Introduction
Homoeopathy signifies a system of treatment based on the similarity between symptoms of the patient and those obtained during proving of drugs on healthy human beings. The basic concept of disease is that, all natural diseases are due to derangement of the vital force of an individual resulting in abnormal sensations and functions manifested as signs and symptoms both in mental and physical plains. This image of the disease which we call as totality of symptoms is the sole guide for the physician to select the similimum – the curative remedy. Thus Homoeopathy is a system of medicine giving more importance to the diseased individual than the disease itself.
Chronic inflammatory changes in the tonsil are usually the result of recurrent acute infections treated inadequately. Recurrent infections lead to development of minute abscesses within the lymphoid follicles..These become walled off by fibrous tissue and surrounded by inflammatory cells.
The most common and the most important cause of recurrent infections of the tonsils is persistent or recurrent infection of the nose and paranasal sinuses.This leads to post nasal discharge which then infects the tonsils as well. Chronic And Recurrent Tonsillitis Are Much More Common As Causes Of Disability
Homoeopathy firmly believes in enhancing body’s own defense mechanism to maintain the healthy status. Tonsils are looked upon as immunological booths. The homoeopathic approach is to encourage the immunological activation of the tonsils, and to save them for body’s own long term interest.
This is a humble effort made by me to show the homoeopathic fraternity and the whole suffering humanity, the efficacy and significance of homoeopathic medicines in the management of Chronic Tonsillitis.
Aims and Objectives
- To determine the efficacy and significance of homoeopathic medicines in the management of Chronic Tonsillitis.
- To determine the medicines and the corresponding potencies frequently indicated in the management of Chronic Tonsillitis
MATERIALS
Population: This study was conducted in the outpatient department of govt. homoeopathic medical college, Thiruvananthapuram, between the age group 3-15 years, irrespective of sex; from 1-5-2005 to 1-11-2005. keeping the aims and objectives in mind and to help in drawing valid conclusions from the study, the following inclusion and exclusion criteria were followed.
Medicines: Prescription:
Medicines are given on the basis of symptom totality in different potencies [based on susceptibility, age of the patient, stage of disease etc]
Placebo: sugar of milk, globules and blank tablets.
Dose: 1 pellet in sugar of milk
Pharmacy: Medicines and sundries supplied by m/s kerala state cooperative pharmacy, alapuzha.
Inclusion criteria:
- Diagnosis of chronic tonsillitis-history, clinical features, examination and investigation are randomly selected.
- Age group-patients within 3-15 years of age
- Sex-both sexes are included
Exclusion criteria:
- Acute tonsillitis unspecialized
- Tonsillitis[acute]
- Follicular
- Gangrenous
- Infective
- Ulcerative
- Cases below 3 and above 15 years
- Cases with other systemic diseases.
Methods sample:
Cases of chronic tonsillitis are diagnosed first on the basis of clinical symptoms. Patients suffering from other systemic diseases were excluded, investigations which included routine blood and urine examination, were done.
The patients, who finally got through the inclusion and exclusion criteria formed the study sample, they were 30 in number, with males and females
Research technique
Sample: Thirty cases of chronic tonsillitis were selected from the Out patient department of Govt. Homoeopathic Medical College Hospital, Thiruvananthapuram.
Data collection: From 1-5-2005 to 1-11-2005.
Research Technique:
The selected cases were thoroughly examined on the basis of special proforma in which the complete symptomatology of patients and investigation reports were recorded.
The signs and symptoms of chronic tonsillitis were assessed subjectively and objectively and scored.
Nature of study: A prospective study was conducted and patients were followed upto a period of 6 months. All cases were treated as out patients and no controls were kept for study. The effectiveness of study was statistically analysed after 6 months.
Assessment criteria:
The symptoms and signs were graded on the basis of intensity and four scores were given-severe symptoms & signs as 3, moderate signs and symptoms as 2, mild symptoms and signs as 1, and absence of symptoms and signs as 0.the signs and symptoms considered are
History of repeated attacks of sore throat or acute tonsillitis, associated with symptoms of dysphasia and discomfort, rise o temperature[at least 3 or 4 attacks per year]
These symptoms if seen with enlarged tonsils, hyperaemic pillars and enlarged jugulodigastric lymph nodes.
Study design:
The study considered of subjecting patients with chronic tonsillitis to homoeopathic treatment and assessing the efficacy by comparing the clinical picture before and after the study. It was decided to conduct a clinical trial without placebo control, with the understanding that a placebo control trial may be attempted in future if the results of the current study are encouraging.
Treatment:
The cases were followed up for a period of twelve months, from the date of first prescription. The treatment period was fixed considering the importance of assessing the efficacy of treatment within a reasonable time frame.
Treatment intervention
Case taking and analysis:
Every patient included in the study was interrogated in detail and the history and examination findings are recorded in the case record. In all cases, a detailed analysis and evaluation were done for erecting the totality. The miasmatic basis of the symptoms was also considered to understand the miasmatic influence in each case.
Repertorisation
Kent’s repertory was used for repertorisation
Remedy selection
Selection of medicine was made after considering the reportorial analysis and further differentiation with Materia Medica.
INFERENCE
The study shows that there is significant difference between the scores representing the symptoms of chronic tonsillitis before & after treatment. The difference can be clearly attributed to homoeopathic medicines & can be said that the treatment is effective.
DISCUSSION
Thirty patients coming between the age group three & fifteen years irrespective of sex were included in the study. The parameters were the signs & symptoms of illness. Among the 30 cases, 11 were males & 19 were females. 4 patients belong to age group of 3 – 6 years, 12 belong to age group of 6 – 9 years, 11 belongs to age group of 9 to 12 years & 3 patients belong to 12 to 15 years.
Major clinical features were recurrent attacks of sore throat( 100%), hypertrophy of tonsils (100%), enlargement of jugulo di-gastric lymph nodes(96.7%), difficulty in swallowing (93.3%), hoarseness(40%) & hallitosis(30%).
In 16.7% cases Calc carb was the indicated medicine, Merc sol in 11% of cases, Calc phos in 13.3%, Hepar sulph in 13.3%, Sulph in 10% of cases, Baryta carb in 10% of case, Tuberculinum in 10%, Lachesis in 6% & Silicea in 3.3% of cases.
Among the 30 cases, 14 were cured, 12 improved & 4 cases showed no relief.
Statistical evaluation of scores before & after treatment clearly shows that Homoeopathic medicines are effective in the management of Chronic tonsillitis.
Conclusion
- Homoeopathic Medicines are effective in the management of chronic tonsillitis.
- Remedies when given on the basis of individualisation are more effective.
Dr. Preetha B
Dept. of Physiology & Biochemistry,
Government Homoeopathic Medical College
Trivandrum. Kerala
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