The following cases of Rheumatoid Arthritis, have been presented in the Indian Journal of Homoeopathic Medicine Vol No-28 Issue No.3 & 4. The authors have clearly applied the concepts and principles of homoeopathy with miasmatic corerelations in the therapeutic management of this disease, and have been successful clinically.
R.K. was a young male patient, 21 years old with Juvenile Arthritis since the last 10 years. He had a moderately severe oligoarthritis in low grade, continuous over the last 10 years. Severe exacerbations occurred 2 or 3 times a year, lasting for 1 month each. This was treated with NSAID’s and steroids.
Currently, he is in a progressively worsening exacerbation for the last 1 month, with moderate synovitis (++) in multiple joints and spine, a lot of stiffness (+++), with restriction of movements (++) and synovial thickening.
In the natural history and course of Juvenile Arthritis, this case falls in the category leading eventually to S.S.A.(Seronegative Spondylo Arthropathy ) having a bad prognosis overall.
This diagnosis and prognosis suggests a low susceptibility. This is further supported by the low grade residual inflammations of multiple joints, non febrile exacerbations with severe stiffness and relatively scanty characteristics. Constant suppressive treatments also contributed to this to some extent. The Life Space below gives us further idea of how mental suppression and inertia also reflect this.
The patient lost his father at 6 years of age from chronic alcoholism. His mother had to play the role of both parents. He has a 22 yr. Old sister who is working and was engaged to be married 6 months back. He seemed to be carrying a heavy emotional burden regarding the pathetic state of the family, the difficulties his mother was facing, financial problems, etc. This was aggravated by his disappointment that his maternal uncle was not helping them as much as he should. Now an additional anxiety is his sister’s dowry. With the increasing pain, the patient became more anxious (+++) and worried.
If he woke up with pain in the morning he would not go to work. Otherwise he would work less or come away early. He felt helpless and quite hopeless. He never communicated these feelings to his mother or his sister. He felt his disease was incurable and he would be unable to help his sister. He decided he did not care if his sister’s engagement was broken as he was unable to take any more tension. He felt she would find another suitable match. Fully aware of the expectations of his mother and sister, he realised that he could not face this challenge.
This history manifests chronic suppressions, ongoing vexation and anxiety, leading to an almost paralysed state of mind and body. We also see a dominant sycotic miasm.
The remedy selection was based on the overall disposition. The attachment to his suffering mother, his despondency, an apprehensive attitude, aggravation of complaints from anxiety in contrast to avoiding genuine worry about his sister’s alliance, with an overall self-centered sensitivity under stress. This along with other physical data led us to the choice of Kali Carb. as the chronic remedy.
Even though the patient seemed to be in acute distress, with pains, < on initial movements,> continued motion, > warmth, along with bodyache, the tempatation to prescribe Rhus Tox was avoided. The chronic remedy covers the picture well and an unclear “acute picture” favours the prescription of Kali Carb.
Kali Carb was given in 30 potency in multiple doses. Improvement was short lasting and the potency was raised to 200 and subsequently to 1M. After 5 weeks of treatment there was considerable relief, but on withdrawal of Indomethacin there was an increase in inflammation of all involved joints. At this stage Thuja 1M 1dose was introduced as intercurrent. The next few weeks his response to Kali Carb was munch better and Thuja was repeated once every week. A definite remission set in after 2 months with withdrawal of all NSAID’s. Within 6 months there was hardly any complaint, and the patient has remained well for 2 years. He now needs infrequent doses of his constitutional medicine for mild synovitis or upper respiratory tract infection.
Dr. Nimish V Mehta
Vinod Kunj, MP Vaidhya Lane,
RB Mehta Marg, Ghatkoper (East)
Mobile: 0-98201 70918