Authored by:
DR.AMBEY JHA
MD SCHOLAR PART I (2018- 19 BATCH)
DEPT. OF HOMOEOPATHIC PHARMACY
FATHER MULLER HOMOEOPATHIC
MEDICAL COLLEGE AND HOSPITAL, MANGALURU
Preliminary data:
NAME: Miss ABC
SEX: Female
AGE: 23yrs
RELIGION: Christianity
OCCUPATION: student
ADD: Father Muller ladies hostel Mangalore
DATE OF CASE TAKING: 8/9/2020
Chief complaint:
| LOCATION | SENSATION | MODALITY | CONCOMITATNT |
| Mouth Since 10 months | Ulcers in mouth Smarting type of pain +++ burning type of pain occasionally bleeding Pain of mouth leads to head pain( temple region) | <eating++, talking++, before menses, left side > after menses < while brushing teeth | |
| Anal region since 6 months | itching | < during menses |
Family history:
Mother: HTN since 4-5 years
Grandparent: HTN and DM II (both maternal and paternal side)
Father: HTN and DM II since 2-3 years
Personal history:
Diet: mixed
Appetite: reduced during menses otherwise good
Craving: sweets
Thirst: Thirstless but since 2 months thirst increased
Bowel: regular no c/o
Urine: 3-4 times no c/o
Thermal: chilly (she cannot tolerate cold)
Sleep: sound sleep, position – sleeps on knee chest position
Menstrual history: Menarche: 12 years.
LMP: 18/8/2020 menses regular 5/28 days cycle, flow normal, no clots
Pain in lower abdomen during menses with nausea and vomiting
Pain in back, loss of appetite during menses, ulcer in mouth before menses and Itching in anus during menses.
Examination:
Local examination: 6- 7 ulcers all over the oral mucosa more on left side , redness at the edge of ulcer with yellow slough in center of ulcer , tenderness +++
Vital examination:
BP– 120/80
Temperature- Afebrile
Pulse– 78/min
P–/I-/C-/O-/D-
Weight– 57kg
Systemic examination: GIT- NAD
R/S- NVBS
Life space: Patient hails from middle class family. She has 2 sibling one sister and one brother she is the middle one. There is no stress in family but one month back her younger sister turned into nun because of which her mother is in stress and thats why she is in tension. Now she is missing her younger sister a lot. She very sensitive person she feels bad when people talk rudely to her. She generally does not react immediately because she don’t want to spoil relationship but later she will ask that person why he behave like that and she will share her problem with her friends whom she is close to.
Working of the case: analysis of case according to Hahnemann
This case has characteristic and common symptoms.
| Characteristic symptoms | Common symptoms |
| Mouth ulcers come before every menses.Itching in anus during menses.Smarting type of pain+++ (because of intensity of pain)Patient has tendency toward left side.Craving for sweetThirst increasedSleep on knee chest position Sensitive personThermally chilly | Mouth ulcer painful< eating, <talkingBleeding from ulcer < brushing of teethBurning type of pain in mouth |
Totality of the case:
Totality is mainly consist of characteristic symptoms but in case where characteristic symptoms are not there we can make totality with common symptoms also, but in this there is ample of characteristic symptoms.
- Ulcers in mouth aggravation before menses.
- Itching in anal region aggravation before menses.
- smarting type of pain+++
- craving for sweet
- sleep on knee chest position
- Left sided affection.
- Thirst increase
- Mind sensitive
Thermal is used as eliminating symptoms so in totality it is not included.
Reportorial totality: synthesis repertory
- Mind sensitive
- Mouth – ulcers- bleeding- menses aggravation
- Mouth- ulcer- painful-sore, smarting
- Stomach thirst
- Rectum – itching- menses during
- Sleep- position- knees- chest position; knee
- Generals-side-left
- Generals-food and drinks-sweets
Remedies:
- Phos. 7/15
- Arg. Nit.5/14
- Lyc. 5/11
- Merc.5/11
- Nit. A. 5/11
- Ars.5/10
- Cina5/10
- Sil.5/10
- Sepia5/9
- Stram5/9
Prescription: 8/9/2020
Phosphorus 1M one powder dose
No. 2 pills half dram for one week
| Follow up: 9/9/2020 | Pain in mouth reduced | SAC LAC |
| Follow up: 10/9/2020 | Patient was much better Pain was not there but still ulcer was there | SAC LAC |
| Follow up: 12/9/2020 | Patient got her menses LMP-12/9/2020 No ulcer present | One dose of phosphorus 1m powder given after her menses got over |
| Follow up: 10/10/2020 | No ulcer this time before menses | SAC LAC |
| Follow up: 14/10/2020 | Got menses LMP-14/10/2020 No ulcer this time before menses No pain during ovulatory period Pain in abdomen during menses reduced Apetite good | SAC LAC |
| Follow up: 18/10/2020 | Patient got 2-3 ulcers in mouth but this time intensity of pain was less and bleeding was there. Slight pain while eating and talking | Arsenic album 200 one powder dose given as complementary remedy to phosphorus. |
| Follow up: 20/10/2020 | Ulcers reduced no pain , no bleeding | SAC LAC |
| Follow up: 21/10/2020 | Patient is completely better | SAC LAC |
Conclusion: Because of our prejudiced mind we ignore characteristic symptoms of the case. In this case also she was given many times Borax and Merc. Sol. as a specific remedy for mouth ulcer but these specific remedies didn’t help her. If there is characteristic symptom we should always consider those symptoms in the totality.
