A Koch's Case
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Jan / Feb VOL III NO 1.
Dr Sushma Metkar
Dr Ram Subramanian
'Sil / Calc-phos / Ars
This case has been selected from Dr Ram's children hospital, Mulund where Dr Dilip is consultant. Case was initially taken in Feb 97 where the simillimum arrived was Calc-Phos and intercurrent was Tub-b. Patient was managed for 2 year. The complete understanding of the totality and the overall assessment of the follow ups are given on next page.
Current Situation
Review: 21/04/99
Date of birth: 6/5/91.
Age: 8y. Sex: male
Occupation: Student 3rd std
Status :single. Religion: Maratha. Diet: Nonveg.
Fa: 55, Estate agent. Mo: 45, housewife.
Sister S1 =20, SYBCom. / S2=15 SSC /S3=12 7th
Res Address: Bhandup.
Chief Complaints
| Location Area Direction | Sensation and Pathology | Modalities, AF | Accompaniments Strict time Relation |
| Respiratory system Throat Onset 11/4/99 Since 14/4/99 Since 16/4/99 Twice in a day Since 18/4 Frequency 1/5- 10 mins 1 bout=2 to 3 cough On 19/4 S Q |
Hoarseness of voice Chilliness (goose flesh)
Fever (up to 103 F) High
grade fever Wet Cough |
< 4-5 am < 11.30 pm <Morning Not better with Mox, Nivaquine, Reziz, etc |
Lachrymation during Fever App - Decreased Thirst - Decreased Sleepy during fever Weakness during fever Talks in sleep Lip red during fever Vomiting twice, offensive Eyes open during sleep Starts during sleep |
Associated Complaints
| H/O: at 2 months of age
(lasted for 8 days ) 6.9.91 (for 2 days ) From 91-97 Since Sept’96-Feb’97 Frequency: 1/ month From 1997- 99 3 time in 2 years NOSE since 20/2/97 To 18/1/99 4 times until now Cough |
Mild
coryza and cough Cold, breathlessness Sneezing Nose block Breathlessness Yellowish, nasal Discharge 2 Nose block+ |
>
Allopathy > Ipecac/ Antim- tart > Solexin and Bisol Pant A/F cold food, Cold drinks A/F C O W3 > fried food |
Dull Thirst- N App - N Restless2 Weakness2 Thirst - Normal |
| Skin | Papules | A/F Pollens in Native Place (Sangli) Post- pigmentary lesions |
|
| Anus Since 6 years on off |
Itching ++ | > night2 |
O/E: Temp+ Throat - N. Chest - Crepts +
P/A : L2 ½ Finger palpable (FP) , (Lt) lobe 2 FP SNP
(1) CBC MP (2) Urine (3) SG PT
(4) Widal (5) MT (6) X RAY CHEST-X RAY
CHEST-haziness LLL with effusion
Hb - 11.5 gm% , WBC- 8700,
M62, L36, MP-No
Urine -NAD, SGPT-36
Widal- O-1:20, H- 1:20
Patient as a Person
Lean ++, Fingers Long, skin clear, wheatish complexion
Perspiration; Moderate2, Neck2, upper lip2 Odor -socks2, offensive2
Craving: sweets2, tomatose2, Av: milk3
Development And Growth
BIRTH WT 3.2 Kg, Milestones-within normal limit
THERMAL MODALITY: C3H2
F/H: Koch 's -MGM and PU. Allergic Rhinitis - Fa: MI-PGF
P/H: recurrent RTI-Pt(self).
SLEEP: eyes remain half open during sleep.
DREAMS: Ghost2, cricket2.
Life Space
The patient is an 8 year old, male child belonging to a Hindu Maratha Family. He is the youngest in the Family with 3 elder sister: SI =20y, S Y BCom, S2= 15 y -SSC, 12 y 7th Std. Father is an estate agent and a loving and caring person while Mother is a house wife caring, anxious2 and co-operative by nature.
He studies in 3rd standard. Always stand 2ndin his class. Very particular about his studies, and will not sleep till his homework is complete. Mother finds it very difficult to convince him as she is not educated and hence keeps awake to help him out. Mother has never to bother, as he does his work well. While writing if he makes a mistake, he will erase it nicely and re-write things. He is very friendly and obedient; hence he is the pet of the class teacher. He likes to wear new clothes but will never make a fuss about it. The reason given by him was that if I wear different clothes whenever I come to doctor, she will think I am a good boy. As soon as he comes from somewhere out, he will immediately change his clothes. He wants others to play perfectly with him. If a boy drops a catch, he will immediately go and explain him how important it is to play nicely. Keeps awake till midnight watching cricket on TV when studying, but the moment the channel is changed, he sleeps.
He starts weeping if scolded. If teacher scolds their entire class, he will come home and repeatedly tell the incident to his mother. Though she will try to convince him otherwise, he will reply that it was definitely their mistake and they should not behave in this manner. While playing also he dose not like colleagues misbehaving. If he finds no one is listening to him, he will come back home.
While walking, if he finds small photographs of gods, he will immediately pick them up and keep them in his book. If in case, it is dropped by anyone, he will immediately start scolding them-will keep the photograph to his chest. If he sees a Mandir, he will join his hands, and ask his mother to do the same. He says: everyone in the house performs pooja but none of us has such religious feelings.
He will take money from parents but not spend a single rupee for buying a chocolate for himself. He likes out side food but does not eat it, as it is bad, text books say. He obeys everyone, shares a good relationship with his sisters, often fights with his younger sister, but most of the time scolds her for eating chocolates etc.
He gets anxious and restless before exams and if anybody is unwell at home.
Our Approach And Chronic Totality after review:
As we had many qualified mentals, Kent's approach was selected.
Differential Remedies
Lyco was ruled out on the basis of sensitivity, behaviour and conscientious and physical hard data.
Understanding Of Intercurrent
FM: Tubercular
DM: Tubercular
- Tubercular constitution: Lean, long fingers.
- A Hypersensitive response which is now unpredictable.
- A rapid progressive pathology can go into complication.
- Anal itching.
Understanding Of Clinico-Pathological Co-Relation
Initially hypersensitive response to food allergens has been noted where the inflammation has been restricted to the level of Bronchus, Pace has been rapid and duration of 1-2 days
Now since 11/04/99
Inflammation in the Lungs 
exudation pressure effect. Hepatomegaly, Clinical impression being: Koch's with pleural effusion.
Susceptibility: low pace-rapid characteristics++
Pathology - deep seated and progressive
Sensitivity - High
Management: Specific
Homoeopathic Planning And Programming
| Repertorial Totality | Potential | Differential Field |
|
Lean AV: milk Desires-sweets. Perspiration: nape of the neck Perspiration: odor-offensive2,feet |
|
| Silica was selected on the basis of hierarchy in the reportorial analysis and structuralisation | ||
| Structuralisation | Physical Generals | Pathology |
| Mind Anxious Tearful Sensitive to reprimand Conscientious Drive ++ Perfectionist |
Lean Long fingers Perspiration: socks2 Feet+ Av: Milk Cr: sweets Eyes-Half open during sleep Behavior Obedient/perfectionist |
Koch's |
