A 47-year-old man visited me in November 2022 for bilateral grade II chronic diffuse renal parenchymal abnormality. There were two hemangiomas in the liver and mild hepatomegaly with grade II fatty infiltration. Patient suffered from Sjogren’s syndrome.
He complained of-bleeding gums, dryness of tongue and eyes with blurred vision. This dryness has nothing to do with water intake. He said, “I hold water in the mouth to make my tongue moist, it relieves for a while. I feel my tongue has become thicker, pulled inside the mouth hence my speech is not clear and mouth had bad odor. This dryness of mouth keeping me awake.”
While talking, he was constantly hacking in his throat. He further said “I feel my energy level is not good even small works make me uneasy and tired. I am not able to handle my shop for two hours. Sometimes I forget important work, names and other stuff.”
Thermal reaction- Hot
Personal H/O- Nothing specific.
Family H/O– Father- Diabetic/ Eczema
Blood pressure was 140/ 96 mm Hg.
Rubrics considered-
EYE – DRYNESS
VISION – BLURRED
MOUTH – BLEEDING – Gums
MOUTH – DRYNESS – Tongue
MOUTH – DRYNESS – thirstless – water in mouth to moisten it and then spits it out; desires to hold
MOUTH – ADHERES to roof of mouth; tongue
MOUTH – DRYNESS – sleep – during
MOUTH – VELVET, sensation as if covered with
MOUTH – SPEECH – defective
MOUTH – ODOR – offensive
THROAT – HAWK; disposition to
KIDNEYS – INFLAMMATION – parenchymatous
ABDOMEN – FATTY DEGENERATION of liver
RECTUM – CONSTIPATION – chronic
GENERALS – EXERTION; physical – agg. – Slight exertion
GENERALS – HEAT – sensation of
GENERALS – WEAKNESS
Phosphorus, Nux Mos, Lycopodium, Belladonna, Natrum Muriaticum, Sulphur, Lachesis, Mercury sol etc. came up.
Obviously, my first choice was Phosphorus as it is the best remedy for fatty infiltration of liver and parenchymal inflammation of kidney.
However, Phosphorus did not cover the following rubrics, which were the main concern and chief complaint of patient. His dryness made life miserable.
MOUTH – DRYNESS – thirstless – water in mouth to moisten it and then spits it out; desires to hold
MOUTH – ADHERES to roof of mouth; tongue
MOUTH – DRYNESS – sleep – during
MOUTH – VELVET, sensation as if covered with
MOUTH – SPEECH – defective
GENERALS – EXERTION; physical – agg. – Slight exertion
Analysis
I was wondering how a normal person suddenly developed kidney disease. Fatty infiltration can be the outcome of unhealthy dietary habits. He had no major illness in the past. This was not a case of bilateral grade II chronic diffuse renal parenchymal abnormality for sure. What was it?
It was a case of Sjogren’s syndrome, an autoimmune disorder that affects parts of the body that produce fluids, like tears and spit (saliva). It usually starts in people aged 40 to 60. The main symptoms are dry eyes and mouth, but other parts of the body may be affected as well, with many people reporting fatigue and joint and muscle pain. In addition, the disease can damage the lungs, liver, kidneys, and nervous system.1
The liver and kidney symptoms are the secondary complication of Sjogren’s syndrome hence I did not recommend any test related to kidney. I personally do not favor biopsy or foreign body injections hence I did not suggest the patient undergo lip biopsy or salivary scintigraphy, the confirmatory tests for Sjogren’s syndrome.
A liver hemangioma is a noncancerous mass in the liver made up of a tangle of blood vessels. It is estimated to occur in up to 20% of the population.2
My cup of tea was the keynote of dryness.
Prescription- Nux Moschata 200 one dose followed by Phosphorus 30 one dose after 15 days.
I did not prescribe the remedy just because it stood first in the repertory chart. It covered all dryness symptom and was suitable to his personality. The man was mild, submissive and emotional. A few years back he suffered from mental shock due to accidental death of his wife.
I chose 200th potency to address the physical level by considering his emotional status. Phosphorus 30 given to address the particular organs; to prevent further pathology.
When a patient is in severe pathology, a homeopath must address the particular weak organs with the indicated remedy to support them along with a constitutional remedy to speed up the recovery and to prevent further damage.
Follow up after a month-
He said I am 50% better, can sleep peacefully.
Mouth dryness reduced but eyes are still dry and constipation is same.
Nux Mos 200 one aqua dose followed by Phosphorus 30 one dose after 15 days prescribed.
Follow up after three months-
He said my constipation is better, mouth dryness is not so much bothering but weakness increased.
His blood pressure was 130/90 mm Hg.
Placebo given.
Follow up after four months-
Blood pressure was 130/90 mm Hg.
His dryness in eyes was a little better and he could sleep well in the night as mouth dryness reduced significantly. He said “Doctor, now I do not hold water in mouth to moisten tongue. Tongue is free and speech is better. Occasionally I fumble. Weakness reduced but I’m still tired. I avoid mending the shop more than two hours. However, I am consuming ample water, urine burns a little.”
Nux Mos 200 one aqua dose followed by Phosphorus 30 one dose after 15 days prescribed.
Follow up after five months-
His dryness in mouth and eyes is better. Sleep is sound. I suggested he drink ample water and continue the teardrops. Blood pressure was 130/90 mmHg.
I prescribed placebo.
Follow up after six months-
Dryness is less but not gone. He complains of constipation and cracks in heels.
Bryonia 30 twice a day prescribed for 10 days.
Conclusion
The patient is doing well. Sonography report confirmed normal status of kidney and liver (excluding hemangiomas). I shall follow up the patient in future for his underlying disorder of Sjogren’s syndrome although it is better symptomatically.
If I would have targeted bilateral grade II chronic diffuse renal parenchymal abnormality, two hemangiomas in liver and mild hepatomegaly with grade II fatty infiltration instead of the underlying disorder, I might have got partial results and patient might have landed in chronic kidney disease. He has already been suggested for dialysis.
We usually get scared with big names of diseases but the beauty of homeopathy is that it treats the person in disease!
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