Ovarian Cyst: The Constitutional Approach
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Nov / Dec VOL III NO 6.
Dr Roop R Nayak
'Sep
Mrs P 29 yr, Hindu housewife came with following complaints on 15th April 1999.
Past History
Pt was operated for ovarian cyst in 1997. No relevant history of Diabetes Mellitus, Hypertension, Tuberculosis or menstrual irregularities.
Family History
Elder sister- Ovarian cyst.
No F/H of DM, Hypertension, TB
Patient as a Person (Physical Generals) Appetite: Spicy food, pickles.
Aversion: Sweets, butter/ ghee.
Thirst: Good
Perspiration - Increased + +. Non-offensive, non-staining.
Bowel Habits - Regular, twice/day, hard stool
Micturition - Normal. 6-8/day. Menstrual History
FMP 13 y LMP 29.3.99
Irregular cycle, scanty discharge.
Character- Dark red in colour, Clots+++
Complaints- B / D / A.
M D - Pain abdomen, radiating to back.
Headache.
Reactions to Physical Factors
Prefers rainy season. Takes warm water bath.
Uses covering during sleep irrespective of seasons.
C2 H2 - C3 H2
Intellectual and Emotion State
Average perceptive module.
Lachrymose+++Weeps thinking about her complaints. Wept continuously during interview.
Brooding ++ Dwells over disagreeable consequences due to health hazards.
Irritable Gets sensitized fast, but conceals her anger to herself.
Fear++ Being alone+, night++, strangers.
Indolent Towards external affairs.
Reactions
Consolation ameliorates; Likes company.
Sleep and Dream: Sleep - good 10 pm to 6 am.
Dreams unremembered.
Life Space Investigations
Mrs P is from a lower middle class family, having 7 sister and 2 brothers. As a member of a large family, she could not concentrate on her career and could study only up to SSLC.
She got married at 22 years. After marriage she remained a housewife. She could not conceive even after seven years of marriage. She was upset by the taunts by her relatives and neighbours regarding her barrenness and it built up tension in her. She would weep for any trifle provocation.
She stays with her in-laws. Basically she is short tempered but has to suppress her anger. She likes to be consoled only by her loved ones. But most times she is indolent event towards family member and reluctant to get involved in personal matters.
General Physical Examination
Appearance: lean. Weight 35 kgs. Ht- 5 ft.
Face Dull appearance. Pallor +++
B P 120 / 80mm/Hg. Pulse 73 / mm
RR 18 / mm Temp 98.4'F
Cyanosis, Clubbing, Oedema feet, significant Lymphadenopathy-Absent
Systemic Examination
Per abdomen- No tenderness
Mass palpable in the Rt iliac and lumbar region, which is movable side to side. No organomegaly.
CVS & RS-NAD
Investigation: Pelvic Sonography
11.6.97 Well defined oval cystic lesion 6x4cms in left adenexa. Rt adenexa 3x3 cm mass.
20.3.98 - Rt ovarian cyst 6.1 cm x 5 cm x4 cm
Diagnosis
Ovarian cyst Rt.
Asymptomatic presentation
Pain abdomen during menses
Irregular menstrual bleeding occasional.
Recurrent involvement of both ovaries (left cyst got operated in ‘97)
Infertility
O/E- Mass per abdomen - lumbar and Rt iliac region mobile side to side.
On investigation- Pelvic sonography confirmed ovarian cyst.
Totality- CHRONIC CONSTITUTIONAL TOTALITY
Mental generals: Already defined above
Physical Generals: Chilly patient
App- good, vegetarian
Cr- spicy food, pickles
Av- sweets, butter / ghee.
Thirst- good
Perspiration- Increased all over.
Bowel- Regular twice / day hard stool.
Micturation- NAD
Menses- Irregular Scanty clots++
Characteristics Particulars Pain abdomen radiating to back. Weakness and fainting with extreme. Headache during menstrual nisus.
Management
General: Diet - Advised fibrous vegetables and more fruits fluids to combat bowel habits and anaemia.
Specific: Sepia as a constitutional remedy in suitable potency according to susceptibility, remedy response of the case.
Conclusion
Although ovarian follicular cyst is a structural variability at tissue level, a prompt constitutional approach can abort the pathology and prevent succeeding complication. In this case, I made an attempt to identify the constitutional remedy to annihilathe underlying cause of infertility to young female and strengthen her, up by stabilizing her blood haemoglobin concentration too.
Sepia- a remedy of inestimable value;, introduced by Hahnemann, led this patient from sickness to health.
Follow-Up
Refernces
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Nov / Dec VOL III NO 6.
Dr Roop R Nayak
'Sep
Mrs P 29 yr, Hindu housewife came with following complaints on 15th April 1999.
| Location | Sensation & Pathology | Modalities A F | Accompaniments |
| Female reproductive System. Since 7 yrs Rt lumbar Rt. Iliac
region. Recurrent attacks Rx- Operated Lt Ovarian cyst in 1997. |
Pain ++ Radiates to back |
< during menses ++ < strain ++ |
Weakness ++ Infertility- |
Pt was operated for ovarian cyst in 1997. No relevant history of Diabetes Mellitus, Hypertension, Tuberculosis or menstrual irregularities.
Family History
Elder sister- Ovarian cyst.
No F/H of DM, Hypertension, TB
Patient as a Person (Physical Generals) Appetite: Spicy food, pickles.
Aversion: Sweets, butter/ ghee.
Thirst: Good
Perspiration - Increased + +. Non-offensive, non-staining.
Bowel Habits - Regular, twice/day, hard stool
Micturition - Normal. 6-8/day. Menstrual History
FMP 13 y LMP 29.3.99
Irregular cycle, scanty discharge.
Character- Dark red in colour, Clots+++
Complaints- B / D / A.
M D - Pain abdomen, radiating to back.
Headache.
Reactions to Physical Factors
Prefers rainy season. Takes warm water bath.
Uses covering during sleep irrespective of seasons.
C2 H2 - C3 H2
Intellectual and Emotion State
Average perceptive module.
Lachrymose+++Weeps thinking about her complaints. Wept continuously during interview.
Brooding ++ Dwells over disagreeable consequences due to health hazards.
Irritable Gets sensitized fast, but conceals her anger to herself.
Fear++ Being alone+, night++, strangers.
Indolent Towards external affairs.
Reactions
Consolation ameliorates; Likes company.
Sleep and Dream: Sleep - good 10 pm to 6 am.
Dreams unremembered.
Life Space Investigations
Mrs P is from a lower middle class family, having 7 sister and 2 brothers. As a member of a large family, she could not concentrate on her career and could study only up to SSLC.
She got married at 22 years. After marriage she remained a housewife. She could not conceive even after seven years of marriage. She was upset by the taunts by her relatives and neighbours regarding her barrenness and it built up tension in her. She would weep for any trifle provocation.
She stays with her in-laws. Basically she is short tempered but has to suppress her anger. She likes to be consoled only by her loved ones. But most times she is indolent event towards family member and reluctant to get involved in personal matters.
General Physical Examination
Appearance: lean. Weight 35 kgs. Ht- 5 ft.
Face Dull appearance. Pallor +++
B P 120 / 80mm/Hg. Pulse 73 / mm
RR 18 / mm Temp 98.4'F
Cyanosis, Clubbing, Oedema feet, significant Lymphadenopathy-Absent
Systemic Examination
Per abdomen- No tenderness
Mass palpable in the Rt iliac and lumbar region, which is movable side to side. No organomegaly.
CVS & RS-NAD
Investigation: Pelvic Sonography
11.6.97 Well defined oval cystic lesion 6x4cms in left adenexa. Rt adenexa 3x3 cm mass.
20.3.98 - Rt ovarian cyst 6.1 cm x 5 cm x4 cm
Diagnosis
Ovarian cyst Rt.
Asymptomatic presentation
Pain abdomen during menses
Irregular menstrual bleeding occasional.
Recurrent involvement of both ovaries (left cyst got operated in ‘97)
Infertility
O/E- Mass per abdomen - lumbar and Rt iliac region mobile side to side.
On investigation- Pelvic sonography confirmed ovarian cyst.
Totality- CHRONIC CONSTITUTIONAL TOTALITY
Mental generals: Already defined above
Physical Generals: Chilly patient
App- good, vegetarian
Cr- spicy food, pickles
Av- sweets, butter / ghee.
Thirst- good
Perspiration- Increased all over.
Bowel- Regular twice / day hard stool.
Micturation- NAD
Menses- Irregular Scanty clots++
Characteristics Particulars Pain abdomen radiating to back. Weakness and fainting with extreme. Headache during menstrual nisus.
Management
General: Diet - Advised fibrous vegetables and more fruits fluids to combat bowel habits and anaemia.
Specific: Sepia as a constitutional remedy in suitable potency according to susceptibility, remedy response of the case.
Conclusion
Although ovarian follicular cyst is a structural variability at tissue level, a prompt constitutional approach can abort the pathology and prevent succeeding complication. In this case, I made an attempt to identify the constitutional remedy to annihilathe underlying cause of infertility to young female and strengthen her, up by stabilizing her blood haemoglobin concentration too.
Sepia- a remedy of inestimable value;, introduced by Hahnemann, led this patient from sickness to health.
Follow-Up
| 15.04.99 | First prescription | Sepia 30 - 1 H S / wkly x 4 weeks No (ii) pills 4-4-4 |
| 10.05.99 | Pain abdomen > 10%. LMP - 29.04.99 Clot during menstrual flow > ++. Weakness > ++ |
Sepia 200 - 1 H S / wkly x 4 weeks No (ii) pills 4-4-4 |
| 10.06.99 | Pain Abdomen > ++. LMP 22.05.99 (26d) No clots during menses. |
Sepia 1 M /1P H S No (ii) pills 4-4-4 |
| 05.08.99 | Pain Abdomen > ++50%. LMP 11th July. (49d) On investigation - cystic right ovary 4.3 x 3 cms with Follicles of 2-3 cms. Follicles reduced as in compared to 20.03.99 (50d) |
Sepia 1 M /1P H S No (ii) pills 4-4-4 |
| 04.10.99 | LMP: Sept 1st. Pain abdomen > ++ No Clots. Generally improved. |
Sepia 1M /1P H S / wkly x 4 weeks No (ii) pills 4-4-4 |
| 02.12.99 | LMP - Nov 17th (47d) Regular cycle, uneventful, no pain abdomen. Occ Backache. | Sepia 1M /1P H S / wkly No (ii) pills 4-4-4 |
| 03.04.00 | Advised pelvic sonography; Report- normal size of right
ovary 3 x 2 cm with follicles 15mm. Normal study with no evidence of hepatabiliary, renal or pelvic pathology. Advised to stop medication thereafter. |
Sepia 1 M /8P(1P) HS/ wkly |
- James Tylor Kent- Lectures on Homoeopathic Philosophy - Emorial edn.
- M. L. Tylor - Homoeopathic drug pictures - B. Jain Publishers.
- N. M. Choudhari - A study on Materia Medica 2nd ed B. Jain Publishers.
- Shaw's textbook of Gynecology- eleventh et al B. I. Churchill Livingstone Pvt Ltd. New Delhi.
- William Boericke - Pocket Manual of Homoeopathic Materia Medica and Repertory - Reprint edn- B. Jain Publishers.
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