A Case Report of Ganglion Cyst Treated With Homoeopathic Individualised Simillimum - homeopathy360

A Case Report of Ganglion Cyst Treated With Homoeopathic Individualised Simillimum

Homoeopathic Individualised Simillimum

Abstract: A 23-year-old male reported the complaint of ganglion cyst on back of the left hand at the wrist joint with ulcers in mouth and hair fall. After analysing the case individualised homoeopathic medicine, Phosphorus, was prescribed which leads to improvement of symptoms. Homoeopathic treatment has shown favourable results in this case and demonstrates the scope of homoeopathy in such cases.

Keywords: Ganglion cyst, individualised homoeopathic treatment, RADAR (version 10.5.003).

Abbreviations: T.D.S. – thrice a day, cm – centimetre.

Introduction: Ganglion is a tense, cystic swelling and occurs due to myxomatous degeneration of the synovial sheath lining the joint or tendon sheath lining the joint or tendon sheath. They are common around joints because of abundant fibrous tissue. They contain gelatinous fluid (1). They are the most common soft tissue mass found within the hand and wrist, but they are also commonly encountered in the knee and foot. Although the majority of ganglion cysts are asymptomatic, patients may present with pain, tenderness, weakness, and dissatisfaction with cosmetic appearance. They can form at any age, they are most commonly found in women between the ages of 20 to 50. Women are three times more likely to develop a ganglion cyst than men. These cysts are also frequently encountered amongst gymnasts, likely secondary to repetitive trauma and stress of the wrist joint (2).

Case presentation: A 23 year old male reported with the complaint of recurrent round, small, painless lump (size 2 cm) on back of the left hand at the wrist joint since 6 months which is dissolves in 8-10 days automatically but now it present from 15 days. Patient also complaint of falling of hair especially from both sides of head since 1 month and small, red, painless, ulcers in mouth since 5 days. Took several allopathic medicines for ganglion cyst but no improvement could be observed. No significant information regarding family history.

Physical generals: Patient was tall, lean, thin, fair complexion, black hair. Thermal reaction of patient was chilly. He liked sweets and perspiration is scanty.

Mental generals: Patient’s memory is weak, easily forget things and always wants to be alone.

Diagnosis: The diagnosis is done on the basis of morphology of ganglion cysts. Ganglion cysts usually present as firm, well circumscribed, freely mobile masses approximately 1 cm to 3 cm in size. They are often fixed to deep tissue and not to the overlying skin (2).

Table 1: Analysis of symptoms

Characteristic mental general symptoms Characteristic physical general symptoms Characteristic particular symptoms
Wants to be aloneWeak memory Desire- SweetsPerspiration- Scanty Lump (ganglion cyst) on back of the left hand at the wrist jointFalling of hair from both sides of headPainless ulcers in mouth

Table 2: Evaluation and miasmatic analysis of symptoms(3)

Symptoms Intensity Miasmatic analysis
Wants to be alone +++ Psora, syphlitic
Weak memory +++ Psora, sycotic, syphilitic
Desire- sweets +++ Psora
Perspiration- scanty ++ Psora
Lump (ganglion cyst) on back of the left hand at the wrist joint +++ Sycotic
Falling of hair from both sides of head ++ Psora
Painless ulcers in mouth + Psora, syphilitic

Conversion of symptoms into rubrics: Reference from Synthesis 9.0 (English) Repertory by Frederick Schroyens using RADAR (version 10.5.003)(4) .

Table 3: Repertorial totality(4)

Symptoms   Chapter Rubrics
Wants to be alone Mind COMPANY, aversion to
Weak memory Mind MEMORY, weakness of memory
Desire- Sweets   Generals FOOD and DRINKS, sweets, desire
Perspiration- Scanty Perspiration SCANTY, sweat
Lump (ganglion cyst) on back of the left hand at the wrist joint Extremities GANGLION, Wrist, on
Falling of hair from both sides of head Head HAIR – falling – Sides
Painless ulcers in mouth Mouth ULCERS – painless

                                   Figure 1: Showing repertorisation chart

Justification of remedy: After taking a detailed case history and repertorisation, Phosphorus in 200C potency was given as homoeopathic individualised simillimum. After repertorisation and knowledge of materia medica, Phosphorus, Calcarea carbonica, Lachesis, Kalium carbonicum, Sepia officinalis were the most simillimum remedies. The reason behind selection of Phosphorus was that the patient was tall, lean, thin, so the constitution matches with Phosphorus (5) and thermal reaction was chilly (6). Kalium carbonicum and Calcarea carbonicum both patients are obese (7). Aversion for company present in this patient but in kali carb never wants to left alone (5). Lachesis mutus’s thermal reaction is hot but patient’s thermal reaction was chilly (6). Phosphorus covered more symptoms in comparison to Sepia officinalis. So, Phosphorus was selected. Overall improvement was noticed.

Prescription: Phosphorus 200C / 1 dose/ stat followed by placebo 30 / T.D.S/ 7 days was prescribed on first visit 7th march 2018 considering that the medicine was covering maximum repertorial totality, miasmatic background and physical general and mental general symptoms of the patient.

Table 4: Follow up

DATE OBSERVATION PRESCRIPTION
14/03/ 2018 Ganglion cyst- no improvement, Ulcers – decreased, Hair fall – no improvement Placebo 30 / T.D.S/ 7 days  
22/03/ 2018 Ganglion cyst- slightly decreased, Ulcers – not present, Hair fall – no improvement Placebo 30 / T.D.S/ 7 days  
28/03/2018 Ganglion cyst- decreased, Ulcers – not present, Hair fall – slight improvement Placebo 30 / T.D.S/ 7 days  
04/04/2018 Ganglion cyst- decreased in size but not completely dissolve Ulcers- not present, Hair fall – improvement Phosphorus 200/ 1 dose/ stat Placebo 30 / T.D.S/ 7 days  
13/04/2018 Ganglion cyst- very much decreased, Ulcers- not present, Hair fall – improvement Placebo 30 / T.D.S/ 7 days  
21/04/2018 Ganglion cyst- not present, Ulcers- not present, Hair fall – significant improvement Placebo 30 / T.D.S/ 7 days  
28/04/2018 Ganglion cyst and ulcers – totally removed, No hair fall Placebo 30 / T.D.S/ 7 days  
05/05/2018 No complaints Placebo 30 / T.D.S/ 7 days  
11/05/2018 No complaints Placebo 30 / T.D.S/ 7 days  

Discussion: The remedy Phosphorus has significant role on ganglion cyst. According to Boericke, Phosphorus should not be repeated too low or in too continuous dose (5), so in this case one dose stat was prescribed on first visit and repetition of single dose of Phosphors 200C after approximately 1 month. Patient is followed for a period of 2 months. The detail of follow up is given in table 4. Ganglion cyst slightly improved within first month, followed by overall improvement within 2 months.

Conclusion: Overall the case suggests the usefulness of homoeopathic medicines in the management of ganglion cyst. However, further research like RCT in multi-centric design is required on larger sample size before making firm recommendations.

References:

  1. Manipal. Manipal Manual of Surgery. 3rd edition. New Delhi: CBS Publishers & Distributors; 2010.
  2.  Ganglion Cyst. Roger E. Gregush; Steven F. Habusta. July 20, 2021. https://www.ncbi.nlm.nih.gov/books/NBK470168/
  3. Banerjea Dr. Subrata Kumar, Miasmatic Diagnosis. Revised edition. New Delhi: B Jain Publishers Pvt. Ltd; 2003.
  4. RADAR. Version 10.5.003. Schroyens Frederich, Reportorium Homoeopathicum Synthesis ‘9.1’. 9th edition, reprint edition. New Delhi: B Jain Publishers Pvt. Ltd; 2010.
  5. Boericke W. Boericke’s New Manual of Homoeopathic Materia Medica with Repertory. 3rd revised & augmented edition based on 9th edition. New Delhi: B Jain Publishers Pvt. Ltd; 2016.
  6. Kent J.T. Repertory of the Homoeopathic Materia Medica. 6th American edition. New Delhi: B. Jain publishers Pvt. Ltd; 2005.
  7. Allen H.C. Keynotes & characteristics Rearranged with Comparison of some of the Leading Remedies of the Materia Medica with Bowel Nosodes. 8thedition. New Delhi: B Jain Publishers Pvt. Ltd; 2016.

About the author

Dr Seema Gupta

MD (Hom.)

Assistant Professor

Homeopathy360 Team
Posted By: Homeopathy360 Team