Acute Haemorrhoids (acute painful pile)
1. PRELIMINARY DATA
- No.: 115/2026
- Patient's Name: JKL
- Address: 123, Anand Nagar, Kondhwa, Pune - 411048
- Occupation: Software Engineer [Prolonged sitting, poor diet]
- Religion: Hindu
- Date: 27/02/2026
- Age: 32 Years
- Sex: Male
- Education: B.E. Computer Science
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Perianal | Severe, burning pain, swelling and throbbing sensation, bleeding per rectum on straining | < Standing, sitting, < lying down, > passing stool, > cold application | Anorexia, loss of sleep |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: No significant medical history
- Family History: Father had piles, mother had hypertension
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Poor
- Desires: Sour taste
- Aversions: Spicy food
- Thirst: Normal
- Elimination:
- Urine: Normal
- Stool: Constipation
- Perspiration: Increased
- Sleep: Disturbed
- Thermal State: Hot
B. Reactions - Physical Factors
- Weather: Heat aggravates
- Position: Prolonged sitting
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Anxiety
- Anxiety: Fear of straining while passing stool
- Fear: Fear of bleeding and pain
6. PHYSICAL GENERAL EXAMINATION
- Wt: 70 kg | Ht: 170 cm | Temp: 101.5°F
- RR: 20/minute | Pulse: 96 bpm | B.P.: 140/90 mmHg
- Face: Pale
- Tongue: Furred
- Nails: Normal
- Skin: Dry
7. SYSTEMIC EXAMINATION
- GIT: Tender abdomen, constipation
- CVS: S1, S2 Normal. No murmurs.
- Respiratory: Clear
- Neuro: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: 5/10
- Physical General: 7/10
- Particular: 8/10
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Painful piles with bleeding on straining, heat aggravates, and constipation.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- • Painful piles with bleeding on straining
- • Heat aggravates
- • Constipation
- • Anorexia
- • Loss of sleep
- • Disturbed sleep
- • Increased perspiration
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Painful piles with bleeding on straining | Pain in piles. Painful piles, bleeding on straining. | 135 |
| 2 | Heat aggravates | Heat. Aggravation from heat. | 143 |
| 3 | Constipation | Constipation. | 56 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Aesculus | Pain in piles, bleeding on straining, heat aggravates | 16 |
| 2 | Lycopodium | Constipation, heat aggravates | 10 |
| 3 | Nux vomica | Painful piles, constipation | 8 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| + | - | - | - |
Dominant Miasm: Psora
14. FINAL STEPS
- Provisional Diagnosis: Acute Haemorrhoids
- Differentiation of Remedies: Aesculus matches the totality of symptoms perfectly, including pain in piles, bleeding on straining, and heat aggravates.
- Selection of Remedy (Materia Medica): Aesculus matches ... (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 30C (Acute condition, sensitive patient)
- Actual Prescription:
- [Aesculus] 30 — 4 pills, 4 times a day until relief
- Placebo — 4 pills thrice a day for 3 days
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 28/02/2026 | Improvement in pain and bleeding | Aesculus 30 | Continue the medicine for 2 more days |