Constipation
1. PRELIMINARY DATA
- No.: 211/2026
- Patient's Name: HIJ
- Address: Row House 18, Lotus Lane, Pune.
- Occupation: Housewife (family responsibilities, sedentary routine)
- Religion: Hindu
- Date: 20/04/2026
- Age: 50 Years
- Sex: Female
- Education: B.A.
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Rectum & Abdomen | Chronic constipation, hard dry stool, no urge for days, incomplete evacuation, straining | < After meals, < Sedentary, < Stress, < Cold food, > Warm drinks, > Walking, since 15 years (worse last 5 years, laxative dependence) | Abdominal bloating, headache, irritability, piles occasionally |
| General | Heaviness in abdomen | < Lying down | Fatigue, low mood, loss of appetite |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Post-marriage constipation after first child; recurrent piles treated with ointments; suppressed skin eruptions in youth; frequent antacids for acidity; laxative abuse for 10 years.
- Family History: Mother has chronic constipation & haemorrhoids. Father has diabetes. Sister has IBS.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Diminished, feels full quickly
- Desires: Warm food/drinks (+++), Spicy food (+)
- Aversions: Cold food/drinks, milk
- Thirst: Scanty
- Elimination:
- Urine: Normal
- Stool: Hard, dry, dark, infrequent (every 3-5 days)
- Perspiration: Scanty, sour when present
- Sleep: Disturbed by abdominal discomfort; wakes with heaviness
- Thermal State: Chilly patient (needs warm clothing, covers abdomen)
B. Reactions - Physical Factors
- Weather: Aggravation in cold weather
- Position: Better walking or gentle motion
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, fastidious, anxious about routine
- Anxiety: About health, family duties, incomplete work
- Fear: Fear of serious bowel disease, fear dependency
- Dreams: Being blocked, falling behind, arguments
- Other: Suppressed anger, feels overburdened
6. PHYSICAL GENERAL EXAMINATION
- Wt: 72 kg | Ht: 152 cm | Temp: 98.4°F
- RR: 16/min | Pulse: 76 bpm | B.P.: 128/82 mmHg
- Face: Dull, tired look
- Tongue: Coated white
- Nails: Brittle
- Skin: Dry, rough
7. SYSTEMIC EXAMINATION
- GIT: Abdomen distended, hard stool palpable in left iliac fossa, sluggish bowel sounds
- CVS: S1, S2 Normal
- Respiratory: Clear
- Musculoskeletal: Mild backache
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about health/duties, fastidious (Grade 3)
- Physical General: Chilly, desire warm food/drinks, scanty thirst/perspiration, hard dry stool (Grade 3)
- Particular: Chronic constipation with no urge, straining, bloating, > walking/warm drinks (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic functional bowel disorder with prominent Mental Generals (irritability, anxiety) and Physical Generals (thermal, desires, stool character) dominating; Kent excels in rectum rubrics for chronic constipation.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and fastidious nature
- Anxiety about health and duties
- Desire warm food/drinks
- Chilly patient
- Scanty perspiration/thirst
- Stool hard dry infrequent
- No urge for stool
- Bloating/abdominal heaviness
-
Walking, warm drinks
- Straining & incomplete evacuation
- Family constipation 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 | Stool hard dry | Rectum; CONSTIPATION; hard stool | 607 |
| 5 | No urging stool | Rectum; CONSTIPATION; no desire for stool | 606 |
| 6 | Perspiration scanty | Perspiration; SCANTY | 1297 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Nux Vomica | 7/7 | 22 |
| 2 | Bryonia Alba | 6/7 | 18 |
| 3 | Alumina | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Hard dry stool, irritability, chilly | Suppression history, incomplete evacuation | Family bowel issues | Destructive fear disease |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Constipation (chronic functional)
- Differentiation of Remedies: Compared Nux Vomica with Bryonia. Bryonia has > absolute rest, < motion; Nux Vomica matches chronic constipation from sedentary/stress, irritable/fastidious, chilly, desire warm/spicy, no urge, incomplete evacuation, > walking. Alumina more for dry paralysis-like stool in elderly.
- Selection of Remedy (Materia Medica): Nux Vomica matches chronic constipation with hard dry stool, no urge, straining, irritability/anxiety, chilly patient, desire warm food, > motion (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic bowel miasmatic case, sensitive constitution)
- Actual Prescription:
- Nux Vomica 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 |
|---|
| 10/06/2026 | Stool every 1-2 days, softer, less straining, bloating reduced | Placebo | High fiber diet, regular walking, warm water morning |
| 10/10/2026 | Daily bowel movement, no laxative need, energy better, no bloating | Placebo | Maintain hydration, avoid sedentary, report any relapse |