Writeups

CASE OF ANGINA PECTORIS TREATED WITH CONSTITUITONAL APPROACH

WriteUps By Dr. Ritu Ajitbhai Lalwani


CASE STUDY

The patient was a 62 years old man. His physical complaints were -

Burning pain in the soles of his feet all day, mostly in the evenings (for 10 years).

Occasional attack of pain on the left side of the chest diagnosed as angina pectoris (for 6 years). 

Loss of appetite.

NARRATION OF PATIENT’S COMPLAINS – 

  • At the time of pain if I occupy myself with some activity (like visiting club with friends, or playing cards with my wife) I begin to feel better. Due to my angina, I can manage to walk only very slowly. I have just one concern and that is I might become bed-ridden because of it. I am a retired man and at this age I have no other way to pass time. 
  • Sometimes I feel very bored I then go to visit the nearby park where I meet some old friends and we chat away about different things, that takes away my attention from my pain.

HISTORY OF PRESENTING COMPLAINTS – 

  • In the last 10 years, he gradually developed the complain of burning soles.
  • For 6 years he was having occasional chest pain – no pathology of heart was diagnosed.

ASSOCIATED COMPLAINTS – 

  • Loss of Appetite.

PAST HISTORY – 

  1. Malaria – before 17 years of age.
  2. Fall on stairs – before 16 years.

TREATMENT HISTORY – 

  • Sometimes takes Pain – killers, when pain severely increases.

FAMILY HISTORY

  • Nothing specific was found in the family members disease inquiry.

PERSONAL HISTORY – 

  1. Appetite – 2-3 chapatis/meal. Prefers warm foods and drinks.
  2. Diet – Vegetarian.
  3. Thirst – Pot water 3 – 4 liters/day.
  4. Desires – Spicy and baked food +, Cold drinks +.
  5. Aversion – Coffee +.
  6. Intolerance – Coffee which causes distension of abdomen & nauseating feeling.
  7. Bowels – Regular and satisfactory.
  8. Urine – No complaints with frequency of 5-6 times/day.
  9. Sweat – Profuse on exertion – no offensiveness
  10. Sleep – Sleeps late, wakes early in morning.
  11. Dreams – No any.
  12. Thermals – Hot patient.

PHYSICAL EXAMINATION – 

  1. Appearance – Lean, sunken face.
  2. Built & Nourishment – Well-built and nourished.
  3. Pallor – No conjunctival pallor.
  4. Cyanosis – No cyanosis.
  5. Clubbing – Absent.
  6. Oedema – No pedal oedema.
  7. Lymphadenopathy – No lymphadenopathy
  8. Respiratory Rate – 16/min.
  9. Pulse – 80/min.
  10. Blood pressure – 120/78 mm Hg.

DIAGNOSIS Angina Pectoris.

ANALYSIS AND EVALUATION OF SYMPTOMS – 

Mental Generals – 

  1. Amel from occupation.
  2. Fear of suffering.
  3. Entertainment amel.
  4. Desires for Amusement.

Physical Generals – 

  1. Desires – Spicy food +, Cold water +.
  2. Aversion – Coffee +.
  3. Hot Patient.

Physical Particulars – 

  1. Chest pain.
  2. Burning soles.

TOTALITY OF SYMPTOMS – 

  1. Amel from occupation.
  2. Fear of suffering.
  3. Entertainment amel.
  4. Desires for Amusement.
  5. Chest pain.
  6. Burning soles.
  7. Hot Patient.

Here, considering the patient as whole with his presenting symptoms, dominating miasm appears to be “Psora-Sycotic”.

RUBRICS SELECTED – 

  1. MIND - OCCUPATION, diversion mind amel.
  2. MIND - FEAR suffering of
  3. MIND - ENNUI, entertainment amel.
  4. MIND - AMUSEMENT, desire for.
  5. CHEST – PAIN.
  6. EXTREMITIES – PAIN, burning, soles.

PROVISIONAL REMEDY – 

Piper methysticum –

  • Very sensitive.
  • Exaltation of mind.
  • Amelioration of pains for a time by diverting attention.
  • Restless desire to change position.
  • > - by turning mind to another topic; changing position.

With the guidance of Synthesis Repertory and Various Materia Medica’s, finally “Piper methysticum” was selected to be the similimum remedy.

  • So, Piper methysticum 30 – 1 single dose stat orally was prescribed along with Placebo TDS for 10 days.

1st FOLLOW-UP AFTER 10 DAYS – 

  • patient reported that the pain in his sole had got better.
  • There had been no attack of chest pain.
  • There was a slight improvement in his appetite.
  • He did not worry about getting bed ridden any more.
  • Hence, Placebo TDS for 15 days was prescribed.

2nd FOLLOW-UP AFTER 15 DAYS – 

  • After 15 days I got a call that he had got an attack of pain in the chest again.
  • I asked his wife what he was doing – “She told me that he was lying with his eyes closed and asking her to sing a prayer. He was lying with his hand on his chest”.
  • Hence, Piper methysticum 200 – 1 single dose stat orally was prescribed along with Placebo TDS for 1 month.

3rd FOLLOW-UP AFTER 1 MONTH – 

  • One day – he had vomited 3 times in two hours.
  • He had no weakness or any other problem accompanying it.
  • Now, patient feels better.
  • Hence, Placebo TDS for 1 month was prescribed.

 

CASE PRESENTED BY - 

Dr. Ritu Ajitbhai Lalwani

PG Scholar (Department of Homoeopathic Materia Medica),

Rajkot Homoeopathic Medical College,

Parul University.

 

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