Keywords: Surgery, Homoeopathy, Miasm

Dr. S. C. F. Hahnemann spent 12 long years in investigating the source of large number of chronic diseases with evidence, to prove this truth he published observation & studies in The Chronic diseases. But truly speaking how many of us have really paid head to it? Furthermore in his masterpiece he claims that he discovered principal (Antipsoric) remedies, which collectively are similimum for thousand-headed monster of disease in all different form.

While going through aphorism 80, one will realize that Dr. Hahnemann was extremely extremely happy & satisfied by this discovery, further to this he claims that he has nearly discovered remedy for chronic affections arising from psora. (Antipsoric remedies).

~Aphorism 80~
“I spent twelve years in investigating the source of this incredibly large number of chronic affections, in ascertaining and collecting certain proofs of this great truth, which had remained unknown to all former or contemporary observers, and in discovering at the same time the principal (Antipsoric) remedies, which collectively are nearly a match for this thousand-headed monster of disease in all its different developments and forms.” -Dr. S. C. F. Hahnemann

Now, let us consider the practical implication of aphorism 80. Aphorism 80 if not detailed needs a broad understanding of miasm. Miasm in the light of modern day pathology can be categorized into 3 basic (Psora, Syphilis, Sycosis) & 4 Combination (Psora-Syphilis, Syphilis-Sycosis, Psora-Sycosis, Psora-Syphilis-Sycosis) miasma.

~Aphorism 80~
“How much greater cause is there now for rejoicing that the desired goal has been so much more nearly attained, inasmuch as the recently discovered and far more specific homoeopathic remedies for chronic affections arising from psora (properly termed antipsoric remedies).” -Dr. S. C. F. Hahnemann

Psora: Psora is the pathology at functional level (cellular dysfunction), wherein dysfunction of a cell, tissue or organ results in sickness. (e.g. Inflammation, itching, exudation, oxidation…)

Syphilis: In Syphilis cellular degeneration / death occurs, but before that functional disturbance has to take place (e.g. inflammation, infection, oxidation…) and thus functional disturbance precedes Syphilis, therefore in such cases Psora can be considered mother of Syphilitic miasm.

Sycosis: In Sycosis cellular proliferation takes place, prior to which functional changes at the cellular level like mitosis meiosis takes place hence once again Psora has to prevail before Sycosis creeps in.

Hence the master even before the advent of modern pathological studies foresaw that Psora (cellular dysfunction) as the fundamental cause of almost all the chronic diseases, therefore its (Psora) consideration / removal is very essential during the management of all chronic cases.

~Aphorism 206~
“...psora is the sole fundamental cause of all other chronic maladies, whatever names they may bear,...” -Dr. S. C. F. Hahnemann

I have restricted the scope of this present study to surgical cases, wherein I will discuss the miasmatic relevance & importance of antipsoric remedies in the management of surgical diseases.

Case I: - Hepato-Cellular Carcinoma (Prediagnosed case)

Mrs. AB aged 62, presented with Hepato-cellular in left lobe of liver, in addition to primary lesion there were two secondary foci (satellite nodule).
She had serious encephalopathy (difficult recognition, incoherence), ascites (thrill +ve), loss of appetite, sleeplessness and Higher medical centers advised liver transplant as last hope. No fear of death, fears surgical procedures, extreme prostration unable to do routine work, bed ridden, cachexia, blank expressionless face.
Blood study: Total Bilirubin 7.2 mg/dl, no albumin production.
H/o: Hepatitis B, Hysterectomy, Blood transfusion, bleeding gums.

27/07/2005:
On basis of totality among Ars, Thuja, Phos, Lyco, Calc. Flour, Acid phos...
Lyco was chosen as Deep acting antipsoric, hence

 Lyco 200 BD X 5 days then Sac Lac for 15 days.
 Carduus MarQ 10 drops TDS X 20 days.

18/08/05:
Much better symptomatically

Carduus Marianus: (Hepatic Antioxidant)
Over the years Carduus Mar Q has been used as Homoeopathic hepatic tonic but only recently it became evident that two of its major components protects liver from Free radical induced oxidative damage. (A study reveals that Silymarin & Silybin (constituents of Carduus) protects Hepatocytes against hepatic Lipid per oxidation & irreversible damage induced by acute ethanol intoxication in rats.)

Free radicals are notorious substance produced in the cell, which damages normal healthy cells, causing cellular dysfunction, death & cellular proliferation. Thus free radicals lay the foundation of sickness (miasm) and antioxidants erases the miasm. Anti0xidants are now widely accepted as antichronic disease.

Patient recognises all around, appetite +, Prostration reduced

 Sac Lac QID X 20 days
 Carduus MarQ 10 drops TDS X 20 days.

25/08/05:
Banging of head against wall, sleeplessness
 Ars 30 TDS X 5 days

02/09/05:
Heavy vertigo, turning head in the bed difficult
 Conium 200 Single dose (relieved the complaint in 4 hours time)

05/09/05:
Sleeps for 6 hours now, appetite much better, participates in family get together.
 Sac Lac QID X 20 days

28/09/05:
Bleeding of gums started after a long gap, taste of blood in the mouth on waking up, desire for cold things, burning in stomach after oily food.
 Phos 200 BD X 5 days
 Sac Lac QID X 20 days
 Carduus MarQ 10 drops TDS X 20 days.

04/10/05:
Symptomatically much better, goes for outing, takes part in household work, no considerable ascites, bleeding of gums did not respond to Homoeopathy & she had to take Vit. K injection. But case on a stand still.
 Lyco 200 BD X 5 days
 Sac Lac QID X 20 days

15/10/05:
Scan showed reduction of primary cancer and dissolution of secondary cancer. Gained weight 2 kgs from 54 to 56. Appetite good, Remains cheerful and does all normal housework. Gets good sleep. Bilirubin 2.6 mg/dl, albumin 3.4 g/dL (normal)
 Sac Lac QID X 30 days

15/11/05:
No complaints pertaining to Hepato-Cellular Carcinoma, quality of life better by 10 times.
 Lyco 1M one dose once a month for three months.

As you can see this deep acting antipsoric with other intercurrent remedies worked wonder in hopeless case.

“...craze in surgery, in the old school, was that they were forced in that direction because of the inadequacy of their therapeutics.”
“it should be our pride & boast, that with our superior system of therapeutics we are able to cure without operation most of disease which under the old school are obliged to come to the knife” – Nash E.B

Case II: - Plantar Hyperkeratosis
Mr. XY aged 39, presented with 7 Corns on right sole & 2 corns on left sole, which were severely painful incapacitating his daily work / duties. Previously he operated for 3 corns. Corns more painful walking bare foot.

17/02/02:
 Sulphur 200 OM X 3 days then after one day gap
 Antim crude 30 TDS X 10 days

Patient didn’t come there after, after a gap of two months, his wife came for consultation for some other problem, in the mean I happened to ask about her husband’s Plantar lesion, she reported that all the corns went away in a weeks time thereafter he never had any plantar lesion. Surprised at this, I took a deep sigh of relief.

(These are some surgical cases among others, where surgery was avoided with homoeopathic medication, bring down the suffering in the most simple, gentle & effective way at the same time pain & complications of surgery were done away with administration of proper antimiasmatic medication.)

In aphorism 213 Dr.Hahnemann guides the physician to think beyond the symptom totality, that is to say other changes related to mind & disposition, but with our deeper understanding of pathological process it is mandatory to include clinical examination in the process of building up the totality in tandem with those related to mind & disposition. To understand this clearly I would like to cite a case: -

~Aphorism 213~
“...and if we do not select, for the patient’s relief, from among the medicines a disease-force which, in addition to the similarity of its other symptoms to those of the disease, is also capable of producing a similar state of the disposition and mind.” -Dr. S. C. F. Hahnemann

Case III: - Acute Otitis Media
Miss. DFG Aged 7 came with severe sudden violent throbbing pain in the left ear, she had just recovered from acute sinusitis, patient could not sleep on account of pain, ear extremely sensitive to touch, Pinna of the left ear red hot, tinnitus, heaviness of ear, patient irritable.

03/05/04:

Taking into consideration acute nature

 Bell 30 2 hourly was prescribed till the pain subsides.

Patients became more sensitive came back on the same evening Placebo was prescribed, Bell was withdrawn.

04/05/04:

Slight relief, patient did not sleep the whole night.
On examination with Otoscope a small pin point nipple was seen on the Tympanic membrane, with congestion of ext. auditory canal.

 Hepar Sulph 30 2 hourly was prescribed.

4 hours latter the blood streaked purulent discharge came out of the ear reliving all the complaints, patient much better irritability<

 Hepar Sulph 200 Single dose, followed by Sac lac for 3 days.

Completely cured the case.

In this case apart from totality of symptoms, clinical / local examination was the pathfinder, hence very truly said by the master in aphorism 213, mere symptom similarity is not similimum there is something more...

SUMMARY:
“If you can cure, cut. Now it is, if you can not cut, cure (if you can).” (Science of symptomatology & how shall we teach Materia Medica & therapeutics, Dr.Nash E.B, Pg. no.13)

I would like to put it in a different way “If you do not cure, cut; if you do not cut, cure.”

“What comes from within must be treated by within. What comes from outside must be treated from out side” – Dr. B.K. Sarkar

Although Homoeopath is a surgeon without knife (who cures / relieves complicated surgical diseases with sweet pills) for many a times you may note that, where cure or recovery doesn’t seem to come or you are not able to arrive at the true similimum, as a physician you should refer the case in the better interest of patient. In the era of CPA spoiling the case in overconfidence will prove futile, Homoeopathy I feel is not opposed to surgery, but to tries to minimise its use, even Dr.Hahnemann in his 7th aphorism advocates removal of causa occasionalis.

In chronic diseases / surgical diseases antipsoric medicines should be preferred as the first line of treatment over the others, as one would note that they remove the fundamental cause (cellular dysfunction), which clears up the basic pathology clearing way for other similimum / antimiasmatic remedies as has been seen in the surgical cases cited in this paper.

AUTHOR: PHARMACOKINSHIP (A Detailed study of Homoeopathic Drug relationship.)