CLINICAL VERIFICATION OF

MATERIA MEDICA

Dr. Manasa Rao, B.H.M.S

A-4059

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 INTRODUCTION
I would like to share my personal observations on:
1. Two cases based on correlating clinical
symptoms with Materia Medica. (without
repertorising)
2. Italicized symptoms: In Boerickes Materia
Medica, lot of symptoms are very succinctly
placed in italics - which have personally
proved very useful to me in my Homoeopathic
practice. Out of these I will try to present 5
symptoms very briefly.
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 Case 1
Mrs. B, aged 76 years, presented on 4th December 2010
with complaints of difficulty in breathing on and off
for nearly 2-3 months. There was significant physical
discomfort while carrying out her general activities.
The breathlessness was worse with walking and
talking, basically with any movement. The slightest
draft of cold air aggravated her breathlessness. No
significant amelioration was noticed/narrated. There
was associated cough with greenish yellow
expectoration, copious, offensive expectoration
worse after coughing, present throughout the day.
There was no history of PND, Orthopnea, chest pain,
palpitation, abdominalHomeobook.com
distention. The patient was 3
remarkably obese.
 History of the presenting complaints:
The breathlessness progressively increased
around 2-3 months back after which she was
taken to the hospital. Was admitted for a
week, but none of the symptoms came down
in intensity. They had her discharged on the
patients request and had sent her home with
a lot of medication and also stating that she
has 2 or 3 months only to live. Since then, the
symptoms of cough, breathlessness and
expectoration remained the same.
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Medical History:

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 Family History:
Two brothers died of IHD/MI.
Elder sister died of carcinoma, oral cavity.

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 Physical Generals:
Appetite: Lost, eats because she has to, with bitter taste
in mouth
Thirst: Reduced
Urine: 1 or 2 times a day, Small quantity, has to press her
lower abdomen to pass urine (ever since medication
was given that incl steroids)
Stool: Constipated severely, NO urge to pass stool, passes
once in 5-6 days (ever since medication was given that
incl steroids)
Sleep: Disturbed, sleeps 2-3 hrs
Discharges: Greenish yellow expectoration, in lumps,
offensive, copious
No characteristic Aversions/desires/ Disagrees with etc.
Temperament: Sad (melancholic), taciturn
Thermal Relation : chilly Homeobook.com 8
 LIFE SPACE INVESTIGATION
CHILDHOOD: NORMAL
Was married at a very early age, had 6 children. No
mental health disturbances until now. Very active
and extremely strong willed in spite of all her
Physical troubles.
Present Mental Status:
LOST THE WILL TO LIVE- SUICIDAL TENDENCIES
MUSIC MAKES HER SAD.
FEELING OF DIRTINESS, FILTHY

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 CLINICAL EXAMINATION
WEIGHT: 64 KG

Pallor, Cyanosis, Icterus,

Lymphadenopathy: NIL
Oedema: Facial, all over , bloated
appearance
Clubbing: ( Grade II)

Temp: 99 F
Pulse: 92/min
RR: 19-21/min
BP: 160/90mm Hg
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 Systemic Examination:
CVS: S1, S2, NO GALLOP/MURMURS
RS: Bilateral Rhonchi heard. Bilateral crepts
scattered. Bilateral air entry equal.
Abdomen: soft, no organomegaly/ distention
etc
Cns: Clinically intact
Locomotion: Reduced

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 DIAGNOSIS:
INTERSTITIAL LUNG DISEASE SUPERIMPOSED
ON CHRONIC BRONCHITIS . PLEURAL
EFFUSION PRESENT.

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 Differential diagnosis:
Pneumonia:
Productive cough, fever, sharp stabbing chest pain
DULL note over the lung affected ( percussion)
Tuberculosis:
Productive cough, fever, weight loss, night sweats
Mantoux test negative
Lung Abscess:
Cough, offensive sputum
Single opacity always unilateral, localised dullness on
percussion, Bronchial breathing
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 TOTALITY OF SYMPTOMS:

1. Lost the will to live

2. Music makes her sad
3. Feeling filthy
4. Hopeless, loss of interest in life
5. Appetite perverted, bitter taste in mouth
6. Urine- Suppressed, Reduced in quantity and
frequency
7. Stool- Severely constipated, passes once in 5-6
days (managed by Carbo veg and other
breathing techniques)

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8. Obese, Retention of water, face swollen
9. Warts on face
10. Breathlessness, worse by motion, esp,
talking and walking.
11.Expectoration greenish yellow, copious,
offensive

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 Differential Drugs:
1. Lost the will to live (Platina, Nat Sulph, Kali-br, Aur met,
Caust)
2. Music makes her sad (Natr-c, Nat Sulph, Coffea, Sabina,
Sep)
3. Feeling filthy
4. Hopeless, loss of interest in life( China, Aurum, Calc, Ph-
acid, Phos, Nat sulph)
5. Obese, Retention of water, face swollen (Apis, Apoc, Nat-
carb, Merc, Ars)
6. Warts on face (Amm-mur, Nat-sulph, Caust, Nit-ac, Thuja)
7. Breathlessness, worse by motion, esp, talking and
walking. (Carbo-veg, Ars, Bry, Nat-sulph, Sil, Antim tart)
8. Expectoration greenish yellow, copious, offensive (
Puls, Hepar, Carboveg, Nat-sulph, Silicea
9. Damp Weather Aggravation ( Hepar, Nat-sulph, Rhus tox,
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 Natrum Sulphuricum (Glaubers Salt)
Suicidal tendency
Music aggravation
Hopeless wants to die ( main reason is feeling of
being dirty, repulsive)
Damp Weather aggravation
Slightest draft of air worsens
Greenish yellow sputum, offensive, copious
Warts on face and abdomen
Pathologically related and useful in respiratory
tract disorders
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 PRESCRIPTION
NATRUM SULPHURICUM 200, 4 pills once a day for 3 days
( alternatively)
Case was first taken on 4th December 2010.
7th December: Cough reduced, now present only at night,
breathlessness persistent, but slightly better. Expectoration
the same but feels better on the whole.

15th December: Expectoration reduced to almost nil, patient

gets up and does her daily activities. Breathlessness better.

25th December: Breathlessness reduced totally, patient feels

much better
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CASE: 2

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 Master A, aged 5 yrs and 8 months presented
on September 17th 2011 with complaints of
reduced concentration since 2 years. The
complaints were gradually progressing. The
main complaint was he delays in answering
questions. No specific aggravation. He almost
never responds to questions , related to any
topic. The other complaint is he never does
any form of writing however much he is
forced. The child was very mild mannered,
shy , quiet by nature.
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HISTORY OF THE PRESENTING COMPLAINT:
The child had no symptoms up until the age of 3.
Slowly and Gradually, he was
not responding to any question asked either
by parents/ preschool teachers. He had to be
coaxed plenty of times to elicit a single word
answer. If spoken nicely to, he feels better and
smiles. Else he cries.
Communication Was Nil.
Prefers Solitude, dislikes company, cries if
taken out.

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 Wavering Concentration, takes a long time to
grasp and read/ speak.
Does not wish to write at all.
Patient stares in to space when questioned..
Bowel and urinary habits are good, goes by
himself with no difficulty.
Keeps making involuntary motions of his
hands, legs, in no frequent order.
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 Medical History:
Medical History:
Delivered by Caesarean section, no trauma/bruising
occurred.
Had an attack of epilepsy when he was 3 months old.
The doctors had given him an anti epileptic which
was continued till date.
Vacccination schedule maintained correctly.
Milestone at proper age. Neck holding, teething,
crawling, walking etc all at correct age. Speaking
delayed
Catches cold frequently.

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 Parental History:
Non consanguineous marriage.
Mast. A, was born after 7 years of marriage.
Mother had one episode of Eclampsia during
third trimester. Her Blood pressure through out
the pregnancy was between 160/90 and
170/100. She was 36 years old when she
delivered Mast. A
Breast fed upto 1 year.
No other significant medical history was obtained

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 Generals:
Appetite: Normal
Thirst: Reduced, drinks forcibly
Urine: good frequency, no nocturnal enuresis
Stool: normal, once a day, no difficulty.
Sleep: Sleeps well, with hands above head. no dreams/nightmares/
not somnambulistic. Occasionally thumb sucking present.

Desires: Egg
Aversions/ Disagrees/Craving: nil

Temperament: Shy, polite, mild mannered, not stubborn, no temper

tantrums
Thermal relation: Hot patient
Discharges: Greenish discharge from nose, repeated tendency to catch
cold

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 Mental Generals:
Will: SHY, MILD MANNERED, PATIENT AND
POLITE. He never gets angry for anything. Only
cries when he is taken to meet people.
Understanding: good, obeys all orders except to
write.
Intellect: Close to dull normal
Concentration: Reduced, looks around after 2-3
mins of activity
Memory: Good for music, can repeat the words
of any song by just listening once

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 PHYSICAL EXAMINATION:
Weight: 25 kg
Height: 4 ft
Build: Skinny, lean
Pallor/Cyanosis/Clubbing/Lymphadenopathy/
Icterus: Nil
Eyes: Dark circles around the eyes
Temp: 98.2 F
Pulse: 98/min

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 Systemic Examination:
RS: Normal VBS all over the lung field
CVS: S1, S2 Heard. No murmurs
ABDOMEN: No organomegaly, tenderness
CNS: Clinically intact, but delayed in verbal
responses. Reflexes normal.
LOCOMOTOR: Normal gait and speed, flaps
hands repeatedly ( no organic cause)

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 Binet Kamath Test
This test is adapted from the famous Stanford-
Binet test used to assess children and their IQ
based on their mental development. Most widely
used intelligence age scale.
It tests judgement, reasoning, memory,
comprehension, word spelling for that age etc
From age 3, the tests are begun. Each age has 6
test items, each test item has a score of 2
months. When the child doesnt do any more
tests, then the mental age is calculated.
IQ= Mental age/ Chronological Age * 100
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BINET SCALE OF HUMAN
INTELLIGENCE
ORIGINAL MODERN
IQ SCORE
NAME TERM
Over 140 Genius or Near-Genius
120 139 Very Superior
110 119 Superior
90 109 Average or Normal
80 89 Dull Dull Normal
Borderline
70 79 Mild
Deficiency
50 69 Moron Moderate
20 49 Imbecile Severe
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DIAGNOSTIC CRITERIA FOR AUTISM

The following is from Diagnostic and Statistical

Manual of Mental Disorders: (DSM )

Criteria is divided into three sets of symptoms:

A total of SIX (or more) items

from (A), (B), and (C), with at least two from
(A), and two each from (B) and (C)

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 -
A) QUALITATIVE IMPAIRMENT IN SOCIAL INTERACTION,
as manifested by at least two of the following:

1. Marked impairment in the use of multiple

nonverbal behaviour such as eye-to-eye gaze, facial
expression, body posture, and gestures to regulate
social interaction.
2. Failure to develop peer relationships appropriate
to developmental level.

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3. Lack of spontaneous seeking to share enjoyment,
interests, or achievements with other people, (e.g.,
by a lack of showing, bringing, or pointing out
objects of interest to other people)

4. Lack of social or emotional reciprocity (not actively

participating in simple social play or games,
preferring solitary activities)

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Qualitative impairment in communication as
manifested by at least one of the following:
1. Delay in, or total lack of, the development of
spoken language
2. In individuals with adequate speech, marked
impairment in the ability to initiate or sustain a
conversation with others
3. Stereotyped and repetitive use of language or
idiosyncratic language
4. Lack of varied, spontaneous make-believe play or
social imitative play appropriate to developmental
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level
 Restricted repetitive and stereotyped patterns of
behaviour, interests and activities, as manifested by
at least two of the following:
1. Encompassing preoccupation with one or more
stereotyped and restricted patterns of interest that is
abnormal either in intensity or focus

2. apparently inflexible adherence to specific,

nonfunctional routines or rituals

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3. Stereotyped and repetitive motor mannerisms (e.g
hand or finger flapping or twisting, or complex
whole-body movements)
4. Persistent preoccupation with parts of objects ( eg:
Twisting the head of toys, pressing a single key on a
keyboard etc)

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 Differential Diagnosis:

Aspergers Syndrome: Pervasive Developmental

People with Asperger
syndrome usually have
some milder symptoms of
autistic disorder.
They may have social
challenges and unusual
behaviors and interests.
However, they typically do
not have problems with
language or intellectual
disability.
Disorder Not Otherwise
Specified (PDD-NOS; also
called "atypical autism")
People with PDD-NOS
usually have fewer and
milder symptoms than
those with autistic disorder.
The symptoms might cause
only social and
communication challenges

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 TOTALITY OF SYMPTOMS:
Shy, polite,
Reduced concentration levels
Grasps music very well
Marked decrease in communication skills be it with
parents/ fellow classmates
Keeps flapping and flailing his hands and legs about,
makes various gestures in no particular order or
frequency.
Refuses to write, more than stubbornness, it has to do
with inability.
Stares into space when questioned, loses eye contact

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 Easily discouraged, but will listen if pacified and
spoken to nicely.
Cries easily.
Prefers solitude.
Doesnt write on his own.
Prefers chill open air.
Desires Egg.
Catches cold often , greenish discharge.

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 Differential drugs:
1. Shy, mild mannered (BARY, CARCINOSIN, LYC,PULS,
STAPH)
2. Reduced response levels, out of mental sluggishness
(taken as mental slowness- PULS, GELS, BARY-CARB,
ALUM, SULPH)
3. Keeps flapping and flailing his hands and legs about,
makes various gestures in no particular order or
frequency. (PHOS, SIL, out of organic causes- APIS,
HELL, BRY)
4. Stares into space when questioned, loses eye contact
(STARING THOUGHTLESSLY- CANN-I, HELL, PULS)

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5. Easily discouraged, but will listen if pacified and
spoken to nicely. Cries easily. (ALUMINA, PULS,
GRAPH, CALC CARB)
6. Prefers solitude. (BRY, NAT CARB, NAT MUR,
PULS, SULPH)
7. Prefers chill open air. (ALUMINA, ARG-NIT, PULS,
MED, TUB)
8. Desires Egg. (CALC, NIT ACID, PULS)
9. Catches cold often , greenish discharge.(SIL,
PULS, HEPAR, TUB, NAT SULPH)

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 Refuses to write, more than stubbornness, it
has to do with inability.
(murphy rep)
AVERSION TO WRITE: Hydrastis, Squilla, Symph,
Thea.
Inability, for learning to write, in children: Caust,
Merc, Sil

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 Pulsatilla
Shy , timid, mild-mannered.
Wants consolation, better by consoling.
Lies with hands above head.
Mental Slowness
Weeps often
Discouraged easily
The patient seeks the open air; always feels better there,
even though he is chilly.
Averse to fat food, warm food, and drink.
Thick, profuse, yellow, bland discharges.
Better, open air, motion, cold applications, cold food and
drinks, though not thirsty.

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 Prescription:
PULSATILLA 1M, two doses was given on 17th September 2011
and on 17th October 2011.
17th Oct: (Before giving 2nd dose). No difference in his action/
behaviour.
19th Nov: Started narrating rhymes and short stories over the
phone to his aunt in India. Writing- no change.
28th Dec: Got his marks card over the last few months. All grades
from D had improved to C and B. (unable to get the report
scanned). Writing- no change.

Had given him one more dose of Puls 1M.

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 1st Feb 2012: Indicates his preference s for food items
only. Doesnt cry when he is taken out. Writes- very
reluctantly, maybe slightly better than before
3rd March 2012: Was told by the teacher that there is
at least 80 % improvement in all other aspects except
writing. But cannot move on to the next academic year
as writing is the major requirement.
Prescribed one dose Zincum met 200 on 10th April
based on mental fatigue/brain fag, been on placebo
ever since.
School results are out, has scored much higher in math
and english

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PRESENT STATUS:
The child speaks moderately well now, INDICATES HIS
PREFERENCE, THUMB SUCKING TOTALLY REDUCED.
In June, he secured admission into school here in
Chennai and attends Occupational therapy classes in
the evening.
He interacts with his peers much better.
Writing has improved
(eg: he can copy well but unable to relate) but there is
still 40 % more that can be done.
Very active, scores much better in maths especially

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