NON ALLOPATHIC THERAPIES
Item
- Title
- NON ALLOPATHIC THERAPIES
- extracted text
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TIGER BALM
TIGER BALM Is specially prepared from an exclusive formula and has been used throughout the world for more
than fifty years. This BALM is manufactured from the finest and purest ingredients under the strict supervision
of highly trained and qualified pharmacists.
It is a safe and reliable treatment for the symptomatic relief of
scular aches and pains, sprains, rheumatism, insect bites, itching, lumbago and headache. Rub gontly on the
ected parts and keep warm For external use only.
Made under licence from
HAW PAR BROS. INTERNpfi^MtUWf v
-------------------------------------EAfiJGAi r4—- -.
*
BALSEM HARIMAU
BALSEM HARIMAU tolah di-chipta khas dari ramuan2 yang terpileh yang telah di-gunakan di-seluroh dunia lebeh
dari lima puloh tahun. BALSEM HARIMAU Ini di-buat dari rempahratus yang terbaik dan asli di-bawah pengawasan
yang toliti oleh ahli2 ilmu pembuat obat yang terlateh dan berijazah. Ini ada-lah pengubatan yang selamat dan
boleh di-porchayai untok molegakan sakit2 sendl, salah urat, bisa2 tulang, sakit tulang, di-glgit sarengga, gatal2,
sakit pinggang dan sakit kepala, sapukan dl-bahagian2 yang sakit dan biarkan ia panas.
Di-perbuat
daripada
HAW PAR BROS. INTERNATIONAL LTD.
uirfr dlijfibiTflb ®OTLirGrb6£6OT6i) &6Ilj51l.Gl l
aigjiiD^Qujiiijj Gicj)® uOfliuirallst) ^luifiMuuLLJji
6U
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iT6ii
FOR THE USE OF MEDICAL PRACTITIONER OR A HOSPITAL OR A LABORATORY
DIRECTIONS FOR USE
Clean the affected part gently but thoroughly with warm water. Mop
dry with a soft clean cloth. Apply the ointment in a thin even layer.
Homoeopathic ointments are safe and can be applied as often asnecessary in a day to keep the affected part constantly covered with
beneficial results.
This is yet another ethical homoeopathic product manufactured in the ultramodern laboratories of
BECK & KOLL LABORATORIES PRIVATE LIMITED
37A,Govt. Ind. Estate, Kandivli (W), Bombay-400 067.
A
For the use only of Registered Medical
Practitioners or a Hospital or Laboratory
®
rILEN
HOMOEOPATHIC
MEDICINE
This combination hes been tried and proved to be effective in piles of any kind
whether internal or external, bleeding or nonbleeding, It helps to reduce
agonising pains and to shrink piles. It can also check bleeding in case of
bleeding piles. It's benefical effect reduces constipation and further
given regular movements to the bowels.
It contains : Nit Acid (200c), Calc floor (200c) & Hamamelis (200c).
ITS INDIVIDUAL DRUGS ACT IN THE FOLLOWING WAY :
NIT ACID 2C0c : It reduces bleeding, soothes the splinter like
pains,
regulates bowel movements.
Calt Flour 200c : It acts on bleeding piles, reduces bleeding, stops itching
sensation in the anal region, renders stool softer and helps to shrink blind
piles, Effectively releaves backache whenever associated with piles complaint.
Hamamelis 200c: It is a very effective drug on the haemorrhagic tendency
thus reducing and controlling haemorroidal bleeding in case of bleeding piles.
Complementary : Topical application of Pilen ointment is concomittantly
recommended.
DOSE : 6 pillets twise a day.
7=RstFlo •>•>£.. .VHrks East.'
^.de effects : Nil
* V
ffesentation : Bottle of 250 Pillets.
••
Registered Trade Mark
FOR THE USE
ONLY
PRACTITIONERS OF A
OF REGISTERED MEDICAL
HOSPITAL OR LABORATORY
.
HOMOEOPATHIC MEDICINE
* verv effective Homeopathic combination formulated to relive flatulent
dyspepsia, eructations, waterbrash, gastralgia & discomforts caused due to
Indigestion
It contains following medidices which have action to improve
the digestive processes,
ite individual drugs act iu the following way Nux Vomica 200c : Reduces acidity and flatulence, thus relieves pressure
on the chest and distress in breathing. Regulates bowel movements therefore
promotes healtheir digestion It helps to overcome the digestive disturbances
in people who have sedentary habits
Carbo Veg 200o : Acts on flatulence causing distressing eructations, acidity
water brash, gastralgia It helps persons who get temporary relief with
eructation
Calchicum 200c It relieves constipation and with a peculiar ineffectual
urge for passing stools it also reduces flatulence and nausea.
These remedies in combination have a marvellous effect on liver and gastric
mucosa reducing the ph of the gastric juice and improving liver activity thus
eliminating acidity aned constipation
Dose : 6 pillets half an hour before meals or every three hourly.
In acute pains six pillats dissolved in hot water gives quicker relief
Side effects : Mil
Presentation : Botrle of 15 gms
Manufactured in india by :
>'-EW EBA HOMOEOPATHIC PHARMACY PRIVATE ITO. DADAR. BOMPAY 400 028.
For the use only of Registered Medical
Practitioners or a Hospital or a Laboratory
HOW
tonsilon ACTS
HOMOEOPATH IC> MS-DIGI^d
tonsilon: the very effective
homoeopathic combination
for relieving various symp
toms like cold, cough, sinu
sitis whichl are responsibly
for causing tonsiller h$»r-«
tophy A inflammations.
TONSILON
thus tonsilon effects a cure
by relieving other factors. It
improves the resistance of a
person to fight against
common cold A improves
general health.
NEW ERA HOMOEOPATHIC PHARMACY
OPP. DADAR STH. (W.R.) BOMBAY-28
QU'
r
TONSILON
tonsils enlarged, septic causing fever
& malaise presence of pseudomem
brane on the tonsils congestive
redness of fauces with painful
deglutition (swallowing) uvula
oedematous, cough with pain in
larynx & hoarse voice.
TONSILON
coryza, sneezing, hay fever, loss of
smell, stringy discharge, throbbing
headache, worse from jar
&
shaking pain over eyes worse from
pressure.
For the use only of a Registered Medical Practitioner or
a Hospital or a Laboratory.
f
WARTEX®
(Oral Pellets &
Callosities)
Topical
Ointment for Verrucae and
COMPOSITION :
Pellets
Ointment
Thuja
200 C
Causticum 200 C
Et al in
Homoeopathic
Dilutions
Calc Fluor
lx
Thuja
Q
Et al in
Homoeopathic
Tinctures
DESCRIPTION :
WARTEX, Oral and topical, a choice homoeopathic remedy
|has been designed to satisfactorily treat cases of Verrucae
(Warts) and Callosities (Corns); WARTEX is a method to
'expunge warts. While various measures such as
electrodessication etc. are possible, the chances of rec
urrence are not uncommon
and
in some cases,
exceedingly high A dermatologist or a surgeon therefore,
still looks for a remedy which could be SAFE, EFFECTIVE
PAINLESS, EASY TO ADMINISTER and MOST IMPORTANT^
DOES NOT LEAVE ANY MARKS OR SCARS (particular™
on the face as an) after effect. WARTEX largely meets all
these requirements and has a sustained result without
side effects or reactions.
ACTION
.
WARTEX is a combination in homoeopathic dilution of
substances known to act on warts & corns. It has been
clinically tried and tested in clinics run by New Era Hom
oeopathic Pharmacy over a long-period It has the property
of tackling the affected part and softening the circular
bed systemically so that normally, atleast after a few
months'treatment of oral pellets and topical ointment,
the warts/corns will be gradually eliminated It is very
important that WARTEX oral and topical ointment
should be concomitantly used.
WARTEX is useful incommon, benign epithelial tumours
and areas of painful hyperkeratosis, To name a few
WARTS :
1. Common warts; 2. Filiform or "thread warts;
3. Moist or "Venereal" warts; 4. Plantar warts;
5. Flat warts; 6. Unusual types-threadlike or ped
unculated or resembling a cauliflower frequently on
the neck head, or bearded region.
CORMS :
(Callosities) Both
without pain.
superficial or conical, with or
DOSAGE :
4-6 pellets t d s. At the same time ointment should
be topically applied to the affected parts, as often as
possible allowing the medicine to penetrate the area,
PACKING :
Oral :
Bottle of 15 gms.
DISPENSING PACK : 80 Gms.
Ointment :
15 gm,-in attractive tubes,
DISPENSING JAR-400 gm.
Note : 1) The medicinal concentration of this preparation
r
has a deep seated action but is designed to be
safe. Because of this, (depending on the chronicity of the case changes) may occur rather slowly
but will generally give ultimate satisfactory results.
Some cases in clinical trials even responded after
a gap of time, treatment having earlier been
given for several months and then discontinued.^
2) The strength and the ingredients have been
chosen to suit the median cases of verrucae and
callosities. In adamant cases, after standard
WARTEX treatment WARTEX FORTE may be tried.
This is specially prepared to suit the individual's
needs on enquiry to the Consulting Homoeopath
of NEW ERA HOMOEOPATHIC
PHARMACY
PVT. LTD. (Phone : 455060 9-00/12-00 Noon and
5-00/8-00 p. m.) or by post. Enquiries from the
prescribing doctors only (and not from patients)
will be entertained. Full details of period of
Wartex treatment already given, type of wart/corn.
changes if any in site, size and colour and other
particulars Including patient's history will be
necessary for preparing SPECIAL WARTEX FORTE.
MANUFACTURED BY :
New Era Homoepathic
Pharmacy Pvt. Ltd.
®
Opp. Dadar Rly. Stn. (W. Rly.) Bombay-400 028.
For the use only of Registrerod Medical Practitioners
or a Hospital or a Laboratory.
ALFAMALT
n. Info-nny Rosd, Bengn|Ore-5CC 001
COMMUNITY H.IALTH cell
47/1.(First. ilvj.iP . .Turks Road
BANGALORE- 580 001
ALFAMALT
( MALT Preparation of Alfalfa Tonic)
Composition :
Calc
gly. Phos 3x
Farr.
gly. Phos 3x
Kali.
gly. Phos 3x
Magn gly. Phos 3x
Nat
gly. Phos 3x
Malt, Syrup & Aromatics q. s.
Alfalfa 2x
Hydrastis 3x
China 3x
Avena Sat 3x
Indications :
Alfamalt is a Homoeopathic Preparation which
is ideally suited for the stimulation and regeneration
of both physical and mental processes of the body
particularly when the normal capacity of assimilation
is retarded as a result of disease. It is therefore
particularly recommended in cases of convalescence
constant fatigue, nervous exhaustion, irritability
sleeplessness, anaemia and chlorosis. It can also be
recommended in cases of underweight, malnutrition
and undernourishment, concomitantly with enriched
food intake.
Action: Homoeopathic tonics have a uniquely
eftective action on the body cells. Quite commonly,
in modern practice it is seen that tonic are simply
not assimilated by the body in weakened state
though
administered in large quantities. The
same substances are seen to be assimilated
more readily if it occurs in a food, fruit, or
vegetable albeit in minute quantity. It is therefore
not the quantity but the size of each individual
particle of the substance that makes one form more
effective than the other. In Homoeopathic tonics,
each individual component is triturated (ground)
to the finest possible, several times reducing
the desired ingredient to a molecularly active
state. In this state it is promptly assimilated by
the body cells.
i
The individual components act as follows:"
Alfalfa (Lucerne) This beneficial plant has long
been known and employed as cattlefeed due to its
uniqu property of adding weight of muscle tissue
without adding fat, tones up the appetite resulting in
greatly improved vigor with gain in weight Disorders
characterised by malnutrition are mainly within its
therapeutic range e. g. neurasthenia, splanchnic
blues, nervousness, insomnia, nervous indigestion etc.
Increases quality and quantity of milk in nursing
mothers, It commonly induces mental exhilaration,
buoyancy and a general feeling of wellbeing.
Avena Sativa (Common oat) Favourably influences
the brain and the nervous system, particularly
nervous exhaustion, sexual debility, convalescence,
nerve tremors, chotea, alcoholism and sleeplessness
of alcoholics and many female troubles.
China (Chincona off-Peruvian Bark) Indicated in
debility from exhausting discharges and loss of vital
fluids. Chronic gout. Chronic suppurative pyelitis
mental apathy, despondency.
Hydrastis (Golden Seal) Especially active in old,
** ref : Homoeopathic Materia Medica by W. Boericke
M. D.( U. S. A.)
easily tired cachectic or greatly debilitated individuals
Cerebral effects prominent, with feel sharpened.
Tones up weak muscular power, poor digestion and
obstinate constripation. In lumbago, emaciation,
prostration, and sluggish liver.
The Glycerophosphates of Calcium,
sium, Kalium and Natrum ;
Ferrum, Magne
Calcium : a tissue remedy specially indicated in tardy
dentition, bone disease, bone fractures.
Ferrum : ( Iron) For first stage of all febrile
disturbances and inflammations, anaemias and
hemorrages : Increases haemoglobin.
Kalium: (Potassium) A nerve remedy. Want of
nerve power, neurasthania depression.
Magnesium : Antispasmodic relieving cramp in
muscles, neuralgic pains.
For bad digestion.
enteralgia and flatulent colic with belching of gas.
Matrum : (Sodium) A good liver toner.
Dosage: Adults two tablespoons, ( Children One )
before meals and bedtime.
Side Effects : The ingredients in Alfamalt Tonic
are naturally occurring vegetable and mineral
substances and the side effects are nil. It can
consequently be used concomitantly with any other
treatment with absolute confidence as there are
no contraindicatious.
Presentation : 400 gms & 1000 gms. bottles.
Manufactured in India by t
BECK & KOLL LABORATORIES
PRIVATE LIMITED
37-A, Govt. Ind. Estate, Kandivli (West), Bombay-400067.
For the use only of Registered Medics'
Practitioners or a Hospital or Laboratcry
EASIDEHT °
HOMOEOPATHIC MEDICINE
lentition causes few symptoms and leads to uneasiness with irritability in
the children during this period the dentition diarrhoea and loss of
appetite or common cold and fever may also associate.
Easident is a combination of three effective Homoeopathic remedies which
have beneficial effect to relieve the dentition disorders such as above.
Its individual drugs act in the following way :
Chamomilla 30c : Acts on mind and soothes irritability, reduces
diarrhoea which may have characteristic green colour. It checks increased
salivation flatulence & redness of anal orifice.
Calcarea Phos 12c : It is a known dentition tonic, thus included in
Easident. It helps in the assimilation of Calcium from the natural source
(milk) thus aids Calcium It reduces the dentition diarrhoea, promotes
healther digestion pre rents vomiting and flatulence.
Lecithina 12c : It influences nutritive conditions, thus increasing the
red blood corpuscles and Haemoglobins in dentition diarrhoea it helps to
over co ne general debility and increase appetite
it is found and proved Easident it started at 4th month of age and given
regularly helps to prevent the severity of the dentition symptoms &
promotes healthier and easier dentition.
COMMUNITY HEA”H CrI
(
DOSE
4 to 6 months
_
,
6 months to 1 year
1 year and above
|>ide Effect : nil
2 pillets jhjeft times a day
....... * 4
_
\1 r St r lOOr) 3 ' MnrPc
3 ,,
,,
* ‘V,«‘KS riOadt
4 ,,
o Ai\JG.'-<LOHE - L Jj 001
m
1
Presentation : Bottle of 15 gms (approx. 250 Pillets)
Manufactured In India by :
NEW ERA HOMOEOPATHIC PHARMACY PVT. LTD. DAOAR BOMBAY—400 028.
O
*’
4 Removing tonsils
1 may weaken kids
TONSILON
coninwn'T .
"
7
1
°lore-'^001
STfO1
Tonsilon Prevents
Enlargement of tonsils,
oedema of uvula, coryza,
throat pain, loss of smell,
throbbing headache,
pain over eyes etc.
Presentation .-Bottles of 250pillets.
COMPOSITION
Mere Bin lod. Belladonna, Hep. sulph.
Kali Bichr
Silica,
Baryta
carb in
200c in Palatable Pillets.
Made in India by:
NEW ERA HOMOEOPATHIC PHARMACY,
OPP: WESTERN RLY. STN. DADAR,
OMBAY-28 DD.
againstNovember
polio13: Is \a
NEW DELHI.
W your child suffering from lonsilitis? Z
W Don’t rush to a doctor to get his ton- A
W sils removed by an operation. It may |
| turn out to be “from the frying pan I
J into the fire" for him.
Road
Dr. P. L. Ogra. associate profes- WJ
sor of paediatrics at the State Univer- 1
shy of New York, says that the re- M
moval of tonsils will make the child £
j
prone to polio—that dreadful disease F
which often leaves a child crippled. W
Dr. Ogra told UNI that in his study f
of about 50 children whose tonsils had
been removed, he found that all of p
them partially or completely lacked
the antibodies which resisted infection g
from viruses like polio.
if
•
He said the removal of tonsils re-*V
duced the antibodies in the human #
body considerably and made it susccp- I
tible to infection.
J
Dr. Ogra, whose findings were pre- I
w nented at the meeting of the Ameri-1
1 can Paediatric Society this year, isW
F now conducting research in children's^
4 diseases at Buffalo, New York State.®
1 The United States health service is"
1 giving him a grant for the research. K
I
Dr. Ogra said polio was most com-f
} mon among children between the age 1
’
group of six months and six years, r
. When a child is born it inherits ab
small percentage of antibodies fromE
its mother. But these soon get ex-®
hausted and the body became suscepti ■
ble to virus
infection, he said.— V
U N.I.
y
y
Because of
\ Tonsils
Jearlier!
Any ENT Specialist will tell you Tonsils could
lead to deafness. It is like one thing leading to
another. And a stitch in time could really save
nine. So, why take chances with tonsils?
As such there are many other side effects with
enlarged and infected tonsils. Chronic indigestion,
bodyache, discharge of puss through ears, pain
in throat etc.
Homoeopathic Tonsilon strikes at the roots of
Tonsils such as cold, cough, sinusitis which cause
tonsiller hypertophy and inflammations.
Results: Tonsils are stopped before they start.
As simple as that. And just as trueW
MODE OF ADMINISTRATION :
Adults: 4 to 6 pills twice daily. Children: Half of
the above or as prescribed by the physician.
FOR THE USE OF ONLY A REGISTERED MEDICAL PRACTITIONER
OR HOSPITAL OR A LABORATORY
RHEUMA -SAJ®
MASSAGE OIL
For muscular or joint pains of any kind this oil
is a boon.
Contents :
Tinctures of Arnica, Cantharis, Gaultheria et. al.
in electromagnetically activated hydrocarbon and
vegetable oil base.
Indication :
Rheumatic pain, arthritis, gout, stiff joints, mus
cular congestion, pain due to exposure and fat
igue, lumbago, stiff neck, backache, bruises,
sprains and strains.
Description :
Most massage oils are merely counter-irritants
which give only temporary relief. Rheuma-Saj
is quite different. The deep acting medicines
penetrate right down to the focus of the pain
due to the unique properties of the electromag
netically treated oil base. Immediate relief of pain
is felt and repeated application in chronic cases
will act on the causatory source and effect com
plete cure.
Presentation :
50 ml. and 450 ml. Bottles.
COMMUNiW iUAtTH
r
Manufactured by:
BECK & KOLL LABORATORIES PVT. LTD.,
37-A, Govt. Industrial Estate, Kandivli (West), Bombay-400 067.
FOR THE USE OF ONLY A REGISTERED MEDICAL PRACTITIONER
OR HOSPITAL OR A LABORATORY
RHEUMA -SAJ®
MASSAGE OIL
For muscular or joint pains of any kind this oil
is a boon.
Contents :
Tinctures of Arnica, Cantharis, Gaultheria et. al.
in electromagnetically activated hydrocarbon and
vegetable oil base.
Indication :
Rheumatic pain, arthritis, gout, stiff joints, mus
cular congestion, pain due to exposure and fat
igue, lumbago, stiff neck, backache, bruises,
sprains and strains.
Description :
Most massage oils are merely counter-irritants
which give only temporary relief. Rheuma-Saj
is quite different. The deep acting medicines
penetrate right down to the focus of the pain
due to the unique properties of the electromag
netically treated oil base. Immediate relief of pain
is felt and repeated application in chronic cases
will act on the causatory source and effect com
plete cure.
Presentation :
50 ml. and 450 ml. Bottles.
K
COMM'JN iiV i j 1AUTH
Wiarks
67/1,{FirstCSO 001
Manufactured by:
BECK & KOLL LABORATORIES PVT. LTD.,
37-A, Govt. Industrial Estate, Kandivli (West), Bombay-400 067.
New Era Homoeopathic Pharmacy Private Ltd.
Dadar, BOMBAY-400 028.
OINTMENTS COMMONLY USED IN HOMOEOPATHY '
Nama of the Ointment
Contents
Indications for usa
1 Aconite
2 Aesculus & Hamamelis
Aconite external
Aesculus & Hamamelis
external
Apis Mel external
Acute inflammations
Piles, Bleeding or painful
3 Apis Mel
4 Arnica
5 Belladonna
Bryonia
7 Calc. Flour
8 Calendol
9 Cantharis
10 Dermoline
11 Echinacea
12 Graphitol
13 Hamamelis
14 Hydrastis
15 Hypericum
16 Ledum Pal
Paeonia
18 Pimplene
19 Rhus Tox
20 Ringoment
21 Ruta G
22 Skookum Chuck
23 Symphytum
24 Thuja
Stings and in sectbites for
oedematous swellings
Soreness resulting from
Arnica external
injury
Belladonna external
Painful inflammations
Rheumatic pains or
Bryonia external
sprains
Glandular and hard
Calc. Fluor 1 x
swellings also for piles
Asan antiseptic medicine
Calendula external
for quick healing
Burns
Cantharis external
Skin diseases in general
Echinacea Q and
for itching
Calendula external
Ulcer and Eczema
Echinacea Q
Weeping eczema and
Graphitis 1 x
psoriasis
Bleeding piles
Hamamelis external
Elephantisis a Leprosy
Hydrastis external
Neuralgia resulting from
Hypericum external
sharp instruments
Insect bites, rat bites
Ledum Pal external
Punctured Wounds
Piles and abscasse
Paeonia Q
Pimples
Berberis Aqui external
Rheumatic Pains
Rhus Tox external
Ringworn
Crysarobinum 1 x
Traumatic affections of
Ruta G external
bones and periosteum
Skookum Chuck external Leprosy Elephantitis or
eczema
Bone pain resulting from
Symphytum external
injury
Warts
Thuja external
COMMUNITY HEALTH CELL
®7/1, (First Floor) J.:. Marks Road
BANGALORE -560 001
&
FOR THE USE ONLY OF A REGISTERED MEDICAL PRACTITIONER
OR A HOSPITAL OR LABORATORY
BECK a KOLL'S
is a choice Homoeopathic preparation made with
Herbal inqredients which have been used and tested
for several generations for the care and protection of
beautiful
and clear complexions. The principal
ingredients Hamamelis (Witch Hazel) and Calendula
(African Marigold) are best known in Homoeopathic
practice as the great vulneraries for the care and
protection of sensitive skins. The preparation acts
as a sun screen to protect the skin from sunburn and
its'regular use helps to lighten sunburnt and over
exposed complexions.
The medication tones up the facial skin and muscles to
help smooth away wrinkles, pouches and “crow s' -feet."
The vulnerary properties of the ingredients help to
quickly heal capillary bleeding or damaged blood
vessels, thus clearing the complexion of spots, blotches
acne and warts- Being herbal,this cream is completely
free from noxious, toxic, allergic or immunizing side
effects and can be used regularly with absolute safety.
K
Manufactured by
BECK a KOLL Labs (P) Ltd.
37A, Government Industrial Estate. Kandivli (west), Bombay-400 067.
COMMUNITY HEALTH CELL
<7/1, (First i :c,or)3£. Marks Road
RAMCTalORE - 500 001
■>
Ct>Q!3Q
Tele: 267-4-$- ’
!
: VCNALLY HOMOEOPATHIC PH«°VA0Y I
11. Infrntry Rord. B.’ng^or? jf. 101
Dr. VcNally's
JONDILA
(An Homoeopathic Liver Tonic in Syrup or Capsules)
O
'
Components :
Kalmegh lx. Carica p. 2x, Myrica lx. Chelidon
lx, Chionanth lx, Syrup and laromatics q. s.
Dr. VcNally’s JONDILA is a liver tonic designed
to cover a wide spectrum of hepatic complaints.
It is specially recommended in cases of jaundice,
liver spots, sluggish liver function, worms etc.
£
Action : Homoeopathic preparations have a uniquely
effective action. Very commonly it is seen In modern
practice that though large doses of a tonic
are administered, it is simply not assimilated
by the body,
particularly
in a weakened
state, At the same time, it is seen that if this tonic
substance is present in fruit, plant or vegetable,
though in minute quantity, it is more easily
absorbed by the cells, it is therefore not the.amount
of the substance that metters but rather the size
of each individual particle of the substance It is
axiomatic that in order that a particle should be
absorbed by the human [cell, the particle must be
smaller than the cell. Our ancients were aware of
this. Hence the common practice of grinding most
remedies in a mortar and pestle.
0')
In Homoeopathic preparations all the ingredients
ate ground several times (triturated) to the finest
possible powder in a scientifically postulated manner
which releases dynamically the individual molecules
of the medicine so that it is absorbed more readily
by the human cells, thus helping the patient to
speedier recovery.
It's individual components act as follows
Chelionium : A prominent liver remedy’covering
many of the direct reflex symptoms of biseased
conditions of that organ. Jaundiced skin and
especially constant pain under inferior angle of right
scapula are certain indications. General lethargy and
indisposition to make any effort, serous effusions
^^nd bilious complications during gestation are also
treated by this.
Chionenthus . A prominent liver remedy. Enlarged
spleen, Jaundice (in ladies with arrest of menses).
Gallstones, Paroxysmal abdominal pain.
Carica Papaya : Helps digestion, checks acidity.
regulates liver function, improves appetite.
Kalmegh : For flatulence and diarrhoea of children.
For worm symptoms. In torpidity of liver neuralgia,
dyspepsia, general debility, convalescence and in
fully developed stage of dysentery.
Myrica : Has a marked action on the liver with
Jaundice and on mucous membranes, Excellent in
the case of persitent sleeplessness as a concommitant
symptom.
**Re,: 1)
Homoeopathic Materia Medica-Dr. William Boericke
M. D. (U.S.A)
2)
The
Homoeopathic
Pharmacoepia
of
the
United
States Seventh edition. (1964).
3)
Guide
to
Homoeopathy-New
Era
Pharmacy Dadar, Bombay-400 028.
Homoeopathic
DOSAGE (Adults) :
SYRUP
INDICATIONS
CAPSULES
JAUNDICE
1 tea sp/3hrs 1 t. d. s.
Other Liver Complaints
and for worms
(2hr. before meals
1 tea sp.b.d.
1 b. a. s.
Note : For Children, Syrup | teaspoon as above.
Distic recommedations :
No particular dietic
restrictions are required for the action of the
medicines. However in the case of all liver com
plaints it is better to avoid “overloading" the function
of the organ. Oily, fatty and rich food should be
avoided. So also excessively pungent or sour items.
During treatment it is better to adopt a bland
diet of boiled items.
For jaundice, such dietic moderation is essential.
Side effects : All the ingredients are natural plant/
vegetable extracts and are absolutely safe. There
are no side effects. This tonic can also therefore
be recommended concommittantly with other
treatment.
Presentation : Syrup
Capsules
: 100 ml. & 450 ml.
: 15 Caps. & 100 Caps
Manufactured in India by 1
BECK a ROLL LABORATORIES PVT. LTD
37-A, Government Industrial Estate, Kandivli (West),
Bombay-400 067.
For the use only of Registered Medical Practioners
or a Hospital or a Laboratory.
ALFALFA TONIC
COMMUNITY health CELL
$7/*), ('■
■
*vlari<s Roa
buJ 001
ALFALFA TONIC
Composition
Alfalfa 2x, Hydrastis 3x, China 3x, Avena Sat. 2x,
Syrup & Aromatics q. s.
Indications :
Alfalfa Tonic is a Homoeopathic preparation which
is ideally suited for the stimulation and regeneration
of both physical and mental processes of the
particularly when the normal capacity of assimilation
is retarded as a result of disease. It is therefore
particularly recommended in cases of convalescence,
constant fatigue, nervous exhaustion, irritability,
sleeplessness, anaemia and chlorosis. It can also be
recommended concomitantly with enriched food
intake, in cases of underweight, malnutrition and
undernourishment.
Action :
Homoeopathic tonics have a uniquely
effective action on the body cells. Quite commonly,
in modern practice it is seen that tonics are simply
not assimilated by the body in a weakened state
though administered in large quantities. The
same
substances are seen to
be assimilated
more readily if it occurs in a food, fruit, or
vegetable albeit in minute quantity. It is therefore
not the quantity but size of eash indivi
particle of the substance that makes one form more
effective than the other. In Homoeopathic tonic's
each individual component is triturated (ground)
to the finest possible, several times reducing
the desired ingredient to a molecularly active state.
In this state it is promptly assimilated by the
body cells.
The individual components act as follows : **
Alfalfa (Lueerne) This benficial plant has long
been known and employed as cattlefeed due to its
unique property of adding weight of muscle tissue
without adding fat, Alfalfa favourably influences
nutritition by toning up the appetite and digestion
resulting in greatly improved mental and physical
vigor with gain in weight Disorders characterised by
malnutrition are mainly within its therapeutic range
e. g. neurasthenia, splanchnic blues, nervousness.
insomnia, nervous indigestion etc. Increases quality
and quantity of milk in nursing mothers Its-pronounced urinary action suggests it clinically in
diabetes insipidus and phosphaturia. It is claimed
to allay vesical irritibality to prostatic hypertrophy
and beneficially influences rheumatic diathesis.
It is commonly seen to induce mental exhilaration
buoyancy and a general feeling of wellbeing so
that all blues are dissipated.
Avena Sativa (Common oat) Has a selective action
on the brain and on the nervous system favourably
influencing their function. Nervous exhaustion, sexual
debility, convalescence after exhausting diseases,
nerve tremors of the aged, chorea, paralysis agitans.
epilepsy, postdiptheric paralyisis, rheumatism of the
heart, alcoholism and sleeplessness of aicoholics, bad
effects of morphine habit and nervous states of many
female troubles.
China (Chincona off.-Peruvin Bark) Indicated in
debility form exhausting discharges and ioss of vital
fluids. Chronic gout. Chronic suppurative
ref ■ Homoeopathic Materia Medida by W. Boericke
M. D (U. S. A')
pyelitis. Post operative gas pain particulary when
there is no relief from passing it. Mental apathy,
indifference, disobedience, taciturnity, despondency,
disposition to hurt others, sudden crying and ideas
crowding in mind preventing sleep.
Hydrastis (Golden Seal) Especially active in old,
easily tired cachectic or greatly debilitated indivi
duals. Cerebral effects prominent, wits feel sharpened
head cleared, facile expression. Tones up week
muscular power, poor digestion and obstinate
constipation. It is claimed to be effective in lumbago,
emaciation, prostration, sluggish liver, goitre of pube
rty and pregnancy and in greatly mitigating the
consequences of smallpox.
Dosage : Adults two tablespoons, (Children One)
before meals and bedtime.
Side Effects : The ingredients in Alfalfa Tonie
are naturally occurring vegetable and mineral
substances and the side effects are nil. It can
consequently be used concomitantly with any other
treatment with absolute, confidence as there are
no contraindications.
Presentation : Sweet syrup in 100, 250 and 450 ml.
Note : If the small proportion of alcohol is thought
unsuitable for any patients,
ALFAMALT (a
similar preparation in malt base) is recommended as
an alternative.
Manufactured in India by I
BECK & KOLL LABORATORIES
PRIVATE LIMITED
37-A. Govt. Ind. Estate, Kandivli (West) Bombay-400 067
For the use only of a Registered Medical Practitioner or
a Hospital or a Laboratory.
AQUIFOLIUM®
cream for treatment of Acne
Comedones and similar affections < f the skin.)
( Oral
tablets
and topical
Vulgaris
COMPOSITION
Tablets
Cream
Berberis Aqui Q
Berberis Aqui. Ext.
Thuja Ext.
Kali Brom
30
in Lactose q
s.
Calendula Ext,
in water soluble base
DESCRIPTION
AQUIFOLIUM Oral and topical, is a choice Homoeopathic treatment
designed to satisfactorily deal with cases of Acne Vulgaris (pimples)
Comedones (blackheads) and similar skin affections.
AQUIFOLIUM expunges pimples and blackheads by the safe and
gentle method of Homoeopathy. Various other measures are no doubt
possible such as use of topical peeling agents, incision, extraction
and drainage. However, the chances of recurrence with such topical
treatment is exceedingly high. A Dermatologist or General Practitioner
therefore would welcome a remedy which could be SAFE, EFFECTIVE
PAINLESS, EASY TO ADMINISTER and MOST IMPORTANT DOES
NOT LEAVE ANY MARKS, P|TS or SCARS ON THE FACE and also
eliminates entirely the risk of extraneous infections as an after effect.
AQUIFOLIUM largely meets all these rigorous requirements and has
a sustained and permanent result without side effects or reactions.
EtioIogy anti symptoms of Acne Vulgaris and Comedonss :
The etiology of Acne Vulgaris and Comedones is largely unknown^
Predisposing causes include hereditary or familial tendencies oj|
disturbances in the metabolic or hormonal balance affecting activity
of the sebaceous glands.
Specific
factors may
exciting
include
excessive carbohydrates and fats, foods allergies, food rich in Iodine.
gastro-intestinal disturbances,
disorders,
endocrine
chemicals
factors, ingestion of halogens and contact with
tar
psycho-genic
such as
associated
or chlorinated-hydrocarbons. It is most commonly
with adolescence. For unexplained reasons
the lesions may become
worse during the premenstruum.
The symptoms of Acne are
sebaceous glands and
often
a
hair follicles
chronic
of
inflammation of the
the skin characterised by
papules or pustules. Cysts and nodules may develop and scarring is
common. It is usually associated with Seborrhoea Congestiva (a facial
form of affection with elevated patches having red borders and som
etimes covered
with
usually result from
crusts
Acne
and
Vulgaris
scars). Comedones
and
is seen
(blackheads)
as a
discoloured
sebum plugging an excretory duct of the skin.
PROGNOSIS
Obstinate, persistent and recurrent
particularly with AQUIFOLIUM.
but
amenable to
treatment,
4
TREATMENT
AQUIFOLIUM tablets
and c»eam concomitantly. Systemic treatment
consists of AQUIFOLIUM
tablets
taken
ocal application of AQUIFOLIUM cream.
orally concomitantly with
ACTION
—AQUIFOLIUM tablets are a combination of Homeopathic ingredients
BP>own to act on Acne Vulgaris and Comedones. The treatment has
been clinically tried and
over a a
tested
long poriod by BecK &
Koll Laboratories Pvt. Ltd., It has the effect of tackling the problem
systemically to restore the hormonal imbalance
normal activity of the sebaceous glands.
and restore the
AQUIFOLIUM cream topically applied has the property of softening the
papules, pustules, cysts or nodules and gently, but surely extracts and
drains the purulent matter in a natural way. It is very important that the
oral tablets and topical ointment
After about a fortnight's
should
be
used concomitantly.
treatment the appearance of new lesions
should slow down or cease with a simultaneous improvement in the
overall condition After a few months treatment the Acne/Comedones will be gradually but entirely and permanently eliminated.
DOSAGE
•
1. Tablets :
In the beginning two
tablets AQUIFOLIUM at a time
three times a day. Once improvement sets in, dose may be reduced
to one tablet three times a day.
2. The
Cream The affected part should be thoroughly washed with
ild soap or "besan" (gram flour) and warm water. After thoro'ughly
drying,
AQUIFOLIUM
cream should
be
applied
over
the whole affected area and
gently worked into the skin
with circular motion of the fingers. The cream should be
applied as often as possible but in any case must be applied
before retiring at night and left overnight.
I
OIETIC
RESTRICTIONS
Refrain from eating or drinking anything (except water) or from
1.
use of tobacco for atleast one hour before or after ingestni^
AQUIFOLIUM tablets
Avoid foods which are known to cause exacerbation particularly
2.
fatty foods, deep
fried
or extremely pungent or sour
items.
coffee and substances, rich in Bromides or Iodides.
CONTRA - INDICATIONS
NIL
EFFECTS
NIL
SIDE
PRESENTATION
1.
In a carrier kit containing 20 gms. tablets and 20 gms. cream
2.
20 gms. tablets in separate pack
3
20 gms. Cream in separate pack.
Manufactured in India by :
BECK & KOLL LABORATORIES
PRIVATE LIMITED
•
37-A, Govt. Ind. Estate, Kandivli (West)
Bombay-400 067.
y\' ft_
ALFAMALT
A weight gainer & body builder
For (he use only of'Registered Medical Practilioners or a Hospital or laboratories!
INDICATIONS:
ALFAMALT is a Homoeo
pathic preparation. It is
—-ideal for the stimulation
♦'and regeneration of both
physical and mental pro
cesses, particularly when
the normal capacity of
assimilation is retarded as
a result of disease. It is
particularly indicated in
cases of convalescence,
constant fatigue, nervous
exhaustion,
irritability,
sleeplessness,
anaemia
and chlorosis. It can also
be recommended conco
mitantly with enriched
food intake, in cases of
under weight, malnutri
tion and undernourish
ment.
ACTION: Homoeopathic
tonics have a uniquely
effective action on the
body cells. Quite com
monly, in modern practice
it is seen that doses of the
desired chemical or sub
stance are simply not
assimilated by the body
in a weakened state
though administered in
large quantities.The same
chemical or substance is
ccmmv;
47/1,(First
b.-.k
seen to be assimilated
more readily if it occurs
in a food, fruit, or vege
table albeit in minute
quantity. It is therefore
not merely the quantity
but more importantly the
minuteness of size of
each individual particle of
the substance that makes
one form more effective
than the other. In Homo
eopathic tonics,
each
individual component is
dynamically ground (tri
turated) to the finest
possible powder several
times reducing the desired
ingredient to a molecu
larly active state. In this
state it is promptly assi
milated by the body cells.
ALFAMALT
A weight gainer 8 body builder
For the use only ot-Registerad Medical Practitioners or a Hospital or Laboratories
The individual components act as follows:
ALFALFA: Long known for its unique property of adding muscle tissue without
adding fat. Tones up the appetite, greatly improves vigor and gain in weight.
Disorders due to malnutrition. Neurasthenia, splanchnic blues, nervousness,
insomnia, nervous indigestion, increases milk in nursing mothers. Induces mental
exhilaration, buoyancy and a general feeling of wellbeing.
AVENA SATIVA: Brain and nerve tonic. Nervous exhaustion, sexual debility,
canvalescence, nerve tremors, chorea, alcoholism and sleeplessness of alcoholics
and many female troubles.
CHINA: Debility, exhausting discharges and loss of vital fluids. Chronic gout.
Chronic suppurative pyelitis, mental apathy, despondency.
HYDRASTIS: Especially active in old, easily tired, cachetic or greatly debilitated
individuals. Cerebral effects prominent; wits feel sharpened. Tones up weak
muscular power poor digestion and obstinate constipation. In lumbago, emaciation,
prostration and sluggish liver.
The Glycerophosphates of Calcium, Ferrum, Magnesium, Kalium and Natrum.
CALCIUM: A tissue remedy specially indicated in tardy dentition, bone disease,
bone fractures.
FERRUM: (Iron) For first stage of all febrile disturbances and inflammations
anaemias and hemorrages. Increases haemoglobin.
KALIUM: (Potassium) A nerve remedy. Want of nerve power, neurasthenia,
depression.
MAGNESIUM: Antispasmodic relieving cramp in muscles, neuralagic pains. For bad,
digestion, enteralgia and flatulent colic with belching of gas.
NATRUM: (Sodium) A good liver toner.
DOSAGE- Adults two tablespoons (Children one) before meals and at bedtime.
DI ETIC RESTRICTIONS: Nil.
SIDE EFFECTS: The ingredients in ALFAMALT Tonic are naturally occurmg vegetA
ble and mineral substances and the side effects are nil. It can also consequents^
be used concomitantly with any system of medicine with absolute confidence as
there are no contra indications.
PRESENTATION: 100 gm, 400 gm & 1000 gm.
"Ref.: Homoeopathic Pharmacopeia of the United States VII ed
Homoeopathic Materia Medica-Or. W. Boerike MD (U.S.A.)
BECK 8 KOLL LABORATORIES
PRIVATE LIMITED
37-A, Government Industrial Estate,
Kandivli (West), Bombay 400 067.
Phone: 695037.
<3 °l ■ (pf'
For the use only of Registered Medical
Practitioners or a Hospital or a Laboratory
BEKOMENT OINTMENTS
A therapeutic index for the general practitioner
Mfgd. by
BECK & KOLL LABORATORIES PVE LTD.
37-A, Govt, Ind. Estate, Kandlvll, BOMBAY-400 067.
BEKOMENT OINTMENTS are NON ANTIBIOTIC salves prepared with herbs,
which have been successfully used through the ages as remedies for various
afflictions with gratifying results.
The treasure of information on these remedies gathered over the centuries
has been combined with clinical trials on scientific principles in our Laboratories
•^determine the most efficacious combination for a particular ailment.
The active ingredients of each herb are extracted by Homoeopathic principles &
combined to make the various ointments under the most hygenic conditions at
the modern and spacious Beck & Koll Laboratories Pvt. Ltd.
BEKOMENT OINTMENTS will be found particularly useful by the practitioner
who seeks topical treatment of a specific nature. It is specially recommended in
cases where antibiotic or sulpha - based ointments are not considered suitable.
They can be freely employed without any reservations about irpmunological
or allergic side-effects.
FOR MOST CASES, ORAL HOMOEOPATHIC TREATMENT CAN BE EMPLOYED
CONCURRENTLY WITH BENEFICIAL RESULTS.
We are at your service for any further guidance.
Contents (all external Mother
BEKOMENT No.
Indications
BEKOMENT 1
ANTISEPTIC-cuts, wounds, &
neuralgia resulting therefrom.
Calendula, Ledum, Hyperi
cum, et. al.
fcKOMENT 2
BITES, & STINGS-of
insects, ants, etc.
Apis, Ledum, et. al.
Tinctures in Petroleum jelly q. s.)
rats.
BEKOMENT 3
BOILS, ULCERS, ABSCESSES
suppurating, indolent, indurated,
slow to heal, also prevents ten
dency. Hastens suppuration.
Echinacea, Silicea, Paeonia
et. al.
BEKOMENT 4
BONE FRACTURES-pain, neura
lgia resulting therefrom. Trauma
tic affection. Aids knitting &
healing of the fracture.
Ruta, Symphytum et. aL
BEKOMENT 5
BURNS-to protect from extrane
ous infection and aid healing.
Cantharis, Calendula et al.
BEKOMENT
No.
Indications
Contents (all external Mother
Tinctures in Petrolium jelly q. s.
BEKOMENT 6
CHAPPED SKIN -winter skin
chapped or cracked lips & cracks
around soles of feet
Borax, Pusikava, et. al.
BEKOMENT 7
ITCH & RASH-Allergic or non
specific rash or itching of skin.
Urticaria, Herpes simplex.
Urtica Urens, et. al.
BEKOMENT 8
PILES-Haemorrhoidsof all types
(Blind &/or bleedingor painful).
Hammamelis,
et. al.
BEKOMENT 9
PSORIASIS-weeping eczema &
psoriasis.
Graphities lx et. al.
BEKOMENT 10
RING WORM, Barber's Itch.
Chrysarobinum lx et. al.
BEKOMENT 11
SKIN DISEASES-(Scrofula) Any
skin disorders. For relief of
pruritus, in general.
Calendula,
Echinacea,
Skookum, et. al.
BEKOMENT 12
INFLAMMATIONS-Due to over
strain, sprains, contusion or in
jury where the skin is not broken.
Arnica, Belladonna,
pericum, et. al.
BEKOMENT 13
SCABIES, Dermatitis.
Sulphur, Echinacea, skoo
kum et. al.
BEKOMENT 14
OEDEMA-Leprous or filariatic
affections of skin.
Hydrastis, Skookum, Chaul
mogra et. al.
BEKOMENT 15
PARASITES-Pedlculii (Lice) a
other skin, hair or body parasites.
Sabadilla, Azadiricta, et. al.
BEKOMENT 16
WARTS a CORNS-of ail kinds.
Aesculus
Hy
Thuja. Antim Crud, Calc.
Flour, et. al.
Presentation:-! 5 gm, Tube or 100 gm. & 450 gm. Dispensing Jars.
SPECIAL PREPARATIONS
AQUIFOLIUM
CREAM
PIMPLES a ACNE - Makes the
complexion clear,
soft and
smooth.
A preparation of Berber
mountain grape in a water
soluble base.
RHEUMA-SAJ
OIL
RHEUMATISM - Or any kind
of joint or muscular pain like
sciatica etc.
A herbal mixture in a specia]
vegetable andelectromagnetically activated oil base.
Presentation : Aquifolium-15 gm. 30 gm. tubes. Rheumasaj-50 ml.
FOR THE USE ONLY OF A REGISTERED MEDICAL PRACTITIONER
OR A HOSPITAL OR LABORATORY
BECK a KOLL'S
CALENDULA
Calendula officinalis. N. O. Compositae. Tincture of leaves and flowers.
Genera! :
Calendula is a herbal antiseptic. The plant species belongs to the same
family as the other great vulneraries in the Homoeopathic Materia MedicaArnica Montana and Bellis Perennis.
The medication in this preparation is the tincture extracted from the leaves
and flowers of Calendula. Being herbal, it is absolutely free from noxious,
toxic or allergic side effects. It is therefore ideally suited even for long
term treatment.
Being safe, effective and uncomplicated in use, this preparation is being
increasingly favoured and prescribed by practitioners of all systems of
medicine and particularly in OPD and post-surgical cases.
Indications :
Calendula, applied locally, is one of Nature's most remarkable healing
agents. The special kind of wounds indicating it's use are lacerated wounds
and suppurating wounds. It has been found to be very useful for open
wounds, wounds that will not heal fast, ulcers and carbuncles. It has also
been usefully employed in cases of erysipelas and superficial burns and
scalds.
Action :
Calendula promotes healthy granulation and rapid healing by first intention.
Calendula further promotes
favourable
cicatrization with minimum
suppuration, slough, proud flesh or raised edges. The entire vulnerary
process takes place in a gentle, safe, natural but effective manner to
nurse the traumatised tissues back to normal health.
Contra-indications :
NIL
Side Effects :
NIL
Presentation :
Calendula Ointment :
Calendula Special
Calendula Tinct, in petroleum jelly base.
Calendula Tinct, in a special soothing
water-soluble base.
Calendula Lotion
Liquid dispersion of Calendula Tinct. in distilled
water, glycerol and alcohol (For cleaning wounds)
K
r Homoeopathy 1
,
is at your
1
t Beck and Call at j
L Beck & Koi I J
Manufactured by
BECK & KOLL Labs (P) Ltd.
37A. Government Industrial Estate. Kandivli (West). Bombay-400 067.
For the use onjy of Registered Medical
Practitioners or a Hospital ora Laboratory
ALBEKA U L
HOMOEOPATHIC MEDICINE
GENERAL TONIC
chi c - LL
ft7n'kBSGAU°
. Nlafk-3 t^oao
^uQ
&
Manufactured by -
BECK & KAUL Bombay~-400 056.
is a composition of the 12 mineral salts of Biochemistry
each of which has been prepared by potentisation wiih LACTOS^
in accordance with Hahnemann’s homoeopathic prescription
Albekaul
All these salts are supplied in large quantities in our food but do not
in that form help to overcome disease. The biochemical method shou
ld not be regarded as a mere substitution method for replacing def
icient substances. The essential point is the preparation of these
substances into a state which can influence the cells.
The organ relations and indications of each of the Biochemical remed
ies are given below in a very condensed form. The detailed study of
these however constitutes a science in itself which deserves special
attention separately and the works of eminent scientists are ava
ilable with BECK AND KAUL.
Calcarea Fiuorica (Calcium fluoride): aims
particularly at the tissue
of capsules, ligaments and tendons and at the teeth, bones, veins
and lymphatic glands.
Calcarea Phosphorica : (Calcium Phosphate) in its potentised form acts
on the whole bony skeletal system, the red marrow, the connective
tissues, the lymphatic glands, the mucous membranes and the gastro
intestinal tracts.
Ferram Phosphorkum :( Ferrum Phosphate ) its chief target is theblood (haemoglobin) blood vassels fibrous tissues of muscles and
joints gastro-intestinal tract, ovaries.
Kail Muriaticum (Potassium Chloride) : in the potentised form acts
particularly on the cornea, the middle and inner ear, the mucous
membranes and glands of the lymphoid ring, the lymphatic gland
system, the lung, the pleura, the peritonium and the synovial
membranes of the joints.
Kan Phosplioricani (Potassium Phosphate) : is present mainly in the
brain and nerve cells and its potentised form acts on them.
Kali Sulphurlcum (Potassium Sulphate) : is found in the epithelial
cells of the skin and the mucous membranes and its potentised
form is useful in advanced inflammatory conditions accompanied
by yellow slimy exudations.
Magnesia Phosphorica
(Magnesium Phosphate) : in its potentised
form is an antispasmodic and analgesic and its main targets are
the central nervous system, the peripheral nerves and all hollow
organs (stomach, intestines, bladder etc.)
Natrum Murlaticutn (Sodium Chloride) : in its potentised form acts
on autonomic nervous system, the mucosa of the upper respiratory
tract, the heart, thyroid, liver, gastro-intestinal tract, the skin and
ihe genitals.
|iatrum Phosphorlcum (Sodium Phosphate): isaconstituent of the blo
od corpuscles, the muscle nerve and brain cells, and the tissue fluids,
Natrum SuiPhuricum (Sodium Sulphate) t acts mainly on the liver,
the gall bladder and the gastro-intestinal tracts.
Silicon : (; Silicic acid ) in its potentised form-acts on the connective
tissues the bone and lymphoid tissues, the skin, teeth, hair nails
and the central ncrvous system.
C'aiccrca Sulplintica _■( Calcium sulphate) has a favourable influe
nce on ulcers and suppurative processes.
. .
if th’c case is treatable biochemically one of these cell salts will gen
erally bcsiilhcient to aid recovery, bur it is essential to choose the
right remedy which is not always easy. Therefore it has been found
expcdicnt to combine these medicaments into product.
Xl&cliiriil ; the constant use of which Will furnish any of the cell salts
needed to replenish the cells destroyed in the initial stages of the
dis.cas.e itself. ,
_. . f
Biochemic medicines arc jabsolutely harmless and there is not
chance of
overdosage”.
the slightest
This form is therefore eminently suited for
very small children.
for adults 2.tablets thr ee a day and for children half this
dosage...half an.ho.u.tjbefore.or after injbibing food or drinks.
Dosage •„
The tablets should be dissolved in the mouth below thc.tongue. Tor
babies and infants the tablets should be crushed and carefully adr^^
histered as a po'wder'if necessary dissolved in a teaspodnful of water.
but not under any circumstances In-the bottle feed.
Diet ; As a general ionic,- ALBEK-AUL docs not need any special dicl
'^oP3thi. Medjcjne
FOff BABIES DURING
'^9. Lie N0 H/2
Dadaf-B^y°2^°PATHlC PHARMACY
OENTITION
TONIC POWDER
A TRIED TONIC FOR DEBILITY AND LIVER DISORDERS
INDICATIONS :
ANEMIA
RETARDED
DENTITION,
DISORDERS.
ORGANIC
LACK
NEURASTHENIA,
LACK
GENERAL
FEBRILE
OF
OF
APPETITE.
ASSIMILATION,
CONDITIONS AND
LIVER
INSOMNIA DUE TO
FATIGUE.
ALSO USEFUL TO PREVENT SUMMER
DIARRHOEAS
TO
AND TENDENCY
CATCH COLD.
IT IS HIGHLY RECOMMENDED FOR
CHILDREN ALONG
WITH
EASIDENT
(TEETHING PILLS) TO ACCELERATE VITALITY.
Calcarea
COMPOSITION ;
Natrum
Phosphoricum,
Kali
Phosphoricum.
Muriaticum.
Ferrum
Magnesia
Phosphoricum
Phosphoricum. in
30 x lactose q.s.
(As per measure spoon enclosed in the carton)
DOSAGE :
: 1 to 2 spoons
Infants
Children : 2 to 3 spoons
: 2 to 4 spoons
Adults
cut level 2 to 3 times a day.
SIDE EFFECTS :
Thi
tonic is a combination of Essential Biochemic
Salts required for the tissues of body,
They are atomised,
will neither be any side effects
contraindicated
nor is
hence there
along
with
any
other treatment,
PRESENTATION :
Bottle of 25 gms. in the form of Trituration.
Mfgrs : New era homoeopathic pharmacy Dadar, Bom.-28
KOFGAN®
Fcr tha use only of Registered Medica
Practitioners or a Hospital or Laboratory
OMOEOPATH1C MEDICINE
KOFGAN is a harmless cough remedy which acts effectively like any of New
Era’s well known Homoeopathic Combinations. It can be given in any cough
viz. dry irritating, or wet. smoker’s chronic cough and old asthmatic, bron
chitic cases. Its dynamic ingredients work within a few hours of its
administration.
THE INDIVIDUAL DRUGS ACT IN THE FOLLOWING WAY
Bryonia 200c : Dry hacking cough, hoarse voice, laryngeal soreness, Itching
in the throat is relieved.
Antim Sulph 200c: Tickling in larynxdry bar dcough, is relieved.Canprevent
pneumonia in early stages. It enhances expectoration to relieve the bronchi.
Drosera 200c: Helps in whooping cough or braking type of cough. It reduces
vomiting, relieves congestion & asthmatic wet cough.
Squilla Mar 200c Violent cough is ameliorated by this when there is
profuse salty expectoration or exhausting dry cough. It also helps in
cases where involuntary urination while coughing or sneezing.
IPECAC 200c : For difficult breathing, wheezing asthmatic cough, irritating
cough
DOS : Adults : 6 Pillets every three hours. Children (over 1 year) : 3 Pillers every three hours
Infants : (be;ow one year) 2 Pillets every three hours.
In acute cases dissolve 6 pillets in half a teacup warm water and administer a teaspoonful every
1 /2 hour
.Side Effect : nil
CQMJVR HtJiTV — A-.,... „
Presentation : Bottle of 15 gms. (approx.,^O,pilLets) ' '' ‘ ■ •-ALTH CEtL
NEW ERA HOMOEOPATHIC PHARMACY PVT. LTO, DAWAir^dMB"4^-400 023 Marks h'oo.-f
BAIXic/.lg
-
TG.-1
Phone : 5S4134
Dr. K. E. Peters
Regd. Homoeo Medical Fiacuu
■ t.-lc.oioA)
No. 11, IoLRd^rsteik&Meiirc^SO 001.
"BIO-COMB" No. 1 To28
(BIOCHEMIC COMBINATION TABLETS)
__
OF
O\
BECK & KOLL LABS PVT. LTD.
lHE human body is composed of watei, organic matter, and inorganic elc-
the amount of inorganic salts, iron. lime, potash, sodium, magnesium, silica.
According to Schuessler. should any of the lie-
I
I VCNALLY HOM
OEOPATHIC PHa^'vIAO'
Practitioners or a Hospital or a Laboratory
experiments Dr. Schuessler completed his new sys<
each contammg one of the rniportant morgamc cell salts found in the human
l— The therapeutic range of these twelve remedies covers a very wide field of
abnormal conditions affecting the human body.
They also offer the-noteworthy advantage of being exceptionally pleasant
X to take and of being entirely free from all undesirable drug effects.
The selection of the required Schuessler remedy simply demands careful
observation of the existing symptoms. A brief study of the functions of the
twelve Remedies will enable the physician to prescribe correctly, because the
symptoms for each remedy arc always distinctly characteristic. Schuessler’s
Biochemistry is in the fullest sense a true constructive science, based on strictly
natural laws.
- BECK & KOLL LABORATORIES PVT. LTD., through years of untiring
efforts in promoting the science of Biochemistry, has earned the reputation as
laboratories arc specially equipped for the scientific preparation of these re-
K
Manufactured by
BECK & KOLL Labs (P) Ltd.
37A, Government Industrial Estate,
Kandivli (West), Bombay-400 067.
I.
Anaemia and Chlorosis (Composition):
Calo, phos., Ferrum phoa., Nat
mur., Kali phoa.
Indications'. Lack of blood and loss of blood from any part of the body.
Cerebral and spinal anasmia; a general wasting of all the tissues; waxy appear
ance of the skin; chlorosis; palpitation, trembling and weakness; ancemia of the
brain from long continued mental strain.
2,
Asthma (Composition) :
Kali, phoe., Magn. phoa., Natr, mur., Natr- Sulf.
Indications: Nervous asthma, accompanied with cough, gasping for breath,
irregular pulse; asthma with troublesome flatulence or spasms, convulsive
tickling cough. Bronchial asthma with yellow sputa worse in the evening or
in warm room and better in cool air.
3.
Colic (Composition) :
Magn. phoa., Calo, phoa., Natr. sulf.. Ferrum phoa.
Indications: Colic of infants with drawing up of legs, during teething;
flatulent colic caused by friction or belching of gas. Colic of children and
adults due to blockage of intestines caused by flatulence or constipation.
Spasmodic pain, patient bends double.
4.
Constipation (Composition) I
Calc. fluor.. Kali, mur , Natr. mur., Silioea
Indications: Bowels constipated without apparent cause; liver torpid; stools
dry, hard and black; dull headache; foul breath; bad taste in mouth; tongue
coated.
5.
Coryza (Composition):
Ferrum phos.. Kali, mur., Natr, mur,, Kali, afilf.
Indications: Pain in the head, sneezing and discharge from nose or bron
chial tubes due to irritation and inflammation of mucous membranes. Feverish
ness.' Thick white discharge from the nose with white or grey coated tongue.
6.
Coughs, Colds and Catarrh (Composition): Ferrum phoe., Kali mur., Magn. phos,
Natr. mur. Natr. Sulf
Indications : Cold in the head; acute catarrh, rattling hollow cough: diffi
cult respiration, pain in chest, bronchitis.
7.
Diabetes (Composition): Cate, phoa., Furrum phoa., Kali., phos., Natr. phoa, Natr. aulf.
Indications : Excessive discharge of urine, pain in calves, thirst, dryness
of the lips, sleeplessness, nervous prostration, all chronic cases with liver dis
orders. It is recommended as a remedy to support the patient's state of health
by assimilating the glucose. Also strengthen the kidneys and nerves impaired
by diabetes.
8.
Diarrhoea (Composition) : Calo. phoa.. Ferrum phoa., Kali, phos-, Kftli sulf. Natr. sulf.
Indications : Thin watery stools with undigested food, thirst; due to fatty
or rich food, white coated tongue Watery stools with prostration.
9.
Dysentery (Composition):
Forrum phr>»., K.li. man, Kali, phos.. Magn,, phos..
Indications : Pain and urging at the beginning of stools. Stools contain
mucous and blood with constant inclination to empty the bowels.
10. Enlarged tonsils (Composition):
Calc, phos.. Ferrum phos.. Kali., mur.
Indications : Fever, lassitude; throat covered with white coating; tonsils
swollen; tongue coated: bad breath; no appetite.
11.
Fevers and inflammatory diseases(Composition): Ferrum phos., Kali mar..
Nat. Mur; Kali sulf., Natr. sulf.
Indications : Fevers; chills in the initial stages of all the inflammatory
diseases; in quick, sudden swellings; in pneumonia. Pleurisy and other inflam
matory affections that tend to suppuration.
Headache (Composition) : Ferrum phos., Natr. mur, Kall phoa., Magn. phos.
Indications : Congestion, rush of blood to the head, neuralgia, relieved
by heat and aggravated by cold, nervous, due to worry or sleeplessness, white
tongue or sluggish liver; better in the open air, worse in a warm room, or in
the evening.
12.
13.
Leucorrhoea (Composition) : Calo, phoa, Kali aulf,, Kali phoa, Natr. mur.
Indications : All forms of leucorrhoea at puberty; during pregnancy and
at the climacteric; also in general weakness and hysteria.
14.
Measles (Composition) :
Forrum phoa,, Kali mur., Kali sulf.
Indications : Sneezing, eyes and nose waters, fever. Useful in all stages of
the disease.
15. Menstruation troubles (Composition) ; Calc, phos, Ferrum phoa., Kali phoa, Magn.
phoa., Kali aulf.
Indications : Menses painful and irregular, scanty and late in young
women, Menses early, lasts too long and profuse in middle aged women.
16.
NerVOUS exhaustion (Composition) : Calo. phoa., Forrum ph03., Kali phos., Magn.
phos, Natr. mur.
Indications : It is recommended for nervous exhaustion and fatigue from
any cause; for general weakness of the heart, stomach and nervous system,
sleeplessness.
17.
Piles (Composition) '. Calc, fluor., Kali phos, Ferrum phoa.. Kali mur.
Indications : An approved remedy against hemorrhoidal knots, all kinds
of piles, external piles with stinging pains. Bleeding piles with or without pain.
18.
Pyorrhoea (Composition).’ Calo. fluor., Silioea. Calo, sulf.
Indications : Gums spongy, swollen; gums bleeding. Pus in the gums with
foul breath.
19.
Rheumatism tablets (Composition):Ferrum phos,Magn. phos, Kaliaulf,Natr.sulf.
Indications
Shooting and slabbing pains in the joints of legs or arms,
worse at night. Fever; swelling of parts; lumbago; sciatica;
matism.
muscular rheu
20.
Skin diseases (Composition) Calc. fluor. Calc, sulf., Kali sulf.. Natr niur.,
Natr. sulf.
Indications : Scurfy eruptions in head and face of children; eczema from
uterine derangements; acne; pemphigus; herpes; erysipelas; crusta iactea; and
similar eruptive diseases.
21.
Teething troubles (Composition)
Calc, phos, Forrum phos.
Indications : When children arc cross and obstinate, crying and weeping,
these tablets help the cutting of teeth easily and quickly by supplying nescssary
salts. The appetite is improved and the digestion is stimulated. Removes griping.
22.
Scrophula (Composition) Calo, phoa., Ferrum phos., Kali, mur., Silices.
Indications:
Useful both in dry and suppurating scrofulous glandular
abscesses. Covers almost all symptoms of the disease.
23.
Toothache (Composition)
Ferrum ph03., Magn. phoa., Calc, fluor.
Indications : Specially recommended in all neuralgic cases. Splendid effect
in rheumatic toothache.
24.
Tonic ; Nerve and Brain (Composition)
Calo, phoa., Ferrum phoa.
Kali phos, Magn.phoa, Natr phoa.
Indications : A general tonic in chronic wasting diseases; in antemia of
of young and rapidly growing people; in women weakened by too frequent
parturition; general debility and exhaustion with lack of vitality.
25.
Acidity, Flatulence and Indigestion (Composition) Natr. phos.,
Natr. sulf., Silicon.
Indications :
Gastric disturbances; acidity; flatulence; dyspepsia; acid, sour
risings; feeling of weight in abdomen; bilious vomiting; flatulent colic;headache;
jaundice.
26.
Easy Parturition (Composition) Magn. phoa, Calc, phoa, Kali phoa. Calo, fluor.
Indications : If these tablets are taken during the entire period of preg
nancy, they will greatly relieve the pains of labour. They also greatly benefit
the mother s general constitution and greatly assist in the development and
the health of the child. These tablets also prevent miscarriage.
27.
Vital Weakness (Composition) Natr. mur, Kalt phos. Calc, phos,
Indications:
Impotence, depression of sexual instinct; lassitude and
general debility; emissions followed by trembling and weakness; prematurely
old; tones up the entire sexual system.
28. General Tonic (Composition): All twelve Tissue Ramediea,
Indications : These tablets are a combination incorporating the twelve
Tissue Remedies found in the human organism. They are of great service to.
those suffering from consumption and other debilitating diseases, to such as
are recovering from fevers, pneumonia, diarrhoea, etc., as they heip to build
up the system by supplying the requisite nutrition. It may be taken by the
weak and the aged as a tonic after meals. Habitual use of these tablets, during
health, will keep off disease.
Arnica 30,
For injuries5 fails, blows o- contusions.
It is particularly suited to cases when any
injury, however remote, has resulted in
certain diseased states. A dose every 4 hours
ipecac 30.
Is particularly suited for children. The
principal feature of Ipecac is its persistent
nausea and vomiting. Hence it is indicated
in billious attacks. Also for colds of
children when chest seems full of phlegm but
does not yield to coughing.
dose every
3 hours.
Dux Vomica 30.Is essentially a man’s remedy. It is pre
eminently the remedy for many of the conditic
incident to modern life. It is an excellent
remedy for indigestion, dyspepsia and consti
pation. (particularly when the evacuations
are small.) a dose every 4 hours.
China 30.
Is good for anaemia and gases in the stomach
when the entire abdomen is bloated. A dose
every 4 to 5 hours.
xulsatilla 1000. Is pre-eminently a woman's remedy. It st
should be administered in this potency only
in chronic complaints. The lower potencies
are useful in
acute
complaints.
Dosage.
For an adult.
5 pills per dose.
For children below 12. 3 pills per dose.
For babies & infants.
For J.
2 pills per dose.
dux Vomica 30. On the first day take two doses
of i<ux Vomica 30 one about 5 r.u.. and the other
at bed-time. For the three succeeding days take
one dose of Nux Vomica at bed-time.
Nux Vomica acts best when taken in the evening
or at night.
COMMUNITY h. alth cell
(First iToonJ.. Marks Hoac?
BANGALORE - 5t>0 001
V
For L
China or Cinchona 30. On three successive days take three
doses of China daily. There should be an
interval of at least 4 hours between the
doses. After a break of two to three days
take the medicine once again (i.e. three
doses a day) and continue in this manner till
a cure is effected.
x-ulsatilla 1000,
Later take one dose ( and one dose only)
at 10 A.m. in the morning and await results.
bo not repeat
unl^fe
advised by me. A week after the drug has
been taken a report should be sent to me.
Gelsemium 3Q.
For influenza and influenza colds, h dose
every two to three hours till acute conditic
abate. Later lengtheii the intervals.
INDICATIONS
PRODUCTS
ALBEKAUL®
(Tablets)
ALFALFA Tabs
ALFALFA
TONIC
Tissue Tonic
Tonic Tablets
A General Tonic Syrup
Hair Tonic
ARNIFLOR®
ENLACTO®
(Baby Tonic)
GASGAN®
GASGAN FORTE®
KOFGAN®
KOFGAN FORTE®
MULLEIN OIL
OVA-TOSTA
PHYTOLACCA
BERRY Tabs
P1LEN®
PILEN FORTE®
General Tissue Tonic
(>
11
(I
’
Eardrops
Ladies’ Complaints
For a Trim Figure
i!
!’
Internal or External
Piles
<I
]i
Tonsils and Common
Cold
General Tissue Tonic
TONIC POWDER
TONSILON®
TONSILON FORTE®
WARTEX®
(Pills & Ointment)
PIMPLENE®
Ointment
DERMOLINE®
Ointment
CALENDOL®
Ointment
indigestion
& Flatulence
Cough
and Bronchitis
Warts & Corns
Pimples &tAcne
Skin Disorders
Antiseptic
GRAPHITOL®
Ointment
Eczemas and Psoriasis
RINGOMENT®
Ointment
Ringworm
BIOCHEMIC
SETS
Mini Dispensary
(Tabs. & Powders)
BIOMIX®
See Guide for Treatment
1 to 28
of 28 Different
Ailments
Do write in for more details or Phone: 45 50 60
Information for the use only of a Registered Medical
Practitioner or a Hospital or Laboratory
NEW ERA’S
Oasgsn®
HOMOEOPATHIC MEDICINE
A very effective Homoeopathic combination formulated to relieve
flatulence, dyspepsia, eructations, waterbrash, gastralgia & discomf
orts caused due to indigestion. It contains the following medicines
which act to improve the digestive processes.
Its individual drugs act in the following way :
Nux Vomica 200c : Reduces acidity and flatulence, thus relieves
pressure on the chest and distress in breathing, regulates bowel
movements, therefore promotes healthier digestion. It helps to ove
rcome the digestive disturbances in people who have sedentary
habits.
Carbo Veg 200c: Acts on flatulence which causes distressing
eructations, acidity, water brash and gastralgia. It helps persons
who get temporary relief with eructation.
Colchicum 200c : It relieves constipation and a peculiar ineffectual
urge for passing stools. It also reduces flatulence and nausea.
These remedies in combination have a marvellous effect on liver and
gastric mucosa reducing the ph of the gastric juice and improving
liver activity, thus eliminating acidity and constipation.
Dose: 4 to 6 pills Twice daily. (Children-Half the dose).
In acute pains, six pills dissolved in hot water and. administe
red every 3 hours gives quicker relief.
Contra-indications: Nil C0Wlivl'-'r-'"^iSe-'effects: Nil
47/1, (First Floor) J .. Marks Road
Presentation: 15 gms. (app?^2-56-pllte)-,'&01?)@'igms.
® Regd. Trade Mark
NEW ERA HOMOEOPATHIC PHARMACY PVT. LTD.
DADAR (W. R.), BOMBAY-400 028
PHONE : 45 50 60
Please See Overleaf For Our Other Popular Specialities
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TIME:—
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Special treatments for-Arthritis, All kinds of Allergies,
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treated ACT NOW-
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$H€RBOflT
AYURVEDA ACHIEVES A BREAKTHROUGH
IN HEALTH SCIENCE
Ayurveda. the ancient med-cal system of India, has estaolished that the human
body s made of Tridosh (Vata. Pitta and Kafa). Saptadhatu (Ras. Rakta. Med.
Mauns. Asthi, Majja & 'Sukra) and Malamutra. Oisharmonv of these three
HERBOLAB. an Ayurvedic Research Foundation, has undertaken sophisticated
research into the traditional medical wisdom of India .and has successfully
developed a new concept in human health science in the form of 'HERBOFIT—
an easy-to-take Capsule of concentrates of vital herbs, fruits and minerals.
HOW DO YOU BENEFIT FROM HERBOFIT
• It restores normal ajpetito. helps digestion alt clears bowels normally.
muscles of the body • Strengthens lung tissues •Improves the quality of
HERBOFIT, in effect helps nourish human systems & increases body resistance
body’s resistance HERBOFIT is on excellent Ayurvedic formulation tor restoring
fcrably after breakfast.
15 and 60 capsule packs. Each, capsule imprinted HERBOFIT
HERBOFIT—THE NATURAL WAY TO HEALTH THROUGH AYURVEDA.
^H£RBOLHB
Regd. Office : Baug-E-Sara, 1st floor, 16, Nepean Sea Road, Bombay 400036.
RINCHEN DANGJOR RILNAG CHENMO
(The Great Precious Cold Compound Black Pill)
" I Prostrate to the Lord of Aquamarine Light,
the Master of Medicine, the Enlightened One,
who cures the ailments caused by the three poisons.
I
,
Those who merely hear His Name
are protected from the sufferings
of the evil states of existence.
by virtue of His Compassion.
Praise to the Victorious One,
who has subdued the host of Evil Forces,
for the benefit of all living beings"
This! Great Precious Cold Compound Black Pill, prepared by fully qualified physicians of the Tibetan
Medical and Astro. Institute, is formulated and derived according to the understanding of the Kalachakra Tantra. This sacred knowledge has been passed down in an unbroken lineage directly from the
thirteenth century Tibetan scholar and saint, khedrup Ugyen Rinchen Pel.
According to the Gyu-shi, the four basic medical tantras of the traditional Tibetan Medical System,
it was predicted that in modern times mankind will suffer from eighteen types of new malignant
disorders. The medicine Buddha prophesized that these, and a large number of other contemporary
’ chronic disorders, would result from mankind’s misconduct, cruelty and improper behaviour’:
<~«^rom an un-wholesome diet : from an abundance of chemical pollutants in food and in the environment.
was also predicted that the appearance of a new micro-organism would bring great suffering to
■ (^ft.nkind at this time.
1
This Great Pill is recommended for all types of contagious fever and colic pains. It removes debility,
greying of hairs and wrinkles, and strengthens the bones. It is also beneficial in case of allergies,
various types of arthritis, and peptic ulcers ; provides physical radiance and clarity of sense organs.
It also purifies major organ systems of the body and assists in proper regulation of the body
'i f^ynperature.
j^jjChis Great Pill is particularly effective against all types of food poisoning, chemical poisoning
' pietal poisoning etc. and chronic illnesses of modern era, especially those caused by the extensive
. 'pollutants of our time.
^It^revents communicable diseases and protects oneself from the evil spirits.
Ry a healthy person, this pill is an excellent tonic I
Thip Great Precious Cold Compound Black Pill contains more than one hundred ingredients, including
'metals, gold, silver, copper, and iron; the precious stones sapphire, emarald, turquiose, ruby,
diamond, all in detoxified form : and a great number of herbal ingredients, including Crocus
'us L,, Silicious concretion of bamboo, Myristica fragrans Houtt, Phytolacca esculenta Van Houtte,
ciodianthus Franch, Delphinium brunonianum Royle, Oxytropis sp, Frittilaria delavayi French,
eris aristata D. C., Myricaria bracteata Royle, Terminalia Chebula retz, etc.
TRUCTIONS :
:pt in case of emergencies, the Great Precious Cold Compound Black Pill is to be taken on
cious dates. For maximum benefit, one should try to observe the following dietery restrictions :
a period of atleast two days after taking the medicine, one should avoid eating meat; eggs ;
■ jaw' fruits or vegetables; fried, pungent, sour foods; and garlic. During this period, one'should
i «Bsq refrain from strenous exercise, sexual activity, and cold baths.
,
1
The Great Precious Cold Compound Black Pill is to be taken early in the morning. On the evening
• before, remove and crush the Great Pill, and then place it in boiled water, in a clean and unbroken
cup. Cover the cup with a clean, white cloth and allow the Pill to soak overnight. On this evening,
it is particularly important to dress warmly, and to be warm during sleep.
I
Early the next morning one should drink the mixture after stirring it thoroughly with the ring’finger.-’
. Tjlis should then be followed by drinking a cup of warm, boiled water.
; IT IS IMPORTANT THAT THIS PILL SHOULD NOT BE EXPOSED TO DIRECT SUNLIGHT
OR BRIGHT ARTIFICIAL LIGHT. IT SHOULD BE PREPRARED AND TAKEN ONLY IN
DIM LIGHT.
TIBETAN MEDICAL & ASTRO. INSTITUTE
Phones : Office 2618
Khara Danda Road, Dharamsala
Clinic 2684
Distt. KangraH.P. (INDIA)
,
RlhlCHEN TSO-TRU DHASHEL
( Precious Purified Moon Crystal)
This Precious Rinchen Tso-tru Dhashel has been compounded from about fifty different
ingredients following the exact formula developed by the renowned fifteenth century Tibetan
scholar and physician, Surkhar Nyam-Nyi Dorjee.
This precious pill is an anti-dote; it purifies and helps with the circulation of the
blood, it heals stomach ulcers, liver ailments; it stops severe pains and ailments caused by
sudden changes in diet and climate. It heals hidden fevers and chronic ailments after a fever,
when one cannot eat well and there is loss of hair and loss of strength and clarity of the
teeth and nails. It is excellent for combatting infections and inflammations. It also heals
ailments caused by excess of diet and alcohol It is a good tonic for dark, thin persons of
weak constitution. This pill clears the senses and restores the memory. It treats inflammations
of the chest, including persistent cough with blood and phlegm discharges as well as
breathing problems. It also combats retention of water in the body. When one is in good
health, this pill will help to better the health, prolong one's life and it is a rejuvenating agent.
Some of the ingredients in this pill are gold, silver, copper, brass, lead and bronze, which
are purified of their toxics before being mixed with other herbal ingredients such as gynachum
forresti (schitr), saussaure lappa (Clarke), commiphora mukul (Engl), strychonos nux-vomica
(linn), myristica fragrans (Houtt) and eugenia caryophyllata (thumb). Many sacred pills and
the precious Ngochu-tsothel are also added to this pill.
Detailed instructions for taking this medicine is mentioned in the medical texts, but the
following prescription will be sufficient. This pill should be taken on an auspicious date, though
at the time of an illness, this pill is taken when needed. Before retiring to bed, take a clean,
unbroken cup and put a crushed pill in this cup, adding a small amount of hot water and cover
the cup with a clean cloth. Early next morning, take the ring finger of the right hand and stir
the mixture in the cup while repeating the mantra of the Medicine Buddha-TADYATHA AUM
BHAISHJYA BHAISHJYA MAHA BHAISHJYA BHAISHJYA RAJA SAMUD GATE SVAHA.
Drink this mixture followed by a cup of hot water. Retire in bed with this thick coverings for
about an hour so that the body prespires.
On the day this medicine is taken and if possible, a couple of days thereafter, refrain from
taking meat, eggs, fish, uncooked grains, garlic, onions, alcohol, sour food and drinks. Raw
vegetables and fruit, old and pungent food should be refrained also. One should not undertake
strenuous exercises nor sleep in the day and one should refrain from sexual intercourse and
cold baths. No other medications should be taken on the day this pills taken.
IT IS MOST IMPORTANT THAT THIS PILL SHOULD NOT BE EXPOSED TO DIRECT SUN OR
LAMP. IT SHOULD BE PREPARED AND TAKEN IN A DIMMED LIGHT.
Office 2618
Phones : Clinic 2484
TIBETAN MEDICAL INSTITUTE
Khara Danda Road, Dharamsala,
Distt. Kangra H. P. (INDIA)
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TIBETAN MEDICAL INSTITUTE
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Khara Danda Road,
Dharamsala.
Di.,it. Kangra H.P. (India)
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RINCHEN RATNA SAMPHEL
PRECIOUS WISH FULFILLING JEWEL
Phones:
Office : 618
Clinic : 484
The Rinchen Ratna Samphel or the Precious wish Fulfilling Jewel is an antidote ;
it combats food poison ; plant, insect and animal poisons, chemical poison and poison
from the sun rays etc. It is beneficial for all strokes and paralysis, for trembling and
numbness in the body, for lame and dislocated limbs, for all types of nerve disorders.
It also combats persistent urination due to nerve disorder, helps those who have difficulty
in opening and closing the eyelids, heals deafness, loss of smell, loss of bodily sensation
and loss of the control of saliva. It is good for controlling high blood pressure, heart
ailments, pulmonary TB, blood clots, ulcers in the body and primary cancer cases. It is
also extremely beneficial for relieving pain in advanced cancer patients and it cures
sudden ailments caused by different spirits.
Obtaining this Precious Pill is like obtaining a precious jewel from the King of
Medicines.
Beside the valuable NGOCHU TSOTHEL, a preparation of purified mercury,
sulpher and sixteen different metals and minerals; developed by the thirteenth century
Tibetan Scholar, Khedroob Ugen Rinchen Pal, there are seventy other ingredients in this
Precious Wish Fulfilling Pill. Some of these ingredients are purified gold, silver, copper,
iron, lead and load-stone; gems such as coral, turquoise, pearls, lapis lazuli and the rare
indigenous gem of Tibet, the Zi, cloves, bamboo manna, nutmegs and Terminalia
chebula Retz, Terminalia belerica Roxb and Emblica officinalis Linn (fruits). Many ancient
sacred pills are mixed in this medicine also.
This pill is to be taken on auspicious dates, though at a time of any emergency,
this pill is taken at the moment. For a period of two weeks or for a minimum of three
days after taking this pill, one should refrain from eating meat, eggs, garlic, onions spices,
raw vegetables and fruits, sour food, sour drinks and alcohol. One should refrain from
cold baths, inter-course and strenuous exercises. No other medication should be taken on
the day this pill is taken.
Take the pill out of the cloth, powder it and soak it overnight in a small
amount of hot water in a clean cup
Early the next morning drink this mixture, followed,
by a cup of a warm water and get back in bed with thick coverings or keep very warm.
IT IS MOST IMPORTANT THAT THIS PILL SHOULD NOT BE EXPOSED TO
DIRECT SUN OR LAMP. IT SHOULD BE PREPARED AND TAKEN IN A DIMMED
LIGHT.
TIBETAN MEDICAL INSTITUTE
DHARAMSALA
Distt. Kangra H. P. (INDIA)
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CHAKR1L CHENMO
(THE GREAT IRON PILL)
The Great Iron Pill consists of about forty (40) different ingredients such as purified iron filings, thret myrobalans without seeds, Kashmiri saffron, musk, solidified bile of elephant, saxifrage pasumensis marg, pur
ified magnetic stone, addatoda vasica, sea shells, white and red sandal woods, iceconopsis species, costus
roots, Indian valerian, rhino horn and asphaltum.
USES:- It is effective for all kinds of eye complaints: conjuctivitis, cataract, inability to tolerate light (pho
tophobia), blood shot eyes, corneal opacity, weakened optic nerve causing blindness, irritation from intro
duction of any foreign bodies in the eyes, swelling of the eye lids due to irritation caused by wind, irritation
due to disorders of the liquid in the eye, unnatural growth and pustules in the eye, micropurulent discharge,
inflammation of the lacrimal gland, lacrimation, dryness of the eyes, involuntary blinking of the eyes and it
eps the vessels of the eyes fresh and healthy.
is also effective to treat eye ailments caused by food poisoning, ailments caused by the impure blood in
the liver and spleen, hematesis (Vomitting of blood) due to stomach ulcer.
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INSTRUCTION:- Take the pill out of the cloth, powder it and soak it overnight in a small amount of hot
water in a clean cup. The preparation has to be done in a dim light. Take the mixture at dawn followed by
a cup of hot water. If possible one should recite the mantra of the medicine Buddha 'TADYATHA AUM
BHAISHJYA BHAISHJYA MAHA BHA1SHJYA RAJA SAMUD GATE SVAHA' and the mantra of
Avalokitesvara 'AUM MANI PADME HUM' as many times as possible before taking the pill.
Healthy person can also take this pill for the betterment of his/her sight and general health.
PRECAUTION:- On the day this pill is taken, avoid eating too much sour and salty items, alcoholic beve
rages, garlic, onion, rancid food, raw vegetables and fruits. One should not indulge in strenuous physical
activities.
TIBETAN MEDICAL INSTITUTE
Khara Danda Road,
Dharamsala.
Distt. Kangra H.P. India
j Office: 618
Phone ) Clinic: 484
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Phone : 618
RINCHEN YU NYING 25
PRECIOUS OLD TURQUOISE 25
TIBETAN MEDICAL INSTITUTE
Khara Danda Road,
Dharamsala-176215
H.P. India
This precious pill is made according to the method developed by
pon Tsang Zana. It consists of 25 ingredients, It is prepared from old
turquoise, coral, pearl which are purified of it’s toxic contents. Other costituents are purified iron filings, asphaitum, crocus satirus linn, muschus
moschiferous (musk), the there myrobalans without seeds, two types of
sandal wood, euqenia caryphyllata (thumb) saxicus pasumensis marg and
addatoda Vasica. Much prayers are recited during and after the pills are
made.
Old turquoise is a special pill. It is detoxicating and of a cool
nature. It is good for all liver ailments. It cures liver pain, enlargement of
the liver, loss of weight due to liver ailment and when there are destruction
of the nerves of the liver, it also helps to release the pressure on the upper
part of the boday, relieves stiff neck, headaches due to blood pressure,
nose bleeding, bloot shot eyes, pain under the airmpits. loss of appetite
due to stomach disorder. It treats damaged liver which is caused by over
consumption of alcohol and food poisoning.
On the day this pill is taken refrain from sour food and beverages,
raw vegetables and fruits, garlic, onion, rancid food and one should not
indulge in strenuous physical activities.
For healthy persons, to keep in better health, it is good to take this
pill sometimes. When one takes this pill, it is good to recite the mantra of
the Medicine Buddha : TADYATHA AUM BHAISHJYA MAHA BHAISHJYA RAJA SAMUD GATE SVAHA.
Laj Printers, Dharmsala Phone : 602
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For the use only of Registered Medical
Practitioners or a Hospital or Laboratory
®
PILEN
HOMOEOPATHIC
MEDICINE
This combination hes been tried and proved to be effective in piles of any kind
whether internal or external, bleeding or nonbleeding, It helps to reduce
agonising pains and to shrink piles. It can also check bleeding in case of
bleeding piles. It's benefical effect reduces constipation and further
given regular movements to the bowels.
It contains : Nit Acid (200c), Calc floor (200c) & Hamamelis (200c).
ITS INDIVIDUAL DRUGS ACT IN THE FOLLOWING WAY :
NIT ACID 2C0c : It reduces bleeding, soothes the splinter like pains,
regulates bowel movements.
Calt Flour 200c : It acts on bleeding piles, reduces bleeding, stops itching
sensation in the anal region, renders stool softer and helps to shrink blind
piles, Effectively releaves backache whenever associated with piles complaint.
Hamamelis 200c : It is a very effective drug on the haemorrhagic tendency
thus reducing and controlling haemorroidal bleeding in case of bleeding piles.
Complementary : Topical application of Pilen ointment is concomittantly
recommended.
ROSE : 6 pillets twise a day.
"de effects : Nil
® Registered Trade Mark
Presentation : Bottle of 250 Pillets.
For the use only of a Registered Medical Practitioner Or
a Hospital or a Laboratory.
WARTEX®
(Oral Pellets &
Callosities)
Topical
Ointment for Verrucae and
COMPOSITION :
Pellets
Ointment
Thuja
200 C
Causticum 200 C
Et al in
Homoeopathic
Dilutions
Calc Fluor
lx
Thuja
Q
Et al in
Homoeopathic
Tinctures
DESCRIPTION :
WARTEX, Oral and topical, a choice homoeopathic remedy
has been designed to satisfactorily treat cases of Verrucae
(Warts) and Callosities (Corns); WARTEX is a method to
'expunge warts. While various measures such as
electrodessication etc. are possible-, the chances of rec
urrence are not uncommon
and
in some cases
exceedingly high A dermatologist or a surgeon therefore,
still looks for a remedy which could be SAFE, EFFECTIVE
PAINLESS, EASY TO ADMINISTER and MOST IMPORTANT
DOES NOT LEAVE ANY MARKS OR SCARS (particularly
on the face as an) after effect. WARTEX largely meets all
these requirements and has a sustained result without
side effects or reactions.
ACTION
WARTEX is a combination in homoeopathic dilution of
substances known to act on warts & corns. It has been
clinically tried and tested in clinics run by New Era Hom
oeopathic Pharmacy over a long period. It has the property
of tackling the affected part and softening the circular
bed systemically so that normally, atleast after a few
months'treatment of oral pellets and topical ointment,
the warts/corns will be gradually eliminated It is very
important that WARTFX oral and topical ointment
should be concomitantly used.
1
WARTEX is useful incommon, benign epithelial tumours
and areas of painful hyperkeratosis. To name a few
WARTS :
1. Common warts; 2. Filiform or "thread warts;
3. Moist or "Venereal" warts; 4, Plantar warts;
)
5. Flat warts; 6 Unusual types-threadlike or ped
unculated or resembling a cauliflower frequently on
the neck head, or bearded region.
CORMS :
(Callosities) Both
without pain.
superficial or conical, with or
DOSAGE :
4-6 pellets t d s, At the same time ointment should
be topically applied to the affected parts, as often as
possible allowing the medicine to penetrate the area,
PACKING :
Oral :
Bottle of 15 gms.
DISPENSING PACK : 80 Gms.
Ointment:
15 gm,-in attractive tubes,
DISPENSING JAR-400 gm.
h’ote : 1) The medicinal concentration of this preparation
has a deep seated action but is designed to be
safe. Because of this, (depending on the chronicity of the case changes) may occur rather slowly
but will generally give ultimate satisfactory results.
Some cases in clinical trials even responded after
a gap of time, treatment having earlier bees^
given for several months and then discontinued.^
2) The strength and the ingredients have been
chosen to suit the median cases of verrucae and
callosities. In adamant cases, after standard
WARTEX treatment WARTEX FORTE may be tried.
This is specially prepared to suit the individual's
needs on enquiry to the Consulting Homoeopath
of NEW ERA HOMOEOPATHIC
PHARMACY
PVT. LTD. (Phone : 455060 9-00/12-00 Noon and
5-00/8-00 p. m.) or by post. Enquiries from the
prescribing doctors only (and not from patients)
will be entertained. Full details of period of
Wartex treatment already given, type of wart/corn.
changes if any in site, size and colour and other
particulars Including patient's history will be
necessary for preparing SPECIAL WARTEX FORTE.
MANUFACTURED BY :
New Era Homoepathic
Pharmacy Pvt. Ltd.
Opp. Dadar Rly. Stn. (W. Rly.) Bombay-400 028.
Vly
fiASGjSN
FOR THE USE
ONLY
PRACTITIONERS OF
A
OF
RE^^ERED
MEDICAL
HOSPITAL OR LABORATORY
HOMOEOPATHIC MEDICINE
A verv effective Homeopathic combination formulated to relive flatulent
dyspepsia, eructations, waterbrash, gastralgia & discomforts caused due to
Indigestion
It contains following medidices which have action to improve
the digestive processes,
its individual drugs act iu the following way Nux Vomica 200c : Reduces acidity and flatulence, thus relieves pressure
on the chest and distress in breathing. Regulates bowel movements therefore
promotes healtheir digestion It helps to overcome rhe digestive disturbances
in people who have sedentary habits
Carbo Veg 200o : Acts on flatulence causing distressing eructations, acidity
water brash, gastralgia It helps persons who get temporary relief with
eructation
Calchicum 200c It relieves constipation and with a peculiar ineffactual
urge for passing stools it also reduces flatulence and nausea,
These remedies in combination have a marvellous effect on liver and gastric
mucosa reducing the ph of the gastric juice and improving liver activity thus
eliminating acidity aned constipation
Dose : 6 pillets half an hour before meals or every three hourly.
In acute pains six pillets dissolved in hot water gives quicker relief
kside effects ; Nil
Presentation : Bottle of 15 gms
MANUFACTURED IN INDIA BY :
NEW ERA HOMOEOPATHIC PHARMACY PRIVATE LTD. DADAR. BOMBAY 400 028.
For the use of
Medical Practitioners or a Hospital or a Laboratory
DIRECTIONS
FOR
USE
Clean the affected part gently but thoroughly with warm water.
Mop dry with a soft clean cloth. Apply the ointment in a thin even
layer.
Homoeopathic ointments are safe and can be applied as often
as necessary in a day to keep the affected part constantly covered
with beneficial results.
OINTMENTS COMMONLY USED IN HOMOEOPATHY
Name of the Oin tment
Contents
Indications for use
1. Aconite
Aconite external
Acute inflammations
2 Aesculus & Hamamelis
3 Apis Me/
Aesculus & Hamamelis
external
Apis Mel external
Stings
4. Arnica
Arnica external
Soreness resulting
from injury.
5. Belladonna
Belladonna external
Painful inflammations.
6. Bryonia
Bryonia external
Rheumatic pains or sprains
7. Calc. Fluor
Calc. Fluor 1 x
Glandular and hard
swellings; also for piles.
8. Calendula
Calendula external
9- Cantharis
Cantharis external
As an antiseptic medicine
(or quick healing.
Burns.
Piles, Bleeding or painful.
and
insectbites.
for oedematous swellings
10. Echinacea
Echinacea Q
Ulcer and Eczema.
II. Graphics
Graphitis 1 x
Weeping eczema and psoriasis.
12. Hamamelis
Hamamelis external
13. Hydrastis
Hydrastis external
Elephantisis and Leprosy
14. Hypericum
Hypericum external
Neuralgia resulting from
sharpinstruments.
15. Ledum Pal
Ledum Pal external
Insect bites, rat bites.
Punctured Wounds.
16. Paeonia
Paeonia Q
Piles and abscesses
17. RhusTox
Rhus Tox external
Rheumatic pains.
18. Ruta G
Ruta G external
Traumatic affections of
19. Skookum Chuck
Skookum Chuck Q
Leprosy, Elephantisis, or
eczema.
Bleeding piles.
bones and periosteum.
20 Symphytum
Symphytum external
Bone pain resulting
from injury.
21. Thuja
Thuja external
Warts & Coms.
This Is yet another ethical Homoeopathic Product manufactured in the ultramodern
laboratories of
BECK & KOLL LABORATORIES PRIVATE LIMITED
37A, Govt. Ind, Estate, Kandivli (W) , Bombay-400 067.
FOR OTHER POPULAR SPECIALITIESS. SEE OVERLEAF.
OUR
OTHER
PRODUCTS
PRODUCT
Short Description
ALFALFA Tonic
ALFALFA Tablets
ALFAMALT®
(Malt Tonic)
ANGIOCARD®
(Heart Drops)
AQUIFOLIUM®
(Tablets & Cream)
ARNIKESH®
(Medicated Hair Oil)
CALENDULA
SPECIAL
KOFEEZ®
EYEBRIGHT
FEMACOL®
(Tablets')
GRIPKOLL®
JONDILA®
(Liver Tonic,)
KOLLDENT
Dr.VcNally’s
LAX-0-LAX®
MULLERIN®
PHYTOFIT®
RECTOLINE®
RHEUMA-SAJ®
UTRONIC®
WITCH HAZEL
WORMIN Tabs.®
BECKOMENT®
Creams
BIO-COMB Tabs.
(Nos, 1-28)
HOUSEHOLD KITS
General Tonic Syrup.
Tab. of Alfalfa Tonic.
For Weight Gain
& Body Building.
Cardiac Tonic.
Treatment Course for
Pimples & Complexion.
For Hairfall & Dandruff.
Antiseptic Cream.
Cough Syrup.
Euphrasia Eyedrops.
Uterine Tissue Tonic.
Gripe Drops.
Jaundice & Other Liver
Ailments.
Medicated Tooth Powder.
Laxative Tablets.
Eardrops.
For a Trim Figure.
Rectal Cream for Piles.
Rheumatic Massage Oil.
Uterine Tonic Syrup.
Complexion Cream.
For Worms.
No. 1 to No.16
(List available).
Biochemic Combinations
(List available)
Biochemic Tablet Kit.
Homoeopathic Kit.
Travelling Mini
Dispensary Kit.
©Regd. Trade Mark.
and
NOW
Cineraria Maritima Succus—
Eyedrops Prepared From
Specially Imported Juice:
Do Write In For Free Detailed Literature or Phone: 695037
^^FOR THE USE OF MEDICAL PRACTITIONER OR A HO^hlAL OR A LABORATORY
DIRECTIONS FOR USE
Clean the affected part gently but thoroughly with warm water.Mop
dry with a soft clean cloth. Apply the ointment in a thin even layer.
Homoeopathic ointments are safe and can be applied as often as
necessary in a day to keep the affected part constantly covered with
beneficial results.
This is yet another ethical homoeopathic product manufactured in the ultramodern laboratories of
BECK & KOLL LABORATORIES PRIVATE LIMITED
37A,Govt. Ind. Estate, Kandivli (W), Bombay-400 067.
Makers, of:
* ALFAMALT P)
A
Malt Preparation, weight
goodness of Alfalfa Tonic
gainer
with
and
body builder. All the
the added richness
of
Barley
Malt.
Soothes nerves, increases appetite.
★ ALFALFA TONIC
The popular
★ JONDILA TONIC $
For Jaundice, liver spots and all
★ PHYTOFIT ®
The Phytolacca formula for weight Watchers and slimming.
★ FEMECOL ®
The
homoeopathic
ladias tonic. For all
rejuvenating
menstruation
complaints.
* . .AND MANY MORE
r)
Regd. Trabe MarK
Literature supplied on request.
tonic used by millions.
liver complaints.
difficulties
and
uterine
Homoeopathic Pharmacy ^ivate Ltd.
New
Dadar, BOMBAY-400 028.
OINTMENTS COMMONLY USED IN HOMOEOPATHY
Name of the Ointment
Contents
Indication for.'use
1 Aconite
2 Aesculus &
Hamamelis
3 Apis Mel
Aconite external
Aesculus &
Hamamelis external
Apis Mel external
Acute inflammation.
Piles bleeding or painful.
4 Arnica
Arnica external
5 Belladonna
6 Bryonia
Belladonna external
Bryonia external
7 Calc Flour
Calc, Flour 1 x
8 Calendol
Calendula external
9 Cantharis
10 Dermoline
11 Echinacea
12 Graphitol
Cantharis external
Echinacea Q and
Calendula external
Echinacea Q
Graphitis 1 x
13 Hamamelis
14 Hydrastis
15 Hypericum
Hamamelis external
Hydrastis external
Hypericum external
16 Ledum Pal
Ladum Pal external
17 Paeonia
18 Pimplene
19 Rhus Tox
20 Ringoment
21 Ruta G.
Paeonia Q
BerberisAqui external
Rhus Tox external
Crysarobinum 1 x
Ruta G external
22 Skookum chuck
23 Symphytum
Skeokum Chuck
external
Symphytum external
24 Thuja
Thuja external
Stings and insect bites, for
oedematous swellings.
Soreness resulting form
injury.
Painful inflammations.
Rheumatic pains or sprains.
Glandular and hard
swellings, also for piles.
As an antiseptic medicine
for quick healing.
Burns.
Skin diseases in general.
Relieves itching.
Ulcers and eczema.
Weeping eczema and
psoriasis.
Bleeding piles.
Elephantisis and Leprosy.
Neuralgia due to injury by
sharp instruments.
Insect bites, rat bites,
Punctured Wounds.
Piles and abscesses.
Pimples.
Rheumatic pains.
Ringworm.
Traumatic affections
of bones and periosteum.
Leprosy. Elephantitis or
eczema.
Bone pain resulting from
injury.
Warts.
FOR THE USE ONLY OF A REGISTERED MEDICAL PRACTITIONER
OR A HOSPITAL OR LABORATORY
BECK & KOLL'S
CALENDULA
Calendula officinalis. N. O. Compositae. Tincture of leaves and flowers.
General :
Calendula is a herbal antiseptic. The plant species belongs to the same
family as the other great vulneraries in the Homoeopathic Materia MedicaArnica Montana and Bellis Perennis.
The medication in this preparation is the tincture extracted from the leaves
and flowers of Calendula. Being herbal, it is absolutely free from noxious,
toxic or allergic side effects. It is therefore ideally suited even for long
term treatment.
Being safe, effective and uncomplicated in use, this preparation is being
increasingly favoured and prescribed by practitioners of all systems of
medicine and particularly in OPD and post-surgical cases.
Indications :
Calendula, applied locally, is one of Nature's most remarkable healing
agents. The special kind of wounds indicating it's use are lace rated wounds
and suppurating wounds. It has been found to be very useful for open
wounds, wounds that will not heal fast, ulcers and carbuncles. It has also
been usefully employed in cases of erysipelas and superficial burns and
scalds.
Action :
Calendula promotes healthy granulation and rapid healing by first intention.
Calendula further promotes
favourable cicatrization with minimum
suppuration, slough, proud flesh or raised edges. The entire vulnerary
process takes place in a gentle, safe, natural but effective manner to
nurse the traumatised tissues back to normal health.
Contra-indications :
NIL
Side Effects :
NIL
Presentation :
Calendula Ointment :
Calendula Special
:
Calendula Lotion
:
Calendula Tinct, in petroleum jelly base.
Calendula Tinct, in a special soothing
water-soluble base.
Liquid dispersion of Calendula Tinct. in distilled
water, glycerol and alcohol (For cleaning wounds)
K
Manufactured by
BECK & KOLL Labs (P) Ltd.
37A. Government Industrial Estate. Kandivli (West), Bombay-400 067.
Alfalfa 2x, hydrastis 3x, China 3«, Aswagandha 2x, Aven-Sat. 2x, Calc. Gly. Phos 3x,
Fern. Gly. Phos 3x, Kali Gly Phos 3x, Magn. Gly.Phos 3x, Nat. Gly. Phos 3x. Formic
Acid 3x, Syrup & Aromatics QS.
The components of this preparation not only stimulate the general physical and mental
efficiency but also support the regenerative processes during and after diseases of an
organ, as well as all stages of exhaustion.
Alfalfa Tonic eliminates symptoms of fatigue and leads to an increase in appetite while
stomach-complaints aro improved simultaneously. A genera! nervous irritability is
soon calmed. With juveniles a remarkable improvement of anaemia and chlorosis
sets in after prolonged madicatlon.
Alfalfa Tonic essentially supports the convalescence after infections or operations and
thus shortens the time of recuperation.
Dose : Adults : 2-3 tablespoonful, Children : 1-2 teaspoonful with equal quantity
of water before meals.
NEW ERA HOMOEOPATHIC PHARMACY PVT. LTD.
OPP. DADAR STN. (W. R.) BOMBAY-WO028.
urrence are not uncommon and
in some cases.
exceedingly high A dermatologist or a surgeon therefore,
still looks for a remedy which could be SAFE, EFFECTIVE
PAINLESS, EASY TO ADMINISTER and MOST IMPORTANT
DOES NOT LEAVE ANY MARKS OR SCARS (particularly
on the face as an) after effect. WARTEX largely meets all
these requirements and has a sustained result without
side effects or reactions.
WARTS :
1. Common warts; 2. Filiform or "thread warts;
3. Moist or "Venereal" warts; 4. Plantar warts;
5. Flat warts; 6. Unusual types-threadlike or ped
unculated or resembling a cauliflower frequently on
the neck head, or bearded region.
CORNS :
(Callosities) Both
without pain.
ACTION
.
WARTEX is a combinational .homoeopathic dilution of
substances known to act on warts & corns. It has been
clinically tried and tested in clinics run b'v New Era Hom
oeopathic Pharmacy over a long period. It has the property
of-tackling the affected part'.and softening the circular
bed systemically so that formally, atleast after a few
months'treatment of oral pellets and topical ointment,
the warts/corns will be gradually eliminated It is’very
important that WARTEX oral and topical ointment
should be concomitantly used.
WARTEX is useful incommon, benign epithelial tumours
and areas of painful hyperkeratosis. To name a few
superficial or conical, with or
OOSAGE :
4-6 pellets t d s. At the same time ointment should
be topically applied to the affected parts, as often as
possible allowing the medicine to penetrate the area,
PACKING :
Oral :
Bottle of 15 gms.
DISPENSING PACK : 80 Gms.
Ointment :
15 gm,-in attractive tubes,
DISPENSING JAR-400 gm.
Note : 1) The medicinal concentration of this preparation
has a deep seated action but is designed to be
safe. Because of this, (depending on the chronicity of the case changes) may occur rather slowly
but will generally give ultimate satisfactory results.
Some cases in clinical trials even responded after
a gap of time, treatment having earlier been
given for several months and then discontinued.
2) The strength and the ingredients have been
chosen to suit the median cases of verrucae and
callosities. In adamant cases, after standard
WARTEX treatment WARTEX FORTE may be tried.
This is specially prepared to suit the individual's
needs on enquiry to the Consulting Homoeopath
of NEW ERA HOMOEOPATHIC PHARMACY
PVT. LTD. (Phone : 455060 9-00/12-00 Noon and
5-00/8-00 p. m.) or by post. Enquiries from the
prescribing doctors only (and not from patients)
will be entertained. Full details of period of
Wartex treatment already given, type of wart/corn,
changes if any in site, size and colour and other
particulars Including patient's history will be
necessary for preparing SPECIAL WARTEX FORTE.
MANUFACTURED BY :
New Era Homoepathic
Pharmacy Pvt. Ltd.
Oppl Dadar Rly. Stn. (W. Rly.) Bombay-400 028.
For the use only of a Registered Medical Practitioner or
a Hospital or a Laboratory.
WARTEX®
(Oral Pellets &
Callosities)
Ointment for Verrucae and
Topical
COMPOSITION :
Pellets
•
t-
Thuja
200 C
Causticum 200 C
Et al in
Homoeopathic
Dilutions
Ointment
Calc Fluor
lx
Thuja
Q
Et al in
Homoeopathic
Tinctures
DESCRIPTION :
WARTEX, Oral and topical, a choice homoeopathic remedy
has been designed to satisfactorily treat cases of Verrucae
(Warts) and Callosities (Corns); WARTEX is a method to
'expunge warts. While various measures such as
electrodessication etc. are possible-, the chances of rec-
Etiology End symptoms of Acne Vulgaris and Comedones :
ACTION
The etiology of Acne Vulgaris and Comedones
AQUIFOLIUM tablets are a combination of Homeopathic ingredients
Predisposing
hereditary or familial
include
causes
is largely unknown.
tendencies or
known to act on Acne Vulgaris and Comedones. The treatment has
disturbances in the metabolic or hormonal balance affecting activity
been clinically tried and
of the sebaceous glands. Specific exciting factors may include
excessive carbohydrates and fats, foods allergies, food rich in Iodine,
systemically
gastro-intestinal
endocrine
disturbances,
disorders,
psycho-genic
factors, ingestion of halogens and contact with chemicals such as
tar
or chlorinated-hydrocarbons. It is most commonly
associated
with adolescence. For unexplained reasons the lesions may become
worse during the premenstruum.
The symptoms
of Acne are
sebaceous glands and
often
chronic
a
inflammation of the
hair foiliclesof, the skin characterised by
common. It is usually associated with Seborrhoea Congestiva (a facial
form of affection with elevated patches having red borders and som
with crusts
usually result from
Acne
to
over a
restore the hormonal
scars). Comedones
and
Vulgaris
and
is seen
(blackheads)
as a
discoloured
a
long period by BecK &
imbalance
and restore the
normal activity of the sebaceous glands.
AQUIFOLIUM cream topically applied has the property of softening the
papules, pustules, cysts or nodules and gently, but surely extracts and
drains the purulent matter in a natural way. It is very important that the
oral tablets and topical ointment
papules or pustules. Cysts and nodules may develop and scarring is
etimes covered
tested
Koll Laboratories Pvt. Ltd., It has the effect of tackling the problem
After about a fortnight's
should
be
used concomitantly.
treatment the appearance of new lesions
should slow down or cease with a simultaneous improvement in the
overall condition
After a
few months treatment
the
Acne/Come-
dones will be gradually but entirely and permanently eliminated.
DOSAGE
1. Tablets :
In the beginning two tablets AQUIFOLIUM at a time
three times a day. Once improvement sets in, dose may be reduced
sebum plugging an excretory duct of the skin.
to one tablet three times a day.
PROGNOSIS
Obstinate,
persistent
and
recurrent
amenable to
but
treatment,
particularly with AQUIFOLiUM
Cream The affected part should be thoroughly washed with
mild soap or "besan" (gram flour) and warm water. After thoro
ughly drying, AQUIFOLIUM cream should be applied over
the whole affected area and
gently worked into the skin
TREATMENT
and
cream
concomitantly. Systemic treatment
consists of AQUIFOLIUM
tablets
taken
AQUIFOLIUM tablets
2. The
orally
ocal application of AQUIFOLIUM creasg^
concomitantly with
,
,
with
circular
motion
of
the
fingers.
applied as often as possible but in
The
any case
before retirinjyat night and left overnight.
cream should
must
be
be
applied
01 ETIC
For the use only of a Registered Medical Practitioner or
RESTRICTIONS
a Hospital or a Laboratory.
Refrain from eating or drinking anything (except water) or from
1.
use of tobacco for atleast one hour before or after ingesting
AQU8FOLIUM®
AQUIFOLIUM tablets
2.
Avoid foods which are known to cause exacerbation particularly
fatty foods, deep fried or extremely pungent or sour items,
coffee and substances, rich in Bromides or Iodides.
( Oral tablets and topical
cream for treatment of Acne
COMPOSITION
CONTRA - INDICATIONS
NIL
Tablets
Cream
EFFECTS
NIL
Berberis Aqui Q
Kali Brom
30
Berberis Aqui. Ext.
SIDE
PRESENTATION
Vulgaris
Comedones and similar affections of the skin.)
in Lactose q
Thuja Ext.
s.
Calendula Ext,
in water soluble base
1.
In a carrier kit containing 20 gms. tablets and 20 gms. cream
DESCRIPTION
2.
20 gms. tablets in separate pack
3
20 gms. Cream in separate pack.
AQUIFOLIUM Oral and topical, is a choice Homoeopathic treatment
designed to satisfactorily deal with cases of Acne Vulgaris (pimples)
Comedones (blackheads) and similar skin affections.
AQUIFOLIUM
expunges
pimples
and blackheads by the safe
and
gentle method of Homoeopathy. Various other measures are no doubt
Manufactured in India by :
BECK & KOLL LABORATORIES
PRIVATE LIMITED
37-A, Govt. Ind. Estate, Kandivli (West)
Bombay-400 067.
possible such as use of
topical peeling agents, incision, extraction
and drainage. However, the chances of
recurrence with such topical
treatment is exceedingly high. A Dermatologist or General Practitioner
therefore would welcome a remedy which could be SAFE, EFFECTIVE
PAINLESS, EASY TO ADMINISTER and MOST IMPORTANT DOES
NOT LEAVE ANY MARKS, P|TS or SCARS ON THE FACE and also
eliminates entirely the risk of extraneous infections as an after effect.
AQUIFOLIUM largely meets all these rigorous requirements and has
a sustained and permanent result without side effects or reactions.
Mew Era Homoeopathic Pharmacy Private Ltd.
Dadar, BOMBAY-400 028.
OINTMENTS COMMONLY USED IN HOMOEOPATHY
Name of the Ointment
Contents
Indication for.'use
1 Aconite
Aconite external
Aesculus &
Hamamelis external
Apis Mel external
Acute inflammation.
Piles bleeding or painful.
Aesculus &
Hamamelis
3 Apis Mel
2
4
Arnica
Arnica external
5
6
Belladonna
Bryonia
Belladonna external
Bryonia external
7
Calc Flour
Calc, Flour 1 x
8
Calendol
Calendula external
9
10
Cantharis
Darmoline
11
12
Echinacea
Graphitol
Cantharis external
Echinacea Q and
Calendula external
Echinacea Q
Graphitis 1 x
14
15
Hydrastis
Hypericum
Hamamelis external
Hydrastis external
Hypericum external
16
Ledum Pal
Ledum Pal external
17
18
19
20
21
Paeonia
Pimplene
Rhus Tox
Ringoment
Ruta G.
Paeonia Q
BerberisAqui external
Rhus Tox external
Crysarobinum 1 x
Ruta G external
22
Skookum chuck
23
Symphytum
Skeokum Chuck
external
Symphytum external
24
Thuja
Thuja external
Stings and insect bites, for
oedematous swellings.
Soreness resulting form
injury.
Painful inflammations.
Rheumatic pains or sprains.
Glandular and hard
swellings, also for piles.
As an antiseptic medicine
for quick healing.
Burns.
Skin diseases in general.
Relieves itching.
Ulcers and eczema.
Weeping eczema and
psoriasis.
Bleeding piles.
Elephantisis and Leprosy.
Neuralgia due to injury by
sharp instruments.
Insect bites, rat bites,
Punctured Wounds.
Piles and abscesses.
Pimples.
Rheumatic pains.
Ringworm.
Traumatic affections
of bones and periosteum.
Leprosy. Elephantitis or
eczema.
Bone pain resulting from
injury.
Warts.
For the use only of Registered Medical
Practitioners, or a Hospital or a Laboratory
BEKOMENT OINTMENTS
A therapeutic index for the general practitioner
Mfgd. by
BECK & KOLL LABORATORIES PVT. LTD.
37-A, Govt. Ind. Estate. Kandlvll, BOMBAY-400 067.
BEKOMENT OINTMENTS are NON ANTIBIOTIC salves prepared with herbs,
which have been successfully used through the ages as remedies for various
afflictions with gratifying results.
The treasure of information on these remedies gathered oyer the centuries
has been combined with clinical trials on scientific principles in our Laboratories
J^determine the most efficacious combination for a particular ailment.
me active ingredients of each herb are extracted by Homoeopathic principles &
combined to make the various ointments under the most hygenic conditions at
the modern and spacious Beck & Koll Laboratories Pvt. Ltd.
BEKOMENT OINTMENTS will be found particularly useful by the practitioner
who seeks topical treatment of a specific nature. It is specially recommended in
cases where antibiotic or sulpha - based ointments are not considered suitable.
They can be freely employed without any reservations about immunological
or allergic side-effects.
FOR MOST CASES, ORAL HOMOEOPATHIC TREATMENT CAN BE EMPLOYED
CONCURRENTLY WITH BENEFICIAL RESULTS.
We are at your service for any further guidance.
BEKOMENT No.
Contents (all external Mother
Indications
Tinctures in Petroleum jelly q, s.)
BEKOMENT 1
ANTISEPTIC-cuts, wounds, &
neuralgia resulting therefrom.
Calendula, Ledum, Hyperi
cum, et. al.
^OMENT 2
BITES, & STINGS-of
insects, ants, etc.
Apis, Ledum, et. al.
BEKOMENT 3
BOILS, ULCERS, ABSCESSES
suppurating, indolent, indurated,
slow to heal, also prevents ten
dency. Hastens suppuration.
Echinacea, Silicea, Paeonia
et. al.
BEKOMENT 4
BONE FRACTURES-pain, neura
lgia resulting therefrom. Trauma
tic affection. Aids knitting a
healing of the fracture.
Ruta, Symphytum et.al,
BEKOMENT 5
BURNS-to protect from extrane
ous infection and aid healing.
Cantharis, Calendula et al.
rats.
BEKOMENT
No.
' Indications
Contents (all external Mother
Tinctures in Petrolium jelly q. s.
BEKOMENT 6
CHAPPED SKIN -winter skin
chapped or cracked lips & cracks
around soles of feet
Borax, Pusikava, et. al.
BEKOMENT 7
ITCH & RASH-Allergic or non
specific rash or itching of skin
Urticaria, Herpes simplex.
Urtica Urens, et. al.
BEKOMENT 8
PILES-Haemorrhoids of all types
(Blind &/or bleeding'or painful).
Hammamelis,
et. al.
BEKOMENT 9
PSORIASIS-weeping eczema &
psoriasis.
Graphities lx et. al.
BEKOMENT 10
RING WORM, Barber's Itch.
Chrysarobinum lx et. al.
BEKOMENT 11
SKIN DISEASES-(Scrofula) Any
skin disorders. For relief of
pruritus, .in general.
Calendula,
Echinacea,
Skookum, et. al.
BEKOMENT 12
INFLAMMATIONS-Due to over
strain, sprains, contusion or in
jury where the skin is not broken.
Arnica, Belladonna,
pericum, et. al.
BEKOMENT 13
SCABIES, Dermatitis.
Sulphur, Echinacea, skoo
kum et. al.
BEKOMENT 14
OEDEMA-Leprous or filariatic
affections of skin.
Hydrastis, Skookum, Chaul
mogra et. al.
BEKOMENT 15
PARASITES-Pedlculii (Lice) Elother skin, hair or body parasites.
Sabadilla, Azadiricta, et. al.
BEKOMENT 16
WARTS & CORNS-of all kinds.
Aesculus
Hy
A
Thuja. Antim Crud, Ca'^F
Flour, et. al.
Presentation:-! 5 gm, Tube or 100 gm. & 450 gm. Dispensing Jars.
SPECIAL PREPARATIONS
AQUIFOLIUM
CREAM
PIMPLES & ACNE - Makes the
complexion clear,
soft and
smooth.
A preparation of Berber
mountain grape in a water
soluble base.
RHEUMA-SAJ
OIL
RHEUMATISM - Or any kind
of joint or muscular pain like
sciatica etc.
A herbal mixture in a special
vegetable andelectromagnetically activated oil base.
Presentation: Aquifolium-15 gm. 30 gm. tubes. Rheumasaj-50 ml.
ALEO5AI.T
A weight gainer 8 body builder
For she use only of Registered Medical Practitioners or a Hospital or laboratories
*
The individual components act as follows:
ALFALFA: Long known for its unique property of adding muscle tissue without
adding fat. Tones up the appetite, greatly improves vigor and gain in weight.
Disorders due to malnutrition, Neurasthenia, splanchnic blues, nervousness,
insomnia, nervous indigestion, increases milk in nursing mothers. Induces mental
hilaration, buoyancy and a general feeling of wellbeing.
fENA SATIVA: Brain and nerve tonic. Nervous exhaustion, sexual debility,
canvalescence. nerve tremors, chorea, alcoholism and sleeplessness of alcoholics
and many female troubles.
CHINA: Debility, exhausting discharges and loss of vital fluids. Chronic gout.
Chronic suppurative pyelitis, mental apathy, despondency.
HYDRASTIS: Especially active in old, easily tired, cachetic or greatly debilitated
individuals. Cerebral effects prominent; wits feel sharpened. Tones up weak
muscular power poor digestion and obstinate constipation. In lumbago, emaciation,
pr'ostration and sluggish liver.
The Glycerophosphates of Calcium, Ferrum, Magnesium, Kalium and Natrum.
CALCIUM: A tissue remedy specially indicated in tardy dentition, bone disease,
bone fractures.
FERRUM: (Iron) For first stage of all febrile disturbances and inflammations
anaemias and hemorrages. Increases haemoglobin.
KALIUM: (Potassium) A nerve remedy. Want of nerve power, neurasthenia,
depression.
MAGNESIUM: Antispasmodic relieving cramp in muscles, neuralagic pains. For bad,
digestion, enteralgia and flatulent colic with belching of gas.
NATRUM: (Sodium) A good liver toner.
DOSAGE: Adults two tablespoons (Children one) before meals and at bedtime.
DI ETIC RESTRICTIONS: Nil.’
DE EFFECTS: The ingredients in ALFAMALT Tonic are naturally occurmg vegetaand mineral substances and the side effects are nil. It can also consequently
be used concomitantlv with any system of medicine with absolute confidence as
there are no contra indications.
PRESENTATION: 100 gm, 400 gm & 1000 gm.
«
‘Ref. : Homoeopathic Pharmacopeia of tho United States VII ed
Homoeopathic Materia Med-ca-Dr. W. Boerike MD (U.S.A.)
BECK & KOLL LABORATOR8ES
PRIVATE LIMITED
37-A, Government Industrial Estate,
Kandivli (West), Bombay 400 067.
Phone: 695037.
‘
Homoeopathy I
isatyour
.
BeckandCallat <
Beck&Koll J
ALFAMALT
A weight gainer & body builder
For the use only of'Registered Medical Practitioners or a Hospital or Laboratories
INDICATIONS:
ALFAMALT is a Homoeo
pathic preparation. It is
ideal for the stimulation
and regeneration of both
physical and mental pro
cesses, particularly when
the normal capacity of
assimilation is retarded as
a result of disease. It is ACTION; Homoeopathic
particularly indicated in tonics have a uniquely
cases of convalescence, effective action on the
constant fatigue, nervous body cells. Quite com
exhaustion,
irritability, monly, in modern practice
sleeplessness,
anaemia it is seen that doses of the
and chlorosis. It can also desired chemical or sub
be recommended conco stance are simply not
mitantly with enriched assimilated by the body
food intake, in cases of in a weakened state
under weight, malnutri though administered in
tion and undernourish large quantities. The same
chemical or substance is
ment. .
seen to be assimilated
more readily if it occurs
in a food, fruit, or vege
table albeit in minutj^
quantity. It is therefo^fc
not merely the quantity
but more importantly the
minuteness of size of
each individual particle of
the substance that makes
one form more effective
than the other. In Homo
eopathic tonics,
each
individual component is
dynamically ground (tri
turated) to the finest
possible powder several
times reducing the desired
ingredient to a molecu
larly active state. In this
state it is promptly assi
milated by the body cells.
pyelitis. Post operative gas rain particular}/ when
there is no relief from pas^ng it. Mental apathy,
indifference, disobedience, taciturnity, despondency,
disposition to hurt others, sudden crying and ideas
crowding in mind preventing sleep.
Hydrastis (Golden Seal) Especially active in old,
easily tired cachectic or greatly debilitated indivi
duals. Cerebral effects prominent, wits feel sharpened
head cleared, facile expression. Tones up week
muscular power, poor digestion and obstinate
constipation. It is claimed to be effective in lumbago,
emaciation, prostration, sluggish liver, goitre of pube
rty and pregnancy and in greatly mitigating the
consequences of smallpox.
Dosage : Adults two tablespoons, (Children One)
before meals and bedtime.
Side Effects : The ingrodients in Alfalfa Tonie
are naturally occurring vegetable and mineral
substances and the side effects are nil. It can
consequently be used concomitantly with any other
treatment with absolute, confidence as there are
no contraindications.
Presentation : Sweet syrup in 100, 250 and 450 ml.
Note : If the small proportion of alcohol is thought
unsuitable for any patients,
ALFAMALT (a
similar preparation in malt base) is recommended as
an alternative.
»
Manufactured in India by i
BECK & KOLL LABORATORIES
PRIVATE LIMITED
37-A, Govt. Ind. Estate, Kandivli (West) Bgmbay-400 067
For the uso ynly of Registered Medical Practioners
)
or a Hospital or a Laboratory.
ALFALFA TONIC
ALFALFA TONIC
The-indiividual components act as follows : **
j
Composition
Alfalfa 2x, Hydrastis 3x, China 3x, Avena Sat. 2x,
Syrup & Aromatics q. s.
Alfalfa (Lucerne) This benficial plant has long
been known and 'employed as cattlefeed due to its
unique property of adding weight of muscle tissue
without adding fat, Alfalfa favourably influences
nutritition by toning up the appetite and digestion
resulting in greatly improved mental and physical
vigor with gain in weight Disorders characterised by
malnutrition are mainly within its therapeutic range
e. g. neurasthenia, splanchnic blues, nervousness.
insomnia, nervous indigestion etc. Increases quality
and quantity of milk in nursing mothers Its-pronounced urinary action suggests it clinically in
diabetes insipidus and phosphaturia. It is claimed
to allay vesical irritibality to prostatic hypertrophy
and beneficially influences rheumatic diathesis.
It is commonly seen to induce mental exhilaration
buoyancy and a general feeling of wellbeing so
that all blues are dissipated.
Indications :
Alfalfa Tonic is a Homoeopathic preparation which
is ideally suited for the stimulation and regeneration
of both physical and mental processes of the body
particularly when the normal capacity of assimilation
is retarded as a result of disease. It is therefore
particularly recommended in cases of convalescence,
constant fatigue, nervous exhaustion, irritability,
sleeplessness, anaemia and chlorosis. It can also be
recommended concomitantly with enriched food
intake, in cases of underweight, malnutrition and
undernourishment.
Action :
Homoeopathic tonics have a uniquely
effective action on the body cells. Quite commonly,
in modern practice it is seen that tonics are simply
not assimilated by the body in a weakened state
though administered in large quantities. The
same
substances are seen to
be assimilated
more readily if it occurs in a food, fruit, or
vegetable albeit in minute quantity. It is therefore
not the quantity but size of eash individual
particle of the substance that makes one form more
effective than the other. In Homoeopathic tonic’s
each individual component is triturated (ground)
to the finest possible, several times reducing
the desired ingredient to a molecularly active state.
In this state it is promptly assimilated by the
body cells.
Avena Sativa (Common oat) Has a selective action
on the brain and on the nervous system favourably
influencing their function. Nervous exhaustion, sexual
debility, convalescence after exhausting diseases,
nerve tremors of the aged, chorea, paralysis agitans,
epilepsy, postdiptheric paralyisis, rheumatism of the
heart, alcoholism and sleeplessness of aicoholics, bad
effects of morphine habit and nervous states of many
female troubles.
China (Chincona ofl'.-Peruvin Bark) Indicated in
debility form exhausting discharges and ioss of vital
fluids. Chronic gout. Chronic suppurative
,
ref : Homoeopath^ Materia Medida by W Boericke
A
M. D (U. S. A-)
FOR THE USE ONLY OF A REGISTERED MEDICAL PRACTITIONER
OR A HOSPITAL OR LABORATORY
BECK & KOLL'S
CALENDULA
Calendula officinalis. N. O. Compositae. Tincture of leaves and flowers.
General :
Calendula is a herbal antiseptic. The plant species belongs to the same
family as the other great vulneraries in the Homoeopathic Materia MedicaArnica Montana and Bellis Perennis.
The medication in this preparation is the tincture extracted from the leaves
and flowers of Calendula. Being herbal, it is absolutely free from noxious,
toxic or allergic side effects. It is therefore ideally suited even for long
term treatment.
Being safe, effective and uncomplicated in use, this preparation is being
increasingly favoured and prescribed by practitioners of all systems of
medicine and particularly in OPD and post-surgical cases.
Indications:
Calendula, applied locally, is one of Nature's most remarkable healing
agents. The special kind of wounds indicating it's use are lace rated wounds
and suppurating wounds. It has been found to be very useful for open
wounds, wounds that will not heal fast, ulcers and carbuncles. It has also
been usefully employed in cases of erysipelas and superficial burns and
scalds.
Action :
Calendula promotes healthy granulation and rapid healing by first intention.
Calendula further promotes
favourable cicatrization with minimum
suppuration, slough, proud flesh or raised edges. The entire vulnerary
process takes place in a gentle, safe, natural but effective manner to
nurse the traumatised tissues back to normal health.
Contra-indications :
Side Effects :
NIL
NIL
Presentation :
Calendula Ointment :
Calendula Special
:
Calendula Tinct, in petroleum jelly base.
Calendula Tinct, in a special soothing
water-soluble base.
Calendula Lotion
Liquid dispersion of Calendula Tinct. in distilled
water, glycerol and alcohol (For cleaning wounds)
K
Manufactured by
BECK & KOLL Labs (P) Ltd.
37A. Government Industrial Estate, Kandivli (West), Bombay-400 067.
for the use only of Registered Medical
Practitioners or a Hospital or a Loborator,
TONIC POWDER
A TRIED TONIC FOR DEBILITY AND LIVER DISORDERS
INDICATIONS :
ANEMIA
RETARDED
DENTITION,
DISORDERS.
ORGANIC
NEURASTHENIA,
FEBRILE
LACK
OF
APP^E.
OF ’ ASSIMILATION.
GENERAL LACK
CONDITIONS AND
LIVER
INSOMNIA DUE TO
FATIGUE.
ALSO USEFUL TO PREVENT SUMMER
CATCH COLD.
*
DIARRHOEAS
IT IS HIGHLY RECOMMENDED FOR
CHILDREN ALONG
AND TENDENCY
WITH
TO
EASIDENT
(TEETHING PILLS) TO ACCELERATE VITALITY.
COMPOSITIO N ;
Calcarea
Natrum-
Kali
Phosphoricum,
Phosphoricum.
Muriatlcum.
Ferrum
Magnesia
Phosphoricum
Phosphoricum. in
30 x lactose q.s.
(As per measure spoon enclosed in the carton)
DOSAGE :
: 1 to 2 spoons
Infants
Children : 2 to 3 spoons
: 2 to 4 spoons
Adults
cut level 2 to 3 times a day.
SIDE EFFECTS :
This tonic is a combination of Essential Bic^^.iic
Salts required for the tissues of body,
They are atomised,
will neither be any side effects
contraindicated
nor is
hence there
along
with
any
other treatment,
PRESENTATION :
Bottle of 25 gms. in the form of Trituration.
Mfgrs : New era homoeopathic pharmacy Dadar, Bom.-28
For the use only of Registered Medical
Practitioners or a Hospital or Laboratory
®
PJLEN
HOMOEOPATHIC
MEDICINE
This combination hes been tried and proved to be effective in piles of any kind
whether internal or external, bleeding or nonbleeding, It helps to reduce
agonising pains and to shrink piles. It can also check bleeding in case of
bleeding piles.
It's benefical effect reduces constipation and further
given regular movements to the bowels.
It contains : Nit Acid (200c), Calc floor (200c) & Hamamelis. (200c).
ITS INDIVIDUAL DRUGS ACT IN THE FOLLOWING WAY :
NIT ACID 200c : It reduces bleeding, soothes the splinter like
pains,
regulates bowel movements.
Calt Flour 200c : It acts on bleeding piles, reduces bleeding, stops itching
sensation in the anal region, renders, stool softer and helps to shrink blind
piles, Effectively releaves backache whenever associated with piles complaint.
Hamamelis 200c : It is a very effective drug on the haemorrhagic tendency
thus reducing and controlling haemorroidal bleeding in case of bleeding piles.
Complementary : Topical application of Pilen ointment is concomittantly
recommended.
DOSE : 6 pillets twise a day.
Side effects : Nil
® Registered Trade Mark
Presentation Aattle of 250 Pillets.
A
KOFGAN®
Fcr ths use only of Registered Medica
Practitioners or a Hospital or Laboratory
HOMOEOPATHIC MEDICINE
KOFGAN is a harmless cough remedy which acts effectively like any of New
Era’s well known Homoeopathic Combinations. It can be given in any cough
viz. dry irritating, or wet. smoker’s chronic cough and old asthmatic, bron
chitic cases. Its dynamic ingredients work within a few hours of its
administration.
THE INDIVIDUAL DRUGS ACT IN THE FOLLOWING WAY
Bryonia 200c : Dry hacking cough, hoarse voice, laryngeal soreness, Itching
in the throat is relieved.
Antim Sulph 200c: Tickling in larynxdry hardcough,is relieved. Can prevent
pneumonia in early stages. It enhances expectoration to relieve the bronchi.
Drosera 200c: Helps in whooping cough or braking type of cough. It reduces
vomiting, relieves congestion & asthmatic wet cough.
Squilla Mar 200c Violent cough is ameliorated by this when there is
profuse salty expectoration or exhausting dry cough. It also helps in
cases where involuntary urination while coughing or sneezing.
IPECAC 200c : For difficult breathing, wheezing asthmatic cough, irritating
cough
DOS : Adults : 6 Fillets every three hours. Children fover 1 year) . 3 Fillets every three hours
Infants : (beiow one year) 2 billets every three hours.
In acute cases dissolves pillets in half a teacup warm water and administer a teaspoonful every
1 !2 hour
Side Effect : nil
PresentatioMkBottle of 15 gms. (approx. 250 pillets)
NEW ERA HOMEOPATHIC PHARMACY PVT. LTD, DADAR BOMBAY-400^K
For the use only of Registered Medical
Practitioners or a Hospital or Laboratory
EASIDENT
H0PJ10E0PATHIC MEDICINE
Dentition causes few symptoms and leads to uneasiness with irritability
in the children. During this period the dentition diarrhoea and loss of
appetite or common cold and fever may also associate.
Easident is a combination of three effective Homoeopathic remedies which
have beneficial effect to relieve the dentition disorders such as above.
its individual drugs act in the following way :
Chamomilla 30c : Acts on mind and soothes irritability, reduces diarrhoea
which may have characteristic green colour. It checks increased saliva
tion flatulence and redness of anal orifice.
Calcarea Phos 12c : It is a known dentition tonic thus included in Easi
dent. It helps in the assimilation of Calcium from the natural source (milk)
thus aids Calcium. It reduces the dentition diarrhoea promotes healthier
digestion, prevents vomiting and flatulence.
Lecithin 12c : It influences nutritive conditions, thus increasing the red
blood corpuscles and Haemoglobine in dentition diarrhoea. It helps to
overcome general debility and increase appetite.
It is found and proved Easident if started at 4th month of age and given
regularly helps to prevent the severity of the dentition symptoms and
promotes healthier and easier dentition.
DOSE
4 to 6 months
2 pillets three times a day
6 months to 1 year
3
1 Year and above
Side effect :
Presentation Bottle of 15 gms. (approx.
Manufactured in Ma by :
Mr
NEW ERA HOMOEOPATHIC PHARMACY PVT. LTD. DADAR BOMBAY-400 02B.
Pillets)
EASiDEN'F
For the use only of Registered Medical
Practitioners or a Hospital or Laboratory
HOMOEOPATHIC MEDICINE
Dentition causes few symptoms and leads to uneasiness with irritability
in the children. During this period the dentition diarrhoea and loss of
appetite or common cold and fever may also associate.
Easident is a combination of three effective Homoeopathic remedies which
have beneficial effect to relieve the dentition disorders such as above.
Its individual drugs act in the following way :
Chamomilla 30c : Acts on mind and soothes irritability, reduces diarrhoea
which may have characteristic green colour. It checks increased saliva
tion flatulence and redness of anal orifice.
Calcarea Phos 12c : It is a known dentition tonic thus included in Easi
dent. It helps in the assimilation of Calcium from the natural source (milk)
thus aids Calcium. It reduces the dentition diarrhoea promotes healthier
digestion, prevents vomiting and flatulence.
Lecithin 12c : It influences nutritive conditions, thus increasing the red
blood corpuscles and Haemoglobine in dentition diarrhoea. It helps to
overcome general debility and increase appetite.
It is found and proved Easident if started at 4th month of age and given
regularly helps to prevent the severity of the dentition symptoms and
promotes healthier and easier dentition.
'
DOSE
4 to 6 months
2 pillets three times a day
6 monthp to 1 year
3
..
1 Year and above
4
,,
Side effect ^mil
Presentation Bottle of 15 gms. (approx. ^250 Pillets)
Manufactured ^Andia by :
NEW ERA HOMOEOPATHIC PHARMACY PVT. LTD. DADAR B0MBAY-4WR28.
FOR THE USE
ONLY
PRACTITIONERS OF A
OF REGISTERED MEDICAL
HOSPITAL OR LABORATORY
HOMOEOPATH’S MEDICINE
A verv effective Homeopathic combination formulated to relive flatulent
dyspepsia, eructations, waterbrash, gastralgia & discomforts caused due to
Indigestion
It contains following medidices which have action to improve
the digestive processes,
its individual drugs act iu the following way Mux Vomica 200c : Reduces acidity and flatulence, thus relieves pressure
on the chest and distress inbreathing, Regulates bowel movements therefore
promotes healtheir digestion It helps to overcome the digestive disturbances
in people who have sedentary habits
Carbo Veg 200o : Acts on flatulance causing distressing eructations, acidity
water brash, gastralgia It helps persons who get temporary relief with
eructation
Calchicum 200c It relieves constipation and with a peculiar ineffectual
urge for passing stools it also reduces flatulence and nausea.
These remedies in combination have a marvellous effect on liver and gastric
mucosa reducing the ph of the gastric juice and improving liver activity thus
eliminating acidity aned constipation
Dose : 6 pillets half an hour before meals or every three hourly.
In acute pains six pillats dissolved in hot water gives quicker relief
Side effects : Nil
Presentation : Bottle of 15 gms
MANUFACTMeD IN INDIA BY:
NEW ERA HCWfiEOPATHIC PHARMACY PRIVATE ITO. DADAR. BOmWi' 400 0z8.
FOR THE USE OF MEDICAL PRACTITIONER OR A HOSPITAL OR A LABORATORY
DIRECTIONS FOR USE
Clean the affected part gently but thoroughly with warm water.Mop
dry with a soft clean cloth. Apply the ointment in a thin even layer.
Homoeopathic ointments are safe and can be applied as often as
necessary in a day to keep the affected’part constantly, covered with
beneficial results.
This is yet another ethical homoeopathic product manufactured in the ultramodern laboratories of
BECK & KOLL LABORATORIES PRIVATE LIMITED
37A,Govt. Ind. Estate, Kandivli (W), Bombay-400067.
Makars, of:
A- ALFAMALY R)
—
A
Malt Preparation,
weight
goodnes^ of Alfalfa Tonic
gainer
with
the
and
body builder. All the
added richness
of
Barley
-Malt.
•> Soothes nerves’ increases appetite.
'k ALFALFA TONIC '
—
* JONDILA TONIC
The popular
homoeooathic
rejuvenating
For Jaundice,Oliver spots and all
tonic used by millions.
liver complaints.
iThe‘ Phytolacca formula for weight Watchers and slimming.
★ PHYTOFIT (§)
* FEMECOL (R)
—
The
ladies tonic. For all
menstruation
difficulties
and
uterine
complaints.
* . . AND MANY MOR E
Literature supplied on request.
fR) Regd. Trabe MarK
Makers of:
* ALFAMALT ®
— A Malt Preparation, weight gainer
goodness of Alfalfa Tonic with
and body builder*.
the added richness
All the
of Barley
Malt.
Soothes nerves, increases appetite.
♦ ALFALFA TONIC
— The popular homoeopathic rejuvenating tonic used by millions.
* JONDILA TONIC ® — For Jaundice, liver spots and all liver complaints.
* PHYTOFIT ®
* FEMECOL ®
— The Phytolacca formula for weight Watchers and slimming.
- The ladies tonic. For all menstruation difficulties
complaints.
* . .AND MANY MORE
® Regd. Trade Mai
Literature supplied on request.
and uterine
FOR THE USE OF MEDICAL PRACTITIONER OR A HOSPITAL OR A LABORATORY
DIRECTIONS FOR USE
Clean the affected part gently but thoroughly with warm water. Mop
dry with a soft clean cloth. Apply the ointment in a thin even layer.
Homoeopathic ointments are safe and can be applied as often as
necessary in a day to keep the affected part constantly covered with
beneficial results.
This is yet another ethical homoeopathic product manufactured in the ultramodern laboratories of
BECK & KOLL LABORATORIES PRIVATE LIMITED
37A, Govt. Ind. Estate, Kandivli (W), Bombay-400 067.
Dose—Ad nits 4 tablets at a time 4 times a day at interval of 3 hours.
Children—Half the dose.
1.
Anaemia and Chlorosis (Composition) :
Calc, phos.. Forrura phos., Nat
mur., Kali phos.
Judications: Lack of blood and loss of blood from any part of the body.
Cerebral and spinal amemia; a general wasting of all the tissues; waxy appear
ance of the skin; chlorosis; palpitation, trembling and weakness; anaemia of the
brain from long continued mental strain.
2.
Asthma (Composition) ;
Kali, phos., Macn. phoa., Natr. mur., Natr- Sulf.
Indications: Nervous asthma, accompanied with cough, gasping for breath,
irregular pulse; asthma with troublesome flatulence or spasms, convulsive
tickling cough. Bronchial asthma with yellow sputa worse in the evening or
in warm room and better in cool air.
Colic (Composition): Magn. phoa. ♦-Calc. phos., Natr. fiulf.. Farrum phoa.
Indications: Colic of infants with drawing up of legs, during teething;
flatulent colic caused by friction or belching of gas. Colic of children and
adults due to blockage of intestines caused by flatulence or constipation.
Spasmodic pain, patient bends double.
3.
4.
Constipation (Composition) ;
Calc, fluor.. Kail, mur , Natr. mur.. Siliooa
Indications: Bowels constipated without apparent cause; liver torpid; stools
dry, hard and black; dull headache; foul breath; bad taste in mouth; tongue
coated.
5.
Coryza (Composition) :
Ferrum phoa.. Kali, mur., Natr, mur., Kali, otllf.
Indications: Pain in the head, sneezing and discharge from nose or bron:
chial tubes due to irritation and inflammation of mucous membranes. Feverish
ness? Thick white discharge from the nose with white or grey coated tongue.
6.
Coughs, Colds and Catarrh (Composition) : Ferrum'phos., Kali mur.. Magn. phos,
Natr. mur. Natr. Sulf
Indications : Cold in the head; acute catarrh, rattling hallow cough: diffi
cult respiration, pain in chest, bronchitis.
X/
7.
Diabetes (Composition) : Calc, phos., Ferrum phos.. Kali., phos., Natr, phos, Natr. sulf.
Indications : Excessive discharge of urine* pain in calves,- thirst, dryness
of the lips, sleeplessness, nervous prostration, all chronic cases with liver dis
orders. It is recommended as a remedy to support the patient’s state of health
by assimilating the glucose. Also strengthen the kidneys and nerves impaired
by diabetes.
8.
Diarrhoea (Composition) 1 Calc. phos.. For-rum phoa., Kali, phos-, Kali sulf. Natr. aulf.
Indications : Thin watery stools with undigested food, thirst; due to fatty
or rich food, white coated tongue Watery stools with prostration.
9.
Dysentery (Composition) !
Ferrum phos., Kall. mur.. Kall, phos.. Maun,, phos..
Indications : Pain and urging at the beginning of stools. Stools contain
mucous and blood with constant inclination to empty the bowels.
10. Enlarged tonsils (Composition):
Calc, phos., Forrum phoa., Kali., mur.
Indications : Fever, lassitude; throat covered with white coating;
swollen; tongue coated: bad breath: no appetite.
11.
tonsils
Fevers and inflammatory discascs(Composition): Ferrum phoa,, Kali mur..
Nat. Mur; Kali sulf., Natr. sulf.
Indications : Fevers; chills in the initial stages of all the inflammatory
diseases; in quick, sudden swellings; in pneumonia. Pleurisy and other inflam
matory affections that tend to suppuration.
Headache (Composition) : Ferrum phoa., Natr. mur, Kali phoa., Magn. phos.
Indications : Congestion, rush of blood to the head, neuralgia, relieved
by heat and aggravated by cold, nervous, due to worry or sleeplessness, white
tongue or sluggish liver; better in the open air, worse in a warm room, or in
the evening.
12.
13.
Leucorrhoea (Composition) : Calc, phoa, Kali aulf,, Kali phoa, Natr. mur.
Indications : All forms of leucorrhoea at puberty; during pregnancy and
at the climacteric; also in general weakness and hysteria.
14.
Measles (Composition):
Forrum phoa., Kali mur., Kali sulf.
Indications ; Sneezing, eyes and nose waters, fever. Useful in all stages of
the disease.
15. Menstruation troubles (Composition) : Calc, phos, Forrum phoa., Kali phoa, Magn.
phoa.. Kali sulf.
.Indications : Menses painful and irregular, scanty and late in young
women, Menses early, lasts too long and profuse in middle aged women.
16.
Nervous exhaustion (Composition): Calc, phos., Forrum phos., Kali phoa.. Magn.
phos, Nair. mur.
Indications : It is recommended for nervous exhaustion and fatigue from
any cause; for general weakness of the heart, stomach and nervous system,
sleeplessness,.
17,
Piles (Composition): Calc, fluor.. Kali phoa, Ferrum phoa., Kali mur.
Indications : An approved remedy against hemorrhoidal knots, all kinds
of piles, external piles with stinging pains. Bleeding piles with or without pain.
18.
Pyorrhoea (Composition): Calc, fluor., silica. Calo, aulf.
Indications : Gums spongy, swollen; gums bleeding. Pus in the gums with
foul breath.
19.
Rheumatism tablets (Composition): Forrum phoa, Magn. pho., Kalt .»lf, Natr. .ulf,
Indications : Shooting and stabbing pains in the joints of legs or arms,
worse at night. Fever; swelling of parts; lumbago; sciatica;
matism.
r **
•
• *
‘
>
muscular rheu-
20.
Skin diseases (Composition} Colo. fluor, Cato, suit., Kali tuff.. Notr raur..
Natr. aulf.
Indications : Scurfy eruptions in head and face of children; eczema from
uterine derangements; acne; pemphigus; herpes; erysipelas; crusta iaciea; and
similar eruptive diseases.
21.
Teething troubles (Composition)
Calc, phoa, Forrum phoa.
Indications : When children arc cross and obstinate, crying and weeping,
these tablets help the cutting of teeth easily and quickly by supplying necessary
salts. The appetite is improved and the digestion is stimulated. Removes griping.
22.
Scrophula (Composition) Calc, phoa., Ferrum phos., Kali, mur„ Siliooa.
Indications :
Useful both in dry and suppurating scrofulous glandular
abscesses. Covers almost all symptoms of the disease.
23.
Toothache (Composition)
Ferrum phoa., Magn. phoa.. Calc, fluor.
Indications : Specially recommended in all neuralgic cases. Splendid effect
in rheumatic toothache.
24.
Tonic ; Nerve and Brain (Composition)
Calo, phoa., Forrum phoa.
Kali phoa, Magn.phoa, Natr phoa.
Indications ; A general tonic in chronic wasting diseases; in anaemia of
of young and rapidly growing people; in women weakened by too frequent
parturition; general debility and exhaustion with lack of vitality.
25.
Acidity, Flatulence and Indigestion (Composition) Natr. phos.,
*
Natr. sulf., Silicea.
Indications :
Gastric disturbances; acidity; flatulence; dyspepsia; acid, sour .
risings; feeling of weight in abdomen; bilious vomiting; flatulent colic;headachc; 1
jaundice.
Easy Parturition (Composition) Magn. phos, Calc. phos?Kali phoa. Caiu. fluor.
Indications : If these tablets are taken during ihc' entire period of preg
nancy, they will greatly relieve the pains of labour. ’
(also greatly benefit
the mother s general constitution and greatly assist’ in* the1 development and
the health of the child. These tablets also prevent-.miscarriage.
26.
27.
Vital Weakness (Composition) Natr. mur, Kail phos. Calc, phoa,
Indications:
Impotence, depression of sexual instinct; lassitude and
general debility; emissions followed by trembling and weakness; prematurely
old; tones up the entire sexual system.
o
28. General Tonic (Composition): All twelve Tissue Remedioo,
Indications : These tablets are a combination incorporating
the twelve
Tissue Remedies found in the human organism. They arc of great service to.
those suffering from consumption and other debilitating diseases, to such as
are recovering from fevers, pneumonia, diarrhoea, etc., as they help to build
up the system by supplying the requisite nutrition. It may be taken by the
weak and the aged as a tonic after meals. Habitual use of these tablets, during
'health, will keep off disease.
.
•
<
. • *
'
• '
c
JjSd
XU^ XL
^1'0
Office
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in Battery with D/D Discount Control
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•
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.4^;
44^
QS0Q s
THE
SLEEK
MOST USEFUL IN CHRONIC PMNS
1.
T. E, N.S. device stimulates the large diameter afferent A fibers. According to the gate
control theory (Meizak and Wall 1965) the stimulation of large diameter afferent A fibers
relieves pain.
2.
With the proposal of the Gate Control Theory by il/lalzack and Wall in 1965, a rational
basis for electro-analgesia was postulated. They produced evidence which showed the dull,
slow, diffuse, burning pain is carried from the periphery by small, primitive, unmyelinated
fibers, while the sensation of light touch is carried by large myelinated fibers, i he sensory
output carried along these two sets of fibers from a given location were modulated in the
substantia gslatinosa of the dorsal horns within the spinal cord and acted upon each other
as a negative feedback mechanism
3.
By forcing the large A fibers to carry light touch sensation by electrical stimulation
of the area, pain signa's from the C fibers were blocked even after the electrical
stimulation stopped.
1.
2.
3-
HOW DOES T. E. N. S. WORK?
WHAT IS GATE CONTROL THEORY?
WILL THE PAIN BE RELIEVED EVEN AFTER APPLYING T. E. N, S. ?
4.
Transcutaneous Electrical Meuro Stimulation has several
definite advantages when
compared with other tests. It is non-invasive and suffers from few complications. Save for
an infrequent occurence of allergic reactions to electrode contact fluid, the only risk is
that of electrical skin burn occuring when excessive electrical stimulation has been applied
to a denavated or poorly inervated area of skin.
5.
“The T. E. M. S. course of pain management may be much less expensive. Most portable
T. E. M. S. units cost approximately § 400. It is not uncommon for a patient to spend
$ 2000 to S 3000 yearly for the medications required for analgesics to sustain
pain relief"
Page 42. Pain Control with T. E. N. S.
Robert A.. Ersek M.D-
6.
The efficacy
of T.E.N.S. treatment depends greatly on the proper selection and
placement of electrodes to ensure the most efficient modulation of the peripheral and central
nervous system. The basis for proper electrode placement appears to rest in the proper
evaluation of the dermatome/s in which the pain exists, so that trigger points within the
involved dermatome/s can be coupled with the corresponding spinal cord segment level/s to
influence the nervous system most effectively.
Random electrode placement has produced random results. It is important to emphasize
that each professional who uses T. E. N. S. should duplicate or create a consistent, logical
procedure for selecting electrode placement sites.
7.
Electrical stimulation in the postoperative period for the prevention of various
complications should become a strong and effective weapon in the hands of the surgeon.
Possibly, in major operations, many serious complications could be prevented by using
this method even without additional drug therapy.
Electrical stimulation is very simple and safe to use, and no undersirable side effects
were observed, nor are any to be anticipated in the future.
Dr. Roman Kurzbaucr, M.D.
4.
5
6
7'
HOW SAFE IS T. E. N. S. ?
WHAT IS THE COST EFFECTIVENESS OF T.E. N- S. ?
HOW IMPORTANT IS THE ELECTRODE PLACEMENT?
„
WHAT IS THE STATUS OF T-E. N. S. IN TREATING PAIN DURING POST-OPERATIVE PERIOD.
8.
Ths effects of th® therapy were estimated according to:
a.
Decrease on healing of the ulcer.
b.
Relief or alleviation from pain due to ulcers.
Decrease of ths size of the ulcers was obtained after a few weeks, i. e. 15 to 25
sessions, by approximately 50% reduction in the initial size. This was more evident in men.
Healing of the ulcers was observed
approximately 3 months.
in
31
patients
(out of 61)
after
a
period
of
Dr. Roman Kurzbauer, M.D.
9.
Success end failure of T.E.N.S. treatment are indicated as relative to injury
and the type of pain perceived. Results indicate that pain at the site of injury is
more successfully than radiating or centra! pain.
location
treated
10.
In one study of 20 patients suffering from myofacial pain dysfunction symptoms at
Kimbrough Army Hospital, 16 patients reported "excellent". 2 reported "good", zaro reported
"fair" and 2 reported "poor" pain relief after stimulation. Of those aided by T.E.N.S., 40 percent
felt ralieved after a single application, while 90 percent were relieved after five applications.
11.
During a six-month period in which 35 patients presented in the General Surgical clinic or
Surgical Ward with low back strain, all achieved from T. E. N. S. therapy what they described
as at least a 50% reduction in their pain. The duration of symptoms ranged from a few
hours to 20 years ; the degree of injury of trauma varied from pain resulting from vacuum
cleaning, to automobile accidents, followed by two laminectomies in previous years. In many
cases of low back pain of acute onset, with ns previous history, of this type of complaint,
the relief of pain was prompt and permanent. In other cases where the low back pain was
preceded by a long history of multiple operations and failure of analgesics and tranquilizers,
the pain relief would vary between several hours and several days.
When we treated patients with this problem, T. E. N. S. therapy suppianted the previous
mode of treatment of one to two weeks of strict bed rest, traction, analgesics and tranquilizers.
Many patients reported that when their pain recurred a few days later, it was less
severe than it has been prior to T. E. N. S. treatment. Of those patients who has temporary
relief, the minimum duration of reaction was three hours. Those who received rsiiaf lasting
for hours or days were treated again in the same manner, and many continued to return
to the clinic for periodic treatments with the T. E. N. S. unit every three days.
8.
HOW EFFECTIVE IS T. E. N. S. IN TREATING VARICOSE ULCER 7
9.
WHAT IS THE EFFECT OF T.E, N. S. IN THE MANAGEMENT OF PAIN IN SPINAL CORD INJURED PATIENTS 7
10.
WHAT IS THE EFFECT OF T.E. N.S. IN THE TREATMENT OF MYOFACIAL PAIN DYSFUNCTION SYNDROME 7
,1. HOW EFFECTIVE T. E. N. S. IS IN LOW BACK PAIN 7
12.
When the device was utilized more specifically in the
Emergency
Department with
34 patients with acute symptoms (lasting less than three days), six of these with acute
pain symptoms were admitted to the hospital for their presenting symptoms of pain or
other diagnoses, usually trauma. Only one of these received no pain relief, nine achieved
what they reported as between 50-75 percent relief, six estimated between 76 and 39 percent
relief, and eight between 90 and 99 percent, while ten attained 100 percent relief of their pain.
13.
Seven patients presented with torticolis, or acute cervical strain. One patient with
acute cervical pain secondary to an automobile accident experienced an increase in pain as
a resuit of T. E, N. S. treatment. One achieved between 50 to 75 percent relief of pain, two
over SO percent relief, and three experienced 100 percent pain relief.
14.
The effect of V. E. N. S. in relieving pain and muscle spasm has often been very prompt
and permanent. This is perhaps best shown in the cases of torticollis, where this form of
treatment relieves pain, interrupting the pain-spasm-pain vicious cycle, allowing the patient
full and voluntary control of his neck within a few seconds. Fifteen patients reporting on
the telephone follow-up of this study said that their relief of pain or muscle spasm was
permanent. One said the relief lasted 24 hours, and although some soreness returned, the
pat’ent still felt there was a 90 percent pain reduction. Another found some pain present on
movement. This was a patient who had low back strain following the lifting of boxes, who
initially reported a 50 percent reduction in pain after T. E. N. S. treatment. Foilow-up five
months later revealed this patient still has some pain upon movement.
The patient presenting with shoulder and arm pain after lifting, initially reported
S5 percent pain relief, and a follow-up report stated the relief lasted for ten days. One
patient with recurring pain in back following a fall, at first reported 80 percent reduction in
pain, with relief lasting four days, and after a second treatment, relief was 100 percent and
permanent. Another had relief for 48 hours, one for four days, another reported some soreness
remaining.
15. According to various reports cited through out the current literature, an appreciable
percentage of patients with chronic pain will be treated by this method alone, without the
need of any additional therapy.
Boleslav; .Rutkowski, M. D.
16.
During the stimulation, the Patient feels only a slight pulsatile sensation at the site of
the electrodes. A few cases have complained of some slight dizziness of very short duration,
just after the session.
much
Many of our patients stated that their
relieved.
sleep
was
improved
and
they
usually
In cases with hypertension, a significant fall of the systolic blood pressure
in the majority of observed patients.
1Z.
13.
14.
15.
’A.
HOW EFFECTIVE T. E. N. S. IS IN PATIENTS WITH ACUTE SYMPTOMS OF PAIN’
HOW EFFECTIVE T. E. N. S. IS IN TREATMENT OF PAIN DUE TO ACUTE CERVICAL STRAIN ’
WHAT IS THE EFFECT OF T.E. N. S. IN RELIEVING PAIN AND MUSCLE SPASM?
WHAT IS THE POSITION OF T.E. N. S. IN THE TREATMENT OF CHRONIC PAIN’
WHAT IS THE SIDE EFFECT DURING TREATMENT OF CHRONIC PAIN?
feel
was noted
17.
1.
Classical Migraine
2.
Cephalgia Vasomotorica
3.
Cluster headache
4.
Cervicas syndrome
5.
Combined headache
18.
This very common disease, with acute attacks of pain,
branches of the nerve. With electrical stimulation, the out look
favourable.
affects one or all three
for these cases is often
19. Pain due to the disease at all levels of the spina, such as spondylitis or degenerative
disc syndrome can be categorized as being potentially aided by electrical
stimulation.
Any conditions such as tuberculosis or tumors of the spine were not treated in this manner.
20.
The most promising results will be expected in chronic low back pain. When due
to
degenerative disc syndrome, the outlook could be as favourably high as 70% with good
to
very good results. The sessions must be continued for weeks or months. Initially, with these
patients, we begin first daily, then weekly, with some having twenty-five and more sessions,
although the average was twelve to fifteen sessions. Though even dramatic results could
be observed, only the final results were evaluated.
Low back pain due to spondylitis is more difficult to be treated, more sessions are
necessary, and the treatment may sometimes be continued indefinitely. Nevertheless, some
50% of the cases in our study will not need any more drugs during the treatment.
Patients operated on for herniated disc responded well to the therapy.
21.
Any neuralgia is a suitable case for the stimulation. Other conditions can also be
treated, such as arterial hypertension, insomnia, neurasthenia, etc., subject to further
experiments and investigation.
The drop of the systolic blood pressure as observed in
hypertonic patients, opens new possibilities in this field. This, as a rule, should be carried
out in a ward rather than in outpatient departments.
22.
In cases where there is not complete remission of the symptoms, the treatment can be
continued indefinitely, usually with intervals between the series of sessions. The physician
will decide as to the length of the interval. So iong as the patient benefits
from the
therapy, there is no limit of time and number of sessions to be applied. If relapses of pain
should occur, as seen in trigeminal neuralgia or low back pain, the treatment will be
performed as before, with the same expectation.
23.
Phantom pain and causalgic-like syndromes have been extremely difficult to counteract
on a non-invasive basis and their responses to TENS have been encouraging even though
variable. It appears that more constant use, of the unit in causalgic and phantom pain
syndrome is warranted in view of the persistent pain patterns that have developed possibly
within sympathetic chains.
^nwTc^RE THE KINDS OF HEADACHE THAT ARE TREATED BY r. E. N. S ?
HnWFSlTIVE IS T.E. N.S. PRIMARY TRIGEMINAL NEURALGIA ?
unw ABnuTV£IS T E N.S. INCASES OF SYMPTOMATIC RADICULITIS?
unw TO TRFA?H»f’ONIC L0w BACK PAIN ?
Tt
ONG ANDNunwAiS5S OF 0THER SITES AND OTHER CONDITIONS?
23 W.US THE EFFectVo?FtE^ X°ou USE T' E- n- S1 im CHRONIC PAIN SITUATION?
LS.
inc crrtcT OF T.E. N.S. IN PHANTOM PAIN ?
Io
M
TRANSCUTANEOUS ELECTRICAL STIMULATION FOR ISCHAEMIC PAIN AT REST
Patients with critically ischaemic legs often develop severe continuous pain at rest. Pain relief
is often provided vjth intramuscular injections of opiates, which can lead to excessive drowsiness
and respiratory problems before major surgery.
Transcutaneous electrical stimulation can provide
effective relief in .everal chronic pain syndromes1; furthermore, electrical stimulation of the
nervous system may affect blood flow to the extremities? We report our initial findings of electrical
stimulation on pain in patients with severe peripheral vascular disease.
PATIENTS, METHODS, AND RESULTS
Twer.ty consecutive patients who had had two weeks' continuous severe pain at rest in a
critically ischaemic foot were allocated randomly (from a tabla of random numbers) to one of two
groups within two hours of admission. One group received transcutaneous electrical stimulation
■for 48 hours and the ether received sham stimulation. Both groups had equal access to
intramuscular morphine 10 mg on demand if pain relief was inadequate An index of ankle brachial
systolic arterial pressure was measured with a Doppler probe before treatment. f*ain was assessed
every 12 hours on a standard 100 mm linear analogue scale3; patients were asked to record the
average amount of pair, experienced over each 12 hour period, and morphine requirements were
noted. Two pregelled six inch electrodes were applied longitudinally to the thigh of the ischaemic
leg, and transcutaneous stimulation was provided by a Wright Care transcutaneous electrical
stimulation system (Dow Corning Wright, Berkshire). All patients had a short demonstration on
the use of the device and were told that they might experience a tingling sensation. The light
indicator on the stimulation device was covered by an opaque material, and the polarity of the
batteries in the device was reversed for the patients receiving sham treatment.
Ten patients (mean age 64, range 44-75) received sham treatment and 10 (mean age 68, range
62-82) transcutaneous stimulation. There were four men and nine smokers in ths control group
and six men and seven smokers in the treatment group. Four patients in each group had had
vascular surgery. In the control group (mean pressure index 0.16, range, 0-0,54) eight patients had
severe ischaemic changes in ths feet while seven patients in the stimulated group had ulceration of
the toes or gangrene (mean pressure index 0.29, range 0-0.54 ; no significant difference). There
was no significant difference in mean analogue scores for pain before randomisation (table). The
mean of the four pain scores for each patient during treatment was 52.9 mm (range 15-5-82) in the
sham group compared with 34.3 mm (range 11.3-53.5) in the stimulated group (p = 0.0S, Student's
test ; 95% confidence interval—1.2 to 38.4). Patients receiving stimulation showed a trend towards
lower linear analogue scores, which was significant at 24 and 36 hours (table). Six patients in the
sham group compared with two in the stimulated group required supplementary analgesia
(p = 0.1698, Fisher's exact test).
The mean morphine requirements were 3 mg (range 0-2G mg) in
the group receiving stimulation compared with a mean of 23 mg (range 0.60 mg) in the control
group(0.05<p<0.06, Mann Whitney U test). No untoward side affects were noted. All patients
underwent arteriography at the end of the study and reconstructive surgery during their admission.
Mean (range) linear analogue pain scores in millimetres
Sham group
Stimulated group
Mann-Whitney U test
Initial
12 h
24 h
36 h
48 h
70 (30-100)
72 (43-100)
NS
53 (15-100)
44 (27-7 i)
NS
58 (20-99)
29 (5-55)
P<OU2
52 (12-831
35 (10-65}
49 (10-91)
30 (3-48)
IVS
p<0'05
COMMENT
Urgent revascularisation is essential in patients with critically ischaemic feet. While they ara
awaiting angiography and assessment of fitness for vascular reconstruction pain relief is often
provided by the intramuscular injection of opiates, with the attendant risks of respiratory
depression, drowsiness, and bronchopneumonia. Alternative methods of providing analgesia
without these side effects—for example, epidural morphine*—have not gained widespread
acceptance because of the technical skill that is often required. In our study transcutaneous
stimulation was found to be simple, safe, non-invasive, and acceptable to both patients and nurses.
It may be of value in the treatment of rest pain, producing good pain relief and reducing narcotic
requirements for patients awaiting reconstructive surgery.
care.
Dr Gordon
Murray,
Lecturer in Medical Statistics,
University of Glasgow,
kindly g&fQ
statistical advice.
1
2
3
4
Miles J: Electrical stimulation for relief of pain. Ann Ft Coll Surg Engl 1984; 66: 108-12
Dooley DM. Kasprak M. Modification of blood flow to the extremities by electrical stimulation of the nervousystem. South Mod 3 1976; 69: 1309-11.
Huskisson EC. Measurement of pain- Lancer 1974 ; ii : 1127-31.
Lomberger RJ, Layfield DJ, Hopkinson UR. Makin GS. Epidural morphine for isc.'.aamic rast
pain Br 3 Surg 1981;68-367.
(Accepted 29 April 1987)
(FROM BMJ
VOL. 295
1 AUG. 1987. 301)
Peripheral Vascular Unit, Royal Infirmary, Glasgow G 31 2 ER
H J CUSCH1ERI. CHM, FRCS, senior registrar
C 6 MOdRAi’.', MB, FRCS, IiHum
Courtesy
j G POLLOCK, mb, FRCS, consultant In administrative charge
.
, , — Selection from
U-tSnU to : Mr Cuschiari.
-^IcpI Journo, pol. j Ncvtmbtr lia7
T. E. M.S. IM
T. E. N. S.
their
employ
it
related
injuries.
in
T. E. N. S.
!
I
was
USEFUL
approved
for
physical
therapy
use
at
the
SPORTS
Olympic
Games
in
or
clinics
tor
department
:
Chronic strain
the cervical
and
sprain
ofl
L
;
in
on
the
spot
job
Paraplegia
I
!
Pancreatitis pain
Diabetic neuropathy
I
I
analgesia
IN.................
I.
I
Wlo^xtreal in ASIS. Lars® companies
Peripheral
]
Orthopedic
neuropathy
procedures
of tho
extremities
I
i
Phantom limb syndrome
I
;
Bursitis
Thrombophlebities
F
I
'
Intractable migraine
|
!
Trigeminal neuralgia
I
;
Dental procedure
'
Low back pain
Adhe.nsive
capsulitis
Intractable cancer
I
pain
I
;
Post operative pain and ileus
I
I
Sports medicine
I
I
Hemiplegia
I
:
Job-related injuries
................
AND
MULTIPLE
NEEDS
OF
PAIN
RELIEF
Kodys Product Range :
12*
Electrocardiograph (ECG)
Foetal Doppler
yj-
Vascular Doppler (Blood flow detector)
Vascular Doppler Recorder (Vaslab)
■K
■$<
?r
i>-
■ft
Pocket T.E.N.S. (Electronic Pain Killer) Patient Model
Table Top T.E.N.S. (Electronic Pain Killer) Hospital Model
Holter Monitor First Ever Solid State
Full Disclosure System
Ambulatory ECG Solid State Silent Ischemia Monitor
Functional Neuromuscular Stimulator
Micro-Electro-Therapy apparatus (M.E.T.)
•ft
Spares : Paediatric Electrodes, Clip-on Electrodes
Ultrasound Jelly or ECG Jelly.
Kodys Sales & Service Network :
Bangalore,
Bhopal,
Bombay,
Madurai,
Coimbatore, Ernakulam,
New Delhi,
Hyderabad,
Kanpur,
Vijayawada, Visakhapatnam.
Kody Medical Electronics Ltd.
Factory :
Central Marketing Division :
No. 2, 12th East Street
Telephone :
Kamaraj Nagar
Thiruvanmiyur
Telegram
Madras-600 041
Telex
T'
°UNS. . . .
KODYS SAIW&'
:
t
Off : 410764
Fact : 415960
KODYELEC
41-6546 KODY IN
multiple needs of pain RELIEF
NETWORK
Type 11/37, Second Phase,
Dr. V.S.l. Estate,
Thiruvanmiyur,
Madras-600 041 ■
THENNHMRMKKUDI’ OIL
RBG1STER NO. 8 9 8 7 3.
( EXTERNAL USE. )
METHOD OF USING. In cases of fracture of
^>ones of the arms or tne legs, dislocation and crash
ing of bones, bandage the arms or legs and pour the
oil on it. For sprain in the leg, in the hip suppressed
breathing and similar diseases, heat the oil in a spoon
and give a massage and after three hours give hot
water fomentation. For swelling contusion, beginning
of swelling in the leg, enlarged testicles, thickening of
the nerves, chest pain, side pain, weakness in the legs
heat the oil and massage. Give warm boiled rice
fomentation. Also give hot water fomentation.
For itches, Boils, ringworm and eczema, clean
the portion well. Massage the portion with the oil
in the morning- After three hours wash with soap
nut powder and take hot water bath. For unhealed
cuts or wounds, burns or wounds caused by
poisonous bites, cuts, etc., soak a piece of cloth in the
oil and apply it to the part.
N. B:- This oil can be used for animals also
similarly. In serious cases, drink hot water and
take a warm water bath.
Sole Manufacturers
R. S. KRISHNA & CO , MAYAVARAM.
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Manufacturers:R. S. KRISHNA %i^0./r4>v^M AYA VAR AM.
------- ---------- ;---------------------------- 'J' . '9O ,. ■
Backiyam Power Press, Mayurain.
9q '^{
Approved
Homoeopathic
Specialities
w
WELLMANS
. WELLMANS HOMOEOPATHIC LABORATORY
Safe Homoeopathic preparation—No Side Effects
FOLLI—CLEAN : HAIR TONIC
Composition:
Internal: AC. Phos 6x, Lycopodium 3x. Jaborandi 2x, Weisbaden 3x
External: China Q. Arnica Q. Jaborandi Q Cantharis Q.
Indications: An excellent tonic to help strengthen roots of hair. Prevents hair loss
due to mental strain or prolonged illness. Very useful against dry scalp, dandruff
split hair and premature greyness. Especially curative in helping to regenerate dead
hair roots.
fl
Dosage:
Internal — Children 5 drops diluted with half tablespoon of water twice daily.
Adults 10 drops diluted with halftablespoon of water twice daily.
External — Add 15-20 drops of FOLLI-CLEAN in a cup of hike warm water, and
massage gently into hair. Wash and dry hair after 10-15 minutes. Use any oil
preferably coconut based oil.
Packing: Internal — 30 ml.. External — 30 ml.
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM—4, Dilkhush Industrial Estate,
G.T. Karnal Road, Delhi-110 033.
Recomended course: Minimum 10-12 weeks
Duration of pack: App. 15 days
Information for use by a Registered Medical Practitioner. Hospital or Laboratory only
Safe Homoeopathic Preparation — No Side Effects
AU-CARE—SKIN CONDITIONER
Composition: Bcrb. Aqua Q. Kali Brom 2x, Pulsatilla 3x, Calc. Carb 3x, Thuja 5x,
Mangifera indi 2x, Excipients q.s.
General Indications: Black heads. Acne. Pimples. Dry skin, rkllergic condition.
Skin rashes, especially recommended for dark rings around eyes.
Contra-Indications: None.
Dosage: 10 drops diluted with half table spoon water 3 limes a day or as directed by
the physician.
Precautions: Do not apply any medicated cream or lotion on the affected areas
during use of AU—CARE. Clean the skin only with fresh water and a mild soap.
Presentation: 30 ml.
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY.
AM—4, Dilkhush Industrial Estate,
G.T. Karnal Road, Delhi-110 033.
Information tor use by a Registered Medical Practitioner. Hospital or Laboratory only
Safe Homoeopathic Preparation—No Side Effects
IMPROVEX — A PEADIATRIC TONIC
Composition: Calc Phos. 6x. Ferr Phos. 3x. Kali Phos 4x, Chamomilla 5x, China
3x, lodium 3x, Cup Oxid Nig 3x, Cypripedium 3x. Chelone 3x, Cataria Nepcta 2x,
Excipients q.s.
Indications: Griping problems. Diarrhoea, worm infection. Delayed
Problematic
dentition. Pyrexia. Nausea. Retarded growth. Intolerance of milk. Weak memory
and Iron deficiency.
Infants 6 months to 1 year 5 drops twice daily. 1 year to 8 years.5 drops four timesj
daily. 3 years and above 10 drops four times daily or as prescribed by physician.
Contra-Indications: Nil
Presentation: 30 ml.
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM—4, Dilkhush Industrial Estate,
G.T. Karnal Road, Delhi-110 033.
Information for use by a Registered Medical Practitioner. Hospital or I-tboralory only
Safe Homoeopathic Preparation—No Side Effects
STIMASIAC
Composition: Testiculus 81). Prostrate 61). Damiana Q. Arid Phos 2D, Cydonia
Vulgaris 2D . Ginseng Q Selenium 31). Crataegus 2D. Excipients q.s.
Dr.
Wellman’s
STIMASIAC
is
a
safe
non
steroid
aphrodasiac.
especially
formulated to give the optimum stimulus to the metabolic activities of the human
body. STIMASIAC a researt h product of Dr. Wellmans Homoeopathic Laboratory,
is absolutely free from any side effects Sttmasiac is a well tolerated combination of
1 drugs for functional and idopathic sexual problems
Indications: Functional impotency, psychic, idiopathic impotency, premature or
delayed ejaculation, lack of retention, sexual neurasthenia, sexual and senile
debility, lack of libido in male painful coitus and deficient spermatozoa.
Dosage:
15-20 drops diluted with half tablespoon of water taken twice daily
preferably evening and night, keeping a lime difference of at least one hour between
the first and second dose.
Duration of pack approx. 15 days. Recommended course minimum 6 to 8 weeks.
Presentation: 30 ml. concentrated drops.
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM—4, Dilkhush Industrial Estate,
G.T. Karnal Road, Delhi-110 033.
Information for use by a Registered Medical Practitioner, Hospital or Laboratory only
Safe Homoeopathic Preparation—No Side Effects
ANTI—TOX
Composition: Strychnium Nit. 3D, Avena Sat. Q, Querecus, Gland Spiritus 2D,
kalmegh
Caiadium 3D,
Daphne Indica 2D
Excipients q.s.
Dr. Wellman’s ANTI-TOX is an ideal homoeopathic formula to reduce the toxic
and after effects of nicotine and alcohol. It also acts as an effective antidotal drug to
reduce the toxicity generated by other allied strong medications. Regular use of
ANTI-TOX has proven to reduce the craving for alcohol and tobacco.
Dosage: 15-20 drops diluted with half tablespoon of water taken twice daily in acute
cases to be taken four times daily.
For optimum results use the medicine regularly, two doses a day for at least 3-4
months then reduce the dose to once in a day and gradually to a minimum of two
doses in a week. The medication may be discontinued by increasing the period of
days without which the patient shows no reversal of state.
Duration of pack approx. 15 days, recommended course minimum 3 to 4 months.
Contra-Indications: Nil
Presentation: 30 ml.
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM—4, Dilkhush Industrial Estate,
G.T. Karnal Road, Delhi-110 033.
Information for use by a Registered Medical Practitioner. Hospital or Laboratory only
Safe Homoeopathic Preparation—No Side Effects
ELIXIR VITA-8—RESTORATIVE TONIC FOR ALL AGES
Composition: Avena Saliva Q, China 2x, Ginseng Q. Hydrastis Q. Alfalfa Q. Acid
formic 4x, Lecithin 2x, Coca Q. Ashoka 2x, Manganum Acet. 2x Excipients q.s
Indications: Restorative tonic, recommended in convalesence. lack of appetite,
anaemia and especially for conditions-of fatigue and impaired digestion.
Dosage: Adults: One table spoon full thrice daily preferably I 2 hour before meals.
fc/n/dren.- One teaspoon full thrice daily half an hour before meals.
^)r as directed by the physician.
Presentation: (Syrup base) 180 ml.
Mfd. in India by.
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM-4, Dilkhush Industrial Estate,
G.T. Kamal Road, Delhi-110 033.
Information for use by a Registered Medical Practitioner. Hospital or Laboratory only
Safe Homoeopathic Preparation—No Side Effects
LEMA—FORTE: SLIMMING DROPS
Composition: Fucus V2x. Phyt, Berry 3x Amm, Brom 2x. Puls Q & Thyroid 6x.
Lerna Forte is the research product of Dr. Wellmans Homoeopathic Laboratory for
slimming.
Being over weight is not only a disease but a grave danger to your life. Among the
dangers associated with excess weight are heart disease, diabetes, gallstones.
respiratory disorders and degenerative changes in the joints especially the hips and
knees. Fat men have a higher incidence of certain cancers including those of the
colon, rectum and prostrate. Over weight women run a greater risk of developing
malignant tumors of the ovaries and uterine lining and after menopause, of the
breasts.
When is your weight dangerous: 1) Men: Whose waists are bigger than their hips
fall into the danger zone. 2) Women: Whose waist and hip measurement differ by
more than 85%.
These are danger zones: You should start being careful not after you come into the
danger zone but much before.
V
Storage of Fat: Men normally carry their extra weight in the upper torso or around
the abdomen. Women collect excess weight below the waist in thighs, fannies and
hips. Fat deposited in these parts is more difficult to remove Change in body
metabolism especially after pregnancy is normally attributed to this.
LEMA—FORTE: Is an ideal combination to fight against the deposition of
unwanted fat.
LEMA—FORTE: E xerts a two Pronged attack. First it changes the B.M.R. (Basic
Metabolic Rate) to release fat more quickly, secondly it helps to regularise
functioning of the thyroid gland which secretes Iodine, malfunctioning of this
gland is the root cause of weight gain.
LEMA—FORTE: is thus a complimentary drug combination to remove the excess
fat in a natural and safe way — the homoeopathic way.
NO CRASH DIETS—: No strenous exercises, Lerna-Forte regulates the body
systems tn such a wav that once a patient reaches the desired weight he/she may
discontinue the medication without any reversal of the procedure. The patient is
cured almost permanently and may only stick to the recommended Diet Chart
enclosed in the Carton as closely as possible. Observe the following instructions
during use of LEMA-FORTE:
1. Check your weight only once in a month.
2. L>se the same machine every time.
1 Check your weight at about the same time preferably in the morning after
breakfast.
4. Check your weight wearing minimum of clothing and without shoes.
5.
Do Not TRY & LOSE MORE THAN 1—2 kg in a month. The morequickly you
lose weight the more the chances are that you will gain it back within a few
months. GRADUAL WEIGHT LOSS IS PERMANENT WEIGHT LOSS.
HOW FAT FORMS
Fats stored in the body can be made from any food component (carbohydrates.
proteins or fats). When food is eaten, it travels to the stomach and intestines.
Enzymes break down the food into glucose,amino acids and minute droplets
of fats. The fats travel to the liver, where they are processed. From the liver,
fats enter the circulatory system, where they can be used for energy by many
organs. Excess fats will be stored in the fat cells 1. When more energy is
needed, fats arc released. If the need continues, the cells will shrink but the
nucleus remains the same 2.
6.
TRY and remain physically active—even a small increase in physical activity
does much to retard weight gain, a brisk walk for 5-10 minutes in a day is best
recommended.
Caution:
1. More than the prescribed use of Lema Forte does not mean more weight loss.
2. If you start losing more than 2kg in a month discontinue the medicine for 10 days
and then start again.
3.
4.
It is essential to follow the diet chart enclosed al least for the first three months.
Not to be used during pregnancy.
LEMA—FORTE REGULATES THE BODY SYSTEMS AND THE BODY
SYSTEMS REGULATE THE FOOD INTAKE NATURALLY.
Indications: Tendency towards excess weight, lethargic disposition, dispropor
tionate protrutions of the figure, especially around hips, post pregnancy weight
gain, easily fatigued.
Dosage: 20 drops of Lema Forte; diluted with half tablespoon water. Take ten
minutes before meals thrice daily.
Packing: 30cc. Duration of pack approx. 8 days. Recommended-course minimum
12 weeks
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM-4, Dilkhush Industrial Estate,
G.T. Karnal Road, Delhi-110 033
Information for use by a Registered Medical Practitioner. Hospital or Laboratory only
Safe Homoeopathic Preparation — No Side Effects
LEUCO F. TONIC - FOR LADIES
Composition: Abroma Radix 3D, Saraca Indica ID, Helonias 3D, Hydrastis 2D, Viburnum
Op. 3D, Pulsatilla 5D, Excip. q.s.
Dr. Wellmans LEUCO F. TONIC is a Homoeopathic Tonic of choice for ladies, removes
fatigue and pains associated with hormonal changes in the body; and brings about a feeling of
well being. LEUCO F. TONIC is a proven remedy for leukorrhea and related discharges, very-
effective in regularizing the menstrual cycle and curative in amenorrhea, menorrhalgia and
Msmenorrhea. Also acts powerfully to remove sensation of weakness and feeling of dragging,
weight in the sacrum and pelvic region and cures backaches associated with metabolic
changes. LEUCO F. TONIC also cures spasmodic and congestive affections.
Indications:
leukorrhea . menstrual disorders - dysmenorrhea, amenorrhea, pain in pelvic
region, diarrhea during or after menses, menopausal disturbances, nervous debility in
women, backache and menorrhalgia. An ideal Tonic in conditions of general fatique.
Dosage: One teaspoon full twice daily preferably after meals or as directed by the physician.
Presentation: 125ml.
Caution: ‘In the prescribed dosage it has no side effect’. If the dosage is doubled to one
tablespoon full and repeated four times daily it may lead to abortion. To be administered to
pregnant ladies only under the guidance of a regd. medical practitioner.
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM-4, Dilkhush Industrial Estate,
G.T. Karn al Road,
£lhi-33.
Information for use by a registered medical practitioner, hospital or laboratory only.
Safe Homoeopathic Preparation—No Side Effects
RHEUMA-SOL
Composition: ?\cid Formic 3D, Colchicin 5D. Rhus Tox 3D, Natrum Salicylicum 3D, Ledum
Pal 3D, Dulcamara 3D, Lithium Carb 5D. Gelsemium 3D, Ulmus 5D, Excip. q.s.
Dr.Wellmans RHEUMArSOL exerts an analgesic and anti-inflammatory action. RHEUMASOL is ven’ useful for treatment of rheumatoid arthritis, osteoarthritis and allied disorders.
RHEUMA“SOL is also specifically indicated in such conditions as spondylitis, arthralgia,
myalgia and other non specific conditions requiring mild analgesia.
Indications: Rheumatoid arthritis, osteoarthritis, spondylitis, acute articular and pe^
articular disorders, pain and muscle spasms associated with truama, lumbago, inflammatory
and degenerative processes, neuritic vasomotor pain and sciatica.
Dosage: One teaspoon full diluted with quarter cup of luke warm water twice daily or as
directed by the physician.
Presentation: 125 ml.
Contra-Indications: Nil
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM-4, Dilkhush Industrial Estate,
G.T. Karnal Road.
Delhi-33.
Information for use by a registered medical practitioner, hospital or laboratory only
Safe Homoeopathic Preparation—No Side Effects
RAUWOLFIA FORTE
Composition: Rauwolfia Serpentina 2D. Viscum Alb 3D, crataegus. Ox 2D, Arnica M 3D,
Valeriana 3D, Melltlotus 3D, Cactus 3D. Excip. q.s.
Dr. Wellmans RAUWOLFIA FORTE is an excellent remedy to cure all grades and varieties of
hyper tension. RAUWOLFIA FORTE Acts upon the muscles of the heart and arteries and
brings about normal constrictions acting effectively tn gradually lowering blood pressure.
RAUWOLFIA FORTE has a marked effect on violent palpitation of heart and laboured
Scathing RAUWOLFIA FORTE also shows effect in insomnia of aortic sufferers, anaemia
and irregularity of heart.
Indications: All grades and varieties of hyper tension, chronic coronary insufficiency, follow
up treatment of myocardial infarction Very helpful in gradually lowering blood pressure
Dosage: One teaspoon full diluted with quarter cup water to lx? taken twice daily. In acute
cases; 5-10 drops to be taken directly without water; or as directed by the physician.
The supervision of a physician is most essential in acute cases. RAUWOLFIA FORTE is
helpful is sustaining the patient till the doctor arrives.
Presentation: 125 ml.
Contra-Indications: Not to be administered to patients having history of depression or low
blood pressure.
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM-4, Dilkhush Industrial Estate,
G.T. Karnal Road,
Delhi-33.
Information for use by a registered medical practitioner, hospital or laboratory only
Safe Homoeopathic Preparation—No Side Effects
ASTHA CURE — EXPECTORANT.
Composition: Yerba Senia 3D, Lobelia Inflata 3D. Ephedra Vulgaris 5D, Spongin 3D. Senega
3D. Cactus 3D. Araiia racemosa 5D. Stramonium 5D. Corallium 5D. Excipients q.s.
Dr. Wellmans ASTHA-CURE is a well balanced, clinically tried formula for bronchial
asthma, chronic bronchitis and emphysema. ASTHA-CURE is a broncho dilator with
mucolytic expectorant action which provides relief from Complicating conditions of allergic
alveolitis, allergic rhinitis and bronchospastic disorders. r\STHA-CURE clears dry ncss of all
air passages, hoarseness of speech and short respiration. ASTHA-CURE also removt
constant constriction of chest and corrects constant sneezing coryza, whooping cough ancT
wheezing cough.
Indications: A broncho dilator with mucolytic expectorant action, clears viscid purulent
sputum
in acute and chronic asthma, bronchitis, complicating conditions of bronchial
asthma, bronchopneumonia. whooping cough, allergic rhinitis, chronic and obstructive
pulmonary emphysema, bronchospastic disorders, hoarseness of speech, wheezing cough and
suffocative cough
Dosage: One teaspoon full twice daily. In acute cases the dosage may Im? increased to one
tablespoon full three times daily or as recommended by the physician.
Presentation: 125ml.
Contra-Indications: Nil
Mfd. in India by
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM-4, Dilkhush Industrial Estate,
G.T. Karnal Road,
Delhi-33.
Information for use by a registered medical practitioner, hospital or laboratory only
Safe Homoeopathic Preparation—No Side Effects
DIGE—COM
Composition: Piper Nig. 2D, Nux Vom 3D, Thymus 5D, Asafoetida 3D, Hydrastis 3D,
Lycopodium 2D, Cornandum Saliva 5D, Carbo Veg 5D, Excipients q.s.
Dr.Wel Imans DIGE-COM is a scientifically developed formula for various types of stomach
disorders. DIGE-COM reduces flatulence of both nature, i.e., rolling flatulence and hysterical
flatulence. DIGE-COM also reduces distention of stomach, violent gastralgia, burning in
stomach and diaphragm region. DIGE-COM removes dyspepsia due to farinaceous and
.fermentable food regurgitation of food.
Indications: Acidity flatulence, dyspepsia, gastritis, colic, gastro cardiac syndrome, hyper
acidity syndromes resulting from erratic food/alcohol intake.distentionof stomach and forcible
eructation of gas, pulsation in pit of stomach, violent gastralgia, obstinate constipation
and related bowel disorders.
Dosage: /Kdults one teaspoon full, children half teaspoon twice daily after meals or as directed
by the physician.
Presentation: 125 ml.
Contra-Indications: Nil
Mfd. in India by:
DR. WELLMANS HOMOEOPATHIC LABORATORY,
AM-4, Dilkhush Industrial Estate,
G.T. Kamal Road,
Delhi-33.
Information for use by a registered medical practitioner, hospital or laboratory only
Dr. WELLMANS
HAIR CARE PRODUCTS
Black K1
ARNICA
HAIR OIL
150 ml
CANTHARIDIN
SULPHIDE
SHAMPOO
60 ml
200 ml
ARNICA AMLA
HERBAL
SHAMPOO
150 ml
300 ml
450 ml
LEHER SERIES
PURE
FLOWER
SHAMPOO
100 ml
(with Amla)
100 ml
SHAMPOO
100 ml
ARNICA
HAIR OIL
(With Vitamin E)
100 ml
ARNICA
BLACK
SHAMPO—.
100 ml
0
e
Manufactured at:
DR. WELLMANS HOMOEOPATHIC LABORATORY
|
AM-4, Dilkhush Industrial Estate
G.T. Karnal Road, Delhi-110 033
f
g>
Marketed by:
®
DR. WELLMANS
HOMOEOPATHIC LABORATORY LIMITED
g
3
|
AM-2, Dilkhush Industrial Estate
G.T. Karnal Road, Delhi-110 033
|
i
?
Price List
HERBO-MINERAL MEDICINES
MARCH 1983
J.& J.DeChane
Laboratories Private Limited
Hyderabad -500 001, INDIA
TERMS OF BUSINESS
This Price List is issued under the provisions of the Drugs (Price Control) Order 1979.
i Prices to the Retailer are inclusive of excise duty. Sales tax and other imposts will be
rged extra. The prices indicated under column 'Retail Price' are those applicable to
consumers and are inclusive of excise duty. Sales tax and other imposts will, however,
be charged extra.
«
Prices are liable to be altered without notice.
The Drug Schedule classifications have been made according to the best of our know
ledge for the benefit of customers, but no responsibility can be accepted for their
correctness.
Parcels are despatched by V.P. Post, lorry or by rail. Please mention the name of your
destination clearly. Parcels by V.P.P., Lorry or Rail are sent on receipt of an advance of
25°i of the value. Packing and transit charges are extra in all cases.
Goods are carefully packed before they leave our warehouse. No claim for breakage
and loss in transit will be entertained. However if expressly authorised, goods will be
insured in transit at customer's cost.
^ftir representatives are not authorised to ask for or receive cash or bearer cheques for
any purpose and the company will not accept any responsibility for such payments
made.
Booklets on “Restoration of Lost Health" are available in 14 languages at 50 P. each.
These booklets are intended to correct certain fallacies of Nutrition and General Prin
ciples of life. For details please refer to our Guide which is available in English and
1 3 other languages.
(THIS SUPERSEDES ALL OUR PREVIOUS PRICE LISTS)
ALLOPATHIC
Drug
Specification
Schedule
of the pack
Name, Type and Composition
Excise
duty
Leviable
Price to the
Retailer
inclusive of
Excise duty
Rs.
Rs.
P.
P.
Retail Price
inclusive of
Excise duty
Rs.
P.
ALBO-SANG* Powder
Calcium Lactate, Calcium Dibasic
Phosphate, Magnesium
Phosphate, & Asgandh
(Withania somnifera)
170 g
450 g
0-81
1-98
8-05
19-68
bottle of 60 tablets
bottle of 250
tablets
0-32
3-14
3-52
0-95
9-40
10-55
1-17
11-58
13-00
4-30
42-76
48-00
0-36
1-08
3-56
10-69
4-00
12 -0^
50 tablets
500 tablets
-
1-76
10-56
2-00
12 00
bottle of 10 g
bottle of 110 g.
0-18
0-67
1-79
6-71
2-01
7-53
9-°4~
22-09|)
ALBO-SANG* Tablets
Calcium Lactate
Calcium Dibasic Phosphate,
Magnesium Phosphate
& Asgandh (Withania somnifera)
DECIL* Tablets
Acetylsalicylic Acid, Paracetamol
& Caffeine
box of 10 strips
of 10 tablets
500 tablets
ENTROPS* Liquid
(For external use only)
Phenol, Eucalyptus Oil & Camphor
FERROUS FUMARATE
Tablets IP
bottle of 30 ml.
bottle of 125 ml.
HEALAN* Powder
(For external use only)
Iodoform, Alum, Boric Acid &
Haldi (Curcuma longa)
* Regd^ Trade Mark
ALLOPATHIC
ALLOPATHIC
Drug
Specification
Schedule
of the pack
Name, Type and Composition
BENZOMONES* Injection
Excise
duty
Leviable
Price to the
Retailer
inclusive of
Excise duty
Retail Price
inclusive of
Excise duty
Rs.
Rs.
Rs.
P.
P.
P.
c,
E
Arusha (Adhatoda vasica)
Datura (Datura metel)
Asgand (Withanid spmnifera)
8 Ephedrine hydrochloride
DIASYN* Injection
box of 10 x 1 ml,
amps.
box of 10 x 1 ml.
amps.
box of 50 x 1 ml.
amps.
Balatagra (Valeriana .wallichii)
Methi (Trigonella foenum-graecum)
& Asgand (Withania somnifera)
♦ Regd. Trade Mark
0-90
8-94
10-04
4-05
40-25
45-19
C
box of 10 x 1 ml.
amps.
box of 50 x 1 ml.
amps.
0-90
8-94
10-04
4-05
40-25
45-19
box of 10 x 1 ml.
amps.
box of 50 x 1 ml.
amps.
0-49
4-92
5-52
2-34
23-26
box of 10 x 1 ml.
amps.
0-90
8-94
C
Nim (Melia azadirachta)
Chirata (Swertia chirata)
& Quinine bihydrochloride
IMERVOPLEX* Injection
5-52
C
Madar (Calotropis gigantea)
Salsa (Hemidesmus indicus)
Chirata' (Swertia chirata)
IO QUI N* Injection
4-92
0)
Kurchi (Holarrhena
antidysenterica)
Balaharde (Terminalia chebula)
Bael (Aegle marmelos)
& Dar-hald (Berberis aristata)
IOBIIUE* Injection
0-49
C
10-04
ALLOPATHIC
Name, Type and Composition
Drug
Specification
Schedule
of the pack
Excise
duty
Leviable
Rs.
RE MOR IN Injection
Chirata (Swertia chirata)
Datura (Datura metel)
(■K^urcf11 (Holarrhena antidysenterica)
'Wflauwolfia (Rauwolfia serpentina)
TOOTH POWDER
• Regd. Trade Mark
c,
E,
H,
box of 10 x 1 ml.
amps.
50 g.
P.
Price to the
Retailer
inclusive of
Excise duty
P.
Rs.
Retail Price
inclusive of
Excise duty
Rs.
P.
0-90
8-94
10-04
0-24
3-11
3-50
ayurvedic
Drug
Specification
Schedule
of the pack
Name, Type and Composition
Price to the
Retailer
Retail Price
Rs.
Rs.
P.
P.
BIO-SAL* Liquid
Dill Oil
Pipli (Piper longum)
Ind. Valerian (Nardostachys
jatamansi)
Balaharde (Terminalia chebula)
Sonth (Zingiber officinale)
Bach (Acorus calamus)
Revandchini (Rheum webbianum)
Glycyrrhiza (Glycyrrhiza glabra)
Ajwan (Ptychotis ajowan)
Talisoatra (Abeis webbiana)
o
bottle of 100 ml.
3-52
4-00
box of 10 strips
of 10 tablets
8-80
10-00
bottle of 30 ml.
bottle of 125 ml.
3-52
10-56
4-00
box of 10 strips
of 10 tablets
8-80
10-00
BRAHAMDINE* Tablets
Lodhra (Symplocos racemose)
Ashok (Saraca indica)
Asgandh (Withania somnifera)
Balatagra (Valeriana wallichii)
Pila dharoora (Argemone mexicanaj
CHESOL* Oil
(For external use only)
Rati (Abrus precatorious)
Sufedrai (Brassica campestris)
Lalmirchi (Capsicum annum)
Ghikanvsr (Aloe barbadensis)
CHINIUMCO* Tablets
Dalchini(Cinnamomum zeylanicum'
Mainphal (Randia dumetorum)
Revandchini (Rheum webbianum)
Kalikatuki (Helleborous niger)
Babunkephool (Matricaria
chamomilla)
* Regd. Trade Mark
I
AYURVEDIC
Name, Type and Composition
Drug
Specification
Schedule
of the pack
Price to the
Retailer
P.
Rs.
Retail Price
P.
Rs.
DANGINE* Tablets
■>
Phitkari, Arusha (Adhatoda vasica)
Nala (Lobelia nicotianaefolia)
'
Dudhi (Euphorbia pilulifera)
box of 10 strips
of 10 tablets
8-80
10- 00
box of 10 strips
of 10 tablets
8-80
10-00
DESMA* Tableta
Huma (Ephedra gerardiana)
Arusha (Adhatoda vasica)
Meradu (Po'yaala chinensis)
Nala (Lobelia nicotianaefolia)
Dudhi (Euphorbia pilulifera)
DIASYN* Tablets
Kurchi (Holarrhena antidysenterica)
Bael (Aegle marmelos)
Sonegeru (Silicate of alumina and
Oxide of iron)
Balharde (Terminalia chebula)
Dar-hald (Berberis aristaia)
box of 10 strips
of 10 tablets
bottle of
250 tablets
8-80
10-00
15-84
18-00
bottle of 50 tablets
3-96
4-50
bottle of 50 tablets
3-96
4-50
) GASTROMONE’ Tablets
Revandchini (Rheum webbianum)
Balaharde (Terminalia chebula)
Sounf (Foeniculum vulgare)
Aunla (Phyllanthus emblica)
GRANDI-CO* Tablets
Arjuna (Terminalia arjuna)
Asgandh (Withania somnifera)
Punarnava (Boerhaavia diffusa)
Khurasani ajvayan (Hyoscyamus
niger)
AYURVEDIC
Drug
Specification
Schedule
of the pack
Name, Type and Composition
Price to the
Retailer
P.
Rs.
Retail Price
P.
Rs
HEMOPLEX* Tablets
Kiryat (Swertia chirata)
Salsa 'Hemidesmus indicus)
Pila dhatoora (Argemone mexicana)
Madar (Calotropis gigartea)
Asgand (Withania somnifera)
Gandak
bottle of 50 tablets
3-96
box of 10 strips
of 10 tablets
500 tablets
7-04
8-00
22-00
25-00
bottle of 100 ml.
4-84
5-50
4-50
HERBITARS* Tablets
Chirata (Swertia chirata)
Manjit (Rubia cordilolia)
Sana (Cassia angustifolia)
Saunf (Foeniculum vulgare)
Bhringraj (Eclipta alba)
HERBITARS* Syrup
Chirata (Swertia chirata)
Manjit (Rubia cordifolia)
Sana (Cassia angustifolia)
Saunf (Foeniculum vulgare)
Bhringraj (Eclipra alba)
HERBO-SULPH* Tablets
Gandak, Haldi (Curcuma longa)
Madar (Calotropis gigantea)
box of 10 strips
of 10 tablets
bottle of
250 tablets
8-80
10-00
15-84
18-00
8-80
10-00
13-20
15-00
1OB1NE* Tablets
Brahmi (Hydrocotyle asiatica)
Chirata (Swertia chirata)
Salsa (Hemidesmus Indicus)
Gandak
’Regd. Trade Mark
box of 10 strips
of 10 tablets
bottle of 200
tablets
AYURVEDIC
Name, Type and Composition
Drug
Specification
Schedule
of the pack
Price to the
Retailer
Retail Price
Rs.
Rs
p.
P.
KOFLYN* Tablets
Arusha (Adhatoda vasica)
Dudhi (Euphorbia pilulifera)
l y Huma (Ephedra gerardiana)
Jethimadh (Glycyrrhiza glabra)
Meradu (Polygala chinensis)
Nala (Lobelia nicotianaefolia)
box of 10 strips
of 10 tablets
bottle of 250
tablets
8-80
10-00
15-84
18-00
KYNOTOMINE* Tablets
Revandchini (Rheum webbianum)
Balharde (Terminalia chebula)
Kalikatuki (Helleborus niger)
Punarnava (Boerhaavia di'fusa)
Bhringraj (Eclipta alba) & Gandak
box of 10 strips
of 10 tablets
500 tablets
8-80
10-00
28-16
32-00
bottle of 100 ml.
5-28
6-00
bottle of 20 tablets
1-76
2-00
KYNOTOMINE* Syrup
’Revandchini (Rheum webbianum)
Balaharde (Terminalia chebula)
Kalikatuki (Helleborus niger)
Punarnava (Boerhaavia diffusa)
Bhringraj (Eclipta alba)
JGt)
MEDITAB* Tablets
Arusha (Adhatoda vasica)
Lasun (Allium sativum)
Nala (Lobelia nicotianaefolia)
Dudhi (Euphorbia pilulifera)
Kapardika Bhasma (Calcined
cowries)
AYURVEDIC
Drug
Specification
Schedule
of the pack
Name, Type and Composition
Price to the
Retailer
P.
Rs.
Retail Price
Rs.
P.
SAL PHOS* Tablets
Revandchini <Rheum webbianum)
Balharde (Terminalia chebula)
Jeera (Cuminum cyminum)
* Sonth (Zingiber officinale)
Chitrak (Plumbago zeylanicum)
Kanphul ( Taraxacum officinale)
1
box of 10 strips
of 10 tablets
bottle of
250 tablets
8-80
15-84
10-00
18-00
SENZINE* Tablets
Sonth (Zingiber officinale)
Asgandh (Withania somnifera)
Lasun (Allium sativum)
Pile Dhatoora (Argemone mexicana)
Gokhru (Tribulus terrestris)
box of 10 strips
of 10 tablets
bottle of
60 tablets
SPOLAX* Granules
Spogel (Ispaghulae testa)
Gum Tragacanth
Ext. Sana
Saunf (Foeniculum vulgare)
Jeera (Cuminum Cyminum)
HD Polythene pack
of 75 g.
HD Polythene pack
of 200 q.
8-80
10-00
4-84
5-50
7-04
8-00
16-28
18-50
TURAICO* Tablets
1
Turai (Luffa amara)
Kababchini (Cubeba officinalis)
Punarnava (Boerhaavia diffusa)
Gokhiu (Tribulus terrestris)
Kanphul (Taraxacum officinale)
box of 10 strips
of 10 tablets
bottle of
250 tablets
8-80
10-00
15-84
18-00
8-80
10-00
15-84
18-00
VITAL ESSENCE Tablets
Chotachand
Balatagra
Asgandh
Khurasani ajvayan
box of 10 strips
of 10 tablets
bottle of
250 tablets
MEDICINE CHEST Tablets
PEOPLE’S MEDICAL SERVICES
(Set of 8 remedies)
Regd. Trade Mark
box of 8 strips
of 10 tablets
8 bottles each of
250 tablets
7-30
8-30
118-80
135-00
’
HOMEOPATHIC
Drug
Specification
Schedule
of the pack
Name, Type and Composition
Price to the
Retailer
Retail Price
Rs.
Rs.
P.
P.
AGARCO* Tablets
Tr. Agaricus Q, Tr. Aethusa Q
& Tr. Lilium Q
bottle of
50 tablets
3-52
4-00
bottle of
50 tablets
3-52
4-00
box of 10 strips
of 10 tablets
8-80
10-00
bottle of
30 tablets
0-88
1-00
AMYGLIA Tablets
Tr. Lilium Q, Glonoinum 3 x
& Natrum Nitrosum 3 x
AURATIftlUM* Tablets
Aurum muriaticum 3 x
Tr. Pulsatilla Q & Tr. Thuja Q
ZAHER-CO Tablets
Lachesis 6 x
Tuberculinum 6 x
* Regd Trade Mark
r
INNER HEALTH...
In today's age of speed, fear and
tension, man, in his rush, has
lost sightof the importance
of his health.
Our forefathers knew
better, they developed a system
of living, prayer, the right food,
exercise and nature's medicines.
HERBO-MINERAL medicines have
been developed to look after
your INNER HEALTH.
o
Telegram :
J.& J.DeChane
Laboratories Private Limited
Hyderabad -500 001, INDIA
''Herbomino"
Hyderabad.
BRANCH
Telephone :
57431 (2 lines)
53533
57648
- <:■
OFFICES
Sevaniketan, Sir J. J. Road
Byculla, Bombay-400 008.
Stockists throughout India.
22, Netaji Subash Marg,
New Delhi-110 002.
IP K I © E
Regd. Office
LIST
Phone : 334551
[rgUrTd] ELECTRONICS
Asarawa Chakla, Ahmedabad-380 016.
,
Gujarat (INDIA)
1.
EIGHT CHANNEL ELECTRO STIM
ULATOR
FITTED
IN
VIP
BRIEF
Battery Indicator
It indicates the life span of Battery.
CASE
Electrostimulator is a multipurpose acupuncture
therapy apparatus which transmits various kinds
of pulsating currents of different frequencies
and intensities through the acupuncture needles
to human body.
The VIP Stimulator is having ........
Eliminator
Stimulator runs on either 4 battery dry cells of
1.5 Volt (total 6 Volt) or you can directly pu'f'
eliminator cord in mains of 230 Volts and
automatically battery connection will disconnects.
No scope for short-circuit or current shock.
Point Detector ( Acuscope )
It detects the acupuncture point accurate^Jkor
detection of points, connect the detector wire
plug to the probe socket by plugging the test
probe used for tracing points and the metal
electrode is to held by patient. When test
probe touches Acupuncture points which are
low resistant point you can immediately hear
the voice Po-Po-Po- in loud speaker. The pilot
lamp is also lighted brightly when the
acupuncture point is detected.
Eight Channels
This stimulator has got eight seperate channels
and it has different eight controls. So that at
a time 16 points can be stimulated.
Imported
Mechanical timer - Racer
fitte^^in
Four
Rnages
2.
There are four ranges to selects the frequencies
0 to 10,000. You can adjust it with 2 cont
rols exactly. So you can use the stimulator for
various diseases and also for Acupuncture
Anaesthesia.
The stimulator is giving various types of waves
like continuous, dense and disperse and saw
tooth etc.
Fc1400/= -
Six Channel Stimulator with point detector is
having also Battery indicator, Both battery and
electric supply facility and loudspeaker.
Four Channel Stimulator F_1000/=
This is 8”X6"X3"
in size having battery
indicator and also having both supply mains
& battery.
4.
Point Detector
Rs. 250 -
(Acuscope)
With battery indicator, sound and light arrangem
ent for detection of acupuncture point exactly.
Speaker
^fcwhich you can hear the constant sound
during stimulation. You can also off it.
stimulator, so you can select the time range
upto 0 to 60 minutes. And after fix time which
you have set, it gives rings so that you can
off the stimulator & Treatment. First you have
to rotate the knob of timer upto 60 and than
set the arrow upto your required time.
The most importent feature of the stimulator is
nicely fitted in VIP travellite Brief Case (original)
so it is portable and there will be the space for
putting Electrode wires and needle boxes and
spirit bottle.
Micro-Ampear Meter
There are
channel.
By separate keys you can detect how much
micro-ampear-Current is passing in patient's
body
Six Channel Stimulator
With Point Detector
3.
Different Type of Wave Pattern
Loud
Auto - timer
of
®equency
two
types
of
stimulators
Eight
'A' Type as mention above
Rc3200/='B' Tvpe as above except
ffe2500/=Microamper Meter & Eliminator'1
5.
Clinometer (Can Caliper)
F. 40/=
This is very useful device for finding out 'exact’
location of acupuncture point. As you know in
acupuncture the unit of measurement is "T-Sun”.
or "bodyinch" which is variable in every patient
and measurement to be taken according to
patient's own body This device is made in such
a fashion that if you measure one T -Sun dist
ance with width of patient's thumbs, you will
have four different types of measurements by
other enos of device that is 0.5 T-Sun,
1.5 T-Sun and 2.0 T Sun
□ We are also supplying all kinds of acupunc
ture books, charts etc. of India and abroad.
Acupuncture Need les
We are supplying all type of acupuncture nee
dles having pure stainless steel (SS Japan)
surgical wire of gause 28 and 30 sizes which
are unbreakable and the sharpness of the point
of needles are of very high quality which are
diamond polished and checked at high tempe
rature.
Pure Silver Needles
All the sizes from 0.5 to
5.0 T-Sun and with or
without head
Rs. 3.75/pc.
2.
Copper Handle Needle Rs. 1.00/pc.
3.
Brass Needle
Rs. 1.25'pc.
1.
Stainless Steel Needle
(from single wire)
Rs. 2.25/pc.
5.
Silver Coated (Original
Copper) Needle
Rs. 2.00/pc,
6.
Body Press Needle
Rs. 2.00/pc.
7.
Ear Press Needle
(Thron type)
Rs. 2.00/pc.
8.
Cosmatic Needle
Rs. 2;00/pc.
9.
Seven Star Needle
Rs. 45.00/Pair
(1 Pair) Mainly used for
the skin disease, Bronchial asthma, Scalp
acupuncture, etc.
10.
Moxa Rolls (4.5" long) Rs. 5.00/each
4.
□ Please ask for any detail regarding acupunct
ure. We are giving minimum 1 years complete
gaurentee of 'acuaid' products on manufacturing
side.
□ Coloured photographs of 'acuaid' products
are available for the training centres or for the
hospitals.
□ We can held exhibition and demonstration
of acuaid products during period of trailing
batch. Acupuncture Diagnosis and treat.SRt
camp, seminar or conferences.
□ Our all products are being used and recogni
sed by many doctors and Training Centres in
India and abroad.
TERMS AND CONDITION
1.
Payment
In advance 25 % of total amount by M. 0. or
Bank Draft in favour of 'Acuaid Electronics'
Ahmedabad-380 016. i.Gujarat) and balance
at the time of delivery.
2.
Delivery
Maximum within 15 days after booking the order.
3.
Shipment
By Regd. Post. Parcel or by V.P.P.
Bank through or by Road transport (if faciljgges
is available at Doctor's place)
Bank through is convient & cheaper on both
the sides.
By our representative if convinent.
4.
Postage
Exactly
according to the postal charges of
post-offices.
5.
Packing
1. to 3% according to the volume of parcel
Write for details
We are at your service and thankful to you.
-SLoutairdl Electronics
ANTI-DIABETIC
Made from :
Pterocarpus Marsupium Roxb
Marketed by : (For : South India & Goa)
SOMA ENTERPRISES
484, I block 2nd cross
3rd Stage, West of Chord Road
BANGALORE-79 (KARNATAKA)
Mfg. By: Shri SATYA SAI INDUSTRIES
BHOPAL 462011 (M.P.)
____________ Gram—KALPATARU_______
Registered with t
D. I. C. Govt, of M. P. No. 10/44/01865
M. P. S. H. C. Board, S. H. B./WA/33/79
Kaipat ar u Glasses
An aqueous infusion of this wood is
said to be of use in Diabetics and water
stored in vessels made of this wood is
reputed to have antidiabetic qualities. Tests
on mice and rabbits with alcohol and aque
ous extracts of heart wood arc said to have
shown hypoglycacmieaction probably by
hindering the absorption of glucose in the
intestine (Trotter 1944, 150. Ojha, Indian
Journel phan 1949. 1 1, 188, GuptaJ med
1963, 51, 716, shah Ibid 1967, 55, 167.
Joglekar Indian phisiology 1959, 3, 76.
Vanoshadhi Nirdeshika 254 Dr. Ram Sushil
Shingh, Medicinal plants-1 IS Dr. S K. Jain
Director-incharge Botonical Survey of lj}_dia
Calcutta.)
£
Instructions :
(1)
Keep water in the glass for minimum
18 to 24 hours before use.
(2)
Drink the water early in the morning
empty stomach regularly for two months.
(3)
Before actually starting the use of
Kalpataru glass, it would be proper to have
the blood and urine sugar examined and
results recorded. Then continue the use of
glass for two months recording the results
of blood & urine sugar weekly. This would
assure you that the peicentageof sugar is
going down steadily to normal. If the
diabeties is in the preliminary stag^the
glass can be used only once a day. If Bin
advanced stage it should be used twice daily.
(4)
This is purely-an Ayuivcdic remedy
for the treatment of Diabeties and there sho
uld be no gap, left once the use of this
Kalapataru glass is started and it can be
used throughout the year in all seasons.
(5)
It would be safe to keep the glass in
side in an almirah always to ensure freedom
from atmospheric influences and also to
avoid cracks in the surface of the glass.
(6)
After 15 days the internal surface of
the Kalpataru glass should be scrapped
weekly by knife and it would be fit to change
the glass after using for two months.
Note:- Avoid heavy non-vegetarian food
during the period of use for quicker
relief.
ADVERSE DRUG REACTION
MONITORING OF
CIPROFLOXACIN IN
PEDIATRIC PRACTICE
S.C. Karande
N.A. Kshirsagar
ABSTRACT
Ciprofloxacin, a fluoroquinolone antibacterial
agent, is not recommended in pediatricpopulation
on account ofits possible adverse effect on growing
cartilage. It is being commonly used for variety of
infections in children in our country and very little
information is available on the risks involved in its
use.
A questionnaire was sent to 750pediatricians
in the last week of November 1990, to retrospec
tively judge over the previous 2 month period the
The Drug Controller of India, Ministry
of Health and Family Welfare, has recently
started 6 Adverse Drug Reaction Monitor
ing (ADR) Centres, ours being the only one
in Maharashtra. Unfortunately, the concept
of ADR reporting is still new in India, in
spite of its immense need(l). One of the
main objective of this project is to identify
ADRs occurring to new drugs being used in
our own population for diseases endemic in
India(l).
With the recent emerging problem of
multiple drug resistant enteric fever(2),
ciprofloxacin (CF) is being used widely, even
in pediatric patients. Concern over possible
joint damage is the reason that quinolones,
viz., nalidixic acid, norfloxacin are not re
commended for rounlinc therapy of infec
tions in children(3). Ciprofloxacin (CF) has
been used for treating enteric fever(4) and
its use in children may be ethically justified
for multiple drug-resistant enteric fever as a
life-saving measure.
Material and Methods
extent of its use and identify the adverse drug
reactions (ADRs). One hundred and fifty-four
pediatricians replied, of which 147 had prescribed
ciprofloxacin in a total of3341 patients under 18
years of age, enteric fever being the commonest
indication for its use. One hundred and fifty-nine
ADRs were reported in 104 (3.1%) patients. They
were: gastrointestinal in 50% ofthese 104 patients,
CNS in 23%, skin and allegic in 19.1%, musculo
skeletal in 8.6%, hematological in 3.8%, CVS in
This was a retrospective survey of CF
use and ADRs to CF in pediatric practice in
Western India (Maharashtra). The mode of
survey was a questionnaire printed on a selfaddressed inland letter sent to 750 pediatri
cians in medical colleges and private prac
tice in the last week of November 1990. A
letter which was enclosed with the question-
2.9% and nephrological in 0.9% cases. Of 159
ADRs, 8 (5%) were severe, 76 (47.8%) were moderate
From the ADR Monitoring Centre, Department of
and 75 (47.2%) were mild. Therapy needed dis
continuation in only 9 (0.3%) patients. Two new
Pharmacology, Seth G.S. Medical College
ADRs were identified, viz., sudden death after
400 012.
intravenous ciprofloxacin and sinus nodal arrest
Reprint requests:
causing bradycardia.
and
tions, Enteric Fever.
Hospital,
Pare!,
Bombay
Dr. (Mrs) NA. Kshirsagar,
Associate Professor of Pharmacology, Seth
G.S.
Key words: Ciprofloxacin, Adverse Drug Reac
K.E.M.
Medical
College,
Pare!,
Bombay
400 012.
Received for publication: February 26, 1991;
Accepted: October 17, 1991
181
KARANDE AND KSH1RSAGAR
naire explained the need to identify ADRs
to CF in actual clinical practice. A short list
of common ADRs to CF were also supplied,
viz., (a) nausea, abdominal discomfort,
headache, and dizziness, (b) skin rashes,
photosensitivity reactions, (c) arthropathy
in immature animals, and (rf) inhibition of
theophylline metabolism.
The survey was intended to collect retro
spective data and to be practicable, and to
get a good response it was kept simple. The
information sought for included (o) Num
ber of cases treated with CF in last 2 months,
(b) Indications for using CF (e.g., enteric
fever................ cases, PUO................ cases
any other...................cases), (c) Did any
ADRs occur to CF ?, (d) If ADRs did take
place, further details, were asked for, viz.,
diagnosis of illness, age/sex of child, des
cription of ADR; whether ADR was certain,
probable or possible; and whether ADR
was mild, moderate or severe. The terms,
certain (i.e., ADR reappeared on rechal
lenge with drug after initially stopping drug),
probable (i.e., ADR disappeared on stop
ping drug, but rechallenge not done) and
possible (i.e., ADR suspected but did not
disappear on stopping drug or when follow
up was inadequate) were clearly explained
in the questionnaire.
This retrospective survey on extent of
use and ADRs occurring to CF has been
analyzed and rare ADRs noted. Whenever
an interesting and rare ADR was reported,
further details were asked for from the
concerned pediatrician.
Results
By the endofJanuary!991,of750 pedia
tricians 154 (20.5%) filled in the question
naire and mailed the inland letter back to us.
Of 154 pediatricians, 147 (95.5%) had pre
scribed CF and only 7 (4.5%) had not used
this new drug. One hundred and one (68.7%)
182
ADVERSE REACTION WITH CIPROFLOXACIN
reported no ADRs with CF in their clinical
practice, while 46 (31.3%) did report ADRs
to CF.
CF was prescribed to treat 3341
patients, under 18 years of age. Their clini
cal diagnosis were enteric fever (2792
patients), PUO (278 cases), bacillary dysentry (134 cases), pneumonia (24 cases), mul
tiple abscesses (18 cases), UTI (15 cases),
pyogenic meningitis (6 cases), septicemia
and upper respiratory tract infection (5 cases
each), neonatal septicemia, malignancy with
neutropenia and acute non-tuberculous
cervical lymphadenitis (4 cases each), os
teomyelitis (3 cases), burns (2 cases), and
septic arthritis, cholera, chronic diarrhea,
and ventriculitis (1 case each). In 43 patients
treated with CF no diagnosis was mentioned.
Of 3341 patients treated with CF, ADRs
were observed in 104 patients, i.e., in only
3.1% of patients. In these 104 patients who
developed ADRs, the adverse reactions noted
were: gastrointestinal in 52 (50%), CNS
complaints in 24 (235), skin and allergic
manifestations in 20 (19.1%), musculoskel
etal in 9 (8.6%), hematological in 4 (3.8%),
CVS manifestations in 3 (2.9%) and 1 (0.9%)
developed a nephrological adverse reaction
(Table T).
A total of 159 ADRs were reported in
104 patients, of which 11 (6.9%) were cer
tain, 103 (64.7%) probable and 44 (22.7%)
possible (Table T). One neonate had a sud
den death immediately after a dose of intra
venous ciprofloxacin. This severe ADR, like
an anaphylactic reaction, could not be la
belled as certain, probable or possible. Of
the total 159 ADRs reported 8 (5%) were
severe, 76 (47.8%) moderate and 75 (47.2%)
were mild in their clinical intensity (TableT).
Therapy with CF needed discontinuation
in only 9 (0.27%) patients, viz., in 2 due
to severe vomiting and diarrhea, 1 due to
marked nausea, severe epistaxis in 1,
volume 29-february 1993
INDIAN PEDIATRICS
TABLE I—Summary ofADRs to Ciprofloxacin Reported**
System
Severe
Moderate
Mild
7
1
16
10
1
2
13
6
1
4
5
24
2
Certain
Probable
Possible
1
—
19
Vomiting
20
(A) GIT
Nausea
Diarrhea
—
6
1
Abdominal discomfort
—
10
19
2
—
Hematemesis
—
1
—
Abdominal distention
1
2
1
—
GI Bleeding
1
1
-
-
2
1
1
1
(B) CNS
Headache
2
9
2
—
6
7
Dizziness
1
2
3
2
1
—
4 + 2*
2
—
—
Irritability/Rcstlcssness
4
—
3
1 *
2
—
—
—
—
3
1
—
3
—
—
3
—
6
—
—
5
—
—
—
1
—
—
1
1
—
Tremors
Depersonalization
Insomnia
1
—
(C) Skin & allergic
Rash
1
—
3
Pruritic rash
Photosensitive rash
—
3
—
Anaphylaxis
9
Angioneurotic edema
Hot flushes
—
—
1 *
—
—
Rigors and itching after IV dose
1
-
—
—
1
Arthralgia
-
5
4
—
1
2
—
-
Myalgia (cramps)
—
Generalized weakness
—
1
—
1
1
—
1
5
3
2
—
2
-
—
(D) Musculoskeletal
3
—
—
(E) Hematological
Drop in Hb
—
1
—
—
1
—
Epistaxis
1
—
2
1
2
—
(F)CKS
—
1
—
Sinus nodal arrest
—
1
—
Phlebitis at IVsite
—
1
—
-
1
Cardiac failure
1
—
1
1
—
-
1
(G) Kidney
Nephritis
-
N.B.: * Patients also on aminophyline.
++
104 patients experienced at least one ADR, but many experienced more than one, hence
total number of ADRs is 159.
183
KARANDE AND KSIIIRSAGAR
moderate pain in hip joint in 1, angioneu
rotic edema in 1, cardiac failure in 1, and in
1 who developed sinus nodal arrest.
Discussion
The problem of chloramphenicol resis
tant strains of S. typhi has been reported
since 1972 from different parts of the world(5).
Unfortunately, due to indiscriminate use of
chloramphenicol, ampicillin and cotrimoxazolc for trivial infections like common
cold and gastroenteritis, this new problem
of multiple drug-resistant S. typhi has
emerged(2). Recently, similar experience
has been reported from Shanghai, China,
and Wang el al., have reported resistance in
80% strains of 5. typhi to commonly used
drugs such as chloramphenicol, ampicillin
and cotrimoxazolc(6).
Ciprofloxacin (CF) is a new, second
generation fluoroquinolone: norfloxacin,
enoxacin and ofloxacin also belong to the
same group. AH are 6-fluorine derivatives of
the quinolone nalidixic acid(7). CF is a broad
spectrum antibacterial drug and the most
potent of the new quinolones, active against
most aerobic Gram-positive and Gram
negative bacteria, particularly Enterobacteriaceae, E. coli (Klebsiella, Proteus, Salmo
nella, Shigella) and Pseudomonas aeniginosa(8). It can be given in a convenient oral
12 hourly dosage and has good tissue pene
tration^). The side effects arc usually tran
sient and subside without discontinuation of
lhcrapy(8). This drug is not recommended
for use in patients under 18 years of age and
in pregnant women due to its possible toxi
city to growing cartilage at the ends of long
bones(8). However, use of CF to treat life
threatening illnesses caused by multiple drug
resistant organisms, even in children, may
be ethically justificd(9).
Data showing that CF is a relatively safe
antimicrobial drug has been gathered from
184
ADVERSE REACTION WITH CIPROFLOXACIN
extensive clinical trials with this drug(10,l 1).
In comparative trials, ADRs generally oc
curred less often than with cotrimoxazolc or
amoxicillin and no more often than with
cefotaxime(8). ADRs to CF occur in 9 to
16% patients(10,ll); predominantly mild
gastrointestinal symptoms like nausea,
vomiting, abdominal discomfort and diar
rhea in 4 to 8% patients; CNS, symptoms
like headache, restlessness in 1.5 to 3.5%
patients and skin rash in 1.1% patients. In
our survey, ADRs reported are much lower
than those by information gathered from
clinical trials (Table IP). Probably, this could
be explained due to under-reporting by the
pediatricians. Also known ADRs like mild
transient alterations in laboratory values,
viz., eosinophilia, neutropenia, prolonged
prothrombin time, elevated SGOT and SGPT,
elevated serum creatinine, blood urea were
not searched for, unlike in clinical trials. A
similar survey done by sending question
naire in Gcrmany(12) enlisting 12,205 pa
tients treated with CF between February
1987 and January 1989, of which only 1.1%
were less than 18 years of age, revealed a
lower rate of ADRs (8.3%) than the ADRs
seen in clinical trials.
Seven children developed pain in vari
ous joints of the body. No objective findings
were seen in any of these children. Five
were followed up for 2 weeks after discharge
and in all of them symptoms had disap
peared. Concern over possiblejoint damage
is the reason that quinolones arc not recom
mended for therapy of infections in those
under 18 years of age and in pregnant
women(3). Schluter(3) studied the effect of
4 orally administered quinolones, viz., nali
dixic acid, norfloxacin, ofloxacin and cip
rofloxacin at very high doses of 100 to 500
mg/kg over 4 weeks on immature rats.
Nalidixic acid caused highest percentage of
cartilage alterations and ciprofloxacin the
INDIAN PEDIATRICS
VOLUME 29—FEBRUARY 1993
TABLE U-Comparison of Our Data with Two Extensive Clinicial Trials
Reference 10
Reference 11
Our Survey
1. Total No. of patients
9473
2829
3341
2. No. of patients who developed ADR
881
457
104
3. Per cent of patients who developed ADR
93
16.2
3.10
4. ADR involving (% ofpatients)
(a)
Gastrointestinal
4.
7.8
1.56
(*)
CNS
1.
33
0.70
(c)
Skin and allergic
1.
1.8
0.59
(4)
Musculoskeletal
0.1
0.2
0.26
(e)
Hematological
0.9
CVS
0.2
1.0
0.9
0.12
(f)
(g)
Kidney
0.8
1.0
0.03
(A)
Special senses
0.2
0.8
(0
Respiratory
0.1
0.4
0.01
—
5. Severity ofADR (%)
(«)
Severe
6
6.8
5
(b)
Mild or moderate
94
93.2
95
N.B.: Some patients experienced ADR in more than one system.
least. Also, there is a clear-cut species dif
ference in the effect of quinolones on cartilage(3). A pilot study of immature beagles
given 100 mg/kg of CF for 3 weeks, with one
leg bandaged for lessening weight-bearing
has postulated that, joint damage can proba
bly be minimized by keeping the joint pres
sure-free during treatment(3). Whether such
animal studies wherein minimum 5 times
the recommended dose in humans were
given, can conclusively predict permanent
joint damage in young children given CF, is
open to speculation. A study of adults given
nalidixic acid in childhood revealed no evi
dence of arthritis(13). Recent studies have
also shown that the original assumption that
joint damage occurs only in juvenile animals
is not true, as arthropathogenic effects have
also been found in adult dogs(4). Me Ewan
et al.(15) have reported tenosynovitis occur
ring in a 67-year-old man within 3 days of
starting CF.
To date, the vast majority of patients
treated with CF have been adults and there
is little clinical evidence to either confirm or
dispute the development of articular changes
in young children. Stutman(16) treated 35
patients of cystic fibrosis under 18 years of
age with CF, and only 1 developed arthropa
thy during the 4 weeks of treatment. Alfaham
et al.(TT) have reported arthropathy of both
knees in a 15-year-old girl suffering from
cystic fibrosis treated with CF. The arthro
pathy developed after. 3 weeks of CF and
completely resolved within 2 weeks of stop
ping the drug. It has been suggested that
Magnetic Resonance Imaging studies could
be used in children treated with CF as a
method to monitor arthropathogenic effects,
if any, even in the early stages of treatment
and even subsequently on long-term follow
up(14).
Rare ADRs that occur in less than 1 % of
CF courses(18) such as gastro-intestinal
185
KARANDE AND KSHIRSAGAR
bleeding, hematemcsis, abdominal disten
tion, dizziness, insomnia, tremors, deper
sonalization, pruritic rash, hot flushes, rig
ors and itching after intravenous admini
stration, myalgia (cramps), generalized
weakness, epistaxis, and phlebitis at intra
venous site of drug administration were
reported to us (Table I). Other interesting
rare ADRs such as angioneurotic edema
(1 case); photosensitive rash (2 cases);
nephritis with edema face and feet, micro
scopic hematuria and mild hypertension
(1 case); unexplained drop in Hb (1 case);
cardiac failure (1 case) and sinus nodal
arrest with bradycardia (1 case) were also
reported to us (Table T). Davis et al. have
reported anaphylactoid reactions to CF in
15 cases(19). But, none of their patients died
during therapy. In the present scries, a
7-day-old baby reported to us died immedi
ately after receiving ciprofloxacin. The exact
cause of death could not be ascertained.
In our survey, 2 patients who developed
restlessness and irritability, and 1 patient
who developed hot flushes and tremors during
CF therapy (Table T), were also on amino
phylline prophylaxis for bronchial asthma.
In this context, the drug interaction of cip
rofloxacin with theophylline, wherein CF
inhibits theophylline metabolism by approxi
mately 30% is worth remembering(20). Five
patients on CF therapy, without any simul
taneous aminophylline also developed irri
tability and restlessness as an ADR to CF
(Table T). The safety of intravenous cip
rofloxacin is comparable to that of the oral
formulation of the drug(21), though intra
venous administration can cause phlebitis
and rigors(lO). We received 1 report each
of phlebitis and rigors after intravenous
ciprofloxacin.
On further enquiry from pediatricians
who reported these rare and interesting
ADRs, we were informed that CF dosage
186
ADVERSE REACTION WITH CIPROFLOXACIN
used was the recommcnded(22) one (7.5 to
15 mg/kg/day orally and 5 to 10 mg/kg/day
intravenous in 12 hourly divided doses) for a
duration of 7 to 10 days or lesser whenever
the drug required to be omitted.
Our survey was specific to identify ADRs
to CF in patients below 18 years of age. A
thorough review of literature could not lo
cate a similar study. Also, we could not find
any literature describing ADRs to CF in
Indian patients. Hence, after comparing our
results with known literature on ADRs to
CF(10-12,18) we conclude that incidence of
ADRs to CF in children is no greater than in
adults, including musculoskeletal reactions.
The ADRs observed in our study were only
during the course of treatment and for a
short period thereafter, of 1 to 2 weeks.
However, the long term effect of CF on
linear growth and joint structure integrity,
or any other structure or organ can only be
judged by follow up over many years. We do
not advocate or even remotely justify shot
gun therapy with CF for enteric fever or
PUO, without culture and sensitivity studies
done on the isolates. Inappropriate and
random use of CF for short-term benefit of
quick cure and to avoid hospitalization is
reprehensible.
Only use of CF for multiple drug resis
tant enteric fever or other serious infec
tions, as a life-saving measure, can be ethi
cally justified, as the benefit from CF use
will outweigh the potential risk of damage to
juvenile cartilage. It would be interesting to
know that CF has been used even in pre
mature infants with multi-resistant Enterobacter cloacae septicemia with no evidence
of adverse effects(23).
Acknowledgements
The authors wish to thank their Dean,
Dr. (Mrs) P.M. Pai for granting them per
mission to publish this article. They also
INDIAN PEDIATRICS
volume 29-february 1993
wish to thank the Drug Controller of India
for his constant encouragement and all the
pediatricians who participated in this sur
vey. The study was supported by a grant
from the Drug Controller of India and ADR
Monitoring Project of the Government of
India, under the Union Ministry of Health
and Family Welfare.
10.
REFERENCES
12.
Schacht P, Arcieri G, Hullmann R. Safety
of oral ciprofloxacin. An update based on
clinicial trial results. Am J Med 1989, 87
(Suppl 5A): S98-S102.
11.
Arcieri G, Griffith E, Gruenwaldt G, el al.
Ciprofloxacin: An update on clinicial expe
rience. Am J Med 1987, 82 (Suppl 4A):
S381-S386.
Reiter C, Pfeiffer M, Hullman RN. Brief
reports: Safety of ciprofloxacin based on
1.
Kshirsagar NA, Kamade SC, Potkar CN.
Phase
ADR Monitoring in India. In: Selected
IV
studies
(“Anwendungs-
beobachtung”) in the Federal Republic of
Germany. Am J Med 1989, 87 (Suppl 5A:
Topics in Clinical Pharmacology Eds
Kshirsagar NA Gupta KC. Bombay, Akshar
S103-S106.
Pratiroop, 1990, pp 60-64.
13.
2.
Schaad UB. Wcdgwood-Krucko J. Nalidixic
KhadOkar W, Khubchandani RP, Amdckar
acid in children: Retrospective matched
YK, Mehta KP, Anand RK. Drug resistant
controlled study for cartilage toxicity.
typhoid
fever-an
emerging
problem.
Infection 1987,15: 165-168.
Indian Pediatr 1990, 27: 1227-1228.
14.
3.
Schluter G. Ciprofloxacin: Review of po
tential toxicologic effects. Am J Med 1987;
82 (Suppl 4A): S91-S93.
4.
Kcusch GT. Antimicrobial therapy for
Med 1989, 87 (Suppl 5A): S37-S39.
15.
16.
fibrosis. Pcdiatriclnfcct Dis J 1987,6: 932-
Guerrant R. Salmonella infections. In:
935.
Harrison’s Principles of Internal medicine,
11th edn. Eds Braunwald E, Isselbachcr
17.
KJ, Petersdorf RD, Wilson JD, Martin JB,
Co, 1987, pp 592-599.
699.
WangF.Gu XI, Zhang MF, Tai TY. Treat
18.
ment of typhoid fever with ofloxacin. J
8.
Stahlmann
R.
Fluoroginolones-a
new
S120-S128.
19.
Davis H, MC Goodwin E, Reed TG.
class of antimicrobial agents. Drugs Today
Anaphylactoid reactions reported after
1988, 24: 529-536.
treatment with ciprofloxacin. Ann Intern
Me.d 1989, 111; 1041-1043.
Fass RJ. Coprofloxacin. Best use of this
new broad spectrum antibiotic. Postgrad
Med 1990, 87: 117-131.
9.
Rahm V, Schacht P. Safety of ciprofloxacin:
A review. Scand J Infect Dis 1989,60 (Suppl):
Antimicrob Chemothcr 1989, 23: 785-788.
7.
Alfaham M, Holt ME, Goodchild MC.
Arthropathy in a patient with cystic fibrosis
taking ciprofloxacin. Br Med J 1987, 295:
Fauci AS. New York, McGraw Hill Book
6.
Stutman HR. Summary of a workshop on
ciprofloxacin use in patients with cystic
S199-S205.
5.
Me Ewan SR, Davey PG. Ciprofloxacin
and tenosynovitis. Lancet 1988, 2: 900.
enteric infections and typhoid fever: State
of the art. Rev Infect Dis 1988,10 (Suppl 1):
Schluter G. Ciprofloxacin: Toxicologic
evaluation of additional safety data. Am J
20.
Schwartz J, Jaurequi L, Lettieri J, Back-
mann K. Impact of ciprofloxacin on theo
Adam D. Use of quinolones of pediatric
phylline clearance and steady state concen
patients. Rev Infect Dis 1989,11 (Suppl 5):
trations in serum. J Antimicrob Chcmother
S113-S116.
1988, 32: 75-77.
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KARANDE AND KSIIIRSAGAR
21.
Neu HC. New ora! and parenteral qui
ciprofloxacin. Drugs Today 1988, 24: 361-
nolones: A summary. Am J Med 1989, 87
401.
(Suppl 5A): S283-S287.
23.
Bannon MJ, Stutchficld PR, Weindling AM,
Damjanoic V. Ciprofloxacin in neonatal
22.
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Paulsen O. The antibacterial activity, phar
Enterobacter cloacae septicemia. Arch Dis
macology and therapeutic application of
Child 1989, 64: 1388-1391.
PAPERS PRESENTED OH AbTERHATIVE SYSTEHS OF HEDICIHE
Team Heater
Title
Horkshop/Seminar
Dr. Shirdi Prasad Tekur
1. State Health Policy - Alternative
Systess of Health Care
VHAK, 1993.
2. Problems of present Health Systems
and alternatives
Workshop on "Sustainability &
Development” -ECC, Whitefield
3. Herbal Hedicine & Hose Remedies
CHAI, Secunderabad,
4. Alternative Systeas A Holistic
Health Care
Faith A Healing Ceil (Back
ground paper).
5. Disability A Alternative Hedicine
Karnataka Welfare Association
for the Blind.
6. Alternative Health Care Systeas ;
Another point of Vies
HADHYAH
T, Acupuncture, Acupressure h Related
Drugless Therapies
Health Action, Vol.4, Ro,3,
March 199i.
8. The Philosophy of Homoeopathy
9. Traditional Hedicine; Hhat A Why
FEVORD-K AGBH - 1990.
10. Alternatives in Health Care
HAVADARSHAHAH: Indian
Institute of World Culture
(1994).
11. Integrating Allopathic A Alternative VHAK - AGBH, June 1995.
Systems of Hedicine
12. Practising Pluralism
CH JI
13, Cosmopolitan Hedicine
Sent to Dr. Balasubramanian
for publication (TTK, Madras)
14. Alternative Hedicine; Myth 8
Reality
HTTC-JIPHER, December 1993.
15. Hedical Health Care Systems :
Attempting Integration - Problems
& Perspectives
April 1993. Background paper
for Bronchial Asthma Study
Circle.
IS. Handbook of Acupressure Points
VHAK, 1993.
IT. Health for All and the Role of
Hedia
Hadhyam, 1991.
Teas Hesber
Title
Horkshop/Seainar
Drs. Ravi Harayan &
Dhruv Hankad
18.
Hedical Pluralism I; A case for
Critical Attention
Bfc Bulletin, Ho.155, 156
September-October 1989.
19.
Hedical Pluralism II; Towards
Integration
ate Bulletin, Ho.155, 156
September-October 1989.
29. Hedical Pluralism - Editorial
ofc Bulletin, Ho.155, 156
September-October 1939.
21, Hon-Allopathic Systems of
Hedlcine - A Journey through
148 ate Bulletins
mfc Bulletin, Ho.155, 156
Septesber-October 1989.
Measures for Nationalisation, Quality Control and Growth
of Drugs & Pharmaceutical Industry in India
Government of India
Ministry of Industry
Department of Chemicals and Petrochemicals
MEASURES FOR RATIONALISATION, QUALITY CONTROL AND
GROWTH OF DRUGS 6 PHARMACEUTICAL INDUSTRY. TN INDIA).
23rd , di;), '
J- P- Nagar 2nd Pha^
^P-^GALOPE-560 07a
1-1.
Health is a fundamental human right. Ttye, .Qpnstjlution
of India directs the State to regard the improvement of' public
health as among its primary duties. The Five Year Plants have been
providing the framework within which the Centre and States have
developed
their health services infrastructure and programmes.
Since the attainment of Independence considerable progress has been
achieved in the promotion of health status of the people - as refleced
in the eradication/control of diseases like small-pox, malaria etc.,.
reduction in mortality rate, j’ise in life expectancy, creation of
a fairly extensive network of health care institutions and the avail
ability of a large stocks of medical and health personnel.
INTRODUCTORY
1.2
The National Health Policy of 1983 marks a significant
step in the national endeavour to improve public health. It reiterates
India's commitment to the goal of "Health for all by the year 2000
A.D." through the universal provision of comprehensive primary
health care service. The attainment of this goal requires an accele
rated development of all inputs to the health care system, including
essential and life saving drugs and vaccines of proven quality.
Drugs alone are not sufficient to provide health care. However,
if rationally used, they do play an important role in protecting
maintaining and restoring the health of the people and in controlling
population.
The Indian Pharmaceutical Industry has, therefore, a
vital role in serving the basic health needs of the poeple.
1.3
The Report of the Hath! Committee (1975) is an important
landmark in the development of the Indian Pharmaceutical Industry.
The Hathi Committee emphasized the achievement of self-sufficiency
in medicines and of abundant availability at reasonable prices of
essential medicines. Since 1975, the Indian Pharmaceutical Industry
has grown to be the most diversified and vertically integrated
pharmaceutical industry in the entire Third World. The country
has achieved self-sufficiency in formulations and also in a large
number of bulk drugs. In 1984-85, imports of formulations were
only Rs. 10.17 crores or about 0.5% of the total formulation production
in the country and imports of 49 bulk drugs were neglible. Techno
logies for the production of several bulk drugs, including antibiotics
like Ampicillin,
Amoxycillin,
Erythromycin, Anti-infectives
like
Sulphamethaxazole and Trimethoprim., anti-TB drugs like EthambutoCardio Vascular drugs likeMethyl Dopa; Analgesics like Ibuprofen and
Isopropyl antipyrine; anti-amoebics like Metronidazole and Tinidazole,
anti-cancer drugs like Vinblastine, Vincristine and Cisplatin were
indigenously developed. The trade balance in pharmaceuticals is
also improving as a result of increasing exports. In 1984-85, exports
of drugs and formulations were Rs.217.49 crores while imports were
Rs.215.62 crores. A wide range of bulk drugs and formulations
1
are
being
exported
to
several
countries,
including;
the
U.S.
and
the West European countries. Some Indian firm
engaged
up production facilities in other countries' and are also engaged
UP
***
----------.
.
.UlWUtUUll
,
____
in
the
sale
ofa turnkey
plants nnd
and toehmral
technical SRFVlCeS
services.. 1116 QlVerse
' _ the Indian
production and technological capabilities developed^by
are valuable assets in achieving the goals
Pharmaceutical Industry
Policy and in fully harnessing the export
of the National Health
potential.
1.4
while these achievements are impressive by themselves,
there are many areas where the industry
has to reorient itself
if it has to effectively serve the health needs of the people. The
present production pattern does not adequately reflect the genuine
requirements of the health care needs of the country. The proliferation of formulations and packs without adequate therapeutic rationale is a matter of concern. While many firms in the organised
as well as small scale sector have excellent internal testing faci
lities and a good record of quality control and adoption of good
manufaturing practices, the same cannot be said of a large number
of firms manufacturing
formulations. The present institutional and
statutory arrangements for enforcing quality control for registration
of new formulations, for monitoring adverse reactions and for dissemi
nation of unbiased information about the safety and efficacy of pro
ducts marketed in the country are far from being adequate.
1.5
Aoundant availability on a continuous basis, at reasonable prices,
of essential, life saving and prophylactic medicines of good quality,
is the corner stone of the new measures. It shall be the end
eavour of the Government to ensure that the above objective, which
is in consonance with the Government's Policy of reaching Health
care facilities to the common masses and with that of ensuring
Health for all by the year 2000 A.D., is achieved. In ord.r to
subserve this objective, changes have been brought about in the
system of price control of drugs as well as in the licensing and
approval procedures. Experience gained in the implementation of
the Drugs (Prices Control) Order, 1979 has clearly shown that
the pricing system needs to be simplified and rationalised, if the
benefits of the price control are to be effectively realised by
the consumer, particularly the weaker sections of the society for
safeguarding whose interests the Government is committed. The span
of price control
at present is impracticably large covering 347
bulk drugs and over 4,000 formulations marketed in' about 20 000
packs. It is proposed to reduce to a considerable extent this span
of control and to make the price control system less cumbersome
but more effective.
I-6
As prices of drugs are also determined by the cost
effectiveness of domestic production, it is imperative to impart
a technological and productivity thrust to the Indian Pharmaceutical
Industry which would also enable it- to harness export opportuni
ties. The objective of ensuring abundant
availability of medicines
2
<
o
at reasonable prices, will be best served by promoting competition
and economic scales of production and also by removing unnecessary
barriers to growth. To this end, licensing and approval procedures
have been simplified and greater
flexibility given in order to
encourage investment and production in the desired areas, specially
those of essential and life saving drugs. The validity of this premise
has already been estanlished by the experience, in recent years,
with the market prices of bulk drugs being lower than the statutory
prices whenever a bulk is produced by a good number of manufac
turers. At the same time, FERA companies will continue to be regu
lated by Government to ensure that their operations are in conso
nance with the national objectives and priorities.
1.7
• It is against this backdrop that the Government has
reviewed the functioning of the Drug Policy and now restructured
the policy in the light of the experience gained and keeping in
mind the objective of achieving "Health for All by the Year 2000
A.D."
PART II - OBJECTIVES
2.
The new measures aim at:
(a)
ensuring abundant availability, at reasonable prices,
of essential life saving and prophylactic medicines
of good quality;
(b)
strengthening the system of quality
drug production and promoting the
of drugs in the country;
(c)
creating an environment conducive to channelising
new investment into the pharmaceutical industry,
to encouraging cost-effective production with eco
nomic sizes and 'to introducing new technologies
and new drugs, and
(d)
strengthening the
tion of drugs.
indigenous capability for produc
PART - III - RATIONAL
3.1
control over
rational use
USE OF DRUGS
Registration of new formulations, rationalisation of exist
ing formulations and creation of a National Drug Authority.
New ’formulations based on drugs already approved for
use in the country would not be allowed to be manufactured unless
their therapeutic efficacy and rationality are adequately tested
and proved. A machinery to be called the National Drug fi Pharma3
at
ceutital Authority would
a permanent secretariat.
be established
3.2
Registration of new drugs
the
Central
level,
with
With a view to exercise closer scrutiny over the intro
duction of new drugs in the country, the Drugs and Cosmetic Rules
will be amended to define clearly a new drug and to give statutory
basis to the detailed guidelines which would be drawn up for the
scrutiny and approval of new drugs.
3.3.
Standardisation of packaging
With a view to ensuring the proper dispensing and use
of
drugs , statutory guidelines for packaging instructions would
be laid down. Colour coding of packs would be insisted upon to
differentiate products according to the degree of hazard. Packs
would also be standardised.
3.4.
Monitoring of adverse reaction
During the VII Five Year Plan, Central and peripheral
units would be set up to monitor adverse drug reactions. It is
also proposed to develop a Central Information Bank on the safety.
efficacy, prescription and use of all drugs.
3.5.
Use of generic name
Pending a final decision by the Supreme Court, per
mission is being granted for marketing single ingredient formulations
of new drugs subject to the following conditions that the generic
(Proper) name should be displayed in double the size of the trade
(brand)name both in equally bold letters. Generic names will be
progressively adopted in the case of all drugs included in the
list of essential drugs.
3.6
Apart from the allopathic system of medicine, it is
also proposed to encourage and improve upon the traditional system
of medicine with a view to widening the coverage of health care
schemes of the government. It is a recognised fact that large portions
of our population, -specially those in the rural areas, prefer to
use the traditional Indian system of medicine, both ’for reasons
of faith as also lack of access to the modern medicines; Ayurveda,
Unani and Siddha systems of medicines have been practised in this
country for several centuries. However, there is no uniformity in
4
'
the methods of preparation of the compound drugs
in
use in
these systems, identification of ingredients and their composition.
In order to bring about some uniformity and standardisation, Ayur-vedic, Siddha and Unani Pharmacopoeia! Committee constituted by
the Government of India are bringing out "National Formularies". The
Formularies indicate the ingredients with their scientific names,
the' proportions in which these drugs are used and the method
of preparation. This is the first phase for the standardisation
work before finalising pharmacopoeial standards. The Pharmacopoeial
Committees have now simultaneously taken up the work of evolving
of standards in respect of single ingredient drugs used in these
systems.
3.7
It is proposed to speedily evolve pharmacopoeial stan
dards in respect of the drugs in these systems and also to enlarge
and reactivate drugs testing facilities in each State in order to
ensure quality control.
It is also
proposed to take steps for
ensuring steady and regular availability of raw material for the
growing pharmaceutical industry in the Indian systems of medicine
both
to meet internal as well as export demands.
PART - IV -
4.1
O
QUALITY CONTROL
Strengthening infrastructural facilities
It is decided to step up the Central and State infrastruc
tural facilities for quality control in a phased manner during the
VII and VIII Five Year Plan periods. The progress made in the
provision of these infrastructural facilities and the effect on en
forcing quality control would be reviewed at the end of the VII
Five Year Plan with a view to make the necessary corrections and
to strengthen the machinery for ensuring quality control.
4.2
Internal Testing Facilities
During the VII Five Year Plan period, it will be ensured,
through intensive inspection and corrective action, that all manu
facturers have internal testing facilities.
4.3
Good Manufacturing Practices
Statutory effect would soon be given to the good manufac
turing practices which lay down the minimum
requirements to be
observed in terms of accommodation,equipment, qualified personnel,
testing facilities and hygiene in a manufacturing unit.
5
Loan Licensing
4.4
It is decided to discontinue the loan licensing system
In a phased manner before the end of the VII Five Year Plan.
Certification Scheme
4.5
With a view to promote quality-consciousness in the
field of drugs both among the manufacturers and user-agencies and
to simultaneously reduce the workload on the statutory Drug Controller
Agencies, efforts will be made to introduce a certification system
under which recognised institutions with proven expertise and testing
facilities can certify the adoption
by formulators of good manufac
turing practices and the quality of formulations manufactured.
PART V - PRICING
Basic Approach
5.1
The Hathi Committee was of the view that more selectivity
in the system of price regulation with a view to ensuring fair prices
of drugs and formulations would be desirable. In the case of formu
lations (other than generic), selectivity could be in terms of (a)
size of the units; (b) selection of items, and (c) controlling the
prices only of market leaders, in
particular, of products for which
price control is contemplated. An appropriate combination of these
criteria is also feasible. The new pricing regulation would be in
conformity with the principle of selectivity commended by the Hathi
Committee.
5.2
Coverage
It is decided to rationalise the present categorisation
of bulk drugs and formulations keeping in view the following objec
tives :
(a)
To stimulate production of drugs and formulations
which are essential to the needs of large majority
of the people of the country;
(b)
To make the price control system less cumbersome
but more effective, by reducing the span of control:
(c)
To ensure a reasonable return to the producers
of essential drugs, while at the same time restric
ting undue increase in their price.
6
Keeping this objective in view, it is now decided to
have 2 categories of formulations and bulk drugs required in place
of 3 categories which exist at present. Category I wlould consist
of drugs required for the National Health Programme and the MAPE
(maximum allowable post manufacturing expense incurred from the
stage of manufacuring to retailing and manufacturers' margin) allowed
for drugs in
this category would be 75%; category II would consist
of drugs other than those in category I but which are also considered
essential for the health needs and a MAPE of 100% for formulations
would be allowed while fixing the prices for this category of drugs.
The list of drugs in Category II on the basis of these
guidelines would be drawn up within 3 months, by a committee consis
ting of representatives of Department of Chemicals 6 Petro-chemicals,
Ministry of Health, Bureau of Industrial Costs and Prices and some
State Governments. Till such time as this is finalised the existing
Drug Price Control Order will continue to be in operation. In the pro
posed Drugs (Price Control) Order which would be announced after
the list of drugs in each category is finalised,
there would be a
stipulation to the effect that Government will have the right to bring
within the ambit to control any drug in the de-controlled category
at any point of time, should it be considered necessary to do so.
With a view to encourage production of drugs which
are more essential to the needs of the country, incentives, other
than the MAPE, would also be considered. Government would at
the same time strictly monitor' the prices of drugs of de-contrrolled
category and for this purpose an effective monitoring machanism
shall be developed.
Norms of Pricing
5.3
It is decided to have a uniform norm for all bulk drugs
falling in the
controlled category I and II and the manufacturers
will be given the following three options
i)
14% post tax return on net worth; or
ii)
22% return on capital employed; or
iii)
Long term marginal costing with 12%
rate of return in the case of new plants.
internal
The maximum
retail price of domestically produced
items excluding excise duty and local taxes, if any, would not
be* higher than ex-factory cost by more than 75% in the case of
category I formulations and by more than 100% in the case of category
II formulations. This is to say, MAPE would be 75% and 100% respec
tively for category I and II formulations, of the ex-factory cost.
7
In respect of imported formulations, selling and distri
bution expenses, including interest and importers'
margin, shall
not exceed 50% of the landed cost.
5.4
Drug Price Equalisation Account (DPEA)
The DPEA was set up essentially to encourage domestic
production of bulk drugs through a system of retention pricing;
However, in actual practice the operation of DPEA is giving rise
to
intractable administrative problems, with anticipated accruals
to the DPEA being thwarted by disputes and claims on the DPEA
put forth promptly. It is, therefore,
decided to discontinue the
system
of retention and pooled pricing. Protection
for indigenous
productio of bulk drugs, wherever necessary, would be provided
through the tariff machanism. However, provision would be made
in. the new Drug Price Control Order to ensure that amounts which
have already accrued to the DPEA and those which are likely to
accrue as a result of action in the past, are protected and used
for the purpose stipulated in the existing DPCO.
PART VI - LICENSING
6-1
FERA Companies
The business operations of FERA companies would have
to be in accord with national objectives and priorities. FERA com
panies would be eligible for entry mainly in those areas where
the entry is desirable from the objectives of. better health care.
The list of bulk drugs open to all sectors has been revised accor
dingly. FERA companies would be eligible for licenses mainly in
respect of these bulk drugs, subject to a phased manufacturing
programme, and related formulations in
order to encourage higher
bulk drug production, the ratio between the value of production
of bulk
drugs
to that of formulations (hereinafter referred to
as ratio parameter) would be reduc.ed from 1:5 to 1:4 for FERA
companies.
The definition of "drugs and pharmaceuticals"
listed
at Entry 14 of Appendix I of the Industrial Licensing Policy, would
now read as in Annexure I.
6-2
Companies other than FERA Companies
These companies would continue to be eligible for indus
trial approvals in respect of all bulk drugs which are approved
for use in the country' and related formulations, subject to sectoral
reservations for public and small scale sectors.
6.3
Role of Public Sector
Public Sector will continue to have an important role
particularly in the production of basic bulk drugs which are central
to the needs of the National Health Programme. However, the Goovernment recognise the fact
that the public sector units will have
8
to
function at optimum levels of efficiency, in production as well
as marketing, in order to fulfil
the role that has been assigned
to them in the new policy, namely, that of making available essential
bulk drugs at reasonable prices. Keeping in view the crucial role
of the public sector in achieving the objectives of National Health
Programme, indepth exercises have already been initiated to prepare
an action plan of steps to improve performance of each of the public
sector units.
Rehabilitation and restructuring plans for these public
sector undertakings are expected to be finalised very shortly.
These plans shall include changing management cultures and values>
improvement of management system; improvement in product strategy;
internal generation of cash; savings in fixed costs; reduction in
line
wastage and batch rejection; improvement in technology; reduc
tion in expenses on utilities; reduction in inventory levels; better
and more sensitive marketing
strategy; higher capacity utilisation;
better utilisation of R5D facilities etc.
It is decided to continue, to a substantial extent, the
present policy of reservation for .manufacture by the public sector
of certain important bulk drugs. At present 17 bulk drugs including
Pencillins
and Polio Vaccines are exclusively reserved for production
by the public sector units. Considering the projections of requirement
of Penicillins, it is decided to expand the capacity of Penicillin
in the existing public sector units along with induction of more
advanced technology. However, it is felt that even with these meas
ures the public secor units will by themselves not be in a position
to meet the entire requirements of the country of these two basic
and essential drugs. The 1989-90 demand of Penicillin is estimated
to be as high as 2470 mmu as .against the existing installed capacity
of 637 mmu inclusive of 390 mmu in the public sector. Thus the
present gap in the demand and production of this crucial drug would
further widen by the end of 7th Plan period unless corrective steps
are taken to narrow it. At present, in
order to meet the require
ments of this essential drug, imports are also resorted to which
result in an outgo of foreign exchange to a substantial extent, this
outgo being of the order of Rs. 24 crores in the year 1985-86. Simi
larly
Polio vaccine which is an extremely important input in the
immunisation
programme of the Government is yet to be produced
in the country. A capacity of 10 million doses is being installed
by M/s. Halfkine, a Maharashtra Government undertaking. However,
the 1989-90 demand is estimated to be 80 . million doses
taking
into account the requirement of the Expanded Immunisation Programme.
Keeping in view the large gap between the capacities created and
the 1989-90 demand for Penicillin and Polio Vaccine, the need to
reach self-sufficiency in these two vital products, it is decided
to open these two products for production by all sectors. The demand
for these essential drugs would continue to be met through imports
also till such time as indigenous production has reached a level
where imports become unnecessary. However
15 other bulk drugs
9
which are presently reserved for the public
sector would continue
to be so reserved (Annexure - II).
6.4
DGTD Registration
DGTD registration would continue to be available to
in respect of proposals which
non-FERA and non-MRTP companies.
satisfy the criteria for DGTD registration.
6.5
Delicensing
The scheme of de-licensing has already been extended
to 94 bulk drugs including all anti-cancer drugs, all new bulk drugs
developed through indigenous research,
and related formulations
as well as two drug intermediates. The scheme, would progressively
be extended subject to the following criteria:
(a)
bulk drugs whose imports are allowed on OGL.
(b)
bulk drugs, whose production is limited to three
producers or less in the organised sector.
(c)
bulk drugs whose formulations
and mass consumption'nature.
are
of
essential
(d)
formulations and drug intermediates related
to
bulk drugs which are delicensed.
The scheme of delicensing would be available for nonFERA and non-MRTP companies only
excepting for new drugs which
would be cleared for use in the country and would not include
bulk drugs reserved for public and small scale sector.
The capacities to be set up under the delicensing scheme
will, however, conform to the economic scales of production.
6.6.
Encouragement of new drugs
Introduction in the country of formulations based on
new bulk drugs require the approval of the Drug Controller (India).
In order to establish the safety and efficacy of the new drugs
proposed to be introduced detailed information has to be furnished.
This information amongst others, should include, toxicity data on
animals, pharmacological studies and results of clinical trials in
Indian conditions, which may extend over several years. Once"a firm
obtains the approval other firms are not required to obtain approval
in respect of that drug again. In order to encourage introduction of
new drugs in the country, all new bulk drugs and related formulations
would be brought under the scheme of de-licensing. If approval for
the introduction of the new drug is based on the clinical trials conduc
ted by a MRTP or FERA company, such a company can also avail the
scheme of delicensing in respect of such new bulk drug and related
formulations. Exemption under Section 22A of the MRTP Act would also
be available in such cases.
10
f
6.7
Phased Manufacturing Programme
To encourage cost-effective indigenisation and to ensure
that bulk drug production does not remain confined to processing
of later intermediates only, it has been decided to introduce system
of a phased manufacturing programme (PMP). This will be applicable
to all manufacturers and to all types of industrial approvals (licence,
registration with the DGTD and registration under the Delicensing
Scheme).
Where the import content is 20% or more of the value
of production, import licenses for bulk drug manufacturers would
be granted only in accordance with the approved PMP which would
specify the indigenisation to be achieved annually as a percentage
of the value of production. The viability of PMP would be examined
in terms of the domestic resources cost of production, with a suit
able shadow rate of foreign exchange. All companies manufacturing
bulk drugs would be required to submit to the Department of Chemi
cals and Petro-chemicals their PMP proposals and the existing com
panies which import drug intermediates or other raw materials
from their principals or their associated companies would be required
to inform the Government of the details of such transactions within
a month of such import.
6.8
Broadbanding
In order to provide greater manufacturing flexibility,
broadbanding would be extended to the pharmaceutical industry,
taking into account the technical factors like plant design, process
and production facilities. To begin with 31 groups of bulk drugs
(Annexure III) would be covered by broadbanding. Products, other
than bulk drugs, would be broadbanded into the following categories
|
on
bulk
drugs
in
(a)
Formulations
III.
(b.)
Surgical ancillaries like sutures, catguts, bandages,
(c)
Seras and Vaccines.
(d)
Diagnostics of all types.
(e)
Allergins.
(f)
Transfusion
based
Annexure
solutions
The facility of broad banding would be available only
in resoect of products which are approved for use in the country
by the Drug Controller!India). For domestic production, companies
in the organised sector would be eligible for broad banding only
in respect of items open to them.
The procedure to be followed for this is as laid down
in the press note No.33 (1986 series) of the Department of Industrial
Development dt.26.9.1986. The scheme of broad banding will also
be subject to the conbditione laid therein.
11
6.9
Export production
For export production, all companies would have total
flexibility to produce any product
with their existing facilities.
They
need only inform the Government of the details of such pro
duction and export.
6.10
Revised Ratio
Parameters
In order to encourage higher production of bulk drugs
in the country, the ratio parameter between the ex-factory value
of bulk drug production to that of formulation has been revised.
The ratio parameter would be related to the size of a company,
which in turn has a relationship with its ability to invest in and
develop/procure technology for production of bulk drugs. For FERA
companies ratio parameter would now be 1:4. For other companies
the ratio parameters would be related to the ex-factory value of
production of bulk drugs and formulations as follows:
Ex-factory value of production
of bulk drugs and formulations
Ratio parameter
1.
Upto Rs.10 crores
1:10
2'.
For production in excess of
Rs.10 crores and upto
Rs.25 Crores.
1:7
3.
For production in excess of
Rs.25 crores.
The following activities
in computing the ratio parameters:
would
continue
(a)
Drug Intermediates.
(b)
(c)
Empty hard gelating capsules
Surgical ancillaries
(d)
Seras and Vaccines
(e.)
Diagnostics of all types
(f)
Allergins
(g)
Transfusion solutions
1:5
to
be
excluded
Inn .cc"(n.panies in the organised sector are required
to submit Xod^ °npr°8ran,m^ ^eluding the production of new
drugs, so that they can reach the new ratio parameters within
a period of 3 years. As and when a Company moved from one category
12
to another, it would
new ratio parameter.
be allowed a period of 3 years
to reach the
In order to encourage production of bulk drugs in the
country
the formulation turnover of all companies in the organised
sector would continue to be baged on a ratio of 2:1 between the
value of consumption of
indigenously produced bulk drugs and
that of imported bulk drugs.
6.11
T'
Supply of Bulk Drug to Non-Asociated Formulators
FERA and MRTP companies would continue to supply
50% of the bulk drug production to non-associated formulators and
other companies, including public sector, 30% of the bulk drug
production to non-associated formulators.
6.12
RfiD/Import of Know-how
R6D would gain an impetus from the various measures
proposed in the policy such as the extension
of delicensing to
companies which conduct clinical
trials and obtain the approval
of the Drug Controller (India] for introduction of new drugs. However,
wherever necessary,
import of know-how would continue to be
favourably considered on merits.
6,13
Regularisation of production
f)
A very large number of formulations are being produced
ranging from one to two decades with industrial approvals which
are
being questioned. Majority of these drugs are claimed to be
covered
under registration certificates issued under Section 10
of the Industries (Development and Regulation) (IDR) Act. According
to the practice then in vogue, these registration certificates did
not mention individual items and capacities but merely permitted
production of "drugs and pharmaceuticals". Another major category
comprises- of items claimed to be covered under notification issued
in the 1960s and 1970s, under Section 298 of the IDR Act, announcing
exemption from industrial licensing, subject to some conditions.
However, COB licences could not be issud in many cases because
of non-fulfilment of one or more of the conditions subject to which
the exemptions were granted. Having regard to the fact that the
infraction in most cases are technical and that the products have
been accepted by the medical profession, Government have decided
to regularise the production of all such formulations and surgical
aids.
6.14
Re-endorsement of capacity
Government's industrial policies in regard to re-endorsement of capacity, and recognition of additional capacities as a result
of replacement/modernisation/renovation of equipment, as announced
13
from time to time, would be applicable to the pharmaceutical industry.
7.1
PART VII - DUTY RATIONALISATION
The measures in the areas of licensing and pricing poli
cies would also be complemented by appropriate fiscal policy mea
sures designed to progressively reduce import and excise duties
to the minimum possible levels and to ensure that the cumuilative
incidence of duty on the bulk drugs is higher than that on the
inputs and drug
intermediates . Duty rationalisation is intended
to encourage cost efficient production of bulk drugs and of high
quality formulations.
PART VII -CO-ORDINATION BETWEEN HEALTH
AND INDUSTRY MINISTRIES.
8.1
With a view to achieve better integration between the
Health policies and the industrial policies in the Pharmaceutical
sector, an inter-ministerial Standing Committee would be constituted
in the Ministry of Industry Department of Chemicals and Petrochemicals
with Secretary, Ministry of Health and officials of the other Depart
ments and agencies concerned as members. In the first instance,
the Committee would oversee the implementation of the new measures
and other related decisions such as revision of the National For
mulary, stregthening of the institutional and statutory arrangements
for enforcing quality control, dissemination of information regarding
safety and efficacy of drugs to medical and paramedical personnel,
centralisation of drug registration, rationalisation of formulations
and monitoring of adverse reactions.
PART
IX
- REVIEW
9.1
The implementation and parameters of these measures
would be reviewed at the end of the 7th Five Year Plan. Appraisal
at short intervals will also be made to ascertain the progress of
implementation and the trends emerging from time to time.
14
(ANNEXURE I)
(See para 6.1)
APPENDIX - I
Industry Policy-Government Decisipn -
Press Note dated 2nd Dec., 1973.
X
14.
0
0
X
X
X
X
X
X
X
X
Drugs 8 Pharmaceuticals
For FERA Drug Companies
Following bulk drugs
subject to a phased manufacture
programme, and formulations based
thereon with an overall ratio
of bulk drug consumption (from own manufacture) to formulations
from all sources of 1:4.
(1)
Rifampicin
(2)
Verapamil
(3)
Cephalexin
(4)
Pantothenate
(5)
Bacitracin
(6)
Neomycin
(7)
Cephaloridine
(8)
Alkaloids of Ergot
(9)
Thiopentone
(10)
Propoxyphenazone
(11)
Pyrantal Pamoate
(12)
Norethistercne
(13)
Oxethazine
(14)
Pentazocine
(15)
Norgestral
(16)
Dipyridemol
(17)
Tolnaftate
(18)
Triprolidine
(19)
Naproxen
(20)
Nalidixic Acid
(21)
Chlorpromazine
(22)
Chlorpheniramine
(23)
Betamethazone
(24)
Dexamethazone
(25)
Chloramphenicol
(26)
Vitamic A
(27)
Digoxin
(28)
Dapsone
(29)
Allopurinol
(30)
Vitamin B12
(31)
Prednizolone
15
(32)
(33)
(34)
(35)
(36)
(37)
(38)
(39)
(40)
(41)
(42)
(43)
(44)
(45)
Baralgan Ketone
Isulin
Primaquine
Amodiaquine
Succinyl Cholinechloride
Clofazamine
Thiabendazole
Tetramisole
Framycetin
Cyclophosphamide
Mepacrine
Triamcinolone
Phenuylephrine
Oxy tecin
(46)
(47)
(48)
(49)
(50)
(51)
(52)
(53)
(54)
(55)
(56)
(57)
(58)
(59)
(60)
(61)
(62)
(63)
(64)
Vitamin P(Rutin)
Prenylamine Lacate
Thioridazine
Phenolthiazine
Penicillins
Mianserin Hydrochloride
Aminoglutethimid
Cinnarizine
Becampicillin
Captopril
Prazinuantel
Tobramycin
Timolol
Caf azoline sodium
Atenolol
Nimustine
Prithyldone
Isosorbidemonoitrate
Any new drug for which
the company conducted clinical
trials and obtained
Drug Controller's
approval.
Polio Vaccine
Measles Vaccine
(65)
(66)
For non-FERA MRTP companies the existing definition
would continue
i.e. all bulk drugs and formulations subject’ to
the ratio parameters applicable on the basis of turnover and subject
to reservation for the public and small scale sectors.
16
(ANNEXURE - II)
(See para 6.3.)
LIST OF BULK DRUGS RESRVED FOR PUBLIC SECTOR
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
Streptomycin
Tetracycline
Oxy tetracycline
Gentamycin
Sulphaguanidine
Sulphadimidine
Sulphamethoxy-pyridazine
Sulphadimethoxine
Vitamin Bl
Vitamin B2
Folic Acid
Quinine
Analgin
Phenobarbitone
Morphine
N.B.Bulk drugs would
vatives, if any.
include
'0
17
salts,
esters
and
deri
(ANNEXURE - III)
(See para 6.8)
GROUP OF BULK DRUGS COVERED BY BROAD-RANGING
GROUPS
1.
(2)
(3)
(4)
(5)
(6)
(7)
(8)
All
types of Penicillins
Erythromycin, Griseofulvin, Rifampicin
Chloramphenicol
and
its
intermediates
namely
L-Base.
6-APA and 7-ADCA from Potassium Pencillin G
Semi-synthetic Penicillins like Ampicillin, Amoxi
cillin etc.
All types of Cephalsporins
Sulpha Drugs other than
those reserved for
Public Sector
Steroids 8 Hormones including the following
v
Prednisolone,
Prednisone,
Hydrocortisone, Beta
methasone,
Ethinyl
Oestradiol,
Norethisterone,
Norgestrel, Testosterone, Progesterons etc.
(9)
(10)
(11)
(12)
(13)
(14)
'
(15)
(16)
(17)
(18)
(19)
(20)
(21)
Theophylline, Aminophylline, Hydroxyethyl-Theophylline Xanthinol Nicotinate and Synthetic Caffeine
All Barbiturates other than Phenobabarbitone
Analgin , Isopropylantipyrine
Chlorpromazine
Prochloroperazine
Promethazine
Trifluoperazine
Triflupromazine
Chloroquine
Amodiaquine
Oxphenbutazone
Phenylbutazone
Diphenydramine
Bromodiphenhydramine
Hydrocholorothiazide
Cyclopentazide
Chlorophenesin
Mephenesin
Xylocaine
Procaine
Benzocaine
Prilocaine
Metronidazole
Tinidazole
Tobutamide
Chlorpramamide
Acetazolamide
Thiacetazone
18
',:-
(22)
(23)
(24)
(25)
(26)
(27)
(28)
(29)
(30)
(31)
N.B.
Diazepam
Chlordiazepoxide
Oxazepam
Nitrazepam
Lorazepam
Pheniramide
Chlorpheniramine
Ibuprofen
Ketoprofen
Flurbiprofen
Naproxen
Salbutamol
Terbutaline
Furazolidine
Nitrofuratoin
Nitrofurazone
Furaitadone
Chlorcyclizine
Cyclizine
Meclozine
Buclizine
Diethyl Carbarn Zine Citrate
Propranolol
'
Atenolol
Metroprolol
Oxprerolol
Pindolol
Mebendazole
Thiabendazole
Benbendazole
Drubs obtained by extraction from plant material
such
as
Belladonna,
Hyocymine,
Sennosides,
Digoxin,
Ammalicine,
Pesperpine,
Vincristine,
Vinblastine, Quinine, Quinidine, Emetine, Strychnine,
Brucine etc.
Drugs of animal origin other than Insulin , such
as Liver extract, Heparin, Pancreatin, Immunoglo
bulin etc.
Bulk drugs would Include salts,
vatives if any.
19
esters and deri
MARTINDALE
(1994)
it tor riasma m a
with arthritis. Analysis or difetion of - patients suggested a
luoseouent enteroneoatic circula^tine between A ana 15.1°?. Didunisal was not
lotnal tluid of any of 28 patients
myeiograontc radiological assessment for ver-'foudsc.' Studies indicate mat elimination of
, raster tn men ana in women raking oral conman in control women.* Smoxing results in
■noaerate increase :n diflunisai .-.earance
THe Extra Pharmacopoeia
risk oi agranulocvtosis. Data collected from li population
grouos in Europe ana Bract revealed (hat there was a Mgnnicani regional variability m the rate-ratio estimate for
agranulocytosis and dipyrone <0.9 in Budapest to 33 3 in
Barcctonai. Although a iaree relative increase in risk be
tween agranulocytosis and use of cipyrone was found, the
incidence was iess than some previous repons had sug
gested.— The IntetTutKxui Agranuiocviosis ana Apluuc Anemia
Study. Risks ot acjinuiocvicnis ana anutic anemia: a first report
Thirteenth
ANNEXURE a
about 100 (o 200 me.
Epirizole i26-m<
Epinzoie <USAS •’/Wi
DA-398: Mepinzoic. -i-Metnoxy-2-(5-metnoxy-3-metnvipvrazoi-1 - v| )-t>-metnvipvnmidine.
C,|H!4N4b: = 234.3.
CAS— /8694^0.1
Effects on the skin. Dioyrone naa been responsible for a
rase of drug-induced toxic epidermal necrolvsis.— Rouicau
Sjogren-hie svnorome atrer crus-induced toxic epiaer-
Pharmacopoeias, in Jon
Hypersensitivity. Cross-sensitivnv between aspirin and
Jipyrone occurred in one patient Dipvrone produced an
exacerbation oi dyspnoea, cyanosis, and respiratory ar
rest.— dinou E. <■: jt. Druz-maucefi hinma. Lancet 1976’ i:
Proprietary Names
Mebron
Preparation details are given in Pan 3.
ana Administration
Epinzoie has analgesic and anii-intlammator. properties.
It nas been used b\ mourn tn doses ot up to oOOmg cany
tn divided doses.
Etenzamide
ni!-inriammatory. and antipyretic propenes:
nours. Maintenance doses
Porpnvna. Dinyrone a as considered io ne unsafe in pa-
Uses and Administration
Dioyrone is me \ouiun*. >uionona:e of amidopsrine i *ee
rnzamide 'BA \
Etenzamide ”.a-> anaicesK. anii-milarnmaiorv ana .tntir;. ■
mouth.
ious adverse effects i:
corrin-Chmin-Drace:
l)iDn>uuaiune
a uh
an innihitorv
Droxicam izryr.h.
Eth\l Salicvlaie
Muiti-incredient
'ruminopnenazonK3W)-dione n.o-dioxiue
Sodium
Droxicam is a non—ieroidal anii-uiliammaiorv aeent. It
Etodoiac
Eloaolac
t’SAN. rl.W'i
>lic Acid. I.S-Dicthyl-i
t-olmdol-1 -x lacetic acid.
Consolidated
and/or
sale
bava
list of products whose consumption
been banned, withdrawn, severely
restricted or not approved by Governments (1987)
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
ANN
Proauct name .
MERCURIC DERIVATIVES (TOPICAL)
Legislative or regulative action :
Country
Description of action tsken/grounds for decision
Effective
date
AMINOMERCURIC CHLORIDE BANNED DUE TO SUM DISORDERS ASSOCIATED WITH LONG-TERM USE. (REFERENCE: UWAB)
1969
JPN
NOTICE BT DIRECTOR GENERAL OF PHARMACEUTICAL AFFAIRS BUREAU
562 . . 23 JULY 1959)
MERCURY-BASED PRODUCTS FOR TOPICAL USE ARE BEING PHASED CUT DUE TO DUBIOUS EFFICACY AND SAFETY.
MOV, ISS3
PHI
WITHDRAWN FROM THE MARKET OWING TO AM UNFAVOURABLE RISK-BENEFIT RATIO ANO THE LACK OF SUBSTANTIAL
EVIDENCE OF EFFICACY.
-HQ COMMENT: PREPARATIONS CONTAINING MERCURIC DERIVATIVES FOR TOPICAL USE HAVE BEEN WITHDRAWN IN MANY
COUNTRIES SINCE THEY MAY PRODUCE HYPERSENSITIVITY ANO ALLERGY. SYSTEMIC ABSORPTION HAS RESULTED IN CHRONIC
MERCURY POISONING ANO ACRODYNIA (PINK DISEASE) IN INFANTS
proauct name
METAMIZOLE SODIUM
C.A.S numoer :
68—39 — 3
Scientific and common names, and synonyms .
ANALGIN
CIPYRON
SIPVRONE
NORAMIDOPYRINE
methanesulfonate sodium
SULPYRIN
SU.PVRINE
Legislative or regulative action
Country
I Effective
Description of action taken/grounds for decision
1
date
ius
1
NOR
i
THE DEPARTMENT OF HEALTH HAS PROHIBITED THE IMPORTATION OF NORAMIDOPYRINE METHANESULFONATE SODIUM.
19651
1
1
JULY 1976 1
WITHDRAWN FROM THE MARKET
|
...
BY ADMINISTRATIVE ORDER NO.330 USED ONLY AS A LAST RESORT IN SERIOUS ANO LIFE-THREATENING SITUATIONS WHEN
1977
OTHER LESS TOXIC ANTIPYRETIC DRUGS ANO OTHER MEASURES HAVE FAILED ANO ARE NOT TOLERATED. ANO ONLY WITH
!
PROPER SUPERVISION ANO MONITORING. THE PACKAGE INSERTS ARE REQUIRED TO CARRY EXTENSIVE WARNING INFORMATION.
ESPECIALLY REGARDING THE RISK OF FATAL AGRANULOCYTOSIS WITH THE USAGE OF THIS DRUG. THE DRUG IS AVAILABLE ONLY
ON PRESCRIPTION. (REFERENCE: (PHAOO) ADMINISTRATIVE ORDER NO . 330
USA
. 1977)
AN ANALGESIC ANTIPYRETIC DRUG. FOUND TO BE EFFECTIVE AT REDUCING FEVER BUT WITHDRAWN FROM THt MARKET ANO
JUNE 1977
PROHIBITED FOR EXPORT BT THE FOOD ANO ORUG ADMINISTRATION ON THE BASIS OF REPORTS OF AGRANULOCYTOSIS. A
SOMETIMES FATAL BLOOD CONDITION. ASSOCIATED WITH ITS USE. THE DIRECTOR OF THE BUREAU OF DRUGS FOUND THAT
AGRANULOCYTOSIS CANNOT BE EFFECTIVELY PREVENTED BT FREQUENT EXAMINATION OF TREATED PATIENTS SINCE THIS
CONDITION CAN OCCUR WITHIN A FEW HOURS FOLLOWING ADMINISTRATION OF THE DRUG TO A SENSITIVE INDIVIDUAL. IN ITS
DECISION THE >‘DA CITED THE AVAILABILITY OF EFFECTIVE ORALLY ADMINISTERED DRUG PRODUCTS (EG. ASPIRIN ANO
ACETOMINOPHEN) AMO CONCLUDED THAT THE RISKS ASSOCIATED WITH THIS ORUG FAR OUTWEIGH AMT BENEFIT DERIVED FROM
ITS USE. INCLUDING USE IN HODGKIN'S DISEASE AMD SIMILAR MALIGNANT DISEASES.
ITA
INJECTABLE PREPARATIONS WITH DOSAGES HIGHER THAN 1 GRAM ANO INTRAVENOUS PREPARATIONS IN COMBINATION WITH
1979
OTHER COMPOUNDS HAVE BEEN WITHDRAWN. THE LABEL FOR CURRENTLY MARKETED PREPARATIONS NOW CARRIES A WARNING
REGARDING FATAL ACCIDENTS DUE TO HYPERSENSITIVITY.
PREPARATIONS CONTAINING METAMIZOLE WERE BANNED FOR SYSTEMIC USE DUE TO THE POTENTIAL RISK OF FATAL
APR. 1979
1 AGRANULOCYTOSIS. (REFERENCE: (UGIAAD) UGESKRIFT FOR IAEGER
1980 |
1873
MAR. 1379)
PROHIBITED FOR INTRAVENOUS OR INTRAMUSCULAR INJECTION DUE TO SEVERAL REPORTS OF ANAPHYLACTIC SHOCK.
...(Continued)
Seconc Issue. 1986
62
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
Product name :
METAMIZOLE SODIUM ...(Continued)
C.A.S number :
68—89—3
Legislative or regulative action •
Country
Effective
i
Description of action taken/grounds for decision
date
BCD
JUNE 1982
BANNED IN ORAL DROPS ANO TABLET FORM QUE TO HIGH' INCIDENCE OF ADVERSE EFFECTS ANO AVAILABILITY OF SAFER
ALTERNATIVES. A SINGLE INGREDIENT INJECTION REMAINS AVAILABLE FOR TERMINAL CARE AS A RESTRICTED DRUG FOR
SPECIALIZED USE.
OEU
JAN. 1983
INDICATIONS FOR USE HAVE BEEN RESTRICTED. THE LABEL MUST BEAR A BOXED WARNING STATING THAT THERE IS A SLIGHT
RISK OF LIFE THREATENING SHOCK OR AGRANULOCYTOSIS ANO THAT PATIENTS WITH YNOWW HYPERSENSITIVITY TO
PYRAZOLONE DERIVATIVES SHOULD NOT TAKE THIS DRUG.
EGY
JULY ’983
FOLLOWING REPORTS OF ANAPHYLACTIC SHOCK NO REGISTRATION LICENCE IS TO BE GRANTED FOR INJECTABLE
PREPARATIONS CONTAINING MORE THAN 1 GRAM OF THIS COMPOUND
ISR
01 OEC. 1985
FIXED OOSE COMBINATIONS OF METAMIZOLE S00IUM ARE NOT APPROVED FQK REGISTRATION. PARENTAL PREPARATIONS OF
METAMIZOLE SODIUM (SINGLE-DOSE PRODUCT) MAY BE ADMINISTERED ONl» i HOSPITALS ANO CLINICS WHERE THERE ARE
SUITABLE FACILITIES FOR RESUSCITATION UN CASES OF ANAPHYLACTIC SHOCK). ENTERAL PREPARATIONS OF METAMIZOLE
SODIUM (SINGLE-DOSE PRODUCT) MAY BE DISPENSED WITHOUT PRESCRIPTION.
GRC
PREPARATIONS CONTAINING METAMIZOLE HAVE BEEN WITHDRAWN FROM THE MARKET. WITH THE EXCEPTION OF INJECTABLE
“REPARATIONS CONTAINING UP TO 1 GRAM BECAUSE OF CONCERN ABOUT AGRANULOCYTOSIS ASSOCIATED WITH THE DRUG’S
USE.
MEX
DUE TO TOXICITY NOT ACCEPTED FOR USE IN PEDIATRIC PREPARATIONS 'ELIXIR. SOLUTION SUSPENSION. SUPPOSITORIES).
OTHER ALTERNATIVES (ASPIRIN PARACETAMOL) MUST BE SOUGHT
PER
THE PACKAGE AND/OR LABEL FOR THIS PRODUCT ADVISES THAT ’HE DRUG .S INTENDED FOR PRESCRIPTION USE ONLY ANO
MAY CAUSE AGRANULOCYTOSIS.
SGP
METAMIZOLE SODIUM ANO RELATED SALTS ANO SULPHONATES OF NORAMIOOPTIUnE HAVE BEEN BANNED FOR IMPORTATION.
SWE
PREPARATIONS CONTAINING METAMIZOLE WERE WITHDRAWN FROM THE MARKET BY THE MANUFACTURERS AFTER MUTUAL
DISCUSSIONS DUE TO ADVERSE REACTIONS SUCH AS AGRANULOCYTOSIS.
NOT APPROVED FOR USE ANO/OR SALE.
VEN
who
COMMENT METAMIZOLE SODIUM A LONG-ESTABLISHED ANALGESIC ANO ANTIPYRETIC HAS BEEN ASSOCIATED. LIKE
SOME OTHER PYRAZOLONES. WITH BLOOD OYSCRASIAS ANO PARTICULARLY AGRANULOCYTOSIS. THE INCIDENCE OF THESE
REACTIONS IS DISPUTED A LARGE INTERNATIONAL COLLABORATIVE STUDY OF
COMPLETED. BUT THE RESULTS ARE NOT AS YET AVAILABLE.
Product name :
METHAMPHETAMINE
C.A.S number :
537-<6-2
THIS QUESTION HAS RECENTLY BEEN
Scientific and common names, and synonyms :
(*)-2 "METHYLAMINO" 1 -PHENYLPROPANE
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
TUR
AUG. 1982
BANNED FOR PRODUCTION. IMPORT. EXPORT. SALE AND USE.
WHO COMMENT: METHAMPHETAMINE IS CONTROLLED UNDER SCHEDULE II OF THE 1971 CONVENTION ON PSYCHOTROPIC
SUBSTANCES. (REFERENCE: (UNCPS) UNITED NATIONS CONVENTION ON PSYCHOTROPIC SUBSTANCES . . . 1971)
63
Second Issue, 1986
MARTINDALE
(1994)
THe Extra Pharmaconoeia
Thirteenth
ANNEXURE D
dren iron) cliiwuin.
product' containin'? either ol
noutu not
-Dichion
iw-eiamic
Decoquinate «I2n2c*-e«
HC-l'’2.v. M&B-I54Q7
drowduinolinc- '-carooxviatc
xHioeoixsis
Abnormal coloration. Green discoloration
oncue.
urine and laeccs ana \eliou discoloration o: me nails
have Peen recocnisec with cnoauino: Tonica, application
ot a siiouuinoi-containine conicosteroic preparation was
A cream to buff-coloured. injaurie*.'
microcrysialhne p<»*oer. Insoluble i
insoluble in aiconoi: vers slightly ^hui
and etner.
Decnoumaie is an antinroio/odl agent
bydroxvauinoime used ionically for*
rrurnrJrTTTrx Its i n skin i n•
Dehydroemetine Hydrochloride
jvTSoutn_for am.Q.enic.-and other
DoasTBut severe neurotoxicity half-
Qjoroioooauine C.iocr.moium ioaolodocniorr.varoxvauinoimc:
ioro-"-ioaoau.
<man . :iani uermatui'
ss.itn mntac; .surrey :r.
non ot cnouutnii. imt
ciiouumoi concentration
emoarea
Dcnx.iri'emeiine Hsdrocnionue >HA\ •
BT-4vn. 2..'-Dcnsuroemetine Hydrocn
Q??a Z. '-Didensdro-o .".H’.l 1-ictram
drocnionde: ?-Etnyi-1 .o.“. 11 b-teiranvi
-i 1.2..'.~-(etran\aro-o.7-ijinietnos>//-benzotuiuuinoiuinc dihvurocnioria;
. jn cummoi
Plied to
Absorption and batt
■- incomoatible
.1 xartani;
EjTecLS
cnouuinoi
Locu application oi ciioauinol in ointarxms mas occasionally cause severe trautnoitres Ciiouumol
clip'* c" contact and
oiour :at." nair.
pven oy moutn has peen associated
neurotoxicity In Jaoar. :ne eotaemte
concuronatns
» the 1960s u.as a
u uh me tn:;to(jutnoi tor
,
and me suit .*•: c.touutno! and
bydroxyouinotinc' >sa' 'doseuuentiy
il Japan. Symptoms ot suoacute myeio-op*^Rtty arc pnncioalty most
Denpneral
including optic atropny ana myeiooapain and diarrnoea Ptten oreceae
lymptoms such as paraestncsias in me
to paramecia m some patients and
acuity sometimes leactng to biind^B®*>ctensiic green pigmen-., a cneiate of
non. is often seen on me longue
gRr'trine and faeces. Cereors. cisturoances.
^SJ^huion ana retrograae amnesia, have
I^B^ponea. Altnoucn many patients imcboauinoi *as wunara-r.. others had
^SJ^emeni.
that the Japanese epidemic might
susceotioiiity. out a rev. similar
^^P^*cuic myeio-ooiiconeuropainy have
^^Pj'from several other countries in asso|;^^pjooumol or related nycroxvauinohne
^^^pch as broxyquinoline :: ai-ioaohy-
Uses and Administration
Cliouuinol. a naiogenatec nxaro'xuuinonne. i
iuminai amoemcioe tormeriy given py mourn in
the treatment ol intestinal amoentasiv I:
also
formerly used lor me propnyiaxi' ano treatment <»:
traveller - diarrnoea ana similar infection*. out ua>
ol douottul value. Orai preparation'
peen wnnorawn oecausr ot neurotoxicity
Cituuutnol has antioacieria. anc anniuncai acnxiis
and is used tn creams ano ointments, usuaitv con
taining ?r<. tn me treatment ot 'Kin iniectiun*. I;
t.s aiso applied tocetner uitn a conicosteroic in in
flammatory skin conditions complicated by oacterial or tuneal intection'
For a discussion ot me hsks irorr. tomcat aDoiiCa-
tmdren
Amoebic inlectiuns. Denvurocnicnn
enteiinv
bitmonoi n* moutr. Tnr c
emetine
Muiti-ineredient preparations. Antible: Edzcrr.. AriMolonr.
Barouinot HC. betneimiA C. oetnosai med cmnoiorrr.. ocinc*denr.. Dtrmaacs Chinonnicu. DtDroiorrr.. Diprosept. rtrs: Aid
Antiseptic holder. Hacun-C. hsaroiorr. idiioiurmic-. ioair
Conilair. Locaconenc-* loionr.c. Locaconer. \ioiorrr.. Lo».aconen-Vioionr. Loconer.. Loconene Vtoiormo. Loconen-V‘i>>.
Diaveridine i12ml
BWU9-2JU; NSC-4087?*. 5-Verain ipynmiatni
Oris. Prooadcrm-C. (Juaonacrm. Quaanaermc. Qumaoanc
Recto Menaoenr.. Renew AnumiconcG. Sermatonr. hsnai^r
or Lotion \iobeu. Viocidina Vmionn-Hvarnconisonc
Preparation oetans arc given in Pan 3
GOODMAN and GILMAN'S the Pharmacological Bas
of Therapeutics, Seventh Edition (1985)
1051
8-HyDROXYQU INCLINES
ANNEXURE C
x^wanide furoate is available in 500-mg tablets
Parasitic Diseases Division. Centers for
Control.
P^rmacoloeical Effects. Diloxanide is directly
pgoicidai wnen tested izi vitro. The furoate ester
b*cu*e at 0.01 to 0.1 ug/ml. and it is thus considmore potent man emetine. Little is known of
gs mccnanum or action.
Absorption. Fate, and Excretion. In experimen
ts animae. •'<) to 90% of an oral dose of diloxanide
f^roaic !' excreted in the urine within 4X hours.
Uoct man r.aif of this appears within t> hours. Ex
action m :ne feces accounts for 4 io 9% of me
Pea* concentrations appear in the blood
••Krun i ■'oar out tail to a fraction ot this within n
sour' Her-c. a major pan of an oral dose i> rap.:OM»rreu from the gastrointestinal tract anu >
rMrnm excreted in the urine. The ester is largely
Honnv/ed in me lumen or mucosa ot the intestine.
«o irui oniv jiioxamde appears in the systemic ctrc»uiion ■Uilmsnurst ana Cliffe. 1964). The drug
occurs m me urine largely as the glucuronide.
Boule »i Administration and Dosage. Diloxanide
ferrule is given oniv orailv . The recommended doc
tor i\ mmi ng. tnree times daily for 10 days. If nee. *eaond course mav be given immediately
ig nrM. Chiklren snouid he given
70-ntka -er J.i\ in rn.ree divided doses lor >i
Tmicio .inn >ide Effects. Side elfects are mud
>'-u;ncr.. - .noxi commons reported: vomiting.
*rwi,l,s
;a: •iiiicaii.-. »ccur occasionailv
>t t
»«le. .
■ administered with an appropn-
There is controversy about
‘cac’’ vvhen used aione in the treatment of
4rncnKisis with tranK dysentery. While good
neen reported from some areas, other
••KT wV reCn less
SuchaK el al..
’ mot et ttl In trials carried out pnO”axvmpiomatic -.uoiects passing trophozo°r on patients with nondysentenc.
. ,,c iniestinai amebiasis, treatment with
*uroa.lc ^suited in a high percentage of
^run anu Beil, i960: Wolfe. 1973). In ail
[to*
UrU? 'V,IS 'Ael* tolerated. The relatively
bbfeuk?1 lh,s vompounu is also an advantage.
fe
v ,n unueraeve:oped countries.
IXF- \nd dehydroemetine
an aikaioid obtained from ipecac
' d is .uxo prepared semisv nthetilaiion .ji cephaeline, anomer aikafhc j\e oi this compound .is a
direct-acting systerr
1912.
when Veader showeu mat me drug Killed amebae
in rum. Since then, emetine has been one of the
most widely used agents in the treatment of severe
invasr-e intestinal amebiasis, amebic hepatitis.
and ameoic abscesses. Dehydroemetme is a close
structural analog of emetine that has similar phar
macological propenies. but it is considered to be
less toxic. Both drugs are being replaced by mixed
amebictaes of the nitroimida~ole class, which are
as effective but far safer 'see beiowj. Thus, emetine
..no uenydroemetine snould not be used unless the
nitroirr.-.cazoles are ineffective or contraindicated.
Disadvantages of these alkaloids are as follows:
li Bom compounds require parenteral administra
tion b*. •'uocutaneous or Jeep intramuscular injec
tion: ocai reactions ranging from pain to abscess
formation are not uncommon «2j Particularly after
prolonged administration, both agents may pro
duce "%'temic toxic reactions, some ot which can
be ‘enou.s or fatal: adverse elfects primarily invoh e tne neart and cardiovascular s\ stem, the neu
romuscular system, tne central nervous system.
ano me gastrointestinal tract.«?) Almougn their use
can occasionally be .ifesavmg because of direct
ameotcidai action, neither compound can be used
aione :or curative purposes. >4i Patients receiving
either -gent require close medicai supervision.
<51 Use •?! either urue is contraindicated in patients
who ..re pregnant <»r in those who nave cardiac.
renai. or neuromuscular disease.
Details of the pnarmacoiogy .md toxicology of
emetine ..nd dehyuroemeune are presented in < ar•ter ■ it;’.<ni\ oi this textnooK 'w .;.v<> Yang and
Dunicx.
Harries. 19X2?. i'he dosage tor
denvuroemeiinc in adults is 1 to i.? me kg per dav
*o a maximal daiiv dose ol QO mg. IT.is regimen is
continued lor up to 5 da\s. I'he daiiv nediatnc dose
is me --me. except mat one naif ot it is given every
12 hours. Emetine nvurocnlonde is available as an
miection *6? mg.mu: dehydroemetme is available
from ne Parasitic Diseases Division. Centers for
Disease Control.
.S-HVDROXYQUINOLINES
3 numoer of halogenated X-hv drpxyqumoiines
have -'eefT synthesized and utilized clinically as
hjnfin’ai ame'tTCTUes. particularly to treat asymptTTma(ic" passers at cysts, oucn direct-actTng
amepictdai agents have also been used in_combinaiion'w 11h metronidazbie to treat intestinal torms ot
.itnecwis: Indffiiuuioi diiDaohyaroxyniiini and
. iititJiii/iui (iodocnlornydrox\aiHn-i—are—die—best
known of this class of compounds^They have been
w ide:-.'anii'airtoo often indiscriminately employed
for"'he'TfeaTmiTnrTir diarrnea. The use ot these
drugs, particularly at high doses tor long peno_ds. is
unfor:unately associated with_sign111cant nsk. The
(aosrnripUrraTTTloxic reaction, wmeh has been ascnreu~nnmanly to clioqumoi. is subacute tnyelo-~
<>Ptu neunuuiihy <SMON>. This disease is a myeli
tis-.ike silness that was first described in epidemic
lorm 'tnousands of afflicted patients) in Japan : only
sporadic cases have been reported elsewhere, but
the ..c'.ual prevalence is unknown. While SMON in
Tha Rational Use of Drugs in the Management of
Acute Diarrhoea in Children, WHO, 1990.
Hydroxyquinolines
ANNEXURE E
Abstract
Halo^eDate44^ydTOXYquioolines are widely used for the routine-treai- ,
merit of diarrhoea, a disorderfoF which they have~not been shown '
to~be-effective:"Osed alo~ne, theyare ineffective in the treatment of |
symptomatic amoebiasis. Severe neurological disorders such as cofib neuritisahd subacutemyeio-opticneuropathy have been associates '
with thefruse~Considenng their lackof efficacy and the availability
bHess toxic. more~effective amoebicides, the use of halogenates
hydroxygumolines in acute diarrhoea cannot be justified and there
-re-thus- no rationale tor their "production and~~saiei
1.
Formulations
Halogenated hydroxyquinolines have been advocated for the treatment
or intestinal amoebiasis in manv pharmacopoeias; however, they are cur
rently widely promoted and used for all types of diarrhoea. A number
or different products are available on the market, the most popular of which
are clioquinol (iodochlorhydroxvquinoline) and iodoquinol (diiodohydroxyqumoline); also available are broxyquinoline (dibromohydroxyquinoline,1
and chlorquinaldol (dichloromethylhydroxyquinoline) (2). These are
marketed under various trade names, either as individual agents or, more
commonly, combined with a wide variety of vitamins, antibiotics, or other
agents (2, 3). Clioquinol is also commonly marketed as an antibacterial/
antifungal agent in dermatological preparations (4).
2.
Pharmacology
Systemic absorption of the hvdroxyquinolines was originally thought
to be minimal, but it is now evident that they are absorbed in substantial
quantities (5). Though most of the drug is excreted in the faeces, up to
25% of an oral dose is conjugated in the liver and can be recovered in
the urine (6, 7). A green chelate of clioquinol and ferric iron found on
the tongue and in the urine of patients taking clioquinol is further evidence
of systemic absorption (4).
3.
Mechanism of action
The mechanism of action oi the hydroxyquinolines is unknown (5).
They are active against both motile and cyst forms of amoeba and have
Consolidated list of products whose consumption
and/or
sale
have
been
banned,
severely
withdrawn,
restricted or not approved by Governments (19 87) .
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
. ANN2XURE
Proouct rum* : CUOCWNOL (SEE ALSO OXYQUINOUNE DSUVATTVES)
number : 130-ZB-7
Scientific and common name*, and synonym* :
CMN0F0RM
OLDROIOCOQUW
ICOOCHLORKTTOOXTQUIN
IOOOXYQUIMXM
7-IOOO-5-CHLOROXINE
Legislative or regulative action :
Country Effective
Description of action tafcan/grounds for decision
date
JPN
1170
TX MINISTRY OF HEATH ANO WELFARE PROMCTTF. THE MU Of QIDOWNOC ANO B*OXTOVTWOIINL ANN PREPARATIONS
CONTAINING THEM. FOUUWTNG REPORTS THAT CDOCtHNOl MIGHT BI MM OF TME CAUSES Of SUBACUTE MTEL0-0PT1C
«UROP ATXT (3 MOK). (REFERENCE: UWPABJ KTIU ST CIRfCTDA GENERAL Of PHARMACEUTICAL AFFAIRS BUREAU . 717 . . 0>
SEP. 11701
non
JAM. ism
WITMOftAWW FROM THE MAMET.
swf
JUNE ISM
WITHDRAWN BT TME MANUFACTURER AFTER MUTUAL 315CUSSI0K3 DUE TO NEUNOLOGICM ADVERSE REACTIONS. fT RE MAW
OR THE MAMET FOR EXTERNAL USE.
- dor
ISM
cm
ism;
PRODUCTS NAVE BEER WITMMAWW FROM THE MARCH. OttFEAERCE: (UGLAAXD UQSUttfT FOR LAE UR .140 .1111 . 1 R7*>
su
June ira
BANNED AS A SINGLE INGREDIENT OR IM COMBINATION DUf TO ITS IMPLICATION IM SUB-ACUTE MTEID-OPTIC MfUBOPATMT.
PMl
a vc.
im
THIS DRUG. USED TO TREAT INFECTIOUS OIARRMA *AS BEER WITHDRAWN FROM TME DOMESTIC MARCH DUf TO MPORTS Of
NEUROLOGICAL DISORDERS tSMOM WITH ITS USE II -APIA.
ITA
ISS3
WITHDRAWN FROM THE MARUT.
wn
IMS
AH PREPARATIONS CONTAINING THIS SUBSTANCE XAfE SEEN BANNED.
OOM
FEB. IMS
PROHIBITED FOR USE AND/OR SALE AFTER AUTNORmtS WfM INFORMED Of TNf MANUFACTURER'S INTENT TO GAAOUAUT
REPLACE THIS INGREDIENT IN AU PREPARATIONS CUNNKTIT MAMEHD WORLDWIDE.
Zwf
FEB. IM3
USE OF CLIOOUINOL IS PROHIBITED BECAUSE OF ITS PROPENSITY TO CAUSE NEUROLOGICAL DISORDERS. (REFERENCE: ttWDCO
DRUGS CONTROL COUNCIL . NEWS BULLETIN . .1 .IUD
OORATIOR OF THE ATMENT ANO DOSAGE ARE RESTRICTED DUE TO THE POTENTIAL MAZARO Of SMON.
PREPARATIONS Of CLIOOUINOL FOR INTERNAL Utt MAT OUT BE IMPORTED OR EXPORTED ON A IICENQ ISSUE! BT TME
DIRECTOR Of MEDICAL SERVKIS. (REFERENCE: UMBSB HATUTORT IRSTRNMENT NO. . 1B4-IIT . . DEC. IBM)
HO
21 OCT. IMS
TME IMPORTATION. MANUf ACTVRE ANO SUE Of PNOOBCTS CONTAINING CU00D1N0L HAVE BEEN PROMBITED MAVMG ttCARO
TO TME DRUG'S POTENTIAL TO CAUSE 3M0R.
cm
ORM PREPARATIONS OF CLIOQUtWOL MAX BEER SUBJECTED TO PRE SOU PIT OG CONTROL ARB TME APPROVED IWKAT10RS
RESTRICTED TO INTESTINAL AMOEBIASIS A NR OUJUMOEA CAUSED BT SENSITm ORGANISMS FOUOWWG CAUS Of
SUB-ACVTE MTELO-OmC NEUROPATWT (SAAOM IN SWTHERLAKL
CUI
USE RESTRICTED TO TREATMENT Of PARASITIC IWECDONS.
ow
PREPARATIONS CONTAINING CLIOQUtNOI INTENOU FOR INTERNU USE MAX BEEN PtAQD UNDER PRESOUPT1DR CONTROL
BECAUSE Of A PNOPfRSITT TO CAUSE NEUROLOUCAL WONDERS.
ESP
THE MINISTRY Of HEALTH ANO CONSUMER PROTECTOR NAS WITHDRAWN APPROVAL FOR CLIOOUINOL-
FRA
CLIOQUINOt MAS BEEN PLACED UNDER SCMEDUU A Of TME POISONOUS SUBSTANCES REGULATIONS.
<0
PREPARATIONS CONTAINING CLIOOUINOL MAX BEEN WCIMORAWN FROM TME MARAET.
—(Continued)
29
Second Issue, 1986
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
Product n«Tw : CLIOQUINOL (SEE ALSO OXYQUINOLINE DERIVATIVES) -.(Continued)
C.A.S rxxnoer : 130-26-7
Legislative or regulative action :
Country
Description of action taken/grounds for decision
Effective
date
SAU
following reports
of sueAcrn myeld-optic neuropathy <smo*o in patients treated with this drug. the drug
committee has prohibited rrs import. PRomtmoR or domehic use amj withdrawal from the market are under
CONSIDERATION.
SUBJECT TO RESTRICTED USE AMO/OR SALE.
VEN
WHO COMMENT: CLIOQUINOl HAS BEEN SHOWN TO BE NEUROTOXIC IN ANIMAL EXPERIMENTS. FT HAS ALSO BEEN IMPLICATED
as a cause of subacute myelo-optic neuropathy csmohj in japan, elsewhere relatively few such CASES NAVE BEEN
DOCUMENTED. CLIOOUINOl WAS SUBSEQUENTLY WITHDRAWN FROM USE IN SOME COUNTRIES AND PLACED UNDER PRESCRIPTION
CONTROL IN MANY OTHERS. IT WAS PHASED OUT WORLDWTOf BY THE MAJOR MANUFACTURER BETWEEN 11X3 AND ISIS ON
GROUNDS OF OBSOLESCENCE. NO ADEQUATELY CONTROLLED EVIDENCE WAS EVER GENERATED THAT CLIOQUINOL IS EFFECTIVE IN
BACTERIAL AND VIRAL DIARRHOEA. HOWEVER PRODUCTS CONTAINING QIOOUtML AND RELATED WTDROXYOUIHOLIMES
CONTINUE TO BE USED IM SOME TROPICAL ANO SUBTROPICAL COUNTRIES WHERE AMOEBIASIS REMAINS AN ENDEMIC PROBLEM
AMD WHERE THE RELATIVELY LOW COST OF THESE PRODUCTS IS AN IMPORTANT CONSIDERATION. (REFERENCE: (WH00I) WHO
DRUG INFORMATION BULLETIN 4 .9 .19771; (REFERENCE: (WHODU WHO DRUG INFORMATION BULLETIN .1.9. 19781
Product name : CLOFIBRATE
C.A.S numoe : 637-07-0
Scientific and common names, and synonyms :
ETHYL alOte-U-CHLOROPHENOXYHsiphs-METHYLPROPIONATE
ETHYL CLOFIBRATE
ETHYL 2-<d-CHL0R0PHEN0XY)IS0BUTYRATE
PROPANOIC ACIO.2-lp-CHLOROPHENOXY)-2-METHYL. ETHYL ESTER
Legislative or regulative action :
Country
Description of action taken/grounds for decision
Effective
date
OK
ISM
INDICATIONS FOR USE WAVE BEEN RESTRICTED.
IS*
IBM
WITHDRAWN FROM THE MARKET FOLLOWING REPORTS Of INCREASED MORTALITY ASSOCIATED WITH USE
NO*
MM
WITHDRAWN FROM THE MARKET FOLLOWING REPORTS OF INCREASED MORTALITY ASSOCIATED WITH USE.
PK
MSO
SEVERELY RESTRICTED IN USE TO CERTAIN PATIENTS ONLY. THIS COMPOUND HAS BEEN SHOWN TO CAUSE HEPATIC TUMOURS
IN RODENTS. THERE IS AN INCREASED RISX OF MALIGNANCY AND CHOLELITHIASIS WITH USE IN HUMANS. A WARNING
STATEMENT IS REQUIRED TO BE PLACED ON THE LABELS OF All PRODUCTS.
HA
1981
CURRENTLY MARKETED IN ITALY WIYH LIMITED THERAPEUTIC INDICATIONS (CERTAIN HYPERPROTEINfMIAS WITH AS CERT A 1*0
DIAGNOSES: DIABETIC EXUDATIVE RETINOPATHY; XANTHOMES).
JAN. 1981
USED ONLY IN CASES OF SEVERE HYPERLIPOPROTEINEMIA DUE TO INCREASED MORTALITY CONNECTED WITH LONG-TERM
TREATMENT.
BGG
UNDER THE PROVISIONS Of THE ORUGSCONTROU ORDINANCE. THIS DRUG HAS BEEN BANNED SINCE IT INCREASES THE
INCIDENCE Of GALLSTONES AND CHOLECYSTITIS. DRUG- INDUCED CARDIAC ARRHYTHMIAS, CAROIOMEGALY. ANGINA.
CLAD01CATI0N ANO THROMBOEMBOLIC PHENOMENA. IT ALSO ENHANCES THE EFFECTS ANO TOXICITY Of OTHER ACIDIC DRUGS
ANO IT IS IMPLICATED IN THE INCIDENCE OF VARIOUS TUMOURS. (REFERENCE: (BGDCO) THE DRUGS (CONTROL) ORDINANCE . . .
1882)
CM
INDICATIONS ARE RESTRICTED TO TREATMENT OF PATIENTS WITH KYPERLIPfOAEMM REFRACTORY TO DIETARY MEASURES.
INDICATIONS ARE RESTRICTED TO TREATMENT Of PATIENTS WITH HIGH PLASMA LIPID LEVELS. RESISTANT TO DISTANT
CONTROL. (REFERENCE: (BMOflJ BOUTIN MORMATfVO SOME MEDICAMENTOS . 1(11 , . I9IW
-.(Continued)
Second Issue, 1986
30
GOODMAN and GILMAN'S the pharmacological Basis
Therapeutics, Seventh Edition., (1985)
Pyrazolon Derivatives
net result may be increased
or toxic effects of the displaced
ding upon the drug and its disposition
displaced. The well-documented inot bleeding associated with concurrent
medication involves such
but phenylbutazone also modifies
jf the oral anticoagulant agent and intluiet junction. The gastrointestinal effects
gfrrnvibutazone also contribute to the hazard.
TLr--rmrni of plasma protein-bound thyroid
The
complicates me interpretation of thyroid
I butazone may cause induction of hepatic
enzymes, -nd it may also inhibit inactic3£a ot utner drugs mat are hydroxylated by the
>tem. It has been said to increase the
!•
:n>uun.
Effects. Phenylbutazone is poorly tolertry num patients. Some type of side effect is
ta io io a5% of patients, and medication may
u> be discontinued in 10 to 15%. Nausea.
E
~ epigastric ciscomfon. and skin rashes
VjB* At moM trequently reported untoward effects.
!
n. • ertigo. insomnia, euphoria, nervousbemaiuna (enhanced by concomitant adminbttaaoa oi ..n anticoagulant), and blurred vision
f•ven observed. In addition, water ano
v 4lKtm>te retention ana euema formation occur.
r
Mere -crams terms of adverse effects include
p
JKcr <»r n> reactivation) with hemorrnage
- « Mrrh'r.iiton .i\per<ensitivity reactions of the
e
:\pe. -iterative stomatitis, hcpatit
•rrtuntix .piaxuc ..nemia. leukopenia, agranu.nu mromnocytopenta. .A numaer.__ >i
— wnu -.■specially from tipiaspc
una ..^ranuiat ' lasts.
bhcnvlnuiazone is given, the patient
vlosciv supervised and his blood should
ircuuentiv: weight should also be
to warn ol unuue retention of sodium. The
tAoukl onlv be given for short periods mot
I week). Even then, the incidence of diselects is unout 10%. The patient must
■^■B*»diKonunue me drug and promptly report
J~Tucuin 11 he Develops fever, sore throat or
*tltJC5lons‘ sk,n rash- Pruritus, jaundice.
MCW
or tarn.' stools. The drug is contra®pauents xith hypertension: cardiac.
dystunciI°n: or a history of peptic
^5K2Ttt CrdrUR
'CnS,t,v,lv
to lhe drue- The loxic efarC Tl0re severe in elderly perUSC ,n ln,s group IS inadvisable.
Route
of
.Administration,
and
^T^!^taZOne ,AZ°L1D. BUTAZOL1DIN)
ms 2oaied tablets and capsules
l'°n- Daily doses
W ‘o
Kihun/T005 provide maximal therapeu-
691
Therapeutic Uses. Phenylbutazone is used for
the therapy of acute xout and for the treatment of
rheumatoid arthritis and allied disorders. Acute
exacerbations of these conditions respond particu
larly well to the drug, and its use should be re
served for such episodes. Phenylbutazone should
beemployed only after other urugs have failed and.
ftrerTonty after caretui consideration of the risks
involved as compared with the advantage to the
patient, indiscriminate use ot phenylbutazone_in
the therapy of trivial acute or chronic muscuioskeleiai disorders can only be condemned.
S only lncrease toxicity), but
(*»doxex ,?,meauenlly be adequately conIm ‘° ‘!tl° mB per day. The drug
fc
h neals to lessen gastric imtak
1
\
Phenylbutazone is an enective alternative to col--—■
chicine in acute aout. Excellent relief can be at
tained with a brier course of medication, and about
85 to 95% of acute attacks are controlled within 24
to 36 hours. Phenylbutazone causes fewer gastrointestmal side effects than does colchicine and is
more reliable when initiation of medication has
been delayed. Dosage recommendations have var
ied: 800 mg daily for 2 days: 800 mg the first day.
followed by 300 mg daily for 3 days: or an initial
dose ot 400 mg. followed by 100 mg every 4 hours
until articular inflammation subsides. The relative
ments and dangers of phenylbutazone, compared
with colchicine, have been discussed by Yu < 1974).
The drug should not be used propnyiactically nor
as a uricosuric agent.
Phenylbutazone has a limited role in the therapy
oi rheumatoid arthritis, primarily for rciief of acute
exacerbations of the disorder that are not relieved
b\ other measures. Synovitis is often reuuced bv a
briet regimen (600 mg on the first day. followed by
4(io mg daily for 3 days). Because ot the hign inci
dence of adverse effects, long-term theraps is not
recommended. Brief courses of the drug,
uisiiiied. may be of similar benefit for acute exacerba
tions of ankslustne s ponds-lilts and nstcoaruintis.
Oxyphenbutazone
Oxyphenoutazone is a p-hydroxy unaiog of phen
ylbutazone <on the N-l phenyl group) and one of
the active metabolites of the parent drug. Vanous
aspects of its pharmacology and metaooiism are
discussed above, m comparison with pnenylbutazone. Oxyphenbutazone has the same spectrum of
activity, therapeutic uses, interactions, and toxic
ity as the parent compound, and it shares the same
indications, dangers, and contraindications for clin
ical use. Oxyphenbutazone is said to cause some
what less gasinc irritation.
Oxyphenoutazone (oxalid. tandearil) is mar
keted in 100-mg tablets. It should be taken in three
or four divided portions after meals to lessen gastnc irritation. Dosage of oxyphenoutazone is lhe
■^ame as that of phenylbutazone.
■I
>ruv
1
I
[
/
Antipyrine and Aminopyrine
Antipyrine <phenazone> and aminopyrine i ami
dopyrine) were introduced into medicine in lhe late
nineteenth century as antipyretics and subse
quently were also widely used as analgesics and
anti-inflammatory agents. However, clinical use of
aminopynne was sharply curtailed after its notenti-
MARTINDALE
The Extra Pharmacopoeia,
Thirteenth
(1994)
Parsalmide/Phenylbutazone
ANNEXURE h
orations used in treating acute otitis mwu. It i.s presuma
bly included in such preparations because it is believed to
have a local anti-mriammatorv and therefore analgesic ac
tion. It would, however, seem unhkeiy mat phenazone
cry <otublc in
membrane and therefore on the pain wmx is due prima
rily to the stretching and distention of me membrane.—
m iirnghf containers.
,^^-nnoCoffcmum Cirsram: Micrenm.
usually containing pncnazonc 90%.
1987: 294: 1333.
CAS — 1034)3-7
Proprietary Names
Aurone. Dentigoa N. Eu-Med mono. Oio-Pben. Spondvlon N.
f^aanxic Salicylate zsw-rn.
Ballotyl. Blepnamide. Brcezeazv. Brulcx. Cxfeemed N. CorNeo-Nervacit-S. Cosavil. Covancainc. Crema Antisolar Eva
nesce. Doppci-Spak N. Efisalin N. Emocicaires. Epistaxol EuMed SC. Felsol. Felsol Neo. Furacin-Otalcscum. H E.C.. Hemostanco Antiscp Asen. Hyaiurectal. Ilvico. Koefazon. Memai-
Salicylate: Sltoynx
xd.trse Effects and Precautions
■^n-uone is liable to g:'t nse to skin eruptions _nu
Occigclures. Oftalmo. Otalcan Onoax Otiwc. Oiocama. Oiocaina Hidrocort. Otodolor. Olo-Flextoie. 3:o-Phen Forte.
Oioseaol. Otosmo. Oiotnncinol. Ovules
• -ua»c me activity of ..'■er enzvmes.
Phenazopyridirie Hydrochloride
n ihe skin
I’henazone was considered to oe unsare in oa-
*pnon and Fate
virtually completely aosoroed from ihc uas"MeMmaJ tract and is d-stn outed tnrougnout the bods
Lc»\ man 10% is bound to Diasma proteins and u
fufi-lile ot about ;2 -ours. Phenazone is metaoover to 3 maxr metabolites 3-hydroxymctnyi•J-hydroxypner.azone. and norphenazone.
-hvoroxvmetnvipnenazone. and giucuronidatsmall porrruv be eliminated via me bile.
4nd Administration
one nas analgesic aca antipyretic properties and
given by mourn: pnenazone and canetne citrate
—.->ave simnariv oecn given
■*' analgesics.
?Oiu,,on$ c°niaminE 5% ot pnenazone have
ncally as ear crops in disorders such as acute
tor the eriect oi other drugs
: on me activity of drug-mc-
,e$,,nE- Review oi normal plasma-pnena■ """KoMnetKs.
er. hcpann
Phenylbutazone
Phenvlbuyazone is a non-steroidal anti-inflammaverse effects include auranuincytosis ana apliisti
2t>
Phenazopyndine Hydrochloride tBA\M
Chloridratode Fenazopmdina: NC-I50:
?-Phenyiazopyndine-2.t>-diyldiamine n\urc»:.“.;onde.
in rnenaceun.
ilercic reactions to pnenaone patient .eucooema wuj
Proprietary Names
Multi-ingredient preparations. Polvpinne.
Phenylbutazone tBAi\'
i
Bucaciione: Fenilbutazona. Phenylbutazonum
Buts I-1.2-diohenvipyrazoiidine-35-dionc.
C.uHs0NsOs= 308.4
1 fTrcts on the blood. Pr.enazone nad been snown to
ucmoiyiic anaemia- n certain individuals wun a
liucose-t'-enosonate denvaroeenase.—
nu rnenuzone
Phenicarbazide has analgesic properties. It has been given
by mouth.
and limit i|
u. Large doses oy mourn may cause nausea.
.oma. and torts visions.
<ome other arues
limited ctihicai information on pncnazonc
Phenicarbazide i2689-wi
Phenvlsemicarbazide. 1 -Phcnvisemicarbazidc.
CtHoN?O= 151.2.
nnr and Caffeine Citrate <2683-b»
■ 'uouric
item odour.
Soluble ! m ?(X) ot cold water. . n 2U c: roiling
? in 59 ot aiconot. i in .ml »H cmoroiorr:. -nd I in l(Xt
•»l glycerot: itn siighth soiubie :n cmer. More in ainignt
containers.
PhenazoDvriumc
tnoved irom labric by soaking in a
'Odium
Jitnionite 11.25%
Adverse Effects
Phenazopyndinc nvdrocnlondc has caused castro-mtestinai
'lue-ettects. ncadacnc. and rashes. Abnormalities in liver
function. naemolvtic anaemia. mcmacmoEiooinacmia. and
acute renal failure nave also been reported. generally as
sociated wun overdosage or wim tnerapeuuc coses in pa
tients with impaired renal Junction. Cr-stai deposits ol
pncnazoDyndine nave termed in me unnan tract.
Abnormal coloration or body tissues or haius mas occur
Staining ot contact lenses has occurred.
Effects on the CNS. Aseptic meningitis, .r-iractensed bv
distinct episodes of fever and contusion, .r. a paueni was
associated with ihc administration ol pncruzoovridtne. —
\frJ 19X7. 106: 11
Precautions
Phenazopyndinc hvorochloride is conira-mctcaied in pa•icnts with impaired renal function. Phenazcoxnuine may
interfere with urinalysis cased un colour reactions or
spectrometry.
Absorption and Fate
Phenazooyndme hydrocnlonde is absorbed from me gas
tro-intestinal tract. It is excreted maims
me urine: up
:o n5% may be excreted as uncnanccd pnenazopsndine.
Uses and Administration
Phenazopyndinc exerts an analgesic erica on me mucosa
oi the urinary iract and is useu to provide -smpiomaitc
relief ot pain and irritability in conditions »ucn as cystitis.
prostatitis, and urethritis. it is gi'jn by mourn in usual
doses ot 2(Xlmg tnrcc times daiiv after icou. If given in
comunution with an antibacterial agent ’-yr me treatment
M urinarv-iract infections it is recommended mat phenazmu .iiiminisirauoii the urine i* imucu i
wrote or ott-whue. ououricss or almost odourless, cry
Uiline oowocr. B P. solubilities are. practicaiis :n>oiubi
•n water, sparingly soluble in aiconot. soluble : in
2
ot cniorotorm and I in 15 ot ether: 'Oiuble in auucoi
solutions ot alkali nsdroxiucs. L S.P solubilities are ’.er
• igntly -oiuble m water: :reeiy soluble tn ..etone -.n
.-:ner: soluble in alconol More tn ainient containers ?r<
me: rrom ugnt.
Adverse Effects
Nausea, vomiting. epigastric distress, diarrhoea
.'enema due to san retention, skin rashes, • eniuo.
neaaacnc. ana olurrea vision mav occur. More se
rious reactions include gastric irritation with ulcer
ation and gasiro-intesitnai bleeding, uiccrame
'tomatitis. hepatitis, jaundice, haematuna. nepnn*.:s. renal failure, pancreatitis, ocular toxicity, and
goitre. Phenylbutazone max precipitate heart laiiare and may also cause an acute pulmonary syn
drome wuh dvspnoea and fever. Salivary gland
enlargement, hypersensitn in reactions, ano severe
generalised reactions including erythema muiti:orme i Stevens-Johnson svndromei. toxic •epider
mal necrolysis, and exfoliative dermatitis nave
been reported.
The most serious adverse effects of phenylbuta
zone are related to bone-marrow depression ano
include agranulocytosis ano apiasuc anaemia. Leu
copenia. pancytopenia, haemolytic anaemia, ano
thromoocytopema may also occur. These adverse
haematological reactions nave resulted in the indi
cations lor use oi pnenx ibutazonc being restricted
in recent years (see under me uses and administra
tion section, belowt. Blood disorders may develop
soon after starting treatment or may occur sudden
ly alter prolonged treatment and regular haemato
logical monitoring should be carried out as
discussed under Precautions.
Effects un the blood. Both pnenylbutazone ’’; and oxyphcnDutazone••• , arc well known tor their adverse effects
on the blood and especially tor fatal agranulocytosis and
aplastic anaemia. Some indication of the extent of this
toxicity can be obtained from the records of me l.'K
Committee on Safety of Medicines** wnich snowed mat
between I MM jnd I9K2 it had received repons ot 4<X
.learns due to none marrow damage associated with these
. ..
.
-
Consolidated list of products whoso consumption
: '■ and/or sale have been banned/ withdrawn/ severely
restricted or not approved by Governments (1987)
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS!
ANNEXURE I
Product name :
C-A.S rxjmocr :
PHEN I ERMINE
122-09—8
Scientific and common nemes, and synonyms :
Motw^ipha- OIMETHYLPHENETHYLAMINE
Legislative or regulative action :
Country
SM
Effective
date
Description of action tokon/grounds for decision
JAH. 1 SSI
PHEKTERMIKE CDWTAIKIKG APPETITE SUPPRESSANTS HAVE SEEK WITHDRAWN FROM THE MARKET, THERE IS A LACK OF
EVIDENCE OF THEIR VALUE IN LONG-TERM MAJ7AGEMEWT OF CSESm. THET HAVE THE POTENTIAL FOR ABUSE AMD DESPITE
WARMINGS THEY ARE FREQUENTLY USED OVER UNACCEPTABLY PROLONGED PERIODS.
uus
MAA. 198Z
UNDER THE PHARMACY AND POISONS (PROHIBITIONS OF HARRIS. DRUGS) REGULATIONS. PHENTERMINE IS DEEMED "HARMFUL"
BY THE MINISTRY OF HEALTH AMD IS PROHIBITED FOR IMPORT MANUFACTURE. STORAGE. DISTRIBUTION. SALE. POSSESSION.
USE. EXPORT OR OTHER TRANSACTION.
PHENTERMINE IS MOT APPROVED FOR USE ANO/OR SALE.
VtN
WWY COMMENT; PHENTERMINE IS CONTROLLED UNDER SCHEDULE IV OF THE
1971
CONVENTION
ON PSYCHOTROPIC
SUES’l XES. (REFERENCE-. (URCPS) UNITED NATIONS CONVENTIOfl ON PSYCHOTROPIC SUBSTANCES . . .1971)
Product name :
C-A-S numoer :
PHENYLBUTAZONE
50—33 — 9
Scientific and common names, and synonyms :
4-3UTYL-L2-0IPHENYL-3.5-PYRAZ0UDINE0I0NE
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
DM
FEB. 1983
INDICATIONS ARE RESTRICTED TO ACUTE 1NFLAMMAY0RY EXACERBATIONS OF RHEUMATIC DISEASE ANO ACUTE ATTACKS OF
GOUT. PHENYLBUTAZONE MAT BE USED AS AN URICOSURIC PREPARATION. BUT DOSAGE ANO DURATION OF APPLICATION ARE
RESTRICTED.
ARE
1984
BY DECISION OF THE MINISTER OF HEALTH. PHENYLBUTAZONE ANO OXYPHENBUTAZONE WILL BE WITHDRAWN FROM USE WITH
IMMEDIATE EFFECT HAVING REGARD TO THEIR POTENTIAL TO CAUSE SERIOUS ADVERSE REACTIONS.
wue
1984
INDICATIONS ARE RESTRICTED TO ANKYLOSING SPONDYLITIS ANO RELATED DISEASES. ACUTE GOUT ATTACKS. ACUTE
EXACERBATIONS OF RHEUMATOID ARTHRITIS ANO INFLAMED OSTEOARTHRITIS. THE DURATION OF TREATMENT IS RESTRICTED
TO 14 DAYS. (REFERENCE: (BNIPH) BULLETIN OF THE NATIONAL INSTITUTE OF PHARMACY . 34/6 . 186-7
1984)
WIRL
!984
APPROVED INDICATIONS FOR PHENYLBUTAZONE ANO OXYPHENBUTAZONE REVISED: NOW RESTRICTED TO CASES OF ACUTE
GOUT. ANKYLOSING SPONDYLITIS. ANO CHRONIC ARTHRITIS IN PATIENTS UNSUITED TO ALTERNATIVE THERAPY. TREATMENT OF
ACUTE GOUT SHOULD NOT EXTENO BEYONO 7-10 DAYS ANO THE LOWEST EFFECTIVE DOSE SHOULD BE USED. TREATED
ARTHRITIC PATIENTS SHOULD REMAIN UNDER REGULAR SURVEILLANCE ANO SPECIALIST SUPERVISION. DOCTORS ARE ADVISED
NOT TO PRESCRIBE THESE DRUGS FOR CHILDREN OR PREGNANT WOMEN ANO TO REDUCE THE DOSE IN ELDERLY PATIENTS.
CERTAIN CONTRAINDICATIONS
INCLUDE PREVIOUS OR EXISTING Gl DISEASE. BLOOD DTSCRASIAS. HEPATIC OR RENAL
DYSFUNCTION. CARDIAC OR PULMONARY INSUFFICIENCY. THYROID OR SALIVARY GLAND DISORDERS OR HYPERSENSITIVITY.
COMBINATION PRODUCTS WITH OTHER ACTIVE INGREDIENTS HAVE BEEN WITHDRAWN FROM USE.
^rue
.
1984
TUR
FEB. 1984
BRI
25 JURE 1984
INJECTABLE AMO TOPICAL PREPARATIONS ARE PROHIBITED. TABLETS ANO SUPPOSITORIES ARE RESTRICTED TO THE
TREATMENT OF ANKYLOSING SPONDYLITIS ANO GOUT.
USE FOR MORE THAN SEVEN DAYS IS PROHIBITED HAVING REGARD TO SERIOUS ADVERSE REACTIONS.
INDICATIONS FOR PHENYLBUTAZONE ARE LIMITED TO ACTIVE AMYLOSING SPONDYLITIS. GOUT ANO PSEUDO-GOUT. IT MAY
ALSO BE USED TD TREAT ACUTE EXACERBATIONS (ft RHEUMATOID ARTHRITIS ANO OSTEOARTHRITIS AND ACUTE
NON-ARTICULAR RHEUMATOID DISEASE UNRESPONSIVE YD OTHER NON-STEROIDAL ANTIINFLAMMATORY DRUGS.
...(Continued)
Second Issue, 1986
82
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
Product n*tw : PHENYLBUTAZONE —(Continued)
C_AS number : 50-33-9
Legilllttre or regulitive ectlon :
Country
yZM
Effective
date
Description of setion teken/groundi for decision
JULY 1984
APPROVED 1 MOI CAT! 0*3 ARE RESTRICTED TO ANKYLOSING SPONDYLITIS. THE DURATION OF THERAPY SHOULD NOT EXCffU
SEVEN OATS. LABELLING MUST CONTAIN A WARNING THAT ADVERSE HAEMATOLOGICAL EFFECTS MAY OCCUR AM THAT THE
BLOOD COURT SHOULD BE MONITORED BEFORE ANO DURING THERAPY. TOPICAL PRODUCTS HAVE BEEN WITHDRAWN. REFERENCE:
(ZWOCO DRUGS CONTROL COUNCIL . MEWS BIXLET1M . . , AUG. 1985)
/ ESP
IB JOLT 1984
APPROVED INDICATIONS
HAVE
BEEN RESTRICTED TO
CONDITIONS, ACTIVE ANKYLOSING
INFLAMMATORY ARTHRITIC
SPONDYLITIS AMO OTHER INFLAMMATORY SPONDYLOPATHIES. ACUTE ATTACKS OF GOUT AMD PSEUDO-GOUT. ACUTE
EXACERBATIONS OF RHEUMATOID ARTHRITIS AMO OTHER P0LYARTHR1TIC CONDITIONS. PARENTERAL PREPARATIONS HAVE
BEEN RESTRICTED TO HOSPITAL USE ONLY.
01 AUG. 1984
J DR
01 OCT. 1384
INDICATIONS FOR PHENYLBUTAZONE HAVE BEEN RESTRICTED TO ANKYLOSING SPONDYLITIS.
REGISTRATION OF ALL PHARMACEUTICAL PRODUCTS CONTAINING PHENYLBUTAZONE HAS BEEN WITHDRAWN. (REFERENCE
(JORMHI MINISTRY OF HEALTH RESOLUTION NO. . 4/2/1659 , , APR. 19841
BGO
MOY. 1984
AUS
1985
BLD
01 JAM. >985
USE HAS BEEN BANNED DUE TO REPORTED SEVERE ADVERSE REACTIONS.
INDICATIONS ARE RESTRICTED TO ACTIVE ANKYLOSING SPONDYLITIS . ACUTE GOUTY ARTHRITIS. ACTIVE RHEUMATOID
ARTHRITIS AKO ACUTE ATTACKS OF OSTEOARTHRITIS IN PATIENTS IN WHOM OTHER THERAPEUTIC MEASURES. INCLUDING
OTHER MON-STEROIDAL AND-INFLAMMATORT DRUGS. HAVE BEEN TRIED ANO FOUND UNSATISFACTORY.
PARENTERAL DOSAGE FORMS ANO COMBINATION PRODUCTS CONTAINING PHENYLBUTAZONE HAVE BEEN WITHDRAWN FROM TM
MARKET. THE APPROVED INDICATIONS HAYE BEEN RESTRICTED TO THE TREATMENT OF SP0N0YL0ARTHRIT1S UNRESPONSIVE TO
OTHER NON-STEROIDAL ANTIINFLAMMATORY AGENTS. (REFERENCE: (NETJANI NEDERLANOS TIJDSCHRIFT VOOR GENEE5KUN0E .
128 .50 . IS84)
SWt
FEB. 1985
INDICATIONS FOR USE HAVE BEEN RESTRICTED TO ACUTE GOUT ANO MORBUS BECHTEREW ON THE GROUWS OF SERIOUS
BLOOD OTSCRASIAS ASSOCIATED WITH ITS USE.
MIL
APR. 1985
OkM
22 SEP. >985
INDICATIONS FOR PHENYLBUTAZONE HAVE BEEN RESTRICTED.
PHENYLBUTAZONE IS AVAILABLE IN SMALL QUANTITIES ONLY IM GOVERNMENT HOSPITALS FOR THE TREATMENT OF PATIENTS
UNRESPONSIVE TO OTHER THERAPY. (REFERENCE: (0MAMHI MINISTRY OF HEALTH DECISION NO. . 3
Atrr
z
. 1 986)
INDICATIONS ARE RESTRICTED TO EXACERBATIONS OF GOUT AMO OTHER ARTHRITIC CONDITIONS. TREATMENT SHOULD MOT
EXCEED SEVEN OATS ANO DOCTORS ARE ADVISED NOT TO PRESCRIBE THIS DRUG TO CHILDREN UNDER 14 TEARS OF AGE OR
ELDERLY PATIENTS. (REFERENCE: (WIMAM) W1CXT1GE MITTEILUNG UEBER ARZNEIMITTEL . . 1 . 19841
DHL
THE MAXIMUM RECOMMENDED PERIOD OF TREATMENT HAS BEEN REDUCED TO SEVEN OATS. USE IS CONTRAINDICATED IN
CHILDREN UNDER 14 YEARS OF AGE ANO PRODUCTS INTENDED FOR PEDIATRIC USE HAVE BEEN WITHDRAW*. COMBINATION
PRODUCTS CONTAINING PHENYLBUTAZONE HAYE BEEN WITHDRAWN.
. CTP
ALL COMBINATION PRODUCTS WITHDRAWN FROM THE MARKET DUE TO THE POTENTIAL TO CAUSE SERIOUS ADVERSE
REACTIONS. THE INDICATIONS FOR MONOCOMPONENT PRODUCTS HAVE BEEN RESTRICTED TO ANKYLOSING SPOMDYLITIS.
DEO
"/
INDICATIONS HAVE BEEN RESTRICTED TO EXACERBATIONS OF RHEUMATISM ANO ACUTE GOUT. DURATION OF ORAL
TREATMENT SHOULD ROT EXCEED ONE WEfl. PARENTERAL PREPARATIONS ARE INDICATED ONLY FOR INITIATING THERAPY. A
SINGLE
INJECTION
ONLY
IS
RECOMMENDED
BECAUSE
LOCAL TISSUE
DAMAGE
MAY
OCCUR.
PREPARAT10XS
ARE
CONTRAINDICATED IN CHILDREN UNDER 14 YEARS OF AGE.
APPROVED INDICATIONS ARE RESTRICTED TO ANKYLOSING SPONDYLITIS. USE IS RESTRICTED TO HOSPITALS.
ISR
THE PHARMACEUTICAL ADMINISTRATION OF THE MINISTRY OF HEALTH HAS NOTIFIED THE WORLD HEALTH ORGANIZATION Of
ITS INTENTION TO WITHDRAW FROM USE ALL PREPARATIONS CONTAINING OXYPHENBUTAZONE AND TO RESTRICT THE
APPROVED INDICATION FOR PREPARATIONS CONTAINING PHENYLBUTAZONE TO ANKYLOSING SPONDYLITIS.
—(Continued)
83
Second Issue, 1986
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
Procuct name :
PHENYLBUTAZONE ...(Continued)
C.A.S number :
50“33~9
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
(TA
INDICATIONS HAVE BEEN RESTRICTED TO ACUTE PHASE Of ANXYLOSIKG SPONDYLITIS. ACUTE GOUT AKO ACUTE PHASE OF
PELV1SP02DTLITIS AND PSORIATIC POLYARTHRITIS. USE SHOULD CKLY BE CONSIDERED WHEN ALTERNATIVE TREATMENT IS
INEFFECTIVE OR INAPPROPRIATE. HO COURSE OF TREATKEKT SHOULD EXCEED SEVEN TO TEH DATS.
J?*
INDICATIONS ARE RESTRICTED TO ACUTE EXACERBATIONS Of RHEUMATOID ARTHRITIS. ANKYLOSING SPONDYLITIS AND ACUTE
GOUT. DOCTORS ARE ADVISED TO PRESCRIBE THESE DRUGS ONLY TO ADULTS ANO FOR PERIODS OF NO LONGER THAN ONE
WEEK.
PK.
PHENYLBUTAZONE RECOMMENDED FOR USE ONLY WHEN OTHER AGENTS FAIL DUE TO RISK Of TOXICITY.
WHO COMMENT: PHENYLBUTAZONE AND OXYPHENBUTAZOM - PTRAZOLDWf ANTIINFLAMMATORY AGENTS WHICH ALSO HAYE
ANALGESIC AND ANTIPYRETIC ACTIVITY - HAVE EACH BEEN ASSOCIATED WITH SERIOUS AND SOMETIMES FATAL ADVERSE
REACTIONS. NOTABLY CASES
OF
APLASTIC ANAEMIA ANO AGRANULOCYTOSIS.
MANY NATIONAL
DRUG REGULATORY
AUTHORITIES CONSIDER THAT MORE RECENTLY INTRODUCED DRUGS OFFER A SAFER ALTERNATIVE FOR MOST. IF NOT ALL.
PATIENTS REQUIRING ANTIINFLAMMATORY AGENTS. OXYPHENBUTAZOME HAS THUS BEEN WIDELY WITHDRAWN ANO
PHENYLBUTAZONE HAS BEEN EITHER WITHDRAWN OR RETAINED WITH RIGOROUSLY RESTRICTED INDICATIONS FOR PATIENTS
UNRESPONSIVE TO OTHER THERAPY.
Proauct name :
PHTHALYLSULFATHIAZOLE
C-A.S numoer :
85—73—4
Scientific end common names, and synonyms :
6*-(THIAZOLYLAMINOSULFAMOYL)PHTHALAN!C ACID
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
BCD
UNDER THE PROVISIONS OF THE DRUGS(CONTROL) ORDINANCE. THIS PRODUCT HAS BEEN BANNED. IT HAS BEEN FOUND TO BE
OF LITTLE OR NO THERAPEUTIC VALUE ITS SIDE EFFECTS CAN BE HARMFUL. AND IT IS SUBJECT TO MISUSE. (REFERENCE:
(BGDCO) THE DRUGS (CONTROU ORDINANCE . . . 1982)
WHO COMMENT: THIS COMPOUND SLOWLY RELEASES THE SULFONAMIDE SULU KIAZOlE IN THE LARGE INTESTINE. IT IS STILL
WIDELY USED IN MANY COUNTRIES IN THE TREATMENT AND PREVENTION Of BACILLARY DYSENTERY AND BEFORE AND AFTER
SURGERY ON THE LARGE INTESTINE: IN MANY OTHER COUNTRIES IT HAS BEEN SUPERSEDED BY MORE RECENTLY INTRODUCED
ANTIBIOTICS.
Proauct name :
C.A.S number :
PIPAMAZINE
84-04-8
Scientific and common names, and synonyms :
1D-(3-(4-CARBAMOYLPIPERIDINE)PROPYL)-2-CHLOROPHENOTHIAZINE
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
USA
JULY 1981
WITHDRAWN FROM THE MARKET AND PROHIBITED FOR EXPORT BY THE FOOD AND DRUG ADMINISTRATION DUE TO THE LACK
OF PROOF OF EFFICACY ANO SAFETY FOR USE AS AN ANT1NAUSEANT ANO ANTIEMETIC FOR PREGNANT WOMEN.
WHO COMMENT: PIPAMAZINE. WHICH HAS GENERAL PROPERTIES SIMILAR TO THOSE OF CHLORPROMAZINE. REMAINS
AVAILABLE IN SOME COUNTRIES AS AN ANTIEMETIC AND AXTINAUSEAMT.
Second I ssue, 1986
84
■ ■ Consolidated list o£ products whose consumption
and/or
sale
have
been
banned,
withdrawn,
restricted or not approved by Governments.
severely-
(1987)
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
Product n*no : MORETHISTERON3 ENANTATE (INJECTABLE) -(Continued)
(LAS nemos- : 383S-23-5
Legislative or reguiativQ actic-a :
Country
Effective
date
Dcseri^tioci; of sstiorc tofeen/greunda for decision
1B53
DfO
TK US Cf IHJECTACLE STEZ0U3 PREFACATKN3S Fas CONTRACEPTIVE PURPOSES HAS deed re5ducted TO USE ST WOMEN
WITH A EXTeiAl KH-3TC3AL CYCLE V)7xJ DO KOT TOLERATE OTHER FOSfctS OF CD£ITRA££PTIO£L PANTICDIA1 STRESS LS LAW
l/Ptri THE It^OSTAECE C? EXCLDOIKG PRK&AJCCT BEFORE TREATMENT 1$ STARTED. AKO USE DURING LACTATION IS ALSO
CD3TRAESXATED. owwa AEWRSE EFFECTS, IKOUDIRG laeustrual distuwbawes AKO headaches , mwt BE DESCMSED IN
DETAIL CH THE LAC-ELL1KC. THE REGULATORY STATE64E0T TAXES NOTE OF THE FACT THAT ELSEWHERE. AND PASTTUJLARLT
WITHIN K¥ao?irs COUNTRIES, THESE DRUGS ARE USED WIDELY FDR CONTRACEPTIVE PURPOSES. THE FEDERAL HEALTH OFFICE.
HOWEVES. DOES KOT UK2SID8J THAT SUCH A POU CT IS JUSTIFIABLE UNDER CONDITIONS OBTAINING IN THE FEDERAL REPUBLIC
OF GERLWn.
WHO Ga&iEHT: INJECTABLE PREPARATIONS OF MOTETHISTERONE ENANTATE ARE REGISTERED IN MANY COUNTRIES.
RISI-BEEfFTT JUDGEMENT DIFFERS SIGNIFICANTLY FROM COUNTRY TO COUNTRY HAVING REGARD TO DIFFERING NATIONAL
CIRCUMSTANCES. (REFERENCE: fWKOOl) WHO DRUG INFORMATION BULLETIN .2.7, 1984) ; (REFERENCE OWOOO WHO DRUG
information bulletin .3.7. 1984)
Proauct name :
OPIUM IN ANTTTUSSIVE PREPARATIONS
CJLS rsjrrroer :
8008-60—4
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
BCD
JUNE 1982
ITA
BANNED IN TINCTURE ANO SPIRIT FORM DUE TO ITS LIABILITY FOR ADDICTION AND MISUSE.
THIS SUBSTANCE FOR USE AS AN ANT1TUSSIVE HAS BEEN REMOVED FROM THE MARKET OWING TO AN UNFAVOURABLE
RISK-BENEFIT RATIO ANO LACK Of SUBSTANTIAL EVIDENCE OF EFFICACY. WHO COMMENT: OPIUM IS CONTROLLED UNDER SCHEDULE 1 OF THE 1981 SINGLE CONVENTION ON NARCOTIC DRUGS.
(REFERENCE: (UNSNO) UNITED NATIONS SINGLE CONVENTION ON NARCOTIC DRUGS . . . 1972)
Prooucl name :
QA.S numoer :
OXYPHENBUTAZONE
129-20-4
Scientific and common names, and synonyms :
BUTANOVA
HYD80XYPHENYLBUTAZM
OXAZOLIDIN
4-BUTYL-1 -<p-HYDROXYPHENYL) - 2 - PHENYL-3.5-PYRAZOLIDINEDIONE
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
ARE
1184
BY DECISION Of THE MINISTER OF HEALTH. PHENYLBUTAZONE ANO OXTPHENBUTAZONE WILL BE WITHDRAW* FROM USE WITH
IMMEDIATE EFFECT HAVING REGARD TO THEIR POTENTIAL TO CAUSE SERIOUS ADVERSE REACTIONS.
CT?
1984
WTTHD*AKN FROM THE MARKET DUE TO THE POTENTIAL TO CAUSE SERIOUS ADVERSE REACTIONS. EXEMPT!® APPLIES FOR
PRODUCTS INTENDED FOR LOCAL OPHTHALMIC USE.
FIB
1984
ORAL AND RECTAL PREPARATIONS HAVE BEEN WITHDRAWN FROM THE MARKET.
—(Continued)
71
Second Issue. 1986
lS"
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
Product nam« :
OXYPHENBUTAZONE -(Contimiod)
(LA.S nuro« :
129- 20-4
Legialatrve or ro^ulat+re action :
Country
Effective
Description of action taken/grounds for decision
date
1184
IM.
APPROVED INDICATIONS FOR PHENYLBUTAZONE ANO 0XYPHEN8UTAZONE REVISED: NOW RESTRICTED TO CASES Of ACUTE
COOT. ANKYLOSING SPONDYLITIS. ANO CHRONIC ARTHRITIS IN PATIENTS UNS U [TED TO ALTERNATIVE THERAPY. TREATMENT Of
ACUTE GOUT SHOULD NOT EXTEND BEYOND 7-10 DATS ANO THE LOWEST EFFECTIVE DOSE SHOULD BE USED. TREATED
ARTHRITIC PATIENTS SHOULD REMAIN UNDER REGULAR SURVEILLANCE AW) SPECIALIST SUPERVISION. DOCTORS ARE ADVISED
NOT TO PRESCRIBE THESE DRUGS FOR CHILDREN OR PREGNANT WOMEK ANO TO REDUCE THE DOSE IN ELDERLY PATIENTS.
CERTAIN CONTRAINDICATIONS INCLUDE PREVIOUS OR EXISTING Cl DISEASE. BLOOD OYSCRASIAS. HEPATIC OR RENAL
DYSFUNCTION. CARDIAC OR PULMONARY INSUFFICIENCY. THYROID OR SALIVARY GLAND DISORDERS OR HYPERSENSITIVITY.
COMBINATION PRODUCTS WITH OTHER ACTIVE INGREDIENTS HAVE BEEN WITHDRAWN FROM USE.
ALL PREPARATIONS OF OXYPHENBUTAZONE HAVE BEEN BANNED FOR USE.
TUN
1984
JOR
10 JAN. 1984
REGISTRATION OF ALL PHARMACEUTICAL PRODUCTS CONTAINING OXT’HENBUTAZONE HAS BEEN WITHDRAWN. (REFERENCE:
UORMH) MINISTRY OF HEALTH RESOLUTION NO. . 4/2/1559 . . APR. 1914)
BRB
25 JUNE 1984
NOTATIONS FOR OXYPHENBUTAZONE ARE LIMITED TO ACTIVE ANKYLOSING SPONDYLITIS. GOUT ANO PSEUDO-GOUT. IT MAT
ALSO BE USEO TO TREAT ACUTE EXACERBATIONS OF RHEUMATOID ARTHRITIS ANO OSTEOARTHRITIS ANO ACUTE
ZWE
JULY 1984
ROM-ARTICULAR RHEUMATOID DISEASE UNRESPONSIVE TO OTHER NON-STEROIDAL ANTIINFLAMMATORY DRUGS.
THE DRUGS CONTROL COUNCIL REQUESTED MANUFACTURERS TO WITHDRAW PREPARATIONS CONTAINING OXYPHENBUTAZOWE
FROM THE MARKET ANO TO EXHAUST STOCKS BY JUNE 1985. (REFERENCE: (ZWOCQ DRUGS CONTROL COUNCIL . NEWS BULLETIN
. AUG. 1985)
15 JULY 1984
ESP
RESTRICTED TO INFLAMMATORY ARTHRITIC CONDITIONS.
APPROVED
INDICATIONS
HAVE
SPONDYLITIS
ANO OTHER
INFLAMMATORY
BEEN
SPONDYLOPATHIES
ACUTE
ATTACKS OF
ACTIVE
ANKYLOSING
GOUT ANO PSEUDO-GOUT. ACUTE
EXACERBATIONS OF RHEUMATOID ARTHRITIS ANO OTHER POLYARTHRITIS CONDITIONS. PARENTERAL PREPARATIONS HAVE
BEEN RESTRICTED TO HOSPITAL USE ONLY.
BCD
NOV. 1984
NLD
01 JAN. 1985
USE HAS BEEN BANNED DUE TO REPORTED SEVERE ADVERSE REACTIONS.
’ARENTERAl DOSAGE FORMS AND COMBINATION PRODUCTS CONTAINING OXYPHENBUTAZONE HAVE BEEN WITHDRAWN FROM
-HE MARKET. THE APPROVED INDICATIONS HAVE BEEN RESTRICTED TO THE TREATMENT OF SPONOYLOARTHRIT1S
IRRESPONSIVE TO OTHER NON-STEROIDAL ANTIINFLAMMATORY AGENTS. (REFERENCE: (NETJAN) NEOERLANOS TIJOSCHRIFT
VOOR GENEESKUMOE . 128(50) .
1984)
swe
01 JAN. 1985
NZL
APR. 1985
OMN
1986
WITHDRAWN FROM THE MARKET AFTER JOINT DISCUSSIONS BETWEEN THE NATIONAL BOARD OF HEALTH ANO WELFARE ANO
THE IMPORTER ON THE GROUNDS OF SERIOUS BLOOD OYSCRASIAS ASSOCIATED WITH ITS USE.
VOLUNTARILY WITHDRAWN
jXYPHENBUTAZDNE
FOB INTERNAL USE (TABLETS. INJECTIONS SYRUPS AMO SUPPOSITORIES) SHOULD NEITHER BE IMPORTED
OR MARKETED AFTER THE STOCK IN THE LOCAL MARKET HAS BEEN USEO. (REFERENCE: (0MAMM) MINISTRY OF HEALTH DECISION
NO. . 3 . . 1985)
0) MAR. 1986
TUR
aut
y-
H4E MINISTRY OF HEALTH HAS PROHIBITED THE MANUFACTURE ANO SALE OF PREPARATIONS CONTAINING OXYPHENBUTAZOKE
FOR ORAL. RECTAL ANO TOPICAL USE.
INDICATIONS ARE RESTRICTED TO EXACERBATIONS OF GOUT ANO OTHER ARTHRITIC CONDITIONS. TREATMENT SHOULD NOT
EXCEED SEVEN OATS AND DOCTORS ARE ADVISED NOT TO PRESCRIBE THIS DRUG TO CHILDREN UNOER 14 TEARS OF AGE OR
ELDERLY PATIENTS. (REFERENCE: (WIMAM) WICHTIGE MITTEILUNG UEBER ARZNEIMITTEL
1
1984)
CHI
.fr
THE MAXIMUM RECOMMENDED PERIOD OF TREATMENT HAS BEEN REDUCED TO SEVEN DAYS. USE IS CONTRAINDICATED IN
CHILDREN UNDER 14 YEARS OF AGE ANO PRODUCTS INTENDED FOR PEDIATRIC USE HAVE BEEN WITHDRAWN, COMBINATION
PRODUCTS CONTAINING OXYPHENBUTAZONE HAVE BEEN WITHDRAWN. 'REFERENCE: (BMCHL) BOLETIN INFORMATIVE) S08RE
MEDICAMENTOS . 1(2) . . 1984)
COC
MJECTABLE PREPARATIONS HAVE
BEEN WITHDRAWN FROM THE MARKET. ORAL PREPARATIONS HAVE
INDICATIONS
RESTRICTED TO THE TREATMENT OF ANKYLOSING SPONDYLITIS GOUT ANO PERIARTICULAR RHEUMATISM.
...(Continued!
Second Issue, 1986
72
PHARMACEUTICALS (MONOCOMPONENT PRODUCTS)
Product name : OXYPHENBUTAZONE -(Continued)
CA.S numder : 129-20-4
Legialative or regulative action :
Country
Effective
date
description of setion taken/grounda for decision
DEU
INDICATIONS ARE RESTRICTED TO SEVERE EXACERBATIONS OF RHEUMATISM AKO ACUTE GOUT. DURATION Of ORAL
TiEAnerr should not exceed one week. parenhral preparations are indicated only for initiating tnfrapt. a
SINGLE
INJECTION
ONLY
IS
RECOMMENDED
DECAUSE
LOCAL
TISSUE
DAMAGE
MAY
OCCUR.
PREPARATIONS
A*
CDXTR A INDICATED IM CHILDREN UNDER 14 TEARS OF AGE.
CM
ALL PRODUCT LI CENGS FOR PREPARATIONS CONTAINING OXTPHE NBUTAZONE HAVE BEEN REVOXED WITH THE EXCEPTION Of
THOSE FOR EYE OINTMENTS.
HUM
INDICATIONS ARE RESTRICTED TO ANKYLOSING SPONDYLITIS AND RELATED DISEASES. ACUTE GOUT ATTACKS. AOTTE
EXACERBATIONS OF RHEUMATOID ARTHRITIS ANO INFLAMED OSTEOARTHRITIS. THE DURATION OF TREATMENT IS RESTRICTS
TO 14 OATS.THERE IS ONLY ONE REGISTERED PREPARATION CONTAINING 0XTPHEN8UTAZ0NE. ITS DISPENSING IS RfSTRJCTH
TO INDIVIDUAL CASES AUTHORIZED BY THE MINISTRY OF HEALTH AT SPECIAL REQUEST.
ISA
THE PHARMACEUTICAL ADMINISTRATION OF THE MINISTRY OF HEALTH HAS NOTIFIED THE WORLD HEALTH ORGANIZATION Of
ITS INTENTION TO WITHDRAW FROM USE ALL PREPARATIONS CONTAINING OXYPHENBUTAZDXf ANO TO RESTRICT TM
APPROVED INDICATION FOR PREPARATIONS CONTAINING PHENYLBUTAZONE TO ANXTLOSING SPONDYLITIS.
JPN
INDICATIONS ARE RESTRICTED TO ACUTE EXACERBATIONS OF RHEUMATOID ARTHRITIS ANO OSTEOARTHRITIS. DOCTORS
Mt
ADVISED TO PRESCRIBE THIS DRUG ONLY TO ADULTS AND FOR PERIODS OF NO LONGER THAN ONE WEEK.
WHO COMMENT: PHENYLBUTAZONE ANO OXYPHENBUTAZONE - PYRAZOLONE ANTIINFLAMMATORY AGENTS WHICH ALSO RAVE
ANALGESIC AND ANTIPYRETIC ACTIVITY - HAVE EACH BEEN ASSOCIATED WITH SERIOUS AND SOMETIMES FATAL AXWQSE
REACTIONS. NOTABLY CASES OF
APLASTIC
ANAEMIA AND
AGRAMULOCTTOSIS.
MANY NATIONAL DRUG REGSLATDBT
AUTHORITIES CONSIDER THAT MORE RECENTLY INTRODUCED DRUGS OFFER A SAFER ALTERNATIVE FOR MOST. IF NOT AU.
PATIENTS REQUIRING ANTIINFLAMMATORY AGENTS. OXTPHEN8UTAZ0NE HAS THUS BEEN WIDELY WITHDRAWN. AM
PHENYLBUTAZONE HAS BEEN EITHER WITHDRAWN OR RETAINED WITH RIGOROUSLY RESTRICTED INDICATIONS FOR PATIENTS
UNRESPONSIVE TO OTHER THERAPY.
Product name :
C.A.S numoer :
OXYPHENISAT1NE ACETATE
115-33-3
Scientific and common names, and synonyms :
ACETOPHENOLISATIN
BISATIN
OIACETCXYDIPHENYLISATIN
OIACETYLDIPHENOLISATIN
0IASAT1N
01PHESATIN
ISAPHENIN
,
OXYPHENISATIN OIACETATE
PHENLAXIN
Legislative or regulative action :
Country
Effective
Description of action taken/grounds for decision
date
CUB
IS70
AUS
1972
BANNED FOR USE FOLLOWING REPORTS OF HEPATOTOXICITY.
THE DEPARTMENT OF HEALTH OF THE COMMONWEALTH WITHDREW FROM THE MARKET AU PREPARATIONS COMTAHBflC
OXTPHENISATINE ACETATE (OIACETOXTDIPHENOLISATIN) AND TRIACETTLOIPHENOLISATIN. THIS RECOMMENDATION WAS BASH
ON AN INCREASING NUMBER OF REPORTS. INCLUDING ONE FATALITY. IMPLICATING THESE COMPOUNDS AS A CAUSE Of AOYTE
ANO CHRONIC LIVER DISEASE.
JPN
l?72
BANNED BY PHARMACEUTICAL AFFAIRS BUREAU IN OVER-THE-COUNTER DRUGS. DUE TO HEPATIC DAMAGE (E.G. JINWWCD
OBSERVED WITH LONG-TERM USE.
—(Continued
73
Second Issue, 1986
WHO, Tech"teal Report Series .722,
Main list
Routo ol adminisltniton,
dosage lorms, nnd strengths
Complomontary
list
(1985) .
__________ "
Complomontary
list
Main list
18.5 Insulins nnd other antidiabetic agents
Insulin injocllon (soluble)
17.6 Diarrhoea, Drugs used In (continued)
17 6 2 Replacement solution
intermediate acting insulin
oral rehydration salts
(lor glucose-salt solution)
g/litre
35
29
1 5
20 0
glibenclamide
^clomifene (c) (2, 8)
fludrocortisone (c)
tablet, 0 1 mg (acetate)
18.2 Androgens
Injection, 200 mg (enanlalo)
In 1-ml ampoule
injection, 25 mg (propionate)
in 1-ml ampoule
testosterone (2)
•
18.3 Contraceptives
norethislerono
’■
levothyroxine
potassium Iodide
* 'propyllhlouiiit.il
tablet, 0.05 mg, 0.1 mg (sodium salt)
tablet, 60 mg
tablet, 50 mg
19. Immunologicals
19.1 Diagnostic agents
tuberculin, purified protein
derivative (PPD)
19.2 Sera and Immunoglobulins
anti-D immunoglobulin (human)
tablet, 0 03 mg 4 0.15 mg.
0 05 mg + 0.25 mg .
tablet, 0 05 mg + 10 mg
antivenom sera
anliscorpion sera
diphtheria antitoxin
immunoglobulin. human
normal (2)
tetanus antitoxin
tablet. 0 05 mg
tetanus antitoxin (human)
'When lhe strength Is specified In terms ol a selected salt or ester, this is mentioned in brackets:
Il rotors to tho active mololy, tiro nntno ol Iho salt or oslor In brackets is preceded by the word ‘ ns'
*Mny bo replaced by sodium blcaibonnln (sodium hydrogen cnrlioiinlo), ? 5 g/lllro, whan citrato nail is
not avartnbla
tablet, 5 mg
18.8 Thyroid hormones and antithyroid drugs
antirabies hyperimmune serum
depot medroxyinjection, 150 mg in 3-rnl vials
prqgesterone
acetate (a) (7, 8)
* Norethislerono (»)
tablet, 0 35 my
norethislerone
injection. 200 mg in vial
enanlate (a) (7. 8)
26
tablet, 50 mg (citrate)
18.7 Progestogens
18. Hormones
18.4 Estrogens
^ethlnylestradlol
Injuclhin, 40 lU/ml In 10 ml vial.
80 lU/ml in 10-ml vial
Injection, 40 lU/ml In 10-ml vial.
80 lU/ml In 10-ml vial
(as compound insulin zinc
suspension or Isophane Insulin)
tablet, 5 mg
18.6 Ovulation Inducers
18.1 Adrenal hormones and synthetic substitutes
1 ^dexamethasone
tablet; 0.5 mg. 4 mg
Injection, 4 rng (sodium phosphate) in
1-ml ampoule
hydrocortisone
powder tor Injection. 10 mg (ns
sodium succinate) In vial
^prednisolone
tablet. 5 mg
r,elhjnylestradiol +
1 ’levonorgestrel
nelhjnyleslradiol 1
' ’norelhlslerone
♦
J^NNEXURE J
18. Hormones (continued)
17. Gastrointestinal Drugs (continued)
sodium chloride
Irisodium citrate dihydrale 6
potassium chloride
glucose
Routo ol administration,
dosage lorms. and strongtl
Injection
Injection.
0 25 mg/ml
injection,
1000 IU
In 5-ml
ampoule
injection
Injection
Injection.
10 000 IU.
20 000 IU.
Injection
All plasma fractions
should comply with the
WHO Requirements Im
Iho Collodion. Processing.
Human Blood and Blood
Products 6
Injection.
50 000 IU.
In vial
Injection,
500 IU
in vial
"When Ilia Strength Is specified In leu ns ol a solnclcd salt or oslnr
wlnni It nitnn In ll(«» m llvo inulnty. Hit) tinnier rd Iho anil or mint In hr ackala la procodcid by l7
*'WIIO iL'chnlciil Roporl Serios, Ho 620. 19/8. Annex I
27
WH technical Report Series, 722 .^985)
prescribcrs should be provided with a cross-index
nonproprietary
and proprietary names.
(3) Concise, accurate, and comprehensive drug information
should be prepared to accompany the list of essential drugs.
(4) Quality, including stability and bioavailability, should be
assured through testing or regulation, as discussed in section 5
Where national resources are not available for this type of conliol.
the suppliers should provide documentation of the product’s
compliance with the required specifications.
(5)
Local health authorities should decide the level of expertise
required to prescribe individual drugs or a group of drugs in a
therapeutic category. Consideration should be given, in particular,
to the competence of the personnel to make a cor rect diagnosis. In
some instances, while individuals with advanced training are
necessary to prescribe initial therapy, individuals with less training
could be responsible for maintenance therapy.
(6)
The success of the entire essential drugs programme is
dependent upon the efficient administration of supply, storage, and
distribution at every point from the manufacturer to the end user.
Government intervention may be necessary to ensure the availability
of some drugs in the formulations listed, and special arrangements
may need to be instituted for the storage and distribution of drugs
that have a short shelf-life or require refrigeration.
(7)
Efficient management of stocks is necessary to eliminate waste
and to ensure continuity of supplies. Procurement policy should be
based upon detailed records of turnover. In some instances, drug
utilization studies may contribute to a belter understanding of ti ne
icquiremenls.
(8)
Research, both clinical and pharmaceutical, is sometimes
required to settle the choice of a particular drug product under local
conditions. '
>
3.
CRITERIA I OR HIE SELECTION
OE ESSENTIAL DRUGS
Essential drugs arc those that satisfy the health care needs of the
majority of the population; they should therefore be available al till
times in adequate amounts and in the appropriate dosage forms.
The choice of such drugs depends on many factors, such as the
pattern of prevalent diseases; the treatment facilities; the training
8
and experience of the available personnel; the financial resources;
and genetic, demographic, ami environmental factors.
Only those drugs should be selected for which sound and
adequate data on efficacy and safety arc available from adequate
clinical studies and for which evidence of performance in general use
in a vatiely of medical settings has been obtained.
Each selected drug must be available in a form in which adequate
quality, including bioavailabilily, can be assured; its stability under
the anticipated conditions of storage and use must be established.
Where two or mote drugs appear to be apptoximalcly similar in
the above respects, the choice between them should be made on the
basis of a careful evaluation of their relative efficacy, safety, quality,
price, and availability. In cost comparisons between drugs the cost
of the total treatment, and not only the unit cost of the drug, must
be consideied. In some cases the choice may also be influenced by
other factors, such as comparative pharmacokinetic properties, or
by local considerations such as the availability of facilities for
manufacture or storage.
’s—
In the great majority of cases essential drugs should be
/
fo rmulaled as singIc~compounds, Hxcd-ralio combination products /
ate acceptable only when the dosage of each ingredient meets tlie /
requirements of a defined population group and when fife
combination provides a proven advantage over single compounds
adntihislereci~5Cprn'aTc1y itiThcrapeulic effect, safety, or compliancc. j
4.
GUIDELINES I OR THE SELECTION
OE 1’1 lARMACEU I ICAL DOSAGE EORMS
I he purpose of selecting dosttge forms and strengths for the drugs
in the model list is to provide guidance to countries wishing to
standardize or minimize the number of preparations in their own
drug lists. As a general rule, pharmaceutical forms are selected on
the basis of their general utility and their wide availability
inlet nationally. In many instances, a choice of judications is
provided. particularly in relation to solid dosage fWmW^Wets are
usually less expensive than capsules, but, while the cost factor should
be taken into account, the selection should also be based on a
consideration of pharmacokinetics, bioavailability, stability under
ambient climatic conditions, availability of excipients, and
established local preference.
9
144
CLINICAL
PHARMACOLOGY,
D.R.'aurence
NERAi.ru p.N.Bennett, Fifth Edition. (1980)
4. maximum tolerated dose is used where the ideal therapeutic ellect
cannot be achieved because of the occurrence of unwanted effects (anti
cancer drugs: some antimicrobials).
A usual way of finding tills is to increase the dose until unwanted
effects liegin to appear and then to reduce it slightly.
5.
minimum tolerated dose. This concept is not so usual as the above,
but it applies to long-term adrenocortical steroid therapy against inflam
matory or immunological conditions, c.g. in asthma or rheumatoid
arthritis the dose that provides symptomatic relief may be so high (hat
serious adverse effects are inevitable if it is continued indefinitely. The
patient must be persuaded to accept incomplete relief on grounds of safe
ty. This can be difficult to achieve.
ANNEXURE L
i
:
FIXED-RATIO DRUG COMBINATIONS
Advantages of fixed-dose drug combinations
Convenience, with improved patient compliance so that there is:
(i) Reliability and enhancement of therapeutic response, where the
drugs are synergistic, have a narrow dose range and, usually, a similar
time-course of effect: c.g. oral contraceptives; isoniazid plus I’AS; cotrimoxazole (Scptrin, Bactrim); thiazide plus reserpine; Aspirin,
Paracetamol and Codeine Tabs have sanction of time rather than of
clinical science.
(ii) minimisation of unwanted effects (a) by including antidotes: the
combination in one tablet of potassium with a thiazide diuretic lias ob
vious theoretical advantage. However, hypokalacmia is a less important
disadvantage of thiazides used as antihypertensives than when used to
produce fluid loss in oedema. In the latter case amounts of K larger than
those generally included in the combined preparation are likely to be
needed.
Combinations of oral broad spectrum antimicrobials with a fungicide
are unnecessary for routine therapy but may be useful in patients specially at risk from suprainfection (those taking immunosuppressives: the
very old).
Narcotic plus narcotic/antagonist combinations have not been shown
to be safer than the narcotic alone, and the combination of methionine
with paracetamol to reduce toxicity in overdose is an example of an in
genious idea.
■
-1
;
!
\
5
145
; same therapeutic effect but
different adverse effects so that there is synergism for therapeutic but not
for adverse effects, e g. thiazide plus reserpine: f
Codeine Tabs.
|
This section refers to combinations of drugs in a single pharmaceutical
formulation. It docs not refer to concomitant drug therapy, e g. in infec
tions and in ce.iccr, where several drugs arc given separately to obtain in
creased therapeutic effect or range, or to treat more than one disease.
Combinations should not be prescribed unless there is good reason to
consider that the patient needs all the drugs in the preparation, that the
doses are appropriate and will not need to be adjusted separately.
and
Disadvantages of fixed-dose drug combinati
I. Impracticability of providing individualised multi-drug prepara
tions because of the amount of labour and the complex pharmaceutical
technology required.
2. Dosage of one drug cannot be altered without altering that of others.
Drugs with a wide range of dosage that must be adjusted to suit the
patient’s response (adrenergic neurone blockers) are best not combined
with a drug for the same disease with a narrow dose range (thiazide,
reserpine). Adrenocortical steroids should never be combined in one
tablet with other drugs.
3. Time course of drug action often demands different intervals
between administration.
4. Irregularity of administration, c.g. in response to a symptom, pain,
cough, may be desirable for some drugs, but not for others.
5. Confusion of therapeutic aims: routine use of combinations of iron
with folic acid and cyanocobalamin arc hazardous as they may delay
diagnosis of pernicious anaemia. The fact that iron phis a little folic acid
is properly used in pregnancy for routine anaemia prophylaxis simply
confirms that combinations must be rationally thought out and adjusted
to meet particular needs.
Combinations of antimicrobial drugs may be essential for particular
situations, but they should be specially critically considered before
prescribing.
Conclusions
A great many marketed combinations are open to criticism, some are
positively desirable and some have the sanction of time alone. Oc
casionally, an advantage can be justified in theory but may be insignifi
cant in practice. Some combinations are marketed to fulfil a commercial
purpose rather than a medical need.
Before prescribing a combination the doctor should pause to consider
whether any of the ingredient a. ra_uiin££ciaaryj if it~i~sril^~comb!natlon
should not be prescribed. It can never b? justifiable to give a patient a
drug he~3oes not need in order to provide him with one that he does need?
The"fact that doctors-sometlmcs prescribe combinations in ignorance of
the cxact ingredients, which are commonly not indicated by the name,
andTrc then surprised to find the patient is taking an undesired drug '
provides a saiTcriticism of tlie iiietucal-nmfcMifllli as doei~the Tact Ih'at
some of the available combinations are prescribed at all.
GOODMAN and GILMAN'S the Pharmacological Basis
of Therapeutics, Seventh Edition.
Vitamin Bl2
loss of central vision. The patient may ex
hibit delusions, hallucinations, or even an
overt psychosis. Since the neurological
damage can be dissociated from the
changes in the hematopoietic system, espe
cially by the administration of pharmaco
logical doses^of folic acid, vitamin B1Z defi
ciency must be considered as a possibility
in elderly patients with psychosis. How
ever. it is unusual to see patients wno are
routinely followed by their physicians de
velop severe neurological complications.
The >ensitivuy of methods for evaluation of
the nematopoietic system, the ease of
measurement of the concentration of vita
min Bi: in piasma. and the awareness of the
medical profession of the causes of vitamin
Bi; deficiency have made possible an ear
lier and more accurate diagnosis of B ^-de
ficient states, early and adequate therapy.
ind hence avoidance of neurologicai com
plications.
Preparations. Dosage. and Routes of Adminis
tration. \'itarr.:n B.: is available in pure form for
axcuon or era. administration or in comoination
.»iner vitamins and minerals tor oral aaminisrjimn. I he cnoice of a preparation must aiways he
xude Mtn i .*—■ gnuion of the cause of the deh.<n<\ Wh/c .-al preparations may be used to
*-TTicmcnt ie:“:::eni diets or to prevent vitamin
Jeticienc*. n situations where there is inot4m.’U utilization, the? arc of little value m the
**aimcni ..t :■ Clients with deficiency ot intrinsic
faci.tr ,.r that ^.scM.ye. Even though small amounts
■ vitamin B.: may be apsorbed by simple diffu•o*- the oral route of administration cannot be reupon tor elective therapy m the patient with a
deficiency of B.: and abnormal hematopoii ***
neurological deficits. Therefore, the prepa.
ot choice for treatment of a vitamin B|=>J*c*ncv
:s cyanocooaiamin. and it should
Il w. OVcn hy intramuscular or deep subcutaneous
l^nion.
mjecnon (redisol. RUBRAM IN
fZ^<hcrs> ,s u ~ear aqueous solution with a charUC reQ co,or- The aqueous solution is avail[CU^C?nCen:nitions ot‘ 3()- 10°- apd 1000 ug/ml.
h°balam:n injection is extremely safe when
J lhc ,rilrarnuscu*ar or deep subcutaneous
kJ 11 ,snou|d never be given intravenously.
Ve h--r- rare reports of transitory exanMit, j a ,,na°nyiaxi.s following injection. TherethfrcijoB, Pail&n: repons a previous sensitivity to
v,Uim,n
an intradermal skin test
carnta out before the full dose is admino hi-
p,s administered in doses of f to
on ih>Ue uplake. storage, and utilization
K^Hi. De c u'Pliability of transcobalamm II Hee
cs n excess of 100 pig are rapidly
m<_
(1985)
1329
cleared from plasma into the unne ■AKTbrF’XURE
lion of larger amounts of vitamin
result in greater retention of the vitamin. Adminis
tration of 1000 ms is of value, however, in the per
formance of the Schilling test. Following oral ad
ministration of isotopically labeled vitamin B12. the
compound that is absorbed can be quantitatively
recovered in the unne if 1000 p.g of cyanocobalamin is administered intramuscularly. This unla
beled matenal saturates the transport system and
tissue binding sues, so that more than 90% of the
labeled and unlabeled vitamin is excreted dunng
the next 24 hours.
A number of multivitamin preparations are mar
keted either as nutnnonal supplements or for the
treatment of anemia. Many of these contain from 5
to 100 jxg of cyanocobalamin without or with mtnnsic factor concentrate prepared from the stomachs
of hogs or other domestic animals. Purified prepa
rations of intrinsic factor are standardized accord
ing to their anility to promote vitamin B!; absorp
tion in patients with pernicious anemia. One oral
unit of intrinsic factor is defined as that amount of
material that will bind and transport 15
of cyanocobalamin. Most multivitamin preparations sup
plemented with intrinsic iactor contain 0.5 oral unit
per tablet. While the combination ot oral vitamin
Bi2 and intrinsic factor would appear to be ideal for
patients with an intrinsic factor deficiency. \ncli
preparations are not reliable. Antibodies to human
intrinsic factor may effectively counteract absorp
tion of vitamin B<:. With prolonged therapy, some
patients develop rctractonness to oral intrinsic :actor.
pernaps related to production ot an
intralumenai antibody against the hog protein
• Ramsey and Heroert. 1965). All oral preparations
of vitamin B.; and intrinsic factor thus carry a
warning that patients must be reevaluated at 3month intervals for recurrence of pernicious
anemia.
Hydroxocobalamin given in doses of 100 pa in
tramuscularly has been reported to have a more
sustained effect than cyanocobalamin. a single
dose maintaining piasma vitamin Bj: concentra
tions in the normal range for up to 3 months. How
ever. a numcer of patients show reductions of the
concentration of Bt? in plasma within 30 days, simi
lar to that seen after cyanocobalamin. Further
more. the administration of hydroxocobalamin has
resulted in the formation of antibodies to the transcobalamin 11-vitamin Bi: complex (Skouby et al..
1971). Hydroxocobalamin (alpharedisol. others)
is thus not recommended.
N
General Principles of Therapy. Vitamin
;
B12 has an undeserved _ reputation as._a
’
health tonic and has.been used for a-numoer
i
oi diverse disease states. Effective use of
the vitamin depends on accurate diagnosis
and an understanding ot the following gen
eral principles of therapy:
1. Vitamin B|2 should be given prophylactically only when there is a reasonable
1330
Drugs Effective in Megaloblastic Anemias
indication. Dietan deficiency in the strict
vegetarian, the predictable malabsorption
of vitamin B12 in patients who have had a
gastrectomy, and certain diseases of the
small intestine constitute such indications.
When gastrointestinal function is normal.
an oral prophylactic supplement of vita
mins and minerals, including vitamin B!2.
may be indicated. Otherwise, the patient
should receive monthly injections of cyanocobalamin.
2.
The relative ease of treatment with
vitamin Bl2 should not prevent a full inves
tigation of the etiology of the disease. Usu
ally. the initial diagnosis of a deficiency
state is made from the characteristic defect
in hematopoiesis: a full understanding of
the etiology of the disease state involves
studies of dietary supply, gastrointestinal
absorption, and transport.
_
3.
Therapy should always be as specific
as posHble. While a large numoer of mtilli-
yitamin preparations are available, the use
of ' shotgun ' vitamin therapy in rne treatment of vitamin B.- deficiency ran be dan
gerous. iV/r/i such therapy. there is me dan
ger mat sufficient toiic acid will he ttiven to
result in a hematoioitical recovery: however, this may mask continued vitamin 13
deficiency, and neuroiouical damaue will
develop or propress if already present.
4.
While a classical therapeutic trial with
small amounts of vitamin B12 can help con
firm the diagnosis, the acutely ill. elderly
patient may not be able to tolerate the delay
in the correction of a severe anemia with
resultant tissue hypoxia. Such patients re
quire supplemental blood transfusions and
immediate therapy with both folic acid and
vitamin B)2 to guarantee recovery.
5. Long-term therapy with vitamin Bi2
must be evaluated at intervals of 6 to 12
months in patients who are otherwise well.
If there is an additional illness or a condi
tion that may increase the requirement for
the vitamin (e.g.. pregnancy), assessment
of treatment should be performed more fre
quently. The concentration of vitamin B12
in plasma should be monitored: peripheral
blood counts and parameters of macrocytosis must be evaluated.
Treatment of the Acutely III Patient. The thera
peutic approach depends on me seventy of the pa-
(Chap
tient's illness. The individual with an
cated pernicious anemia. in which the ahrw^*yW
is restricted to a rmic or moderate anemi/^^W
leukopenia, thrombocytopenia, or neurr^ZSO
signs or symptoms, will respond quite weh^jSB
administration of vitamin B,-. alone M
therapy may be delay ed until other causes ohZSB
loblastic anemia have peen ruled out and
studies of gastrointesunal function have beeiT^iB
formed to reveal the underlying etiology of the
ease. In this situation, a therapeutic tnal withiZi'-B
amounts of parentera vitamin Br (1 to 10 iJTLj
day; can be extreme.? valuable in confirming aa>4
presence of an uncomplicated vitamin B,. otw
ciency.
-fl
In contrast, patient-: with neurological cfu^^ B
or severe leukopenia o" thrombocytopenia
3
ated with infection or deeding require emerwwy 4
treatment. The older individual with
3
-3
-3
anemia (hematocrit less man 2OS7-I is likcls i<> nm
tissue hypoxia, cerebrovascular insufficiency —< 1
congestive heart failure. Effective therapy must m
wait for detailed diagnostic tests. Once the met* 3
blastic erythropoiesis nas been confirmed anu
T
cient blood colleciec for later measurements W J
concentrations of vitamin B.: and tohc acid te '?
patient snould receive intramuscular iniccuom <4 j
l(i(i gg of cyanocooaiamin and I to < mg ot i.fc
acid. For tne next I it 2 weeks the nauem
receive daily intramuscular imecuons oi !<»• -x rf
csanocooaiamin. toget.-.er with a daih oral surrw
men! of I to 2 mg of tc.ic acid. Since an cltcc:»*
increase in red-cell mas? will not occur lor tin. >
davs. the patient witr. _ markedly depressed iw
maiocru and tissue hypoxia should also recent •
j
transiusion of 2 to ? units of packed red ceils 4 <
congestive heart failure is present, phlebotomy •
remove an equal volume of whole blooo can be be
formed or diuretics can be administered. Diwroers
of hemostasis secondary to thrombocytopenm
should be treated with piateiet transfusion' um^t
or every other day) unta the platelet count rus »
creased, and any ongoing infection should t* <
treated aggressively wr_-. appropnate antibiooo.
However, such patients snould not receive ch**amphenicol, since this antibiotic can present re
covery of granulocytes tee Chapter 521.
The therapeutic response to vitamin Bu ■' ch»* .
actenzed by a number c: subjective and obievu*
changes (Figure 57-4). Fatients usually repo11 •
increased sense of weli-oetng within the firut*
hours alter the initiation of therapy. Objecti*™memory and orientation can show dramatic *
provement. although fu.L recovery of mental
tion may take months or. tn fact, may never cx-V*In addition, even before mere is an obvious hu<^
tological response, the patient may report
crease in strength, a better appetite, and *n
provement in the soreness of the mouth ■
tongue.
The first obiective hematological c^angeJ\
disappearance of the megaioblasuc morphok»
the bone marrow. As the ineffective erythropo^
is corrected, the concentration of iron in P“
falls dramatically as the metal is used in the '
non of hemoglobin. This usually occurs wit
810
'
EXTRINSJ
CLINICAL
PHARMACOLOGY
•R.Laurence
P.N.Bennett, Fifth Edition. (1980)
____
...minoiv
rnviuKS
UN
Mfei),3m
1’ E R NIC
AN/EMIA
In 1925 Castle performed classical experiments demonstrating
two factors were required to cure pernicious anremia. He showtjfissjSs
beef muscle and normal human gastric juice were ineffective when rfffiwSi
separately by mouth, but that when they were given together a
reticulocyte response was obtained. "Consequently it was assumed
some unknown but essential interaction between beef musde
extrinsic (food) factor and normal human gastric juice as an intrinxfcqMM&l
tor appeared to be required for the restoration of normal hematopoiaiM^HM
the patient with pernicious anemia”.’ During the succeeding
'
many successful attempts were made to isolate both the extrinsic **4mEK
trinsic factors from various sources. Soon after crystalline nwiScB
cobalamin (vitamin Bn) was isolated in 1948 it was generally
be the extrinsic factor. Intrinsic factor (secreted by the gastric mucoaa^^BHB
a glycoprotein and relatively crude preparations from animal nonaBn
have been used in the oral therapy of pernicious anamiia. InIrinsic faosA||'
acts solely as a vehicle for carrying the important extrinsic factor
' •
body, but if large oral doses of cobalamins arc given they are absorbed
dependently of intrinsic factor.
and
.AMIN), FOl.tC ACID
841
*entm. n. .......___ , ..
in the body leads to:
A megaloblastic anaemia (Addisonian, or pcrnic ANNEXURE O
Degeneration of the brain, spinal cord and peripneral nerves (subtcombined degeneration): symptoms may be psychiatric or physical.
Abnormalities of epithelial tissue, particularly of the alimentary .
(eg. sore tongue and malabsorption).
be exact mechanism of action of vitamin B,, in megaloblastosis
Au uncertain, but it is known to be a coenzyme for an essential stage
Hate metabolism and may affect folate transport into cells.
Baqrdrements of cobalamins are about 1 fig daily. Absorption takes
» mainly in the ileum. After absorption it is carried in plasma bound
proteins (transcobalamins). It is not significantly metabolized, and
rttion is via the bile (there is enterohepatic circulation) and via the
■ey. Several years’ supply are normally stored throughout the body; in
Brer and half-life is about a year. Most animals cannot synthesise
Hhmin and so are directly or indirectly dependent upon micropntms for it. Man gets most of his cobalamin from meat; organisms
the human colon synthesise it but it is not absorbed from this part of
t intestine, and if rabbits in the wild did not eat their own frcccs they
••Jd auffer from pernicious anaemia.
; Cobalamin does not occur in plants (except in legumes in which it is
by bacteria in root nodules) and dietary deficiency occurs
VITAMIN B„ (THE COBALAMINS)
fmgst people who have not enough money to buy meat as well as
T he cellular coenzyme B(1 is formed in the body from '•"Hli»iripW8gE panngst the Vegans, who are a sect of particularly uncompromising
(different forms of vitamin B,,). Hydroxocobalamin is preferred
Wfrtirians.* A rare form of dietary deficiency is due to Scandinavian fish
clinical use.
Bpeworms which live in the gut and take up all the cobalamin before the
Pure crystalline cyanocobalamin was prepared from liver
k* his a chance to absorb it.
tancously and independently in the U.S.A, and in England in 1944,
The fate of cobalamin has been studied by labelling it with radioactive
years after Minot and Murphy first demonstrated the effectiveness of
;
liver therapy in pernicious antvmia. 'The delay was mainly due to MK
•obdt.
great difficulties of assay of the vitamin. Assay of different fractions ise^^H^K
kefiot ions tor vitamin o12
viously essential during any purification procedure, and for many
Indications for administration are the prevention and cure of con
the production of a reticulocyte response in patients with pernicMMM^K, ations due to its deficiency, which commonly presents as megaloblastic
anaemia was the only method. Research has been greatly helped by
fftemii, though neurological or mental disorder (without anaemia) can
discovery that some micro-organisms (Lactobacillus casei,
gracilis) require vitamin B(] as a growth factor, and this has been usedw^^^E •rcur.
In pernicious (Addisonian) nnrernia the gastric mucosa is unable to
develop a relatively simple microbiological assay which is interfered
produce intrinsic factor and so vitamin BIZ deficiency occurs. A
if the patient is taking antimicrobials; radioimmunoassay now elimrnMn
prntigastrin-fast achlorhydria is invariably present. Despite its name, the
this inconvenience. Vitamin Bn, as prepared, was soon shown to rootiii
prognosis of a patient with uncomplicated pernicious anrcmia, properly
cobalt and n cyanide radicle and so was given the chemical
treated, is little different from that of the rest of the population. The
cyanocobalamin, which is now the official name. Its structural fonnahj^^^B irurological complications, particularly spasticity, are often permanent,
has been elucidated by crystallographic analysis. Cyanocobalamin ii
ahbough there may be considerable improvement under treatment. Total
made from cultures of streptomyccs.
f
removal of the stomach, or atrophy of the mucous membrane in a postCastle, W. B. (1953). New F.„gt. J.
2.|9, 60.1.
•Smith. A. I). M. (1962)
842
IRON, VITAMIN B,, (COBALAMIN). FOLIC ACID
gastrectomy reinnant may, after several years, lead to a similar ansmii.
Malabsorption syndromes. In cceliac disease and idiopathic
steatorrhosa vitamin BJ2 and folic acid deficiency Is common although
megaloblastic antemia occurs only relatively late.
A variety of drugs can cause malabsorption including neomycin,
colchicine, metformin, slow-release KCI and antiepileptics.
Deprivation of vitamin Bu by abnormal bowel flora occurs in tropical
sprue, multiple jejunal diverticula, bowel fistula: and blind-loop syn
drome. This can be remedied by a broad-spectrum antibiotic, eg
tetracycline.
Cyanocobulamin Ims liecn tiled empirically, sometimes in enormous
doses, without striking success, in a variety of neurological conditions. In
some types of peripheral neuritis, especially the diabetic, it has been
thought to give benefit, but controlled trials are lacking. Hydroxocobalamin is worth giving in tobacco amblyopia where it is possible
there is an clement of cyanide intoxication from the tobacco, and
cyanocobalamin may be formed.
Diagnostic use. Large doses of hydroxocobalamin may induce an in
complete response in pure folic acid deficiency, but response to a tiny
dose (2 to 4 yig) is diagnostic of cobalamin deficiency.
In addition, the Schilling lest of vitamin B12 absorption may be used
A small oral dose of radioactive vitamin B12 is given (followed by a large
flushing injected dose of non-radioactive vitamin B,2) and excretion of
radioactivity in the urine is measured. In pernicious antemia absorption
and therefore urinary excretion is negligible. If the test is repeated plus
oral intrinsic factor, and the patient has pernicious antemia, absorption
will occur and urinary excretion of radioactivity will rise.
Contraindication: undiagnosed aruemia; therapy of pernicious
anarmia must be both adequate and life-long, so that accurate diagnosis is
essential. Even a single dose interferes with diagnosis by blood picture for
weeks, although the Schilling Test remains abnormal. Inclusion of small
amounts of cyanocobalamin in oral tonics is probably harmless but im
plies an irresponsible attitude in both promoter ami prcscrilxtr. It is a bad
thing that a patient’s health should ever depend on his not absorbing his
physician's inadequate therapy.
Preparations and dosage: hydroxocobalamin is bound to plasma
protein to a greater extent than cyariocobalamin, with the result that
there is less free to be excreted in the urine after an injection so that
rather lower doses at longer intervals are adequate. This is why it is
preferred to cyanocobalamin, though the latter can give satisfactory
results (except in tobacco amblyopia).
The initial dose in cobalamin deficiency anaemias, including un
complicated pernicious anemia, is hydroxocobalamin, 250 to 1,000 /<g,
m., on alternate days for 1 to 2 weeks, then 250 /ig weekly until the
i.
blood count is normal (single large doses are mostly lost in the urine), to
induce remission and to replenish stores. Maintenance may lie 1,000 /tg
IRON, VITAMIN B„ (COBALAMIN), FOI.IC ACID
843
2-4 monthly, but some prefer higher doses for increased assurance.
Higher doses should probably be used in renal and hepatic disease (due to
defects in conversion to the active coemyme and excretion).
The initial stimulation of ha:moglobin synthesis often depletes the Iron
and jolate stores and supplements of these may be needed.
Hypokalsemia may occur at the height of the erythrocyte response in
severe cases. It is attributed to uptake of K by the rapidly increasing
erytlirocyte mass. Oral K should be given.
Failure to respond implies inaccurate diagnosis, or the presence of
other disease such ns carcinoma, hypothyroidism or chronic infection. If
neurological complications have occurred the dosage can lie doubled,
though this probably does no good, but some would give all cases
milligram doses initially as hydroxocobalamin is non-toxic.
Because of increased urinary excretion where high blood levels are
achieved, inadequate response should be treated by increased frequency
of injections as well as increased amount.
Harmoglobin estimations are necessary at least every 6 months to
check adequacy of therapy and for early detection of iron deficiency
anxmia due to carcinoma of the stomach which occurs in about 5% of
patients with pernicious anaemia.
Where injections are refused or are impracticable (rare allergy), ad
ministration as snuff or aerosol has been effective, but these routes ate
potentially less reliable. Large daily oral doses (300 /tg) are probably
preferable. Monitoring of the blood must be close.
Adverse reactions virtually do not occur, but its use as a “tonic" is
aifabuseoT a powerfaTTernecfy for it may_obscure the diagnosis of perT
nlcious anatmia which is a matt_er _of_great importance in a disease
requiring life-long therapy, and prone to serious neurological
complications—
Liver extracts contain folic acid and cyanocobalamin. The introduce
lion of pure cobalamins has made them obsolete. They were the mainstay
of therapy for pernicious anremia for about 20 years.
In pernicious anremia folic acid is incomplete therapy and must
not be used. Although it will improve the antemia it allows progression
of subacute combined degeneration of the nervous system. A patient with
pernicious anaimia who has been given folic acid is in a dangerous
situation.
There arc oral preparations containing a miscellany of substances
necessary for blood formation, including iron, folic acid, cyanocobalamin
and other vitamins, liver, stomach extracts, etc, generally in doses in
sufficient to cure antemias, but often sufficient to interfere with diagnosis.
They arc promoted to preserve the aged in health, for antemia and as
tonics.
Both their indiscriminate promotion by commercial interests and their
use by physicians in undiagnosed cases shows a disregard for patients' in
terests that is inconsiderate at best and callous at worst.
.
GOODMAN and GILMAN'S tha Pharmacological
of Therapeutics, Seventh Edition.
(1985)
J
360
Hypnotics a
Barbiturates max be used in large doses in the man
agement of acute maniacal states, delirium.-ana
certain psychoneurotic disorders, although they
are being superseded by newer agents.
The era wnen barbiturates tparttcularly pheno
barbital) were virtually the only drugs recom
mended for daytime sedation has long passed, and
they have largely been replaced by benzodiaze-_
pines and other compounds. However, phenobar- I
bital and butacaroital are Still Tvailahte-^—-secta- !.
tiVes in a nost ot "inefficacious combinations for
ttie~treatment of funcuonal gastrointestinal dis- |
orders:—Welnra)
inflammation
nvtwnmn
asthrnaranu cu.dliaiV afierv disease Thev.are-alsn
iltrWo in analgesic combinations, nossibiu-coun- ..
terproouctively" Although they may effectively
uei.lease Hyperactivity in hyperthyroidism, benzoI diazepines are preferred. The barbiturates still
u- have valid uses as sedatives to decrease restless
ness curing illnesses in children such as colic.
whooping cougn. pylorospasm. and nausea and
vomiting of functional origin, to suppress excite
ment of various aonormal origins, and to decrease
apprenension preparatory to minor medical and
jental proceoures.
^^Baroiturates are sometimes used to antagonize
^ffiwanted CNS-snmulant effects of various drugs.
such as epnednne. oextroamphetamine and theopnyliine: butabaronal and pnenoparbual are most
commonly used for such purposes. In these uses.
:ney are prooably superior to benzodiazepines.
Baroiturates are still employed for their rapid
onset of action in me emervenc' treatment of
convulsions. sucn as occur in tetanus eclampsia.
status epiiepucus. cerebral hemorrnage. and poi
soning by convuisant drugs: however. oenzouiazepines are generalb superior in these uses. Some
representative dose ranges lor intravenous aumtnistrauon are as follows: phenobaroital sodium lilt)
to 300 mg: pentooarcitai sodium. 10(1 to 500 mg:
amooarbual sodium. o5 to 500 mg: thionental so
dium 1UO to 200 mg. The imection should he made
siowiy with the usual precautions necessary for
intravenous aoministration. Phenooarbital sodium
is frequently used because of its anticonvulsant ef
ficacy: however, even wnen administered intrave
nously. 15 minutes or more may be required for it
to attain peak concentrations in the brain. Thus.
the practice of continuing to administer phenobarbitaiuntil convulsions stop results in orain concenAis that continue to rise and may eventually
v^Kd that requirec to control the seizures. The
suosequent baroituraie-inouced depression may
summate with postictal uepression. Administration
of pnenooarpnal requires restraint and patience
unui the anticonvulsant effect develops before de
ciding whether a second dose is necessary. While
the rapidity of onset of the ultrashort- and short
acting baroiturates wouid seem to have appeal.
these arugs have a low- ratio of anticonvulsant to
hypnotic action. Diazepam offers many advantages
for tne emergency treatment of certain convulsive
disoraers. particularly for status epilepticus. The
use of phenooaroital and mephobarbital in the
symptomatic therapy of epilepsy is discussed in
Chapter 20.
The barbiturates are being replaced by bazepines for preanesthetic mexiicaiion and b "V*esthesia. The ultrashort-acting agents contm *”
be employed as intravenous anesthetics iQk*
14). Short- and ultrashort-acting barbiturate*
occasionally used as adjuncts to other agents
'
production of obstetrical anesthesia. Although '**'
eral studies have failed to affirm gross depress^
of respiration in the neonate at birth, evaluating
the effects on the fetus and neonate is difficult- «■
prudent to avoid the use of barbiturates in
ties.
The barbiturates are employed as diagnostic^'
Z
therapeutic aids tn psychiatry, in narcoanalym
narcotherapy. They are used to activate latent
normalities tn the EEG. In k>w concentration
amobarbital has been administered directly into;* j
carotid artery as a means of identifying the uo^.
nant cerebral hemisphere for speech prior to near*. i
surgery.
;
Anesthetic doses of barbiturates attenuate cet» '
oral edema resulting from surgery, head injury.* i
cerebral ischemia, and they decrease infarct w*
□nd increase survival. The death rate from head*.
juries among juveniles and adults has been reported
to be reduced by 809r and 509c. respectively. Gc*.
era! anesthetics do not provide protection. The pr*.
cedure is not without senous danger, however,
tne ultimate benefit to the patient has been quo
tioned (see Marshall and Bowers. 1982: Micno
felder. 1982: Steer. 1982).
Hepatic Metabolic Uses. Because hepatic mu,uronyl transferase and the biiirubin-bmdinc 1 rntetn are increased by the barbiturates, pnenw
oarbital has been successfully used t<> tier
hvperhiliruhmeinia and keriiictcrus in the neonate
complete failure of this treatment can pronanh re
attributed to premature discontinuation ol the unu
The nondepressant barbiturate phetharbtlal <Spnenylbarbuali works equally well. Phenonartnui
may improve the hepatic transport of biliruom ■
patients with hemolytic jaundice. The effect ofpnenobarbttal on bile salt metabolism and excreti®
has been employed in the treatment of selected
cases of cholestasis.
Preparations and Dosage. Barbiturates arc mar
keted in a vast array of preparations. In the Lnite-States', phenobarbital is an ingredient in more inxr
25 proprietary remedies, which are best ignored n
favor of nonproprietary preparations. Extenueorelease forms are pointless and potentially oangcrous in view of the long half-lives among available
barbiturates, and they are disadvantageous in hyp
notic use.
The hypnotic and sedative doses of the barbitu
rates are listed in Table 17-4.
CHLORAL DERIVATIVES
The pharmacology and uses of the chloral dens’lives that are employed clinically are essentially^*
same, because they are all converted in the body14
the same active intermediate. Two such c0®-
334
SLEEP, HYPNOTICS, 9
CLINICAL
PHARMACOLOGY,
D.R.Laurence
P.N.Bennett, Fifth Edition. (1980)
can be useful in management pn
this is done a full hypnotic dose may cause rcsuessness anu mental
confusion.
'Ilicre is also evidence that barbiturates can antagonise analgesics and
this may be borne in mind wTien they are used in patients with pain.
' ~RTspiraliom K EypnoliEdose of a barbiturate in a patient with marked
respiratory insufficiency, e.g. severe pulmonary emphysema or asthma,
Will depress respiratory minute' volume and arterial oxygen saturation.
Benzodiazepines, paraldehyde and chloral are less objectionable in this
respect.
Cardiovascular function. Barbiturates lower blood pressure at hyp----notic and anaesthetic doses by reducing cardiac output, probably by
reducing venous return to the heart due to peripheral venous pooling.
Compensatory vascular reflexes are depressed.
Toxic doses may depress the myocardium and also reduce the
peripheral resistance by blocking the sympathetic nerves.
Alimentary tract. Prolonged barbiturate sedation constipates.
Tolerance. When eighteen former addicts were given 0-4 g pentobar
bitone or quinalbarbitone daily for 90 days tolerance began to develop
within 14 days. They showed significant decrease in hours of sleep, in
signs of clinical intoxication and in performance in psychomotor tests.
Tolerance probably occurs to all hypnotics, but it is less marked than
with opiates. With barbiturates and meprobamate the tolerance is at least
partly due to enzyme induction, and this can enhance adrenal steroid
metabolism enough to reduce efficiency of steroid therapy.
Emotional and physical dependence occur with regular dosage of 0 4
g/day, or more, of barbiturate. If the dose exceeds 0 6 g/day the subject
generally shows clinical signs of intoxication-—impairment of mental
ability, regression, confusion, emotional instability, nystagmus,
dysarthria, ataxia and depressed somatic reflexes.
The withdrawal syndrome begins in 8 to 36 hrs and passes off over 8 to
14 days. It comprises, in approximate order of appearance, anxiety,
twitching, intention tremor, weakness, dizziness, distorted vision, nausea.
There is now enough evidence that the traditional classification of
barbiturates as long, medium and short acting, derived from experiments
on animal anaesthesia, does not apply to their clinical use and so it should
be abandoned. However, for overdose, rates of metabolism and excretion
do have some relevance (see below). Duration of hypnotic effect is similar
for drugs previously classified into each group, being about 8 hrs. In
cidence of hangover is similar, and it is common after a placclxr, being
more closely related to the patient than to the drug.
Pharmacokinetics. Absorption after oral administration is tepid:
plasma protein binding is variable, those with longer half-lives being less
protein bound than those with shorter half-lives (surprisingly). Plasma
half-lives are the result of renal excretion and of metabolism in those used
as hypnotics and sedatives. For those used as i.v. anaesthetics (which see),
and -IVES AN-
ma half-life of initial doses.
ANNEXURE
Examples. 50-100 hrs: phenobarbitone, barbitone, allobarbitone.
20-40 hrs: pentobarbitone, quinalbarbitone,
amylobarbitone, butobni bitone, cyclobar bi
ANNEXURE
Distribution is throughout the body with rather more in the CNS
elsewhere.
Metabolism and excretion. For most barbiturates metabolism is chiclly
hepatic with a little urinary excretion and, from the point of view of safe
ty, the more rapidly metabolized barbiturates may be preferred. Those
most rapidly metabolized are quinalbarbitone, pentobarbitone and
cyclobarbitone, followed by amylobarbitone and butobarbitone. Tire
most persistent are phenobarbitone (about 25% excreted unchanged by
the kidney) and barbitone, the only member wholly excreted unchanged
by the kidney.
I he reason why there is little renal excretion of most barbiturates is
not that they do not appear in the glomerular filtrate, but because bar
biturate that appears in the glomerular filtrate, if unionised, diffuses back
into the circulation through the renal tubule. This diffusion will be less if
the drug is ionised, and, being weak organic acids, ionisation will be
maximal at a high (alkaline) pH.
Renal excretion of barbiturate can therefore be enhanced both by
making the urine alkaline to pH 8 with a sodium bicarbonate or lactate*
infusion, and by hastening the passage of glomerular filtrate through the
tubule by inducing a diuresis. This has been used successfully in the
treatment of poisoning.
Forced alkaline diuresis is useful only in the case of phenobarbitone
(see pH, pKa) (and aspirin); for other barbiturates nothing useful is
achieved by doing more than ensuring profuse urine volume. The alkaline
diuresis treatment is not itself life-saving and so is never essential. Its
benefit consists in reduction of duration of coma by up to two-thirds;
therefore the complications of prolonged unconsciousness are less; but it
needs skilful hanriling and it should not be begun until the clinical condi
tion (respiration, circulation) is under control. The same remarks apply to
dialysis. A detailed account is included here because anyone in a hospital
may find himself involved in it.
Indications for forced alkaline diuresis (F.A.D) in phenobarbitone
poisoning I: patient unrousable, hypoventilating and hypotensive, plasma
concentration above 550 /rmol/I (10 mg/100 ml) of phenobarbitone itself
(excluding metabolites).
Ill the past sodium laitale has hern p, rlei,I to sodium bientlautalr (l.ulau* is
mrlalmlired, and the sodium Is bred to lake up Im at Lunate Inn made available by dissm'iatiou nl ll,(*O,) because nf diflictdly in sterilising bicnrlxmatc by beat without
chemical change. Dm this has been overcome and sterile sodium btcarlxmale solution is
now getter ally available.
I Houlton-Jones. J. M.(I971). Preset. J. II, 146 with revisions 1978. By permission of the
author and the editor.
GOODMAN and GILMAN's the Pharmacological Basis
of Therapeutics, Seventh Edition. (1985)
I 2^
IOXS
Antimicrobial Agents
[Chun.^j
change in monality with the combination (Korapy. If spontaneous mutation were the p
zeniowski ei al.. 1982).
dominant means by which microorganis
Synergisnc antibiotic combinations have been
acquired resistance to antibiotics, combine.
recommended in the therapy of infections with
lion chemotherapy would, in theory. be
Pseudomonas m neutropenic patients. In vitro. anupseudomonal penicillins plus an aminoglycoside
effective means of prevention. For exanj.
are synergisnc against most strains of Pseud, aeru
pie. if the frequency of mutation for the
ginosa. Studies in animals support the superiority
acquisition of resistance to one drug is iq-’
of the comoination over either drug alone, and clin
and that for a second drug 10”the prob*.
ical studies suggest improved survival with the
biiity of independent mutation to resistance
combination. Despite the fact that the micro
organism is sensitive to gentamicin in vitro, admin
to both drugs m a single cell is the product
istration of gentamicin alone frequently does not
of the two frequencies. 10~13. This makes
cure the iniecnon and may even allow sustained
the emergence of such mutant resistarx
bacteremia. The addition of carbenicillin markedly
strains statistically unlikely. In practice
increases the cure rate, a phenomenon that corre
however, this method has received extenlates witn a more rapid bactericidal effect in vitro.
This success may be a reflection of the importance
sive use only in the treatment of tuberculo
of the use of antibiotics that produce bactericidal
sis. where-the concomitant use of two
effects rapidly when infection occurs in the neutro
more appropriate agents strikingly reduces
penic paueni (Klastersky and Staquet. 1982).
the development of drug resistance by me
Sulfonamides combined with tnmetnoprim are
synergisnc :n vitro and are effective against infec
tubercle bacillus.
tions caused by microorganisms that may be resis
tant to sulfonamides alone. A fixed combination of
Disadvantages of Combinations of Anhn»trimetnopnm ano sulfamethoxazole is available for
clinical use and has emerged as an effective treat- , - crobial Agents. It is important that
mem of recurrent urinary tract infections. Pneumo- j
cians understand the poiential negative rrcv\ti\ (iinmi pneumonia, typhoid lever, xmgellosis. I Tulls ~~6T the
use of yomninanonand certain imections due to ampiciliin-resistant \
antimicrobial agents. The most nnt uni- .ar
H. tntiuvnrui .
the risk ot toxicity' from two or more
There k considerable interest in the application
ol a new concept in comomation chemotherapy— ( agents, the selection of microorganisms
me use ot an inhibitor of beta-lactamase, which has 1 that are resistant to antibiotics mat m.i-- nf
no intrinsic antimicrooial activity, m combination
‘ have neen necessarv, and increased cos: to
with a reta-iactam antibiotic that is susceptible to
the patient. In addition, is nntr'ii ,ipo>c.
beia-iuctamase. The prototypical enzyme inhibitor
antagonism of antibacterial effect mas rris ciavuianic acid: other derivatives are currently
being evaluated. This approach may allow success
■ suit when bacteriostatic and bactericidal
ful treatment of infections by microorganisms that
agents are given concurrently. The clinical
produce beia-lactama.se. For exampie. infections
"significance of antibiotic antagonism is not
caused by beta-lactamase-producing H. influenzae
fully understood. Although antagonism d
may ne treatable with ampicillin plus tne beta-lacta
one antibiotic by another has been a iremase inhibitor. Thus, tne utility of time-tested anti
biotics ir.L'.. penicillin G and ampicillin) may be
quent observation in vitro, well-docu
restored m inlections for which they had become
mented clinical examples are reiatneb
ineffective.
rare. The most notable of these involves the
Advances have also been made by combination
therapy of pneumococcal meningitis01 synergistic agents in the antimicrobial therapy of
fungal infections. The most significant clinical ad
In 1951. Lepper and Dowling reported lhai «
vance to date is in the therapy of cryptococcal
meningitis. A combination of flucytosine and ampnotencm B has been shown to be synergistic in
vnro ana in animai models of infection, in the ther
apy of cr/ptococcal meningitis a comoination of
flucytosine and a low dose of amphotericin B for 6
weeks was as effective as therapy with a higher
dose of amphotericin B for 10 weeks with less renal
toxicity (Bennett ei al.. 1979).
4. Prevention of the Emergence of Resis
tant Microorganisms. The use of combina
tions of antimicrobial agents was first pro
posed as a method to prevent the
emergence of resistant mutants during ther-
fatality rale among patients with pneumoa*meningitis who were treated with penicillin a
was 219c. while those patients who received
combination of penicillin and chlortetracychnc
a fatality rate of 799c. This study was support
Mathies and colleagues <19671. who lrealc~,
dren with bacterial meningitis of multiple eti
with either ampicillin alone or with the comm
of ampicillin, chloramphenicol, and streplo®
The mortality rate among those treated with
cillin was 4.393. while those treated withjhe
nation was significantly greater—10.59c.
Antagonism between antibiotics is proba
tively unimportant in most infections. If a"
nistic interaction between iwo antibiotics
CHEMOTHERAPY a
212
j
4
.
CLINICAL
PHARMACOL
P.N.Bennett, Fifth Edition.
occur tn germ-free guinea-)
non-absorbed antibiotics th
o_
, ,lv
penicillin, by interfering with normal gut flora, allows an enormous
proliferation (10 million-fold) of coliform bacteria in the cecum, with
enterocolitis and fatal bacteremia. This condition may be analogous to
the enterocolitis that occurs In man during broad spectrum antibiotic
*
treatment.
Treatment Failure
Treatment failure may be due to drug resistance, natural or acquired.
Where the organism is sensitive to the drug used, failure is usually due
either to the way the dnig is used or to some factor peculiar to the
patient. Sabatht lists six causes:
Treatment begun too late to save the patient,
Suboptimal use of drug,
(a)
dose too small,
(b)
Intervals between doses too long,
(c)
duration of course too short,
(d)
unsuitable route,
(e)
adjuvant medications not used.
3.
Organisms present in altered state (dormancy, variant forms).
4.
Substances antagonising effect of drug present in the patient, c.g.
pus, or unsuitable pH.
5.
"Barriers” to adequate access of drug to organism,
(a)
natural, e.g. poor entry into eye, cerebrospinal fluid,
(b)
pathological, e.g. abscess, fibrosis.
6.
Reduced host defences,
(a) disease, e.g. congenital agammaglobulinemia, reticuloses,
leukiemia, old age, diabetes, cystic fibrosis.
(b) immunosuppression, e.g. anticancer drugs and adrenal steroids:
bactericrWn/ drugs to be used here.
1.
2.
Combinations of Antimicrobials
A critical attitude is essential towards the use of two or more anti
microbials, whether prescribed separately to suit the patient and his in
fection (concomitant therapy) or as a fixed-dose combined formulation.
The indications for use of two or more antimicrobials are four:
1.
To obtain synergism, i.e. an effect unobtainable with either drug
alone, e.g. co-trimoxazole; penicillin plus gentamicin (in entcrococcal endocarditis).
• Farrar, W. E„ rt al. (1965). Amer. 7. I'nth.. 47, 629.
t Sabath, L. D. (1969). New Engl. / Me,I.. 280, 91
D.R.Laurence
f,
and
L980 )
'
!Rapeutic agents
213
ice, especially in chronic infec-
3. To broaden the spectrum of antibacterial activity in a knot
infection or where treatment is essential before a diagnosis j\jjjjEXURE T
reached; full doses of each drug are needed,
4. Tn reduce severity or incidence of adverse reactions where the
organism is fully sensitive to each drug, but only If doses Hable to
cause adverse reactions are used; here lower therapeutic doses of
each drug are used. This use is uncommon.
The attitude "if one drug is good, two should bo J’.9t,cri and three
/
shoiiltl^iire almosT anybody of almost anything"
*
is naive n,.'dj£[atmnal.
/
When combmecTtherapy is used to treat an infection due to a single —
organism the result may be:
1. Indifference: this is common.
2.
Synergism: uncommon except In certain specific situations, e.g
cnterococcal endocarditis, tuberculosis and Grom-negative bacillus
infections.
3.
Antagonism: also uncommon but most likely when minimally active
doses of a bactcristatic and of a bactericidal drug are used together;
the timing as well as the dose is important in this complex situation.
Clinical demonstration of antagonism has been made for penicillin +
chlortetracycline in pneumococcal meningitis and in Group A streptococ
cal infection; for penicillin + erythromycin in Group A streptococcal
infection.
Bactericidal drugs act most effectively on rapidly dividing organisms.
Tims a bactcristatic drug, by reducing multiplication, may protect the
organism from the bactericidal drug. When a combination must be used
blind, it is best to use two baEteristatic or two bactericidal drugs. But this
is not a firm rule, since it is known that penicillin plus sulphonamide is a
synergistic combination.
*
Jawctz
makes the following important points:
A particular combination cannot be specified as generally syn
ergistic, but only as synergistic in relation to a particular micro
organism.
2.
The need for combinations of antimicrobials arises only
infrequently.
3.
Drug combinations must never take the place of proper diagnosis or
specifically directed antimicrobial therapy.
4.
Fixed-dose combinations arc unsuitable for general clinical use.
I.
•Jawctz, E. (196R) /Inn. Rev. Phnrmaenl., fl, 151
214
CHEMOTHERAPY AND CHEMOTHERAPEUTIC AGENTS
Disadvantage! of combined therapy include:
False sense of security, discouraging efforts towards accurate
diagnosis.
2.
Increased incidence of adverse reactions.
3.
Increased variety of adverse reactions.
1.
Drugs between which there is cross-resistance should obviously not be
used together.
There arc difficulties with even the few rational fixed-dose com
binations, e.g. co-trimoxazole. Sulphonamide resistant organisms are
common and so use of this combination could be equivalent to exposure
to trimethoprim alone thus encouraging development and spread of
trimethoprim resistant organisms.
pH and Antimicrobial Activity
The efficacy of some antimicrobials Is greatly affected by pH and this
has three aspects of practical Importance:
1.
2.
Most laboratory sensitivity tests arc conducted at pH 7 2-7-4.
Whilst tire pH of the body cannot be altered to suit the drug, the pH
of the urine often can be, over a range of 4-6 to 8 2.
3.
Since the pH effect increases antimicrobial activity without in
creasing toxicity to the host, it is possible to use some of the poten
tially toxic antimicrobials (streptomycin, gentamicin, kanamycin) at
lower doses, obtaining therapeutic efficacy with less risk of toxicity;
e.g. in alkaline urine the renal clearance of sulphonamides is gener
ally increased so that the renal tract is exposed to more drug; alka
linity nlso increases solubility of sulphonamides which reduces the
risk of crystalluria.
Duration of Antimicrobial Therapy
Too brief therapy fails to cure.
Unnecessarily prolonged therapy leads to adverse reactions, and
promotes emergence of resistant strains and suprainfcction.
Evidence of cure may be hard to get, and empirical experience must
sometimes be the sole guide. The variations in conduct of therapy, e.g.
between sore throat, typhoid and urinary infections arc due to the
different characteristics of the infecting organisms and to the differences
in pathology of the host. In general, do not change therapy until 3 days
trial han been given; If nn infection deserves tieatment it desei vea nt least
5 days. Further notes will be found under general principles and under
the individual diseases.
Administration of Antimicrobials
Oral administration is convenient, less unplcasauMhan parenteral ad
ministration and is commonly adequate. I’ublisl^^studics on plasma
CHEMOTHERAPY AND CHEMOTHERAPEUTIC AGENTS
215
concentrations in relation to dose give results of administration cn an
empty stomach. Food retards absorption and peak plasma concentrations
arc therefore less. In general antimicrobials should be taken between
meals or at least one hour before a meal. In the case of cioxacillin the
timing in relation to food can make the difference between success and
failure.
Intravenous (or i.m.) administration is user! for its increased certainty
in urgent situations or where vomiting or malabsorption are feared. For
therapeutic efficacy it is probably immaterial whether the drug is given
intermittently (about 4 hrly) or in a continous infusion.* But continuous
infusion introduces risks of incompatibility and drug instability; though
this may be more convenient to doctors, especially at night, where nurses
arc not permitted to give i.v. injections even into the tubing of sn
Infusion.
Some drugs arc given by routes decided by their chemical or biological
(e.g. Irritant) properties.
Chemoprophylaxis and Suppressive Therapy
It is sometimes assumed that what a drug can cure it will also prevent,
but this is not necessarily so.
The basis of effective true chemoprophylaxis is the use of a drug
against one organism of virtually uniform susceptibility, e.g. penicillin
against group A streptococci.
But the term chemoprophylaxis is commonly extended to include
prevention of disease as well as prevention of infection.
The main categories of chemoprophylaxis may be summarised as
follows -■
I.
true prevention of infection: rheumatic feverf, urinary tract
infection.
2.
suppression of existing infection before it causes overt disease
(tuberculosis, malaria, animal bites).
3.
prevention of exacerbations of a chronic infection (bronchitis, cystic
fibrosis).
4.
prevention of opportunistic infections due to commensals getting
into the wrong place (bacterial endocarditis after dentistry and peritonitis
• Hut a dose that gives peak concentrations well strove the minimum inhibitory conccnti.nmu (MIC) lol the mgnnhm when given luletmlUrmly, may tic too low to teach this
conccnltation in tlx: blood if infused continuously over I to 6 hrs.
■ Ithcumatic fever is caused by a large number of types of group A streptococci. Rut
immunity is type specific so that recurrent attacks are commonly due to infection with
dilfercnt strains. AH strains are sensitive to penicillin and so chemoprophylaxis Is used.
Acute glomerulonephritis is also due to group A streptococci. Rut only a few types
cause it, so that nalural^mrmmity is more likely to protect ami, in fact, second attacks arc
rate. I lu-ri-fori- chi-mu|^Biylaxis is mil used.
Harrison's PRINCIPLES OF INTERNAL MEDICINE,
Ninth Edition (1980)
|Wceks with an average of about four weeks. For most acute
^cuons a good genera! rule is to continue, therapy for 2 to 3
jgyjafter the temperature has returned to normal and all signs
/infection have subsided. However, fever can continue for
from stenle cifusions.complicating pneumonia., and cej^vspinal fluid abnormalities can persist for considerable penodsin bacteria! meningitis, leading to a continuation ot che
motherapy for much longer than is necessary. Empiricism
to be tempered with reason and experience, and in acmxi practice the guidelines for duration of therapy must be
,gifiaenlly flexible to be- appropriate lor the patient being
rated.
mERGY AND TOXICITY The patient s anergic history
jeuid always be explored before prescribing antimicrobial
iftnu. In addition to allergic manifestations in general, a re•x^t oi previous drug allergies is of particular importance, and
4icnts mat have caused clear-cut reactions shou.d be avoided.
alortunaieiy. no reliable test is available to determine the
•cscnuc of allergy to the penicillins, and thev mav or may not
<■ ucil tolerated by patients with a history of a previous reacnn. i he possibility of a severe anapnyiactic reaction can ne
riunly excluded by skin tests containing major and minor
xierminant mixtures, but only the major mixture is commer.uiiv available. When administration or a penicillin is considrcu essential. one approach is to begin with a very small dose
ainvcnousiy and increase the amount every tew minutes until
• n learned whether the patient can tolerate the antibiotic.
'pecmcaiiy. wuh an intravenous infusion running I unit peni...,in iiiiuted in 3 to 5 ml saline or glucose solution is injected
■-*i\ .nto the tubing, and 5 min is allowed :o elapse io see it
-i .r.'.ow.irc reaction occurs. A solution of eninennrme .>
..tiunie :r. .mother -vringe to be injected :• needed. If no
rjwii<*n .-ccti.'s. 2. ?. JU. 25. jnd 50 units, etc., arc imected .it 5••n -r’cr’.-n*. ..nd within an hour or *o
eitner necomc* apoent '.-..it :.-.c patient can tolerate a tun •.nerareunc dose. or
r ..i-vci.'Os a reaction mat is reauiiv controlled by cpinepnne. i: i reaction occurs. administering anomer antibiotic is
•muiiv ncsi. ..iihougn in mild reactions, vonunuing tne ncniciia .none wnn antihistamines and/or steroids is possible in
•*ne instances. Sucn a program can be uuite trouniesome as
•al as nskv. requiring ireauent adiustments to suppress urti-*na and itching. The number of alternative antibiotics availis large enough that switching to another agent is usually
Ac best course to tollow
Drue toxicity related to renal function is of particular imWance. Some antimicrobials, sucn as the penicillins, cepna*Mhin- chloramphenicol, erythromycin, and imcomycin. are
’’Utivciv sate at normal or only slightly reduced dosage in the
?tr'<nce oi impaired renal function. Other agents, such as the
‘••noelycosiues. are potentially quite toxic but can ne admm*tTed safely at reduced dosage if proper guidelines, based on
determinations of the serum creatinine, are followed, and
^nicularly if blood levels can be monitored. Certain toxic
should be avoided if at all possible in me presence of
*TU| insufficiency. These include most of the tetracyclines.
•^tomvcin. cephalondine. the sulfonamides, the nitrofurans.
nalidixic acid. One of' the long-acting tetracyclines, doxy^,nc- has the same half-life in healthy and uremic subjects.
b^can he administered to patients with impaired renal lunc^^other orally or intravenously. Many patients with chronic
failure are being maintained on dialysis programs and
Hl jfcAuire antimicrobials for a variety of infections. Table
'Ummarizes adult dosage schedules for various antibiot*
** Pai,ents with renal failure, on or orf dialysis.
INFECTION . Soft-tissue infections in sues with a good
'upply and a minimum of tissue necrose are. ;:i ecnerai.
*2^
ANNEXURE U
iriu
ICT)ON
easily treaicu. in meningitis and endocarditis, on the other
hand, penetration into the site of the infection presents formi
dable problems and is not infrequently responsible for treat
ment failures. Penetration across the blood-brain bamer is a
complex phenomenon involving protein binding, lipid solubil
ity. and ionization of the drug being administered. In addition.
the permeability of this barrier to drugs depends on the degree
of inflammation. Because of their low toxicity the penicillins
can be administered in doses large enough to provide thera
peutic concentrations in the spinal fluid, whereas more toxic
drugs such as the aminoglycosides and polymyxins must be
miecied intrathecally to be effective clinically in meningitis. On
the other hand, agents such as the sulfonamides, chloramphen
icol. and the tetracyclines appear in the spinal fluid in amounts
adequate lor the treatment ot some types of meningitis when
thev are given in doses appropriate for the treatment of sys
temic infections
Other examples oi problems of penetration, and of the in
fluence of localized physiologic conditions, may be cited. The
<ulfonamides are excreted in the saliva in amount«sadequaie to
eradicate the meningococcal carrier state, whereas most peni
cillins and tetracyclines are not. However, most of the strains
of meningococci encountered at the present time are sulfon
amide-resistant. In urinary infections, erythromvcin and the
aminoglycosides are relatively ineffective at an acid pH
whereas a pH at less than 5.5 is essential for the activity >*i
metnenamine mandelate (Mandelaminei. The lack of erticacv
of sulfonamides in the presence oi nus. due to the competition
tor hindinc sites by tne laree amounts «>i p-ammoben/oic acid
present, zreatlv limits the usefulness of this class ot drug*.
I'oremn nodie*. ..n<ces*e* -no obstruction to normal patna.iv% ot drainage utmost always interfere with the respon*e
v.".emotherapy and usually prevent cure until thev .ire re
moved. drained, or relieved. Suture materials, prosthc'e*. -cuuestrations. and caicun are examples of foreign bodies mat
interfere with drug tnerapy and usuailv. but not aiwavs. nee
to ne removed. In many abscesses. bacteria tend io be in a
meta helically inactive state tn which they are not actively *\nthesizing cell wall and are not susceptible to the damaging
effects of some antimicrobial drugs; hence drainage plus che
motherapy is necessary to eradicate (he infection. Obstruction
io broncmai. biliary, and renal drainage interferes seriously
with the response of bacterial infections to antibiotics, and
these intections generally cannot be cured with drugs until the
obstruction is relieved. A thorough knowledge of the mechani
cal. metabolic, and physiologic factors is essential in planning
therapy that will bring about optimal results in infections k»cated in different parts of the body.
COMBINATION THERAPY. SYNERGISM. ANTAGONISM Once
the etiologic agent is known or can be anticipated, most bacte
rial infections can be treated successfully with a single antimi
crobial agent. Combination therapy is used frequently, how
ever. to broaden the antibacterial spectrum while awaiting the
results of cultures, and also to cover the possibility that a poly
microbial infection might be present. For example, in a hospi
talized patient who suddenly becomes ill with presumed sepsis.
cephalothin and gentamicin may be given empirically to pro
vide antibacterial activity against a variety of gram-positive
and -negative pathogens that might be fatal if therapy were
delayed (Chap. 109k Over 100 fixed-dose combinations were
once available commercially in the I'nited Stales for orator
rarenteral therapy, but virtually all have been ordered off the
minTcTnv lhe Food and Drue Administration on the ground*
■ j.| .|
|->een shown m controlled studies that bi»th
agents contribute to the claimed therapeutic effects, that the
jrnT>ljnTs_5Lxa^h agent present were otten not appropriate, and
that patients were often Doing exposed to fhe pA'.-'Uial hazards
oi iwo drugs when only one was needed. When combination
therapy is indicated, it is most rational to presenoe separate!}
ne’morcaicd drugs m coses mnmake into the accuunr ine
patient s age, weight? and physiologic status.
__
tivity irom exposing microorganisms to two or more drugs is
rare. Usually, the drugs have an indifferent effect in vitro;
sometimes an additive action is observed, but this is difficult to
aemonstratc in patients.
True sxnergism occurs between penicillins and aminoglycosides with a number of gram-positive and gram-negative
pathogens. The classic example is enterococcal endocarditis:
penicillins (G. V. ampictihn. caroenicillin) disrupt the cell wall.
permitting streptomycin to gain access to the ribosomes where
their action is lethal. Aoout one-tnird of enterococci arc nbo^mall} resistant to streptomycin, but feu if any strains are
IsBLE I Il-l
Dosage* ol antimicrobials in renal failure
resistant to gentamicin and tobramycin, and
thCs
glycosides arc replacing streptomycin tn treatmc thi-. j,.
Of the penicillinase-resistant penicillins, only natcillm u
gisnc against most strains ot enterococci. In contrast.
dans streptococci streptomycin is synergistic wnh
against virtually ail strains, and it is probable that, m
endocarditis due to vmdans streptococci, there arc ir«.
lapses with combined therapy than with penicillin G
(Chap. 243).
hn acainst Pseudomonas and some other gram-negative
Theoretically, it would be possible to reduce doses <n the
biotics. but m severe Pseudomonas infections full doses 3rc
ally given so as not to risk compromising the therapeutic »
Tnmethopnm-sulfamethoxazole. another synergistic ctw
btnation. will be described below.
Clinically. significant antagonism between arnimim^
agents is also rare a prime example being a htgncr nioruUty
rate m pneumococcal meningitis with penicillin and tcirxochne than w ith penicillin alone. The rate of killing r>\ pcntcilW
" '
(C, o
'
. .. i;../j: puzi.;...
.’-J :.o
I...
•:. !;■■■'. jii eri- -,:u0 'f. ;c-Ccimb<JtOX?<-641108)
Th© dc’.dn nt health care system of: oux country is
c:.:;
Italy
o?t t!'.c rr-c :©rr. .-•llopnthic system. "he
>.■?.•• c? ~r .< t'x r>.--?rh5-t have org nised henlth care to
ote U>? devolc; JShnt. cf this dominant health core
syctcria .-■> .■.•■11 < s . ■ ..■'•.••i:'.•
instltuticsw.l network
c
st"i’y cf e•.’.«?>J’ 1»-.•?;.-.1 institutions, pharmaceutical
w
m.d-.w:;b • J. ■■' ',uf r
:■ e redieb.:;:;
network, weyd.•;• 1
1 loh»<.vntt; ~ hospitals, nursir.?
h-:..••■?£’, clinics and private practices, the huge monolith
of o health care structure established by the state
with-'its hospitals Primary :.c 1th Centres ano Sub centres
have penetrated into the sro&t remote Br-vS, Yet this.
dominant health care syster is not accessible nor affordable
to rw.v of cur people. Zt i highly excluslvist, expensive,
generates WWt use
unneces ary drugs, creates . c <?-.r . noy
■ . class .. .
1/r.
care practitioner through ti e
ne-ii ■■. iof scient ific mystifies! loti. It dees not roach
ih<;? : ajorfr.; c ; our people and o ■presses the majority ci those
who p'.rc-t:h i'.« The •'•min.snt per:.-peer.ive cees the modern
hi??lth. csEij '<• o tnn as .■ lepitiu.^te ar.d logical conclusion
to
-. 'rr <•.■. ■ hesltt ;'ce-.:s of i.he? <c 2e. It : ersi-' ts by j
iurtlivi' establishment of an ■ van : or<.- elaborate system
with nn even
efficient no t;ork t.?-' ijifravtrr.ctural
facilities* • ovelo.dny even iror< in for mat ions, progr: nc.ss,
pc; cr ■ c.. a«i vices that bulldnaes a., one,st oux~ people
to ■ •ar.-vide thr-m with "benefits*' of the ; o.'iern world in ths
srut.: r th .y ci; oce .and under t ■■: e sumption that they are
.11'
b- neficial, apolitical and inevitable.
The r. .. tl ns to such a state of Issa! th cure system
crc
forts tc refom vdthin the . renent system ci health
euro f ci teg :.oclom medicine through ett ss on prim ry
■;•.'■? 1-h c.-ro,
;; of hc-'ltu c.xe facilities to* the
rural urn trib.-sl ;.\;a-t ■ rouetim of consumor rights,
C:‘>■ osi.t.- n to cent. irut.-d n>.■rkotinc o£ banned and bannetle
druejs, pmssur.e
air nt the eorti: umd nos;,'it- 1 — doctcr disease — drug an.; .ro.’.ch to health cer<?, a more, a inorc
ration rl drug :md ho.'1th policy, increase in rrofes^ icn^l
.nd ■ ,s n..i<il
5.11 ui.es of the .
l‘.b •-er.-.-s. ci end
efforts •;! :.-r notion of p<o;-le,s partici;-.at! n .>n-: their
a
self r.tf -;xc
.g;?’
folk. .e-l.al ..< 6.
•'.■n ijv-.or-t■?:'!’ r-.-le.
of tradi - itnal systems of medieir®,
ies ant' loc-1 he- lt.i practices have
t emotion.
Gne .e<:re.of ■ Winking is that the existing Socio-economic
lif.ic-'l syrtem is responsible for the evils o. the
’ue.f-v;
I> h nid .•••:<.-.'ic-1 sy... . cm. The problem is seen as arising
cut of > n elite, arfc-n bias in .l-.e prioritl<-s of olicy rakers.
cc--'mrciallsatlca of medical ; >rofes-? it■ n« the cupitilist distor
tion of n»©.Sox:s£ r=edlc 1 science and -.echnolcgi and its nystific . :. .o
be ;; asii.c stream looks critic 1 .y a the ideological
ar,--; c
wni basis of modern societya ;ho societies in which
nodes n health S & 1' evolved are imperialistic and the
.: -tJ rthis £ ->. T it-elf is part of colon!s tion of
t ire3. worl-.% botr intellectually an t«.-c.teri ally. '-'h sickness
..n li ■ it. lit.'a.-- of th industrial culture, i. which this science
\
i.
■.; rt, -n J. c unities ■:>!■ origin is too evident now.
■>ltern < iw IJ < t-.tyV an-’. culture is seen as. way out.
Indigenous -.?-.'.ier.cc an technologies, including that -:i. health
dlseae
in
co tert -_f j rr-iger;, us live styles and
rr..: -r.-.
I:--- th
sis for evolving ■: truly appropriate
r.ee-'
■- .. wr-re?. -tic .■!".■ • •;rtic.?.pativf. (health cam} system.
7:si; altemeti'.'f• and counter atrecw is to be seen in the
following- contt-.-' ts-
-
=
e trf.-r -ly lirc-i ■■ed access of rcodern heclth t. scorn an. th--.
esc-l ■'tis’.v; lost- of ..’hatever benefits free t.rBditicnal
;o stems
A. j
minorit. ■? joy*; g ^ocesi. to all types Gi'. hralth and
/It. .1
Liciudlcg. grudgir-g an- com? - scendf nr; inccr cratl-'n of trudltional systemr- of mediciner
-
h failure
th< v;est::?rr> .-thro-rentric approach to meet
’.;:
roods
a:- ’rations o; th p ople even .after four
d ■ ? c 3d - ■ s Oi: .'. n t e ye n.; a i s & -;
-
th s cv..lopm-nt process hat increases disparities in the
control icf- use ct resourcesy
-=
th social process wi-Kx .- market forses
cons'.it tit- s •kncs'ledge an.’ rracticey
-
the c-oo. tirn of : t;r state by the r-ark-tr
=•
the hralth of an individual or cure-unity -iefined in t rms
of the ; olitical stats- irn. li ; t.v® ower of Jin ivideal
an--.? cc. cunity to c nrrol deci sit us tnut affect their
ph, s 5 c:. 1, re ■: t ■ 1 : - • • -. i j cm-. ■ n t, 1 -.-• t a te.
etermine what
3
■3<
fiG.~ -? basic rr klSLS"
1.
ifferen?. cctrmunities
ret ive different resources; in
the ear© environment. The seme resources ere more
over -.-revived an -ut to use fit i■ erently by different
communities. The. evolu -1 ••■;« of knowle -i c and practice.
i_.fi science- and technology is a cultural construct ar. is
bused on th‘ specific social formation a»»u ‘-.he mode of
r Pciion of that :-irticular community at that point
of tire. The existence of heirarchy of. cultures is
founded on the ideuio ..y ©«' the oppressive classes and
it. 4$o nsetl as a tool against th oppressive cl-.sses
V-y t;.-.; _■ •>rer sed in a ’iterative .-recess.
2.
Cui turn is built tv ct> complex interact .tens involving
physiefil, ^nvironmenta.'i., Ideological, political and
Economic dimensions. ’-'ho relations c-f roduc
exchange an. conssatp Lien find. 'epre-fision in culture,!
and socio!! responses. Traditions Is the vestiges of
earlier cultural trends Ideologically influencing the
. resent anr future trends.
3.
re ?■ ifonul ecie ce and technologies ■
-the emperical
results of socic-cuitural sn.' enviiwr.-'er.tal demands
r-;tu--.-r i- . r: roer • oco?'ie-imperatives. It ir charac-.«•
c-rise-d foy irs localise? expressitns suited to locally
aveil-jlile resources evol-in lo-.rl shills, are ecologi
cally coun , reived- tc r< rcv^nT- iorf.-r of ■'■'? er-.y, low
ca. ilal outlays an high Iribcur content. The ensuing
/reducts ai’O ”'nsoph; sticated* a;
■■.?.•.••.:■■' t-.. rerve
lijriicd an? specific mar-hets and are based on agrarian
eec?.-!'?2_nics«
h
i'odcrn science <jr technologies are based on the eccno—
:.!c Iny.-r.Titives of in. '■•■:. stria I economies rather t.b.?n the
socic—ci.-lt-jral
onvi?;- rmi'-nt?! vmar.ds. It is cl'.ara—
cterito: by ccn ral i:product] n recuiric-?, r-^er s ills
uti isiix? n ;n-renewable sources of energy, with fif h
ca’-ftal r-utluys Sjh ’ lev 3..i.-our. co? tert a?? are-- * nerally
oco..ojical dis?’stcrs. The ensuin . -ra..ucts art- so-his—
tic-abed and ee-'.red to serve ■? rc d »:.--;rket tbrou< h the
creati-.r: of hcrt’O .oncous ■-.
j .:.n b-"-?x«viour.
Th® I.--, cl th care s; s'- era is •I.-, ys “jr ...icu1.-it-.-I in n riven
social I/imati n an. the ■ ofio r-f r ■ uc: 5 ::n of that so
cial ’.<m-..inn gives -fise ,.■■•- ir.s evrres.: on, in-_ h'-alrh
Cr-rre sphlem. The present social . Oimsticn is th.’.t of
fio- ..Inane■m'. < ntr&l e .crci ;-.;c- - iQ r:m.inr.ain the exgloit-it.iv? isl-iti ns of re .ucti-.-n.
o0
The "loneci.s of mystification ant ; rofessi-nalisrr. is
ro-"-■ -■ -". in the economic bas; # «;■ has nothin to do
wit?: :
systems ;.Z medit-in;•# an .i it the er;rcssicn
of
s' ems in the .yiven socleI fonietJcn.
?o
T?: traditions! s;-s«etns of re Icinc ir. clo.-er to th
inci- or.- u : soclo-culturnl '.ttern# ; ec: les consci pli
ant
of .crith ah- oisc-se, local skills :nd resources*
•.7n a
..tel.-t science wc
■' t in ;?' -It'n c<.ro3
'. ■ r..y . .
ion al
ster.s of cc.ilc ine
« comprehensive
boty of kno’.-.d
in neolth science# wits a well developed
'es; tictd iown-.' <■_■t:ir-jj based on enr-c-rical data# scienti fic
■ c !■ .c -.olo-.v ..;••••'
m-teriali’.>t -.hi 1 ©sophy, It develop1 • in
I.:
,'n ; •_ t' x-ot;«>nous f.-.-’fr coterln-,- to tr . needs of
acco: •In':■ the , soci ' formotim of specific
:'c s, but with the- advent cf th- market with its
i:-_:-- ar . -.echnolor.y ?-.
state as a mechani.im
r.c cv.
*-•-:r-df ti . r.-s f -r trio develop -ent of the- >v.:rkct#' the
ct.-yon ■.
. ertic-.'-, resources hm r.igl -.s of communities to It
ire -.■•.tr.
riated fro.-:; •hr people. Cor.se.u<-..tly, the
uno.lult- z
e practices# the science :ind rechncbhy' and
ski Is .--re :-us';.■ ■ cur c f th- control# accessibility# afternarilj -•.- . .
sui'..shi li ty of the cco unities, -"he btate
• ?-.1 ■ i. ,.i ’r . :- he riyht or c- >ru-r.i . i :s to '.hir-' knowledge- ’-nr
, ,c
- - o; : unities by th ccvolor.. crr of he process
of 1; ■ st i tv 11 on al i sat i on •
. ht- inability of modern nealth care - ys-'.-m of th state
and th' market to sati. fy the hcnlth nre'-is an -nsy irations
of
-;snhe inability of ..he modern medicine to
exclusively provide a su c. in satisfactory sclvticn to all
h?alth pror-lorns has led to ti k- inerr using res octability of
t:. tra 'j i.i nal systems of rr> dicine b;( the state and tlir.
m-jr.Vi;. 'rh-- chopra committee of I'd 18, the bHC forage into
tradlt.i nal :-;ster.:s of medicine, ICS.'-i? <- ICMP re- ort of 19dl#
the tatl<-;.4-l betith policy, 1982 etc, provides r. nctity to
this nr- ck;The state now sets itself to increas- the
pat.< ona? ,e t.. r-.-Jiti nal Systems of r. <?<’•: c i nv
1; g?.rb
of virt’.-.r. -i rich heritage, lorio.us achiever nts ant- cuit-xu.
i • itv. The- present
of heelti. curs, s.stem has
meanwhile roacc- nro>.h5 into trsditi-nal systems of medicine
Cevcl-spln..- institutions of learnin ;,skills an ?. >xcuctl 'n
sui ted to the mode of ■ .rc-.uaticn ar social fermation of the
day. incorporation in the modern health care system on the
i.u sis • b restin', dorse ; rlv brily '. iih modern tr- dlcfne rather
th-v. th t r- mi- work of l.clk knc-.-le-.h e, keep in ■•. with the assuow*
pt!’ n ant logic o.” thut science is the trend considered to l.e
valid. As tie marke. incorporates the products of traditional
- .iju
'■ir.dicine# the r-:’scurc-'"s b;:-sc ut cc«r'>un,iti«s and
tli- ir ri.b.is over it ii? further expngfc^ated. The crisis in
5.
tho form of knowledge, practice an organisation of indigcr-cuo pcocleo h'-clth care deeccns f urt'rer.
A net 1; si science movement in health care should seek
to legitimise the rights of peop c to cornrrt .n properties
•jt t increase the space for individuals and ccranunitiea
to t.aki. c;.?r- vi their ’n■:e.1 th with available resources
anh skills.
j'-rat t’jr
J'oveinert”, Ccirnb./tors,
seminar on "People’s Science
26-27 nece^ber, 1987).
. . .. , ..
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i •
The popularity of alternative and complementary medicine is growing
rapidly. This report investigates the reasons why acupuncture,
homeopathy, herbal medicine, vitamin therapy and other modalities are
flourishing
Alternative Medicine: Why So [Popular?
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1997 America's made 627 million visits to practitioners of alternative medicino
;..2Z
heir own money to pay for alternative therapies. In contrast, Americ
•. :iily doctor, it is estimated, by none other than the Harvard Medical School.
•.: one o. 1 of every two persons in the United States between the ages of 33 and z.9 yea.-.-:
:
least one alternative therapy in 1997. That is a growth of 47.3 per cent since 1990. '.'his is
■ :
by a-y means and of great concern to conventional (allopath ic) medicine espe. < ily
:;o the people .sing alternative medicine are primarily well-educated, aitkent :>eby boc"-trc('. t.
• : rend to alternative medicine is repeated throughout Western society, in Australia 57 ter®
population now use some form of alternative medicine, in Germany 48 perce; do, am: ■
percent do. . he growth of some types of alternative medicine is indeed astomming. io ■ ■ .':91 and 1997 • s use of herbal medicines in the United States grew by 380 or.. ■.;
•crapy ::y <30 per cent. These are impressive numbers by anyone's:
: :md''
•
•■ rat it is and hwt*i
So why do people increasingly prefer alternative to conventional medicine? The reasons are pre
• it is safe and it works! While there is little doubt that allopathic medicine ver m •■/:■ •
sane of bauma and emergency (you don't call your herbalist if you get hit by a e;.;-), '.is ■
s
n-'nn:vs when it comes to prevention, chronic disease, and in addressing the imr , o n.• •:: -r tirai needs of an individual. These are precisely the areas where a ■'.'. • •: vo mm: .• '• ■
nxcnir. To mostof the world's population, over 80 per cent to be precise, alternative me;:' .• •
'.•.r-.ative" at a , bid rather the basis of the health care system. To Wests." m ••.: ■ ■■•.
: •■ •■■ a :vc medio mo is "something not taught in medical schools" and some. '• :
•.
don't do and, one could add, generally know nothing about. A cm
• ■ ■..
encompasses a very large array of different systems and therapies ranging from ayurv
to vitamin therapy.
■ .
mMie has been practiced in India for the past five thousand years and has mom
undergone a renaissance in the West due, in no small measure, to the work and octurcr. : -.
: rmpak Chopra, v.’.l Ayurvedic medicine is a very comprehensive system that p aces eq ta
■ phasis on body, mind, and spirit and uses a highly personalized approach returr
state where ho or she is again in harmony with their environment. Ayurvedic "’edicini: .. :s
■ r.-m, yoga, .’.'.editation, massage, herbs, and medication and, despite its it:Toa';;'-., : •
today as it was 5000 years ago. For example, the seeds of the M rcur.a
■ :• :■
.•
Why sc popular?
http://wwv/.yeurhe?
r
have !ong been used to treat Parkinson's disease in India; it is now receiving atto- :tor:
conventional circles as it is more effective than l-dopa and has fewer side efrectofA).
..n 'rrwdteme has been practiced for over 3000 years and cvo- - ? c
w dd's population now uses one or more of its component therapies. "C?/ comb:
; . juncture, and the use of therapeutic exercises sucf
: ■ effective
'to treatment of many chronic diseases including cancer, aitom;
-v,--.'
IS. As does Ayurvedic medicine, TCM also focuses on the individual an< ooks
: ;■ -reefs the underlying causes of imbalance and patterns of disharmony.
was developed in the early 1800s by the German physician Sam::?., ;ahr.e.T.r: ■
;;w cost, non-tcxic health care system new used by hundreds of million:; o pec ole am. .:
w - r: tto particularly popular in South America and the British Royal Family has had k
■■ mcnat'to
for the last four generations. Homeopathy is an axes in:! ■ .
: .: ac:: ,:,;pe :: i; -he treatment of minor ailments such as earaches, rre
o- co:: . r.
y is again based on the treatment of the individual and when jsed by know
him.nr car: a-iso be very effective in the cure of conditions such as hay 'eve, dices —
arthritis, and respiratory infections.
,
■ : .•. - '.y prir sriiy Involves the adjustment of spine and joints to alleviate pai" a.-.d mernvs
■■ ::ra
was practiced by the early Egyptians and was developed into
■ . ■ :.
the American Daniel David Palmer in 1895. It is now the most common form of alternative mt
too I. .-.'tod Stalos. Chiropractors not only manipulate spine and joints, but also advise ;•:: d diet matters, .'hey believe that humans possess an tonato hea •. ?: ?.•
•no-can be overcome by properly activating this potentia.
-•
. .- :
y
■:::: y s mp-osc
■".nopat
ac
? also strongly believes in the body's inherent ability to
itse
mixes the need for seeking and treating the causes c a disc?.: :n -at: :>■ ■
its symptoms. Naturopaths use dietary modifications, nerba :: radio!
-.net-ire, hydrotherapy, massage, and lifestyle counseling to achieve ■: . :
;;r orthomolecular medicine uses vitamins, minerals, and a:r:lr t: rcids to diseased body to wellness in the belief that the average diet today is one: wo? .
■< :
.
.
y ceded rrtorients and that the need for specific nutrients is highly rxVt ...
::
.
-ypertccrtor:, depression, cancer, and schizophrenia can al: ben:;.1: ? <r.~oto vitamin therapy.
massage therapy, reflexology, hydrotherapy, arc:::?.
a
other forms of energy medicine round out the vast spectrum of alternative medic! •:: mods .to.:.
ifow is ii dWferemli?
?: wtet sots alternative medicine apart from allopathic medicine?
= '.to?‘.ventic; ?ai medicine is preferred in the treatment of trauma and emerge - oies ■aitornativo medicine excels in the treatment of chronic disease, aitf o:.:.:: ;’?’reo:>a'r
also be very effective as a first-aid.
° '.tonventionai medicine focuses on the relief of symptoms and rarely place.; omm "::.:
prevention or the treatment of the cause of a disorder. All alternative systems, or ;• o ? •
hand, strive io find and treat the cause of a disorder and frown on cover!• ; ;. p :
' -r .
Alternative therapies are also much more focused on prevention.
.
° .Jonventic".?.:! medicine is organ specific, hence ophtoalmologisis, cardicinmsto,
nephrologists, neurologists, etc. Alternative medicine, v/ithout exception, ccrsidom : .
person as a unique individual and uses a holistic approach in treatmen:
o Conventional medicine beliefs in aggressive intervention to treat disease i .mv? . . :
such as "magic bullet" and "war" ("the war on cancer"), and prefers quick i'xes (-..;
patients). Alternative medicine believes in gentle, long-term support to
?• tm: :■ ■.? ■
innate powers to do the healing.
° Conventional medicine's main "arsenal" consists of surgery, chamotrto*a:;y.
■
-.1 ■■;::dito':': pmrfetio'iors are g:.:ic::t; in their trctor":'' :■ ■ ■ : i;Colleges cf nnysicians and Surgeons. This often leads to a "one size 'to i:
.-actificn-r.-: of alternative medicine, on the other hand, treat eacf patier
do whfe, in their opinion, is best rather than what is specified \r r.
:: r.cok
:
o Conventional medicine sees the body as a mechanical system (toe heart ; a
.•..
kidneys are a filter) and believes most disorders can be traced to chemica
• .. . ■ :
therefore are best treated with powerful chemicals (drugs). Alternative r:::. tor.s < .
almost wife.out exception, accept that the body is suffused by a network ;; ’ chan - n
(meridians) that carry a subtle form of life energy. Imbalances or blockage..: : "■ 3 'mem? what lead to disease and clearing of the blockages and strengthening o?-o cro;;; . ■ •;
ultimate goal of alternative medicine.
° Conventional medicine prefers patients to be passive and accept tr.ol- • •::. to
many questions. Alternative medicine, in contrast, prefers and indeed, to - - -• o...
sx toes toe patient to take a highly active part in both prevention and m-.
> 3oth conventional and alternative medicine ascribe to the principle "To r.c harm • : ■:.
while alternative medicine is essentially achieving this goal, conventiona edicir . sems
have almost totally lost sight of it. Hospitals are now the third largest kiifer ■.
over one million people are seriously injured in American hospitals every year. 3 ::
infections acquired in American hospitals cause 32,000 fatalities every yo-. - and ::y .r-...
surgery results in 25,000 strokes a year. Two million patients experience adverse : r
-oactions to hospitals in the United States every year; of these, over •100,920 din m ■ to
.-respite! ■!■ iducec adverse drug reactions the fourth leading cause of desfe rtoc -o: disease, cancer, and stroke(5-11).
□
he practice cf conventional medicine is intimately tied in with the v/hoi©
medico-pharmaceutical-industrial complex whose first priority is tn make ;. crux. -.
<•
most conventional physicians have "healing the patient" as their first priority. toe; . '
increasingly difficult to do so while operating within the system with its pha-naceto r.
, it;.: r ’Is books, its fear of malpractice suits, its endless
■ : .’m
bureaucrats and insurance companies, and its time pressures. Most alterrative -ac • r.
practitioners have no such constraints and pressures and car. give too pal :r'. too' • . -: to • ■
attention.
° Conventiona; medicine generally resists the use of natural remedies long a ter thsir fetor..<
has been scientifically proven (Germany is an exception to this). Most alternative sdtoto:
practitioners eagerly embrace new remedies and, in many cases, car. pc 't to years ::
use. Ginkgo biloba is now the most prescribed drug in Germany and has been
:: n
in the prevention and treatment of Alzheimer's disease(12). Also in Serrna 1 :r : ■.
palmetto i;: now prescribed in 90 percent of all cases of enlarged prostate ir ten
.
States 300,000 prostate operations are performed each year to solve this orobfe-o.
orc.Table tonsure, but dangerous and unpleasant for the patient;'13).
°
he major source of funds for medical research is pharmaceutical compar :ee w? o, • .:
surprising^, are very reluctant to support investigations into lifestyle mod'-'catio.tc, g- •
and other unpatentable products. Nevertheless, a growing number o' me.: ca m.:? .
.
are focusing their attention on natural supplements and remedies and arc .- ..biis’-f-g. :::: work in mainstream journals. The benefits of antioxidants have now beer
documented by researchers at the Harvard Medical School and sim'lar c. ;:.ic to ./
institution;:, , 'olic acid, a simple B vitamin, has also been extensively tord'od In . ’ m. ?
laboratories and has been found to be effective in preventing or amaiicra:
nea': t - ;
strokes, angina, intermittent claudication, atherosclerosis, kidney disease, color
•
hearing loss, and Alzheimer's disease(14-18).
A though alternative practitioners and a small group of conventional physicians do embm;;;::...'
of natural therapies and products the vast majority of "establishment" physicians ..re st -ucr ■:
fetor heels and even denigrating and ridiculing alternative medicine. This fact,
'•■aes ; ;
:. '.yelse, is w-^at is driving the rapid and massive switch from conver -‘cna' ;
medicine.
:er a
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{REFERENCES
iisenbarc, David
etal. Trends in alternative medicine use in the
2:;;:::::.
■ 990-1997. Journal of the American Medical Association, Vol. 280, over
' ’. • :
569—75
' Sensouscr;::, Aian. Complementary medicine •• where lies its appeal? v
Australia, Vol. 170, March 15, 1999, pp. 247-48 (editorial)
3 "isher, Peter and Ward, Adam. Complementary medicine in Europe
Vol. 309, ...uly 9, 1394, pp. 107-11
4. Hussain, Ghazala and Manyam, Bala V. Mucuna pruriens proves more effective ■
;• -arkinson's disease animal model. Phytotherapy Research, Vol.
1887, pp • ■
mm,
"armless herbs? A review of the recent literature. America :: .four-.
Medicine, Vol. 104, February 1998, pp. 170-78
m
a-r.m:: m i losmd error;: are number
Immr in A:m m
1995, p. 5
7. Gardner, Stephen M. Australia's preventable hospital deaths, "he Lancet,
.3'
1995, p. 1582
la
Javid W., etal. Incidence of adverse drug events and poter
srsedrug : ;•
..ocrr.R; o tine American Medical Association, Vol. 274, July 5, 1995,pp. /3-3-1
9. Pittet, Didierand Wenzel, Richard P. Nosocomial bloodstream ir fecti:
Medicine, Vol. 155, June 12,1995, pp. 1177-84
■' T Roach, Gary W., et al. Adverse cerebral outcomes after coronary pyrmm
m
■
■ nurna! Of Medicine, Vol. 335, December 19, 1996, pp. 1857-63
azn-ou, ..arson, etai. incidence of adverse drtig reactions in hospital zee
...
theAmer :ar Medical Association, Vol. 279, April 15,1998, pp. 1200-05
1.
12. "he LancL, November?, 1992, pp. 1136-39
13. Wil:., . rmc'riy J., et al. Saw palmetto extracts for treatment of benign prostate hy:.r: :.
•.
ourna! of the American Medical Association, Vol. .280, November'. 1, 139 :, pp. mm 'll
. Murray, Michael T. Encyclopedia of Nutritional Supplements, 1996, RockGA, ■■ "
publishing, pp. 119-26
15. Moghadasian, Mohammed H., et al. Homocysteine and coronary artery disease
stomal Medicine, Vol. 157, November 10,1997, pp. 2299-2308
' 6. Parry, I.J., at al. Prospective study of serum total homocysteine cones- r? Im am: - m
stroke in middle-aged British men. The Lancet, Vol. 346, November 25, ■ '
pj
) 9i
’. 7. .owering :food homocysteine with folic acid based supplements: meta a • u ys:;:.
randomised trials. British Medical Journal, Vol. 316, March 21, 1998, pp. 8<r -98
18. Clarke, Robert, etal. Folate, vitamin B12, and serum total homocysteine r-'sis !r
Alzheimer disease. Archives of Neurology, Vol. 55, November 1998, pp. ■ A'-St- - ::
1407-0| (editorial)
:
•ALTT
L/rtor: Goldberg Group. Alternative Medicine: The Definitive Gukre, .ya
;uture Medicine Publishing, Inc. 1993
° Gursche, Siegfried and Rons, Zoltan, editors. Encyclopedia of Natura: o;
\
TO, Alive Publishing, Inc. 1997
= Micozzi, Marc S., editor. Fundamentals of Complementary and Alterrwv;: , -c
Churchill ivingstone Publishers
.
icite: '•'■fry sc poplar?
httt>://www.yc33:?.e?>.".'sase.".O"rA
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.
•
YEAR
1998-1999
1999-2000
2000-2001
* NNEXURE- 2
:
:
>
I
•
BUDGET ALLOCATION AND EXPENDITURE OF LAST THREE YEARS I.E. FROM 1998-1999 TO 2000-2001
1
•
I
i
;
i(Rs. In lakhs)
State Sector Schemes
District Sector Schemes
|
CSS (100%)
Plan
Non Plan
■
Plan .
Plan
Non Plan
Expr.
B.E. ; * Expr. ■
B.E.
i Expr.
B.E.
i Expr.
B.E.
Expr
B.E.
I
!
:
I
:
247 41
15036 1121 93'
1121.93.
6.00'
4.23
200.00
128 69
1296.12 1082 69
i
i
I
i
238.07
202.53 1318.99
1318.99'
8.00
5.76
270 00
241 24
1547 43 1464.94
I
;
■
i
:
i
i
i
319 28
320.00.
272 47'
1639.36 1546 84
259.00 1314.00
1314.00!
7.90
10.17
!
*
:
•
* NOTE:
'The Non-Plan expenditure of the District Sector schemes are maintained by the concerned Zilla
.Panchayath’s. Fence, the whole budget estimates is considered as expenditure.
i
i
i
increase in the demands is due to creation of posts, sanction of additional DA, Annual Increments,!
and increase in die prices of drugs and chemicals, linen and diet commodities etc., I
|ANNEXURE-1
|
_ STA TEMENT SHOWING THE DETAILS OF BUDGET ESTIMATES UNDER EACH HEAD OF AC COUNT
YEAR 2001-2002
INDIAN SYSTEMS OF MEDICINE AND HOMOEOPATHY.
DEPARTME -IT
...............
si.No.' Head of Account
Total
Plan
Non
BE
Institution
Plan
Page No.
STATE SECTOR:
94.43
86 81
7 62
53-54
DISM & H
1
2210-02-101-1-01
42.41
12 03
30.38
Divisional Offices
54
2 . 2210-02-101-1-02
241.81
241 81
SJIIM, Bangalore.
3 2210-02-101-2-01
55-56
130.12
130.12
56-57
Ay Hospital, Mysore.
4 2210-02-101-2-02
5.81
5 81
64
SMP Centres & Pvt Hosps
5 2210-04-101-1-01
.
146 46
177.77
31 31
65
District Hospitals
6 2210-04-101-1-06
313 60
313 60
67
Private Colleges
7 2210-05-101-1-03
45.45
45.45
68-69
Taranalha Hosp. Bellary.
8 2210-05-101-1-05
100.96
79
27
21
69
Increase
of
Beds
in
ISM&H
Hosp.
73
9 2210-05-101-1-12
420.40
41 85
378 55
74
Govt. Ay Medical colleges
10 2210-05-101-1-13
192.17
0 75
191.42
Govt. Central Pharmacy, B'lore
75-76
11 2210-05-101-3-01
' 12' 2210-05-101-6-00" 77..
0.96 ""2 3.83
Dev. of Medicinal Plants
287
26 29
26.29
79-80
Govt Homoeopathic Hosp B'lore
13 2210-05-102-0-02
72.80
51.99
20.81
GHMC., Bangalore _ .
80-81
14 _ 2210-05-102-0-04
86.80
15 ' 2210-05-103-0-01 " 82....... GUMC, Bangalore.
19 88
66 92
100.00
100 00
83
National Inst., of Unani Medicine
18 2210-05-103-0-02
9.91
9 91
17 2210-05-200-0-01
101
Dev. Of Yoga
12.40
9.56
2.84
18 2210-05-200-0-02
101-102 Govt. Nature Cure College, Mysore
10.29
10.29
19 2210-01-110-1-16
Capital Outlay - Buildings
23
70.00
70 00
Capital Outlay - Buildings
165
20 4210-03-101-1-01
—
...........
100% css
— 2210-05-200-0-04
.
102-103
TOTAL
...........................
Taranatha College Bellary - PG
350.00
1807.25
2157.25
12.00
12 00
. ......
----------- ---------- ----------- ----- -
398 34
335.55
54.92
15.57
294 01
37.02
175.06
" 46.97
98.38
”40.93
21 52
332.06
1186.21
"l518.27
350 00
12.00
“ 332.06
' 694.06
1807 25
2157.25
12.00
1518.27
3687.52
!
f
I
I
rn
I
District Sector VzA
398.34
Govt., Ay Dispensaries
2210-04-101-1-71
.. ..
161.5
174.05
Opening & Maint., of GAD's _
2210-04-101-1-72
41.12
2210-04-101-1-73"”
13 80
Upgrading of GAD's
__
” " 9 83
Staff to Dispensaries
5.74
2210-04-101-1-74
.294 01
TDB Dispensaries
_5_ 2210-04-101-1-75
- 37 02
6
2210-04-101-1-76
Buildings
108.74
66 32
Taluk Level Hospitals
I -7l- 2210-04-101-1-77
17.30 •__ 29 67
8. 2210-04-102-0-71 1
Openin & Maint., of GHD's__
94.85
_ 3.53
2210-04-103-0-01
_9
— Govt, Unani Hospitals__
10‘" 2210-04-103-0-02 "'
"13.80
27.13
Opening & Maint., of GUD's
21.02
Govt., Nature Cure Disp., & Hosp.,
11 2210-04-200-0-71
050
TOTAL
I -----ABSTRACT
•
State Sector
CSS
100%
District Sector
Total
’ 1186 21
2993.46
NUMBER OF PRIVATE DOCTORS QUALIFIED IN AYURVEDIC & UNANI
WORKING IN A TALUK.
.V
SL.NO.
DISTRICT
TOTAL
NAME OF
. NO. OF AYU
NO. OF UNANI
THE TALUK
RVEDIC PRI
PRIVATE PRACT-
VATE PRACT
TITIONERS
ITIONERS.
1
3
2
r
i,
north Taluk
Bangalore
'
6
5
.
’
Bangalore
Carporation
Bangalore
4
193
1415.
7
-
7
South Taluk
7
3
10
Anekal TQ
12
1
13
■■■ '*
2.
Bangalors (R)
£
3.
4.
Kolar Dist
Tumkur Diat
Channapatna
Davangnsaahally
Doddaballapur
Hoakota
Kanakpura
Plagadi
Nslamangala
Ramnagar
6
S
6
4
16
5
8
4
5
2
Chintamanl
Bagarupata
Nulabagulu
Srasnivaoapura
Kolar
KGF
Chikkaballapura
Gouribidanur
Nalur
Shiddlaghatta
6
6
3
4
8
3
7
8
2
-
1
2.
1
8
1
1
-
Tumkar
Gubbi
Turuvekara
Chikkanayakanahally
Sira
Nadugiri
Pavagada
Kunigal
Tiptur
Koratagara
23
11
8
2
-
11
5
6
- 4
16
.5
8
6
'
2
/
/
J
• ■:
■
.
*
'
1222
■;|!
'{
. ' ;i
TT
7
I
8
-i
5
5
( I
16
4 '
J
7
' 1 j
.8.1
' 3
. J
/ 25
11
8
. y •
8
*»
8
7
3
10
6
17
1
■
1
2
2
4
8
8
8-8
.
Shimoga Diat
Shimoga
Bhadravathi
Hoaanagar
Sagara
Shikaripura
Soraba
Thirthahally
94
28
10
16
18
21
25
.
Chitradurga
Chitradurga
Challakera
Hiriyur
Hosdurg
NolakalmfryUVq
Holalkere
30
39
10
22
16 |
1
95
1
29
-10
?
16
IB
21
’ 25
'
•
•
2
1
2
32
39
11
22
.2
15
'
i
i
Pagei 2
1
2
7.
Davangera Diet
8o
9.
Ryaora Dist
ChamaraJ Nagar
10. Hassan Diet
3
4
79
Davangera
Harlhara
22
Chanagiri
2Honalll
2□agalur
5
Harapanahally 4
Ryaora
360
3 r-'
H.D.Koto
Hunaaura
6K.R.Nogsr
15 Priyapattna
11 ~
12 rT0Narislpura
26 _ •
Nanjanagudu
Hassan
56 «•
Alur
- 7
11
Arakalgudu
4 —
Seliur
Araalkaro
— 23Channaraya21 rpatna
Hole Narasi
7
- pure
5
Sakalashopur
17 '
10 —
27.
8-
Randya
Raddur
Ralavalli
K.K.Pete
Nagamangala
Pandavapura
Srirangapatna
39 1410 12 —
2—
10 13 —
13. Kodagu Diet
Radakere
Somwarapata
Vlrajapat __
26.''
912
14. D.K.Dlat
Rangalora ~
Belthangady
Bantual
Puttur
191'
26 57^
42
32
12. Randya Diet
1
80 -
«a
22"
—
*
•
2 2^
54-
23
C0
«s»
- 1 «=
«=»
•
3B3 "
3-' '
6161112 —
26 -
a»
9-"
912
. .
......... ;;;
.
'3 «9
-r
'
■ '• ■
,
3'
4 3 .
ChamaraJ nagar 3 —
4 „
Gundlupats
Kollsgol
3 _
Chlkkamagular
Kadur
Koppa
Roodigera
Narasimarajupura
x
Srigara
Tariksra
11. Chlkkamagular
5
‘\"'V
'59"
.
"7-
■
-121 4 —
23-
«p
•
22 r-
1 <
—
;■
2 oa
2 •»
••
1 1 r
1 —
•»
1 "
1 --
•»
•
3 •
••
<0
5
•
■ s-
.• .•
. i
';rr;
19“
.
10— ...........'
2710 - ‘ . r ■,■■■. ' - J '-
ce»
ca
.
7 "
- '
9
.
9'
12^
40' ’
1511 12311 —
13
26
9 <
12'
19426 57'
4232 _
. .
- "
Pagei’ 3'
1
2
15.
Udupi Gist
16.
17.
18.
19.
20.
21.
22"—~~
Belgaum
Oharuad Gist
Gadag Diet
Haveri Gist
3
Udupi ’
Kundapura >
Karkala .
210 "
55 .
31 _
Belaga]M7'
Attani '
Bailhongal
Chikkodi
Gokak
Hukkari
Khanapur
^aybasyh
Ramadurg r~
Soudhatti _
341
8270 101 11663 —
3957’"
4B 47 <-
Oharuad
Hubli
Kalaghatagi
Kundagsukaola
Navalagunda
72
106 4 11 r26
-
Gadag
Mundargi
Naragunda
Shiratti
Rona
67 17*—
9 11 36 -
Haveri
Hirekerur
Ranabennur
ByadagiSavanur
Hanagal
ShiggM^l<x.v^
3342719 - '
9 - ..
8'
-l'
14 .
Uttar Kannada Karuar
Ankola
Bhatkala
Haliyala
Honnavara
Kumata
flundagoda _
Siddapur
Sirsi
Z«oda ^-^0 ]d-^
YallapuraBijapur Gist
Bagalkota
4
28'
11 7 62228 10 9 29
9 8 "
5
6
1 -
2ir
5531
V
W
1
1 —» -•
■
DC
«D
—
CD j
DC
•
—
1 -
72
107 ~ '
411^'26^
CD
—
CD
—
—
CD
1 •
CD
1'
■
•
1 1*
-
10 "
427
CD
■=CD
Bijapur
Basavana
Bagawadi
Indi
Muddeb^hal
Sindhagi _
417 ”
107 46 5746 _
W»
«D
•
108 "
4657 46.
Begilkote
Oamakhandi
81 "
62 ►
1'
••
82 ‘ .
62’
r
1
.
?
334.
28 19'/r.:
9'
9■
■
■ r
14.x
:
28'
12. 9 6 -■
22 28101030 9s--'
12 -
.
69y':.
17-—'
>
9 —
•
.
11.
36 -
2 —
—
342 - •'
03. :
70 "
101 11663 39 5748 47r . -
’
'
•
: ,:i
. .
■>, .
pagaj 4
1
22.
2
3
4
Hunagunda
Badami
'
24.
25.
26.
27.
6
62
1
, 63 -
53 r47 17
*
53
47 -
Bagalkote Dist
fludhola
23.
5
.
■
I
Gulbarga Dist
Raichur Dist
Koppala Dist
Bidar Diat
Bellary Dist
Bilagi
Gulbarga
Alaanda APazalpur .
Chincholi •
Chittapura
□avargi
Sadam Shahapura
Surapura
Yadagirl
Ml
■81 r15
63 17161013 .
16.
10 .
6 2 -
48 - ' '
13 33 •
23
r-
Koppala
Yalaburga
Kustagi GangavathiSindhanur
4733 25 37
20
Bidar
Basava Kalyana
Abrade ,
Bhalki
Humanabad
Bellary
Hadagali
H.B.Malli
Hoapet
Kudlagi
Sandur
Siraguppa
■
39
18 11 26 _
B
.
161 '
33
25
57
35
14
13
14 ~
7
— .
1 . «»
1- .
2 '
1-
>
Ml
Ml
Ml
5
•» ,
•»
. «•
•
;■
62
1334-
:
'
J-
■
4 8..
33
25_-<
•!<
37 v- .
; 23 _ • .■ i;
3
M
’ -r
a
.;
■
—
•• ‘
87 176'
19 17, 12.
15 .
20 ’■
13
2_
1 2 2 .
43
Raichur
Devadurga
Lingasugur
fn^nVj
’
; 17«
. —
• •
41
1911,r.._
26.
8
166'
3325.
573514
13 -
‘
j;
'■
t
' '
■5^=44------------- c.—,
Karnataka AVtrcvpdk: & Until
(frraciiuonejs^oaidj B’IqI9~?i
11
Indigenous Systems of Medicine at the Crossroads.
India's Post-independence efforts to establish public health delivery systems have been severely
hindered by an acute dearth of resources of all kind. The health care system cannot be extended
adequately because India lacks the necessary means to invest in modern infrastructure, human
resources, drugs and vaccines at affordable costs. There is also the belief that improved health
services in India can only be achieved with modern institutions and sophisticated technology.
Clearly, we cannot think of 'Health for All' on such unaffordable terms. Only if the large
number of traditionally trained human resources, proven medicines, methods, and practical and
theoretical principles of health care, which have been indigenously evolved for managing health
care in India, are included in development plans and encouraged to contribute their fullest
potential, can the present situation change and the resource scarcity position on the health care
front improve.
The different Indian systems of medicine can derive legitimacy only when the theoretical
foundations of indigenous knowledge are accepted and promoted in their own right, and
substantial resources are invested both in the non-government and government sector for their
development.
Recommendations:
It must be noted that revitalization of the Indian medical heritage is not a short-term task
and cannot be achieved 'over-night'. A 'Pilot project' approach needs to be taken to support
strategic and bold initiatives at primary, secondary and tertiary levels of health care, and also for
upgrading manufacturing standards and providing new research models. Another key area is to
take steps to protect indigenous knowledge from bio-piracy. Some of the thrust areas for
promoting traditional medicine in India are outlined below.
1. National guidelines to ensure the efficacy, standardization and safety of ISM drugs should
be drawn up.
2. A nationally co-ordinated, collaborative research programme, involving a number of
government and private research institutes need to be initiated, to set standards for a
priority list of the clinically most important plants and natural products used by ISMs.
3. The
Department
of ISM
urgently
needs
to
work the
Ministry , of
Environment and Forests and the Ministry of Agriculture, to evolve a national policy and
strategic programmes for the conservation of medicinal plants and other natural
resources. If the natural resources base is lost, ISMs are bound to suffer.
4. In the area of primary health care, codified ISMs and allopaths in the government sector,
should collaborate to revitalize the 'oral' local health traditions in our villages.
5. Complete therapeutic centres need to be supported as national centres of excellence;
these need to carry out rigorous documentation. Presently, only anecdotal accounts of
successful ISM management are available.
Future Prospects
Whether one acknowledges the fact or not, trends all over the world would show that for
one reason or the other, people are not only willing to try alternative systems of medicine but are
actively seeking not-conventionai remedies. People have t aright to be educated about what is
efficacious and what is not. If efficacy is established, it is important to give the option to people
to decide what they wish to use. Equally, if there are no side effects, it is time that remedies
based on indigenous systems are offered as adjuvants or adjuncts to help restore normalcy.
Healthy partnership would be built up aimed at preventing disease and encouraging rapid
recovery.
It is time that India with its vast number of public health professionals, array of clinical
material, research laboratories, with long experience in undertaking fundamentals, clinical and
operational research, supported by bodies like the Indian council of Medical Research, move into
this area to avail of funding available through NIH, USA. It is time that proper programmes for
testing the claim of different systems of medicines are drawn up on priority with a view to giving
patients added relief while combating morbidity. It is also time that the available potential is
harnessed and exploited in the name of medical science and patient care. It is a promise but
which have failed to get the attention of public health specialists and scientists till now. Before
the world opinion to be rid of the side effects of conventional medicine pushes people into
medicating themselves and before promising claims are rendered futile, even before they have
been studies, tried and tested, it is time that a direction was given by prioritization, investigation
and proper publication of outcomes. We have the potential to do this efficiently if we decide to
use the opportunity to build an effective partnership. This time is now.
Source: Health for the Millions Sept-Oct & Nov -Dec 1997 & extract of an article by Ms.Shailaja
Chandra, Former Secretary ofISM and Homeopathy, Ministry ofH &FW of Govt, ofIndia.
DEPART IEiSx JF iNulAw oYSEiM
OF .4EDlCImiS AND n-J.4OE0PZ.THY
.'IN 16 TRY OF HEALTH Z-iSl. FAMILY miEnF/LE
GOVhkNr-iENf -JI- INDIA
CEiNiKAL SCiiEi'IE
iA_ ftEi.0i>IEN1*AilId. A ..Hi,sG FitOGt<J
FIE-
Govt
Docf
len stion an d training of ISM&.H personnel (Teachers
h e a°rS ^nd practitioners) is ve/y important particularly
nr
wo"
an^ °
tbe de£ree awarding institutions in this sector
r->.nr.o+~
and ttlerefore there is even Hreac need to upgrade tithe
ho-1?n,enCC and ski11 of
personnel in the interest of public
health pnd standards of education of fresh graduates.
The Department of ISM&.H has been supporting some insti
tutions for re-orientation training purposes in the last four
years, but the programme has not taken up well. The reasons for
this have been two firstly, good institutions for training were
not udentified and approached properly and, seo’ondly, the norms
for cost of training prescribed in 1990-91 are insufficient.
Now keeping in view to correct these deficiencis institutions
of repute belong-ing to different IS;te.II systems were approached
to have their proposals ana willingness to undertake tfrese
training pr ogr am mes.
Now, the br ptt . of ISi'teiH has revised the fund allocations
for all thjae tr<-ining programmes and has also identified the
institutions which are willing to take up these training progo
rammes. The Leptt, has also identified the various specialised
training programmes and the Institutions as well;'
1,
The. following are the main guidlines to implement thio
programme
esv
1.
Good institutions havlnfa requisite infrastrcture of
Hospital, teaching faculty members and hostel facilities
to the trainees should take up this programme.
2.
To make the programme cost effective, a batch of .20
trainees should be made as per the provisions in the
scheme of teachers and physicians and a batch of 10 for
specialised re-orientation training programme like
Ksh ar - su t r a , ■ Pau ch a~k ar m a the rapy and Liental practices
(Ayurveda).
-2-
3.
4..
The training institution should circulate their progra-'ime
of training well in advance, say about two months, to all
the teaching colleges, diisectorates of IS i&H atid Associa
tions of Ayurveda Unani, Siddha, Yoga and homoeopatiy to
invite the participants.
The applicant institutions are required to formulate f,
proper course of training including, all the advances and
no practices relating to the speciality and skill of the
participants.
5.
The diredtions of CCIFI and CCH should also be kept in
mind while designing the course contents.
However,
the information about the contemporary developments in v
various systems of medicine could be given to the
partici pants.
6.
There is provision of one month training for the teachers,
Govt, physicians and practitioner for general subject of
teaching and practice.
For specialised skills and therapies like Panchakarma,
Ksharsutra rind Yoga wherein the background of the holi
ness is very weak, the duration of the course is of two months.
7.
3. -■
In the provisions of the scheme, the amount of honorarium
per lecture as well as provision for teaching material has
been made.
Therefore, it is expected that the text of the
lectures should be cyclost.yled and distributed to the par
ticipants in the class-room.
9.
To make the training programme useful, proper assessment
in the form of written questioh-paper and oral examination
should be conducted at the end of the training period.
Howeve an internal assessmentcould be made at the end' of
two weeks.
10.
The training programmes should be designed practical ori
ented which are directly applicable in the teaching and
practices.
11.
To minimise the delay in implementing the programme as well
as official prodedurss, the financial assistance will bo
diroctly given to the Principals/Dsans of ths Colleges and
Director of the National Institutes.
12.
For one month training, minimum number of training should bo
15. For two months trainingof spocialisddskills, minimum num'
or of trains ;s should bo 5. F ,r th o Yoga training, the minimi
number of trainees should bo 15.
13.
Local participants from the training institute will bo limit
to 1 only. H->u:vor, if more participants aro intoros od to
participat?, thoy will bo supernumerary and will not bo
ontitlod for any financial assistance.
C" ntd..o ..... 3
-3-
14
There will tu separate batches oft each ors and physicians,.
However, in some of th e clinical soucialiti ns th : training
batch may include all th’ categories of participants.
15.
It will he necessary fortho participant to attend 90$ of
lectures and oracticals.
They will appear in- an assessment
examination at the end of the course. The result of bh.e
examination will be communicated to the m emb er s/h’ads of
institutions.
16.
All th? participants will submit a feed- bask oroferma, one
copy of which will b? retained by the institutions uric om
cony will bn sent to the Ministry of H. 1th, Govt, of India.
17.
At the end of the training programme, th e amount of ixpo.ndii’se m
two page ronort of the nrogramme and tl.ee f.o.eri back proforma wi'
bos ent to the Ministry of Health.
18.
10% money inbuilt in the scheme as institute’s support will
be retained by the Department of ISM and will be released
after the completion of the course and submission ofthe
report and accounts to the Govt, of India.
13. Too expenditure mentioned in th? Parlous components rf the schccould be internally adjusted with minor alt -rations under the
head of dost of consumables, cost of stationery, contingencies
etc. Similarly, alight variation could also be done in invintii
the ext ernal/int ernal oxnerts.
20.
Tn-e institution is allowed to fill up the gabs in the scheme
by utilising the fund from th.e institution/State Govt, to
make th? programme a success.
21.
Training institutions will formulate the module of th 1 training
programme, course contents and teaching material, etc. which
will be circulated to the participants.
11
CL IG 13 IL ITY
o )G ov ?rnm ? nt/Priva te/N. G . D. Institutions am eligible to takeup
this training programme.,
b )Teach ei'c, Governmnnt/Privat? Physicians, Private Practitioners
with minimum Degree Graduates in the ISM&H are eligible for
this training.
H -waver, the pref emnea will bo given to Gov'.,
Coll egos,- teachers and Physicians.
Cent'd................ 4
III.
DURATION OF THE TRAINING
The duration of ths ro-oriantation training proqva-n;
as undor
a)
Toachor’s and Physician's Training
nooks
b)
Training in Specialised fields like
Kshar-Sutra, Pancha-karama therapy,
and Dental Practices & Yoga
-c ir<aifz>
The datails regarding training programmes, numb?? -.r c
courses, number of trainees, pattern of fl o .cla' assx
■etc. are given in Annosuro 1, II, and III
oer. » :
ANNE XU RE I
ONE FIONTH RE-DRIENTATITN TRAINING PRTG R.imE FnR
TEACHERS AND PHYSICIANS OF I5F11H PERSON NIL
1.
2.
Number of Trainees
: 20 (Twenty) bu tha minimum numb ar"
could t?a 15, Hipuovor to mk a it co-.*
effective, it is necessary that ft:
strength of participants is mobilisad to reach upto 20.
Number of Training Courses As par the cafScaty of tha Insti.tut.
Col lag a and sanction of tha Govt
of India.
Exoandityro on boarding
. and lodging
; (ij Tha Institution u4.ll arange
53tfial3f§trit3?cornrn':)ciat 10n at a r-f-"
@
SQ X 20 Nos. X 30 days ~
P*. 30,000/(ii) F~ 'd -75 X 20 Nos. X
30 days -- Q'. 45,000/4.
Duration of Training
:
fatal
75,0.00/6 hours par day for 25 days
(24 hours par uaok )
2 hours Lectures
2 hours Practicle
2 hours discussions
<>,/
Total
: 25 days X 6 ho$ts - 150hi
Number of trainers from :
tha faculty
(i)
(ii) Number of trainers from
outside tha faculty
4 trainers
’ .150/- par hour.
80 hours a month.
@ Pa. 150 par hour X 80 hours-£ f12,C0b/
One expert from, outsiera FtK e
faf’ulty par week for L'ijnni Rail
Fare upto Ilnd A. C. uii'3^ bo pal
and one local expert for'whom
only honorarium and local 'conve
yance will b j paid.
Total - n--. 1,000 X 4 - R". 4,000'(b) Honorarium to be paid to
@ Rs, 300/- par day
Guest Speaker
1200/Total - Rs. 300 X 4 -
Cont ’d................ 2
-2-
5 ( ii-)
(c) Boarding and Lodging for i.vz:nal ox lefts @
150/- per day
( C nt 1 d )
4 outsiders in 4 weeks
150 X 4) 600/(d) Honorarium to local/outsido
experts @ "e. 300/- p >r day &
100/- as conv-o’anc 3.
4 local in 4 weeks
X
(Ps. 300+?s. 100 => re. 400) =
Rs. 1600/- per month.
Total of 5.(i) + (ii) =
Ps, 19,400./6 C
Number of technical/
°
a^n^gistijativo support,.
R'.., 2000/-- p : t“>i■•"•be e?;=.rod
am-rig various p :rso.r’,
(Generally 4J
amount of honorarium
to h3 paid
Cost, of consumables
:
l>s. 500/- per trainee per coin so
Total = Rs. 500 X 20 Nos.
Rs. 10,1
5.
Costof Stationary, etc.
:
Rs„ 200/- pur trainee
9.
( Vnual s/books , otc. for
trains is)
Co-ftingsnci os
:
7.
10.
T tai = Rs. 200 X 20 Nos.-hs,
4,0Ci
5% of the above axponditnrc i.o.
Ps. 1.10,400/- =
5520/-
Institute .support charges:
for oroviding inrrastractijro facilitios, otc. to
@ 10% of the expenditure i.o<, R-t
t;ho trainees Institution.
1,10,400/- = O. 11040/The Institution is free to
utilise this amount for the
development activity reg
arding training infrastructu re
Grand Total of oxnenditur-e:
mentioned apainst SI. Nos.
3, 5(i), (ii), 6,7,8,9 &
10
Rs.
1,21,99 0/-
ANNEXURE II
.
TWO MONTHS RE-ORIENTATION TRAINING PROGRAMME FUR
P^ACTICEb OF ISM & H PERSONNEL
1*
Number of Trainees
2.
Number of It a ining
Courses
MR PENTAL
10 (Ten) but the minimum number caul
be_8. Howev »r to make it orsst effe
ctive, the maximum numb pr of train
ops should ba arranged.
As par the capacity of the Institut
College and sanction of thro Govt, of
India. Number of training courses
could bp maximum 4 in a yfflar.
3.
. Expenditure on boarding
and lodging
(i.) The Institution u'ill zjrrango for
hostal accommodation at a reasonable
rate.
@ Rs. 50 X 10 Nos.
Rs. 30, 000/-
X 60 days =
(ii) Food = & Rs. 75’ X 10 Nos.
days = Rs. 45,000/Total :
4.
Duration of training
X 60
Rs. 75,000/-
6 hours training par day for S wor
king days
2 hours'L cturos
2 hours Practicla
2 hours discussions
Total :
50 days X 6 hours = 300
hours for uhnla course.
5.
(i) Number of trainers
from the faculty
4 to 5 trainors @ Rs. 150/- per hour
for 170 hours in 2 months
^Ps.dour X 17 0 hours
(ii.) Number of trainers
from outsida the
faculty
+
One expert from outside the.facul
ty per week for whom rail fara
unto Ilnd A. 0, Mill be paid and
one local export for uhom only
honorarium ano local conveyance
will be paid.
(a) Rail Fare (Upto Ilnd AC) for
External Expanses ©Rs. 1000/- each
Total -= Rs, 1,000 X 8
=
Rs. 9OOU/(b) Honn.rar.ium to be paiid to
Guost Sneakers @ Rs. 300/— per day.
Total =
300 X 3 = Rs. 2400/-
Cont ’d... .2
-2-
(c) Boarding and lodging fir
External experts
Rs. 150/ nor day.
5 (ii) (Cont’d)
G outsiders in 8 weeks
(Rs. 150 X 8) = r-, 1200
(d) Honorarium to 1ocal/outside oxcp.erts @ Rs. 300/- per day + ps. 100,/as conveyance.
in 8 weeks X
(r . 400 X 8) = Ps. 3200/-
3 1ocal
6
7
8.
9.
Number of technical/ .
:
aoitinistrativ'j support,
staff and amount of hono
rarium to bo paid.
Cost of consumables eg.
:
madicines/material of trai
ning
= Pa.
39,200/-
Total Rs. 4000/- for two months.
@ Pa.
1000/- par trainee per course
Total
= Pa.
1000 X 10 Nos. = Pa.
10,000/-
Rs. 200/- par train no par month.
Cost of stationery, etc.
(Manuals/books, otc. for
trainees).
Contingencies
Total of 5(i) + (ii)
® Pa. 500/- per week
Total = Pa. 200 X 2 months X 10 Nos
= R=. 4,000/:
5% of ths above expenditure i.c.
1,32,200/- = Rs. 6510/-
Pa.
1B.
Instituta support chargas:
for providing infrastructure @ 10/5 of the expenditure i.e. Rs.
faciliti os, otc. to tho
1 ,32,200/- = Rs. 13,220/trainees Institution.
The
Institution is free to
utilise this amount for tho
development activity regar
ding training infrastruc
ture.
Grand total of expenditure
mentioned against SI. Nos.
3,5(i), (ii),6,7,8,9 & 10
*
** *
Rs.
1,52,030/-
***
ANNEXLIRE III
TUP MONTHS RE-ORIENTATION TRAINING PROGRAiT-i£ FOR
YOGA OF ISP'&H PERSDNNAL
T.
Numbor of Trainees
20 (Twenty) hut th 3 mini’.urn nu
r
could.ba 15,.H? ,i ?v .1 r tn make.it c - ■
effective, it is necessary that f’Jstrength of participants is mobili
sed to reach unto 20c
2.
Number of training
courses
As per the capacity of the Insritut
Collage arid sanction of the Govt,
of India. Number of training cours
could b e maximum 4 in a pear,
3.
Expenditure on boarding
and lodging
(i) The Institution will arrange
for hostel accommodation at a
roasonablo rats.
:
@?sPg; 50 X 20 Nos.
Rs. 60,000/-
X 60 days •=
(ii) Food =t @ Cs. 75 X 20mNos.
days = Rs. ^0,000/Total
4.
X 60
Rs. 1,15,000/-
:
6 hours trainirgpor day for 5 work
ing days
2 hours Lectures
2 hours Practical
2 hours discussions
Total : 50 days X 6 hours - 300
hours.for whole course.
(i) Number of
;
trainers from the faculty
4 to 5 trainers @ Rs. 150/- per hour
for 170 hours in 2 months.
Duration of Training
@ Rs. 150 par hour X 170 hours =
Rs. 25,500/
On e expert from outside the facul',
per week for nhom rail fare upto II
nd AC will be paid and one local
expert for whom only honnrarium and
local conveyance will be naido
(a) Rail fare (upto Ilnd AC) for
External Expenses @ Rs. 1000/- each,
(ii) Number of trainers :
from outside the faculty
’
Total = Rs. 1000 X 8 = Ps. 8000/-
(b) Honorarium to be paid to Guest
Speakers @ Rs. 300/- per day.
Total .= Ps. 300 X 8 = Ps. 2400/-
Cent ’d
2
-2-
(c) Boarding and lodgino for Exter
nal experts @ Rs. 150/--par day.
5 (ii) (Cont'd)
8 outsiders in 8 woeks
(Rs.
150 X 8) = R-.
1’200/—
(d) Honorarium to 1ocal/outsids
experts @ Rs. 300/- par day
13
- as conveyance.
8 local in 8 weeks X
Rs. 400 X 8 3230/-
Total of 5(1) + (ii) •-= Rs. 40,300/-
6.
Number of technical/
administrative support,
staff and amount of
honorarium to bo paid
:
® Rs. 500/- per week,
lo^al - Rs. 4003/- for two months.
7»
Cost of consumables eg.
modicines/material of
traini ng.
:
Rsy 500/- par trainee per course.
Total - Rs. 500 X 20 Nos. = Rs.
1 G. 000.
3.
Cost of stationery, etc. :
(Manuals/books, ate. for
trainoes).
Rs. 200/- per trainee per month.
Total - Rs. 200 X 2 months X 20 Nr
-= Rs. 8 000/-
9.
10.
Contigencios
:
Institute support chargosx
for providing infrastruc
ture facilities, ate. to
the- trainees Institution.
The Institution is free to
5% of the above expenditure i.e,
Rs. 1 ,77,300/-- = Rs, 8855/@ 10% of tho expenditure i.o.
Rs. 1,77,300/—
Rs. 17,730/—
utilise this amount for the
devolopmnt activity regar
ding training infrastructure.
Grand total of expenditure;
mentioned against si. Nos.
3, 5(i), (ii), 6, 7, 8, 9
& 10
2,03,895/-
Assessment- proforma of. Training Programme
jj
d b -: >.
(To be filled by the participant at the end of the
Training programme,).
Name of the Institution
Title of the Training Programme
with dat-es
Pleaso tick ( \/) mark the column of your choice.
Usefulness of the programme.
1•
Very useful
Useful
Not useful
About the teaching faculty members.
(a) Observation about the local teachers from th
Training Institute.
2.
Very Good.
No
Not good.
NO.....
(b) Observation about the outside expert teacher:
Very good.
Not good.
No.
3.
What input do you suggest to bo incorporated
in tho future trainingproerramme.
' 4.
Bost thing you observed in tho trainingproorammo
5.
Worst thingyou observed in the training
Name and Address
of the Trainee
oroqiram
J2_ A -1
G. K. THRKKRR
PAPER
ON
WONDERS OF UROPATHY
OF
URINE THERAPY AS A UNIVERSAL CURE
PRESENTED
BY
Mr.G.K. THAKKAR
B.A..L.L.B.,Advocate, Urine Therapist
AT
16th WORLD CONGRESS OF COMPLIMENTARY
MEDICINES
Held on April 28th, 29th and 30th 1989
AT
ATHENS HILTON HOTEL, ATHENS, GREECE.
DEDICATED
To
My Guru
KISONLAL TEJPAL
Who Initiated me
To
This Divine Therapy
AND
To
‘Shivambu-Rushl’ Morarji Desai
Who gave me
Inspiration, Courage and Confidence
For
Propogating the Messaage
of
This Divine Therapy
To
four comers of the World.
Friends and fellow Delegates,
1 am very happy and glad to present this paper of mine titled “WONDERS
OF UROPATHY" or “Urine Therapy as a Universal Cure”
I had presented a paper on this subject at the 2nd All India Congress on
Alternate Therapies held on 17th & 18th September 1988 at Tajmahal Hotel,
Bombay under the auspicious of COSMEHRA. It was my first attempt at
writing a paper on the subject. There is a world of difference in the presenta
tion of the same to-day, because that presentation was such a grand success
that I received an Invitation to speak and present my paper from Sir Anton
Jayasuriya at this Congress who was present in that Congress in Bombay and,
I am before you today.
In that paper of mine in the last lap of the same I had claimed and de
clared confidently that when Urine Therapy cures deadly diseases like Cancer
and Kidney failure very easily hence it must, definitely cure the most dreaded
and horrible disease AIDS which is the biggest challenge to the scientists of
present generation. My claim was neither based on the superficial surmise,
nor it was remark of a casual nature, but it was based on my deep and inten
sive study and a perfect scientific approach of Urine Therapy.
Nobody would have paid a serious attention or would have given any im
portance to my above claim because I am neither a doctor nor I had seen any
AIDS patient. But miraculously my paper ‘Miracles of Urine Therapy’
reached U.S.A, via Switzerland and fell in the hands of a doctor named Dr.
Beatrice Bartnett; who is practising Urine Therapy over there and has written
a book named ‘Miracles of Urine Therapy’. What a wonderful coin
cidence! She was so glad to go through my paper that she presented me her
book with the remark “To Mr. G.K. Thakkar, Thank you, so much for your
courage and the great work you are doing. God bless you and your family,
with Universal love”. Sd/- Beatrice Bartnett. In her letter she appreciated my
paper and wrote that she has successfully treated few AIDS Patients with
Urine Therapy. She also enclosed along with her letter a thrilling recovery
story of a full blown AIDS Patient; Quique Palladino in his own words.
Because of this incident about a dozen news papers from Bombay and
several news papers all over India have given me wide publicity by printing
the news that Urine Therapy is the most effective cure for the horrible disease
AIDS. Because of this news message of Uropathy has spread throughout the
length and breadth of India, as wild fire and now it is going to spread to at
least dozens of countries, from which fellow delegates have come to partici
pate in this Congress, and thereby object of my Mission will be fulfilled.
More and more people are turning to Urine Therapy who are disappointed
with Allopathy and other modes of treatment.
5
Friends, how miserable and unlicky we are! Ever loving and all caring God
has given us such a precious and valuable gift right from our birth, which has
the potentiality of curing each and every disease present on this planet includ
ing deadly diseases like Cancer, Kidney failure, heart disease and even horri
ble AIDS, of which we are not aware till we die a miserable premature death
at the hands of experimenting, physicians and surgeons! I am happy and
proud that ever loving God has elected me to be his mouth-piece or repre
sentative for informing the hidden fabulous medicinal values of our own urine
to the masses. I am purposely using the word elected because while electing a
person for any post or job no qualification, education or ability is considered,
which is looked into while selecting a person. In election only God's grace is
needed which comes by devotion, sincerity of purpose and selfless service of
the ailing humanity.
Friends I have not come to sell or advertise any medicine. Urine Therapy
can be carried out by anybody young or old and even a child at home without
any expenditure whatsoever, and with a little knowledge about UROPATHY.
I would start the subject proper by printing the exact wording of the FORWORD given by Dr. Beatric Bartnett and Margie Adelman in their book re
ferred to above published by Water of Life Institute P.O. Box No. 22-3543
Hollywood, Florida-330022 3543, which I have liked very much.
How fortunate we are to be alive in this great time; in this time of change
and growth. Mankind is growing from*adolescence into adulthood, and we
will help this process.
Give thanks that you are one of the chosen ones to be alive in this special
hour. Listen to the voice inside you, so that you will fulfill your destiny and
the destiny of Mankind, Mother Earth and the Universe.
This is the time the prophets foretold in thier books. Mankind has been
waiting thousands of years for its arrival and we are a part of it.
Love yourself, you are special. Love will move mountains, heal the sick
and develop the arts and sciences.
Love yourself, for what you are a God or Godess — perfect, loving, and
good.
The Water of Life is a gift given by our creator for our spiritual growth and
physical well-being.
It was used by the spiritual leaders, sacred groups, and simple folk through
all ages.
It was never lost, only hidden, for truth always exists.
You were guided to find this information, read it and meditate it. Let God
within, be your teacher and go over those obstacles which may hinder you on
your path. Ask for guidance and it shall be given to you.
Give thanks to be a part of this wondrous plan!
6
But most of all - love yourself - love will move any atoms in the universe
and bring positive changes to these times.
With love,
Margie Adelman
Dr. Beatrice Bartnett.
The above authors have coined out a very unique word. UROPATHY
which can interchangeably be used for Urine Therapy. This word cannot yet
be found in any dictionary. It is derived from the word urine (URO) and
PATHY (Dis ease). Uropathy is the method of healing dis-ease by the ap
plication and use of one’s own urine (Auto - Urine - Therapy).
Now 1 am going to share with you some of my miraculous experiences and
experiments of “Auto Urine Therapy” or “SHIVAMBU KALPA VIDHI".
About four years before I got attracted towards this therapy and was thrilled
by its wonderful results. 1 was suffering from Amoebic Dysentry since last 20
years and my physicians had assured me that it will accompany me till end!
Also I was having Eczema since more than 40 years. To my utter surprise I
got rid of both major diseases by this wonderful remedy ‘Auto Urine Ther
apy”. You will be further surprised to know that there are some side effects
too; but not of the usual harmful nature, which you very often suffer in Allo
pathic treatment. I suffered from falling hair and dandruff. I always used to
have cracks in my feet and even on my lips in all the seasons. I had to use
Boroline and other creams for the same. Likewise I suffered from stomatitis
(Ulcers in mouth) once in few months regularly. I got rid of all the above
complaints and ailments unknowingly, as beneficial side effects of this ther
apy! I have grown younger by many years, and today I am having vigour,
stamina and energy which I didn't have thirty years before! My wife says, 1
was not so young, energetic and sexy even in my young days! All these be
nefits on a wholesale basis were achieved by Auto Urine Therapy of few
months.
The biggest miracle or beneficial side effect that has occured in my case is
that Urine Therapy has made me an effective and bold orator overnight. Yes, 1
had never spoken from any stage before even a small audience, prior to doing
Urine Therapy. Now I can speak in four languages for hours at a stretch on
this subject and many more. The secret of this phenomenon is that Lord
Shanker has promised mother Parvati in Shloka 89 of ‘DAMAR TANTRA'
(Five thousands years old scripture) that one who does this therapy for three
years as per his strict instructions acquires "WAK SIDDHI” becomes effec
tive orator! I am glaring example of that promise! This therapy has passed
down from ancient civilization, sacred groups. Yogis and Sages.
My wife was a regular patient for more than 20 years and was suffering
from numerous diseases viz. ear trouble, vertigo, constipation, pain in the
7
joints, cramps in leg and many more. I had tried for her all the best available
talents in Allopathy, Homeopathy, Ayurved and even Unani! But without any
result. At last we stumbled across this wonderful therapy and she got rid of
her all the ailments by Urine Therapy miraculously. Even she got rid of a
tumour in Uterus for which the surgeons had advised operation!
My elder son who is 20 years old was suffering from CHRONIC COLD &
CONSTIPATION since a decade and no need to tell that we had exhausted
all the pathys, without any positive result. He drank it, of course his own
URINE through his nose and got rid of his both the troubles.
Now comes the exciting story of my younger son aged 18 years who
suffered from Hematuria since more than a year. He was passing blood in
urine which could not be cured by the treatment for more than one year. My "
doctors told that something was seriously wrong with his kidneys and advised
that intravenous pylograph should be done to find out as to what was wrong
with his kidneys. 1 told my doctor that if my son agrees to drink his urine, I
have not to go for any investigations or treatment for his trouble. I persuaded
my son for starting Urine Therapy. He said “Dad if I drink urine and don;t get
cured” I assured him, and said “You do this therapy for 30 days and if you
are not cured at the end of this period I will stop drinking urine myself and
stop talking about it.” At the end of 30th day on 17th Feb. 1988 when the
urine report was received my son danced with joy and said “Dad you are
great”! The urine report was absolutely normal! Now our whole family is a
SHIVAMBU family! On being inspired by its wonderful results I resolved to
study this SHIVAMBU science deeply. I gathered all the available literature
and books on the subject and studied the same intensively. On achieving
wonderful results I went deeper & deeper in it. Now it has become Mission of
my life to spread the knowledge of this wonderful therapy and to serve the
ailing humanity thereby in my humble way.
Our elderly Morarjibhai Desai Ex-P.M. of India who is in perfect shape and
health at the ripe age of 94 got the knowledge of this therapy at the age of 68 . about 26 years ago. He is an ardent follower of this therapy, since more than a "
quarter century! Hardly very few might be knowing as to what benefits he has
derived from this wonderful practise! We have come very close to each other
because of common interest and liking, Urine Therapy.
He says that he got rid of his 45 years old constipation. He got rid of his
cataract at the age of 68 which was in the initial stage. He was operated for
cataract recently. He says he could stop cataract formation for twentyfive
years by using his own urine as EYE DROPS! He is massaging his whole
body with old Urine for more than one hour daily since 25 years! Also he has
not used bathing soap for bathing and not used shaving cream or soap for
shaving during the last 25 years! Yes he is using urine as shaving cream as
well as after shave lotion! Every time I meet him 1 come to know from him
8
something new about Urine Therapy. According to him on his becoming
P.M. of India, Shivambu or Urine Therapy got a very big boost for its
spreading in India as well as in various countries around the Globe. He is
perfectly justified in his statement.
It is a feast for the eyes to have a look of him from close quarters and it’s a
unique experience of touch to shake hands with him. He has no old age
wrinkles on his face or body at the age of 94 and his skin has a silky, soft
texture of a small child! The secret lies in Shivambu massage. By its massage
your skin becomes smooth, lustrous, and silky and your aging stops instantly.
If this secret reaches to the modem feminine world and if they choose to shed
away repulsion and nausea for Urine, business of many cosmetic manufactur
ers will be badly affected! Many girls & women have on my advise used their
urine as lotion for improving their skin complexion and the results were
fabulous!
HISTORY
OF
“SHIVAMBU KALPA” OR
URINE
THERAPY
We must congratulate overselves that in every age there are at least some
individuals who have consumate love for TRUTH and they are ever ready to
re-establish it at all costs. J.W. Armstrong of England, Mr. Ravjibhai Patel
and Dr. P.D. Desai of India were such souls. They established and proved
that urine is a remedy par excellence. We can well imagine that it must have
been a matter of great courage and conviction to practise it upon one-self and
on others on the face of adverse public opinion in those days.
Mr. John W. Armstrong an Englishman can be called the pioneer in the
field of Urine Therapy. The whole humanity will remain indebted to him for
ever for his pioneering work he did by writing a magnificent treatise on Urine
Therapy titled ‘WATER OF LIFE’, about 50 years before which is freely
available in almost all the countries around the Globe and which is translated
into innumerable languages of the world. This book is a class by itself and can
be termed ALMA ATTA OF URINE THERAPY.
In India this therapy was made popular by a wellknown freedom fighter and
co-worker of MAHATMA GANDHI, late Mr. Ravjibhai Patel who got cured
of his Asthama, heart trouble and other ailments by urine Therapy. He got the
knowledge of this therapy from the book “WATER OF LIFE” referred
above. Mr. Morarji Desai, Ex. P.M. of India got inspiration from the same
book which was given to him by Ravjibhai Patel. He has written a very
informative book on Urine Therapy, titled “MANAV MOOTRA" which is
translated into English, Hindi and Kannada.
Mr. Armstrong got inspiration from a writing in Bible, which said “Drink
water from thy own cistern" (Proverb 5-15). He interpreted the writing of
9
Bible in a plain manner and got himself cured from the deadly disease Tuber
culosis by drinking and massaging his own urine. Being thrilled by his own
miraculous recovery he tried this therapy on around 40 thousand patients
rejected by allopathy over 20 years of time suffering from incurable diseases
ranging from Cancer, to Kidney failure and Gangrene to Diabetes and cured
majority of them all! The outcome of his intensive and successful experi
mentation was the fabulous book “WATER OF LIFE”!
Friends, you will be astonished to know that though I have called Mr.
Armstrong the pioneer of Urine Therapy, it has its origin in India! And that
too it dates back to more than 5,(XX) years! Does it not sound funny? When the
book “Water of Life" came to India about 40 years before few individuals
came to know about the fabulous medicinal values of our own urine. Few
years after that it was discovered by us that the reference of this therapy is
found in VEDAS, MAHABHARAT and almost all the volumes of AYUR
VEDA, which are the oldest scriptures of our culture.
In one of the volumes of AYURVEDA viz. BHAVPRAKASHA Urine is
termed as “VISHAGHNA ” killer of all poisions and “RASAYANA” which
can rejuvinate even old person and “RAKTAPAMAHARAM" which puri
fies blood and cures all skin diseases. Reference of Urine Therapy is found in
almost all the volumes of Ayurveda viz. SUSHRUT, HARIT, BHAVPRAKASH, GAJNIGHANTU, YOGRATNAKAR. BHAISHAJ-RATNAVALI,
RAJNIGHANTU. VAGBHATT, DHANVANTARI NIGHANTU and many
more. In SHIVAMBU KALP VIDHI” which is part of “DAMARTAN
TRA'' our oldest scripture, Lord Shankara has explained to PAR VATI in 107
verses (SHLOKAS) the procedure and rules to be followed while doing U.T.
and its beneficial effects when taken with certain herbs.
It was used only by YOGIS and RISHIS but not by general populace and
hence it remained hidden. There are several other reasons as to why this prac
tise was kept hidden for centuries. I am not going to discuss the same in this
paper for want of time and space.
You will be further surprised to know that Urine Therapy or “SHIVAMBUKALPA " is part and parcel of TANTRIK YOGA! In spite of this basic
fact this knowledge has not reached the masses, though Yoga has become so
popular and has reached in the four corners of the world and I was not an
exception to it. Yes, though I am practising Yoga and Pranayam since more
than 40 years, I came in possession of the knowledge of Urine Therapy four
years before. I was so much thrilled with its wonderful results that I decided to
inform it to the whole world, and I am before you!
In TANTRIK YOGA culture this practise is termed as ‘AMROLI. Amroli
comes from the root word AMAR which means IMMORTALITY, UN
DYING, IMPERISHABLE, Amroli was therefore a technique designed to
bring about immortality! Amroli was originally a spiritual practise rather than
10
a method of treatment. They term it holy liquid i.e. “SHIVAMBU". Accord
ing to them Urine is more nutritious than even Milk! You are not only physi
cally benefitted by its practice, but you become spiritually advanced because
it is an elixir for body, mind and spirit!
The only unpolluted (Purest) thing in this polluted world is our Urine!
In our scriptures VEDAS & UPNISHADAS our body is compared with the
Universe “ YAA PINDE SAA BAHMANDE". We cannot imagine the exist
ence and survival of our beautiful planet (Earth) for a moment without the sup
port and presence of salty oceans, in the like manner I can’t imagine the existance of healthy human life without the help and support of our salty Urine!
In every passenger vehicle there is always kept an emergency exit, in the
like manner all caring and loving God has given us emergency kit (Urine)
right from our birth. We must know how to use it to our best advantage in
times of emergency. I am going to teach you how to do it.
If disease is a blow of the sword, our urine is the protector DHAL' against that
fatal blow!
This therapy disproves and falsifies one very old and wellknown proverb
‘Little knowledge is always dangerous". Friends, take it from me that even
the slightest knowledge of Uropathy will be immensely useful under any cir
cumstances!
Even though so much is said about U.T. in so many volumes of AYURVE
DA AND several old scriptures like VED, MAHABHARAT, DAMAR TAN
TRA, BIBLE. MASONIC TEACHINGS, SUFI TEXTS. JAIN AND BUD
DHA TEACHINGS etc still it remained hidden and unexplored for centuries!
It was never lost but hidden for TRUTH always exists!
Friends, we all are aware that medicinal values of different medicines
change from time to time because of new inventions, and passage of time
and in many cases they are even proved to be harmful after its prolonged use;
but you will be surprised to know that medicinal values of our Urine have nev
er changed during the period of thousands of years as it is manufactured in the
Divine lab. TRUTH can never change!
There are stories of olden times and even recent ones of travellers and ex
plorers who were often put into hardships and seclusion while in desert and
sea and when water got exhausted have survived for days by drinking their
own urine and successfully completed their journey.
Late Maurice Wilson, who made a magnificent but abortive attempt to
climb Mount everest, ascribed his immunity from ordinary ills and his asto
nishing stamina to his many fasts on URINE only, plus external friction with
URINE.
Tibetan Lamas are known to use their own urine profusely for preserving their
health in isolated, cold dry plateau of Tibet. They live a very long life (More than
hundred years) with the grace of nutritious ingredients of urine. By the same
11
means they can also traverse deserts inaccessible to ordinary mortals!
Even in Western countries efficacy and fabulous medicinal values of urine
were known to the people which is evident from old records. In a book “ONE
THOUSAND NOTABLE THINGS” published in England. Scotland and Ire
land simultaneoulsy in the beginning of Nineteeth Century there are many impor
tant and useful references of Urine Therapy.
Similarly in another book “SOLOMONS ENGLISH PHYSICIAN" pub
lished in 1695, we find good knowledge of properties of Urine. It is written
that urine is watery part of blood, (which is absolutely true). It also prevents
decay and rotting. By drinking of Urine diseases of Kidneys Liver and Biles,
dropsy. Jaundice and other poisonous fevers are cured. It cures wounds
caused by even poisonous arms and weapons. It opens all obstructions of Rein
Mysentary.
The above excerpts prove the point that Urine therapy is not a new thing. It
has been handed down to us from anteriority.
These stories primarily show us that the common notion that urine is some
thing dirty and poisonous is not correct, but it is a living solution. It contains
ingredients which make and nourish human tissues and blood.
In the whole of the Creation we don’t find even a single creature whose
necessities of life have not been taken care of by nature. The human body has
also been equipped to produce remedy for every disease which body is likely
to get in the course of living, and that remedy is URINE.
The final and most profound argument in favour of Urine therapy is that it
WORKS. Any one can test it for himself or herself. In the last analysis this is the
only thing that matters.
SCIENCE AND UROPATHY
Many people believe that Urine is TOXIC substance or dirty excretion of
they body. If this belief was true, how could our elderly Morarji Desai, Ex.
P.M. of India would have survived who is drinking his urine since more than
quarter century?
He has not only survived but is healthier than any other person of his age.
Many individuals trapped in boat, raft or in desert have survived for days by
drinking their own urine. The Governments of several countries recommend
to their soldiers to drink their own urine in cases of liquid shortage-would they
really poison their own people ? Myself and my wife are drinking Urine since
more than four years, have acquired better health and grown younger!
After innumerable clinical and laboratory tests earned out over several years
in Japan, China, U.S.A., Switzerland, and many Europeon countries it has
been conclusively proved that over and above Urea it contains Enzymes (of
different kinds) Vitamins, Antigens, Antibodies, Aminoacids, valuable salts,
12
♦
and minerals Carbonates, Bicarbonates, pigments, Carbohydrates and Hor
mones. It is a watery part of Blood.
If we consider human urine Therapy from the allopathic point of view, it
must be accepted that human urine has close relation to the theory of bacterial
infection. The bacteria in urine have proved to be effective in many dis-eases.
Thus this theory can be evaluated vis-a-vis the allopathic bacteria theory.
Thus this U.T. has the backing of science as allopathic therapy has.
Very recently two Doctors Dr. Alexander N. Glazer and Dr. Stocker from
University of California have discovered that the yellowing dye responsible
for Jaundice, present in Urine long dismissed as valueless bodily waste
appears to have a beneficial function that can lessen tissue damage in CANCER, AGING, INFLAMATION and HEART DISEASE. • Instead of
spending 95% of our time in developing means to get rid of bilirubin, we
should spend time on possible beneficial roles of bilirubin. ’ ’ Dr. Stocker said.
The above news had appeared in "EXPRESS” (U.S.A.) dated 1-3-87.
We all are aware of the biggest drawback of Allopathy that it does not con
sider human being as a whole-an integrated whole and the result is, need has
arisen for spare parts like KIDNEYS, HEARTS, LIMBS, etc. on a wholesale
basis! Moreover Antibiotiic drugs do destroy disease causing bacteria and
viruses, but together with it they also adversely affect the life force, and
digestive flora of the patient which gives rise to further serious diseases. In
tum the scientists have to find out more powerful antibiotics to suppress the
aggravated diseasse, and the vicious circle continues.
In this connection I am reminded of the remark of Dr. Allan cantwell
(AIDS researcher) who says "Medical scientists may have unwittingly produced
more virulent and more contagious cancer bacteria (or viruses), by the widespread
use of chemotherapy, antibiotic therapy and radioactive therapy in the modem
treatment of Cancer”!
Dr. Pragjibhai Rathod (Ayurvedic Practioner) has accidently discovered
that Cow’s urine contains steroids. We al! Indians are fully aware of the fabulous medicinal qualities of Cow’s Urine.
I am fully confident and of the firm belief that our urine also must contain
STEROIDS. This is the secret of its fabulous medicinal qualities.
Friends, we all are fully aware that STEROIDS is one of the most cursed
drugs of our time. It’s bad effects are now internationally known but let me
assure you that there won’t be side effect of any kind even if one consumes
urine in large quantity over a length of time; because Steroids present in our
urine is not harmful like synthetic steroids.
A day is not far off when the athletes taking part in Olympic games might
drink their own urine for'best performance without fear of being disqualified
for the consumption of steroids! They will get STEROIDS from the con
sumption of Urine in the most effective and harmless form.
13
Scientists of Holland have recently discovered a bio-element from human
Urine, which ensures a long healthy life. They have not yet named that ele
ment. This discovery might revolutionise healing greatly.
Professor John W. Pleasch, M.D. did a study on Urine Therapy in the
1940’s. In his paper he states, “Since I started Auto Urine Therapy three
years ago, I have not come across a single case where the patient suffered
any harm. It is for this reason that I decided to publish my findings at this
early stage”.
A study done by Lars. A Hanson and Eng. M. Tan at the Rockefeller Insti
tute, New york in 1965 showed antibodies for cholera, Salmonella typhi.
Diphtheria, Tetanus toxoid, and Polio present in human urine.
Unfortunately in a world of modem medicine and pharmaceutical interests,
a tincture free and self produced, will not profit the health industry. For this
reason a very limited amount of research has been done on this topic.
In recent years lot of scientific research is being carried out by the eminent
scientists in the different countries of the world, but not to the extent it should
be done; as nobody would be able to earn profit out of this free tincture
(Urine).
Friends, you must be aware of the fact that inspite of the above drawback
Japan and China are extracting a very valuable substance called UROKI
NASE out of human urine collected from public urinals, and are earning valu
able foreign exchange by exporting the same since many years. This extract is
useful for dissolving the blood clots in heart and lung disease. It works as a
powerful artery dialating agent resembling Nitroglycerine, which is harmless
as extracted from our Urine.
Reference of UROKINASE is found on page 1354 in the big volume writ
ten by four learned American Doctors who are M.D.Ph.D.. The name of the
book is “Goodman & Gilman's the Pharmacological Basis of Therapeatics”, which is published by Macmilan publishing Co. Newyork and is pre
scribed for the students studying in M. B.B.S. Therein along with other things
it is mentioned that UROKINASE is extracted from human urine and that the
course of therapy with UROKINASE is very expensive. What a pity, the
fabulous free tincture gifted by God becomes prohibitively costly when it is
processed in the factory, which is classified as life saving drug! Instead of
opting for costly treatment why not drink self Urine which is provided freely
by our creator?
Scientists have so far succeeded in isolating only one enzyme. UROKI
NASE from human Urine but it contains several other unknown Enzymes.
which helps the recovery from even incurable and deadly diseases.
Japanese people are known world over for their ingenuity, hardwork and
originality, and that is the reason why they are the leaders in many fields like
electronics, automobiles, ship building and many more. Very recently they
14
have started extracting very precious hormonal ingredients from the Urine of
pregnant women! During pregnancy the Urine is full of particular type of
(Hormones), OESTROGEN and PROJESTROGEN. Friends you will be
wondering as to how and from where that Japanese firm is obtaining the
raw material? (Urine of the pregnant women) You will be surprised to know
that one marketing company from Hyderabad (India) is exporting it in bulk to
Japan! This marketing company chalked out a very novel plan to get the urine
from the pregnant women. They are carrying on some social work in the poor
localities and Zopadpatties of Hyderabad and Secunderabad and in return they
ask for the urine from the pregnant women. They have engaged the services of
lady nurses for the purpose of collection of the same.
In scientific investigations carried out in several countries viz. U.S.A.
Japan, Scandinavia etc. normal human urine has been found to contain mar
vellous healing property promising to cure deadly diseases such as Cancer,
Tuberculosis, Pulmonary and Cardiac Vascular diseases etc. as mentioned in
the Press Reports published in Medical Journals, extracts from which are
given below:-
1. Press Report: San Fransisco (U.S.A.) October 24, 1967 (A.P.)
“An extract of human urine shows great promise for treatment of certain
deadly diseases caused by formation of blood clots. Research Physicians said
at the Scientific sessions of the American Heart Association. The extract is
called ‘Urokinase”. It activates substances in the blood stream that dissolve
the clots
Experience has been obtained with about 200 patients with Pul
monary Embolism, the most common of seious Lung diseases, Dr. Sherry
pointed out”.
2.
Extract from the “Science Digest" July 1958:
"Normal human urine has been found to contain a powerful Artery-dialating
agent resembling Nitroglycerin in its ability to increase the coronary blood
flow to the cardiac muscle, used for the relief of Angina Pectoris”.
3.
Report presented at the annual meeting of the "Federation of American
Society for Experimental Biology" in Atlantic City U.S.A, in April 1966.
under the heading “BRINGING CANCER CELLS INTO LINE". Gives
the account of research showing the effect of human urine on cancer cells
The two Researchers found unexpectedly last year that the urine extract.
which they call “DIRECTIN'' When added to the culture medium, caused all
the cancer cells on which it has so far been tested, to align themselves end-toend into straight rows?"
More than two and even three decades have passed since the above discov
ery’ and research was made, but hardly any further remarkable development or
progress is made in this field during the period of quarter century. 1 presume
that reason for such slow pace and progress is that it is not a profitable ven
ture!
15
These investigations give strong support to the claims of the Auto-Urine
Therapy 1-An Emperic Therapy of Ancient India known as “SHIVAMBU KALP”-of providing an universal remedy for the prevention and
cure of every kind of the patient’s own illness.
MY PERSONAL EXPERIMENTS:
I have tried this remedy on myself, my wife and two sons and got rid of
many ailments as mentioned earlier, and on my advise many others have also
tried it on themselves who got cured of numerous ailments. 1 have seen cases
of chronic cold, Asthama, worst Arthritis, Kidney failure. Piles, fistula, vericose veins, vericose ulcer, psoriasis, eczema, pimples, Acne, all sorts of
eyes, ears, nose and throat troubles, epilepsy, nervous break-down, ladies
problems during pregnancy and menopause being cured.
Friends 1 have achieved very promising results in Obesity in several cases,
even without diet restrictions! It works fantastically on Impotency and sexual
debility. It is world’s best de-aging tonic discovered so far.
A very interesting case of a couple is reported in the book “SHIVAMBU
KALPA” written by Mr. Arthur Lincoln Pauls, a Canadian bom author set
tled in U.K. A Young 27 years old Anglo Indian who got married to a girl of
18. After few years of marriage it was detected that he was not virile and his
semen lacked active sperms, and hence his wife did not conceive. Both of
them drank each others’ Urine and their own urine on alternate days on advise
from boy’s Grand father (Indian) and they both anoited each others urine on
their genital organs and he became more potent and his sperm count in
creased. In two months his wife conceived. Now they have two sons.
I have tried this therapy on worst tooth pain, and all sorts of tooth and gum
troubles, like gingivitis, pyorrhoea and gumboil. On my advise my wife, two
sons and many friends have tried this for their tooth and gum troubles which
has never failed in a single instance. Severest tooth pain disappears in mi
nutes!
Once during my lecture, one gentleman rose from the audience and asked
me "Mr. Thakkar’ you are talking so highly about urine treatment for all tooth
problems, but my experience is otherwise with it. I am rinsing my mouth with
urine since two years, still I have lost my two teeth and the third one is loose
and is on the verge of going". I was so much confident about Urine s efficacy
for all the tooth problems, that I told to that gentleman who happened to be a
homeopathic doctor, that I would put only one question to him and his doubt
would be over! I asked him "How long you rinse your mouth with Urine ?
His reply was “for a minute or two’’. The defect in the treatment was detected
instantly. One has to fill his or her mouth with fresh urine for few minutes
from 5 to 15 depending upon the severity of the tooth problem and pain, so
that it can be absorbed by the gums and would reach the roots of the teeth. The
doubting doctor was fully satisfied and convinced by my explanation.
16
Thereafter I had inquired of him about his loose tooth, which he said had
become all right with my technique.
Friends, 1 have successfully tried this on the worst type of pimples and acne
and even black spots caused by acne and have earned the good wishes of
numerous young boys and girls who had tried all the modem, widely adver
tised, costly creams and lotions with no results. For popularising this success
ful, simple, harmless and sure therapy for pimples and acne I intend to deliver
my talks in colleges and schools so that hundreds and thousands of young
boys and girls suffering from this ugly skin disease will be benefitted most.
In this context I am reminded of a interestly story narrated to me by Mrs.
Nalini Daftary, daughter of my “Guru" Kisonlal Tejpal who gave me "DIKSHA" of Shivambu. who drank my urine to remove my repulsion, nausea and
hesitation and initiated me to this wonderful therapy. He used to drink the urine
of each and every patient suffering from any disease to remove his nausea and
repulsion who went to him for guidance. Naliniben who is staying in States
happened to visit the college where her daughter was studying, to meet her
professor for some work. She could see that Mr. John’s (Professor) face was
full of big lumps of Pimples. He told her he was suffering from this malady
since several years, which he couldn’t get rid of inspite of trying all the latest
medicines and treatment available in States. Wellknown Vaidya Dr. Pragjibhai Rathod, a great exponent of Urine Therapy and writer of a book on
Urine Therapy in Gujrati language terms this as “MAHA ROG" of twentieth
century because it is hard to cure even with most sophisticated drugs, lotions
and ointments. But our Mr. John got rid of this "MAHA ROG" by this ther
apy (by application and drinking of his own urine) which had made his face
ugly. Mr. John who is Ph.D in Maths and Physics is teaching in the Universi
ty of Orlando was so much thrilled and overjoyed by the wonderful results of
this therapy, that he wants to do Ph.D. in "SHIVAMBU KALPA" or
URINE THERAPY. I am doubtful whether he will succeed in doing so. Be
cause to my knowledge no University in India or any country in the World has
got the arrangements for teaching this repulsive, nauseating and obnoxious
but wonderful subject. If any University, College or Institute becomes pioneer
in starting such a course to teach "SHIVAMBU or AUTO URINE THER
APY”, I offer my free services to teach the subject in the service of ailing
humanity. I would request Dr. Jayasuriya to give a serious thought in this
direction to start a faculty for teaching this wonderful therapy in the Open In
ternational University for Complimentary Medicines. The course will be of a
shortest duration of hardly one week. Yes it can conveniently and exhaustive
ly be taught in a period five days from Monday to Friday.
Very recently I have written a letter to Mr. Gorbachev the president of
U.S.S.R. wherein I have made a very unique, timely and useful suggestions
to him. The gist of the same is as under:-
17
In the Science Express (Weekly supplement) of Indian Express, I came
accross a news item, a team of American Scientists have said that those who
were staying in 30 K.M. radius of Chernobyl and who were exposed to radia
tion because of 1986 accident are likely to suffer from cancer in te next de
cade. On reading this news an idea flashed in my mind that when cancer can
be easily cured by Urine Therapy it must prevent also.
I have requested Mr. Gorbachev to carry out a unique experiment on the re
sident population around Chernobyl who were exposed to radiation. I have re
quested him to try Urine Therapy on the 50% of the population staying around
Chernobyl and rest of the individuals who were equally exposed to radiation
may not be given this treatment. After a duration of few months it will be
noticed that those who are kept under. U.T. would not develop any cancer
trouble, while the rest might develop the disease of cancer as forecast by the
American Scientists. This experiment is so safe, simple and sure that it can be
carried out without fear of any harmful side effects. When I am talking of side
effects, which you generally come accross when any new drug or medicine is
invented and experimented; Thats why it is generally first tried on monkeys or
guinea pigs or rats. In case of Urine Therapy not a single untoward incident
has been reported so far of any harmful side effect. On the contrary numerous
cases of beneficial side effects are reported by different patients. Yes, when
any body tries this therapy for any serious or chronic disease minor dis-eases
disappear unknowingly!
Dr. C.P. Mithal
M.D. Ex House Physician, N.F. Medical
College (West Bengal) (India) who has written a wonderful book titled
“Miracles of Urine Therapy" writes in his book that he used to ask his pa
tients suffering from Chronic and hard to cure diseases to bring their urine for
test on each visit. He colured and flavoured the same and would return it in
another bottle to the patients as medicine. After few days when satisfactory
improvement was noticed he would tell the TRUTH to them with the advise
to drink their own waters in purest and most unadulterated form! He got
amazing results in several chronic and deadly diseases!
During four years of my deep involvement in U.T. I have come accross
several, thrilling recovery stories of patients who got recovered from deadly
and incurable diseases like Terminal Arthritis, Kidney failure, Cancer, Vericose-Veins, Vericose Ulcer, epiplepsy, nervous break down, piles, fistula
etc. It's not possible for me to narrate and include all of them in this paper for
want of time and space.
When I came to know that the well known heart surgeon Dr. Christian
Bernard is suffering from severe Osteo-Arthritis and has stopped operating
because of this incapacitating and painful malady, I wrote him a letter inform
ing him about the fabulous medicinal values of our urine and the procedure of
treatment. About six months have passed but so far I have not received reply
to my letter.
18
f
1
EMINENT DOCTOR’S OPINION ABOUT AUTO URINE
TREATMENT
Dr. Rabagliati of Bradfordthat frank and broadminded surgeon admitted
that the surgical treatment of cancer was a complete failure. He had performed
over 500 major operations for Cancer and rarely had any patient survived after
the operation. Regarding the success of Auto Urine treatment in diagnosed
cancer cases, he testified as under:
“I have examined a number of women who according to orthodox treat
ment would have been operated and got one or both of their breasts removed.
These brave and fortunate mortals declined my advice and gone under urine
therapy. When they consulted me again, I did not find, even a scar to suggest
the healing of “INCURABLE MALIGNANT GROWTH”. Some of them
found lumps disappeared within a fortnight and others even in four days.
Thus I think Mr. Armstrong is probably correct in his suggestion that most
of these lumps are not malignant until AFTER surgical and drug interference
and that in the incipient stage. The so-called king of terrible disease can be
easily cured if tackled promptly by the Auto Urine Treatment ” (The
same is the case with the horrible deadly disease AIDS-it is my opinion).
“If, however, any layman claimed and produced a thousand cured cases on
one platform
I doubt if it would impress my profession...even claims for
the improvement of cancer victims are either openly ridiculed or ignored. It is
a sad reflection that my profession thrives on disease, and the inhuman propoganda of official scaremongering and exploitation”. (This is exactly being
done at present about the disease of AIDS by the press and scientists con
cerned).
Is it not surprising that inspite of such high opinion of a renowned surgeon
of England about Urine Therapy for Cancer treatment, expressed by him ab
out half a century before hardly any doctors and scientists have cared to look
into it?
Dr. Jivraj N. Mehta M.D. (London) former chief minister of Gujrat,
writes, in his foreword to the book MANAV MOOTRA (English-Edition)
“The belief that Urine is not an excreta, but is an elixir of life, gifted by na
ture for the purpose of healthy living and for the use as a main therapeutic me
asure for almost the WHOLE RANGE of human disease including Cancer,
T.B. Leprosy etc. is intriguing, interesting and fascinating. If it could be substaniated by human experiments undertaken and planned on a scientific basis,
it would be a great boon to human beings, more so in the modem age of space
travel". (No step is taken by the Govts, of any country in this direction after a
lapse of more than 40 years and inspite of fabulous medicinal qualities of
Urine).
19
EMINENT PERSONS’ OPINION ABOUT AUTO-URINE
TREATMENT:Mr. Morarji Desai, former Prime Minister of India, writes:- “1 personally
know of several cases who have cured their incurable illnesses of various
kinds by the Auto Urine Treatment. This treatment is simple, inexpensive and
harmless and is a great boon for a poor country like India.
I have tried the remedy on myself and on my advise some others have also
tried on themselves, I have seen cases of diabetes, cancer, T.B. and kidney
failure cured by it. For Disease of eyes. ears, teeth and skin it is the most
effective remedy.
Late Mr. Balkoba Bhave, Suprintendent of Nature cure Ashram, UruliKanchan (India) writes:- “The Auto Urine Therapy is superior to Allopathy,
Homeopathy etc. all of which are dependent on medicines for treatment. No
medicine or surgery is necessary in the Auto Urine Therapy hence it makes
the patient self reliant in the treatment of his illness.”
DISEASES WHICH CAN BE CURED BY THIS THERAPY
Friends, I have already stated more than once that there is not a single dis
ease present on this planet which cannot be cured by this Therapy. Still I
would summarise in the words of Dr. T. Wilson Ph.D.M.D. “As the urine
contents vary according to the pathalogical state of the patient its use is indi
cated in all forms of diseases except those caused by traumatism or those that
are of mechanical nature”.
Any how for the befefit of the fellow delegates I would mention some of the
diseases on which it has ben successfully tried by numerous patients known
and unknown.
To name the few serious and chronic diseases: Cancer, (of all types), Osteo
Arthritis of all types. Kidney failure, heart disease (all types) vericose veins,
vericose Ulcer, Gangrene, all skin diseases named or un named including
leucoderma and leprosy. All types of ear troubles like pain, discharge, deaf
ness, giddiness etc. For nose and sinus troubles, mouth and throat diseases
like stomatitis, tonsillitis, dental diseases like gingivitis, pyrorrhoea, gum
boil, shaking teeth etc. for piles fistula and fissure, for Female organs, leucorrhoea, excessive menstruation, tumour in uterus. It acts wonderfully on insect
and other poisonous bites. All sorts of pregnancy problems are remedied by
its use. It works fabulously on fevers, headaches, migrain. constipation, para
lysis, slip disc, and even mental disorders.
The diseases may be many and their names numerous but the remedy is
only one and that is one’s own Urine, Which cures the illness by removing the
waste products and toxins from the body and also by stimulating the defensive
mechanism of the body.
20.
Preferably no other medicines should be taken while doing this therapy.
For injury, bums, swollen painful parts, boils, ulcers and tumours etc. put
urine compresses-cloth soaked in urine on the effected parts.
This remedy is also very effective in poisoning from snake-bite, rat-bite,
bite of scorpion and even dog-bite. We feel more alive, more vital, more cap
able by its use. Self confidence soars and life becomes heaven on earth!
METHOD OF “SHIVAMBU” OR URINE THERAPY
TREATMENT:It is quite difficult for a beginner to start the treatment with this repulsive
remedy, though it tastes much better than beer and liquor. Repulsiveness and
nausea can be overcome by two methods. One psychological and the other
practical one.
Once you are convinced about the fabulous medicinal values of the Urine,
which is produced by your own divine laboratory within the body in its purest
form which has life in it, and when you become aware of the fact that it con
tains valuable minerals, enzymes, vitamins, hormones, antigens and anti
bodies etc., and that it is not a waste product of the body, your repulsion and
nausea is bound to disappear instantly. So whosoever has courage and puts
aside his/her prejudices can use urine and reap the benefits of Urine Therapy.
In the missionary zeal, to spread the message of “SHIVAMBU" or Auto
Urine Therapy, I can drink Urine of any person just to remove the repulsion of
fellow delegates, if it is made available to me.
Practical method for getting rid of repulsion and nausea I have been advis
ing is that, in the beginning one should add some water and honey or syrup to
the fresh urine and drink it. If taken with water and honey one will not have
the slightest repulsive taste of Urine. After few days of drinking you would
like to drink it in its unadulterated form without adding anything!
Dear friends let me point out that nauseating and repulsive taste is due to
the kind of food one eats. If you eat sensible and balanced food without too
much salt, and spices, your urine will be as clear and tasteless as water. You
must have noticed an infant's Urine never smells.
This therapy does not give only physical benefits but it gives spiritual and
mental benefits too. Because U.T. is not a medicine for a specific disease or
diseases, but it is a divine nectar for body mind and spirit (soul)! I have come
accross cases where even nervous break-down and madness is cured by this
treatment.
DOSAGE:1.
Asa best general tonic for keeping fit, healthy and energetic and also as a
preventive against all infections diseases one glass (200 c.c) once or twice a
21
day can be safely taken. (Even if it is taken in more quantity it is beneficial
and not harmful).
2.
For minor illnesses of all kinds such as common cold, cough, gas, in
digestion and fevers, enima of warm water mixed wth urine should be given.
Observe complete fast for 1 to 2 days during which period all food and drinks
should be stopped, all the quantity of Urine passed every time should be
taken, and in the interval one can take only plain water as desired. By such
treatment the acute illness will be cured within two or three days. The fast
should be broken with Orange Juice, Moong water, and subsequently milk or
light liquid food should be taken in small qantity. After two or three days be
gin taking light normal diet.
3.
For chronic illnesses of all kinds, such as cancer. T.B. Asthma. Heart
and Kidney diseases. Diabetes, skin diseases etc.
i. First give an enima of warm water mixed with urine as mentioned above.
ii.
Complete fast should be observed for 3 to 30 days depending upon the
severity of the disease, and condition of the patient as mentioned above
on water and urine only. Long period fast should be undertaken, under
expert guidance. If complete fast is not possible one can remain on liquid
food like moong water and fruit juices; but all the quantity of urine pas
sed should be taken.
iii.
Systematic rubbing of the skin on all parts of the body from head to foot
with old urine is a must during the treatment of chronic diseases; and
while fasting.
Like old wine, old urine is precious for rubbing and massage. (Not for
drinking) Minimum four days old urine should be used for rubbing and mas
sage.
I have just tired to give an outline for the treatment of acute and chronic dis
eases. I am sorry, that I can’t give detailed treatment for the different diseases
in this paper for want of space and time.
MULTIFARIOUS USES OF URINE:Friends you will be astonished to know the multifarious and divergent uses
to which we can put our urine at work!
It can be safely & beneficially used as;- A conditioner for hair. Shaving
cream, after shave lotion, Tanning lotion, antiseptic lotion for cuts and
wounds, complexion improving lotion, eye washes for all eye troubles, astrin
gent lotion for pimples and acne, mouth wash for all dental problems, nasal
passage cleaner for all sinus troubles, rheumatic and muscular pain killer,
soothing & healing lotion for bums & treating piles and fistula, antidote for
snake and scorpion bites, can be used as aphrodisiac, on impotency, as dush
tor ieucorrhoea and other menstrua! diseases and last but not the least an in-
stant energizer. My wife says, I was not so sexy, energetic and young even in
my real young days! I will be completing sixty on 14-10-1989. If you used it
as mouth wash daily, I can give life time guarantee for your teeth! It not only
makes the complexion fair but one can also get rid of old age wrinkles of face
and body. It is the most effective de-aging tonic ever known.
SIDE REACTIONS
MENT
DURING
AUTO-URINE TREAT
The Auto —Urine cures the illness by dissolving the waste products and
toxins accumulated in the body —which is the root cause of most of the
illnesses —or by removing the same from the body by way of mouth, nose,
anus or skin. Thus the patient may have vomiting, cough and cold, diarrhoea
or skin eruptions. The patient need not worry by such reactions, which are
helpful in curing the illness. They will disappear automatically within few
days. Therefore, no other medicine should be taken for removing them. For
skin reaction old urine should be rubbed on the eruptions.
Some patients have got allergy hence eruptions may appear after rubbing
with old urine on the skin of various parts of the body, or there may be severe
itching. In such cases, the rubbing of the old urine should be stopped and only
drinking of fresh urine should be continued, and fresh urine should be rubbed
on the body.
In some allergic patients drinking of urine may cause severe itching of the
whole body and skin eruptions. In such cases the patients should stop drinking
urine and continue only external application (rubbing) of the old urine.
SELECTION OF FOOD WHILE DOING U.T.:“FOOD IS LIFE” is a fundamental principle of the science of health.
Food itself has medicinal value. Most of diseases of the present generation
have spread throughout the world because of wrong food habits and wrong
way of living. Some of you must have read the book titled “Recalled By
Life” written by Dr. Arthur Sattilaro, president of the Methodist Hospital,
Philadelphia, U.S.A..
He was suffering from terminal Cancer (Stage-IV (D)) which had spread
throughout his body. He was operated several times and his testicles and few
ribs of his chest were removed. Being a president of the Methodist Hospital,
panel of Doctors were attending on him and was getting the best treatment
available in States, still his physicians advised him frankly that he had few
months to live.
Accidentally he stumbled accross a group of people propogating strange
diet & philosophy called “MACROBIOTICS” which promised to reverse his
cancer. He strictly followed the “MACROBIOTICS" diet and got cured of
his cancer. Today he is having such a fine health & stamina which he didn’t
have 20 years before!
He became world renowned by writing the above book in which he has
given the detailed account of his miraculous recovery- from the deadly termin
al cancer.
1 intend to meet him in Philadelphia (PA) when I visit States next week, to
acquaint him of this wonderful therapy.
During the treatment with U.T. one should take the following precaution in
selection of food.
All tinned foods, bread, biscuits, jams, pickles, fried and spicy foods
should be strictly avoided.
All intoxicants like wine, and tobacco in all forms are to be tabooed.
Only simple, light, sensible food should be taken. It should include
sprouted cereals (Moong) raw vegetables, salads, fruits and dates. Brown rice
will be much helpful during the treatment.
Regularity in food, rest and sleep is must.
COMMERCIALISATION OF NOBLE PROFESSION
We all of us are fully aware that noble profession of medicine and healing
has been fully commercialised and as such all the unhealthy business tactics
have crept into it. It is high time to realise that to the vested interests healing
and preventive medicines are a DISASTER of the first magnitude! Who can
make large profits off healthy people? In this state of affairs how can we ex
pect healing? So is it not advisable for us to find our own way out of this
disappointing situation? Our Governments are not going to help us in any
manner, we have to help ourselves.
Friends you must have read the news that a division of Medical Research
Council of London, which is doing research on common cold since 1957
which has annual budget of £ 5 lacs is going to be closed for ever as they
couldn’t find a cure for it inspite of intensive research of 37 years!
In-spite of this fact millions of dollars worth medicines are being sold for
the cure of common cold! What a big hoax is being played on the gullible pub
lic for so many years?
Friends take it from me, that any body can get rid of acute common cold in
12 to 18 hours only by Urine Therapy. One has to do fasting for 12 to 18 hours
and drink all the urine he/she passes. If one feels thirsty he/she may drink
lukewarm water. I am telling this to you after successful experimentation on
my self, my wife, my sons and friends!
Dr. J.L. Jamaison from Maripsoa, California, U.S.A, in a letter to Dr.
P.D. Desai of India writes, “Friend, I appreciate your concern for the ailing
humanity, but in the United States of America we have perhaps the most cri-
minal Government in the world. It is Government policy to maintain ill
health, as there is money in it.”
I don't wish to bring politics in our discussion of Complementary medi
cines and criticise any Govt., but at the same time I will be failing in my duty
if 1 don’t bring certain facts to the notice of the W.H.O., heads of different
nations and medical research workers of different countries.
Such a novel and marvellous cure is in existence since centuries yet it is
most surprising that neither the Governments of different Nations nor Medical
workers and the medical profession — the custodians of our Nation’s health
have taken notice of the same so far. Scientific Investigations of this valuable
remedy are most urgently needed for the welfare of the ailing humanity and
especially in view of the impending danger of the AIDS bomb which is going
to be more disastrous than even hydrogen or any neclear bomb.
So it is my humble and sincere request to the W.H.O. and the heads of
different nations that they should take up urgent research work to find out on a
scientific basis the fabulous medicinal qualities of our own Urine. Also they
should find the ways and means to make this therapy acceptable and popular
amongst the masses and save the ailing humanity from total annihilation espe
cially in view of the impending danger of AIDS.
In these days of instant and fast communication and public contact facilities
it should not be difficult to make alternate therapies, established medicine.
The first step is to move the Govts, to include the subject in the curriculum in
all the educational institutions The Hospitals should provide urine therapy for
treatment. Gujrat is the first and only state in India which has given official
recognition to this Therapy.
There should be no confronation or hostility between different medical dis
ciplines but respectful coexistence centred on the Welfare of the ailing
humanity. Everything is imperfect in human affairs but co-operation and co
ordination between different disciplines can overcome all deficiencies and en
hance their efficacy contributing to the happiness, well being and health of
humanity.
So friends, if we want to become self reliant we have to find out an Alter
nate Therapy which will be safe. sure, simple and free. And all these qualities
are present in “SHIVAMBU” or “URINE THERAPY”.
Some time back I met well known. Dr. Vasant P. Mehta M.D., M.S.,
F.C.P.S., F.I.C.S. of Bombay who has taught medicine and surgery (rare
combination) in the leading medical college of Bombay for more than 15
years, says that urine Therapy has played major role in his recovery from
throat CANCER which he suffered about ten years ago. He narrated to me a
very interesting episode he had with Dr. Praful Desai (Head of Tata Memorial
Cancer Hospital, Bombay (India),) whom Dr. Vasant Mehta had taught when
he was a student. When anybody asked Mr. Praful Desai as to whether Urine
Therapy is useful in the treatment of Cancer. He used to say “It’s “HUM
BUG”, One day Dr. V.P. Mehta asked him as to whether he knew any thing
about Urine Therapy? His reply was in the negative. Mr. Mehta then asked
him “When you do not know any thing about Urine Therapy what right you
have got to call it “HUMBUG? He applogized to him for his attitude. Now
he suggests Urine Therapy to terminal cancer Patients! Urine Therapy will
hardly be helpful to serious terminal patients, but I know few lucky cancer
patients who got cured completely by U.T. who where sent home by the physicans to die peacefully! U.T. works fabulously on all sorts of cancer provided
it is done systematically and before the case is spoiled by other harmful treat
ment viz. operation, radiation and chemotherapy etc.
It is my sincere request to my delegate friends that they should try this ther
apy at teast on those ailments for which there is no known cure found so far
and find for themselves the miraculous results. To name such diseases viz.
Arthritis, Diabetes. AIDS. Vericose veins, vericose ulcer etc.
In the last month I came across a very peculiar news in the Indian Express.
A patient was admitted in the leading hospital of Bombay for the operation of
Appendicitis and along with Appendicitis one of his kidneys was removed by
the surgeon without the knowledge of the patient! It was further reported that
this is not a solitary incident. On investigation many more cases of such kid
ney theft may come to light! What does this indicate?
In the month of January there was a startling news in the leading newspap
ers of Bombay. That AIDS virus was found in the medicine prepared out of
human blood plasma! The Govt, has ordered to get back from the market all
the stock of that medicine.
We can well imagine the fate of the patients who had been treated with
AIDS infected medicine.
Friends take it from me that one can remain immune to deadliest viruses
like AIDS virus by drinking a glass of self Urine regularly!
MENACE OF HORRIBLE AIDS
I think this paper will be incomplete if 1 don’t touch this disease “AIDS”
Friends, you will agree with me when I say that this small word of four
alphabets has frightened the whole of mankind to such a great magnitude, that
has no precedence in the human history! The increasing menace of AIDS
poses a big threat to humanity’s survival with dignity!
When the scientists all over te world, inspite of their best endeavour over
almost half a century have not succeded in finding a sure cure for the dreaded
CANCER, we can well imagine of the hopeless situation in the matter of a
cure for this horrifying and super dreaded disease AIDS.
Friends, I have come across some cartoon pictures drawn by Cartoonists of
international fame wherein they have tried to convey the horrifying situation
26
created by the menace of AIDS, in a very light vein. I am going to show you
these cartoons during my presentation of the paper in the Congress.
You will be astonished to read the remark of Dr. Alan Cantwell, well
known AIDS researcher who writes in his book “ADDS” the Mystery and
the solution” that “I have noted that some AIDS patients do not have
famous AIDS virus (H.T.V.L.) in their blood” further states” My belief
based on research studies is that “AIDS IS CANCER, and CANCER IS
AIDS”. One possible reason for the emergency of the new epidemic of AIDS
is that MECICAL SCIENTISTS MAY HAVE UNWITTINGLY PRO
DUCED MORE VIRULENT AND MORE contagious bacteria or Vims),
by the widespread use of CHEMOTHERAPY, ANTIBIOTIC THERAPY
AND RADIOACTIVE THERAPY, in the modem treatment of Cancer”.
On reading the remark of Dr. Alan Cantwell that AIDS is cancer and
CANCER is AIDS, I am reminded of having read the opinion of one Scien
tist, whose name I have forgotten, that "Cancer is not a disease but it is a
biological phenomenon, and as such there cannot be a medicine for the
same”. I think he is perfectly right in his statement, but I would like to inform
him that a sure cure for cancer is there, and that is patient’s own Urine. And as
the AIDS researcher Mr. Cantwell has correctly concluded that AIDS is can
cer and cancer is AIDS. In view of this AIDS is also not a disease, but it is a
biological phenomenon and hence no medicine will be of any help for this
deadly and horrible disease, but Urine Therapy will surely be helpful to the
AIDS patient!
When 1 had first declared confidently in my paper on Urine Therapy pre
sented on 18th September 1988 in 2nd All India Congress on Alternate Mediciens hied in Bombay (India) at Tajmahal Hotel, that AIDS can be cured and
must be cured by Urine Therapy I was unaware that some Urine Therapist has
successfully tried this therapy on few AIDS Patients in the other part of the
World! Yes, as mentioned by me earlier Dr. Beatrice Bartnett and Margie
Adelman, two young, enthusiastic and courageous ladies are doing valuable
research on Urine Therapy and have successfully tried few full blown AIDS
patients with it.
According to me any AIDS patient can very safely undertake Urine Ther
apy as he/she will be the gainer and not the loser at any count, because once
the doctors brand him or her as an AIDS patient he or she is to die sooner or
later as there is no medicine or cure in sight so far for this horrible disease in
any pathy. This therapy will be undertaken only by a courageous and rebel
lious patient who does not want to go home quietly and die off without a fuss,
when told by the doctors that he/she is suffering from an “incurable disease".
And he/she will surely succeed if he/she takes the treatment systematically,
under proper guidance and from the early stage before spoiling the case by
any other treatments. AND now Dr. Beatrice Brtnett has conclusively
27
proved that Urine Therapy works fabulous even on full blown AIDS pa
tients.
So, the ray of hope has came in sight for the miserable and helpless millions
around the Globe, suffering from this horrible, incurable disease.
Friends you will be shocked to know the few stories of miserable AIDS Pa
tients that had appeared in the leading Indian Newspapers, which I am narrat
ing below:
(1)
One Doctor from South India who suffered from AIDS was admitted in
one Govt. Hospital when the doctors and the staff members of the hospital
came to know that the patient is an AIDS Patient they refused to attend on
him, and he was forced to go home!
(2)
In another case a patient was admitted in one of the Govt. Hospitals of
Bombay. When the staff members of the hospital came to know that the pa
tient is suffering from AIDS they refused to attend on him, leaving the patient
to his fate unattended.
(3)
One such case of a similar nature. A call girl (Pros$) from Rajkot. (Gujrat
State) suffered from AIDS. This was reported in the newspapers. It was furth
er mentioned that she must have passed on the AIDS virus to atleast 300 per
sons who might have visited her in last few months. I had gone to Rajkot to
see her for giving her guidance of U.T. I was told by the hospital authorities
of Rajkot where she was treated, that the girl was first transferred to Civil
Hospital Ahmedabad and from there she was sent to her native place in Nepal
of course to die peacefuly without a fuss*
Friends, we don’t have even the proper equipments in our country in suffi
cient numbers for the detection and diagnosis of this horrible disease. I can’t
imagine of the situation when the AIDS Patients will multiply in numbers in
the years to come.
I shudder with agony and pain when I think of the helpless situation in
which the AIDS Patients are placed when the staff members of the hospital re
fuse to attend on them and they are left to their fate unattended!
TALKING RANDOM & RAVE:
While writing this paper my thoughts are going to a great soul, Shri Chandrika Prasad Mishra Shastri, a brave freedom fighter. He had worked with
Mahatama Gandhi and was jailed on several occassions by the British Rulers
for taking part in Independence movement. Exactly 30 years before when he
was around 50 years old, he suffered from several diseases viz. heart disease,
diabetes, sciatica, gout, eye and ear troubles etc. After trying all the conven
tional therapies with no result he stumbled accross U. T. and got rid of all his
ailments on a wholesale basis! He had such a tremendous impact on his mind
after his fabulous recovery that, since then it has become a mission of his life
to spread the knowledge and guidance of this therapy to the masses. For that
purpose he is publishing a fortnightly titled “SHIVAMBU MITRA in
28
0
t
national language Hindi regularly since several years. His writings are very
much spirited and informative.
He has dedicated his whole life for spreading the knowledge of this
wonderful therapy. He has also written a very informative book titled "SWAMUTRA CHIKJTSA " in Hindi. He is travelling throughout India giving talks
on U.T. and holding seminars. He has done lot of experimentation and re
search on U.T. during his involvement of more than 30 years in this therapy.
At the age of about 80 he has health, stamina and vigour of a young person.
In the last week I had a chance to meet this inspiring personality. 1 am giving
below his address for the benefit of fellow delgates.
CHANDRIKA PRASAD MISHRA, Shastri,
ADANPUR, Maharaj Ganj,
VARANASI (U P.). 221314 (INDIA)
I am very pleased to inform to you that in the last month 1 was lucky to have
met a young, sincere, dedicated and a selfless Naturopath, Dr. Shashi Patil
from Kolhapur in Maharashtra who has dedicated his whole life in the ser
vice and propogation of SHIVAMBU or U.T. Yes, he is conducting a “SIHVAMBU UPCHAR KENDRA” Urine Therapy Centre, a hospital with 15
beds. He has treated more than 6,000 patients suffering from incurable and
hard to cure diseases like T.B., LEPROSY, ASTHAMA, KIDNEY FAI
LURE, CANCER, DIABETES, HEART DISEASE etc. in last fifteen
years with a missionary zeal. I have seen testimonials of hundreds of patients
testifying the miraculous recovery from their maladies.
He is not only a naturopath but also a poet and writer too. Yes, he has writ
ten dozens of poems on SHIVAMBU and has also written a three Act play
“EKACH PYALA SHIVAMBUCHA" in marathi language. In the said dra
ma he has given the full information and procedure about U.T. through dia
logues in a very interesting and lucid manner.
I am hereinbelow giving his address, so that any delgate, friend visiting In
dia, wishing to avail of his services can do so.
Dr. SHASHI PATIL, A.U.T. of NAT,
Shivambu Upchar Kendra,
Sane Guruji Vasahat, Plot No. 13,
Washi Naka Road: KOLHAPUR-416011 (India).
I know one more such Naturopathy Hospital in Gujrat State which is situ
ated in Baroda, where the patients are treated with U.T. along with natur
opathy. It is run by a team of dedicated self less naturopaths with missionary
zeal. The address of said centre is also given below:Vinoba Ashram,
Gotri Road,
BARODA-390001 (India)
Recently I came across a very exciting recovery story of a person aged 38
years whose name is Surendra Gupta who suffered from severe terminal
29
osteo-arthritis. I am specifically using the word terminal because not only all
his joints had become stiff, but in the last stage his jaw also had stuck up as
such he couldn't open his mouth and hence eating food was out of question.
He was sent home by the Doctors from Jaslok Hospital (A Prestigeous hos
pital of Bombay) with no hope of survival and was counting his last days.
Accidentally he came across one Urine Therapist named Lajpatrai Agrawal, who guided him to U.T. Within 100 days of treatment with U.T. he com
pletely got rid of his incurable agonising malady. When I met him in the last
month in his factory he was so much enthusiastic and thrilled to narrate to me
his fabulous recovery story! Today he hasn’t got even a trace of that incapaci
tating malady which had made him bed ridden for five long years!
In the month of December 1988 in Sunday edition of Gujarat Samachar (a
leading newspaper of Ahmedabad, Gujarat State)., Thirty three cases of can
cer cure, by urine therapy with names and addresses of the patients were re
ported.
In the book MANAV MOOTRA written by Mr. Ravjibhai Patel, testimo
nials of hundreds of patients are printed with names and addresses, testfying
their miraculous recovery from diseases ranging from Asthama to Arthritis
and Cancer to Kidney failure.
I would like to tell you a very interesting real story narrated to me by my
Guru Kisonlal Tejpal.
There were two ladies, in relation they were daughter-in-law and motherin-law. Both were widows and were living in a small village named TULSISHYAM in Gujrat State. They were of a very helping nature. They had
announced in the village that anybody suffering from any disease may take
away from them enchanted divine water and drink as medicine will get well.
All the village folk young and old were very much benefitted by the divine
water and the word spread to adjoining villages. The number of patients
increased enormously and both the poor ladies were worried because the
source of divine water was very much limited. The secret was that those
obliging ladies were distributing their own urine mixed with drinking water!
One day they disclosed this secret to all the patients and told them to drink
their own urine instead of drinking theirs. All the people were very angry
on hearing this and were bent upon beating the poor ladies, but were calmed
down when they were made to realise that they were benefitted by drinking
the urine of the poor, good hearted ladies! All had a hearty laugh.
One more interesting incident comes to my mind.
A friend of mine named Mr. A.B. (I am not giving his identification, as he
may not like it). Who is serving on a very high Govt, post, got inspiration
from me and started drinking and applying his own urine, without disclosing
this adventure to his wife. After only few months of practise his wife com
mented that he is becoming younger day by day and his hair are turning black.
30
Still he had no guts to disclose the secret to his wife. I advised him to invite
our family for lunch or dinner to their house, so that we can disclose the secret
of his youthfulness to his wife, and accordingly on hearing my talk on the
subject she has also become a staunch follower and propogator of this incredi
ble therapy!
Friends, I forgot to tell you one more side effect of U.T. that occured in my
case. I had gone grey since my child-hood due to heridity. Also I had started
balding since few years. Now due to my involvement with U.T. not only my
balding stopped, but I am getting black hair at bald places, and also my hair
are becoming black. Though the process is very slow but is sure and steady!
Even though this paper is becoming bulky I can’t resist the temptation of
narrating to you a very thrilling recovery story of a patient who suffered from
Kidney failure. His name is Mr. B.C. Desai aged about 45 years staying in
Kandivali, a distant suburb of Bombay hailing from middle class family.
About 4 years before he had a kidney trouble and on investigation it was
detected that God had forgotten to give him second kidney. Yes, since birth
he was living with one kidney only and that too had failed and was kept on
dialysis for some time and was told to arrange for a kidney donor and huge
amount of funds for the operation and hospitalisation charges. He had no
means to undergo Kidney Transplant hence he opted for U.T. very easily. I
am purposely using the word easily because his wife was drinking Urine since
more than 25 years for keeping herself healthy and fit. So he already knew the
fabulous medicinal values of Urine and hence started U.T. sincerely in right
earnest under the guidance of a Urine Therapist. When his urine was ex
amined after the treatment of one month the report was absolutely normal, and
after the treatment of one month he joined his service. His physicians who
had advised him kidney transplant couldn’t believe their eyes when they saw
that their patient was surviving without dialysis & without transplant! He is
hale and hearty today. When 1 met him at his residence Mr. B.C. Desai
himself and his wife both were very much happy and excited to narrate to me
and my wife his thrilling recovery story.
While writing this paper my thought goes to one more great soul staying in
U.S.A.; his name is AMARSHIBHAI KHARECHA, who is a writer and
poet, and writes under the pen name "ANABH1GNA". He is a great propoga
tor and exponent of UROPATHY and a friend of mine.
I would like to narrate to you the incident by which he got attracted to this
divine therapy, the same being very interesting and inspiring.
About ten years before he suffered from a very peculiar disease. He used to
get fever of influenza every three months REGULARLY and would become
weaker and weaker after each attack. Inspite of thorough and intensive,
investigation, checkup and medication as per latest inventions in U.S.A.,
doctors could neither stop the reoccurrance of his fever nor could they find the
cause of the same.
31
He accidentally stumbled across this divine therapy and got rid of his
persisting malady forever. Apart from getting rid of his gripping malady, as a
beneficial side effect he got rid of several small diseases. He got rid of his ear,
eye and teeth trouble; At the age of 72 his teeth are so strong and healthy that
he can devour one full sugarcane with his bare teeth!
Since the time he recovered from his mysterious sickness, it has become his
mission of life to spread and propagate the message of this Divine Therapy.
When he came to know that Mr. Ronald Reagan was suffering from Cancer
he had written a letter to him infroming him about the fabulous medicinal
values of Urine and had sent him the book “SHIVAMBU KALP”, written by
Arthur Licoln Pauls. Looking to his fabulous recovery from cancer and his
fine health, it is possible that Mr. Reagan might have taken a hint of Uropathy
from our Mr. Kharecha and may have practised it!
I can’t resist my temptation to narrrate to you one more very interesting and
thrilling story of one cancer patient that had appeared in one Indian newspap
er. One Mr. Bachubhai Galia staying in U.S.A, had cancer of liver and had
spread to other parts of his body. His daughter being a doctor practising in
States he was frankly told that there is hardly any hope of his survival. He had
faith in Uropathy, so he came to India, got guidance of his treatment from Mr.
Morarji Desai and strictly did Urine Therapy treatment for few months, got
rid of his cancer and went back home in U.S.A. His physicians were utterly
surprised to find their patient’s incredible recovery! I have got the xerox copy
of his thrilling recovery story with his photograph!
A very strange incident comes to my mind which might interest you very
much.
Few months ago one doctor Mr. A B. C. M.B.B.S.. M.S. (1 am not
giving his identity for obvious reasons) practising as an E.N.T. specialist was
introduced to me through a doctor friend of mine. I passed on the message of
Uropathy and gifted him few books on the subject as per my usual habit. He
gets patients for E.N.T. troubles from his doctor friends practising as general
practitioners, complained to him that the patients which were referred to him
for E.N.T. trouble never returned to them for any other treatment thereafter!
The secret behind this strange happening was that my friend Dr. A.B.C. not
only cured the E.N.T. troubles of his patients with Uropathy but also advised
them to practise it for their other ailments.
When he met me in the last month after my introduction to him, he bowed
down before me and said, “You have become my GURU for initiating me to
this Divine Therapy! I have successfully tried it on not less than hundred
patients not only for E.N.T. troubles, but on other ailments too chronic and
acute!’’ 1 am happy and glad to get such an enthusiastic, courageous and open
hearted doctor as a disciple of CHELA.
Friends, during those four years of my deep involvement with Uropathy, I
have come across numerous strange, interesting and miraculous incidents
which 1 feel like telling to you, but because of limitation of time and space I
must stop talking Random and Rave.
SOMETHING ABOUT ME
Friends, before I conclude this paper I would like to tell you something
about me, which might surely interest you.
I am Advocate and Tax consultant practising in Bombay (India) I will be
completing 60 on 14th October 1989. I have been keeping excellent health by
practise of Yoga and Pranayama since more than 40 years, and now I am
growing younger day by day because of my deep involvement with "SHIVAMBU" or UROPATHY! Yes. 1 am having the energy and stamina
which I didn’t have even in my young age! I jog 5 km. daily as a matter of
routine. (De-aging phenomenon of Auto Urine Therapy).
I am fond of music, singing, sports, spiritualism, Photography, reading,
writing, gardening, swimming, driving. I am enjoying every moment of my
life. I sing Bhajans and play flute and even dance with my wife and children,
and have received first prizes in dance competitions (Dandias) on several
occasions. If I get sponsorship I intend to take part in the next Himalayan Car
Rally which is one of the World’s toughest car rallies. I occasionally go for
swimming deep into the Arabian sea with my two children. But now because
of my deep involvement in Urine Therapy most of my time is consumed by
my mission to spread the knowledge and guidance of this wonderful therapy
and thereby serve the ailing humanity in my humble way.
In the year 1983 on completion of 25 years of my tax consultancy, my
clients had honoured and felicitated me for my sincere, devoted and honest
service to them for over a quarter century. For that occasion they had arranged
a grand dinner-cum-dance programme in which around thousand people had
taken part. I have never treated my clients as clients but as friends. To them 1
am a friend, philosopher and guide, and now I am PHYSICIAN too!
There won’t be slightest exaggeration if I say that I am a blessed soul!
Friends I am going to live long and die young! De-aging effect-of uropathy!
For the purpose of propogating the knowledge of this therapy in the four
comers of the Globe I have proposed to establish a charitable trust in the name
of “WATER OF LIFE FOUNDATION (INDIA)”.
I am freely available for lectures, seminars and consultations on urine
therapy. I don’t charge any fees for all the above work, which is a part of my
Mission. Any one wishing to invite me for further information guidance and
lectures, on the therapy in their country hc/she may contact me on the address
and phone nos. given below.
I am herein below giving the address and phone of the foundation, so that
any one wishing to make a donation for the noble cause of propogating the
knowledge of this wonderful therapy in the four comers of the world and for
eradicating disease from our planet, can act upon it.
Such contribution and generosity will be highly appreciated.
WATER OF LIFE FOUNDATION INDIA) (Proposed)
Chairman G.K. THAKKAR,
377-B, J.S.S.Road,
BOMBAY-400 002 (India) Phone:- (022) 290168 & 4229259
From Athens I am proceeding to U.S.A, to meet my only daughter and
son-in-law who have settled there since few years, are staying in German
town near Washington. The other idea of visiting States is to meet those two
young, courageous and bold ladies. Dr. Beatrice Bartnett and Margia Adel
man who are doing commendable and noble work of spreading the know
ledge of this therapy, and doing valuable research on the same. 1 am in
intimate correspondence with them who are like my adopted daughters. We
are planning to start one Intematonal news letter on Urine Therapy. Also in
our minds there is an idea of organising an International Urine Therapy
conference in the near future. They have arranged my few lectures in States.
My visit to Athens and U.S.A, is sponsored by my friends and admirers
who are in plenty! I hereby express my deep gratitude and thanks to them. My
special thanks to my friends Sudarshan Dheer, Dr. C.M. Desai, Dr. Shashi
Patil and Chandrika Prasad Shastri for the valuable suggestions made by them
while writing this paper.
And last but not the least my profound and hearty thanks are due to Dr. Sir
Anton Jayasuriya and the Senate of the Open International University of
Complimentary Medicines for their kind invitation extended to me for pre
senting my paper before this congress and for honouring me with the Degree
of Doctorate of Medicines.
I will conclude this paper with a passagge from a marvellous book written
by Dr. Arthur Lincoln Pauls named SHIVAMBU KALPA. This is the
book which inspired and inducted me into this wonderful therapy.
“This book however, will attempt to show why we should place the blame
where the fault lies, within overselves. To quote Shakespare, “the fault lies
not in our stars but in overselves, that we are underlings". Even if it is true
that we lead ‘Karmic’ existence. It is no excuse for walking around with
closed eyes.”
“It should not surprise us that the situation is as it is. Anything created with
a vested interest in mind is open to all sorts of corruption, especially when it
deals with the emotions and fears of man, as healing undoubtedly does,
“Abraham Lincoln however had a line for it. "You can fool some of the
people all of the time, and all of the people some of the time, but you can t
fool ALL THE PEOPLE ALL OF THE TIME”.
34
So friends I rededicate this small booklet to those who arc tired of being
fooled, and are placed in hopeless situation with the hope that they will heal
themselves by their own medicine.
Thank you,
Jai Hind
G.K. THAKKAR,
After the format of this paper was ready accidentaly I came accross a great
soul by named Mr. Ashok Gaonkar who is an enthusiastic propogator of URO
PATH Y. He gave me a xerox copy of a newspaper cutting with a caption
SAGA OF A GIRL WHO DEFIED DEATH, which had appeared in a leading
newspaper of Bombay. The mysterious recovery story of the girl named Bharti Katbamna is so thrilling and hair raising that I am tempted to give the gist of
the same in this paper with the kind cooperation of my printer Mr. Ramcsh
Radia.
The girl aged 23 was studying Speech Therapy in Nair Hospital Bombay.
on finding a huge blood clot on her tongue was told by her doctors that she is
suffereing from a mysterious disease known as IDEOPATHIC THROM
BOCYTOPENIC PAERPURA which is even difficult to pronounce In this
disease Pletlet count drops dangerously low preventing the clotting of the
blood. It results in bleeding from all orifices of the body. It could result in
bleeding in the brain and resulting in death. For this horrifying Mysterious
disease there is no known cure except STEROIDS! After trying Allopthy she
also tried Homeopathy with no result.
At last her friend gave her the book WATER OF LIFE. On reading the
same she courageously did Urine Therapy, and within a week she started feel
ing energetic, and in six months of treatment she regained Radiant health!
At present she is doing her Ph D. in Audiology in America with no sign of
the horrifying direase! She says "Not all the tests in America have been able
to prove that I had this incurable disease" and further affirms "I must be the
only person in the world with this disease, living without the aid of STER
OIDS”! She is not aware that by drinking her own urine she was getting
STEROIDS in its most harmless and natural form!
My new friend Mr. Gaonkar tells me that after reading the above story he has
come accross few cases of this type of disease which he has cured by Uropathy!
The above story proves my small point that Urine is a Universal Cure!
35
BIBLIOGRAPHY
The Miracles of Urine Therapy with special section of AIDS by Dr.
Beatrice Bartnett and Margie Adelman.
Shivambu kalpa by Dr. A.L. PAULS.
Manav Mootra (Auto Urine Therapy) by Raojibhai Manibhai Patel.
AMAROLI by Dr. Swami Shankardevanand Saraswati M.B.B.S. (Syd.)
The water of Life by J.W. Armostrong.
Shivambu cure, (Guide to Treatment and diet) by Dr. Pragji D. Desai,
M.B.B.S.
7)
Swamutra Chikitsa (Hindi) by Chandrika Prasad Mishra ‘Shastri’.
8)
Miracles of Urine Therapy by Dr. C.P. Mithal M.B.B.S.., MD.
1)
2)
3)
4)
5)
6)
9)
Auto Urine Therapy by Dr. Pragjibhai Rathod.
36
□ MEDICAL EDUCATION
Mixing medicines
Union Health Minister C.R Thakur's move to introduce Indian systems of medicine
into the MBBS curriculum raises a controversy.
PURN1MA S. TRIPATHI
in New Delhi
IRST it was Dr. MurliManohar Joshi,
the Union Minister for Human
F
Resource Development, who bulldozed
his way into the University Grants
Commission (UGC) syllabus with a
course in astrology. Now it is the turn of
Apon Minister for Health and Family
Welfare C.P. Thakur co have his way with
higher education - he wants to introduce
a course in Ayurveda, Unani and Siddha
in the MBBS curriculum. Impressed by
the popularity of the Indian systems of
medicine abroad, the Minister is all set to
see his project through.
The move flouts medical ethics and a
Supreme Court order which prohibits
simultaneous practising of two systems of
medicine. But chat will not hinder the
Minister’s grandiose plans. “We are
proposing wide-ranging changes in med
ical ethics for this,” said a Health Ministry
official. The Health Secretary will soon
hold a meeting to evolve a consensus in
this regard, the official disclosed. The
government also proposes to approach
the Supreme Court for a review of its
judgment.
Consultations are underway with the
Medical Council of India (MCI) to define
importance of the issue, it would finally
be decided only by the general body of the
Council - which could take time.
Meanwhile, the Ministry of Health
and Family Welfare has made necessary
preparations to present the Minister’s
idea as part of the new health policy that
will be unveiled in the monsoon session
of Parliament. A meeting of State Health
Ministers is scheduled to be held in New
Delhi on July 12 to apprise them of the
government’s “look back to the roots”
policy and discuss the changes proposed.
Disclosing this, C.P. Thakur told
Frontline: “There is a need to sensitise stu
dents of allopathic medicine to Indian
systems of medicine like Ayurveda, Unani
and Siddha. We propose to include the
teaching of Indian systems of medicine at
the MBBS level in the All India Institute
ofMedical Sciences (AIIMS) on an exper
imental basis.”
Since Dr. Thakur himself is a prac
tising doctor, he is aware of the hiccups
ahead, such as the problems that would
be caused by medical ethics which pro
hibit the mixing of two streams of medi-
the modalities of the order. In its letter
dated November 30, 2000, the Ministry
asked the MCI to “take necessary action
to include the basic principles and con
cepts of Ayurveda, homoeopathy and
Unani in the curriculum for MBBS stu
dents”. The matter was discussed by the
executive committee of the MCI on
January 22 and a sub-committee was
formed. “It is too important an issue to
be decided by an individual; so a sub
committee consisting of two ViceChancellors and the principal of a
medical college was formed,” MCI secre
tary Dr. Manju Sachdeva told Frontline.
The sub-committee got in touch with
Vice-Chancellors and the principals of
medical colleges across the country to
elicit their opinion on the matter.
Dr.Sachdeva said that in view of the
FRONTLINE, JULY 6, 2001
Union Minister for Health and Family
Welfare C.P. Thakur.
cine by a doctor, and the Supreme Court
order. “This was done to prevent quack
ery. But done properly, the two streams
of medicine can be practised together
with great results because the medicines
prescribed in the Indian system do not
have any side-effects”, Dr. Thakur said.
“We have sent a proposal to the MCI for
an opinion. Once the government’s pro
posal is finalised, the Supreme Court will
be approached for a review of its judg
ment in this connection,” he said. The
plan could start unfolding by the end of
this year and the Health Minister is con
fident of its success because as he says, “the
Prime Minister himself is keenly interest
ed in the promotion of the Indian systems
of medicine.”
According to Dr. Thakur, the Indian
systems of medicine have a great poten
tial but they have not been exploited to
their full potential yer. Besides, there is a
great demand for Indian medicines
abroad. “In two-three years’ time we can
export medicines worth Rs.5,000 crores.
The potential is such that in five years’
time we can increase our export to
Rs. 10,000 crores,” he said.
The Minister said that the govern
ment had decided to set up a medicinal
plant board, which would be based in
New Delhi. The board will be headed by
the Health Minister and will have repre
sentatives from the agricultural and
forestry sectors. It will identify areas
where medicinal plants can be grown and
encourage farmers to take up the cultiva
tion of these. For instance, Dr. Thakur
said farmers who grew tobacco or opium
at present would be encouraged to shift
to medicinal plants which would fetch
them similar returns. The board would
have a corpus or Rs. 100 crores at its dis
posal, which would be utilised to
strengthen the infrastructure for dissem
ination of knowledge, modernise units
engaged in the production of Indian med
icines to facilitate export, and so on. The
government also intends to introduce
Good Manufacturing Practice (GMP) for
the standardisation of Ayurvedic medi
cines. At present there is no system for
standardisation of medi
cines
distributed
by
vaidyas and hakims. The
Minister said this created
a problem of credibility,
which would not be there
once the GMP came into
effect.
The government also
plans ro grant more funds
to the three existing
Ayurvedic universities Varanasi, Jamnagar and
Jaipur - and strengthen
colleges that are currently
engaged in the teaching of
Indian systems of medi
cine. The Minister feels
that this stream of medi
cine
has
remained
neglected by the medical
fraternity. “There is great
demand for our medi
cines in foreign coun
tries,” he said. He said that
at an exhibition relating to
alternative systems of
medicine organised by the
United Nations Health
Conference in early May,
in which 170 countries
participated, rhe interest
shown in the Indian sys
tem of medicines was
overwhelming.
. cult to imagine how the
^®Sli!IS!SSiHliil!!l«HwPM
Minister is going to
implement his agenda.
But he appears deter
mined to go ahead. “The
Director (of AILMS) has
been consulted and the
process is on,” said a
Health Ministry5 official.
The AIIMS administra
f;J|||||||||||||||g01|isWBiiiBpi tion, however, cites lack
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of funds to maintain the
existing
infrastructure
and shortage of space to
house its current man
power as also the fact that
hazardous
chemicals
meant for its laboratories
now lie in the corridors at
great risk to people, to
press the point that tj^h
idea of having more fa^
ulty members (to teach
Ayurveda, Unani and
Siddha) was not feasible.
The MCI too appears
unsure about the propos
al. “Understanding the
basic principles and con
cepts of just one system
takes so much time and
effort. How will the stu
dents do it for two
streams, which are based
on different principles and
concepts? It does not
appear a very practical or
feasible idea. It is more
political in nature,” said a
senior MCI official.
move
controversy. Incensed fac
Outside the All India Institute of Medical Sciences in New Delhi.
ulty members of the
Opposition to the proposal to alter the medical education
A1IMS charge that they
curriculum is growing among the faculty.
HE votaries of th^
are being treated like
Indian systems
guinea pigs. They have termed rhe pro
teal sciences. Replying to the suggestion
medicines, however, are delighted.
by several members in the Lok Sabha on
posal “yet another political gimmick” by
“Better late than never,” said a senior fac
February 18. 1956 that rhe institute also
the government to woo the votaries of
take up the teaching of and research in
ulty member at the Jamia Hamdard
Hindutva. “The Minister does not know
University, where Indian systems of med
Ayurveda and homoeopathy, she said:
what he is talking about. The two systems
“This is an institute for rhe modern sys
icines are taught.
can never be mixed because they work on
“This will remove prejudices about
tem of medicine and it cannot include any
altogether different premises and differ
the system of medicine we practised and
other system.” But when several mem
ent concepts,” said a senior Al IMS offi
give us credibility. Besides, ir will only be
bers, including Mohanlal Saksena from
cial. Besides, the Minister cannot treat the
T
/MIMS like his political laboratory; it is
an autonohious institution created by an
act' of Parliament, and any changes in its
basic structure would have to be approved
by Parliament.
Officials of rhe Al IMS refer ro the
marathon debate in Parliament in
February 1956 that led to the establish
ment of the institute. The then Health
Minister, Rajkumari Amrit Kaur, had
clearly and categorically said that the
institute would teach only modern med
94
Lucknow-Barabanki. persisted with rhe
demand ro refer rhe Bill to a select com
mittee, the Deputy Speaker had ruled:
“Homoeopathy will have another insti
tute. 1 am told by rhe Hon. Minister that
similar institutions for Ayurveda have
al ready been established elsewhere.
Under these circumstances there is no
purpose in referring the Bill to a select
committee because it is a question of prin
ciple and policy.”
Against this background, it is dilfi-
good for the patients because rhe two sys
tems can actually complement each other
without interfering with the line of treat
ment because Indian medicines have no
side-effects,” said Prof. Jameel Ahmad,
Dean, Faculty of Unani Medicine at
Jamia Hamdard. According to him and
many others who think likewise, it is high
time die government recognised the rel
evance and importance of the Indian sys
tems of medicine and did something to
promote them. 12
yv-A - <L~
AN EXPLORATORY STUDY
FOR ASSESSING THE POSSIBILITY OF
POOLING BENEFITS FROM
DIFFERENT SYSTEMS OF MEDICINE
(A BRIEF OUTLINE)
Introduction
1.
Around the world, there are a number of recognized systems of medicine. While most providers of health
care in India restrict themselves to the use of only one of these, some use more than one system.
Moreover, many consumers of health care, on their own, tend to choose from the basket of services
available from the different systems These clearly indicate the existence of some providers and
consumers who earnestly believe that each system of medicine has its own successes and failures. It is
their case that a judicious use of different systems, with the approach of “pooling benefits", can be
more helpful. Expanding the idea further, one could set the long-term goal of an “ideal health care
system" in which any person with a health problem can approach the “family health provider" and get the
best possible care from the provider's health care system Alternatively, he / she may be referred to another
provider (or providers) practicing another system, to ensure delivery of a holistic and comprehensive
health care as appropriate for the problem. Practitioners of different systems of medicine would accept
this pooling approach, only when they have convincing information on the comparative strengths and
weaknesses of each system vis-a-vis each health problem. Therefore, obtaining such information
deserves high priority.
2.
At present, physicians have very little knowledge for choosing the best option out of those available
from the different systems of medicine. Further, the consumers of health care have been left to
themselves for making the choice between different systems without any scientific information enabling
them to make an informed choice. They are even misguided at times by physicians because of some
prejudices and I or the higher priority given to a particular system, owing to the loyalty to their own
system. It is also possible that the practitioners’ behaviour is in conformity with the specific requirements
imposed by the guardians of the respective systems, as well as the laws of the land (e.g., rules under the
Indian Medical Council). It is understandable that physicians in general lack the wider vision needed for
providing the best care to their trusting clients, encompassing all the available recognized systems.
3.
Moreover, practitioners of different systems of medicine need a change in mindset. They ought to
realize that all systems are noble professions with the common aim of providing health care to the needy
and have survived for years because they had the requisite support of satisfied customers for a long
time. Decrying any system without an in-depth study of the actual effectiveness of that system is
unscientific and biased.
4.
A series of scientific studies on the effectiveness of each system vis-a-vis each health problem and
wide dissemination and discussion of these findings are necessary to change this mindset, which has
been deeply entrenched for a long time. The objective is to create an understanding and conviction
resulting in co-operation for pooling of benefits from available systems of medicine by providers and in
choosing of the system appropriate to the health problem, by consumers.
These studies have to cover all aspects of health care viz., curative, preventive and promotional. It is
proposed to take up studies on curative aspects first Further, to start with, these may be restricted to three
5.
well-known systems of medicine used in India viz., western medicine (allopathy), ayurveda and
homeopathy. Thereafter, other systems of medicine could be investigated. Another set of studies will be
required to get similar information with regard to preventive and promotional care provided by different
systems of medicine.
6. Adequate information is not available for proper planning and designing of even studies on curative
aspects. Further, some basic questions about differences in diagnosis (labeling) of disease by physicians of
the different systems and methods used for evaluating the effectiveness of treatment have to be answered
to the satisfaction of all physicians.
7.
Therefore, a necessary first step in the series of studies on curative aspects is to conduct an
exploratory study that can throw light on (1) all such questions and (2) the comparative effectiveness of
treatment options available from the three selected systems, for diseases that are quite common. The
focus on the more common diseases will help in pooling the benefits from different systems to reduce the
sufferings of the maximum number of people and thereby increase the popularity of this pooling
approach. This, in turn, will help to create a demand for extension of this approach for treatment of all
diseases as well as to preventive and promotional care.
8.
A by-product of this exploratory study will be information on (a) the prevalence of less common diseases
(including epidemiologically important diseases) and (b) the incidence of serious and life-threatening
disease occurrences, including those requiring emergency care. This information could also be used to
plan well-designed studies to ascertain the comparative strengths and weaknesses of different systems for
tackling these less common diseases or those posing emergencies.
9.
The proposed exploratory study, and a series of studies which ought to follow on curative as well as
preventive and promotional heath care, have the potential to revolutionize the delivery of health care
and make it possible to achieve the long term goal of establishing the ideal health care system, which
objectively pools benefits from different systems of medicine.
Objectives of the exploratory study
10.
The objectives of this exploratory study are:
.
(1)
to investigate the acceptability of western medicine, ayurveda and homeopathy among
patients suffering from various diseases in the study area.
(2)
to identify the diseases, if any, for which physicians from the above three systems would
themselves like to refer the patient to a physician of another system
(3)
to identify the best treatment option out of those available from these three systems, for each
of the diseases occurring commonly in the area and to study which of these best options are likely
to be accepted by the physicians of all the three systems without any further investigation.
(4)
to provide at least a preliminary assessment of the relative merits and demerits of the
following four methods of evaluating diagnosis and treatment:
diagnostic tests before and after treatment (this may not be feasible for all diseases
a)
and all systems)
b)
judgment of physicians regarding prognosis or cure
c)
ascertaining from the patient the extent to which suffering / symptom has been
reduced / eliminated [this is subjective but important from the patient's (sociological)
point of view. If ail patients accept a treatment as beneficial for a particular disease,
a scientific evaluation may be needed only to ascertain whether there are any long
term ill effects of the treatment.]
d)
(5)
study relapse rates and possible short-term adverse effects of the treatment.
to provide some idea about the cost and duration of treatment and other factors which are
important for the patient and may influence acceptance of the best and second best options.
(6)
to identify, to the extent possible, adverse effects of treatment, if any, which need to be further
investigated.
(7)
to suggest suitable designs for further studies on epidemiogically important diseases for which
best possible options could not be ascertained from this exploratory study because of inadequate
sample size.
Study Area and Population - Design of the Study
11 The study is proposed to be carried out in rural areas to start with because the established treatment
practices of large number of providers in urban areas are likely to interfere with the treatment given under
the study. This choice has been made despite the much higher cost involved as well as longer time
required for a rural study. The study is proposed to be carried out around Bangalore, south India. The total
study population will be about 36,000 spread over 16 clusters of villages, with population of about 2,250
each, situated in four different directions and at varying distances from Bangalore.
12.
For organizational and operational convenience, an entire cluster of villages will be allotted to each
system of medicine. This allotment of entire villages to study one system may influence the reporting of
acceptance pattern by patients. In order to study this aspect, each individual patient will be offered a choice
between the three systems of medicine in another set of clusters of villages.
A study population of 36,000 has been chosen to have a fairly large number of sick persons for
13.
treatment under each system and to cover sickness during all seasons. The entire fieldwork for the study
(implementation part) will be completed in about one year. Evaluation of effectiveness of treatment,
analysis of data and preparation of report may take another 18 months.
Ethical considerations
14.The treatment of patients in the study will be strictly according to the practices adopted by the three
recognized systems. No experimentation with new medicines or using another system will be allowed. An
informed consent, in writing, will be taken from the patients about their acceptance of treatment from the
system chosen Those who do not accept will be offered treatment elsewhere under the system of their
choice or referred to a suitable health facility. Emergencies and life-threatening problems will be suitably
advised / referred. Thus, the design and conduct of the study will fully satisfy all ethical considerations.
Technical Advisory Committee
15. A 10-member committee consisting of experts from the three systems, holistic medicine, sociology,
statistics, clinical pathology, and the Consultants at the central office will provide guidance and advice at
planning and implementation stages and at the time of finalizing the interim and final reports of the study.
Utilization of Results
The results of this study are likely to provide:
16.
(a) the best treatment options available from the three systems of medicine for diseases that are
common in the study area.
(b) a starting point for proper dissemination of these findings and utilization of these best options in
a planned manner for diseases that are common in the study area.
(c)
information for planning further studies required for (i) obtaining the best treatment options for
some other diseases and (ii) for further confirmation of the findings, whenever needed for wider
acceptance.
(d)
the pattern of acceptance of the three systems by the people and the opinion of the physicians
about non-availability of treatment for some diseases under their system
(e)
useful ideas for planning the strategies and follow-up actions needed for obtaining wider
acceptance of the best options by physicians, the regulatory bodies of the different systems as
well as the people.
In all, the findings of this exploratory study are expected to lay the foundation and be a small step for
the much bigger efforts required for achievement of the final goal of the ideal health care system that
pools benefits from different systems of medicine, as envisaged in paragraph 1 above.
Cost
17.
The total cost of the study may be about Rs.27 millions (27,000,000). (At an exchange rate of Rs.44 per
S,
this amounts to $.6,14,000.) This is calculated on the basis of April 2006 prices for goods and services in
Bangalore and may need revision at the start of the study. If the required sanction and clearance are
delayed by more than six months, a cost escalation at the rate of 10% per year will become necessary.
18.
A first installment of 30% may be released soon after the approval of funds by the funding agency and
receipt of the necessary local clearances for conducting the study. A second installment of 25% may be
released after three months from the start of the study. Other installments will become due on receipt of the
later reports viz., 15% each after the 6-month and 12-month reports, 14% after the 18-month report and 1%
after the full report.
CULTURE HAS CATERED TO ITS NEEDS
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