Solution to Dr. Amarsinha Nikam’s Case – Acute Respiratory Distress Syndrome with Septicemia (Pneumonitis with UTI & ARF)

nikam nov image

Dr. Nikam provides the solution to his chronic case quiz of last month.

Here is the original case from Oct 2012 :

https://hpathy.com/case-quizes/acute-respiratory-distress-syndrome-with-septicemia-pneumonitis-with-uti-arf/

Solution:

  • Totality :
  • Jolly jesting.
  • Discontented.
  • Forsaken feeling – relatives.
  • Pessimist.
  • Religious.
  • Loss of presentation – ugly.
  • Abusive.
  • Extravagance.
  • Irritable.
  • Greedy.
  • Irritable.
  • Desire: Sweet.
  • Perspiration: Profuse.
  • Quarrelsome.
  • Sadness.
  • H/o suppression of skin ailments.
  • Pneumonitis –inflammation of lungs.
  • Thermal: Hot.
  • Miasm : Syphilitic.
  • Remedy Selected : SULPHUR 30

  • Response :

The patient responded remarkably just after 10 days. The most amazing & important thing is that the continuous ventilator that he needed was totally removed as he was able to breathe normally. This was the first time that the patient spoke, “Now I’m feeling good and I can breathe easily.”

Patient was able to sit up in his bed with minimal support and was also able to stand for a few seconds. In a few days, his face became normal and gave a healthy look to the patient.

Further, he progressed well and recovered fully.

He said in the follow up that he didn’t know what had happened to him and he thinks that he had just got up from a deep sleep.

  • D/D :

Antimonium Tartaricum : It is a well known remedy for such respiratory manifestations. It shows symptoms of marked respiratory insufficiency.

This case was a perfect match for pathological aspect. But as per our principles, the drug should be a match on physical, mental and particular, along with pathological level, to get a complete result which is not the case with this patient’s presentation.

Lycopodium : Lycopodium seems to be close to this case, but it does not cover the extravagance and untidy character of patient. Also the pace of disease development in this patient is very fast, in contrast to the pace of Lycopodium, which covers mostly slow developing pathology.

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Readers’ Responses

Sulfur 30ch, once – A. Oberoi [email protected]

The rubrics are:

Recurrent inflammation of wounds (suppressed with ointments)

Ailments from suppressed eruptions

Dwells on religion

Septic fever

Thirst

Quarrelsome

Making many plans

Neglects his appearance

Feelings of rage

Insomnia at night, with sleepiness during daytime

Aggravated by heat

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Sulphur – Dr. Gagan Nakra [email protected]

Untidy dress up; He desires for a lavish, hi-fi living. He plans a lot for different things, but never executes. skin eruption suppression several times.

1

1234

1

FEVER – RELAPSING

18

2

1234

1

FEVER – REMITTENT

46

3

1234

1

COUGH – FEVER – during

86

4

1234

1

MIND – QUARRELSOME

189

5

1234

1

MIND – SYMPATHY from others – desire for

6

6

1234

1

MIND – ANGER – violent

93

7

1234

1

MIND – SUPERSTITIOUS etc…

26

8

1234

1

PERSPIRATION – PROFUSE

224

9

1234

1

PERSPIRATION – STAINING the linen – yellow

29

10

1234

0

MIND – INDIFFERENCE, apathy – appearance; to his personal

11

11

1234

1

MIND – TASTELESSNESS in dressing etc…

20

12

1234

1

MIND – PLANS – making many plans

23

13

1234

1

GENERALS – FOOD and DRINKS – fruit – aversion

24

14

1234

1

GENERALS – FOOD and DRINKS – milk – desire

72

15

1234

1

GENERALS – FOOD and DRINKS – spices – desire

74

16

1234

1

GENERALS – FOOD and DRINKS – pungent things – desire

41

17

1234

1

SKIN – ERUPTIONS

210

18

1234

1

HEAD – CEREBRAL HEMORRHAGE

72

19

1234

1

CHEST – INFLAMMATION – Lungs etc…

139

20

1234

1

MIND – MOOD – changeable etc…

215

21

1234

1

MIND – GAMBLING – passion for gambling

10

22

1234

1

GENERALS – SEPTICEMIA, blood poisoning

101

23

1234

1

GENERALS – HYPERTENSION

122

sulph.

ars.

verat.

chin.

phos.

bell.

lach.

nux-v.

bry.

calc.

20

18

17

16

16

15

15

15

14

14

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Sulphur – Elaine Lewis [email protected]

I’m hoping it’s Sulphur.  He has plans but doesn’t complete them, he’s got skin eruptions, he’s hot, he’s messy…what can I say?

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Antimonium Tart – Julija P. Lande -Homeopath

STOMACH – VOMITING – heat – during
CHEST – INFLAMMATION – Bronchial tubes – accompanied by – weakness
PERSPIRATION – PROFUSE – Affected parts, on
SLEEP – SLEEPLESSNESS – night – sleeps by day
MIND – CONTRARY
GENERALS – DISTENSION; sensation of
MIND – PLANS – making many plans – realize them; but don’t
CHEST – INFLAMMATION – Lungs
GENERALS – WEAKNESS – acute diseases – during
COUGH – REMITTENT fever, during

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CHINA ARSENICOSUM  – Dr. Christiane Lhuillier

I have tried to consider the case in its totality and I have repertorized these symptoms:
Pneumonia / septicemia/ fever alternating shivering/ perspiration staining the linen yellow
vomiting on coughing / aversion to fruit/ vegetarian diet

MIND violence vehemence dead of rage /abusive, insulting//husband insults wife/ pessimist/ ambition but indolent

OLD TROUBLES hemorrhage tendency/ stomach ulcers/ swallowing difficult

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Pyrogen(after recovery follow with Phos) Veronique Jack

Due to the severity of symptoms and the urgency of treatment necessary I would immediately treat the patient with Pyrogen. The most important aspect is to get the patient out of danger straight away and deal with the septic condition.

I chose 3 confirmatory rubrics:

Chills, Septic conditions, chills from (Murphy) p358: pyrogen

Fever, septic p849: PYROGEN

Clinical, Septicaemia, blood infection p466: PYROGEN

I would probably give it in the 200 potency repeated as necessary until fever abated and then twice a day until definite signs of recovery.

As the patient recovered, I would consider treating him with Phosphorus which covers most of the symptoms down to his gambling habit according to Philip Bailey.

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PhosphorusPatel Rahul 

LIST OF RUBRICS

1 1234 1 Food – SWEETS, general – desires 67

2 1234 1 Food – FRUIT, agg. – aversion to 19

3 1234 1 Mind – FEAR, general, phobias – noise, from 41

4 1234 1 Mind – CONFIDENCE, lacking, no self esteem 86

5 1234 1 Breathing – DIFFICULT, breathing 287

6 1234 1 Throat – SWALLOWING, general – difficult 151

7 1234 1 Skin – ERUPTIONS – suppressed, eruptions, ailments from 81

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OPIUM – Kaushik Banerjee

Please find the rubrics.

[Allen ] [W]Weakness:Vomiting, after:
[Kent ] [Fever]Intense heat:
[Complete ] [Generalities]Food and drinks:Fruit:Aversion:
[Complete ] [Generalities]Food and drinks:Sweets:Desires:
[Complete ] [Stomach]Thirst:
[Complete ] [Rectum]Constipation:
[Therap ] [Aggravation]Eruptions, after suppression of:
[Complete ] [Rectum]Constipation:Insufficient, incomplete, unsatisfactory stools:

I chose for OPIUM after this small repertorisation & then reading materia medica and inactivity of the organs. OPIUM is thermally HOT & so is SULPHUR too. I took very less symptoms and saw myself closing towards OPIUM, SULPHUR, BRYONIA, ARSENIC etc. In the case the patient is OLD where his vital force is lacking in this acute condition.OPIUM acts well in children and old persons in acute cases like that of Ant-tart in respiratory disorders( but is Ambithermal). I do not know that whether i am correct or wrong because i do not have any experience till now with OPIUM & i am a lay person not a qualified homeopath who’s just hobby is reading homeopathy after my profession. SULPHUR has too come very close but it may be his CHRONIC remedy. Eg., plays with antics covers opium and sulphur both.Since the patient is suffering from acute distress i go for opium first not his chronic(sulphur).

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Bryonia (considering the thirst, cough, thermals and pathology) as an acute prescription. Dimple Kirpalani (B.H.M.S)

My prescription would be –

Lycopodium is the indicated constitutional. Rubrics I went through –

Mental –

Despair – religious

Fear death of

Religious affections

Rage

Quarrelsome

 

Physical –

Perspiration – axillae – stains yellow

Eruptions suppressed

Desires pungent

Desires sweets

Aversion fruits

Weakness – fever with

Lycopodium is followed well by Bryonia.

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VERATRUM-ALB-1M Dr. Suresh Jain

[Mind]Quarrelsomeness, scolding:

X I [C] [Mind]Rage, fury:

[C] [Mind]Striking:

[C) [Mind]Abusive, insulting:

[C] [Mind]Feigning:Sick:

[C] [Mind]Squanders:Money:

I [C] [Mind]Vivaciousness:

[C] [Generalities]Septicemia, blood poisoning, pyemia:

[C) [Skin]Eruptions:General:Suppressed:

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Veratrum Album….Lily Samardzic-Rafik, DiHom Pract., MSc Hom Med

Stramonium, but from the start Veratrum Album came to mind…. the gambling, high life style and the exhaustion after vomiting led me to confirm Veratrum Album….

Rubrics :

Fever -vomiting during

Respiration Difficult

Mind – feigning – sick to be

Stomach vomiting general exhausting

Mind – jesting

Mind – Haughty

Mind – fear – disease of impending

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Veratrum album – Dr. Ana Cristina Costa de Almeida

Rubrics chosen:

Feigning sick

Irritability

Squanders money

Fear from noise

Illusion has an incurable disease

Hot remedy

Vomiting with weakness

Weakness in acute illness

Anemia

Uremia

Respiration difficult, short

Intense heat

Fever with chill

Thirst extreme

Perspiration staining linen yellow

Food fruits aversion

I would choose Veratrum album to solve this case for resemblance with mentality of this medicine beyond the physical symptoms that match.

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Belladonna –  Dr Shweta Nigam

I selected Belladonna. My rubrics are:

1.feigning sick – pt. pretends to be sick to seek attention and gain sympathy

2.perspiration, staining the linen yellow

3.fruits aversion

4.quarrelsomeness

5.constipation-insufficient, incomplete, unsatisfactory stools

6.sleepiness daytime, sleeplessness at night and

7.fever chill with

8.extravagance

9.fear :disease of impending

Belladonna is remedy for sudden onset, hot, thirsty

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China officinalis – (ddx with Veratrum album) Laura Stewart

Here are my rubrics:

Mind; QUARRELSOMENESS, scolding (226)

Mind; FEIGNING; Sick (17)

Mind; RELIGIOUS affections (121)

Mind; PLAY; Desire to, playful; gambling, passion for (22)

Mind; SQUANDERS; Money (7)

Mind; FEAR; Noise, from; sudden, of (3)

Generalities; FOOD and drinks; Fruits; aversion (43)

Perspiration; PROFUSE (326)

Perspiration; STAINING; Yellow (38)

Sleep; SLEEPINESS; Daytime (162)

Sleep; SLEEPLESSNESS; Night; sleepiness, with; daytime (55)

Throat; SWALLOWING; Difficult (316)

Abdomen; DISTENSION (587)

Chest; INFLAMMATION; Lungs, pneumonia (197)

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Chronic Lycopodium” with an acute “lycopodium” state –  Clément

Chronic

Mind

. Outside the home he was friendly, talkative, mixing, jovial and nice. But at home he used to trouble his parents a lot and was very irritable & quarrelsome. (It’s The big lycopodium key-note)

. irritable & nervous, quarrelsome, scream, insulting when anger

. pretends to be seriously ill to seek attention and sympathy of attendants (Mind; deceitful, sly)

. habit of playing lottery (Mind; play; desire to, playful; gambling, passion for; business, making money, for)

. His son added, “He is really worried about my future and that’s because I am not ready to get married.” (even his son seems to be a lycopodium case : Mind; irresolution, indecision; marry, to)

and many others (Mind; religious affections Mind; fear; undertaking anything Mind; anxiety; health, about)

General

. Hot

. Lying on back

. Sweet desire

. Perspiration; staining; yellow

Local

. Abdomen : Distended feeling (no comment : flatus trio Nash)

. Difficulty in deglutition (Throat; swallowing; difficult)

Acute

. frequent high grade fever, profuse vomiting followed by severe weakness

it’s a strange, non characteristic symptom of ARDS, hence interesting and useful (Fever, heat; vomiting; during Fever, heat; intermittent, chronic, ague, malarial; vomiting, with)

. Continuous cough with fever on and off (Cough; fever; during)

. with Septicemia (Fever, heat; septic fevers)

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Lycopodium -Sage
I believe this case is Lycopodium because:
1)  The patient has a desire for stimulants – lottery habit, spicy/pungent food, lavish money spending, sweets
2)  Patient has duel sided temper – friendly with society, irritable with family
3)  Days and Nights are mixed up for sleep
4)  Religious
5)  Fear at sudden noise, and fear of being alone ( worried that son is not getting married thus providing his need for people in his life)
6) Perspiration staining yellow
7)  Difficulty swallowing
8)  Constipation and Distended feeling
9)  Infection involving lung and shortness of breath
Thank you very much for this opportunity to practice my skills.
Sage

Ant-Tartaricum – Sandy Seaman

My thinking on this case is that there was some aspiration during intense vomiting causing inflammation of the lungs. My rubrics are:

Mind; irritability
Chest; inflammation; lungs, pneumonia
Fever, heat; vomiting; during
Generalities; vomiting; after

My choice of remedy would be Ant-Tart. in a low to medium potency because of the weakness and advanced stage of the illness. Ant-Tart can be warm-blooded before the end stages so this would fit with his hot thermals. Also can be very irritable during an acute stage of illness.

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LachesisValerian Mendonca

(Repertorization Chart below)

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Argentum nitricum – Pavol Tibensky

MIND – ALCOHOLISM

MIND – COMPANY – desire for

MIND – DELUSIONS – despised; is

MIND – FASTIDIOUS

MIND – FEAR – high places, of

VERTIGO – WALKING – agg.

MOUTH – BLEEDING – Gums

EXTREMITIES – PAIN – Knees – morning

EXTREMITIES – PAIN – Knees – pressure – amel.

EXTREMITIES – TOTTERING GAIT

EXTREMITIES – WALKING – impossible – eyes closed; with

SLEEP – POSITION – side; on – left side; on

SLEEP – UNREFRESHING

SKIN – MOLES

GENERALS – FOOD and DRINKS – cold drink, cold water – desire

GENERALS – FOOD and DRINKS – fried food – desire

GENERALS – FOOD and DRINKS – sweets – desire

GENERALS – HUNGER – agg.

GENERALS – NEUROLOGICAL complaints

GENERALS – SLOW manifestation

ARG NITR

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SEPIA  Rosman Bin Faridz

See Repertorization charts below:

If I were to based on mental only symptom, I still get SEPIA. Below is my repertorization based on mental only.

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Bromium – Dr.Ramya Gayatri

acute respiratory distress syndrome…-rubrics are:

1.difficulty in deglutition

2.difficulty in breathing

3.continuous cough

4.thermal-hot patient

About the author

Amarsinha Nikam

Amarsinha Nikam

Dr. Amarsinha Nikam is a renowned homeopath who runs Aditya Homoeopathic Hospital and Healing Centre in Pune. He started his career as R.M.O. at Lokmanya Hospital Pune, Homoeopathy Division and subsequently practiced as the consultant Homoeopath for 14 years at various places such as Beed, Khopoli, Chakan, Kate – Pimple, Pimple – Gurav and Pimpri Gaon, Pune. Dr. Nikam teaches students to understand the depth of homeopathic treatment and differentiate it from other pathies. He instructs them in his method of practice, but also inspires them to innovate and explore.

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