Clinical Cases

A Case of Perennial Allergic Rhinitis

allergy
Written by Rajni Gandha

Dr. Rajni Mishra treats a case of allergic rhinitis characterized by sneezing, coryza and watery nasal discharge. After the simillimum, IgE levels came down.

PRELIMINARY DATA-

Name- Ms S D

Age- 27 years

Sex- Female

Marital status- Single

Education- MBA

Occupation- HR

Date of case taking-24.01.17

CHIEF COMPLAINT  –Sneezing and Coryza for the last 3 years

Onset and progression- gradual

SENSATION- Sneezing++ (3-4 times in one spell)

Coryza++

Watery nasal discharge+++

Nose block+

MODALITIES- Ailments from- Dust

< morning++

< cold weather+

< smell of fish or any perfume+++

>warmth

ASSOCIATED COMPLAINTS- Heaviness in head++

HISTORY OF CHIEF COMPLAINT-

The patient has sneezing, coryza and watery nasal discharge for past three years, which aggravates from cold weather, smell of fish or any perfume, in the morning and gets ameliorated by warmth. The complaint is gradual in progression.

PAST MEDICAL HISTORY-

Chicken- pox

FAMILY HISTORY-

Mother- Diabetes mellitus, allergic rhinitis

PAST TREATMENT HISTORY-

Allopathic medication for the same

PAST SURGICAL HISTORY-

No surgical history

PERSONAL HISTORY-

Diet- Mixed

Appetite- Good

Thirst- 2 liters per day

Bowel habits- Once per day; no difficulty

Bladder- 4-5 times per day; occasionally once at night; no painor burning or no other difficulty

Perspiration- Scanty

Craving- Ice-cream+++

Desire- Chicken++, Sweets++

Aversion- Vegetables++

Intolerance- Nil

Sleep- Good

Dreams- Unremembered

Thermal state- Chilly

MENSTRUAL HISTORY-

FMP- at 14 years of age

CHARACTER- Regular cycle, normal flow, dark red in color, no clots

No complaints before or after menses.

GENERAL PHYSICAL EXAMINATION-

Appearance- moderately built and nourished, lean and tall

Pallor- +

RESPIRATORY SYSTEM-

Normal vesicular breath sounds; no added sounds.

VITAL SIGNS-

Pulse- 76

BP- 130/80

Respiratory rate- 20

LIFE SPACE INVESTIGATION-

Patient belongs to a middle socio-economic family. Her father is a driver and mother is a housewife. She has two elder brothers and also has two elder sisters. She has been pampered by everyone at home and shares a good relationship with everyone.

CHILDHOOD- Uneventful. She was very good at studies and at extra curricular activities but neededmotivation from others. She had many friends at school.

COLLEGE LIFE- Even during college she had a good number of friends. She always wants people around her. Presently she is worried about her marriage.

She is very talkative, friendly, wants people around and is always fun loving. Has fear of thunder storm.

INVESTIGATION REPORTS-

IgElevels- 813.9/Iu/ml

REPERTORIAL TOTALITY-

Mental generals-Company desires

Consolation amels

Fear- Thunder storm of

Physical generals- Desires- Ice cream, chicken, sweets

Aversion- Vegetables

Perspiration- Scanty

Particulars-  Sneezing- dust from, perfumes from

Morning aggravation

Result

(Repertorisation was done by synthesis)

  • Natrummuriaticum- 9/12
  • Phosphorous- 8/20
  • Causticum- 8/12
  • Pulsatilla- 7/13
  • Sulphur- 7/12

( Natrummuriaticum, Pulsatilla and Sulphur are thermally hot.Causticum is predominantly chilly but has fear of death, fear as if something is going to happen, has timorous anxiety, has aversion to sweets, etc. Whereas patient doesnot show any such anxieties or fear, etc.)

Hence phosphorous was thought of as it was found the most similiar.

FIRST PRESCRIPTION

Rx a)Phosphorous- 200- 2doses 1-0-1

FOLLOW UP FIFTEEN DAYS-

No watering of nose.

Episodes of sneezing- 2-3 times/spell but has reduced.

Heaviness in head- better

Response to perfumes and fish odour- same

Rx  a) Placebo

FOLLOW UP ONE MONTH-

Watery discharge from nose started again.

Sneezing spells better.

Perfume response- slightly better.

Heaviness in head- absent

Rx   a) Phosphorous- 200- 4doses 1dose weekly

(same potency was administered )

Sent for IgE investigation

FOLLOW UP TWO MONTHS

Nasal discharge absent.

Sneezing episodes- 2-3/spell

Heaviness in head- absent

Perfume response- better

Patients feels 50% better.

IgE level- 541.6/Iu/ml

Rx  a) Placebo

(Since patient was 50 % better, there was no need of repeating the remedy)

FOLLOW UP THIRD MONTH

Nasal discharge- absent.

Episodes of sneezing- once or twice.

Patient feels 80% better.

Perfume response- improved

Rx   a) Placebo

(Sent for IgEinvestigations)

FOLLOW UP FOURTH MONTH-

Nasal discharge again since one week

Sneezing episodes- 8-9 episodes

Headache- frontal region, better by pressure.

Perfume response- brings sneezing again.

IgE levels- 128/Iu/ml

Rx  a) Phosphorous- 1M- 1 dose

As the complaints were coming back again worse, so higher potency was required and hence phosphorous 1M

FOLLOW UP FIFTH MONTH

Nasal discharge better.

Sneezing episodes- twice or thrice.

Headache- not present.

Perfume response- much improved.

(Sent for IgE investigation)

Rx  a) Placebo

FOLLOW UP SIXTH MONTH-

No episodes of sneezing.

No headache.

Nasal discharge absent.

Patient can bear the smell of perfumes now.

Also she is able to bear dust exposure with one or two sneezes.

Patient is 90 % better.

IgE level- 94.3 Iu/ml

Rx  a) Placebo

The patient has not visited after this.

CONCLUSION- This case is not something extraordinary but this was only treated by a single remedy which shows the usefulness of THE SIMILLIMUM, which is the base of our system. In my personal experience I saw that the same potency can be used two or three times in a patient.Homoeopathy can bring down the Immunoglobulin E levels down, provided the patient gives you proper time and regular follow ups are monitored.

About the author

Rajni Gandha

Dr Rajni Gandha Mishra is a student of MD Part II Organon of Medicine at Father Muller Homeopathic Medical College and Hospital, Mangaluru, Karnataka, India.

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