Pathogenesis of RA continued. . .
The relative immobility that pervades during sleep only adds to the already existing problem of the stasis of prana. As one begins to move about, the stiffness gradually decreases because the physical movement helps to reinstall a proper flow of prana.
As we have seen, the disease processes of the mind are different expressions of the same underlying energy process. And so, the physical stiffness and rigidity that are so characteristic of RA are reflections of a rigid and inflexible mind. The brilliant homeopath, Edward Whitmont, has described the psychosomatic aspect of RA as one of defensive rejection or stiffening against aggressiveness and emotion.
4. The hands of the rheumatic patient are cool and damp, reflecting autonomic dysfunction.
5. Raynaud’s phenomenon is common in the prodromal period of RA. Other symptoms of the prodromal period may include vague arthralgias and myalgia, anorexia, weight loss, lethargy, fatigue, malaise, weakness and low grade fever. These can present before the onset of actual joint pain or swelling. If we can become aware of these early expressions of the rheumatic process, it can be nipped in the bud by the appropriate homeopathic or anti-miasmatic treatment.
Secondary stage: Onset of the inflammatory stage of RA may be acute with fever and multiple swollen painful joints. The inflammatory rheumatic process, characterized by swollen stiff joints that are painful on motion, typically manifests symmetrically in the smaller extremities—the proximal interphalangeal joints and metacarpal phalangeal joints of the hands and the metatarsal phalangeal joints of the feet. A strong vital force or apana will try to push the disturbing force as far away from the vital organs as possible. When the primary manifestations are in more central locations such as the shoulders, hips or cervical spine, it indicates that the central health or vital force of the patient is in a fairly weakened condition. Other joints that may be involved include the temporomandibular joints, the cricoarytenoid joint and the articulations of the inner ear, since these are all structures that have synovial membranes.
Though symmetry is the hallmark of joint alteration in this disease, the process may be in one or a few joints initially, before spreading to other joints in a symmetrical pattern, but the pattern may also remain asymmetrical. The rheumatic process usually persists in the initially involved joints as other joints become affected—an additive pattern.
In due time, the process in the small joints of the extremities may develop claw-like deformities with flexion contractures or ulnar deviation of the immobilized fingers.
Local stiffness due to an active inflammatory process is a characteristic of the secondary stage. The degree and severity of dysfunction depend on several factors, including the severity and extent of target tissue involvement. Patients with widespread inflammatory joint disease may also have widespread and symmetric muscle wasting and weakness. Lymphadenopathy may be present, with discrete and non-tender nodes.
. . . to be continued
Dr. Barbara Bova, HOD, Dept of Homeopathy