Why Some Arthritis Cases Are Lost After a Good Development

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Dr. Santanu Maity shares lessons he learned in treating very many cases of arthritis.

When treating arthritis, and infection from a virus or bacteria comes in the way of progress, that condition must be dealt with as an acute, not chronic one. A deep acting miasmatic drug must not be applied here. When an antimiasmatic drug is given during this acute condition, the case becomes an obstinate one. After that, even acute medicines stop acting, and the case is lost. We have to deal with the acute infection. This acute infection should be treated from the aspect of acute disease.

Allied abnormalities are one of the main obstructing causes I have found, which come in the way of treating arthritis. In one difficult case I treated, the patient was suffering from pain at the lumbo-sacral region, with pain radiating towards the legs, aggravation from rest and relived from movement. The pain was intolerable at night and while lying down.  X-Ray showed degeneration of bones at the sacro-pelvic junction. On palpation the junction was sensitive to the least pressure and relieved from moderate heat application. The pain was aggravated also in the morning from first movement and relived from continued movement to some extent.  This patient was a male, 41years of age. I prescribed Mezerium200.

After one week the patient comes back to tell me that nothing has happened. No relief is there.  Once again I investigated the symptoms. He explained that he has susceptiblity to cold and also had constipation for years. Here constipation is the main allied complication. I asked him to explain his constipation. He said he faces difficulties while passing stool whch is hard and dry. The anus is sore and there is slight swelling and sticking pain during and after stool. This time, I did not give any medicine related to his main complaint, but rather tried to treat the constipation with Aesculus Hip 1M(2d), followed by placebo for seven days. Aesculus Hip also has back pain with stiffness. After one week he showed some little improvement from his symptoms. I repeated Mezerium200(2d) followed by placebo for one week. After the week he said there was great relief of nightly pain. Now he can sleep at night. Suffering is there but less than before. Now the same medicine (Mezerium) begins to act when closely related allied abnormalities are treated and controlled. So I think that it is not always necessary to focus on the chief complaint of the patient.

One thing I found which is also necessary, is wiping out the effect of the previous medicines, even when a continuous process of chronic treatment is going on. This condition is often encountered while treating an obstinate type of arthritis. I was treating a lady aged 55 for her arthritic knees for almost one year. She was doing fine and progress was satisfactory.  Then her pain, swelling and soreness increased severely. A uric acid and urea test revealed normal values. She complained of being feverish. Thirst was there, but for little and frequently. Temperature aggravation was midday and midnight. She was weak but restless and I thought of arsenicum album.. She had not done anything wrong which could aggravate the disease. I was confused about what to do and thought I was going to lose her case. Nothing was coming in mind. She was following every instruction. I thought to make a fresh beginning of the case. I gave her Nux Vom 200 (2d) with placebo for five days, with the option in my mind that I was going to take the case anew.

Now I started Arsenicum album 200(3d) with placebo. After a week there was a great relief. Pain and swelling was reduced by 50%. Fever was gone. I prescribed placebo for another week. I was thinking about what Nux did. It wiped out the medicinal effect of the previous medicines, though it is said Nux only antidotes medicines from the vegetable kingdom. But I have seen that Nux Vom200 antidotes the secondary action of every medicine. In several chronic cases where there was a continued treatment that became stuck, one needs a wiping of previous medicine effects. A fresh beginning makes the disease move forward.

The acute exacerbation of symptoms is often encountered. This must be controlled firmly and correctly or the case is lost. I have looked carefully into this acute aggravation of the symptoms. Almost 80% of these cases are due to bacterial or viral infection. What is more common is the common cold virus infection. When the patient is infected with this virus with body ache, fever and malaise, joint pain increases.  When the infection is cured, all other symptoms are gone, but the joint pain remains.This virus mainly affects the synovial membrane, tendons and muscles surrounding the structure. X-Ray of the suddenly aggravated joints reveals no further bony abnormalities. X-ray shows only tissue swelling around the joint. I have been treating a 45years old man for the last eight months. He first came to me with polyarthritis. Every joint of his body was affected. Tearing pain was there with stiffness after rest. There was severe tearing pain from slight movement and aggravation at night. All metacarpal and metatarsal joints were swollen and stiff and sensitive to touch. I started his treatment with Actaea spicata 30, along with a few intercurrent and follow up medicines like Causticum, hypericum, ruta, symphytum, actaea rasemosa etc. His development was satisfactory. He was doing his salsman’s job very well, which was becoming difficult when he first came to me. He discontinued the treatment for one month. Viral fever was the main suffering when he came back after a month’s interval. All his joints were aching. It is difficult to distinguish whether it from the arthritis or because of viral infection. I made a plan. I decided to treat the fever first, then see if there is there is any relapse of the arthritis.  When the fever was over, the sufferings allied with fever were gone. But the pain and swelling and stiffness of the joints remained. He was moving his joints but writhing in pain. The right shoulder joint was much more affected. It swelled and was sensitive to pressure. Previously he had the modalities of getting relief from moderate heat application. Now he said heat aggravates the pain. Previous medicines failed to response. I stopped all the medicines and prescribed Apis mellifica 200(5d)  at 3 hour intervals with placebo for 3 days. His pain swelling and sensitiveness of joints were reduced by 80% when he came back after 5 days. I was also relaxed and happy that the crisis was over. Another 6 doses were required (B.D) to wipe out rest of the suffering.

It is not always necessary that we stick to the chronic treatment plan and wait for a long while before the chronic medicines starts the secondary action and the patient gets relief.  Rather, we can give the patient relief and then can go back to the previously planned constitutional treatment.

If the knees are the parts involved by arthritis, the patient must follow one rule strictly.  He must not bend the knee. This posture stretches and injures the shortened and fibrosed tendon. This only increases the pain and soreness. No medicine will be helpful if this practice is continued. Long walking is injurious to arthritic joints. But patients must walk 30 to 40 minutes every day in two divided slots. Otherwise muscles around joints becomes stiff and mobility decreases.

Cases where indicated medicines fail

In some cases there is frequent relapse of disease. What brings back the disease? Inherited miasm and infection are the causes. Staphylococcus aureus, nesseria gonorrhoea, are the causative organisms which cause infection to the synovial membrane and synovial fluid. Infection spreads to the joint through blood, infection from bone itself, infected places on the skin. All these are infections which cause or aggravate the arthritic condition.

In some cases I did blood tests which revealed that CRP is normal. There are some cases where in spite of staphylococcus infection, CRP remains normal. TSH was normal and urea was within normal limits. Only uric acid levels is sometime at the upper limit. In some cases CRP was elevated. I consider that these internal abnormalities be treated first. I stop all miasmatic medicines. The present aggravations and ameliorations are the main complaints I consider. The time of aggravation is also a main symptom in prescribing. Prescription from this aspect gives quick relief to the patient and the severe pathology of the disease is controlled.

Arthritis without complication responds rapidly to medicines, if the patient is not suffering from vitamin D3 deficiencies or Calcium deficiency. These plays an important role treating arthritis.  I always give emphasis on correcting the deficiencies as well as stopping and controlling the last two conditions mentioned while treating arthritis. Correcting the diet depends on natural foods. Natural foods help much better in correcting these deficiencies, though in some severe deficiencies there remains no time for dietary compensation.  An external supply of calcium and vitamins becomes evident. When the patient is advised dietary supplements, it is important that his digestive function and assimilation is normal. If not, you have to consider digestive treatment along with the main treatment. Calcarea carb and Calcarea phosphoricum in trituration helps much in supplementing the patient who has calcium deficiency.

I wanted to find out whether constitutional treatment gives relief to the patient’s suffering or a therapeutic approach acts earlier.

PatientConstitutional approachTherapeutic approachRemedies with follow up relation.Managementday 1stday 2ndday 3rdday 4thday 5thday 6thday 7thday 8thday9thday 10th
AApis mellifica200.3 hourly.(5d)noArthritic managementpain begins to reduce.Pain more less than 2nd day.Effusion begins to reduce.Effusion less again.Effusion less.Pain and effusion both are less.Both less.Both less.Patient feels better by 50%.
BArsenicum album200(6d). 4 hourly.Ferrum phosphoricum 6x.T.D.Samepain much less.Inflammation slightly less.Pain almost gone.Inflammation much less.Inflammation slightly remains.Patient did not report.Patient did not report.Patient feels better by 50%.
CBellis perenis200(8d). 3 hourlyHelleborus N6SamePain begins to less.Pain less.Pain less.Pain less.Drawing sensation begins to lessen.Drawing sensation less by 60%.Patient feels better. Pain absent.
DKali iod200(6d).3 hourly.Actaea spicata200(4d)B.D.SamePain begins to lessen from evening.Pain less by 50%Pain less by 80%Pain gone. Soreness much lessPain less again.Soreness reducing.Patient feels much relived.
EGraphites200(2d)placebo T.DSame.Pain begins to lessen.Pain less.Pain less. Soreness slight less.Patient feels good by 30%.
FCal hypo.30(6d) T.D.Placebo T.D.SamePain begins to lessen.Soreness less slight.Pain and soreness lessLess.Patient feels better by 40%.
GKalmia lat200(4d)B.D.Placebo T.D.SamePain begins to lessen.Soreness begins to be less.Patient feels better by 30%
HMezerium200(4d) B.D.PlaceboSamePain begins to lessen.Soreness slight less.Patient feels better by 30%.

 

I have seen clinically in treating for the last 10 years that Actaea spicata is complementary and follows Kali Iod very well. Actaea spicata also follows Graphites and Calcarea hypo.

While treating arthritis I always try to do a combination of therapeutic approach and constitutional approach. At the beginning, if the patient’s suffering becomes great and he is at the edge of his tolerance, I prefer to start with the therapeutic approach. When the torture of pain cools down, I start the constitutional approach. In absolutely every case, it stops the disease pathology and reduces sufferings  quickly. The therapeutic approach makes the way smoother for the constitutional medicines.  A disease, like arthritis which cannot be cured, should be treated with the intention that the pathology of the disease process must be held to where it is, and the sufferings of the patient reduced.

About the author

Santanu Maity

Santanu Maity

Dr. Santanu Maity was studying 1st year B.Sc when he came to know about the D.H.M.S. course and its contents. He decided to leave B.Sc. and took admission for D.H.M.S.(four year course under homeopathy medical council of West Bengal affiliated with government of India.) He received his registration certificate on January 5, 2000 and has been in private practice since then.

13 Comments

  • Dr. Santanu-RA can be ‘cured’ as in my mothers case of crippling 20+yrs of RA. One of my first complex cases as a classical homeopath, I was trained to look at cases constitutional and it paid off. Taking aprox 2 yrs before a full cure (blood test indicated no more RA factors)Even her allopathic rheumatologist was shocked.Homeopathy cures the incurable don’t forget that. Thanks for sharing your article

    • Your mother is cured of arthritis it’s very good to hear that. Homeopathy cures incurables i know that. But science does not consider solitery cases or cases with 1% success. RA factor does not reveal the arthritis case. I have seen several cases with normal RA factor. I am working on arthritis for last ten years. I have several cases who are not taking medicines now and not staggering while walking. Still the x-ray of the affected part says no the bones are not in it’s normal configuration.

      • Dr. Santanu Maity
        I am suffering with pain in my joints of Thumb, Elbow and Knees. I was given injections in all these joints and then got some Physiotherapy as well. All these processes did give me a big relieve but after a couple of months the same pain has started developing. This time so far I am not taking any medicine but has started massage with Olive Oil. Some time I feel quite a bit relief. Can you suggest some permanent homeopathy remedy for this pain?

  • I have taken a lot of homeopathic treatment for years. I have also studied it for me and for others. I have given remedies on advice of doctor or rarely ‘home remedies’. I am not a homeopath till date. But I have experience as a ‘patient’. What I have found is that many doctors are too ‘tight’ and ‘strict’ about constitutional treatment and that it may get disturbed, etc. But many times patients need immediate relief. This line of discussion can go on and on and then this may not be the right place to discuss. But all should consider the fact that is it not likely that by giving acute treatment first (when needed), the patient becomes more presentable and is likely to express ‘better’, in some form, his/her constitutional and chronic symptoms?
    I have seen that when I am too sick I am unable to express (orally or otherwise) the real problems.
    Dr Santanu, your approach is highly practical in today’s polluted world and such approach likely to give the doctor a chance of complete cure in long treatment while keeping him in relief during the course of time. Otherwise, as the title says, not only arthritis but all types of patients are ‘lost’ and doctors don’t keep record of whom they have ‘lost’. (They themselves never call back a patient to find out how well he/she is or why he/she is not coming back…)
    The paragraph
    ‘It is not always necessary that we stick to the chronic treatment plan and wait for a long while before the chronic medicines starts the secondary action and the patient gets relief.  Rather, we can give the patient relief and then can go back to the previously planned constitutional treatment.’
    is a very practical approach and I like it and find it useful.

  • This is a very helpful interpretation about the application of deep acting medicines in acute phase of complications. I have found that this type of application becomes obstinate the cases.

  • Very very thinking to Dr maity. to best way of your explanation about this method of application of medicine in appropriate condition.
    Thanking.

    • Yes Dr.Awanesh i have found in every case of arthritis not only in arthritis but in every chronic diseases when an antimiasmatic or constitutional medicine is given in it’s acute phase it makes the case it becomes hard and tough to crack. Suffering of the patient in lengthened and the time of cure is prolonged.

  • I find failures or relapses are not confined to Arthritis alone. In most chronic cases homeopathy showed promising improvements in the beginning, subsequently become more and more indifferent and later a failure. since effect of homeopathy is total including the sensorium, a change in perspective of the patient is invariable. when their physical troubles reduce, so are their associated mental distress, without an internal link to the past. and they tend to under report the benefits.

    A repetition of the same remedy which had given good result is not only unnecessary, but would invariably make the symptoms worse if given after considerable interval of time. A second dose of the similimum is an impossibility because after the first dose it doesn’t remain the similimum anymore.

    Totality of symptoms doesn’t belong to the physiological or pathognomonic symptoms of the disease in question, but it is an abstraction suggestive of a shadow of the physiology. whatever happens to that shadow has corresponding or complementary behavior in the physiology too. But the changes in the abstract partner is not gradual by any means, it’s always instant. The corresponding changes in the physiology would obviously take little longer for completion, due to the tissues involved which must obey biophysical and biochemical laws.

    disease pictures have various observable symptoms, by joining all of them we get a totality like a point in space specified by three observables, the length, breadth and height from a reference point. like location of any thing in space can be defined by three measurements in Euclidean three dimensional space, a disease in homeopathy is defined by numerous dimensions like thermal, appetite, day/night, rest/motion…and so on. Hence as per homeopathy we have a disease space (but abstract). Every disease is a unique point in such an abstract space. any one symptom differing, the point changes to another point in that space. Remedies also can be similarly shown to span such a space. And these two spaces are similar. Or to put it more appropriately “Remedy space is Isomorphic to Disease space”. A disease when meets its isomorphic remedy, they cancel each other. That’s “Similia similibus curentur” to put it in strictly scientific terms. But when a similimum thus cancels or removes the disease, the point representing the disease rotates to another point where the description of that disease picture is slightly different from the original one. Hence the corresponding isomorphic remedy is not the original one anymore. Yet, since that remedy has acted once and there is nothing to prevent it from acting a second time, only thing it can do now is, not rotating the disease point once again, but magnifying the troubles keeping the description or totality unchanged. Again in Scientific parlance we call this magnification a “scalar multiplication” as differentiable from the “Vector rotation” that happens from interaction with a similimum. Despite the fact such a perturbation helps in finding the correct remedy by magnifying the troubles ( consistent with aphorisms 179- 183) Now do we need to trouble the patient with such wrong remedies in order to find the second remedy ? for the purpose we have the excellent works of Gibson Miller in the form of his Remedy relationship table.

    A second dose is absolutely unwanted and besides being responsible for the failure of chronic cases now seems to a great extent responsible for the global skepticism against homeopathy which is threatening the very existence of this highly effective system of medicine. Not withstanding the change of perspective inherent to homeo cures, which makes the patients tend to under-report and RCTs have their blindspots.

    • Thank you,

      I am obsessed with the idea of finding the plausible mechanism. this comment includes the interim conclusions that remedy profiles span a vector space. Their relationship has a vector behavior-
      for example; there are many antidotes for the same remedy but none of them substitute one another. hence there is direction to their actions, which is a vector behavior.

      The remedies have another property known as *Scale Invariance* in physics. that is they are not dosage dependent, whether just one globule is given or hundred globules, make only one dose and there is no difference in their action. Hence why should a second dose have cumulative effect ? not only it doesn’t but is inconsistent with such comparable scientific theories too.

      Moreover Hahnemann has expressly written that a wrong remedy brings out the non manifest symptoms of a disease and thus facilitates choosing the correct remedy on the picture of disease thus completed from such wrong remedies. Whether the wrong remedy is deliberately given or by mistake, there can’t be different rules (obviously). Since the first dose acts instantly to change the disease picture, there is no scope for the second dose or repetition. hence second dose is guaranteed not to change the disease picture in the beneficial ( Vector fashion) way, but to bring out the latent symptoms in the already altered disease picture- hence hastening the necessity for the next remedy which wouldn’t be otherwise necessary at all, at least in some relatively simple cases.

      By giving repeated doses aren’t the homeopaths themselves damaging the image of their beloved system ? Hence should we call it fortunate that majority of homeopaths aren’t capable of prescribing the correct remedy or should we feel sad about it ?

      I feel severely indignant that homeopaths themselves are partly responsible for senile and incompetent heads of healthcare departments of influential Nations talking ill of homeopathy in their websites and being fairly successful in making this a taboo subject in respectable and Scientific circles.

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