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CASES MATERIA MEDICA GENERAL ARTICLES ABSTRACT MISCELLANEOUS Q & A

Case 72: Doctor I Feel Helpless and Unfortunate!
Dr VISHPALA PARTHASARATHY

Ref: S/ 26 /09 Mar 7/09

Mr DSB, aged 57 yrs came to us on 7/3/09 with severe rheumatoid arthritis since 7 months. He also has been diagnosed with osteoarthritis which got further aggravated after he had a ligament injury of the knee about 2 months back.

Follow Up

NO LOCATION SENSATION MODALITY CONCOMITANT
1 Extremities
b/l knee joints
left knee
since Sept 08
Osteoarthritis
Pain and stiffness
Ligament injury + tear in meniscus
A/f injury (banged knee against bed)
< Morning, on waking, < 1st motion
> Warm application
> Hot water bath
 
2 Finger joints Alternating sides. Pain, weakness,
lack of grip
swelling RA factor 486
< morning on waking > heat3 Yet specialist opined that it is NOT RA.
3 Back Since Sept 08 Pain2 Tired feeling > Bending
> Stretching backwards
He lies with head hanging backwards

PHYSICAL GENERALS
APPETITE: Good
APPEARANCE: Obese (mildly)
THIRST: Increased, about 2 lit/day
CRAVINGS: Salty things, sour, bhelpuri, sevpuri, panipuri
STOOLS: Normal
URINE: Normal
PERSPIRATION: Palms and soles3, offensive odour3
THERMAL STATE: Chilly patient. C4H
SLEEP: Good, but sleeps very light
DREAMS: Daily events

PAST HISTORY: B/L kidney stones- lithotripsy done

FAMILY HISTORY: Sis: OA, Fa: Hypertension, Mo: RA

LIFE SPACE INVESTIGATION: Patient was born in 1952 in a lower middle class family in Lower Parel, Mumbai. His childhood was mostly spent in a financial struggle. There were occasions when they would have one meal for the day. The patient has on brother and one sister, both older to him. The patient somehow completed his education well. In school, he performed well academically as well as in sports. He began working at an early age in order to support his family and had to go to Night College. He had to continue this way for about 4-6 yrs. He completed his BCom followed by LLB and then went on to do a diploma in business administration.

In 1976 he got married, it was an arranged marriage and he was quite content with his married life.

By nature, he is a very religious person and claims to have total faith in God. He says that before he does anything he first thinks if his act will make God happy or not. If not he would not do it. "I am a very sentimental person and feel very emotionally weak." The patient has 3 more years to retire which he wishes to complete successfully. Now that his health is giving way, he is very upset and feels very unfortunate. He says that after retirement he planned a lot of social service and spend time in old age homes or in orphanages. Now if I cannot do that then what is the use of this life? When he was asked what he had wanted to become in life, he said that he always just wanted to be a good man. Whenever he thinks about his complaints it brings him to tears. He is also a very principled man. In spite of holding a very important post at work he never used it to make any extra bucks.

The patient said that even if he saw some XYZs daughter getting married and leaving her father, he would feel like crying. If he watched a family drama on TV too he would feel emotionally charged.

REPERTORIAL TOTALITY
Pain, back, lumbar region, backward bending, amelioration
Helplessness
Unfortunate feels
Conscientious
Weeping at trifles
Indecisiveness
Crying, telling of her sickness when
Avoids fights
Careful with money
Coldness and perspiration of palms and soles
Offensive foot sweat
Chilly patient

REPERTORIAL RESULT
Sil 20/9
Sulph 18/8
Sep 15/7
Puls 15/6
Ign 15/7
Calc 14/8
Lyc 14/6

When we first began the case the remedy coming to mind was Lyco. It was only repertorization that saved us.

Puls seemed to be the most likely remedy; somehow the picture was not complete. The weeping tendency and the indecisiveness was better covered by Puls, while on the other hand, the more important symptoms of the patient of being conscientious and careful and his physical generals of palm, sweat and offensive foot sweat almost confirmed the Sil factor in him. There was no indifference of Sep or the irritability and anxiety of Lyc or the lazy traits of Calc seen in him.

Finally, we saw that Sil also covered the other important rubrics of weeping while telling of his symptoms and for trifles to a marked degree.

REMEDY PRESCRIBED: Sil 200, single dose

Follow Up

Date SYPTOM CHANGES REMEDY
14.3.09 Patient feels overall 30 % >Has also started physiotherapy simultaneously. Placebo
21.3.09 > 40% Sil 200 (2nd dose)
28.3.09 > 50% knee pain slightly increased Rhus-tox 200 as SOS for 4 days Followed by Sil 200 (3 powder doses)

Case: 73
The Volatile Headaches!

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