THE MONOGRAM OF GROUPS
Congestive. Catarrhal. Exudative. Ulcerative. Suppurative. Destructive.
Glandular. Scrofulous. Scorbutic. Anemic. Rheumatic. Offensive.
Sensitive. Tremulous. Dropsical. Agile. Chaotic. Debilitated. Syphilitic.
- Congestive: Merc is basically an inflammatory group. Every inflammation begins with congestion and Merc has it forcefully in its pathogenesis. This congestive character has to be differentiated from Aco, Bell or Ferr-p. These three drugs have congestion in their first stage of inflammation. Merc presents a furtherance of activity where suppuration has supervened. An abscess in Merc is of spreading type-more congestion, more redness, more painful, more throbbing and with adjacent lymphadenopathy.
- Catarrhal: Merc causes inflammation of mucous membranes resulting in profuse, thin, slimy, acrid, burning, foul or thick greenish-yellow discharges. Merc covers simple to malignant catarrhs in its pathogenesis.
- Exudative: Exuding the ichorous fluid, pus etc. through affected lesions like boils, abscesses, carbuncles, sinuses, fistulae etc. is the characteristic of Merc. The exudation is usually offensive in nature.
- Ulcerative: Merc has ulcerations of the mucous membranes, esp. of mouth and throat. The syphilitic miasmatic activity is responsible for recurrent and non-healing ulcerations; ulcers based on deep pathologies, or metabolic basis. Syphilitic, phagedenic (necrotic ulceration with prominent tissue destruction) ulcers.
- Suppurative: Inflammation in Merc doesn’t stop at the level of congestion. Inflammatory action is intensely acute and violent and rapidly tends to septic disorganization. It is as if little resistance is offered by the system. Defective mesenchymal system and phagocytosis turns the condition into suppuration. Merc has tendency to pus formation and the pus is thin, green, putrid; streaked with blood. Suppuration in glands, ulcers or even internal vital organs like lungs (e.g. empyema) or kidneys (e.g. peri-nephric abscess or pyelonephritis) comes within the range of Merc.
- Destructive: Merc transformshealthy cells into decrepit, inflamed and necrotic wrecks. Merc is destructive both at body and mind levels. Its lesions resemble those of syphilis. Merc’s action is similar to that of the toxins of infectious diseases. Inflammations of malignant types and often they are associated with prostration. Appropriate Merc salt can be thought of in cases where perforation threatens.
- Glandular: Merchas increased glandular activity, esp. of salivary and mucous glands. Merc has concomitant lymphadenopathy with skin lesions like boil, abscess, ulcer etc. The Syphilitic miasm is responsible for even malignant glandular affections and fevers. Based on scrofulous diathesis, it also covers tubercular glandular affections. Chronic suppurating glands; cold abscesses are dealt with Merc.
- Scrofulous: Tuberculous diseases of lymphatic nodes and of bone, with slowly suppurating abscesses. Merc decomposes the blood, producing profound anemia. It thus affects the nutrition and prepares the ground for scrofulous affections. Syphilitic activity further leads to cachexia.
- Scorbutic: Merc has spongy and bleeding gums. When the general condition is impaired and metabolism gets affected because of malnutrition, scorbusis may get developed. Scorbusis may be a precursor of metabolic diseases like DM
- Anemic: Merc through decomposition of blood, and through bone-narrow depression causes profound or aplastic anemia. Hemorrhages, metabolic disorders, hepatic and renal toxicity are some of the causes of anemia. Hence Merc constitution is emaciated, pale with dark rings around eyes.
- Rheumatic: Rheumatic diathesis is one of the features of Merc group. It has both acute and chronic dimensions. Mercs are sensitive to both heat and cold (human barometers) and they come down with acute joint swellings and pains consequent to weather changes. ‘Redness’ and swelling and throbbing pains characterize Merc.
- Offensive: Merc is filthy, mentally as well as physically. All discharges smell horribly; the decomposition, the debris, the slough, the suppuration; smell emanates from the body. Mercs are, hence, recognized to an observant physician.
- Sensitive: Mercs are very sensitive to weather changes, hence termed as ‘human barometers’. The inflamed part is very sensitive and depicts all characters of inflammation. The reactivity pattern is exhibited well. Sensitivity attracts environmental stimuli; hence modalities or sensory stimuli / inputs are usually available. Sensitivity is also present at mind level.
- Tremulous: ‘Trembling’ is a marked characteristic of Merc. Paralysis agitans – Parkinsonism -come under pathogenetic action of Merc. Syphilitic expressions with a lot of pathologies at nerves, spinal cord and brain resulting in incoordination are responsible for tremulousness.
- Dropsical: Dropsy due to anemia, hepatic, renal or cardiac affections are covered by Merc. Edematous swellings in the affected parts characterize Merc.
- Agile: Merc is basically an‘active’ group. We get rapid development of symptoms leading to destruction. When the active disease processes are present, Merc group is indicated. It is less indicated for remnants or for exhaustion stage. That work is allotted to other groups like Carbon etc. Usually full-blown acute or chronic diseases are found in Merc group because of increased sensitivity and susceptibility.
- Chaotic: The aberrant immune response as expressed in autoimmune disorders give the character of chaos. Under severe infection, the system becomes prey and behaves in an eccentric way. Tubercular miasma actively dominates the scene. The agile character allows the system to go into chaos.
- Debilitated: The sway of disease process under tubercular and syphilitic miasmatic activity depletes the energy. The system can’t continue for long and succumbs. Anemia and malnourishment add to the state of debility. Discharges produced do not ameliorate and further deplete the energy.
- Syphilitic: Merc and syphilis are knot together since antiquity. Merc has in its pathogenesis all stages of syphilis-primary, secondary and tertiary. Low states and phagadenic condition from syphilitic poison. Destructive effects on nerves. It covers both acute and chronic phases. Discharges (which system develops as defense) do not help and syphilitic march is continued.
- CARBON GROUP
|Devitalized –Adynamic – Degenerating – Venous-Scorbutic – Putrescent – Ulcerative – Cachectic Cancerous – Senile- Flatulent – Offensive – Burner|
1.Devitalized: The make-up of the carbon group of remedies is an anemic, broken-down constitution. Persons below par, used up people, by debauchery or from consuming mal-nourished food. Carbon group is indicated in decrepit old people. Defective oxidation and incomplete combustion give rise to low state of vitality. Hence ‘devitalized’ as the character.
- Adynamic: Lack of reaction is the central character of the carbon group. Because of low vitality, they do not respond quickly. They have delayed repair processes or no repair occurs. They are the chief remedies for slow recuperative process. Because of their adynamic character, remedies like Carb-v. or Carbn-sul. are interpolated for the sake of arousing the vitality.
- Degenerating: The carbon group acts on degenerative conditions. The source of Carb-v., for example, is charcoal which is the product after combustion. Fatty degeneration is also covered by carbon group. Senility is characterized by a process of degeneration and Carbon group has slant for old people. Out of all carbon remedies, Carbon-sulph. has more affinity for nerves.
- Venous: The group has venous constitution. It is indicated for varicose veins, varicose ulcers and also for bleeding hemorrhoids. Large protruding blue hemorrhoids are found in Carbo–veg. In other words, when the venous system is predominantly affected, Carbon group is indicated.
- Scorbutic: Bleeding (and swelling) of gums are found in carbon remedies. Because of deficiency of vitamin C or malnourishment in general, scorbusis is developed. Scorbusis may be a precursory indication of metabolic disorders like Diabetes Mellitus.
- Putrescent: Low vitality, lack of repair process, lack of reaction result in decomposition. Discharges are offensive and muco-purulent. Hence putrescent as the character.
- Ulcerative: On the background of the low vitality and repair process slow, there is development of ulceration. We find varicose ulcers; indolent ulcers; chronic phagadenic ulcers; ulcers turning in cancer or gangrene, senile ulcers etc.
- Cachectic: Devitalized character coupled with adynamia and iatrogenic diseases which tell upon the economy make the constitution cachectic. The system breaks down under the sway of conditions like malignancy, metabolic and degenerative disorders.
- Cancerous: Carbon remedies esp. Carb-an.,Carbn-sul., Graph. and Kreos. are indicated in malignant conditions. The syco-syphilitic miasmatic activity produces this diathesis.
- Flatulent: Carbon remedies assume a very important place in acid peptic syndromes. Slow digestion and torpid vitality are chiefly responsible. Food putrefies before it digests; food turns to gas and even the simplest food distresses. Hence ‘Flatulent’ included in the monogram.
- Offensive: The process of decomposition, disintegration, imperfect oxidation and putrescence produce offensiveness of discharges, flatus etc
- Burner: Charcoal, a product of combustion and imperfect oxidation produces this character. Just like ash, internal burning but external coldness is marked. Pains of burning character. Also, it causes ‘burning’ of the tissues through decomposition, cachexia and emaciation.
III. HALOGEN GROUP
|ConcretingGlandular Malignant – Warm blooded Agile -Syco-syphilitic|
1.Concreting: It is the tendency of the system to cause concentric pathologies. To illustrate, Calc-fl. has the concreting pathology of hardness. Instead of an open cancer (this is more for Acid-fluoric), Calc-fl. has more concentric hardness. The process of coalescence is the basis to give the character of concreting to the halogen group and hence its inclusion in the monogram.
2.Glandular: The remedies in the halogen group have affinity for glands. Pathologies of glands range from simple inflammation to ulceration, hypertrophy, atrophy, calculus formation or even malignancy. There are 6 points to mention: Glands get enlarged, inflamed, indurate, suppurate, become atrophied and cancerous.
3.Malignant: All – Flourine, Chlorine, Bromine and Iodine have tendency to malignancy. The halogen remedies act on the reticulo-endothelial system (R.E.S.) and through its disturbance cause malignant changes. Glandular malignancies are more common in the halogen group; or an ulceration may become chronic and then malignant. The miasmatic background of syco-syphilis cultivates the process to develop the cancerous conditions.
4.Warm-blooded: Thermally halogen group of remedies are found to be warm-blooded. They can’t tolerate warmth in general, summer, or hot air. Many disease conditions are aggravated due to above modalities. It is as if the system drains away with heat. Being a strong physical general and being applicable to all halogen remedies, this has been included in the monogram.
5.Agile: The activity index of the halogen group is very high. They are mentally as well as physically very active and it is due to this activity that we find rapid development of grave diseases like tuberculosis, hyperthyroidism, cancer etc. Mentally halogen remedies are restless, active, hurried in nature and in the long run, they may become destructive.
6.Syco-syphilitic: Halogen remedies are poised for organic or structural changes. The illnesses are more found to be in the structural zone rather than in the functional zone. The syco-syphilitic miasmatic dimension which is actively operational over the system produces a lot of chronic, metabolic, endocrinologic and other inveterate disease conditions.
A case of rheumatoid arthritis with lichen sclerosus, varicose veins, HTN and DM :
Age 65 years.
RA since 20 years. Deformities of the fingers and toes since four years.
Lightning like, tearing pains in joints. Stiffness++, < morning, beginning of motion.
LS since 10 years.
DM since 17 years. Tingling and numbness of lower limbs due to neuropathy. Coldness of hands and feet.
Dependent. Daily activities not possible without support.
One left great toe was amputated 1.5 years back due to gangrene.
Chronic hyperacidity. Reflux oesophagitis. Heartburn. Regurgitation. Gases.
Is gradually losing weight.
Recently an ulcer has developed on left foot since three months and and fears that it will turn into gangrene. It is painless and indolent.
Was operated for hysterectomy due to 3rd grade uterine prolapse at 42 years. Now has umbilical hernia and she refuses the surgery.
Despair of recovery. Feels helpless.
Belongs to the rich family. Whole life in luxury. Demanding. Fulfill my demands now. Suspicious. Thinks that she is unwanted at home and others want to kill her. Haughty. Selfish. Restless and anxious. Rigid. What she says and holds is only the right and truth.
Two divorces. The last one due to her loss of libido and sexual dysfunction + her ever demands.
Extravagant in spending money. No compromise in price, will purchase only expensive items. Wears daily an executive saree and keeps it throughout the day.
Worked as a journalist and was always critical of ruling government. Now boasts of her political connections.
Monogram of the case
|Rheumatic – Stiff – Atonic – Gradual – Degenerating Atrophic- Sclerotic – Venous – Progressive – Ulcerative Senile – Dyspeptic – Syphilitic|
Short analysis of the case
Combining the characterswe get through the exercise of monogram with the mental portrait as we receive from the data, it is possible to clinch Plumbummetallicum. In the absence of local/particular symptoms, the module of monogram is very useful.
MONOGRAM WORD MEANINGS
Some word meanings as they appear in remedies have been given for more understanding.
- Calcareous: deposition. Lithemic. Cholelithiasis. Nephrolithiasis.
- Cachectic: malnutrition and wasting.
- Hemorrhagic: pertaining to or marked by hemorrhages.
- Vulnerable: easily injured or wounded. Predisposed.
- Exudative: having pathology of oozing of fluids, result of inflammation.
- Fibrinous: pertaining to a whitish filamentous protein formed by thrombin or fibrinogen i.e. fibrin.
- Tubercular: relating to the tubercular miasmatic activity.Lymphadinopathy, emaciation, hectic fever, profuse bleeding are some of the characters.
- Debilitated: pertaining to weakness.
- Cancerous: pertaining to malignant growth.
- Dropsical: pertaining to edema.
- Collapsy: of state of falling into sudden and extreme prostration resembling shock.
- Agitated: 1. pertaining to excessive restlessness, increased mental and physical activity. 2. the tremor 3. severe motor restlessness, usually non purposeful, associated with anxiety.
- Unstrung: emotionally upset but becoming passive.
- Allergic: pertaining to, sensitive to, or caused by an allergen.
- Dysthrepsia/Athrepsia: digestive failure.
- Dystrophy: disorder caused by defective nutrition or metabolism.
- Herpetic: pertaining to indicate vesicular eruptions.
- Dyspeptic: affected with imperfect or painful digestion.
- Indurating: pertaining to the act of indurations that is hardening of tissue.
- Congestive: pertaining to presence of an excessive amount of blood or tissue fluid in an organ or tissue.
- Constrictive: pertaining to narrowing of vessels. Functional sensation of being restrained or narrow.
- Neurasthenic: person with unexplained chronic fatigue and lassitude with nervousness, irritability, anxiety, depression, headache, insomnia and sexual weakness.
- Ulcerative: pertaining to an ulcer.
- Ataxic: pertaining to or marked by defective muscular incoordination.
- Nervo-billious: Pertaining to stress induced bilious temperament.
- Shaky: Unsteady.
- Senile: pertaining to old age. Cross reference: Aged.
- Plethoric: pertaining to or characterized by over fullness of blood vessels or of the total quantity of fluid in the body.
- Torpid: not acting vigorously, sluggish.
- Anoxic: lack of oxygen and characterized by a generally sub-normal oxygen tension of the blood.
- Scorbutic: concerning or affecting with scurvy.
- Toxic: the state of sickness due to the intense influence of infection or septicemia
- Rheumatic: pertaining to rheumatism.
- Stiff: rigid, firm, inflexible.
- Ecstatic: pertaining to a state of exhilaration, trance like condition or a state of exalted delight.
- Extra-sensory perceptions: pertaining to forms of perception not dependent upon 5 primary senses
- Insidious: deceptive development of a disease (lacking in symptoms or the patient is unaware of it).
- Proliferative: pertaining to reproduction by cell division
- Malignant: growing worse; resisting to treatment, said of cancerous growth. Tending or threatening to produce death; harmful.
- Catarrhal: of nature of or pertaining to inflammation of mucous membranes.
- Flatulent: affected with or caused by gas in alimentary tract.
- Neuralgic: severe sharp pain along a course of nerve.
- Neurotic: one suffering from neurosis.
- Tense: tight, rigid, and anxious, under mental stress.
- Festering: becoming suppurated.
- Sore: tender, painful, any type of tender or painful ulcer or lesion of skin or mucous membrane.
- Venous: pertaining to veins or blood passing through them.
- Degenerative: pertaining to or accompanied by deterioration or impairment of an organ or part in structure of cell and the substances of which they are part.
- Septic: pertaining to pathologic state, usually febrile, resulting from the presence of microorganisms or their poisonous products in the blood stream.
- Soporous: characterized by abnormally deep sleep.
- Stuporous: marked by or resembling sound sleep or coma.
- Concreting: condensing, hardening or solidifying.
- Toxemia: distribution throughout the body of poisonous products of bacteria growing in the focal or local sight thus producing generalized symptoms like fever; diarrhea; vomiting; pulse and respiration weakened or depressed; shock.
- Lymphatic: of or pertaining to lymph or lymph vessel
- Sclerotic: pertaining to sclerosis i.e. a hardening or indurations of an organ or tissue (especially from excessive growth of fibrous tissue)
- Scrofulous: pertaining to scrofula that is a variety of tuberculous adenitis.
- Lithic: pertaining to formation of calculi and concretion.
- Cancerous: pertaining to malignant growths.
- Neurotic: pertaining to neurosis i.e. an unpleasant mental symptoms in an individual with intact reality.
- Epileptic: concerning epilepsy, individual suffering from attacks of epilepsy.
- Deprived: Being not rendered the rights
- Composed: calm and contented.
- Steady: Stable.
- Atrophic: pertaining to wasting; a decrease in the size of organ or tissue.
- Incompetent: not competent, not able or not in position to act.
- Atonic: without normal tension or tone of strength.
- Tremulous: trembling or shaking.
- Atrophied: wasted, affected with atrophy.
- Sickly: pertaining to sickness.
- Fissured: pertaining to fissured i.e. ulcer or crack like sore.
- Devitalized: pertaining to destruction or loss of vitality.
- Declining: pertaining to progressive disease.
- Standstill: still; not moving
- Chronicity: a state of long duration, designating a disease showing little change or of slow progression.
- Depressed: low in spirit; dejected. Decreased level of function.
- Gluttons: Food lover.
- Putrescent: decay; rottenness.
- Destructive: causing ruin or destruction.
- Suppurative: producing or associated with generation of pus.
- Grippy: pertaining to acute infectious disease marked by fever, prostration, pain in head and back and upper respiratory tract symptoms such as cough and nasal congestion; synonym influenza.
- Hyperemic: pertaining to congestion or an unusual amount of blood in a part or a form of macula; red areas on skin that disappear on pressure.
- Malarious: affected with malaria. Causing or resembling malaria.
- Pyemic: related to or affected with blood poison.
- Dyscretic: pertaining to dyscresia or miasmatic constitution.
- Algid: cold, chilly.
- Cyanotic: of the nature affected with or pertaining to slightly bluish grayish slate like or dark purple discoloration of the skin due to presence of abnormal amounts of reduced hemoglobin in blood.
- Glandular: pertaining or of the nature of gland.
- Toxic: pertaining to, resembling or caused by poison. Synonym: poisonous.
- Skinny: pertaining to thin, slender constitution.
- Trepid: marked by tremors.
- Rhoeo-rhematic: various forms of rheumatism.
- Vegetative: having the power to grow.
- Tactophobic: phobia of touch.
- Phthisic: pertaining to tuberculosis
- Neurotoxic: poisonous to the nerve cells.
- Hyperestheic: pertaining to increased sensitivity to sensory stimuli, such as pain or touch.
- Spastic: resembling or of the nature of spasms or convulsions
- Apoplectic: pertaining to apoplexy – 1. copious effusion of blood into an organ. 2. sudden loss of consciousness followed by paralysis caused by hemorrhages into brain; formation of an embolus or a thrombus that occludes an artery or rupture of an extra cerebral artery casing sub arachnoids hemorrhages.
- Syncopic: pertaining to transient loss of consciousness due to inadequate blood flow to the brain.
- Nervous: anxious, characterized by excitability. Pertaining to the nerves.
- Hydric: pertaining to, characterized by, or requiring considerable moisture.
- Chlorotic: of the nature of or afflicted with a form of iron deficiency anemia.
- Salophilic: Craving for salt.
- Inebriate: to make drunk or to become intoxicated.
- Spasmodic: involuntary sudden movement of muscular contraction which occurs as a result of some irritant or trauma.
- Erratic: wandering. Having an unpredictable or fluctuating course or pattern.
- Fitful: Erratic; irregular
- Run down: to lose power, to grow gradually weaker.
- Spoilt: decomposed; destroyed; decay.
- Amative: Sexual
- Periodic: recurring after definite intervals.
- Gouty: of the nature of or related to gout
- Thermophobic: fear of heat.
- Paretic: affected with or concerning partial or incomplete paralysis.
- Stunted: Underdeveloped
- Obsession: pertaining to neurotic, to mental state of having an uncontrollable desire to dwell on an idea or an emotion.
- Hyperplasic: excessive proliferation of normal tissue arrangement of an organ.
- Psychoneurotic: pertaining to emotional mal-adaptation due to unresolved unconscious conflicts. This leads to disturbances in thought, feeling, attitudes and behavior.
The concept of monogram is an objective tool for evaluating the portrait, the patient draws. It opens up the fields of logic, philosophy, pathology, patterns, integration of the intertwining characters and if these characters are understood in their genuineness, a physician is able to see the movement of the disease process under the miasmatic activity in a better way.
The concept of monogram is based on the principle of Generalization. It is as if you precisely and concisely denote the character which defines the problem, highlights the exactness of the problem and you stream down to the essence out of the maze of symptoms. The concept gives justice to the pathology which is nothing but an accentuated form of energy of the disease.
The concept allows one to view the remedy under consideration through not only symptoms but the ‘totality’ through the symptoms. It also allows the study of the patient through a broader vision. The mind-body co-relation is better understood.
While abstraction reduces complexity by hiding irrelevant details, generalization reduces complexity by making a coherent whole. A single construct of monogram thus unifies the raw and scattered data and convincingly puts before the homeopath a roadmap intended for fishing out the most similar remedy, to perceive what is to be cured in a case and to monitor the direction a homeopath is riding. The ability to abstract and to generalize is an essential part of any intellectual activity. Abstraction and generalization are fundamental to philosophy.The concept of monogram is based on fundamental principles of abstraction and generalization.
Remember, it is also possible that the remedy may not cover the monogram characters but can be of use if the symptoms correspond. This occurs due to the layers.The presenting surface layer may be superficial and the system is yet in a process to develop the pathological generals and behavioral patterns. The utility of the monogram concept is tremendous in pathological cases when the PQRS symptoms are scanty. Combining mental expressions, dispositions and state with the monogram words allows the physician to see the parallelism, to see the movement and to assess the miasmatic energy that is operating at various levels of the system.
In ‘Absolute MM’ we have given the ‘Action’ section. It is a natural continuation of the concept of monogram. It explains the rhythm, pace, order and directions of the monogram themes. The blend of Monogram and Action paves the way for a better grasp of the remedy under consideration.There are many rubrics already in our repertory. But a reliable repertory of monogram is the necessity of hour and the author of this paper is working over the project.
I thank my colleague, Guy Tydor,Israel,for his valuable suggestions.
- ‘Absolute Homeopathic Materia Medica’, Dr. P.I. Tarkas and Dr. Ajit Kulkarni, B. Jain Publishers, New Delhi
- ‘On Characteristic Symptoms’, Dr. J. H. P. Frost, ‘Hahnemannian Monthly’, 1874
- ‘Perceiving crucial symptoms’, S. M. Gunvante
- ‘Key-note system of prescribing, some random thoughts’, Dr. Ajit Kulkarni, National Journal of Homeopathy, Mumbai