Articles Practice of Medicine

Constitutional Approach In A Case Of Psoriasis

ABSTRACT: ​The high and only mission of a homoeopathic physician is to restore the sick to health.​1 Homoeopathic treatment aims to enhance and stimulate body’s ​immune system​ and self-regulatory mechanisms. Constitutional refers to treating a person as a whole physically, mentally and emotionally including past and present symptoms. Constitutional treatment is very effective and is efficient in treating many kinds of diseases and long term illness. Constitutional similimum prescribed by the detailed case taking brings out satisfactory results to both patient and physician in the case of psoriasis.
Keywords
Psoriasis, Constitutional similimum, Nux vomica.
Introduction
The ​E​ssential feature of an autoimmune disease is that tissue injury is caused by the immunological reaction of the organism against its own tissue.​2 Psoriasis is one of the disease that comes under this category. Psoriasis is a multi-factorial genetic disease that requires both polygenic and environmental factors for its clinical expression. It is based on T- cell-mediated immune pathogenesis.​3 It is characteri​z​ed by thick elevated scaling erythematous plaques associated with marked increase in the rate of epidermal turnover. Polygenic inheritance, Environmental influences, ​St​ress and infections, influence the onset and course of the disease. It can be pustular or generali​z​ed.​4
A Case Study
Following is a case of long standing psoriasis which has improved dramatically after C​onstitutional homoeopathic treatment.
A Case of Psoriasis
Patient Mr ​.​X came with the complaints of eruptions all over the body since 9 years. The complaints first started anal region then head, followed by back and hands and last on face. Itching is intense without any burning sensation. Bleeds on itching. 3 years back the patches have occurred in abdomen. The patches are scaly and hard to touch. He feels as if insects are crawling over the patch. The prominent modality itching < bathing generally.

Mental generals exhibited by the patient that he gets angered easily, wants everything to be done independently and properly, prominently does not like being looked at when the patches increased in face.
Physical ​G​enerals included desire for ​highly seasoned food.
Totality of Symptoms

  • Aggravation being looked at
  • Fastidious
  • Angered easily
  • Desires for highly seasoned food
  • Crawling sensation in skin
  • Itching scratching amelioration
  • Bathing aggravation

Case Analysis and Remedy selection: Maximum symptoms were covered by Nux vomica and also mind symptoms are more prominent.
After ​R​epertorisation, remedies like ​Sulphur, Nux vomica, Arsenicum album, ​S​epia officinalis, and ​Phosphorus were the first 4 remedies of choice, after including the physical general and mental general into consideration Nux vomica was selected as the similimum to the case at the present state of the patient. Thus Nux vomica 200, single dose was given and patient was said to come after 2 weeks.

Reason for treatment

  1. Conventional treatment taken for many years
  • Susceptibility being moderate
  • History of suppression (​O​intments)
  • Vitality good

Based on Constitution & conventional treatment NUX VOMICA was administered. Nux vomica 200 ​was selected in accordance with the above-mentioned reasons.
The doses were​ given ​on 13.8.2018 ​according to the intensity.
Follow up
Nux vomica 200 was increased to 1M after 2 weeks and the patches in the face started to reduce and the patient hinted that when medicines were taken it healed from centre to periphery which was opposite when ointment was applied in conventional treatment.
The patches ​​disappear​ed​from above downwards.

DATE SYMPTOM INFERENCE PRESCRIPTION
       
13.08.2018 Patient in his first visit First prescription Rx
  according to the symptoms was   Nux vomica 200/1
  prescribed the similar remedy.   dose
       
27.08.2018 Complaints remains same No change Rx After prescribing
      NUXVOMICA
      PATIENT
      IMPROVED BETTER
      Nux vomica 1M/1
      dose
       
11.09.2018 Patches in face reducing. Amelioration (From Rx
  Complaints of crawling of upper part of body) Sac Lac/ 1month
  insects sensation in patches.    
  Patches in left cheek and    
  abdomen reduced.    
       
13.10.2018 Itching and patches reduced in Standstill Rx
  upper part of body. Patches in   Nux vomica 1M/1
  back still persist.   dose
       
16.11.2018 Patches in back reduced. Itching Amelioration Rx
  feels beter. Note: Patient hinted   Sac lac/1month
  that when medicines were taken    
  it healed from centre to    
  periphery which was opposite    
  when ointment was applied in    
  conventional treatment    
       

Discussion and Conclusion:

Psoriasis, an autoimmune disease, when approached constitutionally following principles of Organon of medicine​stated by our master Dr​​ Samuel Hahnemann gives us satisfactory results and lead us to the path of recovery.
The correlation with ​Her​ing’s law made the prognosis of the case good.

  • The ​P​atches disappeared from above downwards
  • From centre to periphery.

Appendices: ​REPERTORY OF THE HOMOEOPATHIC MATERIA MEDICA BY J.T. KENT

                         
Remedy Name Nux- Sulph Sep Phos Ars Rhus- Chin Calc Kali- Staph Ant- Bry
  v         t     c   c  
Totality 12 15 12 11 10 10 8 9 9 8 7 7
Symptoms Covered 7 6 5 5 5 5 5 4 4 4 4 4
Kingdom                        
[Kent ] [Mind]Fastidious: 2       2              
[Kent ] [Mind]Looked 1 1     3 1 2       2    
at,cannot bear to be:              
                         
[Kent ]                          
[Mind]Anger,irascibility(see 3 3 3 2 3 2 1 2 3 3   3  
irritability,quarrelsome):                          
[Kent ]                          
[Stomach]Desires:Highly 2 3 1 3     3            
seasoned food:                          
[Kent ] 2 3 3 1 1 3 1 1 2 3 1 1  
[Skin]Itching:Crawling:  
                         
[Kent ]                          
[Skin]Itching:Scratching 1 2 2 3 1 1 1 3 2 1 1 2  
:Amel:                          
[Kent ] 1 3 3 2   3   3 2 1 3 1  
[Generalities]Bathing:Agg:      
                         

References:
Hahnemann, Samuel, Organon of medicine, 6​th​edition, Aphorism 2;(1921)
Harrison’s Principle of Internal Medicine, 18​th​edition, 318:2719; (2012)
Das, Krishna K.V, Textbook of medicine , 5​th​Edition 208:1361
Panda U.N, Millenium edition, Textbook of medicine, 16:783; (2000)

About the Author:
Dr P.J. Suresh, Professor & HOD, Dept. of Forensic Medicine and Toxicology,
Sri Sai Ram Homoeopathy Medical College and Research Centre, West Tambaram, Chennai – 44.

Dr P J Suresh
Author: Dr P J Suresh

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