Homoeopathic Materia Medica by J.T Kent with manifestations of cervical radiculopathy

Correlating rubrics from the Repertory of the Homoeopathic Materia Medica by J.T Kent with manifestations of cervical radiculopathy

Abstract: Cervical pain associated with radiculopathy is frequently encountered in clinical practice. In this article an attempt has been made to correlate the rubrics (repertorial language of a symptom) available in “Repertory of the Homoeopathic Materia Medica” with clinical manifestations of radiculopathies affecting different spinal segmental levels.

Keywords: Cervical radiculopathy, arm pain, neck pain, Kent’s repertory, homoeopathy, rubrics

Introduction

Radiculopathies (which are chronic diseases with a miasmatic origin) are frequently encountered in homoeopathic practice.  Radiculopathy is defined as “Irritation of or injury to a nerve root (as from being compressed) that typically causes pain, numbness, or weakness in the part of the body which is supplied with nerves from that root” [1]. Depending on the origin of anatomical level, radiculopathies can be commonly cervical or lumbosacral, and much less often thoracic[2][3]. Both males and females are affected mostly in their fourth and fifth decades of life [4]. Homoeopathic treatment is based on the language of the patient and gives utmost importance to history, clinical features and physical examination findings. Materia medica and repertory in homoeopathy contains detailed expressions of the patients.

Repertory of the Homoeopathic Materia Medica” (containing 37 chapters including the subchapters) published in 1897 follows deductive logic from general to particular. It is a major contribution of Dr J. T Kent and is regarded as the most popular repertory of the 19th and 20th centuries. [5]. 

In this article rubrics related to cervical radiculopathy available from the Repertory of the Homoeopathic Materia Medica by J.T Kent (hereinafter referred to as Kent’s Repertory) have been correlated with the spinal segmental levels.

Methods

Literature search was done (in pubmed and google scholar) using the term ‘radiculopathy’ with the following eight different preceding words : ‘cervical’, ‘C2’, ‘C3’, ‘C4’, ‘C5’, ‘C6’, ‘C7’, ‘C8’ to find the various presentations of such radiculopathies. Kent’s Repertory was reviewed to match the rubrics with the various radiculopathies. Page numbers have also been provided for ready reference. [5]

Correlation of symptoms of cervical radiculopathy with rubrics and sub rubrics from Kent’s Repertory:

Cervical radiculopathy causes pain and/or sensorimotor deficit in the corresponding dermatomes and myotomes. The presentation may be of pain (even electrical type pain), numbness, and/or tingling in the upper extremity or even weakness. The compression of the nerve root may occur due to disc herniation, spondylosis, instability, trauma, or rarely, tumours [6].

  1. C2 radicular pain which can manifest itself as eye and/or ear pain and headache (cervico-occipital) [6,7]

Related rubrics [5]

 BACK- PAIN, cervical region, extending occiput, to ( Pg 901)

 HEAD-PAIN, occiput. Extending ears, to ( Pg 165)

 HEAD-PAIN, occiput. Extending eyes, to (Pg 165)

 EAR-PAIN, behind ear (Pg 306)

  1. C3 and C4 symptoms manifest as vague neck  and trapezius pain [6,8,9]

Related rubrics [5]

 BACK- PAIN, cervical region ( Pg 899)

 BACK- PAIN, cervical region, extending clavicles, to ( Pg 901)

  BACK- PAIN, cervical region, extending back, down the ( Pg 901)

 EAR- NUMBNESS, about ear ( Pg 303)

 EAR- NUMBNESS, in mastoid ( Pg 303)

 BACK- NUMBNESS, Cervical region ( Pg 893)

 BACK- NUMBNESS, scapulae ( Pg 893)

  1. C5 pain occurs in the shoulder and radiates down the ventral arm to below the elbow; and deltoid weakness [6]

Related rubrics [5]

EXTREMITIES, PAIN, shoulder. Extending to arm ( Pg 1053)

EXTREMITIES, PAIN, shoulder. Extending to elbow ( Pg 1053)

            EXTREMITIES, WEAKNESS, upper limbs, Shoulder (Pg 1226)   

  1. C6 radiculopathy is associated with pain radiating down the superior lateral aspect of the arm into the first two digits [6]

              Related rubrics [5]

              EXTREMITIES, PAIN, upper arm. Extending downward: to finger ( Pg 1055)

              EXTREMITIES, WEAKNESS, upper arm. Forearm. (Pg 1227)

  1. C7 pain radiates down the dorsal aspect of the arm, through the elbow and to the third digit. [6]

Related rubrics [5]

EXTREMITIES, PAIN, upper arm. Extending downward: to finger ( Pg 1055)

EXTREMITIES, PAIN, upper arm. Posterior part ( Pg 1055)

EXTREMITIES, WEAKNESS, upper arm. Elbow ( Pg 1227)

  1. C8 symptoms appear in the  inferior medial aspect of the arm upto the fourth and fifth digits [6, 10]

Related rubrics [5]

BACK, PAIN, cervical region. Extending arm and fingers, to ( Pg 901)

EXTREMITIES, PAIN, upper arm. Inner side: extending to fingers ( Pg 1055)

EXTREMITIES, NUMBNESS, fingers. Third finger ( Pg 1040)

EXTREMITIES, NUMBNESS, fingers. fourth finger ( Pg 1040)

EXTREMITIES, WEAKNESS. Fingers, third ( Pg 1228)

EXTREMITIES, WEAKNESS, hand grasping objects, on ( Pg 1227)

Discussion

It was found that in Kent’s Repertory, the digits are counted as four fingers and one thumb separately.  Hence, the fourth and fifth finger counted anatomically, corresponds to third and fourth fingers in Kent’s Repertory. In C8 radiculopathy, paresthesia and weakness are seen in fourth and fifth digits. The rubric for “weakness of fifth finger” was not found. [5]

C6 and C7 radiculopathies are more common when compared to other cervical radiculopathies [11]. The symptoms of various radiculopathies may overlap. The clinical presentation may be confused with peripheral nerve lesions [12]. So, physicians must be able to differentiate the condition by physical examination and relevant investigations.  Also, the case will be managed more effectively by keeping in mind the possible associated disabilities.

While attempting to correlate the rubrics from various sections of Kent’s Repertory, most of the rubrics corresponded with the clinical condition. As there are many other rubrics in Kent’s Repertory, the physician can correlate the newly arrived symptomatology also. More specialised homoeopathic repertories containing minute details of the condition may be used in difficult cases.

Conclusion

An attempt has been made to correlate the clinical manifestations of radiculopathies with different rubrics available in “Repertory of the Homoeopathic Materia Medica” by J.T Kent. This work might help in understanding the rubric which is the repertorial language of the symptom which subsequently may help in the selection of simillimum.

References:

  1. Merriam-Webster. (n.d.). Radiculopathy. In Merriam-Webster.com dictionary. Retrieved October 23, 2020, from https://www.merriam-webster.com/dictionary/radiculopathy
  2. Berry, J. A., Elia, C., Saini, H. S., & Miulli, D. E. A Review of Lumbar Radiculopathy, Diagnosis, and Treatment. Cureus. 2019; 11(10): e5934.
  3. Das, S. M. S., Dowle, P., & Iyengar, R. Effect of spinal mobilization with leg movement as an adjunct to neural mobilization and conventional therapy in patients with lumbar radiculopathy: Randomized controlled trial. J Med Sci Res.2018; 6(1):11-9.
  4. Priyanshu J, Usha S, Niketa S. Prevalence of cervical radiculopathy in general population. International Journal of Advanced Scientific Research. 2018; 3(5):66-69.
  5. Kent J.T. Repertory of the Homoeopathic Materia Medica. reprint 6th ed. New Delhi: Indian Books & Periodicals Publishers; 2012.
  6. Caridi, J. M., Pumberger, M., & Hughes, A. P. Cervical radiculopathy: a review. HSS Journal®. 2011; 7(3): 265-272.
  7. Jackson, R. (2010). The classic: the cervical syndrome. Clinical Orthopaedics and Related Research®, 468(7), 1739-1745.
  8. Katsumi, K., Yamazaki, A., Watanabe, K., Hirano, T., Ohashi, M., & Endo, N. The characteristic clinical symptoms of C-4 radiculopathy caused by ossification of the posterior longitudinal ligament: Case report. Journal of Neurosurgery: Spine. 2014;20(5): 480-484.
  9. Malcolm, G. P. Surgical disorders of the cervical spine: presentation and management of common disorders. Journal of Neurology, Neurosurgery & Psychiatry. 2002; 73(suppl 1): i34-i41.
  10. Greathouse, D. G., & Joshi, A. Radiculopathy of the eighth cervical nerve. journal of orthopaedic & sports physical therapy.2010; 40(12): 811-817.
  11. Rainville, J., Joyce, A. A., Laxer, E., Pena, E., Kim, D., Milam, R. A., & Carkner, E. Comparison of symptoms from C6 and C7 radiculopathy. Spine2017; 42(20): 1545-1551.
  12. Kinirons M. Sensation, abnormalities of. In: Kinirons M T, Ellis H, editors. French’s Index of Differential Diagnosis An A-Z. CRC Press; 2016. 608 – 614.
Homeopathy360 Team
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