A
case of Deep vein Thrombosis
Dr.
Vijay H. Vaishnav
Introduction
Dr. Vijay H. Vaishnav is an Asst. Professor
in Materia Medica at the University of Bombay. He has been a full-time
faculty member honorary physician at Smt. CMP Homoeopathic Medical
College, Bombay, India, for almost 19 years. He has been closely
associated in developing new concepts in teaching Materia Medica
and has prepared a unique model of approach to the study of Homoeopathic
Therapeutics. He and lectured at Hahnemann College of Homoeopathy
in the UK, and conducted informational seminars in the USA,Vienna,Austria
. He shares his evidence-based experience with a case of deep
vein thrombosis.
I was called on July 16, 1997 to see
a 34 years old male patient who was admitted at a leading private
hospital in Bombay for the treatment of deep vein thrombosis of
his left leg.
The problem had apparently begun in
May 1995 when he developed pain and redness of the left calf region.
This had gradually worsened even though he was being treated with
anti-coagulants and had reached a point where he had severe pain
in the Lt. thigh that soon spread all the way down to his foot.
He therefore was admitted and had an urgent Angioplasty on July
13, 1997.
When I visited him in the hospital,
he was in great pain, esp. around the lt. ankle. He felt a burning
pain, like sparks of fire < walking, overexertion > pressure
(of stocking) There was a swelling around the ankle.
The Color Doppler studies done post-operatively on July 14 showed
DVT of the Lt. external iliac, posterior tibial and other veins
of the lt. lower limb.
On the basis of the inflammation of
the veins with thrombosis and the history of trauma (angioplasty)
the drug selected for him was Hamamelis (the Aconite of the veins).
This was given in the 30C potency q.i.d. initially and later the
potency was increased to 200C.
After two weeks of Hamamelis, he recovered to the extent that
he could come walking to my clinic for the follow
fresh Color Doppler that showed a residual
thrombus in the veins with a few recanalised flow channels.
These were the other complaints:
For the past ten years, he has been
suffering from a degeneration of the hip and vertebrae causing a
backache with a pulling sensation on the lt. side and a tingling
in the lt. lower limb. This was sometimes associated with a swelling
over the calves
These symptoms were < evening,
1st motion and were > lying down, hot fomentation, massage, continued
motion.
He also had a pain in the lt. shoulder occurring at least once a
month. This was associated with cramps in the lt. side of the neck,
which would then appear to be swollen. The movements of the shoulder
were painful and restricted and were < night, initial motion
and > heat and continued motion.
Personal
history:
He was a chronic smoker and also chewed
tobacco. His business required him to entertain clients in his office
and so he had at least 8-10 cups of tea every day. His appetite
was good and he would be irritable if he did not eat on time. He
craved sweets, cold milk and fried food. His thirst, bowel movements
and urination were normal. The tongue was clean but fissured. He
often had a cold sweat on his palms.
Mental
symptoms:
He described himself as a happy go
lucky person and was generally a mild person. However, since his
hospitalization, he had become irritable, esp. From noise. He would
shout and scream from anger. He had a good memory and a very good
confidence in his abilities. Lately, however, he felt a bit worried
about the future. He wondered if his illness would come in the way
of his capacity to earn a living. He had a fear that if the disease
reached a point where he would need to be operated again or was
bed ridden, he would lose all his business and would soon be a very
poor man.
Past history:
Tonsillectomy- childhood
Jaundice- childhood
Tinea versicolor 1986-87
Severe bleeding piles 1986-87
Malaria
Bronchitis (smoker’s cough)
Family history:
Father- HT, DM, surgery lt. leg
Mother- Skin allergies, operation on leg
Brother- wife had an abortion
Brother- no major illnesses
Sister- no major illnesses
Wife- abortion (Kent mentions in his “Lectures on Homoeopathic
Philosophy” that a miasm can be passed by one spouse to the
other)
On examination: B.P.- 118/78 mm Hg; Lt. leg- pedal oedema, pitting
on pressure
Investigations:
Color Doppler- as noted above
MRI scan of L.S. Spine (Feb. 8, 1996)- Lt. lateral herniation of
L3-4 intervertebral disc; Posterior and Lt. lateral herniation of
L4-5 intervertebral disc; general posterior bulge at L5-S1 intervertebral
disc; Facetal arthropathy at L4-5 and L5-S1
Evaluation:
Miasm- Sycosis (Stagnation and thrombosis)
———à Syphilis (Degeneration- blood vessels,
spine and hip, shoulder joint; family history)
Treatment: Considering the underlying miasm; the location- veins
and joints; the pathology- thrombosis in the veins and degenerative
arthropathy; the mind- fear of poverty, and certain signs like the
fissured tongue and past history of severe bleeding piles the drug
Calcarea fluorica was selected for this patient. It was given in
the 200C potency, 3 times a day for 1 week on July 30, 1997.
Followup
- 1 Aug 6 1997
Burning
and pain +,
Swelling leg- >.
Rx
Calc fluor 200C, tds x 2 weeks
Followup -2 Sep 8 1997
Swelling and pain >2,
backache >2.
Rx
Calc fluor 200C, tds x 2 weeks
Followup
- 3 Oct 10 1997
Rx
Calc fluor 200C, tds x 3 weeks
Followup
- 4 Nov 11 1997
NO backache, Pain left shoulder >2,
Minimal pain and swelling on the
oot. Treatment- S.L. tds x 3 weeks
Follow up 5
NO backache, Pain left shoulder >2,
- range of movement >2,
NO pain and swelling on the foot.
Rx
S.L. tds x 3 weeks
The patient was then asked to follow-up once a month to monitor
his progress. He was not given any medicine (nor placebo) during
this period and the Color Doppler showed resolution of the thrombus
and recanalisation of the veins. The Doppler studies of May 1998
showed complete recanalisation of the leg veins.
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