A Cure of Psychogenic Diabetes Mellitus

Abstract:

The author presents a case of diabetes mellitus of a psychogenic origin that got triggered after a crisis in her son’s life. It was resolved with a deep-acting homeopathic remedy selected on the presenting totality. The case emphasizes the role of the characteristic particular PQRS symptoms in forming a disease-totality, as well as the selection of the most-suitable mother tincture.

PRELIMINARY DETAILS:

MRS ABC; Age: 54 yrs Housewife

CHIEF COMPLAINT:

Diabetes mellitus since March 2004

Patient’s son has settled in USA and he met with a serious car-crash, which resulted in major musculo-skeletal injuries to him and his wife. They were admitted in the hospital for almost three weeks. It was a major shock to the patient and a severe cause of worry. She wanted to rush for his care but couldn’t go, due to some other family responsibilities. Since the news came, she started feeling drained and low in energy. She got a severe attack of bronchitis that persisted for almost a month.

During her follow-up check-up for the bronchitis, her blood sugar was found quite high with fasting 205 and post-prandial 392. Glycosylated Hb [HbA1C] was 7.5%

Urine always showed glucose in the range of ++ to ++++ and also had persistent proteinuria. Her blood sugar never remained normal for a consistent period of time and hence she wanted to opt for homeopathic treatment.

CASE TAKING DATA:

Diabetes mellitus – presented with chest infection [bronchitis] first in March 2004. Since then there were repeated attacks of bronchitis whenever her blood sugar goes haywire.

Bronchitis: Gets productive cough – sticky expectoration << lying down

No other significant modality or triggering factor

Significant changes in general constitution since diabetes:

1. Perspiration increased especially palms and soles

2. Thermally was ambithermal but now has become markedly chilly.

3. Craving for sweets increased significantly

4. Strong & strange craving to eat raw food / vegetables [spinach / okra / raw rice]

5. Profuse strong smelling urine

6. Dryness of mouth with thirst for large quantities of water

7. Constipation – hard dry stools like balls

Patient as a person:

• Motion sickness [car sickness] +

• Cravings: warm food ++; highly seasoned food ++

• Sleep disturbed due to thoughts with lots of dreams [forgets]

• Menstrual history: menopause 4 yrs back, earlier regular menses; no concomitants

• MIND: Gets along well with everyone – never gets angry even if things do not go her way; superstitious – believes strongly in ill-wills; worry and anxiety about family members and their health; does not like to mix with peers but is not reserved – will talk in social gatherings and will share her problems easily – does not mix, since does not like gossiping.

• Thermally: Ambi-Chilly ? Chilly [since diabetes]

• Family history: strong history of diabetes in family- Mother, Mat-uncles, Brother (most of them have got some or the other diabetic complications as well; patient had sustained her health until this crisis happened)

• Past history: nothing significant

CURRENT MEDICATION:

• Tab Reclide 80 mg twice daily

INVESTIGATIONS:

Urine sugar: ++ to ++++ with consistent proteinuria

Glycosylated Hb [HbA1c]: (reading above 8.0 % indicates poor diabetic control)

Date	Apr 2004	Nov 2006	Nov 2008	Mar 2010	Mar 2011	Aug 2011
HbA1C	7.5 %	8.3%	7.8%	9.0 %	9.2 %	10.5 %

Prescribing Totality:

• Ailments from – Bad news, shock

• Craving – raw food

• Craving – sweets

• Perspiration increased – palms & soles

• Bronchitis recurrent, diabetes with [bronchi as region of affection]

• Urine – profuse, offensive, putrid

• Constipation: stools hard, ball like

• Chilly with tendency to catch cold easily

• Car sickness

Remedy correspondence:

From the repertorization, CALCAREA stood out as the remedy covering most of the significant symptoms. This case presented with a ‘phase totality’ where there are few symptoms that represent the change in the original constitutional features of the individual [after the disease got established] and thus they were given higher value in the totality and remedy correspondence.

While searching for remedies covering Diabetic pathology in Phatak’s repertory, I suddenly came across a rubric: Diabetes mellitus, lung affection with. This case presented exactly the same. The diabetes was detected during an attack of bronchitis, and the rise in BSL always gave rise to respiratory infections even later during the course of the disease.

CALC PHOS thus was selected based on this differentiating rubric.

Mother tincture: Characteristic constipation with hard ball-like stools & significant offensive urine with proteinuria lead to the selection of ABROMA AUGUSTA

TREATMENT & FOLLOW-UPS:

Date	Follow-up	Prescription
8 Aug 2011	Case defined: Present complaints = constipation + offensive urine No active respiratory ailment HbA1c = 10.5%; Urine: sugar +++, proteins ++ = = = In addition to the medication, was asked to follow strict exercise schedule for at least 45 minutes including brisk walking, cycling on plain grounds, or treadmill for 30-45 minutes	Calc phos 200 stat + Placebo
10 Sep 2011	Constipation = not hard stools but unsatisfactory; Urine offensive; no respiratory complaints Urine: sugar ++, proteins ++ Following the exercise schedule regularly	Calc phos 200 wkly + Placebo
7 Nov 2011	Constipation >>> soft and satisfactory motions; Urine offensive >>> Feeling much fresher; had few hypoglycaemic episodes in between Urine: sugar +; proteins +; HbA1c = 8.6%	Calc phos 200 wkly AbrAug Q 10 QID
23 Jan 2012	No fresh complaints; Hypoglycemic episodes more frequent Visited diabetologist: reduced medication to – Reclide 40 mg BD	Ct all
3 Apr 2012	No complaints – especially no respiratory affection in spite of winter “This is my first winter without bronchitis in last 8 years” HbA1c = 7.0 %; Urine: sugar – nil, proteins – nil	Ct all
25 May 2012	No complaints, keeping well. Doing regular exercise. BSL: F = 96 & PP = 134; Reclide 40 mg BD continues; Urine – WNL	Calc phos 1M stat AbrAug Q 10 BD*
27 Jun 2012	Three hypoglycaemic episodes in last two weeks; HbA1c = 6.2% BSL: F = 76 & PP = 102; Reclide reduced to 40 mg once daily dose	Placebo dose stat AbrAug Q 10 BD
13 Aug 2012	Fasting BSL = 118 and Post-prandial = 142; HbA1c = 6.8% Regular exercise continued; No other complaints	Calc phos 1M /month AbrAug Q 10 BD
28 Nov 2012	Fasting BSL = 78 and Post-prandial = 136; HbA1c = 6.0% [24 Nov 2012] Reclide stopped by diabetologist from 2nd Nov 2012 – yet maintaining sugar levels well with regular exercise and medication	Calc Phos 1M /month AbrAug Q 10 BD

Discussion:

Her health before the crisis [in spite of having a strong family history of diabetes] and having no organic complications was in favour of the patient. The psychosomatic origin of the disease indicated the sensitivity of the patient, which not only helped in deciding the infrequent doses but also was a significant help in achieving faster response to the medication.

As regards the use of mother tincture, I have always found a remedy selected on the basis of the presenting totality as well as the associated symptoms to work in the most beneficial way. Earlier I used to give Syzigium to all patients with not very promising results. Now I have been using almost six remedies based on various indications [which I guess is the topic for a separate article]. In this case, the presence of proteinuria with constipation and offensively smelling profuse urine made the choice of Abroma augusta easier.