Toxicological Materia Medica

What is toxicological MM? What is the co-relation of toxicology with MM? What are its disadvantages? advantages and

How does it help in understanding of MM?

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Sources of Materia Medica

Physiological: Relating the chief areas of drugeffects of many inorganic substances, (like the Natrums, Kalis and Calcareas) to the role played by their constituents in human physiology. Pharmacological: Comprehend readily some of the Locations and types of changes induced by a drug like Nux vomica or Belladonna. www.similima.com

Sources of Materia Medica

Chemical: Group-characteristics can often be related to the common cation or to a dominant Anion, e.g. a Halogen.

At times, a salt can be readily understood in terms of its constituent elements, like Ferrum phosphoricum.

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Sources of Materia Medica

Analogy (doctrine of signature): Relating some of the drug-effects to the characteristic of the substance or source or to its natural habitat. Examples - Snake venoms, Spider venoms, Sepia etc. Symbolism: Symbolism Linking the concepts of universal and human symbolism to materia medica by Jung, Whitmont etc.
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Sources of Materia Medica

Grouping: Drugs could be conveniently grouped together for their similar effects or their opposite characteristics. The books on Homoeopathic Therapeutics illustrate the similar grouping; differential study of repertorial analysis is another instance of such a study. Substances from a similar source tend to have similar effects. Remedy relationship: One of the advanced methods of study of materia medica. www.similima.com 5

Sources of Materia Medica

Toxicological: Furnishes information about the Locations, Pathological changes, Scope and Sphere of application and coarse indications. Examples: Mercury, Phosphorus, Gelsemium. Render a general idea about the sphere of action which is mainly on CNS, CVS, extremities and skin. There are also subjective symptoms and change in behaviour after poisoning. The unnatural use of and ccidental overdosing produce many signs and symptoms. Hughes was an ardent follower of toxicological data.
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Toxicology
The branch of Medical science which deals with

Reference to their sources

Characters and properties The symptoms they produce The lethal dose The nature of fetal results

The remedial measures which should be employed to combat their actions or effects The method of their detection and estimation and Autopsy findings

Poison

A poison is commonly defined as a substance which, when administered, inhaled or swallowed, is capable of acting deleteriously on the body. In Law, the real difference between a medicine and a poison is in the intent with which it is given. If the substance is given with the intention to save life, it is a medicine but if it is given with the intention to cause bodily harm, it is a poison.
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Classification of poisons
According to mode of action: Corrosive Irritant Neurotic Cardiac Asphyxiants Miscellaneous
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Corrosive Poison Group

Property to corrode. Affinity towards water and tissue fluid. Produces actual ulceration and destruction of the tissue. Consists of strong acids and strong alkalis.

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The Corrosive group includes

Mineral acids: Sulphuric acid (Sul-ac), Nitric acid (Nit-ac), Hydrochloric acid(Mur-ac). Organic acids: Oxalic acid(Ox-ac), Carbolic acid or phenol (Carb-ac), Acetic acid(Acet-ac), Salicylic acid (sal-ac). Vegetable acid: Hydrochloric acid(hydr-ac). Concentrated alkalis: Caustic soda (Nat-caust), Caustic potash (Caust), carbonates of ammonium (Am-c), carbonates of sodium (nat-c), carbonates of potassium (kali-c). www.similima.com
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The Group of Irritants

While corrosives lead to destruction, irritants lead to severe irritation. Both local and remote action. Remote action may progress to systemic effects. Produce symptoms of pain in the abdomen, vomiting and purging. Post-mortem appearances: Redness or ulceration of GIT. The group consists of inorganic, organic and mechanical substances.
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Inorganic sub-group
Non-metallic poisons: Phosphorus (phos), Chlorine (Murates), Bromine (Bromium), Iodine (Iod),Boron (Bor-ac, Bor-met). Metallic poisons: Arsenic (Ars), Antimony (Antimoniums), Mercury(Merc), Lead(Plb), Copper(Cupr),Thallium(Thal), Zinc (Zinc), Barium (Barytas), Radioactive Substances (Thorium, Uranium, Radium).
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Organic sub-group

Vegetable poisons: Castor oil seeds (Ricinus communis), Croton oil (Crot-t), Abrus precatorius (Abr) Colocynth (Colo), Ergot (Ergotium), Capsicum (Caps), Marking nut(Anac), Aloes (Aloe).

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Organic sub-group
Animal poisons: Cantharides (Canth) Snakes (Ophidia) Scorpions (Scorp) Spiders (Spiders) Poisonous Insects(Insects)

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Mechanical sub-group

Chopped hair Powdered glass Dried spong Diamond dust (Diamond)

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Neurotic Poisons

Act directly on nervous system, though some have local irritant action. Act after absorption even after greatly diluted in water. All alkaloidal poisons fall into this group. Symptoms-Headache, Giddiness, Stupor, Paralysis. Drowsiness, Convulsions,

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Classification of poisons according to affinity

Spinal: Action on spinal cord. Examples: Nux-vomica (Nux-v), and its alkaloids, and Gelsemium (Gel). Peripheral: Poisons acting on peripheral nerves. Examples: Curare (Cur), Coniun (Con)

Cardiac:

Acting on heart like Digitalis(Dig), Oleander (Olnd), Aconite(Acon), Tobacco (Tab). Acting on lungs. Coal gas, Carbon monoxide, Carbon dioxide, Sewerwww.similima.com Gas.

Asphyxiants:

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Classification of poisons according to affinity

Cerebral action: Inebriant. Deliriant, Somniferous. Somniferous poisons: Opium and its alkaloids. Inebriant poisons: Alcohol, Anesthetics, Sedatives and hypnotics, Chloral hydrate (Chlorolum hydratum), Fuels: Petroleum(Petr), Kerosene (Kerosolenum), Naphtha (Napthalinum), Insecticides (organophosphorus compounds like Tik20, chloro compounds like DDT and endrin, coal-tar. Deliriant poisons: Dhatura (Stram), Belladonna (Bell), Hyoscyamus (Hyos), Cannabis(Cann-i), Cocaine (Cocainum-hydrochloricum)
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Miscellaneous
Poisons having widely different actions are put together in this group Examples Analgesics Antipyretics Antihistaminics Tranquillizers Reserpine Antidepressants Stimulants Hallucinogens such as LSD
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Toxicology & Homoeopathic MM

One of the chief sources of MM is from toxicological source either accidental or deliberate. The pathogenetic action of a remedy is evident from its action at tissue level, apart from its action on the mind.

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Copper toxicology
Copper in human body The human body contains about 0.2-0.3 gm. Unevenly distributed through the organism ( parts per million) Brain 3 Kidneys 2.98 Pancreas 3 Lungs 2.5 Heart 3 Spleen 1.78
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Nucleus 3 Liver 7.5

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Copper toxicology

Copper is richest in liver, esp. in fetal liver. In brain richest part is substantia nigra (black substance in a section of the crus cerebri), which has melanin containing new cells. Copper is necessary for the formation of blood.
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Copper
Toxicological symptoms: Serum copper-abnormally high in schizophrenia, manic depressive insanity and epilepsy. Copper workers are said to have shown special resistance in cholera epidemics, seldom succumbing to this disease.

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Copper
Toxicological symptoms: Regular consumption of small doses of copper salt over a prolonged period - copper equilibrium. Hugo Scultz describes: Psychic symptoms arise, such as melancholic depression, fright, fear of death, weakness of memory, inability to retain thoughts.
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Copper
Toxicological symptoms Other symptoms dizziness, heaviness, rush of blood to the head affection of consciousness bearing factors. The pulse - accelerated, hard, and short circulation affection. Chills run through the entire body, the warmth organization is upset. The lungs - full of blood. Pressure tension, shortness of breath is experienced.
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Copper
Toxicological symptoms Digestive system: The pharynx constricted, swallowing difficult, nausea, gastric catarrh and vomiting. Constipation followed by diarrhoea. Stools watery, brownish. The liver area painful. Urinary frequency with small voiding. Inky urine.
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Co-relation with Materia Medica

Spasmodic affections, cramps, convulsions. Tonic and clonic spasms. Jerking. Blueness. Collapse. Paralysis of isolated muscles. Fearful. Fear of company, of death. Attacks of rage; wants to bite bystanders. Mania in attacks. Ridiculous or foolish gestures. Nausea. Violent vomiting. Loss of appetite. Colic, violent and intermittent.
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Toxicological symptoms of Cu
Blue lines on the gums.

Inability to control the metabolic process= eczema. Muscular spasms and painful contractions = effects on the limb system.

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Air Pollution
A mixture of solid particles and gases in the air. Car emissions, chemicals from factories, dust, pollen and mold spores. Ozone, a gas, is a major part of air pollution in cities. When ozone forms air pollution, it's also called smog. Known or suspected to cause cancer or other serious health effects, such as reproductive effects or birth defects, or adverse environmental effects.
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Examples of toxic air pollutants

Benzene, which is found in gasoline; perchlorethlyene, which is emitted from some dry cleaning factories, methylene chloride, which is used as a solvent and paint stripper by a number of industries. Also dioxin, asbestos, toluene, and metals such as cadmium, mercury, chromium and lead compounds.
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Repertorial study
Air pollution ailments from: Ars, Berrylium, Carbo-veg, Sulphuric acid.

Silicea,

Carbon gas poisoning: Acon, Am-c, Bell, Bry, Carb-v, Lach, Opium, Phos.

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Comparison of semicarpus poison and anacardium remedy.

Semicarpus poison Local split over skin, bruised, painful lesion. Marginal blisters Itching. Ulceration Anacardium Skin-Intense, itching eczema with mental irritability. Vesicular eruptions. Urticaria. Lichen planus. Neurotic eczema. Ulcer formation on forearm. Weak digestion, eructation, nausea.

GIT Mouth, burning. Pain in throat and abdomen. Blister formation in throat.
Respiratory system

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Oppression of chest with internal heat.

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Comparison of semicarpus poison and anacardium remedy.

Semicarpus poison
Cardiovascular system: Rapid pulse CNS: Loss of reflexes. Delirium, coma, death.

Anacardium
Heart: Palpitation with weak memory. Stitches in heart region. Brain fag. Impaired memory, neuralgia in thumb. Paralytic weakness. Knees feel paralyzed, bandaged.

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Arsenic poisoning
Acute poisoning: Nausea, burning in stomach, < pressure. Then severe, continuous and persistent retching and vomiting,. Vomiting first of stomach contents, then blackish or greenish and finally of mucus mixed with altered blood in varying quantity. Diarrhoea accompanied by tenesmus. The stool is tinged with blood, watery like the rice water stool of cholera, and shreds of mucus membrane and fragments of the poison even in three or four hours. www.similima.com 35

Arsenic poisoning
Acute poisoning Intense thirst-a constant feature but drinking water accentuates the vomiting. Painful cramps in the legs, urine suppressed, collapse with cold clammy skin, pale anxious face, sunken eyes, dilated pupils, rapid feeble pulse and sighing respiration. Sometimes symptoms of acerebro-spinal type with features of narcotic poisoning, such as vertigo, headache, spasms, followed by stupor and profound depression of circulation.
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Arsenic poisoning
Chronic poisoning:

stage of nutritional & gastro-intestinal

disturbances - Gradual loss of weight, with physical and mental fatigue, loss of appetite, nausea and intermittent attacks of vomiting and diarrhoea. Second stage of catarrhal changes - Common www.similima.com cold with running of the nose and sense of

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Arsenic poisoning
Third stage of skin rashes: Irritation of the skin, with vesicular eruption. Fourth stage of long exposure:Patchy exposure: brown pigmentation of skin called rain drop type pigmentation. Hyperkeratosis of palms and soles follow. There may be falling out of hair and brittleness of nails. Other symptoms: Headache, drowsiness and impairment of vision and mental activity.
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Arsenic poison Dehydration due to diarrhoea and vomiting. Irritant properties of poison burning pain mouth. Abdomen tenderness. Throat difficulty deglutition

Arsenicum album Debility, exhaustion, restlessness. Irritable weakness. Cholera. Prostration. Burning everywhere. One of the trio of burning Nash. Throat swollen, odematous, constricted, burning. Unable to swallow. Heart Palpitation. Pain dyspnoea, faintness, pulsemore rapid in morning.

CVS Depression of myocardium. Abnormal Twave.

Ulceration

Local action irritation of mucus membrane.

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Mercury
The taste - metallic, with constriction in throat, burning from mouth to stomach and pain radiating to abdomen. The mouth, tongue and fauces corroded. Mucous membranes - grayish white. Nausea with frequent vomiting of long stringy masses of white mucus, mixed with blood, followed by profuse urging, often bloody with painful tenesmus. Collapse: with cold clammy skin, pale, anxious face, sunken eyes, dilated pupils, rapid feeble pulse and sighing respiration. www.similima.com 40 Acute Poisoning

Mercury
Acute Poisoning Syncope, convulsion and general insensibility precede death which may take place in a few hours. If death is not rapid, salivation may develop. The gums swollen and inflamed and breath foul. Loosening of teeth. Renal lesion- nephrotoxicity of mercury. Urine contains albumin and blood. The output diminishes or stops and death ensues from uremia.
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Mercury
Post- mortem appearance Tongue white and sodden Mouth diffuse grayish white escharotics appearance (eschar means hard crust over a raw surface) Oesophagus- MM corroded and corrugated Stomach MM corroded, inflamed in patches and covered with grayish deposit of mercury. Areas of extravasated blood beneath it.

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Mercury
Post- mortem appearance Small intestine- congestion Caecum and large intestine intense inflammation, ulceration and even gangrene. Kidneys toxic nephritis. Liver and heart- fatty degeneration of heart and subendocardial hemorrhages also.

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Mercury
Chronic poisoning: Excessive salivation with metallic test in mouth, loosing of teeth with painful inflamed gums, and occasionally a blue-black line on gums. Irritation of skin; penetrating ulcers on or near finger nails and knuckles. Nephritic, renal insufficiency uremia. Abortion is common. Discoloration of the capsule of the lens of the eye.
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Mercury
Action on CNS and Mind: Action on tremors and mental symptoms known as erethism. Tremor is known as the HATTERS SHAKE because it is common in workers of that industry. It affects the hands, arms, tongue and later the legs. Exaggerated by voluntary efforts such as writing, speaking or eating and is absent during sleep. The tremor can be detected early in the writing of the patient and then from his stammering speech.
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Mercury
Action on CNS and Mind: Erethism is a peculiar disturbance of the personality characterized by shyness, irritability, tremors, loss of memory and insomnia. Hallucinations and delusions occasionally supervene and may lead to mental changes or insanity.

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Correlation with Materia Medica

Mercurius from Herings Guiding Symptoms Mind: Memory weak, forgets everything. Intellect very weak; shows every mark of imbecility. Imbecility; foolish, mischievous, disgusting actions. Delirium and mental derangement of drunkards. Almost uncontrollable desire to travel far away. Desire to flee, with nightly anxiety and apprehension. Desire to kill the person contradicting her. Continuous moaning and groaning. www.similima.com 47 Hurried and rapid talking.

Correlation with Materia Medica

Mercurius from Herings Guiding Symptoms of our MM Mind: Great desire to murder or commit suicide, particularly during menstrual period; despondency; involuntary crying; great indifference; is fearful that she may commit some wrong and kill herself; something urges her to kill her husband, of whom she is very fond, and she implores him to hide his razor. Excited, lively; everything is done hastily. Morose and mistrustful; treated his associates almost insultingly, looked upon every one as his worst enemy. www.similima.com 48

Correlation with Materia Medica

Mercurius from Herings Guiding Symptoms Mind: Great restlessness; must constantly change her place; fear, with desire to escape, as if she had committed some crime. Hysteria. A universal uneasiness of body, so that he could not remain one moment in the same posture. Bad effects from fright, leaving one in a state of great anxiety, agg. at night. Ailments from mortification; from insults; from egotism. www.similima.com 49

Correlation with Materia Medica

Mercurius from Herings Guiding Symptoms Physical FacePale, anxious face, sunken eyes. Pupils dilated. Tongue- Metallic test in mouth. White, sodden. Throat- Burning pain throat, radiating to stomach.

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Correlation with Materia Medica

Mercurius from Herings Guiding Symptoms Physical Mouth- Mucus membrane, mouth, tongue become corroded. Grayish, salivation increased. Escharotic appearance. StomachNausea with frequent vomiting. Vomitus: slimy, white, mucus , bilious Mucus membrane corroded Intestines feel bruised Teeth looseness of teethes especially molars with painful inflamed gums.
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Correlation with Materia Medica

Mercurius from Herings Guiding Symptoms Physical Skin Irritation, itching here and there. Ulceration in fingers, nails and knuckles. Kidney Nephritis, renal insufficiency may progress to uremia. Pregnancy abortion are common. Eyes (mercuria lentis)bluish discoloration of lens (seen through slit lamp). Metals Erethism
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Phosphorus poison
Taste Burning

Phosphorus
Mouth Burning. One of the remedies of burning trio. Offensive foul smelling sinuses Destructive metabolism.

Smell Garlicky Local destruction of tissue in contact. Cirrhosis of liver. Jaundice.

Atrophy of liver. Sub-acute hepatitis. Fatty degeneration of liver. Jaundice. Blood extravasation.

Bleeding under serous membrane.

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Phosphorus poison Delirium, convulsion. Phossy jaw. Sequestration of gums. Local destruction of tissue in contact.

Phosphorus Neuritism, paralytic symptoms. Osteomyelitis. Bone fragility. Wound bleed very easily. Heal and break out. Ulcer outside large wound. Perpura haemorrgica???

Pain- burning burning.

severe

contact One of trio of burning. Burning back feet and chest.

Diarrhoea stool bloody. Stool blood from rectum, Urine blood, albumin, bile salts, bleeding haemorrhage. sugar. Urine - haematuria, turbid, brown with red sediment.
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Case 1

Name - Mr. MAK Age 23 years Sex- Male C/o Fever since Last 3 days. H/o- Patient had history of eating fish before 3 days. Then he developed fever, suddenly, with profuse sweating, without any relief. Fever used to < at night. Many remedies were tried on symptoms indications without benefit.
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Case 1

Vital data: Temperature-1020 F Pulse rate-120/min Modalities- Chilliness < night Offensive odour from the mouth

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Case 1
Rubrics Fever with Chills Fish aggravation Sweating profuse with no relief Fever aggravation at night Filter Ars 9/4, Sep 9/4, Pul 8/4, Kali-c 6/5, Carb-v 5/4, Thuj 4/4, Merc 9/3, Sulph 8/3 Cham 7/3, Bell 6/3 Treatment Merc sol 1M, 4 hourly
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Co-relation of toxicity of Hg

In the general population, the main source of mercury poisoning is the ingestion of mercury- contaminated food, usually fish. Acute mercury exposure can cause headaches, salivation, a metallic taste in the mouth, chills, cough, fever tremors, abdominal cramps, diarrhea, nausea, vomiting, chest tightness, difficulty breathing, fatigue and/or lung irritation.
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Case 2
Name-Master T. P. D. Age- 5 years. Epileptic attacks since a year. A known case of mental retardation. Epileptic attacks, every month. Attacks of tonic and clonic type, < Morning 3, < 5 am to 6am3. Concomitants- Restlessness. Thermal State- Ambithermal Desires- Salt 4, Pungent 3. Stools-Involuntary. Cant understand the urge of stool.
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Case 2
Mind Obstinate. Cries very loudly when the things are not given to him. Never sits quietly, very restless. Destructive by nature. He throws the things. He tears the clothes and papers. He likes to make noises. Likes to listen to the songs and likes to dance when the music begins. Mischievous by nature. First he comes very quietly, and then he bites and goes away.

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Case 2
Mind He is also very angry by nature. When angry, he strikes his head on wall. Shouts and screams. He bites others and cries loudly. He desires to travel by vehicle only and vehicle must be speedy. He cant understand the boards and words on the roads. He is in his absorbed state of mind. He cant do daily activities of his own.

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Case 2
Rubrics Epilepsy Morning aggravation Restlessness Desire for Salt Desire Pungent Temper tantrum Desire for travelling Desire for biting the cloths
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Case 2
Rubrics Convulsions, children in Desire salt, pungent Temper tantrum Bite, desire to Desire to dance Desire to travel fast Filter Calc-11/5, Calc-p 11/5, Sulph11/5, Tub11/5, Phos10/5, Carc 9/5, Nit-ac 9/5, Verata 9/5, Nat-m 11/4, Chin9/4, Tarent-h-5/3 www.similima.com

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Case 2

Final Remedy: 19-6-06 - Tarentula-hispanica 1M a single dose Follow-up has been continued since then and no episode of convulsions has occurred. Patient has improved mentally too.

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Case 2
Relevant information The implication of neuroligins in cognitive disorders such as autism and mental retardation.

Neuroligins (NL1NL4) are postsynaptic proteins containing an extracellular cholinesterase domain. They participate in intercellular junctions in which neurexins tightly bind to a second class of neuronal cell-surface receptors called neuroligins.

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Case 2
Relevant information -Latrotoxin, a potent neurotoxin from black widow spider venom, triggers synaptic vesicle exocytosis from presynaptic nerve terminals. Neurexin I is a major Latrotoxin receptor that cooperates in Latrotoxin action. Latrotoxin is a potent neurotoxin from black widow spider venom that binds to presynaptic receptors and causes massive neurotransmitter release.
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Case 2
Relevant information The European wolf spider, Lycosa tarentula, said to have caused the historical phenomenon of 'tarantism', is the official medicinal source of the homeopathic remedy Tarentula hispanica. Yet, scientific evidence links the spider's venomous effects with mild necrotic and minor systemic effects that contrast with the proving symptoms of Tarentula hispanica which show a cerebral and neural component.
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Toxicological MM

Spider poisoning:

The venom is secreted from glands

present in chelicerae or fangs of spiders. venoms are different species. different in

These The

higher potencies of spider remedies are prepared not from spider poisons but from living spiders put in alcohol.
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Toxicological MM

Spider poisoning: Symptoms recorded during the proving are collected after actual experimentation on human beings under certain controlled conditions. Remedies belonging to different species of spiders have a closely related symptom picture.

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Toxicological MM
Spider poisoning: Dr.Boger (1926) described 15 cases of Arachinidism treated at Los Angeles general hospital. Important symptoms In 50 % of cases, the reaction at the sight of inoculation- a red spot, fluid filled vesicle and swelling. Severe pain and burning sensation. Intense pain in extremities, lumbar region and severe backache.
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Toxicological MM
Spider poisoning: In 70 % of cases, increased arterial pressure. Cutaneous and mucosal finding-roseolous vesicular papule, pustular rashes on chest, abdomen and neck, with intense itching. GIT findings- acute abdominal pain with rigidity. Urinary findings- moderate albuminuria and hematuria.

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Spider poisoning
Spider poisoning: CNS findings: Frequent psycho-motor excitation, occasional delirium, rarely meningeal symptoms with contraction of extremities, paralysis of facial nerve and widening of pupils. Blood findings: Moderate leukocytosis with raised ESR, increased neutrophil count. Involuntary jerking < any exertion e.g. writing, speaking or eating and >sleep. Sleep insomnia; sleepless at night. www.similima.com

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Case 3

Name Master G.M.T. Age -2 yrs Complaints- Muscular dystrophy ( Duchene amyotrophia) Muscular weakness , unsteady gait. Skin: Atopic dermatitis since 1 yrs Dryness. Redness of skin; crust formation. Terrible itching. < touching. < fish3 Concomitants Irritability, restlessness.
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Case 3
Perspiration- On scalp- Profuse Thermal state- Hot patient C2H3 Stool- Dry hard like balls. Straining3 Pyelonephritis at the age of 6 months Enteritis- at the age of 10 months Tonsillitis at the age of 1 year. Family HistoryMGF- Dermatitis, Asthma, Heart attack. PGF- Rheumatism, Cancer, Down Syndrome. Father- Chronic rhinitis. Myocarditis. Cousin Epilepsy.
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Case 3
Details of the case He likes to play but plays alone. He cant speak a simple sentence. Speech delayed. While playing, he speaks in his own language, esp. when he is in good mood. Sometimes likes dancing but doesnt like high volume. He is not quarrelsome at all. He is soft, calm and yielding. He is not obstinate and most of time, he obeys what has been told to him. He is happy with us (parents say). He likes company. He has fears of loud noise and thunderstorm.
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Case 3
Details of the case When anybody meats him for the 1st time, he tries to hide himself, but then he is comfortable. When mother is crying he tries to console her. He has interest in technical things. He has no interest in household routine items. He wants everything standard. He is fond of car and loves to go by car. He loves new toys. He feels no interest in usual plays. He gets tired suddenly. Wants everything new and standard
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Case 3
Rubrics YIELDING Fish < Itching < Warmth in general Appetite, increased Atrophy Thirstlessness

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Case 3
Result Puls11/5 Lyco 8/4 Phos 7/4 Ars 6/4 Ign 5/4 Staph 6/3 China 5/5 Sep 5/3 Arg-n 4/3 Kali-c4/3 Led4/3 Nat-m4/3 Nux-v4/3 Carc 3/3 Plb-5/2

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Case 3

Final remedy 13/8/07- 1st prescription - Plumbum-met 0/1 7/9/07- The skin is clear than before. Physically become more active. - Plumbum-met 0/1 daily one dose 8/1/08 - Active but irritable too. Skin is again with new set of eruptions. - Plumbum-met 0/2 daily one dose

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Case 3
Discussion The spinal muscular atrophies are a group of genetically determined disorders characterized by degeneration of the anterior horn cells of the spinal cord, that usually manifest as proximal muscle weakness and wasting. Predominantly distal involvement in patients without demonstrable neuropathy is, however, uncommon. Since the first report of distal spinal muscular atrophy localised to upper extremity by Hirayama, et al. in 1959, many patients have been reported in the literature mainly from Asia, 80 with more than 300 www.similima.com from Japan.

Case 3
Discussion Although there have been quite a few reports from India describing adolescent and adults with this condition, we herein describe what is to our knowledge the youngest case reported with this condition. Associated high serum lead level was an interesting and unique feature.

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Case 4
Miss. S. T. Age 21 years Complaints-constant urge for urination, since puberty. She is a known case of mental retardation. Urging every 15 to 20 minutes, both day and night cant control bedwetting. Offensive urine. Concomitants: restless, irritability, weakness. Eructations, < after overeating Desire- highly seasoned4, pungent4, Hot milk4, ice creams4 Past history: - asthma, vaccinations - all given Family history- PGF www.similima.com diabetes mellitus82 and PGM-

Case 4

Mind She likes to put every thing in her mouth. Throughout the day she would bite garments and she becomes irritable when not allowed to pick up garments. She doesnt obey anyones order. Behaves obstinately if anyone disturbs her and she becomes violent. Talks arrogantly if someone scolds her if she is biting the garments. Weeps easily, and < by contradiction. She is domineering too.
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Case 4

Rubrics DISOBEDIENCE Anger Domineering Contradiction < Obstinate Irritable Bites Cloths and garments
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Case 4

Result Lyco 15/6 Nux-v 15/6 Cham 13/6 Merc 12/6 Chin 11/6 Phos 9/6 Am-c 7/6
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ARN 7/6 Anac 13/6 Staph 12/5 Aur 11/5 Chin 11/5 Plb3/3

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Case 4
Treatment Plumbum met 1M single dose 14/11/07 21/11/07:- c/o biting the clothes and garments reduced up to 90%. Bed-wetting frequency reduced, not daily now. However, it has not stopped completely. Obstinacy slightly less. Listens to others. Does some household work. Follow-up still continued.
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Case-5

Mr.BGK. Age 53. A known case of HTN since 9 years. Cramping and throbbing pain in lower extremities since 9 months, more on left side. It evolved from left right. < standing, raising the leg, hanging, warm application, day. > pressure+, night.

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Case-5

Ulcer Size-2/2 cm, pain-aching type, round and flat. Modalities:A/f Mosquito bite, < cold application, warm application, Day time, afternoon 2pm.

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Case-5
Mind Desire to be active always. Investigations Atheromatous abdominal s:aorta with significant narrowing at bifurcation. Almost no flow seen in infrarenal portion of aorta. Collateral flow noted in lower limb arteries. Addictions: Tobacco smoking since age of 8 years.

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Case-5

Past history Operated for cataract, first left and then right. Personal History Appearance- Short statured. Perspiration - Odour ++ Thermal - Ambithermal Hot.
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Case-5
Rubrics Ulcer on leg Atherosclerosis Desire Pungent Desire Tobacco Smoking Tobacco Abuse Activity desire Indifference
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Case-5
Rubrics Aversion to Cabbage Sides Left then Right Ulcer pain Heat aggravation Aggravation Daytime in general Leg pain aggravation by warm Leg pain aggravated by pressure Amelioration Night in general
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Case-5
Result Ars 23/13 Puls 18/10 Sep19/9 Lach 17/9 Calc 16/9 Chin 16/9 Lyco 15/8 Nux-v 14/8 Phos 13/8 Sul 18/7 Nit-ac 13/7

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Repertory Rubrics for Toxicology

Aluminium poisoning alum, bry , plb. cadm-m, cadm-s, camph, cham, ip, puls. Antibiotics ars, carb-veg, chin, lyc, nat-p, thuj. Arsenic poisoning HEP ars-alb ,carb-v, ferr, ip, merc, phos, verat. camph, chin, chin-s, dig, euph, graph, iod, lach, nux-m, nux-v, plb, samb, sulph, tab, thuj. www.similima.com

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Repertory Rubrics for Toxicology

Chemotherapy treatment CADM-S. ip. ars, carb-veg, chin, nux-v. Coal gas ailments from carb-s ,o p. acet-ac, am-c, arn, bell, bor, bov, carb-v, coff, ip ,lach, phos, sec.
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Repertory Rubrics for Toxicology

Copper fumes agg ip , merc, puls. camph, lyc, nux-v, op. Copper vessel agg Hep. Digitalis abuse adon, apoc, chin, crat, dig, nit-ac. Iodine poisoning or abuse ars, conv, hep, iod ,op, phos, sec. ant-c, ant-t , bell, camph, chin, chin-s, coff, hydr, lycps, merc, spong, sulph.
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Repertory Rubrics for Toxicology

Iron poisoning or abuse chin, ferr, ferr-ph, hep, puls, sulph, zinc. ars, calc-ph, iod, ip, merc, nat-m, thea, verat. Lead poisoning ALUM, CAUST, PLB, TUB. alumn , bell, colo, kali-i, nat-s, plat, sul-ac, sulph, ter, verat. alum-sil, ant-c, ars, carb-s, chin, cocc, crot-t, cupr, gels, hep, iod, kali-br, kreos, lyc, mang, merc, nux-v, op, petr, uran, zinc
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Repertory Rubrics for Toxicology

Chronic effect ALUM, CAUST, PLB. alumn, bella, colo, kali-i , nat-s, op, plat, sul-ac, sulph. alum-sil, ant-c, ars, carb-s, chin, cocc, crot-t, cupr, gels, hep, iod, kali-br, kreos, lyc, mang, merc, nux-v, petr, zinc. Paralysis from alumn, ars , op, plat ,plb ,sul-ac. alum, caust, cupr, kali-i, nux-v, pipe. www.similima.com 98

Repertory Rubrics for Toxicology

Mercury poisoning or abuse AUR, CARB-V, HEP, KALI-I, LACH, MERC, NAT-S, NIT-AC, PHYTO, STAPH, SULPH arg-met, asaf, bell, bor, calc, chel, chin, clem, colch, cupr, euph, guai, hydr, iod ,kali-chl, led, lyc, mur-ac ,ph-ac ,puls, sars ,sil.

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Repertory Rubrics for Toxicology

Mercury poisoning or abuse acon, agn, alumn, anan, ang, arn, ars, aur, aur-sul, calad, calo, camph, carbo-an, caust, cic, cina, cocc, coff, con, dig, dulc, euph, ferr, fl-ac, graph, iris, Kali-bi, laur, lycps, merc-i-r, nux-v, op, plat, plat-m, rheum, rhod, rhus-g, rhus-tox, sabad, sel ,sep, spong, still, stram, stront-c, sul-i, valer, verat, viol-t, zinc Mushrooms poisoning from Absin ,ars, bella, astro, camph Agar, pyro.
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Repertory Rubrics for Toxicology

Narcotics abuse AVEN, BELLA, CHAM, COFF, LACH, NUX-V. Camph , dig, graph, iod ,ip, lyc, op, puls, sep, valer. acet-ac, agar, am-c, apom, ars, aur, bry, calc, cann-i, canth, carb-v, caust, chin, cic, cimic, colch, croc, cupr, dulc, euph, hep, ign, kali-per, lob, macro, mag-s, merc, mosch, mur-ac, nat-c, nat-m, nat-ph, nit-ac, nux-m, ox-ac, ozon, passi, ph-ac, phos, plat, plb, rhus-tox, seneg, staph, sulph, thuja, verat, zinc.
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Repertory Rubrics for Toxicology

Ptomain poisoning ailments from ars, cupr-ar ,pyro, verat. absin, acet-ac, all-c, camph, carbo-an, carb-v, crot-h, gunp, kreos, lach, puls, urt-u. Purgatives abuse NUX-V. lyc. aloe, chin, hydr, op, sulph.
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Repertory Rubrics for Toxicology

Radiation sickness for side effects CAD-S, SOL. ip. ars, calc-f, chin, fl-ac, nux-v, phos, rad-br, x-ray. Silica poisoning silicosis CALC, FL-AC, SIL. lyc, puls. agar-t , ars, brom, camph, hep, ictod, ip, mag-m, merc, nat-c, nat-a, nit-ac, penic, ph-ac, sulph.
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Repertory Rubrics for Toxicology

Tea abuse chin, dios. abis-n, ferr, puls, thuj. Tobacco ailments from CALAD,NUX-V. ars, ip, lach, lyc, nicot, phos, plan, thuj. abis-n, arg-n, chin-ar, coca, con, lob, scut, sep, spig, staph, stroph, verat.
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