RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA
ANNEXURE-II
APPLICATION FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATE & DR. M.ILAYARAJA
ADDRESS DEPT OF ORGANON OF MEDICINE AND
HOMOEOPATHIC PHILOSOPHY,
FATHER MULLER HOMOEOPATHIC
MEDICAL COLLEGE AND HOSPITAL,
DERALAKATTE,
MANGALORE.-574 160
KARNATAKA.
PERMANENT ADDRESS DR. M.ILAYARAJA
#4,N.G.G.O.COLONY,
KATPADI ROAD,
GUDIYATHAM,
VELLORE DT.-632 602 ,
TAMIL NADU
2. NAME OF THE INSTITUTION FATHER MULLER HOMOEOPATHIC
MEDICAL COLLEGE AND HOSPITAL,
DERALAKATTE,
MANGALORE.-574 160
KARNATAKA

3. COURSE OF THE STUDY & M.D.(HOM)

SUBJECT ORGANON OF MEDICINE AND
HOMOEOPATHIC PHILOSOPHY
4. DATE OF ADMISSION TO THE 05-06-2009
COURSE
5. TITLE OF THE TOPIC
“A COMPARATIVE STUDY OF HOMOEOPATHIC MOTHER
TINCTURES AND POTENCIES IN THE TREATMENT OF ESSENTIAL
HYPERTENSION”

6.

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BRIEF RESUME OF THE INTENDED WORK

6.1 NEED FOR STUDY

Hypertension is an important public health challenge because of its high prevalence

and concomitant increase in risk of cardiovascular and renal disease. It accelerate the
process of arteriosclerosis in the coronary cerebral and renal arteries , as well as
increasing the workload of the heart , as a result the hypertensive patient is at risk of
myocardial infraction , stroke, renal failure and congestive cardiac failure.
It is major risk factor for cardiovascular morbidity and mortality .In total ,
hypertension is probably directly or indirectly responsible for 10-20% of all deaths .
Hyper tension is an ice burg disease1. In allopathic mode of treatment the way drug acts
in hypertension is by dilatation of arteriolar resistance vessels, Dilatation can be
achieved through direct relaxation of vascular smooth muscle, by stimulation of nitric
oxide (NO) production ,or by blocking endogenous vasoconstrictors, nor adrenaline, and
angiotensin.
Dilation of venous capacitance vessels reduced venous return to the heart
(preload) leads to reduce cardiac output, especially in upright position.
Reduction of cardiac contractility and heart rate and depletion of body sodium.
This reduces plasma volume and reduces neither arteriolar response to nor adrenaline
modern to anti hypertensive drug which lowers the blood pressure with minimal
interference with homoeostatic control i.e. change in posture, exercise.
According to the U.S. Department of health and human services side effects of
anti-hypertensives that are considered common but not serious include slight dizziness,
fatigue, cough and headache. In the event that the symptoms become more pronounced
or difficult to tolerate for the patient should notify a physician2.
Serious side effects of antihypertensives, as cited by the Mayo Clinic, include
insomnia, decreased sex drive, shortness of breath and depressed mood. A patient
experiencing these symptoms should consult with a physician before continuing doses of
any antihypertensive medication3.
Severe side effects associated with antihypertensives that require immediate
emergency medical attention include chest pain, difficulty breathing, fainting, irregular
heartbeat and rash. Swelling of the face, lips, tongue or extremities may be the sign of an

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allergic reaction to the medication. For these symptoms, treatment should not be delayed.
Because of injurious effect of Allopathic medication we need to think of
alternative treatment available. In that sense Homoeopathic treatment offers safe and
effective management and treatment even complete cure of the patient, if the remedy is
similimum. Here no need of continuous medication for life likes Allopathy.
Literature available for the treatment of essential hypertension is very scanty and
there are fewer studies conducted to know the effectiveness of potentised medicine and
mother tincture for treating essential hypertension.
So far, effectiveness of mother tincture for treating essential hypertension is not
systematically studied because of that I took the study of mother tincture for treating
essential hypertension.
The study of mother tincture is not always welcomed in Homoeopathic system
that is not considered as classical method. Now the time as come to know whether
mother tincture is effective or the older method of using potentized medicine is effective.
I have taken this study to know which method is effective for treating essential
hypertension.

6.2 REVIEW OF LITERATURE:

Definition4 :
Essential hypertension is the form of hypertension that by definition, has no
identifiable cause. It is the most common type of hypertension, affecting 95% of
hypertensive patients; it tends to be a familial and is likely to be the consequence of an
interaction between environmental and genetic factors. Prevalence of essential
hypertension increases with relatively high blood pressure at younger ages is at increased
risk for subsequent development of hypertension. It can increases risk for cerebral,
cadiac and renal events.

History :
Hypertension was recognized as early as the beginning of 19th century –more
than half a century before blood pressure measuring devices discovered, that many
patients with renal diseases had diffuse vascular disease and cardiac hypertrophy.

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 The first person to measure blood pressure was the Clergyman Stephen Hales,
Who in 1733 inserted hollow tubing into the neck artery of a horse and was astonished to
see the blood rise 9 feet in a glass column. This is obviously impractical for regular use
with humans, and it took another 143 years to invent B.P measuring instrument in human
without breaking the skin by Ritter Von Basch. This sphygmomanometer was foremost
of the introduced by ingeniously simple device introduced by Scipione Reva-Rocci in
1896, a prototype of the refined instruments of today. Blood pressure was found to equal
the pressure in a inflated cuff, compressing the arm at appoint where the pulse first be
felt as the cuff was deflated , the pressure was called the systolic blood pressure and
there fore it coincided with the contraction of the heart. N S Korotcoff in 1905 ,by
using a stethoscope to monitor the pulse not only achieved a more accurate reading ,but
also discovered that the pulse disappeared as the cuff pressure declined at a point
roughly coinciding with the expanding of head (diastole) thus establishing the diastolic
pressure.
Epidemiology1:

PREVALENCE:
In some industrialized countries, up to 25 per cent of adults have diastolic pressures
above 90 mm Hg. Prevalence in the developing countries seems to be similar to that in
European or other technically developed societies ranging from 10 per cent to as much as
20 percent among adults. Only a few populations, either living at high altitudes or
belonging to primitive cultures (e.g., a small number of ethnic groups living in the
Pacific Islands, Asia, Africa and South America) seem to have exceptionally low levels
of blood pressure.
PREVALENCE IN INDIA:
The data are derived from two well – planned studies which screened all persons aged
20 – 60 years and followed WHO suggested criteria for diagnosis The one in Rohtak is
taken to represent the urban population, and the other in a village in Haryana to represent
rural population in India. The prevalence of hypertension was 59.9 and 69.9 per 1000 in
male and females respectively in the urban population, and 35.5 and 35.9 per 1000 in
males and females respectively in the rural population.
Essential hypertension has no identifiable cause. It may have genetic factors and
environmental factors, such as salt intake or others. Essential hypertension comprises
over 95% of all high blood pressure.

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Clinical symptoms5, 6:

Usually, no symptoms are present. Occasionally, they may experience a mild

headache. If headache is severe, or if experience any of the symptoms below. These may
be a sign of dangerously high blood pressure (called malignant hypertension) or a
complication from high blood pressure5, 6.

- Tiredness
- Confusion
- Vision changes
- Angina-like chest pain (crushing chest pain)
- Heart failure
- Blood in urine
- Nosebleed
- Irregular heartbeat
- Ear noise or buzzing.

HOMOEOPATHIC APPROACH IN ESSENTIAL HYPERTENSION

CASE TAKING7, 8: (§83-104)

Hahnemann in his Organon of Medicine §83 ‘this individualizing examination

of a case of disease, for which I shall only give in this place general directions, of which
the practitioner will bear in mind only what is applicable for each individual case,
demands of the physician nothing but freedom from prejudice and sound senses,
attention in observing and fidelity in tracing the picture of the disease’.

UNDERSTANDING OF MIASMS IN ESSENTIAL HYPERTENSION 9, 10:

Miasms can be understood in following ways in hypertension

1. According to the predisposing (aetiological) factors.

2. According to pathological understanding, signs and symptoms.

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According to the predisposing factors:

A. Non – modifiable factors:

Age: BP in elderly age with atherosclerotic changes with past history of

suppressed gonorrhea indicates sycotic miasm. Elderly people with complications such
as organ failure suggests the syphilitic miasm. Where as in young, elevated BP with the
family history of syphilis suggests syphilitic miasm.

Personality: Type A personality highly ambitious, active, responsible, fastidious

and industrious, are common indications for psora or pseudo psora.

B. Modifiable factors:

Obesity:

It is an important aetiological factor for hypertension; miasmatically obese, fats,

flabby persons belongs to sycotic group.

Excess salt desire is a feature of psora; this is an important risk factor for
development of hypertension. Desire for ft, alcohol, fatty foods are a feature of psora.

Alcohol consumption for over a period of time results in fatty changes of

various organs, which results in fat deposition in the cells. This is a feature of sycotic
miasms.

Environmental stress:

Stress plays an important role in development of hypertension many studies

have proved this factors. Cases with psychosomatic relations like fright, fear anxiety,
anger, suppressed emotion, grief etc., mayinitiate or aggravate the problem. These factors
are purely psoric in origin. Psychological stress factor, which results in dullness,
depression, defect in thinking, and sluggishness, which leads to hypertension, is a feature
of sycotic miasm. Changeable mood, erratic behavior, restlessness and hyperactivity

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usually suggest pseudo psora (tubercular miasm). Suicidal tendencies, total destructive
tendency, rage and tendencies to inflict harm to others usually are a feature of syphilitic
miasm.

According to pathological understanding:

1. Increased peripheral resistance results in thichkness of walls of the big and small
arteies. Atheroma developed in large artery results in narrowing of lumen and
stenosis, which is suggestive of sycotic miasm. Fibrinoid necrosis of the vascular
wall is a feature of malignant hypertension, suggests syphilitic miasm.
2. There is a greater impedance of left ventricular emptying, which results in left
ventricular hypertrophy. Hypertrophy is a feature of sycotic miasm. In well-
developed and long-standing cases left ventricle failure, which expressed as
exertional dyspnoea, orthopnoea and paroxysmal nocturnal dyspnoea, suggests
syphilitc miasm.
3. Reduction in renal perfusion leads to excess renin production, which activates
angiotensinogen to angiotensin-I. Angiotensin-I to Angiotensin-II, which
stimulates the production of aldosterone and further contributes to salt and water
retention. Retention of salt and water, which usually expresse as edema of the
tissues swelling of face and extremities (pedal edema) with increased BP usually,
suggests sycotic miasm. Reduction of renal perfusion leads to decreased
glomerular filtration – reduces sodium and water excretion, results in sodium amd
water retention, which expresses as sycotic miasm.

In malignant hypertension pressure rises rapidly without treatment, death may occur
within one to two years. The accelerated rise in BP produces following changes-

- Cerebral edema expression of sycotic miasm.

- Left ventricular failure expressed as syphilitic miasm.
- Severe renal impairment with proteinuria and microscopic haematuria, which
results in pseudo psoric (tubercular) miasmatic expression.
- Retinal hemorrhage- exudates and papilloedema is a strong indication of tubercular
miasm.

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 Raised blood pressure is not a disease in itself. It is just a sign of some
underlying disorder. Homeopathy offers good prognosis for cases of essential
hypertension. The treatment is based upon the cause and the totality of the case. Many
homeopathic remedies are successfully used to control hypertension.

Homeopathy treats the person as a whole. It means that homeopathic treatment

focuses on the patient as a person, as well as his pathological condition. The
homeopathic medicines are selected after a full individualizing examination and case-
analysis, which includes the medical history of the patient, physical and mental
constitution etc11.

Therapeutics for Essential Hypertension12:

1. Lachesis: It is the chief remedy for high blood pressure. Palpitation, with fainting
spells, especially during climacteric. Constricted feeling causing palpitation, with
anxiety, cyanosis and irregular beats. Heart weak, pulse weak, intermittent slow,
andirregular. Senile arteriosclerosis.
2. Aurum met: Ailments from suppressed anger or resentment, headache, fear of
death. Hopeless, despondent, and great desire to commit suicide. Palpitation and
congestion. Is particularly useful for mercurio-syphilitic dyscrasia. Peevish and
vehement at least contradiction. Weakness of memory. Roaring in the head.
Violent headache. Conngestion to head. Double vision, upper half of object is
invisible. Sees fiery objects. Horrible odor from the n ose and mouth. Obstinate
constipation. Stools hard and painful. Urine turbid likes buttermilk. Dyspnoea
worse at night, sleeplessness. Pulse rapid and irregular. Cardiac hypertrophy.
Arteriosclerosis with high BP and nocturnal pain behind sternum. Tumultuous
fluttering of heart and anxiety with a sense of oppression in chest.
3. Aconitum napellus: Dry heat and red face. Thirsty and restless. Chilliness ad
formication down back. Formication and numbness. Sleeplessnesss with tossing
about, bursting headache, as if brain were moved by boiling water. Vertigo
worse on rising. Pulse full and bounding, almost incompressible. Fears death,
but believes that he will soon die. Pains are intolerable; they drive him crazy.
Bitter taste of everything except water. Burning from stomach to oesophagus.
4. Plumbum met: Hypertension and arteriosclerosis. Excessive and rapid

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 emaciation. Loss of memory. Slow perception, amnesic aphasia paretic
dementia. The face looks pale and cahectic cheek sunken. Cardiac weakness,
palpitation, wiry pulse, soft and small pulse. Paralysis of the lower extremities as
a result of apoplexy. Chronic interstitial nephritis with albuminous scanty urine.
Excessive colic radiating to all parts of the body. Obstructed evacuation from
impaction of feces.
5. Natrum Mur: Irritable, gets int a passion about trifles, consolation aggravates,
headache as if a thousand little hammers were knocking on the brain. Chronic
headache, from sunrise to sunset. Fluttering or palpitation of the heart. Hearts
pulsation shakes the body. Heart intermits on lying down .Cough, with bursting
pain head. Shortness of breath, especially on going upstairs. Has to wait a long
time, befor the urine is passed. Unquenchable thirst.
6. Baryta Mur; Arteriosclerosis and cerebral affection in aged, where a high
systolic pressure with a comparatively low diastolic tension is attended by
cerebral and cardiac symptoms. Scrofulous affections with loss of memory,
irresolute, lacks of confidence in himself and childish; grieves over trifles.( Bar-c)
7. Rauwolfia sepentina; This drug has come to the fore and has very effective in
cases of high blood pressure, in its various degrees of intensity and acuteness. It
has been credited with quickly softening the action of the heart, there by,
normalizing the circulation, dissipating the violent congestion of head and heart,
thus tending to bring the blood pressure down13.

Additional therapeutics12:

1. Agaricus muscarius
2. Ambra griesa
3. Angustra vera
4. Belladonna
5. Bryonia
6. Cactus grandiflorus
7. Crataegus
8. Glonine
9. Veratrum alb

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 10. Viscum alb

General Management5, 6:

Lifestyle changes may help control high blood pressure: Lose weight if you
are overweight. Excess weight adds to strain on the heart. In some cases, weight loss may
be the only treatment needed. Exercise to help your heart.
7. Adjust your diet as needed. Decrease fat and sodium -- salt, MSG, and
baking soda all contain sodium. Increase fruits, vegetables, and fiber.

6.3 OBJECTIVE OF THE STUDY

1. To asses the efficacy of Homoeopathic medicines in the management of
essential hypertension

2. To compare the effectiveness of Homoeopathic mother tinctures and

potencies in the management of essential hypertension

MATERIALS AND METHODS:

7.1 Source of data:

The subjects will be selected from OPD and peripheral centers of Father
Muller Homoeopathic Medical College, Mangalore.

7.2 Method of collection of data

A minimum of 30 cases will be selected those who are having history of
essential hypertension for the purpose of sampling method as per the inclusion criteria
and will be followed for a minimum period of 3-6 months duration.
The data will be collected by purposive sample method and processed in a
standardized case record.
The potency selection and repetition of the doses will be done according to the

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 demand of the case, with consideration of potency selection criteria such as Acute or
Chronic, Susceptibility, Vitality and Suppression (if any), changes in structural and
functional level and the degree of correspondence to the remedies selected.

Inclusion criteria:
1. The sample on both sexes aged from 30-65 years.
2. Diagnostic criteria is mainly on clinical parameter.
3. Only essential hypertension is considered for the study.

Exclusion criteria:
1. Cases below 30 years or above 65 years of both sex..
2. Cases of secondary hypertension.
. 3. Cases with systemic complications are not taken for study.

Research hypothesis:
Both Homoeopathic mother tinctures and potencies are effective in the
treatment of Essential Hypertension.

Null hypothesis:
There is no significant improvement in both homoeopathic mother tinctures
and homoeopathic potencies in the treatment of essential hypertension.

Plan for data analysis:

The collected data will be analyzed by “Chi square” test

7.3 Does the study require any investigations to be conducted on patients, or other
8. humans (or animals)? If so please describe briefly.
Yes, But following investigations are done to rule out complication,
1.Random blood sugar
2.Urine routine
3.Creatine level
4.Urea level
5. E.C.G

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7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, enclosed.

LIST OF REFERENCES:

1) Park K. Parks Text book of preventive and social medicine .18 th ed. Jabalpur: M/S
Banarsidas Bhanot. p. 293-98
2) URL: http://www. U.S. department of health and human services/ side effects of
antihypertensives.htm. Accessed October 09th 2009.
3) Bennett PN, Brown MJ. Clinical Pharmacology,9th ed. New Delhi: Elseiver. p.203-
05
4) URL: http://en.wikipedia.org/wiki/Essential_hypertension. Accessed November 2nd
2009.
5) Chatterjee CC. Human Physiology, Volume I, Reprint ed. Kolkatta: Kalyani
Mukherjee Publishers;2004.p.297-313
6) Kumar Praveen, Clark Michael. Clinical Medicine.6th ed.U.S.A: Elsevier saunder
Publication; 2005. p .645-46
7) Hahnemann samuel. Organon Of Medicine.6th ed. New delhi: B Jain Publishers
Pvt Ltd; 1997. p.172-186
8) Raman Lal P Patel. The Art Of Case Taking And Practical Repertorisation In
Homoeopathy.6th ed. Kerala: Sai Homoeopathic Book Corporation; 1998. p.
9) Allen. J.H. The chronic miasms, New Delhi: B. Jain Publishers Pvt. Ltd; p.159-64
10) Dr. Ortega sanchez proceso. Notes On Miasm. 1ST English ed. New Delhi.
National Homoeopathic Pharmacy.1980. p.34
11) Dhawale ML. Principles and Practice of Homoeopathy. Part –I, 3rd ed .Bombay :
Institute Of Clinical Research ; 2000.p.233-35
12) Boericke William. New Manual of Homeopathic Materia Medica & Repertory, 2nd
revised ed. New Delhi: B Jain Publishers Pvt Ltd; 2001.
13) Dr.Varma.PN, Dr.Kusum Yadav, Dr.Ashok Kumar. Schwabe’s A compendium Of
Rare And Clinically Established Mother tincture.2nd ed. Noida: Dr.Wilmar
schwabe India .Pvt Ltd;2008.p.143
14) Dhama KPS. Hypertension. The homoeopathic prestige. February 1998:57-60

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 15) Balakrishnan E. Cardiovascular disease and homoeopathic treatment.
Homoeopathic Heritage. July 1996:407-411.
9 SIGNATURE OF THE
CANDIDATE
10. REMARKS OF THE GUIDE

11. NAME& DESIGNATION OF DR. SHIVAPRASAD.K, B.Sc, B.H.M.S, M.D

(IN BLOCK LETTERS) (HOM).
11.1 GUIDE PROFESSOR AND HOD,DEPT OF ORGANON OF
MEDICINE AND HOMOEOPATHIC
PHILOSOPHY,
FATHER MULLER HOMOEOPATHIC MEDICAL
COLLEGE & HOSPITAL,
DERALAKATTE,
MANGALORE- 574 160

11.2 SIGNATURE

11.3 CO-GUIDE(IF ANY)

11.4 SIGNATURE

11.5 HEAD OF THE DR. SHIVAPRASAD.K, B.Sc, B.H.M.S, M.D

DEPARTMENT (HOM).
PROFESSOR AND HOD,DEPT OF ORGANON OF
MEDICINE AND HOMOEOPATHIC
PHILOSOPHY,
FATHER MULLER HOMOEOPATHIC MEDICAL
COLLEGE & HOSPITAL,
DERALAKATTE,
MANGALORE- 574 160
11.6 SIGNATURE

12. 12.1 REMARKS OF THE

CHAIRMAN& PRINCIPAL
12.2 SIGNATURE

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