Case Of Pamphigus Vulgaris
NATIONAL JOURNAL OF HOMOEOPATHY 2003 Jan / Feb VOL V NO 1.
Dr Ardeshir T Jagose
'Merc

A 42 year old male, diagnosed as Pamphigus Vulgaris came for consultation in1999.

Chief Complaint
Ulcerations all over the body since 1998. The patient was apparently alright till Dec 1998, when he developed pain in the wisdom tooth for which he took allopathic treatment with little relief. Since then, developed ulcers on the mouth, tongue, nose and limbs, accompanied with severe burning pains with sensation as if fire was coming out from these sites.It first starts as a vesicle, which bursts out a yellowish-whitish-reddish discharge with the formation of ulcers. Patient also has profuse salivation throughout the day, more pronounced at bed time. < eating spicy food, night⁺³, taking sulfa, asprin and chloroquin drugs and > by drinking cold water⁺² and by inhaling cold air.
The patient consulted a dermatologist who diagnosed it as "Pamphigus vulgaris". He is presently on Tab immuran (50mg) i b d, Tab prednisolone (40mg) 1 o.d., Tab dapsone (50mg) i o d, Tab Zevit 1 o d., Tab Shelcal (250mg) 1 o d, Tab alfa D-3 i b d, Tab Trika (2.5mg) 1 h s and Tab folvite 1 b d

The patient opted for homoeopathic treatment as he was put on a high dosage of steroids/immuno-suppressive drugs which had an adverse effect on him viz increase in weight, moon face, premature cataract in both eyes.

Past History: Hypertension since 1994. Tab Aten (25mg) I o d scabies in childhood, admission to hospital 2 times for this complaint and allergy to asprin, sulfa and chloroquin drugs.
Family History: 2 sisters and mother have hypertension. Father expired due to pulmonary TB. Uncle had IHD.

Personal History
Appetite: reduced due to ulcers in mouth.
Thirst: increased, for cold water. Micturition: Passes urine 6-7 times/day, occasional burning during micturation. Bowels: normal. Cravings: sweets⁺³, spicy⁺³, mutton⁺³ and salty things, prefers his food hot.

Digestion: good.
Perspiration: profuse offensive perspiration all over the body.
Sleep: salivation⁺³ during sleep, also used to startle in sleep.⁺³
Dreams: frightful: of dead people.⁺³
Thermals: Chilly ².
Mental state: Suppressed emotions⁺³.Expresses his anger⁺³.Weeps when alone. Likes company³ Bold. Likes consolation especially when worried, when he becomes sad depressed with loathing life⁺³.
Very fastidious and religious by nature.

General examination: Vital parameters normal with a slight increase in diastolic pressure. Ulcers noticed in mouth, on tip of nose and on the lower extrimities with offensive discharge. Tongue moist, indurated with imprint of teeth.There were signs of glossitis also.

Local examination: Ulcers were seen on the inside of mouth, tip of nose and lower extremities -a well defined edge with an indurated base with adherent Offensive yellow colour discharge.

Systemic Examation was essentially normal.

Investigation Reports: Oral lesion Biopsy showed features of pamphigus vulgaris in Dec1998. Hb - 10gm% .

The Non-Repertorial approach was taken into consideration and Merc-sol was the indicated remedy of choice based on the following totality of symptoms: reduced.

·         Loathing life⁺³

·         Suppressed emotions⁺³

·         Better by consolation

·         Dreams of dead people

·         Craving for sweets⁺³,

·         mutton⁺³, spicy⁺³ and salty things

·         Perspiration offensive all over body

·         Salivation⁺³ in sleep and startles⁺³ in sleep

·         Chilly patient

·         Ulcers with offensive discharge < night⁺³

The progress report of the patient was tabulated as given below:

The auxillary mode of treatment was also given due importance viz:

·         Avoidance of sulfa, asprin and lariago drugs in future (this was a general precaution because of history of allergy and not for Pemphigus).

·         Proper hygiene to be maintained.

·         Daily cleaning and dressing of ulcers with hydrogen peroxide and calendula mother tincture.

·         Avoidance of anything sour in the diet which may precipitate suppuration and of spicy food which may aggravate the condition.

CONCLUSION
In this case the indicated remedy was repeated frequently as the speed and depth of the case was of great intensity with a strong syphilitic base which had to be combated with the help of the deep acting indicated remedy.It had been observsed that the patient was on high dosage of immuno- suppressive drugs which would hamper the action of the homoeopathic remedy hence the repition was justified as evident by the progress report of the patient. Furthermore the symptoms were characteristic enough with a good level of susceptibility (in spite of advance pathology of ulceration.) Hence a favourable result could be obtained in this case paving the way to cure.

(Co-ordinating Editor: The allegation that Allopathic medicines caused Pemphigus is baseless. Author should have checked out that it is an Auto Immune disease. Again any ulcers etc coming after Sulpha, Aspirin etc cannot be labelled with pemphigus.-Dr C H Asrani)