Homeopathic Management of Urolithiasis

Introduction:      

One of the most prevalent conditions affecting the urinary system is renal stone, calculus or lithiasis. Men are more likely than women to experience it, and white people are more likely than black people to do so. In children, it is uncommon. It demonstrates a genetic inclination. A colloid matrix of organic components holds urine salts together to form the stone-like substance known as urinary calculus. Urinary salts are accumulated in concentric layers around a nucleus. [1]

Renal Calculus is caused due to

  1. Hyperexcretion of relatively insoluble urinary constituents like oxalate, calcium, uric acid, cystine and some drug induced stones e.g. magnesium trisilicate.
  2. Physical changes in the urine like alkaline with the presence of urea splitting bacteria (proteus mirabilis) and decreased concentration of crystalloids.
  3. Alteration in urinary crystalloids (oxalate, calcium cystine, uric acid etc.) and urinary colloid (mucin and chondroitin sulphuric acid).
  4. Decreased urinary output
  5. Vitamin A deficiency
  6. Urinary infection
  7. Urinary stasis
  8. Hyperparathyroidism
  9. Calcific plaques on renal papillae.

There are Primary and Secondary calculi according to cause.[2]

Quiescent calculus majorly formed by phosphate, may lie dormant for a long period but gradually increase in size and destroys renal parenchyma.[2]

Otherwise, pain is the leading symptom of renal calculus. Those are of two types:

(1) fixed renal pain – if the calculi obstruct ureteropelvic junction, it causes dull flank pain. In case of big phosphate calculus, dull aching or boring pain. Pain over angle between 12th costal rib and vertebra- spinal cord i.e. at Renal angle in lumbar region and referred pain over the corresponding hypochondrium anteriorly.[2]

(2) ureteric colic occurs when the calculi pass down to ureter or temporarily blocks pelviureteric junction. It is agonising pain radiating from loin to groin. Such pain comes on suddenly during which the patient rolling or even tossing in agony. If calculi in intramural part of ureter, it causes painful straining at urination but in vain and ends with only few drops of urine or mixed with blood. Ureteric colic passes off with compensatory polyuria or passage of calculi in urine.[2]

Rarely, referred pain to all over abdomen or to the opposite kidney. Sometimes calculus produces lump in the loin and dull aching due to hydronephrosis. Hematuria, blood in urine, occurs in small amount and makes urine dirty and smoky. Infection of kidney is symptomless presents with pus in urine. There is opalescent urine. [2]

There is tenderness at renal angle over affected side, muscular rigidity, swelling – fixed as it is retroperitoneal, ballotable kidney lump and abdominal distension are signs over examination.[3]

Investigations like renal function test for nonprotein nitrogenous substances and creatinine. Serum hypercalcemia, estimation of serum chloride and differential count for blood investigation. A straight X-ray of both kidneys, ureters and bladder (KUB) for radio-opaque calculi otherwise excretory urogram is required.[3]

HOMEOPATHIC ASPECT:

                According to our Master, Dr. S. C. F. Hahnemann in aphorism 29, 5thedition of Organon of medicine, it is written: “…., when a Homeopathic cure of the vital force deranged by natural disease is accomplished by administration of a medicinal agent selected on account of an accurate similarity of symptoms,…..” this sentence includes many things, that the Homoeopathic treatment is gentle, rapid and permanent. It is also beneficial to manage patients with pain of Urolithiasis with the use of Homeopathic medicines, auxiliary measurement and improvement in mode of living.[4]

                Homeopathy is strongly recommended for primary or secondary renal calculi. In acute sudden ureteric colic, there is a requirement to provide immediate relief with help of Homeopathic medicines along with auxiliary treatments. There is a possibility of sudden obstruction of calculi in case of stoppage of micturition which requires surgical intervention.[4]

                The Homeopathic medicine is selected after a full individualizing of the patient and case-analysis, which includes medical history, past history, family history of the patient, general and particular examination, physical and mental constitution etc.[4][9]

There are following Homoeopathic remedies used for the treatment of Urolithiasis:

(Alphabetically arranged)

Berberis vulgaris:

Source – Plant kingdom (Barberry).

Constitution- Pale, earthy complexion, with sunken cheeks and hollow, blue-encircled eyes. Rheumatic and gouty complaints, with diseases of the urinary organs.

Characteristic particular- The small of the back hurts; the renal area is extremely sensitive to touch; it hurts when sitting and lying; it hurts from exhaustion. pain and burning in the renal area. Lameness, stiffness, and numbness with excruciating pressure in the lumbar and renal areas. Cutting and suturing the left kidney after the ureter passes through the bladder and urethra. renal rubbing feeling.

Modalities- < left side, with urging and strangury. < Motion, walking or carriage riding; any sudden jarring movement.[5][10]

Cantharis:

Source – Animal kingdom (Spanish Flies).

Constitution- Oversensitive patient with Haemorrhagic diathesis.

Characteristic particular- Every area of the body is experiencing intense weakness and raw, painful, burning pain both internally and outwardly. disgust for food, alcohol, and smoke in particular. Bladder pain worsens when even tiny amounts of water are consumed. persistent urge to urinate, passing only a few blood-mixed droplets at a time. During micturition, the urethra experiences burning and cutting pains, as well as severe tenesmus and strangulation.

Modalities- Aggravation with intolerable urging before, during and after micturition.[6]

Hydrangea:

Source – Plant kingdom (Seven-barks).

Constitution – The tendency to formation of calculi. Distress from renal calculus, with soreness over the region of kidneys and bloody urine.

Characteristic particular- Pain in lumbar region with dizziness. Burning in the urethra and frequent desire. Urine hard to start. Heavy deposit of mucus. Sharp pain in loins, especially left. Gravelly and profuse deposit of white amorphous salts.[6][7]

Lycopodium Clavatum:

Source – Plant kingdom (Club Moss).

Constitution- For persons intellectually keen but physically weak. The upper part of body emaciated, lower part semi- dropsical. Patient at the extremes of life, children and old people. Deep-seated, progressive and chronic diseases.

Characteristic particular- Red sand in urine, on a child’s diaper. Child cries before urinating. Renal colicky pain in back. Right sided aching-pressure, drawing pain.

Modalities- < four to eight P.M. (right side) renal colic relieved by urinating.[5]

Ocimum canum:

Source – Plant kingdom (Brazilian Alfavaca).

Constitution- Uric acid diathesis.

Characteristic particular- Severe kidney pain and a lot of red sand in the urine. Its main feature, which is often confirmed, is red sand in the urine. High acidity and the development of uric acid spike crystals are seen. Urine that is turbid, thick, purulent, bloody, and has a brick-dust red or yellow sediment. Musk like smell.

Modalities- right-sided renal colic.[5][7]

Pareria bravia:

Source – Plant kingdom (Virgin-vine).

Constitution- Useful in renal colic, prostatic affections, and catarrh of bladder.

Characteristic particular- Pain radiating down the leg and a feeling of a swollen bladder. Urine is heavy, red and black with mucus. Urging all the time, straining a lot and experiencing thigh pain when trying to urinate. He has a persistent urge to urinate, strains to go down on his knees and experiences pain in his thighs.

Modalities- Dribbling after micturition.[6][8]

Sarsaparilla:

Source – Plant kingdom (Wild Liquorice).

Constitution- For dark-haired persons with lithic or sycotic diathesis. Great emaciation: skin becomes shriveled or lies in folds.

Characteristic particular- Severe, nearly intolerable pain after urinating. Passage of tiny calculi or pebbles along with bloody urine and renal discomfort.

Urine is clear and bright yet unpleasant; it is sparse, slimy, flaky, sandy, profuse, passes without feeling and deposits white sand. Bladder discomfort and painful distention. The urethra allows air to exit. The youngster screams both before and during the passage of sand in their urine or on their diaper.

Modalities- urine dribbles while sitting and passes freely when standing.[5][8]

References:

  1. B D Chaurasia’s Human Anatomy, 9th edition, CBS Publishers and Distributors Pvt. Ltd.
  2. A Concise Textbook of Surgery, 11th edition, Jaypee brother’s Publishers and Distributors Pvt. Ltd.
  3. P. J. Mehta’s Practical Medicine, 22nd edition, Jaypee brother’s Publishers and Distributors Pvt. Ltd.
  4. Organon of Medicine, 5th edition, B Jain Publishers Pvt. Ltd.
  5. Leaders in Homeopathic Therapeutics, 6th edition, B Jain Publishers Pvt. Ltd.
  6. Homoeopathic Therapeutics, 1st edition, B Jain Publishers Pvt. Ltd.
  7. Materia Medica of Homoeopathic Medicines, revised edition, B Jain Publishers Pvt. Ltd.
  8. Lectures on Homeopathic Materia Medica, 2nd edition, B Jain Publishers Pvt. Ltd.
  9. https://plantarc.com/homeopathic-management-of-lumbar-discherniation/.
  10. https://doi.org/10.53945/2320-7094.1031
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