Clinical Cases

Idiopathic Thrombocytopaenic Purpura

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Introduction: Dr. Dilip Dikshit, is a respected homeopath from Mumbai with wide and deep experience. These cases represent the art of perceiving what needs to be cured during the management of a complicated case, especially those where the disease has progressed and developed furthur ‘complications ‘due a factor that we all encounter in practice, the Drug-Disease. What this represents is deviated disease that are observed as ‘complex disease’ or ‘multimiasmatic expression’ of disease that can be traced back to early suppression due to either drugs or surgery.

The method of choice for the appropriate similimum at different points of the case management are either based on keynotes, miasmatic totality or constitutional totality. The chief methods used for reptorization and analysis are either Boenninghausen’s, Kent’s or Bogers, depending on the characteristics in the presenting totality. An essential attribute of the homeopathic prescriber in such situtaions is the art of perceiving the prescriptive totality for the similimum.

Case 1:

Idiopathic Thrombocytopaenic Purpura

Miss S; Age: 11 years; Non-veg

Diagnosis:

Chronic case of Idopathic Thrombocytopaenic Purpura with repeated bleeding episodes.

Recent bleeding episodes:

Observation of a keynote: Movement of tongue, side to side
Kent’s repertory page 407: Mouth, Motion-tongue, side to side: Hell2, Lach, Lyco2

Basis for selection of the remedy:

Destruction, Bleeding tendency, Movement of tongue from side to side, Patient ‘hot’ during the acute episode (while constitutionally chilly).

Progress notes:

Lachesis 30C was administered. the bleeding stopped immediately but the patient became very anxious with a FEAR OF UNKNOWN-3. This had never been present earlier even with more severe episodes. It was interpreted as an over-dose, Lachesis 30C being too crude for the patient. After the dose of Lachesis 30C, she had one episode of Hematemesis which consisted of large clots. In subsequent episodes, Lachesis 200 was used and the ‘fear’ symptom did not return. However in subsequent episodes, it was observed that after the first dose of Lachesis, there was a slight aggravation or no change for about 3 hours and then the bleeding stopped. If the dose was repeated earlier, severe bleeding took place.

Background:

The patient was under my treatment for 2.5 years. Phos used to control her earlier bleeding episodes. Her constitutional remedy is Nat Phos and Tuberculinum was given as intercurrent.

At the age of 3 years she had an attack of measles followed by purpuric rash. The post nasal bleeding started since then and she used to get < at full moon and New Moon, < draft and cold. She was treated with prednisolone and other suppressive drug therapy. At the age of 7, there was no change in her condition and as the bleeding episode continued to be frequent, splenectomy was done. After the operation, the patient was on prednisolone but this did not check the frequency or the severity of attacks.

In March 1976, I started homeopathic treatment. In the last 2.5 years, there were only 2-3 bleeding episodes whereas earlier they used to occur once or twice every month.
Investigations:

Before Homeopathic treatment the platelet count used to be as low as 40,000. At present, it is estimated every week. It consistently ranges between 90,000 to 1,000,000.

Case 2:

Haemolytic Anemia with Jaundice

Mr. P; Age: 26 years; Occupation: Fitter

Diagnosis:

Haemolytic Anemia with Jaundice

Background:

The patient has suffered from Anemia since childhood. There was no history of bleeding from any site. He had 3 attacks of Jaundice in childhood. In 1970 and 72, the concomitant of the illness was feverishness with chills < evening+++ 6pm – 8pm

Since March 1972, there was hyper-acidity on and off with vomiting and pain in the right scapular region < fried food, < oily food, < overeating, < beer+++, alcohol+++, sun+++. Pain > rubbing the sternum.

H/O vertigo from sudden changes of posture eg: sitting and standing. HE also suffered from rumbling in the abdomen with pain and discomfort > Eno’s Fruit salt (a bicarbonate digestive). Urine was dark-colored since a long time with occasional burning during micturition.

H/O Masturbation since childhood+++, the desire for which had considerably reduced. He had become irritable of late, used to brood often and was reserved at home. Adaptability with parents and siblings was poor and he couldn’t enjoy himself at home. However he liked company outside the home.

Bath summer-cold, winter-tepid. Covering-less. Hot+++. Perspiration H/O reddish stains yellow, indelible. Appetite poor in the day but can ear well at night, Craving for spicy food. <Sun+++, > Winter

Physical examination:

Liver palpable ++, Sclera Yellow ++

Keynote:

Perspiration stains red, indelible
Kent Repertory: pg 1301 Arn, Carbo veg, Dulc, LACH, NUX MOSCH, Nux Vom, Thuja

Basis of remedy Selection:

Hot patient.
Destruction – haemolysis
Alcohol < +++
Conflict parents and siblings
Masturbation +++, now desire decreased.
Perspiration – H/O stains reddish and garlic odor
Remedy: Lachesis 30C

Progress Notes:

27/10/77: Lachesis 30C, at bedtime or PRN for 1 week
HB: 7.5 gm%, RBC 2.47 million/c.mm.
WBC 4600, N 68, E 11, M 1, MCH 24, ESR 55mm
Icteric Index 50, Van Deb Berg – Biphasic,
Sr. Bilirubin 4 mg., SGPT 34 units
Stools: Ova of Ascaris L.

9/11/77: Weakness slightly less. Sclera – same.
HB: 10.5 gm%, RBC 4.4 million/c. mm
WBC 8000, MCH 24, ESR 55 mm,
Icteric Index 50, Van Den Berg – Biphasic,
Sr. BIlirubin 4 mgm, SGPT 34 units
Adv: Lachesis 30C, 4 hourly.

17/12/77: Developed Fear of Unknown-3, Weakness+

23/12/77: Icteric Index 40, Van Deb Berg – Indirect +’ve
Sr. Bilirubin 3 mgm, HB. 11 gm.%
Adv: Lachesis 200 HS and PRN

3/2/78 : HB. 12.5 gm.%, RBC 5 million per c.mm
MCH 28, WBC 6400, N 66, E 9, M 1, L 24,
Icteric Index 20, Van Den Berg – delayed Biphasic,
Sr. Bilirubin 3 mgm
Adv: Lachesis 200C 4 hourly

3/3/78 : Weakness absent, Sclera Yellowness absent, Urine – Clear
MCH 28, Van Den Berg direct and Indirect negative
Dr. Bilirubin 0.60 mgm
Adv: Lachesis 200C 4 hourly

Extracted with permission from the ICR Symposium Council Part II – Chapter F1 : PERCEIVING ARTIFICIAL DRUG DISEASE

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Dilip B. Dikshit

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