Dr Sayani Ghosh.(1) Dr Ramkrishna Chatterjee.(2) Dr Jaharlal Barman.(3)
1.PGT Dept of Materia medica of D.N.DE Homoeopathic Medical College & Hospital.
2.Former House-Staff Dept of Medicine of D.N.DE Homoeopathic Medical College & Hospital.
3.MD(HOM), Former PGT Dept of Materia medica of D.N.DE Homoeopathic Medical College & Hospital.
A 25 year old man presented to the homoeopathic opd with pleural thickening. He has recurrent h/o common cold which was treated with several antibiotics and allopathic medications and got recovered from the common cold infections and chest pains but, in the last occasion he developed chest pain along with crackling sound during respiration and breathing distress and at this point, he was treated with constitutional homoeopathic medicine over 1 year. Treatment was started with Radium bromide and later switched to Calcarea Carb. Subsequently, recovery ensued and at the end of the treatment he is cured of his ailments. This case shows the positive role of classical homoeopathic treatment on pleural thickening.
Keywords: Pleural thickening, Homoeopathy, Radium Bromide, Calcarea carbonica.
Pulmonary fibrosis or pleural thickening exemplifies many of the typical features of intestinal lung disease. The Epstein-Barr virus and exposure to metal and wood dusts have been reported to be associated with the disease. It has an incidence of 6-10 per 100000 per year and is about twice as common among cigarette smokers as in non-smokers. Men are also more commonly affected than women.1
Macroscopically, the lungs show sub pleural fibrosis, predominantly in the lower lobes and basolateral pleural regions. Microscopically, there is architectural disruption with temporal heterogenecity and characteristic fibro proliferative lesions representing the site of healing alveolar injury. There is variable mononuclear cell infiltration of
the alveolar walls, fibrosis and smooth muscle proliferation.
Progressive exertional breathlessness is usually the presenting symptom, often accompanied by persistent dry cough.1 Others symptoms are
- Unexplained weight loss
- Aching muscles and joints
- Widening and rounding of the tips of the fingers or toes (clubbing)
Pulmonary fibrosis scars and thickens the tissue around and between the air sacs (alveoli) in your lungs. This makes it more difficult for oxygen to pass into your bloodstream. The damage can be caused by many different factors — including long-term exposure to certain toxins, certain medical conditions, radiation therapy and some medications.
Occupational and environmental factors2
Long-term exposure to a number of toxins and pollutants can damage your lungs. These include:
- Silica dust
- Asbestos fibers
- Hard metal dusts
- Coal dust
- Grain dust
- Bird and animal droppings
- Although pulmonary fibrosis has been diagnosed in children and infants, the disorder is much more likely to affect middle-aged and older adults.
- Idiopathic pulmonary fibrosis is more likely to affect men than women.
- Far more smokers and former smokers develop pulmonary fibrosis than do people who have never smoked. Pulmonary fibrosis can occur in patients with emphysema.
- Certain occupations.You have an increased risk of developing pulmonary fibrosis if you work in mining, farming or construction or if you’re exposed to pollutants known to damage your lungs.
- Cancer treatments.Having radiation treatments to your chest or using certain chemotherapy drugs can increase your risk of pulmonary fibrosis.
- Genetic factors.Some types of pulmonary fibrosis run in families, and genetic factors may be a component.
A 25 year old, Hindu, male presented at opd with mild fever, pain in vertebral column, chest pain along the line of scapula at a certain peak of respiration and a crackling sound during respiration, associated with a constricted feeling in the chest especially in the early morning which automatically subsides in the daytime.
Past history of present complaint :
For the last two years, i.e. before the development of the recent complaint patient used to suffer from recurrent common cold infections with mild chest pain sometimes. So, the patient was treated with courses of antibiotics on various occasions and got recovered from the then complaints.
Finally, when the patient came to us we suggest him to do a chest X-Ray both PA and Lateral view which revealed pleural effusion on right lung and later, HRCT of chest confirmed it to be a case of pleural thickening.
Past history of :-
Reactive Arthritis about 2-3 years before the present complaint developed. History of chicken pox 4-5 years back. History of repeated occurrence of urticaria especially in the rainy season. Measles about 4-5 years back.
Grandfather (paternal) – Bronchial Asthma, Grandfather (maternal) – BHP, Father – BHP, HTN, DM, Mother – HTN.
Patient was extremely anxious about his disease. Hesitated to take decision with lack of self-confidence. He was also forgetful. He was timid in nature. Idle.
Patient was fatty. He was also complaining of foul smelling sweat in both the soles especially in winter and drenching sweat especially about the head in the summer. Patient had a great tendency to take cold easily. Used to suffer from constipation. could not tolerate cold and wet weather.
Clinical findings and diagnostic assessment:
On previous Chest X-Ray, diffuse right pulmonary capacities in the lower lobes.
Blood test revealed increased ESR, CRP.
Therapeutic interventions, follow up and outcome:
Radium Bromide was prescribed as per the present complaint of chest pain and pain in vertebral column with a history of reactive arthritis. Later, Calcarea carb was given on the basis of individualisation, symptom totality and miasmatic analysis following the holistic concept of homeopathy. In this case Detailed follow up is summarised in bellow
Date of first visit and follow-up visits/Symptoms and criteria for prescription/Medicine and doses
Constricting chest pain, mild fever, crackling sound during respiration, along with pain in vertebral column with a previous history of rheumatic disorder (reactive arthritis).
Radium Bromide 200 – BD x 2days.
Fever relieved, pain in vertebral column diminished, frequency of chest pain and crackling sound during respiration diminished.
Rubrum sulph 200 – BD x 7 days.
All the complaints remained diminished as before, but not improved much more than the first occurrence.
Radium Bromide 200 – BD x 2 days.
All the complaints were improving.
Phytum sulph 200 – BD x 14 days.
Chest pain during respiration used to occur at certain intervals, past h/o ineffective diseases & repeated urticaria (which was cured by Dulcamara and later by Calcarea carbonicum), offensive foot sweat with drenching head sweat with a family history of lung diseases.
Calcarea carbonica 200 – OD x 2 days.
Calcarea carb 200 – OD x 2 days
Not so much improved. (Retaking of case history)
Calcarea carb 1M – OD
Pleural thickening or pleural fibrosis is an incurable condition1. But, with the proper homeopathic medicine we can restrain further progress of the disease and can wipe out the tendency lurking in the background which might cause more virulent outbreak of the disease in future.
1. Haslett C. Chilvers E. R. Nicholas A.B. Colledge N.R. Davidson’s Principles & Practice Of Medicine. 19th Ed. Elsevier Limited; 2002. P555-556
2. Pulmonary Fibrosis. Available from: https://www.mayoclinic.org/diseases-conditions/pulmonary-fibrosis/symptoms-causes/syc-20353690?p=1