Rubrics and Remedies useful in DUB
NATIONAL JOURNAL OF HOMOEOPATHY 1998 Sep / Oct VOL VII NO 5.
Dr R K Roy
Remedies Useful In Dub:
A polycrest remedy which covers both the irregularity and unpredictability, hormonal affinity and two extremes of reproductive life is Pulsatilla. Therefore, Pulsatilla and its related remedies are likely to be effective in DUB:
| Pulsatilla Pulsatilla Pulsatilla Pulsatilla Pulsatilla Calc-carb Calc-carb Calc-carb Sulphur Arsenicum Natrum-mur Ignatia |
Calc-carb Sulphur Graphites Natrum- mur Silicea Belladonna Dulcamara Rhus-tox Arsenicum Thuja Ignatia Acid-phos |
The reversible signs between the remedies indicate that the symptoms may change from one remedy to another during the disease evolution.
Nosodes: Amongst the Nosodes, Tuberculinum presents a close picture of unpredictability and irregularity. So, Tuberculinum and other related remedies having tubercular miasmatic elements may be more susceptible to DUB.
Hysterical Group:
Another group of remedies which manifests a picture of DUB are the hysterical group of remedies i.e. those which are unpredictable in their behaviour. Some of these are Stramonium, Hyoscyamus, Aurum, Nux-moschata, Platina, Tarentula etc.
Thuja is also an unpredictable remedy and therefore efficacious in DUB. Lycopodium, which is one of the cyclical triads of Sulph-Calc-Lyco, is found to be effective in DUB. For a particular case, the final selection depends on their peculiarities.
Remedies Selected on Cause:
Ignatia or Natrum-mur may be indicated when DUB develops after a stressful life situation e.g. after the death of loved one. Rhus-tox or Dulcamara may be indicated when DUB develops after catching severe cold, bronchitis or asthma etc.
Case:
I cite here a recent case, which was treated with a constitutional polycrest that is chronic of Pulsatilla. A young girl of 20 had been suffering from oligomenorrhea. An USG of pelvis showed small multiple cysts in her ovaries. Her menses were highly irregular. Her last menses were about six months earlier and very scanty amounting to just spotting. She was overweight [H= 5'2", Wt=70kgs], moderate complexioned, fatty, flabby, sluggish, lethargic, chilly, likes sweets and salts, does not show interest, energy or initiative for any work, including household work. Sweats profusely on palms, reserved, shy and timid. She was given three doses of Calc-carb 200 X 6 hourly, which gave her a period after 23 days. She is under further follow- up.
Repertorial rubrics for DUB:
1. DUB can be considered to mark a kind of hysterical behaviour of women's menstrual cycle. Thus, the rubric 'hysteria' can be used as a starting point This rubric also includes most of the hormone susceptible remedies. Prominent remedies under Hysteria are:
Acet-ac, Acon, Agar, Alum, Anac, Arg-n, Ars, Art-v, ASAF, AUR, Bar-c, Bell, Cact, Caj, calc, Calc-s Camph, Canth, Carb-s, Cast, Canb, CAUST Cham, Chen-a, Chif, Chlol, Cimic, Cinnm, Coca, COCC, Coff, Coff-t, CON, Croc, Elaps, Eup-a, Ferr, GELS, Graph, Grat, Hydr-ac, Hyos, Ictod, IGN, Indg, Kali-c, KALI-PH, Lac ac,LACH, Lil-t, Lyc, MAG-M, Merc, Mill, Mosch, Nat-c, NAT-M,NAT-AC, NUX-M, NUX-V Pall, Ph-ac, Phos, PLAT, Plb, PULS, Raph, Rhus-t, Sec, SEP,SIL, Stict, Stram, Sulph, TARENT, Ther, Tub, VALER, VERAT, Viol-o, Zinc-val, ZIZ
Graded as follows:
Simple ital: 1 mark eg Bell
Italic bold: 2 marks eg Acet-ac,
ITALIC CAPS: 3 marks eg ASAF
Other rubrics to make a totality for DUB are:
| SR 520 | Menses |
| SR 546 | Irregular |
| SR 547 | at puberty |
| SR 547 | long and variable intervals |
| SR 547 | too late |
| SR 550 | at puberty |
| SR 540 | too frequent |
| SR 545 | Intermittent |
| SR 522 | Absent |
| SR 524 | Women, in feeble |
| SR 524 | Plethoric |
| SR 539 | Delayed in girls, first menses |
| SR 535 | During menopause |
| SR 564 | Scanty |
| SR 530 | Copious |
| SR 550 | Protracted |
| SR 567 | too short |
| SR 526 | Before proper age |
| SR 577 | Metrorrhagia |
| SR 591 | Painless |
| SR 528 | Ceases suddenly |
| SR 533 | Alternate period absent, every |
| SR 569 | Suppressed |
| SR 529 | Changeable in appearance |
| SR 540 | Fluid blood contains clots |
| SR 563 | Return after having ceased |
| SR 559 | Pale |
| SR 527 | Bright red |
| SR 538 | Dark |
Tumours [If Established By USG]
| KR 745 | Ovaries |
| KR 745 | Right |
| KR 745 | Left |
| KR 745 | Cysts |
| KR 746 | Fibroids |
| SR 393 | Obesity [If the subject is obese] |
CONSTITUTIONAL SYMPTOMS
- Mental generals
- Physical generals
Modalities
Concomitants
Miasmatic Elements:
The miasmatic aspect connected to DUB provides additional characteristic features to the remedy. For e.g. if the subject has a history of epistaxis [nose bleeding], susceptibility to cold allergy, pneumonia, bronchitis or propensity for worm infestation etc, its tubercular background is further confirmed. Similarly, when ovarian cysts or tumours are established by USG, then a sycotic remedy is indicated, when the bleeding is frequent and profuse. Or a syco-tubercular remedy when the bleeding is infrequent and scanty or profuse. And so on.
Implications of Treatment:
More than 80% cases of DUB in women are due to chronic anovulation. The ovaries fail to ovulate spontaneously and do not secrete estrogen hormone in a normal cyclical pattern, Thus menstrual bleeding is unpredictable. Hirsutism, obesity, oligomenorrhea, amenorrhea and infertility characterize this disorder specifically known as polycystic ovarian disease [PCOD].
Appropriate homoeopathic medicines will bring order to the endocrine functions and establish normal ovulatory cycles.
Chronic amenorrhea needs periodic menses. (even if by withdrawal method), to prevent development of endometrial hyperplasia which sometimes progresses to dysplasia [a pre-cancerous lesion] to carcinoma in-situ to invasive carcinoma. Homoeopathic treatment can prevent uterine malignancy.
