From:

Dr.RAGHUPATHI.V.
Post Graduate Student,
Post Graduate Dept. of Organon of Medicine and Homoeopathic Philosophy,
DBHP Sabha’s. DR. B. D. Jatti Homoeopathic Medical College,
Hospital & P.G. Research Center,
D.C. Compound, Dharwad – 580001.

To:
The Registrar
Rajiv Gandhi University of Health Sciences, Karnataka,
Bangalore

[Through, The Principal, DBHP Sabha’s. DR. B.D. Jatti Homoeopathic Medical
College, Hospital & P.G. Research Center, Dharwad]
Respected Sir,

Subject: Submission of Completed Proforma of synopsis for Registration of

Subject for Dissertation.

I request you to kindly register the below mentioned subject against my name
for the submission of dissertation to the Rajiv Gandhi University of Health Sciences,
Bangalore in partial fulfillment for the award of the degree of M.D.(Homoeopathy)
Organon of Medicine and Homoeopathic Philosophy.

Title of Dissertation:

“MIASMATIC APPROACH IN THE TREATMENT OF LOWER URINARY

TRACT INFECTION”

I am herewith enclosing completed proforma of Sypnosis for registration of

subject for dissertation.

Thanking you,

Yours faithfully,
Date : 30-10-2009
Plae : Dharawad.

(DR. RAGHUPATHI.V.)
 “MIASMATIC APPROACH IN THE TREATMENT OF LOWER
URINARY TRACT INFECTION”

SYNOPSIS

Submitted to

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE,

BY

Dr. RAGHUPATHI.V.

Through

DBHPS’S
DR. B.D. JATTI HOMOEOPATHIC MEDICAL COLLEGE, HOSPITAL &
P.G. RESEARCH CENTRE, D.C. COMPOUND, DHARWAD – 580001.
(KARNATAKA)

In partial fulfilment of requirement for the

DOCTOR OF MEDICINE (HOMOEOPATHY)
ORGANON OF MEDICINE AND HOMOEOPATHIC PHILOSOPHY

Under the valuable guidance of

Dr.G.C.HIREMATH MD(Hom)

Professor, H.O.D. and guide

Dept.of Organon of Medicine and Homoeopathic Philosophy.
DR. B.D. JATTI HOMOEOPATHIC MEDICAL COLLEGE, HOSPITAL &
P.G. RESEARCH CENTER, D.C. COMPOUND, DHARWAD – 580001.
(KARNATAKA)
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,
BANGALORE.

Annexure-II

REGISTRATION OF SUBJECT FOR DISSERTATION

1. NAME OF Dr.RAGHUPATHI.V.
CANDIDATE & Post Graduate Student,
ADDRESS Post. Graduate Dept of Organon of Medicine,
DR. B. D. Jatti Homoeopathic Medical College,
Hospital& P.G. Research Centre,
Dharwad- 580001.

PERMANENT Dr.RAGHUPATHI.V.
ADDRESS #1331, Old Kannikaparameshwari
Temple Street, J.L.B road cross
Hunsur(Tq), Mysore(dist)
PIN- 571105

2. NAME OF THE D.B.H.P.Sabha’s

INSTITUTION. DR. B. D. Jatti Homoeopathic Medical College,
Hospital & P.G. Research Centre,
D.C. Compound,
Dharwad- 580001.

3. COURSE OF STUDY M.D. (HOMOEOPATHY) Organon of

AND SUBJECT. Medicine and Homoeopathic Philosophy

4. DATE OF ADMISSION 01-07-2009

TO COURSE.

5. TITLE OF THE TOPIC. “MIASMATIC APPROACH IN THE

TREATMENT OF LOWER URINARY
TRACT INFECTION”.
6. BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY:
The urinary tract, like the respiratory and digestive tracts ends on the
body surface, never be sterile. When the tract is anatomically and
physiologically normal and local and systemic defence mechanisms
intact. Organisms are confined to the lower end of the urethra.
Urinary tract infection is associated with multiplication of organisms
in the urinary tract and is defined by the presence of more than one
lakh organisms per ml in a mid stream sample of urine. In a
undetermined minority, destruction of renal parenchyma and sever
chronic renal failure ensue.

The prevalence of UTI in women is about 3% at the age of

20, increasing by about 1% in each subsequent decade. About 50% of
women suffer symptoms of UTI, some time during their adult life. In
males such infections are uncommon except in the first year of life
and in those over 60 in whom urinary tract obstruction due to
prostatic hypertrophy is relatively common.

The conventional system of medicine uses antibiotics to treat

this condition. The symptoms of pain, dysuria, frequency and
urgency can be very well treated with homoeopathy with its anti
miasmatic treatment with out any side effects, which tends to occur
after antibiotics. Hence the need for study of lower urinary tract
infection with miasmatic approach.

6.2 REVIEW OF LITERATURE :

UTI may be complicated or un complicated. The later may result in
permanent renal damage, the former rarely if ever do so.
Uncomplicated infections are almost invariably due to a single stain
of organism. 75% of the infections are from e-coli. The remaining
being due to protease, pseudomonas species, streptococci or
staphylococcus epidermis, klebsiella.

UNCOMPLICATED UTI:
Anatomically and physiologically normal urinary tract, normal renal
function and no associated disorder which impairs defence
mechanism.

COMPLICATED UTI:
Abnormal urinary tract eg:obstruction, caluculi, vesicouretric reflux,
neurological abnormalities, indwelling catheter, chronic prostatitis,
cystic disorder which impairs defence mechanism eg: diabetes
mellitus, immunosuppressive theraphy.
Factors which limit multiplication of organisms in the urinary tract.
A high rate of urinary flow.
Micturating cystourethrography to identify and quantify vesico
ureteric reflex and disturbed bladder emptying.
Cystoscopy.1

Clinical features of lower UTI.

a.Uretritis.
b.Urethritis.
c.Cystitis.15

Stuart Close says Inflammation and fever are not evils perse. They
are merely the signs of normal reaction and resistance to an irritant or
poison by which nature protects herself. They are not enemies to be
resisted, but friends and allies to be co-operated with in the
destruction of a common enemy.2

Sarkar B.K says in considering the cause of disease attention should

be but is not always suffiently paid both the (a) Soil or the
constitution of the patient and (b) the seed, such as germs or worms.
Until the second half of the century the conception of diathesis and of
constitution were the common places of everyday in practice. But
when the bacteriological investigations proved that many diseases
were directly caused by and could not develop in the absence of
specific germs, the some what intangible factors of diathesis and
constitution thus contrasted with visible micro organism became
over_shadowed and until recently neglected.3

Allen aptly says, throughout the whole urinary tract, we find latent
symptoms of all the miasms. Of the true chronic miasms, Psora and
Sycosis take an active part in the production of disease in these
organs. The tubercular element, however, will be found to be not
entirely absent by any means for it is the tubercular plus the sycotic
element that gives us many of the so-called malignancies and severe
diseases of these organs.4

Harimohan Choudhary remarks “This source or germ of suffering

and death is positive, demonstrable and perfectly recognizable.”
Hahnemann called it the miasm.5

Herbert Roberts aptly says, Disease endings are found in its

pathology but its beginnings no man can see, except as he sees it
through law and knowledge of the nature of the chronic miasms.6
Kent puts forth that; Psora is the beginning of all physical
sickness. Had Psora never been established as a miasm
upon the human race, the other two chronic diseases
would have been impossible, and susceptibility to acute
diseases would have been impossible. All the diseases of
man are built upon Psora; hence it is the foundation of
sickness; all other sickness came afterwards. Psora is the
underlying cause. And is the primitive or primary disorder
of human race. It is the disordered state of the internal
economy of the human race. This state expresses itself in
the forms of the varying chronic diseases, or chronic
manifestations. 7

Phyllis Speight further adds that, the sycotic element is

seen in children when they scream when urinating.
Sycotics have painful spasms affecting the urethra and
bladder. Also gouty concretions are present in urethra of
young babies when born of sycotic paren ts. Diabetic
patients come under the tubercular / Pseudopsoric miasm
with offensive urine which in children may be involuntary
at night as soon as they fall asleep. 8

Hahnemann elaborately explains in regards to Psoric

manifestations in UTI, he says, Psora, during micturition
has anxiety. At times too much urine is discharged,
succeeded by great weariness with painful uri nation. 9

Clarke J.H. says: Burning or scalding, painful micturition drop by

drop, Canth 3,2h. Constant ineffectual desire, contraction of urethra,
emission in drops, Copaiva 3,2h. Urine scanty and high coloured,
burning soreness when urinating, frequent desire, passes only a few
drops, Apis 3x,2h. Sudden and frequent urging to urinate, Petrosel Q,
8h. Flow interrupted by sudden spasm of urethra, Clem 1-30, 1h.
Urine stops suddenly and does not begin to flow again for some
moments, Con. 6, 2h.Again, he advises, Camph. 1x, gtt 1 for acute as
well as strangury due to Cantharides poisoning. In less urgent cases
with burning and inflammatory symptoms, Canth, 3, ½ hrly. With
lumbago like pain, Tereb 3,1/2 h. In women especially Copaiva 3,
1/2h. In purely nervous cases, Bell 3, 1/2h nation.10

Boericke.W places Copaiva as one of the first grade remedies for

acute cystitis, stating that it acts powerfully on the mucous membrane
especially that of urinary tract, producing burning pressure, painful
micturition by drops, retention with pain in bladder, anus and rectum.
Catarrh of the bladder, dysuria. Constant desire to urinate. Urine
smells of violets, greenish, turbid colour, peculiar pungent odor.11

Pathogenic strains of E. coli are responsible for three types of

infections in humans: urinary tract infections (UTI), neonatal
meningitis, and intestinal diseases (gastroenteritis). The diseases
caused (or not caused) by a particular strain of E. coli depend on
distribution and expression of an array of virulence determinants,
including adhesins, invasins, toxins, and abilities to withstand host
defenses.12

A urinary tract infection (UTI) is a bacterial infection that affects

any part of the urinary tract. The main causitive agent is:Escherichia
coli. Although urine contains a variety of fluids, salts, and waste
products, it usually does not have bacteria in it. When bacteria get
into the bladder or kidney and multiply in the urine, they cause a
UTI. The most common type of UTI is a bladder infection which is
also often called cystitis. Another kind of UTI is a kidney infection,
known as pyelonephritis, and is much more serious. Although they
cause discomfort, urinary tract infections can usually be quickly and
easily treated with a short course of antibiotics.13

Symptoms

The symptoms of a bladder infection include:

• Cloudy or bloody urine, which may have a foul or strong odor

• Low fever (not everyone will have a fever)
• Pain or burning with urination
• Pressure or cramping in the lower abdomen (usually middle)
or back
• Strong need to urinate often, even right after the bladder has
been emptied

If the infection spreads to your kidneys, symptoms may include:

• Chills and shaking or night sweats

• Fatigue and a general ill feeling
• Fever above 101 degrees Fahrenheit
• Flank (side), back, or groin pain
• Flushed, warm, or reddened skin
 • Mental changes or confusion (in the elderly, these symptoms
often are the only signs of a UTI)
• Nausea and vomiting

Severe abdominal pain (sometimes)

6.3 AIMS AND OBJECTIES OF THE STUDY

1.To study the miasmatic background of UTI.

2.To study the role of homoeopathic remedies( miasmatic remedies)
in the treatment of UTI.
3.To study the clinical presentation of UTI.

7. MATERIALS AND METHODS:

7.1 PRIMARY SOURCE:

The subject for this study will be collected from OPD/IPD/Rural

camp of DR. B.D. Jatti Homoeopathic Medical College, Hospital and
Post Graduate Research Centre, Dharwad.

7.2 METHOD OF COLLECTION OF DATA:

Definition of study subject:
Patients are considered on the basis of clinical presentations. That is
asymptomatic bacteruria, symptomatic acute urethritis and cystitis
acute prostatitis, acute pylonephritis, septicaemia( usually gram
negative).

Inclusion criteria:
1. Subject of adult age groups of uncomplicated lower urinary
tract infection will be selected for the study, irrespective of
their occupation and socioeconomic status and based on
clinical presentation.
2. Subjects of irrespective sex will be included.
3. Clinical diagnosis done on case history.

Following are exclusion criteria:

1. Subjects with STD
2. Infants and paediatric cases.
3. Upper UTI.
4. Complicated Lower Urinary Tract Infections.
 Study sampling design:
Prevalence rate of UTI in our hospital is 3% considering the
95%confidence interval at 5% permissible error, sample size works
out to be 46 cases.
Since it is a time bound study all admitted and OPD and Rural cases
are included in my study period.

Study design :
Simple random method, Hospital Based time bound study.

Follow up :
Cases are followed for every 15 days for the first 3 months and then
monthly once till the end of study period. Physical, radiological, and
laboratory examinations done periodically when ever needed.
Study period:
From December-2009 to November 2011

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR

INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR
OTHER HUMANS OR ANIMALS? IF SO DESCRIBE
BRIEFLY.

Microscopic examination of urine for

red blood cells White blood cells and casts All patients

Examination of urine for blood, protein,

glucose All patients

Renal ultrasonography to identify obstruction

Cysts and calculi If required

Quantitative culture of mid stream urine

or urine obtained by supra pubic
aspiration If required.

Measurement 24 hours urine protein

excretion orUrine protein/ creatinine
ratio when dipstick protein++
Are more If required
 Intravenous urography including
film of bladder After voiding,
to identify physiological and
Anatomical abnormalities If required

Creatinine clearance If required

Blood urea,creatinine,electrolytes If required

Complete blood count If required

Blood culture If required

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM

YOUR INSTITUTION IN CASE OF 7.3?

Yes, Ethical clearance has been obtained from the institution.

8. LIST OF REFERENCES:

1)DAVIDSON’S Principle & Practice of Medicine 17th edition ,

international students edition, reprinted in 1996, BCC books ltd edinberg,
published by Churchill and livingstone.

2) Stuart Close.The genius of Homoeopathy – Lectures And

Essays On Homoeopathic Philosophy. New Delhi: B.Jain

Publishers; 1993. p 87 -103.

3) Sarkar. B.K. Hahnemann’s Organon of Medicine. 9 t h Revised

ed. New Delhi: Birla Publications; 2003. p 363, 364

4) Allen J .H. The Chronic Miasms and Pseudo - Psora. Vol 1

and 2, New Delhi: B. Jai n Publishers Pvt Ltd; p 239.

5) Choudhary Harimohan. Indications of Miasm. New Delhi:

B.Jain Publishers Pvt. Ltd; 1994. p 3 -6.

6) Herbert A. Roberts. The Principles and Art of Cure by

Homoeopathy. New Delhi: B. Jain Publishers; 1994. p 84, 98.

7) Kent James Tyler. Lectures on Homoeopathic

Philosophy.New Delhi: B.Jain Publishers Pvt Ltd; 1995. p 126.

8) Speight Phylis. Comparison of Chronic Miasms. New

Delhi:B.Jain Publishers Pvt Ltd; p 1, 66, 69.

9) Samuel Hahnemann. Chronic Diseases (theoretical part).

Reprint ed.New Delhi: B. Jain Publishers;1998. p 119.

10) Clarke John Henry. The Prescriber. New Delhi: B.Jain

Publishers Pvt. Ltd; 1998. p 329,366.

11) Boericke William. Pocket manual of Homeopathic Materia

Medica and Repertory comprising of the characterist ics and

guiding symptoms of all remedies. (Clinical and pathogenetic)

including Indian drugs. New Delhi: B.Jain Publishers pvt. Ltd;

1996. p 193, 234, 806, 807.

12)http://www.textbookofbacteriology.net/e.coli.html, as per
2008

13) http://en.wikipedia.org/wiki/urinary_tract_infection , june

2008.

14)http://www.nlm.nih.gov/medlineplus/ency/article/000521.htm

As per 10/02/08

15) Golwalla_ Medicine for students 22nd Edition Published by Dr. Aspi. F.
Golwalla, Empress Court, Eros Cinema Building, Church Gate, Mumbai.
9. Signature of the
candidate
10. Remarks of the guide

11. Name and Designation

of (IN BLOCK
LETTER)
11.1 Guide Dr.G.C. HIREMATH MD(Hom)
Professor, H.O.D, and Guide
Post Graduate Dept. of Organon of
Medicine and Homoeopathic
Philosophy,
DR. B.D. Jatti Homoeopathic Medical
College, Hospital & Post Graduate
Research Center, Dharwad-01
11.2 Signature

11.3 Co-guide Dr.R.C. HIREMATH MD(Hom)

Reader ,
Post Graduate Dept of Organon of
Medicine and Homoeopathic
Philosophy,
DR. B.D. Jatti Homoeopathic Medical
College, Hospital & Post Graduate
Research Center, Dharwad-01
11.4 Signature

11.5 Head of the Dr.G.C. HIREMATH MD(Hom)

Department. Professor ,H.O.D and Guide
Post Graduate Dept. of Organon of
Medicine and Homoeopathic
Philosophy,
DR. B.D. Jatti Homoeopathic Medical
College, Hospital & Post Graduate
Research Center, Dharwad-01.
11.6 Signature

12.
12.1 Remarks of the
Principal
12.2 Signature.