Tiladharai
NATIONAL JOURNAL OF HOMOEOPATHY 2000 July / Aug VOL II NO 4.
Dr Ranga Krishnan
'Aesc-hip / Nux-v / Ars-a / Paeon / Nit-ac / Alumn / Lyc / Hydr / Puls / Carc / Phos / Arn / Chen-v / Cob / Ham

In the music class I enjoyed as a child, I distinctly remember my teacher telling us that anybody who needed to elaborate the raaga in the alaapanai, must render it like the TILADHARAI. The notes should flow like the continuous flow of TIL oil-without break-no other oil flows so smoothly and evenly. Then the alaapanai would be pleasant and soothing to the ear. Likewise it is common knowledge that blood must flow through our body uninterrupted. Stagnation anywhere leads to a physical disease manifestation, according to the inherent constitution.

Pile or hemorrhoid is congestion in the venous circulation at the rectum. Causes vary, so knowledge of pathology is very helpful in assessing the aetiology of piles.

A few years ago, an elderly lady came to the clinic with chronic prolapsed uterus and bladder displacement and subsequently had developed piles. This information of the uterus and bladder came to light during elaborate case taking. She was treated for the displaced uterus and bladder and her piles too improved.

In elderly women I have repeatedly found that when piles are due to an underlying uterine cause-tortuous varicose veins are usually visible in the upper medial thigh area. In such cases I have found that an occasional dose of Morgan-bach (nosode) as an intercurrent has always helped.

Bleeding piles are of 2 types- when it bleeds only in drops after stools. Cobaltum helps but it fails miserably when there is a gush of blood.

Case 1
In my early practice a 35 yr old lady consulted me for severe pain of both legs since some time. Walking even a few steps was miserable. O/E veins on both thighs were found distended. There was no history of rheumatism or menstrual problems. On asking whether she has piles, she was taken aback. She also revealed that she had erratic bowel movements for which she had taken many medicines unsuccessfully. Aesculus-hip 200 weekly once for 2 months relieved her leg pain, the piles and erratic bowels.

Case 2
On 1-8-89 Mr A, 25yrs, consulted me for headaches, constipation, piles and occasional bleeding PR. However late he slept, he would wake up early. Meat, Bengal gram flour items <, Desired sweets+++. Headache in the morn < after a late night. He had a hectic schedule of study as he was preparing for the IAS exams. Consequently he was extremely tense and irritated with virtually everything - exams, health, future, etc. Initially he responded well to Nux-vom 1000 with occasional doses of Ars-alb 200 and Paeonia Q

21-1-90 Exams were close at hand so night studying increased. Piles pain+++, bleeding++. Nitric-acid 200 one dose followed by Paeonia Q BD helped him write the exams uneventfully.
18-7-90 Fine. No medicine
31-3-91 All the problems: piles, constipation and occasional headaches recurred again. In the new job as he had to sit for long hrs. He felt it generated a lot of heat in him. He was sweating more on the buttocks and anus area and felt always wet and sticky in the anus area. He was thirsty+++ and desired a cool atmosphere.
Kunzli Rep. Pg 539 Anus perspiration, anus, perineum about was consulted andAlumen 200- 3 doses were given.

19-4-91 Return of symptoms after feeling better. Alumen 1M 1 dose
19-8-91 Reported fine.
27-2-96 Was fine so far. Now return of old symptoms - piles, constipation, occasional bleeding per anus. Also feeling of flatus locked in with some acidity.Lycopodium 200 - 3 doses followed by Hydrastis Q bd.
10-6-96 Perspiration in rectum again. Alumen 1M 1 dose. Hydrastis Q to continue for few days.
8-8-96 Called to thank me for his return to good health.
Till today he is fine. Here, the patient's determined effort to give up red meat and have a strict exercise routine along with the indicated Homoeopathic remedies helped him overcome piles et al easily.

Case 3
On 19/12/98 a 75yr-old lady came for rectum pain while passing stools and slightly protruding piles. Pain in the colon area started 6 months ago.She did have constipation on and off since many years.

P/H -Typhoid as a child; 3 cysts in the liver since a long time; Eczema of the foot during 1st pregnancy; cervical spondylosis since 1990; Rt mastectomy due to Cancer1993; angina 1994.
In early 98 with persistent colonic pain, Ca Rectum diagnosed but a biopsy was not possible at the cancer hospital. A colostomy was advised as also chemotherapy.

F/H MA cancer breast and MU cancer brain.
Presently she did not like to take food but had some hunger. She had low back pain while walking, acidity, mouth and tongue dryness, occasional vertigo (nil - neurology). Weakness+++

Observation - As she was in the advanced stage of metastasis I decided to give this warm and affectionate lady an appropriate healer and wait. Since it was a case presenting with deep pathology a deep healer with affinity for the liver, portal circulation, acidity, rectum , piles and weakness was needed.. I referred Boericke, Clarke's Dictionary of Mat med, Burnett's various booklets and Kent's Mat.med on Pulsatilla where Paeonia was mentioned Rx-Paeonia 30 a few doses given.

12/1/99 Constipation, rectum pain, mouth dryness better. Carcinosin 200 one dose followed with Paeonia Q td
1/2/99 felt better overall. Time for constitutional remedy Phos 200 - 1 dose Paeonia Q td
1/3/99 Status Quo. Gaertner 200 1 dose and Paeonia Q td.

Though she felt better her hunger was still low and she was still very weak. In advanced cases of pathology when Phos / Merc / Sil is indicated and yet there is no significant improvement clinically I find an intercurrent dose of the Bowel Nosode Gaertner helps. Of late I have begun to include Chin as well into that list.(reference-Bowel Nosodes by Dr John Paterson)

26/3/99 Felt normal. Phos 200 1 dose Paeonia Q BD
28/4/99 Ok Carcinosinum-adenostomach 200 1 dose Paeonia Q BD
14/6/99 Cancer Institute checkup-all systems normal, to repeat tests and checkup after 6 mths Phos 200 1 dose a month, Carcinosinum-adenostomach 200 one dose every alternate month and Paeonia Q OD
24/1/2000 All clinical tests at Cancer hospital normal. They asked her to return after a year.

There is no constipation, no piles, the colon has healed well, has gained a little wt and is able to lead a normal life. She continues the Homeopathic prescription and feels fine in all respects.
I was very happy to note that in my recently acquired book "The Collected Works of Arthur Hill Grimmer" edited by A.N.Currim my usage of Paeonia was appropriate.

Case 4
In this case the aetiology, pathology and family history played a vital role in the selection of the prescription.
16/3/99 A 69 yr old male, a recently retired typist, developed prostate enlargement with all its usual problems and had no relief from modern medicines. He then developed bleeding piles due to exerting while micturating. Cancer and haemorrhagic tendency runs thru the family. One brother died of brain haemorrhage and his daughter has factor XII deficiency, in whom a small wound on the head did not heal. M-asthma, S-DM.

P/H In 90-DM, '93 - Duodenal ulcer with haematemesis, regular allopathic medicines and careful with his diet. In Nov 98 with acute burning pain during micturation, which became scanty, he was hospitalized. Enlarged prostate with urethral stricture detected. The stricture was surgically cleared and he was on the catheter for urinary drainage. A few days later when the catheter was removed all problems returned - impeded urine flow, pain; irritation - the Allopathic medicines were restarted but no significant relief.

Now there was constant pain in anus due to the piles, which would prolapse on the least pressure even during urination. History of long hours of sitting, haemorrhagic tendency, constant pain and trauma of the catheter made me prescribe Arnica 1M 3 doses initially.
30/3/99 Pain much better, urine flow and output better. Arnica 1M 3 doses Chimaphila-umbellata Q BD
17/4/99 Further improvement Chimaphila Q to continue
6/5/99 Improved further. Now wakes up twice for urination at night instead of 5 times. Now low back pain and piles occasionally bothering him. Aesculus 200 3 doses, Chimaphila to continue.

2/6/99 Blood in drops from rectum independent of stool. Cobaltum1M single doseChimaphila to continue.
12/7/99 Better in every way. Carcinosinum 200 single dose as a preventive for cancer that runs in the family.
21/3/00 Despite losing his wife 2 months ago, he was fine in all respects uptil a fortnight ago-Now occasional bleeding piles and urinary difficulty Aesculus 200 BDX3 days. Carc 200 one dose
16/5/00 Since a few days bleeding from piles independent of stools. Cobaltum 200 3 doses and Hamamelis Q BD

He is still under observation; has gained wt, feels normal, does his normal work, looks healthier.