Case of infective arthritis (TB arthritis)

By Arul Manickam on Tuesday, October 9, 2012 at 5:12 PM

Case of infective arthritis (tubercular arthritis) ---

In1978 he was affected by tuberculosis of knee joint, he had undergone 60 streptomycin injection and get
relieved from pain. But in 2004 again he was suffering from knee pain, crackling on walking and also had
a pain in left ankle, foot pain. Till now he is taking BP tablets from 1999.first right knee was affected then
it shifted to left knee.

Treatment history—
In 1976-- he had undergone 60 streptomycin injections. he got relieved from pain up to 2003
From-2004—2011-he was taking diclofenac daily, if he doesn’t take ,it will leads to severe pain and fever
in extreme degree and he cant able to do his routine job

Physical generals—

Appetite-normal
Thirst—1 lit/day
Motion—morning unsatisfactory
Sleep—reduced from 4 years, waking frequently
Position---lying on right side
Hand below head
Sweating—normal
Urine—uncontrollable—from 1 year, urging to urinate.
Climate---summer---sweating—irritating—tiredness
Aversion
Cold water, cold food causes cold attack only on summer time.
Bathing---cold water bathing
Covering-- uncovering all season.

Food and drinks---

Desire—fish 2+, potato.
Bitter food 2+
Spices
Aversion—sweets
Disagree- potato
Face-warts

Mind—

I felt upset when my wife died; it is the major incident that affected me.
From last 4 years I had no deep sleep. I don’t have a care, proper food. If she is alive she cares me and
nourish me a proper food, but now I alone have to prepare for myself. I lost my conversation with her. I
feel forsaken. I don’t have a help now. I am in alone. I feel depressed when I am alone. I don’t have a
care, consolation and nourishment.

Nature-

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I love Tamil literature; I have created stories, verses.

I want the things to be in the proper places

I love silent

I want to do a work quickly, I don’t want to postpone my work, and it should be done as soon as possible.

I am always sincere in my work. I am always responsible on my work. My wok should be done perfectly,
genuinely, accurately.

I love appreciation; I want to be appreciated in my work.

If some one not gave a respect and insult me, I don’t want to see his face even through out life period.
e.g.—one day I went to barber shop. I was first sat in the shop, but the barber calling an other person to do
a hair cut, I felt insulted, he didn’t give a respect. There after I never go to his shop till now even though
he was my close friend.

I want to be respect

His relative cheated his property, from that issue on words he hate his relative and don’t want to see his
face.

My analysis----

Traditional approach---

Rubrics—

MIND - AILMENTS FROM - mortification

MIND - CONSCIENTIOUS about trifles
MIND - FASTIDIOUS
MIND - FORSAKEN feeling
MIND - HATRED - persons - offended him; hatred of persons who
MIND - VERSES, makes
MIND - OBSTINATE, headstrong
MIND - DUTY - too much sense of duty
RECTUM - CONSTIPATION - ineffectual urging and straining
BLADDER - URGING to urinate
EXTREMITIES - PAIN - right then left
SLEEP - POSITION - side; on
SLEEP - WAKING - frequent
GENERALS - FOOD and DRINKS - bitter food - desire
GENERALS - FOOD and DRINKS - cold drink, cold water - agg.
GENERALS - FOOD and DRINKS - cold drink, cold water - agg. - hot weather, in
GENERALS - FOOD and DRINKS - fish - desire
GENERALS - FOOD and DRINKS - potatoes - aversion
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GENERALS - FOOD and DRINKS - spices - desire
GENERALS - FOOD and DRINKS - sweets – aversion

Above I am fitting mechanically the symptom into rubrics.

I want to eliminate the peculiar symptom in the reportorial chart.

GENERALS - FOOD and DRINKS - cold drink, cold water - agg. - hot weather, in

I consider this peculiar symptom as an eliminative symptom, he was affected a cold attack only on
summer climate when he drunk a cold food and drinks.

Remedies are

1.bry
2. kali carb
3. nat carb
4. veratrum alb

Bry---

agg. MOTION, amel. REST

Materialistic. Possession oriented.
Thoughts, talks about BUSINESS.
Great THIRST for large quantities (often or long intervals)
Dryness

Kali carb----

Systematic, proper, routine-oriented.

work,duty,family-oriented
Starting easily
Fears: being alone
Company desire
agg. 2-4 A.M.
STITCHING pains
agg. DRAFT

Kingdom approach--
Periodic table--
4 th row—safty,security,protection,task,job,
1 collum----depentent like a child,incapable,incapacity

I don’t have the capacity to protect myself.i am dependent.

Natrum carb---

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Forsaken feeling
Deligent
Verses making
Potatoes - desire
Cold drinks < hot weather

jan scholten ---Carb—---diginity,worker,self worth.

Natrum---theme----
Sensitive
Alone, depression
HATRED - persons - offended him; hatred of persons who
Mortification
Bitter food, fish—desire
Sun intolerance.
Kingdom approach—

Periodic table-----

3rd row,1st column

3rd row----forsaken
Alone
Care/uncared
Nurturing
1st column---- dependent like a child, incapable, incapacity

Natrum carb--I don’t have the capacity to find my own nourishment and care.
Loneliness
No one to care

Veratrum album----

Haughty, rudeness.
Dictatorial
Wants social position
Love cold refreshing drinks
Collapse
Maniacal

Natrum carb is fitted in material medica, rubrics, jan scholten method and kingdom approach of
rajan sankaran, so my choice is 100% sure.

24/3/11
Bp—140/110
Rx
Narum carb 200/1d

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31/3/11

Knee pain increased,foot,knee swelling increased, continues fever—99.9f, come to the clinic with stick
and help of other. Cant able to stand. All the complaints are extremely aggravated.
Sleep—well
Urine—uncontrollable—mildly changed
Stool-normal,satisfactory.
rx sl
10/4/11

Pain,swelling reduced,fever on and off.sleep-normal.urine—can able to control.

Rx
Sl

24/4/11

Fever completely stooped

Pain, swelling better.
Generals—good
Rx
Sl

8/5/11
Bp—140/90
Generals—good
Knee pain, swelling, 70% better

Advice to take ice cream and cold drinks, because in may month when ever he took cold drinks ,ice
cream which immediately leads to cold attack,cough,running nose continued up to 20 days .

Rx
Sl

30/5/11
No cold attack even after he drunk cold water ice cream (May month)
Can able to sit on Indian toilet, before cant able to sit on Indian toilet.pain,sweeling---considerably better
Rx
Sl

12/6/11
Sleep—better compare to before but waking 3 am cant able to sleep— from lost 3 days.
Knee pain-mildly increased ,swelling –mild-can able o bearable.
Mind—feels alone, helpless.—lost 3 days.

Rx
I want repeat the drug, but I fear to give the dry dose, because of aggravation, so i decided to give
split potency.

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Nat carb 200/1pill/15ml water+30 drop alcohol—stock solution

Advice to give 2 drop(from stock solution) on 100 ml waer—take only 1 spoon from the
tumbler.(when ever the Pain is more)

28/6/11
1 spoon taken, 1 time (spilt dose)
Pain ,swelling increased again, but tolerable.
Generals—good.sleep—good
Rx
Sl

13/711
Pain sweeling good.sleep-normal,generals—good
Rx
Sl

28/7/11

Pain, swelling—75%better
Sleep-good. Mind—better compare to before—alone feeling reduced
Rx
Sl

11/8/111
1 spoon water dose taken—due to pain. knee pain,sweeling—better, sleep—good, no frequent waking,
urine—controllable –60% better
Rx
Sl

23/8/11
Knee-70% can able to flex
Sleep—waking –3 am, but after can able to sleep
Generals—good
Rx
sl
7/9/11
1 time water dose taken.
Pain ,sweeling—75% better
Can able to ascending the stairs with out pain
Rx
Sl
28/9/11
Bp—140/90
Mild pain only on continuous walking but tolerable.
Generals—good
Rx
Sl
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15/10/11
b-148/100
1 time water dose taken
Sleep-good.
Pain-better but on and off coming when after heavy work
Rx
Sl
20/11/11
140/100
2 time water dose is taken as per my advice by phone
Mild heart burn
Pain better
Urine—urgency-mild
Rx sl
30/12/11
Sleep—feels alone, when ever thinking about this I don’t have sleep
Pain, swelling –improved
Rx
Advice to take 1 spoon from 1st tumbler (1st tumbler contain 100 ml water mixed with 2 drop of
medicine from stock solution)—weekly 2 times
20/1/12
Heart burn –better
Pain-improved at a same level.sweeling complexly gone
Rx
sl
9/2/12
Generals—good. pain—improved at a same level
Mind—alone feeling—there but reduced
Rx
Advice to take 1 spoon from 1st tumbler (1st tumbler contain 100 ml water mixed with 2 drop of
medicine from stock solution)—weekly 2 times
29/3/12
Crackling sound on walking
Pain improved at same level
Sleep—good
Bp—126/90
Rx
Sl
22/4/12
Mild elbow joint pain—10 days
Sleep-good
Mind—well
Rx
Sl
18/5/12
Bp-130/80
1 time water dose taken
Elbow pain gone
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Sleep,mind—well
25/6/12
Bp-130/90
Knee pain –4 days
Ankle pain—2 days
Generals—good
Rx advice o take 1 time water dose
12/7/12
Knee,ankle pain—better
Generals—good
Rx
Sl
28/7/12
Bp-122/90
Pain—reduced—85%
Crackling of knee-mild
Generals—good
Mind –considerably changed, forsaken feeling gone
Rx
Sl, advise to stop the BP tablet.
13/8/12
Bp—130/80
Knee pain,flexing,swelling—all complaints considerably better
Mental well being is good
Generals—good
Rx
Sl
17/9/12
Bp—130/80
Physically, mentally—good
Rx
Sl
8/10/12
Last 19 month he can able to do his work with out help of other
He is still working; pain and swelling are considerably improved
Bp—tablet—stoped completely
Physical and mental well being is good
Rx
Sl.

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