Ghabrahat - A Controversial Manifestation
NATIONAL JOURNAL OF HOMOEOPATHY 1993 Jul / Aug Vol II No 4.
Dr Kasim Chimthanawala.

The term Ghabrahat is often used by patients in order to express certain vague manifestations or sensations which occur without any obvious or proportionate cause and are usually short lasting but quite disturbing. They are observed in individuals whose emotional faculty is not strong enough to face difficult situations due to the affliction by some internal day-to-day conflicts.

In reply to one of the queries on this topic (Jan-Feb 93 issue of NJH) I had translated this particular colloquial complaint into a general term as anxiety because the primary questioner had asked only the relevant rubric for the symptom Ghabrahat without any association or qualification. In response to this reply, I received at least half a dozen letters from readers expressing their own viewpoints. A good and a healthy precedence indeed, provided they remain within the ambit of scientific discipline and do not carry any flavour of envy or ill-will.

I fully agree that my replies on debatable subjects like these can raise controversies from different quarters. It is but natural, simply because of their inherent character of non-specificity and vagueness.

It will not be out of place to state that all my viewpoints and suggestions are based on what I perceived from my Guru, late Dr. Kanjilal and also from my own personal experiences, derived from two decades of clinical academic activities. I request my friends not to take them as empty sermons or exhortations. They should judge each item of the views and suggestions in accordance with their own logic and experience and only then accept or reject them.

Before I express my opinion on Ghabrahat it would be worth-while to see as to what others say on the topic.

1. Dr Laxminarayan from Hyderabad opines:
   
   The word is easily understood as a sense of fear or anxiety. Questioning the patient always reveals that Ghabrahat is always felt in the chest or abdomen or stomach. Kents materia medica has a wide coverage of this symptom in Kali-carb and Mezereum. A little patient search of Kents repertory reveals quite a good collection of rubrics -
   1. Anxiety stomach - Pg. 476
   2. Apprehension stomach - Pg. 480
   3. Anxiety in abdomen - Pg. 541
   4. Apprehension in sensation of - abdomen - Pg. 541
   5. Anxiety chest in - Pg. 822
   6. Apprehension chest, region of heart - Pg. 824
   7. Palpitation heart, fright after Pg. 875
      
      
2. Dr. Prashant Sammanwar from Chandrapur is of the opinion that the Ghabrahat is often used by patients who are mentally disturbed and restless. They are sensitive, nervous with worrying nature. There is always a maintaining cause in the surrounding - family, occupation, school etc. The expressions are diverse, from a simple vague feeling in the chest or the abdomen, to certain specific psycho-physiological manifestations like perspiration, palpitations, increased thirst, frequent stools etc.
   
   
3. Dr. (Mrs.) Raksha Sharma of Lucknow, is of the view that it is a term used by women to express their hidden or suppressed emotions in the form of restlessness, fear, worry etc.
   
   
4. Dr. Lekchand Katoch from Kangra expressed his satisfaction on the reply printed in the Jan-Feb. 93 issue.
   
   
5. Dr. S.K. Agrawal of Indore writes, "In Question Answer column Dr. Kasim Chimthanawala has replied for Ghabrahat - rubric to be applied as anxiety with palpitation or fear. But I think that the rubric Anguish would be more appropriate besides Anxiety, fear or palpitation. The supportive rubrics from Synthetic repertory are:
   1. Anguish
   2. Alone when
   3. Amenorrhoea, in
   4. Anger from
   5. Cardiac
   6. Chill, during
   7. Clothes too tight when
   8. Heat, during
   9. Horrible things hearing after
   10. Loss of his friend, from
   11. Menses from
   12. oppression, with
   13. Stormy weather with

I discussed the word Ghabrahat with some of my colleagues individually and also took the views of those who participated in a discussion on this topic at one of our clinical meetings, I then referred, among others, to Bhargavas Hindi-English dictionary, which gives the meaning as - disorder, perplexity, confusion, fury, agitation, hurry, perturbation, at sixes and sevens etc.

The consensus view was that the term Ghabrahat is a symptom used by nervous patients to express some vague sensations of abnormal psyche. The type, form, site, intensity etc. depends on various factors like emotional state, external influences, family environment and so on. There is always a sense of worry or fear at the back of every manifestation.

Thus, taking into consideration all the views and opinions on this topic, we see that the term Ghabrahat basically revolves around anxiety state - nervousness, fear and worry which constitutes the backdrop on which the entire superstructure of symptom syndrome of an individual evolves. Thus it will not be incorrect to rubricate this abnormal state of mind - Ghabrahat as Anxiety.

According to DSM 11 classification it is defined as a type of neurosis which includes phobias, obsessions and compulsion. A Textbook of Abnormal Psychology describes the manifestations of an anxiety state as a condition characterized by tenseness, irritability, fear of impending disaster, palpitation, irregular breathing, apprehensiveness, excessive perspiration, restlessness, insomnia, etc.

All of these changes are most often observed in individuals who are hypersensitive to criticisms and get discouraged easily, They suffer from a feeling of separation evaluation from reality and have a tendency to avoid rather than cope with stressful conditions. Unfortunately the neurotic paradox is that they have a fixed tendency to remain in the same lifestyle even though it is self destructive and maladaptive. In the mental frame of these individuals there is a feeling of inadequacy, faulty perception and self defeating behaviour. All of these individually or collectively lead to avoidance rather than confrontation.

It is often noticed that the anxiety states get expressed mainly through hollow organs which have potentiality of movement, prominent amongst these being stomach, chest, intestines, uterus, bladder, etc.

Inference: The symptom of Ghabrahat as such can be rubricated as Anxiety only.

1. If there is an associated fear, nervousness, apprehensiveness, anguish etc. then take it as Anxiety with.
2. If associated with physical symptoms like perspiration, loose-motions, trembling, etc., then take accordingly.

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