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1
HOMOEOPATHIC MANAGEMENT OF ANXIETY
DISORDERS WITH THE HELP OF REPERTORIES
A Dissertation submitted to the
BABA FARID UNIVERSITY OF HEALTH SCIENCES,
FARIDKOT, PUNJAB.
In partial fulfillment of regulations for the award of
Degree Of
DOCTOR OF MEDICINE (HOM.) In
HOMOEOPATHIC REPERTORY
Submitted by
DUSHYANT KAMAL DHARI M.D.(HOM.) EXT. STUDENT
SESSION 2004-2006
Under the able guidance of Dr. V.C. ACHARYA
M.D (Homoeo.)
SRI GURUNANAK DEV HOMOEOPATHIC MEDICAL
COLLEGE & HOSPITAL,
CANAL ROAD, BAREWAL, LUDHIANA. (PUNJAB)
Declaration
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I, Dushyant Kamal Dhari, student of MD (HOM) in
Homoeopathic Repertory of Sri Guru Nanak Dev Homoeopathic
Medical College and Hospital, Canal road, Barewal, Ludhiana
affiliated to Baba Farid University of Health Sciences, Faridkot
hereby declare that the dissertation entitled “ Homoeopathic
Management of Anxiety Disorders with the help of Repertories”
submitted by me is not submitted fully or partially, for the award
of any other Degree or Diploma in this or any other University by
me or copied from any other dissertation work.
I make this statement with the best of my knowledge and ability.
Date: Dushyant Kamal Dhari Place: Jammu. A student of M.D. (HOM)
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ACKNOWLEDGEMENT
It gives me immense pleasure to offer my thanks with gratitude to the following dignitaries who have provided valuable guidance and support, without which this stupendous task would not have come to its proper conclusion. In the first place, my special thanks are due to my revered and honorable guide Dr. V.C. Acharya for his sincere and constant guidance, sharp perceptual scientific suggestions, encouragement and important modifications of my efforts, which enabled me to accomplish this work. Without his supervision and close guidance this work would not have completed. I am indebted to him. I would like to offer thanks full of obligations to Dr. Tejinder pal Singh, Director and Dr. S.C. Chambyal, Principal SGND Homoeopathic Medical college and Hospital, Ludhiana for their special guidance. My thanks are also due to the management, Co-ordinator and the college staff for their gracious cooperation and facilities in college. Thanks with gratitude from the core of my heart are due to my dear parents and friends for providing me all kinds of support. My special thanks are due to my dearest wife Dr. Ranjana Gupta for her moral support & inspiration this degree. She was a valuable support in my good and bad times. I am grateful to little master Ojas, my only son, who was very co-operative with me during my P.G. Course. A work of this level could not have been completed without the blessings from God. Date Dushyant Kamal Dhari. Place: Jammu
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INDEX
TOPICS PAGES INTRODUCTION 1 - 3 AIMS AND OBJECTIVES 4 - 4 REVIEW OF LITERATURE 5 - 148
History & evolution of mental disorders 5 - 6
Anxiety general 7 - 12
Physiology of anxiety 13 - 22
Psychodynamic theories of anxiety 23 - 29
Behavioural & Cognitive theories of anxiety 30 - 32
Anxiety in modern medicine Gen 32 - 33
Panic disorder 34 - 37
Phobic disorders 37 - 39
Obsessive compulsive disorders 39 - 41
Generalised Anxiety disorder 41 - 43
Post traumatic stress disorder 43 - 45
Co-morbid depression 45 - 46
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Anxiety disorders in Homoeopathy 46 - 68
Anxiety in repertory general 68 - 73
Kent’s repertory 74 - 77
Anxiety rubrics in Kent’s repertory 77 - 109
Boenninghausen`s repertory 109 - 114
Anxiety rubrics in BBCR 114 - 130
Anxiety rubrics in other repertories 130 - 148 MATERIALS AND METHODS 149 - 161 CASES 162 - 202 DATA ANALYSIS 203 - 208 DISCUSSION 209 - 211 CONCLUSIONS 212 - 212 BIBILIOGRAPHY 213 - 215 APPENDIX
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INTRODUCTION
Anxiety has been derived from french word ‘anxieté’. It means ‘the
state of feeling nervous or worried that something bad is going to
happen.’
The Oxford handbook of psychiatry defines anxiety as “A normal and
adaptive response to stress and danger which is pathological if
prolonged, severe or out of keeping with the real threat of the external
situation. It has two components: psychic anxiety, which is an affect,
characterised by increased arousal, apprehension, sense of
vulnerability and unpleasant emotional state; and somatic anxiety, in
which there are bodily sensations of palpitations, sweating, dyspnoea,
pallor and abdominal discomfort.”
Anxiety is the most common psychiatric symptom in clinical practice
and anxiety disorders are the commonest disorders found in 15 to 20
percent of patients. These are more common in industrially advanced
countries. Anxiety disorders have harmful effects upon physical and
mental health. They also impair functional ability and quality of life.
The causes of anxiety in modern life are uncertainty, insecurity, time
pressures, relationship problems and fears of inadequacy.
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HOLISTIC APPROACH
The modern medicine lacks a holistic approach in its treatment for the
anxiety disorders. In spite of various advances, the medicines for
anxiety in modern medicine are not curative in nature. A risk of
dependency is also associated with them.
The mind and body work harmoniously in health and in disease. Both
of them are considered as a unit in the treatment of diseases.
Homoeopathy is a holistic science and has a psychosomatic approach
in all diseases. This holistic approach of Homoeopathy gives it an
edge in the treatment of affections of the mind. In the Organon of
medicine, mental diseases are classified and their treatment is
described in detail from aphorism 210 to aphorism 230. Hahnemann
was the first to advocate unchaining of the mental patients. He also
wrote in detail about the psychotherapy for such patients.
The study of anxiety through homoeopathic perspective No one can deny the role of emotions as causative modalities in the
origin and maintenance of innumerable diseases. The provings on
healthy human beings has yielded all kinds of emotions that are
recorded in materia medica.
Anxiety falls in the emotional sphere of mind. In homoeopathy, the
symptoms of emotional sphere are of great importance. While
evaluating the symptoms, they are considered after the “will”
symptoms for the selection of remedy.
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Repertory, as an index to the vast materia medica, helps to narrow
down to the similimum more accurately.
Thus, the importance of the “emotional” symptoms in homoeopathy
and the abundance of “anxiety” patients prompted me to take up
“anxiety disorders” as a topic for my dissertation.
In this attempt of mine, I want to highlight the role of repertories in
particular in the management of anxiety disorders. This study on
anxiety disorders will enlighten me in upgrading my knowledge in the
subjects of materia medica, repertory, clinical medicine and overall
management of anxiety cases.
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AIMS and OBJECTIVES
1. To understand anxiety in detail.
2. To manage anxiety with the help of
Repertory.
3. To prove the utility of Repertory in the
management of anxiety.
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History and evolution of mental disorders
Ancient world – Era of superstitions In ancient times, mental patients were considered to be in possession
of evil spirits. The treatment for possession was exorcism, or the
removal of evil through counter-magic. These practices still prevail in
many parts of the world including India and western countries.
India Atharva-veda has the oldest written documentation about mental
disorders. It describes three mental gunas i.e. Sattva, Rajas & Tamas.
Different psychological disorders are believed to occur due to excess
of Tamas guna. Detailed description & treatment of various disorders
such as Manastap (anxiety), Bhaya (fear), etc. are found in it.
Bhagavad-Gita is probably the first recorded evidence of crisis
intervention psychotherapy.
Greece In ancient Greece (800 B.C), abnormal behaviour was intercepted as
punishment for offences against gods. The treatment took place in
temples of Asclepius, the God of healing.
Hippocrates (460 - 377 B.C.) stressed that mental disorders were
caused by brain dysfunction. He described epilepsy and concluded
that it was due to diseased brain.
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Plato (427 - 347 B.C) saw behaviour as a product of totality of
psychological processes. He believed that disturbed behaviour grew
out of conflicts between emotion and reason.
Galen (130 - 200 A.D.), a Greek physician, taught that psychological
characteristics were expressions of bodily processes influenced by a
balance of the four humors - blood, black bile, yellow bile & phlegm.
The Middle ages During the middle age, contrasting views of mental illness existed.
Saint Augustine (354 - 430 A.D), laid the basis for modern
psychodynamic theories of abnormal behaviour. He wrote about
feelings, mental anguish and human conflict.
The Renaissance Johann Weyer (1525 - 1588), a German physician, emphasised
psychological conflicts and disturbed interpersonal relationships as
causes of mental disorders. He argued for clinical treatment for the
mentally ill rather than religious harassment.
William Cullen coined the term ‘neurosis’ in 1777 replacing, ‘illness
of nerves’ and meaning any disease of the nervous system without a
known organic basis.
Sigmund Freud (1856 - 1939) propounded that psychological factors
played an important role in the causation of mental disorders. He also
highlighted the role of social and cultural factors in causing mental
disorders.
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ANXIETY IN GENERAL
Anxiety Anxiety is a common emotion and often a normal response to new,
stressful, or potentially dangerous situations. In its mild forms, it may
be adaptive. It helps one to perform better. A little anxiety, for
example helps a student to prepare for his exams. In its extreme
forms, it is incapacitating or terrifying. It may cause the same student
to lose his concentration, or even his voice.
Anxiety becomes a problem only when it is abnormally severe,
abnormally prolonged, or if it is present at a level out of proportion to
the real threat of the situation.
Anxiety often arises in anticipation of danger rather than after a
situation has occurred. It is a signal of the approach of danger and a
warning to prepare our defenses. It can also indicate an inability to
cope with danger.
Anxiety is an extremely unpleasant feeling – it can make people feel
frightened, uneasy, unhappy and sometimes desperate. Anxiety
symptoms vary widely and may even imitate severe physical or
mental illness. These symptoms may affect on physical level, thoughts
and emotions and the lifestyle of the individual affected.
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The Physical Symptoms of Anxiety Anxiety may present on physical level as:
Breathing difficulties. Feeling faint / dizzy. Dry mouth.
Shakiness. Pounding heart. Muscle aches & pains.
Headaches. Excessive sweating. ‘Lumps’ in throat.
Bowel and urinary problems. Persistent tiredness
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In addition to these, body postures such as crossed arms, crossed
legs, clenched fists, clenched jaw with tight facial muscles, head bent,
rapid and shallow breathing, frowning / staring expression, and
stooped posture also present a picture of anxiety.
Anxiety Posture
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On the mental level:
Fear of variety of things, people or situations.
Negative or unreasonable ideas about themselves or the feared
situation.
Increased episodes of crying, being irritable, difficult concentration,
worrying and feeling guilty.
Two main reasons for persistent anxiety are avoidance of feared
situations and faulty thinking.
Avoidance: We may avoid situations which we know will cause us
anxiety. As the symptoms caused in a particular situation are
uncomfortable, we avoid facing it, but each time we avoid a situation,
its tendency to cause anxiety in us increases.
Faulty thinking: It includes our negative thoughts and irrational
beliefs. The negative thoughts make us expect the worst, while the
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irrational beliefs, make us expect too much from others or ourselves.
So that leaves us prone to constant disappointment.
The Anxiety trap The lifestyle may be seriously affected by a tendency to avoid
situations or escaping them wherever possible. This involves a lots of
‘NOTS’ and ‘CANT’S’ which make a happy and fulfilled existence
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impossible and leads to a poor quality of life. It also affects
relationships and work performances.
FIGHT \ FLIGHT RESPONSE
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PHYSIOLOGY OF ANXIETY Historical Development Descartes saw the mind & body as different units and noticed the
direct effect of emotions on the body reactions. He proposed that
pineal body was the main mediating centre between the body and the
soul.
The Cannon-Baird theory named thalamus as the centre initiating
emotional reactions. It was held responsible for receiving sensory
information. It also communicated with cortex & body organs to bring
about behavioural changes. Cannon also described the characteristic
‘fight / flight’ stress reaction and the role of sympathetic nervous
system in it. The modern basis of emotional expression in the biology of the brain
began with the work of the American neuroanatomist James Papez.
Papez described an "ensemble of structures" in the lower, subcortical
areas of the brain (as the hypothalamus, the hippocampus and the
amygdala) or the limbic system as brain sites associated with
emotion. He emphasized the role of hypothalamus rather than
thalamus as control centre in initiating emotional response.
Recent evidence highlights the role of genetic influences in the
causation of anxiety disorders. Studies have shown that the prevalence
of anxiety and related disorders is higher among the relatives of
affected subjects than among control families.
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THE BRAIN AND ANXIETY
Recent studies suggest that three brain sites are responsible for
regulating anxiety, i.e. prefrontal area of cortex, amygdala and
hypothalamus in sub cortex.
▪ The higher brain or cortex is responsible for:
Identifying and interpreting stressors and Initiating / coordinating the
voluntary action.
▪ The lower brain or sub cortex is responsible for:
Beginning and controlling states of physiological excitement and for
involuntary homeostatic functions.
When exposed to stress, following processes happen:
▪The cortex first perceives the stressor.
▪The prefrontal cortex is involved in the cognitive evaluation of the
stressor.
▪The subcortical structures are then called into play.
▪The amygdala is responsible for generating the fear response.
▪The hypothalamus regulates the stress response and activates the
autonomic and the endocrine systems. It mediates between these two
systems and is involved with limbic cortex in regulating emotions.
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A cross section of brain.
The Amygdala
The amygdala is believed to serve as a communication hub between
the parts of the brain that process incoming sensory signal and the
parts that interpret them. It signals that a threat is present and triggers
a fear response or anxiety.
Hippocampus
Hippocampus is another brain structure that is responsible for
processing threatening or traumatic stimuli. The hippocampus plays a
key role in the brain by helping to encode information into memories.
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Studies have shown that the hippocampus appears to be smaller in
people who have undergone severe stress because of child abuse or
military combat. This reduced size could help explain why individuals
with PTSD have flashbacks, deficit in clear memory, and fragmented
memory for details of the traumatic event.
The Hypothalamus
The hypothalamus helps the body in controlling body temperature. It
also contains centres involved with hunger and pleasure. Its main
function during stress is to activate and regulate the autonomic and
endocrine systems.
The hypothalamus, on stimulation produces emotional and
behavioural responses, both autonomic and skeletal. Three main
reactions have been observed on experimental stimulation of
hypothalamus. They are Alarm, Flight and Rage.
The two lobes of hypothalamus are concerned with the regulation of
arousal. The anterolateral lobe inhibits sympathetic nervous system
activity and the release of activating hormones from the pituitary. The
posteromedial lobe has the opposite effect.
It has direct links with the pituitary gland, the limbic structures, the
cortex and the thalamus. Neural pathways from hypothalamus also
link it to the brainstem and the spinal cord.
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The Autonomic nervous system and anxiety
It has an important part in instigation and maintenance of appropriate
levels of physiological arousal. It has two main branches –
Sympathetic nervous system (SNS). It is responsible for the ‘stress’
response. During ‘stress’ states, the SNS prepares the individual for
‘fight or flight’ response. The flow of blood from digestive organs is
directed to the fighting muscles and the heart rate increases.
Parasympathetic nervous system (PNS). It is responsible for
‘relaxation’ response. During ‘relaxed’ states, the PNS prepares the
individual for digestion, recuperation and sleep.
The two branches of ANS work partly in concert. While most organs
are under control of both, some sites & symptoms are under the sole
control of SNS, i.e. the sweat glands, lung muscles, blood glucose
levels and the basal metabolic rate. Others, such as the ciliary muscles
of the eye, are under exclusive control of PNS.
Individual responses and ANS
While the SNS is usually predominant during stress, some individuals
may respond to stressors with PNS dominance. It causes a fall in
blood pressure and blood glucose levels. Other symptoms may be cold
sweating, dizziness, reduced respiratory action and fainting.
Lacey proposed that persons do not respond with simple PNS or SNS
dominance under stress. It suggested that individuals might react
strongly on one physiological measure and very little on another.
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The nature of reaction profile might be determined by the total life
experience of the individual as well as genetically determined
physiological factors. Several studies on physiological arousal
patterns in anxiety neurosis have demonstrated consistent sympathetic
hyperactivity.
Anxiety disorders have been correlated with a pattern of raised heart
rate levels, frontalis muscle tension, forearm blood flow, skin
conductance, respiration rates and blood pressure.
Each individual has a base line norm of autonomic arousal, or starting
point. It has been shown that a high baseline norm will lead to a
smaller reaction under stress while a low baseline norm will lead to a
larger reaction.
The Endocrine system and Anxiety This system has an important role in total stress response.
During stress, the ‘master gland’ pituitary is stimulated by
hypothalamus to release several chemical messengers to the slave
glands directly into bloodstream. These include vasopressin,
adrenocorticotrophic hormone (ACTH) and thyrotrophic hormone
(TTH). Vasopressin contracts the arteries and causes the blood
pressure to rise. ACTH and TTH pass on to adrenal and thyroid
glands. They work together to increase circulation and basal metabolic
rates.
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The Adrenal glands
Adrenalin & noradrenalin from medulla and corticoids from cortex
are directly released into blood stream.
Adrenalin stimulates the production of glucose from glycogen in liver.
The glucose is released in blood increasing the carbohydrate
metabolism. It also dilates coronary and skeletal muscle arteries,
increases heart rate, blood volume and body temperature.
Gaseous exchange is facilitated by bronchial dilatation and shallow
breathing results. Smooth (visceral) muscles tend to relax while the
sphincters are constricted. Noradrenalin constricts the peripheral
arterioles and increases blood pressure. It has been suggested that
adrenalin is the major hormone in states of fear while noradrenalin is
predominant in anger. Glucocorticoids from cortex tend to raise blood
sugar levels and inhibit inflammation.
Thyroid gland
Thyrotrophic hormone acts on thyroid causing release of thyroxine.
The rise of thyroxine in stress conditions causes increased sweating,
muscle tremor, heart rate and exaggerated breathing. These effects
are similar to adrenalin. Adrenalin tends to predominate in short term
stress while thyroxine is released in large quantities in prolonged
stress.
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General Adaptation Syndrome
Selye used the term ‘stress’ instead of ‘strain’ in its relation to human
psychophysiology. He coined the term ‘general adaptation
syndrome’ or GAS. GAS has three phases:
Alarm reaction (involving shock and counter shock phases).
Resistance (adaptive response).
Exhaustion.
The Alarm phase: In this phase, mobilization takes place following
the detection of a stressor. The stressor can either be psychological or
physiological in nature. Increase in adrenocortical hormones also
takes place in this phase.
The Resistance phase: It involves selection of an appropriate organ
or system to deal with the particular stressor. Adrenocortical
hormones diminish once a specific system is delegated. All the
internal resources are then directed towards the support of this system,
leaving others susceptible. This may reduce the resistance of the
organism to disease.
The Exhaustion phase: When the system assigned the job becomes
overloaded, the exhaustion phase is reached. At this point, the
adrenocortical hormone levels increase again and the alarm phase is
induced again. A different system may then be delegated to handle the
continuing stress.
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The GAS is useful in mobilising protective resources in emergency
situations. In prolonged situations, it may lower resistance. The
energy for adaptive reaction to stress is provided by suppressing
immune reactions and inflammatory responses to invading pathogens.
It is suggested that the ‘weakest link’ or most vulnerable part of the
body breaks down first under stress. Therefore, factors including
heredity and prior disease may predispose an organism towards a
specific somatic disorder.
Allergies may also be associated with stress. Allergic reactions
involve high levels of inflammatory corticoids for destruction of
pathogens. Under stressful conditions the allergic response may be
aggravated.
Selye based his conclusions on experimental work in which rats were
subjected to prolonged stress. It resulted in drastic body changes
including irreversible organ damage. The rats showed enlargement of
adrenal cortex and atrophy of thymus, spleen and lymph nodes. A
severe reduction of white cells and bleeding ulcers in stomach and
duodenum were observed.
According to Selye, ACTH plays an important role in GAS. In acute
stress, adrenalin and noradrenalin from the adrenal medulla are most
important. In chronic stress the corticoids are the primary agents.
The kidney also plays an important role in GAS, as it is responsible
for maintaining a chemical and water balance in the blood and tissues.
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In chronic stress conditions, when corticoids are raised for a
prolonged period, blood pressure may rise and damage the kidney.
Damage to arteries associated with atherosclerosis may also occur.
Continued stress can produce increased hydrochloride acid secretion
in stomach leading to formation of ulcers.
Selye also added some suggestions on ways of dealing with stress as:
Removal of unnecessary stressors from lifestyle.
Do not allow neutral events to become stressors.
Develop skill in dealing with stressors.
Seek relaxation.
Neurotransmitters and anxiety
The nerve cells communicate with one another with the help of
neurotransmitters. Some of these play a significant role in anxiety and
other psychiatric disorders. Examples of these are noradrenalin,
adrenalin, serotonin, GABA, dopamine, acetylcholine and histamine.
The dysfunction of neurotransmitter activity is the cause of the most
psychiatric disorders. The excessive activity may lead to anxiety and
psychosis while under activity may cause depression.
Recent developments support the view that noradrenalin and serotonin
have a central role in mechanisms underlying anxiety in the central
nervous system.
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PSYCHODYNAMIC THEORIES OF ANXIETY Sigmund Freud is the forerunner of this school of thought. He
defined anxiety as: “a specific state of unpleasure accompanied by
motor discharge along definite pathways.”
Freud postulated that human anxiety is initiated during birth process,
when an infant is expelled from the safe, warm uterine environment
into a potentially dangerous one. This anxiety signal is reproduced in
a modified form, whenever danger recurs, throughout the life.
Defense mechanisms:
According to this theory, anxiety is an indication that something is
disturbing the internal psychological equilibrium. It is a signal to the
ego that an unacceptable drive is pressing for conscious representation
and discharge. This is called signal anxiety. This signal anxiety
arouses the ego to take defensive action to cope up rationally against
the pressures from within.
These defenses serve as disguises through which people hide their
motives and conflicts from themselves as well as from others.
Defenses are used to reduce anxiety arising from ego’s fear of being
completely overwhelmed or destroyed by the power of instincts. Thus
the role of defenses is to preserve the psychological organization and
stability of the individual.
The most important & basic defense is Repression. Ideally, the use of
repression alone should result in restoration of the psychological
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equilibrium. Repression reduces anxiety by keeping anxiety-laden
thoughts and impulses out of person’s consciousness. It is often
described as motivated forgetting. It is directed at both, external
dangers, such as fear arousing events and internal dangers such as
wishes, impulses and emotions that arouse guilt.
If the defenses are successful, the anxiety is dispelled or safely
contained. When repression fails, other secondary defense
mechanisms are called into play. These include denial, displacement,
regression and others. Through these defense mechanisms the drives
achieve a partial expression. This expression is disguised in the
symptoms of hysteria, phobic disorder or obsessive-compulsive
disorder depending on the defense that predominates.
If repression fails to function adequately and secondary defense
mechanisms are not called into play, anxiety is found only as a
symptom. When it rises above the low intensity, characteristic of its
function as a signal, it may emerge with the fury of a panic attack.
Developmental stages Freud believed that people normally progress through the five stages
of psychosexual development. Problems at any stage may retard or
arrest development and have long term effect on the life of the person.
Oral stage:
This is observed during first year of life. The newborn is completely
dependent on others for fulfillment of all his needs. During this stage,
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the body pleasure is centered on the mouth. The baby gets satisfaction
from sucking, eating and biting in the course of feeding.
Anal stage:
It is found in the second year of life. It is characterised by a shift in
body pleasure to the anus. It is reflected by concern with retention and
expulsion of faeces.
Freud felt that during this stage of toilet training, a child has the first
experience with externally imposed control. The pattern of toilet
training may influence the personal qualities and conflicts experienced
by the person in his life. Thus, if a person is subjected to very harsh,
repressive type of training during this period, it may make the person
obsessed with cleanliness during the adult phase.
Phallic stage:
In this stage the child observes the differences between male and
female and experiences what Freud called as Oedipus complex. This
occurs at about five years of age. Freud proposed that children
develop a desire for opposite sex parent and a wish to displace the
same sex parent. This type of attraction leads to serious conflict,
which he termed as Oedipus and Electra complex in boys and girls
respectively. These two complexes were named after two Greek
characters. Oedipus unknowingly killed his father and then married
his mother and Electra induced her brother to kill their mother.
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Latency stage:
This stage follows phallic stage and in this stage there is very little
explicit or overt concern with sexuality. The child represses his or her
memories of infantile sexuality and forbidden sexual activity.
Genital stage:
During this stage the person attains maturity in psychosexual
development. The person becomes capable for genuine love for other
people and can achieve adult sexual satisfaction. He or she may relate
to others in a heterosexual fashion.
The Structure of Personality It refers to a person’s unique and relatively stable qualities that
characterise behaviour patterns across different situations and over a
period of time.
The personality consists of three dynamic structures i.e. Id, Ego and
Superego. They are used as strong psychological forces and not
physical locations in brain.
Id: Desire:
This part of personality deals with immediate gratification of
primitive needs, sexual desires and aggressive impulses. It is totally
unconscious and follows the pleasure principle. Thus, Id seeks the
discharge of tension arising out of biological drives. Its main concern
is ‘need gratification’ in any manner. An infant’s mind is conceived as
all Id.
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Ego: Reason:
It develops out of Id. It works on ‘reality principle’. It tries to
maximise pleasure and minimise pain. The ego emerges in childhood
and is the personality which moderates the desires of Id.
Freud’s concept of dynamic structures of personality.
Super Ego: Conscience:
It deals with the ideals. It represents the societal demands and ideals.
If a person falls short of societal norms & ideals, then superego
creates the feelings of guilt and punishes the person. It provides
judgements on what behaviours are ‘acceptable’ and which are ‘bad’.
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Categories of anxiety
Freud broke down his concept of anxiety into three types: Reality,
Moral and Neurotic anxiety.
All three are involved with the ego’s response to actual, or potential,
helplessness when threatened with overwhelming psychic danger. The
function of ego is of mediation between instinctual demands to ensure
that some gratification is achieved, while still preserving its own
integrity. If such an outcome becomes impossible, pathological
anxiety results.
The reality anxiety is due to real external threat. In this the ego’s aim
is to expedite the gratification of instincts without making the
organism vulnerable to anger, e.g. ‘I must have / do this, but I must
avoid having physical harm in the process’. If the ego is uncertain
how to achieve this aim, fear related anxiety results.
The moral anxiety is due to id-superego conflict. In this the ego’s
aim is to preserve its sense of its own goodness while at the same time
placating the instincts, e.g. ‘If I am good and worthy, I cannot allow
myself to have / do this’. Shame / guilt related anxiety results if ego
fails to meet the moral demands of the superego.
The neurotic anxiety is due to id- ego conflict. In this the ego’s aim
is to protect its own identity and structure while an uncharacteristic
and powerful instinctual drive threatens to overwhelm it, e.g. ‘I long
to have / do this, but I cannot allow myself to perceive that I am the
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one who has/ does this’. Neurotic anxiety results when ego cannot
satisfy these conflicting aims.
Freud writes that, “In some cases the characteristics of reality anxiety
and neurotic anxiety are mingled. The danger is known and real but
the anxiety in regard to it is over-great, greater than seems proper to
us.”
While differentiating neurosis from psychosis, he says that for
neurosis the decisive factor would be the predominance of the
influence of reality, whereas for psychosis, a loss of reality would
necessarily be present.
BEHAVIOURAL AND COGNITIVE THEORIES OF ANXIETY
Behavioural theory John Watson, the father of behaviourism, proposed that neuroses
arouse out of traumatic learning situations and then persist to
influence behaviour throughout life.
‘Stimulus – response’ concept of anxiety, which emerged from this,
posits that certain stimuli when associated with fear could show up an
anxiety response. For e.g. if a dog bites a child, the child will respond
with anxiety the next time he sees a dog. This response will occur
40
even if the dog does not actually bite him again. Thus anxiety has a
protective function here. This anxiety could become a reaction to a
danger signal that was recognised to forebode a harmful situation.
So, anxiety is viewed as an unconditioned inherent response of the
organism to painful or dangerous stimuli. In anxiety and phobias, this
becomes attached to relatively neutral stimuli by conditioning.
Systematic desensitization: The principle of reciprocal inhibition
(i.e. anxiety and relaxation cannot coexist) is the core of this.
Systematic graded exposure to the source of anxiety is coupled with
the use of relaxation techniques (the ‘desensitisation’ component).
Flooding/implosive therapy: The high levels of anxiety cannot be
maintained for long periods, and a process of ‘exhaustion’ occurs. By
exposing the patient to the phobic object and preventing the usual
escape or avoidance, there is extinction of the usual anxiety response.
Anxiety and Cognitive performance
The cognitive model of anxiety postulates that anxious individuals
invariably exaggerate the level of threat in a given situation. So, there
is evidence of selective information processing (with more attention
paid to threat related information), negative automatic thoughts and
perception of decreased control over internal and external stimuli.
Cognitive behavioural modification or CBM developed from this
approach helps in treatment of anxiety resulting from inadequate
41
coping skills. It aims to ‘change the way you feel, by changing the
way you think’.
Anxiety and rational thinking
Albert Ellis developed a treatment technique based on rational
thinking in 1955. Several research studies have confirmed the
relationship between anxiety and negative / irrational thinking.
The RET (Rational emotive therapy) belief holds that individual’s
own thoughts and beliefs about difficulties create negative emotions
as anxiety. The individual’s reaction towards a situation is based on
his set of beliefs and attitudes. So, the patients are taught to identify,
challenge, and change their irrational beliefs which maintain and
justify their anxiety. After all, anxiety, by definition is not attributable
to sources of real danger and is as such irrational.
ANXIETY IN MODERN MEDICINE Anxiety, defined as a subjective sense of unease, dread, or foreboding,
can indicate a primary psychiatric condition or can be a component of,
or reaction to, a primary medical disease.
Anxiety has two components:
▪ Psychic anxiety – an unpleasant affect in which there is subjective
tension, increased arousal and fearful apprehension; and
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▪ Somatic anxiety – bodily sensations of palpitations, sweating,
dyspnoea, pallor and abdominal discomfort. The sensations of anxiety
are related to autonomic arousal and cognitive appraisal of threat
which are adaptive primitive survival reactions.
The primary anxiety disorders are classified according to their
duration and course and the existence and nature of precipitants.
The national prevalence rates of anxiety disorders in India are 15 per
1000 for rural and 16 per 1000 for the urban population.
When evaluating the anxious patient, the clinician must first establish
whether the anxiety antedates or postdates a medical illness or is due
to a medication side effect.
Anxiety symptoms may be present at a more or less constant level –
generalized anxiety; or may occur only episodically – panic attacks.
Anxiety symptoms may or may not have an identifiable stimulus.
Where a stimulus can be identified it may be very specific, as in
simple phobia (e.g. fear of cats or spider); or may be more
generalised, as in social phobia and agoraphobia. In phobias of all
kinds there is avoidance of the feared situation. As this avoidance is
followed by a reduction in unpleasant symptoms, it is reinforced and
is liable to be repeated.
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The repetition of behaviours in order to achieve reduction in the
experience of anxiety is also seen in the symptoms of obsessions and
compulsions. Here, the patient regards the thoughts (obsessions) and/
or actions (compulsions) as purposeless, but is unable to resist
thinking about them or carrying them out. Resistance to their
performance produces rising anxiety levels, which are diminished by
repeating the resisted behaviour.
PANIC DISORDER:
‘Panic’ derives its meaning from the Greek god ‘Pan’ who was in the
habit of frightening humans and animals ‘out of the blue’.
Panic attack: It is a period of intense fear characterized by a group of
symptoms (given below) that develop rapidly, reach a peak intensity
in about 10 minutes, and generally do not last longer than 20-30 min
(rarely over 1 hr). Attacks may be either spontaneous (‘out of blue’)
or situational (usually where attacks have occurred previously).
Sometimes attacks may occur during sleep (nocturnal panic attacks),
and rarely, physiological symptoms of anxiety may occur without
psychological component (non-fearful panic attacks).
Panic disorder: The recurrent panic attacks, which are not secondary
to substance misuse, medical conditions, or another psychiatric
condition. There are distinct episodes of intense fear and discomfort
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associated with a variety of physical symptoms. The frequency of
occurrence may vary from many attacks a day, to only a few attacks a
year. There is usually the persistent worry of having another attack or
the consequences of attack (which may lead to phobic avoidance of
places or situations) and significant behavioural changes related to
attack.
Epidemiology: In India the prevalence rate of panic disorder in
psychiatry clinics is around 3 %. Panic disorder without agoraphobia
is more or less equal among males and females, but panic disorder
with agoraphobia is more among females. It develops in early
adulthood, the mean age of onset being around 25 years.
Aetiology and Psychopathology:
The exact etiology of panic disorder is unknown but appears to
involve a genetic predisposition, altered autonomic responsivity, and
social learning. Panic disorder has a moderate heritability of around
30 – 40 %. Most studies suggest that vulnerability is genetically
determined, but critical stressors are required to develop clinical
symptoms.
Intravenous infusion of sodium lactate can evoke an attack in about
two-thirds of the panic disorder patients, as do yohimbine and carbon
dioxide inhalation.
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Neuroanatomical model of aetiology suggests that panic attacks are
mediated by ‘fear network’ in brain that involves the amygdale, the
hypothalamus and the brain stem centres.
Psychoanalytic model suggests that panic attacks are the
consequences of parental deprivation in early childhood.
Clinical features:
The diagnosis of panic disorder is based on the following criteria:-
A separate period of intense fear or discomfort in which four (or
more) of the following symptoms are developed abruptly and reach
the peak within 10 minutes (in order of frequency of occurrence):
1. Palpitations, pounding heart, or accelerated heart rate.
2. Sweating. 3. Trembling or shaking.
4. Sense of shortness of breath or smothering.
5. Feeling of choking. 6. Chest pain or discomfort
.7. Nausea or abdominal discomfort.
8. Feeling dizzy, unsteady, light-headed, or faint.
9. Derealisation (feelings of unreality) or depersonalization (being
detached from oneself).
10. Fear of losing control or going crazy. 11. Fear of dying.
12. Paresthesia (numbness or tingling sensations).
13. Chills or hot flushes.
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In some individuals, anticipatory anxiety develops over time and
results in a generalized fear and a progressive avoidance of places or
situations in which a panic attack might recur.
Researches suggest that individuals with panic disorder had a
significantly higher rate of supporting gastrointestinal symptoms,
including those typically associated with irritable bowel syndrome,
than those with other or no psychiatric diagnosis.
Differential Diagnosis:
A wide variety of conditions can present as panic disorder.
a. Substance or alcohol misuse / withdrawal.
b. Mood disorders/other psychiatric disorders secondary to medical
conditions.
C.Medical conditions presenting with similar conditions e.g.
hyperthyroidism, hypoglycaemia, anaemia, mitral valve prolapse,
atrial tachycardia, coronary heart disease, epilepsy, asthma etc. PHOBIC DISORDERS:
A phobia is a marked and persistent fear resulting in conscious
avoidance of a specific feared object, activity or a situation. The
patient avoids the phobic stimulus, and this avoidance usually impairs
his occupational or social functioning. The affected individual is
aware that the experienced fear is excessive and unreasonable to the
given circumstances, but cannot help it
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Agoraphobia is the fear of public places; the patient tries his best to
avoid such places or situations where escape may be difficult. The
patient avoids crowds, public places, traveling away from home or
alone. Agoraphobia is usually associated with panic disorder, but
there exists a subgroup without panic disorder.
Social phobia is the specific fear of social or performance situations
in which the individual is exposed to unfamiliar individuals or to
possible examination and evaluation by others. This is different from
agoraphobia where the patient is not bothered about the reaction of
other people. Examples include having to converse at a party, use
public restrooms, and meet strangers.
Simple phobias are specific phobias not covered by social phobia and
agoraphobia. It is further sub-divided into five types: animals, aspects
of natural environment, blood/ injection/ injury, situational and
‘other’. Common examples of simple phobia are fear of heights, fear
of closed spaces (claustrophobia), fear of flying, fear of animals, fear
of lightning and thunderstorm, fear of darkness, fear of blood, fear of
crossing streets, etc.
Aetiology and Psychopathology:
Both genetic and environmental factors play a role in the aetiology.
According to psychoanalysis school, phobias are the result of
traumatic experiences in childhood such as separation anxiety
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(separation from mother) and unconscious conflict, which has been
repressed and displaced into phobic symptoms. The unconscious
anxiety is displaced to a neutral object or activity or situation.
Clinical Manifestations:
Onset is typically in childhood to early adulthood. The cardinal feature
of phobic disorders is severe anxiety when the patient is exposed to
specific object or situation or activity. Both mental and somatic
symptoms of anxiety are present.
To prevent the onset of anxiety, the patient avoids these objects or
situations or activities. Most of the patients are able to live normal
lives in spite of the phobic disorder because the phobic object or
situation or activity is easily avoidable, but this avoidance usually
impairs occupational or social functioning.
Panic attacks may be triggered by the phobic stimulus or may emerge
spontaneously during the course of the illness. To get relief from
anxiety, the patient may resort to abuse of alcohol or drugs. He may
also develop features of depression. OBSESSIVE-COMPULSIVE DISORDER (OCD)
Obsessions are persistent, recurring ideas accompanied by a
subjective feeling of compulsion which the patient tries to resist but
cannot get rid of.
Compulsions are irresistible urges to carry out irrational activities.
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The patient knows about the irrationality of these obsessions and
compulsions, but cannot prevent them. When he tries, the emotional
tension mounts and he becomes miserable and exhausted.
These obsessions and compulsions restrict the social activities and
interpersonal relationships of the patient.
Epidemiology:
About 1 % of the patients attending a psychiatry clinic may have this
disorder. The peak age of onset is around early adulthood, and both
males and females are equally affected.
Aetiology and Psychopathology:
Though some genetic or constitutional factors may be involved in
production of an obsessive type of personality, environmental factors
are of primary importance in the causation of the symptoms. It often
has a sudden onset (e.g. after stressful ‘loss’ event).
According to psychoanalysis school, patients with obsessive
compulsive disorder have a disturbed development commonly around
the anal phase of psychosexual development. Anxiety associated with
sexuality is displaced to neutral ideas or acts.
Neuroimaging studies have demonstrated a decrease in caudate
nucleus volume and abnormalities in frontal lobe white matter. The
caudate nucleus seems particularly involved in the acquisition and
maintenance of habit and skill learning.
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Clinical Manifestations:
Patients with obsessive compulsive disorder usually have a particular
type of personality which is characterized by ritualistic, rigid,
perfectionist and meticulous tendencies. Patients often conceal their
symptoms, usually because they are embarrassed by the content of
their thoughts or the nature of their actions. Specific questions
regarding recurrent thoughts and behaviors are to be asked,
particularly if physical clues such as chafed and reddened hands or
patchy hair loss (from repetitive hair pulling) are present. Tics are
sometimes associated with OCD.
In all cases, obsessive-compulsive behaviors take up more than 1 hour
per day & are undertaken to relieve the anxiety triggered by the core
fear.
There are four major symptom patterns.
▪Most common one is an obsession of contamination followed by
washing.
▪Second most common is obsession of doubt followed by a
compulsion of checking.
▪Third form is one with merely intrusive obsessive thoughts without a
compulsion. Such obsessions are usually repetitious thoughts of some
sexual or aggressive act that is reprehensible to the patient.
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▪Fourthly, there is obsessional slowness in which the obsession and
compulsion seem to be united into slow carrying out of daily
activities. Such patients can take hours in bathing, eating, shaving etc.
Most of the patients show features of depression because of the
inconvenience and embarrassment caused by the symptoms. The
patient realizes that the above symptoms are irrational, but cannot
prevent them. GENERALISED ANXIETY DISORDER (GAD)
This is a chronic (longer than 6 months) disorder characterized by
excessive anxiety and worry about various life circumstances. Patients
who have generalized anxiety disorder are pathologically anxious
about everything. They are generally mistrustful of their own general
level of competence and basic merit. They have a low threshold for
anxiety and find it difficult to handle even the normal anxiety-
provoking situations.
Epidemiology:
It is estimated that about 2 % of the general population suffer from
generalized anxiety disorder. Onset is usually before age 20, the peak
age group is 20-25 years. A history of childhood fears and social
inhibition may be present. Women are more prone.
Aetiology and Psychopathology:
52
Though there may be genetic predisposition to develop this disorder,
environmental factors are more important in the aetiology of GAD.
Emotional conflicts in early childhood interfere with normal
development of personality, especially when there is genetic
predisposition. When this abnormal personality is confronted with the
everyday stresses of life, the defense mechanisms which are used to
anxiety normally become inadequate and fail.
Clinical features:
Patients with generalized anxiety disorder have persistent, excessive,
and/or unrealistic worry associated with other signs and symptoms,
which commonly include muscle tension, impaired concentration,
autonomic arousal, feeling "on edge" or restless, and sleep
disturbances. Patients with GAD readily admit to worrying
excessively over minor matters with clinically significant distress or
impairment in social, occupational or other areas of functioning.
The common symptoms are palpitation, trembling / shaking, excessive
sweating, and dryness of mouth, breathlessness, chest pain, abdominal
pain, headache, and heaviness of head, dizziness and unsteadiness,
frequency of micturition, diarrhoea and disturbances of sleep.
Other general symptoms include hot flushes / cold chills; numbness or
tingling sensations.
Common Signs are: Elevation of blood pressure, tachycardia,
increased respiratory rate and sweating etc.
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A person with GAD has tense, anxious, apprehensive appearance.
Increased muscular tension is shown in his facial expression, and it
produces tremors and aches in various parts of the body. He is
irritable, forgetful, and complains of tiredness and lack of
concentration. The person finds it difficult to control the worry.
Differential diagnosis:
Thyrotoxicosis has to be ruled out. Thyroid swelling, exophthalmia,
and abnormal thyroid function tests suggest thyrotoxicosis.
Cold and moist hands are common in GAD in contrast to warm and
moist hands in thyrotoxicosis. POST TRAUMATIC STRESS DISORDER (PTSD)
This condition develops in persons who have experienced extremely
traumatic emotional or physical stress with either actual or threatened
death or injury to oneself or another. Such traumas include combat
experience, natural catastrophes such as earthquake, rape, and
disasters such as fires in buildings. In World War 1, the syndrome was
called ‘shell shock’. Similar features were observed in survivors of
Nazi concentration camps & atomic bombings of Japan in the Second
World War.
Epidemiology:
More than 50 % of the survivors of a disaster can develop PTSD.
Women are more vulnerable. Though it can occur in any age group, it
is most prevalent in young adults.
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Aetiology:
Many factors can precipitate this disorder. The most important one is
the stressor. The other factor is the personality characteristics of high
neuroticism and extroversion of the subject. The third factor is social
support. When there is strong social support, an individual may not
break down even when there is major stress.
Risk factors include a past or family history of psychiatric problems,
low education and previous traumatic events (including childhood
experiences).
Clinical Manifestations:
There is a triad of symptoms in this disorder. These are:
Re-experiencing of the trauma through dreams and waking thoughts.
Emotional numbing to other life experiences
Associated features of autonomic instability, depressive ideas, poor
concentration and panic attacks.
These disturbances cause clinically significant distress or impairment
in social, occupational, or other areas of functioning.
These above symptoms have to be present for at least one month for a
diagnosis of PTSD to be made.
Patients often actively avoid stimuli that precipitate recollections of
the trauma and demonstrate a resulting increase in vigilance, arousal,
and startle response. Patients with stress disorders are at increased risk
for the development of other anxiety, mood and substance-related
disorders
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ANXIETY DISORDERS COMORBID WITH DEPRESSION
Anxiety is closely related to depression. In a clinical situation, the
symptoms are often difficult to differentiate. In a meta-analysis, the
prevalence of anxiety disorder in patients with depression has been
estimated at 57 %. A new diagnostic category – ‘mixed anxiety-
depression’ is being proposed for further study.
Anxiety far more commonly precedes depression than vice versa and
that particular episodes of depression may begin with anxiety
symptoms. Social anxiety disorder and simple phobia are more likely
to precede depression. The comorbidity of depression and anxiety has
been associated with more severe symptoms and worse prognosis.
A classical theoretical distinction is that anxiety is associated with
‘helplessness’ while depression is characterised by ‘hopelessness’.
Also uncertainty about the ability to control important outcomes may
be associated with anxiety, whereas helplessness together with
certainty about negative outcome may be associated with depression.
Furthermore, anxiety disorders are characterized by anxiety / fears
about future events and avoidant behaviour, whereas depression
involves loss of pleasure and thoughts about past events.
Anxiety involves an attentional bias for threatening information. Thus,
when given both threatening & non-threatening cues, anxious patients
attend selectively to threatening cues. On the other hand, depression
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involves a memory bias, with depressed subjects showing bias to
recall negative information, particularly when it is self referential.
ANXIETY DISORDERS AND HOMOEOPATHY Mental health is a growing area of concern in our society and times. It
needs to be understood and treated on an individual level. Every
person is unique and has his life story full of joys, disappointments,
and vicissitudes of life in some shape or form.
Homoeopathy is defined as a system of drug-therapeutics based on the
law of similars. This law states that ‘a drug, acts as a curative agent
when it is capable of producing in a healthy person a diseased-state
exactly similar to that observed in a diseased person.’ As drug
provings show that the actions of a drug manifest themselves on the
body and the mind. So that, in every fully proved drug picture, there
are corporeal symptoms along with alterations of thoughts, feelings,
affections and intellect, memory etc.
The successful application of law of similars depends upon the
concept of individualization and susceptible constitutions. The
concept of individualization takes into consideration the total response
of the organism to the unfavorable environment.
This unfavorable response is seen through signs and symptoms on
three planes: Emotional, Intellectual and Physical, where the life
force manifests itself.
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On this emotional level arise anxiety, anger, anguish, irritability, fears,
phobias, depression and many emotions.
Emotionally disturbed states tend to revolve around the issues of
personal comfort, personal survival and personal expression.
Emotions as maintaining causes
When a patient has some harmful emotions, these emotions may act as
maintaining causes for illness. The homoeopathic medicines boost the
energy of a person to adapt with the energy of his own emotions and
as a result to cope with varying types of environments.
The physician is the best person for this because the patient can talk
freely with the physician. Also the physician can better understand the
emotional problems and co-relate them better with the physical
problems. The physician also has to evaluate that whether the anxiety
is reasonable to circumstances or the patient is over-anxious.
General treatment of mental diseases
During Hahnemann`s time, mental asylums were usually run in
connection with prisons. The mentally ill were crowded in close
quarters with insufficient food, were chained, flogged and teased for
the amusement of visitors. The physicians also abandoned them
believing that insanity was contagious.
Hahnemann founded an asylum in Georgenthal where Duke Ernst of
Gotha put one of the wings of his castle at Hahnemann`s disposal in
1792. He had only one patient Klockenbring from the beginning to the
end. Klockenbring was cured of his illness. Hahnemann evolved a
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humane approach to mentally sick patients. He advocated unchaining
of the mental patients. His principles for treatment of insane were new
to the psychiatry of that time, but are today universally acknowledged
as the chief factor in the treatment of insane. He introduced treatment
to the mentally sick patient with kindness.
While describing his experience on the treatment of insane, he writes
– “I never allow any insane person to be punished by blows or other
painful corporeal inflictions, since there can be no punishment where
there is no sense of responsibility, and since such patients only
deserve our pity and cannot be improved, but must be rendered worse
by such rough treatment.”
He further instructs the physicians attending the mental patients as –
“The physician of such unfortunate creatures ought to behave so as to
inspire them with respect and at the same time with confidence; he
should never feel offended at what they do, for an irrational person
can give no offence. The exhibition of their unreasonable anger
should only excite his sympathy and stimulate his philanthropy to
relieve their sad condition.”
Ahead of times, as Hahnemann was, he has coded some ethical
approach to mental patients, which he describes in § 228 of the
Organon.
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Herein, in addition to Antipsoric treatment, he stresses upon
psychotherapy with regulated mode of life and instructions for a good
behaviour towards the patients by physician and attendants as:
▪ Raving madness should be met by calm fearlessness & firm
resolution.
▪ Painfully disconsolate melancholy should be assuaged by silent
compassion expressed through gestures and looks.
▪ Loquacity should be listened to in silence.
▪ Indecent behaviour and obscene languages are to be totally ignored.
▪ In destructive mental tendencies, things should be kept out of reach
of the patient to prevent mischief.
▪ Absolute avoidance of torture and other corporeal punishments.
▪ All exciting factors, which may influence the mind of the patient,
should be removed.
▪ Contradiction, arguments, rude correction etc. are to be avoided.
▪ The physician and the attendant should pretend to believe the patient
in everything.
In the footnote to § 229, Hahnemann also recommends that the
treatment of violent insane maniac and melancholic patients can take
place only in an institution specially arranged for their treatment, but
not within the family circle of the patient. He believed that the patient
must be left alone and must not be excited or distracted by other
people; as this hindered his recovery.
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Hahnemann on mental diseases
Hahnemann describes mental diseases under One-sided diseases.
In §172 he writes, “A similar difficulty in the way of cure occurs from
the symptoms of the disease being too few – a circumstance that
deserves our careful attention, for by its removal almost all the
difficulties that can lie in the way of this most perfect of all possible
modes of treatment (except that its apparatus of known homoeopathic
medicines is still incomplete) are removed.”
Mental diseases are one-sided diseases affecting the whole
psychosomatic entity where the symptoms of derangement of mind
and disposition are increased while the physical symptoms decline.
§ 210- 230
The § 210 to 230 of the Organon describe in detail different types of
mental diseases and their treatment.
In §210, he attributes Psora as the cause of one-sided diseases and
mental diseases are also a part of it. He stresses for psychic condition
of the patient to be noted along with the totality of symptoms in order
to treat these successfully with homoeopathic medicines.
In § 211, he stresses the importance of the psychic condition of the
patient in selection of a remedy, putting them as characteristic
symptoms and these cannot remain hidden from a careful physician.
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In § 212, he highlights the fact that medicinal substances alter the
mind and disposition of the provers during its proving and every
medicine does so in a different manner.
In § 213, he advises to pay attention to mental symptoms even in
acute cases and that unless the mental and emotional picture does not
match with the remedy, positive results are not possible.
He explains this in the footnote of § 213 as “Thus Aconite will
seldom or never effect either a rapid or permanent cure in a patient of
a quiet, calm, equable disposition; and just as little will Nux vomica
be serviceable where the disposition is mild and phlegmatic, Pulsatilla
where it is happy, gay and obstinate, or Ignatia where it is
imperturbable and disposed neither to be frightened nor vexed.”
In § 214, he starts to tell us that a patient with a mental-emotional
disease must be perceived the same way as other patients i.e. with a
remedy, a disease agent capable of producing in body and psyche of
healthy people symptoms as similar as possible as those of the case.
In § 215, he specifies that most mental and emotional diseases are
extensions of physical disease. So in the mental disease it starts on the
physical level, and then slowly it progresses into the mental level until
you have almost no more symptoms of the physical level and finally
the disease transfers itself (almost like a local malady) to the invisibly
subtle mental and emotional organs.
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CLASSIFICATION OF MENTAL DISEASES: -
Hahnemann has arranged mental diseases into following four types: -
1. Mental diseases appearing with the decline of corporeal disease
which threatens to be fatal --- Somato - Psychic.
Hahnemann refers this type of mental disease in § 216.
In this type of diseases there is quick and dramatic transference of
physical disease, becoming mental disease. In this type of mental
disease, the so-called physical disease declines with a rapid increase
of the psychic symptoms.
Finally, the physical symptoms become insignificant and improve
almost to perfect health and the person is no more in the danger of
death.
So in this way, the physicals or the affections of grosser corporeal
organs become transferred to the spiritual, mental and emotional
organs.
Examples: - A suppuration of lungs gets transferred into insanity.
2. Mental diseases appearing suddenly as an acute disease in
patient’s ordinary calm state caused by some exciting factor: -
Hahnemann refers to this type of mental disease in § 221. In this type
of diseases, an insanity or frenzy that suddenly breaks out as an acute
disease from the patient's usually quiet state may be occasioned by
fright, vexation, drinking alcohol, etc., but it almost without exception
springs from internal Psora.
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He further says that during acute phases deep acting remedies are not
needed but mainly the remedy that corresponds to the acute picture
only. So, it must first be treated with medicines such as Aconite,
Belladonna, Stramonium, Hyoscyamus, etc. in a high potency. This
will control the acute flare-up to such an extent that the Psora returns
to its previous, almost latent state, whereupon the patient appears to
recover.
3. Mental diseases of doubtful origin: -
Hahnemann refers to this type in § 224.
In this he refers to certain type of mental diseases where it is difficult
to ascertain the cause of them. It is not sure here whether these
diseases are from physical affections or some psychological factors.
Various causes proposed by Hahnemann are fault of education, bad
practices, and corrupt morals, neglect of mind, superstition or
ignorance.
4. Mental diseases arising from prolonged emotional causes –
Psycho-Somatic: -
Hahnemann refers this type to § 225.
In comparison with the first type of diseases, there are few emotional
diseases that have not developed from physical diseases. These
diseases originate from emotional causes such as: Persistent anxiety,
worry, vexation, abuse, frequent fear and fright. This is in contrast to
the first type. In this the body is little affected in the beginning but as
the disease progresses, it affects the physical health to a great degree.
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While Hahnemann did not make a difference between psychosis and
neurosis, he differentiated between physical disease extending into
mental disease or Somato-psychic disease and a psychological
condition extending into physical disease or Psycho-somatic disease.
TREATMENT OF MENTAL DISEASES: -
Hahnemann had no other aim in sight except to cure. He challenged
the theories of the treatment of disease of his time.
He taught us that the remedies should be chosen according to the
symptoms of the patient and that physician should always be governed
by what is certain and safe, not by that which is more or less uncertain
and unsafe.
He further instructs that because a remedy has helped us before this is
no reason why it should help again in a similar disease i.e. the
symptoms of the patient and not the name of the disease are to point
out the remedy. He, as an experimenter laid the foundation for a
scientific medicine which had no scope for speculations and opinions.
A. Mental diseases arising from physical diseases: -
In the § 217, 218, 219 & 220 Hahnemann describes the treatment for
these mental diseases.
In § 217, he stresses that totality of the case should be taken into
consideration with importance being given to the mental and
emotional symptoms.
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Sometimes, in a mental disease, it could be a very strong physical
symptom that will be your chief symptom to find the remedy. That is
why a complete case is needed, to match a remedy on the physical as
well as mental and emotional levels.
He further guides in § 218 about the evolution of disease from
physical to mental level, to be studied. For this, the accurate
description of the entire phenomenon of the previous corporeal
diseases before it degenerated into a one-sided mental disorder should
be learned from the patient’s attendants.
In § 219, the remaining symptoms of the physical plane or the
physical symptoms present during the remission of mental / emotional
state are to be used to complete the physical picture of the disease.
In § 220, Hahnemann recommends that the physician should
accurately observe the present mental and emotional symptoms of the
patient and attendant’s observations are added to it. In this way, the
complete picture of the disease is constructed. The medicine is
selected on the above basis and it should be a strong Antipsoric
remedy.
B. Mental diseases appearing suddenly: -
These cases should be firstly treated acute medicines such as Aconite,
Belladonna, Hyoscyamus and Stramonium in potentised form that
have similar states in their proving.
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In § 222, he emphasizes that after the acute state has subsided, these
patients should never be regarded as cured. It should be followed up
by anti-psoric treatment in order to prevent its recurrence.
In § 223, he warns that if this Antipsoric treatment is not done, then a
worse attack from a much slighter cause is bound to follow and this
will be more difficult to cure.
C. Mental diseases of doubtful origin.
In § 224, Hahnemann provides us with a method of distinguishing the
cause of the disease as follows:
A. If the mental affection is based on psychological causes, it will
diminish and improve by “sensible, friendly exhortations, consolatory
arguments, serious representations and sensible advice.”
B. If the mental malady is dependant on some bodily disease, it would
be aggravated by the same measures. Thus, depressive type of patients
will be still more depressed, plaintive, disconsolate & retiring; the
maniac type would become more embittered; the silly prattler will
become more foolish than ever.
If the cause of mental affection is of psychic origin, then the treatment
should be as per the treatment of Psycho-somatic diseases.
If the cause of mental affection is of bodily origin, then the treatment
is same as per the Somato-psychic diseases.
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D. Mental disease arising from prolonged emotional causes –
Psychosomatic.
In § 226 he describes the treatment for these mental affections which
are of psychic origin. For these he recommends
▪ Psychotherapy. He writes that these types of mental affections may
be rapidly changed into a healthy state of mind by psychical remedies
such as display of confidence, friendly exhortations, and sensible
advice, often with a well disguised deception.
▪ Appropriate diet and regimen ▪ Antipsoric treatment
He also tells us that if the psycho-somatic diseases are not cared for in
its milder form then it will progress into serious physical diseases.
In § 227, he again stresses upon Psora being the fundamental cause in
mental diseases and that these patients should be treated with
Antipsorics at the earliest to prevent recurrence.
In § 228, Hahnemann also describes the mode of administration of
homoeopathic medicines. He recommends that medicines are to be
administered to the patient without his knowledge in his drink so that
all compulsion is unnecessary. As the small dose of the medicine does
not upset the taste, it is easy.
In the footnote to § 228, Hahnemann also wonders at the
hardheartedness of contemporary doctors, who, without attempting to
discover the efficacious mode of homoeopathic treatment are content
with cruel some methods of treatment for the mentally sick.
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In § 229, he discusses the importance of psycho-social and physical
environment needed to help the patient to recover. He advocates
removal of all kinds of external disturbing influences on the senses
and dispositions of the patients.
In § 230, he confidently asserts from great experience, the superiority
of homoeopathic system of medicine over other systems and
emphasizes that only through homoeopathy cure of these patients is
possible.
At a time when insanity was believed to contagious & incurable,
Hahnemann was first to assert the curability of mental illness. He
differentiated organic from functional mental illness. He advocated
early treatment of these and with non-violent methods. He inculcated
on the mental symptoms for completing the totality of a case and left
us with numerous remedies that work just as well as they did in his
days.
HOMOEOPATHIC APPROACH TO MENTAL DISEASES:
Homoeopathy considers disease as an affection of both mind and
body. As existence of life is not possible with mind and body
separately, involvement of it is also not possible individually.
Nevertheless, each affection of vital force is manifested by a set of
physical and mental symptoms. Health is considered as a state of
harmony of sensations and functions of both physique and mind.
Even in case of a drug proving, we get series of symptoms in mind
and body. The provings on healthy human beings has yielded
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variegated symptomatology at three levels - physical, mental and
spiritual.
CASE TAKING
Case taking should be more careful in one-sided diseases. In cases of
mental disease, an effort should be made to locate any physical
symptom or involvement of any other part of body.
Some of the physical symptoms may appear quite vague and trivial,
but it is more important to build up the totality. Like, in disease on a
physical plane, any mental symptoms should be given maximum
importance and vice versa.
MIASMS AND ANXIETY DISORDERS
The term miasm comes from the Greek word ‘miasma’, meaning
‘pollution, taint’. In general ‘miasm’ means – a heavy vaporous
exhalation formerly believed to cause disease; obnoxious influence or
atmosphere; polluted material; putrid vegetable matter.
Hahnemann observed that though the acute diseases were rapidly and
completely cured by medicines but chronic diseases always had a
tendency to replace in a more or less varied form with new symptoms.
This he stated as “Its start was pleasing, the continuation less
favorable, and the outcome hopeless.”
After prolonged observations and laborious experimentations for
twelve years (1816 – 1828), he realized the obstacles to cure in the
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chronic diseases. He attributed the origin of all chronic diseases to
chronic Miasms, namely
PSORA – the non – venereal miasm and
SYCOSIS and SYPHILIS – the venereal miasms.
Each miasm produces its own characteristic symptoms on the human
body and these must be recognised to be able to remove them
accordingly.
PSORA – The Universal Miasm
According to Hahnemann, Psora is the only fundamental cause and
producer of all (acute and chronic) diseases of non-venereal nature. It
is the most ancient miasm which produces seven-eights of all chronic
diseases. It is the most infectious of all chronic miasms. This lead him
to declare, “Psora is that most ancient, most universal, and most
destructive and yet most misapprehended chronic miasmatic disease
which for many thousand years has disfigured and tortured
mankind…”
Hahnemann writes in ‘Chronic Diseases’ “-- diseases of the mind and
of the soul, from imbecility up to ecstasy, from melancholy up to
raging insanity – in short, thousands of tedious ailments of humanity
called by pathology by various names, are, with few exceptions, true
descendants of this many-formed Psora alone.”
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He further writes “So great a flood of numberless nervous troubles,
painful ailments – consumptions and cripplings of soul, mind and
body were never seen in ancient times when the Psora mostly
confined itself to its dreadful cutaneous symptoms leprosy. Only
during the last few centuries has mankind been flooded with these
infirmities, owing to causes just mentioned.”
He further makes observations about the disappearance of itch as “It
often disappears through unlucky physical or psychical occurrence,
through a violent fright, through continual vexations, deeply affecting
grief – and the results in such case are just as mischievous as if the
eruption had been driven away externally by the irrational practice of
physician.”
In another foot note he writes, “ I have never either in my practice, nor
in any insane asylum, seen a patient suffering from melancholy,
insanity, or frenzy whose disease did not have Psora as its foundation,
complicated at times, however, though rarely, with syphilis.”
In the Organon also, Hahnemann attributes the cause of all mental
diseases to Psora alone.
Kent writes that, “The miasms that are at the present day upon the
human race are complicated a thousand fold by allopathic treatment.
Every external manifestation of the miasm has in itself a tendency to
straighten mankind, but the human race is being violently damaged
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and diseases are being complicated for the reason that these outward
expressions are forced to disappear by the application of some violent
or stimulating drug.”
According to Ortega - Anxiety is eminently psoric. Its sycotic
equivalent is Fear and has syphilitic color in Panic.
Anxiety is conceived as the outcome of man’s first sensation after
birth, when it abandons the maternal enclosure in which it lives with
practically no effort. When he passes to outside and there he must
work steadily to exist – from oxygenating his blood to taking in food,
digesting it, secreting it, submitting himself to various movements; all
this combined with the aggressiveness of external environment,
stamps on him a feeling of worthlessness, of relative incapacity,
which is translated in anxiety or existential anxiety.
It will be constantly present in our minds, ready to come forth in
various forms, especially if the stimulus is one of the elements which
most profoundly affect the maintenance of that existential insecurity
(an insecurity which we all feel because of the expectation of death
and possibility of harm from many elements around us, including our
fellow human beings), it gives rise to fears: fear of darkness, of being
alone, of ghosts, of people, of evil.
If this existential anxiety grows within us, it becomes Anguish –
which is more destructive and has a markedly syphilitic tinge. But all
these symptoms – Anxiety, Fear and Anguish have a psoric base –
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turning into “Fear” when it has a sycotic admixture, and into
“Anguish” with a syphilitic one. If our fear is externalized and
increases, it then becomes a Panicky terror that has a syphilitic base.
Hering in his foreword to the ‘Chronic Diseases’ writes “Hahnemann
inculcates with so much care the important rule to attend to the moral
symptoms, and to judge of the degree of homoeopathic adaptation,
existing between the remedy and the disease, by the improvement
which takes place in the moral condition and the general well being of
the patient.”
J.P. Gallavardin has exclusively treated psychic symptoms, when
present as a manifestation of latent psychic state or as the symptoms
of an individual temperament. He cites numerous cases wherein
defects of the character and intelligence were cured with the help of
homoeopathic medicines.
He lays down certain conditions essential for the success of psychic
treatment:-
▪ He preferred to use the medicines without the knowledge of the
patient. He felt that the curative effects of the medicine are
developed better in this way.
▪ He advises not to reproach the patients & nor to give them any
advice.
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He further states that these psychic conditions may be some symptoms
of the manifested or latent diseases, or they may be the cause of
stoppage of some development.
Jahr does not promise much hope in chronic mental diseases with a
family history of the same. He advises us to be cautious in promising
too much in these cases. For success in mental and psychical
derangements, he shortlists the following requirements:
▪ Knowledge with physician about the characteristic indications of
remedies.
▪ Use of smallest possible dose.
▪ Exciting cause should be extensively traced & considered.
Farrington also endorses Hahnemann`s views about treatment of
insanity as, “Hahnemann, with his incomparable astuteness, touched
the very keynote, when he bid us treat the insane, as though they were
not insane. By assuming a state harmonizing with that of my patient,
opposing him in nothing, I gained what else might have been
impossible. ”
Kent declares that the symptoms of the mind are the most important
symptoms in a remedy as well in the disease. He stresses the
Hahnemannian thought ‘Mind is the Key to Man’ and advises that the
mind symptoms should not be overlooked.
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Talcott puts forward “The Insane Diathesis” for the conditions
which tend to start and develop mental disorders. He further writes
that, “Mental abnormality is always due to either imperfect or
eccentric physical development, or to effects of inborn or acquired
physical disease, or to injurious impressions, either ante-natal or post-
natal, upon that delicate and intricate physical structure known as
human brain.”
His simple and brief classification of insanity is as follows:-
1. Melancholia, which includes all forms of mental depression.
2. Mania, which includes all forms of mental excitement.
3. Dementia, which includes all forms of mental weakness or failure,
except idiocy and imbecility.
4.General paresis, which is a distinct form of mental disease having
certain characteristics which demand that it shall be classified
separately.
Risquez writes “Emotions guide energy either through the nervous
system, producing feelings, affection, thoughts, etc., or through the
somatic system, producing alterations in the immune system, the
blood circulation, and the hormones: somatic alterations. ”
Edward Whitmont in the introduction to ‘Psyche and Substance’
writes that “while it is certainly true that a hopeless or pessimistic
outlook on life, repressed psychological conflicts and tensions do
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result in organic pathology, and that positive imaging helps in
restoring as well as maintaining health, it is equally true that no one
alive can wholly avoid tension, stress, conflict, repressions,
depressions and disappointment. Indeed, psychological complexes and
crises are building stones of personality. Frustration and repression are
the unavoidable conditions of ego-building no less than approval,
success, satisfaction and joy.”
He further writes that “mental and physical symptoms are largely
interchangeable. Emotional suppression leads to physical disorder;
physical suppression (e.g. menses, lochia etc.) may produce hysterical
and even psychotic states. In psychiatry even the term “conversion”
state is used to denote somatic manifestations of mental or emotional
disturbances.”
Vithoulkas puts people with anxiety as difficult cases. He says, “As
they are excessively anxious about their health – These people tend to
relate a tremendous volume of minute symptoms that cannot be
valued highly by a homoeopath because of these patients tendency to
exaggerate.”
He further writes that symptoms of such patients should be chosen
with caution and perhaps only after confirmation of these by objective
co-workers or relatives.
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Homoeopathic medicines help people attain a calmer state of mind,
greater vitality and better physical health.
Even the word "dis-ease" means (on either mental or physical level)
that the individual is "ill at ease" with himself or some aspect of their
daily life (relationships, their sexuality, family, work etc.).
Usually a trauma or a series of bad life experiences (e.g. a traumatic
childhood, loss, disappointment in love etc.) leave a person with
disturbed thoughts and emotions and for a homoeopath, the mind is
the starting point for all types of health problems (psychological or
physical) of the man.
HOMOEOPATHIC REPERTORY
“All who know how to use a repertory succeed, and not one has
ever discarded it.” – Kent in ‘The language of repertory’
REPERTORY
The word Repertory has originated from Latin word
“REPERTORIUM” which means ‘an inventory; a table or a
compendium, where the contents are so arranged that they are easy to
find’.
Basically, the homoeopathic repertory is an index to the huge mass of
symptoms of various drugs of the Materia medica, the record of
scientific provings, which is reproduced and arranged in a practical
form with relative gradation of medicines to facilitate the quick
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selection of the remedy. Along with Materia medica and Organon it
forms the Triad of Homoeopathy.
Evolution of repertory
Hahnemann in his own life time had become conscious about the need
for suitable index to the growing materia medica. He realized the
limitation of human mind to remember all symptoms and felt the need
for an aid to retrieve the facts. His famous book ‘Fragmenta de
viribus medica mentorum positivis’ published in 1805 contained two
parts. The first part contained symptoms which were observed in the
provers and the second part formed the index or the repertory.
Hahnemann`s pupil, Gross compiled two volumes of a repertory,
which never appeared in print. Another pupil, Ruckert was appointed
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by Hahnemann to compile a repertory. After working hard on it for
eight years, in 1830 he prepared one, but it was not found up to the
mark. Thereafter Hahnemann employed Jahr for compiling a
repertory. Jahr`s repertory was finally published in 1835 in German
language. It was in three volumes.
In 1832, Boenninghausen published a ’Repertory of Antipsoric
medicines’ with a preface by Hahnemann. This repertory of 256 pages
became a foundation stone for all later repertories. Though
technically, Hahnemann was the first repertorian, the credit of
publishing the first repertory goes to Boenninghausen and he is called
as the “Father of repertory”.
Purpose of repertory
H.A. Roberts says that a repertory has two definite purposes:
● To serve as a reference and guide in looking up a particular
symptom that may indicate the similimum or that may make the
necessary distinction between two or more similar remedies in any
given case.
● For careful study of all the symptoms that may appear in a chronic
case.
He also adds that the repertory is not meant for use in those cases
where there are clear indications for the similimum. In these cases, it
might be used in the manner of a quick reference, to verify the leading
indications for the remedy, or if some slight doubt were felt, to
differentiate between those seemingly indicated.
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According to P. Schmidt, “No one can know everything and this is
why in all honesty one must admit that no conscientious
homoeopathic doctor can practice homoeopathy in a serious and really
scientific way without a repertory.”
Kent writes in ‘How to use the repertory’ that, ‘the use of repertory in
homoeopathic practice is a necessity if one is to do careful work. Our
materia medica is so cumbersome without a repertory that the best
prescriber must meet with only indifferent results.’
He advises us as,” The physician must read over and over the rubrics
in the repertory in order to learn what is in it and how symptoms are
expressed.”
Value of Repertory
The value of any repertory depends upon several elements:
▪ The art of the physician in taking the case.
▪ The knowledge of the repertory one attempts to use and
▪ Intelligent use of the resulting analysis.
The aim of repertory is not to replace the materia medica but to help
in narrowing down to the similimum. It is like a bridge link between
the materia medica and the case.
TYPES OF REPERTORIES
Repertories are divided into two main groups:
1. Traditional or the book form 2. Mechanical.
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1. Traditional or the book form is further subdivided into A. General repertories. B. Particular repertories.
A. General Repertories consist of following types: ● Repertories according to Hahnemannian anatomical schema. ▪ Concordance e.g. Knerr`s repertory; Gentry’s repertory ▪ Systematic e.g. Kent’s repertory; Boenninghausen`s repertory; Synthesis; Complete repertory. ● Alphabetical ▪ Section wise e.g. Murphy’s repertory ▪ Rubric wise e.g. Phatak`s repertory.
B. Regional (Particular)
● Disease wise e.g. Bell’s diarrhoea; Allen’s intermittent fever;
Robert’s Rheumatic medicines.
● Part wise e.g. Berridge`s Eye; Minton’s uterine; Hering`s analytical
repertory of mind; Synthetic repertory.
2. Mechanical repertories.
● Card repertories e.g. Field’s cards; Kishore cards; Sharma’s card
repertory.
● Softwares e.g. Radar; Hompath; Cara; Organum etc.
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Value of symptoms
The homoeopathic materia medica has pathology of its own. The
symptoms which the pathologist would exclude as accidental and
meaningless are usually the symptoms which decide the choice of the
homoeopathic remedy. It actually has a vital relation to the case.
Limitations of Repertory:
Repertory provides us with hints about the probable remedy. It leads
us to a group of remedies of which the similimum is to be found with
the help of materia medica, the final authority. It is only in the materia
medica that we will find the exact description of what our patient is
telling us.
No repertory is complete. With growing clinical experiences, new
drugs and remedy confirmations, the materia medica is expanding.
This growth of materia medica is not being updated into the repertory
at that pace, so the repertory is not complete.
Boenninghausen warns us about this in his article, “Warning,
namely, the selection of the right remedy” as he writes, “for this
purpose he should not content himself with the repertories that have
been prepared, a very frequent carelessness, for these books contain
only slight hints as to one or the other remedy that might be selected,
but can never take the place of the careful reading up of the fountain
sources.”
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KENT`S REPERTORY
History Dr Kent’s masterpiece “A repertory of homoeopathic material
medica” better known as Kent’s repertory is a literature which is
popular in homoeopathic system for over 100 years. Dr
Boenninghausen is the one who initiated repertory as a system of
logical concept while Kent put in strength, vigor & vitality to this
system.
J.T. Kent used Lippe`s repertory for a number of years but was not
satisfied with the rubrics and the number of medicines used. Kent was
a great advocate of the use of important generals and individualization
in the treatment of patients. So, he took up the task of producing an
exhaustive repertory.
Taking Lippe`s plan as its base, he expanded it by adding clinical
symptoms which he had recorded. The clinical symptoms which were
consistent with the provings were added, while those which were
contradictory to the provings were rejected. His repertory was first
published in 1897.
Philosophy
Kent believed that Hahnemannian totality demanded study of man as
a whole and puts it as, ‘If we believe an organ is sick and alone
constitutes the disease, we must feel that if we could remove the organ
we would cure the patient.” He further continues this as “The organs
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are not the man. The man is prior to organs. The man is the will and
understanding, and the house which he lives in, is his body.” Kent
advised beginners as, “Treat the patient and not the disease.” He
explains this as, “the symptom that is seldom found in a given disease
is one not peculiar to the disease, but peculiar to the patient.” These
peculiarities must be looked into for the individualization of the
patient. Kent laid much emphasis on the importance of generals. His
repertory is based on the principle of Generals to Particulars. So,
mental generals followed by physical generals including modalities
forms the basis of repertorisation by Kent’s repertory.
Arrangement of Chapters:
Kent’s repertory is divided into 37 chapters. The arrangement of
chapters is on the anatomical schema with certain exceptions such as
Mind, Vertigo, Vision, Hearing, Stool, etc.
The chapters are as follows:
1. Mind. 19. Kidneys.
2. Vertigo. 20. Prostate Gland.
3. Head. 21. Urethra.
4. Eyes. 22. Urine.
5. Vision. 23. Genitalia Male.
6. Ear 24. Genitalia Female.
7. Hearing 25. Larynx and Trachea.
8. Nose 26. Respiration.
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9. Face 27. Cough.
10. Mouth. 28. Expectoration.
11. Teeth. 29. Chest.
12. Throat 30. Back.
13. External Throat. 31. Extremities.
14. Stomach 32. Sleep.
15. Abdomen 33. Chill
16. Rectum. 34. Fever.
17. Stool 35. Perspiration
18. Bladder. 36. Skin.
37. Generalities.
Under each chapter, the symptoms are arranged in the following
order:
1. Location.
2. Sensations in general, unmodified or having modalities.
3. Sides of body or organs.
4. Time modalities.
5. Other modalities arranged alphabetically.
6. Extension of sensation etc. from the specified location to other
areas, arranged alphabetically.
In Kent’s repertory, Anxiety as a rubric under the section Mind is
given on page 4. The main rubric of anxiety is followed by 205 sub
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rubrics. It has 203 drugs in the main rubric of which 37 drugs are in
first grade, 89 drugs in 2nd grade and 77 drugs are in 3rd grade.
In addition to this, there are 36 more remedies found in the sub-
rubrics that are not found in the main rubric of Anxiety.
In mind section more rubrics of anxiety are found under main rubrics
of Cautious, Delirium, Indifference, Laughing, Restlessness, Starting
and Talking in sleep. Anxiety is quoted as a cross-reference in rubrics
Fear & Horror.
REPERTORIAL REFERENCES IN KENT`S REPERTORY SYMPTOMS
MIND – ABSENTMINDED
MIND - ABSORBED, buried in thought
MIND - ABSORBED, buried in thought, as to what would become of him
MIND - ANGER - ailments after anger with anxiety
MIND - ANGER - ailments after anger with fright
MIND - ANGUISH
MIND - ANGUISH - daytime
MIND - ANGUISH - daytime - 5 a.m. to 5 p.m.
MIND - ANGUISH - morning
MIND - ANGUISH - forenoon
MIND - ANGUISH - evening
MIND - ANGUISH - night
MIND - ANGUISH - night - 4 a.m.
MIND - ANGUISH - chill, during
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MIND - ANGUISH - driving from place to place
MIND - ANGUISH - eating, while
MIND - ANGUISH - heat, during
MIND - ANGUISH - menses, before
MIND - ANGUISH - menses, during
MIND - ANGUISH - open air amel.
MIND - ANGUISH - perspiration, during
MIND - ANGUISH - stool, before
MIND - ANGUISH - stool, during
MIND - ANGUISH - walking in open air
MIND - ANTICIPATION, complaints from
MIND - ANXIETY
MIND - ANXIETY - daytime
MIND - ANXIETY - daytime - 5 a.m. to 5 p.m.
MIND - ANXIETY - morning
MIND - ANXIETY - morning - rising, on
MIND - ANXIETY - morning - rising, on - amel.
MIND - ANXIETY - morning - waking, on
MIND - ANXIETY - forenoon
MIND - ANXIETY - forenoon - 11 a.m.
MIND - ANXIETY - noon
MIND - ANXIETY - noon - till 3 p.m.
MIND - ANXIETY - afternoon
MIND - ANXIETY - afternoon - 3 to 6 p.m.
MIND - ANXIETY - afternoon - 4 p.m.
MIND - ANXIETY - afternoon - 4 to 5 p.m.
MIND - ANXIETY - afternoon - 4 to 6 p.m.
MIND - ANXIETY - afternoon - 5 to 6 p.m.
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MIND - ANXIETY - afternoon - until evening
MIND - ANXIETY - evening
MIND - ANXIETY - evening - amel.
MIND - ANXIETY - evening - until 11 p.m.
MIND - ANXIETY - evening - bed; in
MIND - ANXIETY - evening - bed; in - amel.
MIND - ANXIETY - evening - bed; in - closing eyes, on
MIND - ANXIETY - evening - bed; in - uneasiness and anguish; must uncover*
MIND - ANXIETY - evening - exercise, from violent
MIND - ANXIETY - evening - twilight, in the
MIND - ANXIETY - evening - 6 p.m.
MIND - ANXIETY - evening - 7 to 8 p.m.
MIND - ANXIETY - evening - 8 p.m.
MIND - ANXIETY - night
MIND - ANXIETY - night - waking, on
MIND - ANXIETY - night - midnight, before
MIND - ANXIETY - night - midnight, before - on waking, amel, on rising
MIND - ANXIETY - night - midnight, before - 11 p.m.
MIND - ANXIETY - night - midnight, after
MIND - ANXIETY - night - midnight, after - on waking
MIND - ANXIETY - night - midnight, after - 1 to 3 a.m.
MIND - ANXIETY - night - midnight, after - 2 a.m.
MIND - ANXIETY - night - midnight, after - 2 a.m. - until 2 a.m.
MIND - ANXIETY - night - midnight, after - 3 a.m.
MIND - ANXIETY - night - midnight, after - 3 a.m. - after
MIND - ANXIETY - night - midnight, after - 4 a.m.
MIND - ANXIETY - air, in open
MIND - ANXIETY - air, in open amel
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MIND - ANXIETY - alone, when
MIND - ANXIETY - alternating with indifference
MIND - ANXIETY - anger, during
MIND - ANXIETY - anticipating an engagement
MIND - ANXIETY – apparition, from horrible, while awake
MIND - ANXIETY - ascending steps, on
MIND - ANXIETY - bathing the feet, after
MIND - ANXIETY - bed, in
MIND - ANXIETY - breakfast, after
MIND - ANXIETY - breathing deeply, on
MIND - ANXIETY - breathing deeply, amel
MIND - ANXIETY - business, about
MIND - ANXIETY - chagrin, after
MIND - ANXIETY - children, in
MIND - ANXIETY - children, about his
MIND - ANXIETY - children, when lifted from the cradle
MIND - ANXIETY - chill, before
MIND - ANXIETY - chill, during
MIND - ANXIETY - chill, after
MIND - ANXIETY - church bells, from hearing
MIND - ANXIETY - closing eyes, on
MIND - ANXIETY - coffee, after
MIND - ANXIETY - coition, after
MIND - ANXIETY - coition - thought of (in a woman)
MIND - ANXIETY - cold, becoming, from
MIND - ANXIETY - cold drinks, amel
MIND - ANXIETY - company, when in
MIND - ANXIETY - conscience, of (as if guilty of a crime)
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MIND - ANXIETY - continence prolonged, from
MIND - ANXIETY - conversation, from
MIND - ANXIETY - cough, before
MIND - ANXIETY - cough, before the attack of whooping cough
MIND - ANXIETY - coughing, from
MIND - ANXIETY - crowd, in a
MIND - ANXIETY - cruelties, after hearing of
MIND - ANXIETY - dark, in
MIND - ANXIETY - dinner, during
MIND - ANXIETY - dinner, after
MIND - ANXIETY - dinner, after, amel
MIND - ANXIETY - dreams, on waking from frightful
MIND - ANXIETY - drinking, after
MIND - ANXIETY - eating, before
MIND - ANXIETY - eating, while
MIND - ANXIETY - eating, warm food
MIND - ANXIETY - eating, after
MIND - ANXIETY - eating, after amel
MIND - ANXIETY - emissions, after
MIND - ANXIETY - eructations amel
MIND - ANXIETY - excitement, from
MIND - ANXIETY - exercise amel.
MIND - ANXIETY - exertion of eyes
MIND - ANXIETY - expected of him, when anything is
MIND - ANXIETY - fear, with
MIND - ANXIETY - fever, during
MIND - ANXIETY - fever, prodrome, during
MIND - ANXIETY - fits, with
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MIND - ANXIETY - flatus, from
MIND - ANXIETY - flatus, emission of, amel
MIND - ANXIETY - flushes of heat, during
MIND - ANXIETY - foot bath, after a
MIND - ANXIETY - friends at home, about
MIND - ANXIETY - fright, after
MIND - ANXIETY - future, about
MIND - ANXIETY - headache, with
MIND - ANXIETY - health, about
MIND - ANXIETY - health, about, especially during climacteric period
MIND - ANXIETY - hot air, as if in
MIND - ANXIETY - house in
MIND - ANXIETY - house, in amel
MIND - ANXIETY - house, on entering
MIND - ANXIETY - hungry, when
MIND - ANXIETY - hypochondriacal
MIND - ANXIETY - ineffectual desire for stool, from
MIND - ANXIETY - looking steadily
MIND - ANXIETY - lying, while
MIND - ANXIETY - lying amel
MIND - ANXIETY - lying - must lie down with anguish
MIND - ANXIETY - lying - side, on
MIND - ANXIETY - lying - side, on, right, from flatulence
MIND - ANXIETY - lying - side, on - left
MIND - ANXIETY - manual labor, from
MIND - ANXIETY - menses, before
MIND - ANXIETY - menses, during
MIND - ANXIETY - menses, during - amel.
92
MIND - ANXIETY - menses, after
MIND - ANXIETY - menses, after - which prevents sleep
MIND - ANXIETY - mental exertion
MIND - ANXIETY - motion, from
MIND - ANXIETY - motion amel
MIND - ANXIETY - motion downward
MIND - ANXIETY - music, from
MIND - ANXIETY - night watching, from
MIND - ANXIETY - noise, from
MIND - ANXIETY - noise of rushing water
MIND - ANXIETY - others, for
MIND - ANXIETY - pains, from the
MIND - ANXIETY - paroxysms
MIND - ANXIETY - periodical
MIND - ANXIETY - playing piano, while
MIND - ANXIETY - pressure on chest
MIND - ANXIETY - pursued when walking, as if
MIND - ANXIETY - railroad, when about to journey by, amel, while in train
MIND - ANXIETY - reading, while
MIND - ANXIETY - riding, while
MIND - ANXIETY - riding down the hill
MIND - ANXIETY - rising, after
MIND - ANXIETY - rising, from a seat, on
MIND - ANXIETY - rising, from a seat amel
MIND - ANXIETY - salvation, about
MIND - ANXIETY - salvation, about - morning
MIND - ANXIETY - sedentary employment, from
MIND - ANXIETY - sewing
93
MIND - ANXIETY - shaving, while
MIND - ANXIETY - shuddering, with
MIND - ANXIETY - sitting, while
MIND - ANXIETY - sitting, amel
MIND - ANXIETY - sitting, bent
MIND - ANXIETY - sleep, before
MIND - ANXIETY - sleep, before - evening
MIND - ANXIETY - sleep, on going to
MIND - ANXIETY - sleep, during
MIND - ANXIETY - sleep, loss of sleep
MIND - ANXIETY - sleep, menses, after
MIND - ANXIETY - sleep, on starting from
MIND - ANXIETY - sleep, partial slumbering in the morning, during
MIND - ANXIETY - soup, after
MIND - ANXIETY - speaking, when
MIND - ANXIETY - speaking, in company
MIND - ANXIETY - standing, while
MIND - ANXIETY - standing amel
MIND - ANXIETY - stool, before
MIND - ANXIETY - stool, during
MIND - ANXIETY - stool, after
MIND - ANXIETY - stool, while straining at
MIND - ANXIETY - stooping, when
MIND - ANXIETY - stooping amel
MIND - ANXIETY - storm, during a thunder
MIND - ANXIETY - strangers, in the presence of
MIND - ANXIETY - sudden
MIND - ANXIETY - suicidal
94
MIND - ANXIETY - supper, after
MIND - ANXIETY - thinking about it, from
MIND - ANXIETY - thoughts, from
MIND - ANXIETY - time is set, if a
MIND - ANXIETY - tobacco, from smoking
MIND - ANXIETY - trifles, about
MIND - ANXIETY - urination, before
MIND - ANXIETY - urination, during
MIND - ANXIETY - urination, after
MIND - ANXIETY - vexation, after
MIND - ANXIETY - voice, on raising the
MIND - ANXIETY - waking, on
MIND - ANXIETY - walking, while
MIND - ANXIETY - walking - in open air
MIND - ANXIETY - walking - in open air, amel
MIND - ANXIETY - walking - rapidly
MIND - ANXIETY - walking - rapidly - which makes him walk faster
MIND - ANXIETY - warm bed yet limbs cold if uncovered
MIND - ANXIETY - warmth, from
MIND - ANXIETY - warmth amel
MIND - ANXIETY - weeping, followed by
MIND - ANXIETY - weeping amel
MIND - ANXIETY - work, during manual
MIND - AVARICE
MIND - AVERSION, approached to being
MIND - BAD news, ailments from
MIND - BROODING
MIND - BUSINESS, averse to
95
MIND - CAREFULNESS
MIND - CARES, full of
MIND - CARES, full of - ailments, from
MIND - CARES, full of - domestic affairs, about
MIND - CARES, full of - trifles, about
MIND - CARRIED, desires to be
MIND - CAUTIOUS
MIND - CAUTIOUS - anxiously
MIND - CLINGING to persons or furniture
MIND - CLINGING - child awakens terrified, knows no one, screams, clings*
MIND - COMPANY - aversion to
MIND - COMPANY - aversion to - avoids the sight of people
MIND - CONCENTRATION - difficult
MIND - CONFIDENCE, want of self
MIND - CONFUSION of mind - concentrate the mind, on attempting to
MIND - CONSCIENTIOUS about trifles
MIND - COUNTING continually
MIND - COWARDICE
MIND – DARKNESS, agg.
MIND - DEATH, desires
MIND - DEATH, presentiment of
MIND – DEATH, sensation, of
MIND - DEATH, thoughts of
MIND - DELIRIUM - anxious
MIND - DELIRIUM - frightful
MIND - DELUSIONS - crime - as if he had committed
MIND - DELUSIONS - danger, impression of
MIND - DELUSIONS - disease has incurable
96
MIND - DELUSIONS - fail, everything will
MIND - DELUSIONS - happen, that something terrible is going to
MIND - DELUSIONS - heart disease, is going to have, and die
MIND - DELUSIONS - images - frightful
MIND - DELUSIONS - images - frightful - sleep, preventing
MIND - DELUSIONS - insane, that she will become
MIND - DELUSIONS - murdered, that he would be
MIND - DELUSIONS - neglected his duty, that he has
MIND - DELUSIONS - poisoned, that he was about to be
MIND - DELUSIONS - poor, thinks he is
MIND - DELUSIONS - pursued, by enemies
MIND - DELUSIONS - sick, imagines himself
MIND - DELUSIONS - succeed, that he cannot, does everything wrong
MIND - DELUSIONS - troubles, broods over imaginary
MIND - DELUSIONS - wrong, fancies he has done
MIND - DESPAIR
MIND - DESPAIR - health, of
MIND - DESPAIR - recovery
MIND - DESPAIR - religious (of salvation, etc)
MIND - DESPAIR - social position, of
MIND - DESPAIR - trifles, over
MIND - DISCOURAGED
MIND - DISGUST
MIND - DOUBTFUL - recovery, of
MIND - DOUBTFUL - soul’s welfare, of
MIND - DULLNESS, sluggishness, difficulty of thinking and comprehending
MIND - DWELLS on past disagreeable occurrences
MIND - ESCAPE, attempts to
97
MIND - EXCITEMENT - anticipating events, when
MIND - EXCITEMENT - emotional, ailments from
MIND - EXCITEMENT - horrible things, after hearing
MIND - EXCITEMENT - hurried, as if
MIND - EXCITEMENT - nervous
MIND - EXCITEMENT - perspiration, during
MIND - EXCITEMENT - trifles, over
MIND - FANCIES - exaltation of - frightful
MIND - FASTIDIOUS
MIND - FEAR
MIND - FEAR - daytime, only
MIND - FEAR - morning
MIND - FEAR - morning - rising on
MIND - FEAR - morning - until evening
MIND - FEAR - morning - waking, on
MIND - FEAR - forenoon
MIND - FEAR - noon until 3 p.m.
MIND - FEAR - afternoon
MIND - FEAR - afternoon - 4 p.m.
MIND - FEAR - afternoon - 5 p.m.
MIND - FEAR - evening
MIND - FEAR - evening - amel.
MIND - FEAR - evening - bed, in
MIND - FEAR - evening - bed, in - amel.
MIND - FEAR - evening - twilight, in
MIND - FEAR - evening - walking, while
MIND - FEAR - night
MIND - FEAR - night - waking, after
98
MIND - FEAR - night - midnight
MIND - FEAR - night - midnight, after
MIND - FEAR - night - midnight, after - 3 a.m.
MIND - FEAR - abdomen, arising from
MIND - FEAR - accidents, of
MIND - FEAR - air, in open
MIND - FEAR - air, in open - amel.
MIND - FEAR - alone, of being
MIND - FEAR - alone, of being - evening
MIND - FEAR - alone, of being - night
MIND - FEAR - alone, of being - lest - he die
MIND - FEAR - alone, of being - lest - he injure himself
MIND - FEAR - alternating with mania
MIND - FEAR - animals, of
MIND - FEAR - apoplexy, of
MIND - FEAR - apoplexy, of - night at, with feelings as if head would burst
MIND - FEAR - apoplexy, of - palpitation, with
MIND - FEAR - apoplexy, of - stool, during
MIND - FEAR - apoplexy, of - waking, on
MIND - FEAR - approaching him, of others
MIND - FEAR - approaching him, children cannot bear to have anyone near*
MIND - FEAR - approaching him, delirium, in
MIND - FEAR - approaching him, lest he be touched
MIND - FEAR - approaching him, of vehicles
MIND - FEAR - bad news, of hearing
MIND - FEAR - bed, of the
MIND - FEAR - behind him, that someone is
MIND - FEAR - betrayed, being
99
MIND - FEAR - bitten, of being
MIND - FEAR - black, everything
MIND - FEAR - brain, of softening of
MIND - FEAR - brilliant objects, looking glass, etc, of, or cannot endure
MIND - FEAR - burden, of becoming a
MIND - FEAR - censured, of being
MIND - FEAR - chill, during
MIND - FEAR - cholera, of the
MIND - FEAR - church or opera, when ready to go
MIND - FEAR - closing eyes, on
MIND - FEAR - coal scuttle, of the
MIND - FEAR - coition - at thought of coition in a woman
MIND - FEAR - cold, of taking
MIND - FEAR - confusion, that people will observe her
MIND - FEAR - consumption, of
MIND - FEAR - corners, to walk past certain
MIND - FEAR - creeping out of every corner, of something
MIND - FEAR - crowd, in a
MIND - FEAR - crowd, in a - public places, of
MIND - FEAR - cruelties, report of, excite
MIND - FEAR - cutting himself when shaving
MIND - FEAR - danger, of impending
MIND - FEAR - danger, of impending - going to sleep, on
MIND - FEAR - dark
MIND - FEAR - dawn, of the return of
MIND - FEAR - death, of
MIND - FEAR - death, of - morning
MIND - FEAR - death, of - evening
100
MIND - FEAR - death, of - night
MIND - FEAR - death, of - alone, when
MIND - FEAR - death, of - alone, when - evening in bed
MIND - FEAR - death, of - die, fear he will, if he goes to sleep, after night-mare
MIND - FEAR - death, of - heart symptoms, during
MIND - FEAR - death, of - heat, during
MIND - FEAR - death, of - labor, during
MIND - FEAR - death, of - menses, before
MIND - FEAR - death, of - menses, during
MIND - FEAR - death, of - pain, from
MIND - FEAR - death, of - perspiration, during
MIND - FEAR - death, of - predicts the time
MIND - FEAR - death, of - pregnancy, during
MIND - FEAR - death, of - soon, that she will die
MIND - FEAR - death, of - sudden, of
MIND - FEAR - death, of - vexation, after
MIND - FEAR - death, of - vomiting
MIND - FEAR - death, of - waking, on
MIND - FEAR - death, of - walking, while
MIND - FEAR - destination, of being unable to reach his
MIND - FEAR - devil, being taken by the, of
MIND - FEAR - devoured by animals; of being
MIND - FEAR - dinner, after
MIND - FEAR - disaster; of
MIND - FEAR - disease, of impending
MIND - FEAR - disease, of impending - night, in bed
MIND - FEAR - disease, of impending - worse walking in open air
MIND - FEAR - dogs, of
101
MIND - FEAR - downward motion, of
MIND - FEAR - drawn upward, of being
MIND - FEAR - driving him from place to place
MIND - FEAR - drowned, of being
MIND - FEAR - eating, of
MIND - FEAR - eating, after
MIND - FEAR - eating, of - when hungry
MIND - FEAR - emission, after an
MIND - FEAR - epilepsy
MIND - FEAR - epilepsy - in the morning
MIND - FEAR - evil of
MIND - FEAR - evil of - morning, on waking
MIND - FEAR - evil of - afternoon
MIND - FEAR - evil of - evening
MIND - FEAR - evil of - evening - walking in open air, while
MIND - FEAR - exertion, of
MIND - FEAR - exposure night in bed, of
MIND - FEAR - extravagance, of
MIND - FEAR - failure, of, in business
MIND - FEAR - fainting, of
MIND - FEAR - fall upon him, high walls and building
MIND - FEAR - falling, of
MIND - FEAR - falling, of - afternoon
MIND - FEAR - falling, of - evening
MIND - FEAR - falling, of - letting things fall, of
MIND - FEAR - falling, of – room, in, agg.
MIND - FEAR - falling, of - sleep, on going to
MIND - FEAR - falling, of - turning head, on
102
MIND - FEAR - falling, of - walking, when
MIND - FEAR - fasting, of
MIND - FEAR - fever, while chilly
MIND - FEAR - fever, on going to bed
MIND - FEAR - fever, typhus, of
MIND - FEAR - fire, things will catch
MIND - FEAR - fit, of having a
MIND - FEAR - food, after
MIND - FEAR - friends has met with accident, that a
MIND - FEAR - friends, of
MIND - FEAR - gallows, of the
MIND - FEAR - ghosts, of
MIND - FEAR - ghosts, of - evening
MIND - FEAR - ghosts, of - night
MIND - FEAR - grieving, as if
MIND - FEAR - happen, something will
MIND - FEAR - happen, something will - when alone relieved by conversation
MIND - FEAR - happen, something will - warmth of bed amel.
MIND - FEAR - health, that she has ruined
MIND - FEAR - heart, disease of
MIND - FEAR - heart, arising from
MIND - FEAR - heart, will cease to beat unless constantly on the move
MIND - FEAR - heat - during
MIND - FEAR - high places
MIND - FEAR - hurry, following
MIND - FEAR - husband, he will never return, something would happen to him*
MIND - FEAR - imaginary things
MIND - FEAR - imaginary animals
103
MIND - FEAR – imbecile, that he would become
MIND - FEAR - infection, of
MIND - FEAR - injured, of being
MIND - FEAR - insanity, of
MIND - FEAR - insanity, of - night
MIND - FEAR - joints are weak, that
MIND - FEAR - jumps out of bed from
MIND - FEAR - jumps, on touch
MIND - FEAR - jumps, out of the window
MIND - FEAR - killing, of
MIND - FEAR - killing, of - with a knife
MIND - FEAR - labor, during
MIND - FEAR - labor, after
MIND - FEAR - looking before her, when
MIND - FEAR - losing senses
MIND - FEAR - lying in bed, while
MIND - FEAR - manual labor, after
MIND - FEAR - medicine, of taking too much medicine
MIND - FEAR - men, of
MIND - FEAR - menses, before
MIND - FEAR - menses, during
MIND - FEAR - menses, during, menstrual colic
MIND - FEAR - mirrors in room, of
MIND - FEAR - mischief, he might do, night on waking
MIND - FEAR - misfortune, of
MIND - FEAR - misfortune, of - daytime
MIND - FEAR - misfortune, of - morning
MIND - FEAR - misfortune, of - forenoon
104
MIND - FEAR - misfortune, of - afternoon
MIND - FEAR - misfortune, of - afternoon - 2 p.m.
MIND - FEAR - misfortune, of - evening
MIND - FEAR - misfortune, of - evening - bed, in, amel.
MIND - FEAR - misfortune, of - chilliness, during
MIND - FEAR - misfortune, of - heat, during
MIND - FEAR - moral obliquity alternating with sexual excitement
MIND - FEAR - murdered, of being
MIND - FEAR - music, from
MIND - FEAR - narrow place, in
MIND - FEAR - nausea, after
MIND - FEAR - near, of those standing
MIND - FEAR - noise, from
MIND - FEAR - noise, from - night
MIND - FEAR - noise, from - at door
MIND - FEAR - noise, from - rushing water
MIND - FEAR - noise, from - street, in
MIND - FEAR - noise, from - sudden of
MIND - FEAR - observed, of her condition being
MIND - FEAR - occupation, of
MIND - FEAR - out of doors, to go
MIND - FEAR - paralysis, of
MIND - FEAR - people, of
MIND - FEAR - people, of - children
MIND - FEAR - physician, will not see him he seems to terrify her
MIND - FEAR - piano, when at
MIND - FEAR - pins, of
MIND - FEAR - pneumonia, of
105
MIND - FEAR - poisoned, of being
MIND - FEAR - poisoned, of being - night
MIND - FEAR - poisoned, of being - has been
MIND - FEAR - poverty
MIND - FEAR - pregnancy, during
MIND - FEAR - putrefy, body will
MIND - FEAR - rain of
MIND - FEAR - riding, when in a carriage
MIND - FEAR - robbers, of
MIND - FEAR - robbers, of - midnight on waking
MIND - FEAR - room, on entering
MIND - FEAR - run over of being, on going out
MIND - FEAR - say something wrong, lest he should
MIND - FEAR - self-control, losing
MIND - FEAR - serious thoughts
MIND - FEAR - sitting amel.
MIND - FEAR - sleep, before
MIND - FEAR - sleep, he will never sleep again
MIND - FEAR - sleep - to close the eyes lest he should never wake
MIND - FEAR - sleep - to go to sleep
MIND - FEAR - society, of his position in
MIND - FEAR - sold, of being
MIND - FEAR – speak, to
MIND - FEAR - spoken to
MIND - FEAR - starving, of
MIND - FEAR - stomach, arising from
MIND - FEAR - stomach, of ulcer in
MIND - FEAR - strangers, of
106
MIND - FEAR - suffering, of
MIND - FEAR - suffocation, of
MIND - FEAR - suffocation, of - night
MIND - FEAR - suffocation, of - closing eyes
MIND - FEAR - suffocation, of - lying, while
MIND - FEAR - suicide
MIND - FEAR - superstitious
MIND - FEAR - supper, after
MIND - FEAR - surprises, from pleasant
MIND - FEAR - syphilis, of
MIND - FEAR - talking loud, as if would kill her
MIND - FEAR - thinking of disagreeable things, when
MIND - FEAR - thinking - sad things, of
MIND - FEAR - thoughts, of his own
MIND - FEAR - throat, from sensation of swelling of
MIND - FEAR - thunderstorm, of
MIND - FEAR - touch, of
MIND - FEAR - tread lightly, must, or will injure himself
MIND - FEAR - trifles
MIND - FEAR - troubles, of imaginary
MIND - FEAR - unaccountable
MIND - FEAR - undertaking anything
MIND - FEAR - upward, of being drawn
MIND - FEAR - vertigo, of
MIND - FEAR - vexation, after
MIND - FEAR - voice, of using
MIND - FEAR - waking, on
MIND - FEAR - waking, on - from a dream
107
MIND - FEAR - waking, on - of something under the bed
MIND - FEAR - walking, of
MIND - FEAR - walking - across busy street
MIND - FEAR - walking - in the dark
MIND - FEAR - walking, while
MIND - FEAR - walking, open air, while
MIND - FEAR - warm room
MIND - FEAR - water, of
MIND - FEAR - weeping amel
MIND - FEAR - wet his bed, fears he will
MIND - FEAR - wind, of
MIND - FEAR - women; of
MIND - FEAR - work, dread of
MIND - FEAR - work, dread of - headache, during
MIND - FEAR - work, dread of - literary, of
MIND - FORGOTTEN something, feels constantly as if he had
MIND - FRIGHT, complaints from
MIND - FRIGHTENED easily
MIND - FRIGHTENED easily - night
MIND - FRIGHTENED easily - night - wakens at 3 a.m.
MIND - FRIGHTENED easily - chill, during
MIND - FRIGHTENED easily - falling asleep, on
MIND - FRIGHTENED easily - menses, before
MIND - FRIGHTENED easily - nocturnal emissions, after
MIND - FRIGHTENED easily - roused, when
MIND - FRIGHTENED easily - sneezing, at
MIND - FRIGHTENED easily - touch, from
MIND - FRIGHTENED easily - trifles, at
108
MIND - FRIGHTENED easily - trifles, at - day before menses
MIND - FRIGHTENED easily - waking, on
MIND - FRIGHTENED easily - wakens in a fright from least noise
MIND - FRIGHTENED easily - wakens terrified, knows no one, screams, clings*
MIND - FRIGHTENED easily - weeping amel.
MIND - FROWN, disposed to
MIND - GESTURES - plays with his fingers
MIND - GOING out, aversion to
MIND - GRIEF
MIND - GRIEF, ailments from
MIND - GRIEF - trifles, over
MIND – HELPLESSNESS, feeling of
MIND - HIGH places, agg.
MIND – HOME, desires to go
MIND - HORRIBLE things, sad stories affect her profoundly
MIND - IMPATIENCE - trifles, about
MIND - IMPULSIVE
MIND - IMPULSE, morbid - stab his flesh with the knife he holds, to
MIND - INCONSOLABLE
MIND - INCONSOLABLE - over fancied misfortune
MIND – INJURE, fears to be left alone, lest he should himself
MIND - INSANITY - fright or anger, caused by
MIND - IRRESOLUTION
MIND - IRRESOLUTION - acts, in
MIND - IRRESOLUTION - ideas, in
MIND - IRRESOLUTION - trifles, about
MIND - IRRITABILITY
MIND - KILL, desire to
109
MIND - KILL, desire to - barber wants to kill his customer
MIND - KILL, desire to - desire to kill the person that contradicts her
MIND - KILL, desire to - sight of a knife
MIND - KILL, desire to - sudden impulse to
MIND - KILL, desire to - sudden impulse to - herself
MIND - KILL, desire to - sudden impulse to - throw child into fire
MIND - LAMENTING - future, about
MIND - LAUGHING - anxiety, during
MIND - LIGHT - desire for
MIND - MENTAL SYMPTOMS - alternating with - physical symptoms
MIND - MONOMANIA
MIND - MORTIFICATION - ailments, from
MIND - NARRATING her symptoms agg.
MIND - PLAYFUL - indisposition to play, in children
MIND - RELIGIOUS affections
MIND - REMORSE
MIND - REPROACHING himself
MIND - REST, cannot, when things are not in proper place
MIND - RESTLESSNESS
MIND - RESTLESSNESS - anxious
MIND - RESTLESSNESS - anxious - compelling rapid walking
MIND - RESTLESSNESS - anxious - epilepsy, during intervals of
MIND - RESTLESSNESS - bed, driving out of
MIND - RESTLESSNESS - bed, tossing about, in
MIND - RESTLESSNESS - internal
MIND - RESTLESSNESS - menses, before
MIND - RESTLESSNESS - menses, during
MIND - RESTLESSNESS - storm, before
110
MIND - RESTLESSNESS - storm, during
MIND - SADNESS
MIND - SADNESS - misfortune, as if from
MIND - SENSITIVE
MIND - SENSITIVE - ailments to most trifling
MIND - SENSITIVE - cruelties, when hearing of
MIND - SENSITIVE - external impressions, to all
MIND - SENSITIVE - moral impressions, to
MIND - SENSITIVE - music, to
MIND - SENSITIVE - noise, to
MIND - SENSITIVE - noise, to - slightest
MIND - SHRIEKING - children, in
MIND - STARTING, startled
MIND - STARTING - anxious
MIND - STARTING - anxious, downward motion, from
MIND - STARTING - called by name, when
MIND - STARTING - easily
MIND - STARTING - falling, as if
MIND - STARTING - fright, from
MIND - STARTING - hawking, at
MIND - STARTING - noise, from
MIND - STARTING - prick of a needle, at the
MIND - STARTING - sleep, on falling
MIND - STARTING - sleep, during
MIND - STARTING - sleep, from
MIND - STARTING - sneezing, at
MIND - STARTING - spoken to, when
MIND - STARTING - touched, when
111
MIND - STARTING - tremulous
MIND - STARTING - trifles, at
MIND - STARTING - twitching
MIND - STRANGER, presence of, agg.
MIND - SUCCEEDS, never
MIND - SUICIDAL disposition
MIND - SUICIDAL disposition - thoughts
MIND - SUPERSTITIOUS
MIND - TALKING - sleep, in
MIND - TALKING - sleep, in - anxious
MIND - THOUGHTS - frightful
MIND - THOUGHTS - frightful - night on waking
MIND - THOUGHTS - frightful - seeing blood or a knife, on
MIND - THOUGHTS - future, of the
MIND - THOUGHTS - intrude and crowd around each other
MIND - THOUGHTS - intrude and crowd around each other - sexual
MIND - THOUGHTS - intrude and crowd around each other - work, while at
MIND - THOUGHTS - persistent
MIND - THOUGHTS - persistent - alone, when
MIND - THOUGHTS - persistent - evil, of
MIND - THOUGHTS - persistent - expression and words heard recur to his mind
MIND - THOUGHTS - persistent - homicide
MIND - THOUGHTS - persistent - thinks mind and body are separated
MIND - THOUGHTS - persistent - thinks of nothing but murder, fire and rats
MIND - THOUGHTS - persistent - unpleasant subjects, haunted by
MIND - THOUGHTS - profound
MIND - THOUGHTS - profound - future, about his
MIND - THOUGHTS - tormenting
112
MIND - THOUGHTS - tormenting - evening
MIND - THOUGHTS - tormenting - night
MIND - THOUGHTS - tormenting - sexual
MIND - THOUGHTS - vanishing, of
MIND - THOUGHTS - wandering
MIND – THUNDER storm, before
MIND – THUNDER storm, during
MIND - TIMIDITY - about appearing in public
MIND - TOUCHED, aversion to being
MIND - TRIFLES, seem important
MIND - UNREAL, everything seems
MIND - WALKING rapidly from anxiety
MIND - WANDER, desires to
MIND - WASHING always, her hands
MIND - WEARY of life
MIND - WEEPING - emotion, after slight
MIND - WEEPING - future, about the
MIND - WEEPING - nightmare, after
MIND - WEEPING - sad thoughts, at
MIND - WEEPING - trifles, at
MIND - WEEPING - trifles, at - at least worry, children
MIND - WILL, contradiction of
MIND - WORK, aversion to mental
VERTIGO - VERTIGO
VERTIGO - ANXIETY, during
VERTIGO - FRIGHT, after
HEAD - CONGESTION - anxiety, with
HEAD - HEAT - anxiety, with
113
HEAD - NUMBNESS, sensation of
HEAD - PAIN - looking down, out of window cause vertigo, anxiety, sweat*
HEAD - PAIN - Stunning, Forehead - sweats from anxiety - walking in open air*
HEAD - PERSPIRATION of scalp - Forehead - anxiety, as from
HEAD - UNSTEADY feeling
EYE - PUPILS - dilated
EYE - STRABISMUS - mental emotions or fear agg.
VISION - DIM - anxiety, during
EAR - NOISES in - anxiety agg.
EAR - NOISES in - humming - mental anxiety agg.
FACE - EXPRESSION, anxious
FACE - EXPRESSION - bewildered
FACE - EXPRESSION - distressed
FACE - EXPRESSION - frightened
FACE - EXPRESSION - suffering
FACE - EXPRESSION - vacant
FACE - HEAT - anxiety, during
FACE - PERSPIRATION
FACE - PERSPIRATION - cold
FACE - STIFFNESS, muscles
FACE - TENSION of skin
FACE - WRINKLED
FACE - WRINKLED - forehead
MOUTH - DRYNESS
TEETH - PAIN - anxiety, with
THROAT - CHOKING
THROAT - LUMP, plug, etc., sensation of
THROAT - SWALLOWING - difficult
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STOMACH - ANXIETY
STOMACH - APPREHENSION in
STOMACH - EMPTINESS - morning - anxiety with
STOMACH - NAUSEA
STOMACH - NAUSEA - anxiety, after
STOMACH - PAIN - fright, from
STOMACH - PAIN - burning - fright, after
ABDOMEN - ANXIETY in
ABDOMEN - APPREHENSION in, sensation of
ABDOMEN - RESTLESSNESS, uneasiness
RECTUM - CONSTIPATION - stool remains long in rectum, anxiety; awful*
RECTUM - DIARRHEA – anticipation, after
RECTUM - DIARRHEA - anxiety, after
RECTUM - DIARRHEA - excitement
RECTUM - DIARRHEA - fright, after
RECTUM - URGING - anxious
RECTUM - URGING - fright, from
RECTUM - URGING - startled, when
BLADDER - APPREHENSION in region of
BLADDER - RETENTION - fright, after
BLADDER - URGING to urinate - anxious
KIDNEYS - PAIN - Region of - extending to - groin - nausea; with anxious
GENITALIA - MALE - MASTURBATION, disposition to
GENITALIA - FEMALE - ABORTION - fright, after
GENITALIA - FEMALE - INFLAMMATION - uterus - emotional excitement *
GENITALIA - FEMALE - MENSES - copious - excitement, after
RESPIRATION - ACCELERATED
RESPIRATION - ACCELERATED - anxiety, during
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RESPIRATION - ANXIOUS
RESPIRATION - ASTHMATIC - emotions, after
RESPIRATION - DIFFICULT - morning - chest, from anxiety in
RESPIRATION - DIFFICULT - excitement agg.
RESPIRATION - DIFFICULT - fright, after
RESPIRATION - DIFFICULT - perspiration - anxious face and sleeplessness
COUGH - NERVOUS
COUGH - STRANGERS, child coughs at sight of
CHEST - ANXIETY in
CHEST - ANXIETY in - excitement agg.
CHEST - ANXIETY in - heart, region of
CHEST - APPREHENSION
CHEST - APPREHENSION - heart, region of
CHEST - CEASES to beat; as if heart - had ceased
CHEST - CONSTRICTION, tension, tightness
CHEST - INFLAMMATION - Heart - Endocardium - pain and great anxiety
CHEST - OPPRESSION
CHEST - PAIN
CHEST - PALPITATION OF HEART
CHEST - PALPITATION OF HEART - anxiety
CHEST - PALPITATION OF HEART - audible
CHEST - PALPITATION OF HEART - excitement, after
CHEST - PALPITATION OF HEART - fright, after
CHEST - PALPITATION OF HEART - noise, from every strange
CHEST - PALPITATION OF HEART - tumultuous, violent, vehement
CHEST - PALPITATION OF HEART - unrequited affections, from
CHEST - PALPITATION OF HEART - waking, on - startled from a dream
EXTREMITIES - COLDNESS - Foot - anxiety, during
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EXTREMITIES - FORMICATION - fingers - anxiety, as from
EXTREMITIES - GOOSE FLESH
EXTREMITIES - HEAT - Hand - anxiety, with
EXTREMITIES - NUMBNESS
EXTREMITIES - TREMBLING
EXTREMITIES - TREMBLING - anxious
EXTREMITIES - TREMBLING - Hand - anxiety; with
EXTREMITIES - TREMBLING - Lower limbs - anxiety
SLEEP - DISTURBED
SLEEP - DREAMS - accidents
SLEEP - DREAMS - animals
SLEEP - DREAMS - anxious
SLEEP - DREAMS - danger
SLEEP - DREAMS - difficulties, of
SLEEP - DREAMS - falling, of
SLEEP - DREAMS - fire
SLEEP - DREAMS - frightful
SLEEP - DREAMS - misfortunes, of
SLEEP - DREAMS - nightmares
SLEEP - DREAMS - pursued, of being
SLEEP - DREAMS - robbers
SLEEP - DREAMS - snakes
SLEEP - DREAMS - unsuccessful efforts to do various things
SLEEP - RESTLESS
SLEEP - SLEEPINESS - excitement, after
SLEEP - SLEEPLESSNESS - anxiety, from
SLEEP - SLEEPLESSNESS - excitement, from
SLEEP - SLEEPLESSNESS - thoughts activity of mind, from
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SLEEP - SLEEPLESS - thoughts activity of mind, from - same idea repeated *
SLEEP - SLEEPLESS - uneasiness & anxiety, uncovers which cause chilliness *
SLEEP - WAKING - frequent
SLEEP - WAKING - fright, as from
CHILL - COLDNESS in general
CHILL - ANXIETY, caused by
CHILL - EXCITEMENT, after
CHILL - FRIGHT, from
CHILL - SHAKING - fright, from
FEVER - NIGHT - anxiety and sweat, with
FEVER - NIGHT - dry burning heat - anxiety; with
FEVER - ALTERNATING WITH - fright
PERSPIRATION - ANXIETY, during
PERSPIRATION - ANXIETY, during - evening
PERSPIRATION - ANXIETY, during - night
PERSPIRATION - ANXIETY, during - dinner, after
PERSPIRATION - CLAMMY
PERSPIRATION - EATING, while - anxiety and cold sweat
PERSPIRATION - EXCITEMENT, after
PERSPIRATION - FRIGHT, from
PERSPIRATION - STRANGERS, in the presence of
SKIN - GOOSE FLESH
GENERALS - ANXIETY general physical
GENERALS - BATHING, dread of
GENERALS - CATALEPSY - fright, after
GENERALS - CHOREA - emotional
GENERALS - CHOREA - fright, from
GENERALS - CONVULSIONS - excitement, from
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GENERALS - CONVULSIONS - fright, from
GENERALS - FAINTNESS - blood, at sight of in
GENERALS - FAINTNESS - close room, in
GENERALS - FAINTNESS - crowded room, in
GENERALS - FAINTNESS - dark places, in
GENERALS - FAINTNESS - excitement, on
GENERALS - FAINTNESS - fright, after
GENERALS - FAINTNESS - pain, from
GENERALS - HEAT - flushes of
GENERALS - HEAT - flushes of - alternating with chills
GENERALS - HEAT - flushes of - emotions, from
GENERALS - HEAT - flushes of - perspiration - and anxiety
GENERALS - HEAT - sensation of
GENERALS - NUMBNESS
GENERALS - ORGASM of blood
GENERALS - ORGASM of blood - emotions, after
GENERALS - ROOM full of people agg.
GENERALS - STORM, approach of a
GENERALS - STRETCHING - anxiety, from
GENERALS - TREMBLING
GENERALS - TREMBLING - Externally - anxiety, from
GENERALS - TREMBLING - Externally - emotions, after
GENERALS - TREMBLING - Externally - fright, after
GENERALS - TWITCHING
GENERALS - TWITCHING - fright, after
GENERALS - WEAKNESS - fright, after
* - Symptom language slightly altered to fit in the format
119
Boger - Boenninghausen`s Characteristics and Repertory (BBCR)
Introduction
Boenninghausen was a close student and disciple of Hahnemann. The
credit for publishing the first repertory goes to Boenninghausen. He
published ‘Repertory of the Antipsorics’ in 1832, with a preface by
Hahnemann. In 1835, Boenninghausen`s ‘Repertory of medicines
which are not Antipsoric’ and in 1836, ‘An attempt at showing the
relative kinship of homoeopathic medicines’ was published. He
brought out the Therapeutic Pocket Book incorporating the results of
his vast experience in 1846. This became a standard reference book
till the close of 19 th century.
Boenninghausen was the first to evaluate the remedies in relation to
the individual symptoms. He also evolved the doctrine of
concomitants, which he believed to be of peculiar and characteristic
value.
Roberts, H.A says that “The works of Boenninghausen are among the
most comprehensive in logic, philosophy and applicability of early
writers – perhaps with the single exception of the works of
Hahnemann. The most comprehensive and far reaching in influence.”
Boger, C.M was a student of Boenninghausen. He studied many of the
original works of Boenninghausen in German and corrected many
120
faulty translations of his work in English. He was impressed by the
practical utility of the Therapeutic Pocket Book. Boger was also
aware of the difficulties faced by practitioners in using the
Therapeutic Pocket Book as well as the criticism leveled against its
principles. He enlarged this by adding many other works of
Boenninghausen to form BBCR.
He also added 17 new remedies which were proved after
Boenninghausen.
In his preface to the book, Boger says, it embraces the following
major books:
1. Boenninghausen`s Therapeutic pocket book
2. Boenninghausen`s repertory of Apsoric medicines.
3. Repertory of Antipsoric medicines by Boenninghausen
4. Sides of body by G. miller and Boenninghausen.
5. Intermittent fever by T.F. Allen.
6. Whooping cough by Boenninghausen and Clarke.
7. Aphorisms of Hippocrates.
8. Boenninghausen`s characteristics of materia medica.
9. Domestic physician by Hering.
So, the Boger-Boenninghausen`s repertory in its current form
represents the combined wisdom and experience of two masters,
Boenninghausen and Boger.
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Philosophical background
Boger gave new life to Boenninghausen`s work by refining and
enriching the basics and recasting the structure and methodology. This
gave a new lease of life to it after it had receded to back stage. Boger
attempted to bridge Boenninghausen and Kent. He avoided the
extreme generalisation of Boenninghausen and extreme
particularisation of Kent. He took the best part of both. Boger
subscribed to the principle of totality of symptoms as given by
Hahnemann. His concept of complete symptom was comprised of the
Location, Sensation, Modalities and Concomitant.
Boger`s work BBCR is based on the following concepts:
1. Complete symptoms and concomitant.
2. Doctrine of pathological generals.
3. Doctrine of causation and time.
4. Evaluation of remedies.
5. Fever totality.
6. Concordances.
Concomitant Symptoms Concomitant symptoms are the attendant circumstances \ existing
symptoms which accompany or co-exist along with the chief
complaint.
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It was defined as the fourth element for a symptom, the other being
Location, Sensation & Modalities of the symptom. These symptoms
which occurred together or in definite association with a presenting
complaint were considered to be more valuable for prescribing and
more characteristic of the individual’s reaction as they do not have
any connection with the pathology of the case. These are of the same
class as the rare, strange and peculiar symptoms. These symptoms can
be of immense help in difficult cases.
Mostly the concomitant of the symptoms are related to the modalities.
So, the concomitant is to totality what the condition of aggravation or
amelioration is to a single symptom. This is the differentiating factor
for a concomitant.
Evaluation of Remedies
In Boger Boenninghausen Characteristics and Repertory, the grading
of the remedies as done by Boenninghausen has been followed. The
remedies are graded into five ranks as follows:
CAPITAL 5 marks.
Bold 4 marks.
Italic 3 marks.
Roman 2 marks.
(Roman) in parenthesis 1 mark.
The gradation is based on the frequency of appearance of the
symptoms in provers.
123
Structure of Boger Boenninghausen`s Characteristics and Repertory The main divisions could be divided into seven chapters, as follows –
1. Mind, Intellect, Sensorium and Vertigo. 2. Locations of complaints etc.in different anatomical parts. 3. Sensations in general; Glands, Bones, Skin. 4. Sleep and Dreams. 5. Fever, Blood, Circulation, Chill, Heat, Perspiration. 6. Conditions of Aggravation and Amelioration in general. 7. Relationships of remedies. (Concordances).
In Boenninghausen`s Repertory, Anxiety as a rubric is given on page
192. The main rubric of anxiety is followed by 7 sub-rubrics. It has
101 drugs of which 9 are in Capitals, 21 in Bold, 18 in italics and 53
in roman. In addition to this, there are 12 more remedies found in
sub-rubrics that are not found in the main rubric of anxiety. In
addition to the main rubric, anxiety is found in 73 various rubrics in
various repertories. Anxiety as a concomitant symptom under
different chapter of the repertory is edge of this repertory.
“Emotions” is substituted for anxiety in some of the chapters under
concomitants. A total of 173 remedies run through the rubrics of this
book.
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REPERTORIAL REFERENCES OF ANXIETY IN BOGER BOENNINGHAUSEN REPRTORY SYMPTOMS MIND - Absence of mind, lost in thoughts, absent minded
MIND - Agitated
MIND - Alternating with physical symptoms
MIND - Anger, crossness, etc.
MIND - Anthropophobia, aversion to others
MIND - Anticipations, from
MIND - Anxiety, agony
MIND - Anxiety, agony - business, about.
MIND - Anxiety, agony - head, in
MIND - Anxiety, agony - epigastric
MIND - Anxiety, agony - abdominal
MIND - Anxiety, agony - chest, in
MIND - Anxiety, agony - heart, precordial
MIND - Anxiety, agony - waking, on.
MIND - Aversion to - business
MIND - Beclouded, dim
MIND - Benumbed
MIND - Beside oneself, frantic, madness etc.
MIND - Care - full of
MIND - Careful, critical, scrupulous, conscientious
MIND - Cares, affected by daily
MIND - Cautious
MIND - Changeable, inconstant, irresolute etc.
MIND - Collar, pulls at
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MIND - Company, averse to
MIND - Compassion, sympathy (immoderate)
MIND - Concentration, difficult
MIND - Confusion, befuddled, muddled etc.
MIND - Corner, mopes or broods in a
MIND - Counting - continued
MIND - Cowardly, fainthearted etc.
MIND - Death - fear, of
MIND - Death - fear, of - sleep, on going to
MIND - Death - sensation of
MIND - Delirium, frenzy - anxious, fearful, etc
MIND - Depression
MIND - Despairing, discouraged, hopeless etc
MIND - Despairing, discouraged, hopeless etc - recovery, of
MIND - Disconsolate, unhappy
MIND - Distracted, preoccupied, difficult concentration can’t think*
MIND - Dizziness and instability of
MIND - Dullness, mental obtuseness
MIND - Emotional excitement, effects of
MIND - Escape, desire to
MIND - Excitable
MIND - Excitement
MIND - Fastidious
MIND - Fearsome, anxiety, dread, frightened easily, etc
MIND - Fearsome, etc - air, open, in
MIND - Fearsome, etc - alone, of being
MIND - Fearsome, etc - anxious, restless fear
MIND - Fearsome, etc - apoplexy, of
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MIND - Fearsome, etc - approached, being, strangers, etc
MIND - Fearsome, etc - awaking, on
MIND - Fearsome, etc - cats
MIND - Fearsome, etc - crowds, of
MIND - Fearsome, etc - dark, of the
MIND - Fearsome, etc - disease, of
MIND - Fearsome, etc - dogs, of
MIND - Fearsome, etc - door, opening the
MIND - Fearsome, etc - driving, when
MIND - Fearsome, etc - eaten, being
MIND - Fearsome, etc - eating, after
MIND - Fearsome, etc - evening, in
MIND - Fearsome, etc - evil, bad news, misfortune etc
MIND - Fearsome, etc - failure
MIND - Fearsome, etc - falling, of
MIND - Fearsome, etc - future, of
MIND - Fearsome, etc - ghosts, of
MIND - Fearsome, etc - hypochondriacal
MIND - Fearsome, etc - imaginary
MIND - Fearsome, etc - incurable, being
MIND - Fearsome, etc - insanity
MIND - Fearsome, etc - insensible, becoming
MIND - Fearsome, etc - killed, being
MIND - Fearsome, etc - knaves
MIND - Fearsome, etc - lightening
MIND - Fearsome, etc - lying, when
MIND - Fearsome, etc - man, of
MIND - Fearsome, etc - melancholic
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MIND - Fearsome, etc - morning, in early
MIND - Fearsome, etc - nightly
MIND - Fearsome, etc - ordeals
MIND - Fearsome, anxiety, dread, frightened easily, etc - overpowering
MIND - Fearsome, etc - palpitation, with
MIND - Fearsome, etc - pins
MIND - Fearsome, etc - places, of
MIND - Fearsome, etc - poison, of
MIND - Fearsome, etc - pregnancy, during
MIND - Fearsome, etc - rattling, noises from
MIND - Fearsome, etc - recurrent
MIND - Fearsome, etc - restless
MIND - Fearsome, etc - robbers, of
MIND - Fearsome, etc - sadness, alternating with
MIND - Fearsome, etc - shadows, of
MIND - Fearsome, etc - stomach, from
MIND - Fearsome, etc - storms, thunder, of
MIND - Fearsome, etc - suffocation, of
MIND - Fearsome, etc - tearful
MIND - Fearsome, etc - tremulous
MIND - Fearsome, etc - twilight, in
MIND - Fearsome, etc - undertaking, anything
MIND - Fearsome, etc - vexation, after
MIND - Fearsome, etc - work, while at
MIND - Fretful
MIND - Gloomy
MIND - Grief, sorrow and care
MIND - Held wants to be
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MIND - Helpless
MIND - Hiding
MIND - Howling
MIND - Hurry
MIND - Hypochondriasis
MIND - Ideas - fixed
MIND - Ill Humor, crossness
MIND - Illness, sense of and sick feeling
MIND - Illness, sense of and sick feeling - imaginary
MIND - Illusions, delusions, visions, etc. - frightful
MIND - Imaginations, fancies, fixed ideas etc.
MIND - Impatience
MIND - Impulses, morbid
MIND - Inconsolable
MIND - Indecision, hesitation
MIND - Indolence, averse to work etc.
MIND - Insanity, irrational - fear of
MIND - Insanity, irrational - obsession, with
MIND - Insecurity, mental
MIND - Introspective, introverted, absorbed etc.
MIND - Irritable, cross
MIND - Knife, impulse to injure with
MIND - Learning to speak, late in
MIND - Low-spirited
MIND - Meditation, reflection, brooding, etc.
MIND - Meditation, reflection, brooding, etc. - deep, profound
MIND - Memories, disagreeable.
MIND - Memory - involuntary recollection
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MIND - Memory - poor, weak, forgetful, etc. - emotions, from
MIND - Mistrust, suspicious, doubt
MIND - Monomania
MIND - Mortification
MIND - Pain, intolerant of
MIND - Peevish, fretful
MIND - Pensive, deep in thought
MIND - Perplexity
MIND - Phantasies - frightful
MIND - Play, indisposition to
MIND - Plays with fingers
MIND - Presentiments, premonitions, forebodings, etc.
MIND - Religious ideas
MIND - Remorse, condemned feeling etc.
MIND - Repeats same thing
MIND - Restlessness
MIND - Sadness, melancholy
MIND - Senses losing, sense of, faintness etc
MIND - Sensitive
MIND - Shrieking, screams, cries out
MIND - Solicitude
MIND - Solicitude - of one’s health
MIND - Solicitude - for others
MIND - Speech - repeats, same thing
MIND - Startled easily, terror etc
MIND - Strangers, embarrass
MIND - Stupefied, dazed
MIND - Superstitious
130
MIND - Talk - subject, dwells, on one only
MIND - Thought, absorbed in
MIND - Timidity
MIND - Tossing about
MIND -Touched, averse to being
MIND -Touches, everything.
MIND - Trifles, occupied, with
MIND - Trifles, vexed over
MIND - Uneasiness
MIND - Unsociable, shy, averse to society
MIND - Vexation, effects of
MIND - Wailing
MIND - Wanders about, restlessly
MIND - Weeping, tearful
MIND - Will, weak
MIND - Aggravation - Approach of persons
MIND - Aggravation - Blood, rushes of, with
MIND - Aggravation - Company
MIND - Aggravation - Emotions, after
MIND - Aggravation - Excitement
MIND - Aggravation - Face, heat of, with
MIND - Aggravation - Fright
MIND - Aggravation - Hurry, from
MIND - Aggravation - Palpitation
MIND - Aggravation - Restless, when
MIND - Aggravation - Strangers, among
SENSORIUM - Confusion (in head), muddled etc.
SENSORIUM - Faintness, fainting etc.
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VERTIGO - Anxious
VERTIGO - Nervous
VERTIGO - Aggravation - Emotions
VERTIGO - Aggravation - Excitement, mental
VERTIGO - Aggravation - Fear
VERTIGO - Aggravation - Fright, after
VERTIGO - Aggravation - Narrow streets, places, etc.
VERTIGO - Aggravation - Walking - path or bridge, on a narrow
VERTIGO - Concomitants - Anxiety
VERTIGO - Concomitants - Blood, rushes of
VERTIGO - Concomitants - Confusion, bewildered etc.
VERTIGO - Concomitants - Fear of death
VERTIGO - Concomitants - Hypochondriacal mood
VERTIGO - Concomitants - Respiration, difficult
VERTIGO - Concomitants - Restlessness
HEAD - Internal - Anxiety felt in
HEAD - Internal - Anxious headache
HEAD - Internal - Nervous origin
HEAD - Internal - Tension in general
HEAD - Internal - Aggravation - Anxiety, with
HEAD - Internal - Aggravation - Death, fear of, with
HEAD - Internal - Aggravation - Face, hot, with
HEAD - Internal - Aggravation - Fright, after
HEAD - Internal - Aggravation - Grief
HEAD - Internal - Aggravation - Hypochondriacs, in
HEAD - Internal - Aggravation - Irritable, cross, with
HEAD - Internal - Aggravation - Mental disturbances or emotions
HEAD - Internal - Aggravation - Restlessness, with
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HEAD - Internal - Aggravation - Vexation, irritation
HEAD - External - Hair - bristling, standing on end, etc.
HEAD - External - Hair - pulls her hair, or of others
HEAD - External - Aggravation - Emotions, anxiety, etc.
EYES - Look - anxious
EYES - Nervous, sympathetic reflex to symptoms
EYE - Pupils - dilated
CORYZA - Concomitants - heart, anxiety at
CORYZA - Concomitants - Nervous excitement
FACE - Anxious look
FACE - Blood, rush of, to
FACE - Deathly countenance
FACE - Expression - anxious
FACE - Expression - confused
FACE - Expression - despair, of
FACE - Expression - fear, of
FACE - Expression - frowning
FACE - Expression - miserable
FACE - Expression - suffering
FACE - Heat
FACE - Muscles - drawn
FACE - Tension (of skin)
FACE - Wrinkled
FACE - Wrinkled - forehead, forming etc.
FACE - Aggravation - Emotions
TEETH - Uneasiness
TEETH - Gums - Uneasiness
TEETH - Concomitants - Anxiety
133
TEETH - Concomitants - Face - heat of
TEETH - Concomitants - Restlessness
TEETH - Concomitants - Sweat, anxious
MOUTH - Dry feeling in
MOUTH - Dryness
MOUTH - Throat (and gullet) - Anxiety in
MOUTH - Throat (and gullet) - Choking, strangling
MOUTH - Throat (and gullet) - Foreign body, as of a crump, ball, etc
MOUTH - Throat (and gullet) - Globus, as of a ball, lump, knot, hystericus*
MOUTH - Throat (and gullet) - Plug, lump etc
MOUTH - Throat (and gullet) - Swallowing - difficult
MOUTH - Throat (& gullet) - Swallowing - urging to - suffocation, with fear*
MOUTH - Throat (and gullet) - uneasiness in
WATERBRASH AND HEARTBURN - Risings in throat (gulping up)
WATERBRASH AND HEARTBURN - Risings in throat - anxious *
NAUSEA AND VOMITING - Nausea
NAUSEA AND VOMITING - Nausea - anxiety, with
NAUSEA AND VOMITING - Nausea - anxious, deathly, etc.
NAUSEA AND VOMITING - Retching and gagging
NAUSEA AND VOMITING - Retching and gagging - anxious
NAUSEA AND VOMITING - Aggravation - Emotions
NAUSEA AND VOMITING - Aggravation - Fright, after
NAUSEA AND VOMITING - Concomitants - Fear, anxiety
NAUSEA AND VOMITING - Concomitants - Fear, anxiety - death, of
NAUSEA AND VOMITING - Concomitants - Irritability
NAUSEA AND VOMITING - Concomitants - Restlessness
STOMACH - Anxiety at
STOMACH - Anxiety at - rising, from
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STOMACH - Digestion, weak
STOMACH - Digestion, weak - emotions, from
STOMACH - Digestion, weak - hypochondriacs, in
STOMACH - Emotions are felt in
STOMACH - Epigastrium - Anxiety in, emotions felt there, etc.
STOMACH - Epigastrium - Sinking at
STOMACH - Aggravation - Anger, vexation - fright, with
STOMACH - Aggravation - Emotions
STOMACH - Aggravation - Fright, after
STOMACH - Concomitants - Anxiousness
STOMACH - Concomitants - Hypochondriasis, with
HYPOCHONDRIA - Anxiety in liver
HYPOCHONDRIA - Aggravation - Emotions
ABDOMEN - Anxiety, anguish, etc. in
ABDOMEN - Anxiety, anguish, etc. in - rising, from
ABDOMEN - Fright, pain as after a
ABDOMEN - Uneasiness
ABDOMEN - Aggravation - Emotions
ABDOMEN - Aggravation - Hypochondriasis, with
ABDOMEN - Amelioration - Fright
FLATULENCE - Aggravation - Anxiety, with
FLATULENCE - Aggravation - Emotions
STOOL - Concomitants before stool - Anxiety, fear
STOOL - Concomitants before stool - epigastrium - Anxiety in
STOOL - Concomitants before stool - Fear, anxiety
STOOL - Concomitants before stool - Fear, anxiety - of persons
STOOL - Concomitants before stool - Uneasiness, discomfort
STOOL - Concomitants during stool - Anxiety
135
STOOL - Concomitants after stool - Anxiety, fear, etc.
STOOL - Concomitants after stool - Fear, anxiety
STOOL - Aggravation and amelioration - Emotions, anger, fright etc
STOOL - Aggravation and amelioration - Fear, anxiety; with
STOOL - Aggravation and amelioration - Fear - others, of
URINE - Micturition - Urging - anxiety, with
URINE - Micturition - Urination - strangury - fear, fright, etc., agg.
URINE - Before urination - Anxiety
URINE - Before urination - Fright
URINE - During urination - Anxiety
URINARY ORGANS - Bladder - Anxiety
SEXUAL IMPULSE - Semen - emission of - anxiety, then
SEXUAL IMPULSE - Concomitants after coition - Anxiety
SEXUAL IMPULSE - Concomitants after pollutions - Heat, anxious
RESPIRATION - Anxious
RESPIRATION - Short
RESPIRATION - Impeded by - Anxiety
RESPIRATION - Impeded by - Dreams, anxious
RESPIRATION - Impeded by - Epigastrium - anxiety in
COUGH - Anxious
COUGH - Sympathetic reflex
COUGH - Concomitants - anxiety, fear
VOICE AND SPEECH - Anxious
CHEST - Inner - anxiety in
CHEST - Inner - constriction
CHEST - Inner - oppression
CHEST - Heart and region of - agitated
CHEST - Heart and region of - anguish
136
CHEST - Heart and region of - anxiety at
CHEST - Heart and region of - distress
CHEST - Heart and region of - uneasiness
CHEST - Aggravation - anxiety
BACK - Back proper, dorsal region - anxious sensation
BACK - Lumbar region, small of back - uneasiness, in
LOWER EXTREMITIES - Gait - anxious
SENSATIONS & COMPLAINTS IN GEN - Anxious feeling - internal anxiety*
SENSATIONS & COMPLAINTS IN GEN - Anxious feeling - In limbs
SENSATIONS & COMPLAINTS IN GEN - Fainting, faintness etc
SENSATIONS & COMPLAINTS IN GEN - Fainting - emotions*
SENSATIONS & COMPLAINTS IN GEN - Hypochondriasis & hysteria
SENSATIONS & COMPLAINTS IN GEN - Irritability
SENSATIONS & COMPLAINTS IN GEN - Muscles - tense
SENSATIONS & COMPLAINTS IN GEN - Restlessness
SENSATIONS & COMPLAINTS IN GEN – Starting, as if in affright
SENSATIONS & COMPLAINTS IN GEN - Trembling, shaking etc
SLEEP - Falling to sleep, late - prevented by - agitation
SLEEP - Falling to sleep, late - prevented by - anxiety, fear
SLEEP - Falling to sleep, late - prevented by - blood, orgasm of
SLEEP - Falling to sleep, late - prevented by - chest, oppression of
SLEEP - Falling to sleep, late - prevented by - emotions, from
SLEEP - Falling to sleep, late - prevented by - falling, fear of
SLEEP - Falling to sleep, late - prevented by - frightened, easily
SLEEP - Falling to sleep, late - prevented by - restlessness
SLEEP - Falling to sleep, late - prevented by - starting
SLEEP - Falling to sleep, late - prevented by - startled, as if
SLEEP - Sleep - anxious
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SLEEP - Sleep – restless
SLEEP - During sleep - anxiety
SLEEP - During sleep - nightmare
SLEEP - During sleep - nightmare - in first sleep
SLEEP - During sleep – starting up (as in an affright)
SLEEP - Waking - waking - anxious
SLEEP - Waking - waking – fright, as from
SLEEP - Waking - waking - restlessness, with
SLEEP - Waking - sleeplessness - fear or anxiety
SLEEP - Waking - sleeplessness - palpitation
SLEEP - Waking - sleeplessness - tossing about - anxious
SLEEP - Waking - sleeplessness - worry
DREAMS - Anxious, frightful, etc.
DREAMS - Anxious, frightful, etc - of animals.
DREAMS - Anxious, frightful, etc - day’s events of
DREAMS - Anxious, frightful, etc - the dead
DREAMS - Anxious, frightful, etc - difficulties, perplexity*
DREAMS - Anxious, frightful, etc - disease
DREAMS - Anxious, frightful, etc - dying of
DREAMS - Anxious, frightful, etc - exertion, laborious, etc
DREAMS - Anxious, frightful, etc - falling
DREAMS - Anxious, frightful, etc - fire
DREAMS - Anxious, frightful, etc - forms of
DREAMS - Anxious, frightful, etc - ghosts
DREAMS - Anxious, frightful, etc - heavy
DREAMS - Anxious, frightful, etc - lewd
DREAMS - Anxious, frightful, etc - loathsome
DREAMS - Anxious, frightful, etc - misfortune, fatal accidents
138
DREAMS - Anxious, frightful, etc - pursued being
DREAMS - Anxious, frightful, etc - quarrels and strife
DREAMS - Anxious, frightful, etc - shooting
DREAMS - Anxious, frightful, etc - thieves
DREAMS - Anxious, frightful, etc - thunderstorms
DREAMS - Anxious, frightful, etc - vivid
DREAMS - Anxious, frightful, etc - voyages
DREAMS - Anxious, frightful, etc - war
DREAMS - Anxious, frightful, etc – water
DREAMS - Restless, disturbed
CIRCULATION - Congestions - ebullition, rush of blood, flashing, orgasms*
CIRCULATION - Palpitation - anxious
CIRCULATION - Palpitation - audible
CIRCULATION - Palpitation - blood rushes of, with
CIRCULATION - Palpitation - breathing, with short
CIRCULATION - Palpitation - chest, oppression in, with
CIRCULATION - Palpitation - chest, pain in, with
CIRCULATION - Palpitation - emotion from
CIRCULATION - Palpitation - faintness, with
CIRCULATION - Palpitation - nausea, with
CIRCULATION - Palpitation - shaking whole body
CIRCULATION - Palpitation - sweat, with cold
CIRCULATION - Palpitation - violent
CIRCULATION - Heartbeat - heartbeat - audible
CIRCULATION - Heartbeat - heartbeat - shaking the whole body
CIRCULATION - Heartbeat - heartbeat - tumultuous and stormy
CIRCULATION - Pulse - pulse - quick (accelerated)
CIRCULATION - Pulse - pulse - shaking the whole body
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CIRCULATION - Aggravation - Emotions
CHILL - Chill, etc - Aggravation - Emotions
CHILL - Chill, etc. - concomitants - mind - anxiety
CHILL - Chill, etc. - concomitants - chest - palpitation
CHILL - Chill, etc. - concomitants - skin - goose skin
HEAT & FEVER IN GENERAL - Heat and burning - anxious
HEAT & FEVER IN GENERAL - Aggravation - Emotions
HEAT & FEVER IN GENERAL - Concomitants - mind - anthropophobia
HEAT & FEVER IN GENERAL - Concomitants - mind - anxiety
HEAT & FEVER IN GENERAL - Concomitants - mind - delirium - anxious
HEAT & FEVER IN GENERAL - Concomitants - mind - fear
HEAT & FEVER IN GENERAL - Concomitants - mind - frightened easily
HEAT & FEVER IN GENERAL - Concomitants - mind - restlessness
HEAT & FEVER IN GEN. - Concomitants - respiration - breathing - anxious
HEAT & FEVER IN GEN. - Concomitants - chest - heart - anxious
SWEAT - Sweat, sweatiness - anxious
SWEAT - Concomitants - mind - anthropophobia
SWEAT - Concomitants - mind - anxiety
SWEAT - Concomitants - mind - death, fear of
SWEAT - Concomitants - mind – frightened easily
SWEAT - Concomitants - mind - restlessness
SWEAT - Concomitants - mouth - mouth - dryness, of
SWEAT - Concomitants - respiration - breathing - anxious, quick*
SWEAT - Concomitants - respiration - breathing – oppression, of
SWEAT - Concomitants - chest - heart, palpitation of
SWEAT - Concomitants - sensations & generalities - restlessness*
CONDITIONS OF AGG.\ AMEL. IN GEN - Emotions, agg.
CONDITION OF AGG\ AMEL IN GEN - Emotions - anger - anxiety, agg.*
140
CONDITION OF AGG\ AMEL IN GEN - Emotions - fright (anxiety) - agg*
CONDITION OF AGG\ AMEL IN GEN - Emotions - fright - of an ordeal
CONDITION OF AGG\ AMEL IN GEN - Society, company, agg*.
CONDITION OF AGG\ AMEL IN GEN - Strangers, when among agg
CONDITION OF AGG\ AMEL IN GEN - Walking - narrow bridge, agg*
* - symptom slightly altered to fit the format
REPERTORIAL REFERENCES FROM OTHER REPERTORIES. The Rubrics relating to anxiety are also found in other repertories
such a Synthesis, Synthetic, Knerr`s repertory and Phatak`s repertory.
Only those rubrics which are present in these repertories and not in
Kent and Boenninghausen are highlighted here.
SYNTHESIS REPR 5.2 MIND - AILMENTS FROM - anxiety - prolonged, from
MIND - ANGUISH - eating, after
MIND - ANTICIPATION - examination, before
MIND - ANTICIPATION - stage fright
MIND - ANXIETY - night - children, in
MIND - ANXIETY - beside oneself from anxiety, being
MIND - ANXIETY - breakfast - amel.
MIND - ANXIETY - burning of stomach and coldness of body; with
MIND - ANXIETY - cough - whooping, during
MIND - ANXIETY - face - heat of face; with
MIND - ANXIETY - face - pale face; with
141
MIND - ANXIETY - face - perspiration of face; with
MIND - ANXIETY - face - perspiration of face; with - cold
MIND - ANXIETY - face - red face; with
MIND - ANXIETY - flatus - obstructed flatus; with
MIND - ANXIETY - sexual desire; from suppressed
MIND - ANXIETY - swoon, after
MIND - ANXIETY - torturing
MIND - ANXIETY - wine, after
MIND - BITE, desire to - nails
MIND - CLINGING - take the hand of mother, will always
MIND - CONCENTRATION - difficult - attention, cannot fix
MIND - DELIRIUM - terror, expressive of
MIND - FEAR - cancer, of
MIND - FEAR - control, losing
MIND - FEAR - crossing Street
MIND - FEAR - elevators, of
MIND - FEAR - everything, constant of
MIND - FEAR - failure of - examinations; in
MIND - FEAR - fright - previous fright; because of a
MIND - FEAR - full of fear
MIND - FEAR - open space; fear of
MIND - FEAR - shadows
MIND - FEAR - shadows - candlelight; thrown by
MIND - FEAR - wolves, of
MIND - IMPULSE, morbid - absurd things; to do
MIND - IRRITABILITY - imagined occurrences, about
MIND - RESTLESSNESS - driving about
MIND - STARING - thoughtless
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MIND - STUPEFACTION - anxiety, with
MIND - SUICIDAL disposition - anxiety, from
MIND - WEEPING - anxious
HEAD - CONGESTION - anxiety, with
HEAD - HEAT - anxiety, with
HEAD - PERSPIRATION of scalp - forehead - cold - trembling anxiety, with
VISION - DIM - anxiety, during
FACE - HEAT - anxiety, during
FACE - PERSPIRATION - anxiety, with
FACE - TENSION of skin - masseter muscles
ABDOMEN - RESTLESSNESS, uneasiness - anxious
RECTUM - DIARRHOEA - anxiety, after
CHEST - CONSTRICTION - anguish, with
CHEST - PAIN - aching - anxiety, with
SLEEP - DISTURBED - perspiration by - anxiety, from
SLEEP - SLEEPINESS - anxiety, with
GENERALS - CONULSIONS - anxiety, from
SYNTHETIC REPERTORY (VOL 1, 2 & 3).
VOLUME 1 - PSYCHIC SYMPTOMS
MIND - ABSORBED - future, about
MIND - ABSORBED - misfortunes, imagines
MIND - AILMENTS FROM - anticipation
MIND - AILMENTS FROM - anxiety
MIND - AILMENTS FROM - cares, worries
MIND - AILMENTS FROM - fear
143
MIND - AILMENTS FROM - fright
MIND - AILMENTS FROM - fright - accident; from sight of an
MIND - AILMENTS FROM - shock, mental
MIND - ANGER - causeless
MIND - ANGER - happen; anger at what he thinks may
MIND - ANGER - trifles, at
MIND - ANGUISH - noon
MIND - ANGUISH - afternoon
MIND - ANGUISH - evening, 7 p.m.
MIND - ANGUISH - night - paralyzing anguish, impossible to call or move*
MIND - ANGUISH - alone, when
MIND - ANGUISH - bed - after going to bed amel.
MIND - ANGUISH - cardiac
MIND - ANGUISH - clothes too tight when walking in open air; as if
MIND - ANGUISH - constricted, as if everything became
MIND - ANGUISH - driving from place to place - restlessness, with
MIND - ANGUISH - horrible things; after hearing
MIND - ANGUISH - lamenting, moaning
MIND - ANGUISH - lie down, must
MIND - ANGUISH - motion amel.
MIND - ANGUISH - nausea, with
MIND - ANGUISH - oppression, with
MIND - ANGUISH - oppression, with - desire to sit up or jump out of bed
MIND - ANGUISH - palpitation, with
MIND - ANGUISH - perspiration, during - night
MIND - ANGUISH - respiration, preventing
MIND - ANGUISH - room with light and people, agg, in a
MIND - ANGUISH - tossing about, with
144
MIND - ANGUISH - tremulous anguish, rest agg, motion amel.
MIND - ANGUISH - uremia, in
MIND - ANGUISH - waking, on
MIND - ANGUISH - weeping, with
MIND - ANTICIPATION - morning
MIND - ANTICIPATION - dentist, physician; before going to
MIND - ANTICIPATION - stage fright - singers and speakers, in
MIND - ANXIETY - morning - perspiration; during
MIND - ANXIETY - afternoon - 2 - 4 p.m.
MIND - ANXIETY - afternoon - amel.
MIND - ANXIETY - night - amel.
MIND - ANXIETY - night - midnight - after - half waking; on
MIND - ANXIETY - night - midnight - after - 2-4 h
MIND - ANXIETY - night - midnight - after - 3-5 h
MIND - ANXIETY - night - midnight - after - 5 h
MIND - ANXIETY - abdomen; with distension of
MIND - ANXIETY - alternating with - contentment
MIND - ANXIETY - alternating with - exhilaration
MIND - ANXIETY - alternating with - rage
MIND - ANXIETY - anticipation, from
MIND - ANXIETY – bed in, driving out of
MIND - ANXIETY - bed, in - heat of, from
MIND - ANXIETY - bed, in - sit up, must
MIND - ANXIETY - bed, in - tossing about, with
MIND - ANXIETY - bed, in - turning in, when
MIND - ANXIETY - beer, after
MIND - ANXIETY - breathing - must breathe deeply
MIND - ANXIETY - causeless
145
MIND - ANXIETY - chest, in - stitching in, from
MIND - ANXIETY - children - infants, in
MIND - ANXIETY - children - rocking, during
MIND - ANXIETY – climacteric period, during
MIND - ANXIETY - clothes and open windows, must loose
MIND - ANXIETY - clothes - as if clothing too tight, walking out of doors;
MIND - ANXIETY - coffee - amel.
MIND - ANXIETY - coition - during
MIND - ANXIETY - coldness of feet at night, during
MIND - ANXIETY - congestion - to heart
MIND - ANXIETY - conscience; as if guilty of a crime - afternoon
MIND - ANXIETY - conscience; as if guilty of a crime - dreams, a. of c. in
MIND - ANXIETY - conscience; as if guilty of a crime - no rest night / day *
MIND - ANXIETY - convulsions - before
MIND - ANXIETY - cramping rectum, during
MIND - ANXIETY - cramping stomach, in
MIND - ANXIETY - daily
MIND - ANXIETY - dancing, when
MIND - ANXIETY - dentition, during
MIND - ANXIETY - disguises; which he vainly
MIND - ANXIETY - do something; compelled to
MIND - ANXIETY - drinking - cold water amel.
MIND - ANXIETY - driving from place to place
MIND - ANXIETY - duty, as if he had not done his
MIND - ANXIETY - epilepsy, during intervals of
MIND - ANXIETY - epistaxis amel.
MIND - ANXIETY - eructations - ending with
MIND - ANXIETY - everything; about
146
MIND - ANXIETY - exercise - from
MIND - ANXIETY - faintness, with
MIND - ANXIETY - family; about his
MIND - ANXIETY - fasting, when
MIND - ANXIETY - fever - as from
MIND - ANXIETY - fright - remains, if the fear of the fright
MIND - ANXIETY - head, with congestion to
MIND - ANXIETY - head - heat of; with
MIND - ANXIETY - head - perspiration on forehead; with
MIND - ANXIETY - health; about - relatives, of
MIND - ANXIETY - himself, about
MIND - ANXIETY - home, about
MIND - ANXIETY - hurry, with
MIND - ANXIETY - hysterical
MIND - ANXIETY - inactivity, with
MIND - ANXIETY - joyful things, by most
MIND - ANXIETY - masturbation, from
MIND - ANXIETY - menses - during - anger and a.
MIND - ANXIETY - moaning, with
MIND - ANXIETY - money matters, about
MIND - ANXIETY - noise, from - in ear
MIND - ANXIETY - nursing, after
MIND - ANXIETY - oppression, with
MIND - ANXIETY - pains, from - abdomen
MIND - ANXIETY - pains, from - anus
MIND - ANXIETY - pains, from - eyes
MIND - ANXIETY - pains, from - stomach
MIND - ANXIETY - paralyzed, as if
147
MIND - ANXIETY - parturition, during
MIND - ANXIETY - perspiration amel.
MIND - ANXIETY - perspiration - with cold
MIND - ANXIETY - pregnancy, in
MIND - ANXIETY - present, about
MIND - ANXIETY - pressure in the chest, from
MIND - ANXIETY - pressure in the epigastrium, from
MIND - ANXIETY - pulsation in the abdomen, with
MIND - ANXIETY - pursued, as if
MIND - ANXIETY - rest; during
MIND - ANXIETY - rising, after - from lying
MIND - ANXIETY - room, on entering a
MIND - ANXIETY - salvation, about - night
MIND - ANXIETY - salvation, about - faith, about loss of his
MIND - ANXIETY - salvation, about - hell, of
MIND - ANXIETY - salvation, about - scruples, excessifs religious
MIND - ANXIETY - salvation, about - scrupulous their religious practices*
MIND - ANXIETY - sitting - bent -must
MIND - ANXIETY - stitching in spine, from
MIND - ANXIETY - stools, after - bloody
MIND - ANXIETY - stools, as for
MIND - ANXIETY - stormy weather, during
MIND - ANXIETY - success, from doubts about
MIND - ANXIETY - thoughts; from - disagreeable
MIND - ANXIETY - thoughts; from - sad
MIND - ANXIETY - thunderstorm, before
MIND - ANXIETY - touched, anxiety to being
MIND - ANXIETY – tunnel in a train, in
148
MIND - ANXIETY - urination, when the desire is resisted
MIND - ANXIETY - urination, with urging to
MIND - ANXIETY - vomiting, on
MIND - ANXIETY - walking, amel.
MIND - ANXIETY - walking, after
MIND - ANXIETY - walking, cool air, in
MIND - ANXIETY - weary of life, with
MIND - ANXIETY - work, anxiety with inclination to
MIND - ANXIETY - work - anxiety preventing
MIND - ANXIETY - working, while
MIND - AVARICE - anxiety about future, from
MIND - BESIDE oneself being - anxiety, from
MIND - BESIDE oneself being - trifles, from
MIND - CARES, worries, full of - business, about his
MIND - CARES, worries, full of - others, about
MIND - CARES, worries, full of - relatives, about
MIND - DELUSIONS - anxious
MIND - DELUSIONS - doomed, being
MIND - DELUSIONS - fright, after
MIND - DELUSIONS - heart disease, having an
MIND - DISCOURAGED - anxiety, with
MIND - DWELLS - recalls - disagreeable memories
MIND - ESCAPE, attempts to - anxiety at night, with
MIND - FEAR - alternating with exhilaration
MIND - FEAR - alternating with rage
MIND - FEAR - alternating with sadness
MIND - FEAR - appearing in public, of
MIND - FEAR - ascending of
149
MIND - FEAR - blind, of going
MIND - FEAR - business, of
MIND - FEAR - cats
MIND - FEAR - children, in
MIND - FEAR - company, of
MIND - FEAR - crossing bridge or a place
MIND - FEAR - crowd, in a - climacteric period, during
MIND - FEAR - death of - impending death, of
MIND - FEAR - delusions, from
MIND - FEAR - diarrhea, from
MIND - FEAR - disease of impending - incurable of being
MIND - FEAR - dreams, of terrible
MIND - FEAR - enemies, of
MIND - FEAR - escape; with desire to
MIND - FEAR - examination, before
MIND - FEAR - failure of
MIND - FEAR - falling, of - child holds on to the mother
MIND - FEAR - going out, of
MIND - FEAR - hanged, to be
MIND - FEAR - happen, something will - night
MIND - FEAR - humiliated of being
MIND - FEAR - insanity, losing his reason, of – climacteric period, during
MIND - FEAR - insects, of
MIND - FEAR - knaves, of
MIND - FEAR - knives, of
MIND - FEAR - lifelong
MIND - FEAR - lightning, of
MIND - FEAR - menses, after
150
MIND - FEAR - menses, suppressed - from fear
MIND - FEAR - motion, of
MIND - FEAR - narrow places - vaults, churches & cellars, of
MIND - FEAR - neglected, of being
MIND - FEAR - new persons, of
MIND - FEAR - operation, of each
MIND - FEAR - opinion of others, of
MIND - FEAR - ordeals, of
MIND - FEAR - overpowering
MIND - FEAR - palpitation, with
MIND - FEAR - perspiration, with
MIND - FEAR - pitied, of being
MIND - FEAR - position, to lose his lucrative
MIND - FEAR - rage, to fly into a
MIND - FEAR - rail, of going by
MIND - FEAR - recover, he will not
MIND - FEAR - recover, he will not - climacteric period, during
MIND - FEAR - recurrent
MIND - FEAR - reproaches, of
MIND - FEAR - restlessness from fear
MIND - FEAR - robbers - waking, on
MIND - FEAR - sadness, with
MIND - FEAR - scorpions, of
MIND - FEAR - shadows - his own shadow; of
MIND - FEAR - shivering from fear
MIND - FEAR - sighing, with
MIND - FEAR - smallpox, of
MIND - FEAR - snakes, of
151
MIND - FEAR - solitude, of
MIND - FEAR - spiders, of
MIND - FEAR - starting, with
MIND - FEAR - stool, of involuntary
MIND - FEAR - stoppage of circulation, with sensation of (at night)
MIND - FEAR - strangled, to be
MIND - FEAR - struck by those coming towards him, of being
MIND - FEAR - suffocation, of - eating amel.
MIND - FEAR - suffocation, of - heart disease, in
MIND - FEAR - suffocation, of - sleep, during
MIND - FEAR - telephone, of
MIND - FEAR - things, of real and unreal
MIND - FEAR - torturing, of
MIND - FEAR - tremulous
MIND - FEAR - tunnels; of
MIND - FEAR - unconsciousness, of
MIND - FEAR - urine, from - retention, of
MIND - FEAR - work, dread of - afternoon
MIND - FEAR - work, dread of - daily; of
MIND - FEAR - work, dread of – mental, of
MIND - FRIGHTENED easily - noon - nap, after
MIND - FRIGHTENED easily - evening
MIND - FRIGHTENED easily - blood, at sight of
MIND - FRIGHTENED easily - delusions, from
MIND - FRIGHTENED easily - shadow, of his own
MIND - FRIGHTENED easily - waking, on - dream, from a
MIND - IMPULSE, morbid
MIND - INDIFFERENCE - anxiety, after
152
MIND - IRRITABILITY - anxiety, with
MIND - JUMPING - bed; out of - frightful dream, from a
MIND - KILL; desire to - beloved ones
MIND - KILL; desire to - child, the own
MIND - KILL; desire to - poison, impulse to
MIND - LAMENTING - anxious
MIND - MOANING, groaning - anxious
MIND - MOANING, groaning - restlessness, with
MIND - STUPEFACTION - anxiety, with
MIND - SUICIDAL disposition - anxiety, from
MIND - THOUGHTS - tormenting - past disagreeable events, about
MIND - WEEPING - anxiety, after
MIND - WEEPING - anxious
MIND - WEEPING - evil impended, as if
MIND - WEEPING - future, about the
MIND - WEEPING - nightmare, after
MIND - WITHDRAWAL from reality
VOLUME 2 - GENERAL SYMPTOMS
GENERALITIES - CHOREA - anxiety, from
GENERALITIES - FAINTNESS - anguish, after
GENERALITIES - ORGASME OF BLOOD - anxiety with
GENERALITIES - TREMBLING - anxiety – with
VOLUME 3 – SLEEP, DREAMS & SEXUALITY
MALE GENITALIA/SEX - MASTURBATION, irresistible tendency
SLEEP - DISTURBED - anxiety, from
SLEEP - DISTURBED - visions, by - anxious
153
SLEEP - RESTLESS - anxiety, with
SLEEP - SLEEPINESS - anxiety, with
SLEEP - SLEEPLESSNESS - visions, from - anxious
SLEEP - WAKING - frequent - anxiety, with
SLEEP - YAWNING - anxiety, during
DREAMS - ANXIOUS - anxiety amel. on waking
DREAMS - ANXIOUS - siesta, during
DREAMS - FRIGHTFUL - fear, followed by
DREAMS - FRIGHTFUL - waking him
DREAMS - NIGHTMARES - falling sleep. On
DREAMS - NIGHTMARES - full moon, at
KNERR`S REPERTORY
MIND - ANGUISH - abortion, in threatened
MIND - ANGUISH - amenorrhoea, in
MIND - ANGUISH - anger, after
MIND - ANGUISH - choking, from
MIND - ANGUISH - cholera, in
MIND - ANGUISH - colic, with
MIND - ANGUISH - dyspnoea, with
MIND - ANGUISH - fainting, before
MIND - ANGUISH - fever, with
MIND - ANGUISH - headache, in
MIND - ANGUISH - hysteria, in
MIND - ANGUISH - loss of his friend, from
MIND - ANGUISH - meningitis, in
MIND - ANGUISH - metrorrhagia, in
MIND - ANGUISH - peritonitis, in
154
MIND - ANGUISH - perspiration, with cold - forehead, on
MIND - ANGUISH - restlessness, with
MIND - ANGUISH - shock from injury, in
MIND - ANGUISH - stormy weather, in
MIND - ANGUISH - suicide, attempts to commit
MIND - ANGUISH - toothache, with
MIND - ANGUISH - vomiting, with
MIND - ANGUISH - whooping cough, during
MIND - ANTICIPATION - feels matters sensitively before they occur *
MIND - ANTICIPATION - unusual ordeal, of any
MIND - ANXIETY - forenoon - better after little whiskey
MIND - ANXIETY - accident; as if - would happen
MIND - ANXIETY - alone; when - evening
MIND - ANXIETY - alone; as if - and all about were dead and still
MIND - ANXIETY - amenorrhea; during
MIND - ANXIETY - apathy, followed by
MIND - ANXIETY - aphonia, in
MIND - ANXIETY - arms, had to stretch
MIND - ANXIETY - ascites; during
MIND - ANXIETY - asthma; with
MIND - ANXIETY - attacks in - cannot control herself
MIND - ANXIETY - back - small of - paralytic pain with
MIND - ANXIETY - bladder paralysis, with
MIND - ANXIETY - bronchitis, with
MIND - ANXIETY - business, about - dyspepsia, from
MIND - ANXIETY - chest, in - congestion, with
MIND - ANXIETY - chest, in - effusion of serum, with
MIND - ANXIETY - chest, in - gastralgia, with
155
MIND - ANXIETY - chest, in - palpitations and bitter eructations, with
MIND - ANXIETY - cheerful, careless mood, after
MIND - ANXIETY - chorea, in
MIND - ANXIETY - complaints, with all bodily
MIND - ANXIETY - confusion before eyes, after
MIND - ANXIETY - continued - anasarca, in
MIND - ANXIETY - crime - committing, as if
MIND - ANXIETY - domestic affairs about - pregnancy during
MIND - ANXIETY - flatulent distention - from
MIND - ANXIETY - fly away, as if she must, no peace anywhere
MIND - ANXIETY - fright, after - seventh month of pregnancy, in
MIND - ANXIETY - friend had forsaken her, as if
MIND - ANXIETY - future, about - childbed, after
MIND - ANXIETY - future, about - chronic orchitis, with
MIND - ANXIETY - future, about - disgust of life, with
MIND - ANXIETY - future, about - spermatorrhoea, with
MIND - ANXIETY - gloomy forebodings, with
MIND - ANXIETY - head - heat of; with - cold feet, and
MIND - ANXIETY - mania, in
MIND - ANXIETY - melancholy, with
MIND - ANXIETY - restlessness, with
MIND - ANXIETY - suffering, with
MIND - ANXIETY - terrible
MIND - ANXIETY - twitching, with *
MIND - ANXIETY - typhus, in
MIND - ANXIETY - unconquerable
MIND - ANXIETY - vaccination, after
MIND - APPREHENSIONS
156
MIND - APPREHENSIONS - anxious
MIND - APPREHENSIONS - bad news - would soon hear, as if
MIND - APPREHENSIONS - chlorosis, in
MIND - APPREHENSIONS - control, loss of - with feeling of
MIND - APPREHENSIONS - disease, of
MIND - APPREHENSIONS - disease, of – diarrhea, in
MIND - APPREHENSIONS - disease, of - fatal termination, of
MIND - APPREHENSIONS - emission, after
MIND - APPREHENSIONS - evil, of - with sadness and weeping
MIND - APPREHENSIONS - menses, after
MIND - APPREHENSIONS - night - cannot remain in bed
MIND - APPREHENSIONS - room seemed gloomy and unpleasant
MIND - APPREHENSIONS - weep, with inclination to
MIND - APPREHENSIONS - wrong, of something indescribable
MIND - CONSCIENCE - over conscientious
MIND - FEAR - amenorrhoea from fear
MIND - FEAR - anorexia from fear
MIND - FEAR - bed, jumps out of - fear from
MIND - FEAR - breath away, takes
MIND - FEAR - coition - during - impotence from fear, with
MIND - FEAR - crazy, of becoming - fright, after
MIND - FEAR - crazy, of becoming - with restlessness & heat
MIND - FEAR - death of - amenorrhoea, in
MIND - FEAR - death of - anger, from
MIND - FEAR - death of - cholera, in
MIND - FEAR - death of - hemorrhage, in uterine
MIND - FEAR - death of - loquacity, with
MIND - FEAR - death of - prolapse of uterus; with
157
MIND - FEAR - death of - suffocation, from
MIND - FEAR - death of - uterus; from pain in
MIND - FEAR - surgeon, of
MIND - FEAR - touched; of being - gout, in
MIND - FEAR - weary of life, with
MIND - FEAR - work, of - persuaded to work; cannot be
MIND - FEAR - wrong of something - commit something
MIND - FOREBODINGS - brain fag, with
MIND - FOREBODINGS - constant
MIND - FOREBODINGS - dysmenorrhoea, in
MIND - FOREBODINGS - evil
MIND - FOREBODINGS - impending disaster, of
MIND - HASTY - heart, with anxiety and fluttering
MIND - HYPOCHONDRIASIS - anxiety, with
MIND - INCONSOLABLE - anxiety about his family during a short journey*
MIND - RELIGIOUS - mania - prays all the time
MIND - RUNS about - as if in fright
MIND - SADNESS - impending evil, with apprehension of
MIND - TALKING - misfortune, about
MIND - THOUGHTS - terrible - take possession of him
MIND - UNEASY
MIND - WORRY
MIND - WRITING - unable to as rapidly as he wishes, anxious, makes mistakes*
FACE - EXPRESSION - anxious - fear of death, with
FACE - EXPRESSION - fear - and terror
STOMACH - ANXIETY - apprehensive
FEMALE GENITALIA/SEX - menses - too late - anxiety, with
DREAMS - ANXIOUS - palpitation, with
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DREAMS - ANXIOUS - talking and crying in sleep, with
DREAMS - ANXIOUS - weeping during sleep, with
PHATAK`S REEPRTORY
MIND - BORROWS trouble
MIND - CARE & WORRY - causeless
MIND - FEAR - hurt, of being
MIND - FEAR - sharp things, of
MIND - FEAR - stool, after
MIND - FEAR - waking, on - slowly must, otherwise something will happen *
GENERALITIES - FORMICATION, crawling - anxiety, with
Rubric altered a little to fit the format
159
160
MATERIALS AND METHODS
MATERIALS
This study is on the patients attending my own clinics. It is based on
clinical study on the patients from Mar 2005 to Feb 2006.
Medicine sources:
Medicines prepared by reliable and reputed companies like SBL,
Medisynth, Willmar Schwabe, India; available at my own clinics are
used.
Potencies of medicines being used are 30, 200, 1M, 10M.
Globule no 10 and sugar of milk are used for dispensing the
medicines.
Rectified Spirit and distilled water is used for dispensing of medicine
as and when required.
Placebo is used in 10 no. globules.
Medicine Selection:
Medicine is selected after proper case taking, using a standard format
for recording (please refer Appendix) and repertorisation. The potency
selection is made on the basis of susceptibility and individualization.
A single dose of the selected medicine is given followed by placebo.
Inclusion criteria:
161
▪ Patients of ages 10 to 65, of both sex, of different socio-economic
status and different habits, having anxiety disorder are included in this
study.
▪ For the purpose of this study, 30 cases are taken.
▪ The diagnostic criteria of the DSM- IV is used for diagnosing &
differentiating the different types of anxiety disorders. (As given in
Materials and Methods).
▪ Patients already on other medication for anxiety disorder are also
included.
Exclusion criteria:
The cases which either do not follow our instructions, or do not attend
clinics / follow ups have been excluded.
METHODS To fulfill our aim and objectives, 30 cases of anxiety disorder are
studied from my clinics (1 in urban area and 1 in rural area.). The data
during case - taking is collected in accordance to the Homoeopathic
principles.
Instructions before case taking:
The patients are instructed to be free and frank in providing us fullest
information possible. Also the importance of each question asked and
its importance in selection of the correct Homoeopathic remedy is
162
stressed. They are also assured about the confidentiality of the
information.
Confirmation and completion of data
Case is further confirmed and completed from observers, attendants
and family members, for the authenticity.
Allopathic Medication
Some of the patients are already on allopathic medication for anxiety
when their Homoeopathic treatment is started.
The allopathic medication is not disturbed initially and the
Homoeopathic medicine is started in addition to that. During the
course of treatment, as per the response of the patient the allopathic
medication is tapered & stopped.
Psychotherapy
No Psychotherapy is used during this study, to observe the effects of
homoeotherapeutics only.
Precautions advised
During the treatment, the patients are advised to keep away from
factors that might aggravate their conditions in addition to Alcohol,
Coffee, and Tobacco etc.
Medicine Repetition
The minimum dose of the medicine is repeated only when there is
recurrence or aggravation of symptoms.
163
DSM IV Criteria for the Anxiety Disorders:
Generalized Anxiety Disorder
A. Excessive anxiety and worry (apprehensive expectation), occurring
more days than not, for at least 6 months, about a number of events or
activities (such as work or school performance).
B. The person finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the
following six symptoms (with at least some symptoms present for
more days than not, for the past 6 months). Note: Only one item is
required in children.
• Restlessness or feeling keyed up or on edge
• Being easily fatigued
• Difficulty concentrating or mind going blank
• Irritability
• Muscle tension
• Sleep disturbance (Difficulty falling or staying asleep or
restless, unsatisfying sleep)
D. The focus of the anxiety and worry is not confined to features of an
Axis I disorder, eg, the anxiety or worry is not about having a panic
attack (as in Panic Disorder), being embarrassed in public (as in social
phobia), being contaminated (as in obsessive-compulsive disorder),
being away from home or close relatives (as in separation anxiety
disorder), gaining weight (as in anorexia nervosa), having multiple
physical complaints (as in somatization disorder), or having a serious
164
illness (as in hypochondriasis), and the anxiety and worry do not
occur exclusively during post-traumatic stress disorder.
E. The anxiety, worry or physical symptoms cause clinically
significant distress or impairment in social, occupational or other
important areas of functioning.
F. The disturbance is not due to the direct physiological effects of a
substance (eg, a drug of abuse, a medication) or a general medical
condition (eg, hyperthyroidism) and does not occur exclusively during
a mood disorder, a psychotic disorder, or a Pervasive Developmental
Disorder.
Criteria for the Anxiety Disorders: Panic Attack
A discrete period of intense fear or discomfort, in which four (or
more) of the following symptoms develop abruptly and reach a peak
within 10 minutes:
• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Derealization (feelings of unreality) or depersonalization (being
165
Detached from oneself)
• Fear of losing control or going crazy
• Fear of dying
• Paresthesias (numbness or tingling sensations)
• Chills or hot flushes
DSM IV Criteria for the Anxiety Disorders: Panic Disorder
A discrete period of intense fear or discomfort, in which four (or
more) of the following symptoms develop abruptly and reach a peak
within 10 minutes:
A. Both (1) and (2):
1. Recurrent unexpected panic attacks
2. At least one of the attacks has been followed by 1 month (or
more) of one or more of the following:
a. Persistent concern about having additional panic attacks
b. Worry about the implications of the attack or its consequences
c. A significant change in behavior related to the attacks
B. Presence or absence of agoraphobia
C. The panic attacks are not due to the direct physiological effects of a
substance (eg, a drug of abuse, a medication) or a general medical
condition (eg, hyperthyroidism).
D. The panic attacks are not better accounted for by another mental
disorder.
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DSM IV Criteria for the Anxiety Disorders:
Obsessive Compulsive Disorder
A. Either obsessions or compulsions:
Obsessions as defined by (1), (2), (3) and (4):
1. Recurrent and persistent thoughts, impulses, or images that are
Experienced, at some time during the disturbance, as intrusive and
Inappropriate and that cause marked anxiety or distress.
2. The thoughts, impulses or images are not simply excessive worries
about Real-life problems.
3. The person attempts to ignore or suppress such thoughts, impulses
or images, or to neutralize them with some other thought or action.
4. The person recognizes that the obsessional thoughts, impulses or
images are a product of his or her own mind (not imposed from
without as in thought insertion).
Compulsions as defined by (1) and (2):
1. Repetitive behaviors (eg, hand washing, ordering, checking) or
mental acts (eg, praying, counting, repeating words silently) that the
person feels driven to perform in response to an obsession, or
according to rules that must be applied rigidly.
2.The behaviors or mental acts are aimed at preventing or reducing
distress or preventing some dreaded event or situation; however, these
behaviors or mental acts either are not connected in a realistic way
with what they are designed to neutralize or prevent, or are clearly
excessive.
167
B. At some point during the course of the disorder, the person has
recognized that the obsessions or compulsions are excessive or
unreasonable. Note: This does not apply to children.
C. The obsessions or compulsions cause marked distress, are time-
consuming (more than 1 hour a day), or significantly interfere with the
person's normal routine, occupational (or academic) functioning, or
usual social activities or relationships.
D. If another Axis I disorder is present, the content of the obsessions
or compulsions is not restricted to it.
E. The disturbance is not due to the direct physiological effects of a
substance or a medical condition.
Specify if:
With Poor Insight: If, for most of the time during the current episode,
the person does not recognize that the obsessions and compulsions are
excessive or unreasonable.
DSM IV Criteria for the Anxiety Disorders: Post-Traumatic
Stress Disorder
A. The person has been exposed to a traumatic event in which both of
the following were present:
1.The person experienced, witnessed or was confronted with an event
that involved actual or threatened death or serious injury, or a threat to
the physical integrity of others.
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2.The person's response involved intense fear, helplessness or horror.
Note: In children, this may be expressed instead by disorganized or
agitated behavior.
B. The traumatic event is persistently re-experienced in one (or more)
of the following ways:
1.Recurrent and intrusive distressing recollections of the event,
including images, thoughts or perceptions. Note: In young children,
repetitive play may occur in which themes or aspects of the trauma are
expressed.
2.Recurrent distressing dreams of the event. Note: In children, there
may be frightening dreams without recognizable content.
3.Acting or feeling as if the traumatic event were recurring (includes a
sense of reliving the experience, illusions, hallucinations and
dissociative flashback episodes, including those that occur on
awakening or when intoxicated). Note: In young children, trauma-
specific reenactment may occur.
4.Intense psychological distress at exposure to internal or external
cues that symbolize or resemble an aspect of the traumatic event.
5.Physiological reactivity on exposure to internal or external cues that
symbolize or resemble an aspect of the traumatic event.
C.Persistent avoidance of stimuli associated with the trauma and
numbing of general responsiveness (not present before the trauma), as
indicated by three (or more) of the following:
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1. Efforts to avoid thoughts, feelings or conversations associated with
the trauma
2. Efforts to avoid activities, places or people that arouse recollections
of the trauma
3. Inability to recall an important aspect of the trauma
4. Markedly diminished interest or participation in significant
activities
5. Feeling of detachment or estrangement from others
6. Restricted range of affect (eg, does not expect to have a career
marriage, children or a normal life span)
D.Persistent symptoms of increased arousal (not present before the
trauma) as indicated by two (or more) of the following:
1. Difficulty falling or staying asleep
2. Irritability or outbursts of anger
3. Difficulty concentrating
4. Hypervigilance
5. Exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C and D) is
more than 1 month.
F. The disturbance causes clinically significant distress or impairment
in social, occupational or other important areas of functioning.
Specify if:
Acute: if the duration of the symptoms is less than 3 months.
Chronic: if the duration of symptoms is 3 months or more.
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With Delayed Onset: if the onset of symptoms is at least 6 months
after the stressor.
DSM IV Criteria for the Anxiety Disorders: Social Phobia
A. A marked and persistent fear of one or more social or performance
situations in which the person is exposed to unfamiliar people or to
possible scrutiny by others. The individual fears that he or she will act
in a way (or show anxiety symptoms) that will be humiliating or
embarrassing. Note: In children, there must be evidence of the
capacity for age-appropriate social relationships with familiar people
and the anxiety must occur in peer settings, not just in interactions
with adults.
B.Exposure to the feared social situation almost invariably provokes
anxiety, which may take the form of a situationally bound or
situationally predisposed panic attack. Note: In children, the anxiety
may be expressed by crying, tantrums, freezing or shrinking from
social situations with unfamiliar people.
C.The person recognizes that the fear is excessive or unreasonable. In
children, this feature may be absent.
D.The feared social or performance situations are avoided or else are
endured with intense anxiety or distress.
E.The avoidance, anxious anticipation, or distress in the feared social
or performance situation(s) interferes significantly with the person's
normal routine, occupational (academic) functioning, or social
171
activities or relationships, or there is marked distress about having the
phobia.
F.For individuals under the age 18 years, the duration is at least 6
months.
G.The fear or avoidance is not due to the direct physiological effects
of a substance (eg, a drug of abuse, a medication) or a general medical
condition and is not better accounted for by another mental disorder.
H. If a general medical condition or another mental disorder is
present, the fear in Criterion A is unrelated to it.
Specify if:
Generalized: If the fears include most social situations (eg, initiating
or maintaining conversations, participating in small groups, dating,
speaking to authority figures, attending parties). Note: Also consider
the additional diagnosis of avoidant personality disorder.
DSM IV Criteria for the Anxiety Disorders:
Specific Phobia (formerly Simple Phobia)
•Marked and persistent fear that is excessive or unreasonable, cued by
the presence or anticipation of a specific object or situation.
•Exposure to the phobic stimulus almost invariably provokes an
immediate anxiety response, which may take the form of a
situationally bound or situationally predisposed panic attack. In
children, the anxiety may be expressed by crying, tantrums, freezing
or clinging.
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•The person recognizes that the fear is excessive or unreasonable. In
children, this may be absent.
•The phobic situation(s) is avoided or else is endured with intense
anxiety or distress.
•The avoidance, anxious anticipation, or distress in the feared
situation(s) interferes significantly with the person's normal routine,
occupational (or academic) functioning, or social activities or
relationships, or there is marked distress about having the phobia.
•In individuals under 18 years, the duration is at least 6 months.
•The anxiety, panic attacks, or phobic avoidance associated with the
specific object or situations are not better accounted for by another
mental disorder.
173
174
CASE NO.1 Serial No: -- 1 Date: 06--06--2005
A) Patient’s Biodata:
Name: Aarti Age: 26 years Sex: Female
Martial Status: Single
Residence: Urban Occupation: Lecturer
Socioeconomic Status: Middle
B) Presenting Complaints:
Cracking in knee joint; Weak eyesight; Irritable; Fatigued easily;
Difficulty in getting sleep; Takes cold easily; Pain in breast.
C) History of the present Illness:
All complaints have started since 1 year. It started after a
disappointment in love affair. Had a love affair since last 3 years, but
last year they broke up. She felt that he was taking her for granted and
that he was not committed. Felt jealous, when he talked with other
girls, so she broke up. Felt very sad after that break-off.
Is on allopathic medication Anxit for her problems.
Cracking in knee joint < on rising from a seat.
Weakness of eyesight.
Irritable over small matters.
Gets fatigued easily after little exertion. Does not feel like doing any
work. Mental as well as physical exertion fatigues.
175
Has difficulty in getting sleep due to various thoughts that disturb her.
Pain stitching in the left breast. D) History of the previous Illnesses:
Malaria 5 years back. Chicken pox in childhood. Eruptions on face
for which allopathic T/t was done. Recurrent sore throat in
childhood.
E) Family History: NAD
F) Personal Details:
APPEARANCE: Lean Thin Tall
WEIGHT: Static at 50 kg.
APPETITE/TASTE/THIRST: Normal.
AVERSIONS, DESIRES & EFFECTS OF FOOD:
Desires Pizza, Chocolates.
STOOL AND URINE: Occasionally constipated.
PERSPIRATION: Copious when she has anxiety.
MENSTRUAL FUNCTION: Menarche:
At the age of 13 years. Were irregular in the start but now normal.
L. M. P. 20/05/2005.
Menses: 3 / 28 ± 3 days. Flow normal. Backache before and during
menses.
176
Leucorrhoea: Thick and offensive, which is more before the menses.
SLEEP & DREAMS:
Type of sleep: Light Un-refreshing sleep. Disturbed due to
thoughts.
Position during sleep: No special position.
This Unrefreshing and disturbed sleep is since 1 year and before
that she had no problems.
Dreams and their nature: Unremembered.
REACTIONS:
Weather: Change of weather aggravates.
Odors: Odors aggravate. They make her uneasy.
Exertion: Physical exertion aggravates.
Thermal state: Hot +
G) Emotional State:
Disappointment in Love++. Irritability with restlessness. Fearful of
exams. Anxiety feeling + < morning on waking, with heat sensation,
nausea & perspiration.
Jealousy +. Weeping Easily. Very Emotional. Sensitive ++.
H) Intellectual State:
Lack of confidence +.
177
I) Life situations and circumstances:
The patient is the youngest of three sisters. The elder sisters are
married and she is still to be married. She has good relationship
with everyone in the family especially with her middle sister, with
whom she shares every secret of hers. Her both parents were
working and she felt a lot of insecurity in her childhood. The
environment at home is comfortable. She works as a lecturer in a
polytechnic college and is satisfied with her job. The relations
with colleagues are fine. Has few friends, but has good relations
with them.
J) Body Language:
Gait: Rapid.
Gestures: Restlessness limbs.
Postures: Leaning.
Facial expressions: Smiling.
K) Physical Examination General:
Temp. Normal No Jaundice
B.P 120/ 76 No Cyanosis
Pulse 80 / min No enlargement of Lymph nodes
No Oedema
No Anemia
Hair: Premature graying since 2 years.
L) SYSTEMIC EXAMINATION:
178
RESPIRATORY NAD PER ABDOMEN NAD
CVS NAD CNS NAD.
MUSCULO-SKELETAL NAD.
Diagnosis: Generalised Anxiety Disorder
Date: 06/06/2005 Aarti Kent’s Repertory 1 MIND – LOVE, ailments, from disappointed 18 2 MIND - JEALOUSY 18 3 FEM GENITALIA,LEUKORRHEA, offensive 46 4 FEM GENITALIA,LEUKORRHEA - thick 45 5 FEM GENITALIA,LEUKORRHEA,menses,before 36 6 GENERALS – CHANGE of weather agg. 53 7 BACK - PAIN – menses, before 39 Lach. Calc. Puls. Nux-v. Sep. Calc-p. Ph-ac. 12/7 11/5 11/5 9/5 10/5 8/5 8/4 ----------------------------------------------- 1: 2 - - 1 1 2 3 2: 3 - 2 2 - 1 1 3: 1 1 - 3 3 1 - 4: 1 3 2 - 2 - - 5: 2 3 2 - 3 2 2 6: 1 2 2 1 1 2 2 7: 2 2 3 2 - - - RX Lachesis 200 - 1 dose. Placebo t.d.s for 15 days. 21/06/05. Feeling better. Feels that she is little more energetic than before.
Placebo t.d.s for 15 days.
179
13/07/05. Feeling of being better continues. Her sleep is also better. General
feeling of well being is there. Anxiety is less. Irritability and fatigue
are also better by about 60 percent. Placebo t.d.s for 30 days.
14/ 08/ 05. Was feeling O.K. till 09/08/05. Had a small quarrel with her sister.
Was much disturbed due to that and after that she feels that her main
complaints have relapsed though the intensity is still less.
Lachesis 200 1 dose. Placebo t.d.s for 1 month.
18/09/05. Felt better after the dose. The feeling of well being is persisting. Has
tapered her original anti-anxiety medicine to half. Appetite, sleep,
stools and fatigue are better. Placebo t.d.s for 1 month.
20/10/05.
Feeling of well being persisting. Patient is better overall. She feels
that even people around her feel that she is a changed person now. Is
advised to continue with the reduced dosage of anti-anxiety medicine.
Placebo t.d.s for 1 month.
25/ 11/ 05.
Feeling of well being on all levels continues. Now the anxiety
thoughts do not disturb her. Feels very good about the change. The
180
dose of the allopathic drug is now stopped completely. Gained 1 kg
weight. Placebo t.d.s for 1 month.
1/1/06.
Has a relapse. The anxiety, fatigue are now back. On deeper
interrogation revealed that she had a fight with her parents over the
issue of her marriage. They wanted that now she should get married,
while she felt that she needs some more time. So this had an intense
effect on her and it brought back her chief complaints.
Lachesis 1M 1 dose Placebo t.d.s for 1 month.
5/ 02/06
Better and improving. She feels that now she is the same person as she
was, before her fight with the parents. The energy are levels better.
Appetite, stools and sleep are also better. Placebo tds for 1 month.
20/03/ 06.
Feeling better in all respects. Improvement on all levels as of sleep,
Appetite, general well being. Not disturbed by the anxious feelings
now. Placebo tds for 1 month.
181
DISCUSSION OF CASE NO 1. The case presented us with diagnosis of Generalised Anxiety Disorder
on 6th June 2005 and was already taking allopathic medicine for this.
As it had a strong mental causation, “Love, disappointment from” in
along with mental gen., the Kent’s repertory was preferred for the
repertorisation.
On Repertorisation, the following drugs came up for consideration.
Lach 12/7, Calc 11/5, Puls 11/5, Nux-v 9/5, Sep 10/5, Calc-p 8/5.
Out of these drugs, as Calc & Puls did not cover the main rubric
“Ailments from”, they were not considered. As our patient was
thermally hot, the chilly remedies were left out i.e. Nux-v, Sep,
Calc-p, Ph-ac and Hyos were also ruled out. So Lachesis was left as
our similimum which covered all the rubrics of the totality too.
As the case was based on the mental causation, 200 potency was
selected to start with. The remedy was given in single dose followed
by placebo. The remedy was repeated in the same potency when there
was a slight relapse on 14/08/05.
The potency of the remedy was raised to 1M, when she again had a
slight relapse on 01/01/06. The allopathic medicine was tapered on
18/09/05 after a continued favorable response from the remedy.
182
The response of the remedy was interpreted as favorable on the basis
of the following: 1. General sensation of well being of the patient.
2. Improved energy levels.
3. Improvement in Appetite, Sleep and betterment of the main
complaints.
With the help of Kent’s repertory only, the drug Lachesis could be
selected. As Aur, Hyos, Ign, Nat-m, Ph-ac and Staph are prominently
placed in the main rubric “Love, ailments from disappointment”. This
also highlights that how with the help of repertory, the proper
similimum can be selected.
During the course of treatment we observed that the relapses were
mainly due to anxiety situations which occur in the life course of the
patient. These relapses were encountered successfully with the same
remedy either through repetition or through a raise in potency.
183
Case No 2
Serial No: -- 2 Date: 08 --07--2005 A) Patient’s Biodata:
Name: Shalini Kapoor Age: 45 years Sex: Female
Martial Status: Married
Residence: Urban Occupation: Housewife.
Socioeconomic Status: Middle
B) Presenting Complaints: Pain in stomach with heartburn; Nausea; Flatulence with distension
of abdomen; Palpitation; Restlessness; Muscle aches; Headache;
Irritable.
C) History of the present Illness:
All these problems started around 2 years back after a separation
from the joint family setup. They were not given their due share in the
paternal property of her husband. So, they had to start from the
scratch and it was a very stressful period.
Pain in the Stomach. Burning type < after meals, < evening, < from
stress. Since 2 years.
Occasional nausea & vomiting of food.
Distension of abdomen < eating. < Evening. > stools, after.
Palpitation heart < from anxiety +.
Restlessness
184
Muscle aches which are more in the evening after a day’s work.
Pain in the head , busting < when anxious +
Irritability. Gets angry over small matters. Shouts during anger.
< Evening.
D) History of the previous Illnesses:
Operated for Gall bladder stones – 5 years back.
E) Family History:
Diabetes in father. High Blood pressure in mother and brother.
F) Personal Details:
APPEARANCE: Average built. Tall. WEIGHT: Static. APPETITE: Appetite diminished. THIRST: Thirst less.
AVERSIONS, DESIRES & EFFECTS OF FOOD:
Desires Salty food; Fruits +. Aversion Sweets.
STOOLS AND URINE: NAD.
PERSPIRATION: There is profuse perspiration on face during
anxiety.
MENSTRUAL FUNCTION:
Menarche: at the age of 16 years. L. M. P. 3/07/05
Menses: 4 / 28 ± 4 days. Flow Clotted
Irritability + < during menses.
185
Leucorrhoea: Thin and watery, this is more after the menses. PREGNANCY AND OBSTETRIC HISTORY:
G 3 P 2 A1 Normal full term deliveries.
Suffered from constipation & nausea during pregnancies.
Used to take isabgol.
No H/o Oral contraceptives.
SEXUAL FUNCTION:
Normal desire.
SLEEP & DREAMS:
Type of sleep: Has very restless sleep. It is disturbed from anxious
thoughts and dreams. No special position during sleep
Concomitants: Talks in sleep.
Dreams and their nature: Accidents +
REACTIONS:
Air: Feels better in open. Seasons: Better in winters. Time: Evening agg. Noises agg. Exertion: Mental exertion aggravates. Thermal state: Hot +.
G) Emotional State:
Is fearful of going out in the Dark +; Crossing the road +. Sadness,
takes bad part of everything. She has anxiety about small matters with
trembling of body; Anxious about the future of her children as to what
would happen. Worries a lot about every small matters. She wants to
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do away with this anxiety and worry of hers but is unable to do so.
She is sensitive about the suffering of others.
H) Intellectual State:
Memory is weak as to where she has kept her things. She feels lack
of confidence for doing various things.
I) Life situations and circumstances:
Patient was the eldest daughter of 2 female and 3 male children of
her parents. Her father was very strict with her. She was also
responsible for various household chores in her teens. She was
much anxious about her performance in school. Now, she is
anxious about her children’s performance at school though they are
doing well. Relations with husband are good but as he is busy with
his shop, most of the responsibility of the kids is on her. She is
very anxious about the future of her children. Her daughter is
doing B.Sc in computers while her son is studying in Class 10th.
She is a housewife, though she is well educated. Relations with her
brothers are good and they are very helpful to her.
J) Body Language: Postures: Arms and legs crossed.
Facial expressions: Anxious +
Avoids eye Contact
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K) Physical Examination General: Temp .N No Jaundice Mouth Dryness of B.P.124 / 80 No Cyanosis Pulse 80/min No enlarged lymph nodes No Oedema Anemic +
L) SYSTEMIC EXAMINATION: RESPIRATORY NAD P ER ABDOMEN NAD CVS NAD CNS NAD MUSCULO-SKELETAL NAD Diagnosis: Generalised Anxiety Disorder.
Date: 08/07/2005 Shalini Kapoor. Kent’s Repr. 1 SLEEP - DREAMS - Accidents 25 2 GENITALIA – FEMALE - MENSES – clotted 77 3 STOMACH – DESIRES - fruit 9 4 GENERALITIES – WET weather agg. 85 Puls. Ars. Chin. Lach. Calc. Rhus-t. Bell. 8/4 7/3 5/4 6/3 6/2 6/2 5/3 -----------------------------------------------1: 1 3 1 - - - 1 2: 3 - 2 3 3 3 3 3: 1 1 1 1 - - - 4: 3 3 1 2 3 3 1 Rx Pulsatilla 200 1 dose. Placebo t.d.s for 15 days.
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25/07 /05.
Felt slightly better for few days after medicine but now is all the same.
Pulsatilla 1M 1 dose. Placebo t.d.s for 15 days.
13/08/05.
Feeling slightly better. Feels her appetite has improved a bit and
slight improvement in energy levels. Had her menses on 2/8/05. The
irritability which aggravates during menses was also little better this
time. Placebo t.d.s for 15 days.
1/9/05.
The improvement which was there since the last visit is standstill.
This time she had a new symptom i.e. frightful dreams. Appetite is
also better. Pulsatilla 10 M 1 dose. Placebo t.d.s for 1 month
4/ 10/05.
Feels much better. The irritability, muscle aches, pain stomach have
improved much. Appetite is much better. Lethargy is also better.
Just finished from her menses which started on 1/10/05. The clots
were much better this time and the irritability during menses was also
reduced. Placebo t.d.s for 6 weeks.
189
26/11/ 05.
Feels better on every level. Last menses were on 3/11/05. They were
much better with respect to clots and irritability. The energy levels
have improved. For the first time since the start of treatment, she felt
that now she can leave off the allopathic medicine she is taking. Is
advised to reduce the allopathic medication.
Placebo t.d.s for 1 month.
2/1/06.
Better. The main complaints for which she started medicine are much
better. The clotted menses and irritability during menses is much
better. The reduced dose of allopathic medicine is continued. Appetite
better. Sleep better. Chief complaints also much better.
Placebo t.d.s for 6 weeks.
30/01/06.
Slight relapse of anxiety. Her parents had an accident and were
admitted in hospital. This had a bad effect on her with relapse of
anxiety. Pulsatilla 10 M 1 dose Placebo t.d.s for 1 week.
07/02/06.
Better in all respects. Allopathic medicine further reduced.
Placebo t.d.s for 2 months.
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Discussion of Case No 2.
The case presented us with diagnosis of Generalised Anxiety Disorder
on 8th July 2005 and was already taking allopathic medicine for this.
As the case presented had dreams along with female generals as
prominent symptoms, the Kent’s repertory was preferred for the
repertorisation.
On Repertorisation, the following drugs came up for consideration:
Puls 8/4, Ars 7/3, Chin 5/4, Lach 6/3, Calc 6/2, Rhus-t 6/2, Bell 5/3.
As our patient is hot thermally, the chilly medicines i.e. Ars, Chin,
Calc, Rhus-t and Bell were ruled out. Furthermore as Pulsatilla
covered all the symptoms of the totality especially the “Desire, fruits
for”, it was preferred over the left over drugs.
Considering that the mind has been affected and the presence of
dreams led to the 200 as the potency of choice. The remedy was given
in single dose followed by placebo. The remedy was raised to 1M
potency on 25/07/05 as the patient felt that there was slight betterment
followed by relapse. The potency of Pulsatilla was raised to 10 M on
01/09/05 when the improvement came to a standstill. This 10M
potency was again repeated on 30/01/06 when her parents had an
accident, thus increasing her anxiety. The attack was brought under
control with the help of Pulsatilla. The allopathic medicine was
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tapered on 02/01/06 when the patient has started feeling comfortable
on all levels.
The response of the remedy was interpreted as favorable on the basis
of the following: 1. General sensation of well being of the patient.
2. Improved energy levels.
3. Improvement in Appetite, Sleep and betterment of the main
complaints.
With the help of Kent’s repertory only, the drug Puls could be
selected as China also covers the case. Lachesis also comes in close
comparison to Pulsatilla but as it did not cover the dreams of the
patient, it was not preferred.
During the course of treatment we observed that the relapses were
mainly due to anxiety situations which occur in the life course of the
patient these relapses were encountered successfully with the same
remedy either through repetition or through a raise in potency.
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Case No 3 Serial No: -- 3 Date: 10 --11--2005 A) Patient’s Biodata:
Name: Sukhwinder Singh Age: 12 years Sex: M
Martial Status: Single
Residence: Rural Occupation: Student
Socioeconomic Status: Middle
B) Presenting Complaints:
Fearful; Vertigo; Sleeplessness; Irritability; Startles from slightest
noise.
C) History of the present Illness: All complaints started since 8th Oct 2005, when the Earthquake
struck. He was in the school when the quake struck & there was
stampede in the class. In this process he fell down and received some
injuries also. The walls of his class cracked from this. It was his first
experience with earthquake of such intensity and was it was full of
horror for him.
Has constant fear of earthquake happening again.
Is sleepless due to frequent waking. < From slightest nose.
Since the quake has struck, he prefers to remain outdoors even sleeps
in the open.
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Irritable from noise from. Shouts from anger.
He startles from the slightest noise and touch.
Vertigo / Dizzy feeling which started after the earthquake.
D) History of the previous Illnesses: NAD
F) Personal Details:
APPEARANCE: Lean Thin Tall
APPETITE: Diminished
STOOLS: Constipated.
SLEEP & DREAMS:
Sleeplessness from disturbed sleep from fears, slightest noise,
frightful dreams.
Dreams: Frightful, waking him REACTIONS:
Thermal state: Hot
G) Emotional State:
Anxious, Fearful, Apprehensive.
I) Life situations and circumstances:
Only son of his parents. Both parents are working and the patient is
cared by his grandparents. Is described as very sensitive child by
the parents. Gets scared easily. Good in studies and extra-
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curricular activities. Like to play cricket and computer games. Has
lost interest in things which he used to enjoy since that episode.
J) Body Language: Facial expressions: Anxious +
K) Physical Examination General: Temp. N No Jaundice
Pulse No Cyanosis No Oedema No Lymph nodes enlarged. No Anemia
L) SYSTEMIC EXAMINATION: RESPIRATORY NAD PER ABDOMEN NAD CVS NAD CNS NAD MUSCULO-SKELETAL NAD
Diagnosis: Post Traumatic Stress Disorder.
Date: 10/11/2005 Sukhwinder Singh
Kent’s Repertory. 1 MIND – FRIGHT – complaints, from 46 2 MIND - STARTING - easily 39 3 MIND - STARTING - sleep - during 82 4 MIND - STARTING – fright, from 53 5 MIND - SENSITIVE - noise, slightest to 18 6 VERTIGO - FRIGHT, after 3
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Op. Phos. Sil. Nat-m. Nux-v. Kali-c. Acon. 12/6 12/5 9/5 11/4 9/4 9/3 9/5 -------------------------------------------- 1: 3 3 3 3 2 - 3 2: 1 3 2 3 2 3 - 3: 2 2 1 2 2 3 1 4: 1 2 - 3 - 3 2 5: 3 2 3 - 3 - 1 6: 2 - - - - - 2
Rx Opium 1M 1 dose. Placebo t.d.s for 2 weeks. 26/ 11/05. Better. Vertigo is almost fully better. Temper is also better. Now gets
comfortable sleep and the sensitivity / starting is also much better.
Placebo t.d.s for 2 weeks. 15/12/05. Better by more than 70 percent. Vertigo is not there. Appetite has
improved. Constipation is also better. The frightful dreams are less
now and not much disturbing. Placebo t.d.s for 1 month. 22/01/ 06. The patient is now better in all respects. His appetite & constipation
are better. His temper is now under control. The sensitivity to noise is
now normal. The starting from sleep and frightful dreams are also not
disturbing now. Placebo t.d.s for 1 month.
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26/02/06. Better in all respects. Placebo t.d.s for 1 month. 29/03/06. Better. No complaints on any levels. Placebo t.d.s for 1 month.
Discussion of Case No 3
The case presented to us with Post Traumatic Stress Disorder which
was there due to the earthquake in Northern India on 8/10/05. This
case had a strong mental causation, which deranged a perfectly
healthy child to an abnormal one. So Kent’s repertory was the best
choice for repertorisation.
On Repertorisation, the following drugs came up for consideration
Op 12/6, Phos 12/5, Sil 9/5, Nat-m 11/4, Nux-v 9/4, Kali-c 9/3 &
Acon 9/5.
From the following drugs, Op and Acon were given preference as they
covered the Causation and “Vertigo, fright after”. Opium was given
preference over Aconite as the “Fear of death, predicts the day of
death”, a grand general of Aconite was absent in this case. Also on
referring to Knerr`s repertory in the section Mind following rubric
was found in favor of Opium i.e. **MIND - After fright, fear of the
fright still remaining. On the basis of acute condition of the mind,
high potency of Opium i.e. 1M was selected and given as single dose.
As continued progress in the improvement of the general state
continued, Opium was not repeated.
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Hahnemann refers to this type of diseases as “Mental diseases
appearing suddenly as an acute disease in patient’s ordinary calm state
caused by some exciting factor” in § 221 of the Organon. He explains
that in this type of disease, an insanity or frenzy suddenly breaks out
as an acute disease from the patient’s usually quite state. This may be
caused by fright, vexation, drinking alcohol etc., and attributes it to
Psora. He recommends that during acute phase, deep acting remedies
are not needed but remedy that corresponds to the acute picture is
needed. Hahnemann stresses that after the acute state has subsided,
these patients should be followed up with Antipsoric treatment to
prevent recurrence & if this is not done, a worse attack from a much
slighter cause is bound to follow which will be more difficult to cure.
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Case No 4 Serial No: -- 4 Date: 20--08--2005 A) Patient’s Biodata:
Name: Rubina Age: 27 years Sex: F
Martial Status: Single
Residence: Urban Occupation: Student
Socioeconomic Status: High
B) Presenting Complaints: Falling of Hair; Lump sensation in the throat; Rash forearm;
Irritability; Difficulty in concentrating; Anxiety feelings.
C) History of the present Illness:
All her complaints started around 1 year back. They had a theft at
their place in which they lost all their valuables, money etc in the safe.
In addition to this, the jewellery and valuables of her maternal uncle
which were with them for safe custody were also lost. After the theft,
the maternal uncles were heard telling many of their relatives that the
patient and his family had themselves done this in order to grab their
valuables. Even a brother of hers, who did not live with them, also
accused them of the theft. After this incident, her parents shifted to
USA to live with her brother. This also according to her was the worst
part of her life. Hair falling since 1year.
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Lump sensation in the throat; Persistent; Feels like ball in throat,
though no problems in eating & drinking.
Rash forearm / back / legs since 1 year. More during the change of
weather.
Occ. Itching.
Irritability ++.
Difficult in concentrating.
Anxiety feeling, which she feels is not able to control. With this
anxiety she has body aches, weakness, and pain stomach. Much
worried about future +.
D) History of the previous Illnesses: NAD
E) Family History:
Cancer throat in paternal aunt.
F) Personal Details:
APPEARANCE: Average built. Tall
WEIGHT: Static APPETITE/TASTE/THIRST: Normal. AVERSIONS, DESIRES & EFFECTS OF FOOD: Desires Spices, Pickles. STOOLS AND URINE: Constipated hard stools. PERSPIRATION: Profuse face & back. No other abnormality.
200
MENSTRUAL FUNCTION:
Menarche: at the age of 14 years. L. M. P. 10/08/05 Menses: 3 / 16 days. Flow normal. No concomitants. No Leucorrhoea.
SLEEP & DREAMS:
Type of sleep: Un-refreshing; Is disturbed from anxiety.
Position during sleep: mostly on back.
Dreams and their nature: Water; Preparing for examinations+
REACTIONS:
Exertion: Mental exertion agg. Thermal state: Chilly +.
G) Emotional State:
Anxiety feeling as to what would happen. Worries a lot about her
parents though they don’t have any problems. Can’t control thinking
about them. Worries about small matters.
Fearful. Anxiety about Future +. Short tempered. Can’t support
injustice with anybody.
H) Intellectual State: Intelligent +.
I) Life situations and circumstances:
The patient is doing her doctorate in sciences. She has three elder
brothers, one of whom lives in USA and one of them is separated
from the family. She belongs to a well to do family and everything
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was fine until that incident occurred which changed the course of
her life and from which she with her family had to suffer.
The persistent anxiety feeling are hampering her studies and the
normal functioning. Had many friends but now only a few.
J) Body Language: Gestures: Nail biting + K) Physical Examination General:
Temp. N No Jaundice B.P. 110 /70 No Cyanosis Pulse 76 No Lymph nodes enlarged. No Oedema No Anemia
Skin: Fair color
L) SYSTEMIC EXAMINATION: RESPIRATORY NAD PER ABDOMEN NAD CVS NAD CNS NAD MUSCULO-SKELETAL NAD.
****************
Diagnosis – Generalised Anxiety Disorder.
202
Date: 20/08/2005 Rubina Kent’s Repertory 1 MIND – HONOR, effects of wounded 3 2 DREAMS - MENTAL EXERTION 34 3 DREAMS - WATER 44 4 SLEEP - POSITION - back, on 52 5 FEM.GENITALIA, MENSES, frequent, too 161 6 STOMACH – DESIRES – sour, acids etc. 77 Ign. Rhus-t. Sulph. Bry. Nux-v. Puls. Nat-m. 11/6 10/5 9/5 10/4 9/4 8/4 9/5 ----------------------------------------------- 1: 1 - - - 1 - - 2: 3 2 2 2 3 2 2 3: 1 1 1 - - - 1 4: 2 3 2 3 2 3 1 5: 2 3 2 3 3 1 3 6: 2 1 2 2 - 2 2 Rx Ignatia 200 1 dose Placebo t.d.s for 2 weeks. 6/09/05.
Was better a little for few days but now the same. Had her menses on
27/08/05. Ignatia 1m 1 dose Placebo t.d.s for 2 weeks.
24/09/05.
Feels better. Hair falling has decreased. Had her menses on 20/09/05.
203
Sleep better & refreshing. Anxiety also better. Lump sensation throat
improved slightly. Occasional dreams still irritate.
Placebo t.d.s for 3 weeks. 17/10/05. More better. Energy levels improved. Constipation has also improved.
Had her menses on 13/10/05. Lump sensation throat better. Better
over all. Placebo t.d.s for 1 month.
20/11/05. Has a relapse of complaints. Though the complaints are not that worse
as at the start of treatment. The reason is the stress for her studies as
she has to present some papers at a conference. Anxiety +. Lack of
confidence +. Lump sensation throat aggravated. Recurrent dreams of
preparing for exams. Ignatia 1M 1 dose Placebo t.d.s for 1 month.
23/12/05. Had a favorable effect of the last dose. Could complete the papers
well in time and presented them well. Last menses on 13/12/05.
Irritability; Hair falling; Constipation; Lump sensation throat much
better. Occ. Dreams. Placebo t.d.s for one month.
26/01/06. Better in all respects. Last menses on 22/01/06. No Hair falling. Lump
sensation almost gone. Confidence levels high. Got engaged in early
January. No dreams since last dose. Placebo t.d.s for 6 weeks.
204
28/02/06. Has a relapse of all the complaints. She got the news that her father
was ill and was admitted in the hospital. Could not her control
weeping. Had her last menses on 11/02/06 and now again on
27/02/06. Ignatia 1M 1 dose. Placebo t.d.s for 1 week.
07/03/06. Not much of change. The anxiety has increased with lack of
confidence. Ignatia 10 M 1 dose Placebo t.d.s for 1 week.
14/03/06. Better now. Leaving for states to see her father. Placebo t.d.s for 2 months.
Discussion of Case No 4
The case presented us with the diagnosis of Generalised Anxiety
Disorder on 20-08-2005. On detailed inquiry, an important mental
causation was got as “Effects of wounded Honor”.
So, in presence of mental cause along with Dreams, the Kent’s
repertory was preferred for repertorisation.
On repertorisation, the following drugs came up for consideration:
Ign 11/6, Rhus-t 10/5, Sulph 9/5, Bry 10/4, Nux-v 9/4, Puls 8/4,
Nat-m 9/5, Ferr 9/4 and Phos 9/4.
As we had a mental causation in our case, so the remedies which
covered this were to be considered. Ignatia and Nux-vomica were the
205
only remedies that covered the cause. These could not be ruled out
further on the basis of thermals as both of them are chilly and our
patient is also chilly.
Ignatia was selected as the drug of choice as it completely covered the
dreams & the physical general of food cravings, which Nux-v could
not qualify.
The case had a base in the mental causation, so, 200 potency was
selected to start with. The remedy was given in single dose followed
by placebo. The remedy potency was raised to 1M on 06/09/2005 as
200 had a little effect. The 1M potency had a favorable effect on the
patient leading to improvement in anxiety, sleep, bowel movements,
lump sensation and general well being. There was a relapse due to the
stress of her studies and a repetition of Ignatia 1M on 20/11/05 helped
her a lot. This repetition helped her further by relieving her of
stressful dreams and improving her confidence levels. Again on
28/02/06, she had a relapse on hearing the news of illness of her father
& his hospitalization whom she loved too much. She being far away
from her father couldn’t do much for him. So she felt a state of
helplessness and that precipitated her anxiety state. This could not be
helped with 1M potency, so the potency was raised to 10 M which had
a favorable effect on her.
The response of the remedy was interpreted as favorable on the basis
of the following: 1. General sensation of well being of the patient.
2. Improved energy levels.
206
3. Improvement in anxiety, sleep, appetite, constipation and hair
falling.
Kent repertory helped us in the selection of Ignatia as the similimum.
On the basis of repertorisation only, we could eliminate Nux-vomica
and Staphysgria, both of which are present in the rubric “Honor-
effects of wounded” and differentiate it from Nux-v which was in
contention for the similimum.
From this case, we learnt that persistent worry and anxiety situations
in the course of one’s life, result in the weakening of the favorable
action of the similimum but the same can be countered effectively
with the repetition or a raise in the potency of the similimum.
207
Case No 5 Serial No: -- 5 Date: 04--09--2005 A) Patient’s Biodata:
Name: Bikram Gupta Age: 57 years Sex: Male
Martial Status: Married
Residence: Urban Occupation: Pharmacist.
Socioeconomic Status: Middle
B) Presenting Complaints:
Has attacks of fear with sensation as if would die with increased blood
pressure.
Obstruction of flatulence, which leads to palpitation, anxiety, with
heaviness chest and as if it would burst.
Numbness of left arm / side, sensation as if the brain does not work
and fear about the disease.
These attacks are mostly in the morning. The distention of abdomen is
very distressing and he feels if it could get better he would be better.
In addition to this, there is confused feeling during the attack. These
attacks last for about half an hour and then he gets better.
Is under treatment for these attacks but without any relief. C) History of the present Illness:
These attacks are since 2 years. No cause could be elicited.
208
D) History of the previous Illnesses:
Heart burn which on Endoscopic investigation revealed 2nd Grade
Oesophagitis.
E) Family History: Psychiatric problems in mother.
F) Personal Details:
APPEARANCE: Lean Thin.
WEIGHT: Decreasing
APPETITE/TASTE/THIRST: Diminished.
AVERSIONS, DESIRES & EFFECTS OF FOOD:
Desires juicy refreshing things.
STOOLS AND URINE: Stools mucoid, difficult to flush.
SLEEP & DREAMS: Sleep Increased alternating with diminished.
Unrefreshing. Aggravated in the morning. Startles from the slightest
noise.
Dreams and their nature: Water, Dead Persons.
REACTIONS:
Morning Agg.
Thermal state: Chilly.
209
G) Emotional State:
Fear of closed / crowded places. So much that that he is fearful of
taking a bath in the bathroom. Apprehensive about the anxiety attacks
as they are unexpected. Is persistently occupied with this. Desires
sympathy. Negative thoughts about the disease.
I) Life situations and circumstances:
The patient is a govt. servant about to retire. His family life is
normal. He has been a sensitive patient affected easily by small
matters.
K) Physical Examination General:
Temp. N No Jaundice
B.P. 130/ 90 No Cyanosis Tongue: Apthae.
Pulse 84/ min No Lymph nodes
No Oedema
Anemia +
Hair: Baldness.
L) SYSTEMIC EXAMINATION:
RESPIRATORY NAD PER ABDOMEN NAD
CVS NAD CNS NAD
MUSCULO-SKELETAL NAD
210
Diagnosis – Panic Disorder.
Date: 04/09/2005 Boenninghausen`s Repertory BIKRAM GUPTA 1 CONDITIONS IN GENERAL - Time - morning 144 2 SENS. & COMPL.GEN.- Bursting, splitting,* 104 3 MIND - Fearsome, anxiety,* - disease, of 33 4 MIND - Confused, befuddled, muddled, etc.140 5 MIND - Anxiety, agony - chest, in 43 6 SENS.&COMPL.IN GEN.,Starting,in affright*104 7 FLATULENCE - Flatus - incarcerated,obstructed, displaced* 84 8 ABDOMEN - Inflation, distension – abdomen in general 120 9 STOOL - Mucus, of 73 10 MIND - Sympathy, craves 2 11 APPETITE - Desire - juicy things 8 Phos. Nux-v. Puls. Kali-c. Sep. Bell. Bry. 32/11 32/9 26/10 26/8 24/9 24/8 24/8 -----------------------------------------------1: 4 4 1 3 3 2 2 2: 2 2 2 3 4 4 4 3: 3 4 3 3 2 - 2 4: 3 4 3 4 4 4 4 5: 4 3 3 - 1 1 4 6: 2 4 2 3 2 4 4 7: 4 4 4 4 2 2 - 8: 4 4 3 4 3 4 3 9: 4 3 4 2 3 3 1 10: 1 - 1 - - - - 11: 1 - - - - - -
211
Rx
Phosphorus 200 1 dose. Placebo t.d.s for 2 weeks.
19/ 09/05. No change in any of the major complaints. Had an attack
on 10/09/05 & 18/09/05.
Phosphorus 1M 1 dose. Placebo t.d.s for 2 weeks.
4/10/05.
Had an attack on 27/10/05 which was less in intensity. Obstructed
flatulence is slightly better. Sleep little better & stools also improved a
little. Fear of having attacks still persists.
Placebo t.d.s for 2 weeks. Phosphorus 1M 1 dose as an S.O.S to be
taken during the attack.
20/11/05
Had an attack on 10/11/05. Took the S.O.S during the attack and felt
better. Other complaints are also slightly better.
Placebo t.d.s for 1 month. Phosphorus 1M 1 dose as S.O.S.
22/12/05.
Had two attacks – one on 24/11/05. He took S.O.S during the attack
and it relieved him. The intensity was slightly less. The second attack
was on 19/12/05 and felt it was same as before. Had no S.O.S. to be
212
taken. Other complaints are also little better. No cause or any other
detail could be elicited on investigation.
Phosphorus 1M 1 dose Placebo t.d.s for 1 month.
Phosphorus 1M 2 doses as S.O.S
25/01/06.
Had one attack on 23/01/06 and it was not relieved by S.O.S dose.
Very fearful about the disease. Feels would die. All other complaints
also agg. Phosphorus 10M 1 dose. Placebo t.d.s for 1 month.
26/02/06.
Was quite fine during the whole month but got an attack on 24/02/06.
Though it was less in intensity, still he is very fearful. Palpitations &
trembling of whole body is there.
Phosphorus 10 M 1 dose. Placebo t.d.s for 1 month.
25/03/06.
Had an attack of lesser intensity on 20/03/06 but the mental state of
fear is still persisting. Stools better. Obstructed flatulence also better a
little. Phosphorus 10 M 1 dose Placebo t.d.s for 1 month.
Discussion of Case No 5 The case presented us with diagnosis of Panic Disorder on 4th
September 2005 and was already under allopathic treatment but
213
without any relief. In spite of much inquiry, no probable cause could
be elicited from the patient or his attendants.
Apart from the symptoms pathognomic of Panic disorder, the patient
presented us few mental symptoms, strong modalities and complaints
which were physical in nature. So Boenninghausen`s repertory was
selected for repertorisation in this case. The totality of the case was
erected and following drugs came up strongly:
Phos 32/11, Nux-v 32/9, Puls 26/10, Kali-c 26/8, Sep 24/9, Bell 24/8,
Bry 24/8, Calc 24/8 and Carb-v 24/8
As Phos comes out prominently from the analysis and it covered all
the rubrics, it was selected as the drug of choice.
The potency was selected as 200 the psychic symptoms are prominent
As there was no change with 200 potency, the potency was raised to
1M on 19/09/2005. With 1M potency, the patient felt a little better,
though he had an attack of lesser intensity. Considering that the
patient is not able to contact us during the attack due to far off
residence of the patient, a dose of Phos 1M was given to the patient as
a S.O.S dose to be taken during the attack. The S.O.S had a beneficial
effect on the patient during the attack. In the further follow ups too, a
S.O.S was given to the patient to be taken during the attack. The
attacks diminished in intensity during the next follow-ups.
On 23/01/06, the patient had and attack which was not relieved by the
S.O.S. So on 25/01/06, the potency of Phosphorus was raised to 10M
214
as it was felt that the 1M potency has exhausted its action. The
intensity of attacks has reduced though the panic state still persists.
The response of the remedy was interpreted as favorable on the basis
of: 1. Decreased intensity of attacks.
2. Improvement in the Obstructed Flatus & distention of abdomen.
215
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STA
TUS
1 23-04-2005 JYOTI DEVI 22 F Un R L K BELL 1M NI PHOBIC2 30-04-2005 ANU 19 F Un U M K COCC 1M IM GAD3 09-05-2005 SAVITRI DEVI 50 F Ma R L B PULS 200 IM GAD4 15-05-2005 NATASHA 23 F Un U H K ARG-N 200 IM GAD5 22-05-2005 KANTA 45 F Ma U M K ARS 200 NI PHOBIC6 30-05-2005 RINKI 29 F Ma U M K PULS 200 IM GAD7 03-06-2005 SOBHA RAM 50 M Ma U M K CALC 200 NI GAD8 06-06-2005 AARTI 26 F Un U M K LACH 10M IM GAD9 08-06-2005 REENA 37 F Ma U M K SIL 200 IM GAD
10 23-06-2005 RAJESHWARI 23 F Un R M B NAT-M 200 IM GAD11 30-06-2005 SAKSHI 32 F Ma U H K STAPH 200 IM GAD12 08-07-2005 SHALINI 45 F Ma U M K PULS 1M IM GAD13 13-07-2005 KAMLESH 23 F Un R L K NIT-AC 1M NI GAD14 26-07-2005 VISHNO 50 F W R L K NAT-M 200 IM GAD15 02-08-2005 PANKAJ 32 M Ma U M K BOR 200 IM PHOBIC16 08-08-2005 ANIL 25 M Un U M K NAT-M 200 NI GAD17 18-08-2005 VEENA 52 F W U M B ARS 200 IM PHOBIC18 20-08-2005 RUBINA 27 F Un U H K IGN 1M IM GAD19 26-08-2005 SUCHITRA 12 F Un U M K ARG-N 200 IM PHOBIC20 04-09-2005 BIKRAM 57 M Ma U M B PHOS 10M IM PANIC21 07-09-2005 NEHA 38 F Ma U M K SEP 200 IM GAD22 14-09-2005 VIPIN 38 M Ma U H K NUX-V 200 NI GAD23 30-09-2005 LOVI SETHI 21 F Un U H K LYC 200 IM GAD24 13-10-2005 KIRAN 49 F Ma U H B PHOS 1M NI GAD25 10-11-2005 AKSHIT 14 M Un U M K CALC 200 IM PTSD26 12-11-2005 NAMRATA 23 F Un R M K PHOS 1M IM PTSD27 14-11-2005 SAHIL 15 M Un U M K ACON 1M IM PTSD28 12-12-2005 SUKWINDER 10 M Un R M K OP 1M IM PTSD29 16-12-2005 KAINATH 13 F Un U H K NAT-M 200 IM PTSD30 21-12-2005 DEVINDER 37 M Ma U M K ACON 200 IM PTSD LEGEND H HIGH F FEMALE Ma MARRIED
M MIDDLE M MALE Un UNMARRIED
L LOW W WIDOWED
R RURAL K
KENT REPR IM IMPROVED
U URBAN B B.B.C.R. NI
NOT IMPROVED
216
217
Age and Sex ratio of cases
3
9
35
13
13
1 10
5
10
Age group of cases
No.
of c
ases
Female Male
Female 3 9 3 5 1Male 3 1 3 1 1
10 - 20 20 - 30 30 - 40 40 - 50 50 - 60
Anxiety in different areas
15, 50%
8, 27%
1, 3%
6, 20%
Urban Female Urban Male Rural Male Rural Female
218
ANXIETY ALONG DIFFERENT AGE GROUPS
012345678
10 - 20 20 - 30 30 - 40 40 - 50 50 - 60
Age group
No.
of c
ases
GAD Female GAD Male PHOBIC Female PHOBIC Male
PANIC Female PANIC Male PTSD Female PTSD Male
1
6
8
11
0
4
0
2
4
6
8
10
12
Socio-economic status of cases
MALEFEMALE
MALE 1 8 0
FEMALE 6 11 4
HIGH MIDDLE LOW
219
4
11
5
8
0202
468
101214
16
Martial status of cases
FEMALEMALE
FEMALE 11 8 2
MALE 4 5 0
SINGLE MARRIED WIDOWED
Results with different potencies
19
9
2
15
6
24 3
00
5
10
15
20
200 1m 10m
Potencies
No. O
f cas
es
No. of cases Improved Not Improveed
220
Results in Anxiety Disorders
23, 77%
7, 23%
Improved Not Improved
Results with Kent and BBCR
25
5
19
461
05
1015202530
KENT BBCR
Total cases Imrovement No Improvement
221
Medicines Used in Anxiety Disorders
0
2 2 2
1 1
2
1 1 1 1
4
1 1 1
3 3
1 1 1
0
1
2
3
4
5
Medicines
No. o
f cas
es
MedicinesACONARG-NARSBELLBORCALCCOCCIGNLACHLYC NAT-MNIT-ACNUX-VOPPHOSPULSSEPSILSTAPH
222
223
DISCUSSION
For the purpose of this study, cases of anxiety disorders are taken
up in detail and are followed by proper repertorisation. The data of the
30 cases from my clinics, gives me an insight to various facets of the
anxiety disorders. The killer earthquake which rocked the northern
region with much intensity on 8th October 2005 is providing me a
chance to understand and treat cases of Post Traumatic Stress
Disorder.
Of the 30 cases under study, the females are found to be more
affected by anxiety. The female to male ratio is around 2:1. These
disorders are more in the age group of 20 – 30 years and cases of this
age group alone account for the 1/3 rd of the total sample.
Furthermore, it is observed that the age group 20 to 40 years account
for more than half of the cases, as this age group is under great mental
strain & stress, and has occupational problems etc. More cases of
anxiety are reported from the people residing in the urban area than in
the rural areas. The ratio of the urban to rural cases is found to be
around 3: 1. Females of the urban area alone account for the 50
percent of the whole sample. While considering the socio-economic
status of the patients, 63 percent of the cases are from the middle
class.
For the percentage as per the disease diagnosis, GAD accounts for the
60 % of the total cases and the Phobic disorders account for 17 % of
224
the cases. The PTSD cases because of earthquake account for 20
percent of the cases of my study.
While analysing the cases as to their martial status, an equal incidence
is found for both single and married cases under study.
77 percent of the total cases are showing improvement with the
administration of the similimum selected with the help of repertories.
For the purpose of repertorisation, 83 percent of the cases are
repertorised using Kent’s repertory while for the remaining 17
percent, BBCR is used. As these are the cases of psychiatric disorder
and are deficient in somatic ailments or symptoms, so Kent’s
repertory is required more as compared to BBCR. This is also
evident from the cases being discussed in detail, where in the presence
of strong mental causation or mental generals, sleep & dreams is
there. 76 percent of the cases for which Kent’s repertory is used, are
showing improvement. BBCR, though a neglected repertory is also
did not lag behind and 80 percent of the cases for which it is being
used, also show improvement.
Natrum mur, Phosphorus and Pulsatilla are the remedies which are
indicated in 3 or more than 3 cases. Aconite, Arsenic album,
Argentum nitricum and Calcarea carb are the remedies of choice in 2
cases each. A total of 19 remedies are indicated for a sample of 30
cases, which strengthens the individualization part of homoeopathy.
The 1M and 10M potencies are required only when 200 potency did
not work. Yet if we see the average, 200 potency worked in 80
225
percent of the cases in which it is given, thus concluding that it is the
right potency to begin with.
In case no.1 & 3, which are given in detail, Natrum Mur and
Aconite respectively seem to be the remedies at the start. The
repertorisation provides me with Lachesis and Opium respectively.
These have a very good effect on the patients, thus authenticating the
Master’s advice to be an un-prejudiced observer.
226
227
CONCLUSION
The data obtained from clinical studies; weigh heavily in favor of, the
use of repertories in the management of the anxiety. The
repertorisation of cases did not let any medicine to be out of sight till
the final selection. In a number of cases, repertorisation led me to a
medicine which in routine prescribing, would have been missed.
In cases which present with strong mental causation, mental
symptoms & generals and dreams; Kent’s repertory is of vast help.
While cases which present with strong modalities, physicals and
concomitants; BBCR is of enormous help.
Both these repertories, though having different philosophical
backgrounds have given positive results in cases where they are used
judiciously, thus authenticating their value respectively.
The utility of repertory can not be underestimated and it has proved
beyond doubt to be of immense help in selection of similimum in the
management of Anxiety disorders.
228
229
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233
CASE TAKING PROFORMA Serial No: -- Date: __--__--____ A) Patient’s Biodata:
Name: ………………………………… Age: ……….. Sex: M/F Martial Status: Single/Married/Divorced/Widowed Residence: Urban/Rural Occupation: …………… Socioeconomic Status: High/Middle/Low
B) Presenting Complaints: C) History of the present Illness:
(Detailed history of present illness with respect to cause and circumstances, duration, mode of onset, location with extension, sensations, modalities and concomitants, if any)
D) History of the previous Illnesses:
Past Medical H/o patient as per the check list given at the end.
E) Family History:
In his own, paternal and maternal families as per the check list at
the end.
F) Personal Details:
APPEARANCE:
Lean/Obese/Emaciated/Average/Thin/Short/Tall/Stooped/Underno
urished
WEIGHT: (Increasing/Decreasing/Stationary) APPETITE/TASTE/THIRST:
234
AVERSIONS, DESIRES & EFFECTS OF FOOD: STOOL AND URINE: PERSPIRATION: MENSTRUAL FUNCTION:
Menarche: Late/Early L. M. P. Menses: Cycle and Duration with concomitants: Menopause and associated complaints: Leucorrhoea:
PREGNANCY AND OBSTETRIC HISTORY:
G P A: Mode of deliveries: Mental State during and after Pregnancy Illness and Medication during Pregnancy: H/o oral contraceptives used
SEXUAL FUNCTION:
Desire/Aversion/Performance and associated complaints. PAEDIATRIC HISTORY:
Birth: Normal /Abnormal Birth Wt.: Mother's health: Neo-natal problems: Milestones: Problems: Physical Development / Mental Development Speech: Retarded/Lisping/Stammer/Slow/Rapid Feeding: Breast/Top/Bottle/Solids Observation: Activity: Hyper/Dull/Restless/Destructive/Quiet. Emotional: Anger/Fears/Attachments/Shyness/Change/Responsibility
235
Intellectual: Performance at School and in Extra-curricular activities Hobbies Obedience Socialization Behavioural Problems: Aggressive(Beats, Bites)/Breath-holding/Clinging/Contrary/Cruel/Criminal/Dirty/Fastidious/Headbanging/Obsessive/Homesick/Hurry/Stealing/Nailbiting/Obstinate/Rocking/Tantrums/ Tics/ Thumb sucking/ Truant/Weepy
SLEEP & DREAMS:
Type of sleep: Light/Catnaps/Deep/Un-refreshing/Poor/Siesta Disturbed Due To:
Anger/Anxiety/Work stress/ Dreams/Fears/Lovesick/Thoughts Position during sleep Any change in sleeping pattern Concomitants:
Enuresis/Gestures/Grinding/Moaning/Nightmare/Perspiration/Salivation/ Snoring/Starting/Talking/Walking
Dreams and their nature:
REACTIONS: [Physical factors: (Effects, Ailments from, Agg.
And Amel.)]
Air: Cold/Open/Fan/Drafts/A.C./Closed room Weather: Clear/Dry/Foggy/Storm/Cloudy/Humid/Cold/Damp/warm/Seashore
Seasons: Summer/Spring/Monsoon/Winter/Autumn Wet, getting: General/Local Covers: Covering/Uncovering,
Bath Motion Time Position/Posture Coition Meditation Music/Noise/T.V.
Light/Lightening/Moonlight Odors/Pain/Color/Dark/Touch/Pressure/Rubbing
236
Sun exposure/Temperature/Thunderstorms/Moon phases Exertion: Physical / Mental Thermal state: Hot/Chilly/Ambithermal Anything else…….
G) Emotional State:
LOVE/ ANGER/ SADNESS/ FEAR/ ANXIETY/HATE/ GUILT/ ENVY / JEALOUSY / SUSPICION AND OTHERS
H) Intellectual State:
PERCEPTION/THINKING/MEMORY/DECISION/CONFIDENCE/CONSCIOUSNESS/WORK/PERFORMANCE AND OTHERS I) Life situations and circumstances:
Self: Major areas of concern and worries: Past:/Present
Major fears Habits and Hobbies
Family Patient’s position in family Spouse Dependents Relationship with wife and children Relationship with parents and siblings Marital Relationship Environment at home
Work Environment at work Relationship with Juniors/Seniors/colleagues Job satisfaction
Society Relationship with friends and relatives
237
J) Body Language: Gait: Gestures: Postures: Facial expressions: Eye Contact Voice and speech:
K) Physical Examination General:
Temp. Jaundice Mouth B.P. Cyanosis Tongue Pulse Ear Lymph nodes Oedema Nose Sinuses Anemia Throat
Skin: Complexion & Texture, Discoloration, Eruptions, Growths
Nails: Brittle, Clubbing, Colour, Deformed, Ingrown, Infection Hair: Growth, Baldness, Colour, Dandruff, Dry, Loss, Tangled
L) SYSTEMIC EXAMINATION: RESPIRATORY PER ABDOMEN CVS CNS MUSCULO-SKELETAL Comments if any:
Questionnaire used to elicit the symptoms of the patients:
Patients and the attendants were given ample time to explain about the
problem, without interrupting them in haste, yet as and where needed the
following type of questions were used;
1. What are the factors that make you worse?
238
2. What are the factors which make you comfortable?
3. What are the concerns in your life those are bothering you much?
4. In what type of environment you like to be?
5. How will you describe yourself i.e. your nature, behavior,
temperament, likings, disliking etc?
6. What fears do you have?
7. How do you react to different situations?
8. What gives you the pleasure most?
9. What makes you angry or anxious?
10. Apart from your business/profession what other activities you like.
11. Which was the worst event of your life?
12. Which were the happiest moments of your life?
Checklist for Past and Family History: Anaemia Heart diseases Hypo/Hyper - tension
Asthma Resp. diseases Syphilis / Gonorrhoea
Diabetes Rheumatism /O.A. R.A. / S.L.E
Cancer Leprosy Skin Diseases
T.B./Pleurisy Musculo-skeletal Paralysis / Polio/Stroke
Injuries / # Jaundice Poisoning / Pollution
Bleeding Tendency Malaria / Typhoid Epilepsy / Fits
Chicken-pox/ Measles Mumps / Rickets Stones / Renal diseases
Cholera /G.E. /Ulc. colitis Mental retardation/Suppressions
Diarrhoea/Dysentery Neurosis / Psychosis Vaccination
Exposure : x-ray / radiation Otorrhoea / Otitis Warts / Growths Whooping cough Worms Anything else
239
Checklist of some Probable Causes Emotionally disturbing experiences in childhood.
Prolonged insecurity.
Feeling of unloved / unwanted during childhood.
Preference of brother / sister.
Death of family member / friend.
Disappointment in a love affair.
Career disappointment.
Unfavourable work situation.
Domestic quarrels between parents / spouse / siblings.
Separation from parents / spouse.
Loss of social position.
Disappointment in close relationships
Work stresses.
Retirement from work.
Strict upbringing during childhood.
Major personal injury.
Monetary losses.
Unemployment.
Change in Job / Residence.
Any other.
240
Checklist of some Important Observations that can indicate Anxiety Disorders
Hyperactivity of Hands.
Fine Tremor of hands.
Profuse and cold perspiration Palms and Forehead.
Increased Pulse rate.
Rapid and short breathing.
Facial expression.
Biting nails.
Tenseness of facial muscles.
Hands held in a fist.
Crossed Arms.
Shoulders Bent forward.
Crossed legs.
Shoulders bent forward.
Head thrust forward.
Sitting bent forward.
Clenched Jaw.
Restlessness of limbs.
Avoids Eye Contact.
Chafed and reddened Hands.
Patchy hair loss.