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 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 6  |  Issue : 2  |  Page : 80-84

Individualized homeopathic approach in a case of multiple renal calculi


Department of Case Taking and Repertory, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital (Government of West Bengal), Howrah, West Bengal, India

Date of Submission06-Jan-2021
Date of Acceptance20-Jan-2021
Date of Web Publication05-Mar-2021

Correspondence Address:
Dr. Raj K Pandit
Department of Case Taking and Repertory, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital (Government of West Bengal), Howrah, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AYUHOM.AYUHOM_7_21

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  Abstract 


Calculi may form at any level in the urinary tract but mostly arises in the kidney (nephrolithiasis). People suffering from renal calculi entirely depend on the surgery although it is expensive, on the one hand, and may have complications, on the other hand. Hence, there is a need for alternative medicine (Homeopathy), as it avoids surgical intervention, complication, as well as cost-effectiveness. In Homeopathy, the basis of therapy is vital rather than a physiological one, i.e., the vital force must be stimulated to cure the patient, and that only other drug therapy is palliative or suppressive. The aim of the study is to know the efficacy of individualized homeopathic remedy in the dissolution or expulsion of calculus. A 23-year-old male patient came to the outpatient department, presented with pain in the right side of the lumbar region and hypochondrium for 4–5 days with difficulty in urination. Ultrasonography (USG) of the kidney, ureter, urinary bladder revealed two calculi in the right kidney, one at the upper pole (8 mm) and another one at lower pole (12 mm) calyx. Individualized homeopathic medicine Tuberculinum was prescribed in centesimal scale. USG revealed no calculus in the kidney, and serum urea and creatinine levels were found within normal limit. Therefore, it is concluded that constitutional medicine helped the patient in subsiding the pain, dissolution or expulsion of stone, and return of the natural state of the patient.

Keywords: Homeopathy, individualized medicine, renal calculi


How to cite this article:
Pandit RK, Pandey S. Individualized homeopathic approach in a case of multiple renal calculi. AYUHOM 2019;6:80-4

How to cite this URL:
Pandit RK, Pandey S. Individualized homeopathic approach in a case of multiple renal calculi. AYUHOM [serial online] 2019 [cited 2021 Apr 12];6:80-4. Available from: http://www.ayuhom.com/text.asp?2019/6/2/80/310853




  Introduction Top


Urolithiasis or formation of urinary calculi at any level of urinary tract is the most common, painful, costly clinical condition.[1],[2] It is estimated that 5%–15% of population worldwide experiences this disease during their life span.[3],[4],[5] National Health and Nutrition Examination Survey data for 2007–2010 indicate that up to 19% of men and 9% of women will develop at least one calculus during their lifetime.[2] The peak age of onset is between 20 and 30 years.[6] Although the exact mechanism of calculus formation is not known. Many risk factors that act as either cause or effect such as high urine calcium level, obesity, calcium supplement, gout (hyperuricemia), hyperparathyroidism (hypercalcemia, hypercalciuria), certain food (diet rich in meat, fish, egg, tomatoes, milk, spinach, rhubarb, and high salt intake), drinking less amount of fluid (single most important determinant of stone formation), hot climate, and infection are found to be associated with the calculus formation.[7],[8],[9] Apart from these, deficiency of Vitamin A, decreased level of urinary citrate, inadequate urinary drainage and urinary stasis, and prolonged immobilization are responsible for calculus formation.[10]

Pain is the leading symptom in 75% of people. Hematuria is common, but the quantity of blood is scanty and fresh.[9],[10] It has been demonstrated that calculus of size <5 mm in diameter can pass naturally with intake of copious amount of fluids, while the calculus of size 5–7 mm has 50% chance of passage and those more than 7 mm mostly require surgical intervention.[3],[4],[5],[9] Depending upon the size and location of the calculus, various typed of procedures are done (conservative treatment, extracorporeal shock wave lithotripsy [ESWL], endoscopic procedure, and open surgical procedure).[9]

At present, in India, Homeopathy is the third most popular method of medical treatment.[11] About 12.7% of population depends solely on Homeopathy for their healthcare.[4] Case reports demonstrate both symptomatic relief and dissolution or expulsion of renal calculus with the homeopathic medicines.[3],[4],[5],[12],[13] The present case highlights the effect of individualized homeopathic medicine in the successful treatment of renal calculus.


  Case Report Top


A 23-year-old, lean, thin, tall, fair complexioned male came to the outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital with pain in the right side of the back (lumbar region) and abdomen (hypochondrium) for 4–5 days with difficulty in urination. Initially, the patient had consulted an allopathic physician for acute pain in the lumbar region 14–15 days before and was temporarily relieved after painkiller injection. Later, he was diagnosed with right renal calculi and was advised for surgery.

Past history

The patient had a history of (h/o) measles at childhood and h/o attack of acute gastroenteritis 9 years ago (treated by allopathic medicine).

Family history

Grandfather had a h/o pulmonary tuberculosis and father was suffering from asthma. No h/o urolithiasis was found.

Generals

The patient was very short tempered, irritable, and wanted to travel most of the time. He had an addiction to smoking. His memory was not good; it takes time to remember the things. The appetite was good with a strong desire for mutton++, sweets++, and cold things. He drank very less quantity of water and the tongue was dry. The patient also had a tendency of profuse sweating which was nonoffensive in nature and takes no staining on clothes. His bowel movement was irregular, usually at 1 day intervals and the character of stool was hard and offensive. The patient usually preferred to lie on his abdomen and was restless during sleep. He was susceptible to cold and always used a thin cover during sleep. His thermal reaction was chilly.

On examination

Tenderness of the right renal angle was noted. No other abnormal finding was revealed. Complete blood picture and renal profile test were within normal limits. Ultrasonography of the kidney, ureter, urinary bladder showed two calculi in the right kidney, one at the upper pole (8 mm) and another one at lower pole (12 mm) calyx [Figure 1].
Figure 1: Ultrasonography of kidney, ureter, urinary bladder

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Assessment of severity of disease was done using urolithiasis symptom score (USS) scale [Table 1] comprising eight most prominent symptoms of renal stone (pain/colic, hematuria, dysuria, stone, size of stone, position of stone kidney, position of stone in ureter and position of stone in bladder). Each symptom was scored on a 4-point scale where 0 signifies absent, 1 – mild, 2 – moderate, and 3 – severe form of symptoms. USS was further categorized as mild (1–7), moderate (8–14), and severe (15–22). Symptom scores were assessed at every visit of the patient.[14]
Table 1: Urolithiasis symptom score chart

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At the time of entry, the symptom score of the patient was 12 which is moderate in severity.

Repertorial analysis

Repertorization was done using HOMPATH classic 8.0 (complete repertory) [Figure 2].
Figure 2: Repertorization chart

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Figure 3: Ultrasonography of kidney, ureter, urinary bladder

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Figure 4: Ultrasonography of whole abdomen

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Figure 5: Serum Urea, Creatinine

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After repertorial analysis, Arsenicum album was found to cover 10 rubrics and scored highest marks of 25. However, after consulting Homeopathic Materia Medica, Tuberculinum was selected as it covered all the rubrics (11) and scored 24 marks.

Prescription

One dose of Tuberculinum 1M [Table 2] was prescribed on the day of first visit along with placebo for 3 days. Later patient was followed at an interval of 3-4 weeks until the dissolution or expulsion of calculi. [Table 3]. The patient was advised to take a plenty of water and avoid red meat, fish, egg, tomatoes, milk, spinach, etc.
Table 2: Prescription

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Table 3: Follow up

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  Discussion Top


Urolithiasis is a worldwide problem. The majority of the population experiences one episode of calculus formation in their kidney, while about 35% of the population experiences recurrence of calculus formation. Until the 20th century, open surgery remained the first line of treatment; however, over the last 30 years, the approach for treatment of urinary stone disease has been advanced such as conservative, ESWL, endoscopic, and open surgical procedures depending upon the size and location of stone. Under surgical approach, internal injury may seem to happen in the urinary tract.[3],[9] Hence, there is a need of alternative therapy (Homeopathy) where vital force must be stimulated to cure the patient. Many homeopathic medicines such as Berberis vulgaris, Lycopodium, and Sarsaparilla are well-known organ-specific medicine for the treatment of calculus. The presented study therefore was aimed to report the case study with the individualized medicine (Tuberculinum) in a 23-year-old male patient suffering from multiple renal calculi

The present case study was found to be very similar with Sumithran's study in which the individualized medicine Nux vomica was found very effective in the dissolution or expulsion of multiple calculi.[4]

Limitation of the study

As this is a case report, similar study may be carried out on a large sample size.


  Conclusion Top


The present study concluded the dissolution or expulsion of stone and restoration of general state or well-being of the patient with the help of individualized medicine, which proved the importance of holistic approach in the treatment considering the individuality of patient and not just disease symptoms for remedy selection and outcome assessment. However, it would not be appropriate to generalize on the basis of this study. Furthermore, randomized control trial is suggested to ascertain the result obtained in the present study.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mohan H. Textbook of Pathology. 6th ed. New Delhi: Jaypee Brother Medical Publisher Pvt. Ltd.; 2010. p. 690.  Back to cited text no. 1
    
2.
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's Principles of International Medicine. 19th ed. New Delhi: McGraw-Hill Medical Publishing Division; 2015. p. 1867.  Back to cited text no. 2
    
3.
Hati A, Sasmita R, Nayak C, Raj I, Sahoo A, Paital B. Successful treatment of ureteric calculi with constitutional homoeopathic medicine Lycopodium clavatum: A case report. J Drug Deliv Ther 2018;8:1-7.  Back to cited text no. 3
    
4.
Sumithran P. A case of multiple urinary calculi. Indian J Res Homoeopathy 2016;10:142-9.  Back to cited text no. 4
  [Full text]  
5.
Gupta AK, Gupta J, Siddiqui VA, Mishra A. A big urinary calculus expelled with homoeopathic medicine. Indian J Res Homoeopathy 2008;1:50-5.  Back to cited text no. 5
    
6.
Kumar V, Abbas A, Fausto N, Robbins EJ. Cotran Pathologic Basis of Disease. 8th ed. Haryana: Saunders Elsevier; 2010. p. 962.  Back to cited text no. 6
    
7.
Kumar P, Clark M. Kumar and Clark's Clinical Medicine. 17th ed. New York: Saunders Elsevier Ltd.; 2009. p. 609-10.  Back to cited text no. 7
    
8.
Dawson C, Tomson C. Kidney stone disease: Pathophysiology, investigation and medical treatment. Clin Med (Lond) 2012;12:467-71.  Back to cited text no. 8
    
9.
Shenoy KR. Manipal Manual of Surgery. 2nd ed. New Delhi: CBS Publishers & Distributors; 2007. p. 216-9.  Back to cited text no. 9
    
10.
Fowler C. The kidneys and ureters. In: Mann CV, Russell RC, Williams NS, editors. Bailey and Love's Short Practice of Surgery. 22nd ed. London: ELBS Publication; 1995. p. 924-5.  Back to cited text no. 10
    
11.
Ghosh A. A short history of the development of homeopathy in India. Homeopathy 2010;99:130-6.  Back to cited text no. 11
    
12.
Bhalerao R, Oberai P, Mehra P, Rai Y, Choubey G, Sahoo A, et al. Lycopodium clavatum for the management of urolithiasis: A randomised double blind placebo-controlled trial. Indian J Res Homoeopathy 2019;13:139-49.  Back to cited text no. 12
  [Full text]  
13.
Chakma A. Renal calculi: An evidence based case study. RA J Appl Res 2015;1:227-34.  Back to cited text no. 13
    
14.
Siddiqui VA, Singh H, Gupta J, Nayak C, Singh V, Sinha MN, et al. A multicentre observational study to ascertain the role of homoeopathic therapy in Urolithiasis. Indian J Res Homoeopathy 2011;5:36.  Back to cited text no. 14
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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