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Dr. (Mrs.) Arpana
Pareek
Reader, Dept Of
Repertory
Smt. KBAHMC,
Chandwad
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PRELIMINARY DATA
Name: Mr. Vishal Pawar
Age: 45 years
Sex: Male
Occupation: Businessman
Religion: Hindu
Address: Raipur
Marital Status: Married
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CHIEF COMPLAINTS
Pain in left ear since 2 years
Discharge from ear
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HISTORY OF CHIEF COMPLAINTS
Pain in left ear
Onset: Gradual
Duration: 2 years
Progress: Rapid
Sensation pressing with burning and itching.
< Lying of left side
< after midnight
> External pressure
Sensation of cold water running out of ear
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Discharge from ear
Onset: Gradual
Duration: 2 years
Progress: Rapid
Character: Purulent
Modalities: Same as above
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PAST HISTORY
Malaria 4 years back
No any major illness like DM, TB or HT.
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FAMILY HISTORY
No any major illness in family members like
Pneumonia, TB, DM, HT, Cancer etc.
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PERSONAL HISTORY
Food habit: Mixed
Appetite: No change
In morning takes tea
At Lunch 2-3 Chapatis and sabji + Dal +
Chawal
At Dinner 3-4 Chapatis and sabji
Desire: Not specific
Aversion: Not specific
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Thirst: Increased since complaints started
Bowel: Once a day, stool yellow, semisolid,
not bloody
Urine: 3-4 times/day, Offensive since the
complaints started
Sleep: Normal, Not disturbed
Dreams: Not remembered
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Thermals:
Food: Hot food
Open Air/cold/air: In open air, he feels better
Season: Not specific
In general no any special seasonal aggravation
Summer Winter
Bathing Warm water Hot Chilly
Fanning ++ No Patient
Covering Single Double
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MENTALS/LSI
LSI: Patient born in poor family. His father was
farmer. Patient is fourth child of his parents. He is
having 3 elder brothers and one younger brother.
From childhood he is very dull and stubborn.
Whenever he had done wrong he felt guilty and till
now after remembering those wrong deeds he feels
guilty.
He was average in studies, he had done his SSC only
because his understanding power was not good.
He gets angry on little things and his wife informed
that whenever he gets angry he does violence, breaks
the household things.
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PHYSICAL EXAMINATION
Built: Good, whitish complexion and tall
Weight: 65 kg
Height: 5’4”
Pulse: 76/min
BP: 118/76 mm of Hg
RR: 18/min
Pallor: Absent
Temperature: 980 F
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Cyanosis: Absent
Icterus: Absent
Oedema: Absent
Lymphadenopathy: Absent
Tongue: Pink and Moist
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LOCAL EXAMINATION
Inspection:
Redness and congestion in the left ear.
Purulent discharge is seen.
Palpation:
Tenderness present.
No lymph node is palpable.
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DIFFERENTIAL DIAGNOSIS
CSOM
Boil in the ear
Ruptured TM
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INVESTIGATIONS
Urine Routine
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NOSOLOGICAL DIAGNOSIS
CSOM
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MIASMATIC DIAGNOSIS
Syphilis
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CASE PROCESSING
Analysis of Symptoms according to Boenninghausen:
Location Sensation Modalities Concomitants
Pain in Pressing < lying on Urine
left ear Itching painful side offensive
Burning < After Thirst
Purulent midnight increased
discharge > Pressure
external
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Evaluation of Symptoms according to
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Boenninghausen:
Agg lying on painful side
Agg after midnight
Amel external pressure
Pain in left ear
Pressing, itching and burning type of
sensation with purulent discharge
Urine offensive
Thirst increased
Destructive
Sensation of cold water running out of ear 20
Synthesis with the totality of symptoms by www.similima.com
considering conceptual image and portrait
building:
Constitution nervous
Chronic phase of disease
Diagnosis CSOM
Pain in left ear
Pressing, itching and burning sensation with purulent discharge
< Lying on painful side
< After midnight
> Pressure external
Urine offensive
Thirst increased
Thermally chilly patient
Miasm syphilis
Destructive
Sensation as if cold water is running out of ear
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Repertorial Totality PDF
Pain if left ear Constitution - Nervous
Pressing type of pain Chronic phase of disease
Burning in the ear Syphilis miasm
Itching in the ear Diagnosis CSOM
Purulent discharge from ear Thermally chilly patient
< Lying on painful side
< after midnight
> External pressure
Thirst increased
Urine offensive
Sensation as if cold water is
running out of ear 22
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SELECTION OF REPERTORY
BTPB
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Repertorial Analysis
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Sr. Symptom Section Sub/
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No Sub rubric No. ation
1 Pain in left ear Ear Left 42
2 Pain pressing Sensation Pressing 173
internally
3 Itching Sensation Itching internally 165
4 Burning Sensation Burning 147
Internally
5 Purulent discharge Ear Discharges from 41
from ear ears, purulent
6 < lying on painful side Aggravation Lying, on side, 290
painful
7 < After midnight Aggravation After midnight 271
8 > External pressure Amelioration Pressure, external 317
9. Thirst increased Hunger and Thirst 66
thirst
10. Urine offensive Urine Offensive 95
11. Sensation as if cold
water is running out of D
ear
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12. Destructive D
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SPECTRUM OF REMEDIES
Sr . No Drug RV Sr . No Drug RV Sr . No Drug RV
1 11 21
2 12 22
3 13 23
4 14 24
5 15 25
6 16 26
7 17 27
8 18 28
9 19 29
10 20 30
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Chilly www.similima.com
Patient
(KRHMM
)
P. No.
Diagnosis Chronic
CSOM Phase
(Boericke) (BBCR)
P. No. P. No.
PDF
Miasm
Constitution Syphilis
(Murphy) (Synthesis)
P. No.
P. No.
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DIFFERENTIATION
Symptom
Destructive
Sensation
as if cold
water is
running
out of ear
Sphere of
action
Rubrics not
covered by
the remedy
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Selection of Final Remedy
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Administration of Remedy
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General Management
1. Avoid exposure to cold wind
2. Use muffler on ears while going out
3. Don’t touch or press the ear
4. Try to sleep on opposite side of pain.
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Follow up
Date Complaints Prescription
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Remedy Response
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Second Prescription
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