Oppresses the breath, can’t inhale sufficiently, dyspnoea from anger
Bad effects of alcohol
Delirium tremens
Day blindness
Hiccough in alcoholics
Epileptic attacks in
Eruptions
Vesicular, on hands, feet and body
Pustulous exanthema
Pain
Like a shock through body
Whole body feels beaten and pains as if ulcerated
Sore spots on body
Pains with shuddering
Agg < morning, evening
Agg < change of temperature (getting cold when heated or getting heated when cold), motion, stretch
Crawling
Sp about nose, chin
Very sensitive to open air
Chilliness in chest on walking in open air
Pleurisy pneumonia from sudden change of weather
Degeneration of spinal cord, symptoms agg change of weather
Tingling in fingers
Shooting neuralgic pains in chest, paroxysmal
Intercoastal rheumatism, < wet stormy weather
Shingles/ herpes neuralgia (MEZEREUM)
Pleurisy
Muscular pains, sp shoulder blade
After doing fine work (ACTEA RACEMOSA)
After playing piano
Corns very sensitive to touch
Dreams of drowning/ or swimming
(Think of a person who suffers from bad effects of alcohol. He is quarrelsome and has body aches as if body is beaten like ARNICA. Every change of temperature affects him badly. He gets pneumonia, headaches, neuralgias etc. You might think of SPIGELIA but keep RAN BUL in mind. He also has vesicular eruptions which might lead you to think of RHUS TOX. When you are thinking of RHUS TOX and SPIGELIA think of RANUNCULUS BULBOSUS as it covers both remedies.)
This article is an attempt to correlate symptomatic corelation of AMYL NITROSUM with pathophysiology of NEUROENDOCRINE TUMORS and is yet to be seen by author in practice.
NEUROENDOCRINE TUMORS
Def:  originating from chromaffin cells in the adrenal medulla in case of pheochromocytomas while GIT is the main site for carcinoid tumors.
Release of hormones in response to nervous stimuli.
Eg are- Pheochromocytoma, Carcinoid tumor, Islet cell tumor and some lung cancer like Small Cell CA, Merkel cell carcinoma etc.
PHEOCHROMOCYTOMAS
Hormones involved
Overproduction of catecholamines (group of hormones and neurotransmitters maintaining homeostasis and regulating the body’s response to stress eg dopamine, norepinephrine, and epinephrine).
Characteristic-
Sporadic or familial
Benign or malignant
Often associated with familial syndromes such as neurofibromatosis type 1, multiple endocrine neoplasia type 2, and von Hippel-Lindau disease.
Triggers for catecholamine release
Mechanical factors such as abdominal palpation, sexual intercourse, coughing, sneezing, defecation,
Pain,
Extreme emotions, and
Exposure to cold
Clinical Features
Release of hormone from tumor can be- paroxysmal, continuous, or mixed.
Norepinephrine is typically released continuously, leading to persistent hypertension, while epinephrine is released in a paroxysmal manner.
Episodes of hypertension associated with symptoms such as headaches, tachycardia, and sweating.
Presence of hypertension that is resistant to multiple antihypertensive therapies should raise suspicion for pheochromocytoma
Most commonly overlooked causes of secondary hypertension
Abdominal pain
Constipation
Chest pain
Dizziness
Elevated blood sugar
Facial flushing (redness)
Increased respiratory rate
Nausea
Nervousness, anxiety, and irritability, sense of doom
Typically spells characterized by headaches, palpitations, and diaphoresis in association with severe hypertension.
CARCINOID
Hormones involed and location- neuroendocrine tumors, most commonly arising from the GIT characterized by the secretion of serotonin, leading to symptoms, eg, flushing, diarrhoea, bronchospasm, and systemic complications
Characteristic
Sporadic or familial
Small or bulky
Trigger
Spontaneous
Triggered by certain factors, eg, eating, alcohol consumption.
Liver palpation, or anesthesia.
Exercise, stress, or emotional stress
Certain foods (eg, cheese) may trigger an attack.
Clinical Features
Flushing- Sudden episodes of salmon-pink characterize it to dark-red discoloration of the upper body, particularly the face, neck, and upper trunk, associated with an unpleasant warm feeling, itching, rash, sweating, palpitation tachycardia, swelling around the eyes, and increased lachrymation.
Episodes lasting anywhere from 30 seconds to 30 minutes
Periodic abdominal pain
Valvular heart lesions
Cough dyspnoea or asthma like symptoms from bronchoconstriction
Watery, frothy Diarrhoea and malabsorption or bulky stools, gastrointestinal (GI) bleed or fat in stool
Abdominal cramps
Lengthening duration of attack from initially few minutes to later few hours to even constant flushing in some cases.
DIFFERENTIAL DIAGNOSIS, D/D of Pheochromocytomas and Carcinoid tumor
Facial flushing is a grand concomitant of this remedy and accompanies almost all the symptoms.
Congestion as generality
Acute or chronic
Rush and Congestion of blood to head and face
Flushing and then hot sweat, all over the body or in parts
Localized flushings
Other parts may be icy cold
Least emotions cause flushing of face (FERRUM, COCA) (From the slightest emotion flushing of the face- Hering Guiding Symptoms)
Throbbing and pulsations
Craves fresh air, opens the window in the coldest of the weather (SULPH, LACHESIS, ARGENTUM NITRICUM)
Can’t bear anything around neck, loosens collar
Constant stretching and yawning (KALI CARB)
Convulsions
Immediately after delivery
Paroxysms run close to each other
Grasping at imaginary things during convulsions
Chorea, all muscles are in motion
Angina
With facial flushings
With pain in rt shoulder and arm
Sensation of band around chest
Choking in throat, pain extending into chest
Fluttering and tumultuous action of heart at slightest excitement
Headache
Dreamy confounding with headache
Flushing of face with headache
Migraine with pallor (ARS)
Aggravations
emotions
slight causes
climacteric
heat and closed room
DIFFERENTIAL MATERIA MEDICA
GLONINE
BELLADONNA
LACHESIS
ACONITE
COMPARISON of manifestation
A close comparison of the symptoms the Neuroendocrine tumors sp pheochromocytoma and carcinoid tumors show that AMYL NITROSUM very closely covers the main symptoms of both the conditions sp flushings diarrhoea headache and also triggers such as agg from emotional causes etc.
This is comparison of the most prominent features, further detailed study reveals the parallels between the manifestation in the disease and the medicine AMYL NITROSUM.
Few prominent comparisons are given below:
Intense surging of blood to the face and head, heat and redness; feels as if the blood would start through the skin, with lachrymation. Intense redness of surface with great subjective feeling of heat in face and head. Left side of face and 1. ear get intensely red, coming suddenly and disappearing suddenly during the intervals of the attacks of headache; most after mental symptoms- Hering Guiding Symptoms.
Face, and even the back of the hands, deeply reddened- Hering Guiding Symptoms
Flushing- Sudden episodes of salmon-pink characterize it to dark-red discoloration of the upper body, particularly the face, neck, and upper trunk, associated with an unpleasant warm feeling, itching, rash, sweating, palpitation tachycardia, swelling around the eyes, and increased lachrymation.
Feature
Pheochromocytoma/Carcinoid
Amyl Nitrosum
Flushing
Episodic, emotional triggers
Sudden, emotion-induced
Tachycardia
Paroxysmal, stress-related
Palpitations, tumultuous heart
Sweating
Common in spells
Hot sweat following flushing
Emotional aggravation
Prominent trigger
Marked aggravation
RUBRIC SUGGESTION
COMPLETE DYNAMIS
Face
Redness
Asthmatic complaints with- ACO, CAPS, THUJA
Diarrhoea with- FERR PHOS, JABORANDI
Hypertension in- STRONTIUM CARB
Pulsation about heart with- AMYL NITROSUM,
KENT REPERTORY
Face
Discolouration
Red
Many remedies are given under this rubric
BELL, GLONINE and ACONITE are other medicines which come very close to AMYL NITROSUM in repertorial analysis of symptoms of NET’s.
The final selection of the remedy is just not a pathological similimum but covers the whole history of the patient (anamnesis) with its PQRS, concomitants aggravations and particulars. The angle of prescription depends on many factors.
REFERENCES
Kent Repertory
Boericke Materia Medica and Repertory
The Encyclopedia of Pure Materia Medica- T. F. Allen
NB: This similarity is found only while studying the medicine from a pathological point of view. The confirmation can only be done by applying this knowledge in such a clinical condition, in a patient.
A similar pathogenetic condition may also be present in another drug, the differentiation between such drugs in similar pathologic condition is what makes homoeopathy an individualistic medicine.
This kind of approach is especially helpful when:
The patient is not able to give refined symptoms and sensations
One is not able to find any characteristic symptom or
The attendants are not able to give one,
There is time constraint or
The physician has not seen the patient but has received a diagnosis from attendants.
Pathology is advanced enough to wipe out the PQRS of the case.
The patient has taken conventional treatment masking or modifying the individualistic feature. (Refer to Organon of Medicine for treatment of such cases)
The results in such prescriptions would nonetheless depend on the accuracy of diagnosis and its pathological similarity to chosen medicine.
(This post is for the practitioners of Homoeopathy and not for patients for diagnosis and treatment of the said entity.)
(Similar to collapse remedies VERAT, ARS, CARBO VEG in last stages. So weak that cannot even hold neck when lifted or made to sit down, the head falls back. They are very sensitive individuals, sensitive to others misdeeds, to external stimuli, odors noise etc. They feel nauseated even at the smell of the food. They have joint pains which are very sensitive that mere touch excites pain, least stubbing causes excruciating pain. They have tingling and weakness almost bordering to paralysis. Complaints come after studying hard at night.)
(A detailed d/d of medicines is given in NM Choudhry for nausea of pregnancy. It is as follows:
Nausea of pregnancy
In COLCH. the nausea is felt in the head and is worse while riding a carriage or sailing.
IPEC. is very much like Colch. The nausea is incessant and there is not a moment’s relief.
In KALI CARB we have nausea without vomiting, coming on only during a walk. She feels like lying down anywhere and prefers even dying to such nausea. Great sleepiness while eating is also a marked symptom of Kali carb.
In KREOSOTE the patient vomits sweetish water before breakfast. She retains her breakfast and dinner, but vomits out her supper.
LOBELIA- nausea and vomiting in Lobelia with profuse running of water from the mouth. She is invariably worse after sleeping, and is relieved by taking a little food; after vomiting she breaks out into profuse sweat.
NUX VOM. has ineffectual desire for vomiting. She feels she would be better if she could only vomit.
PULSAT. can be very easily distinguished from other remedies by the excessive bad taste in the mouth in the morning.
TABACUM should not be forgotten where we notice deathly faintness and pallor of the face relieved by going out into the open air.
VERATRUM is to be distinguished by the presence of cold sweat on forehead while vomiting and a great desire for fruits, juicy things, and for acid and salty food.)
Post scarlatinal dropsy (APIS, HELL, LACH) (post streptococcal glomerulonephritis)
Albumin in urine < damp cellars
Pain alternate between naval and bladder
Lungs
Burning
Everywhere, mouth, gums, throat, stomach, GIT, rectum, anus
Meninges
Uterus
Air passages, chest,
Kidney, bladder, urethra (CANTH, BEREB)
Tip of tongue
Epigastrium
Back
Cystitis, cutting in bladder tenesmus
Haemorrhage
Haematuria, cloudy bloody urine, painless
Purpura haemorrhagic, fresh ecchymosis (SULPH AC)
Bowels from, with ulceration and epithelial degeneration (as in ulcerative colitis, typhoid ulcers etc), passive oozing from bowels
Glazed glossy skin, with prominent papillae (ARG NIT, BELL, KALI BI, NUX MOS), peeled off in patches
Excessive distension of abdomen (COLCH)
Worms
Sp lumbricid
With foul breath (SPIG)
Itching of anus
Choking (CINA, SPIG)
Diarrhoea
Fetid, exhausting, watery greenish
Congestion and inflammation of viscera
With haemorrhage
With malignant tendency
Unconsciousness followed by inability to concentrate mind
Capillary bronchitis
Convulsions
Sp on pressing on bladder
Damp weather <<
Neuralgia, as if hot water running in tubes
Sudden gripping and aching
Sore muscles
Urination excited by pain
Pain in bowels cause frequent urination
Pain in knees
Advancing purpuric spots
Band like headache
Enterocolitis with ulceration and haemorrhage from bowels
Typhoid
With tympanitis
Haemorrhage
Prostration
Biliary colic
(Note- Terebinth is an oil prepared from distillation of resinous product from some species of Pines, highly flammable in nature its toxicity closely resembles the symptoms derived in potencies with much finer shades, as happens in provings.)
Link to the medical conditions that are covered by Terebinth
Urticaria after exposure to cold temperature, water, weather, cooling after overheated, swimming in cold water, exposure to cold during surgery.
It is a chronic inducible form of urticaria that can be precipitated and tested by Cold stimulation test
Mechanism- this type of urticaria is IgE mediated, the pathophysiology is thought to involve the cold-induced formation of auto allergens and IgE to these auto allergens, which provoke a release of proinflammatory mediators from skin mast cells.
Symptoms
Appear within minutes of exposure
Swelling redness – angioedema
Itching and wheal formation
In rare cases if airway affected leading to swelling and choking which is emergency condition
Many other GIT/ cardiovascular effects etc
Localized reflex cold urticaria: Confined to specific areas. It has been reported to occur after exposure to cold at the sites of previous ragweed injections for allergies or ladybug bites.
Underlying types
Hereditary or acquired
Primary/ Idiopathic
Autoallergy, autoimmunity, neurogenic pathways and aberrant temperature sensing as underlying mechanism
Secondary
Various underlying conditions have been recognized to which cold urticaria may be associated. A physician when presented with this type of urticaria should suspect the following conditions as underlying disease rather than simply labelling it as cold urticaria.
Rhus tox and Dulcamara are the two classical remedies listed for this type of urticaria. The new repertories list many more medicines other than these two. In author’s practice this urticaria is not as uncommon as is purported by medical literature. Even long standing cases respond quickly and are easily amenable to homeopathic treatment with complete resolution. None of the cases were found to have underlying condition, despite detailed case evaluation. Nevertheless, it is always recommended to keep looking for the starting point of condition (Most probable cause/ exciting cause/ ailment from ) as sometimes patient forget the precipitating event as it happened long back in the past, making the condition chronic in its temporal dimension.
The Encyclopedia of Pure Materia Medica- T. F. Allen
Allen’s Keynotes
Pulford Keynotes
NB: This similarity is found only while studying the medicine from a pathological point of view. The confirmation can only be done by applying this knowledge in such a clinical condition, in a patient.
A similar pathogenetic condition may also be present in another drug, the differentiation between such drugs in similar pathologic condition is what makes homoeopathy an individualistic medicine.
This kind of approach is especially helpful when:
The patient is not able to give refined symptoms and sensations
One is not able to find any characteristic symptom or
The attendants are not able to give one,
There is time constraint or
The physician has not seen the patient but has received a diagnosis from attendants.
Pathology is advanced enough to wipe out the PQRS of the case.
The patient has taken conventional treatment masking or modifying the individualistic feature. (Refer to Organon of Medicine for treatment of such cases)
The results in such prescriptions would nonetheless depend on the accuracy of diagnosis and its pathological similarity to chosen medicine.
(This post is for the practitioners of Homoeopathy and not for patients for diagnosis and treatment of the said entity.)
Colic after eating, stools contain undigested food
< milk sugar, fats
Mouthful of acidic fluid rises from stomach
Sour eructations with one ear hot and itchy
Vertigo with gastric derangement
< coition
Urging for stool and urine after coitus
Itching at meatus after coitus
Thunderstorm causes trembling
< Gaslight
Joint pains
Esp big toe
Alternate with heart complaints, Heart pains better when joint pains aggravate
Eruptions around joints
One pupil dilated
Headache with nausea with one pupil dilated and blurred vision. (? Due to SOL)
Dysphagia
Worms
Colic with worms
Child grinds teeth
Picking of nose
Roundworms and pinworms
Squinting of eyes
Yellowness of all discharges
Tongue coated thick yellow
Yellowish leucorrhoea
Yellowish d/c from eyes
Tonsils covered with yellow coating
Yellow phlegm
Yellow crusta lactae
Very weak/ debilitated
Paralytic weakness of lower limbs
Stool
Sour
Undigested
While passing flatus fears will pass stool
Legs give way while walking
Sensation as if a marble dropped down the descending colon at stool
Itching
Nose, mouth, anus
Eczema and itching near ankles
Morning sickness in pregnancy
Liver enlarged and engorged
Jaundice, give 1x
One ear red hot other pale, one side of face flushed
Sore hamstrings
Sterility with acid secretions from vagina
Semen fluid and watery, smells like urine
Skin
Chafing of skin
Eczema with creamy honey discharge
Hives
Rosy erysipelas
Eczema with symptoms of acidity
Desires
Strong tasting flavors, eggs, fried fish, beer
Aversion bread and butter
(Comes very close to Sepia in its pain in joints, eruptions around joints and indifference to family. Compare Rheum in sourness. A medicine with many facets.)
Post traumatic stress disorder is a constellation of condition that arises in response to exposure to traumatic event or series of traumatic events such as
Exposure to actual or threatened death,
Serious injury, or sexual violence
Or chronic, constant, threatening exposure to violence causing constant concern for safety and life.
Natura disaster/ war
Abuse (sexual, emotional, physical)
The trauma can be either
Directly experiencing by the person,
Witnessing a person experiencing trauma,
Or learning that the traumatic event occurred to a close family member or friend.
Following the trauma the processing of traumatic event is affected in the brain and the trauma maintains its intensity in the memory as it first happened, modifying cognition, mood, causing somatic experiences, and behaviour changes, leading to chronic impairments and an increased risk of comorbid psychiatric illnesses and susceptibility to suicide.
Presentation includes but is not limited to:
Intrusive memories or nightmares
Avoidance behaviours
Negative changes in mood and cognition,
Heightened arousal.
Dissociative symptomsÂ
Recurrent, involuntary, and intrusive thoughts associated with the traumatic event.
Flashbacks, in which the individual may feel or act that the traumatic event is happening again.
Marked physiological reactivity such as increased heart rate and blood pressure on exposure to traumatic reminders
SPONGIA
The following symptomatology indicates that SPONGIA can be one of the leading remedies for the above-mentioned presentation of PTSD. Each of the following symptoms can be corelated with the phenomenon of PTSD.
From various sources:
Anxiety with feeling as if will die or suffocate
Anxiety in sleep, wakes up sudden anxious and sudden, with sense of suffocation, violent loud cough, great alarm agitation, anxiety and difficult respiration
Inclination to weep during sleep
Clarke (A Dictionary of Practical Materia Medica)
Rouses up in sleep as if in a great fright.
She is very timid, and is esp. pursued and incessantly tormented by a frightful scene of some mournful event of the past
< When thinking of her symptoms.
Sad, anxious, frightful dreams
Excessive moral and physical dejection.
Attacks of heat with anxiety; heat and redness of face and perspiration.
The Encyclopaedia of Pure Materia Medica
Anxiety, as if a misfortune would befall him, which he seemed to foresee, she is very fearful, and tormented by a frightful image of a past sad event. She was very easily frightened, and started at every trifle; it always seemed that fear shoot into her feet, and afterwards they seemed to remain heavy,
This kind of presentation can also cover following disorders
D/D
Generalized anxiety disorder
Panic attacks
Sleep disorders or parasomnias
(Many medicines esp. ones which cover AILMENTS FROM FRIGHT/ FEAR will be useful in PTSD and related conditions. Each drug behaves differently when faced with a situation. The final remedy selection depends on this reaction and presentation of patient, its PQRS and analysis by the physician.)
Some Rubrics from Complete Dynamis Repertory, that can be used in PTSD
The Encyclopaedia of Pure Materia Medica by T F Allen
A Dictionary of Practical Materia Medica by Clarke
Boericke Materia Medica
The Guiding Symptoms of Our Materia Medica by Hering
Complete Dynamis Repertory
NB: This similarity is found only while studying the medicine from a pathological point of view. The confirmation can only be done by applying this knowledge in such a clinical condition in a patient.
This kind of approach is especially helpful when:
The patient is not able to give refined symptoms and sensations
One is not able to find any characteristic symptom or
The attendants are not able to give one,
There is time constraint or
The physician has not seen the patient but has received a diagnosis from attendants.
Pathology is advanced enough to wipe out the PQRS of the case.
The results in such prescriptions would nonetheless depend on the accuracy of diagnosis and its pathological similarity to chosen medicine.
(This post is for the practitioners of Homoeopathy and not for patients for diagnosis and treatment of the said entity.)
Sits and stares, doesn’t care about anything that goes around
Can read only left half of the line
Liver
Enlargement after anger
Cracking of joints
Sensation
Emptiness of inner parts
Bones broken, tearing
Vertigo as if swimming with giddiness
Hard swollen glands with stinging pain
Fever
Angry and irritated during fever
Intermittent fever with lameness of back
Chilliness and perspiration with heat
Eating or drinking cold causes tearing in the limbs
Obstinate constipation with tendency to hernia after nux von fails
Aversion to open air
Spasms
Oesophagus, throat, stomach, everywhere
Swallowing difficult after paralysis
Aversion to sour food
Desire beer
Menses
Severe weakness during menses, cant even stand.
Feels better at night than at day
Time passes rapidly
Slowness, takes time to complete each job
Speaks slowly, cannot comprehend
Occipital headache
Metallic taste in mouth
Troubles during pregnancy
Vomiting
Backache
(Compare- GELSEMIUM, PETROLEUM)
(Think of a person who has suffered grief or anger or both, some personal tragedy or trauma. Think in myasthenia gravis, multiple sclerosis, brain tumors, or conditions which cause great weakness. Weakness and paralysis after that. Feels empty inside. Can’t bear contradiction and cries. Trembles. Startles. In a dazed state.)
Gelastic seizure or laughing seizures are spells of unmotivated laughter. The patient has short interval episodes of involuntary laughter.
These unprovoked, out of context episodes are perceived as bizarre by people around.
There is no social context or external trigger for the laughter and happen with no related emotion such as joy or sadness.
The patient may or may not remember the laughter spell. There may be post ictal confusion.
Etiology
These seizures indicate presence of Hypothalamic Hamartomas most of the times.
Some cases have been reported in literature with temporal lobe or frontal lobe as foci of pathology such as tumors, post infectious foci or malformations giving rise to gelastic seizure.
These are non-cancerous, nonprogressive lesion lesions in hypothalamus and are essentially abnormal tissue development in foetus
Associated features
Hypothalamic hamartomas may also be associated with developmental delays, aggression, precocious puberty etc.
Many behavioural and psychiatric symptoms are relatively common such as oppositional defiant disorder, attention-deficit/hyperactivity disorder, conduct disorder, and mood disorder in patients with hypothalamic hamartomas.
D/D
A wider variety of conditions can produce involuntary laughter pseudobulbar effect, which can happen after injuries to brain, in multiple sclerosis or even dementia.
In our Materia Medica this will be addressed by changeability or even laughter alternating with sadness etc.
Agaricus muscaris
A remedy which closely resembles gelastic seizure in its pathogenesy. Below are the different symptoms from various sources mentioned to point towards the similarity between the disease and the drug.
Hering
Gaping: followed each time by involuntary laughter; makes him giddy; and sneezing, with pain in maxillary joint; with stretching, most of arms; and shaking chill.
During violent shaking chill, after undressing in evening, a peculiar inclination to laugh.
Morose, self-willed, stubborn, slow in learning to walk; and talk; on trying to walk; stumbled singularly often.
The Encyclopaedia of Pure Materia Medica
Several convulsions followed each other in quick succession, first in posterior part of the chest, then in the epigastrium, afterwards in the hypogastrium, especially on the right side, attended with a sensation as if the whole body was shaken through; in the evening when standing.
Epilepsy. In patients with epilepsy the fits came on at short intervals.
He yawned frequently and each yawn was followed by involuntary laughter. An impulse to laugh came over in bed, owing to an indiscernibly mixed sensation of happiness and misery.
Boericke
Laughing involuntary from pressure of spine.
Yawning followed by involuntary laughter.
D/D- In complete repertory many other medicines are given, such as- AGAR, BORAX, AURUM, CANN IN, IGNATIA, NAT MUR, PHOS, SEPIA, TARENTULA
In summary Gelastic seizures require careful evaluation for underlying neurological conditions like hypothalamic hamartomas. From a homeopathic standpoint, Agaricus Muscarius stands out as a close remedy due to its unique symptoms of involuntary laughter, convulsions, developmental and behavioural, and emotional disturbances aligning well with the clinical picture of gelastic seizure.
References
The Guiding Symptoms of Our Materia Medica by Hering
Boerick’s Materia Medica
The Encyclopedia of Pure Materia Medica by T F Allen
Complete Repertory
www.medscape.com
www.sciencedirect.com
https://www.ncbi.nlm.nih.gov/books/NBK560663/
NB: This similarity is found only while studying the medicine from a pathological point of view. The confirmation can only be done by applying this knowledge in such a clinical condition in a patient.
This kind of approach is especially helpful when:
The patient is not able to give refined symptoms and sensations
One is not able to find any characteristic symptom or
The attendants are not able to give one,
There is time constraint or
The physician has not seen the patient but has received a diagnosis from attendants.
Pathology is advanced enough to wipe out the PQRS of the case.
The results in such prescriptions would nonetheless depend on the accuracy of diagnosis and its pathological similarity to chosen medicine.
(This post is for the practitioners of Homoeopathy and not for patients for diagnosis and treatment of the said entity.)