A female aged 25 years presented with swelling in the neck region since 10 years.

She presented the following symptoms
· Loss of weight with dwindling of her breast

· Increased appetite and hungry after eating

· Palpitation < Exertion

· Breathlessness on movement

· Irregular periods with intermittent flow

Past History
H/o frequent tendency to catch cold and cough with fever

Had been vaccinated for all communicable disease.

Family History
Paternal Grand father - Diabetic

No history of Thyroid Disorders

Treatment History
Took allopathic treatment for the swelling in the neck

Physical Generals
Appetite - Increased
Thirst - Normal
Stool - Normal
Urine - Normal
Sweat - Profuse, more in palms
Sleep - Normal
Food Type - Vegetarian,
Desires - Spicy food

Has the habit of drinking tea

On examination
BP - 130/90 mm Hg
Pulse - 74 beats /min
Temp - Afebrile

Mental Generals
Mental and intellectual state of mind is very irritable
Anxious and depressed.
Provisional Diagnosis
Goitre with Hyperthyroidism

Before	After

First prescription 10-1-2004
Rx
· Iodum 1M one dose o.d on empty stomach
· Placebo for one month

Follow Up -1 10-2-2004
Anxiety and depression -Better
Swelling in the neck persists
· Iodum 1M one dose o.d on empty stomach
· Placebo for one month

Follow Up -2 14-3-2004
Swelling in the neck started reducing
· Iodum 1M one dose o.d on empty stomach
· Placebo for one month

Follow Up -3 20-4-2004
Palpitation reduced
Generally feels better
· Iodum 1M one dose o.d on empty stomach
· Placebo for one month

Follow Up -4 28-5-2004
Swelling reduced further, complaints better
· Iodum 1M one dose o.d on empty stomach
· Placebo for one month

Follow Up -5 01-7-2004
Swelling completely reduced
· Iodum 1M one dose o.d on empty stomach
· Placebo for one month

Refer the plate - Before and After

Discussion
This case simply responded to prescription based on the Totality of Symptoms. The Dynamic Medicinal force has evicted the Disease Force from her body by the suitable remedy. Here the signs and symptoms makes a clear provisional diagnosis of Hyperthyroidism with Goitre. Investigations and imaging studies had not been done since the patient is not affordable for the cost.