Abstract
Gout has increased in frequency among people all over the world over the last few decades. It usually develops in middle age, but it can also affect younger people. Women typically don’t develop gout until after menopause. Urtica urens are best indicated in case of gout with burning, stinging Pains in the joints, along with the itching and swelling. In the “Prescriber”, the treatment of gout by Dr. JC Burnett is mentioned as “tincture of 5 drops of Urtica urens in warm water in 2-3 hours gap can produce the urine dark loaded with uric acid”. Dr. JC Burnett in his experiments found the impact of Urtica urens in reducing the uric acid level in the body.
Case summary: This case was treated with individualised homoeopathic medicine at the OPD of RBTS GOVERNMENT HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, MUZAFFARPUR, and BIHAR. A 70 year old female presented with complaints of itching eruption on both palms with pain from fissures for 3 years. Homoeopathic medicine sulphur was given to the patient on the basis of individualistic approach. The patient improved in his presenting complaints as well as the patient mentally also feeling better. This case report suggests that a correctly choosen homoeopathic medicine can be beneficial in the treatment of Gout.
Keywords: Homoeopathy, gout, individualisation, Urtica urens
Abbreviations: OPD: outpatient department
Introduction
Gout is a type of inflammatory arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then resolve. Gout flares often begin in your big toe or a lower limb. Gout happens when high levels of urate build up in your body over a long period of time, which can then form needle-shaped crystals in and around the joint. This leads to inflammation and arthritis of the joint. When the body makes too much urate, or removes too little, urate levels build up in the body. However, many people with high levels of serum urate will not develop gout.
Areas of the body that can be affected by gout include:
- Joints.
- Bursae, cushion-like sacs between bones and other soft tissues.
- Tendon sheaths, membranes that surround tendons.
- Kidneys, because the high uric acid levels can lead to stones.
Gout is a disease that can move through several stages:
- Hyperuricemia, when you have elevated levels of urate in your blood over a long period of time and even crystals in the joint, but you do not have symptoms.
- Gout flares, when you have periodic attacks of intense pain and swelling in your joints.
- Interval or intercritical gout, which is the time between gout attacks when you do not have any symptoms.
- Tophi, a late stage of gout when crystals build up in the skin or other areas of the body. Depending on their location, tophi can permanently damage your joints and other internal organs such as the kidneys. Proper treatment can prevent the development of tophi.
Miasms are thought to be the root cause of every disease, including hyperuricemia which can be thought of under sycotic miasm . Miasms set the body up for a particular disease. Due to uric acid or lithic diathesis, the patient develops hyperuricemic symptoms and a tendency to build up uric acid crystals in his body, which is a constitutional dyscrasia.
Indications of Urtica urens :
Through the posterior spinal ond organs, Urtica has four special centers of action:
I. SKIN. Edema; Erysipelatous Inflammation; Urticaria.
II. MUCOUS MEMBRANES. Gastro-Intestinal Inflammation.
III. GLANDULAR SYSTEM. Increased Secretion of Milk.
IV. VASO-MOTOR SYSTEM. Stimulated.
Skin. This is the grand center for the action of Urtica urens. When taken internally, or applied locally, Urtica produces an inflammation very similar to nettle-rash, with great oedema, the least puncture causing serum to follow, with suppression of urine. In one case of poisoning, it caused: “Pricking heat, numbness, burning of the skin of the face, arms, shoulders, and breast; eyes puffed, odematous; on the lips, nose, and ears, vesicular eruption; speech became difficult, with extreme anxiety; followed by desquamation.”-J. G. Howard, M. D.
Mucous Membranes.-Here it produces gastro-enteritis, dysentery, nausea, vomiting, with fainting, and inflammation of the genito-urinary organs.
Glandular System- On the mammae, Urtica has a specific action. In a case cited by Dr. J. G. Howard, milk was re-established in the woman’s breast three years after the birth of the last child, although she never had been able to suckle, no milk having been secreted after labor. The breasts were greatly swollen, dis- charged at first serum, afterward perfect milk for eight days, in large quantities. It has also been reported to have cured goiters.
Therapeutic Individuality.
Skin. The chief use of Urtica is found in the treatment of urticaria, where the skin becomes elevated, with a white central spot and a red areola, attended by stinging, burning pains, and requires to be rubbed all the time. (Internally and as a cerate.) When the eruption looks pale like the stings of nettles, and re- quires to be rubbed all the time, Urtica is of great value.
“As soon as she lay down again, eruption and itching disappared entirely, and reappeared immediately after rising again. Will only cure when this symptom is prominent.”-Dr. Chapusat
“The upper part of the body enormously swollen, pale, and dropsical, and covered with confluent, small, transparent vesicles, filled with serum and sudamina.” Dr. King.
In anasarca and dropsy following scarlatina, where the kidneys are involved, with excessive odema of the foot. It is the most useful remedy we have for scalds and burns, where the tissues are not too much destroyed.
CASE REPORT
Case history:-
A 70 years old, Hindu female reported in the surgery out patient department of RBTS Government Homoeopathic Medical College & Hospital, Muzaffarpur, Bihar on 20/09/2024 with a complaint of pain on right sides of joints mostly on knee and shoulder joints; small joints also affected. Stitching pain on forehead region with burning sensation on face; itching on genital part which aggravate from contact of urine; pain of joints aggravation from cold.
Past History –jaundice at age of 16 years
Family history- Mother- N/S Father – N/S
Personal history – Took allopathic medicine and used ointment for the treatment of palmar eczema
PHYSICAL GENERAL
- Outlook -lean and thinÂ
- Tongue – MoistÂ
- Thirst – 3-4 LiterÂ
- Appetite – GoodÂ
- Perspiration – Profuse from whole body
- Thermal – chilly
- Desire – Salt
- Aversion – Not specificÂ
- Stool- Sometimes constipatedÂ
- Urine -Normal
- Sleep – SoundÂ
- Dream – Not specific Â
Mental general
When I went through the mental symptoms there is nothing specific I found the patient was quite well sound minded and happy like to live with their family that is normal.
Provisional diagnosis
Gout
Figure 1 BEFORE TREATMENT
Figure 2 AFTER TREATMENT
Totality of symptoms
- Pain on right sides of knee and shoulder joints.
- Pain on small joints
- Stitching pain on forehead region
- Burning sensation on face
- Aggravation from cold
- Itching on genitals parts aggravate from urine contact
- Itching on anal region
- Burning sensation on shoulder region
Analysis and Evaluation of Symptoms with Miasmatic Analysis
| S. NO | SYMPTOMS | ANALYSIS | EVALUATION | MIASMATIC ANALYSIS |
| 1 | Pain on right sides of knee and shoulder joints | Particular general | ++ | Psora |
| 2 | Pain on small joints | Particular general | +++ | Psora |
| 3 | Stitching pain on forehead region | particular general | +++ | Psora |
| 4 | Burning sensation on face | Particular general | +++ | Psora |
| 5 | Aggravation from cold | Physical general | ++ | Syphilitic |
| 6 | Itching on genitals parts aggravate from urine contact | Particular general | ++ | Psora |
| 7 | Itching on anal region | Particular general | +++ | Psora |
| 8 | Burning sensation on shoulder region | Particular general | ++ | Psora |
| 9 | Desire for salt | Physical general | ++ | Sycotic |
Repertorization sheet
Figure: 3 Repertorisation from complete repertory
Repertorial analysis:-
Urtica urens:- 36/12
Sulphur:- 32/9
Lycopodium:- 31/9
Causticum:-31/8
Ferrum met:- 30/9
Repertorial selection:-
As urtica urens covers maximum numbers of symptoms and got highest marks. After consulting with materia-medica, urtica urens was choosen for prescription.
Therapeutic intervention:-
After detailed case taking on a standard case taking performa, the totality of symptoms was built for patient based on mental generals, physical generals, constitution, miasmatic background, past history etc. as per the homoeopathic principles.
After repertorisation, the top medicines were urtica urens, Sulphur, lycopodium,causticum, ferrum met came. After carefully analysing the mental and physical generals of patient, considering the repertorial result and referring back to homoeopathic MM, a similimum was prescribed. Individualised homoeopathic treatment was started with six doses of urtica urens 200 by following the law of minimum dose.
Prescription –
Urtica urens 200/6 dose /4 GLOUBLES were given on the first visit in an empty stomach early in the morning on date -20/09/2024
Follow up
| Date of visit | Change of symptoms | Medicine/ dose/potency | Justification |
| 30/09/2024 | Decreased in pain of joints and forehead | Rubrum200/6 dose/4globules | Wait and watch for following improvement |
| 8/10/2024 | Pain decreased others symptoms also subsided | Rubrum200/6 dose/4globules | Marked improvement |
CONCLUSION
Here from this case I concluded that In case of Gout Urtica urens is being effectively used with good results without any harm. With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis. Many people avoid gout flares and can decrease the severity of their symptoms, and can even become gout free after the homoeopathic treatment and avoids the complications. In this case case on the basis of individualisation of the patient by proper case taking; single homoeopathy medicine cured the case without any complication in easily comprehensible principles.
BIBLIOGRAPHY
- Kasper, Dennis, et al. Harrison’s principles of internal medicine, 19e. Vol. 1. No. 2. New York, NY, USA: Mcgraw-hill, 2015.
- Walker, Brian R., and Nicki R. Colledge. Davidson’s principles and practice of medicine e-book. Elsevier Health Sciences, 2013.
- Kent, James Tyler. Lectures on homoeopathic philosophy. B. Jain publishers, 2003.
- Roberts, Herbert A. The Principles and Art of Cure by Homoeopathy: A Modern Textbook. B. Jain Publishers, 1997.
- Boericke, William. Pocket Manual of Homoeopathic Materia Medica & Repertory: Comprising of the Characteristic and Guiding Symptoms of All Remedies (clinical and Pahtogenetic [sic]) Including Indian Drugs. B. Jain publishers, 2002.
- Complete repertory
- Kent, James Tyler. Repertory of the homoeopathic materia medica. B. Jain Publishers, 1992.
