A CASE OF COLLOID GOITRENAME: MR A
AGE: 47 YRS
SEX: M
OCCUPATION: BUSINESS
STATUS: MARRIED
RELIGION: HINDU
ADDRESS: EAST DELHI
CHIEF COMPLAINTS: THE PATIENT PRESENTED WITH A HUGE LUMP IN THE LEFT SIDE OF NECK WHICH WAS DIAGNOSED AS A COLLOID GOITRE. HE HAD THIS SWELLING SINCE LAST 2 YRS AND WAS PROGRESSIVE IN NATURE. HE WAS REFERRED TO THE CHANDERNAGAR DISPENSARY BY ONE OF THE ADVOCATES FROM KARKARDOOMA COURT, DELHI.
ON EXAMINATION: THE SWELLING WAS FIRM IN CONSISTENCY; THE THYROID STATUS REPORTED EUTHYROID STATUS.HE WAS ON NO MEDICINES WHEN HE CAME TO THE DISPENSARY. PAST HISTORY: NOTHING SIGNIFICANT EXCEPT WAS DIAGNOSED WITH CHRONIC SUPPURATIVE OTITIS MEDIA LEFT EAR WITH PERFORATED TYMPANIC MEMBRANE-OPERATED.
APPETITE--GOOD. CANNOT TOLERATE HUNGER.EXHAUSTION IF FASTING.
THIRSTTHIRSTY
DESIRE-NO SPECIFIC CRAVING
AVERSION-NO SPECIFIC
STOOL- REGULAR, NORMAL
URINEOFFENSIVE. NO COMPLAINTS
PERSPIRATION- PROFUSE, GENERALISED
THERMAL MODALITYHOT PATIENT
SPEED OF ACTIVITYFAST, HURRIED
SIDELEFT SIDED AFFINITY OF COMPLAINTS (LT SIDED CSOM, GOITRE LT LOBE)
SENSITIVITYTO TIGHT CLOTHING AROUND THE NECK (NOTE SHOULD BE MADE IN BOTH PHOTOGRAPHS-PATIENT DID NOT WEAR UPPER TWO BUTTONS OF HIS SHIRT)
MENTAL GENERALS: THE PATIENT WAS FOUND TO BE EXTROVERTED AND COMMUNICATIVE. NOTABLE FEATURE WAS HIS BOASTING ATTITUDE THROUT THE CASE. HE HAD GOOD BUSINESS ACUMEN AND RAISED HIS BUSINESS TO HIGH LEVELS THROUGH HIS MANIPULATIVE NATURE.TOTALITY OF SYMPTOMS
1. SWELLING NECK REGION.
2. THERMALLY HOT
3. THIRSTY
4. LEFT SIDED
5. EXTROVERTED
6. LOQUACITY/COMMUNICATIVE EXPANSIVE
7. SENSITIVITY TO TIGHT CLOTHING AROUND THE NECK
CLASSIFICATION OF DISEASEPROGRESSIVE SYCO-SYPHILITIC
MIASMATIC DIAGNOSISSYCO-SYPHILITIC
RUBRICS SELECTED FOR REPERTORISATION:
1. GENERALITIES: SWELLING GLANDS OF, HARD2. EXTERNAL THROAT, CLOTHING AGGRAVATION
3. MIND: BOASTING
4. GENERALITIES: SIDE LEFT
REMEDY SELECTED: LACHESIS
TREATMENT:
6-8-2014: LACHESIS 1M 1 DOSE, SL FOR 1 MONTH
17-9-2014: SQ. SL FOR 1 MONTH.
2-11-2014: SWELLING SLIGHTLY REDUCED AS PERCEIVED BY RELATIVES. SL CONTINUED FOR 1 MONTH
12-12-14: SWELLING REDUCED FURTHER; THIS TIME PERCEIVED EVEN BY PATIENT HIMSELF. SL CONTINUED FOR 1 MONTH.
21-1-15: SWELLING REDUCED FURTHER. SL FOR 15 DAYS.
5-2-15: SQ. INBETWEEN PATIENT TOOK ANTIBIOTICS FOR ACUTE GASTROENTERITIS.
LACHESIS 1M REPEATED. SL FOR 1 MONTH.
15-3-15. SWELLING ALMOST GONE (SEE THE REPEAT PHOTOGRAPH). THE CASE REMAINS UNDER OBSERVATION WITH PERIODIC FOLLOW UPS. THE PATIENT RECEIVED ONLY TWO DOSES OF LACHESIS 1M IN THE ENTIRE TENURE OF AROUND 6 MONTHS TREATMENT.
BEFORE TREATMENT
AFTER TREATMENT