Endometriosis is a very common illness.
Patients suffering from endometriosis have very severe menstrual pain. This is often the reason why the patient comes to the clinic.
Menstrual pain is a common symptom--so common that people with this pain just take a painkiller and carry on working, if they are able to.
It is often very easy to prescribe for menstrual pain.
It is abundantly recognized that for "funktional" diseases homeopathy often "works wonders" and thus it is often very easy to prescribe for menstrual pain. The case yields to treatment after a few cycles, and in cases of "funktional dysmenorrhea" the patient may then actually be cured, since there are no organic resp. structural changes.
In other cases, where structural changes have occurred or are in the process of occurring, the menstrual pain may also get better, But this will often be only palliative action. The process will go on, and five years later she may come back. This it may be with a diagnosis from the gynecologist of ovarian cysts, intestinal adhesions. The gynocologist then may want to do a total hysterectomy and bilateral oophorectomy.
It is therefore important to assess right at the start whether the
menstrual pain is a case of funktional dysmenorrhea.
Since at the beginning of pathological processes there may not be anything
to be noticed in a gynecological examination (including ultrasound scans
and even laparotomy), it is important to get an idea from the clinical
picture at such a time.
This patient is usually young, has been having period pains since she started
menstruating.
The pain is just before and during the first day of her menses. She
also may be somewhat irritable and may feel chilly, but her bowels and
her urination are not affected during the menses.
She does not have much in the way of digestive upsets either.
The pains are suprapubic, sometimes with some body aches, sometimes
a low backache.
Her menstruation has an average duration of a few days, no clots are
present in the blood, the blond does not have foul smell; it may smell
strong but not foul.
The menstrual pains are of the same intensity month after month, i.e.do
not get worse, though they may sometimes be slightly better.
Then we have the lady who is middle aged; she may have had no children or several. She has not had dysmenorrhea when she first started menstruating but began developing it gradually; and it has become steadily worse. It gets so bad that she has to bend forwards in pain. The abdomen is so sore that, when she rides in a car, the slightest jar makes her wince in pain. The pain is worst on her second day of bleeding and lasts throughout her menses - and a few days longer. During her menses, bowel evacuation may be painful, and sometimes she feels no appetite or is willing to eat but gets full of wind afterwards. The pain is not only suprapubic but along her thighs sometime she gets a bit febrile during the first day of her menses. She may be incapacitated for half the month, every month. You are dealing with lot of organic and structural changes here.
My first diagnosis would be endometriosis.
The other common causes of a severe dysmenorrhea, with the characteristic features I described above, may point to
J.T. Kent said, in an article
The difficulty in prescribing for patients with such altered tissue --cataract, hepatization (in pneumonia), induration of glands, arteriosclerosis, fibroids, cancer, etc. -- rests in the fact that, when these tissue changes occur, the symptoms on which a prescription should be based -- the symptoms of the patient -- have disappeared. The symptoms present at the time are symptoms of the pathology.
If the symptoms that preceded this condition can be learned,and considered together with the later results of disorder -- the pathological tissue --it may be possible to select a remedy that is sufficiently related to both the patient and his pathology, to effect a cure of both, provided always that the reaction and vitality of the patient are sufficient to permit the resolution.
By reference to the repertory the prescriber may find remedies which have thus been established as suitable for suppuration, those suited for cancer, those suited for tuberculosis, those related to apoplexy, etc., and as an intelligent prescriber, the physician should select a remedy for the patient similar to the condition of the ultimate disorder.
This is totally different from prescribing on the pathology alone, or seeking a specific for the name of the ultimate, regardless of the patient.
In selecting a remedy for pain during menses, we therefore have to be aware of the pathology involved, recognize its presence from the symptoms and bear in mind that remedies which have been known to be of help in reversing the pathology should be prescribed.
The following are the remedies which I have found useful for these pathologies. I have not detailed their symptoms, because these are easily available from the Materia Medica.
apis, nat mur, pulsatilla, thuja, platina, palladium,thyroidinum sepia, vaccinotoxinum, lachesis, carcinosinum. medorrhinum, tuberculinum.
These should be prescribed according to similarities to the pathology or, where possible to what Kent in the above article calls "the patient".
Frequently, as Kent said, it is only the symptoms of the pathology that you see.
In these cases I prescribe on these symptoms. The picture of the case will then change and show other symptoms, sometimes e.g. the original state of mind. I will then prescibe on this changed picture - sometimes on the totality then presenting - ---but often the patient is cured by prescribing on the state of mind only---.
The treatments are long and protracted, but it is possible to effect a cure.
The important thing is to recognize that you are dealing with a serious problem, and to refer the patient for further monitoring, e.g. ultra sound scans, which I prefer, because they are non-invasive and can still show you a lot of the pathology: such as fibroids, cysts etc.
Many organs are located in the pelvis of a woman, including the uterus, ovaries, fallopian tubes. The bladder, intestines, and appendix also are located next to the reproductive organs, and sensations from these organs can feel like pain from the uterus or ovaries. To further confuse things, pain from the kidney and pain from muscles and from the abdominal wall can also seem to come from the pelvis.
One of the problems in this case for diagnosing or excluding endometriosis is that it is possible that pain from these organs may also be caused by endometriosis, because the lesions that constitute the latter can stick to any of these pelvic organs.
Hence the differentiating point is the cyclical nature of the complaint in endometriosis.
The endometrium is the tissue that lines the inside of the
uterine cavity. Endometriosis is a disease state in which some of this
tissue has spread elsewhere -- such as to the ovaries, or elsewhere in
the abdominal cavity.
Physiologically, i.e. in a healthy state, the cells of
the endometrium build up from being very basic and thin at the end of the
menses to their peak a week before menses; then they disintegrate and start
to bleed during menses. (This is when the hormones oestrogen and progesterone
are at their lowest levels.)
To recall what has been said above: these endometrial
cells are physiological as lining of the uterus, and when they are limited
to this location, the resulting cycle is a sign of health.
When, however, endometrial tissues have implanted in other
organs, they will also bleed.
Then one of the problems is that this blood does not have
a natural way out of the body. So the bleeding occurs e.g. inside the ovaries
in ovarian endometriosis, which is among the commonest. Sometimes bleeding
takes place in the fallopian tubes, behind the uterus in the pouch of douglas,
onto the peritoneal tissues in peritoneal endometriosis. This may cause
adhesions to the intestines and other pelvic structures and result in those
attendant symptoms of digestive disturbances and pains.
The following are some of the commonest characteristic symptoms of endometriosis:
Infertility, debilitated state of patient who may be unable to assume daily activities, usually for weeks in a month, every month.
A constant cycle of pain, recovery, a short period of feeling relatively well then a repeat.
Body aches and tiredness as well as inability to cope are frequently associated with this condition when severe.
Pathological changes are blood cysts in the ovaries, fallopian tubes, adherent to intestines or within the uterus, resulting in adhesions, blocked tubes, and its consequences such as hydrosalpinx.
The aetiology of endometriosis can only be guessed at. Most likely are inherited dyscrasias, which include allergies, thyroid dyscrasias, a sycotic base with tubercular and sometimes cancer miasm. It is a disease of a mixed miasm.
Environmental pollution cannot be ruled out, dioxins have been implicated, as is an oestrogen-like waste product now widely found in drinking water and food.
Allergic conditions such as hay fever, vasomotor rhinitis, and asthma are frequent accompaniments, and may precede the endometriosis.
Yeast infections which are frequently present and precede the endometriosis may point to the possibility that the condition is spread by yeast cells, which bring the endometrial tissue from the uterus to the other places, on which gets is implanted.
The fact that endometrial tissue can be implanted and grow at the implanted site shows a loss of natural body resistance, which, under normal conditions, should prevent any such cells from growing at these sites.
A theory of retrograde blood caused by sexual intercourse during menses does not hold water, because strict Muslims abstain from intercourse during menses and are still not immune to this disease. However, there is still the possibility of retrograde menstrual blood being a reason for the implanting of the endometrial tissue in the ectopic sites.
Drug treatment is aimed at regressing the ectopic tissues and causing it to narcotize and disappear.
This is achieved by synthetic hormones used continuously to suppress the menses and make the decidual lining of the uterus and thus the ectopic tissues thin. A state of pseudo pregnancy is produced. Drugs in this class include progestins, and combination progestins and oestrogens. Another group of drugs produce an artificial menopause and achieves the same results. These include Danazol and GNRH (gonadotrophin releasing Hormone) analogues. Side effects are plenty and in most cases very distressing.
Surgical treatments include cautery and cyst removal, which can be complicated in the presence of adhesions: in some cases the adhesions may result in the need to remove all of the reproductive organs.
Combined treatment is frequently used.
Recurrence is common after surgery and drug treatment.
is through the history, by ultrasound and during a laparoscopy.
An ultrasound finding of cysts with the characteristic
history is diagnostic, but a negative finding for cysts does not preclude
the disease and a definitive diagnoses is only possible by laparoscopy
This is merely my opinion based on observations I have made regarding the cases that I see.
I believe that prostaglandins used to induce labor may be implicated in causing the lowered resistance and predispose to the implantation of the endometrial cells at ectopic sites. Other procedures done in the investigation of infertile women may also cause the same problems.
Also, I have seen cases of endometriosis worsen or become symptomatic after the woman has been given clomiphene, a fertility drug which over-stimulates the ovaries, can cause hormone imbalances and a lot of scarring in the ovaries. This in turn predisposes to endometriosis of the ovaries.
Also, there seems to be a strong emotional element in that many patients have a history of strong emotions, especially regarding their husbands and sexual matters before the onset of the complaint. These emotions are negative, and may involve the sex act.
It is important to record emotional events in history-taking since emotions may have a bearing on your choice of remedies.
Below are some remedies that have been frequently used by me, based on the women's feelings towards their spouse/sexual partner. Women tolerate a lot of mistreatment, but it is manifested in them as disease.
Platina (married someone not good enough),
Sepia (does not like her husband very much),
Nat Mur (suppresses her anger etc),
Ignatia (lost her fiancé, did not get to go to college),
Lachesis (found out husband has a lover, second wife),
Arnica (the abused wife fearing that the husband will hit her),
Thuja (believing she is fragile, cannot tolerate the rough handling by spouse/partner)
..........................
Consider these rubrics for finding the remedy
Rubrics regarding the pathology
Other possible rubrics include the type of pains and time of pains as well as the rubrics pertaining to the emotional state, as well as possible concomitant complaints such as asthma, etc
Remedies to look at
Among the remedies that I have found most frequently useful are the following.
natrum mur, pulsatilla, lachesis, sepia, nux vom, ignatia,platina, palladium, thuja, apis, hamamelis, arnica .lycopodium, graphites staphisagria .
#Sarcodes Thyroidinum #
Nosodes, carcinosin, tuberculinum, vaccinotoxinum, variolinum
The above are familiär, but there are some others that are not included in most materia medica.
aphis, flav, nep, rauw
The following I consider the ones most commonly indicated:
coloc, mag phos, pulsatilla, thuja, thyroidinum, sepia, lach, calc fluor
What is, most needed in treating endometriosis is to resolve and regress the ectopic endometrial tissues, which cause symptoms to worsen during each menses.
In some cases the menstrual flow itself is heavy,
The presence of bleeding at the ectopic sites during the menstrual periods produces a deposition of iron at these sites, with attendant problems. Absorption of this iron would certainly be of use.
You will find that remedies to aid in the absorption of
iron may be used at different times during the treatment.
These include
Arnica, Hamamelis, Lachesis.
I suggest that:
induration female genitalia and
injuries with extravasations,
found in Kent rep be used as eliminating rubrics, because remedies which are not included in these rubrics may not act deeply enough.
Also, there are homeopaths who use herbs intercurrently with homeopatuy. For these people, I suggest looking at
dong quai, a Chinese herb, and shark cartilage.
These have been known to be useful in controlling the proliferation and inhibiting the ovarian hormones, thus regressing the lesions.
I very seldom resort to herbs, though in Malaysia we have Paramaria and the Gel from a sea cucumber called Gamat ,which seems to be even more effective in shrinking the lesions and absorbing the necrotic tissue.
I prefer to use homeopathic acute remedies when needed to control these symptoms.
Among them are
mag phos, arnica, hamamelis, colocynthis
Endometriosis is a very complex condition , which you will find needs frequent change of remedies, because of the changing symptoms picture, and treatment is very protracted and sometimes frustrating for the inexperienced.
This is certainly not always the case, because some respond very quickly.
The degree of pain may not be an indicator of the seriousness of the lesions; some very bad lesions may be almost painless and some with very minimal pathology may be very painful. I consider the case to be moving in the right direction when the patient is emotionally stable, her cysts shrink, the inter-menstrual bleeding stops and her cycles lengthen while the duration of the bleeding reduces.
Pain is among the first to disappear, but sometimes this does not mean a cure, but a palliation, because you may find the cysts continuing to grow and all the cyclical symptoms remaining the same.
Per vaginal discharge (watery or pink or brown or bloody) which may be absent when first starting treatment, will first appear. It may even become copious, and is often a source of worry for the patient. However, this is necessary, because that is the way the cysts shrink, by expelling their fluids. It is only when the cysts have truly shrunk and the cycles lengthened that the discharge disappears again. This can take months.
As I have mentioned, while the endometriosis is the most worrisome problem to the patient, there are many other systems which will affect the patient and the remedy selected will have to take all of the patient into consideration.
These conditions will come back if they have disappeared at the onset of the endometriosis.
I find it very useful to draw a timeline when I start my management, so that I can anticipate what will come back, and can select a remedy that will fit the whole patient.
Sometimes, the patient will forget to tell you everything. I do not find this is too much of a problem; adjustments can be made, and in my experience, spoiling a case is not an easy thing to do.
Homeopathy is a very benevolent and forgiving art. That is what I find, perhaps because that is what I expect it to be.
Also to take into consideration is the cyclical nature of many of the symptoms-- the pain will come at a certain time, the abdominal pain and indigestion, even the emotions will go up and down, the discharges come and go only to come back at the same part of the cycle the next month. Selection of the right remedies has to take this into account.
Because of this, sometimes the patient may not be aware that she is improving and it is only on close questioning and examination that you will be able to monitor the progress.
Vacinosinum or vaccinotoxinum and variolinum
Vacinosinum is similar to variolinum, but seems to be
more appropriate , since almost everybody has been vaccinated for smallpox
if they are above 25 years old, and those who have not been, would have
inherited it from their parents as a form of vaccinosis.
In fact the remedy is more effective than variolinum
in cases of moluscum contangiosum.
It is a sycotic remedy , variolinum was used by Burnett
mosts successfully for tumors when the symptoms matched.
The person needing this remedy is chilly
Also if the patient has a kind of gut dysbiosis or the
more modern term leaky gut with its characteristic allergies etc, it could
be that vaccinotoxinum maybe needed. I suggest this remedy be studied and
thought of to be used ,especially in intractable cases of uterine bleeding
with tumors and accompanied by the characteristic backache.
Allen has variolinum, also in Clarke's there is mentioned
characteristic headache, and there is a brief description of the emotional
state. Julian OA has a description of both vaccinotoxinum and variolinum in
his materia medica of nosodes
I usually do not start off with this remedy, but have found that, when indicated and given at some point, the progress that comes after is remarkable. This remedy is very close to thuja, and in some cases thuja would be indicated, sometimes both, at different times.
Arnica
You may not think of arnica ,but it is frequently indicated because of its ability to absorb the extravasated blood.
I use it as an intercurrent remedy in low potency in intractable cases.
Indeed, to use it you would have to base your prescription on the patient's totality as well.
It is sometimes more than just an intercurrent in that it may correspond very well to the mental state of some wives who for some reason regard sexual union as an act of violence upon them and fear the `attack' yet at the same time submit.
Hamamelis
may be bettersuited to some;
and you may need other remedies which have the rubrics
of injuries: extravasation of blood and induration female genitalia.
Thyroidinum
It is worth noting that thyroid dysfunctions, even when the thyroid tests are normal, can lead to a general aggravatio during menses.
I have frequently prescribed thyroidinum successfully when Im have met with these symptoms:
Thyroidinum is a remedy which I find really helps the general health of the patient when indicated, but is never the principal remedy.
Other remedies are indeed needed to bring the patient to cure.
While the thyroidinum patient is usually chilly, there ares ome who are very hot, but the characteristic sensitivity to weather changes should be present.
Too thin or rather overweight are the two poles of this
remedy, as is too active or too sluggish, and so on.
Skin is usually dry.
Carcinosinum
This nosode is frequently called for, and I would use it when there is a strong family history of cancer, diabetes and or mental illness, along with the other pointers to this remedy, including controlling parents or spouse, the food likes and dislikes, concern over appearance , liking for cats etc.
In one of the first few cases I treated, indicated remedies failed to act until I gave the carc, then the patient's energy erturned , she underwent a personality change ,and from then on things started moving.
This patient had mild asthma, the carc brought that back as well, and this case is one of the most complicated that I have treated .
Lachesis
A case I particularly remember had a pain that came on while she was sleeping, which woke her up. She always had a lot to say. Her cyst was on the left. She first noticed her periods becoming painful after a very difficult year in her marriage when she was trying to come to terms with the fact that her husband had been unfaithful for a whole year and she had been oblivious to it. She decided to stay in the marriage, but every time she had relations with her husband, she relived her revulsion of his unfaithfulness.
She had had Sepia before the Lachesis, which seemed to help, but it was the Lachesis which shrunk her cysts.
When Lachesis fits the patient like this, it is a most suitable remedy for the per vaginal discharge which is frequently bloody, and if you understand how this snake poison actually causes a necrosis, you may begin to understand how it repairs the damaged tissues and resorbs the blood cysts in endometriosis .
One problem I encountered with this patient was that while the Lachesis suited her a lot, she was very much an affectionate and sweet person, Under Lachesis she lost some of her mildness, and she complained, "Dr, I come on too strong!.' You may not agree with me over this, but when the Lachesishad done all that it could, I gave a dose of Pulsatilla, which was very much like her before the onset of the problems, and she recovered her sweet mildness.
Thuja
Endometriosis is an -osis , which means that it is essentially a sycotic condition.
Thuja corresponds very well in many ways to the disease and would be an extremely useful remedy in this condition.
The left side is usually affected.
Thuja has a general aggravation during menses, and the urinary symptoms may point to its use.
The sounds and live animal' in the abdomen may be present as well as the mental state of thinking herself fragile and fearing a rough spouse/partner.
Staphisagria
It may be useful in endometriosis because it is related to suppressed anger, to which some women are prone.
It has inflammation of ovaries, menses late but heavy
or irregular, and the aggravation during menses may manifest as toothache.
It has aggravation every new moon or before full moon,
which I may take as a periodicity which is typical of endometriosis.
It is a sycotic remedy, with lots of urinary symptoms.
It also has all the allergy manifestations so common in endometriosis cases.
It has effects of operations with sharp instruments.
I find many cases of infertility either already have
endometriosis or develop it after instrumentation, and endometriosis cases
do end up with all kinds of surgical interference which sometimes worsens
the condition instead of improvement.
There are many other useful remedies you may want to study
in detail.
Among these are mag. carb and kal. carb.
These have periodicity as well as the aggravation
during menses.
These are the main points to consider in treating a case of endometriosis
This example illustrates two of the above points.
A patient with a very long history of dysmenorrhea came to me asking for help in getting pregnant.
Her menstrual history made me I suspect an organic reason for the dysmenorrhea. Scanning showed an ovarian cyst on the right side.
I drew a timeline and got the patient relate to me her history as far as she could.
These are the events in her life and how they relate to
her disease
Age related events:
13 Menarche, not painful no problems
19 left school worked in factory, not happy, wanted to further her studies
20 gradually started to have painful menses, aggravated by cold, less severe if she was physically active
21 went to college, menses pain improved; she attributed this to her involvement in games, handball.
23 menses started being painful again, she lost her fiancé in an accident before this, but attributed the subsequent pain to the fact that she stopped games and started to work as a teacher.
25 Got married, initially reluctant to do so; it was an arranged marriage. She grew to love her husband but her menses remained painful.
She works as a teacher, wonders why she is not yet pregnant after one and a half years of marriage.
This sequence of events shows that her menses started getting painful when she was working in the factory , which she did not like; she was very sad because her ambition was not to be a factory operator but an educated professional. Her pains reduced when she was happy in college and came back when she lost someone she loved very much.
When I repertorised this case, even the modalities which she reported pointed to Ignatia, and Ignatia alone solved almost the whole case.
There are times when the person is so dominated by the illness, you can hardly see the person. Her life is ruled by the time of the month - each time in the month bringing with it some health problems, the peak of it being a few days of excruciating pain, which may or may not be relieved by painkillers.
In these cases, I take the complete history and then
concentrate on the endometriosis, its cyclic nature and the character of
the pain.
Sometimes I can see the constitutional remedy and
I will give that, but the constitutional remedy is not enough to deal with
the endometriosis.
So, I will have other remedies, carefully selected
to deal with the time of the month.
This very complicated case illustrates these points.
A woman of 25 who had had surgery to remove cysts, had been on Danazol and later GNRH analogues, came only a month after the GNRH analogue treatment. A scan showed a fibroid uterus as well as some more new cysts.
Taking her case was not easy, and I first gave her pulsatilla, because it seemed to fit. There was a general improvement but she had other problems, which the pulsatilla did not cover, and I gave her Nux vomica, to no avail.
I retook her case one day after she came in during a rather
severe episode of dysmenorrhea. I noted her physical symptoms; she was
pale and had cold sweat, the pain came in spasms, very severe, she vomited
during the pains and said she had diarrhea just before the onset of the
menses. She presented a picture of veratrum album.
On further questioning, I managed to get a few more symptoms,
which I had missed earlier, including a tendency to sore throats, relieved
by cold drinks. I discovered also that she was very easily startled.
Constitutionally and from her appearance she was phosphorus.
I gave her phosphorus to take after her menses and veratrum
album to take during. This worked fine for her. She still has the fibroid
uterus, but the pains are improving, and her other problems are also reducing.
I do not know what would have happened had I given her
kali carb which seems to cover all her symptoms, but I felt it was not
actually suited to her as a person and to her general modalities. Another
remedy I may consider later is mag carb.
In the case above, besides homeopathic remedies to cover the acute episode, I had on occasion resorted to giving mefenamic acid or ibuprofen for a few days during the pain. It helps to control the pain as well as the bleeding, while not interfering with the cure.
The bleeding, when heavy or protracted, may also need to be dealt with by another remedy besides the main one given for her whole person.
I have found to be of use
arnica, hamamelis, mille folium, calc fluor.
To find the best remedy, however, look to the color of the blood, the nature of the pain, and use all the usual methods of selecting a remedy, because homeopathy is never routine prescribing. I give this usually on the third day of the menses and it seems to act to heal the bleeding ectopic spots which contribute to the pain and suffering the patient experiences during her menses.
Some useful rubrics for this are:
Injuries extravasations, with:arn., bad., bry., cham., chin.,cic. con., dulc, euphr, ferr., hep., iod., lach., laur.,nux-v., par., plb., puls., rhus-t., ruta., sec., sul-ac., sulph.
Why did I include calc fluor?
I find it useful; it also has b leeding, as noted in
Clarke's materia medica and, you will find calcarea good for repairing
the damage of endometriosis lesions.
Endometriosis, as I mentioned before, is sycotic, and I have found that some writers have named thuja to be of immense help in endometriosis. I have no doubt that it is, if the case fits.
Agar., alum., alumn., anac., ant-c., ant-t.apis.,aran.,arg-m., arg-n., aster., aur-m., aur., bar-c., bry.,calc., carb-an., carb-s., carb-v., caust.,cham.,cinnb., con., dulc., euphr., ferr., fl-ac.,graph., hep., iod., kali-c.,Kali-s., lach., lyc., mang.,med., merc., mez.,nat-s.,nit-ac.,petr.,phyt.,puls.,sabin., sars., sec., sel., sep., sil., staph., sulph.,thuj.``````
Remark by Luise: Dr. Osman here said she had marked in bold the remedies that are relevant for endometrioses. This marking got lost in the conversion from "word" to my text processing program. Sorry.
Possible adhesions in the abdomen in cases of endometriosis can mean abdominal pain throughout the month as well as backache, sacroiliac pain and other bodyache and a very poor digestion. These symptoms can also be a result of surgery for removal of cysts, whether it be conventional surgery or laparoscopic surgery with electrocautery.
This URL is for a website on the complications of laparoscopic surgery http://www.chirurgieendo.asso.fr/endosurg/2%20CONDITIONS/INSTALLATION/anglais/complic.html
While I normally would give remedies that fit the whole case
and include the symptoms of the adhesion colic, it would not be wrong to
base a prescription on the cause of the abdominal pains, and give remedies
known to treat the complications of surgery. This would include among others,
thiosinaminum, graphites,silica, calc flour, staphisagria and others.
For this you may check on the rubrics indurations
in general as well as indurations uterus and indurations ovaries,
and also side effects ovariotomy.
In Kent there is one remedy for induration after injuries
and that is conium.
Also useful may be injuries soft parts of.
It is interesting to note that many remedies listed in
Kent for this are also remedies which I have already mentioned.
Under injuries soft parts of, are:
arn, cham, con, dulc, euphr,lach, puls, samb, sulph, sul ac
Regarding the cyclic nature of the ailment, these are the useful remedies from the rubrics as below
G; Generals; PERIODICITY, of symptoms or complaints; twenty-first day (10):ant-c., ars., ars-met., aur., chin-s., mag-c., psor., sulph.,tarent., tub.G; Generals; PERIODICITY of symptoms or complaints; twenty-eighth day (6):
mag-c., nux-m., nux-v., puls., sep., tub.
Added to this are remedies not easily found in any repertory, that is,
oophorinum, folliculinum, hypophysin, orpituitarin.
These have periodicity and may be of use.
I hesitate to give suggestions on posology because frequently this is very much individuated and will differ on a case to case basis. I have often had to make adjustments to the potency when the patient has shown a great deal of sensitivity, and in some cases a lack of sensitivity. Endometriosis however is a condition which affects very sensitive individuals with deep pathology, and my usual method is to give low and repeat frequently, although some may prefer using LMs. In the case of nosodes and remedies which fit the patient mentally, I usually give above 30c.
As I have said before, endometriosis is an identifiable condition which affects more women than have been diagnosed with it, One author claims that it affects 10% of all women, and 30% of infertile women between the ages of 15 and 48.
The approach that I have suggested can be used even for cases that have the symptoms even if no positive diagnosis have been made.
In the light of the possible complications of a laparoscopic diagnosis, I would encourage that treatment be started without the need for this, and, I usually rely on the clinical picture as well as an ultrasound diagnosis.
Having said that, in cases of possible neoplasms (cancers), it is much safer to refer the patient for further investigations. When in doubt, refer!
The approach that I hope to offer here is a practical one, that deals with the real life problems in less than perfect situations - hence my inclusion of other means for the patient's comfort and speed of cure.
As Hahnemann said,
The physician's high and only calling is to restore health to the sick, which is called healing. The highest aim of healing is the speedy, gentle, permanent cure of the sick according to clearly intelligible reasons. The physician should understand: 1st. What is curable in disease in general and in each individual case in particular 2nd. What is curative in drugs in general and in each individual drug in particular; 3rd. How to apply, with distinct reason, what is curative in drugs to what is curable in diseases, and match the proper
Repertories: Boericke, Synthesis rep, Complete rep. Clarke's
materia medica Ghosh's materia medica of nosodes
Golan, Ralph MD, Optimal Wellness
Julian OA's materia medica of nosodes,
Kent Kent's article on Remedies Related to Pathological
and tissue changes.
Kent's materia medica.
Murphy's 2,
Murtagh's Text book of General Practice,
Stencher, Morton, Office Gynecology
Generals; PERIODICITY, of symptoms or complaints; twenty-first day (10) G; Generals; PERIODICITY, of symptoms or complaints; twenty-eighth day (6) F; Female; MENSES, general; agg. during (89) F; Female; MENSES, general; after, agg. (43) F; Female; MENSES, general; before, agg. (78) A; Abdomen; SORE; pain; menses, during (12) A; Abdomen; DISTENSION,; menses, during (28) A; Abdomen; DISTENSION,; menses, during; after (5) A; Abdomen; DISTENSION,; menses, during; before (20) A; Abdomen; SORE; pain; menses, during; after (4) A; Abdomen; SORE; pain; menses, during; before (6) F; Female; CYSTS, genitalia; ovarian (41) F; Female; CYSTS, genitalia; ovarian; left (7) F; Female; CYSTS, genitalia; ovarian; right (6) A; Abdomen; PAIN, abdomen; menses; during (105) A; Abdomen; PAIN, abdomen; menses; after (18) F; Female; ENDOMETRIOSIS, acute (38) F; Female; ENDOMETRIOSIS, acute; chronic (44) F; Female; INFERTILITY (81) F; Female; DISCHARGE, vagina, (see Vaginitis) (164) F; Female; DISCHARGE, vagina,; bloody (77) F; Female; DISCHARGE, vagina,; brown (22) F; Female; DISCHARGE, vagina,; bloody; menses, after (9) F; Female; DISCHARGE, vagina,; bloody; menses, instead of (1) F; Female; DISCHARGE, vagina,; brown; menses, during; before (2) F; Female; DISCHARGE, vagina,; brown; menses, during; after (2) F; Female; DISCHARGE, vagina,; gushing (14) F; Female; DISCHARGE, vagina,; gushing; menses, after (1) F; Female; DISCHARGE, vagina,; alternating, with bloody discharge (3) F; Female; DISCHARGE, vagina,; menses, during; after (82) F; Female; DISCHARGE, vagina,; menses, during; after; seven days (1) F; Female; DISCHARGE, vagina,; menses, during; after; some days (1) F; Female; DISCHARGE, vagina,; menses, during; after; ten days (2) F; Female; DISCHARGE, vagina,; menses, during; after; two weeks (6) F; Female; DISCHARGE, vagina,; menses, during; before (63) F; Female; DISCHARGE, vagina,; menses, during; before; and after (3) F; Female; DISCHARGE, vagina,; menses, during; before; vicarious (1) F; Female; DISCHARGE, vagina,; menses, during; between (14) F; Female; SEXUAL, desire; diminished (50) F; Female; SEXUAL, desire; increased (121) F; Female; MENSES, general; mental symptoms, menses, during (32) F; Female; MENSES, general; mental symptoms, menses, during; after, agg. (4) F; Female; MENSES, general; mental symptoms, menses, during; before (18) F; Female; INDURATION; genitalia (5) F; Female; INDURATION; ovaries (27) F; Female; INDURATION; uterus (17)
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