ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER...

ICR SYMPOSIUM ON HOMOEOPATHIC PRESCRIBING DECEMBER 2018, MUMBAI,

EXPLORING DR. C. M. BOGER’S PHILOSOPHY & ITS APPLICATION IN CLINICAL

PRACTICE

SINTHUJA/BHAVIK

BOGER SYMPOSIUM/DECEMBER 2018

OBJECTIVES:

1. Learning to size up the clinical understanding of a patient by correlating clinical history,

examination and investigations

2. Learning to understand the tissue affinity, pathogenesis and evolutionary march of

events and sizing up the TPD

3. Understanding the concept of morality and immorality for the patient and physician when

receiving the patient.

4. Learning to select appropriate approach and arrive at the simillimum.

DIRECTIVES:

1. Go through the history form and give your feeling state about the patient.

2. List down the various illnesses suffered by the patient from time to time.

3. Give your understanding of tissue affinity and pathogenesis and conclude your diagnosis

4. Identify pathological generals noted in the history of the patient

5. Study the life space and share your understanding of the mental state of the patient.

6. Make a totality and evolve a suitable approach. Integrate the entire understanding of the

patient and come to a final remedy after differentiating closely coming remedies.

HISTORY FORM (Translated):

Name: XXXX

Age: 32 yrs

Wt: 92 kg

Nature: Fun loving, Helping Sociable, Doesn’t keep anything inside, If felt bad about anything

then doesn’t get resolved easily.

Achievements: Whatever I think I will achieve.

Responsibilities: Providing all the facilities for all family members and fulfilling their

requirements.

Relationship with family members: Family consists of Father, Mother, Brother, Wife, 2 daughters

& Brother’s daughter.

Father disappointed with me and mother’s nature is good .Brother also keeps distance with

me. I love my daughters. Wife is good but I can’t fulfill her needs and lot of demands so I feel

disappointed ,daily quarrels because of this but still I try my best to act according to her

wishes. My friends always remain with me in all situations. My friends are like my family

members. Relationship with my friends is good and I like spending time with them.

Diet : Like pungent food, Chinese, south Indian, Like outside food more than home food , and

can tolerate hunger.



PRACTICE

Drinks: Like alcohol very much, sprite, coffee. Like alcohol very much I feel alcohol is medicine

for everything. I feel relaxed after taking alcohol. In any condition whether it is happiness or

sorrow or anger I feel relaxed after taking alcohol

Entertainment: Travelling, Movies, Games in mobiles, Talking with friends

Sleep & Dreams: Like sleeping very much, sometimes dreams. Snoring during sleep, Excessive

perspiration during sleep it is causing eruptions.

Past History: In 2016 operated for Hydrocele. Now better.

Had injury on the right leg in childhood which In 2017 gradually caused varicose

vein and also blockage of blood vessels, due to which I also developed Chest pain. Was

Hospitalized and I was in ICU and for this I took medicine for 6 months.

Present Illness: Till date my important complaint is cold. Because of this I have frequent

sneezing, headache, bodyache. All these complaints are increasing after not getting proper

sleep, dust, sun. As soon as going in sun complaints of cold will start.

Cold gets better by alcohol and hot soup but again reappears. In month of May took

Homoeopathic medicine from Khargar suggested by friend which was very helpful then cold

reduced. It is very far from here so I came to this hospital.



PRACTICE



PRACTICE



PRACTICE

SCR RECORDING

NAME: XXX

Date of case taking: 15/6/2018

AGE/SEX: 32 yrs/ Male EDUCATION: 6th std

OCCUPATION: Production Shift officer in company

STATUS: Married since 6 yrs SPOUSE: yyy 24 yrs old Occupation: House wife

Father: 50 yrs Mother: 45 yrs

Brothers: 1 younger (30 yrs), Married Daughters: 2 (4 & half yrs,3 yrs)



PRACTICE

Address: Boisar, Marathi School

Income: 20000

PRESENT HISTORY

CHIEF COMPLAINTS:

No. LOCATION

SENSATION

&

PATHOLOGY

MODALITIES

A.F.,<,>

ACCOMPANIMENTS

1. Respiratory System

(Nose)

Since Childhood(12

yrs of age)

O – Daily

D – Continuous

F – Daily (1 to 2

times)

P-No progression

Watery thin

coryza +2

Sneezing+3

Irritation of nose +2

(Has to touch nose

continuously)

Cough occasionally

No nose block

No throat irritation

< Dust+3

<Sun +3

<Mental tension+3

<Travelling+2

<Early morning

<Change of

weather

>Drinking

Alcohol+3 >Soup

<Physical exertion

>Rest+2

<Night Watching+2

>Steam Inhalation

<Night+2

Headache (Whole

Head)

2.

Veins

Extremities(Lower)

Both Knee joint

extending down in

both legs

(Right to left)

Since 10 yrs

(Increased since 2

yrs)

Varicosity+1

Pain+1

Itching+1

Discoloration

Greenish black++

<Rising from seat

after sitting+3

<Walking+1

<Squatting

>Sitting

ASSOCIATED COMPLAINTS:

3. Extremities(Lower)

Right leg

Veins-Popliteal and

Tibial

Right Sapheno femoral

junction

Deep Vein

Thrombosis with

history of

Pulmonary

embolism

>Anticoagulants

>Rx CROPIVAS-

AP 75

(Stopped since 6

months)



PRACTICE

In 2017 April Currently pain

which increases

intermittently.

PATIENT AS A PERSON:

Physical Characteristics: Fair

Stocky

Wight Gain since 12 yrs of age (After starts drinking alcohol)

Facial Configuration & Expression: Smiling

Greenish Discolouration in both the legs

Increased perspiration all over the body

Digestion: Appetite-Normal (3 times/Day)

Hunger-Normal

Eructations ++

Cravings :

Alcohol+3 (All types) Coffee+1 Spices+3 Cold Drinks+3

Eliminations:

Stool-Normal (1 time/Day), Satisfactory

Urine – Normal (5 times/Day)

Sexual Function: Increased desire. But feeling inferior and not fully satisfied after hydrocele

surgery

Sleep: Normal , Refreshing.

DAILY ROUTINE:

8 AM – Wake up

9AM-Breakfast

10 AM to 1 PM – Par time job in Textiles

After 1 PM- Lunch with friends

3 PM to 11 PM –Do Job in company

After 11 PM –Dinner

11PM to 8AM-Sleep

LIFE SPACE INVESTIGATION:

A 32 yrs male patient, native of Bihar, but born and brought up in Mumbai, came to

the OPD for case definition at appointed time. Fa-Very strict hence IPR with father was not

good. Mother is good but she follows father. Whatever father tells, patient and his brother have

to follow. So from childhood relations with parents were not good. Patient studied up to 6th std.

After 6th std patient had to go to another school which was at a long distance where travel

expenses were more. Father didn’t have enough money to spend for him as well as brother for

higher studies. So he was told to go for work and brother tol go for further studies. Patient felt

sad, angry and rejected and thought why only brother should be permitted and not me? Even

though he is not much interested in studies. After this he started separating emotionally from



PRACTICE

parents and brothers. Then he went for manual work from 12 yrs of age. While expressing this

patient told “I did almost all difficult works in childhood”. Initially he used to give all the money to

father. Then he stopped it & he doesn’t give because patient thought “father is not taking care of

me, then why should I give money to him?”

From 12 yrs he started friendships with many people even with elders and started

drinking alcohol and smoking daily. Once father scolded him for something and patient felt

angry, left home and went to Kerala for 3 days with 2 friends. Then he started to go faraway

places when some situation occurs e.g, when father gets angry with him. Patient can’t express

his anger towards father. He shares everything with friends or weeps when alone. Patient told

whatever the problem is; he will feel better by drinking alcohol and sharing with friends.

He had relationship with a lot of girls and many of them were ready to marry him.

Patient didn’t took that much interest in it and doesn’t have courage to tell to his father. So he

used to refuse them. Father fixed the date for marriage without informing anything to patient and

told patient the date for marriage. Patient got angry but could not do anything. On the day of

marriage he first saw his wife. Patient told he was having a lot of expectations about future wife

eg , She should work with patient or else somewhere and wife should also take care of family

and financial responsibility and overall she should be supportive for everything. But patients’

wife doesn’t have any job and she has lot of demands on patient and he has to fulfill all that.

Due to this fights occur between patient and wife. Patient used to get angry when wife

demands something he used to scold her that ”You don’t like me that’s why you are getting

angry with me. Better you go to your parents home. Then I will be happy. After that wife used to

cry and after sometime she starts talking with the patient. But inside patient feels guilty that “why

I told like that & I shouldn’t tell like that”. But outside he never expresses it.

Patient told wife is also same like his father. So he doesn’t like her. “If she is in

mother’s home I feel very happy because she concentrates only on her household works, taking

care of children etc. When I come from office she starts with all her demands. It irritates him.

When PP asked patient what are you expecting from her? Patient told that he is feeling wife not

sitting with him and never talks about him and doesn’t care about him.

When PP asked what you like about her? Patient told she cooks very well and lot of varieties.

That patient likes very much and he told he doesn’t like if she is cooking same food daily.

Father, Mother and brother (married) staying together in same house near to patients’

house. But patient doesn’t go there. No good IPR with brother also. If he is going there he

doesn’t talk to father because father is upset that he is not giving money to them. Patient

doesn’t care about that. Patient is very close with his 2 daughters.

Patient is very ambitious, works very hard for success. Satisfied in current job .First he

worked as a normal labor. Then he got promoted because of his ability and experience. But he

has lot of work pressure and tension. After marriage also he had lot of girl friends .1 girl is very

close to him, working together since 3 yrs .He listens to whatever she is telling because she is

taking role of father, mother, friend and everything. He reduced alcohol and smoking because of

her. She is married and her husband is also patient’s friend (He came with patient during the

day of case taking).He used to spend lots of time with them. Friends are very important in his



PRACTICE

life. They are like family members. They stand with him for all situations. He likes spending time

with them and he feels better.

REACTIONS-PHYSICAL FACTORS:

Season SUMMER WINTER RAINY

Fan Likes(Speed 4) Likes(Speed 4) Likes(Speed 4)

Covering Doesn’t like Doesn’t like Cover upto neck if

feels chilly

Bathing Cold water Cold water Cold water

PAST HISTORY:

April 2017-DVT-Right leg and Pulmonary embolism (Patient was hospitalized in ICU for 4

days).

FAMILY HISTORY:

Father – COPD

Mother-HTN, Asthma and DM

ADDICTIONS:

Alcohol, Beer and Tobacco

PHYSICAL EXAMINATION:

PR-74/min, RR-18/min, BP-118/80 mm hg

Throat-NAD

Nose-DNS (Left)

Tongue-Pink & White coated

R.S- NAD

Lower Limbs-Right leg (Below knee)-Varicose veins and Greenish black discoloration++

Left Leg (Below Knee)-Varicose vein

CVS-NAD

INVESTIGATIONS:

On 12/4/2017: USG both LL venous Doppler-Extensive DVT involving right popliteal and

tibial veins,80% lumen obliteration poor augmentation seen at the right sapheno femoral

junction & popliteal vein on calf compression & ankle dorsiflexion.

Mild Varicose veins seen in left leg. No incompetent perforators in left leg. No sapheno femoral

or sapheno popliteal incompetency.

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