Pathological rubrics for diabetes Mellitus in Phatak’s Repertory

Dr Mohammad Furqan Aamer

In Phatak’s Repertory, rubrics related to Diabetes Mellitus are distributed across different sections that capture the metabolic, urinary, and systemic manifestations of the disease. Below is an expanded and more detailed collection of rubrics associated with Diabetes Mellitus and its related symptoms, overall if you want to utilize it, you have to collect different rubrics from various sections and repertories it and finalised a remedy. The selected similimum should be match with the constitution of the patient and confirm by the materia medica.

1. Generalities:

• Weakness, General – Diabetes causes general debility due to poor glucose utilization and energy production.
• Emaciation – Despite increased food intake (polyphagia), patients may lose weight, especially in Type 1 Diabetes.
• Dropsy – Oedema, particularly when associated with kidney complications in diabetic patients.
• Abscesses, tendency to – Diabetes make individuals prone to recurrent abscesses, particularly due to immunosuppression.

2. Urine:

• Urine, Sugar in – The presence of glucose in urine (glycosuria) is one of the hallmarks of diabetes.
• Urine, Frequent Urination (Polyuria) – Frequent and excessive urination is a primary symptom in both Type 1 and Type 2 Diabetes.
• Urine, Profuse – An increase in the volume of urine, indicating renal complications or high blood sugar.
• Urine, Odour of Acetone – Ketones in the urine (ketonuria) due to diabetic ketoacidosis (DKA).
• Urine, Milky – Sometimes seen in nephrotic syndrome, which can be a complication of long-term diabetes.
• Urine, Turbid – Urine may appear cloudy or frothy due to protein loss or infection, common in diabetics.
• Urine, Aluminous – Proteinuria, indicating kidney damage, a serious complication of uncontrolled diabetes (diabetic nephropathy).
• Urine, High Specific Gravity – The urine has a high concentration of solutes due to excess glucose and ketones.
• Urine, Ammoniacal odour – Seen in infections, especially in diabetic patients prone to urinary tract infections.

3. Appetite:

• Appetite, Increased (Polyphagia) – A constant feeling of hunger despite eating large amounts of food.
• Appetite, Diminished – As complications arise, especially in Type 2 Diabetes, appetite may reduce due to gastrointestinal disturbances.
• Appetite, Ravenous during night – Nocturnal hunger can be a feature in some diabetic patients with unstable glucose levels.

4. Thirst:

• Thirst, Excessive (Polydipsia) – Persistent thirst is a significant symptom of uncontrolled diabetes.
• Thirst, Constant – A continuous desire to drink water due to dehydration caused by polyuria.
• Thirst, Unquenchable – The patient cannot satisfy their thirst, often due to persistent high blood sugar levels.

5. Skin:

• Skin, Dryness – Dry and flaky skin, which is common in diabetic patients, particularly due to dehydration and poor circulation.
• Skin, Ulcers – Non-healing ulcers, especially on the feet, is a complication of diabetic neuropathy and poor blood flow.
• Skin, Itching – General itching or pruritus can be associated with diabetes, often due to dry skin or poor circulation.
• Gangrene, Diabetic – Gangrene is a severe complication of poorly controlled diabetes, often affecting extremities.
• Wounds, Slow Healing – Diabetic patients have poor wound healing due to reduced immune function and circulation problems.
• Eruptions, Pustular – Recurrent skin infections or abscesses, which diabetics are prone to due to immune dysfunction.

6. Mind:

• Mental dullness – Confusion or mental sluggishness due to fluctuating blood glucose levels.
• Irritability – Patients with diabetes may experience mood swings and irritability, especially when blood sugar levels are not stable.
• Despair of recovery – Diabetics, particularly those with complications, may feel hopeless or despondent about their condition.

7. Extremities:

• Numbness, Tingling (Neuropathy) – Diabetic neuropathy leads to numbness and tingling in the feet and hands, a common complication.
• Burning in soles – A frequent complaint in diabetic neuropathy, where patients feel burning sensations in their extremities.
• Cramps, especially at night – Muscle cramps and spasms, particularly in the legs, are associated with diabetic nerve and vascular damage.
• Coldness of extremities – Poor circulation in diabetic patients can lead to cold hands and feet, often indicating peripheral vascular disease.

8. Respiratory:

• Breath, Fruity odour – A sign of diabetic ketoacidosis, where the breath has a sweet, fruity smell due to ketones.
• Breathlessness – Can occur due to diabetic complications like metabolic acidosis or heart disease.

9. Eyes:

• Vision, Blurred – Diabetes can cause fluctuating or progressively worsening vision due to diabetic retinopathy.
• Cataracts – Early onset cataracts can occur in diabetic patients.
• Retinal haemorrhage – Damage to the blood vessels of the retina due to long-term uncontrolled diabetes.

10. Digestive System:

• Dryness of Mouth – A dry mouth is common in diabetics due to dehydration.
• Constipation – Often seen in patients with long-standing diabetes due to neuropathy affecting the gastrointestinal tract (diabetic gastro paresis).
• Diarrhoea – Alternating with constipation, diarrhoea may also be seen due to autonomic neuropathy.
• Hepatic complaints – Fatty liver disease and other liver-related issues can co-exist with diabetes.
• Taste, Sweet – A sweet taste in the mouth may indicate high levels of glucose in the bloodstream.

11. Metabolism:

• Ketosis – The presence of ketones in the body due to fat metabolism in the absence of sufficient insulin.
• Hyperglycaemia – Elevated blood sugar levels, a core feature of diabetes.
• Hypoglycaemias – Low blood sugar levels, often occurring in diabetic patients on insulin or oral hypoglycaemic medications.
• Acidosis – A serious condition where the blood becomes acidic due to the accumulation of ketones (ketoacidosis).

12. Sexual Organs:

• Impotence – Erectile dysfunction is common in diabetic men due to neuropathy and vascular complications.
• Sexual Desire, Diminished – Loss of libido is another feature due to metabolic and vascular changes in long-standing diabetes.

13. Sleep:

• Somnolence – Patients with diabetes may feel excessively drowsy or fatigued during the day, particularly when blood sugar levels fluctuate.
• Sleeplessness – Sleep disturbances may occur due to nocturnal polyuria, pain from neuropathy, or fluctuations in blood glucose.

Also these rubrics cover various aspects of the pathology, symptomatology, and complications associated with Diabetes Mellitus in Phatak’s Repertory. We can use these rubrics to select remedies that match the totality of symptoms in diabetic patients, addressing both acute manifestations and long-term complications.

Dr Mohammad Furqan Aamer
MD(HMM),PhD(Research fellow)
Dean M.Wahed HMC Sillod Aurangabad
Email.drfurqanaamer@gmail.com
www.doctorfurqan.com