Samuel Hahnemann32 in his book ‘The chronic diseases , their peculiar nature and homoeopathic cure’ says that ‘At the stools , cutting pains in the rectum belongs to the psoric miasm .

P.N.Banerjee45 in his book ‘Chronic disease – its cause and cure’ says that “… syphilis joins hands with psora and carries on its insidious destructive process in the mucous membrane , flesh etc by ‘gradually overpowering the normal vital force and weakening its resistance .”

J.H.Allen12 in his book “The chronic miasm , psora and pseudopsora” says that haemorrhage from rectum is due to tubercular element in our system.

H.A Roberts46 in his ‘The principles and art of cure by homoeopathy’ says that psora denotes deficiency , sycosis over construction and syphilis destruction . According to him haemorrhages from rectum are signposts of tuberculosis .. The alternation of rectal diseases with heart , chest or lung troubles is characteristic of tubercular patients . In the rectum , strictures , sinuses , fistulas and pockets are all of tubercular origin.

According to Dr. Harimohan Choudhary22 in his book ‘Indications of miasm’ says that psora has the worst form of constipation with no desire for stool and stools are dry , hard and difficult to expel . Syphilis has night aggravation of all its complaints with profuse perspiration. Tubercular miasm is characterized by chronic ulcerative state and bleeding from rectum .

Dr. J .T. Kent36 in his ‘Lectures on homoeopathic philosophy’ says that psora is due to evil thinking and willing , but syphilis and sycosis is due to evil action .

Dr. Subrata Kumar Banerjee52 has included bleeding per rectum as a characteristic of tubercular miasm

Medicinal management
Kent’s repertory35 gives the following rubrics for anal fissure

RECTUM
(i) Fissure
(ii) Pain , stool during
(iii) Pain , stool after
(iv) Pain , burning , fissure in
(v) Pain , burning , stool during
(vi) Pain , burning , stool after
(vii) Pain , cutting , stool during
(viii) Pain , cutting , stool after
(ix) Pain , tearing , stool during
(x) Pain , tearing , stool after
(xi) Haemorrhage , stool , from hard
(xii) Constipation , painful

Drugs used in the treatment of Anal Fissure
As per the various Homoeopathic Repertories and text book on Materia Medica and Therapeutics , the pathology of large number of medicines is found to be corresponding to the clinical picture of anal fissure . The effectiveness of various medicines has been highlighted by eminent Homoeopathic physicians .

J.T.Kent35 has mentioned the following remedies in the Repertory of Homoeopathic Material Medica Rectum , fissure
Cham , Graph , Nit – ac , Rat , Sep , Thuj
Agn , All-c , ars , calc-p , Caust , Cund , Fl-ac , Hydr , Ign , Lach , Merc , Nat- m , Nux-v , Paeon , Petr , Phos , Phyt , Plb , Sil , Sulph
Aesc , Alum , Ant-c , Arg-m , Arum-t , Berb , Calc , Calc-f , Carb-an , Cur , Grat , Kali-c , Med , Merc-i-r , Mez , Mur-ac , Plat , Rhus-t , Syph .

Clark .J.H.20 in his prescriber gives the following medicines for anal fissure
Nit-ac ,Graph , Aescul .hip , Ratanhia

Clark .J.H.21 in his Clinical Repertory to Dictionary of Material Medica mentioned the following drugs for anal fissure
Cep , Iris , Paeon , Pet , Phos , Phyt , Rhus , Sil , Syph , Thuj.

Boger C.M.16 has mentioned the following drugs in A Synoptic Key of Materia Medica
Graph , Ig , Nit-ac
Alum , Caus , Nat-m , Paeo , Rat , Syph , Thu

Boger .C.M.17 In Boenninghausen’s Characteristic and Repertory has given the following drugs under ANUS AND RECTUM fissure of NIT-AC
Alu , Caus , Grap , Nat-m
Cham , Paeon , Sil
Ag-c , Alo , Calc-p , Plb , Thu .

Nash . E.B.41 in Leaders in Homoeopathic Therapeutics projected the following drugs for fissure ani
Graph , Nit . ac , Nat . m

Farrington .E.A27 in his Clinical Materia Medica mentions the following drugs for fissure of the anus
Graph , Nit-ac , Paeon , Ratanhia , Silicea , Thuja

Harris E Ruddock47 in his Ruddock’s Homoeopathic vade mecum suggests the following measures
The bowels must be regulated , copious hot enema being used when necessary , an ointment of Calendula , Hamamelis , or Aesculus applied.

Rai Bahadur Bishambar Das25 has suggested Graph , Sanguinarianit , Paeonia , Silicea , ,Acid nitric , Ratanhia , Alumina , Platina , Thuja , Bereberis and Lachesis in his book ‘Select Your Remedy’

Dr Frederik Schroyens50 has given the following drugs in repertorium homoeopathicum – Syntheticum

Graph , Cham , Nit.ac , Rat , Sep , Thuj
Agn , All.c , Ars , Calc.p , Caust , Cund.cur , Hydr , Ign , Lach , Merc , Nat.mur , Nux.v , Paeon , Petr , Phos , Phyt , Plb , Sil , Sulph
Aesc , Aloe , Alum , Anac , Androc , Ant.c , Arg.met , Ars.s.f. , Arum.t , Berb , Calc , Calc.f , Carb.an , Carc , Led , Med , Merc.i.r , Mez , Mur.ac , Pip.n , Plat , Rhus.t , Sulph , V.a.b

Dr Robin Murphy40 in his Homoeopathic Medical Repertory mentions the following drugs in addition to that mentioned in Kent’s repertory
Aloe , carb-v
Anac , apis , arg-m , cimx , ham , iris , kali-I , led , morph , sang-n , sanic , vib .

Dr S.R.Pathak43 in his “Concise Repertory of Homoeopathic Medicines” gives the following medicines for anal fissure
GRAPH , NIT.AC
Ign , Rat , Thuj
Caust , Cham , Nat.mur , Paeon , Sep , Sil , Syph

Cowperthwaithe A.C.19 in his “Text book of Materia Medica and Therapeutics” gives the following medicines for anal fissure   Hydras , Ign , Graph , Nit.ac , Merc .

Hoynes S. Temple34 in his “Clinical Therapeutics” mentions the following medicines for anal fissure
Caust , hep , nit-ac , rhus , sep

William D Gentry38 in his Concordance Repertory of the Materia Medica vol (3) suggests the following medicines for anal fissure
Mez , Nit.ac , Paeon , Plb
Pain in anus more while walking: Caust
Pain of anus with periodical , profuse bleeding piles:Rhus.tox
With sharp cutting pain during stool: Graph

Jahr GHG31 in his Therapeutic Guide of 40 years practice gives the following suggestion in treatment of anal fissure
Sulph , Ign , Calc , Silic , Sep , Nux.vom and Merc.

Raue CG48 in his “Special Pathology and Diagnosis with Therapeutic Hints” gives the following drugs for anal fissure
Aloe , Alum , Arum.t , Coloc , Graph , Ign , Nit.ac , Nux.v , Paeon ,
Plat , Rat , Rhus.t and Silicea

Otto Lesser42 in his “Text book of Homoeopathic Materia Medica” suggests Acid nitricum , Calc-flour , Graphites and petroleum as important remedies in anal fissure

Samuel Lilianthal39 has mentioned the following drugs under anal fissure
Aesc . hip , Berb , Calc.phos , Caust , Flour.ac , Graph , Grat , Hydr , Ign , Lach ,Nat.mur , Nux.vom , Paeonia , Petr , Phos , Plat , Plumb , Ratrn , Ledum , Sep , Sil , Sulph , Sulph.ac , Rhus.tox and Thuja .

William Boericke and W.A.Dewey54 in “Twelve Tissue Remedies of Schussler” suggests the following drugs for anal fissure    Silica ,Calc-phos , Nat-mur and Calc-flour

Richard Hughes33 in his “Principles and Practice of Homoeopathy” suggests Nitric acid , Ignatia , Aesculus , Sedum acre and Ratanhia in treatment of anal fissure

Calvin B knerr37 in his “Repertory of Hering’s Guiding Symptoms of Our Materia Medica” gives the following remedies
Agn , All.c , Caust , Hydr , Ign , Nat.m , Paeon , Petr , Phos , Plb , Sil , Sulph
Cund , Graph , Nit.ac , Rat , Sep , Syph
Aesc , Berb , Calc.p , Fl.ac , Grat , Lach , Mez , Nux.v , Plat , Thuj

William Boericke24 in his “Pocket Manual of Homoeopathic Materia Medica and Repertory” suggests the following medicines in the treatment of anal fissure
Aesc , Agn , Aloe , Apis , Arg-n , Ars , Calc-fl , Carbo-veg , Caust , Cimex , Condur , Graph , Ham , Hydr , Ign , Iris , Kali-iod , Lach , Led , Merc-d , Merc , Morph , Mur-ac , Nat-m , Nit-ac , Nit-mur-ac , Paeonia , Petrol , Phos , Phyt , Plat , Plumb , Ratanh , Rhus-t , Sang-n , Sanic , Sedum , Sep , Sil , Sulph , Syph , Thuya , Vib-op

W.A.Dewey55 in Practical Homoeopathic Therapeutics gives following remedies
Graph , Nit-acid , Paeonia , silicea
Ratanhia , Sang –nit , Platina , ,Krameria .

Shingal51 in his Quick Bed side Prescriber suggests the following medicines for anal fissure
Graph , Nit-ac , Nat , Paeon , Platina , Ledum and Petroleum

N. M. Choudhari23 in his book “A study on Materia Medica” gives the following remedies
Agn , All.c , Carb.v , Caust , Cham , Cund , Fl.ac , Graph , Hydr , Ign Lach , Merc , Nat.m , Nit.ac , Nux.vom , Paeon , Petr , Phos , Phyt , Plb , Rat , Sep , Sil , Sulph and Thuja

Edwin.A.Neatby26 in his book “A Manual of Homoeopathic Therapeutics” suggests Nit.ac ,Graph , Caust and silicea as remedies for anal fissure.

Joseph Laurie30 in his book “An Epitome of Homoeopathic Domestic Medicine” gives the following remedies for anal fissure    Ars , Hydr , Nit.ac , Nux.vom , Aesc , Aloes and Plb

Alexander Blackwood15 in his book “ A Manual of Materia Medica, Therapeutics and Pharmacology ” suggests the following remedies for anal fissure
Acid.Nit , Graph , Kali.arsen , Krameria , Nat.mur , Paeonia.off and Petroleum

Alexander Blackwood14 in his book “ The food tract , its ailments and disease of the peritoneum” gives the following remedies for anal fissure
Aesculus , Ratanhia , Nitric.acid , Graphites and Nat.mur

In his book “ The A B C Manual of Materia Medica and Therapeutics” G.Hardy Clark29 suggests the following measures for anal fissure - Apply pure ichthyol , clean with antiseptic ointment and saturated solution of potassium permanganate.

Banerjee.N.K.13 in “ Realistic Materia Medica with Therapeutic Repertory gives the following remedies for anal fissure
Aesc , Graph , Lach , Nit.ac , Paeon , Ratan , Sil ,Thuj

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