The Importance Of a Good History
NATIONAL JOURNAL OF HOMOEOPATHY 1996 Mar / Apr Vol V No 2.
Vishpala Parthasarathy.
Cases.
` Tarent.

An interesting little girl came to our clinic on 16/4/96. I was out of town that day but my colleague gave her Gelsemium. On the next visit the father gave such an insightful history that the remedy emerged beautifully and she is doing well. That is why, though it is a relatively recent case, I wanted to share the details with subscribers.

This patient was a 2 1/2 years old, thin, tiny, retarded looking child, unable to walk and was carried in by her fathers. The father 39, is an HRD officer in a pharmaceutical company and also a subscribe of NJH.

CHIEF COMPLAINTS:

Epilepsy. Treated with Eptoine 1/2 OD
July 95: Face, Eyes turned up.
Nov 95: Limbs pulled up, stretches arms, Eyes squint.
Muscles all weak. Retracted.

PERSONAL HISTORY:

Height- 28". Weight - 6 Kg.
Perspiration - palms.
Likes to rub nose.
Stool-constipation - Hard stool. Passes alternate day.
Appetite - Poor
Craving - Sweets.
Birth History - Caesarean
Milestones-Dentition at 1 1/2 years. Started Talking words at the same time. Does not walk till now.
Sleeps - only on the swing. Salivation in sleep.
Thermal - Hot. Likes open air. Aversion to Bathing.

MENTALS:

Fear loud noises, crackers, weeps easily. If she gets angry, stretches body like a cat.

PAST HISTORY: Eosinophilia, Chicken-pox, Measles, Worms

FAMILY HISTORY: MGF Asthma; PGF Hypertension; FA Ring Worm, bleeding gums and suppuration.

CHRONOLOGY:

She was born on 13/11/93 on Hindu Title - 13th, 13 years after marriage held on 13/11/80 (13th really proved unlucky in this case!).

She was 15 days post mature. Her birth was through a caesarian section. She did not cry immediately and suffered from hypoxia of brain for which she was kept in the ICU for 12 days. Her CT Scan did not reveal any abnormality. After she was brought home there were a couple of convulsions daily, lasting for a few seconds. There were jerks in Jan 1995. No jerks in Feb 1995.

Later in July 1995, at 4.30 pm she started jerking of face and coughing. There was salivation and frothing at the mouth. She then became conscious from 4.30 - 8.30 pm, was hospitalised, an EEG was done. She was diagnosed as having epilepsy and discharged. She was then taken to a homoeopath who prescribed Puls 30, Bryonia 30, Ferrum Phos 6x. Stramonium 30 and Syph 10M with no result. On the 24th April 1996, when she visited me, her father gave a wonderful history which is as follows.

Fears loud noises. Very angry, sensitive. Loves music and is very sensitive to it. If she hears 1942 A Love Story "Koochh Na Kahon" song she weeps. With music, her restlessness is soothed. She likes Rocking Very moody, impulsive and obstinate. In the morning at a particular time she must see a particular photograph. Nothing can move her from this desire till it is fulfiled.

You really wonder how this little child, so thin and emaciated, hardly able to do anything for herself, can communicate so strongly and firmly.

And you feel great respect for the parents who treat her like a completely normal baby with all the moods and emotions of a normal baby.

REPERTORIAL TOTALITY:

RUBRICS:

1. 1) Hot Patient.
2. 2) SR 307 - Sensitive
3. 3) SR 787 - Stubborn
4. 4) SR 778 - Music ameliorates.
5. 5) SR 861 - Rocking ameliorates
6. 6) SR 761 - Moods, changeable
7. 7) SR 607 - Impulsive.
8. 8) SR 39 - Anger, violent.
9. 9) SR 955 - Fear loud - noise.
10. 10) KR 417 - Salivation.
11. 11) KR 221 - Perspiration on head.
12. 12) SR 983 - Suspicious/ Superstitious
13. 13) KR 1390 - Periodicity.

Ars Bell Cham Bufo Hyos Sulph Lach Nux-v Plat Plb Taren

1. Hot patient
2. 1 3 2 - 1 1 3 3 2 1 1
3. 2 3 3 - 2 2 1 3 1 1 3
4. - - - - - - - - - - 4
5. - - 4 - - - - - - 1 -
6. 2 2 1 1 1 1 1 3 2 1 1
7. 2 - - - - - - 1 - - -
8. 1 1 3 - 2 1 1 3 2 - 3
9. - 3 - 1 3 2 - - - 1 -
10. 1 2 2 1 1 2 2 3 - 2 -
11. - 2 1 - - - - - - - -
12. 3 2 1 1 2 3 3 2 1 1 -
13. 3 1 - 1 - 2 2 - - - 2
14. 19 17 5 12 14 13 18 8 10 12 8 9 8 5 7 8 7 7 5 8 5

Remedies for Differentiation: Sulphur, Hyos, Lach, Plb, Tarent-hsp.

Tarentula-hisp picture clearly emerges on referring the materia medica.

FOLLOW-UP:

24/4/96 Tarent-H 200 - 1 dose. (1).
+ SOS if convulsions.
2/5/96 Marked improvement. Placebo.
Sleeps in afternoon.
Constipation better.
Salivation decreased.
Sleeps without swing.
Acidity decreased.
On hearing song still weeps.
9/5/96 some complaints + Tub b 1M - (1) -1st Night.
constipation > Tarent-H 200-2nd dose-.
2nd Night
11/5/96 Sleeps only with swing. Tarent-H 200 -3rd dose.
Averse outing. Mild.
convulsion. (Tarent given.immediately)
18/5/96 11/5/96 very uncomfortable.
Sleep 0. (?<) Placebo.
12/5/96 Slight better. Placebo.
>cold>sleep>No convulsions.
Can lift head, leg, turns. without crying.
Photo must see in morning.
Talks sings (in her own way)
6/6/96 > Activity all better Tarent-H 200-4th dose.
App poor. Stools 1/2 days. Omit Eptoin.
Convul 1/w x 4 secs.
Takes bath without crying.
Still under active treatment.

CONCLUSION:

This case has been given mainly for the purpose of teaching a good history. There is no way this remedy could be found out without the father narrating the history. We are not claiming cure, but just establishing good improvement.

CASE 2:

A young girl 6 years, brought by her mother on 17/2/96 for Epilepsy which started three years ago.

Her Father work for MTNL and Mother, 36 a BA, Red, works in Reserve Bank of India. She has a brother 3 1/2 years and a sister 7 years and stays in Dahisar.

Her epilepsy started since 3 years in 1993, averaging once in 2 weeks. A typical attack starts with shivering, mouth turns left then right and eye balls are turned upwards with frothy salivation. Attack lasts about 1 minute. Then she hugs the mother and snores. She is on Tegretol, Epilex, Permoline 20 mg, 1/2 am, Frisum etc.

Repertorial Totality Pg No

1. Hot patient
2. Anger Violent SR 39
3. Restless pulls hair SR 835
4. Fear Dark, alone SR 487
5. Affectionate SR 13
6. Clings SR 143
7. Sleep talks starts SR 957
8. Perspiration profuse K 1299
9. Craving Fish (3+) SR 242.Salt SR 266
10. Aversion Sweets SR 274

OTHER COMPLAINTS:

Frequent monthly colds and throat infection and cough, with sinus X-ray +ve. Fever of 103 frequently for which she was given Anti-Kochs treatment for 6 months. (Remalizin PPA).

PATIENT AS A PERSON:

Lean, 20 kg, 39 1/2", profuse sweating slightly dull and reserved looking.
Appetite - good.
Craving - Fish (3+), Spices, Salt.
Aversion - Sweets.
Stools - hard.

Developmental Landmarks: Her mother had vomiting in all pregnancys. She was FTND, weight 3 1/2 Kg. Dentition 8th month. Walking months.

Thermal - Hot. Fan desires. Likes open air, winter. Worse in sun, summer. Hot bath.

MENTALS:

Anger (3+). Violent. Pulls hair. Fear being alone. Dark.
Poor concentration.
Sleep Drowsy always.
Concom: Talking, Thumb sucking. Starts.
Past history: Chicken pox.

Family history:.

PGM, PGF : Hypertension.
MGM. : IHD.

PLANNING & PROGRAMMING:.

Constitutional : Stramonium 200.
Acute : Bell/ puls 30.
Aco Ars Bufo Bell Cham Hyos Lach Nux Puls Sul Str Tar Tub

1. 3 1 - 1 3 2 - 3 - - 1 3 -
2. 3 3 - 3 2 3 2 2 3 3 3 3 1
3. 2 - - 1 - - - - - - 4 - -
4. - 3 1 1 - 3 - 1 2 - 2 1 -
5. 1 2 - - - - 1 2 2 - - - -
6. - 1 - - - - 2 - - 1 1 - -
7. - 3 - 3 - - 2 2 - 3 - - 1
8. - 2 1 2 1 2 2 2 2 2 1 - 3
9. - 1 - - - - - 1 - 1 - - -
10. - - - - - - - - - - - - -
11. - - - - - - - - - - - 2 -
12. - 2 - - - - - 1 1 2 - - -9 18 2 11 6 10 9 14 10 13 12 9 5 4 9 2 5 3 4 5 8 5 6 6 4 3

Intercurrent : Tuberculinum-b 1 M.
Patient under active treatment Stram 200 to be.

TREATMENT and FOLLOW-UP

17/2/96: Cold, cough (Taper Allop gradually Puls 30(7) HS.(Night)
20/2/96: Fever 101 chilly 3 and Throat pain Ferrum-phos 6X
24/2/96: Fever > Sleepy Drowsy (Hom <) Puls 30 (3) HS.
1/3/96: Epil convulsions 4 per day. SL
8/3/96: 1/3/96 Attacks 4/d x 2d. Tub-b 1M-one dose.
(Acute x Intercurrent give).
11/3/96: Acute tooth ache, chilly. (Acute) Hep s 200 1 P = 4
27/3/96: Tooth removed pain +. (Post surgical).
1/4/96: Convulsion 2/d x 2 days. Tub-b 10 M.One dose.
11/4/96: Convulsion after powder (<) Placebo.
1/5/96: Well x 3 weeks. Again Fits 3-4/d Bell 1M SOS.
School has advised to stop attending. Tub b 10 M -2nd.
Fever. dose.
20/5/96: Convulsion 1/15 day (19/5 for 2 secs) Stramonium 200,.1 dose.
14/6/96: Better. No Convulsion for 1 month.
No colds for 6 wks; No hair fall. . 
Anger + Concentration improved.
repeated according to sleep and attacks, after every convulsion etc.

The improvement seen in both these cases show great promise and therefore have been presented prematurely.

CONCLUSION:

In treating Epilepsy the important things which I learnt are -

1. Schedule.
2. To give anti-miasmatic-mainly Tuberculinum every month.
3.  

a.   To gradually withdraw anti-convulsives and take care of ensuing fits by acute or constitutional eg., in case 2, Bell helped more than Stram.

b.   Proper positioning: lateral with extended head.

4. Patient Education: Not to forcibly put spoon in mouth during attack.
5. My pet theory is that prolonged use of anticonvulsants do more damage to the brain than an occasional convulsion.

Therefore Homoeopathy is a much more viable and safer alternative than putting the patient on 2-5 years of allopathic anticonvulsants. I have discussed with Neurologists who felt treatment could be reduced to six months only. But is this also really required?.