The effects of Homoeopathic Medicines in Renal Stones

painDr Apurva Gagroo
This research was done under the valuable guidance of Dr Priyanka Monga (MD),Reader,SGNDHMC,Ludhiana.

Renal Stone is a stone like body composed of urinary salts bound together by a colloid matrix of organic materials. It consists of a nucleus around which concentric layers of urinary salts are deposited. The condition of having renal stones is termed Nephrolithiasis. Renal Stone or calculus or lithiasis is one of the common diseases of the urinary tract. It occurs more frequently in men than in women and in whites than in blacks. The existence of renal stones has been recorded since the beginning of civilization and lithotomy for removal of stones is one of the earliest known surgical procedures. In 1901, a stone was discovered in the pelvis of ancient Egyptian mummy and was dated of 4800 BC. Stone formation is also documented in the early Sanskrit documents during 3000 and 2000 B.C.

The Famous personalities who suffered from renal stones were Sir Isaac Newton, Emperor Napoleon bonaparta, Benjamin Franklin and philosopher Francis Bacon.It shows a familial predisposition.

Renal stones are biquitous and is prevalent in relatively young and productive age group. It carries significant morbidity and imposes tremendous financial burden on healthcare system. With changing lifestyles and climate, its prevalence has shown a rise over decades, e.g., 37% rise in USA from 1976 to 1994.

The lifetime risk of renal stones is about 10–15% in the developed world, but can be as high as 20–25% in the Middle East. It is affecting 4-8% in UK, 15% in US, 20% in gulf countries and 11% population in India with a relapse rate of 50% in 5–10 years and 75% in 20 years. The incidence of  renal stones varies in different countries depending on environmental conditions of the geographical area. In India, incidence of renal stones is high in northern states compared to that of southern states. Renal stones are more frequently seen in warmer climate and during summer. This may be due to dehydration and increased concentration of urine, which is one of the causes of stone formation  may require surgical intervention.

India, Pakistan and Southern China comprise an important part of the stone belt in Asia. Jammu and Kashmir, Punjab, Haryana, Delhi, Rajasthan, Madhya Pradesh and Gujarat are the states which form the stone belt of India.

Up to 98% of urinary tract stones with size less than 5 mm in diameter, especially in the distal ureter, pass spontaneously. Stones of size 5–7 mm have a modest chance (50%) of passage, and those greater than 7 mm almost always require surgical intervention.

The major types of stones are calcium oxalate stones [80% of cases], followed by Calcium Phosphates stones and struvite stones [Magnesium, Ammonium and phosphate], uric acid stones [ 5-10%] and cystine stones.

According to homoeopathy incidence of stones is seen in few individuals who have predisposition to the thing.To be predisposed to a thing is to have a weakness in that direction beforehand, or in other words, we have within us a sort of attribute [perverted, of course] or weakness that predisposes us to certain diseases or conditions of life.

In Homoeopathy, we don’t treat the disease but the diseased man as a whole. It is a holistic system of medicine in which we treat the patient as a whole taking into account the role of Body, Mind and Spirit and not just the disease.

“The good physician treats the disease; the great physician treats the patient who has the disease.”Sir William Osler

Homoeopathy believes in concept of vital force, which when get deranged through disharmonious living and thinking, manifestation of symptoms takes place. The patient is treated by taking into consideration his constitution, mental makeup, his desires and aversions, his reaction to environment, his past and family history of any chronic diseases. Above all, homoeopathic medicines are given in dynamic form in ultra-diluted doses, which do not cause any side effects. This type of treatment Boost the immunity of the patient and helps in maintaining the harmony of vital force and to get rid of the diseased condition.

Homoeopathic literature provides a good scope for treating cases of nephrolithiasis but due to poor documentation of case reports and studies, the role of homoeopathic therapy and its cost effectiveness remain a subject of discussion in the minds of research personnel.

There have been many research work done on understanding of occurrence, types and prevention of  renal stones in modern medicine till date. But in homoeopathy there are very few authoritative research work done on nephrolithiasis.

Now a days homoeopathy is playing a crucial role in management of renal stones and thus helping in treating the problem without surgery and also in avoiding recurrence of disease. Even in some unavoidable surgical cases of   renal calculi, homoeopathic treatment after surgery can prevent further recurrence.

Renal stones is the third most common disease of urinary tract after urinary tract infection and BPH and it affects all ages and sexes. It has low mortality but High morbidity.

This study was confined to a population (males and females) of the age group from childhood to old ages from Ludhiana  suffering from symptoms of  renal stones. Uni-centric open clinical trial adopted for the evaluation of the positive effect of the homoeopathic medicines in renal stones. The patients were collected from OPD and IPD of Sri Guru Nanak Dev Homoeopathic Medical College and Hospital.At first, a full case taking was done according to the Case Taking Performa. Then, Miasmatic analysis was done after the diagnosis of the case. Later, medicine was selected on the basis of totality of symptoms after doing Repertorisation. Potency, dose was decided following homoeopathic principles strictly after which selected medicine has been verified in the context of Materia Medica after doing Repertorisation. The patients were prescribed medicines and doses according to requirement in each individual case, thus doses and repetition of medicines were different in each particular case ,along with that each patient was advised certain general management at each visit. On reporting, the cases were followed up properly and results assessed. Patients were also advised to report in any case of acute exacerbation via phone or personally.

For clinical evaluation, the efficacy is assessed by using UROLOGICAL SYMPTOM SCORE criteria for scoring according to the clinical symptoms shown by the patient as well as objective evidence of Stone on USG.

Among the patients selected for the study, maximum no. of patients belongs to the group between 30 to 45 yrs of age covering 66 % while 12patients (24%) were in the group between 15-30 yrs. 3 patients (6%) were in the category of 45-60 years and 2 patientsthat is 4% were in category of 1 to 15 years of age group. Lowest frequency was seen in the group of patients above 60 years of age (0%).

When duration of illness was analysed 37 patients (74 %) had duration of illness ≤ 1 year ,11 patients(22%) had between 1-2 yrs . 1 patient (2%) each had duration of illness for other 2 categories of duration.

On the other hand symptomatology of Renal stones in 50 patients more than 70% patients complained of pain in loin region may be dull or sometimes severe 25 patients(50%) presented with colicky pain.About 56% patients showed the referral of pain to abdomen,thighs or genitals. 20% patients suffered from frequent micturition  as well as 48 % with tenderness in renal region. There were 24 % cases where patient showed blood in urine whether microscopic or gross. About 24% patients presented with episodes of nausea and vomiting  during attack of colic or due to dull loin pain.26 patients(52%) had painful urination.

After the miasmatic analysis of 50 cases, Psoro-sycotic expression was well marked and found to be dominating in 27 cases (54%). Psoric expression was seen in 17 cases (34%). In 3 cases (6%) a psoro-syphilitic miasmatic presentation was seen while mixed miasm was noticed in 3 cases (6%).

Among the 50 patients, Lycopodium was prescribed to maximum no. of 26 patients (52%).Nux Vomica prescribed to 4 patients (8%). Calc Carb and Medorrhinum  were given to 3patients(6%)each.Natrummur.,Pulsatilla,Sepia,Sulphur  and thuja were prescribed to 2 patients (4 %) each. Argentum nitricum and Belladonna was also prescribed to one patient that is to 3.33% of patients

The study showed the predominance of lycopdium but only in 33.33% of patients.Many medicines like thuja and medorrhinum were chiefly antisycotic ,which also tallys with the miasmatic dominace of sycotic miasm in Urolithiasis

.Prescription of 8 different remedies of polychrest group for the 50 patients under study showed the Individualization principle of Homoeopathy.  .

Out of the 50 cases, 22 cases showed complete improvement in USS score.   2 cases showed increase in the USS score even after the proper treatment.

Out of  patients 4 in severe category, 22 patients were completely improved while remaining  patients enter into moderate category.

Before the treatment on their first visit 11 patients.(22%) were in severe category and 39 patients(78%) were in moderate category. After treatment, 15 patients (30%) were in moderate category and 12 patients (24%) were in mild category. In the remaining 23 patients [46%], stone were expelled and that’s why the effect of the cause that is the clinical symptoms were also removed and patients were relieved.

Patients included in this study were advised USG KUB region in order to find any change in the size of Stone or any complication like hydronephrosis due to blocking of urinary tract by stone.

Also during the treatment of patients whenever any patient got an acute exacerbation and reported to hospital, they were prescribed acute/specific medicines on the basis of totality at that moment.

After this study of 1 year, it can be claimed that Homoeopathy is safe, simple, less expensive and more effective in treating renal stones cases. Unnecessary surgery and complications can be avoided.

Homoeopathy plays a significant role in improving the symptomatology of renal stones patients as well as its helpful in expulsion/dissolution of stones in urinary tract.

This interventional study on the cases of renal stones was undertaken to know the incidence, miasmatic background and various approaches that can be adapted in the treatment.

Among the medicines selected, Lycopodium was the most frequently prescribed and found effective, followed by other medicines like Calc carb, Thuja, Nux vom,Medorrhinum  etc. As seen in the literature the miasmatic analysis of the symptoms of Urolithiasis showed predominance of psoro-sycotic miasm, same thing was observed in the miasmatic analysis of the cases under this study.As far as potency is concerned no specific potency came as marked one as all the cases were prescribed individually on the basis of general symptoms as well as particular one .

Statistically also, the USS Score before and after treatment showed statistically significant result.

But there arises some question in minds of many people such as whether homoeopathic medicines dissolve or break the stone .Also whether homoeopathic medicines acts physiologically on urinary tract and aids in passing of stone outside. To avoid such questions we can give the logic that in footnote of aphorism 1 of Organon of medicine ,Hahnemann warns us to make any theoretical assumption.

Although this study has showed marked improvement in the cases of renal stones, however, such study with randomized control trial is needed to further validate the usefulness of the homoeopathic medicines especially in cases of large stones which as per modern medicine can’t be expelled or dissolved. This study would have been still better if the blinding technique would have been included.

Dr Apurva Gagroo
BHMS(NHMC,DU)
PG Diploma In Cardiac Rehabilitation(APOLLO)
MD (SGNDHMC,LDH)

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