PRELIMINARY DATA
NAME XYZ
AGE/SEX 55/F
OCCUPATION housewife
MARITAL STATUS widowed
C/O
A middle aged lady, with no known co-morbidities, came to the clinic complaining of numbness of her right hand, its ring finger and middle finger extending to the tip, whenever she puts her hand in cold water. This complaint started one month earlier.
LOCATION | SENSATION | MODALITY | CONCOMITTANT |
Right hand and Middle, ring finger | Numbness and tingling | <cold water
<working/using the hand >hot/warm water |
ASSOCIATED C/O
LOCATION | SENSATION | MODALITY | CONCOMITTANT |
Right shoulder | Pain ,stiffness | < Lifting grocery bags |
PAST H/O nothing specific
FAMILY H/O nothing specific
PERSONAL H/O
PHY GENERALS
App normal
Thirst normal
Craving nothing specific
Aversion nothing specific
Stool /Urine Normal
Sleep sound
Dreams nothing specific
Habits/ Addiction-NA
Perspiration normal
Thermals towards chilly
SUMMER | WINTER | RAINY | ||
FANNING | ++ | — | — | |
COVERING | ++ | ++ | ++ | |
BATHING | Hot water | Hot water | Hot water | |
WOOLEN | — | ++ | ++ |
Menstrual H/O: – menopause around 50 years of age
Obstetric H/O :- 1 female child, FTND
Clinical examination: Power/strength in both hands 5/5
Reflexes: motor/sensory: normal
Grip : normal
DATE | COMPLAINTS | Rx | Dose |
13/4/2016 | Numbness of right hand and distal interphalyngeal joint of its middle finger extending to the tip.
<cold water < morning > movement |
Rhus Tox 200 | 4 pills QID x 1 week |
20/4/2016 | Almost status quo, no change in complaints, 10% better | Causticum 200 | 4 pills QID x 1 week |
28/4/2016 | Status quo , no change, says complaint is better by putting hands in warm water | Hypericum 200 | 4 pills QID x 1week |
4/5/2016 | 30-40% better, <working, cold water | Hypericum 200 | 4 pills QID x 1week |
11/5/2016 | Status quo, 30-40% better, but now not aggravated by putting hands in cold water or working
Pain in right shoulder, can’t take her hand back |
Hypericum 200 | 4 pills TDS x 1week |
24/5/2016 | Ring finger complaints reduced, middle finger numbness ++ 40-45% , | Hypericum 200 | 4 pills BD x 1week |
8/6/2016 | She was almost 50% better, but c/o Right arm pain | Hypericum 200 | 4 pills BD x 2 weeks |
22/6/2016 | Better. No fresh complaints. 70-80% better. Pain intermittently. | Sac Lac | 4 pills x BD x 2 weeks |
3/7/2016 | No fresh complaints. | Sac Lac | 4 pills x BD x 2 weeks |
15/7/2016 | Better. Now no pain even if she uses cold water. | Sac Lac | 4 pills x BD x 2 weeks |
10/8/2016 | For routine follow up. No fresh complaints. | Sac Lac | 4 pills x BD x 2 weeks |
5/9/2016 | For routine follow up. No fresh complaints. | Sac Lac | 4 pills x BD x 2 weeks |
She was completely better, and did not have any complaints. I asked her to follow up only if required. She followed up. Whenever she felt slight recurrence, it did not require anything other than placebo.
SELECTION OF RHUS TOX:
When the results weren’t satisfactory, I remembered our teachings ‘The remedy which comes through repertorisation is best described in Materia Medica and not in the repertory.’ After all, Repertory is an aid to the Materia Medica. When one finds the indicated medicine through repertorisation, one should not be satisfied with it but must read the effects of the medicine in the Materia Medica and compare it with other remedies.
SELECTION OF CAUSTICUM :
I went through the Boereicke’s materia Medica and found- “Causticum: extremities- unsteadiness of muscles of forearm and hand. Numbness; loss of sensation in hands, worse by cold, better by warmth. “
However, it didn’t give good results, hence I again went back to Boericke’s Materia Medica, and hypericum covered the following: ‘The great remedy for injuries to nerves, especially of fingers, toes and nails. Neuritis, tingling, burning and numbness. Pain in toes and fingers, especially tips. Crawling sensation in hands and feet.
Phatak’s Materia Medica quotes “An excellent remedy for the injury to parts rich in sentient nerves, especially fingers, toes, matrix of nails.”
Thus hypericum was chosen, and gave the above results!