A two year old child, son of the rickshaw driver, presented with a reported complaint of persistent constipation for 6 months. The patient has no urging to pass stool, passes stool once every 4 days after giving strong laxatives. Cries bitterly while passing stool refuses to sit on the potty seat. Stools are so hard like stone, that it makes a “thud” sound. Extreme anxiety and fear of pain wants to pass stools in standing position. Sometimes stool had to be mechanically removed.The child is the younger of two siblings, and has a healthy 6 years older sister. Both parents are healthy.The patient eats normal food yet appetite reduces when constipated.Milestones are normal. Speech slightly delayed, even at 2 years speaks only in monosyllables. Mother had an uneventful pregnancy. The patient is hot, and wants a fan all the time.Observation: during the time, that patient was in the clinic cabin, he refused to let go of his mother. The child was cranky when offered a toy would grab it and be entertained only for a few minutes. He would throw it away and then demand something else.On examination: large distended abdomen though the child is quite thin.P/A: soft; liver, spleen non-palpable.RS: clearCVS: clear
The patient allowed physical examination with great difficulty, was shrieking throughout.
Was constantly popping one candy after another from his father’s pocket, mother says that’s the only thing he demands when constipated.
Analysis: After Repertorisation the prominent remedy was Cina as it covered the chief complaint, temperament, and thermal modalities. CINA 30, BD, for 4 days followed by SL.
Patient-reported for follow up after 2 weeks. He was less irritable, more comfortable, yet chief complaint SQ. On observation the single keynote that was coming up was the character of the stool. The only remedy that has stool as hard as stone is PLUMBUM MET. Plumbum met 30C once a week for 4 weeks.
After a month, patient-reported for follow up; continues to be in good mood; constipation totally ameliorated, passes stool every day, the stool is soft and painless.
Inference: In pediatric cases, very often the physician relies on the parents’ reporting. The parent’s perception of the child’s problem may be prejudiced by his/her own constitution, thus prejudicing the homeopath’s prescription. Therefore in such cases it is the well-defined objective symptoms that must be given priority. Here, ”stool as hard as stone” became the well-defined differentiating rubric which clinched the remedy
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