Learning from Seniors
Shahida A Baig.
Cases.
` Merc-s / Alum / Plb
An approach to a case is a difficult topic. Every Physician has his own way and no one likes to loose his case just as no driver wishes for an accident. The basic knowledge of medical education trains a doctor to learn about his patient and disease. But for the rest, his intuition works. Medical science is an imperfect science. Whatever is written in books should not necessarily be also found correct in our day to day practice, which in fact is an art.
My introduction to Homoeopathy was incidental. I was very sick and declared incurable by my doctors. Those were bad days formed & my family but finally my sufferings and agony were treated by Homoeopathy. This gave an excitable joy to my husband, Dr. Mirza Anwar Baig, a famous allopath then and now a Homoeopath. He insisted that I learn Homoeopathy.
The clinical approach or a pathophysiological approach to assess Homoeopathic remedy requires a lot of clinical background. Here I would like to share my clinical experience with some of the critical cases treated by us. The first case is of my aunt.
Case 1:
She was a known case of Diabetes and Hypertension with Ischaemic Heart Disease. She was admitted in intensive care unit of a hospital in Mumbai for the treatment of myocardial infarction. One day she developed severe chest pain with respiratory distress and became critical. My cousin sister called me desperately saying that the attending doctors have expressed their inability to manage the case, as she had a second massive attack and could die at any moment. "Call all your relatives" they said.
I saw she was in a state of collapse. She was deathly pale, prostrated and was restlessly fighting for her last breath. Her eyes were sunken, face swathed in perspiration and whole body was drenched even though fans and A/C were on. She caught my hand to lean forward, looked restless and begged; Beti, save me. I gave her a dose of Carbo veg 200 which gave her a little ease after two-three eructations but she still was critical.
I came out from the intensive room and phoned my husband. He prescribed Merc sulph 30, repeated doses. My aunt was discharged from the hospital after a couple of days. When I asked my husband about the diagnosis of the remedy which helped her so quickly, he explained: what I described on phone was a clinical picture of Acute Congestive Pulmonary Oedema which she developed because of the severe heart attack with signs of left sided failure.
Pulmonary oedema is one of the gravest emergencies in clinical practice. The patient is dyspnoeic, orthopnoeic and restless, actually drowning in own secretions. This matched with the clinical picture, I described of my aunt. Dyspnoea pathophysiologically was caused by an elevation in left ventricular end diastolic and left atrial pressure leading to back pressure & fluid collecting in the Lungs.
The rubric selected was DROPSY, in CHEST, Kents repertory; page 829. Nine remedies are listed with three marks. Amongst them two are restless. Since the patient was warm Arsenic was overruled and Merc-sulph was prescribed.
Case 2:
He was a 10 year old boy suffering from obstipation (Chronic constipation). The boy was not able to pass his stools for fifteen days at a time. Enema and rectal suppositories were ineffective. The duration of his illness was three months. During this time he could only pass his stools twice and that too surprisingly,in the hospital, when he was administered barium for the purpose of investigations. His reports were normal and the doctors of two different hospitals were not able to find the cause of his disease. Serological reports were also normal. In spite of this, they gave him antitubercular line of treatment with no result.
The detailed history revealed that the child used to get frequent diarrhoea for which he was treated but it resulted in constipation. Thereafter he was treated as a T.B. patient. However the child did not experience any uneasiness because of the constipation.
I gave the boy Plumbum on basis of totality and later Pulsatilla on the basis of constitution but both the remedies failed. I discussed the case with my husband who gave me the clue to get the simile which finally worked.
The clue was that whenever he received barium meals he was able to pass stools. This was interpreted as similar to paralytic ileus. The barium meal is a heavy metal and has its own weight which passes out with the force of gravity and not with the bowel movement. The remedy was Alumina 1M single dose.
Similar pathology or state of intestines has been registered during the proving of Alumina, where the accumulated stools passed out at a time (ref. Dr. Herings Guiding Symptoms; page 157, vol. 1-2: No desire for, and no ability, until there is a large accumulation).
Case 3:
He was two and half year old with inability to stand or walk. (see photo below) His limbs had become flexed as if they had no life, although he was able to move them. The child was constipated with no appetite and was on antitubercular line of treatment. His CT Scan Brain did not reveal any pathology. He was treated as a polio case.
The detailed history revealed that the mother noticed twitching on the right side of the face. Later the child went into spasm, followed by loss of power. The history further revealed that the first problem of the child was diarrhoea following measles and was treated with antidiarrhoeal remedies for a long time. And gradually he developed loss of power. The history further revealed that the first problem of child was diarrhoea following measles and was treated with antidiarrhoeal remedies for a long time. And gradually he developed loss of power and weakness of his limbs along with wasting. The child was mentally active and mischievous with a constant desire to travel outside.
I prescribed Causticum but did not find any further change. On 17-11-969 the case was seen by my husband who prescribed him Plumbum met 200-3 doses, One dose every 3rd day. Next week when the patient reported there was not much improvement in the power of the muscles but the child had started eating food (earlier he was taking only biscuits, the mother had disclosed) and started passing normal stools. In the 2nd week the child started to step forward with the help of his father and from the 3rd week onwards he started walking with the help of father. On 8-12-96 the child was given Calcarea carb 200, single dose which further aided in the recovery.
Plumbum met was prescribed on clinical observation alone and that too on the basis of pathophysiology. The rubrics selected were two 1) Sardonic laughter (K R page 62) and 2) Flexed leg when tries to walk (page 1006).
Pathologically sardonic laughter and flexed limbs are actually rigidity due to painless tonic spasms of the masseter and lower limb muscles. This kind of tonic rigidity of the facial muscles and of the limbs matches with that of Plumbum. This typical picture one can see in a tetanus ward. Tonic rigidity is thought to be due to the action of the toxin on the neuro muscular end plates, whereas reflex spasm or convulsions are caused by the increased excitability of the anterior Horn cells.
In such cases CATSCAN or MRI will not reveal any clue, but of course the FACE of the patient will. The boy was given later a few weekly doses of Silica after long observation and reflection about his condition. Although he could walk with the help of parents, it is only if he can walk unaided that we can claim to have cured him. If silicon (silica) in the soil can provide grit and help the plant to grow erect we though it can also help this boy to walk erect. And, lo, the result of Silica was dramatic and the boy is now able to walk erect on his own.
