Hypertension
1. PRELIMINARY DATA
- No.: 205/2026
- Patient's Name: PQR
- Address: Villa 9, Royal Enclave, Pune.
- Occupation: Senior Manager in Bank (high responsibility, frequent travel, job stress)
- Religion: Hindu
- Date: 20/03/2026
- Age: 52 Years
- Sex: Male
- Education: M.B.A.
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Head & Cardiovascular | Throbbing headache (occipital/vertex), vertigo, flushing of face; B.P. persistently 150-170/90-100 mmHg | < Mental exertion, < Anger/anticipation, < Morning on rising, < Heat/sun, > Rest in dark room, > Open air, since 8 years (worsening last 3 years despite allopathic meds) | Palpitations, ringing in ears, nosebleeds occasionally, irritability |
| General | Fatigue, heaviness in chest | < After meals, < Suppressed emotions | Sleeplessness from thoughts, anxiety about health |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Childhood recurrent nosebleeds; acidity & constipation treated with laxatives; suppressed anger outbursts; overweight since 30s; on anti-hypertensive since 5 years but control poor.
- Family History: Father died of stroke at 58. Mother has hypertension & diabetes. Elder brother has coronary artery disease.
- 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: Salty food (+++), Meat (++), Alcohol occasionally (+)
- Aversions: Sweets, milk
- Thirst: Increased, for cold water
- Elimination:
- Urine: Frequent, scanty
- Stool: Hard, unsatisfactory
- Perspiration: Profuse on head & face, sour
- Sleep: Disturbed by thoughts; wakes 3-4 AM with anxiety
- Thermal State: Hot patient (flushes easily, prefers cool air)
B. Reactions - Physical Factors
- Weather: Aggravation in hot humid weather
- Position: Better lying with head high
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Ambitious, irritable, dictatorial, suppressed rage
- Anxiety: About career, family security, sudden death
- Fear: Fear of stroke/heart attack, fear poverty in old age
- Dreams: Falling, business failure, arguments
- Other: Broods over insults, feels overworked
6. PHYSICAL GENERAL EXAMINATION
- Wt: 88 kg | Ht: 175 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 88 bpm (bounding) | B.P.: 162/96 mmHg
- Face: Flushed, tense
- Tongue: Clean but dry
- Nails: Normal
- Skin: Oily, occasional eruptions
7. SYSTEMIC EXAMINATION
- CVS: Apex beat displaced, S2 accentuated, no murmurs
- Nervous: No focal signs; fundoscopy shows grade II hypertensive changes
- Respiratory: Clear
- GIT: Soft, no tenderness
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about health/future, fear stroke/poverty (Grade 3)
- Physical General: Hot patient, desire salt/meat, profuse sour sweat, thirst cold (Grade 3)
- Particular: Chronic hypertension with throbbing headache, flushing, palpitations < exertion/anger (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic cardiovascular condition with strong Mental Generals (irritability, fears) and Physical Generals (thermal, desires, sweat) dominating; Kent suits deep constitutional prescribing in sycotic/syphilitic miasmatic hypertension.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and dictatorial nature
- Anxiety about health and finances
- Fear of stroke and poverty
- Desire salt and meat
- Hot patient with flushes
- Profuse sour perspiration
- Throbbing headache occipital/vertex
- Hypertension with palpitations
- < Anger, mental exertion, morning
-
Rest, open air
- Family history of stroke & hypertension
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 stroke | Mind; FEAR; apoplexy, of | 41 |
| 4 | Desire salt | Stomach; DESIRES; salt | 486 |
| 5 | Heat flushes | Generalities; HEAT; flushes of | 1365 |
| 6 | Perspiration sour | Perspiration; ODOR; sour | 1298 |
| 7 | Headache throbbing | Head; PAIN; throbbing | 149 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Lachesis | 7/7 | 22 |
| 2 | Nux Vomica | 6/7 | 19 |
| 3 | Sulphur | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Throbbing, irritability, anxiety | Suppressed emotions, flushes | Family vascular issues | Destructive fear of stroke, suppression |
Dominant Miasm: Sycotic-Syphilitic
14. FINAL STEPS
- Provisional Diagnosis: Hypertension
- Differentiation of Remedies: Compared Lachesis with Nux Vomica. Nux Vomica has more digestive issues, chilly, desire spicy; Lachesis matches hot flushes, left-sided symptoms, suppressed anger/jealousy, fear of death/stroke, loquacity/irritability, worse after sleep. Sulphur hot but more untidy.
- Selection of Remedy (Materia Medica): Lachesis matches chronic hypertension with throbbing headache, flushes, palpitations < after sleep/mental exertion, hot patient, anxiety/fear of stroke, suppressed rage (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic vascular miasmatic case, sensitive constitution)
- Actual Prescription:
- Lachesis 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 |
|---|
| 20/05/2026 | B.P. down to 140/88 average, headaches rare, flushes milder | Placebo | Reduce salt/alcohol, daily walk, anger management |
| 20/09/2026 | B.P. stable 130-135/80-85, no palpitations, energy improved, meds tapered | Placebo | Continue lifestyle changes, monitor B.P. weekly |