Right Pleural Effusion in a Woman of 49

A married woman of 49 consulted me by video call for pleural effusion. Due to the nationwide lockdown, it was difficult to personally consult the patient, hence the entire case was consulted over the video call.

The patient presented an X ray showing massive pleural effusion (diagnosed on 25/6/2020 – 2 days prior to starting homoeopathic treatment)

She was referred by a friend, and she didn’t want to risk herself out of the house for pleural tapping.

Following are her complaints as of 27/6/2020 –

1. Everything started from last week of May.

Cough started since last week only

Cough started after eating oily food last week

<lying on right side

Cough – hacking, dry

<eating coconut

<outside food – moong dal from outside

<talking occasionally

<lying down occasionally

<morning waking on

> when in open air

<but when in the house, feels little better

2. Pain in chest < coughing

Can’t lie on right side

If tries to lie down à starts coughing – so she lies on left side only

Stitching pain

Holds chest during cough

3. Breathless <deep breathing <walking/exertion

4. Headache – Right sided < doesn’t like to lie on right side

Feels oppression on chest on lying on right side

Head pains < during cough, thus she needs to hold her head during cough

F/H – Aunt died of paralysis stroke

Mother – death – in accident

Father – death – old age

Brother – tumour in abdomen, cancer

Past History:

Tuberculosis of the lung 20 years ago. Took Koch’s anti-tuberculosis treatment

PHYSICAL GENERALS –

Appetite reduced from second week of June, 2020

No desire to eat, due to which she feels a lot of weakness.

Urine – NS

Stools – alternate days, constipated

Menses – menopause since 4 months, LMP February 2020.

Sleep – good

Bad dreams – as if something bad is going to happen

Dreams of people getting sick/ill or death of people

Doesn’t know who is dying in the dream and that causes anxiety

MIND SPACE –

Doesn’t have children

Had some ovulation problem, so could not conceive due to it

Feels lonely at times as she thinks there is no one elder in the family. Everyone has died early in life. Also, she doesn’t have any children which makes her feel gloomy.

The cousins wanted to take away her father’s house after his death, but she fought for it and got the house in her name, as she doesn’t have any siblings.

Currently, she just wants to get rid of the cough, chest pain and breathlessness, as it is causing tremendous anxiety. She fears that if she gets infected with COVID-19, what will happen to her, and due to weak immunity she might not be able to survive.

TOTALITY –

Using the Boger Boeninghausen Characteristc Repertory, we see how characteristically BRYONIA comes up.

REFERENCES –

1. PHATAK MATERIA MEDICA:

• Bryonia develops a marked action on all serous membranes and the viscera they contain, causing inflammation and exudation.
• Complaints develop slowly, but forcibly.
• Pains are bursting; stitching or sore.
• Painful on coughing, holds sides, chest, head.
• Dropsical swelling gradually increases as the day progresses and disappears during the night.
• Cough is dry, hard, very painful, at night as of from her stomach, must sit up agg. eating and drinking.
• Wants to take deep breath, but cannot or it excites cough
• Pleurisy
• Holds chest, or presses the sternum when coughing

2. BOERICKE MATERIA MEDICA:

• Acts on all serous membranes and the viscera they contain.
• The general character of the pain here produced is a stitching, tearing; worse by motion, better rest.
• These characteristic stitching pains, greatly aggravated by any motion, are found everywhere, but especially in the chest; worse pressure.
• Dropsical effusions into synovial and serous membranes.
• It prefers the right side, the evening, and open air, warm weather after cold days, to manifest its action most markedly.
• Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored sputa
• Difficult, quick respiration; worse every movement; caused by stitches in chest.
• Cough, with feeling as if chest would fly to pieces; presses his head on sternum; must support chest

DATE	FOLLOW UP	PRESCRIPTION
27/6/2020	1st Prescription. (X Ray attached Below)	BRYONIA 200 twice daily in plussing potency
13/7/2020	Pain in chest and cough reduced almost 60-70% within 2 days of the medicines itself. Breathlessness much better, but still feels  some stitches in the chest occasionally. Headache better. Generals better.	BRYONIA 200 twice daily in plussing potency
30/7/2020	Pain in chest almost negligible. Cough almost gone. Breathless only when there is some dampness in the weather or if it has rained heavily. Headache better. Generals better. Advised to do a repeat X ray Chest.	Sac lac twice daily in plussing potency
17/8/2020	Feels much better. Occasional pain in chest on exertion. Didn’t get chest X ray as she is scared to go out of the house due to covid pandemic..	Sac Lac twice daily in plussing potency
9/9/2020	Pain in chest aggravated again, accompanied by breathlessness on exertion. Headache almost absent.  Generals better. Patient advised X ray of chest again.	Bryonia 1M – 2 doses / once a week. First dry on tongue, second dissolved in water.
27/9/2020	All symptoms almost gone. No complaints. X ray of chest done (report attached below)	Sac Lac – 2 doses / once a week. First dry on tongue, second dissolved in water. SOS – Bryonia 1M
15/10/2020	No complaints. SOS not used.	Sac Lac to be continued for 15 days. Inform SOS.

X ray Chest PA view dated 25/6/2020 (BEFORE TREATMENT) –

A zoom in picture is attached below. One can appreciate the massive pleural effusion of the right side of the chest.

X ray Chest PA dated 26/9/2020 (AFTER TREATMENT) –

A zoom in picture is attached below. One can appreciate that the pleural effusion of the right side of the chest has completely been resolved.

The patient has been on homoeopathy only for the pleural effusion.

Thus, we can say that Bryonia has been extremely effective in pleural effusion as mentioned in the source books.