A Multicentric, Double Blind Randomized, Homoeopathic Pathogenetic Trial of Allium
A Multicentric, Double Blind Randomized, Homoeopathic Pathogenetic Trial of Allium
A Multicentric, Double Blind Randomized, Homoeopathic Pathogenetic Trial of Allium
222]
I J R H
ORIGINAL ARTICLE
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sativum
Raj K. Manchanda1, Anil Khurana1, Raj Pal2, Bhopal Singh Arya3,
Anil Kumar Vichitra3, P. G. Mohanan4, Pritha Mehra3*, Shilpa Sharma1, Vinay K. Singh3
1
Central Council for Research
in Homoeopathy, New Delhi,
ABSTRACT 2
Homoeopathic Treatment Center,
Safdarjung Hospital, New Delhi,
3
Nodal Office and Center for Drug
Background: Homoeopathic drug proving is an integral part of Homoeopathic System
Proving Research Study, Dr. D.
of Medicine. It is the first step in finding out the pathogenetic powers of a drug. P. Rastogi Central Research
Institute (H), Noida, Uttar Pradesh,
Objective: To elicit the pathogenetic response to Allium sativum in homoeopathic 4
Center for Drug Proving Study,
potencies on healthy human provers. Central Research Institute (H),
Kottayam, Kerala, India
Materials and Methods: A multi‑center randomized, placebo‑controlled, double-
*Address for correspondence:
blind trial was conducted at two centers of the Central Council for Research in Dr. Pritha Mehra,
Homoeopathy (CCRH). Proving was conducted on 33 healthy provers after the pretrial Dr. D. P. Rastogi Central Research
medical examination. All the provers were given 12 doses of placebo divided in 4 Institute (H), A 1/1, Sector 24,
Noida, Uttar Pradesh, India.
doses/day for 3 days during the first phase of the trial. After randomization, in the E‑mail: ccrhdp@gmail.com
intervention group (21 provers), Allium sativum (A. sativum) was proved in 6C and 30C
Received: 28-11-2015
potencies, in two phases. In the placebo group, 12 provers were administered placebo Accepted: 02-03-2016
in the same manner. The symptoms manifested during the trial period were noted
down by the provers and then elaborated by the proving masters. The generated data
on A. sativum were then compiled and analyzed at proving‑cum‑data processing cell
at CCRH headquarters.
Results: Out of 21 provers who were on actual drug trial, only nine provers manifested
symptoms. Drug was able to manifest symptoms in both the potencies, in more or less
every part of the body.
Conclusion: The pathogenetic response elicited during the proving trial expands the
scope of use of the drug A. sativum and will benefit the research scholars and clinicians.
The generated symptoms of this drug will carry more value when verified clinically.
times. It was used for dressing wounds during the Garlic as a drug, “Allium sativum” was introduced
First World War. In the 16th century B.C., the Egyptians in Homoeopathic Materia Medica proved in France
used it in about 22 remedies for various ailments such by Petroz and Teste, 1852.[6] Homoeopathic drug
as heart diseases, tumors, and insect bites etc. Wealthy proving is an integral part of Homoeopathic system
Romans but gave it to their soldiers to make them of medicine. This is the first step in finding out the
strong. In today’s world, it is used as an antibiotic, pathogenetic powers of a drug. As the extensive
expectorant, antidiabetic, and as an aid for expelling proving of this drug have not been done therefore,
worms, reducing blood clotting, and lowering blood a systematic homoeopathic pathogenetic trial (HPT)
pressure. It is used in treating the infections, for of the drug in homoeopathic potencies to elicit its
example, bronchial and digestive. It is administered as pathogenetic power was carried out by the Central
a circulatory remedy and in diabetes.[1] Council for Research in Homoeopathy (CCRH) at two
of its centers as per the approved protocol.
Hippocrates warned that garlic “causes flatulence,” a
feeling of warmth on the chest and a heavy sensation Description
in the head. In 1955, a Russian study found that An acaulescent, bulbous, hardy perennial herb,
garlic extracts bind heavy metals, thus aiding their cultivated as an annual, up to 60 cm in height.
elimination.[2] Bulbs ovate, flattened below, tapering upward and
compound, i.e. composed of small bulblets. Stem
It is used in Ayurveda, Unani.[3] It is known for its
much reduced (disc), convex‑conical, internodes very
pungent, heating, oleaginous, tonic, aphrodisiac,
compressed from where fleshy scale leaves arise,
fattening, digestive, and antihelminthic effects.
a bud present at the apex from which flowering
appetizer, sharp taste, diuretic, carminative,
scape develops. Leaves are linear, flat, lanceolate,
alexipharmic effects. It is found to be useful in
scape slender, spathe one‑leaved, long, pointed,
diseases of the eye, heart, low fevers, bronchitis,
head‑bearing bulbs, and flowers in umbel. Flowers
inflammation, piles, leucoderma, asthma, “vata,”
small, white; perianth trimerous with six petals,
lumbago, tumors, epileptic fits, thirst, and earache,
segments lanceolate, acuminate; stamens six,
inflammation, paralysis, pain in the body and joints,
filaments of inner whorl tricuspidate; ovary trigonous,
troubles of the spleen, liver, and lungs. chronic
trilocular, style filiform. Fruit is a capsule.[7,8]
fevers, caries of the teeth, and thins the blood.
Botanical Name : Allium sativum L.
In Cambodia, the leaves are used in the treatment
Family[2] : Alliaceae (Liliaceae)
of asthma.[3] Chinese have reported in their
Order : Asparagales
trial that garlic can be successfully used for
cryptococcal meningitis.[2] has anticarcinogenic Common names[3,5]
activity, antitubercular activity against Hindi : Lasan
Mycobacterium tuberculosis in vitro and in vivo. Sanskrit : Arishtha, Bhutabhna, Dirghapatraka
antibacterial activity against shigellosis anti- Bengali : Rasun
atherosclerosis activity, hepato-protective Tamil : Vellaipundu
activityand antidiabetic effect. Handling of garlic English : Garlic, Churl’s Treacle, Poor man’s
for cooking causes contact dermatitis.[4] Garlic treacle
also demonstrated ameliorative effects in acute Arabic : Saum, Taum
lepromatus neuritis.[5] Chinese : Suan, suan T’eou, Ta Suan
German : Knoblaunch, lauch
Toxicity studies of garlic extract and garlic oil
Chemical : Volatile oil (e.g. allyl alcohol, alliin,
revealed a significant rise in urea and alkaline
alliinase, allicin), scordinins
phosphatase in serum.[4] The signs and symptoms of
Constituents[1,2] : Selenium, Sulphur, and Selenium-
acute overdose of garlic as herbal medicine includes
containing compounds, Vitamins A,
dizziness, light‑headedness, burning sensation of
B, C, and E.
mouth, haematoma, nausea, sweating, leukocytosis,
anorexia, diarrhea, emesis, and menorrhagia. It can Distribution:
Native of Mediterranean region,
exacerbate bleeding in patients taking aspirin or cultivated universally[7,8]
anticoagulants.[2] Part used: Mature bulbs.[7,8]
No. of volunteers
screened = 42
Randomization
• OS: Old symptom. State when the symptom appearance of new sign(s) and/or symptoms(s),
occurred previously their progress and the number of doses after
• AS: Alteration in present or old symptom (e.g. used which such sign(s) and/or symptoms(s) appeared,
to be left side, now on the right side) with date, time of onset, and duration for which
• US: An unusual symptom. they persisted
• Any change in normal routine of the prover in
Duration of Study
respect of daily habits pertaining to diet, living
Proving period: One year (2011–2012).
conditions, etc./any treatment taken was also
Ethics and Consent noted in the Prover’s Day Book Proforma.
The Council’s Ethical Committee approved the After disappearance of sign(s) and/or symptom(s)
study protocol. Proving masters with experience in produced by the drug, the volunteer had to wait for
drug proving were sensitized about the protocol. a further period of 30 days (washout period) before
Written informed consent was received from all the starting the next phase following the same dose
volunteers prior to enrollment in the study. schedule as stated above.
Procedure The symptoms recorded in “Prover’s Day Book
The study was conducted in three phases at each Proforma” were verified by the proving master and
of the centers. In each phase, 12 doses of drug or completed through further interrogation with the
placebo as per randomization were administered, provers in respect to their location(s), sensation(s),
divided in 4 doses/day for 3 days (if no symptom modalities and concomitants, extension of
arises). symptoms, causation, clinico‑pathological findings,
1. Phase I: Placebo phase. All the provers were and other treatment taken, if any, in “Symptoms
given placebo in Phase I. It is useful in generating Elaboration Proforma.”
prover’s response to placebo in both the groups
and therefore symptoms generated by the prover During the course of proving, the provers were
in this stage act as control for subsequent phases referred for specific laboratory investigation(s) to
2. Phase II: In 2nd phase, the verum group received rule out any pathological cause of appearance of
the drug in 6C potency and placebo group received symptom(s). Since laboratory tests were performed
optically identical placebo to identify any correlation between the subjective
3. Phase III: In 3rd phase, the verum group received the and objective changes during the course of proving,
drug in 30C potency and placebo group received the expert opinion of the honorary consultant(s) was
optically identical placebo. obtained, wherever needed.
cell at the Council’s headquarters. After decoding, of body mass index (BMI), haemoglobin (Hb),
the sign(s) and/or symptom(s) generated by the erythrocyte sedimentation rate (ESR), fasting
provers kept on the drug were separated from those blood sugar (FBS), total cholesterol, serum urea,
generated by the provers kept on placebo. serum glutamate oxaloacetate transferase (SGOT),
Randomization and Blinding and serum glutamate pyruvate transferase (SGPT)
Provers were randomized in two groups, were calculated by independent “t‑test.” In all the
Group I (n = 21): Homoeopathic group and analyses, P < 0.05 was considered significant.
Group II (n = 12): Placebo group. Random numbers Pathogenetic Effects
were generated with the help of computer‑based Pathogenetic effects (proving symptoms) are defined
software available at http://www.randomizer. as all changes in the state of health and laboratory
org (accessed in August 2011) and the random code findings reported by the provers during the HPT
was kept at CCRH headquarters. The decoding of and recorded in the final report. The incidence of
the group was done after the compilation of the pathogenetic effects per prover is defined as the
symptoms produced in both the groups. total number of findings observed in verum group
Both homoeopathic drug and placebo were made in of the trial divided by the total number of provers.[10]
identical form so indistinguishable. Provers and the Pathogenetic effects were deduced from:
investigators were kept blinded to the group allocation i. Comparison of symptoms developed in placebo
and also to the identity of the drug. All the provers phase with symptoms during intervention
were assigned code numbers, and coded drugs of phases (intraprover comparison)
different potencies were supplied in separate glass ii. Comparison of symptoms developed by provers on
phials, bearing code numbers of the respective prover. control (for all phases) with provers on actual drug
Intervention trial (interprover comparison).
Homoeopathic group
About 100 ml sealed bottles of A. sativum in 6C RESULTS
and 30C were procured from a GMP‑certified
homoeopathic drug manufacturer in India. Globules A total of 33 healthy provers were enrolled. Out of
of number thirty were medicated with these whom, 30 provers underwent the Terminal Medical
attenuations at the CCRH headquarters office. Examination (TME). 2 and 1 prover(s)were dropped
out from the verum and placebo group respectively.
Placebo group Thus the data analysis was done on 30 provers. The
Placebo was made up of un‑medicated flow of the patients in the study is given at figure 1.
globules (number thirty) moistened with the baseline information in both the groups were
un‑medicated dispensing alcohol (unsuccussed) and comparable [Table 1]. Though there was difference
was therefore indistinguishable from Verum. in FBS at baseline between the groups but they were
Management of Adverse Effects within normal limits.
A vial of medicated globules of Camphora 30C was During the pathogenetic trial, out of 21 provers who
sent with each quota to each center as “antidote” were in verum group, only 9 (42.85%) provers reported
as it is believed to antidote nearly every vegetable symptoms consequent upon the administration
medicine.[9] In case of prolonged or intensely of the drug. In the placebo group, 8 (66.67%)
disturbing symptoms, antidote was to be used by the provers reported the incidence of symptoms. The
proving master after consulting the medical expert. Chi‑square test shows that there is no difference
Statistical Analysis between the 6C and 30C groups for producing the
Statistical analysis was done by using IBM SPSS symptoms (P = 0.068, confidence interval: −0.68
20.0. Comparison between Homoeopathy and to − 0.019). The symptoms were observed from both
placebo groups were performed at baseline to the potencies, i.e. 6C and 30C. Out of 23 symptoms
assess randomization effect using independent which were produced by the provers of verum group
“t‑test” for continuous variables and Chi‑square in 2nd and 3rd phases, 14 symptoms were produced
test for categorical variables. Changes from in 6C potency [Table 2] whereas nine symptoms were
the PME to TME in the pathological variables produced in 30C potency [Table 3].
The present study shows that there is no statistically 12.7 ± 1.6 at TME. Statistically, there is no difference
significant difference between the pathological between PME and TME in BMI and Hb [Table 4].
variables of Hb, ESR, FBS, total cholesterol, blood urea,
Intragroup analysis was done considering the
SGOT, and SGPT in the PME and TME of the verum and
physical built, physical generals, and mental generals
placebo groups. In BMI, mean changes occurred in the
of the provers in verum group who have produced
verum group from PME at 20.7 ± 2.8 to 20.8 ± 2.9
symptoms, but no significant similarities were
at TME and in control group from PME at 23.2 ± 4.3
found in these provers. Further, intergroup analysis
to 23.3 ± 4.2 at TME. In verum group, Hb values
considering the above parameters was done in the
decreased from 12.5 ± 1.5 to 11.9 ± 1.3 and in control
provers who have produced symptoms in the verum
group, changes noticed from PME at 13.3 ± 1.8 to
group and control group. There were no significant
Table 1: Baseline information similarities or dissimilarities found.
Variable Homoeopathy Placebo P A comprehensive qualitative symptom profile of
(n=21) (n=12) intervention group, control group, and former
Age (in years) 22.1±1.2 22.0±1.4 0.83
homoeopathic‑proving symptoms found in
Gender
literature[11‑13] [Table 5] reflect that:
Male 4 (12.1) 5 (15.2) 0.16
• No symptoms were generated in intervention
Female 17 (51.5) 7 (21.2)
Weight (in kg) 53.4±9.3 56.7±14.8 0.47
group in regional spheres of mind, eye, ear, mouth,
BMI 20.7±2.8 23.2±4.3 0.05 teeth, throat, rectum, and skin in the present study,
Hb (g/dl) 12.5±1.5 13.3±1.8 0.13 although they are present in the literature
ESR (mm after 1 h) 27.3±13.3 19.0±14.0 0.19 • In present and previous proving, the common
FBS (mg/dl) 85.9±11.3 83.6±10.2 0.02 regional affinities were found in head, nose, face,
Total cholesterol (mg/dl) 161.6±17.2 146.4±17.2 0.66 stomach, abdomen, chest, back, extremities, and
SBP (mm of Hg) 113.0±8.2 112.5±7.5 0.85 generalities.
DBP (mm of Hg) 76.0±5.6 74.8±5.1 0.55
Blood urea (mg/dl) 20.4±6 21.6±8.2 0.66
The number of symptoms developed in control
SGOT (U/L) 5.1±5.6 5.3±5.8 0.94 (placebo) group was almost 3 times of those produced
SGPT (U/L) 13.1±2.4 11.6±2.8 0.29 in the verum group. Some of the symptoms are
SD: Standard deviation; SBP: Systolic blood pressure; DBP: Dystolic different from those developed in verum group and few
blood pressure; Hb: Haemoglobin; FBS: Fasting blood sugar; SGOT:
Serum glutamic oxaloacetic transaminase; SGPT: Serum glutamic pyruvic
are overlapping. No adverse effect was observed during
transaminase; ESR: Erythrocyte sedimentation rate the trial; hence, antidote (Camphora) was not used.
Among the symptoms manifested in verum group, • Sudden aching pain in frontal region with burning
headache was produced in six provers and in both in eyes, amel. pressure (1, 1)
potencies. Heaviness of head was manifested in only one • Aching pain in frontal region with burning in eyes
prover after taking seven doses of 30C potency and this (2, 1)
has been also cited in Homoeopathic literature.[11,12,14] All • Headache with heaviness in frontal and vertex
other symptoms were produced in single prover each. regions, amel. closing eyes (12, 3)
The incidence of pathogenetic effects in this study • Aching pain in temporal region, amel. pressure
has been found to be 1.09. (9, 3)
• Pulsating pain in right temporal region, amel. by
Symptoms Developed During Drug Proving pressure (6, 1)
(Control Group) • Pulsating pain in left parietal region, agg. talking;
Each of these symptoms mentioned below were amel. open air (10, 1)
generated and reported by one prover. • Aching pain in occipital region with increased thirst
1. Mind: and decreased appetite. Pain agg. stooping (10, 1)
• Difficulty in concentration (4,1)Ψ • Pain in right occipital region, stretching and
2. Head: pulling sensation, agg. stooping, laughing; amel.
• Headache in single spot left side. Pain was keeping head still, straight (6, 6)
constant, severe, aching with heat of the single • Heaviness of head, amel. bathing (8, 2)
spot, amel. cold application (6, 1) • Stitching pain in right temporal region, amel.
Sleep, rubbing (4, 1)
Ψ
In parenthesis, the first number denotes number of doses after which that • Pain in forehead extends to right frontal
particular symptom was produced and the second number denotes the
duration (in days) for which the symptom lasted. region (9, 1)
12 Indian Journal of Research in Homoeopathy / Vol. 10 / Issue 1 / Jan-Mar 2016
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• Shoulder pain with tired feeling with fever discharge from nose. Symptoms of cough with and
(13, 1) without expectoration are found in the literature,
• Aching pain in left shoulder, agg. lifting things; but in the present study, dry cough with tiredness
amel. lying on left side and pressure (3, 2) and increased thirst have been noted.
• Peeling of skin of both hands, agg. morning (12, 1).
Chest, Back, and Extremities
15. Fever:
Symptoms have been generated related to these
• Fever (Temp. 103°F) accompanied with coryza,
anatomical regions in the present study and on
body ache, chill, sweating, and increased
comparison with older literature, it has been found that:
frequency of urine. Fever decreased to 100°F
after sweating (12, 2). The symptoms related to eruptions on chest are
16. Skin: found in the present study and older literature.
• Slight itching all over the body more on scalp, However, other symptoms found in the previous
remained the whole day (12, 1). proving are not found in the present study.
17. Generalities: Under back, the old literature mentions about the
• Weakness with body ache (8, 1). symptoms related to the nape of neck, sacrum,
coccyx, and even related to the skin, but in the
DISCUSSION
present study, only the symptoms related to pain in
In the present study, when the symptoms generated the scapular region have been found.
in the verum group were compared with the earlier In the extremities section, the present study has
proving symptoms available in the Homoeopathic symptoms related only to the upper extremities,
literature, it was found that symptoms were related to: whereas the older literature has symptoms related
to upper and lower extremities involving the joints
Head
as well.
Dyspeptic subjects as per prior proving are similar to
headache with nausea and other gastric disturbances Fever
in the present study. Similarly, heaviness of head In the older proving, it has been found that fever
preventing opening the eyes is also found in this has all the three stages of fever, i.e. chill, heat, and
study. sweat; but in the present study, there is no detailing
found.
Face
The eruptions in the earlier proving were related to Generalities
herpes and also having facial neuralgia, but in the The general weakness and lassitude along with the
present study, no herpes eruptions appeared, rather body ache in different parts of the body are seen in
there are nonitching macular eruptions. both, in the present and previous provings.
Stomach and Abdomen It has been noted that number of symptoms has
Nausea and increased appetite found in present been produced in both the groups along with a wide
study are similar to those found in the previous range of overlapping of symptoms, but still there
proving. Besides these symptoms, the proving data were symptoms exclusive of A. sativum distinguishing
in older literature has much more in store related it from the placebo. There is always a scope to
to digestive system. There are symptoms related improve upon and the parameters for defining the
to pain in the epigastrium and hypogastrium in the symptoms as characteristic, old and new symptoms
present study, whereas in the literature, there are may be incorporated. This will be an aid for better
colicky symptoms in various parts of the abdomen qualitative and quantitative analysis of the primary
with flatulence and borborygmi. outcome of the study.
Respiratory System In one of the articles, Teut et al.[15] has mentioned
The nasal symptoms, coryza and nasal blockage, that placebo proving occasionally seem to produce
are similar in the present and older literature, but similar symptoms to the proving symptoms, thus
the characteristics of discharges are different, as in casting further doubt on the use of this medium
older literature, there is dry coryza and epistaxis, in proving’ and has attributed it to nocebo effect.
whereas in the present study, there is thick yellow A nocebo response is explained as subject’s own
head still, straight. Heaviness of head, to temple and ears. amel. rest. It is Mild headache on right side of
amel. Bathing. Stitching pain in right Forehead hot to touch accompanied with forehead and on right eye after half
temporal region, amel. Sleep, rubbing. Pain in left occipital pain in eyes. an hour pain in whole head and eyes
Pain in forehead extends to right frontal region, amel. after Pain in right side of Then, stitching type of pain in parietal
region. Piercing pain in right side of sleep. frontal region of head region. It is accompanied with nausea,
forehead. Aching pain in occipital and Throbbing pain in right accompanied with heaviness in forehead. The complaints
parietal region, agg. noon, evening; temple, agg. bright heaviness of head, relieved after bathing next day.
Manchanda, et al.: Homoeopathic Pathogenetic Trial of Allium sativum
amel. tight bandage. Then, aching pain light, noise; amel. agg. midnight; amel. Throbbing pain in right temple, agg.
in forehead. Dull pain in frontal region hard pressure, beating sleep. bright light, noise; amel. pressure, hard
of head, amel. lying down, pressure. head with hand. pressure, beating head with hand.
Dandruff with itching ‑ white powder falling Pain in left occipital region, amel.
while scratching head. sleep.
Eye Pain in right eye, agg. reading. Catarrhal ophthalmia at night; smarting,
burning lachrymation; agglutination; returns
every night when he tries to read. Tarsi
sore with irritation.[12] Could read only with
spectacles; heaviness in eyes. Profuse
watering of eyes without coryza.[13]
15
Contd...
16
Table 5: Contd...
Section Placebo (C) Allium sativum Allium sativum Symptoms produced by Profile of Allium sativum by
6C (A1) 30C (A2) intervention ([A1+A2]−C) previous homoeopathic proving[11‑13]
Ear Pain in ears. Catarrhal deafness. Hardened ear‑wax and
Pain in right ear. crusts.[12] Humming in the ears.[11] Deafness
Stitching type of pain in right ear extending of left ear (catarrhal). Customary aural
to right shoulder. catarrh disappeared; he heard better in
diseased ear.[13]
Nose Coryza, watery, profuse, bland, nasal Coryza with sneezing, Coryza with sneezing, agg. morning. Coryza dry rather than fluent, with pressive
discharge with incessant sneezing in bouts agg. morning. It is It is accompanied with nasal blockage pain above the root of the nose. On
of 5-6 sneeze within 2-3 minutes interval, accompanied with with thick yellow nasal discharge. blowing nose, blood from nose at night.[12]
agg. cold water; amel. hot drinks and food. nasal blockage with Increased secretion of nasal mucous with
It is accompanied with smarting in eyes thick yellow nasal slight blockage of both nostrils.[11] Ozaena.
with watery discharges. discharge. smarting at junction of alae nasi and face,
Running nose. mostly left.[13]
Face Open comedones on left cheek, agg. Nonitching macular Nonitching macular eruptions on face. Lancinations on one side of the face. Dry
afternoon. eruptions on face. Later eruptions with dryness, agg. lips.[11,12] Smarting, itching; spots in upper
Small red eruption with slight itching. Later eruptions evening, washing with warm water. face. Stinging in one side of face. Smarting
Boil on face. with dryness, agg. Eruptions subsided, leaving dryness as from herpetic eruptions near left angle
evening, washing with on the area. of lips.[13]
warm water. Eruptions
subsided, leaving
dryness on the area.
Mouth Dryness in middle of tongue, tongue Swelling of lower gums. Troublesome
sticks to upper palate, no relief in spite feeling during the night and in the morning,
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and inflammation, agg. swallowing liquid. taking the medicine and returning after
Pain extending to neck. breakfast to such a degree as to cause a
flow of saliva. The symptoms of mouth are
agg. by reading.[12] Scurvy. Tongue furred
white, with a disagreeable taste. Tongue
dry at night. Sores in mouth.[13]
Teeth Pain in right premolar teeth. Tickling sensation in the lower teeth.[12]
Transient pressive pulling (in the forenoon)
in both jaws, and in the right upper molars.[11]
Toothache paroxysmal and severe.[13]
Contd...
17
Contd...
Table 5: Contd...
18
Section Placebo (C) Allium sativum Allium sativum Symptoms produced by Profile of Allium sativum by
6C (A1) 30C (A2) intervention ([A1+A2]−C) previous homoeopathic proving[11‑13]
Rectum Diarrhoea, loose, watery stool, hot. It Expels flatus. Stool first fecal, then watery
is accompanied with burning in rectum and hot. Involuntary stools. Diarrhoeic
during stool. (A/f took momos last night). stool,[11‑13] 3 a.m., preceded, accompanied,
Diarrhea, yellow, watery, forceful with and followed by cuttings in abdomen and
rumbling and gushing had to rush to loins. Normal stool immediately after a
toilet (A/f ate chicken in dinner). meal. Stool delayed from morning until
Loose stool with rumbling in abdomen after dinner, great urging; with stool and
reoccurring after passing stool. heat in rectum. Constipation with almost
constant dull pain in bowels. Prolapsus ani.
Worms.[12] Haemorrhoids.[11,12] Constipation,
which becomes obstinate.[11]
Cough Dry cough Dry cough accompanied by tiredness Painful irritation of windpipe when
accompanied by and increased thirst. coughing. Scraping in larynx exciting dry
tiredness and cough. Cough seeming to come from
increased thirst. stomach. Cough giving rise to perceptible
fetid smell. Dry cough after eating. Morning
cough, after leaving his bedroom, with
extremely copious mucous expectoration.
Sudden paroxysms of hard, dry cough
while smoking, compelling him to desist.
Great difficulty in expectorating a glutinous
mucous. Expectoration of thin, yellowish,
purulent‑looking blood‑streaked mucous
of putrid odor. Cough, agg. bending head;
after eating; by open air.[12] Deep‑seated
cough. Expectoration increased.[11]
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Chest Painful, red boil in Painful, red boil in axilla. Pain in left chest with dark urine.
axilla. Darting pain in the chest which prevents
sleep.[12] Oppression of the chest during
sleep. Lancinations in one side of the chest.
Twitching pain in the side of the chest; it
seems to him as if there was an empty spot
in his chest. Lancinations under the shoulder
Manchanda, et al.: Homoeopathic Pathogenetic Trial of Allium sativum
Itching in sole of left foot, left knee, which bed, cannot then change his position or
became raw and sore. sleep. Weakness in lower limbs; painful
Small red eruption with slight itching on weariness in the thighs. Legs do not grow
right leg and right forearm. as rapidly as the rest of the body. Pain as
Shoulder pain and tired feeling with fever. from a sprain in ankle‑joint; in toe‑joints.
Aching pain in left shoulder, agg. lifting Tingling in feet; burning in soles; stiffness
things; amel. lying on left side and in feet. Tearing pain in the feet. Pains agg.
Manchanda, et al.: Homoeopathic Pathogenetic Trial of Allium sativum
19
Contd...
20
Table 5: Contd...
Section Placebo (C) Allium sativum Allium sativum Symptoms produced by Profile of Allium sativum by
6C (A1) 30C (A2) intervention ([A1+A2]−C) previous homoeopathic proving[11‑13]
Fever Fever (Temperature 103°F) accompanied High fever with Fever with increased temperature, Chilliness on one side only. During
with coryza, body ache, chill, sweating, weakness and body weakness and body pain coldness, redness of face. Vomiting during
and increased frequency of urine. Fever ache. Fever with Fever with piercing pain in frontal the fever. Sweat in afternoon. Sweat: acrid;
decreased to 100°F after sweating. stitching pain in region, agg. heat; amel. sleep, tight causing itching; fetid.[12] Shivering before
forehead, agg. heat; bandage. midday and in evening.[11,12] Chilliness
amel. after sleep, tight from 1 day to another. Catarrhal fever
bandage. with predominant coldness. General heat
during which there is distress. Heat during
which she feels twitching in the limbs.
Sweat of sour smell.[11] Cold at night in
bed. Chilliness and heat alternate, more
evenings, hard pulse.[13]
Skin Slight itching appeared all over body more Skin sensitive. Loose; dry; wilted skin.
on scalp, remained the whole day. Swelling with itching and burning. Red
spots; on hands, on chest, on back.
Herpetic itching burning, red or whitish
spots on a swollen surface.[12] Hard
swelling in the integuments. Swelling with
the tingling. It blisters the skin (locally).
Spots at first white, and which become
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Contd...
negative expectations and/or negative suggestions earache. Similarly, in Unani system of medicine, it
from therapists/clinical staff in the absence of has diuretic effect and has been found to be useful in
any treatment. Nocebo phenomena are generally inflammation, paralysis, pain in the body and joints,
explained by Pavlovian conditioning and expectations troubles of the sleep, liver, and lungs. It clears the
induced by verbal information and suggestions. voice, found to be good for lumbago, chronic fevers,
In this trial also, nocebo phenomenon can be thirst, caries of the teeth, leucoderma, and thins
considered and apart from the individual’s own the blood.[4] In the present study, certain similarities
perception, this can be attributed to the discussion have been found in the symptoms produced and
which usually takes place among the students of also reported in the older homoeopathic literature.
homoeopathic colleges who are the participants in The usefulness of this drug in case of leucoderma,
the study. This poses a limitation as it is difficult to epileptic fits, paralysis, tumors, etc., which is not
keep a check on them for not discussing or sharing found in the present study can be explored further.
the experiences. The massive number of symptoms There are certain other limitations in the study
developed in control group could be considered apart from the nocebo effect such as unbalanced
because of such discussions among the students. randomization allocation, no defined parameters to
Some symptoms of head, skin, nose, extremities, classify characteristic symptoms, and less number of
etc., lasted for many days; this shows that drug provers.
has affinity toward these regions. Some symptoms
appeared immediately after administration of few CONCLUSION
doses such as increased appetite after administration
of 1st dose itself whereas symptoms of head, fever, The pathogenesis of the A. sativum found in this
and weakness appeared after administration of 5 study has produced symptoms which were already
doses or more. Skin symptoms which persisted for noted in the Homoeopathic literature and there
more than 17 days appeared after the administration are many symptoms which are new. The research
of 12th dose. scholars such as postgraduate and PhD students,
who wish to take up research studies on the drug
In Boericke’s Materia Medica,[14] A. sativum has A. sativum, can make this as one of the references and
been mentioned as weight gainer whereas in this take up further studies. These signs and symptoms
proving of A. sativum, although BMI has increased, need to be subjected to clinical verification study for
there is no statistically significant difference in the confirming there therapeutic utility and introducing
homoeopathic group and also in the control group. them in the Homoeopathic Materia Medica and can
Studies have revealed that A. sativum can suppress the be of help to clinicians.
lipopolysaccharide inflammatory signals by generating
an anti‑inflammatory gene expression profile and Acknowledgement
by modifying adipocyte metabolic profile, which is The authors are indebted to Ms. Maya Padmanabhan,
considered in the treatment of obesity.[16] In addition, Statistical Assistant, Central Council for Research in
the studies conducted on mice with S – methyl Homoeopathy, New Delhi for doing the statistical
L – cysteine compound extracted from A. sativum have analysis of the data. The provers who participated in
shown significant reduction in the animal weight.[17] the study are thankfully acknowledged.
Apart from BMI, other physiological parameters were Financial Support and Sponsorship
also compared. Inter‑ and intra‑group analyses were The study has been funded by Central Council
done and difference in the entry and end point was for Research in Homoeopathy, an autonomous
found, though not statistically significant. organization under Ministry of AYUSH, Govt. of
India.
As given in the background of this article regarding
garlic in Ayurvedic context that it is has action on Conflicts of Interest
the digestive system, fattening effects, and it is There are no conflicts of interest.
known to improve appetite, voice, complexion, and
found to be useful in diseases of the eye and the REFERENCES
heart, low fevers, bronchitis, inflammation, piles, 1. Patil DA. Medicinal Plants History, Culture and Usage. 1st ed. Delhi:
leucoderma, asthma, lumbago, tumors, epileptic fits, Mangalam Publications; 2010. p. 24.