A Case of a Hemorrhagic Ovarian Cyst

A young girl, 21 years old, presented with an ovarian cyst on 19th January 2007.

I had treated this girl for chronic prostration, recurring headaches and menstrual irregularities and other problems in early 2004. The two remedies that I found indicated for her at different times were Natrum-carb and Natrum-mur. She had responded well to the treatment and was doing well since 2004.

This time around she complained of pain in the abdomen, which was radiating down her leg. A USG done on 19/02/2007 revealed a large hemorrhagic cyst (4.4 * 2.7 * 4.1 cm / 27ml) in the left ovary and PID.

The patient was thirstless and had profuse leucorrhoea.

In the rush of the clinic hours, I did not repertorise the case and thought – “There is an ovarian cyst and it is left sided. It is also hemorrhagic, which probably indicates a syphilitic remedy. There is pain in the left ovarian region and it is extending downward. The patient is thirstless and also has profuse leucorrhoea. The remedy should be Argentum-met.”

First prescription: On 19th Feb 2007, I prescribed Argentum-met 30.

Result: No improvement. The pain persisted.

Mistake: The mistake I made was that I did not take the case properly and relied on my clinical knowledge. Technically the prescription was not very wrong, because if you repertorize the symptoms that I chose, Argentum-met does come up strongly. Another mistake was to use the pathology as eliminative symptom.

Lessons:

1. If you do not take the case properly, your chances of finding the simillimum are remote. ‘A case well taken is a case half cured’
2. Do not use the pathology as eliminative. Focus on the symptoms first and use the pathology in the end (if needed) to differentiate.

A couple of days later a homeopath in her college noticed that she had to hold her abdomen while descending stairs because every little jerk aggravated the pain. On this symptom alone, he suggested Bryonia. So the girl, a homeopathic student herself, took a dose of Bryonia 200. Soon the pain subsided totally. She called me up and told me the happy news. I suggested to her that she could continue the remedy if the pain came back. ) The pain did come back after a few hours. Every time she repeated the remedy, the pain would subside but would come back again after a few hours. With each repetition the result from Bryonia was getting less dramatic.

Mistake: The homeopath prescribed on just one characteristic symptom. There was no respect paid to the totality of the case. Such single keynote prescribers sometimes do hit the bull’s eye, but in most cases they won’t be able to effect a cure.

Lessons: A remedy that covers a few characteristic symptoms but does not cover the totality can only work as palliative.

When the Bryonia stopped working, she came to me again. I still felt that my first prescription was OK and probably Bryonia taken soon after might have interfered with it. I stuck with my prescription and upped the potency to 200.

12/03/2007 – Argentum-met 200C.

Result: No change.

Mistake: Overconfidence. I should have reviewed the case here.

Lesson: If your remedy is not working, review the case thoroughly before repeating. A simillimum usually does show some action, even if the potency is not perfect.

25/03/2007 – When Argentum-met 200 also did not give any result, I decided to review the case and took the following symptoms:

Pain, abdomen

< walking, while

> warmth

> pressure

extending to back

extending to lower extremities

Pain, stitching

Based on this repertorization, I prescribed Colocynth 30.

25/03/2007 – Colocynth 30 in liquid solution for 10 days.

Result – Significant amelioration. Only slight discomfort left.

03/04/2007 – Colocynth 200C b.d. in liquid solution.

Result: No complaints.

Lesson: Always remember to complete the symptoms as regards location, sensation, modality and concomitants. A case well-taken is a case half-cured!

29/04/2007 – A USG showed both ovaries were normal and there was no evidence of a cyst or PID.