Rheumatoid Arthritis (RA):

- A usually chronic autoimmune disease that is characterized especially by pain, stiffness, inflammation, swelling and sometimes destruction of joints.

- A chronic autoimmune disease with inflammation of the joints and marked deformities, something triggers an attack on the synovium by the immune system, which releases cytokines that stimulate an inflammatory reaction that can lead to the destruction of all components of joints.

- RA happens when the immune system attacks your own tissues and causes joint pain, swelling, and stiffness. It’s not part of normal aging.

- Rheumatic arthritis is a general term for inflammation of joint. Inflammation is characterized by swelling, redness, heat, pain. In addition to affecting the joints, rheumatoid arthritis may occasionally affect organs outside of the joints including the skin, eyes, lungs, heart, blood, nerves, or kidneys.

- Rheumatoid arthritis is an autoimmune disease, meaning that patient’s immune system -reacting against its own.

‘Rheumatic disorders’ include:-

Polymyalgia Rheumatica – in this disorder there is pain and stiffness in a lot of different muscles, especially those around the shoulders. It affects mainly the elderly.

Tenosynovitis – This is an inflammation of the sheathes of the tendons – they are the cord-like structures in the wrist and elsewhere, which many older people call ‘leaders’.

Capsulitis – this is an inflammation of the capsule (the covering) of the joint, often the shoulder.

Bursitis – This is an inflammation caused by friction between soft tissues and underlying bone. A ‘sac’ of fluid develops.

Symptoms:

- Pain and swelling in multiple joints (usually the same joints on both sides of your body, like both wrists or both ankles)

- Problems in other organs such as eyes and lungs

- Joint stiffness, especially in the morning

- Fatigue

- Lumps called rheumatoid nodules

Diagnosis: X-rays, blood tests, and samples of your joint fluid.

Homoeopathic Remedies:

RHUS TOX -

- Rhus Tox is a great Homeopathic remedy for rheumatoid arthritis.

- Restlessness and desire to move about continually, on account of the relief it to the aches and pains.

- Suitable especially to rheumatism affecting fibrous tissues, sheaths of muscles etc., Rheumatism from exposure to wet when overheated and perspiring.

- The joint pains are worse after rest and the pains get slowly better after walking or moving around.

- There is recurring attacks due to getting chilled when hot.

- Rheumatism caused by damp weather and worse in damp weather.

- There is restlessness and the pains are worse at first motion, better by continued motion and again worse after moving for some time when it becomes necessary for him to repose.

BRYONIA ALBA-

- Bryonia is an excellent remedy in cases of acute pains of rheumatoid arthritis.

- Bryonia may be given when the pains are worse by slightest motion or touch.

- The joints are acutely inflamed and there is anguish and agony on account of pain.

- Bryonia may also be given when the pains are associated with swelling of the joints.

- In acute exacerbations when there is fever, bryonia can be prescribed.

- There may be whitish coating on the tongue and the mouth and the throat are extremely dry. Fever may be associated with thirst.

SALICYLIC ACID-

- Salicylic acid is an effective remedy which can be given during acute attacks of rheumatoid arthritis.

- Salicylic acid may be prescribed when the involvement is primarily in the upper extremities.

- There may be profuse swelling and redness in the affected joints.

- Most often, the pains are associated with high to very high fever.

- The pains are pricking type and may be worse by exposure to cold and better by warmth in general.

RHODODENDRON-

- Rhododendron is prescribed when pains wander from joint to joint with swelling of joints, worse before and during thunderstorm, cold or wet or unsettled weather; Better from warm wrapping.

COLCHICUM-

- Colchicum is a great homeopathic remedy for sever pains in Rheumatoid Arthritis.

- There may be swelling of joints which may be red or pale.

- Abdomen bloated with wind.

- There is aversion of food which smells as soon as served.

- Albumin in urine which becomes black like ink, scanty urine with dropsical swelling, marked irritability from pains or odours.

- Pain is worse by motion, touch, or mental effort . Better by warmth, rest or sitting.

- Rhuematoid arthritis of smokers.

CAULOPHYLLUM-

- Complaints worse during menstruation; beginning at the time of menopause; more in hands and feet.

- Rheumatic pain in small joints like fingers, toes, ankles etc.

- Aching in the wrists.

- Cutting pain on closing the hands.

- Erratic pains, changing place every few minutes.

LEDUM PAL-

- Rheumatism of the great toe and joints with swelling

- Soreness and drawing pain on stepping, worse from warmth, pressure and by motion.

- Pain travels upwards, better cold compression.

PULSATILLA-

- Pulsatilla is one of the most indicated remedies in rheumatoid arthritis when the pains keep changing their locations.

- This homoeopathic medicine may be given in women with an unusual tendency to cry.

- They cannot narrate their symptoms without crying.

- The pains changing locations. For a few days pains may be in the right knee, then shift to the left knee, then in the ankles.

- The pains are worse in the night, on rest and in warm closed rooms. However, the pains are better in open air and by warm applications.

AMMONIUM PHOS-

- Chronic nodosities of the joints, hands twisted, out of shape due to deposits of water of soda.

ARNICA MONTANA-

- ArnicaMontana is an effective remedy  with lameness and soreness all over the body.

- Arnica is indicated when there is extreme pain all over the body and every joint hurts.

-The whole body feels bruised and sore; as if it had been beaten with sticks.

- Arnica is also a great homeopathic remedy when the pain in joints is a result of a fall or injury.

ACTEA SPICTA–

- It is an excellent remedy for rheumatism of small joints of the fingers and wrists.

- Swelling of joints from slight fatigue.

GELSEMIUM –

- Gelsemium may be indicated in acute pains which are of burning nature and are worse by heat.

- There is extreme weakness with lethargy.

- Gelsemium may be given in cases of rheumatoid arthritis which become worse during change of seasons and in damp surroundings.

- The joints are swollen and there may be extreme weakness in the surrounding muscles.

- During an acute attack, there is marked trembling of all the limbs.

- Gelsemium may be given when there is a sore, bruised feeling in the back muscles as well.

MERCURIUS SOL –

- Merc sol is indicated when the arthritic pain occurs with very offensive sweats – the more he sweats the worse he feels.

- Great weakness, Better in bed, but as soon as he gets warm in bed the pain increases and he has to throw off his clothes to get better.

- The latter position also aggravates pain, then again he has to cover himself in bed and so it goes on the whole time, Worse during night.

KALMIA LAT-

- Pain travels downwards affecting large part of limb and passes through quickly along the course of nerve.

STELLERIA MEDIA- 

- Shifting pain in all parts of body, worse by motion.

WRITTEN BY- DR.MAYUR MODI

MELASMA AND HOMOEOPATHY

Melasma or Chloasma is a common skin condition in which light to dark brown or grayish pigmentation develops on face. It can affect both genders. It is more common in women and people with darker skin- types who live in hot climates. Melasma usually becomes more visible in the summer.

Causes- The exact cause is not known. There are few factors are prgnancy, hormonal drugs such as contraceptive pill, and very occasionally medical conditions affecting hormonal levels. Some cosmetics, especially those containing perfume can bring on melasma. It can also be caused by stress. Sunshine and the use of sun –beds usually worsen any tendency to melasma. Melasma can run in families, suggesting an inherited tendency.

Symptoms- Melasma is simply darker than normal skin affecting cheeks, forehead, upper lip, nose and chin usually in a symmetrical manner. The neck and chest are rarely. the forearms can also be affected. Areas of melasma are not raised. The affected skin may itchy or sore.

Diagnosis- Melasma is usually recognized by the characteristics of the pigmentation and its distribution on the face.

HOMOEOPATHIC REMEDIES:

SEPIA OFFICINALIS –

-  Sepia is first the remedy for melasma.

- There are yellow-brownish spots on face, especially cheeks, forehead and cheeks and nose.

- A yellow saddle across the upper part of cheeks and nose.

- There is dark circle under the eyes.

- Facial discoloration during pregnancy, after childbirth and menopause.

- Sepia is suited to persons having dark hair, and rigid fibre.

LYCOPODIUM CLAVATUM -

- Lycopodium is another effective remedy for melasma with grayish –yellow discoloration of the face, with blue circles around the eyes.

- Lycopodium patient always suffer from flatulent complaints.

- The person likes warm food and drinks.

- There is a special craving for sweets.

PHOSPHORUS-

- Acts beautifully on freckles that worsen during the summer.

- Tiny brownish spots appear on the face, notably on the nose.

- Heat may be felt in the cheeks which show the appearance of freckles.

- An unusual craving for ice cold things.

ARGENTUM NITRICUM -

- Argentum nitricum is prescribed for melasma where the face looks sunken, old, pale and bluish.

- Old man’s look, sickly, sunken grayish of muddy color. Skin is brown, tense and hard.

CADMIUM SULPH-

- Cadmium sulph is effective for melasma with yellow stains on nose and cheeks.

- The color varies from yellowish to brown. The colour gets worse from exposure to sun and wind.

- Itching of the face.

COPAIVA OFFICINALIS –

- Copaiva is prescribed for melasma where brown spots are seen on the face.

- Presence of circumscribed lenticular patches with itching.

- Mottled appearance.

CAULOPHYLLUM THALICTROIDES-

- Caulophyllum is prescribed where moth spots on forehead with leucorrhea.

- Discoloration of skin in women with menstrual and uterine disorders.

- Skin was hot and dry.

THUJA OCCIDENTALIS-

- The skin is pale, waxy, shiny, dark circle under eyes.

- Nettled with spider like veins.

- Skin looks dirty, dry with brown spots.

PLUMBUM METALLICUM-

- Yellow, corpse like spots on sunken cheeks.

- Skin of face is greasy and shiny.

- Face pale and emaciated.

SULPHUR-

- Sulphur is suited to dirty, filthy people, prone to skin affections.

- It is best for skin pigmentation after local medication.

- The skin is unhealthy, dry, rough and dirty.

- Old looking spotted face.

- The person feels itching and burning sensation on the face, worse from heat.

GUARANA-

- Chloasma on temples and arms.

- Intellectual excitement; uncontrollable sleepiness.

PLUMBUM MET-

- Yellow, corpse like dark brown liver spots; cheeks sunken. Skin of face is greasy, shiny.

- Face pale cachetic

BERBERIS AQU.- 

- Clearing off skin pigmentation to reveal clean, glowing skin.

- A prominent symptom for use of Berberis Aquifolium is the presence of yellow-brown patches on the face.

- The skin on the face may feel dry, waxy, rough or scaly.

Benign prostatic hyperplasia or hypertrophy and homoeopathy

Benign prostatic hyperplasia:

- Benign prostatic hyperplasia is also known as benign prostatic hypertrophy.

Benign prostatic hyperplasia (BPH) is an enlarged prostate gland. 

- The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. This often causes problems with urinating.

- Generalized disease of the prostate due to hormonal derangement which leads to enlargement of the gland (increase in the number of epithelial cells and stromal tissue) to cause compression of the urethra leading to symptoms.

BPH occurs in almost all men as they age. BPH is not cancer. 

- An enlarged prostate can be a nuisance. But it is usually not a serious problem. About half of all men older than 75 have some symptoms.

Cause:

- Benign prostatic hyperplasia is probably a normal part of the aging process in men, caused by changes in hormone balance and in cell growth.

Symptoms:

BPH causes urinary problems such as:

- Trouble getting a urine stream started and completely stopped (dribbling).

Often urging to urinate. This feeling may even wake you up at night.

- A weak urine stream.

- A sense that your bladder is not completely empty after you urinate.

- In a small number of cases, BPH may cause the bladder to be blocked, making it impossible or extremely hard to urinate. This problem may cause backed-up urine (urinary retention), leading to bladder infections or stones, or kidney damage.

- BPH does not cause prostate cancer and does not affect a man's ability to father children. It does not cause erection problems.

Examination:

RENAL AREA - Tender

TONGUE - Brown, dry

RECTAL EXAMINATION - Absence of full bladder

- Bimanual : Dorsal position : the enlargement can be felt

BLOOD          

- Blood urea increased, ESR increased

- Prostate-specific antigen (PSA): It is a protein produced by the cells of the prostate gland. The PSA test measures the level of PSA in the blood. The doctor takes a blood sample, and the amount of PSA is measured in a laboratory. Because PSA is produced by the body and can be used to detect disease, it is sometimes called a biological marker or tumor marker. It is normal for men to have low levels of PSA in their blood; however, prostate cancer or benign (not cancerous) conditions can increase PSA levels. As men age, both benign prostate conditions and prostate cancer become more frequent. The most common benign prostate conditions are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) (enlargement of the prostate). There is no evidence that prostatitis or BPH cause cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well. PSA levels alone do not give doctors enough information to distinguish between benign prostate conditions and cancer. However, the doctor will take the result of the PSA test into account when deciding whether to check further for signs of prostate cancer.

PSA test results report the level of PSA detected in the blood. The test results are usually reported as nanograms of PSA per milliliter (ng/ml) of blood. In the past, most doctors considered PSA values below 4.0 ng/ml as normal. However, recent research found prostate cancer in men with PSA levels below 4.0 ng/ml (2). Many doctors are now using the following ranges, with some variation:

- 0 to 2.5 ng/ml is low

- 2.6 to 10 ng/ml is slightly to moderately elevated

- 10 to 19.9 ng/ml is moderately elevated

COMPLICATIONS of Prostate Enlargement

- Acute Retention

- Chronic Retention: The bladder is not completely emptied after  passing urine. Some urine remains in the bladder at all times. This is called ‘chronic (ongoing) retention’. This may cause recurring urine infections, or incontinence (as urine dribbles around the blockage rather than large amounts being passed each time patient goes to the toilet).

- Infection

- Uremia

- Hydronephrosis

- Renal Failure

HOMOEOPATHIC REMEDIES:

ANCARDIUM ORI.- Prostrate fluid passes while at stool and after having made water

ARGENTUM NITRICUM- Chronic enlargement  in old people

ARNICA MONTANA- In traumatic cases where the enlargement is due to injury. Sensation as if bruised and beaten, darting or tingling, with numbness

BARYTA CARB- Enlargement of the prostrate in old people

CADMIUM PHOS- Useful in suspected carcinoma of the prostrate gland.

CANTHARIS- One of the best medicine for prostate enlargement with burning urination. Burning pain and an intolerable, constant urge to urinate while only losing a few drops of urine. All pains are sore, raw, burning, cutting, biting and smarting. Intense sexual desire arises from the inflamed pelvic region. The urge to urinate is intolerable and constant; before, during and after the painful urination. Only a few bloody drops will pass at a time and the pain in the urethra and bladder are intense burning, cutting and itching. Symptoms get worse by drinking of water or coffee, urination, glittering objects, the sound of water. The person feels better by warmth, rubbing and massage.

CANNABIS INDICA- Sensation in anal region as if sitting on a ball.

CHIMAPHILA- Tenesmus. Frequent urination. Sensation as of sitting on a small ball. Straining and pain in bladder is due to enlarged prostate glands and pain in the bladder is relieved by urination.

CISTUS CANADENSIS- Cancer of the prostrate gland

CONIUM MACULATUM- Discharge of prostratic fluid on every motion with itching of prepuce and enlargement. Urine starts and stops again and again

CROTALUS HOR.- Cancer with bleeding of the prostrate gland

ERYNGIUM- 3-5 drops in acute cystitis with dysuria, difficult and frequent urination, burning pain with tenesmus in bladder or urethra during urination. Frequent desire to urinate, urine scanty passes in drops, after every few minutes- during irritable bladder or due to enlarged prostate glands, Renal colic, with pain in back, running down ureters and thighs- legs.

EUPATORIUM PURPUREUM- Dull pain in kidneys, burning in bladder and in urethra during urination, bladder feels full with desire to urinate, urine sometimes milky and scanty - often indicated in dysuria, enlarged prostate, renal dropsy, copious urine, bladder irritation.

FERRUM PICRICUM- One of the best medicine for senile prostatic hypertrophy or enlarged prostate in old men. Good medicine to complete the action of other medicines (Boericke). Frequent micturition at night. Full feeling and pressure in rectum. Retention of Urine. Smarting at neck of bladder.

HOANG NAN- Cancer of the prostrate gland. Start with 5 drops thrice daily and gradually increase to 20 drops

HYDRANGEA- Enlargement of the prostrate without any complication. 2 doses of 5-10 drops, morning and evening every day. Very difficult urination. It also works well in 200 and 1000 potency. Urine may be retained , specially in men over 50 years of age. Enlargement of prostate. Remedy for stones, profuse deposits of white amorphous salts in urine. Burning in urethra and frequent desire. Urine hard to start. Sharp pains in loins.Enlarged prostate with great thirst

IODIUM- Inflammation of prostate in scrofulous and tubercular persons

LYCOPODIUM CLAVATUM- Backache before urination, which goes afterwards. Urine is slow to come and the patient strains to pass it. In 1000 potency it is useful in curing prostrate cancer

MERC IODIDE- In cases where suppuration of prostate has occured

PARIERA BRAVA- Retention  of urine due to prostrate enlargement. 5 drops in lukewarm water, after every 30 minutes till relief in acute cystitis with distention of bladder, pain extending down thighs, constant urging and great straining to urinate with pain in the urethra and glans penis, can pass urine when he goes on knee and pressing his head against the wall with dribbling of urine and perspiration breaks cut. This is due to the inflammation of the bladder or due to enlarged prostate gland, bloody turbid, muco-pus filled urine due to stone in the bladdersometimes, there is red sand present in the urine.

PITUITRINUM- Prostatitis, chronic nephritis and high blood pressure, difficult concentration and confusion are removed by the use of this remedy

PHOSPHORIC ACID- Prostrate fluid passes even when passing a soft stool.

PULSATILLA-Continued dull stitches in neck of bladder, with a pressure of urine, while lying upon his back; after micturition spasmodic pains in neck of bladder, extending to pelvis and thighs; prostatic troubles of elderly people, faeces flat, small in size. 

SABAL SERRULATA- Burning in the urethra while passing urine and difficulty in passing urine. Recent or chronic enlargement of the gland. Sensation of coldness from the prostrate gland to genitals. Constant desire to urinate < night. Enuresis. Paresis of sphincter vesicae. Dysuria. Cystitis. Acts on membrano-prostatic part of urethra.

SELENIUM MET.- Discharge of prostratic fluid during stool. Prostratitis in elderly men.Dribbling of prostratic fluid during sleep

SOLIDAGO: Pain in region of Kidneys, with dysuria. Kidneys sensitive to pressure. Difficult and scanty urine. Makes the use of catheter unnecessary. Associated with calculus. Kidney and urinary symptoms are more marked. Used when cystitis and kidney affections are present with BPH. Reddish brown urine with thick sediments. Pain in kidneys , extending to abdomen and bladder. Clear and offensive urine. Very helpful in case of retention, makes the use of the catheter unnecessary at times.

SPONGIA- Suitable when there is small stream of urine which is frothy and swelling of testes and spermatic cord

STAPHYSAGRIA- Enlargement with frequent urge to pass urine. Sensation as if a few drops remained

TUJA OCCIDENTALIS- Prostratic discharge ic thick and green. Inflammation of the gland. Acts on genito urinary tract producing sycotic dyscrasia.. Sycotic pains: pain muscles and joints. Hydrogenoid constitution. Rapid emaciation and exhaustion. Fixed ideas: as if a strange person is at his side, as if soul and body were separated, as if something alive were in abdomen. Enlarged prostate. History of gonorrhea. Inflammation of glans and prepuce. Gonorrheal rheumatism. Swelling of urethra with split stream. Sensation of tickling in urethra after urinating. Desire sudden and urgent, can not be controlled.Frequent desire to urinate. Pain lower abdomen.

TRIBULUS TER.- Prostatitis. 15 drops thrice daily corrects prostratitis and ill effects of masturbation

TURNERA ( DAMIANA )- It cures prostratic discharge, which is chronic and accompanied with sexual debility