Nutrition may be defined as the “Science of food” and its relationship to Health, It is concerned primarily relationship to Health. It is concerned primarily with part played by nutrients in body growth development and maintenance. The essential elements lost from the body must be replaced constantly. 

Through centuries food has been recognized as important for human beings in health and disease .The history of man has been to a larger extent is struggle for existence and survival and need for food. Until the turn of the century the science of nutrition has a limited range.   

Proteins, fats and carbohydrates were recognized early in the I9 th century as energy yielding foods. The discovery of vitamins at the turn of the present century (20th) has rediscovered science of nutrition. Between the two world wars the research on the protein gained momentum. Nutrition gained recognition as a scientific discipline with roots in physiology taught as such to the medical students.

For the past 50 years great advances have taken place in the nutrition science an its practical application. Specific nutritional deficiencies were identified and technologies were developed to control them eg. PEM, Endemic goiter, Nutritional anemia, nutritional blindness and diarrhoea disorders.
Attention was concentrated on Nutritional deficiency diseases during the first decade of the century. The problem of the nutrition began to attract the international attention as the cause of the socials problem. International activities in the field of the nutrition initiated by the league of the National and later continued by the FOOD and AGRICULTURAL ORGANIZATION, WHO and UNICEF. further advances have been made during the past two decades. The association of nutrition with infection, immunity, fertility, maternity and family welfare engaged scientific attention.

Nutritional deficiency diseases generally can be classified into
v Primary Nutritional deficiency diseases
v Secondary Nutritional deficiency diseases

Primary Nutritional deficiency diseases: It is defined as inadequate intake of nutrients, for the normal body requirement, which may result from
1. Poor socioeconomic status coupled with shortage of food.
2. Faulty selection of food.
3. Ignorance and indifference to the good nutrition.
4. Mental status like stress, loneliness and other psychological factors.
5. Lack of nutritional knowledge.

Secondary Nutritional deficiency diseases:
Nutritional diseases have a predisposing illness when this is prominent; the resulting malnutrition is spoken of as conditioned or secondary. Mostly these diseases result from interference with the ingestion, absorption or utilization of essential nutrients or from stress factor that increases the requirements destruction or excretion.

1 Defective intake of food, due to systemic disorders.
A) Loss of appetite may be an important symptom of organic disease like Cancer Stomach or psychogenic disease like Anorexia Nervosa.
b) Persistent vomiting from any cause.
c) Food fads and idiosyncrasies leading to deficiency disorders.
d) Alcohol provides calories but not nutrients. Chronic alcoholics suffer from malnutrition more often than under nutrition.
e) Unbalanced therapeutic diet. Eg. Diets for digestive diseases lack ascorbic acid unless care is taken to provide it.
f) Prolonged parental feeding with intravenous glucose after surgical operation may precipitate acute deficiency of Vit.B. Complex.

2. Defective digestion and absorption
a) Achlorhydria is a contributory factor in the causation of Iron deficiency anemia.
b) Steatorrhoea leads to malabsorption.
c) Intestinal hurry due to surgical short circuits may impair digestion.
d) Prolonged administration of Antibiotics may interfere with synthesis of Vitamins 3.

3) Defective utilization
a) Cirrhosis of liver may interfere in the proper utilization of ingested nutrients eg. Proteins and vit. K
b) In malignancy some unknown ways may produce a state of under nutrition in spite of adequate diet. In the same way may be TB and other prolonged infections.
c) In renal failure Vit. D is not converted in to active metabolism.
d) Some drugs like anticonvulsants are antagonists of folate and Vit.D.
e) Inborn error of metabolism may interfere with nutrients Eg. Hartnup diseases leads to pellagrous signs in ordinary diet.

4. Loss of nutrients from body
a. In Nephrotic Syndrome there is loss of protein in urine
b. In DM uncontrolled Glycosuria causes under nutrition
c. In Mennorhagia excessive bleeding leads to Iron deficiency and anemia is common.
d. In severe chronic diarrhoea potassium is lost.

5. Increase nutritional needs:
a. In pregnancy, lactation, adolescence, after an illness and those engaged in hard  physical work particularly in cold climate, the usu I diet may be insufficient.
b. In fevers and Hyperthyroidism the increased metabolism calls for more calories.
c. After burns, fractures and major surgery there is an increased catabolism of Vit C and protein.
The expression of disease in nutritional diseases [nutrients] be it Primary or secondary the effect will be same. The intelligent physician must clearly discover whether it is primary or secondary, before he attempts to restore the system in order. Deficiency of one single nutrient is rare, conditions of deficiency of several nutrients is what is generally seen. If he goes through carefully the food habits of person in question, it is easy for him to decide whether it is primary or secondary
One should also keep in mind the parasitic infection as another cause of deficiency disorders.
Hahnemann in his Organon of Medicine §5 “Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease as also the most significant points in the whole history of the chronic disease, to enable to discover its fundamental cause, which is generally due to chronic miasm. In these investigations the ascertainable physical constitution of the patient (esp. When the disease is chronic) his moral & intellectual character his occupation mode of living and habits (including food habits), his social and domestic relation5 his age, sexual function etc., are to be taken into consideration.

A} PRIMARY NUTRITIONAL DEFICIENCY DISORDERS:
Hoomeopathy has absolutely no scope, in primary nutritional disorders as it deals with purely dynamic diseases. For a fact combating the nutritional disorders is the responsibility of state. The Physician’s role is only limited to recognizing the nutritional disorder and advice accordingly.

While in § 77 says “Those diseases are inappropriately named chronic, which persons incur who expose themselves continually avoidable noxious influence, who are in the habit of indulging in injurious liquors or ailments, are addicted to dissipation of many kinds which undermine the health,who undergo prolonged abstinence from things that are necessary for the support of life These states of ill health, which persons bring upon themselves, disappear spontaneously,pirovided no chronic miasm lurks in the body, under an improved mode of living, and they cannot be called chronic diseases.”

In the lesser writings, Hahnemann said if it be necessary make considerable changes in diet and regimen the ingenious physician will do well to mark what effect such changes will have on disease, before prescribing even the mildest medicine.
A deeply rooted scurvy can often be cured by the united action of warm clothing, dry country air, moderate exercise, and change of the old salted meat for that freshly killed, alone with sauerkraut, cresses and such like vegetable and brisk beer for drink. What would be the use of medicine in such cases? he says.
Richard Hughes in his Principle & Practice of Homoeopathy says that scurvy is typical instance of disease resulting from pure dietetic causes and requiring only dietetic treatment.

Further he adds [unsuspected] in two cases of scurvy in which the most careful medicinal treatment was ineffective where rapidly cleared by supply of fresh vegetables. Sir James Simson seems to think that has made a point against Homoeopathy when he argued that lemon juice cures scurvy but is incapable a producing it, the argument is really altogether wide of the mark that lemon juice is the only convenient form of supplying certain necessary constituents we call scorbutic. I plays no essential part in the treatment of scurvy it is generally sufficient to place the sufferer on full diet of a Hospital comprising as it does fresh meat and vegetables with milk and nothing more is required for cure -Hughes.

CHLOROSIS:-- Dr.Dudgeon has lately given us in our language he writes “What iron contributes as chemical remedy in such caves to the increase of the necessary quantity of iron in the blood is altogether different question which has got nothing to do with subject of Homoeopathy cure by similarly acting medicine.”

B} SECONDARY NUTRITIONAL DEFICIENCY DISORDERS:
In the secondary nutritional disorders this condition clearly indicates that there is no deficiency or excess of the intake of nutritious food but the organism is not in a position to properly utilize the nutrients. The causes are many, and the manifestations are unlimited. The intelligent physician clearly perceives them as secondary nutritional disorders and depending upon the cause he plans the treatment.

Nutrition imbalance impairs a variety of immune system components & functions, including the skin and the exterior barriers as well as the activities of the cells of immune system. For this reason people who suffer from malnutrition develop more infections than well nourished people. Infection in turn increases nutritious requirement further impairs nutritional status creating synergetic cycle that must be broken to recoverfrom the disease. Hence the careful investigation in to such obstacles to cure is so much the more necessary in the case of patients affected by chronic diseases, as their diseases are usually by such noxious influences and other diseases causing errors in the diet and regimen which often pass unnoticed [ 2601. The most appropriate regimen during the employment of medicine in chronic diseases consists in the removal of such obstacles to recovery and in supplying where necessary the reverse. Innocent moral and intellectual recreation active exercises in open air almost all kinds of weather [daily walks, slight manual work, labor]. Suitable nutritious unmedicinal food and drinks etc. [ 261].

Richard Hughes says in his Principles & Practice in chapter XXII regarding anemia. Anemia presents a wider field for inquiry. In one form indeed in which it occurs it is just the correlative of plethora both as to cause and as to treatment. I mean when it results from deficiency of air, light, and suitable food and from other depressing causes. The only rational and permanently successful treatment of such cases must be removal of the injurious cause or restoration of lacking sanantia.

But even when his indication one satisfied, and still more when they can only partially be fulfilled, remedies acting homeopathically upon the blood making process are useful. While having the comfort of feeling the value of Iron in anemia constitutes no exception to the homoeopathic law, it is mainly a matter of dietetics with which similia similibus has no concern---Hughes.

HOMOEOPATHIC APPROACH IN NUTRITIONAL DEFICIENCY DISORDERS

Homoeopathy believes in susceptibility a general quality or capability of the living organism of receiving impression; and the power to react to the stimuli. Upon this susceptibility all the functioning, all vital processes, physiological and pathological, digestion, assimilation, nutrition, repair, secretion, excretion, metabolism & catabolism as well as all the disease process arising from infections or contagion depend upon the power of the organism to react to specific stimuli.
This susceptibility varies in degree in different patients and at different times in the same patient.
The power of assimilation and nutrition is one of these phases of susceptibility. One easily assimilates a certain kind of food while other finds the same food indigestible. One man’s meat is other man’s poison.
Susceptibility varies according to age, sex, constitution and temperament, habit, occupation and pathological conditions.
Homoeopathy recognizes the individuality of each patient, the entire examination of the patient is conducted with a view to discover not only the general or common feature of the case by which it may be classified diagnostically & pathologically But the special & particular symptom which differentiate the case from other of the same general class, It recognizes the fact that no two patients even with same disease are exactly alike. And maintains that a true science of therapeutics must enable the practitioner to recognize these differences and find the needed remedy for each individual.

      CLASSIFICATION OF NUTRITIONAL DEFICIENCY DISORDERS    (AS PER HAHNEMANNIAN CLINICAL CLASSIFICATION)

Primary nutritional deficiency disorders due to inadequate food. These disorders can be treated by supplementing only, no medical treatment is necessary. These disorders can be grouped under pseudo-chronic diseases. If it is allowed to run for some time it may lead to true chronic disease.
The secondary nutritional deficiency disorders are not due to deficiency of nutritional factor. The organism cannot utilize the nutrient properly because of some other disturbances or diseases. These disorders are grouped under true dynamic diseases.

PLAN OF TREATMENT
Non miasmatic chronic diseases: Prime importance is to correct the underlying maintaining or exciting cause. i.e., by supplementation.
Dynamic diseases: In acute, important thing is to supplement the nutrition arid any other desire or craving. ( In chronic diseases: These should be treated only by indicated Homoeopathic remedy under the rules of strict individualization. When ever the nutritional tax is much more apart from the indicated remedy, supplementation may be necessary.
However, we should remember vitamins (nutrients) are supplements not substitutes. They are like friends happy to lend their nutritional shoulders at your low times. But, they can never replace wholesome food.
Concentrated vitamins can never replace wholesome natural food, which has a complex enzymatic relation with the system.