Hemorrhoids; miasmatic assessment in homoeopathy

Dr Riya Susan George

“A physician skilled in anti-miasmatic prescribing dips deeper into the case and applies an agent that has a deeper and closer relationship with the perverted life force. The results are always better”- Dr. Samuel Hahnemann

ABSTRACT

BACKGROUND: This article includes the clinical understanding of hemorrhoids along with their miasmatic aspects.

METHODS: Various literature and journals about hemorrhoids and their homoeopathic approach are reviewed.

CONCLUSION: Helps the homoeopathic physician to understand the importance of miasmatic analysis in treating the cases of hemorrhoids and improving the quality of life of patients.

KEYWORDS: Haemorrhoids, Homoeopathy, Miasm.

INTRODUCTION

Hemorrhoids/piles are the dilated vessels of the haemorrhoidal plexus in the anal canal. Increased pressure in the veins of the anorectal area leads to hemorrhoids. This pressure may result from pregnancy, frequent heavy lifting, or repeated straining during defecation. Hemorrhoids can be classified as external and internal. Hemorrhoids are life disturbing disease that affects all age groups especially seen more in adults. Females are more commonly affected than males.¹

SIGNS AND SYMPTOMS ^[1]

• Hemorrhoids are often asymptomatic or they may simply protrude.
• Pruritus ani is not commonly caused by hemorrhoids unless they are significantly prolapsed.
• External hemorrhoids may become thrombosed resulting in painful purplish swelling.
• Internal hemorrhoids can cause mucus discharge and the sensation of incomplete evacuation.
• Strangulated hemorrhoids occur when protrusion and constriction occlude the blood supply.

HOMOEOPATHIC APPROACH

Homeopathy is a holistic system of medicine that helps individuals suffering from hemorrhoids to reduce the rates of surgery. Various studies proved that homeopathy is very efficient in pain management and is a ray of hope.^{[2],[3],[4],[5],[6]}

Homeopathy treats the patient as a whole. According to $5 of organon of medicine, the fundamental cause of all chronic disease is nothing but Miasm ^[7]. Miasms are dynamic disease-producing powers that pollute human organisms and produce all possible diseases. Homoeopathic prescription is based on the totality of the symptoms which includes constitution and Miasm. Allen says that the disease is the vicarious embodiment of some miasmatic influence that has bonded itself with the life force, producing disease. ^[8]

MIASMATIC ANALYSIS OF HEMORRHOIDS ^[9],[10]

PSORA

Psora, the sensitizing Miasm produces almost no structural changes but mainly functional disorders manifested by hypersensitivity, itching, irritation, congestion, and inflammation.

The psoric predominance in hemorrhoids is characterized by venous congestion, obstruction of venous outflow secondary to pregnancy or pelvic mass, discomforts, and constipated stool in the rectal ampulla.^[11]

• Venous knots in the anus pass bloody stools.
• Passing of mucus from the anus, with or without feces.
• Itching in the anus.
• Hard stools, skips days, knotted often covered with mucus.
• Burning pain in the rectum.
• Constipation with pain remote, such as headaches, pain in the liver region; drowsiness, sleepiness, stupor, and heaviness.
• Constipation with foul breath, coated tongue.

SYCOSIS

Sycosis manifests itself by local excrescences. Sycosis manifestations are characterized by slowness of recovery.

Sycotic predominance in hemorrhoids is characterized by thrombosis, hereditary tendencies, painful bulging hemorrhoids, hardness, and a sedentary lifestyle.^[11]

• Pruritus, scanty, thin watery discharge oozing from the rectum that has a fishy or fish brine odor.
• Stricture in the rectum, sinuses, fistulae.
• Fistulous pockets are all of a tubercular origin but are greatly manifested by sycosis.

TUBERCULAR

Depreciation and destruction are the characteristics of tubercular Miasm. It is also known as Responsive or reactive Miasm. Symptoms are ever-changing in this Miasm

The tubercular predominance in hemorrhoids is characterized by bleeding piles.^[11]

• Rectal disease alternate with heart, chest/lung troubles especially asthma and respiratory difficulties.

Eg) hemorrhoids if operated on or suppressed are followed by lung difficulties or asthma and not infrequently by heart troubles.

• Hemorrhage from the rectum.
• Stricture, fistulae, sinuses, and pockets.

SYPHILIS

Destruction/perversion/dissolution or degeneration is the significant characteristic of syphilis. Syphilis has always a tendency to develop open ulcers of a virulent type. Organic changes with degenerative diseases such as sinus, and fistula are the indications of syphilis.

The syphilitic predominance in hemorrhoids is characterized by weakness of the blood vessel wall, painless bleeding, and hemorrhoid cushion deterioration.^[11]

• Black offensive stools
• Perverted and dysenteric spasms are syphilitic.
• Worse at night.
• Accompanied with profuse warm or cold perspiration which is very exhausting and debilitating.

RESEARCH STUDIES

• A clinical study with thirty cases showed that 28 (93%) cases were markedly improved and 2 (7%) cases showed mild improvement. The results are based on the statistical analysis of before and after treatment score. The study resulted that antimiasmatic treatment is very effective in the treatment of patients with haemorrhoids.^[12]
• In an another study under “classical” or “individualized” homeopathic treatment of 6 months, the severity of hemorrhoidal symptoms – pain, bleeding, heaviness, and itching improved substantially; however, there was no significant lowering of discharge. Overall, homeopathic treatment appeared promising but needs further rigorous exploration in different designs for arriving at a confirmatory conclusion.^[13]
• A study confirms the efficacy and safety of Homoeopathic treatment in relieving symptoms of hemorrhoids. Symptoms such as straining on defecation and constipation was significantly reduced at the end of the study. Hence, it can be concluded that individualised Homoeopathic treatment can be used safely and effectively in the treatment of haemorrhoids.^[14]
• Two hundred and seventy‑eight patients (Homoeopathy: n = 140, placebo: n = 138) were analysed in another study . After 90 days of treatment, a significant difference (P = 0.0001) was found in the median area under the curve (AUC) for bleeding {difference: −64.0 [95% confidence interval (CI): −90.0, −31.4]}, pain [−243.0 (−280.9, −202.4)], heaviness [−208.0 (95% CI: −245.5, −174.9)], and itching [−198.5 (−246.4, −158.5)] between the Homoeopathy and placebo groups.^[15]

HOMOEOPATHIC THERAPEUTICS ^[16],[17]

AESCULUS HIPPOCASTANUM

• The action of the drug is most marked on the lower bowel, producing engorged haemorrhoidal veins, with characteristic backache and absence of actual constipation
• Severe pain but little bleeding
• Feels full of small sticks
• Hemorrhoids like ground nuts
• Anus raw, sore.
• Hemorrhoids with sharp shooting pain up the back; blind and bleeding
• <standing or walking

ALOE SOCOTRINA

• Hemorrhoids protrude like grapes; very sore and tender; better cold water application
• Burning in the anus and rectum prevents sleep

ARSENICUM ALBUM

• Painful spasmodic protrusion of rectum
• Tenesmus, burning pain, and pressure in the rectum and anus
• Hemorrhoids burns like fire relieved by heat and at night
• Emission of mucus by the anus, with tenesmus

COLLINSONIA CANADENSIS

• Pelvic and portal congestion resulting in hemorrhoids and constipation, especially in females
• Pruritus in pregnancy with piles
• The sensation of sharp sticks in the rectum
• Sensation of constriction
• obstinate constipation with protruding piles
• painful, bleeding piles
• itching in the anus

HAMAMELIS VIRGINIANA

• Hemorrhoids with bruised and soreness of affected part
• hemorrhoids bleeding profusely with soreness
• pulsations in rectum
• fullness and weight; back as if it would break

LACHESIS MUTUS

• hemorrhoids protrude, become constricted, and purplish
• stitches in them on sneezing or coughing
• Constant urging in the rectum, not for stool.
• Piles, irritable with painful drawing upward like a mouse tugging at one side and drawing it up
• Large Haemorrhoidal tumors in persons addicted to spirituous drinks

MURIATIC ACID

• Hemorrhoids are extremely sensitive to any touch; even a sheet of toilet paper is painful
• Anal itching and prolapses ani while micturating
• Hemorrhoids during pregnancy; bluish hot with violent stitches
• Hemorrhoids protrude like a bunch of grape

NITRIC ACID

• Violent cutting pain after stools, lasting for hours
• Hemorrhages from bowel; profuse bright
• Hemorrhoids bleed easily
• After stools, irritable and exhausted
• Swelling of haemorrhoidal tumors in the anus which bleeds at every evacuation

NUX VOMICA

• Itching blind hemorrhoids with ineffectual urging to stool
• Very painful; after drastic drugs
• Constant uneasiness in the rectum
• <during medication and intellectual labor
• Bloodless piles in hysterical women

PHOSPHOROUS

• White hard stools
• Bleeding hemorrhoids
• Protrusion and ready bleeding of haemorrhoidal tumors in rectum and anus, with pain from excoriation, when sitting or lying down

SULPHUR

• Great Hahnemannian antipsoric
• Itching and burning in the anus
• Piles depending on an abdominal plethora
• Frequent unsuccessful desire
• Hemorrhoids oozing and itching
• Blind piles with burning as if something were biting at the anus, going away when lying down, coming on when standing or walking about
• Hemorrhoids that protrude, ooze and bleed
• Anus inflamed, swollen covered with red veins
• Suppressed hemorrhoids with colic palpitation, congestion to lungs; back feels stiff as if bruised.

CONCLUSION
A true Similimum is always based on the existing Miasm. As J H ALLEN says “Most of the time we fail to select the true basic remedy because we first fail to understand the miasmatic phenomena and the relation they ear to each other and the life force”. Hence to make a miasmatic assessment we need to uncover the layers of predisposing weakness.

REFERENCES

1. Porter R, Kaplan J, Lynn R, Reddy M. The Merck manual of diagnosis and therapy.
2. Shah IP. Prospective Clinical Study of Hemorrhoids with Individualized Homeopathic Treatment. JMSCR. 2018;6:12.
3. Ghosh S, Debdas K, Das AK, Ghosh A, Mondal R, Banerjee T, Ali SS, Koley M, Saha S. Treatment of hemorrhoids with individualized homeopathy–an open observational pilot study. Allgemeine Homöopathische Zeitung. 2017 Mar;262(02): R04-02.
4. Ratnaparikh P, Adkine SS. Haemorrhoids and Its Homoeopathic Management. Journal of Medical and Pharmaceutical Innovation. 2021 Mar 5;8(39):5-9.
5. Kariyil JT. A clinical study on homoeopathic medicines in pain management of hemorrhoids in adult age group.
6. Joseph TK. A Clinical study on Homoeopathic Medicines in Pain Management of Haemorrhoids in Adult Age Group (Doctoral dissertation, Sarada Krishna Homoeopathic Medical College, Kulasekharam).
7. Hahnemann S, Boericke W. Organon of medicine. 6th ed.
8. Allen JH. The chronic miasms. B. Jain Publishers; 1998.
9. Speight P. A comparison of the chronic miasms (psora, pseudo-psora, syphilis, sycosis). InA comparison of the chronic miasms (psora, pseudo-psora, syphilis, sycosis) 1977. Health Science Press.
10. Hahnemann S. The chronic diseases. Boericke & Tafel; 1904.
11. Concepts R. Role Of Homoeopathy In Haemorrhoids With Miasmatic Concepts [PDF|TXT] [Internet]. Pdfcookie.com. 2022 [cited 28 March 2022]. Available from: https://pdfcookie.com/documents/role-of-homoeopathy-in-haemorrhoids-with-miasmatic-concepts-9025e8864521
12. Divya P. A Clinical Study of Antimiasmatic Treatment on Patients with Haemorrhoids (Doctoral dissertation, Sarada Krishna Homoeopathic Medical College, Kulasekharam).
13. Das KD, Ghosh S, Das AK, Ghosh A, Mondal R, Banerjee T, Ali SS, Ali SS, Koley M, Saha S. Treatment of hemorrhoids with individualized homeopathy: An open observational pilot study. Journal of intercultural ethnopharmacology. 2016 Sep;5(4):335.
14. Shah IP. Prospective Clinical Study of Hemorrhoids with Individualized Homeopathic Treatment. JMSCR. 2018;6:12.
15. Chakraborty PS, Varanasi R, Majumdar AK, Banoth K, Prasad S, Ghosh MS, Sinha MN, Reddy C, Ravi G, Singh V, Nayak C. Effect of homoeopathic LM potencies in acute attacks of haemorrhoidal disease: A multicentric randomized single‑blind placebo‑controlled trial.
16. Clarke JH. A dictionary of practical materia medica. homoeopathic publishing Company; 1902.
17. Boericke W. Pocket Manual of Homoeopathic Materia Medica & Repertory: Comprising of the Characteristic and Guiding Symptoms of All Remedies (Clinical and Pathogenetic [sic]) Including Indian Drugs. B. Jain publishers; 2002.

Dr. Riya Susan George
PG Scholar
Under the guidance of Dr Jacintha Monteiro, HOD, Professor, Dept of Organon of Medicine and Homoeopathic Philosophy, Father Muller Homoeopathic Medical College.