The author presents a case of diabetes mellitus of a psychogenic origin that got triggered after a crisis in her son’s life. It was resolved with a deep-acting homeopathic remedy selected on the presenting totality. The case emphasizes the role of the characteristic particular PQRS symptoms in forming a disease-totality, as well as the selection of the most-suitable mother tincture.
MRS ABC; Age: 54 yrs Housewife
Diabetes mellitus since March 2004
Patient’s son has settled in USA and he met with a serious car-crash, which resulted in major musculo-skeletal injuries to him and his wife. They were admitted in the hospital for almost three weeks. It was a major shock to the patient and a severe cause of worry. She wanted to rush for his care but couldn’t go, due to some other family responsibilities. Since the news came, she started feeling drained and low in energy. She got a severe attack of bronchitis that persisted for almost a month.
During her follow-up check-up for the bronchitis, her blood sugar was found quite high with fasting 205 and post-prandial 392. Glycosylated Hb [HbA1C] was 7.5%
Urine always showed glucose in the range of ++ to ++++ and also had persistent proteinuria. Her blood sugar never remained normal for a consistent period of time and hence she wanted to opt for homeopathic treatment.
CASE TAKING DATA:
Diabetes mellitus – presented with chest infection [bronchitis] first in March 2004. Since then there were repeated attacks of bronchitis whenever her blood sugar goes haywire.
Bronchitis: Gets productive cough – sticky expectoration << lying down
No other significant modality or triggering factor
Significant changes in general constitution since diabetes:
Perspiration increased especially palms and soles
Thermally was ambithermal but now has become markedly chilly.
Craving for sweets increased significantly
Strong & strange craving to eat raw food / vegetables [spinach / okra / raw rice]
Profuse strong smelling urine
Dryness of mouth with thirst for large quantities of water
Constipation – hard dry stools like balls
Patient as a person:
Motion sickness [car sickness] +
Cravings: warm food ++; highly seasoned food ++
Sleep disturbed due to thoughts with lots of dreams [forgets]
Menstrual history: menopause 4 yrs back, earlier regular menses; no concomitants
MIND: Gets along well with everyone – never gets angry even if things do not go her way; superstitious – believes strongly in ill-wills; worry and anxiety about family members and their health; does not like to mix with peers but is not reserved – will talk in social gatherings and will share her problems easily – does not mix, since does not like gossiping.
Thermally: Ambi-Chilly ? Chilly [since diabetes]
Family history: strong history of diabetes in family- Mother, Mat-uncles, Brother (most of them have got some or the other diabetic complications as well; patient had sustained her health until this crisis happened)
Past history: nothing significant
Tab Reclide 80 mg twice daily
Urine sugar: ++ to ++++ with consistent proteinuria
Glycosylated Hb [HbA1c]: (reading above 8.0 % indicates poor diabetic control)
Ailments from – Bad news, shock
Craving – raw food
Craving – sweets
Perspiration increased – palms & soles
Bronchitis recurrent, diabetes with [bronchi as region of affection]
Urine – profuse, offensive, putrid
Constipation: stools hard, ball like
Chilly with tendency to catch cold easily
From the repertorization, CALCAREA stood out as the remedy covering most of the significant symptoms. This case presented with a ‘phase totality’ where there are few symptoms that represent the change in the original constitutional features of the individual [after the disease got established] and thus they were given higher value in the totality and remedy correspondence.
While searching for remedies covering Diabetic pathology in Phatak’s repertory, I suddenly came across a rubric: Diabetes mellitus, lung affection with. This case presented exactly the same. The diabetes was detected during an attack of bronchitis, and the rise in BSL always gave rise to respiratory infections even later during the course of the disease.
CALC PHOS thus was selected based on this differentiating rubric.
Mother tincture: Characteristic constipation with hard ball-like stools & significant offensive urine with proteinuria lead to the selection of ABROMA AUGUSTA
TREATMENT & FOLLOW-UPS:
8 Aug 2011
Present complaints = constipation + offensive urine
No active respiratory ailment
HbA1c = 10.5%; Urine: sugar +++, proteins ++
= = =
In addition to the medication, was asked to follow strict exercise schedule for at least 45 minutes including brisk walking, cycling on plain grounds, or treadmill for 30-45 minutes
Calc phos 200 stat
10 Sep 2011
Constipation = not hard stools but unsatisfactory;
Urine offensive; no respiratory complaints
Urine: sugar ++, proteins ++
Following the exercise schedule regularly
Calc phos 200 wkly
7 Nov 2011
Constipation >>> soft and satisfactory motions; Urine offensive >>>
Feeling much fresher; had few hypoglycaemic episodes in between
Urine: sugar +; proteins +; HbA1c = 8.6%
Calc phos 200 wkly
AbrAug Q 10 QID
23 Jan 2012
No fresh complaints; Hypoglycemic episodes more frequent
Visited diabetologist: reduced medication to – Reclide 40 mg BD
3 Apr 2012
No complaints – especially no respiratory affection in spite of winter
“This is my first winter without bronchitis in last 8 years”
HbA1c = 7.0 %; Urine: sugar – nil, proteins – nil
25 May 2012
No complaints, keeping well. Doing regular exercise.
BSL: F = 96 & PP = 134; Reclide 40 mg BD continues; Urine – WNL
Calc phos 1M stat
AbrAug Q 10 BD*
27 Jun 2012
Three hypoglycaemic episodes in last two weeks; HbA1c = 6.2%
BSL: F = 76 & PP = 102; Reclide reduced to 40 mg once daily dose
Placebo dose stat
AbrAug Q 10 BD
13 Aug 2012
Fasting BSL = 118 and Post-prandial = 142; HbA1c = 6.8%
Regular exercise continued; No other complaints
Calc phos 1M /month
AbrAug Q 10 BD
28 Nov 2012
Fasting BSL = 78 and Post-prandial = 136;
HbA1c = 6.0% [24 Nov 2012]
Reclide stopped by diabetologist from 2nd Nov 2012 – yet maintaining sugar levels well with regular exercise and medication
Calc Phos 1M /month
AbrAug Q 10 BD
Her health before the crisis [in spite of having a strong family history of diabetes] and having no organic complications was in favour of the patient. The psychosomatic origin of the disease indicated the sensitivity of the patient, which not only helped in deciding the infrequent doses but also was a significant help in achieving faster response to the medication.
As regards the use of mother tincture, I have always found a remedy selected on the basis of the presenting totality as well as the associated symptoms to work in the most beneficial way. Earlier I used to give Syzigium to all patients with not very promising results. Now I have been using almost six remedies based on various indications [which I guess is the topic for a separate article]. In this case, the presence of proteinuria with constipation and offensively smelling profuse urine made the choice of Abroma augusta easier.