A female of 55yrs came with c/o acidity and joint pains. She was not able to sleep at night because of acid reflux. She also complained of joint pains. On detailed inquiry, it was discerned that when she had acidity, she did not have joint pains. They seemed to be alternating with each other. One appeared when the other disappeared. Based on this Kali Bi 200 one dose was given. A follow-up one month later showed no change in her condition. Since I was sure of medicine the potency was increased and Kali Bi 1m.  Even now nothing happened. The case was taken again in detail. I was going to suggest some blood tests but the patient was reluctant to undergo them. It was found that the patient had taken OCPs for a very long time to regulate her periods. On this basis, Thyroidinum 10m was given. This time she responded very well and the follow-up a month later showed marked improvement in her complaints. She was kept on placebo till her last follow-up.

Explanation

I wanted to bring forth a very important point through this case and highlight the need for an intercurrent or another medicine (by whatever name you call it), to remove a block created by prolonged use of OCPs in this case. Kali Bi despite being indicated (acidity alternating with joint pains is PQRS) did not work till the block was removed using Thyroidinum. You will come across many cases like this where a well-indicated medicine will fail to produce results. Look for such blocks/events/accidents/incidences etc, address them with appropriate remedy and you would find them unlocking the case for you or churn the wheels of a machine that refused to budge earlier.

(For those who would like more, I would like to refer to a discussion/case of Dr. S P Dey as mentioned in one of his books “Essays on Homeopathy”. He gives an example of a patient with severe skin manifestations who would be given a dose of Sulph which will apparently cure a patient for time being, only to return 6 months later with a recurrence. He says should Sulph be indicated, as it would be from the symptomatology, it should take care of the case for once and for all, why the recurrence? On delving deeper, it would be found that the mother had skin allergy during pregnancy, in which case Thyroidinum would do the job, or Medo if there’s a family history of sycosis in parents.   These obstacles need to be removed if we are ever expected to travel towards a cure.)

Aude Sapere

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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A 20 yr old girl came with acute severe menstrual pain. She had taken cyclopamine without relief at home. She was given an analgesic and antispasmodic injection (allopathic medication) as well without any relief. As hours passed, her pains increased in severity. It is in this situation that she sought the help of homoeopathy. She was bending double with pain, was crying and trembling as the pain came on. She was given colo 1m, given the severity of her pains without any relief. Bell and mag phos also failed to provide any relief. Almost an hour passed without any change in her condition. I was desperate to provide relief to her but was failing again and again. It was then that I decided to repertorize the case. Fingers crossed, a dose of nat carb 200 was given. She slept in the waiting room after 10 min. Later her scan revealed that she suffered from endometriosis.

Explanation
The rubrics taken for repertorization were:
Pain with trembling
pain with sweating

I used Knerr Repertory (the one I had easy access to at that time).
The only remedy that came in 3+ was nat carb in both rubric. I was skeptical as I had never
used nat carb in acute dysmenorrhoea, but the symptoms chosen were marked and
characteristic, and repertorization result unmistakable. A dose of nat carb 200 showed its
mettle and taught me to think outside therapeutics. (of course, she needed a long-term
treatment of her condition to fully recover).

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com

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This is a case of a boy who completed age of 20yrs and wanted to gain some more height. He was 5 feet 4 inches. The boy went to the gym, where his instructor advised him to take homoeopathy. He had an inverted triangular face, long fingers and fine skin (tubercular features). There were no other complaints and he confessed to having stopped growing 2 yrs back.

He was counselled and given a small lesson in growth in males during puberty. He was assured that I would nevertheless give him the medicine, and do what can be done from my side. He was given a dose of tuberculinum 1M and asked to come a month later. Lo and behold, the patient stretched 2cm above Earth. Wait another month and the patient gained another centimetre. In total a gain of 3cm (more than an inch), in 2 months. I had learnt my lesson as well.

Explanation

The growth of males during puberty usually stops around the age of 18 yrs (when the growth plates fuse), it may sometimes be a little later but that is the tail end of the curve. This patient had stopped growing 2 yrs back. The chances were bleak that he would gain any more height. However, my medical wisdom was to be proven wrong. Tuberculinum was chosen based on the physical features of the patient as a guide (as there was no overt disease in the patient, just a latent miasm). It helped the patient gain another inch and a little farther beyond the age one would expect a boy to gain more height. It helped the boy fulfil a part of what his potential was. Maybe if he was to come earlier, he would have benefitted more! But there is no way to know, for there are no parallel universes when it comes to medicine.

Aude Sapere

Dr Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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A 60-year-old diabetic female came with ulceration of lateral malleoli of the right leg. She had this ulceration that developed in the traumatic pressure callus on the lateral malleoli as a result of sitting crossed legs for a long time on the floor, causing friction-induced callus formation. The ulcer measured almost an inch and a half in diameter, had resisted conventional treatment, and was painless (the patient was a diabetic and suffered from diabetic neuropathy). She was advised to undergo skin grafting as a result. She had mild varicosity. The ulcer was indurated and had suppurated. She was given Silicea 1m / 3 doses to be taken once in 10 days, along with dressing with calendula dressing powder.

Follow-up after a month showed dramatic improvement with ulcer size reduced to almost half, suppuration cleared, and healthy granulation tissue.  she was advised to continue only dressing and given a placebo for another month.

The wound completely healed at the end of the second month and averted the need for skin grafting.

Explanation

This was a very simple prescription based on pathological similarity (the character of lesion similar to that of medicine) of the lesion with those of the homoeopathic medicine Silicea (viz ulceration, induration, suppuration). The ulcer was non-healing that resisted treatment (non-healing ulcer- silicea).  Silicea worked its charm and healed the ulcer.

Dr Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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A 40 yr old male with no comorbidities came with plantar keratoderma (subset palmoplantar keratoderma- PPK). He had lesions on the left foot, almost a 3- inch superficial ulcer with a punched-out appearance on the heel, slowly increasing in size for the last 2 yrs. In the other areas, the skin was thickened and he experienced severe itching. There was a dearth of any other symptoms in the case. 3 doses of Nat carb were given to be taken at 10 days intervals, with
instructions to stop the medicine if improvement starts. After a month the patient reported that the ulcer started healing and there was a reduction in the depth of the lesion. 2 more doses were given with similar instruction: to repeat only if improvement stops, otherwise continue saclac. This time patient returned 2 months later with lesions almost reduced to 1/3rd
the original size. He was kept on saclac without any further dosages and the lesion was completely healed a month later, ending his 2 yr ordeal.

Explanation
This case was a one-sided case with no other symptoms than just the ulcer and itching. The modalities were not clear so were the exciting cause and concomitants. Looking at the ulcer I thought of silicea, kali bi etc. The ulcer was dry and there was no tendency to suppurate. It had the punched-out quality of kali bi but no other characteristic, discharge, or pointer. Pulford keynotes to materia medica describe Nat Carb (given in lycopodium- lyco has ulcer on
instep) as having ulcer on heels. It was on this basis that Nat carb was chosen in a moderate potency. In retrospect maybe a single dose of higher potency would have done the trick, instead of repeating frequent doses of a lower one.

Dr Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com

Download a copy of the case here.

This is a case of 7 yr old boy who came with a complaint of bedwetting at night. The frequency of urination was 4-5 times at night. There was no wetting-free interval since birth (i.e. though the child was potty trained in time, he continued bedwetting). The parents tried everything from reducing fluid intake in the evening to wake him up at night for urination but to no avail. On inquiry, it was found that the urine was very offensive. There was also a crack at the corner of the mouth (persisting despite vitamin supplementation). A dose of nitric acid 200 was given along with a placebo. After 2 months the frequency of wetting was reduced to just once, and the offensiveness of urine was much better. Another month on placebo and parents reported a complete resolution of the complaint.

Explanation

Nocturnal eneuresis is a very common problem in children and causes a dent in the confidence of a growing child. This problem is very easily treated by homoeopathy. Though every case is new and requires individualistic medicine, personal experience shows that medicines like nitric acid, cal phos, tuberculinum etc are more commonly indicated than others. This child had very offensive urine (concomitant) so much so that parents had to use the air freshener in the bathroom every time the child used the toilet (other medicines for offensive urine- benz acid, sep). There was a crack in the corner of the mouth (another concomitant) which led to the prescription of nitric acid. (Offensive urine is a very reliable indication for nitric acid and with that, affection of mucocutaneous junction makes a formidable duo. I once treated a case of vitiligo of perineum in a child based on these concomitants with complete repigmentation of the affected area)

Aude Sapere

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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A female patient of 65 years of age had multiple comorbidities. She was diabetic, hypertensive, and had hypothyroidism. She developed bullous eruptions all over her body which were filled with fluid with severe itching. She was put on wysolone, and was on medication for some time, which neither gave any relief of symptoms nor caused regression of disease. There was no trigger that could be found. However, she had amelioration of symptoms during wet weather. In a detailed case taking she was found to have a liking for cold things and slept in knee-chest position. A dose of medorrhinum 200 was given. In the follow up a month later she said she was much relieved, but was feeling slightly itchy again. Her wysolone was tapered and another dose of medorrhinum 200 was repeated. Her eruptions resolved completely at the end of 2nd month. A follow-up (no medication) after a year showed no recurrence.

Explanation

When the patient is already on so many crude medications, it becomes very difficult to treat (as it masks all the indications of medicines and causes iatrogenic disease). This patient despite having taken so many medicines showed some marked modalities and peculiarities as a person, which helped in the selection of suitable remedy on homeopathic principles.

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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A 23 yr old male sought consultation for hypertension. He was on antihypertensives for last 3 yrs and there was a progressive increase in dosage of the medication needed, gradual, nevertheless increasing. On presentation he was anxious, had palpitations and raised BP despite having taken regular allopathic medication in the morning. There was some stress in the family. Aconite 200/3 doses/ od was given. Given his age, he was also advised some tests, which included 24 hr urine VMA, serum aldosterone levels and renal artery doppler and some other basic investigations. A follow up after 5 days showed his anxiety levels reducing and his BP stabilizing. He was again given aconite 200 but this time only SOS, whenever he felt anxious. During conversation an observation was made which was missed in the first consultation. The patient’s hands were thick and seemed big for his arms. I asked him if there had been any change in shoe size recently which he denied. I asked him to show an old photograph of himself, before hypertension had set in. What was seen raised an alarm. Immediately I sent him for an endocrinology consult with aconite 200 SOS. What was feared was proven right, when he returned a week later. The patient had a pituitary microadenoma as seen in his MRI(advised by endocrinologist). It was this culprit that raised his BP and that thickened his jaw (discerned from comparison of him with his old photograph), his growth hormone (GH) was going off the roof (also advised by endocrinologist) and he was heading towards acromegaly and diabetes. It is here that he mentioned that also experienced profuse sweating. His diagnosis was made within 12 days, and he felt much relieved of his anxiety. His BP readings were more settled now. But this was only a calm before the storm and his pathology had to be tackled. I gave him aconite again, this time alternate day for another 10 days as patient was also sent for a neurology consult. This was the last time I saw this patient, a country wide lockdown had been imposed due to COVID 19 pandemic.

Explanation

A young patient with hypertension should be evaluated to find out the underlying cause of hypertension. This patient had a progressive increase of hypertension, becoming refractory to medicine. This is what raised a reg flag and kicked my medical training into action. Hypertension in young adult should first be evaluated for surgically correctable causes (as per medical literature). The most common include:

• Renal artery stenosis (diagnostic modality used- renal artery doppler)
• Hyperaldosteronism (diagnostic modality used- serum aldosterone levels)
• And pheochromocytoma (diagnostic modality used- 24 hour urinary VMA)

It was a relief to see all the tests negative. However, the cause was still unknown. It was a casual observation that led to his diagnosis. Had his big hands, gone unnoticed or the observation shoved under the carpet and had not his old photograph been compared with his present self, it would be no one knows how long before his diagnosis would be made. He had no other symptoms, no headaches, no vision disturbance. Aconite was a purely symptomatic prescription. He was anxious and had high BP. It would not have helped in the long run. After his diagnosis was made, I had to give him a deeper acting medicine that would target his pathology as well. Before I had a chance to further his case the circumstances (pandemic) ended the treatment prematurely and patient was lost to follow up. This case emphasizes the need for diagnostic skills in homeopathic physicians. It epitomizes Aphorism 3 of Organon of Medicine: the physician must know, what is to be cured in a disease (knowledge of disease, indications). It was not his hypertension that needed treatment but a deeper lurking pathology.

Aude Sapere

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

Download a copy of the case here.