24 year old unmarried female
C/o :-
- Occasional cramps in small muscles , specially of arms and hands since 2 years.
- No history of any injury or trauma.
- Aggravates at night, feels better by walking in open air.
- Can not sleep without listening songs ( romantic and or inspirational ) Even though it aggravates!
- Desire for cold water, salty food, wafers.
- Emotionally very sentimental, tries to make everyone happy, feels dejected later on! Can not tolerate contradiction.
Does these details are enough to initiate treatment?
- If NO, what should be further questions / investigations?
- If YES, what should be further management?
please, give your expert opinions through comment(s)...
It's Natrum Mur case.
ReplyDeleteCan I ask, HOW?
ReplyDeleteAt least specify one or two other symptoms which are symmetrical operators
ReplyDeleteHot /cold
Early/late (menses)
Desires /aversions
are examples of symmetrical symptoms
The value of such symmetrical operators called "modalities" can never be sufficiently overstressed, whether the other peculiars are sufficient for making a good prescription or not.
hence I'm compelled to reiterate this, being abundantly concerned about students acquring the skills required for homeopathy.
I know sir my students are not perfect, but at least they are trying to be without doing any harm to patients! Isn't it good?
ReplyDeleteAnyways, thank you for your complements, I hope one day you will get satisfactorily perfect case from my students.
High probability of simple case of anaemia and bit b12 deficiency.
ReplyDeleteGet CBC done and rectify.
Meanwhile ask her to drink one glass of ORS or lemon+salt+sugar+water morning and evening.
Please allow her to enjoy any music she wants, no need to keep on dissecting normal things. At 24 what do you expect? No need to fit Nat Mur everywhere.Everyone passes through such phases, normally
Thank you very much Dr. Dhrupad sir.
ReplyDeleteNervous jerking during sleep
ReplyDeleteSentimental mood
Desire for salt
Worse at night
Worse by music
Better in open air
Clearly indicates Natrum Mur.
May be! But in that way each and every normal person can have one or either medicine, does it really mean they need it??
ReplyDeleteIf things can be came under control simply by few glasses of ORS and improvement in diet, I think we should not use medicines just because we have it!!
It is no doubt every minor complaint doesn't need medicinal intervention. but that is not the intention of the patient if she consults a physician.
ReplyDeleteIf we say she doesn't require medicine, she will consult someone else. if we give placebo, it is deception and not confiding our opinions with the patient is bad practice.
As students it is the duty to prescribe the correct remedy even if it serves nothing but as an exercise.
Now Dr. Karnav you are also obliged to give your own opinion of the above case. hence will you please add your personal findings and suggest a remedy ?
Respected Dr.venkatesh sir,
ReplyDeleteSorry if I hurt you.
I am still in the phase of internship and not at all capable to be in comparison with you, I will never be.
I know we are already passing through critical phase, hence some security is inevitably required, but though what if we give true guidance to our patients, even if he / she does not required any medicines!?
Here, in this particular case, after getting confirmation through CBC, What if we let her know that it is because of poor nutrition and hence you will need to improve your diet. Meanwhile take ORS or lemon + salt + sugar + water for few days as per suggested by Dr. Dhrupad sir.
after the period of one week we will take follow up, and will start medicine if it will be required.
Even after our true guidance if she does not get satisfaction and finds some another doctor, it won't be our fault.
Isn't it?
It is not a question of hurting me. No, but you can disappoint me of course, as a homeopath ( or aspiring homeopath) you are not attempting a prescription for a genuine case is not a reassuring feeling for one who wants to see Homeopathy in its fullest Glory.
ReplyDeleteSince it is a real case, there has to be a remedy because I believe "there isn't a time or person whereon a homeopathic remedy doesn't match the totality" except perhaps the medicinal diseases produced by allopathic material dosages given for a long period.
Hence it is possible to at least attempt a prescription on the basis of available symptoms however inconsistent they are.
Well, in that case I am sorry to disappoint you, but I still believe that best doctor is one who gives least medicines where it is inevitably required.
ReplyDeleteStill, we can work out the similimum to the best of our abilities aided by the available symptoms if the case is genuine.
ReplyDeleteThat doesn't mean we can't lay our hands off. Actually that decision to give or not give the remedy should be supported by the similimum thus arrived at. because in homeopathy prescription and diagnosis are not different. hence asking for a prescription here is equivalent to asking for the diagnosis. Is it not prudent to make a decision on the basis of the Rx cum dx?
Hope I'm not offending.
Not atol sir, you aren't offending me but i am sorry i am not being able correlate you.
ReplyDeleteNow I'm reasonably in a position to prescribe a preliminary remedy for this case. I must admit that I am so obsessed with correct prescriptions that whenever a real case is mentioned, I can't rest until I find the similimum on the basis of available totality
ReplyDeleteIt is Aconite ( preferably 30th) single dose.
Sir, If you won't feel offended can I ask, why aconite?
ReplyDeleteI'm not.
ReplyDeleteafter turning the repertory upsidedown I felt that the modality, " ameliorate from walking in open air " does not belong to the principal remedy indicated for main complaint of cramps.
So, a modality for the patient as a whole and that for a particular part are in conflict. usually in such circumstances, the one that describes the patient is responsible for the maintaining cause. hence compulsion to walk/move and desire for open air is a maintaining cause. the principal remedy having the opposite modality and desire
desire for open air and amelioration generally from motion happens to be aconite.
remaining symptoms form the total picture of Cocculus. but let's see if the maintaining cause is addressed, whether it's sufficient to restore or not)
I want your attention here. Presence of a symptom is not an indication of a remedy.
ReplyDeleteWe need qualifying symptoms to prescribe.
By giving placebo we are not at all decepting a patient. Giving placebo requires great courage, where you are confident that this altered state does not require any dynamic support.
Please look into following words by our one and only Master, aph. 153:
In this search for a homoeopathic specific remedy, that is to say, in this comparison of the collective symptoms of the natural disease with the list of symptoms of known medicines, in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms of the case of disease are chiefly and most solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure. The more general and undefined symptoms: loss of appetite, headache, debility, restless sleep, discomfort, and so forth, demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and from almost every drug.”
I don't dispute with the above views. and you always deserve the attention.
ReplyDeletehowever, while the decision to give or not to give the remedy is subject to the individual discretion of the homeopath, a similimum is not so. there can't be two opinions about the similimum. if it is there, one of them has to be wrong.
In the same way, though presence of a symptom is not an indication, presence of a totality IS an indication for a particular remedy and only for that particular remedy.
here in the case discussed, Romantic type, unmarried, concerned about the health of others, can't tolerate contradictions - these constitute a unique totality indicative of Cocculus.
but desire for open air, and amelioration ( in general) from walking aka motion- are quite opposite to Cocculus symptoms. Since we have a well established relation that Cocculus follows Aconite, and the fact those symptoms not belonging to Cocculus here are consistent with the totality of aconite, we can safely conclude that Aconite is the preliminary remedy and if at all there is further necessity Cocculus is beneficial.
Again I wish to tell that "to give or not to give'' is left to the homeopath's judgment. but there is no harm in understanding the similimum at least for the sake of an exercise to improve the skill.