Dr Puneet Kumar Misra
Potentised phosphorus is a good remedy of nervous system but most of the symptoms are due to the chronic disordered condition of the gastro intestinal tract, mainly upper gastro duodenal i.e stomach and duodenum and this disordered condition effect ultimately all system of body one by one. And most of its indication is covered and affected by the nature of eating and drinking condition along with nervous, respiratory and cardiac disorder.
Key words – abdomen distance, flatulence, belching,
Introduction – the phosphorus predominately mentioned as nervous medicine but during observe it is found that it’s main center of action shows on the digestive system with chronic tendency of disorder and associated with symptoms of other important system i.e. respiratory, cardiac, urinary are shown in different materia medica.
Boerickes new manual of homoeopathic materia medica with repertory. – Pain in stomach; relieved by cold food, ices. Region of stomach painful to touch, or on walking. Inflammation of stomach, with burning extending to throat and bowels. A VERY WEAK, EMPTY, GONE SENSATION felt in whole abdominal cavity.
Allen’ s keynotes and characteristics with comparisons. – Longs for: cold food and drink; juicy refreshing things; ice cream >. gastric pains. As soon as water becomes warm in stomach it is thrown up. Regurgitation of ingesta, in mouthfuls [Alum.]. A weak, empty, all-gone sensation in head, chest, stomach and entire abdomen. Apathetic; unwilling to talk; answers slowly; moves sluggishly [Phos. ac.].
Physiological materia madica WM.H. Burt – drawing pain in the stomach, extending into the chest, with oppression of breathing, and palpitation of the heart; the pulse intermitting every few beats; chronic dyspepsia. In dyspepsia, where there is excessive flatulency, with frequent palpitation and intermittent pulse , accompanied with much despondency ,I have seen grand result from phosphorus.. Sensation of great weakness and emptiness in the abdomen; this distresses and aggravates all the other symptoms. This is a ruling key for the use of Phosphorus.
A Dictionary of Practical materia medica vol 2nd
Stomach – Nausea of various kinds, especially in morning or in evening, or else after a meal. Nausea with violent hunger or thirst, which disappears on eating or drinking water abdomen Distention of abdomen, especially after a meal. Uneasiness in abdomen after breakfast. Pressure outwards against sides of abdomen. Soreness of abdomen to touch when walking.
Respiratory Organs- Dry cough every day, which continues several hours, with pains in stomach and abdomen.
Heart and Pulse- Anxiety about heart with nausea and a peculiar hunger, somewhat better by eating, distressing even in bed. Sensation of warmth about right side of heart. Pressure, heaviness, aching in heart. Rush of blood to heart and palpitation, that becomes very violent after eating. Palpitation of heart of different kinds, especially after a meal, morning and evening, as also when seated, and after all kinds, especially after a meal, morning and evening, as also when seated, and after all kinds of mental excitement.
Dr C.hering. The guiding symptoms of our materia medica Volume VII
Coryza: frequent alterations of fluent and stopped coryza; with sore throat and great dulness of head; feverish, dry; secretion dries to crusts which adhere tightly; complicated with hoarseness and bronchial catarrh; obstruction often in morning; discharge from one and stoppage of other nostril; sneezing causes pain in throat or head; smell and taste gone; with sleepiness, especially during day and after meals;
#Appetite Thirst Desires Aversions
Hunger: soon after eating; must eat during chill, before he can get up; ravenous at night, feels faint; with nausea and anxiety about heart recurring several successive evenings,
amel. by eating but afterwards tormenting him for hours in bed.
#Eating and Drinking
Pains always commence when eating and last as long as he continues to eat. After eating: sick, and fullness of abdomen; sleepiness; belches much even after a little food.
in chronic dyspepsia when there seems to be simple exhaustion of stomach;
#Scrobiculum and Stomach
Dyspepsia with excessive flatulency, frequent palpitation of heart, intermittent pulse and much despondency;
#Inner Chest and Lungs – Oppression of chest: as if clothes were too tight; in morning; in bed; after walking in open air, at night, so that she could not perfectly yawn; of lower portion, with shortness of breath; with anxiety, after dinner; with a constrictive sensation under sternum.
Tightness of chest: as from rush of blood; of upper part of chest; across upper third of lungs; as if lungs themselves were constricted; as if air were forcibly kept out; with feeling of dryness; with dyspnoea; with pain; as if a band were about it; with aching in cardiac region, amel. by eructation.
Abdomen- Incarceration of flatus beneath the ribs, with oppression of chest. Loud rumbling and rolling in intestines; fermenting in bowels with empty eructations. Feeling of incarcerated flatus moving in abdomen, catching breath and causing cough; paroxysmal, agg. from excitement or sitting; amel. lying down, straightening up or by eructations; pressure on abdomen agg. suffocative feeling.
Heart pulsation and circulation – Anxiety about heart associated with nausea and a peculiar sensation of hunger, somewhat relieved by eating distressing her even in bed, sometimes for several hours.
Tissue- Blood when drawn seemed very pale, and under microscope exhibited only about twice as many red as white corpuscles.
Lectures on homeopathic materia medica J T Kent
Many of the complaints of Phosphorus are ameliorated by eating. The nervous symptoms of Phosphorus drive the patient to eat and he feels better for a little while, and then he must eat again or the nervous symptoms will come on. Often he can sleep better after eating and cannot go to sleep until he eats something. The stomach symptoms are numerous—pains, nausea, vomiting, burning. The stomach symptoms are ameliorated-by cold things and aggravated by warm things. Pressing pains, burning pains, tearing pains in the
stomach; pain in the stomach after eating; sensitiveness in the pit of the stomach; inflammation of the stomach. long- standing dyspepsia; much flatulence; regurgitation of food; distended stomach and abdomen
Dr samuel Hahnemann. The chronic diseases 2nd part
650. After eating, even with appetite, his abdomen feels full at one. After dinner, headache every day. After dinner, her head feels so chaotic that she can hardly remember anything. At once, after eating much heat in the face. After eating in the eating, a sort of vertigo; objects appear either dark or they are invisible, while flickering zigzags and rings before the eyes impede vision; he feels as if his head turned, and he did not know whether he sat properly on his chair.
665. After meals, pressure on the chest and shorter breath. After dinner, violent throbbing of the heart for two hours, compelling her to cough frequently and often causing a flush to mount to her face (4th d.). After eating the least quantity, tightness of breath. After dinner, tightness of the chest, with anxiety. After every meal, an anxious pressure in the abdomen, with inflation.
1240. Tightness of the chest, above the xiphoid cartilage, with oppression of the respiration, in the evening, when stooping, always relieved by straightening himself. (Ng) Frequent tightness on the chest, with nausea. Asthma, with brief attack of nausea.
Asthma, when taking a deep breath. Tightness of the chest, worse when sitting, relieved by eructation (aft. 22 d.).
Dr S R Phatak. Materia Medica of Homeopathic Medicine
Generalities *Phos. causes inflammation and degeneration of the MUCOUS MEMBRANES OF STOMACH AND BOWELS;
C .H.G.JAHR. Hull’s JAHR A new of manual of homoeopathic practice
The majority of the symptoms appear early in the morning, and in the evening in bed, other symptoms commencing at dinner, and disappearing after dinner, in the forenoon. Most of the symptoms cease after dinner, in the forenoon.
Practice of Medicine View
In the different practice of medicine or internal medicine book digestive tract disorder mainly presenting with main complain are indigestion ,Dysphagia , Dyspepsia, Heartburn and regurgitation , Vomiting ,Diarrhea , Malabsorption , Weight loss , Constipation and abdominal pain associated with digestive system
Indigestion – The most common causes of indigestion are gastro esophageal reflux and functional dyspepsia.
Gastro Esophageal Reflux(GERD)– . Occasional episodes of gastro-oesophageal reflux are common in healthy individuals. Reflux is normally followed by oesophageal peristaltic waves that efficiently clear the gullet, alkaline saliva neutralises residual acid and symptoms do not occur. Gastro oesophageal reflux disease develops when the oesophageal mucosa is exposed to gastro duodenal contents for prolonged periods of time resulting in symptoms . Several other factors are also known to be involved in the development of gastro-oesophageal reflux disease . GERD classically produces heartburn, a sub sternal warmth OR retrosternal, burning discomfort that moves toward the neck OR often rising up into the chest and sometimes accompanied by regurgitation of acidic or bitter fluid into the throat. Heartburn often is exacerbated by meals , on lying down or with bending, straining or heavy lifting and may awaken the patient. Associated symptoms include regurgitation of acid or non acidic fluid and water brash, the reflex release of salty salivary secretions into the mouth. Atypical symptoms include pharyngitis, asthma, cough, bronchitis, hoarseness, and chest pain that mimics angina. Some patients with acid reflux on esophageal pH testing do not report heartburn, but note abdominal pain or other symptoms. Dyspeptic patients typically report symptoms referable to the upper abdomen that may be meal-related, as with postprandial distress syndrome, or independent of food ingestion, as in epigastric pain syndrome. They are classical symptoms of gastro-oesophageal reflux but up to 50% of patients present with other symptoms, such as chest pain, belching, halitosis, chronic cough or sore throats. In young patients with typical symptoms and a good response to dietary changes, antacids or acid suppression investigation is not required, but in patients over 55 years of age and those with alarm symptoms or atypical features urgent endoscopy is necessary. Gastro-oesophageal reflux resulting in heartburn affects approximately 30% of the general population. ‘Waterbrash’, which is salivation due to reflex salivary gland stimulation as acid enters the gullet, is often present. The patient is often overweight. Some patients are woken at night by choking as refluxed fluid irritates the larynx. Others develop odynophagia or dysphagia. A variety of other features have been described, such as atypical chest pain that may be severe and can mimic angina; it may be due to reflux-induced oesophageal spasm. Others include hoarseness (‘acid laryngitis’), recurrent chest infections, chronic cough and asthma. The true relationship of these features to gastro-oesophageal reflux disease remains unclear . Most cases of heartburn occur because of excess acid reflux, but reflux of non acidic fluid produces similar symptoms. Alkaline reflux esophagi it is produces GERD-like symptoms most often in patients who have had surgery for peptic ulcer disease. Ten percent of patients with heartburn exhibit normal esophageal acid exposure and no increase in non acidic reflux (functional heartburn). Disturbed gastric motility may contribute to gastro esophageal reflux in up to one-third of cases. Delayed gastric emptying is also found in 30% of functional dyspeptics. Conversely, some dyspeptics exhibit rapid gastric emptying.
Impaired gastric fundus relaxation after eating (i.e., accommodation) may underlie selected dyspeptic symptoms like bloating, nausea, and early satiety in 40% of patients. Heartburn is due to acid reflux from the stomach into the oesophagus. It causes pain in the epigastrium, retrosternally and in the neck. It is occasionally difficult to distinguish from angina pectoris and may cause atypical chest pain in various sites. It occurs particularly at night when the patient lies flat in bed or after bending or stooping when abdominal pressure is increased. Heartburn may be exacerbated by dietary intake (such as alcohol or very spicy foods) and certain medications (such as bisphosphonates).Reflux is a symptom which occurs without heartburn, when non-acidic fluid or bile regurgitates into the mouth, causing a bitter taste and a disagreeable sensation retrosternally. Overeating and aerophagia override the barrier function of the lower esophageal sphincter (LES), whereas reductions in esophageal body motility or salivary secretion prolong fluid exposure. Increased intra gastric pressure promotes gastro esophageal reflux in obesity. Severity of GERD may be graded as:
Stage 1: Occasional heartburn (<3 episodes/ week), mostly only in relation to a precipitating factor, mild symptoms, no esophageal lesions.
Stage 2: > 3 Episodes/week of moderately severe symptoms, nocturnal awakening due to regurgitation, esophagitis present or absent
Stage 3: Daily/Chronic symptoms, disturbed sleep, esophagitis/erosions/stricture/extra esophageal symptoms like laryngitis, hoarseness, dry cough, asthma. Symptoms recur soon after treatment stopped.
Functional Dyspepsia– Indigestion (dyspepsia)
Dyspepsia is the medical term for Indigestion, a symptom which may include epigastric pain, heartburn, distension, nausea or ‘an acid feeling’ discomfort, bloating Dyspepsia describes symptoms originate from the upper gastrointestinal tract occurring after eating or drinking. The symptom is subjective and frequent. In many patients there is no demonstrable cause but it may be associated with Helicobacter infection, peptic ulceration, and acid reflux. Upper GI malignancy should be excluded in older patients who present with new onset dyspepsia. Nearly 25% of the populace has dyspepsia at least six times yearly, but only 10–20% present to clinicians. Functional dyspepsia, the cause of symptoms in >60% of dyspeptic patients, is defined as ≥3 months of bothersome postprandial fullness, early satiety, or epigastric pain or burning with symptom onset at least 6 months before diagnosis in the absence of organic cause. Functional dyspepsia is subdivided into postprandial distress syndrome, characterized by meal-induced fullness, early satiety, and discomfort, and epigastric pain syndrome, which presents with epigastric burning pain unrelated to meals.
Most cases follow a benign course, but some with H. pylori infection or on nonsteroidal anti-inflammatory drugs(NSAIDs) develop ulcers. As with idiopathic gastroparesis, some cases of functional dyspepsia result from prior infection. Functional dyspepsia overlaps with other disorders including GERD, IBS, and idiopathic gastroparesis. The physical exam with GERD and functional dyspepsia usually is normal. In atypical GERD, pharyngeal erythema and wheezing may be noted. Recurrent acid regurgitation may cause poor dentition. Dyspeptics may exhibit epigastric tenderness or distention. Discriminating functional and organic causes of indigestion mandates excluding certain historic and exam features. People who present with new dyspepsia at an age of more than 55 years and younger patients unresponsive to empirical treatment require investigation to exclude serious disease.
Flatulence describes excessive wind. It is associated with belching, abdominal distension and the passage of flatus per rectum. It is only infrequently associated with organic disease of the GI tract but usually represents a functional disturbance, some of which is due to excessively swallowed air. In some patients it is clearly associated with certain foods such as vegetables.
The many routine nonspecific abdominal discomfort which associated with digestive tract disorder, daily or recurrent complained like distention or pain in the abdomen region which associated with different condition , the study are focused on the all disorder mentioned in the table , the Continues observation of drug action in two and half years on the 136 case the following finding are occurred
|Total case||Age group||Adult and child||Male and female|
|136||2.5year to 80year||126 adult 10 child||75 male 61 female|
|S.No||Disorder||No of case||Observation|
|01||Pain or distention of upper abdomen||65||Moderate to marked response|
|02||Pain or distention in lower abdomen||34||Mild to Moderate response|
|03||Loss of appetite with abdomen distention||19||Moderate to marked response|
|04||Hair fall with GI disorder||18||Mild to Moderate response|
- The distention of abdomen occasional or continues is the result of sudden gastro duodenal disorder i.e. over eating or chronic dyspeptic condition ,which shows symptoms of the GI trouble in the earlier stage but after chronic nature it shows the symptoms of nervous ,cardiac or respiratory system.
- the many patient come with non specific complain pain or distention of the abdomen with prolong history of gastric disorder but on the quarry he/she unable to explain the correct discomfort and this discomfort associated with meal and daily life pattern, and on the physical examination of abdomen it is found that on the mild pressure the patient tells about the pain or pain after just after meal .
- the above mention non specific disorder is present in the phosphorus in the many materia medica with the main gastric complaint
- The distention of the abdomen in clinical practice occurs in the two pattern occasional or continues ,in the occasional presentation there are no need of the specific or long treatment but when the distention found continues then it also needed continues treatment
- The phosphorus shows improvement in the both form means occasional or continues in the frequent or infrequent dose, in the many cases when we apply the infrequent dose the duration of the improvement is very short i.e. one or two day, and patient again feel discomfort, when the patient gives the history of continues/ chronic tendency ,but in the occasional complain of discomfort one or two dose is sufficient for the improvement .while in the continues disorder there are need of frequent dose up to eight to ten days or more .
- For the occasional condition 30th ,200th ,or 1M,of phosphorus one or two dose is found sufficient for the improvement, but in the continues complain the 30c in the child and 200c in the adult one dose empty stomach in the daily morning upto eight to ten days. it is also observed that empty stomach dose give better result instead after meal . and use of the phosphorus empty stomach improve the ability of other drug after meal i.e. carbo veg/nux vomica/ mag phos and other gastric drugs symptomatic.
- The continuous or frequent abdomen distention show the chronic nature of the gastrointestinal disorder mainly upper abdomen with gastro duodenal and lower abdomen with mild to moderate constipation .
- Many patients complain the loss of appetite or no desire of meal show gastric disorder heart burn or pain in the chest or upper abdomen before or after meal, In this case phosphorus 200th empty stomach give response after frequent dose and firstly disorder reduce ( gastric disorder heart burn or pain in the chest or upper abdomen) then desire start or appetite increases.
- In the modern medicine the treatment of GERD or acid peptic disorder is treated in the majority of case with help the of Proton pump inhibitors (PPIs),H2 blockers ,Antacids , Prokinetic drugs, but when we observe it is found symptomatic that the phosphorus function is like as in between Proton pump inhibitors (PPIs) and H2 blockers while not match with the Antacids , Prokinetic drugs.
- Most of the case of hair loss having the background of gastric origin. When liver function test and CBC done we find in the many patient protein level below then normal or towards lower side along with towards the higher side of MCV or large RBCs size i.e. macrocytic and this phenomena also explain in the hering guiding under tissue section .
Chronic gastro duodenal disorder treated with the phosphorus, all disorder of nervous, respiratory and cardiac system are improve which are associated with the chronic gastroduodenal origin or due to it , and major disorder of nervous, respiratory and cardiac system are aggravated by the gastroduodenal complaints are also improve when it is treated with the same i.e. main disorder v/s associated disorder .future study for more evidence the CBC,LFT ,X-ray chest and ultrasound whole abdomen investigation provide more help for better application of this medicine .
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Dr Puneet Kumar Misra
Lecturer(Practice of Medicine)
Govt Pt J LN H M C Kanpur