Jaundice: Its Homoeopathic Management

NATIONAL JOURNAL OF HOMOEOPATHY 2001 May / Jun VOL III NO 3.
Dr Jyotsna Shivaprasad
'Mag-c / Chel

Disorders of the hepatobiliary system even though symptomatically similar, vary in their pathogenesis. The clinician must have a thorough understanding of the physiological processes, to identify these changes. Majority of cases present with the common symptom Jaundice, but the causes vary.

Jaundice refers to yellowish discolouration of the skin and mucous membranes due to Serum Bilirubin exceeding 1.2mg/dl.

4 types of jaundice are commonly seen:

·         Haemolytic Jaundice

·         Hepatocellular Jaundice.

·         Cholestatic or Obstructive jaundice

·         Congenital Non-haemolytic Hyperbilirubinanemia.

Haemolytic Jaundice
Results from increased destruction of red blood cells. Anemia is usually mild. So patient may present with pallor due to Anemia and splenomegaly due to excessive reticuloendothelial activity. Other symptoms like icterus, nausea, vomiting, dark yellow urine etc may be gathered from the patient.

Investigations show Anemia and reticulocytosis. Liver function tests (LFT) other than raised serum bilirubin, may be normal.

Hepatocellular Jaundice
This results from inability of the liver to transport bilirubin into the bile as a result of liver damage. Here, the concentration in the blood of both conjugated and unconjugated bilirubin increases. Jaundice usually ranges from mild to severe and the clinical features may depend on the underlying diseases.

Investigation show raised levels of both conjugated and unconjugated bilirubin in LFT.

Cholestatic Jaundice
Cholestatic Jaundice results due to obstruction of the flow and its cause may be anywhere between the hepatocyte and the duodenum. Jaundice is prolonged and severe with pale or clay colored stools, steatorrhoea and dark urine. Some patients also present with anorexia, generalized pruritus or a metallic taste in the mouth. Upper abdominal pain may be present with fever, with other manifestations of the underlying disease.

Investigations: Liver Function test: Altered.

Congenital Non-Haemolytic Hyperbilirubinanemia
This results due to the disturbance in the bilirubin transport conjugation or excretion of bilirubin. Presents in children or in early adulthood as Gilbert's syndrome, Criggler-Najjar syndrome, Dubin Johnson's syndrome and Rotor's syndrome.

Investigations (LFT): Altered.

Finally, I discuss below one case of jaundice, treated with homoeopathic medicines.

Case:
Mr S K, 25 yrs, reported on 27-04-98 with complaints of:

Recurrent Jaundice since 2-3 years; 3 attacks; marked nausea since 2 days, water brash, vomiting. Pain in the upper abdomen with bitter taste in the mouth, flatulence and loose stools.

All complaints were aggravated in the night after food (1-2 hrs later), more in early morning, especially while brushing the teeth. Eyes were yellow.

Accompanying Symptoms:
Feverish feeling with weakness and low back pain. Increased appetite, increased perspiration with marked weight loss. There was no itching.

Past History - 3 attacks of Jaundice in 2 years treated with Ayurvedic Treatment. No other significant history in the past and family.

Patient as a Person
Appetite- was good but decreased since 2 months.
Cravings- for Icecream3 and also sweets2 and cold food
Aversion - Non-veg+.
Thirst - increased since 2 months.
Bowels - regular except for present loose stools.
Urine - normal.
Thermal - chilly.
Mental Sphere: basically he had lack of love since childhood and therefore had no support in life.
He was irritable, used to get angry and react but never suppressed his feelings. Anticipatory anxiety was present, especially in crowds, leading to palpitation and sweating. Likes company. Sleep disturbed by thoughts but no dreams.

General Physical Examination: Appearance-lean, Wt 48 kgs with pallor and jaundice. BP - 110/70 mm of Hg; P - 64 /min.

Systemic Examination
Abdomen - no tenderness or organomegaly.
Other symptoms - Nothing abnormal was detected. With these few symptoms, I suspected it to be a case of Liver disease.
Then, the question arose as to what could be the cause of recurrent, Hepatocellular or Cholestatic in origin.
According to the onset of the illness, duration and clinical history in this patient, my probable diagnosis was chronic hepatitis. So, I sent the patient for investigations, which were as follows:

Blood Report done on 24.04.1998

Differential: Neutrophils - 53 %; Lymphocytes - 35%; Monocytes - 1%; Eosinophils - 11%

Final diagnosis: Haemolytic Anaemia.

Next, to treat this case, I erected an Acute totality.
Pain abdomen - Upper abdomen, Nausea, Vomiting -Bilious, Bitter taste in the mounth; Increased after food (1-2 hrs. later); Weakness
Rx: Chelidonium -30 x 3 pills QID with Placebo x 2 days.

Criteria for Follow Up:

1. Appetite - A
2. Water brash - W
3. Nausea - N
4. Vomiting - V
5. Taste - T
6. Pain abdomen - P
7. Jaundice - J

I^st follow up 29-04-98
Symptom abbreviations as follows:
S = Same/O = zero/x>3/+present,

Tired feeling3, Backache +, Sleepy, Drowsiness.
O/E - Wt - 48 Kg, Jaundice ++, Temperature - N.
Now, the chronic Constitutional totality was put up:

Mind
A/F lack of Love Irritability - Never suppresses Anxiety - Anticipatory - In crowd. Likes company

Physicals
Lean C³ H²
Cr - Sweets², cold food²
Perspiration - Increased on the head.

Characteristic Particulars
Pain Abdomen - Upper Abdomen < after food < HSv Bitter taste in the mouth
Flatulence - upper abdomen
Constitutional Remedy: Magnesia-carbonica.
Patient had a comfortable period between the attacks.
In due course the attacks stopped.
This Case of Haemolytic Anemia was dealt in a holistic way and as per Homoeopathic principles and it showed marked improvement with the chosen constitutional remedy. Patient improved in his general health along with the disease symptoms.