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IMPORTANCE OF INTRA UTERINE HISTORY IN HOMOEOPATHIC CASE TAKING:

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An infant in the mother’s womb is as much in the hands and under the will of the mother as clay in the hands of the potter; who from it makes whatever pleases him….
-PARACELSUS

The study of life is the study of beginning and its constant evolution up to the present moment of development. The spirit of life begins with the moment of conception. The moment of conception is not merely a moment of union of sperm and ovum but rather the moment at which the material as well as dynamic union of cell becomes endowed and animated with the dynamics, marking the beginning of life. It is the moment which marks beginning of a continuous process of development and introduces something new which is radically discontinuous with what has come before it.

It is widely acknowledge fact that pregnancy is a state associated with drastic physiological and psychological changes.

The genetic material which the child incurs from his parents and forefathers makes him predisposed to certain types of illness like there may be a predisposition to depression, obesity or schizophrenia yet these genes do not cause the malfunctions; it is environment which triggers them at earliest phase of life i.e. intra uterine life. in other words, the kind of experience the developing foetus has with his care givers and especially with his mother is gets biologically embedded in the child and is manifested in the later years of life. They got written into the child’s physiology because this is the period of human life when regulatory habits are being formed and the brain sets its automatic emotional and psychological controls.

There are many variations in prenatal environment and the pressures to one which one foetus is subjected may greatly differ from those exerted on other. Recent research suggests that the mother’s physical and emotional states and consequently, the prenatal environment that she provides have important influences on foetal development and adjustments of the child. The attitude of the parents towards the arrival of the child, their fears, beliefs , and expectations and the mother’s nutrition and general health, all effect the child’s progress. The alteration in maternal physiology that is related with pregnancy related hormone secretions can, for most part, be interpreted as biological adaptations to the needs of developing foetus.

In a fashion parallel to the physiological adjustments, pregnancy is also time of radical attitudinal and emotional changes. The prenatal environment exerts profound influences on the development of organism inducing changes which extends from early to later life. Prenatal stress in the early gestation exerts a larger impact on outcomes related to the length of gestation and foetal growth than stress in the latter part of gestation.
The best way to begin an examination of the prenatal environmental influences is to mention briefly all those influences which act as a stress to the pregnant female. These stresses to have an impact on the unborn child, the mother’s experiences must involve actions that will affect either the conditions of the uterus and placenta or the substances that pass through the placenta to the child.

PATHWAY OF STRESS MANIFESTING DURING PRENATAL PERIOD-
Chronic maternal stress may exert a significant influence on foetal developmental outcomes. The effect of maternal stress may be mediated through biological and or behavioural mechanisms.

Maternal stress may act via one of the 3 major physiological pathways – neuroendocrine, immune/inflammatory and vascular pathways. Maternal transfers to the in growing foetus via one of these pathways and bring forth the changes in the immediate environment of foetus, thereby causing a great impact on the immediate as well as remote development of the foetus.
One of the proposed mechanisms involves the effect of the stress reaction on blood flow. Stress sets up a persistent fright/flight response. This response in part ,involves the diversion of blood flow from maintenance function (eg. digestion) to functions related to movement (muscle and heart) . Placental blood flow is similarly affected signifying negative relationship between maternal anxiety and blood flow to the foetus. Thus, the foetus may be deprived of oxygen and nutrients by this reduced blood flow, resulting in a broad range of developmental difficulties. The developing neurological system may be particularly sensitive to reduced blood flow during crucial periods of rapid development.

Another mechanism involves the transport of neurohormones to the foetus through the placenta. Neurohormones releases in response to stress (eg, cortisol) are necessary for normal foetal development. Thus, they can easily cross the placental barrier. High levels of these neurohormones alter neurological development by ‘’Programming’’ neurological structures in a way that is maladaptive. When these ‘’disturbing factors’’ act during the specific sensitive periods of development, they exercise organisational effect – or program some set points – in a variety systems. If these set points were programmed to fit environmental circumstances different from those faced by organism later in life, the organism is then hampered because of the programmed set points do not easily adapt to this new environment. These mal adapted set points constraint the flexibility of biological systems to adjust to alter environments and can result in poorly adapted physiology and disease.

The stress also implicates the development of embryo through the Hypothalamus Pituitary Axis.  The responses of the HPA have a variety of other effects, including a suppression of immune system functioning during pregnancy may be particularly detrimental to maternal and foetal health because the immune system is already suppressed as a normal part of pregnancy. This is because the developing foetus is defined by the immune system as non self but the foetus is not destroyed by the mother’s immune system because the uterus has protective features rendering it a privilege site for implantation. There is also a decrease in NK cell activity and a decrease in Interleukin-2 release along with the decreased proliferative response to antigens by T helper cells during pregnancy. As a result of these changes, viral, fungal and protozoan infections are often more common in pregnant women and the symptoms are more severe than they would be in non-pregnant women.
The maternal-placental-foetal neuroendocrine system is the primary physiological mediator of the effects of prenatal stress on adverse foetal outcomes because it constitutes the fundamental substrate for foetal growth, development and parturition, and because pathways through which alterations in other systems ( eg, immune , vascular ) produce pathophysiological consequences are mediated, in part, by maternal-placental-foetal neuroendocrine processes.

Stressors during the first trimester are most strongly associated with negative outcomes. One of the best studies of timings of stress was by Van den Bergh, who found that antenatal anxiety between 12 and 22 weeks of gestation had a strongest association with hyperactivity, frequent crying , sleeping and feeding difficulties and difficult temperament during the first seven months of life. The strongest effects discerned of maternal prenatal stress on the offspring were on the behavioural and emotional problems. The personality characters of the mother during the pregnancy affected the neurological development of the infant to produce a more difficult child. The strength of effect was stronger from stress at 12 weeks prenatal than 18 weeks, & resulted in double the levels of offspring’s hyperactivity, & emotional & conducts disorders. Also excessive stress in the 7th to 10th week of pregnancy – when the roof of mouth and bones of upper jaws are being formed in the growing foetus – can cause cleft palate & harelip.
Stress in the later pregnancy is less likely to cause any physical abnormalities. The children of anxious mothers in late pregnancy had high waking level of cortisol. However, stressful conditions (physical & psychical) in later months of pregnancy can result in preterm labour pains, premature delivery of the child and even sometimes miscarriage or stillborn baby.

Maternal stress and/or low birth weight has been associated with the following central nervous system and mental health alterations in the children in later years of life:

Elevated activity of sympathetic nervous system
Elevated cortisol levels
Increased risk of psychopathology, including anxiety and depression
Increased risk of schizophrenia,
Motor and social developmental delay.

Maternal stress and/or low birth weight has been associated with the following physical health alterations in the children in their future years of life :

Characteristics of the metabolic syndrome (body mass index, waist-hip-ratio, diastolic blood pressure, insulin plasma insulin, triglycerides, HDL & LDL cholesterol)
Higher total cholesterol in men,
Hypertension,
Insulin resistance and type 2 diabetes.

§284 fn 6th edition:
. But the case of mothers in their (first) pregnancy by means of a mild antipsoric treatment, especially with sulphur dynamizations prepared according to the directions in this edition ($270), is indispensable in order to destroy the psora – that producer of most chronic diseases – which is given them hereditarily; destroy it both within themselves and in the foetus, thereby protecting posterity in advance. This is true of pregnant women thus treated; they have given birth to children usually more healthy and stronger, to the astonishment of everybody. A new confirmation of the great truth of the psora theory discovered by me.

As the homoeopathic medicine given to mother affect the child’s health, similarly the stress factors to mother during pregnancy affects the health of the child.
Scattered throughout the history, one can find numerous instances which all point to the same fact that a child is able to endure all the experiences which the mother go through during her pregnancy,& can listen to her own thoughts even. Yet no one was able to explore this field any further until Master Hahnemann, a Philanthropist & a man of great wisdom, who was the first one to enlighten not only the darkness prevailing in the medical practices at his time through the lamp of rational healing art but also to bring forth in the lime light, the dynamic influences which the mother have on her child during the prenatal period.
So the real essence of development of an individual has to be perceived from the very beginning, the moment of conception. As the seed of evolutionary biographic development of each individual is sown at the moment of conception and from thence. Nurtured by the waters of its surrounding  environment.
Hahnemann by his artistic perceiving, auscultated the mother’s womb and perceived in its darkness some crucial sparks of prescribing light- the cry of unborn creature manifested through mother’s behaviour, desires, cravings & aversions , hate & love feeling , dreams & many more, to decade the facts & turn them into therapeutic measures.
As ever day is different from the other day so does every human being differs from one another. It is important to individualize the person; this can only be done if the physician takes the entire case unprejudiously from the point of beginning in the holistic manner. It is the process of perceiving as to how a patient as a person evolved and distinguished himself as a unique entity. So, for an artistic prescribing in childhood as well as in later stages of life, it is important to know the historic evolution & taking intrauterine life as an avenue for prescribing.

BIBLOGRAPHY:
●Behavioral perinatology: biobehavioral processes in human fetal development.
Wadhwa PD1, Glynn L, Hobel CJ, Garite TJ, Porto M, Chicz-DeMet A, Wiglesworth AK, Sandman CA.

●Fetal programming of hypothalamo-pituitary-adrenal function: prenatal stress and glucocorticoids
Amita Kapoor, Elizabeth Dunn, […], and Stephen G Matthews

●Glucocorticoid excess and the developmental origins of disease: Two decades of testing the hypothesis – 2012 Curt Richter Award Winner
Volume 38, Issue 1, January 2013, Pages 1-11
Rebecca M. Reynolds

● Organon of medicine: Dr.Samuel Hahnemann 6th edition , translation william boericke

Written by:
Abbas Kazim

Abbasdelhi@live.com

Bakson Homoeopathic Medical College and Hospital,
Greater Noida

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