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Case Study

A Case of Tubercular Diathesis
NATIONAL JOURNAL OF HOMOEOPATHY 2000 May / Jun VOL II NO 3.
Dr Sumit Chatterjee
'Coccus-c / Calc-p / Tub-b

Mast S, 11 years, lean built, was brought on 28.02.2000 with C/O fever, cough and cold for the past 2 months. Homoeopathic treatment taken elsewhere during this period gave no relief.

Fever: Low-grade, intermittent with burning heat of the body. < from evening, through-out night. > next morning, at times with profuse perspiration. Cough +++, paroxymal, ending in vomiting (+++) < esp after eating, < morning after waking Rhinorrhoea, nasal obstruction Dyspnoea - followed cough or after playing a little while. Appetite - reduced (++) O/E: Bilateral nasal polyps and tonsils Chest: Bilateral Rhonchi ++ P/H/O: Broncho-pneumonia 2 years ago, treated with allopathy. Since then patient has been having recurrent C/o cough, cold and fever. Circumcision on 20.05.98. Thinking the recurrent fevers to be due to UTI. But complaints continued to relapse.

Personal History
Appetite: reduced (2+) THIRST: ++
Desires: meat3, egg2 Sour, fast foods.
Aversion: Sweets
Bowels: Alternate days; N; Occ. Pruritis ani, passes small worms in stools
Urine: N
Perspiration: 3+ - all over, scalp and extremities too. Stains yellow.
Sleep: N
Thermals: Hot Patient (2-3+)
P/H - Milestones - N
- Contact dermatitis from sap of a tree - 5 yrs ago
- Blood dysentery - 2½ years ago.
- Broncho-pneumonia - 2 years ago.
- Circumcision (under GA) - 20.5.98

F/H - Mo - PTB - 1992 - Endometrial TB (Rx: 94-97)
Appendicectomy.
Fa - Epilepsy (now no allopathic Rx since last 1 year)
F H/O - Asthma +

Patient is restless2, obstinate2; intelligent2 but has no interest in studies.
Investigations (on 03.03.2000)
- CXR - Hilar Opacities with bilateral patchy pulmonary congestion.
- Mantoux' test: POSITIVE 10 mm x 8 mm induration
- AFB Sputum - could not be performed, as patient could not hawk out phlegm. By then the cough also had reduced considerably.
- Hb - 11.5%, TC, DC-WNL; ESR: 18, 40 mm at 1 and 2 hr respectively.

Treatment

28.02.2000

Cough http://www.njhonline.com/images/rtarrow.gif vomiting, fever - evening rise

Rx Coccus-c 200
TDS x 3 days

02.03.2000

Cough > but fever ++ burning heat, cheeks flushed

Sang-can 200 TDS x 5 days
KM - 6X QDS

11.03.2000

Cough > Fever > but again slipped +App: poor

Sang-can 200-2 doses (Plussing in water) Hydrastis 2x-10 gtt x BD

16.03.2000

Better

SL

28.03.2000

Occ Cough, sneezing, morning A. wakingO/E : B/L - Rhonchi (1+)- N. Polyps +Tonsils +I took advice of Dr Kasim Chimthanawala

Calc-phos 200 - 3 doses in 1 day then SL- Hydr 2x - (5 - 5)

Whole of April 2000

Better - App improving

SL pills.

01.05.2000

Cough again: 3 days ending in vomiting. AGG: Morning waking, Night bed timeRonchi ++

Coccus-c - 200 TDS x 3 days

13.05.2000

Better

Tuberculinum 0/3 - OD
- 16 doses in 120 ml.
- D/W with 2 globules (10 size) and 1ml Rect. Spirit to give 10 strokes before each dose.

29.05.2000

Better

Tub. 0/6 - OD as above

15.06.2000

Better

Tub. 0/9 - OD as above

01.07.2000

Better

Tub. 0/9

05.07.2000

Oral aphthae ++: last 7-8 days; painful, can't eat. On enquiry had H/O Rec. aphthae - so return of old symptom, but causing distress to Patient ++.

Merc-sol - 200TDS x 2 days

The patient is still under observation but his improvement is definite.

Comments 
This case was detected early, before the "disease-proper" (TB) could set in, with its pathological lesions. The Tubercular Diathesis condition which had started 2 years ago (after H/O Broncho-pneumonia) in the form of recurrent C/O cough, cold, fever had towards the end, nearly given in to constancy of the features with no remission in the last 2 months, so that, another few months of improper Rx and the patient could well have become truly phthisical

Discussion: Calc-phos was selected on strong craving for meat, excessive perspiration, lean built and other tubercular symptoms.
Tub was given in LM potencies keeping in mind the fluctuating weather then (May was hot, humid and raining off and on) and the oncoming monsoons dictated repetition to prevent further recurrence of complaints due to the inclement environmental conditions.