Utility of Throat chapter of Boericke’s Repertory in various disorders

Dr Sreeja L

ABSTRACT
Boericke repertory is a clinical repertory widely used bedside which has been attached to homoeopathic materia medica by William boericke¹.Throat conditions can be very bothersome and worrisome for individuals. A sore or burning throat can be due to any number of condition from acid reflux,over use of voice to post nasal drip².One of the most common reason people go to an ENT doctor is a sore throat.A Sore throat is not an unusual condition, causes can range from a cold or allergies,to dry air,smoking or over use.but an ongoing sore throat that does not get better is cause for concern.This condition may lead to difficulty swallowing continued horseness or loss of voice³. In this article an attempt is made to trace out the utility of chapter ‘Throat’ from Boericke repertory in various disease

KEY WORDS : Boericke repertory,Throat,GERD

INTRODUCTION
The most common symptoms of throat is sore throat. The cause is usually a viral infection but other cause include allergies, infection with streptococcal bacteria or the leaking of stomach acids back up into the oesophagus called Gastroesophageal reflux disease (GERD).

Other problems that affect the throat include:

• Tonsillitis
• Cancer
• Croup
• Laryngitis⁴

Symptoms of the throat or pharynx include a variety of abnormal or unusual sensation or problems of the throat.Throat symptoms can vary greatly in character and severity depending on the underlying disease,disorder or condition.The common throat symptoms include :

• Change in voice,such as muffled or altered speech or hoarseness
• Dry throat
• Feeling of itchiness or tickling in the throat
• Persistent irritation
• Phlegm or mucus build up due to Postnasal drip,Infection or Inflammation
• Sore throat
• Difficulty swallowing such as dysphagia or odynophagia
• Swollen tonsils
• Throat lumps or growth
• White patches on the tonsils and throat

Homoeopathy is very useful in treating the cases of  throat diseases by the help of many repertories.In Boericke repertory there is a chapter ‘Throat’ which consists of important rubrics such as oesophagus, fauses, pharynx, tonsils, adenoid vegetation, diphtheria, inflammation, hypertrophy, papules etc, which is  systematically arranged with more number of medicines for the purpose of Repertorisation

BOERICKE’S New Manual of Homoeopathic Materia Medica with Repertory

• Author : William Boericke
• Year of publication: 1906
• Number of chapters: 25
• Number of remedies: 1414
• Typography : First grade: italic

Second grade :Roman⁶

Application of Throat chapter in various disorders can be understood by the following rubrics under each content such as

• Location rubrics
• Modalities rubrics
• Clinical condition rubrics
• Extensions rubrics
• Concomitant rubrics
• Cross reference rubrics

LOCATION RUBRICS

• Oesophagus
• Burning,smarting : GERD,Oesophagitis
• Inflammation(oesophagitis): inflammation that damages the tube running from the throat to the stomach
• Conditions: GERD,Chemical/infectiousoesophagitis, Herpes simplex, Oesophagitis, Barrettes oesophagus
• Spasm: Esophageal spasms occur when the oesophagus contracts abnormally and they can be painful and uncomfortable
• Conditions:GERD,Achlasia cardia,heart attack,Nutcracker esophagus
• Fauces
• Anesthesia
• Burning heat
• Dryness
• Inflammation
• Necrosis
• Redness
• Roughness,sensitive
• Tingling
• Ulceration
• Conditions : Aphthous ulcers,Canker sores,Aphthous stomatitis
• Pharynx
• Abscess
• Adherent crusts
• Anesthesia
• Burning,smarting,scalded feeling
• Coldness
• Constriction,spasmodic: Stroke,Botulinum neurotoxins
• Tonsils
• Abscess ( peritonsillar)
• Conditions : Chronic tonsillitis,Infectious mononucleosis, Chronic lyphocytic leukemia
• Uvula
• Inflammation (uvulitis) : it is the inflammation of the uvula
• Conditions : Streptococcal bacterial infections,allergic reactions or injury
• Ulceration: Apthous ulcer are small,painful, and shallow sores that can appear white or gray surrounded by a red halo.They usually appear on moveable,soft tissue inside the mouth-the tongue,throat (including tonsils and uvula )
• Conditions:Oropharyngeal cancer,Herpangina,Chemotherapy,Behcet syndrome
• Constricted feeling
• Edematous,sac like
• Elongation,relaxation
• Pain
• Whitened,shrivelled

MODALITY RUBRIC

Aggravation

• From cold
• From drinks,warm or hot
• From pressure
• From swallowing empty
• From swallowing solids
• On left side
• On left to right
• On right side

Amelioration

• From inspiring cold air
• From swallowing
• From swallowing liquids
• From swallowing liquids warm
• From swallowing solids

CLINICAL CONDITION RUBRICS

a)Type

• Ataxic : it is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality,speech changes and abnormalities in eye movement.it can include trouble eating and swallowing
• Laryngeal
• Malignant
• Nasal

b) Adenoid vegetation: Adenoid vegetation in the vault of the pharynx are common in childhood.They are produced by hypertrophy of the adenoid tissue which is abundant in this situation where it forms a mass known as Luschka’s tonsil

c) Diphtheria: Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae.Symptoms include sore throat and fever,grey or white patch develops in the throat. This can block the airway and creat a barking cough as in croup

d) Inflammation( pharyngitis) : Atrophic sicca

• Pharyngitis is inflammation of the back of the throat known as the pharynx.it typically results in a sore throat and fever
• Chronic pharyngitis is a chronic inflammatory and irritative process with no infectious component of the pharyngeal mucosa
• It can be simple hypertrophic or atrophic
• Conditions: Group A beta hemolytic streptococcal pharyngitis ,Non group A beta hemolytic streptococcal pharyngitis,Viral pharyngitis, Infectious mononucleosis
• Inflammation,follicular,chronic ( Clergymen’s sore throat)
• Chronic inflammation of the pharynx often occurring in persons who habitually overstrain or misuse the voice
• Conditions: Cold and flu like common cold, Measles, Mumps, Allergies, Irritants, GERD,Tumors
• Inflammation,herpetic- Herpes in the throat also known as herpes esophagitis is when herpes simplex virus invades the esophagus.it is a viral infection caused by the herpes simplex virus
• Inflammation,rheumatic – Rheumatic fever can occur after a throat infection from a bacteria called group A streptococcus
• Inflammation,septic – Septic inflammation of throat can occur in streptococcal bacterial infection that can make your throat feel sore and scratchy.if left untreated streptococcal throat can cause complication such as kidney inflammation or rheumatic fever
• Inflammation,tubercular – it is the inflammation of throat caused by Mycobacterium tuberculosis affecting the lymph nodes ( cervical) resulting in swollen throat

e) Hypertrophy – Induration

• It occurs in infection of throat leading to swollen tonsils
• Hypertrophy with hardness of hearing
• Conditions: Streptococcal throat, Cold, Mononucleosis, Flu, Allergies, GERD, Irritant
• Inflammation( tonsillitis) : Acute catarrhal and follicular
• Condition: Scarlet fever and Epstein barr virus,infectious mononucleosis,herpes simplex virus infection
• Inflammation,acute phlegmonous ( Quinsy) : Phlegmonous means a diffuse spreading inflammation of or within the connective tissue caused by phelgmon produces pus.phlegmon can affect internal organs such as you tonsils or appendix or can be under your skin
• Conditions : Peritonsillar cellulitis, Tonsillar abscess, Mononucleosis Neoplasm
• Quinsy : inflammation of the throat especially on abscess in the region of the tonsils

     f ) Dysphagia : refers to a difficulty in swallowing

• Causes : Achalasia cardia,Diffuse spasm,Stroke,Esophageal ring,Eosinophilic esophagitis,Multiple sclerosis, Myasthenia gravis,Esophageal stricture,Esophageal cancer
• Can swollow only liquids: conditions such as oesophageal cancer and oesophageal stricture
• Can swallow only solids,liquid descends with difficulty: condition such as Achalasia cardia
• Choking when eating,drinking : condition such as Diffuse oesophageal spasm,Nutcracker oesopahagus
• Food descends wrong way : condition such as incordinated movement of cricopharyngeal reflux disease
• Liquids descends with gurgling sound
• Swallow food and drink hastily

g ) Hawking – Hemming ( clearing throat )

• Hawking with cheesy fetid lumps
• Hawking with fetid pus
• Hawking with gelationous,viscid,gluey mucus,difficult raising
• Hollow feeling as if pharynx had disappeared
• Inclination to swallow constantly
• Conditions: Post nasal drainage,Allergy,Chronic rhinitis,Chronic sinusitis,Asthma

     h ) Deposits on

• Creamy extends over tonsils uvula soft palate
• Dark gangrenous
• Grayish patchy on tonsils
• Plugs of mucus constantly form in crypts
• Conditions : Tonsilloliths – Malignancy,Calcified granuloma,Tertiary syphilis tuberculosis and Deep fungical infection,Infectious mononucleosis,Oral thrush,Tonsilitis

EXTENSION RUBRICS

• Extension downwards
• Extension left to right
• Extension right to left
• Extension upward

CONCOMITANT RUBRIC

• With croup
• With drooling
• With objective symptoms only
• With post diphtheritic paralysis
• With spasm of glottis
• With urine scanty

CROSS-REFERENCE RUBRIC

• Cross reference is the indicator to the similar meaning rubric elsewhere in the same repertory
• Fauces – ulceration
• Deposits – membranous
• Globus hystericus – see hysteria
• Hawing – see chronic pharyngitis
• Papules – see follicular pharyngitis
• Pustules – see ulceration
• Spasm – see constriction
• Hypertrophy,swelling – see tonsillitis

CONCLUSION
Boericke  repertory is a trustworthy guide in clinical practice for the selection of homoeopathic similimum as it has been completly remodelled and brought up to date,by embodying with clinical rubric,technical terms and frequently verified clinical remedies.Many of the sections have been carefully rewritten with approapriate expansion.According to the author being a clinical repertory and not truly a ‘symptomatological index’ for which the practioners and students should refer the monumental works of Kent,Knerr and Clarke⁶.So the repertory becomes very useful in throat disorders relating to parts,symptoms,sign and clinical symptoms which helps in the selection of suitable remedy according to the Similimum.

REFERENCES

• Shashi kant Tiwari,Essentials of Repertorisation,Published by B Jain Publishers.5/e.2012
• Google : https://throatdisorder.com/throat-disorders/
• Google : https://www.austinregionalclinic.com/services/ear-nose-and-throat-ent/throat
• Google : https://medlineplus.gov/throatdisorders.html
• Google:https://www.healthgrades.com/right-care/ear-nose-and-throat/throat-symptoms
• Shanu Salim.Ginu D Mohan,Genesis D M D,Repertory Expert A New Experience on Understanding Repertories,Published by Dr SALIM’s Center for Homeopathic Healing 1/e.2020

Dr Sreeja L
MD Part 2
Department of Case taking and Repertory
Under the guidance of  Dr Anusuya M Akareddy
Government Homoeopathic Medical College and Hospital, Bengaluru