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 Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 8  |  Issue : 4  |  Page : 200-208

Assessing the therapeutic usefulness of Ricinus communis: A multicentric observational clinical verification study


1 Scientist - IV, Dr. Anjali Chatterjee Regional Research Institute for Homoeopathy, Kolkata, West Bengal, India
2 Scientist - IV, Central Research Institute for Homoeopathy, Noida, Uttar Pradesh, India
3 Scientist - IV, Regional Research Institute for Homoeopathy, Imphal, Manipur, India
4 Regional Research Institute for Homoeopathy, Shimla, Himachal Pradesh, India
5 Scientist - II, Homoeopathic Drug Research Institute, Lucknow, Uttar Pradesh, Former Director General, Central Council for Research in Homoeopathy, New Delhi, India

Date of Submission16-Jun-2014
Date of Acceptance09-Dec-2014
Date of Web Publication18-Dec-2014

Correspondence Address:
Dr. P S Chakraborty
Scientist - IV, Dr. Anjali Chatterjee Regional Research Institute for Homoeopathy, Kolkata, West Bengal
India
Subhash Kaushik
Scientist - IV, Central Research Institute for Homoeopathy, Noida, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-7168.147317

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  Abstract 

Introduction: Clinical verification is an ongoing research programme of the Central Council for Research in Homoeopathy, under which many symptoms of Indian and rarely used drugs in Homoeopathy have been clinically verified.
Objectives: To clinically verify the symptomatology of Ricinus communis as observed during its proving conducted by Council and also to ascertain the clinical symptoms relieved in the process of verification.
Materials and Methods: Two hundred and twenty-five patients from all age-groups and both sexes were enrolled from the outpatient departments (OPDs) of the institutes and units of the Council following the exclusion and inclusion criteria as per protocol and obtaining written consent. The presenting signs and symptoms were recorded in a predefined case recording proforma and if Ricinus communis was found very closely similar to the symptoms of the patient, the patients were enrolled in the study. The medicine was prescribed in different potencies as per the need of the case and in accordance with homoeopathic principles. The progress was noted in a follow-up sheet to determine the effects of the medicine, in relieving the symptoms of the patient.
Result: Forty eight out of fifty three symptoms obtained from proving of Ricinus communis could be clinically verified. The characteristic indications were left-sided affinity, aggravation from sun, amelioration in open air, dryness of mucous membrane of gastrointestinal tract, dissatisfaction leading to irritability and anger. The usefulness of the medicine was mostly marked in relieving headache, coryza, aphthae, gastritis, diarrhoea, constipation and acne. All the verified symptoms indicated the scope of its therapeutic action.
Conclusion: Ricinus communis can be considered as an important medicine for the management of acne, aphthae, backache, colic, constipation, coryza, cough, diarrhoea, dyspepsia, fever, gastritis, headache and irritability.

Keywords: Acne, Backache, Clinical verification, Constipation, Diarrhoea, Gastritis, Headache, Homoeopathy, Ricinus Communis, Upper Respiratory Tract Infections


How to cite this article:
Chakraborty P S, Kaushik S, Singh P, Nain S S, Singh O, Ramteke S S, Das K C, Debata L, Nayak C. Assessing the therapeutic usefulness of Ricinus communis: A multicentric observational clinical verification study. Indian J Res Homoeopathy 2014;8:200-8

How to cite this URL:
Chakraborty P S, Kaushik S, Singh P, Nain S S, Singh O, Ramteke S S, Das K C, Debata L, Nayak C. Assessing the therapeutic usefulness of Ricinus communis: A multicentric observational clinical verification study. Indian J Res Homoeopathy [serial online] 2014 [cited 2019 Nov 18];8:200-8. Available from: http://www.ijrh.org/text.asp?2014/8/4/200/147317


  Introduction Top


Under homoeopathic system of medicine, the role of each individual drug on human beings is identified by the process of drug proving. But unless these symptoms obtained from proving process are verified at bed side, it does not get importance for its clinical acceptance. A proving symptom that has never been verified by clinical application, bears no therapeutic value for homoeopathic practice. Hence, clinical verification not only provides us to help in confirmation of available data but also enlarges the pathogenesis of a drug for its wider use.

In Materia Medica, there are many Indian drugs which are not well proved and are lesser known but having tremendous therapeutic potential. Hence their pathogenesis needs to be verified clinically so that the reliable indications for their therapeutic use could be found out, which may be added in literature after subsequent confirmation.

The Central Council for Research in Homoeopathy (CCRH) is conducting the clinical verification and more than 100 drugs have been verified, most of which are of Indian origin. One such drug is Ricinus communis. It is commonly known as 'Arand' in Hindi and 'Castor oil plant' and 'Palma Christ' in English. [1] The plant is commonly found in Egypt and India. [2] The medicine is prepared from the oil of ripe seeds. [1],[3] The oil chiefly consists of tri-ricinolein with a small quantity of palmitin and stearin. Apart from this, it contains 'Ricin' which is a very toxic substance. The glycerides of ricinoleic acid are mainly responsible for the purgative effects. When ingested, the oil is decomposed by the pancreatic juice into ricinoleic acid, which irritates the bowels and causes purgation. It takes about 4 to 5 hours to produce liquid stool without pain or griping in the intestine. [4]

Ricin is a powerful poison. Fatal effect has been observed following the ingestion of more than three seeds. One seed is enough to produce violent symptoms causing gastroenteritis, general convulsions and collapse. [3] Ricinus is a violent irritant of intestine, kidneys and bladder, which may lead to development of jaundice or dysuria. It has also having effect on coagulation of blood, producing haemorrhages, inflammation of the gastrointestinal tract, even when given subcutaneously. [4]

Since 2000 B. C. the seeds of Ricinus communis are used in dyspepsia and for preparing a poultice to treat arthralgia in Ayurvedic system of medicine. [5] Its oil is used as a very effective purgative in cases of constipation. It is also recommended for ascites, intermittent fever, heart troubles, bronchitis, asthma, colitis, jaundice, elephantiasis, arthritis, dysentery, piles, gout, obesity, lumbago, constipation, rheumatism, sciatica, skin diseases, etc. [6] Likewise in Unani system of medicine the drug is used for constipation, rheumatism, paralysis, tremor, asthma, cough and colicky pain. [4]

Having known its traditional use, the drug Ricinus communis was proved and introduced in Homoeopathy by Langier, through the American Journal of Medical Science, in 1828. Later, Allen and Clarke also proved it. [3] In Homoeopathy, it is used in albuminuria, aphthae, arthritis, breast disorders, cholera, constipation, diarrhoea, dysentery, gastroenteritis, jaundice, lactation, myalgia, peritonitis and sprain. [2],[3] As there was no systematic drug proving conducted earlier, the Council conducted a drug proving on this drug followed by its clinical verification to ascertain its therapeutic usefulness.

Objectives

Primary Objective


To clinically verify the symptomatology of Ricinus communis as observed during the proving of this drug conducted by the CCRH.

Secondary Objective


To ascertain the clinical symptoms that did not appear during the proving of the drug but were relieved in the patients after the administration of the medicine, either completely or partially.


  Materials and Methods Top


Patients for the study were enrolled from the outpatient departments (OPDs) of 11 Institutes/Units of the Council, viz. Central Research Institute, Noida (U. P.), Homoeopathic Drug Research Institute, Lucknow (U. P.), Regional Research Institute, Puri (Odisha), Regional Research Institute, Shimla (H. P.), Regional Research Institute, Gudivada (A. P.), Regional Research Institute, Imphal (Manipur), Dr. Anjali Chatterjee Regional Research Institute, Kolkata (W. B.), Clinical Research Unit, Port Blair (Andaman and Nicobar Islands), Clinical Verification Unit, Ghaziabad (U. P.), Clinical Verification Unit, Patna (Bihar), Clinical Verification Unit, Vrindaban (U. P.).

In this multicentre study, 225 patients comprising of 107 males and 118 females were prescribed Ricinus communis according to the similarity of symptoms during the period October 2005-March 2010 [Figure 1]. The medicine was procured from the licensed pharmacy in various potencies, viz. 6C, 30C and 200C. The selected patients were from all age-groups and both sexes. Patients who were on any medication for one week prior to being enrolled in the study were put on a wash-out period of 7 days. The patients, who were suffering from any systemic disease and were under regular medication for that, were excluded from the study. An informed written consent was obtained from the eligible subjects before initiating the study.
Figure 1: Flow chart of the par ticipants in this study. OPDs = Outpatient departments

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The presenting symptoms and signs of the patients were recorded in a predefined case recording proforma. After doing the anamnesis of each enrolled case, special attention was given to the peculiarity of complaints, their characteristic sensations, modalities and any associated or concomitant symptoms. Special attention was given to the causation, mental symptoms, thermal reaction, cravings, aversions, perspiration, sleep, dreams, appetite, thirst, stool, urine, etc. The symptoms were repertorised using a repertory compiled by the Council for the study and subsequently the characteristic symptoms of the patients confirmed from the drug picture from Materia Medica.

Thus, if Ricinus communis was found indicated for the patient on the basis of symptom-similarity, it was prescribed in 6C potency thrice a day. If Ricinus communis was not indicated, the patient was excluded from the study and treated in the general O. P. D. The changes in presenting symptoms and signs were recorded during the follow-up visits. In any kind of improvement, medicine was stopped and was followed by placebo. If there was no change in symptoms and signs even up to seven days, the next higher potency like 30C and 200C were prescribed, as per the need of the case and in accordance with homoeopathic principles. If no change was observed, even after change of potency, the case was closed and considered as a clinical failure. If the patient presented with new symptoms of mild intensity, placebo was prescribed; while appearance of severe symptoms, sufficient to cause considerable discomfort to the patient, called for change of medicine or therapy.


  Results Top


The data of all the cases was collected, compiled and thereafter analyzed. The clinically verified symptoms are given in [Table 1] along with the number of patients prescribed on the basis of proving records (drug proving profile generated by CCRH) and also the symptoms available in other literature. The numerical superscripted on every symptom denote the source of literature of that symptom. Elements of the main symptom (character, modalities, concomitants, etc.) which were not observed during the proving but disappeared in the patients during the study, either completely or partially, and are not mentioned in the referred literature have been kept along with the main symptom in italics. In the column 'Improvement status', the first figure denotes the number of patients who had the symptom and to whom the medicine was prescribed and the second figure denotes the number of patients who got relief of the same symptom. In the column of percentage of improvement, percentage is calculated in those symptoms where the improvement is observed in more than ten patients.
Table 1: Clinically verified symptoms

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[Table 2] contains those symptoms which are not found in the proving literature of the medicine, but found to have disappeared after the administration of Ricinus communis, otherwise known as clinical symptoms. In the column of percentage of improvement, percentage is calculated in those symptoms where the improvement is observed in more than ten patients [Figure 1].
Table 2: Clinical symptoms

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Repertory

A concise repertory of the verified symptoms according to the structure of the Kent's Repertory of the Homoeopathic Materia Medica has been compiled for quick reference. The rubrics in which Ricinus communis has been found as a single remedy, have been identified separately and highlighted in shades so that these could be verified subsequently by the profession in various clinical conditions and based on their observations these rubrics could be graded in future.



Therapeutic utility identified

Anorexia, Aphthae, Backache, Colic, Coryza, Cough, Diarrhoea, Dysentery, Fever, General weakness, Headache, Nausea and vomiting, Sore throat.

Sphere of action

Mind, Head, Eyes, Ear, Nose, Face, Mouth, Throat, Stomach, Abdomen, Rectum, Urinary system, Respiratory system, Back and extremities, Fever, Skin, Generalities.


  Discussion Top


During the study, 48 proving symptoms of Ricinus communis were verified out of 53 proving symptoms and along with these six clinical symptoms were also observed in the study. The usefulness of the medicine was mostly marked in relieving headache, coryza, aphthae, gastritis, diarrhoea, constipation and acne. While dealing with these clinical conditions, many of the related symptoms, as mentioned in various literatures, were reconfirmed.

The results indicate that its action on mental sphere is marked with irritability, leading to anger. The patients are suffering from a great displeasure in their life and also about the happenings around them and this gradually leads to an irritated state of mind, which was controlled by Ricinus communis. The patients under this drug are offended easily, which indicates that there is always a feeling of indignation, a feeling of hatred or a feeling of displeasure in every matter. Here, it may be compared with Nux vomica but it has outbursts of his emotion which has not been observed in Ricinus. Such patients generally are very sensitive in nature. They feel insulted at trifles and take even the most harmless remark to their heart and think about it all the time.

The head symptoms are marked with congestion. Nature of pain is bursting or throbbing in nature and is caused or aggravated from heat of sun and is better by tight bandage. In this condition Ricinus communis is similar in action with Belladonna, Glonoine and Sulphur. All these medicines are having a common modality i. e. aggravation in sun, but Belladonna is worse on lying down, whereas Ricinus communis is amel. by lying. Glonoine is better in open air, by uncovering and Sulphur is marked with recurring periodicity and a sensation of heat on head.

The symptoms verified under gastrointestinal system, indicates the role of this drug in relieving the inflammatory conditions of stomach (gastritis). The symptoms are marked with nausea and vomiting worse from taking anything, either food or even water, and this may be associated with burning in stomach. This distinguished feature of Ricinus may be compared with Arsenic album and Phosphorus. Whereas Arsenic is relieved by hot things, Phosphorus is relieved temporarily by taking cold food. The drug is equally useful in diarrhoea and constipation, as found mentioned in various literatures. During diarrhoea, stool becomes greenish, absolute absence of pain in abdomen and in constipation the stool is very dry and hard. This diarrhoeic phase of Ricinus communis is having much similarity with Podophyllum and Magnesia carb. But Podophyllum is identified with its offensiveness and Magnesia carb. by its acidic smell and character of stool. Interestingly, none of these two medicines are chilly during stool, as found in Ricinus communis. This study, also confirms that it can relieve the most obstinate type of constipation even. This unusual dryness of stool indicates the dysfunction of absorption in intestine, both small and large.

The drug may be used in acute and chronic rhinitis when the discharge from nose is worse in closed room and better in open air and associated with alternate blockage of nose.

Action of this medicine on skin is marked with painful acne and also with vesicular eruptions on face with itching.

Predominantly its action is noted on left side of the body and its general modalities are worse after eating and in morning. Here it is similar in action with Sulphur, Phosphorus and Sepia. All these medicines are having their affinity for left sided complaints of abdomen but in Ricinus communis it is more marked on upper part of the body, specially head, eyes and in ears. The medicine was also useful in relieving the pain and stiffness in nape of neck and back, worse during rest or sleep and relieved by motion (Rhus tox.). Aphthae with dry and white coated tongue, obstructed feeling in ears, pain in throat and profuse perspiration were also amenable to Ricinus communis.

During the study, a few clinical symptoms also emerged, exploring the wider therapeutic area of this drug and these were acid dyspepsia, swelling of nasal turbinates and yellowish discoloration of face.


  Conclusion Top


The study verified symptoms of the drug proving conducted by the Council and symptoms found in other literature. Hence, all these verified symptoms accompanying the clinical symptoms confirm the wider therapeutic action of Ricinus communis. Further study may be conducted to verify the remaining symptoms obtained during the proving the clinical utility of this drug.


  Acknowledgement Top


The authors are thankful to Dr. Raj K. Manchanda, Director General, Dr. Anil Khurana, Deputy Director (H) Dr. B. S. Arya, Assistant Director (H), Central Council for Research in Homoeopathy, for giving valuable suggestions in the construction of this article.

The efforts and motivation imparted by Drs. J. P. Govekar, R. P. Yadav, V. G. Prasad, P. K. Pradhan for data collection and contribution made by Dr. Suhana P. Azis, SRF (H), CCRH, New Delhi in data compilation is also appreciated.

The facilities and infrastructure provided by the Programme officers and In-charges of the respective Institutes/Units is deeply acknowledged. [9]

 
  References Top

1.
Govt. of India, Ministry of Health and Family Welfare. Ricinus communis. Homoeopathic Pharmacopoeia of India. 1 st ed., Vol. 3. New Delhi: The Controller of Publications; 1978. p. 95.  Back to cited text no. 1
    
2.
Murphy R. Ricinus communis. Lotus Materia Medica. 2 nd revised ed. New Delhi: B. Jain Publishers (P) Ltd.; 2002. p. 1491-93.  Back to cited text no. 2
    
3.
Clarke JH. Ricinus communis. A Dictionary of Practical Materia Medica. Reprint 1 st ed., vol. 3. New Delhi: B. Jain Publishers (P) Ltd.; 2006. p. 1012-15.  Back to cited text no. 3
    
4.
Nadkarni KM. The Indian Materia Medica. Reprint 3 rd revised and enlarged ed. Vol. 1. New Delhi: Popular Prakasan Pvt. Ltd.; 1982. p. 1065-70.  Back to cited text no. 4
    
5.
Castor oil plant. Accessed from: https://en.wikipedia.org/wiki/Castor_oil_plant [Last accessed on 2013 May 7].  Back to cited text no. 5
    
6.
Sheth AK. Ricinus communis. The Herbs of Ayurveda. Vol. 3. Gujarat: Ashok Sheth 'ALANKAR'; 2005. p. 980.  Back to cited text no. 6
    
7.
Central Council for Research in Homoeopathy. Ricinus communis. Homoeopathic Drug Provings. 1 st ed. New Delhi: CCRH; 2005. p. 97-9.  Back to cited text no. 7
    
8.
Allen TF. Ricinus communis. The Encyclopedia of Pure Materia Medica. Reprint 1 st ed. vol. VIII. New Delhi: B. Jain Publishers Pvt. Ltd.; 2001. p. 400-2.  Back to cited text no. 8
    
9.
Boericke W. Ricinus communis. Boericke's New Manual of Homoeopathic Materia Medica with Repertory. 3 rd Revised and augmented 9 th ed. New Delhi: B. Jain Publishers (P) Ltd.; 2007. p. 492-93.  Back to cited text no. 9
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]



 

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