Category: Information On Microbiology
AN ENCOUNTER WITH HIV/AIDS PATIENT
It was during September/October, 1990 when I read heart-rending articles on AIDS patients of Kamatipura, Bombay. This made me curious to come across some AIDS afflicted persons. Later news about AIDS victims appeared in local newspapers. As some of the patients were residing in and around Chandigarh and Punjab, I tried to contact them personally by visiting their places and through post until on 4th May, 1992 at about 5 p.m. when an AIDS patient was brought to me in a critical condition.
Frankly speaking, although I was keen to treat HIV/AIDS patients but when I was informed by the attendant, younger brother of the victim about the disease (prior to my coming face to face with the patient) I developed fear psychosis and hesitation for a while. Somehow, I reconciled and prepared myself to examine the patient.
The patient seemed seriously ill. He was laid down on a bench with his head o the lap of his brother. I thoroughly inspected the patient. He was in a state of stupor and remained thus throughout the physical examination and my interrogation with the attendant except when he asked for water and when I tried to remove his undergarments for physical examination of his genitals, the patient did not allow me to do so. I too did not insist too much.
On the basis of PGIMER, Chandigarh OPD’s cards, reports, narration by the attendant and Physical Examination of the patient, I noted the following things:
1. Name : M.S. Age - 25 years, married
2. Occupation : Truck Driver, he happened to go to Bombay where
He (might have) frequented Kamatipura, the den of prostitution and contracted Syphilis (information gathered from brother) through sexual intercourse.
3. Constitution : Wrecked, lean and thin built.
4. Skin : Pale hue of the skin of the face. The skin of the trunk, extremities and back was full of reddish brown popular rash. On the left upper arm, right thigh and on the abdomen bluish purple colour circumscribed spots of purpura haemorrhagica were also seen.
5. Body Temperature : 100 degrees Fahrenheit
6. General Condition : Excessive prostration. The patient remained in a propped position and in a state of semi-unconsciousness.
7. Respiratory Condition : Patient was coughing often, with the feeling of soreness in the chest but without any expectoration.
8. Mouth : Dry and thickly brownish coated tongue.
9. Thirst : Patient took tumbler full of water twice at about half an hour interval.
10. Lymphatic System : Left cervical lymph nodes were enlarged.
11. Past History : On the basis of prescription note made on 26.10.91 by a doctor (Ex-Professor and Head of Medicine, Rajindra Hospital, Patiala).
i) The patient was a daily drinker for 15 years.
ii) Spontaneous bleeding from gums for 3-4 months.
iii) Epistaxis – 4 months
iv) Ecchymosis
v) C/O Easy fatigability
vi) Reduced appetite
12. Family History : Not of special keeping in view with the nature of the disease.
13. Treatment Taken : Allopathic from various practitioners and PGIMER Chandigarh on different cards stipulating the dates.
20.11.91 — Thrombocytopenia
Leukocytosis
Anaemia
27.11.91 ? ITP with sessile type of condyloma acuminata + Recurrent Herpesprogenitalis.
? ITP – Leukaemia
Lesions on trunk, face acneform, lesions are steroid induced taken for his ITP Oral lesions part of ITP.
Lesion over pubic region – healed folliculitis purpuric lesion’
HIV report – negative (ELISA)
19.2.92 Lymphoma
? Hodkins – disease
10.3.92 A case of thrombocytopenia
ANF +
On Steroids
Receiving Wysolone 60 mg. OD.
Present C/O – Fever x 7 days
Cough
No other local symptoms.
4.5.92 Immunothrombocytopenia
HIV +ve
Fever with cough
Lymph nodes – left cervical region enlarged
Throat – multiple small ulcers.
Lab Investigations
24.10.91 Private Lab at Sunam, Punjab
Hb – 5.8 gm%
TLC 13700/cmm
& DLC P62 L34 E2 M0 B0
Serum Bilirubin 0.4 mg%
26.10.91 Private Lab at Patiala
i) Hb 6.0 gm%
TLC 6100/cmm
DLC P62, L33, M3, E2, B0
Platelet count 52000/cmm
Prothrombin Time 16 sec.
Control 16 sec.
Index 100%
ii) Hb 7.5%
TLC 20400/cmm
DLC P83, L15, EO M2
Platelet count 38000/cmm
7.11.91 Private Lab at Patiala
Hb 7.5 gm/dl
TLC 20,400/cmm
DLC P83, L15, M0 E2 Bo
Platelet Count 38000/cmm
26.11.91 PGIMER, Chandigarh Department of Haematology
i) Report of Bone marrow Aspirate/Trephine Interrogation:
Although aspirate is a particulate, a few Megakaryocytes thrombocytopenia. A report aspirate with Trephine is advised at a later date
ii) PFNA
Hb 8.4%
Retic – 0.5%
Platelets – 5000
TLC - 16000/cmm
DLC P75 L15 My 3 MM1
Ratio – 2m RBC/100 WBC
Mild — Anisopoikilocytosis with Micro, Macro Ovalocytes, mildly hypochromic Platelets reduced on smear
5.12.91 Haematology Clinic
Platelets/cmm < 5000
30.12.91 Department of Immunopathology, PGIMER, Chandigarh
HIV test is negative both by ELISA and Western BLOT Sd/-
30.12.91 Haematology Clinic
Hb 10.4% gm%
TLC 11700/cmm
Mid January, 92 Department of Immunopathology,
PGIMER, Chandigarh
HIV-I is positive by ELISA with fresh sample taken during mid January. To be treated at positive.
Sd/-
5.2.92 Department of Medical Microbiology, PGIMER, Chandigarh
V.D.R.L. Test – Nonreactive Sd/-
12.2.92 Department of Immunopathology ( Pathology)
AIDS Surveillance Center, PGIMER, Chandigarh
HIV test: By ELISA – Negative Sd/-
N.B. It does not rule out the possibility of HIV but at the same time western BLOT was not conducted, which was a must since – It is the only confirmatory test, further mid January, 92 sample was declared HIV positive by ELISA.
On the basis of PGIMER OPD’s findings and clinical investigations, the case was repertorised for the following symptoms :-
Medicamentum abuse
Dry mouth with thirst
skin – discoloration
Anemia
Cough dry, soreness in chest coughing while
fever-heat in general
weakness
Syphilitic history.
Ars. Album, Sulphur and Nitric Acid were the three medicines covering all the symptoms. Patient was given medicines keeping inn view the cause of the present state of the patient and chronicity of the disease
R/ Sulphur 1M 3 doses 1 hourly
Ars. Album 1M 9 doses (SOS) – 1-3 hourly
Plo 21 doses TDS Sd/-
N.B. While I was busy in repertorising the case, the attendant as well other accompanying persons of his village wanted me to be hurry in issuing the medicines to the patient so that they could reach their home at Sunam(Punjab) well in time before mid-night. They all were reluctant to night stay at Chandigarh. The patient was given one dose of Sulphur 1M at the clinic and the rest two doses were to be given after an hour interval while enroute to his home. In case there was increase in the temperature after the first dose of Sulphur 1 M or otherwise, Ars. Album 1M, SOS was to be given as per instructions. They all left the clinic at about 6 p.m.
Nobody turned up to report the condition of the patient even after a week or 10 days time. I therefore, realised my folly in not compelling the attendant for making the patient stay at Chandigarh as long as he needed constant observation. I had almost lost the hope of turning up of the patient or the attendant when on 20th June the attendant of the patient turned up at my residence around noon and accounted for the events pertaining to the patient’s condition thus:-
“After leaving my clinic, when enroute home of the patient the temperature rose high (around 104 degrees Fahrenheit). The patient became anxious, restless and started speaking (O God I am dying).
He was offered water which he took in a small amount first at Banoor then at Rajpura and next at Patiala (The patient might have not been given any medicine) After reaching home at Sunam, one dose of Ars. Album 1M was given which relieved the patient of his anxiety and restlessness but temperature remained between 102-104 degrees Fahrenheit throughout the night as well as the next morning (I can’t say whether Ars. Album 1M was further repeated or not but I have no mention in my case file. I might have either forgotten to ask or to note the same).
Next day they called a local allopathic physician to examine the patient, who not only gave Sporidex, wysolone and crocine 6 hourly 5-6 times but also warned the family against the so called harmful effects of the homeopathic medicines. Thenceforth homoeopathic medicines were stopped. On 6th May there was no temperature and the patient was alright for about 10 days. Patient started taking 2-3 chapati and some juicy fruits daily. Then again he got temperature (between 100 to 103 degrees Fahrenheit). This time besides above noted allopathic medicines, injections of Vetenisol and Cal. Sandose + one bottle of Dextrose were also administered I.V. resulting in coming down of the body temp. to 100 degrees Fahrenheit.
Patient was alright for another 7 days. Thereafter, he started bleeding from gums. It was checked with the help of Allopathic drugs but it did not sttop completely.
On 14th June the patient went to see his in-laws in another village, there he developed 102-103 degrees Fever temperature. Either there itself or after his coming home, he was given usual course of steroids and antipyretic drugs. Meanwhile, his maternal uncle visited the patient, who not only cleared all doubts about the alleged harmful effects of homoeopathic medicines but also insisted on taking them (at least along with the allopathic drugs). Thus the patient started taking medicines of both the systems together. He was alright on 15,16,17 June.
On 18th June, patient passed two loose motions in the morning and another at 3 p.m. which were stopped by giving antipurgatives. On 19th June at about 7 p.m. patient complained of headache, pain in the abdomen and legs. The body temperature rose to
99 degrees Fahrenheit to 100 degrees Fahrenheit. He was given both the types of medicines and the temperature did not shoot.” The attendant turned up on 20th June to report and to fetch more medicines. According to him:
“In the morning temperature was 100 degrees Fahrenheit.
Bleeding from the gums continued.
Pain in the whole body remained.
Patient passed 3 motions in the morning. The first one was loose and subsequent two were normal.
Left cervical lymph nodes got enlarged during fever and when there was no fever these would become invisible.
Reddish brown discoloration of the skin of the body was no more.
Bluish purple spots (purpurea haemorrhagica)
were no more on the upper left arm and abdomen but appeared on the back.”
Since the patient was getting the temperature often along with haemorrhages, following prescription was made this time.
R/ 1. Ars. Album 1M, 6 doses (SOS) 3-4 hourly.
Ars. Album 10 M, 6 doses (SOS) 2-4 hourly (when the temperature does not come down by No.1.
Acid Nitric 10M 3 doses (SOS) 4 hourly when the temperature does not come down by No.2.
Ars. Album 50M 6 doses (SOS) 4 hourly when the temperature does not come down by No.3.
Acid Nit. 50M 3 doses (SOS) 4 hourly when temperature still does not come down by No.4.
N.B.: The attendant was instructed not to give allopathic drugs in the first and second instance but if homoeopathic medicine did not work only then the former could be tried. No PLO was given this time as there were already sufficient PLO left with the patient.
The attendant revisited me on 29th June and reported:
“on 20th June evening, no rise of temperature
On 21st June morning at 7 p.m. – 100 degrees Fahrenheit – Ars. Album 1M
As the temperature continued throughout the evening and night, the patient was given 3 doses of Allopathic drugs. On 22nd June Morning –
Temperature – 100 degrees Fahrenheit, Day time – 102 degrees Fahrenheit
Evening at about 7 p.m. – 100 degrees Fahrenheit.
At Night below 100 degrees Fahrenheit.
On 23rd June: Morning at 8 A.M. – 99 degrees Fahrenheit N.B.
Forenoon 11 A.M. – 98 degrees Fahrenheit
Evening 7-8 P.M. – 100 degrees Fahrenheit
Night 9 to 9:30 P.M. – 102 degrees Fahrenheit
N.B. Although I did not mention the names of medicines of any kind in my case file but there could not have been almost low-grade temperature without giving medicines.
On 24th June, 1992: Morning – 100 degrees Fahrenheit Ars. Album 50 M
Forenoon at 11 A.M. – 102 degrees Fahrenheit Ars. Album 50 M
Afternoon at 11 A.M. – 102 degrees Fahrenheit Ars. Album 50 M
Afternoon 1.30 p.m. – 102 degrees Fahrenheit inj. of allo. drugs
Evening 6 p.m. – 102 degrees Fahrenheit Tab Steroid and Antiypyretic given.
25th June, 92 No rise of temperature – still the patient was given above mentioned drugs.
N.B.: The patient was given allopathic medicines, might be as per instructions of the attending physician or as a precautionary/preventive measure.
26th June, 92 Morning, Forenoon, Noon temperature 100 degrees Fahrenheit
Afternoon at 3 P.M. Nitric Acid 50 M
At 6 P.M. Inj. allopathic drugs.
At midnight 1 dose of allopathic drugs.
27th June, 92 Morning 100 degrees Fahrenheit Allopathic medicines
Noon 100 degrees Fahrenheit Plo
Afternoon 100 degrees Fahrenheit
Evening 7.30 P.M. 100 degrees Fahrenheit Ars. Album 50M
Night 9.30 P.M. 100 degrees Fahrenheit Ars. Album 50M
Night 11.30 P.M. 100 degrees Fahrenheit Allopathic Medicine
28th June, 92 Morning 6 A.M. Normal Allopathic medicines
Forenoon 10.30 Normal Plo
Afternoon 100 degrees Fahrenheit Allopathic drugs
Evening normal
Night normal
On 29th June, 92 the attendant further reported: Morning – Normal Body temperature
The patient felt pain all over the body during fever and desired the body to be pressed lightly.
Mouthful: Bleeding from the gums in the morning daily. Thereafter no bleeding.
Temperature during last one week i.e. from 20th June to 28th June did not go beyond 102 degrees Fahrenheit with the use of different potencies of homoeopathic medicines as well as allopathic drugs which otherwise would go up and above 104 degrees Fahrenheit—
Cervical lymph nodes becoming prominent during fever.
Since the patient was still getting fever off and on and he was also having bleeding in sufficient quantity from his mouth(gums) owing to low platelet count (thrombocytopenia), I presumed bleeding resulted in weakness, which further resulted in rise of body temperature quite often. It was therefore imperative to stop the bleeding first so that the rise of the temperature could be stopped and thus use of immunosuppressive allopathic drugs could be stopped.
Keeping in view this fact in the mind, I made the following considerations for the selection of another suitable remedy. The following symptoms were taken into account and repertorisation was done as per Kent and Kerr repertories.
Blood, Anemia: Pernicious, in Constitutional breakdown by gonorrhoea, syphilis, alcoholic etc.
Tendency to haemorrhage from gums, mucous membrane and skin, blood non-coagulable. Knerr Page. 820.
Blood, Leukemia (Leucocytemia) – Constitution broken down by gonorrhoea, syphilis, alcohol, etc. Knerr Page. 822. Fever, blood:
Haemorrhagic symptoms or tendency to putrescence Knerr Page 1091.
Fever, continued: haemorrhagic: oozing of dark thin blood from capillaries,
Kent Page. 1060.
The common medicine was found to be Crotalus horidus (basically an antihaemorrhagic medicine and the cognate of Lachesis. Lachesis is presently being considered and developed as an effective medicine for AIDS patients by Researchers in the U.S.A)
The medicine was given in 30 potency, nearly 21 doses to be taken as SOS, BD, TDS or QIDS. Since I was over-confident, I had instructed the attendant to give only this medicine to the patient for fever as well as for bleeding from the mouth. The attendant contacted me on phone on 5.7.92 and informed that temperature was now rising to 103-104 degrees Fahrenheit and would not come down merely by giving homoeopathic medicines. He did not speak about bleeding from mouth. I too could not ask him about this. Therefore I presume that the patient might have been given the usual course of steroids and antipyretic drugs, in order to bring the temperature down. Although I had asked the attendant to come to Chandigarh for Change of medicine but he did not turn up. Later on I received a letter describing the same thing as was narrated by him on the Phone. I sent a letter advising him to come for the same medicine which was able to contain the temperature to some extent or some new medicine could also have been looked into but there was no response from the patient side. Later on, sometime in Oct’ 92, I came to know through some reliable source that the patient had succumbed to the fatal disease.
Comments: After having successfully tried homoeopathic medicines on another HIV +ve patient who became asymptomatic i.e. free from AIDS symptoms, I have come to the conclusion that this patient was rightly kept on Ars. Album for his fever and general cachectic condition and there seemed some respite in the rise of temperature as it did not go beyond 102 degrees Fahrenheit but Ars. Album did not help him in bleeding from the gums i.e. in raising the Platelet count, for which either Phosphorus should have been preferred to Crotalus horidus on three reasons: first it is a great constitutional (lean and thin or wrecked) remedy. Secondly a great antihaemorrhagic medicine particularly for the purpurea haemorrhagica of the gums and thirdly a great complementary to Ars. Album or Crotalus Horidus could have been given in high potency doses may be Ars. Album way had the attendant turned up for the medicine. I can’t say what other homoeopathic physicians would have done, if this patient was taken to them but it is a fact that in the absence of clear-cut symptoms, the points of consideration for evaluation of the symptoms and selection of remedy would definitely have been i) drugs after-effects ii) Pathological manifestations and iii) Syphilitic history.
Since the condition of the patient had already been made critical by indiscriminate use of immunosuppressive drugs, the patient in fact needed constant observation by expert physician especially for the administration of the medicine.
I think I did my utmost in such a situation when the patient had already spent his time, energy and money either to private allopathic practitioners or at the PGIMER, Chandigarh through repeated clinical investigations, etc. for being declared HIV positive patient. Hardly an hour time was given to me for the case taking, examination of the patient, who was a rejected case and was in a terminal stage of a fatal type of the disease where his life principle was completely downed by the drugs. The result was death of the patient. Now I can say with confidence that had the patient been brought well in time and kept under constant observation here at Chandigarh, he would have been helped to the extent of removal of the presenting symptoms i.e. asymptomatic stage of the disease within this short span of time with homoeopathic (trial) treatment. The patient was already declared HIV –ve i.e.
sero-negative on the basis of HIV test report dated 12.2.92.
HIV consideration: While going through the details of the case reports and nature of treatment provided to the patient, it is clear that the immunity, in other words; the body’s resistance power or the vitality of the patient was first weakened by STD, most probably by Syphilis and by the immunosuppressive drugs thereby giving chance to HIV to invade, proliferate and destroy the special WBC i.e. T4 cells, which in turn further deteriorated body’s immunity. Thus a vicious circle went on. The test reports for HIV however show how a patient who was HIV negative in the beginning both by ELISA (Ensyme Linked Immuno Sorbent Assay) test as well as by Western BLOT when kept on steroids and other Immunosuppressive drugs, ultimately got declared an HIV +ve case just by ELISA test which was not even confirmed by the Western BLOT. Further the same patient was declared negative for HIV by ELISA test alone. Another notable feature of the case is, that even near similimum medicine like Ars. Album could not help the patient from his terminal stage of the disease because the patient was still kept under such drugs as are basically immunosuppressive and were responsible for creating such a state of affairs, so called HIV/AIDS condition.
Now, like many readers, I can vouch that this case was the fine example of Immunossupression caused by STD, the syphilitic and allopathic system. It was wrongly simulated and treated as an HIV/AIDS condition from the beginning.
*Detail of the essence given in the book – AIDS, FACTS, AND MHYTHS by the author.
Dr. P.S. Rawat
B.Sc., B.H.M.S.
Place: Chandigarh M.D.(Homoeo)Scholar
Date: August 15, 2010 Cum Clinical Researcher
Formerly:- Professor & Principal-cum-officer incharge Research,
H.M.C & Hospital Chandigarh and
S.A.S Nagar (Mohali) Punjab. M.D (Homoeo)
Address for correspondence:-
Flat No. 2032/1, Sector 45-C,
Chandigarh (U.T), Pin-160047 INDIA.
Phones: 91-9456577638, 91-9463966155, 91-0172-2630069
E-mail addresses: dr.psrawat47@gmail.com, premrawat182@gmail.com