Case of Chronic Eczema - homeopathy360
Clinical

Case of Chronic Eczema

Abstract: This article presents a study of a case of eczema which was very chronic and distressing the day to day activity of the patient even he was taking allopathic treatment since a long time. Through this case we are able to appreciate the importance of the homoeopathic simillimum which gives permanent relief without any medicinal adverse effects.
Keyword: Homoeopathy, Eczema, Chronic disease,                                                                                                         Sulphur, Graphites, Psorinum , Irreversible cure.
What is Eczema
Eczema is a mode of reaction of the skin. Characterized histologically by-
• Intercellular and intracellular
oedema of the epidermis
• Leading to vesicle formation
within the epidermis and,
• Capillary dilatation, oedema
and a perivascular of
lympocytes and histocytes in
the dermis.
These are represented clinically by erythema, oedema, and grouped papulovesicles.
Causes of Eczema
• Emotional stress.
• Allergic to an ingested or inhaled antigen.
• A process of autosensitisation can occur, the patient having become allergically sensitized to his own altered skin proteins.
• Sweat retention is often an important factor.
• In some cases Endocrine and nutrition factors.
• Occupational hazards like exposure to allergic agents. e.g. Chemical agents, cleaning
agents, disinfectants, plants, clothing, cosmetics etc.
Case of Eczema
28 years male patient has complaints of skin eruptions with itching, burning and discharges which is sticky, offensive on palms of both hand and itching, burning on foot. Complaints since childhood for which he was taking allopathic treatment which gives relief for some days and recurs again but from last two years skin complaints are not responding to allopathic medication, in addition to that he feels weakness and
giddiness and was able to do his routine work.
Similar eruptions on forearm, lips, neck and chest. He also had the same from knee to foot in past.
Patient as a Person
Patient is eldest among the 3 siblings followed two younger, (26 years old brother and 24 years old sister). He lost his mother when he was 6 years old and lost father
when he was in 12th std. and all responsibility of the family fell on his young shoulders and he had to quit his studies to manage the finances of the family. He was an average student. Patient has been a loner since his childhood as he lacked emotional support. By nature he is extremely irritable, but can’t express this anger. He prefers the company of friends but get off ended easily on slight hard talks between them. He says that he is introverted, reserved and can’t express his feelings at times due to lack of courage and timid nature.
Two months back, he got married. His wife is very anxious about his skin trouble, which
is not responding to allopathic medicines. The patient felt bad about this. He never shares his feelings with anyone, but now started sharing a little bit with his wife.
Regarding work he had aversion to work. He joined as supervisor but the salary was very low so looking for another job.
Physical Generals
Appearance- Lean, thin, tall, stooping shoulder.
Thirsty-Prefers cold water, Good appetite,
Desires salty things like pickles and Papad, avoid to take eggs because it causes acne on face,
Aversion for sweet and milk,
Bowels are regular and satisfactory, Takes sound sleep, sometimes with fearful dreams but doesn’t remember,
Perspiration is profuse on slight exertion with offensive smell and it stains linen yellow. Needs covering in winter season up to neck,
Habit of taking tea for 2-3 times per day and cigarette smoking 2-3 per day since 2 years.
Vital Data
BP-130/90 mm/hg, Pulse-70 b/min regular in rhythm.

Hahnemannian Classification of Disease
Chronic disease of Psora

Disease Diagnosis
Chronic Eczema
Totality of Symptoms
• Maism –Psora.
• Physically weak, emaciated.
• Mind- Aversion to work indolence,
• Mind- Timidity,
• Mind- Reserved,
• Mind- Off ended easily,
• Thermally- Hot.
• H/O – Abuse of Medication.
• H/O – Suppressed Skin Disease
• Desires –Salty things.
• Aversion – Sweets.
• Thirst- Prefers cold water.
• Perspiration- profuse,
• Perspiration- offensive,
• Perspiration- stains linen yellow,
• Skin – Discoloration – Blackish
• Eruptions – Itching- bleeding
• Eruptions- Discharges- moist glutious-thin-offensive
Repertory Sheet
See Repertorial Sheet.
Prescription
Sulphur 200 single dose followed
with placebo for 6 days.
Reason for selection
Remedy Sulphur
• Boericke’s Repertory- page no. 957- Chapter-Generality,
Rubric-Chronic Diseases, to begin treatment-Cal.C; Cal.p; Nux vom.; Pulsatilla; Sulphur.
• Maism –Psora.
• Physically weak, emaciated.
• Thermally- Hot.
• H/O – Abuse of Medication.
• H/O – Suppressed Skin Disease
• Skin –Eruptions –Itching-burning-bleeding foetid discharge.
• Mind- Aversion to work indolence,
• Mind- Timidity,
• Mind- Reserved,
• Mind- Off ended easily,
On 18-3-2013
Observation- NECK & BACKERUPTIONS
APPEARS AND
SUBSIDES AFTER 4 DAYS.
Discharges from eruptions of hands and feet increases with itching+. Eruptions on forearm appears as it was in past. Burning pain absent.
What we Observed
• Eruptions on forearm reappears
• Discharges from eruptions of hands and feet Increases.
Is a Good Sign or Bad?
IT IS GOOD SIGN .Why? And What to do in such situation
WHY?
• The well selected medicine
will compel the suppressed
internal disease to come out on
the external parts, otherwise
cure is not possible.
• Eruptions and Discharges
which was suppressed
by external application of
ointment and prolonged use
of allopathic medicines since
childhood has comes out.
• It is a progressive sign. It
indicates, that the disease
curing process has started on
the correct path.
• It follows HERING’S LAW OF
CURE.
What to do?
So long as old symptoms come back and then, the medicine must be lefy alone. OR If the old symptoms come back to stay then a repetition of the dose is necessary.
So here time is given to complete the action.
Prescription
Placebo given for next 8 days.
On 26-3-2013
Lips dry and bleeding on stretching . Itching reduced upto 80% . Since last two days burning pain of affected part absent. Discharges+. Pain and inflammation of inguinal
gland both side.
Prescription
GRAPHITES 200 Three doses X 1day followed with placebo.
Why Graphites after Sulphur?
Here we choose Graphites because Graphites is of Follow well remedy to Sulphur in case of skin diseases. It act as a complimentary in action, which will complete the
action of the first given remedy that is Sulphur.
• Miasm – Psora
• Diathesis – Scrofulous
• Skin H/O – Suppressed Skin Disease
• Aversion – Sweets.
• Skin – Discoloration – Blackish
• Eruptions – Itching- bleeding
• Eruptions- Discharges- moistglutinous-thin- offensive
On 2-4-2013
Itching absent. Burning pain absent. Discharges from eruptions
of hand and feet increases. Fever 100° F with pain at inguinal region
.On examination infl ammation of inguinal lymph gland.
Prescription
Ferrum Phos 6x 4 glbs tds X 8 days
On 11-4-2013:
Itching absent. Burning absent. Offensiveness of discharges reduced. Discharges from
eruptions of hand and feet increases.
Prescription
Sulphur 200 single dose. Followed with placebo .
Interpretation
Here discharges increased but internal burning pain totally vanished.
• Internally patient feels better though external symptoms aggravated.
• Healing starts from centre to periphery.
• From within outward.
• We are on the right path.
On 26-4-2013
Offensiveness of discharges reduced. Occasional itching. Inguinal pain absent. Fever absent.
Prescription
Sulphur 200 Three doses X2days
On 10-5-2013
Occasional itching < night. Burning absent. Offensiveness of discharges reduced oozing of discharge from legs+.
Prescription
Sulphur 1M single dose.
On 27-5-2013
Occasional itching < night. Burning absent. Offensiveness of discharges reduced, but oozing is there from eruptions of legs+.
This is about two months Patient is in state of oozing eruptions.
Interpretation
Here even after increasing the potency of Sulphur the symptom remains at a standstill.
Sometimes in a chronic case we find that the action of a well indicated constitutional remedy becomes blocked and the patient refuses to make further progress.
Under the circumstances we should make a detailed study of the symptomatology and the circumstances of occurance.
Analysis from the miasmatic standpoint might indicate the type of miasm responsible for this block and a suitable antimiasmatic remedy will help to remove it and restore the path for the constitutional remedy.
Prescription
Psorinum 1M single dose followed with placebo for 20 days.
Here Psorinum will act as an intercurrent remedy.
Psorinum is A Nosode. Points to remember about Nosodes-
• They are prepared from diseased parts so it should be given in higher potencies.
• Nosodes should not be frequently repeated.
• Nosodes should not be used in lower potencies.
• They can be used an intercurrent remedy.
• They are used to remove diseased inherited trends.
On 19-6-2013
Itching reduced. Itching and eruptions on forearm absent.
Off ensive discharge absent.
Prescription
Placebo for 30 days.
On 16-7-2013
Itching only on legs occasionally. Discharge – absent. Eruptions absent.
Only discoloration-black.
Prescription
Sulphur 1M three doses for 1 day. followed with placebo for 20 days.
On 6-8-2013
No recurrences of symptoms.
Prescription
Placebo for 30 days.
On 17-9-2013
No recurrences of symptoms.
Prescription
Placebo for 30 days
Figure 1
Figure 2
On 29-10-2013
No recurrences of symptoms.
Prescription
Placebo for 30 days. (See Figure 1)
What we see in this case?
1. DR. KENTS ELEVENTH OBSERVATION, AND
2. HERINGS LAW OF CURE.
Lets see about-
1.    DR. KENT’S ELEVENTH OBSERVATION:
• When old symptoms are observed to reappear the disease is curable just in that
proportion as old symptoms which have long been away return.
• The patient is on the road to recovery and it is well to say to the patient that this is
encouraging, that disease get well from above down ward.
• Symptoms are disappearing in the reverse order of their appearance.
• Old symptoms often come back and go off without any change of medicine- according to the law of cure.
• It is indicated that the medicine must be let alone. (See Figure 3)
2. HERINGS LAW OF CURE:
At the time of cure the symptoms will disappear as follows.
(i) FROM ABOVE DOWNWARD.
(ii) FROM WITHIN OUTWARD.
(iii) FROM AN IMPORTANT ORGAN TO LESS IMPORTANT ORGAN.
(iv) IN THE REVERSE ORDER OF THEIR APPEARANCE.
(i) FROM ABOVE DOWNWARDS –
In this case it is seen that symptoms disappears from-
UPPER PART OF THE BODY

THEN TO ARMS AND

THEN TO FINGERS AND LOWER EXTREMITIES.
(ii) FROM WITHIN OUTWARD:
• On 26-3-2013 i.e. after 14 days of treatment the condition of patient
shows increased discharges from eruptions but internal burning pain was totally absent.
• Internally patient feels better though external symptoms aggravated.
• Healing starts from centre to periphery.
• From within outward
(iii) FROM AN IMPORTANT ORGAN TO LESS IMPORTANT ORGAN:
• In this case along with skin eruptions and discharge there were symptoms of enlarged
lymph gland, fever, and increased pulse rate.
• These symptoms related to lymph gland subsides first – and – then skin discharges.
• LYMPH GLAND
TO SKIN i.e. CURE TAKES PLACE FROM IMPORTANT ORGANS TO LESS IMPORTANT ORGAN
That was the time where there was a chance of taking oral antibiotics by patient “Impatiently” without bothering with instructions. If it would have happened, then
again their would be suppression and the case might have been taken along time to
cure.
“ WHEN SUPPRESSION IS CAUSED BY SOME ARTIFICIAL MEANS IF FOLLOWING
BY PROLONGED A L L O P A T H I C T R E A T M E N T BY INTERNAL MEDICATION OR BY SUPPRESSION OF SKIN MANIFESTATIONS
BY EXTERNAL APPLICATION. THESE ARE THE OBSTACLES
WHICH PREVENTS COMPLETE CURE OF
CHRONIC DISEASE.”
So it was instructed to patient not to apply any external application, and he followed it well. The eruptions were oozing for about 2 to 3 months but he didn’t apply any external
application. For this, I thanked him for his cooperation .
(iv) IN THE REVERSE ORDER OF THEIR APPEARANCE:
In cases of chronic diseases it is found that the patient will retrace the road along which his disease has travelled and he will experience again the various ailments from which he has suffered until he gets back to the condition from which his disease started.
Such appearance of old symptoms indicates that we are proceedings in the
proper direction, i.e. cure. Appearance of symptom sequence: (See Figure 4)
Disappearance of symptom sequence:(See Figure 4)
Interpretation
• DISAPPEARANCE OF SYMPTOMS IN THE REVERSE ORDER OF THEIR APPEARANCE.
• THE FIRST TO APPEAR BEING LAST TO DISAPPEAR.
Administration of
Medicine
According to Aporism no. 272 –274 of the Organon of Medicine, only a single, simple medicine is to be given to the patient at one time.
• 12-3-2013 Sulphur 200 single dose, After 14 days
• 26-3-2013 Graphites 200 TDS for 1 day, After 16 days
• 2-4-2013 Ferrum Phos 6x 4 glbs TDS 8 days
• 11-4-2013 Sulphur 200 single dose, After 15 days
• 26-4-2013 Sulphur 200 TDS for 2 day, after 14 days
• 10-5-2013 Sulphur 1M single dose, After 17 days
• 27-5-2013 Psorinum 1M single dose, After 50 days
• 16-7-2013 Sulphur 1M TDS for 1 day
• 6-8-2013 Placebo
• 17-9-2013 Placebo
• 29-10-2013 Placebo
Susceptibility and Sensitivity Assessment-
Susceptibility- Moderate
Structural pathology at epidermis.
Sensitivity is moderate as reactivity of mind and emotion is moderately reactive.
Conclusion
When the patient came to me, he was hopeless about a cure. He was mentally prepared to live life long with this disease. (This negative approach by the patient was a positive and potential motivation for me to work out the case.)
By giving the Homoeopathic medicines we had given good
results which was seemed apparently difficult.
Patients taking homoeopathic treatment reports themselves better when compared with those who do not take it.
Period of treatment varies according to the area of disease involved and the chronicity of the disease and individual response of the patient.
As the patient was on corticosteroids daily since 2 years, if he missed his steroid dose his complaints became worse which was intolerable to him even though he was feeling weakness and giddiness since starting the
Steroids
It is the greatness of Homoeopathy that now he is free from steroids as well.
Eczema can be cured permanently with suitable
homoeopathic drugs. Homoeopathic drugs are cost effective and have no side effects.
The recurrence rate after homoeopathic treatment in eczema is nil or very less.
Reference
1. Kent J.T. Lectures on Homoeopathic Philosophy, B. Jain Publisher, New Delhi,1991.
2. Kent, J.T. Repertory of Homoeopathic Materia Medica, B. Jain Publishers, New
Delhi, 2006.
3. Boericke, W. Pocket Manual of Homoeopathic Materia Medica, B. Jain Publisher, New Delhi, 2004.
4. Samual Hahnemann, Organon of medicine. 6th edition, B. Jain Publisher, New Delhi,
2014.
5. E.C. Warner. Savill’s System of Clinical Medicine, 14th edition, CBS Publisher,
Delhi, 1964.
6. Cases from OPD of my clinic.
7. Computer software to repertories.
About the Author
Dr. Kalika Adhikkumar Devakate, M.D. (H.M.M) is a Homoeopathic Physician, Practicing classical homoeopathy since 18 yrs, Professor and Head of Department of
Homoeopathic Materia Medica at K.E.S., C. H. Keluskar Homoeopathic
Medical College & Hospital Alibag, Examiner for diploma, degree courses in homoeopathy attached to Mumbai University and MUHS Nashik.

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