Chronic COPD
1. PRELIMINARY DATA
- No.: 201/2026
- Patient's Name: ABC
- Address: 123, Karve Nagar, Pune
- Occupation: Welder [chronic exposure to smoke and fumes]
- Religion: Hindu
- Date: 01/03/2026
- Age: 45 Years
- Sex: Male
- Education: 10th standard
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Lungs | Chronic difficulty in breathing, wheezing | <Cold weather, >warm environments, since 5 years | Anxiety, restlessness |
| Throat | Irritation, dry cough | <Morning, >after taking warm drinks | Headache, fatigue |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Chronic bronchitis, pneumonia, and asthma. Vaccinations are up to date.
- Family History: Father had tuberculosis, mother has hypertension.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: +++ Spicy food, ++ sweets
- Aversions: None
- Thirst: Normal
- Elimination:
- Urine: Normal
- Stool: Constipated
- Perspiration: Profuse, especially on palms and soles
- Sleep: Disturbed, with frequent awakenings and dreams of choking
- Thermal State: Hot, prefers cool environments
B. Reactions - Physical Factors
- Weather: < Cold, humid weather
- Position: > Sitting up, < lying down
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, anxious
- Anxiety: Fear of suffocation, claustrophobia
- Fear: Death, losing control
- Dreams: Recurrent dreams of being trapped in a small space
- Other: Easily irritated, mood swings
6. PHYSICAL GENERAL EXAMINATION
- Wt: 60 kg | Ht: 165 cm | Temp: 98.6°F
- RR: 24/min | Pulse: 90 bpm | B.P.: 140/90 mmHg
- Face: Puffy, with signs of chronic hypoxia
- Tongue: Coated, white
- Nails: Clubbing of fingers
- Skin: Dry, with poor circulation
7. SYSTEMIC EXAMINATION
- Respiratory: Wheezing, crepitations heard over both lungs
- CVS: S1, S2 normal, no murmurs
- GIT: Tender abdomen, especially in the epigastric region
- CNS: No focal neurological deficits
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety (Grade 3)
- Physical General: Breathlessness (Grade 3)
- Particular: Wheezing, cough (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic case with strong Mental Generals and Physical Generals dominating over particulars; Kent's hierarchy suits constitutional approach.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety about health
- Fear of suffocation
- Irritability
- Breathlessness on exertion
- Wheezing
- Dry cough
- Constipation
- Profuse perspiration
- Warm-bloodedness
- Desire for spicy food
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety about health | Mind; Anxiety; about health | 12 |
| 2 | Fear of suffocation | Mind; Fear; suffocation, of | 34 |
| 3 | Irritability | Mind; Irritability | 67 |
| 4 | Breathlessness on exertion | Chest; Dyspnoea; exertion, on | 145 |
| 5 | Wheezing | Chest; Wheezing | 156 |
| 6 | Dry cough | Chest; Cough; dry | 173 |
| 7 | Constipation | Rectum; Constipation | 210 |
| 8 | Profuse perspiration | Generalities; Perspiration; profuse | 233 |
| 9 | Warm-bloodedness | Generalities; Temperature; warm | 245 |
| 10 | Desire for spicy food | Stomach; Desire; spicy food | 278 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Arsenicum | 1, 3, 6, 8, 9 | 15 |
| 2 | Ipecac | 4, 5, 7 | 9 |
| 3 | Nux Vomica | 2, 10 | 6 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Anxiety, irritability | Fear of suffocation | Wheezing, breathlessness | None |
| Breathlessness | Constipation | | |
| Warm-bloodedness | | | |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Chronic COPD
- Differentiation of Remedies: Arsenicum covers more symptoms including anxiety and breathlessness, making it a stronger candidate compared to Ipecac and Nux Vomica.
- Selection of Remedy (Materia Medica): Arsenicum matches the deep constitutional picture of the patient, including anxiety about health and fear of suffocation (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic deep-seated case, sensitive constitution)
- Actual Prescription:
- Arsenicum 200C — single dose
- Placebo — 4 pills twice a day for 2 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 01/04/2026 | Partial improvement in breathing, less anxiety | Placebo | Continue exercises, avoid smoke |
| 01/07/2026 | Further improvement, wheezing reduced | Arsenicum 200C (repeat) | Diet, lifestyle modifications |