Sjogren’s – look beyond dry eyes

When you have a hammer in your hand, everything looks like a nail!
Sjogren's Syndrome dryness moist parts

Sjogren’s – dryness of moist parts – like a dried up river

Sjogren’s Often Overlooked

Sjogren’s Syndrome is far more common than is diagnosed. Why is this?

Taking a patient’s history
In conventional medicine, taking a history (anamnesis) means a G.P. or “specialist” in a particular field of expertise, will ask a patient a few specific closed-ended questions. In homeopathy, case-taking means a very different thing. We tend to eschew specifics and take a detailed history of the person’s whole story, including family history, personal history, the development of their illness and the associated symptoms – mental and physical.

This is because, as Hahnemann says in aphorisms 6-8 of the Organon (here or here), disease consists in the totality of symptoms and if the totality of symptoms are removed then the disease is cured internally and in its entirety. Treating a single symptom, as medicine does, is only a symptomatic palliative treatment and is to be avoided. (See Hahnemann’s instruction on this in paragraph 18 of the Organon here or here)

To understand a person’s history let’s look at the aetiology of the word as well as its antonym.

Anamnesis: remembrance, the act of remembering, from Greek ana- denoting backward motion (looking back) and mimnēískō, call to mind”.

Amnesia: from the Greek words; without and memory: forgetfulness.

What is to be remembered can be debatable and arbitrary – though not meant to be restricted to answering yes/no questions – and is beyond the scope of this blogpost but what I do wish to emphasise for the purpose of this post is the reason doctors almost always miss a diagnosis of Sogren’s Syndrome. To explain the reason why this is a common problem, let me relate a story from the wisdom literature of Anthony De Mello, S.J. (link).

An artist had just finished painting a portrait of a young lady. Pleased with his work he asked a friend, a local doctor, to view it. “What do you think?,” asked the artist. “It looks like double pneumonia,” replied the doctor.

This story reiterates the joke at the top of this post and emphasises the difference between a homeopathic case-taking and a conventional one. Homeopathy looks at the whole person and their story, not the physician’s own limited specialty. This isn’t a problem limited to medicine either; a chiropractor often sees a patient’s problem as being due to their back. Even cold sores have been blamed on the need for “an adjustment.” (For a guide to a more detailed history-taking have a look at Hahnemann’s explanation in his Organon, aphorisms 83-92, on the individualised examination of a patient (here or here) and in aphorisms 93-100 where he explains the importance of a personal history of a patient (here or here).)

Sjogren’s Syndrome

Now we understand the limitations with conventional medical case-taking, it is easier to understand why doctors miss seeing Sjogren’s. Here’s the typical scenario. A patient – almost always female – goes to her family physician complaining of a gritty sandy feeling in her eyes. “Oh,” he’ll say, “you’ve got dry eyes” and will prescribe something on that basis. Had the doctor not reached a preconceived conclusion so hastily, he could have asked, “well, do you feel dry anywhere else: inside the nose?; the ears?; the mouth?; vagina?; dry skin?; in the trachea?” If the answer to these questions is yes, then we can assume she has more than dry eyes; she has Sjogren’s.

These patients are so dry, in fact, they will confess to being bone dry regardless of how much water they drink. It’s as if none of the liquid consumed is absorbed. You will probably find on further investigation she suffers from some sort of “arthritic” pains. This is to be expected as Sjogren’s is an auto-immune disease affecting the connective tissue.

Treatment of Sjogren’s

While it is not the homeopathic way to recommend a specific medicine for a specific disease name, one remedy in homeopathy is almost specific for Sjogren’s. A medicine can be specific if it suits the characteristic symptoms. (Just because somebody put a name on a group of symptoms does not mean one remedy cannot fit a specific disease most or all of the time. This is why the remedy Asclepias tuberosa will suit most people with cystic fibrosis.) The remedy I’m thinking of appropriately is physiologically a constituent of animal/human connective tissue. To quote the authoritative Wikipedia (here),

The current consensus is that it certainly seems important in the growth, strength, and management of many connective tissues. This is true not only for hard connective tissues such as bone and tooth but possibly in the biochemistry of the subcellular enzyme-containing structures as well.

This same remedy is used by Blackmore’s, the Australian naturopathic company, who regard it as the “beauty mineral” as it keeps moisture in the skin and helps maintain the skin’s elasticity. In toxic doses, silica causes silicosis, lupus, scleroderma and other auto-immune diseases. So, you see the connection between Silica, our homeopathic remedy, and Sjogren’s? Other remedies I’ve found useful over the years are Abroma augusta and Natrum muriaticum. You might also consider some of the Lanthanides as per the observations and Element Theory of Dr Jan Scholten.

The Wikipedia entry on the origins of the term Sjogren’s Syndrome (link) and the “discovery” of the symptoms by the ophthalmologist Henrik Sjogren is as follows,

Johann von Mikulicz-Radecki (1850–1905) is generally credited with the first description of Sjögren’s syndrome. However his criteria wasn’t clear… In 1930, Henrik Sjögren (1899–1986), an ophthalmologist in Jönköping, Sweden, observed a patient with low secretions from the lacrimal and salivary glands. Sjögren introduced the term keratoconjunctivitis sicca for the symptom of dry eyes (keratoconjunctivitis). In 1933, he published his doctoral thesis, describing 19 females, most of whom were postmenopausal and had arthritis, showing clinical and pathological manifestations of the syndrome. Sjögren clarifies that keratoconjunctivitis sicca, resulting from water deficiency, had no relation to xerophthalmia, resulting from vitamin A deficiency. Sjögren’s thesis was not well received as the Board of Examiners criticized some clinical aspects.

But one has only to look at the homeopathic literature to find observations of Sjogren’s symptoms (e.g. the rubric for the symptom “dryness of usually moist parts”) by homeopathic doctors predating Henrik Sjogren by some 150 years…

Credits Photo: Wikimedia: Dried river bed between Skoura and Ouarzazate. Page link

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