This is a case of autoimmune thyroid disease (Hashimoto Thyroiditis) in a female of 39 years.
Presenting Symptoms and Their Development
This patient came to me in January 2021 with the complaint of chronic cough for 4 years which used to aggravate on every change of season. She explained that it always started with a running nose and after taking allopathic medication, it become severe bouts of spasmodic cough.
The cough was so severe that she could hardly talk, as talking caused another paroxysm of cough. Laughing loudly also aggravated her cough. There was a sensation of weight in the neck.
While taking her case I saw a prominent enlargement on her neck and asked her if she ever suffered from any disorder of the thyroid. She explained that she had hypothyroidism since class 10th during of school. I advised her to get an autoantibody test done for autoimmune thyroid disease, as I suspected structural changes in the thyroid gland from looking at her neck.
The autoantibody titre was raised (145U/ml). The patient had been on Thyroxin 100 mcg since childhood, and nobody got the autoantibody testing done, as once the antibodies are raised, they can seldom be reduced with allopathic treatment (and only the serum TSH values can be altered by chemical thyroxine).
It was a case of autoimmune thyroiditis with enlargement and destruction of thyroid gland associated with coughing which may have been a result of the pressure caused by the glandular enlargement. The patient also suffered from severe dysmenorrhoea ever since her menarche.
She also had xanthelasmas (cholesterol deposits) over her right eye. There were other occasional symptoms like low back pain during menstruation, nausea and weakness felt in the legs.
Physical Generals
Thermal Reaction – Hot
Thirst – moderate
Sweat – face, chest
Stool -D1-2, nad
Urine – D5-6,N0-1, nad
Desires- sweets, spicy
Patient As a Person
Introverted and reserved since childhood; emotional person; preserves her old belongings; extremely hardworking, uncommunicative and seldom speaks in public, irresolution, hurried and wants her child to be quick as well and gets irritated when the child cannot finish her homework fast enough.Anxiety about the future of the child. Angry when she is not able to do things that she likes. Weeps when angry. Anger at child when she does not do her homework on time
Hobbies – Reading, cooking, craft
Lives in constant stress about future
Fear of earthquakes, Fear of dogs
Anamnesis
The patient had been a very diligent student throughout her school time. She used to take a lot of unnecessary stress before her exams. Prior to the development of hypothyroidism, the patient failed miserably in a mathematics examination.
She changed a lot after that set back. Her interest in studies reduced drastically. The patient said that she still remembers the plight she had to suffer that time and the effect of the incident was so deep seated that she could never teach her daughter mathematics.
She used to get trembling whenever the daughter asked her for help her with mathematics. There were sleepless nights when she thought about the incident. The effect of the past incident was long lasting and in turn lead to the development of a syco-syphilitic state of her thyroid (sycosis – lingering effect with prolonged enlargement of gland; syphilis –fibrosis/ autoimmunity).
Prescription
Rx: Spongia Tosta 200C
Posology
One globule of 200C potency dissolved in 100 ml water. Two succussions, then one spoon from solution. Once a day for 16 days. (This course was repeated once after two months because of aggravation of cough and body pains).
Follow Up
The auto-antibody titre came within normal range within 6 months of treatment.
The glandular swelling disappeared and she no longer complained of heaviness felt in the neck.
Basis Of Prescription
1. Thyroid- gland – endodermal origin
2. Endoderm – An emotional trauma the patient was unable to assimilate.
3. Thyroid enlargement and dysfunction – sycosyphilis – persistent conflict activity leading to enlargement and hardening of the thyroid gland. The conflict after which the patient developed thyroid disease was the failure in an examination. Very seldom do we see such causes creating an autoimmune pathology in the patient (aphorism 206 and its footnote).
Most of the times it leads to some acute affection but in this case the effect of the incident had a prolonged bearing on the mind of the patient. One especially important but lesser used indication of Spongia guided me in this case and it was as follows:
- She is very timorous and particularly pursued and incessantly plagued by a frightful picture out of a melancholy past. (Materia Medica Pura – S. Hahnemann)
- MIND – DWELLS – past disagreeable occurrences, on – frightful scene of some mournful event of the past; tormented by a: (1) spong. – SYNTHESIS REPERTORY- F. SCHROYENS
This shows the prolonged nature of the influence that the conflict had on the patient. There was the auto-immune aspect of the thinking in which the person cannot get rid of the tormenting event of the past caused by a mistake made by the patient. This is a very lesser used angle for prescribing Spongia and should be used more often and especially in cases of such deep seated and progressive pathologies.
Other indications:
MATERIA MEDICA PURA – S. HAHNEMANN
- That remarkable swelling of the thyroid gland of the neck called goitre, which is peculiar to the inhabitants of deep valleys and their termination in plains, which arises from a concurrence of apparently tolerably identical causes, though most of these are unknown to us, constitutes a malady which is almost always uniform in its nature, for which a medicine, if it has in one case been proved serviceable, must be so always and in every case (specific).
- Painful pressure over the thyroid cartilage increased by touching (immediately). [Hbg.]:
- The region of the thyroid gland is as if indurated (aft. 4 d.). [Ws.]:
SYNTHESIS REPERTORY – F. SCHROYENS
COUGH – IRRITATION; FROM – Thyroid gland; in region of: (1) spong. + (3)
KEYNOTES AND CHARACTERISTICS – H.C. ALLEN
Swelling and induration of glands; goitre (Brom.).
Thyroid glands swollen even with chin; with suffocative paroxysms at night. Goitre.
