Considering “CONDITIONS” for the management of anorectal symptoms with Boenninghausen’s Characteristics and Repertory

Dr Babita Rani Jamwal

Abstract: Anorectal diseases like Piles, fissure, fistula are common in human being due to his erect posture as well has habitat. Patients with anorectal disease present with symptoms like bleeding, pain, discharge, itching, protrusion, changed bowel habits, seepage and incontinence. Most of the patients with anorectal diseases are scared, embarrassed, uncomfortable and nervous, therefore proper history with focus on the complaints will help to gain the confidence of the patient before physical examination and management is undertaken. Modalities are one of the most important aspects to consider when chossing a remedy. For example anorectal symptoms symptom worse  from stooping is Ruta graveolens and better from stooping is chelidonium.

Keywords: Conditions, BBCR, Ameliorations, Anorectal Symptoms, Rubrics, Aggravations.

Introduction:  Rectum is the distal part of large gut which stores the faces. Anus is the opening for passage of stool and is formed of sphincter muscles. Patients with anorectal disease present with symptoms like bleeding, pain, discharge, itching, protrusion, changed bowel habits, seepage and incontinence.¹ Most of the patients with anorectal diseases are scared, embarrassed, uncomfortable and nervous, therefore proper history with focus on the complaints will help to gain the confidence of the patient before physical examination and management is undertaken.²

Not only must be taken of all the symptoms of patient’s careful note  but each symptom must be investigated as to its details and modalities. It is the individual peculiarities of the symptom and its mode of responding to heat and cold and other modifying factors that provide the data for accurate symptom-matching. Kent says that from the homoeopathic point of view the symptom itself was not so important, but it is the modalities by which the syndrome is established, which are much more important. It is for this reason much importance to the modalities which translate the temperament and the reaction of the organism, while reaction of the organism is nothing but the pathogenesis itself.³

Common anorectal diseases encountered in the day to day practice include:-hemorrhoids, anal fissure, anal abscess, fistula, pruritis ani, anal warts, neoplasm, pre-malignant conditions, proctitis, rectal prolapsed, polyps etc. Anorectal diseases like Piles, fissure, fistula are common in human being due to his erect posture as well has habitat.⁴

 According to Dr. Hahnemann, While considering totality of symptom with accompanying factors which modified or which changes to the patient’s equilibrium the factors which increases and decreases the condition in every individual case the modalities are the sole guide to the choice of remedy.⁵ The sum of all the modalities help to individualizing and also help to selection of remedy. Modalities guide to select remedy. Dr. Boger was fully  agreed with the idea of what constitutes a complete symptom i.e. Location, Sensation, Modality and Concomittant. 

Rubrics worth considering from chapter ANUS AND RECTUM:-⁶

• ANUS AND RECTUM – Conditions – beer, amel. : aloe
• ANUS AND RECTUM – Conditions – bending – agg.: crot-t.
• ANUS AND RECTUM – Conditions – Bladder symptoms, during: apis Canth. Erig. merc-c. mur-ac. Senec.
• ANUS AND RECTUM – Conditions – coffee: fl-ac.
• ANUS AND RECTUM – Conditions – coition, after: anac. calc. caust. merc-c. sil.
• ANUS AND RECTUM – Conditions – cold – agg.: mur-ac.
• ANUS AND RECTUM – Conditions – cold – bathing, amel.: Aloe Euphr.
• ANUS AND RECTUM – Conditions – cold – taking: nat-c.
• ANUS AND RECTUM – Conditions – coughing agg.: ign.KALI-C. lach. nit-ac.
• ANUS AND RECTUM – Conditions – driving: borx. psor.
• ANUS AND RECTUM – Conditions – eating, after: Aloe clem. Lyc. sel.
• ANUS AND RECTUM – Conditions – flatus, emission – agg.: Aloe bar-c. zinc.
• ANUS AND RECTUM – Conditions – flatus, emission – amel.: colch. coloc. kali-c. mag-c. nux-v. plat. zinc.
• ANUS AND RECTUM – Conditions – lying, agg.: graph. ign.sep. sulph.
• ANUS AND RECTUM – Conditions – meals, before: bry.
• ANUS AND RECTUM – Conditions – menses – before, agg.: petr.
• ANUS AND RECTUM – Conditions – menses – during: aloe ars. berb. BOV. carb-v. cocc. eupi. lys. phos. zinc.
• ANUS AND RECTUM – Conditions – menses – after: ars. zinc.
• ANUS AND RECTUM – Conditions – mental exertion, agg.: NUX-V. podo.
• ANUS AND RECTUM – Conditions – motion, agg.: Podo. puls.
• ANUS AND RECTUM – Conditions – night: ars.
• ANUS AND RECTUM – Conditions – nosebleed, amel.: am-m.
• ANUS AND RECTUM – Conditions – periodically: plat.
• ANUS AND RECTUM – Conditions – pregnancy, during: caps. hydr. mur-ac. podo.
• ANUS AND RECTUM – Conditions – pressure on abdomen amel.: alum.
• ANUS AND RECTUM – Conditions – pressure on abdomen amel. – hard: camph. kali-c.
• ANUS AND RECTUM – Conditions – riding – agg.: bov.
• ANUS AND RECTUM – Conditions – riding – amel.: KALI-C.
• ANUS AND RECTUM – Conditions – scratching – agg.: alum.borx.
• ANUS AND RECTUM – Conditions – scratching – amel.: sars.
• ANUS AND RECTUM – Conditions – sitting – agg.: calc. chel. chin. Cocc. graph. mag-c. mur-ac. nat-m. nux-v. puls. Staph. sulph.
• ANUS AND RECTUM – Conditions – sitting – amel.: Ign.
• ANUS AND RECTUM – Conditions – sneezing, agg.: Podo.
• ANUS AND RECTUM – Conditions – standing – agg.: Aloe_. caust. Ign. nit-ac. sulph. valer.
• ANUS AND RECTUM – Conditions – standing – amel.: sulph.
• ANUS AND RECTUM – Conditions – stool – during – amel.: calc. Sep.
• ANUS AND RECTUM – Conditions – stool – after – agg.: aloe_. ant-c. kali-bi. phos.
• ANUS AND RECTUM – Conditions – stool – after – agg. – prolonged: nit-ac.
• ANUS AND RECTUM – Conditions – stooping – agg.: RUTA
• ANUS AND RECTUM – Conditions – stooping – amel.: chel.
• ANUS AND RECTUM – Conditions – thinking of it, agg.: caust.
• ANUS AND RECTUM – Conditions – touch, agg.: ars. Merc. nat-m. op.
• ANUS AND RECTUM – Conditions – urination, agg.: alum. arg-n. kali-c. Mur-ac. Nit-ac. rhus-t.
• ANUS AND RECTUM – Conditions – vomiting, agg.: kali-c.
• ANUS AND RECTUM – Conditions – walking – agg.: aloe_. alum. Ars. calc. CAUST. cic. crot-t. kali-bi. kali-c. Mag-c. merc-c. Mez. nat-m.Nit-ac. Nux-v. SEP. zinc.
• ANUS AND RECTUM – Conditions – walking – rapidly, agg.: sil.
• ANUS AND RECTUM – Conditions – warm applications, amel.: phos.
• ANUS AND RECTUM – Conditions – wiping, agg. :aloe GRAPH. lach. mur-ac.

Conclusion: Decision for right option of treatment for anorectal diseases is very important in order to avoid complications and recurrence. Modalities are one of the most important aspects to consider when chossing a remedy and are used whether it’s an acute or a chronic case. They are essential criterion that enables us to decide between remedies and without this defining information the remedy search is often too generalized. For example anorectal symptoms symptom worse  from stooping is Ruta graveolens and better from stooping is chelidonium.

References:- 

1. Skrica T, Vedra P. New approaches in ambulatory proctology. Acta Chir Yugosl 2002;2;57-61.
2. Bhalla BS, Singh S, Tayal A,  Singh M. Management of Anorectal  Disorders. JIMSA April-June 2011; 24 (2).
3. Fortier B. What we must not do in Homeopathy. New Delhi: Jain Publishers : 1974.
4. Gupta PJ. Common Anorectal Conditions. Perspectives In Medical Sciences. Turk J Med Sci .34 (2004); 285-29.
5. Hahnemann S. The Chronic Diseases: Their peculiar nature and their homoeopathic cure. 5^thed. New Delhi :B Jain Publishers (p) Ltd;1995. 
6. Boger CM. Boenninghausen’s  Characterstics & Repertory. 2^nd ed. New Delhi: B. Jain Publishers (p) Ltd;2005.

Dr.Babita Rani Jamwal, M.D.(Hom.) Asst.Prof.( Dept. Of Repertory ) Solan Homeopathic Medical College & Hospital Kumarhatti, Himachal Pradesh.