Two Cases of Renal Disorder
NATIONAL JOURNAL OF HOMOEOPATHY 1994 May / Jun Vol III No 3.
Kasim Chimthanawala.
Cases.
` Rhus-t / Apis / Berb-v.

Case 1:

A young male was admitted with acute retention of urine along with restlessness due to stretching pain in the bladder region. On examination his look was anxious, fearful and wanting, the lips dry. He was conscious and answered relevantly. He was febrile with BP 140/90. There was no past history of a similar attack.

He was catheterized and 650ml of dark brown urine was removed, after which the patient become comfortable and slept well. At about 6 in the morning, he had a similar attack of acute retention of urine.

A detailed physical examination revealed vesicular eruptions on the back region (left side only). It was Herpes Zoster an atypical site indeed.

Taking the clue of this unusual association of vesicular eruptions and retention of urine with restlessness, Rhus tox 0/3 was administered at 10 minutes interval.

No change was seen. So 0/6 was given. By 7 or so, he passed 450 ml of urine (immediately after the third dose touched his tongue).

Comments- An atypical association of Herpetic eruption along with urinary retention is not to be found in commonly used repertories. Hence if this information is verified and if found worthy, may be introduced in our Materia Medica as a clinical symptom.

CASE 2:

A 43 year old male presented with generalised anasarca along with scanty urine (about 120ml/24 hrs) on 21-4-93.

He complained of recurrent attacks of UTI with puffiness of face and Oedema of legs since 1978, for which sympathetic treatment was given.

On 29-5-89, he was admitted in a private nursing home in a serious condition due to UTI.

Investigations revealed-

1. Urine Routine showed Albumin ++++, Pus cells- 25-30/HPF, Epithelial cells- 4-6/HPF with Hyaline casts.
2. Blood Urea- 76mg percent
3. Serum Sodium- 133 Serum Potassium- 46
4. ESR- 86 mm

He was treated with Antibiotics, Diuretics and massive doses of Steroids. On the 3rd day, he got faint erythematous eruptions all over the body. A Dermatologist diagnosed it Eczematoid Dermatitis on both the feet, legs and back of hands. Steroid application relieved the skin disorder.

When he was discharged (14-6-89) his Renal Functions were the except the Blood Urea which remained high (52mg percent).

On 20-7-90, he was re-admitted with the same complaints. However this time the blood area was 123mg percent and the patient was in a comatose condition. Once again the same treatment was administered but there was no substantial response even after 24 hours, So massive doses of steroids were administered parenterally which worked. On discharge his condition was better with Betnesol 30 mg / day (maintenance dose).

He was referred to Christian Medical College and Hospital, Vellore for renal transplant at the earliest. His poor economical condition prevented him from doing so.

Subsequently, he was brought to me as a last resort. I admitted him for close monitoring of his mental state, input / output charting. BP levels and routine investigations. Gradual tapering of allopathic drugs was done.

Homoeopathic Treatment and Follow-up:

Apis 0/3- 0/12 TDS and Berberis- vul Q 10 drops TDS were given.

17 days later he suddenly became serious, but survived with the help of peritoneal Dialysis and Apis and Berberis continued.

No peculiar symptoms or signs which could help in selecting a suitable remedy were known. So he was then reinterrogated by the RMO.

A detailed history revealed that when he was 22, he suffered from Syphilis, for which prolonged courses of Procaine Penicillin in massive doses (12 lacs) were taken. It was about a year after this that the urinary complaints had started.

On the basis of this vital information, Penicillin 6x (no other potency is available) in fractional doses was administered for two days. The drug could unlock the entire constitutional error. On the third day, he started feeling revitalised. His urine output increased to 650 ml and started feeling hungry (for the first time in 20months). Urine albumin++ with occasional Epithelial cells. He was also given Eels serum as a renal tonic.

He was discharged Eels Serum 200, 3 doses in one day followed by Berberis-vul Qwith Penicillin 6x SOS.

It is now more than a year that he is normal and has the renal profile within normal limits except that blood Urea is 47 mg percent and the urine still shows occasional epithelial cells.

Comments:

Particularly in an emergency when the symptom picture is not clear or is confusing, one must try to extract the causation / causative modality, (which is usually present but not reported due to the intensity of the manifestations).

In this case Penicillin was given for bad effects of Penicillin and Eels serum as a Renal Tonic (589 Boericke MM). If symptoms relapse, drugs like Syphillinum or Nat-mur may be thought of.