Saturday, September 12, 2009

Papers On ArthritisTo be Presented at 18th International Conference On Homeopathy at Kuala Lumpur 4-5 Oct 2009

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Role of psycho – social causation and subsequent abnormal traits, and also normal traits for the treatment of various types of Arthritis in Homoeopathy.Dr. Sudhansu Sekhar Moharana M.D.(Hom), M.A., M.F. HOM (Malaysia)
Professor & Head, P. G. Dept. of Repertory,
Dr. B. D. Jatti Homoeopathic Medical College & Hospital,
P.G. & Research Centre, Dharwad – 580 001, Karnataka State, INDIA.

Abstract

Psycho – social causation and subsequent abnormal traits is well known causation of psychosomatic ailment such as hypertension, duodenal ulcer, skin disorders, but very few people suffer arthritis. Moreover, normal traits sometimes predispose for arthritis. In this paper six critical arthritis cases e.g., three rheumatoid arthritis cases with defomity, one case of avascular necrosis and one case of gout and one case of post – streptococcal arthritis was cured when medicine selected and differentiated by repertorisation considering all these psycho – social causations, abnormal and normal traits. These cases were referred from allopathic orthopedician and had no relief and got cured by homoeopathic treatment by considering cause, normal and abnormal trait rubrics along with the pathological general, physical generals and other sign and symptoms rubrics by repertorisation. The statistical analysis is done and is as follows:
Medicine Control Group Experimental Group Total
Same as Before 6 (After allopathic treatment) 0 (After Homoeo. Treatment) 6
Cured 0 (After allopathic treatment) 6 (After Homoeo. Treatment) 6
Total 6 6 12
12(6 × 6 – 0 × 0)2 ⁄ 6×6×6×6 = 12
At the degree of freedom 1, at 1% significance level upper tailed value is 6.63, both tailed value is 7.88 and our value is 12. So the test is statistically highly significant.
Introduction
PERSONALITY is the unique dynamic organization within the individual of those psychophysical systems that determine the unique adjustment to his environment stated by G.W.Allport. Thus two identical twins even differ in their behavior with certain unique characteristics in relation to response pattern to both physical as well as psychosocial environment. The sum of these mental and physical differential characteristics from others by external and internal environments are used in psychology for behavioral therapy and for development of interpersonal relationship whereas in homoeopathy the process is known as Individualization used for selection of remedy as well as for counseling. Thus we take the trait approach where “a trait is any distinguishable, relatively enduring way in which one individual differs from another” as stated by Guliford.

Determination of Traits : A trait is determined by unique response to a specific stimuli. For example,

Stimuli Trait Responses
1.Meeting friends
2.Meeting with stangers
3.Dealing with poor and disabled children. Friendliness 1.Helpful
2.Pleasant
3.Warm and interested.
“According to R.B. Cattell, traits are relatively permanent and broad reaction tendencies and serve as the building blocks of personality. He distinguishes between constitutional and environmental mold traits; ability, temperament, and dynamic traits; and surface and source traits.”

The Traits are further subdevided into ability temperament and dynamic traits.
Ability trait refers to person’s skill in dealing with the complexity of a given situation. Thus Intelligent is the ability test by R. B. Cattell.
Temperament traits refers to stylish tendencies – being for example, chronic irritable, moody, easygoing, or bold.

Dynamic traits refers to person’s motivation and interests. An individual may be characterized, for example, as ambitious, power-seeking, or sports oriented.
Unique traits: Unique traits are those specific to one person; for example, Bill is the only person with an interest in collecting 1898 census records for the cities of Baltimore and Los angeles. Virtually all of cattell’s work focuses on common traits, but his incorporation of the Unique – trait concept enables him to emphasize the fact that personalities are unique.

Surface versus Source traits : “The distinction between surface and source traits is perhaps the most important one. Cattell makes.
Surface traits : “simply a collection of trait elements, of greater or lesser width of representation which obviously ‘go together’ in many different individual’s and circumstances”.

A source trait : It is the underlying factor that controls the variation in the surface cluster.”

The major Source traits in 16 Personality Factors:
Low Scored Description Factor Factor High Score Description
Reserved (schizothymia) A- A+ Outgoing (affectiothymia)
Less Intelligent (low”8”) B- B+ More intelligent (high “8”)
Emotional (low ego strength) C- C+ Stable (ego strength)
Humble (submissiveness) E- E+ Assertive (dominance)
Sober (desurgency) F- F+ Happy – go – lucky
Expedient (low superego) G- G+ Conscientious (high superego)
Shy (threctia) H- H+ Venturesome (parmia)
Tough-minded (harria) I- I+ Tender-minded (premsia)
Trusting (alaxia) L- L+ Suspicious (pretension)
Practical (paraxernia) M- M+ Imaginative (autia)

Forthright (artlessness) N- N+ Shrewd (shrewdness)
Placid (assurance) O- O+ Apprehensive (guilt-proneness)
Conservative (conservatism) Q1- Q1+ Experimenting (radicalism)
Group tied (group adherence) Q2¬- Q2+ Self-sufficiency(self-sufficiency)
Casual (low integration) Q3- Q3+ Controlled (high self-concept)

Relaxed (low ergic tension) Q4- Q4+ Tense (Ergic tension)
Newly Discovered Source Traits: In addition to 16 Personality Factors measured by his personality test, Cattell has proposed, based upon extensive subsequent research, seven new factors:

1.Excitability : a factor found in children, increases until early adolescence, and then decreases through adulthood. Cattell stresses that this factor is not to be confused with emotionality and instability. Rather it is a cognitive excitability – a restlessness in which people become hyperactive (Cattell and Kline, 1977, p.113).
2.Zepia versus Coasthenia : People with high scores on Zepia are zestful, enjoying attention, and group action ; Coasthenics lack energy and are reflective and restrained in their behavior.

3.Boorishness versus Mature Socialization : People high on boorishness are ignorant of social requirement, awkward, and unconcerned about others; people characterized by mature socialization are self disciplined, polish and alert to their social responsibility. (Cattell, 1979, pp.66-67).
4.Sanguine Casual individuals are unambitious, self assured, modest and casual. High scores in group dedication with sense of inadequacy are devoted to groups but thinks that others do not see them as successful.
5.Social Panche : People high in social panche feel persecuted by society, whereas explicit self-expression people like drama and the heady discourse of avant grade ideas (Cattell and Kline, 1977, p.119).

Abnormal Traits: Although the source traits utilized in the 16 Personality Factor book can distinguish between normals and neurotics, they do not measure all aspects of deviant behavior and do not asses the characteristic of psychotics. Applying factor analysis to surface traits in the normal and abnormal personality spheres, Cattell has derived 12 new factors that measures psychopathology. These are:
Major abnormal source traits of Cattell asscessed by Clinical Analysis Questionaire:
Fac Normal Source Traits Abnormal Source Traits
D1 Low hypochondriasis: is happy, mind works well, does not find ill health frightening. High hypochondriasis: Shows overconcern with bodily functions, health or disabilities.

D2 Zestfulness: is contented about life and surroundings, has no death wishes. Suicidal disgust: is disgusted with life, harbors thoughts or acts of self destruction.
D3 Low brooding discontent: avoids dangerous and adventurous undertakings, has little need for excitement. High brooding discontent: seeks excitement, is restless, takes risk, tries new things.
D4 Low anxious depression: is claim in emergency, confident about surroundings, poised. High anxious depression: has disturbing dreams, is clumsy in handling things, tense, easily upset.

D5 High energy euphoria: shows enthusiasm for work, is energetic, sleeps soundly. Low energy euphoria : Has feeling of weariness, worries, lacks energy to cope.
D6 Low guilt and resentment: is not troubled by guilty feelings, can sleep no matter what is left undone. High guilt and resentment: Has feeling of guilty, blames self for everything that goes wrong, is critical of self.

D7 Low bored depression : is relaxed, considerate, cheerful with people. High bored depression : Avoids contact and involvement with people, seeks isolation, shows discomfort with people.
Pa Low paranoia: is trusting, not bothered by jealousy and envy. High paranoia: Believes he or she is being persecuted, poisoned, controlled, spied on, mistreated.

Pp Low psychopathic deviation: Avoids engagements in illegal acts, or breaking rules, sensitive. High psychopathic deviation: Has complacement attitude towards own or others’ antisocial behaviour, is not hurt by criticism, likes crowd.
Sc Low Schizophrenia : Makes realistic appraisals of self and others, shows emotional harmony, and absence of regressive behaviour. High Schizophrenia : Hear voices and sounds without apparent source outside self , retreats from reality, has uncontrolled and sudden impulses.

As Low Psychoasthenia: is not bothered by unwelcome thoughts, or ideas, or compulsive habits. High Psychoasthenia : Suffers insistent , repetitive ideas, and impulses to perform certain acts.
Ps Low general psychosis: Consider self as good, as dependable, and as smart as most others. High general psychosis: Has feeling of inferiority and unworthiness, timid, loses control easily.

Utility of mental causation and abnormal or normal traits in treatment:
Case No. 1 Anxiety Ailments: A case of avascular necrosis of head of both the femur
Mr. J.P. aged 28 years, had allergic bronchial asthma with avascular necrosis of head of the femur of both the legs. He had severe mental agony with wife resulted in divorce.

Present Complaints : He had pain in hip, limping & was unable to sit in squating position complained on 21st August 2004.Severe pain in hip, aggravated by movements.
He had pain in hip, limping & was unable to sit in squating position.Cough and hip pain is aggravated by cold. Oedema of the synovial membrane. All the problems were aggravated by alcohol to which he was used to especially after matrimonial anxiety. Patient had undergone allopathic treatment and core drilling by allopathic orthopedicians without any relief.

The X-Ray : Patchy sclerotic / lytic areas are seen involving the right femoral head.
Magnetic Resonance Imaging was done on 25th July 2004.Findings:
• Hypointense crescent is seen within the right femoral head. Marrow within appears hypointense on both T1 and T2 weighted images. Some marginal irregularity is seen. Superior and anterior quadrants are involved.
• Articular cartilages are intact.
• Synovial effusion is seen.

• Hypointense crescent is seen within the left femoral head.

GRADE II AVSCULAR NECROSIS SEEN IN RIGHT FEMORAL HEAD.
GRADE I AVSCULAR NECROSIS SEEN IN LEFT FEMORAL HEAD.


Medicine Anxiety
Ailment Alcohol.
(ailment) Ex,caries
Bones Inflam.
Bones. Motion
Aggrav. Pains
Bones. Results
Ars.alb. 3 1 2 1 2 1 10/6
Asafoet. 1 2 3 2 2 3 13/6
Aur.met. 3 2 1 1 2 2 11/6
Bellad. 3 2 0 2 3 1 11/5
Phos. 3 2 2 2 2 2 13/6
Ph.acid 2 1 2 3 1 3 12/6
Silicea 2 2 3 3 3 2 15/6
Sulphur 3 2 2 2 3 2 14/6
Post – Repertorial Result Analysis :
The high valued chilly remedies are Ph-ac-12/6, Asaf-13/6(both 3rd grade heat and chilly remedy), Phos-13/6, Sil.-15/6.
Silicea may not be indicated here as silicea causes inflammation for removal of necrosed / dead tissues. So silicea is contraindicated where inflammation in vital parts not required although in this case scores highest value i.e., 15/6.
1st Prescription : On 21st August 2004, patient was given Asafoetida 30, 4 globules every 6 hourly in water doses. Justicea adhatoda Mother Tincture 15 drops every 6 hourly with water if patient gets bronchial asthma s.o.s. in spite of asafetida action.

After seven days on 28th August 2004, patient reported that he is well of both bronchial asthma and severe pain in both limbs. He was discontinued to take Justicea adhatoda Mother tincture and kept in Asafetida 30, twice a day in water doses as patient’s bronchial asthma may be precipitated in high potency.
After 15 days, on 14th September 2004, patient reported that his pain is reduced but pain in deep pressure and was limping still. He begged permission to go to Dubai to attend the duty at his regular job. Asafoetida 30, twice daily was continued in water doses and permitted to join his job at Dubai.

After one year, patient came from Dubai, he was asymptomatic of pain, tenderness and limping. The MRI was done on 6th day of September 2005 of both hip joints and the MRI finding report is as follows:
Findings:

• Hypointense crescent is seen within the right femoral head. Marrow within appears hypointense on both T1 and T2 weighted images. Minimal marginal irregularity is seen. Superior and anterior quadrants are involved.

• Articular cartilages are intact.
• No synovial effusion is seen.
• Hypointense crescent is seen within the left femoral head.
• Artocular margins are intact. Acetabuli appear normal.
• Post operative changes are seen within both femoral heads. So, here we only find the Minimal marginal irregularity and diminution of synovial effusion only although pain is totally decreased. He is advised to continue Asafoetida 200, once daily in water doses for another two years as there was no asthmatic episode. Meanwhile he is again married and leading a happy wedded life.

Case No. 2. Anxiety Ailment causing high Bored Depression (D7 of R. B. Cattell’s abnormal trait): Here was a case of E.R.R. aged 30 years suffering from Rheumatoid arthritis due to severe mental tension for her drunkard husband’s torture. She was thin, sad, and in apathy. She had taken Nimusilid tablets for one year by allopathic doctors but without any remarkable effect. When she came to me on 23rd March 2004 she had amenorrhoea since three months. She was anaemic, soreness all over body, schwan neck deformity of mid phallengeal joint of right hand’s ring finger. She had soreness in back. All the joints of hands was affected along with knee joints and ankle joints. There was morning stiffness more than one hours and aggravated exertion, and cold and amelioration by rest and warmth. Patient was extremely chilly. She had piles previously. The above complaints started eight years back slowely when her husband started drinking wine and tortured her. She had no significant past history, only burning sole in her childhood. Her appetite was less, thirst was more. She had sweat more in palm and head during summer.

Lab. investigations: Haemoglobulin – 9.6 gm%, ESR – 58 mm at 1st hour by westerngreen method, R.A. factor was positive, Uric acid was 6mg%, in D. L. C. – Neutrophills – 68%, Lymphocytes – 30%, Eosinophils – 2%.
Med Depress-
ion Apathetic
Uric acid diathesis Arthritis Anaemia Ameno-
rrhoea Haemo-
rrhoids Sore
Fingers
Joints Cold
Temp.
Agg. Motion
General
Agg. Total
Bry 2 1 0 3 2 2 1 1 2 3 17/9
Kali-c 2 2 0 3 2 3 3 0 3 0 18/7
Nat-m 3 3 0 2 3 2 2 1 2 2 20/9
Puls 3 3 0 2 3 3 3 0 2 1 20/8
Rhus-t 3 1 0 3 2 2 2 0 3 0 16/7
Sep 3 3 1 2 2 3 3 1 3 2 23/10
Sulph. 3 2 0 2 3 3 3 1 2 3 22/9

So here we find great value in Sepia which has high bored depression. Thus Sepia 10m one dose was given followed by placebos. After one month she had mense and her schwan neck deformity and sore pain in all joints was reduced. Sepia 10m was repeated after 3 months. On 14th September 2004 her Haemoglobin had increased to 11.2 gm%, ESR was 52 mm at the end of 1st hour, Serum uric acid 5.4 mg%, and RA factor was weakly positive i.e. 1 : 4 .Patient was now totally symptom free but still time is required to get all pathological report negative.

Case 3 Where suspicious trait (L+ of R.B. Cattell’s trait normal trait) predominates.
Miss A.K.M. 58 years Hindu Female, Retd. School Head Mistress complained on 27th September 2009: Pain and swelling in all joints since 10 years. Taken allopathic medicines Swan neck deformity of all the fingers of the hands. All complaints are aggravated in cold and in night. Can not sit in squating position comfortably. Pain in shoulder and small back. Desire open air.

Appetite less, Indigestion and flatulence, Desire salt, sweets and spicy, Aversion : Grams.

Thirst: 3 lters of water / day, Tongue: Coated and moist.
Stool: Not clear, 2 – 3 times / day.
Urine: Normal, Sweat: More in neck and arm pit. Palm sweating.
Mental Generals: She was highly suspicious of boys, did not married in fear of not to be taken care. Built: Thin and tall.
Menarchy: 14 years. Regular and normal flow. Menopause: 45 years.
She had taken all allopathic treatment without any remission of pain and deformity of hand occurred later.

Repertorisation by Complete Repertory by taking Suspicious trait & Fear to men.
Med Suspicious Fear
Men of Night Cold Anemia Ex.Pain Rhe. Joint Open air
Amelior. Flatulence, food after Mense,
delayed Total
Puls 4 3 4 4 4 3 4 0 4 30/8
Lyc 4 0 4 4 3 4 4 3 3 29/8
Caus 4 0 4 4 3 4 4 0 4 27/7
Sulp 4 0 4 4 4 3 4 0 3 26/7
Bry 4 0 4 4 4 4 4 0 1 25/7
Sep 3 1 4 4 4 1 4 0 3 24/8
C-p. 3 0 4 4 4 4 1 0 3 23/7
Pho 3 0 4 4 4 3 4 0 1 23/7
R-t 4 0 4 4 3 4 4 0 0 23/7

Follow up:
1. On 3rd December 2008, there was no pain in fingers, swan neck deformity is reduced 90%.Pain of shoulder and back reduced 80%.
2. On 9th February 2009, pain in finger joints, shoulder and back no more but can not sit in squating position for prolong period. On 9th February 2009, the Haemoglobin increased from 9 gms% to 10.2 gms%, ESR reduced to 16 mm in 1st hour by westerngreen method.

Case 4. Where tenseful (Q4+ normal trait of R.B. Cattell), and weeping disposition predominate.
Mrs. P.V.J, 39 years old, Hindu Female, Dharwad on 16th March 2007, Pain both leg, hands and in all the joints of fingers especially mid-interphallengeal joints since 3 months. Pain is aggravated by cold, ameliorated by warm application. Morning stiffness. Burning of sole, can not bend the leg fingers. Weak, and anaemic, weeping disposition, fearful, tense about her disease. Undergone allopathic treatment but no relief. Case was referred by orthopedician after allopathic treatment by Dr. Parag Melvanki.

Repertorisation by Complete Repertory
Medicine Fear disease of Weeping, tearful
mood Morning agg.


5 – 9. Pain rheum-atic Anaemia Total
Cal-c 4 4 4 4 4 20/5
Kali-c 4 4 4 4 4 20/5
Phos 4 4 4 4 4 20/5
Puls 3 4 4 4 4 19/5
Nux-vom 3 4 4 4 4 19/5
Ars-alb 3 4 4 4 4 19/5
Sep. 3 4 4 4 4 19/5

After treatment with individual medicine by fear complexity, weeping disposition.
1. Fear of disease consequence, future.
2. Weeps much.
3. Morning aggravation.
4. Aggravation from cold.
5. Rheumatic pain in joints and muscles.
6. Anaemia



Case No. 5 A case of High intelligent Trait (B+) of R.B. Cattell).
Mr. G. S. S., age 35 years ,Hindu Male., Address - Dharwad. Present Complaints on 20th September 2004: 1. Low backache since 10 years, pain comes gradually and goes gradually, aggravated by exertion, standing, lying in bed, ameliorated by motion. 2. Pain in great toes of left leg since 6 months, sudden onset, severe pain and tenderness with swelling, aggravated by walking, and pressure, ameliorated by rest. 3. Indigestion since childhood, aggravated by fried foods. Mental: Most active and intelligent person, scored 95% in Chemistry, did project on Ozone layer. Case had taken earlier modern treatment.

Repertorisation by Boger’s Repertory

Medicine Uric acid diathesis Active, busy, inclined to work, thoughts Desire, sweets Thirst Total value/ Total no. of rubrics
Colch. 2 0 0 4 6/2
Colo 2 0 0 2 4/2
Led. 2 0 0 2 4/2
Lyc. 3 4 5 2 14/4
Sang. 2 0 0 0 2/1
Sars. 2 2 0 2 6/3
Sep. 3 3 2 4 12/4
Sul. 2 2 3 5 12/4
Terb 3 0 0 0 3/1
Post – reportorial analysis: By Materia Medica Knowledge we find that
Sepia is eliminated as patient is hot, and Sepia is a chilly remedy.
Lycopodium has the negative general of Hot patient likes warm foods, where as Sulphur has negative general hot patient but aversion to bathing. So the choice of remedy is Lycopodium as it is hot patient and likes warm food and Lycopodium covers the particular symptoms by differentiation.

Follow up:
6th October 2004: Backache has decreased to 50%. Pain and swelling in great toe as before. Indigestion is as before, Gastro-colic reflex is as before.
Medicine Prescribed: Lycopodium 0/1, daily.
11th October 2004: Pain of back has decreased further 10% < bending. Pain in left leg’s great toe persists. No indigestion problem.

Medicine Prescribed: Lycopodium 0/1, daily.
3rd November 2004: Pain in back decreased 80%. Pain in left toe only on pressure. Swelling and tenderness has decreased 70%.
Medicine Prescribed: Lycopodium 0/1, daily.
8th November 2004: Pain in back is decreased to 90%, No pain at all in great toe of left leg. Swelling has decreased to 90%. Uric acid level – 5.4mg/dl, ESR-10mm/1st hour.

Case No. 6, A case of Tender – minded trait of R. B. Cattell .
R. M., 16 years old, Hindu Male, Occupation – Student, Residence – Dharwad.
Present complaints on 26th May 2004:
Pain and swelling in all joints, shifting pain since 2 months, aggravated by movements
History of present complaints: Patient was apparently well before 2 months. To start with he first developed fever with joint pain. He was under allopathic antibiotics. Fever subsided but joint pains and swelling remained. The details of the present complaints are:

Family history: Maternal uncle suffers from lumber spondylosis and arthritis.
Personal history: Built – Thin and tall, Weight-40 k.g., Height-5ft. 8inches
Appetite – Does not feel hungry at all.
Thirst – Little water at a time, Tongue moist and clean.
Reaction to Heat and cold: Aggravated from cold
Likes open air.

Baths in warm water
Mental generals: Simple, innocent, very mild.
General Physical Examination: No anaemia, No jundice, No cyanosis, No clubbing.
Pulse rate – 83/minute, regular, low tension, no atherosclerosis. B.P.- 90/64 mmHg.
Systemic examination: C.V.S. – Apex beat at normal position. S1 & S2 are normal, no 3rd and 4th heart sounds, no murmurs.
Respiratory System – Respiration rate – 20/minute, vesicular breathing, no added sounds.

Locomotor system – Wrist and ankle and knee joints are enormously swollen, extremely tender to touch and restricted movements of joints.
Investigations done on 29th May 2004: Haemoglobin – 6.9gram%, ESR – 80mm at the 1st hour. ASLO titre – Positive (1:16), CRP – Positive ( 1:32).
Nosological Diagnosis – Post Streptococcal arthritis.
Miasmatic Diagnosis : Sycotic miasmatic state.
The case had taken earlier allopathic treatment.



REPERTORISATION by Kent’s Repertory.
Med. Air op
desire Cold
Ge.ag. Thirst
small App.
Want. Anem.
Hb6.9 Pain
Rheu. Pain
Wand. Total
Value
Bry. 2 2 0 2 2 3 1 12/6
Puls. 3 2 1 3 3 3 3 18/7
Rh-t 1 3 1 3 2 3 0 13/6
Sul. 3 2 2 3 3 3 1 17/7
Cross – repertorised by Boger’s Repertory
Med. Anemia Rhe.
Pain Cold
agg War
Air ag. Wand
Pain Thirst
Liitle App.
Want of Total
Pul 5 4 5 5 5 ------ 5 29/7
Bry 5 4 5 3 2 ------ 5 24/6
N.V 5 5 5 2 ----- ------ 5 22/5
Sul 5 ------ 4 4 3 ------ 5 21/5
R.T 4 4 5 2 ------ ------ 4 19/5
PDF: Mildness
Post – Repertorial Result Analysis: Pulsatilla comes as the highest valued remedy in both Kent and Boger’s Repertory repertorisation. Pulsatilla is mild3(Hering Guiding Symptoms : II MILD, GENTLE), anaemic3, both pulsatilla and sulphur has high value in open air amelioration, characteristic wandering pain is most prominent in pulsatilla. Bryonia alba is not so mild than pulsatilla.

Follow up:
On 15th June 2004, patient had no pain at all. Swelling has reduced to 60%. Pulse rate was 70/minute, regular, normal tension and without atherosclerotic changes. B.P. – 100/80 mmHg. Weight – 41 k.g.

On 14th July 2004, there was no swelling at all, no pain. ESR – 16mm/1st hour, ASLO was weakly positive and CRP was negative. Pulse rate – 74/minute, regular, good tension, without atherosclerosis. B. P. – 110/74 mmHg. Weight increased to 43 k.g.
Conclusion: The mental causation and traits rubrics can be utilized for repertorisation or differentiation keeping at PDF. Thus we can achieve perfect drug selection for total cure.

Bibliography:
1. Ryckman R.M., Theories of Personality, 5th edition, Califernia: Brooks/Cole Publishing Company; 1993, pages – 261, 263, 270, 271.
2. Chauhan S.S., Advanced Educational Psychology; Fifth Edition, New Delhi: Vikas Publishing HousePvt.Ltd.; 1989, page 319, 324.
3. Repertories used: 1. Murphy’s , 2. Complete, 3. Kent’s, 4. Boger’s Repertories.

From:
Dr. S. S. Moharana
Professor and Head.
Post – Graduate Dept. of Repertory, and Rheumatology Unit,
Dr. B. D. Jatti Homoeopathic Medical College and Hospital, Post-Graduate and Research Centre, Dharwad – 580 001, Karnataka State, INDIA.

To,
The Chairman,
Scientific Committee,
AHML’S INTERNATIONAL CONFERENCE,

Sub: Submission of Paper for Presentation in Malaysia regarding.

Respected Sir,
I am the life member of AHML having the membership no. L – 105. I am herewith sending a unique paper “Role of psycho – social causation and subsequent abnormal traits; and normal traits for the treatment of various types of Arthritis in Homoeopathy”. Please accept it to publish whole extent as it is one of the unique in kind and having the practical approach of arthritis treatment to publish in your souvenir and send the acceptance letter soon for oral presentation at your official pad stating time, and date of presentation to enable me for sanctioning some of the Govt./private fund to visit Malaysia, and for grant of official leave and visa to Malaysia as my office is of Central Govt. Organisation.
Please do it soon sending first by E-Mail, followed by same by post and let me meet you all once again for the sake of Homoeopathy.
All the best for your faculty of Homoeopathy and Service to Mankind.
May God help you to have the AHML conference a Grand Success.

Thanking You,
With regards. Your’s truly
E-Mail: ssmoharana62@yahoo.co.in Dr. S.S.Moharana
Dr.moharana@rediffmail.com (Life – Member to AHML no. L – 105, INDIA)

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