Hahnemann Ki aawaz Posted on 14 – 10 – 2012
It is the disease of musculo – skeletal system. It is characterised by fever, pain in joints, swelling and redness, restriction of movement, etc. according to the onset & intensity of the disease.The relevance of the symptoms, recognition of its cause and proper diagnosis of the Rheumatic disorders in most instances can be obtained by careful history, physical examination, observations of extra articular manifestation, combined with appropriate laboratory findings and radiological investigations.The efficacy of Homoeopathy and Homoeopathic drugs in treatment of Rheumatism through this I wish to prove once again Homoeopathy has more effective, easier ,comprehensive and soft approach in this treatment over other Pathies.
The rheumatic diseases have been recognized since 5th Century B.C. The
term ‘Rheumatism’ was first used in 1642 by G. Guillaume de Baelleue (or
Bellonius ) in its present sense of an acute polyarthritis, which has no
connection with gout.
In 1676, Thomas Sydenham, the greatest clinical physician of his century
wrote, “It is commonest during the autumn chiefly attacking the young and
vigorous, those in the flower of their age. After a few days, the patient is attacked
by severe pains in the joints………. This pain changes its place from time to time,
takes the joints in turn, and affects the one that it attacks the last with redness
Many of the times the patients suffering from Rheumatism take the pain
relievers and got the temporary relief and the problem persist and the physician
of the other Pathies of the medicines find themself helpless and here the miracle
of the sweet pills works. Homoeopathy alongwith only present, past & family
history and after getting the totality of symptoms, successfully tackles & cures the
sufferings of the old peoples.
In heavens when ‘Adam’, the first man on earth, ate the apple of wisdom, against the wish of his lord, the Lord of life sentenced him a life of Mortal as a punishment. To become mortal, mean that the influx of miasms had started. The miasm which is the deepest, most vividly expressed and most ancient of all had made an entry in ‘ Adam’ in form of ‘PSORA’ as a result of this mental itch to the ‘Sacred apple of wisdom’. This was the beginning of influx of miasms in mankind, Which was later afflicted with the more grievous & more corroding miasms. namely Sycosis & SYPHILIS respectively. Thus to reach to a Sycotic or syphilitic stage one must pass-through the Psoric state at least for some time.
AGING AND JOINTS
The aging process usually results in decreased production of synovial fluid in joints. In addition, the articular cartilage becomes thinner with age, and ligaments shorten and lose some of their flexibility. The effects of aging on joints, which vary considerably from one person to another, are affected by genetic factors; and by wear and tear. Although degenerative changes in Joints may begin in individuals as young as 20 years of age, most do not occur until much later. In fact, by age 80, almost everyone develops some type of degeneration in the knees, elbows, hips and shoulders. Males also commonly developes degenerative changes in the vertebral column, resulting in a hunched over posture and pressure on nerve roots. As you see in the following section, one type of arthritis called osteoarthritis is at least partially age related. Nearly everyone over age of 60 has evidence of some oestroarthritic changes. Joint disorders are common in the elderly population. Commonest conditions are rheumatoid arthritis, osteo-arthritis, crystal induced arthritis, spondylitis, sciatica and lumbago. Comorbid events in the eldeny patients make disease management even more difficult. Some tests are needed to distinguish these conditions from more serious diseases like carcinomatous arthritis or multiple myeloma. Management strategies are usually similar to that of younger onset arthritis with dose adjustment of drugs due to underlying age related hepatic and renal dysfunctions.
The word Rheumatism is a Greek derivation and it means
stream, to flux, running or flowing. The old physicians were of the opinion that there was an evil acrid fluid, originating in the brain which propagated disease throughout the body. The meaning conveys an idea that some disorder is flowing to &fro or finally settling somewhere.
Rheumatism indicates a number of diseases or disorders of connective tissue, presenting symptoms of pain, stiffness or swelling of muscles & joints.All the rheumatic condition is marked by some inflammation or other change in connective tissue. The course of rheumatic complaints may show the greatest varieties. There are differences graduating from slight pains & stiffness, disappearing after a few days to serious manifestation in joints, accompanied by most painful contradictions & distortions, continuing over months or even years.
1. Hereditary disposition 2. Specific infection e.g. Gonorrhoea 3. Injury to bones & joints 4. Over weight
5. Poor nutrition 6. Faulty metabolism 7. Endocrine disorders 8. Allergy & poisons
The Ministry of Health recognizes the following varieties of rheumatism
according to there clinical symptoms:-
1. Arthritis 2. Gout 3. Sciatica 4. Lumbago 5. Spondylitis 6. Torticolis
Rheumatism can be classified under two main groups :
1. Non-articular rheumatism that affects mainly the muscles.
2. Collagen diseases that affects chiefly the connective tissues.
The World Health Organisation classifies rheumatic diseases under four
1. Back disorders 2. Regional periarticular or soft tissue disorders 3. Osteoarthitis and related diseases.
4. Inflmmatory arthropathies. The American Rheumatism Association has published the following
functional classification of rheumatic diseases :
1. Functional capacity to carry on all usual duties. 2. Functional capacity adequate to carry on normal duties despite limited
mobility of one or more joint. 3. Functional capacity only to perform few of the duties of self-case.
4. No functional capacity to do any duty and the patient is bedridden or confined to wheel chair.
Routine Haemogram- ESR-CRP(C-reactive protein-no change)
Routine urine analysis 106
X-ray of affected joint –
Synovial fluid aspiration- viscus with low turbidity and CPPD crystals (calcium pyrophostate)
Radio Isotope – Bone scan – Discrete increased uptake in OA joints
MIASMATIC THEORY OF RHEUMATISM
Homeopathy is a system of medicine based upon Nature’s
Law of Cure – Similia Similibus Curentur (likes are cured by likes), with
a vitalistic, holistic, individualistic, approach to persons in health, diseases and its cure and the same approach to all the branches of medical knowledge inherited or acquired and using the dynamic properties of drugs especially prepared to release their potencies singly at a time and in minimum dose. Though selection of medicine is important aspect in dealing with any case only this much is not enough to attain 100% recovery of the patient. But we can derive a simple equation of cure as follows.
Drug + Faith + A Will, to be cured = Medicine
When a patient is cured by a medicine, it is not only the drug which has acted but also his faith in it and his will to get well.
It is the inflammation of joints. All the inflammatory processes come under the domain of Psora. Psora is the mother of all the chronic diseases. All the functional diseases, all the disturbances at the level of working and functioning and sensation come under Psora. Arthritis could be due to primary inflammation of synovial membrane of the joint forming surface, the bones could be inflamed. Secondly there could be exudation of serous fluid into joint cavity. So it could be even sorted under the Sycotic trend. The Sycotic philosophy goes by accumulation and by progression of the disease condition. Here there could be hypo or hyper secretion phenomenon. In this there is accumulation of fluid which is the pathogenesis of Sycosis.
Thus ARTHRITIS = PSORA + SYCOSIS.
Materials & Methods
Period of study:
Practical and philosophical. During the study, utility of Kent’s repertory and its philosophy was applied clinically for treating the patients. The total 30 patients were treated for a period of 6 to 10 months.
Result of treatment in Rheumatism:-
This study revealed that 60% of the cases of Rheumatism recovered after treatment with Homoeopathic remedies while 37 % showed improvement and remaining 3% relapsed but afterwards recovered.
Clinical Protocol :-
Data was collected by proper method and processed in a standard format :
1) All the patients (30 cases) satisfying the criteria of case definition, inclusion and exclusion were studied.
2) Detail case taking and exclusion were studied.
3) Guidance of Senior Homoeopathic Physician, Guide/ Teachers and Physician of Allied Science was taken.
4) Time duration was 15 months.
5) Follow-up was done every fortnight for first few months, then every month.
6) Review of literature from standard books, journals, internet and software was done for study purpose.
Inclusion Criteria :
Inclusion criteria includes common diseases found in old age persons in day to day OPDs like
1) Inflammatory joint diseases like
- · Osteoarthritis
- · Acute monoarthritis
- · Chronic inflammatory arthritis
- · Oligoarthritis
- · Polyarthritis
2) Crystal deposition disease like Gout
3) Soft tissue rheumatism like neck pain due to cervical spondylosis and
4) Back pain diseases like Lumbago, lumbar spondylosis and sciatica
All cases fulfilling the definition were taken.
Patients of all age groups were taken.
Cases with Location, Sensation, Modalities and concomitant and pathological generals taken.
Cases were taken for study irrespective of socio-economic status.
Exclusive Criteria :
Exclusive criteria includes –
_ Psoriatic arthritis _ Reactive arthritis
_ Rheumatic fever _ Rheumatoid arthritis
_ Septic arthritis _ Systemic lupus erythematosus
_ Tuberculous arthritis _ Viral arthritis
_ Crico arytenoid _ Lyme disease
_ Ankylosing spondylitis _ Reiter’s disease
_ Juvenile chronic arthritis _ Bechet’s syndrome
__Whipples diseases __Infective arthritis
_ Disorders of bone __Arachnoiditis
__Scheurmans disease __Soft tissue rheumatism all except neck pain All the cases suffering with sever concurrent illness All the cases with severe calcium deficiency and marked osteoporosis
As my topic of dissertation is “Efficacy of Homoeopathy in the
treatment of Rheumatism” based on path physiology, miasmology and therapeutic value. The study has been done on intricate details.
- · While doing the miasmatic and comparative study of Homoeopathic remedies through the source books, more emphasis is given on Rhus tox, Ledum Pal, Rhod., Nux Vom, Dulcamara, Bryonia, Arnica, Calc carb, Less on, Causticum, Ruta, Benzoic Acid, Sulphur and least on Colchium, Urtica Urens, Lithum carb and Lycopodium. This needs more proving as acute and constitutional remedies.
- · A review of literature regarding Rheumatism and its Homoeopathic management was done comprehensively from the bulk of text available, the essence of extracted only from those, which were the exceptionally profile writings.
- · The efficacy of Homoeopathic remedies has been proved in the treatment of Rheumatism and the most useful potency was found to be 200 C & 30 C.
- · I have studied 30 clinical chronic and acute cases of Arthritis, Spondylitis, Lumbago, Sciatica, Torticollis and Gout, with their etiopathogenesis, clinical manifestations, personal history, physical examinations and associated conditions. I have also followed the origin of the cases considering the miasmatic background evident in the past and family history of the patient.
- · This study has given me an insight into the various aspects of Rheumatism and the role of Homoeopathic remedies in managing them.
- · I have discussed the various aspects and results observed in the 30 cases
The study reveals maximum incidence of Rheumatism in i.e. 13% in the age group of 20-35 yrs., 30% in the age group of 36-50 yrs., 13% in the age group of 51-65 yrs., 3% in the age group of 66-70 yrs and above.
Relation of Miasm to Rheumatism:-
The study revealed maximum incidence of Rheumatic patients i.e. of Fundamental miasm Psora 67% and mixed miasm are 33%. Syphilis and Sycotic miasm are found to be in 0% of cases.
Remedies used as indicated constitutional, antimiasmatic, acute and complementary in the treatment of Rheumatism:-
The study reveals that R.T. covered maximum incidences of cases i.e. 30%. Whereas Rhod., L.Pal, and N.V. is 30%, Ruta, Arnica, A.A., Bryo. and Col. is 40% respectively as a indicated remedy in the case. Drugs like C.C., R.T. given as antimiasmatic carried an equal incidence of 34% while Caust., Bryo., Suplh. and Puls. carries 12 %.
The personalities more prone to be affected by Rheumatism can be called as Rheumatic personalities which can be described as follows:-
Pre-illness personalities Hyperactive in initial phase of life.
_ Which makes them ambitious and workaholic
_ TARGET ORIENTED
_ Always in thought of targets and certain goals in life. So
cannot be idle. Continuously busy.
RESPONSIBLE AND ENERGETIC
INDEPENDENT AND SELF RELIANT
After this, in depth study, I derived this conclusion that amongst the varied prescription for my Rheumatic cases, of course very much according to their totality Rhus tox and Rhododendron gave me the best result, other medicines utilized were Belladonna, Bryonia alba, Colchicum, Ledum pal, Arnica, Ars alb, Ledum pal, Calc carb etc.
The Homoeopathic efficacy is established in all the wonderfully responding cases to mine. It is my firm belief on futher research and reproving on similimum remedy, the Homoeopathy World shall surely boast of a jewel a class apart from combating the Rheumatism . The existing management with the NSAID’s and steroids give partial annihilation along with hordes of dreaded side effects. However on detailed study we will surely establish that the homoeopathic remedies, physically, mentally and clinically cures the patients of Rheumatism . We can very well arrive at constitutional medicine Thus the double edged sword of NSAID’s and steroids can definitely be replaced with the gentle Homoeopathic management. After administration of Homoeopathic remedies rheumatism was cured and clinically proved as leucocytosis, increased ESR, increased uric acid levels, increased C-reactive proteins in blood were seem to be at normal levels after completion of treatment with remedies like Rhus Tox, Benzoic acid, Arnica Montana, Calc carb. Remedies like Phytolacca, Ruta, Calc carb after administration efficiently repairs the non-ossification, curvatures and caries of bones (Though I have not included such cases in this dissertation but I have experienced it in my 11 years practice.). In acute exacerbation of Rheumatism remedies like Belladonna and Rhododendran gives us magic relief like as any NSAID’s.
- Principles and Practice of Medicine – Sir Stanley Davidson 20th edition.
- Clinical Methods – Sir Robert Hutchison 21st edition.
- Man and Medicine, A History – Farokh Erach Udwadia 3rd impression 2002.
- Pocket manual of the Homoeopathic – William Boericke Materia Medica with Indian Medicines and Repertory
- Handook of Materia Medica – T.F.Allen
- Homoeopathic Therapeutics – Samuel Lilianthal.
Reprint edition 2001.
- Chronic Miasms – Allens.
- Principles and Art of cure by – Dr. Robert .
- Lectures on Homeopathy – Dr. J.T. Kent
Reprint edition 2006.
- Organon of Medicine – B.K.Sarkar.
- Notes on Miasms – Dr. Proceso S. Ortega
1st English edition.
- Comparison of Chronic Miasms – Phyllis Speight.
Dr. Anil Wakode ,Dr. Sunita M. Jain.