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Case Study

Jaundice-cases from our Heritage
Compiled by
T K Kasiviswanathan
'Sulph / Bry / Nux-v / Chel / Lyco / Crot-h

Case 1
A young woman, aged 18, consulted Dr Dorothy Shepherd for recurrent attacks of gallbladder colic with jaundice and vomiting. She had three attacks after the birth of her child; every 3-4 week. She had no previous illness prior to becoming pregnant. She developed jaundice some weeks before delivery, was hospitalized and diagnosed with instructions to follow a strict diet regimen-no fat, no butter, skimmed milk etc to which she faithfully adhered to and yet the colic attacks with jaundice recurred.

She complained of hammering right sided pains from the region of gallbladder, extending to right shoulder blade; she was restless with pain. The type of pain and location indicated Chelidonium; on the other hand, she had a great craving for fat (Ars, Hep-sulph, Nit-acid, Nux-vom, Sulph). Sulphur was indicated in the highest degree. Further probing her mental symptoms confirmed Sulphur intelligent, inquisitive, typical know-all and argumentative philosopher". Sulphur 30 single dose ameliorated after a week she was better with no attacks of jaundice or pain. When there was a recurrence of pain Sulphur was given in 6 potency bds for 10 days. She was free from jaundice and pain and the remedy was repeated for another 15 days where after she was completely all right.
-Dr Dorothy Shepherd, Magic of Minimum Dose

Case 2
A 6 year-old boy was brought to the above doctor with a history of diarrhoea of 10 days duration, which came on after a chill. The boy by that time was deeply jaundiced, with yellow eyes and encircling deep rings, stools were white and urine thick and deeply pigmented. He was very thirsty for warm drinks, his tongue was thickly coated white; felt worse after eating. He complained of pain in the abdomen especially in the liver and gallbladder region, which was ameliorated by firm ting a cutting, stitching pain in the right side. The symptoms clearly called for Bryonia 30 tds given. He was put stools were usual brown 24 hours later; eyes on examination were clear; and urine was clear in two days.
-Dr Dorothy Shepherd

Case 3 A middle aged man, who, as a master of ceremonies, had to participate in dinner engagements and frequently got attacks of jaundice, yellowish eyes, dirty skin, a coated and foul tongue, worse in the morning with bursting headaches and a wild temper, the morning after such dinners. He obviously could not digest the rich food served in such dinners and "his liver.

Dr Shepherd writes: "The Nux-vom patient is a gourmet; he likes good food, but he cannot eat much; his digestion is easily upset and his liver gets easily disordered by the richness of the particular food he likes. Bryonia on the other hand is a gourmand; he does not mind what he eats, it is the quantity he is after, a ravenous eater and is made ill by eating too much. They both get jaundice a after an attack of anger, Nux-vom feels so angry that he has a desire to stab the person who makes him angry; he is particularly angry and irritable in the mornings. Bryonia on the other hand, loses his temper in the evening. He is very thirsty with his liver and stomach complaints, Nux is not thirsty. Bryonia is worse from motion and better from firm pressure. Nux is worse from slightest pressure and worse motion and has constant and repeated call to go to stool, with a feeling as if he was never done".
Dr Dorothy Shepherd

Case 4
A young carpenter developed jaundice. He complained chiefly of a continuous aching pain at the lower angle of the right scapula or shoulder blade. He was found sitting in bed, bent forward on his elbows, unable to move because of the acute stabbing pain it produced whenever he changed his position. There was creeping chilliness, nausea and vomiting and only hot, almost boiling water, would be retained. He had loose stools bright yellow, confirming jaundice. The first sign his wife noticed was that the carpenter now disliked cheese of which he was very fond earlier. A few doses of Chelidonium 30 cured him of his jaundice, vomiting and pain.
Dr Shepherd

The prescription was based on the characteristic key noted of this remedy. Dr E B Nash writes "The centre of action of this remarkable remedy is in the liver and its most characteristic symptom is a fixed pain (dull or sharp) under the lower inner angle of the right shoulder blade. This very characteristic symptom may be found in connection with general jaundice, cough, diarrhoea, pneumonia, menses, loss of milk exhaustion etc; in fact, no matter what the name of the disease, this symptom present should always bring to mind Chelidonium and close questioning will generally reveal hepatic troubles or complications as would be naturally expected with such a remedy.

Chelidonium is like Lyco, by preference a right a right sided remedy right supra-orbital neuralgia, right hypochondrium and scorbiculum cordis, tense and painful to pressure; right side pneumonia and shoulder painful to pressure; right sided pneumonia and shoulder painful; shooting pain in right hip extending to abdomen; drawing pains in hips, thighs, legs, or feet, more right sided; right foot cold as ice, left natural. Further study will show that Chelidonium is not only a right sided remedy but in many other points stands close to Lycopodium and in my experience one is often found indicated after the other. Although this characteristic infra-scapular pain is as reliable as any in the Materia Medica, there may be cases in which it does not appear at all.

If we should find pressive pain in the region of liver, whether it be enlarged and sensitive to pressure or not, bitter taste in the mouth, tongue coated thickly yellow, with red margin, showing the imprint of the teeth, yellowness of whites of eyes, face, hands and skin; stools grey, clay coloured or yellow as gold, urine also yellow or dark brown, loss of appetite, disgust and nausea or vomiting of bilious matter and especially if the patient cannot retain nothing but drinks, we would have a clear case for Chelidonium even though the infra-scapular pain were absent. All these symptoms may be found in a chronic or acute case. In a chronic case, an anti-psoric like Lyco might have to be employed to help complete the cure, but Chelidonium would be the chief reliance." -(Dr Nash, Leader in Homoeopathic Therapeutics)

Another peculiar and characteristic symptom in this case was the preference for very hot almost boiling water which only could be retained. In Boericke the symptom is italicized as under: Prefers hot food and drink; Nausea with vomiting; better very hot water. This case clearly clinically confirms the peculiar and keynote symptoms of this remedy. It is also interesting to note the marked aversion to cheese of which the patient was fond earlier and insisted on it at every meal; this marked aversion appears in the proving. This case also confirms the need to note the major change in desires and aversions of the patient during illness as compared to his usual likes and dislikes.

Case 5: Find the Remedy
On 7-5-1986, a boy aged 7 years was brought for consultation to (late) Dr Lakshminarayanan for loss of appetite. He was prescribed Lycopodium 1 M once a day for 3 days; but the patient came on 2-5-1986 with suspected jaundice. O/E the liver region was found tender and painful to touch. The unine anlalysis result NAD. The family doctor prescribed Gelnsil and Digene. On the next day, the same doctor suspected enteric fever and referred the case to a pediatrician, who suspected jaundice and hence asked for fresh urine and blood tests. The tests revealed urine red, Birubin and Bile salts were present; also pus and eptithelial cells.

Serum bilirubin test showed 3.5mg%. He was given Liv 52 and B complex tablets. the boy vomited everything including B-complex medicine. Then Dr Lakshminarayanan was consulted; Phos 30 and later 1 M had no effect; Crot-hor 200 doses eliminated the pus cells from the urine but had no effect on the bilirubin. At this stage the mother reported casually that the boy was scratching himself uncontrollably all along but she thought that it was due to some allergy. Immediately on this peculiar concomitant Dr Lakshminarayanan prescribed the indicated similimum in 200 potency four hourly. Within 3 days the dilirubin dropped to 3.07mg% and the urine was clear of bile salts and pigment. By 18-6-86 it cam down to 1.0mg% and by the next day the itching of increased to 10 M in stages and number of doses reduced and by 29th bilirubin level was normal. The patient was his normal self thereafter.

What is the remedy used? It is not the usually remedy for jaundice. The similimum was ascertained mainly on the peculiar concomitant of severe itching of the skin during the jaundice attack. It is a single remedy rubric in Kent's repertory. It cured the patient and the doctor reports that he had cured some more cases of jaundice with this remedy when this concomitant was present in a significant degree. Please take the trouble of finding the remedy by looking up in the Repertory before giving up. Solution on page.
Jaundice- A Peculiar Concomitant In - Dr Lakshminarayananv

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