hemorrhoids can cause anemia and is seen in long standing
cases of hemorrhoids with profuse and persistent bleeding but this is almost never
General symptoms can occur at any stage of disease.It also depends on size and
type of hemorrhoid,whether they are external or internal and wether they are acute
or chronic.
In some cases there may be only a few symptom but later it may get developed into
Colour of blood is usually bright red due to presence of ateriovenous channel in the
hemorrhoid tissue. Dark red blood mixed with stool may indicate that bleeding is
RISK FACTORS
Bowel habits and life styles can be the risk factors for hemorrhoids
People who have frequent bowel movements and or strain habits and more
People with strain or who spend a long time sitting in toilet during bowel
13
Some hemorrhoids patient report normal bowel movements.
hemorrhoids (20)
COMPLICATIONS OF HEMORRHOIDS
Anaemia: Excessive bleeding can cause anaemia. Most common variety is iron
deficiency anaemia. Massive bleeding can occur due to portal hypertension.In such
1. A prolapse outside presents with severe pain in the perianal region. Piles
followed by strangulation.
3. Skin tags – They are extra skin left behind when a blood clot in an external
hemorrhoid.
infection.
6. Strangulated hemorrhoid –When the muscles around the anus cut off, the
14
8. Thrombosis and fibrosis.-after thrombosis ,internal hemorrhoids sometimes
pyaemia and liver abcess.it can occur when patient with strangulated
hemorrhoids are advised to surgery and have been reported to follow banding.
Septic embolism may occur through the portal system to cause liver abscess or
Piles develop when the veins in anal canal become swollen .This happens for a
numnber of reasons :
constipation,hyper acidity
Ageing as getting older may be more likely to get piles because of rectal vein
weakens.
Long term coughing that increase intra abdominal pressure hence develops
piles.
ANAL FISSURE
Anal fissure is a small cut or tear in the lining of the anus .The crack in the skin
causes severe pain and some bright red bleeding during and after bowel movements.
15
There are acute anal fissures (a shallow crack on the surface of the skin)and a chronic
fissure (deep fissure with additional skin changes).symptoms are strong stingingpain
ANAL FISTULA
of the anal canal and perianal skin. An anal fistula can be described as a narrow tunnel
with its internal opening in the anal canal and its external opening in the skin near the
anus .Anal fistulae commonly occur in people with a history of anal abscesses. They
ANAL ABSCESSES
local pressure and increased chronic pain especially when sitting down.
ANAL BARNACLES
Barnacles are skin flaps in the anus .The shape and size of them can vary but they are
ANAL THROMBOSIS
Acute pain and swelling on the anus can be an indicator of anal vein thrombosis.when
16
POSTANAL DERMOID
A soft cystic swelling infront of the lowerpart of the sacrum and coccyx. A
PHYSICAL EXAMINATION
External Hemorrhoids are visible on perianal inspection itself but the non prolapsed
internal hemorrhoids are not visible .It may protrude on gentle straining.When the
with the patient in lithotomy position. Rectal pain and bleeding should never be
have ulcerations with bloody drainage .Skin tags may be signs not only of prior
hemorrhoids but also of fissure disease.Digital examination will exclude distal rectal
mass and ano rectal abscess or fistula.Lastly, anoscopy and rigid or flexible
or fissures ,and to rule out distal rectal masses.Internal haemorrhoids can be reliably
INVESTIGATIONS
A complete blood cell count may be useful as a marker for infection, anemia
17
PROCTOSCOPY
SIGMIDOSCOPY
It is done to rule out other causes of bleeding (like carcinoma of rectum, anal
fissure,crohn‟s disease).It is also a screening test for colon cancer and rectal cancer .A
(23)
sigmoidoscopy is performed using a thin ,flexible tube called a sigmoidoscope
COLONOSCOPY
It is done to visualize the entire colon (large intestine) and rule out other problems
(pathologies) in colon which could be responsible for bleeding through the anal canal.
BARIUM STUDY
It is done to see the entire inner part of colon to visualize any entire abnormality.
GENERAL MANAGEMENT
treated with increased intake of fiber rich food and fluid intake. Recent meta analysis
confirmed that fibre supplements moderately improve over all symptoms and
bleeding, and should be recommened at an early stage. Patients are advised to add
more vegetables in their diet along with fluid intake. Taking more fruits can increase
the quantity of dietary fibre. Eight glasses of water a day is considered to be an ideal
quantity. And also patients are adviced to avoid straining during defeceation. Long
hours of standing or sitting , particularly sitting on the toilet for long time can increase
18
the pressure on the veins in the anus. Walking and engaging in other activities for 30
minutes everyday will help the digestive system to work.Laxatives can be avoided
which may become habitual and some can lead to diarrhoea. Other life style
and avoiding straining are used in primary care and may help in the treatment and
SURGICAL PROCEDURES
BANDING
Banding is used to treat internal hemorrhoids.It is also called as rubber band ligation.
This procedure involves using a tight band around the base of hemorrhoid to cut off
SCLEROTHERAPY
COAGULATION THERAPY
It is also called infra red photocoagulation. This treatment uses infra red light ,heat
or extreme cold to make hemorrhoid retract and shrink.It is performed along with
inches into your rectum.Most people experience only mild discomfort or cramping
during treatment.
19
HEMORRHOIDAL ARTERY LIGATION
hemorrhoid.This method locates the blood vessels causing the hemorrhoid using an
HEMORRHOIDECTOMY
It is used for large external hemorrhoids and internal hemorrhoids that have prolapsed
HEMORRHOIDOPEXY
surgical staple fixes the prolapsed hemorrhoid back in to place inside your rectum
and cut off the blood supply so that the tissue will shrink and be reabsorbed.
20
Potential risk of hemorrhoidectomy include
Infection
Bleeding
Stool leakage
Excessive bleeding
work was published in 1892. The author‟s aim is to direct his readers to a method of
therapeutics which will produce a cure in the surest and easiest manner and absolute
safety to the patient. The author also quotes that “There exists a proved remedy to
restore to health of all patients‟ sufferings and the assets. However he also cautions
that the complicated cases need not be quickly turned over to surgery except those
Arrangement of book:
Preface
The Remedies and their indication
Repertory.
Appendix.
21
CONSTRUCTION
Therapeutic part
Subjective
Objective
Aggravation
Amelioration
Concomitant
Repertory part:
Subjective symptoms
Objective symptoms
AND REPERTORY‟.It was of great use in the 2nd half of the 19th century because it
was the only work of its kind available to practitioners. He was fully satisfied with
22
Location
Sensation
Modalities
concomitants
Total number of medicines used in this book is 464 and there are 53 chapters.
relation to the time (before, during or after) which are called concomitant. Boger
totality, but he improved over it by relating sensation and modalities to specific parts.
Boger was not satisfied by merely following the principles of complete symptom.
Pathological generals tell the state of the whole body and it changes in relation to the
simillimum .The chapter in the book “Sensation and Complaints in generals”is full of
Boger has given adequate place and importance to causation and time of the
expressions .Each chapter in the book is followed by time aggravation. In his own
23
practice he has successfully employed these factors to find the simillimum in the
physical generals) which hold the key in the remedy as well as in the person.
Clinical rubrics
Boger was the first person who appreciated the use of clinical symptom in grouping
the remedies.He mentioned several clinical conditions, which he came across in day
to day practice.They help the physician in cases of advanced tissue changes, where he
left without getting a clear picture because of poor susceptibility .These rubrics are
useful to arrive at a group of medicines that can be further narrowed down with the
Evaluation of Remedies
remedies.He indicated the grading of symptoms in to five ranks by the use of different
typography such as
CAPITALS- 5 marks
BOLD- 4 marks
Italics- 3 marks
24
Fever totality
Aggravation,Amelioration,and Concomitant .
Concordances
By including a chapter on concordance, Boger has made the philosophy clearer and
Pocket Book.
Arrangement of this repertory in most of the chapters start with general rubric.
subsections.
This book contains 53 Chapters and the 24 th chapter is ANUS and RECTUM.
In this section various conditions &cross reference related to the parts are given. The
25
General section- deals with medicines related to anus and rectum in general
cross reference.
METHOD OF REPERTORIZATION
Fever totality
INTRODUCTION PART
MATERIA MEDICA
REPERTORY PROPER
CONCORDANCE PART
26
ADVANTAGES
repertorization.
simillimum
different medicinal substances are used in varied potencies to help cure hemorrhoids
case.
challenges them, as the only method for treatment is local medication and surgical
removal.
offers the best treatment for piles or hemorrhoids. At the same time the homoeopathic
medicine does not have any side effects.This is one of the biggest advantages of
homoeopathy over any other system of medicine. While under treatment of any other
27
system of medicine the risk of getting one or the othetr side effect while homoeopthic
Homoeopathic treatment of piles not only focuses on relieving the symptom of the
patient, moreover it acts mainly on the root cause of piles which actually gives quick
treatment that does not require a surgery or invasion.A combination of life style
changes and homoeopathic treatment can be a great relief to a person suffering from
treatment can remove the tendency and there by prevent its recurrence .
According to Dr.Gilchrist J.G “Hemorrhoids are,by irregulars,often tied,but
the practice is not only useless ,but may be a source of positive danger. (29)
28
According to Dr.Burnet “There is no such a thing as primary pile –they are all
in vein affections only comes in as a last resort where nothing elsecan be done
According to Dr.J.H Clarke “An operation does not remedy the state on which
the piles depend ,on the co ntrary,it merely removes an expression of the
Hemorrhoids are generally sycopsoric and are classed under the psoric miasm
when they are associated with discomfort and itching .Rectal hemorrhoids with
extreme sensitiveness and pain are sycotic.Rectal fissures and hemorrhoids with
putrid and foetid discharges are syphilitic .They may also ooze pus .Strictures,
hemorrhoids sinuses, fistulas and pockets in rectum are of tubercular origin and are
are tubercular(34)
Treatment of hemorrhoids with individualized homoeopathy :An open observational
pilot study
342.
was using five standardized like bleeding ,pain itching heaviness and anoscopic
29
score.In India it was conducted in 2 homoeopathic hospital during mid july 2014-mid
enrolled ,38 completed,14 dropped out statiscally ,in this significanant reduction of
scales.However being observational Trial ,our study cannot provide efficacy data
Lot of people do kmow that they have hemorrhoids .Rectum is not an area one can
readily see.Sometimes one don‟t know he or she has hemorrhoids until it bleeds , the
toilet water after a bowel movement or having pain or discomfort in the rectum or
feel extra tissue around the rectum are noticed.The only way you can get
pregnant and not eating fiber ,Daily heavy lifting ,eating excessive processed foods.
review Botanical treatment and nutritional theraphy safe and effective theraphy for
year after year,becausethey have no knowledge of how to treat or get rid of it.The
sufferer will usually develop an internal Hemorrhoid mostly due to constipation .(37)
30
Homoeopathic similimum treatment on Heemorrhoids during pregnancy Of the
patienrs had been assessed during the period of 6 months and progress reported in
hemorrhoids. (39)
A DOCUMENTATION OF PRESCRIPTIONS &CLINICAL OUTCOMES IN A
ailments .The study was a prospective and observational which was carrried out in
Bhattacharya homoeopathic medical college & hospital ,west bengal. Each case was
documented for a period of 3 months out of 2,095 appointments 2,272 cases gaves a
positive outcome after treatment strong positive results (scores of +2 or +3 ) were got
31
CORECT SCALE
Colorectal Evaluation of Clinical Therapeutic scale(CORECTS) combines the 5
cardinal symptoms of hemorrhoids: pain, itching, swelling, bleeding and discomfort, each
rated to a numeric 0-10 scale, where 0 indicates no symptoms and 10 indicates worst
possible symptoms. In addition, CORECTS also accounts for quality of life with an
“impact on well-being (IW)”. Score , that measure the impact of hemorrhoidal symptoms
on well-being[43]
CORECT SCALE
SYMPTOM SCORE
32
4. MATERIALS AND METHODS
SOURCES OF DATA
• Both sexes
ruled out.
33
4.4 EXCLUSION CRITERIA
• Pregnant women
improvement.
• The data was collected based on the pre –structured skhmc case record
format.
4.6 INTERVENTION
homoeopathic principles.
34
4.7 SELECTION OF TOOL
• CORECT scale.
homoeopathic principles.
35
4.9 OUTCOME ASSESSMENT
• Effectveness of 2 repertories.(BBCR&GUERNSEY).
• Pre test score observed with CORECTS and after treatment with indicated
• Paired „ t‟ – test for statistical analysis was done .Analysis was done in
36
5. OBSERVATION & RESULTS
A Sample of 30 cases from patients who attended the outpatient department, inpatient
& rural centers of Sarada Krishna Homoeopathic Medical college & Hospital was
taken for the study. All thirty cases were followed up for a period of study of 6
months The cases are subjected to statistical study following table reveals
CHART 1
No. of Patients
Male
Female
In 30 cases under study 15 females and 15 males were equally affected with a
37
TABLE:2 DISTRIBUTION OF CASE ACCCORDING TO SEX
Sl No. Age No. of Patients Percentage
1 21-30 8 26.67%
2 31-40 4 13.34%
3 41-50 12 40%
4 51-60 6 20%
CHART 2
60
50
40
Percentage Affected
30
No. of Patients
20
10
0
Age 21-30 31-40 41-50 51-60
30 Patients are selected from the OPD for the study purpose,the age of the sample
varies from 20-60 years.Among these 41-50 age group shows maximum number of
cases as 12 ,and followed by 20-30 age group as 8.Next frequency is seen in the age
group 51-60 age group as 6 .the least came under the age group 31-40 age group as 4
38
TABLE 3 DISTRIBUTION OF CASE ACCORDING TO DIET
Mixed 25 83%
Vegetarian 5 17%
CHART 3
No .of patients
Mixed Vegetarian
17%
83%
The study reveals that total 30 cases 25 cases were mixed (veg & non veg)83% and
39
TABLE 4 DISTRIBUTION OF CASES ACCORDING TO FAMILY HISTORY
CHART 4
Persons affected
23%
Non affected
77%
According to family history in 30 cases there are 7 cases (23%) having the
hereditary relation ship in hemorrhoids and 23 cases doesn’t have any relation ship.
40
TABLE 5 DISTRIBUTION OF CASE ACCORDING TO OCCUPATION
CHART 5
HOUSE WIFE
DRIVER
STUDENT
BUSINESS
WELDING WORK
INTERIOR DESIGNER
TEACHER
MAISON
SECURITY
PHARMACIST
PHARMACIST
The study reveals that the house wives are predominantly affected 11 cases
Business man 3 cases (10%)and then welding work cases 2 cases(7%).The least
41
TABLE 6 DISTRIBUTION OF CASES ACCORDING TO SYMPTOMS OF
HEMORRHOIDS
CHART 6
DRYNESS
ITCHING
NO OF CASES
STITCHING PAIN
PERCENTAGE
DIFFICULT STOOL
BLEEDING
0 5 10 15 20
NO OF PERSONS
According to frequent symptoms among 30 cases 13 cases have Burning pain ,7 cases
have stitching pain ,7 cases have aching pain ,Bleeding present among 17 cases
42
TABLE 7 DISTRIBUTION OF CASES ACCORDING TO AGGRAVATING
FACTORS
CHART 7
14
12
10
8
NO OF PERSONS
6
4 PERCENTAGE
2
NO OF CASES
0
According to aggravating factors of 30 cases ,12 cases were suffering from pain
during stool, 12 cases during sitting 5 cases were during spicy food , ,8 cases during
touch ,5 cases during walking ,3 cases stool hard after ,& finally 3 cases during riding
43
TABLE 8 DISTRIBUTION OF FIRST FIVE MEDICINES IN BBCR
No. of
cases
1 SULPHUR 29 96%
2 NUX VOMICA 27 90%
3 CALCAREA CARB 12 36%
4 SEPIA 12 36%
5 NATRUM MUR 8 26%
6 ARSENICUM ALBUM 6 20%
7 NITRIC ACID 5 16%
8 PHOSPHORUS 4 13.3%
9 ALOES 4 13.3%
10 GRAPHITES 3 13%
11 LYCOPODIUM 2 6%
12 MERCURIS 2 6%
13 BELLADONNA 1 3%
14 ALUMINA 1 3%
15 CAUSTICUM 1 3%
16 IGNITIA 1 3%
17 MURATIC ACID 1 3%
44
CHART 8
GRAPHITES
ALOES
PHOSPHORUS
NITRIC ACID
ARSENICUM…
SEPIA
CALCAREA…
NUX VOMICA
SULPHUR
0 5 10 NO OF15CASES 20 25 30
Among 30 cases first five medicines which comes under BBCR are 29 cases covers
sulphur,27 cases covers nuxvomica,12 cases cover Calcarea carb,12 cases covers
sepia,8 cases cover Natrum mur ,6 cases covers Arsenicum album ,5 cases cover
Nitric acid ,4 cases cover phosphorous & Aloes.3 cases covers Graphites,2 cases
cover Mercuris & lycopodium and the least cover 1 Medicines are
45
TABLE 9 DISTRIBUTION OF FIVE MEDICINES IN GUERNSEY
REPERTORY
SL MEDICINES NO. OF
NO CASES
1. SULPHUR 27
2. MURIATIC ACID 14
3. ALOES 12
4. NITRIC ACID 11
5. GRAPHITES 8
6. CALCAREA CARB 7
7. ARSENICUM ALBUM 6
8 ASECULUS 6
9. THUJA 5
10 PULS 5
11 KALI CARB 2
12 SILICEA 2
13 BELLADONNA 2
14 CAUSTICUM 2
15 PHOSPHORUS 1
CHART 9
MEDICINES
Among 30 cases first five medicines in guernsey, in which sulphur covers 29 cases
,muriatic acid covers 14 cases ,Aloes cover 12 cases,nitric acid covers 11
cases,Graphites with 8 cases,Calcarea carb with 7 cases,Arsenicum album and
46
Aseculus with 6 cases ,Thuja & pulsatilla with 5 cases,kali carb,silicea
,belladonna,causticum with 2 cases,& phosphorus with 1 case.
CHART 10
3% 3%
6%
6% 29%
7%
7%
10%
29%
According to final similimum among 30 cases,Nux vomica & sulphur which equally
47
acid with 2 cases , Arsenicum with 2 cases ,Aloes with 2 cases and Least covers
CHART 11
NO OF CASES
Both
Repertories
40% Based on
general &
particular
57%
Particular
3%
Among 30 cases , 17 cases (57%) medicine prescribed by considering the general &
48
TABLE 12 COMPARISON OF BEFORE AND AFTER VALVES OF CORECT
SCALE
1. 29 4
2. 28 6
3. 27 11
4. 29 14
5. 28 4
6. 21 4
7. 31 10
8. 32 2
9. 31 4
10. 29 6
11. 30 6
12. 33 14
13. 19 6
14. 30 2
15. 28 13
16. 27 3
17. 28 14
18. 24 6
19. 18 3
20. 30 3
21. 21 3
22. 27 10
23. 28 9
49
24. 32 4
25. 29 4
26. 28 7
27. 30 5
28. 31 4
29. 25 4
30. 32 6
CHART 12
20 21 21
19
18
15
14 14 14
13
10 11
10 10
9
7
5 6 6 6 6 6 6
5
4 4 4 4 4 4 4 4
3 3 3 3
2 2
0
1 2 3 4 5 6 7 8 9 10 11 12 13 NO
14 15
OF 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
CASES
Total 30 cases were compared using CORECT scale and the improvement marked
based on before & after scale and it shows a marked improvement
50
TABLE 13 DISTRIBUTION OF CASE ACCORDING TO MEDICINE
PRESCRIPTION
WEEKLY DOSE
26%
NUMBER OF
POTENCIES USED PERCENTAGE
PATIENTS
200 21 70%
MILLESIMAL POTENCIES
5 17%
(0/3,0/4)
1M 4 13%
51
CHART 14
17%
13%
13%
70%
Among 30 Cases ,21 cases were prescribed with 200 potency (70%),5 cases were
prescribed with 0/3,0/4 (Millesimal potency )and only 4 cases were prescribed with
1M potencies
MILD IMPROVEMENT 2 7%
52
CHART 15
DISTRIBUTION OF CASE
ACCORDING TO IMPROVEMENT
40
NO OF
20
PERSONS NO OF CASES
0
IMPROVEMENT
Among 30 cases under study 23 cases shows marked improvement, 5 cases shows
moderate improvement & 2 cases shows mild improvement .
53
STATISTICAL ANALYSIS
TABLE NO.14
d= mean difference
54
A.NULL HYOTHESIS
There is no difference between the disease intensity scores taken before and after the
homoeopathic treatment .
B.ALTERNATE HYPOTHESIS
There is difference between the disease intensity scores before and after the
homoeopathic treatment .
Ʃ(d1- 1)2=686.6
SD =√Ʃ( ̅ ) ⁄
√ ⁄ =4.86
= 4.86/√ =.887
̅
Critical ratio, =21.4/(0.889) =24.07
⁄
√
55
t-Test: Pai red two samp le for means
X Y
Observations 30 30
Df 29
t Stat 24.11391
The above data depicts that the mean and varianceeof before and after intensity score
56
E.COMPARISON WITH TABLED VALVE
The critical ratio ‘t’ follows a distibution with n-1 degrees of freedom.The 5%level is
2.04523 and 1%level is 1.69 for 29 degrees of freedom .since the calculated valve
24.07 is greater than the tabled value at 5%and 1% level the null hypothesis is
rejected.
F.INFERENCE
This study shows significant reduction in the disease intensity scores after the
homoeopathic treatment. Hence ,this study shows that homoeopathic treatment is very
57
6. DISCUSSION
My study mainly focused to show comparison of Rubrics in BBCR with the rubrics of
Hemorrhoids by guernsey repertory .The subjects for the study were selected from the
patients with symptoms of Hemorrhoids who attended the OPD& IPD of Sarada
cases are selected for the study between the age group 18-65 years,based on clinical
presentation.
The medicines were selected for each individual case, after analysis & repertorization
using BBCR & guernsey repertory .Case were reviewed at regular intervals of follow
up criteria were fixed based on symptom ,score chart & cases are followed for a
minimum of 6 months Assessment of all 30 patients are done before & after treatment
.Symptom scoring was done based upon the intensity of the disease before & after
study .Sum of these grades were considered before & after treatment analysed
From the observations recorded in the study.I discuss some of the findings that have
been brought out new from my study and also relate my evolvement with some
58
GENDER
In my current study in 30 cases under study 15 patients were female (50%) and 15
A Study in a semi urban area GG.Rabindranath B.G Rahul .Dept of general surgery
says that 33.3 were female and remaining 30 were males .So my study when corelated
with previous study shows that males and females are prone to have Hemorrhoids .
AGE
In my study 30 patients are selected from OPD for study purpose.The age sample
varies from 18-65 years .Among these 41-50 age group shows maximum number of
patients 12 cases (40%).21-30 years shows 8 cases (27%) .31-40 years age group
shows 4 cases.
Institue of Unani Medicine “An overview a cross sectional study by Rizwan mansoor
khan A study was Carried out in 311 patients of National Institue of unani
This corelation conveys that age group 41-50 years are more eminent to develop
Hemorrhoids.
OCCUPATIONAL STATUS
59
cases,welding workers 2 cases .The least representation was among interior designer
A Study of Related to Risk Factors and clinical features of Hemorrhoids by S.Asif Ali
Mysore .Among 250 patients,55 patients are housewives ,15 students and 10 business
man.
Another study was conduct from department of clinical pharmacy and pharmacy
In the study housewives were affected due to pregnancy.sendentary food styles ,spicy
food .At first they neglect the disease after worsening they seek Medicine ,This may
DIET
Based on dietary Habits of my study ,Among 30 cases the 25(83%) cases are Mixed
“A Study in a semi urban area GG.Rabindranath B.G Rahul .Dept of general surgery
patients less that 40% of patients were vegetarians with more than half of patients
When compared with my study mixed diet patients are prone to get Hemorrhoids.
Vegetarians diet has more chance of fiber content indiet.This may be reason why
60
FAMILY HISTORY
A Study in a semi urban area GG.Rabindranath B.G Rahul .Dept of general surgery
patients more No.of women with h/o of Hemorrhoids in their family 47.6% while H/o
This corelation conveys that there is relation ship between family History in case of
Hemorrhoids.
SELECTION OF RUBRICS
In ,my study ,rubrics are selected from Boger Boenninghausen‟s characteristics &
Repertory & guernsey repertory .from this the most frequently used rubrics are
Bleeding in 17 cases (56)% Burning pain in 13 cases (13), ,stiching pain in 7 cases
case,Dryness in 2 (6%) cases ,Difficult stool in 8 cases(26%) .So in this study ,the
most commonly used rubric was Bleeding which had been used in 17 cases (56%).In
61
under subjective symptom,fissure & sensitiveness are objective symptom. Since there
& Repertory & Guernsey repertory from this most frequently used aggravating
factors are during stool in 12 cases (40%) sitting in 12 cases (40%),,spicy food in 5
3(10%) cases ,riding in 3 (10%)cases .So in this study the most commonly used
motor cyclistsin Kaduna state ,Nigeria 290 motor cyclists in kaduna state ,that
BBCR
Among 30 cases first five medicines which covers in BBCR are Sulphur in 29
62
common medicine in BBCR is Sulphur with 29 (96%)cases. Since there was no
previous studies based on these ,my study says that sulphur is found to be effective in
GUERNSEY
Among 30 cases first five medicines which cover in Guernsey are Sulphur in 27
most common in Guernsey repertory is Sulphur with 27 cases (90%). Since there was
no previous studies based on these ,my study says that sulphur is found to be effective
&GUERNSEY )
By comparing 30 cases the medicines in Both Repertories ,Sulphur occupies the top
position in BBCR & Guernsey .Other than this ,Medicines common in both
Repertories are Calcarea, Arsenicum album Phosphorous, Aloes,Graphites
Belladonna,Causticum,Muriatic acid but with different gradations.The medicines
which present only in BBCR are
Sepia,Nat.mur,Lycopodium,Mercuris,Ignitia,Alumina.The medicine which present in
Guernsey are Aesculus,Thuja,Pulsatilla,kali carb,Silicea.Since there was no previous
studies based on these ,my study says that sulphur is found to be effective in all
hemorrhoids case.
63
DISTRIBUTION OF CASES ACCORDING TO MEDICINE PRESCRIBED
The most used medicine was Nux vomica & sulphur out of 30 patients ,9 patients
(29%) got improved after prescribing nux vomica , & 9 Patients (29%) got relief
prescribing sulphur ,3 patients (10%) prescribed with Calcarea carb, 2 Patients (7%)
clinical case recorder ,A peer reviewed journal,by Patilj.d ,Ashish Bhagat in this
study it mentions that nearly about 76%of cases avoid the surgery and few peoples to
relieve them of suffering with the help of sulphur and proved sulphur was effective in
This study correlates with my study that sulphur is very effective in treatment of
Hemorrhoids
Hemorrhoidal disease it was a randomised single blind placebo –controlled Trial “(41)
Among 125 patients 30 patients improved with phosphorous & next 22 improvement
by Nux vomica.
This study also corelates with my study that nux vomica is effective in treatment of
hemorrhoids.
64
DISTRIBUTION OF CASES ACCORDING TO COMPARATIVE SIMILARITY
OF BOTH REPERTORIES
Among 30 cases , 17 cases (57%) medicine prescribed by considering the general &
the both repertories rubrics , and only 1 case (3%)medicine prescribed according to
selecting medicine from individual repertory , BBCR Covers 17 cases, and it found to
By this study can conclude that complete symptom Repertory (ie BBCR –Repertory
with mental ,physical ,& particular symptom) helps in improvement of patient more
than other Repertory (GUERNSEY- Only particular symptom ) Since there was no
previous studies based on these ,my study says that complete symptom repertory
According to my study from 30 cases ,10 cases are prescribed with daily dose,7 cases
are prescribed with weekly dose,6 cases were prescribed with alternating dose ,4
cases are prescribed with once in a month. Since there was no previous studies based
on these ,my study says that medicine prescibed on daily dose shows improvement
of patient .
65
DISTRIBUTION OF CASES ACCORDING TO POTENCY GIVEN
According to this study from 30 cases ,21 cases (70%) were treated with 200
potency ,and 5 cases (17%) with ) 0/3,0/4 potency,and 4 cases with 1M Potency .
And so,the commonly used potency in this study was 200 potency. And it reveals that
the majority of the patients were improved with 200 potency in Hemorrhoids.
adult age group by Dr.joseph T.kariyil ,among 30 cases 23 cases were prescribed with
centisemal potencies ,13 cases were decimal potencies and 3 cases were LM scale
PATIENT
66
7. LIMITATIONS
2. This was a time bound study .The cases were followed up only for a period of
maximum 2 months
3. Selection of cases were difficult since many of the cases were irregular in
5. There was no control group since the sample size was small.
6. In some cases necessary information was lacking and the study was based on
7. There was not enough standard studies to compare or take guidance from a
study of this nature in homoeopathy .There fore some human errors are
expected .
8. Proctoscopy procedure was limited because ,Most of the patients are from
rural areas and also mostly females and they were not ready to do protoscopy .
67
RECOMMENDATIONS
1. Bigger sample size with extended time for research will provide better
results .
68
8.CONCLUSION
The study results showed prevalence in the age group of 41-50 years .Males and
females are equally affected .females were more affected are mostly they were
housewives.Sulphur & Nuxvomica were frequently used remedy which equally
covers 9 cases (29%),Calcarea carb with 3 cases (10%),Graphites with 2 cases,Nitric
acid with 2 cases , Arsenicum with 2 cases ,Aloes with 2 cases and Least covers
Muriatic acid & Natrum Mur .7 cases showed family History of Hemorrhoids.
The disease intensity score before treatment showed marked reduction after treatment
in all the cases.Marked improvement in 76% and remaining 24% reported one or two
symptoms like swelling or pain during defecation.
The statistical analysis for testing the significance of the study by „t test „showed that
Homoeopathic treatment is very effective in treatment of Hemorrhoids .
69
9. SUMMARY
Inclusion &Exclusion criteria. The cases were repertorized under 2 categories and
prescription after careful analysis based on totality of symptoms .30 cases were
statistical analysis and results were made from observations My study which was
which was the scale I had used for pain .On analysis marked reduction of symptom
was noticed after medicine prescription in BBCR. Clinically it was proved that
70
10. BIBILOGRAPHY
2. Das somen A Concise text bok of surgery with orthopedics and fractures 4 th
edition ,Calcutta;Dr.S.Das;2006
2018
2008
,october 2008
71
12. Shenoy Rajgopal k.manipal Manual of surgery 2 nd edition CBS Publishers
15. Jennifer whitlock “causes and risk factors of Hemorrhoids march 11,2019
16. Beson and pernolls Hand book of obstetrics and gynaceology ,9 th edition
21. Ravindranath G.G and B.G Rahul .”prevalence and Risk Factors of
72
25. Swirezewki ,stanley “Gastointestinal surgery procedures “ post operative
30. Hahnemann samuel .The chronic disease their peculiar nature and their
31. Gilchrist J.G Homoeoapthic treatment of surgical diseases ,New delhi ,jain
32. Burnett compton J. Diseases of the vein 5th edition.New delhi B .jain
33. Clarke john H.Hemorrhoids and habitual constipation their constitutional cue
73
36. Hemorrhoids –A common ailment among adults ,causes & treatment :A
,Homeheathandfitnessoctober2015
20082009
clinical case recorder ,A peer reviewed journal volume 19.no 5 may 2012
40. Saha,suhranil,munmunkloley,shubhamoyghosh,mohangiri,asimdas,and
41. A Study on associated risk factors of hemorrhoids R.M khan –google search-
https://www.researchgate.net/publication/276575970_A_STUDY_ON_ASSOCIATED
_RISK_FACTORS_OF_HAEMORRHOIDS
scale.
74
APPENDIX 1
GLOSSARY/DEFINITIONS
REPERTORY
MATERIA MEDICA
The branch of medical science concerned with the study of drugs used in the
treatment of disease .It includes Pharmacology ,clinical pharmacology,and the history
,physical and chemical properties of drugs&the drugs used in the treatment of disease.
RUBRICS
Rubrics are the converted forms of symptoms of aperson or drug thus a rubric is the
repertorial language of reperesenting a symptom.
SIMILIMUM
The homoeopathic remedy that produces the set of symptoms most like that which the
disease produces.
POTENCY
The power is derived by the grades of medicinal power as developed by the process of
dynamisation.potency means dilution of energy .
AGGRAVATION
AMELIORATION
75
APHORISM
PLACEBO
ANEMIA
HEMORRHOIDECTOMY
SKIN TAG
Skin Tags are small flesh –coloured or brown growths that hangs off the skin and look
a bit like warts.
PYLEPHLEBITIS
HEMATOCRIT
The hematocrit also known aas packed cell volume ort erythrocyte volume fraction is
the volume percentage of red blood cells in the blood .
76
Appendix - V
SARADA KRISHNA
Name:
Age: Sex: Religion: Nationality:
Name of father/Spouse/Guardian/Son/Daughter:
Marital status:
Occupation:
Family size:
Diet:
Address:
Phone No (Mobile):
FINAL DIAGNOSIS:
Homoeopathic
Disease
77
2. INITIAL PRESENTATION OF ILLNESS
PATIENT’S NARRATION PHYSICIAN’S PHYSICIAN’S
(in the very expressions INTEROGATION (details OBSERVATION
used by him/her) Regarding symptoms narrated
78
3. PRESENTING COMPLAINTS
79
5. HISTORY OF PREVIOUS ILLNESS
exposure(s), innnoculation,
analgesics, etc.
80
6. HISTORY OF FAMILY ILLNESS
7. PERSONAL HISTORY
A. LIFE SITUATION
Place of birth: Caste:
Socio- economic status:
Nutritional status:
Dwelling: Customs: Nature of Work:
Political Status:
Religion:
Educational status :
Marital status: Year of Marriage:
Family status:
Father: ; Mother: Siblings: Male: Children:
Addictions:
Sleep:
Artistic:
Games/Sports:
C. DOMESTIC RELATIONS
With family members:
With neighbours/friends/colleagues:
D. SEXUAL RELATIONS:
Pre-Marital: Marital: Extra Marital:
Others:
81
8. LIFE SPACE INVESTIGATION
9. MENSTRUAL HISTORY:
CONCOMITANTS
After Marriage
C. Climacteric:
82
Symptoms associated
Child
83
B.Contraceptive method(s) adopted 1.Temproary
(used/inuse/duration)
Other Complaints
A. PHYSICALS
I. FUNCTIONAL
1. Appetite :
2. Thirst :
3.Sleep :
4. Dreams
II. ELIMINATIONS
1. Stool :
2. Urine :
3. Sweat :
4. Breath
5. Discharges
III . REACTIONS TO
84
REACTIONS Aversions Desire Intolerance/ Aggravation Amelioration
TO Sensitive to
Time
Thermal
Season
Meterological
Moon Phase
Places
Air/Fanning
Clothing/Covering
Bathing/Washing
Food/Drinks
Undigested Food
Touch/Pressure
Posture
Motion
Sleep
Sex
Spl.Senses
Eliminations
Menses
IV . CONSTITUTIONAL
B. MENTAL GENERAL
1. Will & Emotions including motivations ( Love, hat, anger, sadness, fear.fright,
anxiety, suspicious, cause, modalities, state, aversion and cravings ( excluding food &
drinks,) etc.
85
3. Memory (Effect on Behaviour & functions)
A) GENERAL
Conscious :
General appearance:
Height
Weight
BMI
Anaemia:
Jaundice:
Clubbing:
Cyanosis:
Oedema :
Nails
Gait
Lymphadenopathy:
Temp
Others
86
B.SYSTEMIC EXAMINATION
1.Respiratory system:
2.Cardiovascular system:
4.Urogenital system:
6. Musculoskeletal system
8 . Endocrine:
10.Others:
C.REGIONALS
14. DIAGNOSIS
Provisional Diagnosis :
Differential Diagnosis:
87
15 .DATA PROCESSING
A . ANALYSIS OF CASE
COMMON UNCOMMON
C. MIASMATIC ANALYSIS:
Family History
Past History
Mind
Body
88
Miasmatic Diagnosis:
D. TOTALITY OF SYMPTOMS
E. HOMOEOPATHIC DIAGNOSIS
16 . SELECTION OF MEDICINE
B. Repertorial Approach
for repertorisation)
89
b) Repertorial result:
Medicine
c) PDF if any
A. Potency
B. Dose
18. PRESCRIPTION
A. General/Surgical/Accessory:
90
Disease Medicinal
91
APPENDIX III
SCORE CHART
BEFORE TREATMENT
92
SCORE CHART
AFTER TREATMENT
93
FORM - 4 : CONSENT FORM (A)
The procedures include 30 cases of Hemorrhoids from the OPD, IPD and Peripheral OPD
centres of Sarada Krishna Homoeopathic Medical College. Protoscopy will be done in
the patients presenting with the symptoms of Hemorrhoids . The case details will be
recorded in standardized case record format of Sarada Krishna Homoeopathic Medical
College. Then the cases will be analysed and totality will be evaluated. Repertorisation
was done and a well selected remedy will be prescribed based on totality. Follow up will
be done once in two weeks and patient will be assessed according to CORECT scale.
The benefits to the subject or others, reasonably expected from research are the
participants are investigated to find out whether he/ she is having Hemorrhoids if a
participant is identified to have Hemorrhoids or is a known patient with Hemorrhoids
he/ she will be given an awareness about the risk factors of Hemorrhoids .Thus study is a
benefit not only to the participant but also to the society as a whole. The records are
maintained highly confidential. Only the investigator have the access to subjects medical
records. Participants identity will never be disclosed at any time , during or after the
study period or during publication of the research. Securely store data documents in
locked locations and Encrypt identifiable computerized data. All information revealed by
patient will be kept as strictly confidential. Free treatment for research related injury is
guaranteed. Compensation of the participants not only for disability or death resulting
from such injury but also for unforeseeable risks is provided, in case situation arises.
94
Contact for trial related queries, rights of subjects and in the event of any injury.
INVESTIGATOR
Dr R.Reeba
Department of Repertory
Sarada Krishna Homoeopathic Medical College and Hospital
KulasekharamKanyakumari District, Tamilnadu -629161
Ph no: 9159262486
GUIDE
95
FORM - 4 A
i. I confirm that I have read and understood the information sheet dated [ ]
__________ for the above study and have had the opportunity to ask question.
ii. I understood that my participation in the study is voluntary and that I am [ ]
free to withdraw at any time’ without giving any reason. Without my medical care
or legal rights being affected.
iii. I understand that the sponsor of the clinical trial, others working on the sponsor’s
behalf’ the Ethics Committee and the regulatory authorities will not need my
permission to look at my health records both in respect of the current study and
any further research that may be conducted in relation to it, even if I withdraw
from the trial. I agree to this access. However, I understand that my identity will
not be revealed in any information released to third parties or published. [ ]
iv. I agree not to restrict the use of any data or result that arise from this study [ ]
Provided such a use is only for scientific purpose(s)
v. I agree to take part in the above study.
96
APPENDIX – V
SAMPLE CASE -1
SARADA KRISHNA
FINAL DIAGNOSIS:
Homoeopathic HEMORRHOIDS
97
2. INITIAL PRESENTATION OF ILLNESS
PATIENT’S PHYSICIAN’S PHYSICIAN,S
NARRATION (in INTEROGATION (details OBSERVATION
the very expressions Regarding symptoms narrated)
used by him/her)
Iam suffering from how long do you suffer from this Talkative
Burning pain in complaint? Answers in one word
anus, swelling Since 6 months
,sensitiveness in
anus While touching When did your complaint get worse?
no bleeding ,but
itching present It get worse after stool, wiping
Coughing, urination, during stool.
98
3. PRESENTING COMPLAINTS
99
Complaint of patient started before 6 month as burning pain in anus A/F
taking chicken after one month he noticed that swelling present in anus ,sensitive to
touch ,no bleeding but itching present .She had undergone traditional medicine and
got temporary rellief .since 4 months again complaint appears.
exposure(s), innnoculation,
analgesics, etc.
7. PERSONAL HISTORY
A. LIFE SITUATION
100
Place of birth: Kadiyapatinam
Socio- economic status: good
Nutritional status: good
Dwelling: kadiyapatinam Customs: - Nature of
Work: mild
Political Status: -
Religion: muslim
Educational status :12th
Marital status: married Year of Marriage: 25 years
Family status: 5 members
Father:diedMother: alive Siblings: Male: Children:
Artistic:nil
Games/Sports:kabadi
C. DOMESTIC RELATIONS
With family members:good
With neighbours/friends/colleagues:good
D. SEXUAL RELATIONS:
Pre-Marital: nil Marital: Extra Marital:nil
Others: nil
101
.He is not having children up to 10 years after marriage .After treatment they got 3
children .As a person he was well talented ,easily tensed ,intelligent ,he knows more
than 3 languages (marathi ,arabic english ,tamil,malayalam) He was worked as an
security officer before some years.
CONCOMITANTS
After Marriage
C. Climacteric:
102
Symptoms associated
Child
103
C.Present Pregnancy: L.M.P Date of Quickening
E.D.C
Other Complaints
A. PHYSICALS
I. FUNCTIONAL
1. Appetite : 3-4 times meals/day
3.Sleep :good
II. ELIMINATIONS
1. Stool :regular
2. Urine : normal
4. Breath-nil
5. Discharges- nil
104
III . REACTIONS TO
IV. CONSTITUTIONAL
105
B. MENTAL GENERAL
1. Will & Emotions including motivations ( Love, hat, anger, sadness, fear.fright,
anxiety, suspicious, cause, modalities, state, aversion and cravings ( excluding food &
drinks,) etc.
Easily tensed
Normal
Intelligent
A) GENERAL
Conscious :conscious
General appearance:good
Height-170 cm
Weight-84.4kg
BMI
Anaemia:No pallor
Jaundice:not icteric
Clubbing:Nil
Cyanosis:Nil
106
Oedema :nil
Gait- steady
Lymphadenopathy:nil
of hg
Temp-98.6 F
Others- Nil
B. SYSTEMIC EXAMINATION
1. Respiratory system:NAD
2. Cardiovascular system:NAD
4. Urogenital system:NAD
Inspection –Externally no ulcer ,no bleeding ,no discharge , 1 inch prolpase during
strainning.
6. Musculoskeletal system:NAD
107
8. Endocrine:NAD
10. Others:NIL
C.REGIONALS
Nothing specific
15 .DATA PROCESSING
A . ANALYSIS OF CASE
COMMON UNCOMMON
Burning in anus with lumbar pain
Burning pain in anus &abdominal pain
Itching Intelligent
<stool during++
<stool after
<coughing+
<Urination
<wiping
108
B. EVALUATION OF SYMPTOMS/TOTALITY OF SYMPTOMS
109
BBCR GUERNSEY
C. MIASMATIC ANALYSIS:
110
PSORA SYCOSIS SYPHILIS
Hemorrhoids
pox
C. TOTALITY OF SYMPTOMS
According to BBCR
Burning
hemorrhoids swelled
sensitive,blind
urine burning
ACCORDING TO GUERNSEY
111
Swollen hemorrhoids see large,
burning
sensitiveness
,<stool after
<cough,
<mituration during
<wiping
<after Stool
itching
16 . SELECTION OF MEDICINE
B. Repertorial Approach
According to BBCR
symptom
112
swelled symptom
symptom
blind symptom
with
aggravation
aggravation
aggravation
b) Repertorial result:
113
According to Guernsey
Repertorial totality
c) PDF if any_nil
114
18. PRESCRIPTION
RX
Disease Medicinal
Avoid Spicy food Avoid strong stimulants like coffee &
narcotics
Avoid meat
Avoid egg
Follow up Prescription
Date Rx
20.12.18 ALOES 1M /1D
Pain Itching Swelling Bleeding Discomfort Impact
4 6 4 3 5 5
Burning in anus persists
Sensitive to touch slighty better
Abdominal pain & lumbar region pain
<stool after
<during stool
<coughing
<micturation
Date Follow up Prescription
31.12.18 Rx
SL 1D
Pain Itching Swelling Bleeding Discomfort Impact
3 0 6 0 2 2
Burning in anus persists
Sensitive to touch slighty better
Abdominal pain & lumbar region pain
<stool after persists
115
ate Follow up Prescription
9.1.19 Rx ALOES 1M /1D
116
Date Follow up Prescription
27.2.19 Rx SL1D
CORECT SCALE
117
SAMPLE CASE -2
SARADA KRISHNA
FINAL DIAGNOSIS:
Homoeopathic CHRONIC MIASMATIC DISEASE-PSORA
Disease HEMORRHOIDS
118
2. INITIAL PRESENTATION OF ILLNESS
PATIENT’S PHYSICIAN’S PHYSICIAN,S
NARRATION (in the very INTEROGATION (details OBSERVATION
expressions used by Regarding symptoms
him/her) narrated
Iam suffering from aching How long do you suffer Anxious about disease
pain, discomfort & from this complaint ?
inflammation in anus Maintain eye to eye
since six months, it get since 5 year A/F after contact
aggravated during menses pregnancy.
sitting ,while touching. Moderate status
Any other concomitant
symptom with this? Thick long hair
119
LOCATION SENSATION MODALITY CONCOMITANTS
&
(tissues,organs,systems
PATHOLOGY
extensions & duration (>,<) & A/F (=) IF ANY
<sitting
<touch
<mental exertion
Discomfort
Inflammation
discomfort in the anal region later on aching pain started after delivery had adopted
traditional medicine and got a temporary relief .since 6 month again old complaints
operation(s), exposure(s),
innnoculation,
120
vaccination(s), serum,
steroids, hormone
therapy, antibiotics,
analgesics, etc.
year
2. Before 5
Hemorrhoids Homoeopathy Relieved
year
Nothing Relavant
7. PERSONAL HISTORY
A. LIFE SITUATION
Place of birth: Marthandam
Socio- economic status: Moderate
Nutritional status: Moderate
Dwelling: Thiruvattar
121
Nature of Work: Mild
Political Status: -
Religion: Christain
Educational status: BE
Marital status: Married Year of Marriage: 24 years
Family status: 4 members
Father; Alive Mother: Died Siblings: 2 brothers Children:2 female
Addictions:
Artistic:Nil
Games/Sports:Caroms
C. DOMESTIC RELATIONS
With family members:Good
With neighbours/friends/colleagues:Good
D. SEXUAL RELATIONS:
Pre-Marital: Nil Marital: good Extra
Marital: Nil Others: Nil
8. LIFE SPACE INVESTIGATION
Patient was born in a Moderate Christianfamily. Her father is a business man and
mother was ahousewife. She had 2 brothers and she is younger of all. Her child hood
life was so happy. She was good in studies.She studied up to BE engineering , she
wish to do ME but her father didn’t allow to her do .She got married at the age of 24
years and she have 2 female children. She was working in an IT company. Her
marriage life was good. At first she had some inconvenience to adjust in husband
family Before 4 months her mother died due to cardiaccomplaints. She have angrief
122
regarding this.one who supported in all situations have lost. She was in good
understanding between brothers family. Easily get tensed
9. MENSTRUAL HISTORY:
CONCOMITANTS
After Marriage
C. Climacteric:
123
Pre-Menopause With Menopause Post Menopause
Child
124
C.Present Pregnancy: L.M.P Date of Quickening
E.D.C
Other Complaints
A. PHYSICALS
I. FUNCTIONAL
1. Appetite: 3-4 times meals/ day
4. Dreams-Nil
II. ELIMINATIONS
2. Urine : Normal
3. Sweat :Generalized
4. Breath-Nil
5. Discharges- Nil
III . REACTIONS TO
125
Time
Thermal Hot
Season
Meteorological
Moon Phase
Places
Air/Fanning Fanning
Clothing/Coverin
g
Bathing/Washing
Food/Drinks Cold food,
meat
Undigested Food
Touch/Pressure
Posture
Motion
Sleep
Sex
Spl.Senses
Eliminations
Menses
IV. CONSTITUTIONAL
1. Will & Emotions including motivations ( Love, hate, anger, sadness, fear.fright,
anxiety, suspicious, cause, modalities, state, aversion and cravings ( excluding food &
drinks,) etc.
Good
Good
126
A) GENERAL
Conscious :Conscious
Height-159 cm
Weight-67 kg
BMI
Anaemia: No pallor
Clubbing: Nil
Cyanosis: Nil
Oedema :nil
Nails- clean
Gait- Steady
Lymphadenopathy: Nil
B.P: 110/80 mm of Hg
Temp-98.6 f
Others- nil
B.SYSTEMIC EXAMINATION
4.Urogenital system:
127
INSPECTION-Externally no ulcer ,no bleeding spots no discharge and 2 inch
6. Musculoskeletal system:NAD
8 .Endocrine:NAD
10.Others:NIL
C.REGIONALS
Nothing specific
14. DIAGNOSIS
128
15 .DATA PROCESSING
A. ANALYSIS OF CASE
COMMON UNCOMMON
Hemorrhoids painful <mental exertion ++
Hemorrhoids painful ,pain in anus
<menses during Appetite decreased
<sitting++ Stool difficult to pass
<touch Grief regarding mothers death
Aversion fanning
Desire cold food
BBCR GUERNSEY
129
C. MIASMATIC ANALYSIS:
Family History
Miasmatic Diagnosis:psora
C. TOTALITY OF SYMPTOMS
ACCORDING TO BBCR
Hemorrhoids in general,
aching ,inflammation ,
discomfort
aversion meat,
130
ACCORDING TO GUERNSEY
Hemorrhoids pain
aching ,
discomfort
inflammed,
<afternoon
menses during ,
sitting,
touch ,
mental exertion
D. HOMOEOPATHIC DIAGNOSIS:Chronic miasmatic Disease Psora
16 .SELECTION OF MEDICINE
B. Repertorial Approach
BBCR
No
in general
anus
131
3. Discomfort Discomfort Particular 610
menses during
sitting
touch
metal exertion
food
pass stool
Repertorialresult:
132
ACCORDING TO GUERNSEY
b) Repertorial result:
133
18. PRESCRIPTION
2. B.PILLS 3XTDS
3. B.DISC 1X B.D
Disease Medicinal
Avoid spicy Avoid strong stimulants
Avoid meat
Avoid egg
Take fibre rich foods
CORECT SCALE
SYMPTOM SCORE
Before After
How much pain do you experience?
0 1 2 3 4 5 6 7 8 9 10
How much itching do you experience?
0 1 2 3 4 5 6 7 8 9 10
How much swelling do you experience?
0 1 2 3 4 5 6 7 8 9 10
How much bleeding do you experience?
0 1 2 3 4 5 6 7 8 9 10
How much discomfort do you experience?
0 1 2 3 4 5 6 7 8 9 10
134
How much impact does your condition have on your well-
being?
0 1 2 3 4 5 6 7 8 9 10
1 0 4 0 1 1
Pain in anus <sitting ,touch mental tension slightly persists.
Appetite improved
Stool difficult to pass persists but better than before
Discomfort improved
Inflammation slightly persists
BP :126/80 mm of hag
135
Date Follow up Prescription
30.8.18 RX NUX VOMICA
200/14D
Pain Itching Swelling Bleeding Discomfort Impact
1 0 4 0 1 1
136
Date Follow up Prescription
11.11.18 RX
SL
Pain Itching Swelling Bleeding Discomfort Impact
0 0 3 0 3 3
Pain in anus <sitting, touch mental tensionbetter.
Appetite better
Stool difficult to pass persists better
Discomfort better
Inflammation better
BP :116/80 mm of hg
CORECT SCALE
137
APPENDIX VI
CASE SUMMARY
Case No.1
Mr.MA of 32 years ,male , who is residing in enayam was a Business man, came to
OPD with the complaints of burning pain and bleeding per rectum Since 4 years ,
increased since 1 month which was aggravated during spicy food ,travelling ,while
passing stool &Ameliorated by standing . irregular Stool once in 2or 3 days .Desire
cold food .He was very much worried about the complaints, Father had a history of
difficult to pass stool appetite- desire cold food . His pulse was 70/min regular BP
complaints was slightly relieved but few weeks after stool becomes hard and the
medicine was repeated asssessing the symptoms of the patient .The presenting
complaints markedly reduced after treatment of 2 months . Before and after scores
were recorded.Case was followed for 8 months.Patient showed good prognosis with
Case No.2
Mr.SS of age 43 years male ,who is residing in Thirunelveli was a driver ,came to
OPD with the complaints of small swelling in anus with protusion & bleeding with
sensation of heaviness in anus since 2 years increased since 6 months which was
138
,fish.Stool become regular but hard The common rubrics in two Repertories were
anus,<sittting ,walking ,Aversion salty food desire potato ,his pulse was 69/min
regular BP 110/70 ,NUX VOMICA 200 was Prescribed based on the totality of the
symptoms. complaints was slight relieved but few weeks later presented with
abdominal distension .So again Nux Vomica 200 and the medicine was repeated
assessing the symptoms of the patient . Before and after scores were recorded .The
Case No.3
Mr .YD of age 48 years male ,who is residing in kumarapuarm was a Business man
came to OPD with the complaints of Burning &itching in anus Since 1 year and
increased since 3 month <passing stool,oily food,spicy food ,sitting ,rubbing .Desire
warm food .Fastidious in nature ,easily weeps. Father & mother had a H/o of
food. mind fastidious ,weeping tearful , His pulse was 70/min regular, BP 112/78
mmof Hg GRAPHITES 200 was given on the basis of totality of the symptoms and
the medicine repeated assessing the symptoms of the patient . Before and after scores
were recorded case followed for 4 months The presenting complaint markedly
139
Case No 4
Mr.RH of age 30 years male who is residing in elaluvilai was a driver came to OPD
with the complaints of Bleeding in anus with cutting pain and also fissure and a
sensation of something is lodged out since 4 months < touch ,Desire sweets.Common
on totality rubrics were Bleeding ,cutting pain in anus fissure ,swollen sensation
,Hemorrhoids painful,aggravation touch ,Desire sweets ,his pulse was 68/min regular
,BP 116/80 mm of Hg. SULPHUR 200 was given based on the totality of the
symptoms and the medicine repeated assesssing the symptom of the patient . Before
and after scores were recorded ,case followed for 6 months The presenting
symptomatic relief.
Case No .5
Mrs.SI of age 41 years female who is residing in chenkodi was a housewife came to
OPD with the complaints of Burning pain in anus,bleeding from anus no itching
and the medicine repeated assesssing the symptom of the patient. The presenting
140
complaint markedly reduced after treatment of 3 months . Followed by Placebo is
given Before and after score were recorded .Patient showed good prognosis with
Case No.6
Mr.DD of age 60years male who is residing in veyanoor was a driver came to OPD
With the complaints of Hemorrhoids shooting type of pain ,mild swelling in anus
regular BP 130/90 mmof Hg SULPHUR 200 was given based on the totality of the
symptoms and the medicine repeated assesssing the symptom of the patient .Followed
by placebo was Prescribed Before and after scores were recorded The presenting
Case No.7
Mr.SS of age 43 years male who is residing in keezhkulam was a driver came to OPD
With the complaints of Aching tearing pain in anus,sensitiveness ,no bleeding ,mild
,Desire spicy food,aversion fat food. Father had a h/o of Hemorrhoids Common
141
based on the totality of the symptoms and the medicine repeated assesssing the
symptom of the patient . After a month complaint get worse so that time Nux vomica
daily dose was prescribed The presenting complaint markedly reduced after treatment
of 3 months . Before and after scores were recorded Patient showed good prognosis
Case No.8
Mr.JH of age 48 years male who is residing in kaliyakavilai was a coolie came to
Since 3 months <oily food ,taking chicken ,Morning ,touch ,sitting ,Desire cold water
,fish,appetite soon after eating ,Thirst increased for warm water stool once in 2
AFTER ,TOUCH ,SITTING .Based on the totality rubrics are Burning ,Bleeding
,stool constipation on alternate days,Desire cold water ,fish .His pulse was 69/min
regular BP 130/70 mm of Hg Mild pallor present . NUX VOMICA 200 was given
based on the totality of the symptoms and the medicine repeated assesssing the
symptom of the patient . After a fortnight complaints was slight relieved .So again
Nux vomica is prescibed .Before and after scores were recorded The presenting
142
Case No.9,
exertion,grief sorrow and care Aversion meat ,Desire cold food ,difficult to pass
stool.Her pulse was 68/min regular 130/76 mmof Hg.NUX VOMICA 1M was
Prescribed and repeated for once in 2 weeks.based on the totality of the symptoms and
the medicine repeated assesssing the symptom of the patient . case was followed for 8
months Before and after scores were recorded The presenting complaint markedly
Case No.10
Miss.AJ Of age 19 years female who is residing in Thalakulam was a student came
to OPD with the complaints of Pain & Bleeding per rectum,difficult to pass
143
was prescribed Before and after scores were 4 months recorded Case was followed
Case No.11
Mrs.MSB of age 43 years female who is residing in kallukottam was a house wife
came to OPD with the complaints of Bruised betean pain asif ,bleeding from rectum ,
since 2 months <stool hard after ,touch, spices,>sitting,sweat profuse over whole
200 was given based on the totality of the symptoms and the medicine repeated
assesssing the symptom of the patient . Before and after scores were recorded The
Case No.12
Mrs.PL of age 30 Years female who is residing at mekkavilai was a house wife came
144
,bleeding,burning in Anus,< stool during ,touch,stool after ,Constipation,Desire cold
drinks fluid,weeping tearful .Her pulse was 68/min BP 110/90 mm of Hg. SULPHUR
200 was given based on the totality of the symptoms and the medicine repeated
assesssing the symptom of the patient . Before and after scores were recorded The
Case No.13
with the complaints of burning pain in the anus and sensitive since 2 years, increased
since 2 months. Complaints started after pregnancy and aggravated during stool, spicy
food, eating fish, touch, eating after. Complaints gets ameliorated by cold water
fear of darkness and easily gets angered. The common rubrics in two repertories were
AFTER, BLEEDING. Based on the totality rubrics were burning pain in anus,
sensitiveness, < stool hard after, eating after, bleeding, easy sweating and profuse,
fear of disease, anger and crossness. His pulse was 74/min and BP is 130/80 mm of
Hg. Based on the totality NUX VOMICA 1M was prescribed. complaints was
slightly relieved but few weeks after stool becomes hard and the medicine was
repeated asssessing the symptoms of the patient .The presenting complaints markedly
reduced after treatment of 2 months . Before and after scores were recorded Patient
145
Case No .14
with the complaints of aching pain with bleeding and backache since 1 year.
Complaints have increased since 1 month. The complaints gets aggravated during
stool, after stool and touch. Complaints get better by scratching. She has desire for
salty food. Increased output of Urine and thirst has increased. The common rubrics
totality rubrics were aching pain in anus, < during stool, stool after, touch and
straining of stool. Her pulse is 69/min and regular BP is 120/80 mm of Hg. Based on
relieved but few weeks after stool becomes hard and the medicine was repeated
assessing the symptoms of the patient .The presenting complaints markedly reduced
after treatment of 2 months . Before and after scores were recorded Patient showed
mild improvement .
Case No.15
Miss.PS of 19 years female residing from arumanai, who is a student came to OPD
with the complaints of protrution of mass around the anus and dryness since 2 years
and complaints have increased since 2 months. There is fissure, swelling and irritation
in the anus and backache is also present. Complaints get ameliorated by scratching.
Stool is difficult to pass and stool is hard in nature. Thirst is decreased and she has
desire for fried food. Common rubrics in two repertories were DRYNESS SENSE
146
AND DISCOMFORT. Based on the totality rubrics were protruding prolapsed,
dryness sensation of, > scratching, fissure in anus, swelled, stool difficult to pass,
irritation in anus, appetite hunger without, thirstlessness, desire fat food.Her pulse is
74/min and regular BP is 120/80 mm of Hg. Based on the totality ALOES 1M was
prescribed. Complaints were better but few weeks after dryness with protrusion was
present and the medicine was repeated assessing the symptoms of the patient .The
presenting complaints markedly reduced after treatment of 2 months .Before and after
scores were recorded Patient showed good prognosis with marked symptomatic relief.
Case No.16
Mr.SA Of 35 years male residing from neyyor who is a maison came to OPD With
,stool burning while passing ,appetite decreased ,thirst decreased desire rainy season
,fanning ,warm food,cold water ,spicy food since 3 years and complaints have
SULPHUR 200 was prescribed. Complaints were better but few weeks after stool
burning was present and the medicine was repeated assessing the symptoms of the
patient Before and after scores were recorded The presenting complaints markedly
reduced after treatment of 2 months . Before and after scores were recorded .Patient
147
Case No.17
OPD With the complaints of Hemorrhoids with burning pain in anus prolapsed
<menses during,rising after ,stool difficult to pass,easily weeps ,desire weeps ,desire
juicy things ,aversion salty food.Common rubrics in two repertories were BURNING
69/min regular BP was 120/70 mm of Hg. Based on totality SULPHUR 200 was
prescribed. Complaints were better but few weeks after stool burning in anus was
present and the medicine was repeated assessing the symptoms of the patient .The
after scores were recorded .Patient showed good prognosis with marked symptomatic
relief.
Case No.18
Mr.SF of 20 years Male residing from mandaikadu who is a engineer came to OPD
<urination ,scratching ,stool during ,desire cold food ,appetite diminished ,thirst
decreased ,fear of disease ,desire spicy food ,cold food.Common Rubrics in two
148
pulse was 68/min regular ,BP was 130 /90 mm of Hg . Based on totality was
NITRIC ACID 200prescribed. Complaints were better but few weeks after Itching in
anus was present and the medicine was repeated assessing the symptoms of the
Before and after scores were recorded Patient showed good prognosis with marked
symptomatic relief.
Case No.19
exertion,>warm application desire sour things aversion coffe His pulse was 70/min
prescribed. Complaints were better but few weeks after stool burning was present and
the medicine was repeated assessing the symptoms of the patient .The presenting
complaints markedly reduced after treatment of 2 months . Before and after scores
were recorded Patient showed good prognosis with marked symptomatic relief.
149
Case No.20
Mr.AR of 60 years male residing from Nagercoil who is an interior designer came to
season.His pulse was 66/min and Bp was 140/100 mm of Hg. Based on totality
NUXVOMICA 200 was prescribed. Complaints were better but few weeks after stool
burning was present and the medicine was repeated assessing the symptoms of the
Before and after scores were recorded Patient showed good prognosis with marked
symptomatic relief
Case No.21
OPD With the complaints of swelling in anus,bleeding with pricking pain, <during
anus< walking ,stool after ,fear future of vexation of .Her pulse was 68/min and BP
150
was 110/68 mm of Hg . Based on totality GRAPHITES 0/3 was prescribed.
Complaints were better but few weeks after stool burning was present and the
medicine was repeated assessing the symptoms of the patient . Before and after scores
Case No 22
abdominal pain since 6 months < stool during ,lumbar pain ,itching ,burning
DURING DURING ITCHING ,WIPING .Based on the totality rubrics were swollen
concomitants during stool,hemorrhoids lumbar pain with anus,& rectum itching ,urine
ALOES 1M was prescribed. Complaints were better but few weeks after stool
burning was present and the medicine was repeated assessing the symptoms of the
Before and after scores were recorded Patient showed good prognosis with marked
symptomatic relief.
151
Case No .23
OPD with the complaints of Aching pain ,prolapse & protusion ,itching in anus,stool
difficult to pass ,sweat increased on head ,desire eating ,thirst increased for warm
anus,protruding prolapsed ,stool constipation on alternate days .Her pulse was 66/min
prescribed. Complaints were better but few weeks after stool burning was present and
the medicine was repeated assessing the symptoms of the patient .The presenting
complaints markedly reduced after treatment of 2 months . Before and after scores
were recorded Patient showed good prognosis with marked symptomatic relief.
Case No.24
Mr.BD of 60 years male residing at thirpparapu who is an security came to OPD with
the complaints of Stitching pain in anus since 4 years increased since 4 months
<sitting,touch, night >lying on back Hard swelling ,itching ,constipation with difficult
to pass stool ,thirst decreased ,grief about wife death .Common rubrics in two
rubrics were sticking ,stitches etc,sore pain ,itching in anus <stool after,sitting ,touch
,night .His Pulse was 69/min and BP was 148/90 mm of Hg. . Based on totality was
MURIATIC ACID 200 prescribed. Complaints were better but few weeks after stool
burning was present and the medicine was repeated assessing the symptoms of the
152
patient .The presenting complaints markedly reduced after treatment of 6 months .
Before and after scores were recorded .Patient showed good prognosis with marked
symptomatic relief.
Case No 25
69/min and BP was 158/90 mm of Hg . Based on totality NUX VOMICA 200 was
prescribed. Complaints were better but few weeks after Burning in anus was present
and the medicine was repeated assessing the symptoms of the patient .The presenting
complaints markedly reduced after treatment of 5 months . Before and after scores
were recorded Patient showed good prognosis with marked symptomatic relief.
Case No.26
stool,spicy food, after stool >cold water application ,cold water drinking
153
,irritation,sensitiveness,<stool during ,stool after ,aversion meat ,desire cold food
religious ideas.Her pulse is 76 /min and BP was 90/60 mm of Hg. Based on totality
ARSENICUM ALBUM 200 was prescribed. Complaints were better but few weeks
after stool burning was present and the medicine was repeated assessing the
symptoms of the patient .The presenting complaints markedly reduced after treatment
of 7 months . Before and after scores were recorded Patient showed good prognosis
Case No. 27
Mrs.SK of 55 years female residing at thalakulam came to OPD with the complaints
,touch ,company averse to ,grief sorrow & care. Her Pulse was 64 /min and BP was
were better but few weeks after stool burning was present and the medicine was
repeated assessing the symptoms of the patient .The presenting complaints markedly
reduced after treatment of 7 months . Before and after scores were recorded Before
and after scores were recorded Patient showed good prognosis with marked
symptomatic relief.
154
Case No.28
Mrs.MV Of 48 years female residing at Mulluvillai came to OPD with the complaints
days,desire egg,salty things loquacity Her Pulse is 68/min & BP was 138/80 mm of
Hg. Based on totality SULPHUR 0/4 was prescribed. Complaints were better but few
weeks after Constipation was present and the medicine was repeated assessing the
symptoms of the patient .The presenting complaints markedly reduced after treatment
of 8 months . Before and after scores were recorded Patient showed good prognosis
Case No.29
Mr.RU of 36 years male residing at manalikkarai came to OPD with the complaints
,walking ,Alcoholic drinks aversion coffee meat .Common rubrics in two repertories
CARB 0/3 was prescribed. Complaints were better but few weeks after bleeding
present and the medicine was repeated assessing the symptoms of the patient .The
155
after scores were recorded Patient showed good prognosis with marked symptomatic
relief
Case No.30
food,stool difficult to pass inability to take right decision ,grief about health & family
sitting,aversion fat food desire cold food ,stool difficult to pass, indecision ,grief
sorrow & care .Her pulse is 75/min & BP Was 116/64 mm of Hg. Based on totality
NITRIC ACID 200 was prescribed. Complaints were better but few weeks after stool
burning was present and the medicine was repeated assessing the symptoms of the
Before and after scores were recorded Patient showed good prognosis with marked
symptomatic relief
156
APPENDIX VII
MASTER CHART
Sl no Preliminary Totality of symptoms Family Rubrics Total no of Total no of Individual Medicine Cover under Final RX Explanatio Disease Inference
data,Age/se history common in individual rubrics in Guernsey n intensity
x/address/o BBCR & Rubrics in BBCR for final CORECT
ccupation/D GUERNSEY similimum SCALE
iet BBCR guernsey Before after
1. 1Maheenabu Complaints of Father Burning pain Hemorrhoids in Burning pain Sulphur, Sulphur, sulphur The totality 29 4 Improved
backar/32/ hemorrhoids with Bleeding general in anus Nux Arsenicum of the
M/Enayam/ burning pain & Stool during Burning pain Bleeding vomica, album,calcar patient suits
business/ bleeding, Stool difficult Bleeding <during stool> Mercuris, ea carb, for sulphur,
Mixed <spicy <during stool Stool difficult to pass Nitric kali which has
food,travelling,while Stool difficult to acid,igniti carb.silicea got higher
passing pass a marks in
stool,>standing, stool Appetite desire both the
once in 2 days,desire cold food repertories
cold food
2. 2Sathya Small swelling, Nil Protruding Protruding External protruding, Sepia Sulphur, Nux Based on 28 6 Improved
sheelan/43/ protruding prolapse prolapsed bleeding , Sulphur Calcareacarb vomica the totality
m/Thirunel outside,bleeding, Bleeding Bleeding Heaviness sensation of, Calcarea ,Thuja of the
veli/driver/ heaviness, Heaviness Heaviness sense Itching in anus carb Mur.acid,pul symptoms
mixed <during sensation of <stool Nuxvomic s,aloes (including
stool,sitting,sitting,w Itching Itching in anus during,sitting,walking a,aloes generals &
alking ,aversion salt ,<sitting,walking <sitting,walking, particulars)
fish,desire potato aversion salty Nux
chicken food,desire potato vomica is
found to be
similimum
157
3. 3Yesudhas/4 Burning and itching Father, Burning pain, Burning pain in Burning pain in anus Arsenicu Sulphur, Graphite Totality of 27 11 Moderate
8/m/kumara in anus,<passing mother Itching in anus. Itching in anus m Graphites s the patient improvement
puram/busi stool,oilyfood,spicy anus,,<sitting, Itching in anus, <sitting,rubbing, alb,graphit arsenicum suits for
ness/veg food ,sitting ,rubbing rubbing . <sitting,rubbing stool during es,calc.car aloes Graphites
Appetite desire b,nuxvomi which got
warm food, ca,sulphur same
Mind fastidious gradation in
Weeping tearful both
repertories
4. 4Ramesh /3- Bleeding in anus,with Nil Bleeding Bleeding from Bleeding Natmur Sulphur Sulphur Based on 32 2 Improved
0/m/elavuvi cutting pain,fissure Cutting pain anus Cutting pain Sulph Nitric acid the totality
lai/driver/m ,sensation of Fissure in anus Cutting pain Fissure Nuxvomic Belladonna of
ixed something lodged swollen Fissure in anus Swollen sensation a, causticu symptoms
out,<touch ,desire sensation Hemorrhoids fullness feeling Causticum m (including
sweets <touch painful,swollense Touch aggravation alumina generals &
nsation,touch particulars
aggravation Sulphur is
,desire sweets found to be
similimum
5. 5Suni/41/f Burning pain in anus Nil Burning in anus Burning in anus Burning in anus Sulphur Sulph Sulphur Totality of 21 4 Improved
/chenkodi ,bleeding, no itching, Bleeding Bleeding Bleeding Sepia Kali.carb patient suits
/housewife/ protruding outside Itching in anus Hemorrhoids in Itching in anus,swollen Aloes Causticum for sulphur
veg ,A/F Swollen general sensation Phos Ignitia ,which has
preganacy<sitting, sensation Itching in anus Fullness feeling Calc.carb Nitric acid got higher
Coughing, <sitting Swollen sensation <sitting ,cough,standing, mark in
standing, ,coughing <sitting coughing, >stool during both
>passing stool,sitting < standing standing >,stool Repertories
in cold water during ,
158
6. 6Devadhas Hemorrhoids, Nil Cutting pain in Cutting pain in Cutting pain ,itching in Sulphur Sulphur Sulphur The totality 31 10 Moderate
/60/m shooting pain,mild anus anus anus Graphites Puls of the improvement
/veyanoor/d swelling ,protruding Itching in anus Itching pain in Discomfort ,eruption of Nuxvomic Mur.acid patient suits
river/ outside,Itching& Protruding anus anus a Lyco for sulphur,
Veg eruptions in prolapsed Eruption, External protruding Lyco,calc. Aloes which has
anus,discomfort,<eve Eruption in anus protruding <evening ,sitting carb got higher
ning,sitting,passingst <sitting prolapsed dry marks in
ool,Stooldifficulit to stool,dry stool both the
pass repertories
7. 7Selvester/4 Aching ,tearing pain Father Aching pain in Aching pain in Aching pain in anus Nux Muriatic Nux Based on 28 4 Improved
3/m/keezhk in anus, anus. anus, Sensitiveness vomica acid vomica the totality
ulam/driver Sensitiveness ,no Tearing pain Tearing Tearing pain Sulphur Sulph of
/mixed bleeding ,mild No bleeding pain,hemorrhoids No bleeding Puls, Aesulus symptoms
protusion,<alcoholic (blind) in general blind,protruding external Sepia,Ars Puls Nux
drinks,night,walking, Protuding Protruding <alcoholic drinks,night Nux vomica vomica
Desire spicy outside outside blind walking found to be
food,aversion fat <night,walking ,<night ,walking similimum
food aversion fat food
8. 8Joseph/48/ Burning &Bleeding nil Burning pain Burning pain in Burning &congestion in Nux Based on 29 14 Mild
m/kaliyaka in anus,inflammation Congestion in anus anus, bleeding <stool Mercuris Sulphur vomica the totality improvement
vilai/coolie/ ,congestion,<oily anus Congestion in after , Sulphur Nitric acid of
mixed food ,taking Bleeding anus Nuxvomic Belladonna symptoms
chicken,morning,touc <stool Bleeding a causticum Nux
h,sitting ,desire cold after,touch <stool after Arsenicu vomica
water ,fish,appetite ,sitting ,sitting m album found to be
increased soon after Appetite satieted Carb.veg similimum
eating ,thirst quickly
increased for warm Thirst excessive
water ,stool once in 2 Stool constipation
days. on alternate days
Desire cold water
,fish
159
9. 9Bhuvenendr Stitching pain in anus Nil Stitching pain in Sticking ,stitches Stinging Arsenicu Sulphur Muriatic Based on 31 4 improved
an/60/m/sec <sitting,touch,night anus, etc (stitches),soreness, m Aloes acid the
urity/thirpar >lying on back Soreness Sore pain Itching ,stool hard after Sulphur Mur.acid particular
apu/veg Hard swelling feeling, Itching in ,<sitting ,touch , Nux Graphites, symptoms
,itching ,constipation Itching in anus anus,<stool after night vomica Thuja only the
with difficult to pass <sitting,touch,ni ,sitting ,touch Aloes medicine is
stool,thirst decreased ght ,night Nat.mur found to be
,grief about wife Muriatic
death acid
10. Manikanda Burning pain in Nil Burning & Burning Burning in anus Nuxvomic Sulphur Nux Based on 28 7 Improved
prasad/41/ anus,bleeding in bleeding in &bleeding in Bleeding a Mur.acid vomica the totality
m/neyyor/p anus,hemorrhoids anus,swollen anus,hemorrhoids Swollen hemorrhoids Sepia Aloes of the
haramacist/ swelled hemorrhoids,He swolled ,<touch large,<touch ,sitting, Sulphur Calc.carb symptoms
mixed <touch morrhoids sitting hemorrhoids painful Aconite Nitric acid (including
sitting,hemorrhoids painful ,hemorrhoids aching ,stool straining phos generals &
painful <touch,sitting painful ,stool particular )
Stool irregular, strainning ,stool Nuxvomica
constipation on irregular, found to be
alternate days desire constipation on similimum
company alternate days
11. f Clinu/19/f/ Burning pain with Nil Burning pain in Burning pain in Burning pain ,bleeding Sepia Muriatic Arsenicu The totality 29
marthandan bleeding,irritation,sen anus, anus ,irritation feeling Sulphur acid m album of patient 6 Improved
thurai/stude sitiveness,<during Bleeding Bleeding &discomfort Arsenicu Sulphur suits for A
nt/mixed stool,spicyfood,after Irritation Irritation ,sensitiveness,<stool m Nitric acid rsenicum
stool,>cold water Sensitiveness Sensitiveness during ,stool after Mercuris calc.carb album
application ,cold <stool <stool during Nux Ars which were
water drinki ng during,stool stool vomica covers in
,religious after after,aversion both
meat,desire cold Repertories
food,religious
ideas
160
12. Latha/42/f/ Burning sensation in Nil Burning pain in Burning pain in Burning Sulphur Muriatic Nux Based on 30 6 Improved
kumbakona anus,sensitive ,A/F anus,sensitivene anus,sensitivenes pain,sensitiveness,<stool Sepia acid vomica the totality
m/housewif preganancy<during ss,<stool hard s, <stool hard during ,stool hard after Nux Sulphur of the
e/mixed stool,spicyfood,eatin after,eating after after ,eating after ,eating after vomica Aloes symptoms
g fish ,touch,eating ,Bleeding ,bleeding ,easy Phos Arsenicum (including
after >cold water sweatness Calc.carb generals &
application,stool profuse,fear d/s particular )
difficult to of ,anger Nuxvomica
pass,pespiration crossness found to be
increasedon whole similimum
body ,fear of
darkness,anger easily
13. Shyna/49/f/ Aching pain with Nil Aching pain in Aching pain in Aching pain in anus,stool Arsenicu Sulphur Arsenicu Based on 33 14 Mild
nagercoil/h bledding and anus anus during ,stool after <touch m album Mur.acid m album the totality improvement
ousewife/m backache,<during <stool during Dryness sense of ,stool straining Sulphur Graphites of the
ixed stool,afterstool,touch, ,stool after <stool during Nux Ignitia symptoms
>scratching,stool stool after vomica aloes (including
difficult tppass,desire touch,aversion Sepia generals &
salty salty Nitric acid particular )
food,urine&thirst things,thirstinsati Arsenicum
increased able,urine hot album
burning ,anger found to be
crossness similimum
14. Pratheesha/ Protusion of mass Mother Dryness sense of Protruding Heaviness sense of Nat.mur Aloes Aloes The totality 19 6 Improved
20/f/aruman around ,swollen prolpased, dryness & fissure in anus Sulphur Nitric acid of patient
ai/student/ anus,dryness,fissure,s sensation dryness sense of swollen sensation in Nux Sulphur suits for
mixed welling ,backache of,fissure in >scratching anus,<stool hard vomica Aesculus Aloes
irritation,>scratching, anus,irritation fissure in after,Irritation feeling & Alum Graphites which were
difficult to pass hard feeling & anus,swelled,stoo discomfort Aloes covers in
stool,Thirst discomfort l difficult to both
decrease,desire fried pass,irritation in Repertories
food anus,appetite
hunger with out
thirstlessness
desire fat food
161
15. Amalorpam Aching pain ,prolap Nil Aching pain in Aching pain in Aching pain in Nux Pulsatilla Calcarea Based on 30 2 improved
mary/53/f/k se &protusion itching anus,prolapse of anus, anus,prolapsed feeling vomica Sulph carb the totality
allukootam/ in anus,stool difficult rectum,itching Prolpase of heaviness sense of Sulphur Aloes of the
housewife to pass,sweat in anus<stool rectum, <stool during Calc.carb Aesulus symptoms
/mixed increased on during Itching in anus , Mercuris graphites (including
head,desiremilk,easil Protruding Nat.mur generals &
y angered prolpased .stool particular
difficult to )Calcarea
pass,sweat carb found
especially onhead to be
Desire milk,anger similimum
crossness etc.
16. Annie Pain &Bleeding per Nil Bursting pain in Bursting pain in Bursting as if see Sulphur Sulphur Sulphur The totality 28 13 Moderate
jenisha/19/f rectum difficult to rectum,bleeding, rectum fullnessfeeling of natmur Hamamilles of the improvement
/thalakulam pass stool sensitiveness,sto Hemorrhoids Bleeding Ant.cur Aesculus patient suits
/student/mi sensitiveness ,stool ol difficult to painful Sensitivessness Lyco belladonna for sulphur,
xed difficult to pass Bleeding Stool difficult Nux which has
pass,desire spicy Stool difficult Sensitiveness vomica got higher
food ,easily satiety sensitivessness in Stool difficult marks in
anus,appetite both the
satiety quickly repertories
17. Annie Hemorrhoids painful Nil Aching Hemorrhoids in Hemorrhoids pain Nux Sulphur Nux Based on 27 3 Improved
jasmine ,pain in anus pain,discomfort general,aching aching ,discomfort vomica Lyco vomica the totality
rani/30/f/thi A/f pregnancy ,inflammed, ,inflammation inflammed,<afernoon Nat.mur Thuja of the
ruvattar <menses ,<afernoon ,discomfort menses during ,sitting Sulph Causticum symptoms
/housewife/ during,sitting ,mensesduring <afternoon,mense touch ,mental exertion Puls Mur.acid (including
mixed ,touch,mental sitting touch s during merc generals &
exertion ,appetite ,mental exertion ,sitting,touch particular
decreased ,stool mental )Nux
difficult to pass ,grief exertion,grief vomicafoun
mother death sorrow and care d to be
aversion fanning ,aversion similimum
meat desire cold food meat,desire cold
food ,difficult to
pass stool
162
18. Mary suja Bruised beaten pain Nil Bruised beaten Soreness Bruised pain Sulphur Sulphur Sulphur The totality 28 14 Moderate
bai/43/f/kall as if ,bleeding ,stool pain as if contused feeling bleeding,<stool hard Nat.mur Mur.acid of the improvement
ukottam/ho after ,<touch ,>sitting Bleeding beatean as if after ,touch ,>sitting Phos Aloes patient suits
usewife/ <stool hard <stool bruised ,bleeding Nuxvomic Puls for sulphur,
veg after<spices ,sweat after,touch, ,external a which has
profuse over whole sitting desire protruding ,stool Sepia got higher
body, eaily get meat,aversion hard after,<touch marks in
anger,intolerance to potatoes ,desire ,sitting both the
hot ,desire agg,sweat easy repertories
meat,disagrees sweatness profuse
potatoes ,nuts ,stool hard ,anger
crossness
19. Premalatha/ Hemorrhoids ,painful Nil Burning in Hemorrhoidsinge Burning ,bleeding ,<stool Sulphur Sulphur Sulphur The totality 24 6 improved
30/f/mekka ,tendernesss,burning anus,bleeding neral,bleeding during ,touch <stool after Nat.mur Mur.acid of the
vilai/house in anus,,<during from anus,<stool ,burning in ,stool straining Nux Calc.carb patient suits
wife/mixed stool,touch,stool during ,touch anus,<stool vomica Arsenicum for sulphur,
difficult in ,stool after during touch,stool Phos Nitric acid which has
passing,desire cold after constipation Bell got higher
season,coffe,cold desire marks in
drinks,spicyfood, coffee,desire cold both the
weeps easily drinks,fluid,weepi repertories
ng tearful
20. Siva/35/m/n Hemorrhoids,bleedin Nil Bleeding from Hemorrhoids in Bleeding ,<stool during Calc.carb Sulphur Calcarea Based on 18 3 improved
eyyoor/mai g with burning rectum,burning in general,<stool burning in anus,<stool Arsenicu Silicea carb the totality
son/maison/ pain<passing anus<stool during during bleeding during ,<sitting m Ant,crud of the
mixed stool,during ,sitting burning pain in Bell Calc.carb.gr symptoms
stool,sitting ,stool- anus,<sitting Lyco aphites (including
burning during appetite Mercuris generals &
passing stool,appetite Increased, particular
decreased,thirst thirstlessness Calcarea
decreased,desire desire cold carbfound
rainy season,fanning liquids ,water to be
,warmfood,cold desire warm food similimum
water ,spicy food
163
21. Chandra/43 Hemorrhoids with Nil Burning pain in Burning pain Burning pain in Sulphur Sulphur Sulphur The totality 30 3 Improved
/f/unnamala burning pain in anus anus,itching in anus,itching anus,itching in anus Nux Aloes of the
kadai/teach ,prolapsed <menses anus protruding inanus,hemorrhoi external protruding vomica Graphites patient suits
er/mixed during ,rising after hemorrhoids ds prolapse inflamed <morning rising Sepia Kali.carb for sulphur
,stool difficult to ,<menses during <menses after <menses during Carbo Muratic acid which has
pass,easily weeps during,stool .veg got higher
,desire juicy things insufficient,weepi Calc.carb marks in
,aversion salty food ng tearful both the
,thirstlessness, repertories
desire juicy
refereshing
things,aversion
salty food
22. Kala devi Swelling in the Nil Swelling in anus Swelling in Swollen anus Nuxvomic Sulphur Graphite Based on 21 3 Improved
/53/f/cheruv anus,bleeding with Itching, anus,hemorrhoids Itching in anus a muracid s the totality
allor/house pricking pain <during Hemorrhoids itching Prolapsus Graphites Ignitia of the
wife/mixed stool,hardstool,straini Prolapsed ,protruding Aching pain in anus Sulphur Aloes symptoms
ng,desire warm Aching pain in prolapse Bleeding & fissure in Calc.carb Graphites (including
food,spicy food anus, ,hemorrhoids anus<walking ,stool after generals &
,aversion Bleeding painful ,bleeding particular )
meat,talkative,fear of &fissure in anus ,fissure in graphites
travelling ,<walking ,stool anus,<walking found to be
after stool after ,fear similimum
future of,vexation
of.
164
23. Prabhu Swelling .burning in Father Swollen sensation Swollen sensation Swollen hemorrhoids see Aloes Aloes mur Aloes The totality 27 10 Moderate
Mohammed rectum,sensitive ,no in anus,burning in rectum burning, large,burning Mur.ac acid of the improvement
naina/46/m/ bleeding ,abdominal anus,sensitivenes hemorrhoids ,sensitiveness ,blind (not Sulphur Sulph patient suits
kadiyapatin pain <stool after s,blind ,<stool swelled bleeding)stool Nux Kali.c for sulphur,
am/driver/ coughing,urination,w after ,sensitive,blind after,<stool vomica Nitric acid which has
mixed iping ,Painful ,cough,mituration ,hemorrhoids aftercough,mituration Nitric acid got higher
<during stool,lumbar during itching with abdominal during ,wiping after marks in
pain itching ,burning <wiping pain <stool after stool,itching both the
urination ,easily coughing repertories
tensed desire sweets ,urination
wiping,hemorrhoi
ds painful
concomitants
during
stool,hemorrhoids
lumbar pain with
,anus &rectum
itching ,urine
burning
24. Sahayaflexi Burning pain in Nil Burning pain in Burning in Burning pain in Nuvomica Aloes Nitric Based on 28 9 improved
n/20/m/man anus,protruding anus ,bleeding anus,protruding anus,bleeding painful Nitric acid Thuja acid the totality
daikadu/eng hemorrhoids,bleeding <urination ,stool prolapsed aching pain,<micturation Sulph Aesculus of the
ineer/mixed <urination,scratching during ,bleeding from during ,stool during Calc.carb Arsenicum symptoms
,stool during ,desire hemorrhoids,hem Mur ,acid (including
cold food ,appetite orrhoids generals &
diminished ,thirst painful<urination particular )
decreased ,fear of d/s scratching ,stool graphites
desire spicy food during,desire cold found to be
,cold food food,appetite similimum
with out
,thirstlessness
,fear of d/s
165
25. Albin Aching pain in Nil Aching pain in Aching Aching pain in Sepia Sulphur Nuxvomi Based on 32 4 improved
vinu/36/m/ anus,itching in anus ,heaviness pain,heaviness anus,heaviness sensation Sulph Aloes ca the totality
mekkamand anus,heaviness sensation of sense of ,itching in Nux Mur.acid of the
apam/weldi sensation ,itching in of,hemorrhoidsitc anus,<walking ,stool vomica Silicea symptoms
ng <walking,mental anus,<walking himg ,<walking during ,mental Phos (including
work/mixed exertion >warm stool stool during excitement Calc .carb generals &
application ,<passing during,mental mental exertion particular )
stool,desire sour excitement . >warm Nux
things,acids,aversion application desire vomica
coffee,sensitiveness sour found to be
things,aversion similimum
coffeee,sensitive
26. Ameer/60/ Aching pain in Nil Aching pain in Aching pain in Aching pain in Sulphur Sulphur Nux Based on 29 4 improved
m/nagercoil anus,bleeding anus ,Bleeding, anus,bleeding anus,<sitting nux Mur.acid vomica the totality
/interior swelling ,itching in itching ,<sitting protruding ,touch,bleeding ,large vomica Causticum of the
designer/ve anus <sitting ,touch touch,walking prolapsed ,itching congested ,itching Calc.carb Graphites symptoms
g walking ,summer protrusion of <walking Aloes Aloes (including
season ,fastidious in hemorrhoids Merc generals &
nature ,Headstrong during Sulphur particular )
cheerful,desire cold stool<sitting Nux
drinks touch ,walking vomica
stool <summer found to be
season similimum
27. Sivakalai/5 Protruding piles Nil Hemorrhoids Hemorrhoids External Nuxvomic Sulphur Nuxvomi Based on 28 9 improved
5/f/thalakul bleeding ,swelling, protruding protruding protruding,bleeding a Mur.acid ca the totality
am/veg itching &fissure in Bleeding prolapsed, ,swollen hemorrhoids Graphites Aloes of the
anus,<riding walking swelled,itching in bleeding,swelled,i (large ),itching in Sepia Calc.carb symptoms
,touch ,aversion to anus,cuttingpain,f tching in anus,cutting pain in anus Mur.acid Nitric acid (including
company ,grief about issure<riding anus,cutting pain ,fissure in Sulphur generals &
son ,walking ,touch in anus,fissure in anus<riding,walking, particular )
anus touch Nux
,<riding,walking vomica
,touch company found to be
averse to ,grief similimum
sorrow & care
166
28. Mary Protruding Nil Protruding Protruding Hemorrhoids external Sulphur Sulphur Sulphur The totality 31 9 Improved
vimala/48/f/ Hemorrhoids prolapased prolapsed protruding Sepia Silicea of the
mulluvillai/ ,burning pain in burning pain in Burning pain in Burning pain Nux Ant.c patient suits
housewife/ anus,<stool during anus<sitting anus,<sitting,cold <stool during ,sitting vomica Calc.c for sulphur,
mixed ,sitting ,>bathing >cold bathing bathing ,stool .cold bathing ,stool Phos Nitric acid which has
cold.stool difficult to constipation on difficult to pass Calc.carb got higher
pass alternate days alternate marks in
,desire egg,salty days,desire both the
things loquacious eggs,salty repertories
things,loquacity
29. Reghu Aching pain in Nil Aching pain in Aching pain in Aching pain , Nux Aloes Calcarea Based on 25 9 Improved
/36/m/mana anus,swollen anus anus,swelled Swollen sensation in vomica Thuja carb the totality
likkarai/wel sensation in Swelled sensation anus,bleeding anus Sulphur Arsenium of the
ding/mixed anus,bleeding<stool Bleeding, <stool ,<stool after Bleeding Calc.c Mur.acid symptoms
after ,touch walking after touch,walking <alcoholic drinks, Merc (including
,alcohoilc touch,walking Aversion coffee Stool morning after Nat.mur generals &
drinks,aversion meat touch ,walking particular )
coffee meat calcarea
carb found
to be
similimum
30. Sandhya Aching pain in anus Nil Aching pain in Aching pain in Aching pain in anus Nitric acid Nitric acid Nitric The totality 32 9 Improved
/25/f/vizhun Dryness, anus anus ,dryness in anus,itching& Sulphur Nux vomica acid of the
thayambala Itching in Dryness in anus Dryness in anus sensitiveness of Aloes Phos patient suits
m/housewif anus,sensitiveness to Itching & Itching anus,blind (no bleeding Mur.acid Graphites for Nitric
e/mixed touch,no bleeding sensitiveness in &sensitiveness in )<evening ,night,sitting Acid ,
<evening,night,sitting anus anus which has
,desire cold Blind not Blind(dry)<night, got higher
food,aversion eating bleeding sitting ,aversion marks in
food,fat food ,stool <evening ,night fat both the
difficult to ,sitting food,desirecold repertories
pass,inability to take food,stooldifficull
right decision,grief t to
about health & pass,indecision,he
family sitation ,grief
sorrow & care
167