homoeopathic management of anxiety disorders with the help o

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HOMOEOPATHIC MANAGEMENT OF ANXIETY

DISORDERS WITH THE HELP OF REPERTORIES

A Dissertation submitted to the

BABA FARID UNIVERSITY OF HEALTH SCIENCES,

FARIDKOT, PUNJAB.

In partial fulfillment of regulations for the award of

Degree Of

DOCTOR OF MEDICINE (HOM.) In

HOMOEOPATHIC REPERTORY

Submitted by

DUSHYANT KAMAL DHARI M.D.(HOM.) EXT. STUDENT

SESSION 2004-2006

Under the able guidance of Dr. V.C. ACHARYA

M.D (Homoeo.)

SRI GURUNANAK DEV HOMOEOPATHIC MEDICAL

COLLEGE & HOSPITAL,

CANAL ROAD, BAREWAL, LUDHIANA. (PUNJAB)

Declaration

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I, Dushyant Kamal Dhari, student of MD (HOM) in

Homoeopathic Repertory of Sri Guru Nanak Dev Homoeopathic

Medical College and Hospital, Canal road, Barewal, Ludhiana

affiliated to Baba Farid University of Health Sciences, Faridkot

hereby declare that the dissertation entitled “ Homoeopathic

Management of Anxiety Disorders with the help of Repertories”

submitted by me is not submitted fully or partially, for the award

of any other Degree or Diploma in this or any other University by

me or copied from any other dissertation work.

I make this statement with the best of my knowledge and ability.

Date: Dushyant Kamal Dhari Place: Jammu. A student of M.D. (HOM)

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ACKNOWLEDGEMENT

It gives me immense pleasure to offer my thanks with gratitude to the following dignitaries who have provided valuable guidance and support, without which this stupendous task would not have come to its proper conclusion. In the first place, my special thanks are due to my revered and honorable guide Dr. V.C. Acharya for his sincere and constant guidance, sharp perceptual scientific suggestions, encouragement and important modifications of my efforts, which enabled me to accomplish this work. Without his supervision and close guidance this work would not have completed. I am indebted to him. I would like to offer thanks full of obligations to Dr. Tejinder pal Singh, Director and Dr. S.C. Chambyal, Principal SGND Homoeopathic Medical college and Hospital, Ludhiana for their special guidance. My thanks are also due to the management, Co-ordinator and the college staff for their gracious cooperation and facilities in college. Thanks with gratitude from the core of my heart are due to my dear parents and friends for providing me all kinds of support. My special thanks are due to my dearest wife Dr. Ranjana Gupta for her moral support & inspiration this degree. She was a valuable support in my good and bad times. I am grateful to little master Ojas, my only son, who was very co-operative with me during my P.G. Course. A work of this level could not have been completed without the blessings from God. Date Dushyant Kamal Dhari. Place: Jammu

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INDEX

TOPICS PAGES INTRODUCTION 1 - 3 AIMS AND OBJECTIVES 4 - 4 REVIEW OF LITERATURE 5 - 148

History & evolution of mental disorders 5 - 6

Anxiety general 7 - 12

Physiology of anxiety 13 - 22

Psychodynamic theories of anxiety 23 - 29

Behavioural & Cognitive theories of anxiety 30 - 32

Anxiety in modern medicine Gen 32 - 33

Panic disorder 34 - 37

Phobic disorders 37 - 39

Obsessive compulsive disorders 39 - 41

Generalised Anxiety disorder 41 - 43

Post traumatic stress disorder 43 - 45

Co-morbid depression 45 - 46

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Anxiety disorders in Homoeopathy 46 - 68

Anxiety in repertory general 68 - 73

Kent’s repertory 74 - 77

Anxiety rubrics in Kent’s repertory 77 - 109

Boenninghausen`s repertory 109 - 114

Anxiety rubrics in BBCR 114 - 130

Anxiety rubrics in other repertories 130 - 148 MATERIALS AND METHODS 149 - 161 CASES 162 - 202 DATA ANALYSIS 203 - 208 DISCUSSION 209 - 211 CONCLUSIONS 212 - 212 BIBILIOGRAPHY 213 - 215 APPENDIX

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INTRODUCTION

Anxiety has been derived from french word ‘anxieté’. It means ‘the

state of feeling nervous or worried that something bad is going to

happen.’

The Oxford handbook of psychiatry defines anxiety as “A normal and

adaptive response to stress and danger which is pathological if

prolonged, severe or out of keeping with the real threat of the external

situation. It has two components: psychic anxiety, which is an affect,

characterised by increased arousal, apprehension, sense of

vulnerability and unpleasant emotional state; and somatic anxiety, in

which there are bodily sensations of palpitations, sweating, dyspnoea,

pallor and abdominal discomfort.”

Anxiety is the most common psychiatric symptom in clinical practice

and anxiety disorders are the commonest disorders found in 15 to 20

percent of patients. These are more common in industrially advanced

countries. Anxiety disorders have harmful effects upon physical and

mental health. They also impair functional ability and quality of life.

The causes of anxiety in modern life are uncertainty, insecurity, time

pressures, relationship problems and fears of inadequacy.

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HOLISTIC APPROACH

The modern medicine lacks a holistic approach in its treatment for the

anxiety disorders. In spite of various advances, the medicines for

anxiety in modern medicine are not curative in nature. A risk of

dependency is also associated with them.

The mind and body work harmoniously in health and in disease. Both

of them are considered as a unit in the treatment of diseases.

Homoeopathy is a holistic science and has a psychosomatic approach

in all diseases. This holistic approach of Homoeopathy gives it an

edge in the treatment of affections of the mind. In the Organon of

medicine, mental diseases are classified and their treatment is

described in detail from aphorism 210 to aphorism 230. Hahnemann

was the first to advocate unchaining of the mental patients. He also

wrote in detail about the psychotherapy for such patients.

The study of anxiety through homoeopathic perspective No one can deny the role of emotions as causative modalities in the

origin and maintenance of innumerable diseases. The provings on

healthy human beings has yielded all kinds of emotions that are

recorded in materia medica.

Anxiety falls in the emotional sphere of mind. In homoeopathy, the

symptoms of emotional sphere are of great importance. While

evaluating the symptoms, they are considered after the “will”

symptoms for the selection of remedy.

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Repertory, as an index to the vast materia medica, helps to narrow

down to the similimum more accurately.

Thus, the importance of the “emotional” symptoms in homoeopathy

and the abundance of “anxiety” patients prompted me to take up

“anxiety disorders” as a topic for my dissertation.

In this attempt of mine, I want to highlight the role of repertories in

particular in the management of anxiety disorders. This study on

anxiety disorders will enlighten me in upgrading my knowledge in the

subjects of materia medica, repertory, clinical medicine and overall

management of anxiety cases.

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AIMS and OBJECTIVES

1. To understand anxiety in detail.

2. To manage anxiety with the help of

Repertory.

3. To prove the utility of Repertory in the

management of anxiety.

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History and evolution of mental disorders

Ancient world – Era of superstitions In ancient times, mental patients were considered to be in possession

of evil spirits. The treatment for possession was exorcism, or the

removal of evil through counter-magic. These practices still prevail in

many parts of the world including India and western countries.

India Atharva-veda has the oldest written documentation about mental

disorders. It describes three mental gunas i.e. Sattva, Rajas & Tamas.

Different psychological disorders are believed to occur due to excess

of Tamas guna. Detailed description & treatment of various disorders

such as Manastap (anxiety), Bhaya (fear), etc. are found in it.

Bhagavad-Gita is probably the first recorded evidence of crisis

intervention psychotherapy.

Greece In ancient Greece (800 B.C), abnormal behaviour was intercepted as

punishment for offences against gods. The treatment took place in

temples of Asclepius, the God of healing.

Hippocrates (460 - 377 B.C.) stressed that mental disorders were

caused by brain dysfunction. He described epilepsy and concluded

that it was due to diseased brain.

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Plato (427 - 347 B.C) saw behaviour as a product of totality of

psychological processes. He believed that disturbed behaviour grew

out of conflicts between emotion and reason.

Galen (130 - 200 A.D.), a Greek physician, taught that psychological

characteristics were expressions of bodily processes influenced by a

balance of the four humors - blood, black bile, yellow bile & phlegm.

The Middle ages During the middle age, contrasting views of mental illness existed.

Saint Augustine (354 - 430 A.D), laid the basis for modern

psychodynamic theories of abnormal behaviour. He wrote about

feelings, mental anguish and human conflict.

The Renaissance Johann Weyer (1525 - 1588), a German physician, emphasised

psychological conflicts and disturbed interpersonal relationships as

causes of mental disorders. He argued for clinical treatment for the

mentally ill rather than religious harassment.

William Cullen coined the term ‘neurosis’ in 1777 replacing, ‘illness

of nerves’ and meaning any disease of the nervous system without a

known organic basis.

Sigmund Freud (1856 - 1939) propounded that psychological factors

played an important role in the causation of mental disorders. He also

highlighted the role of social and cultural factors in causing mental

disorders.

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ANXIETY IN GENERAL

Anxiety Anxiety is a common emotion and often a normal response to new,

stressful, or potentially dangerous situations. In its mild forms, it may

be adaptive. It helps one to perform better. A little anxiety, for

example helps a student to prepare for his exams. In its extreme

forms, it is incapacitating or terrifying. It may cause the same student

to lose his concentration, or even his voice.

Anxiety becomes a problem only when it is abnormally severe,

abnormally prolonged, or if it is present at a level out of proportion to

the real threat of the situation.

Anxiety often arises in anticipation of danger rather than after a

situation has occurred. It is a signal of the approach of danger and a

warning to prepare our defenses. It can also indicate an inability to

cope with danger.

Anxiety is an extremely unpleasant feeling – it can make people feel

frightened, uneasy, unhappy and sometimes desperate. Anxiety

symptoms vary widely and may even imitate severe physical or

mental illness. These symptoms may affect on physical level, thoughts

and emotions and the lifestyle of the individual affected.

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The Physical Symptoms of Anxiety Anxiety may present on physical level as:

Breathing difficulties. Feeling faint / dizzy. Dry mouth.

Shakiness. Pounding heart. Muscle aches & pains.

Headaches. Excessive sweating. ‘Lumps’ in throat.

Bowel and urinary problems. Persistent tiredness

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In addition to these, body postures such as crossed arms, crossed

legs, clenched fists, clenched jaw with tight facial muscles, head bent,

rapid and shallow breathing, frowning / staring expression, and

stooped posture also present a picture of anxiety.

Anxiety Posture

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On the mental level:

Fear of variety of things, people or situations.

Negative or unreasonable ideas about themselves or the feared

situation.

Increased episodes of crying, being irritable, difficult concentration,

worrying and feeling guilty.

Two main reasons for persistent anxiety are avoidance of feared

situations and faulty thinking.

Avoidance: We may avoid situations which we know will cause us

anxiety. As the symptoms caused in a particular situation are

uncomfortable, we avoid facing it, but each time we avoid a situation,

its tendency to cause anxiety in us increases.

Faulty thinking: It includes our negative thoughts and irrational

beliefs. The negative thoughts make us expect the worst, while the

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irrational beliefs, make us expect too much from others or ourselves.

So that leaves us prone to constant disappointment.

The Anxiety trap The lifestyle may be seriously affected by a tendency to avoid

situations or escaping them wherever possible. This involves a lots of

‘NOTS’ and ‘CANT’S’ which make a happy and fulfilled existence

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impossible and leads to a poor quality of life. It also affects

relationships and work performances.

FIGHT \ FLIGHT RESPONSE

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PHYSIOLOGY OF ANXIETY Historical Development Descartes saw the mind & body as different units and noticed the

direct effect of emotions on the body reactions. He proposed that

pineal body was the main mediating centre between the body and the

soul.

The Cannon-Baird theory named thalamus as the centre initiating

emotional reactions. It was held responsible for receiving sensory

information. It also communicated with cortex & body organs to bring

about behavioural changes. Cannon also described the characteristic

‘fight / flight’ stress reaction and the role of sympathetic nervous

system in it. The modern basis of emotional expression in the biology of the brain

began with the work of the American neuroanatomist James Papez.

Papez described an "ensemble of structures" in the lower, subcortical

areas of the brain (as the hypothalamus, the hippocampus and the

amygdala) or the limbic system as brain sites associated with

emotion. He emphasized the role of hypothalamus rather than

thalamus as control centre in initiating emotional response.

Recent evidence highlights the role of genetic influences in the

causation of anxiety disorders. Studies have shown that the prevalence

of anxiety and related disorders is higher among the relatives of

affected subjects than among control families.

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THE BRAIN AND ANXIETY

Recent studies suggest that three brain sites are responsible for

regulating anxiety, i.e. prefrontal area of cortex, amygdala and

hypothalamus in sub cortex.

▪ The higher brain or cortex is responsible for:

Identifying and interpreting stressors and Initiating / coordinating the

voluntary action.

▪ The lower brain or sub cortex is responsible for:

Beginning and controlling states of physiological excitement and for

involuntary homeostatic functions.

When exposed to stress, following processes happen:

▪The cortex first perceives the stressor.

▪The prefrontal cortex is involved in the cognitive evaluation of the

stressor.

▪The subcortical structures are then called into play.

▪The amygdala is responsible for generating the fear response.

▪The hypothalamus regulates the stress response and activates the

autonomic and the endocrine systems. It mediates between these two

systems and is involved with limbic cortex in regulating emotions.

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A cross section of brain.

The Amygdala

The amygdala is believed to serve as a communication hub between

the parts of the brain that process incoming sensory signal and the

parts that interpret them. It signals that a threat is present and triggers

a fear response or anxiety.

Hippocampus

Hippocampus is another brain structure that is responsible for

processing threatening or traumatic stimuli. The hippocampus plays a

key role in the brain by helping to encode information into memories.

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Studies have shown that the hippocampus appears to be smaller in

people who have undergone severe stress because of child abuse or

military combat. This reduced size could help explain why individuals

with PTSD have flashbacks, deficit in clear memory, and fragmented

memory for details of the traumatic event.

The Hypothalamus

The hypothalamus helps the body in controlling body temperature. It

also contains centres involved with hunger and pleasure. Its main

function during stress is to activate and regulate the autonomic and

endocrine systems.

The hypothalamus, on stimulation produces emotional and

behavioural responses, both autonomic and skeletal. Three main

reactions have been observed on experimental stimulation of

hypothalamus. They are Alarm, Flight and Rage.

The two lobes of hypothalamus are concerned with the regulation of

arousal. The anterolateral lobe inhibits sympathetic nervous system

activity and the release of activating hormones from the pituitary. The

posteromedial lobe has the opposite effect.

It has direct links with the pituitary gland, the limbic structures, the

cortex and the thalamus. Neural pathways from hypothalamus also

link it to the brainstem and the spinal cord.

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The Autonomic nervous system and anxiety

It has an important part in instigation and maintenance of appropriate

levels of physiological arousal. It has two main branches –

Sympathetic nervous system (SNS). It is responsible for the ‘stress’

response. During ‘stress’ states, the SNS prepares the individual for

‘fight or flight’ response. The flow of blood from digestive organs is

directed to the fighting muscles and the heart rate increases.

Parasympathetic nervous system (PNS). It is responsible for

‘relaxation’ response. During ‘relaxed’ states, the PNS prepares the

individual for digestion, recuperation and sleep.

The two branches of ANS work partly in concert. While most organs

are under control of both, some sites & symptoms are under the sole

control of SNS, i.e. the sweat glands, lung muscles, blood glucose

levels and the basal metabolic rate. Others, such as the ciliary muscles

of the eye, are under exclusive control of PNS.

Individual responses and ANS

While the SNS is usually predominant during stress, some individuals

may respond to stressors with PNS dominance. It causes a fall in

blood pressure and blood glucose levels. Other symptoms may be cold

sweating, dizziness, reduced respiratory action and fainting.

Lacey proposed that persons do not respond with simple PNS or SNS

dominance under stress. It suggested that individuals might react

strongly on one physiological measure and very little on another.

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The nature of reaction profile might be determined by the total life

experience of the individual as well as genetically determined

physiological factors. Several studies on physiological arousal

patterns in anxiety neurosis have demonstrated consistent sympathetic

hyperactivity.

Anxiety disorders have been correlated with a pattern of raised heart

rate levels, frontalis muscle tension, forearm blood flow, skin

conductance, respiration rates and blood pressure.

Each individual has a base line norm of autonomic arousal, or starting

point. It has been shown that a high baseline norm will lead to a

smaller reaction under stress while a low baseline norm will lead to a

larger reaction.

The Endocrine system and Anxiety This system has an important role in total stress response.

During stress, the ‘master gland’ pituitary is stimulated by

hypothalamus to release several chemical messengers to the slave

glands directly into bloodstream. These include vasopressin,

adrenocorticotrophic hormone (ACTH) and thyrotrophic hormone

(TTH). Vasopressin contracts the arteries and causes the blood

pressure to rise. ACTH and TTH pass on to adrenal and thyroid

glands. They work together to increase circulation and basal metabolic

rates.

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The Adrenal glands

Adrenalin & noradrenalin from medulla and corticoids from cortex

are directly released into blood stream.

Adrenalin stimulates the production of glucose from glycogen in liver.

The glucose is released in blood increasing the carbohydrate

metabolism. It also dilates coronary and skeletal muscle arteries,

increases heart rate, blood volume and body temperature.

Gaseous exchange is facilitated by bronchial dilatation and shallow

breathing results. Smooth (visceral) muscles tend to relax while the

sphincters are constricted. Noradrenalin constricts the peripheral

arterioles and increases blood pressure. It has been suggested that

adrenalin is the major hormone in states of fear while noradrenalin is

predominant in anger. Glucocorticoids from cortex tend to raise blood

sugar levels and inhibit inflammation.

Thyroid gland

Thyrotrophic hormone acts on thyroid causing release of thyroxine.

The rise of thyroxine in stress conditions causes increased sweating,

muscle tremor, heart rate and exaggerated breathing. These effects

are similar to adrenalin. Adrenalin tends to predominate in short term

stress while thyroxine is released in large quantities in prolonged

stress.

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General Adaptation Syndrome

Selye used the term ‘stress’ instead of ‘strain’ in its relation to human

psychophysiology. He coined the term ‘general adaptation

syndrome’ or GAS. GAS has three phases:

Alarm reaction (involving shock and counter shock phases).

Resistance (adaptive response).

Exhaustion.

The Alarm phase: In this phase, mobilization takes place following

the detection of a stressor. The stressor can either be psychological or

physiological in nature. Increase in adrenocortical hormones also

takes place in this phase.

The Resistance phase: It involves selection of an appropriate organ

or system to deal with the particular stressor. Adrenocortical

hormones diminish once a specific system is delegated. All the

internal resources are then directed towards the support of this system,

leaving others susceptible. This may reduce the resistance of the

organism to disease.

The Exhaustion phase: When the system assigned the job becomes

overloaded, the exhaustion phase is reached. At this point, the

adrenocortical hormone levels increase again and the alarm phase is

induced again. A different system may then be delegated to handle the

continuing stress.

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The GAS is useful in mobilising protective resources in emergency

situations. In prolonged situations, it may lower resistance. The

energy for adaptive reaction to stress is provided by suppressing

immune reactions and inflammatory responses to invading pathogens.

It is suggested that the ‘weakest link’ or most vulnerable part of the

body breaks down first under stress. Therefore, factors including

heredity and prior disease may predispose an organism towards a

specific somatic disorder.

Allergies may also be associated with stress. Allergic reactions

involve high levels of inflammatory corticoids for destruction of

pathogens. Under stressful conditions the allergic response may be

aggravated.

Selye based his conclusions on experimental work in which rats were

subjected to prolonged stress. It resulted in drastic body changes

including irreversible organ damage. The rats showed enlargement of

adrenal cortex and atrophy of thymus, spleen and lymph nodes. A

severe reduction of white cells and bleeding ulcers in stomach and

duodenum were observed.

According to Selye, ACTH plays an important role in GAS. In acute

stress, adrenalin and noradrenalin from the adrenal medulla are most

important. In chronic stress the corticoids are the primary agents.

The kidney also plays an important role in GAS, as it is responsible

for maintaining a chemical and water balance in the blood and tissues.

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In chronic stress conditions, when corticoids are raised for a

prolonged period, blood pressure may rise and damage the kidney.

Damage to arteries associated with atherosclerosis may also occur.

Continued stress can produce increased hydrochloride acid secretion

in stomach leading to formation of ulcers.

Selye also added some suggestions on ways of dealing with stress as:

Removal of unnecessary stressors from lifestyle.

Do not allow neutral events to become stressors.

Develop skill in dealing with stressors.

Seek relaxation.

Neurotransmitters and anxiety

The nerve cells communicate with one another with the help of

neurotransmitters. Some of these play a significant role in anxiety and

other psychiatric disorders. Examples of these are noradrenalin,

adrenalin, serotonin, GABA, dopamine, acetylcholine and histamine.

The dysfunction of neurotransmitter activity is the cause of the most

psychiatric disorders. The excessive activity may lead to anxiety and

psychosis while under activity may cause depression.

Recent developments support the view that noradrenalin and serotonin

have a central role in mechanisms underlying anxiety in the central

nervous system.

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PSYCHODYNAMIC THEORIES OF ANXIETY Sigmund Freud is the forerunner of this school of thought. He

defined anxiety as: “a specific state of unpleasure accompanied by

motor discharge along definite pathways.”

Freud postulated that human anxiety is initiated during birth process,

when an infant is expelled from the safe, warm uterine environment

into a potentially dangerous one. This anxiety signal is reproduced in

a modified form, whenever danger recurs, throughout the life.

Defense mechanisms:

According to this theory, anxiety is an indication that something is

disturbing the internal psychological equilibrium. It is a signal to the

ego that an unacceptable drive is pressing for conscious representation

and discharge. This is called signal anxiety. This signal anxiety

arouses the ego to take defensive action to cope up rationally against

the pressures from within.

These defenses serve as disguises through which people hide their

motives and conflicts from themselves as well as from others.

Defenses are used to reduce anxiety arising from ego’s fear of being

completely overwhelmed or destroyed by the power of instincts. Thus

the role of defenses is to preserve the psychological organization and

stability of the individual.

The most important & basic defense is Repression. Ideally, the use of

repression alone should result in restoration of the psychological

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equilibrium. Repression reduces anxiety by keeping anxiety-laden

thoughts and impulses out of person’s consciousness. It is often

described as motivated forgetting. It is directed at both, external

dangers, such as fear arousing events and internal dangers such as

wishes, impulses and emotions that arouse guilt.

If the defenses are successful, the anxiety is dispelled or safely

contained. When repression fails, other secondary defense

mechanisms are called into play. These include denial, displacement,

regression and others. Through these defense mechanisms the drives

achieve a partial expression. This expression is disguised in the

symptoms of hysteria, phobic disorder or obsessive-compulsive

disorder depending on the defense that predominates.

If repression fails to function adequately and secondary defense

mechanisms are not called into play, anxiety is found only as a

symptom. When it rises above the low intensity, characteristic of its

function as a signal, it may emerge with the fury of a panic attack.

Developmental stages Freud believed that people normally progress through the five stages

of psychosexual development. Problems at any stage may retard or

arrest development and have long term effect on the life of the person.

Oral stage:

This is observed during first year of life. The newborn is completely

dependent on others for fulfillment of all his needs. During this stage,

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the body pleasure is centered on the mouth. The baby gets satisfaction

from sucking, eating and biting in the course of feeding.

Anal stage:

It is found in the second year of life. It is characterised by a shift in

body pleasure to the anus. It is reflected by concern with retention and

expulsion of faeces.

Freud felt that during this stage of toilet training, a child has the first

experience with externally imposed control. The pattern of toilet

training may influence the personal qualities and conflicts experienced

by the person in his life. Thus, if a person is subjected to very harsh,

repressive type of training during this period, it may make the person

obsessed with cleanliness during the adult phase.

Phallic stage:

In this stage the child observes the differences between male and

female and experiences what Freud called as Oedipus complex. This

occurs at about five years of age. Freud proposed that children

develop a desire for opposite sex parent and a wish to displace the

same sex parent. This type of attraction leads to serious conflict,

which he termed as Oedipus and Electra complex in boys and girls

respectively. These two complexes were named after two Greek

characters. Oedipus unknowingly killed his father and then married

his mother and Electra induced her brother to kill their mother.

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Latency stage:

This stage follows phallic stage and in this stage there is very little

explicit or overt concern with sexuality. The child represses his or her

memories of infantile sexuality and forbidden sexual activity.

Genital stage:

During this stage the person attains maturity in psychosexual

development. The person becomes capable for genuine love for other

people and can achieve adult sexual satisfaction. He or she may relate

to others in a heterosexual fashion.

The Structure of Personality It refers to a person’s unique and relatively stable qualities that

characterise behaviour patterns across different situations and over a

period of time.

The personality consists of three dynamic structures i.e. Id, Ego and

Superego. They are used as strong psychological forces and not

physical locations in brain.

Id: Desire:

This part of personality deals with immediate gratification of

primitive needs, sexual desires and aggressive impulses. It is totally

unconscious and follows the pleasure principle. Thus, Id seeks the

discharge of tension arising out of biological drives. Its main concern

is ‘need gratification’ in any manner. An infant’s mind is conceived as

all Id.

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Ego: Reason:

It develops out of Id. It works on ‘reality principle’. It tries to

maximise pleasure and minimise pain. The ego emerges in childhood

and is the personality which moderates the desires of Id.

Freud’s concept of dynamic structures of personality.

Super Ego: Conscience:

It deals with the ideals. It represents the societal demands and ideals.

If a person falls short of societal norms & ideals, then superego

creates the feelings of guilt and punishes the person. It provides

judgements on what behaviours are ‘acceptable’ and which are ‘bad’.

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Categories of anxiety

Freud broke down his concept of anxiety into three types: Reality,

Moral and Neurotic anxiety.

All three are involved with the ego’s response to actual, or potential,

helplessness when threatened with overwhelming psychic danger. The

function of ego is of mediation between instinctual demands to ensure

that some gratification is achieved, while still preserving its own

integrity. If such an outcome becomes impossible, pathological

anxiety results.

The reality anxiety is due to real external threat. In this the ego’s aim

is to expedite the gratification of instincts without making the

organism vulnerable to anger, e.g. ‘I must have / do this, but I must

avoid having physical harm in the process’. If the ego is uncertain

how to achieve this aim, fear related anxiety results.

The moral anxiety is due to id-superego conflict. In this the ego’s

aim is to preserve its sense of its own goodness while at the same time

placating the instincts, e.g. ‘If I am good and worthy, I cannot allow

myself to have / do this’. Shame / guilt related anxiety results if ego

fails to meet the moral demands of the superego.

The neurotic anxiety is due to id- ego conflict. In this the ego’s aim

is to protect its own identity and structure while an uncharacteristic

and powerful instinctual drive threatens to overwhelm it, e.g. ‘I long

to have / do this, but I cannot allow myself to perceive that I am the

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one who has/ does this’. Neurotic anxiety results when ego cannot

satisfy these conflicting aims.

Freud writes that, “In some cases the characteristics of reality anxiety

and neurotic anxiety are mingled. The danger is known and real but

the anxiety in regard to it is over-great, greater than seems proper to

us.”

While differentiating neurosis from psychosis, he says that for

neurosis the decisive factor would be the predominance of the

influence of reality, whereas for psychosis, a loss of reality would

necessarily be present.

BEHAVIOURAL AND COGNITIVE THEORIES OF ANXIETY

Behavioural theory John Watson, the father of behaviourism, proposed that neuroses

arouse out of traumatic learning situations and then persist to

influence behaviour throughout life.

‘Stimulus – response’ concept of anxiety, which emerged from this,

posits that certain stimuli when associated with fear could show up an

anxiety response. For e.g. if a dog bites a child, the child will respond

with anxiety the next time he sees a dog. This response will occur

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even if the dog does not actually bite him again. Thus anxiety has a

protective function here. This anxiety could become a reaction to a

danger signal that was recognised to forebode a harmful situation.

So, anxiety is viewed as an unconditioned inherent response of the

organism to painful or dangerous stimuli. In anxiety and phobias, this

becomes attached to relatively neutral stimuli by conditioning.

Systematic desensitization: The principle of reciprocal inhibition

(i.e. anxiety and relaxation cannot coexist) is the core of this.

Systematic graded exposure to the source of anxiety is coupled with

the use of relaxation techniques (the ‘desensitisation’ component).

Flooding/implosive therapy: The high levels of anxiety cannot be

maintained for long periods, and a process of ‘exhaustion’ occurs. By

exposing the patient to the phobic object and preventing the usual

escape or avoidance, there is extinction of the usual anxiety response.

Anxiety and Cognitive performance

The cognitive model of anxiety postulates that anxious individuals

invariably exaggerate the level of threat in a given situation. So, there

is evidence of selective information processing (with more attention

paid to threat related information), negative automatic thoughts and

perception of decreased control over internal and external stimuli.

Cognitive behavioural modification or CBM developed from this

approach helps in treatment of anxiety resulting from inadequate

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coping skills. It aims to ‘change the way you feel, by changing the

way you think’.

Anxiety and rational thinking

Albert Ellis developed a treatment technique based on rational

thinking in 1955. Several research studies have confirmed the

relationship between anxiety and negative / irrational thinking.

The RET (Rational emotive therapy) belief holds that individual’s

own thoughts and beliefs about difficulties create negative emotions

as anxiety. The individual’s reaction towards a situation is based on

his set of beliefs and attitudes. So, the patients are taught to identify,

challenge, and change their irrational beliefs which maintain and

justify their anxiety. After all, anxiety, by definition is not attributable

to sources of real danger and is as such irrational.

ANXIETY IN MODERN MEDICINE Anxiety, defined as a subjective sense of unease, dread, or foreboding,

can indicate a primary psychiatric condition or can be a component of,

or reaction to, a primary medical disease.

Anxiety has two components:

▪ Psychic anxiety – an unpleasant affect in which there is subjective

tension, increased arousal and fearful apprehension; and

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▪ Somatic anxiety – bodily sensations of palpitations, sweating,

dyspnoea, pallor and abdominal discomfort. The sensations of anxiety

are related to autonomic arousal and cognitive appraisal of threat

which are adaptive primitive survival reactions.

The primary anxiety disorders are classified according to their

duration and course and the existence and nature of precipitants.

The national prevalence rates of anxiety disorders in India are 15 per

1000 for rural and 16 per 1000 for the urban population.

When evaluating the anxious patient, the clinician must first establish

whether the anxiety antedates or postdates a medical illness or is due

to a medication side effect.

Anxiety symptoms may be present at a more or less constant level –

generalized anxiety; or may occur only episodically – panic attacks.

Anxiety symptoms may or may not have an identifiable stimulus.

Where a stimulus can be identified it may be very specific, as in

simple phobia (e.g. fear of cats or spider); or may be more

generalised, as in social phobia and agoraphobia. In phobias of all

kinds there is avoidance of the feared situation. As this avoidance is

followed by a reduction in unpleasant symptoms, it is reinforced and

is liable to be repeated.

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The repetition of behaviours in order to achieve reduction in the

experience of anxiety is also seen in the symptoms of obsessions and

compulsions. Here, the patient regards the thoughts (obsessions) and/

or actions (compulsions) as purposeless, but is unable to resist

thinking about them or carrying them out. Resistance to their

performance produces rising anxiety levels, which are diminished by

repeating the resisted behaviour.

PANIC DISORDER:

‘Panic’ derives its meaning from the Greek god ‘Pan’ who was in the

habit of frightening humans and animals ‘out of the blue’.

Panic attack: It is a period of intense fear characterized by a group of

symptoms (given below) that develop rapidly, reach a peak intensity

in about 10 minutes, and generally do not last longer than 20-30 min

(rarely over 1 hr). Attacks may be either spontaneous (‘out of blue’)

or situational (usually where attacks have occurred previously).

Sometimes attacks may occur during sleep (nocturnal panic attacks),

and rarely, physiological symptoms of anxiety may occur without

psychological component (non-fearful panic attacks).

Panic disorder: The recurrent panic attacks, which are not secondary

to substance misuse, medical conditions, or another psychiatric

condition. There are distinct episodes of intense fear and discomfort

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associated with a variety of physical symptoms. The frequency of

occurrence may vary from many attacks a day, to only a few attacks a

year. There is usually the persistent worry of having another attack or

the consequences of attack (which may lead to phobic avoidance of

places or situations) and significant behavioural changes related to

attack.

Epidemiology: In India the prevalence rate of panic disorder in

psychiatry clinics is around 3 %. Panic disorder without agoraphobia

is more or less equal among males and females, but panic disorder

with agoraphobia is more among females. It develops in early

adulthood, the mean age of onset being around 25 years.

Aetiology and Psychopathology:

The exact etiology of panic disorder is unknown but appears to

involve a genetic predisposition, altered autonomic responsivity, and

social learning. Panic disorder has a moderate heritability of around

30 – 40 %. Most studies suggest that vulnerability is genetically

determined, but critical stressors are required to develop clinical

symptoms.

Intravenous infusion of sodium lactate can evoke an attack in about

two-thirds of the panic disorder patients, as do yohimbine and carbon

dioxide inhalation.

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Neuroanatomical model of aetiology suggests that panic attacks are

mediated by ‘fear network’ in brain that involves the amygdale, the

hypothalamus and the brain stem centres.

Psychoanalytic model suggests that panic attacks are the

consequences of parental deprivation in early childhood.

Clinical features:

The diagnosis of panic disorder is based on the following criteria:-

A separate period of intense fear or discomfort in which four (or

more) of the following symptoms are developed abruptly and reach

the peak within 10 minutes (in order of frequency of occurrence):

1. Palpitations, pounding heart, or accelerated heart rate.

2. Sweating. 3. Trembling or shaking.

4. Sense of shortness of breath or smothering.

5. Feeling of choking. 6. Chest pain or discomfort

.7. Nausea or abdominal discomfort.

8. Feeling dizzy, unsteady, light-headed, or faint.

9. Derealisation (feelings of unreality) or depersonalization (being

detached from oneself).

10. Fear of losing control or going crazy. 11. Fear of dying.

12. Paresthesia (numbness or tingling sensations).

13. Chills or hot flushes.

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In some individuals, anticipatory anxiety develops over time and

results in a generalized fear and a progressive avoidance of places or

situations in which a panic attack might recur.

Researches suggest that individuals with panic disorder had a

significantly higher rate of supporting gastrointestinal symptoms,

including those typically associated with irritable bowel syndrome,

than those with other or no psychiatric diagnosis.

Differential Diagnosis:

A wide variety of conditions can present as panic disorder.

a. Substance or alcohol misuse / withdrawal.

b. Mood disorders/other psychiatric disorders secondary to medical

conditions.

C.Medical conditions presenting with similar conditions e.g.

hyperthyroidism, hypoglycaemia, anaemia, mitral valve prolapse,

atrial tachycardia, coronary heart disease, epilepsy, asthma etc. PHOBIC DISORDERS:

A phobia is a marked and persistent fear resulting in conscious

avoidance of a specific feared object, activity or a situation. The

patient avoids the phobic stimulus, and this avoidance usually impairs

his occupational or social functioning. The affected individual is

aware that the experienced fear is excessive and unreasonable to the

given circumstances, but cannot help it

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Agoraphobia is the fear of public places; the patient tries his best to

avoid such places or situations where escape may be difficult. The

patient avoids crowds, public places, traveling away from home or

alone. Agoraphobia is usually associated with panic disorder, but

there exists a subgroup without panic disorder.

Social phobia is the specific fear of social or performance situations

in which the individual is exposed to unfamiliar individuals or to

possible examination and evaluation by others. This is different from

agoraphobia where the patient is not bothered about the reaction of

other people. Examples include having to converse at a party, use

public restrooms, and meet strangers.

Simple phobias are specific phobias not covered by social phobia and

agoraphobia. It is further sub-divided into five types: animals, aspects

of natural environment, blood/ injection/ injury, situational and

‘other’. Common examples of simple phobia are fear of heights, fear

of closed spaces (claustrophobia), fear of flying, fear of animals, fear

of lightning and thunderstorm, fear of darkness, fear of blood, fear of

crossing streets, etc.


Both genetic and environmental factors play a role in the aetiology.

According to psychoanalysis school, phobias are the result of

traumatic experiences in childhood such as separation anxiety

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(separation from mother) and unconscious conflict, which has been

repressed and displaced into phobic symptoms. The unconscious

anxiety is displaced to a neutral object or activity or situation.

Clinical Manifestations:

Onset is typically in childhood to early adulthood. The cardinal feature

of phobic disorders is severe anxiety when the patient is exposed to

specific object or situation or activity. Both mental and somatic

symptoms of anxiety are present.

To prevent the onset of anxiety, the patient avoids these objects or

situations or activities. Most of the patients are able to live normal

lives in spite of the phobic disorder because the phobic object or

situation or activity is easily avoidable, but this avoidance usually

impairs occupational or social functioning.

Panic attacks may be triggered by the phobic stimulus or may emerge

spontaneously during the course of the illness. To get relief from

anxiety, the patient may resort to abuse of alcohol or drugs. He may

also develop features of depression. OBSESSIVE-COMPULSIVE DISORDER (OCD)

Obsessions are persistent, recurring ideas accompanied by a

subjective feeling of compulsion which the patient tries to resist but

cannot get rid of.

Compulsions are irresistible urges to carry out irrational activities.

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The patient knows about the irrationality of these obsessions and

compulsions, but cannot prevent them. When he tries, the emotional

tension mounts and he becomes miserable and exhausted.

These obsessions and compulsions restrict the social activities and

interpersonal relationships of the patient.

Epidemiology:

About 1 % of the patients attending a psychiatry clinic may have this

disorder. The peak age of onset is around early adulthood, and both

males and females are equally affected.


Though some genetic or constitutional factors may be involved in

production of an obsessive type of personality, environmental factors

are of primary importance in the causation of the symptoms. It often

has a sudden onset (e.g. after stressful ‘loss’ event).

According to psychoanalysis school, patients with obsessive

compulsive disorder have a disturbed development commonly around

the anal phase of psychosexual development. Anxiety associated with

sexuality is displaced to neutral ideas or acts.

Neuroimaging studies have demonstrated a decrease in caudate

nucleus volume and abnormalities in frontal lobe white matter. The

caudate nucleus seems particularly involved in the acquisition and

maintenance of habit and skill learning.

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Patients with obsessive compulsive disorder usually have a particular

type of personality which is characterized by ritualistic, rigid,

perfectionist and meticulous tendencies. Patients often conceal their

symptoms, usually because they are embarrassed by the content of

their thoughts or the nature of their actions. Specific questions

regarding recurrent thoughts and behaviors are to be asked,

particularly if physical clues such as chafed and reddened hands or

patchy hair loss (from repetitive hair pulling) are present. Tics are

sometimes associated with OCD.

In all cases, obsessive-compulsive behaviors take up more than 1 hour

per day & are undertaken to relieve the anxiety triggered by the core

fear.

There are four major symptom patterns.

▪Most common one is an obsession of contamination followed by

washing.

▪Second most common is obsession of doubt followed by a

compulsion of checking.

▪Third form is one with merely intrusive obsessive thoughts without a

compulsion. Such obsessions are usually repetitious thoughts of some

sexual or aggressive act that is reprehensible to the patient.

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▪Fourthly, there is obsessional slowness in which the obsession and

compulsion seem to be united into slow carrying out of daily

activities. Such patients can take hours in bathing, eating, shaving etc.

Most of the patients show features of depression because of the

inconvenience and embarrassment caused by the symptoms. The

patient realizes that the above symptoms are irrational, but cannot

prevent them. GENERALISED ANXIETY DISORDER (GAD)

This is a chronic (longer than 6 months) disorder characterized by

excessive anxiety and worry about various life circumstances. Patients

who have generalized anxiety disorder are pathologically anxious

about everything. They are generally mistrustful of their own general

level of competence and basic merit. They have a low threshold for

anxiety and find it difficult to handle even the normal anxiety-

provoking situations.

Epidemiology:

It is estimated that about 2 % of the general population suffer from

generalized anxiety disorder. Onset is usually before age 20, the peak

age group is 20-25 years. A history of childhood fears and social

inhibition may be present. Women are more prone.


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Though there may be genetic predisposition to develop this disorder,

environmental factors are more important in the aetiology of GAD.

Emotional conflicts in early childhood interfere with normal

development of personality, especially when there is genetic

predisposition. When this abnormal personality is confronted with the

everyday stresses of life, the defense mechanisms which are used to

anxiety normally become inadequate and fail.

Clinical features:

Patients with generalized anxiety disorder have persistent, excessive,

and/or unrealistic worry associated with other signs and symptoms,

which commonly include muscle tension, impaired concentration,

autonomic arousal, feeling "on edge" or restless, and sleep

disturbances. Patients with GAD readily admit to worrying

excessively over minor matters with clinically significant distress or

impairment in social, occupational or other areas of functioning.

The common symptoms are palpitation, trembling / shaking, excessive

sweating, and dryness of mouth, breathlessness, chest pain, abdominal

pain, headache, and heaviness of head, dizziness and unsteadiness,

frequency of micturition, diarrhoea and disturbances of sleep.

Other general symptoms include hot flushes / cold chills; numbness or

tingling sensations.

Common Signs are: Elevation of blood pressure, tachycardia,

increased respiratory rate and sweating etc.

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A person with GAD has tense, anxious, apprehensive appearance.

Increased muscular tension is shown in his facial expression, and it

produces tremors and aches in various parts of the body. He is

irritable, forgetful, and complains of tiredness and lack of

concentration. The person finds it difficult to control the worry.

Differential diagnosis:

Thyrotoxicosis has to be ruled out. Thyroid swelling, exophthalmia,

and abnormal thyroid function tests suggest thyrotoxicosis.

Cold and moist hands are common in GAD in contrast to warm and

moist hands in thyrotoxicosis. POST TRAUMATIC STRESS DISORDER (PTSD)

This condition develops in persons who have experienced extremely

traumatic emotional or physical stress with either actual or threatened

death or injury to oneself or another. Such traumas include combat

experience, natural catastrophes such as earthquake, rape, and

disasters such as fires in buildings. In World War 1, the syndrome was

called ‘shell shock’. Similar features were observed in survivors of

Nazi concentration camps & atomic bombings of Japan in the Second

World War.

Epidemiology:

More than 50 % of the survivors of a disaster can develop PTSD.

Women are more vulnerable. Though it can occur in any age group, it

is most prevalent in young adults.

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Aetiology:

Many factors can precipitate this disorder. The most important one is

the stressor. The other factor is the personality characteristics of high

neuroticism and extroversion of the subject. The third factor is social

support. When there is strong social support, an individual may not

break down even when there is major stress.

Risk factors include a past or family history of psychiatric problems,

low education and previous traumatic events (including childhood

experiences).


There is a triad of symptoms in this disorder. These are:

Re-experiencing of the trauma through dreams and waking thoughts.

Emotional numbing to other life experiences

Associated features of autonomic instability, depressive ideas, poor

concentration and panic attacks.

These disturbances cause clinically significant distress or impairment

in social, occupational, or other areas of functioning.

These above symptoms have to be present for at least one month for a

diagnosis of PTSD to be made.

Patients often actively avoid stimuli that precipitate recollections of

the trauma and demonstrate a resulting increase in vigilance, arousal,

and startle response. Patients with stress disorders are at increased risk

for the development of other anxiety, mood and substance-related

disorders

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ANXIETY DISORDERS COMORBID WITH DEPRESSION

Anxiety is closely related to depression. In a clinical situation, the

symptoms are often difficult to differentiate. In a meta-analysis, the

prevalence of anxiety disorder in patients with depression has been

estimated at 57 %. A new diagnostic category – ‘mixed anxiety-

depression’ is being proposed for further study.

Anxiety far more commonly precedes depression than vice versa and

that particular episodes of depression may begin with anxiety

symptoms. Social anxiety disorder and simple phobia are more likely

to precede depression. The comorbidity of depression and anxiety has

been associated with more severe symptoms and worse prognosis.

A classical theoretical distinction is that anxiety is associated with

‘helplessness’ while depression is characterised by ‘hopelessness’.

Also uncertainty about the ability to control important outcomes may

be associated with anxiety, whereas helplessness together with

certainty about negative outcome may be associated with depression.

Furthermore, anxiety disorders are characterized by anxiety / fears

about future events and avoidant behaviour, whereas depression

involves loss of pleasure and thoughts about past events.

Anxiety involves an attentional bias for threatening information. Thus,

when given both threatening & non-threatening cues, anxious patients

attend selectively to threatening cues. On the other hand, depression

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involves a memory bias, with depressed subjects showing bias to

recall negative information, particularly when it is self referential.

ANXIETY DISORDERS AND HOMOEOPATHY Mental health is a growing area of concern in our society and times. It

needs to be understood and treated on an individual level. Every

person is unique and has his life story full of joys, disappointments,

and vicissitudes of life in some shape or form.

Homoeopathy is defined as a system of drug-therapeutics based on the

law of similars. This law states that ‘a drug, acts as a curative agent

when it is capable of producing in a healthy person a diseased-state

exactly similar to that observed in a diseased person.’ As drug

provings show that the actions of a drug manifest themselves on the

body and the mind. So that, in every fully proved drug picture, there

are corporeal symptoms along with alterations of thoughts, feelings,

affections and intellect, memory etc.

The successful application of law of similars depends upon the

concept of individualization and susceptible constitutions. The

concept of individualization takes into consideration the total response

of the organism to the unfavorable environment.

This unfavorable response is seen through signs and symptoms on

three planes: Emotional, Intellectual and Physical, where the life

force manifests itself.

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On this emotional level arise anxiety, anger, anguish, irritability, fears,

phobias, depression and many emotions.

Emotionally disturbed states tend to revolve around the issues of

personal comfort, personal survival and personal expression.

Emotions as maintaining causes

When a patient has some harmful emotions, these emotions may act as

maintaining causes for illness. The homoeopathic medicines boost the

energy of a person to adapt with the energy of his own emotions and

as a result to cope with varying types of environments.

The physician is the best person for this because the patient can talk

freely with the physician. Also the physician can better understand the

emotional problems and co-relate them better with the physical

problems. The physician also has to evaluate that whether the anxiety

is reasonable to circumstances or the patient is over-anxious.

General treatment of mental diseases

During Hahnemann`s time, mental asylums were usually run in

connection with prisons. The mentally ill were crowded in close

quarters with insufficient food, were chained, flogged and teased for

the amusement of visitors. The physicians also abandoned them

believing that insanity was contagious.

Hahnemann founded an asylum in Georgenthal where Duke Ernst of

Gotha put one of the wings of his castle at Hahnemann`s disposal in

1792. He had only one patient Klockenbring from the beginning to the

end. Klockenbring was cured of his illness. Hahnemann evolved a

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humane approach to mentally sick patients. He advocated unchaining

of the mental patients. His principles for treatment of insane were new

to the psychiatry of that time, but are today universally acknowledged

as the chief factor in the treatment of insane. He introduced treatment

to the mentally sick patient with kindness.

While describing his experience on the treatment of insane, he writes

– “I never allow any insane person to be punished by blows or other

painful corporeal inflictions, since there can be no punishment where

there is no sense of responsibility, and since such patients only

deserve our pity and cannot be improved, but must be rendered worse

by such rough treatment.”

He further instructs the physicians attending the mental patients as –

“The physician of such unfortunate creatures ought to behave so as to

inspire them with respect and at the same time with confidence; he

should never feel offended at what they do, for an irrational person

can give no offence. The exhibition of their unreasonable anger

should only excite his sympathy and stimulate his philanthropy to

relieve their sad condition.”

Ahead of times, as Hahnemann was, he has coded some ethical

approach to mental patients, which he describes in § 228 of the

Organon.

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Herein, in addition to Antipsoric treatment, he stresses upon

psychotherapy with regulated mode of life and instructions for a good

behaviour towards the patients by physician and attendants as:

▪ Raving madness should be met by calm fearlessness & firm

resolution.

▪ Painfully disconsolate melancholy should be assuaged by silent

compassion expressed through gestures and looks.

▪ Loquacity should be listened to in silence.

▪ Indecent behaviour and obscene languages are to be totally ignored.

▪ In destructive mental tendencies, things should be kept out of reach

of the patient to prevent mischief.

▪ Absolute avoidance of torture and other corporeal punishments.

▪ All exciting factors, which may influence the mind of the patient,

should be removed.

▪ Contradiction, arguments, rude correction etc. are to be avoided.

▪ The physician and the attendant should pretend to believe the patient

in everything.

In the footnote to § 229, Hahnemann also recommends that the

treatment of violent insane maniac and melancholic patients can take

place only in an institution specially arranged for their treatment, but

not within the family circle of the patient. He believed that the patient

must be left alone and must not be excited or distracted by other

people; as this hindered his recovery.

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Hahnemann on mental diseases

Hahnemann describes mental diseases under One-sided diseases.

In §172 he writes, “A similar difficulty in the way of cure occurs from

the symptoms of the disease being too few – a circumstance that

deserves our careful attention, for by its removal almost all the

difficulties that can lie in the way of this most perfect of all possible

modes of treatment (except that its apparatus of known homoeopathic

medicines is still incomplete) are removed.”

Mental diseases are one-sided diseases affecting the whole

psychosomatic entity where the symptoms of derangement of mind

and disposition are increased while the physical symptoms decline.

§ 210- 230

The § 210 to 230 of the Organon describe in detail different types of

mental diseases and their treatment.

In §210, he attributes Psora as the cause of one-sided diseases and

mental diseases are also a part of it. He stresses for psychic condition

of the patient to be noted along with the totality of symptoms in order

to treat these successfully with homoeopathic medicines.

In § 211, he stresses the importance of the psychic condition of the

patient in selection of a remedy, putting them as characteristic

symptoms and these cannot remain hidden from a careful physician.

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In § 212, he highlights the fact that medicinal substances alter the

mind and disposition of the provers during its proving and every

medicine does so in a different manner.

In § 213, he advises to pay attention to mental symptoms even in

acute cases and that unless the mental and emotional picture does not

match with the remedy, positive results are not possible.

He explains this in the footnote of § 213 as “Thus Aconite will

seldom or never effect either a rapid or permanent cure in a patient of

a quiet, calm, equable disposition; and just as little will Nux vomica

be serviceable where the disposition is mild and phlegmatic, Pulsatilla

where it is happy, gay and obstinate, or Ignatia where it is

imperturbable and disposed neither to be frightened nor vexed.”

In § 214, he starts to tell us that a patient with a mental-emotional

disease must be perceived the same way as other patients i.e. with a

remedy, a disease agent capable of producing in body and psyche of

healthy people symptoms as similar as possible as those of the case.

In § 215, he specifies that most mental and emotional diseases are

extensions of physical disease. So in the mental disease it starts on the

physical level, and then slowly it progresses into the mental level until

you have almost no more symptoms of the physical level and finally

the disease transfers itself (almost like a local malady) to the invisibly

subtle mental and emotional organs.

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CLASSIFICATION OF MENTAL DISEASES: -

Hahnemann has arranged mental diseases into following four types: -

1. Mental diseases appearing with the decline of corporeal disease

which threatens to be fatal --- Somato - Psychic.

Hahnemann refers this type of mental disease in § 216.

In this type of diseases there is quick and dramatic transference of

physical disease, becoming mental disease. In this type of mental

disease, the so-called physical disease declines with a rapid increase

of the psychic symptoms.

Finally, the physical symptoms become insignificant and improve

almost to perfect health and the person is no more in the danger of

death.

So in this way, the physicals or the affections of grosser corporeal

organs become transferred to the spiritual, mental and emotional

organs.

Examples: - A suppuration of lungs gets transferred into insanity.

2. Mental diseases appearing suddenly as an acute disease in

patient’s ordinary calm state caused by some exciting factor: -

Hahnemann refers to this type of mental disease in § 221. In this type

of diseases, an insanity or frenzy that suddenly breaks out as an acute

disease from the patient's usually quiet state may be occasioned by

fright, vexation, drinking alcohol, etc., but it almost without exception

springs from internal Psora.

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He further says that during acute phases deep acting remedies are not

needed but mainly the remedy that corresponds to the acute picture

only. So, it must first be treated with medicines such as Aconite,

Belladonna, Stramonium, Hyoscyamus, etc. in a high potency. This

will control the acute flare-up to such an extent that the Psora returns

to its previous, almost latent state, whereupon the patient appears to

recover.

3. Mental diseases of doubtful origin: -

Hahnemann refers to this type in § 224.

In this he refers to certain type of mental diseases where it is difficult

to ascertain the cause of them. It is not sure here whether these

diseases are from physical affections or some psychological factors.

Various causes proposed by Hahnemann are fault of education, bad

practices, and corrupt morals, neglect of mind, superstition or

ignorance.

4. Mental diseases arising from prolonged emotional causes –

Psycho-Somatic: -

Hahnemann refers this type to § 225.

In comparison with the first type of diseases, there are few emotional

diseases that have not developed from physical diseases. These

diseases originate from emotional causes such as: Persistent anxiety,

worry, vexation, abuse, frequent fear and fright. This is in contrast to

the first type. In this the body is little affected in the beginning but as

the disease progresses, it affects the physical health to a great degree.

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While Hahnemann did not make a difference between psychosis and

neurosis, he differentiated between physical disease extending into

mental disease or Somato-psychic disease and a psychological

condition extending into physical disease or Psycho-somatic disease.

TREATMENT OF MENTAL DISEASES: -

Hahnemann had no other aim in sight except to cure. He challenged

the theories of the treatment of disease of his time.

He taught us that the remedies should be chosen according to the

symptoms of the patient and that physician should always be governed

by what is certain and safe, not by that which is more or less uncertain

and unsafe.

He further instructs that because a remedy has helped us before this is

no reason why it should help again in a similar disease i.e. the

symptoms of the patient and not the name of the disease are to point

out the remedy. He, as an experimenter laid the foundation for a

scientific medicine which had no scope for speculations and opinions.

A. Mental diseases arising from physical diseases: -

In the § 217, 218, 219 & 220 Hahnemann describes the treatment for

these mental diseases.

In § 217, he stresses that totality of the case should be taken into

consideration with importance being given to the mental and

emotional symptoms.

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Sometimes, in a mental disease, it could be a very strong physical

symptom that will be your chief symptom to find the remedy. That is

why a complete case is needed, to match a remedy on the physical as

well as mental and emotional levels.

He further guides in § 218 about the evolution of disease from

physical to mental level, to be studied. For this, the accurate

description of the entire phenomenon of the previous corporeal

diseases before it degenerated into a one-sided mental disorder should

be learned from the patient’s attendants.

In § 219, the remaining symptoms of the physical plane or the

physical symptoms present during the remission of mental / emotional

state are to be used to complete the physical picture of the disease.

In § 220, Hahnemann recommends that the physician should

accurately observe the present mental and emotional symptoms of the

patient and attendant’s observations are added to it. In this way, the

complete picture of the disease is constructed. The medicine is

selected on the above basis and it should be a strong Antipsoric

remedy.

B. Mental diseases appearing suddenly: -

These cases should be firstly treated acute medicines such as Aconite,

Belladonna, Hyoscyamus and Stramonium in potentised form that

have similar states in their proving.

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In § 222, he emphasizes that after the acute state has subsided, these

patients should never be regarded as cured. It should be followed up

by anti-psoric treatment in order to prevent its recurrence.

In § 223, he warns that if this Antipsoric treatment is not done, then a

worse attack from a much slighter cause is bound to follow and this

will be more difficult to cure.

C. Mental diseases of doubtful origin.

In § 224, Hahnemann provides us with a method of distinguishing the

cause of the disease as follows:

A. If the mental affection is based on psychological causes, it will

diminish and improve by “sensible, friendly exhortations, consolatory

arguments, serious representations and sensible advice.”

B. If the mental malady is dependant on some bodily disease, it would

be aggravated by the same measures. Thus, depressive type of patients

will be still more depressed, plaintive, disconsolate & retiring; the

maniac type would become more embittered; the silly prattler will

become more foolish than ever.

If the cause of mental affection is of psychic origin, then the treatment

should be as per the treatment of Psycho-somatic diseases.

If the cause of mental affection is of bodily origin, then the treatment

is same as per the Somato-psychic diseases.

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D. Mental disease arising from prolonged emotional causes –

Psychosomatic.

In § 226 he describes the treatment for these mental affections which

are of psychic origin. For these he recommends

▪ Psychotherapy. He writes that these types of mental affections may

be rapidly changed into a healthy state of mind by psychical remedies

such as display of confidence, friendly exhortations, and sensible

advice, often with a well disguised deception.

▪ Appropriate diet and regimen ▪ Antipsoric treatment

He also tells us that if the psycho-somatic diseases are not cared for in

its milder form then it will progress into serious physical diseases.

In § 227, he again stresses upon Psora being the fundamental cause in

mental diseases and that these patients should be treated with

Antipsorics at the earliest to prevent recurrence.

In § 228, Hahnemann also describes the mode of administration of

homoeopathic medicines. He recommends that medicines are to be

administered to the patient without his knowledge in his drink so that

all compulsion is unnecessary. As the small dose of the medicine does

not upset the taste, it is easy.

In the footnote to § 228, Hahnemann also wonders at the

hardheartedness of contemporary doctors, who, without attempting to

discover the efficacious mode of homoeopathic treatment are content

with cruel some methods of treatment for the mentally sick.

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In § 229, he discusses the importance of psycho-social and physical

environment needed to help the patient to recover. He advocates

removal of all kinds of external disturbing influences on the senses

and dispositions of the patients.

In § 230, he confidently asserts from great experience, the superiority

of homoeopathic system of medicine over other systems and

emphasizes that only through homoeopathy cure of these patients is

possible.

At a time when insanity was believed to contagious & incurable,

Hahnemann was first to assert the curability of mental illness. He

differentiated organic from functional mental illness. He advocated

early treatment of these and with non-violent methods. He inculcated

on the mental symptoms for completing the totality of a case and left

us with numerous remedies that work just as well as they did in his

days.

HOMOEOPATHIC APPROACH TO MENTAL DISEASES:

Homoeopathy considers disease as an affection of both mind and

body. As existence of life is not possible with mind and body

separately, involvement of it is also not possible individually.

Nevertheless, each affection of vital force is manifested by a set of

physical and mental symptoms. Health is considered as a state of

harmony of sensations and functions of both physique and mind.

Even in case of a drug proving, we get series of symptoms in mind

and body. The provings on healthy human beings has yielded

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variegated symptomatology at three levels - physical, mental and

spiritual.

CASE TAKING

Case taking should be more careful in one-sided diseases. In cases of

mental disease, an effort should be made to locate any physical

symptom or involvement of any other part of body.

Some of the physical symptoms may appear quite vague and trivial,

but it is more important to build up the totality. Like, in disease on a

physical plane, any mental symptoms should be given maximum

importance and vice versa.

MIASMS AND ANXIETY DISORDERS

The term miasm comes from the Greek word ‘miasma’, meaning

‘pollution, taint’. In general ‘miasm’ means – a heavy vaporous

exhalation formerly believed to cause disease; obnoxious influence or

atmosphere; polluted material; putrid vegetable matter.

Hahnemann observed that though the acute diseases were rapidly and

completely cured by medicines but chronic diseases always had a

tendency to replace in a more or less varied form with new symptoms.

This he stated as “Its start was pleasing, the continuation less

favorable, and the outcome hopeless.”

After prolonged observations and laborious experimentations for

twelve years (1816 – 1828), he realized the obstacles to cure in the

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chronic diseases. He attributed the origin of all chronic diseases to

chronic Miasms, namely

PSORA – the non – venereal miasm and

SYCOSIS and SYPHILIS – the venereal miasms.

Each miasm produces its own characteristic symptoms on the human

body and these must be recognised to be able to remove them

accordingly.

PSORA – The Universal Miasm

According to Hahnemann, Psora is the only fundamental cause and

producer of all (acute and chronic) diseases of non-venereal nature. It

is the most ancient miasm which produces seven-eights of all chronic

diseases. It is the most infectious of all chronic miasms. This lead him

to declare, “Psora is that most ancient, most universal, and most

destructive and yet most misapprehended chronic miasmatic disease

which for many thousand years has disfigured and tortured

mankind…”

Hahnemann writes in ‘Chronic Diseases’ “-- diseases of the mind and

of the soul, from imbecility up to ecstasy, from melancholy up to

raging insanity – in short, thousands of tedious ailments of humanity

called by pathology by various names, are, with few exceptions, true

descendants of this many-formed Psora alone.”

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He further writes “So great a flood of numberless nervous troubles,

painful ailments – consumptions and cripplings of soul, mind and

body were never seen in ancient times when the Psora mostly

confined itself to its dreadful cutaneous symptoms leprosy. Only

during the last few centuries has mankind been flooded with these

infirmities, owing to causes just mentioned.”

He further makes observations about the disappearance of itch as “It

often disappears through unlucky physical or psychical occurrence,

through a violent fright, through continual vexations, deeply affecting

grief – and the results in such case are just as mischievous as if the

eruption had been driven away externally by the irrational practice of

physician.”

In another foot note he writes, “ I have never either in my practice, nor

in any insane asylum, seen a patient suffering from melancholy,

insanity, or frenzy whose disease did not have Psora as its foundation,

complicated at times, however, though rarely, with syphilis.”

In the Organon also, Hahnemann attributes the cause of all mental

diseases to Psora alone.

Kent writes that, “The miasms that are at the present day upon the

human race are complicated a thousand fold by allopathic treatment.

Every external manifestation of the miasm has in itself a tendency to

straighten mankind, but the human race is being violently damaged

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and diseases are being complicated for the reason that these outward

expressions are forced to disappear by the application of some violent

or stimulating drug.”

According to Ortega - Anxiety is eminently psoric. Its sycotic

equivalent is Fear and has syphilitic color in Panic.

Anxiety is conceived as the outcome of man’s first sensation after

birth, when it abandons the maternal enclosure in which it lives with

practically no effort. When he passes to outside and there he must

work steadily to exist – from oxygenating his blood to taking in food,

digesting it, secreting it, submitting himself to various movements; all

this combined with the aggressiveness of external environment,

stamps on him a feeling of worthlessness, of relative incapacity,

which is translated in anxiety or existential anxiety.

It will be constantly present in our minds, ready to come forth in

various forms, especially if the stimulus is one of the elements which

most profoundly affect the maintenance of that existential insecurity

(an insecurity which we all feel because of the expectation of death

and possibility of harm from many elements around us, including our

fellow human beings), it gives rise to fears: fear of darkness, of being

alone, of ghosts, of people, of evil.

If this existential anxiety grows within us, it becomes Anguish –

which is more destructive and has a markedly syphilitic tinge. But all

these symptoms – Anxiety, Fear and Anguish have a psoric base –

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turning into “Fear” when it has a sycotic admixture, and into

“Anguish” with a syphilitic one. If our fear is externalized and

increases, it then becomes a Panicky terror that has a syphilitic base.

Hering in his foreword to the ‘Chronic Diseases’ writes “Hahnemann

inculcates with so much care the important rule to attend to the moral

symptoms, and to judge of the degree of homoeopathic adaptation,

existing between the remedy and the disease, by the improvement

which takes place in the moral condition and the general well being of

the patient.”

J.P. Gallavardin has exclusively treated psychic symptoms, when

present as a manifestation of latent psychic state or as the symptoms

of an individual temperament. He cites numerous cases wherein

defects of the character and intelligence were cured with the help of

homoeopathic medicines.

He lays down certain conditions essential for the success of psychic

treatment:-

▪ He preferred to use the medicines without the knowledge of the

patient. He felt that the curative effects of the medicine are

developed better in this way.

▪ He advises not to reproach the patients & nor to give them any

advice.

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He further states that these psychic conditions may be some symptoms

of the manifested or latent diseases, or they may be the cause of

stoppage of some development.

Jahr does not promise much hope in chronic mental diseases with a

family history of the same. He advises us to be cautious in promising

too much in these cases. For success in mental and psychical

derangements, he shortlists the following requirements:

▪ Knowledge with physician about the characteristic indications of

remedies.

▪ Use of smallest possible dose.

▪ Exciting cause should be extensively traced & considered.

Farrington also endorses Hahnemann`s views about treatment of

insanity as, “Hahnemann, with his incomparable astuteness, touched

the very keynote, when he bid us treat the insane, as though they were

not insane. By assuming a state harmonizing with that of my patient,

opposing him in nothing, I gained what else might have been

impossible. ”

Kent declares that the symptoms of the mind are the most important

symptoms in a remedy as well in the disease. He stresses the

Hahnemannian thought ‘Mind is the Key to Man’ and advises that the

mind symptoms should not be overlooked.

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Talcott puts forward “The Insane Diathesis” for the conditions

which tend to start and develop mental disorders. He further writes

that, “Mental abnormality is always due to either imperfect or

eccentric physical development, or to effects of inborn or acquired

physical disease, or to injurious impressions, either ante-natal or post-

natal, upon that delicate and intricate physical structure known as

human brain.”

His simple and brief classification of insanity is as follows:-

1. Melancholia, which includes all forms of mental depression.

2. Mania, which includes all forms of mental excitement.

3. Dementia, which includes all forms of mental weakness or failure,

except idiocy and imbecility.

4.General paresis, which is a distinct form of mental disease having

certain characteristics which demand that it shall be classified

separately.

Risquez writes “Emotions guide energy either through the nervous

system, producing feelings, affection, thoughts, etc., or through the

somatic system, producing alterations in the immune system, the

blood circulation, and the hormones: somatic alterations. ”

Edward Whitmont in the introduction to ‘Psyche and Substance’

writes that “while it is certainly true that a hopeless or pessimistic

outlook on life, repressed psychological conflicts and tensions do

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result in organic pathology, and that positive imaging helps in

restoring as well as maintaining health, it is equally true that no one

alive can wholly avoid tension, stress, conflict, repressions,

depressions and disappointment. Indeed, psychological complexes and

crises are building stones of personality. Frustration and repression are

the unavoidable conditions of ego-building no less than approval,

success, satisfaction and joy.”

He further writes that “mental and physical symptoms are largely

interchangeable. Emotional suppression leads to physical disorder;

physical suppression (e.g. menses, lochia etc.) may produce hysterical

and even psychotic states. In psychiatry even the term “conversion”

state is used to denote somatic manifestations of mental or emotional

disturbances.”

Vithoulkas puts people with anxiety as difficult cases. He says, “As

they are excessively anxious about their health – These people tend to

relate a tremendous volume of minute symptoms that cannot be

valued highly by a homoeopath because of these patients tendency to

exaggerate.”

He further writes that symptoms of such patients should be chosen

with caution and perhaps only after confirmation of these by objective

co-workers or relatives.

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Homoeopathic medicines help people attain a calmer state of mind,

greater vitality and better physical health.

Even the word "dis-ease" means (on either mental or physical level)

that the individual is "ill at ease" with himself or some aspect of their

daily life (relationships, their sexuality, family, work etc.).

Usually a trauma or a series of bad life experiences (e.g. a traumatic

childhood, loss, disappointment in love etc.) leave a person with

disturbed thoughts and emotions and for a homoeopath, the mind is

the starting point for all types of health problems (psychological or

physical) of the man.

HOMOEOPATHIC REPERTORY

“All who know how to use a repertory succeed, and not one has

ever discarded it.” – Kent in ‘The language of repertory’

REPERTORY

The word Repertory has originated from Latin word

“REPERTORIUM” which means ‘an inventory; a table or a

compendium, where the contents are so arranged that they are easy to

find’.

Basically, the homoeopathic repertory is an index to the huge mass of

symptoms of various drugs of the Materia medica, the record of

scientific provings, which is reproduced and arranged in a practical

form with relative gradation of medicines to facilitate the quick

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selection of the remedy. Along with Materia medica and Organon it

forms the Triad of Homoeopathy.

Evolution of repertory

Hahnemann in his own life time had become conscious about the need

for suitable index to the growing materia medica. He realized the

limitation of human mind to remember all symptoms and felt the need

for an aid to retrieve the facts. His famous book ‘Fragmenta de

viribus medica mentorum positivis’ published in 1805 contained two

parts. The first part contained symptoms which were observed in the

provers and the second part formed the index or the repertory.

Hahnemann`s pupil, Gross compiled two volumes of a repertory,

which never appeared in print. Another pupil, Ruckert was appointed

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by Hahnemann to compile a repertory. After working hard on it for

eight years, in 1830 he prepared one, but it was not found up to the

mark. Thereafter Hahnemann employed Jahr for compiling a

repertory. Jahr`s repertory was finally published in 1835 in German

language. It was in three volumes.

In 1832, Boenninghausen published a ’Repertory of Antipsoric

medicines’ with a preface by Hahnemann. This repertory of 256 pages

became a foundation stone for all later repertories. Though

technically, Hahnemann was the first repertorian, the credit of

publishing the first repertory goes to Boenninghausen and he is called

as the “Father of repertory”.

Purpose of repertory

H.A. Roberts says that a repertory has two definite purposes:

● To serve as a reference and guide in looking up a particular

symptom that may indicate the similimum or that may make the

necessary distinction between two or more similar remedies in any

given case.

● For careful study of all the symptoms that may appear in a chronic

case.

He also adds that the repertory is not meant for use in those cases

where there are clear indications for the similimum. In these cases, it

might be used in the manner of a quick reference, to verify the leading

indications for the remedy, or if some slight doubt were felt, to

differentiate between those seemingly indicated.

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According to P. Schmidt, “No one can know everything and this is

why in all honesty one must admit that no conscientious

homoeopathic doctor can practice homoeopathy in a serious and really

scientific way without a repertory.”

Kent writes in ‘How to use the repertory’ that, ‘the use of repertory in

homoeopathic practice is a necessity if one is to do careful work. Our

materia medica is so cumbersome without a repertory that the best

prescriber must meet with only indifferent results.’

He advises us as,” The physician must read over and over the rubrics

in the repertory in order to learn what is in it and how symptoms are

expressed.”

Value of Repertory

The value of any repertory depends upon several elements:

▪ The art of the physician in taking the case.

▪ The knowledge of the repertory one attempts to use and

▪ Intelligent use of the resulting analysis.

The aim of repertory is not to replace the materia medica but to help

in narrowing down to the similimum. It is like a bridge link between

the materia medica and the case.

TYPES OF REPERTORIES

Repertories are divided into two main groups:

1. Traditional or the book form 2. Mechanical.

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1. Traditional or the book form is further subdivided into A. General repertories. B. Particular repertories.

A. General Repertories consist of following types: ● Repertories according to Hahnemannian anatomical schema. ▪ Concordance e.g. Knerr`s repertory; Gentry’s repertory ▪ Systematic e.g. Kent’s repertory; Boenninghausen`s repertory; Synthesis; Complete repertory. ● Alphabetical ▪ Section wise e.g. Murphy’s repertory ▪ Rubric wise e.g. Phatak`s repertory.

B. Regional (Particular)

● Disease wise e.g. Bell’s diarrhoea; Allen’s intermittent fever;

Robert’s Rheumatic medicines.

● Part wise e.g. Berridge`s Eye; Minton’s uterine; Hering`s analytical

repertory of mind; Synthetic repertory.

2. Mechanical repertories.

● Card repertories e.g. Field’s cards; Kishore cards; Sharma’s card

repertory.

● Softwares e.g. Radar; Hompath; Cara; Organum etc.

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Value of symptoms

The homoeopathic materia medica has pathology of its own. The

symptoms which the pathologist would exclude as accidental and

meaningless are usually the symptoms which decide the choice of the

homoeopathic remedy. It actually has a vital relation to the case.

Limitations of Repertory:

Repertory provides us with hints about the probable remedy. It leads

us to a group of remedies of which the similimum is to be found with

the help of materia medica, the final authority. It is only in the materia

medica that we will find the exact description of what our patient is

telling us.

No repertory is complete. With growing clinical experiences, new

drugs and remedy confirmations, the materia medica is expanding.

This growth of materia medica is not being updated into the repertory

at that pace, so the repertory is not complete.

Boenninghausen warns us about this in his article, “Warning,

namely, the selection of the right remedy” as he writes, “for this

purpose he should not content himself with the repertories that have

been prepared, a very frequent carelessness, for these books contain

only slight hints as to one or the other remedy that might be selected,

but can never take the place of the careful reading up of the fountain

sources.”

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KENT`S REPERTORY

History Dr Kent’s masterpiece “A repertory of homoeopathic material

medica” better known as Kent’s repertory is a literature which is

popular in homoeopathic system for over 100 years. Dr

Boenninghausen is the one who initiated repertory as a system of

logical concept while Kent put in strength, vigor & vitality to this

system.

J.T. Kent used Lippe`s repertory for a number of years but was not

satisfied with the rubrics and the number of medicines used. Kent was

a great advocate of the use of important generals and individualization

in the treatment of patients. So, he took up the task of producing an

exhaustive repertory.

Taking Lippe`s plan as its base, he expanded it by adding clinical

symptoms which he had recorded. The clinical symptoms which were

consistent with the provings were added, while those which were

contradictory to the provings were rejected. His repertory was first

published in 1897.

Philosophy

Kent believed that Hahnemannian totality demanded study of man as

a whole and puts it as, ‘If we believe an organ is sick and alone

constitutes the disease, we must feel that if we could remove the organ

we would cure the patient.” He further continues this as “The organs

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are not the man. The man is prior to organs. The man is the will and

understanding, and the house which he lives in, is his body.” Kent

advised beginners as, “Treat the patient and not the disease.” He

explains this as, “the symptom that is seldom found in a given disease

is one not peculiar to the disease, but peculiar to the patient.” These

peculiarities must be looked into for the individualization of the

patient. Kent laid much emphasis on the importance of generals. His

repertory is based on the principle of Generals to Particulars. So,

mental generals followed by physical generals including modalities

forms the basis of repertorisation by Kent’s repertory.

Arrangement of Chapters:

Kent’s repertory is divided into 37 chapters. The arrangement of

chapters is on the anatomical schema with certain exceptions such as

Mind, Vertigo, Vision, Hearing, Stool, etc.

The chapters are as follows:

1. Mind. 19. Kidneys.

2. Vertigo. 20. Prostate Gland.

3. Head. 21. Urethra.

4. Eyes. 22. Urine.

5. Vision. 23. Genitalia Male.

6. Ear 24. Genitalia Female.

7. Hearing 25. Larynx and Trachea.

8. Nose 26. Respiration.

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9. Face 27. Cough.

10. Mouth. 28. Expectoration.

11. Teeth. 29. Chest.

12. Throat 30. Back.

13. External Throat. 31. Extremities.

14. Stomach 32. Sleep.

15. Abdomen 33. Chill

16. Rectum. 34. Fever.

17. Stool 35. Perspiration

18. Bladder. 36. Skin.

37. Generalities.

Under each chapter, the symptoms are arranged in the following

order:

1. Location.

2. Sensations in general, unmodified or having modalities.

3. Sides of body or organs.

4. Time modalities.

5. Other modalities arranged alphabetically.

6. Extension of sensation etc. from the specified location to other

areas, arranged alphabetically.

In Kent’s repertory, Anxiety as a rubric under the section Mind is

given on page 4. The main rubric of anxiety is followed by 205 sub

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rubrics. It has 203 drugs in the main rubric of which 37 drugs are in

first grade, 89 drugs in 2nd grade and 77 drugs are in 3rd grade.

In addition to this, there are 36 more remedies found in the sub-

rubrics that are not found in the main rubric of Anxiety.

In mind section more rubrics of anxiety are found under main rubrics

of Cautious, Delirium, Indifference, Laughing, Restlessness, Starting

and Talking in sleep. Anxiety is quoted as a cross-reference in rubrics

Fear & Horror.

REPERTORIAL REFERENCES IN KENT`S REPERTORY SYMPTOMS

MIND – ABSENTMINDED

MIND - ABSORBED, buried in thought

MIND - ABSORBED, buried in thought, as to what would become of him

MIND - ANGER - ailments after anger with anxiety

MIND - ANGER - ailments after anger with fright

MIND - ANGUISH

MIND - ANGUISH - daytime

MIND - ANGUISH - daytime - 5 a.m. to 5 p.m.

MIND - ANGUISH - morning

MIND - ANGUISH - forenoon

MIND - ANGUISH - evening

MIND - ANGUISH - night

MIND - ANGUISH - night - 4 a.m.

MIND - ANGUISH - chill, during

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MIND - ANGUISH - driving from place to place

MIND - ANGUISH - eating, while

MIND - ANGUISH - heat, during

MIND - ANGUISH - menses, before

MIND - ANGUISH - menses, during

MIND - ANGUISH - open air amel.

MIND - ANGUISH - perspiration, during

MIND - ANGUISH - stool, before

MIND - ANGUISH - stool, during

MIND - ANGUISH - walking in open air

MIND - ANTICIPATION, complaints from

MIND - ANXIETY

MIND - ANXIETY - daytime

MIND - ANXIETY - daytime - 5 a.m. to 5 p.m.

MIND - ANXIETY - morning

MIND - ANXIETY - morning - rising, on

MIND - ANXIETY - morning - rising, on - amel.

MIND - ANXIETY - morning - waking, on

MIND - ANXIETY - forenoon

MIND - ANXIETY - forenoon - 11 a.m.

MIND - ANXIETY - noon

MIND - ANXIETY - noon - till 3 p.m.

MIND - ANXIETY - afternoon

MIND - ANXIETY - afternoon - 3 to 6 p.m.

MIND - ANXIETY - afternoon - 4 p.m.




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MIND - ANXIETY - afternoon - until evening

MIND - ANXIETY - evening

MIND - ANXIETY - evening - amel.

MIND - ANXIETY - evening - until 11 p.m.

MIND - ANXIETY - evening - bed; in

MIND - ANXIETY - evening - bed; in - amel.

MIND - ANXIETY - evening - bed; in - closing eyes, on

MIND - ANXIETY - evening - bed; in - uneasiness and anguish; must uncover*

MIND - ANXIETY - evening - exercise, from violent

MIND - ANXIETY - evening - twilight, in the

MIND - ANXIETY - evening - 6 p.m.

MIND - ANXIETY - evening - 7 to 8 p.m.

MIND - ANXIETY - evening - 8 p.m.

MIND - ANXIETY - night

MIND - ANXIETY - night - waking, on

MIND - ANXIETY - night - midnight, before

MIND - ANXIETY - night - midnight, before - on waking, amel, on rising

MIND - ANXIETY - night - midnight, before - 11 p.m.

MIND - ANXIETY - night - midnight, after

MIND - ANXIETY - night - midnight, after - on waking

MIND - ANXIETY - night - midnight, after - 1 to 3 a.m.

MIND - ANXIETY - night - midnight, after - 2 a.m.

MIND - ANXIETY - night - midnight, after - 2 a.m. - until 2 a.m.


MIND - ANXIETY - night - midnight, after - 3 a.m. - after


MIND - ANXIETY - air, in open

MIND - ANXIETY - air, in open amel

89

MIND - ANXIETY - alone, when

MIND - ANXIETY - alternating with indifference

MIND - ANXIETY - anger, during

MIND - ANXIETY - anticipating an engagement

MIND - ANXIETY – apparition, from horrible, while awake

MIND - ANXIETY - ascending steps, on

MIND - ANXIETY - bathing the feet, after

MIND - ANXIETY - bed, in

MIND - ANXIETY - breakfast, after

MIND - ANXIETY - breathing deeply, on

MIND - ANXIETY - breathing deeply, amel

MIND - ANXIETY - business, about

MIND - ANXIETY - chagrin, after

MIND - ANXIETY - children, in

MIND - ANXIETY - children, about his

MIND - ANXIETY - children, when lifted from the cradle

MIND - ANXIETY - chill, before

MIND - ANXIETY - chill, during

MIND - ANXIETY - chill, after

MIND - ANXIETY - church bells, from hearing

MIND - ANXIETY - closing eyes, on

MIND - ANXIETY - coffee, after

MIND - ANXIETY - coition, after

MIND - ANXIETY - coition - thought of (in a woman)

MIND - ANXIETY - cold, becoming, from

MIND - ANXIETY - cold drinks, amel

MIND - ANXIETY - company, when in

MIND - ANXIETY - conscience, of (as if guilty of a crime)

90

MIND - ANXIETY - continence prolonged, from

MIND - ANXIETY - conversation, from

MIND - ANXIETY - cough, before

MIND - ANXIETY - cough, before the attack of whooping cough

MIND - ANXIETY - coughing, from

MIND - ANXIETY - crowd, in a

MIND - ANXIETY - cruelties, after hearing of

MIND - ANXIETY - dark, in

MIND - ANXIETY - dinner, during

MIND - ANXIETY - dinner, after

MIND - ANXIETY - dinner, after, amel

MIND - ANXIETY - dreams, on waking from frightful

MIND - ANXIETY - drinking, after

MIND - ANXIETY - eating, before

MIND - ANXIETY - eating, while

MIND - ANXIETY - eating, warm food

MIND - ANXIETY - eating, after

MIND - ANXIETY - eating, after amel

MIND - ANXIETY - emissions, after

MIND - ANXIETY - eructations amel

MIND - ANXIETY - excitement, from

MIND - ANXIETY - exercise amel.

MIND - ANXIETY - exertion of eyes

MIND - ANXIETY - expected of him, when anything is

MIND - ANXIETY - fear, with

MIND - ANXIETY - fever, during

MIND - ANXIETY - fever, prodrome, during

MIND - ANXIETY - fits, with

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MIND - ANXIETY - flatus, from

MIND - ANXIETY - flatus, emission of, amel

MIND - ANXIETY - flushes of heat, during

MIND - ANXIETY - foot bath, after a

MIND - ANXIETY - friends at home, about

MIND - ANXIETY - fright, after

MIND - ANXIETY - future, about

MIND - ANXIETY - headache, with

MIND - ANXIETY - health, about

MIND - ANXIETY - health, about, especially during climacteric period

MIND - ANXIETY - hot air, as if in

MIND - ANXIETY - house in

MIND - ANXIETY - house, in amel

MIND - ANXIETY - house, on entering

MIND - ANXIETY - hungry, when

MIND - ANXIETY - hypochondriacal

MIND - ANXIETY - ineffectual desire for stool, from

MIND - ANXIETY - looking steadily

MIND - ANXIETY - lying, while

MIND - ANXIETY - lying amel

MIND - ANXIETY - lying - must lie down with anguish

MIND - ANXIETY - lying - side, on

MIND - ANXIETY - lying - side, on, right, from flatulence

MIND - ANXIETY - lying - side, on - left

MIND - ANXIETY - manual labor, from

MIND - ANXIETY - menses, before

MIND - ANXIETY - menses, during

MIND - ANXIETY - menses, during - amel.

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MIND - ANXIETY - menses, after

MIND - ANXIETY - menses, after - which prevents sleep

MIND - ANXIETY - mental exertion

MIND - ANXIETY - motion, from

MIND - ANXIETY - motion amel

MIND - ANXIETY - motion downward

MIND - ANXIETY - music, from

MIND - ANXIETY - night watching, from

MIND - ANXIETY - noise, from

MIND - ANXIETY - noise of rushing water

MIND - ANXIETY - others, for

MIND - ANXIETY - pains, from the

MIND - ANXIETY - paroxysms

MIND - ANXIETY - periodical

MIND - ANXIETY - playing piano, while

MIND - ANXIETY - pressure on chest

MIND - ANXIETY - pursued when walking, as if

MIND - ANXIETY - railroad, when about to journey by, amel, while in train

MIND - ANXIETY - reading, while

MIND - ANXIETY - riding, while

MIND - ANXIETY - riding down the hill

MIND - ANXIETY - rising, after

MIND - ANXIETY - rising, from a seat, on

MIND - ANXIETY - rising, from a seat amel

MIND - ANXIETY - salvation, about

MIND - ANXIETY - salvation, about - morning

MIND - ANXIETY - sedentary employment, from

MIND - ANXIETY - sewing

93

MIND - ANXIETY - shaving, while

MIND - ANXIETY - shuddering, with

MIND - ANXIETY - sitting, while

MIND - ANXIETY - sitting, amel

MIND - ANXIETY - sitting, bent

MIND - ANXIETY - sleep, before

MIND - ANXIETY - sleep, before - evening

MIND - ANXIETY - sleep, on going to

MIND - ANXIETY - sleep, during

MIND - ANXIETY - sleep, loss of sleep

MIND - ANXIETY - sleep, menses, after

MIND - ANXIETY - sleep, on starting from

MIND - ANXIETY - sleep, partial slumbering in the morning, during

MIND - ANXIETY - soup, after

MIND - ANXIETY - speaking, when

MIND - ANXIETY - speaking, in company

MIND - ANXIETY - standing, while

MIND - ANXIETY - standing amel

MIND - ANXIETY - stool, before

MIND - ANXIETY - stool, during

MIND - ANXIETY - stool, after

MIND - ANXIETY - stool, while straining at

MIND - ANXIETY - stooping, when

MIND - ANXIETY - stooping amel

MIND - ANXIETY - storm, during a thunder

MIND - ANXIETY - strangers, in the presence of

MIND - ANXIETY - sudden

MIND - ANXIETY - suicidal

94

MIND - ANXIETY - supper, after

MIND - ANXIETY - thinking about it, from

MIND - ANXIETY - thoughts, from

MIND - ANXIETY - time is set, if a

MIND - ANXIETY - tobacco, from smoking

MIND - ANXIETY - trifles, about

MIND - ANXIETY - urination, before

MIND - ANXIETY - urination, during

MIND - ANXIETY - urination, after

MIND - ANXIETY - vexation, after

MIND - ANXIETY - voice, on raising the

MIND - ANXIETY - waking, on

MIND - ANXIETY - walking, while

MIND - ANXIETY - walking - in open air

MIND - ANXIETY - walking - in open air, amel

MIND - ANXIETY - walking - rapidly

MIND - ANXIETY - walking - rapidly - which makes him walk faster

MIND - ANXIETY - warm bed yet limbs cold if uncovered

MIND - ANXIETY - warmth, from

MIND - ANXIETY - warmth amel

MIND - ANXIETY - weeping, followed by

MIND - ANXIETY - weeping amel

MIND - ANXIETY - work, during manual

MIND - AVARICE

MIND - AVERSION, approached to being

MIND - BAD news, ailments from

MIND - BROODING

MIND - BUSINESS, averse to

95

MIND - CAREFULNESS

MIND - CARES, full of

MIND - CARES, full of - ailments, from

MIND - CARES, full of - domestic affairs, about

MIND - CARES, full of - trifles, about

MIND - CARRIED, desires to be

MIND - CAUTIOUS

MIND - CAUTIOUS - anxiously

MIND - CLINGING to persons or furniture

MIND - CLINGING - child awakens terrified, knows no one, screams, clings*

MIND - COMPANY - aversion to

MIND - COMPANY - aversion to - avoids the sight of people

MIND - CONCENTRATION - difficult

MIND - CONFIDENCE, want of self

MIND - CONFUSION of mind - concentrate the mind, on attempting to

MIND - CONSCIENTIOUS about trifles

MIND - COUNTING continually

MIND - COWARDICE

MIND – DARKNESS, agg.

MIND - DEATH, desires

MIND - DEATH, presentiment of

MIND – DEATH, sensation, of

MIND - DEATH, thoughts of

MIND - DELIRIUM - anxious

MIND - DELIRIUM - frightful

MIND - DELUSIONS - crime - as if he had committed

MIND - DELUSIONS - danger, impression of

MIND - DELUSIONS - disease has incurable

96

MIND - DELUSIONS - fail, everything will

MIND - DELUSIONS - happen, that something terrible is going to

MIND - DELUSIONS - heart disease, is going to have, and die

MIND - DELUSIONS - images - frightful

MIND - DELUSIONS - images - frightful - sleep, preventing

MIND - DELUSIONS - insane, that she will become

MIND - DELUSIONS - murdered, that he would be

MIND - DELUSIONS - neglected his duty, that he has

MIND - DELUSIONS - poisoned, that he was about to be

MIND - DELUSIONS - poor, thinks he is

MIND - DELUSIONS - pursued, by enemies

MIND - DELUSIONS - sick, imagines himself

MIND - DELUSIONS - succeed, that he cannot, does everything wrong

MIND - DELUSIONS - troubles, broods over imaginary

MIND - DELUSIONS - wrong, fancies he has done

MIND - DESPAIR

MIND - DESPAIR - health, of

MIND - DESPAIR - recovery

MIND - DESPAIR - religious (of salvation, etc)

MIND - DESPAIR - social position, of

MIND - DESPAIR - trifles, over

MIND - DISCOURAGED

MIND - DISGUST

MIND - DOUBTFUL - recovery, of

MIND - DOUBTFUL - soul’s welfare, of

MIND - DULLNESS, sluggishness, difficulty of thinking and comprehending

MIND - DWELLS on past disagreeable occurrences

MIND - ESCAPE, attempts to

97

MIND - EXCITEMENT - anticipating events, when

MIND - EXCITEMENT - emotional, ailments from

MIND - EXCITEMENT - horrible things, after hearing

MIND - EXCITEMENT - hurried, as if

MIND - EXCITEMENT - nervous

MIND - EXCITEMENT - perspiration, during

MIND - EXCITEMENT - trifles, over

MIND - FANCIES - exaltation of - frightful

MIND - FASTIDIOUS

MIND - FEAR

MIND - FEAR - daytime, only

MIND - FEAR - morning

MIND - FEAR - morning - rising on

MIND - FEAR - morning - until evening

MIND - FEAR - morning - waking, on

MIND - FEAR - forenoon

MIND - FEAR - noon until 3 p.m.

MIND - FEAR - afternoon

MIND - FEAR - afternoon - 4 p.m.

MIND - FEAR - afternoon - 5 p.m.

MIND - FEAR - evening

MIND - FEAR - evening - amel.

MIND - FEAR - evening - bed, in

MIND - FEAR - evening - bed, in - amel.

MIND - FEAR - evening - twilight, in

MIND - FEAR - evening - walking, while

MIND - FEAR - night

MIND - FEAR - night - waking, after

98

MIND - FEAR - night - midnight

MIND - FEAR - night - midnight, after

MIND - FEAR - night - midnight, after - 3 a.m.

MIND - FEAR - abdomen, arising from

MIND - FEAR - accidents, of

MIND - FEAR - air, in open

MIND - FEAR - air, in open - amel.

MIND - FEAR - alone, of being

MIND - FEAR - alone, of being - evening

MIND - FEAR - alone, of being - night

MIND - FEAR - alone, of being - lest - he die

MIND - FEAR - alone, of being - lest - he injure himself

MIND - FEAR - alternating with mania

MIND - FEAR - animals, of

MIND - FEAR - apoplexy, of

MIND - FEAR - apoplexy, of - night at, with feelings as if head would burst

MIND - FEAR - apoplexy, of - palpitation, with

MIND - FEAR - apoplexy, of - stool, during

MIND - FEAR - apoplexy, of - waking, on

MIND - FEAR - approaching him, of others

MIND - FEAR - approaching him, children cannot bear to have anyone near*

MIND - FEAR - approaching him, delirium, in

MIND - FEAR - approaching him, lest he be touched

MIND - FEAR - approaching him, of vehicles

MIND - FEAR - bad news, of hearing

MIND - FEAR - bed, of the

MIND - FEAR - behind him, that someone is

MIND - FEAR - betrayed, being

99

MIND - FEAR - bitten, of being

MIND - FEAR - black, everything

MIND - FEAR - brain, of softening of

MIND - FEAR - brilliant objects, looking glass, etc, of, or cannot endure

MIND - FEAR - burden, of becoming a

MIND - FEAR - censured, of being

MIND - FEAR - chill, during

MIND - FEAR - cholera, of the

MIND - FEAR - church or opera, when ready to go

MIND - FEAR - closing eyes, on

MIND - FEAR - coal scuttle, of the

MIND - FEAR - coition - at thought of coition in a woman

MIND - FEAR - cold, of taking

MIND - FEAR - confusion, that people will observe her

MIND - FEAR - consumption, of

MIND - FEAR - corners, to walk past certain

MIND - FEAR - creeping out of every corner, of something

MIND - FEAR - crowd, in a

MIND - FEAR - crowd, in a - public places, of

MIND - FEAR - cruelties, report of, excite

MIND - FEAR - cutting himself when shaving

MIND - FEAR - danger, of impending

MIND - FEAR - danger, of impending - going to sleep, on

MIND - FEAR - dark

MIND - FEAR - dawn, of the return of

MIND - FEAR - death, of

MIND - FEAR - death, of - morning

MIND - FEAR - death, of - evening

100

MIND - FEAR - death, of - night

MIND - FEAR - death, of - alone, when

MIND - FEAR - death, of - alone, when - evening in bed

MIND - FEAR - death, of - die, fear he will, if he goes to sleep, after night-mare

MIND - FEAR - death, of - heart symptoms, during

MIND - FEAR - death, of - heat, during

MIND - FEAR - death, of - labor, during

MIND - FEAR - death, of - menses, before

MIND - FEAR - death, of - menses, during

MIND - FEAR - death, of - pain, from

MIND - FEAR - death, of - perspiration, during

MIND - FEAR - death, of - predicts the time

MIND - FEAR - death, of - pregnancy, during

MIND - FEAR - death, of - soon, that she will die

MIND - FEAR - death, of - sudden, of

MIND - FEAR - death, of - vexation, after

MIND - FEAR - death, of - vomiting

MIND - FEAR - death, of - waking, on

MIND - FEAR - death, of - walking, while

MIND - FEAR - destination, of being unable to reach his

MIND - FEAR - devil, being taken by the, of

MIND - FEAR - devoured by animals; of being

MIND - FEAR - dinner, after

MIND - FEAR - disaster; of

MIND - FEAR - disease, of impending

MIND - FEAR - disease, of impending - night, in bed

MIND - FEAR - disease, of impending - worse walking in open air

MIND - FEAR - dogs, of

101

MIND - FEAR - downward motion, of

MIND - FEAR - drawn upward, of being

MIND - FEAR - driving him from place to place

MIND - FEAR - drowned, of being

MIND - FEAR - eating, of

MIND - FEAR - eating, after

MIND - FEAR - eating, of - when hungry

MIND - FEAR - emission, after an

MIND - FEAR - epilepsy

MIND - FEAR - epilepsy - in the morning

MIND - FEAR - evil of

MIND - FEAR - evil of - morning, on waking

MIND - FEAR - evil of - afternoon

MIND - FEAR - evil of - evening

MIND - FEAR - evil of - evening - walking in open air, while

MIND - FEAR - exertion, of

MIND - FEAR - exposure night in bed, of

MIND - FEAR - extravagance, of

MIND - FEAR - failure, of, in business

MIND - FEAR - fainting, of

MIND - FEAR - fall upon him, high walls and building

MIND - FEAR - falling, of

MIND - FEAR - falling, of - afternoon

MIND - FEAR - falling, of - evening

MIND - FEAR - falling, of - letting things fall, of

MIND - FEAR - falling, of – room, in, agg.

MIND - FEAR - falling, of - sleep, on going to

MIND - FEAR - falling, of - turning head, on

102

MIND - FEAR - falling, of - walking, when

MIND - FEAR - fasting, of

MIND - FEAR - fever, while chilly

MIND - FEAR - fever, on going to bed

MIND - FEAR - fever, typhus, of

MIND - FEAR - fire, things will catch

MIND - FEAR - fit, of having a

MIND - FEAR - food, after

MIND - FEAR - friends has met with accident, that a

MIND - FEAR - friends, of

MIND - FEAR - gallows, of the

MIND - FEAR - ghosts, of

MIND - FEAR - ghosts, of - evening

MIND - FEAR - ghosts, of - night

MIND - FEAR - grieving, as if

MIND - FEAR - happen, something will

MIND - FEAR - happen, something will - when alone relieved by conversation

MIND - FEAR - happen, something will - warmth of bed amel.

MIND - FEAR - health, that she has ruined

MIND - FEAR - heart, disease of

MIND - FEAR - heart, arising from

MIND - FEAR - heart, will cease to beat unless constantly on the move

MIND - FEAR - heat - during

MIND - FEAR - high places

MIND - FEAR - hurry, following

MIND - FEAR - husband, he will never return, something would happen to him*

MIND - FEAR - imaginary things

MIND - FEAR - imaginary animals

103

MIND - FEAR – imbecile, that he would become

MIND - FEAR - infection, of

MIND - FEAR - injured, of being

MIND - FEAR - insanity, of

MIND - FEAR - insanity, of - night

MIND - FEAR - joints are weak, that

MIND - FEAR - jumps out of bed from

MIND - FEAR - jumps, on touch

MIND - FEAR - jumps, out of the window

MIND - FEAR - killing, of

MIND - FEAR - killing, of - with a knife

MIND - FEAR - labor, during

MIND - FEAR - labor, after

MIND - FEAR - looking before her, when

MIND - FEAR - losing senses

MIND - FEAR - lying in bed, while

MIND - FEAR - manual labor, after

MIND - FEAR - medicine, of taking too much medicine

MIND - FEAR - men, of

MIND - FEAR - menses, before

MIND - FEAR - menses, during

MIND - FEAR - menses, during, menstrual colic

MIND - FEAR - mirrors in room, of

MIND - FEAR - mischief, he might do, night on waking

MIND - FEAR - misfortune, of

MIND - FEAR - misfortune, of - daytime

MIND - FEAR - misfortune, of - morning

MIND - FEAR - misfortune, of - forenoon

104

MIND - FEAR - misfortune, of - afternoon

MIND - FEAR - misfortune, of - afternoon - 2 p.m.

MIND - FEAR - misfortune, of - evening

MIND - FEAR - misfortune, of - evening - bed, in, amel.

MIND - FEAR - misfortune, of - chilliness, during

MIND - FEAR - misfortune, of - heat, during

MIND - FEAR - moral obliquity alternating with sexual excitement

MIND - FEAR - murdered, of being

MIND - FEAR - music, from

MIND - FEAR - narrow place, in

MIND - FEAR - nausea, after

MIND - FEAR - near, of those standing

MIND - FEAR - noise, from

MIND - FEAR - noise, from - night

MIND - FEAR - noise, from - at door

MIND - FEAR - noise, from - rushing water

MIND - FEAR - noise, from - street, in

MIND - FEAR - noise, from - sudden of

MIND - FEAR - observed, of her condition being

MIND - FEAR - occupation, of

MIND - FEAR - out of doors, to go

MIND - FEAR - paralysis, of

MIND - FEAR - people, of

MIND - FEAR - people, of - children

MIND - FEAR - physician, will not see him he seems to terrify her

MIND - FEAR - piano, when at

MIND - FEAR - pins, of

MIND - FEAR - pneumonia, of

105

MIND - FEAR - poisoned, of being

MIND - FEAR - poisoned, of being - night

MIND - FEAR - poisoned, of being - has been

MIND - FEAR - poverty

MIND - FEAR - pregnancy, during

MIND - FEAR - putrefy, body will

MIND - FEAR - rain of

MIND - FEAR - riding, when in a carriage

MIND - FEAR - robbers, of

MIND - FEAR - robbers, of - midnight on waking

MIND - FEAR - room, on entering

MIND - FEAR - run over of being, on going out

MIND - FEAR - say something wrong, lest he should

MIND - FEAR - self-control, losing

MIND - FEAR - serious thoughts

MIND - FEAR - sitting amel.

MIND - FEAR - sleep, before

MIND - FEAR - sleep, he will never sleep again

MIND - FEAR - sleep - to close the eyes lest he should never wake

MIND - FEAR - sleep - to go to sleep

MIND - FEAR - society, of his position in

MIND - FEAR - sold, of being

MIND - FEAR – speak, to

MIND - FEAR - spoken to

MIND - FEAR - starving, of

MIND - FEAR - stomach, arising from

MIND - FEAR - stomach, of ulcer in

MIND - FEAR - strangers, of

106

MIND - FEAR - suffering, of

MIND - FEAR - suffocation, of

MIND - FEAR - suffocation, of - night

MIND - FEAR - suffocation, of - closing eyes

MIND - FEAR - suffocation, of - lying, while

MIND - FEAR - suicide

MIND - FEAR - superstitious

MIND - FEAR - supper, after

MIND - FEAR - surprises, from pleasant

MIND - FEAR - syphilis, of

MIND - FEAR - talking loud, as if would kill her

MIND - FEAR - thinking of disagreeable things, when

MIND - FEAR - thinking - sad things, of

MIND - FEAR - thoughts, of his own

MIND - FEAR - throat, from sensation of swelling of

MIND - FEAR - thunderstorm, of

MIND - FEAR - touch, of

MIND - FEAR - tread lightly, must, or will injure himself

MIND - FEAR - trifles

MIND - FEAR - troubles, of imaginary

MIND - FEAR - unaccountable

MIND - FEAR - undertaking anything

MIND - FEAR - upward, of being drawn

MIND - FEAR - vertigo, of

MIND - FEAR - vexation, after

MIND - FEAR - voice, of using

MIND - FEAR - waking, on

MIND - FEAR - waking, on - from a dream

107

MIND - FEAR - waking, on - of something under the bed

MIND - FEAR - walking, of

MIND - FEAR - walking - across busy street

MIND - FEAR - walking - in the dark

MIND - FEAR - walking, while

MIND - FEAR - walking, open air, while

MIND - FEAR - warm room

MIND - FEAR - water, of

MIND - FEAR - weeping amel

MIND - FEAR - wet his bed, fears he will

MIND - FEAR - wind, of

MIND - FEAR - women; of

MIND - FEAR - work, dread of

MIND - FEAR - work, dread of - headache, during

MIND - FEAR - work, dread of - literary, of

MIND - FORGOTTEN something, feels constantly as if he had

MIND - FRIGHT, complaints from

MIND - FRIGHTENED easily

MIND - FRIGHTENED easily - night

MIND - FRIGHTENED easily - night - wakens at 3 a.m.

MIND - FRIGHTENED easily - chill, during

MIND - FRIGHTENED easily - falling asleep, on

MIND - FRIGHTENED easily - menses, before

MIND - FRIGHTENED easily - nocturnal emissions, after

MIND - FRIGHTENED easily - roused, when

MIND - FRIGHTENED easily - sneezing, at

MIND - FRIGHTENED easily - touch, from

MIND - FRIGHTENED easily - trifles, at

108

MIND - FRIGHTENED easily - trifles, at - day before menses

MIND - FRIGHTENED easily - waking, on

MIND - FRIGHTENED easily - wakens in a fright from least noise

MIND - FRIGHTENED easily - wakens terrified, knows no one, screams, clings*

MIND - FRIGHTENED easily - weeping amel.

MIND - FROWN, disposed to

MIND - GESTURES - plays with his fingers

MIND - GOING out, aversion to

MIND - GRIEF

MIND - GRIEF, ailments from

MIND - GRIEF - trifles, over

MIND – HELPLESSNESS, feeling of

MIND - HIGH places, agg.

MIND – HOME, desires to go

MIND - HORRIBLE things, sad stories affect her profoundly

MIND - IMPATIENCE - trifles, about

MIND - IMPULSIVE

MIND - IMPULSE, morbid - stab his flesh with the knife he holds, to

MIND - INCONSOLABLE

MIND - INCONSOLABLE - over fancied misfortune

MIND – INJURE, fears to be left alone, lest he should himself

MIND - INSANITY - fright or anger, caused by

MIND - IRRESOLUTION

MIND - IRRESOLUTION - acts, in

MIND - IRRESOLUTION - ideas, in

MIND - IRRESOLUTION - trifles, about

MIND - IRRITABILITY

MIND - KILL, desire to

109

MIND - KILL, desire to - barber wants to kill his customer

MIND - KILL, desire to - desire to kill the person that contradicts her

MIND - KILL, desire to - sight of a knife

MIND - KILL, desire to - sudden impulse to

MIND - KILL, desire to - sudden impulse to - herself

MIND - KILL, desire to - sudden impulse to - throw child into fire

MIND - LAMENTING - future, about

MIND - LAUGHING - anxiety, during

MIND - LIGHT - desire for

MIND - MENTAL SYMPTOMS - alternating with - physical symptoms

MIND - MONOMANIA

MIND - MORTIFICATION - ailments, from

MIND - NARRATING her symptoms agg.

MIND - PLAYFUL - indisposition to play, in children

MIND - RELIGIOUS affections

MIND - REMORSE

MIND - REPROACHING himself

MIND - REST, cannot, when things are not in proper place

MIND - RESTLESSNESS

MIND - RESTLESSNESS - anxious

MIND - RESTLESSNESS - anxious - compelling rapid walking

MIND - RESTLESSNESS - anxious - epilepsy, during intervals of

MIND - RESTLESSNESS - bed, driving out of

MIND - RESTLESSNESS - bed, tossing about, in

MIND - RESTLESSNESS - internal

MIND - RESTLESSNESS - menses, before

MIND - RESTLESSNESS - menses, during

MIND - RESTLESSNESS - storm, before

110

MIND - RESTLESSNESS - storm, during

MIND - SADNESS

MIND - SADNESS - misfortune, as if from

MIND - SENSITIVE

MIND - SENSITIVE - ailments to most trifling

MIND - SENSITIVE - cruelties, when hearing of

MIND - SENSITIVE - external impressions, to all

MIND - SENSITIVE - moral impressions, to

MIND - SENSITIVE - music, to

MIND - SENSITIVE - noise, to

MIND - SENSITIVE - noise, to - slightest

MIND - SHRIEKING - children, in

MIND - STARTING, startled

MIND - STARTING - anxious

MIND - STARTING - anxious, downward motion, from

MIND - STARTING - called by name, when

MIND - STARTING - easily

MIND - STARTING - falling, as if

MIND - STARTING - fright, from

MIND - STARTING - hawking, at

MIND - STARTING - noise, from

MIND - STARTING - prick of a needle, at the

MIND - STARTING - sleep, on falling

MIND - STARTING - sleep, during

MIND - STARTING - sleep, from

MIND - STARTING - sneezing, at

MIND - STARTING - spoken to, when

MIND - STARTING - touched, when

111

MIND - STARTING - tremulous

MIND - STARTING - trifles, at

MIND - STARTING - twitching

MIND - STRANGER, presence of, agg.

MIND - SUCCEEDS, never

MIND - SUICIDAL disposition

MIND - SUICIDAL disposition - thoughts

MIND - SUPERSTITIOUS

MIND - TALKING - sleep, in

MIND - TALKING - sleep, in - anxious

MIND - THOUGHTS - frightful

MIND - THOUGHTS - frightful - night on waking

MIND - THOUGHTS - frightful - seeing blood or a knife, on

MIND - THOUGHTS - future, of the

MIND - THOUGHTS - intrude and crowd around each other

MIND - THOUGHTS - intrude and crowd around each other - sexual

MIND - THOUGHTS - intrude and crowd around each other - work, while at

MIND - THOUGHTS - persistent

MIND - THOUGHTS - persistent - alone, when

MIND - THOUGHTS - persistent - evil, of

MIND - THOUGHTS - persistent - expression and words heard recur to his mind

MIND - THOUGHTS - persistent - homicide

MIND - THOUGHTS - persistent - thinks mind and body are separated

MIND - THOUGHTS - persistent - thinks of nothing but murder, fire and rats

MIND - THOUGHTS - persistent - unpleasant subjects, haunted by

MIND - THOUGHTS - profound

MIND - THOUGHTS - profound - future, about his

MIND - THOUGHTS - tormenting

112

MIND - THOUGHTS - tormenting - evening

MIND - THOUGHTS - tormenting - night

MIND - THOUGHTS - tormenting - sexual

MIND - THOUGHTS - vanishing, of

MIND - THOUGHTS - wandering

MIND – THUNDER storm, before

MIND – THUNDER storm, during

MIND - TIMIDITY - about appearing in public

MIND - TOUCHED, aversion to being

MIND - TRIFLES, seem important

MIND - UNREAL, everything seems

MIND - WALKING rapidly from anxiety

MIND - WANDER, desires to

MIND - WASHING always, her hands

MIND - WEARY of life

MIND - WEEPING - emotion, after slight

MIND - WEEPING - future, about the

MIND - WEEPING - nightmare, after

MIND - WEEPING - sad thoughts, at

MIND - WEEPING - trifles, at

MIND - WEEPING - trifles, at - at least worry, children

MIND - WILL, contradiction of

MIND - WORK, aversion to mental

VERTIGO - VERTIGO

VERTIGO - ANXIETY, during

VERTIGO - FRIGHT, after

HEAD - CONGESTION - anxiety, with

HEAD - HEAT - anxiety, with

113

HEAD - NUMBNESS, sensation of

HEAD - PAIN - looking down, out of window cause vertigo, anxiety, sweat*

HEAD - PAIN - Stunning, Forehead - sweats from anxiety - walking in open air*

HEAD - PERSPIRATION of scalp - Forehead - anxiety, as from

HEAD - UNSTEADY feeling

EYE - PUPILS - dilated

EYE - STRABISMUS - mental emotions or fear agg.

VISION - DIM - anxiety, during

EAR - NOISES in - anxiety agg.

EAR - NOISES in - humming - mental anxiety agg.

FACE - EXPRESSION, anxious

FACE - EXPRESSION - bewildered

FACE - EXPRESSION - distressed

FACE - EXPRESSION - frightened

FACE - EXPRESSION - suffering

FACE - EXPRESSION - vacant

FACE - HEAT - anxiety, during

FACE - PERSPIRATION

FACE - PERSPIRATION - cold

FACE - STIFFNESS, muscles

FACE - TENSION of skin

FACE - WRINKLED

FACE - WRINKLED - forehead

MOUTH - DRYNESS

TEETH - PAIN - anxiety, with

THROAT - CHOKING

THROAT - LUMP, plug, etc., sensation of

THROAT - SWALLOWING - difficult

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STOMACH - ANXIETY

STOMACH - APPREHENSION in

STOMACH - EMPTINESS - morning - anxiety with

STOMACH - NAUSEA

STOMACH - NAUSEA - anxiety, after

STOMACH - PAIN - fright, from

STOMACH - PAIN - burning - fright, after

ABDOMEN - ANXIETY in

ABDOMEN - APPREHENSION in, sensation of

ABDOMEN - RESTLESSNESS, uneasiness

RECTUM - CONSTIPATION - stool remains long in rectum, anxiety; awful*

RECTUM - DIARRHEA – anticipation, after

RECTUM - DIARRHEA - anxiety, after

RECTUM - DIARRHEA - excitement

RECTUM - DIARRHEA - fright, after

RECTUM - URGING - anxious

RECTUM - URGING - fright, from

RECTUM - URGING - startled, when

BLADDER - APPREHENSION in region of

BLADDER - RETENTION - fright, after

BLADDER - URGING to urinate - anxious

KIDNEYS - PAIN - Region of - extending to - groin - nausea; with anxious

GENITALIA - MALE - MASTURBATION, disposition to

GENITALIA - FEMALE - ABORTION - fright, after

GENITALIA - FEMALE - INFLAMMATION - uterus - emotional excitement *

GENITALIA - FEMALE - MENSES - copious - excitement, after

RESPIRATION - ACCELERATED

RESPIRATION - ACCELERATED - anxiety, during

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RESPIRATION - ANXIOUS

RESPIRATION - ASTHMATIC - emotions, after

RESPIRATION - DIFFICULT - morning - chest, from anxiety in

RESPIRATION - DIFFICULT - excitement agg.

RESPIRATION - DIFFICULT - fright, after

RESPIRATION - DIFFICULT - perspiration - anxious face and sleeplessness

COUGH - NERVOUS

COUGH - STRANGERS, child coughs at sight of

CHEST - ANXIETY in

CHEST - ANXIETY in - excitement agg.

CHEST - ANXIETY in - heart, region of

CHEST - APPREHENSION

CHEST - APPREHENSION - heart, region of

CHEST - CEASES to beat; as if heart - had ceased

CHEST - CONSTRICTION, tension, tightness

CHEST - INFLAMMATION - Heart - Endocardium - pain and great anxiety

CHEST - OPPRESSION

CHEST - PAIN

CHEST - PALPITATION OF HEART

CHEST - PALPITATION OF HEART - anxiety

CHEST - PALPITATION OF HEART - audible

CHEST - PALPITATION OF HEART - excitement, after

CHEST - PALPITATION OF HEART - fright, after

CHEST - PALPITATION OF HEART - noise, from every strange

CHEST - PALPITATION OF HEART - tumultuous, violent, vehement

CHEST - PALPITATION OF HEART - unrequited affections, from

CHEST - PALPITATION OF HEART - waking, on - startled from a dream

EXTREMITIES - COLDNESS - Foot - anxiety, during

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EXTREMITIES - FORMICATION - fingers - anxiety, as from

EXTREMITIES - GOOSE FLESH

EXTREMITIES - HEAT - Hand - anxiety, with

EXTREMITIES - NUMBNESS

EXTREMITIES - TREMBLING

EXTREMITIES - TREMBLING - anxious

EXTREMITIES - TREMBLING - Hand - anxiety; with

EXTREMITIES - TREMBLING - Lower limbs - anxiety

SLEEP - DISTURBED

SLEEP - DREAMS - accidents

SLEEP - DREAMS - animals

SLEEP - DREAMS - anxious

SLEEP - DREAMS - danger

SLEEP - DREAMS - difficulties, of

SLEEP - DREAMS - falling, of

SLEEP - DREAMS - fire

SLEEP - DREAMS - frightful

SLEEP - DREAMS - misfortunes, of

SLEEP - DREAMS - nightmares

SLEEP - DREAMS - pursued, of being

SLEEP - DREAMS - robbers

SLEEP - DREAMS - snakes

SLEEP - DREAMS - unsuccessful efforts to do various things

SLEEP - RESTLESS

SLEEP - SLEEPINESS - excitement, after

SLEEP - SLEEPLESSNESS - anxiety, from

SLEEP - SLEEPLESSNESS - excitement, from

SLEEP - SLEEPLESSNESS - thoughts activity of mind, from

117

SLEEP - SLEEPLESS - thoughts activity of mind, from - same idea repeated *

SLEEP - SLEEPLESS - uneasiness & anxiety, uncovers which cause chilliness *

SLEEP - WAKING - frequent

SLEEP - WAKING - fright, as from

CHILL - COLDNESS in general

CHILL - ANXIETY, caused by

CHILL - EXCITEMENT, after

CHILL - FRIGHT, from

CHILL - SHAKING - fright, from

FEVER - NIGHT - anxiety and sweat, with

FEVER - NIGHT - dry burning heat - anxiety; with

FEVER - ALTERNATING WITH - fright

PERSPIRATION - ANXIETY, during

PERSPIRATION - ANXIETY, during - evening

PERSPIRATION - ANXIETY, during - night

PERSPIRATION - ANXIETY, during - dinner, after

PERSPIRATION - CLAMMY

PERSPIRATION - EATING, while - anxiety and cold sweat

PERSPIRATION - EXCITEMENT, after

PERSPIRATION - FRIGHT, from

PERSPIRATION - STRANGERS, in the presence of

SKIN - GOOSE FLESH

GENERALS - ANXIETY general physical

GENERALS - BATHING, dread of

GENERALS - CATALEPSY - fright, after

GENERALS - CHOREA - emotional

GENERALS - CHOREA - fright, from

GENERALS - CONVULSIONS - excitement, from

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GENERALS - CONVULSIONS - fright, from

GENERALS - FAINTNESS - blood, at sight of in

GENERALS - FAINTNESS - close room, in

GENERALS - FAINTNESS - crowded room, in

GENERALS - FAINTNESS - dark places, in

GENERALS - FAINTNESS - excitement, on

GENERALS - FAINTNESS - fright, after

GENERALS - FAINTNESS - pain, from

GENERALS - HEAT - flushes of

GENERALS - HEAT - flushes of - alternating with chills

GENERALS - HEAT - flushes of - emotions, from

GENERALS - HEAT - flushes of - perspiration - and anxiety

GENERALS - HEAT - sensation of

GENERALS - NUMBNESS

GENERALS - ORGASM of blood

GENERALS - ORGASM of blood - emotions, after

GENERALS - ROOM full of people agg.

GENERALS - STORM, approach of a

GENERALS - STRETCHING - anxiety, from

GENERALS - TREMBLING

GENERALS - TREMBLING - Externally - anxiety, from

GENERALS - TREMBLING - Externally - emotions, after

GENERALS - TREMBLING - Externally - fright, after

GENERALS - TWITCHING

GENERALS - TWITCHING - fright, after

GENERALS - WEAKNESS - fright, after

* - Symptom language slightly altered to fit in the format

119

Boger - Boenninghausen`s Characteristics and Repertory (BBCR)

Introduction

Boenninghausen was a close student and disciple of Hahnemann. The

credit for publishing the first repertory goes to Boenninghausen. He

published ‘Repertory of the Antipsorics’ in 1832, with a preface by

Hahnemann. In 1835, Boenninghausen`s ‘Repertory of medicines

which are not Antipsoric’ and in 1836, ‘An attempt at showing the

relative kinship of homoeopathic medicines’ was published. He

brought out the Therapeutic Pocket Book incorporating the results of

his vast experience in 1846. This became a standard reference book

till the close of 19 th century.

Boenninghausen was the first to evaluate the remedies in relation to

the individual symptoms. He also evolved the doctrine of

concomitants, which he believed to be of peculiar and characteristic

value.

Roberts, H.A says that “The works of Boenninghausen are among the

most comprehensive in logic, philosophy and applicability of early

writers – perhaps with the single exception of the works of

Hahnemann. The most comprehensive and far reaching in influence.”

Boger, C.M was a student of Boenninghausen. He studied many of the

original works of Boenninghausen in German and corrected many

120

faulty translations of his work in English. He was impressed by the

practical utility of the Therapeutic Pocket Book. Boger was also

aware of the difficulties faced by practitioners in using the

Therapeutic Pocket Book as well as the criticism leveled against its

principles. He enlarged this by adding many other works of

Boenninghausen to form BBCR.

He also added 17 new remedies which were proved after

Boenninghausen.

In his preface to the book, Boger says, it embraces the following

major books:

1. Boenninghausen`s Therapeutic pocket book

2. Boenninghausen`s repertory of Apsoric medicines.

3. Repertory of Antipsoric medicines by Boenninghausen

4. Sides of body by G. miller and Boenninghausen.

5. Intermittent fever by T.F. Allen.

6. Whooping cough by Boenninghausen and Clarke.

7. Aphorisms of Hippocrates.

8. Boenninghausen`s characteristics of materia medica.

9. Domestic physician by Hering.

So, the Boger-Boenninghausen`s repertory in its current form

represents the combined wisdom and experience of two masters,

Boenninghausen and Boger.

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Philosophical background

Boger gave new life to Boenninghausen`s work by refining and

enriching the basics and recasting the structure and methodology. This

gave a new lease of life to it after it had receded to back stage. Boger

attempted to bridge Boenninghausen and Kent. He avoided the

extreme generalisation of Boenninghausen and extreme

particularisation of Kent. He took the best part of both. Boger

subscribed to the principle of totality of symptoms as given by

Hahnemann. His concept of complete symptom was comprised of the

Location, Sensation, Modalities and Concomitant.

Boger`s work BBCR is based on the following concepts:

1. Complete symptoms and concomitant.

2. Doctrine of pathological generals.

3. Doctrine of causation and time.

4. Evaluation of remedies.

5. Fever totality.

6. Concordances.

Concomitant Symptoms Concomitant symptoms are the attendant circumstances \ existing

symptoms which accompany or co-exist along with the chief

complaint.

122

It was defined as the fourth element for a symptom, the other being

Location, Sensation & Modalities of the symptom. These symptoms

which occurred together or in definite association with a presenting

complaint were considered to be more valuable for prescribing and

more characteristic of the individual’s reaction as they do not have

any connection with the pathology of the case. These are of the same

class as the rare, strange and peculiar symptoms. These symptoms can

be of immense help in difficult cases.

Mostly the concomitant of the symptoms are related to the modalities.

So, the concomitant is to totality what the condition of aggravation or

amelioration is to a single symptom. This is the differentiating factor

for a concomitant.

Evaluation of Remedies

In Boger Boenninghausen Characteristics and Repertory, the grading

of the remedies as done by Boenninghausen has been followed. The

remedies are graded into five ranks as follows:

CAPITAL 5 marks.

Bold 4 marks.

Italic 3 marks.

Roman 2 marks.

(Roman) in parenthesis 1 mark.

The gradation is based on the frequency of appearance of the

symptoms in provers.

123

Structure of Boger Boenninghausen`s Characteristics and Repertory The main divisions could be divided into seven chapters, as follows –

1. Mind, Intellect, Sensorium and Vertigo. 2. Locations of complaints etc.in different anatomical parts. 3. Sensations in general; Glands, Bones, Skin. 4. Sleep and Dreams. 5. Fever, Blood, Circulation, Chill, Heat, Perspiration. 6. Conditions of Aggravation and Amelioration in general. 7. Relationships of remedies. (Concordances).

In Boenninghausen`s Repertory, Anxiety as a rubric is given on page

192. The main rubric of anxiety is followed by 7 sub-rubrics. It has

101 drugs of which 9 are in Capitals, 21 in Bold, 18 in italics and 53

in roman. In addition to this, there are 12 more remedies found in

sub-rubrics that are not found in the main rubric of anxiety. In

addition to the main rubric, anxiety is found in 73 various rubrics in

various repertories. Anxiety as a concomitant symptom under

different chapter of the repertory is edge of this repertory.

“Emotions” is substituted for anxiety in some of the chapters under

concomitants. A total of 173 remedies run through the rubrics of this

book.

124

REPERTORIAL REFERENCES OF ANXIETY IN BOGER BOENNINGHAUSEN REPRTORY SYMPTOMS MIND - Absence of mind, lost in thoughts, absent minded

MIND - Agitated

MIND - Alternating with physical symptoms

MIND - Anger, crossness, etc.

MIND - Anthropophobia, aversion to others

MIND - Anticipations, from

MIND - Anxiety, agony

MIND - Anxiety, agony - business, about.

MIND - Anxiety, agony - head, in

MIND - Anxiety, agony - epigastric

MIND - Anxiety, agony - abdominal

MIND - Anxiety, agony - chest, in

MIND - Anxiety, agony - heart, precordial

MIND - Anxiety, agony - waking, on.

MIND - Aversion to - business

MIND - Beclouded, dim

MIND - Benumbed

MIND - Beside oneself, frantic, madness etc.

MIND - Care - full of

MIND - Careful, critical, scrupulous, conscientious

MIND - Cares, affected by daily

MIND - Cautious

MIND - Changeable, inconstant, irresolute etc.

MIND - Collar, pulls at

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MIND - Company, averse to

MIND - Compassion, sympathy (immoderate)

MIND - Concentration, difficult

MIND - Confusion, befuddled, muddled etc.

MIND - Corner, mopes or broods in a

MIND - Counting - continued

MIND - Cowardly, fainthearted etc.

MIND - Death - fear, of

MIND - Death - fear, of - sleep, on going to

MIND - Death - sensation of

MIND - Delirium, frenzy - anxious, fearful, etc

MIND - Depression

MIND - Despairing, discouraged, hopeless etc

MIND - Despairing, discouraged, hopeless etc - recovery, of

MIND - Disconsolate, unhappy

MIND - Distracted, preoccupied, difficult concentration can’t think*

MIND - Dizziness and instability of

MIND - Dullness, mental obtuseness

MIND - Emotional excitement, effects of

MIND - Escape, desire to

MIND - Excitable

MIND - Excitement

MIND - Fastidious

MIND - Fearsome, anxiety, dread, frightened easily, etc

MIND - Fearsome, etc - air, open, in

MIND - Fearsome, etc - alone, of being

MIND - Fearsome, etc - anxious, restless fear

MIND - Fearsome, etc - apoplexy, of

126

MIND - Fearsome, etc - approached, being, strangers, etc

MIND - Fearsome, etc - awaking, on

MIND - Fearsome, etc - cats

MIND - Fearsome, etc - crowds, of

MIND - Fearsome, etc - dark, of the

MIND - Fearsome, etc - disease, of

MIND - Fearsome, etc - dogs, of

MIND - Fearsome, etc - door, opening the

MIND - Fearsome, etc - driving, when

MIND - Fearsome, etc - eaten, being

MIND - Fearsome, etc - eating, after

MIND - Fearsome, etc - evening, in

MIND - Fearsome, etc - evil, bad news, misfortune etc

MIND - Fearsome, etc - failure

MIND - Fearsome, etc - falling, of

MIND - Fearsome, etc - future, of

MIND - Fearsome, etc - ghosts, of

MIND - Fearsome, etc - hypochondriacal

MIND - Fearsome, etc - imaginary

MIND - Fearsome, etc - incurable, being

MIND - Fearsome, etc - insanity

MIND - Fearsome, etc - insensible, becoming

MIND - Fearsome, etc - killed, being

MIND - Fearsome, etc - knaves

MIND - Fearsome, etc - lightening

MIND - Fearsome, etc - lying, when

MIND - Fearsome, etc - man, of

MIND - Fearsome, etc - melancholic

127

MIND - Fearsome, etc - morning, in early

MIND - Fearsome, etc - nightly

MIND - Fearsome, etc - ordeals

MIND - Fearsome, anxiety, dread, frightened easily, etc - overpowering

MIND - Fearsome, etc - palpitation, with

MIND - Fearsome, etc - pins

MIND - Fearsome, etc - places, of

MIND - Fearsome, etc - poison, of

MIND - Fearsome, etc - pregnancy, during

MIND - Fearsome, etc - rattling, noises from

MIND - Fearsome, etc - recurrent

MIND - Fearsome, etc - restless

MIND - Fearsome, etc - robbers, of

MIND - Fearsome, etc - sadness, alternating with

MIND - Fearsome, etc - shadows, of

MIND - Fearsome, etc - stomach, from

MIND - Fearsome, etc - storms, thunder, of

MIND - Fearsome, etc - suffocation, of

MIND - Fearsome, etc - tearful

MIND - Fearsome, etc - tremulous

MIND - Fearsome, etc - twilight, in

MIND - Fearsome, etc - undertaking, anything

MIND - Fearsome, etc - vexation, after

MIND - Fearsome, etc - work, while at

MIND - Fretful

MIND - Gloomy

MIND - Grief, sorrow and care

MIND - Held wants to be

128

MIND - Helpless

MIND - Hiding

MIND - Howling

MIND - Hurry

MIND - Hypochondriasis

MIND - Ideas - fixed

MIND - Ill Humor, crossness

MIND - Illness, sense of and sick feeling

MIND - Illness, sense of and sick feeling - imaginary

MIND - Illusions, delusions, visions, etc. - frightful

MIND - Imaginations, fancies, fixed ideas etc.

MIND - Impatience

MIND - Impulses, morbid

MIND - Inconsolable

MIND - Indecision, hesitation

MIND - Indolence, averse to work etc.

MIND - Insanity, irrational - fear of

MIND - Insanity, irrational - obsession, with

MIND - Insecurity, mental

MIND - Introspective, introverted, absorbed etc.

MIND - Irritable, cross

MIND - Knife, impulse to injure with

MIND - Learning to speak, late in

MIND - Low-spirited

MIND - Meditation, reflection, brooding, etc.

MIND - Meditation, reflection, brooding, etc. - deep, profound

MIND - Memories, disagreeable.

MIND - Memory - involuntary recollection

129

MIND - Memory - poor, weak, forgetful, etc. - emotions, from

MIND - Mistrust, suspicious, doubt

MIND - Monomania

MIND - Mortification

MIND - Pain, intolerant of

MIND - Peevish, fretful

MIND - Pensive, deep in thought

MIND - Perplexity

MIND - Phantasies - frightful

MIND - Play, indisposition to

MIND - Plays with fingers

MIND - Presentiments, premonitions, forebodings, etc.

MIND - Religious ideas

MIND - Remorse, condemned feeling etc.

MIND - Repeats same thing

MIND - Restlessness

MIND - Sadness, melancholy

MIND - Senses losing, sense of, faintness etc

MIND - Sensitive

MIND - Shrieking, screams, cries out

MIND - Solicitude

MIND - Solicitude - of one’s health

MIND - Solicitude - for others

MIND - Speech - repeats, same thing

MIND - Startled easily, terror etc

MIND - Strangers, embarrass

MIND - Stupefied, dazed

MIND - Superstitious

130

MIND - Talk - subject, dwells, on one only

MIND - Thought, absorbed in

MIND - Timidity

MIND - Tossing about

MIND -Touched, averse to being

MIND -Touches, everything.

MIND - Trifles, occupied, with

MIND - Trifles, vexed over

MIND - Uneasiness

MIND - Unsociable, shy, averse to society

MIND - Vexation, effects of

MIND - Wailing

MIND - Wanders about, restlessly

MIND - Weeping, tearful

MIND - Will, weak

MIND - Aggravation - Approach of persons

MIND - Aggravation - Blood, rushes of, with

MIND - Aggravation - Company

MIND - Aggravation - Emotions, after

MIND - Aggravation - Excitement

MIND - Aggravation - Face, heat of, with

MIND - Aggravation - Fright

MIND - Aggravation - Hurry, from

MIND - Aggravation - Palpitation

MIND - Aggravation - Restless, when

MIND - Aggravation - Strangers, among

SENSORIUM - Confusion (in head), muddled etc.

SENSORIUM - Faintness, fainting etc.

131

VERTIGO - Anxious

VERTIGO - Nervous

VERTIGO - Aggravation - Emotions

VERTIGO - Aggravation - Excitement, mental

VERTIGO - Aggravation - Fear

VERTIGO - Aggravation - Fright, after

VERTIGO - Aggravation - Narrow streets, places, etc.

VERTIGO - Aggravation - Walking - path or bridge, on a narrow

VERTIGO - Concomitants - Anxiety

VERTIGO - Concomitants - Blood, rushes of

VERTIGO - Concomitants - Confusion, bewildered etc.

VERTIGO - Concomitants - Fear of death

VERTIGO - Concomitants - Hypochondriacal mood

VERTIGO - Concomitants - Respiration, difficult

VERTIGO - Concomitants - Restlessness

HEAD - Internal - Anxiety felt in

HEAD - Internal - Anxious headache

HEAD - Internal - Nervous origin

HEAD - Internal - Tension in general

HEAD - Internal - Aggravation - Anxiety, with

HEAD - Internal - Aggravation - Death, fear of, with

HEAD - Internal - Aggravation - Face, hot, with

HEAD - Internal - Aggravation - Fright, after

HEAD - Internal - Aggravation - Grief

HEAD - Internal - Aggravation - Hypochondriacs, in

HEAD - Internal - Aggravation - Irritable, cross, with

HEAD - Internal - Aggravation - Mental disturbances or emotions

HEAD - Internal - Aggravation - Restlessness, with

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HEAD - Internal - Aggravation - Vexation, irritation

HEAD - External - Hair - bristling, standing on end, etc.

HEAD - External - Hair - pulls her hair, or of others

HEAD - External - Aggravation - Emotions, anxiety, etc.

EYES - Look - anxious

EYES - Nervous, sympathetic reflex to symptoms

EYE - Pupils - dilated

CORYZA - Concomitants - heart, anxiety at

CORYZA - Concomitants - Nervous excitement

FACE - Anxious look

FACE - Blood, rush of, to

FACE - Deathly countenance

FACE - Expression - anxious

FACE - Expression - confused

FACE - Expression - despair, of

FACE - Expression - fear, of

FACE - Expression - frowning

FACE - Expression - miserable

FACE - Expression - suffering

FACE - Heat

FACE - Muscles - drawn

FACE - Tension (of skin)

FACE - Wrinkled

FACE - Wrinkled - forehead, forming etc.

FACE - Aggravation - Emotions

TEETH - Uneasiness

TEETH - Gums - Uneasiness

TEETH - Concomitants - Anxiety

133

TEETH - Concomitants - Face - heat of

TEETH - Concomitants - Restlessness

TEETH - Concomitants - Sweat, anxious

MOUTH - Dry feeling in

MOUTH - Dryness

MOUTH - Throat (and gullet) - Anxiety in

MOUTH - Throat (and gullet) - Choking, strangling

MOUTH - Throat (and gullet) - Foreign body, as of a crump, ball, etc

MOUTH - Throat (and gullet) - Globus, as of a ball, lump, knot, hystericus*

MOUTH - Throat (and gullet) - Plug, lump etc

MOUTH - Throat (and gullet) - Swallowing - difficult

MOUTH - Throat (& gullet) - Swallowing - urging to - suffocation, with fear*

MOUTH - Throat (and gullet) - uneasiness in

WATERBRASH AND HEARTBURN - Risings in throat (gulping up)

WATERBRASH AND HEARTBURN - Risings in throat - anxious *

NAUSEA AND VOMITING - Nausea

NAUSEA AND VOMITING - Nausea - anxiety, with

NAUSEA AND VOMITING - Nausea - anxious, deathly, etc.

NAUSEA AND VOMITING - Retching and gagging

NAUSEA AND VOMITING - Retching and gagging - anxious

NAUSEA AND VOMITING - Aggravation - Emotions

NAUSEA AND VOMITING - Aggravation - Fright, after

NAUSEA AND VOMITING - Concomitants - Fear, anxiety

NAUSEA AND VOMITING - Concomitants - Fear, anxiety - death, of

NAUSEA AND VOMITING - Concomitants - Irritability

NAUSEA AND VOMITING - Concomitants - Restlessness

STOMACH - Anxiety at

STOMACH - Anxiety at - rising, from

134

STOMACH - Digestion, weak

STOMACH - Digestion, weak - emotions, from

STOMACH - Digestion, weak - hypochondriacs, in

STOMACH - Emotions are felt in

STOMACH - Epigastrium - Anxiety in, emotions felt there, etc.

STOMACH - Epigastrium - Sinking at

STOMACH - Aggravation - Anger, vexation - fright, with

STOMACH - Aggravation - Emotions

STOMACH - Aggravation - Fright, after

STOMACH - Concomitants - Anxiousness

STOMACH - Concomitants - Hypochondriasis, with

HYPOCHONDRIA - Anxiety in liver

HYPOCHONDRIA - Aggravation - Emotions

ABDOMEN - Anxiety, anguish, etc. in

ABDOMEN - Anxiety, anguish, etc. in - rising, from

ABDOMEN - Fright, pain as after a

ABDOMEN - Uneasiness

ABDOMEN - Aggravation - Emotions

ABDOMEN - Aggravation - Hypochondriasis, with

ABDOMEN - Amelioration - Fright

FLATULENCE - Aggravation - Anxiety, with

FLATULENCE - Aggravation - Emotions

STOOL - Concomitants before stool - Anxiety, fear

STOOL - Concomitants before stool - epigastrium - Anxiety in

STOOL - Concomitants before stool - Fear, anxiety

STOOL - Concomitants before stool - Fear, anxiety - of persons

STOOL - Concomitants before stool - Uneasiness, discomfort

STOOL - Concomitants during stool - Anxiety

135

STOOL - Concomitants after stool - Anxiety, fear, etc.

STOOL - Concomitants after stool - Fear, anxiety

STOOL - Aggravation and amelioration - Emotions, anger, fright etc

STOOL - Aggravation and amelioration - Fear, anxiety; with

STOOL - Aggravation and amelioration - Fear - others, of

URINE - Micturition - Urging - anxiety, with

URINE - Micturition - Urination - strangury - fear, fright, etc., agg.

URINE - Before urination - Anxiety

URINE - Before urination - Fright

URINE - During urination - Anxiety

URINARY ORGANS - Bladder - Anxiety

SEXUAL IMPULSE - Semen - emission of - anxiety, then

SEXUAL IMPULSE - Concomitants after coition - Anxiety

SEXUAL IMPULSE - Concomitants after pollutions - Heat, anxious

RESPIRATION - Anxious

RESPIRATION - Short

RESPIRATION - Impeded by - Anxiety

RESPIRATION - Impeded by - Dreams, anxious

RESPIRATION - Impeded by - Epigastrium - anxiety in

COUGH - Anxious

COUGH - Sympathetic reflex

COUGH - Concomitants - anxiety, fear

VOICE AND SPEECH - Anxious

CHEST - Inner - anxiety in

CHEST - Inner - constriction

CHEST - Inner - oppression

CHEST - Heart and region of - agitated

CHEST - Heart and region of - anguish

136

CHEST - Heart and region of - anxiety at

CHEST - Heart and region of - distress

CHEST - Heart and region of - uneasiness

CHEST - Aggravation - anxiety

BACK - Back proper, dorsal region - anxious sensation

BACK - Lumbar region, small of back - uneasiness, in

LOWER EXTREMITIES - Gait - anxious

SENSATIONS & COMPLAINTS IN GEN - Anxious feeling - internal anxiety*

SENSATIONS & COMPLAINTS IN GEN - Anxious feeling - In limbs

SENSATIONS & COMPLAINTS IN GEN - Fainting, faintness etc

SENSATIONS & COMPLAINTS IN GEN - Fainting - emotions*

SENSATIONS & COMPLAINTS IN GEN - Hypochondriasis & hysteria

SENSATIONS & COMPLAINTS IN GEN - Irritability

SENSATIONS & COMPLAINTS IN GEN - Muscles - tense

SENSATIONS & COMPLAINTS IN GEN - Restlessness

SENSATIONS & COMPLAINTS IN GEN – Starting, as if in affright

SENSATIONS & COMPLAINTS IN GEN - Trembling, shaking etc

SLEEP - Falling to sleep, late - prevented by - agitation

SLEEP - Falling to sleep, late - prevented by - anxiety, fear

SLEEP - Falling to sleep, late - prevented by - blood, orgasm of

SLEEP - Falling to sleep, late - prevented by - chest, oppression of

SLEEP - Falling to sleep, late - prevented by - emotions, from

SLEEP - Falling to sleep, late - prevented by - falling, fear of

SLEEP - Falling to sleep, late - prevented by - frightened, easily

SLEEP - Falling to sleep, late - prevented by - restlessness

SLEEP - Falling to sleep, late - prevented by - starting

SLEEP - Falling to sleep, late - prevented by - startled, as if

SLEEP - Sleep - anxious

137

SLEEP - Sleep – restless

SLEEP - During sleep - anxiety

SLEEP - During sleep - nightmare

SLEEP - During sleep - nightmare - in first sleep

SLEEP - During sleep – starting up (as in an affright)

SLEEP - Waking - waking - anxious

SLEEP - Waking - waking – fright, as from

SLEEP - Waking - waking - restlessness, with

SLEEP - Waking - sleeplessness - fear or anxiety

SLEEP - Waking - sleeplessness - palpitation

SLEEP - Waking - sleeplessness - tossing about - anxious

SLEEP - Waking - sleeplessness - worry

DREAMS - Anxious, frightful, etc.

DREAMS - Anxious, frightful, etc - of animals.

DREAMS - Anxious, frightful, etc - day’s events of

DREAMS - Anxious, frightful, etc - the dead

DREAMS - Anxious, frightful, etc - difficulties, perplexity*

DREAMS - Anxious, frightful, etc - disease

DREAMS - Anxious, frightful, etc - dying of

DREAMS - Anxious, frightful, etc - exertion, laborious, etc

DREAMS - Anxious, frightful, etc - falling

DREAMS - Anxious, frightful, etc - fire

DREAMS - Anxious, frightful, etc - forms of

DREAMS - Anxious, frightful, etc - ghosts

DREAMS - Anxious, frightful, etc - heavy

DREAMS - Anxious, frightful, etc - lewd

DREAMS - Anxious, frightful, etc - loathsome

DREAMS - Anxious, frightful, etc - misfortune, fatal accidents

138

DREAMS - Anxious, frightful, etc - pursued being

DREAMS - Anxious, frightful, etc - quarrels and strife

DREAMS - Anxious, frightful, etc - shooting

DREAMS - Anxious, frightful, etc - thieves

DREAMS - Anxious, frightful, etc - thunderstorms

DREAMS - Anxious, frightful, etc - vivid

DREAMS - Anxious, frightful, etc - voyages

DREAMS - Anxious, frightful, etc - war

DREAMS - Anxious, frightful, etc – water

DREAMS - Restless, disturbed

CIRCULATION - Congestions - ebullition, rush of blood, flashing, orgasms*

CIRCULATION - Palpitation - anxious

CIRCULATION - Palpitation - audible

CIRCULATION - Palpitation - blood rushes of, with

CIRCULATION - Palpitation - breathing, with short

CIRCULATION - Palpitation - chest, oppression in, with

CIRCULATION - Palpitation - chest, pain in, with

CIRCULATION - Palpitation - emotion from

CIRCULATION - Palpitation - faintness, with

CIRCULATION - Palpitation - nausea, with

CIRCULATION - Palpitation - shaking whole body

CIRCULATION - Palpitation - sweat, with cold

CIRCULATION - Palpitation - violent

CIRCULATION - Heartbeat - heartbeat - audible

CIRCULATION - Heartbeat - heartbeat - shaking the whole body

CIRCULATION - Heartbeat - heartbeat - tumultuous and stormy

CIRCULATION - Pulse - pulse - quick (accelerated)

CIRCULATION - Pulse - pulse - shaking the whole body

139

CIRCULATION - Aggravation - Emotions

CHILL - Chill, etc - Aggravation - Emotions

CHILL - Chill, etc. - concomitants - mind - anxiety

CHILL - Chill, etc. - concomitants - chest - palpitation

CHILL - Chill, etc. - concomitants - skin - goose skin

HEAT & FEVER IN GENERAL - Heat and burning - anxious

HEAT & FEVER IN GENERAL - Aggravation - Emotions

HEAT & FEVER IN GENERAL - Concomitants - mind - anthropophobia

HEAT & FEVER IN GENERAL - Concomitants - mind - anxiety

HEAT & FEVER IN GENERAL - Concomitants - mind - delirium - anxious

HEAT & FEVER IN GENERAL - Concomitants - mind - fear

HEAT & FEVER IN GENERAL - Concomitants - mind - frightened easily

HEAT & FEVER IN GENERAL - Concomitants - mind - restlessness

HEAT & FEVER IN GEN. - Concomitants - respiration - breathing - anxious

HEAT & FEVER IN GEN. - Concomitants - chest - heart - anxious

SWEAT - Sweat, sweatiness - anxious

SWEAT - Concomitants - mind - anthropophobia

SWEAT - Concomitants - mind - anxiety

SWEAT - Concomitants - mind - death, fear of

SWEAT - Concomitants - mind – frightened easily

SWEAT - Concomitants - mind - restlessness

SWEAT - Concomitants - mouth - mouth - dryness, of

SWEAT - Concomitants - respiration - breathing - anxious, quick*

SWEAT - Concomitants - respiration - breathing – oppression, of

SWEAT - Concomitants - chest - heart, palpitation of

SWEAT - Concomitants - sensations & generalities - restlessness*

CONDITIONS OF AGG.\ AMEL. IN GEN - Emotions, agg.

CONDITION OF AGG\ AMEL IN GEN - Emotions - anger - anxiety, agg.*

140

CONDITION OF AGG\ AMEL IN GEN - Emotions - fright (anxiety) - agg*

CONDITION OF AGG\ AMEL IN GEN - Emotions - fright - of an ordeal

CONDITION OF AGG\ AMEL IN GEN - Society, company, agg*.

CONDITION OF AGG\ AMEL IN GEN - Strangers, when among agg

CONDITION OF AGG\ AMEL IN GEN - Walking - narrow bridge, agg*

* - symptom slightly altered to fit the format

REPERTORIAL REFERENCES FROM OTHER REPERTORIES. The Rubrics relating to anxiety are also found in other repertories

such a Synthesis, Synthetic, Knerr`s repertory and Phatak`s repertory.

Only those rubrics which are present in these repertories and not in

Kent and Boenninghausen are highlighted here.

SYNTHESIS REPR 5.2 MIND - AILMENTS FROM - anxiety - prolonged, from

MIND - ANGUISH - eating, after

MIND - ANTICIPATION - examination, before

MIND - ANTICIPATION - stage fright

MIND - ANXIETY - night - children, in

MIND - ANXIETY - beside oneself from anxiety, being

MIND - ANXIETY - breakfast - amel.

MIND - ANXIETY - burning of stomach and coldness of body; with

MIND - ANXIETY - cough - whooping, during

MIND - ANXIETY - face - heat of face; with

MIND - ANXIETY - face - pale face; with

141

MIND - ANXIETY - face - perspiration of face; with

MIND - ANXIETY - face - perspiration of face; with - cold

MIND - ANXIETY - face - red face; with

MIND - ANXIETY - flatus - obstructed flatus; with

MIND - ANXIETY - sexual desire; from suppressed

MIND - ANXIETY - swoon, after

MIND - ANXIETY - torturing

MIND - ANXIETY - wine, after

MIND - BITE, desire to - nails

MIND - CLINGING - take the hand of mother, will always

MIND - CONCENTRATION - difficult - attention, cannot fix

MIND - DELIRIUM - terror, expressive of

MIND - FEAR - cancer, of

MIND - FEAR - control, losing

MIND - FEAR - crossing Street

MIND - FEAR - elevators, of

MIND - FEAR - everything, constant of

MIND - FEAR - failure of - examinations; in

MIND - FEAR - fright - previous fright; because of a

MIND - FEAR - full of fear

MIND - FEAR - open space; fear of

MIND - FEAR - shadows

MIND - FEAR - shadows - candlelight; thrown by

MIND - FEAR - wolves, of

MIND - IMPULSE, morbid - absurd things; to do

MIND - IRRITABILITY - imagined occurrences, about

MIND - RESTLESSNESS - driving about

MIND - STARING - thoughtless

142

MIND - STUPEFACTION - anxiety, with

MIND - SUICIDAL disposition - anxiety, from

MIND - WEEPING - anxious

HEAD - CONGESTION - anxiety, with

HEAD - HEAT - anxiety, with

HEAD - PERSPIRATION of scalp - forehead - cold - trembling anxiety, with

VISION - DIM - anxiety, during

FACE - HEAT - anxiety, during

FACE - PERSPIRATION - anxiety, with

FACE - TENSION of skin - masseter muscles

ABDOMEN - RESTLESSNESS, uneasiness - anxious

RECTUM - DIARRHOEA - anxiety, after

CHEST - CONSTRICTION - anguish, with

CHEST - PAIN - aching - anxiety, with

SLEEP - DISTURBED - perspiration by - anxiety, from

SLEEP - SLEEPINESS - anxiety, with

GENERALS - CONULSIONS - anxiety, from

SYNTHETIC REPERTORY (VOL 1, 2 & 3).

VOLUME 1 - PSYCHIC SYMPTOMS

MIND - ABSORBED - future, about

MIND - ABSORBED - misfortunes, imagines

MIND - AILMENTS FROM - anticipation

MIND - AILMENTS FROM - anxiety

MIND - AILMENTS FROM - cares, worries

MIND - AILMENTS FROM - fear

143

MIND - AILMENTS FROM - fright

MIND - AILMENTS FROM - fright - accident; from sight of an

MIND - AILMENTS FROM - shock, mental

MIND - ANGER - causeless

MIND - ANGER - happen; anger at what he thinks may

MIND - ANGER - trifles, at

MIND - ANGUISH - noon

MIND - ANGUISH - afternoon

MIND - ANGUISH - evening, 7 p.m.

MIND - ANGUISH - night - paralyzing anguish, impossible to call or move*

MIND - ANGUISH - alone, when

MIND - ANGUISH - bed - after going to bed amel.

MIND - ANGUISH - cardiac

MIND - ANGUISH - clothes too tight when walking in open air; as if

MIND - ANGUISH - constricted, as if everything became

MIND - ANGUISH - driving from place to place - restlessness, with

MIND - ANGUISH - horrible things; after hearing

MIND - ANGUISH - lamenting, moaning

MIND - ANGUISH - lie down, must

MIND - ANGUISH - motion amel.

MIND - ANGUISH - nausea, with

MIND - ANGUISH - oppression, with

MIND - ANGUISH - oppression, with - desire to sit up or jump out of bed

MIND - ANGUISH - palpitation, with

MIND - ANGUISH - perspiration, during - night

MIND - ANGUISH - respiration, preventing

MIND - ANGUISH - room with light and people, agg, in a

MIND - ANGUISH - tossing about, with

144

MIND - ANGUISH - tremulous anguish, rest agg, motion amel.

MIND - ANGUISH - uremia, in

MIND - ANGUISH - waking, on

MIND - ANGUISH - weeping, with

MIND - ANTICIPATION - morning

MIND - ANTICIPATION - dentist, physician; before going to

MIND - ANTICIPATION - stage fright - singers and speakers, in

MIND - ANXIETY - morning - perspiration; during

MIND - ANXIETY - afternoon - 2 - 4 p.m.

MIND - ANXIETY - afternoon - amel.

MIND - ANXIETY - night - amel.

MIND - ANXIETY - night - midnight - after - half waking; on

MIND - ANXIETY - night - midnight - after - 2-4 h

MIND - ANXIETY - night - midnight - after - 3-5 h

MIND - ANXIETY - night - midnight - after - 5 h

MIND - ANXIETY - abdomen; with distension of

MIND - ANXIETY - alternating with - contentment

MIND - ANXIETY - alternating with - exhilaration

MIND - ANXIETY - alternating with - rage

MIND - ANXIETY - anticipation, from

MIND - ANXIETY – bed in, driving out of

MIND - ANXIETY - bed, in - heat of, from

MIND - ANXIETY - bed, in - sit up, must

MIND - ANXIETY - bed, in - tossing about, with

MIND - ANXIETY - bed, in - turning in, when

MIND - ANXIETY - beer, after

MIND - ANXIETY - breathing - must breathe deeply

MIND - ANXIETY - causeless

145

MIND - ANXIETY - chest, in - stitching in, from

MIND - ANXIETY - children - infants, in

MIND - ANXIETY - children - rocking, during

MIND - ANXIETY – climacteric period, during

MIND - ANXIETY - clothes and open windows, must loose

MIND - ANXIETY - clothes - as if clothing too tight, walking out of doors;

MIND - ANXIETY - coffee - amel.

MIND - ANXIETY - coition - during

MIND - ANXIETY - coldness of feet at night, during

MIND - ANXIETY - congestion - to heart

MIND - ANXIETY - conscience; as if guilty of a crime - afternoon

MIND - ANXIETY - conscience; as if guilty of a crime - dreams, a. of c. in

MIND - ANXIETY - conscience; as if guilty of a crime - no rest night / day *

MIND - ANXIETY - convulsions - before

MIND - ANXIETY - cramping rectum, during

MIND - ANXIETY - cramping stomach, in

MIND - ANXIETY - daily

MIND - ANXIETY - dancing, when

MIND - ANXIETY - dentition, during

MIND - ANXIETY - disguises; which he vainly

MIND - ANXIETY - do something; compelled to

MIND - ANXIETY - drinking - cold water amel.

MIND - ANXIETY - driving from place to place

MIND - ANXIETY - duty, as if he had not done his

MIND - ANXIETY - epilepsy, during intervals of

MIND - ANXIETY - epistaxis amel.

MIND - ANXIETY - eructations - ending with

MIND - ANXIETY - everything; about

146

MIND - ANXIETY - exercise - from

MIND - ANXIETY - faintness, with

MIND - ANXIETY - family; about his

MIND - ANXIETY - fasting, when

MIND - ANXIETY - fever - as from

MIND - ANXIETY - fright - remains, if the fear of the fright

MIND - ANXIETY - head, with congestion to

MIND - ANXIETY - head - heat of; with

MIND - ANXIETY - head - perspiration on forehead; with

MIND - ANXIETY - health; about - relatives, of

MIND - ANXIETY - himself, about

MIND - ANXIETY - home, about

MIND - ANXIETY - hurry, with

MIND - ANXIETY - hysterical

MIND - ANXIETY - inactivity, with

MIND - ANXIETY - joyful things, by most

MIND - ANXIETY - masturbation, from

MIND - ANXIETY - menses - during - anger and a.

MIND - ANXIETY - moaning, with

MIND - ANXIETY - money matters, about

MIND - ANXIETY - noise, from - in ear

MIND - ANXIETY - nursing, after

MIND - ANXIETY - oppression, with

MIND - ANXIETY - pains, from - abdomen

MIND - ANXIETY - pains, from - anus

MIND - ANXIETY - pains, from - eyes

MIND - ANXIETY - pains, from - stomach

MIND - ANXIETY - paralyzed, as if

147

MIND - ANXIETY - parturition, during

MIND - ANXIETY - perspiration amel.

MIND - ANXIETY - perspiration - with cold

MIND - ANXIETY - pregnancy, in

MIND - ANXIETY - present, about

MIND - ANXIETY - pressure in the chest, from

MIND - ANXIETY - pressure in the epigastrium, from

MIND - ANXIETY - pulsation in the abdomen, with

MIND - ANXIETY - pursued, as if

MIND - ANXIETY - rest; during

MIND - ANXIETY - rising, after - from lying

MIND - ANXIETY - room, on entering a

MIND - ANXIETY - salvation, about - night

MIND - ANXIETY - salvation, about - faith, about loss of his

MIND - ANXIETY - salvation, about - hell, of

MIND - ANXIETY - salvation, about - scruples, excessifs religious

MIND - ANXIETY - salvation, about - scrupulous their religious practices*

MIND - ANXIETY - sitting - bent -must

MIND - ANXIETY - stitching in spine, from

MIND - ANXIETY - stools, after - bloody

MIND - ANXIETY - stools, as for

MIND - ANXIETY - stormy weather, during

MIND - ANXIETY - success, from doubts about

MIND - ANXIETY - thoughts; from - disagreeable

MIND - ANXIETY - thoughts; from - sad

MIND - ANXIETY - thunderstorm, before

MIND - ANXIETY - touched, anxiety to being

MIND - ANXIETY – tunnel in a train, in

148

MIND - ANXIETY - urination, when the desire is resisted

MIND - ANXIETY - urination, with urging to

MIND - ANXIETY - vomiting, on

MIND - ANXIETY - walking, amel.

MIND - ANXIETY - walking, after

MIND - ANXIETY - walking, cool air, in

MIND - ANXIETY - weary of life, with

MIND - ANXIETY - work, anxiety with inclination to

MIND - ANXIETY - work - anxiety preventing

MIND - ANXIETY - working, while

MIND - AVARICE - anxiety about future, from

MIND - BESIDE oneself being - anxiety, from

MIND - BESIDE oneself being - trifles, from

MIND - CARES, worries, full of - business, about his

MIND - CARES, worries, full of - others, about

MIND - CARES, worries, full of - relatives, about

MIND - DELUSIONS - anxious

MIND - DELUSIONS - doomed, being

MIND - DELUSIONS - fright, after

MIND - DELUSIONS - heart disease, having an

MIND - DISCOURAGED - anxiety, with

MIND - DWELLS - recalls - disagreeable memories

MIND - ESCAPE, attempts to - anxiety at night, with

MIND - FEAR - alternating with exhilaration

MIND - FEAR - alternating with rage

MIND - FEAR - alternating with sadness

MIND - FEAR - appearing in public, of

MIND - FEAR - ascending of

149

MIND - FEAR - blind, of going

MIND - FEAR - business, of

MIND - FEAR - cats

MIND - FEAR - children, in

MIND - FEAR - company, of

MIND - FEAR - crossing bridge or a place

MIND - FEAR - crowd, in a - climacteric period, during

MIND - FEAR - death of - impending death, of

MIND - FEAR - delusions, from

MIND - FEAR - diarrhea, from

MIND - FEAR - disease of impending - incurable of being

MIND - FEAR - dreams, of terrible

MIND - FEAR - enemies, of

MIND - FEAR - escape; with desire to

MIND - FEAR - examination, before

MIND - FEAR - failure of

MIND - FEAR - falling, of - child holds on to the mother

MIND - FEAR - going out, of

MIND - FEAR - hanged, to be

MIND - FEAR - happen, something will - night

MIND - FEAR - humiliated of being

MIND - FEAR - insanity, losing his reason, of – climacteric period, during

MIND - FEAR - insects, of

MIND - FEAR - knaves, of

MIND - FEAR - knives, of

MIND - FEAR - lifelong

MIND - FEAR - lightning, of

MIND - FEAR - menses, after

150

MIND - FEAR - menses, suppressed - from fear

MIND - FEAR - motion, of

MIND - FEAR - narrow places - vaults, churches & cellars, of

MIND - FEAR - neglected, of being

MIND - FEAR - new persons, of

MIND - FEAR - operation, of each

MIND - FEAR - opinion of others, of

MIND - FEAR - ordeals, of

MIND - FEAR - overpowering

MIND - FEAR - palpitation, with

MIND - FEAR - perspiration, with

MIND - FEAR - pitied, of being

MIND - FEAR - position, to lose his lucrative

MIND - FEAR - rage, to fly into a

MIND - FEAR - rail, of going by

MIND - FEAR - recover, he will not

MIND - FEAR - recover, he will not - climacteric period, during

MIND - FEAR - recurrent

MIND - FEAR - reproaches, of

MIND - FEAR - restlessness from fear

MIND - FEAR - robbers - waking, on

MIND - FEAR - sadness, with

MIND - FEAR - scorpions, of

MIND - FEAR - shadows - his own shadow; of

MIND - FEAR - shivering from fear

MIND - FEAR - sighing, with

MIND - FEAR - smallpox, of

MIND - FEAR - snakes, of

151

MIND - FEAR - solitude, of

MIND - FEAR - spiders, of

MIND - FEAR - starting, with

MIND - FEAR - stool, of involuntary

MIND - FEAR - stoppage of circulation, with sensation of (at night)

MIND - FEAR - strangled, to be

MIND - FEAR - struck by those coming towards him, of being

MIND - FEAR - suffocation, of - eating amel.

MIND - FEAR - suffocation, of - heart disease, in

MIND - FEAR - suffocation, of - sleep, during

MIND - FEAR - telephone, of

MIND - FEAR - things, of real and unreal

MIND - FEAR - torturing, of

MIND - FEAR - tremulous

MIND - FEAR - tunnels; of

MIND - FEAR - unconsciousness, of

MIND - FEAR - urine, from - retention, of

MIND - FEAR - work, dread of - afternoon

MIND - FEAR - work, dread of - daily; of

MIND - FEAR - work, dread of – mental, of

MIND - FRIGHTENED easily - noon - nap, after

MIND - FRIGHTENED easily - evening

MIND - FRIGHTENED easily - blood, at sight of

MIND - FRIGHTENED easily - delusions, from

MIND - FRIGHTENED easily - shadow, of his own

MIND - FRIGHTENED easily - waking, on - dream, from a

MIND - IMPULSE, morbid

MIND - INDIFFERENCE - anxiety, after

152

MIND - IRRITABILITY - anxiety, with

MIND - JUMPING - bed; out of - frightful dream, from a

MIND - KILL; desire to - beloved ones

MIND - KILL; desire to - child, the own

MIND - KILL; desire to - poison, impulse to

MIND - LAMENTING - anxious

MIND - MOANING, groaning - anxious

MIND - MOANING, groaning - restlessness, with

MIND - STUPEFACTION - anxiety, with

MIND - SUICIDAL disposition - anxiety, from

MIND - THOUGHTS - tormenting - past disagreeable events, about

MIND - WEEPING - anxiety, after

MIND - WEEPING - anxious

MIND - WEEPING - evil impended, as if

MIND - WEEPING - future, about the

MIND - WEEPING - nightmare, after

MIND - WITHDRAWAL from reality

VOLUME 2 - GENERAL SYMPTOMS

GENERALITIES - CHOREA - anxiety, from

GENERALITIES - FAINTNESS - anguish, after

GENERALITIES - ORGASME OF BLOOD - anxiety with

GENERALITIES - TREMBLING - anxiety – with

VOLUME 3 – SLEEP, DREAMS & SEXUALITY

MALE GENITALIA/SEX - MASTURBATION, irresistible tendency

SLEEP - DISTURBED - anxiety, from

SLEEP - DISTURBED - visions, by - anxious

153

SLEEP - RESTLESS - anxiety, with

SLEEP - SLEEPINESS - anxiety, with

SLEEP - SLEEPLESSNESS - visions, from - anxious

SLEEP - WAKING - frequent - anxiety, with

SLEEP - YAWNING - anxiety, during

DREAMS - ANXIOUS - anxiety amel. on waking

DREAMS - ANXIOUS - siesta, during

DREAMS - FRIGHTFUL - fear, followed by

DREAMS - FRIGHTFUL - waking him

DREAMS - NIGHTMARES - falling sleep. On

DREAMS - NIGHTMARES - full moon, at

KNERR`S REPERTORY

MIND - ANGUISH - abortion, in threatened

MIND - ANGUISH - amenorrhoea, in

MIND - ANGUISH - anger, after

MIND - ANGUISH - choking, from

MIND - ANGUISH - cholera, in

MIND - ANGUISH - colic, with

MIND - ANGUISH - dyspnoea, with

MIND - ANGUISH - fainting, before

MIND - ANGUISH - fever, with

MIND - ANGUISH - headache, in

MIND - ANGUISH - hysteria, in

MIND - ANGUISH - loss of his friend, from

MIND - ANGUISH - meningitis, in

MIND - ANGUISH - metrorrhagia, in

MIND - ANGUISH - peritonitis, in

154

MIND - ANGUISH - perspiration, with cold - forehead, on

MIND - ANGUISH - restlessness, with

MIND - ANGUISH - shock from injury, in

MIND - ANGUISH - stormy weather, in

MIND - ANGUISH - suicide, attempts to commit

MIND - ANGUISH - toothache, with

MIND - ANGUISH - vomiting, with

MIND - ANGUISH - whooping cough, during

MIND - ANTICIPATION - feels matters sensitively before they occur *

MIND - ANTICIPATION - unusual ordeal, of any

MIND - ANXIETY - forenoon - better after little whiskey

MIND - ANXIETY - accident; as if - would happen

MIND - ANXIETY - alone; when - evening

MIND - ANXIETY - alone; as if - and all about were dead and still

MIND - ANXIETY - amenorrhea; during

MIND - ANXIETY - apathy, followed by

MIND - ANXIETY - aphonia, in

MIND - ANXIETY - arms, had to stretch

MIND - ANXIETY - ascites; during

MIND - ANXIETY - asthma; with

MIND - ANXIETY - attacks in - cannot control herself

MIND - ANXIETY - back - small of - paralytic pain with

MIND - ANXIETY - bladder paralysis, with

MIND - ANXIETY - bronchitis, with

MIND - ANXIETY - business, about - dyspepsia, from

MIND - ANXIETY - chest, in - congestion, with

MIND - ANXIETY - chest, in - effusion of serum, with

MIND - ANXIETY - chest, in - gastralgia, with

155

MIND - ANXIETY - chest, in - palpitations and bitter eructations, with

MIND - ANXIETY - cheerful, careless mood, after

MIND - ANXIETY - chorea, in

MIND - ANXIETY - complaints, with all bodily

MIND - ANXIETY - confusion before eyes, after

MIND - ANXIETY - continued - anasarca, in

MIND - ANXIETY - crime - committing, as if

MIND - ANXIETY - domestic affairs about - pregnancy during

MIND - ANXIETY - flatulent distention - from

MIND - ANXIETY - fly away, as if she must, no peace anywhere

MIND - ANXIETY - fright, after - seventh month of pregnancy, in

MIND - ANXIETY - friend had forsaken her, as if

MIND - ANXIETY - future, about - childbed, after

MIND - ANXIETY - future, about - chronic orchitis, with

MIND - ANXIETY - future, about - disgust of life, with

MIND - ANXIETY - future, about - spermatorrhoea, with

MIND - ANXIETY - gloomy forebodings, with

MIND - ANXIETY - head - heat of; with - cold feet, and

MIND - ANXIETY - mania, in

MIND - ANXIETY - melancholy, with

MIND - ANXIETY - restlessness, with

MIND - ANXIETY - suffering, with

MIND - ANXIETY - terrible

MIND - ANXIETY - twitching, with *

MIND - ANXIETY - typhus, in

MIND - ANXIETY - unconquerable

MIND - ANXIETY - vaccination, after

MIND - APPREHENSIONS

156

MIND - APPREHENSIONS - anxious

MIND - APPREHENSIONS - bad news - would soon hear, as if

MIND - APPREHENSIONS - chlorosis, in

MIND - APPREHENSIONS - control, loss of - with feeling of

MIND - APPREHENSIONS - disease, of

MIND - APPREHENSIONS - disease, of – diarrhea, in

MIND - APPREHENSIONS - disease, of - fatal termination, of

MIND - APPREHENSIONS - emission, after

MIND - APPREHENSIONS - evil, of - with sadness and weeping

MIND - APPREHENSIONS - menses, after

MIND - APPREHENSIONS - night - cannot remain in bed

MIND - APPREHENSIONS - room seemed gloomy and unpleasant

MIND - APPREHENSIONS - weep, with inclination to

MIND - APPREHENSIONS - wrong, of something indescribable

MIND - CONSCIENCE - over conscientious

MIND - FEAR - amenorrhoea from fear

MIND - FEAR - anorexia from fear

MIND - FEAR - bed, jumps out of - fear from

MIND - FEAR - breath away, takes

MIND - FEAR - coition - during - impotence from fear, with

MIND - FEAR - crazy, of becoming - fright, after

MIND - FEAR - crazy, of becoming - with restlessness & heat

MIND - FEAR - death of - amenorrhoea, in

MIND - FEAR - death of - anger, from

MIND - FEAR - death of - cholera, in

MIND - FEAR - death of - hemorrhage, in uterine

MIND - FEAR - death of - loquacity, with

MIND - FEAR - death of - prolapse of uterus; with

157

MIND - FEAR - death of - suffocation, from

MIND - FEAR - death of - uterus; from pain in

MIND - FEAR - surgeon, of

MIND - FEAR - touched; of being - gout, in

MIND - FEAR - weary of life, with

MIND - FEAR - work, of - persuaded to work; cannot be

MIND - FEAR - wrong of something - commit something

MIND - FOREBODINGS - brain fag, with

MIND - FOREBODINGS - constant

MIND - FOREBODINGS - dysmenorrhoea, in

MIND - FOREBODINGS - evil

MIND - FOREBODINGS - impending disaster, of

MIND - HASTY - heart, with anxiety and fluttering

MIND - HYPOCHONDRIASIS - anxiety, with

MIND - INCONSOLABLE - anxiety about his family during a short journey*

MIND - RELIGIOUS - mania - prays all the time

MIND - RUNS about - as if in fright

MIND - SADNESS - impending evil, with apprehension of

MIND - TALKING - misfortune, about

MIND - THOUGHTS - terrible - take possession of him

MIND - UNEASY

MIND - WORRY

MIND - WRITING - unable to as rapidly as he wishes, anxious, makes mistakes*

FACE - EXPRESSION - anxious - fear of death, with

FACE - EXPRESSION - fear - and terror

STOMACH - ANXIETY - apprehensive

FEMALE GENITALIA/SEX - menses - too late - anxiety, with

DREAMS - ANXIOUS - palpitation, with

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DREAMS - ANXIOUS - talking and crying in sleep, with

DREAMS - ANXIOUS - weeping during sleep, with

PHATAK`S REEPRTORY

MIND - BORROWS trouble

MIND - CARE & WORRY - causeless

MIND - FEAR - hurt, of being

MIND - FEAR - sharp things, of

MIND - FEAR - stool, after

MIND - FEAR - waking, on - slowly must, otherwise something will happen *

GENERALITIES - FORMICATION, crawling - anxiety, with

Rubric altered a little to fit the format

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MATERIALS AND METHODS

MATERIALS

This study is on the patients attending my own clinics. It is based on

clinical study on the patients from Mar 2005 to Feb 2006.

Medicine sources:

Medicines prepared by reliable and reputed companies like SBL,

Medisynth, Willmar Schwabe, India; available at my own clinics are

used.

Potencies of medicines being used are 30, 200, 1M, 10M.

Globule no 10 and sugar of milk are used for dispensing the

medicines.

Rectified Spirit and distilled water is used for dispensing of medicine

as and when required.

Placebo is used in 10 no. globules.

Medicine Selection:

Medicine is selected after proper case taking, using a standard format

for recording (please refer Appendix) and repertorisation. The potency

selection is made on the basis of susceptibility and individualization.

A single dose of the selected medicine is given followed by placebo.

Inclusion criteria:

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▪ Patients of ages 10 to 65, of both sex, of different socio-economic

status and different habits, having anxiety disorder are included in this

study.

▪ For the purpose of this study, 30 cases are taken.

▪ The diagnostic criteria of the DSM- IV is used for diagnosing &

differentiating the different types of anxiety disorders. (As given in

Materials and Methods).

▪ Patients already on other medication for anxiety disorder are also

included.

Exclusion criteria:

The cases which either do not follow our instructions, or do not attend

clinics / follow ups have been excluded.

METHODS To fulfill our aim and objectives, 30 cases of anxiety disorder are

studied from my clinics (1 in urban area and 1 in rural area.). The data

during case - taking is collected in accordance to the Homoeopathic

principles.

Instructions before case taking:

The patients are instructed to be free and frank in providing us fullest

information possible. Also the importance of each question asked and

its importance in selection of the correct Homoeopathic remedy is

162

stressed. They are also assured about the confidentiality of the

information.

Confirmation and completion of data

Case is further confirmed and completed from observers, attendants

and family members, for the authenticity.

Allopathic Medication

Some of the patients are already on allopathic medication for anxiety

when their Homoeopathic treatment is started.

The allopathic medication is not disturbed initially and the

Homoeopathic medicine is started in addition to that. During the

course of treatment, as per the response of the patient the allopathic

medication is tapered & stopped.

Psychotherapy

No Psychotherapy is used during this study, to observe the effects of

homoeotherapeutics only.

Precautions advised

During the treatment, the patients are advised to keep away from

factors that might aggravate their conditions in addition to Alcohol,

Coffee, and Tobacco etc.

Medicine Repetition

The minimum dose of the medicine is repeated only when there is

recurrence or aggravation of symptoms.

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DSM IV Criteria for the Anxiety Disorders:

Generalized Anxiety Disorder

A. Excessive anxiety and worry (apprehensive expectation), occurring

more days than not, for at least 6 months, about a number of events or

activities (such as work or school performance).

B. The person finds it difficult to control the worry.

C. The anxiety and worry are associated with three (or more) of the

following six symptoms (with at least some symptoms present for

more days than not, for the past 6 months). Note: Only one item is

required in children.

• Restlessness or feeling keyed up or on edge

• Being easily fatigued

• Difficulty concentrating or mind going blank

• Irritability

• Muscle tension

• Sleep disturbance (Difficulty falling or staying asleep or

restless, unsatisfying sleep)

D. The focus of the anxiety and worry is not confined to features of an

Axis I disorder, eg, the anxiety or worry is not about having a panic

attack (as in Panic Disorder), being embarrassed in public (as in social

phobia), being contaminated (as in obsessive-compulsive disorder),

being away from home or close relatives (as in separation anxiety

disorder), gaining weight (as in anorexia nervosa), having multiple

physical complaints (as in somatization disorder), or having a serious

164

illness (as in hypochondriasis), and the anxiety and worry do not

occur exclusively during post-traumatic stress disorder.

E. The anxiety, worry or physical symptoms cause clinically

significant distress or impairment in social, occupational or other

important areas of functioning.

F. The disturbance is not due to the direct physiological effects of a

substance (eg, a drug of abuse, a medication) or a general medical

condition (eg, hyperthyroidism) and does not occur exclusively during

a mood disorder, a psychotic disorder, or a Pervasive Developmental

Disorder.

Criteria for the Anxiety Disorders: Panic Attack

A discrete period of intense fear or discomfort, in which four (or

more) of the following symptoms develop abruptly and reach a peak

within 10 minutes:

• Palpitations, pounding heart, or accelerated heart rate

• Sweating

• Trembling or shaking

• Sensations of shortness of breath or smothering

• Feeling of choking

• Chest pain or discomfort

• Nausea or abdominal distress

• Feeling dizzy, unsteady, lightheaded, or faint

• Derealization (feelings of unreality) or depersonalization (being

165

Detached from oneself)

• Fear of losing control or going crazy

• Fear of dying

• Paresthesias (numbness or tingling sensations)

• Chills or hot flushes

DSM IV Criteria for the Anxiety Disorders: Panic Disorder

A discrete period of intense fear or discomfort, in which four (or

more) of the following symptoms develop abruptly and reach a peak

within 10 minutes:

A. Both (1) and (2):

1. Recurrent unexpected panic attacks

2. At least one of the attacks has been followed by 1 month (or

more) of one or more of the following:

a. Persistent concern about having additional panic attacks

b. Worry about the implications of the attack or its consequences

c. A significant change in behavior related to the attacks

B. Presence or absence of agoraphobia

C. The panic attacks are not due to the direct physiological effects of a

substance (eg, a drug of abuse, a medication) or a general medical

condition (eg, hyperthyroidism).

D. The panic attacks are not better accounted for by another mental

disorder.

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Obsessive Compulsive Disorder

A. Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3) and (4):

1. Recurrent and persistent thoughts, impulses, or images that are

Experienced, at some time during the disturbance, as intrusive and

Inappropriate and that cause marked anxiety or distress.

2. The thoughts, impulses or images are not simply excessive worries

about Real-life problems.

3. The person attempts to ignore or suppress such thoughts, impulses

or images, or to neutralize them with some other thought or action.

4. The person recognizes that the obsessional thoughts, impulses or

images are a product of his or her own mind (not imposed from

without as in thought insertion).

Compulsions as defined by (1) and (2):

1. Repetitive behaviors (eg, hand washing, ordering, checking) or

mental acts (eg, praying, counting, repeating words silently) that the

person feels driven to perform in response to an obsession, or

according to rules that must be applied rigidly.

2.The behaviors or mental acts are aimed at preventing or reducing

distress or preventing some dreaded event or situation; however, these

behaviors or mental acts either are not connected in a realistic way

with what they are designed to neutralize or prevent, or are clearly

excessive.

167

B. At some point during the course of the disorder, the person has

recognized that the obsessions or compulsions are excessive or

unreasonable. Note: This does not apply to children.

C. The obsessions or compulsions cause marked distress, are time-

consuming (more than 1 hour a day), or significantly interfere with the

person's normal routine, occupational (or academic) functioning, or

usual social activities or relationships.

D. If another Axis I disorder is present, the content of the obsessions

or compulsions is not restricted to it.

E. The disturbance is not due to the direct physiological effects of a

substance or a medical condition.

Specify if:

With Poor Insight: If, for most of the time during the current episode,

the person does not recognize that the obsessions and compulsions are

excessive or unreasonable.

DSM IV Criteria for the Anxiety Disorders: Post-Traumatic

Stress Disorder

A. The person has been exposed to a traumatic event in which both of

the following were present:

1.The person experienced, witnessed or was confronted with an event

that involved actual or threatened death or serious injury, or a threat to

the physical integrity of others.

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2.The person's response involved intense fear, helplessness or horror.

Note: In children, this may be expressed instead by disorganized or

agitated behavior.

B. The traumatic event is persistently re-experienced in one (or more)

of the following ways:

1.Recurrent and intrusive distressing recollections of the event,

including images, thoughts or perceptions. Note: In young children,

repetitive play may occur in which themes or aspects of the trauma are

expressed.

2.Recurrent distressing dreams of the event. Note: In children, there

may be frightening dreams without recognizable content.

3.Acting or feeling as if the traumatic event were recurring (includes a

sense of reliving the experience, illusions, hallucinations and

dissociative flashback episodes, including those that occur on

awakening or when intoxicated). Note: In young children, trauma-

specific reenactment may occur.

4.Intense psychological distress at exposure to internal or external

cues that symbolize or resemble an aspect of the traumatic event.

5.Physiological reactivity on exposure to internal or external cues that

symbolize or resemble an aspect of the traumatic event.

C.Persistent avoidance of stimuli associated with the trauma and

numbing of general responsiveness (not present before the trauma), as

indicated by three (or more) of the following:

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1. Efforts to avoid thoughts, feelings or conversations associated with

the trauma

2. Efforts to avoid activities, places or people that arouse recollections

of the trauma

3. Inability to recall an important aspect of the trauma

4. Markedly diminished interest or participation in significant

activities

5. Feeling of detachment or estrangement from others

6. Restricted range of affect (eg, does not expect to have a career

marriage, children or a normal life span)

D.Persistent symptoms of increased arousal (not present before the

trauma) as indicated by two (or more) of the following:

1. Difficulty falling or staying asleep

2. Irritability or outbursts of anger

3. Difficulty concentrating

4. Hypervigilance

5. Exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C and D) is

more than 1 month.

F. The disturbance causes clinically significant distress or impairment

in social, occupational or other important areas of functioning.

Specify if:

Acute: if the duration of the symptoms is less than 3 months.

Chronic: if the duration of symptoms is 3 months or more.

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With Delayed Onset: if the onset of symptoms is at least 6 months

after the stressor.

DSM IV Criteria for the Anxiety Disorders: Social Phobia

A. A marked and persistent fear of one or more social or performance

situations in which the person is exposed to unfamiliar people or to

possible scrutiny by others. The individual fears that he or she will act

in a way (or show anxiety symptoms) that will be humiliating or

embarrassing. Note: In children, there must be evidence of the

capacity for age-appropriate social relationships with familiar people

and the anxiety must occur in peer settings, not just in interactions

with adults.

B.Exposure to the feared social situation almost invariably provokes

anxiety, which may take the form of a situationally bound or

situationally predisposed panic attack. Note: In children, the anxiety

may be expressed by crying, tantrums, freezing or shrinking from

social situations with unfamiliar people.

C.The person recognizes that the fear is excessive or unreasonable. In

children, this feature may be absent.

D.The feared social or performance situations are avoided or else are

endured with intense anxiety or distress.

E.The avoidance, anxious anticipation, or distress in the feared social

or performance situation(s) interferes significantly with the person's

normal routine, occupational (academic) functioning, or social

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activities or relationships, or there is marked distress about having the

phobia.

F.For individuals under the age 18 years, the duration is at least 6

months.

G.The fear or avoidance is not due to the direct physiological effects

of a substance (eg, a drug of abuse, a medication) or a general medical

condition and is not better accounted for by another mental disorder.

H. If a general medical condition or another mental disorder is

present, the fear in Criterion A is unrelated to it.

Specify if:

Generalized: If the fears include most social situations (eg, initiating

or maintaining conversations, participating in small groups, dating,

speaking to authority figures, attending parties). Note: Also consider

the additional diagnosis of avoidant personality disorder.


Specific Phobia (formerly Simple Phobia)

•Marked and persistent fear that is excessive or unreasonable, cued by

the presence or anticipation of a specific object or situation.

•Exposure to the phobic stimulus almost invariably provokes an

immediate anxiety response, which may take the form of a

situationally bound or situationally predisposed panic attack. In

children, the anxiety may be expressed by crying, tantrums, freezing

or clinging.

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•The person recognizes that the fear is excessive or unreasonable. In

children, this may be absent.

•The phobic situation(s) is avoided or else is endured with intense

anxiety or distress.

•The avoidance, anxious anticipation, or distress in the feared

situation(s) interferes significantly with the person's normal routine,

occupational (or academic) functioning, or social activities or

relationships, or there is marked distress about having the phobia.

•In individuals under 18 years, the duration is at least 6 months.

•The anxiety, panic attacks, or phobic avoidance associated with the

specific object or situations are not better accounted for by another

mental disorder.

174

CASE NO.1 Serial No: -- 1 Date: 06--06--2005

A) Patient’s Biodata:

Name: Aarti Age: 26 years Sex: Female

Martial Status: Single

Residence: Urban Occupation: Lecturer

Socioeconomic Status: Middle

B) Presenting Complaints:

Cracking in knee joint; Weak eyesight; Irritable; Fatigued easily;

Difficulty in getting sleep; Takes cold easily; Pain in breast.

C) History of the present Illness:

All complaints have started since 1 year. It started after a

disappointment in love affair. Had a love affair since last 3 years, but

last year they broke up. She felt that he was taking her for granted and

that he was not committed. Felt jealous, when he talked with other

girls, so she broke up. Felt very sad after that break-off.

Is on allopathic medication Anxit for her problems.

Cracking in knee joint < on rising from a seat.

Weakness of eyesight.

Irritable over small matters.

Gets fatigued easily after little exertion. Does not feel like doing any

work. Mental as well as physical exertion fatigues.

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Has difficulty in getting sleep due to various thoughts that disturb her.

Pain stitching in the left breast. D) History of the previous Illnesses:

Malaria 5 years back. Chicken pox in childhood. Eruptions on face

for which allopathic T/t was done. Recurrent sore throat in

childhood.

E) Family History: NAD

F) Personal Details:

APPEARANCE: Lean Thin Tall

WEIGHT: Static at 50 kg.

APPETITE/TASTE/THIRST: Normal.

AVERSIONS, DESIRES & EFFECTS OF FOOD:

Desires Pizza, Chocolates.

STOOL AND URINE: Occasionally constipated.

PERSPIRATION: Copious when she has anxiety.

MENSTRUAL FUNCTION: Menarche:

At the age of 13 years. Were irregular in the start but now normal.

L. M. P. 20/05/2005.

Menses: 3 / 28 ± 3 days. Flow normal. Backache before and during

menses.

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Leucorrhoea: Thick and offensive, which is more before the menses.

SLEEP & DREAMS:

Type of sleep: Light Un-refreshing sleep. Disturbed due to

thoughts.

Position during sleep: No special position.

This Unrefreshing and disturbed sleep is since 1 year and before

that she had no problems.

Dreams and their nature: Unremembered.

REACTIONS:

Weather: Change of weather aggravates.

Odors: Odors aggravate. They make her uneasy.

Exertion: Physical exertion aggravates.

Thermal state: Hot +

G) Emotional State:

Disappointment in Love++. Irritability with restlessness. Fearful of

exams. Anxiety feeling + < morning on waking, with heat sensation,

nausea & perspiration.

Jealousy +. Weeping Easily. Very Emotional. Sensitive ++.

H) Intellectual State:

Lack of confidence +.

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I) Life situations and circumstances:

The patient is the youngest of three sisters. The elder sisters are

married and she is still to be married. She has good relationship

with everyone in the family especially with her middle sister, with

whom she shares every secret of hers. Her both parents were

working and she felt a lot of insecurity in her childhood. The

environment at home is comfortable. She works as a lecturer in a

polytechnic college and is satisfied with her job. The relations

with colleagues are fine. Has few friends, but has good relations

with them.

J) Body Language:

Gait: Rapid.

Gestures: Restlessness limbs.

Postures: Leaning.

Facial expressions: Smiling.

K) Physical Examination General:

Temp. Normal No Jaundice

B.P 120/ 76 No Cyanosis

Pulse 80 / min No enlargement of Lymph nodes

No Oedema

No Anemia

Hair: Premature graying since 2 years.

L) SYSTEMIC EXAMINATION:

178

RESPIRATORY NAD PER ABDOMEN NAD

CVS NAD CNS NAD.

MUSCULO-SKELETAL NAD.

Diagnosis: Generalised Anxiety Disorder

Date: 06/06/2005 Aarti Kent’s Repertory 1 MIND – LOVE, ailments, from disappointed 18 2 MIND - JEALOUSY 18 3 FEM GENITALIA,LEUKORRHEA, offensive 46 4 FEM GENITALIA,LEUKORRHEA - thick 45 5 FEM GENITALIA,LEUKORRHEA,menses,before 36 6 GENERALS – CHANGE of weather agg. 53 7 BACK - PAIN – menses, before 39 Lach. Calc. Puls. Nux-v. Sep. Calc-p. Ph-ac. 12/7 11/5 11/5 9/5 10/5 8/5 8/4 ----------------------------------------------- 1: 2 - - 1 1 2 3 2: 3 - 2 2 - 1 1 3: 1 1 - 3 3 1 - 4: 1 3 2 - 2 - - 5: 2 3 2 - 3 2 2 6: 1 2 2 1 1 2 2 7: 2 2 3 2 - - - RX Lachesis 200 - 1 dose. Placebo t.d.s for 15 days. 21/06/05. Feeling better. Feels that she is little more energetic than before.

Placebo t.d.s for 15 days.

179

13/07/05. Feeling of being better continues. Her sleep is also better. General

feeling of well being is there. Anxiety is less. Irritability and fatigue

are also better by about 60 percent. Placebo t.d.s for 30 days.

14/ 08/ 05. Was feeling O.K. till 09/08/05. Had a small quarrel with her sister.

Was much disturbed due to that and after that she feels that her main

complaints have relapsed though the intensity is still less.

Lachesis 200 1 dose. Placebo t.d.s for 1 month.

18/09/05. Felt better after the dose. The feeling of well being is persisting. Has

tapered her original anti-anxiety medicine to half. Appetite, sleep,

stools and fatigue are better. Placebo t.d.s for 1 month.

20/10/05.

Feeling of well being persisting. Patient is better overall. She feels

that even people around her feel that she is a changed person now. Is

advised to continue with the reduced dosage of anti-anxiety medicine.

Placebo t.d.s for 1 month.

25/ 11/ 05.

Feeling of well being on all levels continues. Now the anxiety

thoughts do not disturb her. Feels very good about the change. The

180

dose of the allopathic drug is now stopped completely. Gained 1 kg

weight. Placebo t.d.s for 1 month.

1/1/06.

Has a relapse. The anxiety, fatigue are now back. On deeper

interrogation revealed that she had a fight with her parents over the

issue of her marriage. They wanted that now she should get married,

while she felt that she needs some more time. So this had an intense

effect on her and it brought back her chief complaints.

Lachesis 1M 1 dose Placebo t.d.s for 1 month.

5/ 02/06

Better and improving. She feels that now she is the same person as she

was, before her fight with the parents. The energy are levels better.

Appetite, stools and sleep are also better. Placebo tds for 1 month.

20/03/ 06.

Feeling better in all respects. Improvement on all levels as of sleep,

Appetite, general well being. Not disturbed by the anxious feelings

now. Placebo tds for 1 month.

181

DISCUSSION OF CASE NO 1. The case presented us with diagnosis of Generalised Anxiety Disorder

on 6th June 2005 and was already taking allopathic medicine for this.

As it had a strong mental causation, “Love, disappointment from” in

along with mental gen., the Kent’s repertory was preferred for the

repertorisation.

On Repertorisation, the following drugs came up for consideration.

Lach 12/7, Calc 11/5, Puls 11/5, Nux-v 9/5, Sep 10/5, Calc-p 8/5.

Out of these drugs, as Calc & Puls did not cover the main rubric

“Ailments from”, they were not considered. As our patient was

thermally hot, the chilly remedies were left out i.e. Nux-v, Sep,

Calc-p, Ph-ac and Hyos were also ruled out. So Lachesis was left as

our similimum which covered all the rubrics of the totality too.

As the case was based on the mental causation, 200 potency was

selected to start with. The remedy was given in single dose followed

by placebo. The remedy was repeated in the same potency when there

was a slight relapse on 14/08/05.

The potency of the remedy was raised to 1M, when she again had a

slight relapse on 01/01/06. The allopathic medicine was tapered on

18/09/05 after a continued favorable response from the remedy.

182

The response of the remedy was interpreted as favorable on the basis

of the following: 1. General sensation of well being of the patient.

2. Improved energy levels.

3. Improvement in Appetite, Sleep and betterment of the main

complaints.

With the help of Kent’s repertory only, the drug Lachesis could be

selected. As Aur, Hyos, Ign, Nat-m, Ph-ac and Staph are prominently

placed in the main rubric “Love, ailments from disappointment”. This

also highlights that how with the help of repertory, the proper

similimum can be selected.

During the course of treatment we observed that the relapses were

mainly due to anxiety situations which occur in the life course of the

patient. These relapses were encountered successfully with the same

remedy either through repetition or through a raise in potency.

183

Case No 2

Serial No: -- 2 Date: 08 --07--2005 A) Patient’s Biodata:

Name: Shalini Kapoor Age: 45 years Sex: Female

Martial Status: Married

Residence: Urban Occupation: Housewife.


B) Presenting Complaints: Pain in stomach with heartburn; Nausea; Flatulence with distension

of abdomen; Palpitation; Restlessness; Muscle aches; Headache;

Irritable.


All these problems started around 2 years back after a separation

from the joint family setup. They were not given their due share in the

paternal property of her husband. So, they had to start from the

scratch and it was a very stressful period.

Pain in the Stomach. Burning type < after meals, < evening, < from

stress. Since 2 years.

Occasional nausea & vomiting of food.

Distension of abdomen < eating. < Evening. > stools, after.

Palpitation heart < from anxiety +.

Restlessness

184

Muscle aches which are more in the evening after a day’s work.

Pain in the head , busting < when anxious +

Irritability. Gets angry over small matters. Shouts during anger.

< Evening.

D) History of the previous Illnesses:

Operated for Gall bladder stones – 5 years back.

E) Family History:

Diabetes in father. High Blood pressure in mother and brother.


APPEARANCE: Average built. Tall. WEIGHT: Static. APPETITE: Appetite diminished. THIRST: Thirst less.


Desires Salty food; Fruits +. Aversion Sweets.

STOOLS AND URINE: NAD.

PERSPIRATION: There is profuse perspiration on face during

anxiety.

MENSTRUAL FUNCTION:

Menarche: at the age of 16 years. L. M. P. 3/07/05

Menses: 4 / 28 ± 4 days. Flow Clotted

Irritability + < during menses.

185

Leucorrhoea: Thin and watery, this is more after the menses. PREGNANCY AND OBSTETRIC HISTORY:

G 3 P 2 A1 Normal full term deliveries.

Suffered from constipation & nausea during pregnancies.

Used to take isabgol.

No H/o Oral contraceptives.

SEXUAL FUNCTION:

Normal desire.

SLEEP & DREAMS:

Type of sleep: Has very restless sleep. It is disturbed from anxious

thoughts and dreams. No special position during sleep

Concomitants: Talks in sleep.

Dreams and their nature: Accidents +

REACTIONS:

Air: Feels better in open. Seasons: Better in winters. Time: Evening agg. Noises agg. Exertion: Mental exertion aggravates. Thermal state: Hot +.

G) Emotional State:

Is fearful of going out in the Dark +; Crossing the road +. Sadness,

takes bad part of everything. She has anxiety about small matters with

trembling of body; Anxious about the future of her children as to what

would happen. Worries a lot about every small matters. She wants to

186

do away with this anxiety and worry of hers but is unable to do so.

She is sensitive about the suffering of others.


Memory is weak as to where she has kept her things. She feels lack

of confidence for doing various things.


Patient was the eldest daughter of 2 female and 3 male children of

her parents. Her father was very strict with her. She was also

responsible for various household chores in her teens. She was

much anxious about her performance in school. Now, she is

anxious about her children’s performance at school though they are

doing well. Relations with husband are good but as he is busy with

his shop, most of the responsibility of the kids is on her. She is

very anxious about the future of her children. Her daughter is

doing B.Sc in computers while her son is studying in Class 10th.

She is a housewife, though she is well educated. Relations with her

brothers are good and they are very helpful to her.

J) Body Language: Postures: Arms and legs crossed.

Facial expressions: Anxious +

Avoids eye Contact

187

K) Physical Examination General: Temp .N No Jaundice Mouth Dryness of B.P.124 / 80 No Cyanosis Pulse 80/min No enlarged lymph nodes No Oedema Anemic +

L) SYSTEMIC EXAMINATION: RESPIRATORY NAD P ER ABDOMEN NAD CVS NAD CNS NAD MUSCULO-SKELETAL NAD Diagnosis: Generalised Anxiety Disorder.

Date: 08/07/2005 Shalini Kapoor. Kent’s Repr. 1 SLEEP - DREAMS - Accidents 25 2 GENITALIA – FEMALE - MENSES – clotted 77 3 STOMACH – DESIRES - fruit 9 4 GENERALITIES – WET weather agg. 85 Puls. Ars. Chin. Lach. Calc. Rhus-t. Bell. 8/4 7/3 5/4 6/3 6/2 6/2 5/3 -----------------------------------------------1: 1 3 1 - - - 1 2: 3 - 2 3 3 3 3 3: 1 1 1 1 - - - 4: 3 3 1 2 3 3 1 Rx Pulsatilla 200 1 dose. Placebo t.d.s for 15 days.

188

25/07 /05.

Felt slightly better for few days after medicine but now is all the same.

Pulsatilla 1M 1 dose. Placebo t.d.s for 15 days.

13/08/05.

Feeling slightly better. Feels her appetite has improved a bit and

slight improvement in energy levels. Had her menses on 2/8/05. The

irritability which aggravates during menses was also little better this

time. Placebo t.d.s for 15 days.

1/9/05.

The improvement which was there since the last visit is standstill.

This time she had a new symptom i.e. frightful dreams. Appetite is

also better. Pulsatilla 10 M 1 dose. Placebo t.d.s for 1 month

4/ 10/05.

Feels much better. The irritability, muscle aches, pain stomach have

improved much. Appetite is much better. Lethargy is also better.

Just finished from her menses which started on 1/10/05. The clots

were much better this time and the irritability during menses was also

reduced. Placebo t.d.s for 6 weeks.

189

26/11/ 05.

Feels better on every level. Last menses were on 3/11/05. They were

much better with respect to clots and irritability. The energy levels

have improved. For the first time since the start of treatment, she felt

that now she can leave off the allopathic medicine she is taking. Is

advised to reduce the allopathic medication.

Placebo t.d.s for 1 month.

2/1/06.

Better. The main complaints for which she started medicine are much

better. The clotted menses and irritability during menses is much

better. The reduced dose of allopathic medicine is continued. Appetite

better. Sleep better. Chief complaints also much better.

Placebo t.d.s for 6 weeks.

30/01/06.

Slight relapse of anxiety. Her parents had an accident and were

admitted in hospital. This had a bad effect on her with relapse of

anxiety. Pulsatilla 10 M 1 dose Placebo t.d.s for 1 week.

07/02/06.

Better in all respects. Allopathic medicine further reduced.

Placebo t.d.s for 2 months.

190

Discussion of Case No 2.

The case presented us with diagnosis of Generalised Anxiety Disorder

on 8th July 2005 and was already taking allopathic medicine for this.

As the case presented had dreams along with female generals as

prominent symptoms, the Kent’s repertory was preferred for the

repertorisation.

On Repertorisation, the following drugs came up for consideration:

Puls 8/4, Ars 7/3, Chin 5/4, Lach 6/3, Calc 6/2, Rhus-t 6/2, Bell 5/3.

As our patient is hot thermally, the chilly medicines i.e. Ars, Chin,

Calc, Rhus-t and Bell were ruled out. Furthermore as Pulsatilla

covered all the symptoms of the totality especially the “Desire, fruits

for”, it was preferred over the left over drugs.

Considering that the mind has been affected and the presence of

dreams led to the 200 as the potency of choice. The remedy was given

in single dose followed by placebo. The remedy was raised to 1M

potency on 25/07/05 as the patient felt that there was slight betterment

followed by relapse. The potency of Pulsatilla was raised to 10 M on

01/09/05 when the improvement came to a standstill. This 10M

potency was again repeated on 30/01/06 when her parents had an

accident, thus increasing her anxiety. The attack was brought under

control with the help of Pulsatilla. The allopathic medicine was

191

tapered on 02/01/06 when the patient has started feeling comfortable

on all levels.




3. Improvement in Appetite, Sleep and betterment of the main

complaints.

With the help of Kent’s repertory only, the drug Puls could be

selected as China also covers the case. Lachesis also comes in close

comparison to Pulsatilla but as it did not cover the dreams of the

patient, it was not preferred.

During the course of treatment we observed that the relapses were

mainly due to anxiety situations which occur in the life course of the

patient these relapses were encountered successfully with the same

remedy either through repetition or through a raise in potency.

192

Case No 3 Serial No: -- 3 Date: 10 --11--2005 A) Patient’s Biodata:

Name: Sukhwinder Singh Age: 12 years Sex: M


Residence: Rural Occupation: Student



Fearful; Vertigo; Sleeplessness; Irritability; Startles from slightest

noise.

C) History of the present Illness: All complaints started since 8th Oct 2005, when the Earthquake

struck. He was in the school when the quake struck & there was

stampede in the class. In this process he fell down and received some

injuries also. The walls of his class cracked from this. It was his first

experience with earthquake of such intensity and was it was full of

horror for him.

Has constant fear of earthquake happening again.

Is sleepless due to frequent waking. < From slightest nose.

Since the quake has struck, he prefers to remain outdoors even sleeps

in the open.

193

Irritable from noise from. Shouts from anger.

He startles from the slightest noise and touch.

Vertigo / Dizzy feeling which started after the earthquake.

D) History of the previous Illnesses: NAD


APPEARANCE: Lean Thin Tall

APPETITE: Diminished

STOOLS: Constipated.

SLEEP & DREAMS:

Sleeplessness from disturbed sleep from fears, slightest noise,

frightful dreams.

Dreams: Frightful, waking him REACTIONS:

Thermal state: Hot

G) Emotional State:

Anxious, Fearful, Apprehensive.


Only son of his parents. Both parents are working and the patient is

cared by his grandparents. Is described as very sensitive child by

the parents. Gets scared easily. Good in studies and extra-

194

curricular activities. Like to play cricket and computer games. Has

lost interest in things which he used to enjoy since that episode.

J) Body Language: Facial expressions: Anxious +

K) Physical Examination General: Temp. N No Jaundice

Pulse No Cyanosis No Oedema No Lymph nodes enlarged. No Anemia

L) SYSTEMIC EXAMINATION: RESPIRATORY NAD PER ABDOMEN NAD CVS NAD CNS NAD MUSCULO-SKELETAL NAD

Diagnosis: Post Traumatic Stress Disorder.

Date: 10/11/2005 Sukhwinder Singh

Kent’s Repertory. 1 MIND – FRIGHT – complaints, from 46 2 MIND - STARTING - easily 39 3 MIND - STARTING - sleep - during 82 4 MIND - STARTING – fright, from 53 5 MIND - SENSITIVE - noise, slightest to 18 6 VERTIGO - FRIGHT, after 3

195

Op. Phos. Sil. Nat-m. Nux-v. Kali-c. Acon. 12/6 12/5 9/5 11/4 9/4 9/3 9/5 -------------------------------------------- 1: 3 3 3 3 2 - 3 2: 1 3 2 3 2 3 - 3: 2 2 1 2 2 3 1 4: 1 2 - 3 - 3 2 5: 3 2 3 - 3 - 1 6: 2 - - - - - 2

Rx Opium 1M 1 dose. Placebo t.d.s for 2 weeks. 26/ 11/05. Better. Vertigo is almost fully better. Temper is also better. Now gets

comfortable sleep and the sensitivity / starting is also much better.

Placebo t.d.s for 2 weeks. 15/12/05. Better by more than 70 percent. Vertigo is not there. Appetite has

improved. Constipation is also better. The frightful dreams are less

now and not much disturbing. Placebo t.d.s for 1 month. 22/01/ 06. The patient is now better in all respects. His appetite & constipation

are better. His temper is now under control. The sensitivity to noise is

now normal. The starting from sleep and frightful dreams are also not

disturbing now. Placebo t.d.s for 1 month.

196

26/02/06. Better in all respects. Placebo t.d.s for 1 month. 29/03/06. Better. No complaints on any levels. Placebo t.d.s for 1 month.

Discussion of Case No 3

The case presented to us with Post Traumatic Stress Disorder which

was there due to the earthquake in Northern India on 8/10/05. This

case had a strong mental causation, which deranged a perfectly

healthy child to an abnormal one. So Kent’s repertory was the best

choice for repertorisation.

On Repertorisation, the following drugs came up for consideration

Op 12/6, Phos 12/5, Sil 9/5, Nat-m 11/4, Nux-v 9/4, Kali-c 9/3 &

Acon 9/5.

From the following drugs, Op and Acon were given preference as they

covered the Causation and “Vertigo, fright after”. Opium was given

preference over Aconite as the “Fear of death, predicts the day of

death”, a grand general of Aconite was absent in this case. Also on

referring to Knerr`s repertory in the section Mind following rubric

was found in favor of Opium i.e. **MIND - After fright, fear of the

fright still remaining. On the basis of acute condition of the mind,

high potency of Opium i.e. 1M was selected and given as single dose.

As continued progress in the improvement of the general state

continued, Opium was not repeated.

197

Hahnemann refers to this type of diseases as “Mental diseases

appearing suddenly as an acute disease in patient’s ordinary calm state

caused by some exciting factor” in § 221 of the Organon. He explains

that in this type of disease, an insanity or frenzy suddenly breaks out

as an acute disease from the patient’s usually quite state. This may be

caused by fright, vexation, drinking alcohol etc., and attributes it to

Psora. He recommends that during acute phase, deep acting remedies

are not needed but remedy that corresponds to the acute picture is

needed. Hahnemann stresses that after the acute state has subsided,

these patients should be followed up with Antipsoric treatment to

prevent recurrence & if this is not done, a worse attack from a much

slighter cause is bound to follow which will be more difficult to cure.

198

Case No 4 Serial No: -- 4 Date: 20--08--2005 A) Patient’s Biodata:

Name: Rubina Age: 27 years Sex: F


Residence: Urban Occupation: Student

Socioeconomic Status: High

B) Presenting Complaints: Falling of Hair; Lump sensation in the throat; Rash forearm;

Irritability; Difficulty in concentrating; Anxiety feelings.


All her complaints started around 1 year back. They had a theft at

their place in which they lost all their valuables, money etc in the safe.

In addition to this, the jewellery and valuables of her maternal uncle

which were with them for safe custody were also lost. After the theft,

the maternal uncles were heard telling many of their relatives that the

patient and his family had themselves done this in order to grab their

valuables. Even a brother of hers, who did not live with them, also

accused them of the theft. After this incident, her parents shifted to

USA to live with her brother. This also according to her was the worst

part of her life. Hair falling since 1year.

199

Lump sensation in the throat; Persistent; Feels like ball in throat,

though no problems in eating & drinking.

Rash forearm / back / legs since 1 year. More during the change of

weather.

Occ. Itching.

Irritability ++.

Difficult in concentrating.

Anxiety feeling, which she feels is not able to control. With this

anxiety she has body aches, weakness, and pain stomach. Much

worried about future +.

D) History of the previous Illnesses: NAD

E) Family History:

Cancer throat in paternal aunt.


APPEARANCE: Average built. Tall

WEIGHT: Static APPETITE/TASTE/THIRST: Normal. AVERSIONS, DESIRES & EFFECTS OF FOOD: Desires Spices, Pickles. STOOLS AND URINE: Constipated hard stools. PERSPIRATION: Profuse face & back. No other abnormality.

200

MENSTRUAL FUNCTION:

Menarche: at the age of 14 years. L. M. P. 10/08/05 Menses: 3 / 16 days. Flow normal. No concomitants. No Leucorrhoea.

SLEEP & DREAMS:

Type of sleep: Un-refreshing; Is disturbed from anxiety.

Position during sleep: mostly on back.

Dreams and their nature: Water; Preparing for examinations+

REACTIONS:

Exertion: Mental exertion agg. Thermal state: Chilly +.

G) Emotional State:

Anxiety feeling as to what would happen. Worries a lot about her

parents though they don’t have any problems. Can’t control thinking

about them. Worries about small matters.

Fearful. Anxiety about Future +. Short tempered. Can’t support

injustice with anybody.

H) Intellectual State: Intelligent +.


The patient is doing her doctorate in sciences. She has three elder

brothers, one of whom lives in USA and one of them is separated

from the family. She belongs to a well to do family and everything

201

was fine until that incident occurred which changed the course of

her life and from which she with her family had to suffer.

The persistent anxiety feeling are hampering her studies and the

normal functioning. Had many friends but now only a few.

J) Body Language: Gestures: Nail biting + K) Physical Examination General:

Temp. N No Jaundice B.P. 110 /70 No Cyanosis Pulse 76 No Lymph nodes enlarged. No Oedema No Anemia

Skin: Fair color

L) SYSTEMIC EXAMINATION: RESPIRATORY NAD PER ABDOMEN NAD CVS NAD CNS NAD MUSCULO-SKELETAL NAD.

****************

Diagnosis – Generalised Anxiety Disorder.

202

Date: 20/08/2005 Rubina Kent’s Repertory 1 MIND – HONOR, effects of wounded 3 2 DREAMS - MENTAL EXERTION 34 3 DREAMS - WATER 44 4 SLEEP - POSITION - back, on 52 5 FEM.GENITALIA, MENSES, frequent, too 161 6 STOMACH – DESIRES – sour, acids etc. 77 Ign. Rhus-t. Sulph. Bry. Nux-v. Puls. Nat-m. 11/6 10/5 9/5 10/4 9/4 8/4 9/5 ----------------------------------------------- 1: 1 - - - 1 - - 2: 3 2 2 2 3 2 2 3: 1 1 1 - - - 1 4: 2 3 2 3 2 3 1 5: 2 3 2 3 3 1 3 6: 2 1 2 2 - 2 2 Rx Ignatia 200 1 dose Placebo t.d.s for 2 weeks. 6/09/05.

Was better a little for few days but now the same. Had her menses on

27/08/05. Ignatia 1m 1 dose Placebo t.d.s for 2 weeks.

24/09/05.

Feels better. Hair falling has decreased. Had her menses on 20/09/05.

203

Sleep better & refreshing. Anxiety also better. Lump sensation throat

improved slightly. Occasional dreams still irritate.

Placebo t.d.s for 3 weeks. 17/10/05. More better. Energy levels improved. Constipation has also improved.

Had her menses on 13/10/05. Lump sensation throat better. Better

over all. Placebo t.d.s for 1 month.

20/11/05. Has a relapse of complaints. Though the complaints are not that worse

as at the start of treatment. The reason is the stress for her studies as

she has to present some papers at a conference. Anxiety +. Lack of

confidence +. Lump sensation throat aggravated. Recurrent dreams of

preparing for exams. Ignatia 1M 1 dose Placebo t.d.s for 1 month.

23/12/05. Had a favorable effect of the last dose. Could complete the papers

well in time and presented them well. Last menses on 13/12/05.

Irritability; Hair falling; Constipation; Lump sensation throat much

better. Occ. Dreams. Placebo t.d.s for one month.

26/01/06. Better in all respects. Last menses on 22/01/06. No Hair falling. Lump

sensation almost gone. Confidence levels high. Got engaged in early

January. No dreams since last dose. Placebo t.d.s for 6 weeks.

204

28/02/06. Has a relapse of all the complaints. She got the news that her father

was ill and was admitted in the hospital. Could not her control

weeping. Had her last menses on 11/02/06 and now again on

27/02/06. Ignatia 1M 1 dose. Placebo t.d.s for 1 week.

07/03/06. Not much of change. The anxiety has increased with lack of

confidence. Ignatia 10 M 1 dose Placebo t.d.s for 1 week.

14/03/06. Better now. Leaving for states to see her father. Placebo t.d.s for 2 months.

Discussion of Case No 4

The case presented us with the diagnosis of Generalised Anxiety

Disorder on 20-08-2005. On detailed inquiry, an important mental

causation was got as “Effects of wounded Honor”.

So, in presence of mental cause along with Dreams, the Kent’s

repertory was preferred for repertorisation.

On repertorisation, the following drugs came up for consideration:

Ign 11/6, Rhus-t 10/5, Sulph 9/5, Bry 10/4, Nux-v 9/4, Puls 8/4,

Nat-m 9/5, Ferr 9/4 and Phos 9/4.

As we had a mental causation in our case, so the remedies which

covered this were to be considered. Ignatia and Nux-vomica were the

205

only remedies that covered the cause. These could not be ruled out

further on the basis of thermals as both of them are chilly and our

patient is also chilly.

Ignatia was selected as the drug of choice as it completely covered the

dreams & the physical general of food cravings, which Nux-v could

not qualify.

The case had a base in the mental causation, so, 200 potency was

selected to start with. The remedy was given in single dose followed

by placebo. The remedy potency was raised to 1M on 06/09/2005 as

200 had a little effect. The 1M potency had a favorable effect on the

patient leading to improvement in anxiety, sleep, bowel movements,

lump sensation and general well being. There was a relapse due to the

stress of her studies and a repetition of Ignatia 1M on 20/11/05 helped

her a lot. This repetition helped her further by relieving her of

stressful dreams and improving her confidence levels. Again on

28/02/06, she had a relapse on hearing the news of illness of her father

& his hospitalization whom she loved too much. She being far away

from her father couldn’t do much for him. So she felt a state of

helplessness and that precipitated her anxiety state. This could not be

helped with 1M potency, so the potency was raised to 10 M which had

a favorable effect on her.




206

3. Improvement in anxiety, sleep, appetite, constipation and hair

falling.

Kent repertory helped us in the selection of Ignatia as the similimum.

On the basis of repertorisation only, we could eliminate Nux-vomica

and Staphysgria, both of which are present in the rubric “Honor-

effects of wounded” and differentiate it from Nux-v which was in

contention for the similimum.

From this case, we learnt that persistent worry and anxiety situations

in the course of one’s life, result in the weakening of the favorable

action of the similimum but the same can be countered effectively

with the repetition or a raise in the potency of the similimum.

207

Case No 5 Serial No: -- 5 Date: 04--09--2005 A) Patient’s Biodata:

Name: Bikram Gupta Age: 57 years Sex: Male

Martial Status: Married

Residence: Urban Occupation: Pharmacist.



Has attacks of fear with sensation as if would die with increased blood

pressure.

Obstruction of flatulence, which leads to palpitation, anxiety, with

heaviness chest and as if it would burst.

Numbness of left arm / side, sensation as if the brain does not work

and fear about the disease.

These attacks are mostly in the morning. The distention of abdomen is

very distressing and he feels if it could get better he would be better.

In addition to this, there is confused feeling during the attack. These

attacks last for about half an hour and then he gets better.

Is under treatment for these attacks but without any relief. C) History of the present Illness:

These attacks are since 2 years. No cause could be elicited.

208


Heart burn which on Endoscopic investigation revealed 2nd Grade

Oesophagitis.

E) Family History: Psychiatric problems in mother.


APPEARANCE: Lean Thin.

WEIGHT: Decreasing

APPETITE/TASTE/THIRST: Diminished.


Desires juicy refreshing things.

STOOLS AND URINE: Stools mucoid, difficult to flush.

SLEEP & DREAMS: Sleep Increased alternating with diminished.

Unrefreshing. Aggravated in the morning. Startles from the slightest

noise.

Dreams and their nature: Water, Dead Persons.

REACTIONS:

Morning Agg.

Thermal state: Chilly.

209

G) Emotional State:

Fear of closed / crowded places. So much that that he is fearful of

taking a bath in the bathroom. Apprehensive about the anxiety attacks

as they are unexpected. Is persistently occupied with this. Desires

sympathy. Negative thoughts about the disease.


The patient is a govt. servant about to retire. His family life is

normal. He has been a sensitive patient affected easily by small

matters.


Temp. N No Jaundice

B.P. 130/ 90 No Cyanosis Tongue: Apthae.

Pulse 84/ min No Lymph nodes

No Oedema

Anemia +

Hair: Baldness.

L) SYSTEMIC EXAMINATION:

RESPIRATORY NAD PER ABDOMEN NAD

CVS NAD CNS NAD

MUSCULO-SKELETAL NAD

210

Diagnosis – Panic Disorder.

Date: 04/09/2005 Boenninghausen`s Repertory BIKRAM GUPTA 1 CONDITIONS IN GENERAL - Time - morning 144 2 SENS. & COMPL.GEN.- Bursting, splitting,* 104 3 MIND - Fearsome, anxiety,* - disease, of 33 4 MIND - Confused, befuddled, muddled, etc.140 5 MIND - Anxiety, agony - chest, in 43 6 SENS.&COMPL.IN GEN.,Starting,in affright*104 7 FLATULENCE - Flatus - incarcerated,obstructed, displaced* 84 8 ABDOMEN - Inflation, distension – abdomen in general 120 9 STOOL - Mucus, of 73 10 MIND - Sympathy, craves 2 11 APPETITE - Desire - juicy things 8 Phos. Nux-v. Puls. Kali-c. Sep. Bell. Bry. 32/11 32/9 26/10 26/8 24/9 24/8 24/8 -----------------------------------------------1: 4 4 1 3 3 2 2 2: 2 2 2 3 4 4 4 3: 3 4 3 3 2 - 2 4: 3 4 3 4 4 4 4 5: 4 3 3 - 1 1 4 6: 2 4 2 3 2 4 4 7: 4 4 4 4 2 2 - 8: 4 4 3 4 3 4 3 9: 4 3 4 2 3 3 1 10: 1 - 1 - - - - 11: 1 - - - - - -

211

Rx

Phosphorus 200 1 dose. Placebo t.d.s for 2 weeks.

19/ 09/05. No change in any of the major complaints. Had an attack

on 10/09/05 & 18/09/05.

Phosphorus 1M 1 dose. Placebo t.d.s for 2 weeks.

4/10/05.

Had an attack on 27/10/05 which was less in intensity. Obstructed

flatulence is slightly better. Sleep little better & stools also improved a

little. Fear of having attacks still persists.

Placebo t.d.s for 2 weeks. Phosphorus 1M 1 dose as an S.O.S to be

taken during the attack.

20/11/05

Had an attack on 10/11/05. Took the S.O.S during the attack and felt

better. Other complaints are also slightly better.

Placebo t.d.s for 1 month. Phosphorus 1M 1 dose as S.O.S.

22/12/05.

Had two attacks – one on 24/11/05. He took S.O.S during the attack

and it relieved him. The intensity was slightly less. The second attack

was on 19/12/05 and felt it was same as before. Had no S.O.S. to be

212

taken. Other complaints are also little better. No cause or any other

detail could be elicited on investigation.

Phosphorus 1M 1 dose Placebo t.d.s for 1 month.

Phosphorus 1M 2 doses as S.O.S

25/01/06.

Had one attack on 23/01/06 and it was not relieved by S.O.S dose.

Very fearful about the disease. Feels would die. All other complaints

also agg. Phosphorus 10M 1 dose. Placebo t.d.s for 1 month.

26/02/06.

Was quite fine during the whole month but got an attack on 24/02/06.

Though it was less in intensity, still he is very fearful. Palpitations &

trembling of whole body is there.

Phosphorus 10 M 1 dose. Placebo t.d.s for 1 month.

25/03/06.

Had an attack of lesser intensity on 20/03/06 but the mental state of

fear is still persisting. Stools better. Obstructed flatulence also better a

little. Phosphorus 10 M 1 dose Placebo t.d.s for 1 month.

Discussion of Case No 5 The case presented us with diagnosis of Panic Disorder on 4th

September 2005 and was already under allopathic treatment but

213

without any relief. In spite of much inquiry, no probable cause could

be elicited from the patient or his attendants.

Apart from the symptoms pathognomic of Panic disorder, the patient

presented us few mental symptoms, strong modalities and complaints

which were physical in nature. So Boenninghausen`s repertory was

selected for repertorisation in this case. The totality of the case was

erected and following drugs came up strongly:

Phos 32/11, Nux-v 32/9, Puls 26/10, Kali-c 26/8, Sep 24/9, Bell 24/8,

Bry 24/8, Calc 24/8 and Carb-v 24/8

As Phos comes out prominently from the analysis and it covered all

the rubrics, it was selected as the drug of choice.

The potency was selected as 200 the psychic symptoms are prominent

As there was no change with 200 potency, the potency was raised to

1M on 19/09/2005. With 1M potency, the patient felt a little better,

though he had an attack of lesser intensity. Considering that the

patient is not able to contact us during the attack due to far off

residence of the patient, a dose of Phos 1M was given to the patient as

a S.O.S dose to be taken during the attack. The S.O.S had a beneficial

effect on the patient during the attack. In the further follow ups too, a

S.O.S was given to the patient to be taken during the attack. The

attacks diminished in intensity during the next follow-ups.

On 23/01/06, the patient had and attack which was not relieved by the

S.O.S. So on 25/01/06, the potency of Phosphorus was raised to 10M

214

as it was felt that the 1M potency has exhausted its action. The

intensity of attacks has reduced though the panic state still persists.


of: 1. Decreased intensity of attacks.

2. Improvement in the Obstructed Flatus & distention of abdomen.

215

S.N

O

DA

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NA

ME

AG

E

SEX

M.S

TATU

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RES

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S.E.

Sta

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REP

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MED

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TUS

1 23-04-2005 JYOTI DEVI 22 F Un R L K BELL 1M NI PHOBIC2 30-04-2005 ANU 19 F Un U M K COCC 1M IM GAD3 09-05-2005 SAVITRI DEVI 50 F Ma R L B PULS 200 IM GAD4 15-05-2005 NATASHA 23 F Un U H K ARG-N 200 IM GAD5 22-05-2005 KANTA 45 F Ma U M K ARS 200 NI PHOBIC6 30-05-2005 RINKI 29 F Ma U M K PULS 200 IM GAD7 03-06-2005 SOBHA RAM 50 M Ma U M K CALC 200 NI GAD8 06-06-2005 AARTI 26 F Un U M K LACH 10M IM GAD9 08-06-2005 REENA 37 F Ma U M K SIL 200 IM GAD

10 23-06-2005 RAJESHWARI 23 F Un R M B NAT-M 200 IM GAD11 30-06-2005 SAKSHI 32 F Ma U H K STAPH 200 IM GAD12 08-07-2005 SHALINI 45 F Ma U M K PULS 1M IM GAD13 13-07-2005 KAMLESH 23 F Un R L K NIT-AC 1M NI GAD14 26-07-2005 VISHNO 50 F W R L K NAT-M 200 IM GAD15 02-08-2005 PANKAJ 32 M Ma U M K BOR 200 IM PHOBIC16 08-08-2005 ANIL 25 M Un U M K NAT-M 200 NI GAD17 18-08-2005 VEENA 52 F W U M B ARS 200 IM PHOBIC18 20-08-2005 RUBINA 27 F Un U H K IGN 1M IM GAD19 26-08-2005 SUCHITRA 12 F Un U M K ARG-N 200 IM PHOBIC20 04-09-2005 BIKRAM 57 M Ma U M B PHOS 10M IM PANIC21 07-09-2005 NEHA 38 F Ma U M K SEP 200 IM GAD22 14-09-2005 VIPIN 38 M Ma U H K NUX-V 200 NI GAD23 30-09-2005 LOVI SETHI 21 F Un U H K LYC 200 IM GAD24 13-10-2005 KIRAN 49 F Ma U H B PHOS 1M NI GAD25 10-11-2005 AKSHIT 14 M Un U M K CALC 200 IM PTSD26 12-11-2005 NAMRATA 23 F Un R M K PHOS 1M IM PTSD27 14-11-2005 SAHIL 15 M Un U M K ACON 1M IM PTSD28 12-12-2005 SUKWINDER 10 M Un R M K OP 1M IM PTSD29 16-12-2005 KAINATH 13 F Un U H K NAT-M 200 IM PTSD30 21-12-2005 DEVINDER 37 M Ma U M K ACON 200 IM PTSD LEGEND H HIGH F FEMALE Ma MARRIED

M MIDDLE M MALE Un UNMARRIED

L LOW W WIDOWED

R RURAL K

KENT REPR IM IMPROVED

U URBAN B B.B.C.R. NI

NOT IMPROVED

217

Age and Sex ratio of cases

3

9

35

13

13

1 10

5

10

Age group of cases

No.

of c

ases

Female Male

Female 3 9 3 5 1Male 3 1 3 1 1

10 - 20 20 - 30 30 - 40 40 - 50 50 - 60

Anxiety in different areas

15, 50%

8, 27%

1, 3%

6, 20%

Urban Female Urban Male Rural Male Rural Female

218

ANXIETY ALONG DIFFERENT AGE GROUPS

012345678

10 - 20 20 - 30 30 - 40 40 - 50 50 - 60

Age group

No.

of c

ases

GAD Female GAD Male PHOBIC Female PHOBIC Male

PANIC Female PANIC Male PTSD Female PTSD Male

1

6

8

11

0

4

0

2

4

6

8

10

12

Socio-economic status of cases

MALEFEMALE

MALE 1 8 0

FEMALE 6 11 4

HIGH MIDDLE LOW

219

4

11

5

8

0202

468

101214

16

Martial status of cases

FEMALEMALE

FEMALE 11 8 2

MALE 4 5 0

SINGLE MARRIED WIDOWED

Results with different potencies

19

9

2

15

6

24 3

00

5

10

15

20

200 1m 10m

Potencies

No. O

f cas

es

No. of cases Improved Not Improveed

220

Results in Anxiety Disorders

23, 77%

7, 23%

Improved Not Improved

Results with Kent and BBCR

25

5

19

461

05

1015202530

KENT BBCR

Total cases Imrovement No Improvement

221

Medicines Used in Anxiety Disorders

0

2 2 2

1 1

2

1 1 1 1

4

1 1 1

3 3

1 1 1

0

1

2

3

4

5

Medicines

No. o

f cas

es

MedicinesACONARG-NARSBELLBORCALCCOCCIGNLACHLYC NAT-MNIT-ACNUX-VOPPHOSPULSSEPSILSTAPH

223

DISCUSSION

For the purpose of this study, cases of anxiety disorders are taken

up in detail and are followed by proper repertorisation. The data of the

30 cases from my clinics, gives me an insight to various facets of the

anxiety disorders. The killer earthquake which rocked the northern

region with much intensity on 8th October 2005 is providing me a

chance to understand and treat cases of Post Traumatic Stress

Disorder.

Of the 30 cases under study, the females are found to be more

affected by anxiety. The female to male ratio is around 2:1. These

disorders are more in the age group of 20 – 30 years and cases of this

age group alone account for the 1/3 rd of the total sample.

Furthermore, it is observed that the age group 20 to 40 years account

for more than half of the cases, as this age group is under great mental

strain & stress, and has occupational problems etc. More cases of

anxiety are reported from the people residing in the urban area than in

the rural areas. The ratio of the urban to rural cases is found to be

around 3: 1. Females of the urban area alone account for the 50

percent of the whole sample. While considering the socio-economic

status of the patients, 63 percent of the cases are from the middle

class.

For the percentage as per the disease diagnosis, GAD accounts for the

60 % of the total cases and the Phobic disorders account for 17 % of

224

the cases. The PTSD cases because of earthquake account for 20

percent of the cases of my study.

While analysing the cases as to their martial status, an equal incidence

is found for both single and married cases under study.

77 percent of the total cases are showing improvement with the

administration of the similimum selected with the help of repertories.

For the purpose of repertorisation, 83 percent of the cases are

repertorised using Kent’s repertory while for the remaining 17

percent, BBCR is used. As these are the cases of psychiatric disorder

and are deficient in somatic ailments or symptoms, so Kent’s

repertory is required more as compared to BBCR. This is also

evident from the cases being discussed in detail, where in the presence

of strong mental causation or mental generals, sleep & dreams is

there. 76 percent of the cases for which Kent’s repertory is used, are

showing improvement. BBCR, though a neglected repertory is also

did not lag behind and 80 percent of the cases for which it is being

used, also show improvement.

Natrum mur, Phosphorus and Pulsatilla are the remedies which are

indicated in 3 or more than 3 cases. Aconite, Arsenic album,

Argentum nitricum and Calcarea carb are the remedies of choice in 2

cases each. A total of 19 remedies are indicated for a sample of 30

cases, which strengthens the individualization part of homoeopathy.

The 1M and 10M potencies are required only when 200 potency did

not work. Yet if we see the average, 200 potency worked in 80

225

percent of the cases in which it is given, thus concluding that it is the

right potency to begin with.

In case no.1 & 3, which are given in detail, Natrum Mur and

Aconite respectively seem to be the remedies at the start. The

repertorisation provides me with Lachesis and Opium respectively.

These have a very good effect on the patients, thus authenticating the

Master’s advice to be an un-prejudiced observer.

227

CONCLUSION

The data obtained from clinical studies; weigh heavily in favor of, the

use of repertories in the management of the anxiety. The

repertorisation of cases did not let any medicine to be out of sight till

the final selection. In a number of cases, repertorisation led me to a

medicine which in routine prescribing, would have been missed.

In cases which present with strong mental causation, mental

symptoms & generals and dreams; Kent’s repertory is of vast help.

While cases which present with strong modalities, physicals and

concomitants; BBCR is of enormous help.

Both these repertories, though having different philosophical

backgrounds have given positive results in cases where they are used

judiciously, thus authenticating their value respectively.

The utility of repertory can not be underestimated and it has proved

beyond doubt to be of immense help in selection of similimum in the

management of Anxiety disorders.

229

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Hahnemann S. The Lesser Writings. Ed. & Trans. Dudgeon, R.E

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Edition. New Delhi: National Homoeopathic Pharmacy, 1980.

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231

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Problem of Maladaptive Behaviour. Tenth Edition. Delhi:

Pearson Education Asia, 2002.

Semple David, Et all. Oxford Handbook of Psychiatry. First

Indian Edition. New Delhi: Oxford university press, 2005.

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Depression. First Edition. London: Martin Dunitz Ltd, 2002.

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233

CASE TAKING PROFORMA Serial No: -- Date: __--__--____ A) Patient’s Biodata:

Name: ………………………………… Age: ……….. Sex: M/F Martial Status: Single/Married/Divorced/Widowed Residence: Urban/Rural Occupation: …………… Socioeconomic Status: High/Middle/Low

B) Presenting Complaints: C) History of the present Illness:

(Detailed history of present illness with respect to cause and circumstances, duration, mode of onset, location with extension, sensations, modalities and concomitants, if any)


Past Medical H/o patient as per the check list given at the end.

E) Family History:

In his own, paternal and maternal families as per the check list at

the end.


APPEARANCE:

Lean/Obese/Emaciated/Average/Thin/Short/Tall/Stooped/Underno

urished

WEIGHT: (Increasing/Decreasing/Stationary) APPETITE/TASTE/THIRST:

234

AVERSIONS, DESIRES & EFFECTS OF FOOD: STOOL AND URINE: PERSPIRATION: MENSTRUAL FUNCTION:

Menarche: Late/Early L. M. P. Menses: Cycle and Duration with concomitants: Menopause and associated complaints: Leucorrhoea:

PREGNANCY AND OBSTETRIC HISTORY:

G P A: Mode of deliveries: Mental State during and after Pregnancy Illness and Medication during Pregnancy: H/o oral contraceptives used

SEXUAL FUNCTION:

Desire/Aversion/Performance and associated complaints. PAEDIATRIC HISTORY:

Birth: Normal /Abnormal Birth Wt.: Mother's health: Neo-natal problems: Milestones: Problems: Physical Development / Mental Development Speech: Retarded/Lisping/Stammer/Slow/Rapid Feeding: Breast/Top/Bottle/Solids Observation: Activity: Hyper/Dull/Restless/Destructive/Quiet. Emotional: Anger/Fears/Attachments/Shyness/Change/Responsibility

235

Intellectual: Performance at School and in Extra-curricular activities Hobbies Obedience Socialization Behavioural Problems: Aggressive(Beats, Bites)/Breath-holding/Clinging/Contrary/Cruel/Criminal/Dirty/Fastidious/Headbanging/Obsessive/Homesick/Hurry/Stealing/Nailbiting/Obstinate/Rocking/Tantrums/ Tics/ Thumb sucking/ Truant/Weepy

SLEEP & DREAMS:

Type of sleep: Light/Catnaps/Deep/Un-refreshing/Poor/Siesta Disturbed Due To:

Anger/Anxiety/Work stress/ Dreams/Fears/Lovesick/Thoughts Position during sleep Any change in sleeping pattern Concomitants:

Enuresis/Gestures/Grinding/Moaning/Nightmare/Perspiration/Salivation/ Snoring/Starting/Talking/Walking

Dreams and their nature:

REACTIONS: [Physical factors: (Effects, Ailments from, Agg.

And Amel.)]

Air: Cold/Open/Fan/Drafts/A.C./Closed room Weather: Clear/Dry/Foggy/Storm/Cloudy/Humid/Cold/Damp/warm/Seashore

Seasons: Summer/Spring/Monsoon/Winter/Autumn Wet, getting: General/Local Covers: Covering/Uncovering,

Bath Motion Time Position/Posture Coition Meditation Music/Noise/T.V.

Light/Lightening/Moonlight Odors/Pain/Color/Dark/Touch/Pressure/Rubbing

236

Sun exposure/Temperature/Thunderstorms/Moon phases Exertion: Physical / Mental Thermal state: Hot/Chilly/Ambithermal Anything else…….

G) Emotional State:

LOVE/ ANGER/ SADNESS/ FEAR/ ANXIETY/HATE/ GUILT/ ENVY / JEALOUSY / SUSPICION AND OTHERS


PERCEPTION/THINKING/MEMORY/DECISION/CONFIDENCE/CONSCIOUSNESS/WORK/PERFORMANCE AND OTHERS I) Life situations and circumstances:

Self: Major areas of concern and worries: Past:/Present

Major fears Habits and Hobbies

Family Patient’s position in family Spouse Dependents Relationship with wife and children Relationship with parents and siblings Marital Relationship Environment at home

Work Environment at work Relationship with Juniors/Seniors/colleagues Job satisfaction

Society Relationship with friends and relatives

237

J) Body Language: Gait: Gestures: Postures: Facial expressions: Eye Contact Voice and speech:


Temp. Jaundice Mouth B.P. Cyanosis Tongue Pulse Ear Lymph nodes Oedema Nose Sinuses Anemia Throat

Skin: Complexion & Texture, Discoloration, Eruptions, Growths

Nails: Brittle, Clubbing, Colour, Deformed, Ingrown, Infection Hair: Growth, Baldness, Colour, Dandruff, Dry, Loss, Tangled

L) SYSTEMIC EXAMINATION: RESPIRATORY PER ABDOMEN CVS CNS MUSCULO-SKELETAL Comments if any:

Questionnaire used to elicit the symptoms of the patients:

Patients and the attendants were given ample time to explain about the

problem, without interrupting them in haste, yet as and where needed the

following type of questions were used;

1. What are the factors that make you worse?

238

2. What are the factors which make you comfortable?

3. What are the concerns in your life those are bothering you much?

4. In what type of environment you like to be?

5. How will you describe yourself i.e. your nature, behavior,

temperament, likings, disliking etc?

6. What fears do you have?

7. How do you react to different situations?

8. What gives you the pleasure most?

9. What makes you angry or anxious?

10. Apart from your business/profession what other activities you like.

11. Which was the worst event of your life?

12. Which were the happiest moments of your life?

Checklist for Past and Family History: Anaemia Heart diseases Hypo/Hyper - tension

Asthma Resp. diseases Syphilis / Gonorrhoea

Diabetes Rheumatism /O.A. R.A. / S.L.E

Cancer Leprosy Skin Diseases

T.B./Pleurisy Musculo-skeletal Paralysis / Polio/Stroke

Injuries / # Jaundice Poisoning / Pollution

Bleeding Tendency Malaria / Typhoid Epilepsy / Fits

Chicken-pox/ Measles Mumps / Rickets Stones / Renal diseases

Cholera /G.E. /Ulc. colitis Mental retardation/Suppressions

Diarrhoea/Dysentery Neurosis / Psychosis Vaccination

Exposure : x-ray / radiation Otorrhoea / Otitis Warts / Growths Whooping cough Worms Anything else

239

Checklist of some Probable Causes Emotionally disturbing experiences in childhood.

Prolonged insecurity.

Feeling of unloved / unwanted during childhood.

Preference of brother / sister.

Death of family member / friend.

Disappointment in a love affair.

Career disappointment.

Unfavourable work situation.

Domestic quarrels between parents / spouse / siblings.

Separation from parents / spouse.

Loss of social position.

Disappointment in close relationships

Work stresses.

Retirement from work.

Strict upbringing during childhood.

Major personal injury.

Monetary losses.

Unemployment.

Change in Job / Residence.

Any other.

240

Checklist of some Important Observations that can indicate Anxiety Disorders

Hyperactivity of Hands.

Fine Tremor of hands.

Profuse and cold perspiration Palms and Forehead.

Increased Pulse rate.

Rapid and short breathing.

Facial expression.

Biting nails.

Tenseness of facial muscles.

Hands held in a fist.

Crossed Arms.

Shoulders Bent forward.

Crossed legs.

Shoulders bent forward.

Head thrust forward.

Sitting bent forward.

Clenched Jaw.

Restlessness of limbs.

Avoids Eye Contact.

Chafed and reddened Hands.

Patchy hair loss.

homoeopathic management of anxiety disorders with the help o

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