Utility of accessory symptoms in curing case of Hyperthyroidism
Homeopathic Journal :: Volume: 5, Issue: 4, Feb 2012 (Regulars) - from Homeorizon.com
|Article Updated: Feb 29, 2012|
Mrs. S. Q. a 44-year-old elegantly dressed women visited me on 8. June, 2010 to receive treatment for her Hyperthyroidism. She had been suffering from the same since around 2 years.
Patient approached with
- Pressure in throat as if a heavy load was pressing on her chest and throat.
- Shortness of breath on climbing stairs; she was even unable to do physical exercise.
- Headache once or twice a month with distorted vision which dimmed during headache.
- Sensation of intense heat, burning eyes, flushed cheeks.
- Constant palpitations
- Nervousness, restlessness, sleeplessness
When the patient was first time diagnosed as Hyperthyroidism she was prescribed carbimazole, an anytithyroid drug but she soon developed a serious kind if rheumatism. She was then prescribed cortisone which suppressed the joint complaint but her hyperthyroidism remained as such. She also approached a homeopath who gave her Lachesis 30 and Bromium 30 twice daily for a month. But still she was not relieved.
History of Present Complaints
It all started 2 years back when after heavy exertion owing to her sister’s marriage she felt both her lower limbs were swollen; she also felt a pressing sensation in her throat. She also suffered from headaches, difficulty in respiration when climbing stairs. She felt hot while earlier she was chilly. She lost weight even though she developed a ravenous appetite. After sonography, histology and blood analysis she was diagnosed as having Hyperthyroidism. While taking Carbimazole she had first developed arthritis in the ankle followed by inflammation of knees which finally spread to her wrists and hand. When she took cortisone treatment her joint pains were relieved but her original complaints aggravated. Her general condition remained poor and she felt weak, as such she approached a homeopath who gave her the above medicines which did not relieve.
- Recurrent tonsillitis in adolescence
- Bone fractures at age of 15 years.
- Cesarean section for delivery of son at 25 years
PATIENT AS A PERSON
Appetite: Increased extraordinarily; patient feels that she eats like a “hog” but is happy that it “does not show itself”.
Desires: Nothing specific but more of Sweets, Coffee
Sleep: Earlier deep but presently unrefreshing. Feels lethargic in morning.
L.M.P: 2, June, 2010
Menarche: 14 years
Cycle: 4-5 days/21 days.
Associated: Weakness excessive
After conversing for more than 2 hours I could not find a single prominent mental symptom other than that she was easily irritated.
CASE WORK OUT
The case did not have prominent mentals and the physicals were also not very marked so I was compelled to undertake the case according to § 180 for paucity of symptoms.
So the Rubrics chosen were
- THROAT: Constriction
- HEAD: Pain: blinding
- RESPIRATION: difficult: ascending stairs.
- GENERALS: Emaciation, Appetite with emaciation ravenous.
- GENERALS, Heat, sensation of
Repertorial Analysis showed remedy Natrum mur: 9/4; Sulphur: 9/4; Iodum: 8/4: Petroleum 7/4; Phosphorus 7/4; Silicea: 7/4.
The patient had occasionally suggested that she had also felt as if her breasts were shrunken and had become flabby. Considering this and the above analysis I prescribed her IODUM 30 o.d, alternate morning for 3 days followed by Placebo to be taken at night for 14 days.
19, June, 2010: The patient came after 15 days with relief in constriction of throat, headache, respiratory symptoms but her appetite and sensation of heat remained unchanged. No change was felt by her in the flabbiness of breasts.
Again Placebo 30 was prescribed for next 10 days.
4, July, 2012: No further change in any complaint was found. Periods came on 20th June with heavy flow for 5 days. IODUM 200, 3 doses to be taken at 5 minutes interval each and Placebo od, HS was prescribed for 7 days.
7, July, 2012: just 3 days after taking Iodum 200, the patient noticed a sudden constriction in the throat (re-appearance) with profuse gushing menstrual bleeding and she became extremely irritable. She also complained of burning sensation in back along spine in spots , though overall she felt chilly. Patient became extremely sensitive to odors which made her dizzy - even had to leave waiting room as soon as another patient using strong perfume entered. Her thirst was markedly increased.
Her Blood analysis showed increased thyroxine (T3, T4) level.
The case was again repertorised considering the Full blown picture of Diseased State and the rubrics chosen were:
Mind: Irritability: trifles from
Generals: Faintness, smell from.
GENERALS: Emaciation, Appetite with emaciation ravenous
Female Genitalia: Menses, copious.
Stomach: Thirst, large quantities for.
Repertorial Analysis showed: Phos: 14/6; Natrum-mur: 12/5, Nux-vom: 11/4; Sulphur: 10/5; Arsenicum: 9/4; Bell: 9/4;
Cosidering the above result along with Back: Pain, burning, Spine the remedy chosen was: PHOSPHORUS 30, 6 doses to be taken 2 hourly followed by Placebo for 3 days.
Patient returned on 12th July, 2010 with stoppage of menses flow. Thirst was normalized and constriction in throat was relieved. She also had relief in burning in spine. She was advised Placebo for 10 days.
2, August, 2010: constriction in throat was absent; she had no other complaints and only got the medicine (Placebo) repeated without consultation. She was advised to have her T3, T4 levels checked.
25, August, 2010: Her LMP was on 7th August with normal flow, lasting for 3 days with no associated trouble. There was no further complaint even her husband was very happy reporting that her irritability was also reduced. On enquiring further she told that her breast symptoms are also better. Her Thyroxine level was normal.
Placebo was prescribed for 1 month. She was advised to come with repeated blood analysis.
Further, follow up showed normal thyroxine level and no complaints. She was advised to discontinue treatment and to report only if she had any problem or latest after 6 months with repeat blood (thyroxine) analysis.
In this case, Iodum was prescribed and it ameliorated the constriction in throat and headache but since it did not relieve completely, meaning thereby that it was not the simillimum. As such on prescribing the medicine, Accessory symptoms in the form of Burning along spine, dizziness in response to strong smell, gushing menstrual bleeding were produced.
The case was re-repertorized taking the complete picture i.e new symptoms produced and those existing. The Medicine chosen, Phosphorus was covering the case in totality. It relieved the patient and till date she is having normal thyroxine level. This shows that in cases with paucity of symptoms Aphorism 180 was utilized to extract the complete patient picture which in turn helped in choosing simillimum and bringing about cure.
Refer: § 180
“In this case the medicine, which has been chosen as well as was possible, but which, for the reason above stated, is only imperfectly homœopathic, will, in its action upon the disease that is only partially analogous to it - just as in the case mentioned above (§ 162, et seq.) where the limited number of homœopathic remedies renders the selection imperfect - produce accessory symptoms, and several phenomena from its own array of symptoms are mixed up with the patient’s state of health, which are, however, at the same time, symptoms of the disease itself, although they may have been hitherto never or very rarely perceived; some symptoms which the patient had never previously experienced appear, or others he had only felt indistinctly become more pronounced.”