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Case Study

Case of Chronic fatigue syndrome
Dr Ardeshir T Jagose

A 58 year old male patient, diagnosed as suffering from chronic fatigue syndrome came for consultation in 1996.
The chief complaints were bodyache- sore and bruised sensation, aggravated in the morning on awakening3 and in the afternoon. It was worsened by overwork3, business tension3, and when alone, upper respiratory tract infection and to sunlight. It improved after sleep, taking rest, when occupied and busy. Towards evening he felt normal3. His symptoms were accompanied by a peculiar pain in the region of the lower back which disappeared as soon as the tired feeling abated.
He was taking allopathic medication-Tab Alprax1 1 TDS and Tab Survector 1 daily. Inspite of this treatment, the complaints persisted.

Past History
: Borderline Diabetes Mellitus controlled by medication; H/o recurrent colds off and on, relieved by allopathic medicines; H/o tonsillectomy, bleeding gums, thread worms and pica in childhood.
Family History
 Two sisters also suffer from similar fatigue syndrome. One brother died due to a heart attack. Wife had one abortion in third month of pregnancy and two daughters were in good health.

Personal History
 - Good
craving: Sweets2, Spicy, Pungent food3 Salty, hot food.
aversions: none
Thirst: Reduced.
Bladder and Bowel habits: Normal.
Digestion: Poor. Hyperacidity.
Perspiration: Hairline 3, Offensive. .
Sleep: Disturbed due to business and domestic tension. Used to get cramp in the calf muscles, salivation and crying when in sleep.
Dreams: Frightful as if someone was torturing him.
Thermals: Ambithermal.
Mentals: Irritability at his place of work-he used to shout and abuse his coworkers. At home he suppressed his anger due to the dominating nature of his wife. He was very anxious when undertaking new assignments. He was exceptionally meticulous and fastidious in whatever he did. H/o suicidal thoughts was obtained on deep probing.

Life Situation
 - Patient highlighted that at his place of work he had to cope up with situations which made him very anxious and nervous. In the afternoon he used to take a short nap and would work till 7 pm and would come home late - around 9-10 pm. He then went either swimming or jogging. He would consume alcohol and dine late at night due to business commitments.

At home, his wife was dominating and he would have to listen to her or else she would threaten him with dire consequences. He would take care of all his wife’s needs, as he was very much attached to his two daughters and did not want disharmony at home. This resulted in suppression, which was vented as anger at his place of work. Many a times he had suicidal thoughts, but lacked the courage. (This same feeling of suppressed anger was reflected in his dreams.) This whole case revolves around suppressed grief3 which forms the core of the case.

The Non-Repertorial approach
 was taken into consideration and Mag-mur was the constitutional remedy of choice based on the following totality of symptoms:

  1. Suppressed grief3
  2. Irritability.
  3. H/O suicidal thoughts.
  4. Anticipatory anxiety.
  5. Dreams of being tortured.
  6. Pica in childhood.
  7. Craving for sweets, spicy, salty and hot food.
  8. Disturbed sleep with crying in sleep.
  9. Perspiration on head.
  10. Tired feeling with backache<morning and>evening.


In the acute phase Nux-vomica was the drug of choice due to the important concomitant symptom of backache worse in the morning, by overwork and better in the evening and by rest.

Follow-up: Initially
 Nux-vomica 200 QDS was given in the acute phase to which the patient responded dramatically and the body ache, backache and tired feeling was relieved to a great extent. His sleep improved and his frightening dreams also disappeared. The anxilolytic and anit depressant were gradually tapered and withdrawn after two months. He was off all allopathic medication till 10-9-1999.

After two months, the constitutional remedy namely Mag-mur 200 was given repeatedly and the chief complaint was totally relieved. But now depression had set in. Mag-mur was given in successively higher potencies from 200 to 10 M and the depression was cured i.e. by 19-5-2000.

On 9-10-2001 the patient returned for recurrent cold off and on. He had a cold with nose block, which was worse at night. Nux-vomica 200 was prescribed followed by Tuberculinum 1 M 1 dose. Since then he is well.

Conclusion: In this case it was observed that the superficial or top most layer was of anxiety with disturbed sleep. Hence after
 Nux-vomica he felt better. Once this layer was removed, the next layer of depression came up which was treated with Mag-mur. Lastly, the suppressed symptom of cold reappeared wherein Nux-vomicaonce again provided relief. It was followed by Tuberculinum 1 M- 1 dose as an inter-current remedy based on the past and family history, and the fundamental miasm was thus tackled, paving the way to cure.

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