Clinical Cases

A Case of Hemorrhoids Wrongly Treated

Written by Amit Singh Pal

Dr. Amit Singh Pal presents a case that had been wrongly treated for three years. He shares the evolution of his thinking on the case.

This case comes to show what happens to a case when wrongly treated with homoeopathy over a period of years (3yrs in this case). I shall be happy to have your feedback below in the comment section or by email : [email protected]



Mr. IM, aged 33yrs first consulted this clinic in July, 2010. I was not working in this clinic then and some other doctor took this case. The case is as follows:

Presenting complaints:

  1. 1.     Hemorrhoids, internal and external since 3yrs.
  2. 2.     Constipation since 2yrs.

Details of presenting complaints:

–         Hemorrhoids internal and external II degree.

–         Pain during defecation

–         < in summer season, non-veg, spicy food.

–         > In winter and rainy season.

Past History: There is h/o hypertension but presently he does not have it.

Family History:

–         Elder brother has same complaints.

–         Father has suffered with paralysis rt. side.

–         Mother had breathing problems, cured by homoeopathy.

Physical generals:

–         Diet: Mixed.

–         Appetite: Reduced since 2yrs.

–         Desires and aversions: Nothing specific.

–         Passes stools once in 4-5days. Unsatisfactory, constipated.

–         Micturition: 4-5/0-1 day/night.

–         Sleep and Dreams: Sound sleep. Dreams are not specific.

–         Habits: no habits.

–         Thermals: Hot patient.

–         Thirst: Thirsty, at short intervals.


–         Suppressed anger, loss of business, worried about business.

–         Intolerable of sound ++.

–         Non-expressive, suppressed and more worried about his family because of financial problems.


Patient has born into a poor family. He has three brothers and four sisters. In childhood only his mother suffered from breathlessness. She and the patient’s sister both suffered with mental  problems.  Due to this he never got mother’s love and did not go to school. He concentrated on work more because of financial problems. After some years he had a business loss and was emotionally disturbed by that. He desires to be alone. He suffered with hemorrhoids and constipation. He is unmarried.



This case was treated until Nov, 2012 when it came under my care. Multiple remedies were given during this time by different doctors in potencies ranging from 30 to 10M. Even daily doses of nosodes were given. Various homoeopathic combinations were also administered. During these treatments, he got typhoid once, but after that never got acute fevers until he came under my treatment. I am not giving any follow-ups until now, as it will unnecessarily increase the bulk of data. When the pt. came under my care, I decided to retake the case my way and then treat. So here is the case with all follow-ups to the present day:

Mr. IM, aged 35yrs was referred to me by another physician in clinic on Nov, 2012. I saw the bulk of the case-file and was surprised to see that still he has the same complaints that he had 3yrs back. I checked the follow-up dates and found that he had regular follow-ups, every week or every fortnight for these past years. This surprised me because if it was any other patient, he would have left the clinic and got a second opinion. I started to wonder what kind of person continues to see the same physician for so long without any improvement. My first thought was Silicea The case is as follows:

He arrived alone.

Presenting complaints with details:

 Bleeding piles since 5yrs.

Constipation is also there. Passes stools once in 4-5days. This complaint had gradually+++  developed over  1-1/2 yrs. Constricting pain++. Bleeding is like a fountain, red, fresh blood <summers++, during stool only.

Heaviness of body and weakness since 2yrs.

Heaviness of eyes++, with heat of eyes.

Vertigo <sun++.



Past History & Family History: I did not waste time with past or family history as it was already noted on case-sheet.


Physical generals:

–         Appetite: Reduced. Aversion to breakfast. Desires warm food.

–         Thirst: ½ glass at a time. Good. Aversion to warm drinks.

–         Desires: Spicy+++, Sweets++, Milk. Banana.

–         Aversions: Salt++. Sour. Fat food.

–         Bowels: mentioned earlier.

–         Micturition: N.

–         Sleep and Dreams: Regular since 3months. Sleeps on back. Covers. Nothing specific about dreams.

–         Habits: no significant habits.

Thermals: Hot patient.

–         Fan: Never.

–         Season: Likes summers.

–         Likes to stay Indoors. An in-house person.

–         Hill-station / Sea-shores: No info.

–         Nausea < while travelling in bus.

–         Keeps windows open at home.


Nowadays irritability is increased very much. Easily gets irritable over everything. Confusion when talking to others. Atheist. Earlier decision making was good, now reduced. Fear of making mistakes. Feels much anger but keeps quiet. Takes advices from others. Routinist. Vertigo on looking at blood.  Memory reduced+++, for recent as well as past events.


Analysis and prescription:   I did not have much to go on here.  His overall energy levels were reduced, his memory had also gone down and he had not suffered from any acutes in past few years. I knew that his state of health was very low. Also with this kind of constipation I was already thinking of Alumina. However, going through the case I found a PQRS symptom: Vertigo on looking at blood. This was because he was scared to look at blood. This was in answer to my question ‘Do you help if you find a stranger injured on the road’. He answered that ‘I get so scared looking at blood that I feel vertigo and feel that I may faint. Hence I never go near blood’. Searching the repertory, I considered the following rubric:

  1.   Synthesis 9.0: MIND – BLOOD; cannot look at: Aloe ALUM. mang-n. mang-p. nux-m. NUX-V. phos. plat. sacch. staph.
  2.   Complete dynamics 14.3: Mind; blood or a knife, cannot look at: aloe ALUM clad-r NUX-M NUX-V PLAT sac-alb staph


Alum belonging as a high grade remedy in both repertories, I decided to go with it. Because he had persistently stayed with treatment and the slowness with which his disease had initially developed, I decided to go with alumin-sil, though it was not in the above rubric. Rx: Alum-sil 30 in 30ml, BD as LM potency on 2 Nov,2012.

Nov 15-2012: Bleeding was much reduced all these days. Now, as the medicine is stopped for 3days, there is a relapse of bleeding. Energy level also increased. Heaviness of body SQ. Stools now once in 2 days. Pain per rectum still present.

Rx: Same bottle diluted and asked to continue in same pattern.

7/12/2012: Prolapse of anus++. Eyes feel heavy and tired from 3-4days. No bleeding. Occasional constipation, only in past 3days. Body feels heavy during work. No pains anymore.

Rx: Same bottle diluted and he was asked to continue in same pattern.

12-1-2013: Always feels tired. Hectic fever. Eyes are wet, watery. Headache with heaviness.  Both comps. Agg morning and afternoon. On repertorising (Lil-t, Alum, Nux-v). General bodyache with pain in bones. No stool problems now. Not telling me clearly if he has coryza or not. Sluggish+++, slow to talk. Rx: Alum 10M / 1dose with Placebo for 4weeks.



27-2-2013: At this time, he came back with a total SQ with relapse of his bleeding and constipation; and I realized probably Alumina is not the group I should be looking into.

I decided to restudy the case then and there and try to see what I was missing. It was then I realized that I had forgotten to take the Physical Generals. I then asked him about any skin complaints he suffered in the past, examined his nails, hair and teeth. I found that his front teeth were broken in odd shapes from the roots. When asked about it, he said that they broke on their own. Thus I thought that this must be a symptom of an internal disorder. I considered it for my fresh repertorisation along with the PQRS symptom which was still present and was a part of his innate nature.

Staphysagria was the only remedy covering both symptoms. Now my mistake was clear to me but I decided to wait and see the remedy reaction.



Rx: Staph 1M / 1dose. Placebo for 15 days.


1-10-2013: Note that he showed up 8months later! When asked why he did not come all these days, he said that he was fine.  Now, agg since 1week. Also there are palpitations in morning++. Irresolution++.  No clear symptoms. Rx: Staph 1M / 1dose. Placebo for 15days.

26-10-2013: He came to thank me that all his complaints are better now and he feels completely healthy.  His whole countenance was changed and he looked healthy. I asked him, what he thought brought back all his complaints. He said that his mother had died and from this shock there was a relapse. Hence after finishing all rituals, he had come to take medicines again. I let him go with instructions to only come back if he needed medicines. He has not yet returned and I treasure this case-sheet with me to always remind me of my mistakes.

Only out of interest I am showing this rubric to highlight one more symptom of Staphysagria

Synthesis 9.0: MIND – AILMENTS FROM – death of loved ones: ACON. Ambr. anthraci. ARS. calc. caps. carc. caust. gels. IGN. Kali-br. LACH. nat-s. nux-v. OP. PH-AC. plat. podo. STAPH. sulph. verat.

Complete dynamics 14.3: Mind; death; ailments from, agg.: ACON alum ambr ars aur-m-n beryl calc calc-sil caps carc caust gard-j gels hippo-k hoch IGN KALI-BR lac-c lac-f LAC-H lach lim-b-c lyc NAT-M NIT-AC nux-m nux-v OP peg-h PH-AC plat rhod salx-f sile-c spig staph sulph urt-c urt-u verat.

I realized my mistake in prescribing Alum-sil and Alumina This person was Staphysagria from the beginning. His reserved nature, quiet disposition, suppressed anger etc. all pointed to it, but I missed the remedy because of two mistakes that I made:

–         When I knew that the patient had already undergone 2yrs of multi-drug homoeopathic treatment, I should have looked into the original case rather than retake the case which was all ready corrupted.

–         I should not have underestimated the value of physical generals – breaking of teeth in this case.

Also, once again I learnt from this case that even multidrug homoeopathy therapy doesn’t change the original remedy of the case, and the essence always remains the same. As noted by Vithoulkas in his various works, it’s only the correct sequence of remedies which can raise the level of health.

I shall be happy to have feedback/queries from the readers.

Find more about Hemorrhoids/Piles visit-

Homeopathy for Piles Treatment

About the author

Amit Singh Pal

Dr. Amit Singh Pal is presently working as Senior Medical Officer at Bharatesh Homeopathic Medical College, Belgaum, Karnataka, India. A teacher of Homoeopathy, he has lectured at various colleges. Dr. Amit has wide experience in the practice of classical homoeopathy, lately practising solely on the guidelines of George Vithoulkas, after having trained under the late Dr. Sunil Parse from Nagpur. He has completed the E-learning course of IACH and also attended their training for treatment of difficult cases. He is also involved in maintaining quality standards for hospitals, as a NABH Accreditation Coordinator for Bharatesh Homoeopathic Medical College. Dr. Amit provides free service as a life coach, guiding young students and practitioners in learning homeopathy, setting up practice and achieving their life goals. He has gathered his clinical experiences in the form of his first book : ‘Secrets of Case-Interview’


  • In two cases, I have seen sulphur and Natmur have completely cured the patients. Alum seems to be a good medicine for treating Hemorrhoids as detailed by Dr.Amit singh Paul.

  • The most interesting part of the case had been, the person has not lost faith in homeopathy and the clinic where he was treated. Reasons could be:
    1) His faith in homeopathy/clininc because of his mother’s successful treatment.
    2) Cost of treatment cheaper compared to other forms.
    Overall he had been of very mild and submissive nature for sure to continue his treatment and obeying advices. You were very correct to think about sil at first and finally Staphysgaria. Qudos to you for noticing the very important aspects to come out with the right remedy. This reflects the kind of commitment required for treating such cases. I agree with your assessment.
    God bless to you and your patient!

  • Both the patient and the doctor, showed lot of patience. It proves that the power of correct analysis is always right and finally pays with reward. Thanks and congrats to Dr. Amit

  • I recently came across this article. I live in the US. I love the fact that you were not only willing to go back and admit your mistake, but you were also willing to put it out there for others to see. If only more dr.s had that type of humility. Thank you so much for sharing.

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