My experience with Tb
NATIONAL JOURNAL OF HOMOEOPATHY 2000 Sept / Oct VOL II NO 5.
Dr Anwar Amir Ansari
'Bacil / Ars / Nat-m / Tub / Stann / Bacil / Lyc / Merc-sol / Stpah / Tub / Phos / Bacil / Mezer / Kali-c / Plat

Introduction: I have been fortunate to be associated with masters like Dr S K Dubey and Dr Prakash Vakil who, by their clinical acumen and good use of the available Homeopathic armamentarium, have instilled confidence in me to handle major pathological cases including Tuberculosis cases. Dr Vakil in particular handled numerous such cases at the Government Homoeopathic hospital. Of course many a times we vociferously questioned his approach. But in the end his diligence and experience reigned supreme.

To cite one such case: He was a thin scrawny enfeebled constitution with Pulmonary TB and low susceptibility- the totality pointed to Phosphorous but sir was skeptical in using it due to the cautions given by Kent and other masters. But finally, no other remedy being indicated, we cautiously gave it in 30 potency and we succeeded without any aggravation. Encouraged by the above success, I started treating even Acute Pulmonary TB, albeit low doses cautiously with infrequent repetition.

I encourage others also to treat Tuberculosis.
There were two ways to approach a case:

1. Give a dose and call for follow up after a long time. Remain isolated in our AC chambers. Be satisfied that we have done something Homoeopathic. Be least concerned about what has happened in between all this time and what other medication has been taken in between.
2. Or to give the dose and be in constant touch with the ups and downs of the case. This will cost you a lot of time and patience and much, much botheration.

The second approach pays rich dividends.
Please note bbreviations used: PTB = Pulmonary TB MDR= Multiple Drug Resistant
VDRL / TPHA, Urine Rt N= urine routine normal
VMB= Very much better

Case 1
Mr LYS, 38y. Seen on 30/5/98
Past h/o Koch's in '83. Re-infection Jan '97; AKT for 10 months Fibroinfiltration Koch's cavity (R) apex
Hb-10.8 Gm%; WBC total 7300 N- 57 L-37 E- 4 M-2 B-0 ESR-56 at the end of 1 hr
VDRL / TPHA -ve, Urine (R)-N
CC: Apthous ulcers in mouth - cannot eat though hungry. Bloating after eating.
Burning in the stomach. Burning from mouth to abdomen with burning eructation. Cannot eat anything.
Cough, fever, body ache, congestion chest, weakness, cannot breathe. Throat stuck together. Cannot close fist. Pain from hair to nails.

High-grade fever: sensation as if eyes will fall. Heat emanates from mouth, eyes, vertigo, crawling sensation on face. Cannot sit, walk or sleep - wakes frequently.
Profuse expectoration on coughing - thick balls after 6 to 8 bouts of cough; every spasm gives pain in abdomen. Pain hypochondria to navel < coughing.
Mouth and throat dry, must have water with every morsel of food. Food sticks in throat. Dry sensation in pit of throat.
Does not like people talking. Irritable, Doesn't talk to me, he says. When people talk, the words fall like hammer on my head. Let me be as I am.

Can you treat me fast? He asks the doctor.
Weak and out of breath.
Cough < rising in night. (Restless, Fearful, anxious)

Breathlessness	< lying Rt side
	< lying back on < lying Lt side

Chill < 2.30 - 3.00 pm
Thirst, frequent, small - every 10 mins
Cravings: meat, fish, spicy
Perspiration: profuse < exertion < sitting < face < axilla

1/6/98 - Bacill 200/ 1
The remedy was selected on the symptoms of cough with severe congestion and bubbling rales in the chest; difficult breathing / dyspnoea. It often relieves congestion and paves the way for other remedies in TB (As advised by Boericke)

13/6/98 - S Q SL
20/6/98 - S Q SL
22/6/98 - S Q Arsenic 30/1

Ars-alb was selected on the following rubrics:

1. Talk indisposed to
2. Talk of others <
3. Irritability spoken to when
4. Desire to be carried fast (The patient asked whether the doctor can treat him fast)
5. Restless/fearful/ anxious
6. Dry sensation in throat
7. Chill midnight after
8. Thirst, frequent, small quantities
9. Head pain hammering
10. Perspiration profuse/ exertion from slight
11. Eructations hot
12. Burning in GIT

24/6/98 Fever SQ. headache SQ. But otherwise Pt comfortable. Pain ext > 50%. Pain top to bottom > 50%. Cough > expectoration > breathlessness > restlessness > sleep
27/6/98 >> Rx SL
4/7/98 Vertigo < looking up, turning head - head heavy. Swelling lips, ?from ulcers. Rest But in general feels very. Much Better. Rx SL
13/7/98 General improvement with good sleep and appetite. No clinical symptom.

This case was followed up for 1½ yrs till he shifted to native place in UP.
Has received infrequent doses of Arsenic 30 to 1M over long intervals, although there were no acute symptoms.
His other parameters including ESR and X-ray became normal, but I could not ascertain the detailed reports, as he is not in contact now.

Case 2: HIV + Koch's Abdomen
A colleague referred Mr V V, aged 22 on 23/6/97 for HIV

Chief Complaints: 
Fever every 1-2 weeks, since 1½ years
H/o tuberculous cervical lymph nodes - 1995, Excised. AKT for 6 months. Irregular Hom treatment but with appreciable improvement.
Reported on 17/5/99 with:
Swelling of abdomen / legs
Severe Backache < sitting < walking > lying on hard ground. Weeps whole night due to pain
Pain - soles / ankles < walking.
Fever. Breathlessness on exertion. Admitted for tapping

Diagnosis: ?Koch's abdomen
Fever at night with chilliness < 3 - 4 am and 7 - 8 pm
Thirst extreme, during heat 5/6 glasses at night 8/ 10 times during day.
Unquenchable THIRST with dryness of mouth / lips / throat.
Weakness, feels like falling down. Weakness more in legs.
Chilly under fan but > in open air
Urination - sudden urge during sleep, but no urge when he gets up to urinate.
Feels like sleeping all the time. Aversion to going out though > open air
No stools since 2 days. Eructation frequent after food.
Loss of Appetite. Eating little cause fullness in abdomen.
Desires: spices 3 salty, cold drinks, sour, ice cream3

The following rubrics were selected.:

1. Weeping when alone.
2. Weakness/weary-weakness of lower limbs
3. Pain, lumbar region> lying on something hard
4. Thirst extreme-large quantities/ heat during/unquenchable
5. Mouth-dryness with thirst
6. Bladder-urging ineffectual at night
7. Fever with morning chills
8. Desires salty, spicy and sour food
9. Tendency to dropsy/oedema-fluid retention

Natrum-mur emerges as the similimum
Rx Natrum -mur 0/3 QDS 7 days - then BD till 16/7/99. 17/7/ 99 0/5 BD -15 days.

31/1/2000	- -	Tub 200/1-- wt: 43kg Nat-mur 0/5 BD x 15d
24/3/2000	-	Ctall / 7d -- wt: 44kg
26/6/2000	- -	Tub 200/1 Nat-mur 0/5 BD/7d -- wt: 45kg
11/7/2000	- -	Tub 200/1 Nat-mur 0/5 BD/ 7d -- wt: 47kg

He is doing extremely well till date. Does routine work. No complaints. Good general improvement. Normal CD4 count / ESR etc as seen from the reports enclosed.

Case 3
Miss ANS

Complaints:
Fever - off and on since 1 month
Cough - since 15 days. Expectoration little and difficult
< night, on lying down.
< lying on Lt side  Rt side
Vertigo < morning, on waking
Headache with heaviness in vertex and pain along blood vessels.
Pain in the neck with headache; cannot sit; must lie down
Weakness. There is throat pain and therefore cannot eat.

Nausea since previous day.
Loss of appetite since past few days
Back: Lt scapular pain < coughing
Leg pain but cannot precisely locate the pain. Chilly pt and covers with a shawl.
Irritable, averse to talking. Weep from intolerance of suffering
Irritable < noise. Cannot concentrate < noise. Desires silence/ quietness.
Weeping from anxiety and apprehension that she would not get well. Something will happen to her.

A constant symptom she had was fear of death, that something bad will happen to her and that she will not get well; restlessness and intolerance of pain and the prevalent mental state led to selection of Ars-alb.

Rx Arsenic 200/1
Investigations on 20/12/99
Hb 12.4; ESR 110mm; X- ray chest - Koch's LU and Mid zone
31/12/99 No fever since last 3 / 4 days.
No throat pain - can eat food now
Chilliness slightly better but persists. Loose Expectoration + sweetish 3 thick, and yellow. Chest feels very weak - empty sensation Rx Stannum 200/1

5/1/2000 - cough >>> 75%. No fever. No throat pain. Vertigo + weakness + loss of appetite + nausea
XR chest 4/1/00: Regression in size of lesion since previous one.
Please note duration treatment and pathological improvement along with clinical improvement. Rx: SL
12/1/00 No fever. No throat pain
cough >>>> other symptoms > but +

Appetite - Improved, weakness +
Rx :Stannum 200/1- Rptd as weakness persisting.
Strong family history of tuberculosis.
Bacillinum 200, a dose about 4 times afterwards, at intervals of about 1½ months. She is free of all symptoms and her pathological reports are encouraging. (Reports attached but not reproduced).
Note: She needed Allopathy twice or thrice for acute problems. Each time the GP wanted to start AKT in spite of the constant improvement, but somehow Homoeopathy prevailed.

Case 4
Master MUDS, 3 yr, came on 8/8/97
Lt Cx glands small, mobile soft for 1 yr.
Skin: Vesicular eruptions < summer.
Discharge leaves a hardened area
H/o repeated infections
HOT PT 4 - thin, tall, skinny and emaciated about neck

Profuse perspiration on whole body.
Loss of appetite3- not eating well. Aversion - milk
Heat of palms / soles.
Sharp/ active / good memory/
Speaks a lot; Mixes easily
Family h/o Pulm TB

Rx Tub 0/3 BD/15d
21/8/97 All glands disappeared within a week time - no Medicine.
(Editor: In this case the diagnosis NOT fully established. Normally Tuberculous glands are hard and matted).

C ase 5
An obstetrician referred Mrs MT as she had a third relapse of PTB; this time complicated with pregnancy. She was pregnant, in a pitiful condition- literally bedridden. She came on 27/12/98 with breathlessness, cough, backache, pain in abdomen < coughing.

She was in her 7th month of pregnancy complicated with MDR-TB and Lt Kidney stones. X-Ray - Rt basal Pleural effusion. Urination involuntary < walking < coughing Fever since 5/6 days < 7 pm followed by chills and body ache < 8 am- 12 pm. Cough < lying,<="" p="">

Vomiting < waking on, followed by cough lasting I hour.
Pt is always thinking about the disease, not getting well since 3 years. 3 years back her first child died. She had a fear that this child will also die. Her mother and sister are ill, so Anxiety about all at home in village.
Weeps much, weeps from consolation- tears come automatically on thinking. Feels much relieved after weeping.
Chilly patient < Draft of air < cold
Perspiration profuse < face < chest < coughing on < exertion, breathlessness.

Rubrics:

1. Weeping from consolation
2. Weeping ameliorates
3. Cold in general
4. Anxiety, fear with
5. Perspiration, exertion during slight
6. Perspiration, coughing from
7. Urination, involuntary coughing

	1	2	3	4	5	6	7	Total
Bell	1		2	1	1	1	2	8/6
Cact	1							1/6
Calc	1		3	2	3	2		11/5
Calc-p	2		3					5/2
Chin	1		3	2	3	1		10/5
Hell	1		2	1				4/3
Ign	1	1	2	3			1	8/5
Kali-c	1		3	2	3	1		10/5
Lil-t	1							1/1
Lyco	1	2	3	2	3	1	2	14/7
Merc	1	1	2	2	2	2		10/6
Nat-m	1		2	2	2	1	3	13/6
Nit-ac	1	1	3	2	3		1	11/6
Nux-v	1		3	1		2	2	9/5
Plat	2			2				4/2
Sep	3				3	2	2	10/5
Sil	3		3		2			8/3
Staph	1		1			1	1	4/4
Sulph	1		3		3	1	1	9/5
Tarent	1		2			1	1	5/4
Thuja	1		2		1	2	2	8/5

A few doses of Lyco 30 brought about a remarkable clinical improvement. All her symptoms vanished and the effusion cleared; she had a safe and normal delivery. The obstetrician was so surprised and happy. She has started incorporating Homoeopathic medicines in her practice.

Note that in spite of being a predominantly hot remedy Lyco also covers cold in general < in a high grade. But let me clarify that this chilliness is not the inert chilliness of patients, which we use in eliminating chilly remedies from hot remedies, but the sort of the chilliness persistent with most of the TB cases. This is to put to rest any misunderstanding.

Case 6
Mrs AMA 62 years first seen on 15/2/98
Chief Complaints:
Cough for 3/4 yrs off and on < 3 months
Constant dry cough - evening to morning.
Numbness of head < coughing
Appetite lack of, aversion food; nausea before food; nausea after/before cough. Sometimes brings out sticky, slimy mucous. Numbness in extremities.
Sleeplessness whole night
Bodyache, cannot move. Aversion to talk, to move; wants to lie with eyes closed.
Little things cause tension, anxiety and palpitation.
Perspiration - profuse and constant on head, neck and back, below the eyes - cold Perspiration breathlessness on exertion. Feels must sit, not move further.
Pain abdomen, occasional. Pain Rt inguinal region < coughing.
X-Ray - Lt Hilar Lymphadenopathy.
ESR 47 mm at 1 hour. E 8. MT 25mm

Analysis:
This elderly lady had been complaining of cough since so long that I first suspected Ca-Bronchus and not TB. The cough had < since 3 months, hence I insisted on a CT scan to rule out Ca. But she turned out to be a TB patient.
The numbness in head was very predominant and hence used as an eliminating Rubric.

Rubrics:

1. Head - Numbness sensation of (KR - 132)
2. Perspiration, exertion during slight (KR - 1297)
3. Perspiration, Cold (KR - 1296)
4. Nausea, Cough during (KR - 506)
5. Palpitation, Anxiety from (KR - 874)

	1	2	3	4	5	Total
Bry	2	2	2	1	2	9/5
FI-Ac	2					2/1
Graph	3	3		2	2	8/3
Lach	2	1	2		2	7/4
Merc	2	2	2	2	2	10/5
Nit-Ac	3	3	1	1	2	10/5
Petr	2		2	1		5/3
Plat	2				2	4/2

A few doses of Merc-sol 30 and later a dose of 200, brought relief in the cough.

Case 7
Mr KS Dated: 12/3/97
Tuberculosis Sinus
H/o Koch's 7 years ago. Treated 1 yr
No P/H other major illness/ operations 
Presented with painful swelling on Rt lower rib- 20 days
H/o pain over the area 1 yr ago; treated symptomatically. Later developed swelling over that area, which became hard after 6 months.

Was told there was fluid in the chest
Nil aspirate. Started on AKT but had a persistent discharge of khaki colour fluid; he was then operated and pus started forming in that area with swelling.
Loss of weight, with evening rise of fever
Anorexia .No urinary / bowel disturbance. No respiratory problems
Taken 7 months AKT in the past for (?)Koch's effusion
XR chest PA View: Evidence of minimal pulmonary scarring noted in Rt lower zone with mild blunting of the Rt CP angle { ? Due to the pleural thickening }
Rest of the X-ray is normal

Right lateral View: NAD
Impression: Old Koch's Rt lower zone [no obvious rib involvement noted]
However a penetrated view { bucky films } would be worthwhile to rule out any suitable rib lesion.

X-Ray Sinogram Oblique for Ribs
Small cavity at sight of injection no sinus track seen
Underlying ribs are normal
He had profuse perspiration
After allopathic medicine the swelling subsided but the oozing is again continuous. The pain is < by inspiration feels nauseated (before and after operation)

The following is the text of the interview.
PP (Dr): How you got TB and what were the tensions?
Pt: From the beginning I have to earn as I am the eldest in the family; father was not well, only had fever. I borrowed around RS 20,000, part of which was spent on his treatment and another part was spent by my mother assign to my financial worries.

PP: If some body calls you bad names what will be your reaction? Pt: I will beat the person if I have something on hand (any object like paper weight I will throw it at that person). I get angry very much from injustice, angry at trifles. Sensitive; feel much about small issues. My face becomes red with extreme trembling. I throw things, cannot sleep.

PP: Did you do that in any case, if person is stronger?
Pt: No, because I feel that if I beat he will also beat me in turn. I will beat only if the person is weaker than me; if he is stronger, I wont. One boy was making mistakes inspite of repeatedly explaining to him. I beat him and after beating I felt the same pain as the person beaten.

PP: What is the affect of anger on you?
Pt: My whole body trembles.

PP: Any other tension?
Pt: No

PP: Tell me some thing about your nature? What is there inside your mind?
Pt: I have to return the money before the person asks for it because one should not get abused or insulted.

PP: What happens if somebody abuses you?
PT: Why one should give the chance, I want to return the money before the time so that next time when I need it, I will get it and if I won't return on time he will not give the money again if I ask.

The patient was observed to be sensitive to insults and abuses; did not like to listen to bad words from anybody. He had anxiety about financial matters

12/3/97	Rx Staph 30/1
26/3/97	Sleep disturbed (as before) - irritability > Discharge stopped after 2 days of dose. Rx SL x 15d
9/4/97	Stools: constipation, hard, knotty. Pain chest < expiration Pain all over body < motion, wants to rest Rx Bryonia 200 TDS
16/4/97	> but body ache + Rx ct-all
1/5/97	No problem of discharge. Wt 49kg Generally > Rx SL
17/5/97	Wt 48kg- c/o slight pain around lesion H/o Exertion much 3 / 4 days. No discharge Rx Staph 200/ 1
10/6/97	Wt 48 kg. C/o pain Rt side of chest < machine work < exertion Rx Staph 200 /1
16/7/97	c/o headache - nausea on attempting to eat; cough /cold /catarrh 1 week Rx Staph 200/1
12/8/97	Body ache < 6/7 pm - 1 week Pain chest < breathing deeply Rx Staph 1M/1
4/10/97	Wt 49kg. >>> in general. Rx Tub 200/1

The patient stopped treatment thereafter, as he had no problems. He has referred many cases. Reports to me about his health when he accompanies other patients. He has received no further medication from me till date.

Case 8
Miss AA, 22 yrs Weight 58 kg. First seen on: 20/2/99
K/c/o MDR - TB. With Lt Renal Para Pelvic cyst with h/o repeated urinary tract infection. H/o fever since July '97.
Pain Rt hypochondrium, lower abdomen with vomiting.
Loss of appetite - vomiting after eating little.
First treated for urinary tract infection.
Then developed cough, expectoration, fever, weakness and chilliness
Was very critical in '98, no response to AKT. LUZ resistant Koch's. Advised Lobectomy by a Tb specialist.

Presentation
Dry cough < HS < sleep during < AM with pain Lt chest.
Chills < night < l am < evening. Feverishness day and night. Vomiting immediately after eating little.
Amenorrhoea for 6 /7 during course of AKT
Chilly pt - slight chill, slight cold < winter < draft of air fan < work in water <.
Heat > covering >. Covers even in summers, cannot tolerate cold bath.
Doesn't perspire.
CRAVINGS: fish4, sweets, ice cream2, ice gola3, falooda3
AVERSION: Veg, milk4, curds, prawns.

Father expired 12 years ago. Since the age of six he had to take responsibility - worked as a cook in a 'bissi'. Now since one year started is own bissi.
Anxious about health - whether I will survive or die after the operation? Tense about money, arrange money for the operation. The tension writ on face
Menses: always scanty although regular. Now better.
Pain calves 2 days before menses > after menses.
Mind: Excitable, irritable, offended easily, very reactive to all stimuli (mental or emotional).
When said no for anything keeps quiet - feels bad.
Likes to wear new clothes, new dresses, to prepare new dishes, to travel.
Dreams: Clairvoyant

Investigation Reports
The X-ray taken on 15/11/97 shows cavernous Koch's infiltration over Lt lung mediastinum does not reveal any mass, pull or shift; no diaphragmatic or pleural anomaly seen. Xray report of KUB dated 1911-97 showed no abnormal; radio-opaque density along with renal, biliary or pancreatic system; no evidence of visceromegaly; sacrilization of L5 X-ray report dated 29/12/97/2/2/9811/4/98F

Fibro-productive Koch's noted in the left lung field; The pleural cavities are clear. No significant changes noted in the parenchymal left lung lesion in the X-ray taken on 15/6/98 and other periodical X-rays till 27/10/99. The patient is still under treatment and has been relieved of some of her symptoms of cough and chilliness. Dr Ansari says ESR tests showed positive response- KV}

Rx Phos 30/1 Phytum 30 tds

6/3/99	fever > chilliness > cough > but + No vomiting, No chest pain Rx Phylum 30 tds
6/4/99	>>> Rx Phytum 30 tds
24/6/99	Wt 60kg. No feverishness - no cough - no chills Rx Phytum 30 tds, Phos 30/1
13/5/99	Wt 61 ½ kg. No complaints. Rx Phos 30/1 Phytum 30tds
11/6/99	wt 61½ kg VMB in her complaints Rx Phos 200/1, SL 30 tds
19/7/99	Wt 63kg - No complaints. VMB. Sleep / appetite, menses scanty as before only for two days. Rx Bacill 200/1 SL 30 tds
23/8/99	Wt 65kg - Rx ctall
9/10/99	Wt 66kg. VMB in general. No complaints except scanty menses. Rx Bacill 200/1.

She is under treatment till date- mainly placebos except for her acute problems in between for which she has received Pulsatilla 200 on 28/10/99 for a few days, Dulcamara 30 on 15/1/00 for a week, or Bryonia 30 on 13/5/00 for a week.

Here Lt lung field was totally fired due to acute TB and difficult to evaluate the haziness Radiologically - but ESR is a good parameter for monitoring the FU. Along with clinical improvement.

Comments
This was a very bad case of MDR-TB. In spite of full drug regimen many times, there was no improvement either clinically or radiologically as shown by the X-rays. She came to us for treatment only when she was advised lobectomy.

Cough /fever and other classical symptoms were present when she was first prescribed. The physical., mental ad general state of the patient demanded Phos. The dilemma was to give or not to give Phos - almost the whole lung was fired and symptoms pointed towards Phos but the stalwarts cautions against use of Phos can not be ignored. If it triggers off bleeding then we have had it. Anyway I proceeded with caution, hoping for the best. Bacillinum followed her up as intercurrent only after the presenting totality was taken note of.

NB:

1. Note that the condition is Acute TB and the prescription 'Phosphorous' -- ???
2. AKT was stopped the same day when homoeopathy started. No other allopathic treatment was given even during the acute phase.

Case 9:
Mr ARA, 22 yrs. Koch's abdomen (TB-intestine) First seen on 27/6/98

Chief Complaints:
From April '95 pt started getting pain abdomen.
5th January '96 operated for appendicitis, pain relieved for 2 months. Then pt moved from Assam to Mumbai and again pain started.
Pain: whole abdomen but much around umbilicus, with large passage of gas / flatus.
Stools not clear: No gas, if stools are clear. Any change in stool pattern à gas which causes pain.
Pain < eating after > empty stomach
< Always around 10 / 11 pm (dinner around 8 pm). Pain 2 /3 hours after dinner. > Only by vomiting 4 / 5times. Sleepiness immediately after eating.

Treatment: AKT last 2 months. < after AKT. Also advised operation for small bowel loop Borborygmus / gas and gurgling could also be heard by others.

Past H/o  Jaundice 4 months back.
H/o  skin eruptions since childhood, better since 4 years, ? Allergic dermatitis, thick crusty eruptions with pus and serous exudation.
H /o < SKIN in winter < night < washing < warmth of bed.

Pt as a Person:
H3C2  feels much heat but cannot bear cold air.
Perspiration profuse < little heat < whole body < NECK - perspiration sole
Craving: fried 4. Oily, salty, meat. Av fish
Appetite loss of. Stools: constipated - goes 2 / 3 times but passes little and hard.
Fever once in 2 / 3 months with headache and bodyache

Life Situation and Mental State.
Eldest in the family. 2 brothers and 1 sister. Father face, wrinkles on the forehead when talking. Fears death during operation. Anxiety when somebody is sick at home. Since 3 months, he is sleepless till 4am: anxiety about money, about business. Angry if he does not get money. Aversion to fighting. He is cool even if somebody hits him he does not hit back, but bad words make him angry but cools down fast. Fear of being hit or struck. Fear of being injured. Very conscious - others should not say, "He is bad". We are poor people, we have no manpower, we are small fry, we have come to earn, so one should not fight.

Other people have the resources.
Sensitive to pain- cannot bear pain even for 2 minutes. Loses consciousness
Restless from pain - sudden pain with chilliness
Always bothered how to earn money.
Dreams:

1. Of becoming a big man -- lots of money and property.
2. Somebody trying to hit him - fighting with him and thrashing him with fists and blows.
3. Snakes following him.

AKT was stopped along with all allopathic medicines. Rx Mezerum30/1(27/6/98) and Mezereum 200/1 on 2/9/98. 2nd dose on 11/10/98 brought about old skin symptoms and remarkable improvement.

Mezereum was selected because it was felt that the present complaint arose from suppression of the skin eruptions in childhood- A/f suppressed skin eruptions and history of eczema with pus. The other rubrics were- Draft of cold air <; anger alternating with repentance and financial melancholia. The site of disease metastasis from the skin to GIT was interesting as the suppression of the skin eruptions led to development of GIT symptoms. The other presenting complaints support the choice of Mezereum.

Case 10
Mrs RM, 27 yr. First seen on 8/5/99

Chief Complaints
Since April 99 Fever with chills with Lt chest pain
PTB started AKT - started having a burning sensation in abdomen, Allergy, Amenorrhoea. AKT did not suit her, hence came for homoeopathic treatment after a month.
Feverish - low grade internal fever. Cough with pain chest when coughing - cough with expectoration and nausea - Aversion to eating. Nausea at sight of food.
Amenorrhoea + did not get her last menses - urine test for pregnancy + <-> MTP

Chain of Events
Last delivery in November - girl died after delivery in January. Depression during pregnancy with constant weeping. Depression increased after delivery. Stopped crying after child's death in January.

Sleepless after delivery, which increased after daughter's death. Tensed easily. Last delivery was a daughter again. Husband was not happy after 2nd daughter. She felt guilty - What have I done? Husband was not talking to her. She felt depressed. Husband wanted a boy. After 2 months child expired. Husband realized --- Patient developed boy or girl syndrome. She conceived again but she terminated pregnancy-fearing that the child may be a girl again. Again husband will misbehave. "If I am sure of a boy I may keep.- Fear of bearing a female child - Husband should not be affected because of me. Lack of confidence-- whether I can undertake responsibility of children" were her feelings.

Personal H/O
Chilly pt. Appetite  loss of -- aversion to eating < at the sight of food
Cravings: sweets²
Aversions: not marked; THIRST: ++
Perspiration: profuse3 face, neck - cold perspiration
Stools: constipated; not satisfactory; has to take laxative.
Urine: N Occasionally involuntary urination on coughing.
Menses - Amenorrhoea now --- previously OK.

Rubrics Taken:
Anxiety;
Weeping causeless/ without knowing why;
Chilly patient;
Craves; sweets;
Perspiration +++
Rx Kali Carb 30 /1 on 8/5/99
Kali Carb 30/1 on 22/7/99
Kali Carb 30/4 on 27/8/99
Kali Carb 200/1 on 16/9/99

Editor: Dr Ansari must give symptoms reasoning and proper FU Reasoning given but follow-up not given.
Dr Ansari replies: I have given the gist of all cases and follow up as cases were numerous. These are cases with long f/u and would take much valuable space. Hence they are summarised.

Case 11
Miss FS. 19 yr, First seen on 29/06/93
H/O: Koch's infection in Oct 91 - Upper mid zone.
Full course of AKT taken.

Chief Complaints:

1. Induration of Lt cervical glands since Oct 92. Glands operated previously in March 92. Now again glands reappeared.
2. Cough, Dry; difficult expectoration, sticky, viscid, often stringy mucous. < Night < lying down. > Drinking.
3. Throat - dryness < cough during.

Other Symptoms:
Hot patient - desire for open air.
Leucorrhoea < urination after.
Perspiration only on face/ neck.
Stools - constipation, hard stool once in 2 / 3 days c great straining.
Concomitant: Pain in the legs on straining at stool
ESR 94 mm at 1 hour. Hb10 gm. RBC 4.2

She was prescribed Pulsatilla 30 followed by Bacillinum 200 with some improvement and after a few weeks discontinued treatment as cough was less and glands had reduced. 5/7/95 Came back again with cough and headache, pain Lt Scapula, glands, vertigo on looking up. Shivers run through the whole body.

She had been married in the meantime into a joint family. The husband was away in the gulf. The in-laws did not like her. They quarreled and never accepted her as their daughter-in -law, even though she did everything to please her. She was always hindered at work and told to go and stay with her mother as her husband was not here. So she stayed with her mother and came to in-laws only when husband came on vacation. In-laws tried to influence her husband by spinning yarns about her faults. They also wrote to him-accusations against her, trying to force him to divorce her, as unfit for the family, and marry someone else.

Patient feared that one day he would fall prey to their accusations and leave her. This fear constantly haunted her.

I prescribed Platina 10 M-1 dose with dramatic clinical improvement in all symptoms. She also gained weight of 5 kg within a short time.
One more dose in Dec '95 completely cured her. No other medicine required. She has settled family life now.

Editor: This case did not show the overt traits of the usual Platina understanding. Then what understanding it showed? On what u based your prescription. Ans: MM: The source books describes Platina as the only remedy having 'fear that she will lose her husband'. Although the complete Repertory gives addition of 2/3 more remedies like Baryta-carb etc. in the rubrics I fear, happen something with,