ABSTRACT
The term psychosomatic is derived from Greek word “psyche” (mind) and “soma” (body). A psychosomatic disorder is a disease which involves both mind and body. Sometimes mental and emotional factors may act as risk factor that could influence the initiation and progression of physical disorders. This review highlights the important aspects of the psychosomatic diseases and the concept of Homoeopathic philosophy i.e. When an individual becomes normalized by the homeopathic cure, the deeper side of his being, the will and the understanding or the rational mind are balanced. With the change in the mental and moral sphere, physical health improves with a high degree of resistance to maladies of all kinds. Such is the transition from constitutional weakness and suffering to homeopathic health and comfort. This review also states about the views of Homoeopathic pioneers in psychosomatic disorders.
Key words: homeopathy, individulisation, sulphur , psychosomatic disorder.
INTRODUCTION
“Psychosomatic” as a pathogenic concept tending to have psychic influences play an important role in the determination of functional troubles and even certain organic diseases. This doctrine which has been extensively developed in America in the past few years is not a new discovery, for ever since the time of Hippocrates and Galen the influence of the psychic over the physical has been admitted. But this has come about as a consequence of certain physiological discoveries such as those of Pavlov at the beginning of the twentieth century on conditional reflexes and of the American, Cannon, on the role of the emotions and their repercussions on salivary secretions, the endocrine glands and on the metabolism. It owes much also to the development of deep and extensive psychological studies to which so many psychiatrists and psycho-analysts have devoted themselves.
In fact the physicians of the orthodox school are only now discovering the psychosomatic. After cutting a man in two and having isolated his psyche and mind from his soma, they have stuck the two pieces together again to consider him at last as a biological whole.
DIAGNOSIS OF PSYCHOSOMATIC DISEASE
The diagnosis of psychosomatic disease requires the presence of clearly defined signs and symptoms consistent with each diagnostic category. Reliance upon the total clinical examination, including an adequate history, review of systems, psychiatric assessment, and clinical judgment, is more valid than reliance upon any single laboratory or diagnostic test. Till date in the conventional medical system there is no clear test to differentiate organic and psychological diseases.
Hahnemann in 1810 itself made a clear distinction between them. In fact, he prescribed psychotherapeutic techniques. In paragraph 224 he recommends “If the mental disease is still somewhat doubtful whether it really arose from a corporeal affection or result from faults of education, bad practices, corrupt morals, neglect of the mind, superstition or ignorance. The mode of deciding this point will be, that if it proceed from the latter causes it will diminish and be improved by sensible friendly exhortations, consolatory arguments, serious representations and sensible advice. Whereas a real moral or mental malady, depending on bodily disease, would be speedily aggravated by such a course, the melancholic would become still more dejected, querulous, inconsolable and reserved, the spiteful maniac would thereby become still more exasperated, and the chattering fool would become manifestly more foolish.
Master Hahnemann states in Aphorism 211 “This holds true to such an extent, that the state of disposition often chiefly determines the choice of the homoeopathic remedy”.
These drugs are capable of exerting a curative influence, not only on the body but on the patient’s personality as well. They can be used equally well in functional diseases as in organic maladies. Moreover, the Law of Similar makes no such absurd distinction between functional and organic disease because the former untreated is invariably the precursor of the latter.
VIEW OF PIONEER ON PSYCHOSOMATIC DISORDER
BOENNINGHAUSEN
Boenninghausen remarked, with regard to one of the “Aphorisms of Hippocrates” that there are numerous cases of icterus which manifest themselves on the day following an emotional upset and are cured equally quickly by the remedy corresponding to the symptoms, such as Aconite, ChamomiIla, Nux vomica, etc
KENT
JT Kent considered that the mind is the centre of the whole functioning of the organism and that it is also the focal point from which the disease process starts. Kent states that “The mental symptoms must be first worked out by the usual form until the remedies best suited to the patient’s mental condition are determined. When the sum of these has been settled, a group of five or ten remedies, or as many as appear, we are then prepared to compare them and the remedies found related to the remaining symptoms of the case . In his Lectures on Homoeopathic Materia Medica, Kent says of Chamomilla: “It will never cure a sore throat except in these irritable constitutions, The chamomilla mental state determines when you are to give Chamomilla in sore throat.
C. M. BOGER
C. M. Boger The relative time for the appearance of each symptom naturally varies with the speed of the disease. From this we reason that the earliest mental manifestations are decidedly the most important of all symptoms.
WILLIAM BOERICKE
William Boericke Where mental states and emotions are evident primary causes or contributing factors to the production or continuance of diseased conditions, Homoeopathy offers much useful aid, thus: Remember the adaptability of Coffea, Aconite and Opium to the ill effect of different emotional disturbances, especially Gelsemium to the effect of fear. Ignatia and Phosphoric acid to the effect of grief, etc
HOMOEOPATHIC APPROACH TOWARDS PSYCHOSOMATIC DISORDERS
Homoeopathic approach towards Psychosomatic Disorders The fundamental principle of Homoeopathy is that it treats the patient as a whole and as an individual. There is no medicine for any particular disease, but there is a medicine for the patient suffering from the disease. “The individual, not the disease, is the entity”, said the celebrated Sir William Osler. The general factors which should be taken into consideration are age, intelligence, and duration of illness, insight, nature of physical illness, environmental stress and personality structure of the individual.
Along with this, the homoeopath takes into consideration the conceptual image of the patient which comprises:
- Constitution, Temperament, Diathesis of the patient
- Causative factors (Endogenous, Exogenous, Physical or Mental) Peculiar mental states
- Characteristic physical generalities including its general modalities
- Characteristic particular symptoms including its particular modalities
- Relevant information from the Past/Personal/Family/Treatment history of the patient
- Miasmatic profile of patient.
In treatment of chronic psychosomatic ailments, the data should be considered for totality of symptoms and a similimum is to be selected accordingly. Whereas in acute cases, the presenting symptoms along with causative emotional factors are considered, to reach the similimum30. As regards the miasmatic background of the Psychosomatic disorders Psora plays an indubitable role according to Hahnemann, so in all cases appropriate antipsoric treatment must be employed for complete cure.
Case report
A 31 year old, Hindu, married man from lower-middle socioeconomic status presented at OPD of R.B.T.S. Govt. Homoeopathic Medical College and Hospital, Muzaffarpur, Bihar, on 10th july 2023 with complaints of frontal headache, insomnia, acidity, flatulency with anger after contradiction, consolation amelioration, irritability, introvert for 2 months. Insomnia and all with additional complaints, started after the loss of his shop.
Past history
His childhood history was uneventful. He was pursuing some kind of training for job. But he did not get job. So he started a shop by taking loan from nearby bank. His business was going quite well but after 20 days someone looted his shop at night.
Family history
His father was a farmer of lower middle socio-economic status. Mother is suffering from multiple joint pains, gout. His wife is suffering from gall stone. The doctor has advised for surgery.
Physical generals
- Tongue coated white in the middle, moist.
- He had a desire for sweet things. Aversion from egg.
- He was constipated; stool hard two or three times/daily, urine burning.
- Thermal reaction – he was a hot patient.
Mental generals
- Like to be alone
- Very irritable
- Consolation aggravation.
- Full of anxiety that is about bank loan payment.
- Anger on contradiction.
Sleep
- Sleep disturbed.
- Restlessness while sleeping.
- While going to bed for sleep, thought rushes.
Provisional diagnosis
Insomnia ICD11-7A00.
Justification of diagnosis
Symptomatic.
ANALYSIS AND EVALUATION OF SYMPTOM WITH MIASMATIC ANALYSIS
| S.NO | SYMPTOMS | ANALYSIS | EVALUATION | MIASMATIC ANALYSIS | |
| 1 | FULL OF ANXIETY DUE TO MONEY LOSS | MENTAL GENERAL | +++ | PSORA | |
| 2 | INTROVERT(INTROSPECTION) | MENTAL GENERAL | +++ | PSORA | |
| 3 | IRRITABLE | MENTAL GENERAL | ++ | PSORA | |
| 4 | SOLITUDE DESIRE | MENTAL GENERAL | +++ | PSORA | |
| 5 | CONSOLATION AGGRAVATION | MENTAL GENERAL | ++ | PSORA | |
| 6 | DESIRE –SWEET | PHYSICAL GENERAL | ++ | PSORA | |
| 7 | THERMAL –HOT | PHYSICAL GENERAL | +++ | PSORA | |
| 9 | STOOL –HARD | PHYSICAL GENERAL | ++ | PSORA | |
| 10 | SLEEP -DISTURBED | PHYSICAL GENERAL | +++ | PSORA | |
| 11 | FRONTAL HEADACHE | PARTICULAR GENERAL | +++ | PSORA | |
Figure : Repertory used: Radar 10.5 ( Schroyens F., synthesis 9.0)
Prescription: After case taking, repertorisation and book references,⁶ first prescription was Sulphur 200/2 dose/OD morning empty stomach prescribed on date 10/07/2023.
MANAGEMENT:
Provide emotional support by the family.
SELECTION OF REMEDY WITH JUSTIFICATION
Here SULPHUR is selected because it possesses the highest mark and also matches with maximum number of rubrics. So our final selection is done with the help of Materia Medica. So, I choose it. It also covers most of the generals as well as particular symptoms of the patient.
SELECTION OF POTENCY WITH JUSTIFICATION
It was based on the susceptibility of the patient. Higher the susceptibility higher the potency was selected.
FOLLOW UP
| FOLLOW UP DATE | INDICATION FOR PRESCRIPTION | MEDICINE WITH DOSE |
| 21/07/2023 1ST FOLLOW UP | FRONTAL HEADACHE, ACIDITY FLATULENCE CONSTIPATION WAS BETTER BUT, SLEEPLESSNESS WAS NOT IMPROVED. | PLACEBO/BDS/15 DAY |
| 08/ 08/2023 2nd FOLLOW UP | MARKED IMPROVEMENT IN SLEEPING AND HAVE SOUND SLEEP. | PLACEBO/BDS/15 DAY |
DISCUSSION AND CONCLUSION
Homoeopathy carries a good scope to treat insomnia. There are numerous homoeopathic medicines that can help in management of insomnia.
Also Homeopathy offers an approach that could play a significant role in enhancing the psychotherapeutic process. Homeopathy offers safe, gentle, non-toxic remedies, administered with holistic principles. They can provide ideal alternatives to conventional medications without any adverse effects. From the days of Hahnemann to the present time master prescribers have stressed the importance of mental and emotional symptoms as being most valuable for the selection of the needed remedy to effect the cure.
REFERENCES
1. Feather A, Randall D, Waterhouse M; Kumar and Clark’s clinical Medicine; 10 th international edition; Elsevier; Sydney ;2021; 788.
2.Kent JT. Repertory of the Homeopathic Materia Medica. Reprint Edition. New Delhi: B Jain Publishers Pvt Ltd; 2000.
3. Walker BR, Colledge NR, Ralston SH, Penman ID, Davidson’s principles and practice of medicine, 22th edition, Elsevier Science Limited 2014;242.
4. Banerjea SK; Miasmatic prescribing;2nd extended edition;B. jain publishers(p) Ltd.;2019.
5. Schroyens F., synthesis 9.0 Radar 10.5 Software (Kent Repertory), Mind technology, Mumbai.
6. Boericke W, Boericke’s New Manual of Homoeopathic Materia Medica with Repertory ;3rd Revised & Augmented Edition Based on Ninth Edition, B. Jain Publishers;2014:422-425.
7. Sarkar BK. organon of Medicine: Birla publications Pvt.Ltd; 2005-2006. 8. Hahnemann S. Organon of Medicine. Translated by William Boericke. Reprint. B. Jain Publishers (P) Ltd.; 2002. p. 105, 144.
