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On 21 – 3 – 1992, I was called to see a 40 years old patient, suffering from severe pain and swelling in right ankle and in right big toe. The patient was writhing with pain in his bed. Following points were noted:
• Large swelling around the right ankle.
• Slightest pressure on the swollen ankle caused the patient to shriek with pain.
• The pain was worse always during night.
• Pain was agg. in cold.
• Previously he used to vomit mucus and ingesta during severe pain.
• Thirst ++ and increases with pain.
• Frequent bouts of paroxysmal cough, with expectoration of lumps of mucus.
• A lot of chilliness, shivering and yawning.
Past history: The trouble started about 6 years ago. He donated blood twice in one month. He recalls that he also had a sprain. After about one and half years of the above incident he went on a pilgrimage to Rajasthan in the month of January, where, he walked barefooted, 108 times around a big temple on very cold marble floor. When he returned back to Dehradun, he found it very difficult to come out of the car due to severe pain in the right ankle. Since then the pain is continuing in spite of Allopathic and Homoeopathic treatment. The pain used to worsen intermittently, forcing him to be confined to bed.
He had taken the following medicines before I was called in -
Homoeopathic medicines:
Phyto. 1M 5 to 7 drops once in 15 days. Acid. phos. 200, Bryonia 1M for past 1 year regularly, China 1x Rhus tox. 1M, Antimonium crud. 200 + Rhus tox. 200 and Biochemic medicines: Nat. mur. 12X and 30X, Ferrum phos. 30X Calc. phos. 30X,
DIAGNOSIS: (by the Orthopaedic surgeon) Gouty Arthritis. He also took Allopathic treatment.

INVESTIGATIONS: 23 – 3 – 1992
- ESR 48 mm/ at the end of 1 hr
- S. Uric Acid 8.9 mg/dl
- Blood Urea 32 mg/dl
- RA factor negative, though the patient was suffering a lot with rheumatic like pains.

Now the following medicines were given which he commenced taking on 23 – 3 – 1992.
℞ Camphora 200 1 dose
and Chelidonium 30 TDS.

His pain worsened during the night, with the dose of Camphora, but after taking the dose of Chelidonium he had instant relief and slept well. This was followed by a dose of Colchicum 200 every fifth day and Chelidonium 30 TDS till 24 – 5 – 1992.
Subsequently Colchicum 200 was given at longer intervals.

On 13 – 6 – 1992 S. Uric acid came down to 6.4 mg/dl

Last medicine was given on 7 – 7 – 1992 for a week. During the past 5 years, the pain and swelling have not recurred i. e. so far the cure is holding.

DISCUSSION: As the patient had been taking various Homoeopathic medicines for a long period and as Camphor antidotes most of the remedies, a dose of Camphora 200 was given to make the selected remedy work favorably. Kent repertory was consulted on following rubrics:
K 1078 pain ankle < motion
K 1201 pain ankle rheumatic
K 1201 swelling ankle
K 1201 swelling, ankle rheumatic.
On looking into the Materia Medica under Chelidonium, other symptoms of the case were found fitting in it. Dr. Clarke, in his "A Dictionary of Practical Materia Medica", says, in rheumatic affections Chel. has a large field: Edema, heat, tenderness, and stiffness are the leading indications.
Swelling of feet, mostly round ankles. The slightest movement or touch extorted screams.
Colchicum is a gouty remedy and controls Serum uric acid. vide Alien's Encyclopaedia. Hence Colchicum was given inter-currently.
And, the Chelidonium plus Colchicum worked and cured the patient.

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Comment by DR. Sushil Bahl on October 4, 2010 at 1:47am
Fine case discussion.Expecting more to come.Thanks.
Comment by Debby Bruck on October 3, 2010 at 11:46am
I'm always thrilled to read your case presentations. They teach as they illustrate how to take a case and evaluate they symptoms. They also show how to repair a case that has not gone well with other treatments, including some homeopathy.

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