Clinical Cases

Nocturnal Enuresis in a Ten Year Old Girl

Parth Aphale
Written by Parth Aphale

Dr. Parth Aphale presents a case of chronic bedwetting in a 10 year old girl.

Bed-wetting, also called Enuresis, is one habit disorder that causes trauma, pain and disturbance to all concerned. It is the parents who normally wakes up each night to check on the child, maybe even to disturb her sleep to check on whether she wants to urinate. When the child wets her bed, it is the parents and the maid who have to change and wash the sheets and air the room. And what about what the little child has to go through herself – the shame at having lost control once again?

A Case of Nocturnal Treated with Homoeopathy

A 10 year old girl with thin and fair complexion, dark hair and eyes, delicate, sensitive skin came with complaint of bedwetting. She started involuntary urination at night after the sudden death of her father in a road accident. She was extremely close to him. She passes urine at least two times a night. She had taken other treatment for this but without effect. 

Chief complaints

Bed wetting at night for last 2 yrs   

Past history   

NAD

Family history

Mother     had T.B.

Personal history 

Appetite               Poor

Desires                           fried foods

Aversions                      Bitter foods

Thirst                   4-6 glasses of water daily

Perspiration         scanty non offensive

Stool                    Passes stool every alternate day

Urine                    Involuntary urination at night, 2- 3 times

Sleep & Dreams Good sleep

Thermals             Aggravation winters, change of season

Mental generals

She is absent minded, not obedient and is defiant. She does exactly the opposite of what her mother asks. She has a tendency to eat fast. She is sensitive and is offended easily at the slightest remarks by others.

Vital data

General Examination:

Temp:  Afebrile                         Pulse: 72\min

Systemic Examination:   CVS: NAD                 RS: NAD             CNS: NA

P\A: Soft, non tender; no organomegaly.

Physical make up:  Thin and fair complexion. Dark hair and eyes, delicate, sensitive skin

Investigation :  No abnormalities detected on routine stool and urine investigations               

Final diagnosis: Nocturnal Enuresis

Miasmatic background:  Psoric

Analysis of symptoms

  1. Absent minded- Mental general characteristic
  2. Ailments from death of parent / Contradict, disposition to- Mental general characteristic
  3. Hurry haste tendency eating while
  4. Offended easily- Mental general characteristic
  5. Urination night involuntary children in

Evaluation of symptoms

  1. Absent minded
  2. Ailments from death, parent of
  3. Contradict disposition to
  4. Hurry haste tendency eating while
  5. Offended easily
  6. Urination night involuntary children in

PDF:

Chilly patient

Melancholic temperament

Thin and fair complexion. Dark hair and eyes, delicate, sensitive; skin

Totality of symptom                                                              

  1. Mind – Absent-Minded, Preoccupied
  2. Mind – Depression, Sadness
  3. Mind – Contradict, Disposition To
  4. Mind – Hurried, Feelings – Eating, While
  5. Mind – Offended, Easily
  6. Bladder – Bedwetting, Enuresis – Children, In 

Repertorisation

 

Remedial differential diagnosis

Causticum            6/17

Lyco                     6/13

Lach                     5/13

Sepia                              5/11

Final remedy

Causticum  200 single dose followed by S.L

Follow up

Sr.noDateComplaintsRemedyReason
17/09/15Frequency of bed wetting not reducedCausticum 200 T.D.S for 8 days

 

Complaint NOT reduced hence repetition of same medicine.
215/09/15Complaints are decreasing slowly.S.L for 12 days

 

As improvement is there S.L continued
327/09/15bed wetted only once this weekS.L for 15 days.As improvement is there,.S.L contd.
411/10/15Frequency has increased to 3 times a day. Mother had scolded the child and beaten her for answering back.Causticum 1M one dose.S.L for 15 days.Recurrence of symptoms was seen, so dose was increased.
526/11/15No bed wetting in 15 daysS.L for 15 days.As improvement is there S.L contd.
627/12/15No bed wetting in 15 daysS.L for  1 monthAs improvement is there S.L contd.
730/01/16Frequency has increased to 2 times a night.Causticum 10M I Dose S.L. T.D.S for 15daysAs recurrence of symptoms, dose increased.
817/02/16Frequency reducedS.L. T.D.S for 1monthAs improvement is there S.L contd.
925/03/16Occasion bed wetting. Much betterS.L. T.D.S for 1monthAs improvement is there S.L contd.
10.29/04/16Started bed wetting again due to tension of exams.Causticum50M I Dose, S.L T.D.S for 15days.As recurrence of symptoms, dose increased.
11.16/05/15No bed wetting in 15 daysS.L for  1 monthAs improvement is there S.L contd.
12.27/06/16No bed wettingS.L for  1 monthAs improvement is there S.L contd.
13.01/08/2016Started bed wetting again due to starting of rainy season. <damp cold weatherCausticum CM I Dose, S.L T.D.S for 15days.As recurrence of symptoms, dose increased.
1403/09 16No bed wettingS.L for  1 monthAs improvement is there S.L contd.
1517/09/16No bed wettingStop treatment. Follow up as and when required.

 

Comments  

After analyzing the case I found that the patient had a melancholic temperament and was of the carbo-nitrogenoid constitution. After considering these facts and repertorial totality, CAUSTICUM was selected as her constitutional remedy. Patient responded very well and improved almost completely. This shows that when a correct constitutional remedy is selected and given in the right potency with correct repetition, it does wonders. Thus constitution plays a very important role in homoeopathy.

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About the author

Parth Aphale

Parth Aphale

Dr. Parth Aphale, M.D.(Hom.), is a homeopathic physician in Pune, and Assistant Professor, Department of Homoeopathic Pharmacy at Dr. D.Y. Patil Homoeopathic Medical College and Research Centre, Pune.

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