Clinical Cases

A Case of Hemorrhoids

Last modified on November 15th, 2018

Ramkrishna Valaki

Dr. Ramkrishna Valaki presents a case of hemorrhoids in a man of 30. Sensation is used to confirm the remedy.

A 30 year old man who had been suffering from piles for the last 3 years arrived at the homoeopathic OPD for treatment.

LocationSensationModalityConcomitant
1.GIT

RECTUM

 

 

 

 

 

2.RS

 

 

Bleeding++

Burning Pain++

Pricking++

Bursting +++

Constipation++

 

 

Dyspnea++

Straining+3

Coughing++

 

 

>  Warm

application

> Walking

< Cold damp

weather+3

 

 

< Morning

< Dust, fume,

wheat

 

 

CASE TAKING

D – Tell me about your dreams?
P – I got dreams of wild animals and they pursue me i.e. lion, tiger and many others.

D – What you feel in your body?
P – Headache and feeling of stretching in my head when I wake up from dream.

D – Whenever you are in stress what you do?
P – My body frightened after dream. Then gradually I become relaxed.

D – What do you experience at that moment?
P – My body became stiff, kadak. (stiff) and akkad (can’t move) and then relax.

D – Stiff, akkad (can’t move)?
P – All muscles became stiff. Then I stretch my body and gradually it became relax. When I go for walk muscles are relax. (hg)

D – Stretching?
P – I feel like my body muscles are strained. My wrist became Kadak (stiff) and tight.

D – Kadak (stiff)?
P – Tight.(hg)

D – At that time what do you experience physically?
P – Trembling.

D – Then what happen?
P – After sometime I relax.

D – Tell me about other dreams?
P – I have only dreams of wild animals and they are pursuing me.

D – What do you experience in the dream?
P – My body becames stiff, kadak (stiff) and akkad (can’t move). I feel stretching sensation in my body. Stretching feeling in my head. There is great Straining of my muscles. I feel relax after walking.

D – Fears?
P – Scared when I go near the cow. Fear that she will hurt me. Recently I am on bike and just passing near cow and was frightened.

D – Frightened?
P – Fear that cow will hurt me.

D – What is your feeling in fear?
P – My body muscles are contracted.

D – What do you feel in that part?
P – Kadak. (stiff)

D – Kadak . (stiff)?
P – Before this we are absolutely normal and suddenly all muscles are come together. There is pressure on my abdomen. Stiffness of  my body.

D – What you do at that time?
P – That fear remains for some time and then gradually it goes. Then I become relaxed.

D – When you get angry?
P – When I got angry I use to avoid talking for some time.

D – Tell me one incidence in which you got angry.
P – Once I fight with my trusty. At that time my respiration rate is increase. My body muscles are stiff and I am very anxious.

D – What do you experience physically and mentally?
P – I become much energetic.

D – What do you experience at that moment?
P – I punch my hand on table.

D – What are changes in you?
P – My face muscles are twitching.

 

  1. FAMILY HISTORY:

Father, Grandfather, Brother, Cousin having asthma.

  1. PHYSICAL EXAMINATION:

           P/R examination – Grade 2 internal piles 

  1. SYSTEMATIC EXAMINATION:

GIT – Not any abnormality detected

Respiratory system

At present wheezing not heard.

  1. DIAGNOSIS

Hemorrhoids

  1. DIFFERENTIAL DIAGNOSIS

          Rectal tumor

Fissure

Fistula

Rectal varices

Rectal  polyp

 

  1. ANALYSIS OF CASE

Here we have many similar sensations of in different areas like in anger, fear and in dreams.

Similar sensations:

Active – stiffness (kadak), stretching, twitching, contraction, tight, straining.

Passive – relax. Motion amelioration, can’t move (akkad).

Constipation amelioration by walking is maybe common but all complaints are better by walking, so this is peculiar in this case.

Stiffness amelioration by motion is genius of this case and it must be genius of selected remedy also.

The remedy which has this prominent symptom is Rhus. Tox. which belongs to anacardiaceae family. We have to confirm by studying sensation of this family and pathogenesis.

Sensation of anacrdiaceae family

Sensation

  • Caught, stiff
  • Tight
  • Tension
  • Stuck
  • Cramps
  • (Pressing)

Passive reaction

  • Paralysed
  • Immobile

Active reaction

  • Stuck and want to move constantly.
  • Motion ameliorates
  • Aggravation sitting
  • Sedentary aggravates
  • Aggravated in the house
  • Pain on beginning to move
  • Restlessness

Compensation

  • Always on move
  1. RUBRIC SELECTION

MIND: DELUSION, pursed he is

MIND: OBSTNATE, headstrong

GENERAL: FOOD AND DRINK, milk aversion

HEAD: PERSPIRATION scalp

PERSPIRATION: ODOR, offensive

RECTUM: HEMORRHOIDS

GENERAL: HOT application amelioration

  1. REPERTERISATION

  1. EXPLANATION

Here we have Rhus. Tox. in repertorisation which covers all the symptoms. Sensation of anacardiaceae family is also present in this case. So on that basis Rhus Tox is given.

  1. EXACTNESS WITH MATERIA MEDICA

DR PHATAK MATERIA MEDICA
Worse ; EXPOSURE TO – WET; COLD; air; draft; chilled;
BEGINNING OF MOTION; REST; BEFORE STORMS;
SPRAINS; Ice cold drinks;
Better ; Continued motion; HEAT; Hot bath; if heated; Warm wrapping; Rubbing; Stretching limbs;
Change of position;

The Soul of Remedies – Dr Ssankaran
Rhus toxicodendron has a constant anxiety, “as if something is going to happen”. The patient has many fears: fear of evil, fear of being hurt, of being murdered.
He is extremely superstitious. This constant anxiety makes him restless and doesn’t allow him to rest in any position..There is a feeling of helplessness, of being forsaken by all his friends, a feeling that something bad is going to happen. And this anxiety is more inside the house and is ameliorated by walking in open air.

  1. REMEDY:

Rhus tox.

  1. POTENCY SELECTION:

Moderate similarity of symptoms of patient with materia medica, so moderate potency.  Potency – 200

  1. FOLLOW UP
DATESYMPTOMSTREATMENT
30-07-2014Full case takenRhus. Tox. 200(single dose)

Placebo (TDS) for 7 days

13-08-2014Bleeding stop+++

No pain

Size of piles as it is

All over improved

Rhus. Tox. 200(single dose)

Placebo (TDS) for 7 days

26-08-2014Size of piles decreased

Sleep good

Stool – hard ++

Rhus. Tox. 200(single dose)

Placebo (TDS) for 7 days

10-09-2014No complaint at all

No bleeding

No pain

No constipation

All over improved

 

 

Placebo for 15 days

29-09-2014Improved+++

No complain at all

Placebo for one month
19-11-2014Improved +++Placebo for one month
13-12-2014Improved+++Placebo for one month
26-02-2015Improved in piles

Constipation since last 7 days.

Rhus. Tox. 200(single dose)

Placebo (TDS) for one month

25-04-2015All over improved

Constipation+

Rhus. Tox. 200(single dose)

Placebo (TDS) for one month

27-05-2015Improved+++Placebo for one month
08-07-2015Improved+++Placebo for one month
14-08-2015Improved+++Placebo for one month

 

  1. BIBLIOGRAPHY
  • Asthma – Harrison’s 15th edition principal of internal medicine
  • Material medica of homoeopathic medicine by DrS.R.Phatak (2nd edition)
  • Complete repertory by Roger van zandvoort (First edition)
  • Homoeopathic posology by DrAjitkoulkarni
  • Physical diagnosis by RustumJalVakil and Aspi f. golvala

Find more about Hemorrhoids/Piles visit-

About the author

Ramkrishna Valaki

Ramkrishna Valaki

Dr. Ramkrishna Valaki (B.H.M.S.) has been practicing for the last four years at Dhara Homoeopathic Clinic Bhavnagar, State – Gujarat. India, working as Medical Officer at Swami Vivekanand Homoeopathic Medical College and Hospital.

1 Comment

  • Dr. Ramkrishna Valaki, Thank you for sharing your case and knowledge. This is good presentation and I hope for you to keep sharing.

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