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Case Study

Secrets of Classical Homoeopathy
Dr Mirza Anwar Baig

Case 1: She was 33 yrs married woman, lean and tall; suffering from Tracheo-oesophageal fistula. She was weak and bed ridden and was some how fed through "Ryle’s Tube". Initially she had been treated for TB, but her condition deteriorated after conventional anti-TB therapy, thus labeled as a case of Resistant TB. She lost 6-7 kg weight just in two weeks. Now the only option was surgical palliation without any positive prognosis because of the suspected causative TB-HIV-Nexus? The treatment would cost 3 to 4 Lac Rupees. Her husband was only a motor mechanic, owned a small workshop and so opted for Homoeopathy. He came to us with only her reports on 15.07.02, since the patient was not fit to travel.
History of abortion four years ago. Addicted to "Baking Powder" (carbonates of sodium).
ODP: The problem started only few days ago while drinking, (not eating): She started gagging and retching with violent cough. She vomited out whatever was eaten along with copious expectoration. < morning. In the last four years, the patient had been repeatedly treated for chronic cough of Tuberculosis, which started after an abortion. The cause of abortion was the dispute between her and her husband. Husband opposed frequent visits to her mother’s who is a famouts lady who lived in the same town. The difference turned to quarrels and then ended in court! And became a long dispute for a divorce. During this phase, in a fit of anger, she aborted her child but finally repented & compromised and decided to obey husband’s wishes. She stopped visiting her parents.

Past History: Frequent colds. Severe cough with expectoration. She was disgusted with this kind of long treatment.
History of TB in the family (paternal side).
Sensitive to heat. Very warm with a peculiar sensation of warmth inside her chest.

Personal History: Disliked milk, but loved ice creams. Husband said that she feels so much heat inside, that she keeps table fan near her chest to get relief. Drinks cold water to keep feeling cool.

Mentals: She was a little peculiar: never wished to cook at home. Always wanted to have outside food. Loved to move around, meet people and discover new food. Otherwise sits at home and does no work. Decent in behavior and good in character.
In analysis of the case, I gave importance to the internal heat. Imagine a patient who needs fan so close and constantly near the chest itself. I have never seen a patient who kept fan near the chest to make him cool.

Other Distinguishing Features: Disgust with the treatment but not irritable; bearing it coolly. Lean and thin but bold and decent. Desire for cold things. Above all suppressed secretions (expectoration) and aggravations < liquids. Remedy!
Lachesis, Phos, Nat-mur 
or Puls? If we repertorise: possibly Lachesis would score maximum. But if one sees the clinical remedy as per the totality of the patient, the possible remedy would be Phos. In addition to this, if one takes patient as a whole and if one also knows about the totality of Carcinosin, her constitution would be of that?
 and Carc rare similarities and difference. One can learn with an insight, which can come after a little exercise.
Until I am sure about the remedy I don’t prescribe. There were many missing links! Whether it was an arranged marriage? What was the cause of dispute which escalated reach court and abortion? And what was the factor, which made them compromise? So I went on delving into the case. As I told earlier, he came with her reports and not with the patient. A friend of his had accompanied him. I asked his friend to wait outside.

History: Love marriage. Her mother had political links; she was the chairperson of that political party organization, which looked after women’s welfare. But husband believed rumors, (or facts), that organization also used to supply women to some politicians!
After the compromise and reunion, she didn’t visit her mother. She was true to her husband. I selected the following rubrics:
Bold & Decent,
Lean & Tall,
Ailments from disappointed love with silent grief. Warm; desire for cold things and fanning. I also included the pathological symptom; swallowing difficult, (liquids).
Sensation of heat inside the chest.
 30, single dose was sent to her on 15.07.02, follow up on 18.07.02, report encouraging. Patient slept well and looked comfortable. Patient kept on improving, she also gained weight. We also asked removal of Ryle’s tube.

02.08.02 cough less but expectorant easy and copious. Difficult in swallowing liquids and solids were still persists. To which she became nervous and timid. Silicea 200 single dose was administered as complementary. Follow up was further encouraging. She gained more weight. Loose expectorant with cough more towards morning. Now she was hopeful.

19.08.02 Sulphur 200/single dose as intercurrent. Again good response, weight further gained, started moving around. Appetite also improved but liquids were still gagging. Reported by her husband on 26.08.02.
Now nosode I (Carcinosin) was given to her. Husband again reported on 02.09.02 good response. Now husband made me talk to her on phone. She was in good mood but as I asked about her mother she burst out in tears. Nat-mur 30/single dose was sent to her on 02.09.02.

Patient reported personally on 16.09.02. She was absolutely fit. Nat-mur dealt the final stroke towards her recovery, possibly as causative remedy. Brooding in silence. Now she walks, talks, eats, and drinks (without Ryle’s tube) and also goes out. Husband also changed his attitude. He took her to her mother’s place. Her recovery was a shock for the surgeon who told them the only option was surgery! Maybe that surgeon would also be converted to homoeopathy!

In terms of Urdu Poetry the actual Rubric was: "Atka Kaheen Jo Aapka Dil Bhee Meri Tarah; Roya Karenge Aap Bhi Phehron Isee Tarah."

If your heart would also be stuck like mine, you will also weep (non-stop) like this!

(Ed: It would really help if the claim of tracheo-oesophageal fistula had been substantiated by investigations or later by showing that fistula closed.)

Planning and Programming:
Acute: Phosphorus.
Complimentary - Silica
Intercurrent miasmatic: Sulphur
Constitutional: Natrum-mur. Carcinosin.

This is one of my most gratifying cases she is so well she can walk! It was really a mystery of Homoeopathy! It was so difficult a case. . .