
Abstract
The term “psycho” refers to the mind, and “soma” refers to the body. Therefore, a psychosomatic disorder is a condition that involves both the mind and the body. This dualism, or separation between mind and body, is evident in how diseases are traditionally categorized among medical specialties and how healthcare institutions are structured.
In the traditional medical model, different specialties focus on specific body systems or organs, often separating mental health from physical health. Hospitals and medical facilities may also have separate departments for physical health and mental health, further reinforcing this dichotomy. This is the case of early onset of psoriasis, was improved as per modified Naranjo Criteria & clinical evidence of gradual decrease of itching and thickness in the skin of knee and leg region after administration of individualized homoeopathic medicine Nat. mur. followed by Sulphur.
Keywords: psychosomatic, psycho, soma, homoeopathy, health, individualized
Introduction
The term ‘Psychosomatic’ originates from the Greek words “psyche” (mind) and “soma” (body), signifying the close relationship between the mind and body. A psychosomatic disorder is a condition that involves both psychological and physical aspects. Mental and emotional factors can act as risk factors, influencing the onset and progression of physical diseases. Homoeopathy, a system of alternative medicine, is based on the principle that “like cures like.” It uses highly diluted substances to stimulate the body’s natural healing abilities. According to homoeopathic philosophy, when an individual is cured using homeopathic remedies, not only physical symptoms improve but also the deeper aspects of their being, including the will, understanding, and rational mind are balanced. This leads to an improvement in mental and moral spheres, resulting in better physical health and increased resistance to various diseases. The transition is from constitutional weakness and suffering to a state of health and comfort. Homoeopathic pioneers have also expressed their views on psychosomatic disorders. They believed that treating the underlying emotional and psychological imbalances could lead to significant improvements in physical health. It is essential to consult with qualified homoeopathic practitioners or healthcare professionals to explore personalized treatment options for psychosomatic disorders based on individual needs and medical history1.
Diagnosis of Psychosomatic Diseases
The diagnosis of psychosomatic disease requires the presence of clearly defined signs and symptoms consistent with each diagnostic category. Reliance upon the total clinical examination, including an adequate history, review of systems, psychiatric assessment, and clinical judgment, is more valid than reliance upon any single laboratory or diagnostic test. Till date in conventional medical system there is no clear test to differentiate organic and psychological diseases. But Hahnemann in 1810 itself made a clear distinction between them. In fact, he prescribed psychotherapeutic techniques. In paragraph 224 he recommends “If the mental disease …be still somewhat doubtful whether it really arose from a corporeal affection or… result from faults of education, bad practices, and corrupt morals, neglect of the mind, superstition or ignorance. The mode of deciding this point will be, that if it proceed from…the latter causes it will diminish and be improved by sensible friendly exhortations, consolatory arguments, serious representations and sensible advice. …whereas a real moral or mental malady, depending on bodily disease, would be speedily aggravated by such a course, the melancholic would become still more dejected, querulous, inconsolable and reserved, the spiteful maniac would thereby become still more exasperated, and the chattering fool would become manifestly more foolish.2
CASE HISTORY
Patient information
A 20 year old boy had complained on 15/09/19 of whitish dry scaly eruption on legs, palm, knee, and feet, behind the ears, back of neck and at the region of hip for 2 years. The eruptions were thickened and had dark red margins and sometimes when the scales were removed, especially on the knee, bleeding occurred and the complaint spread rapidly. There were occasional itching present which were aggravated during summer and ameliorated from cold application.
History of present complaint:It was initially treated by Allopathic drugs and ointments but without any relief and the complaint gradually spread to the whole body.
Past history
There was Jaundice, Suppressed skin disease, chicken pox.
Family history
Psoriasis and Diabetes- to his mother.
Addiction
Nothing as such found.
Physical generals:
- Hot patient
- Cannot tolerate heat even sun heat of winter season.
- Great desire of sweet.
- Easily prostrated.
- Stool constipated; dry, hard, difficult to pass and smarting after passing stool.
- Had tendencies to take cold easily.
- Perspiration scanty though with offensive odour and blackish staining on clothes.
Mental Generals:
- Introvert patient and had strong aversion towards consolation, cannot tolerate any consolation from anyone.
- Sad and depressed with vexation.
- Likes to make drawings when he is alone.
Origin of development of the disease:
In searching for the development of the case an incident of emotional upset was found around 2 and a half years ago which he was unable to express to anyone and everyday he used to brood for the incident; was constantly in a depressed mood but didn’t share the incident to anyone. The patient was by nature an introvert but was very cheerful in his daily life, but after that incident he gradually became irritable and later developed vexation. Gradually day by day he became more closed mouth person, always preferred to stay alone, to not talk to anyone and most of the time kept himself alone in the room by shutting the door. His parents were greatly upset with these. Gradually the patient started from suffering with headache and indigestion for which he took allopathic drug and after that, few days later he developed the skin complaint.
Particulars:
- Dry scaly eruptions in leg of right side.
- Itching and burning were also present on affected area.
- Itching and burning aggravated during summer and ameliorated after cold application.
Evaluation of symptoms:
- Introvert patient and had strong aversion towards consolation, cannot tolerate any consolation from anyone.
- Sad and depressed with vexation.
- Likes to make drawings when he is alone.
- Cannot tolerate heat even sun heat of winter season, hot patient.
- Great desire of sweet.
- Stool constipated; dry, hard, difficult to pass and smarting after passing stool.
- Perspiration scanty though with offensive odour and blackish staining on clothes.
- Dry scaly eruptions in leg of right side.
- Itching and burning were also present on affected area.
- Itching and burning aggravated during summer and ameliorated after cold application.
Treatment and Management
On the basis of totality of symptoms and final consultation with material medica, Nat. Mur 0/1 was selected once in a day for 14 days 15/09/2019.The medicine prescribed was Natrum muriaticum in LM potencies from 0/1 to 0/15 with occasionally Sulphur 30 was used for 2 times and Sulphur 200 was given once as an intercurrent.Advised to maintain proper personal hygiene.
DATE | FOLLOW UP | PRESCRIPTION |
29-09-2019 | After 14 days itching and burning sensation in knee and leg was slightly better. | Nat. Mur 0/2Followed by Nat. mur 0/3 |
03-11-2019 | The thickened eruptions with dark red margins were slightly decreased, bleeding occurred but the rarely. | Nat. mur 0/4Followed byNat. Mur 0/5 |
01-12-2019 | Condition stand still | Sulphur 30; 1 dose |
15-12-2019 | Scaly dandruff was still present but itching and burning sensation in scalp is slightly improved. | Nat. mur 0/6Followed byNat. Mur 0/7 |
12-01-2020 | Markedly improved of the symptoms. | Nat. Mur 0/8Followed byNat. Mur 0/9 |
09-02-2020 | Patient was better after medication. | Nat. Mur 0/10Followed byNat. Mur 0/11 |
08-03-2020 | Condition stand still | Sulphur 30; 1 Dose |
05-04-2020(From this date prescription was made virtually and over phone) | Patient was feeling better after medication; no new complaints physically and mentally | Nat. Mur 0/12Followed byNat. Mur 0/13 |
03-05-2020 | Normal skin colour appears in some places and mentally feels better. | Nat. Mur 0/14Followed byNat. Mur 0/15 |
31-05-2020 | Patient feels mentally and physically better. No brooding was found. | Sulphur 200/ 1dose |
28-06-2020 | Markedly improved of the symptoms with no new complaints. | Placebo 200 |
Follow up
The patient now has the only few whitish spots here and there but with no thickened skin or itching or scaling or any other complaint with that regards.
Modified Naranjo’s criteria
Sl. NO. | DOMAIN | CASE 1 |
1 | Was there an improvement in the main symptom or condition for which the homeopathic medicine was prescribed? | +2 |
2 | Did the clinical improvement occur within a plausible timeframe relative to the drug intake? | +1 |
3 | Was there an initial aggravation of symptoms? | 0 |
4 | Did the effect encompass more than the main symptom or condition (i.e., were other symptoms ultimately improved or changed)? | +1 |
5 | Did overall well-being improve? (Suggest using validated scale) | +1 |
6 A | A Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease? | +1 |
6 B | Direction of cure: did at least two of the following aspects apply to the order of improvement of symptoms: –from organs of more importance to those of less importance? –from deeper to more superficial aspects of the individual? –from the top downwards? | +1 |
7 | . Did “old symptoms” (defined as non-seasonal and non-cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement? | 0 |
8 | Are there alternate causes (other than the medicine) that—with a high probability— could have caused the improvement? (Consider known course of disease, other forms of treatment, and other clinically relevant interventions) | +1 |
9 | Was the health improvement confirmed by any objective evidence? (e.g., laboratory test, clinical observation, etc.) | +1 |
10 | Did repeat dosing, if conducted, create similar clinical improvement? | +1 |
TOTAL SCORE | +10 |
Total score = 10
As the total score is ‘10’ so causal attribution is definite and improvement is solely due to homoeopathic medicines.
Discussion
Homoeopathy is a system of medicine which deals with a holistic approach in the treatment of sick individual. In Homoeopathy, detailed case taking is done to find out the constitutional makeup of the patient. Finally, a single medicine with minimum dose is selected on the basisof totality of symptoms. At the first instance, the present case appeared to be a case of Psoriasis. After considering the totality of symptoms, homoeopathic medicine Nat. mur 0/1 was selected as similimum. When prescribed in appropriate dose, it resulted in healing with a very reliable manner. Homoeopathy treatment is very commonly sought generally towards the terminal stages of incurable diseases. This case report is an evidence in preclinical condition highlights the use of Homoeopathy right from the beginning of disease.
Conclusion:
Natrum muriaticum has been used as a drug for several skin complaints vastly but in this case the medicine was chosen principally observing the developmental of psychic state after that emotional upset and from that gradually development of physical complaints. The improvement made by prescribing Natrum muriaticum in this case signifies the importance of psychic factor in development of physical ailments and whenever we are dealing a case according to our Homoeopathic law and principles we should enquire if the case was of a mere physical ailments or the case is a Psychosomatic; as this particular case was. So, this case shows us a wonderful evidence of cure by homoeopathic treatment of psychosomatic disorder.
References
1. Ramakrishnan, Vivek & Samaran, Dr. (2020). Concept of psychosomatic disorders in homoeopathy: A review. International Journal of Homoeopathic Sciences. 4. 10.33545/26164485.2020.v4.i2c.161.
2. Hahnemann S. Organon of Medicine. Reprint Edition. Indian Books and Periodicals Publishers; 2004. P.142,143,146.