BODY WATER IN HEALTH: Water accounts for 60% of the body weight in the men and 50% in

[Link]
1. Intracellular(ICF).
2. Extracellular(ECF).
TheproportionofIntracellularwatertoextracellularwateris2:[Link]
2components
1. Intravascular([Link]).
2. ExtravascularorInterstitial([Link],lymph).
The proportion of Interstitial to Intracellular water is 3:1. Taking all these facts into account the
totalbodywaterinamale,weighting72kgis42litersanditsdistribution
TotalBodyWeight
Totalbodywater
a. Intracellularwater
b. Extracellularwater
i. Interstitialwater
ii. Plasma

100%

70kg

60%

42liters

40%

28liters

20%

14liters

15% 10.5liters
5%

3.5liters

Water in these compartments continually interchanges positions but this interchange does not
necessarily alter the net amount of water in each compartment. Infact, in health, this partition of
water is remarkably constant. However body water is never stagnant as there are normal daily
water losses (output) and allowances (intake). The daily turn over of water in health is about 2.5
litresasfollows
A. WaterIntake
1. Exogenous:
a. Watertakenasdrinks1200ml.
b. Water(moisture)insolidfood1000ml.
2. Endogenous:i.e.waterlibratedduringoxidationoffood300ml.
B. WaterOutput
a. Urine1500ml.
b. Fces100ml.
C. Insensibleloss
a. DryingofSkin(insensibleperspiration)500ml.
b. DryingofRespiratoryEpithelium400ml.
Severalfactsdeservespecialattentioninthisrespect
1. The amount of water taken as liquid and that as solids is unknowingly, almost the same.
Hence,apatient,keptonfluidsonly,shouldconsumedoubletheamountofhisnormalliquid
intake.
2. In health and in the absence of visible sweating, a rough estimate of daily water turnover

maybemadebyaddingonelitretotheurinaryoutput.
3. Children require greater quantity of water in comparison to their body weight because of
severalreasons
a. Theyhavealargebodysurfaceareaperunitofbodyweight.
b. Thereisagreatermetabolicactivitybecausetheyaregrowing.
c. Theirimmaturekidneys(onlytheneonates)havepoorconcentratingability.
4. About8000mloffluidissecreteddailyinthebowellumenasdigestivejuicesbutalmostthe
wholeofthisamountisreabsorbedfromthegut,exceptamergeamountof100mlwhichis
expellingstools.
ELECTROLYTEBALANCEINHEALTH:Wheninorganicsaltsareinsolution(asinbodyfluid)they
dissociatesintotwotypesofions
I. Anions.
II. [Link]
maybe
a. Atom(e.g,Na+,Cl).
b. LargerRadicals.
c. Molecules([Link]).
Cations are positively charged and Anions are negatively charged and one positive charge is
equivalenttoonenegativecharge.
ChemicalcompositionofBodyfluidcomponents(mEq/L)
Component

Plasma

Interstitialfluid

Intracellularfluid

Cl

103

114

NIL

HCO3

27

30

10

HPO4

02

02

100

SO4

01

01

30

OrganicAcids

05

05

NIL

Proteins

16

01

60

TOTAL

154

153

200

Component

Plasma

Interstitialfluid

Intracellularfluid

Na+

142

144

10

K+

04

04

150

Ca++

05

03

NIL

A
N
I
O
N

Mg+

03

01

30

TOTAL

154

153

200

[Link].
SODIUM It is predominant electrolytes of the extra cellular fluids, and has specific biological
[Link]
spaces and has been called Osmotic Stuffing. After any stress and injury, as a result of
Adenocorticoidactivity,theoutputofsodiumisreducedtonil.
Theaveragedailyintakeofsodiumis100mEq,[Link]
sodiumamountsto5000mEqofwhich44%isinECF,only09%intheICFand47%inthebone.
A sodium depleted person must be dehydrated and he cannot be rehydrated unless sodium
deficiency is simultaneously corrected. Conversely, retention of sodium is usually associated with
overhydration,manifestedasdema,necessitatingtheuseofdiureticstoincreaseeliminationof
sodium salts in the urine. In case of sodium retention, the plasma level is seldom above 150
mEq/litre.
PotassiumThetotalbodypotassiumamountstoapproximately3,[Link]
cation of the ICF. 98% of the body K+ is intracelular and only 2% is extracellular 75% of the
potassium is in the muscles. The average daily intake of potassium is about 75 mEq/L available
from03gmofpotassiumchloride.
Dietary potassium is chiefly derived from animal and plant tissue as well as fruits and milk. The
normalfunctionsofpotassiumaremaintenanceof
a. Waterandelectrolytebalance.
b. Osmoticbalance.
c. Muscular Irritability. The most important vital action is its effects on moderating the
contractility of the Heart muscle opposing the action of calcium, which enhances its
contractilityandhelpsontheconductionofNerveimpulses.
Abnormal level of potassium may be result from various causes producing disturbances of normal
Acidbase,water&electrolytebalance,e.g.
DiabeticKetoacidosis(DKA).
Prolongvomiting.
Diarrha.
Hmorrhage.
Excessivelossoffluidfromfistula.
Adrenocorticalinsufficiency.
Renalfailureetc.
DISTRIBUTIONINWATER&ELECTROLYTEBALANCE
In deciding the causes, effects and management of these disturbances certain basic facts require
attention.

1. Of the three body fluid compartment viz. intravascular, interstitial and intracellular, body is
primaryaimistomaintainintravascularvolume.
2. Theintracellularfluidcontainsverylittlesodiumbutveryhighamountofpotassiumandthe
ECF(bothintracellular&interstitial)justthereverse.
3. The level of body water and sodium run hand in hand, potassium not so. Depletion of water
(dehydration) is usually (but not always) associated with a fall in the sodium level and vice
versa.
Taking into account all these facts, disturbances in water and electrolyte balance may be of the
followingtypes
Totalbodywaterdepletion

DEHYDRATION.

Totalbodywaterexcess

OVERHYDRATION.

Sodiumdepletion

HYPONATRMIA.

Sodiumexcess

HYPERNATRMIA.

Potassiumdepletion

HYPOKALMIA.

Potassiumexcess

HYPERKALMIA.

TotalBodyWaterDepletion(Dehydration)
"Dehydrationorpurewaterdeficiencyisastateofdeprivationofwaterwithoutcorrespondingloss
of Electrolyte. Pure water deficiency is less common than salt depletion but can occur in the
followingconditions
1. [Link],Obstructivelesioninsophagus,Intenseweakness,
Coma.
2. [Link],Hyperparathyroidism,Pyrexia,Hyperpna
andmanifestedas
a. Intensethirst.
b. Oliguria.
c. Weakness.
d. FeverThismaybeimportantfeatureofchildren.
3. PlasmaChanges
a. Thelevelofplasmaconstituents,[Link],areraised.
b. However,HmoglobinconcentrationandPackedCellVolume(PCV)unchangedbecause
oflossofwaterfromtheRBC.
c. The plasma urea level rise because of increased reabsorption of Urea by the renal
tubules(cannotbecauseofrenalfailure).
Totalbodywaterexcess(Overhydration)
This is also known asWaterIntoxications. Healthy individuals can safely take large amount of
water because they react by correction directive i.e. excreting water without electrolytes. This is
donebytheglomeruliincreasingtheGFRandthedistaltubelessproducingdiluteurine.
[Link]

1. OverhydrationwithPeripheraldema
ARFandCRF.
CCF.
CirrhosisofLiverwithAscites.
2. OverhydrationwithoutPeripheraldema
Suddenabsorptionoflargevolumeofwaterintheintravascularcompartmentasin
a. Irrigatingwithplainwaterduringtransurethralresection.
b. Repeated colonic wash out with plain water especially is cases of mega colon,
whichhasmuchhighercapacityofabortingwaterthannormalcolon.
c. Impairedwaterexcretionbythekidneys,asin
i. SyndromeofInappropriatesecretionofAntiDiureticsHormone(SIADH).
ii. ADHsecretingtumors.
Itismanifestedas
1. The features of impaired cellular function are most predominant with the brain cells feature
[Link]
apathy,dizziness&headachewithplasmasodiumlevelbelow160mEq/[Link]
anddrowsinesswithfurtherdecline(<110mEq/litre),convulsions&comasetin.
2. Plasmasodiumlevelbelow100mEq/[Link]
Cardiacarrhythmias.
Ventricularfibrillation.
3. Nauseaandvomiting.
4. PlasmaChanges
i. Theplasmalevelofallelectrolytesfallsprogressivelybecauseofdilution.
ii. Thereisalsoreductionofplasmaproteinslevel.
iii. ThePCVisreduced.
[Link]
fluid we drink. Electrolytes are essential for nerve and muscle function but during warm weather
months a lot of people loose electrolytes viz. Magnesium, Sodium and Potassium through
perspiration.
Normally,electrolytesarereplacedthroughhealthyeatingbutsometimesweneedaboostduring
a bout of illness, after an intense workout or if we are experiencing dehydration or suffering from
anelectrolyteimbalanceduetodisease.
Women are especially at risk of electrolyte imbalance because the high level of estrogen in
womens brain makes it less adaptive to upward or downward shifts in the bodys amount of
electrolytes.
KEEPWATER&ELECTROLYTEBALANCE
Hydration:LOW

Hydration:OK

Hydration:HIGH

ElectrolytesHIGH

ElectrolytesHIGH

ElectrolytesHIGH

Hypernatrmiawith

Hypernatrmia

Hypernatrmiawith

dehydration.

Likelihood:rare,transitoryif

overhydration.

Likelihood:moderate.

wateravailable.

Likelihood:veryrare.

Weightisdownafew
poundsormore.

Weightisnormal.

Weightisupafewpounds
ormore.

Thirstishigh,andsalty
foodstastebad.

Thirstishigh,andsaltyfoodstaste
bad.
Mouthisnotverydry.

Thirstishigh,andsalty
foodstastebad.

Mouthandskinaredry.

Causes:noaccesstowater,or

Possiblementalconfusion.

Foodacceptanceispoor.

Handsmaybepuffy.

Absenceofurination.

voluntaryrestrictionofwater
intake,bodyelectrolytes

Causes:noaccessto

concentratedbylossofwater.

Shortnessofbreath,rapid
heartrate.

waterorvoluntary

Whattodo:Drinktosatisfythirst,

Foodacceptanceispoor.

restrictionofwater

sothatexcesselectrolytesare

Causes:overconsumption

intake,body
electrolytes

removedbysweatingand
[Link]

ofsalt,probablyfroma
combinationofsources.

concentratedbylossof
water.

untilexcessisurinatedand

Whattodo:Stop

sweatedout.

electrolyteintake,drink

Whattodo:Getaccess

onlytowetmouthuntil

towateranddrink.

weightisnormal.

Restrictelectrolytes
untilweightisnear
normal.
Hydration:LOW

Hydration:OK

Hydration:HIGH

ElectrolytesOK

ElectrolytesOK

ElectrolytesOK

Dehydration.

Properhydrationand

Overhydrated.

Likelihood:common.

electrolytebalance.

Likelihood:moderate.

Weightisdownafew

Likelihood:common.

Weightisupafewpounds

poundsormore.

Weightisstableorslightlydown.

ormore

Thirstishigh,andsalty

Stomachisfine,foodacceptanceis

Wristsandhandsare

foodstastenormal.

normal.

probablypuffy

Mouthisdry,food

Mouthismoist(canspit)andskin

Stomachisqueasy

acceptanceispoor.

isnormal.

Thirstislow,andsalty

Skinisdryandmaytent

Cramps:none.

foodstastenormal.

ifpinched.

Urinationisnormal.

Mouthismoistcanspit.

Mayhavedizzinesson

Causes:properwaterand

Causes:fluidintakein

standingup.

electrolyteintake.

excessofneeds.

Mayhavecramping.

Whattodo:Continuewith

Whattodo:Drinkonlyto

Mentalperformance

hydrationandelectrolytepractice

wetmouthuntilweightis

maybeaffected.

unlessconditionschange.

nearnormal.

Hydration:OK

Hydration:HIGH

Causes:insufficientfluid
intake.
Whattodo:Drinksports
drinkwithelectrolytes
orwater.

Hydration:LOW

ElectrolytesLOW

ElectrolytesLOW

ElectrolytesLOW

Hyponatrmiawith
dehydration.

Hyponatrmia

Hyponatrmiawith

Likelihood:mildformis
common.

overhydration.

Weightisnormal.

Likelihood:moderate.

Stomachisqueasy,withpoorfood
acceptance.

Weightisupafewpounds

Wristsmaybepuffy.

Wristsandhandsarepuffy.

Mouthisdry,cantspit.

Saltyfoodstastegood.

Nausea,stomachsloshing,

Mayhavecramping

Thirstisnormal.

possiblevomiting.

Skinisdryandmaytent
ifpinched.

Mouthismoistcanspit.

Thirstislowandsaltyfoods

Mayhavecramping.

tasteverygood.

Mayhavedizzinesson
standingup.

Causes:Insufficientelectrolyte
intake.

Athletemayshowmental

Causes:insufficient

Whattodo:Increaseelectrolyte
intakeuntil

Mouthismoistcanspit.

stomachfeelsok.

voluminousandcrystal

Likelihood:rare.
Weightisdownafew
poundsormore.
Thirstishigh,andsalty
foodstastegood.

drinking,noelectrolyte
intake.

ormore.

confusion,oddbehavior.
Urinationmaybe
clear.

Whattodo:Take
electrolytesanddrink
sportsdrinkorwater.

DANGEROUS!

Thisinformationdoesnot

Causes:overhydration,

substituteformedical

insufficientsodiumintake.

diagnosisortreatment.

Whattodo:Drinkonlyto
wetmouthuntilweightis
normal,andthencorrect
anysodiumdeficit.

SodiumDepletion(Hyponatrmia)
Becauseoftheintimaterelationshipbetweensaltandwaterbalance,lossofsodiumisusually
associatedwithareductioninthewatercontentofthebody.
Hyponatrmia or sodium depletion is said to exist when the serum sodium level is < 130
mEq/L.
Thecausesare
1. GIlosse.g.
SevereVomiting.
SevereDiarrha.
IntestinalFistul.
GastricAspiration.
Postoperativedrainage.
VillainousAdenomaofRectum.
2. Renallosse.g.
Nephritis.

RenalTubularAcidosis.
RenalFailure.
DiabetesMellitus.
AdditionsDisease.
Hypopituitarism.
Excessivediuretics.
Mannitoltherapy.
3. SickCellSyndromeorEssentialHyponotrmia.
4. Cutaneouslosse.g.
ExcessiveSweating.
Burns.
Mucoviscidosis.
Innormalindividuals,about810litresofGIsecretiontakeplacein24hourswiththeirelectrolyte
compositionas
Type

Amount

Na+(mEg/L.)

K+(mEg/L.)

Cl(mEg/L.)

Saliva

1500cc

100

05

75

GastricJuice

2500cc

60

10

100

Bile

500cc

140

20

100

PancreaticJuice

700cc

140

20

75

IntestinalJuice

3000cc

100

20

100

Total

8200cc

540

75

450

5. Excessive ADH stimulation by drugs viz. Barbiturates, Haloperidol, MAO inhibitors, Laxative,
Imipromine,NSAIDSanddiseaseviz.
Tuberculosis.
LungAbscess.
BronchogenicCarcinoma.
CerebralTumour.
HeadInjury.
Encephalitis.
CarcinomaofProstate&Pancreas.
CirrhosisofLiver.
HeartFailure
CyephriticSyndrome.
6. ThroughLungsasinPulmonaryAdemmatosis.
7. LossofNa+throughserouscavitybyrepeatedParacentesis.
8. Hypothyroidism.
9. Idiosyncraticreactiontodiuretics&ACEinhibitors.
10. Beerpotamania(intakeatleast8L/day).
11. Psychogenic Polydipsia (Urine Na+ is elevated > 20 mEg / L and urine osmolarity < 300
mosmperkgofbodyweight).

Hyponatrmia

may

be

of

types

Isotonic

Hyponatrmia,

Hypotonic

HyponatrmiaandHypertonicHyponotrmia.
ClinicalFeatures:
Weakness.
Extremeapathy.
Tiredness.
Lassitude.
Nausea.
Vomiting.
Anorexia.
Muscularcramps.
Lossofelasticityofskin.
Coldextremities.
FallofBPandfainting.
Convulsiveseizures.
Mentalconfusion.
Headache.
Giddinessandfinallycomamaydevelop.
Thirstabsent.
Skintugour&elasticitymaydisappear.
Clinicalsymptomsareaggravatedafterdrinkingpurewater.
Investigation:
ThereishmoconcentrationMCVhighandMCHClevelislow.
Na+levellowBloodUrea&K+mayrise.
UrinaryNa+islowbutinSIADHahighlevelmaybeseen.
SodiumExcess(Hypernatrmia)
Hypernatrmia is said to exist when serum sodium is more than 145 mEq/L. It may result from
less renal excretion of sodium or from various other causes of dema originating from Renal,
Cardiac, Hepatic or Nutritional disease. Decrease in body water and increase in body sodium
specificconditioninwhichHypernatrmiaoccursare
1. Simple Dehydration:Thisoccursasaresultofexcessivesweatingwithinadequateorno
[Link]
[Link]
thewaterlosskeepsonincreasingkidneyscannotexcretemoreamountofNa+intheurine
and as a result serum Na+ level rises up. At this stage even though there is high sodium in
urineandtotalbodysodiumislow.
2. DiabetesInsipidus:[Link]
[Link]
usually as a complication of pituitary surgery when hormone is not produce is adequate
amount.
3. Miscellaneous:

Hypokalmia.
Hyperkalmia.
SickleCellAnmia.
NephrogenicDiabetesInsipidus.
Premenstrualphase.
DuringPregnancy.
Hypoproteinmia.
Beriberi.
IdiopathicCyclicdema.
ChronicStarvation.
ClinicalFeatures:
1. Swellingofthebody.
2. Accumulationoffluidinvariousseroussacs.
3. Weakness.
4. Oliguria.
5. Ifthereisseverehyperosmolarity,themanifestationsmaybe
Delirium.
Hyperpyrexia.
Coma.
ROLEOFNATRUMMUR.&[Link]
NatrumMur.(NaCl)

NatrumSulph.

1. Attractwater.

1. Attractwater.

2. It attracts water c is to be utilized in

2. Itattractswaterwhichhasbeenused

thesystem.

upandistobethrownoutofsystem.

3. Findinsidesthecells.

3. FoundnotinsidethecellsbutinICF.

4. Byitsactioncellsaremultiplied.

4. By its action water is removed from

5. Nat. mur. is formed inside the cells

outsidefluidsthus,[Link]
prevented.
5. Nat. sulph. has action on the nerves
which carry the impression to the
brain, as in passing urine, water is
thrown out by muscular action.
Without this salt, brain will not have
the consiousness of throwing out
excessqualityofwaterinurine.

Potassium is the most important action of the cell 98% of the body potassium is actually
intracellular at a concentration of about 160 mmol/L. Extra cellular concentration is about 3.5 to 5
mmol/[Link].

POTASSIUMDEPLETION(HYPOKALMIA)
A total deficient of about 350 mEq results from decrease of each 1 mEq/L of serum concentration
belowalevelof4mEq/[Link]
1. Gastrointestinal:
SevereDiarrha.
Vomiting.
Fistula.
Continuousgastricorintestinalaspiration.
Anorexianervosa.
Starvation.
ChronicHepaticFailure(HE).
2. Renal:
PotassiumloosingNephropathy.
NephroticSyndrome.
RenaltubularAcidosis.
Cytotoxicdrugs.
3. Metabolic:
DiabetesMellitus.
MetabolicAlkalosis.
Hypomagnesmia.
RespiratoryAlkalosis.
4. Endocrinal:
CushingsSyndrome.
POTASSIUMEXCESS(HYPERKALMIA)
Thecausesare
1. ARF.
2. SickleCellAnmia.
3. AddisonsDisease.
4. Hypoaldosteronism
5. DepletionofNa+orCa++salt.
6. Acidosis.
7. CirculatoryFailure.
8. Burn.
9. SevereExercise.
10. Hyperosmolairty.
HOWTOPREVENTFLUIDELECTROLYTEIMBALANCEINSTRUCTIONS
1. [Link],coffee,
juices and other liquids. Either too much or too little fluid can result in an electrolyte
[Link]
orsolittlethattheconcentrationiselevated.
2. Do not ignore the need to replace electrolytes after an illness. Replace any electrolytes that

you loss during your

especially

when it prevented
you

from

eating

properly, exercising,
or taking vitamins
and

mineral.

sickness

that

interferes

with

mobility and takes

depletion

gradual
of

electrolytes, such as
sodium. Sodium is
essential

in

maintaining a fluid
balance in the cells
it also keeps the
muscles in proper
[Link]
blood test to confirm suspicions of an electrolyte loss ask the physician if it is okay to take
anelectrolytesupplementtorestorebalance.
3. Limit or avoid over the counter medications (OTC). These drugs deplete and/or reduce
[Link]
electrolytes, which results in poor health. Stop taking aspirins and other OTCs if there is
dizziness, cramping or nausea. Consult the physician right away to determine if these
mineralsaretoolow.
4. Do not drink too much or too little fluid during exercise or overexertion. Consult physician
aboutanelectrolytesupplementsifyourexerciseroutineisintense,suchasthatofaweight
lifter,[Link].
5. Eatabalancedandhealthydietorfoodsthatbuildthebody,[Link],legumes,fresh
fruits, vegetable and salmon. A proper diet enhances the electrolytes and maintains proper
functioningoftheelectrolytes,[Link],osmosisandminerals.
6. Take a good quality multivitamin and mineral to stay healthy and get the vitamins and
mineral that your body needs to maintain an electrolyte balance. Make sure that sugar,
starch, additives and corn are not among the ingredients in your supplements, as this is
[Link],getbackon
schedule,butdonotdoublethedosagemanyphysiciansconsidervitaminsmedicine,sotreat
itlikeamedicineandtakeitasprescribed.
7. MagnesiumsulphateorEpsomsaltallowsthemineralstosoakdirectlyintothebodyspores,
instantlyreplenishingneededelectrolytes.Use2cupsofEpsomsaltinawarmbathweekly.

Magnesium level in serum is about 1.9 2.5 mg% (1.5 1.8 mEq / L. of which 1/8 is bound to

proteinsand2/3remainsasfreecation.)
MAGNESIUMDEPLETION[HYPOMAGNESMIA]
Thecausesare
ProlongedDiarrha.
Vomiting.
MalabsorptionSyndrome.
CirrhosisofLiver.
Kwashiorkor.
Alcohalism.
ChronicMalnutrition.
Hyperparathyroidism.
HungaryBoneSyndrome.
DiabeticComa.
Eclampsia.
Convulsion.
Epilepsy.
Clinical Feature: Neuromuscular irritability, Muscle cramp, Tetany, Convulsion, Nystagmus,
DepressedBabinskisSign.
MAGNESIUMEXCESS[HYPERMAGNESMIA]
Thecausesare
ARF&CRF.
Excessuseofmagnesiumascathartics.
ClinicalFeatures:
Apathy,drowsinessandcomamaydevelop.
Motorweakness,flaccidparalysis,urinaryretention.
ImportanceofMagnesiumMineralasHomopathicMedicine:
Magnesium is the stress element. Under stress it fails to be recycled by the kidneys and is
losttourine.
It is suggested that Natrum muriaticum restore Magnesium uptake in the distal kidney
tubulesCalcarea carbonica in the proximal tubulesandMagnesium muriticum in the loop of
Henley.
These details need confirmation, but we believe that remedies regulating magnesium metabolism
should be supported by Magnesium supplements whenever Magnesium loses are suspected and
whetherstressorphysiologicalinduced.
HOMOPATHICMANAGEMENT
1. In most cases, replacing lost fluid to prevent dehydration is the only treatment necessary.
Medicines that stop diarrha may be helpful in some cases, but they are not recommended

for people whose diarrha is from a bacterial infection or parasite, stopping the diarrha
traps the organism in the intestines, prolonging the problem. Instead, physicians usually
prescribe antibiotics. Viral causes are either treated with medication or left to run their
course,dependingontheseverityandtypeofthevirus.
2. In adults with diarrha, it may help to drink plenty of fluids to avoid becoming dehydrated.
Adding bulk to the diet may thicken the stool and decrease the frequency of stools. Certain
foodsthickenthestools,includingrice,bananas,[Link]
wholewheatgrainsandbranaddbulktothediet.
Preventing Dehydration Dehydration occurs when the body has lost too much fluid and
electrolytes(thesaltspotassiumandsodium).Thefluidandelectrolyteslostduringdiarrhaneed
to be replaced promptly, the body cannot function properly without them. Although water is
extremely important in preventing dehydration, it does not contain electrolytes. To maintain
electrolytelevels,onecouldhavebrothorsoups,whichcontainsodiumandfruitjuices,softfruits
orvegetables,whichcontainpotassium.
Tips About Food Until diarrha subsides, one should try to avoid milk products and foods that
aregreasy,[Link],one
can add soft, bland foods to the diet, including bananas, plain rice, boiled potatoes, toast, cooked
carrotsandbakedchickenwithouttheskinorfat.
Travellers diarrha happens when one consumes food or water contaminated with bacteria,
viruses or parasites. One can take the following precautions to prevent travellers diarrha when
abroad
Donotdrinkanytapwater,notevenwhenbrushingyourteeth.
Donotdrinkunpasteurizedmilkordairyproducts.
Donotuseicemadefromtapwater.
Avoid all raw fruits and vegetables (including lettuce and fruit salad) unless they can be
peeledorpeelthemoneself.
Donoteatraworraremeatandfish.
Donoteatfoodfromstreetvendors.
One can safely drink bottled water, carbonated soft drinks and hot drinks like coffee or tea.
Depending on where one is going and the period of stay, the doctor may recommend some
preventivemedicinesbeforeleavingtoprotectonefrompossibleinfection.
RecommendedHomopathicMedicines
Dehydration:
1. Abrotanum.
2. Arsenicalbum.
3. Camphor.
4. Carbovegetabilis.
5. China.
6. Cuprumvmetallicum.
7. Phosphurus.
8. Veratrumalbum.

Hypokalmia:
1. [Link].
2. Indropsy,Digitalis,whenAceticacidandBlattaorientalisfailstoimprove.
3. InScarlatina&Albuminuri,Apismellificaisthechoiceofremedy
Hyperkalmia:Gelsimiumistheprincipleremedy.
[Link].
ThesphereofactionsofPotassiumgroupofmedicines
1. Itinfluencesthemuscularactivity.
2. InvolvedinAcidBaseBalance.
3. Ithasimportantroleincardiacfunctions.
4. Itactsasacofactor.
5. Involvedinneuromuscularirritability.
Dr. E. A. Farrington and Dr. C. Hering recommended their chief use in muscular
weakness,paresisandexhaustionasaccompaniesconvalescencesfrommajordiseases.
Diarrha:
InAcuteDiarrha(accordingtoRaibahadurBisamberDas)Aconiteif2or3doses
fail, then, Ipecac. When it fails, Pulsatilla and Nux vomica alternately. If still
diarrhapersists,Phosphorusis to be administered. When it fails,Arsenic album is
[Link],Veratrumalbumisrecommended.
In Chronic Diarrhoea according to Dr. E. B. Nash, Nitric acid is the best
medicine. According to Dr. P. Banerjee, Chapparo 30, Nitric acid 30, Aloe
Socotrina30fourtimesdailyisveryeffective.
ACIDBASEBALANCE
TheintracellularpHisabout7butthepHofserumorinterstitialfluidisabout7.4(7.36to7.44)
or40mmol/[Link]
ofbufferacidsandbufferalkalis.
DisturbanceinAcidBaseBalance
Acidosis(Acidmia).
Alkalosis(Basemia).
LossintheformofH2CO3
RespiratoryAcidosis.
RespiratoryAlkalosis.
LossofHydrogenGas
MetabolicAcidsis.
MetabolicAlkalosis.
ACIDOSIS

ALKALOSIS

Anabnormalconditioncausedbythe

Anabnormalconditioncausedbyexcess

Accumulationinthebodyofexcessacidor
bylossofalkalifromthebody.

alkaliaccumulationorbylossofacid,in
thebody.

InMetabolicAcidosis,thereisprimary

MetabolicAlkalosis.

[Link]

IncreasedofHCO3.

changeorslightchangeinH2CO3because
ofoverproductionandaccumulationof
nonvolatileacids.
Causes

Causes

UncontrolledDMwithKetosis.

Excessiveadministrateofalkali.

RenalInsufficiency.

IntestinalObstruction.

Anorexia.

Prolongedvomiting.

Hmorrhage.

RemovalofGastricSecretion.

EtherAnsthesia.

CushingsSyndrome.

ProlongedStrenuousExercise.

Cortisone

HCO3 loss by vomiting, renal

deficiency).

administration

(K+

diseases,poisoning,lossofintestinal
fluid&electrolytes

RESPIRATORYACIDOSIS

RESPIRATORYALKALOSIS

Increasedincarbonicacidcontentdefect

Decreaseincarbonicacidcontent.

inrespiratorysystem.
Causes

Causes

MorphineorBarbituratepoisoning.

ProlongedHyperventilation.

PulmonaryCongestionorFibrosis.

Hysteria.

Mechanical

Obstruction

of

air

passage.
Breathing

Fever.
Anorexia.

air

with

raised

CO2

HighExternalTemperature.

content.

CNSdiseases.

Pneumonia,BronchialAsthma.

LargedoseofSodiumSalicylate.

PoorPFT.

HOMOPATHICAPPROACHINTHEWATER&ELECTROLYTEIMBALANCE
The Homopathic system has curative medicine, though certain medicines have applied and the
medicine proved their prophylactic effects too. The Homopathy believes and practice on the
[Link]
[Link].
Water and electrolyte imbalance are commonly seen in prolonged debilitated illness and in acute

conditions, it is frequently found in loose motions, vomiting, pregnancy, highgrade fever etc. In
suchcasespatientneedsimmediatecareandthemanagementandthequantitativereplacementof
electrolytes&waterinthebody.
Waterlosscanberesuscitatebythedehydrationofthepatient,eitherbytheincreasingoralintake
butifpatientisnotinconditiontotakefluidorally,parentalroutecanbeusedforthereplacement
offluids.
Inthefluidtherapythefollowingthingsshouldbecarefullyobservedbythephysician
1. Howmuchfluidisrequiredtothepatient.
2. Andtherequiredquantityisgiventothepatientinhowmuchtime.
Duringtheelectrolyteimbalanceandinthedeficiencystate,quantitativeelectrolytereplacementis
needed.
ButintheHomopathicPracticeithasbeenseensincelongtimethattheHomopathicmedicines
[Link]
medicineswhichcanbeusedduringtheelectrolyteimbalance
1. Natrummuriaticum.
2. Kaliumphosphoricum.
3. Natrumphosphoricum.
4. Magnesiumphosphoricum.
5. Calcareaphsophorica.
These medicines are used in lower potency and with frequent repetition, till the requirement of
patientbecomefulfilled.
Thesemedicinesarehavingtremendousresultandcapabletomanageelectrolyteimbalanceinthe
bodyintheminimumtimeandthesemedicinesalsohelpintheabsorptionoffluidsinthebodyand
thuspreventsrenalfailure.
Duringthemanagementandtreatmentoftheelectrolyteimbalance,thetreatmentofthecausesis
[Link]
this case the treatment of the diarrha is simultaneously important with the management of the
water and electrolyte imbalance. This principle is implemented with the every disease which are
directlyorindirectlycausesofwater&electrolyteimbalanceinthebody.
[Link]
medicines we can treat the disease which is responsible for the any sort of imbalance and the
deficiencystates.