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A case of Hepatitis

A male patient, single, 22 years of age, Chartered Accountant by profession.
Had gone out station for an account audit. There he had outside food and on returning home he had the following symptoms-

Chief complaints -

Weakness and tired feeling, bodyache
<< slightest motion
Yellow urine, Increased frequency
Appetite reduced with pain in abdomen
Persistent nausea, << morning
with dryness of mouth
Pain in the chest with hiccoughs
Weight loss

Associated symptoms -

Allergic bronchitis, hydrocele with pain in the scrotum.

Personal history

Appetite- Reduced

Cravings- sweets, spicy, delicasis

Aversion- none

Thirst- Increased,for large quantities

Stool- yellow

Urine- yellowish white

Perspiration- Less

Sleep- Restlessness, unsound, gets up unrefreshed

Thermal state- Chilly

Physical Examination

Weight- 50 kgs.(lost about 3/4 kg.)
Mouth- Ulcers
Skin- Yellow
Nails- Yellow

Past History
No major illnesses

Family History
No major illnesses

Mental state -

Irritability through out the day
Want to go to the office to complete the work
Constantly talking about the office work
Despair about the 'speed of recovary'
Restlessness of mind.

First investigations - Done on 05/01/1998

Urine examination -

Protein- positive (trace)
Bile salts- positive +
Bile- present ++
Crystals- uric acid 1-2 /h.p.f.
Pus cells- 1-2 / h.p.f.

Blood Examination -

Haemaglobin- 16.5 gms (normal-14-18gms)
Erythrocytes- 5.8 mill/cu.mm (normal- 4.5-6)
Colour Index- 0.97 ( normal- 0.9-1.2)
Leucocytes- 5,5000 (normal- 5000- 10000/cu. mm)
E.S.R.- 6mm (normal-3-15m.m.)
Liver function test -

Total Bilirubin- 8.3mg% (normal value- 0.5-1.0 mg %)
Conjugated Bilirubin- 5.4 mg % (normal value- 0.5-1.0 mg %)
S.G.O.T.- 2860 IU/L (normal value- 8-40 IU/L)
S.G.P.T.- 2180 IU/L (normal value- 5-35 IU/L)
Total Protein- 7.4 gms% (normal value- 6-8 gms%)
Albumin- 4 gm% (normal value- 3-5 gm%)
Globulin- 3.4 gm% (normal value- 2-3.5 gm%)
A/G Ratio- 1.17 (normal value- 0.9- 2.0)
Serum Alkaline Phosphatase- 10.7 KA Units (normal- 3-11 KA Units)

Prescriptive totality -

Weakness and tired feeling, bodyache
<< slightest motion
Yellow urine, Increased frequency
Appetite reduced with pain in abdomen
Persistent nausea, << morning
with dryness of mouth
Thirst- Increased,for large quantities
Irritability through out the day
Want to go to the office to complete the work
Constantly talking about the office work
Despair about the 'speed of recovary'
Skin- Yellow, Nails- Yellow

Treatment -

Bryonia alba 200 was prescribed on the above indications along with Berberis vulgaris (Q) mother tincture for three times/day.

The selection of the remedy was done on the acute symptomatology. The cause of infection of the viral Hepatitis was very clear as the patient had outside unhygienic food.
It was an acute disease with no deep-rooted constitutional disturbances.
The disease picture was giving a clear cut indication of a remedy
which is Bryonia alba
The reason for giving another medicine in mother tincture form (Berberis vulgaris) along with the potentised medicine (Bryonia alba) was the - Intensity of the Yellowness indicating the excessive bile production.

Follow up -

3 days after -
Patient started feeling better in general
Appetite improoved with desire for food
No change in the yellowness was found for 7 days

10 days after -
Yellowness started decreasing in general
improoved appetite
freshness mentally and physically.

Investigations done on 23/01/1998

Blood Examination -

Haemaglobin- 15.8 gm%   (normal- 14-18 gms)
Erythrocytes- 5.2 mill/cu.mm (normal- 4.5-6)
Colour Index-             (normal- 0.9-1.2)
Leucocytes- 6150 /cu.mm (normal- 5000-10000 /cu.mm)
E.S.R.- 5mm (normal-3-15 m.m.)

Liver function test -

Total Bilirubin- 5.8 mg% (usually bilirubin comes to normal after 2/3 months)
S.G.O.T.- 50.0 IU/L
S.G.P.T.- 48 IU/L
Serum Alkaline Phosphatase- 9.0 KA Units

Treatment was discontinued 1 weak after these investigations. The patient was asked to report on telephone every month for 3 months to check for relapse.

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