To Re-evaluate the prescriptions practically in every aliment as mentioned in THE PRESCRIBER. By Dr. J. H. Clarke.
Dr. Tansu Mujawar.
Intern BHMS
Bharati Vidyapeeth Homoeopathic Medical College, Pune, Maharashtra.
Abstract –
There are many books which tell us about disease, their history, etiology, course, progress, pathology histopathology and all the rest. They also give us information about treatment at some point. But, ‘THE PRESCRIBER’ only deals with prescriptions. It gives all the ready made prescription for the particular condition or the disease. Prescription means not only selection of drugs but also the attenuation, dose, frequency of the repetition. The purpose of selecting this topic is to determine the significance worth of the remedies given in this book for the particular disease i.e. To Re-evaluate the prescriptions practically in every aliment as mentioned in THE PRESCRIBER. By Dr. J. H. Clarke.
Introduction-
For a case study, I took a case of renal calculi.
A kidney stone also known as a renal calculus is a solid concretion or crystal aggregation formed in kidneys or anywhere in the urinary tract from dietary minerals in urine.
Risk factors-
Kidney stones are formed when there is a decreased in volume and/or an excess of stone forming substances in the urine.
Dehydration, low fluid intake, high dietary intake of animal protein, sodium, refined sugars, fructose, high fructose corn syrup oxalate.
About 80% of those with kidney stones are men.
Urinary stones are typically classified by their location in the kidney (nephrolithiasis),ureter (ureterolithiasis), or bladder(cystolithiasis), or by their chemical composition (calcium-containing, struvite, uric acid, or other components).
Types of kidney stones-
The kidney stones are made up of different crystals.
1.Calcium-
Most common, made of calcium oxalate, phosphate or maleate.Eating fewer oxalate rich foods can reduce your risk of developing this type of stone. High oxalate food includes potato chips, peanuts, chocolate, beet and spinach.
2.Uric acid-
More common in men than women, they can occur in the people with gout or those going through chemotherapy. This type of stone develops when urine is too acidic. A diet rich in purines can increase urine acidic level. Purines is colorless substance animal proteins, such as fish, shellfish and meat.
3.Struvite-
This type of stone is found mostly in women with UTI. Stones are large and cause urinary obstruction. This stone is caused by kidney infection, prevention of the infections can prevent the development of struvite stones.
Symptoms-
Symptoms of kidney stones may not occur until the stone begin to move down the ureters.
Excruciating, intermittent pain that radiates from flank to groin or to inner thigh (renal colic)
Urinary urgency, restlessness, hematuria, sweating, nausea, and vomiting.
Diagnosis –
Information obtained from history, physical examination, urinalysis and radiographic study.
Clinical diagnosis is usually made on the basis of the location and severity of the pain, which is typically colicky in nature. Pain in back occurs when calculi produce an obstruction in kidney. Physical examination reveals fever and tenderness at costovertebral angle on the affected side.
Prevention –
Increase total fluid intake.
Increase intake of citrate rich drinks such as lemonade and orange juice.
Limiting sodium intake to less than the normal intake per day.
Maintain normal calcium intake per day.
Decrease vitamin D intake to less than the normal intake per day.
Limiting animal protein intake.
Limiting consumption of soft drinks which contain phosphoric acid.
Case study-
Presenting complaints
Male patient 22 yrs. age, presents with the complaint of continuous severe piercing pain in back and loin more on left side which is < by jar, soft drinks, 7-8 pm, with burning micturition; sharp burning pain in the urethra after micturition, there is also cutting pain in urethra before, during and after micturition.
History of chief complaints-
Patient is suffering from renal calculi since 2013 (6yrs.). pain in left lower back is present on and off. Episode of pain comes mostly once a month or 2 months. Patient was apparently well one week back and suddenly he develops episode of pain in left lower back. During the pain patient become restless and irritable. Pain was so severe and unbearable that he has to take painkillers. He has also taken homoeopathic medicine for the same but no relief.
Family history-
Patient has strong family history of renal calculi. Father, brother and sister are also k/c/o renal calculi.
Personal history-
Thirst- thirsty for cold water
Craving- cold drinks, chicken, salt.
Urine – 4-5/ 0-1 D/N, dark yellow, odorless. Burning and cutting pain in urethra before, during and after micturition.
Thermal – towards hot.
O/E- per abdomen palpation- tenderness present at the left lumbar and iliac region.
Investigation –
USG abdomen and pelvis- impression- the right kidney measures 9.9 by 4.0 cms. The left kidney measures 10.0 by 4.0 cms and shows 6-7 mm calculus in lower pole. Mild hydronephrosis is seen in left kidney.
Diagnosis– Renal calculi.
Specific totality-
Bladder- 4-5/0-1 D/N, dark yellow,burning micturition; sharp burning pain in the urethra after micturition, there is also cutting pain in urethra before, during and after micturition
Continuous severe piercing pain in back and loin more on left side which is < by jar, soft drinks, 7-8 pm.
Prescription –
Rx
Berberis vulgaris mother tincture, 6 hourly.
(10 drops of mother tincture in half glass of water 4 times a day)
(THE PRESCRIBER page no. 115, calculus – renal passage of. – Page no. 116 Prevention- gravelly urine, pain in back and loins, Berb. Mother tincture, 6 hourly.)
Follow up 1. (11/3/2020)
No episode of pain
No burning and cutting pain before urination
Urine- dark yellow, painless 4-5/0-4 D/N
Has to rush for urine
Perspiration increased
Thirst less, wants cold water
Rx
Berberis vulgaris mother tincture, 6 hourly.
Follow up 2. (13/05/2020)
He passed 2 stones in urine, on 09/05/2020 as shown in the above picture.
History of burning micturition one day before passing stones.
Presently no pain
Stones- approx. 3-4 mm in size each
Urine pale, painless
Thirst decreased
Has to rush for urine
Rx
Berberis vulgaris mother tincture, 6 hourly.
Follow up 3. (03/07/2020)
No episode of the pain
No new complaints
Urine is pale, profuse, painless, no burning present
Urine 4-5/0-1 D/N
Thirst improved
Sleep – sound and refreshing.
Rx
Berberis vulgaris mother tincture, 6 hourly.
Follow up 4. (14/07/2020)
No episode of the pain
Urine is pale painless, no burning present
Urine 4-5/0-1 D/N
Thirst improved.
Rx
Sac lac 30, 3 pills tds.
Conclusion-
On complete case taking based on THE PRESCRIBER, I was able to prescribe the remedy for the particular symptom presented in the chief complaints.The utility and efficacy of the prescriptions mentioned in THE PRESCRIBER is seen in this case (renal calculi).
Reference–
THE PRESCRIBER by J.H. Clarke
Organon of medicine 6th edition (aphorism 83- 104)
