Chronic Sinusitis
1. PRELIMINARY DATA
- No.: 216/2026
- Patient's Name: WXY
- Address: Flat 802, Sapphire Enclave, Pune.
- Occupation: Call Center Executive (night shifts, AC exposure, dust from office)
- Religion: Hindu
- Date: 15/05/2026
- Age: 34 Years
- Sex: Female
- Education: B.Com
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Sinuses (frontal & maxillary) | Chronic headache over forehead/cheeks, thick yellow-green nasal discharge, post-nasal drip, facial pressure/pain | < Stooping/bending, < Cold dry air/AC, < Morning/night, < Change of weather, > Warm applications, > Open air, since 9 years (recurrent acute exacerbations, CT shows mucosal thickening) | Loss of smell, bad breath, fatigue, irritability |
| Eyes & Throat | Burning eyes, sore throat from drip | < Light | Anxiety about infections spreading |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Recurrent common colds in childhood turning into sinusitis; suppressed nasal allergy with steroids; frequent antibiotics for sinus infections; nasal polyps removed 5 years ago; deviated septum noted.
- Family History: Father has chronic sinusitis. Mother has allergic rhinitis. Brother has bronchial asthma.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal but diminished during attacks
- Desires: Warm drinks (+++), Spicy food (+)
- Aversions: Cold food/drinks
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Profuse on face & head, sour
- Sleep: Disturbed by headache/post-nasal drip; wakes with congestion
- Thermal State: Chilly patient (sensitive to cold drafts/AC)
B. Reactions - Physical Factors
- Weather: Aggravation in cold dry & rainy season
- Position: Better sitting erect
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, anxious, fastidious about work
- Anxiety: About job performance, chronic illness
- Fear: Fear of brain infection, fear losing job
- Dreams: Suffocation, being trapped, work failure
- Other: Suppressed frustration, feels stuck
6. PHYSICAL GENERAL EXAMINATION
- Wt: 62 kg | Ht: 158 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 82 bpm | B.P.: 126/80 mmHg
- Face: Puffy over cheeks, tender
- Tongue: Coated yellowish
- Nails: Normal
- Skin: Dry
7. SYSTEMIC EXAMINATION
- ENT: Nasal mucosa congested, thick yellow-green discharge, maxillary tenderness on percussion
- Respiratory: Clear
- CVS: S1, S2 Normal
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about health/job, fastidious (Grade 3)
- Physical General: Chilly, desire warm drinks, sour sweat, thick yellow discharge (Grade 3)
- Particular: Chronic sinusitis with frontal/maxillary pressure, thick discharge, < stooping/cold/AC, > warm/open air (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic sinus disorder with strong Mental Generals (irritability, anxiety) and Physical Generals (thermal, desires, discharge) dominating; Kent suits face/nose rubrics for chronic sinusitis.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and fastidiousness
- Anxiety about health/job
- Desire warm drinks
- Chilly patient
- Profuse sour perspiration
- Thick yellow-green nasal discharge
- Facial pressure/pain sinuses
- < Stooping, cold air, morning
-
Warm applications, open air
- Loss of smell
- Family sinus/allergic history
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Irritability | Mind; IRRITABILITY | 57 |
| 2 | Anxiety health | Mind; ANXIETY; health, about | 6 |
| 3 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
| 4 | Face pain sinuses | Face; PAIN; sinuses | 381 |
| 5 | Nose discharge yellow thick | Nose; DISCHARGE; thick; yellow | 333 |
| 6 | Perspiration sour | Perspiration; ODOR; sour | 1298 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Kali Bichromicum | 7/7 | 23 |
| 2 | Pulsatilla | 6/7 | 18 |
| 3 | Mercurius Sol | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Pressure pain, irritability, chilly | Thick discharge, polyps history | Family sinus/allergic issues | Destructive fear complications |
Dominant Miasm: Sycotic-Psoric
14. FINAL STEPS
- Provisional Diagnosis: Chronic Sinusitis
- Differentiation of Remedies: Compared Kali Bich with Pulsatilla. Pulsatilla has more changeable symptoms, thirstless, > open air; Kali Bich matches thick stringy yellow-green discharge, sinus pressure < stooping, > warm/open air, chilly, irritability/anxiety. Merc sol more offensive discharge.
- Selection of Remedy (Materia Medica): Kali Bichromicum matches chronic sinusitis with thick ropy yellow-green discharge, pressure pain in sinuses < stooping/morning, chilly, desire warm drinks (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic sinus miasmatic case, sensitive constitution)
- Actual Prescription:
- Kali Bichromicum 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 |
|---|
| 05/07/2026 | Discharge thinner & less, pressure reduced 70%, smell improving | Placebo | Steam inhalation, saline wash, avoid AC/dust |
| 05/11/2026 | Minimal symptoms, no acute exacerbations, CT shows reduced thickening | Placebo | Maintain nasal hygiene, report seasonal triggers |