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Case Study

A Case Of Opium.
Piyush Joshi. 
` Op.

The girl was referred to me by the factory owner where the patients father was working. The patient had "some skin complaints which were not yielding to conventional treatment of local applications along with oral antibiotics and steroids.

As the patient was young she could not describe her agony but the father reported - "The skin eruptions started a few months after he birth. We consulted our local doctor (they lived in an industrial area some 20 kms away from this Baroda city) who prescribe few medicines which did not help. Then we were asked to consult some skin specialist, who diagnosed the condition as infantile eczema and gave the above treatment. We religiously continued it for 6 months. With treatment eruptions subsided for few days and reappeared when treatment was discontinued. We consulted another doctor but met with same situation. My employed has asked me to consult you".

Does she have any other complaints? - "No, none at all".
How is her appetite? - "Normal, but she never asks for food".
How is her nature? - "Nature?".
Does she have any spells of moods? - "No, my daughter is very quiet. She never weeps, not even when the soap filters through in her eyes while bathing".
Does she have any complaints regarding stool? -
"Oh, yes, she passes very hard stool like balls, but she does not seem to be affected by it, though it is difficult for her to pass it".
Does she sleep well? - "Yes. If we leave her in her cradle and go out for some work, we are sure to find her there only, without moving from it, but during night if we keep her with us she will roll down out of our bed. (They sleep on mattress on floor) and there she stays the whole night. If we put her back on the mattress, again she will roll down to floor. Why is it so doctor?".

During the whole interview she was seated on her fathers lap. She neither moved any of her limbs nor showed any concern about the surroundings. Her mouth remained open all the time.

I selected the following rubrics:

  1. Synth Rep - Generalities, anaesthesia.
  2. Kent Rep - Mind, Indifference, apathy, suffering to
  3. Kent Rep - Mind, Indifference, apathy, complaints does not.
  4. Kent Rep - Mouth, Open
  5. Kent Rep - Rectum, Constipation, Difficult stool,
  6. Kent Rep - Stool, Balls, like.

On repertorisation, the medicine came out to be Opium.

On 28 January 94 she was given Opium 200 one dose and was asked for follow-up after 20 days. On 14 February, her father reported that patient had developed fever yesterday which started around 10 p.m., and lasted up to 5 a.m. She had constipation again and was very drowsy during the fever. I repeated the same dose. On 21 February, the eruptions started reappearing but subsided by itself within a couple of days.

I have kept continuous follow-up since then and the child is progressing well.