Some Trios of Medicines

In my daily practice I had seen that many cases have clear therapeutic indications, which are very important in acute cases as well as chronic cases. So, in my opinion a physician must have knowledge of therapeutic indication in cases. In chronic cases also, physician must focus on his recent complain of chronic case first, and then he can approach different medicine according to case. Now trios, which are given by our mentors, are very useful in acute & chronic cases. These are medicine which having similar indication yet having differential symptoms. Here some trios of medicines with their differential symptoms, which may help in clinical cases.

Trio of thirstlessness:
Apis Melifica:  Thirstlessness especially during dropsy, with burning micturition.
Desire for cold milk

Pulsatilla: Thirstlessness with dry white coated tongue.
Drinks often & little at a time which provokes vomiting.
Bad taste in mouth.

Aethusa Cynapium: Complete absence of thirst
 Intolerance of milk; all complaints worse after drinking milk.

Trio of pain:
Chamomilla: Intolerable pain with numbness of affected parts.
Over sensitiveness
great debility as soon as pain begins < from heat.

Aconite: Acute sudden & violent invasion
scream with pain, intolerable, drive him crazy with restlessness.

Coffea Cruda:
great sensitiveness to pain & pain seems almost insupportable, driving patient to despair.
Pain with insomnia.

Trio of croup:
Aconite: Hoarse, dry croupy cough.
Dry hacking cough worse at night & after midnight.
Loud labored breathing, shortness of breath.
Oppressed breathing on least motion.

Spongia: Croup worse during inspiration & before midnight.
Feeling of plug in larynx, cough after eating or drinking warm things.
Awakes in fright; feels as if suffocating.

Hepar Sulph: Croup with loose, rattling cough.
Cough excited whenever any part of body gets cold or uncovered.
Chocking cough.

Trio of restlessness: 
Arsenic album: Mental restlessness but physically too weak & exhausted to move about.
Restlessness with great prostration.
Sinking of strength out of proportional to degree of illness.

Aconite: Restless with intense nervousness; can’t remain in one place.
He is full of energy , vigor & strength; as such moves frequently.

Rhus toxicodendron: Can’t stay in one place. Must change position frequently to obtain relief from pain.
Great rigidity , stiffness & lameness.
Pain on 1^st moving the joint after rest or on waking up in morning; > by waking / Continued motion.

Trio of flatulence:
Lycopodium: Accumulation of gas & flatulence in lower abdomen with loud grumbling, croaking.
Rolling of flatus as through fermentation was going on.
Not > by passing flatus & eructation,
Belching always sour & acrid.

Carbo veg: Simple food disagree, causing excessive flatulence; weak digestion.
Abdomen is full to bursting point especially on UPER PART.
<: from least food; >: eructation, on passing flatus

China: Tympanitic abdomen with much flatulence & belching which gives no relief.
Great distension of entire abdomen; sensation as is abdomen is full of gas.
Each food particles seems to have turned into gas.

Trio of sleepiness:
Antim tart: Irresistible desire to sleep nearly with all complaints. Great drowsiness.
On falling asleep feels electric like shocks.

Opium: Sleepiness from nervous irritation.
Great drowsiness; falls into heavy stupid sleep.
Profound coma; loss of breath on falling sleep. Picking at bed clothes. Very sleepy but can’t go to sleep. Sleeps with half eye opened.

Nux Moschata: Drowsiness & sleepiness which accompany all ailments.
Complaints cause sleepiness. Coma.

Trio of burns:
Sulphur: External burning; all over the skin in the parts on which he lies.
< From heat of bed & covering.

Arsenicum album: Violent & acute > by heat, except in head which is > by cold.
Burning with marked prostration & restlessness.
Burning especially in acute disease; < mid-day, mid-night.
Has fear of death

Phosphorus: Internal burning; anywhere & everywhere all over body.
Burning in spots along the spine between scapula, of the palm, hands, in chest, lungs etc., < evening.

Trio of prolapse of uterus:
Sepia: Bearing down pressure from back of abdomen. Must cross her legs to prevent protrusion of parts.
Mentally pt. is very indifferent & apathetic with complete absence of sexual desire.

Lilium tig: Bearing down, everything forcing down, as if contents of pelvis were being pushed down through a funnel, the outlet being vagina.
Must support vagina with her hands; mentally pt. is hurried, worried; sexual desire much more marked.

Murex: prolapse of uterus with sore pain. Profuse & excessive hemorrhage. Intense sexual desire. Must keep her legs tightly crossed. Pain from rt. Side of womb to right / left breast. Nymphomania.

Trio of delirium: 
Belladonna: Delirium with throbbing of carotids, the heat, redness & congestion of face & conjunctiva; when it passes away then delirium subsides.
In proportion- great violence & excitement.
Flood of subjective visual impression & fantastic illusions. Hallucination; sees monsters, hideous face.

Hyoscymus: Non-inflammatory type of increased cerebral activity. Ridiculous gesture.
Horrible lascivious mania & desire to remain uncovered.

Stramonium: During delirium, pt. gets up & wants to escape; difficult to be located.
Loquacious, furious delirium but not much inflammation found. Religious mania.
Strange delusions about his own identity.

Trio of offensiveness:
Baptisia: Offensive breath, ulcerated mouth with offensive smell. All discharges like urine, stool and sweat are offensive. It is very difficult for doctor to examine the patient.

Kreosote: With offensiveness, there is acridity, putridity of all discharges.
Cadaverous smelling with corrosiveness of discharge.

Mercurius: Offensiveness with profuseness of discharge foulness pt. as a whole smells offensive.
Discharges are bloody, profuse & offensive.
< At night.

Trio of offensive urine: 
Benzoic acid: Urine dark, brown, scanty & urinous odor. Highly intensified. Nocturnal enuresis.
Repulsive odor, changeable color. Cystitis.

Nitric acid: Scanty, dark offensive urine, smells like horse’s urine. Cold on passing. Burning & stinging.
Urine- bloody & albuminous. Alteration of cloudy, phosphatic urine with profuse urinary secretion in old prostatic cases.

Sepia: Red, adhesive, sand in urine, Involuntary urination, during 1^st sleep.
Chronic cystitis. Slow micturition with beating down sensation above pubis.

Trio of ptosis:
Causticum: Ptosis, vision impaired as  if film were before eyes. Paralysis of ocular muscles after exposure to cold. Inflammation of eyelid.

Gelsemium: Heavy eyelids; ptosis.
Pt. can hardly open then. Double vision blurred. Smoky. Dim slighted; pupils dilated & insensible to light. Orbital neuralgia with contraction & twitching of muscles.

Sepia: Muscular asthenopia.
Black spots in field of vision. Tarsal tumor; ptosis cilliary irritation.
Venous congestion of fundus.

Trio of warts:
Causticum: Warts large, jugged, bleeding easily on tips of fingers & nose.
Cicatrices freshen up- old injuries reopen.

Dulcamara: Warts large smooth, on face & palmer surface of hands.
Thick, brown yellow crusts; bleeding when scratched. <: in cold, wet weather.

Thuja: Warts in ano-genital region. Eruptions only on covered parts. Brown spots on hands & arms. Coldness of one side.

Trio of diarrhoea: 
Gambogia: Rumbling & rolling. Pain & distention of abdomen from flatulence, after stool.
Dysentery, diarrhoea with sudden & forcible ejection of bilious stool. Tenesmus after, with burning at anus. Profuse watery diarrhoea in hot weather.
Pain in coccyx.

Gratiola: Diarrhoea; green frothy water followed by anal burning. Forcibly evacuation  without pain.
Constipation with gouty acidity. Rectum constricted.

Oleander: Undigested faeces. Stool passes when emitting flatus. Burning pain in anus.
Gnawing around navel.

Apis Mellifica

General Introduction about Apis Mellifica:
Apis Mellifica is medicine from animal kingdom, which is prepared from poison of western honey bee (Apium Virus). This bee sting produces stinging pain, burning, redness, soreness & puffiness of particular affected part. Pain from bee sting is too much that it will make any person cry!

Apis Mellifica has few characteristic symptoms which we should keep in mind which are HOT+TIRSTLESS+RIGHT SIDED. If one is going to approach a case with these symptoms then he should keep apis in mind. Well, thirst of apis has peculiarity which is thirstless is marked but especially in dropsy but it is thirsty when there is chill stage of intermittent fever.

Clinical Uses:
Abscess, apoplexy, asthma, carbuncles, constipation, diarrhoea, DROPSY, eye affection, gangrene, intermittent fever, renal affection, skin affection, urinary complain & more.

Action of Apis Mellifica:

It acts on cellular tissues, glands, skin, urinary organs, and serous membrane.
Constitution of Apis Mellifica:

Apis is adapted to person with strumous constitution (goitrous). Enlarged & indurated glands, Scirrous or open cancer & tendency to dropsy of external coverings.

 Bag like swelling under lower eyelids. Pale, waxy, oedematous face. 
Temperament: irritable temperament.
Thermal: HOT patient.
Miasm: Psora in the background.

Diathesis: Scrofulous.

Mental/ Mind symptoms of Apis Mellifica:
          Apis patient is very much awkward, he drops things easily while handling things; so when we see a patient with butterfingers that patient might be apis.
          Person who cannot concentrate his mind while reading or studying are might be apis patient. Apis patient cannot keep his mind in studying. Patient cannot think clearly.
          Apis patient is very irritable, nervous & having fidgety. Patient maybe irritable due to unbearable stinging pain.
          Apathy, indifference & unconsciousness are well marked in apis. Weeping disposition; cannot help crying; he is quite discouraged.
          Muttering delirium, loquacity; suppression of rosy eruption. Stupor alternating with erotic mania.
          There is fear of impending death. Jealousy & suspicion.
          All mental complains aggravates from heat & in warm room, better by after cold weather.

Physical general / key-note symptoms:
         
          Apis affects right side of the body. In apis symptoms goes right to left. As apis is hot medicine its general modalities will be aggravation from heat / warmth & its amelioration will be cold in general.
          Pain: burning & stinging pain which is suddenly goes one part of another part of the body. Apis is great pain remedy.
          Oedema: puffy, bag like swelling under the lower eyelids. Here is difference in apis mellifica, kali carb & phosphorous; kali carb has bag like swelling but in upper eyelids, but in phosphorous has puffy swelling around eyes. Swelling of hands & feet.
          Dropsy: Dropsy & fever with thirstlessness & scanty urine. In dropsy skin become transparent, with a waxen look, whitish yellow. There is ‘dropsy of brain’ that is hydrocephalus. Hydrothorax especially when the trouble is of cardiac origin. He feels suffocated as if every breath would be his last breath, especially in dropsical condition.
           There is aversion to tight clothing, bandage. He cannot tolerate tight clothing around waist, he must loosen them. There is extreme sensitiveness to touch.
            Skin is dry but alternates with perspiring. Tongue of apis is fiery red.

           Urinary symptoms: painful & burning micturition, scanty urine which is coming in drops. As soon as few drops of urine collect in bladder, he has sudden urge to urinate; constant ineffectual urge to urinate. There is great incontinence of urine with great irritation of parts. He scarcely retains urine for while.

A case of apis mellifica:
          When I was in my internship days, I used to learn under some homeopaths. One day a lady came with her complain regarding pain in feet & weakness. My sir & I both learned detailed case but on her first visit sir gave her only placebo. Then sir told me that he need more time to understand case. After that sir asked that lady to visit another time & he gave her natrum mur. But when sir prescribed her natrum then I wasn’t there to ask why he had given her natrum mur. After few follow up she came to visit but then sir wasn’t present there so I asked her how she was. Is she having improvement? She said no doctor I have no relief in complain. Then I decided to re-take the case found strange thing that she said she had feeling of stinging in her feet. I asked few more question which was indicated that medicine was actually apis mellifica! Then I gave her apis, and next week she came & said doctor I have such relief! I think she had 75% relief in her all complain. Then I told sir what was happened. After this incidence I learn apis mellifica & this event show me the genius of this wonderful remedy!

Obstacle to cure : Diet & regimen

            Homoeopathy is application of minute dose of medicine for the treatment of various diseases. The action of this small medicinal dose should not be disturbed or removed by any foreign medicinal irritant through diet or regimen.

Diet & regimen in Chronic diseases:-

Careful investigation of diet & regimen which may act as obstacle to cure is necessary in chronic disease. This disease causing or maintaining errors may passed unnoticed which results in failure to achieve cure. Master Hahnemann has advised to avoid following type of diet & regimen in patient suffering from chronic disease.

1) FOOD:- Highly spiced foods & dishes of herbs, roots & stalks of plants possessing medicinal qualities, ONIONS & crude medicinal vegetables. All excesses in food & in use of sugar, salt, spirituous drinks. Chines foods are highly spiced with various oils mixed should avoided during treatment.

2) BEVARAGES:- Coffee, Herbal tea, liquors, beer made with medicinal substances, perfumes. Coffee & tea are most popular beverages all around world. It often become obstacle to cure as this drinks removes medicinal action of medicines.

3) TOILET ARTICLES:- Tooth powders, strong scented flowers in room, perfumes, odorous water.

4) CLOTHING AND MODE OF LIFE:-

- Sedentary life style

- Uncleanliness

- Long-time stay in heated rooms

- Woollen clothing next to skin

-  Onanism or suppressed sexual intercourse

- Poor living, Damp rooms

- Over exertion of body or mind.

Above all things are obstacle to cure. This all may result in failure in achieving cure. Let me tell you about one of my clinical case.

CASE :- One of my patient was taking medicines from me for his eczema. He was suffering for over 1 year and visiting my clinic for over 4-5 months. Now, I couldn’t recall which rubrics I had taken but single medicine Sulphur came after rapertorization. Sulphur was covering 8 out of 8 rubrics. I prescribed it in 30 potency but in follow up, no change at all I got. I tried 200 potency and even sulphur 1M also I prescribed but no change in eczema found. This all changing potencies runs for 4 months. I retake the case but after rapertorization, only 1 medicine came Sulphur. What will you do when your best selected medicine fails in give result? I couldn’t understand why my selected medicine didn’t bring cure. I decided to retake case again.

             During case taking I found out that patient was drinking COFFEE 4-5 times/day. I became damn sure that coffee is the OBSTACLE TO CURE in my case. I asked patient to stop drinking coffee and prescribed sulphur 200 single dose with sac lac TDS for 7 days. In next visit, patient’s eczema decreased about 30 %. On following visits, patient was completely cured.



         I faced failure then after I learned something that I will never forget in my lifetime. I am sharing this knowledge to you so that you don’t have to face what I faced. Diet and regimen is very important things while treating chronic cases. My personal advice is not to change medicines too rapidly if you don’t get results. First try changing potencies if didn’t get result then check for error in case taking as for example, diet and regimen and still not getting the result then only change remedy according to case which is most similimum.

The Follow Up

When physician had taken the case & prescribed similimum medicine, the physician expects response in patient’s condition. What should a physician do when patient came for follow up? Answer to this question depends upon patient’s reaction toward remedy. Dr. J.T. Kent had given us possible twelve observations which are made after administration of the similimum medicine. Which are—

1.    A prolonged aggravation & then final decline of the patient.

2.    Long aggravation but final and slow improvement.

3.    The aggravation is quick, short & strong with rapid improvement of the patient.

4.    No aggravation, with recovery of the patient.

5.    The amelioration comes first & the aggravation comes afterwards.

6.    Too short relief of symptoms.

7.    A full time amelioration of the symptoms, yet no special relief of the patient.

8.    Some patients prove every remedy they get.

9.    The action of the medicine upon provers.

10.                     New symptoms appear after the remedy.

11.                     When old symptoms are observed to reappear.

12.                     Symptoms take the wrong direction.

So, these were twelve observations that Master Kent had given. What changes we sought in patient after giving similimum medicine?

We as a physician should look for both good & bad changes. What will physician will do in follow up? When patient had taken given homeopathic similimum medicine & then come for his further follow up, physician needs to look for changes in patient. Which may be good or bad, but one should know what needs to be done, especially in chronic cases & in acute also! So now what changes one have to find in case? Answer of the question is depend upon case, there may have following possibilities—

1.    Case has some aggravation but relief in complain.

2.    Case is in standstill situation after little improvement.

3.    Patient produces other symptoms which are not of current disease, but of medicine which is given to the patient in first prescription.

4.    Patient does not react to the medicine.

5.    Patient’s response to the first prescription is in satisfactory or good enough.

6.    A complementary medicine needs to be given.

7.    Case shows new group of symptoms, that is symptoms changed but there is no relief to the patient.

8.    Case shows symptoms of another miasm that the case had before. 

All these possibilities I had seen in my practice were based on twelve observation of Dr. J. T. Kent. I had seen that many of my students do not follow these observations during their practice. I insist them to do so.

Now if physician have above mentioned possibilities in the follow up, then he must give further prescription according to the case. Let’s understand these.

·       When a case has some aggravation but relief in complain, that means our medicine had acted. When medicine is right then there will be homeopathic aggravation. (Ok for those who are wondering what is homeopathic aggravation; it is slight, but noticeable intensification of patient’s current symptoms after given similimum homeopathic medicine, along with simultaneously better feeling.) Homeopathic aggravation is good sign in case. By which we can interpret that the case is curable & prognosis is quite favorable. Then one must not disturbed given medicine till it completes its action, one can give placebo for patient’s satisfaction.

·       When to repeat dose? Yes the repetition is necessary in some cases. When physician gives first prescription & then wait for its reaction with patient & finds that the medicine is acting and patient having improvement. But after some days or weeks may be patient stop improving. So then the repetition of the medicine (which was given in first prescription) is must. But to do so one must have to wait till medicine had acted in first place. And there is another situation where one can repeat same medicine. When first prescription had acted and there is relief to patient, but after some days original symptoms of case are seems to appear then one can also repeat the same medicine.

·       As I mentioned above ‘Patient produces other symptoms which are not of current disease, but of medicine which is given to the patient in first prescription.’ Then what one should perceive? & what should do? It is quite simple it is wrong medicine! In this case patient must be antidote first. When patient says medicine cured me those symptoms but now I have these symptoms. Ok means medicine is partly indicated but still it is wrong one. For curing the case one must give similimum medicine. So when wrong medicine given & it produces ill effect on patient then it must be antidote.

·        Patient does not react to the medicine means given medicine & potency is wrong. So what one should do in this case? He has to re-take the case thoroughly. When patient does not react to medicine this condition is call “status quo.”

·       What happen when we give wrong potency? There may be two possibilities; one can be higher potency than it needed or another is lower than it needed in case. If there is high potency then it will produce more aggravation in case, which is completely unnecessary. Yes our master Hahnemann said that potency & dose should be minimum, to avoid unwanted aggravation. What if potency is lower than it needed? Simply it will give relief to patient nut not satisfactory. So if the medicine is similimum than one must change its potency. Dr. J.T. Kent had given an opinion regarding potency that same potency be not repeated on more than two times.

·        We give exact similimum medicine to the patient but failed to complete cure. There are relations between remedies, and there are medicines to complementary to other medicines. In these cases our follow up should be complementary to first one.

·        When case shows new group of symptoms, that is symptoms changed but there is no relief to the patient indicates a new medicine. But before give another medicine make sure that these symptoms are not symptoms of the medicine given. If it is not, then on basis of current totality one should give another medicine.

A physician is dealing with case, suppose it is psoric case. During anti-psoric treatment patient shows symptoms from another miasm which may be sycotic or syphilitic, then he must not give anti-psoric treatment, but he should re-investigate case and have to change his way of treatment. That means he should treat the current miasm that case posses.

So, this was about the follow up, hope it helps in case study.

Clinical Case #3 : Corns

       Today, Let's get some knowledge about Corn and after that I will share my clinical case of corn.

What is Corn ? :-
      "Corns are Small calloused areas of skin caused by local pressure irritating tissue over a bony prominence. It is just thickening of surface layer of skin due to local pressure as from shoes, ground, and   It occurs mostly on the foot and palms of hands. It occurs due to local friction of part and due to pressure to the skin tissue.

Case :-
              One patient visited my clinic for 4-5 corns on the both foot since 1 year. Patient had taken Allopathic treatment , used salicylic acid creams but got no relief in corns so that he had surgically removed all corns from foot but after 2 months corns reoccurred. After that , He had taken treatment from homeopathic doctor for around 5-6 months. Corns shrinks somehow but again grow repeatedly. Patient became very much frustrated about this problem (Corns) so that he stopped medicines of that homeopathic doctor and after 1 month he got my address from my other patient and he decided to visit me.
             It were very much painful. Patient can't walk with bare foot. Corns were red, painful and burning in morning. pain < in morning and better in evening & night. Patient was chilly. Patient's body structure was weak. Patient was very nervous (may be due to 1st visit but it's also important symptom to prescribe homoeopathic medicine.) I asked him in which foot corn appeared first. He told me 1st corn was appeared on left foot then after 1 month corns appeared on right foot also. He always need to add extra salt in food. I immediately checked his tongue, it was mixed type of as imprint of teeth with somewhat map like drawing in tongue. When I told patient that Corns will be cured soon so don't worry about it, patient replied in anger that all doctors had told him it but it were never cured.
           This is the whole case. Now I have to select medicine. Frankly speaking, I was confused because it covers most symptoms of Nat Mur but 2 symptoms are not of Nat Mur and for 1 minute, I felt to prescribe specific medicine like Antim crud, Silicea, Sulphur etc. But, This remedies may already prescribed by other Homoeopath. It didn't given result.
          Symptoms of Nat Mur in this case-
          - Left sided as corns appeared on left foot 1st
          - < Morning
          - > Evening  (<Sunrise to sunset)
          - Patient's body emaciated
          - Mapped tongue
          - Salt craving
          - Nervous patient
          - Consolation aggravates (I told him that not to worry but he replied me in anger)

     Controversial symptoms to Nat Mur-

        - Chilly patient

        - Imprint of teeth

        - Burning corns



I decided to go with Nat Mur as most similimum medicine. I prescribed  Nat Mur 30 OD x 3 doses with sac lac BD for 7 days.



Follow up:- After 1 week, Corns were become soft & painless. No redness. No new corn appeared after medicine. I prescribed Sac lac for another 15 days and after that again for 15 days. After nearly 1 month all corns were cleared. Don’t go for specific medicine. Prescribe only which suits the case most, Result will definitely good.

Suppression of Disease

WHAT IS SUPPRESSION ?

      "Suppression is disappearance of existing disease symptoms at cost of some new suffering involving more vital organ of the body."

Example :- Psoriasis disappear (Skin complaint) but respiratory disease develops later. In suppression, Disease goes Periphery to center which is more dangerous for body.

Different between suppression & palliation:-

"Palliation is temporary relief of symptom of a disease"

Example :- Patient suffering from Headache so that whenever he takes pain killer medicine, headache relieves but after few days it reappears in same form. In this symptom (Headache) is just temporary relieved without any new suffering.

In Suppression, Disease disappears at cost of new suffering as example given above, Skin complaint relieved but at cost of new suffering (Respiratory trouble).

Types of suppression :-

1) Natural suppression : It is caused by nature.

2) Artificial suppression : It is caused by some artificial means.

Artificial suppression :- 

It occur in following different ways -

- Suppression by prolonged allopathic treatment

- Suppression of skin disease by external application

- Suppression by miasmatic states

- Suppression of natural body secretion by medicines

- Suppression by removing organs by surgery

Clinical example of Suppression :-

       A 40 year old patient was suffering from Eczema for 4-5 months. He visited allopathic skin specialist doctor. He gave him medicines and ointment which contain steroid so that eczema disappears in just 15-20 days. Patient was very happy as eczema was very irritating him and he was tired from constant itching. But, after 1 to 1.5 month he started suffering from cough and few days after he had difficulty in breathing. Now he was suffering from Asthma. after developing asthma, This patient visited one of my friend's clinic. He took case in very detailed and found out cause of asthma which is suppression of eczema.

=>Prescribing symptoms was as following-

 Asthma comes on by suppressed skin eruptions. Breathlessness immediately after lying down so that patient was unable to lie down. Patient feels tightness of chest. Breathlessness comes especially at midnight. Patient was chilly and extreme restless. Patient was worried about his health and anxiety can be seen on his face clearly. Patient feels better while eating hot food and in warm places.

Above all symptoms clearly suggest 1 medicine which is ARSENICUM ALBUM.

My homeopath friend prescribed Arsenic alb in 30 potency OD for 3 days and Sac lac for 7 days.

FOLLOW UP:- Patient was better in every aspect. Coughing frequency decreased. No feeling of tightness of chest. Mentally, all anxiety disappeared. Breathlessness occur only 3 time in whole week. He prescribed another 3 doses of arsenic alb with 1 week of sac lac.

  After 1 week, No cough , No breathlessness. Patient was completely out of asthma but old eczema reappeared. Patient became anxious and feared from reappearance eczema but doctor convinced him that it is good sign. We are at road to cure the disease. This is pure example of Hering's law of cure which is symptoms disappears from above downward , within outward and in reverse order of its appearance.

Disease is going from center to periphery that is from respiratory to skin, from more vital organs to less vital organ. This is perfect example of homeopathic cure.

Homeopathic suppression:-

In nowadays, some homeopathic doctors use homeopathic medicines in allopathic way. It will not lead to cure but it will do only one thing that is suppression. Many Homeopathic doctors I had seen using specific remedies for specific disease. This is not homeopathy at least it's not Hahnemann's homeopathy. This doctors blindly uses specific medicines for particular disease.

Example :- Sulphur for any skin disease , Thuja for any type of warts etc.

This will only suppress disease. Cure can't be achieved by this way. I request all homeopathic doctors take case in detail and give medicine which is most similimum to the case. Whatever the name of disease, it doesn't matter because "WE TREAT MAN IN DISEASE NOT DISEASE IN MAN".

 

 

Difficulties During Chronic Cases

In my last post (Here) I  mentioned  about homeopathic case taking. It is easy to take acute cases because in acute cases symptoms are fresh in patient’s mind so you will get exact picture. But in chronic cases symptoms are old patient may not remember all symptoms. So there are many difficulties that a homoeopathic physician might faces while taking a chronic case. In these certain situation physician might use some other way to get clear picture of the patient.

Now what is chronic case? A chronic case is defined as a case which has a long history of its existence with a miasmatic background. In the course of progress and development of chronic disease, the individual passes through a slow and gradual change in his functioning and finally loses his capacity to function efficiently. Only when the individual realizes that he is no more able to function effectively, he seeks the opinion of a physician. When the physician takes chronic case, some difficulties might come in the way of case taking. Some of the difficulties are mentioned below:

In chronic cases the progress is slow and sometimes un-noticeable and uneventful, many a times; the patient cannot recall the initial symptoms in details. In these cases, only a few striking changes in the health are mentioned to the physician. Thus, acquiring all the components of the initial symptoms will be difficult for a physician.

Since a chronic disease is gradual in onset, it is difficult to ascertain the accurate time of its beginning. Physician cannot ascertain its origin of the disease.

Initially, when a disease starts with a few trivial symptoms the patient does not gives much importance to them and tries to think that they are insignificant. Only the subsequent grave changes are remembered. Therefore, there is a tendency to patient only a partial picture of the disease in a chronic case.

Generally in a chronic case, a patient does not come to a physician in the beginning. The realization that he is sick occurs late in a majority of cases. Even when some realize it, they try to take some kind of palliative treatment by themselves due to various reasons or might seek the help of some non-medical person. In the process of seeking relief from symptoms, a considerable time is wasted and the disease picture is greatly altered when he finally reports to a homoeopathic physician. Therefore, the physician may find it difficult to understand the whole phenomenon of such cases.

Chronic cases come to a homoeopathic physician, generally after patient has taken long, palliative and suppressive treatment. Thereafter the entire picture and presentation of disease is different. In such cases, it is difficult to obtain an original, unmodified picture, which is a very important aspect of case taking.

In chronic cases patient had suffered for long time, several symptoms become a part parcel of the patient’s life. In such cases, he uses his discretion to present a few symptoms significant to him and does not give out many valuable symptoms. So patient may not reveal these symptoms to physician.

Due to lack of knowledge, the patients may consider some symptoms as an expression of health due to their long standing presence. In such cases, many concomitants and auxiliary symptoms are not narrated to the physician.

In some chronic cases the patient has alternating symptoms like join complaints in winter. In such cases, they mention only the presenting complaints and forget to mention the other component. Hence, the physician does not get a complete picture.

In the case of chronic diseases, all the deviations on the physical and mental planes should be obtained from the patient in order to form a portrait of disease. Due to lack of understanding of the homoeopathic physician, sometimes the patient does not cooperate while taking the case and does not share his symptoms in relation to emotions and intellect. In such cases, constructing a totality would be difficult. If a totally is not arrived at, case taking remains unfruitful.

In cases of children and in persons with communication problem, it would be difficult to understand the exact sensations. These patients cannot express themselves. In these chronic cases, obtaining the correct and whole picture would be a difficult task. In such cases patient’s attendees are valuable source of symptoms.  

So these are some difficulties which is seen during chronic case taking, to avoid these difficulties one have to get familiar with them. Physician has to approach these situations with different way. Hope this is helpful to you. 

Clinical Case #2 : Sciatica

             Homoeopathy Cured so called incurable Disease as per Allopathic mode of treatment "Sciatica."

             My old patient Rajeshbhai ( Name changed due to respect Secrecy.) Visited me for pain in lower back to hip to leg till knee joint. Pain was very severe. He has to suffer very much to walk. He had done X-ray of leg and hip and diagnosed as Sciatica.

             First of all we learn something about what is Sciatica ? Its Causes , Symptoms.

What is Sciatica ?
             " pain affecting the back, hip, and outer side of the leg, caused by compression of a spinal nerve root in the lower back, often owing to degeneration of an inter vertebral disc. "

Causes :-

Sciatica is caused by irritation of the root(s) of the lower lumbar and lumbosacral spine.
Additional common causes of sciatica include:

-Lumber spinal stenosis
-Degenerative disc disease
-Spondylolisthesis
-pregnency
-Sacroiliac joint dysfunction

Case Taking :-
            Patient suffering from backache and its pain radiating to left thigh to posterior side left knee joint since 6 months. Pain stated gradually. Patient was irritable due to pain previously he was calm in nature. Movement of the leg was difficult due to pain. Patient was chilly. Thirst was normal. Leg feels heavy and numbness of left leg. Patient had difficulty in walking. Pain was like lightning spark type in whole left hip to knee. Pain > by lying on left side. Patient had taken painkiller for 1 month but it gives temporary relief (It's obvious..)
          The Medicine came in my mind was COLOCYNTHIS because of following symptoms
     - Left sided sciatica
     - Heavyness & numbness of Leg
     - Pain like lightning spark
     - Amelioration by Lying on Left side

I prescribed Colocynth 30 Single dose with Placebo of 1 week.

FOLLOW UP :- After 1 week pain was relieved up to 40% so that I prescribed another 1 week Placebo.

AFTER ANOTHER 1 WEEK :- Leg again become as painful as medicine prescribed . No relief at all so that I decided to repeat colocynth 30 single dose again & as usual placebo for 1 week.

AFTER ANOTHER 1 WEEK :- Pain relieved up to 30%.

I tried different potencies of colocynth for approx 4 month but relief become stand still at 30-40 %.

AFTER 4 MONTH :- Patient visited my clinic as usual. We were talking about recovery , prognosis , treatment of sciatica at that time Rajeshbhai told me , "I forget to informed you doctor as I didn't notice it previously but I feel Chilliness in my left leg during pain."

I Immediately opened Kent's repertory in which I found 1 rubric in extremities section.
CHILLINESS -> Legs -> in Sciatica
Single medicine NUX VOMICA

I prescribed single dose of Nux Vomica 30 with 1 week placebo.

AFTER 1 WEEK :- Patient came to my clinic with smiling face. Pain was completely gone. He told me that now he can walk without any difficulty.

Now it's has been 1 year , still he didn't feel pain in back & in legs. I had repeated another 1-2 doses of Nux Vomica in this whole year and given placebo.

NOTE:- Sometimes we or our patient miss some symptoms so that we can not achieve cure. Do not give up on any case because may be in next visit of patient can give you some new clue to find out most similimum remedy. Have a nice day.

How to approach homeopathic case

Taking a homeopathic case is an art and every homeopathic physician must learn it. As our mentor Hahnemann stated ‘a well taken case is half cured.’ Your case taking starts as soon as the patient takes an appointment on the phone and or as soon as he enters your clinic. So, the physician must be vigilant enough in his observation of the patient. When we should thoroughly observe the patient before we starts taking case. For an example when patient enter in our OPD we should observe the way of making his entrance, i.e. is he/she enter fast or slow, looks timid or bold? Does he/she look anxious?  How was his/her expression on face? All these little things matter in homeopathic case taking. They fill missing gaps in case. Mostly they are helping in construct the constitution of the patient.

·       Before taking a case one must collect preliminary data & basic information from the patient. Preliminary data are very useful in case study & in medico legal information. This includes —

1.    Name of the patient

2.    Age & Sex of the patient

3.    Occupation & Qualification of the patient

4.    Relationship status of the patient

5.    Religion of the patient

6.    Address & Contact number of the patient

·       After basic information from patient physician must ask for chief complain.  It is main part of the case taking so it must be noted very well. Duration of the chief complains must be note, by which we can one can know how long patient did suffer. A physician must ask how was onset of the complain, which was gradual or sudden. If complain includes pain then one must ask for location of pain, duration of pain, how long pain remains, how the pain comes and goes, what is character of pain, extension of pain, how does it decrease & increase in intensity. If it has any particular side affection then it must be noted and also where did it started first left or right or it was from left to right or right to left. For a complete symptom we must includes modifying factors i.e. how complain aggravates and how it is ameliorates. A physician must investigate patient locally and systemically for finding any physical or significant symptoms. From chief complain physician must rule out for probable diagnosis of the case. History will also rule out other disease in case if there is any.

·       Now comes part when physician notes about vital status of the patient. This includes—

1. Blood pressure

2. Pulse

3. Temperature

4. Respiratory rate

5. Urine output

These are very important in all cases especially in acute one. This will help in determine condition of the patient.

·       Past history is important in homeopathic case taking. This includes any major illness which patient has suffered in the past. In past history physician should try to elicit any major illness where in patient was not well after suffering from it. For instance, never well since typhoid, malarial fever etc. Past history does not mean only certain disease condition, but it also includes any trauma it maybe mental or physical, accidents, surgery or any laser surgery etc. Try to find the journey of disease in chronological order and the ascending nature of the disease layer wise.

·       Does patient have any family history of any disease? This will give idea about any hereditary disease which runs in family.

·       Personal history will give many characteristic symptoms which is helpful in erecting totality of symptoms. This includes—

1.    Appetite:Ask Patient about his food habits; does it increased or decreased? Does patient is OK with cold or warm food? Can he stay hungry? If he cannot bear hunger then ask when. Does he prefer veg or non-veg? Which drinks he likes? Soft drinks, cold drinks, juices, lemonades? Ask what he desire for & aversion to. Any food or drinks he likes.

2.    Thirst:How much water you drink in a whole day? Do you feel thirsty or it is your habits? Does your mouth, tongue or throat get dry? Do you prefer warm or cold water? Do you often drink water or prefer to drink water at long time? Approx how much do you drink water at a time?

3.    Tongue:Observe patient’s tongue is it moist, dry, flabby, any imprint of teeth, coated, cracked, mapped (geographical), dirty.

4.    Thermal:Ask patient what he can tolerate more heat or cold? Does he want fan or A.C. on or OK without it? Does he the one who take sweater first in family?

5.    Stool & Urine:Does it have any particular or specific symptoms in it?

6.    Sleep:How much he sleeps? Is it refreshing? In which position you sleep? Any habits of snoring, salivation from mouth, nocturnal enuresis?  Is sound or alert?

7.    Dreams:Do you remember any dreams? If yes then what is it about? How does it affect you?

8.    Perspiration:How much you perspire? Which part of body? When? Is it offensive? Does it cause stains on clothes?

9.    Addictions:Which addiction does patient have & since when? Addiction may be is the maintaining cause of the disease e.g. smoking for respiratory complains.

10.                       Speech:Hasty & hurried? Slow? Loud? Low? Jerky? Stammering? Nervous? Confused? Excited?

11.                       Milestones:Teething, walking, speaking etc.

·       Appearance of patient is really matter in homeopathic case taking. This includes—

1.    Built of body

2.    Body structure

3.    Posture

4.    Hair & face

5.    Complexion

6.    Discoloration or pigmentation

7.    Way of clothing

·       Drug history:Ask patient if he is taking any medication. Certain patient has allergy towards medicines. If he is taking medicines then ask him what for he is taking medicines & since when he started to take. In this one should think about any chronic side effect of the medication if patient is taking for long periods as presenting complaints.

·       Gynecological and obstetric history:Ask her about menarche was on normal age or early or delayed. Take full menstrual history. Before, during, after menses any characteristic complaints like backache, weakness, irritation etc. In menopausal women ask the time of menopause normal-early-delayed. Ask any other common or uncommon gynecological complains like leucorrhea etc. Was there any habitual abortion or miscarriages? Full gynecological & obstetric history requires in female cases.

·       Mental and life span:This will make patient individual one. Try to get familiar with patient. Get in to conversation with patient in deep like his hobbies, will, fear, anger, reaction, emotions, memory, intellectual level etc.

After note down all symptoms homoeopathic physician must erect totality of symptoms. Try to find group of medicines which suits in case by aid of repertory. And final similimum medicine is decided by materia medica.

So this was regarding homeopathic case taking.