Category Archives: case report

Merawat eczema, lapuran kes 2

Ini adalah AT, saya mula merawat anak lelaki berumur 5 bulan pada 5 hb February 2014. Lapuran kes ini dengan izin dari ibunya .

Anak ini mengidap eczema dan antara faktor yang boleh mencetuskan eczemanya adalah faktor genetic serta pengambilan antibiotic selepas dilahirkan . Anak ini juga tidak dapat susu badan selepas beberapa bulan dan mula mendapat eczema selepas minum susu formula .

  • Eczemanya jenis circinate, ie bentuk membulat .
  • Pemeriksaan menunjukkan keliling dubur pun merah
  • Najis berbau masam dan lembut.

Berdasarkan sejarah dan juga sejarah keluarga, saya memberi satu dos sebuah nosode . Selain itu, anak ini mendapat sejenis lagi nosode untuk jangkita candida dan juga sejenis ubat untuk betulkan bakteria usus ( MP)

Berikut adalah komunikasi antara saya dan ibunya sereta beberapa gambar AT sepanjang perjalan ke arah penyembuhan .

10 February, flare selepas ubat
10 February, flare selepas ubat

 

Gambar sebelah ini adalah ‘flare yang berlaku selepas makan ubat pertama satu dos . Ini mesej ibunya

“Salam doc..condition skin anas thaqif skang.jumpa doc n amik ubat start last thursday.then flare up.saturday stop ubat n now juz mkn al manna”

Memang begitu selepas makan ubat homeopathy, kerap kali akan menjadi lebih merah dulu dan mungkin lebih gatal . Bila berlaku begini saya suruh hentikan ubat dan ibunya telah pun hentikan ubat .

Tanpa ubat dengan hanya mengambil lactulose dan Al Manna. Bila gatal, diberikan antihistamine, ini langkah sementara sahaja dan dihentikan bila gatal berkurangan .

Seterusnya pada 22 hb February

Pada 22 February kulit AT sudah mula sembuh dan tidak lagi merah
Pada 22 February kulit AT sudah mula sembuh dan tidak lagi merah
Perbandingan AT semasa eczema dan bila mula sembuh
Perbandingan AT semasa eczema dan bila mula sembuh

Ibunya rasa lega sebab kulit anak sudah pulih, masih tanpa memberi sebarang ubat homeopathy.

Seterusnya pada 26 hb February, eczemanya datang semula !

feb 26 flare again
26 February selepas 4 hari sembuh mula merah semula !

Apa sudah jadi ? Sebenarnya tak perlu risau, hanya petanda bahawa kena makan ubat semula maka dimulakan semula MP tapi kali ini diberi dengan lebih cair dan lebih jarak . Dua titik dalam air secawan, beri hanya satu sudu teh. Bukan bagi secara routine hari-hari tapi beri dan nilai response. MP diberi tiga hari dengan cara mencairkan dengan air . Selepas hari ketiga, AT demam!

Ibu mana tak risau kalau anak demam? Sudahlah demam, saya suruh biarkan demamnya itu tanpa memberi paracetamol !

Bila demam, MP dihentikan seketika .

Demam AT kurang dari 24 jam rupanya ! Ibu AT memberi komen bahawa kemungkinan sistem immune AT bertambah baik !

AT sudah baik demam, nak berus gigi pulak !
AT sudah baik demam, nak berus gigi pulak !

Selain dari ubat homeopathy, ibu AT memberi susu rice milk mengantikan susu formula serta olivenol dan Al Manna. Untuk sapu diguna Udder cream dari Mogoo.

Kenapa diberikan prebiotics Lactulose dan Al Manna? Ia adalah untuk membiakkan bakteria baik dalam usus. Ciri-ciri circinate dan dubur merah menyebabkan saya syak ada candida. Najisnya pula masam pada peringkat awal .  Ubat MP yang diberikan adalah nosode juga yang merupakan bakteria usus yang telah disediakan mengikut kaedah homeopathy.

AT memang akan memerlukan ubat homeopathy lagi tapi bukan untuk makan hari hari, mungkin seminggu sekali dan mungkin juga sebulan sekali .

Memang ada gejala aggravasi dalam bentuk flare dan demam.  Oleh kerana ibu AT telah ikut sebagai mana saya ajarnya dan sentiasa berkomunikasi dengan saya, penyembuhannya ‘smooth and gentle ‘.

Ini gambar hari ini 5 hb Mac 2014

Riang ceria hari ini ! Cuma beberapa dos ubat homeopathy dan pembetulan sistem immune melalui pembetulan usus !
Riang ceria hari ini ! Cuma beberapa dos ubat homeopathy dan pembetulan sistem immune melalui pembetulan usus !

Perlu saya ingatkan setiap kes berbeza, ubatnya berbeza dan ubat sapunya pun mungkin berbeza  maka rawatan eczema pada banyak ketika perlukan bimbingan dan preskripsi dari homeopath yang mahir dalam cara merawat eczema .

 

 

Menilai respons kepada rawatan- maklumbalas pelanggan

Kepala A, jadi ruam pula, yang asal adalah serupa cradle cap atas kepala bahagian berambut
Kepala A, jadi ruam pula, yang asal adalah serupa cradle cap atas kepala bahagian berambut

 

Dibawah ini saya pastekan maklumbalas dari ibu kepada anak yang saya rawat. Anaknya mengidap eczema. Bukan mudah untuk dirawat dan yang mengalami ‘perjalannya adalah ahli keluarga kepada yang mengidapnya. Kadangkala saya sendiri rasa cemas dengan keadaan pesakit saya tapi tidak ada jalan mudah untuk rawat penyakit ini. Krisis penyembuah pasti berlaku dan ibubapa perlu tahu baca sama ada anak semakin sembuh.
Saya bersyukur penulisan saya sebelum ini dapat membantu sedikit sebanyak ibubapa untuk baca perkembangan anak dari segi sama ada semakin sembuh atau tidak .
Ikuti dibawah ini deskripsi perkembangan anaknya dalam masa dua minggu dirawat dengan penawar homeopathy.
Dari maklumbalas ini saya dapati ibu ini patuh pada arahan saya dan hentikan dos apabila ada respon kepada penawar.
Sehari selepas rawatan, pada 2 hb February 2014
Assalamualaikum Dr Suriya. saya ialah xxxx, terima kasih atas pertemuan kita semalam. Doktor ialah doktor pertama yang sanggup menjawab persoalan kami dan mengajar kami bagaimana untuk menjaga keadaan anak kami dengan baik.
Kami ingin memberikan situasi terkini mengenai keadaan A semenjak kami pulang dari rawatan untuk rujukan di masa hadapan. apabila kami balik, A mengalami cirit birit, najis terakhirnya cair sebelum dia boleh tidur dengan baik.
Pagi ini, kami perasan ada satu benjolan kecil dibahagian kanan kulit kepalanya. rupanya seperti gigitan serangga, tetapi hilang setelah beberapa jam.
Sewaktu mandi, saya menyedari ada benjolan yang lebih besar di sebelah kiri kepalanya, dan ia juga hilang selepas beberapa jam.
Saya juga menyedari yang dia lebih manja dan juga merengek berbanding semalam. dan dia juga asyik tertidur sahaja.
Saya berhajat untuk memberinya dos pertama Morgan Pure, dan saya akan terus memerhatikan keadaannya esok
Saya harap tindakan saya ini betul. saya ingin bertanya mengenai agen pelembap seperti minyak bijan dan nasihat doktor untuk berhenti menggunakan ubat apabila ada perubahan yang baik atau keadaannya bertambah buruk. seperti yang sedia maklum, minyak bijan membantu penghasilan ceramide, adakah kita menghentikan penggunaannya juga apabila dia menjadi lebih baik/buruk?
Jawapan saya :
Terus gunakan minyak tersebut. ianya seperti sudah ada penyembuhan. berhenti menggunakan Morgan pure sehinggalah ianya benar-benar statik, ia itu sudah stabil .
Dari mesej facebook saya : 17hb Feb 2014
Ibu pada A :
Assalamualaikum Dr suriya, harap anda sihat dan kami baru sedar yang A sudah menggunakan rawatan homeopathy selama 2 minggu dan kami mengemaskini perjalanan rawatannya.
Alhamdulillah, entri terbaru tentang proses penyembuhandari blog Doktor telah menjadi panduan yang besar yang mententeramkan jiwa kami. semua perkara yang anda sebutkan adalah tanda-tanda positif yang A secara perlahan-lahan bertambah baik.
Alhamdulillah, dia sudah mula ‘berbual-bual’ dengan kami semalam selepas lama sebelum ini. moodnya juga berubah menjadi lebih baik, lebih banyak tersenyum dan ketawa.
Dalam blog doctor ada menyebut bahawa ubat seharusnya diberi seminggu sekali ( setelah keadaan stabil)
Saya hanya memberi A secara total 2 dos Morgan dan 2 dos Grafit ( dalam rawatan homeopathy, sedikit adalah memberi nilai kesembuhan yang lebih banyak) keduanya-duanya mengalami selang masa yang panjang disebabkan oleh tindakbalas tersebut. dos terakhir diberikan pada hari selasa 11 February, selepas tindakbalas yang kuat seperti kulit pecah-pecah dan keluarnya lelehan, tetapi alhamdulillah 70% daripada kulit yang pecah-pecah hilang keesokan harinya.
Kami tidak lagi memberikan apa-apa ubat selepas itu. najisnya menjadi lebih konsisten. ( Nota saya, amat penting perhatikan najis anak , najis yang sihat warna kuning hingga coklat dan berbau seperti pisang busuk)
Pipinya masih mempunyai pecah-pecahan kecil dan sedikit lelehan selepas mandi. tangan kanannya sudah benar-benar sembuh daripada apa-apa benjolan, sementara tangan kirinya nampak sedang beransur sembuh. Hanya minggu lepas leher dan dadanya dipenuhi dengan benjolan merah yang gatal, tetapi semenjak semalam beransur hilang. Kakinya yang sebenarnya paling gatal merenyam menyebabkan dia tidak boleh tidur malam.
Walaupun sudah beransur baik, adakah patut saya hentikan ubatnya atau menyambungnya paling kurang seminggu sekali?
Jawapan saya :
Salam, boleh sambung tetapi cairkan di dalam air. titiskan satu titik dalam 100ml air kosong, kemudian ambil satu sudu kecil. boleh beri sekali seminggu. nampak seperti satu tindakbalas yang baik, memang atas kering turun ke bawah
Bolehkah saya berkongsi pengalaman anda dengan pembaca saya? ianya akan banyak membantu mereka, dengan izin Allah.

Ibu A
Bolehkah saya campur dengan air zam zam?
Jawapan saya:
Itu akan menambah galian air zam zam, ianya boleh dilakukan asalkan tidak digoncang, kerana ia boleh mengubah sifat ubat tersebut

Penulisan asal dalam BI

Sehari selepas rawatan pada 2 hb February 2014

Salaam Dr Suriya, This is XXX, thank you for meeting with us yesterday. You are the first doctor that we went to that was willing to answer our curiosity and taught us how to care for our daughter.

We would like to update you on A’s condition since we returned for your own future reference insyallah. When we got back A had a session of diarrhea, her last stool was watery before she was able to sleep. (Nota saya:  Ini adalah respon yang hampir serta merta)

This morning we noticed a small bump on the right side of her head. Similar to an insect bite, but was gone after a few hours.( Nota saya: ini adalah respon pada ubat, keluar dan hilang sendiri )

During her bath, I noticed a bigger bump on the left side. Again it was gone after a few hours.

I’ve also noticed that she is more clingy and cranky compared to yesterday. And she wants to sleep more.( Nota saya, ini juga respon pada ubat, perangai lebih merengek )

I have yet to give her the first dose of Morgan pure, I am going to further observe how she is tomorrow. ( Nota saya, absolutely right )

Hope that is the right move to do. I would like to ask a question regarding her moisturizing regime using the sesame oil and your advice to stop using the meds when we see improvement or when her condition has worsen. Since sesame oil helps in the production of ceramides, do we stop with usage as well after she is better/worse?

Jawapan saya :
Keep using oils. Sounds like a healing reponse stop the morgan till settled

Dari ibu :
Ok. Noted. Thanks.

Dari mesej facebook saya : 17hb Feb 2014

Ibu pada A :
Salaam Dr Suriya, Hope you are well I just realised that its been 2 weeks since A

started on her homeopathy journey while updating her journal on her recovery.

Alhamdulillah your latest entry on the process of recovery has been a great help and comfort for us. All the things mentioned by you are positive signs that Aisyah is recovering slowly.

Alhamdulillah, she has started “talking” to us again yesterday after a long break. Her mood has been leaps and bounds better, laughing and smiling more now. ( Allhamdulillah, ini menunjukkan kuasa hayat anak ini sudah mula pulih dan begitu juga sistem immunenya )

In your blog entry, you mentioned that medication should be given once in a week (Nota saya; bukan semestinya tetapi apabila semakin sembuh, kita jarakkan ulangan penawar) .

I’ve only given A a total of 2 dose of Morgan and 2 dose of Graphite. (Nota saya, dalam rawatan homeopathy, less is more)  Both had a long interval in between because of the reaction. The last dose was given Tuesday, 11 Feb, after which, the reaction was quite strong, cracks and oozing, but Alhamdulillah 70% of the new cracks cleared by the next day ( nota saya: healing crisis akan menunjukkan gejala penyakit tapi cepat sembuh berbeza dengan yang asal, lambat atau tidak sembuh ) 

We have not given her any meds since then. The texture of her poop has been consistent since yesterday. ( Nota saya, amat penting perhatikan najis anak , najis yang sihat warna kuning hingga coklat dan berbau seperti pisang busuk )

Her cheeks still has cracks and ooze slightly only after baths. Her right hand is completely clear of any bumps, while her left looks to be recovering.
It was last week that her neck and chest area seems to be one of the itchy area and red with bumps, but they are starting to clear since yesterday. Her legs by far are the ones that itches the most and keeps her up at night.  ( Nota saya : Memang arah penyembuhan dari atas kebawah )

Although it looks to be smoother despite the bumps. Based on her development, should i stop the meds completely or give once a week?

Jawapan saya :
Salam, please continue giving but in a diluter form. Drop in water about one drop, to 100 ml, then a dose is 1 teaspoon from this . Can give once a week ! Looks like good reactions, memang atas kering turun kebawah.
May I share your description with my readers? It would help guide them insya allah

Jawapan ibu memberi izin saya sharekan dialogue kami

yes sure. thank you dr suriya

can i mix with zam2 water?

Jawapan saya:
That will add the zam zam minerals , should be ok so long as you just dilute without shaking, if you shake it will change in properties

Merawat Eczema – Lapuran sebuah kes

Ini adalah cerita adik Nadine, seorang baby comel yang  pada 8 Mei 2013 sebelum eczema bermula . Perkataan dalam caption adalah perkataan ibu Nadine sendiri dan gambar-gambar ini adalah dengan izin ibubapa Nadine.

Nadine sebelum eczema Mei 2013
Nadine sebelum eczema Mei 2013 Keadaan Nadine selepas ini bertambah teruk . Nadine hanya hisap susu badan ! Maka, Nadine dibawa jumpa doktor
2 weeks after DTAP vaccine - 24 July 2013.
2 weeks after DTAP vaccine – 24 July 2013.

Dua minggu selepas pelalian DTP Hib, muka Nadine mula mendapat eczema, mulanya sedikit sahaja dipipi kanan .

Keadaan Nadine bertambah teruk dan ibubapa Nadine bawa Nadine jumpa doktor dan Nadine diberi preskripsi ubat sapu topical steroids .

During steroid usage - 27 Aug 2013 Topical steroid usage - 1 months and a half. Started with: 1. Elomet 2. Cutivate 3. Foban(H) - Hydrocort 0.1%
During steroid usage – 27 Aug 2013
Topical steroid usage – 1 months and a half.
Started with:
1. Elomet
2. Cutivate
3. Foban(H) – Hydrocort 0.1%

 

2 days after stopping steroid cream - 29 Aug 2013. Using moogoo product
2 days after stopping steroid cream – 29 Aug 2013.
Using moogoo product

Ibu Bapa Nadine hentikan steroid sebab merasakan bahawa rawatan dengan steroid tidak dapat memberi kesembuhan yang baik .

 

 

 

 

 

 

One of the bad days – 10 Sep 2013. Applied moogoo during daytime and mebo at night.

 

                                                                              

 

 

 

 

 

 

 

 

 

3rd time recurring infection. Start to seek Doctor Suriya Osman's help religiously with Allah's blessing. 1st and 2nd infection treats the skin with oral antibiotic but the infections come back 3-4 days after she finishes the antibiotic course.
3rd time recurring infection.
Start to seek Doctor Suriya Osman’s help religiously with Allah’s blessing.
1st and 2nd infection treats the skin with oral antibiotic but the infections come back 3-4 days after she finishes the antibiotic course.

Saya jumpa Nadine semasa eczemanya telah terkena jangkitan kuman dan setelah dia diberikan antibiotik  kali ketiga. Antibiotic cuma redakan sekejap dan ia datang semula dalam keadaan begini. Kebetulan  pula ibu Nadine pun pada masa yang sama alami sakit kulit dimuka.  Saya melihat dengan amat simpati dan hanya mampu memberi nasihat tentang penjagaan, termasuk membasuh dengan air ozone, mengunakan pottasium permanganate dan disokong dengan rawatan homeopathy untuk betulkan kesan toksin yang mencetuskan keadaan eczema ini (mungkinkah dari bahan dalam vaksin ? )

Mengikut ibu Nadine, walaupun lambat kering eczemanya tanpa antibiotic namun demikian bila sembuh eczemanya , kulit mula pulih dan Nadine mula nakal dan berdikari

2 Dec 2013 Used truveno cream, al manna and olivenol liquid
2 Dec 2013
Used truveno cream, al manna and olivenol liquid
 11 Jan 2013 current state

11 Jan 2013
current state

Akhirnya Nadine kembali normal . Masih ada sedikit merah dipipi dan ibu Nadine masih perlu menjaga makan minumnya .

Antara usaha ibu Nadine adalah mengamalkan Daun Betik Tua dan Kunyit hidup yang dia sendiri minum. Gum Arabic jenama Natural Prebiotic Al Manna dan Tayebat juga diberikan kepada Nadine dan ibunya.  Rawatan Homeopathy diberikan  untuk ibu serta Nadine sendiri .

Rawatan yang saya berikan setakat ini adalah detox pada ususnya. Ini termasuk bowel nosode, Morgan Pure 30c dan Cina 30c . Seketika diberikan Graphite 30c .

Saya masih mahu melihat watak Nadine sebenar yang sudah mula muncul dan ini akan membantu saya untuk memilih ubat homeopathy yang sesuai untuk hilangkan terus keadaan Nadine yang masih sensitif terhadap apa yang ibunya makan . Kulitnya akan menjadi merah seketika bila ibu salah makan .

Endometriosis: recognising its chronic origin

The purpose of this paper is to point out the miasmatic nature (chronic disease)  of a condition known as endometriosis and to suggest a possible approach in the homeopathic treatment of endometriosis . It is not intended that this paper present a cured case of endometriosis .

 As such a general discussion of endometriosis as regards its nature , aetiology and pathophysiology will be touched upon and a homeopathic interpretation based on miasmatic theory will be offered and a case that responded dramatically to miasmatic prescribing will be presented.

 What is endometriosis?

 Endometriosis is the growth of cells similar to those that form the inside of the uterus (endometrial cells), but in a location outside of the uterus. Endometrial cells are the same cells that are shed each month during menstruation. The cells of endometriosis attach themselves to tissue outside the uterus and are called endometriosis implants. The implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain. Endometrial implants are generally benign (not cancerous).1

 Characteristics of Endometriosis:

 The following are some of the commonest characteristic symptoms of endometriosis. This list is compiled from clinical experience of patients suffering from endometriosis.

·       ·.Aggravation of many symptoms in the patients before, during, or after senses.  

·       ·.Periodicity of 4 weeks, the cycles are frequently shortened to 3 weeks, showing a poor development of the corpus luteal phase of the menstrual cycle and a weak progesterone phase.  

·       ·.Bleeding, per vaginal discharge, brown, bloody, black, copious watery, color and nature will vary with the phase in the cycle. The watery discharge, gushing and slightly bloody can occur during ovulation.  

·       ·.Insidious onset, usually in the mid 30’s, a close association with infertility or after long period of not being pregnant.  

·       ·.Worsens with time and regresses after menopause, regresses during pregnancy and lactation because endometrial tissues regress with the depletion in hormones during menopause and the loss of the cyclical rhythm during pregnancy under hormonal influence.  

·       ·.Pain may be severe depending on the staging and other factors but coming at 4 week intervals, pain may be felt in the abdomen, supra pubic, back, down thighs ( referred pain ), rectum, etc. depending on the location of the cysts. Dyschaesia, i.e. pain when passing stools especially before during and after menses and dyspareunia i.e. pain during intercourse may be present. These symptoms may be due to the endometriotic lesions in the pouch of Douglas..  

·       ·.Associated problems include emotional upsets, usually suppressed emotions, digestive problems from dyspepsia to colitis, the mildest being irritable bowel syndrome but may be severe mucous colitis, and adhesion colic.  

 Consequences

·       ·.Infertility, debilitated state of patient who may not be able to assume daily activities usually two weeks in a month, every month.  

·       ·.A constant cycle of pain, recovery, a short period of feeling relatively well then a repeat. Body ache and tiredness as well as Inability to cope are frequently associated with this condition when severe.  

·       ·.Pathological changes are blood cysts in the ovaries, fallopian tubes, adherent to intestines or within the uterus resulting in adhesions, blocked tubes, and its consequences like hydrosalpinx.  

·       ·.Occasional malignant change.  

·       ·.Emotional upsets and relationship problems  

 There are many theories as to why endometriosis happens and the one that I am quite convinced is true is that there is a genetic predisposition to endometriosis and also , it is not a disease of the reproductive organ but is part of a larger disease that involves the immune system .

 Genetic studies have shown that endometriosis may have a genetic basis , just like diabetes and hypertension. Studies on a species of monkey that spontaneously develops endometriosis are being done to demonstrate this 2

 That the immune system is affected in endometriosis was researched in a survey where the following conclusion was arrived at

 “Hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma are all significantly more common in women with endometriosis than in women in the general USA population.”3  

 Most of the diseases mentioned here are related to a defective immune system and to auto antibodies. It is possible that all of it is related to a defective immune system except we do not have all the information about many of these conditions yet .While it is not stated that the hypothyroidism mentioned here is autoimmune , there is autoimmune thyroiditis which is also known as Hashimoto’s Thyroiditis which leads to hypothyroidism

 In endometriosis what seems to be happening is that cells that are normally found only in the endometrium of the uterus implant in other places as where they respond to the ovarian hormones in a cyclical manner and bleed when the hormone levels drop as in the normal menstrual cycle.

 Two main theories exist for the pathogenesis of endometriosis. One theory is that endometrial tissue is spread by retrograde menstruation or by vascular and/or lymphatic spread. The second theory holds that the serosal epithelium of the peritoneum undergoes metaplastic differentiation into endometrium-like tissue.4

 Endometriosis is a chronic disease that has established itself by the time a diagnosis is made ., While I have not been able to find any researcher who links endometriosis to pelvic infections, there is evidence that patients with endometriosis do have infections

 Infected Endometriotic Cysts Schmidt et al found pathologic evidence of infection in11of 510 endometriotic cysts(2%). The patients had a mean age of 34.7years and typically presented with fever and lower abdominal pain; about half had a history of pelvic inflammatory disease Histologic examination revealed endometriotic cyst s that contained a  fibrino purulent exudate, microabscesses, and inflammatory cells other than neutrophils,such as plasma cells. All of the patients who had one or both fallopian tubes removed at the same operation had histologic evidence of acute and/or chronic salpingitis.5

 A Miasmatic theory of Endometriosis

 In Webster’s dictionary, the term “miasm” is followed by these meanings: “a vaporous exhalation (as of a marshy region or of a putrescent matter) formerly believed to contain a substance causing disease (as malaria)” “a pervasive influence or atmosphere that tends to deplete or corrupt”. Its Greek root is “miainein” which means “to defile”. “to defile” means “to make something dirty or no longer pure” “to damage something holy or sacred”.

 According to Shahrdar,

 “From Hahnemann’s writings, it is evident that he also uses the word “miasm” simply to describe an infectious and contagious disease with a specific cause and pattern of growth which can appear in different forms of propagation such as sporadic, endemic or epidemic. In his view, a miasm may be acute or it can be chronic with ever progressing effects on the individual. Speaking in Hahnemann’s language, it should be noted that what is now known as a miasm is actually a chronic miasm”.6

 Hence , a chronic miasm is a disease that keeps progressing even when a prescription has been made that covers the presenting symptom for according to Hahnemann, there is a hidden process that needs to be prescribed on and an unmasking of the original symptoms before a miasmatic prescription can take place .

 I have made a graphic presentation of what I understand about Hahneman’s Chronic disease theory and to learn more please visit the minutus.org library and study Dr Shahrdar’s writings

.The terms ponos and pathos are from the writings of Hans Selye7 and have been adapted  by Shahrdar hence I have placed them in brackets.

 Ponos is the acute symptoms as a reaction to the pathogen .

 Pathos is Latin for suffering and refers to secondary symptoms as the patient’s body adjusts to a state of incomplete resolution after a pathogen.

 Miasmatic remedy  refers to the remedies that are chosen based on the combined symptoms of many patients who are affected by a similar pathogen . ( Shahrdar uses the term genus epidemicus)

 Dr Shahrdar has proposed that the most important group of pathogens that can cause a chronic state are viruses He has written materia virosum and repertorium virosum that discusses these theories in great lengths and shows how they can be applied to treat cases miasmatically and I will show how it can be applied in the case we will be discussing shortly.8

image001

When a person is infected by a pathogen , there is an acute illnesss  ( ponos) which is an acute disturbance caused by the pathogen .. In acute diseases the infection is resolved and the patient returns to the normal optimal state. When this does not take place the patient develops more suffering and the illness becomes chronic ( pathos). Chronic illness is an adaptive state where the health is compromised and the body develops ways to adapt to the compromise in health in order to survive. An example of this happening is when a splinter is  in the flesh and the body deals with the splinter at first by suppuration. This is the ponos reaction and then when the splinter still remains , the body acts by depositing fibrous tissue and sending white blood cells to continue attacking the spinter and the person develops a foreign body granuloma and this secondary reaction is the pathos..

In the state of Pathos the disease progresses like what we frequently see in many chronic diseases like rheumatoid arthritis, systemic lupus , diabetes ,and will keep getting more and more complex because of the presence of the unhealed chronic miasmatic state that has been hidden under the pathos .A homeopathic remedy that can heal this person has to address the original unmasked hidden state , that is the original illness hence has to be a miasmatic  remedy that is similar to the hidden state and not to the general adaptive symptoms of the patient .To put it in another way,what we see is the secondary adaptive symptoms , the secondary pathological changes and not the hidden disease process that causes these reactions . In order to cure the person , we have to prescribe a remedy similar to the active hidden process  We need to unmask the hidden miasm .

A hidden state here means that the VF did not return to normal and remains off balance .
Obviously when something is off balance , the body has to make adjustments to deal with the lack of balance.

Example :

You hurt your foot because of  walking on a piece of glass and there is a cut on the sole .
Now you walk bearing weight on the other healthy foot .
When a homeopath sees you , he sees the limp but he does not see the cut and injured sole.which remains hidden unless you tell him about the injury and show it to him . If not , it is hidden but still active .
The limp is to compensate for the injured foot and the pain that comes from walking on the injury .
It this situation remains for  say 10 days, then more things start to happen .
Because the uninjured foot has had to bear more weight , it is now being strained and , let us say there is an underlying weakness of the hip joint on this side , and now there is a limp , and pain in the hip on the uninjured side .
What needs to be treated is still the cut on the sole because apparently there is still pain caused the whole compensatory way of walking.
All of the compensation is due to the vital force acting in total  but the primary state  and the whole cause is still the injured foot .
Ok one might say then , since I added that the hip has an inherent weakness that there is actually another state at work here and we would be right .
But , if we tried to deal with this part first, the cure would not  work because , the injured foot was what started to make the hip painful and it is still active.

SUMITA: Endometriosis with Primary Infertility

Sumita is a patient of a homeopath in India and I am in Malaysia . I agreed to help him treat Sumita as a consultant and he is the homeopath who took this history . I was consulted because of primary infertility due to endometriosis which was discovered after she was married. She did not get pregnant in the two and a half years of marriage and had undergone both homeopathic as well as allopathic management before I was consulted. She has been diagnosed to be having Endometriosis by ultrasound as well as by Laparoscopy .This is important since a diagnosis of endometriosis by clinical picture or ultrasound alone is not conclusive. Note also the ultrasounds were done intra vaginal which makes them more accurate.

This case was taken at the first interview .Unless indicated as allopathic , all the doctors mentioned refer to qualified homeopathic doctors ( BHMS)

Age: 27 + Married , 2 and half years, No children

Fair , Height 5 ft, Wt 46 Kg, Built Medium

Before

Menstrual Cycle 28 days, Last time flow for 1-2 days. Soreness in lower abdomen with both legs painful. Occasional pain in both ovaries. Occasional Leucorrhea (thick lump).

last menstural period,  2nd June 2007.

History and Background

1. Had a history of severe injury to the head when 7 or 8 years old

2. Had a history of headache from last 10- 12 years agg. from sunlight, Tension, Concentration, long journey. Used to take painkiller (diclofenac .25 mg) to relieve pain.

3. Left sided. pain after sitting for long time in front of Computer (Last 3-4 years)

4. Homeopathy treatment commenced after marriage i.e. Feb 2005 to treat headache. Had B Coli infection on March 2005. After eight months of treatment, started having menstrual pain. Pain used to stay during the periods with fever. However headache reduced subsequently.( under a different homeopath

5. Menstrual Pain did not reduce after continued homeopathic treatment till June 2006. i.e one and half year of homeopathic treatment.

The then homeopath expired in July 2006. He gave the following medicine in chronological order. Arnica 1M 2 doses , Cannabis Sataiva 1M 2 doses (For B coli infection), Tub 1M 2 doses, Bell 2C, Syphillinum 10M  1 dose , Rhus Tox 1m 2 doses, Kali Bich 1M 2 doses, Ant Crud 1M 3 doses,  Sulph 30 1 dose Puls 1M 2 doses Calc Phos 1M 8 doses  Sabina 30, Colocynth 200, Bovista 200 3 doses ( Note the frequent change of remedies over one month )

6. At the  end of July 2006 the menstrual pain became very severe. Pain particularly in left ovary region. USG done in July 2006 and diagnosed as Chocolate cyst in left ovary of size 3.7cm x 3.2 cm. Uterus anteverted.

7. A new doctor was consulted who gave Viburnum Opulus 6 to be taken twice daily. Next period menstrual pain was less but flow lasted for only one day. Patient bed ridden with severe ovarian pain.

8. Another doctor was consulted . He gave Lachesis 30 c,3 doses, repeated 30c3  doses after 10 days and then repeated 200c 2 doses after 14 days. First and second dose was very helpful but 200c  had an adverse reaction with severe pain in both ovary. The doctor said the medicine has been overdosed.

9. Was again referred to another doctor in August 2006. He gave Camphor 200 2 doses to neutralize Lachesis and gave Apis 200 three doses. Was better after Apis, than given Pulsatilla CM. Again pain started.

10. Ultrasound scan on September 2006  (2months after first scan) the cyst of left ovary increases to 6 x5.5cm  cm and the in the right ovary new chocolate cyst was developed of size 3.2cm. Uterus Bulky. Musculature, Endometrium 6mm Thickness.

11. Allopathic doctor immediately recommended for diagnostic laparoscopy in September 2006. During Laparoscopy the endometrial cyst contents  from the  right ovary was aspired.

Report:

Dye Test : Spillage in both side, Endometriosis and adhesions were found ,

 Hysteroscopy  showed  Uterine Cavity & Cervical canal appeared normal,

 Both Ostea Visulised.

 Bulky Uterus with endometriosis and adhesions.

12. Given an injection of GNRH 3.75 advised Super Ovulation.

13. Again Homeopathic treatment commenced from November 2006 under the same Doctor . Has given the following medicine in Chronological order

Bacillinium 10m 1 dose  with Calc Phos 6x and Ashoka Q, Cimicifuga 1M with Bell Perenis  Q and Oophorinum 30c, Calc Phos 200 cwith Bell Perenis Q with Ashoka Q, Bryonia 0/2 with Ustiliago Q.

 ( a mixture of remedies and repeated over a short period of time )

14. Again undergone ultrasound examination on 23-04-2007. The following findings was found

Uterus is anteverted, normal in shape, size and outline. Myometrial echo pattern is Homogeneous, Cavity is empty. Middline echo is normal. Endometrial thickness is 0.5cm. Cervical canal is normal.

Right adnexal region shows a partly solid and partly cystic space occupying lesion, measuring 5.4 x6.3 cm.

Left adnexal region shows a cystic mass  measuring 5.*5.8 cm.

Both the space occupying lesions (SOL) are adherent to the uterus.

IMPRESSIONS

Bilateral Ovarian Cyst(Chocolate cyst) Features of Pelvic endometriosis.

 PRESENT COMPLAINT

·       ·.Headache ( much reduced from Homeopathic treatment )  

·       ·.Occasional Vertigo, Occasional nausea during morning  

·       ·.Developed Nails yellowish blackish with spoon type shape  

·       ·.Nerve stimuli (kind of nerve shock) of mainly right leg during sleep. After this leg cannot be straightened for 1 minute. Than the affected leg become sore for 1 -2 days. This has happened 5-7 times in last 2 years.  

·       ·.Both breast sore agg. before periods amel. after periods.  

·       ·.Itching eruptions in elbow joint (front side) itching agg. with sweat.  

·       ·.Piles. Constipation  

·       ·.Mild pain in ovarian region after urination and stool. Cannot control the urge to stool (entire stomach becomes stiff and movement and standing difficult until and unless stool passes)  

Physical Generals

Warm Patient, Consolation amel., Sweating ++ under arms and face, Craving for cold food and cold water, Crave for Salty food, Craving for egg but cannot tolerate omelet. Appetite normal. Cold palms occasional

Mental General

Mild, easily weeps, Fear from shouting quarrel, Religious, Good Natured, Family life comfortable, Irritability before period, Depressed (better after Puls 200)

Family History

Migraine of Mother, Diabetes of Maternal Uncle.

Past History

 Vaccination, Typhoid (Detected in early stage), Injury to head, hand and collar bone.

 …………………………………………………………………………………………………………………………………….

Another ultrasound was done before she started treatment with me

 Here is the report

 6 July 2007

 Uterus is antiverted, normal in shape, size and outline. Myometrial echo pattern is homogeneous Cavity is empty.  Midline echo is normal. Endometrial thickness is .4cm.

Cervical canal is normal.
A thick walled cystic SOL, measuring 2.9 x 5.2 cm another rounded thick walled cystic SOL measuring 3.4cmx4.2 cm. is seen in the Pouch of Douglas.

Both cystic SOL show low level internal echoes.
IMPRESSION

 Bilateral ovarian cyst (?Chocolate cyst).

 After discussing with her husband I discovered that Sumita was very sensitive to homeopathic remedies and aggravated a lot after remedies given repeatedly.

 Also , since I knew endometriosis had a miasmatic background ,it is to be noted also that any remedy chosen has to match not only the miasmatic background but also aspects of her presenting symptoms ,signs and modalities.

  Endometriosis is a sycotic condition because of the nature of the disease which involves the pelvic organs and the sexual organs.  it has cysts and fibrosis and these are also sycotic.

 Here is a bit about the general naturs of the main miasms

General Nature of the Miasm ( from JH Allen )

 A – Psoric Miasm: Itching, burning, inflammation leading to congestion – philosopher, selfish, restless, weak, fears.

B – Sycotic Miasm: Over production, growth like warts, condylomata, fibrous tissue, attacks internal organs, pelvis, and sexual organs. (these are characterostoc of endmetrosis)

C – Syphilitic Miasm: Destructive, disorder everywhere, ulceration, fissures, deformities, ignorance, suicidal, depressed, memory diminished.

D – Tubercular Miasm: Changing symptomology, vague, weakness, shifting in location, depletion, dissatisfaction, lack of tolerance, careless, “problem child”, cravings that are not good for them.

 I am quoting an article by Dr Ardavan Shahrdar on miasmatic analysis here

 “1.Miasmatic analysis is the process of referring to Genus Epidemicus of infectious states to complete the image which is needed for the selection of simillimum.

 2. This type of analysis is actually based on the Hahnemannian definition of miasmatic prescription. In some schools of homeopathy, you may see different miasmatic categories instead of what is here called Genus Epidemicus. Here, the term miasm means infectious disease, as termed by Hahnemann.

 3. By ‘infectious diseases’ I am not referring to ‘infectious agents’:. ‘Infectious disease’ is the dynamic state following the stress caused by ” infectious agent”. The infectious “state” can persist without the presence of “‘infectious agent'”

I would like to point out that by Sycosis I mean sycosis according to what Hahneman wrote in chronic diseases and not the sycosis that has been defined by various authors according to their own notions of what sycosis it.

  Hahneman refers to sycosis as the fig wart disease and we now know that it is venereal wart which is condyloma acuminatum.

 Here is another quote that may bring more clarity to the meaning of sycosis

 “Now we clearly know that the figwart part of Sycosis is actually Condyloma acuminatum. HPV, the virus related to condyloma acuminatum, does not cause urethritis and gonorrhea in common terminology. The type of gonorrhea that Hahnemann linked to Sycosis is actually the urethritis caused by Herpes Simplex Virus type 2 (HSV-2) which can occur as co-infection with HPV. That’s why Hahnemann states that figwarts is not always associated with gonorrhea.”9

Hence the sycosis that is meant by Hahnemann is actually a HPV infection that has been complicated by a Herpes Simplex type 2 . This is merely a theory of Shahrdar that I chose to accept in analysing cases and Sumita’s case is one of many that I have successfully treated applying the same theory. The reason for choosing Sumita’s case was that in this particular case the records were complete and I also had a history of her previous remedies which I usually fail to get when patients come to see me from other homeopaths.

 Shahrdar has compiled a materia virosa in which he has collected from various sources the pathology that is produced by various viruses and below you see how Sumita’s symptoms correspond to the HSV2 viral state and the HPV viral state . Note that I am not saying she has these two infections, only the viral state which Hahneman named miasm. JH Allen in his book Chronic Miasms and Pseudopsora clearly stated that the sycotic miasm affected the pelvic organs as we see in cases of endometriosis in general and in Sumita’s case in particular.

  Hahnemann differentiates sycotic gonorrhoea from what he called the common gonorrhoea .A careful reading of his description of the initial stages of Sycosis in his book Chronic diseases will show that he distinguishes simple gonorrhea from the more compels gonorrhoea of sycosis .10

 “The gonorrhoea dependent on the figwart-miasma, as well as the above-mentioned excrescences (i.e., the whole sycosis), are cured most surely and most thoroughly through the internal use of Thuja,* which, in this case, is Homoeopathic, in a dose of a few pillets as large as poppy seeds, moistened with the dilution potentized to the decillionth degree, and when these have exhausted their action after fifteen, twenty, thirty, forty days, alternating with just as small a dose of nitric acid, diluted to the decillionth degree, which must be allowed to act as long a time, in order to remove the gonorrhoea and the excrescences; i.e., the whole sycosis. It is not necessary to use any external application, except in the most inveterate and difficult cases, when the larger figwarts may be moistened. every day with the mild, pure juice pressed from the green leaves of Thuja, mixed with an equal quantity of alcohol”chronic diseases page 84

 Below is a repertorization to search for viral states using repetorium virosum image003

 This is a repertorium virosum analysis of Sumita’s symptoms. Note that the rubrics chosen are

female Leucorrhea

female Itching

Buttock Pain shooting

Rectum constipation

Rectum hemorrhoid

The reason for the brevity and seemingly general symptoms are because of the way the materia virosa is recorded , it is all just clinical symptoms and very brief.

The other limitation of materia virosa is that it does not record secondary symptoms , for example there is no entry on dysmenorrhea or endometriosis . The only entry on endometrium is endometritis which is an acute state and not related to endometriosis , it would however be related to fibroid uterus which is actually a culmination of chronic inflammation. which we later found out Sumita had .

In this the RV has many limitations

1. few and brief symptoms

2. most secondary symptoms are not in it , and have to be deduced .

In spite of these limitations , in the hands of a  person who can translate secondary symptoms back to their primary symptoms , the software is a great tool for deducing the viral state that is still active .Please note that viral state is another name for viral miasm which can be said to be a subgroup of the original miasms of Hahnemann.

In this analysis the virus that has all the rubrics is HSV2 .

HPV has only one rubric but knowing the Human Papiloma virus’s affinity to the pelvic mucous membrane as well as it being implicated in Hahnemann’s original sycotic miasm , I am inclined to think that this is a miasm that at the moment is not dormant but present.

 Below are the materia virosa of the two viral states that I mentioned above .

 Papilloma viruses/Human Papilloma Virus (HPV) Main Regions

Skin, Male organs, Female organs, Mind, Extremities, Larynx, Respiration. Modalities

Aggravations: Night. Mind

Sadness. Taciturnity. Loathing at life. Dullness. Anger. Irritability.

Crusty eruptions. Occipital pressing pain. Eye

Conjunctivitis. Pressing pain. Vision

Dim vision Nose

Catarrh. Yellow discharge. Mouth

Condyloma. Throat

Mucous. Pain on swallowing.

External throat

Cervical lymphadenopathy.

Stomach

Increased appetite. Eructations.

Abdomen

Distention and rumbling. Cramping pains.

Rectum Hemorrhoids. Burning pain after stool.

Prostate gland

Enlarged prostate.

Urethra

Burning pain during urination.

Larynx

Altered cry in children. Hoarseness.

Respiration

Distress. Stridor.

Female organs

Cervical cancer. Maculopapular eruptions. Warts.

Male organs Maculopapular eruptions. Warts. Increased sexual desire.

Expectoration Increased.

Extremities

Warts. Painful plantar warts. Itching of lower limbs. Weakness of knee.

Back

Stiffness in cervical region.

Sleep Sleeplessness. Falling asleep late.

Skin Warts. Painful warts.

General

Weakness. Lack of vital heat. Burning pains. Stitching pains. Yellow discharges. Aggravation at nights.

Antimiasmatic remedies THUJ, NIT-AC, CALC, LYC, Nat-s, Staph, Sabin, Sars.

Herpes Simplex Virus 2 (HSV-2)

Main Regions

Skin. Genital organs. Rectum. Extremities. Chest. Eye. Head. Mind. Urinary system.

Modalities

Aggravations: Cold.

Mind

Irritability. Anger, Excitement, Dullness, Weakness of memory.

Vertigo

Head

Encephalitis. Meningitis aseptic. Headache pressing, stichting. Frontal headache. Occipital pressing headache. Headache aggravated by stooping. Crusty eruptions on head. Moist eruptions. Falling of hair. Heaviness.

Face

Herpetic eruptions. Heat.

Eye

Chemosis. Retinitis. Ophthalmitis. Chorioretinitis. Conjunctivitis pustular. Dendritic lesions of cornea. Keratitis. Retinal necrosis. Pain burning, pressing, stitching. Photophobia. Blepharitis.

Vision

Blindness. Blurred. Dim.

Ear

Pain stitching.

Nose

Catarrh. Coryza. Purulent discharge. Dryness inside nose. Internal sore pain. Scurfy nostrils.

Mouth

Gingivitis. Stomatitis. Ulceration. Ulceration of tongue.

Throat

Exudation. Pharyngitis. Tonsillitis. Ulceration. Stitching pain.

Esophagus

Dysphagia. Odynophagia.

External throat

Cervical lymphadenopathy.

Stomach

Diminished appetite. Increased appetite. Nausea. Vomiting. Eructations. Pain pressing.

Abdomen

Hepatitis. Distention. Rumbling. Cramping pain.

Inguinal region

Tender lymphadenopathy. Herpetic eruptions.

Rectum

Constipation. Diarrhea. Discharge. Necrosis. Pain burning, after stool. Proctitis. Tenesmus. Ulceration. Excoriation. Weakness of anal sphincter. Hemorrhoids. Hemorrhage. Itching.

Stool

Frequent.

Bladder

Enlarged bladder. Enuresis.

Urethra

Discharge gleety.

Urine

Dysuria. Frequency. Retention. Cloudy.

Larynx

Hoarseness of voice

Chest

Vesicular eruptions. Axillary lymphadenopathy. Substernal pain. Interstitial pneumonia. Pneumonitis. Irritation in trachea. Oppression. Stitching pain.

Cough

Dry. Short.

Female organs

Endometritis. Herpetic eruptions. Pustular eruptions. Vesicles. Salpingitis. Ulcers. Inflammation. Excoriation. Itching. Leukorrhea. Menorrhagia.

Male organs

Herpetic eruptions. Impotency. Prostatitis.

Extremities

Arthritis monoarticular. Edema of fingers. Herperic eruptions on thighs. Pustular eruptions on fingers. Vesicular eruptions fingers. Erythema of fingers. Tenderness of fingers. Shooting pains. Tingling. Herperic whitlow. Coldness and perspiration of feet and hands. Cracking in joints. Heaviness of lower limbs. Itching of lower limbs. Stitching pain in knees. Right side.

Back

Stiffness of cervical region. Anesthesia or hyperesthesia of lower back and sacral region.

Buttock

Herpertic eruptions. Shooting pain. Tingling.

Perineal region

Anesthesia. Hyperesthesia.

Sleep

Falling asleep late.

Dreams

Anxious.

Skin

Eruptions. Erythema multiforme. Herpetic eruptions. Tubercles. Boils. Ulcers. Itching.

Fever

Fever.

General

Anorexia. Hemorrhage. Hyperesthesia. Hypothermia. Lymphadenitis. Malaise. Myalgia. Myelitis transverse. Radiculopathy. Sepsis. Weight loss. Thrombocytopenia. Dryness of mucous membranes. Weakness. Emaciation. Ulceration. Excoriation. Stitching pains.

 Antimiasmatic remedies

MERC, Nat-m, Petr, Nit-ac, Calc, Thuj.

 From the above note the genus epidemicus ( miasmatic ) remedies for HPV are:

 THUJ, NIT-AC, CALC, LYC, Nat-s, Staph, Sabin, Sars.

And the genus epidemicus ( miasmatic ) remedies for HSV2 are :

MERC, Nat-m, Petr, Nit-ac, Calc, Thuj.

Below is a repetorizing using Hompath Classic version 8 .

Hompath Rubrics were taken from almost all of the symptoms she was having at that point.These are the rubrics that I chose . The reason I chose them is because they are the symptoms of the underlying miasm  which is active at that point in time .. I had included some general symptoms but ignored her pain after stools because it is a secondary symptom caused by adhesions due to endometrial lesions in her peritoneal cavity which means they are of no use in pointing to the underlying miasm in that they are secondary symptoms . You will find some of thse symptoms in the HSV2 of the materia virosum which means they belong to the Viral State of Herpes Type 2.

 1. Rectum haemorrhoids.

2. Head Pain headache in general sore bruised sensitive to pressure

3. Female genitalia pain general

4. Extremities Cramps leg Calf Night

5. Vertigo

6. Breast sore before menses

7 Food and drinks Salt desires

8 Extremities Nails discoloration

 Here is the repertorization

image005

  The top 5 remedies are Nitric Acid , Sulphur, Calc Lyc, Phos .The only remedy with all the rubrics is Nitric Acid .. This is also the remedy present in Shahrdar’s materia virosum list for both HSV2 and HPV.

 The remedy that seemed to be the closest similimum for Sumita in both her total self as well as the viral state ( miasm ) that was present is NITRIC ACID .

 I had instructed Sumita to take Nitric Acid 200c in water . The reason being that I knew she was sensitive . Some may want to know why I did not use LM .I do use LM but in this case I wanted to use the 200c potency . Homeopathy as many of us know is not such an exact science of knowing exactly what and how to give a remedy and many of us will just make a decision and change the decision or not based on the results obtained .

 Here is a report after this first 3 doses , actually a split liquid dose since a few drops of tincture was place in 60 ml of water and the remedy given in three doses, shaking the bottle before each dose .

The medicine Acid Nitric 200c ;was given one dose on;9.07.2007 and another; two doses on 10. 07.2007.I am writing down the symptoms on chronological manner

11.07.2007

Slight pain in both ovary,feeling very hot

12.07.2007

– Vertigo (a kind of crawling pain in the head), feeling very drowsy, had mild temperature 99 deg F

13.07.2007

– No fever

-,Vertigo or crawling pain agg morning, afternoon and night

14.07.2007.

– Constipation and Vertigo or crawling pain head.

15.07.2007-

-Hard stool followed by normal stool, again diarrhoea three times also vertigo or crawling pain in the head.

16.07.2007

– once semi solid stool, stomach rumbling, left hip portion

feel stiff feeling discomfort while breathing, slight discomfort in ovarian region while walking and breathing and sitting.

She says that there there is something moving along the nerves in the head. when stooping eyes get closed.

reported on 15 Jul 2007

 After this report I asked to wait before any further dosing , and here is the next report Note the ultrasound findings.

Medicine taken: Acid Nitric 2C on 9th and 10th July 2007

Aggravation for 10 to 12 days including leg pain, headache, fever, diarrhea

LMP: 26th July 2007

Flow after 26 days of last period (usually 28) (Last period 30.06.07)

Just before flow she had gone four times to stool. Stool was in adequate quantity, which aggravated the fissure and piles.

Heaviness of the lower abdomen before period and continued for first two days.

Slight pain in ovary during period. Normal flow

Before period irritation, tension and weakness.

Before 4 to 5 days of period (21 and 22 July), there was both leg pain and hand pain (shoulder to finger tip)

Flow lasted for 2 days

On 4th and fifth day there was diarrhea.

 General Symptoms

Breast soreness is always present but very less earlier aggravation was before period.

Heaviness of the head with headaches (slight), which seems to come from top and move downwards to forehead(last two days)

When getting up there is a slight sensation (Like air lock) in the right ovarian region.

When urinating urine feels as if it is flowing out of lower abdomen.

For last two days there is vomiting tendency agg. on seeing food and smell of vegetable.(Now less)

Nails dotted/flattened still present.

Itching eruption in the front portion of both elbows had reduced but now it more agg. Form water & sweat. Seems to spread in area.

Abdominal gas present.

Rectal fissure is not there but piles present (which comes out and moves in).

Now can control urge to stool. But slight discomfort present. (Lower abdomen becomes stiff –as if filled with gas on urge to stool)

No cough and cold.

Sweat in underarms.

There is a slight soreness in the lower abdomen, which can be felt on breathing.

 Ultra sound report ( Intra Vaginal Probe) Report done on 2.08.2007

Uterus is normal in size, cavities free.

Rt. side ovary there is a organized cyst of 2.98 cm by 2.76 cm

Lt side ovary there is cyst of 2.45 by 2.22 cm.

Pouch of Douglas is free

It was obvious that her endometriosis was on the retreat. The cysts were smaller and the lesions in the pouch of Douglas had disappeared .

She was given a repeat split dose of Nitric Acid 200c again on 13-15 August 2008 and she subsequently became amenorrheic and was tested to be pregnant.

  Here is a tabular record of her progress.

Date of Med

Medicine

Main Events

my comment

8th June 2007

After Puls 200c ( By Another Doctor

Symptom date: 28thJune 2007

Cyst Size measuring Right 2.9 x5.2 cm left 5.9×4.8cm another rounded thick walled cystic SOL measuring 3.4 x 4.2 cm. is seen in the Pouch of Douglas. Headache present agg on Journey and tension and from sunlight. Pain in ovarian region during/after urination and stool. Kind of Nerve shock of mainly right leg during sleep. After this leg cannot be straightened for 1 minute affected leg become sore for 1 –2 days. Could not control the urge to stool, as there was much stiffness of the lower abdomen.

Menses Last for 1-2 days. During Menses soreness in lower abdomen with both leg pain. Occasional pain in both ovaries during menses.

Nails infection. Itching eruptions on anterior portion of both hinge joints of hands. Headache present.

Constipation, piles with rectal fissure present.

There was pain after stool.

The vaginal ultrasound showed the lesion progressing now to pouch of Douglas

9th July 07

After Ac Nit 200c (60 ml , 1/3, 1/3, 1/3)

Rt Side Ovary there is a organized cyst of 2.98 cm by 2.76 cm Lt side Ovary there is a cyst of 2.45 by 2.22 cm. POD is free. Improvement in head ache. Pain in ovarian region after urination and stool was not there but reappeared in last three days. Nerve shock happened once during period on awaking.. Happened again on 10.08.07. Can control urge to stool but slight discomfort present. Heaviness of lower abdomen before period and continued for first two days. Flow lasted for 2days. Third day there was a slight flow. Normal Flow. Just before flow she had four times stool, which aggravated her fissure and piles. Nails infection same. Itching eruptions on left elbow joint same, not much itching.Right elbow joint itche  seems to increase in area with more itching. No rectal fissure.Piles is present

She aggravated for 12 days after this dose.

Many symptoms improved but started to reappear hence I asked her to repeat the dose after this report .

13th August 07

After Ac Nit 200c (180 ml , 1/3, 1/3, 1/3)

Sonography not done. No Headache but a kind of heaviness (crawling sensation) is there particularly when awakening. Pain in ovarian region after urination and stool was not there. Nerve shock of the legs did not occur. Can control urge to stool. Flow last for 2-3 days.1st day was very little (few drops). 2nd day watery flow. 3rd day was in clot (slimy thread like). No heaviness but on 2nd & 3rd day mild pain in lower abdomen. Nails infection same. Itching eruption of Left side has reduced in area but right side has increased in area with more itching. Constipation and rectal fissure is not there. Piles present . NEW Symptoms Teeth infection.

Her headache went away entirely, so did ovarian pain after urine and stools as well as the nerve shock . The dysmenorrhea was markedly reduced .She developed a tooth ache which went away shortly ..

This was her last menstrual period .

The nail has improved !

When I got this report we already knew she was pregnant . The pregnancy explains why some of her symptoms came back and she developed new symptoms probably due to adhesions from the endometriosis which had not had time to resolve.

 image007

The diagram above shows the ultrasound changes before and after treatment . There was only one ultrasound report after she took the miasmatic remedy and she subsequently got pregnant.

It may be argued that she may have got pregnant without the miasmatic treatment but if you compare her progress in terms of symptoms which corresponded to the cysts disappearing from the pouch of Douglas then it is highly probable she became pregnant because the cysts regressed .

Note also the improvement in her nails as well as her general symptoms of headache and vertigo .

It would also be too much of a coincidence that she got pregnant after miasmatic treatment if it had not been curative to her infertility because she had been married two and a half years without conceiving .prior to miasmatic treatment.

No doubt at this point she still needed homeopathic treatment . She had become pregnant too early after the miasmatic treatment started and she still had adhesions in her abdomen from the endometriosis , also , while we did not know it at that time, she had small fibromas in her uterus that caused the placenta to implant in her lower uterus and hence the delivery was by caesarean section. The fibromas were discovered during the C section. I continued to prescribe homeopathic remedies through out her pregnancy and she managed to have a drug free pregnancy even though she had some discomfort due to the adhesions and the growing pregnancy.

Sumita gave birth to a healthy baby boy and is currently breastfeeding the baby which she delivered by caesarean section on 11.05.08. I am continuing to record her progress and no doubt will have more to report when she starts to menstruate again and we can make an assessment of her reproductive system .

I have not reported on her ongoing treatment and will do so when the case is complete.

DISCUSSION

Sumita had been under the care of homeopaths for a very long time before I took over . What was not done in her treatment was to look into the miasmatic nature of her disease and to prescribe accordingly. While treating her for headache earlier , even though the headache reduced, her menses became more and more painful and , as we saw later, her endometriosis became progressively more severe with more and more lesions found on subsequent ultrasound scans.

This is consistent with Samuel Hahnemanns observation of Chronic Disease

“It was a continually repeated fact that the non-venereal chronic diseases, after being time and again removed homoeopathically by the remedies fully proved up to the present time, always returned in a more or less varied form and with new symptoms, or reappeared annually with an increase of complaints. This fact gave me the first clew that the Homoeopathic physician with such a chronic (non-venereal) case, yea in all cases of (non-venereal) chronic disease, has not only to combat the disease presented before his eyes, and must not view and treat it as if it were a well-defined disease, to be speedily and permanently destroyed and healed by ordinary homoeopathic remedies but that he has always to encounter only some separate fragment of a more deep-seated original disease”Samuel 11

 I decided upon Nitric Acid based on the repertorizing and elimination from the lists of the Materia Virosa for the HSV2 state and the HPV state and from the dramatic response in which the cysts regressed and she subsequently became pregnant , it was a near perfect similimum to the miasm behind the disease. An aspect of the patient that was not addressed by the other homeopaths was her sensitivity to remedies. She only needed two doses of the remedy given in water as a split dose . She did not need multiple remedies either.

To take this one step further if we chose to accept Shahrdar’s viral miasms .Her symptoms are those of a viral state or a viral miasm. Sumita is having the HSV 2 viral state and possibly the HPV state although this does not come out very well in the RV analysis. .It is to be noted that at any one time , one state will dominate and be uppermost that the other state will manifest when one state is cured by a similumum remedy. This is consistent with what Hahneman points out in Chronic diseases . At this point in the treatment I have not presented enough data to demonstrate this .

In conclusion

In my practice , Endometriosis has become a treatable disease and with the application of the Miasmatic theory and prescribing accordingly , the disease is not just palliated but cure is possible .It is my conviction that one day the medical profession via research will validate what Dr Shahrdar12 has theorised, that viral infections cause miasms in the body. 13

Post note

It is now May 2009 and almost 2 years since I started treatment in July 2007. Sumita has pain free periods now . Her treatment is still under my supervision and she is still having symptoms of  chronic miasmatic states but they are no longer endometriosis symptoms

 Further reading

Endometriosis , the homeopathic management , Suriya Osman IBPS publications,

Chronic Diseases , Samuel Hahnemann

Mary Lou Ballweg Endometriosis Source Book Published 1995

McGraw-Hill Professional ISBN:0809232634

Mintus.org library

May 2009

contact the author at

drsuriya@medicalhomeopath.info

1Melissa Conrad Stöppler, MD Endometriosis http://www.medicinenet.com/endometriosis/article.htm

2Krina Zondervana, Ion Cardona, Ronald Desrosiersb, Dallas Hydec, Joseph Kemnitzd, Keith Mansfieldb, Jeff Robertsc, Joan Schefflerd, Daniel E.Weekse and Stephen Kennedy The Genetic Epidemiology of Spontaneous Endometriosis in the Rhesus Monkey Annals of the New York Academy of Sciences 955:233-238 (2002)

3Cleary, S. D. 2; Ballweg, M. L. 3; Nieman, L. K. 1; Stratton, Ninet Sinaii , High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis.  Human Reproduction. 17 No (10): pages 2715-2724, October 2002

4Shawn Daly, MD,,Eric Outwater, MD, Endometrioma/Endometriosis  Aug 16, 2007 http://www.emedicine.com/radio/topic250.htm

5Schmidt CL, Demopoulos RI,WeissG. Infected endometriotic Int JGynecol Pathol. 2002;22:8388. 1981;36:2730

6http://minutus.org/library/article_read.asp?id=72

7 Hans Selye The Stress of Life Published 1984 McGraw-Hill reference to ponos page 3

8http://www.repertoriumvirosum.com/

9Ardavan Shahrdar., Sycosis and Gonorrhoea http://minutus.org/library/article_read.asp?id=16

9

10Samuel Hahnemenn Published 1999 B. Jain PublishersA footnote of page 84 of Chronic diseases tells about common gonorrhoea

11Samuel Hahnemann Chronic Diseases  Published 1999 B. Jain Publishers

12http://minutus.org/en/shahrdar.asp

13http://minutus.org/library/articles.

TREATING AMY

TREATING AMY (AMZ)
This article was published in the Australian Homeopathy Journal Similia in 2007 under the title Treating Maryam

I first saw AMZ when she was a month old .She was born in 2003.
AMZ is the youngest child in a family o 3 children. Her other siblings had no history of eczema or asthma . Her parents are also healthy and have no history of any chronic skin problems or asthma.
When her mother was pregnant with AMZ , she was treated for a viral fever which subsided after a week.
AMZ first had an exfoliating rash when she was a month old. I treated her with homeopathic remedies based on the law of similars. The remedy that I had given her when she was a baby was Bell which ameliorated what looked like a bad infantile eczema. Bell worked well several times, whenever she had a recurrence.
The reason I chose Bell in the first place was because the rash always had an erysepelous base and in my experience Bell works well. It proved to work quite well at first.

From Lippes Materia Medica on Bell:
Under face:“Erysipelatous swelling of the face. “
Under skin:”Vesicular eruptions, with scabs, white edges and œdematous swellings. “
Whenever she had a fever, she also had a very mild erythematous rash and Bell also suited the fever which was very hot and dry.

I usually give Bell in 200c potency as a liquid dose. I ask the dose to be stopped when the condition starts to improve. If 5 doses failed to act, they were to stop the dosing and get back to me.
Her condition recurred several times throughout the years, leading up to her flare up in December of 2006 which makes one think of a miasmatic base. I should have suspected it already, seeing that her initial complaint was at one month old!

She was not always treated with homeopathic remedies, since she was also seeing other doctors who were panel doctors for the company her father worked in so I note several occasions when she was given paracetamol, anthistamine and steroid creams for her skin.
What I write below is the focus of this paper so I will put a time line for the events that took place as well as try to give a rationale of my prescriptions.

27/11/2006
She had a bad flare up on for which I gave Bell. Her symptoms at this time were the same rash on an erythematous base on her head. Her rash was exfoliating, which gave me more reason to prescribe Bell.
I gave Bell 30c to be taken daily until improvement. This time I gave dry doses.
She did not get better and then, in fact she became steadily worse.
In December 2006( 1/12/2006) she had a very bad flare up which spread to her whole body .
Her symptoms were again, an exfoliating rash now not confined to her head but had spread from her head to her limbs as well as her torso in the front and in the back.

I was away at this time and my locum doctor panicked and she was referred to the General Hospital and admitted to the ward for one week. She was pumped full of steroids and antibiotics. They thought she had childhood psoriasis. The doctors warded her for a week and, 3 days after they discharged her and she had was ill again, only this time it was worse than before she was admitted.

15/12/2006
She came to see me again. She was febrile, her joints were stiff and painful, her knees swollen and red with the skin exfoliating.!She also had a wet cough . I gave her hepar sulph 200c , 5 doses in water , 6 hourly based on her extreme sensitiveness and she seemed a wee bit better when I saw her after 3 days But , she was still quite bad I changed to pulsatilla 200c , 5 doses 6 hourly in water. My rationale for the pulsatilla was her extreme clinginess as well as the polyarthritis and the weepiness and the cough which was worse lying down. I was also thinking that the rash resembled an exanthema .

Lippe on Pulsatilla.
“Peevishness, which increases to tears, with chilliness thirstlessness “
“Red-hot swelling of the feet extending up to the calf, with stinging pain. “
“Cough, with expectoration in the morning or during the day only, without expectoration at night. “

“Exanthemata itching-stinging, chapped. “
26/12/2006
No improvement , if anything she seemed worse, with severe chilliness, needed to be wrapped up with extreme sensiviteness, joint pain,swelling and stiffness, the whole body was peeling.She was febrile and her legs looked like erysipelas , with redness swelling and heat as well as pain. I feared for her life since she was losing a lot of heat and moisture from her skin but parents refused to send her to hospital and there are no homeopathic hospitals here. .Her whole body was peeling away , the skin was red and inflammed., she had an exhausting cough and she was also having rigours . It was too painful for her to move so she was lying down semi curled up , at the same time she was uncomfortable and had to move slightly to change position.

Then, based on her appearance which reminded me of scarlet fever and taking note of all her symptoms , I repertorised for the case and I gave rhus tox 200c in water, with instructions not to exceed 5 doses and to stop as soon as there was some change. I also gave her a referral in case the remedy did not work since she was in grave danger of dying from dehydration..You can see the repertorising I did was only for her symptoms .The remedies that were in all the rubrics were Aconite, Arsenicum, Rhus Tox, Sulphur Phosphorus and Mercury. I chose Rhus Tox because of her modality of finding it painful to stay in one position while it was also painful to move. The desquamation was also a deciding factor and I was certainly not going to prescribe sulphur in such an acute state. Arsenicum would seem an obvious choice given the severe anxiety everybody was going through but the extent of the skin made me think Rhus Tox .Mercury might have made some sense as would Phosphorus but Rhus Tox scored higher using weightage.

ARYANA1

repetorizing
repetorizing

I saw her 5 days later, a real huge change,the skin on her face and body was no longer peeling, joints were no longer stiff nor were they swollen, the skin on her legs were still red and the skin from her feet were still peeling but she was cheerful and afebrile. Her cough had become very minimal . Her appetite was good! No remedies at this point.

When I saw her five days after the Rhus tox, She was very well and very cheerful, all that was left was some rough skin and a wee bit of scurf on her head .

Follow up11 /1/2007
AMZ still had a mild rash but was otherwise well.
I retook her case and gave her Phosphorus a remedy that fitted her very well constitutionally. It is a miasmatic remedy in Hahneman’s book Chronic Disease and seemed to be a good constitional remedy as well. (When she is well, she is a very cheerful and friendly girl) Looking through her notes again I discovered she had seen a regular doctor a month prior to her severe attack complaining of cough and was found to be having asthma. Another reason for the phosphorus since I found that in my practice, more than 60 % of the asthma cases seemed to need phosphorus. I have her 3 dry doses of 200c to be taken 12 hourly.

Follow up: 11/2/2007

Not even any scurf, very well indeed.

24/4/2007
She came in with a cough cold and fever , for the first time she had a fever without any accompanying rash. Prior to this , she would always develop a slight erythematous rash when she had a fever from a cold or a flu. The dandruff was also quite persistant. There was none on this visit .What comes to mind is that such chronic symptoms in one so young should have given me warning of the miasmatic basis of her dandruff rash and erythema.
There was some slight exfoliation on the feet , it was very mild and I would wait and see if she needs another remedy. This exfoliation is a feature of both psoriasis and eczema but at this point , I am thinking perhaps another miasmatic picture is showing itself. Ardavan says to let the miasm speak to you and I think now she is expressing a different miasm. Her mum showed me eczema of her nails which recently manifested as pitting of the nails., another feature that could be either eczema or psoriais except it is rare in childhood psoriasis.. According to Ardavan’s materia virosa , this could be a herpes miasm. If we waited for a bit, a better picture of this would turn up and be easier to treat.

Here are some photos I took as she was getting better, I did not take any pictures when she was gravely ill, never thought to take them at that point!

ARDYANA5
1st Jan

5 days after Rhus Tox 200c no more exfoliating on her face which was still slightly red and she had dandruff on her head .

1st Jan
She was very much better but her feet and legs were still red and peeling.

ADRYANA4

9th Jan
When she came again a week later, there were only scabs in her scalp .

ARYANA5

24 April.
She had a cold and a slight fever, which explains her solemn look. No rash , only mild exfoliating on her feet which is good because being confined to her feet would be consistent with the direction of cure.

Discussion:
Thus far it seems that I have noted that the rash was erythematous and also that right from the start there was an element of exfoliation and desquamation. The clinical picture would be consistent with infantile eczema or childhood psoriasis .

Going by the above description, it would not have been off the mark for the doctors to suspect that AMZ had a severe form of childhood psoriasis as well as their wanting to opt for cytotoxic drugs.
It is claimed that the cause for childhood psoriasis is unknown but also that it can be triggered by a viral such as chicken pox or bacterial infection such at a strep throat .2 This is interesting in the treatment of AMZ because I noted that the symptoms looked like a very bad case of Scarlet Fever .

AMZ did have her skin peeling in the hands and the fingers and toes as well as on the limbs , in fact all over her body! She also had swollen legs which looked like erysipelas , only it did not respond to antibiotics which I presume was chosen according to what the lab findings showed was
Differential Diagnosis for the pitted nails and the skin peeling: Both psoriasis and eczema have pitted nails but pitted nails is rare in childhood

Postcript May 2009
It is almost 3 years since AMZ was cured from this condition.
In this time, the past remedy was repeated 2 times when there was a very mild rash during epsisodes of fever.
For the past one year, AMZ has had a few episodes of viral fevers with NO rash.
Her nails are normal .
There is not the slightest skin problem .

1http://www.bbc.co.uk/health/conditions/psoriasis2.shtml
2Childhood bouts of psoriasis can be triggered by a cold, chicken pox, tonsillitis, or a respiratory infection, like strep throat
3http://dermnetnz.org/bacterial/scarlet-fever.html
4http://www.gpnotebook.co.uk/cache/772145171.htm
5http://www.pubm