ABSTRACT
A case report of a female aged 44 years diagnosed with haemorrhagic cyst in ovary was cured by homoeopathic treatment based upon individualisation of the patient.
KEYWORDS
haemorrhagic cyst, homoeopathy, individualisation, Colocynthis.
ABBREVIATIONS
HOC – Haemorrhagic ovarian cyst
TDS – thrice a day
ICD – international classification of diseases
Sept – September
Oct- October
Nov – November
Dec- December
Jan – January
Feb – February
Mar – March
Apr – April
Jun – June
INTRODUCTION
Haemorrhagic ovarian cyst (HOC) is an adnexal mass formed because of occurrence of bleeding into a follicular or corpus luteum cyst. Haemorrhagic cysts are commonly seen in clinical practice because haemorrhage into a cyst is usually painful, triggering the patient to consult her physician. They can present with variable clinical symptoms and signs ranging from no symptoms up to acute abdomen. (1)
CASE
CHIEF COMPLAINTS
A 44 years old female patient came with continuous, dull, aching, stinging pain in lower abdomen especially in the centre of pelvis since one month which aggravated during menstrual cycles.
HISTORY OF PRESENT ILLNESS
Patient had continuous pain in lower abdomen two and a half years ago due to which she went to a general allopathic physician who advised her for an ultrasound scan of lower abdomen. After which he gave her some medications which relieved her symptoms and finally after a span of 3 months, the right haemorrhagic cyst was gone. But after a span of 3 months, her menstrual cycle which was earlier of 7 days reduced to 4 days and the bleeding which was earlier very heavy was reduced. Menses became painful. The pain aggravated while passing urine and stools and while thinking of it.
Then again after a span of two years, she had continuous pain in lower abdomen for one month after which scanned her abdomen which showed left haemorrhagic cyst.
ASSOSCIATED COMPLAINTS
There was distention of abdomen since 2014. The stomach felt heavy; aggravated by little eating. Sometimes it was so much distended that she could not breathe properly at night, felt that her nose was blocked and had to get up from bed and go outside of the room to get some relief. There were continuous eructations and lot of flatulence which was aggravated by eating fast food continuous for 1-2 days. Due to excessive formation of gas, it leads to frequent severe headaches from the centre of head. She had started allopathic treatment of the same since 2018 after which she had got some relief but not cured yet. Used to take Nexpro 40 tablet every morning.
MENSTRUAL HISTORY
She had menarche at the age of 13 years. Her cycle was of 25 days and she had a flow of 4 days. Menstrual blood was dark red, non-offensive, not so profuse and without clots. She had severe pain in lower abdomen during first two days of menses. Pain aggravated while passing stools and urine.
PHYSICAL GENERALS
Her Appetite was good. If not ate food upon time, then there was higher chances of gastric headache and flatulence. She was chilly and thirsty. She had to go for stools 2-3 times in a day. She had a desire for ice.
LIFE SITUATION
She was a teacher. She lived with her husband and 2 kids – 1 girl and 1 boy. She had done double M.A. in English. She had average relations with her husband. She felt neglected and restricted by her husband.
MENTAL GENERALS
She was average in studies. She only studied due to fear of parents. She was non-diligent. But she had a keen interest in teaching since start. She was a hard worker. She mixes up very easily with other people. If anyone did bad to her then initially, she thought to do bad with them but later on leave it upon god. If she has fight with someone then she would not talk for 15-20 days with that person but later on she initiated by herself. She was a courageous woman. She boldly could stand up for right things in front of the authority. She roamed freely and did everything that she wanted to without anyone’s support. If someone spoke rude to her then she got hurt and felt that she does not have any respect. She got angry if someone lied to her, blamed her wrongly or forced her to do something. She easily expressed her anger out. But now she had become more coward. She kept her grudges and feelings inside herself. She avoided fight, did not react back and kept a smile always as she used to cry when alone.
CAUSE
She was given the duty to sell books in school where occurred cash imbalance. 2000 rupees were stolen by principal of the school. It was proven and principal got fired from school by director of school. But after that the staff and teachers of her wing stopped talking to her. She was very upset due to this. She felt bad that her colleagues didn’t show trust upon her and believed the principal who was just appointed 2 months ago.
DIAGNOSIS [4][5]
Haemorrhagic ovarian cyst based upon ultrasound reports.
ICD CODE: ICD-10-CM-N83.2
TOTALITY OF SYMPTOMS
- Chilly
- Thirsty
- Ovarian cyst
- Feels neglected
- Felt disappointed when colleagues did not show trust in her.
- Desires ice
- Continuous pain in lower abdomen
ANALYSIS AND EVALUATION OF SYMPTOMS
| S.NO. | SYMPTOM | EVALUATION OF SYMPTOMS | MIASM[7] |
| 1 | Felt disappointed when colleagues did not show trust in her. | Mental general | Sycosis |
| 2 | Haemorrhagic Ovarian cyst | Pathological symptom | Syphilis |
| 3 | Chilly | Physical general | Sycosis |
| 4 | Thirsty | Physical general | Psora |
| 5 | Feels neglected | Mental general | Psora |
| 6 | Desires ice | Physical general | Sycosis |
| 7 | Continuous pain in lower abdomen | Particular symptom | Sycosis |
– This is a multi-miasmatic case predominating with sycotic miasm.
– Importance is given in this case to the cause and pathology. Why it was started in the first place and what kind of pathology has taken place inside the body.
So symptoms are:
- Felt disappointed when colleagues did not show trust in her.
- Cysts in ovaries
REPERTORIAL TOTALITY
So 2 eliminating symptoms were taken into consideration and repertorisation was done with the help of Complete repertory in ISIS software.
| Symptoms | Rubrics |
| Felt disappointed when colleague did not show trust in her | [C] [MIND]Ailments from disappointment, deception |
| Cysts in ovaries | [C] [FEMALE] Tumors general ovaries cysts |
PRESCRIPTION
Prescribed on 4th September 2020
Colocynthis 1M – 1dose along with placebo- 5 globules Tds x 15 days
On repertorisation, medicines which came up were Lycopodium clavatum, Aurum metallicum, Colocynthis, Lachesis mutus, Apis mellifica, Bryonia alba, Mercurius solubilis, Platina, Arsenicum album and Carcinosinum.
- Lycopodium clavatum was ruled out as Lycopodium clavatum patient would be an intelligent person who would never do mistakes in calculations. He would be ambitious, achiever and good manager.
- Aurum metallicum would have more target action upon bones.
- Lachesis mutus would have been malicious.
- Apis mellifica would have bag like swelling under the lids. There would be retention of fluids and Apis mellifica is not an abdominal remedy. This patient has gastric headache and flatulence.
- Bryonia alba would be more business minded.
- Mercurius solubilis’ reaction to the colleagues would be like if you don’t want to talk to me, then go away, I will on mine way.
- Platina’s reaction to the colleagues would be like if you have stopped talking to me, you will regret one day what you have lost.
- Arsenicum album would be more fastidious kind.
- Carcinosinum is an artistic remedy.
So COLOCYNTH was finally chosen which was constitutionally similar to the patient. Colocynthis has marked abdominal symptoms and continuous pain in abdomen. It is an abdominal remedy. [6]
SELECTION OF DOSE AND REPETITION [3]
As higher potency was chosen based upon the susceptibility of the patient, so single dose was given as per the instructions giving in 245 aphorism in Organon of Medicine. Medicinal dose was only repeated when its action was ceased.
FOLLOW UPS
| Date | Symptoms | Prescription |
| 19 Sept 2020 | The intensity of pain reduced. | Placebo x 4 globules x three times a day x 15 days |
| 5 Oct 2020 | There was no continuous pain | Placebo x 4 globules x three times a day x 15 days |
| 22 Oct 2020 | Pain decreased during menses. | Placebo x 4 globules x three times a day x 15 days |
| 9 Nov 2020 | No as such pain in lower abdomen. Flatulence decreased. | Placebo x 4 globules x three times a day x 15 days |
| 26 Nov 2020 | There was only slight pain during menses. The flow was slightly better. | Placebo x 4 globules x three times a day x 15 days |
| 19 Dec 2020 | Mood was better. | Placebo x 4 globules x three times a day x 15 days |
| 02 Jan 2021 | No complaints as such. | Placebo x 4 globules x three times a day x 15 days |
| 21 Jan 2021 | No as such pain during menses | Placebo x 4 globules x three times a day x 15 days |
| 8 Feb 2021 | Slight gastric trouble after eating junk food. | Placebo x 4 globules x three times a day x 15 days |
| 26 Feb 2021 | Menses were so painful and pain continued even after menses. | Colocynthis 1M – 1 dose Placebo x 4 globules x three times a day x 15 days |
| 13 March 2021 | No continuous pain | Placebo x 4 globules x three times a day x 15 days |
| 1 Apr 2021 | No pain during menses | Placebo x 4 globules x three times a day x 15 days |
| 26 Apr 2021 | No complaints as such. | Placebo x 4 globules x three times a day x 15 days |
| 26 Jun 2021 | In report, no haemorrhagic cysts seen | Placebo x 4 globules x three times a day x 15 days |
BEFORE TREATMENT
AFTER TREATMENT
CONCLUSION
Homoeopathy recognises the individuality of each patient or case. The entire examination of the patient is conducted with a view to discover not only the general or common symptoms of the case by which it may be classified diagnostically and pathologically, but also the symptoms which differentiate the case from others of the same general class. So, in order to reach out to the simillimum to ensure cure, individualisation in each case is very important.
REFERENCES
- Abbas AM, Amin MT, Tolba SM, Ali MK. Hemorrhagic ovarian cysts: Clinical and sonographic correlation with the management options. Middle East Fertil Soc J [Internet]. 2016;21(1):41–5. Available from: https://www.sciencedirect.com/science/article/pii/S1110569015300157
- Isis 2.0
- Das AK. A treatise on Organon of medicine: Part 1. 2nd ed. Kolkata, India: Books & Allied; 2013
- Konar H. DC dutta’s textbook of gynecology. 8th ed. New Delhi, India: Jaypee Brothers Medical; 2020.
- The Radswiki. Hemorrhagic ovarian cyst [Internet]. Radiopaedia. Radiopaedia.org; 2011 [cited 2022 Jan 25]. Available from: https://radiopaedia.org/articles/haemorrhagic-ovarian-cyst
- Phatak SR. Concise Materia Medica of Homoeopathic Medicine. New Delhi, India: B Jain; 2002.
- Vijayakar P. The End of Myasmtion of Miasms. 1st ed. Dadar, Mumbai: Mrs. Preeti Vijayakar; 2006.
ABOUT THE AUTHOR
Manila Gulati
B.H.M.S. (Pb.) M.D. Scholar
SGNDHMC, Ludhiana
