Overuse of homeopathic medicine: An unusual case of Guaiacum toxicity

The case report of a 40 years old male patient who was diagnosed with a sudden decrease of vision and increased respiratory rate after being allegedly injected with a homeopathic medicine was published in the Journal of Association of Physicians of India (JAPI).

The case highlighted the results of overuse of homeopathic medicine Guaiacum which may lead to life-threatening situations and permanent blindness if taken in excess. Also, it addressed the possible link between substance abuse and homeopathic medicine.

In the case report a 40 Yrs old male patient presented with sudden diminution of vision and increased respiratory rate since 1 day after alleged ingestion of homeopathic medicine GUAIACUM 30 (about 200ml). There was no nausea, vomiting, pain in the abdomen, weakness in any limb.

On examinations, his vitals were normal except respiratory rate which was 30/mins. Chest examination was normal with bilateral equal air entry. On visual acuity, finger counting was there. Fundus shows bilateral blurred disc margins.

Investigations show normal CBC, LFT, and KFT. ABG shows severe metabolic acidosis. He was given symptomatic treatment and one session of dialysis. His blood sample for alcohol screen was negative. He improved remarkably and discharged on the third day. Vision improved to 6/60. But in follow up there is no further improvement in vision. Follow up fundus examination was normal.

The authors feel that as the government in Bihar banned alcohol, there is a resurgence of various kinds of substance abuse. As this patient took this homeopathic medicine Guaiacum 30. This medicine is used for various purposes especially for acute rheumatism, arthritis, secondary syphilis, and tonsillitis.

Guaiacum is extracted from flowering plant Guajacum Officinale and Guaiacum sanctum found in tropical and subtropical regions of America and commonly known as lignum –vitae, guaiacum(Spanish) and guaic (French). Gum extracted from this plant used for various medicinal purposes. In the fifteenth century, it was used to treat syphilis.1 It is a uterine stimulant and used as an abortifacient. Its local stimulant action has been described in a Textbook of Pharmacognosy and explained its use in sore throat. Its derivatives are used in the laboratory for testing blood in the stool, as food additives, and an expectorant (guaphensin)

Its toxicity causes restlessness, forgetfulness, dilated pupils, diminution of vision, constipation, and headache.its effects on the retina are not well described. Its long term effect is also not well documented.

Its antidote described in homeopathy is NUX. It was not available to us and so we treated the patient with hemodialysis and steroids for toxic retinopathy. His metabolic parameters improved but the vision shows initial improvement but he had residual vision impairment.

The authors conclude: since we enforce a ban over alcohol by all means, we should be prepared to see more different types of substance abuse which can be lethal anytime.

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www.japi.org