CENTRE FOR EXCELLENCE IN

HOMEOPATHY

CONTINUING HOMEOPATHIC MEDICAL EDUCATION

SERVICES

QUARTERLY HOMEOPATHIC DIGEST

VOL. VII, 1990

Lead me from Untruth to Truth

Lead me from Darkness to Light

Lead me from Death to Immortality

Adyaya I Brahmana 3 Mantra 28

(This service is only for private circulation. Part I of the journal lists the

Current literature in Homeopathy drawn from the well-known

homeopathic journals published world-over - India, England, Germany,

France, Belgium, Brazil, USA, etc., discipline-wise, with brief

abstracts/extracts. Readers may refer to the original articles for detailed

study. The full names and addresses of the journals covered by this

compilation are given at the end.)

Compilation, translation, publication by

Dr.K.S.Srinivasan,

1253, 66th Street,

Korattur,

Chennai - 600 080, India.

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

INDEX

S.No Topic Page. No.

1. QHD, Vol. VII, 1, 1990 3

2. QHD, Vol. VII, 2, 1990 23

3. QHD, Vol. VII, 3, 1990 49

4. QHD, Vol. VII, 4, 1990 74

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

1. QHD, Vol VII, 1, 1990

PART I CURRENT LITERATURE LISTING

A list of current homoeopathy literature, subject all the others are from the

British, American, German journals, not readily accessible to every homoeopathy.

Some of the articles may appear in PART II of this Quarterly Homoeopathic DIGEST

later as abstract/summary / condensation / full etc. We are trying access of French,

Dutch, Swiss etc. journals also, excerpts from which will find place in our DIGEST in

due course.

I. MATERIA MEDICA:

1. Hypernergetic Graphites: Case

analysis by the Kali car-bonicum

study by Edward H.CHAPMAN,

MD (JAIH, Vol. 82, 1/89)

2. A study of lris versicolor 3c

by A.E. VAKIL, Y.E. VAKIL

and A.S. NANABHAI (BHJ,

Vol. 78, 1/89)

3. Tarentula hispanica – a reproving

by V.M. NAGPAUL, L.M.

DHAWAN, A.K. VICHITRA, D.P.

RASTOGI (BHJ, Vol. 78, 1/89)

4. Cajeputum melaleuca

leucadendron linn - a proving of

Cajuputum ny GEBHAR) DT,

K.H. (AHZ, Band 234, Heft 1/89)

5. Fabiana imbricate by H.

MEHUERT (AHZ, Band 234, Heft

1/89)

6. Borax veneta by Miranda

CASTRO (The Homoeopath, Vol,

9, 1/89)

7. Gentiana lutea by Matthew

WOOD (The Homoeopath, Vol. 9,

1/89)

8. Lllustrating a certain Syndrome of

Bellis perennis by Royal E.S.

HAYES (Resonance, Jan/Feb.89)

9. Teucrium marum verum by

Prakash VAKIL (CCRH Qly,

Bulletin Vol, II (1&2)’89)

II. THERAPEUTICS:

1. Thoughts on the management of

Myalgic encephalomyelitis

The problem of ? ME’ by Michael

JENKINS (BHL, Vol. 78, 1/89)

2. Therapy of Allergies by

MOEHRKE (AHZ, Band 234, Heft

1/89)

3. Allergy to bee and wasp stings:

Two Apis cases by B. HASS

(ZKH, Band 234, Heft 1/89)

4. Umbilical hernia – Aethusa

cynapium by K.S. SRINIVASAN

(ZKN, Band 33, Heft 1/89)

5. Case study by Teresa

SALVADORE (Resonance,

Jan/Feb. 89)

III. PHILOSOPHY

1. Homoeopathy prescribing and

oppressing the child within by

Libby de MARTELLY (JAIH, Vol.

82, 1/89)

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

2. Anatomical resonance of

homoeopathic potencies by M.M.

van BENSCHOTEN, OMD (JAIH,

Vol, 82, 1/89)

3. More on Similia Simillbus

Curentur, by Richard

MOSKOWITZ (JAIH, Vol. 82,

1/89)

4. Miasms by H. LEERS (AHZ, Band

33, Heft 1/89)

5. On the imaging of Disease picture

by G.V. KELLER (ZKH, Band 33,

Heft 1/89)

6. How to study Materia medica by

Eugenio CANDEGABE (The

Homoeopath, Vol.9, 1/89)

7. The Alchemist and the Goddess by

Misha MOSKOWITZ (The

Homoeopath, Vol.9, 1/89)

8. Could there be more than one

‘correct’ remedy by Dick

MOSKOWITZ (Resonance,

Jan/Feb 89)

9. Homoeopathic methodology –

practical guides to the correct

interval between doses by Robert

M. SCHORE, Jennifer JACOBS

(Resonance, Jan/Feb 89)

IV. VERIFICATIONS AND

CLINICAL SYMPTOMS

(ZKH, Band 33, Heft 1/89)

V. RESEARCH:

1. Study of Heart Rate in Swiss

Albino mice treated with potentised

Sodium pentobarbitone during

anaesthesia by A.S. PARANJPE et

al (CCRH Qly. Bulletin Vol. II,

(1&2) 89)

2. Effect of homoeopathic drugs in

controlling multiplication of

Hepatitis B virus by Hari SINGH et

all (CCRH Qly. Bulletin Vol. II,

(1&2) 89)

3. Investigations for the development

of scientific basis for homoeopathy

by G.D. JINDAL, A.S. PARANJPE

(CCRH Qly. Bulletin Vol. II, (1&2)

89)

4. Efficacy of homoeopathic drugs in

gall bladder diseases by Girish

GUPTA (CCRH Qly. Bulletin Vol.

II, (1&2) 89)

5. Pharmacognostic studies of

Anagallis arvensis by Padma RAO

et all (CCRH Qly. Bulletin Vol. II,

(1&2) 89)

VI. PHARMACOPAEIA:

1. Homoeopathic Flora of India, I

Violaceae by M.S. DAWRE et all

(CCRH Qly. Bulletin Vol. II, (1&2)

89)

VII. VETERINARY HOMOEOPATHY

:

1. Veterinary homoeopathy by Ed

SHEAFFER (The Hahnemannian,

Mar, 89)

2. An alternative to vaccinations –

Protecting the dog by Richard

PITCAIRN (Resonance, Jan/Feb,

89)

VIII. HISTORY

1. The final decade of Dr.

HAHNEMANN’s glories in life

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

and death by S.R. WADIA (BHJ,

Vol, 78, 1/89)

2. Historical column – 2 by Bernard

LEARY (BHJ, Vol.78, 1/89)

3. A look at BOENNINGHAUSEN’s

practice by A. WEGENER (ZKH,

Band 33, Heft 1/89)

4. A study of the source of KENT’s

Repertory by G.V. KELLER (ZKH,

Band 33, Heft 1/89)

5. Annotations to the transcription of

HANNEMANN’s Case Record

No.5 by T. GENNEPER (ZKH,

Band 33, Heft 1/89)

6. The Foundations of homoeopathic

literature, Part I, by Jullian

WINSTON (The Hahnemannian,

Mar. 89)

IX. GENERAL

1. A growing involvement in

homoeopathy by Dorothy

J.COOPER (BHJ, Vol.78, 1/89)

2. In the light of experience – The

Polio saga by R.A.F. JACK (BHJ,

Vol.78, 1/89) JAIH, Journal

Homoeopathic Journal, BHJ,

British Homoeopathic Journal;

AZH Allgemine Homoeopathische

Zeitung. ZKH, Zetischrift fur

Klassische Homoeoapthy)

Vol. VII

PART II ABSTRACTS /

SUMMARIES / CONDENSATIONS

/ FULL ARTICLES

From American, British, German

etc. journals.

Willmar SCHWABE learnt of the

plant Luffa operculata during his tour

of Columbia and the adjacent Central

American countries and presented his

experiments before the LIGA Congress

in Bad Godesberg in 1962. SCHWABE

gave a colleague in NELSONS,

London, a preparation of Luffa

operculata (Espargilla) and the

English faculty carried out a proving I

1962-63.

SCHWABE conducted provings

with 11 members of his fir, with D5,

D3 and D2; these were published in

1963. 50 doctors out of whom 22

recorded their results carried out

therapeutic provings by Willmar

SCHWABE. These were homoeopathic

physicians and specialists of ENT

diseases.

Out of 90 patients with frontal

sinusitis and maxillary sinusitis, 15

acute and 75 sub-acute and chronic, 9

out of the 15 responded very well to

the medicine, the rest 6 to a lesser

degree. The chronic sinusitis patients

reacted much better. In 80% of the

cases a bland secretion from the nasal

mucous membrane set in after which

the subjective ailments passed off.

Of the 9 asthmatics 4 had a

remarkable amelioration. 3 had no

change and the remaining 2 had an

PROVINGS OF LUFFA OPERCULATA

UPTO 1986 C, Bottcher Hasse, H. Lido

and M. Stubler AHZ, 233, 3, 1986)

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

initial aggravation and the medicine

was therefore stopped.

Of 8 chronic rhinitis patients 6

became completely well soon. The

potencies used most were D6 and D12.

Of 6 with vasomotor rhinitis 5 showed

a very good relief. These began with

Luffa D6 and went to D12 as soon as

the nasal secretion set in.

Of 7 hay fever patients some were

treated before the blooming of the

grass. They showed an essentially

milder attack of the otherwise severe

allergic symptoms. 3 of the patients

treated after the illness manifested,

showed clear alleviation after taking

Luffa D6, and in one case the ailments

were completely removed.

Of 6 patients with pharyngitis 4

became free from the disease. Luffa D6

was used.

Dr.J.R. RAESIDE of the London

faculty carried out three successive in

1962-63 with 10 provers, in each

proving, in Nov.1962 with Luffa C6, in

Feb 1963 with C12 and in May 1963

with C30. The C30 brought to light

most of the symptoms. The provers

responded better during the 2

nd

and 3

rd

provings.

Luffa was again proved during an

Intensive Course in Homoeopathic

Medicine in Nov. 1986. in D6 and D30

potencies. After eliminating the

placebo controlled provers, there were

31 provers with D6 and 36 with D30.

This proving was carried out under

M.STUBLER and evaluated by the

Niedersachsisch Academy for Natural

Medicine. The proving medicine was

supplied by the DHU, Karlsruhe.

M.STUBLER observed about 50

cases in which Luffa was used in sinus

diseases according to South American

folk medicine. The Luffa pulp was

steeped overnight the nostrils carefully;

A drastic flow of mucus, pus and blood

through the nose followed. In some

cases there was increase of temperature

with general changes and grippe-like

disease. The medicine was from South

America.

The proving by Willmar

SCHWABE with colleagues in his firm

were carried out with D5, D3 and D2

and later partly with D12 and

symptoms in some parts were

experienced. Severe headache,

substantial pains, sensation of

vibrations in the heart, over sensitively

to light, stress feeling in eyes and

inflated feeling in head and stomach.

Asthmatics observed that sometimes

there was increased thin mucus with at

the same time frequent attacks of

asthma. Nasal mucous membrane

inching and sneezing, yellowish

secretions in mornings, and colorless in

daytime, were observed. Dry sensation

in mouth and throat, much pressing at

the back of the tongue and feeling of

pressure in the palate.

Further gastro-intestinal symptoms

were observed; 2 female provers spoke

of severe dysmenorrhoea.

The more than 120 provers of

RAESIDE confirmed the symptoms

observed by Willmar SCHWABE as

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

also the side effects observed from

therapeutic proving. Prominent were

the nasal symptoms mentioned above.

In addition to the head-aches there was

also vertigo. The face was hot and red,

the mouth was dry. Thickly coated

tongue, painful gums, cracks in the

corners of the mouth.

Regarding stomach, nausea with

thirst, increased appetite, as also

flatulence of the stomach and

abdomen.

In the uro-genital region there was

frequent micturition with pains in the

right kidney region and delayed

appearance of menses.

Sharp, stabbing pains in the chest

together with palpitation.

In the extremities pains in muscles

and joints with numbness or cramps, as

also general perspiration.

The proving of 1986 confirmed

number of symptoms recorded by

RAESIDE. Number of new,

particularly clear symptoms;

Mind: Irritable and unbalanced,

without confidence; angry; flying into

rage over trifles, every noise

aggravations (D6, D30)

Anxiety, wringing, fear of cancer,

thoughts of a colon tumor (D30)

Dreams: Prover (female) was shot at

but she escaped.

Very restless dreams of music and

noise (D30)

She dreamt of rescuing her

children from a burning house.

Eye: Distinct Exophthalmus (right)

reverses (in association with euthyreot

Struma) (D6)

Mouth: Herpes simplex on the chin

below the left corner of the mouth

(D30)

Metallic, bitter taste (D6)

Bleeding of gums under D6 and

D30

Throat: Two hours after taking the

medicine felt as it tried up; as if very

narrow, obstructing breathing; about

2300 hrs it is all suddenly clear again,

especially the it, nose (D30)

Swallowing difficulties as if the throat

pressed from without (D30).

Tonsillitis (D30)

Heart: Extrasystole which was there

since long disappeared under D6.

Desires/Aversions: Peculiar desire for

sour; a prover ate a slice of lemon

(D6); a female prover drank pure

vinegar with water (D6). Aversion to

fatty foods (3 provers – D6/D30)

Back: Pain in the ileo-sacral region,

both sides, as if broken, worse while

sitting, better from motion and rubbing.

Skin: Paraesthesia as if burning, in

hands and also legs (D6/D30)

A picture of Luffa operculata

Mind: Lack of concentration, absent-

minded: disinterested in studies.

Feels much estranged.

Irritated and unbalanced, without

confidence; angry at trifles.

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

Anxiety, wringing, after loss of

sleep (unable to sleep well) the

pervious night; fear of cancer; on the

following day, thoughts of having a

tumor in colon.

Sleep/Dreams: Was shot at, but

escaped.

She resued her children from a

burning house.

Head: Pains in forehead stuffy room,

particularly mornings, better in

evening; Headache with over

sensitivity to light.

Eye: Eyes heavy, dry, tearful, with

sensitivity to light; hazy vision.

Exophthalmus (rt) recedes.

Nose: Obstructed, with frequent

sneezing; cold reappeared after yeas.

Colds with sinus involvement.

Dryness of nose (inner); light

epistaxis.

Face: Disposed to Herpes simplex

Face red and hot

Mouth: Dryness; metallic of bitter

taste.

Ulcers, corners cracked.

Tongue thickly coated with ulcers.

Throat: Dryness; inflammation;

coated.

Pains worse talking; swallowing.

Constriction; as if too narrow to

breathe properly, in the evenings;

clears up in an hour.

Complaints while swallowing, as if

the throat being pressed from outside,

morning to early afternoon.

Heart: An extrasystole of 2 Yrs’ no

oppression, no extrasytoles.

Stomach: Increased appetite, aversion

to spicy food Nausea with thirst.

Fullness in stomach and abdomen

after eating, worse from eating.

Desires lemon slices, vinegar with

water.

Aversion to fatty foods.

Abdomen: Flatulence with

constipation and colic

Diarrhoea with disturbing flatus

Colicky pain in abdomen with

diarrhoea

Sharp pains with flatulence and

liver pains.

Urogenital system: Frequent urging to

urination, especially on cold days.

Menses two weeks delayed,

copious menses.

Back: Stitching pains in back and

neck; severe lumbar pains, worse from

bending.

Distrinct pains in the region of

ileo-sacral joints, both sides as if

broken, worse in siting and while at

rest; pressure, motion and rubbing

ameliorate.

Extremities: Muscular pains in

evening; weakness of hands.

Sharp pains in the rt.shoulder,

rheumatic pains in the it shoulder joint.

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

Numbness of hands, numbness and

coldness of middle finger of the it, had,

burning of fingertips.

Pains in the it, thumb and it, knee

Pains in the muscles of leg with

heaviness and weariness.

Cramps in the calf and leg

muscles.

CLINICAL SYMPTOMS FOR

PRACTICAL TRIALS:

Chronic rhinitis with involvement of

the sinuses:

Obstructed nose, sneezing spells, dry

nose with epistaxis.

The secretion of sinuses is brought

out.

Forehead pains, worse morning,

better evening evening with

involvement of the eyes: Headaches

with irritability and oversensitivity

tolight; Nervous, excitable mood

Chronic conjunctivitis, Exophthalmus:

The eyes are heavy and burning,

sensitive to light.

Vision hazy

Affinity to struma; the rt. eye

protrudes (exophthalmus)

Virus infection with Herpes: Herpes

on the mouth.

Dry mouth with metallic or bitter

taste.

Fissure of corners of mouth

Thickly coated tongue.

Pharyngitis, Tonsillitis: Throat pains

it. With globus sensation.

Throat as if constricted.

Soreness in the tract with cough

and whitish expectoration.

After the discovery

of Mycobacterium

leper in by Gerhard

Armauer HANSEN,

views about Leprosy

have become

clearer: Though not

hereditary, the off

spring remains susceptible. Incidence

of conjugal leprosy is surprisingly low

(2-5%)

Following the line of evolution of

Tuberculinum, Carcinosin etc., a

clinical study of Leprominium was

conducted.

Preparation of nosode: (i) from leprous

nodule from the ear of a patient where

the presence of lepra bacilli was

microscopically demonstrated.

Leprominium A, and (ii) Lepromin,

which is used for ascertaining the

reactivity of the patient (prepared

from), leprabacillin cultured on the foot

web of the armadilio) – Leprominium

H. Preparations were made up to 30c

ad 30x according to homoeopathic

pharmacopoeia: Leprosy M (Nelsons’

origin unknown) also was obtained.

Sings and symptoms were

collected from 100 patients suffering

from various types of leprosy, carefully

eliminating symptoms of despone,

filampicin etc.

LEPROMINIUM

A NEW

NOSODE

Clinical Study

By Prakesh

VAKIL

(The

Homoeopath

Vol.8, 2/89)

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

Sings and symptoms observed in

25 or more patients are given in

BLACK TYPE: those found in 15 or

more patients are given in small caps:

those observed in 5 or more patients

are given in ordinary type: 6 new cases

not on despone or other drugs were

also taken.

Leprominium A, Leprominium

H and Leprosy (Nelsons) were used in

the clinical trial on non-leprous

patients manifesting symptoms similar

to those obtained from leprous patents.

Symptoms which disappeared in

response to Leprominium are marked

with two vertical sidelines.

Sings and symptoms reported by

physicians in leprosy hospitals and

authors like DHARMENDRA and

others were also considered.

Patients with some pathology like

psoriasis, joint pains etc. were given

Leprominium. But cases with only

mental symptoms were not taken up; in

cases using mental among others and

the patients improved overall, these

have been sidelined, though the mental

themselves may take a long time to go.

The remedy was administered

whom symptoms were collected, about

60 had either a F/H leprosy or

prolonged contact with leprosy

patients.

Mind: Brooding

Likes company

ATTRIBUTES THE DISEASE

TO FATE

Fearless

It can make an individual MIND or

irritable

 Hopeful of recovery

 LOCATING OF LIFE WOULD

NOT LIKE TO COMMIT

 Meticulous

FEELS NO ONE SHOULD

SUFFER FROM SUCH A DISEASE.

 Is sympathetic and desires

sympathy yet in the initial stage

secludes himself as he does not want

others to know about his diseases.

DESIRE TO PUT ON WHITE

COLOURED CLOTHES. Aversion to

black colored clothes.

Weeping, WOULD NOT LIKE TO

BEG; would prefer to die than beg.

Vertigo: Vertigo with nausea, worse

opening eyes; sun.

Head: Alopecia

Hair gray prematurely

 Hemicrania

Weak feeling and blackout

Eyes: Cataract, left to right

Cannot close the eyes completely

Sleeps with eyes half-open

Corneal opacity

Painless redness

DRYNESS, with lachrymation

Ectropion

Eruptions: Herpes simplex, cornea

Eyelashes fall out

Heat, sensation of

Interstital keratitis

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

 Iritis, iridocyclitis

Itching and agglutination

Legophthalmus

PHOTOPHOBIA: lachrymation,

bland or acrid; light agg; sun agg.

 Squint

Swelling, puffy; baggy under eyes

Trachoma

Xerophthamia

Ears: Appearance as if bitten by rat

Chronic otorrhoea

Nodules on the ear: thickening and

nodulation of the ear.

Nose: Atrophy: anterior and inferior

turbinate

Clinkers and scabs

Collapse of the nose

DEPRESSED NOSE

Expistaxis: Worse: cold wetting

head; washing face; sneezing; change

of weather.

FLATTENED TIP.

 obstruction

Perforation of septum

Rhinitis, atrophic

Sense of smell affected; offensive

scabs from nose but patient cannot

smell

WAXY NOSE

Face: ALOPECIA REATA

ANAESTHESIA OF THE FACE,

ANAESTHETIC PATCHES

APPEARANCE: APE-LIKE,

DEFORMED AND UGLY,

LEONINE, prematurely old

EYEBROWS: OUTER ONE

THIRD LOST

Nodules on the face, nodulation

and ulceration of nose and lips.

Numbness and cobweb sensation

Moustache: hair falls out in the

middle

Angioneurotic oedema.

Palsy: infra nuclear type

Paralysis

Thickned skin: with permanent

transverse and vertical wrinkling.

Trigenminal neuralgia

WAXY OR OILY LOOK

Mouth: Adherent uvula to soft palate.

Gums bleed easily

Uvula ulcerated and destroyed.

Deep fissure on tongue.

Gingivitis

Infiltraction and nodules on uvula

and soft palate.

Nodules: flat topped, on lips, on

antherior tongue especially.

Decreased sensitivity to pain.

Perforation of hard palate.

Pulpitis glossitis

Lips swollen.

Gums turgid and swollen, shiny

purplish (MIRANDA & MIRANADA)

Small ulcers.

Throat: Cicatrices; laryngial

constriction; pharyngeal constriction.

Difficult breathing (true vocal

cords not involved)

Hoarseness of voice.

Complete aphonia

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

As if something stuck in throat

Stomach: Appetite normal

Sour things agg.

Aversion to milk; sweets

Desires: Green chillies, MEAT,

FISH, spicy, sour, sweets, ICE COLD

WATER.

Thirst increased or normal

Abdomen: Flatulence; lower abdomen,

passing flatus agg. (may be due to

Rifampicin)

Rectum: Normal bowel movements;

occasional constipation.

 3-4 semi-solid stools with mucus;

without abdominal pain

Urine: Glomerulonephritis

Intermittent flow

Nephritic syndrome; in

lepromatous cases after recurrent lepra

reactions with normal cholesterol

level.

Urination frequent in some

patients, painful from walking in the

sun.

Genitalia Male: Sexual desire absent.

Desire increased in some, with

nocturnal emissions

Testes enlarged in some patients,

with repeated lepra reaction, Bilateral

involvement of testes.

Gynaecomasita.

Aspernatogenesis Oligospernia.

Later impotence, 50% of the cases

with lepra reaction between the ages of

21-30.

Genitalia Female: Early menopause.

Sexual desire absent.

Respiratory: Tendency to catch cold.

Cough: Chronic cough in some

smokers with emphysematous changes.

Chest: Pulmonary tuberculosis in some

patients (Leprosy patients can suffer

from tuberculosis but tuberculosis

seems to confer some soft of immunity

against leprosy – CHAUSSINAND)

Back: Joint pains

Extremities: Anaesthesia of hands;

feet.

Ice-cold sensation in extremities,

warm clothes agg.

Wrist drop; foot drop

Gangrene

Heat of palms and soles

TOES and FINGERS LOST

Maggots

Nodules: like neurofibromatosis

Numbness: ascending, hands and

feet icy cold.

Numbness and tingling,

simultaneous onset in arms and legs,

worse at noon, continued motion. In

some cases it started on the rt. side.

Oedema of feet: Worse: evening;

walking; hanging feet down

Osteoarthritic changes.

Pain: extremities; massaging agg; calf-

muscles, exertion agg; initial motion;

continued motion. Joints, especially

knees.

Paralysis: one-sided; paraparesis

or paraplegia.

Patches: hypopigmented, well

defined, thickned, raised.

Peripheral neuritis

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

SHORTENING and

DEFORMITIES of limbs

THICKENED: popliteal and

UNLAR NERVES

Ulcers: non-healing.

Sleep: Dreams: dead people: dead

relatives, frightful; unremembered.

Eyes remain half-open during

sleep

Normal sleep: refreshed on

waking.

Fever: Malaria giving rise to lepra

reaction.

Perspiration scanty

Remittent or intermittent fever

with infections

Rigoros with fever.

Skin: Alopecia areata

ANAESTHESIA or

HYPOAESTHESIA or THICKENED

ERYTHEMATOUS ANAESTHETIC

PATCHES.

Deep cracks in palms and soles

 Dark pigmentation

 Dryness with scanty perspiration

Erythema multiforme

Eruptions: bullous; MACULE:

FLAT, HYPOPIGMENTED or

ERYTHEMIATOUS (depending on

the type of leprosy), VARYING IN

SIZE, NUMBER

AND LOCATION.

 LUPUS

VULGARIS

Noudles:

disseminated, small,

pedunculated.

 Scabs, dark brown, small.

Scaling, resembling exfoliative

dermatitis, ichthyosis,

 psoriasis.

 Itching all over

Neurofibromatosis

Ringworm: lesions resembling

Scabies: tendency to

Sinuses, discharging

Sticking: skin sticking to the bones

giving a shiny appearance like

scleroderma.

Ulcerous lesions

 Urticaria

General: H/O tendency to catch cold.

Cardiovascular system:

hypertension.

H/O haemorrhagic tendency.

Radiating heat agg; sun agg.

LEPROSY: F/H; no f/h

Rest agg.

H/O Scabies, smallpox, tendency

to suppuration, worms, pulmonary

tuberculosis (also f/h); REPEATED

VACCINATIONS

Results: Leprosy M (Nelsons) 10

patients – 7 with initial relief (2 of

them subsequently relapsed) 3 could

not be observed. Leprominium H 30c

– 7 patients – 3 relieved, 4 could not

be observed; Leprominium A 30x – 9

patients 6 – relieved, 3 could not be

observed.

Cajuptum is a growing up to 21 meter

height and grows wildly in Australia,

Burma,

Cambodia, Thailand,

Malaysia

and also islands of the Indian

CAJEPUTUM

MELALEUCA

LEUCADENDR

ON

LINN

- a proving by

K.H. Gebhardrt

AHZ, Band 234,

1/89

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

archipelago. An oil – Oleum Cajuput –

is distilled. It contains approx. 2/3

Cineol, Terpene, Azulene,

Benzaldehyde and Valerianaldelhyz. It

is used internally in folk medicine and

also externally, also as drops in ear

aches and deafness.

A proving was done in 1985/86.

Cajuputum D2 was taken internally

5x5 drops per day. 5 men and 8

women were the proves, in age group

23-65 years. Highest evaluated

symptoms came from 2 women of 46

and 49 yrs. Very sparse symptoms

were verified.

Remedy picture:

General: Sudden weakness, unusual

weakness, slight vertigo as if confused

despite 10 hrs sleep, peculiarly more

sleepy in forenoon.

Mind: More or less a euphoric mood,

fully energetic to do work, must hold

himself from, “gossipy hang-over type

mood” was much better after taking the

drops.

AtBAM on waking up, as if tens,

restlessness, excitable like a caged lion

Had more energy in forenoon

An otherwise depressive person

reported that his depression was better

from Cajuputum and after stopping

taking the proving material, the

depression worsened.

Head: Stitching pains for seconds,

sometimes in the right parietal,

sometimes in the left, sometimes

drawing in the neck above the below

(1)

Light headache from waking up for a

short time (2)

Pain forehead from rising, better lying

down (2)

On waking up dull headache which

cannot be localized, during the course

of forenoon in the neck and occipital

region: throbbing, pulse-synchronous,

worse while lying (4)

Pressure on head and vertigo after

lunch (2)

Dull pain under and behind the It. eye,

worse stooping (4)

Red spot in the region of It.check (8)

Nose: Unpleasant odor long time after

taking the medicine (1)

Sudden Sensation of unpleasant odor

(1)

Nasal mucous membrane totally dry

(1)

Stopped, alternate sides (4), It. nose

stopped at 2000hrs (8) 1445 hrs

creeping in the nose, must sneeze 2-3

times in the course of afternoons and

evenings (9)

Flowing coryza more in left than right,

worse in cold, creeping in the nose like

ascending coryza at 1730 hrs (9)

Eye: Sensation of a foreign body in the

it.eye which is red, at 16 hrs;

movement of the eyeballs painful.

Towards evening the whole eyeball is

red, also upper and lower lids red. (B)

Sensation of foreign body in the rt.

lower lid (9)

Rt. Lower lid and lachrymal sac

swollen and red with some itching (9)

Lachrymation both eyes (8)

Slight burning, tired eyes (9), at 16hrs

sensation of foreign body in rt. eye (9)

Mouth: As if tongue sharp, 30 min

after taking medicine (1)

Throat: Repeated sensation of globus,

mornings (1)

Sensation of a lump behind upper

sternum, at least the size of a fist (1)

Pain, shortly before 1700 hrs (7)

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

Thirst: Strikingly increased (1),

increased (10), much thirst in morning

with dry tongue (12) -5 days after

taking the medicine.

Stomach: Desires sweet (1), much

desire for sweet (11), after that

increasing nausea (11)

Slight nausea after the first mouthful of

the lunch (8), slight nausea after every

meal (1)

Transient nausea afternoon (2)

Nausea before breakfast (2), nausea

night (2), nausea at 2000 and 2130 hrs

(7)

On the 7

th

day midday severe nausea

and diarrhea thrice (1)

Eructation and feeling of fullness

worse eating (4)

Increased flatulence (1), during the day

much flatulence (2)

Flatulence in evening (5)

Slight cramps in gastro-intestinal

region (5), at 1100 hrs slight cramps in

stomach (5)

During the lunch cramp-like pains in

the whole abdomen, soom passing off

(2)

Flatulence the entire afternoon (2)

Dull pain in rt. upper abdomen (1)

After every meal approx. ½ hour long

pressure in the rt. upper abdomen (2)

Feels as if the belt is constricting (6)

The gall bladder region sensitive, belt

is inconvenient (1), forenoon a

transient drawing in the rt. upper

abdomen

No appetite, better eating (11)

Intestines: Morning at 0800 hrs

abdominal pain which continued for

about ½ hr. (8)

Stool hard, scanty (9), flatulence (11),

constipation (8)

Difficult passage of stool (2)

Morning somewhat diarrhea (2)

Stool less spastic than usual, almost

normal-formed, larger evacuation (3)

Urinary tract: With normal filling of

bladder almost every hour urging for

urination (11), must urinate strongly

often (2), frequent urination,

particularly afternoon and evening (3),

must urinate every ¾ hour (5).

Urine smells like cat’s (1)

Heart and Circulation: Stitching in

the apex, passing off in the evening (1)

Sensation of pressure over the heart,

alternating with stitching which

alternate between the apex and scapula

(1)

Sensation of pressure and constriction

in the heart. The heart beats upto the

throat, worse 15-17hrs. the complaints

are in the scapula also (1)

Sensation of constriction in the entire

It. thorax, worse in rest, passing off

lying (1)

Disagreeable pressure in thorax from

walking in steep path and is better

walking on even plane (6)

Heavy and as-if-a stone feeling behind

the sternum and between scapulae (6)

On awaking pressure on the heart

radiating to the It. arm and the finger

served by the ulnar It. (6)

Frequent extrasystoles while sitting,

lying and standing (4)

Respiratory organs: Constantly ‘out

of breath’ with even slight household

work (1)

Sensation that she cannot any more

breathe well, more often during the day

(5)

Oppression in a warm room (6)

Oppression of breath immediately on

taking the medicine (8), two or three

times tickling causing cough as if from

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

dust, after short dry cough, better

without expectoration

Locomotive organs: Atrocious itching

of coccyx (1), the otherwise usual

backache disappeared during the night.

Severe pain in the It. groin after

waking up; drawing pains which

radiate to the innerside of the It. thigh

(2)

On the sixth day after taking the

medicine, almost unbearable irritating

pain in the It. thigh since 4o’clock

night. Analgesics were not effective (2)

At about 0330 hrs night awakened

from severe pain, cold relieves it

somewhat, during day, light bearable

suffering.

The pain localizes at the lateral border

of the symphysis and is ameliorated

from application of an ice bag and

becomes worse while at rest and in

warmth.

The character of the pain ultimately is

least irritating, it becomes dull and

burning, amelioration after passing

stool

After 7 days of slight drawing in the It.

groin, a general weakness, unwell, sick

feeling (2)

Back aches in the region of the lower

lumbar vertebrae about 1900 hrs

continuing the whole evening (8), back

as if broken in afternoon (9), pains in

the entire back radiating upto the

lumbar, from suddenly bending the

head forward, violent pain in the neck

as if a nerve between the vertebrae

constricted (12)

Spontaneous twitching of the muscle

fibres of the upper arm (1)

At 1800 hrs, dull drawing pains in the

rt. shoulder, top, irregular pulsating

pains in the rt. axilla for about 2 ½ hrs

(1)

Stitching pains, at times in the rt. hip,

at times in the finger joints, in the

middle of foot and tarsal bone, always

quite brief and elsewhere (1)

Tightness in cervical region (5)

Heavy feeling in the extremities,

ascending stairs cost more energy than

otherwise (7)

Severe myalgia of the legs (9)

Dull tension in the legs wors in the

evenings and from warmth, better lying

and ferm cold douching (11)

Male genitalia: About 1200 hrs

stitching pain in the It. tests for about

15 mts. from walking, better while

sitting (4)

Drawing, stitching pain in the It. testes

while sitting, also for about 10 mts. (4)

Female genitalia: Libido slightly

increased (1)

Viscous bleeding (8)

Menstrual blood dark and lumpy (11)

Severe pains of lower abdomen, more

on It, than rt. with pressure downward

towards ovulation time, did not come

in this form since many years, had

undergone hysterectomy, better from

movement. (9)

Hours before the menses, dull drawing,

slightly cramping pains with radiation

to thing. Otherwise it came one day

before the period, now surprisingly

scanty (11)

Stitches above the It. groin for an hour

alternating with stitches elsewhere in

the body (1)

Thermoregulation: The whole day

felt pleasantly warm, later

uncomfortably warm with cold feet,

sensation of warmth in the arm which

at the same time was painful, about

2000 hrs sudden chill with ice-cold

nose. Chill alternating with

uncomfortable warmth which was felt

as glowing with at the same time cold

sensation of parts least covered by skin

like nose, chin, fingers, toes etc. (1)

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

Very cold feet with chilling about 1800

hrs (5)

Chill and shuddering as if would

become ill (7)

Freezing around 2100 hrs (8)

Afternoon pronounced cold sensation,

better from warm clothes and a blanket

(11)

Sensitive to drafts (1)

Six days after proving he required

almost thrice the time to perspire in the

Sauna.

Leading symptoms: Parasympathetic,

Smooth muscles, Mucous membranes,

Connective tissue.

Tendency to spasms: these manifest

in the digestive tract as globus

sensation, obstruction in swallowing,

nausea, pressure in the rt. upper

abdomen, constipation alternating with

diarrhea;

In the thoracic organs as pressure on

heart and dyspnoea;

In the urogenital system as frequent

urging to urination and dysmenorrhoea.

Modalities: Worse: 16-18 hrs,

evening, after midnight; warmth.

Better: cold local applications;

movement

Peculiar symptoms: Sensation of

pointed tongue

Fuzzy feeling in perioral deltoid

As if foreign body in eye

Stitching and tearing above the It.

groin

Uncomfortably warm feeling despite

cold feet

Urine smells like cat’s

Certain interesting features exist in the

current material medica, which have

not been brought out in the proving:

General feeling of enlargement (JH

CLARKE)

Effects of checked perspiration (JH

CLARKE)

Hiccough on slightest provocation

(BOERICKE)

Alae-nasi and earlobes suddenly turn

red (TF ALLEN)

A thorough study of the provings with

the various current Material medica

will be rewarding.

–––––––––––––––––––––––––––––––

A proving of

Dioscorea (D4) and

its major alkaloid

Diosgenin (D6) was

undertaken during

the spring course in

1979, in Baden,

Vienna. The proves were, 5 women/4

men for Dioscorea; 3 women/7 men

for Diosgenin; 7 women/3 men as

placebo group, taking daily 3-5 drops

of the proving substance, over a 3 week

period; the provings were not double-

blind Outline.

1. the current remedy picture of

Dioscorea according to ALLAN and

HUGHES;

2. the results of the re-proving of

Discorea compared with the existing

picture;

3. the emerging picture of Diosgenin,

attributed with a Cortisone-like action,

compared with the existing picture of

Dioscorea:

4. the symptoms of the placebo group.

1. Current picture of Dioscorea

according to ALLEN and HUGHES:

General state: Unusual lassitude,

nevertheless desires to go for a walk;

Weakness, sometimes faint-like.

Vertigo/Head: Dizziness while

walking.

DIOSCOREA

D4 AND

DIOSGENIN

D6- A proving

by L. Wecker

AHZ, 5, 1981

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

Headache of various locations; dull,

cutting; partly radiating to ear; worse

cold air; with heaviness.

Mouth/Stomach: Taste: Bad,

sweetish; salivation

Tongue: coated, thick yellowish-hite;

pricking like needles in tip; as if burnt.

Eructations like spoiled eggs.

Frequent nausea.

Burning in stomach

Abdomen: Burning pain worse

pressure in umbilical region; cutting,

tearing, spastic pains, radiating, worse:

Lying; Bending forward; pressure.

Better; Bending backward; Movement;

Standing erect.

Rumbling in abdomen

Stool: Black, hard, dry, painful,

changing to whitish, white and

yellowish; Diarrhoea, with cutting

pains.

Genitalia: Genitals cold

Heart: Palpitation; Pains, stitching

with vertigo.

Back/Extremities: Pain: Dull achive;

Cervival; Between shoulder-blade;

Lumbar; worse bending; along

vertebrae, worse pressure.

Walking, movement – cutting pains.

Sleep: Restless sleep

Dreams: Anxious; Of women;

peculiarly vivid on 1

st

day. (3)

2. THE RESULTS OF RE-

PROVING OF DIOSCOREA (D4):

The protocol number of individual

prover recording each symptom given

in brackets after the symptom.

Mind: Unstable during the provings

(2)

Internally much calm and equable,

tense otherwise; urge to be

venturesome during the provings. (3)

Pecuriarly vivid dreams on the first day

(3)

Well-disposed and enterprising (8)

Head: Rusting noise ‘as from fainting’

(2) 1-2

nd

day

Headaches: Light to severe, mornings

(4) 7, 9, 18

th

day

Migraine : Nightly, originating in the

nape of neck (9) 12

th

day

Ears: Buzzing, with rushing noise in

head (2) 1-2

nd

day

Pain: Cutting, both sides; worse

Evenings; Lying (7)

Hearing poor; ‘ears as if stopped up’,

worse morning and evening. Cracking

while swallowing 3-16

th

day

Face: Skin looks unclean, many

pimples (7) 19-26

th

day (19

th

day was

the last proving day)

Eruptions: Forehead and cheeks; small,

pustulous, dry, not red eczema (9) 5-

10

th

day

Mouth: Aphthae-like ulcers inside

cheeks (3) 8-13

th

day

Gums: Violent pains, worse least

touch, no bleeding, in spots previously

injured by dentist; so severe, proving

was almost discontinued (6) 5-17

th

day

Abdomen: Violent pains from alcohol

(1/4 glass red wine + ½ glass spirits)

(2) worse: Pressure; Skirt-band; Deep

breathing.

Severe nausea 15

th

day

Genitalia-Female: Drawing in lower

abdomen, as if menses would appear;

drawing and tension in mammae

Smear of bleeding on 15-18

th

day of

proving. Conception during the

proving, after fruitless wait for 2 yrs

after thorough gynaecologcla findings

(3)

Leucorrhoea increased 4-26

th

days;

Menses delayed by 2 weeks, beginning

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

on 26

th

day of proving, no leucorrhoea

at end (7)

Heart: Pains almost during the entire

proving period; “stitching when

proving medicine was first taken,

severe, but better immediately when

pressed; later, pressing with some

burning, lighter pains of longer

duration, not better from external

pressure”. She suffered otherwise from

palpitations with irregular heart pains,

partially extending to left arm. (2).

Back: Shorts, frequent cramps in

cervical region 3

rd

day; Stiffness in hip,

originating from uterus – 15

th

day (3)

Extremities: Formication in upper

extremities (2) 2

nd

day

Pain: Drawing in rt. shoulder,

radiating in the arm, with sensation of

paralysis; could not carry weights as

before; better warmth (3) 8

th

day

Complaints in I. forearm flexors, as

from inflammation of sheaths of

tendon. Pains hot, stitching, appearing

in intervals of minutes, at times for

seconds only (9) 8-10

th

days

Renewed increased appearance on 21

st

day, the flexors and extensors of the I.

forearm and I. hand were affected.

Height of complaints on 25

th

day, then

rapidly easing.

Modalities: Worse REst and warmth;

Not agg. from work. Better Nights.

Skin: Blister, lentil-sized, on shoulder,

non-itching (1) 6-18

th

days

Pustule, suppurating, on I.throat (3)

Stitching of back of hard ‘as if a gnat

had stung’, without visible alteration of

skin (9) 2-4

th

days

Generals: Heart flushes with blushing

(2)

Briskness x worn-out feelong (1-4

th

days); Then very tired, with almost

uninterrupted sleep (6-8

th

days) (2)

Lively, ‘exceptional state’. (8)

Discussion: Compared to the existing

Materia medica of ALLAN and

HUGHES where abdominal symptoms

find prominence, only one prover has

reported abdominal symptoms.

Whereas skin/mucous membrane

symptoms reported by 4 provers in this

proving hav not been found in existing

Materia medica; The tendo-vaginitis

like pains expressed by prover 9 are

interesting; this symptom which

appeared twice makes it a truly genuine

proving symptom (BREYER)

3. PROVING OF DIOSGENIN (D6):

It has the reputation of a Cortisone-

like action.

Head/Vertigo: Very giddy (14) 18, 19,

21

st

days

Head: Pain: Aching behind eyes (11)

4

th

day

Pain: Forehead, evening, with

throbbing in ear (12) 23

rd

day

Headache always starts about 13-14 hrs

– 1,3,4,6, 11

th

days; begin as cramp in

neck, drawing, boring and throbbing in

occiput;

Worse Gong for a walk; Better Rest in

dark; with ‘spastic rumbing’ and

‘colic’ in abdomen during the headache

(13) 1,6, 11

th

days.

Pain: Nape of neck, evenings, I.side,

sensitivity to noise (14) 8

th

day

Pain: Temples and forehead, worse

pressure (15) 4,5,7, 11, 17

th

days; on

the 17the day, worse Looking down;

Hunger.

Pressure in temple region (16) 19

th

day

Pain: Forehead, worse Pressure (20)

1,2,3,5

th

days

Eyes: Pain from moving eyes, ‘burning

like cold wind’ with headache (11) 3,

4

th

days

Burning from reading in artificial light

(16) 3

rd

day

As if swollen (20) 6

th

day

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

Ears: Ache in rt.ear on awaking; both

side in evening, after a walk and worse

in the open air, better in a room, ‘as if

from a cold’ (12) buzzing, 7

th

day 17

th

days; pounding sensation (12) 8, 23-

25

th

days

Itching in canal (15) 5

th

day

Mouth: Gums: Swelling of, molar 7

rt.lower (13) 11

th

day; bleeding while

brushing teeth (15) 13, 14

th

days

Unusually dry mouth (17) 2, 4-7

th

days

Throat: Soreness (15) 4

th

day

Abdomen : The sensitivity of right

epigastrium for fat and alcohol is better

during the proving; in connection with

the proving ‘a light icterus was noted

by me (Billi. 2mg.%) the cause of

which could not be explained

(transaminase in upper range);

Hepatitis B is ruled out (Hbs. Ag. neg)

(11)

Nausea in rt. upper abdomen,

‘everything blocked’ and ‘remains

below the rt.costal arch’, lying on

rt.side impossible, spastic rumbling;

comes together with headache (13) 1,

6

th

days.

Almost daily nausea after taking the

medicine (14)

Pain, stitching, both sides (15) 4

th

day

Flautulence, metorism (16) 2, 5-7, 13

th

days

Nausea, pressure in stomach (17)

Stool: Dark and lumpy, obstipation

(12) 12-17

th

days

Diarrhoea 6, 11, 13

th

days; gray stools

13

th

day (6)

Bladder: Burning while urinating ‘as

if fissure in fossa’ (14) 8-11

th

days

Sexual organs: During the day easily

excitable (12) 1

st

day

Female: The usual ailments and

mental upsets were absent and menses

appeared in time (19

th

day of proving)

(12)

Heart: Prickling sensation with

sensation as if bound from physical

exertion (15) 5

th

day

Back: Sudden painful cramps of

muscle, worse right, lumbago like, for

a week (17) 1-6

th

days

Extremities: Heaviness (13) 1st day

Pain rt.calf ‘like cramp’ (17) 3, 4

th

days

Repeated light trembling of hands,

evenings (18) 2

nd

day

Sleep: Restless sleep (17)

Chill: Chilly, room is not sufficiently

warm (12) 14-17

th

day

Perspiration: Disposed to perspire

(15) 5

th

day

Skin: Itching of torso, without

eruption, worse evening extending

slowly to extremities (11) 7

th

day to

end of proving. Prover clarified later

than ‘it has healed since 5 months’.

Itching of legs (13, 1400 hrs) (12) 19,

20

th

days

Severely itching efflorescences of the

whole torso, despite taking calcium

tables (20) 21-22

nd

days

General: Internal restlessness with

desire to move (13)

For about ½ an hour vibration of hands

(15) 4

th

day

Motor unrest with desire to be

occupied which ameliorates the

internal unrest; particularly for

movement of hands (17) 3, 4, 9, 20

th

days

Discussion: The results of the

Diosgenin proving are similar more

clearly to the remedy pictures of

ALLEN and HUGHES than in the case

of Dioscorea. The motor restlessness

comes to light clearly in this. The

intensity of headaches agrees

somewhat with ALLEN’S. Above all

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

the intestinal tract symptoms come to

the forefront clearly in 7 provers. In

conformity with Dioscorea the skin

symptoms manifest only to some

extent, in itching without eruptions.

The Cortisone-like effects of

Diosgenin – there is nothing more to

be affirmed after this proving.

4. THE SYMPTOMS OF THE

PLACEBO GROUP:

Mind: Irritable (21) 11

th

day

Capactiy to bear mental strain

diminished (24)

Head: Pain: Aching: (21) 11

th

day;

(28) 1, 2

nd

days (30) 1

st

day

Face: Unclean, oily, pimply face (26)

7-21

st

days

Mouth: Pains in maxilla with aphthae

(23) 18-22 days

Dryness of throat

Abdomen: On the left side pains with

flatulence in evenings (21) 3

rd

day;

Pyrosis (21) 6

th

day

Sudden brief attacks of pain, griping

(25) 6

th

day

Presistent hunger despite eating (26)

16

th

day

Stools bright coloured (26) 7, 8

th

days

Bladder: Nightly urge for urination

(21) 2, 3, 6th days

Genitalia-Female: Severe pain in the

vagina, drawing inwards, ‘as if stick in

anus and vagina’. Severe pain,

soreness, worse swimming (26) 7, 8

th

days

Heat: The usual daily palpitation

disappeared completely during the

proving (25)

Back/Extremities: Cramping pains –

lumbar/sacral, severe, 8-20

th

day,

interrupting proving, which was re-

commenced on the 25

th

day, back pain

returned, better warmth. About 1600

hrs severe pains in rt.kidney region

(21) 5

th

day

Unsteadiness while walking; 5, 13, 17,

21

st

days, therefore tumbled on stairs

on 5

th

day (21)

Skin: Reddish, vesicles on the back of

hands and tibia, severe itching (23) 19-

22

nd

days

Discussion: Two symptoms should be

picked out:

(1) The headache – came only for a

brief time and in two provers only at

the commencement of the proving,

indicating suggestive action; (2) The

skin symptoms reported by two provers

taking placebo. Did the atmospheric

Sulphur of Baden induce this? To

clarify this, these provers were asked;

Did you stay in Baden during the

proving? if yes, did you not any

influence of the climate on the skin?

Have you been in Baden before, and

suffered any skin irritation? The

answers were that the provers had been

in Baden only during the ‘course’

week, and the provings were later

pursued in their houses. None of them

had found the climate of Baden

irritating to the skin, nor on earlier

visits. Therefore simply no explanation

can be given.

The new skin manifestations brought

out in the provings of Dioscorea need

clinical verification and these should

be communicated.

BOOK SHELF

1. SEPIA and LACHESIS: A

DIALOGUE WITH A DIFFERENCE

by Drs. Sarla SONAWALA and

Vishpala PARTHASARATHY,

published by Milan Polyclinic Pvt Ltd.,

71-B, Saraswati Road, Santa Cruz (W),

Bombay – 400054, pp. 43, Rs. 35/-

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

The authors- mother and daughter –

presented a dialogue as between Sepia

and Lachesis, in the 1983 HMAI

Congress and later in the

Int.Hom.Congres, Lyon, France in

1985.

With the aid of cartoons, drawings and

verses the ‘drug pictures’ of Sepia and

Lachesis have been well brought out.

Two cases of Sepia (both females) and

three cases (one male, one female and

one child) of Lachesis have been

given, highlighting the essential

features of these remedies.

In both the Sepia cases the patients

were childless but conceived

immediately after administration of

Sepia.

The major ‘mental’ symptoms of the

remedies haves been well brought out

in all the five cases.

The ‘evolution in the time and space’.-

childhood, adolescence, adulthood, old

age, in respect of both the remedies

have been very well and briefly

sketched. The authors have gone

through almost all the hitherto

available literature on these two

remedies before presenting these.

Very good printing, paper, get-up.

Recommended.

2. PROBING THE MIND AND

OTHER GUIDING SYMPTOMS- a

blueprint for success – by Sri S. M.

GUNAWANTE, published by Sri S.

M. GUNAWANTE, Moraya Villa, 12

th

Road, Khar, Bombay-400052, pp. 32,

Rs. 15/-

The author contributed, in 2 parts

an article “Probing the Mind of the

Patients” in the Indian Journal of

Homeopathic Medicine, 1989. This

article received such good appreciation

that Sri GUNAWANTE went ahead to

improve the article further and publish

it in a handy booklet. The result, I am

glad to say, has been quite good and

worthy.

There has been, in recent past two

decades, a growing interest and enquiry

into the ‘Mind’ of the patient as a key

to his/her curative homeopathic remedy

further aided by the physical Generals.

The significant aid to this diagnosis

was ushered in with publication of the

Synthetic Repertory (I Edn.) (Tri-

lingual) by Horst BARTHEL and Will

KLUNKER, in 1973. An entire volume

is devoted to the ‘Mind’ and the

remaining two to ‘Generals’,

‘Sleep/Sex’. The importance of the

‘mental’ symptoms in the selection of

the remedy is evident and needs no

further stress.

Sri GUNAWANTE has ‘classified’

the major ‘groups’ of mental traits e.g.,

‘Domineering,’ ‘Mild’ ‘Restlessness’

‘Sad’ etc. Practical illustrations have

been given as to how to proceed in this

manner and obtain a full image of the

patient.

In subsequent sections hints for

case taking, evaluation, repertorisatin

have been explained. What is the

‘Minimum syndrome of maximum

value’ is told in section 5.

Section 6 contains 12 steps for

success.

Section 7, the last, contains a list

(drawn from SR) of’

Personality Groups’ and the relevant

rubrics as quick aid for repertorisation.

The booklet is a brief ‘lesson

written for ‘practice’ day-to-day

Paper, printing, get-up are all very

good. Recommended.

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

2. QHD, Vol. VII, 2, 1990

PART I CURRENT LITERATURE LISTING

A list of some current homoeopathy

literature, subject-wise, is given below.

Some of these articles may appear later

in PART II of this Quarterly

Homoeopathic DIGEST, as

abstract/summary/condensation/full.

1. MATERIA MEDICA:

1. Apis mellifica

THOMPSEN, Michael (The

Homoeopathy, Vol.

6, No. 1/86)

2. Darkness aggravates

MICKELM, Bob (The Homoeopath,

Vol.6,No1/86)

3. Buto-the remedy

GUESS, George, MD (Resonance,

May/Jun-89)

4. Aconite

ELMORE, Durr, DC,ND. (Resonance,

May/Jun-89)

5. Granite-a proving

The making of a new remedy,

EISING,Nuala (Resonance, May/Jun-

89)

6.Tamarindus Indicus

(pulp of Tamarind fruit)

VAKIL,Prakash (CCRH Qly, Bulletin,

Vol. 10 (3&4)/88)

II THERAPEUTICS:

1. Bronchial Asthma-Three cases

ILLING,K.H. (AHZ, Band

234,Heft2/89)

2. Acute Exogenous Depression,

EICHLER, R (AHZ, Band 234,Heft

3/89)

3. Anxiety neurosis,

MULLER, H.V. (AHZ, Band 234,Heft

3/89)

4. Migraine with Mental Confusion and

Amnesia,

WEGENER, A (ZKH, Band 33, Heft

2/89)

5. Homoceopathy in proiapse of

vertebral discs,

GYPSER, K.H. (ZKH, Band 33, Heft

2/89)

6. Pyelonephritis and Cystitis-

Lycopodium,

WALDECKER, A (ZKH, Band 33,

Heft3/89)

7. The treatment of warts,

ROMER, D (ZKH,Band 33,Heft 3/89)

8. Treating the common cold in

paediatric patients,

ZAND, Janet, ND(JAIH,

Vol.82,No.2/89)

9. Temperament and behaviour

assessment of children in classical

homoeopathy,

NEUSTAEDTER, Randall, OMD, CA

(JAIH,Vol.82, No.2/89)

10. A Phobia dissolved using the law

of similars without homoeopathic

medicines.

ROBINSON, Kari, MD

(JAIH,Vol.82,No. 2/89)

11. Stopping drug therapy,

LEE, Felicity (The Homoeopath,

Vol.6,No.1/86)

12. Meningitis,

ADAMS, Peter (The Homoeopath,

Vol.6, No.1/86)

13. The Weihe Points,

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

URQUHART,Ian (The Homoeopath,

Vol.6,No.1/86)

14. Homoeopathy at altitude.

THOMOS, Emelyn, (The Homoeopath,

Vol.6, No.1/86)

15. Indian oddities: a Traveller’s Tale,

TRUHERZ, Francis, (The

Homoeopath, Vol.6, No.1/86)

16. Sciatica: A Case Study and

Different,

KIPNIS, Sheryl, ND (Resonance, Mar-

Apr/89)

17. Viscum album (ISCADOR),

KASAD, K.N, MBBS, MF Hom

(Lond)

CCRH Qly. Bulletin, Vol/10 (3&4)/88)

18. Homoeopathy influences modern

trends in management of colo-rectal

malignancies,

PAREEK, Alok, B.S .,DHMS, PGR

(CCRH Qly. Bulletin, Vol.

10,(3&4)88)

III.Phillosophy:

1.Experimental proofs of Action of the

Homoeopathic Single Remedy,

KRETSCHMER, M.,HARISCH, G.

(AHZ, Band 234, Heft 3/89)

2. On a quotation of HERING,

KLUNKER,W. (ZKH.Band 33, Heft

2/89)

3. The application of Medicine by

Offaction by HAHNEMANN and

BOENNINGHAUSEN,

WALDECKER, A. (ZKH, Band 33,

Heft 3/89)

4. Local and General Sensations,

KELLER, G. v. (ZKH, Band 33, Heft

3/89)

5.How to use the repertory,

GUNAWANTE, S. M. (JAIH,

Vol.82,No2/89)

6. A possible mechanism of

homoeopathic prophylazis,

GOLDEN, Isaac (JAIH, Vol.82,

No.2/89)

7. Potentization and the peripheral

forces of nature,

ADAMS, George, M.A. (Cantab)

(BHJ, Vol.78,No.2/89)

8.Choice o potency in homoeopathic

prescribing,

VOEGELI,Adolf, M.D. (

BHJ,Vol.78,No.2/89)

9. The Similar Medicine,

COULTER, Harris (The

Hahnemannian, June 89)

10. On Generais and Particulars,

SANKARAN, Rajan (The

Homoeopath, Vol.6, No. 1/86)

11. One Comp,

TYLER, Margaret, (The Homoeopath,

Vol.6,No.2/86)

12. The Second Prescription,

KELLER, G.V.(The Homoeopath,

Vol.6,No.2/86)

13. Is Cancer Incurable?

CROTHERS, Dean, M.D.(Resonance,

Mar-Apr/89)

IV. Verifications:

1. Errors in KENT’s Repertory, Part7:

Chimaphilaumbellata and china

officinalis.

EPPENICH,H.(ZKH. Band 33,

Heft2/89)

2. Errors in KENT’s

Repertory,Part8:Zincum and Zingiber,

EPPENICH, H. (ZKH.Band 33,

Heft2/89)

V. Research:

1. Chronic Poisoning by

Formaldehyde,

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

MATTHIESEN, C. (AHZ, Band 234,

Heft 3/89)

2. Causticum: Medicine or a Product

of Fantasy,

GRIMM, A. (ZKH, Band 33, Heft

2/89)

3. Report on the status of research on

homoeopathy with recommendations

for future research,

RUBIK, Beverley, PH.D,

(BHJ,Vol.78,No.2/89)

4. Elevation of serum globulin levels in

Chelidonium majus 6c provers,

VAKIL, A.E.VAKIL,

Y.E.,NANABHAI, A.S.

(bhj,Vol.78,NO.2/89)

5. Biologic properties of Iscador: a

Viscum album preparation,

RENTEA, Razvan, MD.,LYON,

Edward, MD, and

HUNTER, Robert, MD. (CCRH Qly

Bullein, Vol.10,(3&4)/88)

6. Concept of homoeopathic research

and some of its practical hints,

PRAMANIK, M.S.(CCRH Qly.

Bulletin, Vol.10, (3&4)/88)

7. Action of homoeopathic medicines:

a physicist’s view,

PARANJPE, A.S. (CCRH Qly.

Bulletin, Vol.10, (3&4)/88)

8. Methodology of research in

homoeopathy with special emphasis

regarding the effect of homoeopathic

medicine upon plant chromosome,

CHAKRAVARTHI, B.N.,B.Sc.,

DMS(hom)etc.

(CCRH Qly.Bulletin, Vol.10(3&4)/88)

VI. History:

1. HAHNEMANN and the writers,

SAUERBERK, K.O.(AHZ, Band 234,

Heft 2/89)

2. Bibliography of HAHNEMANN’S

Writings,

SCHMEER, E.H. (AHZ, Band 234,

Heft3/89)

3. History of medicine, Trascription

from HAHNEMANN letters (1),

GENNEPER,T. (AHZ, Band 234, Heft

2/89)

4. Rediscovered: a basic manuscript of

HAHNEMANN, KAISER, D. (ZKH,

Band 33, Heft3/89)

5. Publication of

BOENNINGHAUSEN’S writings,

KUNZLI von FIMMELSBERG (ZKH,

Band 33, heft 3/89)

6. A brief history of potentizing

machines,

WINSTON, Julian (BHJ, Vol.78,

No.2/89)

7. Twenty years ago,

PRATT, Noel, MRCS, LRCP, FF

Hom. (BHJ,Vol. 78,No. 2/89)

8. The Foundation of Homoeopathic

Literature, Part II

WINSTON, Julian (The

Hahnemannian, June 1989)

9. Homoeopathy in Canada,

KLEIN, Louis (The Homoeopath, Vol.

6,No.1/86)

VII. General:

1. On the search of symptoms with the

help of Computer,

KELLER, G.V. (AHZ,Band 234, Heft

2/89)

2. Homoeopathy in the Family,

PFEIFFER, H. (AHZ, Band 234, Heft

3/89)

3. Cholesterol Confusion,

GABY, Alan R.,MD.(JAIH,

Vol.82,No.2/89)

5. the man who fell out of bed,

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

SACKS,Oliver, (The Homoeopath,

Vol.6,No.2/86)

6. Pinkroot conversion,

WINSTON, Julian (Resonance May-

June/89)

7. Mortar and Pestle.

BORNEMANN, P.Jay (Resonance,

May-June/89)

VIII Reports:

1.Annual Day 1989 of the Central

Union of Homoeopathic Physicians of

Germany, Official Report (AHZ,Band

234, Heft2/89)

2. Report on the second meeting of the

Working Group of Homoeopathic

History on 5-6 Nov. 1988 in the

Institute of History of medicine,

Report-Bosch Foundation, Stuttgart,

(ZKH,Band 33, Heft 2/89)

3. Blackie Foundation Trust

Symposium and Blackie Memorial

Lecture-Bristol Student’s Day

EEC initiative on Homoeopathy-

Hufeland society discusses Natural

Medicine in the EEC

Avisitor’s view on homoeopathy in

Leningrad, USSR

(BHJ,Vol.78,No.2/89)

4. Clinica Homoeopathica of Oxaca-A

major homoeopathic teaching center in

Mexico,

JACONS, Jennifer, MD. (Resoonance,

Mar-Apr/89)

IX. Veterinary Homoeopathy:

1. Protecting the cat from the most

common diseases,

PITCAIRN, Richard,

DVM(Resonsnce, May-Jun/89)

X. Seminars/Conferences:

1. AIDS update,

CROTHERS, Dean, MD(Resonance

Mar-Apr/89)

XI. Others:

1. Cancer immunology,

KASAD, K.N., MBBS, MF Hom (Lon)

(CCRH Qly. Bulletin, Vol.10

(3&4)/88)

Vol. VII.

PART II ABSTRACTS / SUMMARIES /

CONDENSATIONS/FULL ARTICLES

Review Article

[Both carkiologists

and psychiatrists have

observed that the

onset of myocardial

infarction is often

preceded by feelings

of decreasing energy,

general malaise, and

minor depression.

This paper describes

these observations and tries to integrate

the findings. It is proposed that the

mental state preceding myocardial

infarction can be best described as

‘vital exhaustion’.]

The recognition of an impending

heart attack is one of the major

diagnostic challenges to medicine.

Both cardiologists and psychiatrists

have therefore investigated the

premonitory or prodromal symptoms of

myocardial infarction and sudden

death. However, few attempts have

been made to integrate the observations

made by the two disciplines.

Cardiological studies suggest that

the premonitory symptoms of

myocardial infarction and sudden

cardiac death are divisible into three

major categories: chest pain, dyspnoea,

and fatigue. Estimates of the

prevalence of these symptoms are

rather crude because it has not uet been

established want questions should be

asked or what kind of feelings should

be grouped into one or more

categories. The labels used in most

cardiological studies are ‘excess

MENTAL

PRECURSORS

OF

MYOCARDIAL

INFARCTION

APPELS, A.

British Journal of

Psychiatry,(1990)

156

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

fatigue’, ‘general malaise’, and ‘lack of

energy’. The estimated prevalence

ranges from30% to 60% and is equal to

or greater than the prevalence of any

other premonitory symptom (Stoers &

Short, 1970;Rome, 1973;Alonzo etal,

1975;Fenleib et al,1975;Kuller, 1978;

Rissanen at al, 1978; Fraser, 1978;

Klaeboe et al;1987).

Psychiatrists who looked into the

mental state of coronary patients

observed similar symptoms. Their

descriptions contain many similar

elements, but they use different terms,

such as “hidden withdrawal and

masked depression” (Fischer et al,

1964), “ a combination of depression

and arousal affects” (Greene et al,

1972), “pseudoneurasthenic

syndrome”(Poizien & Walfer,1971),

and “emotional drain” (Bruhn et al,

1968). Most cardiologists avoid further

interpretation of excess fatigue.Some

authors suggest that it is a side-effect

of medication or reflects subclinical

levels of atherosclerosis. Some

psychiatrists are inclined to interpret

this state as a breakdown of defence

mechanisms before the onset of

myocardial infarction. Others explain

the depressive symptoms as a reaction

to the life-threatening event or as a

‘home-going’ depression (Billing et al,

1980; Hacket, 1985).

Because of the retrospective nature

of these studies, a number of questions

remain unanswered. Which feelings

exactly precede myocardial infarction?

How long had these feelings existed?

What is their origin? Prospective

studies of feelings are called for,

controlling the classic risk factors. Two

such studies are considered;thereafter

the remaining questions are discussed.

Quantitative studies of mental

precursors to coronary heart

disease:

The first prospective psychiatric

study of the mental precursors to

myocardial infarction was published by

Crisp et al (1984). The Database of this

study was formed by patients, aged 40-

65, who were registered with a group

general practice in south-west England.

This group was screened in 1969,

1971, and 1973. Nearly all subjects

completed the Crown-Crisp Experintial

Index (CCE) on each occasion. During

the five-year observation period, 26

men were admitted to hospital with a

confirmed diagnosis of severe

myocardial infarction. Their scores on

the CCEI were compared with those of

the remainder of the male study

population.

Future coronary patients were

found to have significantly more

somatic experiences (especially of

sweating, heart flutter, and loss of

libldo) and were significantly more

depressed (In particular, feeling sad).

Differences between the groups were

sought in their scores on the individual

items on the CCEI and in a

discriminant analysis seeking a linear

combination of the variables that

discriminate most between individuals

destined and those not destined for

early infarction. A set of 12 items was

found that reflected a states of sadness,

coupled with loss of libido and

exhaustion. These results should be

interpreted cautiously, because change

fluctuations may strongly influence the

results of discriminant analysis

(Thompson, 1984). No attempt was

made to control for confounding

factors or for a time dependent

association.

In a new analysis of the same

database, Haines et at (1987) observed

that the scales ‘obsessional neurosis’,

‘depression’, and ‘hysteria’ were

predictive of all cases o f ischaemic

heart disease. However, these scales

lost their predictive power when they

were controlled for phobic anxiety.

This rather surprising result, surprising

because an association between phobic

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

anxiety and coronary heart disease had

never been mentioned before in the

literature, may indicate that only those

symptoms of depression, which are

also experienced by phobics, are

predictive of myocardial infarction.

The second prospective study of

the mental precursors of coronary heart

disease was conducted by Appels &

Mulder(1988). This study was done

among 3877 male civil sevants of the

city of Rotterdam (the Rotterdam Civil

Servants Study (RCSS)). The cohort

was screened for cardiovascular risk

factors between 1979 and 1980 and

was followed up for an average of 4.2

years. During the screening, all

subjects completed a questionnaire

asking about different manifestations

of exhaustion, emotional drain,

irritation, depression, and sleep

problems. This questionnaire, called

the Maastricht Questionnaire (MQ),

was composed of two parts: Form A,

consisting of 37 items, developed in an

earlier study; and 21 additional

questions, derived from clinical

interviews. it was hypothesized that

future cases of muocardial infarction

would have elevated scores on Form A

of the MQ at screening. Furthmore it

was expected that an exploration of the

prodictive power of the added set of

questions would reveals some risk

indicatiors not yet included in Form A

of the MQ.

Among those free of past or present

coronary heart disease at the time of

screening, there were 59 subjects who

experienced myocardial infarction

during the follow-up. Form A of the

MQ was found to be significantly

associated with an increased risk of

future myocardial infarction when

controlling for age, smoking,

cholesterol, and blood pressure. An

analysis of the observed association

against length of time interval showed

a strong decrease in the relative risk of

events occurring during the first,

second, third, or fourth year of the

follow-up. The age-adjusted relative

risk associated with a score above the

median of the MQ was found to be

10.05 in the first year of the follow-up,

while fisks for the following years

were 2.23, 3.04, and 0.68, respectively

(relative risk is defined as the ratio of

the proportion of respondents

experiencing myocardial infarction to

that of those who did not). These data

indicate that exhaustion is a strong

short-term risk factor risk factor

Appels &Mulder, 1988).

Separate analyses of each single

item showed that 24 of the 57 items

were predictive of future myocardial

infarction when adjusted for age:

often tired

have trouble falling asleep

often wakeup during the night

feel weak

feel as though I am not

accomplishing much

gave difficulties coping with

everyday problems

believe to have come to a ‘dead

end’

feel listless

sexual interest lessened

feel hopeless

have difficulty in grasping a new

problem

easily irritated

wanted to give up trying

feel fine(no)

body is lide a battery that is losing

its power

want to be dead at times

just don’t have what it takes

anymore

feel dejected

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

feel like crying

wake up exhausted

have difficulty in concentrating

have strange bodily sensations

shrink from regular work

have spells of shaking and

tremhling all over

The item analysis was completed

by an analysis of the age-adjusted

relative risk for each year of the

follow-up. Most of these 24 items were

found to have quite stable relative

risks, averaging around 2.00. However,

some items had remarkably decreasing

risk rations (TableI). These items

reflect a loss of vitality and strong

feelings of irritation or demoralization.

If DSM-III criteria were applied to the

set of predictive items listed above, it

should probably be concluded that the

RCSS has provided some evidence that

the onset of myocardial infarction is

preceded by depressive feelings. This

corresponds with the findings of the

other studies, which observed that

especially patients dying of myocardial

infarction passed through one or more

perids of distress, exhaustion, or

depression in their lives (Sheklle &

Ostfeld, 1965; Brozek et at, 1966;

Paffenbarger et al, 1966; Lebowitz et

al, 1967; Greene et al, 1972; Klatsky et

al,1976; Talbot, 1977; Lloyd &

Cawley, 1983; Murphy et al, 1988).

TABLE I

Age-adjusted relative risk of

myocardial infarction associated with

five mental complaints during four

years of follow-up:

Items

Year of follow-up

1 2 3 4

Not accomplishing

much

4.53** 2.80** 1.89* 1.37

Easily irritated 5.88** 1.90* 1.53 1.40

Want to be dead 7.65** 4.32** 3.60** 2.90**

Strange bodily

sensations

3.30** 1.04 0.91 1.04

Shrink from work 3.01** 1.49 1.39 1.33

*P 0.05, **P0.01.

Data from the RCSS (Appels &

Mulder, 1988).

A statement like “depression

increases the risk of myocardial

infarction” would be a parsimonious

formulation for summarizing the crude.

Important elements of the mental

precursors of myocardial infarction

might go unnoticed or could be

misinterpreted if the most economical

formulation is chosen.

The set of predictive items includes

some known characteristics of

depression, such as a sad, apathetic

mood, loss of sleep and sexual desire,

fatigue, and tiredness. Two other major

elements of depression, a negative self-

concept and feelings of guilt, do not

belong to the precursors of myocardial

infarction. None of the items about

lowered self-esteem or feelings of guilt

were found to be predictive in the

RCSS. Self-reproach is rare among

coronary victims. Typically, coronary

patients blame others for the

occurrence of negative events (Byrne,

1980).

The item with the strongest

predictive power in the RCSS was ‘Do

you want to be dead at times?’ When

we formulated this item, we believed

that it related to depression; in fact

discussions with coronary patients who

had endorsed that item showed that a

positive answer was often chosen to

express very strong feeling of

annoyance or irritation. Increased

irritability is a major component of the

precursors of myocardial infarction.

Next to symptoms of lack of energy

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

(such as decreased participation in

social activities like birthdays or

celebrations), increased irritability is

often mentioned by relatives of

coronary victims when asked which

behavioral changes they noticed in the

months preceding the coronary event.

Because lowered self-esteem and

feelings of guilt are not among the

precursors of myocardial infarction,

and in order to fit the description of

this state into the description given by

cardiologists, we have chosen the label

‘vital exhaustion’ for describing the

construct measured by the MQ. Labels

should communicate something, and

this label fits well into the self-

descriptions of coronary patients, who

seldom use words like ‘sad’ or

‘depressed’ to describe their condition,

but often prefer metaphors like ‘my

battery lost its power’ or ‘the well was

drying up’.

The origins of vital exhaustion:

Cardiological views: Many patients

feel much better and lose their feelings

of fatigue after bypass surgery or

angioplasty. Therefore, many

cardiologists are inclined to attribute

the feeling of tiredness to the impaired

oxygen supply to the myocardium or to

side-effects of medication, especially

diuretics and beta-blockers. Few, if

any, cardiological studies have directly

addressed the question of the origin of

excessive tiredness before myocardial

infarction.

Freeman & Nixon (1987) observed

an association between some

symptoms of exhaustion (especially

‘waking up unrefreshed from sleep’

and ‘poor energy levels’) and the

number of symptomatic episodes of

ischaemia during ambulatory

monitoring. These authors note:

‘Even the shorter periods of

ischaemia which do nto cause

infarction are still highly undesirable,

because they can impair myocellular

function and cause what Branuwald

has termed the stunned myocardium.

This depresses left ventricular

functions and may be the main reason

why many patients report a poor

energy level when due inquiring is

made.”

This finding is important. However, the

observed association can be explained

in two ways; ischaemic periods cause

poor energy levels or vice versa.

Sleep problems form part of the

syndrome of vital exhaustion, and may

be understood as a cause, an effect, or

as a reinforcing element. Sleep

problems and sleep apnoea have been

reported as a risk factor for coronary

heart disease by several authors

(Siegrist, 1987). sleep apnoea has a

prevalence of 5-15% in middle-aged

male populations. It facilitates the

development of arterial hypertension

and of left ventricular hypertrophy

independent of volume load. Sleep

apnoea increases the vulnerability of

the myocardium to ischaemic attacks

and, subsequently, to angina and acute

myocardial infarction. It is therefore

possibly a confounding factor in the

association between vital exhaustion

and future coronary heart disease.

Given this possibility and the

possibility that early unrecognized

ischaemia may result in poor energy

levels, there is no suggestion that vital

exhaustion is a cause of coronary heart

disease.

Pschodynamic views: One of the

earliest psychiatric studies of the

personality characteristics of

myocardial infarction patients was

conducted by Kemple (1945). His

description is quoted at some length

because it contains many elements that

have been studied during the past two

decades.

“The subject is extremely ambitious, he

generalizes compulsively, has good

QUARTERLY HOMOEPATHIC DIGEST Year 1990, Vol.VII

organizing ability. He is active and

aggressive but productivity is

inhibited by anxiety. Inner

creativity is extremely limited, the

inner life being dominated by

infantile instinctive drives. Strong

hostile aggressive impulses

associated particularly with sex

arouse feelings of guilt and of inner

tension as he attempts to repress

them. Emotional responses to the

outer world are limited and when

given are violent, uncontrolled and

diffuse. he lacks subtle adaptive

responses, and sensitivity to

nuances in his environment. Moods

and feelings are not stable,

however, He is highly reactive,

displaying infantile aggressiveness,

oral dependence, guilt, depression

and anxiety regarding his

adjustment… (He) strives

compulsively to achieve goals

incorporating power and prestige.

Limitation of the introversive

experiences of creative thought and

imaginative reflection increases the

dependence upon achievements in

the external world for satisfaction

and security… although they try to

keep their strong aggressive

impulses under control, they

manage to justify to themselves a

good deal of outwardly expressed

hostility.”

Kemple’s description influenced

Friedman in his description of the

aggressive, ambitious, and impatient

‘type A’. Friedman et al (1987)

speculated that persistent struggle

resulted in a chronic state of

hyperarousal, both physiological and

behavioural, which manifested itself in

the way in which individuals acted

(e.g. rapid, abrupt speech), what they

said (e.g. perceiving others as

challenging their control of situations),

Furthermore, he reasoned that

underlying such behaviours was a basic

profound feeling of insecurity, a

pervasive doubt about the level of their

value in certain contexts, such as at

home or at work. This insecurity

seemed to be linked to a fear that the

person was not genuinely respected

and admired by others, and heightened

arousal was associated with a constant

striving to seek the symbols of

recognition was reward as a way of

allaying what appeared to be basic

fears of inadequacy and insecurity.

Hence, the type-A behaviour pattern

served to diminish feelings of

insecurity or self-doubt and was

strongly reinforcing (Thoresen et al,

1985).

The type-A behaviour pattern has

been found to double the risk of

myocardial infarction, while attempts

to change this behaviour pattern have

resulted in a decreased risk of recurrent

myocardial infarction (Rosenman etal,

1976; Friedman et al, 1987). The

predictive power of the type-A

behaviour pattern was confirmed in the

Framingham study and in numerous

case-control studies (Haynes &

Feinleib, 1982; Matthews & Haynes,

1986). However a prospective study,

which used a structured interview to

assess type-A behaviour, could not

replicate the original findings (Shekelle

et al, 1985). Furthermore, Ragland &

Brand (1988) observed that type-A

behaviour is inversely related to

survival after myocardial infarction.

It is hard to integrate the old

findings with the recent ones. Any

attempt to do so would be beyond the

scope of this paper. Suffice it to say

that in recent years several scientists

have directed their attention to one of

the behavioural components leading to

susceptibility to coronary problems

mentioned by Kemple, namely

hostility. This factor was found to be

the strongest predictive component of

type-A behaviour in the Western

Collaboration Group Study and was

also found to be associated with future

QUARTERLY HOMOEOPATHIC IGEST Year 1990, Vol.VII

coronary heart disease in other studies.

(Matthews et al, 1977; Shekelle et al,

1983).

Limitation of creative thought and

imaginative reflection was found to be

predictive of future coronary heart

disease in a study by Bonami & Rime

(1972). They observed that future

coronary patients responses to Van

Lennep’s four-picture test were less

rich in fantasy and imagination, and

reflected more ambivalent conflicts in

relations with other males than the

responses of a control group who

remained free of coronary heart disease

during a ten-year follow-up. High

reactivity is now mainly studied by

psychophysiologists who assume that

‘hyperactivity’ forms the link between

type-A behaviour and coronary heart

disease (Matthews & Hynes, 1986).

Other elements of Kemple’s

description, such as the lack of subtle

adaptive responses, deserve detailed

investigation, but this has yet to be

carried out.

Arlow (1945) interpreted coronary

patients’ compulsive striving as a result

of an unsuccessful identification with

their father. According to Arlow the

usual story of the patient with coronary

artery disease is that of a stubborn,

self-willed child who enters a

competitive relationship with a much-

feared and envied parent at an early

age. The conflict is then repressed and

identification with the parent takes

place. Through working hard, self-

discipline, and compulsive devotion to

the completion of tasks which he

assigns himself, the patient keeps

driving himself to success. However,

he is constantly drawn into new

situations in which he repeatedly

recreates the original competitive

situation, a situation which he attempts

to master by identifying with his

superiors. The adaptive mechanism of

compulsive striving for achievement

and mastery starts to fail in the period

before the onset of myocardial

infarction.

The first quantitative psychiatric

study of the short-term precursors of

myocardial infarction was published by

Hahn (1971), who observed that

coronary patients were significantly

more compulsive, involuntary counters

of trivial things, like houses or trees,

than controls were. He interpreted this

compulsive behaviour as a defence

mechanism directed against a

depressive ambivalence conflict. Upon

decompensation of this defence

through conflicts or stress, the

underlying anxieties and depressive

way of coping with conflicts

manifested themselves. By means of a

questionnaire, Hahn looked into the

ways in which the decompensation was

experienced increasing irrtablilty,

strong mood changes, increasing

sweating, and the general feeling of not

being well (Hahn, 1971).

Psychological views: On the basis of

the type-A theory, Glass (1972)

developed a psychological model in

which type-A individuals, who

suffered from coronary heart disease,

passed a state of frustration and

exhaustion preceding myocardial

infarction:

“If the type A individual concludes

that little can be done to rectify the

situation, we may expect him to

experience more intense feelings of

helplessness than are experienced by a

type Bin similar circumstances. This

prediction is derived from the

assumption that type A’s probably try

harder than type B’s to avoid losing

their jobs when that possibility first

become convinced that nothing can be

done about being fired.

The precise role of initial

hyperresponsiveness and subsequent

hyporesponsiveness (helplessness) in

the development of cardiovascular

pathology remains unclear …. we