Homeopathic Drug Proving of Phyllanthus Amarus

Homeopathic Drug Proving of Phyllanthus Amarus

Dr George Mathew & Dr TK  Jithesh

(Hahnemannian Method)
The tincture and potencies of these drugs are available with the authors till they get into the open market
Contact: Dr. T. K. Jithesh, “Ushass”, Paral (P.0), Madapeedika, Tellicherry —670 671. Kerala. India. Phone: 0490-344580.®
Dr.George Mathew, Kodambattu Parambil, Muriyanal, Kunnamangalam P.O. Kozhikode, Kerala. India.
Ph: 0495-201826 ®

Preface
Dr. Samuel Hahnemann. had paved the path to Homoeopathy through “Drug proving” way back in 1790. Our work is . humble effort to show the Homoeopathic fraternity the simplicity and feasibility of “Drug proving”.

As part of our M.D.course, the thesis topics we decided upon were the Hahnemannian Drug Proving and clinical verification of Sida alnifolia and Phyllanthus amarus. These two plants were being used very effectively in the indigenous system and had no studied toxicological effects. Phyllanthus amarus known as Kizharnelli in local language (Malayalam) is used as a very effective single drug therapy in hepatitis, whereas Sida alnifolia, known as Kurunthotti is extensively used in Ayurveda for various diseases, especially arthritis, diseases of women during pregnancy, etc.

The study was conducted at Kozhikode under the guidance of Dr. Esmail Sait, Principal and Professor of Materia medica, G.H.M.C, Kozhikode, in 40 provers after obtaining their written consent. Of these provers, 30% were treated as placebo i.e. 6 provers for each drug. The drugs were proved in the tincture, 30C and 200C potencies.

Before proving, each prover was subjected to case-taking, physical examination and laboratory investigations, to assess their state of health. The dosage for the tincture was one drop per kilogram body weight. Eg. 60 drops for 60 kg. weight. This was divided and administered as 4 doses daily. 30C and 200C were given as 4 medicated pills, 4 times daily and the frequency of administration increased, if there was no response. The period of proving for each potency was 2 weeks and the provers were advised to stop medication as soon as distressing symptoms appeared.

Daybooks maintained by the provers were elaborated by us every 2 days. After proving, each prover was again subjected to case-taking, physical examination and laboratory investigations to see if there were any changes.

The proving was conducted as a double blind cross-over randomized controlled trial, to make it most reliable and scientific. The provers were given code numbers initially, which were decoded only after the proving experiment. Cross-over method helped to conduct proving very effectively and in the shortest time possible. A prover who received placebo in the first phase was given 30C and 200C later, thus making the best use of the small study population.

Clinical verification was carried out after the construction of the final materia medica, in 30 acute cases each. Clinical study showed 80% success rate in various acute diseases. The action in chronic diseases should be studied and re-proving thereby to be conducted before these drugs can find their proper place in the therapeutic armamentarium of Homoeopathy.

We humbly request all Homoeopaths to use these medicines in their daily practice for various diseases if the symptomatology of the patient corresponds to that of these medicines. We also request each one of you to inform us your successes and failures after using these medicines, so that we can make this work a complete one and the Materia medica more reliable.

Proving these drugs has made our belief in Homoeopathy stronger and clearer. There are many endemic plants in Kerala used extensively by the indigenous system of medicine which have to be proved. Hope this  will be an inspiration to the sincere and enthusiastic Homoeopaths to take to the proving of more and more easily available drugs and thus contribute to the progress of Homoeopathy.

Introduction to Final Materia Medica
The final Materia medica of Sida alnifolia and Phyllanthus amarus have been formed after proving the drug in tincture, 30C and 200C, followed by clinical verification of these proved symptoms. The symptoms included in final Materia medica were selected based on certain criteria, which are given below in the order of importance.

They are
I) Those symptoms, which are verified during clinical verification.
2) Those symptoms, which have been obtained commonly while proving all three potencies — Q, 30C and 200C.
3) Those symptoms, which are very intense, and persists for several days during proving.
4) Those symptoms, which were seen in majority of provers.
5) Those symptoms which were peculiar, characteristic or striking even if seen in only very few provers.
All vague and incomplete symptoms have been omitted from the final Materia medica.
The potency (for e.g. Q, 30C and 200C) is given after each symptom, to show in which potency a particular symptom was produced. ‘Q’ is used to denote mother tincture. Symptoms obtained from empirical usage or clinical studies are denoted by (:). Various materia medicas (Hahnemann’s, Hering’s, Kent’s, Cowperthwite’s and Boericke’s Materia medica) have been consulted for preparing the final Material medica.

Phyllanthus Amarus

Botanical name : Phillanthus amarus
Schum & Thonn
Natural Order(Family) : Euphorbiaceae.
Vernacular name : Kizharnelli.
Kirganelli,
Kizhkaynelli
Names in other Indian languages
Sanscrit : Bhumya  malaki,Thamalaki
Hindi : Jar amla, Jangli   amli
Bengali : Bhui amla
Sadhazur mani
Bihar : Mui koa. Kantara
Kannada : Nelanelli
Tamil : Kilanelli
Names in foreign languages
Spanish      : Yerba De Guinina
Franse : Herb Du Chagrin
Brazil : Erva, Pombinha
West Indies : Petit tamarin blanc
Source : Whole plant.

Habitat
It is seen in Kerala commonly, in cultivated or waste places, especially in moist localities.

Preparation
Tincture from the dried, powdered whole plant according to Class IV method.

Sphere of action:
Like other members of the Euphorbiaceae family, Phyilanthus amarus also has a prominent action on the gastro intestinal system and skin. It affects the whole of GIT from mouth to rectum. On the skin, it produces itching, with or without eruptions,warts, moles etc. Other important sites of action are the throat, respiratory system, female genitalia, ears, head, extremities, eyes etc.

Side affinity
Predominantly left sided.

Empirical uses
The antiseptic, styptic, carminative, deobstruent, coolant, febrifugal, stomachic, astringent, and diuretic properties of this drug have been utilized in traditional medicine, since time immemorial. Its efficacy in the field of gastro intestinal disorders like dyspepsia, colic, diarrhoea, constipation, and dysentery is undisputed. In females it is used as a galactogogue, in leucorrhoea, menorrhagia and mammary abscess. In skin conditions, especially scabby or crusty lesions, bruises, wounds, scabies, offensive ulcers and sores, oedematous swellings, tubercular ulcers, and ringworm, it has been utilized with good effect since many years. It is applied effectively in intermittent fevers and gonorrhoea as well as in ophthalmia and conjunctivitis. It has a urolithic property, dissolving renal calculi. Also used in cough, asthma and other bronchial affections.

Clinical Studies
Clinical studies conducted with the extract of this plant, points to its great therapeutic efficacy, in the treatment of hepatitis B. Thyagarajan et a! in 1988 have done detailed clinical studies in this respect. In clinical trials, it has also been shown to be effective against infective hepatitis (hepatitis A). It’s antifungal, antiviral, and anticancerous properties have also been demonstrated in experimental animals. It is of great utility in the treatment of diabetes mellitus especially NIDDM as shown in clinical studies in Tanzania and elsewhere. The diuretic and hypotensive effects of this drug on human subjects have also been assessed by Srividya et al in 1995.

Mind:
Aversion to do both mental and physical work (Q). Laziness (Q). Aversion to playing (Q). Fatigue (Q). Concentration difficult (Q). Restlessness, wants to walk about, doesn’t like to lie down (Q). Angry at trifles (Q). Confusion as to whom she had spoken to earlier, and later repeating those same things to other people (Q). Laughing during sleep (Q). Delusion as if he would fall, while walking, and while riding the two wheeler (30C). Delusion of some incidents happening, which have not actually occurred (200C).

Head:
Dull aching pain in both temples and forehead, worse talking, motion, l p.m. and 9 p.m., better after sleep, and lying down (Q, 30C). Headache with heaviness of head and eyes (Q,30C). Heaviness with sensation as of a tight helmet placed over the head, worse pressure (Q).Heaviness with lack of concentration, desire to lie down, and weakness (Q). Stitching pain in right temple with vomiting of sour yellow fluid at first and later of undigested food, without nausea, accompanied by prostration, cold sweat of face and dryness of lips and mouth, better from hard pressure, lying on painful side, and after eating (Q). Headache starts in nape of neck, then in both supra orbital regions, and finally settles in occipital region, with burning as from a volcano, worse 10 p.m., reading, morning in bed and slightest motion (30C). Itching painful papular eruptions on scalp, worse touch (30C). Itching of scalp, also without eruptions (30C). Refrigerant for the scalp (:)

Eyes:
Heaviness of eyes with dull headache and coryza (Q, 30C). Heaviness with sensation of drooping of eyelids and sensation as if eyeballs were full of water (Q). Heaviness worse from reading, and in the evening especially 3 — 7 p.m. Sensation of heat and burning in the eyes, better closing eyes tightly (Q, 30C). Stitching pain in left eyeball with lachrymation (Q, 30C) accompanied by fever, coryza and dry cough, worse slightest motion. Reddish painful stye, on left upper eyelid with redness of conjunctiva (200C). Pain worse stooping. Ophthalmia (:) Conjunctivitis (:)

Ears:
Stitching pain in both ears, especially left ear (Q, 30C, 200C) with pain in left tempero mandibular joint and itching in left ear. Sensation as if left ear is stopped up while empty swallowing (Q). Pain passing from left eustachian tube to left ear, worse exposure to dry cold wind (30C). Intense stitching pain in right ear accompanied by body pain, chilliness, decreased appetite, and heaviness of head, worse lying on painful side, evening, night, slightest touch, slightest draft of air, stooping, and chewing (Q). Extreme tenderness in front of tragus and in mastoid region (Q). Pain comes and goes suddenly(Q).

Nose:
Watery nasal discharge (Q,30C, 200C) especially from left nostril (Q, 30C). Watery discharge from the free nostril, while the other is stopped up (200C). Stoppage of nose (Q, 200C) especially left nostril, in the morning, on waking (Q). Both nostrils alternately stopped up (200C). Sneezing (Q, 200C), sometimes paroxysmal. White mucoid discharge from left nostril (Q). Sneezing, stoppage of nose and post nasal catarrh of thick transparent tenacious mucus (Q, 200C), worse morning on rising. Loss of smell (Q). Rawness in posterior nares better eating, warm drinks (200C). Thick yellowish green coryza with stitching pain in forehead and tenderness in temples (Q). Thick yellowish — white coryza, alternating with stoppage of nose.

Face:
Dryness of lips with headache and weakness (Q). Dryness compels to take frequent sips of water, without any relief(Q). Cold sweat of face during headache (Q). Small black mole below lower lip, with visibly congested capillaries (30C). Multiple aphthae, on both lips (200C). Pimples on both cheeks (200C).

Mouth:
Dryness of mouth with sensation as if tongue is sticking to palate (Q). Bitter taste (30C, 200C). Redness of soft palate (Q, 30C) with pain, dryness and itching. Marked loss of taste (Q). No taste for food , after eating a little (Q). Pain in gums during fever (Q). Multiple aphthae (Q, 🙂

Throat:
Rawness in throat (Q, 30C, 200C), worse morning on waking, better drinking warm water. Soreness in throat (Q, 30C) especially left side (Q, 30C) radiating to left ear on swallowing. Soreness accompanied by hoarseness (Q). Redness of uvula, pharynx and throat (Q, 30C). Sensation as if left ear is stopped up while empty swallowing (Q). Soreness of throat, alternating sides (Q, 30C). Rawness and dryness of throat with constant inclination to swallow (Q, 200C). Soreness, burning pain and dryness in throat worse empty swallowing, and talking (Q). Sensation of a membrane in throat on swallowing (Q). Sensation of mucus collected in throat pit (Q). Has to hem and hawk constantly without relief (Q). Pricking sticking pain in left side of throat, especially left tonsil, worse evening(Q).

Stomach:
Appetite decreased (Q, 200C) with easy satiety (30C, 200C). Thirst decreased (Q). All gone empty sensation and burning in stomach, worse morning (Q, 30C). Nausea after eating with salivation, better after sleep (Q). Vomiting of food without nausea (Q). Vomiting of sour yellow fluid and later of undigested food, associated with headache (Q). Dyspepsia (:). Stomachic (:) Alleviates thirst (:)

Abdomen:
Stitching colicky pain in left iliac fossa, coming and going suddenly (Q, 30C), worse sudden motion. Colicky pain around umbilicus, compelling to lie on abdomen, worse morning (Q). Burning in abdomen, worse morning (Q). Burning in abdomen better after eating (Q). Dull aching pain in umbilical region, worse evening and night, better by cold drinks (Q). Discomfort and colicky pain in night, better by cold drinks (Q). Discomfort and colicky pain in right hypochondrium better by eructations (Q). Itching around umbilicus without eruptions, worse perspiration and touch of clothing (Q).

Rectum:
Painless diarrhoea (Q, 30C, 200C) worse 5.30 a.m. (30C). Tenesmus before stool (Q, 200C). Unfinished sensation after stool (Q, 200C). Soreness and burning in anus after stool, lasting 10-20 minutes (Q, 200C). Urging for stool worse after eating (200C) and morning on rising from bed (Q). Frequent urging for stool, sometimes ineffectual (200C). Diarrhoea worse morning after breakfast (200C). Has to sit for a long time, and strain to pass stool, even though stool is loose (200C). Tenesmus and great burning, during and after stool (Q). Diarrhoea accompanied by bitter taste in mouth, easy satiety and decreased appetite (200C). Dysentery (:) Diarrhoea (:). Constipation (:)

Stool:
Loose stool (Q, 30C, 200C). Scanty (Q, 200C). Sometimes profuse, passed with great force and much flatus (Q)

Urine:
Diabetes rnellitus (:) Renal calculi (:)

Male:
Itching in upper part of pubic region without eruptions (30C), scratching gives no relief for itching (30C). Itching worse perspiration and touch of clothing (30C) Gonorrhoea (:)

Female:
Dysmenorrhoea (Q, 30C). Stitching pain left ovarian region, worse sitting, walking and in the evening, better by hard pressure, lying on abdomen, pressing thighs against abdomen (Q). Dysmenorrhoea with weakness of lower limbs and vomiting of food without nausea (Q). Pain accompanied by dull lumbosacral backache, with sensation as of a blunt wooden instrument sticking or pressing into the back (Q). Menses early by 4-7 days (Q). Menses scanty and short, lasting only 3 days (Q). Menses with frequent urging for stool, passing soft stool (Q). Intermittent flow of mucoid bloodstained vaginal discharge, during menses (200C). Menorrhagia (:) Leucorrhoea (:) Mammary abscess (:) Galactogogue (:)

Respiratory:
Dry cough (Q, 30C, 200C) from rawness, itching and irritation in throat (Q, 30C, 200C). Dry cough with chest pain (30C, 200C) worse early morning, 9 p.m., night, lying down, and exposure to sun, better daytime. Dry cough with sensation of membrane in throat (Q). Salty expectoration (Q, 30C, 200C). Whitish or greenish sputum (30C). Sensation of suffocation, as if lungs cannot expand properly, worse closed room, lying down, better open air (30C). Dyspnoea with oppression in chest, better expectoration (200C). Has to hem and hawk constantly, to clear the throat of tenacious mucus, which causes dyspnoea (200C). Itching on chest without eruptions, worse perspiration, touch of clothing (Q) Cough (:) Asthma (:)

Back:
Pain lumbosacral region (Q, 30C, 200C) Aching type (Q, 200C), worse stooping and rising from stooping. Intense pain as if bruised, in lumbosacral region, worse morning on waking and rising from lying down, better standing and continued motion (30C). Pain both sacroiliac joints (Q) especially left (Q, 30C), worse stooping and motion, alternating with pain in right sacroiliac joint (Q). Aching pain left side of neck (Q, 30C), and left scapular region (Q). Backache during menses (Q).

Extremities:
Warts (Q, 30C) on fingers of right hand (Q), painful, worse pressure (Q). Warts on dorsum of right foot (30C). Rheumatic pains come and go suddenly (30C, 200C). Pain in small spots (30C, 200C), especially on left knee and left lateral malleolus (200C). Shifting pains (30C, 200C) . Pains alternating sides — left then right ( 30C, 200C) especially
Pain in kness(30C) and pain radial styloid process of hands ( 2000C) .Pain in fore arms (30C) (2000C) knees (Q, 30C, 200C), ankle and malleoli (30C, 200C). Cramps in both calves, worse bathing (30C). Cramps in right calf muscles, worse morning in bed, rising from bed in morning, 2 p.m. and walking (30C).

Sleep:
Sleepiness (Q, 200C), cannot open eyes (200C). Sleepy, but cannot sleep (Q). Disturbed sleep especially in early morning hours (Q). Sleep disturbed with frightful dreams of being murdered especially in the first part of sleep (Q). Dreams of hard work or exertion (Q). Laughing during sleep (Q). Continuation of dreams after waking up(200C).

Fever:
Fever with prostration and chilliness (Q, 200C). Feverish in morning on rising (Q, 200C). Chilliness and gooseflesh (Q, 200C), worse least exposure to cold (200C). Body pain (Q), worse slightest touch. Restlessness during fever (Q) doesn’t like to lie down,wants to walk about (Q).Heat sensation of upper part of body especially head and neck (Q).Heat sensation of upper parts of the body especially head and neck.(Q). Heat first on trunk then on extremities with severe pain in back (Q). Febrifugal (:) Intermittent fevers (:)

Skin:
Warts (Q, 30C) hard, painful worse pressure (Q), flat (30C). Itching in hairy parts of body without eruptions (Q), worse perspiration and touch of clothing. Scratching gives no relief. Small black moles on different parts of body (Q). Pimples on various parts of body (200C). Scabby, crusty eruptions (:), Wounds, bruises (:) Offensive ulcers (:) Scabies (:) Ringworm (:)

General Modalities:
Worse:
Morning, morning on waking, stooping, motion, touch, empty swallowing, sitting,
perspiration, walking.
Better: Pressure, sleep, after eating, warm drinks.

Dr. George Mathew – the author after getting their basic graduation in Homoeopathy, completed the Post Graduation in Homoeopathic Materia medica from Govt. Homoeopathic Medical College, Kozhikode. The proving, which was part of their PG curriculum was also conducted there

Dr. George Mathew. BHMS,MD (Hom)
Medical Officer,Govt. of NCT Delhi