It was in April 1979, on a sunny day, I was examining a patient in my consulting room at St.Thomas Mission Hospital, Kattanam. A stretcher was moving 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 Mathew, a house wife, aged 32 years having four children, hailing from Niranam, a village near Thiruvalla. It was in september 1978, she noticed that her urine was high coloured. She had itching all over the body. She was admitted to a pirvate hospital in Thiruvalla and investigated. The doctors there detected that she was suffering from jaundice. Since she did not get any improvement, she was discharged from the hospital. A course of Ayurvedic treatment also did not give her any relief. Kunjumol was admitted to a Government district hospital.

 

All investigations were done and the doctors knew that the jaundice was due to obstruction in biliary tract. As her condition deteriorated, she was referred to the best Government Medical college in Kerala state. She was investigated and treated in the Dept: of Gastroenterology of 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 there, showed diffuse narrowing and obstruction in the biliary tract. But they did not know what this disease was. The treatment failed and her condition deteriorated further. The professor of the Gastroenterolology of the Medical college told Kunjmol's husband that Medical science does not know what her disease is and it cannot find out an effective treatment.

 

Kunjumol was later treated at a mission hospital at Neyyoor in Tamil Nadu and had Yunani treatment at Nagarcoil. But her condition worsened 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 it struck to me that 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 I had an intuition that the disease could be due to Anaerobic bacteria and the drug Metronidozole is effective. Immediately I put in a Ryles tube in her stomach and administered Metronodozole in the dose of 800mg thrice daily for ten days. I could not believe myself that she had a miraculous recovery. Her serum bilirubin level came down from 36mg% to 2.7 mg% after 14 days and she started walking in the ward. She was discharged from the hospital after 6 weeks.

 

Kunjumol lived healthy for 20 long 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 of 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 Metronidozole in patients of Primary Cholangitis, in the prestigious International Medical Journal 'Alimentary pharmacology and Theraputics' and they concluded that the drug Metronidozole demonstrated efficacy in patients with 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]. The whole credit for this treatment goes to Jesus.