A Case Report of Staphysagria as Constitutional Remedy with Importance to its Psychosomatic Correlations

Introduction-

The meaning of psyche means ‘mind’ and soma means ‘body’.  Psychosomatic diseases are the diseases that arise from prolonged emotional disturbances. They are developed fully into corporeal disease. If they are not treated they damage the body. The conditions like anxiety, anger, worry, vexation are of the long standing causes’ destruction of corporeal state.  Stress contributes many disease processes and is an important etiological factor for hypertension. 

The hypothalamo- pituitary- adrenal axis is activated by psychological stress which leads to hemodynamic and hormonal responses. The glucocorticoids increase which causes enhanced adrenocorticotropic hormone which increases both arterial blood pressure and blood pressure. When hypothalamo- pituitary-adrenal axis and sympathetic- adrenal system were activated and they secrete catecholamines from adrenal medulla which function as neuro-hormonal regulation of blood pressure. (1)The journey is usually as follows.

Brain→ hypothalamus → receptor→ muscle→ viscera

The below given case helps us to understand this phenomenon in detail. Here, the stress caused by sudden death of Father has caused disturbance at hypothalamo- pituitary level causing long standing hypertension. The characteristic symptoms in this case leading to prescription of similimum remedy i.e. Staphysagria which has helped in the improvement of this case. 

Keywords– constitutional remedy, psychosomatic, Staphysagria, stress

Abbreviations– DMT2- Diabetes Mellitus Type 2, OD- Once Daily, BID- 2 times a day, CVA- Cardiovascular Accident, OA- OsteoArthritis, TDS- Three times a day, Agg- Aggravation, Amel- Amelioration 

Case History-

A 54-year-old male patient visited the Hospital OPD on 26th Feb 2022.

Preliminary Data-

Name- Mr. MMR, Age/Gender- 54/M, Address- S, Occupation- Teacher/Farmer, Married

Chief Complaints- 

1. Recurrent Coryza along with irritation in the throat. Aggravated by open air. Allergic to dust particles. Recurrent episodes of sinusitis for 15 years on and off. Aggravation by exposure to dew early morning. 
2. Loss of appetite for 10 years on and off. Aggravation by sight or smell of food++. Occasional spells of giddiness. No desire to work. Desire to lie down. Aggravation by least mental++ and physical++ work. 

Associated Complaints- 

1. Right-sided knee pains for 3 years. Dull, aching pain+ Aggravated by getting up, and amelioration by Motion. Occasional B/L Leg pains, get relieved by pressure. The patient needs to take analgesics recurrently for knee pains. Tab Ultracet ½ BD. 
2. Patient is a known case of Primary Hypertension since 2002. Systolic Blood pressure is always on the higher side. He was on-. Tab. Telsartan 80 OD, Tab. Rosufit CV-20 OD,

 Tab. Cetanil 10 BID.

Past History-

The patient had 2 episodes of Left-sided CVA; the first in October 2002 and the Next in December 2012. Both times he was hospitalized and has been under the same medication since 2013. 

Also, he had an episode of metabolic encephalopathy in 2017 where the MRI of the Brain showed cerebral lacunar infarcts. He was admitted to the ICU of a multi-specialty hospital for treatment for 15 days. 

Family History- 

Physical Generals-

Life Space-

The patient is a hard-working person. His childhood was uneventful. He failed his matric exam on the 1st attempt. But, he studied hard and cleared his exam with flying colors. He used to go to school and college by traveling 30-40 km on a bicycle. He started the habit of tobacco during his college days. He cleared his B.Ed exams and started the job as a primary school teacher. In 2001, his father died of myocardial infarction. Suddenly all the familial responsibilities fell on his shoulder. He had to look after all the financial matters of the family too. He was stressed out during that period. His anger spells started increasing. He was diagnosed with primary hypertension at the same time. He is a very irritable person by nature. He cannot tolerate the contradiction. He threw things away in anger. He uses abusive language in anger. He expresses irritability at the workplace too. Everyone in the family and school fear his anger. He is very caring about his family. He likes his family members around him. He fears seeing the death of others. 

Physical Examination-

1. General Physical Examination- Weight- 59 kgs
2. Nose Examination-B/L Nostrils NAD
3. Knee Examination- No Tenderness, No Swelling B/L

Crepitation Rt>Lt

1. CNS Examination- Patient was conscious and oriented to time, place and person. 
2. Tandem Walk- Swaying absent 
3. Romberg’s Test-Negative both sides
4. Deep Tendon Reflexes- All reflexes were normal

Diagnosis-

1. Primary Hypertension I10
2. Allergic Rhinitis J30.9
3. Right OA Knee M17.11

Case Analysis-

Mental Generals:

1. Ailments of Death of Father++
2. Violent Anger+++
3. Throws things during anger+++
4. Intolerable to Contradiction++
5. Irritability at work++
6. Affectionate Person

Physical generals:

1. Loss of appetite along with Giddiness++
2. Loss of appetite < smell and sight of food++ 
3. Giddiness < mental or physical work++
4. Thirsty Patient
5. Habit of Tobacco eating++
6. Chilly Patient

Particulars:

1. Coryza along with sneezing < Open Air++
2. Coryza < early morning
3. Allergic to Dust
4. Right Sided Knee pain< getting up ++
5. Knee pain > motion++
6. Knee pain> pressure++

Evaluation of symptoms

Grade I:

1. Ailments from Death of Father++
2. Violent anger +++
3. Intolerant to Contradiction++
4. Throws things during anger+++
5. Irritability at work++
6. Affectionate Person

Grade II:

1. Loss of appetite along with giddiness++
2. Loss of appetite < smell and sight of food++ 
3. Giddiness< mental or physical work++
4. Thirsty Patient 
5. Coryza along with sneezing < Open Air++
6. Coryza < early morning
7. Allergic to Dust
8. Right knee pain< getting up++
9. Knee pain > motion++
10. Knee pain > pressure++
11. Habit of Tobacco eating++
12. Chilly Patient