Assignment

“TO UNDERSTAND THE EFFECT OF STRESS AND IMPORTANCE OF CLINICO-
PATHOLOGICO-MIASMATIC C0RELATION IN THE CASES OF ALLERGIC RHINITIS”

AN ASSIGNMENT
SUBMITTED BY
BINAL K. TIMBADIYA
OF
SMT.MALINI KISHORE SANGHVI HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL ,
MIYAGAM-KARJAN
TO THE
GUJARAT UNIVERSITY
IN PARTIAL FULLFILLMENT OF THE REGULATION FOR THE
AWARD OF THE DEGREES
BACHELOR OF HOMOEOPATHIC MEDICINE AND SURGERY
UNDER THE VALUABLE GUIDANCE OF

DR.CHIRAG SHAH
M.D. (HOM.) PSYCHIATRY
DEPARTMENT OF RESPIRATORY SYSTEM
YEAR 2017- 2018
1
TO UNDERSTAND THE EFFECT OF STRESS AND IMPORTANCE OF CLINICO-
PATHOLOGICO-MIASMATIC CORELATION IN THE CASES OF ALLERGIC RHINITIS
GUIDED BY: Dr. CHIRAG SHAH
INTERNEE: BINAL K. TIMBADIYA
2
SMT.MALINI KISHORE SANGHVI HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL
CERTIFICATE
This is to certify that

Miss. BINAL K. TIMBADIYA
As an Intern, with provisional

Provisional Registration no.: 16669
Has satisfactorily completed her assignment on topic TO UNDERSTAND THE

EFFECT OF STRESS AND IMPORTANCE OF CLINICO-PATHOLOGICO-MIASMATIC
CORELATION IN THE CASES OF ALLERGIC RHINITIS during internship,
IN
RESPIRATORY DEPARTMENT
From the period of 5th May 2017 to 4th May 2018.
DATE:
PRINCIPAL SEAL OF COLLEGE HEAD OF THEDEPARTMENT
ACKNOWLEDGEMENT
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It is privilege to be part of SMT. MALINI KISHORE SANGHVI HOMOEOPATHIC MEDICAL COLLEGE
AND HOSPITAL.
I take this opportunity to express my profound gratitude and deep regards to my guide DR.
CHIRAG SHAH [M.D. (Hom.) psychiatry] for his exemplary guidance, monitoring and constant
encouragement throughout of this assignment.
My thanks and appreciation also goes my college in developing the assignment and people who
have willingly helped me out with their ability.
INDEX:
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NO. DEFINE NAME OF PATIENT PAGE NO.
NO.
1. Title 1
2. Certificate 3
3. Acknowledgement 4
4. Aim and objectives 6
5. Review of literature 7
6. Design of study 17
7. 10112 Case: 1 18
8. 9944 Case: 2 25
9. 9678 Case: 3 32
10. Rural case Case: 4 39
11. 9656 Case: 5 45
12. 9979 Case: 6 52
13. 10020 Case: 7 58
14. 9792 Case: 8 64
15. 10030 Case: 9 70
16. 10422 Case: 10 77
17. Conclusion 83
18. Summary 84
19. Bibliography 85
20. Master table 86
INTRODUCTION:
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I have selected the topic “TO UNDERSTAND THE EFFECT OF STRESS AND IMPORTANCE OF
CLINICO-PATHOLOGICO-MIASMATIC CORELATION IN THE CASES OF ALLERGIC RHINITIS” in my
internship training period as my assignment.
In our day to day practice we get many cases of allergic rhinitis. Now a day’s stress is the main
issue for developing different diseases according to their sensitivity and constitution.
Homeopathy treats person as a whole. It affects both at mind and body level.
AIM AND OBJECTIVES:

AIM: To understand the clinico-pathologico-miasmatic corelation and Effect of stress in the
development of allergic rhinitis
OBJECTIVES:
 To understand the clinico-pathologico-miasmatic corelation through SFFT.
 To study what is stress and stress theory.
 To study the different types of stress and daily life stressors.
 To study the effect of stress on our body especially on respiratory system.
 To study the role of suceptibility in understanding miasm and posology.
REVIEW OF LITERATURE:
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ALLERGIC RHINITIS
 Allergic rhinitis refers to the nasal and ocular symptoms that occur because of
development of an inflammatory hypersensitivity reaction to aeroallergens deposited
on the nasal mucosa and conjunctiva.
 It is characterized by sneezing,rhinorrhoea,obstruction of the nasal
passages;conjunctival,nasal and pharyngeal itching;and lacrimation all occurring in a
temporal relationship to allergen exposure. Although commonly seasonal due to
elicitation by airborne pollens, it can be perennial in an environment of chronic
exposure.
 Aetiology:
o Allergic rhinitis is due to an immediate hypersensitivity reaction in the nasal
mucosa.
o Seasonal antigens include pollens from grasses, flowers, weeds or trees. grass
pollen is responsible for hay fever,the most common type of seasonal allergic
rhinitis.
o Perennial allergic rhinitis may be a specific reaction to antigens derived from
house dust, fungal spores or animal dander, but similar symptoms can be caused
by physical or chemical irritants: for exa; pungent odours or fumes, including
strong perfumes, cold air and dry atmosphere.
 Causes:
o The allergic process called atopy, occurs when the body overreacts to a
substance that it senses as a foreign ‘invader’. The immune system works
continuously to protect the body from potentially dangerous intruders such as
bacteria, viruses, and toxins.
o Some people are hypersensitive to substances that are typically harmless.
o When the immune system inaccurately identifies these substances (allergens) as
harmful, an allergic reaction and inflammatory response occurs.
o The antibody immunoglobulin E (IgE) is a key player in allergic reactions. When
an allergen enters the body, the immune system produces IgE antibodies. These
antibodies then attach themselves to mast cells, which are found in the nose,
eyes, lungs and digestive tracts.
o The mast cell release inflammatory chemical mediators, such as histamine, that
causes atopic symptoms (sneezing, coughing, and wheezing). The mast cells
continue to produce more inflammatory chemicals that stimulate the production
of more IgE, continuing the allergic process.
o There are many types of IgE antibodies, and each are associated with a specific
allergen. This is why some people are allergic to cat dander, while others are not
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bothered by cats yet are allergic to pollen. In allergic rhinitis, the allergic reaction
begins when an allergen comes into contact with the mucous membranes in the
lining of the nose.
 Pathophysiology and Manifestations:
o Episodic rhinorrhoea, sneezing, obstruction of the nasal passages with

lacrimation, and pruritus of the conjunctiva, nasal mucosa and oropharynx are
the hallmark of allergic rhinitis.
o The nasal mucosa is pale and boggy, the conjunctiva congested and oedematous,
and the pharynx generally unremarkable. Swelling of the turbinate and mucous
membranes with obstruction of the sinus Ostia and eustachian tubes precipitates
secondary infections of the sinuses and middle ear, respectively.
o Nasal polyps, representing mucosal protrusions containing oedema fluid with
variable numbers of eosinophils, can increase obstructive symptoms and can
concurrently arise within the nasopharynx or sinuses.
o The nose presents a large mucosal surface area through the folds of the
turbinate and serves to adjust the temperature and moisture content of inhaled
air and to filter out particulate materials >10 micro meter in size by impingement
in a mucous blanket; ciliary action moves the entrapped particles toward the
pharynx. Entrapment of pollen and digestion of the outer coat by mucosal
enzymes such as lysozymes release protein allergens generally of 10000-40000
molecular weight. The initial interaction occurs between the allergen and
intraepithelial mast cells and then proceeds to involve deeper perivenular mast
cells, both of which are sensitized with specific IgE.
o During the symptomatic season when the mucosas are already swollen and
hyperaemic, there is enhanced adverse reactivity to the seasonal pollen. Biopsy
specimens of nasal mucosa during seasonal rhinitis show submucosaloedema
with infiltration by eosinophils, along with some basophils and neutrophils.
o The mucosal surface fluid contains IgA that is present because of its secretary
piece and also IgE, which apparently arrives by diffusion from plasma cells in
proximity to mucosal surfaces. IgE fixes to mucosal and submucosal mast cells,
and the intensity of the clinical response to inhaled allergens is quantitatively
related to the naturally occurring pollen dose.
o In sensitive individuals, the introduction of allergen into the nose is associated
with sneezing, “snuffiness”, and discharge, and the fluid contains histamine,
PGD2, and leukotrienes. Thus, the mast cells of the nasal mucosa and sub
mucosagenerate and release mediators through IgE-dependent reactions that
are capable of producing tissue oedema and eosinophilic infiltration.
 Clinical features:
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o In the seasonal type, there are frequent sudden attacks of sneezing, with profuse
watery nasal discharge and nasal obstruction. These attacks last for a few hours
and are often accompanied by smarting and watering of the eyes and
conjunctival infection.
o In perennial rhinitis, the symptoms are similar but more continuous and
generally less severe.
o Skin hypersensitivity tests with the relevant antigen are usually positive in
seasonal allergic rhinitis, but are less useful in perennial rhinitis.
o The general symptoms of rhinitis are congestion, runny nose, and postnasal drip,
in which mucus drips into the throat from the back of the nasal passage,
especially when lying on the back. Symptoms may vary depending on the cause
of the rhinitis. Symptoms of influenza and sinusitis must also be differentiated
from allergies and colds.
 Symptom phases:
Symptoms of allergic rhinitis occur in two phases, early and late.
 Early phase symptoms: The early phase occurs within minutes of exposure to the
allergens and includes:
 Runny nose
 Frequent or repetitive sneezing
 Watery or itchy eyes
 Itching in the nose, throat, or roof of the mouth
 Late phase symptoms: The late phase occurs 4-8 hours later and may include one
or more of these symptoms:
 Nasal congestion and possibly plugged ears
 Fatigue
 Decrease sense of smell or taste
 Plugged ears
 Sinus headache
 Postnasal drip or some combination
 Dark circles may develop under the eye
 The lower eyelid may be puffy and lined with creases
 Mental changes can include
 Irritability
 A slight decrease in attention span
 Worsened memory
 Slower thinking
 MIASM:
 Literally meaning of MIASM during Dr. Hahnemann’s time
• Polluting exhalations
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• Malarial poisons
• Morbific emanations from putrescent organic matter, animal or vegetable.
• Effluvia arising from the bodies of those affected by certain diseases. Some of which
were regarded as infectious and others not.
Miasm denotes the dynamic process producing power which pollutes the human
organism and become the producer of every possible disease condition.
Miasm as predisposition to ill health brought about through hereditary genetic
influence or due to long term deleterious consequences of certain past illness, leaving system
either in a depleted state or with enhanced/ morbid susceptibility that keeps on attracting
further Morbific influences from environment to react in a typical, specifiable morbid manner.
Further this morbidity itself assures a progressive disorder through alteration in the
susceptibility.
• The fundamental miasm: indicated by family history of disease as well as personal past
history.
 The dominant miasm: deduced from a consideration of prominent expression of disease
at the time of observation.
TYPES OF MIASM:
• Psora: it is associated with intense activity/ reactivity of system at all levels and
in all areas with poor sustenance. A shift in favor of sympathetic tone is
inevitable for permitting this type of variety of activity index. It is obvious that
such activity can’t be sustained for long. We denote it by sign.
• Sycosis: it is associated with sluggishness of response of system at all levels and
in all areas. We could denote this state by sign.
• Tubercular: it described as pseudo psora to denote its similarity to psora as far
as activity index goes. Structural pathology resembling that of tubercular
inflammatory response all goes associated with this miasm.
• Syphilis: get characterized by, Active, destructive type with the sign, Passive
degenerative type with sign. That represents the final stage of exhaustion of all
resources.
 PSORA:
According to funk and wagnail’s dictionary the term psora means,
• The itch or some such similar skin disease
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• The itch mite
The psoric substance demonstrates excessive sensitivity to environmental inputs
at all levels in all areas, sustained engagement with any particular input is lacking, thus
resulting in transient engagement which may not permit achievement of results.
The mind find diverse interest and is characterized by quickness, sharpness,
intense responses, swing, oscillations, alterations, changeability, moodiness, periodicity
in expressions and an overall confused state reflected in indecisiveness.
The sleep is light, disturbed and with dreams of diverse types, difficult to remember.
The skin tends to dry, scaly, and given to superficial desquamations in response
to change of seasons. Dry, cold as well as heat tends to aggravate skin as well as mucous
membrane.Control tends to be all poor at all levels and in all areas.
Differential thermal state of body tends to be common.Sensation of all types
commonly experienced.
 Primary Psora: express itself on envelopes –mind, skin, mucous membrane. Mind gets
agitated, excited in progressive, erratic manner to lose which tend to become
progressively inefficient, ineffectiveness and inappropriate.
Expression on skin eruption that, itch a lot especially at night and while in bed and on
perspiration, boils, and secondary infection of eruption, simple urticarial and so on.
The mucous membrane also participates in response excessive normal discharge as well
as discharges from mucous membrane which are irritated. These are generally bland,
they could however be acrid.
 Secondary psora:that gets a start when primary psora is not permitted its
manifestation.
All regulatory systems are thrown out.
Idiosyncratic responses are often released. Intense effect in different area and levels are
common.
The system tends to go into negative balance reflected in debility, defective recovery
and inability to respond adequately and in good time to variable environmental
circumstances.
 SYMPTOMS OF PSORA:-
 Mental symptom
• Bright, active, alert, quick.
• Easily fatigue both mentally & physically
• Restless: in Thought, feeling & will and this lead to restlessness in action.
• Fearful- fear of death, illness, darkness, alone.
• Anxiety –anxious when ill, great inward uneasiness & anxiousness.
• Irritable- angered easily
• Sensitive to many impression
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• Sudden changeable mood
• Despondent , melancholy , sad
• Physical symptoms
• Functional disturbances.
• All kind of functional complaints which arising from emotional disturbances.
• Weak & debilitated
• Coldness is the main ailments
• Dirty, the great unwashed
• Usually chilly, susceptible to cold
• Desire of hot & cold.
• Modality:- worse: sunrise to sunset, after eating, standing, new moon, winter & morning
• Better:- lying down, being quiet, heat, slow movement, weeping,
disturbances,weeping ,diarrhoea, perspiration, urination.
 SYCOSIS:
The word Sycosis had derived from the Greek word“sykon” which means a fig.Sycosis is
a veneral chronic miasm developed due to the suppression of gonorrhoea and is primarily
manifested externally by the cauliflower like excrescences on the genitals.Hence sycosis is also
known as fig wart disease or the condylomatous disease.
It signifies onset of negative energy balance characterized by sluggish responses,
nitrogen and sodium retention with water logging, slowing down of metabolic process and
neural excitability, vagotonia, obesity, a thickened greasy skin with seborrhoea an overall non
engagement pattern of behaviour with continued pre occupation with past, anaemic genoid
constitution, aberrant immune response characterized by non suppurative inflammatory
involvement of fibro muscular structure, serous membrane, basement membrane with immune
response injury on account of defective complement utilization in response to streptococcal/
gonococci/ viral infections and collagen disease.
Suppuration and bleeding occur in next phase of tubercle.<cold, damp weather
SYMOTOMS OF SYCOSIS:-
 Mental symptoms:
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• Suspicious
• Jealous , quarrelsome ,deceitful , -criminal insane
• Mischievous
• Secretive
• Tendency to suicide but fears
• Cross, irritable,with hit of anger
• Self-condemnation
• Fixed ideas
• Slow mental power
• Physical symptoms:
• Serous, fibrous tissue & muco-cutaneous margins are involved.
• Tendency to develop rheumatic condition.
• Slowness of recovery
• General relief from discharges
• Greenish or yellowish colour &fish brine odor of all discharges.
• Worse: cold, damp place rain, thunderstorm, thinking of disease, day time.
• Better: moving, lying on abdomen, stretching
 TUBERCULAR (PSEUDO-PSORA):
Increase activity at all the levels- Intellect, emotional and physical.Phase of
hypersensitivity is prolonged & marked. Responses are:hyper dynamic , changeable ,&
alternating in relation to the emotion , desires , will , intellect , motives ,drives ,
disposition in time &space circulation , endocrines including sex, GI tract , bones and
sensory-motor system.
Tubercular process is identified through the indurations. It produces with
subsequent softening, abscess formation, sinus formation, subsequent fibrosis &
scarring of puckered type with tendency to break down frequently.
 MENTAL SYMPTOM:
 Extreme hypersensivity to external stimuli
• Quick responsiveness
• Quick registration of sensory inputs, their analysis &interpretation by mind.
• Active & adequate memory–storehouse & recall system for reference
• There is heightened perception, extra sensory perception & clairvoyance.
• Active thinking to the point of precocity , creativity , & imagination
• But , will , drive , & motivation being poor, the heightened imaginations , desires and
strong attachments fall quiet short of translation in to practice results in frustration ,
disappointment & consequent feeling of insecurity leading to anxiety , fear & fright
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• Unfulfilled desires express through day & night dreams
• Extreme desire and attachment to sex at mental level lead to excessive indulgence with
its consequence of incompetence & physical debility
• Extreme nervous irritability & excitability
• Irritability express at the physical level- spasmodic effects, epilepsy, grinding of teeth
during sleep.
• Physical symptom:
• Overstimulation of the sympathetic results in activation of endocrines & metabolic
process
• Increased catabolism, decreased anabolism, poor assimilation & anaemia
• Excessive action of the thyroid, hyperthermia,hectic fever with night sweat ends with
debility
• Emaciation general as well as local
• Diabetic syndrome
• Skin pigmentation
• Cracks & fissures of skin
• Premature greying of hair & pustules formation
 SYPHILIS:Destruction at all the levels

Following data suggest the presence of syphilis:
• History/evidence of clinical syphilis
• Repeated abortion /miscarriage
• Still birth, neonatal death, foetal abnormalities, congenital anomalies,placenta previa,
vesicular mole, toxaemia of pregnancy, cancer, ectopic organs & tissue
 Mental symptoms:
• Less subjective symptom • Impulsive
• Dull, stupid, idiot, imbecile • Thinks of suicide & commits it
• Suspicious • Mistrustful
• Closed mouthed fellow. Keeps his • Fixed moods & ideas
troubles to him self • Slow in action
 Physical symptoms:
• Destruction & ulceration of tissues
• Involvement of mucocutaneous parts, nervous system & blood
• Eruption on joints , flexures of body , arrange in circular grouping , copper coloured. No
itching & heavy soreness
• Thick & heavy scales
• Varicose ulcers are the last destructive manifestation on skin
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STRESS
What is stress?
Stress can be described as a circumstance that disturb,or is likely to disturb, the normal
physiological or psychological functioning of the person.
Stress is primarily a physical response, when stressed, body thinks it is under attack and
switches to ' fight to flight ' mode, releasing a complex mix of hormones and chemicals such as
adrenals, cortisol and norepinephrine to prepare the body for physical action.
Stress Theory:
In the 1920s, Walter cannon conducted the first systematic study of the relation of stress
to disease. He demonstrated that stimulation of the autonomic nervous system, particularly the
sympathetic system, readied the organism for the "fight or flight" response characterized by
hypertension, tachycardia and increased cardiac output. In the person who could do neither
civilized, the ensuing stress resulted in disease.
In the 1950s, Harold Wolff observed that the physiology of gastrointestinal tract appeared to
correlate with specific emotional states. Hyper function was associated with hostility and hypo
function with sadness.
Hans Selye developed a model of stress that he called the general adaptation syndrome. It
consisted of three phases:
1) The alarm reaction.
2) The stage of resistance, in which adaptation is ideally achieved.
3) The stage of exhaustion, in which acquired adaptation or resistance may be lost.
He considered stress a nonspecific bodily response to any demand caused by either pleasant or
unpleasant conditions. Selye believed that stress, by definition, need not always be unpleasant.
He called unpleasant stress distress. Accepting both types of stress requires adaptation.
The body reacts to stress - in this sense defined as anything (real, symbolic, or imagined) that
threatens an individual's survival - by putting into motion a set of responses that seeks to
diminish the impact of the stressors and restore homeostasis. Much is known about the
physiological response to acute stress, but considerably less is known about the response to
chronic stress.
 TYPES OF STRESS:
1. Acute stress: Most common type. It's your body's immediate reaction to a new
challenge, event or demand and it triggers your fight or flight response.
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2. Episodic acute stress: When acute stress happens frequently, it's called episodic acute
stress. People who always seem to be having a crisis tend to have episodic acute stress.
They are often short tempered, irritable and anxious.
3. Chronic stress: If acute stress isn't resolved and begins to increase or last for long
periods of time, it becomes chronic stress. It can stem from such things as poverty, a
dysfunctional family, an unhappy marriage, a bad job etc...
 TYPES OF STRESSORS:
a. Eustress: Eustress is any kind of challenging stimulus that stresses the individual but with
the result that they feel energized, motivated or compelled to respond or make some
kind of beneficial action for themselves.
b. Distress: Distresses is when stress, trauma, anxiety and worry are not productive and
instead of inspiring healthful action, cause the person to shut down.Stresses that
paralyzes a person in fear, interferes with their ability to think clearly, work, interact with
others or fulfil their obligations in daily life is not helpful stress.
 IMPLICATIONS AND APPLICATIONS:
The most important applications of the stress concept as regards purely somatic
medicine are derived from the discovery that the body can meet various aggressions
with the same adaptive defensive mechanism. This shows that how to combat disease
by strengthening the body’s own defences against stress.
This also has important psychosomatic implications. Bodily changes during stress
act upon mentality and vice versa. Stress plays a role in such diverse manifestations of
life as aging, the development of individuality, the need for self-expression, and the
formulation of man’s ultimate aims.
Stress is usually the outcome of a struggle for the self-preservation of parts
within a whole.
THE STRESSORS OF DAILY LIFE:
Stress was identified with mental arousal, frustration at one’s work or in private life, the
necessity of facing responsibilities beyond one’s capacities, physical exhaustion, and
fatigue-and not with its agreeable, even curative actions. The stress mechanism, like the
consumption of energy, and, indeed, nature in general, is quite indifferent to human
concepts of good or bad.
Stressors are such as, air and water pollution, social and cultural stressors,
crowding, sensory deprivation and boredom, isolation and loneliness, migration,
relocation and travel, urbanization, catastrophes and neuro psychologic stressors.
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DESIGN OF STUDY
A) Inclusion & exclusion of study
Inclusion criteria of study:

 I will take the cases of patients with the diagnosis of allergic rhinitis.
 I will take the cases in which patients have any type of stress either mental or physical in
their life.
 I will take the cases of those patients whose case is defined thus; I can get both physical
& mental symptoms of patient.
 I will take those cases in which result is better after giving constitutional remedy.
Exclusion criteria of study:

 I will exclude the cases of allergic rhinitis in which there is no any type of stress.
 I will exclude the cases in which there is no follow up after first dose of medicine, in
which I cannot get the action of our medicine.
 I will exclude the cases in which cannot found the details of patient in manner of
physical as well as mental symptoms from which I cannot evaluate the patient.
B) Method of collection of cases
 I have collected the cases from different OPDs of MKSHMC; especially from respiratory
department,
o in which i have seen the follow ups,
o observed the case definition
o discussed with my guide about old cases
 I have collected cases in which stress is one of the factor to cause allergic rhinitis
C) Method of study:
 First of all I will study the sign & symptoms of patient that will match with allergic
rhinitis’s sign & symptoms.
 Then I will take the physical generals of patient.
 Then I will study the mental symptoms of patient. From both of these physical &
mental symptoms of patient, I can come to the similimum homoeopathic medicine.
 After giving medicine I will make criteria of symptoms from which I can conclude the
level of cure in patients.
 At last I will study the follow up from which I can come on conclusion about action of
medicine.
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Case no: 1 Define no: 1011 OPD no: 57567
Name: PCS
Age: 33 years Sex: male Education: 10th fail
Occupation: job in company of wiring Status: marriedReligion: hindu
Veg/Non-Veg: all Brothers: 1 younger – 30 years of age Sisters: 0
Address: shokhada, padara.
CHIEF COMPLAIN:-
SENSATION& MODALITIES
NO. LOCATION ACCOMPANIMENTS
PATHALOGY A.F, <, >
1. RS Running watery A.F: dust, strong Sleep: disturbed
Nose discharge+2 smell Thirst: increased
O:since 2-3 years Sneezing+2 <+2damp rainy Appetite: decreased
increased since 1 Coughing+ weather
year <+2night
f:10-15 >+2allo RX cetirizine
days/month
2. Difficulty in breathing+ <+2night
chest
o:since 2-3 years Heaviness+2 <+lying down
<+2by sitting
3. +2
>+allopathic Rx
eyes Watering >+2cold water
o:since 2-3 years Burning+2 application
Itching+2
Redness+2
ASSOCIATED COMPLAINTS:-
SENSATION& MODALITIES ACCOMPANIMENT

NO. LOCATION
PATHALOGY A.F, <, > S
1. Skin Papular eruption A/F: allopathic RX
O: 1 year Redness+ >+2cold water bath
D: 3-4 hours Itching+2
Burning+2 due to
scratching
A. PHYSICAL CHARATERISTIC:
 APPEARANCE: lean, thin, dark complexion
 PERSPIRATION:General: scantyPartial: legs+2, chest+, axilla+
 DIGESTION:Thirst: 2-3 litres/dayAppetite: intolerable, <weakness
Craving: sweets+3, pungent+2Aversion: bland+2
 ELIMINATION:Stool: normalUrine: normal
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 SLEEP:Duration: 8-9 hours/night Position: on both sides Disturbed: by noise & complains
 DREAMS: as if someone died
 DIET AND DAILY ROUTINE: he wakes up at 6 a.m., then after fresh up do breakfast of tea, roti.
Then goes to job at 8 a.m., then take tiffin with him and do lunch at 12 p.m., then return at
5:30 p.m. at home. Then do breakfast with tea and dinner at 7 p.m., then watch t.v. and sleep
at 9 p.m.
B. LIFE – SPACE
A 33 yearsold man came to the opd withcomplaints of cold, cough, sneezing and
watering of eyes.
Pt was born in kurali. Pt passed his childhood in sokhda village in padara. Pt lived with
mother, father, uncle, gfa, gmo and one younger brother. His uncle got married when pt was
20 years old. Pt has one cousin sister. Now their family lives separated since 10-15 years due
to quarrels between pt’s fa and uncle. Uncle not do work and not earn money. His fa is doing
job in banko (aluminium made things). Uncle got married after they separated. Their financial
condition was good. All needs were fulfilled.
Pt was good in study but writings were not good, so failed in 10 th std. and got more than
50%. Pt was interested in study but pt got job 40 Rs. per day. So pt left study by himself. He
not took part in other cultural activities, likes to play cricket. Pt has good relations with
teachers. Once pt had beated one friend a pen in masti and teacher had punished him but pt
not got angry on him because it’s his fault. Pt has 4-5 best friends. Good relations with all
friends. Sometimes gets angry on friends but then forget. Pt said, ”mari koi masti kare to
thodo time game pachchi gusso ave etle boli dau.” Good relations with brother. Now they live
separately in one house in different floors. His parents lived with brother. Both brothers’
wives have not good relations with each other, quarrels in matter of working.
Pt got married in 2005. His wife’s nature is good. When pt came after drinking, his wife
gets angry on him. Pt not replied anything, “pote bole to lambu thay.” Then after pt has
regret for it. Pt sleeps after drinking. Pt not gets angry on her wife. Sometimes gets angry but
not speak anything to anyone. Pt said, “boline su faydo, man ma j rakhvanu.” Anger remains
15-20 min. pt keeps anger in mind and thinking about it and speaks out in time. Pt has good
relations with parents. Their nature was good. Not tell him anything. Fa hit sometimes pt in
anger and take him to home when he wanders outside in sun heat. Pt not tell anything in
matter of his wife and bhabhi’s quarrels. First parents lived with pt but now lived at bro’s
home because bro has one son, newborn child. So they have anxiety for son. Now pt’s
financial condition is good. His son is good in study but wanders much so pt has anxiety for
him that if he will study or not. Pt is sympathetic by nature, helps others of money. Pt has
hobby of watching t.v., travelling and sports. He is interested in work and good relations with
collegues. He also has good relations with neighbours. He does work fast and clean. He has 4
vigha land and his fa is doing farming now. And his wife is house wife.
C. REACTIONS - PHYSICAL FACTORS:

 MOTION & POSITION: no any effects
 METROLOGICAL:- Thermal: C3H2
19
D. CHRONOLOGICAL SEQUENCE:
 PAST HISTORY: jaundice at the age of 22 years
 FAMILY HISTORY: fa: asthma
 PHYSICAL EXAMINATION:
B.P.: 120/100 mmhg PULSE: 76/min WEIGHT: 56 kg
CONJUCTIVA: pinkNAIL: pink TONGUE: pink, moist
 SYSTEMIC EXAMINATION: RS: clear, air entry: BLE, breath sound: vesicular
 INVESTIGATION: serum IgE-1677.2 IU/ML
 PROVISIONAL DIAGNOSIS:
ALLERGIC RHINITIS and URTICARIA
20
SFFT (structure-form-function-time):
Nose, Para nasal Sinus, Mucus Membrane

Para nasal sinus inflammation
Enlargement of mucous glands
Oedema of sub mucosa
Hypertrophy of mucous membrane
Structure
tit
Since 2-3 years
Form Function
Running watery discharge,
Sneezing Formation of tenacious mucous
Increase mucous secretion
Coughing
Nerve irritation
Watery and burning eyes Increase lacrimation
Difficulty in breathing
Diagnosis: Allergic rhinitis

Miasm: sycotic
21
 TOTALITY:
 Cool and calm by nature
 Irritable+2: when someone tease him
 Anger+2: keeps in mind, not express out
 Anxiety+2: for future of son
 Sympathetic+: helps of money
 Fastidious+2
 Dreams as if someone died+2
 Sleep: position- on sides, disturbed by noise+2 and due to complains+2
 Perspiration: scanty on legs+2, chest+2 and axilla+2. Staining linen white.
 Cravings: pungent things+2, sweets+3.
 Hunger<+2weakness
 Flatulence<+2night and eating onions
 REPERTORIAL REPERSENTATION:
 Mind- irritability- aroused when
 Mind- anger- suppressed
 Mind- anxiety- children- about his
 Mind- fastidious
 Dreams- dead- of the relatives
 Sleep- position- side on
 Sleep- disturbed- noise by the slightest
 Perspiration- scanty sweat
 Perspiration- staining the linen- white
 Generals- food and drinks- sweets- desire for
 Generals- food and drink- pungent things- desire for
 Extremities- perspiration- legs
 Chest- perspiration- axilla
 Generals- weakness- hunger from
 Rectum- flatus- night- aggravation
 REPERTORIAL RESULT:
 Sulph-19/9
 Phos-16/9
 N.v.-18/8
 Calc p-8/6
 Lyc-8/5
 Nat.m-8/5
 Sil-7/5
 Calc-9/4
22
 REMEDY DIFFERENTIATION:
Calc carb Calc phos
 Cool and calm by nature  Bad effects after grief, vexation
 Irritable when someone teases  Peevish
 Sympathetic  Com.<thinking about them
 Craving-sweets  <damp cold weather
 Weakness<by hunger  >summer and warm weather
 Disposition to catch cold easily  Chilly pt.
 Chilly pt
 MIASMATIC UNDERSTANDING:
Miasm: In this case, clinico-pathological symptoms indicate sycotic miasm.
 PLANNING & PROGRAMING:

Define with reasons the states PotencyChoice Repetition
1. Susceptibility (tissue) Moderate Infrequent
Age: 33 yearsSex: male
Pace of disease: gradual 200
Tissue Changes: functional
2. Sensitivity (Mind & Nerves) Moderate Infrequent
Mind: ++Nerves: +++
200
Sleep: ++Dreams: ++
3. Correspondence (degree & level) Const. Rx - Cal.carb Infrequent
Mind: ++Body: + 200
4. Functional changes Moderate to high Infrequent
Present 200 to 1M
5. Structural changes
No
6. General vitality Low to moderate Infrequent
Good 30 to 200
7. Presentation-
Moderate Infrequent
A. Fundamental miasm
Fa-asthma
200
Miasm: sycotic
B. Dominant miasm Moderate toHigh Infrequent
Sycosis 200 to 1M
 ENTRY-FIRST Rx WITH DATE:

1/11/17: CAL CARB 200 3P HS
SL PILLS TDS/ 1 WK
 CRITERIA:
1. Running nose 4. Heaviness in 7. Itching in eyes
2. Sneezing chest 8. Redness of eyes
3. Breathing 5. Watery eyes 9. Skin: papular
difficulty 6. Burning in eyes eruption
23
10. Itching at 11. Burning due to
eruption scratching
 FOLLOW-UP:
DATE 1 2 3 4 5 6 7 8 9 10 11 INTERPRETATION PRESCRIPTION
+ + ++
8/11/17 > > > >+ >+ >+ >+ SQ >+ >+ >+ Better 25% CALC CARB 200
3P HS
SL PILLS TDS/
×2 WEEKS
22/11/1 >++ >+ >+ >++ >+++ >++ >+ >+ >+ >++ >++ Better 50% CALC CARB 200
7 3P HS
SL PILL TDS/
×4 WEEKS
20/12/1 <+ <+ >+ >++ <+ >+ >+ <+ >+ >++ >++ Since 10 Days CALC CARB 200
7 Acute episode but 3P HS
feels better SL PILLS TDS/
Appetite-normal ×4 WEEKS
Thirst-normal
24/1/18 >++ >++ 0 0 >++ >++ >++ 0 >++ >++ >++ Overall better CALC CARB 200
Appetite-normal 3P HS
Thirst-normal SL PILLS TDS/
O/E: BP- 130/80 ×4 WEEKS
mm of hg
Pulse-64/min
RS- clear
14/3/18 >+ >++ <+ <+ >++ >++ >++ >++ <+ <+ >++ Better CALC CARB 200
Appetite-normal 3P HS
Thirst-normal SL PILLS TDS/
O/E: BP-126/80 ×4 WEEKS
mm of hg
Pulse-76/min
RS- clear
18/4/18 >++ >++ >+ O >++ >+ o >++ <+ <++ <++ Appetite-normal CALC CARB 200
both
Thirst-normal 3P HS
cubital
SL PILLS TDS/
fossa
×2 WEEKS
 CONCLUSION:
Pt has anxiety of his son’s future and has stress due to quarrels at home. Due to this, he
developed allergic rhinitis / urticaria.
Allergic Rhinitis has a functional Changes. Overall case indicates sycotic miasm. After giving
constitutional medicine Calc.Carb in moderate potency and in infrequent doses, pt feels
better all over.
24
Name: CCH
Age: 40 years Sex: female Education: 10th pass
Occupation: house wife Status: married Religion: darbar
Veg/Non-Veg: Veg only
Brothers: 1-younger-38 years Sisters: 1-elder-expired in 2004
Address: karjan
CHIEF COMPLAIN:
PATHALOGY A.F, <, >
1. RS Cold++ +2
< winter
O: since 5 years Watery discharge+ <+2monsoon
D: 3-5 days <+2dust
F: 1-2 times/month <+2eating ice cream
and bananas
2. Throat Pain+2 <+2fan
Soreness+ <+2drinking cold
Stinging pain+2 drink
>+2allo Rx
3. >+2warm water
Head Pain+2 >+2lying down
Rt side
Frontal and above
upper eyelids
4. Pain+2
MSS >+2rest
Whole body
ASSOCIATED COMPLAINTS: NO
 APPEARANCE: medium built and fair complexion
 PERSPIRATION:General: mediumPartial: on face+2, axilla+2, head+2
 DIGESTION:Thirst: 2-3 litres/dayAppetite: tolerable
Craving:pungent+2, sweets+2, sour+2 Aversion: no
 SLEEP: Duration: 9 hours position: changingDisturbed: no
 DREAMS: dead(sis), snake bites, snake in water, pt hits to snake, as if someone died,
robbers
 MENSTUAL HISTORY:
F.M.P: 15 years of ageL.M.P: 5/9/2017Menses: regular Cycle: 28 daysDuration: 3-4 days
Color: dark redStains: no
Concomitants:- B.M: no
D.M: 2 days: back pain and abdominal pain
A.M: no
 LEUCORHOEA: since 2 months, D: 1 week after menses
 PATIENT'S/ MOTHER'S OBSTETRIC HISTORY:
Pregnancies: Gravida: 6 Para: 2
25
 DIET AND DAILY ROUTINE: 7 a.m.-wake up and fresh up
8 to 8:30 a.m.-breakfast, do pooja and then cooking
12:30 to 1 p.m.-lunch
Afternoon-2 hours-sleep
Take tea then cooking at evening
8:30 to 9 p.m.-dinner then watch t.v. and sit with neighbours
12 to 12:30-sleep.
B. LIFE – SPACE
A 40 years old lady came to the opd with complains of cold, throat pain,
headache and body ache.
Pt was born in moti koral. She has passed childhood in mangrol. She was lived
with mo, fa, bro and sis. Gfa and Gmo lived separated. Father is doing service of police.
Mo is house wife. Brother is younger and sister got married when pt studied in 7 th std. pt
has not interest in study but more interest in playing. Done cheating in exam and sir
caught her and scold her. But pt had not much effect of that matter. Pt has one best friend
and 6-7 other friends. Good relations with friends. Till 5 th std. she was studied in mangrol
then till 10th std. in miyagam. Her friends said, “navi chhokri avi to bolvanu nai eni jode.”
They said her to sit at last bench and laughed at her. That time pt feeled that I don’t have
to study. She feels sad and can’t speak and cry in alone. Don’t share with anyone. Only
share with sister. Good IPR with teachers. Once one teacher scolds her and then she
bunked her lecture. She went for wandering and watching movie with friends. Not
interested in other activities. She took part in singing and garba. She has anxiety before
performance and exam. Then she left study. Her father feels that she has weak mind in
study. Then he refused her for study.
She got married at the age of 20 years. There she lived with FIL, MIL, one
younger BIL, and one kaki sasu. Pt has good relations with all family members. Pt has some
fights with BIL and younger co-sis. Pt’s husband and her BIL fight with each other. Fight
occurs because her BIL feels that “emne vadhu kharch thay chhokrao no, amare ochho.”
So then they separated. Younger co-sis lives in Baroda and pt has to live with kaki sasu, FIL
and MIL. So pt complain her about this. Pt has to wear sari and co-sis wears dress. Due to
fights, pt has much anger. Pt speaks bad words but not hit anyone. Then after she has
regret for what she spoken. But now they living separated. So not fight with anyone.
Her husband’s nature is good, Mostly no fights with him. She said, “ene
anukul lage evu kare.” Keep work separately. Sometimes husband anger on pt. when
fights occur at In law’s home, she went to maternal home. So husband got angry on pt. pt
not replied to husband. Her husband don’t like when pt went her maternal home. Hus
refused pt for go to her maternal home. Her hus. Said that “chhokrao na admission mate
tara bhai paisa kem na aape, to rakhadi bandhva nahi javu” pt said that “apno hak tya na
lage, ghar ma thi j paisa lavo ane na ape to jamin alag kari do.” Pt said to her husband that
let to do farming to your brother himself. Pt keeps good relations with kaki sasu. “emne
bolva joie, sambhlave pn hu kai na bolu.” Her kaki sasu is widow and she has no child, so
pt has sympathy for her. Pt has also good relations with MIL and FIL. Their nature is good
and no fight occurs between pt and them. Pt has anxiety for daughter. Daughter is now in
Rajasthan, studying B.D.S. Pt said, ”I want to live with her in Rajasthan but my husband
refused.” Pt said, ”jiv balya kare.” Pt has continuous thoughts of her daughter in her mind.
When her daughter is not present at home, she feels sad and cried. Daughter is good in
26
study. Her son has not much interest in study but passes exam. Pt has no anxiety for son
because if he would not study, he will do farming. They have 80 vigha land. She allows her
children to do whatever they want. Pt likes to be alone. She has hobby of garba and
travelling. But she can’t complete it because she has restrictions from in law’s family.

 MOTION & POSITION:no any complains
 METROLOGICAL:- Thermal:C3H2
D. CHRONOLOGICAL SEQUANCE:
 PAST HISTORY:small pox and dysentery
 FAMILY HISTORY:FA-DM, MO-asthama
PULSE:70/min CONJUCTIVA:pinkNAIL:pink TONGUE: pink
 SYSTEMIC EXAMINATION:RS-clear, Breath sound-vesicular
 ALLERGIC RHINITIS WITH SINUSITIS
 MUSCULAR PAIN
27
Rs-Nose, paranasal sinus, mucous membrane of nose and throat

Oedema of submucosa
Inflammation of mucous membrane
Inflammation of paranasal sinuses
Structure
Time
Since 5 years
Since
Since
5 years
5 years
Form function
Watery running discharge Formation of tenacious mucous

Throat pain Mucosal protrusion
Soreness of throat
Headache
Diagnosis: Allergic rhinitis with sinusitis

Miasm: sycosis
28
 TOTALITY:
 Anger++-when feels restricted-spoken out
 Anxiety++-about her daughter
 Anticipatory anxiety++
 Suppressed desires and wills
 Cry in alone
 Memory-weak
 Sleep-changed positions
 Dreams-of daily routine++, dead people+, snakes biting+, snake in water+, robbers+ and if
someone will died.
 Cravings-pungent++, sweet++, sour++
 Perspiration-scanty on face++, axilla++, head++
 Sun<skin eruptions
 Back pain during menses
 Leucorrhoea-after menses
 Chilly pt
 Mind- anger- aroused when
 Mind- anxiety- children-about her
 Mind- anxiety- anticipation from
 Mind- desires- suppressing her desires
 Mind- weeping- alone when
 Mind- memory- weakness of memory
 Sleep- position- changed frequently
 Dreams- dead, of the
 Dreams- snakes- biting her
 Dreams- robbers
 Face- perspiration
 Chest- perspiration- axilla
 Head- perspiration of scalp
 Generals- F & D- pungent things- desire for
 Generals- F & D- sweets- desire for
 Generals- F & D- sour food- desire for
 Skin- eruptions- sun from
 Back- pain- menses during
 Female genitals- leucorrhoea- menses after
 Phos- 24/13  Sulph-24/11  Sep- 22/10  Calc p- 17/9
 Kali c-21/12  Sil- 22/11  Lyc- 20/10  Mag c- 16/9
 Nat mur- 20/12  Calc- 24/10  Puls- 20/9
29
Nat mur: Kali carb
Anger+2-spokenout Anxiety-for her children
Anxiety-about her children Anxious when children go outside home
Desires-suppressed Desire company
Dreams of dead people and snake Alternate mood with irritability
Desire-pungent and sour food A/F-exposure to cold, ice cream, iced
Cry in alone water
Back pain during menses
 MIASMATIC UNDERSTANDING:
From overall understanding of this case, it indicates sycotic miasm.

Age- 40 yearsSex- female
Pace of disease- gradual 200
Tissue changes- functional
Mind-++ Nerves-++ 200
3. Correspondence (degree & level) Const. Rx
Infrequent
Nat.mur
Mind-++ body-++
4. Functional changes High Infrequent
Present 1M
No
6. General vitality Good Infrequent
Good 200
7. Presentation-
Moderate Infrequent
Sycotic 200
B. Dominant miasm Moderate Infrequent
Sycotic 200

6/9/17:
SL 1P HS
RHUS TOX 200 TDS/ 1 WEEK
 CRITERIA:
1. Throat pain 4. Expectoration 7. Leucorrhoea
2. Nasal discharge 5. Headache 8. O/E: RS
3. sneezing 6. Bodyache
 FOLLOW-UP:
30
DATE 1 2 3 4 5 6 7 8 INTERPRETATION PRESCRIPTION
10/1/18 Sq sq sq sq >+ sq <+ RS-clear Acute episodes SL 1P HS
f-2-3 SL PILLS TDS/
times/month ×2 WEEKS
24/1/18 0 >+ >+ 0 <+ >+ >+ RS-clear Better NAT MUR 200 1P
BP- HS
110/80 SL PILLS TDS/
mm hg ×2 WEEKS
Pulse-
68/min
28/3/18 O >+ >+ 0 0 >++ Sq 2 corns Better over all NAT MUR 200 1P
in left HS
foot SL PILLS TDS/
RS-clear ×4 WEEKS
BP-
110/70
mmhg
 CONCLUSION:
Pt has very much anxiety for daughter. And she suppressed her desires and feels restriction
from in laws. Due to all this stresses, she developed allergic rhinitis. There is ongoing
continuous process of inflammation which is functional in nature. Overall case indicates
sycotic miasm. After giving constitutional remedy NATRUM MUR, 200 potency, infrequent
repetition, she feels better overall and decreased frequency of episodes.
31
Case no: 3 Define no: 9678OPD no: 58737
Name: PAK Age: 23 years Sex: female Education: M.C.A. Occupation: job at BIT INFO.TECH
Status: single
Religion: leuva patelVeg/Non-Veg: veg.
Brothers: 1-younger-B.E.Sisters: noAddress: karjan, Sai sumeru soc.
CHIEF COMPLAIN:
PATHALOGY A.F, <, >
1. RS
Nose Running+2 <+2after wake up Appetite-normal
o- since 1 year Discharge: <+2fumes Thirst-normal
f- daily white+2,sticky <+2dust
D-once it comes, <+2closed room
remaining for ½ <+2summer
hour <+2winter
f-10-15/once Sneezing+2 >+2open air
<+2change of
weather
Suffocation+2 <+2closed room
No breathing difficulty
No fever
2.
Throat Dry cough++
o- since 1 week
f- occasionally
ASSOCIATED COMPLAINTS: NO
 APPEARANCE: fair, medium built
 PERSPIRATION:General: scantyPartial: face+2
 DIGESTION:Appetite: goodCraving: curd+2, pungent+2, sour+2
Aversion: cold drinks+2, sweets+2
 SLEEP:Duration: 9 hoursposition: on backDisturbed: by slightest noise and light
 DREAMS: of daily routine, not remembered.
 MENSTUAL HISTORY:
F.M.P: 7th std.L.M.P: 07/06/2017Menses: regular Cycle: 30 daysDuration: 4 days
Color: cherry red Stains: no
Concomitants:- B.M: back pain before menses
D.M: abdominal pain for 1-2 days
A.M: no
 LEUCORHOEA: white drops <hard work or exertion, washable
 DIET AND DAILY ROUTINE:
7 a.m.-wake up
32
7:30 to 8:00 a.m.-household work
8:30-gets ready
9 a.m.-go Baroda for job
10 a.m.-reach office
10 a.m. to 1 p.m.-work at office
1 p.m.-lunch
1:30 p.m. to 5:30 p.m.-work at office
6 p.m. to 8 p.m.-reach home
8:30 p.m.-dinner
10 p.m.-sleep
B. LIFE – SPACE:
Pt came in opd with complain of rhinitis since 1 year. She is of fair complexion
and medium built.
Pt was born at Sarbhan. She passed her childhood at sarbhan. Over all childhood
passed good. Her all demands were fulfilled. She has 2 uncle and 3 foi. Her father was
youngest of all. She was living with father, mother and younger brother. Her father’s
nature is angry and scolds in anger. Her mother’s nature is angry. She scolds to pt when
pt works slowly. Pt has no any effect of it. Pt is spoken out only in front of her mother.
Pt gets irritated when parents scolds to her brother because of he rides bike fast. So pt
told to them that they should told him, not to scold him. Sometimes pt fights with her
brother. She is more attached with her mother.
Pt has passed 1 to 6 std. at sarbhan. After that she went to hostel because
further study was not satisfied in sarbhan. She passed 7 th std. in nadiad. But there has
no enough facility and pt was not comfortable there. First time when she went to
hostel, she cried and missed her mother. She told parents to take her home. After that
she studied 11th and 12th std. at amreli. There were more facilities than nadiad. And pt
was comfortable there. After few times, she became habituated to hostel and less
missed mother.
Pt was good at study. She got 70% in exams. Pt also participated in other
activities like judo. She had also taken part in N.C.C. camp. When some girls fight in
hostel, she became irritable.
Pt has studied till M.C.A. She had passed B.C.A. at vidhyanagar and M.C.A. at
changa. At starting of B.C.A. she missed her school friends and thought that school life
was better than college life. She felt lonely. But after some times, she made friends in
college. Her cousin was with her during whole study. Pt had some friends who were
doing B.C.A. when she was doing M.C.A. There were also boys in friend circle. Pt has
good IPR with all friends. When some problems occurs, her friends handle it and didn’t
reach to the pt. Once one boy messages and calls to pt continuously. Pt didn’t like it. So
pt’s friends handled it. Pt had no any affair. When there was fight occurs with friends,
she short out it as soon as possible but if fight occur with some other person, she let go
her and make distance with her.
When there is late night parties, pt’s father don’t like it, but he mot tell her
directly. He tells to pt’s mother that it is better that pt should not go there. Pt wanted to
go but she didn’t, because she don’t do anything that father don’t like.
33
Pt had completed her study 6 months before. She has started job since 1 year
from the time of internship. At job, she has good IPR with all. Now a day, pt’s parents
started talking about her marriage. Pt doesn’t like it. She has anxiety about in law’s
nature and anxiety if she will be mix with them or not. She doesn’t like to get ready and
sit with them surrounded by unknown people. She only likes to sit with known person
and talk with them. But she has to go there because her parents want.
Pt’s nature: pt gets angry on smallest things. But she can’t express it. Due to
anger she got headache. Pt is very irritable. She doesn’t like quarrels. Pt doesn’t easily
mix with unknown person. She always wants to surround by known persons only. Pt
cries when alone.

 MOTION & POSITION:no any effects
 METROLOGICAL:- Thermal:chilly pt
D. CRONOLOGICAL SEQUANCE:
 PAST HISTORY:lasic operation before 3 years
 FAMILY HISTORY: MO-thyroid, DM. FA-back pain
PULSE: 72/min WEIGHT: 54 kg CONJUCTIVA:pink
NAIL:pink TONGUE:pink
 SYSTEMIC EXAMINATION: RS-clear, air entry-BLE, Breath sound-vesicular
 PROVISIONAL DIAGNOSIS: ALLERGIC RHINITIS
34
Rs-nose, throat, paranasal sinus, mucous membrane, mucous glands

Inflammation of paranasal sinus
Since 1 year
Running white, sticky discharge

Sneezing
Nerve irritation
Coughing
Obstruction of nasal passage
Suffocation

Miasm:psora
35
 TOTALITY:
 Anger+3-suppressed-causes headache
 Irritable+3
 Anxiety++-anticipatory-about marriage and in law’s nature
 Aversion to quarrels+2
 Don’t mix easily with anyone
 Slowness+2 in work
 Like company+2 of friends
 Fear+2-horror movie-thoughts after watching
 Dreams-snake++-unremembered
 Sleep-disturbed by slightest noise+2, light+2
 Cravings-sour+2, spicy+2, curd+2
 Aversion-sweet+2, cold drinks+2
 Perspiration-scanty on face
 Before menses-back pain+2
 During menses-abdominal pain+2
 Leucorrhoea-white-drop like
 Sun<+2headache
 Hunger<+2headache
 Strong smell<+2headache
 Chilly pt
 mind-aliments from-anger suppressed
 head-pain-anger from
 mind-irritability
 mind-anxiety-anticipation from
 mind-company-desire for-friend, if
 mind-quarrelling-aversion
 mind-weeping-alone when
 mind-slowness-work in
 dreams-unremembered
 dreams-snakes
 sleep-disturbed-noise, by the slightest
 generals-F&D-pungent-desire
 generals-F&D-sour food and acids-desire
 generals-F&D-sweet-aversion
 generals-F&D-cold drink, cold water-aversion
 perspiration-scanty sweat
 face-perspiration
 abdomen-pain-menses-during
 back-pain-menses-before
 head-pain-sun-from exposure to
 head-pain-fasting from
 head-pain-odours-strong-from
36
 sleep-position-back, on
 Sulph-29/14  Lyco-25/13  Puls-23/10
 Nat mur-26/14  Ign-21/13  Kali carb-16/10
 Phos-26/14  Sep-19/11  Calc-19/9
Nat carb Calc carb
A/F:anger suppressed Irritable
Headache due to anger Anticipatory anxiety
Weeping in alone Aversion to quarelles
Irritability Dreams-unremembered
Desire-spicy, sour Desire-spices
Headache <sun Perspiration of face
Chilly pt Chilly pt
This case is indicating of psoric miasm.

Age-23 yearsSex-female
Pace of disease-gradual 200
Tissue changes-functional
Mind-++ Nerves-++ Sleep-++ 200
Mind-++ Body-++ Nat carb 200 Infrequent
4. Functional changes Moderate Infrequent
Present 200
No
6. General vitality Moderate Infrequent
Good 200
7. Presentation-
Moderate
Sycotic 200 Infrequent
B. Dominant miasm High
Psora 1M Infrequent
 ENTRY-FIRST Rx WITH DATE: 21/6/17
37
NAT CARB 200 1P HS
SL PILLS TDS
PT 1-1-1/× 1 WEEK
 CRITERIA:
1. Sneezing-F/D 4. LMP
2. Nasal discharge 5. Back pain-BM
3. suffocation 6. Abdominal pain-DM
 FOLLOW-UP:
DATE 1 2 3 4 5 6 INTERPRETATIO PRESCRIPTION
N
26/6/17 >++ >++ >++ 7/6/17 >+ >+ over all much NAT CARB 200 1P
better HS
SL PILLS TDS
PT 1-1-1/
×2 WEEKS
 CONCLUSION:
Pt has anxiety for her future about how will the natures of in laws and due to this stress,
she becomes irritable. She suppresses her anger. She doesn’t like to talk with unknowns
and now due to parent’s wish, she has to mixes with others. This all causes stresses to her
and development of allergic rihinitis. This is functional changes without any further
development. Clinico-pathology of this case indicates psoric miasm. After giving
constitutional remedy NATRUM CARB in moderate potency, at infrequent repetition, she
feels much better.
38
Case no: 4
Name: PDP
Age:16 years Sex:female Education: 10th std. Occupation:study
Status:single Religion:Hindu Veg/Non-Veg:veg.
Brothers: 1 Sisters:0 Address:vemar
CHIEF COMPLAIN:
PATHALOGY A.F, <, >
1. RS Cold++ <++dust Appetite-normal
Nose Discharge – watery, <++night 9-10 p.m. Thirst-normal
o-since 2 year thin <++cold things
f-continuous Sneezing+ >++Nash with warm
Head Pain+2 water
Frontal >++allo Rx
ASSOCIATED COMPLAINTS:
SENSATION& MODALITIES ACCOMPANIMENT
NO. LOCATION
PATHALOGY A.F, <, > S
1. FGUT Leucorrhoea-white <++before menses
Vagina or yellowish >++during menses
o-since 2-3 years Curd like <++after menses
f-daily Sticky++
Tenacious++
Itching++
Redness
No burning
2. back <++sitting long time
Pain++
o-since 5 month >++lying on back
<++beginning of
menses
 APPEARANCE:wheatish complexion
 PERSPIRATION: General:scanty Partial:hands++, face++
 DIGESTION:Thirst:normal Appetite:normal
Craving:pungent++, sweet++ Aversion:milk++, bitter+
 ELIMINATION:Stool:normalUrine:normal
 SLEEP:Duration: 8-9 hours position: on left sideDisturbed:not disturbed by any influence
 DREAMS:frightful and of kidnapping
 MENSTUAL HISTORY:F.M.P:at 8th std L.M.P:24/12/17Menses:regular
Cycle: 28 days Duration:4-5 daysColour:dark redStains:no
Concomitants:- B.M:back pain D.M:no A.F:no
 LEUCORHOEA:daily since 2-3 years
Character: white or yellow, curd like, watery.
39
6 a.m.-wake up, 7 a.m.-breakfast,7:15 a.m.-school, 2 p.m.-lunch (2 roti, sabji), 2
to 4 p.m.-sleep, 4 p.m.-wake up, 8 p.m.-dinner, 11 p.m.-sleep.
B. LIFE – SPACE
Pt was born at vadodara at maternal uncle’s home. Her family consist of fa,
mo, gfa, gmo and one younger uncle and aunty and one younger brother. Pt’s fa is
luhar. He has his own shop. So he is doing work in his own shop. Her fa gets angry on
both children when they don’t study. And when fa scolds pt, she has fear of fa. She
is sensitive to scolding. Her mo is house wife and her nature is good. Mo scolds both
children when both quarrels with each other. In childhood, her mo sometimes beats
her also. Pt is more attached with her mo and gmo. Fa is angry by nature and gets
angered on small matters. He shouted and abused words. But pt has good IPR with
him and her gmo’s nature is good. But now some conflicts occurs between gmo and
other family members,Because they have made new house at farm. So all family
members are decided to lives in that house, but her gmo is not agreed with this
decision because there not lived people around. So quarrels occur. pt feels bad and
don’t like quarrels so she escapes from that place. She fears as if some big quarrels
occur.
40
Pt has one uncle. He is doing business of gold and has own jewellers. His
nature is very irritable and he gets irritate in very small matters. He not gives answer
of any question and leaves home. Her aunty’s nature is good. She is doing job in
medical shop. She also helps pt in her study and good IPR with her.
Pt’s fa and her uncle also has good relations. Pt has one younger brother,
who is irritable by nature. When pt doing her works like reading and study, he teases
her. So pt gets angered on him and beat to him. She is obstinate in nature.
Pt’s memory is sharp. She is active. She got 91-92%. She likes to study. She
likes to read other books like story books. She likes to drawing and listening the
music. She wishes to become paediatrician and also a professor. She has good IPR
with teachers and classmates. Pt has anticipatory anxiety before exam and before
any performance. But after starting of performance she gets back confidence. She
feels nervousness before exam. Pt has fear of darkness, of being alone and of ghosts.
Pt has dreams of kidnapping to her. She is more sensitive for her parents and
get sensitive when someone cries. She said one incidence. Once she has some
quarrel with her friend, and her friend was crying. So pt felt guilty and said sorry to
her. She is also helpful in nature, helps people when anyone needs.
 PAST HISTORY:nil
 FAMILY HISTORY:nil
 PHYSICAL EXAMINATION: PULSE: 84/min CONJUCTIVA:pink
NAIL: pinkTONGUE:pink, moist Throat: clear
 SYSTEMIC EXAMINATION:RS-clear, air entry-BLE, breath sounds-vesicular
1. ALLERGIC RHINITIS 2. PHYSIOLOGICAL LEUCORRHOEA
Rs-nose, paranasal sinus, mucous membrane

Since 2 years
41
Watery thin discharge Formation of tenacious mucous
Sneezing Nerve irritation
Headache
Diagnosis: allergic rhinitis
Miasm: sycosis
42
 TOTALITY:
 Sensitive+++ to scolding
 Sentimental++-for family, friends
 Aversion to quarrels++
 Responsible++
 Anxiety++ for exam
 Fear-of darkness++, alone++, ghost+, stage fear++
 Dreams of kidnapping
 Cravings-sweet+3,spicy+2,curd+2
 Aversion-sour+2, bitter+2, milk+2
 Perspiration-scanty on mouth
 Sleep-on left side
 Menses-dark red
 Leucorrhoea-itching++, redness of skin-white, yellow, stringy
 Back pain<+2BM
 AM-weakness
 Chilly pt
 Mind-sensitive-to scolding
 Mind-sentimental-family
 Mind-quarrelling-aversion to
 Mind-obstinate-headstrong
 Mind-responsibility-taking too seriously
 Mind-anticipation-examination before
 Mind-anticipation-stage fright
 Mind-fear-dark of
 Mind-fear-ghosts of
 Dreams-kidnappers
 Gen.-F&D-sweets-desire
 Gen.-F&D-spices, yoghurt-desire
 Gen.-F&D-sour food-aversion
 Gen.-F&D-milk-aversion
 Perspiration-scanty sweat
 Extremities-perspiration-hand
 Female genitals-menses-dark
 Female genitals-leucorrhoea-itching
 Female genitals-leucorrhoea-ropy, stringy, tenacious
 General-weakness-menses after
 Phos-36/19  Lyc-34/19  Calc-33/17
 Sulph-35/19  Nat mur-33/19  Sil-25/15
 Sep-34/19  Puls-32/18  Kali c-25/15
43
Silicea Cal sil
Responsible Aversion to quarelles
Anxiety before exam Anxiety-anticipatory
Sensitive to scolding Craving-sweet
Fear of darkness and stage fear Leucorrhoea causes itching
Craving-sweet, curd Back pain before menses
Aversion-milk Chilly pt
Highly chilly
This case is indicating of sycotic miasm.
1. Susceptibility (tissue) Low to moderate Infrequent
Age-16 years Sex-female
Pace of disease-gradual 30 to 200
Mind-++ Nerves-++
200
Sleep-+ Dreams-+
Infrequent
Silicea 30
Mentals-++ physicals-++ Moderate
Present 200 to 1M
No
Good 200
7. Presentation-
High Infrequent
Psora 200 to 1M
Sycotic 200
 ENTRY-FIRST Rx WITH DATE: 17/1/18

ARS ALB 200 TDS× 3 DAYS
SL 3×3×3 ×7 DAYS
SL 1P HS / 7 DAYS
 CRITERIA:
1. Sneezing 5. Itching at genitals
2. Nasal discharge 6. Redness of genitals
3. Headache 7. Back pain
4. Leucorrhoea
 FOLLOW-UP:
44
DATE 1 2 3 4 5 6 7 INTERPRETATION PRESCRIPTION
+2
24/1/18 > >+2 <+2 Sq >+ >+ Sq pt feels better SILICEA 30 1P HS
SL 3-3-3
SL PILLS TDS/
2 WEEKS
14/2/18 >+ >+ >++ Sq >+2 >+2 Sq Remedy selection SILICEA 30 3P HS
is right SL 3-3-3
SLPILLS TDS/
1 WEEK
21/2/18 >+2 >+2 >+ sq >+2 >+2 >+ O/E:Wt-42 kg SILICEA 30 3P HS
Right remedy and SL 3-3-3
potency SL PILLS TDS/
1 WEEK
28/3/18 >+2 >+2 >+2 sq >+2 >+2 >+ Better over all SILICEA 30 3P HS
SL 3-3-3
SL PILLS TDS/
1 WEEK
 CONCLUSION:
Pt becomes very anxious before exam and before stage performance and she becomes
very sensitive to scolding. Due to this stresses, she developed functional changes of
allergic rhinitis and physiological leucorrhoea. This indicate sycotic miasm. After giving
constitutional remedy SILICEA in low potency, at infrequent repetition, pt feels so much
better in her all complaints.
Case no: 5 Define no: 9656 OPD no:58332
45
Name:PRR
Age:21 yearsSex:female Education:12th arts pass
Occupation:house workStatus:single Religion:Hindu leuva patel
Veg/Non-Veg: veg.Brothers:2: 1 bro expired at the age of 5-6 years
Sisters:1 elder-28 years-marriedAddress:karjan
CHIEF COMPLAIN:
PATHALOGY A.F, <, >
1. RS Watery discharge+2 A/F-dust Thirst-increase with
Nose White+2 <+2day time episodes
o-since 2 to 3 years Sticky+2 >+2allo Rx Appetite-normal
f-on/off Stoppage+
f-4 to 5/day Sneezing+2
<+2dust
O-after cold Cough+ <+2night
D-on/off Yellow+2
Thick+2
Sticky+2
no irritation
<+2work load
occ. Breathlessness+
General <+2slight exercise
weakness+2
0-5-6 years <+2night
Legs pain+2 >+2rest
Now increase since pulling sensation+2
2 years
ASSOCIATED COMPLAINTS:NO
 APPEARANCE:lean, thin, fair complexion
 PERSPIRATION:General:medium Partial:on upper lips+2, axilla+2, forehead+3
 DIGESTION:Thirst: 7-8 glass/day for cold waterAppetite:decrease since 2-3 months
Craving:sour+2, dal-rice+2, khichdi+2 Aversion:chocolate+2
 ELIMINATION:Stool:f-once/day, normal Urine:normal
 SLEEP:Duration:10 hours position:changed Disturbed:no
 DREAMS:daily routine, going to school and college, and studying her friends
 MENSTUAL HISTORY:F.M.P:at 8th std.L.M.P:14/5/17
Menses:regularCycle: 30 days Duration:5 days
Color: brownStains:red, delible
Concomitants:- B.M:lower abd. Pain, lumbar pain
BEGGINING: lower abdominal pain, lumbar pain
 LEUCORHOEA:3-4 days before menses and after menses
Character: white, thick
B. LIFE - SPACE
46
pt was born at sarbhan. She passed her childhood in Tailod near amod. Now
she lives in karjan since 10-12 years. She has one elder sister, who was expired before pt’s
birth. Pt passed her childhood with her mother, father, sister, brother, gfa and gmo. Her fa
is doing job in ceramic (tiles smoothing). Her mother is house wife. They have 7-8 vigha
land. So her mother is doing farming work also. Over all her childhood was passed good.
Her all demands are fulfilled.
Her mo is angry by nature. So sometimes she scolds to pt for work. But pt not
replies against them because she respects to elders. She also has some fear of them. She
has more attachment with her father.
She passed 1 to 6th std. with 90% marks. She was average in study. She also
took part in extra cultural activities, games like; limbu chamchi, dorda kud etc. She also
took part in singing songs for many times. She has some stage fear but she performs well.
After starting of performance she has no fear. After 6 th std, her results became down. Even
she studies well, she can’t remember things well. Then results decreases to 70-75%. Then
in the 10th std., she got 50% marks. So she got admission in the arts in 11 th class. She taken
this decision by self. Then she failed in 12 th std in one subject for few marks. That time she
feels bad and then she took admission in B.A. but she failed many times, can’t solve KT.
She was failed in 3 subjects so she didn’t perform in final exam. Before it, she left college
because she has weak memory and she had some anxiety before exam.
She has good relations with sister. Her sister went Africa after 4-5 years of
marriage. So she feels alone and cried for some days.
She had friend circle of 5-6 friends in college, also including boys. One of them is her
best friend and one another boy is her boyfriend with whom she is in relationship. She has
one girl best friend also. She shares everything with her.
She had one boyfriend during college life. He was her classmate. They went and
came together in college but not sit together or talk with each other in college. They only
chat through mobile. Then in around 1-2 months, she got information from her male best
friend that her boyfriend has one another girl friend in village. And then her boyfriend also
told her that he has one another girl friend and he wants to marry her. Then he has
broken up with pt. So pt has stopped talking with him and getting hurt and cried for some
days. She feels bad and thinks that other time this will not happen. Her trust was broken.
So now she can’t trust easily on any boy. After 15 days, she left college. Her boyfriend met
her in college but they didn’t talk with each other. Sometimes she has thought that she
wants to leave home.Her nature is shyness. If guests came home, she can’t easily mixes
with them. She becomes sentimental by seeing sad scenes in TV and has fear of
quarrelling. She is helpful by nature.
 FAMILY HISTORY:bro-asthma
 PHYSICAL EXAMINATION: PULSE:82/min CONJUCTIVA:pink
NAIL:pinkTONGUE:pink, moist
 SYSTEMIC EXAMINATION:RS-clear, breath sound- vesicular
 PROVISIONAL DIAGNOSIS:CHRONIC ALLERGIC RHINITIS
47
Rs-nose, mucous membrane, paranasal sinus

Since 2-3 years
White, sticky discharge

Formation of tenacious mucous
Red nasal skin
Nose blockage
Nerve irritation
Breathlessness
Irritation of mucous membrane
Sneezing
Coughing
Breathlessness
Diagnosis: Allergic Rhinitis

Miasm: psora
48
 TOTALITY:
 anger+2- when someone teases her
 anger-suppressed+2
 Shyness+2-in presence of others
 Active+2-takes part in all activities
 Introvert+2
 Anticipatory anxiety+2- before performance and exam
 Sentimental+2
 Memory-weak
 Dreams-of daily routine+2, of going to college with friends+2
 Fear of ghost+ and snakes+2
 Cravings-sour+2, dal-rice+2, khichdi+2
 Aversion-chocolate+2
 Perspiration-on face+2, forehead+, upper lips+2 and axilla+2
 Abdominal pain+2 and back pain+2 before menses
 Leucorrhoea+ before and after menses
 Sun <+itching and redness of face
 Chilly pt
 Mind-anger-contradiction from
 Mind-anger-suppressed
 Mind-reproaches herself
 Mind- company-desires
 Mind-anxiety-anticipatory
 Mind-shyness
 Mind-sentimental
 Mind-fear-ghosts of
 Mind-fear-snakes of
 Mind-memory-weakness of
 Dreams-of friends-meeting them
 Gen-F&D-sour-desire for
 Gen-F&D-chocolate-aversion
 Face-perspiration
 Chest-perspiration-axilla
 Abdomen-pain-menses-before
 Back-pain-menses-before
 Lyco-24/11  Ign-20/9  Nat mur-15/8
 Phos-22/8  Sep-19/10  Calc-14/6
 Puls-20/10  Acon-16/9
49
Calc carb Pulsatila
Cool and calm Mild, gentle, yielding
Contradiction excites anger Sad and crying easily
Weakness of memory Fear of dark, ghost and to be alone
Aversion to work Likes sympathy
Takes cold easily Aversion-fat foods
Fear of dark and alone Ambi thermal
Chilly pt
This case indicate Psora miasm by looking in to the pathophysiology of Inflammation.
Duration of disease is long. But changes are functional and without any residue.
Age-21 years Sex-female
Mind-++ nerves-+
200
Sleep-+ Dreams-++
Infrequent
Calc carb
Mentals-++ physicals-++ 200
Present 1M
No
Good 200
7. Presentation-
Moderate Infrequent
Sycotic 200
B. Dominant miasm Moderate to High Infrequent
Psora 200 to 1M
 ENTRY-FIRST Rx WITH DATE:7/6/17

SL 1P HS
SL PILLS TDS/ 1 WEEK
 CRITERIA:
1. Nasal discharge 7. Weakness
2. Nose block 8. Legs pain
3. Coughing 9. Pulling sensation in legs
4. Expectoration
5. Sneezing
6. Breathlessness
50
 FOLLOW-UP:
DATE 1 2 3 4 5 6 7 8 9 INTERPRETATION PRESCRIPTION

14/6/17 >+2 >+2 >+2 >+2 >+2 >+2 sq >+ sq Better over all SL 1P HS
SL PILLS TDS
PT 1-1-1/ 1 WEEK
21/6/17 >+2 >+2 >+2 >+2 >+2 >+2 >+2 >+2 >+2 Better 90% SL 1P HS
SL PILLS TDS
PT 1-1-1/2 WEEKS
5/7/17 0 0 0 0 0 0 >+3 0 0 Better SL 1P HS
SL PILLS TDS
PT 1-1-1/2 WEEKS
19/7/17 0 0 0 0 0 0 0 0 0 New c/o: abd. MAG PHOS 200
Pain at umbilical 1P HS
region since 7-8 SL PILLS TDS/
days<+2during 2 WEEKS
menses
9/8/17 0 0 0 0 0 0 sq 0 0 >+++ in all c/o CALC CARB 200
1P HS
SL PILLS TDS/
4 WEEKS
13/9/17 >+2 >+2 <+ <+ >+2 >+2 0 >++ >++ Coughing agg. CALC CARB 200
Since 3-4 days 1P HS
+2
< night SL PILLS TDS/
2 WEEKS
27/9/17 >+2 >+2 <+ >+2 >+2 >+2 >+2 <+ >+2 Calf muscular CALC CARB 200
pain since 2-3 1P HS
+2
days< work SL PILLS TDS/
2 WEEKS
11/10/17 <+2 >+2 >+2 >+3 <+2 >+2 >+2 >+2 <+2 Complaints CALC CARB 200
started since 2 1P HS
days SL PILLS TDS/
4 WEEKS
15/11/17 <+3 <+ <+2 <+ <+3 <+ sq >+2 <+ Gfa expired on CALC CARB 200
8/11/17. So c/o 1P HS
chill+ with feverish SL PILLS TDS/
feeling 4 WEEKS
20/12/17 <+2 <+ >+2 >+ <+2 <+ <+ >+2 >+2 c/o again started CALC CARB 200
since 2-3 days 1P HS
SL PILLS TDS/
4 WEEKS
10/1/18 >+2 >+2 >+2 >+3 >+2 >+3 >+3 >+2 >+2 Better over all CALC CARB 200
1P HS
SL PILLS TDS/
1 WEEK
51
17/1/18 <+2 >+ >++ >++ <++ >++ >+ >+3 >+3 Throat pain since SL 1P HS
2 days HEP SULPH 200
<+2swallowing TDS/
water, >+2drinking 1 WEEK
warm water
24/1/18 <+ <+ >+2 >+2 <+2 >+2 >+ >+3 >+2 Throat pain-sq CALC CARB 200
3P HS
SL PILLS TDS/
1 WEEK
31/1/18 <+ >+2 >+2 >+2 <+ >+2 >+3 0 0 Throat pain and CALC CARB 200
abd. Pain better 3P HS
SL PILLS TDS/
2 WEEKS
14/2/18 >+2 >+2 <+2 <+ 0 >+3 >+2 0 0 Over all better CALC CARB 200
3P HS
SL PILLS TDS/
2 WEEKS
28/2/18 >+2 >+2 <+2 <+2 >+3 >+2 >+2 0 0 Cough aggravates SL 1P HS
KALI CARB 200 3
PILLS BD/1 WEEK
7/3/18 <+ >+2 >+2 >+3 <+ >+2 >+2 0 0 Over all better SL 1P HS
KALI CARB 200 3
PILLS BD/ 1 WEEK
14/3/18 >+2 >+2 0 0 <+3 >+2 <+2 0 0 c/o started since SL 1P HS
2-3 days KALI CARB 200 3
PILLS BD/1 WEEK
 CONCLUSION:
Pt has anticipatory anxiety and she suppresses anger. So she developed allergic rhinitis.
She has developed functional changes. That indicate psoric miasm, After giving
constitutional remedy calc.Carb, 200 potency, infrequent repetition, she feels better
overall.
52
Name:PPN
Age:6 yearsSex:male Education:1st std.
Occupation:study Status:single Religion:leuva patel
Veg/Non-Veg:veg. Brothers:no Sisters:1- 8 years
Address:keshalo, bharuch.
CHIEF COMPLAIN:
SENSATION & MODALITIES
PATHALOGY A.F, <, >
1. RS Recurrent cold+2 A/F-change of Sleep-disturbed due to
Nose Sneezing+2 weather, dust, nose block
Since birth after 5 Rattling cough+2 damp wet weather Appetite-normal
to 6 monthsof age Thin, watery <+2fan Thirst-normal
F-once/month discharge+2 <+2night Stool-normal
D-1 week Blockage+2 <+2morning Urine-normal
On/off <+2cold wind
Ear Pain+ <+2cold water
drinking and
bathing
>+2nasal drops
>+2allo Rx
No
 PERSPIRATION:General:profuse+3 Partial:forehead+2-occ. wet pillow in summer
 DIGESTION:Thirst:normal of pot waterAppetite:normal
Craving:milk+2, sweets+2Aversion:sour+2, salt+2
 ELIMINATION:Stool:normal, f-once/day Urine:normal
 SLEEP:Duration:8-9 hour position: on abdomen Disturbed:occ. enuresis
 DREAMS:not remembered, of ghost+2 and god+
 MOTHER'S OBSTETRIC HISTORY:
Pregnancies: Gravida: 3 Para:2 Abortion: 1-induced
Delivery: FTND Birth weight of pt: 3 kg 200 gm

Wakes up at 6:30 am
Breakfast at 6:45 am
School time: 7:15 am to 12:30pm
Lunch: 12:45 pm
Sleeping: 1:30 pm to 3:30 pm
Dinner: 7:15 pm
Sleeping: 9 pm
53
B. LIFE – SPACE
Pt was born at Bharuch. There were gmo, gfa, father, mother and 1 elder sister in family.
Father is strict in nature when work not done properly. Pt has good IPR with father. Mother
is very mild in nature and occ. gets angry when someone did wrong. Pt has good IPR with all
family members especially with gfa.
Pt is irritable in nature. He used to beat sister and friends. Pt cried when mo scolds him. He
is very sensitive to scolding. Pt is very obstinate in nature but understands the situation
easily. When his mo beats him, he goes to sister and said, “Mo is only used to beat me, not
you.” He cries on beating by mo. He is mixing in nature. He is very curious to know new
things. He repeatedly asks mo until he satisfies and learns that thing. Pt is good at study. He
has many friends in school. Good IPR with all friends. He occ. used to beat them when they
teasing him. He likes to play with paper. He likes to draw new pictures. He likes to wear new
clothes, going to fair and rides in train. He likes to play with new toys and likes to wear new
cap. He wants everything neat and clean. He doesn’t like dirty clothes. He immediately
changes them.
He is sharing in nature. He never used to eat chocolate without sharing it with sister. He is
very perfect in his own work. He puts his wrappers in dustbin himself. He is very
understanding and emotional when anyone gets ill in family. He feels jealous with sister
when mo pampers her. He is very obedient in work when mo orders him some work. His
memory is good. Never forgets money or anything at shop. He likes to talk with others. Pt
has no any fear. He cries when fa stays out from home for few days. He doesn’t like at home
without fa. He became anxious when fa comes back late at home. He never cries in front of
strangers even after mo beats him in front of other person.
He wants company. He likes to watch cartoon in TV and at that time no one has to disturbed
him. Pt has fear of ghosts. He has occ. dreams of ghost and of god, but most of times, not
remembered it.

 FAMILY HISTORY:fa-mild MI, gfa-HTN, gmo-hypothyroid, HTN.
WEIGHT:15.7 CONJUCTIVA:pink NAIL: pink TONGUE:pink, moist
 SYSTEMIC EXAMINATION:air entry-BLE, breath sound-vesicular
 PROVISIONAL DIAGNOSIS:CHRONIC ALLERGIC RHINITIS
54
Rs-nose, mucous membrane, paranasal sinus, eustachian tubes, sinus ostia.

Secondary infection of Eustachian tubes
Since 5 ½ years
Thin, watery discharge Increase mucous secretion

Sneezing Nerve irritation
Rattling cough Irritation of mucous membrane
Blockage of nose Obstruction of passage
Ear pain Obstruction of sinus ostia

Miasm:Sycosis
55
 TOTALITY:
 Irritable+2-beating
 Sensitive to scolding+2
 Curious+2
 Likes+2-play with papers, drawing, wear new clothes, going to fair, ride in train,
playing with new toys
 Fastidious+2
 Anxious+-about family
 Wants company+
 Fear of ghost+
 Dreams of ghost+2, god+, unremembered
 Perspiration-profuse+2 on forehead+2
 Aversion-salt+2, sour+2
 Craving-milk+2, sweets+2
 Sleep-on abdomen
 Nocturnal enuresis
 Chilly pt
 mind-striking-children in
 mind-sensitive-reprimands to
 mind-curious
 mind-travelling-desire for
 mind-fastidious
 mind-anxiety-family about
 mind-company-desire for
 mind-fear-ghost of
 dreams-ghost
 dreams-unremembered
 perspiration-profuse
 head-perspiration of scalp-forehead
 gen-F&D-sweet-craving
 gen-F&D-milk-craving
 gen-F&D-sour-aversion
 gen-F&D-salt-aversion
 sleep-position-abdomen on
 bladder-enuresis-nocturnal
 Lyco-22/12  Puls-15/9
 Sil-20/11  Nat mur-15/8
 Phos-20/10  Carc-12/7
 Calc-16/9
56
Silicea
Irritable-beating Calc sil
curious Irritable
Sensitive to scolding Wants company
Fastidious Dreams of ghost, god
Fear of ghost Dreams-unremembered
Craving-sweets, milk Craving-sweets
Aversion-sour Sleep-on abdomen
Nocturnal enuresis Chilly pt
Chilly pt
This case indicates sycotic miasm. There is chronic inflammation with hypertrophy.

1. Susceptibility (tissue) Moderate to high Infrequent
Age-6 years Sex-male
Pace of disease-sudden
200 to 1M
Chara-++
Mind-++ Nerves-+
200
Sleep-+ Dreams-+
3. Correspondence (degree & level) Const. Rx Infrequent
Mind-++ physicals-+ Sil 200
Present 1M
No
Good 200
Presentation-
7. Moderate Infrequent
Sycotic 200
sycotic 200

13/9/17
SILICEA 200 1P HS
SL 3 PILLS TDS×7 DAYS/2 WEEKS
57
 CRITERIA:
1. Coryza-watery, thin, white 5. Ear pain
discharge 6. Nocturnal enuresis
2. Sneezing 7. Sleep disturbed due to nose
3. Nose block block
4. Rattling cough 8. Activity
 FOLLOW-UP:
DATE 1 2 3 4 5 6 7 8 INTERPRETATION PRESCRIPTION
27/9/17 <+2 <+ >+2 <+ >+2 >+ >+ normal RS-clear SILICEA 200 1P HS
SL 3 PILLS TDS×7 DAYS/
2 WEEKS
11/10/17 >+ >+ >+2 >+ >+2 >+ >+2 normal RS-clear SILICEA 200 1P HS
SL PILLS TDS×7 DAYS/
4 WEEKS
29/11/17 <+2 <+2 <+2 <+2 <+ >+ <+ normal RS-clear T-97.3®F PULS 200 6P TDS
Wt-17 kg SILICEA 200 1P
c/o-started since 4 HS/WKLY
days SL PILLS TDS×2 WEEKS
27/12/17 >+ >+2 >+2 >+2 0 >+2 0 normal RS-clear SILICEA 200 1P HS WKLY
SL PILLS TDS×4 WEEKS
13/2/18 >+2 >+2 0 0 0 0 0 normal Over all better SILICEA 200 1P HS WKLY
SL PILLS TDS×4 WEEKS
 CONCLUSION:
Pt has anxiety for family members and he is very sensitive to reprimands. Due to this
stresses, he developed functional changes of allergic rhinitis. The pathophysiology
indiactes chronic inflammation with hypertrophy. That suggest sycotic miasm. After giving
constitutional remedy SILICEA, in moderate potency, at infrequent repetition, pt feels
much better.
58
Name: DYM Age: 65 years Sex: Male
Education: SSC fail Occupation: Selling clothes of children
Status: Married Religion: Muslim Veg/Non-Veg: Non veg
Brothers: 1 younger Sisters: 1 elder Address: Bank faliyu, Varediya
CHIEF COMPLAIN:

PATHALOGY A.F, <, >
1. Nose Watery discharge+2 +2
< Cold weather
O: 2004-2005 Breathlessness+2 >+ Steam inhalation
F: 1-4 times/month <+2 Cold drinks &
D: 5 days Food
Right side Blockage+2 <+2 Rice
<+2 Night
<+2 Winter,
monsoon
Throat Coughing+2 occ <+2 Fan
No pain
Head Pain+2
Temporal Throbbing >+2 Tight bandage
Frontal >+2 Allo Rx
O: 2004-2005 >+2 Baam application
 APPEARANCE: Medium built
 PERSPIRATION:General: Profuse+2Partial: On Chest+2
 DIGESTION:Thirst: ½-1 glass/hour, Matka waterAppetite: Normal
Craving: Chicken+2, Boiled egg+2, Pungent+2, Sour+2
 ELIMINATION:
Stool: Blackish+2, Hard+2, Unsatisfactory, Straining at stool Urine: Normal
 SLEEP:
Duration: 7-8 hours position: On both sides, back on Disturbed: Due to noise+2
 DREAMS: Dead occ.+, Robbers+
5-5:30 am: Wake up
11-11:30 am: Lunch
Go for selling clothes
5-6:00 am: Return at home
7:30-8:00 am: Dinner
9:30-10:00 am: Sleep
59
B. LIFE – SPACE
Pt was born at Varediya at 15-09-1952. Pt lived with Mo, Fa, 2 Br, Uncle-aunty and 4
cousins. Sis was married.
Fa’s nature was cool and calm. Mo’s nature was also cool and calm. Aunty’s nature
was angry, quarrel with his mother, then got separated due to quarrels. Pt quarrels with
aunty. Never got angry on Mo and Fa. Good IPR with sis. He also has good relation with
Brothers. Brother didn’t come to home but pt went to his home.
Pt was good at study. good in Gujarati subject but less interested in science. He was
more interested in cricket. Pt failed in SSC. At that time financial condition was not good.
Not fulfilled all needs. Pt had interest in study but had to left it. He has done classes for ST
conductor. Pt was not obstinate for things. He is understanding in nature.
Pt got married in 1970 at the age of 18-19 years because of mother’s illness, mo was
not able to do work. Wife’s nature is good but now irritated due to illness. Wife is
illiterate. Pt has good relation with her. Once or twice beat his wife in anger but anger was
only for few times after that he pleased her again. Pt lived with Mo, Fa, Br. Fa was doing
work in Masjid. Mo and wife is H.W. Mo was doing work in farm. They had 2 vigha land.
He had good relation with brother.
Pt is generally cool and calm by nature. Good IPR with teachers. Pt had many friends.
He is easily mixable.
Pt has no much anxiety, Sometimes of money and family illness. Good feelings for
others and pray for others. Pt is sympathetic by nature. He helps them by money and
food. Pt cried when Mo and Fa expired. Not much effect. He got emotional by
remembering them.
All sons are married. One son is living with him. Younger son is living with them. All
sons are doing job. One is watchman. Pt want to followed by all sons and DIL, if don’t
follow he gets angry. Sometime he has to borrow money from others but return them in
time.

 MOTION & POSITION:
Bus: Before 10-15 years < Vomiting Swing: < Vertigo
 METROLOGICAL:- Thermal: C3H2
 PAST HISTORY: Jaundice in 1988
 FAMILY HISTORY:Father: Asthma, Uncle: Asthma
CONJUCTIVA:PinkNAIL: Pink TONGUE:Pink
THROAT: Clear NOSE: Deviated nasal septum (left side)
 SYSTEMIC EXAMINATION:
RS:- Air entry: Bilateral equal Breath sound: Vesicular
 PROVISIONAL DIAGNOSIS: 1) Allergic Rhinitis with sinusitis
2) DNS
60
Rs-nose, mucous glands, mucous membrane, paranasal sinus

Since 12-13 years
Watery discharge Formation of tenacious mucous

Blockage of nose Obstruction of nasal passage
Breathlessness Nerve irritation
Coughing
Expectoration of sputum
Headache

Miasm: sycosis
61
 TOTALITY:
 Anger+2: When someone not respect him, when someone not follow his command,
when someone tease him, Keeps the matter in mind
 Anger+2: Speak abussive word and beat in anger
 Anxiety+2: For money and illness of himself or others
 Anticipatory anxiety+2
 Easily mixable+2
 Memory sharp
 Fear of lightning+2
 Dreams+2: Of dead, as if someone beat him, as someone falling in to pit, of robbers,
as he sit on the plane
 Sleep: Position: on sides and on back
 Sleep: disturbed by the noise+2 and by dreams+
 Perspiration: Profuse+2, On chest
 Craving: Pungent+2, Sour+2, Chicken+2, Fish+, Boiled eggs+
 Stool: Blackish+2, Hard+2, Unsatisfactory, Straining at stool+2
 Swing < Vertigo
 Bus < Vomiting
 Chilly Pt
 Mind-anger-contradiction from
 Mind-anger-violent-things don’t go as he wishes, when
 Mind-anxiety-anticipation from
 Mind-anxiety-money matters, about
 Mind-anxiety-health about-own health his
 Mind-anxiety-health about-relatives of
 Mind-communicative
 Mind-memory-active
 Mind-fear-lightning of
 Dreams-dead of the-relatives
 Dreams-robbers
 Dreams-beaten, being
 Dreams-airplanes-on an airplane, being
 Dreams-falling-pit, into a
 Sleep-position-back, on
 Sleep-position-side on
 Sleep-disturbed-noise, by the slightest
 Perspiration-profuse
 Chest-perspiration
 Generals-food & drinks-chicken-desire
 Generals-food & drinks-fish-desire
 Generals-food & drinks-eggs-desire
 Generals-food & drinks-pungent things-desire
 Generals-food & drinks-sour food, acids-desire
 Rectum-straining
62
 Stool-black
 Stool-hard
 Generals-motion-aggravates
 Phos-38/20  Lach- 22/12  Puls-20/10
 Nat M-27/13  Sil-21/12  Calc P-13/10
 Kali P-16/13  Sep-22/11  Nat m-12/10
 Calc-24/12  Lyc-22/10  Kali C-17/9
 REMEDY DIFFERENTIATION :
Calc phos Calc carb
Angery when someone not follows his Generally cool and calm
commands Anger with irritability
Anxiety for money and for health Anxiety for money
Memory-sharp Fear of lightening
Fear of lightening Sleep-on sides
Dreams of dead, of robbers, of flying in Perspiration-profuse on chest
plane Craving-fish, boiled eggs, chicken, sour
Perspiration-profuse Straining at stool
Craving-pungent, sour Chilly pt
Motion sickness
Chilly pt
This case indicate sycosis as a miasm.

1. Susceptibility (tissue) Low Infrequent
Age: 65 yearsSex: Male
SOD: Structural reversible 30
POD: Gradual
2. Sensitivity (Mind & Nerves) Moderate-Low Infrequent
Mind: ++Nerves: ++
200-1M
Sleep: ++Dreams: ++
Mind ++Body ++ Calc Phos
200
Present 1M
5. Structural changes Low Infrequent
Irreversible 30
Good 200
Presentation- Moderate
7. Infrequent
63
Sycotic 200
B. Dominant miasm Moderate
Infrequent
Sycotic 200

27-09-17: CALC PHOS 30 3P HS
II PILLS TDS/ 2 WEEKS
 CRITERIA:
1) Nasal discharge 5) Expectoration
2) Nose block 6) Headache
3) Breathlessness 7) Constipation
4) Coughing
 FOLLOW-UP:
DATE 1 2 3 4 5 6 7 INTERPRETATION PRESCRIPTION

11-10-17 SQ SQ + 0 0 >+ >++ Better+ Calc Phos 30 3P HS
ii pills TDS/4 wks
03-11-17 >+ >++ >++ >++ >+ >++ >++ Better++ Calc Phos 200 1P HS
ii pills TDS/4 wks
13-12-17 >++ >++ >+ >++ >+ + >+++ Better++ Calc Phos 200 1P HS
40- ii pills TDS/4 wks
50%
10-01-18 <+ >++ >++ Occ occ SQ >++ Better++ Calc Phos 200 1P HS
ii pills TDS/2 wks
07-02-18 <+ + <+ + White SQ >+++ Better+ Calc Phos 200 3P HS
, thick ii pills TDS/2 wks
21-02-18 SQ >+ + >+ >+ SQ >+++ Better+ Calc Phos 200 3P HS
ii pills TDS/2 wks
07-03-18 >+ >+ >+ >+ >+ >++ >++ Better++ Calc Phos 200 3P HS
ii pills TDS/2 wks
21-03-18 + >+ >++ >+ >+ <+ 0 Better+ Calc Phos 200 3P HS
ii pills TDS/4 wks
 CONCLUSION:
Pt has anxiety for health of relatives and his own and also for money matters and also has
conflicts from contradiction. So pt developed functional changes of allergic rhinitis and
structural changes of deviated nasal septum. This case fall under sycosis miasm. After
giving constitutional remedy calc phos, in 200 potency; infrequent repetition, he feels
much better.
64
Name: PPK Age: 72 years Education:M.A. B.Ed
Occupation:Retired from teacher’s job in 2004 Status:W
Religion:Hindu Veg/Non-Veg:Veg
Brothers: 1: 74 years Sisters:1: 76 years Address:Nava bazar, Karjan
CHIEF COMPLAIN:
PATHALOGY A.F, <, >
1. RS Sneezing+3 A/f- dust, c.o.w. Appetite: N
Nose Watery coryza+2 >+2 Allo Rx Thirst: N
O: since childhood Then thick discharge >+2 Ayurvedic Rx Urine: N
Increase since 2 Difficulty in breathing+ <+3 Morning Stool: N
years Blockage+2 <+2 Wetting
D: continue <+2 Fan
<+2 Open air
>+2 Covering
<+2 Summer
>+2 Tea with tulsi
and fudina
 APPEARANCE:Fair complexion, Medium built
 PERSPIRATION:General:ScantyPartial:Scalp+2, Back+, Chest+
 DIGESTION:Thirst:NormalAppetite:NormalCraving:Sweet+2, Salt+
 ELIMINATION:Stool:Yellowish, Hard+, SatisfactoryUrine:Normal
 SLEEP:Duration: 8 hours position:On sides Disturbed:No
 DREAMS:Religious+2, Quarrels+2, Sexual activity+
6:00 am: Wake up
Do pooja, doing pranayam at 11:30 am
Then take Lunch
Sleep at afternoon for 2 hours, drink tea
Dinner at 7:00 pm
Prayer to good for 4-5 hours of day
Watch T.V.
Sleep at 11:30 pm
C. LIFE – SPACE
Pt was born in Ranapur near Nareshwar. He passed his childhood with his Mo, Fa,
Elder Br and elder Sis. He studied till 11 th Std at Ranapur. He was good in study. He took
part in sports like volleyball, long jump, high jump. He has good relation with teachers
and his friends. He said friends are life. Once he had fight with one boy in bus but he
didn’t used bag words and told in disciplinary manner. He never does fights, don’t like to
do it. Sometimes he is spoken out when needed. In childhood their financial condition
was poor. So left study in between. His mother was house wife and his father was
drinking alcohol and not doing farming. So their financial condition was poor. He has
conflict with parents because of their thoughts. His parents wished that pt do farming but
65
pt wanted to study. Then he left home and went to vadodara at jiju’s home and was
doing job for 2 years in hotel. He wanted independent life. Then at the age of 25 years he
came back home in karjan and started college. He has done M.A in Dabhoi. He got 90%
up in 3rd M.A. exams. He has done job in primary school for 1 year then started tuition.
Then he did B. Ed. He was late for study because in between he was doing job for 4 years.
His friend circle was living hifi life and pt was poor but pt had no jealousy of them. His
friends keep same behaviour with him. His sister was married. Her in laws home was at
Bharuch. But she became widow at the age of 26 years and she has 3 sons. So she came
back and not done marriage again and now lived at pt’s bro’s home in pathiya, Ranapur.
He has also good relations with brother, not quarrel anytime and even not get separated
till. His Fa has not got studied but his nature was good. He gives all things if someone
needed and ask for. Father has addiction of alcohol for 5-7 years and has asthma.
Mother’s nature was also good and pt has good attachment with bro and sis. He got
married at the age of 31 years because till he wasn’t settled and even there is no toilet in
house. Wife’s mental condition was not good, she ran away from home and can’t do all
work when guests come. So pt helped her in work. Pt was not known her condition
before marriage. Then after marriage his wife brings out many files of reports and she
has no uterus. So she was having no chance of pregnancy. Then they adopted 1 baby girl
and 1 baby boy of his nephew’s children. Both were 3 and 4 months old when adopted.
He was happy with all. He doesn’t get angry on her wife even when she was in fault. He
never quarrels with her because he believed that it is not true love if he does so. He
never gets angry on anyone for his benefits, he only scolds children when they don’t
study and beat them. His daughter is now married and happy, son in law has doing C.A.
and daughter is pregnant now. He has no anxiety for his son’s marriage. His son was 10 th
fail. He was self decisive. He said decisions are sometimes believed right and sometimes
wrong. He doesn’t likes to beleader but helps everyone in work. He has hobby of
drawing, reading books and he lives according condition, either lonely or with company.
He is sympathetic by seeing people, birds and animals in pain. His wife was expired in
2005 because of pneumonia. He has good relations with neighbours. There is no enemy
of him due to his helping nature.
 METROLOGICAL:- Thermal:C4H
 PAST HISTORY:Food poisoning at 42 years of age, Typhoid before 3-4 years, Malaria
before 3-4 years
 FAMILY HISTORY:Father: Asthma
B.P.: 100/70 mm of Hg PULSE: 72/min CONJUCTIVA:Pink
NAIL: Pale+2 TONGUE:Pink THROAT: Clear
AIR ENTRY: BLE BREATH SOUND: Vesicular
 PROVISIONAL DIAGNOSIS: 1) Chronic allergic rhinitis
66
Nose, paranasal sinus, mucous membrane, mucous glands
Since childhood, Increase since 2 yrs
Watery running discharge Formation of tenacious mucous

Sneezing Nervous irritation
Breathing difficulty Obstruction of nasal passage
Blockage of nose

Miasm: sycosis
67
 TOTALITY:
 Anger+2-beat children in anger
 Religious+3
 Sympathetic+2
 Memory sharp
 Desire+2 to live independent life-leaved home
 Suppressed sexual desire+2
 Dreams-religious+3,quarrels+2,family members+, sexual activity+, flying and reach to
favourite place+
 Sleep-deep, position-on both sides
 Craving-sweet+2,salt+
 Perspiration-scanty on scalp, chest, back
 Coldness of soles and foot
 Chilly pt
 mind-anger-contradiction from
 mind-religious affections
 mind-sympathy for
 mind-memory-active
 Dreams-religious
 Dreams-quarrels
 Dreams-flying-people
 Sleep-deep
 Sleep-position-side on
 Generals-F & D-sweets-desire
 Perspiration-scanty
 Head-perspiration-of scalp
 Chest-perspiration
 Back-perspiration
 Extremities-coldness of foot-soles
 Phos-20/9  Bell-16/8  Sil-12/9
 Calc-18/9  Caust-14/9  Lach-12/7
 Sep-18/8  Puls-15/8
 Lyc-17/8  Sulph-15/8
Mag carb Calc carb
Anger-from contradiction Anger-from contradiction
Religious Dreams of flying, of quarelles
Sympathetic Perspiration of scalp, chest, back
Dreams of quarrels and religious Coldness of foot
Desire-sweets, Chilly Pt Chilly pt
Perspiration of scalp, chest, back
68
This case indicates sycosis miasm.

Age:72 yearsSex:Male
Seat of disease:Functional 200
Pace of disease:Gradual
Mind: ++Nerves: +
200
Dreams: ++Sleep: -
Infrequent
Mag carb
Mind ++Body ++ 200
4. Functional changes Moderate Infrequent
Present 200
- - -
Good 200
7. Presentation-
Moderate Infrequent
Sycotic 200
B. Dominant miasm moderate Infrequent
Sycotic 200

19-07-17: TUB 1M 1P HS
SL PILLS TDS
PT 1-1-1/1 WEEK
 CRITERIA:
1) Sneezing 4) Nose block
2) Coryza 5) Burning soles
3) Difficulty in breathing
 FOLLOW-UP:
DATE 1 2 3 4 5 INTERPRETATION PRESCRIPTION
+
26-07-17 < <+ + >++ + No better ARS ALB 200 TDS
SL 1P HS
PT 1-1-1/1 WEEKS
02-08-17 >+ + + >+ + Better +
CALC PHOS 200 1P HS
10% SL PILLS TDS/4 WEEKS
09-08-17 >+ SQ + >+ + Not much better CALC PHOS 200 1P HS
SL PILLS TDS/2WEEKS
16-08-17 SQ SQ SQ SQ SQ No better MAG CARB 30 3P HS
69
SL PILLS TDS
PT 1-1-1/2 WEEKS
30-08-17 >+2 >+ >+ >++ 0 Better++ 50-60% MAG CARB 30 3P HS
SL PILLS TDS
PT 1-1-1/1 WEEKS
06-09-17 >++ >++ >++ >++ 0 Better++ MAG CARB 30 3P HS
SL PILLS TDS
PT 1-1-1/2 WEEKS
SL PILLS TDS
PT 1-1-1/4WEEKS
08-11-17 >+++ >++ >+ >++ 0 Better+++ MAG CARB 30 3P HS
SL PILLS TDS
PT 1-1-1/8WEEKS
SL PILLS TDS
PT 1-1-1/4 WEEKS
SL PILLS TDS
PT 1-1-1/4 WEEKS
SL PILLS TDS
PT 1-1-1/4 WEEKS
SL PILLS TDS
PT 1-1-1/4 WEEKS
 CONCLUSION:
Pt has suppressed his desires and faces daily life stresses due to his wife’s mental illness.
So he developed functional changes of allergic rhinitis. This case indicates sycosis miasm.
At first, he has given calc carb as a constitutional remedy, but he not feels better. Then
after giving constitutional remedy, mag carb in low potency, he feels much better.
70
Name:RHS
Age: 5 years Sex:male Education:K.G.
Occupation:study Status:single Religion:muslim
Veg/Non-Veg:all Brothers:0 Sisters:0
Address:amod
CHIEF COMPLAIN:
PATHALOGY A.F, <, >
1. RS Coryza+2 A/F: change of Appetite-decreased
Nose white+2, sticky+2 – weather Thirst-normal
O-since 3-4 years expectoration+2 <+2night Sleep-disturbed
D-5 days blockage+ <+morning
F-15 days breathlessness+ <+cold weather
feverish feeling+ >+vicks application
>+allo RX
ASSOCIATED COMPLAINTS:NO
 PERSPIRATION:General: profuse+2Partial:scalp+2
 DIGESTION:Thirst:normalAppetite:decreased
Craving:chicken+3, chocolate+3 Aversion:fish+2
 ELIMINATION:Stool:yellow Urine:normal
 SLEEP: Duration: 8-10 hours position: on sides Disturbed:no
 DREAMS:daily routine+2
 MOTHER'S OBSTETRIC HISTORY:
Pregnancies:2 Gravida:1 Para:1 Abortions: natural at 3 months
Wake up at 6:30 am
Goes to school -7:30 to 12:30
Breakfast-7 am
Lunch-1 pm
Dinner-7:30 pm
Sleep-10 to 10:30 pm
B. LIFE – SPACE
Pt was born at Bharuch. There were mo, fa, gfa, gmo, foi and foi’s daughter. There is
good IPR with all family members. Fa is cool and calm in nature. He never used to got
angry on him. Mother is quite irritable in nature and occ. got angry on him for his
mischievousness. He is only child in family so pampered a lot by everyone.
Pt is quite irritable in nature. He is obstinate in nature occ. for mobile. He throws
toys and all things in anger. He used to shout and cry in anger. He likes so much to going
to school. He is very punctual for his homework and exam preparation. He is very anxious
about homework and exams. He has friends at school and has good IPR with all of them.
He participated in extracurricular activity in school like drawing etc. He got 1 st price for it.
71
He is good at study. There is no complaint from school. He is very ambitious. He wants to
open a company of car in London. He likes to play with cars. He used to separate parts of it
and then makes a car. He wants to become engineer. He likes to make car, not to ride. He
wants everything neat and clean. He puts his toys at right place after playing. He likes to
stay with those with whom he is adjusted, not with everyone. He not easily mixes with
strangers. He has fear of being alone, of dark etc. He is very choosy in nature. He is helpful
when someone gets ill when he is in mood. He has fear of lightening. He is sensitive to
scolding. He used to cry while scolding. He wants to do better than others. He doesn’t like
that others lead than him. He likes to watch horror movies. He never used to got angry
outside home. He likes to bath. There was no identical mental stress on mother during
pregnancy. She wants to carry this pregnancy. Pt has fear of ghost. Pt is very clever in
study. Pt has sharp memory. Pt has dreams of daily routine.

 PAST HISTORY:pneumonia at the age of 1.5 years
 FAMILY HISTORY:gmo-HTN
PULSE:80/minWEIGHT: 13 kg CONJUCTIVA:pink
NAIL:pink TONGUE:pink
 SYSTEMIC EXAMINATION:RS: air entry: BLE, breath sound-vesicular
 PROVISIONAL DIAGNOSIS: ALLERGIC RHINITIS
72
Nose, paranasal sinus, mucous gland, mucous membrane

Since 3-4 years
White, sticky discharge

Coughing
Nervous irritation
Breathlessness
Nose block
Feverish feeling

Miasm: psora
73
 TOTALITY:
 Anger+2-throw things, shouting and crying
 Scholastic+2
 Perfectionist+2
 Anxious+2-before exams, homework
 Likes drawing
 High morals+2
 Fastidious+2
 Fear of-being alone+2,dark+2,lightening+2,ghost+2
 Sensitive to scolding+2
 Likes to bath+2
 Intelligent+2
 Precocious+2
 Dreams of daily routine+2
 Perspiration-profuse+2, scalp+2
 Craving-chicken+2, chocolate+2
 Aversion-fish+2
 Sleep-side on
 Chilly pt
 Mind-throw things-anger in
 Mind-shrieking-anger in
 Mind-weeping-anger during
 Mind-anxious-anticipation from
 Mind-precocious
 Mind-fastidious
 Mind-sensitive-reprimands for
 Mind-art-ability for
 Mind-perfectionist
 Mind-intelligent
 mind-fear-alone, being of
 mind-fear-dark of
 mind-fear-lightening of
 mind-fear-ghost of
 mind-bathing-desire for
 perspiration-profuse
 head-perspiration of scalp
 generals-F&D-chicken-craving
 generals-F&D-chocolate-craving
 generals-F&D-fish-aversion
 sleep-position-side on
74
 Phos-24/16  Calc-15/9  Sil-10/7
 Carc-20/12  Puls-14/8
 Lyc-15/11  Nat mur-11/8
Silicea Calc sil
Scholastic Anger-throw things and shouting
Perfectionist Anxious before exam
Anxiety before exam and homework Perfectionist
Likes drawing Fear of dark and ghost
Fear of ghost and lightening Dreams of daily routine
Sensitive to scolding Perspiration-profuse of scalp
Intelligent Aversion-fish
Perspiration-profuse Chilly pt
Chilly pt
This case falls under posoric miasm

Age-5 yrs sex-male
Pace of disease-sudden 200
2. Sensitivity (Mind & Nerves) Moderate to high Infrequent
Mind-+ nerves-+
200
Sleep-+ dreams- _
Mind-++ body-+ Silicea 200
Present 1M
5. Structural changes - -
- - -
Good 200
Presentation-
7. Moderate Infrequent
Sycotic:
200
gmo-HTN , H/O- pneumonia
B. Dominant miasm High Infrequent
Psora 1M
75
29/9/17: SILICEA 200 1P HS/WEEKLY
PT 1-1-1/4 WEEKS
 CRITERIA:
1. Coryza 4. Breathlessness
2. Nose block 5. Anger
3. Coughing-white, sticky 6. O/E
expectoration
 FOLLOW-UP:
DATE 1 2 3 4 5 6 INTERPRETATION PRISCRIPTION

7/11/17 sq >+ >+ >+ Sq RS-clear, Better but again SILICEA 200 1P
P-80/min, started since 1 HS/WKLY
Throat-clear week PT TDS×7
DAYS/4 WEEKS
21/11/1 <+2 <+2 <+ >+ >+2 Sleep- Acute episode of KALI CARB 200
7 disturbed rhinitis, need for 9P TDS×3 DAYS
due to acute remedy Then,
coughing Advice to
continue old
medicines
19/12/1 0 0 >+ 0 >+2 RS-clear Rattling cough KALI CARB 2OO
7 since 4-5 days 6P TDS×2 DAYS
Pt feels better SILICEA 200 1P
HS WKLY
SL PILLS TDS/7
DAYS/
4 WEEKS
11/1/18 0 0 >+2 O >+2 Pt absent Better+2 SILICEA 200 1P
HS WKLY
SL 3 PILLS
TDS×7 DAYS/
4 WEEKS
2/2/18 <+ >+ <+ <+ >+ RS-rattling Has to take KALI CARB 200
Rt>lt Ibugesic syrup for 9P TDS×3 DAYS
T-99.9 f fever(5-6 am) SL 3 PILLS
Throat-clear Activity-normal TDS/4 DAYS
Nose-crusts
9/2/18 >+2 >+2 >+ 0 >+2 RS-clear Better+2 SILICEA 200 1P
HS WKLY
SL 3 PILLS
TDS×7 DAYS/
4 WEEKS
23/3/18 <+2 <+ <+2 >+ >++ RS-clear Complain started KALI CARB 200
76
No from 2 days 9P TDS×3 DAYS
congestion SILICEA 200 1P
T-96.2 f HS WEEKLY
Wt-14.8 kg SL 3 PILLS
TDS×7 DAYS
/10 WEEKS
6/4/18 <+2 <+2 <+2 >+ >++ Rs-clear Not better KALI CARB 200
Wt-15 kg Complain started 9P TDS
Temp-99® f from 1 week SL 3PILLS
TDS×4 DAYS
13/4/18 >+2 >+3 0 0 >+2 Rs-clear Better now SILICEA 200 1P
Wt-15 kg HS WEEKLY
Appetite- SL 3 PILLS
decrease TDS/7 DAYS
×4 WEEKS
12/5/18 0 >+3 >+3 >+3 >+2 Rs-clear Better+++ SILICEA 200 1P
Appetite-N HS
Thirst-N SL PILLS TDS
×4 WEEKS
 CONCLUSION:
Pt has anxiety for exams and homework. He is very sensitive to scolding. It all causes
stresses to him. So he developed functional changes of allergic rhinitis. This case indicates
psoric miasm. After giving constitutional remedy SILICEA 200, infrequent repetition, he
feels relief.
Case no: 10 Define no: D- 10422 OPD no: 58796
77
Name: TTY Age: 28 Sex: male
Education: 10th Pass Occupation: Plumber Status: Single
Religion: MuslimVeg/Non-Veg: ALL
Brothers: 1-elder-32 yr Sisters: 1-elder-34 yr
Address: Khushboo Park, Bharuch
CHIEF COMPLAIN:
PATHALOGY A.F, <, >
1. RS Dry cough++ A/F – Dust, Lacrimation
NOSE Sneezing++ perfume, Cold Headache ( Heaviness of
Watery discharge++ exposure Head)
O: 10 yrs of age Itching++ <++ Early morning Appetite- normal
D - 1 wk Difficulty in breathing+ <++Night Thirst – normal
F- On / Off Nose blockage++ <++Fan Stool – normal
Heaviness of chest++ <++Monsoon Urine –normal
>++Warm Water
>++Hot Fomentation
>++Allo Rx
>++Sun Exposure
No Any C/o
 APPEARANCE: Short, Medium built, Wheatish Complexion.
 PERSPIRATION:General: Profuse+++Partial:Forehead++,Face ++,Axilla ++
Odour:Offensive
 DIGESTION:Thirst: NormalCraving: Fish ++,Pungent(Spicy) ++Aversion: Milk ++
 ELIMINATION: Stool: normal Urine: normal
 SLEEP: Good (Deep)Duration: 7 hrs position: On Abdomen
 DREAMS: Daily Routine.
- 7:00 am – Wake up
- 8:00 am – Breakfast
- 8:30 am – Going to job
- 2:00 am – Lunch (Sabji Roti)
- 9:00 pm – Came home
-10:00 pm – Dinner
- 11:30 pm - Sleep
B. LIFE - SPACE
A 28 yrs old man came in our respiratory OPD with c/o sneezing, watery nose,
heaviness of chest, difficulty in breathing. His appearance is short. He is of medium built &
wheatish complexion.
CHILDHOOD: - Pt was born in Vorashamni Village in TA- Vagara, Dist-Bharuch;
Patient lived with MO, FA, Elder Bro, Elder Sis, Gfa & Uncle- Aunty. Patient’s father is
Farmer. He has 7 vigha lands in other village. He is angry in nature. Pt has always fear of
78
his father. Pt’s Mo was cool& Calm in Nature & She was H.W. pt has good IPR with her.
Pt’s elder brois also cool & calm in nature. Pt has good IPR with her brother. Pt’s elder sis
is angry in nature. Pt has not good IPR with her. Always quarrels occurs between them,
then after pt not talk with her, After Sometime Pt’s sis talk with pt by herself. Financial
condition was poor. In childhood, pt’s desires were not fulfilled and If he requires
anything, pt asked to her MO. In childhood, pt’s uncle separated with any quarrel but pt
not known it.
SCHOOL LIFE: - Pt completed 1 to 10 th STD in vorashamni Village. After 10th STD Pt left
study by himself because financial condition was poor. Pt has got 52% in 10 thSTD; Pt had
not participated in any activity because pt has fear of crowd& stage fear. Pt has 6-7 friends
in school. But no one best friend in school time,Pt not went to school but went to playing
with friends. Then after pt’s teacher complained of pt to home & pt’s uncle bit pt & pt’s Fa
got angry on him. Pt’s family was shifted from vorasomni to kolavas in 2012 because of
quarrel between pt’s fa & pt’s uncle. So pt’s Fa decidedto leave village. They lived 2 yr in
vorasomani then after pt’s family shifted bharuch in 2015.
After completed 10th STD, Pt started job of printing of kankotri. He done job for 6
months. After left this job, he joinedgarage for 2 months.Because of pt not like work of
garageand not know working of there, he left the job and started to sewing of clothing.
After doing this for 5-10 days, pt joined with elder brother and done plumber work. Then
after that work, he joined the company for 2 yrs.
PT AS A PERSON: - Pt as a person is angry in nature. Pt’s anger was violent & broken the
things which was present around him & bit the person. Pt is also obstinate in nature &
easily irritable by someone. Pt also has low confidence& not takes decision by himself. He
has to ask to his elder brother, Pt is more attached with his mother. Pt not shares his all
problems& his all things with anyone. Pt has grief about his hobby which was not fulfilled
in childhood so pt became sensitive.
REACTIONS - PHYSICAL FACTORS:
 MOTION & POSITION: swing < Vertigo, bus < Gabhraman, car< Gabhraman, < Nausea.
TEMP: Normal PULSE:60/min WEIGHT: 61 kg CONJUCTIVA:Pink
NAIL:Pink TONGUE:Pink, Moist
RS: AE-BLE- Clear, Vesicular breathsound CVS: S1- S2- Normal, No murmur
CNS:Conscious, OrientedP/A: Soft, Non tender, No Organomegaly, No distension.
 PROVISIONAL DIAGNOSIS:ALLERGIC RHINITIS
79
Nose, paranasal sinus, mucous membrane, mucous glands

Inflammation of sub mucosa
Since 18 years
Sneezing
Nervous irritation
Dry cough
Formation of tenacious mucous
Watery discharge
Mucosal irritation
Itching in nose
Breathing difficulty
Nose blockage

Miasm: sycotic
80
 TOTALITY:
 Anger +3:- Violent, beating, broken things around him.
 Obstinate+3
 Irritable++
 Confidence – Law
 Grief++- About his hobby which was not fulfilled in childhood
 Attachment with mother
 Fear of stage
 CR- Spicy+2,Fish+2, Milk +2
 Perspiration – profuse +++,Face ++,Axilla++,Forehead ,odour-Salty& Offensive
 Sleep-deep, disturbed due to fan
 Position – On Abdomen
 Fear – Height+++,Waterfall++,Snack++,Father++
 Motion - <Vertigo
 swing- <vertigo
 sneezing <perfume
 Hot Pt
 MIND – Anger – violent-breaking everything
 Mind- Anger – throwing things around
 Mind- obstinate
 Mind – irritability
 Mind – grief
 Mind- attached – strongly to others
 Mind – anticipation – stage fear
 Mind – fear – high place of
 Mind – fear – water of
 Mind – fear – snack of
 craving – food & drinks – pungent things desire
 cravings – food & drinks – Fish – desire
 perspiration – profuse
 Face – perspiration
 Head – perspiration of scalp – forehead
 chest – perspiration- axilla
 perspiration- odour – offensive
 sleep – deep
 sleep – position- abdomen ,on
 stomach – nausea – riding , while carriage or on the cars , in a
 Nose – Sneezing-perfume,from
 SULPH-28/16  Lac-26/13  Cal C-24/12
 Nat Mur- 27/16  Hep-25/13  Cal P-15/11
 Phos -25/12  Kali Phos-15/13  Sil-23/10
81
Nat sil Nat carb
Anger-violent, beating Anger-violent, beating and broken
Obstinate things around
Low confidence Irritable
Craving-spicy, fish Perspiration-profuse on face, axilla
Perspiration smells salty Sleep- on abdomen
Fear of height, snakes, stage fear Fear of height and of father
Motion aggravation Swaying<vertigo
This case is falls under sycosis miasm due to chronic inflammation with hypertrophy and
enlargement of glands.

Age – 28 years Sex- Male
seat of disease- Functional
Mind-++ nerves-++
200
Sleep-++ dreams-++
Const. Rx
3. Correspondence (degree & level) Infrequent
NAT SIL
Mind-++ body-++ 200
Present 1M
No
6. General vitality High Infrequent
Good 1M
Presentation-
7. High Infrequent
Tubercular 1M
Sycotic 200
 ENTRY-FIRST Rx WITH DATE:24/1/2018

SL 1P HS
SL PILLS TDS / 2 wks
 CRITERIA:
1. Sneezing 5. Cough 9. Lacrimation
2. Nasal discharge 6. Expectoration 10. New C/o
3. Itching 7. Heaviness of chest 11. O/E
4. blockage 8. Heaviness of head
82
 FOLLOW-UP:
DATE 1 2 3 4 5 6 7 8 9 10 11 INTER- PRESCRIPTION
PRETATION
7/2/18 <+2 >+ >+ 0 >+ 0 >+ 0 >+ no BP-130/90 Better SL 1P HS
mmhg SL PILLS TDS/
Pulse-78/min 2 WEEKS
28/2/18 <+ <+ <+2 <+ 0 0 >+ 0 >+ Heavin Bp-120/90 Not better NAT SIL 200 1P
ess of mmhg HS
abd Rs-clear SL PILLS TDS/
1 WEEK
7/3/18 >+ >+ >+2 >+ 0 0 >+ 0 >+ New Bp-130/80 Better ++ NAT SIL 200 1P HS
com.-0 mmhg SL PILLS TDS/
Rs-clear 2 WEEKS
Pulse-78/min
28/3/18 >+ >+ >+2 >+ 0 0 0 0 sq No Rs-clear Much NAT SIL 200 1P HS
Bp-110/80 better SL PILLS TDS/
mmhg 2 WEEKS
Pulse-74/min
11/4/18 >+2 0 >+ >+ 0 0 0 0 >+ No Rs-clear Much NAT SIL 200 1P HS
Bp-110/90 better SL PILLS TDS/
mmhg 3 WEEKS
Pulse-82/min
9/5/18 >+2 0 >+3 0 0 0 0 0 >+ No Rs-clear Much NAT SIL 200 1P HS
better SL PILLS TDS/
6 WEEKS
 CONCLUSION:
Pt couldn’t complete his wishes due to poor financial condition in childhood and till now
he has grief of that. He has fear of crowd and stage. He also fears of his father due to his
angry nature and fear of beated by him. Due to these all stresses, he developed functional
changes of allergic rhinitis. This indicate sycosis miasm. After giving constitutional remedy
NAT SIL 200, infrequent repetition, he feels much better.
83
FINAL CONCLUSION:
 All of 10 cases have anxiety and other stresses in their life.
 In most of above cases, physician has prescribed constitutional remedy in moderate
potency. In 2 cases, physician has prescribed low potency and in 1 case; moderate to
low potency.
 Allergic rhinitis is more common in males than females. From above cases, 6 cases
are of males and 4 cases are of females.
 Allergic rhinitis is more common in age group 20-40 years. There are 5 cases of 20-40
years of age group, 3 cases of below 20 years of age and 2 cases of above 40 years of
age.
 There are 7 cases of sycotic miasm & 3 cases of psoric miasm
 Constitutional remedy SILICEA is prescribed in 3 cases, CALC CARB in 2 cases, NAT
MUR in 1 case, NAT CARB in 1 case, NAT SIL in 1 case, CALC PHOS in 1 case and MAG
CARB in 1 case.
84
SUMMARY:
 I have understood Allergic rhinitis as a clinical diagnosis very well during my period of
internship through the clinico-pathological condition.
 I have learned SFFT of many cases. It helped me in diagnosis and for the treatment
plan of each case.
 I have also could able to understand mental symptoms, stresses of individuals and its
effect in development of disease.
85
BIBLIOGRAPHY:
PSYCHOLOGY:
 Kaplan & sadock’s SYNOPSIS OF PSYCHIATRY- Tenth edition

 Hens seyle’s THE STRESSES OF LIFE
MEDICINE:
 By Longo, Fauci, Kasper, Hauser, Jameson, Loscalzo,HARRISON’S PRENCIPLES OF

INTERNAL MEDICINE- 18th edition, volume 2.
 By Nicki R. Colledge, Brian R. Walker and StuartH. Ralston -DAVIDSON’S PRINCIPLES
AND PRACTICE OF MEDICINE- 21st edition.
 By Yash Pal Munjal-API TEXT BOOK OF MEDICINE-9th edition-volume 2.
 By Goldman and Ausiello- CECIL MEDICINE- 23rd edition, volume 2.
ORGANON:
 Dr. M.L.Dhawale ‘S PRINCIPLES AND PRACTICE OF HOMOEOPATHY –Part 1.

 Dr. M.L.Dhawale’S & Edited By Dr. Anand R. Kapse – ICR OPERATIONAL MANUAL 2 nd
EDITION 2003
 By B.K.Sarkar- HAHNEMANN’S ORGANON OF MEDICINE
 Herbert A. Roberts-THE PRINCIPLES AND ART OF CURE BY HOMOEOPATHY
 James Tyler Kent-LECTURES ON HOMOEOPATHIC PHILOSOPHY- 7th edition
 Dr. Harsh nigam-MIASMA-THE ROAD LESS TRAVELLED
REPERTORY:
 J.T.Kent-REPERTORY OF THE HOMOEOPATHIC MATERIA MEDICA

 RADAR HOMOEOPATHIC SOFTWEAR 10.1 EDITION
MATERIA MEDICA:
 James Tyler KENT-LECTURES ON HOMOEOPATHIC MATERIA MEDICA

 William Boericke - HOMOEOPATHIC MATERIA MEDICA
86
MASTER TABLE:
NO. CASE NO. NAME AGE/SEX SUSCEPTIBILITY MIASM CR IR

1. Case: 1 PCS 33/male Moderate Sycosis Calc carb --
2. Case: 2 CCH 40/female Moderate Sycosis Nat mur --
3. Case: 3 PAK 23/female Moderate Psora Nat carb --
4. Case: 4 PDP 16/female Low Sycotic Silicea Thuja
5. Case: 5 PRR 21/female Moderate Psora Calc carb --
6. Case: 6 PPN 6/male Moderate Sycosis Silicea --
7. Case: 7 DYM 65/male Moderate to low Sycosis Calc phos --
8. Case: 8 PPK 72/male Low Sycosis Mag carb --
9. Case: 9 RHS 5/male Moderate Psora Silicea --
10. Case: 10 TTY 28/male Moderate Sycosis Nat sil --
87

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“TO UNDERSTAND THE EFFECT OF STRESS AND IMPORTANCE OF CLINICO-

PATHOLOGICO-MIASMATIC C0RELATION IN THE CASES OF ALLERGIC RHINITIS”

UNDER THE VALUABLE GUIDANCE OF

GUIDED BY: Dr. CHIRAG SHAH

INTERNEE: BINAL K. TIMBADIYA

This is to certify that

As an Intern, with provisional

Has satisfactorily completed her assignment on topic TO UNDERSTAND THE

PRINCIPAL SEAL OF COLLEGE HEAD OF THEDEPARTMENT

AIM AND OBJECTIVES:

 Pathophysiology and Manifestations:

o Episodic rhinorrhoea, sneezing, obstruction of the nasal passages with

 SYPHILIS:Destruction at all the levels

Inclusion criteria of study:

Exclusion criteria of study:

B) Method of collection of cases

SENSATION& MODALITIES ACCOMPANIMENT

C. REACTIONS - PHYSICAL FACTORS:

Nose, Para nasal Sinus, Mucus Membrane

Diagnosis: Allergic rhinitis

 PLANNING & PROGRAMING:

 ENTRY-FIRST Rx WITH DATE:

C. REACTIONS - PHYSICAL FACTORS:

Rs-Nose, paranasal sinus, mucous membrane of nose and throat

Watery running discharge Formation of tenacious mucous

Diagnosis: Allergic rhinitis with sinusitis

 PLANNING & PROGRAMING:

 ENTRY-FIRST Rx WITH DATE:

C. REACTIONS - PHYSICAL FACTORS:

Rs-nose, throat, paranasal sinus, mucous membrane, mucous glands

Running white, sticky discharge

Diagnosis: Allergic rhinitis

 PLANNING & PROGRAMING:

 ENTRY-FIRST Rx WITH DATE: 21/6/17

Rs-nose, paranasal sinus, mucous membrane

 ENTRY-FIRST Rx WITH DATE: 17/1/18

Case no: 5 Define no: 9656 OPD no:58332

Rs-nose, mucous membrane, paranasal sinus

Since 2-3 years

White, sticky discharge

Diagnosis: Allergic Rhinitis

 ENTRY-FIRST Rx WITH DATE:7/6/17

DATE 1 2 3 4 5 6 7 8 9 INTERPRETATION PRESCRIPTION

 DIET AND DAILY ROUTINE:

C. REACTIONS - PHYSICAL FACTORS:

 PROVISIONAL DIAGNOSIS:CHRONIC ALLERGIC RHINITIS

Rs-nose, mucous membrane, paranasal sinus, eustachian tubes, sinus ostia.

Thin, watery discharge Increase mucous secretion

Diagnosis: allergic rhinitis

 PLANNING & PROGRAMING:

Define with reasons the states PotencyChoice Repetition

 ENTRY-FIRST Rx WITH DATE:

SENSATION & MODALITIES

C. REACTIONS - PHYSICAL FACTORS:

Rs-nose, mucous glands, mucous membrane, paranasal sinus

Since 12-13 years

Watery discharge Formation of tenacious mucous

Diagnosis: allergic rhinitis

 PLANNING & PROGRAMING:

 ENTRY-FIRST Rx WITH DATE:

DATE 1 2 3 4 5 6 7 INTERPRETATION PRESCRIPTION

Case no: 08 Define no: 9792 OPD no: 51279

Since childhood, Increase since 2 yrs