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Case 53: Dysuria only in night
Dr S C Mishra
'Cauticum / Sepia

A Bengali lady aged 69, slim, fair, mother of two; had sustained an injury to her back bone on 12th May 2004 which resulted in minor compression of L 1 vertebra, was treated by an orthopedic in a renowned Hospital in Jabalpur. She was advised complete bed rest for one month and was put on pain-killers. Inspite of best possible treatment, her pain did not subside and MRI revealed a possibility of POT'S spine.

She consulted some other orthopaedic who suspected spinal infection, but Elisa test was inconclusive. She had been given treatment for TB which continued from September 04 to December 04. Having no considerable relief of pain she consulted another orthopedic who ruled out the possibility of TB, at this age advised spinal surgery, by implanting rod to the spine to do away with the possibility of paralysis of the lower extremities in near future.

The spine was operated on 10th Dec 04 and she was advised to be taken to Mumbai as, during the operation, he had noticed a tumor on the other side of the spine.

The Mumbai doctors did not find any such tumor and she was advised to start treatment for osteoporosis with regular sunbathing, physiotherapy etc. All these measures did help for sometime but again the pain became acute. She was now taken to her surgeon, who advised removal of the rod as the spine was heavily infected. The removal was done on 14th Feb. 2006. The patient was paralyzed and bed-ridden. Later, she started walking with difficulty with a walker. She developed an abscess in her back, which was operated on 27th July 2006.

On 20th October she had a heart attack in the morning while taking treatment for back pain in a hospital.

Now her husband wanted to consult me [20/01/07] for her Dysuria which she had only in the night. She has to exercise a lot by straining continuously in standing position. Her husband keeps on pouring water on her feet for some time, applies water to her bladder region, puts on fan over her head with the hope that perhaps it may help her to pass urine freely. To some extent this type of nursing did help her for few minutes.

I went to see her. She was lying on bed. She started weeping narrating her life situation; how she had brought up her one son and one daughter. Daughter is married. Her daughter -in-law is very indifferent. She does not get proper care and response from her son also. She had done a lot for her son, Being a graduate in arts, she had taken lot of pain to teach herself mathematics and science in order to teach her son when he was in school. Now he is well-established and an engineer in railways.

He informed me that the patient was given Causticum 200 sporadically for a period of one year, as advised by a lay homeopath.

I thought to antidote Causticum 200 and prescribed the same medicine in 1M potency. But before this prescription, I had advised her husband to give her black coffee for 2 to 3 days, which did not show any result. She was given Causticum 1M but it did not help.

9/01/07: Based on her syc-syphilitic state and mental dejection, sadness, frustration for not having any compensation towards her dutifulness, I prescribed Aur-met 200 1 dose in one ounce of water to be given 5 jerks each time before use, twice a day for 7 days. 14/02/07: No change. Still ineffectual urge for urination. Better in day time but appears at night only.

I took the help of the following Rubrics
Bladder, urging ineffectual; night [Syn 839]
Bladder, urination, retarded, must wait for urine to start [Syn 845]
Forsaken feeling [Syn 120]

Sepia is seen to cover all the above rubrics. I prescribed Sepia 6 TDS for seven days. After 7 days her husband reported that her urination is quite free and no trouble at night as before, though her paralysis is still untouched. Medication is stopped.

Observation: As usual I review the medicine after it finishes cure and found that all the symptoms were present in the patient except that of "wetting feet<" which is one of the cardinal symptoms of Sepia. In this case the patient is immensely relieved of her Dysuria with Sepia. We know that every medicine has two faces. If the medicine is capable of creating diarrhoea, it can create constipation too. Besides that Sepia is full of paradoxical symptoms like Ignatia.

Theme of the case: What has Sepia done in the bladder symptom? Has it neutralized the overdosing effect of Causticum or can a new rubric be added as "wetting feet<" which is not found in the repertories. Readers are requested to verify this symptom and report from their valuable experience.