Tuesday 11 December 2012

A case of tuberculinum

A case of tuberculinum
 


 

Dr. A.P. Sivakumaran, BHMS
37, SBOA Colony Extension
Behind Hotel Gowri Krishna By-Pass Road
Madurai - 625010

    Introduction:
       Dr. A.P. Sivakumaran, is a young homoeopath, dedicated and renders service to homoeopathy.He holds clinical meets and medical camps.He had authored a book in tamil and his papers had published in journals.Here he presents a case of Tuberculinum.

       A eleven years old male child presented the complaints of recurrent tendency to catch cold, sneezing < morning, slightest climatic change, weakness2+ want of appetite, recurrent attacks of fever, emaciation, pain in abdomen with nocturnal enuresis, and offensive diarrhea. He also has dry cough < morning. The patient is physically weak, mentally active and keen.

    Past history
    He gave the history of tonsillectomy one year back and Anti tuberculosis treatment for primary complex. History of recurrent boils treated by allopathic medications.

    Family history
    Mother with a history of Dysfunctional Uterine Bleeding

    Physical generals:
    Appetite - Want of appetite; Thirst – drinks less than 2 liters per day;
    Stool – offensive diarrhea; Urine – nocturnal enuresis; Sleep – disturbed by cough; Sweat – normal; Desire for eggs, Craving for non-veg3+

    Physical examination
    Examination of the neck shows enlargement of cervical glands. Inguinal lymph nodes enlarged, temperature was
    103 F.

    Systemic examination
    CVS - NAD, RS – monophonic wheezing heard throughout the lung fields. Weight – 18 kgs.

    Mental generals
    Active, restless, but physically weak.

    Investigations 
    Mantoux positive.
    The Ultra Sonogram of the abdomen illustrated that Multiple Enlarged mesenteric Lymph Nodes and large iliac nodes are seen in the right iliac fossa -Mesenteric adenitis
    (Refer Plate I)

    First prescription                                        26/08/2009 
    Tuberculinum 1M / one dose orally. He was also
    advised to take a protein-rich diet and to avoid coffee and tea intake.

    Follow-up 1                                                   31/08/2009
    Cough and cold had decreased significantly. He complained of mild left-sided headache and left-sided nasal obstruction. Temperature was 100 F. Placebo was administered. They were given some general management tips and asked to wait for further progress. No complaints of diarrhea. No complaints of abdominal pain. Nocturnal enuresis reduced.

    Follow-up 2                                                   18/09/2009 
    Acute coryza1+ , appetite had improved, generals were normal. Placebo was administered.

    Follow-up 3                                                  02/10/2009 
    No complaints, generally improved. Placebo was administered. No complaints of nocturnal enuresis.

    Follow-up 4                                                  04/11/2009
    On examination, the cervical gland enlargement had reduced to a significant extent. Inguinal node enlargement had also reduced well. No attacks of fever, cold, or cough. Weight – 23 kgs. The patient was further encouraged to consume a protein-rich diet. Placebo was given.

    Follow-up 5                                                  23/11/2009 
    The patient had improvement. Placebo was given for
    15 days.

    Follow-up 6                                                   10/12/2009
    The patient was advised to undergo another USG .It shows no evidence of enlarged mesenteric glands. (Refer plate - II) Mantoux negative.

    DISCUSSION
    Tuberculimnum is the similimum for this case which was prescribed based on the tubercular miasmatic
    expression. This factor was well-indicated by the history of suppression of primary complex. Tuberculinum is the most suitable prescription for children with respiratory complaints. In my practice, majority of children have shown improvement with this remedy. 

    A case of disseminated Koch’s with right basal lung collapse where concurrent treatment by a specialist was being given.
    · A case of a 4-month-old child is presented to highlight the result of homeopathic treatment with successive radiographic pictures. This child had developed disseminated Koch’s with right basal lung collapse caused by a necrotic lymph node eroding the bronchus.

    The case was treated with standard anti tubercular treatment (AKT). The pediatrician was planning to do intervention through bronchoscopy to remove cause of obstruction. But the parents were unwilling and sought to try homeopathy.The case was treated on the classical homeopathic lines using anti-miasmatic and symptomatically indicated remedy. Under homeopathic treatment gradual but steady improvement took place as revealed through successive x-rays and the treating pediatrician decided to wait. The case completely responded to occasional doses of Tuberculinum and Phosphorus, which was given in 0/1 potency over a period of few weeks.

    Conclusion 
    Homeopathy is a safe and effective therapy.Use of repertory as a tool provides valuable guidance in the selection of the remedy.
    Homeopathy can be used effectively with conventional medicine.