CASE OF RECURRENT MOUTH-APHTHAE WITH FISSURE-IN-ANO [ Case is presented by Dr.Samadhan Ghule] 21 years old boy was suffering from recurrent aphthous ulcers in mouth since 9-10 years. He had complaints of fissure-in-ano since one and half month. Actually he had come to my village as a guest. Someone his relative suggested him to consult me for Homeopathic treatment of his complaints so why he came to see me on 16/12/2014 at morning session of clinic. Following details was taken by my assistant doctor: CHIEF COMPLAINTS: Mouth ulcers since childhood (Approximate age of 11-12 year) but recurrence is increased since one year. Complaints of fissure since one and half months. DETAILS OF CHIEF COMPLAINTS: • Mouth ulcers: At first red discoloration of mucous membrane of mouth and throat, then white patches appeared. Ulcers mostly appear on the tip and sides of the tongue and also inside the lips. Burning sensation in mouth < morning, evening 6pm >Cold water • Fissure: Hard stool. He has to wait for long time to pass stool. Burning in rectum after passing stool. He had once per rectum bleeding. ASSOCIATED COMPLAINT: Acidity: sometimes since he is taking allopathic medicines for mouth ulcers. Complaints during acidity : Burning in chest during swallowing food. Headache- Pain in the frontal region of the head and eyebrow, throbbing pain. < loss of sleep. Yellowish discoloration of teeth during acidity. MIND: Usually calm nature but anger, irritability on contradiction. Average in study. Not share feeling with others. Fear of dog. Wants to be alone. Want silent music. Like sky blue color and all faint colors. PHYSICAL MAKE UP – Tall and thin. PERSONAL HISTORY: • Chilly • Thirstless • Appetite reduced • Desire for milk++, spicy++, banana+ • Sleep position on back. Sleepless. Falling asleep late. • Dreams about daily life. • Perspiration on palms and soles especially in winter season. PAST HISTORY: • Typhoid at the age of 10 years. • Chicken pox at the age of 11 years. • Accidental fracture of the left radius and ulna due to trauma after falling from swing. FAMILY HISTORY: Father of father had hypertension and he died of brain-hemorrhage with paralysis. Mother of father has hypertension. INVESTIGATION REPORTS: Serum vitamin B12 - 247 pg/ml. [Within normal range] Serum 25 hydroxi cholecalciferol (vit B3) – ng/ml [within normal range.] HB – 13.2gm/dl [within normal limit] but morphology of RBS is somewhat deranged that is values like MCV-105.4FL, MCH-35.37PG, RDW-CV-18.31%, RDW-SD-66.61FL,MPV- 11.8FL are raised above than normal range. See here problem with structure [Mineral]. On this apparent totality of case I had thought of Ignatia but Ignatia was not fully agree with pathogenesis of case as it is not mentioned under mouth Apthae.[ Essential Synthesis]. So I asked some further details. D – What else do you want to tell me? P- I like milk, green leafy vegetables but don’t like vegetables like brinjal etc. D – Ok. Tell me about your mental condition during disease. P – I scare of disease as if not going to cure. D – Have you any other mental stress? P - Nothing but some domestic. D – What is that exactly? P - No one communicate with each other in family? D – So what happen? P - When I used to tell something about my college, examination and career but my father did not respond. D - Then? P – I feel depressed. D – Means? P – As if under pressure? D - Under pressure means? P - As if restless, can’t concentrate in study, diversion of mind. D – So what happen? P – I become irritable. Feeling whether I can do or not something. [Lack of confidence] D – What do you think in this situation? P – I think all family members should come together and should communicate with each other. D – How did it affected on you? P- I lost 1okg weight in last 6 months. D – Is there weakness? P – Yes, I feel weak and also feeling of giddiness while rising from sitting or while sitting down. Here patient would feel that lack of communication in family [Broken relationship]. He would become irritable [Active reaction]. He want to be alone, does not share feelings with other [Passive reaction]. He wants all family members should be together and in communication [Unity and Symbiosis]. Here matter is of his identity and existence [first row of Periodic table] in family so he struggle for care and love from father in form of appreciation which is not getting [third row of periodic table] KINGDOM – Mineral from first and third periodic table. As a matter of structure that is communication, unity, symbiosis, and feeling of first and third row of periodic table. GROUP - Acid. Case is characterized by acid properties like weakness, emaciation and irritability. MIASM - Typhoid. As family crisis, sub acute problems, childlike attitude, demanding love and care from family, past history of typhoid all these points indicate TYPHOID miasm. [Sankaran’s miasm] BASIC MIASM - PSEUDO-PSORA as pathogenesis covering both psora[inflammation] and syphilis[ulcer,fissure]. Rubrics from Synthesis Repertory: • Mouth – Aphthae. • Rectum – Hemorrhoid. • Rectum-pain – stool – after – agg. – burning. • Emaciation • Weakness • Irritability • Lack of confidence Now we have to select the medicines which have: • Mineral kingdom. • Acid group • Typhoid miasm • Sphere of action is mouth, anus and stomach mucosa. • Sensation of broken relationship, unity, symbiosis. • Feeling of the first and third row of the periodic table. • Chilly • Thirstless • Tall and thin With following rubrics from Synthesis Repertory: • Mouth – Aphthae. • Rectum – Hemorrhoid. • Rectum-pain – stool – after – agg. – burning. • Emaciation • Weakness • Irritability • Lack of confidence “Muriaticum acidum” is the remedy which agrees all above conditions of the case. Muriaticum acidum is nothing but hydrochloric acid that is HCL includes ‘H’ from first row of periodic table and ‘CL’ from third row of periodic table which is the essential sensation of this case so I gave him a dose of Muriaticum acidum 200 twice daily for 2 days in water potency. Follow up after 3 days. On 19/12/2014 : • No ulcers in mouth • No pain in rectum • No acidity • No headache • Stool normal • Mentally feeling better • Appetite and sleep improved If we consider syphilitic background of family the anti-syphilitic medicine would be needed for complete cure in next follow up. Here I would like to quote about Muriatic acid from Boericke’s Materia Medica: Mouth and anus chiefly affected. Irritable and peevish. In this case though PQRS characteristic symptom is not present, we reached the remedy of the case through the proper understanding of pathogenesis, exact sensation, kingdom, miasm and generals of the case.
Posted on: Tue, 30 Dec 2014 12:42:47 +0000
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