Fibromyalgia
1. PRELIMINARY DATA
- No.: 218/2026
- Patient's Name: CDE
- Address: Flat 1104, Ivory Towers, Pune.
- Occupation: Homemaker (previously clerk, now limited activity due to pain)
- Religion: Hindu
- Date: 25/05/2026
- Age: 45 Years
- Sex: Female
- Education: B.A.
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Muscles & Joints (whole body, tender points: neck, shoulders, back, hips, knees) | Widespread aching pain, stiffness, burning sensation, multiple tender points | < Cold damp weather, < Stress/fatigue, < Morning, < Overexertion, > Warm bath/applications, > Gentle stretching, since 7 years (progressive, no structural damage on tests) | Profound fatigue, sleep disturbance (non-restorative), brain fog, depression |
| General | Exhaustion after minimal activity | < Mental exertion | Anxiety about daily tasks, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Post-viral fatigue after dengue 8 years ago; suppressed skin rash with steroids; recurrent headaches treated with painkillers; hypothyroidism diagnosed 5 years ago (on replacement); frequent infections.
- Family History: Mother has fibromyalgia & chronic fatigue. Sister has chronic pain syndrome. Father has depression.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Diminished
- Desires: Warm food/drinks (+++), Sweets (+)
- Aversions: Cold food/drinks
- Thirst: Scanty
- Elimination:
- Urine: Normal
- Stool: Irregular, hard
- Perspiration: Scanty, dry skin
- Sleep: Unrefreshing, frequent waking, feels worse after sleep
- Thermal State: Very chilly patient (multiple layers, warm baths relieve)
B. Reactions - Physical Factors
- Weather: Aggravation in cold damp/monsoon
- Position: Better gentle movement after initial stiffness
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Weepy, irritable, foggy thinking
- Anxiety: About family responsibilities, inability to function
- Fear: Fear of permanent disability, fear burdening family
- Dreams: Being paralyzed, failing duties, falling
- Other: Depression, low self-worth, feels overwhelmed
6. PHYSICAL GENERAL EXAMINATION
- Wt: 68 kg | Ht: 158 cm | Temp: 98.2°F (subnormal)
- RR: 16/min | Pulse: 74 bpm | B.P.: 124/78 mmHg
- Face: Tired, expressionless
- Tongue: Clean
- Nails: Brittle
- Skin: Dry, cool
7. SYSTEMIC EXAMINATION
- Musculoskeletal: Multiple tender points (18/18 classic), no swelling/deformity
- Nervous: Brain fog, poor concentration
- CVS: S1, S2 Normal
- Respiratory: Clear
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Depression, weepiness, anxiety about dependency, brain fog (Grade 3)
- Physical General: Extreme chilliness, scanty secretions, unrefreshing sleep, widespread aching (Grade 3)
- Particular: Fibromyalgia tender points, pain < cold/stress, > warm/gentle motion (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic widespread pain syndrome with strong Mental Generals (depression, anxiety) and Physical Generals (chilliness, sleep disturbance) dominating; Kent suits generals in functional disorders like fibromyalgia.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Depression and weepiness
- Anxiety about dependency
- Brain fog & fatigue
- Extreme chilliness
- Desire warm food/drinks
- Scanty perspiration
- Widespread aching & tender points
- Unrefreshing sleep
- Pain < cold damp/stress
-
Warm bath, gentle motion
- Family chronic pain history
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | 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 pain aching | Generalities; PAIN; aching | 1376 |
| 7 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Calcarea Carbonica | 7/7 | 22 |
| 2 | Gelsemium | 6/7 | 18 |
| 3 | Natrum Muriaticum | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Chilliness, aching, weepiness | Widespread pain, fatigue | Family chronic pain | Destructive fear disability |
Dominant Miasm: Psora
14. FINAL STEPS
- Provisional Diagnosis: Fibromyalgia
- Differentiation of Remedies: Compared Calcarea carb with Gelsemium. Gelsemium has more trembling, anticipatory anxiety, chilly but drowsiness; Calcarea carb matches profound chilliness, sluggishness, depression/weepiness, unrefreshing sleep, widespread aching, desire warm food, anxiety about duties. Nat mur more grief/thirstless.
- Selection of Remedy (Materia Medica): Calcarea Carbonica matches fibromyalgia with extreme chilliness, fatigue, brain fog, unrefreshing sleep, depression/weepiness, widespread aching, desire warm food/drinks (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic functional pain 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 |
|---|
| 15/07/2026 | Fatigue reduced 50%, pain milder, sleep slightly better, tender points less sensitive | Placebo | Warm baths, gentle yoga, regular sleep routine |
| 15/11/2026 | Pain minimal, energy improved, no major flares, mood better | Placebo | Continue light exercise, balanced diet, stress management |