December 2009 | Vol 6 | Issue 12

December 2009 | Volume 6 | Issue 12

 

case
 
A Repertorial case study on haemorrhoids
 


 


Dr. Krishnendu Maity, MD (Hom.)
D. K. Homoeopathic Stores
B-5, D.K. Tower, J.K. Road, Indrapuri
Bhopal – 462023.
Phone: +91-755-2688741.
Mobile: +91-9926822960;
E-mail:dr_krishnendu@yahoo.com

    Introduction:

       Dr. Krishnendu Maity is an associate professor and Head of the Department of Practice of Medicine, Lal Bahadur Shastri Homoeopathic Medical College, Bhopal. He is a leading academician and clinician. He is interested in scientific studies and dedicated for research in Haemorrhoids with his more clinical out comes.

       A 63 years old male presented the following complaints
    1. Bleeding from anus with protrusion of soft mass during stool and recedes after evacuation – for about 6 months < walking
    2. Insufficient stool – for about 8 months
    3. Dimness of vision, different colours around the light, with a sense of burning in both the eyes and watering – for about 7 days

    Past History
    Small pox at the age of 7 or 8 years – treated allopathically
    Hepatitis A – 3 years back – treated homoeopathically
    Immunization scheduled – completed
    Sensitivity (Drug & Allergen) – Brinjal [causes Prickly-heat like eruptions over face, with itching].
    Mile-stone – Not delayed.
    Family History
    Father – Died of Carcinoma Prostate

    Mother – Rheumatism

    Brother – Sensitive to cold (? cold allergy)

    Sister – Bronchial asthma

    Paternal Grand father – Died; was alcoholic

    Maternal Grand mother – Died (?) CVA

    Maternal Grand father – Rheumatism

    Maternal Uncle – Once attempted suicide by consuming poison

    Personal History
    Built – Thin and tall

    Complexion – Fair

    Habits:
    Addiction – Tobacco smoking

    Physical General
    Appetite – Increased

    Thirst – Diminished

    Sleep – Sound

    Bowels – Irregular has to go twice in a day, ‘not finish’ sensation

    Character of stool – hard, knotty, difficulty while passing, rectum protrudes during and recedes after stool. Burning pain and bleeding after stool

    Urine – Nothing significant

    Sweat – Less

    Thermal reaction – Hot3; a sense of flushes in the face and ears

    Desire – Sweet3, salty things3 (no extra salt)

    Intolerance – Hunger, especially at the forenoon after bathing

    Tongue – Clean, slightly moist, red

    General Aggravation – Light

    General Amelioration – Lying down

    Mind General
    Anxious3, restless3, forgetful3, wants to be alert, sensitive; easily becomes frightened, wants to be alone.

    Physical Examination
    Temperature – 100oF

    Pulse – 90 / min

    BP – 136 / 88 mm of Hg

    Pallor – Moderately present

    Systemic Examination
    CVS – No abnormality

    Respiratory system – No abnormality

    Nervous system – No abnormality

    Eye – Normal light and accommodation reflexes

    Erecting totality
    1. Anxious and restless

    2. Wants to be alone

    3. Easily becomes frightened

    4. Forgetful

    5. Hungry after bathing, especially forenoon

    6. Desires sweet

    7. Desires salty things

    8. Hot patient; sense of flushes of heat in face and ears

    9. Constipation

    10. Burning of anus after stool

    11. Bleeding from anus after stool

    12. Dimness of vision

    13. Watering from eyes, with burning

    14. A sense of different colours around light

    15. Haemorrhoid protrudes during stool

    16. Haemorrhoid < walking

    17. < Light.

    18. > Lying down



    Repertorial Result
    1. SULPHUR – 47/20 [Sulph. doesnot cover the symptom ‘Hæmorrhoid protrudes during stool’]
    2. PHOSPHORUS – 35/17
    3. PHOSPHORIC ACID – 19/11

    Analysis of reportorial result
    From the study of the whole case and reference to the Materia Medica – SULPHUR covers the most of the features. According to the Potential Differentiating Field (PDF), SULPHUR ranks highest.

    Cross-repertorization from roberts’ ‘sensations as if’ :
    1. The rubric ‘Halo about light’ in Roberts’ Sensations as if ——’ is covered by SULPHUR [chapter Eyes & Vision]
    2. The rubric ‘Sensation as if – Burning’ in Roberts’ ‘Sensations as if ——’ is advised to see the GENERAL

    REPERTORIES [chapter Generals].
    3. The rubric ‘Heat were streaming out of ears’ in Roberts’ ‘Sensations as if ——’ is covered by SULPHUR [chapter Ears & Hearing].

    First prescription                     05.02.2009
    R/x
    Sulphur 200 / 1 dose in Sac lac in the early morning in empty stomach
    Followed by Placebo for 15 days
    Advised Ophthalmoscopic examination for refractory errors

    Follow Up -1                              22.02.2009
    · Stool softer, but irregular ’ 25% improvement
    · Lachrymation > ’ 50% improvement
    · Burning of eyes > ’ 50% improvement
    · Burning of anus & bleeding slightly > ’ 25% improvement
    · Refractory error (Report): Rt. eye + 2.5D and Lt. eye + 2.75D
    R/x
    Placebo for 30 days

    Follow Up -2                              27.03.2009
    Overall 60% improvement
    R/x
    Placebo for 30 days

    Follow Up -3                             12.04.2009
    Bleeding P/R started after stool for last 2 days slight burning
    R/x
    Sulphur 200 / 1 dose repeated
    Followed by Placebo for 7 days.

    Follow Up -4                              20.04.2009
    Bleeding and burning
    R/x
    Placebo for 15 days.

    Follow Up -5                              7.05.2009
    No such complaints. Placebo for 15 days.

    Conclusion
    After taking the case, as there were prominent mental, physical and particular symptoms, I had chosen the Kent’s Repertory for the repertorization. In the case there were some ‘sensations’ and I had decided to cross-repertorize the rubrics of sensations by Dr. Herbert Alfred Roberts’ ‘Sensations as if ——’.
    The result from Kent’s Repertory was SULPHUR and the result of cross-repertorization did not differ. This also signifies that the regional / clinical repertories are as useful as the general repertories.