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Nutritional
Support in Fever
By.Dr.G.Satheesh
MD(Hom)
1.
Introduction In
the management of diseases diet and nutrition plays an important role. Well
thought out nutritional support is a valuable aid to any practitioner. This is
particularly true about febrile cases because fever is a common symptom of many
diseases. In fact, it is one of the
early responses of our body to many harmful agents. Also many patients with high
and/or prolonged fever develop nutritional depletion, which in turn lead to
other complications. Hence dietary care plays an important role in the
management of many cases of high and prolonged fevers. 2.
Causes of nutritional depletion Fever
is produced by metabolic processes and muscular activity.
This accelerated metabolism leads to breakdown of tissues and results in
loss of calories and nutritional depletion. Again,
when you are hot, your body perspires to cool you down.
Increased perspiration result in water and electrolyte depletion as in
the cases of high fever. 2.1
Functional consequences of nutritional depletion (fig. 1) 1.
Reduced cellular or humoral responses to infection 2.
Impaired wound healing 3.
Bed sores and Ulcers 4.
Reduced haemopoiesis 5.
Muscle weakness; reduced ability to cough; susceptibility to
bronchopneumonia. 6.
Dehydration-Dryness of mouth, herpes, Parotitis, oral infection
Constipation
Oliguria; dysuria; retention
of urine. 2.2. Objectives of nutritional care 1.
Nutritional support to compensate energy loss 2.
Correction of fluid and electrolyte deficit 3.
Prevention of complications developing from the causes mentioned above 4.
To pave way for speedy recovery 3.
Principles 1.
Assess calorie and protein needs 2.
Mark out clearly the route of administration 3.
(Oral Route, Tube feeding, parenteral nutrition) 4.
Specify the frequency and rate of feeding 5.
Designate special restrictions (if any)
(Na, Ca, K, fluid, gastric
irritants, fibre, residue, gluten, fat, carbohydrate, protein, galactose,
oxalate, lactose) 6.
Designate special additions (if any)
(Fibre, vitamins, prepared
nutrient supplements. etc.) 7.
Restrictions and / or additions according to the indicated Homoeopathic
Medicine. 3.1 Diet Generally
diet should be easily digestible, soft and palatable.
In order to maintain a positive calorie balance, it should provide
2500-3000 k cal / day. 3.2 Fluid intake Unless
contraindicated the fluid intake should be about 3000 ml/day - to prevent
dehydration. Fresh fruits and fruit
juices (rich source of K+ and Na+) and vegetable juices (eg- carrot juice) can
be given to prevent constipation associated with fever. Frequent
sips of fluids and proper oral hygiene also helps to prevent herpes and
Parotitis. 3.3 Caloric requirements In
hospitalized patients with prolonged febrile illness, the daily caloric
requirements can be estimated by using the Harris-Benedict equation for
basal energy expenditure (BEE) Men,
k cal / day BEE
= 66 + 13.8W + 5H - 6.8A Women,
k cal / day BEE
= 665 + 9.6W + 1.8H - 4.7A Where
W = Weight in Kg, H = height in cm, and A = age in years Average
energy expenditure is 1.37 BEE - 312. To
maintain a positive caloric balance when energy expenditure is increased as in
prolonged fevers, burns, infections etc. the energy intake should be 1.5 -2
times this value. 3.4 Administration Can
be oral intake, tube feeding or parenteral. 3.4.1 Tube feeding This
is indicated in patients who are very sick and unable to take oral feeds.
Total amount of feed varies from 2000 ml to 3000 ml / day.
Each feed should not exceed 150-300 ml because rapid feeding may cause
rapid distension of stomach, nausea and regurgitation. Feeds should be at 380C.
Food must be nutritious, in liquid form containing milk, egg, cream, glucose,
vegetable soup, rice water etc. 3.4.2 Parenteral nutrition It
is indicated when the patient cannot eat or deteriorate on oral feeding.
Partial or total nourishment can be given through the parenteral route. 3.4.3 Parenteral feeding by a peripheral vein Can
be easily established for caloric and fluid support.
In order to prevent the development of phlebitis, the concentration of
glucose infusions should not exceed 10%. Adequate
total energy requirements cannot be achieved from 10% glucose infusions alone. 3.4.4 Parenteral feeding by central nervous alimentation Glucose
infusions of higher concentration (25-35%) can be administered in this way.
It is best to give about 30% energy as intravenous fat emulsion, along
with glucose, amino acids and micronutrients. 3.4.5 Total parenteral nutrition (TPN) TPN
is indicated in malnourished persons who cannot tolerate oral feedings.
In TPN all the essential nutrients have to be given.
TPN should generally provide 2500 - 3000 3.5
Restrictions and additions Needs
for special restrictions and / or additions to diet depends on diagnosis.
For eg. Protein and sodium free diet in Hepatic coma and anemia.
High protein and high calorie diet in T.B., chronic fevers, infections
and in burns etc. 3.6 Diet and Homoeopathic Medicines When
patients are under constitutional remedies, they need caution about certain
kinds of foods that are known to disagree with their constitutional
remedy. For example a patient
taking Bryonia is often made sick from eating vegetable salads.
It is wise to caution persons under the influence of pulsatilla to avoid
the use of fatty foods, as it will upset the action of the remedy.
At the same time increase in the intake of coffee in diet will
enhance the curative action of medicines like aconite, arsenic alb and
colocynth. There
is no general rule on the dietetic restrictions for all the patients.
In other words, the foods that should be avoided temporarily and that
should be taken by a patient differ from one patient to another depending up on individuality
of each case as well as that of the patient. (Dr.Kent
says “In accordance with a principle and not by rule... do not have one
list of foods for your patients, do not have a list of things for everybody.
There is no such thing in Homoeopathy”). 4.
In acute fevers. Apart
from all this, in acute febrile conditions, plenty of fluids (as much as the
patient normally can) preferably isotonic will be the best advice. Juices of
citrus fruits, tender coconut water, soups etc are all very good and also
readily available at home. Also,
in acute cases restriction of dietary items is not advisable unless some food
items are strongly contra indicated in the malady.
As the master himself said “In acute diseases, on the other hand-except
in cases of mental alienation - the subtle unerring internal essense of the
awakened life preserving faculty determines so clearly and prescisely, that the
physician only requires to councel the friends and attendents to put no
obstacles in the way of the voice of nature by refusing any thing the patient
urgently desires in the way of food or by trying to persuade him to partake of
anything injurious”. ($262,
Organon of Medicine). 5.
Conclusion Serious
illnesses are associated with chance of severe nutritional depletion because
patients may be unable to take, digest or absorb their food and also due to the
loss of large amount of Calories. The
major problem in the nutritional support is to provide water, calories and
proteins to the patient. The
type of diet, its ingredients, quantity, concentration rate and route of feeding
depends up on the requirements of the patient, nature of his illness and the
ability of the GI tract to absorb sufficient nutrients. The
basis of dietary additions and restrictions is according to the precise
diagnosis. (A
Homoeopath should impose dietary addition and restrictions not only according to
the diagnosis but according to the similimum also). 6.
References 1. Rudman.D- Diet Therapy Chapt.74 2. Jeejeebhoy K.N., Baker J.P- Parenteral Nutrition Chapt.75 3.
Braunwald.E, Isselbacher K.J ET al- Harrison’s Principles of Internal
Medicine 11th
Ed.
Companion Handbook. 4. Park .K- Park’s Textbook of Preventive and Social Medicine 15th Ed. 5. Santwani M.T- Practical Diet Guide in Homoeopathy. B.Jain Publishers New Delhi 6. Teachers of M.C. Calicut- Doctors Pocket Companion 7. Debora Tkae-The Doctors Book of Home Remedies Rajendra Publishing house Pvt.Ltd., P 258-264. 8. Edwards C.R.W, Bouchier IADET al- Principles and Practice of Medicine 15th edition. Churchill Livingstone 9. Krishna Das K.V- Textbook of Medicine 3rd edition Jaypee Brothers Medical Publishers 10. Kent, James Tyler- Lectures on Materia Medica. B.Jain Publishers New Delhi. Abrus precatorius; An Image yet to be formulatedBy.Dr.P
Sunilraj BHMS. When
we think about valuable therapeutic agents of various homoeopathic materia
medica available at present and comparing it with the possible advanced types of
materia medica in the future, we would be astonished to see that our present
treasure of medicines is much less than what is really required for dealing
with the ever increasing human ailments. The
number of new homoeopathic medicines which will be added in our pharmacology
are beyond limits because, anything which can make a change in the healthy state
is something which is surely to be considered as an agent which is
therapeutically effective. Nature
creates diseases and as a compensation it also creates materials which can
conquer these disturbing, debilitating and destructive forces effectively. Each
and every nation has abundant treasure of indigenous therapeutic agents.
The question regarding the origin, nature and market value of these drug
substances are not the primary matter of concern, because even a member from a
precious stone family may not provide much help as pure flint do.
Here let me quote P.B. Bell’s emphatic statement, “whether derived
from purest gold or purest filth, our gratitude for its excellent service
forbids us to inquire or care.” The
only thing one has to do is to explore the therapeutic possibilities of these
agents effectively. Here comes
the need of observations, pharmacological experimentations and clinical trials
of the suspected and apparently useful medicinal agents. Dr.
Samuel Hahnemann elaborately described various sources of information regarding
the pathogenetic powers (and thereby the curative powers) of medicinal
substances in the aphorisms 105-145. Among
this we know that drug proving on healthy human beings is the most important,
reliable and recommendable source. He
wrote that every medicine exhibits peculiar actions on the human frame, which
are not produced in exactly of a different kind (apho.118).
He also told that anyone who has a thorough knowledge of, and can
appreciate the remarkable difference of, effects on the health of man of every
single substance from those of every other, will readily perceive that among
them there can be, in a medical point of view, no equivalent remedies whatever,
no surrogates (foot note of apho.119)-ie, no medicine can be used as a
substitute for another one. He
said that morbid lesions which resulted from medicinal substances when taken
into the stomach of healthy persons, either in large doses given by mistake or
inorder to produce death in themselves or others, or under other circumstances,
accorded very much with his own observations when he was experimenting with the
same substances on himself and other healthy
individuals. In addition to
these accidental, homicidal and suicidal poisoning cases, Dr. Hahnemann also
described about Idiosyncrasy as a source of information regarding the disease
producing properties of substances (apho.117). Eventhough the hypersensitiveness
is a constitutional peculiarity, the basis of such manifestations cannot be
attributed to the peculiar constitution alone, because the power of producing
such manifestations lies with the particular substance itself. The
therapeutic use of more and more agents from vegetable, animal and mineral
origin and also from various energies should be discoverd and systematically
arranged so that these can be used as valuable medicines.
Among these sources vegetable group play an important role especially
when we think about the possibility of the additon of new medicines because of
the availability of a large number of plants both cryptogams and phanerogams
around us. Now
let us think something about the plant ‘Abrus precatorius’, which is
commonly seen in India, but the medicinal properties of which is not well known,
especially in the Homoeopathic point of view.
Our traditional system of medicine namely Ayurveda explained about the
plant regarding the parts used and also the individual therapeutic properties of
these parts in the angle of ayurvedic approach.
In Homoeopathy we know that it is not a well proved drug substance and is
using ayurvedic instructions of medication. Well, it will be far away from
classical Homoeopathy. So it is
high time to prove this drug on healthy human beings in non-toxic doses and
obtain a portrait of the pathogenetic effects. Anyway
we are lucky to have so many toxicological effects of this plant and its various
parts which will help us to know about its Homoeopathic therapeutic aspect upto
cerain extent. It also gives an
idea about the part or parts which is to be used for the preparation of our
medicine, about the nature and strength (dilution) of the extracts to be used
and also about the precautions to be taken during drug proving.
So let us now consider about this plant in a systematic way. Botanical
name :
Abrus precatorius Synonyms
: Abrus aaculatus, Abrus minor;
Abrus pauciflorus; Abrus squamulosus; Indian liquorice; Jequirity. Names
in different languages English
: Crab’s eye vine Malayalam
: Kunni Sanskrit
: Gunga, Kakachinji; Kakanandi;
Kakadanee; Kakavallari; Kakacheelu; Rakthika; Hindi
: Rati, Ghungchi Tamil
: Kunti Telugu
: Guriginja Kannada
: Galaganji Bengali
: Kunch Marathi
: Gunj Family
: Leguminosae Distribution
: All over India, in land up to
1000 metres high; also cultivated in gardens. Description Macroscopic:- Abrus
precatorius is a beautiful deciduous, creeping or climbing plant.
Stem is about 1.2 cm. in diameter; branches slender, flexible and tough. Leaves
5-10 cm. long compound, paripinnate; Leaflets narrow, 10-20 pairs, opposite,
increasing slightly in size from the base, 7.5 to 23mm by 3.6 to 6 mm, linear or
linear oblong, thinly depressed, silky beneath.
Rachis produced beyond the last pair of leaflets as a soft bristle.
Leaves may taste sweety when chewed.
Inflorescence one sided, usually leaf bearing, axillary, pedunculate
raceme, 5-10 cm long. Flowers may
be red, purple, yellowish, pink or white and are like the flowers of pea,1.0 to
1.25 cm long, clustered on tubercles arranged along the rachis of raceme.
Seed pot (fruit) have more or less the shape of beans (pod), borne in
clusters, 2.5-4.5 by 1.0-1.25c.m, turgid, thinly pubescent, having a sharp
deflexed beak, green when immature, becoming brown and dry later, splitting open
and remaining on the branch with 3-6 seeds exposed.
Seeds egg shaped (ovoid), hard, smooth and polished.
The colour of the seed may be either of these-bright scarlet red with a
black spot at the hilum; white with black spot; all white; all black; all
yellowish or all blue. Seeds are
odourless and tasteless. Each seed
is about 8 mm long and 6 mm broad and average weight of each seed is about
105mg. They were used by Indian
goldsmiths for weighing silver and gold. Microscopic:-(Seed) Seed
coat:- Testa and tegmen
fused. From outer to inner there
are 5 types of cells. (a)
Epidermis; single layer of tangentially elongated thick walled
cells. (b)
7-10 layers of red colour bearing (towards proximal portion) and black
colour bearing (towards distal portion) thin walled tangentially flattened
cells. (c)
A zone of 1-2 layers of rectangular cells. (d)
8-10 layers of highly sinous thick walled sclerotic cells (e)
Single layer of hyaline sclerotic palisade cells. Cotyledon:-
There are two types of cells. (a)
Epidermis of 1-2 layers of thin walled angular cells. (b)
Cells of ground tissue having conspicuous beaded cell walls and full of
starch granules. Toxicological
aspects Abrus
precatorius is mainly an organic irritant poison.
All parts of the plant are poisonous.
Seeds contain a variety of poisonous proteins, among which the most
important one is abrin, a thermolabile toxalbumin, which is very similar
to viperine snake venom in their physiological and toxic properties.
In addition to abrin the seeds contain a fat-splitting enzyme; Abrine,
an aminoacid, haemagglutinine in the cotyledons; Abralin, a glycoside; Abrussic
acid and urease. The root and stem also contain an active principle, glycyrrhizin.
The shell of the seed contain a red colouring matter. Abrin,
the most important active principle of Abrus precatorius seed is a tasteless,
amorphous, pale grey solid substance. It
dissolves readily in cold water, and the solution which is of slight yellowish
in colour froths on agitation. Abrin is also soluble in glycerin.
When taken internally by mouth, the gastric juice has some inactivating
action on it. Abrin loses its
activity on boiling, and therefore the seeds when cooked can be taken without
any harmful effects. It is said
that the powdered seeds in 60-200mg doses boiled with milk are used as a nervine
tonic. Method
of extracting abrin from the seeds First
remove the seed envelope and the inner portion is taken and rubbed in a mortar
with 4% sodium chloride solution in which abrin is soluble.
It is allowed to settle when the sodium chloride solution of abrin is
separated out. This process is
repeated twice or thrice. The
combined extracts are filtered and concentrated in vacuo.
They are then acidified with acetic acid and saturated with sodium
chloride to precipitate the abrin. The
precipitate is separated and purified by dialysis in a parchment dialyzer for
several days. Lastly the residual
abrin is dried in vacuo over sulphuric acid when an amorphous powder is
obtained. Identification
tests of Abrin (a)
Physiological:- A
watery infusion of abrin or a decoction of the seeds, if dropped into the eye
causes purulent ophthalmia. (b)
Agglutination test:- If
one or two drops of abrin solution made by dissolving 0.1gm of the substance in
10ml of 4% sodium chloride solution are added to 2ml of defibrinated blood in a
small test-tube, the red blood corpuscles agglutinate into a mass resembling
sealing wax. Fatal
dose of abrin:- 90-120mg. If
injected subcutaneously abrin is 100 times as toxic as by oral route. A
dose of about 0.0001mg-0.0002mg of abrin per kilogram of body weight, injected
subcutaneously said to be poisonous. Fatal
period:- 24 hours to 5 days. Symptoms
and signs of Abrus precatorius poisoning [Pathological
Drug Proving, Symptoms
may be delayed from a few hours to 2-3 days. If uncooked seeds are taken, the
following signs and symptoms develop. They
include abdominal pain, nausea, vomiting, diarrhoea, weakness, sunken eyes, cold
perspiration, trembling of the hands, dyspnoea, weak, rapid and irregular pulse,
vertigo, faintness, rectal bleeding, oliguria and features of uraemia. If
injected subcutaneously in man, at the site of injection painful swelling and
ecchymosis develop with inflammation and necrosis; generalised septicemia and
haemolysis can occur. There may
develop convulsions and death may occur from cardiac failure (cardiac paralysis)
within 3-5 days. A
decoction of the decorticated seeds or a watery infusion of abrin if instilled
into the eyes will produce purulent ophthalmia and may cause fatal poisoning due
to its absorption through the conjuctiva and here also certain features of
generalised poisoning can occur. An
extract of the seeds if injected subcutaneously in an animal causes
inflammation, oedema, oozing of haemorrhagic fluid from the site of puncture and
necrosis surrounding the site of injection within few hours.
There is disinclination to take food and three or four days later it
drops down and is unable to move. Then
it becomes cold, drowsy and comatose or may develop tetanic convulsions and dies
within the next 24 to 48hours. The
symptoms resemble those of viperine snake bite, so one may think that the animal
died from the effects of snake bite. Autopsy
studies in man shows ecchymotic patches under the skin, pleura, pericardium and
peritoneum. The mucous membrane of
stomach and intestine is highly congested with numerous haemorrhagic patches
on its surface as well as in the interio
History
and authority as regards to Homoeopathic use. First
mentioning and few symptomatology of Abrus precatorius as a homoeopathic
medicine is done by Dr.William Boericke in his Homoeopathic Materia Medica under
the heading Jequirity. Parts
used:- Seeds Boericke
mentioned certain conditions where Abrus precatorius can be used. They are
epithelioma; lupus; ulcers; eye complaints like purulent
conjunctivitis-inflammation spreads to face and neck; granular ophthalmia and
keratitis. Here we find that there
is no rare, striking, singular, uncommmon or characteristic features which can
help us to individualise this particular medicine and select it as a remedy,
when a patient is brought to us with the above mentioned pathological
conditions. This is because of the fact that the drug is not well proved.
So here comes the need of thorough drug proving of Abrus precatorius
seeds. We can also conduct drug
proving using the active principle Abrin alone.
[The drug picture of the entire seed and abrin alone may not be the same.
So here we can have even two different medicines.] While conducting drug
proving we should not forget that the seed as such is poisonous and we should
not select potencies below 3x. Preparation
of the mother tincture To
prepare one litre of the mother tincture, take Fine
powder of Abrus precatorius seed- 100gm Purified
water-320ml Strong
alcohol-700ml Drug
strength of the mother tincture is 1/10 or 1x Preparation
of potencies 2x
and higher potencies can be prepared using dispensing alcohol as the vehicle. Caution:-
Mother tincture should not be taken internally as it is highly toxic and
abortive. Potencies
to be used:- In
classical homoeopathic prescriptions one can freely use 30th potency and above. More
clinical conditions where Abrus precatorius can be used:- Based
on the toxicological effects (Pathological drug proving) let me mention some of
the clinical conditions where this drug can be used in addition to those
mentioned by Boericke. They are
cholera, gastritis, dysentery, typhoid, cellulitis, gangrene, purpura,
hypertension, nephritis, angina pectoris, myocardial infarction, valvular
insufficiency, cardiomyopathies, epilepsy, brain tumour, septicemia and
septicemic shock, tetanus and late sequelae of viperine snake bite. In
additon to drug proving we can also conduct clinical trials using the drug in
30th potency and above and try to have an idea about the therapeutic use of it.
Anyway thorough drug proving is essential so that this medicine can have
a better position both in our materia medica and in our mind References:- (1)
Text book of Homoeopathic Pharmacy:Mandal and Mandal (2)
‘Oushadha Sasyangal’:Dr:S.Nesamony (3)
The Essentials of Forensic Medicine and Toxicology:Dr:K.S. Narayan Reddy (4)
Hand book of Forensic Medicine & Toxicology (Medical Jurisprudence) :
Dr:P.V. Chadha (5)
Modi’s Medical Jurisprudence and Toxicology:N.J.Modi (6)
Encyclopaedia of Homoeopathic Pharmacopoeia; Vol II:P.N. Varma & Indu
Vaid (7)
Materia Medica with Repertory : Boericke (8) Organon of Medicine:Dr:Samuel Hahnemann. Two
Rare Drugs Beneficial In Angina. By.Dr.Kavitha
Sunilkumar MD. (Hom) Diseases
of heart and circulation attributes to 50% of deaths.
Angina pectoris, the name itself depicts a picture of intense agony and
the mere mentioning of such a case often steals a beat out of even the most
experienced physician’s heart. It
is in such tricky situations that rare drugs come of help. Here
we are going to discuss about two rare drugs those come from two different
kingdom viz.animal and vegetable. 1.
Latrodectus mactans It
is a spider of genus Retitelariae under the family Theridide.
It is a native of America. The
females, after copulation eat up the male; hence they are also known as ‘Black
widow’. The
venom is often lethal and a bite can produce tetanic effects that lasts for
several days. Its pathogenesis and
effects were published in 1933 by Hering proving committee. It
causes cramps of muscles, haemorrhage of black blood, vascular spasms of
extremities and the precordial region seem to be the centre of attack.
Coagulability of blood is lowered considerably.
Angina pectoris, Vasomotor ataxia, constriction of chest muscles with
radiation of pain down the axilla, left arm and forearm to the fingers are the
main indications. Mother
tincture is prepared from the live insect.
Trituration from 6x and higher dilutions are highly advisable in Angina
pectoris. Symptoms
which often indicate the drug includes: n
Anxiety with intense fear of death n
Violent constrictive pain of precordial region radiating towards armpit
along the left arm to fingers with numbness of the extremity (1, 2, 3, 4, 5, 6,
7, 10). Later most violent precordial pain & pain in
left arm which seems about to be paralysed (1, 2, 3, 4, 8, 10). n
Sinking sensation at abdomen and cramping pain from chest to abdomen (10) n
Coldness of body with rapid soft thready pulse (4,6,8) Pulse so frequent
that it can’t be counted and so feeble that it can’t be felt (1,2,3,4,5)
Pulse 130/mt. (1,2,3). n
With intense distress patient cries out, screams with pain.
Pain in precordium with apnoea. Screaming
fearfully (4) exclaiming that she would loose her breath and die (1, 6 ,7) with
sensation of severe thoracic constriction (4) n
Hesitating speech with weeping n
Coldness of whole surface. Skin
cold as marble (3, 7, 10) n
Blood, when cupped flows like water; will not coagulate (1,3,4,5,8).
Haemorrhage of black blood; black vomit, stool copious & black.
Vomiting of black blood which ameliorates n
Vascular spasm of the extremities. Shivers,
Vascular hypotonia (4) n
Complaints of thermal regulation. Shivers
with temperature and profuse perspiration n
Trembling tongue with great thirst, vomits what he drinks. n
Itching and redness of the
part bitten, at first without pain n
Cold sweat and above all pains like those of angina pectoris(4,5,6,7) n
Loss of vital heat n
Puffiness of face n
Blood: Leucocytosis (4,8) Bleeding increases, clotting time increased
blood pressure decreased (8) n
General aggravation- by least movements, in the afternoon n
General amelioration- by sitting still, cold bath. Over all, its action
is comparable to that of Nitroglycerine. 2.
Haematoxylon Campechianum Common
name:Logwood. Order Leguminosae
Habitat-West Indian Islands. It
is useful in Angina pectoris where the sensation of constriction is
characteristic (10) The
main indications of the remedy are as follows n
Sensation as if a bar lay across the chest, (9,10) across the region of
heart with acute pain in left upper portion of chest (1,6) (The bar sensation
has been frequently removed by haematoxylon and in a case of zona with
agonising pain as if a bar lay across the chest, arresting breathing,
Haematoxylon served better) n
Angina pectoris with soreness in cardiac region with anguish redoubled by
throbbing. Small pulse, burning in
hands and shivering of the body (1). n
Sensation of weakness and palpitation n
Palpitation with diminished sensitivity of feet. (1) n
Palpitation with diminished sensitivity of feet. (1) n
Painful sensibility of limbs with lassitude (1) n
Convulsive pain in heart region with oppression (10) n
Painful dysentery with colic & tympanitic distention n
Bellyache with inclination to vomit (1) n
General uneasiness with anxiety and anguishes n
Painful digging from abdomen to throat causing sore bruised pain in the
region of heart with oppression aggravated by touch (10) n
Better open air (6) Mother
tincture is prepared from the heart of the wood.
Use of Q, 1-10 drops or 3rd potency is often beneficial. References 1. Dictionary of Practical Materia Medica-JH Clarke 2. Gibson D.M. Studyof Homeopathic remedy 3. GrimmerA.H. Collected works 4. Materia Medica of New Homoeopathic Remedies - Julian O.A. 5. Concise Materia Medica of Homoeopathic Medicine - Pathak S.R. 6. Homoeopathic Materia Medica of Graphic Drug Pictures- Pulford. A. 7. Samual . Key Notes 8. Materia Medica and Repertory- Stephenson.J.A. 9. Encyclopaedia of Pure Materia Medica - Allen T.F. 10. Pocket Manual of Materia Medica with Repertory - W. Boerike Secale Cornutum: PharmacologyBy.Dr. Krishnan BHMS
Botanical
name :
Claviceps purpurea Family
: Hypocreaceae Synonym
: Acinula clavus,
Clavaria clavus English
: Ergot of rye. French
: Ergo German
: Mutterkorn Food
grains such as bajra, rye, sorghum and wheat have a tendency to get infested
during flowering stage by the fungus - claviceps purpurea.
The fungus grows as blackmass and the seeds become black and irregular
and are harvested along with food grains. Consumption
of Ergot infested grains leads to Ergotism. Our
medicine is prepared from the sclerotium (dense compact tissue of fungal hyphae)
in the ovaries of rye called secale cornutum. History In
BC 1100 CHAU KUNG, a Chinese physician recorded the efficiency of ergot in
obstetric conditions. Ancient
Mexicans (BC 3500) considered Ergot as forbidden
as it causes effects against the laws of God.
There are records about the habit of ancient German midwives visiting
fields to collect ergot seeds for preventing post partum haemorrhage.
In the year 1764 VON-MUNCH HAUSEN proved ergot as a Fungi.
According to MONSIER GUY CRESCENT FAGON, the meaning of Ergot is ‘Spur
of Cock’. French
people called it secale cornutum because the seeds having the shape of animal
horn. Pathological Effect:
Consumption
of Ergot infected rye causes painful gangrene of extremities due to it vascular
effects. This disease was called
“St.Anthonys Fire” or “Holy Fire”, because the sufferers obtained relief
by visiting saint’s shrine, either because they had left the area where
contaminated grains was being used or by super natural intervention. Description: A
fungus growing on the seeds of secale cornutum.
The fungus infected grains are 8-12 mm long; 3-6 mm in diameter sub
cylindrical or obtusely triangular, tapering towards the ends, generally some
what curved, transversely fissured, having 3 longitudinal furrows and a
detachable yellowish hood at the apex; externally it is purplish black in colour
and internally whitish surface of uniform texture and fracture smooth; Having
offensive odour, peculiar, rancid taste. Deteriorates
when kept for a long time. Macroscopy: Dark
violet to nearly black usually about 1-3 cm long and 1-5 mm broad, fusiform
obscurely triangled, usually tapering towards both ends, often with a
longitudinal furrow on each face and transversely cracked, brittle, internally
whitish or pinkish white, showing darker lines radiating from the centre. Microscopy:
Consists
mainly of two layers. Outer region
thin, of a few layers of dark purple to dark brown collapsed cells in regular
longitudinal rows; remainder of the sclerotium consists of dense pseudo
parenchyma, small rounded or oval cells, varying in size, some what elongated in
the central region, with thin and colourless, highly refractive chitinous wall. Constituents:
Ergot
contains two types of alkaloids in
two series (1) Lysergic acid series. (2) Clavin series. Important
alkaloids in
Important alkaloids in Lysergic
acid series
clavin series 1. Ergotamine 1. Agro clavin 2. Ergotaminine 2. Elymoclavin 3. Ergosine 3. Molliclavin 4. Ergosinine 4. Penni clavin 5. Ergocristine 5. Festu clavin 6. Ergocristinine 6. Costa clavin 7. Ergokryptine 7. Setoclavin 8. Ergokryptinine 8. Chano clavin 9. Ergocornine 9. Lysergine 10. Ergocorninine 10. Lysergol 11. Ergostine 11. Fumiga clavin 12. Ergostinine 12. Cycloclavin 13. Ergometrin 14. Ergometrinine 15. Ergine 16. Erginine Medicinal
properties of ergot is due to the presence of alkaloids in lysergic acid series.
They are amides of lysergic acid. They
may be simple or compound peptides. List
of lysergic acid series alkaloids and the amino acids contained: Alkaloid
Aminoacid1
Aminoacid2
Aminoacid3 Ergotamine
Proline
Alanine
Phenyl Alanine Ergosine
,,
,,
Leucine Ergocristine
,,
Valine
Phenyl Alanine Ergokryptine
,,
,,
Leucine Ergo
cornine
,,
,,
Valine The
alkaloids in calvin series have some structural changes when compared with
lysergic acid series. Carboxyl group of lysergic acid series changes to
Methyl/Hydroxymethyl group and they have no medicinal properties. Medicinal uses of Ergot (Non-Homoeopathic) 1) In obstetric treatment for preventing Post partum haemorrhage and for induction of labour. 2) It is used in the treatment of Migraine 3) In controlling Hypertension 4) For psychiatric complaints ERGOT
POISONING: Ergotism (Chronic Poisoning) Occurs
among persons who take ergot as a medicine for a long period.
Or it can be from eating bread, contaminated with ergot.
The features of Ergotism are seen in two types.
In one type Gangrene of the extremities occurs; whilst in the second or
convulsive type, spasmodic contraction of the limbs are the chief features. In convulsive form: Starts
as complaints of itching, tingling,
sensation as if insects are creeping over the skin and advancing as numbness of
hands and feet. Extremites cold and pale which then spreads to the whole body.
Pain occurs on walking, with diminished or absent arterial pulsation. In
later stages periodic violent convulsion, especially in extremities occurs with
dimness of vision, and fixed and dilated pupil. There may be loss of hearing,
giddiness, ataxia, and CNS depression. Death
usually occurs from asphyxia. Gangrenous form: Starts
as general lassitude with vague pain in limbs and followed by numbness and
tingling due to vaso spasm. Later
limbs become swollen. Skin gets covered with red patches and blisters followed
by gangrene which is caused by constriction and damage to the intima of the
small blood vessels and then obliterations. This
gangrene usually of dry type affects fingers, toes, and may extend up to knee
and elbow. Sometimes gangrene
occurs in nose, ear and even internal organs.
There may be myocardial infarction also, with complaints of angina. Homoeopathic Uses Secale
cornutum has a wide sphere of action in the human body matching closely to its
pharmacological/pathological action. The
major actions are centered around female reproductive system, uterus in
particular. Peripheral vascular
system is also affected to a great extent.
Neuralgias and spinal irritations are also seen. In
the female genital system the uses include abortion (especially when
threatened at the early months), miscarriage and a variety of menstrual bleeding
problems. The blood is usually of a
dark oozing type. It is also good
for postpartum haemorrhage. False
pains during labour and retained placenta are also covered by it.
Have some influence on overies also producing neoplasia. Another
important group of symptoms are peripheral vascular constriction leading to
complaints of tingling, numbness, formication and may end up in gangrene.
A very good remedy for TAO. Cold
extremities are characteristic, with a peculiar sensation of burning as from
sparkles and bluish dark colour. Even
useful in anthrax when it becomes gangrenous. In
the nervous system paralysis of various types is seen along with neuralgias.
Bladder paralyis, post diphtheritic paralysis, dysphagia and lock jaw are
a few conditions. May be useful in
convulsions and epileptic conditions. And
also in stiff neck. Skin
is typically cold blue to bluish dark with particles, blisters and ulcers with
peculiar dark oozing non-coagulable blood with diminished pulsations. Also
useful in Raynaud’s disease, tingling and formication, cold to touch yet
relieved by cold applications. Homoeopathic
Mother Tincture Preparation Drug
Strength
- 1/10 Secale
cornutum in coarse
powder
= 100 gm. Purified
water
= 530ml Strong
alcohol
= 500ml Make
1000 ML of Q References
: 1.
Clinical Pharmacology
Dr. Laurence ELBS 2.
Encyclopedia of Hom. Drugs
Indu & Varma B. Jain 3.
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r of the organs, such as lungs, liver and spleen.