GERD
1. PRELIMINARY DATA
- No.: 221/2026
- Patient's Name: JKL
- Address: Flat 702, Emerald Court, Pune.
- Occupation: Chef (long hours standing, tasting spicy/oily food, stress in kitchen)
- Religion: Hindu
- Date: 10/06/2026
- Age: 42 Years
- Sex: Male
- Education: Diploma in Hotel Management
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Chest & Throat | Burning retrosternal pain (heartburn), sour/acid regurgitation, throat irritation, chronic cough | < Lying down, < After heavy/spicy/oily meals, < Bending forward, < Night, > Sitting up, > Cold milk, > Walking, since 8 years (worse last 4 years, endoscopy shows erosive esophagitis) | Belching, nausea, hoarseness, irritability |
| Stomach | Fullness, bloating | < After eating | Anxiety about heart issues, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Recurrent acidity since youth treated with antacids; suppressed skin boils with antibiotics; frequent NSAIDs for joint pain; overweight gain from job; smoking 5 cig/day (quit 1 year ago).
- Family History: Father has GERD & hiatus hernia. Mother has chronic gastritis. Brother has peptic ulcer.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Good but hurried eating
- Desires: Cold milk (+++), Spicy food (+)
- Aversions: Fatty food, sour things
- Thirst: Increased, for cold water
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Profuse on upper body, sour
- Sleep: Disturbed by heartburn/regurgitation; wakes coughing
- Thermal State: Hot patient (prefers cool, uncovers chest)
B. Reactions - Physical Factors
- Weather: Aggravation in hot humid weather
- Position: Better sitting upright or walking
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, impatient, worried
- Anxiety: About job performance, health (fear cancer/heart)
- Fear: Fear of esophageal cancer, fear choking
- Dreams: Burning sensation, falling, arguments
- Other: Suppressed anger, feels stressed
6. PHYSICAL GENERAL EXAMINATION
- Wt: 85 kg | Ht: 170 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 84 bpm | B.P.: 138/86 mmHg
- Face: Flushed, anxious
- Tongue: Clean but dry
- Nails: Normal
- Skin: Oily
7. SYSTEMIC EXAMINATION
- GIT: Epigastric tenderness, no guarding, hyperacidity signs
- CVS: S1, S2 Normal
- Respiratory: Occasional cough
- ENT: Throat mildly red
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about health, fear cancer (Grade 3)
- Physical General: Hot patient, desire cold milk, thirst cold, sour sweat (Grade 3)
- Particular: Chronic GERD with heartburn/regurgitation < lying/spicy, > sitting/cold milk (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic gastroesophageal disorder with strong Mental Generals (irritability, fears) and Physical Generals (thermal, desires, sweat) dominating; Kent suits stomach rubrics for GERD symptoms.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and impatience
- Anxiety about health
- Fear cancer/choking
- Desire cold milk
- Hot patient
- Profuse sour perspiration
- Heartburn burning retrosternal
- Sour regurgitation
- < Lying down, spicy food, night
-
Sitting up, cold milk
- Family gastric issues
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 | Fear cancer | Mind; FEAR; cancer, of | 42 |
| 4 | Desire milk cold | Stomach; DESIRES; milk; cold | 485 |
| 5 | Stomach burning | Stomach; PAIN; burning | 511 |
| 6 | Perspiration sour | Perspiration; ODOR; sour | 1298 |
| 7 | Heat sensation | Generalities; HEAT; sensation of | 1366 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Nux Vomica | 7/7 | 21 |
| 2 | Robinia | 6/7 | 18 |
| 3 | Arsenicum Album | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Burning, irritability, anxiety | Regurgitation, chronic erosion | Family gastric issues | Destructive fear cancer |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: GERD (Gastroesophageal Reflux Disease)
- Differentiation of Remedies: Compared Nux Vomica with Robinia. Robinia has more intense burning/acid, chilly; Nux Vomica matches stress-induced GERD, irritable/fastidious, hot, desire cold milk/spicy, sour sweat, < lying/spicy, > sitting. Arsenicum more restless/fear death.
- Selection of Remedy (Materia Medica): Nux Vomica matches chronic GERD from overwork/stress/irregular meals, heartburn < lying/spicy, > sitting, irritable/anxiety, hot patient, desire cold milk (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic gastric 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 |
|---|
| 20/07/2026 | Heartburn reduced 70%, regurgitation rare, night episodes gone | Placebo | Small frequent meals, avoid spicy/oily/late dinner, elevate head while sleeping |
| 20/11/2026 | No major symptoms, endoscopy shows healed mucosa, energy better | Placebo | Maintain lifestyle, weight control, report recurrence |