Scope of A Concise Repertory of Homoeopathic Medicine By Dr . S .R. Phatak Repertory in Homoeopathic Management of Asthma

Abstract

Asthma is a chronic inflammatory condition of the airway characterized by reccuring episodes of wheezing , breathlessness , chest tightness and coughing particularly at night or in the early morning and frequency vary from person to person and affecting people of all ages . Phatak’s repertory has been one of the most reliable and trusted bed side repertory for quick and systematic repertorization. It is a concise and alphabetically arranged handy repertory with many clinical and pathological rubrics. Published in 1963 by Dr. S. R. Phatak, it is mainly based on, “Repertory part of Synoptic key to Materia Medica” by Dr. C.M. Boger. He has also made many editions based on his clinical observations and other authentic sources like Kent, Boger, Clarke.Conventional modern medicine tries to mitigate the symptoms of asthma and provides palliation whereas Homoeopathic medicine can provide a true “cure” for the condition through a constitutional Similimum.

Keywords:  Asthma  ,  Homoeopathy, Pathak repertory , Rubric , Management .

Introduction

Asthma is a chronic inflammatory condition of the airway characterized by reccuring episodes of wheezing , breathlessness , chest tightness and coughing particularly at night or in the early morning and frequency vary from person to person and affecting people of all ages.

In addition

 to respiratory symptoms of wheezing , breathlessness , chest tightness and coughing , asthma may also present with feeling very tired or weak when exercise , easily upset , sign of cold , trouble sleeping , difficult talking , pale and sweaty face , blue lips and finger nails , sinusitis .

Asthma is associated with T-helper cell type 2 immune responses , which are typical of other atopic condition. Asthma triggers may include allergic and non – allergic stimuli , which produce a cascade of events leading to chronic airway inflammation.

Prevelance – 

• Over 3%  or about 30 million people suffer  from asthma in india .
• Aprox 2.4 % in adult age group and 4 to 20 % in children . 
• Highest prevelance in age group of  20-24 years of age  with total 9.5 % . 
• Before puberty prevelance more in boys and after puberty it affect more to female . 
• In urban area it affect male more but in rural area female suffer more . 
• Globally India contribute approximately 12.9 % in asthma cases and 42.4%  in cases of death due to asthma . 

 

Causes –  

The causes of asthma are not completely understood . The risk factors for developing asthma are a combination of genetic predisposition with environmental exposure to inhaled substance and particles that may provoke allergic reactions such as  : – 

• Indoor allergens ( i.e.- house dust , mites in beds , pollution and pet dander )
• Outdoor allergens ( i.e. – pollens and moulds )
• Smoke
• Chemical irritants in the workplace . 

Other trigger factors are : – 

• Cold air
• Extreme emotional arousal such as anger , fear and physical exercise
• Drugs : like aspirin and other non – steroid anti – inflammatory drugs and beta blockers .

Classification – 

Based on causes – 

• Allergic asthma
• Non – allergic asthma
• Aspirin – induced asthma
• Steroids – resistant asthma
• Occupational asthma
• Exercise – induced asthma
• Cough – variant asthma 

Based on Symptoms Severity :- 

• Intermittent or persistent
• Mild
• Moderate
• Severe

Symptoms – 

• Recurring episodes of wheezing ,
• Breathlessness ,
• Chest tightness and coughing , 
• Sign of cold ,
• Trouble sleeping ,
• Difficult talking ,
• Pale and sweaty face , 
• Blue lips and finger nails 
• Sinusitis

Complication – 

Complications in children – * Growth delay

     * Higher risk for learning disabilities .

Complications in adults –    * Higher risk for depression

     * Frequently sick

Common in both –

• Loss of lung functions
• Airway wall thickening
• Chronic coughing
• Oral yeast infection
• Throat irritation
• Insomnia
• Gastroesophageal reflux
• Respiratory failure
• High risk of obesity

Diagnostic Criteria :- 

Clinical diagnosis of Asthma made on a history and physical examination. Radiographic imaging is routinely recommended for the diagnosis and is primarily used to rule out other conditions such as pneumonia , pneumothorax etc. Specific Spirometry testing should be performed only if the diagnosis is uncertain or when determination of a specific target allergen is needed.In case of obstructive lung disease like asthma , emphysema , there is a significant decrease in  FEV1 AND FVC ratio , which varies from 50 % to 56 % . ( FEV1 – 40% – 50%  , FVC – 65% – 70% ) . spirometry ( pre and post bronchodilators response ) help to identify such underlying pathophysiology via assessment of bronchial hyper reactivity and lung mechanics and Absolute Eosinophil count which is elevated in allergic asthma . FeNO test which is also known as Exhaled Nitric Oxide Testing in which excessive amounts of nitric oxide show the increased inflammation in airways . hence, clinical diagnosis is the most recommended and approved criterion .

Common Therapeutic Treatment

The present modern system of medicine aims at managing Asthma with antihistamines, cortico – steroid, leukotriene receptor antagonist, oral steroid, and immunotherapy. This however gives only transient relief and recurrence of symptoms once the treatment is discontinued and hence the disease is not permanently extinguished. Not only is the cost of treatment high, but these medicines also produce many side effects such as dry mouth, increased drowsiness, epistaxis, constipation, and tachycardia. 

the adverse effects of continued use of short – acting beta agonist ( SABA ) even for short term , i.e. – decrease bronchoprotection and response for bronchodilator , increased responsiveness of airway , bronchoconstriction due to exercise and response to allergic substance , inflammation caused by increased eosinophilic count and release of mast cell mediator .

Corticosteroids inhalation can cause suppression of adrenal when administered in high dose ( > 400 ug/ day ) and for long term ( > 18 to 24 months) .

A Conscise Repertory of Homoeopathic Medicine By Dr. S. R. Phatak :- 

Phatak’s repertory has been one of the most reliable and trusted bed side repertory for quick and systematic repertorization. It is a concise and alphabetically arranged handy repertory with many clinical and pathological rubrics. Published in 1963 by Dr. S. R. Phatak, it is mainly based on, “Repertory part of Synoptic key to Materia Medica” by Dr. C.M. Boger. He has also made many editions based on his clinical observations and other authentic sources like Kent, Boger, Clarke. 

The most striking peculiarity of the repertory is that no drug is given unless the author has used it in his own practice or unless there is strong justification provided to it by authorities like Dr. Kent, Boger, Clarke. 

It aims at reducing the burden of prescriber in every sense of the work. Repertory follows the concept of generalization. Hence in cases with prominent generals and particular symptoms, Phatak repertory will provide a skillful anchor in reaching towards the indicated remedy. 

 There are many rubrics specially modalities which are exclusively found in this repertory and hence is the source to many new modern repertories. Also being an Indian repertory, it includes many Indian food items, helping the physician further to find a more refined picture of disease presented by the patient.

 

In hereditary Asthma , it is among the sycotic disorder of the Hahnemann . In initial phase of practice DR. Kent was not able to prescribe for patient of Asthma , but when he learned that Asthma is one of the sycotic disorder , Dr. Kent made judicious prescription of anti – sycotic remedies which results were beneficial . Mainly anti – sycotic remedies can cure the Asthma and other drugs have partial effect .

 

In A CONSCIOUS REPERTORY OF HOMOEOPATHIC MEDICINES ALPHABETICALLY ARRANGED BY DR. S.R.

PHATAK  Various rubrics are mentioned  :- 

 

ASTHMA ( Bronchial ) – Aco , Amb. , ARS. , Kali-c .  , PULS . , SPO. , 

Bed , turning in agg – Ars 

CARDIAC – Sumb. , Naj , Cact .

CATARRHAL – Calad , Caps . ,

COITION AGG – Amb , Asaf , Kali – bi . 

COLD , PRECEDED BY + – Sul . 

CONSTITUTIONALLY –  Calc , Iod , Sul .

ASPHYXIA – 

Charcoal , fumes , from + – Bov. 

Neonatorum – Ant – t , cam , laur . 

Full moon + – Spo . 

DRUNKARDS , OF  – Meph . 

HIVES , FROM – Ap , Pul .

FOG AGG – Hypr. 

GOITRE , IN – Spo .

DUST , INIHALATION  OF + – Poth.

ERUCTATION AMEL – Carb – v , Nux v. 

NIGHT FROM 1 AM TO 4 AM – Syph .

OLD PEOPLE , IN – Amb. , Coca + , Seneg , Con , Bar – m ,

RHEUMATISM , WITH – Benz – ac , Visc . 

ROCKING AMEL – Kali- c. 

SEXUAL EXCITATION  , WITH – Nat – c.

SITTING UP  , AMEL – + – Naj .

SKIN DISEASE , WITH – Ip 

STOOL , AMEL + – Poth .

TOBACCO SMOKING AMEL – Merc 

TALKING  AGG – Dros. 

URINATING , WHEN  – Chel ,Dul .

VERTIGO , WITH –  Kali – c 

WEEKLY – Chin, Ign , Sul

WINTER AGG –  Carb – v , Nat – m , Nux-v 

CHEST – BAND ,  SENSATION  OF A – Aeth , Cact , Helo , Ign , Lob , Pho. , Sul.

BAR ACROSS – – Kali – bi 

CHEST – CONGESTION –  SUL , Terb . , phos .

CRAMP , CONSTRICTION , SPASM –  Aeth + , Grap + ,   Vip , Cact , .

LUMP , PLUG SENSATION –  PHOS , Stic , Tarx.

PARALYSIS OF LUNG –  ANT – T , Kali – io.

RATTLING –  Hep , Lob , Phos , Sil , Sul ,Tub .

COUGH – ASCENDING  STAIR , WHEN –  Arg – n .

COUGH – BARKING –  Amb + , Aco , Bell , Dros , spo 

EXHALATION – AGG – CHLOR , Caus . , Dros .

EXHALATON – AMEL – ACO . , Bry .

EXPECTORATION – AGG – Coc – c ,Dig , Led , Nux-v 

EXPECTORATION – AMEL –   Ant- t , Ap , Coc – c , Grind , Hypr . 

FACE – BESOTTED , STUPEFIED –  Arn , Bap , Crot – h , Bry , Gel , Hyo , Op , Stram . 

FACE – COLD –  CARB – V . Cocl + ,  VER-A , 

FACE – HIPPOCRATIC , DEATH – LIKE , PINCHED –  ARS , VER –A , Cam + .

FANNING , AGG – Mez .

FANNING , AMEL –  CARB –V , Chin , Arg- n , Lach , . 

HAEMOPTYSIS –  Aco , Am – c , Ars , Bell , Bry , Chin , Fer , Hyo , Ip , Sul , Terb + .

INSPIRATION – AGG –  Crot – h , Ip , Kali – n , Lob , Mez , Nux – m , Spo , Sumb.

INSPIRATION – AMEL –  Colch , Cup , Ign , Lach , Spig , Stan , Verb . 

RESPIRATION – AFFECTION IN GENERAL –  ARS , IP , LACH , OP , PHO , PUL , SPO , SUL .

RESPIRATION – CHEYNE – STOKES –  Bell , Carb – v , Coca , Grind , Op , Sul . 

RESPIRATION – DIFFICULTY , SUFFOCATING  , CHOKING –  ARS , IP , LACH , PUL , SPO , SUL .

RESPIRATION – GASPING –  Ap , Carb – v , Cor –r  , Hyd – ac , Kali – n  ,Latro , Laur . 

RESPIRATION – WHISTLING , HISSING , WHEEZING –  Ars , Aur , Caus , Chin , Hep , Ip , Kali – c , Kali – io , Samb , Seneg , Spo , Stram . 

COMMONLY INDICATED HOMOEOPATHIC REMEDY FOR  ASTHMA :- 

• BLATTA ORIENTALIS ( INDIAN COCKROCH ) –  

• Asthma associated especially with bronchitis , indicated after arsenic .
• Cough with dyspnea in bronchitis and phthisis with much pus like mucus
• Act best in stout and corpulent patient .

 

• ZINGIBER OFFICINALE ( GINGER ) :- 

• Asthma without anxiety , worse toword morning .
• Hoarseness , smarting below larynx , breathing difficult .
• Scratching sensation in throat , stitches in chest .
• Cough dry , hacking , copious , morning sputa .
• State of debility in gastric , sexual and respiratory system  call for this remedy .

 

• TARAXACUM OFFICINALE ( DANDELION ) :- 

• Nervous asthma with sleeplessness . 
• Profuse night sweat  . 
• Characterstic mapped tongue with jaundiced skin . 
• Worse on resting , lying down , sitting 
• Better on touch . 

• TUBERCULLINUM  :- 

• Nosodes from tubercular abcess .
• Light complexion , narrow – chested subjected  , very susceptible to changes of weather , cold taken from slightest exposure .
• Aversion to work , wants constant changes  ,  fear of dog . 
• Hard dry cough during sleep , expectoration thick , easy , profuse bronchorrhea . 
• Shortness of breath , sensation of suffocation , even with plenty of fresh air , longging for cold air . 
• Broncho – pneumonia in children , hard , hacking cough , profuse sweat with loss of weight , rales all over the chest . 
• Deposit begin in apex of lungs . 
• Worse by – motion , music , before a strom , standing , early morning , after sleep . 
• Better by – open air . 

1. THUJA OCCIDENTALLIS ( ARBOR VITAE ) – 

• Ill – effect of vaccination , hydrogenoid constitution , so damp weather , air , water are inmical . 
• Rapid exhaustation and emiciation , left sided and chilly medicine  with  persistant insomnia . 
• Complaint from moon light , fixed ideas , emotional senstiveness . 
• Papilloma of larynx , chronic laryngitis  . 
• Asthma in children ( nat sulph ) , dry , hacking cough in afternoon with pain in pit of stomach  , stitches in chest . 
• Worse by – at 3 am and 3 pm , cold drinks , from heat of bed , at night , damp air , after breakfast , fat and coffee . 
• Better by – left side , while drawing up a limb . 

• DROSERA ROTUNDIFOLIA ( SUNDEW ) :- 

• Spasmodic , dry irritative cough , like whooping cough , the paroxysms following each other very rapidly ,can scarely breathe , chokes .
• Cough very deep and hoarse , yellow expectoration with bleed from nose and mouth . 
• Asthma when talking , with contraction of throat at every word uttered . 
• Voice hoarse , deep , toneless , cracked , requires exertion to speak , clergyman’s sore throat . 
• Worse by – after midnight , lying down , on getting warm in bed , drinking , singing , laughing .

Conclusion –  

Hence we can see that phatak’s Repertory can be used clinically for managing asthmatic cases in opd, and clinic setting as well. The repertory only needs a thorough study for better usage by students, practitioners and even experienced homeopaths.

References

1. Castillo Vizuete JA, Sastre J, del Cuvillo Bernal A, Picado C, Martínez Moragón E, Ignacio García JM, et al. Asthma, rhinitis, and nasal polyp multimorbidities. Arch Bronconeumol [Internet]. 2019;55(3):146–55. Available from: http://dx.doi.org/10.1016/j.arbr.2018.12.020.
2. Me A. A Concise Repertory of Homoeopathic Medicines by Pathak [Internet]. Homeopathy Resource by Homeobook.com. Homeobook; 2013 [cited 2023 Oct 3]. Available from: https://www.homeobook.com/a-concise-repertory-of- homoeopathic-medicines-by-pathak/
3. B. J Lipworth Fortnightly review: Modern drug treatment of chronic asthma Year: 1999 Container: BMJ Volume: 318 Issue: 7180 Page: 380-384 DOI: 10.1136/bmj.318.7180.38
4. Phatak SR. Concise Repertory of Homoeopathic Medicines. B. Jain Publishers; 2004.
5. ‌ Anon Container Types of Asthma: www.lung.org URL: https://www.lung.org/lung-health-diseases/lung-disease- lookup/asthma/learn-about-asthma/types
6. Anon Asthma Complications: Long- and Short-Term Effects By Year: 2014 Container: Healthline URL: https://www.healthline.com/health/asthma- complications#emergency
7. Boericke W. Boericke’s new manual of homoeopathic materia medica with repertory : including Indian drugs, nosodes, uncommon rare remedies, mother tinctures, relationships, sides of the body, drug affinities, & list of abbreviations. New Delhi: B. Jain Publishers; 2007.

About the Author

DR . NARENDRA JATAV 

MD SCHOLAR 

BATCH – 2022 – 23 

DEPT . OF HOMOEOPATHIC REPERTORY AND CASE TAKING 

GOVT . HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL BHOPAL ( MP) .

• GUIDED BY – 

DR . NEETU KUSHWAH 

PROFESSOR , GHMC BHOPAL .