ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI
EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL
PRACTICE
Dr.Sunil.D.Bhalinge/Dr.Saima Modak
OBJECTIVES-
1. Understanding impact of neurological pathology on behavior of patient( wife/mother)
and its effect on caretaker ( husband)/son and family relationships
2. Understanding the importance of causation, organ-tissue affection and characteristic
effects on mind and body in constructing totality.
3. Demonstrating the value of symptom analysis and evaluation in selecting a suitable
approach to case.
4. Exploring role and scope of homoeopathic similimum in treating after effects of
neurological pathologies.
DIRECTIVES-
1. Study the Case History, Clinical notes and SCR.
2. Give your understanding of impact of illness on patient and its effects on family
dynamics
3. Considering above -Process the case -Patient as a person and characteristic mental
state .
4. Present the CI & Construct EET.
5. Suggest totality and a suitable approach with reasons.
6. Discuss your differential MM with levels of similarity and dissimilarity.
7. Present your TPD-TPR and follow up Criteria.
8. Fill up the RREF
1. Case History –Written by Husband & clinical notes –Scanned copy
2. SCR-
PRELIMINARY INFORMATION
CASE REGISTRATION NO: V/112/ 18, DATE OF CASE TAKING: 24/4/2018
NAME: Mrs. G.S DOB:12/10/1963 AGE: 54 yrs SEX: female
EDUCATION:B.A.(Sociology) MARITAL STATUS: Married (1990)
RELIGION: Hindu- Tamilian DIET: Veg
OCCUPATION: -Zee Telefilms- Sony
SPOUSE: 63/Retired/Taj Hotels-Finance Dept;Now doing Insurance agency from Home.
SON-27/IT-Zee TV
FATHER:65/Expired/Indian airlines MOTHER:88/HW
ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI
EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL
PRACTICE
BROTHERS:-- SISTERS-(4) 67/65/64/63
ADDRESS:-----------
CHIEF COMPLAINTS
LOCATION SENSATION&
PATHOLOGY.
MODALITIES
A.F.,<,>,
ACCOMPANIMENTS.
(Strict time relation.)
2001
Head-Brain
For 1 month
Lungs D=6
months
April 2002-
Insidious onset
over a week
Since then
continuous
Right UE/LE
Could not recognize
any one
No LOC
Started with High fever
with Increased BP
Developed Miliary
Koch’s
Severe
headache,Neck
pain,diplopia,
Tendency to fall on
right side,
Loss of coordination
Gait Unsteady Ataxia
Right Cerebral
Tuberculoma
(45x32x26 mm)
Operated –Excision
Done on 17/4/2002
3 months in ICU
Speech slow & slurred
Tremors 2 /
Weakness Grade 4
Coordination loss of
Need help in daily
activities
Pain3,
A/F-Fall from bed
Rx AKT
Rx,physio
ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI
EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL
PRACTICE
ASSOCIATED COMPLAINTS:
LOCATION SENSATION& MODALITIES ACCOMPANIMENTS.
Head-Occiput 3
Circulation
Since then 3-
4/week
D= few hours
Now since 10
days aggravated
Large vomiting
3 hrs after dinner
involuntary.
nausea absent.
hunger after vomiting
BP 160/170-95 with
headache or else
120/80
(9/2017)CT-
Angiogram Brain –
NAD
All neurological
symptoms of 2001-2
aggravated since
current form
Rx-Migranil
<3midnight after
<fasting3
<2sun
<getting wet
Rx Starpress XL
100mg 0d
2Mind
Since Surgery
Mood swings.
obstinacy.
childlike behavior.
Wants care, attention
or gets irritated easily.
concentration less2
Confidence loss of 2
>2 company of
husband
ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI
EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL
PRACTICE
PATHOLOGY. A.F.,<,>, (Strict time relation.)
Lungs-Blood
2001
Miliary TB Rx Anti Kochs
May 2010-Right
Kidney
Colic
Right hand-
radius and Ulna
1992
Fracture
Cannot Lift weight
A/F fall
Plating done
Right
malleolus 2011
Fracture A/F fall
Left Knee 2010 OA
Xray\Tibial spiking
Metabolism
Since
Menopause 3 yrs
DM 2 -
Asymptomatic
Detected -FBS-160
PP-180
Normal or Max
range same as
above
Rx Janumet 50/500
1 od
Circulation
Since
menopause
BP 150/100
Headaches
/palpitations
Rx Starpress XL 1-
od
Mouth –Oral
mucosa since 1
year
F-1/month
d-2-3 days
Recurring painless
Ulcers
No aggr- heat or
cold
GIT –
retrosternal
since 5 years.
F-1/month
d-2-3 days
Bloating 2
Belching
Sour, bitter
eructations
Reflux
Sensation of Dry
mouth with
Increased salivation
Occ vomiting
< 2 loss of sleep
< 2 irregular meals
Sleeplessness
Increased app
Nose – Throat
Since 8 yrs
F-1/month
D-1 week
Block 2
Watery discharge
Pain
cough Dry or wet.
< COW 2
< cold food 2
Warm2
.
Sensation of Dry
mouth
With Increased thirst
and salivation.
ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI
EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL
PRACTICE
Sputum
green,white,thick.
expectoratio
n.
Loss of appetite
Dullness 2
Bodyache 3
PATIENT AS A PERSON
APPEARANCE : Short height, short hair
Wound Healing: n
Perspiration: Forehead 2; Axilla 2 , : Odors: Offensive 2 since menopause : Staining :Nil
Appetite: N (Increased/Decreased in acutes) Cravings : warm food 3
Stool:. Frequency: N Urging : N Satisfaction: N
Urine: Frequency: N Urging : N Control: N
Menstrual function-H/o Regular, Flow –n, Color-black or dark Red; H/o menses During – Back
ache2 /bodyache2- used to take painkillers occ
Menopause since 3 yrs –Persp; BP fluctuating; Mood swings, (DM 2- Now under control)
Leucorrhea- H/o during menarche and offensive during menopause
Sexual Function: H/o N ; Interest /Desire –Less since Illness
Sleep : Disturbed due to thoughts;anxiety -financial
DREAMS-Dirty Toilets; not able to pass stools
< 2 sun= Headaches < 2 Fasting= Headaches No food Aggravations.
Fan- Summer-Full/winter/rainy-Medium AC- in summers + Covering –Light
Bath- Cold in Summer ;Warm in Winter and rainy { C3 H2 }
FAMILY HISTORY : Father-IHD
PHYSICAL EXAMINATION:
Temp: N Pulse: 76/m RR: N BP: 181/122 Weight: 58 Kg Height:
RS: NAD CVS : S1 S2- N, No Oedema P/A: NAD
CNS- Conscious ; Speech- Slow,Dysarthric
Gait- Unsteady; Short Wide steps Imbalance on closing eyes;Walks 1 km with support
Power Left Side UE-LE-Normal Right UE/LE- Grade 4
Reflexes –DTR-K/A/S-Left-Normal Right-Sluggish
Tremors – Right side
C. LIFE – SPACE INVESTIGATION.
Mrs G was residing in Chennai till 3 std with mother, brother, sister and Gr Pa. Father
was Personal Officer in Indian airlines was posted in Delhi (transferable) . He visited them on
weekends. Family did not move with father so that schooling of children is not affected. Patient
ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI
EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL
PRACTICE
used to get many things when father returned so his absence did not affect her. Father was
calm and most nonviolent person. She described mother as smart, intelligent, mild aggressive,
decisive3, cleanliness maintaining 3, fastidious. Parents shared a good relationship She used to
adore her parents. She is attached to her mother. IPR with grandparents good.
She has 4 elder sisters. Elder one; she described as one who is thinks is smart but
actually is foolish. (there was an expression of dislike for her while talking ) she has done BA
and now house wife (waste of education). She had done love marriage. She described this BIL
as an ideal man.
Second sister is very patient. She has done BSc and now works as regional manager
in pharmacy. Relationship with this sister is good. She said 2nd sister's husband is very short
tempered, it was a shock for her to witness their fights, she feels sad for sister but does not
interfere saying its his nature.
With third sister good IPR.She is a teacher in montessori.
Fourth sister, she is attached3, one with whom she can speak her heart out. She has
done B. Com and is secretary in office. She said her house was like any other house-very nice,
no fights, understanding, lucky to have such family.
When patient was in 6std father expired, it was sudden, as a child she said had no
effect and did not know what can be the consequences. 4th sister helped her a lot, like a mother
she is to her. Patient family experienced financial crunch3, home was given on rent, relatives
stopped coming to their place, she said they are selfish people and is thankful that she
witnessed such phase to identify the people and is grateful to her elder sisters and BIL for help.
Mother played double role and gave full attention to family.
School /college was fun3, enjoyed3, selective friends, good in academic and sports,
essays. ECA3. Daring, no fears, liked to read fiction and enjoy nature. She likes work perfect,
punctuality and has self-reproaching attitude. She studied up to B.A. Sociology.
Post marriage, MIL FIL had expired. BIL stayed in Chennai . SIL in Mumbai. She has
cordial relations with them, not attached as their wavelength doesn't match. Described husband
as understanding, caring, motivator, lucky to have one
She stayed in Chennai for few years then Mumbai with son and husband as husband job got
transferred. She works as a content editor in censor department in TV. Tamil, now Zee.
Enjoys3 satisfied 3 with work-desk job3. She is workaholic, no time for family, when worked up
(maximum times) used to displace anger, frustration on family, loose temper easily at work
when done wrong, not listened to.
About illness- she earlier felt ‘why me? I cannot work. She feels she has wasted
golden years of life.Was depressed, she had lost her confidence, was unable to do any work,
needed help for day to day activities., house EMI burden on husband because of her, there was
neglect of son's health and education. Son is very attached to her, he suffering from
somnambulism, depression with suicidal attempts and hallucinations, practises meditation3
which relieves him.
ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI
EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL
PRACTICE
Since 3 years is attending 'Access Consciousness -' it has made her more calm, she
does not shout now at family as realizes they are close precious ones. She closes door and sits
down quietly for some time. It has even increased her confidence and contributed on a good
way to life. She has changed, gives time and value to family. Family has come closer, husband
more caring, he left his job and did insurance work from home so that he can take full care of
patient, son has become more responsible and caring, now she thinks only about the positive
outcomes of that phase that family came closer.
HUSBAND VERSION OF PATIENT.
Before surgery-she was calm, understanding. Now she is child like,mood swings 3,obstinate 3,
manipulates to get what she wants. I have to handle her like a child. She doesn’t forget. She will
not talk. She wants company of husband . No socialization.
He left his job to take her care but she never appreciates him. Since then he has started
Insurance work, but whenever he has an client visit, she is unhappy as wants him at home all
the time.
INVESTIGATION:
MRI- Brain- Gliosis on Opertaed Site USG Thyroid -NAD
Scanned by CamScanner
Scanned by CamScanner
Scanned by CamScanner