Father muller homoeopathic medical college and hospital, university road,deralakatte




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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

ANNEXURE-II

APPLICATION FOR REGISTRATION OF SUBJECT FOR DISSERTATION



1.


NAME OF THE CANDIDATE AND ADDRESS


Dr NAZIA ALI

DEPARTMENT OF MATERIA MEDICA,

FATHER MULLER HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL,

UNIVERSITY ROAD,DERALAKATTE,

MANGALORE-575018

KARNATAKA.




PERMANENT ADDRESS

MANATTIL HOUSE,

KURUKKOLKUNNU,

VALAVANNUR P.O.,

MALAPPURAM DISTRICT,

KERALA- 676555




2.


NAME OF THE

INSTITUTION

FATHER MULLER HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL,

DERALAKATTE,

MANGALORE.




3.



COURSE OF THE STUDY AND SUBJECT

M D.(HOM)

MATERIA MEDICA.



4.


DATE OF ADMISSION TO THE COURSE

24.05.2010.




5.


TITLE OF THE TOPIC

“A STUDY ON OPHIDIA GROUP OF REMEDIES USED IN HOMOEOPATHY”




6.


BRIEF RESUME OF THE INTENDED WORK








INTRODUCTION:

A true homoeopathic materia medica is a “collection of real, pure, reliable modes of action of simple medicinal substances”1. But this collection today has a large number of remedies, which makes it difficult for the practitioner to have a detailed study of each drug. Group study facilitates easier comprehension of drugs mentioned in our materia medica.


6.1 NEED FOR STUDY:

There are many ways to study the homoeopathic materia medica. Among them, group study of remedies is an important and useful method of study. Various remedies with common or similar characters are studied as a group.

The animal kingdom is a major source of drugs used in homoeopathy. Within this kingdom, serpents or snakes proper, which come under Ophidia, form important sources of preparations of homoeopathic remedies.

6.2 REVIEW OF THE LITERATURE:
Definition:

The term “group” implies “A number of similar drugs or remedies taken or considered together, related in some definite way.”2



History:

Group study was brought into focus by Dr. Kent who studied and wrote for the first time on this subject.

Historically, Dr. E. A. Farrington in his classical book “Clinical Materia Medica” made an attempt to study the remedies by classifying them in various groups.2

Dr. Clarke in his “Clinical Repertory” tried to give remedy relationships according to different groups2. Otto Lesser in his “Textbook of Homoeopathic Materia Medica” divided medicines into different groups, according to the periodic table of elements2. This was further continued by Jan Scholten in his books “Homoeopathy and Elements” and “Homoeopathy and Minerals”2. This work was further continued by other stalwarts like M.L. Dhawale, Morrison and Rajan Sankaran.2

Coming to the Ophidia group, the Serpent is one of the most ancient and most grandiose mythological characters. Also, the early leader of Greek medicine, Aesculapius is still cherished in medical circles- his staff, encircled by a serpent. So, the serpent continues to be the symbol of medicine2.
DISTRIBUTION AND LIFE SITUATION OF SNAKES:

Ophidia comes under class Reptilia, which comes under phylum Chordata, under Metazoa3. There are more than 2600 species of snakes in the world. Of these, about 216 species are found in India, of which 52 are poisonous.2

Majority of snakes inhabit the warm parts of the world. Snakes never stop growing, but they grow the fastest in the first two years of their lives. The outer thin layer of their skin becomes too tight, so they grow a new one and crawl out of the old. This is called SHEDDING or SLOUGHING. Just before shedding its skin, the snake becomes dull and lazy. After its shed, it looks bright and alert.
Senses2:


  • Hearing: Snakes cannot hear any sounds. Only the internal ear is present, but they receive vibrations transmitted through the ground.

  • Vision: Snakes have a distinct visual system. They do not have eyelids. The eye has a transparent cover, which changes every time the skin is shed. The thinner and active species like tree- & rat-snakes have good eyesight. Some snakes which hunt at night have heat-sensitive areas on their face. They can detect and strike the prey in the dark by sensing the warmth given off by the animals.

  • Smell: Snakes depend mostly on the forked tongue to pick up the scent from the air and ground and transfer them to the Jacobson’s organs at the roof of the mouth. That is why a snake constantly flicks its forked tongue out. With the smell, they not only hunt prey, but also avoid predators like mongoose and man.

  • Pain and temperature: Snakes feel pain and are acutely sensitive and can suffer from changes in temperature and humidity. When it’s too cool, their metabolic rate goes down, it becomes too sluggish: when too hot, it gets dehydrated and dies.


THE SNAKE-VENOM:

The venom of the snake is the source of homoeopathic drug-preparations. The poison of the snake is generally held in a little sac behind the fangs.4 On the under-surface of the fangs is a small groove, into which empties a little tube that conveys the poison from the gland.4 In the venomous snakes, the poison is secreted from the modified salivary gland. In vipers, it’s shot through hollow teeth.5


Physical properties of snake-poison:2

  • It’s an odourless, tasteless and viscid fluid of pale yellow colour.

  • Specific gravity ranges from 1.03 to 1.07


Chemical properties:

Snake poisons are supposed to be chemically cyanhydrates of soda and other salts.6 Constituents include peptides, fibrinolysins, proteolysins, neurotoxins, cholinesterase (predominant in Elapid viper), hemolysins and thromboplastin (predominant in viper venom), agglutinins, cardiotoxin, coagulase hyaluronidase (helps venom to spread rapidly). Also contain inorganic phosphorus and metallic ions like sodium, potassium, zinc, calcium, magnesium, iron, cobalt etc. Snake poisons are acidic to litmus paper.2

In addition, cobra and krait venoms contain highly neurotoxic components like basic polypeptides, which cause neuromuscular block.3

Viperine venom contains haemorrhagic, necrotic, coagulant and hemolytic substances which lead to extensive necrosis.3

Sea-snake poison is myotoxic, neurotoxic and even nephrotoxic.3
PATHOPHYSIOLOGIC ACTION:2


  • Neurotoxic venom causes muscular weakness and paralysis, involving the muscles of the face, throat, respiration, legs etc. It acts primarily on the motor nerves.

  • Haemotoxic venom produces enzymatic destruction of cell walls and coagulation disorders. As a result, there is destruction of endothelium of blood vessels.

  • Myotoxic venom produces generalized muscle pains, followed by myoglobinuria 3-5 hours later, ending in respiratory failure in fatal cases.

SPEED OF ACTION OF VENOM:

Depends on the site of injection and the amount injected. If the venom directly enters the bloodstream, the effect maybe rapid and leads to sudden death. In most cases, the absorption of venom is slower and especially in viperine bites, with extensive local reaction, considerable amount of venom may remain locally which is absorbed into circulation only in due course.3

The poison is more potent at some times than at other times. For eg. the more angry the serpent is, the more active is its venom. Also, if, in inflicting the wound, the fang passes through the clothing, some of the poison may thus be absorbed. Again, the power of resistance of the individual has some effect.4
EFFECTS OF SNAKE-BITE:

Maybe divided into three sorts:



  1. Immediately after the bite, the patient starts up with a look of anguish on his face and then drops dead. This represents the full, unmodified, lightning rapidity of the poison.4

  2. In the second form, commonly, the part bitten swells and turns, not a bright red, but rapidly to a dark purplish colour. The blood becomes fluid, and the patient exhibits symptoms like those characteristic of septicaemia. The heart beat increases in rapidity, but lessens in tone and strength. The patient becomes prostrated and covered with a cold, clammy sweat. Dark spots appear on the body where the blood settles into ecchymoses; the patient becomes depressed from weakness of the nervous system, and then sinks into a typhoid state and dies. Or, there follow nervous phenomena. Vertigo, dark spots before the eyes, blindness, a peculiar tremor all over the body, face besotted, dyspnoea or even stertor.4

  3. Or the process may assume a slower form. After the vertigo or trembling, the patient remains weak and the wound turns dark or gangrenous. All the discharges- the sweat, the urine and the faeces become offensive. Dysenteric symptoms of a typhoid character show themselves. The patient goes into a low state and finally dies.4

These are all the phases of action of these powerful poisons on the blood and nerves.

  • Neurotoxic venom: Soon after the bite, the patient complains of a sinking feeling, drowsiness, blurring of vision, diplopia, dysphagia and dyspnoea. There will be flaccid paralysis of limbs, associated with hypotonia and a diminution in tendon reflexes. Coma and death can happen due to respiratory failure or shock in 6 to 48 hours. Sometimes the symptoms may present as acute myasthenic crisis. Egs. Cobra-bite, krait-bite.3

  • Haemotoxic venom: Eg. Viper bite. Within 3-4 hours of bite, there will occur the following features:

  1. Haemorrhagic manifestations which appear as extensive bruises, bleeding from the bitten part, bleeding from gums, epistaxis, blotchy purpura haemorrhagica, haematemesis and malena. Bleeding can lead to shock. Cardiac manifestations occur as tachycardia, myocarditis and cardiac failure.3

  2. Rarely, there will be optic neuritis, leading to partial or complete blindness in 2-7 days. Renal changes occur as proteinurea and haematuria. A dreaded complication due to direct nephrotoxicity is anuric renal failure, the lesions of which are acute tubulonecrosis, haemorrhagic interstitial nephritis and acute glomerulonephritis. Death in viperine bite occurs due to shock, haemorrhages, secondary infection, renal failure or cardiac failure.3

  • Myotoxic venom: Pain and stiffness of muscles of neck, back and proximal parts of limbs. Eg: sea-snake poison. Its venom is also neurotoxic and nephrotoxic. Ophthalmoplegia, trismus, ptosis, proteinurea, myoglobinuria and death due to respiratory paralysis and renal failure.3


SPHERE OF ACTION:

Nerves: especially affected by snake-poisons are the pneumogastric and the spinal accessory nerves. Consequently, we expect to find as eminently characteristic, symptoms of the larynx, of the respiration and of the heart. All of the ophidian therefore cause choking, constrictive sensation coming from irritation of the pneumogastric. All of them have dyspnoea and heart symptoms.4

Muscles: paralysis and weakness, involving the muscles of the face, throat, respiration, legs etc. There can also be generalized muscle pains, followed by myoglobinuria. Fatal end through respiratory failure.

Blood: Destruction of endothelium of blood vessels, due to enzymatic destruction of cell walls and coagulation disorders.2

Skin: Moreover, the Ophidia produce a yellow staining of the skin. It comes from the blood, and is due to the decomposition of that fluid.4

Cellular tissue: All of the snake-poisons cause inflammation of the cellular tissue.4


GROUP CHARACTERISTICS OF OPHIDIA:

The main issue with animals is that of competition. Also common to the animal remedies is a conflict which has its basis in a split within the self. There are two sides to such personalities- the animal side, and the human side. While the animal side is concerned with competition, the human side seems to have contempt for the animal within.8


Mind:

Among the animal sub-groups, snakes have the following unique features:



  • Choking / strangulating and/or poisoning8

  • Very competitive, one upmanship8

  • Manipulative, deceitful, scheming8

  • Jealous and suspicious8

  • Split or antagonism with self8

  • Loquacity8

  • Clairvoyance8

  • Vivid and descriptive8

  • Dreams of snakes8

  • Fear of death, being attacked8

  • Feeling of being pursued and desire to hide8

  • Desire to kill8

  • Violent8

  • Sexuality8

  • Show and appearance8

  • Lack of morals8

  • Themes of superior and inferior8

  • Religious insanity – there is a state of religious melancholy and clairvoyance. Thinks he is under control of some supernatural power.2

  • Attractiveness is a common character of all ophidians.8

  • Activeness: Ophidians have an active memory and are of a very striking nature.2

  • Double standards: Ophidians are known to have two sets of rules – one for themselves, and another for others, because of egotism and jealousy.2


Physicals:

  • Face: sickly, pale, anxious, bloated, dark red or bluish.4

  • Haemorrhagic diathesis: Haemorrhages, particularly where the colour is quite dark.9 All snake poisons decompose the blood, rendering it more fluid; hence a haemorrhagic tendency is marked.6 Dark red blood which changes rapidly to purplish colour.2 Petechial haemorrhages or spots seen.2

  • Skin: The ophidian produce a yellow staining of the skin.4 It comes from the blood, and is due to the decomposition of that fluid.4 Dark spots appear on the body and blood settles into ecchymosis. Thus a mottled purple appearance.2

  • Side affinity: Predominantly left, except crotalus and elaps.2

  • Paralysis: As a group, Ophidia is characterized by their paralyzing action upon the nerves.4

  • Pains: predominantly shift from left to right, except crotalus and elaps.2 Predominant even with the pains are torpidity, numbness, twitching and formications.4

  • Periodicity in onset of pains and ailments.3: The periodicity of snake poisons is related to the spring.10

  • Discharges: Foetid4.Very offensive, profuse, bloody and dark.2 Suppression of these discharges gives rise to worse complaints.3

  • Hypersensitiveness is a marked feature of all ophidians, esp.to slight noise or touch, motion, covering etc. Cannot wear tight clothing around neck and waist.2

  • Debility, prostration, collapse and trembling of tongue and extremities.2

  • Senses: altered- vision, hearing etc.2

  • All snake poisons cause inflammation of cellular tissue4.This leads to effusion of inner organs and septicaemia.

  • Constriction: Nerves especially affected by snake poisons seem to be the pneumogastric and spinal accessory; consequently we expect to find as eminently characteristic, symptoms of the larynx, of the respiration and of the heart. All of the ophidian cause choking, constrictive sensation coming from irritation of the pneumogastric. All of them have dyspnoea and heart symptoms.4 There’s constriction of throat, larynx and sphincters.3


Characteristic General Modalities:

Aggravation:

  • Sunlight and/or summer and heat aggravation (snakes avoid direct sunlight and temperatures.)5

  • Empty swallowing. Swallowing liquids is more painful than swallowing solids (Snakes do not bite their prey. They merely gulp it down)5

  • Left side (When the snake strikes, the mandible rotates from left to right. Also, when it swallows, vertebrae move from left to right. Most of the organs of the snake are situated on the left side. Even the snake coils itself from left to right.5 All these are exempted in case of crotalus and elaps2).

  • Slightest noise, touch, jar (The snake is very sensitive to touch and vibrations.)2

  • Sleep: All the snake poisons, more or less, sleep into troubles.7

  • Spring: The periodicity of snake poisons is related to the spring.10

  • Suppression of discharges


Amelioration:

  • Cool and warm (Snakes cannot stand extremes of temperature).

  • Wakeful period

  • Appearance of discharges


CLINICAL CONDITIONS:

Inflammations and fevers of low destructive type like gangrene, malignant ulcerations, diphtheria, typhoid, pyaemia, carbuncles etc.4 Alcoholism, angina, cardiac asthma, endocarditis, cardiac hypertrophy, valvular affections, ciliary neuralgia, laryngitis, haemorrhages, haemorrhoids, necrosis of tissues and bones, skin affections like ulcers, boils and carbuncles, varicose veins, phlegmasia alba dolens.


POTENCY:

As M. L. Tyler says, “The greater the poison, the greater the remedy; and some of the most rapidly-acting and heroic medicines in desperate diseases are the snake poisons. They cure, of course, just the conditions they produce: but, when used for healing purposes, these poisons must be given in small, innocuous doses; and only to persons whose symptoms (physical, mental or moral) resemble the poison-symptoms. Where this is the case, the curative power is amazing.”10


RELEVANCE OF INDIVIDUALISATION:

William H. Burt mentions, “Dr. Richard Hughes has written up the poisonous effects of the ophidians all together, making no distinction between the action of the venom of Crotalus, Lachesis and Naja tripudians. This we believe to be all wrong; for, the effects of each differ greatly.”11

Accordingly, the following 15 commonly-used medicines are individually studied in my work:


  1. Lachesis – surukuku snake

  2. Naja tripudiens – Indian cobra

  3. Elaps corallines – coral snake

  4. Crotalus horridus – The rattle snake of North America

  5. Crotalus cascavella – North-eastern Brazilian Rattlesnake

  6. Bungarus fasciatus – krait

  7. Bothrops lanceolatus – yellow viper

  8. Cenchris contortrix – copperhead snake

  9. Vipera berus – German viper

  10. Vipera communis – common viper

  11. Hydrophis cyanocinctus – sea snake

  12. Toxicophis – moccasin snake

  13. Clothoarietans – puff adder

  14. Oxyuranus scutulettus – common taipan snake

  15. Echis carinata – saw-scaled viper


6.3 OBJECTIVES OF THE STUDY:

  1. To study the group and individual characteristics of the ophidia group of remedies.

  2. To verify the main clinical utility of ophidian group of drugs.








7.



MATERIALS AND METHODS








7.1 SOURCE OF DATA:

The subjects will be selected from OPD, IPD and peripheral centers of Father Muller Homoeopathic Medical College, Mangalore.


7.2 METHOD OF COLLECTION OF DATA:

A sample of minimum 30 cases will be studied as per the inclusion criteria and will be followed for a minimum period of 4-6 months’ duration.

The data will be represented in the Standardised Case Record. According to the guidelines in SCR, the case will be analysed, totality will be erected and suitable remedy will be administered. Every case is analysed, reference from materia medica and repertory will be taken as per requirement. The potency selection and repetition of the doses will be done according to the demand of the case, with consideration of potency selection criteria. Follow-ups would be watched and analysed as per criteria set up in each case.

INCLUSION CRITERIA:

The sample is taken from both the sexes between age group 15-90.


EXCLUSION CRITERIA:

  1. Patients below 15 and above 90.

  2. Patients suffering from terminal illnesses.


RESEARCH HYPOTHESIS:

Ophidian drugs are effectively used in homoeopathy for a wide range of clinical conditions, where the totality corresponds.


NULL HYPOTHESIS:

Ophidian drugs are not of clinical utility in homoeopathy.


PLAN FOR DATA ANALYSIS:

The collected data will be analysed by paired ‘T’ test.



7.3 Does the study require any investigations to be conducted on patients, or other humans (or animals)? If so please describe briefly.

Yes. Routine blood and urine tests, ultrasonography, ECG, CT, MRI and other investigations, as relevant to the case.



7.4 Has ethical clearance been obtained from your institution in case of 7.3?

Yes, enclosed.








8.


LIST OF REFERENCES


  1. Dudgeon R.E., Organon of Medicine by Samuel Hahnemann (5th and 6th edition), New Delhi, Indian Books and Periodicals Publishers, aphorism 143, p.122




  1. Dr. Patil J.D., Group Study in Homoeopathic Materia Medica, New Delhi, B. Jain Publishers (P) Ltd., Reprint edition: 2008, p.1, 5, 6, 7, 11, 19-30.




  1. Mathew George, Snake remedies (Ophidia) in Homoeopathy, published in http://www.similima.com/gp16.html




  1. Farrington E.A., Clinical Materia Medica, New Delhi, B. Jain Publishers (P) Ltd., 4th edition (Reprint edition: 1996), p. 33-36




  1. Master Farokh J., Snakes in Homoeopathic Grass, New Delhi, B. Jain Publishers Pvt. Ltd., 1st edition : 1995, p.12-14




  1. Boericke William, Pocket Manual of Homoeopathic Materia Medica and Repertory and a chapter on rare and common remedies, Reprint edition: 1996, New Delhi, B. Jain Publishers Pvt. Ltd.; p. 240, 387




  1. Kent, James Tyler, “Lectures on Materia Medica”, New Delhi, B. Jain Publishers (P) Ltd., Reprint edition : 1996, p. 474, 475




  1. Sankaran Rajan, The Sensation in Homoeopathy, New Delhi, Homoeopathic Medical Publishers, 2nd edition : 2005 (Reprint edition: 2006), p. 53,54




  1. Vithoulkas George, Essence of Materia Medica, New Delhi, B. Jain Publishers (P) Ltd., 2nd edition : 1990 (Reprint edition : 2008), p.105




  1. Tyler M.L., Homoeopathic Drug Pictures, New Delhi, B. Jain Publishers (P) Ltd., Reprint edition : 1996, p. 492, 337




  1. Burt Willium H., Physiological Materia Medica, New Delhi, B. Jain Publishers (P) Ltd., Reprint edition : 1995, p. 357








9.

SIGNATURE OF THE CANDIDATE




10.

REMARKS OF THE GUIDE




11.

11.1 NAME AND DESIGNATION OF GUIDE

(IN BLOCK LETTERS)


Dr. SUNNY MATHEW MD (Hom.)

PROFESSOR,DEPARTMENT OF HOMOEOPATHIC MATERIA MEDICA

FMHMC, DERALAKATTE, MANGALORE


11.2 SIGNATURE




11.3 CO – GUIDE


    1. HEAD OF THE

DEPARTMENT


Dr. Srinath RAO MD (Hom.)

PROFESSOR,DEPARTMENT OF HOMOEOPATHIC MATERIA MEDICA



FMHMC, DERALAKATTE, MANGALORE

11.6 SIGNATURE


12.

12.1 REMARKS OF THE

CHAIRMAN AND PRINCIPAL






12.2 SIGNATURE








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