Obstructive Jaundice can be treated with homoeopathic medicines. Present day scientific society wants evidenced based treatment, a case unsuccessfully treated in a nursing home was treated with Nux vomica successfully. It was an evidenced based treatment with investigations.
Introduction
Gallstones
Gallstone disease is a complex disorder where both environmental and genetic factors contribute towards susceptibility to the disease. Epidemiological and family studies suggest a strong genetic component in the causation of this disease. Gallstone disease in the population is complex because it involves the interaction of multiple genes with varied environmental factors.
Some details
Gallstones affect about 10% of adults over 40. They occur in nearly 6% in the adult population of North India ,25% of women in the U.S. by age 60 and in up to 50% by age 75. About 20% of men have gallstones by the time they reach 75 years of age. Because most cases are asymptomatic, however, these rates may underestimate the disease in elderly men. Gallstone disease is relatively rare in children.
Risk Factors
Women are probably at increased risk because the female hormone estrogen stimulates the liver to remove more cholesterol from blood and divert it into the bile. Female ratio is 1.9:1. very low calorie diets and Obese individuals are more likely to form gallstones than thin individuals. Pregnancy increases the risk for cholesterol gallstones because during pregnancy, bile contains more cholesterol. Individuals with Crohn’s disease. Gallstones occur more frequently in individuals with elevated blood triglyceride levels.
Causes of Obstructive Jaundice
Common causes of Obstructive jaundice are Neoplasm’s of the pancreas, liver, and bile duct. The others are cholelithiasis , hepatoma rarer causes of Obstructive jaundice include parasites such as worms, scarring from previous surgical procedures, bile duct inflammations and congenital malformations of the bile duct system.
Symptoms of Obstructive Jaundice
Charcot’s triad of intermittent fever, pain in right upper quadrant , jaundice is characteristic of ascending cholangitis and indicates biliary obstruction, Nausea or vomiting preceding Jaundice, stone dark urine, pale feces, and itching are other symptoms. Mild elevation of SGPT levels, An elevated alkaline phosphatase (above 30 K.A. units) is ,always present in obstructive jaundice.
Diagnosis of Obstructive Jaundice
Diagnosis is based on elevated Alkaline phosphatase (twice the normal value more ,30 K.A. units), SGPT and total serum bilirubin. Ultrasonography is the initial diagnostic procedure. A percutaneous transhepatic choleangiogram or ERCP is a option to localize and characterize the obstruction. If a distal common bile duct obstruction is noted, a CT scan is recommended to image the head of the pancreas.
Some more details
When obstruction of the bile-carrying duct is prolonged (more than 6 hours), then distention and inflammation can develop with secondary bacterial infection in about 50% of cases. This is a serious complication that usually requires immediate medical attention
In treating such patients, the homoeopathic doctor has to consider the whole constitution of the patient in order to clear the gallstones. To find the drug most suitable for the patient, we have to keep in mind not the diagnosis but the symptoms of the patient are of the greater importance. H.C. Allen, who made the statement he quoted. It is a case well taken is a long way to a cure. The dominant miasm for Cholelithiasis is Sycosis on the basis of Pathology, Pressure and pain in the lower region of liver and hypochondrium favor the Psoric miasm. So the allover miasm of Gall Stone is Psoro-sycosis.
A Case of Obstructive Jaundice
A Patient aged 42 years visited Kamla Health Care on 03-07-2018, came with following complaints:-
PRESENTING COMPLAINTS:
Fever with chills since 30 days, itching all over the body,
Thirst. ++++, difficult to swallow, bowels: constipated and offensive smell pale in colour, urine: yellow, appetite: decreased. Desires: spicy food or snakes.
H/o PRESENTING COMPLAINTS:
PAST HISTORY: Nothing Specific
FAMILY HISTORY:
Father: Healthy
Mother: apparently healthy
Siblings: apparently healthy.
H/o HTN, DM, in the family.
PERSONAL HISTORY:
Appetite: Diminished
Thirst: increased
Desires: spices
Aversions: – not specific
Stool: constipated, offensive, pale colour
Urine: No burning
Sleep: NR
Thermal Reaction: Chilly
GENERAL PHYSICAL EXAMINATION:
Weight: 41 Kgs
Pt is moderately built , O/E: throat not congested,
Icterus – Present
SYSTEMIC EXAMINATION:
CVS: NAD
RESP: NAD
CNS: NAD
GIT: Mild tenderness in the liver region –slight enlargement of the liver, Murphy’s sign positive .
PROVISIONAL DIAGNOSIS: Obstructive Jaundice
INVESTIGATIONS OF SIGNIFICANCE:
Before start of treatment:
31/07-2018: Serum Bilirubin: 7 mg%
31-07-2018: USG Scan was done, impression was-
1) Mildly altered echogenicity of Liver parenchyma.
2) Gall bladder lumen septate with calculi measuring 6 mm.
02-08-2018:
Serum Bilirubin: 5.6 mg%
DIRECT: 3.9 mg%
Albumin: Globulin Ratio: 1.2: 1
S G O T: 129 IU
S G P T: 14.3
Alkaline Phosphatase: 230 IU
Reticulocyte count: 2.0%
TLC: was 10400 /cu mm
CLINICAL DIAGNOSIS: obstructive jaundice
CLINICAL CLASSIFICATION: Dynamic chronic fully developed Psoro sycotic disease.
MIASMATIC DIAGNOSIS: Psora– Sycotic
TOTALITY OF SYMPTOMS:
REPERTORIAL TOTALITY:
1-Fever thirst
2-Itching whole body
3-Constipation
4-Desire spicy food
5-Offensive stool
6-Colic pain from jaundice
7-Jaundice
REPERTORIAL RESULT:
Nux Vom – 18/7, Ars – 16/6, China 12/6, Hepar Sulph 9/6.
ANALYSIS OF REPERTORIAL RESULT:
Nux Vom covered maximum rubrics.
SUSCEPTIBILITY: High
TREATMENT AND FOLLOW UP:
First prescription: 3-08-2018
Nux Vom 30/5D, Natrum Sulph-6x/4tabs 12th hourly, China-Q 10 drops 12 hourly in water for a 10 days were Given.
Comment: As Alkaline Phosphatase: 230 IU was high indicate Biliary Tract obstruction (If it raises more than 2 times the normal value). As patient was shifted from a nursing home and on the bases of the condition of the patient I gave above medicines.
Patient reported on 17-08-2018 with liver function report as shown below : fever reduced , weakness, itching slight, pain in right and left hypochondria, Serum Bilirubin: 5.6 mg% to 1.1 mg% , Alkaline Phosphatase: reduced from 230 IU/L to 135IU/L,
On examination abdomen was movable but little tender, as he was complain pain in right and left hypochondria ,he was advised to under go US Scan of whole abdomen.
Mag Phos-30/5 doses , Nat Sulph-6x/4 tabs 12th hourly for 2 days followed by NUX VOM 30, 5 doses and Nat sulph-6x for 7 days were given and waited for US Scan report.
L F T Report : 21/08/2018
Serum Bilirubin: 1.1 mg%
Bilirubin Direct: 0.4 mg%
Total Proteins: 7
SGOT: 145 IU
SGPT: 180 IU
Alkaline Phosphatase : 135 IU/L
29-9-2018– Patient reported on 29-09-2018 with occasional pain in upper abdomen (right hypochondria) Bowel movement was normal, regular. Urine colour was white in colour, slight weakness. Serum Bilirubin : reduced from 1.1 mg to 0.7 mg and Serum alkaline phosphatase : from 135 IU/L to 84.0 IU/L.
Rubrum 15 days, was given.
15-10-2018-
Patients general condition improved, with good appetite, normal bowel movement.
Sulphur 30/3D, were given Rubrum 15days were given.
Conclusion
There is a misconception that homoeopathy may not work in serious complication that usually requires immediate Surgical or medical attention. The above illustrated case is an example how homoeopathy does wonders.
