A MIASMATIC APPROACH TO ENDOMETRIOSISDr Suriyakhatun Osman

A MIASM IS:

“Miasm“ dictionary meaning: "a vaporous exhalation (as of a marshy

region or of a putrescent matter) formerly believed to contain a substance causing disease (as malaria)" "a pervasive influence or atmosphere that tends to deplete or corrupt"

Its Greek root is "miainein" which means "to defile". "to defile" means "to make something dirty or no longer pure" "to damage something holy or sacred". Webster’s Dict

A MIASM IS

According to Hahnemann An infectious disease A chronic miasm is a disease that keeps

progressing even when a prescription has been made that covers the presenting symptom for according to Hahnemann, there is a hidden process that needs to be prescribed on and an unmasking of the original symptoms before a miasmatic prescription can take place .

Stressor acts on

Organism

MIASMATIC APPROACH

Body restores balance

Body unable to restore balance

Remedy that mimics original stategiven

Body restores balance

ENDOMETRIOSIS

 Endometriosis is the growth of cells similar to those that form the inside of the uterus (endometrial cells), but in a location outside of the uterus

The cells of endometriosis attach themselves to tissue outside the uterus and are called endometriosis implants. The implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis

CHARACTERISTICS OF ENDOMETRIOSIS

Aggravation of many symptoms in the patients before, during, or after menses.  

Periodicity of 4 weeks, the cycles are frequently shortened to 3 weeks, showing a poor development of the corpus luteal phase of the menstrual cycle and a weak progesterone phase.  

Bleeding, per vaginal discharge, brown, bloody, black, copious watery, color and nature will vary with the phase in the cycle. The watery discharge, gushing and slightly bloody can occur during ovulation.  

CHARACTERISTICS OF ENDOMETRIOSIS Insidious onset.   Worsens with time and regresses after menopause,

regresses during pregnancy and lactation.   Pain may be severe depending on the staging coming at 4 week intervals, Pain may be felt in the abdomen, supra pubic, back,

down thighs ( referred pain ), rectum, Dyschaesia, dyspareunia

Associated problems: emotional upsets, usually suppressed emotions, digestive problems from dyspepsia to colitis, the mildest being irritable bowel syndrome but may be severe mucous colitis, adhesion colic

CONSEQUENCES OF ENDOMETRIOSIS

Infertility, debilitated state of patient who may not be able to assume daily activities usually two weeks in a month, every month.  

A constant cycle of pain, recovery, a short period of feeling relatively well then a repeat. Body ache and tiredness as well as Inability to cope are frequently associated with this condition when severe.  

Pathological changes are blood cysts in the ovaries, fallopian tubes, adherent to intestines or within the uterus resulting in adhesions, blocked tubes, and its consequences like hydrosalpinx.  

Occasional malignant change.   Emotional upsets and relationship problems  

A CASE OF ENDOMETRIOSIS

27 yr old married woman diagnosed with endometriosis by ultrasound and laparoscopy

Primary infertility , no pregnancy in 2.5 yrs marriage

Severe menstrual pain and other accompanying symptoms

Chronic headache attributed to head trauma during childhood

POSSIBLE CAUSES (CONVENTIONAL)

Metaplasia of cellsRetrograde mensesGenetic predispositionImmune system dysfunctionEnvironmental toxins

TREATMENT AND CASE HISTORY

Homeopathic treatment by Homeopath A initially for headache and later for both headache and dysmenorrhea from Feb 2005- July 2006

AT THE END OF JULY 2006

Headache did reduce After 8 months developed

dysmenorrhea and this became severe in July 2006

U/S done in July 2006 and diagnosed as Chocolate cyst in left ovary of size 3.7cm x 3.2 cm. Uterus anteverted

THE REMEDIES GIVEN

For Headache Arnica 1M 2 doses , Cannabis Sativa 1M 2 doses

(For B coli infection), Tub 1M 2 doses, Bell 2C, Syphillinum 10M  1 dose , Rhus Tox 1m 2 doses, Kali Bich 1M 2 doses, Ant Crud 1M 3 doses,  Sulph 30 1 dose

For the dysmenorrhea and headache: Puls 1M 2 doses Calc Phos 1M 8 doses  Sabina

30, Colocynth 200, Bovista 200 3 doses

HOMEOPATHIC TREATMENT FOR ENDOMETRIOSIS STARTED (HOMEOPATH B) Viburnum op, Lachesis , Camphora, Apis ,

Puslatilla Ultrasound scan on September 2006  (2

months after first scan) the cyst of left ovary increases to 6 x 5.5cm   and in the right ovary new chocolate cyst was developed of size 3.2cm. Uterus Bulky. Musculature, Endometrium 6mm Thickness

Patient was worse

SURGICAL INTERVENTION WITH CONVENTIONAL MEDICAL TREATMENT

Laparoscopy and GNRH in September 2006 Dye Test : Spillage in both side,

Endometriosis and adhesions were found ,  Hysteroscopy  showed  Uterine Cavity &

Cervical canal appeared normal,  Both Ostea Visualised.  Bulky Uterus with endometriosis and

adhesions.  Given an injection of GNRH 3.75 advised

Super Ovulation

ENDOMETRIOSIS PROGRESSES

Again undergone ultrasound examination on 23-04-2007. The following findings was found

 Uterus is anteverted, normal in shape, size and outline. Myometrial echo pattern is Homogeneous, Cavity is empty. Midline echo is normal. Endometrial thickness is 0.5cm. Cervical canal is normal.

 Right adnexal region shows a partly solid and partly cystic space occupying lesion, measuring 5.4 x6.3 cm.

Left adnexal region shows a cystic mass  measuring 5x 5.8 cm.

Both the space occupying lesions (SOL) are adherent to the uterus.

  IMPRESSIONS:  Bilateral Ovarian Cyst(Chocolate cyst) Features of Pelvic endometriosis.

MORE HOMEOPATHIC TREATMENT HOMEOPATH C

November 2006Bacillinium 10m 1 dose  with Calc Phos 6x and Ashoka Q, Cimicifuga 1M with Bell Perenis  Q and Oophorinum 30c, Calc Phos 200 c with Bell Perenis Q with Ashoka Q, Bryonia 0/2 with Ustiliago Q.

ENDOMETRIOSIS PROGRESSES

Ultrasound report6 July 2007 Uterus is antiverted, normal in

shape, size and outline. Myometrial echo pattern is homogeneous Cavity is empty. Midline echo is normal. Endometrial thickness is .4cm. Cervical canal is normal. A thick walled cystic SOL, measuring 2.9 x 5.2 cm another rounded thick walled cystic SOL measuring 3.4cmx4.2 cm. is seen in the Pouch of Douglas.

Both cystic SOL show low level internal echoes. IMPRESSION Bilateral ovarian cyst (Chocolate cyst).

REPERTORIZING

1. Rectum haemorrhoids.2. Head Pain headache in general sore bruised

sensitive to pressure 3. Female genitalia pain general  4. Extremities Cramps leg Calf Night 5. Vertigo 6. Breast sore before menses 7 Food and drinks Salt desires 8 Extremities Nails discoloration

REMEDY SELECTED

Nitric acid 200c in water : 9.07.2007 and another; two doses on 10. 07.2007.

One dose per day on 13-15 August 2008

SUBSEQUENT ULTRASOUND

Report done on 2.08.2007 Uterus is normal in size, cavities free. Right. side ovary there is an organized cyst

of 2.98 cm by 2.76 cm Left side ovary there is cyst of 2.45 by 2.22

cm. Pouch of Douglas is free There was a REGRESSION of the lesions

PREGNANCY!

Urine pregnancy test positive in September 2007 and gave birth to healthy baby boy by C

section on 11.05.08

DISCUSSION

Sumita had been under the care of homeopaths for a very long time before I took over. What was not done in her treatment was to look into the miasmatic nature of her disease and to prescribe accordingly. While treating her for headache earlier, even though the headache reduced, her menses became more and more painful and, as we saw later, her endometriosis became progressively more severe with more and more lesions found on subsequent ultrasound scans.

THE DIFFERENCE IN MY APPROACH AS COMPARED TO HOMEOPATHS A, B AND C I looked at the underlying miasm in cases of

endometriosis I studied the case using Repertorium

Virosum, which studies chronic conditions induced by viral infections and compares them to the traditional Homeopathic observations on miasms

I chose a remedy that: Covers the signs and symptoms of Sumita as an

individual Matches a remedy that belongs to the chronic

miasmatic state that I arrived at via analysis with Repertorium Virosum

UNDERSTANDING THE MIASMS (JH ALLEN)

Psoric •Itching, burning, inflammation leading to congestion - philosopher, selfish, restless, weak, fears

Sycotic •Over production, growths like warts, condylomata, fibrous tissue, attacks internal organs, pelvis, and sexual organs

Syphilitic •Destructive, disorder everywhere, ulceration, fissures, deformities, ignorance, suicidal, depressed, memory diminished

UNDERSTANDING THE MIASM

.

REPERTORIUM VIROSUM

ULTRASOUND REPORTS 2005-2010

IN CONCLUSION

By knowing what is to be cured in any condition, and it this case, the manifestations described as endometriosis and prescribing accordingly , the endometriotic cells that flourish outside its usual position can no longer happen because the the body no longer allows it to happen and the disease is not just palliated but cure is possible.

A MIASMATIC APPROACH TO THE CASE

Considerations in this case:

Sensitive patient , single remedy, stop when reaction

Miasmatic background to be studied

Remedy to match her person and the chronic miasm

Repertorising by Hompath and Repertorium Virosum

REFERENCES 1Melissa Conrad Stöppler, MD Endometriosis

http://www.medicinenet.com/endometriosis/article.htm 2Krina Zondervana, Ion Cardona, Ronald Desrosiersb, Dallas Hydec, Joseph Kemnitzd, Keith

Mansfieldb, Jeff Robertsc, Joan Schefflerd, Daniel E.Weekse and Stephen Kennedy The Genetic Epidemiology of Spontaneous Endometriosis in the Rhesus Monkey Annals of the New York Academy of Sciences 955:233-238 (2002)

3Cleary, S. D. 2; Ballweg, M. L. 3; Nieman, L. K. 1; Stratton, Ninet Sinaii , High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis.  Human Reproduction. 17 No (10): pages 2715-2724, October 2002

4Shawn Daly, MD,,Eric Outwater, MD, Endometrioma/Endometriosis  Aug 16, 2007 http://www.emedicine.com/radio/topic250.htm

5Schmidt CL, Demopoulos RI,WeissG. Infected endometriotic Int JGynecol Pathol. 2002;22:8388. 1981;36:2730

6http://minutus.org/library/article_read.asp?id=72 7  Hans Selye The Stress of Life Published 1984 McGraw-Hill reference to ponos page 3 8http://www.repertoriumvirosum.com/ 9 Ardavan Shahrdar., Sycosis and Gonorrhoea http://minutus.org/library/article_read.asp?

id=16 10Samuel Hahnemenn Published 1999 B. Jain Publishers A footnote of page 84 of Chronic

diseases tells about common gonorrhoea 11 Samuel Hahnemann Chronic Diseases  Published 1999 B. Jain Publishers 12 http://minutus.org/en/shahrdar.asp 13http://minutus.org/library/articles.asp  

CONTACT INFORMATION

Email : suriya@cybermed.edu.my CYBERJAYA UNIVERSITY COLLEGE OF

MEDICAL SCIENCES,   Faculty of Traditional and Complementary Medicine, Department of Homeopathy, No. 3410, Jalan Teknokrat 3, Cyber 4, 63000 Cyberjaya, Selangor Darul Ehsan, Malaysia.

Telephone :+60383137058

FINANCIAL CONFLICT OF INTEREST

There is no financial gain for me from any party in presenting this