Haemorrhoids
1. PRELIMINARY DATA
- No.: 212/2026
- Patient's Name: KLM
- Address: Plot 25, Rosewood Colony, Pune.
- Occupation: Shop Owner (prolonged standing, heavy lifting)
- Religion: Hindu
- Date: 25/04/2026
- Age: 48 Years
- Sex: Male
- Education: 12th Pass
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Rectum & Anus | External & internal piles, bleeding bright red during stool, pain burning/stitching, prolapse on straining | < Prolonged standing/sitting, < Constipation, < Spicy food, < After stool, > Cold applications, > Lying down, since 10 years (worse last 4 years, bleeding frequent) | Itching anus, mucus discharge, low backache, irritability |
| Abdomen | Bloating, heaviness | < After meals | Fatigue, anxiety about bleeding |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Chronic constipation since 30s; recurrent piles treated with ointments & oral meds; suppressed skin boils with antibiotics; frequent acidity & bloating; overweight gain after 40.
- Family History: Father has chronic haemorrhoids & constipation. Brother has piles. Mother has varicose veins.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Good but hurried
- Desires: Spicy food (+++), Salty food (++), Warm drinks (+)
- Aversions: Cold food, milk
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Hard, dry, with blood
- Perspiration: Profuse on back, sour
- Sleep: Disturbed by pain/itching; wakes with discomfort
- Thermal State: Chilly patient (wants warm clothing)
B. Reactions - Physical Factors
- Weather: Aggravation in cold weather
- Position: Better lying on side
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, impatient, fastidious about cleanliness
- Anxiety: About bleeding, business loss if hospitalized
- Fear: Fear of cancer, fear surgery
- Dreams: Falling, bleeding, arguments
- Other: Suppressed anger, feels overburdened
6. PHYSICAL GENERAL EXAMINATION
- Wt: 85 kg | Ht: 168 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 80 bpm | B.P.: 138/86 mmHg
- Face: Tense, flushed
- Tongue: Coated white
- Nails: Normal
- Skin: Dry
7. SYSTEMIC EXAMINATION
- Rectum/Anus: External thrombosed piles, internal prolapsing on straining, bleeding on touch, sentinel tag
- GIT: Abdomen soft, piles palpable
- CVS: S1, S2 Normal
- Respiratory: Clear
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about health/business, fear cancer/surgery (Grade 3)
- Physical General: Chilly, desire spicy/salt, sour sweat, hard stool with bleeding (Grade 3)
- Particular: Chronic haemorrhoids with bright red bleeding, burning pain, prolapse, < standing/spicy (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic rectal disorder with strong Mental Generals (irritability, fears) and Physical Generals (thermal, desires, stool) dominating; Kent excels in rectum rubrics for piles.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and fastidiousness
- Anxiety about health/business
- Fear of cancer/surgery
- Desire spicy and salt
- Chilly patient
- Profuse sour perspiration
- Haemorrhoids bleeding bright red
- Burning/stitching pain anus
- Prolapse on straining
-
Cold applications, lying
- Chronic 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 | Fear cancer | Mind; FEAR; cancer, of | 42 |
| 4 | Desire spicy | Stomach; DESIRES; spicy | 486 |
| 5 | Rectum haemorrhoids bleeding | Rectum; HAEMORRHOIDS; bleeding | 619 |
| 6 | Pain burning anus | Rectum; PAIN; burning | 625 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Hamamelis | 7/7 | 21 |
| 2 | Sulphur | 6/7 | 18 |
| 3 | Aesculus | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Bleeding, irritability, chilly | Prolapse, chronic constipation | Family venous issues | Destructive fear cancer |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Haemorrhoids (chronic, bleeding)
- Differentiation of Remedies: Compared Hamamelis with Sulphur. Sulphur is hot, untidy; Hamamelis matches venous congestion, bright red bleeding, burning/stitching pain, prolapse, > cold applications, chilly, irritability/anxiety. Aesculus more for backache & purple piles.
- Selection of Remedy (Materia Medica): Hamamelis matches chronic bleeding haemorrhoids with bright red blood, burning pain, prolapse, venous stasis, > cold, chilly patient (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic venous miasmatic case, sensitive constitution)
- Actual Prescription:
- Hamamelis 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 |
|---|
| 20/06/2026 | Bleeding stopped, pain reduced 70%, prolapse less, stool softer | Placebo | High fiber diet, sitz bath, avoid straining |
| 20/10/2026 | No bleeding in 4 months, piles shrunken, no prolapse, regular bowel | Placebo | Continue fiber & water, avoid heavy lifting, report recurrence |