Clinical Cases

Acute Ulcer with Trauma and Cough


Dr. Rajv Peres presents a case of acute ulcer with trauma and cough.

This is a case of a 30 year old mason, father of three boys. He presented with complaints of a hacking cough with cramps in his stomach. Very irritable during cough.  Shouts without reason at his co-workers. Picks on children accusing them of not doing their studies, although they are completing their homework diligently. Shouts at his wife also. His anger was uncontrollable the last two days. In fact, to avoid being angry he slept outside the house. When he is busy talking or working there is no cough. If he sits silently, then the cough begins and exhausts him. He feels internal trembling in his whole body.

He had developed the cough with yellowish expectoration five days ago, along  with itching in his throat. He had drunk fresh well water at a new job site.

On March 18th he travelled by bike 150km to his village in Karnataka in order to make some payments. He returned home hurriedly. On his way back he felt a chill and goose bumps on his skin. He drank some hot tea which relieved him. That same night he got a fever. First chill then heat followed by sweat. He covering himself and slept during the chill. No appetite. Did not eat dinner last night nor breakfast this morning.  He only desired for hot drinks which relieved him generally. Yesterday at work he had a fall from two meters and landed on some broken glass.

Thermally chilly. Cannot bear to listen to the slightest noise as it makes him angry. He feels like beating up the person who is making noise. He was so weak that he wanted to sit all the time but he had to go to work to earn money and also because when he is occupied he suffers less.

In addition to this he had an ulcer on the left thigh since last 6 days which produced an offensive odour.  I made two pictures on every second day to note  the pace of healing after giving the remedy.

Prescription was made on 20th March 2018 at 10.30am –  Sulphuric Acid 200, 1 single dose.

I used BBCR and Phatak’s repertory to solve this case. I did not consider “ailments from” . I considered the concomitant of 1. Pain in stomach during cough. 2. The general modality of hot drinks ameliorate from Phatak’s repertory. I checked for the prevailing mental state of dissatisfaction, cross, hurried and his weakness which was out of proportion. Being a mason he is used to toiling hard each day. I consulted materia medica and found that Sulphuric Acid is also a medicine for after trauma. It has lot of irritability and violence. I also considered that this case fit the psoric- tubercular miasm.

Same day follow up at 5.20pm:   No hacking cough since afternoon. Internal trembling 50 % better. Doesn’t feel angered easily at his co-workers and did not shout at anybody the whole post lunch session of work. At lunch he felt hungry enough to eat Javari roti with vegetables. Earlier he could not drink cool water due to aversion. Now in the evening he drank cool water without any problem. He did not feel the urge to have hot drinks like tea. Expectoration is coming out easily, where before it was thick, and now it is thin and yellow. By the next day his internal trembling had vanished totally. The ulcer in the thigh also healed beautifully. The patient’s wish of anger management was achieved. With homoeopathy one relieves oneself of all useless baggage.


Before treatment                                                After 3 days on remedy


About the author

Rajiv Peres

Dr. Rajiv Rui Viegas Peres M.D(Hom) Assistant Professor, Dept of Organon of Medicine, Aarihant Homoeopathic Medical College, Bhoyan Rathod, Gandhinagar, Gujarat. Pin 382721 Received Best Teacher’s Award 2010-11, Received Hahnemann Award 2018, Received Excellence in Homoeopathy Award in April 2022, Active Member of H.E.R.I Mumbai.


  • Hi Dr. Rajiv,

    When considering this patient what would you say were the most characteristic (or unique) symptoms he presented with, that helped you navigate the Materia Medica?

    • Dear Ally Hilario,
      In this acute presentation the irritability at the level of the mind and the violence of the cough we’re characteristic. Secondly the observation of him resting while at work suggests weakness out of proportion which for a mason is strange. Thirdly the ulcer which he showed me at the end of the case taking is filled with slough suggestive of an unhealthy state, hereby calling for a remedy that should have acute deep pathology which is found in strong acids. I navigated Materia Medica to confirm the prescription and to my utter surprise discovered the symptom of ailments from fall which was also other element in this case.

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