Clinical Cases

A Case of Bronchial Asthma

Written by Kushala N. Salian

The author presents a case of Bronchial Asthma in a 6 year old child

Miss R .P     Age-6yrs      Schooling- 1st standard –  Vegetarian

Date of interview-11/7/2011

Pt had been well till Age-2yrs, 2008 onwards, regular attacks of Viral Fever followed by cold and cough.

1st attack of wheezing in 4/3/2009

<lying down++, > lying head high+

She was medicated with Romelast 5mg 1 OD, and Neubiliser.

Family history of Allergic cold in brother and Bronchial Asthma in Mother and Grandfather (paternal).

Location Sensation Modality Concomitant
Resp-SystemF-1/1 month

D-10 days

ODP

Coryza↓

Wet cough

Wheeze immed

Throat feels choked++

Vomitting++

<contagion++<dust++

<change of weather++,rainy++

<cheese++,butter++

<Orange drink++

<cold items++

<brown chocolate++

<banana++

<orange++,sweet lime++

<bakery++

<lying on back++

<direct air++

>warmth++

>vomitting++

 

App-↓Quiet+

Glassy eyes+

Red cheeks+

Drowsy+

Lazy+

 

Physical generals

Appetite-fussy eater

Cravings-fruits++,sweets++,sour++

<maggie noodles-stomachache

<bakery items-stomach ache and constipation,anything which is not natural affects her.

Perspiration-cold on face+,palms+,non staining,non offensive

Thermal-Ambithermal

Urine-N

Stool-N

Thirst-4-6 glass/day

Appearance-lean,short,large forehead,fair looks.

LIFESPACE-

R is a 6 yr old girl who is lean, fair, with large forehead. She is the 2nd child of the parents after a gap of 12 yrs. The elder brother is 18yrs old and parents are in mid 40’s.

R is an extrovert, outgoing, normal happy child. She is very positive and inquisitive. Her curiousity is greater than her brothers. She plays on her own, reads books on her own. She is very attached to her mother, and comes into the kitchen to see if the mother is there. She knows she can rely on her mother. She is smart, friendly and mixes with everybody, unlike the brother who is quiet and sober. She is observant, watches how her grandmother fills water in bottles and will do it on her own. She has an independent and strong willed nature. She is different, has got interest in everything. She is more open. The mother feels that the wheezing is hampering the girl’s childhood. It is a burden on her. Her education suffers with her illness. She is curious, alert and observant of her surroundings. She has a sharp memory, knows names of people living in her surroundings. She is never cranky nor fussy, never trouble, will listen when told by her elders.

During nursery after seeing another child cry, then she too would start crying. She easily takes the impression of others. In school she is a hardworking, good learner, attentive in class. She is talkative, not shy and quiet. She will go ahead and ask Q’s. Teachers are happy with her. She likes music, dance, drawing but not able to participate due to ill health. She loves to dress up, wear colourful clothes, go on holidays, outings. As father and brother do not have holidays, they are stuck up. She easily falls ill with the dust, outside food and AC. She is the peacemaker at home. She wants everyone happy. Until 2yrs of age she was a chubby and healthy baby. Her milk tooth had not fallen so far. She got her teething at 11 months. Until 2 yrs she was growing well, but now she looks small, thin, short and her growth is stunted. She started talking monosyllables at age 1 yr and walking at 1 yr. She is an active child, can roll over and go anywhere. After 2 yrs health the problem started and the slowing of growth. The brother was also short as he missed out on his play. She copies her elder brother and they are good and loving to each other. She listens to him.

Mothers Pregnancy – mental state:

Mother conceived R late, after 12 yrs of 1st child. It was an unplanned pregnancy. Once before she had undergone abortion, after her 1st child as son was small and there was no one to look after another child at home (inlaws were old and sick). The mother did not want to abort and have the guilt of aborting one more child. MIL, her mother and the husband said, they would not be able to help her much in pregnancy and child rearing. Mother decided to go ahead with her decision, the responsibility was all hers. She was full of doubts and confusion whether her decision was right or wrong. She had doubts as to how it will affect their future and the future of the child. Their bathroom was under repair, so due to fine dust, she was wheezing and had to be admitted. She was in doubt whether it would be a boy or girl. She ate well and read religious books to keep her mind stable. Mother was in constant conflict all thro pregnancy whether society will accept the child after so many yrs’ gap. They had to plan their finances again for next 20 yrs. She had no extra help in form of maid, which she got 1 month before delivery, who would do the house work. All sorts of thoughts went on and on. Her mother and MIL told her they can’t do any work. He said, financially there is no problem, but he put it on her, “you are going ahead with the child, so the child is all your responsibility”. Mother worried if it would be girl child then the responsibility would be of parents. She was aware that she had to suffer the late delivery, but at the same time she did not want the guilt of another abortion. People will talk, she will have to bear it. Inlaws were old, all doubts, thoughts, confusions were going on in her mind, which she could never express to anyone. She ate well so she could have a healthy baby. She was wheezing with the repairs. She was worried about son as to who will send him to school. She delivered a healthy baby 2.9 kg. After maid left in 1 yrs time she put baby in cradle and worked. Things got solved easily and she was confident in handling them. Then she was not coloring her hair and people would ask ,”Are you mother or grandmother?” Some would ask ,’Is your elder son 12 yrs old and so much gap between children?”.She could see her son’s loneliness, he never had any company. She wanted some joy for self and son. She would think when son grew up, what her DIL‘s age would be. There would be a lot of questions in her mind. She would meditate, read religious books and be happy. Her husband was not worried about 2nd child, he was stressed with office work, and one of his colleague had died of myocardial infarct, so he was all the more stressed, had cut his diet and lost weight. They had no outings at all. Old in-laws at home, always sick, her duty bound husband never left his parents. They had sacrificed too much, lost all joys of life. All these years, all her holidays were spent on in-laws illness.

 

R is a happy child as she does not know what a holiday is like. She is active, participative in activities, is restless. She is like her father who constantly needs company of people, who is positive, confident and wants to go ahead. She is assertive in all her actions. The mother is more reserved, negative, full of doubts, who keeps her inner feelings to herself, quiet and subdued. Her older son is like her and keeps his feelings to himself, and cannot express. The son was over protected by the family. Mother had to join office within a month and a half after his birth. GP dominated his upbringing. They did not allow him to touch anything, saying “you will get hurt”. He never developed, remained lonely, it affected his studies and activity. There was no freedom for the son. The natural mother was not around. So in 2003 mother decided to give up her job, to pay full attention to son, she could not stop the overprotective environment but she wanted to give freedom to the son, remove his loneliness.

So with R , the natural mother in her was always around, observant, attentive to her needs and allowed her to grow up naturally. So R is a positive child, expressive and bold. She has temper which she has picked up from Br. Her mother allows her freedom in everything, whatever the child wants to explore. The mother had read a book on child rearing in which the natural internal instincts of the child should be brought about, so that child develops a positive nature. It is like how animals in jungle live with their natural instincts. R has her natural instincts strong, she observes where mother is keeping the knife and will tell where exactly objects are placed. These basic instincts to one’s natural surroundings are developed by mother in 1st 5 yrs of life, which are later influenced by social environment. R was attached to mother, she knew even as a baby, when mother got out of bed. Her innate natural instinct, mother allowed to develop, so she has become a more confident and assertive person.

TOTALITY:-

ASSERTIVE(AUDACITY)

INTELLECTUAL

MEMORY ACTIVE

OBSTINATE HEADSTRONG CHILDREN

POSITIVENESS

MAGNETISED DES TO BE

FOOD AND DR. FRUITS DES/SWEETS DES/SOUR ACIDS DES

PERSPIRATION COLD

FACE; PERSPIRATION

PERSPIRATION; HANDS; PALMS

GEN; LEAN PEOPLE

HEAD; LARGE

COUGH; DUST ; AS FROM

COUGH;WEATHER;CHANGE OF

COUGH; WEATHER;DAMP WET

COUGH; COLD DRINKS <

COUGH ; FRUITS  <

COUGH; AIR DRAFT OF<

COUGH; LYING<ON BACK

COUGH; WARMTH  >

STOMACH; VOMITING ;GEN;COUGHING ON

 

Repertorization:  PHOS 31/17;   CALC 30/17;   SILICEA 27/17

REMEDY: SILICEA– She is development wise in 3rd row of periodic table, where she asserts herself well in her identity. She is clear, intelligent, observant of her needs and her surroundings.

17/11/2011-Silicea 200 1pudi

SL tds for 1 week

FOLLOW-UP:-

17/11/2011 to 31/12/2011-

Frequency of cold cough reduced. Stopped Romilast completely.

No wheezing in 2 months

Cold and cough + on certain trigger factors

Needed 3 doses of Silicea 200 at intervals in 2 months

Jan to Aug 2012:-

Infrequent attacks of cold and cough continues on certain < factors to do with food and climate, but no wheezing.

R settles most of the time with SL, occasional doses of Sil 200 (5)  given in past 8months.

She is active, playful, has grown tall, plays a lot of active games.

Parents are less anxious of her health.

She eats many of the food items which would previously disagree with her.

About the author

Kushala N. Salian

Dr. Kushala N. Salian M.D (Hom) from Mumbai University has been practising classical homoeopathy for 22 years. She trained for five years with ICR (Institute of Clinical Research) run by Drs. Kumar and M .Dhawale. She has also attended seminars and online training courses with WWR, Basic Program and CME’s of Sensation method By Dr Rajan Sankaran and his team. Dr. Salian has a private practice and occasionally acts as a guest lecturer.

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