RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA BANGALORE

ANNEXURE – II

APPLICATION FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 Name Of The Candidate And Address

Dr. AKANSHA SINGH P.G. STUDENT,DEPARTMENT OF REPERTORY,HKE’S HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, SEDAM ROAD GULBARGA- 585105

2 Name of the institution

HKE’s Homoeopathic Medical College And Hospital. Sedam Road Gulbarga – 585105

3 Course of study MD(Homoeo) Repertory4 Date of

admission to the course

20-10-2011

5 Title of the topic

Application of Allen’s fever and BBCR in treatment of ‘TYPHOID FEVER’.

6 Brief resume of the intended work

6.1 Need for the study

Typhoid or enteric fever is a

condition in which there is an insidious fever, a typical course of temperature, marked abdominal symptoms.

Typhoid fever is most prevalent in developing countries where sanitary water and sewage systems are lacking. Persons with typhoid fever usually have a sustained fever as high as 103° to 104° F (39° to 40° C).

The disease remains an important public health problem in developing countries in 2000, it was estimated that over 2.16 million episodes of typhoid occurring worldwide, resulting in 2,16,000 deaths and that more than 90% of this morbidity and mortality occurred in

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Asia.

Here are statistics of the comparative mortality in TYPHOID in one homoeopathic hospital & 2 allopathic hospitals, in homoeopathic hospital typhoid cases treated 305 among those died 22 so the mortality rate is 7.2%. It is in compare with two Allopathic hospitals,

i) Melbourne hospital where typhoid cases treated 431 among died 78 so the mortality rate is 18.1%.

ii) Alfred hospital where typhoid cases treated 324 among died 50 so the mortality rate is 15.4% (Refer-5).

Homoeopathy view microorganisms not as the cause for disease but rather as opportunist invaders to an already weakened body. The disease diagnosis is important but in homoeopathy, the cause of disease is not just probed to the level of bacteria and viruses.

Homoeopathic medicine stimulates

the natural healing power of the body and the illness is driven outward and thrown off. Homoeopathy is well known for the treatment of chronic illness. But even acute cases show quick response without side effects. Modern medical system treats typhoid fever through a long course of antibiotics taking several weeks. Homoeopathic treatment is usually very effective and prompt in treating typhoid fever. Homoeopathic remedy selected according to the symptoms does not take too long in curing the typhoid fever completely.

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Boger’s Boenninghausen’s Characteristic Repertory is the latest among the three well known repertories in use, the other two being, THERAPEUTIC POCKET BOOK and KENT’S REPERTORY. There is a separate FEVER CHAPTER in this repertory. This is a unique work of Boger. From the practical point of view, this chapter is of immense use. So, I selected this repertory for my study.

Allen’s repertory is one of the frequently used repertory to find out the similimum in the treatment of Typhoid fever. Hence here is an attempt.

6.2 Review of literature

1) ALLEN H.C THERAPEUTICS OF

FEVER Typhoid, typhus and continued fever

There is perhaps no disease the homoeopathic physician is called to face, that has received more patient investigation, more care taking scientific research than typhoid fever and it’s allied infections. Future investigation will increase our knowledge and broaden our views of the pathology of typhoid, but the quick sands of an imperfect ever changing pathology can never be the basis for the safe practice or a stable therapeutics. This is corroborated by the fact that notwithstanding the discovery of pathological lesions the mortality under the practice of dominant school remains unchanged. The law of similars point to be the better way, a natural method of cure and an unequal success is to those who follow it, not to those who simply believe in it, but to those obey it’s every mandate.

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2) ALLEN.H.C THERAPEUTICS OF FEVER.

TYPHOID: Acet.ac., Anth., Apis,

Arn., Ars., Bap., Bry., Carbo v., Carb.ac., Coc., Crot., Elaps, Gels., Ham., Lach., Lyco., Mur. Ac., Naja., Nit.ac., Op., Phos.ac., Phos., Psor., pyr., Rhus., Sec., Sil., Stram., Sul., Sul.ac., Tar., Ter., Tub., Zinc.

3) A.P.I. TEXT BOOK OF MEDICINE.

The classical syndrome of enteric fever is an acute illness that presents with fever, headache, abdominal symptoms, splenomegaly and leucopenia. It is an acute generalized bacterial invasion and multiplication within the mononuclear phagocytic cells of liver, spleen, lymph nodes, payer’s patches, and the gall bladder caused chiefly by salmonella typhi organisms. Salmonella typhi persists mostly in developing nation’s where sanitation is generally poor. Sporadic outbreaks occur in developed nations also, but most of the individuals with typhoid fever in such areas have recently returned from travel to an endemic region.

4) BOGER BOENNINGHAUSEN’S CHARACTERISTICS REPERTORY.

Typhoid fever: Aco., arg., arn., Ars., Bap., Bell., BRY., calc-c., cam., carb-v., cham., chin., cocl., cup., hell., Hyo., kali-c., kali-n., Lach., lyc., Merc., merc-c., mez., MUR-AC., nat-mur., nit-ac., nux-m., Nux-v., Op., pho., Pho-ac., pul., RHUS-T., Stra., Sul., sul-ac., tarx., terb., ver-a.

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slow type, febris nervosa lenta: Ars., bell., cam., chin., cocl., con., cup., dig., fer., hell., hyo., ign., iod., merc., merc-c., nux-v., PHO., PHO-AC., SEP., stan., stap., ver-a. pituitous type: Alu., ars., Asar., bell., bor., bry., CALC-C., cham., Chin., cina., dig., Dul., grap., hyo., Ign., ip., lyc., Merc., merc-c., mez., Nux-v., par., PHO., PUL., rhe., Rhus-t., sele., seng., sep., spi., stan., SUL., sul-ac., THU., zin.

5) CLARKE .J.H HOMOEOPATHY EXPLAINED.

In the book “HOMOEOPATHY EXPLAINED” by J.H.Clarke M.D. In the Homoeopathic world of July 1889, are given the comparative statistics of the treatment of an epidemic which visited Melbourne, Australia. The following is a list of the cases treated at three hospitals; two of them are allopathic hospitals, with the number of death and percentage in each case. They are taken from the Melbourne herald of APRIL 29TH 1889. Here are statistics of the comparative mortality in TYPHOID in homoeopathic hospital, typhoid cases treated 305 among those died 22 so the mortality rate is 7.2%. It is in compare with two Allopathic hospitals,

i) Melbourne hospital where typhoid cases treated 431 among died 78 so the mortality rate is 18.1%.

ii) Alfred hospital where typhoid cases treated 324

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among died 50 so the mortality rate is 15.4%.

It is observed that the homoeopathic hospital, with much smaller accommodation than the others, was able to treat nearly as many as cases, the reason being that the patients were got well in a much shorter time.

6) HARRISON’S INTERNAL MEDICINE. Typhoid fever is a systematic

disease characterized by fever and abdominal pain and caused by dissemination of Salmonella Typhi. The disease was initially called typhoid fever because of its clinical similarity to typhus. However in early 1800’s, typhoid fever was clearly defined pathologically as a unique illness on the basis of its association with enlarged payer’s patches and mesenteric lymph nodes. In 1869, given the anatomic site of infection, the term enteric fever was proposed as an alternative designation to distinguish typhoid fever from typhus.

7) KENT.J.T LECTURES ON HOMOEOPATHIC MATERIA MEDICA.

A) BAPTISIA: Baptisia is suitable for acute diseases. It is principally a short acting remedy. Suitable for complaints that are not long lasting. All of its acute diseases and complaints have the appearance of zymosis, like scarlet fever, diphtheria, typhoid, gangrenous complaints.

B) BRYONIA: In rheumatic

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complaints, in pneumonia, and in typhoid conditions, when he is aroused from this stage of stupefaction he is confused sees images, “thinks he is always from home and wants to be taken home”. Sometimes he will lie and say nothing but that he “wants to go home”. The delirium is of a low type.

C) HYOSCYMUS: Finally, in typhoid state, after he has progressed some time, he passes into quite a profound stupor. Early in the case he can be roused, and he answers questions correctly, and he seems to know what you have said to him; but the instant he finishes the last answer he appears to be sound asleep. Then you shake him and ask him another question, he answers that, and again he is sound asleep. The delirium that belongs to typhoid grows more and more profound, more and more passive, more and more muttering, until he passes into a complete unconsciousness from which he cannot be roused.

D) LACHESIS: “Most extraordinary loquacity, Making speeches in very selective phrases, but jumping off to most heterogeneous subjects”. One word often leads to midst of another story. These stories may come on in acute diseases like typhoid, when it will take the usual typhoid delirium.

E) PYROGEN: In cases of typhoid where there is the confusion like that found in Baptisia and the heart is too intense for that remedy, Pyrogen should always be

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considered. When the temperature reaches 106 and there is great soreness and aching this remedy will make great changes in a single day; but the pains are ameliorated by motion and heat it will abort the fever.

8) LILIENTHAL SAMUEL

HOMOEOPATHIC THERAPEUTICS. TYPHOID FEVER

A) Arnica: At an early stage diarrhea of offensive gushing stools and apathy and stupefaction, weakness weariness and bruised sensation , general sinking of vitality, compelling the patient to lie down, and still he asserts that he feels perfectly well; forgets the words while speaking and goes to sleep while answering questions; desires constantly on account of general soreness, to move or to be moved about, as everything upon he lies seems too hard; irritable and angry, wants to be let alone, fear of being touched; involuntary stool and urine , brown or white diarrhea, with distension of abdomen before and rumbling in abdomen during stool; head hot rest of the body cool, stupor and petechiae.

B) Baptisia : First stage of typhoid or septic fever with predominance of nervous symptoms; face flushed, dusky red or hot with a besotted expression, dullness and confusion of mind; chilliness and soreness of body with intolerance of pressure on lying; chilly all day

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and hot at night; tongue dry and brown down centre; pulse full and rapid, restless, tosses about the bed with illusion that he is double, or that he is scattered and tries to get himself together again; all discharges and exhalations exceedingly offensive. Blood is decomposed from high temperature and sepsis.

C) Belladonna: In the beginning, during the stage of irritation by the typhoid poison, furious delirium with screaming out and violent efforts to escape from bed and house; face more often bright than deep red; full of fear; frightful visions and dreams disturb sleep; tongue red, hot, dry, papillae inflamed and much swollen; speech difficult and stammering.

D) Hyoscymus: Advanced stage of typhoid fever; profound stupor, when aroused answers correctly; patient, as it were, lives an inward life, full of delusions and hallucinations; unconscious of the outside world; delirium continues while awake and sees and converses with persons who are not and were not present; thirst only wanting during chill; high fever, thermometer 104, with cool face and cold extremities.

E) Rhus tox: Whenever an acute disease takes on a typhoid form. Mild temperament. Excitement and over activity in the functions of vegetative life, and simultaneous depression in functions of animal life; desire for frequent and constant movement, giving temporary relief; chills, vertigo with

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closing eyelids, altered color of face, dryness of throat, vomiting of food, tendency to mild delirium

9) FEVER – MEDICAL INFO SERIES JOURNAL

CONTINUOUS FEVER: Temperature remains above normal throughout the day and does not fluctuate more than 1 C in 24 hours.

EX: Lobar pneumonia, Typhoid,

Urinary tract infection, Brucellosis. Typhoid fever may show a

specific fever pattern, with a slow stepwise increase and a high plateau.

10) INTERNET :

All systems of holistic medicine view microorganisms not as the cause for disease but rather as opportunist invaders to an already weakened body. Hence the first priority for maintaining health is always to strengthen and balance of organism as much as possible.

Typhoid fever, also known as Salmonella typhi or commonly just typhoid, is a common worldwide illness, transmitted by the ingestion of food or water contaminated with the feces of an infected person.

The organism is a Gram-negative short bacillus that is motile due to its peritrichous flagella. The bacterium grows best at 37 °C/99 °F – human body temperature.

EPIDEMOLOGY: With an estimated 16-33 million cases of annually resulting in endemic areas. The WHO identifies typhoid as a

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serious public health problem. Its incidence is highest in children and young adults between 5 and 19 years old.

INCIDENCE: •Endemic •Endemic •Sporadic cases

HOMOEOPATHIC TREATMENT: i) BAPTISIAii) RHUSTOXiii) BRYONIAiv) ARNICA.

6.3 Objective of the study 1. To evaluate a group of homoeopathic

remedies in the treatment of Typhoid fever.

2. Application of H.C.Allen’s (THE THERAPEUTICS OF FEVER) and BOGER.C.M BOENNINGHAUSEN’S CHARACTERISTICS REPERTORY in the treatment of Typhoid fever.

7 Materials and methods

7.1 Sources of data Subject will be collected from1. H.K.E’s Homoeopathic Medical College,

Hospital (OPD and IPD).7.2 Method of

collection of data including sampling procedure if any

Including sampling procedure if any.

1. By interrogation of individual case.2. By physical examination of the patient.3. By laboratory investigations.4. Sampling size 30 cases are to be studied.5. Sampling procedure: samples collected

using simple random sampling technique.6. Statistical data analyzed by X2 test (chi

square test).

Inclusive criteria fixed for the study11

The subjects will be selected irrespective of age, sex, socioeconomic status & occupation.

All the patient suffering from Typhoid fever is selected for study.

Exclusive criteria fixed for the study Cases of infants and pregnant women are

excluded. Cases having complication of typhoid

fever are excluded such as intestinal haemorrhage, colocystitis, cardiovascular complications and intestinal perforation.

Duration of the study 01-05-2012 to 30-04-2014

7.3 Does the study require any investigations or intervention to be conducted on patients or other humans or animals?If so please describe briefly

The study requires the following investigations to be conducted on patients. 1) Blood – (a) Hb% (b) CBC. (c) ESR. (d) Widal test .

7.4 Whether ethical clearance has been obtained from your institution in case of 7.3

Yes, ethical clearance has been obtained from our institution.

8 List of references 1. ALLEN H.C. THERAPEUTICS OF

FEVER.B.JAIN PUBLISHERS PVT. LTD. NEW DELHI.REPRINT EDITION 2001.PAGE NO-30.

2. ALLEN.H.C THERAPEUTICS OF FEVER.

B.JAIN PUBLISHERS PVT LTD. NEW DELHI. REPRINT EDITION-2001.

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PAGE NO-393.

3. A.P.I. TEXT BOOK OF MEDICINE. PUBLISHED BY: THE ASSOCIATION OF PHYSICIANS OF INDIA. MUMBAI, 8TH EDITION: 2008.VOL-1.

PAGE NO-57.

4. BOGER BOENNINGHAUSEN’S CHARACTERISTIC REPERTORY.BJAIN PUBLISHERS(P) LTD NEW DELHI.

REPRINT EDITION-2001. PAGE NO-1005.

5. CLARKE J.H., HOMOEOPATHY EXPLAINED.CHAPTER XX.SOME COMPARATIVE STATISTICS.B.JAIN PUBLISHERS, NEW DELHI.

PAGE NO:-159-160.

6. HARRISON’S, PRINCIPLES OF INTERNAL MEDICINE.MC GRAW HILL MEDICALNEW DELHI 17TH EDITION: 2008. VOL-1.

PAGE NO- 957.

7. KENT.J.T. LECTURES ON MATERIA MEDICA.INDIAN BOOKS AND PERIODICALS PUBLISHERS.NEW DELHI.INDIAN EDITION.

PAGE NO-174, 241, 531,624, 814.

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8. LILIENTHAL SAMUEL HOMOEOPATHIC THERAPEUTICS.INDIAN BOOKS AND PERIODICAL PUBLISHERS NEW DELHI.REPRINT EDITION: APR-2004.PAGE NO-437.

9. FEVER-MEDICAL INFO SERIES. BAKSONS HOMOEOPATHY. VOL-V.

JAN-APR-2011. PAGE NO-1.

11. INTERNET(WEBSITE) www.isnare.com/.typhoidfever

DATE: 25/02/2012.

9 Signature of the candidate

10 Remarks of the guide

11 Name and designation of(in block letters)

11.1 Guide Dr. S. KRISHNA M.D. [Homoeo]Prof. and H.O.D. Department of Repertory, H.K.E’s Homoeopathic Medical College & Hospital, Gulbarga

11.2 Signature

11.3 Co-guide (if any)

11.4 Signature

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11.5 Head of the department

Dr. S. KRISHNA M.D. [Homoeo]Prof. and H.O.D. Department of Repertory, H.K.E’s Homoeopathic Medical College & Hospital, Gulbarga

11.6 Signature

12 12.1 Remarks of the chairman and principal

12.2 Signature

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