Welcome User!
Case Study

Alterness is the Key!
NATIONAL JOURNAL OF HOMOEOPATHY 2004 Mar / Apr VOL VI NO 2.
Dr Navin Pawaskar
'Psor / Merc-dul / Tub-b

Baby G C, Female child of 20 days.

Chief Complaints :

Location

Sensation

Modalities

Accompaniments

Liver

Vomiting

 

Sleepy

Hepato Biliary System

Curdled Milk

 

 

 

Distension

 

 

Since birth Abdomen

 

 

 

Freq every 6 hourly

Stool 4-5/day white

 

 

 

Yellow, non-offensive, semisolid

 

 

Onset Age : 8 days Sclera

Yellow

 

 

After birth

 

 

 

Gradually

 

 

 

increasing

Skin Yellow

Not better by

 

 

Mucosa Yellow

Photo Therapy

 

 

Sucks milk well

 

 

 

Cries before urination

 

 

 

Activity normal

 

 

Patient as a Person:

History of mother: morning sickness. Recurrent fever during 1stTrimester.
Delivery: Pre-term 37 Wk; delivered at home
Lactation: Normal
Mental State during pregnancy: no characteristic data available
Reactions: Physical Factors:
Fan: Comfortable with fan at 2-3 speed.

Covering: prefers Comfortable with warm bath.
C3H2

Past History:
Mother: Tuberculosis: before pregnancy. Rx AKT 1 year.
Father Typhoid:
Paternal Grandmother: Tuberculosis

Physical Examination:
GeneralTP - Normal; Resp Rate 30/ min
Local: Conjunctiva No Pallor
Mucous membranes-icteric; Skin-icteric
Hard palate - icteric
Anterior fontanelle open. Posterior fontanelles closed.
Genitals normal. Testes well descended size normal.
Nipple buds well formed.
Umbilical stump NAD.
Anus NAD
Reflexes normal
Unable to hold the head.
RS NAD/CVS NAD.
PA soft/distended/tympanic/child cried on touching Abdomen/Liver ??? finger palpable
Provisional Clinical Diagnosis:
Intrahepatic Obstructive Jaundice

Investigations

CBC

5/02/99

Serum SGOT

60

Hb

7.4

SGPT

80

WBC Total

9650

Bromsulphalein Exc.

17.55

N

29

Bilrubin

T

21.7

E

2

 

D

4.15

L

69

Ultrasonography abdomen scanned

Liver Function Test

04/02/99

organs are normal.

Conceptual Image: Classification and Evaluation of Symptoms

Item
Cause
Aggravations in General
Ameliorations in General
Sensations and Complaints
Mentals
Characteristic Particulars

Data
Tubercular Miasm (Fundamental and Dominant)
Nil
Nil
Stasis
Nil
Liver Hepato-biliary System Periodic Vomiting of curdled milk

Analysis of the totality
Phase: Functional intrahepatic obstructive jaundice.
Freq.: 1 every 6 hrs Cyclical Vomiting
Mucous Membranes: Icteric
Infant (time)
Hepato Biliary system-biliary stasis due to high viscosity.
Phase: Functional intrahepatic obstructive jaundice.
Vomiting Curdled Milk.
Time is the key to the case. Cyclical emphasizes time and the other time is the time in the epoch of the individual, ie the infancy.
Location of the liver assumes secondary importance along with the pathology of biliary stasis due to high viscosity of the bile.
So the remedy which is needed should have the characteristic of time and rhythm and also the stage of life and the disease with characteristic pathology and of stasis and viscous discharges.
Merc-dulcis 
30 was prescribed in infrequent doses.
Tuberculinum
 was used as an intercurrent considering the fundamental tubercular miasm.
Ref Kent: Chapter on stomach as the main rubric and vomiting as the sub rubric.

Follow-up:
There was an extremely gratifying response to the remedy. Within 5 weeks, Bilirubin returned to normal with overall improvement in the general condition.

References
1. Dhawale M L, ICR Educational Series Booklet No. 4: Standardized Case Record (1984), Institute of Clinical Research, Mumbai.
2. Hahnemann S, Organon of Medicine, Aphorisms 83-104, B Jain Publishing Co. New Delhi.
3. Dhawale M L, Symptomatology from the standpoint of Homoeopathic Practice, Principles and Practice of Homoeopathy Vol 1 Homoeopathic Philosophy and Repertorization, Institute of Clinical Research, Mumbai.
4. Kasad K N, ‘Repertorization: Concept and Technique’ in ICR Symposium Volume on Hahnemannian Totality. ICR Bombay Symposium on Totality.

Emergency Case 2
A 9 month chubby male child came with C/o coryza, cough and fever with respiratory distress since 2 days.
There was audible wheeze which could be heard even outside the room. According to the mother audible wheeze was worse only when awake. >3 http://www.njhonline.com/images/toparrow.gif Sleep During
Thirst increased2, fever during
O/E: T: 102F RR: 80/min Suprasternal Retraction + Ch: Wheeze + Bil Crepts
L 2 FP S 1 FP
Observation
: Child was sleeping with arms spread apart. According to mother child usually sleeps on sides.
Totality
:
Respiration whistling < When awake
Thirst increased 2 heat during
Respiration audible > Lying back with arms but stretched

Treatment:
Psorinum 200 Multiple doses resulted in short amelioration
Psorinum
 1M Single dose settled the case

Conclusion:
The case demonstrates the importance of observation during practice for prescription.