Clinical Cases

A Constitutional Approach to a Case of Hypertension

Parth Aphale
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Dr. Parth Aphale presents a cured case of hypertension in a man of 52.

 Abstract:

Homoeopathy considers health as a state indicating harmonious functioning of the life force. Disease is a deviation from health, which develops when the life force is unable to overcome obstructions to its smooth functioning. It can be seen as the total response of the organism to adverse environmental factors, internal or external, conditioned by constitutional factors, inherited or acquired. This stands true for all diseases, including essential hypertension. A closer examination of the modern concepts of health and disease accepted in the medical world today shows that they are coming closer to the homoeopathic model. Perhaps nothing epitomizes this better than the etiological concepts of essential hypertension, which is seen as a product of “constitutional” and environmental factors. 

Keywords:

Homoeopathy, life force, essential hypertension, constitution,

Homoeopathic Concept of Hypertension

Homoeopathy considers health as a state indicating harmonious functioning of the life force. Disease is a deviation from health, which develops when the life force is unable to overcome obstructions to its smooth functioning. It can be seen as the total response of the organism to adverse environmental factors, internal or external, conditioned by constitutional factors, inherited or acquired. This stands true for all diseases, including essential hypertension. A closer examination of the modern concepts of health and disease accepted in the medical world today shows that they are coming closer to the homoeopathic model. Perhaps nothing epitomizes this better than the etiological concepts of essential hypertension, which is seen as a product of “constitutional” and environmental factors.

Notwithstanding these similarities, there remain for the most part significant differences in the concept of disease in both systems. The essence of this difference is contained in the Hahnemannian statement — “there are no diseases, but sick people”. Perhaps a more eloquent exposition is given by Dr. Kent in his lecture on “the sick”. He says “the allopath thinks that the house in which the man lives, which is being torn down, expresses all there is in sickness. In other words, tissue changes are all there is to the sick man. But homoeopathy perceives that there is something prior to the results. It is the man who is sick and has to be restored to health, not his body, not his tissues”. Thus in the case of essential hypertension, homoeopathy focuses on the patient with the hypertension, rather than on the hypertension itself. The totality of various characteristic signs and symptoms exhibited by this patient leads the homoeopath to the similar remedy. The similar remedy relieves the totality of symptoms and with it the symptoms of an elevated blood pressure.

A Case of Hypertension successfully treated with Homoeopathy, the constitutional way

An obese male patient, XYZ, 52 years old, with dark complexion having sweat on his forehead came with a complaint of sleeplessness followed by palpitation. Patient was all right before 4 months. His sleep was disturbed followed by palpitation. He also started feeling heaviness of head which progressed to frank pain in his head. He used to take pain killers but eventually that wouldn’t help either. He then visited a physician who diagnosed it as hypertension. He is on allopathic medicines – Stamlo 5 mg, 2 times a day since 2 months but his complaints are not better.

Chief complaints

Sleeplessness with palpitations from 4 months

LocationSensationsModalitiesConcomitants
HeartPalpitations< night

 

Sleeplessness
HeadHeaviness,

dull pain

< night


Past history   

Rt Sided Renal Calculi 2 years back.

Family history  : NAD

Personal history

Appetite     Good

Desires        oily food salty food ,

Aversions             Nothing specific

Thirst          6-7    glasses a day. Prefers cold water in summers

Perspiration     Scanty, Non staining No odour

Stool           2 times a day properly formed

Urine                    NAD

Sleep & Dreams –  Has sleepless nights once or twice a month but sleep on the whole is satisfactory even though the patient feels otherwise.

Thermals:  Hot Patient

Mental generals –  Patient is very irritable, becomes angry easily. He wants to stay alone and has a brooding nature, especially from bad events.  Gets angry when consoled.

Vital data                       

Temperature            98.70 F

Pulse                       78/min

Blood pressure       160/9o mm of Hg

Respiratory rate      19/min

Systemic Examination: No Abnormality detected.

Physical make up

Obese person with dark complexion.

Provisional diagnosis

Hypertension

Hyperlipidemia

Investigation

Serum Triglycerides 220 mg%

Hb 10.2 gm%

Final diagnosis

Hypertension with hyperlipidemia

Miasmatic background

Sycotic

Analysis & Evaluation of symptoms

  1. Anger irascibility tendency – Mental general characteristic (emotion)
  2. Consolation aggravates –        Mental general characteristic (Emotion)
  3. Dwells on past disagreeable – Mental general characteristic (Emotion)
  4. Hypertension- Physical general characteristic
  5. Sleep disturbed- Physical general characteristic
  6. Desires oily and salty food Physical general characteristic
  7. Obese person
  8. Complexions, general – dark, brunette

Repertorial totality                                                                      

  1. Mind – ANGER, general
  2. Mind – CONSOLATION, general – agg., from kind words
  3. Mind – BROODING
  4. Constitutions – OBESITY
  5. Constitutions – COMPLEXIONS, general – dark, brunette
  6. Food – SALT, general – desires
  7. Diseases – HYPERTENSION, high blood pressure
  8. Food – FAT, food agg. – desires, fat
  9. Sleep – DISTURBED, sleep – palpitations, by

Repertorisation (Van Zandvort R., Complete Repertory,2001)

Remedial differential diagnosis  (Grading of Remedies)

Natrum mur                   9/20

Calc carb                            9/15

Sulphur                             9/15

Nitric acid                         7/17

Final remedy                       

From the above analysis Nat mur covered all the symptoms. Natrum mur 200 single dose followed by S.L was given as the remedy.

 

Follow up summary:

Sr.noDateComplaintsRemedyReason
120/09/2015Feels heavy in head. B.P 180/100 mm of hgS.LConsidering it as homoeopathic aggravation S.L was given.
227/09/2015B.P 190/110 mm of hgNat mur 200 T.D.SThere is no further improvement hence Potency & repetition reconsidered.
304/10/2015Feels better, Sleep better. B.P 180/90 mm of HgNat Mur 1M I Dose

S.L T.D.S

On seeing generals better S.L contd.
420/10/2015General feeling better, B.P 160/80 mm of HgS.L. Tablet Stamlo 5mg now only in morningOn seeing generals better S.L contd.
518/11/2015Slight Headache ,B.P 160/80 mm of HgNatrum Mur10M I Dose

S.L t.d.s

Headache so potency increased.
624/12/2015B.P 140/80 mm of HgS.LOn seeing generals better S.L contd.
720/02/2016B.P- 160/100, Headache+Natrum Mur 50M Single dose, S.L T.D.SAggravation, so potency increased
819/03/2016No headache, B.P-130/80S.L T.D.SSince improvement seen, S.L
920/05/2016B.P-130/80S.L T.D.S

Tablet Stamlo 5mg stopped

No Complaints, so S.L
1022/06/2016B.P-130/90Nat Mur CM I Dose, S.LT.D.SSlight increase in diastolic BP, So increase the potency
1125/07/2016B.P- 130/70S.L T.D.SImprovement, so S.L
12.30/08/2016B.P- 130/80 No complaintsS.L T.D.SImprovement so S.L
13.28/09/2016B.P-130/80 No complaintsStop treatment. Follow up as needed


Comments  

In the above case the patient has a hydrogenoid constitution & melancholic temperament. By considering his mental and physical general sphere the remedy Natrum muriaticum was selected. After considering his susceptibility, 200 potency was selected. After a single dose the patient showed an aggravation followed by slight improvement. After two months, tests found that there is improvement in haemoglobin & triglyceride levels. After 6 months, lipid profile of the patient had come to a completely normal level, which shows that Natrum Mur given on a constitutional basis did wonders. This proves that a proper constitutional medicine is required for complete and gentle cure. According to Dr. J.T. Kent, high potencies like the 1M, 10M, 50M, CM are required for managing acute exacerbations of chronic disorders. In such exacerbations always start with medium potency 200 and ascend up to CM or even DM, as the case requires to achieve complete cure (Dr. Kent). According to Dr. Samuel Hahnemann, whenever there is improvement, wait and watch till improvement is there and repeat when the symptoms recur or intensify. So the patient was kept on Sac Lac during improvement.

About the author

Parth Aphale

Parth Aphale

Dr. Parth Aphale, M.D.(Hom.), is a homeopathic physician in Pune, and Assistant Professor, Department of Homoeopathic Pharmacy at Dr. D.Y. Patil Homoeopathic Medical College and Research Centre, Pune.

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1 Comment

  • dear dr aphale i have read your case i want to know is there any diet and regimen restriction or not because all these conditions are related to your diet /digetion /daily routine life style i think in your opinion is there any importance to above factors or not kindly guide me dr bade