A Case of Pain in Knee Joints

Mr. A. K.

Gender: Male

Age: 17 years

Profession: Student

Marital Status: Unmarried

Chief Complaints:

Pain – Both knee joints since the last 2 years. He cannot not sit on the ground and cannot fold his legs.  Various injections and painkillers did not relieve the pain.

Pain in legs and knee joints – aggravated by walking [3] and also by any motion [2]

On examination – knee joints were red, warm [3] and showed a little swelling [2] there was stiffness [2]

Other Complaints:

Patient used to have cough and cold, watery nose and frequent sneezing.  He would also get headaches very often.  Also, he would experience sudden darkness if he went in the sun.

Personal Medical History:

Bronchial asthma when he was11years old, which was treated with homoeopathy

Urinary tract infection at age of 12 years

Family Medical History:

Grandmother (F) has Asthma, died at age of 59 years.

Father has Asthma.

Physical Generals:

Desire          Sweet [3] fruit juice, lemon juice and cold drinks [3]

Aversions     hot food

Thirst           thirstless – desires cold water

Sleep            12hrs. It was excessive sleep and he did not wake refreshed. Dreams          Someone was shooting him from behind with a bullet. He was falling from a mountain

Thermal       Hot

Mental/Emotional Sphere:

He was always very angry. Whenever he was angry, he would not like to answer anyone. When frequently asked, he would get irritable. His mother explained that he became rude whenever he had a headache. He used to take baths in hot water. He always wanted to be left alone and did not mix with others. He could not tolerate heat.

He was “lazy” and required more than 12 hours of sleep.  He craved for flattery and loved to be hugged by his mother. He felt his younger brother was being given more importance than him. He did not listen to any one and did whatever he wanted to. He was very generous, affectionate and loved small babies and animals.

In college, everyone would bully him, beat him or tease him, but he could not fight back. He would respond by weeping.  He would not even complain to his professor. Sometimes, he would complain to his mother.

Once, he was caught drawing cartoons of two girls. He had drawn a donkey and monkey to represent them because they used to harass him. He was punished but that was the only way he gave vent to his anger, as he couldn’t fight.

He was a good student till his primary class. He was good in studies, always standing 1st or 2nd in the class. Later on, he became dull and lost interest in his studies.

He had a fear of darkness and of blood in childhood. He was also scared of lightning and thunderstorms.

Analysis:

1. Generally, in the case of a knee joint pain, we think of the sycotic miasm. This is not always true, as when we examined the knee joints, they were red, warm and had a little swelling. These were signs of inflammation.  Now in this case, the x-ray of the knee joint was normal, so it was Psora. If there was any evidence of degeneration in the x-ray, it would suggest the syphilitic miasm.

1. The pathology in this case is on the physical level i.e. skeleton. It can only be dealt with when the damage to the joints is not serious. When, making a prognosis it’s important to keep in mind that the change is irreversible, so we can’t claim complete cure. Here his emotional plane seems to be affected due to the loss of his mother which needs to be considered while selecting the medicine. The patient is in disturbance on the emotional and physical level which gave us a clear idea of the affection of psyche and soma.

1. There may be a chance of suppression of asthma with the wrong homoeopathic treatment.

1. The family tendency shows that the disturbance is on the respiratory system. In the patient there is connective tissue pathology.

• Selection of Symptoms

1. Peculiars :

Timid

Obstinate

Rude

Dull

2. Intensity

Pain legs <wailking+3

Knee Warmness+3

Stiffness+3

Craves sweet+3, cold+3

• Repertorization

• Differentiation of Remedies

Bry – Along with the totality, Bryonia covers all the essence of the patient, so Bry would be drug of choice.

Lyc – though Lyc covers the totality well, intensified symptoms are not covered well by Lyco.

• Prescription

Bryonia 1M Single Dose Followed By S.L.

Follow Up:

• Second consultation after one month:

The breathlessness started, cough and cold had increased, and pain in the legs was the same, but he claimed to feel good. Also his appetite had increased. For the first time in his life, he fought with one of his classmates. The classmate was writing on his back, so he got angry and slapped his shocked classmate. I asked, “Do you fight with everyone?”   He said no, he only fought for his protection.

Understanding: Now fighting and beating, we generally consider as the syphilis miasm, but here we have to try and understand that he was not fighting with everyone, but only for his defense. This is a Psoric defense.

Placebo prescribed.

• Third consultation after a month:

In sleep now he is getting more dreams. Dreams were good and positive, so the medicine was correct. He was now getting sound sleep. He confessed that he felt fresh in the mornings after getting up, and had become serious in his studies. In the past, he used to study on just the day before the exams. But now, he had started studies well in advance and claimed that for the first time, he realized the tension of exams. In the past, he exuded carelessness but this attitude underwent a change despite no one asking him to study.

Understanding: This showed that he had become conscientious. He realized his duty and responsibility. Cough and cold had increased, but pain in the legs was less, however could not squat. Placebo prescribed.

• Fourth consultation after the one month:

During exams, one of his classmates asked for his answer paper to which he refused. His classmate threatened him, but he was not fazed and replied that he would attend to that later. His friends also remarked that he had now changed totally. In the past, though he would never beat anyone, he was a coward. Now, he would fight for his defense. He had fared well in the exams. It was the first time he had prepared well in advance. He would go to bed at 11 pm and get up at 5 and start studying.  His mother said that he had become a good boy. He no longer saw dreams.  He got a burning sensation during urination three days before, but it was tolerable. Cough and cold were the same, but more pronounced in the morning for 2-3 hours daily. The later part of the day, he had no problem. Leg pain (Homeopathy for Leg Pain) was improving. Squatting had improved. Placebo prescribed.

• Fifth consultation after one month:

He could walk more. Now his knee pains were less. There was no breathlessness. Cough and cold persisted more in the mornings. He got a headache only if he looked at the sun. Previously, he used to get headaches even in his room. His appetite had increased. Even his mother had started praising him. Nowadays, no one troubled him, but other boys approached him for help solving their study problems. Placebo prescribed.

• Sixth consultation after a month:

His stamina had increased. For the first time, he came to clinic on a bicycle. It was a ride of about 5-6kms, without any rest in between. There was no breathlessness. His leg pain was less. Squatting had improved. He was now playing football.  He no longer liked to stay in the house, but wanted to go out and enjoy life. He could now squat in a better manner. His sleep was now normal and dreams were good. Placebo prescribed.

• Seventh consultation after a month:

He started cycling every day. He also started playing football. His marks showed an increase by10%.

Placebo prescribed.

• Eighth Consultation after a month:

His squatting was normal. No more problems of cough and cold. He had started enjoying his college life.

Conclusion:  The importance of dreams in follow up since he was young; the predominant miasm was Psora. Therefore the disease had not travelled to the sycotic miasm. There was suppression from bronchial asthma to urinary tract infection and from urinary tract infection to rheumatic pain. As is stated in Kent’s lectures, “ If the physician clearly perceives what is to be cured in the disease, that is to say, in every individual case of disease, if he clearly perceives what is curative in medicine, that is to say, in each individual medicine.”