Chronic Fatigue Syndrome
1. PRELIMINARY DATA
- No.: 226/2026
- Patient's Name: XYZ
- Address: Flat 1801, Ruby Enclave, Pune.
- Occupation: IT Analyst (previously high-pressure job, now part-time work from home due to fatigue)
- Religion: Hindu
- Date: 05/07/2026
- Age: 38 Years
- Sex: Female
- Education: B.Tech
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| General & Nervous | Severe persistent fatigue not relieved by rest, post-exertional malaise lasting days, muscle weakness/pain | < Physical/mental effort, < After sleep (worse mornings), < Stress/infections, > Complete rest, > Warm environment, since 5 years (post-viral onset after severe flu, no structural cause on tests) | Brain fog, unrefreshing sleep, sore throat, tender lymph nodes, depression |
| Body | Diffuse myalgia, joint pain without swelling | < Concentration | Anxiety about future, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Severe viral illness (suspected EBV) 5 years ago triggering onset; suppressed recurrent infections with antibiotics; hypothyroidism diagnosed 2 years ago (on replacement); frequent headaches treated with painkillers; overwork burnout before onset.
- Family History: Mother has chronic fatigue & fibromyalgia. Father has depression. Sister has ME/CFS-like symptoms.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Diminished
- Desires: Warm drinks (+++), Sweets (+)
- Aversions: Cold food/drinks
- Thirst: Scanty
- Elimination:
- Urine: Normal
- Stool: Irregular
- Perspiration: Scanty, dry skin
- Sleep: Excessive but unrefreshing; daytime hypersomnia
- Thermal State: Very chilly patient (multiple layers, warm baths relieve)
B. Reactions - Physical Factors
- Weather: Aggravation in cold weather
- Position: Better lying down completely
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Dull, weepy, foggy thinking
- Anxiety: About inability to work, financial dependence
- Fear: Fear of permanent invalidity, fear isolation
- Dreams: Being trapped, failing tasks, exhaustion
- Other: Depression, low motivation, feels worthless
6. PHYSICAL GENERAL EXAMINATION
- Wt: 64 kg | Ht: 162 cm | Temp: 97.8°F (subnormal)
- RR: 16/min | Pulse: 70 bpm | B.P.: 118/76 mmHg
- Face: Pale, tired, expressionless
- Tongue: Clean
- Nails: Brittle
- Skin: Dry, cool
7. SYSTEMIC EXAMINATION
- General: No lymphadenopathy active, muscle tenderness diffuse
- Nervous: Poor concentration, memory issues
- CVS: S1, S2 Normal
- Respiratory: Clear
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Depression, weepiness, anxiety about future, brain fog (Grade 3)
- Physical General: Extreme chilliness, unrefreshing sleep, scanty secretions, post-exertional malaise (Grade 3)
- Particular: Chronic fatigue syndrome with widespread pain, fatigue not relieved by rest, < exertion/stress (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic functional fatigue syndrome with strong Mental Generals (depression, anxiety) and Physical Generals (chilliness, sleep disturbance) dominating; Kent suits generals in post-viral/chronic debility cases.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Depression and weepiness
- Anxiety about future
- Brain fog & memory issues
- Extreme chilliness
- Desire warm drinks
- Scanty perspiration
- Profound exhaustion post-exertion
- Unrefreshing sleep
- Muscle/joint aching without pathology
- Sore throat/tender nodes
- Post-viral onset
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Sadness depression | Mind; SADNESS | 75 |
| 2 | Weeping tendency | Mind; WEEPING; tendency | 92 |
| 3 | Chilliness extreme | Generalities; COLD; agg. | 1348 |
| 4 | Perspiration scanty | Perspiration; SCANTY | 1297 |
| 5 | Sleep unrefreshing | Sleep; SLEEP; unrefreshing | 1254 |
| 6 | Generalities weakness | Generalities; WEAKNESS | 1413 |
| 7 | Mind dullness | Mind; DULLNESS | 37 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Calcarea Carbonica | 7/7 | 22 |
| 2 | Phosphoric Acid | 6/7 | 18 |
| 3 | Gelsemium | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Chilliness, aching, depression | Post-viral debility, lymph nodes | Family chronic fatigue | Destructive fear invalidity |
Dominant Miasm: Psora
14. FINAL STEPS
- Provisional Diagnosis: Chronic Fatigue Syndrome
- Differentiation of Remedies: Compared Calcarea carb with Phosphoric acid. Phosphoric acid has more grief/exhaustion after mental shock, chilly but indifference; Calcarea carb matches profound chilliness, sluggishness, depression/weepiness, unrefreshing sleep, anxiety about duties, desire warm food. Gelsemium more trembling/drowsiness.
- Selection of Remedy (Materia Medica): Calcarea Carbonica matches chronic fatigue syndrome with extreme chilliness, unrefreshing sleep, brain fog, depression/weepiness, fatigue not relieved by rest, desire warm food/drinks (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic post-viral miasmatic case, sensitive constitution)
- Actual Prescription:
- Calcarea Carbonica 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 20/07/2026 | Energy improved 40%, less post-exertional crash, sleep slightly refreshing | Placebo | Graded activity, warm baths, balanced nutrition |
| 20/11/2026 | Fatigue minimal, able to work few hours daily, mood better, no major setbacks | Placebo | Continue pacing, avoid overexertion, regular rest |