Casos clínicos de / Clinical cases of ROBERTS

                                   (los subrayados en los textos no son originales / underlined texts are not original)

La Homeopatía considera al hombre como una totalidad, no sólo sus partes individuales.
            H. Roberts.- ¿Qué tiene para ofrecer la Homeopatía al joven?, en Los Principios y el Arte de Curar de la Homeopatía.

…la Homeopatía como método se traza lógicamente según las reglas estrictas de la generalización inductiva a partir de los datos obtenidos de la observación cuidadosa de los hechos y los experimentos. Todos los procesos desde la experimentación pura hasta la prescripción curativa están controlados por los principios del razonamiento inductivo.
            H. Roberts.- Introducción al estudio de la Homeopatía, en Los Principios y el Arte de Curar de la Homeopatía.

Caso Sulph. de neuralgia del trigémino / Sulph case of neuralgia of trigeminus

Case i. This case offered comparatively few symptoms, but those few so clearly cut that we find them illustrative of the four necessary elements which we must have to use as foundations for our perfect case.
This man suffered terribly with tic douloureux, the intense spasms coming at about five-minute intervals. There was acute pulling pain in the left trigeminus nerve, accompanied with marked flushing of the face, with profuse sweat on head and chest. The upper jaw and cheek were very tender and painful. The conditions were greatly agg. by touch, excitement or talking; agg. wet weather; agg. at night; amel. by rubbing. With this condition there was ravenous hunger which always came on with the attacks.
His history divulged the fact that he had had for years a discharge from the ear, which had been stopped eight years ago by an ear specialist. Since then he had suffered from these attacks, which were increasing in frequency and violence. 
Now let us see what a well rounded repertory analysis can make of this case.
1. Location : Left side of face, page 59
Cheeks, page 57
Upper Jaw, page 57
2. Sensation : Pulling Sensation, page 175
3. Conditions of aggravation and amelioration :
agg. touch, page 304
agg. talking, page 303
agg. night, page 270
agg. excitement, page 279
agg. wet weather, page 309
amel. rubbing, page 318
4. Concomitants : Ravenous hunger, page 66
Sweat, upper parts, 262
Heat in flushes, 258
Ear, discharge, 41
The concomitant symptom of ravenous hunger is one which seemingly has no relationship to the case, but it actually occurs in distinct relationship to the case and is a most interesting concomitant.
The symptom of discharge from the ear might seem to have no relationship to the case, but since we find no rubric in Boenninghausen's Pocket Book relating to the suppression of ear discharges, and since it was one of the first symptoms present in the chronic constitutional condition of this patient, we are certainly justified in using it in our analysis.
From the fourteen rubrics, then, we worked this case. Let us consider those remedies which came through these rubrics, having twelve or more symptoms. They were : Ars. 12/41; Bry. 14/45; Calc. c. 12/47; Caust. 12:36; Chin. 12/42; Kali c. 13/38; Merc. 13/46; Nit. ac. 12/38, Nux vom. 13/47; Phos. 13/47; Puls. 13/50; Rhus 13/51; Sep. 13/47; Sil. 12/45; Spig. 13/44; Stann. 13/39; Staph. 12/40; Sulph. 14/58.
Calc. carb. Caust., Merc. Phos. and Rhus all lacked the characteristic sweating (note the difference here between the sweat of upper parts and sweat of anterior parts for Calc. carb.) Caust. Lacked the agg. wet weather. The trembling and twitching of the chronic Merc. case was absent; neither did this patient have the general constitutional symptoms of Phos. or Rhus tox.
The characteristic pulling sensation was absent from Ars. Calc. carb., Chin., Kali carb., Nit. ac. and Sil., Ars. lacked also the agg. wet weather; China lacked the relationship to discharges from the ear; Nit. ac., lacked the agg. talking; Puls., Sep. And Sil. lacked the amel. rubbing.Nux vom. and Stann. Have no relationship noted to discharging ears.Spig.lacked the agg. excitement.
In Bry. 14/45 and Sulph. 15/58 we find every symptom present. The family attested to the fact that this man showed marked irritability during the attacks. Both Bry. and Sulph. have marked irritability, so we cannot use this as a means of differentiation. We might have used this as a rubric in analyzing the case. For further means of differentiation let us consider the depth of the disorder, and the fact that, while the ear was not discharging at this time, we must consider the significance of these symptoms coming on after the ear discharges were suppressed. Sulphur is one of those deep-acting remedies that have the power to unlock suppressions and to open up masked conditions, and it has also the power in itself to carry the case on, many times, to a complete cure.
This consideration confirmed our decision to give this patient Sulphur. It is no part of this exposition of Boenninghausen's Pocket Book to consider the question of potencies, but it may be remarked here that Sulphur 1M., one dose, was given this patient. There was a slight aggravation during the first few hours, the amelioration. As amelioration took place the discharge from the ear returned. Occasional doses of the remedy over a period of time-three doses in a period of some eighteen months-not only cured the recurrence of these attacks but the ear discharge as well. The ear discharge, being the earliest obtainable symptoms in the man's chronic case, and a mater of several years' priority to the other symptoms, was the last symptom noted to disappear, as we have been taught to expect, thus demonstrating once more the accuracy of the law of the direction of cure.

Caso Phos. de dolor agudo en epigastrio e hipocondrio / Phos. case of acute pain in epigastrium and hypochondrium

Case ii. This acute case was a peculiarly interesting one, as it had received the prescriptions of two able prescribers of the homoeopathic school without any help-rather, the patient continued to grow worse. The case had the further merit of being checked by laboratory analysis.
The patient, a woman 65 years of age, complained of a pain which began as a soreness in the epigastrium and right hypochondrium, increasing to a sore pain. The pain was amel. while siting, amel. belching; agg. lying on the back, markedly agg. lying on right side; agg. on motion, especially on turning over in bed. There was a constant sensation of pulling in the right hypochondrium, agg. lying on the right side. The pain causes sweating. There is pain as of repeated blows in the region of the right scapula. The mouth is exceedingly dry. There is a great aversion to food or drink, and the odor of food, or any other strong odors, are very offensive and cause nausea. The patient vomits as soon as water becomes warm in the stomach; there is no thirst. Although there is much flatus, none passes. The urine has an offensive odor.
It may seem strange that two of our ablest prescribers failed to see the outstanding characteristics of the remedy, possible because this patient was not the characteristic "type" of the simillimum, which was found by this repertorization. At this time the white blood count was 19,000. Let us consider the case further.
This case presents the four points so necessary in making a repertory analysis :
Location : Epigastrium, page 79
Hypochondrium, right, page 82
Sensation : Pulling page 175
Hammering, page 162
Sore Pain, Internally, page 181
conditions of aggravation and ameliortion :
Agg. lying on back, page 290
Agg. lying on right side, page 290
Agg. motion of affected part, page 292
Agg. turning over in bed, page 304
Agg. strong odors, page 293
Amel. siting, while, page 319
Amel. belching (eructations), page 313
Concomitants :
Sweat with associated symptoms, page 265
Thirstless, page 66
Mouth in general, page 62
Dryness internally (of parts usually moist), page 156
Incarcerated flatus, page 85
Urine offensive, page 95
Since Boenninghausen has no rubric covering the concomitant symptom, vomiting as soon as water becomes warm in the stomach, this was reserved for reference to the materia medica.
The case was repertorized on the eighteen symptoms noted above, with the following results : Sulph. 18/71; Phos. 18/68; Nux vom. 16/71; Puls. 16/63; Bry. 15/58; Acon. 15/57.
In spite of the considerable difference in numerical totality between Sulphur and Phosphorus, it was a simple mater to differentiate between the simillimum and the similar.
Phosphorus 1m. was administered; the patient became more comfortable and two days later the white blood count had dropped to 11,200. Improvement continued and the whole condition cleared completely within a few days.
It is almost unnecessary to point out that the symptom, vomiting as soon as water becomes warm in the stomach, served as the differentiating factor in the case. With a knowledge of our materia medica it would seen unnecessary to repertorize a case so clearly marked, yet after the failure of two outstanding homoeopathic prescribers one might hesitate to undertake to select the simillimum without a thorough analysis of the case. The result warranted the time taken.

Caso Calc. de asma / Calc. case of asthma

Case iii. A young man, 25 years of age, gave the following history :
As a child he was very stout, and as a small child he had asthmatic attacks. At 11 years of age he was exposed to the weather, soaked through with rain and thoroughly chilled; rheumatic fever that settled in his knees followed. He later (following the rheumatic fever) became very thin, and developed chorea to the point of clonic convulsions. He was sent to a camp in Maine where the regular hours and the out-door life entirely relieved his condition and he began to gain in weight.
In 1919 he developed eczema on his arms; this was suppressed by local applications. The eczema itched to the point of agony; it was agg. night, agg. warmth of the bed, agg. sweating. He could not endure being covered at night as it caused sweating and this in turn agg. the itching.
In 1930 he contracted a cold that was thought to be tubercular; he was sent to an institution but was discharged at the end of six months. In 1932 he had scabies "cured" by external applications, and a return of asthmatic attacks. These attacks waken him from sleep at night. There is copious expectoration, gray, green or yellow. Attacks come on also or are agg. from wind, agg. winter, agg. wet weather, agg. dust. He is still nervous; he craves candy and sweets.
The following rubrics were chosen :
1. Oppressed respiration, page 113
2. Agg. wind, page 309
3. Agg. wet weather, page 309
4. Agg. winter, page 310
5. Symptoms causing sleeplessness, page 246
6. Expectoration gray, page 118
7. Expectoration green, page 118
8. Expectoration yellow, page 119
9. Sweat with associated symptoms, page 265
10. Scabies suppressed with mercury and sulphur, page 211
11. Agg. warm wraps, page 308 (cannot endure being covered)
12. Tetter itching, page 229
13. Agg. night, page 270
14. Agg. warmth of bed, page 308
15. Nervous excitement, page 157
16. Convulsions clonic, page 150
17. Arthritic pains (in the joints), page 161
18. Agg. getting wet, page 309
19. Desires sweets, page 69
The following remedies came through in sufficient rank for consideration :
Calc. carb. 19/66 has every symptom, Puls. 17/69 lacks 7 and 19; Sep. 17/69 lacks 2 and 19; Sulph. 17/66 lacks 7 and 10; Phos. 17/61 lacks 10 and 19; Lyc. 17/65 lacks 10 and 15; Nux vom. 17/56 lacks 10 and 18; Carb. veg. 17/51 lakcs 7 and 15; Ars. 16/59 lacks 14, 15 and 19.
Without any question Calc. carb. not only met every symptom but was his constitutional remedy-the remedy he should have had in childhood. Fortunately, it was still indicated.
-Calc. carb. 1m. was given with amelioration of the asthmatic attacks but return of the eczema, to the patient's disgust. He returned at long intervals for a period of two years, but distrusted the remedy because of the skin aggravation that he twice suffered. The asthmatic attacks disappeared except for an occasional very mild reminder of the difficulty, and the eczematous condition steadily improved until it, too, practically disappeared. The patient was so much better he stopped coming, and the last reports were that he was in good health and gaining weight, although there was some itching at times.

Caso Sil. de fiebre del heno / Sil. case of hay fever

Case iv. A young woman, 17 years of age, had suffered from hay fever for fifteen years. Her appearance was one sodden mess. Her symptoms were as follows :
Attacks begin in April and last until frost. Itching of the eyes when the attacks start, then profuse lachrymation, and later, a sensation as i pins were sticking in the eyes. Raising the eyes to look upward is painful; for relief she pulls the lids away from the eyes. Conjunctiva very red, worse in the left eye, but this condition alternates from side to side. She wants to shut the eyes often. Stopped nose, which is amel. upon first rising in the morning; there is some discharge, white, watery and profuse at times. Considerable sneezing agg. toward night. Quantities of mucus in the throat in the morning, thick and yellow, which she must cough to raise. All the above conditions are agg. night, agg. dry weather, amel. rainy days, agg. light and agg. reading. There is swelling of the cheeks with these attacks and pimply eruptions on the face.
It is hard to get to sleep because of the stuffy nose and her sleep is restless.
She takes cold easily, and has frequent attacks of bronchitis in winter.
She always wants warm clothing, and there is no sweating. Menstrual periods are three weeks late but there are no other menstrual symptoms.
She has had measles, scarlet, fever, whooping cough. Vaccinated at 11 years; injections four years ago and allergic treatments with mixed pollens.
The case was repertorized on the following symptoms :
1. Lachrymation, page 32
2. Conjunctiva, page 31
3. Itching, page 165
(Mucous surface being internal surfaces in essence)
4. Inflammation mucous membrane, page 164
5. Agg. pressure, page 294
6. Agg. opening eyes, page 294
7. Agg. looking upward, page 288
8. Agg. light, page 287
9. Agg. reading, page 295
10. Swelling of cheeks, page 55
11. Eruptions on face, page 53
12. Becomes chilled easily, page 255
13. Tendency to take cold, page 148
14. Mucous secretions increased, page 168
15. Falling asleep prevented by symptoms, page 240
16. Sleep restless, page 244
17. Agg. evening, page 270
18. Agg. dry weather, page 278
19. Stopped coryza, page 47
20. Nasal discharge watery, page 48
21. Sneezing, page 49
22. Internal throat, page 64
23. Cough with expectoration, page 115
24. Expectoration yellow, page 119
25. Menses late, page 108
26. Skin dry (want of sweat), page 207
27. Internal chest, page 124
28. Amel. rising from bed, page 317
The following remedies ranked :
Sil. 27/113 lacked 28 (but it has amel. change of position); Sep. 27/109 lacked 6; Puls. 26/115 lacked 6 and 18; Phos. 26/110 lacked 18 and 28; Sulph. 26/109 lacked 6 and 7; Nux vom. 26/103 lacked 7 and 28; Bry. 26/102 lacked 7 and 28; Ars. 26/97 lacked 3 and 6; Caust. 26/78 lacked 6 and 20.
At first glance this girl appeared to be a Pulsatilla case, but a repertorization and closer study demonstrated that Silica was the correct choice, since it had the modalities that Puls. lacked. After Sil. 1m. there was a sharp but very brief aggravation and steady and rapid improvement and but one very mild return of the symptoms, that was quickly cleared by a second powder of the same potency.

Caso Sep. de depresión / Sep. case of depression

Case v. A young woman, 35 years of age, was brought in by her family physician who felt he needed help on the case. She was greatly depressed, cried a great deal, and felt so unlike her cheerful self that she "felt frightened at herself." She has a "mad desire to walk" although she is averse to any work, mental or physical. She "faces the day with dread"; feels as if alone in the world; music, of which she has been very fond, is now extremely distasteful. She admits there is no reason why she should not be happy and content, since she has pulled through some hard times and now the road has been smoothed out. She has not slept for several days. Previously, she would awaken from sleep with a general quivering, especially in the pit of the stomach. She feels "weak in the knees" and has an "all-gone" sensation which is better after 4 p.m.  She has developed an aversion to being with people, especially crowds.
There is a great deal of headache, dull pain that comes and goes across the forehead, agg. in the morning; it becomes throbbing on stooping. There is a ringing in the left ear and sense of pressure in the ears as if they were stopped. Her tonsils are enlarged.
She is eating poorly and has recently lost 15 pounds.
She sweats all over. Her feet blister, and sweat. The nails are brittle.
The following rubrics were used :
Disposition generally affected, page 17
Sadness, page 19
Desire for motion, page 167
Epigastrium, page 79
Trembling internally, page 193
Waking in distress, page 240
Sleeplessness, page 245
Nervous weakness, page 195
Sensation of emptiness, page 157
Agg. music, page 293
Pain dull, page 169
Forehead, page 24
Sweat easy, page 264
Sweat, special parts, page 262
Stopped sensation in ears, page 44
Ringing in ears, page 43
Throbbing internally, page 191
Agg. stooping, page 301
Emaciation, page 157 (Tendency to lose weight)
Agg. morning, page 269
Eruptions, blisters, page 214
Feet, page 138
Nails brittle, page 223
Tonsils, page 64
Of the 24 rubrics used the following remedies ranked; Sepia 23/92 (lacks Tonsils); Puls. 22/90 (lacks Tonsils, Nails brittle); Merc. 22/86 (lacks Waking in distress, agg. music); Calc. carb. 22/84 (lacks Waking in distress, Tonsils); Sul. 21/91; Bry. 21/86; Lyc. 21/76.
Reference to the materia medica showed that Sepia reflected the likeness of the patient, and the remedy was administered. There was a decided aggravation and later amelioration, but it was necessary to repeat the potency within a few days later to raise the potency, which held the patient in a satisfactory manner.

Todos los casos extraídos de Adaptability en ROBERTS H. A. and WILSON A. C., The Principles and Practicability of Boenningshausen's Therapeutic Pocket Book.

No hay comentarios: