Chronic Renal Calculi
1. PRELIMINARY DATA
- No.: 201/2026
- Patient's Name: ABC
- Address: 123, Karve Nagar, Pune
- Occupation: Software Engineer [chronic stress due to long working hours]
- Religion: Hindu
- Date: 01/03/2026
- Age: 42 Years
- Sex: Male
- Education: Bachelor of Engineering
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Right flank | Severely sharp, stabbing pain radiating to groin | <at night, after urination, since 2 years> | Nausea, vomiting, irritability |
| Left flank | Occasional dull ache | >after drinking plenty of water | Anxiety about health |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: History of recurrent urinary tract infections, appendectomy 10 years ago
- Family History: Father had hypertension, mother has diabetes
- Developmental Landmarks: All milestones were reached at the appropriate age. No delays noted.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Good
- Desires: +++ spicy food, ++ sweets
- Aversions: None
- Thirst: Moderate
- Elimination:
- Urine: Frequent, painful urination
- Stool: Constipation
- Perspiration: Normal
- Sleep: Disturbed due to pain at night
- Thermal State: Hot, prefers cooler environment
B. Reactions - Physical Factors
- Weather: <Summer, due to increased thirst and urination>
- Position: >Lying down on the back
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Perfectionist
- Anxiety: Anxiety about health, fear of losing control
- Fear: Fear of failure, fear of death
- Dreams: Recurrent dreams of being lost
- Other: Irritability, occasional outbursts of anger
6. PHYSICAL GENERAL EXAMINATION
- Wt: 65 kg | Ht: 170 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 80 bpm | B.P.: 140/90 mmHg
- Face: Flushes easily
- Tongue: Dry, coated
- Nails: Brittle
- Skin: Dry, with occasional itching
7. SYSTEMIC EXAMINATION
- Urinary System: Tenderness in the right flank, radiating pain to the groin
- CVS: Normal
- Respiratory: Normal
- GIT: Constipation noted
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety (Grade 3)
- Physical General: Pain (Grade 3)
- Particular: Urinary symptoms (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic case with strong Mental Generals and Physical Generals dominating over particulars; Kent's hierarchy suits constitutional approach.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety about health
- Fear of losing control
- Irritability
- Sharp, stabbing pain in the right flank
- Radiating pain to the groin
- Nausea and vomiting
- Desire for spicy food
- Aversion to none
- Thirst moderate
- Frequent, painful urination
- Constipation
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety about health | Mind; Anxiety; about health | 12 |
| 2 | Fear of losing control | Mind; Fear; of losing control | 685 |
| 3 | Irritability | Mind; Irritability | 763 |
| 4 | Sharp, stabbing pain in the right flank | Abdomen; Pain; right side; stabbing | 104 |
| 5 | Radiating pain to the groin | Abdomen; Pain; radiating to groin | 105 |
| 6 | Nausea and vomiting | Stomach; Nausea; vomiting | 466 |
| 7 | Desire for spicy food | Stomach; Desire; spicy food | 479 |
| 8 | Thirst moderate | Stomach; Thirst; moderate | 484 |
| 9 | Frequent, painful urination | Urine; Pain; urination; frequent | 515 |
| 10 | Constipation | Stool; Constipation | 539 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Lycopodium | 1, 3, 5, 7, 9, 10 | 24 |
| 2 | Nux Vomica | 2, 4, 6, 8 | 18 |
| 3 | Pulsatilla | 1, 3, 9 | 12 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Anxiety, fear, irritability | Frequent urination, pain | Radiating pain, nausea | None |
| Desire for spicy food, constipation | | | |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Chronic Renal Calculi
- Differentiation of Remedies: Lycopodium covers the most symptoms including anxiety about health, irritability, and urinary symptoms. Nux Vomica and Pulsatilla also cover some key symptoms but not as comprehensively as Lycopodium.
- Selection of Remedy (Materia Medica): Lycopodium matches the deep constitutional picture including the desire for spicy food, constipation, and the nature of the pain. (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic deep-seated case, sensitive constitution)
- Actual Prescription:
- Lycopodium 200C — single dose
- Placebo — 4 pills twice a day for 2 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 01/04/2026 | Partial improvement in pain, still anxious | Placebo | Increase water intake, avoid spicy food |
| 01/07/2026 | Further reduction in pain, less frequent urination | Lycopodium 200C (repeat) | Continue dietary advice, monitor for any new symptoms |