Dr Puneet Kumar Misra Abstract – the lemna m relief the acute and chronic tendency of the inflammation of nasal mucosa and prevent the growth of polyps in the nose with inhibit the chronic tendency with variability in symptoms and related to exposure .
Key words – nasal mucosa, nasal obstruction, polyps, chronic,
Introduction – the lemna m having the high reputation in the treatment of nasal polyps ,but it is a matter of study that the polyps formation are the result of the chronic and recurrent tendency of inflammation in the nasal mucosa. The nasal polyps and inflammamed mucosa both produce the nasal blockage, and commonest cause of the nasal block is allergic rhinitis.
Fact present in the materia madica
1) Pocket Manual of Homoeopathic Materia Medica by W.Boericke.
2) A Dictionary of Practical Materia Medica Clarke vol 2nd
The following findings are narrate
Pocket Manual of Homoeopathic Materia Medica by W.Boericke
#General A catarrhal remedy.Acts especially upon the nostrils. Nasal polypi; swollen turbinates . Atrophic rhinitis .Asthma from nasal obstruction;worse in wet weather.
#Nose putrid smell ;loss of smell.Crusts and muco-purulent discharge very abundant.Post-nasal dropping.Pain like a string from nostrils to ear.Reduces nasal obstruction when it is an oedematous condition.Dryness of naso-pharynx
A Dictionary of Practical Materia Medica Clarke J.H vol 2nd
#Characteristics
Dr. Cooper. Some tentative clinical experiments proved to him that *Lemna had a very definite affinity for the nose, acting beneficially in cases of nasal obstruction and catarrh with or without polypus. I removed with *Lemna 3 x four times a day a very chronic catarrh in a lady, and at the same time made her tolerant of the smell of strong-scented flowers, which she could not bear before. In a man I cured with *Lemna 3 x, given three times a day, an aggravated nasal catarrh.
Burnett has recorded several cases of polypus in which immense relief was give by *Lemna by shrinkage of the swelling,but not actual cure.
NASAL POLYPS. Nasal polyps are common and are pedunculated grape-like masses of tissue. They are the end result of prolonged chronic inflammation causing polypoid thickening of the mucosa. They may be allergic or inflammatory. They are frequently bilateral and the middle turbinate is the common site. Antrochoanal polyps originate from the mucosa of the maxillary sinus and appear in the nasal cavity. Morphologically, nasal and antro-choanal polyps are identical. They are gelatinous masses with smooth and Shining surface. They are composed of loose oedematous connective tissue containing some mucous glands and varying number of inflammatory cells like lymphocytes, plasma cells and eosinophils. Allergic polyps have plenty of eosinophils and hyperplasia of mucous glands. Both inflammatory and allergic polyps are covered by respiratory epithelium which may show squamous metaplasia.
Nasal blockage
The commonest cause of nasal blockage is allergic rhinitis.A constant blockage suggests a structural abnormality(deviated nasal septum, nasal polyposis, adenoidal hypertrophy (children). the mucosal protrusions of polyp containing edema fluid with variable numbers of eosinophils and degranulated mast cells, can increase obstructive symptoms and can concurrently arise within the nasopharynx or sinuses. the mast cells of the nasal mucosa and submucosa generate and release mediators through IgE-dependent reactions that are capable of producing tissue edema and eosinophilic infiltration. The nasal mucosa is pale and boggy and Swelling of the turbinates and mucous membranes produce the obstruction in the nasal passage. Mast cells are present in tissues, especially in connective tissue around blood vessels and in submucosal location. Mast cells have IgE surface receptor; thus on coming in contact with antigen binding to IgE (e.g. allergic reaction to parasites), these cells get activated and release granules i.e. they degranulate. These granules contain active substances such as histamine, platelet activating factor, heparin and certain chemical mediators (e.g. prostaglandins, leukotrienes). Mast cells are thus involved in mediating inflammation in allergic reactions and have a role in wound healing.
Allergic rhinitis
This is a disorder in which episodes of nasal congestion, Watery nasal discharge and sneezing. It may be seasonal or perennial, and is due to an immediate hypersensitivity reaction in the nasal mucosa. Episodic rhinorrhea, sneezing, obstruction of the nasal passages with lacrimation, and pruritus of the conjunctiva, nasal mucosa, and oropharynx are the hallmarks of allergic rhinitis. 1) Seasonal antigens include pollens from grasses, flowers, weeds or trees. Grass pollen is responsible for hay fever. In the seasonal type, there are frequent sudden attacks of sneezing, with profuse watery nasal discharge and nasal obstruction. These attacks last for a few hours and are often accompanied by smarting and watering of the eyes and conjunctival irritation. 2) Perennial allergic rhinitis may be a specific reaction to antigens derived from house dust, fungal spores or animal dander, but similar symptoms can be caused by physical or chemical irritants, e.g. pungent odours or fumes, including strong perfumes, cold air and dry atmospheres. In perennial rhinitis, the symptoms are similar but more continuous and usually less severe.
The Continues observation of drug action on the chief complaint nasal congestion with or without nasal obstruction during the course of one year in all weather condition on the 98 case mention below in table.
| Total Case | Age Group | Male | Female |
| 098 | 07y to 75y | 66 | 32 |
Discussion
- The nasal congestion are most common disorder of upper respiratory tract found occasional or recurrence tendency in the all age group suffer , and there may be variability in symptoms that can be related to exposure.
- The patient are unable to describe the conditions and cause of nasal congestion when occasionally suffer.
- Few patient unable to describe the conditions and cause of the disorder while having the seasonal or perennial tendency.
- The frequently suffering patient provides the details of the seasonal or perennial cause and condition in the good manner.
- The patients comes with the chief complained in the acute stage of nasal congestion with sneezing, recurrent cough. And on physical examination the nasal mucosa shows redness with edema and in many cases nasal congestion along with throat congestion are also seen.
- when acute or chronic state of nasal congestion only treated by the lemna m the obstruction is reduce but rest symptoms like burning , irritation or sneezing persist .
- the acute or acute on chronic state of nasal congestion treated by the lemna with the association of other medicine like belladonna /hepar sul /aconitum nap facilitated its activity and reduce the burning and Irritation of mucus membrane rapidly with obstruction .
- Belladonna is needed when patient is febrile,when marked burning or irritation in the mucus membrane are need of hepar or aconitum ,and arnica is useful when body ache is the associated symptoms.
- The potency 30th and 200th show the good response in the all age groups. but the starting of treatment with 200th provide better and fast response instead of the 30th in all age group, and manner of the dose in the two time a day(pervious views 3 or 4 time a day) for two to three weeks shows sufficient amelioration and reduce the frequency of recurrence.
- The observation of effect shows that medicine reduces the mucosal protrusions when containing edema while asymptomatic polyp is unaffected. So the medicine reduce edema and created non obstructed atmosphere in the nasal mucosa and make easy breathe .
- When treatment start with lemna in the every episode it inhibit the further growth of polyp in the nasal mucosa .
- The many patient give the history of the previous raised eosinophils count in the CBC/PBS/GBP/FBS During the period of observation. it found normal after the 3 or 4 week treatment, therefore here I give the detail of one case of 24 year male which suffering nasal congestion recurrently treated by the leman 200th TDS only having the 22% eosinophilia at starting of the treartment after one week 11% and end of third week 06%
- for further information it is necessary needs to all patient treated in future on the above mentioned complain and rest totality of medicine is investigated in the following way i.e. CBC, IgE test , X-ray PNS view along the pulse and temperature monitoring .
- The lemna m may also support the mast cell activity when see the entire symptomatology of the medicine because the nasal mucosa richer for mast cell.
Conclusion – The above discussion and all observation shows that the lemna proved the effective medicine for assistance in the treatment of nasal obstruction or respiratory discomfort produce due the nasal congestion, but ineffective in the case of asymptomatic polyps, and inhibition for polyps development every episode of congestion needs the treatment from the medicine in standard manner .
Reference
- Davidson Sir Stanley. Davidson Principal & Practice of medicine. 23nd Edition. Elsevier Ltd; 2018. Page 622
- Harrison T. R. Harrison’s Principles of Internal Medicine. 19 Editions. By McGraw-Hill Education; 2015. page 2121
- Dr Robert Hutchison .Hutchison’s Clinical Methods. 24th editions . Elsevier Ltd; 2018.Page 453
- Dr Harsh Mohan.Text Book of Pathology.7TH Edition. Jaypee Brothers Medical Publishers (P) Ltd; 2015 Page no 47, 497
- W Boericke. Pocket manual of Homoeopathic meteria medica and repertory. Reprint edition 1997 .B Jain publishers Pvt.Ltd.1997. Page 399
- Dr John Henry Clarke. A Dictionary of Practical materia medica vol 2nd. Reprint edition 1999 .B Jain publishers Pvt.Ltd.1999. Page 267,268
Dr Puneet Kumar MisraB.Sc, BHMS
Lecturer, Practice of Medicine
Govt Pt J LN H M C Kanpur
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