Clinical Cases

A Case of Chronic Otitis Media

otitis media

Dr. Atul Rajgurav presents a case of chronic otitis media in a man of 17.

A male patient, 17 yrs. old came to my clinic complaining of severe pain in the right ear for two months. He had already been treated with allopathic medicines for this. A whitish sticky discharge started. Pain was aggravated from hot applications. There was extreme pain behind the right ear. The pain was in a single spot.

Chief complaint:

  • Discharge from right ear since 2 months
  • fullness of the ear
  • Hearing loss
  • Chronic ear drainage
  • Persistent deep ear pain or headache
  • Fever
  • swelling behind the ear

 

Location Sensations Modalities Concomitants
Right Ear since 2 months

 

Pain in single spot,

Whitish thicky discharge

Fullness of the ear

< hot applications.

 


Past history   

No major illness in the past

Family history

Mother      Diabetic

Father      Diabetic

Personal history:

Appetite  –     Average

Desires    –     Cold milk, peanuts

Aversions  –  nothing specific

Thirst   8- 10 glasses a day.

Perspiration moderate

Stool   once a day usually after his afternoon meal

Urine 6-8 times a day

Sleep & Dreams  – Good sleep. Doesn’t remember his dreams

General modalities -Aggravation – Hot, hot applications, 2-3 am

Mental generals:

Patient is a non-obedient child. He has a tendency to skip school. He is not bothered about studies. He likes to go to his uncle’s farm and walk a baby calf around. When scolded he will start rearranging the stack of hay in the farm. He is living in a joint family and always feels he is not wanted and that the people at home will poison him to death because he is not good in studies.

Vital data:

Temperature-       990 F

Pulse                    78 /min

Blood pressure-      130/80 mm of Hg

Respiratory rate –    19/min

Weight                   41 kg

Height                   5ft 2inch

Pallor-                      +

Systemic examination:

Respiratory system

Air entry on both sides equal. No any added sound heard on auscultation. No any abnormality seen.

Cardiovascular system  

No any abnormality seen. S1S2 normal, no any added sound heard on auscultation.

Central nervous system

All reflexes are normal. No any abnormality seen.

Gastrointestinal system   

Abdomen is soft, no tenderness on palpation. Normal peristaltic sound heard on auscultation.

Physical make up:

Patient is average build with a frown on his face.

Investigation :

Lymphocytes =70%

E.S.R. = 42

Final diagnosis:

Chronic otitis media

Miasmatic background: syphilis

Analysis of symptoms:

  • Forsaken, feelings
  • Suspicious, mistrustful – poisoned, of being – Forsaken, feelings
  • Work, general – aversion to mental work
  • Milk, general – desires –   cold
  • Peanut, desires
  • Discharges, from right ear
  • Discharges, from – gluey, sticky
  • Discharges, from – night – in warm bed
  • Night, agg. – 2 a.m. – 2 a.m. to 3 a.m.

Evaluation of symptoms:

  1. Forsaken, feelings
  2. Suspicious, mistrustful – poisoned, of being
  3. Work, general – aversion, to, mental work
  4. Milk, general – desires – cold
  5. Peanut butter, desires
  6. Discharges, from – right
  7. Discharges, from – gluey, sticky
  8. Discharges, from – night – in warm bed
  9. Night, agg. – 2 a.m. – 2 a.m. to 3 a.m.

PDF:

Physical make up:

Patient is average build with a frown on his face.

Thermals: patient is thermally hot.

Miasm: syphilis: as the patient build is average, he has night aggravation, chronic otitis media which is degenerative.

Repertorial totality:

  1. Mind – suspiciousness, mistrustfulness
  2. Mind – forsaken feeling
  3. Mind – work, general – aversion, to, mental work
  4. Generals – night, agg. – 2 a.m.
  5. Food – milk, general – desires – cold
  6. Food – peanut butter, desires
  7. Ears – discharges, from – night – in warm bed
  8. Ears – discharges – general – thick

Repertorisation

A Case of Chronic Otitis Media 1

Remedial differential diagnosis:

Pulsatilla      18/6

Lycopodium         11/5

Silicea                   10/5

Calcerea carb        9/5

Final remedy:

Pulsatilla 200 single dose followed by S.L

Follow up summary

Sr.no Date Complaints Remedy Reason
1 24/02/2015 Discharge better slightly. S.L Complaint ameliorates
2 24/03/2015 Discharge better by 50%. Pain much better S.L Further improvement in condition is seen.
3 12/04/2015 No further improvement Pulsatilla 1M repeated Potency is changed  as there is no improvement beyond certain limit.
4 27/04/2015 Patient feel much better S.L
5 12/05/2015 Mother accompanied the patient  for the first time. She was delighted not only with the treatment but also with the behavioral change of the child. He now doesn’t miss school and waste his time in useless activities. S.L Improvement seen.
6 12/06/2015 Discharge completely gone. S.L Improvement seen.
7 12/07/2015 Discharge from ear started again after getting wet in rain Pulsatilla 1M Recurrence of complaints
8 30/07/2015 Not better

Discharge still present

Pulsatilla 10M Potency is changed  as there is no improvement.
9 15/08/2015 Discharge better by 50%. Pain much better S.L Improvement seen.
10 29/08/2015 Discharge slightly decreased,  no further improvement seen Pulsatilla 50M Paucity of symptoms seen
11 14/09/2015 Discharge better slightly. S.L Complaints ameliorates
11 14/10/2015 Discharge better slightly. S.L Improvement seen.
11 16/11/2015 Discharge completely gone. S.L Improvement seen.
11/12/2015 Better S.L Improvement seen.
16/01/2016 Better S.L Improvement seen.
14/02/2016 Better S.L Improvement seen.


Comments  

By analyzing the patient’s case in detail it was found that he has marked phlegmatic temperament. Considering his physical make up, he belongs to oxygenoid constitution and after repertorising, Pulsatilla was selected as the constitutional remedy. By considering his susceptibility I prescribed the drug in  200 potency. On prescribing, improvement was seen in chief complaints, but there was not complete relief. After giving the same drug in 1M single dose the general as well as particular symptoms of the patient improved. The symptom of discharge from ear recurred after getting wet in rain, hence the potency was increased. When a constitutional medicine is given in correct potency with proper repetition there is complete and gentle cure.

About the author

Atul Rajgurav

Atul Rajgurav

Dr. Atul Rajgurav M.D. (Hom.) is a consulting Homoeopath working in Pune. He is HOD and Associate Professor in the Department of Homoeopathic Pharmacy, Dr. D.Y. Patil Homoeopathic Medical College, Pune.

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