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  Treatment of Graves' Disease - A Case Report
  

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By: Hans Werner, M.D.
(Original title: Der Morbus Basedow und seine Behandlung - Eine Krankengeschichte. Der Merkurstab 1996; 49: 321-3. English by A. R. Meuss, FIL, MTA.)

Anthroposophical Clinical Practice
By the age of 57, the patient had pneumonia in infancy and whooping cough, chickenpox and measles in her first 7 years. Until her 10th year she had recurrent otitis as well as hepatitis A at age 7. At age 10, a serious accident was followed by recurrent headaches, migraine from her 15th year; surgical treatment of uterine myomas at age 44.

The patient has been in my care from the age of 43. When she was 57 she complained of nervousness, increasingly unstable/irritable emotionally, palpitations, occasional shooting pains in the heart region, and sensation of pressure in the thyroid.

The thyroid showed medium diffuse enlargement. A small nodule, about the size of the pea, was palpable in the right lower pole. Moderate degree of exophthalmos. Fine tremor of hands. BP 140/80, pulse regular at c. 72/min.

Extended periods of considerable tension characterize the biography. In the months that preceded the diagnosis, psychological stress had reached a peak in several spheres of her life. Emotional outbursts were becoming more frequent. Life felt less secure.

Sleep was good, with many dreams. No changes in vision and hearing. Dexterity, which had been considerable, was becoming less. Ravenous hunger was a problem, in this case leading to weight gain; preference for salty and bitter. Stools twice daily, on the soft side.
The clinical symptoms, elevation of T3 to 4.1 (normal range 3-3.5), TSH receptor auto antibodies (TAA) to 44.4 (normal range 0-10.0) confirmed the diagnosis of Graves' disease (Basedow's disease). A scintiscan showed diffuse goiter I, with distinctly elevated uptake (14%). Ophthalmological examination gave a Hertel value of 18/18 to a base of 104, with 2 mm protrusion bilaterally, i.e. slight exophthalmos. No secondary changes were noted.
Increased catabolism indicates that the soul organization is growing stiff in the metabolic processes. This physical deviation of the soul organization is reflected in the excitation of autonomic and psychological symptoms. The leadership qualities of the Ego are reduced, causing the influence on physical and psychological daytime activities of the soul to be lost.To find the indicated treatment, we need this image of the sick individual, reflecting the situation in body, soul and spirit.

This was as follows:
Chalcosine 3x, 30 drops t.i.d.
Thyreogutt (Schwabe, herb. leomm, herb. lycopi) 7 drops
t.i.d. ABNOBAviscum Amygdali 10,1 amp. s.c. every 2nd week. Thyreoidea 60x, 1 amp. s.c. monthly.

Chalcosine or chalcosite; copper glance, helps the Ego to set limits to, configure and order the soul organization's daytime activity in the system of limbs and metabolism. If these processes can be restored to their proper order, it will also be possible to strengthen the unstable autonomic and psychological situation. This is supported by the action of Lycopns virginicns, which makes the soul organization inclined to take hold of the life organization again in a healthy way. Mistletoe in high potency will subdue the formless processes of the life organization that come to expression in the auto-aggressive aspect of the disease and guide the soul organization to resume its proper function in the immune process. Thyreoidea concentrates the medicinal actions of the other substances in the site where me pathological process comes to physical expression, in the thyroid.

Subjectively, a slow but steady regression of the excited state with its subliminal anxieties started after about 6 weeks. For a long time, however, this growing stabilization was not matched by changes in TSH and T3 levels. It was 7 months before the T3 was 3.2, TSH levels remained unchanged at 0.00. After 12 months, T3 had normalized and TAA was reduced to 28.9. All parameters (TAA, T3 and TSH) were in normal range after 2 years and continue to be so (5 years). There was, however, an interval of 8 months between the last laboratory investigations giving pathological readings and those giving normal results. The patient was never unable to work, probably because she had an inner connection to her work.

Coming to terms inwardly with the illness and facing what lay behind the process of becoming ill, allowed me as the physician walking the path with the patient to experience the signature of a birth that led to a new stage in life.

References
Steiner R. An Outline of Medical Research. Report of 2 lectures (in GA 319). Tr. not known. 28 & 29
August 1924. London: Rudolf Steiner Press 1939. Matthias Girke. The Thyroid. Tr. A. R. Meuss. Journal of Anthroposophical Medicine 1996; 13:49-62
& 72-93.





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