Dr SKANDHAN. S. KUMAR (Assistant professor, Department of Organon of medicine, Father Muller Homeopathic Medical college & Hospital Mangalore)
Dr Prashantgouda Patil (PG Scholar -MD – I (2018-19 Batch) Department of Organon of Medicine) Father Muller Homoeopathic Medical College and Hospital, University Mangalore.
According to Hahnemann when man falls sick he becomes as a whole, and we have to study his symptoms as a whole and remove his disease as a whole. Hahnemann writes that it is the totality of symptoms- and not a few symptoms however prominent or painful they may be should be noted by the physician as the object of his treatment.1
Hypothyroidism is the most common endocrine disease that is seen in the clinical practice especially in females. Hypothyroidism is a condition in which the thyroid gland doesn’t produce enough of certain crucial hormones. The main causes are autoimmune diseases, iodine deficiency, pregnancy, stress and sedentary life habits.2
A 50-year female came with the complaints of glandular swelling at neck for past 2 years which is painless and also complains of cough which aggravates during change of weather. She also complaints of occasional weakness with this.
Past history: Nothing significant
Family history: Mother had thyroid problems
Treatment history: Allopathic medicine for the presenting complaint
No other significant history
Patient as a person:
Appearance: moderately built and nourished.
Cravings: salty food3, spicy food3
Bowel habit: regular, no difficulty
Bladder habit: regular, no difficulty
Thermals: hot patient
General physical examination:
Moderately built and nourished
Well oriented with time, place and person.
No pallor, cyanosis, clubbing, icterus, oedema and lymphadenopathy.
Temp: afebrile at the time of examination.
BP: 120/80 mmHg
Pulse rate: 72bpm
Swelling around thyroid gland
Diagnosis of the case: Hypothyroidism
Life space analysis:
Patient hails from a middle socio-economic background. Father was a Cooli worker and mother a housewife. Father died at very early age due to cancer. and further her mother took the responsibility of the house, she was doing housemaid work and taking care of family. She has one elder brother. Her childhood was uneventful and studied up to 5th std. She was an a dull student at school and due to financial difficulty and since childhood she says she was very sensitive in nature and weeps easily , she discontinued her studies her brother started working in Bombay and was taking care of house and meanwhile she was helping her mother at home further she got married at an early age. Her married life was not good according to patient, after she came to know that her husband was a drunkard and for 6 months he will work and further do not work and use money for drinking alcohol she was doing beedi rolling and used to look after her family always after drinking he used to hit her badly and seeing this children used to cry at times I could not control the pain and used to hit him back but again he used to hit me harder she says I cannot bear anyone contradicting me. Later decided to come out of this relationship and further I myself took care of my children and now also I take care of them I do not know where my husband went after that whether he is alive or even dead also. I have one son and two daughters. my son is now working and he is taking care of me and my daughters got married and they are leading a happy life I get tears when I think about my past but also feel happy about myself that how I overcame this problem.
Patient as a person:
As a person, she is very reserved by nature but very talkative to close ones only, doesn’t express her emotions easily but sensitive. She is anxious about her children’s future. She likes company and hates consolation. Talkative in nature and sensitive in nature doesn’t want to have any deep relationships with anyone always maintains a superficial relationship with others.
Mental generals Physical generals Characteristic particulars
Consolation aggravation Cr- salt3, spicy food3
Hot patient swelling around neck painless2
4/4/2018- THYROID PROFILE
• T3- 100ng/dl
• T4- 6.4 µg/ dl
• TSH- 10.26µIU/ml
Prescription (14/4/2018) For 2 weeks
1. Natrum mur 10 M (1P) EMES
2. Thyroidinum 6c 3-3-3-3
1. 28/4/2018 – Complaints were better
1. SL 3Pkts(1P weekly EMES)
2. Thyroidinum 6c/ 3-3-3-3 x 3wks
2. 16/5/2018 – Complaints were better
1.Nat mur 200 4P (1P weekly once)
2. Thyroidinum 6c/ 3-3-3-3 x 1 month
3. 14/6/2018 – Complaints were better
1. SL Pkt 4P (1P weekly once)
2. Thyroidinum 6c/ 3-3-3-3 x 1 month
4. 28/7/2018 – Wants same medicine
Repeat as per 14/6/2018 x 6wks
5. 15/9/2018 – Complaints better. All generals good.
Adviced for Thyroid profile.
Rx Repeat as 14/6/2018 x 10wks
1.Nat mur 200 4P (1P weekly)
2. Thyroidinum 6c/ 3-3-3-3 x 4wks
7. 29/12/2018 – All complaints better.
Repeat as per 1/12/2018 x 3months
8. 20/4/2019 All complaints better.
Repeat as per 1/12/2018
9. 4/5/2019 – Complaints are better, wants same medicine.
Repeat as per 1/12/2018 x 3wks
10. 1/6/2019 – C/o eruptions on B/L arms, neck and back since 15 days <after bath
1. Nat mur 6x 2-0-2
2. Thyroidinum 6c/ 3-3-3-3 x 3 weeks
11. 29/6/2019 – Complaint completely better. No new complaints.
1. SL Pkt 1P EMES
2. Thyroidinum 6c 3-0-3
3. 5 Phos tab 1-1-1
To understand what kind of illness a person is actually suffering from, there should always be a in depth case taking and that is always the base of case taking and as we all know it should be strong to construct anything and the strong base in this case is the life space analysis from which could go into the core of the patient and construct the similimum.
The reaction of an individual to stress and strains varies from person to person. To know about the patient’s reaction pattern physicians must first give importance to the life situations of the patient and the relation between the body and mind should be clearly known. Mr. MD Rafi says about the mind like — the mind is termed as a mirror which gives us a true picture of the sick, whatever may be the cause of the disease.3
Role of mental plane A healthy mind should be characterized in its functions and actions from the following three qualities: clarity, coherence, and creativity. The practice of selfishness and acquisitiveness are the major factors that derange the mind.
Role of emotional plane This plane is ill to the extent that the person maintains within himself, is trapped by himself within, and expresses negative feelings, as envy, irritability, anguish, fanaticism, sadness. If the individual can free himself from such “passions” then he can be healthy4.
This case gives the complete picture of constitutional approach to thyroid disorder with Homoeopathy with the evidence as its base.
1. Sarkar B.K. Hahnemann’s Organon of Medicine. 6th edn. Kolkata : M. Bhattacharya & Co. Private Ltd; 1980. 89-90, 298 p.
2. Park K. Park’s Textbook of Preventive and Social Medicine. 22nd edn. Jabalpur, India : M/S Banarasidas Bhanot Publishers; 2013. 369 p.
3. 5.Rafi Ahmed M.D. Mind gives the key [NJH] Vol I Sep, 1992. Dharmasastra Press, New Bombay.
4. Vithoulkas G. The Science of Homoeopathy. Reprint ed. New Delhi: B. Jain Publishers Pvt. Ltd; 1993. p 21, 23, 25, 27, 42.