A Case Of Hiatus Hernia with Reflux Oesophagitis

© Dr.R.S.Mann 2011

 Presented By 

Dr. R. S. Mann

 A patient, Mr S.Kumar, 33 yrs male, has following complaints since last 7 years, increasing year after year.

Eructations, violent, continuous, loud, starts from morning, increase in afternoon after lunch and constantly increasing, pain in hypochondriac region, epigastrium, back, chest, sometimes left arm, sometimes pain knee with these eructations. Vomiting which relieves for few minutes. Burning and pain in epigastrium region which relieves by eating (it seems a mild relief) and sitting bent. Sleep disturbs by these eructations, have wake up and stand up so that he can eruct and get relief when flatulence passes that is collected in stomach. Can sleep very late and not more then 4 – 5 hours. When he has flatulence, no position gives him relief, sometime lie down, sometime stand up and then sit up but no relief anyway.

He thinks how good it would be if there is no need and provision to eat. He is very much worried about his disease, works very far from his native place, he thinks to resign the job and shift back to that place, thinks what will happen about his wife and kids after him. Thinks if he will die so far, how his dead body will go to his native place.

Angry, very easily on kids when they want to play with him, even he slap them, get angry on wife, noise hurts him.

Thirst very less, not want to eat.

Due to vomiting, he feels rawness in throat and eruptions, which bother him.

Stool hard sometimes. Go once for stool in a day.

Pulse slow. He says his pulse drop as less as to 62 sometimes, and then he feels become much more worried about his health.

Endoscopy report says he has Hiatus hernia and gastritis.

D/H – Taking different kind of antacids, antibiotics off and on since his disease.

P/H – Three years back he quit tobacco chewing.

Repertorization

Radar :

STOMACH - BENDING - forward - amel.

STOMACH - THIRSTLESS

STOMACH - ERUCTATIONS - constant

STOMACH - ERUCTATIONS - violent

STOMACH - VOMITING

STOMACH – PAIN

ABDOMEN - PAIN - Hypochondria

ABDOMEN – FLATULENCE

STOOL - HARD

BACK - PAIN

EXTREMITIES - PAIN - Upper arm

EXTREMITIES - PAIN – Knee

SLEEP - DISTURBED

GENERALS - NIGHT - midnight - before

GENERALS - CHANGE - position - amel. - not amel.

GENERALS - NOISES - agg.

GENERALS - FOOD and DRINKS - food - aversion

GENERALS - PULSE - slow

GENERALS - VOMITING - amel.

MIND - DESPAIR - recovery, of

MIND - ANXIETY - health; about - own health; one's

MIND - ANGER - easily

MIND - DEATH - thoughts of

MIND - FEAR - happen, something will - himself; to

Phos 22/48, Puls 19/43, Acon 19/32, Ars 18/42, Lyco 18/42, 
Nux V 18/38, Sulphur 18/35, Ferrum Met 18/32, Kali Carb 18/31,
Lach 18/31

Another Repertorization on

Complete Dynamics

Generic Symptoms:
Throat; pain; sore, bruised
Heart & circulation; pulse; slow, brachycardia
Back; pain
Sleep; disturbed
Generalities; food and drinks; food in general; aversion to
Generalities; noise; agg.
Generalities; vomiting; amel.

Stomach:
Stomach; bending; amel.; forward
Stomach; eructations; constant
Stomach; eructations; empty; profuse
Stomach; eructations; violent
Stomach; pain
Stomach; thirstlessness
Stomach; vomiting
Abdomen:
Abdomen; flatulence
Abdomen; pain; flatulence; from
Abdomen; pain; hypochondria
Stool; hard
Extremities:
Extremities; knees
Extremities; pain; upper limbs
Mind:
Mind; anger; easily
Mind; anxiety; health, about
Mind; death; thoughts of
Mind; despair; recovery, of
Mind; fear; happen; something will; family, to, or to him

Prescription:-
Phosphorus is the most similar medicine for the case which comes out in both repertorization.

Oct. 14, 2011

Phos 200 CH 3 doses prescribed 6 hourly. With Sac lac for 10 days.

Oct. 21, 2011

Very much relieved, no vomiting, eructations reduced lot much. Sound sleep. After many years he has some days when he has no burning, eructations or abdominal discomfort.
Sac Lac for 15 days.

Nov. 5, 2011

Remain normal on every alternate day. Mild eructations on alternate day for few hours.
Pain throat as if raw and stinging.
Phos 1M CH 3 doses prescribed 6 hourly. With Sac lac for 10 days.

Nov. 8, 2011

Vomiting this morning, just after drinking water, water becomes hot as if boiling in stomach, and vomited out.
Restless, anxious.
Note*:- Phos 1M must not be given; it was early to shift to upper potency, early repetition.
Sac lac prescribed with assurance.

Nov. 16, 2011

Eructations, burning, pain, vomiting reduced.
If he has some discomfort after eating, it remains just for half to one hour.
Sleeping very well.
Stool normal.
Appetite good can eat everything now without any burning and worry about abdomen.

Sac Lac prescribed for 10 days.

Nov. 26, 2011

Very much improved.
Eructations only 2 times in 1 day.
Sleep very good.
No vomiting.
Sac Lac prescribed for 10 days.

Dec. 6, 2011

Pain head, from 3 days, continuous whole the day, with vertigo.
Throat feels raw and heavy.
Eructations better.
Vomiting once, just 2 days before.
Worried again for his disorder, although better.

Phos 200  1 dose.
Sac lac for 10 days.

Dec. 17, 2011

Head pain and vertigo improved on next day of last prescription.
Sac Lac for 10 days.

Dec. 27, 2011

Patient has started some discomforts again. Eructations which improves after eating.
Burning pain in throat which also ameliorates after eating. Patient is feeling feverish constantly.
Throat inflamed. 

Another Repertorization on
Radar: 

THROAT - INFLAMMATION
THROAT - PAIN - burning - eating, after - amel.
THROAT - PAIN - burning
THROAT - PAIN - rawness
STOMACH - ERUCTATIONS
FEVER - FEVER, heat in general
GENERALS - EATING - after - amel.

Mez 7/15, Phos 6/17, Merc Sol 6/15,Natrum Mur 6/15,Puls 6/15, Sepia 6/15,Aconite 6/14, Hep 6/14, Lachesis6/14,Nux V 6/14,Sulphur 6/14.

Phos prescribed on Dec. 6 although help in headache and vertigo but it produced new symptoms in patient. On repertorization Mez seems best similar now which also antidotes the Phosphorus.

Prescription:- Mez 30 Ch 3 doses prescribed with sac lac for 10 days.

Jan 7, 2012

All the symptoms relieved very next day of prescribing Mez 30. Not any symptom and discomfort present.
Sac lac for 10 days.

Jan 18, 2012

Not any discomfort or symptom is felt by patient. Medicine is discontinued.

Clinical Cases By Samuel Swann. M.D.

This article on clinical cases was published originally in "The Hahnemannian Monthly   Vol  6, September 1870." Repertorization part is prepared to understand the case by modern tools.This article is presented by Dr Ravinder S. Mann.

Clinical Cases

By Samuel Swann. M.D.

Acidum Lactis in Morning Sickness during Pregnancy

Mrs.H., a healthy brunette, two months pregnant with her first child, had nausea and vomiting in the morning on rising and after eating, with water-brash so profuse as to require the constant use of a spittoon, while at night her pillow was saturated with saliva. Gave one dose Acid Lac. 1 M and in less than an hour the water-brash had ceased, and she had no return of that or the nausea.

In this, as in several cases where the morning sickness had been cured with Acid Lac., I did not again see the patient till confinement, there being apparently entire exemption from the usual derangements attendant on pregnancy.

I use the 1 M potency, because one dose at night is sufficient, while with the 15th, 30th and 200th, I have sometimes been obliged to repeat the dose.

Repertorization:

MOUTH - SALIVATION - sleep, during

MOUTH - SALIVATION – profuse

STOMACH - VOMITING - pregnancy, during

STOMACH - NAUSEA - pregnancy - during

STOMACH - NAUSEA - morning - rising - agg.

STOMACH - NAUSEA - eating - after

STOMACH - VOMITING - morning

STOMACH - VOMITING - eating - after

STOMACH - ERUCTATIONS; TYPE OF - water brash - pregnancy, during

On repertorization  Lactic Acid come prominently with Natrum Mur, Lyco, Nux Vomica, Sepia, Phos, Sil  as indicated remedy. In small Rubrics + Small Remedies group it comes on 1^st rank.

                              

Cerebral Irritation- Apis Mel.

A male infant, seven months old, with the large head and large prominent hazel eyes. Symptoms: single, sharp, shrill scream, both while sleeping and waking; at the same time raising the hand to head back of the ears; bores the head in the pillow; breathes heavily and with difficulty, and gasping; vomits food as soon as taken, followed by retching; retention of urine twenty-four hours; small movement from the bowels, dark, and smelling brassy; high fever; full pulse; short sleep; eyelids half open, pupils turned up. Gave Apis 1 M, one dose dry on tongue. In one hour after, he urinated profusely; urine of a dark color and strong, ruinous odor. Six hours after, had a profuse evacuation, olive green, slimy, and full of bright red lumps, like chopped beet, with colic and tenesmus. The next day he was well and continued so. The mother states, that after taking the remedy he did not scream and the breathing became easier very soon.

Repertorization:

MIND - SHRIEKING - sleep, during

MIND - SHRIEKING - waking - on

HEAD - BORES head in pillow

STOMACH - VOMITING - eating - after

STOMACH - RETCHING - vomiting - after

RESPIRATION - DIFFICULT

RESPIRATION - GASPING

BLADDER - RETENTION of urine

STOOL – SCANTY

STOOL - ODOR - brassy

Combined Rubric

STOOL - DARK

STOOL - BLACK

FEVER - INTENSE heat

GENERALS - PULSE - full

SLEEP - SHORT

EYE - TURNED - upward

EYE - OPEN eyelids - half open

Out of 16 rubrics :  Apis 16/33, Ars 13/29, Arnica 13/25, Lyco 12/28, Bell 12/26, Cupr 12/24, Zincum 12/24