Preliminary Information: Male child, 10 months
A 10 months old boy was brought to the casualty of the homeopathic hospital around 7 pm with sudden dyspnoea. His parents had traveled almost 60 km in desperation as they were strong believers in homeopathy. The symptoms were:
Complaints started in afternoon with mild cough and fever. By evening (4 pm ) Dyspnoea started suddenly, with loud audible wheeze. P/H/O: Similar episode twice where the child had to be admitted for 3-4 days. There was a loud stridor while breathing which suggested tracheomalacia as the possible cause that needed further investigation.
Mother’s observation was that the audible wheeze would subside when child was asleep.
Category II traige
RS: Loud3, Audible wheeze
Temp: 101 F
Heart rate: 160/min
Respiratory rate: 80/min.
Supra sternal notching +
Inter costal retraction
Sub costal retraction
Flapping of alae nasi
Chest: Wheezing ++, crepitation +
CVS: S1S2 : Normal
P/A: Liver 2 cm palpable. Spleen 2 cm palpable
Observation in the ward
Child used to sleep on back with outstretched arms.
According to mother child usually sleeps on sides.
X -Ray: Straightening of ribs with Hyper inflated lung
Hypersensitive Airways disease with tracheomalacia with entrapment emphysema In respiratory distress.
Emergency Analysis and Totality
Respiration whistling – awake when
Dyspnoea > lying on back with outstretched arms
Dyspnoea > Sleep during
Pace : Moderate to Fast
Pathology : Structural reversible
Sensitivity : High
Characteristics : Present
Correspondence : Key note prescription
Dominant miasm : Tubercular
Since this was reversible pathology, with characteristics and the diagnosis suggesting hypersensitivity, the susceptibility is high indicating a 1M potency.
This is classified as acute exacerbation of chronic disease, with tubercular miasm being the dominant miasm.
IV fluids for hydration and to maintain electrolyte imbalance
Plan of Emergency Management:
In an emergency, the focus is to control the wheezing to prevent respiratory fatigue and possibility of CCF. Since this was of sudden onset and moving at a fast pace, a higher potency with frequent repetition is needed.
The important aspect is to avoid an aggravation following the remedy when the child was already going into a state of fatigue with an accelerated respiratory rate of 80/min. It was decided to use a 200 potency instead, more frequently as long as its action lasted. This would help to calm down the emergency situation and reduce the respiratory rate gradually.
Prescription: Psorinum 200C 4 doses 4 hrly
When the 200C failed to produce further improvement, Psorinum 1M single dose was given.
Within 12 Hrs: Audible wheeze better3
RR: 50/ min
Chest: Harsh Breath sounds
Within 24 hrs No audible wheeze; RR: 36/min
Chest almost clear
Child active and playful
This is a good representation of how a KEYNOTE PRESCRIPTION deals with an emergency. What played an important role here was that the power of accurate observation was converted into a characteristic symptom that indicated the simillimum . Often, in an emergency, an alert homeopath well versed in remedy characteristics and characteristic repertorial rubrics, would be able to find an appropriate remedy very quickly.
Regarding management, the recovery under homeopathic management was quicker, within 24 hours, as compared to 3-4 days in earlier episodes of conventional management.
Dr. Navin Pawaskar, MD (Hom)
Director, Clinical services,
ML Dhawle Trust and Organizations