Preliminary Data:
Mrs. P 40 years old female presented with the complaints of numbness and pain in bilateral forearms and hands in the past 2 years.
| LOCATION | SENSATION | MODALITIES | ACCOMPANIMENT |
| Locomotor system B/L Forearms and Hands Since 2 years Gradual onset & Gradual progression Rx Ayurveda | Numbness2+ Pulling pain 2+ Swelling sensation 2+ | <Grasping3+ <Exertion3+ <Morning2+ >Pressure2+ >Movement+ |
HISTORY OF CHIEF COMPLAINT:
Patient presented with complaints of numbness and pain in bilateral forearms and hands since 2 years. Gradually patient presented with symptoms of swelling sensation followed by pain which is of pulling type and also presented with numbness only on holding the objects for a long time (cutting vegetables, holding handles in the bus, grasping). The complaint is worse during exertion, in the morning, and better by applying pressure and movement.
She had taken Ayurvedic treatment for the same complaints but had no relief.
No History of Fever, weakness of bilateral forearms & hands, claudication of pain, radiation of pain and muscle wasting.
PAST HISTORY:
Past medical history – chickenpox in childhood
Past treatment history – Ayurvedic medication for the above complaints.
Family history- Father death due to myocardial infarction, Elder brother has Hypertension.
Mother – Paralysed due to Cerebro vascular accident.
Allergic history – not allergic to environmental factors.
Personal History:
Diet – Mixed
Appetite – Good, 3times/day
Thirst – Normal 1L/day
Craving – Fish2+, tea 2+
Aversion – Bittergaurd 2+
Bladder habits – 3-4times/day
Bowel habits – 1time/day, satisfactory
Perspiration – Increased, generalised, staining absent, odour – absent.
Sleep – Good, 10pm to 6am, refreshing
Dreams – Unremembered
Thermals – Prefers winter season, likes open air, fan – wants fan, covering – wants to cover, wears tight cloths, bath in tepid water – habit.
Menstrual History:
FMP – 14 years
LMP – 28/8/2022
Cycle – regular
Duration – 3 days
No clots present
PAST OBSTETRICAL HISTORY: 1 son, birth weight 1.1kg
C section, Hypertension during pregnancy.
LIFE SPACE INVESTIGATION:
Patient hails from a middle socio-economic family. Father was a coolie worker and mother was working as a beedi roller. She has 3 elder brothers,2 elder sisters and 1 younger sister. She has good relation with all the family members.
Childhood: She was very selective in making friends and used to speak very less. She had very few friends and was not mingling with all. She studied upto 2nd puc, later she discontinued her studies as her parents did not let her to study further due to which she feels guilty but do not regret for the same.
Adulthood: She married at the age of 21 years. She has 1 son and is more attached to him. She used to have fights with her husband, if he denies giving money for her requirements. She will not share any feelings with him. Before 1 year her husband was working in foreign country, at present he settled in mangalore and working as a tailor. Before 1 year they used to live in joint family at present they are staying separately as nuclear family. Father expired due to Heart attack and she griefs over it. 3 years back her mother had an attack of paralysis and she used to take care of her. She is more attached towards her mother. When she was narrating about her mother’s health she had tears in her eyes and was emotional. Constantly thinks about the life problems
As a person – she speaks less, reserved, selective in making friends, suppressed emotions, weepy while narrating about her mother’s health, wants to be loved and wants affection from her husband, prefers to be alone, whenever she gets angry she will not speak and shout back.
GENERAL PHYSICAL EXAMINATION:
Moderately built and Well nourished
Well oriented with time, place and person.
Pallor is present
No signs of cyanosis, clubbing, icterus, odema and lymphadenopathy.
Weight – 71Kg
Vitals:
Temperature – Afebrile
Pulse- 66 bpm, rhythm regular, moderate volume and condition of vessel wall-not palpable.
B.P- 140/90 mm Hg in Rt arm supine position.
Local examination:
Tone of the muscle-Normal
Power of muscle: 5/5- Normal in bilateral upper limbs.
Radial and brachial pulse – Normal
No restricted movements.
No Wasting of muscle.
Systemic Examination:
Respiratory system – NVBS heard, no added sounds.
CVS- S1 S2 HEARD, no murmurs.
As the case was having predominant mind symptoms thus Kentian approach was selected
Kentian totality was erected.
KENT’S EVALUATION & ANALYSIS
| MENTAL GENERALS | PHYSICAL GENERALS | CHARACTERISTIC PARTICULARS |
| Desire to be left aloneRestlessness with emotional excitementHas a feeling why should I go through all this troubles why me?Not happy with the lifeConstantly thinks about the life problems. | Hot patientCraving – Fish2+, tea 2+Aversion – Bittergaurd 2+Perspiration – Increased, generalized. | Bilateral forearm Numbness2+ Pulling pain 2+ Swelling sensation 2+ <Grasping3+ <Exertion3+ <Morning2+ >Pressure2+ |
Based on the above totality Gelsemium Sempervirens was selected as a constitutional remedy.
The key symptom of this remedy is Aggravated by all emotions, they always feel like why they have to go through these life situations and thus will be depressed and gloomy seeking solitude.
Terrified of everything unexpected, fear of losing her self-control and her calmness.
Constantly aggravated by thinking of her troubles & life problems are the core of this remedy.
Prescription: 8-09-2022
Gelsemium 10 M (1P)
- No II Pills
For 1 Month it was prescribed
1st Follow up 22-09-2022
All the complaints are better
Generally, she feels much better
80 % better
Burning in soles present
Rx: Gelsemium 1M (1P), Causticum 30 (3-3-3) Only if required
2nd Follow up 27 -10-2022
Complaints are better
Burning sensation on the finger tips on & off occasionally present.
Rx: Gelsemium 0 (2P), Formica Rufa 30 (3-3-3) Only if required
Conclusion:
Homoeopathy has a great scope in the treatment of chronic diseases, sometimes even after clinical diagnosis it becomes difficult to treat the case but if the symptoms are well defined and if we are able to construct a logical corelation with the case and the Materia medica then definitely the patient will be going towards the road to recovery and permanent cure will be possible with Homoeopathicity.
About Authors:
Dr Skandhan. S. Kumar, BHMS MD Organon of Medicine (Gold Medalist), Assistant professor department of organon of medicine and philosophy, Father Muller Homoeopathic Medical College. Consultant Homoeopathic Physician at Dr Padiyar’s Homoeopathic Clinic Mangalore.
Dr Deeksha Ballal, BHMS (Intern) Father Muller Homoeopathic Medical College.
