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Question: Sir, I am practicing homoeopathy in a very small village near Balaghat district (MP). I have under my care 6 patients of end stage renal disease who require dialysis frequently. Although I do administer symptomatic homoeopathic medicines, yet dialysis needs to be continued for all of them. For this the patients need to travel to the city. It’s a costly affair and very impractical for the patients. Is there a method where I may learn and do their dialysis at the village itself? Dr. Bharne (Lanji)

Answer: Yes! Nowadays dialysis can be done at the patient’s home itself. The method is called Continuous Ambulatory Peritoneal Dialysis (CAPD). It is a simple and domiciliary treatment. The patient need not go to the hospital and can continue with his/ her daily routine. There is no requirement of expensive equipment and trained medical manpower and is better tolerated by the patient especially diabetics, hypertensives and those suffering from Ischemic heart disease. There is better control of Blood pressure since there is greater removal of sodium. Also there is no blood loss, so the Hemoglobin concentration is maintained. There is a better preservation of residual renal function which plays a very important role in deciding the prescription of haemo or peritoneal dialysis. The dietary restriction of sodium and potassium is less as compared to haemodialysis. The only dreaded complication of CAPD is peritonitis. Well, you may learn the procedure from any Nephrologist and can conduct the same at your village.

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Question: In Allens Keynotes in the chapter of Acid Phos it is written, “Interstitial inflammation of bones, scrofulous, sycotic, syphilitic, mercurial; periosteum inflamed”. Please throw light.Dr. Arif Husain (Karachi, Pakistan)

Ans: Sensation of pain in the bones as if they are scraped with a knife.

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Question: If Vital force is a force, can’t it be measured like other forces in the cosmos? Likewise Miasm is also a force (although corrupt) hence can’t it too be objectively measured?Dr. Nirupama(Houston, Texas)

Ans: Dear Dr. Nirupama, this question is of importance to the physicists or those scientists with a materialistic bent of mind. How does it matter to a homoeopath, whether or not Vital force or Miasm can or cannot be measured by any means? We should be interested in the expressions (functional or structural) of the vital force (deranged) upon the economy and the methods of rectifying the derangement by the selection of proper similimum and subsequent follow-up.

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Question: I have a female patient aged 2 years 6 months who has been diagnosed with Congenital Heart Disease – Pulmonary Stenosis. Sir when should I advice her for surgical intervention? John Lee (Singapore)

Ans: Although pulmonary stenosis is a Congenital Heart disorder yet all patients do not warrant immediate surgical correction. However, surgery is recommended at any age if

• The patient is symptomatic,
• An asymptomatic patient is detected with critical stenosis and heart failure on 2D echo/ Cardiac Catheterization,
• If the patient has cyanosis,
• On investigations if the right ventricular systolic pressure is greater than the systemic pressure,
• If the pulmonary artery gradient is more than 75/mm if Hg

If any one or more of these parameters are present in your case then you may recommend surgery in your patient.

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Question: What is the difference in Blood Pressures of the arm and leg? Dr. Nishant Pandya (Rajkot)

Ans: Well! since you have not mentioned the sides we consider the arm and leg of same side. There are no significant differences in systolic, diastolic or mean pressures when intra-arterial, brachial and femoral pulses are compared in normal persons. But by auscultation, the systolic pressure in the femoral artery is about 10mm higher than the brachial pressure measurements. Diastolic pressures are practically same in upper and lower extremities of the same side.