To Study the Efficacy of Arsenic Album, Pulsatilla  & Spongia in Management of Bronchial Asthma. - homeopathy360

To Study the Efficacy of Arsenic Album, Pulsatilla  & Spongia in Management of Bronchial Asthma.

AsthmaAbstract:
Background: The objectives of the study were to determine therapeutic efficacy of homoeopathic medicines in the management of bronchial asthma and to identify reliable indications of the effective medicines, most useful potencies, frequency of administration, and their relationship with other medicines. The objectives also included determining the efficacy of homoeopathic medicines to alleviate acute exacerbation of asthma and to prevent further progression of disease by controlling recurrent attacks.
Methods: 30 patients were followed up regularly. The detailed case recording was done for each case and the medicine (similimum) was prescribed according to the principles of Homoeopathy. During acute attacks, medicines were selected on the basis of presenting symptoms while during asymptomatic phase, medicines were selected on constitutional basis.
Results: Improved cases showed less frequent acute exacerbations and decreased intensity and duration of subsequent attacks of asthma. Arsenicum album was seen to be the most effective and most frequently indicated medicine in the treatment of asthma.
Conclusion: The outcome of the study shows that homoeopathic medicines are effective in managing acute attacks of bronchial asthma as well as in controlling recurrent attacks of asthma. A group of most effective medicines in asthma were evolved and their most reliable indications were deduced in this study. The other objectives of the study that included most useful potencies of medicines, their frequency of administration and relationship with other medicines could not be achieved.
*INTRODUCTION*
Bronchial Asthma is a syndrome characterized by airflow obstruction that varies markedly, both spontaneously and with treatment. Asthmatics harbor a special type of inflammation in the airways that makes them more responsive than nonasthmatics to a wide range of triggers, leading to excessive narrowing with consequent reduced airflow and symptomatic wheezing and dyspnea. Narrowing of the airways is usually reversible, but in some patients with chronic asthma there may be an element of irreversible airflow obstruction. Bronchial asthma is a common clinical problem in our country. WHO estimates that there are between 15 and 20 million asthmatics in India, the commonest cause being various allergens, from the environment and changes in weather. Considering the atmospheric conditions allergic respiratory illnesses are on the rise. The prevalence of childhood asthma has increased since 1980, especially in younger children. The International Study of Asthma and Allergies in Childhood (ISAAC), found great disparities (as high as a 20 to 60-fold difference) in asthma prevalence across the world, with a trend toward more developed and westernized countries having higher asthma prevalence.[1]
Asthma is a heterogeneous disease with interplay between genetic and environmental factors. Several risk factors have been implicated like
Endogenous factors: Genetic predisposition, Atopy, Airway hyper responsiveness, Gender and Ethnicity.
Environmental factors: Indoor allergens, Outdoor allergens, Occupational sensitizers, Passive smoking, Respiratory infections,
Triggers: Allergens, Upper respiratory tract infections, Exercise and hyperventilation, cold air, Sulphur dioxide, drugs, Stress etc. [2]
There is inflammation in the respiratory mucosa from trachea to terminal bronchioles, but with predominance in the bronchi (cartilaginous airways). The airway mucosa is infiltrated with activated eosinophils and T lymphocytes, and there is activation of mucosal mast cells. . A characteristic finding is thickening of the basement membrane due to sub epithelial collagen deposition[3,4]
The characteristic symptoms of asthma are wheezing, dyspnea, and coughing which are variable, both spontaneously and with therapy. Symptoms may be worse at night, and patients typically awake in the early morning hours. Patients may report difficulty in filling their lungs with air.
Typical physical signs are inspiratory, and to a great extent expiratory, rhonchi throughout the chest, and there may be hyperinflation.
The diagnosis of asthma is usually apparent from the symptoms of variable and intermittent airways obstruction, but is usually confirmed by objective measurements of lung function.[5,6]
Homeopathy has proven treatment which helps towards: Relieving cough, controlling   tendency to catch cold and cough, Improving immunity and general vitality, Reducing the severity, frequency and duration in case of recurrent asthma, helping allergic as well as infective cases of asthma
Dr. Hahnemann has stressed upon the individualizing examination of the patient to cure the patient in the shortest, most reliable and the most harmless way and on easily comprehensible principles. Homoeopathy is based on the nature’s law of cure and therefore brings about cure in the most harmless manner.[7]
With homeopathy treatment asthma has a good recovery scope free from side effects of conventional medicine.
The goal of homeopathic treatment for asthma is to identify the root cause for the attacks, and then to use the bodies own healing processes to transform the triggers into remedies. Asthma is viewed differently in each person, because each person is afflicted in a different way. Factors considered by the homeopath include frequency of attacks, possible allergens and other symptoms. The health of the whole body, not just the respiratory system, is addressed. Ultimately, homeopathy might create a cure for the asthma by strengthening and balancing the immune system.
HOMEOPATHIC SCOPE
Homeopathic treatment is very strongly suggested during for all forms and stages of Asthma
Homeopathy has proven treatment which helps towards:

  • Relieving cough
  • Controlling tendency to catch cold and cough
  • Improving immunity and general vitality
  • Reducing the severity, frequency and duration in case of recurrent asthma
  • Helping allergic as well as infective cases of asthma

Goals of treatment comprise of :

  •  Prevention of recurrent exacerbation,
  •  Correction of hypoxaemia,
  • Reversal of airflow obstruction,
  •  Maintain normal pulmonary function and physical activity levels.

Prognosis
With homeopathy treatment asthma has a good recovery scope free from side effects of conventional medicine.
It is very useful in acute, chronic attacks and prevents recurrence of attacks.
*PURPOSE OF SELECTION OF TOPIC*
Bronchial asthma is a common clinical problem in our country. WHO estimates that there are between 15 and 20 million asthmatics in India, the commonest cause being various allergens, from the environment and changes in weather.
With homoeopathy we, not only alleviate the sufferings of the patients but also reduce the recurrence of the attacks by increasing the immunity.
*AIMS & OBJECTIVES*
*AIM*
EXPLORING THE EFFICACY OF ARSENIC ALBUM, PULSATILLA & SPONGIA IN MANAGEMENT OF BRONCHIAL ASTHMA
 
*OBJECTIVES*

  1. To reduce the duration of asthmatic attack.
  2. To prevent recurrence of attack.
  3. To prevent any complication occurring from asthma.

MATERIALS AND METHODS
SOURCES OF DATA:

  1. The present study was undertaken at own practice.
  2. 30 cases are studied to know their clinical presentation.
  3. Patients of various age groups and both sexes involved are assessed in the study.
  4. Cases were recorded keeping the holistic approach in mind.
  5. In all cases family history and past history was recorded to evaluate hereditary tendencies.
  6. The cases were analyzed and evaluated, later repertorization done by Murphy’s repertory.
  7. Drugs were selected as per the totality and potency and repetitions followed as per the susceptibility of the case.
  8. The posology and remedy reaction was studied in the follow up.
  9. Auxillary measures like alteration in diet and relaxation of mind were advised.

 
INCLUSION CRITERIA

  1. Patients with symptoms of cold, cough and dyspnoea.
  2. Patients with a strong family history of Bronchial asthma.
  3. Patients exposed to environmental allergens at the work place, at home.
  4. Patients who constantly stressed which may precipitate the attack.
  5. Patients who have a history of allergic skin ailments in the past or as a presenting complaint.

EXCLUSION CRITERIA:

  1. Patients who are proven to have structural abnormalities in the form of chronic bronchitis or emphysema
  2. Patients who present with an acute severe attack of asthma(status asthamaticus).
  3. Pregnant females.

 
OBSERVATION AND ANALYSIS
Table no 1.
Showing age incidence in years for production of Bronchial asthma.
 

Age ( in yrs) range No. of patients Percentage
0 to 10 3 10 %
11 to 30 7 23 %
31 to 50 16 53 %
51 to 70 4 13 %

 
As shown in the table, maximum number of patients is from the age group between 31-50 yrs of age. 
Table no 2.
Showing sex incidence in Bronchial asthma.

Sex No. of patients Percentage
Male 17 57 %
Female 13 43 %

 
The above table shows the percentage of male patients to be much more than females.
Table no 3.
Showing the miasmatic background in Bronchial asthma cases.

                 Miasm                 No. of patients Percentage
PSORA 9 30 %
SYCOSIS 17 57 %
TUBERCULAR 3 10 %
SYPHILIS 1 3 %

 
The above table is suggestive that, the dominant miasm is Sycosis.
Table no 4.
Showing the result of treatment.
 

Result of treatment No. of patients Percentage
Improvement 28 93 %
No improvement 1 3 %
Discontinued treatment due to long distance 1 3 %

 
Table no.5
Showing presentations of the acute and chronic cases.
                           

Presentation No. of patients Percentage
Acute 7 23 %
Chronic 23 77 %

 
Master Chart:

Case no. Age Sex Family history Past history Miasm Result
1 58 F Father asthma Nothing significant Psora Improved
2 37 F Mother asthma Nothing significant Sycotic Improved
3 40 F Maternal uncle asthma Chickenpox-7yrs.age
K\C\O Asthma
Psora Improved
4 43 M Mother HT. Nothing significant Psora Improved
5 41 M Mother -asthma
 
K\C\O Asthma Sycotic Improved
6 48 F Mother HT, Elder brother- Liver cirrhosis. HT since one year Psora Improved
7 22 M Mother –DM Atopic dermatitis Psora Improved
8 38 F Grandmother-asthma,
Father-warts
Nothing significant Sycotic Improved
 
9
 
 
28 M Father RA
Mother-HT
 Nothing significant Sycotic Improved
10 16 F Mother-asthma
Father-Tuberculosis
Recurrent cough Tuberc Improved
11 52 M Elder brother has DM. Known case of DM and HT Syphilis SQ
12 37 M Father asthma Atopic dermatitis Psora Improved
13 54 M Father HT K\C\O Asthma Sycotic Improved
14 45 F Grandma-asthma Hysterectomy 3 yrs back Sycotic Improved
15 22 F Mother-asthma Nothing significant Psora Improved
16 48 M Grandmother asthma. K\C\O HT Sycotic Improved
17 32 F Nothing significant. Nothing significant. Sycotic Improved
18 33 F  Mother -Tuberculosis Nothing significant. Psora Improved
19 36 M  Mother DM,Rheumatism Nothing significant. Sycotic Improved
20 33 M Father DM and HT Nothing significant Sycotic Improved
21 10 F Mother –Tuberculosis Nothing significant Tubercular Improved
22 8 M Mother Rheumatic complaints Nothing significant. Sycotic Improved
23 21 M Nothing significant Dengue fever at the age of 18 Sycotic Improved
24 25 M Nothing significant. Nothing significant. Psora Improved
25 9 M Mother asthma Nothing significant Tubercular Improved
26 39 F Mother and Father HT. Nothing significant Sycotic Improved
27 68 F Mother-asthma  Hysterectomy 20 yrs back,
K/C/O Asthma since 10 yrs
Sycotic Discontinued  due to long distance
28 33 M Mother-asthma K/C/O Asthma since childhood Sycotic Improved
29 23 M Mother  & Father HT K/C/O Asthma since childhood Sycotic Improved
30 47 M Nothing significant K/C/O Asthma since 10 yrs Sycotic Improved

 
DISCUSSION:
We have studied 30 clinical cases with their varied presentations.
This study has shown an insight into the various aspects of this illness and the role of Homoeopathic Medicine in treating them.
Constitution and Source Materia medica’s form a potent combination for deciding the similimum, complementing and completing each other, going hand in hand to arrive at a similimum.

  • Most of the patients had single or multiple triggering factors like change of weather, cold, dust, smoke, pollution, draft of cod air, strong smell, animal dander, rain and damp wet weather.Triggers were the major precipitating causes in development of the symptoms of asthma.
  • The age groups of patients involved were children, adults, middle age and also from the old age there were 3 patients of age group 0-10 yrs, 7 patients of age group 11-30 yrs, 16 patients of age group 31-50 yrs and 4 patients of age group 51-70 yrs.
  • The predominant miasm was Sycosis which is present in17 cases, in 9 cases the dominant miasm was psora, in 3 cases the miasm was tubercular, in 1 case the miasm was syphilis.
  • The topic of study was related to Bronchial asthma and therefore the cases had a lot of allergic symptoms and also lots of mental symptoms. The utility of Homoeopathic Medicine was well established due to the predominance of mental and clinical symptoms.
  • Breathlessness due to allergic triggers which is a major feature of Bronchial asthma has 3 remedies, Arsenic album, Pulsatilla & Spongia which are indicated. The follow ups of the cases showed steady and continued improvement, in the symptoms, a few cases however did not respond well.
  • The cases had symptoms of breathlessness, cold and cough, no cases had severe structural symptoms of asthma or symptoms suggestive of complications of asthma, and hence none of the patients were advised to undergo PFT or sputum examination.

 
SUMMARY
Need for the study:

  • Due to the increasing amount of pollution and stress in today’s life every individual has greater or lesser amount of respiratory tract problems and more so of allergies. This has contributed to the increase in the amount of cases of asthma in the recent past.
  • Large number of the patients has allergic respiratory illnesses including asthma.
  • Not all patients present with all the classical symptoms of asthma, and many of them do not have much to tell about their mentals. In such cases Homoeopathy becomes an useful tool because it can be used to solve cases both classically and clinically.

Methods used:

  • 30 cases of patients with symptoms of asthma were taken up for study.
  • Clinical symptoms were recorded in details.
  • Co-relation of the mind and physical symptoms was done.
  • Analysis and evaluation of the symptoms following detailed history taking was done.
  • Repertorial totality and repertorization was done by Murphy’s repertory.
  • Discussion carried out at the end of each case regarding the approach used in solving the case (Classical or clinical) and the result of the given treatment discussed.

 
Result:

  • With the study of cases of the different types of presentations of asthma were studied and relation of allergies in the production of asthma was established.
  • There was a family history of asthma in many of the cases and so the role of genetic factors in the production of asthma was established
  • Few cases presented with suppression of emotions leading to aggravation of symptoms of asthma and also as the precipitating cause in development of asthma. Thus psycho somatic relation in the development of asthma was established.
  • Expansion of the knowledge of materia medica was achieved through repertory.

CONCLUSION
Bronchial asthma is a common clinical problem in our country. WHO estimates that there are between 15 and 20 million asthmatics in India, the commonest cause being various allergens, from the environment and changes in weather. Considering the atmospheric conditions allergic respiratory illnesses are on the rise. The prevalence of childhood asthma has increased since 1980, especially in younger children.
With the increase the allergens in the atmosphere and the increase in the amount of allergic symptoms in cases of asthma the role of allergy in the production of asthma is well established.
Many of the patients had a family history of asthma or other respiratory illness like tuberculosis so the role of genetic inheritance in the production of the symptoms of asthma was well understood.
It has been observed that there was no age group which was particularly vulnerable to the production of Asthma. Though the patients of middle age group were found to have mostly affected.
Because the characteristic finding in cases of asthma is thickening of the basement membrane due to sub epithelial collagen deposition. The airway wall itself may be thickened and edematous the dominant miasm is sycotic.
Most of the patients had a common set of triggering factors like change of weather, cold, dust, smoke, and pollution, draft of cod air, strong smell, animal dander, rain and damp wet weather.
The efficacy of Homoeopathic Medicine was established clinically.
Clinical and pathological rubrics like asthma, bronchial cattrah, allergic hay fever with, spasmodic; wheezing etc are well represented in this repertory as compared to other repertories.
Direct rubrics of various diseases like asthma which covers pathology, ailments etc helped in easing repertorisation.
Chapter on toxicity mentions the ailments from alcohol, drugs, chemicals, poisons tobacco smoke. Some cases had aggravation of asthmatic symptoms from tobacco smoke thus it was very helpful in such cases.
Remedies used were: Arsenic album, Pulsatilla & Spongia.
The follow up showed improvement in most of the cases, one case did not respond well and one left the treatment due to long distance.
Auxiliary measures, like dietary corrections with nutritious food, relaxation of mind by meditation with breathing exercises were advised. Patients were asked to exercise regularly, avoid allergens, and follow physician’s advice.
BIBLIOGRAPHY

  1. Harrison’s Principles of Internal Medicine; Volume II; 17th edition; Edited by, Kasper, Braunwald, Fauci, Hauser, Longo, Jameson; Part X, section 248; Pg. no.1596 _ 1607
  2. API Textbook of Medicine, 9th Edition, p- 1106-1120
  3. Davidson’s Principles and Practice of Medicine, 22nd Edition, p-678-720
  4. Principles of Anatomy and Physiology by G.J. Tortora and S.R. Grabowski, …
    www.liv.ac.uk/~gdwill/hons/gul_lect.pdf
  5. American Academy of Allergy, Asthma, and Immunology
    http://www.aaaai.org
  6. Medical info series, Volume II, Issue 3, September 2008
  7. Organon of Medicine. 6th Edition.
  8. Dr. Kent, Lectures on Homoeopathuc Philosophy, 5th Edition, p-47, 203-242

 
 
 
 
 
 
 
 
 
 
 
 
 
 

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