Dr Gheorghe Jurj, MD, DSc Course: Visual Semiology XXIX Brazilian Congress of Homeopathy São Paulo, 2008
Dr Gheorghe Jurj, MD, DScCourse: Visual Semiology
XXIX Brazilian Congress of HomeopathySão Paulo, 2008
• 6 year-old girl, consults with fever (39.4 oC) and erythematoustonsillitis.
• Frequent colds with running nose and inflammation of the throat.
• Nasal obstruction, cannot breath at night and sleeps with open mouth. Cough “from the throat”, as if trying to eliminate a lump. During consultation, coughed rarely, dry cough.
• NET doctor has suggested adenoidectomy.
• 2 or 3 episodes of middle ear infection.
• In the past year took ATB 10 times.
• All along theconsultation, tossingon the chair.
• Notice her posture
• Every time, beforeanswering a question, turns to her mother
• Cannot breaththrough the nose, the mouth is open allthe time
• Dry lips, cracks onthe angles. On theleft side, eczematization
2 Gestures
Licks the corners of the mouth Bites the lower lip
• Red tongue, papillaeincreased in anterior part, whitish coatingin the posterior part; Crack on the middleline and transversally(“cross-like”)
• Pharynx congestive; large tonsills(touching in themiddle line); whitespots of suppuration
• NATRIUM: dry lips; nasal obstruction; well-behaved, quiet... But, usually with much secretions, thirst, suppurated tonsillitis is lessfrequent, congestion is not as intense.
• CARBON: perspiration of the scalp, wet hands, cold-blooded
• MERCURIUS: important remedies of suppurated tonsillitis in children, high fever, copious perspiration, thirst, copious yellow-whitish suppuration in tonsillsc
• REMEDIES OF ACUTE INFLAMMATION (Phyt, Bell, Acon, etc.): presentation is more dramataic, much more congestion
1 MOUTH - CRACKED - Tongue fissured - Centre
2 MOUTH - CRACKED - Tongue fissured
3 FACE - CRACKED - Lips
4 FACE - CRACKED - Lips - Lower
5 MOUTH - DISCOLORATION - Tongue - white - heavily coated
6 THROAT - DISCOLORATION - redness - Tonsils
7 THROAT - DISCOLORATION - redness - Uvula
8 THROAT - INFLAMMATION – accompanied by - cough
9 THROAT - INFLAMMATION - Tonsils
10 FACE - DRYNESS - Lips - licks them frequently
11 FACE - DRYNESS - Lips
puls. sulph. merc. nit-ac. bapt. apis cham. mez. nux-v. bell.
10/17 8/15 7/15 7/15 7/14 7/12 7/12 7/9 7/8 6/14
1 - 1 - 2 1 - - 2 - -
2 1 2 2 3 2 2 2 1 1 2
3 1 3 2 1 2 1 2 2 1 1
4 2 1 - 2 - 1 1 1 1 -
5 3 - 3 - - - - 1 1 -
6 2 2 2 2 3 2 2 - - 3
7 2 1 1 - 3 2 - - - 3
8 1 - - - - - 2 - 1 -
9 1 2 3 3 2 2 2 1 1 3
10 1 - - - - - - - - -
11 3 3 2 2 1 2 1 1 2 2
• Calm, quiet, “perhaps too quiet”
• Cries easily; always asks permission to do anything
• Thirstless, esp during fever
• Sleeps rolled up or on the back, with the handson the head
Pulsatilla 30x e/6-8 hours until resolution of tonsillitis, then 200CH for 1 month.
No further recidives appeared; tonsillectomy was ruled out
1. “Mental atmosphere”, reflected also in her posture: sitting on the edge of the chair, with fixed hands; turning always to look for her mother
2. Nasal obstruction, esp in the night – constant of Pulsatilla in children. Although a generic sign of adenoidism, according to the context its value may increase.
3. Licking the lips – its value is increased by the local context (lips, tongue, pharynx)
4. Although tonsillitis is suppurative, secretion is white, in relatively welll delimitatedareas, on a background of intensely red congestion, but not as in Bell, Lac-c, Merc orLach. Moreover, as in Apis, tonsills are swollen, touching each other on the middleline (Bar-c) but no other symptoms of these remedies are present.