A CLINICAL STUDY OF BRONCHIAL ASTHMAIN CHILDREN AND ITS HOMOEOPATHICTHERAPEUTIC STRATEGIES

A CLINICAL STUDY OF BRONCHIAL ASTHMA IN CHILDREN AND ITS HOMOEOPATHIC THERAPEUTIC STRATEGIES by DR BINYMOL ANEY KURIAN Dissertation Submitted to Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore In partial fulfillment of the requirements for the degree of Doctor of Medicine in Homoeopathic Pediatrics Under the Guidance of DR SHASHI KANT TIWARI Department of Homoeopathic Pediatrics Father Muller Homoeopathic Medical College Deralakatte , Mangalore 2010 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE DECLARATION BY THE CANDIDATE I hereby declare that this dissertation entitled “A CLINICAL STUDY OF BRONCHIAL ASTHMA IN CHILDREN AND ITS HOMOEOPATHIC THERAPEUTIC STRATEGIES” is a bonafide and genuine research work carried out by me under the guidance of DR SHASHI KANT TIWARI Professor, during the year 2007–2010, in partial fulfillment of requirement for the award of DOCTOR OF MEDICINE (HOMOEOPATHIC PEDIATRICS) I have not previously submitted this work (partial or full) to any other university for the award of any other Degree or Diploma Date: Place: Mangalore DR BINYMOL ANEY KURIAN CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled “A CLINICAL STUDY OF BRONCHIAL ASTHMA IN CHILDREN AND ITS HOMOEOPATHIC THERAPEUTIC STRATEGIES” is a bonafide research work done by DR BINYMOL ANEY KURIAN under my guidance and supervision during the year 2007 – 2010, in partial fulfillment of the requirement for the award of the degree of “ DOCTOR OF MEDICINE” (HOMOEOPATHIC PEDIATRICS ) I have satisfied myself regarding the authenticity of her observations noted in this dissertation and it conforms to the standards of Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore It has not been submitted (partial or full) for the award of any other Degree or Diploma Date: Guide Place: Mangalore DR SHASHI KANT TIWARI D.M S , Dip (N I.H ) , M D (H O M ) Professor, Fr Muller Homoeopathic Medical College and Hospital, Deralakatte, Mangalore ENDORSEMENT BY THE HOD, PRINCIPAL/ HEAD OF THE INSTITUTION This is to certify that the dissertation entitled “A CLINICAL STUDY OF BRONCHIAL ASTHMA IN CHILDREN AND ITS HOMOEOPATHIC THERAPEUTIC STRATEGIES” is a bonafide research work carried out by DR BINYMOL ANEY KURIAN under the guidance and supervision of DR SHASHI KANT TIWARI during the year 2007 – 2010, in partial fulfillment of the requirement for the award of the degree of “DOCTOR OF MEDICINE” (HOMOEOPATHIC PEDIATRICS) We have satisfied regarding the authenticity of her observations noted in this dissertation and it conforms the standards of Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore It has not been submitted (partial or full) for the award of any other Degree or Diploma Head of the Department Principal DR JYOSHNA S DR SRINATH RAO B.H.M.S M.D (HOM) B.H.M.S M.D (HOM) Professor, Professor and H.O.D Dept of Homoeopathic Pediatrics Department of Materia Medica Fr Muller Homoeopathic Medical Fr Muller Homoeopathic College, Deralakatte, Medical College, Mangalore Deralakatte, Mangalore Place: Mangalore Place: Mangalore Date: Date: COPYRIGHT Declaration by the Candidate I hereby declare that the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore shall have the rights to preserve, use and disseminate this dissertation / thesis in print or electronic format for academic / research purpose Date: Place: Mangalore DR BINYMOL ANEY KURIAN © Rajiv Gandhi University of Health Sciences, Karnataka ACKNOWLEDGEMENT “My help comes from the LORD, who made heaven and earth” Psalm 121:2 I consider this as my privilege to thank the Almighty God, for helping me to achieve this humble task through the following persons who have been of immense help and a source of encouragement in my endeavor I would like to express my sincere and heartfelt thanks to my respected teacher and guide, Dr Shashi Kant Tiwari , D.M.S., Dip N.I.H., M.D(Hom), for providing me expert guidance, constructive criticism, timely support and encouragement throughout my post graduation course and during this dissertation work It is my good fortune to be his student and to this work under his guidance It is my privilege to express sincere gratitude to Rev Fr Baptist Menezes, Former Director, FMCI, Rev Fr Patrick Rodrigues, Director, FMCI, Rev Fr Stany Tauro, Former Administrator, FMHMC&H and Rev Fr Wilfred Prakash D’souza, Administrator of FMHMC, Deralakatte, Mangalore for providing me an opportunity and adequate facilities to carry out this work to my satisfaction in this reputed institution I would like to express my gratitude to Dr Srinath Rao , Principal, Head of the Department of Homoeopathic Materia Medica for the support during the study I express my sincere thanks to Dr Shivaprasad, Vice-Principal, Head of the Department of Organon of Medicine and Homoeopathic Philosophy, and P.G Coordinator, for his support and guidance My sincere thanks to, Dr Sunny Mathew, Medical Superintendent for his help and support especially at the OPD set up and dispensing section It is my esteemed privilege to express my gratitude to Dr Jyoshna Shivaprasad, Professor, and Head of the Dept Pediatric for the care and concern, valuable suggestions, timely support & encouragement throughout my post graduation course and during this dissertation work I am grateful to Dr M.K Kamath, Dr.N.C Dhole , Dr Praveen, Dr Guruprasad, Dr Pravas Kumar Pal, Dr Roshan Pinto, Dr Girish Navada, & Dr Kurian for their timely guidance I extend my gratitude to all my friends, colleagues, seniors, and juniors whose cooperation and timely help considerably eased my task A word of gratitude to Mrs Sucharita Suresh for helping to formulate the Research Methodologies for my synopsis and helping to carry out the statistical work of my thesis I would like to convey my thanks to the help, kindness and cooperation that I have received from the staff of various departments of FMHMC & also to the Pediatric Department of FMMC I thank all members of Non-teaching staff of FMHMC for their help during the study I am most grateful to my own community MEDICAL SISTERS OF ST JOSEPH has been a great source of encouragement through out these years I thank my present & former Superior Generals, Provincial Superiors & all my loving sisters who nurtured, loved and faithfully supported me over the years I would have never accomplished my goal without the support, encouragement and prayers of my parents, brothers & sisters Last but not the least; I owe my deep indebtedness, to all the lovely children, involved in this study for their co operation, and to their parents who showed their confidence in Homoeopathic treatment and also to Microbits, Kankanady for making pains to complete this work in time Dr Binymol Aney Kurian (SR Vidya M.S.J.) “Honor physicians for their services, for the LORD created them; for their gift of healing comes from the most high, and they are rewarded by the king The skill of physicians makes them distinguished, and in the presence of the great they are admired.” (Sirach 38/1-3) LIST OF ABBREVIATIONS USED A : Absent : Absent App : Appetite Av : Aversion < : Aggravation > : Amelioration A/F : Ailments from A Rx : After treatment ABG : Arterial Blood Gas B : Brother BA : Bronchial asthma BBCR : Boger: Boenninghausen’s Characteristic Repertory BTPB : Boenninghausen’s Therapeutic Pocket Book B Rx : Before treatment BP : Blood Pressure B&B : Bladder and Bowel CBC : Complete Blood Count Cr : Craving cm : Centimeter CVS : Cardio Vascular System CNS : Central Nervous System Compt : Complaint C.pox : Chickenpox ↓ : Decreased DM : Diabetes Mellitus DM : Dominant Miasm Dn : Duration Dispo : Disposition F : Female F : Father F : Family FM : Fundamental Miasm Name: Master.M.S Address: Konaje Reg.No: 45222 2yr M Coryza, cough and breathlessness with wheezing Sleep disturbed and wants to be carreid all the time On and off attack < night2, coldthing2, cold exposure, lying down >Allopathic treatment 1yr B - BA GM- HTN FM Sycotic DM - Tub Name: Master.S.S Address: Moodbathri Reg.No: 44923 8yr M Coryza, cough with yellowish expectoration Breathlessness with wheezing Sleep disturbed A/F icecreams and cold drinks < winter3, cold drinks, after midnight , oily things > Allopathic treatment 5yrs NS FM:Psora DM:Psora Mental General: Anger violent, falls down on the floor & hits the head Active, mingles easily Wants to be carried during the complaints Physical General: Cr- chocolate Persp- forehead C.P: Breathlessness A/F cold food and drinks < Rainy season, after eating fruits Anger with irritability during complaint Mental General: Obstinate3, Fear of darkness, ghost Dreams of black ghost Physical General: Cr- icecream3, pastry, cold drinks3, chicken, Av- Fish Persp- ↑sed App↓sed, Stool- hard C.P: Coryza, cough with yellowish expectoration Breathlessness A/F icecreams and cold drinks < winter3, cold 166 BBCR Acute : Ars Alb 30-200 Chronic: Calc phos 30 - 200 Inter: Tub Bov 200 18 Improved BBCR Acute : Rhus Tox 30 Chronic: Sulphur 200 14 Improved Name: Master.M.S Address: Ullal Reg.No: 43473 7yr M 10 Name: Master.B Address: Surathkal Reg.No: 44233 12yr M Coryza and cough with thick expectoration Breathlessness with wheezing On and off attack of fever Appetite decreased Gets attack 2-3 per year < fruits2, coldwater2, cold climate, after cold water bath < night3 > warm climate, warm water O/E Turbinates enlarged Coryza,dry cough and breathing difficulty Itching of eyes with lachrymation Sleep disturbed On and off attack < winter season3, colddrinks3, night3, oily food, dust < fan3 > morning3, inhalation, allopathic treatment O/E - turbinates enlarged B/L 3yrs GM HTN UncleDM FMSycotic DMSycotic Mental General: Obstinate3, Fear of being alone, dogs, thunderstorm Likes company Physical General: Cr- Chicken2, fruits2, sweets Persp- ↑sed forehead App-↓sed C.P: Coryza, cough with thick expectoration < fruits2, cold water2, night3 KENT Acute : Ars Alb 30-200 Chronic: Phos 200 Inter:Nat S 30 - 200 16 17 Improved 7yrs Mo : Allergic Rhinits GM: DM, HTN Pt : Pneumoni a, Typhoid FM: Tub DM: Tub Mental General: A/F Fright, jealousy Indifferent to brother, delusions of murder Physical General: Cr- Spicy2 Av - Warm food Persp - ↑sed on back occiput, & abdomen, sticky & offensive Stool - Hard once in days Chilly pt C.P: Coryza,dry cough and breathing difficulty < winter season3, cold3, night3, dust, fan3 > morning3 BBCR Acute : Ars alb 6-200 Chronic: Kali carb 30-200 Inter: Tub Bov 200 11 20 Improved 167 11 Name: Ms.S.A Address: Jeppu Reg.No: 49543 4yr F Cough dry, breathlessness with wheezing On and off attack of fever Irritable during attack A/F cold food and drinks < Rainy season, after eating fruits, perspiration > Allopathic treatment 2yrs MO - BA GM - BA FMSycotic DMSycotic 12 Name: Ms.R Address: Balmatta Reg.No: 36314 4yrs F Coryza, sneezing with congestion in the chest Difficulty in breathing Cough with scanty expectoration Wheezing On and off attack A/F dust, cold climate < change of weather, night, > warm water, nebulization, day time O/E wheeze 2yrs F - BA S - BA GM HTN FM Sycotic DM – Tubercular Mental General: Anger violent, aversion to company, weepy, capricious, likes consolation, shy Physical General: Cr- chocolate, biscuits Pers forehead Burning micturition C.P: Breathlessness A/F cold food and drinks < Rainy season, fruits Anger with irritability associated with Mental General: Activity increased Aggressive nature Fear of darkness, thunderstorm (loud noise), possessive, wants to be magnetized Physical General: Cr - Egg3, chicken Av - Sweets2 Persp - ↑sed in head & back C.P: Breathlessness < evening, Cough with yellowish expectoration warm water Allopathic treatment O/E Turbinates enlarged B/L yrs MO- BA S- BA FM- Tub DM Sycotic Mental General: Playful and intelligent Desires company < contradiction Fear of blood & cockroach Mingles easily Desire to be magnetized Physical General: Cr- Sweets3, icecream2, fruits Urine- Offensive Thermally Chilly C.P: Cough difficult expectoration A/F dust < cold food and drinks, rainy season KENT Acute : Ars Alb 200 Chronic: Phos 200 Inter: Nat S 30 20 Improved 169 15 Name: Master A Address: Kanjangad Reg.No: 46871 8yrs M Sneezing and coryza Cough with whitish expectoration and breathlessness Wheezing Redness and itching of the eyes < exposure to cold2 and dust2 < night, smoke On and off attack 3yrs MO - BA B - BA FMSycotic DMSycotic Sneezing and coryza Cough with whitish expectoration and breathlessness Redness and itching of the eyes < exposure to cold2 and dust2 < night, smoke BBCR Acute : Ars Alb 6-30 19 12 No Improvem ent 16 Name: Ms.A Address: Bikarnakatte Reg.No: 50167 10yr s F Coryza and sneezing Dry cough with breathlessness and wheezing On and off attack A/F cold2 < coldwater2, < night3, morning 5mon Pt - C.pox FM: Psora DM: Sycotic Mental General: Gets angry fast Desire for company always Physical General: App-↓esd Cr- Fish, chicken, sweet C.P: Dry cough with sneezing A/F Cold2, cold water, night3 BTPB Acute : ArsAlb Inter: Thuja 30 14 Improved 170 17 Name: Ms.D Address: Pumpwell Reg.No: 46032 14yr s F Cold and cough with scanty expectoration Breathlessness with tightness of chest < colddrinks2, lying on back, morning, laughing > bending foreward, lying on sides On and off attack ( once in 3-4 months) 10yrs MO- BA GM- BA FMSycotic DMSycotic Mental General: Sympathetic, anxious future about, sensitive, dreams of ghost Physical General: Appearence - lean Persp - on palms Cr - icecreams Av - milk C.P: Breathlessness with wheezing < cold drinks2, lying on back, laughing < lying on sides KENT Aute : Ars Alb Chronic : Phos 30 Inter: Nat s 30 -200 12 18 Improved 18 Name: Ms.V.H Address: Surathkal Reg.No: 50493 5yrs F Cough dry, breathlessness with wheezing Nose block On and off attack of fever A/F dust < cold food and drinks < cold weather, night, lying down > Allopathic treatment (Nebulization) 3yrs MO - BA S - BA FMSycotic DM: SycoticTub Mental General: Timid, irritable and reserved Fear of cockroach Likes company Physical General: App- ↓sed, Thirst - ↓sed Cr- Icecream, buttermilk Av- Spicy Talk during sleep Urine - Offensive C.P: Cough with breathless < lying down2, cold food, cold climate KENT Acute: ArsAlb 30 Chronic : Sil 200 20 Improved 171 19 Name: Master A Address: Chemmanadu Reg.No: 46697 2yrs M Cough dry, breathlessness and wheezing Rattling in the chest Recurrent attack of nose block A/F dust < lying down2, morning 1yr Aunt - BA B - BA F - HTN GF - HTN GM- DM, HTN FMSycotic DMSycotic Mental General: Gets angry fast.Irritable, obstinate Physical General: App-↓esd Persp- ↑sed Thirst for small quantities Sleep disturbed due to small sounds Lying on abdomen C.P: Breathlessness < morning Cough < lying down KENT Acute: ArsAlb 30 Chronic : Sil 200 Inter: Nat s 1M 13 Improved 20 Name: Master A.H Address: Pavoor Reg.No: 8076 8yrs M Cough with scanty yellowish expectoration, breathlessness2, nose block, sleep disturbed, Appetite ↓sed, nausea and vomiting Throat pain Recurrent attack ( once in 2months) Treatment Allopathic A/F colddrinks < night2, morning2, lying down2, cold climate > summer, allopathic treatment 3yrs MO HTN GF - DM, HTN FMSycotic DM - Tub Mental General: Frightful dreams, startled during sleep Physical General: Persp - ↑sed on exertion App - ↓sed Cr - vegetables Av - Fish Burning during micturition Thermally Hot C.P: Cough with scanty yellowish expectoration, breathlessness2, A/F colddrinks < night2, morning2, lying down2, cold climate > summer BBCR Acute: ArsAlb 30 Inter:Tub bov 200 12 18 Improved 172 21 Name: Master I.S Address: Derelakatte Reg.No: 11764 7yrs M Coryza, sneezing and cough dry Breathlessness with wheezing On and off attack Appetite decreased < fruits2, coldwater2, cold climate, after cold water bath < night3 > warm climate, warm water 4yrs NS FM- Psora DMPsora 22 Name: Master M.S Address: Ullal Reg.No: 7558 14yr s M Coryza, sneezing and nose block Cough with scanty whitish expectoration Breathlessness with wheezing On and off attack Itching and burning in the eyes Weakness < cold climate2, morning (3-4 A.M) < night2, lying down, bending foreward, dust 10yrs MO - BA F - HTN FMSycotic DMPsora Mental General: Obstinate, fear of darkness, of dogs.Irritable during complaints Physical General: Appearance - lean Persp - profuse Cr - Cold juices, sweets3, chicken C.P: Coryza, sneezing and cough dry Breathlessness with wheezing < fruits2, coldwater2, cold climate, after cold water bath < night3 > warm climate Mental General: Mild Calm Physical General: Appearence Stocky Cr - Fish Av - Vegetables Winter aggravation C.P: Breathlessness with wheezing < Early morning (3-4am), Cold climate2, dust2, bending foreward < midnight (after 12am).Cough with yellowish expectoration 173 KENT Aute: Bry 200 Chronic: Tubbov 1M 15 Improved BTPB Acute: Kali carb30 Chronic : Ars Alb 200 Inter: Sulphur 200 19 Improved 23 Name: Ms.S Address: Kulsekhar Reg.No: 8435 2yrs F Coryza, cough, breathlessness with wheezing A/F Coldair, rainy season (3 attacks a year) < midnight > daytime Treatment Allopathy (Bronchodilators) 1yr MO - BA GM - DM FMSycotic DMPsora Mental General: Mild Physical General Persp - Forehead Screams during passing stool, scanty C.P: Coryza, cough, breathlessness with wheezing A/F Coldair, rainy season < midnight (after 12am) > daytime BTPB Acute : Ant tart 200 Chronic : ArsAlb 200 14 Improved 24 Name: Master A.S Address: Ullal Reg.No: 7499 12yr s M Cough with scanty expectoration and breathlessness2, with wheezing Recurrent attack of coryza Perspiration increased Treatment Allopathic < colddrinks < night2,exertion2, change of weather, cold drinks, dust2, walking > sitting 5yrs F - BA GF HTN, BA GM - DM FMSycotic DM- Tub Mental General: Sensitive,active Fear of being alone Foregetfullness Physical General: Cr - Chicken, egg Av - Vegetables, fish Persp - ↑sed during complaint Stammering < anger C.P: Breathlessness < exertion, night < night2,exertion2, change of weather, cold drinks, dust2, > sitting KENT Acute: ArsAlb30 Chronic: Sil 200 Inter: TubBov 1M 17 Improved 174 25 Name: Ms N Address:Arek ala Reg.No: 6936 7yrs F Coryza, cough with scanty whitish expectoration.Breat hlessness with wheezing, Nose block and throat pain Sleep disturbed Recurrent Attack < night2 > Allopathic treatment O/E Wheeze expiratory 3yrs 26 Name: Master A.R Address: Kiniya Reg.No: 9462 8mo M Nose block, difficulty in breathing Dry cough with wheezing Irritable and cries during attack Sleep disturbed On and off attack (twice in a month) < night3, morning2 O/E Turbinates enlarged 4mon M - DM FMSycotic DMSycotic Mental General: Active Physical General: Cr - Egg2, icecream, milk, vegetables Av - Fish Persp - ↓sed C.P: Breathlessness & cough < night2, Yellowish expectoration Nose block < night KENT Acute : Ars Alb 30 Chronic: Phos 200 Inter : Nat sulph 200 12 18 Improved M- B.A BAllergic complaint GM- DM, HTN GF - O.A FMSycotic DM: SycoticTub Mental General: Wants to be carried always Weeps continuously Irritable and cries during attack Physical General: Stocky appearance.App ↓sed Thirst - ↓sed Av - Cow's milk Stool - Hard & offensive Catnap sleep C.P: Dry cough with nose block < night Breathlessness < night2 KENT Acute: Spongia 30 Chronic : Calc carb 200 13 Improved 175 27 Name: Ms.S.P Address: Varkkady Reg.No: 13959 (Main Case) 7yrs F Coryza,sneezing Cough with scanty whitish expectoration and wheezing.Nose block and throat pain On and off attack O/E Turbinates enlarged (right side) < dust2, cold water2, change of weather > Allopathic medicine 1yrs M - BA GM HTN FMSycotic DM SycoticTub Mental General: Obstinate & head strong Active Likes to be in company Physical General: App - Lean Cr – Chicken, Sweets, cold drinks Persp - Profuse cold in palms & upper lips C.P: Coryza with breathlessness.Dry cough with breathlessness < dust2, cold water2, night2 Throat uvula elongated KENT Acute : Ars Alb 30200 Chronic : Sil 200 12 Improved 28 Name: Ms S.S Address: Kudlamkul Reg.No: 8549 10 yrs F Dry cough, breathlessness and wheezing Allopathic medicine O/E Turbinates enlarged Wheeze expiratory On and off attack 8yrs Uncle DM, HTN FM: Sycotic DM: Sycotic -Tub KENT Chronic : Baryta carb200 12 15 Improved 29 Name: Master J 4yrs 6mo M Coryza watery and cough scanty 2mon M - BA B - BA Mental General: Reserved, timid, doesnot talk much Appearence - lean Fear of robbers Physical General: Persp - ↑sed on cervical region Cr - cucumber C.P: Dry cough with breathlessness < during skin complaints, night Skin itching < night, dust Mental General: Timid3 Shy to go KENT Acute : Ant tart 30 14 Improved 176 Address: Arekal Reg.No: 10277 30 Name: Master A.R, Address: Kapitanio Reg.No: 48423 yellowish expectoration Breathlessness and wheezing Appetite decreased Cries during attack Dull with slight rise of temperature drinking warm water O/E Turbinates enlarged Treatment Ayurvedic treatment 3yrs M Dry cough, breathlessness and wheezing Tight feeling in the chest On and off attack.Nose block , tonsils enlarged Itching in scalp A/F dust2 < cold food 3, rainy season2,nigh > Allopathic medicine O/E Wheeze On and off attack FM: Sycotic DM: Sycotic -Tub 2yrs MGF- BA Pt : Pneumoni a FM: Tub DM: SycoticTub infront of others Dull2 Physical General: Stocky appearance App - ↓sed Thirst - ↑sed, CrBiscuits2, apple2 Av - milk3 Chilly patient C.P: Breathlessness and cough with scanty thick whitish expectoration < night2, early morning3, cold3 Persp - ↑sed during attack Mental General: Irritable, social & playful, company desire for3 Delayed milestones (talking & walking) Physical General: App - Obese, Cr - cold food3 Av - milk, sweets Persp - ↑sed on scalp C.P: Breathlessness & cough with scanty expectoration < dust2,change of weather < cold food 177 Chronic : Kali carb 200 BBCR Acute : ArsAlb 200 Chronic : Calc Carb 200 1M 19 Improved 178 179 180 ... irritated but not worsen airways inflammation or hyper responsiveness.10 The hygiene hypothesis is a hypothesis about the cause of asthma and other allergic disease, and is supported by epidemiologic... the Research Methodologies for my synopsis and helping to carry out the statistical work of my thesis I would like to convey my thanks to the help, kindness and cooperation that I have received... Karnataka, Bangalore shall have the rights to preserve, use and disseminate this dissertation / thesis in print or electronic format for academic / research purpose Date: Place: Mangalore DR BINYMOL