First BHMS Term Test I — April 2024

HMM-I: Homoeopathic Materia Medica — Complete Answer Key

Section A: Multiple Choice Questions (1 mark each)

Section B: Short Answer Questions (5 marks each)

Q6. Compare the Glandular Affections of Baryta Carb and Bryonia Alba (2½ + 2½)

• Tonsils: Enlarged, indurated tonsils that suppurate every time the patient catches cold; quinsy; tonsils swollen after every exposure to cold
• Submaxillary and cervical glands: Hard, enlarged, and indurated; tendency to chronic enlargement without suppuration
• Parotid glands: Enlarged, with hardness
• General tendency: Slow development, dwarfishness, hypertrophy of glands that become stony-hard (scrofulous tendency)
• The glandular enlargements in Baryta Carb tend toward induration and hardness rather than suppuration
• Associated with mental dullness, bashfulness, and aversion to strangers

• Mammary glands: Stony hardness of the breasts; painful, hot, hard breasts especially in early mastitis; breasts feel heavy, must be supported
• Thyroid: Can produce goitre associated with its rheumatic constitution
• Lymph nodes: Hardness and stiffness of affected glands; not prone to suppuration
• Key distinction: In Bryonia, glandular affections are characterized by stony hardness, dryness, and aggravation from motion; any movement worsens the pain
• Stitching, tearing pains worse from motion and better from rest are the hallmark
• Glands associated with Bryonia tend to be hard, dry, and inflamed rather than scrofulous

Q7. Female Complaints of Calcarea Carbonica (5 marks)

• Menses too early, too profuse, and too long-lasting — this is the hallmark
• The least excitement causes return of menses or increases the flow
• Leucorrhea: Milky white, bland, profuse, like milk; occurs in little girls before puberty and between periods in adult women
• Menstruation with chilliness; feet icy cold during menses

• Fat, fair, flabby, cold, and damp — the typical Calc. Carb. constitution
• Sweating: Profuse sweating of the head during sleep, sour-smelling
• Tendency to obesity; weakness and fatigue on exertion

• Craving for indigestible things (chalk, charcoal, earth) — pica during pregnancy
• Sour vomiting during pregnancy
• Milk scanty or ceases; or milk profuse and too thin
• Breasts swollen and painful before menses

• Uterine prolapse with weakness and bearing-down sensation
• Leucorrhea in little girls with vulvar itching

• Nails brittle and soft; tendency to cracks in skin
• Cold, damp hands and feet

• Anxiety about health; fear of going insane; overwhelmed by slightest emotional stress
• Apprehension worse in the evening

Q8. Common Name and Family of the Following Drugs (1 mark each)

Q9. Sources of Homoeopathic Materia Medica — Names and Description of Three Sources (2 + 3 marks)

1. Vegetable kingdom (Plant sources)
2. Animal kingdom (Animal sources)
3. Mineral/Chemical kingdom (Inorganic sources)
4. Nosodes (Disease products)
5. Sarcodes (Healthy secretions/tissues)
6. Imponderabilia (Physical forces)
7. Synthetic sources
8. Toxicological sources

Q10. GIT and Skin Complaints of Sulphur (2 + 3 marks)

• Morning diarrhoea: Drives the patient out of bed early in the morning (5–6 AM) — the most characteristic GIT symptom; stool offensive, urgent, and painless
• Hunger: Sudden hunger at 11 AM; sinking, faint feeling at 11 AM which compels eating
• Acidity: Frequent eructations, sour and offensive; heartburn; water brash
• Gastritis: Burning in the stomach and abdomen; everything seems to turn sour
• Constipation alternating with diarrhoea; stools hard, knotty, offensive
• Haemorrhoids: Burning, itching piles with oozing; much flatulence
• Thirst: Great thirst for cold water; aversion to sweets despite craving them initially
• Appetite alternately ravenous and absent
• Abdomen: Distended, tympanitic; fermentation; must loosen clothing

• Dryness: Skin is habitually dry, rough, scaly, and unhealthy; every little injury suppurates
• Itching: Intense itching of the skin, especially in warmth of bed; scratching causes burning; voluptuous itching — scratching feels pleasurable but leads to burning
• Skin eruptions: Tendency to pustular, vesicular, and papular eruptions; especially at skin folds (bends of elbows, behind knees)
• Aggravation: All skin symptoms worse from warmth, washing, bathing, and at night in bed; "worse from washing" is a keynote
• Eczema: Chronic, offensive-smelling, weeping eczema; skin moist and dirty-looking; dry eczema in old neglected cases
• Redness: Redness of orifices — lips, nostrils, ears, anus are characteristically red (strawberry-red); "red orifices" is a keynote
• Suppressed eruptions: Sulphur is the first remedy to think of when skin eruptions have been suppressed by ointments causing internal disease (asthma, rheumatism, etc.)
• Dirty, filthy skin: Patient averse to washing; skin looks dirty even when clean; characteristic "Sulphur cachexia"
• Burning: Burning sensations throughout skin; heat of the palms and soles; puts feet out of bed to cool them

Section C: Long Answer Questions (10 marks each)

Q11. Indications of Injury for: Ledum Pal, Calendula, Symphytum, Arnica, Ruta, Hypericum

• Punctured wounds from needles, nails, awls, insect stings, animal bites (rats, cats, dogs)
• Prevention and treatment of tetanus after puncture wounds; spasms travel upward from the wound
• Wounds that feel cold to touch but the patient is relieved by cold applications — characteristic inverse modality
• Black eye (ecchymosis of eye) — Ledum is the first remedy after Arnica for this
• Bruised parts feel cold; coldness of the affected part with relief from cold water
• Rheumatism that begins in the feet and travels upward; joints swollen, purple, cold
• Insect stings and bites with swelling, purplish discolouration, cold sensation

• Lacerated wounds with raw, jagged, torn edges; prevents suppuration and promotes rapid, clean healing
• Superficial wounds, cuts, abrasions — used locally as mother tincture and internally
• Surgical wounds: Promotes healing after operations; prevents cicatrization and excessive scarring
• Cleanses wounds; destroys septic organisms; reduces inflammation
• Wounds that are excessively painful relative to their size
• Rupture of muscles and tendons
• Also used in: erysipelas, burns, scalds, fissures, and cracked nipples

• Fractures: Promotes union of fractured bones; accelerates callus formation; first remedy after fracture is set
• Non-union of fractures — where bones refuse to knit
• Injuries to the periosteum (bone covering) — exquisitely sore periosteum after injury
• Injury to the eyeball — blunt trauma to the eye (e.g., from a fist or ball); proptosis after blow
• Injuries to cartilage and tendons
• Bone pains after fractures even when fully healed ("after-pain" in bones)
• Irritable stump after amputation

• Mechanical injuries: Blows, falls, bruises, contusions — any mechanical trauma to soft tissues
• Bruised, sore feeling all over the body — parts feel as if beaten; refuses help saying he is "not hurt"
• Overexertion: Muscular soreness and fatigue from overuse, overexertion, athletic effort
• Head injuries: Concussion, traumatic headache; epistaxis (nosebleed) from injury
• Haemorrhage from trauma — bleeding into tissues (haematomas)
• Prevents and treats surgical shock; given before and after operations
• Prevents sepsis in wounds; helps absorption of haematomas
• Mind: Says he is well when sick; fears being touched; does not want a physician

• Tendon injuries: Sprains, strains; bruised lame feeling in tendons, especially wrists and ankles
• Periosteum: Bruised soreness of the periosteum after blows; bones feel bruised
• Eyestrain injuries: Asthenopia from overuse of eyes; eyes feel strained, hot, aching from fine work, reading, computing
• Ganglion of the wrist (from tendon injury)
• Cartilage damage: Torn cartilage; cartilaginous injuries
• Hamstrings feel shortened — stiffness of hamstrings; injury to hamstring muscles
• Prolapse of rectum from overexertion or straining

• Nerve injuries: Wounds in parts rich with nerves — fingers, toes, spine, coccyx
• Lacerated wounds with excruciating, shooting, burning pains travelling upward along nerve paths
• Crushed fingers and toes: Most characteristic indication — crushing of tips of fingers/toes; nails torn off
• Spinal injuries: Concussion of the spine; coccyx injuries from falls; terrible pains after spinal trauma
• Dental surgery: Pain after tooth extraction; preventive for nerve pain post-extraction
• Tetanus-like spasms after puncture wounds (alongside Ledum)
• Prevention of tetanus in nerve-rich wounds
• Neuritis and neuralgia following injury; pains shoot upward along nerve course
• Standing is the worst position (as in Q1 above) — in the context of spinal injury
• Burns to nerve-rich areas; supersensitiveness to touch in injured area

Q12. Definition of Materia Medica, Homoeopathic Materia Medica, and Types of Homoeopathic Materia Medica (3 + 7 marks)

Definition: Materia Medica is the branch of medical science that deals with the study of drugs — their origin, preparation, identification, physical and chemical properties, physiological actions, and therapeutic uses in disease.

Definition: Homoeopathic Materia Medica is that branch of Homoeopathic science which contains a systematic record of the effects (symptoms and signs) produced by various medicinal substances on healthy human beings through the process of drug-proving (homoeopathic pathogenesis), supplemented by clinical experience, toxicology, and other sources — for the purpose of therapeutic application according to the Law of Similars.

• Based solely on drug-provings on healthy persons
• Records exact symptoms produced by the drug in sequence (Mind, Head, Eyes, Ears... downward)
• Example: Hahnemann's Materia Medica Pura (6 volumes), Chronic Diseases (miasmatic Materia Medica)
• Most accurate and purest form; free from clinical interpolation
• Arranged in schema/organ-system order

• Arranged according to a fixed schema — following the order of organ systems from head to foot
• Kent's schema: Mind → Head → Eyes → Ears → Nose → Face → Mouth → Throat → Stomach → Abdomen... → Generalities
• Example: Kent's Repertory (the corresponding Materia Medica to this), Hering's Guiding Symptoms (10 volumes)
• Comprehensive; easy cross-referencing

• Emphasizes only the most characteristic, unusual, and individualizing symptoms (keynotes) of each drug
• Avoids lengthy symptom lists; focuses on what is unique to each remedy
• Example: H.N. Guernsey's Keynotes and Characteristics, E.B. Nash's Leaders in Homoeopathic Therapeutics
• Practical for quick prescribing; good for students learning drug portraits

• Compares two or more similar remedies side by side to bring out differentiating characteristics
• Helps in differential prescribing when multiple remedies share similar symptoms
• Example: Nash's Regional Leaders, Gibson Miller's Relationship of Remedies, Farrington's Clinical Materia Medica
• Very useful in clinical practice

• Arranged by disease conditions/clinical diagnosis rather than drug names
• Physician can look up the disease and find the indicated remedies
• Example: Boericke's Pocket Manual of Materia Medica with Repertory (therapeutic index section), Clarke's Clinical Repertory
• Practical for clinically-oriented physicians; bridges homoeopathy with clinical medicine

• Written as teaching texts; combines provings, clinical verification, toxicological data, and therapeutic hints
• Comprehensive; includes pharmacological background and drug relationships
• Example: William Boericke's Materia Medica with Repertory, Clarke's Dictionary of Practical Materia Medica
• The standard reference for BHMS students

• Presents the drug as a personality portrait or constitutional picture
• Describes the typical patient needing the remedy — their mental makeup, physical constitution, behaviour
• Focuses on mental/emotional symptoms, miasmatic background
• Example: Catherine Coulter's Portraits of Homoeopathic Medicines, Philip Bailey's Homoeopathic Psychology, Masi Elizalde's constitutional approach
• Useful for deep constitutional prescribing; popular in modern homoeopathy

References: Boericke's Pocket Manual of Materia Medica (9th ed.); Kent's Lectures on Homoeopathic Materia Medica; Nash's Leaders in Homoeopathic Therapeutics; Allen's Keynotes and Characteristics; Hahnemann's Organon of Medicine (6th ed.); Clarke's Dictionary of Practical Materia Medica.