Can Still's Disease (JCA) be cured through H...?
NATIONAL JOURNAL OF HOMOEOPATHY 1999 Mar / Apr VOL VIII NO 2.
Dr Mirza Anwar Baig
'Puls / Sulp / Aur-met
Still's disease or Juvenile Chronic Arthopathy (chronic juvenile polyarthritis, rheumatoid type juvenile arthritis) is a rare disease of `Psoric' origin. It commonly affects the under-16. Although these cases look like rheumatoid arthritis, they are usually Seronegative or RA-negative.
The exact cause and pathogenesis are not known. Types of cases:
- Begin in childhood and progress to adult type, often with nodules and RA factor.
- Begin with peripheral arthropathy with a marked tendency to ankylose, with RA -ve but ANA +ve, usually affecting young men.
- Some remit in adolescence leaving less disability than in adult RA.
- Still's disease is difficult to diagnose.
Aetiological Factors:
Aetiology unknown but affected by many factors, including infection, toxins or antibodies, psychogenic, emotional, and systematic disturbances. Disease was unknown before the era of "Alexander". History reveals that majority of the Alexander's army contracted this mysterious disease; and that this was the actual reason for his return.
Case:
Master J A of Sultanpur, 11 yrs, was admitted to Sanjay Gandhi Research Institute, Lucknow (DOA: 7/12/95, DOD: 16/12/95). Diagnosed as JCA with cardiomegaly. Treated at hospital with Naprosyn and Prednisolone. Declared incurable at discharge. He was brought to Mafkhar Clinic (Bandra) on 26.2.97 in a hopeless condition.
History:
FTND and healthy until 8 years. He was calm, quiet, well-dressed, shy, eyes sunken, coffee-coloured skin, yielding, and non-complaining child.
At 8 yrs, he developed pain in calf muscles and knee joints with fever. During fever, thirst increased for cold water with restlessness. Fever started with chilliness at 4 to 5 pm. Allopathic treatment helped.
2nd attack in winter: Fever with chilliness in the afternoon with pains in all joints, with occasional swelling. Pains wandering,
AGG < walking & ascending.
Appetite - decreased. THIRST - decreased.
Stools - clear, twice or thrice daily. TONGUE - coated white.
Desire - open air, spicy food, eggs AVERSION - milk.
Past History - nil.
Family History - Maternal uncle- Koch's
Follow-Up: Pulsatilla 200/three doses, along with biochemic salt given on 26.2.97 and 1.3.97 No response.
On 4.3.97, I saw the case. He had already deteriorated, was very weak and looked as if he would die. As if sensing this, he looked sad, but his face showed no anxiety or fear of death. Originally he may have been a Pulsatilla, as his constitutional remedy. But now the situation was different; his vitality was sinking due to effects of disease and drugs. This formed a strong sycotic neoplastic miasm and was the hurdle to the response.
Follow-Up:
Thuja 200 [1] dose, followed by Pulsatilla 200 in repeated doses. The follow up was encouraging.
6.3.97: Patient better, no fever, appetite good, weakness reduced, mood happy. Placebo.
8.3.97: Relapse of fever. Pulsatilla 200 did not help. Sulphur inter-current given followed by Pulsatilla with good response.
11.3.97: Patient started walking. No joint pain or swelling.
18.3.97: Fever relapsed again, with joint pains and night AGG. And depression. Thus emerged the totality of Aur-met - with night aggr and depression with joint- pains. Aur-met 30/4 doses cleared the pain but fever persisted. Child was observed for two days but the fever did not come to normal.
20.3.97: Fever < afternoon; child sleeps during fever. Waited for 2 more days.
23.3.97: No fever. Placebo.
26.3.97: No fever, appetite improved, desires spicy food, placebo continued.
29.3.97: Patient better. Placebo.
8.4.97: Fever again, but no joint pain. Bacillinum 200/one dose with F/H of TB.
12.4.97: Placebo continued.
22.4.97: Placebo continued.
29.4.97: Fever again, with pain in the neck and hands, hiccough before fever paroxysm, and during sleep. Case repertorised. Pulsatilla again emerged with maximum marks. 10M single dose.
5.5.97: Patient better. Itching of eyes + lachrymation (old symptom). No Rx.
13.5.97: No other complaint. Placebo.
20.5.97: Marked improvement in every respect, except itching of the eyes. Placebo continued.
27.5.97: Itching persists. Sulphur one dose. Itching became little less but fever appeared; Bacillinum was administered, fever went down but itching persists. Elimination process. No medicine.
7.6.97: Child was better except for itching of the eyes. No medicine. But I asked myself, how long I should allow this itching? His father wanted to go home to UP, but was afraid of his fever relapsing. He was ready to do anything for his son. After carefully observing the appearance of the child, his behaviour and his ambition, I suspected a malignant force behind his relapse. A dose of Carcinosin 200 was administered. This resulted in a severe aggravation.
This time his fever was very high and was of the exact kind what he had for the first time, two years back. Possibly Carcinosin had stimulated his leukopoeitic system and his immune system.
The fever had the exact modalities and peculiarities of China:
Intermittent fever-high with chill < forenoon
Thirst before chill.
This was old symptom, which had returned. China-off 200 -one dose given on 5.7.97. The patient felt better. Thereafter no relapse. China was repeated on 15.7.97, after which patient felt perfect in every respect. Placebos followed this prescription for six weeks.
2.9.97: Patient developed mild constitutional ailment with dry cough, very much like the Phos cough.
Phosphorus 200/ single dose, was administered on basis of symptoms.
3.1.98: Chest cough and cold for which Pulsatilla helped.
24.1.98: Patient left for his native place and is healthy till today.
28-1-98 AF Exposure to cold wind -fever with joint pains. Agaricus 200-1 dose >. This was followed up with Carc 1M -2nd dose.
20-2-98 Mild Fever. Placebo
16-4-98 Well Placebo.
His father has been communicating off and on about his progress.
Editor: This case has had a zig-zag cure, with medicines given too frequently. Particularly the China-off seemed unnecessary. But maybe the fever was so high that too wait seemed too troublesome to this already weakened patient. Maybe Still's disease has so vitiated the susceptibility that this course had to be followed. But the result is certain, so the case is worth reporting.
This case is important from another point. It demonstrates the difficulty in actual practice of the wait policy, so graphically described in the article: Second Prescription in this issue.
The third noteworthy point is the courage of the author in reporting this case, knowing that penning this down is going to earn him some brickbats on the Follow-up schedule.
