A male patient 17 yrs old presented with severe abdominal burning pain, fever and drawing sensation in abdomen for the last two days. Pain in urethra during urination. Moaning with pain. Due to the abdominal pain he was slightly stooped while walking +++
On examination of abdomen
Tenderness in the right illiac region when pressing the mecburgn’s point
I advised him to do usg scan of abdomen
Colocynth and Ars alb given while he was going to scan centre .He was slightly relieved by those remedies but no remarkable improvement.
Scan report – Diagnosis —acute appendicitis – favour perforation
Retaking case 25/6/16
Present mental state
Wants the complaints cured fast
Fear of operation
Mental state just before onset of complaints / ailments from /never well since
He was staying in a hostel to study 11 th std . Within one week he developed diarrhoea and took some allopathic medication which relieved. After that he developed abdominal pain, stomach burning. The last three days he was suffering from fever and abdominal pain.
He felt emotionally stressed by his mother’s separation.
He complained that his chemistry teacher was not teaching well and he couldn’t understand the work. He feared failure in exams.
“Now I am studying in B1section. If I went to A1section, most of the teachers are HOD from whom I would have got more training. In B1section teachers are not teaching well as compared to A1. HOD’S are teaching good and understandable manner.”
Complete picture of presenting illness:
Fever –intermittent , covering during chill. Thirst moderate; fever with chill and burning eyes.
Pain in penis during urination. Late to pass urination.
Pain in abdomen agg : rising from lying , rising from stooping , unable to turn in bed.
Amel: lying on back and bending while sitting
Nature of pain : spotty pain
Drawing pain in lower abdomen during urination. better after urination.
Tongue: Yellow at centre – Red tip
Location : right side of pelvis ( 8cm *0.76cm thickened segment of bowel )
Acute appendicitis – favour perforation
Must bend while walking (due to abdominal pain)
Thermal condition: towards chilly
Affinity: appendix and ileum
Causation: suppression of diarrhoea and emotions prior to the illness
Fear of operation
Carried desires to be, fast
Spotty, drawing pain
Abdominal pain must walk bent +++
< TURNING – bed, in
< RISING – agg. – lying, from
> LYING – amel. – during – back, on
< RISING – agg. – sitting, from
Materia medica confirmations :
ileo-caecal symptoms —- C.M.BOGER SYNOTIC KEY
Colic, compelling to walk bent, —-PHATAK
Ileo-caecal symptoms; appendicitis. ——PHATAK
Prescription 25/6/16 – 8.30AM
Rhus tox 1m /split water dose /repeat every 3hr
Pain 40% better
Offensive stool passed 3 times.
26/6/16 – Pain 50% better. Only mild fever and appetite good.
He can walk without bending forward.
No pain, no fever, motion normal, no tiredness.
Mild burning in abdomen when he eats late
He went back to hostel. I advised him to take USG .
He took USG on 17/7/16 – No abnormality in abdomen and pelvis, no evidence of appendicitis.