Introduction:
Dr. Syed Afsar Ali is an young enthusiastic
physician doing his post graduation at National Institute of
Homoeopathy Kolkata, West Bengal. He is highly dedicated for
the development of Homoeopathic System and he presents a case
of case Nephrolithiasis.
A male aged 32 years had treatment for renal
stones
Presenting Complaints
A) As narrated by the patient
Pain in right loin from last 10 months
to 1 year
Acidity, flatulence from last 2 years,
with indigestion
B) Present complaints in details
Pain in right loin from
last 10 months to 1 year. The pain is mild in nature. better
little from urination, by rubbing on the region. Frequent urination
though small in amount. There is a history of passing tiny particles
through urine.
Indigestion with acidity
and flatulence from last 2 years. The complaints aggravated
in afternoon and last up to 6 or 7 pm. Nauseating tendency in
morning, sour taste in mouth, sour eructation, occasionally
sour vomiting.
C) Complaints on further enquiry: burning in palms
and soles and generalized weakness
Past History
Chicken pox in early childhood
Jaundice-about 4 years back (2005?)
Family History
Father suffered from arthritis
Mother has hypertension.
Paternal Uncle –Kidney disease problem(did
not tell definite diagnosis)
Personal History
Married
Irregular mode of living
Semi urban habitat
Lower middle class
Occupation - Grocer
Mental General
Dislike company
Very irritable
Consolations <
Anxious about future
Memory: Weak, Forgetful
Physical General
General modalities time: acidity, flatulence aggravates
at afternoon
General sensations and complains (including burning
etc.) Burning in palms and soles. Intolerance to
tight clothing.
General Tendencies : Easily susceptible to cold,
< change of weather
Other physical general
Thermal reaction: Hot
Intolerance to sun heat
Appetite: Normal, easy satiety
Thirst: Moderate
Perspiration: from arm pits, sweaty warm palms
& soles.
Bowel: on alternate days, unsatisfactory, hard
offensive.
Urine: offensive, frequent of little quantity.
Burning at beginning of urination.
Sleep: Sound. Sleeps on rt. Side. Feels worse after
waking in morning.
Dreams: of daily business.
Craving: fat, sweet, salt, warm food
Aversion : Meat
Other particulars
Taste: Sour taste in mouth.
Tongue: flabby imprinted, trembling.
Sexual function: Normal.
Clinical Examination
General Survey
Fair complexioned, wrinkled in the skin of forehead.
Average body built. Pulse-78 /min. BP-130/80 mm. of Hg. Resp.-22/min.
Sweaty warm palms and soles. Tongue large flabby, salivated,
trembling. Rest within normal limit.
Systemic Examination: P/A- NAD except
mild sore ness on right loin on palpation.
Laboratory Examinations
Haemoglobin: 11.5 gm/dl
Total count- Erythrocytes: 3.9 Mill. /cmm
Leucocyte: 9,800 /cmm
Differential Leucocytes count - Neutrophils: 76%
Lymphocytes: 20%
Monocytes: 01%
Eosinophils: 03%
Basophils: 00%
Plasma Glucose (Fasting): 88mg/dl
Urea: 30 mg/dl
Serum lipase: 37 U/L
USG of whole abdomen reveals- (02/04/08)
Hepatomegaly. Multiple small calculi in right kidney and multiple
sand like tiny calculi in left kidney. Right sided mild hydronephrotic
changes
No calculus is seen in upper visible part of right ureter. But
some obstruction by small calculus might be present in poorly
visible middle part of right ureter. (Suggested I.V.P for further
a evaluation)
Creatinine: 1.1mg/dl (04/04/08)
Intravenous pyelogram/intravenous urography (Digital)-Right
ureteric calculus at its lower end.-08/04/08
Diagnosis
Renal calculus with hydronephrotic changes
Miasmatic diagnosis
Multimasmatic with sycotic predominance.
Conversion of symptoms in to rubrics [using
Synthesis repertory]
Mind - Irritability
Mind - Company- aversion to
Mind – Consolation – agg.
Mind - Anxiety – future about.
Mind – Memory - weakness of memory.
Generalities – food and drinks – sweets - desire.
Generalities – Food and Drinks – Salt – desire.
Generalities – Food and Drinks – warm food –
desire.
Generalities - Heat sensation of
Generalities - cold, taking a- tendency.
Generalities-weakness-waking on.
Face-wrinkled-forehead.
Stomach-eructation, type of -sour
Stomach – eructations - afternoon
Urinary organ – urine – odor – offensive .
Repertorisation
Sepia 30/15, Lyco 28/15, Nat mur 29/15, Nux vom 24/15,
Calc. 23/15, Sulph 23/15, Ars 20/15, Chin 20/15, Kali carb 18/15,
Phos 24/15.
Analysis of repertorial result
Though Sepia carries the highest mark during repertorisation,
prominent generalities are covered by the polycrest medicine
Lycopodium.
Final selection of medicine (after consultation of materia medica
and with reasons)
Lycopodium carries 28 marks covering 15 symptoms, it was selected
as the final medicine for prescription as it covered the important
characteristic physical generals and characteristic particulars.
First prescription 10/04/08
Rx
Lycopodium 0/1, 16 doses, OD
| Date |
Observation |
Interpretation |
Prescription |
| 26.04.08 |
little better regarding uneasiness in the loin, acidity
and flatulence |
The complaints have decreased in intensity.
Medicine is correct. So higher potency of 1st prescription
is prescribed. |
Lycopodium
0/2/16 Doses/OD.. |
| 14/05/08 |
All the complaints are better. Patient have informed that
with urine little particle like sand grain passed. |
Patient is on the way to cure. So medicine was continued. |
Lycopodium
0/3/16 doses/OD. |
As the
patient was improving under Lycopodium he was given the same
upto 0/10 in the same manner till September. Pain in right loin
is absolutely absent, appetite is improved, acidity and flatulence
is better. No burning in palms and soles. Sound sleep with feeling
of refreshness on waking in morning. He was advised to do USG
of whole abdomen which reveals the following report-01/09/08
Mild Hepatomegally(?) Left renal calculus. No renal calculus
is seen in rt. Kidney. No hydronephrotic change. Right ureter
is not dilated.
