Alterness is the Key!
NATIONAL JOURNAL OF HOMOEOPATHY 2004 Mar / Apr VOL VI NO 2.
Dr Navin Pawaskar
'Psor / Merc-dul / Tub-b
Baby G C, Female child of 20 days.
Chief Complaints :
| Location | Sensation | Modalities | Accompaniments |
| Liver | Vomiting | Sleepy | |
| Hepato Biliary System | Curdled Milk | ||
| Distension | |||
| Since birth Abdomen | |||
| Freq every 6 hourly | Stool 4-5/day white | ||
| Yellow, non-offensive, semisolid | |||
| Onset Age : 8 days Sclera | Yellow | ||
| After birth | |||
| Gradually | |||
| increasing | Skin Yellow | Not better by | |
| Mucosa Yellow | Photo Therapy | ||
| Sucks milk well | |||
| Cries before urination | |||
| Activity normal |
Patient as a Person:
History of mother: morning sickness. Recurrent fever during 1st Trimester.Delivery: Pre-term 37 Wk; delivered at home
Lactation: Normal
Mental State during pregnancy: no characteristic data available
Reactions: Physical Factors:
Fan: Comfortable with fan at 2-3 speed.
Covering: prefers Comfortable with warm bath.
C3H2
Past History:
Mother: Tuberculosis: before pregnancy. Rx AKT 1 year.
Father Typhoid:
Paternal Grandmother: Tuberculosis
Physical Examination:
General: TP - Normal; Resp Rate 30/ min
Local: Conjunctiva No Pallor
Mucous membranes-icteric; Skin-icteric
Hard palate - icteric
Anterior fontanelle open. Posterior fontanelles closed.
Genitals normal. Testes well descended size normal.
Nipple buds well formed.
Umbilical stump NAD.
Anus NAD
Reflexes normal
Unable to hold the head.
RS NAD/CVS NAD.
PA soft/distended/tympanic/child cried on touching Abdomen/Liver ??? finger
palpable
Provisional Clinical Diagnosis:
Intrahepatic Obstructive Jaundice
Investigations
| CBC | 5/02/99 | Serum SGOT | 60 | |
| Hb | 7.4 | SGPT | 80 | |
| WBC Total | 9650 | Bromsulphalein Exc. | 17.55 | |
| N | 29 | Bilrubin | T | 21.7 |
| E | 2 |
D |
4.15 | |
| L | 69 | Ultrasonography abdomen scanned | ||
| Liver Function Test | 04/02/99 | organs are normal. | ||
Conceptual Image: Classification and Evaluation of Symptoms
| Item Cause Aggravations in General Ameliorations in General Sensations and Complaints Mentals Characteristic Particulars |
Data Tubercular Miasm (Fundamental and Dominant) Nil Nil Stasis Nil Liver Hepato-biliary System Periodic Vomiting of curdled milk |
Analysis of the totality
Phase: Functional intrahepatic obstructive jaundice.
Freq.: 1 every 6 hrs Cyclical Vomiting
Mucous Membranes: Icteric
Infant (time)
Hepato Biliary system-biliary stasis due to high viscosity.
Phase: Functional intrahepatic obstructive jaundice.
Vomiting Curdled Milk.
Time is the key to the case. Cyclical emphasizes time and the other time is the
time in the epoch of the individual, ie the infancy.
Location of the liver assumes secondary importance along with the pathology of
biliary stasis due to high viscosity of the bile.
So the remedy which is needed should have the characteristic of time and rhythm
and also the stage of life and the disease with characteristic pathology and of
stasis and viscous discharges.
Merc-dulcis 30 was prescribed in infrequent doses.
Tuberculinum was used as an intercurrent considering the fundamental
tubercular miasm.
Ref Kent: Chapter on stomach as the main rubric and vomiting as the sub rubric.
Follow-up:
There was an extremely gratifying response to the remedy. Within 5 weeks,
Bilirubin returned to normal with overall improvement in the general condition.
References
1. Dhawale M L, ICR Educational Series Booklet No. 4: Standardized Case
Record (1984), Institute of Clinical Research, Mumbai.
2. Hahnemann S, Organon of Medicine, Aphorisms 83-104, B Jain Publishing Co. New
Delhi.
3. Dhawale M L, Symptomatology from the standpoint of Homoeopathic Practice,
Principles and Practice of Homoeopathy Vol 1 Homoeopathic Philosophy and
Repertorization, Institute of Clinical Research, Mumbai.
4. Kasad K N, ‘Repertorization: Concept and Technique’ in ICR Symposium
Volume on Hahnemannian Totality. ICR Bombay Symposium on Totality.
Emergency Case 2
A 9 month chubby male child came with C/o coryza, cough and fever with
respiratory distress since 2 days.
There was audible wheeze which could be heard even outside the room. According
to the mother audible wheeze was worse only when awake. >3 
Sleep During
Thirst increased2, fever during
O/E: T: 102F RR: 80/min Suprasternal Retraction + Ch: Wheeze + Bil Crepts
L 2 FP S 1 FP
Observation: Child was sleeping with arms spread apart. According to mother
child usually sleeps on sides.
Totality:
Respiration whistling < When awake
Thirst increased 2 heat during
Respiration audible > Lying back with arms but stretched
Treatment:
Psorinum 200 Multiple doses resulted in short amelioration
Psorinum 1M Single dose settled the case
Conclusion:
The case demonstrates the importance of observation during practice for
prescription.
