Preliminary data:
Name: Mr. B
Age: 16
Sex: Male
Religion: Christian
Education: PUC
Occupation: Student
Marital status: Single
Address: Surathkal, Mangalore
Chief complaint
Patient presented with the complaint of breathlessness leading to cough since past 18 years.
| Location Respiratory System Since18 years, on & off attack Sudden onset Gradual progress allopathic treatment |
Sensation Watery expectoration profuse breathlessness+ Leading to cough 4-5 attack in a month for about 1hour Wheezing |
Modality < after eating <night <change of weather <cold items intake >allopathic medicine < dust |
Concomitant |
History of Chief Complaint
Patient presented with the complaint of breathlessness leading to cough since 18 years. Breathlessness used to last for about 2-3mins and he used to get nearly 4-5 attacks in a month with watery expectoration and wheezing. Breathlessness is more at night, when there is change of weather, dust exposure and during intake of cold items and he is better during by allopathic medicine.
Past medical history: NS
Past treatment history: Taken allopathic medication for same complaint
Family history: Grandmother: Hypertension
Allergic history: allergic to dust
Personal history:
Diet: mixed
Appetite: decreased
Thirst: 2-3lt day
Craving: spicy food items
Aversion: bitter food items
Bowel habits: once per day
Bladder habits: 3-4 times per day
Perspiration: general
Sleep: good
Dreams: does not remember
Thermal: likes summer
: doesn’t use fan and blanket
: doesn’t like open air,
: takes bath in warm
General Physical Examination:
Appearance: stocky
Skin: dry
No signs of pallor, cyanosis, icterus, clubbing, and lymphadenopathy
Vital signs:
Temp: afebrile
Pulse: 74 beats /min
B.P: 120/80mm of hg
Local examination
Respiratory system:
O/E wheeze heard on right supra-mammary region
Systemic:
CVS: no murmurs
Life space investigation: Patient hails from a middle socio-economic status family. His father was a businessman and mother was a school teacher. The relationship between his father and mother was not good, always fighting and then when he was about 4 years they got divorced and he was very sad & gloomy. His mother was also sad and depressed after divorce. Her husband was irresponsible and thus they decided to separate. This was the time as per patient that he started with respiratory problems. After all this, he stopped mingling much with others but was close to some of the friends only.
As days passed on, he stopped thinking about past events and was happy with his friends and family. Once his mother decided to marry again, she asked his permission and he said like it’s your life, you can get married. He felt that since so many years’ mother was suffering at least now let her have a better life and was happy for her. But the relationship with his stepfather was not good. Patient says as a person he is good, but he could not accept him as father and had superficial relationship. Later his mother delivered a baby boy. His relation with siblings is good and he loves his brother a lot. But he also has a feeling that the love shown by stepfather to his brother was never shown to him. He also feels that the relationship between his mother and stepfather is not good and same way fights have started as before. Thus he feels that what if they get divorced, he doesn’t want his brother to suffer same way as he suffered.
But patient says that he respects his mother a lot as she has gone through so much of pain and struggle in life but she never showed it to him. He feels sorry for his mother.
He mingles with friends. Even though they are having bad habits, he never crossed limits and did not learn any bad habit from them. If they fought he could not see it, somehow he used to resolve the fight and see to it that they don’t fight.
Patient as a person:
He has a feeling of loneliness and very sad about what has happened in his life. He feels why me? Why I have to suffer? Before he used to be alone during childhood, now mingles with people, seeks for company, cannot see anyone fighting, gets angry but keeps it for himself, doesn’t want to share his feelings and sadness to others.
During case taking: patient cried while narrating about his family issue.
Diagnosis
Extrinsic bronchial asthma
(also sometimes called as atopic or allergic asthma)
-early age of onset (since childhood)
-external allergens have a strong role
Positive personal history of allergic diseases like rhinitis
Breathlessness leading to cough
Wheezing
> dust, change of weather
Differential diagnosis:
Intrinsic bronchial asthma
R/o – external allergens has no role
– late age of onset
– negative allergic history
General management
- Symptoms can typically be improved
- A specific customized plan for pro-actively monitoring and managing symptoms should be created
- This plan includes reduction of exposure to allergens, asses the symptom severity
- Identify the triggers – pets, cigarette smoke, eliminating exposure to them
Overall exercise is better in patients with stable asthma, yoga
Education and orientation – educate the patient about the triggering factor so as to avoid dust exposure and use face mask while travelling
Counsel the patient so that he gets positive thoughts and thus comes out of negatives and difficulties and take life in a positive way
Specific management: Constitutional approach
Constitutional totality:
| Mental generals | Physical generals | Characteristic particulars |
| Self-pity Grief Brooding Likes consolation Cannot see anyone fighting, tries to solve the issue . |
Craving: spicy food Aversion: bitter food items Thermal : chilly patient |
Breathlessness leading to cough < night+++ |
Provisional remedy
Magnesium carbonicum (Mag.carb)
Grief (mainly family issue) a feeling of dejected child as if proper love is not given to him
Brooding
Self-pity
Breathlessness with profuse expectoration < night, change of weather, wheezing
Differential remedy:
Silicia
R/o – there is no obstinacy, marked brooding, as the patient is a kind of person who does not think before executing any work just do it and also unable to see any fight (peace maker), self-pity
Thus Silicia ruled out as these patients are mainly obstinate and perfectionist
Prescription:
Rx –13-6-14
Mag carb 200 (2p)
1 pack HS weekly once
Nat sulph 3x
2-2-2 x 2 weeks
Follow up:
| Date | Follow up | Prescription |
| 4-7-14 O/e rhonchi |
Complaints are much better 3 days back 1 attack of breathlessness (before used to get every 2 days’ attacks) All generals are better Pt wants more med as he is going to abroad for studies |
Rx
1-1-1 x 1month |
| 9-9-15 O/e Chest is clear 11-11-16 O/e wheezing, turbinate enlarged 12-3-17 O/e chest is clear |
Occasionally attacks of cough All general good Cough with runny nose, with scanty expectoration. Generals good Patient says he was fine all throughout the year and was much better with the treatment Occasionally cough with wheezing, whitish expectoration All generals good |
Rx
1-1-1 X 1month |
Conclusion:
Patient named Mr. B, aged 20 years old presented with the complaints of breathlessness and wheezing with cough and was diagnosed as bronchial asthma. The case was taken in detail and constitutional approach was followed, and the patient was treated with Mag. carb 200 and has improved with the treatment.
From this case, I want to convey to all the budding homoeopathic healers that, each patient teaches us homoeopathy, there is learning from every single patient. Homoeopathic system is like an ocean. There is lot of treasure hidden in it. Homoeopathy is not magic. Homoeopathy is not miracle but its mathematics. I can say that because the exact match and exact permutation and combination gives you the result i.e. Nothing but the cure. It’s all about hope for the hopeless.
Acknowledgement
Under the guidance of Dr Shivaprasad K., HOD Organon of Medicine, Principal Father Muller Homoeopathic Medical College, Mangaluru.
Edited by: Dr Abha
