INTERPRETATION

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• INTERPRETATION INTEGRATION OF SYMPTOMS
  ACCORDING TO HOMOEOPATHIC CONCEPTS
• Dr. Y. Dinesh Rao
  MD (Hom)
• Member Institute of Clinical Research
  Mumbai
• Reader Dept. of Gen. Medicine MLDMHI
• CMO Dr. M.L.D. Trusts Holistic Mother
  Child Hospital, Dahisar Mumbai.

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• SYMPTOMS The only perceptible form of
  Disease, Expression of
  SUSCEPTIBILITY
• SYMPTOMS Building Blocks of Totality
• Totality guides a Homoeopath to SIMILIMUM
• Aphs. 6,7,8 17,18

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• SYMPTOMS are Subjective as well as Objective
  (SIGNS)
• IMPORTANCE OF EACH SYMPTOM SIGNS
• SYMPTOMS 3 ELEMENTS
• Location
• Sensation
• Modality

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• SYMPTOMS 3 PLANES
• Mental (Emotional)
• Spiritual (Intellectual)
• Physical
• PLANES OF SYMPTOMS
• 1) Mental Symptoms Depicting the Emotional State
  (Feeling)

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2) Spiritual Depicting the Affection of
Intellect a) Aberration of
Perception b) Aberration of Thought c)
Affection of Memory d) Affection of Will
(Conative Function) (Behavior /
Action) 3) Physical Depicting the Bodily
Affections
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EVOLUTION OF SYMPTOMS I
Stage PRODROMAL II Stage Disordered
Functioning III Stage Structural
Alteration IV Stage Secondary Signs
Symptoms Secondary Neurosis (Somato-Psychic)
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INTENSITY OF SYMPTOMS 3 2 1 5
BOENNINGHAUSEN IMPORTANCE FOR FINAL EVALUATION
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• CAUSES
• Predisposing
• Precipitating
• Maintaining

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Mentals Physical Detailed Life
Space Suppression of Discharge/ Eruptions
Susceptible Constitution (Diathesis)
Miasms Aggravations Ameliorations
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• SYMPTOMS OF THE MIND
• Direct Expression
• Feelings
• Thoughts
• Perception Changes
• Memory Changes
• Inability to exercise Will
• Indecisiveness
• Inappropriate Activities
• Defective engagement Patterns
• Loss of Competence in General.

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2) Indirect Expression through i) Opposite
Feelings ii) Disturbed Functioning of the Body
through a) Voluntary Nervous System b)
Autonomic Nervous System c) Endocrine System
iii) Dreams
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• MENTAL SYMPTOMS
• 1. Emotional Modalities
• 2. Emotional State
• 3. Behavior
• 4. Symptoms of Intellect
• CLASSIFICATION OF SYMPTOMS
• Common Symptoms
• Characteristic Symptoms
• Key-notes
• Concomitants

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• Particular Symptoms
• General Symptoms
• Mentals
• Physical Generals
• Pathological Generals
• Negative Generals
• Incomplete Symptoms
• Recent Symptoms
• Old Symptoms

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• Alternating Symptoms
• Paucity of Symptoms
• Maze of Symptoms
• Eliminating Symptoms
• Accidental Symptoms
• Acute Symptomatology
• Chronic Symptomatology
• Signs

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• Importance of Classification of Symptoms
• 36 Category Chart
• Types of Totalities
• Acute
• Chronic
• Intercurrent
• Sequential
• Split
• Related Totalities
• What is a CASE? PD

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APPROACHES REPERTORIAL NON REPERTORIAL Boennin
ghausen Keynote Kent Structuralisation Boger
Mixed
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• CASE 1
• BACKGROUND
• Female, 36 yrs
• H/O PID since 8 years, operated 6 yrs back
• Patient better, but relapse of back pain since 1
  yr
• Patient on treatment since 6 mths
• Patient on Silica 30 7 P, acute Bryonia given
  - not better

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• ACUTE PRESENTATION
• Sudden onset of backache since 3 days
• Pain() started on getting up from sitting
  position
• Left lumbo -sacral region, radiating from centre
  to side
• Pain, lt movements ()
• lt lying left side ()
• lt turning while ()
• gt lying right side ()

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• O/E
• GC Patient in acute pain, could barely walk
• Lumbo-sacral region tenderness (L4,5 S1)
• SLR Bilateral free
• SIST Negative
• CNS LL Motor/ sensory NAD
• Back ROM - Severely restricted, Painful ()
• Patient wept during examination due to pain
• DIAGNOSIS?

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FFST H/O PID BACK LS DEGENERATIVE
MUSCLE LIGAMENTS STRUCTURE
TIME FORM FUNCTION SUDDEN SPASMS/
STRAIN PAIN FROM CENTRE TO SIDE O/E
SLR NEG

SISTS - NEG lt MOVEMENTS, ROM -
RESTRICTED lt LYING LEFT SIDE,
TENDERNESS L4,5, S1 lt TURNING
WHILE
gt LYING RIGHT SIDE
Diagnosis Lumbo sacral strain
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• TOTALITY
• Back, lumbo sacral region
• Muscle, ligaments, fibrous tissues, left side
• Pathology of strain
• Back pain, lt movements ()
• Back pain, lt lying left side ()
• Back pain, lt turning while ()
• Back pain, gt lying right side ()

• Action Admission
• Rx Kali Carb 200 2 hrly

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• CASE 2
• Mast A. G. Age 6 yrs
• Rx. in our hospital since age 2 yrs,
• Patient gt3 with treatment.
• Recc. Allergic Bronchitis Primary Nocturnal
  Enuresis
• Acutes Puls 200 (GIT infections)
• Ant Tart ? Ant Ars
  (RS infections)
• Constitutional C. Phos 1M 3P

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What is TOTALITY ?

• PP CHASING FORM!!
• ANAMNESIS
• No prodromal symptoms
• Fever - Remittent type. Temp 102 F
• Started suddenly, No chills or Sweat
• Pain in Abdomen

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• Breathlessness, wheezing, Rapid breathing
• App??, Thirst ?3, Sleep ?, Weakness
• Sneezing, watery discharge
• Cough, Dry 1st 2 days, then wet cough (),
  lt night
• Frequent ()
• Sleep gets up in middle of night.
• Talking in sleep calling mummy
• Fear startles, Dont beat me.
• Talk averse to
• Wants company while sleeping esp. Mo.

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• Observation
• Dullness, Drowsy
• Comfortable when lying down
• Responds to commands well.
• O/E Temp 102 F
• Pulse 96/min
• Tongue thick creamy coating
• RR - 48/min
• RS Scattered creps
• CVS S1S2

DIAGNOSIS Acute Bronchitis
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TOTALITY
E V A L U A T I O N

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Susceptibility - High Sensitivity - High
ACTIONS Admission OBS Temp Clinical
state Gen Care Invest Rx Phos 1M 3 hrly
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• CASE 3
• 2 Yrs old boy brought to casualty, ANXIOUS
  parents
• Swelling() of prepuce since morning, noticed
  by mother
• No cause, or any other complaints
• Local Exam Edematous() swelling of the
  prepuce till upper 2/3 of penis
• Redness (), warmth (), ?Tenderness
• Mild pustular discharge
• Prepuce not retractable
• Pin hole opening of skin

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General Exam G.C. Good, child playful,
comfortable Temp A febrile Child under
homoeopathic treatment for Recurrent
URTI Molluscum Contagiosum Acute
Rx Merc Sol 200 Chronic Rx Kali Iod 30 7P
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• Diagnosis
• Balanoposthitis with Phimosis
• Totality BOGER
• Acute Inflammation
• Skin
• Connective Tissue (Loose Areolar tissue)
• Edema

Rx Apis 200 2 hrly
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• CASE 4
• Female 33 yrs
• Seen in OPD, could barely walk
• Pain in rectum, since 10 days
• Pain radiating to abdomen back()
• Pain stitching() burning()
• Pain lt During After Stool()
• Pain lt Sitting for more than ½ hr
• Pain gt Warmth
• Stool hard (), straining ()

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H/O Similar episodes 1/3-4 mths since 5 yrs H/O
Pain in chest Dyspnoea (10 days back) patient
admitted for obs, but NAD. Discharged O/E
G.C. Pt in distress/ pain Local
Fissure in Ano. 12 oclock External
hemorrhoids at 6 oclock Painful () PR
not done. No discharges
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• TOTALITY
• Rectum
• Anus
• Stitching pain
• Burning pain
• Pain rectum- radiating to abdomen back
• lt During passing stool
• lt After passing stool
• gt Warmth application
• Chest complains along with rectal symptoms

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• MODIFIED TOTALITY
• Chest complains along with rectal complains
• Pain rectum- radiating to abdomen back
• lt After passing stool

Rx Collinsonia 200
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• CASE 5
• 32 yrs, multipara.
• In Labor since early am Induced SQ
• Caulophyllum 200 1M ½ hrly, till midnight- SQ.
• RMOs call. Action - Case Definition.

• Unearthly hour, patient in lithotomy position, in
  labor scanty data.
• Patient very cooperative supportive.
  Comforting the doctors.

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What constitutes a TOTALITY? PROBLEM
DEFINITION?? DATA BASE ? OBSERVATION BEHAVIOUR---
STRESS EXPERIENCE(S) FEELINGS PECULIAR SITUATION!
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• TOTALITY
• Patience of this patient
• Ability to stand pain/ suffering
• Concern for others
• Ability of expression
• Sense of responsibility

Living Materia Medica Impression Silica In 200
potency. Patient delivered after 2 doses.
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SYMPTOMS IN FU

• Importance of symptoms in management of cases.
• Male 30 yrs brought to casualty with H/O Fever
  since 21 days.
• C/O Sub-acute on Chronic Appendicitis, with
  rising titer of Widal O Para A.
• Temp pattern, continuous and range 104 F.
• Acute Totality Phos 200 3 hrly.
• Pt gt3 in 3 days- Generals and Particulars.
• Fever spike on D4.
• Action ??

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• Change Remedy ?
• Change Potency ?
• Review of Totality.
• Characteristic symptoms of Phos gone.
• Constitutional Remedy.
• Kali Carb 200 1P. Temp N within 12 hrs. Gen
  Particulars gt3. Response was sustained.

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• CASE 6
• Female 33 yrs, Nepali, Illiterate
• C/O Corn left foot, since 5 yrs Surgically
  removed 2-3 times, recurred lt
• Severe spasmodic Dysmenorrhoea, since 3 yrs
  after T.L.
• Life space
• Parental home, no stress. Calm quiet people.
• In-laws loud harsh, pt. feels bad
• MIL Abusing the pt., talked ill about pts
  family
• Pt. quiet, - never spoke

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• H in India Mumbai Pt. stayed on a separate
  floor
• Behavior of elder son abusive, violent,
  abusive physically, anti-social
• Vexed (), Anxious () Weepy
• - Palpitations
• Dreams Blood
• - Young person in white strangulating her
• - Ghosts

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• Physical Generals
• Chilly
• Perspiration offensive ()
• Menses dark, offensive ()
• Craving sour ()
• Craving sweet ()
• Aversion pungent ()
• Heat sensation of sole, gt cold water
• gt cold floor
• Physical Reactions Sun Headache
• Motion Sickness - vomiting

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Remedies Given Sepia Graphites Silica Ant
i-miasmatic Thuja Multiple remedies indicates
different thinking / locations of P.P. ?
Anxiety ? Sensitivity
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• Review Totality - BOGER
• Corns
• Corns Painful
• Uterus Dysmenorrhoea
• Suppression Surgical
• Bad effects of surgery
• lt During menses
• lt Movement
• lt Working in water
• lt Bending double

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• gt Pressure
• gt Cold Application
• Discharges Black
• Discharges Offensive
• PDF
• Palpitation Anger, due to
• Palpitation Anger after
• Dreams - Someone killing her
• Dreams Excreta
• Dreams Ghosts
• Dreams Blood

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• Cr Sour()
• Cr Sweet()
• Av Pungent()
• (Heat sole gt Cold application)
• Remedies
• Sulphur 20/12
• Bryonia 15/10
• Pulsatilla 17/10
• Causticum 11/10

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Differentiation Sulphur 4/2 Puls
4/2 Phos 5/3 Thermal ? Review Hot
Final selection Sulphur 200 1 P infrequent.
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• CASE 7
• Female, 30 yrs, Roman Catholic, MA, B Ed.
• H Very good, gentleman, co-operative
• Son 3 yrs, severe asthmatic
• Mo Depression
• Since 6 mths - Giddiness, Restlessness
  Nervousness, Palpitation, Sweating
• - Feeling of impending gloom
• - Anticipation/ Tension
  (Sr marriage outside caste)
• - lt Crowded places

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- Depressed mood
Accomp c/c Ant. Cruciate Ligament
Laxity Allergic Rhinitis
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• What is the susceptibility trying to tell us?
• Imbalance Mind
• Reflects what ? symbolically
• - Body
• Language of Disease? What purpose it
  serves?
• Predominant Psychological
• Personality Disposition
• Stresses/ Conflicts
• Defense Mechanisms
• Coping strategies/ Adaptation

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Perfectionist CONATION Allergic
Rhinitis (Behavior/ Action) Ant. Cr Lig
Laxity (Pains) Sleep unrefreshing Palpi
tation, Sweating, App Congestive
Dysmenorrhoea AFFECT COGNITION
(Feeling) ( Thinking) Forsaken Something
wrong with me H does not love me Wants to work/
teach Tensed/ Anxious Depressed/ women Good for
nothing Anger Happy talking/ Company Guilt
Diagnosis Panic Disorder with Agarophobia

Dysthymia
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MULTI AXIAL DIAGNOSIS Axis I Panic Attacks
with Agarophobia Axis II -- Axis III Allergic
Rhinitis, Congestive Dysmenorrhoea,
Ant. Cruciate Ligament Laxity Axis IV
Severe illness of child Marriage of Sr
outside caste Depression of mother Axis V
Global Assessment of Functioning - Erratic
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CASE 8 D I S C U S S I O N
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• REPERTORIAL TOTALITY
• A/F Grief
• lt Anxiety future about
• lt Vexation
• lt Indignation
• lt Brooding
• gt Sex after
• Sexual desire high
• Suicidal disposition
• Loquacity

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• Dreams Daily Events
• Dreams Fights
• Craving Alcohol
• Craving Cold Drinks
• Craving Non veg ( meat)
• lt Sun.

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• PDF
• Conscientious
• Egotism
• Alcoholism
• Back pain lt night
• Back pain lt lying down
• Back pain lt rains (damp)
• Back pain lt winter

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REMEDIES Lach 28/12 Puls 27/14 Nat M
26/14 Lyc 25/17 Sulph 24/15 Nux Vom
35/17 Staph 30/16
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• CONCLUSIONS
• Symptoms are the building blocks of the TOTALITY
• TOTALITY is influenced by different philosophical
  bases
• A homoeopath is required to undergo the process
  of Analysis then synthesize the data at his
  possession
• Different Tools help him to Achieve his Travel
• These operations are based on / influenced by the
  depth breadth of the CONCEPTS that he holds,
• CONCEPT OF MAN
• CONCEPT OF DISEASE
• CONCEPT OF HEALTH

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• REFERENCES
• Organon of Medicine Samuel Hahnemann, 6th Ed,
  Translated by William Boericke.
• Principles Practice of Homoeopath, Ch 3
  Symptomatology from the standpoint of Homo.
  Practice. Dr. M.L. Dhawale
• Perceiving - 1
• A. Perceiving Totality
• Dr. M.L. Dhawale

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THANK YOU