Oct 2012|Vol 9|Iss 10

A case of Goitre


Dr. K. Savitha presents here a case treated at AKP Homoeopathic Clinical Research Centre. She can be contacted at AKP Homoeopathic Clinical Research Centre , #6, Lloyds IInd Lane, Royapettah, Chennai - 600 014. Ph : 044 - 28113300


         A sixty five years old lady consulted me for swelling in the neck since 2 years. Initially she had a small swelling and later increased it in size. She was taken to a family physician, later he was referred to city hospital at Salem.

The thyroid profile showed as follows
•T3 : 129 ng/dl
•T4 : 5.50 ug/dl
•TSH : 1.61 uiU/mldl

The imaging studies confirmed as goitre and Fine Needle aspiration cytology stated Goitre with cystic change. The Chest X ray PA view was normal

Additionally the patient had

•Loss of weight since 2 years
•Pain and numbness of legs since 6 months
•< Night > warm applications, pressure
•Dry skin since two years < winter

Past History

•Had been hospitalized for PUO last year
•Had chicken pox in childhood
•Had an injury in her feet after an accident five yeas back
•Undergone vaccination for small pox in childhood

Family History

•Similar complaint is reported with her maternal cousin
•Paternal aunt had a swelling in the left upper shoulder
•Maternal aunt had tuberculosis.

Life Space

        The patient lives in a village, not educated, got married when she was 16 years old, one son and one daughter, both of them got married, son lives at Chennai with two kids and daughter lives in nearby village. Her husband had hypertension, ignored the treatment, suddenly met with myocardial infarction. She was brooding for some years and her complaints made her more worried by neighbor’s words with suspicion on malignancy.

        She is mild, gentle, takes more pity on others sufferings, short, medium complexioned, hard physical worker, engage her duties in horticulture at her own place. Doesn’t like to live in son’s or daughter’s house, doesn’t like to trouble them. But visits both house and spare her time with grand kids.

Physical Generals

Appetite – Increased
Thirst - Normal
Stool - Normal
Urine - Normal
Sweat - Normal
Sleep - Normal
Desire - Sweets
Dreams - Daily events, funerals
Food Type - Non Vegetarian
Has the habits of taking tea, coffee

Mental generals

        Calm in nature, anxious, worried about her illness.

Menstrual history

        Menopause at the age of 50, after having her periods regularly

General examination

        B.P 110/70 mm of Hg, Weight : 47 kg

Analysis of symptoms

• Swelling in the neck
• Pain and numbness < night > warm applications, pressure
• Skin dry < winter
• Weight loss
• Family history of thyroid swelling, lipoma
• Increased appetite
• Desire for sweets
• Dreams of daily events, funerals
• Mild gentle
• Worries about her illness

Diagnosis of the Disease


Diagnosis of the miasm

        Fundamental miasm: Sycosis
        Dominant miasm : Sycosis

Diagnosis of the Remedy

        Miasmatic drug: Thuja
        Totality: Iodum

First prescription                         29-4-2008

        Thuja lm tds for one day on empty stomach
        Followed with placebo for fifteen days

Follow ups

        The patient was prescribed in subsequent prescription with Iodum 6 twice daily and Thuja lm was repeated every month. She had her consultation once in fifteen days, later once in a month. The swelling had reduced completely after three years. The photographs taken before and after are given in Plate No I and Plate No II


        Even though the totality directs the prescription Iodum, Thuja was prescribed on the miasmatic understanding. While treating a chronic disease it is always better to cover the totality with miasmatic cleavage, to shorten the duration and rational cure as Hahenmann gives his guidelines in the “The Chronic Diseases and its peculiar nature & their Homoeopathic Cure”