‘DEMENTIA AND IT’S HOMOEOPATHIC APPROACH’
Dr. Mehak Gupta
B.H.M.S (DLI), MA Psychology
M.D. Scholar, Department of Psychiatry, Bakson Homoeopathic Medical College and Hospital, Greater Noida, U.P
Abstract: Dementia is an umbrella term used to describe the set of symptoms that affect the brain function of the individual. It is one of the leading causes of cognitive impairment that affect the independent functioning of everyday activities. Dementia is a symptom of disease rather than a single disease entity. It causes a significant emotional and social impact on both the patient and the family. The article attempts to provide an overview to this complex disease process and detail the homoeopathic approach in the treatment of dementia.
Keywords- Dementia, Alzheimer’s disease, Cognitive impairment, Homoeopathy, Miasmatic understanding
Dementia was named ‘Major Neurocognitive Disorder’ (NCD) in the DSM-5. However, the term dementia may still be used as an acceptable alternative. The two terms are essentially different labels for the same condition (1).
Neurocognitive disorders are not developmental conditions but are acquired conditions that represent underlying brain pathology that results in a decline in faculties. It is characterised by progressive deterioration of intellect, behavior and personality as a consequence of diffuse disease of the brain hemispheres, maximally affecting the cerebral cortex and hippocampus.
They are caused by brain damage in areas that:
Affect learning and memory, planning and decision making;
The ability to correctly use and understand language, hand-eye coordination, and the ability to act within social norms, such as dressing appropriately for the occasion, showing empathy, and performing routine tasks.
Types of Dementia- The most common causes of dementia in individuals older than 65 years of age are (2) –
1. Alzheimer’s Disease- most common accounts for 50-60%
2. Vascular Dementia (Multi Infarct Dementia) accounts 15- 30%
3. Mixed Vascular and Alzheimer’s Dementia
4. Other illnesses include Lewy body dementia, Pick’s disease- fronto-temporal dementia, Normal pressure Hydrocephalus, alcoholic dementia. These account for about 10% of the illnesses (accounts for 10- 15%)
5. Dementia due to reversible causes- Pseudo- Dementia due to drug medications; Dementia Due to nutritional deficiencies (Vitamin B-1, B-6, B-12) (less than 1%)
Stages Of Dementia- The Functional Assessment Staging- (FAST) Scale: To check the highest consecutive level of disability (3)
a) First Stage- Normal Adult, no functional Decline
b) Second Stage- Awareness of some functional decline.
c) Third Stage- early Alzheimer’s . The person functions at about 12 years of age.
d) Fourth Stage- Mild Alzheimer’s. He/She requires some assistance.
e) Fifth Stage- Needs help getting dressed. Functions at 5-6 years of age.
f) Sixth Stage- Needs 24/7 care. Functions at 2-4 years of age.
g) Seventh Stage- Severe. Functions at level of a newborn.
Memory must be impaired to make the diagnosis of dementia. It is the earlist feature of dementia. Subsequent symptoms include abnormal behavior, loss of intellect, mood changes, and difficulty coping with ordinary routes. Insight may be retained initially, but is then usually lost. Ultimately there is loss of self-care.
MIASMATIC UNDERSTANDING OF DEMENTIA
It is important to understand the fundamental cause and include it into our homoeopathic prescription. Dr. Hahnemann in aphorism 5 stated that, it is important to discover the fundamental cause in chronic diseases that is generally due to a chronic miasm. In aphorism 204, he states that, it is important to remove all the persisting reversible causes of a chronic illness, ‘as all the remainder, without exception, result from the development of these three chronic miasms, internal syphilis, internal sycosis, but chiefly and in infinitely greater proportion, internal psora(4)’
In aphorism 206, he then states, ‘psora is the sole fundamental cause of all other chronic maladies, whatever names they may bear, which are,’ Indicating that after the most careful investigation into cause (to rule out other causes) ‘Psora is far the most frequent (most certain) fundamental cause of chronic diseases, either united (complicated) with syphilis (or with sycosis),..(4)’
The Miasmatic prescribing requires a deep understanding to help eliminate the underlying cause of the disease and help us reach our penultimate aim of achieving successful treatment of cases.
Miasmatic Analysis (5):
• PSORA- Prostrated easily from metal exertion or impressions; Vanishing of thoughts while reading or writing; cannot control thoughts. They are often in trouble; Unsatisfied, never well and yet quite able to locate their trouble. Likes hot food. Cravings for unnatural things to eat; sweets;
• SYCOSIS- Forgets words, sentences and previous lines just read. He has momentary loss of thought. Loses thread of discourse frequently. Recollection of recent events is difficult whilst they can recall things of past. Suspicious, mean, selfish. Likes either hot or cold foods. Craves beer.
• SYPHILIS- Depression of mind; Melancholia; Thoughts and ideas vanish away and he has no mental ability to bring them back. Quickness of thought is gone; incapacity for understanding things. Mind grows slow- A kind of Mental paralysis; Forgets what he is about to utter. Reads but cannot retain. Desires cold things to eat and drink; Aversion to meat.
HOMOEOPATHIC THERAPEUTICS (4, 6, 7)
Aurum metallicum –
For Old people, weak vision; corpulent; tired of life. Pining boys; low spirited, lifeless, weak memory. Profound melancholy: feels hateful and quarrelsome; desire to commit suicide (7). He looks on the dark side of everything, constantly expecting bad news, looking for everything to go wrong.
VIOLENCE; .Full of excitement, rage, everything is tumultuous, violent, the face looks wild, anxious, fearful; eyes are fixed on a certain object; face flushed, hot raging fear with hot head and cold extremities, violent delirium. Numerous, observations, and among others those made by P. Schenk, have shown us that it can destroy recollection and memory in a very short time; (4).
Nux moschata –
Weakness of old age; oversensitive to light, hearing, smell, touch. Absence of mind; cannot think; great indifference to everything. Vanishing of thoughts while reading, talking or writing; uses wrong words; does not recognize well known streets (7). ‘The patient appears to be dazed; there is complete loss of memory; she is automatic in her actions. She goes about performing duties but if interrupted, forgets what she has been doing. She speaks with intelligence about the things of present but knows nothing about the past.’
A gentleman has an altercation, an argument which ends in insult, and the gentleman turns his back on the other. He goes home and suffers; He does not speak it out but controls it and then suffers. Great indignation about things done by others or himself; grieves about consequences. Apathetic, indifferent, low spirited, weak memory from sexual abuses (7).
‘The woman married several years’ desires to become mother. She was healthy when she married, but now she has ovarian pains, menstrual troubles, she has lost all sexual response, becoming violently sensitive and nervous.’ Has to ask name of most intimate friend; even forget his own name. Cannot spell correctly; wonder how a well-known name is spelled. Constantly loses the thread of conversation. Great difficulty in stating her symptoms, question has to be repeated as she loses herself.
He may have most violent sexual desire yet he is impotent. Gradually growing paralytic weakness. Exhaustion of body and mind, that is, a general slowing down of all the activities of the body. Memory weak, unable to sustain any mental effort. No inclination for business or study; indolent, indifferent, takes no interest in anything.
Dementia refers to a disease process marked by progressive cognitive impairment in clear consciousness. Along with the ongoing psycho social support for the patient and the family it is necessary to understand its Homoeopathic perspective. It requires a detailed case taking along with the evolutionary history and the most important aspect of Homoeopathic prescribing, the miasmatic understanding. A thorough study of the case with an unbiased approach would help reaching to a promising and favourable outcome.
1. American Psychiatric Association, ‘Diagnostic and Statistical Manual Of Mental Disorders’ DSM- 5, Fifth Edition, 2017
2. Kaplan &Saddock, ‘Synopsis Of Psychiatry, Behavioural Sciences/ Clinical Psychiatry- Eleventh Edition, 2015
3. Reisberg, B. Functional Assessment Staging (FAST). Psychopharmacology Bulletin, 1988; 24:653-659 Posted: July 31, 2008
4. Dudgeon. R.E, ‘Organon of Medicine by Samuel Hahnemann, Aude Sapere’, Translated from fifth edition, with an Appendix. 2005
5. Speight, Phyllis, ‘A Comparison of the “Chronic Miasms” (Psora, Pseudo- psora, Syphillis, Sycosis)
6. Kent. J.K. ‘Lectures On Homoeopathic Materia Medica’. 2007
7. Allen. H.C. ‘Keynotes and Characteristics With Comparisons with Bowel Nosodes’.2007