SPECTRUM OF HEPATO-BILIARY DISEASES: A HOMOEOPATHIC PERSPECTIVE

1. SPECTRUM OF HEPATO-BILIARY DISEASES: A HOMOEOPATHIC PERSPECTIVE Dr. Alok Pareek Pareek Hospital & Research Centre Agra (India) e-mail: alokpsr@gmail.com Web: www.pareekhospital.com

2. THE LIVER Embarking on a study of this great chemical laboratory one is amazed with the genius of its creator. Innumerable Complex vital Physiological Processes

3. LIVER • It is the LARGEST,HEAVIEST and the most complex gland in our body.

4. LIVER • It breaks down harmful substances absorbed from the intestines or elsewhere in the body and excretes them as harmless bio product. • It also serves as a storage organ—glycogen. • It synthesizes many important compounds– especially proteins.

5. HISTORYLIVER 1500 B.C. - ‘Yakrata’ Ancient Indian atharvaveda 300 B.C. - Erisistractus of alexandriarecognised involvement of liver in dropsy. 5th Century A.D. - Reference to jaundice as KamlaRoga by charak.

6. IN RECENT ERA • - First authentic study of a (John Brown) case of cirrhosis of liver. 1965 The discovery of Australia (Blumberg) Antigen revolutionised the entire study of viral hepatitis.

7. Embarking on the study of liver is like entering into a tropical forest -Humidity- -Heat-

8. LIVER AND CANCER • Liver has a dual blood supply from both intestines and the heart. • Hence it is very much vulnerable to early secondary metastasis in cancer.

9. THE HOMOEOPATHIC PERCEPTION Hepatocytes Complex Blood Supply Biliary Fluids Liver as an organ has its entity only with the individualised personality of the patient as a whole

10. THE PSYCHIC SYMPTOMATOLOGY OF THE LIVER When the liver no longer plays its proper role- We find weakness of spirit, depression, obsessed by fear, afraid of life. Becomes very argumentative and obstinate KENT RELATES THE DEPRESSION OF AURUM NOT ONLY TO THE HEART BUT ALSO TO THE LIVER.

11. THE SOMATIC SYMPTOMATOLOGY OF THE LIVER Tiredness Feeling of Dullness

12. A STUDY ONHEPATO-BILIARY DISEASES CONDUCTED AT Pareek Hospital & Research CentreAGRA (INDIA)(June 95 — July 2004) Total Number of Documented cases 308 AGE : 4 -73 Yrs Cases studied included • Acute hepatic failure, Infective Hepatitis, chronic persistent hepatitis • Cirrhosis of liver with portal hypertension including Indian childhood cirrhosis • Persistent Hepatitis B and C Antigenaemia.

13. INFERENCE OF THE STUDY • China off, Calc. carb., Hydrastis, Iodum, Lachesis, Lycopodium, Magnesium Mur, Mercurius sol, Nat.sulph, NuxVomica, Phosphorus and sulphur were the most indicated general constitutionals with positive response Potencies used 200 C — 10 M. • AndographisPaniculata, BerberisVulgaris, Carduus mar, Chelidoniummaj, Chionanthus, Cholesterinum, Hydrastis, Leptendra, Mag Mur, Myrica, PodophyllumPtelia and Taraxacum were the most useful Organo-Clinical Remedies. Used in mother tinctures and lower potencies.

14. INFERENCE OF THE STUDY (contd.) • Andographis and calc. Ars. Helped the younger age group of patients. • Hepatitis B. & C nosode CHRONIC PERSISTENT HEPATITIS B & C. USED AS AN INTERCURRENT REMEDY IN SINGLE DOSE (POTENCY USED 200 C) A history of blood transfusion or surgical procedure in the past. The medical and nursing personnel exposed were the most benefited by it. Depression in the mental sphere was noticed in all cases benefited by hepatitis B & C nosode

15. The Hepato-Biliary Remedies The list of remedies could be as long as the complete length and width of our Materia Medica. FROM A TO Z ZINCUM ACONITE

16. Hepato-Biliary Constitutional Remedies Deep acting remedies for abnormal constitutions with primary dent in the liver • AURUM • Calc. carb. • CHINA OFF. • IODIUM • Kali carb. • Lachesis • LYCOPODIUM, • MERC.SOL • NAT.SULPH • PHOSPHORUS • SEPIA • SULPHUR

17. Hepato-Biliary General Remedies • Aesculus, Aloe, Aurum Mur Nat, Aurum mur, BerberisVulg, Bryonia, Belladonna, Carduus.M, Ceanothus, Cholesterinum, China off, Calc.Ars, Conium Mac, Hydrastis, Iris.Vers, Iodium, Kalmegh, Leptandra, Lycopodium, Mag. Mur, Merc Sol, Myrica, Nat.Sulph, NuxVomica, Phosphorus, Podophyllum, Ptelea, Sepia, Sulphur, Taraxacum.

18. Remedies with special affinity for hepto-biliary region Aloe, Carduus, Chelidonium, Chionanthus, Cholesterinum, digitalis, calc.ars, hydrastis Kalmegh, leptendra, mag mur, myrica, podophyllum, ptelea, teraxacum

19. Clinical Hepato-Biliary Remedies Remedies used specifically for liver diseases on their clinical weightage. These are used in physiological doses orlower potencies especially for advanced tissue pathology. Berberis vulg., Carduus mar., Chelidonium, chionanthus, cholesterinum Kalmegh, Leptandra, Myrica, ptelia, Taraxacum.

20. CLINICAL HEAPATO-BILIARY REMEDIAL REPERTORY • ASCITES FROM LIVER DISEASE – APOCYNM C, Arsenic alb., CARDUUS MAR. CHINA OFF, Digitalis, LIATRIS SPICATA, LYCOPODIUM • LIVER ABSCESS – BELLADONA, HEPAR SULPH, MERCURIUS, SILICA • LIVER DISEASE WITH INVOLVEMENT OF LUNGS – CARDUUS MAR., PHOSPHORUS • LIVER DISEASE DURING MENOPAUSE – LACHESIS, SANGUINERIA CAN., Sepia, Sulphur • BILIARY DUCTS – CHOLESTERINUM, CARDUUS M, Chelidonium, FEL TAURI

21. CLINICAL HEAPATO-BILIARY REMEDIAL REPERTORY • LIVER DISEASE WITH INVOLVEMENT OF PANCREAS – CHIONANTHUS, IODIUM, IRIS VERS, MERCURIUS, PANCREATINUM, PHOSPHOROUS • LIVER DISEASES WITH DIABETES MELLITUS – NAT. SULPH, INSULIN, Uranium nitricum • FATTY DEGENERATION OF LIVER – Aurum, Carduus mar., CHELIDONIUM, LYCOPODIUM, MERC SOL, PHOSPHOROUS • AFFECTION OF LIVER WITH SPLEENIC INVOLVEMENT – CALC ARS, CARDUUS MAR, CEANOTHUS AMERI, CHIONANTHUS, CHINA OFF, FERRUM ARS, NAT MUR.

22. CLINICAL HEAPATO-BILIARY REMEDIAL REPERTORY • CANCER LIVER – ARSENIC, Carcinosin, CHELIDONIUM, CHOLESTERINUM CONIUM MAC, HYDRASTIS, NAT. SULPH, PHOSPHORUS • CIRRHOSIS OF LIVER – AURUM MET, CARDUUS MAR, CHINA OFF, HYDRASTIS, IODIUM, LYCOPODIUM, MERCURIUS, PHOSPHORUS, SULPHUR • PORTAL HYPERTENSION – Aesculus, Carduus, HAMAMELIS, Lachesis

23. GALL BLADDER REMEDIES CLINICAL HEAPATO-BILIARY REMEDIAL REPERTORY • CHOLELITHIASIS – BERB. VULG, CALC CARB, CARDUUS MAR, CHIONANTHUS, CHELIDONIUM, CHOLESTERINUM, CHINA OFF, DIOSCOREA, FEL TAURI, HYDRASTIS, Morgan gaertner, NAT SULPH. • GALL STONE COLIC – BELLADONNA, BERB VULG, CARDUUS, CHINA OFF, DIOSCOREA., Morgan gaertner

24. Clinical Hepato-Biliary Repertory • Jaundice neonatal : Aconitenap, Chelidonium, China off, Myrica, Nat Sulph. • Jaundice during pregnancy : Phosphorus. • Jaundice with diarrhoea : Aloe, Mercurius, Podophyllum, Pulsatilla.

25. Clinical Hepato-Biliary Repertory • Chronic Jaundice : Aurum, Cholesterinum, Chelidonium, Carduus Mar, Chionanthus, Conium mac, Iodium, Lycopodium, Natrumsulph, Phosphorus, Sulphur. • Haemolytic Jaundice : Arsenic, CrotalusHorr, Lachesis, Phosphorus.

26. Clinical Hepato-Biliary Repertory • Gall stone colic: Belladonna, BerberisVulgaris, Calcarea, Chelidonium, China off, Chionanthus, Carduus Mar, Cholesterinum, Colocynth, Dioscorea, Morgan gaertner, Lycopodium, Nat Sulph • Post Gall bladder Surgery: Carduus Mar, China off, Lycopodium

27. Clinical Hepato-Biliary Repertory • Pain liver better by rubbing : Podophyllum. • Better lying on painful side : Bryonia, Ptelia. • Dragging pain turning to the left side : Ptelia.

28. Clinical Hepato-Biliary Repertory • Pain liver worse lying on left side: Bryonia, Carduus, Mag Mur, Nat Sulph, Ptelia. • Pain liver worse lying on right side:Chelidonium, Kali Carb, Mag Mur, Mercurius, Lycopodium.

29. Hepatic disorders with urinary complaints Jaundice, gall stone colic. Berberisvulgaris Berberis takes hold of primarily two organs :- • The liver and the kidney. Pains from liver run to all parts of the body to chest to back to abdomen

30. Berberisvulgaris • Liver Disorders with rheumatic and urinary problems. • Stitching pain in hepatic region. • Colic from gall stones– it promotes the flow of bile(Boericke). • Urine- dark,bright red with sediments and pain in the region of kidneys. • Liver diseases with Fistula ano.

31. Carduus Mar. • Dropsical effusion with Liver diseases. • Cirrhosis of Liver. • Liver disorders cause lung diseases. • Haemorrhages with Hepatic diseases. • Portal congestion. • Haemetemesis. • Portal Hypertension. • Lower portion of Rt. Lung affected – Hepatic Cough. Dragging pain in Right hypochondrium < lying on left side Taste – bitter No desire for food

32. CARDUUS MARIANUS One of the most important organ remedy for the Liver. We use it in 5 drop doses of the Mother tincture twice daily before meals with one table spoon of water

33. CARDUUS MARIANUS Primary Liver Cancer Liver is secondarily involved with Metastases • It is indicated Liver because of its dual blood supply is very much prone to metastases from Various sites.

34. CARDUUS MARIANUS Cirrhosis Persistent Hepatitis Hepatitis B+C Antigenaemia. Damaged Liver from Alcoholic Beverages (Abuse of Beer) CLINICAL EXPERIENCE Pre Cancerous Conditions of the Liver Cancer of the Gall Bladder

35. CARDUUS MARIANUS CLINICAL EXPERIENCE Physical Sphere Bitter taste - improves the taste in Cancer patient Mental Sphere Joyless Melancholic and Depressed. Very Poor Appetite Improves the Appetite Nausea and Vomiting of yellow green biliary fluid. Stitching pain in the region of the Liver

36. ChelidoniumMajus Right sided remedy Pain under the inner and lower angle of the right specula. Prefers Hot Food and Drinks. Right lower lung Right side of abdomen. (liver and portal system) All symptoms better by eating. Eating temporarily relieves.

37. CalcareaArs • Infantile Liver, Indian childhood cirrhosis. • Children with enlarged liver and spleen in Chronic Malaria. • Pancreatic diseases. • Relieves burning pain in cancer of pancreas.

38. CalcareaArs • Children with enlarged liver and spleen. • Indian childhood cirrhosis. • Hepato-splenomegaly in children in lukaemia and chronic malaria.

39. Chionanthus Virginica A prominent liver remedy. Hypertrophy of liver with enlarged spleen. Jaundice with arrest of menses. Chronic jaundice. Jaundice recurring every summer.

40. ChionanthusVirginica • Soreness in the region of liver. • No appetite,tongue coated yellow,stool clay coloured • Enormous liver(Lilienthal) • Cholecystitis,gall stones.

41. Cholesterinum • Chronic Jaundice. • Cholelithiasis, gall stone colic. • Stones in biliary duct. • Improves portal circulation and helps to reduce biliary congestion.

42. CHOLESTERINUM A very useful remedy for cancer of the liver, gall bladder and the biliary ducts.

43. CHOLESTERINUM CLINICAL EXPERIENCE PRIMARY LIVER CANCER LIVER IS THE SEAT OF SECONDARY METASTASES VERY USEFUL

44. CHOLESTERINUM IN ADVANCEED CASES THE METASTATIC LIVER MANIFESTS ITS SYMPTOMS • SEVERE PAIN IN RIGHT HYPOCHONDRIUM. • TOTAL LOSS OF APPETITE. • NO TASTE, YELLOWISH TONGUE • SEVERE JAUNDICE GALL BLADDER CANCER IT IS VERY USEFUL IN COMFORTING THE PATIENT WTH THE PAIN.

45. Digitalis • Heart diseases with very slow pulse and deranged liver functions. • Jaundice with Heart disease. • Enlarged painful liver with white pasty stool. • Jaundice with enlarged prostate in elderly.

46. Hydrastis canadensis • Its action on liver is marked. Grimmer =>It is in liver cancer that hydrastis has proven really effective. LIVER CANCER Broken down cachectic individual with great debility. Very poor digestion. Thick ropy, yellow acrid discharge. Very poor appetite. Bad taste. Constipation.

47. Hydrastis canadensis • Liver Cancer • Very poor digestion • Flabby large tongue • Very poor appetite • Bad taste in mouth • Fullness, goneness in stomach • Constipation

48. Hydrastis canadensis • Atrophy of liver with marasmus. • Jaundice with emaciation and great loss of weight. • Liver diseases tend to turn chronic and proceed towards malignancy.

49. Leptandra • One of our very important liver remedies. Very dark almost black stool. In any variety of liver disorders when black stools are present this is almost always the remedy.

50. Leptandra • Black fetid stool. • Tarry or black foul stools in cirrhosis of liver with portal hypertension.