Abstract: A case of Idiopathic Pulmonary Fibrosis was palliated with Arsenic Iodatum 3X based on clinical observations.
Key Words: Idiopathic Pulmonary Fibrosis, Arsenic Iodatum 3X
Case Presentation:
Introduction:
I want to share my experience with an unusual case of Idiopathic Pulmonary Fibrosis (IPF). It can be defined as an interstitial lung disease characterized by chronic inflammation, accompanied by an uncontrolled healing response that causes progressive scarring or thickening (fibrosis) of tissues between the lung’s alveoli, or air sacs.
The patient presented with very few symptoms giving rise to one-sided disease (Aphorism no: 173). Mr. AML, aged 60 years came to me for consultation in May of 1991. The clinical diagnosis of the case was Interstitial Fibrosis of lung- steroid dependent.
Chief Complaints: The only complaint was breathlessness on exertion for the last 5 years aggravated by slightest exertion and ameliorated by rest. Marked weakness was also present. The patient was on corticosteroids.
Past History:
No significant history obtained
Family History:
Mother: h/o pulmonary tuberculosis
Father: h/o right -sided pleural effusion
Brother: h/o pericardial effusion
Personal History:
Appetite: normal
Thirst: 1-2 liters per day
Urine: normal
Stool: normal
Craving: sweets+++, spicy +++, green chillies, very hot food
Aversion: nothing particular
Perspiration: on exertion on body
Sleep: startles in sleep. Refreshing 8 hours of sleep
Dreams: frightful
Thermal: hot patient
Mind:
- Very obstinate+++.
- Miser: was extremely stingy and was cautious in money matters
- Great anxiety about his health
- Extremely fastidious especially about his belongings
- Very religious
- Likes to wear light colours, especially white and had a dislike for dark colours, especially black.
Case discussion:
This case was a challenge to treat as the patient had taken homoeopathic treatment from most of the celebrated homoeopaths from central and south Mumbai. Furthermore this case had come in the initial days of my clinical practice.
The Patient had taken the commonly prescribed homoeopathic medicines including:
Phosphorus, Silicea, Arsenicum album, Thiosinaminum, Lycopodium, Chamomilla, Sulphur, Calcarea iodatum etc. None of the prescribed homoeopathic medicines gave any relief.
Thus, I had to logically think of a drug which was different in kind and had not been used by other homoeopaths. This was a difficult task as the patient had presented with common clinical symptoms of the disease itself with few characteristic symptoms in the personal history and mental state.
In this case, two seemingly similar drugs came to my mind namely, Arsenic album and Arsenic iodatum. Since Arsenic album had not relieved the patient, I opted to prescribe Arsenicum iodatum. Here, I would like to express my gratitude to my teacher, the late Dr Prakash D Vakil, who taught me much about the drug and its differentiation from Arsenic album.
Since both these drugs have similar symptomatology, the following chart will be of use to differentiate them:
| Arsenic album | Arsenic iodatum |
| 1: Fastidious about himself and his belongings | 1: Fastidious only about his belongings. |
| 2. Desires to dress in any light colour and has an aversion to any dark colour | 2. Desires to dress in white and has an aversion to the color black. |
| 3. Predominantly Syphilitic miasmatic background | 3. Predominantly Tubercular miasmatic background |
| 4. Thermally Chilly patient | 4. Thermally Hot patient. |
The first two points are clinical observations made by the late Dr Prakash D. Vakil and he has added them to his Materia medica study.
Arsenic iodatum 3X was selected, 2 grains twice a day and the patient started improving gradually. The breathlessness gradually reduced and within a period of 2-2 ½ years, the corticosteroid was tapered off and finally stopped. Later on, Arsenicum iodatum 3X, 2 grains once a day was planned to palliate the disease.
Totality of symptoms:
Arsenicum iodatum was chosen on the following indications:
- Dominant tubercular miasmatic background.
- Extremely fastidious about his belongings
- Desires white and aversion to black
- Anxiety about his health
- Very religious minded person
- Dreams: frightful
- Cr: sweets+++, spicy +++, green chillies, very hot food
- Breathlessness aggravated on slightest exertion.
- Great weakness
Selection of potency:
The potency chosen was 3X as pathological changes were predominant with a few characteristic symptoms. Furthermore, Dr. Vakil had reported that the 3X potency gave beneficial results.
Conclusion:
In this case an adequate palliation was observed according to the Law of Similars. I would to like to mention that I have used Arsenic iodatum 3X in difficult/ refractory cases of pleural effusion, pericardial effusion and ischemic heart disease with good results.
I would request the homoeopathic fraternity to try this remedy (Ars iod 3X) when indicated according to the Law of Similars. It has much to offer to relieve suffering.
Thank you Dr. Jagose. This case demonstrates the advantage of careful repertorization, knowledge of small remedies and the importance of palliation, something that is often overlooked. Many cases can not have a perfect cure, but those patients deserve the best quality of life possible.