Treatment of Spleen-Centered Symptoms in an HIV-Positive Patient: A Case Review and Materia Medica of Ceanothus

This case review explores the five-year journey of a 33-year-old-woman with human immunodeficiency virus (HIV) whose chronic symptoms were resolved following a carefully selected homeopathic remedy. Homeopathy addresses the whole person, physically, emotionally, mentally, socially, and spiritually making it particularly useful in complex cases where symptoms persist despite ongoing conventional treatment. Before describing the case, a short note about living with HIV in South Africa is included.

Living with HIV in South Africa.

South Africa has the largest HIV epidemic in the world, with about 7.8 million people living with HIV (around 13% of the total population). There is free publicly available Antiretroviral Therapy (ART). Even though HIV has shifted from being a fatal disease to a manageable chronic condition, social and economic challenges remain. Mental health disorders, TB, and chronic pain are common among people with HIV. Public clinics are often overcrowded and under-resourced, leading to frustration or fragmented inconsistent care, especially in rural areas. Many people experience persistent fear of death, rejection, or illness especially early after diagnosis. Depression, anxiety, and trauma-related distress are common but often underdiagnosed and undertreated. Women, especially from low-income backgrounds, face higher rates of infection and still bear most caregiving responsibilities.

Case Report: Patient profile and presenting complaints

Age: 33

Gender: Female

Medical History: HIV (2010), one spontaneous miscarriage (2010), Tuberculosis (TB)  (2015)

Medication: ART for her HIV-positive status

Children: Two alive, one deceased

Consent: Was obtained from the patient.

The patient, a mother of two and former roadside cleaner, presented with symptoms persisting for over three years. Her health had deteriorated to the point that she could no longer work. ART for her HIV-positive status was taken consistently. Emotionally, she experienced intense distress particularly a persistent fear of death, which she described as “every minute, I feel like I’m going to die.” This was accompanied by palpitations and body tremors.

Physically, she reported ongoing pain in the 11th intercostal space on the left side. This was often attributed to her HIV status, and had not yet been thoroughly investigated as a distinct issue, at the time she presented for homeopathic treatment.

Case Timeline

Mid 2018

Initial presentation: palpitations, fear of death, tremors

Symptoms worsened by anxious thoughts

Initial remedy: Arsenicum album 30CH, 10 drops times a day

Late 2018

Worsening psychological symptoms: anxiety, apathy, mood swings

Remedy: Sepia 200CH, 1 powder biweekly

2019

Emotional suppression of grief and anger, sighing, tremors continue.

Ceased working due to intense worry and fear. Afraid that she is not fit for work.

Remedy: Ignatia amara 30CH, 10 drops twice a day.

2020–2021

Physical symptoms stable; emotional state unchanged.

Left-sided chest/abdominal pain linked to panic episodes.

Anxiety considered psychosomatic.

Remedy: Aconite 6CH, 10 drops twice a day.

2022

Sharp pain in left 11th intercostal space. Symptoms still attributed to stress or HIV by her medical team.

Patient presents with anemia and body aches.

Remedy: Sulphur 30CH, 1 powder daily (for possible remedy overuse).

Early 2023

Physical exam reveals splenic tenderness and possible enlargement. Revised diagnosis: splenic congestion.

Remedy: Ceanothus 30CH, 10 drops every 4 hours.

Results within two weeks: Pain subsides, appetite and emotional balance return, palpitations decrease. Patient expresses desire to resume work and care for children.

While earlier remedies matched her emotional state, they failed to address the core physical disturbance, leading to only partial relief.

Turning point: The spleen as a central focus

Dr. Hahnemann emphasised the importance of unprejudiced observation. In this case, a thorough physical exam in 2023, finally identified splenic tenderness and mild enlargement both key findings that had been overlooked. Her long-standing pain clearly corresponded to the spleen’s location in the 11th intercostal space. In HIV patients, splenic enlargement (splenomegaly) is common and can cause left-sided abdominal pain along with systemic symptoms, however, 11th intercostal pain is not common.

This revelation reframed the case: what had been interpreted solely as emotional or HIV-related was, in fact, rooted in splenic dysfunction.

Typical pain patterns in HIV

While people living with HIV can experience various kinds of pain, most of these are secondary to:

• Opportunistic infections (e.g., shingles, TB, pneumonia, etc.)
• HIV-associated neuropathy (often in the feet and hands, not the chest wall)
• Medication side effects (e.g., peripheral neuropathy from older style drugs)
• Muscle aches or generalized pain from chronic inflammation or wasting.

Localised intercostal pain is not a common feature of HIV alone. Clinicians sometimes link new or chronic pain automatically to the HIV status, especially if other causes are not obvious. This can lead to under-investigation of potentially treatable problems.

Final prescription and rationale

With splenic involvement confirmed, Ceanothus was prescribed. According to Boericke’s Materia Medica, this remedy has a strong affinity for spleen-related conditions.

Indications for Ceanothus 30CH:

• Splenic pain and tenderness
• Left-sided abdominal discomfort
• Anxiety rooted in physical imbalance
• Fear about not being fit to work
• Weakness associated with chronic illness.

Though not commonly prescribed for emotional disturbances, it can alleviate psychological symptoms when they stem from a physical origin such as splenic distress.

Conclusion

This case highlights the effectiveness of a holistic homeopathic approach in chronic, complex conditions. The patient’s recovery only occurred after the physical component, specifically, splenic pathology, was integrated into the case analysis.

The success of Ceanothus illustrates the value of revisiting cases that have plateaued and considering overlooked physical signs. This case reinforces homeopathy’s foundational principle: treating the whole person, not just isolated symptoms.

Understanding the spleen’s role

The spleen, is a small organ located in the upper left abdomen, inside the rib cage and is protected by the left 9th to 11th ribs. It is part of the lymphatic system which is part of the immune system. Many different conditions, diseases, disorders and injuries affect how the spleen works. The spleen is not essential for survival as other organs can take over its role. It contains high numbers of lymphocytes and macrophages, the primary targets of HIV, making it a significant viral reservoir where the virus can persist even with effective treatment.

The spleen plays vital roles in:

• Filtering blood and recycling old, or damaged red blood cells
• Storing platelets and white blood cells
• Supporting immune function and fighting infection
• Producing antibodies
• Maintaining the levels of fluid in the body.

Materia Medica of Ceanothus americanus

Ceanothus americanus (New Jersey Tea). Family: Rhamnaceae. Photo attribution: H. Zell

Ceanothus is also called Red Root, or New Jersey Tea because it was used during the American Revolutionary War of Independence as a substitute for tea. American Indians used the root tincture of Ceanothus to treat skin cancer. 

The plant belongs to the Rhamnaceae family and is used clinically for conditions like jaundice, diarrhea, and bronchitis. It is associated with abdominal symptoms such as splenitis, pain on the left side, and dyspnea, particularly worsening with motion and lying on the left side. The remedy is compared with Tinospora cardifolia, Berberis, and Agaricus.

It is to be thought of in cases affecting the lymphatic system or blood cells, and seems to possess a specific relation to the spleen. A left-sided remedy generally. Anæmic patients where liver and spleen are at fault. Chronic bronchitis with profuse secretion. It has marked ability to reduce blood pressure. It is an active hemostatic, materially reducing the clotting of blood. In his book First Aid with Homeopathy, Dr Manuel Mateu Ratera says it is a homeopathic antidote for the effects of radioactivity. 

Mind: Low-spirited, fears he will become unfit for work. Great nervous excitement, with chilliness and loss of appetite; felt as if nerves were shaken; at dinner could scarcely hold knife and fork. “Don’t-care” feeling all the time, and cannot work. Fear of not being suitable to do his job. 

Head: Headache, right side, accompanied by pain in region of spleen. Head seems to move with every beat of the heart. Head feels as if the brain were too large. Dull frontal headache, better from lying down.

Eyes: Feel too large; lids swollen; dry sensation of cornea; with a dull pain in orbital region.

Abdomen: Splenitis. Deep-seated pain in left hypochondrium. Leucæmia. Violent dyspnœa. Unable to lie on left side. Pain in liver and back. Pain and fulness in left side; cutting pain. Pain, inflammation, enlargement of spleen, either alone or with other affections.

Bowels and bladder: Diarrhoea. Constant desire to urinate. Greenish and smelly urine.

Female: Menses profuse, and yellow profuse leucorrhœa which makes the woman feel weak.

Generalities: Chilliness, principally down the back; shivering; rigors; must sit over the fire; < in cold weather. Aversion to move; feels too weak. Cheeks and ears hot, with cold fingers.

Reported cases 

1. C. Majumdar (1851-1922) cured with Ceanothus 3x a case which had been diagnosed as one of heart-disease (there was palpitation and dyspnoea on exertion). Majumdar found the spleen enormously large. 
2. K. Ghosh has cured with it many cases of suppression of menses and leucorrhoea in patients from malarial districts. Menses too profuse and too early with pain in left side. Cannot lie down for pain in left side.
3. Dr. Burnett’s work with Ceanothus (1840-1901) revolutionised the treatment of spleen disorders at the time. He documented numerous cases where patients with enlarged spleen and associated symptoms experienced significant improvement. One notable case involved a woman who had endured left-sided pain for 25 years. After taking Ceanothus, her symptoms resolved, and she regained her quality of life. In many such cases he would prescribe Ceanothus for about four months in small appreciable doses; at first the 1x and then the 1st centesimal.
4. A young lady of about 26 consulted Dr Burnett for a chronic swelling in the left side under the ribs, with considerable cutting pain. She stated that it was worse in cold damp weather, and she always felt chilly; the chilliness was so severe that she had spent the greater part of the previous winter sitting at the fireside. In the summer she had felt nearly well, but the lump, the chilliness and pain nevertheless persisted. Ceanothus “quite cured her of all her symptoms, and subsequent observation proved its permanency”.
5. Eric Sommerman, reported a case in 1992*, of a disabled veteran with PTSD and agent orange exposure who was nervous, sensitive and home bound because of anxiety. He was unable to work and had been unable to work even during his time in the service. The case describes his dramatic cure of non-Hodgkin’s lymphoma with Ceanothus.

Burnett emphasised that Ceanothus is particularly effective for pain deep in the left hypochondrium, often mistaken for heart disease. His success stories underscore the importance of identifying the root cause of symptoms and addressing them with the right remedy.

*Morrison, Roger. Clinically Verified Materia Medica, Vol.1 The tapestry of Homeopathy. HahnemanncClinic Publishing, USA. 2025: pages 551-552.

Thank you to Dr Sandile Gumbi for this case history contribution to the AP blog

Author: Dr Sandile Gumbi 

Qualifications: Masters of Health Science (Homeopathy) Durban University Technology

Certifications in clinical trial ethics and project management

Country and place of practice: Centurion, Gauteng, South Africa

“I’ve come to appreciate that in healthcare—and in life—small improvements can make a huge difference.”