Introduction
Homeopathy, as Dr. Hahnemann described, uses individualization to treat diseases. Later, Dr. Hahnemann discovered miasm to treat chronic diseases.[i]In fact his concept of miasm was on the basis of infectious diseases like syphilis and gonorrhoea. It helped him to handle chronic cases more successfully. After careful observations of the incurable cases he handled, he came to the conclusion that these cases have some genetic link with these diseases. Allopathy, which was focusing on the concept of microorganism as cause of all infectious diseases, is shifting its focus back to genetics what Dr. Hahnemann said around a couple of centuries ago. They were puzzled why the Urinary Tract Infection (UTI) is recurring only in some people, as like Dr. Hahnemann was revolving around why he could not permanently cure certain diseases. Many researchers have been working on to find out the genetic link to the disease for decades. Finally 10 years ago a team of researchers at Lund University in Sweden have discovered a gene linking recurrent UTI.[ii] As true for many diseases, it is not a single gene, but a group of genes responsible for the proneness of UTI. The susceptibility to UTI is controlled by specific innate immune signalling and by promoter polymorphisms and transcription factors that modulate the expression of genes controlling these pathways.[iii] This fact of genetic link with UTI is more specifically established in women by D. Scholes et al.[iv]
Though researchers have only discovered the genetic link, conventional medicine might not have any solution so far. Linking Hahnemann’s concept of miasm with genetics has been substantiated by modern scientific evidences, primarily by a team lead by Dr. Khuda-Bukhsh.[v],[vi],[vii],[viii],[ix],[x],[xi] Hence miasmatic approach seems to be the only possible solution to the genetically predisposed chronic recurrent UTI in women as of date. This article covers the miasmatic indications of recurrent UTI in women and the drugs thereof.
UTI in women
UTI is one of the main conditions causing morbidity and medical expenditure in women. It is reported that young adult women experience approximately 0.5 to 0.7 episodes per woman per year and 60% of women experience UTI at some point. A subset of these women has more frequent recurrent infections.In otherwise healthy premenopausal women behavioral host factors such as sexual and contraceptive practices are strongly associated with recurrent cystitis and pyelonephritis. As stated, many studies have linked genetics influencing the susceptibility to infection. Studies also report that women with recurrent UTIs or pyelonephritis have stronger family histories of UTI compared to other women.4,[xii]
Miasms – a general view
Psora, syphilis and sycosisare the three basic miasms Hahnemann discovered. Later, some authors have extended the concept of miasmwith tubercular, cancer, AIDS, etc. But,more or less, these are the combinations of two or three of the above basic miasms at some proportion. Deficiency, lacking, hypo functional physiology, slow and sluggish mental nature, dryness and weakness are the basic manifestations of psoric miasm. Malfunction or dysfunction, destruction, ulceration, abnormal secretions, putrefaction, tendency towards destruction like suicidal mentality are coming under syphilitic miasm. Hyperplasia, excessive growth, physiological hyperactivity, etc. are from psycotic miasm.Tubercular miasm is the combination of psora and syphilis.
Psora – Mind and generalities
Patient has the tendency to go extreme dullness or extreme intelligence. They are hypersensitive and hyperactive, emotional, anxious and restless. Symptoms can be triggered by suppression of emotions, grief and excitement. Fatigue, malaise and uneasiness may lead to vertigo, which can be aggravated by any motion. General modalities of psora are worse in the morning, new moon, before menses and odours and better by rest. Sour, sweet and bitter tastes in the mouth are especially in the morning. Yellow coating on tongue is one of the key symptoms of psora. Craving for sour acids, sweets and pickles. UTI may be associated with generalised itching and skin rashes. Burning would follow itching and scratching, which aggravates at evening and midnight. Dry, rough, dirty and unhealthy skin would give the clue for psoric presentation. Amenorrhoea or menses would be bland, scanty and too short. Pains worse by motion and better by warmth.Pain may be with constant feeling of coldness in the extremities.
Syphilis – Mind and generalities
In syphilis, the changes would be from functional to structural disorders like ulcers in the urinary tract. Mentally they are dull, introvertic, slow in understanding, with suicidal thoughts, anxious and depression. The intensity of pain would be very high and intolerable. Complaints aggravate during and after rest, extremes of heat and cold, and at night; better by constant motion and cold application. There is always metallic or coppery taste in the mouth.Changes in the body fluids are shown in biochemical evaluation. Extensive damage to the organs, easy bruising and bleeding tendencies.Skin rashes are usually copper coloured and brownish, sometimes with no itching. Rashes leave scar formation after the subsidence. Dark urine may come under syphilitic miasm, since there are structural changes. Grinding and boring pain in joint pains which worse at night and in change of weather.
Sycosis – Mind and generalities
Slow recovery is the cardinal point. Sycotic people are suspicious and jealous. They quarrelsome, deceitful, cruel, cunning and have fixed ideas. They think suicide, but not daring to commit. General aggravating factors are damp weather, change of weather, daytime and meat. Feeling of weakness after sweating and other natural eliminations like stool and urine. Complaints generally relieved by slow motion, lying on abdomen, dry weather and return of suppressed normal discharges. Pain worse by slightest food. Rumbling is there both in psora and sycosis, but relief from pressure and release of gas is sycotic.Scaly and circumscribed spots of skin rashes.Itching worse at daytime and change of weather. Shooting and tearing pains in joints and pain worse at rest, damp cold climate with lameness and soreness; better by moving, rubbing, stretching the body and dry warm weather.
Indications of UTI in different miasms
In order to diagnose the miasm, one has to look at the symptoms of UTI in women more closely. Differentiating the symptoms based on miasm is more important. When the symptoms are differentiated, it is easier to pick an indicated drug covering that particular miasm. Below table gives the symptoms of UTI in women as covered by different miasms.
| Nature | Psoric UTI | Syphilitic UTI | Sycotic UTI | Tubercular UTI | |
| Passage of urination | Retention of urine with body becomes chilled. Painful retention of urine. Sensation as if extremely full. Sense of constriction.
Urine will pass off frequently, involuntarily, when sneezing, coughing or laughing and also in sleeping. |
Severe boring, tearing, bursting and burning pain during urination. Sensation as if acid comes out. | Unbearable pain with screaming when urinating. Frequent urination.
Painful spasms affecting urethra and bladder.
|
Urine is pale, colourless and copious with very little solids present. | |
| Nature, colour and appearance | Yellow, brown, whitish, blackish urine.
Bloody urine, hematuria. |
Dark urine. Brownish dark red urine. Thick blood in urine. | Yellow or dark like dirty water. | Yellowish, greenish-yellow. | |
| Odour | Odourless. | Offensive. | Pungent and musty odour like fish-brine or stale fish. | Offensive and musty. Sweetish or no discernible odour. | |
| Corroding nature | Usually bland. | Bland or acrid producing ulcers. | Acrid and excoriating, producing pruritis. | Bland or excoriating producing itching and eruptions. | |
| Others | Scanty urine.Lack of sexual desire. Sterility, without any original organic defect in the sexual parts. | History of suppression. | History of tumour/polyp | ||
| Modality | Worse | By standing, motion, exercise, morning, new moon and before menses. | During and after rest, extremes of heat and cold, and night. | Damp wet weather, change of weather, daytime and meat. | Milk, fruits, greesy, & oily foods, thunderstorm and night. |
| Better | By rest, lying down and heat in general. | Movement and cold in general. | Slow motion, lying on the abdomen and dry weather. | Dry weather, open air and day time. | |
Frequently used anti-miasmatic drugs in UTI in women[xiii],[xiv],[xv]
Antipsoric: Ars. alb, Ars. iod, Aloes, Apis, Calc. Caust. Hep., Lach, Lyco, Nat. Carb. Natrum.m, Nit. Ac, Psorin, Selen, Sep. Sulph, Tuber, Zinc.
Antisyphilitic: Arg. Nit.Ars.iod, Aurum, Aur.m. n., Carb. an., Carcinosin.,Caust., Kali. sulph., Merc. cor., Merc.iod. fl., Merc. iod.r. , Merc. sol, Nit. ac., Phyto, Sili, Stiling, Syphilin, Tuber.
Antisycotic: Arg. m. , Arg.n., Calc., Caust., Kali.s. Medo, Nat.s. , Nit. ac., Sepia., Staph., Thuj.
Antitubercular:Acetic ac., Ars. alb., Calc., Bacil, Ferr. met., Kali.c.,Nit. Ac. Phos., Sili, Stann. met., Thyroidin.,Tuber.
Drugs for UTI in women with their miasmatic affinity[xvi],[xvii],[xviii],[xix],[xx],[xxi],[xxii],[xxiii]
Arsenicum album
It is a tri-miasmatic drug. Inflammation of the kidneys, with scanty urine, burning micturition, dropsy, and many associated symptoms.Urine scanty, passed with great difficulty; strangury; burning during discharge; suppression in cholera.Involuntary discharge of burning urine.
Belladonna
Though it is a tubercular drug, it covers the acute symptoms of UTI in all three miasms. Violent distress with clutching sensations, burnings and constant urge to urinate. Tenesmus is felt in the bladder after passage of urine. Involuntary dribbling occurs while standing or walking. The urine may be dark and turbid with presence of blood. Burns intensely along the whole length of the urethra.
Lycopodium
Though it is a tri-miasmatic, predominantly a psoric drug. Covers common urinary symptoms of UTI like frequent urination; burning during micturition. Haematuria, urinates quantities of clotted blood. The pain of a burning, cutting character; urine dark and fetid. Urine burning hot, like molten lead. Frequent urging to urinate better riding in cars. Pain in back before urinating, ceases after flow, slow in coming, must strain. Kidney colic in ureter (right) to bladder. Urine, scanty, cries before urinating, red sand, must strain, suppressed, retained. Urine, milky, turbid.Involuntary urination with fever.Urine burning hot.
Nux vomica
Predominantly a psoric remedy due to its functional disturbances.Suits people of more sedentary lifestyle. Covers urging to urinate, with discharge of a few drops of red, burning urine. Pressure to urinate at night, with discharge of a few drops of red, bloody, burning urine. Urine passes in drops, tearing at neck of bladder. Painful, ineffectual efforts to pass urine, with scanty discharge and burning; strangury. With urging to urinate there is also urging to stool.
Arnica montana
It is more of tubercular miasm. History of injury is significant cause of UTI. Urine very acid, burns and excoriates. Frequent emissions of urine. Urine looks like saturated and has a foul smell. Desire to urinate, accompanied by some biting burning, increased after micturition, but not while urinating.
Helleborus niger
It is a psoric drug. Burning heat in urinary organs.Scanty urine scanty with dark and coffee-ground like sediment.Desire to urinate, with only scanty discharge, with violent burning through the whole urethra, in the afternoon.
Kreosotum
It is one of the leading syphilitic drugs. It covers frequent urination, scanty, offensive and burning. The urine smarts and burns the pudenda. Corrosive urine.
Natrum muriaticum
Predominantly psoric, but covers all three miasms. Cutting and burning after urinating, form acidic, copious watery urine. Discharge of pus from the urethra during and after urination (Mer. cor.), causing itching and biting. Urethra painfully sore to pressure.Frequent desire to urinate, with copious flow of light watery urine.Urine dark, turbid, clear and pale. Urine passes involuntarily while walking, coughing or laughing (Caust., Puls., Zinc.).
Opium
A psoric drug.Burning micturition, slow to start; feeble stream.Retained or involuntary, after fright.Scanty and red urine.Diminished secretion of urine.
Phosphorus
A tri-miasmatic remedy, with the predominance of tubercular miasm.Burning in the urethra, with desire to urinate.Tension and jerking, or burning pain in urethra when not urinating. Involuntary emission of urine; smarting and burning in urethra, with frequent desire to urinate; tension over the region of the bladder; acrid, offensive-smelling urine; bloody urine; urine with a sediment of white flocculi; full bladder, but causing no trouble or desire to urinate; unable to pass water or incontinence, both from paralysis of bladder.
References
[i]Samuel Hahnemann, The Chronic Diseases: Their Peculiar Nature and Their Homeopathic Cure, B. Jain Publishers, New Delhi.
[ii]Lundstedt A-C, McCarthy S, Gustafsson MC, Godaly G, Jodal U, Karpman D, et al. (2007) A Genetic Basis of Susceptibility to Acute Pyelonephritis. PLoS ONE 2(9): e825.
[iii]Godaly G, Ambite I, Svanborg C. Innate immunity and genetic determinants of urinary tract infection susceptibility. Current Opinion in Infectious Diseases. 2015;28(1):88-96.
[iv]Scholes D, Hawn TR, Roberts PL, et al. Family History and Risk of Recurrent Cystitis and Pyelonephritis in Women.The Journal of urology. 2010;184(2):564-569. doi:10.1016/j.juro.2010.03.139.
[v]Saha SK, Roy S, Khuda-Bukhsh AR. Evidence in support of gene regulatory hypothesis: Gene expression profiling manifests homeopathy effect as more than placebo. Int J High Dilution Res 2013;12:162-7.
[vi]Saha SK, Das S, Khuda-Bukhsh AR. Phenotypic evidence of ultra-highly diluted homeopathic remedies to act at gene expression level: a novel probe on experimental phage infectivity in bacteria. Jour of Chinese Integrative Medicine. 2012;10:210-27.
[vii]Das D, De A, Dutta S, Biswas R, Boujedaini N, Khuda-Bukhsh AR. Potentized homeopathic drug Arsenicum Album 30C positively modulates protein biomarkers and gene expressions in Saccharomyces cerevisae exposed to arsenate. Jour of Chinese Integrative Medicine.2011; 9:752-60.
[viii]Khuda-Bukhsh AR. Potentized homeopathic drugs act through regulation of gene expression: A hypothesis to explain their mechanism and pathways of action in vivo. Comp Ther Med. 1997; 5:43-6.
[ix]Bigagli E, Luceri C, Dei A, Bernardini S, Dolara P. Effects of Extreme Dilutions of Apis mellifica Preparations on Gene Expression Profiles of Human Cells. Dose-Response. 2016;14(1)
[x]Dei, A. and Bernardini, S. Hormetic effects of extremely diluted solutions on gene expression. Homeopathy. 2015; 104: 116–122
[xi] Debora Olioso et. al., Arnica montana effects on gene expression in a human macrophage cell line. Evaluation by quantitative Real-Time PCR. Homeopathy (2016) 105, 131e147
[xii]Brown PD, Foxman B. Pathogenesis of urinary tract infection: the role of sexual behavior and sexual transmission. Curr Infect Dis Rep. 2000;2:513
[xiii]Harimohan Chaudhary, Indications of Miasms, B. Jain Publishers, New Delhi
[xiv]W. Boericke, New Manual of Homeopathic Materia Medica & Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[xv]R. Murphy, Repertory Version 3, RadarOpus 1.43 (Homeopathic Software), Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[xvi] W. Boericke, New Manual of Homeopathic Materia Medica & Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[xvii] T. F. Allen, Encyclopaedia of Pure Materia Medica, B. Jain Publishers, New Delhi.
[xviii] E. P. Anshutz, New, Old and Forgotten Remedies, 2nd Edition, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[xix] R. Murphy, Homeopathic Remedy Guide, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[xx] W. H. Burt, Physiological Materia Medica, B. Jain Publishers, New Delhi.
[xxi] J. H. Clarcke, Dictionary of Practical Materia Medica, Reprint Edition 1992, B. Jain Publishers, New Delhi.
[xxii] A. L. Blackwood, A Manual of Materia Medica, Therapeutics and Pharmacology, Reprint Edition 1995, B. Jain Publishers, New Delhi.
[xxiii] F. Schroyens, Synthesis Treasure Edition 2009V, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[1]Samuel Hahnemann, The Chronic Diseases: Their Peculiar Nature and Their Homeopathic Cure, B. Jain Publishers, New Delhi.
[1]Lundstedt A-C, McCarthy S, Gustafsson MC, Godaly G, Jodal U, Karpman D, et al. (2007) A Genetic Basis of Susceptibility to Acute Pyelonephritis. PLoS ONE 2(9): e825.
[1]Godaly G, Ambite I, Svanborg C. Innate immunity and genetic determinants of urinary tract infection susceptibility. Current Opinion in Infectious Diseases. 2015;28(1):88-96.
[1]Scholes D, Hawn TR, Roberts PL, et al. Family History and Risk of Recurrent Cystitis and Pyelonephritis in Women.The Journal of urology. 2010;184(2):564-569. doi:10.1016/j.juro.2010.03.139.
[1]Saha SK, Roy S, Khuda-Bukhsh AR. Evidence in support of gene regulatory hypothesis: Gene expression profiling manifests homeopathy effect as more than placebo. Int J High Dilution Res 2013;12:162-7.
[1]Saha SK, Das S, Khuda-Bukhsh AR. Phenotypic evidence of ultra-highly diluted homeopathic remedies to act at gene expression level: a novel probe on experimental phage infectivity in bacteria. Jour of Chinese Integrative Medicine. 2012;10:210-27.
[1]Das D, De A, Dutta S, Biswas R, Boujedaini N, Khuda-Bukhsh AR. Potentized homeopathic drug Arsenicum Album 30C positively modulates protein biomarkers and gene expressions in Saccharomyces cerevisae exposed to arsenate. Jour of Chinese Integrative Medicine.2011; 9:752-60.
[1]Khuda-Bukhsh AR. Potentized homeopathic drugs act through regulation of gene expression: A hypothesis to explain their mechanism and pathways of action in vivo. Comp Ther Med. 1997; 5:43-6.
[1]Bigagli E, Luceri C, Dei A, Bernardini S, Dolara P. Effects of Extreme Dilutions of Apis mellifica Preparations on Gene Expression Profiles of Human Cells. Dose-Response. 2016;14(1)
[1]Dei, A. and Bernardini, S. Hormetic effects of extremely diluted solutions on gene expression. Homeopathy. 2015; 104: 116–122
[1] Debora Olioso et. al., Arnica montana effects on gene expression in a human macrophage cell line. Evaluation by quantitative Real-Time PCR. Homeopathy (2016) 105, 131e147
[1]Brown PD, Foxman B. Pathogenesis of urinary tract infection: the role of sexual behavior and sexual transmission. Curr Infect Dis Rep. 2000;2:513
[1]Harimohan Chaudhary, Indications of Miasms, B. Jain Publishers, New Delhi
[1]W. Boericke, New Manual of Homeopathic Materia Medica & Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[1]R. Murphy, Repertory Version 3, RadarOpus 1.43 (Homeopathic Software), Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[1] W. Boericke, New Manual of Homeopathic Materia Medica & Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[1] T. F. Allen, Encyclopaedia of Pure Materia Medica, B. Jain Publishers, New Delhi.
[1] E. P. Anshutz, New, Old and Forgotten Remedies, 2nd Edition, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[1] R. Murphy, Homeopathic Remedy Guide, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[1] W. H. Burt, Physiological Materia Medica, B. Jain Publishers, New Delhi.
[1] J. H. Clarcke, Dictionary of Practical Materia Medica, Reprint Edition 1992, B. Jain Publishers, New Delhi.
[1] A. L. Blackwood, A Manual of Materia Medica, Therapeutics and Pharmacology, Reprint Edition 1995, B. Jain Publishers, New Delhi.
[1] F. Schroyens, Synthesis Treasure Edition 2009V, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.