The Irresponsible Father
NATIONAL JOURNAL OF HOMOEOPATHY 2000 May / Jun VOL II NO 3.
Dr C B Jain
Dr Bipin Jain
Ars-iod / Phos / Tub

Now let us take the actual case and try to:

1. Learn to evolve the concepts of
   1. case-receiving
   2. clinical record
   3. clinico-pathological immunological and miasmatic correlation
   4. totalities
   5. problem structuralisation.
2. Management of a complex pediatric case.

Chief Complaints

Location Direction Spread; Duration	Sensation & Pathology	Modalities AF	Accompaniments Strict time relation
Gen Since 4 years Recurrent1/15 days 1/7 days No prodrome Sudden onset Duration 2- 8 days	Pyrexia: Body Hot with chills Delirium Speech unintelligible No violence When asked are you frightened - says yes	AF Bathing in cold water AF cold drinks AF Ice creams	Occ Teeth grinding Wants and keeps covers. Lies down as soon as fever begins. Appetite poor Thirst small and frequent- 3-4 times initially then falls asleep. SLEEPY3 within ½ - 1 hr of fever. Head hot H/o 1 convulsion with eyes rolled up
Respiratory tract.Recurrent freq.At age of 1 ½ yrs	Coryza watery. Nose block, Cough Breathlessness - heavy Breathing Rep Municipal hosp Discharge Card DOA 17/8/92, DOD 21/8/92 Hb 8.19, TC-12500, P56. L40, E-04, ESR 35 mm at 1 hr; MT +ve, XR chest-Rt Hilar haziness.		Treatment AKT 6mths.
Face - below eyesSince 2 yrs, recurs	oedema
GUT since birth	Urine output low H/o phimosis operated-1994 Urine output better.

Assoicated Complaints

1mm after birth since age of 2 years, 1/5-6 mnths x 1-2 wks

"Jaundice" urine yellow, eyes yellow Pain abdomen, vomiting, no fever

Patient As A Person:
Lean, no bleeding tendency, no cracks, no suppuration, no coldness, no heat. Sick-looking, malnourished, cranky child with unclean running nose, dirty clothes, unwashed dirty look and lusterless skin. Mother also mal-nourished, but certainly better in appearance.
Perspiration: diminished. Mainly around neck, abdomen
Appetite: increased, frequent small quantities.
Stool: Dry, hard since two months, strain+, no lienteria.
Urine: day/night 4-5 times quantity adequate.
Milestones: teething: 9 mths no problem. standing and walking:1and1/2 yrs because of weak health. Speech 11/2 yrs. Breast feeding till 11/2 yrs, solids after two yrs.
Thermal: sun no aggr. Fan in summer and winter, never covers. No Woollens, likes cold bath.

Family History: PA and PGM - Hypertension
O/E: BP 120/80. Wt 10 Kg, Nails - pallor, frontal bossing, conjunctival xerosis ++, oedema- periorbital & below eyes Liver + 1 F RS/CVS- NAD

Investigations - CXR PA VIEW
25.09.92: para-hilar ? Retrocardiac infiltration, increased, thickened bronchial wall favours bronchopneumonia.
17.08-95: Right hilar haziness.

Mentals And Life Space: Egoistic. Irritated if touched and if harrassed further, hits and beats. Beats a child who offends by words or opposes him. Obstinate3- lies and rolls on ground.

Pt does not get along with elder sister, so harrasses and beats her. Likes younger sister and plays with her. If younger beats elder then feels bad and starts crying. POSSESSIVE3 about own things. Afraid of father, who has beaten and scolded him twice. But he is not afraid of his mother inspite of a lot of beating. No other fears More history was obtained after mother wrote down full history form:

Family Set Up: Patient has 2 sisters- 6 and 2 yrs. They live with their parents and PGM. One paternal aunt, who has left her husband's house in Gujarat, also stays here with her children. Another paternal aunt recently committed suicide. Her children also stay with them.

Father is an auto rickshaw driver working irregularly and not shouldering responsibility. This financial constraint lead to strained family relations at times Pt has a violent temper, will not rest till beats up the one who offends him. The intense obstinacy manifests through lying on floor and rolling on ground.

Mother spontaneously said that he has much attachment for both sisters, even cries if they have some problem. As such he is possessive about his own things, but if mother beats this same demanding elder sister, patient starts crying and gives things to sister immediately. Weeps with anger, when dominated, when his own demand is not fulfilled or he is scolded..

Follow-Up of previous treatment at the OPD

28/6/95			Sac-lac
30/6/95	cough < 2-3 a m. thirst - N covers sometimes in morning only. Wants Fan. coryza - yellow white; morning cough, vomiting-sticky mucus + tea and bread Activity-N O/E Ant Basal fine crepts Ant upper lobe mild wheeze Then SL for 3 days.		Phos 200 QDS -3days
3/7/95	Cough >. occ < 2 am Coryza was >++ Again watery 2 dys. stools passed, thirst # for cold water sips Activity -G Temp N. Fan ++ No covers Fine crepts Rt base		Tub-bov 1M -1  HS Sac-lac
5/7/95	cough >2 once or twice a day. cold >+ No fever till yesterday; again 5 am, chilly wants covering +Activity G thirst #2 for sips. O/E RS clear T-98.4oF	Paediatrician's opinion of nutritional status sought	Sac-lac
10/7/95	Fever night 3-6 am with chills, since 2-3 days. Asks for sips of water during fever. Poor App. Pain in abd - Rt & Lt hypo.No throat pain. Cough >2 only 2-3 times/day ? rattling in chestCoryza yellowish or whitish- thin to thick. Covers in fever. Fan3 O/E Temp 100 F (axilla) RR-28/min RS/ PA-NAD XR # Bronchovascular marking. Findings and report of x-ray don't match T ongue moist+ mapped + strawberry. Throat+		Sac-lac
11/7/95	10 pm fever with chill covering + Fan on 1Asks for water3 , complaint # after allopathic Rx. Continuous cough at night with 1 vomiting in morning. Coryza- watery+ Throat pain++ Weeps at trifles. Irritability#. pain in abd.O/E T 100 F Head hot, ext. warm. RR 26/min P110/m Throat++ Tongue mapped, strawberry RS clear PA centralised tenderness XR progressive Kochs Hilar Nodes+ Lung Infiltrates MT -ve ESR 35		Paediatrician started AKT- l
15/7/95	Cough ++ < night watery coryza. Fever ++with chilliness since 4-5 days <nightCovers++, sweat after fever wants to uncover. Thirst ++; throat pain+; salivation in sleep (chronic) O/E: Rt. Ant/Post crepts++, Wheeze+ mapped tongue, uvula mild congestion.Additional information: Patient was lying down, very weak++, coughing ++. Patient is lean thin, malnourished. Confirmed examination finding of MO. WT- 9 KG. Pt is hot when not having fever. Thirst increased++ Fever with chiils at midnight for 2-3 hrs.		Wt loss 1 kg in 2 wks

Patient Came To Us At This Stage :
Till now case was treated under other Homoepathic OPD and under paediatrician. Taken AKT for 5 days when he came to us on 15/7/95. On seeing the case history, treatment and state of patient, first important thing was to understand the clinical state with general vitality and immunity.

R S Early Infancy Nose Once/15 days For 2-8 days at age of 11/2 year Again 2m < 15d

Cold Running watery Block ++ cough++ fever++ chilliness + wants covers febrile convulsion, rolling of eyeballs; does not recognize person Heat of the body ++ Cold ++ cough ++ Persp ++ back. App N

AF cold water 2 < night 3 2-5am> ?

Talking + Lethargic Wants to lie down Sips frequently Alert. Thirst : frequently, sips.

Continue Reading...

Back