Miasmatic management of leucorrhoea

Dr Jubin 

The word leucorrhoea means a white flow from the vagina, almost any color or shade presents itself in this disease process. Any discharge that is not blood is called leucorrhoea. It is not a disease, but the product of disease  state or condition of the system. The genital canal is one of the waste gates of the body. Through these, discharges get eliminated and if suppressed (dried up locally) the organism gets affected unfavourably. The patient who is well with a leucorrhoeal discharge is made sick when the flow is suspended by local treatment.

Clinically we have 4 divisions of leucorrhoea.

Vulvular, Vaginal, cervical and Uterine. The first is in aged women and children and the other three in the child-bearing period.

1. Vulvular :  Sero-purulent, viscid, unctuous with the odor of old cheese or at least an offensive smell.  It comes largely from a rapidly developing sebaceous fluid. It is found oftener in children and in aged women.
2. Vaginal : Occurs in young women and is creamy or white, purulent, may be either bland or excoriating.
3. Cervical : Thick, tenacious, ropy or stringy showing the albuminous elements.
4. Uterine is more watery and is similar to that of cervical. It may be tinged with blood or mixed with pus.

Some women suffer all their lives with such discharges while others suffer only occasionally as the result of temporary congestion due to fatigue, cold, exhaustion, febrile states or acute processes which pass away in a few days leaving them normal. It is the permanent conditions with which we have to deal and if we do not understand about the nature of miasmatics, we will soon lose ourselves in the labyrinth of pathological names and conditions to which the leucorrhoea is attributed.

They are menstruation, foreign growths, laceration, congestion, parturition, abortion, sexual overindulgence, uterine displacements, efforts to prevent conception, infections of all kinds, specific diseases such as syphilis, and gonorrhoea, gouty states of the blood, tuberculosis, struma and a thousand other causes. Homoeopathy searches deeper than this, although the pathological conditions are not to be despised or overlooked and they have a bearing on the case. Leucorrhoea is only a symptom, a cleansing and sanitary process to eliminate that which taints the stream of life. Homoeopathy, the law of cure is truth.

The symptoms of leucorrhoea are changeable and numberless like all other chronic diseases, our voluminous Materia Medica testifies fully to his fact. Some of the more prominent and more constant symptoms are pain in the back, head and loins, languor, often loss of strength and general debility which is made worse by standing or by working and is worse about the menstrual period. In the treatment of leucorrhoea, It has to be studied from the standpoint of Chronic Miasms and from the light thrown upon disease by Hahnemann’ teachings in his Organon and Chronic Disease and it is by studying the phenomena of chronic miasm, active or latent in the organism, slumbering by virtue of the presence of leucorrhoeal discharge or awakened by its suppression.

The constitutional treatment of leucorrhoea is of the greatest importance says Dr.A.C. Cowperthwaite. He further continues that leucorrhoea is in itself but a symptom, either of some constitutional dyscrasia or of some local exciting cause. A dyscrasia is a sin process or something that makes the body healthier.(Jeremy Taylor) or a disease of a defined character; a general impairment of health; a degeneration, a faulty condition of the body; a morbid diathesis, and a predisposed condition of the state of the organism. Here we must understand the character of the discharge, pus, anaemia, mental and physical phenomena of the diathesis. (Vol I , Chronic Miasms under Sexual Organs)

Leucorrhoea of a tubercular patient is thick and yellowish, creamy, or greenish-yellow. It often has a sweetish odor, at other times there is no discernable odor.

Leucorrhoea of psora is whitish, albuminous, odorless and usually bland

That of pseudo-psora is purulent, thin, or thick, yellowish, with weakness before menses.

That of sycosis thin, watery, greenish-yellow or dark, like dirty water and usually acrid, and excoriating, producing pruritus of the parts passed over. Odor is pungent, musty like fish-brine or stale fish.

The tubercular patient must have a nourishing diet, plenty of fresh air and sunshine, exercise, appropriate bathing, and anything that will restore the vigor and tone to the system. A tubercular leucorrhoea is that which produces great drain upon the system due to blood changes and the death of the red blood cell.

In the true sycotic no such blood changes, anaemia or loss of strength and the body is well-nourished only in pseudo-psora or sycopsora we find cachexia and diathesis develops that approaches malignancy with its blood changes greater even than the simple tubercular. Each case must be carefully studied and remedy based on  the totality of the active miasm must be prescribed.

In the sycotic miasm douches or injections once a day can be prescribed, not too often, if oftener it produces ballooning of the vaginal canal, producing reaction of the tissue and in the end it becomes a local irritant. Also the patient demands hot water and at last he cannot do without it. To be on the good side only wash the vagina as the trouble lies entirely in the uterus. Raw eggs replace the loss of albumin and raw foods and fresh air are good in renovating the system. Olive oil increases the amount of fat in the body, and in assists in overcoming the work of the tubercular element. The loss of adipose tissue with blood changes we see in these patients and it is the same in children suffering from worms. Urine will soon be covered with fat globules. Potatoes and meats are to be avoided for a short time and increase in amount of fats should be done. The best fat is olive oil; two desert spoonfuls a day are sufficient. Eggs, pure butter and cream follow in the order as fat producers, fresh air and plenty of walking together with the indicated remedy will soon restore these patients to health.

Repertorisation with Synthesis repertory

1. Tubercular leucorrhoea – Rubrics selected

1. Female genitalia /sex – leucorrhoea – thick
2. Female genitalia /sex – leucorrhoea –yellow
3. Female genitalia /sex – leucorrhoea –cream like.
4. Female genitalia /sex – leucorrhoea –greenish- yellow
5. Female genitalia /sex – leucorrhoea –offensive –sweetish.

•       Sepia –8/4
•       Calcarea carb – 7/3
•       Pulsatilla – 7/3
•       Sulphur – 7/3
•       Sabina – 6/3

2. Psoric leucorrhoea

1. Female genitalia /sex – leucorrhoea –white.
2. Female genitalia /sex – leucorrhoea –albuminous
3. Female genitalia /sex – leucorrhoea –bland.
4. Female genitalia /sex – leucorrhoea –scanty.

• Borax  —7/3
• Natrum muriaticum – 7/3
• Sepia – 7/3
• Alumina—6/3.
• Ammonium muriaticum–  6/3
• Calcarea phosphoricum – 5/3

3. Pseudo-psora leucorrhoea.

1. Female genitalia /sex – leucorrhoea –purulent.
2. Female genitalia /sex – leucorrhoea –thin.
3. Female genitalia /sex – leucorrhoea –thick.
4. Female genitalia /sex – leucorrhoea –yellow.
5. Female genitalia /sex – leucorrhoea –weakness with
6. Female genitalia /sex – leucorrhoea –menses before.

• Calcarea carb– 15/6
• Sepia – 14/6
• Kreosotum – 13/6
• Pulsatilla – 12/6,
• Hydrastis – 11/5
• Graphites — 11/4

4. Sycotic leucorrhoea.

1. Female genitalia /sex – leucorrhoea –thin.
2. Female genitalia /sex – leucorrhoea –greenish yellow.
3. Female genitalia /sex – leucorrhoea –dark.
4. Female genitalia /sex – leucorrhoea –dirty.
5. Female genitalia /sex – leucorrhoea –acrid, excoriating.
6. Female genitalia /sex – leucorrhoea –offensive
7. Female genitalia /sex – leucorrhoea –offensive-fish brine like

• Sepia – 10/4
• Kreosotum 9/4
• Sulphur – 9/4.
• Nitric acid – 9/3.
• Secale cor – 7/5

Therapeutics of leucorrhoea.
1.Alumina : For psoric leucorrhoea. After menses great exhaustion both mental and physical with copious discharge of mucus from vagina during menses. Leucorrhoea profuse, yellow, corroding or acrid, creamy or transparent and worse after menses. Leucorrhoea like cream, causing itching in the pudenda, copious only in the daytime, sensation as if everything would fall from the vagina with much weakness. Leucorrhoea chronic, painless from the cervix, copious, running down the limbs (Med). Leucorrhoea relieved by cold douches, worse when walking, Pain in back as if iron thrust through lower vertebrae. Burning in the spine, sensation as if a tight cord were around the body. Numbness of the head, trembling in limbs with great exhaustion. Gonorrhoea and leucorrhoea of  long standing, a whole week passes before she gets over the effects of menstruation which is prolonged by leucorrhoea.

2.Ammonium muriaticum : For psoric leucorrhoea. Leucorrhoea like the white of eggs preceded by griping pains around the navel. Constant, painless, brownish, slimy, albuminous, great distension of abdomen and violent backache at night.

3.Borax : For psoric leucorrhoea. Leucorrhoea white, albuminous, feels hot like    warm   water while passing over the parts, appears midway between the menstrual periods, like starch or white of egg, bland and without pain, between the menstrual period it may be corrosive. During leucorrhoea she is very nervous, easily startled, cannot bear a downward motion such as descending stairs or going down in an elevator. Even rocking affects her. Adapted to lax, sensitive, nervous women. She is subject to aphthae in the mouth during the menses, or to herpetic eruptions about the mouth (Natrum mur) ; urine hot, burns like fire, This has cured some cases of leucorrhoea especially in children when there was an aphthous condition of the mouth and external genitals.

4.Bovista : Leucorrhoea following the menses thick, slimy, tenacious, acrid and corrosive. It like Borax has a leucorrhoea like the white of the egg. It comes out coagulated when walking, or it is of yellowish- green color and leaves a green stain on linen. It excoriates the labia, perineum and groins and thighs by its acridity. Menstrual flow is only at night.

5.Calcarea carbonica : For tubercular and pseudo-psoric leucorrhoea. Leucorrhoea after menses like mucus or milk; worse after urination; albuminous leucorrhoea from cervix with lassitude and debility, of little girls, the least excitement brings on the leucorrhoea or menses. It is thick, yellow, acrid or bland. Indicated in pale, blonde, light haired anaemic women. Tubercular leucorrhoea in pale, fleshy, soft muscled blondes, perspiration about the face or head, hands and feet cold and damp always. Thinks she will lose her mind, much anxiety with fear of death. Thick, yellow, acrid, continuing from one menstrual period to another. Leucorrhoea following copious long lasting menses.

6.Calcarea phosphorica : For psoric leucorrhoea. Leucorrhoea like the white of egg,     odor sweetish, worse in the morning on arising, also worse after stool or urination (Calc carb) Feeling of great weakness in the sexual organs. She takes cold at every change of weather. This remedy is indicated in school girls who develop too rapidly and who suffer with rheumatic pain in their extremities. Albuminous leucorrhoea comes in gushes, worse from walking or running sewing machine.

7.Caulophyllum thalictroides : Leucorrhoea profuse, mucous, acrid or bland with congestion of the uterus and bearing down pains, often indicated in little girls. Leucorrhoea with aching and dragging in small of back and rheumatism in the small joints. Spasmodic dysmenorrhoea in young girls, upper eyelids heavy, moth spots on forehead, very similar to Pulsatilla. Leucorrhoea with uterine congestion or sensation of congestion, articular rheumatism of all joints.

8.Graphites : For pseudo-psoric leucorrhoea. Leucorrhoea profuse, white, thin, mucous, with great weakness in the small of back when sitting or when walking, discharge more profuse in the morning in gushes during day, painful pressing towards the pudenda, soreness of labia with a rash, leucorrhoea sticky, glutinous, copious, flowing down thighs and produces erythema of the parts even ulceration, smells like herring pickle or very offensive. Nails hard, thick, crippled, break or split easily. Stools hard, knotty, large and are often covered with viscid mucus (Puls similar in many symptoms) more indicated near the climacteric period. Skin unhealthy, everything suppurates, cracks and fissures in feet, toes, fingers, lips and face. (Follows Sepia in leucorrhoea)

9.Hydrastis : For pseudo-psoric leucorrhoea. Leucorrhoea viscid, hangs from the os uteri in viscid strings, ropy, yellow, tenacious, cheese like discharges from vagina or uterus. Leucorrhoea complicated with hepatic difficulties and constipation, superficial ulceration of the cervix uteri with tenacious leucorrhoea, debility and general prostration. Patient cachectic- looking, sallow; leucorrhoea discharges very offensive in the early stages of uterine cancer, fissures about the mucous openings of the body, weakened, debilitated, scrofulous subjects with ropy catarrhal discharges ; gastric and hepatic difficulties.

10.Kreosotum : For sycotic and pseudo- psoric leucorrhoea. Leucorrhoea, thick mucus with bad odor, excoriating the perineum, menstrual and leucorrhoeal flow intermittent, discharges almost ceases then begin again, Acrid with voluptuous itching of pudenda and swelling, heat and redness, whitish leucorrhoea, bland, smelling like green corn,. It may be bloody in the beginning, then yellowish, white and acrid, causing much irritation and itching of the vulva. It stiffens the linen and turns it yellow, Leucorrhoea like washings of meat, acrid, dark, bloody with stitches in the vagina and great debility of lower extremities. Frequent urging to urinate at night, burning between the thighs on urinating, Leucorrhoea flows from her like milk with urinary irritation and burning in the small of back. Indicated in delicate blondes who are tall for their age, irritable and despondent, yellow and sallow complexion, even cancerous, gums often spongy and bleed easily, leucorrhoea with burning in abdomen like a ball of fire.

11.Magnesia carbonica : Leucorrhoea white mucus, often acrid after menses, then watery scanty, with pinching pain about the umbilicus. Tongue coated white, mouth full of white mucus. Leucorrhoea smells sour, stool like clay, hard, dry, crumbling. Face pale, waxy, sallow. She always feels tired and feels relaxed in the morning. Menses dark, acrid, pitch like with cutting colic, sour belching and desire for meat.

12.Medorrhinum : Anti-sycotic. Gonorrhoeal leucorrhoea, usually profuse, whitish or yellow, corrosive, producing biting and pruritus of the vagina and vulva. Cannot retain urine long, stains napkin dirty brown. Leucorrhoea opaque, white mucus, stains linen yellow and soreness and burning when urinating. Leucorrhoea like dirty water, thin, offensive prodiucing pruritus, odor like stale fish, musty and pungent. Breasts sensitive and sore. Vagina and cervix mottled with alternate bluish and pinkish spots. Sensation a if something were pulling down in left ovary. Ovary sensitive. Leucorrhoea suppressed by medicated douches. She has great difficulty in telling symptoms, stops and begins over again. Mind weak and forgetful. Cannot remember names. Gonorrhoea of rectum or nose with thin, scanty, watery, oozing. Pruritus vulvae which is aggravated by thinking about it.

13.Mercurius corrosivus : Leucorrhoea pale, yellow, sweet  smelling, tinged with blood or composed of mucus and thin water, it is very acrid causing intense heat and burning in genitals, pimples and nodules even ulcers. Gonorrhoeal leucorrhoea, greenish with vesical tenesmus with burning in the orifice, bloody urine pass in drops with much pain and tenesmus.

14.Mercurius solubilis : Leucorrhoea either acrid or bland, it may be whitish, greenish, bloody or sweet smelling, when it is purulent it produces burning, rawness, pimples and pustules on the labia, the itching and burning is relieved by washing in cold water also  aggravation in the evening and at night. There is much viscid cottony saliva in the mouth, tongue usually large and flabby, taking the imprint of teeth, taste metallic or bitter, putrid, gums are soft, spongy recede from teeth and bleed easily. The discharge is mucopurulent, thin, acrid, lumpy with milk in the breasts during menses. Burning and throbbing in the  vagina, aphthae, patches on labia, weakness and weariness in lower limbs, skin sallow, jaundiced looking.

15.Natrum muriaticum : For psoric leucorrhoea. Leucorrhoea thick, white or transparent, profuse, acrid smarting in the vulva. Bearing down or pressure sensation as if the menses were coming or a cutting pain in the urethra after urinating. Leucorrhoea greenish, especially when walking, aversion to sexual intercourse, very irritable afterwards. Melancholy, sad, dejected, despondent and made worse by consolation, extremely sad during menstruation, she had headache every morning as if it would burst. Sensation as if sand were in the eyes or fiery zigzag flashes before the eyes. Skin is pale, waxy, greasy, dropsical and subject to goose flesh when she becomes chilled. She drops things from her hands because of a nervous weakness; gets into passion about trifles, tongue is often mapped and she suffers from herpes about the chin and mouth during the menstrual period, or urticaria aggravation from 10-11 am.

16.Nitric acid : For sycotic leucorrhoea. Leucorrhoea after menses, greenish mucus or flow is watery (Lil). Flesh colored or cherry colored, leucorrhoea acrid, offensive, brownish water (Sycosis) Occasionally stringy ( Kali bich, Hydrastis) Head aches as if it were tightly bound. Stitches in vagina, soreness in vulva with itching. Taking cold greatly aggravates the leucorrhoea and pruritus. Bearing down in lower abdomen is quite a constant symptom. Face pale, yellow  or brownish. (Sepia, Lyc) Ulceration in corners of mouth, aversion to meat and bread. Likes salt fish, herring, chalk and lime(Kali carb) Urine brownish, strong smelling and foetid (Benzoic acid) Indicated frequently in tall, dark, lean women with black eyes and hair, she is generally aggravated at night from riding in a carriage or car, adapted to diseases coming from secondary or tertiary syphilis or syco-syphilis. The ulcers, warts and abnormal growths, bleed easily or ooze a thin yellowish- green or dirty water secretion. Suitable to haemorrhages due to a syphilitic taint. As Phosphorus to the tubercular, so it is to the syco-syphilitic.

17.Pulsatilla : For pseudo-psoric and tubercular leucorrhoea. Indicated more frequently in the pseudo-psoric. We can readily see that it meets the pseudo-psoric state that cures the disease. Leucorrhoea is thick, milky and cream like. It appears in young girls during puberty or during suppression of menses due to fright or exposure to cold or damp. Corrosive and burning at menses (Before, during and after) with cuttings worse lying down with swollen vulva. Menses retarded, delayed in young girls at or about puberty. Pains cramp-like, colicky accompanied with chilliness. It may be suppressed from cold, or becoming chilled, pains as well as the mental symptoms are changeable, she weeps with her pains. Before menses, weeping, sadness, moody, melancholy, goose flesh during menses (Nat m) nausea, often vomiting with heaviness and pains in abdomen, colic with vomiting, pale, feels faint, shivers as if cold, weeps often and easily, tongue coated white, no thirst. Breathing difficult, cannot get a full breath when in her room, must throw windows and doors open which relieves her at once. Pains in back, sides of abdomen with pressure in abdomen and small of back as of a stone with ineffectual desire for stool (Nux v) adapted to mild, cheerful, gentle, blondes of a tearful disposition, whose symptoms are constantly changing, to lymphatic constitutions, pale-face, light haired, blue-eyed women with great tendency to catarrahal troubles and leucorrhoea. Craves ice cream, butter and fat things which aggravate her much. Milk in breast during menstruation (Merc sol) sore, tender during the menstrual flow. Milky leucorrhoea during menses. Sleeps with hand over head (Plat) and cannot sleep on her left side as it aggravates her heart symptoms. Chilly, thirstless, veins distended, puffy about the face and eyes during menses. Aggravation in warmth, evening on beginning to move, lying on left side, by fats or rich pastries, warm applications Amelioration from gently moving about, cool air, eating cold things and cold applications.

18.Sabina : For tubercular leucorrhoea. Anti-sycotic. Leucorrhoea thin, milky, foetid, suppression of menses with a milky discharge or with a copious and starch like discharge with drawing pains in the small of the back through to the pubes. Sycotic or gouty leucorrhoea, yellowish ichorous, producing severe itching suitable to plethoric women. Bloody leucorrhoea comes on every two weeks, offensive, smelling, weariness and bad feeling in the lumbar region, dragging from back forwards. Leucorrhoea after abortion or miscarriage about the third month of pregnancy. Figwarts with itching and burning amelioration in cool fresh air, music intolerable.

19.Secale cor : For Tubercular leucorrhoea.. An anti-psoric remedy, but it acts in all the three miasms even in syphilis. Leucorrhoea is brownish and offensive or it is jelly like, alternating with menorrhagia, not infrequently it is dark, sanious, putrid, as in malignancies. In uterine cancer or ulcer, the discharge is dark, putrid, bloody, burning pains in uterus, leucorrhoea looks like coffee grounds or disorganized blood, (Ars, Con, Pyro) General coldness although heat aggravates her. Indicated in feeble, cachectic, thin, scrawny women who are full of fear and who are very despondent and melancholy. Skin cold to touch and worse from  warm covering, and relief  in  the open air.

20.Sepia : For tubercular, psoric, psuedo-psoric and sycotic leucorrhoea. Syco-psoric. The leucorrhoea of this wonderful remedy is varied and changeable, but found to be either milky and white or thick and yellow, staining the linen. Occassionally it is yellowish-green in gonorrhoea, it is sometimes lumpy or of foetid odor. In the latter case it is often accompanied by stitches in the cervix and is quite acrid causing soreness of the pudenda, in most forms with a sensation of a downward pressure and in displacements and malpositions, this is very marked. Crossing the limbs relieves the downward pressure, dirty or moth spots about the face are very marked. It is suited to physically feeble women and dark eyed, skin fine with rigid fibre, but mild and gentle disposition, general weakness of the sexual organs. Aggravation forenoon and evening Relief from severe exercise. Sensation as of a ball in inner parts causing the genitals to feel as though everything were coming out through the vagina. This gives Sepia a good picture in pelvic difficulties.

21.Sulphur : In sycotic and tubercular leucorrhoea. Anti-psoric. Leucorrhoea with cutting and pinching pains about the navel. Scanty, acrid, inducing soreness , itching, smarting and burning of the vulva. Thick, yellow, smarting like salt and itching aggravation at night when she becomes warm in bed. Burning in the soles of the feet with much heat and restlessness with desire for cool air, throwing the clothes off. Old chronic cases of leucorrhoea with marked psoric or sulphur diathesis.

22.Syphilinum : Anti-syphilitic. Leucorrhoea yellow, profuse, it soaks through the napkin, running down the limbs (Alumina). Menses too soon and profuse, often two weeks before the regular flow, flow bright red, to occasionally of  a pinkish color. During flow, the uterus is very sensitive, shooting pains in uterus and darting pains in ovaries, worse left ovary. Mammae sore and sensitive between periods. Pains increase and decrease gradually and worse from dark and near morning. She dreads the night on account of severe periosteal and bone pains. Loss of memory (Med, Nat m) Worse at 4 am (Lyc, Bell, Kali iod). She feels worse after sleeping.

Hereditary or acquired syphilis. Round or irregular shaped ulcers at every menstrual period. Aggravation at night ( Nit acid, Merc) ulcers with salivation. Lardaceous borders. Fiery-red edges, Wall straight cut, tongue show imprint of teeth, taste putrid or metallic, herpetic eruptions about the mouth. Desire for alcohol and aversion for meat. Heavy aching in back or neuralgic pains that begin at about 4 pm and last all night, Sleepy at the beginning of the menstrual period, Aggravation at night, dreads to be all alone, Asthma or cough in summer only, aching in pelvis or extremities, tibia especially which is sensitive to touch. Syphilitic eruptions break out during the menses or in the summer times Aggravation night, change of weather, heat of bed. All pains and sufferings aggravation at night.

Bibliography :

1. J.H.Allen—Psora and Pseudo-psora.
2. Repertorium Homoeopathicum Syntheticum – Frederick Schroyens.