A Relief at Last for Dysphagia Torture (Achalasia Cardia - 2009)
When this 37-year-old man walked into my clinic with measured steps, I could sense the general weakness in his body, and rightly so. He had great difficulty in swallowing and used to vomit after having food. He was working at Kuravilangad in Kottayam district of Kerala. He used to travel almost 16 kms daily by motorcycle to reach his place of work. One day on his way home from office his motorbike hit an old woman who was trying to cross the road. He was terribly upset when he later came to know that the woman had passed away in the hospital. A few days later he developed difficulty in swallowing, and later started vomiting. The food was getting stuck in his mid-chest while eating. Gradually he was unable to swallow solids. He had to twist and turn his body to push the food down. He could drink liquids only in drops, that too with great difficulty.
He consulted several doctors. Finally, he was referred to Lakeshore Hospital, one of the leading hospitals in Kochi, with expert doctors and advanced medical facilities. They carried out various investigations (Copy of the investigation reports and discharge summary attached). An endoscopy revealed simultaneous oesophageal body contractions and poor lower oesophageal sphincter relaxation. The doctors diagnosed his condition as ACHALASIA CARDIA and performed endoscopic balloon dilatation twice, which gave him temporary relief. But after a few days, the symptoms resurfaced. When the symptoms recurred a third time, the doctors advised him not to repeat balloon dilatation as they felt it could rupture his oesophageal blood vessels. The patient and his family were utterly disappointed and worried. His wife was apprehensive about her husband's health and started crying when she narrated the history. I consoled her that God willing her husband will get relief under this great system.
The patient informed me that he had cold, feverishness, chilliness and throat pain for the past 2-3 days, after getting drenched in rain. I decided to treat his acute complaints first. I gave him Rhus tox 200 on 09-05-2009.
After a week when he came, he had relief from fever and cold. Amazingly, his difficulty in swallowing was also slightly better. I smiled to myself. I referred Rhus tox in Hering's Guiding Symptoms before I made my next prescription. I found in Hering's, to my delight, the following entry on Rhus tox: “Pain in back, in a spot corresponding with about centre of oesophagus, while eating and drinking, when the food reaches this spot it refuses to go further, so that she can take only fluids; seeks to force food past affected spot by twisting body about or assuming some favourable position, after which she is relieved” - Hering's Guiding Symptoms of our Materia Medica, volume 9, B. Jain Publishers(1971), pg no. 64. I was happy to learn that such a symptom was present for Rhustox.
The improvement continued and the patient was put on placebo. Higher potencies of Rhus tox were given till 50M, whenever the
improvement came to a plateau. Natrum mur & Phosphorus were also given during the five years of treatment, as and when indicated by the symptoms.
When he developed a hammering headache, Natrum mur was given, taking into account the fact that his entire problems developed following the emotional trauma caused by the death of that old lady.
Phosphorus was given as a constitutional medicine. As Phosphorus enhanced the action of Rhus tox and gave immense relief, I continued giving it from 200 to 50M potency over a period of one year from mid 2010 to mid 2011.
Each dose of medicine was given in powder form with one medicated poppy seed sized globule in it. He is now completely relieved of all his distressing symptoms.
Discussion
The engineer visited me to get a cure for an acute fever. During the case taking process, he also explained a chronic ailment he was suffering from, that had shattered his family. While treating the acute problem at hand, I happened to notice his chronic condition getting better as well. It encouraged me to go back to my books. What I assumed was clearly given in Herring's Guiding Symptoms. It is always advisable to refer books and reassure yourself, however experienced a doctor you are. Minute, yet useful clues can surface with every reading. Dr. Hahnemann says in Organon of Medicine that when a perfect similimum is given for
any specific ailment, it will automatically cure other problems too, if any, coming within its sphere. Rhus tox given for fever after getting drenched was, incidentally, therapeutic to his chronic ailment as well. The observation after administering Rhus tox during the course of treatment of this patient was correct. That was why I could move forward on the right path.
Though Rhus tox gave considerable relief, the constitutional medicine Phosphorus achieved the permanent restoration of his health. In Kent's Repertory, Chapter Throat, under the rubric “Swallowing difficult-impossible-constriction of oesophagus- cardiac opening”, there is only one medicine given, that too with 3 marks and that is PHOSPHORUS.
