Palliation through Homoeopathy
NATIONAL JOURNAL OF HOMOEOPATHY 2001 May / Jun VOL III NO 3.
Dr Dilip Dixit
Dr Anil
'Tub-b / Nat-ph / Puls

DBD- I am sending you this case for correction and inserting comments. Why he died. What we achieved what is the rationale of treatment. Please do it urgent and return tonight if possible.

Our patient is a 36 yr, Maharashtrian, male patient, educated till XIIth and working as Scientific Officer in BARC, married since 1991 and came for treatment in Jan 99 for Hepatitis B (Australia antigen +ve) at Dr M L Dhawale Memorial Trust's Homoeopathic Hospital, Palghar. He was brought by our local ICR-ite Dr Desle who was treating him.

Associated Complaint

1. Fever low grade -100° F < Change of weather < Change of food Chill < 6.30 - 8 pm.
2. Constipation since 5-6 yr
3. Diarrhoea < Spicy, Pungent food , Coconut
4. At the age of 9 yr myopia (hereditary): 3 5

Concomitants
Dark circles and puffiness lower eyelids
Perspiration Less

Patient as a Person
Appearance: Lean, thin, tall with puffiness of face with bloated abdomen.

Past History: in childhood

1. Diphtheria
2. Open Heart surgery - June 77 for Fallot's tetralogy
3. Measles
4. Father Hypertension, osteoarthritis

Clinical Examination
Pulse: 68/min. BP: 110/60. Wt: 57 kg. RS: Clear
CVS: Mitral regurgitation, Murmur
P/Abdomen: Soft, Bloated, Non-tender.
Liver: 3 finger palpable, Spleen 4 finger palpable
Tympanic Sound at Rt lumbar region, dullness at Lt lumbar region
Tongue: Posterior coating, Slight, Cracked.
No pallor.

Mentals: Optimistic, Hard working, reserved, irritable with suppressed anger later leading to depression, emotional, MWD ++, work satisfaction good.

Life Space
Patient and his sister were born and brought up in Morgaon Supe, Dist Pune. Father worked in state government office and mother was a housewife. Patient studied till12th std Science, then took Diploma in Electronics from Satara in 88. Then he worked in Computer section in Sakal press at Pune. In '88 he came to BARC at Boisar as a Scientific Officer (Electronics Maintenance). He got married in '91 and since then his whole family- mother, father and wife live at BARC colony, Boisar.

The environment at home is peaceful with good interpersonal relationship between all family members; everyone sharing responsibility as per their capacity. Father is retired and looks after granddaughter (patient's daughter). Wife works at TAPS; gets irritated often - due to job and housework, which affects patient. Patient too is irritable but never expresses his anger and compromises himself each time. At work also he gets tense or irritated with his colleagues due to workload. Patient is reserved and non-mixing and thus has few friends. But he is very ambitious and wants to provide all comforts to his family. As father’s ambition was to have their own house. he had done it by taking loan, so pt has tension about loan plus responsibility of parents and marriage of sister. This he accomplished. Now the responsibility left is of educating and marriage of daughter.

Investigations
USG: Feb 16 '01: Liver cirrhosis with splenomegaly with portal hypertension. Moderate Ascites and moderate Rt pleural effusion.

22/5/99 Endoscopic result: Esophagus Gr. II varices. Small columns
Stomach - mild portal hypertensive gastropathy
Duodenal cap - normal.

Follow Up

17/1/01	W=57 kg.		Tub 1M 1P Nat-phos 200 1P
24/1/01	Wt 55 kg. Liver 2F spleen 3F	Patient feels better than last week Fever 1/week -100° F. Stools 4 to 5 / day. Pain Rt Hypochondrium. Chilliness Urine yellowish Adv. Liver profile	Ct all
31/1/01.	Wt 54.5 kg	Fever +. GC better; Weakness >³. Thirst ed, fever < evening loose motions 29-1-01- 10 to 12 times.	Puls 200 3 pills 4 hrly x 7 days
7/2/01		Fever >. GC > weakness >³ Urine colour firstly dark yellow. Fullness of abdomen, chillness of back O/E: P/A: liver 1 F; Spleen 3 F; dullness +, ascites +, Pedal oedema Gr. III.	Tub 1M 1P Puls 200 3 pills 4 hrly.
14/2/01.	Wt.57 Kg Abdominal girth 76cm Liver 2 F Spleen 3 F	Fever >3; general state >, weakness >2, Urine colour dark yellow Nose bleed on and of < morning, odema foot - same	Tub 1M 1p Nat-ph 200 1P Puls 200 4 hrly
21/2/01.	See USG & Blood. Report		Nat-ph 6x BD
28/2/01		Fever with chills+; Edema vomiting2	Rx. Ctall Stock Puls 200 3P
7/3/00	L 1 F, Spleen 3F BP110/60.	fever - A; Temp-A; Gen. State Fresh Wt. Sq Weakness >2, sleep-Good, no vomiting O/E: Pedal edema ++, Ascitis2, since 3 wks	Nat-ph 6x QDS-7d
14/3/01	Liver 1F spleen 3F	Fever 2/w 100.6. Gen. State > Urine colour reddish yellow O/E: B.P: 106/64. abdominal girth 80.5 cm. No tenderness	Puls 200 QDS X 2d Nat-ph 6x QDS-2w
4/4/01	Wt 56 Liver JP, Spleen3F BP112/60.	Fever >3, Temp - A; Gen. State good. Weakness > Urine colour > sleep good O/E: abdomen soft, distended, non tender, Icterus Mild, swelling under lower eyelid	Tub 1M 1P Nat-ph 6x QDS x2w
15/4		Normal. Holiday so in good mood.
16/4		Mild fever
17/4		See attach report in Marathi- few acute episodes > SOS Rx 4/4/01 ate spicy <= fever and diarrhoea evening. Taken Rx from Dr Desale on 6/4/01- Better but took Crocin.(in spite of rptd attack after spices, and repeated warnings, he ct to take spices- could not resist them !!) 7/4 to 15/4 normal > Sunday fever > SOS Rx. Monday morning feverish ½ crocin. Tuesday 17/4, 3 pm fever with chill ½ crocin 14/4 to 17/4 No stools- not clear stomach Breathless on walking and climbing. Very Weak	Rx. Ct-all Stock Hep-s200 3P
9/5/01	Wt: 56 kg. Throat congesion + RS: clear Liver 2 F Spleen 2 F	Weakness 3 since 1 wk. Can't even walk/climb for a short distance, Breathlessness +, Dry Couth +++, immediately on lying down < night, has to sit up whole night since 1 wk. Pain in renal angle since 8-10 days Thirst increase since 15 days Abdominal girth - above umbilicus 82 cm. Below umbilicus 77 cm. Abdominal fullness on eating for 5-6 hr. Paedal oedema pitting +++ Icterus ed	Nat-ph 200 3P Alternate day
June 01		Report that the patient died, but overall in the 4 months under Hom care, he was comfortable and even able to go to work, except on bad days and have a good quality of life for 4 mths. ie from Jan to May when he took a turn for the worse and was unable to recover. This is palliation at its best.

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