Welcome User!
Case Study

Two Sides Of The Same Coin
Dr Raji Govindarajan
'Phos / Thuj / Carb-v

Two cases of bleeding PR were cured by the same remedies, their prescriptions backed by constitutional factors.

Case 1: Retarded Young Man
RM, 26 yr, came on 16.7.97 with his mother. He was fair, tall, slim and good-looking Throughout case taking, he just sat with a smiling and contended expression on his face. The entire conversation was only with the mother. He only tried to repeat some of mother's words like a parrot. In mother's words:

"My son is mentally retarded and has congenital hydrocephalus. I was vaccinated for small pox when I was 3 months pregnant with him, which I feel has affected his brain. By nature, he is very affectionate, happy, cheerful and behaves like a 5 year old. He can speak a little English, Hindi, Tamil and can partially express his needs but is unable to read nor write. He went to a special school till last year but learnt nothing. He loved to go to school only to be with small children and took good care of them".

Appetite, thirst, urine, stools, sweat, sleep - normal; desires - sweet.

Chief Complaint
Profuse bleeding per rectum for last 15 days. Patient never complained but walked around restlessly with an anxious expression. Under garments were always bloodstained. He refused to allow any doctor to examine him. Mother was worried due to his deteriorating condition with so much loss of blood.

P/H Protruding bleeding piles for the past 5yrs on and off. < Constipation. Frequent in past 8 mths.
F/H F-Parkinson-bedridden for the past 7-8months. MGM - HT and breast cancer.

Other Details
Patient took care of his ailing father, by attending to his day to day needs- taking to bathroom, making him sit, feeding him etc. Slept only when his father slept. Looked very upset and wanted to know why dad was not playing with him. He was very attached to his father, who spent a lot of time playing with him until his illness .He loved to dress up and tore the clothes he did not like. He loved traveling, eating out and the company of family members. He was exuberant when his recently married sister visited him and refused to leave her side even for a second, which surprised everybody.

For the past 8 months the patient's complaint was < +++ as a result of his fathers illness. Even though mentally retarded, he was capable of reacting to both joy and sorrow.

Repertory-Synthesis-edition 5.2 edited by Dr. F.Schroyens
Pg - 4 Ailments from grief : Aur, Caust, Cocc, Ign, Lach, Nat-mur, Ph-ac, Phos, Staph
Pg - 771 Haemorrhage from anus: Acon, Ars, Bar-carb, Cact, Calc, Coll, Crot-h, Ham, Lach, Lyc, Nat-mur, Nit-acid, Nux-vom, Phos, Psor, Sulph
Common remedies - Lach, Nat-m, Phos
Phos was best indicated when looked at the person in totality.

16.7.97: Phos 30, 6 p td. SL for 10 days.
31.7.97. Bleeding completely stopped after 1 dose of Phos. Plan-wait
11.8.97 bleeding started again. Father admitted in hospital. Phos 30 bd x 2days
10.9.97 Was fine all these days and had put on some weight. Bleeding since yesterday while straining for stools and protruding piles? Phos 200 6pkts on demand.
12.9.97 Mother called and said that the bleeding had stopped with 1 dose of medicine but he was in great pain and distress and piles had grown in size. Advised to bring the patient to the clinic.
13.9.97 Patient turned up with his mother. O/E rectum-- a mass (size of Lemon) half filled with solid matter and the other with fluid. Patient was screaming with pain. No bleeding in spite of the external growth. Thuja 30 OD x 10d, as it was indicated for the pathology and organ affinity as well as for the H/O mother being vaccinated when pregnant.

15.9.97 thick, stinking, bloody discharge oozed from the growth. Ct. all
16.9.97 Pain subsided completely, oozing still on. Ct. all.
20.9.97 Oozing completely stopped and the cyst totally vanished without leaving any marks. Advised to stop the medication
9.12.98 Was fine all these 15 months. 15 days ago, had severe diarrhoea for one day which was controlled by allopathic medicines. Since yesterday afternoon bright red bleeding from rectum and the cyst was back. Phos 200, one dose, SL 6 days.
14.12.98: Bleeding stopped and the cyst was shrinking. Thuja 30 BD x 2days SL 15days
5.1.99 Since two days sudden bleeding from the rectum. Sister developed labour pain and was hospitalised for delivery. Phos 1M one dose SL 15 days

24.2.99 Mild bleeding from rectum stopped without any medication. No cyst.
15.4.99 Mild bleeding on and off. Phos 1M 1dose, SL 15 days
16.6.99 Diarrhoea with few drops of blood. Phos 1M 1dose, SL 15 days
9.7.2000 Pt is fine.

Case 2: The Wise Old Man
Mr M, 71yr, artist. Fair, long beard and hair. A bachelor and a very talented artist knowing several forms of art. Born into a family of four brothers and five sisters, he worked as a video cameraman in Singapore for several yrs. Earned a lot of money till all his brothers and sisters got married and settled down. Came back to India and took care of his parents and stayed alone after they expired. He was not interested in marriage and lead a simple and pious life. He ate only once a day and did a lot of meditation. He was very helpful, warm and affectionate by nature and spent his time reading, painting, and visiting temples.

Chief Complaint
Bleeding piles for the past 12yrs on and off - bleeding while passing stools . Since one week profuse bleeding +++ as if water from a running tap. Aggr. meditation. Bleeding even while passing flatus. Whitish stools, burning rectum during and after stools. Uncomfortable to sit. Hot flatus.

P/H Constipation, small pox, distended abdomen after eating.

Physical Generals

  1. Food bland diet, eats only once.
  2. Stools, urine, thirst, sweat normal.
  3. Prefers cold weather and takes cold water bath.

Repertory: Synthesis -edn5.2 edited by Dr.F.Schroyens
Pg - 686 Abdomen distension
Pg - 770 Rectum/ Flatus/Hot
Pg - 772 Hemorrhage/Stool during/after
Pg - 779 Rectum/ pain/burning/stool during/after
On the basis of the above analysis Carbo-veg was selected. 17.2.94 Carbo-veg 30 8 p bd.

23.2.94 Bleeding/burning/tiredness much better but still there. Carbo-veg 30 8 p bd.
26.2.94 Bleeding stopped completely but burning still persists Carbo-veg 30 8 p od.
4.3.94 Fine.SL 6p OD.
22.1.95 was perfectly all right for the past 10 months. Return of symptoms now.Carbo- veg 30 8p BD.
25.1.95 No effect, profuse bleeding with protruding piles. Phos was selected as it suited the patient's constitution and his acute condition.
(Pg - 772 Rectum haemorrhage/stool during/after/external haemorrhoids)Phos 30 3 p td.

26.1.95 Bleeding stopped completely. Distention of abdomen, burning, protruding piles persists Phos 30 2 p OD.
The patient is fine till date with no recurrence of his complaints. At the age of 77, he is now leading a very active life and conducts many drawing classes for children, my daughters being his first disciples.