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Wednesday, October 17, 2012

A case study of Rheumatoid Arthritis (RA) and Homeopathy

Contributed by Dr Saji
A Female 36yrs, Housewife with Knee pain – Right : 4-5 months duration. Intense pain aggravated 3-4 days. Aggravated by walking, rising from sitting, ascending stairs . Pain in finger joints – vague pain, with mild stiffness aggravated in the Morning .Pain in wrists - occasional
She had temporary relief with pain killers at the beginning. The case was diagnosed as RA by an Post Graduate (GM) doctor. He referred the case to Homoeopathy.
On enquiry there was a history of Skin eruption 10 yrs back – On dorsum of feet – for about 3-4 yrs. Had AGN in the course of treatment. Both relieved with allopathic medication. Twin sister has  Eczema - RA; Mother has DM and Father* - HTN Husband is a Auto driver and has two children ( 5,1)
she has a sensation of heat and the Appetite is diminished. She  Desires sour food and has Unsatisfactory stools.
she had Perspiration of face (Observed Symptom) and Itching between thighs, with discolouration and desquamation–7-8 yrs duration. She had recurrent Brittle finger nails, Shapeless. – 2-3 yrs duration. she has Ingrowing nails – toes – 4-5 yrs duration and  Back pain – lumbar – during menses.
Husband was a bit handicapped. He corrected his complaint recently with a surgery. Now she is living in her house with her mother for the last 5-6 months. She never mentioned anything about her family problem. Investigation : Before : 20/08/11. RA Factor - Positive : 86 IU/ml. Investigation : After : 27/10/11. RA Factor - Negative

Rubrics :
1.Extremities; ingrowing toenails
2.Extremities; eruptions; feet; back
3.Extremities; inflammation; chronic; joints

 Repertorial Result : Caust Sil Thuj Hep ( Sil and Thuja - Complementary; Sil and Hep - Antidote )

Remaining symptoms :
1. Extremities; pain; knees; ascending stairs agg. : Thuj.
2. Extremities; pain; knees; right : Caust., Thuj.
3. Extremities; pain; fingers; joints : Caust., Sil., Thuj., Hep.
4. Extremities, pain, rheumatic, knees : Caust., Thuj.
5. Skin; eruptions; suppressed : Caust., Sil., Thuj., Hep.
6. Generals, Heat, sensation in body : Caust., Thuj.
7. Generalities; food and drinks; sour, acid; desires : Thuj., Hep.
8. Rectum; constipation; insufficient, incomplete, unsatisfactory stools : Sil., Thuj., Hep.
9. Face; perspiration : Sil., Thuj., Hep.
10.Extremities; excoriation; thighs, between : Caust., Thuj.,Hep.
11.Extremities; brittle; nails : Caust., Thuj., Hep.
12.Back; pain; lumbar region, lumbago; menses; during : Caust., Thuj.

lab report, before treatment

lab report, after treatment
 Prescription : Thuja CM/1d

Some important facts!
If you are making a Repertorial prescription, identifying the thermals is less important. What is more important is finding out the rubrics with moderate number of medicines ( characteristics ) for Repertorisation proper. Hot patient means 'Warm in general agg' and Chilly patient means 'Cold in general agg'. These rubrics contain 542 and 664 medicines respectively - that means both are common symptoms ! More over both of them are synthesised rubrics.

It is better to follow this in repertoisation.
"Two or more rubrics from the same sphere or region should not be taken for repertorisation proper, unless unavoidable. If selected, two from the same region should not be considered for elimination process"
I have have selected all the three rubrics from the same location i.e. extremities.This is because
In my own repertory the chapter division is almost like that in Murphy with 76 chapters. ( Nails, Feet and Joints - separate chapters ) The selection rule I tried to explain was based on that. But when other repertories are considered, there arises some confusion because many locations come under a single chapter.


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