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A Case Of Rheumatoid Arthritis

Miss. Aparna consulted me on 10th May 2010. She had been under the treatment of department of rheumatology Medical College Thiruvanathapuram. Final diagnosis of Rheumatology Department Thiruvananthapuram in this case was SLE with parenchymal renal disease.


Her case was taken in detail and we got the following details. She was born into a poor family as the second daughter of her parents. Her mother was a part time sweeper in animal husbandry department. Her father was absconding when she was born and returned to the family after 10 years i.e. the age of 9 of Aparna. Their life became more troublesome after the arrival of her father. He was a drunkard and was a suspicious husband. His teasing and harassments made Aparna’s child hood very much miserable. As her age advances she started quarreling and even fighting with her father to protect her mother. Survival of her mother, one elder sister and a new born kid aged 6 months was depending upon the courage and fight of Aparna at her 13th year of existence in this world.


Though things are like these, Aparna studied well and reached each examination with high marks. Her menarche was at the age of 13th. And her health problems started then and there. There were repeated episodes of joint pains and brownish discoloration on face during menses. She was not able to look in to her health issues as her mother was too weak to move due to the concussions and contusions in her mind and body that received from her husband. To add fuel to fire Aparna’s father fell ill due to tuberculosis. He was admitted in a T B asylum to protect others from TB. Her father died after one year and mother also left her soon after the death of father. Aparna’s elder sister was taken cared by an orphanage but Aparna didn’t go. She took the responsibility to look after her younger sister but for that she sacrificed her studies for one year. By sharing a small room in her uncle’s house she started studying after one year and has crossed SSLC with a distinction. Meanwhile she got a small job in a press run by the orphanage where her elder sister stays. She manage her plus 2 studies and part time job very well and send her younger sister to LKG then UKG and so on. But unfortunately the disease grows inside her system to make her unable to continue studies or even mange her job in press. Orphanage authorities shifted her to the local hospital and she got relief of pain and swelling of joins that recurred again and again. Finally she was investigated thoroughly at Thaluk hospital and referred to medical college hospital. She was admitted in Medical College Hospital Thiruvananthapuram on 8th November 2008 and was treated by specialists who put her under steroids. She was discharged from MCH from nephrology department with a discharge summary shows SLE, Lupus Nphropathy! (See Lab result –

1). She was doing well with steroids initially and changed her job from press to a tailoring shop. Very painfully she realized that she cannot continue studies because of financial crisis as well as health crisis. She gave up her ambition to become a BSc nurse. In her words it was the most painful reality of her life. But she continued studies even without going college. She took BA in psychology through distant education. She found pleasure in her job and enjoyed it. She herself starts a new tailoring center and was very particular in her job. Though she fell in negative thoughts of her past bitter experience she was active and cheerful while doing her job. She wants to earn money to secure the future of her family. She doesn’t have any friends and she doesn’t want to face them. She kept in home and enjoys tailoring and earns money. But her happiness ends with in a year.

She became fatty due to continue usage of steroids and her kidney damaged and fell in to a worst form of SLE. Her life has been totally changed due to the last episode of SLE. She has been changed both mentally and physically. She lost her confidence and fighting instinct. She transformed from an optimist to a pessimist. She gave up her ambition to make money and to save her sisters from poverty. She doesn’t want to move even and refused to take medicines as it worsens her condition. She was forcefully admitted in Medical College Hospital that further worsened her condition. She was discharged on her request and orphanage authorities who had been taking care of her. Orphanage authorities told her about Homoeopathic treatment. Because of their repeated request she agreed for treatment. She herself narrated her story and was weeping in between. Two to three times she stopped her story because of her tears.

Just after going through the discharge summery our team of doctors examined her. She was anemic; there was yellow coating of tongue and yellow discoloration of sclera.

Heart Rate


Pulse rate


Respiratory rate



Very few questions were asked as she drew her picture very well. She likes sweets and her menses was irregular or absent since steroids started. Perspiration only on face and she was sleepless because of pain.

Her case put on analysis immediately as she was suffering than anything. Primary conclusion and existing miasmatic ratio was as follows.

There was lots of suppression in mental level due to her childhood circumstances and in physical level due to steroids. All suppressions come under sycotic miasm. Now she is in a degenerated state mentally and physically. SLE itself is a degenerating disease so prominent miasm in existing combination is syphilitic.

So she is in need of a Syco-syphilitic remedy.

Her case was repertorised with following rubrics.

MIND - AILMENTS FROM - cares, worries
MIND - AILMENTS FROM - rudeness of others
MIND - CARES, full of - domestic affairs, about
MIND - COMPANY - aversion to - sight of people; avoids the
MIND - DUTY - too much sense of duty
MIND - RESPONSIBILITY - taking responsibility too seriously
GENERALS - FAMILY HISTORY of - tuberculosis
GENERALS - FOOD and DRINKS - sweets - desire
GENERALS - MEDICINE - allopathic - abuse of
GENERALS - PUBERTY - ailments in - girls; in


Fight for survival was the theme of her life so as to Animal remedies. A fighting autoimmune disease further confirms the need of an Animal Remedy.
Whether it is a Snake, Spider, Insect of fish is the next question.
She started her physical complaints just at Menarche.
She was struggling and never takes rest till she fell ill.
She likes sweets
When she fell ill she behaves just like a fish thrown out of water.
So she is in need of a FISH Remedy.
See the Repertory Chart


First Animal remedy in repertorisation was CALC CARB (remember CALC is the shell of an Animal!). But calc never behave like a fish thrown out of water. It can move even without water and it won’t struggle when it thrown out of water. So the nearest Fish SEPIA was selected and was given in 1M potency as and when required. She might have received 6 to 8 doses within a matter of 8 months. She brought back to life with her old vim and vigor. Instead of going back to tailoring she herself started a tailoring Institute and taught poor ladies how to stich and how to make money out of stitching. Painful 5 years in her life made her bold enough to fight for survival again. After withdrawing steroids she became slim like a fish. Sepia made her symptom free and tension free so she was advised for an ANA & Anti Ds DNA on 1st February 2011 and found negative. (See Lab Result 2 & 3) As she is symptom free as well as disease free she is advised to discontinue treatment on2/02/11.

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Comment by Dr. Rajiv Chopra on July 25, 2012 at 1:33pm

In my opinion she responded because Sepia was indicated.

Whether an animal or a plant remedy is indicated cannot be judged by how the patient responds to the situation. By doing this we are limiting our search for the correct remedy. I suppose these our only our imaginations [fish out of water or shell remedy] which we are trying to incorporate with the Materia Medicas.


Comment by Sushanth Chemmanatil on July 21, 2012 at 12:44am

Interesting case... 

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on July 19, 2012 at 11:23pm

So good.... Blessings..

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