Effect of Homoeopathic remedy Phosphorus

Dr Puneet Kumar Misra 

Abstract
Potentised phosphorus  is a good remedy of nervous system but most  of  the symptoms are due to the chronic disordered condition of the  gastro intestinal tract, mainly upper  gastro duodenal  i.e stomach and duodenum and this disordered condition effect ultimately all system of body one by one. And most of its indication is covered and affected by the nature of eating and drinking condition along with nervous, respiratory and cardiac disorder.

Key words – abdomen distance, flatulence, belching,

Introduction – the phosphorus predominately mentioned as nervous medicine but    during observe it is found that it’s main center of action shows on the digestive system with chronic tendency of disorder and associated with symptoms of other important system i.e. respiratory, cardiac, urinary are shown in different materia medica.

 Boerickes new manual of homoeopathic materia medica with repertory.  – Pain in stomach; relieved by cold food, ices.  Region of stomach painful to touch,  or  on walking.  Inflammation of stomach, with burning extending to throat and bowels. A VERY WEAK, EMPTY,  GONE SENSATION felt in whole abdominal cavity.

 Allen’ s keynotes and characteristics with comparisons.  – Longs  for: cold  food  and  drink; juicy refreshing things; ice cream >.  gastric  pains.  As  soon  as  water  becomes  warm  in  stomach  it  is  thrown   up.  Regurgitation  of  ingesta, in mouthfuls  [Alum.].  A  weak, empty, all-gone  sensation  in  head,  chest, stomach and entire abdomen. Apathetic; unwilling to  talk;  answers slowly; moves sluggishly [Phos. ac.].

Physiological materia madica  WM.H. Burt – drawing pain in the stomach, extending into the chest, with oppression of breathing, and palpitation of the heart; the pulse intermitting every few beats; chronic dyspepsia. In dyspepsia, where there is excessive flatulency, with frequent palpitation and intermittent pulse , accompanied with much despondency ,I have seen grand result from phosphorus.. Sensation  of  great weakness and emptiness in the  abdomen;  this  distresses and aggravates all the other symptoms. This is a ruling key for the use of Phosphorus.

A Dictionary of Practical materia medica vol 2^nd

Stomach – Nausea of various kinds, especially in morning or in evening, or else after a meal. Nausea with violent hunger or thirst, which disappears on eating or drinking water abdomen Distention of abdomen, especially after a meal. Uneasiness in abdomen after breakfast. Pressure outwards against sides  of  abdomen. Soreness of abdomen to touch when walking. 

Respiratory Organs- Dry cough every day, which continues several hours, with pains in stomach and abdomen.

Heart and Pulse- Anxiety about heart with nausea and a peculiar hunger, somewhat better by eating, distressing even in bed. Sensation  of  warmth  about right side of heart. Pressure, heaviness, aching in  heart.  Rush of blood to heart and palpitation, that becomes very violent  after eating. Palpitation of heart of different kinds, especially  after a meal, morning and evening, as also when seated, and after  all kinds, especially after a meal, morning and evening, as  also  when   seated,  and  after  all  kinds  of   mental   excitement.

 Dr C.hering.  The guiding symptoms of our materia medica Volume VII 

Coryza: frequent alterations of fluent and stopped coryza;   with  sore    throat  and   great  dulness  of  head;  feverish,   dry;    secretion  dries to crusts  which  adhere  tightly;   complicated    with  hoarseness  and bronchial catarrh; obstruction   often   in    morning;  discharge  from  one and  stoppage  of  other  nostril;    sneezing  causes pain  in throat  or head; smell and taste  gone;    with sleepiness, especially during  day  and after meals;

#Appetite Thirst Desires Aversions

Hunger:  soon  after eating; must eat during chill, before he can   get   up;  ravenous   at  night,  feels faint;  with  nausea  and    anxiety   about  heart  recurring several  successive   evenings,   

amel.  by  eating but afterwards  tormenting  him  for  hours  in    bed. 

#Eating and Drinking

Pains  always  commence  when  eating and  last  as  long  as  he    continues to eat. After eating: sick, and fullness of abdomen; sleepiness; belches  much even after a little food.

 in    chronic  dyspepsia when there seems to be simple   exhaustion  of  stomach; 

#Scrobiculum and Stomach 

Dyspepsia  with excessive flatulency, frequent  palpitation    of  heart,   intermittent   pulse   and   much    despondency;

#Inner Chest and Lungs – Oppression of chest: as if clothes were too tight; in    morning;  in   bed;  after walking  in  open  air, at night, so that    she  could  not  perfectly  yawn;  of  lower portion,  with  shortness   of  breath;  with  anxiety, after dinner;  with  a   constrictive    sensation under sternum.

Tightness  of  chest:  as from rush of blood; of  upper  part  of    chest; across upper third  of lungs; as if lungs themselves  were    constricted;  as if air  were  forcibly kept  out;  with  feeling  of dryness; with dyspnoea; with pain; as if a band were about it;    with aching in cardiac region, amel. by eructation.

Abdomen- Incarceration  of  flatus beneath the ribs,  with  oppression  of    chest. Loud  rumbling  and rolling in intestines; fermenting  in  bowels  with  empty eructations. Feeling  of  incarcerated  flatus  moving  in  abdomen,  catching    breath  and  causing cough; paroxysmal, agg. from  excitement  or    sitting;  amel. lying down, straightening up or  by  eructations;    pressure on abdomen agg. suffocative feeling.

Heart pulsation and circulation – Anxiety  about  heart  associated  with  nausea  and  a  peculiar    sensation  of hunger, somewhat  relieved  by  eating  distressing    her even in bed,  sometimes  for  several hours.

Tissue- Blood   when   drawn  seemed  very  pale,  and  under  microscope  exhibited  only  about twice as many red as white corpuscles.

 Lectures on homeopathic materia medica J T Kent

Many of the complaints of Phosphorus are ameliorated by  eating.  The  nervous symptoms of Phosphorus drive the patient to eat  and  he feels better for a little while, and then he must eat again or  the  nervous  symptoms will come on. Often he  can  sleep  better after eating and cannot go to sleep until he eats something.  The  stomach  symptoms are numerous—pains,  nausea,  vomiting,  burning. The stomach symptoms are ameliorated-by cold things  and  aggravated by warm things.  Pressing pains, burning pains, tearing pains  in  the 

stomach;  pain in the stomach after eating; sensitiveness in  the  pit  of the stomach; inflammation of the stomach.  long- standing  dyspepsia;  much  flatulence;  regurgitation  of  food;  distended stomach and abdomen

 Dr samuel  Hahnemann. The chronic diseases 2^nd part

650. After eating, even with appetite, his abdomen feels full  at  one. After dinner, headache every day.  After dinner, her head feels so chaotic that  she  can  hardly  remember anything.  At once,  after eating much heat in the face.  After  eating  in the eating, a sort of vertigo;  objects  appear  either  dark or they are invisible, while flickering  zigzags  and  rings  before  the eyes impede vision; he feels as  if  his  head  turned, and he did not know whether he sat properly on his chair.

665. After meals, pressure on the chest and shorter breath.  After  dinner,  violent  throbbing of the heart  for  two  hours,  compelling  her to cough frequently and often causing a flush  to  mount to her face (4th d.).  After eating the least quantity, tightness of breath.  After dinner, tightness of the chest, with anxiety.  After  every  meal,  an anxious pressure  in  the  abdomen,  with inflation. 

1240.  Tightness of the chest, above the xiphoid cartilage,  with  oppression  of  the respiration, in the evening,  when  stooping,  always relieved by straightening himself. (Ng)  Frequent tightness on the chest, with nausea.  Asthma, with brief attack of nausea. 

Asthma, when taking a deep breath.  Tightness   of  the  chest,  worse  when  sitting,  relieved   by  eructation (aft. 22 d.).

 Dr S R Phatak. Materia Medica of Homeopathic Medicine 

Generalities *Phos.  causes  inflammation and degeneration of  the  MUCOUS  MEMBRANES OF STOMACH AND BOWELS;

 C .H.G.JAHR. Hull’s JAHR A new of manual of homoeopathic practice

 #CHARACTERISTIC PECULIARITIES

 The majority of the symptoms appear early in the morning, and in  the  evening  in bed, other symptoms commencing  at  dinner,  and  disappearing after dinner, in the forenoon.  Most of the symptoms  cease  after dinner, in the forenoon.

Practice of Medicine  View

 In the different practice of medicine  or internal medicine book digestive tract disorder  mainly presenting with main complain are  indigestion ,Dysphagia , Dyspepsia, Heartburn and regurgitation , Vomiting  ,Diarrhea , Malabsorption , Weight loss , Constipation and abdominal pain associated with digestive system  

Indigestion – The most common causes of indigestion are gastro esophageal reflux and functional dyspepsia. 

Gastro Esophageal Reflux(GERD)– . Occasional episodes of gastro-oesophageal reflux are common in healthy individuals. Reflux is normally followed by oesophageal peristaltic waves that efficiently clear the gullet, alkaline saliva neutralises residual acid and symptoms do not occur. Gastro oesophageal reflux disease develops when the oesophageal mucosa is exposed  to gastro duodenal contents for prolonged periods of time  resulting in symptoms . Several  other factors are also  known to be involved in the development of gastro-oesophageal reflux disease . GERD classically produces heartburn, a sub sternal warmth OR retrosternal, burning discomfort  that moves toward the neck OR often rising up into the chest and sometimes accompanied by regurgitation of acidic or bitter fluid into the throat.  Heartburn often is exacerbated by meals , on lying down or with bending, straining or heavy lifting and may awaken the patient. Associated symptoms include regurgitation of acid or non acidic fluid and water brash, the reflex release of salty salivary secretions into the mouth. Atypical symptoms include pharyngitis, asthma, cough, bronchitis, hoarseness, and chest pain that mimics angina. Some patients with acid reflux on esophageal pH testing do not report heartburn, but note abdominal pain or other symptoms. Dyspeptic patients typically report symptoms referable to the upper abdomen that may be meal-related, as with postprandial distress syndrome, or independent of food ingestion, as in epigastric pain syndrome. They are classical symptoms of gastro-oesophageal reflux but up to 50% of patients present with other symptoms, such as chest pain, belching, halitosis, chronic cough or sore throats. In young patients with typical symptoms and a good response to dietary changes, antacids or acid suppression investigation is not required, but in patients over 55 years of age and those with alarm symptoms or atypical features urgent endoscopy is necessary. Gastro-oesophageal reflux resulting in heartburn affects approximately 30% of the general population. ‘Waterbrash’, which is salivation due to reflex salivary gland stimulation as acid enters the gullet, is often present. The patient is often overweight. Some patients are woken at night by choking as refluxed fluid  irritates the larynx. Others develop odynophagia or dysphagia. A variety of other features have been described, such as atypical chest pain that may be severe and can mimic angina; it may be due to reflux-induced oesophageal spasm. Others include hoarseness (‘acid laryngitis’), recurrent chest infections, chronic cough and asthma. The true relationship of these features to gastro-oesophageal reflux disease remains unclear .  Most cases of heartburn occur because of excess acid reflux, but reflux of non acidic fluid produces similar symptoms. Alkaline reflux esophagi it is produces GERD-like symptoms most often in patients who have had surgery for peptic ulcer disease. Ten percent of patients with heartburn exhibit normal esophageal acid exposure and no increase in non acidic reflux (functional heartburn). Disturbed gastric motility may contribute to gastro esophageal reflux in up to one-third of cases. Delayed gastric emptying is also found in 30% of functional dyspeptics. Conversely, some dyspeptics exhibit rapid gastric emptying.

Impaired gastric fundus relaxation after eating (i.e., accommodation) may underlie selected dyspeptic symptoms like bloating, nausea, and early satiety in 40% of patients. Heartburn is due to acid reflux from the stomach into the oesophagus. It causes pain in the epigastrium, retrosternally and in the neck. It is occasionally difficult to distinguish from angina pectoris and may cause atypical chest pain in various sites. It occurs particularly at night when the patient lies flat in bed or after bending or stooping when abdominal pressure is increased. Heartburn may be exacerbated by dietary intake (such as alcohol or very spicy foods) and certain medications (such as bisphosphonates).Reflux is a symptom which occurs without heartburn, when non-acidic fluid or bile regurgitates into the mouth, causing a bitter taste and a disagreeable sensation retrosternally. Overeating and aerophagia override the barrier function of the  lower esophageal sphincter (LES), whereas reductions in esophageal body motility or salivary secretion prolong fluid exposure. Increased intra gastric pressure promotes gastro esophageal reflux in obesity.  Severity of GERD may be graded as: 

Stage 1: Occasional heartburn (<3 episodes/ week), mostly only in relation to a precipitating factor, mild symptoms, no esophageal lesions.

Stage 2: > 3 Episodes/week of moderately severe symptoms, nocturnal awakening due to regurgitation, esophagitis present or absent

Stage 3: Daily/Chronic symptoms, disturbed sleep, esophagitis/erosions/stricture/extra esophageal symptoms like laryngitis, hoarseness, dry cough, asthma. Symptoms recur soon after treatment stopped.

 Functional Dyspepsia– Indigestion (dyspepsia)

Dyspepsia is the medical term for Indigestion, a symptom which may include epigastric pain,  heartburn, distension, nausea or ‘an acid feeling’ discomfort, bloating Dyspepsia describes symptoms  originate from the upper gastrointestinal tract occurring after eating or drinking. The symptom is subjective and frequent. In many patients there is no demonstrable cause but it may be associated with Helicobacter infection, peptic ulceration, and acid reflux. Upper GI malignancy should be excluded in older patients who present with new onset dyspepsia. Nearly 25% of the populace has dyspepsia at least six times yearly, but only 10–20% present to clinicians. Functional dyspepsia, the cause of symptoms in >60% of dyspeptic patients, is defined as ≥3 months of bothersome postprandial fullness, early satiety, or epigastric pain or burning with symptom onset at least 6 months before diagnosis in the absence of organic cause. Functional dyspepsia is subdivided into postprandial distress syndrome, characterized by meal-induced fullness, early satiety, and discomfort, and epigastric pain syndrome, which presents with epigastric burning pain unrelated to meals.

Most cases follow a benign course, but some with H. pylori infection or on nonsteroidal anti-inflammatory drugs(NSAIDs) develop ulcers. As with idiopathic gastroparesis, some cases of functional dyspepsia result from prior infection. Functional dyspepsia overlaps with other disorders including GERD, IBS, and idiopathic gastroparesis. The physical exam with GERD and functional dyspepsia usually is normal. In atypical GERD, pharyngeal erythema and wheezing may be noted. Recurrent acid regurgitation may cause poor dentition. Dyspeptics may exhibit epigastric tenderness or distention. Discriminating functional and organic causes of indigestion mandates excluding certain historic and exam features.  People who present with new dyspepsia at an age of more than 55 years and younger patients unresponsive to empirical treatment require investigation to exclude serious disease.

Flatulence

Flatulence describes excessive wind. It is associated with belching, abdominal distension and the passage of flatus per rectum. It is only infrequently associated with organic disease of the GI tract but usually represents a functional disturbance, some of which is due to excessively swallowed air. In some patients it is clearly associated with certain foods such as vegetables. 

The many routine  nonspecific abdominal discomfort  which associated with digestive tract disorder,  daily or recurrent complained like distention or pain  in the  abdomen  region which associated  with  different condition  , the study are focused on the all  disorder mentioned in the table , the Continues observation of drug action in two and half years  on the  136 case  the following finding are occurred

Total case	Age group	Adult and child	Male and female
136	2.5year to 80year	126 adult 10 child	75 male 61 female

 

S.No	Disorder	No of case	Observation
01	Pain or distention of upper abdomen	65	Moderate to marked response
02	Pain or distention in lower abdomen	34	Mild to Moderate  response
03	Loss of appetite with  abdomen distention	19	Moderate to marked  response
04	Hair fall with GI disorder	18	Mild to Moderate  response

 Discussion

1. The distention of abdomen occasional or continues  is the result of sudden gastro duodenal disorder i.e. over eating or chronic dyspeptic condition ,which shows symptoms of the GI trouble in the  earlier   stage but after chronic nature it shows the symptoms of nervous ,cardiac or respiratory system. 
2. the many patient come with non specific complain pain or distention of the abdomen with prolong history of gastric disorder but on the quarry he/she unable to explain the correct discomfort and this discomfort associated with meal and daily life pattern, and on the physical examination of abdomen it is found that on the mild pressure the patient tells about the pain or pain after just after meal .
3. the above mention non specific disorder is present in the phosphorus in the  many  materia medica with the main gastric complaint 
4. The distention of the abdomen  in clinical practice occurs in the two  pattern  occasional or continues ,in the occasional presentation there are  no need of the specific or long treatment but when the distention found   continues then it also needed continues treatment 
5. The phosphorus shows improvement in the both form means occasional or continues in the  frequent or infrequent dose, in the many cases when we apply the infrequent dose the duration of the improvement is very short i.e. one or two day, and patient again feel discomfort, when  the patient gives the history of continues/ chronic tendency  ,but in the  occasional complain of discomfort one or two dose is sufficient for the improvement .while in the continues disorder there are need of frequent dose up to eight to ten days or more .
6. For  the occasional condition 30^th ,200^th ,or 1M,of phosphorus one or two dose  is found sufficient for the improvement,  but  in the continues complain the 30c in the child and 200c in the adult one dose empty stomach in the daily morning upto eight to ten days. it is also observed that  empty stomach dose give better result instead after meal . and use of the phosphorus empty stomach improve the ability of other drug after meal i.e. carbo veg/nux vomica/ mag phos  and other gastric drugs symptomatic.
7. The continuous or frequent abdomen distention show the chronic nature of the gastrointestinal disorder mainly upper abdomen with gastro duodenal and lower abdomen with mild to moderate constipation .
8. Many patients complain the loss of appetite or no desire of meal show gastric disorder  heart burn or pain in the chest or upper abdomen before or after meal, In this case  phosphorus 200^th empty stomach give response after frequent dose and firstly disorder reduce ( gastric disorder  heart burn or pain in the chest or upper abdomen) then desire start or appetite increases. 
9. In the modern medicine the treatment of GERD or acid peptic disorder is treated in the majority of case  with help the  of Proton pump inhibitors (PPIs),H2 blockers ,Antacids , Prokinetic drugs, but when we observe it is found  symptomatic that the phosphorus function is like as in between Proton pump inhibitors (PPIs) and H2 blockers while not match with the Antacids , Prokinetic drugs.
10. Most of the case of hair loss having the background of gastric origin. When liver function test and CBC done  we find in the many patient  protein level below then normal  or towards  lower side along with  towards the higher side of MCV or large RBCs size i.e. macrocytic  and this phenomena also explain in the hering guiding  under tissue section .

Conclusion
Chronic gastro duodenal  disorder treated with the phosphorus, all disorder of nervous, respiratory and cardiac system  are improve  which are associated with the chronic gastroduodenal   origin or due to it , and major disorder of nervous, respiratory and cardiac system  are aggravated by the  gastroduodenal complaints are also improve when it is treated with the same i.e. main disorder v/s associated disorder .future study for more evidence the   CBC,LFT ,X-ray chest and ultrasound whole abdomen investigation provide more help for better application of this medicine . 

Reference 

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15) WH.H.Bburt. physiological  Materia Madica .3^RD Edition 17^th impression. B Jain publishers (p) Ltd; 2017. Page no 709 

Dr Puneet Kumar Misra
B.Sc, BHMS
Lecturer(Practice of Medicine)
Govt Pt J LN H M C  Kanpur