A case of Ulcerative Colitis
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Jan / Feb VOL III NO 1.
Dr Pravin M Shah
'Magp-sulph

Case History: A Hindu male, 58 years, Jain, married, having hardware-manufacturing factory and residing at Mulund with his wife and children, came to us on 10/3/2000 with the following chief complaints.

Chief Complaints

Associated Complaints

1) Skin 1st episode 1982 L 2nd toe	Eczema Dry, Itching ++	>3 cold water >2 Betnovate Ointment
2nd episode 1998 ?(R) lat malleolus	Eczema Dry, Left black Depigmentation3	>2 Betnovate Ointment
2) R S Since 4 - 5 yrs	Rhinorrhoea Allergic Rhinitis	AF - Dust2 < Cold drinks2 < morning2 < C O W2 < getting wet

Physical Appearance
Height 5´7" Weight 60 Kg
Appetite - since 3 months
Generals: < hunger since 1½ months - vertigo.
Headache
Craving: sweets³, cold drinks².
Aversion: Nil
Thirst: N
Stool: C/C Urine - (N)
Sweat: H/o profuse³ since 2-3 yrs, scanty chest², nape of neck²
Sleep: Sleep - sound and deep
Dreams: mostly nil
Once (2-3 years back): Father is alive and working in the factory with him.

Thermal State

	S	W
Fan	4/5	x
Cover	x	Thin, over head

Bath: p/H Tepid before 6 years
Now cold through out since 6 years
Woolens: Occ during morning walk
Overall assessment: Hot C2H3

F/H
MO: TKR done 16 years back
All brothers (3) - NIDDM
Elder brother - Bil Renal failure

P/H

R S Jan 99	Pulm Koch’s - Lt Pleural Effusion Pain Lt side of chest No cough, No fever	Tapping AKT x 9 months Stopped in Nov ’99	While on AKT, developed Hepatitis, stopped AKT But pleural Effusion S. Bil - 1.8 SGPT - 480 SGOT - 350
Anus, August ‘89	Fissure-in-ano.Haemorrhoids Infected anal Fistula with Perianal abscess	>3 operation

Life Space
Mr XYZ is a B Com graduate, 58 yrs, eldest son, runs a hardware manufacturing factory at Mulund with his brothers and residing with his BA, graduate wife, 52, and the younger son. Elder son studies computer engineering in USA and daughter is happily married after doing B Sc with home science in Fashion Designing.

Father expired at 44 yrs, when the patient was just 20 yrs old. Pt, eldest of 4 br and 1 si had to shoulder the entire responsibility of the house ie financial, social and familial. After passing B Com, he gave up further studies, and took up a job to support the family. Later he started a hardware-manufacturing unit, once his brothers completed their education.

Though in joint business, some interpersonal strains started developing amongst brothers over property issue. Younger brothers put impossible demands on patient. He wanted to be the "peace maker" and hence yielded to them in spite of reservations and his wife’s open disapproval. Now they live separately, yet patient’s mission is to see that everybody is happy, facing no problem.

Patient described his nature as sentimental - can’t disappoint or say "No" to anybody and tries his best to fulfill other’s demands - no matter if sometimes he has to go out of the way to do things for others. Always felt the need of a father figure in his life. "It is always good if you have somebody to guide you in times of stress".

Gets irritated if things don't work out the way he wants. Is a very active social worker and gets tense if some social responsibility is left hanging and unfinished. Even at family functions, he feels responsible and is tense until it gets over in the best possible manner.

O/E
Wt = 60 Kg
BP = 120/70 mm Hg
TONGUE = vertical fissure in middle of tongue
SKIN = blackish depigmentation of eczema on feet
PA = NAD
RS = NAD
CVS = NAD

Investigation Findings
2-11-99
CBC: Hb 13.9 gm% RBC 4.6 cu mm WBC 8,200, N 68 L 30 ESR = 6
BUN 9.4 S Cr 1.0
Total Proteins 6.0 Albumin 4.3 Globulin 1.7
SGOT 14 , SGPT 18, Alk-PO4 5.2 ka
Total chol 161, LDL 90.6, HDL 52, VLDL 18.4, HDL 3.0
Triglycerides 92, Serum CEA 1.5, Serum CA-125=285(??)
Total Bil 0.78, Direct 0.48, Indirect 0.38.
Blood Sugar

Colonscopy (Sept’98)
Distal 50 cm only shows the disease
Oedema, granularity, tendency to bleed.
Ulceration and early pseudopolyp. Marked exudate
Higher up colon - (N)

Diagnosis: segmental severe ulcerative colitis.
Interpretation
The patient gave us the impression of:

• Responsible3, Yielding and a peace-maker.
• A sentimental person is one who takes decisions with his heart rather than brains at the same time suffering from within and not knowing why he is suffering.
• He seemed to have pushed his emotions to such deep level of consciousness ? to survive and meet the demands of the situation, that he is hardly aware about repressed emotions within, as it manifests itself on the physical plane in the form of Ulcerative colitis.
• Now let us try to understand what is the psychosomatic analysis of ulcerative colitis.
• Ulcerative colitis is the name of an inflammatory condition of the large intestine, which starts in acute form but tends to become chronic and is accompanied by bodily pain and blood and slime (mucus) in stools.

Editor: an aside: Let us take the dictionary meaning of slimy: Greasy, oily, slippery, slick. All these words, when applied to a human characteristic, have an connotation of being a not-so-nice character; one out to get his work done at any cost, sliming his way into your confidence. The Hindi term ‘matlabi’

Somehow this does not fit in with my concept of Magnesium. Anyhow the author’s appreciation has worked, so for the time we will let it rest. And the trait he has chosen the remedy on is peace-lover rather than slimy. Which is why it has worked.

Remedy What other than our grand peace lover of our Materia Medica? Of course "Magnesium".
Taking into consideration - other physicals such as

1. Hot.
2. Cr: sweets³.
3. Suppressed skin eczema.
4. Diarrhoea <3 in the morning with urgency driving him out of the bed and has to rush.
5. Diabetes (NIDDM)
6. Skin complaints >3 cold application.
7. Dreams-dead relatives.

Planning and Programming of the case
A)Susceptibility: At the level of tissues- mucosa and sub-mucosa---breach in its continuity
Ulceration with bleeding and mucus---- Destruction of mucosal integrity
Suppression: eczema suppressed with steroids
Pace of disease- progressive yet reversible
Miasmatic Correlations:
Tubercular-Lean, thin, flat-chested constitution
Rapid and sudden loss of weight
NIDDM- P/H/O and F/H/O
Ulcerative colitis - blood and mucus in stools.

B) Sensitivity:
At the level of mind and nerves-moderate?low- overt expressions of emotionality, subdued feelings.
From the above understanding, we came to the conclusion of 30 C as the choice of potency.
Synthetic prescription of "Mag-sulph" was arrived at.

Treatment and Follow-Up

Date	Symptoms	Prescription
11-3-2000	Case defined	Mag-sulph 30, 3P HS SL 4PHS
17-3-2000	Pt feeling fresh Stools Fluctuating- Twice a day No mucus/ No blood	Ct all x 1 week and till
7-4-2000	Right Lower limb itching ++ with hyperpigmentation ++ Interpretation: Hering’s law of Cure in operation. Pt reassured Ulcerative colitis symptoms >2	Mag-sulph 30 7P HS x 1 wk
9-5-2000	Skin >3 Ulcerative Colitis >2 T Salozypyrine - BD to OD	Ct all
16-5-2000	Cold/ Cough Fluctuating Rest >2	Mag-sulph 200 1 P HS
11-8-2000	>2 T Salozopyrine-alternate day	Mag-sulph 200 1 P HS
25-8-2000	>2 yet Respiratory symptoms fluctuating	Tub-bov 1M 1 P HS Mag-sulph 200 1P HS
13-10-2000	BS 80; PP 141; Milk started again Salozopyrine stopped	Mag-sulph 200 1P HS /weekly
8-1-2001	Wt 62 Kg; Stop Glyboral	Ct all

Continued the Rx with improvement at all levels.
At present, patient is off Tab Solazopyrine with good control over disease activity. The latest blood sugar report showed BSF-80and BS PP - 141.

Fair control of diabetes also which used to shoot up initially in spite of continuing hypoglycemic agents. We plan to stop slowly OHA’s also with good control of diet and exercise.

Interesting point learnt through this case: "Hering’s law of cure". As Ulcerative colitis symptoms started getting better, the skin eczema suppressed long back started giving problem. This elated us. The implications of such a recurrence were explained to the patient to relieve his anxiety.

The use of Tub as an intercurrent was needed only once - thereby seeing the maximum effect of the minimum dose of the "Similimum"!!!

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