Homoeopathic Management of Renal Colic

Drs. Navin Pawaskar and G. Chand Sharma discuss the homoeopathic management of renal colic. Colic produced by small multiple stones to fairly large calculi are seen to be amenable to homoeopathic treatment. Six cases illustrate the principles.

Homoeopathic Management of Renal Colic

Reprinted with permission from the Indian Journal of Applied Homoeopathy where it first appeared. https://www.jimshomeocollege.com/ijah-publications/ 

ABSTRACT

Stone formation is one of the painful urological disorders that occur in approximately 12% of the global population and its re-occurrence rate in males is 70-81% and 47-60% in females. Renal Colic is one of the commonest conditions that a Homoeopath has to encounter in his day to day practice. Acute Renal Colic is disturbingly painful and has to be managed in the nick of time. The conventional mode of treatment at best   offers temporary alleviation of the pain, however the issue of crushing the stone and its passage remains unaddressed.  An intuitive Homoeopathic physician with sound knowledge of working principles of Homoeopathy not only relieves the acute pain but also resolves the issue of further recurrence of episodes of pain. A thorough case taking and minute attention to details can help arrive at a simillimum which relieves the patient of the immense suffering. Further Homoeopathy comes across as a painless, non- intrusive and a cost-effective method of treatment. It is the clinical acumen of the physician that determines the degree of efficacy of his treatment.

Introduction

The urinary tract includes kidneys, ureters, bladder and urethra. Renal Colic is a type of pain experienced when urinary stones block and irritate part of the urinary tract. Colic is characterised by an acute onset of severe flank pain radiating from loin to the groin, gross or microscopic haematuria, nausea and vomiting. As renal colic is invariably caused due to a calculus, it becomes imperative to understand the process of formation of renal stone.

The formation of stone in the urinary system, i.e. in the kidney, ureter, urinary bladder or in the urethra is called urolithiasis. ‘Urolithiasis’ = ouron (urine) and lithos (stone). Urolithiasis is one of the major diseases of the urinary tract and is a major source of morbidity. A Calculus is composed of urinary salts with a colloidal matrix of organic materials.

Renal Stones are classified as primary stones when there is no antecedent infection and secondary stones when preceded by infection, e.g. mixed stones. Eg; struvite stones which form secondary to the urea splitting species ‘Proteus’ infection. Primary stones are further classified as Radio-opaque Stones & Radio-luscent Stones. Radio Opaque stones have a higher incidence than the latter.   Calcium Stones account for about 75-80 % of ROS. Oxalates Stones are irregular in shape with projections or spicules bearing the color of altered blood pigments, Cysteine stones are multiple pink colored stones, turn green on exposure to air and account about 1-2% of ROS. Radio luscent stones are of 2 types, namely Uric acid and Xanthine.  Uric acid stones which account for 6%  of cases are hard, multiple, orange colored stones with a multifaceted appearance.  Xanthine Stones are smooth, red in color and account for about 1-2 % of cases.

Etiology of a Kidney Stone:

  1. Dietetic: Deficiency in Vit. A leading to desquamation of epithelium which ultimately leads to nidus formation.
  2. Hypersecretion of relatively insoluble salts through urine
  3. Changes in urinary pH due to infection
  4. Urinary stasis allows crystalloids to precipitate and infections to take place and cause a change in pH.
  5. Hyperparathyroidism and other medical conditions causing mobilization of calcium from skeletal framework and thus hypercalciuria.

MECHANISMS OF STONE FORMATION: Saturation and Stone Growth

Understanding the underlying causes of nephrolithiasis is imperative to establish medical treatment and for the prevention of future kidney stones. A salt can dissolve in a given solution until an equilibrium is attained between the solid and aqueous phase at a defined pH and temperature. Super saturation sufficiently high to induce crystallization, which is referred to as the upper limit of metastability, is needed for the formation of kidney stones.  Inhibitors raise the limit, whereas promoters lower it.

As shown in Fig 2, crystal nucleation encompasses the process of free ions building loose clusters. Special cell types (e.g., renal epithelial cells) and Casts can act as nucleating centres. When a nucleus is established, additional crystal components can be added to the existing nucleus in a process defined as crystal growth. Larger crystal particles combine in a process called crystal aggregation. After having skimmed through the pathogenesis of stone formation and aetiology it is important to review some of the relevant concepts in homoeopathy.

Health -Diathesis – Disease   Conceptual trio In Homoeopathy

The Human Structure is a balanced coordinate system. It maintains homeostasis in spite of inherent weakness that it is born with. It is able to maintain the apparent state of health as long as adaptation mechanisms help compensate to create a defensive alternate state, essentially  protective adaptation. Thereby, allowing emotional, intellectual and physical functionality to be maintained. 

In the presence of continuous stress and maintaining factors, this adaptation mechanism based on arbitrary piecemeal changes starts to give way, stressing the inherently weak end organ and localising in it, as a disease. Finally, in the evolution of disease it is this inherited or acquired organic weakness and systemic inferiority which, leads to the morbid disposition and specific pathogenies.

Diathesis hints to this, inherent weakness of the system which otherwise, not sufficiently marked to be called as disease yet, has potential to react abnormally as hypersensitive, exaggerated or erratic when, subjected to stress either, internal or external. Diathesis, a resultant of an inherent defect in the human system predisposes an individual towards a particular state, condition, pathogenesis or disease. It is a compromise a human system has to live with till the end of life.

As stress continues to build up or if maintaining factors are not taken care of, the human system further reacts. This reaction is exhibited through a predetermined maladaptive pattern of; suppression, exaggeration, accumulation, hypersecretion, erratic behaviour and loss of function or structure. The suppressions or maladaptation of the human system give rise to further stresses, building a, vicious cycle.  The System moves further towards the qualities it has found useful in its operations, so far. This is done with an anticipation that, this move of exaggeration, erraticism or hypersensitivity will strengthen the system to deal effectively with the new state of morbidity which, is a fallacy. The fallacy is due to the limitation of biological intelligence which, is a predetermined biological response pattern of tissue and PNE axis. The lack of discriminative acumen in biological intelligence structure leads to failure of adaptation and creates an emergence from diathesis to disease. Under these circumstances, the original compromise of diathesis and alternate defensive state no longer is workable and the structure has to modify itself to accommodate the stress in the form of a pathology.

Most people are seen to have a perfect assimilation and excretion mechanisms, due to which no solute depositions seem to occur. This suggests that there is something more to the formation of renal stones than just diet and metabolism. The structure is fashioned by two things, the genetic predisposition the nature and the environmental and social nurture it undergoes. Well established cultural practices in diet, high fluoride content in the ground water are things which provide a fertile soil to those genetically predisposed. 

In urolithiasis the Stressors may be environmental like high density water, faulty dietary practices etc. Stressors coupled with inherent filtration defects of system manifest as, stones in kidney. This is similar to diathesis stress model where in disease is resultant of dynamic interaction between pre-dispositional vulnerability and environmental or life experiences acting as stresses. Under the effect of these stressors, the system reacts by initially producing change; in PH, high specific gravity urine, super saturation and occurrence of gravel, affinity to agglutinate to a nidus finally, leading to generation of a stone. There are silent expressions of the system which go unnoticed in the preclinical phases and only when the gravel or stone forms, does the body throw up recognisable signs and symptoms of unease. From the above discussion it is evident that, potential of disease development, including Urolithiasis is decided by hereditary characteristics, constitution and the immediate environment of an individual.

Sites of Stone Growth:  1937, Randall suggested that calcium phosphate deposits located on the tip of renal papillae build an ideal foundation for the formation of calcium oxalate stones (thereafter called Randall’s plaque). Research from investigators at the University of Chicago and the Indiana University has further advanced the field over the past decades by demonstrating that Randall’s plaque forms at the basement membranes of the thin loops of Henle, moving through the interstitium, occasionally encasing the renal tubules and vasa recta, and ultimately protrudes into the uroepithelium in the renal papillae. Using techniques such as digital endoscopy, transmission electron microscopy, and histopathologic evaluation, they were able to show different phenotypes with respect to patterns of tissue mineralization and injury among stone formers, and that stone type is the key evidence to the mechanism in a particular patient. Recently, a vascular theory concerning the development of Randall’s plaques has been hypothesized that may mirror the coincidence of kidney stones with diabetes, hypertension, or arteriosclerosis. It has been suggested that stone formation may resemble plaque aggregation after vascular injury or represent papillary necrosis in the setting of advanced arteriosclerosis.

Clinical features:

  1. Clinical presentation of calculus at various locations slightly differs which are as follows:
    1. Renal stones- quiescent: causing silent destruction of renal parenchyma, fixed dull flank pain
    2. Ureteric stones:
      1. Fixed pain – pain at the side of impaction; colic replaced by dull pain which is < exercise, motion
      2. Pelviureteric junction – fixed full flank pain < Jarring
    3. Ureteric Colic:
      1. Upper 2/3rd Ureter- radiating pain from loin to groin ii) Lower 1/3rd Ureter- radiating to testicles, labia majora iii) Intramural- ineffectual urge to urine, pain referred to tip of penis

Accompaniments: sympathetic stimulation causes symptoms like nausea, vomiting, profuse perspiration.

  1. Bladder stones – frequency of urine and dysuria
  2. Haematuria, but as a rule minimum bleeding.

Individualization in Renal Colic

Renal stones do not form overnight.  The sites chosen for development of the renal calculus, the size, constitution and the pattern of expression of pain differs widely in different individuals. Very small stones produce severe pain in certain individuals whereas fairly large calculi develop silently in others without producing any discomfort. In certain individuals we find a marked affinity to formation of stones and recurrence in a particular part in the urinary tract viz; renal pelvis, upper ureter, lower ureter, bladder, VUJ in some and in the urethra in others. Persons with similar dietary practices are seen to have wide variations in formation of a renal calculus. This variability in expression is decided by combination of the genetic predisposition, constitutional make up,  the environmental and dietetic factors.

Renal Colic is caused by a stone getting impacted in the urinary tract, commonly in the ureter where, it stretches the surrounding area of tissue while, trying to pass through. Nature itself has designed the   calculus in such a manner that there spicules around the calculus which cause friction against the surfaces it passes thorough. This friction and stretch causes pain and attracts our attention to the affected part. 

When the calculus is in the region of ureters and travelling downwards, the acute pain sets in. This pain presents with griping and the patient tosses in bed and then the pain passes off suddenly. In some it passes off and persists in others in a lesser intensity .Sometimes, sudden pain starts in the loin and radiates down to the testis, groin or inner side of the thigh along the distribution of the genitor femoral nerve, L1 and L2. Often, pain is accompanied with profuse sweating and nausea vomiting. In some Tenderness can be elicited over the renal angle in others it makes no difference.. As each organism is built uniquely, the onset of pain, progression and resolution of pain differs widely in individuals.

Bladder stone (Vesical calculi)   have no spicules and do not produce any friction along the bladder surfaces. Therefore they can exist for long periods in the urinary bladder without producing any discomfort. Their recognition occurs due to production of bladder symptoms such as frequency in voiding, hematuria and acute retention of urine.

Recognition of a no- self body occurs and the natural instinct ushers to throw it out from the body and that’s when the spasm sets in. This spasm takes the form of a colic. Many times, it succeeds if the stone is small and goes unnoticed in the urine. If the stone is big enough or if a small stone is getting obstructed due to its faulty position in the urinary tract causing complications such as hydro nephrosis with cortical pressures in kidney then, the patient may be referred for surgical management at the discretion of the treating Physician. 

Homoeopathic medicines no doubt aid in the expulsion of the stones, but we need to understand the anatomical and physiological limitations of the system. If the case at hand is not found to be amenable to homoeopathic treatment then our aim should be to render prompt aid in effective management of the pain.

Miasmatic Understanding of Colic

“Colic” in Homoeopathic parlance denotes the body’s ability to recognise a “non – self” from self. The difference in intensity of pain and time at which the body initiates a repulsion of the non – self hints at the susceptibility of the patient in question. 

Agonizing pain with a gravel suggests a highly reactive and a hypersensitive system. The system gears itself to restore balance through quick, immediate and adequate mobilization of inbuilt natural defences, disposal and return to normalcy. This is highly suggestive of a Psoric miasm at the helm of affairs.

Initiation of renal colic indolence in reaction, slowness in perception and absence of symptoms till the calculus grows to a substantial size, the erroneous metabolism leading to depositions, affinity for hollow organs, tubular structures, and the fatigue ensued due to repeated overstimulation of the system points to sycosis lurking in the background.

CHRONIC EFFECTS OF STONES

  1. SAME KIDNEY A) Hydronephrosis
  2. Complete obstruction
  3. Stasis  Infection
  4. Metaplasia  Neoplasia

B) OPPOSITE KIDNEY

  1. Compensatory Hypertrophy
  2. Retrograde Infection
  3. Calculus anuria – Reno – renal reflex.

INVESTIGATIONS

  1. USG KUB with full bladder
  2. X – Ray KUB after bowel preparation.
  3. IVP – only after S. creatinine.
  4. Urine routine for haematuria and crystaluria
  5. CBC for infection
  6. Creatinine and BUN for renal functioning.
  7. Uric Acid, if uric acid stone.
  8. Alkaline Phosphatase for hyperparathyroidism
  9. Serum and Urine Calcium.

INDICATIONS FOR SURGERY

  1. Recurrent attacks of pain in an impacted stone
  2. Stone too large to pass/enlarging stones
  3. Complete obstruction of kidney
  4. Stones obstructing solitary kidney or bilateral obstruction
  5. Renal Stone

TREATMENT in Conventional medicine.

Small Stones

Small stones usually get off from the body without much treatment.

  • Drinking plenty of water (04-05lts) a day may help flush out the stone through urine.
  • Pain relievers are used to relieve the pain at the time of stone moving.
  • Medical therapy: Usually doctors suggest an alpha blocker, which relaxes the muscles in the ureter, helps to pass the kidney stone more quickly and with less pain.
  • Diuretics which increase the urine flow may also chance to pull out the stone.

Large stones

Large stones cannot pass out from the body by their own because of too large. They also cause bleeding, damage in kidneys (loss of nephrons) or ongoing urinary tract infections.

Extracorporeal shock wave lithotripsy: In this kidney stones are broken into small pieces by using sound waves or shock waves to create strong vibrations. The tiny pieces can be flushed out of the body through urine.

Nephrolithotomy: The doctors generally go for Nephrolithotomy if they find large stones in or near the kidneys. During surgery the patient receives general anaesthesia, removes the kidney stones by using the thin telescopic instrument.

Ureteroscopy: Ureteroscopy is suggested when a stone gets stuck in the ureter or bladder.  Ureteroscopy is a small wire having a camera at the end is inserted into the urethra and passed into the bladder. A small cage is used to snag the stone and remove from the body.

General  Management  in urolithiasis.

  • Drinking plenty of water. Formation of clear urine is a sign of getting enough fluids to the body.
  • Restricting oxalate-rich foods like spinach, rhubarb, okra, sweet potatoes, tea and soy products.
  • Restricting salt intake
  • Avoiding foods that raise uric acid levels like sardines, organ meats, anchovies, red meat.
  • Reducing foods containing sucrose and lactose preferably should be reduced
  • Taking Low protein diet
  • Proper life style to prevent the reformation of kidney stones
  • regular exercise aiming at losing  excess weight
  • Maintenance of personal hygiene to prevent urinary tract infections

The Goals of treating a case of Renal Colic

  1. Relieving the Acute Pain
  2. Natural way of expelling the Stone
  3. Prevention of the Recurrence of the Stone

Scope and Limitation of Homoeopathy in Urolithiasis

In case of small urinary stones, medicines are helpful in dissolving or crushing them, so that these can easily pass away through the urinary tract. Thus, it helps in clearing off the urinary tract; this protects it from damage and thereby prevents formation of urinary stones again. It can be given along with other modes of treatment or when other treatment modalities may not be advisable.

In cases of large stones, multiple stones or for stones causing obstruction, surgical intervention may be considered. When kidney stones are treated with conservative medicine or with surgical intervention, there are chances of recurrence, therefore prevention becomes important. Homeopathic treatment prevents kidney stones from recurring by treating the tendency of stone formation, controlling urinary complaints and aiding in regular flushing out of the urinary tract along with prescribed diet and regimen or life style changes.

Demonstrative cases with illustration are listed below. These cases demonstrate the simple method of individualization in renal colics with acute pain. Chronic deep acting medicines were prescribed after colic responded to prevent recurrence of pain, and to milk out stone.

Case no. 1 

Name: Miss. Y.C.,  27 yr, female, K/C/O Renal Calculi on  5/3/01 presented with colic abdominal pain not localized > by pressure. Associated with Back pain, Urethral Pain2, < AT END OF URINATION , < Movement , > Standing, Reddish yellow urine with hypogastric pain .

Investigations: X-Ray- Radio opaque density on (L) side pelvis just below SI joint. USG: Calculi in lower1/3rd of ureter without Hydronephrosis.

TOTALITY

  • Urethral Pain2
  • <3 AT END OF URINATION
  • < Movement
  • > Standing
  • Uretric Calculus

Prescription:  Rx Sarsaparilla 200 

Case no. 2 Mr. K.D. Age: 64 yr, male, complains of colicky pain in left hypochondrium radiating to lumbar gradually increasing intensity. Associated weakness of legs. Due to hypoglycemia with a history of loose motions in morning. On examination there is tenderness in left hypochondrium and lumbar region

Investigations USG Abdomen: Left Kidney mild hydronephrosis with calculus in PCS with lower pole big renal cortical-50×50 mmpara renal-40 x 40 cm. chronic cholecystitis with cholelithiasis (gall bladder calculi 7.8 mm.)

TOTALITY

  • Left Sided renal calculus
  • Colicky pain radiating from hypochondrium to lumbar.

Prescription: Rx Berberis Vulgaris 200

Case no. 3 Mr. RVS Age: 37yrs, male, complains of pain at the tip of penis at the beginning of urination. Increased urge for urination, dribbling of urine, in drops, ineffectual urge for urination

Investigations: Urine Report: – Pus cells 10 –12/HPF, RBC – OCC

USG Abdomen: – NAD

PROBABLE DIAGNOSIS: Intramural Calculus

TOTALITY

  • Pain at the tip of penis at the beginning of urination
  • Patient shouts with pain
  • Ineffectual urge for urination
  • Dribbling of urine
  • Burning pain

Prescription: Rx Cantharis 200 

Case No. 4:  Ms. P Age: 21yrs, female, pricking pain3 on Rt. side of abdomen, sudden onset on waking up started with 3-4 vomiting, Pain with nausea3.Pain< Standing2, Pressure2, Sitting2, Walking2> Lying down2

O/E: Tenderness ++ in Rt. lumbar regions

Investigations

USG: – Right sided Hydronephrosis with 14 mm stone

DIAGNOSIS: Right sided renal Colic

TOTALITY

  • Renal pain with nausea
  • Renal pain with vomiting
  • Right sided affection

Prescription: Rx Ocimum Can 200

Case No. 5 Mr. S.B., 34yrs, complaints started with right testicular pain in the morning along with lower back pain and restlessness. Till Evening: intermittent hypogastric pain. Pain on right side of abdomen radiating to right testes. Complaints accompanied by unsatisfactory stools ++ & Thirst decreased++,

On examination: Right iliac fossa tenderness+, Hypogastric Tenderness+

Investigations

USG: Right renal 6mm calculus at Right VU junction.

DIAGNOSIS: Right sided lower ureteric colic

TOTALITY

  • Ineffectual urge for stools++
  • Right sided ureteric pain radiating to Right testis.  Right sided affection.

Prescription: Rx 1.Nux.vom 200

Case no. 6

Name: Mr. Mn 35yrs, male complains of left sided ureteric colic since 2 days, Spasmodic colicky pain, Pain radiating in upward direction > Stretching leg3< Jar2, Jerk2, Movement2, > Hard pressure2, lying on affected Left side,

O/E: Mild Tenderness on Left Hypochondrium

Investigation

USG: Multiple Urinary Bladder stones. No renal calculus

Provisional Diagnosis: Left sided upper Ureteric Colic

TOTALITY

  • Left ureteric colic > Stretching leg3
  • Left ureteric colic > hard pressure++

PrescriptionDioscorea Villosa 200

It was prescribed based upon the specific modality seen in the patient > Stretching leg3 < Jar2, Jerk2, Movement2 > Hard pressure2, lying on affected Left side,

All the above cases were followed up and patients were relieved of the renal colic and some of them passed out the stone while passing urine.

 

s.no  Age   Sex Site of calculus  USG findings  Remedy given
1 27FUreterCalculi in lower 1/3rd without hydronephrosisSarsaparilla 200
2 64M Renal pelvisCalculus in PCS with lower pole big renal calculusBerberis Vul 200
3 37MIntramuralNADCantharis 200
4 21FRenal calculusRt       Sided

hydronephrosis

with   14      mm stone.

Ocimum can 200
5 34MVesicoureteric junctionRt renal 6 mm

calculus at VUJ

Nux Vom 200
6 35M BladderMultiple bladder calculiDioscorea Villosa 200

The table below provides a model of study for therapeutics of renal colic and urolithiasis.

RemedyLocationSensation          ModalityConcomitant
1.Berberis VulgarisKidneys3

Ureters- upper1/3 Bladder

Lt. Sided

Radiating Pains loin to groin  to the calves

Wandering   Pains

Bubbling

Sensation  kidney & bladder

 

<  motion3

 

> standing

 

<jarring

< urination

2.Cantharis

 

Bladder

Kidney     Right sided

In tolerable urge with tenesmus

Violent paroxysm of BURNING and cutting    pain  fearful tenesmus

Urine scanty in drops

<Before Urination3

<During

Urination3

<After Urination3

 

< Drinking small quantity  of  water3

<Hearing running water3 > Rubbing3 > Pressure on glans penis

> Warm

application

3. Colocynth

 

Kidney

Right sided

SPASMODIC

-Renal colics with diuresis

-Pain whole abdomen

on urination

 

– Red hard crystals

adhere to the vessel

 

A/F-Emotions

-Anger

–     Vexations

–     Chagrin

< During Stool >Bending double3  >Hard pressure3

 

>Lying on abdomen3

4.Dioscorea

 

Kidney

 

Urethra

Right sided

SPASMODIC Pain

Unbearable sharp gripping pain –  Paroxysm -Radiations to different parts up  & down

–  Stop suddenly & start in other parts

-Nervous shuddering from pain

A/F: Excessive tea drinking Fasting

Masturbation

 

< doubling up2

< lying

< tea

> stretching2 out >bending backwards2 > hard pressure

5.Nux Vomica

 

Lower 1/3rd

ureter

 

Intramural calculi

 

 

 

Bladder

Kidney

-Painful ineffectual3 urge to urinate  with frequent urge to

stool

–                      Renal pains extending to rectum &

genitals

–                      Irritability of bladder & rectum at same time

 

A/F: High living

Drugs

Liquor

Over eating

Loss of sleep

Sexual excess

< pressure

<disturbed sleep

>free discharge

>  Hot drinks >lying on sides

hypersensitive nerves

 

violent spasm

 

6.CalcareaRenalis

 

Lt. sided

Kidney

Bladder

Violent lancination pain in kidney region Lessens tendency to accumulation of

stones

7.OccimumCanum

 

Kidney3 Bladder

Rt. Sided

 

Kidney pains with

VIOLENT

VOMITING

–  Wrings hands &  moans & cries all the time

-Red urine with sediments after attack

8.Sarsaparilla

 

Bladder

Urethra

Rt. sided

 

Painful micturation

especially LAST

DROP

-Crusty urinary sediments on diaper -Can pass urine only on standing

<  At close of urination3 < Before Menses

<  Standing

 

–  Urine- bloody- last part
9.Lycopodium

Lithic-Acid

Diathesis

 

Kidneys

Rt. sided  (lt)

Pain in renal region –  Slow urine- must strain

–  Red sand in urine

Gravel

 

A/F   Fright

Anger

Mortification Reserved displeasure   <  before urination <  4-8 pm

<  oysters

>  warm food

>  riding in car

>  after flow

10. Hydrangea

Stone Breaking

Remedy 

URIC-ACID

DIATHESIS

Arrests tendency of formation of stones Relieves from distress of kidney stones

Bladder

Kidney

Lt. sided

 

Sharp pain in loins on

left side

 

Great thirst with

abdominal pain

 

Urine difficult to start.

 

Profuse deposits of white amorphous salts in urine

11.CalcareaRenalis Prepared from kidney stonesLt. sided

Kidney

Bladder

 

Violent lancination pain in kidney region Lessens tendency to accumulation of

stones

12.Cannabis Sativa

 

Ureter

URETHRA

Lt sided

 

-Burning in urethra while urination extending upward to  bladder

-Zigzag pains along urethra

-Sensation as if urethra tied in knots -Highly sensitive urethra as if burnt -Forked stream of urine

-Urine retained with obstinate constipation -Dances around the room in agony

-Walks with legs apart

<closure of urination3 <  during

urination

 

obstinate constipation
13.Equisetum Hymale

Kidney Tonic- Decreases

irritability of the urinary tract

 

Kidney

Rt. sided

 

 

-Dull pain in kidney & bladder not better by urination -Constant desire to urination -Passes large quantities of urine without relief -Aching pain in bladder as if distended not better by urination<close of urination2 < pressure

>  lying down >Continued

motion

 

14.Thlapsi Bursa

Pastoris

Uric acid diathesis  Anti-uric acid remedy

Kidney

Urethra

 

 

-Dysuria & spasmodic retention

-Brick dust sediment -Urine runs in little jets

 

Replaces use of

catheter

 

-Urine heavy

phosphatic

 

15. Petroselinum

Solvent in Uric

Acid Stone

 

Bladder

Urethra

 

-Sudden urging to urinate with burning & tingling in perineum through whole urethra during

Urination

-Urinary difficulties in

babies

-Painful urination causing the child to dance around the room in agony -Intense voluptuous itching deep in urethra

16.Thuja

 

Bladder

Lt. sided

 

-Squeezing acting pains in bladder -Bladder feels paralyzed, must wait for urination -Frequent urination till bladder is

completely empty

-Feeling as if drop of urine running down urethra after urination -Pains from Left kidney to epigastrium

Foamy urine Forked urinary stream
17. Calc. Carb Tendency to Calculi Defective metabolismKidney

Bladder

Rt. sided

 

-Colicky pains

-Irritable Bladder

– Kidney colics

 

A/F:  Standing on cold

Damp pavement     -working in cold water

-Overwork

18. Benzoic Acid

Uric-Acid

Diathesis

Action on

-Metabolism

– Heart

-joints

Kidney

Left sided to

Right side

-Renal pains

-Renal pains alternate  with heart &

Rheumatic complaint

 

A/F Wine >Profuse urination

 

Strong smelling urine ammonical Urine smells like horse urine Metasatic

Complaints Right knee swelling

19.Pariera Brava

 

Kidney

Bladder3 Intramural calculi Left sided

 

 

-Constant urging to urinate

-Violent pain in glans penis down the thighs during effort for     urination

-Must get on knees & hands with head pressing firmly on floor to urinate -Painful urination since confinement, cannot urinate except in    above described position

 
20. Lithium Carb:

Uric Acid

Diathesis

 

Bladder kidney Right sided

 

-Pain Bladder extending to spermatic cord after urination

—  Pressure in the heart while urinating -Urine scanty with decreased thirst -Reddish brown deposits

<  after urination

> before

Urination

>   motion

 

21.Chimaphila

Umbellata

 

Kidney

Bladder

 

-Feeling in perineum on if sitting on a ball -Must strain to urinate

-Can pass urine only on standing with feet apart &      body inclined forward

<  Standing <  Beginning of urination

<  sitting on cold

stones >  Walking

 Conclusion:

  • The idea behind this write up is to belie the myth that Homoeopathy can cure only chronic cases and that “when it ails the most, we aren’t around”. Relieving the patient of immense agonizing pain goes a long way in reinforcing the belief in the system.
  • All the 6 cases mentioned in the article deal with urinary calculi at various sites in the urinary tract and present with a multitude of expressions which is an important point for the clinician. Expressions are varied and highly individualistic and hence the “One Size Fits All” approach of prescribing mother tinctures like Berberis Vulgaris, Hydrangea etc. On a random basis is not the right approach. Recognition of pain, its ascent and characterisation aid in arriving at the simillimum.
  • An understanding of the development of the disease potential helps us in understanding the distinctive patterns thrown up at an individual level. In the cases it is seen that the size and number of the calculus is not proportional to the intensity of renal colic. Expressions of the disease like the timing of the colic, its onset, progression, and association with micturition, expressions of the individual susceptibility in terms of quality of symptoms as well as other distinguishing features of the case have served as a guide to erection of the acute totality and treatment.
  • Colic produced by small multiple stones to fairly large calculi are seen to be amenable to Homoeopathic treatment. However, a clinician should try to expel only those which are anatomically feasible. Those not amenable should be subjected to endoscopic procedures to avoid risk of permanent damage to the kidney by back pressure changes and hydronephrosis.

References:

  1. T Vijaya. Urolithiasis and Its Causes – Short Review. The Journal of Phytopharmacology.2013;(2 (3): 1 – 6). doi:SSN 2230 – 480X.
  2. Muraro E, et al. Nephropathy by oxalate deposits:not only a tubular dysfunction. J Clin Case Rep. 2016;6:713.
  3. Agrawal, Aron, Asopa. Endourological renal salvage in patients with calculus nephropathy and advanced uraemia. BJU International. 2001;84(3):252-256. doi:10.1046/j.1464-410x.1999.00159.x
  4. Chakm DA. Renal Calculi: An Evidence Based Case Study. RA Journal Of Applied Research.

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  6. Shenoy, K. R., & In Shenoy, A. N. (2014). Kidney and ureter. In Manipal manual of surgery (4th ed., pp. 935-939, 955).
  7. Lilienthal, S. (1879). Homœopathic therapeutics (2nd ed.). New York, USA: Boericke&Tafel.
  8. Murphy R. Lotus Materia Medica: 1,200 Homeopathic and Herbal Remedies. New Delhi: B. Jain Publishers; 2002.
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  10. Dhawale M L, Principles and Practice of Homoeopathy,Mumbai, B Jain Publishers, 7 th reprint edition , (Page no 34,51 ).
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List of Abbreviations

  1. A/F – Ailments from
  2. A- Vitamin A
  3. USG KUB – Ultra Sonography Kidneys, Ureters, Bladder
  4. IVP- Intravenous Pyelogram
  5. X – Ray KUB – Kidney, Ureter, And Bladder
  6. CBC- Complete Blood Count
  7. BUN -Blood Urea Nitrogen Test
  8. K/C/O- Known Case of
  9. C/O- Complaints of
  10. < – Aggravation
  11. >– Amelioration
  12. H/O- History of
  13. O/E- On Examination
  14. OCC-Occasional
  15. NAD- No Abnormality Detected
  16. Q- Mother Tincture
  17. – Right
  18. – Left
  19. VU-vesical-ureteric
  20. Mm- Millimeters
  21. P – Powder dose
  22. ROS- Radio Opaque Stones.

About the author

Navin Pawaskar

Navin Pawaskar
M.D.(Hom), MICR(BOM),MHA(USA),CPDM(USA).
JIMS Hospital, Hyderabad.
[email protected]
Mobile: +91 750 62 63 508”

About the author

Gurumayum Chand Sharma

Gurumayum Chand Sharma

Dr. Gurumayum Chand Sharma MD (Organon) Final Year, Department of Organon of Medicine & Homoeopathic Philosophy, Father Muller Homoeopathic Medical College & Hospital, Deralakatte, Mangaluru(Karnataka).

1 Comment

  • This is homeopathy as it should be practiced. Dr. Pawaskar demonstrates the knowledge and discipline as well as dedication to craft that all students of homeopathy should strive to emulate.

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