A Case of Diabetes Mellitus

Name – Mr. P. R

Age – 55yrs

Occ – Professor

A 55 yr old man diagnosed as diabetes mellitus type II visited me on 25/09/13. He has been a professor at the renowned college of Wardha. He is a post graduate and doing some law course at this age.

Chief complaints –

Drowsiness with weakness after physical exertion since 3 months.

Amelioration by taking light food.

No other modality detected.

After taking meal he feels drowsy again. His daily routine was as follows

       Takes breakfast

       Go to college and take lectures

       After 3 lectures (each of 45 min.) feels drowsy with mild sensation of

vertigo

       Again takes some light food and feels fresh and resumes his work.

All this is suggestive of hypoglycaemia.

The interesting thing is that the patient was diagnosed as hyperglycaemic and on allopathic medication (metformin 500 mg TDS). It means the symptoms are due to anti diabetic drugs.

Physical generals –

• Appetite – good. Can hold hunger but causes dullness and vertigo, so do not

wait

• Desire – N A P
• Aversion – N A P
• Intolerance – N A P
• Thirst – small quantity after long time. Thirstless
• Urine – no complaint. No colour changes noted by patient. No pain.
• Stools – satisfactory. No bleeding p/r. No pain before, during, after.
• Perspiration – scanty on forehead.
• Sleep – sound, refreshing.
• Dreams – routine things and that too rarely.
• Habits – N A P

Thermal interpretation – chilly patient

• Bathing – prefer lukewarm water
• Fanning – prefer in low speed
• Season – prefer winter
• Covering – prefer according to season

Past history –

• Recurrent tonsillitis in childhood
• Operated for inguinal hernia (bilat) at age of 36
• # rt ankle with dislocation of rt knee in RTA
• Cervical spondilosis before 10 yrs.

Family history –

• Father – Ca. Throat. Died
• Mother – COPD. Died
• Brother – 1) DM  2) hypertension 3) BHP
• Grandparents – ?

On interrogation I found him to be very hurried. His speech, activity, even entry in my chamber, everything was hurried. He was on perfect given time of appointment. When I asked him about this , he said “I don’t want to give a chance of complaint to you”.

On further interrogation, about his life till now:

His father died due to Ca throat when he was of 16 yrs. He has 3 younger brothers and a sister. Mother was asthmatic. As he is the oldest son, whole responsibility of family was on his shoulders, including his own development. He made everyone well educated and he himself become PG. Learning with earning was going on. Mother died due to COPD when he was of 21yrs.  He felt like he lost his inspiration due to the death of his mother. After 2 yrs his sister got married. Then he asked his brothers to earn by themselves and went to district place for a job. Found his job as lecturer at age 26.  He was married at age of 30 and has one son and one daughter.

He said that at his institution some people have tried to suspend or demoralize him, bit he just concentrated on his work. “People used to come for their work and I happily helped them without any reward, but some appreciation of my work is always desired”. Some chances of promotion he didn’t accept due to fear of failing. He’s now doing a law course as a backup plan after retirement, so that he can earn some money and help people avoid getting cheated in this field.

Mind –

–        Fear of high places

–        Appreciation, want of

–        Hurried

–        Fear failure of

–        Anticipatory anxiety

Investigations –

08/09/14

Blood sugar – f – 84.45 PP – 204.21

Urine sugar – f – nil  PP – +

Case analysis –

Miasm – syco – syphilis

Layer  –

       V – DM

       IV –

       III – # ankle , dislocation of knee, spondilytis

       II – hyperacidity

       I – recurrent tonsillitis

Side prominence – right side

Thermals – ambi to chilly

Thirstless

Rubrics –

       Mind – fear – high places of

       Mind – fear – failure of

       Mind – anxiety – anticipation from

       Mind  – hurry

Final remedy- Argentum nitricum 200 

01/10/13

Sl for 7 days with advice to make anti-diabetics drugs half the dose

09/10/13

Better+. Vertigo and dullness slightly decreased. Sl for 7 days with advice to make ant diabetics    ½ bd

16/10/13

Better+. No vertigo. Dullness as it is. Advised to stop anti diabetics. Sl for 7 days

29/10/13

Generalities good. No vertigo. Dullness as it is. RBS 138. Sl for 7 days

18/11/13

Dullness as it is. Vertigo mild.

Arg nit 200/1d. Sl for 15 days.

04/12/13

Better++. No vertigo, dullness decreased. Generalities good. Mild pain in back.

Sl for 15 days

02/01/14

Back pain increased. Stiffness of back. Mild nausea with burning in oesophagus. Sl for 15days

15/01/14

No back pain. No vertigo. No dullness. Can take lectures continuous without any break. Mild fullness of abd with flatulence. Sl for 15 days

03/02/14

Better++. Flatulence as it is. No new complaint. Sl for 1 month

14/03/14

Better++. No backache. No abdominal discomfort. No vertigo. No dullness

Sl for 1month

08/04/14

Dullness with mild fever. Tl. Chilly. Gels 30/1d sl for 7days

16/04/14

Better + dullness as it is. Gels1m/1d sl for 7 days

02/05/14

Better+++. No new comp. Adv bsl f & pp

Sl for 15 days

28/05/14

Bsl f – 82  pp – 112. Urine sugar nil.

No new complaint. Gen good

Sl for 1 month

Advised to stop medicine and enjoy the life