1. PRELIMINARY DATA
- No.: 110/2026
- Patient's Name: LMN
- Address: Sector 5, Green Park Society, Pune.
- Occupation: Delivery Executive (frequent bending, lifting heavy parcels)
- Religion: Hindu
- Date: 21/02/2026
- Age: 29 Years
- Sex: Male
- Education: 12th Pass
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Lower Back | Severe aching & stiffness in lumbar region, shooting pain down right leg | < Lifting, < Bending forward, < Cold damp weather, < Night, > Warm applications, > Lying on hard surface, > Gentle continued motion | Restlessness, irritability, cannot find comfortable position |
| Right Hip & Leg | Sciatic-like shooting pain | < Sitting long, < Standing still | Cold sensation in back |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Occasional back strain from work; no major accidents or surgeries.
- Family History: Father has chronic back pain (degenerative). Mother healthy.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal, slightly reduced due to pain
- Desires: Warm food/drinks (++)
- Aversions: Cold food
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Slight, mostly on back during pain
- Sleep: Very disturbed; pain worse at night, wakes frequently
- Thermal State: Chilly (cannot tolerate cold air or fan)
B. Reactions - Physical Factors
- Weather: Aggravation from cold damp weather or after getting wet
- Position: Better lying on hard surface or walking slowly; worse sitting/standing still
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable and impatient when in pain
- Anxiety: Worried about losing daily income if cannot work
- Fear: Fear pain will become permanent
6. PHYSICAL GENERAL EXAMINATION
- Wt: 68 kg | Ht: 172 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 82 bpm | B.P.: 124/80 mmHg
- Face: Grimacing with pain
- Tongue: Clean
- Nails: Normal
- Skin: Slightly cold to touch on extremities
7. SYSTEMIC EXAMINATION
- Musculoskeletal: Lumbar region tender on palpation, paraspinal muscle spasm, straight leg raise positive on right at 45°, limited forward flexion
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability from pain, anxiety about livelihood (Grade 2)
- Physical General: Chilly patient, > Warm applications, > Continued gentle motion (Grade 3)
- Particular: Lumbago with right sciatic radiation, < cold damp/night/lifting, > hard surface/warmth (Grade 3)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Acute back pain case with clear modalities, thermal generals, and position ameliorations; Kent has detailed back and extremities rubrics for lumbago/sciatica.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and restlessness
- Lumbago with right-sided sciatic shooting
- < Cold damp, night, bending, lifting
-
Warm applications, lying on hard surface, continued gentle motion
- Chilly patient
- Pain forces change of position constantly
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Irritability | Mind; IRRITABILITY | 57 |
| 2 | Back pain lumbago | Back; PAIN; lumbar region | 893 |
| 3 | Sciatica right side | Extremities; PAIN; sciatica; right | 1064 |
| 4 | < Cold damp | Back; PAIN; cold damp agg. | 894 |
| 5 | > Warm applications | Back; PAIN; warm applications amel | 895 |
| 6 | > Lying on hard surface | Back; PAIN; lying; hard surface amel | 894 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Rhus Toxicodendron | 6/6 | 18 |
| 2 | Bryonia Alba | 4/6 | 12 |
| 3 | Nux Vomica | 3/6 | 09 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Chilly, irritability, stiffness | Shooting pains | Overexertion history | Chronic family back issues |
Dominant Miasm: Psora
14. FINAL STEPS
- Provisional Diagnosis: Acute Lumbago
- Differentiation of Remedies: Compared Rhus tox with Bryonia. Bryonia has > absolute rest, < slightest motion; Rhus tox matches > continued gentle motion, stiffness better on moving, < cold damp, > warmth/hard surface. Nux vom more for irritability from overwork but less specific to motion modalities.
- Selection of Remedy (Materia Medica): Rhus Toxicodendron matches lumbago/sciatica from strain or cold damp, stiffness & pain > continued motion/warm applications, restlessness, chilly (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 30C (Acute painful condition with clear modalities)
- Actual Prescription:
- Rhus Toxicodendron 30 — 4 pills every 1–2 hours until relief (max 6 doses in 24 hrs)
- Placebo — 4 pills thrice a day for 3 days
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 22/02/26 | Pain reduced 70%, can bend slightly, better after moving around | Placebo | Avoid heavy lifting, apply warm compress, gentle walking |