Abstract: The following article describes the outcome of Classical Homoeopathic Constitutional Antimiasmatic Medicines in treatment of a case of Rheumatoid Arthritis which gave relief within seven days of treatment. With the decline in RA factor of the patient from 127 iu/ml to 10 iu/ml. The patient was prescribed Natrum muriaticum 1m followed by Natrum muriaticum 10m.
Keywords: Homoeopathy, Antimiasmatic, Constitutional Treatment, Rheumatoid Arthritis, Natrum Muriaticum.
Abbreviations: RA – Rheumatoid arthritis.
INTRODUCTION
According to WHO, Rheumatoid Arthritis is a chronic systemic autoimmune disease that affects the joints, connective tissues, muscle, tendons, and fibrous tissue. It tends to strike during the most productive years of adulthood, between the ages of 20 and 40, and is a chronic disabling condition often causing pain and deformity.1 It usually involves the same joints on both sides of the body.2
Our discussion is on the topic of Miasm & Role of Antimiasmatic medicine in treatment of Rheumatoid Arthritis. According to the common definition, Miasm is defined as a polluting agent.
Dr Hahnemman has spoken on miasmas, “an aerial fluid mixed with atmospheric air,” of which his “miasma” was composed.3
If A Deep Acting Anti-Miasmatic Medicine is given to a patient of RA, the medicines centrifugal action will open up such (RA) case and (brings to the surface the suppressed symptoms) where the totality of symptoms will be formed. Antimiasmatic medicines help to clear up the suppressions ( of past); clear up the presenting symptoms from their root or origin ( to the present); and clear up the susceptibility to get an infection and thereby strengthens the constitution . Thus it will remove the layer of suppression .patient will have an improvement in energy level, there will be .increase in appetite., sleep will be better, patients mental status will be in harmony & have a stable temperament, it will show a clear cut picture of the case.4
In cases of rheumatoid arthritis, as the medicine to be used should actually remove the layer of suppression of past , present as well as susceptibility as we know Susceptibility to be as a miasmatic infection A miasmatic infection is when a person or any living person is susceptible the dynamic inimical, invisible principle of miasm gets the chance to penetrate inside the body (as the immunity is low and therefore the person is susceptible to receive infection) the miasmatic force creates a vacuum in the constitution, which can only be removed by suitable anti-miasmatic medicine, otherwise it is transmitted to the next generation. The Antimiasmatic constitutional medicine can help to come out of the severe suppression formed in the constitution from years of their suffering formed one upon another and creating a complex state of derangement of health where miasm travels from one to another forming a complex mix miasmatic state. These type of cases can be taken care properly if well selected constitutional anti miasmatic medicine are selected, It removes one layer of suppression then moves to next layer as it clears the previous state of severe complex deformity state in their life.4c
SYMPTOMS
Fever, feeling of being unwell, malaise, pain, swelling, and stiffness in more than one joint usually symmetrical with progressive joint deformity, can’t walk properly, gradual loss of function and mobility of affected part accompanied by weight loss, loss of appetite & progressive weakness of the whole body.
DIAGNOSIS
CLINICALLY RA ARE DIAGNOSED BY LAB INVESTIGATION – BLOOD
Erythrocyte sedimentation rate i.e. ESR, if raised, gives a gross idea of the levels of inflammation in the body.
Rheumatoid factor, If an antibody is known as a rheumatoid factor which is present in the blood, it can indicate that RA is present. However, not everyone with RA tests is always positive for this factor.
X-ray or MRI of a joint can identify the level of deformity in the patients affected with RA. 2a
In my practice, I have treated many cases of Rheumatoid Arthritis, even patients having RA factor above 350 iu/ml, got completely cured as 14 iu/ml2b. Is considered to be the normal range.in a healthy person.
CASE STUDY
A 19 1/2 years aged married lady with pain and swelling of rt index & ring finger an already diagnosed case of Rheumatoid Arthritis (as confirmed by blood test) came to my college OPD.she was very lean & thin in appearance, fair complexion, very thin neck & had a look of very sorrow, sunken, morose face. Her neck was very thin compared to her head. She was admitted to the IPD of my college by my Senior Medical Officer. While going through my regular morning round in the female IPD I found the young lady having some deep-rooted sorrow within herself which she was hiding and could not speak in front of anyone.so I thought of taking a thorough case taking separately away from her relatives.
She complained that there are swelling and stiffness with pain in her right index, ring finger and thumb for the last 7 months. The pain is throbbing in nature with the hot feeling of the affected fingers when touched. The pain aggravates at night and after exposure to contact with water. Ameliorated by application of dry heat & dry sand compress. She has pain accompanied by the chill in all complaint.
HISTORY OF PRESENT COMPLAINTS
She told that she complain started at first with pain swelling and stiffness of left shoulder then the medial surface of both palms followed by right knee, right hand .the swelling and stiffness, then gradually started progressing and settled on the right side of the hands for last 7 months.
FAMILY HISTORY
Paternal Grand Father died of a heart attack.
PHYSICAL GENERALS
She told her appetite is loss does not like food, desire sour, sweet, warm food with extra salt preference, aversion to milk, oily food which cause vomiting, thirst only 3-4 glass or sometimes no desire. Sleep disturbed due to apprehension of disease. The patient is chilly. Have dreams of ghost, sweat at night, sleep disturbed, on right side.
PSYCHOLOGICAL BEHAVIORIAL PATTERN
She got married at the age of 18yrs being the only daughter of family after getting married she got a very dominating mother in law who use to always rebuke her in day to day life. Her parents told her not to react with her. This situation started creating suppression of her emotions, she initially used to cry on any occasion later on use to cry all alone hiding her emotions, sometimes thought of committing suicide as well felling no need to stay in this world as she is of no use to the family. She wanted to be out of her family and stay outside her village. Her husband was the only person who use to give her consolation and her place of comfort. But he couldn’t speak against her mother. The patient initially being mild started getting irritable in nature, consolation causing amelioration from husband but not from other person, gradually she started stopped talking with people who caused her pain & trouble in her life. Angry on the person who abuses her family members. (Maternal) She had fear of darkness. She was scared of getting a baby due to the suffering of the disease.
SYSTEMIC EXAMINATION
On musculoskeletal examination there where hard nodules found in the middle phalanges of the index finger, ring finger and thumb. There was tenderness while examining all the joints.
DIAGNOSIS
ON 1ST DAY, RA FACTOR – 127 Iu/Ml
AFTER 4TH DAY, RA FACTOR – 32 Iu/Ml
AFTER 8TH DAY, RA FACTOR 10 Iu/Ml
FROM FIRST DAY ONLY, ASO TITRE SHOWED NEGATIVE
ANALYSIS AND EVALUATION OF SYMPTOMS WITH INTENSITY
| ANALYSIS AND EVALUATION OF SYMPTOMS ACCORDING TO Dr KENT | ||
| MENTAL GENERAL | PHYSICAL GENERAL | PARTICULAR |
| Anxiety about health3,Oversensitive3Irritable3, Morose3,Sorrow,Dullness2 | Desire Extra Salt3, sweet,sour | Rheumatic Pain & Swelling in Rt Index finger,Ring Finger & Thumb3 |
| H/O Disappointment3 ,Deception2, | Aversion- Fatty Food 3, Milk | SENSATION-Throbbing 3,pulsating 3 |
| Grief3, Suppressed Anger3 | Thirst- Thirstlessness2 | CONCOMITANT-Pain with chilliness3 |
| Contradiction Aggr3 | Menses profuse2 | Aggr. Night3, Water exposure2,Sun3 |
| Weeps When Alone3 | Sleep- unrefreshing2 ,on right side3 | |
| Obstinate3 | Sweat- night3 | |
| Does not want to speak with person those who hurts her3. Reserved3 | Appetite- Diminished3 | |
| C/O Fright2, | ||
| Fear Darkness2 | ||
| Dreams Ghost3 | ||
MIASMATIC ANALYSIS4a: Psoro-Syco-Syphilitic
| PSORA | SYCOSIS | SYPHILIS | PSEUDO-PSORA /TUBERCULAR | |
| FAMILY HISTORY | HEART ATTACK | |||
| PAST HISTORY | H/o of suppressed mental state | |||
| MIND | Irritable, anxious | Depression/sorrow/obstinate/ailments from grief/ailments from vexation, suppression /consolation aggravation/reserved nature/melancholic | Thought to Commit suicide, thoughts of leaving house | |
| BODY | Rheumatism/swelling in joints /formation of nodosites Ameliorated by/the return of suppressed normal discharges (e.g. menses). | Rheumatic pain,, aggravated from sunset to sunrise i.e. night |
TOTALITY OF SYMPTOMS
- Irritable, Morose, Sorrow, Dullness
- H/O Disappointment, Deception, Grief, Suppressed Anger
- Contradiction Aggravation
- Weeps When Alone
- Obstinate
- Does not want to speak with person those who hurt her. Reserved
- Complaints from Fright, Fear
- Fear Darkness
- Dreams of Ghost
- Chilly
- Desire Extra Salt, Sweet, Sour
- Aversion- Fatty Food, Milk
- Rheumatic Pain and Swelling in Right Index finger, Ring Finger and Thumb
- Throbbing, Pulsating Pain With Chilliness
- Aggravated by Night, Water Exposure, Sun
- Thirstlessness
- Ameliorated by Dry Hot Compress, Sand Heat
- Menses, profuse
- Sleep Unrefreshing On Right Side
- Complexion: Fair, Blonde, Light, Prostrated
- Anxiety About Health, Oversensitive
- Sweat- Night
- Appetite- Diminished
SELECTION OF REMEDY
- REPERTORIAL RUBRIC
- MIND – AILMENTS FROM GRIEF, SORROW
- MIND – AILMENTS FROM DISSAPOINTMENT, DECEPTION
- MIND – AILMENTS FROM FRIGHT OR FEAR
- MIND – AILMENTS FROM ANGER, VEXATION, SUPPRESSED FROM
- MIND – CONSOLATION AGGRAVATION
- MIND – DARKNESS AGGRAVATION
- MIND – TEARFUL MOOD AGGRAVATION
- MIND – IRRITABLE
- MIND – OBSTINATE, HEADSTRONG
- MIND – RESERVED
- MIND – DULLNESS
- MIND – CONTRADICTION – AGGRAVATION
- DREAMS – GHOST
- MIND – WEEPS – WHEN ALONE
- MIND – DOES NOT WANT TO TALK WITH PEOPLE WITH WHOM OFFENDED
- MIND – ANGER, IRRASCIBILITY TENDENCY
- MIND – TALK DESIRE TO BE SILENT, TACITURN
- MIND – ANXIETY, HEALTH ABOUT
- MIND – COMPANY DESIRE (ONLY HUSBAND)
- MIND – SENSITIVE, OVERSENSITIVE
- MIND – SADNESS, DESPONDENCY, DEPRESSION, MELANCHOLY
- MIND – WEEPING, TEARFUL MOOD TENDENCY CONSOLATION AGGRAVATION
- MIND – WEEPING, TEARFUL MOOD TENDENCY TRIFLES AT
- EXTREMITIES – PAIN, NIGHT
- EXTREMITIES – SWELLING FINGERS
- GENERALS – AGGRAVATION – SUN
- GENERALS – AGGRAVATION – WATER
- GENERALS – FOOD & DRINKS, DESIRE-EXTRA SALT
- GENERALS – FOOD & DRINKS, MILK, FATTY FOOD AGGRAVATION
- GENERALS – FOOD & DRINKS, FAT & FOOD AGGRAVATION
- GENERALS – FOOD & DRINKS, SALT & SALTY FOOD DESIRE
- GENERALS – FOOD & DRINKS, SWEAT DESIRE
- GENERALS – FOOD & DRINKS, SOUR & ACID DESIRE
- SLEEP – POSITION SIDE RIGHT
- SLEEP – UNREFRESHING
- PERSPIRATION – NIGHT
- FEMALE GENITALIA – MENSES, PROFUSE
- STOMACH – THIRSTLESSNESS
- STOMACH – APPETITE DIMINISHED
- GENERALITIES – EXHAUSTION PROSTRATION
- GENERALITIES – PAIN GENERAL DIRECTION OF PAIN RIGHT SIDE ON
- GENERALITIES – SWELLING JOINTS
- GENERALITIES – INFLAMMATION JOINT ARTHRITIS
- GENERALITIES – NIGHT AGGRAVATION 5
REMEDY SELECTION
Considering the Mental General, Physical General & Particular Symptoms of the patients Nat Mur6 was being selected as an Antimiasmatic constitutional remedy.
REMEDY SELECTION & DISCUSSION
On considering the Repertorial totality of the case, an Antimiasmatic Constitutional Medicine, Natrum muriaticum 6 in 1m potency was given.
As in the case, susceptibility and sensitivity of the patient were too high. Next day morning patient developed a high-grade fever along with a reduction in the pain and swelling of joints, there was an onset of menses even.so homoeopathic elimination started. then in the evening she started feeling a bit better and wanted to go outside the IPD for open-air she was feeling Claustrophobic inside the IPD. 1st layer of suppression phase got cleared after giving her Natrum muriaticum (Psoro-Syco-Syphilitic) her symptoms got removed. Then her fever went down she started feeling better physically as well as mentally. She started taking proper diet, on the other hand, she was having no appetite before treatment. Her energy level increased, she started becoming active started giving smile else before was morose dull and sorrow. Her sleep improved stared having sound sleep. But after waiting for seven days for observation, a case-taking again was done. It was found the patient started developing fear in her mind regarding her mother in law as she has to go back to that place here needs again the hammering of vital force with Natrum muriaticum 6in higher potency was given in the next evening. In this case, high potency was selected as the susceptibility of the patient was too high considering the mental symptoms of the patient. As we know higher the susceptibility, higher the potency, higher the mental symptoms higher the. Potency3a.So hereby prescribing Natrum muriaticum 10m potency was prescribed Then waiting for few days when all her vitals came to normal as well as she had no signs and symptoms of the disease as well as the decline in the blood report of RA Factor. She was advised for discharge. She was being counselled to go for pregnancy as the medicine Natrum muriaticum will block the progress of the disease to the next generation. (The miasmatic force creates a stigma or vacuum in the CONSTITUTION, which can only be eradicated by suitable ANTI-MIASMATIC MEDICINE or a suitable NOSODE, otherwise, it is transmitted to the next generation.4b
PRESCRIPTION
Natrum muriaticum 6 1m potency was prescribed to her one dose in the evening on the 1ST Day. In the next day morning, she had a high-grade fever of 102OC.she was not advice any medication only sponging and cold water application on the forehead. For one day the fever continued from 100-102 °C. Taking into totality as soon the fever erupted patients swelling & pain in joints subsided gradually. The patient was having mild pain with a chill, there was no thirst. In the evening next day, she wanted to go outside in the open air to sit for some time. Patient started feeling better, in physical as well as mental level. She wanted to cry we allowed her to do so. Her mental suppression went away her pain and swelling in joint went away. She started giving a smile on her face or else use to be very morose and gloomy. Her irritability went away. She started feeling better but her fever still remained up to 99Oc Next day there was no fever and no pain no irritability, her appetite increased, she is passing normal stool, urine her thirst has increased. She is now away from this dangerous crippling disease known RA from her life. After one month, re-case taking of the patient was done again and found the patient started developing fear in her mind regarding her mother in law as she has to go back to that place here needs again the hammering of vital force with Natrum muriaticum 10M potency was given in the evening. Next morning, she became perfectly well as well her physical, mental, emotional symptoms came to normal as well as her lab reports showed within normal limit. She was discharged from the hospital.
FOLLOW UP
After waiting for all her vitals to become normal, the patient was discharged from hospital. The disease never came back.
CONCLUSION
Thus it can be concluded, this case as a classical representation of Scope Of Antimiasmatic Constitutional Remedy” In Treatment Of An Auto-Immune Disease, i.e. Rheumatoid Arthritis. In considering the reportorial totality and constitution of the patient, Natrum muriaticum remedy was selected. The Antimiasmatic and Constitutional symptoms reward back her to her original state, I could stop the progress as well as use it as to remove the miasmatic block in the patient which is developed due to the hypersensitivity of the patient in her life disturbing up to the level of immunity, creating AUTO-IMMUNE DISEASE. Thus, the Constitutional Antimiasmatic Medicine covers the essence of the person and is capable of surfacing the suppressed symptoms and helps to easily frame the totality. Even in this modern world of heroic suppressions, a proper Constitutional Antimiasmatic treatment is capable of achieving the above result.7
References
- https://www.who.int/chp/topics/rheumatic/en/WHO/ Topic Chronic rheumatic conditions
- Harrison’s Principles of Internal Medicine, 20e
- PART 11 Immune-Mediated, Inflammatory, Rheumatologic Disorder
- Chapter 351: Rheumatoid Arthritis
- Close S. “The Genius Of Homoeopathy – Lectures and Essays on Homoeopathic philosophy”, B. Jain Publishers Pvt. Ltd, New Delhi, Chapter VIII, p. no. 97, Student’s Economy Edition, Reprint Edition,1998.
- Banerjea S K “Miasmatic Diagnosis – Practical tips with clinical comparisons”, B. Jain Publishers Pvt. Ltd, New Delhi, Revised Edition, 2003., p. no. 5-6
- 4a P. NO 11-20
- 4b., P. NO 1=2
- 4c P NO 12-13
- Complete Repertory (Mobile Version)
- Kent J.T Lectures On Homoeopathic Materia Medica (Public Domain Text Converted Into Pdf Format) p. no. 2361
- Created / Validated By: Dr Eswara Das/ PRINCIPALS OF PRESCRIBING/ Published Date : Dec 17, 2015/ Published By: Zahid/ NATIONAL HEALTH PORTAL OF INDIA/ .
