Clinical Cases

A Case of Duchenne’s Muscular Dystrophy

Dr. Gaurang Gaikwad presents a case of Duchenne’s Muscular Dystrophy in a 5 year old boy.

A young boy of 5 from the rural areas of Maharashtra was seen by me in September 2014. He was unable to walk properly, stooped when walking and had excessive wasting of the proximal muscles of lower extremities and pseudohypertrophy of calf muscles. The Gower’s sign was positive in the patient – that is, he got up from the sitting position very slowly and with the help of a support. He tested positive for deletion of Axon 44 Dystrophin gene and his recent CPK level was 26150.

April 2016 Gurang GaikwadB

The child’s parents were farmers and of middle socio-economic class. They were asked about the child’s nature. They said that he is very playful nature, plays with his friends outside the whole day and is very restless by nature. His father stated (with some pride and a grin on his face) that the boy will never sit in one place and is always jumping and playing. Mentally he is not much developed and is not very good at understanding. He does not do well in studies and is very poor at even simple calculations. He is very naïve but pure at heart, and quite helping by nature.

The parents said that he likes to go to travelling and see new places. He loves running and is running about with the neighbours’ kids the entire day. He likes playing cricket, kho-kho and football. Though he is slow to run and walk, he loves participating in running races. He is very competitive by nature and is very upset if he loses or if there is misunderstanding between the participants. If he is not allowed to or does not get a chance to play cricket, he starts crying. The parents said that they could not tell much more.

I then asked about his physical generals. He is aggravated by warmth and craved for eggs, fish, vegetables, chicken and ice-cream. He also loved carbonated drinks. He has a very healthy appetite and is hungry every 2 hours. He generally has a very sound sleep and does not get up easily in the morning. He sleeps on his back. Perspiration is more on the scalp.

In children’s cases, it is very important to explore the mother’s history during pregnancy as the mother’s state then often affects the child. In this case, the mother said that it was difficult for her during the pregnancy. Her father had a heart attack and was rushed to ICU where he passed away. She was very attached to her father and he was everything for her; he was like her support, her lifeline. She could not describe the experience but said she broke down and was numb when she heard of the news. She started crying when talking about this.

Analyzing this case was very interesting as there are a lot of mental and physical symptoms. Often in these cases, I look for the central aspect of the case or the core of the case. What was obvious was that he was extremely restless, physically hyperactive, but seemed less developed emotionally and intellectually. This was a kind of anchor for me, the central aspect of the case. When we hunt for this symptom in the repertory, we get:

April 2016 Gurang GaikwadC

(MacRepertory 8.2.01, Professional, Kent Homoeopathic Associates)

This gave me a faint hint that the remedy for the case could be Calcarea phosphorica This was like an entry point into the case for me. I am just trying to bring out the importance of the single drug rubric here; I then tried to evaluate the case with an open mind.

The other symptom in the case was the competitive feeling in the race, especially when there was a misunderstanding amongst friends, which was a kind of jealousy. The rubric for this is:

April 2016 Gurang GaikwadD

(MacRepertory 8.2.01, Professional, Kent Homoeopathic Associates)

Considering the mother’s history during pregnancy, if we go by the feeling of shocked and numbness, we may think of the Loganiaceae family which has sudden shock, numbness and disappointment as its experience, so we can think of a remedy like Gelsemium, which has ailments from bad news which belongs to the family for this case. But again being unprejudiced is important, so I put the exact symptom in the repertory to see what came up. I was shocked to see Calc phos in the rubric. This is what constitutes the artistic use of Repertory

April 2016 Gurang GaikwadE

(MacRepertory 8.2.01, Professional, Kent Homoeopathic Associates)

I then tried to analyze using the other symptoms and repertorizing them and again Calc phos came up:

April 2016 Gurang GaikwadF

(MacRepertory 8.2.01, Professional, Kent Homoeopathic Associates)

Now that Calc phos covered all symptoms, I tried to see if it also had the pathology of the case as one of its main sphere of action, i.e. to see if it covered the Genius of the case. For this I used Boger’s Synoptic Key, which in a few words explains the sphere of action and the main symptoms of the remedy.

April 2016 Gurang GaikwadG

(Michael Hourigan and David Kent Warkentin, ReferenceWorks Pro, 4.2.1.1, Kent Homoeopathic Associates)

Finally I referred to the Soul of Remedies by Dr. Rajan Sankaran, my guru, to see if Calc phos matched the overall picture of the case. I was again pleased to see the state of Calc phos as explained by him, matched the patient beautifully.

April 2016 Gurang GaikwadH

(Michael Hourigan and David Kent Warkentin, ReferenceWorks Pro, 4.2.1.1, Kent Homoeopathic Associates)

As this case belonged to level 4, the level at which psycho-neuro-endocrince and immune (PNEI) axis action is prominent and as the picture of the case matched that of the remedy quite well, I chose to give the patient Calc phos 1M.

Follow up:

After 5 months of treatment, the parents arrived smiling with gifts for us. His CPK level on investigations had dramatically reduced from 26000 to 5000 IU. They said our pediatrician told us that this was unheard of in his practice so far. His walking was much better and he seemed more stable. His posture was better too. He seemed less restless than before and was more relaxed and talkative.  He seemed more cheerful. The parents were very happy with his progress and also brought in another patient with a similar complaint for treatment.

April 2016 Gurang GaikwadI

About the other song:

‘the other song: International Academy of Advanced Homoeopathy                                               is a world class premium medical centre which puts good health and well being at the core of an academic culture dedicated to complete patient care. Situated in Mumbai, this institute is one in its kind where a team of 35 doctors headed by Dr. Rajan Sankaran (the pioneer of the Sensation Approach in Homoeopathy) come together and practice Homoeopathy. At the Academy, the students and practitioners are trained in advanced Homoeopathic practices, using new methodologies in combination with the traditional approaches, all with the use of state-of-the-art technologies. The Academy is also a meeting point for different schools of thought in Homoeopathy, where renowned homoeopaths – national and international are invited, to share their knowledge and experience, so that there is a constant flow of ideas on a common platform.

About the author

Gaurang Gaikwad

Gaurang Gaikwad

Dr. Gaurang Gaikwad, B.H.M.S. graduated in 2011 from CMP Homoeopathic Medical College. He mainly got his motivation for studying homoeopathy from Dr. Vijay Vaishnav. He studied for seven months under renowned homoeopath Dr. Sarkar from Kolkotta. Later, he learned from L.M. Khan. Dr. Gaikwad has been with Dr. Sankaran in his OPD clinics for the last two years. He greatly contributed to the books Synergy in Homoeopathy and Synergy Synopsis by Dr. Rajan Sankaran and also worked on The Pathological Factor in Homoeopathic Prescription by Dr. Ashok Borkar. He is tremendously passionate about homoeopathy, especially studying the repertory in great detail.

6 Comments

  • A very wonderful usage of Repertory sir. Thank you for sharing the importance of Single Remedy Rubrics.
    In such cases, where there is marked muscle degeneration and may persist from birth, what is the repetition of the drug chosen? And how long should one wait? What are the possible follow-ups we may get?

    • Hello Sheetal ,

      your question is Good and Valid ,

      generally – these cases of muscular Dystrophy respond well to homeopathy
      we need to evaluate in follow ups – clinically – also With help of Investigations ( we can evaluate with help of CPK ) – what are the changes within 45 days – 2 Months In treatment… we generally evaluate the case monthly .. there should be Some positive changes within 2 – 3 months of treatment , if Not we need to evaluate the remedy we have prescribed …

      need to be flexible

      Few pointers Towards the Selecting the Remedy – especially In These cases
      state of mother during pregnancy
      Solid Symptoms in the case
      completeness and Exactness

      Hope these Pointers help

      regards
      dr gaurang

      • Thank you Sir for your prompt reply.
        Your pointers did help out.
        Homoeopathy works wonders in DMD, but in the few cases that I have witnessed the child would have good improvement in generals which is taken as a positive sign and the strength of the child would show mild improvement. Still should the remedy be evaluated ? Or the Posology needs to be reviewed? What is the probable repetition of the similimum you would advise ?

  • A very nice learning case…exactness of the rubric is always essential to understand the whole…thank u dr. Gaurang for sharing…

    • hi Rajesh ,…

      yes … Exactness … SHARPNESS

      especially when you get that as Single Drug Rubric …you are in business , straightaway … the More Exact the rubric … more closer the Similimum

      regards
      gaurang

  • Hello Dr… Very good presentation of case. & congrats..for ur success.. If u have treated any cases of rubella syndome & Downs syndrome. , CP., plz share ur experiences… Tx for sharing.. Dr.swarupa., consultant Homeo physician& Early interventionist at NILOUFER govt hospital , Hyderabad

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