Thyroid Nodules
1. PRELIMINARY DATA
- No.: 246/2026
- Patient's Name: HIJ
- Address: Flat 3203, Sapphire Heights, Pune.
- Occupation: Teacher (stress from teaching, long speaking hours)
- Religion: Hindu
- Date: 05/10/2026
- Age: 48 Years
- Sex: Female
- Education: M.Sc. B.Ed
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Neck (thyroid region) | Palpable thyroid nodules, sensation of pressure/lump in throat, occasional hoarseness, mild dysphagia | < Stress, < Cold weather, < Hormonal changes, < Swallowing, > Warm drinks, > Rest, since 5 years (multinodular goitre, USG shows mixed solid-cystic nodules, FNAC benign) | Fatigue, weight gain, anxiety about malignancy, irritability |
| General | Heat intolerance occasionally | < Emotional upset | Depression, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Goitre noticed after stress 5 years ago; suppressed with thyroxine (partial size reduction); recurrent throat infections; hypothyroidism borderline; suppressed skin rash with creams.
- Family History: Mother has multinodular goitre & hypothyroidism. Sister has thyroid nodules. Father has diabetes.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Increased
- Desires: Warm drinks (+++), Sweets (+)
- Aversions: Cold food
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Occasional hard
- Perspiration: Profuse on neck/face, sour
- Sleep: Disturbed by worry; wakes anxious
- Thermal State: Ambithermal (occasional heat intolerance)
B. Reactions - Physical Factors
- Weather: Aggravation in cold weather
- Position: Better warm room
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Anxious, worried, irritable
- Anxiety: About nodules turning malignant, family health
- Fear: Fear of cancer, fear surgery
- Dreams: Lump growing, illness, family burden
- Other: Depression, low self-worth
6. PHYSICAL GENERAL EXAMINATION
- Wt: 72 kg | Ht: 158 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 80 bpm | B.P.: 130/82 mmHg
- Face: Mild goitre visible
- Tongue: Clean
- Nails: Brittle
- Skin: Dry
7. SYSTEMIC EXAMINATION
- Endocrine: Diffuse goitre with palpable nodules, no retrosternal extension
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety about malignancy, depression, fear cancer (Grade 3)
- Physical General: Desire warm drinks, sour sweat, thyroid pressure (Grade 3)
- Particular: Thyroid nodules with lump sensation, < stress/cold, > warm/rest (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic thyroid disorder with strong Mental Generals (anxiety, fear) and Physical Generals (thermal, desires) dominating; Kent suits neck/external throat rubrics for nodules.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety about malignancy
- Fear cancer/surgery
- Desire warm drinks
- Sour perspiration
- Thyroid nodules pressure
- Goitre sensation lump
- < Stress, cold
-
Warm drinks, rest
- Fatigue/irritability
- Family thyroid nodules
- Hoarseness/dysphagia occasional
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety health | Mind; ANXIETY; health, about | 6 |
| 2 | Fear cancer | Mind; FEAR; cancer, of | 42 |
| 3 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
| 4 | External throat swelling | External Throat; SWELLING | 474 |
| 5 | Perspiration sour | Perspiration; ODOR; sour | 1298 |
| 6 | Chilliness | Generalities; COLD; agg. | 1348 |
| 7 | Generalities weakness | Generalities; WEAKNESS | 1413 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Calcarea Carbonica | 7/7 | 22 |
| 2 | Iodum | 6/7 | 18 |
| 3 | Spongia Tosta | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Pressure lump, anxiety, chilly | Nodules, goitre | Family thyroid issues | Destructive fear cancer |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Thyroid Nodules (multinodular goitre, benign)
- Differentiation of Remedies: Compared Calcarea carb with Iodum. Iodum has more heat intolerance, hyperthyroid; Calcarea carb matches thyroid nodules/goitre, chilly, anxiety about health, desire warm drinks, fatigue/depression, family thyroid history. Spongia more dry cough/goitre.
- Selection of Remedy (Materia Medica): Calcarea Carbonica matches thyroid nodules with pressure/lump sensation, goitre, chilly patient, anxiety/fear cancer, desire warm drinks (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic thyroid miasmatic case, sensitive constitution)
- Actual Prescription:
- Calcarea Carbonica 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 |
|---|
| 20/10/2026 | Pressure sensation reduced 50%, goitre size stable, mood better | Placebo | Warm drinks, avoid stress, regular USG/TSH |
| 20/02/2027 | Nodules smaller on USG, no new growth, energy improved | Placebo | Maintain thyroid monitoring, balanced diet |