It was in April 1979, a sunny day, I was examining a patient in my consulting room at St. Thomas Mission Hospital, Kattanam in India. A stretcher moved towards me carrying a female patient.
I was stunned by the pathetic look of the patient. She was looking at me in despair and agony. I knew that she was in a sinking state. She was kunjumol, a housewife aged 32 years hailing from Niranam, a village near Thiruvalla, in India. It was in September 1978, she noticed that her urine was high colored. She had itching all over the body. She was admitted to a private hospital in Thiruvalla and was investigated. The doctors there detected that she was suffering from jaundice. Since she didn’t get any improvement, she was discharged from the hospital.
A course of Ayurvedic treatment also didn’t give her any relief. Kunjumol was admitted to Government District Hospital. All investigations were done and the doctors knew that the jaundice was due to obstruction of the biliary tract. As her condition deteriorated, she was referred to the best government medical college in Kerala state. She was investigated and treated at the department of Gastroenterology at the medical college for three months. The doctors suspected of cancer in the abdomen. Hence they did the surgery ‘Laprotomy’ on her.
They found that her liver was enlarged but there was no sign of cancer. The investigation named ‘Cholangiography’ done showed diffuse narrowing and obstruction of the biliary tract. But they don’t know what this disease is. The treatment failed and her condition worsened further. The professor of the Gastroenterolology at the medical college told kunjmol’s husband that medical science doesn’t know what her disease is and it can’t find out effective treatment. Kunjumol was later treated at a mission hospital at Neyyoor in Tamil Nadu. She had Yunani treatment at Nagarcoil. But her condition deteriated further and she was taken back to her home.
Special prayers were offered in the churches and at the Maramon convention. I patiently heard the story of Kunjumol. Suddenly Jesus whispered in my heart, it is the rarest of rare condition, named ‘Primary Sclerosing Cholangitis’ for which there is no specific treatment. Even the etiology of the disease is not known. Again it was whispered that the disease could be due to anaerobic bacteria and the drug Metronidazole is effective. Immediately I put a Ryle’s tube in her and administered Metronodazole in the dose of 800mg thrice daily for ten days. I could not believe that she had a miraculous recovery. Her serum bilirubin level came down from 36mg% to 2.7 mg% after 14 days. She started walking in the ward and she was discharged from the hospital after 6weeks.
Kunumol lived healthy for 20 years. I published her case report in the national medical journal JIMA in the year 1983. I also presented my clinical observation at the international level. Dr. Dame Sheila Sherloc, the world authority on liver disease and the chief professor at the ‘Royal Free Hospital, London’, described my observations as ‘most interesting’. The editors of the prestigious postgraduate medical book ‘Harrison’s Principles of Internal Medicine’ showed their appreciation on my clinical observations.
My clinical observations were quoted in many international medical journals. Thirty years after the publication of my article, Dr. James H. Tabiban and associates of Mayo Clinic of North America published their clinical trial with the drug Metronidazole in patients of Primary Cholangitis, in the prestigious International medical journal ‘Alimentary pharmacology and Theraputics’ and they concluded that the drug Metronidazole demonstrated efficacy in patients of ‘Primary Sclerosing Cholangitis’. My clinical observation was quoted by Dr. James J. Tabiban and associates of Mayo Clinic, North America in their scientific article ‘Role of Microbiota and Antibiotics in Primary Sclerosing Cholangitis’ in the prestigious Biomedical Journal ‘Biomed Research international’ [volume 2013- Article ID389537, 7pages].
©Dr. K. K. Mathew