Dr. (MRS.) Arpana Pareek: Reader, Dept of Repertory Smt. KBAHMC, Chandwad

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Dr. (Mrs.) Arpana Pareek


Reader, Dept Of Repertory
Smt. KBAHMC, Chandwad

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Preliminary Data
 Name: Mrs. Asha Patil
 Age: 28 years
 Sex: Female
 Occupation: Housewife
 Religion: Hindu
 Address: Niphad
 Marital Status: Married

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Chief Complaints
 Coryza on and off since 4 years.
 Swelling in the right nostril since

2 years.

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History of Chief Complaints
 Coryza on and off since 4 years
 Onset: Gradual
 Duration: 4 years

 Progress: Slow

 Crawling Sensation in the nose with sneezing

followed by acrid discharge associated with


feverishness
 < Morning
 < In open air

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 Swelling in the right nostril since 2 years
 Onset: Gradual
 Duration: 2 years

 Progress: Slow

 Nose feels obstructed while lying on bed.

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Past History
 Childhood:
 All the milestones were normal.
 No any major illness in childhood
 No any history of tuberculosis, chicken pox,
measles, mumps, etc.
 Adulthood:
 H/O appendectomy at the age of 22 years.
 H/O fracture right hand 8 years back.
 Removal of wart from right side of neck by
cauterization
 Cyst in the right ovary – treated
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Family History
 Mother has Obsessive compulsive
neurosis and father has rheumatoid
arthritis.
 She has only one brother who is healthy
and one sister who is having
hypothyroidism.
 Husband is in good health.

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Personal History
 Habits: Tea 3-4 times daily
 Food habit: Veg
 Appetite: Normal.
In morning takes only tea with two
biscuits
At Lunch 3 rotis, sabji and dal + chawal
At Dinner 3 Rotis + Sabji
 Desire – Cold Drinks
 Aversion: Not specific
 Thirst: Less
 Bowel: Once a day, No any complaint 8
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 Micturition: 4-5 times in a a day
 Perspiration: Normal
 Sleep: Sound
 Dreams: Not particular
 Thermals:
 Food: Hot food

 Open Air/cold/air: In open air, he feels better

 Season: Summer

 In general no any special seasonal aggravation

Summer Winter
Bathing Hot water Hot Chilly
Fanning + Patient
Covering Single
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Mentals/LSI
 She was borne in a middle-class family. She was
the 1st child born to her parents. She has one
younger brother and one younger sister.
 She is living in a small village near Niphad. The
area is very damp, near hills. There are lots of
congress grass which gives her trouble of sneezing.
 She had done his schooling up to 10th after that
she had got married. The area was very too small
for her to adjust as she was living before marriage
in a big city.
 Two months after marriage, she gradually started
her trouble of sneezing and since then she is
suffering from the same complaint.
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 She has one son who is healthy.
 IPR with in laws and husband are good.
 She gets irritated sometimes due to her health
problem.
 No any other incidence in the family which
troubled her otherwise family life is going on
smoothly.
 Repeatedly she was saying that after her
marriage due to change in environment she got
this trouble because before she was living in a
dry area now the area in which she is living is
damp.
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Physical Examination
 Built: Lean, thin, fair complexion with black
hairs.
 Weight: 45 kg
 Height: 5’1”
 Pulse: 76/min
 BP: 110/78 mm of Hg
 RR: 14/min
 Pallor: Absent
 Temperature: 99.00 F
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 Cyanosis: Absent
 Icterus: Absent
 Oedema: Absent
 Lymphadenopathy: Cervical lymph node
enlarged
 Tongue: Pink and moist
 Nails: Pale
 Pupils: Reacts to light
 Hairs: Black

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Systemic Examination
 Respiratory System: On inspection, in the
right nostril there is a big swelling.
 Cardiovascular System: NAD
 Central Nervous System: NAD
 Alimentary System: NAD
 Locomotor System: NAD

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Differential Diagnosis

Nasal polyp
Allergic Rhinitis

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Investigations

CBC
X-ray Paranasal Sinuses

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Nosological Diagnosis

Nasal Polyp

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Miasmatic Diagnosis

Sycosis

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Case Processing
Analysis of Symptoms according to Boger
Location Sensation Modalities Concomitants

Swelling Crawling < Damp Feverishness

in right Discharge Area


Nostril < Morning
acrid
with
> Open air
sneezing

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 Evaluation of Symptoms according
to Boger:
1. Causative Modalities: Damp area
2. Other modalities: < Morning, > open air
3. Concomitants: Feverishness
4. Physical generals: Desire cold drinks,
Thirstless
5. Location and sensations: Swelling right
nostril with sneezing and crawling sensation
in the nose with acrid discharge
6. Clinical Rubrics: Nasal polyp

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 Synthesis with the totality of symptoms by considering conceptual image and portrait
building:
 Modalities
 Living in damp area
 < Morning
 < in open air
 Nose obstructed while lying on bed
 Mind
 Suspicious
 Sensation
 Crawling sensation with acrid discharge
 Parts affected
 Right nostril
 Others:
 Feverishness
 Thirstless
 Desire cold drinks
 Chronic phase of disease
 Miasm Sycosis
 Diagnosis Nasal polyp
 Chilly patient
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 Right side affinity
Conceptual Image – Repertorial
Totality
= Potential Differential field (PDF)

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Repertorial Totality PDF
Living in damp area Chronic phase of disease
Sneezing in morning Sycotic miasm
> In open air Diagnosis Nasal Polyp
Feverishness Thermally chilly patient

Desire cold drinks Side affinity right side

Thirstless

Swelling in Right nostril

Crawling sensation

Discharge acrid

Suspicious

Nose obstructed while lying in bed


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Selection of Repertory

BBCR

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Repertorial Analysis

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Sr. Symptom Section Sub/ Page Diff.
No Sub rubric No.
1 Living in damp area Agg and Damp, dwellings, 1112
Amel in beings in, agg
general
2 Sneezing in morning Coryza Time, Morning 385
3 > In open air Coryza Amelioration, air, 387
open
4 Feverishness Coryza Concomitants, 388
feverishness
5 Desire cold drinks Appetite Desire, cold food, 476
liquids, water etc.
6 Thirstless Thirst Thirstlessness 481

7 Right nostril Nose Right 365

8 Swelling Nose Swelling 377


9. Crawling sensation Nose Crawling 369

10. Discharge acrid Nose Discharge, acrid 369

11. Suspicious D

12. Nose obstructed while D


lying in bed
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Spectrum of Remedies
Sr . No Drug RV Sr . No Drug RV Sr . No Drug RV

1 11 21
2 12 22
3 13 23
4 14 24
5 15 25
6 16 26
7 17 27
8 18 28
9 19 29
10 20 30
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Potential Differential field
Chilly patient (Kent) Miasm –Sycosis (Synthesis)
Page No. XXX Page No. 1688

Diagnosis – Nasal Polyp Chronic phase of disease


(Murphy) (BBCR)
Page No. Page No. 185

Right side affinity


(Boericke)

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Differentiation
Symptom Aconite Belladonna Chamomilla

Crawling
sensation in
right nostril

Suspicious

Sphere of action

Rubrics not
covered by the
remedy www.similima.com 29
Selection of Final Remedy

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Administration of Remedy

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General Management
1. Avoid cold drinks
2. Avoid wetting in rain
3. Avoid direct contact with fan
4. Maintain good hygiene

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Follow up

Date Complaints Prescription

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Remedy Response

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Second Prescription

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