Competition Entries. Competition closes September 25th 2010

Comment by Dr. Gary Weaver on August 16, 2010 at 11:26pm

Example of presenting a case for evaluation.

1/. Notes of the patients Presenting symptoms, possibly in the patients own words.

2/. Evaluation of Patients symptoms with possible diagnosis and prognosis if applicable.

3/. Choice of Symptoms for repertorizing and why.

4/. rubrics chosen

5/. Prescription made, reasons for the choice.

6/ Mode of application and frequency of the medicine.

7/ Progress of Patient, changes in prescriptions if any.. stating reasons.

8/. Follow up

9/ Result

10 Evaluation of how the patient did from commencement till finish of treatment and expectations for the future.

Comment by Dr. Navneet Bidani on August 18, 2010 at 7:44am

Here's my case:

‘Ananya’, a girl of 5 years was first brought to me by her mother on 10/01/2007 for treatment of her epileptic attacks. She is of average height, medium built, fair complexion and thick curly hair. It was a very cold day and she arrived with a thin jacket, wearing a skirt and no tights or socks on her legs.

The mother begins: 'About two year’s age, Ananya started to close her eyes. At first, it seemed that she did so only for fun, but later we noticed that she started to develop many tics.

I asked for further clarification of the convulsions: “Ananya has never slept peacefully; we therefore were not sure whether she had had other such periods. One night, I found out by accident that she was ill, because I heard a thud. It was Ananya who had fallen out of bed. I saw how she was all rigid and the white of her eyes was visible. Later she did the same when she had a high fever.”

“She often falls out of bed and gets back into it by herself. Things happen with her teeth too, she often bangs them into something or grinds them, or bites her lips or tongue... a while ago I became worried when I saw a blood stain on her pillow.”

I asked for more information about her sleeping patterns: “We have never been able to make her sleep with covers on, right from the time she was born.”

Observations:
When the child was first brought into the clinic she was quite restless - sat on every chair in the room. I asked the mother to leave her on her own and allow her to do what she wanted. She set off to play with the books, furniture etc. in the clinic. The mother started relating her history as she showed me the child's thick file. I found that the child hardly allowed her mother to speak to me. She kept interrupting our conversation and the mother was getting very annoyed. This went on for sometime. I was trying to understand what was happening. I gradually realised that the child would stop playing and ask the mother something. As the mother was involved in talking to me, her reply to the child would be either curt or without really bothering as to what the child was actually asking. This would further make the child angry. She would tug at her mother and shout in anger. The state of the child now at the clinic and during her attacks was that the child would get angry if her request was not understood.

The mother further added that the child is very intelligent and inquisitive. I confirmed both these things and found that the child was very curious. She had to be explained how each and everything worked. Her mother further told me that she is afraid of nothing and does things for the experience, great curiosity - life is full of interest to her, needs knowledge and questions everything. This was what I was observing, within last 10 minutes she asked me around dozen of questions. “What is this Doctor (pointing to an electronic table calendar)?” “Do you change the dates everyday or is it automatic?” “From where had you purchased it, mummy we’ll buy this for my table as well.” “Doctor how much it costs you?” etc etc.

Her school teacher says that her IQ is much above average, but she will only do things if she feels like doing it. She knows all her studies, but when asked, she will not reply. For e.g. she knows all the days of the week, but if you ask her what comes after Sunday, she will not answer.

On further questioning her mother told me that she loved ghost stories, The only kind of book she like to read is a book about horror. She likes horror films. Suddenly out of nowhere she planted a question again, “Doctor had you seen a movie ‘Raaj’ in which ‘Bipasha Basu’ acted very well, but the movie was not that much horror, I had not felt any sort of fear while seeing that movie, infact ‘The Ring’ is much better than that”. I was wondering that even while going through different books laying in book shelf her concentration was quite sharp, she was paying full attention as to what her mother was saying to me.

She would love to travel, loves the sea, and prefers cold drinks, bread & butter but avoids eggs, very talkative, friendly and jolly; she made me laugh many times during consultation but whenever I asked some question as who is your best friend etc., she never gave me the reply, instead she herself put a question thereby shutting my mouth, but all her questions were quite good as if she was desperate to know each & everything.

On reviewing the case I now saw that the most peculiar thing about this patient was her inquisitiveness or curious nature

Treatment:
I decided to prescribe Agaricus Muscarius 200-1ds, based on the reported symptoms & repertorising considering following rubrics:

Mind- Inquisitive
Mind- Anger when not understood
Mind- Answering - aversion to answer - sings, talks, but will not answer questions
Mind- Loquacity - answers no questions, but
Mind- Fearless
Mind- Mischievous
Mind - Unconsciousness - twitching of limbs, with
Face - Distortion – Mouth
Generals - Convulsions - children, in
Generals - Convulsions - epileptic
Generals - Food and drinks - bread - desire - butter, and
Generals – Food and drinks - eggs - aversion


Follow Up:
The mother phoned me a few days after the first drops had been taken, to tell me that her child had tonsillitis with a fever of about 101 °F, but that despite her temperature, she was very lively and refused to drink anything. I advised continuing the treatment, prescribed a placebo, and asked her to keep me informed. After a day, the fever episode resolved and the girl started to drink.

I saw Ananya again a month later. Her mother told me: “I am enthusiastic. I don't know what you gave her, but two weeks ago she stopped making all those contorted faces.” In addition, her appetite has improved, and she sleeps peacefully.

I prescribed a placebo, and advised the mother to call me again should something occur. The mother telephoned almost two months later, and told me that Ananya had again started to become restless in her sleep, and that she was developing her winking tics again. I gave her another dose of Agaricus 200 & advised her to continue giving her the same medicine (placebo). This time, however, the remedy did not work, and I therefore raised the potency to 1M. After some days, Ananya again began to sleep peacefully and no longer winked.

After three more months I inquired about Ananya & the mother told me spontaneously: “Ananya is doing excellent, there are no more attacks since then.” The mother added that the child sleeps very well & eats much more of her own accord, and that she has gained weight.

The patient was followed for many months afterwards. She was well without any further attack of epilepsy.


Discussion:

Here in this case, the thing which leads me to think of Agaricus was the curious nature of Ananya. Curiosity which is a desire to know or learn is an important trait of a genius. I don’t think you can find an intellectual giant who is not a curious person. Samuel Hahnemann, Constantine Hering, Thomas Edison, Leonardo da Vinci, Albert Einstein, Columbus, they were all curious characters.

What is that? Why is it made that way? When was it made? Who invented it? Where does it come from? How does it work? What, why, when, who, where, and how are the best friends of curious people.

While curiosity is a state commonly experienced by all people, and there are some events which arouse curiosity in almost everyone, it is also a trait which is much more typical of some people than others. The trait which varies between people is seen in the way that some events will be seen by some people as strange or peculiar while others will pass them by with little interest.

That is why in our Repertory there are only few medicines which are placed under curious or inquisitive rubric & they are:

Agaricus
Aurum
Carcinosin
Chocolate
Hyoscyamus
Lachesis
Laurocerasus
Lycopodium
Phosphorus
Pulsatilla
Sepia
Sulphur &
Veratrum Album

But the curiosity of each medicine is different from each other. Let’s try to learn how much eager these remedies are & the curiosity is limited to which special field.

Agaricus curiosity is much towards super-natural things like Ghosts, dead people, things associated with dead people like coffins, UFO’s, planets etc etc. Child may be very curious, asking questions often about religious or metaphysical things in order to relieve these fears about life and death.

Carcinosin’s curiosity is not however by any means chaotic as of Sulphur, but carefully careful. One gets the impression, as if they would have to make themselves individually familiar with each article, in order to lose the shyness and be able to move more freely by themselves. They must hold everything in the hand, feel it, turn it and then reset it in order to its respective place (unlike Sulphur). They are more interested in subject of Geography. He would love to know more about different places & nature. They like to see channel ‘Animal Planet’ & keeps on asking about different animals, their habitat & the way they live, survive etc. They also have an obsession with time and watches; they open up watches in order to learn how they are ticking.

Lachesis curiosity is limited to materialistic things like jewelry, clothes & ornaments. Her clothes are upscale, fancy and colourful, and very stylish.
And just because of her curious nature she’s very bright, very smart & knows a lot. Lachesis is often attracted to philosophical ideas & mystical traditions.

In Phosphorus children, curiosity is another expression of combined natural excitability & extroversion. In the office they play all over the floor with their siblings or friends, touching everything & exploring one toy or game after another. This is done in a far neater fashion than Sulphur children exhibit. It also lacks the destructiveness found in Tuberculinum, although they may tear apart toys & machines to find out how they work with a straight-forward curiosity. If they wish to know something, they will ask the doctor point blank, as shyness will not prevent inquisitiveness from manifesting for very long. The questioning will seem appropriate and not irritating as might be found in Medorrhinum.

Lycopodium’s curiosity is a superficial curiosity; it is just to impress the other person. His main aim in life is to appear interesting enough to attract friends, a girl-friend, & a modicum of respect from other people, & it is to these ends that he collects facts & tries to interest people in them.

Sepia gets attracted towards different types of music & dance, steps of dances & other physical activities which involve the experience of physical harmony. She is always curious to know & learn visual arts & physical healing arts like yoga, massage & Shiatsu. A Sepia child keeps on looking a television show which is showing how to make best out of waste, crafts like weaving and basket-making etc.

Sulphur youngsters may commonly be found playing with two toys at the same time, or holding onto one while playing with another. Upon entering the reception area, the doctor may find the child speaking to the secretary, asking about the telephone or the computer, wanting to know how it works & what all the wires are for. The child touches everything, as it is her way of experiencing the environment. It is this sensual inquisitiveness that is partially to blame for the “messiness” of child, who quickly figures out the workings & function of a toy, object, or game & then goes to the next one, perhaps never finishing any activity or puzzle completely. She simply drops what she was working on & goes to the next fascination. Without any restraint, in ten minutes the office floor would be filled with most of the doctor’s possessions, tossed about in no particular order; the room would look like a disaster area.

Tuberculinum children are curious about artistic & musical endeavours, whereas Pulsatilla child loves visual beauty & is eager to learn about flowers, animals & nature & also the taste of her favourite food.


Curiosity & questioning go hand-in-hand in the development of higher-level thinking skills & teaching for understanding. Curiosity fuels imagination & leads to wonderment, so curiosity is a critical factor in the learning process, both as a motivator & a facilitator.

But why is curiosity so important? Here are four reasons:

1) It makes your mind active instead of passive
Curious people always ask questions and search for answers in their minds. Their minds are always active. Since the mind is like a muscle which becomes stronger through continual exercise, the mental exercise caused by curiosity makes your mind stronger and stronger.

2) It makes your mind observant of new ideas
When you are curious about something, your mind expects and anticipates new ideas related to it. When the ideas come they will soon be recognized. Without curiosity, the ideas may pass right in front of you and yet you miss them because your mind is not prepared to recognize them. Just think, how many great ideas may have lost due to lack of curiosity?

3) It opens up new worlds and possibilities
By being curious you will be able to see new worlds and possibilities which are normally not visible. They are hidden behind the surface of normal life, and it takes a curious mind to look beneath the surface and discover these new worlds and possibilities.

4) It brings excitement into your life
The life of curious people is far from boring. It’s neither dull nor routine. There are always new things that attract their attention; there are always new ‘toys’ to play with. Instead of being bored, curious people have an adventurous life.

So, don’t spend too much time on just one world; take a look at another world. It will introduce you to the possibilities and excitement of the other worlds which may spark your interest to explore them further. Be curious….. :)

Comment by Debby Bruck on August 24, 2010 at 11:32pm

Awesome Navneet. Someone will have to work hard to beat this entry! Very educational.

Comment by sajjadakram on September 3, 2010 at 3:34am

This is the case of my wife. From time to time, while washing she was complaining of roughness and itching of her hands. I ignored. One day she developed a small ulcer which began to suppurate. Within days it started spreading and soon both hands swelled and covered with thick layer of pus coming out like a hydrant. No other problem anywhere in the body.
I was forced to consult a skin specialist who advised the external application of dilute silver nitrate solution and internally steroids and antibiotics which I refused for the danger of bad consequences of suppression. I took the case and repertorized as;
Extremities, eruptions, eczema, hands.
Extremities, eruptions, hands.
Skin, eruptions, itching.
Skin, eruptions, itching, warmth agg.
Skin, eruptions, suppurating.
Skin, eruptions, swelling, with.

Mercurius came up as a leading remedy. Since suppuration was the most troublesome and important symptom I prescribed Mercurius 6c, mixed in water, shaken well before every use. It was repeated every two hours due to acuteness, with the result that after three days the condition began to improve and Suppuration stopped. The repetition was reduced and restricted to once daily. After a few days further progress stopped. The case was retaken and reperorized with the following symptoms;
Extremities, eruptions, hands.
Generalities, bathing, washing, agg.
Skin, dryness.
Skin, dryness, rough.
Skin, inflammation.
Skin, itching.
Skin, itching, scratching, amel.

Since emergency was over Natrum carb, 30c was given in infrequent doses with steady improvement and in about 5 months the skin was clear and the hands were free from any eruption, clean and smooth as nothing happened.
You can see throughout the treatment I used only, objective signs and symptoms because they can be accurately assessed by the prescriber.
Once George Dimitriadis said “I always teach my students, is never trust your patient; do not necessarily believe what they tell you; you must verify by your powers of observation, and if your observation do not agree with the statement of the patient then you must trust in your observation.”That is what I do.
sajjad.

Comment by Dr. Wequar Ali Khan on September 3, 2010 at 9:02pm

Frankly speaking this case has no rightful place here;It does not live up to the standard of what one would like to see in a case in this competition.

My intention to present it was based on two points first one was the first hand experience of seeing the development of the symptom of progressive swelling and climbing of the vein and secondly the modality of amelioration when there was activity such as walking or even playing tennis.Rest was not an option because the pain would increase unbearably.

Since location,sensation,and modality were all there i used the OPENREP software.and the results were astonishing.



This is a case of what i call "SNAKING VEINS",It happened to my wife;
Avid tennis player and yoga instructor.Very active lifestyle.Strong
likes and dislikes.Problem with sleep.

Last July she suddenly complained of cutting and twisting pain in her
right leg.Pain would start with a vein swelling up and climbing up.
This climbing phenomena was clearly visible,as if a worm was moving
under the skin She would be in deep pain, and found it to improve if
she should be on the move, say playing tennis or walking.

The pain would come back if she lay down for rest. Many medication were
tried,also saw an orthopedic surgeon for opinion but nothing came out
of it.

Those days i was trying to under stand the intricate use of TPB which
i had down loaded from Hpathy.Also same time some serious discussion
was going on,on HWC about Boeninghausen,ad his repertory.

In desperation i used the following rubric and found PULS on top. Gave
a dose in water of 30 C potency.She was in Pain but reluctantly took
it at bed time.
It was a shot in the dark.The night passed away,and she got up with only
little soreness .She was surprised that PULS could have done it.A
couple of doses more and that pain had gone.

That was the moment i got seriously interested in the method by which
one can find an answer with Boenninhhausen's repertory and the
software based on it.
PULS LYC APIS R TOX
Agg after lying down 4 4 4 4
Agg rest 4 4 4 4
Bones painful in general 4 3 2 3
Circulation blood vessel varicose veins 4 3 3 -
Lower extremities leg below knee 4 4 2 3
Sensation swelling in general 4 3 4 4

Comment by Dr. Gary Weaver on September 3, 2010 at 10:40pm

Comment by Dr. Wequar Ali Khan on September 5, 2010 at 2:39pm

Thank you Gary.That's being a gentleman and a dedicated professional.You made my day;

Comment by Dr. MAS on September 16, 2010 at 12:18am

If you add
Extremities, eruptions, eczema, hands.
then is it necessary to add
Extremities, eruptions, hands.

Comment by Dr. Gary Weaver on September 16, 2010 at 12:19am

why?

Comment by Dr. MAS on September 22, 2010 at 2:20am

Let's take an example to understand it.

An Infant is suffering from constipation just becuase he is in denitation stage. For that purpose, Do we need to add three extra symptom with the actual problem?

Constipation
Constipation in Children
Constipation in Children infant
Constipation in Children infant during denitation

Those who practice such techniques are adding access of symptoms which may sometime lead to wrong remedy. As general symptoms contain polychrest remedies. That is a wrong habit. You just need to check and add

Constipation in Children infant during denitation

The above two symptoms would only be added when you don't have the reason of the problem then you may add two symptoms

Constipation
Constipation in Children

and can add more other type of symptoms to find the exact similimum.

Same is the case with eruption, when you know the eruption type and location then adding all eruption symptoms are not logical. For example

Mouth : Eruption lips
Mouth : Eruption corners
Mouth : Eruption corner right
Mouth : Eruption corner below
Mouth : Eruption corners around

Athough all these symptoms are different but If you have added all these symptoms in one case then it is wrong.

When you add
Mouth : Eruption corners around

Then it is confirmed that the patient does not have the symptom

Mouth : Eruption corner right

or

Mouth : Eruption corner below

But if the patient does has one symptom "right or below" then other cannot be added. If the patient has both then instead of adding both add one "eruption around"

Mouth : Eruption corners around

What I want to tell you that if the patient has "eruption mouth right" then it is absoutly confirmed that it does not have eruption "below". but if both are visible then don't add both and find other similar like symptom that covers the aspect of both symptom. Adding all the symptoms in a case is irrational.

Same like, if the patient has

Mouth : Eruption, corners around, but crusty

then don't add

Mouth : Eruption corners around

Although it has the symptom in patient.

if your purpose of adding both symptom is to give extra weightage then simply add single symptom and mark as priority symptom or add extra weightage.

I hope the clarification is done -:)

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