Introduction:
Dr.Jayasudha, a young homoeopath takes much
initiative to present the case studies with evidence based applications.
She is highly enthusiastic in studies and practice. Here she
presents a case of Chronic ulcerative colitis with evidence
based studies.
A 35 year old male, driver by profession,
presented the complaints of
· Bleeding per rectum with oozing of mucus since 5 years
· Increased frequency of stool since 5 years
History of presenting complaints
Initially the patient experienced increased frequency of stool,
passed stool 8 – 10 times per day .The stool was loose
with mucus and alternated with hard pellety stool, the stool
was very offensive and painful during passing.
Flatulence experienced loud during expulsion, loud and he didn’t
know weather he passed stool or flatus. The yellowish stool
was passed along with blood and yellowish mucus. Pain was stitching
after stool, felt in the rectum for hours together with bleeding
sometimes.
The complaints caused anxiety while eating and using toilet.
Frequency disturbed his sleep. He felt pain in the left ileoceacal
region.
Past history
He had headache in the past and underwent allopathic treatment.
He was under the care of a Gastro enterologist for the presenting
complaints since 6 months.
Family history
Nothing significant
Personal history
He was addicted to alcohol, pan, chewing and smoking
Physical generals
Appetite
is good and takes at regular intervals
Thirst:
Good, regular, satisfied
Cravings:
Mutton++
Sleep:
Decreased due to occupation and disturbed with least noise
Urine:
Day/5-6 times, night /1-2 times
Mental generals
He is a driver by profession, has to drive continuously for
a long time with loss of sleep. One time he was unfortunate
to see a fire accident of his friend’s vehicle and it
grounded for his anxiety and fear while driving. Gradually he
developed the digestive complaints.
Anxiety
– Hypochondriac
Anxiety
– Loss of sleep
Anxiety
– long lasting
Obstinate
Hatred
Fear
of Accident
General examination
Appearance: Oily dark and Anaemic
Systemic examination
Mild tenderness over the left ileocaecal region
Investigation report
Sigmoidoscopy impressed that severe distal ulcerative colitis
The
rectum was with multiple exudates++, multiple petechial haemorrhages
++ and few polyps
The
sigmoid colon presented with exudates++, multiple petechial
haemorrhage+ few polyps up to 40cm (Refer plate I)
Provisional Diagnosis
Distal ulcerative colitis (severe)
Totality of symptom and Repertorial Analysis
[Kent Repertory with Generalities]
Obstinate
Hatred
Anxiety-loss
of sleep
Anxiety
- Hypochondriac
Anxiety
- long lasting
Fear
of accidents
Hot
patient
Anaemia
Cravings
- mutton++
Startles
in sleep with least noise
Stool-Diarrhoea
alters with constipation
Stool-Haemorrhage
Stool-Offensive
+
Sweat
- profuse - offensive++
Stool
- Anxiety from
Abdomen-ulcerating
pain
Pain
ilieocaecal region
Remedy Analysis
Nitric
acid
Arsenicum
album
Sulphur
Miasmatic Cleavage
Fundamental Miasm: Psora
Dominant Miasm: Syphilis
Hahnemann’s classification of Disease:
Fully developed chronic mixed miasmatic disease.
Plan of Treatment
It’s the chronic disease of syphilitic and Psoric miasm.
A remedy based on miasmatic and constitutional is considered.
First the syphilis is to treat and the Psoric manifestations
Remedy of Choice
Nitric Acid – the right choice as it constitutionally,
miasmatically and symptomatically selected as similimum
Potency selection
Nitric acid – 30C is selected as it is the minimum dose
with the susceptibility of the patient.
First Prescription 28.8.2008
R/x
Nitric acid 30 – 1 globule in 15 ml of aqueous solution
thrice daily 2 drops for 15 days with 8 succession for 1st week
and 10 succession for later 1 week.
Investigation Report on 10.7.09
Normal CT Colonography. No abnormality in the large bowel. (refer
plate II)
Conclusion
As Ulcerative Colitis is a fully developed mixed chronic miasmatic
disease has responded well to the miasmatic and constitutional
treatment.the similimum has matched the constitution, miasm
and totality of the patient.
