Clinical Cases

A case of Encephalomalacia

Written by Narendra Mehta

A case of Encephalomalacia. Homeopathic Treatment by Dr. Narendra Mehta.

We have learned from this case the importance of remedy relationship. The miasm helps in deciding the medicine. As the patient was in the syphilis miasm, the medicine covering syphilis symptoms was helpful to us.

As in this case on Repertorisation medicine was coming Nux vomica that is as per constitution but this will not work. If we consider syphilitic symptoms and present condition our medicine is Sulphur. This is nothing but state similimum. That is “SIMILIA SIMILIBUS CURENTUR”.   

Though diarrhoea is physical general, but when it is the chief complaint, it will not disappear first.

Miasm had shifted from syphilis to sycosis. As we know, involuntary diarrhoea at night represented the syphilis miasm and styes and an increase in weight represents the sycosis miasm. His helping others is exteriorization.


Name:    S.     I.                      Reg no.: 2038A

Date:       9/12/03                    Age:        62 years

Sex:         Male                      


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Encephalomalacia in the left antero-inferior frontal lobe with evidence of chronic haemoglobin degradation products, most likely representing previous hemorrhagic contusion.

The patient was advised by a neuro-surgeon for an operation. They told the patient that a panel of surgeon would decide on his operation. He was prescribed tab. Eptoin. His family members were apprehensive because it involved a brain operation.

The patient was brought to my clinic by his relatives who were holding him from both sides. He was looking lean thin and very weak.  He could not sit for a long time, so while giving the history, he was lying down on the examination table. His face was looking sunken as if he was dehydrated. He came in wearing only lungi (plain clothes that are tied on the waist and wrapped casually around the lower half of the body) and half shirt


Chief Complaints

He suffered from convulsions since November 2000. At present, he had involuntary loose motions since one month.  He was afraid of loose motions and loss of weight. He had hypertension, BP 170/110.

H/o head injury.

His loose motions were involuntary and he had to rush to the toilet. He went to the toilet 10-11 times or more at night. H/o passing mucus in stools, but there was no blood. He took tablets and injections for it. He was so scared of his loose motions that to avoid it, he had stopped eating.

Whenever he got loose motions, he became nervous and felt that he would become weak and die soon – so immediately he would rush to the doctor. He was particularly worried about the pattern of his stools, especially at night.

He had convulsion for 2 minutes the previous night in his sleep, at around 4.30 – 5.00 a.m. H/o convulsions since November 2000 and was on tablet Eptoin.

P/h He had loose motions for 3-4 days for which he took allopathic treatment. The loose motions stopped and the next day in the morning, at 11.00 a.m., he got jerks with stiffness of the body. The angle of his mouth deviated which lasted for 5-10 minutes. After an hour, he again got 3-4 convulsions.  He passed stools and urine involuntarily in his sleep. His convulsions would start with jerks. There was clonic spasm with stiffness and his head would bend backwards.

H/o. Head injury in the occipital region, two months before the convulsions.

Looks:  He appeared to be religious and had a  tikka on his forehead. He was lean thin and had a sunken face. He was marasmus.

Past History

H/O – Hypertension

H/O – Loose motions with bloody stools (20 years back)

Appetite        Felt hungry but did not eat due to fear of loose motions.

Desires           Salt and sugar. But did not eat due to Hypertension.

Sour things – Sweet +++, spicy things++, pickles,

Nausea at the sight of food

Stools             involuntary loose motions – very frequently

Urine              Normal

Thermals       Cannot tolerate heat of Bombay (HOT)

Aversion        Bitter things

Sleep              Normal

Dream            No



He was the eldest brother and the other two brothers were too young. He was the only earning member in the family and they had a financial crisis. He used to work hard, day and night, to fulfil the needs of his family. He felt a sense of duty towards his family, that is, brothers and parents. A self-made and hard-working person, he took too much responsibility of his family. While being very conscientious about his duty, he did not want a single penny from his brothers, instead he was ready to give his own share of property to them.

When he would get very angry, he would want to beat the other person and warn him accordingly. He would turn very aggressive in anger and two people were needed to hold him. He would get instigated only when things would go out of his control, till which time, he would suppress his anger. Whatever work he did was up-to-date, neat and clean and nobody could find fault with it. He had left his son in childhood at his wife’s place for a better upbringing. He was never afraid of anything even disease or death and had a philosophical attitude that whatever had to happen would happen, but now, he did not wish to die early because he still had to perform his son’s marriage and complete other duties. If somebody insulted him, he would harbour the hurt in his heart and would decide to retaliate at the right opportunity. He did not believe in weeping and crying though he was sad from within. But tears would not come in his eyes. He would get consolation only from his close relatives. He was a honourable person who was strict about his words – if he took money from somebody, he would return back on the same day.  He would share his sufferings only with one close relative.



What was the miasm in this case?

The miasm was Syphilis.






Anxiety of Health

Desire for Sweet

Head Injury



Based on the above rubrics, we had to give either Nux-v. or Sepia Since Sepia indicates indifference and sadness, we thought of Nux-vom. But the patient was hot, so we could not give Nux-vom.

Why were we not getting the remedy?

We were not getting the correct medicine because we did not examine his present condition. We had not considered the predominant miasm, which was Syphilis. Now we had to consider the rubrics as per the miasm syphilis.


Syphilitic Rubrics

He was passing involuntary stools on the bed at night.

He was passing involuntary stools during sleep.

He would desire sweets +++.


Now we infer that the remedy is Sulph, which is hot.

We were earlier getting Nux-v, which was not wrong   because originally he was a Nux personality but he had gone from Nux-v to Sulph. Currently, he was at the Sulph stage.  So we will see the remedy relation.


Remedy Relation

Complementary Remedies

Bry   Cham   Con   Kali c   Phos   Puls   Sep   Staph   Sulph

Similar Remedies

Asar   Aur   Carc   Cham   Ign   Lil t   Lyc   Med   Sep   Strych   Sulph


Remedies which follow well

Act sp   Aesc   Aran   Ars   Bell   Bry   Cact   Calc c   Carb v   Cob   Cocl. Colch   Hyos   Kali c   Kalm   Lyc   Phos   Phos ac   Puls   Rhus t   Sep Sulph   Verat a


On 9/12/’03

Finally the remedy given was

Sulph 200



Convulsions had stopped. Many people commented to him that now he looked better. He was happy because all other medicines had been stopped. He was only on our medicine.  His appetite had increased.  Previously, he used to feel nauseous looking at food. That had stopped. He had only one problem now, of involuntary stools at night.  The continuous loose motions of about 10-11 times during the day and night had stopped and now the problem showed aggravation only at night. He started walking for one km. in the morning. Previously, he could not get up from bed in the morning.

UnderstandingMentals and physical generals need to improve first. Here he was showing improvement.  His face looked better and, as we all know, the face is the mirror of one’s health. Also, in this case, though diarrhoea is physical general, it had not improved substantially, because it was the chief complaint. Here, diarrhoea represents the disease symptoms. He could walk one km. each day showed that his stamina had improved.



His loose motions had come under control. He now   passed motions only once, either before going to sleep or after sleep.  The frequency of stools had also stopped.  His brother-in-law confirmed that he had improved a lot as earlier, at night, he used to get up very frequently, but now it had stopped.  His appetite too increased. He also started being regular in saying his religious prayers.



He had styes on both eyes. His weight had increased from 39 to 41 kgs. For the first time, he came to the clinic alone. He now passed motions only once in the mornings. His appetite had increased. He also felt like working. He started helping others too.

Understanding- Miasm had shifted from syphilis to sycosis. As we know, involuntary diarrhoea at night represented the syphilis miasm and styes and an increase in weight represents the sycosis miasm. His helping others is exteriorization.



He passed regular motions once. He would get sound sleep. His strength also increased.  He suffered from cold.

Understanding-Cold indicates endoderm layer.



His weight increased to 46 kgs. He now looked healthy, similar to how he looked before his sickness. He came alone, all the way, from distant Kalyan, which is on the outskirts of Mumbai. He had developed a fungal infection on his skin on the left hand. BP was 122/80.  For the first time, he came in trousers instead of lungi. Earlier, he would wear a lungi because he had lost a lot of weight and could not wear his trousers.

Understanding-Layer wise, the disease had come down from the 6th layer neural plate to the ectoderm as per the chart of suppression.



He was planning to go on a pilgrimage. He was going alone.



His weight increased to 49 kgs. He visited Tirupati alone.  His health was as good as it was four years ago.  He was advised to stop my medicine after the completion of another month but told to come for a follow up after a few months.



Weight was now 49.5 kgs.



Weight was now 50 kgs.

He worked on a farm with a worker.

His stamina, appetite and stools were all normal.

About the author

Narendra Mehta

Dr. Narendra Mehta, M.D. (Hom.) practices in Mumbai, India. He has studied homeopathy intensively for thirty years. Dr. Narendra Mehta is an internationally acclaimed physician and teacher. Over the years, he has conducted seminars and workshops for practitioners and students in many countries around the world. He is the author of two books - Understanding of the Homeopathic Materia Medica and
The Follow-up .


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