Homoeopathic approach of chronic rhinitis with Murphy Repertory

 Dr Manish Kumar Shrivastava

This is an inflammation disease of mucous membrane  of nose. Chronic rhinitis is usually an extension of rhinitis caused by inflammation or infection.

CAUSE :   There are following cause of chronic rhinitis :

INFECTIOUS :   a) viral  :rhinovirus, influenza virus, adeno virus etc.

B) bacterial :streptococcus, moraxella catarrhalis etc

ALLERGIC :     triggered: i.e. Pollen grain, mold animal dander, dust   etc

NON – ALLERGIC :

A) Vasomotor :   it is vasodilation,  due to an overactive parasympathic nerve response . i.e. Occupation (chemical), smoking, hormonal, eosinophilia syndrome etc.

B) Nsaid : asprin and non steroid anti inflammatory drugs, cyclo-oxygenase-1(coxi)

C) Rhinitis medicamentosa: drug induced – non allergic rhinitis- nasal congestion.

D) Chronic atrophic rhinitis:  atrophy of mucous membrane and glands

E) Rhinitis sicca : dryness of mucous membrane.

F)  Polypus rhinitis : associated with polyps in nasal cavity.

COMPLICATION OF CHRONIC RHINITIS: 

There are following complications which is related to chronic rhinitis:

1. Earache
2. Loss of hearing
3. Middle ear infection
4. Middle loss of balance
5. Sinusitis
6. Nasal polyp
7. Symptoms of asthma
8. Disturb sleep
9. Restlessness
10. Slightly headache ,  etc.

ABOUT  REPERTORY :

HOMOEOPATHIC  MEDICAL  REPERTORY :  By Robin Murphy
Homoeopathic medical repertory is a modern  alphabetical repertory is mainly based on repertory of homoeopathic materia medica by dr. J. T. Kent and repertory of hering guiding symptoms of our materia medica by dr. C b knerr.

This repertory is based on the principle of clinical as well as classical homoeopathic practice. It has the advantage of meeting the requirement of various type of cases. This is the unique repertory, which helps a practioners, to find out the similimum on the basis of clinical.

The homoeopathic medical repertory was designed as a modern , practical , and easy to use as a  clinical guide to vast homoeopathic materia medica. To achieve these goal completely new repertory had to constructed with a new schema , terminology chapters , clinical rubrics, addition and upgrades.

IMPORTANCE OF MURPHY REPERTORY IN CASES OF  CHRONIC RHINITIS :  This homoeopathic medical repertory was designed as a modern, practical and easy to use reference guide to vast homoeopathic material medica. It  is clinical repertory and easily finding of rubrics and clinical symptoms which is arranged in alphabetically. So this repertory is very useful for any clinical approach for chronic rhinitis.

RUBRIC RELATED TO CHRONIC RHINITIS : 

• Clinical – hay fever- spring
• Clinical – cold, ailments , from – spring, in
• Clinical – cold, tendency to catch – sneezing with alots of
• Eyes – LACHRYMATION, general – sneezing with
• Eyes – inflammation , eyes – chronic scurfy nose
• Eyes- BURNING pain – eyelid – evening
• Headache – sneezing with , general – agg-
• Headache – BURNING pain – forehead- eyes , over
• Headache – Forehead , headache pain, general – eyes, above – sneezing with
• Headache – Forehead , headache pain, general –sneezing
• Hearing –  nose in ear- ringing- sneezing on
• Larynx – pain , larynx – sneezing
• Nose – itching , nose crawling and trackling – inside.  ,
• Nose – discharge , general thick
• Nose – sneezing -, general violent
• Nose – ALLERGIC , rhinitis
• Nose  – COLD  tendency, to take – sneezing with a lot of
• Nose – OBSTRUCTION, nose- sneezing , when nostrils stick together.
• Nose- fullness , sensation of –  frontal, sinuses from inflammation.
• Nose – inflammation , nose- post nasal – chronic
• Nose – coryza – general- watery discharge
• Nose – discharge nasal watery – sudden copious from , eyes , nose and mouth
• Nose – smell , general – odors , general , imaginary and real- watery discharge.
• Nose – smell , general – odors , general – imaginary and real – intolerable after frequent sneezing
• Nose – discharge , nasal – crust, scab, inside, high up- large must nasal discharge through post nasal
• Nose – coryza – general discharge dry – nose , without obstruction with.
• Nose- sneezing , general – odors, from
• Throat – foreign , object , in sensation of sneezing while.
• Throat – sore pain , throat bruised – pharynx sneezing
• Vaccination – allergic, reactions – rhinitis.

PRESCRIBING INDICATIONS OF HOMOEOPATHIC MEDICINE : 

NAME OF MEDICINE	PRESCRIBING INDICATION
Agaricus muscaricus	Chronic inflammation. Frequent sneezing, without coryza. Flow of clear water without coryza. Itching externally and internally. Dark, fetid, bloody discharge, Epistaxis. Obstruction on stooping.
Allium-cepa	Hay fever. Polypus. Fluent coryza with headache, cough and hoarsenesss, Acrid, Copious, watery discharge. Sneezing in a warm room. Sensation of a lump at root of nose.
Argentum-nitricum	Loss of smell. Coryza with chilliness, lacrymation, headache. Violent itching. Rubs it.
Arsenic album	Watery, thin, excoriating, cold sore in nose. Nose feel stopped with fluent coryza. Sneezing with biting watery coryza without relief. Cannot bear the smell and sight of food.
Asafoetida	Inflammation of nasal bone. Offensive discharge from the nose. Ozena, caries of nasal bone. Tension over nasal bone with numbness.
Bovista	Nose stopped with stringy discharge. Difficulty in breathing. Bleeding early in the morning (during sleep). Few drop escape on sneezing. < lying down.
Calcarea carbonica	Sore, dry, ulcerated nostril. Obstruction in nose. Offensive odor in nose; offensive yellow discharge. Swelling of the nose and upper lip. Epistaxis in children inclined to be fat.
Capsicum	Nose red but cold with hot tip. Explosive cough. Nose bleeding in morning, in bed.
Carbo vegetabilis	Descending cold, hay asthma. Frequent sneezing, much coryza especially in warm, moist weather. Epistaxis in daily attacks with pale face. Sneezing < sneezing.
Causticum	Coryza with hoarseness. Sneezing in the morning, nose bleed. Nostrils ulcerated. Thick yellow or greenish yellow discharge.
Euphrasia	Fluent Profuse bland coryza. Cough with much expectoration. Flat cancer on the right side of the nose. > lying dowm
Graphites	Dryness with loss of smell, stuffed coryza. Discharge offensive esp. during menses. Scabs and fissures in the nostrils. smell acute, cannot bear the smell of flowers.
Hepar sulphuris calcareum	Sneezing and running nose from dry cold wind. Sore pain at the root of nose. Stuffed painful nose, smell like old cheese. Ripened colds  and old catarrh. Croupy, inflammation of mucus membrane as a sequale of scarlatina.
Hydrastis	Thick, tenacious secretion from posterior nares to throat. Watery, excoriating discharge. Blows all the time. Ozaena, with ulceration of septum.
Iodum	Pain at the root of nose and frontal sinus, ulceration. Coryza with heat of skin < open air. Acute nasal engorgement with high blood pressure. Nose red and swollen; sudden sneezing with dripping of hot water. Descending cold, loss of smell.
Kali bichromicum	Coryza with obstruction of nose. Nose feels heavy and dry. Fetid smell from retention of discharge. Violent sneezing < in the morning. Purulent Inflammation of mucous membrane. Ozena. Catarrhal, in all its continuation. Septal ulceration. Chronic inflammation of frontal sinuses with stopped up sensation. Loss of sensation. Frontal sinuses, highmorian, cavities and fauses. < In warm room, >in cold temperature.
Kali carbonicum	Chronic cold breathes through mouth. Descending coryza.  Swollen, hard red, ulcerated nostrils. Foetid yellow green or crusty discharge. Nose bleed on washing the face in the morning. Post nasal drooping.
Kali iodatum	Descending coryza with profuse acrid, hot, watery discharge. Violent sneezing. < Cool air, take cold on every damp day. Stuffiness and dryness of nose, without discharge, Tightness at the root of nose, frontal sinus. Ozena with perforated septum.
Lycopodium	Nasal trouble from childhood, nose stopped up, breathes through mouth, snuffles. Fan like motion of alae nasi. Feeling of dryness posteriorly. Ozena, acrid chronic coryza, ulcerated nostrils, blows nose often.
Magnesia-muriatica	Coryza, ulcerated nostril, acrid crusty Ozena. Nocturnal obstruction of nose, must breathe through  the mouth. Loss of taste and smell.
Natrum muriaticum	Violent, fluent coryza changing into stoppage of nose. Discharge like raw white of egg. Loss of smell and taste. Left side, painful to touch. Internal soreness of nose. Infallible for stopping a cold commencing with sneezing.
Natrum carbonicum	Inflammation of external nose in rhinitis. Red nose with white pimples on it. Coryza < least draft, alternate days, obstruction of nose at night, posterior nasal catarrh. Bad smell, thick, yellow or green discharge.
Nitric-acidum	Coryza with sore and bleeding nostrils Inflammation of alae. Chronic nasal catarrh, with yellow, offensive, corrosive discharge. Ozaena, Green casts from nose every morning. Caries of mastoid, nosebleed with chest affection. Frequent sneezing without coryza, during sleep.
Petroleum	Nostrils ulcerated, cracked, burning. Tip of nose itches. Ozena, purulent discharge. Epistaxis.
Phosphorus	Tip shining nostril dry. Inflammation of membrane with suppressed and sensitive smell. Scrofulous.  Caries of mastoid. Nosebleed with chest affection. Sensation of dryness with plugs and slow bleeding.
Psorinum	Inflammation of septum, with white suppurating pustules. Hay fever, recurring cold. Dripping from posterior nares.
Pulsatilla	Green, orange colored, fetid, urinous nasal-discharge/ odor before the nose. Obstruction of nose. < lying down, in a room > going out in the open air. Loss of smell.  Nasal bone sore.
Rhus-toxicodendron	Red sensitive tip; it drips water. Sneezing, fluent coryza from getting wet. Tip of nose sore, red, ulserated. Nosebleed < night, stooping, at stool, in fever. Violent aching in bones of the nose. Breath hot, it burns nostrils.
Sabadilla	Lingering Coryza with severe frontal pains and redness of eyes and lacrimation, Copious, watery, nasal discharge from the odor of flower. Cannot tolerate the smell of garlic. Spasmodic sneezing with running nose. Hawks bright red blood from nasopharynx.
Sanguinaria	Coryza stopped then diarrhoea. Pain at the root of nose. Nasal polypi. Rose cold, sensitive to odors. Loss or perverted sense of smell. Smell is nose like roasted onion.
Silicea	Nasal duct discharges large clots of blood mixed with dry mucus of foul smell. Dry, obstructed with loss of smell. Perforation of septum. Coryza with Epistaxis. Obstinate cold with ear affection
Thuja occidentalis	Chronic catarrh, blow thick, green mucus. Ulcerated nostrils. Dryness of nasal cavities. Painful pressure at root. Epistaxis < after being overheated.

MIASMATIC POINTS OF VIEW :

PSORIC SYMPTOMS :

• Psoric patient increased sensitivity of smell, like odors of cooking, smell of perfumes, paints, and flower.
• Symptoms begin with sneezing, redness, heat, redness.
• Sensation of dryness in the nose even when full of air.
• Sense of smell weak and lost.
• Sensitive to touch when blown for some time.
• Discharge thin, watery and acrid.
• The septum looks dirty or sooty looking. It is often dry, hot and burning.
• Painful pimples and vesicles in septum.

PSEUDO-PSORA :

• In worst forms of hay fever where there is much sneezing with much local trouble
• Hemorrhage from the nose on slightest provocation- blowing the nose, a slight blow or washing the face.
• Hemorrhages are profuse, bright red, difficult to arrest, rush of blood to surface inducing great heat; > by cold application.
• Headaches, vertigoes, congestion of brain are often relived by nose bleeds.
• Discharge thick, purulent, and sometime bloody.
• Catarrhal discharge is thick, usually yellow and of the odour of old cheese and constantly drooping down the throat.

SYCOSIS :   

• A red nose with enlarged capillaries.
• Snuffles in children- nose dry, stuffed up. Child will scream in attempts to breathe with its mouth closed.
• Children from sycotic parents complicated with gout take cold easily at slightest exposure and frequently from coryza.
• Discharge copious, watery often excoriating. Loss of smell.
• Stoppage of nose due to local congestion and thickening of the membrane or enlargement of the turbinated bodies.
• Gouty concretion in nose.
• Discharge is yellowish green, scanty but in fresh air it is copious thin mucus.
• Purulent, scanty discharge, odour of fish brine or stale fish.
• Loss of smell.
• Hay fever, nose clear one hour, the next he cannot get a particle of air through his nasal passages.

SYPHILIS :

• Loss of smell.
• Snuffles in children.
• Ulceration, thick crust (clinkers) often filling whole nasal cavity.
• The crust are dark, greenish, black, brown, thick are not always offensive.
• Destruction of nasal bone.

MIASMATIC INDICATION IN CHRONIC RHINITIS  

SYMPTOMS	PSORA	PSEUDO PSORA	SYCOTIC	SYPHILIS
Coryza constant	+	+	+
Coryza with diphtheria	+
Coryza  annual	+	+
Coryza hay fever	+		+	+
Nasal discharge Mucoid Mucopurulent Thick Viscid Cheesy Offensive	++	++ ++	++ ++ ++	+
Nasal obstruction	+	+	+
Ozaena	+	+
Caries of septum	+			++
Crust formation		+		++
Foul smell from nose	+		+
Anosmia	+			+
Red nasal mucosa	+	+	+
Swollen turbinate	+		+
Hypertrophy of turbinate		+	+
Heiring impairment	+	+	+
Middle ear infection	+	+	+
Ulceration	+		+	+
Epistaxis	+	+
Destruction of nasal bone/sinus	+			+
Perforation of septum	+	+
Deviated septum			+	+
Immune deficiency	+	+
Rhinitis	+	+	+	+
Sinusitis	+	+	+	+
Atrophic pharyngitis		+	+	+
Atrophic laryngitis		+	+	+
Dermatitis of nasal vestibule	+	+

REFERANCES /  BIBLIOGRAPHY

A-BOOKS:

• 1. API text book of medicine  , 8^th edition 2008, Siddharth N .Shah, M.Paul Anand, 1573 pages, The association of physician of India , Mumbai -11 Page no-353 , section – Pulmonary, chatper 4- upper respiratory tract infection, Rhinitis, Pharyngitis and Sinusitis. Vol – I

• 2. Disease of Ear , Nose and Throat fourth edition , P L Dhingra , 4^th edition  Elsevier a division of Reed Elsevier India Private Limited, New Delhi– . page no 157-165

• 3. Practical medicine, P J Mehta , 20th edition the national book depot, Mumbai , Chapter no  is 4-  Respiratory System page no 122-187.

• 4. Medicine for the student by Aspi F Golwala & Sharukh A Golwala 24th edition 1238 page , tha national book depot. Opp- wadia children hospital parel – Mumbai

• 5. Devidson’s  principle and  practice of medicine ,20^th edition , Nicholas A BOON , Nicki R Colledge, Brain R W alker 2006, 1386 pages , Chuchill Livingstone Elsevier publication Philadephia.

• 6. organon of medicine 6^th edition , Author – Dr. Samual Hahnemann translated and preface by William Boerick Publisher- Bjain , New delhi 340 page.

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• 20. 20.Homoeopathic medical repertory  by robin Murphy  reprint Indian edition  1994, by IBPS New Delhi  Pages 1590.

DR. MANISH KUMAR SHRIVASTAVA
M.D.(HOM.) BVDU-HMC – PUNE
MBA – HRM- BHOPAL
drmanishshrivastava@gmail.com