Renal Stone and Relevant Rubric from Different Repertories with Medicine Differentiations

Abstract :- Kidney problems are among the most common complaints in the modern world. When chemicals such as calcium oxalate, uric acid, and struvite crystallise because of their high concentration in urine, stones or calculi form in the kidneys. Blockages in the excretory system can result from these crystals aggregating to form stones of different sizes. Kidney stones are among the most prevalent ailments. The paper suggests widespread use of homoeopathy at all stages of kidney stone problems, along with relevant rubrics from several repertories and a discussion of the differentiation of homoeopathic medicines

 

Key Words :- Renal, Stone, Homoeopathy, Medicine, Rubrics, Repertory, Calcium Oxalate, Uric Acid, Struvite, Cystine, Materia Medica.

Introduction :- kidney stone also known as renal calculus which is derived from the Latin word “renes,” which means “kidneys,” and “calculus,” which means “pebble”. A renal calculus is a solid crystalline mineral substance that builds up in the urinary tract when one or more materials that form crystals separate from urine that is supersaturated. The formation of renal calculi occurs when crystals grow and combine to create larger lumps or aggregates of crystals, ultimately forming stones.

Epidemiology :- Due to a number of etiological variables that are prevalent in northern India, stone disease is more prevalent there. In southern India, the patterns are shifting. The population’s food habits or socioeconomic status may have changed as a result of emigration to the Gulf countries. Between the ages of 20 and 50, urinary stones are frequently observed. In India, men make about 90% of the stone patients. Due to the rise of androgen-using menopausal women, it is equal in both age groups after 50 years. Sedentary lifestyles are more likely to exhibit this. Summertime is associated with higher rates of stone disease.

Risk Factors For Renal Stone :-

Diet: A diet low in calcium causes the absorption of oxalate to be up-regulated. Consuming a lot of animal protein decreases urine pH, which promotes crystallization. Consuming a lot of salt causes the excretion of calcium in the urine. Because vitamin C is converted to oxalate, consuming foods high in oxalate (such as spinach) and vitamin C may increase the risk of stone development. A low-potassium diet lowers the excretion of citrate.
Fluids: If urine production is less than 1 litre per day, trace substances such as fluorides in water can raise the risk of stone formation by five times.
Genetic factors: Nephrolithiasis, cystinuria, and familial renal tubular acidosis are present in one out of four patients with renal stones.

Systemic conditions: primary hyperparathyroidism (20%), 60% of people with gout, Crohn’s disease, diabetes, and high blood pressure.
Infection :- Urinary infection, produced by urease producing organisms (Proteus, Klebsiella, Pseudomonas, Ureaplasma) increases the incidence of struvite stones. Matrix stones were observed in

Main Types :-

1. Calcium oxalate stone or oxalate calculus (40-60%) :- Because of the spikes that cover its surface, it has an extremely uneven shape and produces haematuria.
2. Phosphate Calculus or calcium phosphate stone (20-60%) :- It has a dirty white colour and an extremely smooth surface. It usually forms in urine that is alkaline.
3. Urate Calculi (5-10%) :- It has a multifaceted surface and ranges in color from yellow to reddish brown. It is usually radiolucent, but if it has calcium impregnated into it, it becomes radio-opaque. 
4. Cystine calculus  (1%):- It is a relatively rare kind that is present in people who have congenital metabolic disorders that cause cystinuria.

Sign and Symptoms  :- Resolved kidney pain. The symptoms include ureteric colic, hydronephrosis, fever, sweating, nausea, vomiting, hematuria, oliguria, and dysuria. 

Investigations :- 

1. Urine Routine & microscopical Test
2. Blood Test: For Renal Function Test.
3. Radiological Investigations 

      ∙ X-Ray KUB 

      ∙ IVU(intravenous urography) to know the exact position of the Stone or to assess Hydronephrosis.

      ∙ USG Whole abdomen with special attention to KUB. 

      ∙ Non contrast CT Scan 

Treatment In Modern Medicine :- The size and position of the stone determine the course of treatment. Some medications and surgical procedures like Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Laser Lithotripsy are a few of the techniques.

Rubrics From Kent  :- 

• URINARY ORGAN, URINE, SEDIMENT 

1. URINARY ORGAN, URINE, SEDIMENT, oxalate of lime : 
2. URINARY ORGAN, URINE, SEDIMENT, phosphates : 
3. URINARY ORGAN, URINE, SEDIMENT,renal calculi :
4. URINARY ORGAN, URINE, SEDIMENT, gravel (small calculi) :
5. URINARY ORGAN, URINE, SEDIMENT, sand:
6. URINARY ORGAN, BLADDER, URGING, frequent
7. URINARY ORGAN, BLADDER,URINATION, frequent
8. URINARY ORGAN, BLADDER,URINATION, dysuria
9. URINARY ORGAN, KIDNEY, PAIN, 

RUBRICS FROM BTPB:- 

 

1. 1. URINARY ORGAN, Urine, sediment in general 
   2. URINARY ORGAN, Urine, sediment-purulent 

• URINARY ORGAN, Urine, sediment

1. URINARY ORGAN, Urine, Scanty
2. URINARY ORGAN, Urine, Red
3. URINARY ORGAN, Micturition, Too Frequent

 

RUBRICS FROM BBCR:- 

1. URINE, Oxaluria
2. URINE, Scanty, suppressed
3. URINE, SEDIMENT, Sediments in general
4. URINE, SEDIMENT, Brick-colored
5. URINE, SEDIMENT, Crystalline
6.  URINE, SEDIMENT, Sandy
7. URINARY ORGAN, KIDNEY, Left
8. URINARY ORGAN, KIDNEY, Right
9. URINARY ORGAN, KIDNEY, Gravel, stone etc
10. URINARY ORGAN, KIDNEY, Hydronephrosis,
11. URINARY ORGAN, KIDNEY, Pain, region of
12. URINARY ORGAN, KIDNEY, Renal colic
13. URINARY ORGAN, KIDNEY, Stitches

RUBRICS FROM BOGER’S SYNOPTIC KEY :-

1. SEDIMENT, RED, brickdust, etc
2. SEDIMENT, SANDY
3. SEDIMENT, WHITE
4. URINE, BLOODY
5. URINARY ORGAN, KIDNEY, Right
6. URINARY ORGAN, KIDNEY, Left

RUBRICS FROM PHATAK’S REPERTORY :-

• KIDNEY, colic

• URINE, Bloody

• URINE, Phosphates, containing

• URINE, Sandy

• URINE, Sediment

RUBRICS FROM BOERICKE’S REPERTORY :-

• URINARY SYSTEM, CALCULI, GRAVEL(nephrolithiasis), COLIC

• URINARY SYSTEM, PAIN IN RENAL REGION

• URINARY SYSTEM, SEDIMENT, TYPE, Lithic acid, uric acid, gravel, brick dust

• URINARY SYSTEM, SEDIMENT, Oxalates(oxaluria)

• URINARY SYSTEM, SEDIMENT, Phosphates(phosphaturia)

Medicines Differentiation :- 

Pareira Brava :– Useful in renal colic, ache radiating down the thighs and renal colic. The anterior crural area is experiencing neuralgia. Great straining, constant urging. Only when he is kneeling and pressing his head firmly on the floor does he release pee. Urine that is thick, red, and black. Micturition followed by dribbling. prostatitis and urethritis.

Hydrangea Arborescens :- Hydrangea has long been used to treat calculous disorders and has a reputation as a “stone-breaking” cure. Gravel, renal calculi, and a large amount of white, amorphous salts in the urine. Renal colic, sharp pain in loins, especially left. Frequent desire and urethral burning. Urine is difficult to start. Prostate enlargement, and extreme thirst with abdominal symptoms.

Berberis Vulgaris :– Renal colic < left side. Stitching, cutting pain from left kidney following course of ureter into bladder & urethra. Burning & soreness in region of kidneys. Bubbling sensation in region of kidneys.— Lancinating or tearing pulsative pain in the region of the kidneys; worse when stooping and rising again, sitting or lying; better when standing.─ Violent sticking pains in the bladder, extending from the kidneys into the urethra, with urging to urinate.— Frequently recurring, crampy, contractive pain, or aching pain, in the bladder, when the bladder is full or empty.─ Urine thick, yellowish, like whey, or clay-coloured water.─ Urine of a deep yellow, with abundant sediment.─ Urine dark yellow, red, becoming turbid, copious; mucous sediment, or transparent, jelly-like reddish, bran-like sediment (which is easily crushed and dissolved between the fingers).─Greenish urine, depositing mucus.─ Urine reddish, as if inflamed, with abundant sediment.─ Urine reddish, sanguineous, with slimy, mealy, and abundant sediment, of a bright red colour.

Cantharis Vesicatiria :- Constant urging to urinate, passing but a few drops at a time, which is mixed with blood. Intolerable urging before, during & after urination. Violent paroxysms of cutting & burning in the whole renal region. Violent tenesmus & strangury. Urine scalds & is passed drop by drop. Membranous scales looking like bran in water. Urine jelly-like, shreddy.

Sarsaparilla Officinalis :- Urine scanty, slimy, flaky, sandy, bloody. Gravel. Renal colic. Severe pain at the conclusion of urination. Urine dribbles while sitting. The bladder is distended and tender. The child screams before and while passing urine. Sand on diaper. Renal colic and dysuria in infants. Pain from right kidney downward. Tenesmus of bladder; urine passes in a thin, feeble stream. Pain at meatus.

Solidago :- “A very old and good kidney medicine”. Pains in kidneys.─ Region of kidneys painful on pressure.─ Pains in kidneys which extend forward to abdomen and bladder.─ Dysuria; scanty and difficult. Urine: dark, red-brown, with thick sediment; dark with sediment of phosphates; slightly sour, neutral, or alkaline; with numerous epithelial cells or small mucous particles; epithelial cells with gravel of triple phosphates or phosphate of lime.— Bright’s disease.— Clear, stinking urine.

Thalapsi Bursa Pastoris :- Hematuria ─ Urine burning, passing frequently, of strong odour.─ Copious discharge of urinary sand, increased flow of urine, relief of dropsy.─ Renal calculus.─ Increased quantity of urine with brick dust sediment.─ Strangury after accouchement; dribbling of urine.─ Dysuria of old persons; with dribbling.

Asparagus Officinalis :- Urine straw colour, scanty, soon becomes turbid, with little white specks; afterwards (about four hours), a white flaky sediment; the urine deposits a fatty sediment on the sides of the vessel; urine brown, without sediment; clear, and of a fetid smell; a peculiar smell from the urine.─ Urgent inclination to urinate; frequent and scanty emission of urine, preceded by a sensation as if a foreign body were introducing itself into the urethra, and followed by a burning sensation; diminished secretion of urine augmentation, in the last stage of experimenting; burning in the urethra fine stitches in the orifice of the urethra; sometimes incisive pains, sometimes with dragging in the groins, colic, diarrhœa, and pain in the anus, sometimes with a sensation as though there were more urine to pass.─ Urine loaded with phosphates and the urate of ammonia (in renal dropsy).─Gravel passes in small quantities with the urine.

Epigea Repens :- Chronic cystitis, with dysuria; tenesmus after micturition; muco-pus and uric-acid deposit, gravel, renal calculi. Fine sand in urine of a brown colour. Burning in the neck of the bladder whilst urinating and tenesmus afterward. Pyelitis, incontinence of urine. Croaking noise and rumbling in bowels.

Equisetum Hyemale :-  Deep pain in region of right kidney, extending to lower abdomen, with urgent desire to micturate. The right lumbar region is painful. Frequent urging with severe pain at the close of urination. Urine flows only drop by drop. Sharp, burning, cutting pain in urethra while urinating.

Ocimum Canum :- High acidity, formation of spike crystals of uric acid. Turbid, thick, purulent, bloody; brick-dust red or yellow sediment. The odour of musk. Pain in ureters. Cramps in kidneys. 

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AUTHOR :– DR. NARENDRA DHAKAD, MD Scholar, dept. of homoeopathic repertory and case taking, Govt. homoeopathic medical college and hospital Bhopal

CO-AUTHOR :–  Prof. Dr. GYANESH SHAKYA ( Associate professor), department of forensic medicine and toxicology, Govt. homoeopathic medical college and hospital Bhopal