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Individualised homoeopathic treatment for a longstanding meibomian cyst: A case report
*Corresponding author: Tamara Afroza, Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India. tamara.afroza1@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Hait H, Afroza T. Individualised homoeopathic treatment for a long-standing meibomian cyst: A case report. J Intgr Stand Homoeopathy 2022;5:74-7.
Abstract
A chalazion is a chronic sterile lipogranuloma. They are typically slowly enlarging and non-tender. A deep chalazion is caused by inflammation of a tarsal meibomian gland, while a superficial chalazion is caused by inflammation of a Zeis gland. A 4-year-old child was brought for homoeopathic treatment of a meibomian cyst of the left upper eyelid with the hope to avoid surgical intervention. After full case taking, case analysis and proper individualisation, a single homoeopathic medicine was prescribed. After 2 months of treatment, the child was relieved of her presenting symptoms and showed general improvement in health. This article provides a clinically useful review of a case with evidence about how an individualised homoeopathic medicine treated a likely surgical case successfully.
Keywords
Chalazia
Individualisation
Homoeopathy
Case report
INTRODUCTION
A chalazion (Plural: Chalazia) is a localised bump on the eyelid of varying sizes.[1,2] Chalazia are the most common inflammatory lesions of the eyelid. They are typically slowly enlarging and non-tender. Multiple chalazia can occur simultaneously in an eyelid. They can occur in either eye and on upper and lower eyelids.[1] Chalazia are typically benign and self-limiting, although chronic complications such as lash loss, lid notching, or preseptal cellulitis may develop if they are left untreated. Recurrent chalazia do not cause malignancy, but malignant tumours can look like chalazia.[2] When the viscosity of the secreted lipids and proteins (termed meibum) increases due to age, hormonal disorders, or environmental factors, the meibum accumulates in the ducts of the gland causing widening of the duct resulting in a chalazion. A superficial chalazion is caused by inflammation of a Zeis gland and a deep chalazion is caused by inflammation of a tarsal meibomian gland. Histopathology demonstrates lipogranulomatous inflammation with lipid surrounded by foreign body giant cells, epithelioid cells, lymphocytes, plasma cells, neutrophils and eosinophils. A fibrous pseudocapsule may form around the lesion.[2] It has been seen repeatedly in clinical cases that if homoeopathic medicines have been selected and given by following homoeopathic principles, a chalazion can be treated fairly successfully. In the below-described case, it is clear that individualised similimum remedy can enable a fairly quick recovery.
CASE REPORT
Patient information
A 4-year-old girl, with a dark complexion, and moderate build.
Case history
The patient presented with hard, nodular, persistent, glandular swelling of the outer corner of the upper left eyelid for 1 month. She has experienced repeated episodes of similar swellings in the past.
There was no history of refractive error; the patient had not taken any medication for the same. The parents denied any rubbing of the eyes. The patient appeared to have a good hygiene level. Based on her mother’s narration, the child is very sentimental and weeps silently even when mildly criticised or scolded. She has craving for sweets and meat.
Clinical findings
No slit-lamp test was done.
Physician’s observation
She was restless, and anxious, did not interact well with the physician, and avoided eye contact.
She was angry at the physician after she tried to take the stethoscope but was not allowed to do so.
Analysis and evaluation of symptoms
| Mental generals | Physical generals | Particulars |
|---|---|---|
| 1. Oversensitive to slightest mental impressions | 1. Hot patient | 1. Stool hard |
| 2. Introverted | 2. Craving for meat | 2. Hard, nodular swelling on the left upper eyelid |
| 3. Angry when desire not fulfilled | 3. Repeated eruptions | |
| 4. Weeping silently |
- Left eye.
Totality of symptoms
Oversensitive to slightest mental impressions
Introverted
Angry when desire not fulfilled
Hiding tears
Hot patient
Craving for meat
Stool hard
Hard, nodular swelling on the left upper eyelid
H/O repeated chalazion.
Miasmatic analysis
The mental and physical characteristic symptoms indicate that the psychotic and psoric miasms are dominant.[3]
Repertorisation (Hompath Zomeo)
As the case presented with prominent mental and physical general symptoms, the complete repertory was selected for repertorisation with the help of Hompath Zomeo [Figure 2].[4]
- Repertorisation.
Therapeutic intervention
Treatment plan
Individualised homoeopathic medicine with proper dose and potency by the following Homoeopathic Law and Principles.[5-7]
Prescription
Repertorisation was done considering the mental generals and the uncommon, peculiar symptoms, all of which indicate the remedy Staphysagria.
Follow-up sheet and outcomes
Follow-up criteria:
Changes in swelling size
Recurrence of the complaints
Improvement in physical and mental health indicators: Appetite, stool, thirst and sleep.
DISCUSSION
Why individualisation is the option of choice?[5]
It is described in §153 of Organon of Medicine that it is the most striking, singular, uncommon, peculiar, or characteristic symptoms of the disease that is to be kept chiefly and most solely in view; it is for analogues to these that we must search through the lists of medicinal symptoms.[5]
| Date | Symptoms | Prescription |
|---|---|---|
| 11 December 2020 | Chief complaints | Staphysagria 200 Single dose |
| 9 January 2021 | Improvement started. Size of swelling reduced |
Placebo 30 for the next 1 month |
| 11 February 2021 | Swelling disappeared | Placebo 30 for the next 1 month |
| 10 March 2021 | No recurrence of the complaints reported | Placebo 30 for the next 1 month |
| 11 April 2021 | No recurrence of the complaints reported | Placebo 30 for the next 1 month |
| 14 May 2021 | No recurrence of the complaints reported | Placebo 30 for the next 6 months. |
| 30 December 2021 |
|
Advised to report if complaints return No medicine; advised to report immediately if complaint returns |
- (a) 2nd visit (size reduced), (b) 3rd visit (complete disappearance of the hard swelling).
For this particular case, some very striking characteristic symptoms of the patient could be correlated with the medicinal symptoms of Staphysagria like oversensitive to the slightest mental impressions, weeping silently and hot patient.
The homoeopathic dose must be given in a minimum doses.[7,8] The success of homoeopathic treatment depends to a great extent on the correct selection of the potency and the requisite potency should be selected through the susceptibility of the patient.[9,10] In this particular case, the most similar homoeopathic medicine was prescribed that is, Staphysagria 200C. The remedy was selected through individualisation of the case through proper evaluation and analysis of the symptom totality. A single dose was administered, as the law of similia and law of minimum dose was followed.
CONCLUSION
This article presents a clear case of long standing chalazion which was presented with hard,nodular,persistent glandular swelling [Figure 1] and cured by an absolute individualised homoeopathic treatment by giving a result of complete removal of the hard swelling as well as general improvement of health [Figure 3].
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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