Osteoarthritis
1. PRELIMINARY DATA
- No.: 230/2026
- Patient's Name: JKL
- Address: Bungalow 12, Green Valley, Pune.
- Occupation: Retired Teacher (previously standing for long hours, now limited mobility)
- Religion: Hindu
- Date: 25/07/2026
- Age: 62 Years
- Sex: Female
- Education: M.A. B.Ed
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Joints (knees, hips, fingers – bilateral) | Chronic aching/stiffness in joints, crepitus, bony enlargement (Heberden's/Bouchard's nodes in fingers), pain on movement | < Cold damp weather, < Rest/inactivity, < Rising from sitting, < Night, > Gentle continued motion, > Warm applications, since 15 years (progressive, X-ray shows joint space narrowing & osteophytes) | Fatigue, muscle weakness, depression, irritability |
| General | Heaviness in limbs | < Overexertion | Anxiety about dependency, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Menopausal onset of joint pains; suppressed eczema in youth with ointments; recurrent knee swelling treated with painkillers; overweight since 50s; hypertension diagnosed 8 years ago.
- Family History: Mother has osteoarthritis & osteoporosis. Father has rheumatoid arthritis. Sister has knee replacement history.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: Warm food/drinks (+++), Sweets (+)
- Aversions: Cold food
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Scanty
- Sleep: Disturbed by pain/stiffness; wakes stiff
- Thermal State: Chilly patient (needs warm clothing, 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, feels helpless
- Anxiety: About household duties, mobility loss
- Fear: Fear of becoming bedridden, fear dependency
- Dreams: Being paralyzed, falling, losing family
- Other: Depression, low self-worth
6. PHYSICAL GENERAL EXAMINATION
- Wt: 78 kg | Ht: 155 cm | Temp: 98.4°F
- RR: 16/min | Pulse: 76 bpm | B.P.: 140/86 mmHg
- Face: Puffy, sad
- Tongue: Clean
- Nails: Brittle
- Skin: Dry
7. SYSTEMIC EXAMINATION
- Musculoskeletal: Knee crepitus, bony enlargement in fingers, limited flexion/extension, antalgic gait
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Weepiness, anxiety about dependency, depression (Grade 3)
- Physical General: Chilly, desire warm food/drinks, scanty sweat, morning stiffness (Grade 3)
- Particular: Chronic osteoarthritis with joint aching/crepitations, < cold damp/rest, > motion/warmth (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic degenerative joint disease with strong Mental Generals (weepiness, depression) and Physical Generals (chilliness, modalities) dominating; Kent suits extremities rubrics for osteoarthritis.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Weepiness and depression
- Anxiety about dependency
- Desire warm food/drinks
- Chilly patient
- Scanty perspiration
- Joint aching/stiffness
- Crepitus in knees/fingers
- < Cold damp, rest
-
Gentle motion, warmth
- Bony enlargements
- Family joint issues
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Sadness depression | Mind; SADNESS | 75 |
| 2 | Weeping tendency | Mind; WEEPING; tendency | 92 |
| 3 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
| 4 | Extremities pain joints chronic | Extremities; PAIN; joints; chronic | 1046 |
| 5 | Joints stiffness morning | Extremities; STIFFNESS; morning | 1191 |
| 6 | < Cold damp | Generalities; COLD; damp agg. | 1349 |
| 7 | Motion continued amel | Generalities; MOTION; continued amel | 1374 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Rhus Toxicodendron | 7/7 | 22 |
| 2 | Calcarea Carbonica | 6/7 | 18 |
| 3 | Bryonia Alba | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Aching, weepiness, chilly | Degenerative changes, stiffness | Family joint issues | Destructive fear dependency |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Osteoarthritis
- Differentiation of Remedies: Compared Rhus tox with Calcarea carb. Calcarea carb has more obesity, extreme chilliness; Rhus tox matches chronic OA with stiffness > continued motion, chilly, < cold damp/rest, > warmth, weepiness/irritability. Bryonia has > absolute rest.
- Selection of Remedy (Materia Medica): Rhus Toxicodendron matches osteoarthritis with aching/stiffness > continued gentle motion, chilly patient, < cold damp/rest, > warmth/motion (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic degenerative joint miasmatic case, sensitive constitution)
- Actual Prescription:
- Rhus Toxicodendron 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 |
|---|
| 20/08/2026 | Stiffness reduced 50%, pain milder, better mobility | Placebo | Gentle walking, warm compress, avoid overexertion |
| 20/12/2026 | Joint pain minimal, no major flares, energy improved | Placebo | Continue light exercise, weight management, physiotherapy |