Approach to treating TB cases
NATIONAL JOURNAL OF HOMOEOPATHY 2000 Sept / Oct VOL II NO 5.
Dr C B Jain
Dr Bipin Jain
'Kali-c / Ars-a / Sil / Phos / Kali-bi
Mr P V M, Kutchi Brahmin, 29 yrs, Married 2 ½ yrs, reported at Dr (Mrs) S S Shah's clinic on 23/08/97 with the following acute complaints.
Low grade fever T:99.4 since 1 week. A/F Cold bath when heated. Cough with white expectoration
O/E: RS NAD. Weakness3 last 2 days. Thirst: Poor3 TASTE bitter
Patient received Gelsemium 200 4 hourly for 2 days.
Keeping in mind the course of the disease, XR chest was ordered.
25/08/97 Headache > 2, cold + cough +. O/E fever 99oF
XR mild infiltration in both apices. ? Koch's origin
Rx Gels 200 4 hrly ct for 4 days
Without any general symptoms XR showed bilateral infiltration. The primary Physician telephoned me for help. I asked to see the XR. I could confirm presence of infiltrates but plate quality was poor. XR repeated with another radiologist.
29/08/97: No fever since last 4 days. Weakness >3 mild cough
Repeat XR: (Lt) apical cavitation of Koch's origin.
As he was better, Placebo given, but the tissue level disease was progressing. Within 4 days between two x-rays, infiltration 
cavity. This alarmed us. The case was defined immediately.
Chief Complaints: See the follow up 23/08/97 - 29/08/97
Associated Complaints
| Location | Symptoms | Modalities |
| Head, Rt side | Severe pulsating pains | < Increasing and decreasing with sun |
| Sinuses 3-4 years back; for 2-3 days and 8 months back for 4 days |
< touch < stooping > pressure |
|
| UR Tract Recurrent Throat and Nose |
Coryza + thick discharge Throat irritation |
|
| Ears | Sensitive to draft | < cold draft >with allopathic RX |
Patient As A Person:
Appetite N, irregular eating habits
Desire - salty food, aversion - spicy2, sweet
Perspiration: General 2 in hot weather
No stains or odor
Sleep: OK.
Dreams: Black snake
Friend committing suicide in front of him
Playing cricket
Running and someone behind him, trying to catch him, all doors closed, can't run.
Thermal: Chilly C3H2
P/H/O: Typhoid
O/E B P - 130/90, wt 64 kg, temp - N
Chest NAD, teeth - cavities
Investigations: CBC - ESR - WNL
XR chest already reported
XR PNS: Mucosal thickening Rt. Maxillary sinus S/O chronic sinusitis. Bony nasal septum is deviated to Rt.
Life Space: Patient a graduate from Kutch, married 3 years, is from a joint family. Right now he is alone in Mumbai while rest of the family is at native place. Highly anxious person, his main anxiety revolves around family, their well-being and their telephone calls. Whole night he is disturbed and restless, if he has not received message from family! Apart from this, life is not stressful. Making the totality on the basis of emotional state of person, his constitutional selected was Kali-c.
High sensitivity (emotional) and deteriorating tissue: so susceptibility: moderate.
Selected moderate (30) potency and cautiously repeated daily doses.
3/11/97: Repeat X-R: cavity absent with fibro-nodular shadows with calcifications at left lung apex. All these days he did not have any symptoms.
Important point that strikes is the absence of cavity and enhancement of healing process up to calcifications in the small period of 8 weeks.
Case 2
A similar case: of a young boy of 21 years already under my care. He reported to me after a gap of 6 months for fever for 2 days - 100-101oF with mild chest pain, Rt Side pleural reaction and fibronodular infiltration. An experienced radiologist diagnosed an early tubercular lesion.
Fever and generals were taken care of within 2 days with acute Ars-alb 200 4 hrly. I did not hesitate to give his constitutional medicine Silicea 200 in single dose. 2 doses in few weeks cleared every thing. X-R totally normal after 6 weeks of treatment. In both these cases, because of the prompt action, there was a prompt response and quick result, healing was fast and complete at the end of few weeks. This proves the efficacy of Homoeopathic Treatment. At minimum expenditure of energy we could restore the susceptibility. This was possible because the disease had just begun. The damage was minimal and susceptibility was un-tampered by other medicines. We struck with right force at the right time- first the acute and immediately the constitutional force. This conclusion is the result of research at the hospital level practice. The results are better and very quick. This is what we are trying to teach and spread.
Case 3
Mr S 25 years old, NV married since 6 month; consulted on 22/07/97
Occupation: Begari. Residence in slums.
| L | S | M | C |
| R S For 2 months 1 yrs Back in village In between Inc. since 7 months |
Cough with yellowish Expectoration | < 2 lying on back < 2 eating rice < 3 evening 4 pm X 5 pm |
|
| Inc. 3 since 1 month | Thick now thin, not Stringy NO HAEMOPTYSIS Breathlessness |
<lying on sides >1(AKT-for 4months) Discontinued due to Money shortage < exertion < cycling- double seat |
|
| Chest (Lt) side & sternum D-> 5-10 min |
Pain3 stitching pain like needle, Difficulty breathing Fever with chilliness3 Weakness++ Fever with chilliness3 Wants covering Wants to sit in sun Bodyache3 App.3 decrease Cough-SNo cold, breathlessness, Increased, Weakness3, giddiness cannot move/getup |
< inspiration Headache3 Eyepain3,Burning3,Watering of eyes,Headpain3 Sleeplessness Yellow urine < 3coughing <evening |
Thirst no change |
| GIT> Abdomen More than 1 yr Generalized |
Pain3, drawings3Does not allow me to get up from the bed. No nausea/vomiting, no burning | 2<6 pm 3 < 4 am to 8 pm 2 > pressure no abd. Bending |
|
| Again started since 1month After chest pain | Stool-N, no flatulence. App 2 decrease. Cannot go to work due to abdominal pain | lying on abdomen 3 < empty stomach 3 > eating. |
Associated Complaints:
Extremities: < 2 exertion < 3- 4 pm
< 3 morning(4 - 8 am
Physical Characteristics:
Tall, lean, thin, dark complexion, long eyelashes
Wt: 43 kg
Perspiration: general on exertion, no odor, no staining
App: dec. since 1 year
Cr: Highly seasoned - > spicy2
Sleep: Good otherwise, less since 4 days
Dreams: not much; 2 years back++ dreamt of village.
Meterological
Sun < covering - S-x, W-1 Blanket
Getting wet <
Bath-cold throughout
No major significant F/H or P/H
Physical Examination
T: Afebrile. P: 80/mon (R)
BP: 120/80 mm of Hg
Conjunctiva - pale+ clubbing, throat-NAD
Tongue: clean, moist imprints+
No Lymphadenopathy
RS: Trachea-central, chest expansion equal, air entry equal, percussion - NAD breath sounds normal (vesicular) crepts in infra-scapular areas Lt > Rt.
P/A: NAD. CVS-NAD
Chest XR case caverabues lesions Rt. mid and lower zone
Objectives of the case presentation
- Learning the importance of interpretation of data and its repercussion on construction of TOTALITY.
- Experiencing the fixities of ideas we carry about the MMI.
- Understanding the significance of appropriate assessment of susceptibility in management of ILL-TREATED KOCHS.
The totality undoubtedly pointing towards Phosphorus. Yes, everybody had a fear in his mind that it can damage the case. The susceptibility/sensitivity was studied; it was moderate with high respectively. The potency selected was moderate, structural changes in lung tissue and high tubercular sensitivity forced us to prescribe the dosage cautiously. 29/7/97: Phos 30 1/week. Within 3 weeks patient was asymptomatic. In absence of symptoms team overcautiously gave Placebo and observed for few weeks.
14/10/97 Symptoms recurred. Phos 30 1/week till 16/1/97. Patient was again asymptomatic. XR chest showed marked improvement. Patient gained weight by 2 kg, but c/o weakness and feverish feeling. Phos 200 single dose. Patient is under observation till date and does require infrequent doses of Phos 200 for other complaints, but tuberculosis is completely healed. This case also gives us the learning that we need not be scared with this drug force but we should follow the rule of defining susceptibility and manipulating it with required/indicated force for our advantage i.e. the healing.
