Patient is a loving individual and is particularly attached with daughter who was looking after him. Sentimental, weeps when anyone phones him and ask about his health, even if asks how are you? Generally Reserved, does not talk much about personal matters yet, socially helpful to friends in need. Patient was anxious by nature, anticipates and likes to plan. Anticipatory anxiety- passes motions before going out for travelling, thinking may not find the suitable place for elimination. Modest doesn’t like to do show off. Extremely humble and good with bosses but would have rift with subordinates. During the stay in hospital patient was sad and weepy. He was emotional yet reserved would keep to himself. He was feeling embarrassed to pass urine or stool in bed pan would insist on being left alone in the room. He would avoid passing urine and stool as much as possible hence was constipated for 5 days post-operative.
- Weeping easily.
- Desire to be alone.
- Embarrassment cannot pass stool in front of others.
- Fever aggravates at 11a.m.
- Resistant malaria.
Chronic transfusion induced resistant falciparum malaria with complication.
- Sentimental, weeps easily if inquired in to.
- Anticipatory anxiety.
- Hot patient.
- Craving for sweets
Patient has resistant infection in blood and reticulo-endothelial system is unable to throw it off, in spite of treatment. Infection is impacting other organs like liver and kidney rendering them dysfunctional and threatening life. This pathophysiological phenomenon indicates weakness of immune system leading to resistant infection and spread to other organs, typical of tubercular Miasm.
Susceptibility is judged by pace of disease, stage of pathology and characteristics expressed in the case. During fever, patient has time modality, mental concomitants, and constitutional symptoms are also well indicated through physical generals and attributes of mind. The overall assessment indicates moderate deviation from state of health. Patient may require multiple dosages or sequential prescribing to complete the treatment.
Crux of the management lies in identifying indicated remedies at different times during the course of treatment.
- Fever Phase: Natrum Muriaticum.
- Constitutional: Lycopodium.
- Inter-current remedy: Tuberculinumbovinum.
|25/9/07||Patient febrile. Temperature range 100oF, Haemoglobin 8.5gm%.||Wait and watch|
|27/9/07||Patient febrile. Prescription released during the declining phase of fever.||Natrum Muriaticum 200 Single dose|
|29/9/07||Restlessness at night after administration of Natrum Muriaticum.|
Temperature 99.8oF – 100oF throughout the night.
28/9: Temperature 99.2oF – 99.4oF
Today restlessness better. Temperature 98.8o F
|Fever spike has gradually reduced within 4 days.|
Maximum temp has come down from 99.4 to 98.4o F One fever spike on 2/10/07 (previous day) with peak temperature of 99.4oF.
|Tuberculinum 1M single dose|
|11/10/07||No fever for four days. One single spike on 10/10/07 During spike developed flatulence as a concomitant.||Lycopodium|
200 single dose.
|25/10/07||Generals improved. No fever throughout the week. Single spike of fever in entire week.||Lycopodium 200 single dose|
|27/10/07||No episode of fever, Generals Normal, Emotional out bursts reduced, weakness reduced, appetite normal|
Patient has started evening stroll. Haemoglobin 9.3 gm%.
In this case, three indicated remedies were prescribed in specific sequence and helped to clear malaria. Initially, for the presenting fever totality to address the fever phase, the remedy NAT MUR was selected, followed by intercurrent TUBERCULINUM to mitigate the current impact of disease, as there is multi organ involvement with complications. Finally the constitutional remedy LYCOPODIUM was given to address morbid susceptibility and to prevent relapse and aid in convalescence. It is essential to note here, that each remedial force had specific indications, and was prescribed when indications for that remedy appeared on the surface in a sequential fashion. The key concept is identifying timing of the introduction of different forces in the repertoire of a homoeopath.
- Homoeopathy is effective in managing the cases of acute & chronic relapsing malaria. Dr Hahnemann in his book ‘Organon of Medicine’as well as Dr H C Allen in his book ‘Intermittent fever’ have set clear guidelines for case taking, management and time of administration of remedies in cases of intermittent fevers.
- Understanding susceptibility of the patient holds the key to homoeopathic management of malaria. Deviationfrom original state of health understood through pace of disease, stage of pathology and quality of characteristics in a case provides quantitative assessment of susceptibility.
- Depending on an individual’s susceptibility we get different varied presentations of the malarial infection and based on these varied presentations we need to address our prescription which helps to cure the case.
- Miasm is the qualitative aspect of susceptibility; to be able to differentiate Miasmatic phases clinically helps identify intercurrent remedies which play an important part in management of malaria.
- For the cases which present with clearly defined heat chill and sweat stages, a remedy selected on the basis of presenting totality will abort the fever paroxysm. A single dose of the indicated remedy administered during apyrexia or declining phase of fever aborts the fever but in a few cases repetition is required for controlling the fever paroxysms.
- In cases where recurrence of malarial fever is noted but the fever totality is clearly represented, a best suited remedy covering the fever totality should be administered. This remedy aborts the fever paroxysm. But the tendency to relapse can be prevented only by administration of the constitutional remedy.
- In cases with recurrence, in a few cases both the fever totality as well as constitutional totality is covered by a single remedy.In such cases administration of that single remedy will not only abort the current fever episode but also prevent further relapses.
- In cases with a high miasmatic load and when the fever stages are not well represented, the anti-miasmatic remedy is the best indicated as it will bring down the miasmatic load and pave the path for recovery.
- Cases with chronic relapses without a clear fever totality but a clear misamatic block, can be better managed with an intercurrent followed by a deep acting constitutional remedy.
- In cases which have a deeper pathology and multi organ involvement, initially the fever phase is to be managed with an indicated remedy, followed by an anti miasmatic remedy to mitigate the overall impact of the disease and finally a constitutional remedy helps complete the cure.