The Relationship of Anatomy with Materia Medica

Dr R D Pavalan

Abstract:
The whole Relationship of Anatomy with Materia Medica is mainly revolving around the sphere of action of remedies and their localization

Partially we know about the sphere of action of the most of the remedies, but it is not yet fully understood

The reason for this is, our drug provings are mostly concentrating on subjectivity of the prover, we never (can’t) allow the drug proving to its pathological level or we never done it on lower animals because of various reasons.

The Relationship of Anatomy with Materia Medica  :
Most of the knowledge what now we have about the sphere of action is mainly from toxicology or from clinical proving

The lack of understanding about localization is so true, if we consider the mental symptoms, which are still the main key for the selection of simillimum

The knowledge on CNS (neurology) is still in rudimentary form since it is a recently evolving science and most of the knowledge what we acquire in this field is only after 1950

This knowledge was not available during HAHNEMANNIAN time (proving) or HERRING’S period (reproving)

So now, we are only reading about the mental symptoms, though it is very important, we never bother about which part of the brain is involved in all these things and what is the mechanism behind this.

In the present study I deliberately made an attempt to relate the action of the drug to physical level, as well as to correlate the recent development in the neurology, to localize the brain part which could be responsible for the development of mental symptoms in different drugs, so that we can understand in deep about the sphere of action of the drug in relation to physical body, brain and mental symptoms.

This kind of study ‘ll be useful in treating the Psychiatric and Psychosomatic diseases.

Though it is a retrograde theoretical study to correlate the drug symptoms with the part of the brain, it ‘ll be a new area for the study of materia medica with the help of Knowledge of ANATOMY.

Of course, lots of sophisticated clinical trials are required to prove these facts, I honestly put my theoretical view in front of this learned gathering

The plan… Drugs and their localization…

Physical level :

• Parts of the body, Organs of the body– with example case
• System of the body  – with case 

Mental level:

• Drugs and parts of brain (brain mapping)
• Drug personalities – mental evolution – localization
• Their behavioural pattern
• Psychiatric illness and their localization

Conclusion note :
Parts of the body / Organ remedies
The characterizing value of Locality is often underrated by contemporary homeopathic practitioners. This may stem from a confusion between how we look at Local disease (as described in aphorisms 185-203 in Hahnemann’s Organon), versus how we can look at Locality as a characterizing dimension of complex symptomatology.

The observation that we can generalize modalities and sensations and apply them by analogy across localities, along with the central importance of the mental/emotional state suggested by Hahnemann’s aphorisms 210-213, the writings of Kent, and the teachings of many contemporary lecturers, has sadly placed Locality somewhere in the background of our attention.

” The seat of the disease … deserves to be more particularly emphasized, as it frequently furnishes a characteristic symptom, since almost every medicine acts more and also more decidedly on certain particular parts of the living organism.”

A Contribution to the Judgement Concerning the Characteristic Value of Symptoms  – Boeninghausen

Perhaps no other name is as closely related to the topic of Locality, as that of James Compton Burnett (1840-1901).

BURNETT…
Burnett was born in Redlynch, England in 1840. He attended medical school in Vienna in 1865, where he remained 2 additional years studying Anatomy, receiving a gold medal for his accomplishments in that field. He graduated from Glasgow in 1872, and completed an internship for his MD degree at Barnhill Parochial Hospital and Asylum in Glasgow in 1876.

• Rademacher published his 1600-page Erfahrungsheillehre (empiric medical practice) in 1841, giving birth to the practice of Organopathy
• Rademacher’s Organopathy – drawing on Paracelsus to rationally support his empirical observations
• As with Hahnemann, Rademacher did not seek the nature of these diseases in the “invisible interior of the organism,” but rather identified them by similitude to their remedial substance – a Celandine liver disease, a Cardus Mariae liver disease, etc.
• Remedies were selected on the basis of their affinity for the organ in which the disease was felt to reside, and differentiated further on the basis of the “genus” of the disease – a concept less well defined than Hahnemann’s totality of symptoms, and based on empiricism and considerations arcane to the practice.
• This concept of “specificity of seat” of a remedy, and Burnett’s borrowed Organopathic concept of organ-specific remedies for diseases “of the organs,” seem to stand in conflict with the homoeopathic understanding of disease originating in the dynamic plane, and of remedies acting on the dynamis, rather than on specific tissues of the body.
• Burnett fuels this seeming contradiction with his assertion (in Diseases of the Liver):
• “That the organ in the organism does indeed possess not only autonomy but hegemony, i.e. the organ is an independent state in itself and in and on the organism exercises an important influence. 

James Tyler Kent speaks to this in his 1912 article, Remedies Related to Pathological Tissue Changes.

• Disease may exist, and remedies may act, on the dynamic plane; but there are clearly observable patterns in which these dynamic disharmonies manifest and eventuate in the tissues.
• The medicinal disease of Lycopodium, and those natural diseases bearing similitude to Lycopodium, exist in the dynamis, and not really in the gut, the liver, or the right side of the body; yet these dynamic diseases preferentially manifest in these tissues.
• It would be difficult to describe Lycopodium without referring to its specificity of seat in the gut, the biliary tree and the right side of the body; and it would be difficult to prescribe this remedy in a case where disharmony was not expressed in these localities.
• Where does Locality come in as a characterizing dimension of disease or of remedial action?
• In the study of remedies, there is often a clear display of “seat” in a remedy. The figures below display the number of references to several remedies in each region-of-body section of the Repertory.
• This figure is for Ledum, Rhododendron, andKalmia, three members of the botanical family Ericaceae.
• These remedies display a strong specificity of seat for rheumatic affections of the joints, synovial tissues and connective tissues of the body, seen in the prominence of symptoms in the Head Pain, Back, Extremities and Extremities Pain sections of the repertory.
• The second figure  is for Uva-ursi, Oxydendron, Epigea and Chimaphilla, four other members of the botanical family Ericaceae.
• For these remedies, a strong specificity of seat is demonstrated for the urinary tract, with a preponderance of symptoms in the Bladder, Kidney, Prostate, Urethra and Urine sections of the Repertory.
• This particular graph depicting the distribution of the Drug Mercurius Dulcis in the synthesis repertory – 9.1
• Here in THIS remedy a strong specificity of seat is demonstrated for the gut, ear with a preponderance of symptoms in the mouth, Ear, Rectum and Stool of the Repertory.
• This is not to suggest that these remedies act directly  on or through those tissues – but rather, that the disharmonies with which these remedies are associated manifest preferentially in these localities. And this allows us to have a purely homoeopathic perspective on Burnett’s “organ remedies”
• Chelidonium is not really a remedy that acts on the body through the liver, but a remedy whose dynamic disharmony expresses preferentially in (whose specificity of seat is in) the liver and biliary tree.
• Burnett suggested so much himself, when in his Diseases of the Spleen, he wrote:
• “I am not maintaining that treating an organ affection by an organ remedy after the manner of Hohenheim, Rademacher and their respective co-doctrinaires, will stand as a medical system in itself, but that it is eminently workable, and is largely of the nature of elementary homoeopathy, is, in fact, specificity of seat…
• Whatever else Cantharis may be, it is first and foremost a kidney medicine; whatever else Digitalis may be, it is primarily a heart medicine; and let Belladonna be what it may, it is before all things an artery medicine, and just in this sense Ceanothus Americanus is a spleen medicine. 

Burnet’s case…
This charwoman was, it was said, suffering from an incurable disease of the heart, causing her terrible distress; on rising in the morning she would have to fight for her breath, so that it would take her often three-quarters of an hour to get dressed, having to pause and rest from the dyspnoea and its effects, nevertheless she persisted in thus getting up and dressing, and did as much charing as she could get.

Her pride would not allow her to beg of her friends. Such was the story, and I really felt curious to see the charwoman, and promised to do what I could, though from the account given me by the general’s wife, I certainly thought it quite a hopeless case.

Burnet’s case…

• A careful physical examination. showed that the heart-sounds were normal, but there was much beating visible in the neck, arid the heart’s action was labored. In the left hypochondrium there was a mass corresponding to the position of the spleen, and a dull percussion note was elicited not only in the left hypochondrium, but also in the right, and all across the epigastrium, or pit of the stomach, from side to side.

• The following notes were put down at the time: “Heart-sounds, normal; apex beat, exaggerated; splenetic dullness extending up to the left mamma; the whole region very tender, so much so that she cannot bear her clothes or any other pressure.”
• The prescription was: Ceanothus Americanus 1x 3ij, five drops in water three times a day.

Burnet’s case…

• The pain was improving after taking the regular medicine more than 1 month
• There is still some tenderness on pressure, and the swelled spleen can still be felt towards the median line and inferiorly. She can now do her work (charing) very much better.
• R. Tr. Ceanoth-Am. 1, four drops in water three times a day. 

Burnet’s case…

• Her Liver seems considerably enlarged, and there is still too much beating of the blood-vessels (Veins) in the neck.
• In my opinion the condition of the blood-vessels calls for Ferrum 6, which I now -prescribe, and when that has done its duty-as it surely will – the liver will call for attention.
• But what I wanted to bring out was the specific affinity of Ceanothus Americanus for the spleen, and its consequent brilliant effects, as the simile only grounded on the homoeopathic specificity of seat, which some say has no existence.

 Burnet’s case…
This poor woman thus took Ceanothus during about four months in small appreciable doses: at first the 1x and then the 1 centesimal. The existence of the hypertrophy was ascertained by percussion and palpation; and subsequently I ascertained by the same means that it had ceased to exist.

Although patient took the drug for four months I could not find that it affected any other organ-liver, kidney, bowel – save and except the spleen.

Burnet’s case…

• The secretions and excretions were not affected in the least degree; the remedial action must, therefore, be considered specific.
• My conception of the cure is simply this, that the specific Ceanothus stimulus persistently applied restored the spleen tissue to the normal. This homoeopathic specificity of seat suffices only in simple local disturbances; it is only a simile, not a simillimum.
• The latter would, I apprehend, have affected the liver also and the right heart, and I should then not have needed further detail treatment.

Discussion…
In this case, the apparently peculiar symptoms originally attributed to heart disease are fully explainable as merely resulting from mammoth splenomegaly. As such, these symptoms lose their aphorism 153 status as characterizing symptoms, and the only symptoms of genuine note remaining in the case are “massive splenomegaly” and “splenic pain worse pressure (of clothes, etc.)”.

The rubric {ABDOMEN – ENLARGED – Spleen} lists 61 remedies in the Quantum view of the Synthesis Repertory (Kent listed 51), with Ceanothus, China and Iodium in boldtype.

{ABDOMEN – PAIN – pressing – Spleen – pressure agg.} lists only Ceanothus andZincum.

{ABDOMEN – PAIN – Spleen – lying on left side, while} lists Agar, Cean, Cocc andColch.

Discussion…
We find in Hering, for Ceanothus, “Enlarged spleen, extending to within an inch of crest of ilium, with severe pain in side.” – the only remedy in our materia medica described for such massive enlargement of the spleen, and one of our remedies with a primary“specificity of seat” for the spleen.

Here an “organopathic” remedy is indicated – not because Burnett made a decision to abandon Hahnemann and resort to organopathy, but because the focal involvement of a particular tissue – a locality – was overwhelmingly the most characterizing feature of the case.

CASE No. 1
Case summery
This 58 years old gentle man came with c/o, severe pain and paresthesia over the Left forearm and Left hand fingers. The fingers are very sensitive and he did not allow me to touch his hand due to sensitiveness and pain. All these complaints started after he underwent surgery for his Coronary Artery Disease (CAD). Since it was triple vessel disease he under went CABG 6 months before.

For CABG the graft was taken from the Left Radial artery. That area healed with much fibrosis. After the surgery 4^th week he developed sever pain over the site of graft taken, and ultimately diagnosed as having “CARPAL TUNNEL SYNDROME”. Immediately the pt. was taken to the theater and under went a minor surgery where the adhesions were removed.

Since then the pt. was having severe hyperesthesia over the fingers. He could not able to do any work with his Left hand. Can not able to drive a car.

When consulted the pt. was told the sensitiveness ‘ll be reduced gradually, nothing much to do. He was advised to do some physiotherapy which he could not continue because of severe pain and sensitiveness. since the complaints were not improving for the past 6 months pt. wanted to have a homoeopathic consultation.

Prescription:
On the basis that the nerve has been compressed as well as during the reduction surgery the median nerve could have handled frequently – which were the reason for the development of the present hyperesthesia – Hypericum 6c was given daily dose for 1 week.

Follow up 1 : With in the first week itself  more than 90% improvement was there. Hypericum 6c was repeated for another 2 weeks daily dose

Follow up 2:

                There was no further improvement
Hypericum 30 / 3 doses with in 24 hours

Follow up 3:

Patient feels better. Almost there was no sensitiveness in the hand.
The remaining complaints were removed by the higher potency.

The controversies….

• But in our daily practice most of the time a local remedy may not permanently remove the disease.
• Most of the occasions we need to affect the patient constitutionally in order to get a complete restoration of health
• The following 2 cases are examples for that…

Case No. 2
Aphorism 186:

… affections of the external part requiring machanical skill, properly belong to surgery alone; as for instance, when external obstrucles are to be removed that prevent the vital force from the accomplishing cure. E.G. reduction of dislocation, setting a fractured bone, the union of edges of wounds by sutures; opening of cavities for the outlet of pent-up discharges etc…

… but when in such injuries the whole living organism requires, as it always does, active dynamic aid to put in a position to accomplish the work of healing …

 … then the help of dynamic physician and his helpful homoeopathy come in to requisition…
– Page No. 218, ORGANON OF MEDICIEN… SIXTH EDITION… by Samuel Hahnemann

Name of the patient : Mrs. B

• Age : 28 years
• Sex : Female
• Religion : Hindu
• Occupation : House maker
• Address : Coimbatore
• Date : 20-04-2007
• Socioeconomic status : Upper Middleclass 

Chief Complaints : Patient C/ O,

1. Loss of smell, after sustained head injury since 3 years
2. Late menses since 2 years
3. Attacks of vomiting, head ache, vertigo on and off since 6 months
4. Swelling over the front of the neck since 1 week

History of present complaints:
Complaining of, loss of smell after sustained head injury in a Road traffic accident before 3 years. While traveling in a two wheeler she fell down and became unconscious. Admitted in to the ICU of a general hospital. She recovered from unconsciousness but lost the smell. The Neurologist told, it is difficult to get the smell in future hence there is neuronal damage.

Complaining of, late menses since two years. Before that this late menses was on and off since menarche, for the past two years it is always late, once in 50 days.

She had, frequent attacks of nausea, vomiting, head ache and vertigo since 6 months. 1 week before she developed similar attacks with swelling of neck and all over the body admitted in to Kongunad Hospitals, Coimbatore there diagnosed as having Hypothyroidism and advised to take T. Eltraxin 1½ tablets OD. (see report, Before treatment) And calcium supplements. She was advised that she may need to take this medicine for life time.   

History of past illness and treatment: NAD

Family history : Father  – HTN, Mother – Epilepsy (GTCS), Maternal Gr. Father – Lipoma

Patient as a whole: Developmental landmarks  : Normal., Hyperactive in childhood

Physical generals:

1.  Appetite   : Good, can not  tolerate hunger = faintness

2.  Desires      : Fish, Fruit juices

3.  Aversion : Sweet

4.  Thirst             : Takes only 4 – 5  glasses/day

5. Bowel habits: Occasional constipation

6. Bladder habits : Normal

7. Sleep and dreams : Refreshing,  wants to cover whole body. Startling during sleep especially when transition of conscious to unconscious.

8. Perspiration : More over the back part of the body.

9. Thermal reaction: < in winter, can not tolerate cold.

10. Female complaints : Menarche at the age of 13. Irregular bleeding up to the age of 17.  became late on and off. For the past 2 years regular late menses, once in 45-50 days, duration – 5 days, during menses – vomiting and diarrhea. Leg pain and sleeplessness before menses.

Life space investigation :Patient hailed from upper middle class family. Childhood history was uneventful. Relation with parents and sibling are good. Patient was hyperactive during childhood. She told that during her childhood both parents were working in different places and could not able to take care on her. She got married at the age of 23. Has one female child. Her relation with her husband is good. She is a house maker. She keeps her house very neat and decorates her house with lot of articles.

She told “people who come to my home never leave immediately. They see all the materials show cased there and tell “this is like a museum”. She is artistic, and much interested in interior decoration. She gets anger very easily and expresses it. She used to weep for trivial things. After weeping  she feels better. When asked about specific fears she volunteered that she is having tremendous fear on Cats. She tells I feel very weak now – a – days.

Objective symptoms(Mind) : Talks a lot.  Loquacity +

General physical examination:

• Appearance       :  Dark Complexion, lean, active.
• Built                   :  Poor built up
• Nourishment     : Good
• No Pallor/ Cyanosis/ Clubbing/ Edema/ Icterus/ Lymphadenopathy
• Oral cavity          :  Black color discoloration of the tongue.
• Nails & skin        : Normal
• Neck examination :  Mild uniform swelling over the anterior part of the neck, moves on deglutition.
• Vital signs:
• Pulse : 72/ Min,  Temp : 98 ­0  F, RR : 16/ Min , BP : 100/ 70 mm of Hg 

Provisional diagnosis: Hypothyroidism

Investigations:Routine Blood / Urine – NAD

Discharge summery
Basis of Prescription…

Follow up criteria:

Subjective:                               Objective:

• Mental state                           Thyroid profile                                              (TSH level)
• General well being
• Weakness
• Menstrual regularities

 First prescription: 20 – 04 – 2007
Tuberculinum 1M / 1 Dose, early morning on empty stomach.
S.L. – 15 packs/ 1 OD.
patient is asked to reduce the  T. Eltroxin  – to 1/day
24 – 04 – 07
Patient called and told, first time after the accident since 3 years she got the smell of coffee prepared by her in home. (Neurologist told that she may not get the smell back)

18 – 07 – 07 Patient feels better. Patient came with TSH report which shows very low level of TSH :     (TSH level – < 0.01mIU/ ML)

Rx.To continue Phosphorous 0/2
To stop T. Eltroxin

This reduction

• In the TSH
• Probably ‘cos
• Of continuation
• Of T. Eltraxin.
• Adv. To stop  

The pattern of cure…herring’s law
A local Disease, in most of the occasions need a constitutional remedy… 

Neuroscientists are beginning to understand the neural circuitry of the brain that controls anxiety. The structures of the brain involved include the limbic system, the frontal lobes of the cortex, parts of the thalamus and basal ganglia, the locus coeruleus, dorsal raphe nucleus and the white mater connections between them such as the internal capsule and cingulum.

While the general areas involved are beginning to be recognized, much is unknown about the specific functions of the areas and the nature of the signals between them.

Single remedy rubric – Merc.

• MIND – ANARCHIST – revolutionary
• MERC.gl1.fr,vh,vml2
• MIND – COMPLAINING – relations and surroundings, of
• Merc.hr1,kr1
• MIND – DELUSIONS – animals – jumping – her; jump at
• Merc.k1,st
• MIND – ESCAPE, attempts to – crime, for a fear of having committed a
• Merc.k,kr1
• MIND – EXCITEMENT – lascivious, with painful nocturnal erections
• Merc.kr1
• MIND – EXCITEMENT – waking, on – frightened, as if
• Merc.kr1
• MIND – FEAR – night – grief; with
• Merc.kr1
• MIND – FEAR – wrong, of something – commit something
• Merc.kr1
• MIND – GRIEF – fear at night, with
• Merc.hr1,kr1
• MIND – KILL; desire to – husband; impulse to kill her beloved – menses agg.; during
• Merc.kr1
• MIND – KILL; desire to – husband; impulse to kill her beloved – razor; therefore implores him to hide his
• Merc.kr1
• MIND – KILL; desire to – hysterical sadness, with
• Merc.kr1
• MIND – MANIA – liver complaints, with
• Merc.kr1
• MIND – MISCHIEVOUS – imbecility, in
• Merc.kr1
• MIND – SUSPICIOUS – daytime
• Merc.a1,k
• MIND – TRAVELLING – desire for – almost uncontrollable desire to travel far away
• Merc.kr1 

Sadam husaine..

• Saddam Hussein was the ruthless dictator of Iraq from 1979 until 2003
• April 28, 1937 — December 30, 2006
• Father abandoned his family
• Mother married to another man  – who is immoral, brutal, illiterate
• Sadam moved to his uncle’s place
• Not interested in studies – in politics
• Tried military – failed
• Joined in the baath – party
• Tried to associnate then president –      failed – flee from country
• Arrested – tortured – his party gained the power
• Released – vice president – 10 years
• Then president – 1979
• Ruled with brutal hand – used fear and terror – to stay in power 

Top 5 Crimes of Saddam Hussein

• Reprisal Against Dujail
• Chemical Weapons Against Kurds
• Anfal Campaign  (spoil – kurdhish)
• Invasion of Kuwait 

Localization of drugs – brain mapping
Evolution of nervous system…

When examined as a series, researches demonstrate clearly that the vertibrate brain has evolved by a gradual “cephalic shift” of function from the lower brain stem (Fish) to the Higher cerebral cortex (Man).

It also is evident that certain neural structures attain considerable size and obvious functional importance in lower forms, but become proportionately smaller and therefore less conspicuous in higher forms (Olfactory bulb, optic lobe)

Though Brodmann classified the brain in to 57 areas, no single function of the body or mind is localized to single part of the brain. It is the combination of different part of the brain come in to play for executing a single function.

When the single area of brain may have specific function to do, but most of the day to day functions need more than one area to work together. If more than one area involves in a particular function the resultant functions will be more than the summation of their individual functions.. (ie. 2 + 3 > 5)

So each and every functions ‘ll primarily have one area and associated with many other areas.

• Brodmann
• Motor  area
• Primary motor 4,
• Secondary motor 6, 8
• Motor planning 6, 13-16; 24, 32-33; 40
• Motor Imagery 5, 7, 4, 6, 8; 24, 32-33
• Motor Learning 4, 1-3, 6, 8; 23, 26, 29-31
• Inhibition of blinking 4 

Area 4 – Primary Motor Cortex – motor homunculus
Area 6 – Pre-Motor and Supplementary Motor Cortex (may contribute to planning of complex coordinated movements.)

GENERALS – PARALYSIS – right (33) : CAUST. CROT-C.
GENERALS – PARALYSIS – left (39) : ACH. NUX-V. RHUS-T.
MIND – TALKING – slow learning to talk (21)
agar. AGRA. aloe bar-c. Bell. borx. calc. calc-p. caust. mag-c. med. NAT-M. nux-m. op. ph-ac. phos. sanic. sil. sulph. thuj. tub. 

GENERALS – WALKING – learning to walk – late (34)
acon. Agar. all-s. arg-n. Ars. ars-s-f. aur-m-n. Bar-c. bell. CALC. calc-f. CALC-P. Carb-v. CAUST. cupr. ferr. fl-ac. kali-i. lil-t. lyc. mag-c. med. merc. NAT-M. nux-v. Ph-ac. Phos. pin-s. Sanic. sep. Sil. sulph. thlas. thuj.

EXTREMITIES – MOTION – control of, lost (6) : Bell. chinin-s. Gels. merc-c. op. Stram.

Area 8 – Dorsolateral prefrontal cortex involved in management of uncertainty (increasing uncertainty increases activation here, fMRI). Hope occurs here, a high-order expectation positively correlated with uncertainty. This area also includes frontal eye fields where conscious control of eyes is believed to take place. 

MIND – DESPAIR (193)
AMBR. AUR. CALC. COFF. HELL. IGN. LYC. NAT-M. PSOR. SULPH. VERAT.
EYE – MOVEMENT – involuntary ( = Nystagmus)
Agar. atra-r. bell. ben-n. bufo Calc. canth. caust. cupr. gels. hyos. ix. kali-i. Mag-p. meny. Nux-v. spig. stram. sulph. syph. zinc.

Area 9 – Dorsolateral prefrontal cortex – sustaining attention and working memory. Lesions cause difficulty in inhibiting responses.

• MIND – ABRUPT (24) – CALC. NUX-V.
• MIND – INDISCRETION (41)- PULS. 

Area 10 – Frontopolar area (involved in strategic processes of memory retrieval and executive function)

MIND – EXHILARATION – recall things long forgotten, can (1) : Gels. 

MIND – MEMORY – active (96) : BELL. COFF.. HYOS. LACH. LYC. NAT-M. OP.

Area 11 – Orbitofrontal area (orbital and rectus gyri, plus part of the rostral part of the superior frontal gyrus). involved in planning, reasoning, and decision making. Perhaps the only cortical constraint of the hypothalamus.

Area 12 – Orbitofrontal area

MIND – IRRESOLUTION (197) : BAR-C. HELL. IGN. LACH. ONOS. OP. PETR.

MIND – PROGRAMMING – everything (2) : •ARS. nat-m.

MIND – REASON increased, power of (18) : •bry. Calc. carb-v. Cham. coff-t. Lyc. merc. mur-ac. nit-ac. nux-v. olib-sac. phos. puls. rhus-t. sep. spig. staph. Sulph.

Sensory

• Proprioception 1-3, 4, 8
• Touch, temperature, vibration 1-3, 4, 5, 7, 13-16
• Somatosensory integration 40 

Areas 1, 2 & 3 – Primary Somatosensory Cortex (rostral to caudal is 3, 1, 2) -Homunculus representation: legs and trunk fold over midline; arms and hands (most tissue dedicated) are along middle of strip; face (with much tissue dedicated to lips) near bottom.

Area 5 – Somatosensory Association Cortex

Area 7 – Somatosensory Association Cortex (involved in locating objects in space; where vision and proprioception converge, enabling us to determine where objects are in relation to parts of the body. Generally, use in visuo-motor coordination such as in reaching to grasp an object).

MIND – DISTANCES – inaccurate judgement of (25)
agar. anac. arg-n. atro. bros-gau. Cann-i. cann-xyz. carb-an. coca cypra-eg. dat-m. des-ac. glon. hyos. irid-met. lac-h. magn-gr. nux-m. onos. op. ozone podo. sal-fr. stann. Stram.

MIND – SIZE – incorrect judgement of (7) : agar. calc. cann-i. chinin-s. onos. plat. stram.

Area 17 – Primary Visual Cortex (V1) – highly specialized for processing information about static and moving objects and is excellent in pattern recognition.

MIND – DELUSIONS – objects; about – far off; too : anac. sal-fr. stann.

MIND – DELUSIONS – objects; about – large : hyos. nux-m.

MIND – DELUSIONS – objects; about – recede : cic.

MIND – DELUSIONS – objects; about – reel : bell. bry. glon. merc-i-r.

Area 18 – Secondary visual Association Cortex (V2) – bulk of the volume of the occipital lobe.

Area 19 – Tertiary visual association cortex (V3) – with area 18, involved in feature-extraction, shape recognition, and visual attention.

Area 20 – Inferior Temporal gyrus – high-level visual processes and recognition

MIND – DELUSIONS – objects; about – different; appear : cic. germ-met. nat-m.

VISION – ACUTE (52) : con. agath-a. anac. ang. ant-c. arge-pl. aspar. bamb-a. BELL. Bufo camph. carb-an. Chin. choc. cic. coff. colch. coli. Con. conch. cycl. falco-pe. fic-m. fl-ac. galla-q-r. haliae-lc. hell. hyos. ign. lac-del. lac-loxod-a. lac-lup. lach. luna m-arct. Nux-v. ozone ph-ac. Plut-n. positr. ribo. sal-al. sanguis-s. sars. seneg. spig. suis-pan. suprar. tung-met. valer. viol-o. visc.

Area 21 – Middle Temporal gyrus – auditory processing and language, notably left side

Area 22 – Superior Temporal Gyrus, includes Wernicke’s area in its posterior. Left side involved in generation and understanding of words. Right side, melody, pitch, and sound intensity. 

MIND – COMPREHENSION – easy (43) : aesc. ambr. anac. ang. anh. aur. bar-c. bell. borx. brom. buth-a. calc-f. camph. cann-i. cann-s. cann-xyz. caust. COFF. hyos. ign. LACH. lyc. lyss. meph. olib-sac. OP. PHOS. Pip-m. Plat. puls. querc-r. rhus-t. sabad. sal-al. sel. sep. sulph. tab. thiop. ulm-c. valer. Verat. Viol-o. 

MIND – FORGETFUL – words while speaking; of (79) : ARN. BOTH. CANN-I. PH-AC. 

MIND – MISTAKES; making – speaking, in – words (10) : am-br. bov. cham. Chin. Lyc. mang. merc. nat-m. Nux-m. sil.

HEARING – ACUTE – music, to (16) : ACON. aloe ambr. bufo Cact. carb-v. Cham. Coff. Lyc. Nat-c. NUX-V. ph-ac. Sep. sulph. Tab. viol-o.

Area 23 – Ventral posterior cingulate cortex

Area 24 – Ventral anterior cingulate cortex – motivation, will

MIND – AMBITION – increased (55) : acon. alum. anac. apis ars. asar. aur. Aur-m-n. bov. calc. camph. canth. carb-an. carc. Caust. cina Cocain. cocc. coloc. con. crot-c. crot-h. cupr. cycl. dros. form. graph. ignis-alc. kali-c. kola lac-e. lac-leo. Lach. lyc. nat-ar. nat-m. NUX-V. Pall. phos. PLAT. polys. puls. ran-b. rhus-t. sars. sil. spig. staph. Sulph. tanac. ulm-c. vanad. VERAT. vesp. vip.

MIND – AMBITION – loss of (31) : am-m. Ambr. apoc. arag. arb-m. arg-n. ars. bar-c. bro-r. calc-sil. caps. caust. clem. cocain. dios. dream-p. erig. nat-p. pall. petr. plac. polys. rob. ros-ca. Sep. skat. Sulph. tax-br. tub. ulx-eu. viol-o.

Anatomical aspects of Mind…

Olfactory

• Area – primary – Ant. Perforated substance, Gyrus ambiens, Gyrus Semilunaris, Cortical medical part of Amygdala
• Secondary – Ento Rhinal area
• Function – Detection of particular smell may cause a person to have a specific memories that may involve strong emotions. 

NOSE – ODORS; imaginary and real (42)
agn. alum. am-m. ambr. anac. ars. Aur. bell. benz-ac. calc. canth. chin. cina con. corv-cor. dig. Graph. hep. kali-bi. kreos. laur. lyc. M-ambo. M-arct. manc. Meny. merc. mez. mosch. Nit-ac. Nux-v. par. ph-ac. phos. plb. Puls. Seneg. sep. sil. sulph. valer. Verat.

MIND – DELUSIONS – smell, of (25)
Agn. Anac. aran-ix. ars. Aster. bell. calc. carc. cic. cina corv-cor. der. euph-a. Kali-bi. lach. lact-v. manc. musca-d. Op. par. puls. Sang. sulph. valer. zinc-m. 

HEAD – PAIN – odors – strong – from (23)
acon. anac. arg-n. Aur. aur-s. Bell. cham. chin. Coff. Colch. ephe-si. gink-b. graph. Ign. kali-p. Lyc. nux-v. ozone Phos. scut. sel. Sil. Sulph.

MIND – ANGER – odors – agg. (2) : colch. lac-h.

Amygdala: Root of inferior horn of lateral ventricle, deep to the Gyrus ambiens, Semilunaris, uncinate gyrus, cont. behind the tail of caudate nucleus. Having stong connections to the Hypothalamus

Function – agonistic behavior with aggressive reaction or fear response.

Lesion – loss of aggression, docile with occasional hypersexual behavior.

• MIND – LASCIVIOUS
• MIND – NYMPHOMANIA
• MIND – SATYRIASIS
• MIND – AMATIVENESS
• MIND – AMOROUS
• MIND – LEWDNESS
• MIND – LIBERTINISM
• MIND – MORAL FEELING; want of
• MIND – OBSCENE, lewd
• MIND – DELIRIUM – erotic . Etc.
• Main drugs – Plat., Hyos., Vert., Canth., Phos., Lach.
• MIND – FEAR – sudden (= panic attacks) (24) : Acon. apis arg-n. Ars. atra-r. bamb-a. Cann-i. carb-v. carc. cypra-eg. diosm. gard-j. gels. glon. heli-n. kali-ar. kali-c. levo. meli-a. merc. nit-ac. ozone Ruta ther. 

Septal area:

• Paraterminal gyrus, Septal nuclei of septum pellucidum
• Function – inhibits aggressiveness and produces pleasure reaction – a pleasure centre 

MIND – INDIFFERENCE – everything, to (106)
CADM-MET. CARB-V. PH-AC. STAPH. THYR.

Hippocampus…

• Area – induseum greasium, longitudinal striea, gyrus fasciolaris, dentate gyrus, uncus
• Function – long term memory 

MIND – MEMORY – loss of memory (68)
absin. agath-a. ail. Anac. Arg-n. bamb-a. bar-c. BELL. bry. calc-p. Camph. carbn-s. Cic. Coli. Con. convo-s. cori-r. cycl. des-ac. Dig. diph-t-tpt. elec. euon-a. fago. graph. hell. hippoc-k. HYOS. Hyper. kali-br. kali-c. kali-m. kali-p. kali-x. lac-e. lat-h. lyc. mand. med. Nat-m. nat-s. nux-m. olnd. onos. op. perh-mal. PETR. ph-ac. phos. plb. pneu. podo. psor. puls. rhod. rhus-t. sel. sil. spig. staph. Stram. sulfa. sulph. syph. tab. trif-p. VERAT. visc.

Hypothalamus …

Function – internal environment

                                Regulation of complex mood

                                Pituitary – stress hormone –    emotions

Lateral – pleasure & rage

Medial – aversion, displeasure, loud laughter

Limbic system:

Mid brain – emotional facial responses, CVS & RS control (connected to hypothalamus)

Fore brain

– prefrontal – 9 -12 area – depth of feeling, thinking, judgment, foresight and tactfulness

Orbito frontal – mood control, mental state

Psychical cortex – anterior part of temporal lobe – hallucination memory and dreams

Controlling the emotions…

Limbic system…

Thalamus …

Ant . Nucleus – lesion – loss of recent memory – korsakoff’s psychosis

Dorsomedial – integration of somatic and visceral impulses – conn. prefrontal cortex, – mood or feeling tone to emotional aspect of behavior

MIND – MEMORY – weakness of memory – happened, for what has – just happened (14) : absin. adam. allox. androc. anh. carb-ac. Carb-v. coli. cycl. graph. hydr. irid-met. Med. sacch-a.

Other emotions …

• Pleasure – hippocampus, septal nuclei
• Motivation – cingulate gyrus
• Fear – amygdala
• Joy – Globus pallidus
• Guilt and Anxiety – orbito frontal cortex
• Love & sadness – caudate nucleus 

Psychiatric diseases and homoeopathy
Patient was under regular Allopathic anti psychotic and antihypertensive drugs for the past 10 years. She was having remission and recurrence through out the year. Especially before menstrual nisus she ‘ll have either one panic or depressive attack. Pt. told if she takes Allopathic drugs or not the, effects ‘ll be same.  The social stressors are continuous and acting on her, especially from her husband’s side. He was fed-up with the issue.

Counseling was given to her husband also, and the importance of supportive life situation to the patient is clearly explained.

Discussion …

• After full case taking, the importance was given to the Physical generals on that basis Sepia 0/1 was given as daily dose. Patient was slowly improving.
• The potency was increased gradually up to 0/7,
• In between twice she had episodes of head ache and was tackled with Nat. Mur. 0/1 and 0/2.
• Her BP became normal, we slowly tapered the BP tablets and Anti psychotic tablets. For the period of 6 months and both the drugs were with drawn.
• Now for the past 6 months patient was on regular follow ups, with occasional mild symptoms which she can cope up very well. Patient says she is ok.

Neuroendocrine regulation:
The Hypothalamus is central to the regulation of the neuroendocrine axes and it self receives many neuronal inputs that use Biogenic amine neuro transmitors.

Various neuroendocrine dysregulation have been reported in patients with Mood disorders, and thus the abnormal regulation of Neuroendocrine axes may be the result of abnormal functioning of biogenic amine – containing neurons

Discussion… (from Kaplan’s)
Although it is possible for a particular disregulation of a neuroendocrine axes (such as Thyroid or Adrenal Axes) to be involved in the cause of Mood Disorder, the Dysregulations are more likely reflections of a fundamental underlying brain disorder.

The major neuroendocrine axes of interest in mood disorders are the Adrenal, Thyroid and Growth Harmon axes.

Other neuroendocrine abnormalities that have been described in patients with mood disorder include decreased Nocturnal secreation of Malatonin, Decreased Prolactin, Decreased Basal levels of FSH and LH and decreased testosterone levels in males.

Discussion…
So Hypothalamus is a major structure which has specific role over the development of BPD. Since the patient’s symptoms have been improved very well with Sepia and the related remedy Nat. Mur. – these drugs probably ‘ll have some or other action over the HYPOTHALAMUS.

Conclusion…
If we deeply look in to the evolution of drug personality as well as the localization of Psychiatric illness, most of the time it will point towards the higher centers especially Amygdala, Hippocampus, Limbic system, Basal ganglia and Hypothalamus.

The Hypothalamus is a head ganglion, head of the endocrinal orchestra, through altering the internal environment by means of controlling releasing factors, and endocrine glands it controls almost all the part of the body. It function is indispensable in reproduction.

Conclusion…
Several studies on the hypothalamus suggests that Hypothalamus can affect each and every part of the body including Mind. Though it is called the biological clock, the functions of the hypothalamus has not yet been understood thoroughly.

There is no single or comprehensive investigations are available to know whether the Hypothalamus is functioning normal?

Conclusion…

• The homoeopathic constitutional remedy has been selected on the basis of Mind
• Physical generals – which includes
• Appetite (desire and aversion)
• Thirst
• Sleep
• Sex
• Menses
• Perspiration
• Hot or Chilly etc.

If we single out any one organ in brain which affects all the above said functions which are used for constitutional prescription,  it is none other than HYPOTHALAMUS

Thus, Homoeopathic remedies probably acting on HYPOTHALAMUS and altering the internal environment to make the sick to cure as it is termed.

The sphere of action of constitutinal homoeopathic remedies could be  on hypothalamus

NB: this is only my theoretical conclusion. Much sophisticated clinical trials are needed to prove or disprove this Hypothesis.

• None of the diseases in this universe can be called as incurable…
• It is only our lack of wisdom which made it incurable…
• I believe, it is possible to acquire the wisdom enough to heal the so called incurable diseases… 

Dr R D Pavalan, MD (Hom.), M. Sc. (Psy.)
Reader, RVS Homoeopathic Medical College, Sulur,
Coimbatore 641 402