2007 April

Tuberculinum in 'Need for Freedom'

by Dr. Jayesh Dhingreja
NEED FOR FREEDOM


Mst. J.V., 2 years 2 months old, complaining of recurrent coughs and colds, occurring once or twice a month.
He is a low birth weight baby with a birth weight of 2.6 kg and was born through a LSCS (sectio caesarea) due to non progression of labor.
Also suffered from neonatal jaundice.
At the age of 1 year, developed Bronchiolitis; was hospitalized for 4 days and treated with nebulization and antibiotics.
3 months later, suffered from gastroenteritis and was again hospitalized for more than a week.
Since birth has recurrent tendency to catch cold.
Gets a constant cough which is worse during daytime.
No other symptoms could be given by the mother regarding his chief complaint.
Dentition started around 7 months….but he has stained teeth.
(Mother had taken antibiotics during pregnancy).
Walking was early around 7-8 months, but talking was delayed.
A very restless child, cannot sit in one place for even a few minutes; always wants to go out of the house.
Also, very obstinate and throws tantrums and shrieks if things do not go his way.
He even gets breath holding spasms.
According to his mother his appetite is very poor; does not demand any food and has to be fed forcibly.
She says that he is surviving only on water.
Perspires on his cervical region and is worse during sleep.
Does not take any covering in sleep and he throws off if anything is put over him.
Talks in his sleep and he awakens from the slightest noise.


O/E:
Hairy child.
Weight – 10 kg
Cervical lymphadenopathy
R.S. (Respiratory system)– Harsh Breath sounds.
Throat – Tonsils enlarged and congested.


Mother’s history during pregnancy:
'The child is my second child. I have an elder son.
After my marriage I was living in a joint family.
Prior to my marriage I was from a nuclear family.
My in-laws are good, but there are a lot of restrictions living in a joint family.
After sometime my dream of having my own house and living separately was realized.
I did not know about my pregnancy as I was busy in my moving plans.
I came to know about it in the 2nd month.
I was underweight during my whole pregnancy and that is the reason why my son is also underweight.
I was shocked when I got the news about my pregnancy.
I did not want the child because it would hamper my freedom.
I had just moved to a new house and I wanted to work, to live a life according to my own wishes.
Previously it was a routine life like a housewife; I wanted to move out of the house, meet different people. I didn’t like being in the house day and night.
I had many plans for myself, I had just shifted to a nuclear family, I did not want a child.
I cried a lot for two full days when I came to know about my pregnancy.
I decided for the child later, because my husband wanted it.
I already had a Cu-T inserted, so I was relaxed thinking that I will not get pregnant.
After deciding about keeping the child, the tension was of Cu-T (Cuprum), that will the baby survive? Will it have any complaints?
I was very much stressed out, not able to eat at all, not liking food, so no weight gain in the last two months of the pregnancy.
The major thought in my mind was, how will I cope if I have a physically or a mentally deformed child.
During the whole pregnancy I used to get irritated a lot, not liking food at all. Irritated with small matters and I used to shout at my elder son.
The main question was of freedom; to do whatever, when ever I desired to do so.
Pregnancy would take away my freedom and I will be stuck with my baby for 5 years even after the delivery.'

Strong family history of Tuberculosis – Grand father and uncle.


Remedy prescribed: Tuberculinum 200, I dose.


Follow up:
After 15 days:
The child was better; he had no cough or cold.
Weight – 10 kg.
R.S. (Respiratory System)– NAD
Remedy prescribed: Placebo


Follow up:
After 15 days:
No cough and cold.
Eating better.
Temper tantrums – better.
Remedy prescribed: Placebo


Follow up:
In a week’s time after placebo, the child developed a fever with cold and cough. This time the mother told me that the cough is worse during sleep, but he does not get up. His face was red during fever.
R.S. – clear.
Throat – tonsils enlarged.
Remedy prescribed: Tuberculinum 200, I dose, if needed repeat after 3 hours.


The fever responded in 2 doses and the cough was also better in 2 days.


Follow up:
After 15 days:
No fever, no cough and cold.
Appetite improved
Restlessness better; can sit in one place for some more time now.
Throat – very minimal congestion. Swelling of tonsils much better.
Weight – 10.5 kg.
Remedy prescribed: Placebo


The child is still on Placebo and is doing quite well.


UNDERSTANDING OF THE CASE

RUBRICS for the mother’s state:
MIND - AILMENTS FROM - anticipation
MIND - DELUSIONS - trapped; he is
MIND - DESIRES - full of desires
MIND – SELFISHNESS
The basic mental state of Tuberculinum can be understood with the help of the following rubrics:
MIND - DELUSIONS - crushed - everybody rushing; crushed by
MIND - DELUSIONS - trapped; he is
MIND - DELUSIONS - suffocating; as if

The feeling of restriction and oppression clearly emerges from the above rubrics. The trapped and suffocated feeling is symbolic of lack of space and time for oneself. Inability to pursue one’s interests leads to discontentment and frustration.
This frustration of unfulfilled desires is expressed in the form of violent anger and anxiety.
This anger either finds a vent in violent activities or in mutilating oneself.
The anxiety is expressed in the form of restlessness and fidgeting.
The great desire for open air and traveling is very symbolic of the desire for freedom.
The blocked mental energies finally give rise to pathologies in the respiratory system, glands, gastrointestinal system, nervous system, etc.


Dr. Jayesh Dhingreja
Email: jayeshdhingreja@gmail.com

Categories: Remedies
Keywords: freedom, restriction, anxiety, tuberculinum
Remedies:

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Posts: 8
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Re
Reply #5 on : Sun July 08, 2012, 10:10:29
indubitably a wonderful case that may help the novices to delve deeply into the thorough exploration of their patients' troubles. a lot of guidance can be had from the case.
regards
Dr. Hamaish

Posts: 8
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Reply #4 on : Sun December 02, 2007, 06:21:21
Very nicely written article. Very useful for the novices who are learning the ropes. Please keep up the good work.

Balbhadra Rana.

Posts: 8
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Reply #3 on : Wed April 11, 2007, 11:38:36
A very well pesented case where in 'cause and effect ' is explained explicitly . This case has encouraged me to use Tub. in acute cases. However the basis on which 200 th potency was used is still not very clear.
Regards,
DR. KANCHAN.

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Reply #2 on : Fri April 06, 2007, 08:01:50
Through this case, Dr. Dhingreja has explained very well, the influence of the mother's state on the child.He has brought about a better understanding of the theme of Tuberculinum.Also helped me to understand that,if it is indicated for the patient, a drug like Tub.can even be used in an acute episode of fever, without causing any aggravation.

regards,
Dr. Apeksha

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Reply #1 on : Sun April 01, 2007, 13:59:40
Very well presented case, in terms of history, follow up, rubric selection and understanding the mother's state which is inhereted by the child. This whole remedy picture of tuberculinum-"freedom, restriction, anxiety, obstinacy is very well described in Materia Medica be Dr. Philip Bailey, helped me understand much better through this case.
However, the physicals and differential remedies that were considered would have given a perfect end to the case.

regards,
Dr. Snehal