A Case of Hemorrhoids

A 30 year old man who had been suffering from piles for the last 3 years arrived at the homoeopathic OPD for treatment.

Location

Sensation

Modality

Concomitant

1.GIT

RECTUM

2.RS

Bleeding++

Burning Pain++

Pricking++

Bursting +++

Constipation++

Dyspnea++

Straining+3

Coughing++

> Warm

application

> Walking

< Cold damp

weather+3

< Morning

< Dust, fume,

wheat

CASE TAKING

D – Tell me about your dreams?
P – I got dreams of wild animals and they pursue me i.e. lion, tiger and many others.

D – What you feel in your body?
P – Headache and feeling of stretching in my head when I wake up from dream.

D – Whenever you are in stress what you do?
P – My body frightened after dream. Then gradually I become relaxed.

D – What do you experience at that moment?
P – My body became stiff, kadak. (stiff) and akkad (can’t move) and then relax.

D – Stiff, akkad (can’t move)?
P – All muscles became stiff. Then I stretch my body and gradually it became relax. When I go for walk muscles are relax. (hg)

D – Stretching?
P – I feel like my body muscles are strained. My wrist became Kadak (stiff) and tight.

D – Kadak (stiff)?
P – Tight.(hg)

D – At that time what do you experience physically?
P – Trembling.

D – Then what happen?
P – After sometime I relax.

D – Tell me about other dreams?
P – I have only dreams of wild animals and they are pursuing me.

D – What do you experience in the dream?
P – My body becames stiff, kadak (stiff) and akkad (can’t move). I feel stretching sensation in my body. Stretching feeling in my head. There is great Straining of my muscles. I feel relax after walking.

D – Fears?
P – Scared when I go near the cow. Fear that she will hurt me. Recently I am on bike and just passing near cow and was frightened.

D – Frightened?
P – Fear that cow will hurt me.

D – What is your feeling in fear?
P – My body muscles are contracted.

D – What do you feel in that part?
P – Kadak. (stiff)

D – Kadak . (stiff)?
P – Before this we are absolutely normal and suddenly all muscles are come together. There is pressure on my abdomen. Stiffness of my body.

D – What you do at that time?
P – That fear remains for some time and then gradually it goes. Then I become relaxed.

D – When you get angry?
P – When I got angry I use to avoid talking for some time.

D – Tell me one incidence in which you got angry.
P – Once I fight with my trusty. At that time my respiration rate is increase. My body muscles are stiff and I am very anxious.

D – What do you experience physically and mentally?
P – I become much energetic.

D – What do you experience at that moment?
P – I punch my hand on table.

D – What are changes in you?
P – My face muscles are twitching.

FAMILY HISTORY:

Father, Grandfather, Brother, Cousin having asthma.

PHYSICAL EXAMINATION:

P/R examination – Grade 2 internal piles

SYSTEMATIC EXAMINATION:

GIT – Not any abnormality detected

Respiratory system

At present wheezing not heard.

DIAGNOSIS

Hemorrhoids ( Homeopathy Treatment for Hemorrhoids )

DIFFERENTIAL DIAGNOSIS

Rectal tumor

Fissure

Fistula

Rectal varices

Rectal polyp

ANALYSIS OF CASE

Here we have many similar sensations of in different areas like in anger, fear and in dreams.

Similar sensations:

Active – stiffness (kadak), stretching, twitching, contraction, tight, straining.

Passive – relax. Motion amelioration, can’t move (akkad).

Constipation amelioration by walking is maybe common but all complaints are better by walking, so this is peculiar in this case.

Stiffness amelioration by motion is genius of this case and it must be genius of selected remedy also.

The remedy which has this prominent symptom is Rhus. Tox. which belongs to anacardiaceae family. We have to confirm by studying sensation of this family and pathogenesis.

Sensation of anacrdiaceae family

Sensation

Caught, stiff
Tight
Tension
Stuck
Cramps
(Pressing)

Passive reaction

Paralysed
Immobile

Active reaction

Stuck and want to move constantly.
Motion ameliorates
Aggravation sitting
Sedentary aggravates
Aggravated in the house
Pain on beginning to move
Restlessness

Compensation

Always on move

RUBRIC SELECTION

MIND: DELUSION, pursed he is

MIND: OBSTNATE, headstrong

GENERAL: FOOD AND DRINK, milk aversion

HEAD: PERSPIRATION scalp

PERSPIRATION: ODOR, offensive

RECTUM: HEMORRHOIDS

GENERAL: HOT application amelioration

REPERTERISATION

EXPLANATION

Here we have Rhus. Tox. in repertorisation which covers all the symptoms. Sensation of anacardiaceae family is also present in this case. So on that basis Rhus Tox is given.

EXACTNESS WITH MATERIA MEDICA

DR PHATAK MATERIA MEDICA
Worse ; EXPOSURE TO – WET; COLD; air; draft; chilled;
BEGINNING OF MOTION; REST; BEFORE STORMS;
SPRAINS; Ice cold drinks;
Better ; Continued motion; HEAT; Hot bath; if heated; Warm wrapping; Rubbing; Stretching limbs;
Change of position;

The Soul of Remedies – Dr Ssankaran
Rhus toxicodendron has a constant anxiety, “as if something is going to happen”. The patient has many fears: fear of evil, fear of being hurt, of being murdered.
He is extremely superstitious. This constant anxiety makes him restless and doesn’t allow him to rest in any position..There is a feeling of helplessness, of being forsaken by all his friends, a feeling that something bad is going to happen. And this anxiety is more inside the house and is ameliorated by walking in open air.

REMEDY:

Rhus tox.

POTENCY SELECTION:

Moderate similarity of symptoms of patient with materia medica, so moderate potency. Potency – 200

FOLLOW UP

DATE	SYMPTOMS	TREATMENT
30-07-2014	Full case taken	Rhus. Tox. 200(single dose) Placebo (TDS) for 7 days
13-08-2014	Bleeding stop+++ No pain Size of piles as it is All over improved	Rhus. Tox. 200(single dose) Placebo (TDS) for 7 days
26-08-2014	Size of piles decreased Sleep good Stool – hard ++	Rhus. Tox. 200(single dose) Placebo (TDS) for 7 days
10-09-2014	No complaint at all No bleeding No pain No constipation All over improved	Placebo for 15 days
29-09-2014	Improved+++ No complain at all	Placebo for one month
19-11-2014	Improved +++	Placebo for one month
13-12-2014	Improved+++	Placebo for one month
26-02-2015	Improved in piles Constipation since last 7 days.	Rhus. Tox. 200(single dose) Placebo (TDS) for one month
25-04-2015	All over improved Constipation+	Rhus. Tox. 200(single dose) Placebo (TDS) for one month
27-05-2015	Improved+++	Placebo for one month
08-07-2015	Improved+++	Placebo for one month
14-08-2015	Improved+++	Placebo for one month