CASE 1 Cold, Cough, Fever
A female child, 3yrs old presentedwith the complaints of cold, cough, fever (101f), throat strain with pain, hoarse voice and slight difficulty in breathing for two days. Her parents gave her some syrup but without any relief. The child was constantly on the shoulders of the father in an OPD. She was not ready to come down and to get examined. After enquiry, the mother said that the child is not ready to leave the parents, so either of the parents was engaged since yesterday.
O/E- R/SBecause examination was difficult as child was not allowing it. The child was not ready to leave the parent for toilet also.
Cold, cough, fever are the common symptoms but the behavior of the child was very characteristic in the case, so I took the rubric:
Mind; CARRIED desires to be; in croup (1): brom. KENT REPERTORY
Prescription was BROMIUM 200(1 dose STAT and second SOS) And SL.
1) FOLLOW UP 1- AFTER 12 HRS
- Child was better within 12 hours. Started playing on its own
- Fever came down (reported temp by mother was 97.6 f without antipyretics)
- Child went to sleep normally
- Cold persisting and cough reduced
- Child allowed me to examineher and R/S was A.E.B.E.
2) FOLLOW UP 2- AFTER 24 HRS
- Child is playing and eating well
- One spike of fever (100f) which passed went uneventfully without any allopathic medicine. They gave another dose of BROM. 200.
- Watering from the nose persisting
- Activity normal
- R/S- A.E.B.E.
3) FOLLOW UP 3- AFTER TOTAL 72 HRS
- child remained playful
- activity, appetite, stool , urine etc remained apparently normal
- r/s – a.e.b.e.
- no fever
- cold persisting butless now
4) FOLLOW UP 3- AFTER 30 DAYS
- no episode after that
- she has started eating better than before
- she gained weight – 1 kg in a month
- child came in the OPDand showed me her new dress as well and greeted me
Learning – Main idea here is also – Knowing to use single drug rubric
CASE 2 – Headache of 10 years
A Female of 45years
C/o – headache on left side, on and off, since 10 years, suffers it every 2-3 days.
Headache starts above left++ eye and shifts to whole head with nausea ++.
Pain in left eyebrow, forehead and eyeball and shoots to back.
Pain agg by fasting, light, noise and better by rest+
She said that she has to press her head continuously with her hand which used to give her relief and as soon as she used to remove her hand, pain would return.
The pain is neuralgic
She used to take pain killers and antacids as and when required with just temporary relief.
She used many types of medications even homoeopathic, with no long standing effects.
I took the whole case but could not find anything specific in past history, family history, personal history, examination etc.
GENERALS – thirsty +, chilly+, occasional stool disturbances.
M/H – 30/ 2-3 days, non- staining, no odor, clotted m/c. M/C sometimes irregular.
B.P- 140/90 mm of hg PULSE- 82/ MIN
Nooedema, icterus, clubbing, L’pathy etc
Diagnosis : migraine headache
I took the whole case and selected rubrics based on location, sensation, modality, concomitants.
In the Phatak repertory there is one interesting rubric given which I learnt from Dr. Gaurang Gaikwad (The Other Song Academy, Mumbai)
PRESSURE, steady AMEL. – Nit. Acid, Spig
In the Phatak repertory there is an idea of generalization, so you can apply this rubric at the local level also. My patient had exactly this symptom during pain.
I gave Spigelia 200= 2 doses with one stat and second sos and SL for 7 days.
1st FOLLOW UP after 7 days-
- Took second dose as there was one attack.
- Feeling better but yet not convinced whether medicine was acting or not.
- Instead of headache, feels heavy now. Nausea is better.
- Generals remained better.
Spigelia 200= 2 doses with SL given for 15 days
2nd FOLLOW UPafter another 15 days-
- Had one attack inbetween that was aborted with another dose.
- Heaviness in head reduced, no nausea or vomiting
- Had cold one day with no fever. Did not take any medicine for that
SL continued for 15 days.
3rd FOLLOW UPafter another 15 days
- Only one episode occurred which was again settled with the doses of SL.
- Generals remained better. Had some nausea which passed after resting.
- She said that now she has started thinking about her work rather than her pains.
SL continued for 15 days.
4th FOLLOW UPafter 3 months
Patient came late and reported that there was no medicine for 10days (SL)
No episode in between. She did her routine tests which were normal.
- Had some acidity issues for which she took antacid tab which helped.
- No heaviness in the head.
- No nausea or eye disturbances.
- She is doing well at her work place
5th FOLLOW UPafter 5 months
- She got up with an attack of cold, cough, fever.
- Thirsty, chilly
- Body pain ++
- Activity normal and energy level slightly deranged
ANALYSIS– As she was suffering from so called self-limiting VIRAL FEVER,
SL was given for 2 days and she was advised to take complete bed rest, warm water for drinking and to report as and when required.
6h FOLLOW UP Almost after another 4 days after viral fever episode
- She recovered well without any further medication except she took one painkiller for her body pain.
- No episode of headache in between
SL was continued for a month and one dose of Spig. 200 was given to be taken SOS
7h FOLLOW UPafter total 7 months
- She had to take a dose of Spig. 200 once, as one episode of headache was there after fasting(she had to perform some religious rituals so she fasted for a day)
- No gastric complaints in between
- Started her own business and told me that she is doing well
- P. – 130/ 84 mm of Hg, Pulse – 78/min
SL was continued for another 1 monthand one dose of Spig. 200 was given to be taken SOS
Lessons from this case:
Eliciting characteristic symptoms in a case is very important.