A case of lumbar spondylosis treated with agaricus muscarius

Dr Jayasree V

ABSTRACT
The 43 year old patient complaints of having backache since 4 years. Based on the totality of symptoms AGARICUS MUSCARICUS 200 / 1 Dose was given and it was repeated weekly once for a period of 3 ½ years and the patient feels improved in his complaint.

KEYWORDS :Lumbar spondylosis, Agaricus muscarius

INTRODUCTION
Lumbar spondylosis is a degenerative joint disease that is very common in the elderly. Lumbar spondylosis is due to aging and time-related wear and tear on the vertebrae (bones) of the lower back. The deterioration due to lumbar spondylosis also affects the cartilage, a slippery substance that helps bones to move easily, and the discs, which are pillow-like tissues between the vertebrae that cushion movement of the lower back.

In many cases, there are no symptoms or complications associated with lumbar spondylosis. In some cases the degenerative changes in the lower back due to lumbar spondylosis can lead to compression of the spinal nerves (nerve roots), resulting in lower back pain and pain that radiates to the buttocks and legs. Lumbar spondylosis may also lead to abnormal growths (bone spurs) on the vertebrae, spinal osteoarthritis, chronic pain, and disability.

CASE REPORT

OP.No: 5508/16                                                                           Date: 18/06/2016

Name of patient: Mr. SEKHAR                                                   Age: 43 yrs,    Sex: Male 

 Address: Puthenveedu, Thalayamkottai                                     Occupation: Gold smith

                 Karungal 

PRESENTING COMPLAINTS

LOCATION, EXTENSION & DURATION SENSATION     & PATHOLOGY MODALITIES < , >, A/F ACCOMPANIMENTS
Back

Lumbosacral region

Since 4 years

Pain < sitting

< raising from seat

>lying down

<exertion

HISTORY OF PRESENTING COMPLAINTS
The patient complaints of having backache since 4 years. The pain in lumbosacral region started gradually and now the intensity of pain is increased. Taken allopathic medication and he got only temporary relief.

HISTORY OF PAST ILLNESS

  • 20 years back- appendiecectomy  done
  • 12 years back – typhoid fever-

FAMILY HISTORY

Not relevant 

GENERALS

  •  Appetite –  Normal                           
  • Stool- Regular
  •  Thirst – Normal Urine –Normal
  •  Sleep- Normal     Sweat –Normal

REACTION TO

  • Desire fanning
  • Desire covering
  • Desire cold season
  • Desire cold food and drinks
  • Desire sweet

MENTAL GENERALS

  • Desire company
  • Easily angered

GENERAL PHYSICAL EXAMINATION 

  • Anemia – No Pallor            
  • Jaundice – Not icteric                  
  • Cyanosis – Nil                                                                    
  • Clubbing –Nil                      
  • Lymphadenopathy –Nil  
  • Oedema – Nil                                                                                       
  • Nails – Normal       
  • Gait–Steady                                                                                                 
  •  Pulse – 72/ min    
  •  Resp .rate – 16/ min  
  •  Temp – 98.60 F  
  •  BP-  120/80mm of Hg

SYSTEMIC EXAMINATION

MUSCULO-SKELETAL SYSTEM

Inspection: No swelling, no discolouration, no scar marks, no deformity 

Palpation:  No tenderness, no local rise of tempertaure

Range of movements: Flexion, extension, lateral flexion are possible but painful

JAPANESE ORTHOPAEDIC ASSOCIATION SCORE FOR LOW BACK PAIN – PRE ASSESSMENT

ITEM POINTS SCORE
Subjective symptoms (9 points)
Low back pain 3,2,1,0 3
Leg pain or tingling 3,2,1,0 2
Gait 3,2,1,0 1
Clinical signs (6 points)
Straight-leg-raising test 2,1,0 2
Sensory disturbance 2,1,0 0
Motor disturbance 2,1,0 1
Restriction of activities of daily living 

(14 points)

Turning over while lying 2,1,0 1
Standing  2,1,0 2
Washing  2,1,0 2
Leaning forward 2,1,0 2
Sitting ( 1 h) 2,1,0 2
Lifting or holding heavy object 2,1,0 2
Walking  2,1,0 2
Urinary bladder function  0,-3,-6 0

TOTAL SCORE: 22

SEVERITY ASSESSMENT: MILD: Below 13

                                                 MODERATE: 14-20

                                                 SEVERE: Above 20

PROVISIONAL DIAGNOSIS: LUMBAR SPONDYLOSIS ANALYSIS

                     COMMON SYMPTOMS                        UNCOMMON SYMPTOMS
Easily angered

Desire cold food and drinks

Desire cold season

Desire covering

Backache < exertion

Desire sweets

Desire fanning

Backache  < sitting

< raising from seat

>lying down

EVALUATION OF SYMPTOMS

Mental generals Physical generals Particulars 
Easily angered Desire sweets

Desire fanning

Desire cold food and drinks

Desire cold season

Desire covering

Backache  < sitting

< raising from seat

>lying down

< exertion

MIASMTIC ANALYSIS

PSORA SYCOSIS SYPHILIS
Easily angered

Desire covering

Backache  < sitting

< raising from seat

>lying down

Desire cold food and drinks

Desire cold season

Backache < exertion

Desire cold season

HOMOEOPATHIC DIAGNOSIS: CHRONIC FULLY DEVELOPED MIASMATIC DISEASE – PSORA

TOTALITY OF SYMPTOMS

  • Easily angered
  • Desire covering
  • Desire fanning
  • Backache  < sitting
  • < raising from seat
  • >lying down
  • < exertion

REPERTORIAL TOTALITY

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REPERTORIAL RESULT

  • Agar – 6/3
  • Cob – 6/3
  • Nat.m – 5/3
  • Berb – 6/2
  • Rhust. T – 6/2
  • Calc – 6/2
  • Phos – 6/2
  • Puls – 5/2
  • Sulph – 5/2
  • Arg. N – 4/2

MANAGEMENT: FIRST PRESCRIPTION:  Rx                                                                                                                                       

  1. AGARICUS MUSCARIUS 200/ 1 DOSE (M)
  2. SAC LAC / 6 DOSES (M x 6 days)
  3. B.PILLS 3 x BD
  4. B.DISK 1 x BD      x 4 Weeks

ADMINISTRATION OF DOSE: A single globule of no.30 sized medicated globules in 1 grain of sugar of milk is administered orally.

BASIS OF SELECTION OF MEDICINE

  • Pain in lumbosacral region
  • < exertion
  • <rising from seat
  • Neuralgia 
  • < sitting

FOLLOW UPS

DATE FOLLOW UPS AND PROGRESS PRESCRIPTION
22/07/2016 Pain over lumbosacral region feels better than before.

Generals – Good

BP : 130/80 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

15/08/2016 Pain in the lumbosacral region feels better than before but persisting slightly

< sitting

Generals – Good

BP : 130/80 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

14/11/2016 Pain over lumbosacral region feels better than before but persisting.

Sweating over whole body and sensation of vertigo present, occasionally.

Generals – Good

BP : 130/100 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

 

08/02/2017 Pain over lumbosacral region feels better than before.

Sweating over whole body persists.

< physical exertion

< sun exposure

Generals – Good

BP : 110/90 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

27/03/2017 Backache slightly better

Pain in sacral region < rising from sitting

< initial motion

Generals: good

BP: 140/90mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

21/04/2017 Backache  feels better than before.

Sweating over whole body slightly persists but feels better than before..

Generals – Good

BP : 128/86 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

12/06/2017

TO

21/09/2018

Backache  feels better than before.

Generals – Good

BP : 140/100 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

31/10/2018 Pain in lumbar region feels better than before

Weakness all over body since 2 days

Generals – good

BP: 150/100 mm of Hg

LAB REPORT

Haemoglobin : 13.8gm/dl

Rx

1.BAPTISIA TINCTORIA 30 

 

10/12/2018 Pain in lumbar region feels better

Generals: Good

BP: 130/90 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

07/01/2019 Pain in lumbar region feels better

Generals: Good

BP: 124/90 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

 

08/02/2019 Pain in shoulder joint, elbow, arm of right hand persists.

< exertion

Pain in lumbosacral region present

< stooping

Generals:

Sleep: disturbed

Other generals: good

BP: 140/90 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

08/03/2019 Lumbar pain better

Shoulder pain better

Generals:

Sleep: disturbed

Other generals: good

BP: 140/100 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)                         x 4 weeks

12/04/2019 Lumbar region pain feels better but persists

< bike riding

Right sided Shoulder joint pain better

Generals:

Sleep: disturbed

Other generals: good

BP: 120/80 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

07/06/2019 Lumbar region pain feels better but persists

< bike riding

< pressure

Pain in shoulder joint better

Generals:

Sleep: disturbed

Other generals: good

BP: 130/90 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

05/07/2019 Lumbar region pain feels better but persists

< bike riding

 Shoulder joint pain better

Generals:

Sleep: disturbed

Other generals: good

BP: 130/80 mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

02/08/2019 Pain in lumbar region feels better than before but persists

Pain in shoulder joint feels better

Generals: good

BP:110/80mm of Hg

Rx

1.AGARICUS MUSCARIUS 

   200/1 D0SE (M)

26/08/2019 Numbness of both sides of gluteal region

< raising from seat

< prolonged sitting

>walking

Lumbar region pain feels better than before

Generals: good

BP: 116/76mm of Hg

Rx SL

 

16/10/2019 Numbness in gluteal region feels better than before

Lumbar region pain feels better than before

Generals: good

BP: 110/80mm of Hg

Rx

1.SAC LAC / 7 D0SES

 

13/11/2019 Numbness on gluteal region better

Lumbar region pain feels better 

Generals: good

BP: 116/70mm of Hg

Rx

1.SAC LAC / 7 D0SES

JAPANESE ORTHOPAEDIC ASSOCIATION SCORE FOR LOW BACK PAIN – POST ASSESSMENT

ITEM POINTS SCORE
Subjective symptoms (9 points)
Low back pain 3,2,1,0 1
Leg pain or tingling 3,2,1,0 0
Gait 3,2,1,0 0
Clinical signs (6 points)
Straight-leg-raising test 2,1,0 0
Sensory disturbance 2,1,0 0
Motor disturbance 2,1,0 0
Restriction of activities of daily living 

(14 points)

Turning over while lying 2,1,0 0
Standing  2,1,0 0
Washing  2,1,0 0
Leaning forward 2,1,0 0
Sitting ( 1 h) 2,1,0 0
Lifting or holding heavy object 2,1,0 1
Walking  2,1,0 0
Urinary bladder function  0,-3,-6 0

TOTAL SCORE: 2

DISCUSSION: POTENCY SELECTION

 H.A.Robert – Remedy Reaction (5) 

The chronic condition causing disturbances to which the remedy is applicable is not of very great depth, it belongs to the functional conditions, exhibiting its effects in the nervous manifestations and the relations of the patient to his surroundings and to tissue changes. These  are the changes in the vital force that are so profound as to cause many symptoms that are very trying to the patient and yet so slight that will all the instruments of precision we don’t observe any pathological changes. It is in these conditions that we sometimes get considerable suffering, yet cures will come without any aggravation. In these cases the single remedy in a moderate potency (say the 200th) will probably complete the work. In such cases we know the potency and the remedy are correct

According to TAPAN CHANDRA MONDAL (7)
To avoid any danger,it is always advisable to begin with medium potency and cautiously go higher to catch the proper wavelength and critical potency for cure

REPETITION OF DOSE(2)

§ 248 Fifth Edition
The dose of the same medicine may be repeated several times according to circumstances, but only so long as until either recovery ensues, or the same remedy ceases to do good and the rest of the disease, presenting a different group of symptoms, demands a different homoeopathic remedy

§ 280 Fifth Edition
The incontrovertible axiom of experience is the standard of measurement by which the doses of all homoeopathic medicines, without exception, are to be reduced to such an extent that after their ingestion, they shall excite a scarcely observable homoeopathic aggravation, let the diminution of the dose go ever so far, and appear ever so incredible to the materialistic ideas of ordinary physicians; their idle declamations must  cease before the verdict of unerring experience. 

ACUTE MISHAPS 

  • Acute apperance of a new symptom during the chronic course of treatment.
  • ie) acute mishappenings 
  • It will disturb the treatment only in a temporary way.  – Hahnemann’s Chronic diseases 

FUTURE PLAN OF TREATMENT
After taking AGARICUS 200 in repetited doses, the patient feels improved in his complaint. If the complaint shows relapses, then we can think of an antipsoric remedies in future.

CASE SUMMARY
 The patient complaints of having backache since 4 years. Based on the totality of symptoms AGARICUS MUSCARICUS 200 / 1 Dose was given and it was repeated weekly once for a period of 3 ½  years and the patient feels improved in his complaint. In between the course of treatment once an acute mishaps occur for that BAPTISIA 30/ 1 Dose was given and the patient got improvement. The assessment score shows marked improvement in his present state than the initial assessment score. 

REFERENCE

  1. Banerjea Kumar Subrata. Miasmatic Prescribing. New Delhi; B. Jain Publishers(p)Ltd;2015
  2. Hahnemann Samuel. Organon Of Medicine. Aphorism 5th and 6th edition. New Delhi; B Jain     Publishers (P) Ltd; 2005.
  3. Boericke William. Pocket Manual of Homoeopathic Materia Medica. AGARICUS MUSCARIUS. Indian books and periodicals publishers (P) Ltd; 2010
  4. Schroyens Fredericke. Synthesis repertory 9.1. Radar. New Delhi: Homoeopathic Book Publishers; 2002
  5. Roberts.A.Herbert.The Principles and Art of Cure by Homoeopathy  .New Delhi; B Jain Publishers(P) Ltd;2002
  6. Dhawale M L.Principles and Practice of Homoeopathy.New Delhi;B Jain Publishers(P) Ltd;2014
  7. Mondal Chandra Tapan.Spirit of the Organon. New Delhi;B Jain Publishers(P) Ltd;2004

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