Dr Meera P Ambaliya
We hear & use the term ‘Acidity’ very often at daily basis. Acid means anything with a ph level between 0-7. But that is not the case with our stomachs. Our stomach requires a very acidic pH of 1.5-2.5 to maintain digestive health this acidic pH is mainly determined by HCl (Hydrochloric acid). Disturbance in the production of HCl may lead to various symptoms that are conjointly referred to as acidity.
Acidity can affect the quality of life severely by symptoms such as heartburn and acid regurgitation. Studies says that, In India, its prevalence ranges from 7.6 to 30%, being < 10% in most population studies
Homoeopathy has wide range of medicines for the symptom acidity. As homoeopathy works on causation of disease, it should be first preferable to remove it from the roots and to avoid further injuries.
KEY WORDS: Acidity, heartburn, homoeopathy, repertory, J.H.Clarke, clinical repertory, the presriber.
“All acidity and indigestion diseases begin in the gut” -Hippocrates
What Hippocrates, the father of modern medicine said 2400 years ago is still a gold sequin ground event today. Millions of people worldwide have various gastric issues-Acidity being one of them. Homoeopathy serves the best treatment for acidity, some of the homoeopathic drugs like nux vomica and pulsatilla are so popular that even non-homoeopathic medical practitioner takes it for him self and prescribes it for his patients too.
PHYSIOLOGY OF ACIDITY: The regulation of acid and pepsin secretion reflects an intricate balance of chemo transmitters delivered to the gastric mucosa by several pathways that mediate both stimulatory and inhibitory mechanisms. Similarly, several mechanisms contribute to the remarkable ability of normal gastroduodenal mucosa to defend itself against injury from the acid/peptic activity in gastric juice and to rapidly repair injury when it does occur. Secretory, defense, and healing mechanisms are regulated by the same type of overlapping neural, endocrine, paracrine, and autocrine control pathways.
The stomach consists of three anatomical (fundus, corpus, and antrum) and two functional areas (oxyntic and pyloric). The oxyntic area comprises approximately 80 percent of the stomach and contains parietal cells that produce gastric acid. Also present in the oxyntic area glands are neuroendocrine cells producing paracrine and hormonal agents that modify parietal cell activity. Oxyntic glands contain ghrelin-containing cells, histamine-containing enterochromaffin-like cells, and somatostatin-secreting D cells. The antrum of the stomach contains pyloric glands, and their main feature is the presence of gastrin-secreting G cells. Somatostatin-secreting D cells are present in the pyloric and oxyntic glands and modulate gastrin release and gastric acid secretion. The cardia region of the stomach is adjacent to the gastro-esophageal junction. Cardia glands are characterized by an absence of parietal cells and chief cells and resemble antral glands.
Gastric acid secretion is regulated by three local hormones: acetylcholine, gastrin, and histamine. Of these three, acetylcholine has the largest effect. Parietal cells, G cells, and enterochromaffin-like cells are stimulated by acetylcholine released in response to vagus nerve stimulation.
Hydrochloric acid secreted from gastric parietal cells generates the strongly acidic environment of the gastric lumen (pH <2) (305), which kills food-derived bacteria, facilitates food digestion, and promotes absorption of minerals including phosphate, calcium, and iron.
ETIOLOGY OF ACIDITY:
The following can cause irritation in the lining of stomach and lead to ACIDITY
- OVER EATING
- bacterial infection, most commonly with Helicobacter pyloribacteria
- excessive alcohol consumption
- bile reflux
- drug use (certain recreational and over the counter drugs can irritate the stomach linings if used frequently)
- certain illnesses, such as diabetesor kidney failure
- a weakened immune system
Chronic gastritis is organized into three types based on related causes:
- Type Ais caused by your immune system destroying stomach cells. And it can increase your risk of vitamin deficiencies, anemia, and cancer.
- Type B, the most common type, is caused by pylori bacteria, and can cause stomach ulcers, intestinal ulcers, and cancer.
- Type Cis caused by chemical irritants like nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, or bile. And it can also cause stomach lining erosion and bleeding.
REPERTORY SERVES CLEAR-CUT GUIDANCE FOR PRACTITIONERS TO PRESCRIBE FOR THE SYMPTOM ACIDITY.
HISTORY OF REPERTORY: Homoeopathic repertory is a systematically and logically arranged index to Homoeopathic Materia Medica. It serves as a connecting link between Materia Medica and the disease. Repertory is a tool which breaks our prejudices and preconceived notions. Dr. Hahnemann himself felt a need for an index to our vast Materia Medica and in 1805 his book “Fragmenta de viribus medicamentorum positivis” had an index but it was not published. Thereafter the most intimate disciple of Dr. Hahnemann made a serious attempt for a repertory and in 1832, The Father of Repertory -Von Boenninghausen gave “Repertory of Antipsoric remedies” which became a progenitor of all the later repertories.
In the whole era of development and evolution of repertories, many different types of repertories were made and classified; some based on a distinctive philosophy, some with no distinctive philosophy, clinical repertories, card repertories, mechanically aided repertories, etc.
Amongst these, Clinical Repertories are those repertories which are based on clinical verification of symptoms and remedies in clinical practice. These repertories have many clinical rubrics under different systems and the medicines are grouped against the name of the disease.
Clinical repertories can be classified under two types:
- Those which covers the symptomatology of the patient as a whole, for example: – Clinical Repertory by Dr. J. H. Clarke, Clinical repertory appended to Boericke’s Materia Medica, A Concise repertory of Homoeopathic medicines by Dr. S. R. Phatak, etc.
- Those which covers the symptomatology of parts or system, for example: – Repertory on Diarrhoea by Dr. Bell, Repertory of Haemorrhoids by Dr. Guernsey, Repertory of the Eyes by Dr. Berridge, Repertory of Intermittent Fever by Dr. Allen W. A., etc.
THE PRISCRIBER BY DR J H CLARKE:
About the author : DR J H CLARKE
Dr. John Henry Clarke was born in 1853. He was one of the most eminent homoeopaths of England, who devoted his whole life for the advancement of Homoeopathy. He took his degree at Edinburgh University in 1875 as gold medallist in several subjects, followed it up with the M. D. and further academic successes and appointments in 1877.
He became a keen follower of Dr. Compton Burnett who was himself in the direct hierarchy of Ruddock. In April 1885, Dr. Burnett edited his last volume of The Homoeopathic World and the next month, May 1885, Dr. Clarke commenced as editor. He was editor of ‘The Homoeopathic World’ for twenty-nine years. He was also a consulting physician to the London Homoeopathic Hospital. Clarke was keen in his writing and it is even said that he had a desk in his carriage. For many years, he was the editor of The Homeopathic World. He wrote many books, his best known were Dictionary of Practical Materia Medica and Repertory of Materia Medica
The prescriber by Dr J H Clarke
without any doubt this is the best book for beginners and students of homoeopathy for prescribing. The pocket sized clinical repertory that contains medicines as well as dosages and repetition guide within it. This little book has helped thousand of new practitioners to prescribe successfully and carry a message of homoeopathy world wide. in this book the name of disease are given in alphabetic order like a dictionary and under each
it was first published by firm of Messrs. Keene and Ashwell. Later by B. Jain Publishers.
- It was first published in 1885
- Updated by Clarke in 1925-1940
- Third Edition published in 2006
- 30thimpression 2009.
The whole book can be divided into two main sections –
- Introduction to the prescriber
- The Prescriber.
THE FIRST SECTION:
The introduction to the Prescriber is divided into 4 parts.
- deals with how to practice Homoeopathy and it throws light on the following topics.
- Necessary implements
- The comparative value of symptoms. “The Prescriber” and the “Clinical Repertory”. Cases in point.
- The dictionary of practical Materia Medica.
- Boenninghausen “Pocket Book”.
- The scope of clinical repertories.
- Kinds and degrees of similarity.
- Hahnemann’s doctrine of chronic disease.
- The genius epidemicus
- The homoeopathic Materia Medica.
- Symptom repertories
The Part-II deals with Case Taking and it throws light on the following topics.
A suggested form.
- “totality of the symptoms” and the invisible nature of disease.
- “treating symptoms”. Hahnemann’s case.
- Indications from heredity and history.
- The value of the names of diseases.
The part-III deals with the Plan of – The Prescriber, and How to use it and it throws light on the following topics.
- The plan.
- Rules of prescribing.
- Examples of prescriptions.
The part –IV contains
- the list of remedies
THE SECOND SECTION:
This is the main part which deals with treatment of diseases arranged alphabetically.
DISEASES WHICH INCLUDE SYMPTOM- ACIDITY.
GERD- gastro esophageal reflux disease:- Gastroesophageal reflux disease (GERD) is a condition that develops when there is a retrograde flow of stomach contents back into the esophagus.
Hiatal hernia:- A hiatal hernia is a condition in which the upper part of the stomach or other internal organ bulges through the hiatus of the diaphragm. When there is laxity in this hiatus, gastric content can back up into the esophagus and is the leading cause of gastroesophageal reflux disease (GERD).
Gastritis:- Gastritis is an inflammation of the protective lining of the stomach.
Gastric ulcer: Stomach ulcers (gastric ulcers) are open sores that develop on the lining of the stomach. Ulcers can also occur in part of the intestine just beyond the stomach. These are called duodenal ulcers.Stomach and duodenal ulcers are sometimes called peptic ulcers.
RUBRICS GIVEN IN THE PRISCRIBER: – J.H.CLARKE
- Simple, Arg. n. 6, 4h.
With white tongue, loaded urine, flatulence and constipation,Lyc. 6, 4h.
Sensation of fire rising from stomach to throat, Manc. 6, 4h.
With loaded tongue, flat taste, bowels loose, Puls. 3, 4h.
During an attack, Caps. 3, every fifteen minutes.
When due to acidity
Acid. Sulph. 3, 4h.
With gastralgia and eructations of wind,Arg. nit. 6, 4h.
After food ; everything taken (especially fat, oils, and sugar) “rises acid” ; the kind of dyspepsia that precedes tubercle, Calc. c. 6, 4h.
Regurgitation of food tasting acid, an hour after eating ; sinking sensation at epigastrium, Sulph. 6, 4h.
With distended feeling after the least food, constipation, thick urine with red deposit, Lyc. 6, 4h.
Constant eructations and vomiting of intensely sour fluid, principally at night, Robinia 3, 4h.
With much stomach flatulence, Carb. v. 6, 4h
Want of appetite, which returns while eating, Chi. 3, 6h.
Aversion to meat, Calc. c. 6, 6h.
Bitter taste ; tongue coated yellow at back, Nux v. 3, 6h.
Complete loss of appetite for food, drink and tobacco, without disgustor bad taste for these things, Ign. 3, 6h.
Loss of appetite for everything, Rhus t. 3, 6h.
Fullness after a few mouthfuls, as if too much had been eaten, Pru. s. 3, 6h.
Simple loss of appetite, or after acute illness, Gent. lut. Ø – 3x, gtt. v. 1/2h. before meals.
- – See Eructations
- With Diarrhśa, seeDiarrhoea .
Cutting colic relieved by pressure or bending double ; sensation as if the intestines were being squeezed between two stones, diarrhśa, Coloc. 3, 20m. – 2h.
Griping, drawing, bursting, or cutting pains; flatulent spasms, < by pressure, by doubling up, > by standing erect and by moving about, Dioscor. 3, 20m. – 2h.
When a spot is as if gripped with the nails ; when the transverse colon is distended like a pad, Bell. 1, 20m. – 2h.
Flatulent colic when the flatus collects in several spots ; intolerance of pain, < at night and by warmth, Cham. 6, 20m. – 1h.
Colic from anger, Staph. 3, 1h.
In young children, the pain > by firm pressure ; pain coming on gradually and passing off gradually, Stan. 6, 20m. – 1h.
Flatulent colic in older children, with or without worms, Cina 1, 20m. – 2h.
Flatulent colic accompanying menstruation, Cocc. i. 3, 20m. – 1h.
With obstinate constipation, Plumb. acet. 3, gr. ii. – 6, 2h.
Flatulent colic in spare, dark subjects, with constipation, Nux v. 1, 1/2h.
With blueness, cold sweat on forehead, and symptoms of collapse, Verat. alb. 1, 1/2h.
- SeeMucous Colitis
From indigestible food, tongue brown at the back, cramping or spasmodic pain, flatulence, vomiting, constipation ; dyspepsia of drunkards, Nux v. 3, 3h.
Flatulent dyspepsia, great belching of wind, cutting pains in the chest, acidity, loose bowels, Carb. v. 6, 3h.
Feeling as of a stone at the stomach, sharp pain going through from epigastrium to the back of the chest, pain between the shoulders, bilious vomiting, pain across the forehead, white tongue, constipation, Bry. 1, 2h.
Craving for meat, pickles, and other coarse food ; gnawing, hungry, faint feeling at epigastrium, Abies Canad. 3x, 4h.
Sensation of undigested hard-boiled egg in the stomach ; constriction at lower end of śsophagus ; sensation as of something lodged in the chest to be coughed up, but nothing does come up, and coughing only aggravates ; loss of appetite in mornings, great craving for food at noon and night, Abies nigra 3x, 4h.
Bilious dyspepsia with great irritability and spasms, Cham. Ř, gtt. i., frequently.
(Put about twenty drops of the medicine in a tumbler of hot water, and let the patient drink it in sips.)
Bilious vomiting, black stools, dull pain in forehead, and as if a band were tied across it, Lept. 1, 3h.
Pale flabby tongue, depraved taste, foul breath, light stools, depression of spirits, Merc. sol. 6, 3h.
Vomiting from chronic catarrh of the stomach, tongue thick yellow coat, red beneath ; in beer-drinkers ; weight rather than pain after food, alternation of gastric symptoms with rheumatism, Kali bichr. 3x, 3h.
Ravenous hunger, white-coated tongue, heartburn ; waterbrash ; milk disagrees ; swelling of epigastrium, tight clothes unbearable ; abdomen distended and hard ; offensive, white stools, Calc. carb. 6, 6h.
Dry, sore tongue, white ; fatty and acid risings ; nausea on every inwar demotion ; constant feeling as if the stomach were filled with water ; great sensitiveness of epigastrium ; burning and sticking pain in liver ; great distension of abdomen after eating a little ; stitches in the chest ; sick headache, Kali. c. 6, 6h.
Yellowish-white coating of tongue, it feels burnt ; longing for indefinite things ; for spiced food ; offensive eructations ; nausea not relieved by vomiting ; salivation ; bitter vomiting with headache, burning, pressure or empty feeling at stomach, soreness in epigastrium, Sang. c. 3, 6h.
Tongue blistered, dry, burning when eating ; bitter taste ; loss of taste, loss of all desire for tobacco in smokers ; salivation ; intense thirst ; waterbrash ; heartburn ; heart-distress, palpitation, throbbing in epigastrium after food ; “swashing” and fermentation in abdomen ; constipation with hard, dry, unsatisfactory stools, feeling as if part remained behind, Nat. mur. 6, 6h.
From eating fat food ; mucous derangement, thickly coated, moist white tongue, nausea with little vomiting, heartburn, absence of much pain, feeling of distension, clothes have to be loosened, bowels loose or regular, Puls. 3, 3h.
Tongue milky-white, eructation of wind and fluid tasting of food taken, Ant. crud. 6, 8h.
Milky-white tongue, nausea, vomiting, prostration, Ant. tart. 6, 8h.
Waterbrash, tongue coated white, flatulent distension of bowels, borborygmi, cannot bear the pressure of the clothes, constipation, gravelly urine, great sleepiness after dinner, Lyc. 6, 4h.
Sodden-looking face, yellow slimy tongue, sour or putrid eructations, “goneness” after meals, alternate diarrhśa and constipation, Hydrast. 1, 3h.
Vomiting, acute dyspepsia, great flatulent distension, Carbol. ac. 3x – 3, 2h.
Heartburn, flatulence coming away easily, excess of acid, heart’s action disturbed by the stomach disorder, Arg. n. 6, 3h.
Deficiency of gastric juice, Alumina 6, 3h.
Irritative dyspepsia red tongue, loose bowels, fever, irritability, faintness, Ars. 3, 2h.
Sense of weakness and oppression at epigastrium, oppression at the chest, acidity with heartburn and lateritious urine, lump in the throat-pit, impeding respiration and swallowing ; “stomach cough”, Lobel. 3, 2h.
Inability to digest milk : vomiting of curdled milk immediately after taking it, Ćthus. 3, 4h.
Symptoms disappear during eating, and return in two hours, Anac. 1, 2h.
- Loud, copious, painless belchings, Arg. n. 6, gtt. ii. 3h.
Distension of the stomach ; eructations tasting of food taken, with or without heartburn, Carb. v.6, 6h.
After Carb. v. ; flatulence rising up into œsophagus and causing pressure and choking, Carb. an. 6, 6h.
With nervous dyspepsia, Carbol. ac. 3x – 3, 2h.
With sensation of painful lump at epigastrium, Abies nig. 3, 4h.
Burning sensation rising up from pit of stomach to the throat, Manc. 30, 4h.
Flatulence in nervous subjects, Nux mosch. 1 – 3, 2h.
Eructations of particles of food very sour (rumination), Sul. 30, 8h.
(During the attacks, Cham. Ø, gtt. i. in hot water 1/2h., for three or four hours, will often give relief if the others, which may be given both in the attacks and over a length of time, fail to do so.
- SeeGastrodynia .
- Gastric Catarrh.
SeeDyspepsia , Stomach
- Gastric Ulcer.
(Rest and milk diet ; if milk is not tolerated, Sanvia.)
In general, especially when the ulceration is near the pyloric end of the stomach, nit.3x, gr. ii. 6h.
In chlorotic subjects, Arg. nit. 6, gtt. ii. 6h.
With dry, red tongue, thirst, cachectic or typhoid condition. Ars. 3, 4h.
After burns, Kali bichr. 3x, gr. ii. 6h.
In elderly people with incarcerated flatulence, suspicion of cancer, Ornith. u. Ø gtt. i. in powder, unit dose, or 3x, 8h.
(For the relief of the pain which sometimes accompanies the affection, if the remedy most indicated does not suffice, Atrop. sulph. 2, gr. ii. may be given intercurrently.)
- HÆMORRHAGE FROM.
If bright, 1, every fifteen minutes.
If dark, Ham. 1, every fifteen minutes.
(Ice to suck ; small pieces may be swallowed.)
- Acute croupous inflammation of the stomach is due to poisoning, and this must be treated by the appropriate antidote.
Catarrhal, seeDyspepsia, Stomach .
Degenerative inflammation of the stomach causing destruction of the peptic glands, Phos. 3, 4h.
- Gastrodynia, Gastralgia, Pain in the Stomach.
Cramping, spasmodic pain, Nux v. 3, 2h.
Burning pain,3, 2h.
Cutting pain, Oxal. ac. 3, 2h.
Cramp-like and pressive pains in stomach, especially after eating, Bism. 6, 2h.
- Mucous Colitis.
Membranous discharges, flatulence and constipation, pains in splenic flexure of colon, n. 5 – 30, 4h.
Almost gelatinous stools, cutting pains in bowels and kidneys, Cadm. s.5 – 30, 4h.
Stools like scrapings of intestines, burning pains, thirst, nausea and vomiting, Canth. 3, 4h.
Membranous stools, colic with tearing pains, much nausea, < by sight or smell of food, Colch. 3, 4h.
Acute crises of pain, > moving about, Diosc. 1 – 30, 1h.
Spasms of pain > by pressure and bending double, Coloc. 1 – 30, 1h.
There are many factors to be considered in this condition and the best results will be obtained by prescribing on individual indications, in the classical manner.
- Peevish ; intolerance of pain. Cham. 6, 4h.
Nervous, hysterical,Ign. 3, 4h.
Great intolerance of light and noise, Bell. 3, 4h.
Over-sensitiveness to all impressions ; over-sensitive to the action of medicines, Nux v. 30, 4h.
- SeeAcidity, Dyspepsia .
- CANCER OF.
Burning at stomach ; thirst for little and often ; anguish, restlessness, wasting,3, 4h.
Balls of flatulence rolling about in upper abdomen, Ornith. u. Ø, single doses at intervals of one, two, or three weeks.
Constant sinking sensation ; eructations of sour fluid ; vomits all she eats except milk and water mixed ; constipation, Hydrast. 3, 4h.
Burning in stomach ; cracks in corners of mouth, Cundurango 3, 6h.
[These medicines may be given singly and persistently according to the general symptoms. Should the medicine that is being given appear to be losing its effect, one of the others should be substituted.]
For the vomiting, Kreas. 3, 4h.
Constant feeling as if the stomach were full of water, Kali c. 6, 4h.
- Coldness, flatulence, cutting pains about the chest, vomiting of mucus, tongue clean or coated,Carb. v. 6, 3h.
Vomiting, pain in pit of stomach spreading into the chest, flatulence, Carbol. ac. 3, 2h.
Intense pain at the stomach, sharp or burning, vomiting of slimy matter ; great prostration ; coldness, Oxal. ac. 3x, 4h.
Tongue milky white ; eructations of wind and fluid tasting of food taken, Ant. crud. 6, 8h.
Sodden-looking face, yellow slimy tongue, “goneness” after meals, alternate diarrhœa and constipation, Hydrast. 3, 3h.
See also Duodenum and Dyspepsia .
- PAIN IN.
- ULCER OF.
- INFLAMMATION OF.
If this fails after forty-eight hours, Podoph. 6, 3h.
- ULCER OF.
(1) nit.3x, gr. ii. 3h. (2) Orinth. u. Ř, gtt. ii. in powder ; unit-dose. (3) Cad. Sul. 3 gtt. ii. 4h.
From burns, Kali bichr. 3x, 3h
REGIMEN: Exercise- Decrease obesity
- Reduce stress by production of Endorphins
- Sleep – Durations of Sleep (6-8 hours) and a fixed sleeping schedule help keep the circadian rhythm synced.
- Eat slowly and chew well
- Do not get to bed immediately after meals. Slow walking after meals.
- Eat smaller meals
- Avoid eating two to three hours before bedtime and avoid lying down after eating
- Sleep with your head elevated
- Maintain a healthy weight
- Limit or avoid alcohol and smoking
- Avoid tight-fitting clothes, as this can exacerbate symptoms
Common foods that make symptoms worse include:
- Tomatoes and tomato sauce
- Garlic and onions, especially when raw
- Citrus fruits, such as oranges, lemons and limes
- Acidic fruits, like pineapple
- Spicy foods
- High-fat foods in large amounts
- Large meals
MEAL ONE CAN HAVE TO MANAGE ACIDITY
- Oats and oatmeal
- Whole grains
- Non-citrus fruits, like melon, pears and bananas
- Vegetables, especially leafy greens
- Lean proteins, including seafood
- Healthy fats, such as olive oil, avocado, nuts and seeds
- Low-fat dairy products, like yogurt and kefir, for those without lactose intolerance
For Acidity: Adequate water intake consumes meals at regular intervals Increase consumption of antioxidants & raw foods.
Avoid Carbonated drinks, Fried, spicy, and junk foods.
Processed foods Caffeine Smoking and alcohol
Avoid Citrus fruits during an acute attack of acidity
Toast, stale bread, white fish, chicken, game, stewed mutton, floury potatoes, and rice may be taken ; flatulent vegetables generally to be avoided.
Ripe fruits which do not disagree with the individual.
An egg broken into a wineglass, and swallowed whole with a little vinegar and pepper, or a tablespoonful of wine, is a sustaining and easily digested form of food.
For ulcer of stomach
Milk in some form or other, if tolerated, should be the chief if not the only diet.
Slippery Elm Food will prove of great service until more substantial foods are tolerate
- = minute.
- = hourly repetition
- = one rising.
- s.s. = at bed-time.
- = globule.
- = drop.
- = grain.
- Ø = mother tincture
- 1,2,3 = centesimal scale
- 1x,2x,3x = decimal scale
- < = worse, or aggravation.
- >= better, or amelioration.
- Shashi Kant Tiwari. Essentials of Repertorization. Fourth edition. B. Jain Publishers (P) Ltd.2005; New Delhi.
- H. Clarke. The Prescriber. Third edition. B. Jain Publishers (P) Ltd.2006; New Delhi.
Dr. Meera P Ambaliya
PG Scholar, Part 2, Department of Case taking and Repertory
Baroda homoeopathic medical college, Vadodara, Gujrat.