Dr. Ashok yadav, HOD Dept. Of Practice of Medicine (Hom.) Dr. M.P.K. Homoeopathic Medical College, Hospital and Research Center. Homoeopathy University, Jaipur.
Dr. Virendra chauhan , Prof. Dept. Of Practice of Medicine (Hom.) Dr. M.P.K. Homoeopathic Medical College, Hospital and Research Center. Homoeopathy University, Jaipur.
Dr. Bhupendra Arya , MD Scholar, Department of Practice of Medicine (Hom.) , Dr. M.P.K Homoeopathic Medical College, a constituent college of Homoeopathy University, Jaipur.
Abstract: Renal calculus is a stone like body composed of urinary salts bound together by a colloid matrix of organic materials.1 In the United states 13 % of men and 7 % of women will develop a kidney stone during their lifetime and the prevalence is increasing throughout the industrialized world.2Men are more frequently affected by renal calculus than women with a ratio of 2.5:1.3 This article provide information about nephrolithiasis along with homoeopathy medicine and important rubric from different repertories like J.T. kent Repertory4 , Boennighausen’s Therapeutic Pocket book , Boericke Repertory .
Keywords: Nephrolithiasis, , homoeopathy
Introduction: Renal stone or calculus or lithiasis is one of the most common diseases of urinary tract. It is becoming one of emerging challenges in the medical field because of modern life style changes, sedentary habits, an unhealthy dietary plan and overweight problems of the affluent societies emerge to be the important promoters of the “stone boom” in the new millennium both in developed and underdeveloped countries. 1.
Causes of nephrolithiasis –
• Hyper excretion of relatively insoluble urinary constituents.
• Physical changes in urine.
• Altered urinary crystalloids and colloids.
• Decreased urinary output of citrate.
• Vitamin A deficiency.
• Prolonged immobilisation.
• Renal infection.1
• Inadequate urinary drainage and urinary stasis.4
• Excessive intake of animal protein, diet high in red meat, hypercalciuria, hyperoxaluria.5
Types of renal calculi :2
• Calcium Oxalate
• Calcium Phosphate
• Uric Acid
Pathogenesis- The mechanism of calcium stone formation is explained on the basis of imbalance between the degree of supersaturation of the ions forming the stone and the concentration of inhibitors in the urine. Most likely site where the crystals of calcium oxalate or calcium phosphate are precipitated is the tubular acting as nidus of the stone. The stone grows, as more and more crystals are deposited around the nidus. A number of other predisposing factors contributing to formation of calcium stones are alkaline urinary pH, decreased urinary volume and increased excretion of oxalate and uric acid.6
• Renal pain: Dull aching to pricking type of pain posteriorly in the renal angle formed by the sacrospinalis and 12th rib. Murphy’s kidney punch test demonstrates tenderness at renal angle.
• Ureteric colic: When the stones is impacted in the pelviureteric junction or anywhere in the ureter.
• Haematuria: The quantity of blood lost is small but it is fresh blood.
• Recurrent UTI: Fever with chills and rigors, burning micturition, pyuria may occur, along with increased frequency of micturition.7
• Hydronephrosis: Sometimes patient complains of lump in the loin and a dull ache, which are due to hydronephrosis caused by renal stone.1
• Tenderness: mostly present in the “renal angle” posteriorly.
• Muscle rigidity: over the kidney may be found.
• Swelling: may be felt in the flank. Abdominal distension and diminished in peristalsis may accompany with ureteric colic.1
• Blood urea and creatinine to rule out renal failure.
• Plain X-ray KUB.
• Urine for culture and sensitivity
• Conservative measures.
• Percutaneous methods: Percutaneous nephrolithotomy.
• Extracorporeal Shock Wave Lithotripsy.
• Surgical methods
• Open surgery:
b. Partial nephrectomy
Some important rubrics from different repertories related to nephrolithiasis:
Rubrics Medicines Repertory
Bladder : Calculi: Benz-ac, Berb, Calc, Canth, Lyc, Sars, Sep, Chin, Coc-c, Eup-per, Lach, Lith, Mill, Nit-ac, Nux-m, Nux-v, Pareir,Petr, Phos, Puls, Raph, Ruta, Sil Kent
Bladder : Ulceration:Calculi,caused by: All-s Kent
Urine : Sediment:Renal calculi: Benz-ac, Calc, Lith, Lyc, Pareir, Sars. , Berb, Canth, Phos, Sil
Urine : Sediment:Sand:Gravel (small calculi):
Lyc, Sars, Sep, Berb, Calc.
Urinary organs : Kidneys:Calculi: Lyc, Sars , Ant-c, Calc, Cann-s, Nux-v, Phos, Ruta, Sep, Sil, Zinc, Canth, Nit-ac, Nux-m, Petr, Sulph
Urinary system: Kidneys:Calculi,gravel (nephrolithiasis)-Colic Arg-n, Bell, Berb, Canth, Coc-c, Dios, Epig, Eup-pur, Fab, Lyc, Nit-ac,Nux-v, Oci, Pareir, Sars, Stigm, Tab, Baros, Benz-ac, Calc, Calcul-r, Cham, Chin-s, Coll, Erig, Ery-a, Hedeo,Hep, Hydrang, Ipom, Med, Onis, Op, Oxyd, Pipe, Polyg, Sep, Solid,Thlaspi, Urt-u, Uva, Vesi.
• Argentum nitricum- Urine passes unconsciously, day and night (enuresis). Urethra inflamed, with pain, burning, itching; pain as from a splinter (urethritis). Urine scanty and dark. Emission of a few drops after having finished. Divided stream. Early stage of gonorrhea; profuse discharge and terrible cutting pains; haematuria.10
• Belladonna- Retention. Acute urinary infections. Sensation of motion in the bladder, as of a worm. Urine scanty, with tenesmus; dark and turbid, loaded with phosphates. Vesical region sensitive (cystitis). Incontinence, continuous dripping. Frequent and profuse. Hematuria where no pathological condition can be found. Prostatic hypertrophy.10
• Berberis vulgaris- Burning pains. Sensation as if some urine remained after micturating. Urine with thick mucus and bright red,mealy sediment. Bubbling, sore sensations in kidneys. Pain in the bladder region. Pain in the thighs and loins on micturating. Frequent micturition;urethra burns when not micturating (urethritis).10
• Cantharis- Intolerable urging and tenesmus. Nephritis with hematuria. Violent paroxysms with cutting and burning in the entire renal region with painful urging to micturate; bloody urine passes in drops. Intolerable tenesmus; cutting before, during, and after urine. Urine scalds and is passed drop by drop. Constant desire to micturate. Membranous scales looking like bran in water. Urine jelly-like, shreddy.10
• Hydrangea abrorescens- Burning in the urethra and frequent desire (urethritis). Urine hard to start. Heavy deposit of mucus. Sharp pain in the loins, especially left. Great thirst with abdominal symptoms and an enlarged prostate. Gravelly deposits. Spasmodic stricture. Profuse deposit of white amorphous salts.10
• Lycopodium- Pain in the back before micturating; ceases after flow; slow in coming, must strain. Retention. Polyuria at night. Heavy red sediment. Child cries before micturating.10
• Nitric acid- Scanty, dark, offensive. Smells like horse’s urine. Cold on passing. Burning and stinging. Hematuria and albuminuria. Alteration of cloudy, phosphatic urine with profuse urinary secretion in old prostatic cases.10
• Nux vomica- Irritable bladder; from spasmodic sphincter. Frequent calls; little and often. Hematuria. Ineffectual urging, spasmodic and strangury. Renal colic extending to genitals with dribbling urine. While micturating,itching in the urethra and pain in the neck of bladder.10
• Ocimum canum- Uric acid diathesis. Red sand in the urine. Renal colic, especially right side. High acidity, formation of spike crystals of uric acid. Turbid, thick, purulent, bloody; brick-dust red or yellow sediment. Odor of musk. Pain in ureters. Cramps in kidneys.10
• Pareira brava- Black, bloody, thick mucoid urine. Constant urging; great straining; pain down thighs while making efforts to micturate. Can emit urine only when he goes on his knees, pressing the head firmly against the floor. Bladder feels distended; neuralgic pain in the anterior crural region. Dribbling after micturition. Violent pain in glans penis. Itching along the urethra; urethritis with prostatic problems. Inflammation of urethra; becomes almost cartilaginous.10
• Sarsaparilla officinalis- Urine scanty, slimy, flaky, sandy, bloody. Gravel. Renal colic. Severe pain at the conclusion of micturition. Urine dribbles while sitting. Bladder distended and tender. Child screams before and while passing urine. Sand on diper. Renal colic and dysuria in infants. Pain from the right kidney extends downward. Tenesmus of bladder; urine passes in a thin, feeble stream. Pain at meatus.10
1. Das S. A concise textbook of surgery. 7th ed. Kolkata: Dr. S. Das; 2012 July. p. 1203-7, 1210-17.
2. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J,et al, editors.Harrison’s principles of internal medicine. 18th ed. New York: McGraw Hill, Health Professions Division; 2012. p. 2382.
3. Tierney LM, Mcphee SJ, Papadakis MA. Current medical diagnosis and treatment. 51st ed. USA: MacGraw Hill Companies Ltd; 2000. p. 920.
4. Williams NS, Bulstrode CJK, O’Connell PR. Bailey’s & Love short practice on surgery. 25th ed. London: Edward Arnold Ltd; 2008. p. 1295.
5. Golwalla AF, Golwalla SA. Medicine for Students. 22nd ed. Mumbai: The National Book Depot; 2008. p. 641.
6. Mohan H. Textbook of pathology. 5th ed. New Delhi: Jaypee Brothers Medical Publisher (P) Ltd; 2005. p. 715.
7. Shenoy KR, Nileshwar A. Manipal manual of surgery. 3rd ed. New Delhi: CBS Publisher & Distributer; 2010. p. 753-54.
8. Seller RH. Differential diagnosis of common complaints. 5th ed. New Delhi: Elsevier Ltd; 2008. p. 14
9. Kent J.T, Repertory of the Homoeopathic Materia Medica, New Delhi: B.Jain Publishers(P)Ltd; 2015
10. Boericke William. New Manual Of Homoeopathic Materia Medica, New Delhi: B. Jain Publishers(P) Ltd; 2011