TITLE

“STUDY OF KENT’S TWELVE

OBSERVATION WITH
SPECIAL EMPHASIS ON
SIGNIFICANCE OF KENT’S
3RD OBSERVATION IN
ACUTE CASES”

ABSTRACT

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Observation means the act or instance of noticing a condition, perception, the faculty
of taking notice, the accurate watching and noting of a phenomenon. Good
observational skill remains to be one of the requisite qualities of a homoeopathic
practitioner.

Dr. Hahnemann has emphasized the importance of observation in clinical practice.

Observations often exposes the peculiarity of the patient and therefore demands
making summary of such observations after noting the symptoms expressed by the
patient. Dr. Kent, the great scholar and true disciple of Hahnemann followed the
pathways of his principles and summarized his observations of years of clinical
practice into 12 observations. These observations given by him have grown out of
much watchfulness, long waiting and watching. He has explained it in his book
“Lectures on Homoeopathic Philosophy” in chapter 35 i.e. Prognosis after observing
the action of the remedy.

After the simillimum is selected and administered to the patient, what will happen
next is the most absorbing and intricate aspects of homoeopathy. There are fine
changes in the symptomatology after a remedy is administered and correct
interpretation of these changes enables us to arrive at certain conclusions as per 12
observations. Among these the 3rd observation is most assuring and has best
prognosis i.e.- “The aggravation is quick, short, and strong with rapid improvement of
the patient”.

We have tried to study and interpret what happens after a remedy is administered in
accordance with the Law of Similars. So, an observational study with 30 cases was
conducted, to study the significance of Kent’s 3rd observation in acute cases. Since
the time of research is of limited time period so chronic cases were not feasible
therefore acute cases were taken into st udy. The study concluded that Kent’s 3 rd
observation is significant in acute cases.

TABLE OF CONTENTS

CHAPTER NO. TITLE PAGE NO.

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 1 TITLE PAGE 1

2 ABSTRACT 2

3 TABLE OF CONTENTS 3
4 LIST OF FIGURES AND 4
PHOTOGRAPHS

5 LIST OF TABLE 5

6 LIST OF ABBREVIATIONS 6

7 LIST OF APPENDICES 8

8 INTRODUCTION 9

9 AIMS AND OBJECTIVES 12

10 REVIEW OF LITERATURE 14

11 MATERIAL AND METHOD 39

12 OBSERVATION AND RESULTS 42

13 DISCUSSION 50

14 CONCLUSION 63

15 SUMMARY 65

16 REFERENCES/BIBLIOGRAPHY 67

17 APPENDIX 70

LIST OF FIGURES AND PHOTOGRAPHS

Sr. No. CONTENT PAGE NO.

1 Graph showing Result Analysis of total 30 44
cases
2 Graph showing incidence according to sex of 45
patient out of total 30 cases
3 Graph showing age wise distribution of total 46
30 cases

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 4 Graph showing Miasmatic Cleavage of total 47
30 cases
5 Graph showing case-wise distribution of 49
selected remedies

LIST OF TABLES

Sr. No. CONTENT PAGE NO.

1 Table showing Result Analysis of total 44
30 cases
2 Table showing Incidence according to 45
sex of patient out of total 30 cases.
3 Table showing age wise distribution of 46
total 30 cases
4 Table showing Miasmatic Cleavage of 47
total 30 cases
5 Table showing case-wise distribution of 48
selected remedies

LIST OF ABBREVIATIONS

Agg / < - Aggravation

Amel / > - Amelioration

Ab - Absent

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Kg - Kilogram Min

- Minute b/min -

Beat per minute º F -

Degree Fahrenheit

CNS - Central nervous system

CVS - Cardio vascular system

RS - Respiratory system

GIT - Gastro intestinal tract

B.P. - Blood Pressure

NAD - No abnormal deviation

N.P. - Not Particular

BD - Bis in dies (twice a day)

TDS - Three times per day

Mm of Hg - Millimeter of mercury

LMP - Last menstrual period

OPD - Out patient department

IPD - In patient department

§ - Aphorism

F. N. - Foot Note

SL - Saccharum Lactis

Veg. - Vegetarian
Ars. Alb. - Arsenicum Album

Puls. - Pulsatilla Pratensis

Bry - Bryonia Alba

Hep Sulph - Hepar Sulphur

Bell. - Belladonna
Plantago M - Plantago Major

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 Kali Mur - Kalium Muriaticum

Mag Phos - Magnesium Phosphoricum

LIST OF APPENDICES

Sr. No. CONTENT PAGE NO.

1 Glossary / Definitions 71

2 Case Recording Format 72

3 Data Collection Format 75

4 Questionnaire 76
5 Scales (for outcome Assessment, Quality of 78
Life etc.)

6 Special Methods, if any 79

7 Reagents 79

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8 Patient Information Sheet & Written Patient 80
Consent

9 Case Records 85

10 Master Chart 105

INTRODUCTION

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Page | 8
 INTRODUCTION

“Kent’s 12 observation” is based on the remedy response he observed after

prescribing a remedy. As per Dr. Kent- After a prescription has been made the
physician commences to make observations. The whole future of the patient may
depend upon the conclusions that the physician arrives at from these observations,
for his action depends very much upon his observations, and upon his action
depends good of the patient. If the homoeopathic physician is not an accurate
observer, his observations will be indefinite; and if his observations are indefinite, his
prescribing is indefinite.

If a medicine is acting it commences immediately to affect changes in the patient and

these changes are shown by signs and symptoms which are studied under Kent’s 12
Observations. There may be a disappearance of the symptoms, amelioration of the
symptoms or increase of the symptoms, and these changes are the manifestation of
the action of the remedy on the vital energy or vital force; and it is these
manifestations we must study. Among the most common reactions after the remedy
[4]
has been administered is aggravation or amelioration.

Kent’s observation helps students and new budding homoeopaths by simplifying

their queries and guiding them towards right way of clinical practice. It solves the
huddles faced by us by mentioning his real experience of clinic which includes all
cured and failed cases. Therefore doing research on it is like plunging into the ocean
of deep knowledge and experience it in real. A homoeopathic physician should be a
great observer and it only comes with deep learning and years of practice. It’s like an
iceberg, seen little on top but giant inside similarly Kent’s observation includes
almost complete homoeopathic knowledge i.e. knowledge of susceptibility, posology,
knowledge of drug, its preparation, drug proving, and helps in second prescription
etc.

Third observation is considered to be most assuring because of its prognosis and

remedy reaction. Studying its significance in acute cases as to get to see the
observation in short interval of time which may not be feasible incase of chronic
cases which take long time in recovery. In acute cases it helps us to determine

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whether we are proceeding towards the right direction i.e. route of recovery or not
else it may leads to worse or may be fatal condition sometimes.

Therefore, Kent’s observation is a very important, inerasable and unavoidable part of

Homoeopathy without which a homoeopath feels empty hollow space inside which
can only be filled by thorough study of it.

AIMS AND
OBJECTIVE

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AIMS:

• To explore Kent’s 12 Observation.

• To understand significance of Kent’s 3rd observation in acute cases.

OBJECTIVES:
Primary Objectives :- To explore Kent’s 12 Observation in detail.

Other Objectives 1 :- To understand significance of Kent’s 3rd observation in

acute cases

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 REVIEW OF
LITERATURE

REVIEW OF LITERATURE

Homoeopathy is both an art and science. The successful homoeopath must be both
an artist and a scientist. Theory and practice must go hand in hand. Technique must
[2]
be governed by definite principle.
Always the sick individual hopes for the cure should takes place, as stated by Dr.
Samuel Hahnemann in the second aphorism, “The highest ideal of cure is rapid,
gentle and permanent restoration of the health, or removal and annihilation of the
[1]
disease in its whole extent in the shortest, most reliable and most harmless way”.
One of the first things required of homoeopathic physician is that his power of
observation shall be highly developed. [6] If he is not conversant with the import of
what he sees, he will undertake to do wrong things, he will make wrong
prescriptions, he will change his medicines and do things to the detriment of the
patient.
There is absolutely but one way, and nothing can take the place of intelligence. If you
talk with a great many physicians concerning the observations you have made after
giving the remedy you will find that the majority of them have only whims or notions

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on this subject and see nothing after the prescription is made. It is taken for granted
after a prescription has been made, and it is an accurate prescription, that it has
acted. Now, if a medicine is acting it commences immediately to affect changes in
the patient, and these changes are shown by signs and symptoms. This watching
and waiting and observing has to be done by the physician in order that he may
[4]
judge by the changes what to do, and what not to do.

Dr. Robert in chapter, “Remedy Reaction” of his book “The Principles and Art of Cure
by Homoeopathy” has written about how a good observer is i.e.- ‘His powers of
discrimination should be very keenly attuned, first, that he may observe the patient in
the analysis of the symptoms and the selection of the remedy, and second, that he
may have the keen perception of the import of the symptoms after the remedy has
[6]
been carefully selected and administered.
As per Dr. Kent, there’s a index which tells a physician what shouldn’t be done and
only a keen and vigilant observer can see it. Of course, if a prescription is not related
to the case, if it is a prescription that effects no changes, it does not take long to, see
what to do ; much patient waiting for a foolish prescription is but loss of time, and
that should be taken into account among the observations. The observations taken
after a specific remedy has been given sufficiently related to the case to cause
[4]
changes in the symptoms are those of value.

According to Hahnemann, the nearer similar the remedy the more reaction we may
expect as mentioned in aphorism 154 and 155.
The remedy is known to act by the changing of the symptoms. The disappearance of
symptoms, the increase of symptoms, the amelioration of symptoms, the order of the
symptoms, are all changes from the remedy, and these changes are to be studied.
Among the commonest things that remedies do is to aggravate or ameliorate. The
aggravation is of two kinds; we may have an aggravation which is an aggravation of
the disease, in which the patient is growing worse, or we may have an aggravation of
the symptoms, in which the patient is growing better. The true homoeopathic
aggravation, I say, is when the symptoms are worse, but the patient says, "I feel
better." The aggravations and ameliorations, the directions of symptoms and many
other things have to come up, and be observed and judgment has to be passed
upon them. [4]

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First of all, the patient should be the aim of the physician, his whole idea should be
centered upon the patient to determine whether he is improving or declining. We
have to judge by the symptoms to know that this is taking place. The symptoms
themselves must be corroborated. The patient's opinion must be corroborated by the
symptoms. The symptoms do corroborate what the patients say in many instances,
[4]
but the symptoms are the physician's most satisfactory evidence.
Dr. Kent has pen downed his clinical cases, his experience and observation at that
time, to make it more understandable to curious and enthusiastic minds. These small
details help us to understand how these 12 observations were deducted and make it
easier for us to study in todays practice.

DETAILED STUDY OF KENT’S 12 OBSERVATION

To understand it in a better way a broad study of experiences of great stalwarts of
homoeopathy is required. How with time our great homoeopaths studied it and
presented it in a simplified and different manner but the basic remains unaltered. So
let’s discuss it in detail-

1ST Observation: - "A prolonged aggravation, and final decline of the patient".
Meaning: The medicine may or may not have been a correct one; but surely the
potency was very high, and the medicine was deep-acting antipsoric. Therefore,
instead of helping, it has established destruction; since there have been enough
irreversible tissue changes.
Duty of the Physician: It necessitates immediate antidoting. After re-case-taking, a
[7]
more similar medicine in low potency is to be prescribed.

According to Dr. Kent, - “ In incurable and doubtful cases give no higher than the
30th or 200th potency, and observe whether the aggravation is going to be too deep
or too prolonged”.[4]

According to Dr. H. A. Roberts, 'It is probably wiser not to use an antipsoric in these
conditions'. [6]

Prognosis: Very bad.

In § 255, "......Now, supposing the remedy is perfectly appropriate, if the
improvement delay too long in making its appearance, this depends either on some

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error of conduct on the part of the patient, or on the homoeopathic aggravation
produced by medicine lasting too long (§ 157), consequently on the dose not being
small enough."
In § 276, Dr. Hahnemann described that, "....., even though it may be
homoeopathically suited to the case of disease, does harm in every dose that is too
large, the more harm the larger the dose, and by the magnitude of the dose and in
strong doses' it does more harm the greater its homoeopathicity and the higher the
potency selected, and it does much more injury than any equally large dose of a
medicine that is unhomoeopathic, ....."
In § 279, it is said, "This pure experience shows UNIVERSALLY, that if the disease
do not manifestly depend on a considerable deterioration of an important viscus
[1]
(even though it belong to the chronic and complicated diseases), ....."
In The Chronic Disease, Dr. Hahnemann has mentioned, "But if these aggravated
original symptoms appear on subsequent days still of the same strength as at the
beginning, or even with an increased severity, it is sign that the dose of this
antipsoric remedy, although properly selected according to homoeopathic principles,
was too large, and it is to be apprehended that no cure will be effected by it; because
the medicine in so large a dose is able to establish a disease, which in some
respect, indeed, is similar to it; with respect to the fact, however, that the medicine in
its present intensity unfolds also its other symptoms which annul the similarity, it
produces a dissimilar chronic disease instead of the former, and, indeed, a more
severe and troublesome one, without thereby extinguishing the old original one".
Again in the same text, The Master instructed, "Now when the stormy assault caused
by too large a dose of medicine, although homoeopathically selected, has been
assuaged through an antidote or the later use of some other antipsoric remedies,
then, later on, the same antipsoric remedy - which had been hurtful only because of
its over-large dose - can be used again, and, indeed, as soon as it is
homoeopathically indicated, with the greatest success only in a far smaller dose and
[9]
in a much more highly potentized attenuation, i.e., in a milder quality".
Dr. M. L. Dhawale mentioned this observation as “Killer Homoeopathic Aggravation”.
He mentioned in his book, ‘Principles and Practice of Homoeopathy’ that, ‘In this
form of Aggravation, the tree of life is clean uprooted as a result of the misplaced
zeal of a Homoeopathic physician who aims at curing an incurable case or whose

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knowledge of disease is inadequate to diagnose correctly the advanced pathological
changes that have taken place in vital organs.
This time the storm that has been unleashed proves too much for the depleted vital
force which is now unable to meet the fury of the reaction, precipitated by the
tremendous energy of the constitutional remedy. The entire system is thrown out of
gear and the resultant suffering pathetic. The patient declines rapidly, nothing short
of the eternal sleep now provides the much needed relief.
This tragedy would have been avoided by a Homoeopathic physician who has a firm
grasp of the Principles and Practice of Homoeopathy. He would have straight off
rejected the idea of ‘curing’ this patient and contented himself with the humbler idea
of palliation. He would have succeeded in giving reasonably good relief by limiting
himself to a few superficially acting related remedies. He would shun any deepacting
[3]
constitutional remedy which only proves a ‘Killer’ in such a case’.

2ND Observation: - "Prolonged aggravation, then very slow improvement".

Meaning: Had the case come a bit later, it would also have fared the same fate as in
1st Observation. The medicine was right. The potency was very high. There have
[7]
been enough tissue changes. The dose would act for a very long period.

According to Dr. Kent – ‘You will find in such a patient there was the beginning of
some very marked tissue change in some organ. We may know by observing the
action of a remedy what state the tissues are in, as well as know something about
[4]
the prognosis for the patient’.
Duty of the Physician: The action of the medicine is not to be disturbed till the dose
has worn off.
Prognosis: Favourable.
In § 245, Dr. Hahnemann explained, "...... Every perceptibly progressive and
strikingly increasing amelioration in a transient (acute) or persistent (chronic)
disease, is a condition which, as long as it lasts, completely precludes every
repetition of the administration of any medicine whatsoever, because all the good the
medicine taken continues to effect is new hastening towards its completion. Every
new dose of any medicine whatsoever, even of the one last administered, that has
hitherto shown itself to be salutary would in this case disturb the work of
amelioration."

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In § 276, "Too large doses of an accurately chosen homoeopathic medicine, and
especially when frequently repeated, bring about much trouble as a rule. They put
the patient not seldom in danger of life or make this disease almost incurable. They
do indeed extinguish the natural disease so far as the sensation of the life principle is
concerned and the patient no longer suffers from the original disease from the
moment the too strong dose of the homoeopathic medicine acted upon him but he is
in consequence more ill with the similar but more violent medicinal disease which is
most difficult to destroy." [1]
In The Chronic Disease, "Least of all, need we to be concerned when the usual
customary symptoms are aggravated and show most prominently on the first days,
and again on some of the following days, but gradually less and less. This so-called
homoeopathic aggravation is a sign of an incipient cure (of the symptoms thus
[9]
aggravated at present), which may be expected with certainty."

According to Dr. M. L. Dhawale, ‘This consists of a very severe type of reaction in

which all symptoms in the patient are profoundly aggravated and the patient appears
to be going through a sort of rehearsal of the things to be expected in the future. This
storm lasts for quite some time once it is unleashed and the patient is just tossed
around helplessly. After a good amount of beating the fury of the storm spends itself
and the patient slowly finds himself on his feet, as it were. He may appear stationary
during the brief spell of observation; however, as one observes him over a period of
[3]
a few days, one is convinced that he is making a slow but definite progress’.

3RD Observation: - "The aggravation is quick, short and strong with rapid
improvement of the patient".
Meaning: The reaction of the economy is vigorous. There is no much tissue
[7]
changes, or very superficial, if any. The potency was a bit higher.

According to Dr. Kent, ‘Improvement will be marked, the reaction of the economy is
vigorous, and there is no tendency to any structural change in the vital organs. Any
structural change that may be present will be found on the surface, in organs that are
not vital; abscesses will form and often glands that can be done without will
suppurate in regions that are not important to the life of the patient. Such organic
changes are surface changes, and are not like the changes that take place in the
liver, in the kidneys, in the heart and in the brain. Such is the slight aggravation of

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the symptoms that occurs in the first hours after the remedy in an acute sickness, or
[4]
during the first few days in a chronic case.
Duty of the Physician: An aggravation of this kind is very much reassuring.
Medicinal action is not to be disturbed.
Prognosis: Very good.
The aphorisms which are related to above condition are– 157, 158,159,160,161, and
F.N. to aphorism 282. [8]
In § 157, Dr. Hahnemann explained, "But though it is certain that a homoeopathically
selected remedy does, by reason of its appropriateness and the minuteness of the
dose, gently remove and annihilate the acute disease analogous to it, without
manifesting its other unhomoeopathic symptoms, that is to say, without the
production of new, serious disturbances, yet it usually, immediately after ingestion -
for the first hour, or for a few hours - causes a kind of slight aggravation when the
dose has not been sufficiently small and (where the dose has been somewhat too
large, however, for a considerable number of hours), which has so much
resemblance to the original disease that it seems to the patient to be an aggravation
of his own disease. But it is, in reality, nothing more than an extremely similar
medicinal disease, somewhat exceeding in strength the original affection."
In § 158, "This slight homoeopathic aggravation during the first hours - a very good
prognostic that the acute disease will most probably yield to the first dose - is quite
as it ought to be, as the medicinal disease must naturally be somewhat stronger than
the malady to be cured if it is to overpower and extinguish the latter, just as a natural
disease can remove and annihilate another one similar to it only when it is stronger
than the latter (§§ 43 - 48)."
In § 159, "The smaller the dose of the homoeopathic remedy is in the treatment of
acute diseases so much the slighter and shorter is the apparent increase of the
disease during the first hours."
In § 160, "But as the dose of a homoeopathic remedy can scarcely ever be made so
small that it shall not be able to relieve, overpower, indeed completely cure and
annihilate the uncomplicated natural disease of not long standing that is analogous
to it (§ 249, note), we can understand why a dose of an appropriate homoeopathic
medicine, not the very smallest possible, does always, during the first hour after its
ingestion, produce a perceptible homoeopathic aggravation of this kind."

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In § 161, "When I here limit the so-called homoeopathic aggravation, or rather the
primary action of the homoeopathic medicine that seems to increase somewhat the
symptoms of the original disease, to the first or few hours, this is certainly true with
respect to diseases of a more acute character and of recent origin, but where
medicines of long action have to combat a malady of, considerable or of very long
standing, where one dose, consequently, must continue to act for many days, we
then occasionally see, during the first six, eight or ten days, the occurrence of some
such primary actions of the medicine, some such apparent increase of the symptoms
of the original disease (lasting for one or several hours), whilst in the intervening
hours amelioration of the whole malady is perceptible. After the laps of these few
days the amelioration resulting from such primary action of the medicine proceeds
almost uninterruptedly for several days longer."
In F.N. to § 282 (6 th edition), "The rule to commence the homoeopathic treatment
if chronic diseases with the smallest possible doses and only gradually to augment
them is subject to a notable exception in the treatment of the three great miasms
while they still effloresce on the skin, i.e., recently erupted itch, the untouched
chancre (on the sexual organs, labia, mouth or lips, and so forth), and the figwarts.
These not only tolerate, but indeed require, from the very beginning large doses of
their specific remedies of ever higher and higher degrees of dynamization daily
(possibly also several times daily). If this course be pursued, there is no danger to be
feared as is the case in the treatment of diseases hidden within, that the excessive
dose while it extinguishes the disease, initiates and by continued usage possible
produces a chronic medicinal disease. During external manifestations of these three
miasms this is not the case; for from the daily progress of their treatment it can be
observed and judged to what degree the large dose withdraws the sensation of the
disease from the vital principle day by day; for none of these three can be cured
without giving the physician the conviction through their disappearance that there is
[1]
no longer any further need of these medicines."
In The Chronic Disease , "These attacks, however, if the antipsoric remedy was
selected fittingly and homoeopathically and the dose was a moderate one, during its
continued action take place, even more and more rarely and more feebly, but if the
dose were too strong they come more frequently and more strong, to detriment of
the patient."

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Again He says in The Chronic Disease, "The physician must, therefore, in chronic
diseases, allow all antipsoric remedies to act thirty, forty or even fifty and more days
by themselves, so long as they continue to improve the diseased state perceptibly to
the acute observer, even though gradually; for so long the good effects continue with
the indicated doses and these must not be disturbed and checked by the new
remedy." [9]

Dr. M. L. Dhawale explained it under “Simple Homoeopathic Aggravation”.

4TH Observation: - "Recovery without any aggravation whatsoever".

Meaning: It was the most similar medicine. The potency exactly fitted the case.
[7]
There was no tissue change. There was only a functional disorder.
According to Dr. Kent, ‘There is no organic disease and no tendency to organic
disease. The chronic condition itself to which the remedy is suitable is not of great
depth, belongs to the functions of nerves rather than to threatened changes in
tissues. You must realize that there are changes in tissues so marked that the vital
force is disturbed in flowing through the economy, and yet so slight that man with all
[4]
of his instruments of precision cannot observe them.
Duty of the Physician: This is the highest ideal of cure in the acute disease
condition.
Prognosis: Very good (in acute disease).
Dr. Hahnemann explained in § 156, "There is, however, almost no homoeopathic
medicine, be it ever so suitably chosen, that, especially if it should be given in an
insufficiently minute dose, will not produce, in very irritable and sensitive patients, at
least one trifling, unusual disturbance, some slight new symptom while its action
lasts; for it is next to impossible that medicine and disease should cover one another
symptomatically as exactly as two triangles with equal sides and equal angles. But
this (in ordinary circumstances) unimportant difference will be easily done away with
by the potential activity (energy) of the living organism, and is not perceptible by
patients not excessively delicate; the restoration goes forward, notwithstanding, to
the goal of perfect recovery, if it be not prevented by the action of heterogeneous
medicinal influences upon the patient, by errors of regimen or by excitement of the
passions."

Page | 20
Again in § 159, He stated, "The smaller the dose of the homoeopathic remedy is in
the treatment of acute diseases so much the slighter and shorter is the apparent
increase of the disease during the first hours."
In § 253, "Among the signs that, in all diseases, especially in such as are of an acute
nature, inform us of a slight commencement of amelioration or aggravation that is not
perceptible to everyone, the state of mind and the whole demeanor of the patient are
the most certain and instructive. In the case of ever so slight an improvement we
observe a greater degree of comfort, increased calmness and freedom of the mind,
higher spirits - a kind of return of the natural state. In the case of ever so small a
commencement of aggravation we have, on the contrary, the exact opposite of this:
a constrained helpless, pitiable state of the disposition, of the mind, of the whole
demeanor, and of all gestures, postures and actions, which may be easily perceived
[1]
on close observation, but cannot be described in words."
In The Chronic Disease, "There are not a few cases, where the practiced careful
Homoeopath sees a single dose of his remedy, selected so as to be perfectly
homoeopathic, even in a very severe chronic disease, continue uninterruptedly to
diminish the ailment for several weeks, year, months, up to recovery; a thing which
could not have been expected better in any other way, and could not have been
effected by treating with several doses or with several medicines. To make the
possibility of this process in some way intelligible, we may assume, what is not very
unlikely, that an antipsoric remedy selected most accurately according to
homoeopathic principles, even in the smallest dose of a high or the highest potency
can manifest so long-continued a curative force, and at last cure, probably, only by
means of a certain infection with a very similar medicinal disease which overpowers
the original disease, by the process of nature itself, according to which (Organon, §
45, Fifth Edition), two diseases which are different, indeed, in their kind but very
similar in their manifestations and effects, as also in the ailments and symptoms
caused by it, when they meet together in the organism, the stronger disease (which
is always the one caused by the medicine, § 33, ibid.) destroys the weaker (the
natural one). In this case every new medicine and also a new dose of the same
medicine would interrupt the work of improvement and cause new ailments, an
[9]
interference which often cannot be repaired for a long time."

According to Dr. M. L. Dhawale, ‘When the patient starts feeling better and his
complaints are relieved immediately after the remedy is given, we term the response
Page | 21
as Simple Amelioration and this type of reaction could be said to be an ideal type of
response. Like all ideals this is rarely attainable and indicates a fortuitous
circumstance where functional changes only are present and the patient has
[3]
received the Similimum in the correct potency and dose’.

5TH Observation: - "The amelioration comes first, then comes the aggravation".
Meaning: The medicine was antipathic in nature, or it was only partially or
superficially similar. [7]

According to Dr. H. A. Robert, ‘Either we selected too superficial a remedy, that

could act only as a palliative, or the case is incurable and the remedy has been
[6]
somewhat similar but not completely so.’
According to Dr. Kent, ‘It is not a very uncommon thing in severe cases, in cases of a
good many symptoms, to have an amelioration of the remedy come at once; but
whatever you may say, the condition is unfavorable.’ He further says, ‘The
acknowledgement of one's own ignorance begets confidence in an intelligent
patient.’ [4]

Dr. Stuart Close has written in his book of philosophy that, ‘"Suppression," or
palliation of disease, is the removal of the external symptoms of disease by external,
mechanical, chemical or topical treatment; or by means of powerful drugs, given
internally in massive doses, which have a direct physiological or toxic effect but no,
true therapeutic or curative action.
The "suppressed" case always "goes bad." The practical bearing of the foregoing
consideration appears when we come to the treatment of disease; If we regard the
external, tangible manifestations as the all of disease and make them the object of
treatment, we are likely to lose sight of the logical relation between cause and effect,
overlook important etiological factors, invert the natural order and direction of
treatment and end by using measures which can result only in failure or in mere
palliation instead of cure. Such treatment fails because it is one-sided and
superficial. It is not guided by knowledge of the true nature and causes of disease
[2]
and their relation to its external manifestations.
Duty of the Physician: A more similar medicine is to be given after re-case-taking
after a sufficient period of waiting.
Prognosis: Bad.

Page | 22
Dr. Hahnemann explained in § 256, "On the other hand, if the patient mention the
occurrence of some fresh accidents and symptoms of importance - signs that the
medicine chosen has not been strictly homoeopathic - even though he should
goodnaturedly assure us that he feels better, as is not infrequently the case in
phthisical patients with lung abscess, we must not believe this assurance, but regard
[1]
his state as aggravated as it will soon be perfectly apparent it is."
In The Chronic Disease, "Yet when a sudden great and striking improvement of a
tedious great ailment follows immediately on the first dose of a medicine, there justly
arises much suspicion that the remedy has only acted palliatively, and therefore
must never be given again, even after the intervention of several other remedies."
Again in The Chronic Disease, "We cannot flatter ourselves that the antipsoric
medicine given was rightly selected, or that it will forward the cure of a chronic
disease, if it quickly and entirely destroys as if by a stroke of magic the most
troublesome symptoms, old, great, continuous pains, tonic or clonic spasms, etc., so
that the patient almost immediately after taking the medicine, fancies himself as
much freed from sufferings as if he were already restored, and as if in heaven. This
deceptive effect shows that the medicine here acts enantiopathically as an opposite
or palliative, and that in the days following we cannot expect anything from this
remedy but an aggravation of the original disease. As soon then as this deceptive
improvement within a few days begins again to turn to aggravation, it is high time to
give either the antidote to this medicine, or, when this cannot be had, a medicine
which is homoeopathically more appropriate. Very rarely will such an enantiopathic
remedy do any good in future. If the medicine which is thus antipathic at once in the
beginning, i.e., which seemed so to alleviate, is inclined to reciprocal action, it is
possible that when the aggravation from this dose takes place, a second dose of the
same remedy may produce the contrary, and thus bring about a lasting
improvement, as I have at least perceived in Ignatia." [9]
According to Dr. M. L. Dhawale, ‘When the amelioration is followed by aggravation, it
indicates a bad prognosis. Perhaps the remedy-selection was superficial; but, more
often that not, this response is indicative of an incurable condition.
We should distinctly separate this type of reaction from the one in which
recrudescence or relapse occurs after a period of full and complete amelioration.
This type of response is seen in the relapsing disorders when the action of the

Page | 23
remedy has exhausted or the environmental stresses are renewed, as often occurs
[3]
in the psycho-somatic group of diseases’.

6TH Observation: - "Too short relief of the symptoms".

Meaning: In Acute disease, the medicine has to be repeated much oftener. The
infection being violent or virulent in nature. In Chronic disease, the medicine was
[7]
partially similar. There is a condition which interferes with the action of the remedy.

As per Dr. H. A. Robert,’ If amelioration is too short in chronic diseases it means that
structural changes are taking place and have destroyed or threatened to destroy the
[6]
proper functions of the patient.
According to Dr. Kent, ’ These changes cannot always be diagnosed in life, but they
are present, and an acute observer, who has been working earnestly for years, will
often be able to diagnose the meaning of symptoms without any physical
[4]
examination whatever, so that be can prophesy as to the patient.’
Duty of the Physician: In Acute disease, a more similar medicine is to be found out
and given. In Chronic disease, there is a very precarious condition.
Prognosis: Very bad (in chronic disease).
Dr. Hahnemann explained in § 167, "Thus if there occur, during the use of this
imperfectly homoeopathic remedy first employed, accessory symptoms of some
moment, then, in the case of acute diseases, we do not allow this first dose to
exhaust its action, nor leave the patient to the full duration of the action of the
remedy, but we investigate afresh the morbid state in its now altered condition, and
add the remainder of the original symptoms to those newly developed in tracing a
new picture of the disease."
In § 250, "When, to the observant practitioner who accurately investigates the state
of the disease, it is evident, in urgent cases after the lapse of only six, eight or twelve
hours, that he has made a bad selection in the medicine last given, in that the
patient's state is growing perceptibly, however slightly, worse from hour to hour, by
the occurrence of new symptoms and sufferings, it is not only allowable for him, but it
is his duty to remedy his mistake, by the selection and administration of a
homoeopathic medicine not merely tolerably suitable, but the most appropriate
possible for the existing state of the disease (§ 167)."

Page | 24
Again in § 252 Master stated, "But should we find, during the employment of the
other medicines in chronic (psoric) diseases, that the best selected homoeopathic
(antipsoric) medicine in the suitable (minutest) dose does not effect an improvement,
this is a sure sign that the cause that keeps up the disease still persists, and that
there is some circumstances in the mode of life of the patient or in the situation in
which he is placed, that must be removed in order that a permanent cure may
ensue."[for Chronic disease] [1]
In The Chronic Disease, "The only allowable exception for an immediate repetition
to the same medicine is when the dose of a well-selected and in every way suitable
and beneficial remedy has made some beginning toward an improvement, but its
action ceases too quickly, its power is too soon exhausted, and the cure does not
proceed any further. This is rare in chronic diseases, but in acute diseases and in
chronic diseases that rise into an acute state it is frequently the case. It is only then, -
as a practiced observer may recognize - when the peculiar symptoms of the disease
to be treated, after fourteen, ten, seven, and even fewer days, visibly cease to
diminish, so that the improvement manifestly has come to a stop, without any
disturbance of the mind and without the appearance of any new troublesome
symptoms, so that the former medicine would still be perfectly homoeopathically
suitable, only then, I say, is it useful, and probably necessary to give a dose of the
same medicine of a similarly small amount, but most safely in a different degree of
dynamic potency. When the remedy is thus modified, the vital force of the patient will
allow itself more easily to be further affected by the same medicine, so as to effect
[9]
by it everything that may be expected of this medicine and in this ailment."

Dr. M. L. Dhawale has mentioned in his book, ‘In this instance, the amelioration that
has set in does not last for the expected period. This type of response obtains under
the following circumstances:
(i) The patient does something, knowingly or unknowingly, which cuts short the
action of the remedy that was administered. Thus, he may have taken Coffee which
is known to antidote the action of a large number of Homoeopathic remedies,
especially the plant remedies; or, he may have handled Camphor which serves as a
universal antidote to Homoeopathic remedies; or, he may have partaken of acid food
when his remedy was Sepia. Alcohol and Tobacco are also known to interfere with
the action of some remedies.

Page | 25
(ii) Acute illness characterized by high grade inflammation in internal organs and
which calls for more frequent administration of the Similimum. Thus, even a high
potency may be administered every two hours till a definite response is obtained, the
remedy being continued in reduced frequency for 12 hours after defervescence. (iii)
The chronic illness has already progressed to structural changes in the organs’. [3]

7TH Observation: - "A full time amelioration of the symptoms, yet no special
relief of the patient".
Meaning: There are latent conditions (existing organic conditions) in such patients
that prevent improvement beyond the certain limit. E.g. a patient with one kidney or
bigger part of the lungs having been fibrosed or calcified; and can only be relieved to
a certain limit. [7]
According to Dr. Kent, ‘The patient is palliated in this instance, and it is a suitable
[4]
palliation for homoeopathic remedies.’
Duty of the Physician: Patient is curable to a certain degree. If there is some
deterioration of the important viscus, complete CURE is not possible.
As per Dr. H. A. Robert, ‘The remedy may keep the patient comfortable, however;
and by careful repetitions of the remedy at infrequent intervals the patient may be
kept comfortable for a considerable period of time even though you will not be
[6]
justified in expecting a cure. Prognosis:

Bad.

In § 279, Dr. Hahnemann says, "This pure experience shows universally, that if the
disease do not manifestly depend on a considerable deterioration of an important
viscus (even though it belong to the chronic and complicated diseases), and if during
the treatment all other alien medicinal influences are kept away from the patients, the
dose of the homoeopathically selected remedy can never be prepared so small that
it shall not be stronger than the natural disease, and shall not be able to overpower,
extinguish and cure it, at least in part as long as it is capable of causing some,
though but a slight preponderance of its own symptoms over those of the disease
resembling it (slight homoeopathic aggravation, §§ 157 - 160)immediately after its
ingestion." [1]
Dr. M. L. Dhawale has explained it under heading “Apparent Amelioration”.
According to him, ‘This is a type of reaction in which the symptoms are relieved yet

Page | 26
the patient appears to be no better. On the contrary, the disease keeps on
progressing further with the patient declining, although relieved of his sufferings. This
represents the best palliation that can be achieved in patients in the incurable stage
of a disease’. [3]

8TH Observation: - "SOME patient PROVES every remedy they get".

Meaning: He is inclined to be hypersensitive to all things. He has an idiosyncrasy to
[7]
be affected by everything. He is often incurable.
Dr. Kent said, ‘Some patients prove every remedy they get; patients inclined to be
hysterical, overwrought, oversensitive to all things. The patient is said to have an
idiosyncrasy to everything, and these oversensitive patients are often incurable. It
takes possession of them, and acts as a disease does; the remedy has its prodromal
[4]
period, its period of progress and its period of decline.’
Duty of the Physician: He is to be given lowest, rather crude, potencies of the
indicated drug - both in acute & chronic diseases. He is useful to proving.
According to Dr. Kent, ‘You will often cure their acute diseases by giving them the
30th and 200th, and you will relieve their chronic diseases by giving them the 30th,
[4]
200th and 500th potencies.’ Prognosis:
Bad.
In § 116, Dr. Hahnemann says, "Some symptoms are produced by the medicines
more frequently - that is to say, in many individuals, others more rarely or in few
persons, some only in very few healthy bodies."
Again in § 117, "To the latter category belong the so-called idiosyncrasies, by which
are meant peculiar corporeal constitutions which, although otherwise healthy,
possess a disposition to be brought into a more or less morbid state by certain things
which seem to produce no impression and no change in many other individuals. But
this inability to make an impression on every one is only apparent. ..........."
".....the obvious derangements of health in the so-called idiosyncrasies cannot be
laid to the account of these peculiar constitutions alone, but they must also be
ascribed to these things that produce them, in which must lie the power of making
the same impressions on all human bodies, yet in such a manner that but a small
number of healthy constitutions have a tendency to allow themselves to be brought
into such an obvious morbid condition by them. That these agents do actually make

Page | 27
this impression on every healthy body is shown by this, that when employed as
remedies they render effectual homoeopathic service to all sick persons for morbid
symptoms similar to those they seem to be only capable of producing in so-called
idiosyncratic individuals." [1]

9TH Observation: - "Action of the medicines upon provers".

Meaning: Healthy prover is always benefited by proving, if they are properly
conducted. [7]
As per Dr. H. A. Robert, ‘Before a remedy is used the constitutional condition of the
patient should be very carefully noted. Write down the peculiarities of the patient in
as much detail as possible, and then these observations should be deducted from
the proving.’ [6]
Prognosis: Favorable.
Of the 12 Observations of Kent, the 9 TH observation is the action of the medicine on
[8]
healthy human beings (i.e. drug proving).
Master Hahnemann in his Organon of Medicine, from § 105 to § 145 has given
instructions regarding drug proving.
In § 108, Dr. Hahnemann says, “There is, therefore, no other possible way in which
the peculiar effects of medicines on the health of individuals can be accurately
ascertained - there is no sure, no more natural way of accomplishing this object, than
to administer the several medicines experimentally, in moderate doses, to healthy
persons, in order to ascertain what changes, symptoms and signs of their influence
each individually produces on the health of the body and of the mind; that is to say,
what disease elements they are able and tend to produce, since, as has been
demonstrated (§§ 24-27), all the curative power of medicines lies in this power they
possess of changing the state of man's health, and is revealed by observation of the
latter.” [1]
10TH Observation: - "New symptoms appear after the remedy".
Meaning: The medicine was wrong; and greater the number of such symptoms is,
more wrong the medicine has been. [7]
According to Dr. Kent, “The greater the array of new symptoms coming out after the
[4]
administration of a remedy, the more doubt there is thrown upon the prescription.”
Duty of the Physician: If the symptoms are of light nature we should wait till the

Page | 28
new symptoms pass off; and after re-case-taking a more similar medicine is to be
given. If the symptoms are of serious nature & threaten, it has to be antidoted.
Prognosis: Bad.
In § 249, Dr. Hahnemann says, "Every medicine prescribed for a case of disease
which, in the course of its action, produces new and troublesome symptoms not
appertaining to the disease to be cured, is not capable of effecting real improvement,
and cannot be considered as homoeopathically selected; it must, therefore, either, if
the aggravation be considerable, be first partially neutralized as soon as possible by
an antidote before giving the next remedy chosen more accurately according to
similarity of action; or if the troublesome symptoms be not very violent, the next
remedy must be given immediately, in order to take the place of the improperly
selected one." [1]

In The Chronic Disease, "But if the symptoms are different and had never before
occurred, or never in this way, and, therefore, are peculiar to this medicine and not to
be expected in the process of the disease, but trifling, the action of the medicine
ought not for the present to be interrupted. Such symptoms frequently pass off
without interrupting the helpful activity of the remedy; but if they are of a burdensome
intensity, they are not to be endured; in such a case they are a sign that the
antipsoric medicine was not selected in the correct homoeopathic manner. Its action
must then be checked by an antidote, or when no antidote to it is known, another
antipsoric more accurately answering its symptoms may continue a few more days,
or they may return, but they will soon come to a final end and be replaced by a better
help." [9]

According to Dr. M. L. Dhawale, in his book ‘Principles and Practice of

Homoeopathy’, ‘Whenever new symptoms can be identified as belonging to the
sphere of the disease, we can rest assured that the disease is following its natural
tendency to progress and that the treatment applied so far has proved ineffective in
altering that tendency. This calls for an immediate reassessment of the case and a
revision in the prescription. Under these circumstances, if the case has been
welltaken, the error perhaps lies in selecting a remedy which is on the fringe of the
circle of similarity; a study of the case from the standpoint of Boenninghausen’s
RemedyRelationship will prove rewarding.
When the main block of symptoms in the case is left materially unaltered but new
symptoms representing the pathogenesis of the remedy start appearing, it indicates
Page | 29
that a wrongly selected remedy is proving itself. This medicinal aggravation will tend
to pass off if the remedy is not too deep acting (like Lachesis) or is not administered
in high potency or has not been repeated indiscriminately. If, however, these
symptoms tend to persist, an antidote (general like Camphor or Coffee) may have to
be administered’. [3]

11TH Observation: - "Old symptoms are observed to reappear".

Meaning: The medicine has been very right. More such old symptoms reappear;
more the chronic disease is curable. [7]
Dr. Kent in his book said, ‘In proportion as old symptoms that have long been away
return just in that proportion the disease is curable. They have only disappeared
because newer ones have come up. It is quite a common thing for old symptoms to
appear after the aggravation has come, and hence we see the symptoms
disappearing in the reverse order of their coming. Those symptoms that are present
subside, and old symptoms keep coming up. The physician must know himself that
the patient is on the road to recovery, and it is well to say to the patient that this is
[4]
encouraging; that diseases get well from above downwards, etc.’

Dr. H. A. Robert has explained it by mentioning Hering’s Law of Cure i.e.-“ Old
symptoms reappearing we know to be a step in the right direction of cure: CURE
TAKES PLACE FROM WITHIN OUTWARD, FROM ABOVE DOWNWARD, FROM
THE IMPORTANT ORGANS TO THE LESS IMPORTANT ORGANS; AND
[6]
SYMPTOMS DISAPPEAR IN THE REVERSE ORDER OF THEIR APPEARANCE.
Duty of the Physician: The action of the medicine should not be disturbed. Only, if
the re-established symptoms / discharge / eruption stay for pretty long time, the
medicine may be repeated. Here, the old symptoms / diseases may come and go in
[7]
reverse order of their appearance. Prognosis: Very good.
In § 280, Dr. Hahnemann says, "The dose of the medicine that continues serviceable
without producing new troublesome symptoms is to be continued while gradually
ascending, so long as the patient with general improvement, begins to feel in a mild
degree the return of one or several old original complaints. This indicates an
approaching cure through a gradual ascending of the moderate doses modified each
time by succussion (§ 247). It indicates that the vital principal no longer needs to be
affected by the similar medicinal disease in order to lose the sensation of the natural

Page | 30
disease (§ 148). It indicates that the life principle now free from the natural disease
begins to suffer only something of the medicinal disease hitherto known as
[1]
homoeopathic aggravation."
In The Chronic Disease, "For if the symptoms occurring during the action of the
remedy have also occurred, if not in the last few weeks, at least now and then some
weeks before, or some months before in a similar manner, then such occurrences
are merely a homoeopathic excitation, through the medicine, of some symptom not
quite unusual to this disease, of something which had perhaps been more frequently
troublesome before, and they are a sign that this medicine acts deeply into the very
essence of this disease, and that consequently it will be more effective in the future.
The medicine, therefore, should be allowed to continue and exhaust its action
[9]
undisturbed, without giving the least medicinal substance between its doses."
According to Dr. M. L. Dhawale; ‘A closer enquiry will very often indicate that the
socalled new symptoms are the old ones long since forgotten. It is incumbent on the
Homoeopathic physician, therefore, to question closely the patient when he reports
with new symptoms and to make certain whether they are really new or they are old
symptoms which are appearing a new. Everything will turn on this important
decision.
If the old symptoms persist, however, it is considered an indication for the same
remedy in the same potency, the higher potency being employed later if the
symptoms do not respond. If the symptoms still do not yield, then it is certain that
slight deviations have occurred in the total picture and these have been missed by
the prescriber. The Homoeopathic physician, therefore, will restudy the case from
[3]
the standpoint and select the next remedy on the basis of Relationship’.

12TH Observation: - "Symptoms take the wrong direction".

Meaning: The medicine has been a wrong one. E.g. the Rheumatism of extremities
[7]
disappears and the Heart becomes involved.
Dr. Kent has shared one of his experience in his book of philosophy which as
follows, “I remember one time I was discharged from a violent old woman. With quite
a considerable amount of Billingsgate, who told me that when she called me in she
could walk about, and now her ankles were swelled up with rheumatism so that she
could not move. That patient got another doctor, but soon died.”

Page | 31
He again mentions, ‘There is a great danger in selecting a remedy on external
symptoms alone, i.e., selecting a remedy that corresponds only to the skin and
ignoring all the symptoms that the patient may have, ignoring the whole economy
and general state of the patient; because it is true that that remedy that is related to
the skin alone may drive in that skin disease and cause it to disappear while the
[4]
patient himself is not cured.’
Duty of the Physician: Medicine is to be antidoted at once. A more similar remedy
is to be found out after re-case-taking and administered.
Prognosis: Unfavorable.
In § 256, Dr. Hahnemann says, "....., if the patient mention the occurrence of some
fresh accidents and symptoms of importance - signs that the medicine chosen has
not been strictly homoeopathic - even though he should good-naturedly assure us
that he feels better, as is not infrequently the case in phthisical patients with lung
abscess, we must not believe this assurance, but regard his state as aggravated as
[1]
it will soon be perfectly apparent it is."
In The Chronic Disease, "The frequent request of a patient to have one symptom,
which above others is troublesome to him, removed first of all, is impracticable, but
the ignorant patient should be excused for his request.
In the daily written report during the use of an antipsoric medicine, the patient who
lives at a distance should underscore once, for the information of the physician,
those incident symptoms during the day, which after a considerable time or a long
time he has now felt again for the first time; but those which he never had before and
which he first felt on that day, he should underscore twice. The former symptoms
indicate that the antipsoric has taken hold of the root of the evil, and will do much for
its thorough cure, but the latter, if they appear more frequently and more strongly,
give the physician a hint that the antipsoric was not selected quite homoeopathically,
[9]
and should be interrupted in time and replaced by a more appropriate one."

So, this how Kent’s 12 observation is a very important part of learning for students
and new homoeopathic physicians. It’s full of guidelines which is very important
especially in initial years of practice. Along with it we come across the views of other
renowned stalwarts of homoeopathy and their experience as well.

Page | 32
Though 4th observation is also said to have highest order of cure but, the most
assuring one is 3rd Observation i.e.- “The aggravation is quick, short, and strong
[5]
with rapid improvement of the patient”.

So, we here now study the significance of Kent’s 3 rd Observation in acute cases.

Significance Of Kent’s 3rd Observation In Acute Cases

As 3rd observation is already discussed in detail let’s first discuss here about acute
case. What exactly is acute case as per homoeopathy? What kind of diseases
comprises acute? Why significance of 3 rd observation in acute cases is taken for
study? Etc.
As per definition, “A disease or disorder that lasts a short time, comes on rapidly, and
is accompanied by distinct symptoms is called as acute disease. Acute disease is
mainly self-limiting in nature. It is characterized by the symptoms having a rapid
onset. These symptoms are fairly intense and resolve in a short period of time. For
example- furuncle, abscess formation on surface, cold coryza, acute fever, acute
cough, throat pain , acute gastritis, diarrhea, vomiting, food poisioning, constipation
from oily food and more. [19]

As per Dr. Kent while explaining 4 th observation, “It is the highest order of cure in
acute affections, yet the physician sometimes will be more satisfied if in the
beginning of his prescribing he notices a slight aggravation of the symptoms.” i.e. as
in 3rd observation. [4]
Dr Hahnemann just wrote, ‘that a slight homoeopathic aggravation is a very good
[11]
prognostic that the acute disease most probably yield to the first dose’.
Homoeopathic aggravation is the temporary appearance of new symptom or
[10]
temporary exciting symptom following a dose of a homoeopathic remedy.

R. E. Dudgeon
“If we have not only selected the right remedy but have also hit upon the proper
dose, the remedy causes within the first few hours after the first dose has been taken
a kind of slight aggravation, which the patient imagines to be an increase of his
disease which is nothing more than the primary symptom of the medicine, which are
somewhat superior intensity to the disease, and which ought to resemble the original

Page | 33
malady so closely as to deceive the patient himself in the first hour, until the recovery
[12]
that ensues after a few hours teaches him his mistakes”.

Dr. George Vithoulkas

The issue of the homoeopathic aggravation is perhaps the most controversial and
most misunderstood aspect of curative prescribing. It is in this respect, perhaps, that
homeopaths depart most dramatically from other therapeutic systems, and
misunderstandings over this issues have created serious schisms within
homeopathic profession as well.
Since the simillimum for a given patient produces similar symptoms in healthy
individuals, it must be expected that it will produce the same symptoms in the sick
individual as well. Thus it is logical to assume that a truly curative response will be
preceded by some degree of aggravation of symptoms. As has been described at
great length in section 1, the defense mechanism of a patient can only manifest its
activity by means of symptoms. Our purpose in giving a homoeopathic remedy is to
stimulate the defense mechanism of the patient in such a way that it can finally cure
the illness against which has been struggling. In order, therefore, to produce a truly
curative response, it is not only expected but desirable that an aggravation of
symptoms be produced after administration of the correct remedy.
The homoeopathic aggravation can be considered as a way in which the organism is
“encouraged” by the indicated medicine to “confess”, to bring to light deep-seated
troubles or evil tendencies that were oppressing it before”.
The common practice of some homeopaths, therefore, to try to suppress
aggravations is actually a process which prevents cure. In the vast majority of
patients, the homeopathic aggravation cannot be considered harmful. The defense
mechanism always obeys the fundamental principle of cybernetics, which states that
any highly organized system will react to any stress with the best possible response
[13]
of which it is capable at any given moment.

Richard Hughes
The first to propound such a theory of cure by SIMILIA SIMILIBUS was Hahnemann
himself. He supposed that every drug, whether given in health or disease, produced
two series effects, the secondary being precisely opposite to the primary; that, if
given in morbid states corresponding to its secondary effects, i.e., Antipathically, it
Page | 34
acted at first as a palliative, but then its own secondary operation supervening,
increased the disease: while if given when a condition answering to its primary effect
was present, it caused a temporary aggravation indeed, but then by secondary
[14]
effects, which were opposite to the disease, a considerable amelioration thereof.

B. K. Sarkar
Another effect which is often perceptible after the administration of a homoeopathic
remedy is the seemingly intensification of the symptoms of the original disease. The
drug effects being somewhat superior in intensity and very similar to the original
disease, produce a slight aggravation resembling the original disease, occurs in the
course of a few hours and then subsides leading to complete recovery. But this is a
[15]
good sign an indicates that it will yield to the first doses.

Dr. M. L. Dhawale,
Simple homoeopathic aggravation is explained as, ‘This consists of a sharp initial
aggravation of the symptom in a patient but with the patient feeling better in general.
This brief phase is followed by a general amelioration which last for quite sometime if
not hampered. This type of reaction occurs when organic changes are not yet far
advanced and indicates a good prescription. This phase of aggravation should not be
[3]
interfered with but should be allowed to run its course unimpeded.
Hahnemann was apprehensive as he thought he might be making the individual
worse, but he soon realized that this temporary homoeopathic aggravation of
[16]
symptoms was the sign of a correct choice of homoeopathic remedy.
Above description clearly presents how aggravation can even be beneficial in route
to recovery but many times this is wrongly conceived and propagated. Dr. M. L.
Dhawale has explained this in his book as following; ‘Considerable misconception
exists about this type of reaction. To many, this type of reaction appears to be a
‘must’ if the patient is to be cured. A Homoeopathic physician who intentionally
precipitates an aggravation in a patient under his care certainly cannot claim to be
‘gentle’! Unfortunately, aggravation has been so much linked by the laity with
Homoeopathy that many a patient approaches a Homoeopathic physician with the
‘fuse all set’ for an aggravation. No wonder they report an aggravation even after a

Page | 35
placebo! This is a point well worth remembering when evaluating the remedy
reaction’. [3]
The many things learn by the action of the first remedy determine the kind of demand
[17]
made upon the physician for the second prescription.
In aphorism 272-277 of ‘Organon of Medicine, ‘Dr. Hahnemann laid down the
guidelines for the second prescription. This remedy response on the patient can be
observed and interpreted on these principles. In some cases the response may be
favourable and in some other cases it may be unfavourable. Dr. James Tylor Kent
and Dr. Constantine Hering, two stalwarts in Homeopathy further elaborated the
norms to be observed, the possible changes after the first prescription and
interpreted its effects. Dr. Kent codified 12 responses after an indicated remedy is
given to a patient.
Every homeopath has to observe the response of a remedy and take decision as to
what he should do next based on the teaching of Dr. Kent.
Dr. Constantine Hering had formulated the law of the direction of cure after a well
selected remedy is given to the patient. He postulated that the favorable direction of
cure in a disease should be :
1. The complaints improve from above downwards.
2. The symptoms disappear from within outwards.
3. From a more important organ to a less important one.
[18]
4. In the reverse order of their coming.

We have tried to do thorough study and interpret what happens after a remedy is
administered in accordance with the Law of Similars. How significant is Kent’s 12
observations in clinical practice especially 3rd observation in detail.
According to Dr. M. L. Dhawale, ‘Minute changes in the symptomatology indicate to a
trained Homoeopathic physician not only the ultimate prognosis in a patient but also
the changes to be made from time to time in the dose, potency and prescription.
These reactions result from the peculiar susceptibility exhibited by the patient to the
similar force.

A thorough knowledge of susceptibility and remedy reaction, therefore, will be found

essential to the proper grasp of Homoeopathic posology.

Page | 36
Regulation of the administration of the similar remedy is perhaps more difficult than
its selection and that is why many a case in Homoeopathic practice is spoilt in the
hands of an impatient prescriber who fails to realise that the principle of
individualization applies to the administration as well as to the selection of the
[3]
remedy in Homoeopathic practice’.

MATERIAL
AND
METHODS

MATERIAL AND METHODS

1) Study design: Observational study.

2) Study Setting: Proposed study will be conducted in the O.P.D, I.P.D. & various
camps of Homoeopathic Medical College.

3) Study population: Cases of OPD

Page | 37
4) Sample size: 30 cases will be selected.

5) Sample technique: Simple random Sampling Technique.

6) Selection of study subject:

A) Inclusion criteria

1. Patient of different age and both sexes will be considered for this study.

2. Patients who continue their treatment till the end of study will be included.

3. Patients who are coming for regular follow up

B) Exclusion criteria

1. Patients having advanced and irreversible pathology.

2. Patients with complicated systemic diseases.

C) Subject withdrawal criteria 1. Patients who discontinue follow ups.

7) Operational Definitions:

• Sick- It is a man that is sick and to be restored to health, not his body, not
the issue.

• Aggravation- An aggravation is something that makes a situation or

condition worse.

• Homoeopathic aggravation- An aggravation is the temporary

appearance of new symptoms, or a temporary intensification of exciting
symptoms, following a dose of a homoeopathic remedy.

• Acute Cases- A disease or disorder that lasts a short time, comes on

rapidly, and is accompanied by distinct symptoms.

• Potency- potency is the dose of a drug required to produce a specific

effect of given intensity as compared to a standard reference.

8) Method of measurements: Assessment of cases with the help of case recording,

patient interview with questionnaire.

Page | 38
9) Study instrument and data collection tools: A comprehensive case taking
proforma which will lead us towards the individualization of patient as a person.

10) Data collection: Data will be collected relevant to the objective by taking case
of patients according to comprehensive case taking proforma. Relevant
investigation if required.

11) Data management & analysis procedure (coding and use of computer):
Data will be managed from the case records of our OPD and IPD. Analysis
procedure will be done with standard statistical technique by use of computer.

12) Data analysis plan and method: Observation will be done at the end of

study and result of observed study will be done with standard statistical

procedure. 13) Additional points for research in ayush: Not applicable

OBSERVATION
&
RESULTS

Page | 39
 OBSERVATION

My work on “Study Of Kent’s Twelve Observation With Special Emphasis On

Significance Of Kent’s 3rd Observation In Acute Cases” was very encouraging.

In this opportunity we have taken more than 100 cases from which 30 cases have
included in this thesis as sample. The study was observational study. The patients
were collected from the O.P.D & I.P.D. & various camps of Homoeopathic Medical
College. From the 30 cases 27 patients have shown the favorable result, 2 patients
did not improved and 1 patient dropped out before the completion of the study,
because she did not continued the treatment after the first visit. Hence the success
rate is 90%.

Our observation is that, how a slight homoeopathic aggravation after intake of

medicine is not always a sign of worry, as when followed by amelioration leads to
recovery. In many of cases results achieved was faster and permanent as reported
by patient. There were few cases where allopathic drugs failed to show any good
result but homoeopathic drug have shown beautiful result.

Last but not the least the reaction of the patient were very good and their full
cooperation have made this efforts possible. They have followed the advice with
medicines regularly and also maintained the regular follow-up.

RESULTS

In this study it was noted that out of 30 patients 27 got improved (90 %) and only 2
patients were not improved (6.67 %) while 1 dropped out (3.33 %)

Table No. - 1 Table showing Result Analysis of total 30 cases

RESULT FREQUENCY PERCENT

Page | 40
 IMPROVED 27 90 %

NOT IMPROVED 2 6.67 %

DROPPED OUT 1 3.33 %

TOTAL 30 100 %

RESULT ANALYSIS

3%
7%

IMPROVED
NOT IMPROVED
90%
DROPPED OUT

Figure No.1

Graph showing Result Analysis of total 30 cases

It was noted that the male patients (53.33 %) were more in number than the female
patient (46.67 %).

Table No. - 2 Table showing Incidence according to sex of patient out

of total 30 cases

SEX FREQUENCY PERCENT

Page | 41
 MALE 16 53.33 %

FEMALE 14 46.67 %

SEX RATIO

46.67%

53.33%

MALE
FEMALE

Figure No.-2 Graph showing incidence according to sex of patient out

of total 30 cases

In this study it has been observed that the maximum number of patients
belonged to the age groups 0-10 (33.33 %%) and then of the age group
1120 years (26.67 %).

Table No. - 3 Table showing age wise distribution of total 30 cases

S.N. Age of Patient (Yrs) No. of Cases Percentage

1 0-10 10 33.33 %

2 11-20 8 26.67 %

3 21-30 5 16.67 %

4 31-40 5 16.67 %

5 41-50 2 6.67 %

Page | 42
 FREQUENCY-AGE GRAPH
10
10
9 8 FREQUENCY
8
7
FREQUENCY

6 5 5
5
4
3 2
2
1
0
0-10 11-20 21-30 31-40 41-50
AGE RANGE

Figure No.- 3

Frequency Graph showing age wise distribution of total 30 cases

Most of the cases were of psoric miasm (83.33 %) and few were psorosycotic
(16.67 %)

Table No. - 4 Table showing Miasmatic Cleavage of total 30 cases

MIASM FREQUENCY PERCENTAGE

PSORA 25 83.33

PSORO-SYCOSIS 5 16.67

Page | 43
 MIASMATIC PERCENTAGE
PSORA PSORO-SYCOTIC

17%

83%

Figure No. - 4 Graph showing Miasmatic Cleavage of total 30 cases

The table and figure shows the case-wise distribution of remedies.

Table No. - 5

Case-wise distribution of selected remedies

NAME OF REMEDIES FREQUENCY PERCENTAGE

BRYONIA ALBA 1 3.33 %

ARSENIC ALBUM 2 6. 67 %

NUX VOMICA 2 6. 67 %

BELLADONA 4 13.33 %

HYPERICUM 1 3.33 %

PULSATILLA 4 13.33 %

ACONITE 1 3.33 %

MAG PHOS 1 3.33 %

KALI PHOS 1 3.33 %

HEPAR SULPH 2 6. 67 %

Page | 44
 PLANTAGO MAJOR 1 3.33 %

LYCOPODIUM 1 3.33 %

CINA 1 3.33 %

SPIGELIA 1 3.33 %

CARBO VEG 1 3.33 %

GELSEMIUM 1 3.33 %

ARNICA MONTANA 1 3.33 %

ALOE SOCOTRINA 1 3.33 %

CANTHARIS 1 3.33 %

CHAMMOMILA 2 6. 67 %

CHAMMOMILA,
CANTHARIS, 3.33%6.67% BRYONIA ALBA, 3.33%
ARSENIC ALBUM,
ALOE SOCOTRINA, 6.67%
3.33%
ARNICA MONTANA, NUX VOMICA, 6.67%
3.33%
GELSEMIUM, 3.33%
CARBO VEG, 3.33%
BELLADONA, 13.33%
SPIGELIA, 3.33%
CINA, 3.33%

LYCOPODIUM, 3.33%

HYPERICUM,
PLANTAGO MAJOR, 3.33%
3.33%

HEPAR SULPH, 6.67% PULSATILLA, 13.33%

KALI PHOS, 3.33%

ACONITE, 3.33%
MAG PHOS, 3.33%

Figure No. – 5

Pie Graph: Case-wise distribution of selected remedies

Page | 45
 DISCUSSION

Case No. 1

A 29 yr. old working female came with a complaint of high fever 102 0F with
bodyache since 1 day. Feeling chills and cold. Profuse perspiration with odour.
Severe headache. Worst by least motion and evening. Better by lying still. Want to
be left alone, Very thirsty, with desire to eat spicy and hot food. On the basis of
examination and clinical history, the patient was diagnosed as of having viral fever.
On the basis of totality of symptoms, Bryonia 30, 1 dose was prescribed. After one
hour slight aggravation was observed i.e. slight increase in temperature and chills,
SL one dose was given. There was decrease in temperature and chills observed
after an hour. Further, Bryonia 30 dose and SL was repeated with complete relief in
3-4 days.

Case No. 2

A 26 yr. old working male came with a complaint of fever 101 0F with watery, running
nose since 1-2 days. Sneezing paroxysms and dry cough. Feels chilly, weaken and
exhausted. Worse at midnight. Very restless and anxious, thirst increased. On the
basis of examination and clinical history, the patient was diagnosed as of having
common cold. On the basis of totality of symptoms, Arsenic album 30, 3 Doses was
prescribed for a day with SL ,3 doses in alternate with that. As per patient there was

Page | 46
increase in temperature and restlessness approx. 1 hr. after taking first dose but
after taking dose of SL he started feeling better and temperature also started to
decrease. Next day Arsenic album 30 was repeated along with SL in similar way for
1 day. It was observed that after 1 day temperature decrease to 99 0F, sneezing
reduced, no chills, but no change in watery running nose, weakness reduced.
Therefore potency was increased Arsenic album 200 1 dose was given along with
SL. On further follow-ups patient got improved.

Case No. 3

A 25 yr. old male came with a complaint of sour and bitter eructation and bloated
abdomen since last night after eating spicy and oily food. Severe nausea and
retching. Distension of stomach aggravated after drinking water, strong coffee and
after eating. He drinks alcohol once a week, very irritable even on small things. On
the basis of examination and clinical history, the patient was diagnosed as of having
dyspepsia. On the basis of totality of symptoms Nux Vomica 30 three doses for 1
day was prescribed along with SL 3 doses in alternate with that was given. Slight
increase in bloating 45 mins after taking medication as per patient but decreases
later. Next day Nux Vomica 30, three doses for 1 day was repeated along with SL in
similar way for 2 days. He got improved in 3-4 days.

Case No. 4

A 3 yr. old male child came with a complaint of boils on leg one day ago. Very
painful, pulsating, throbbing, red, swollen and hot to touch. Affected parts were
sensitive to touch. The child lived in a very unhygienic environment. On the basis of
examination and clinical history, the patient was diagnosed of having boil. On the
basis of totality of symptoms Belladona 30 three doses for 1 day was prescribed.
Slight increase in redness and pain for some time after 1 st dose but felt better 1hr
later as per patient. Next day, Belladona 30 and SL 2 dose for 1 day was given.
Further SL was repeated with complete relief in 3-4 days.

Case No. 5

A 25 yr. old female who is a teacher came with a complaint of injury in big toe of right
foot last night. Very painful stitching, darting pain as in nerves, extending to whole

Page | 47
leg. Nail is slightly uprooted from nail bed. Swelling along with bluish-red
appearance. Worse from touch and feels better by tight band. On the basis of
examination and clinical history, the patient was diagnosed as of having toe nail
injury. On the basis of totality of symptoms, Hypericum 30 three doses one hourly
along with SL three doses was prescribed for a day. No further observation as
patient didn’t come for follow-up next day. Dopped out.

Case No. 6

A 10 yrs. old school going female child came with a complaint of pulsating pain in left
ear with thick, profuse yellowish-green offensive discharge since 2 days. Patient
complaints of difficulty in hearing due to stuffiness. The left ear lobe was hot, red and
swollen. Pain, worse at night and feels better when moves slowly across room. She
is mild, gentle, weeps easily and likes company. On the basis of examination and
clinical history, the patient was diagnosed as of having acute otitis media. On the
basis of totality of symptoms, Pulsatilla 30, 3 Doses was prescribed for a day with SL
3 doses in alternate with that. As per patient there was increase in earache after 1 st
dose but decreases around 1 hr later. SL dose was given. Next day Pulsatilla 30 was
repeated along with SL for 2 days. She got improved in 3 days.

Case No. 7

A 6 yr. old school going male child came with a complaint of high fever 101 0 F with
chillness since yesterday. Had sudden rise in temperature after coming from school.
He was scolded by teacher that day as per mother. Extreme restlessness and
frightful. Hot flushes, face red. Worse at evening and before midnight. Took some
medication but no proper relief. On the basis of examination and clinical history, the
patient was diagnosed with fever. Patient was admitted. On the basis of totality of
symptoms, Aconite 30, 1 Dose was prescribed. After around half an hour there was
slight aggravation, SL 1 dose was given. After which patients conditions started to be
better. After 1 hr. temperature decrease to 100 0F, chilliness reduced , redness of
face and hot flushes decreased. Aconite 30 and SL was given on subsequent
followups with complete relief in 4-5 days.

Case No. 8

Page | 48
A 19 yr. old female student came with a complaint of severe menstrual colic since
last night. Menses started yesterday evening. Painful cramps in abdomen, leg and in
the pelvic region usually on the right sided. Lightning type of pain. Discharge dark
red, stringy. Worse from being cold and at night. Better by pressure and warmth. On
the basis of examination and clinical history, the patient was diagnosed with
dysmenorrhoea. She took pain killer but no remarkable relief. On the basis of totality
of symptoms, Mag Phos 30, 3 Doses was prescribed for a day with SL 3 doses. As
per patient there was slight increase in pain initially but better after sometime. Next
day Mag Phos 30 was repeated along with SL in similar way for 1 day with
subsequent repetition of SL on further follow-ups. She got complete relief 2-3 days.

Case No. 9

A 18 yr. old female student came with a complaint of pain and sore throat with
redness since 1 day. Feel as if something is plugged in while swallowing. Feels like
hawking while trying everytime to remove it. Worse by cold and feel better by warm
food and drinks. Very much peevish. On the basis of examination and clinical history,
the patient was diagnosed with acute tonsillitis. On the basis of totality of symptoms,
Hepar Sulph 30, 3 Doses was prescribed for a day with SL 3 doses in alternate with
that. As per patient there was slight increase in pain and redness but decreases later
after sometime. Next day Hepar sulph 30 was repeated along with SL in similar way
for 1 day. Patient still felt something plugged kind of sensation, therefore, potency is
increased Hepar sulph 200, 1 dose was given with SL repetition for 2 days. Further
subsequent repetition of SL was done on further follow-ups. She got complete relief
in 4-5 days.

Case No. 10

A 34 yr. old male patient who is a businessman came with a complaint of toothache
since one day. He had severe pain with sensitivity of teeth. Swelling of cheeks with
pain extending to ear. Excessive salivation due to complaints. Pain better while
eating and worse by touch, cold air. On the basis of examination and clinical history,
the patient was diagnosed with toothache. On the basis of totality of symptoms,
Plantago Major 30, 3 Doses was prescribed for a day with SL 3 doses. As per patient
there was slight increase in pain but decreases later after sometime so SL dose was

Page | 49
given. Next day Plantago Major 30 was repeated along with SL in similar way for 2
days. He got improved in 3-4 days.

Case No. 11

A 15 yr. old male student came with a complaint of fever 100.6 0F with extreme
chilliness and shivering since one day. Wants to cover him. Fever was followed by
sweat. Patient yawns frequently. Pain in limbs and back, headache with little sound.
Feel nauseating. Worse by uncovering, exertion and better by sound sleep. He was
very anxious and highly irritable due to fever. On the basis of examination and
clinical history, the patient was diagnosed with pyrexia. On the basis of totality of
symptoms, Nux Vomica 30, 3 Doses was prescribed for a day with SL, 3 doses in
alternate with that. As per patient there was slight increase fever i.e. 101 0F and
shivering around half an hour after 1st dose so was advised to take SL dose, after
sometime there was decrease in temperature. Next day Nux Vomica 30 was
repeated along with SL in similar way for 2 days. Further repetition of SL was done
on subsequent follow-ups with complete relief in 3-4 days.

Case No. 12

A 30 yr. old female who is housewife came with a complaint of redness of eye with
thick, bland yellowish discharge since 2-3 days. Excessive lachrymation with burning
and itching of eyes. Eyelids inflamed and swollen. Blurred vision and stinging pain
Worse in warm room and feels better by cold application. On the basis of
examination and clinical history, the patient was diagnosed with conjunctivitis. On the
basis of totality of symptoms, Pulsatilla 30, 3 Doses was prescribed for a day with
SL, 3 doses in alternate with that. As per patient there was slight increase in redness
and lachrymation around half an hour after 1 st dose but decreases later after 30-45
mins. Next day Pulsatilla 30 was repeated along with SL in similar way for 2 days.
She got improved in 3 days.

Case No. 13

A 40 yr. old businessman came with a complaint of loose watery stools since last
night. Loose stool, offensive odor, excessive nausea, vomiting, stomach pain, and a
sour/bitter taste in the mouth. Extreme weakness and fatigue due to dehydration. It

Page | 50
started after eating stall food. Worse after eating, midnight and better by heat
especially stomach pain. On the basis of examination and clinical history, the patient
was diagnosed with diarrhoea. On the basis of totality of symptoms, Arsenic album
30, 3 Doses was prescribed for a day with SL 3 doses in alternate with that. As per
patient there was slight increase in pain and restlessness around half an hour after
1st dose but with decrease in frequency of stool later after 30-45 mins. Next day
Arsenic Album 30 was repeated along with SL in similar way for 1 day. Further
repetition of SL was done on subsequent follow-ups with complete relief in 3 days.

Case No. 14

A 2 yr. old child came with his mother with a complaint of itching in anal region due
to worm infestation since 1-2 day. Unable to sleep due to itching, cries in anguish.
Grinds teeth while sleeping. Shifting, pinching pain in abdomen sometimes.
Pinworms as observed by mother. On the basis of examination and clinical history,
the patient was diagnosed with worm infestation. On the basis of totality of
symptoms, Cina 30, 3 Doses was prescribed for a day with SL 3 doses. As per
patient’s mother there was slight increase in irritability after 1 st dose but becomes
normal after sometime. Next day Cina 30 was repeated along with SL in similar way
for 1 day. Further repetition of SL was done on subsequent follow-ups with complete
relief in 2-3 days.

Case No. 15

A 20 yr. old female came with a complaint of distension of abdomen with sour
eructation since 1-2 days. Pain in abdomen with fullness, heaviness and tightness
due to flatulence. Burning in stomach. Cramping pain worse by lying down. Better by
bending. Eructation starts sometime after eating and drinking and slight better by
belching. On the basis of examination and clinical history, the patient was diagnosed
with acute gastritis. On the basis of totality of symptoms, Carbo Veg 30, 3 Doses
was prescribed for a day with SL 3 doses in alternate with that. As per patient there
was slight increase in pain after 1st dose but decreases later. Next day Carbo Veg 30
was repeated along with SL in similar way for 2 days. Further repetition of SL was
done. Patient got complete relief in 3-4 days.

Case No. 16

Page | 51
A 45 yr. old female teacher came with a complaint of high fever 101.4 0F with severe
headache since 1-2 days. Fluctuating temperature i.e. high and low. Hot flushes,
redness of face. Coldness of hand and feet. Throbbing headache especially right
side. Worse in afternoon. On the basis of examination and clinical history, the patient
was diagnosed with Fever. Patient was admitted. On the basis of totality of
symptoms, Belladona 30, 2 Dose was prescribed at 1 hourly. After around 2 hrs
there was slight increase in temperature and excitement. SL 1 dose was given and
patient was monitored. Temperature decrease to 100 0F, headache and chilliness
along with other symptoms also reduced after 2 hrs approx.. Now Bell 30, 3 doses
and SL was repeated alternately 1 hourly. Further repetition of Bell 30 and SL was
given on subsequent follow-ups. She got improved in 3-4 days.

Case No. 17

A 50 yr. old female came with a complaint of pain in left foot 1 day back after minor
accident. Severe pain with swelling. Swelling area is hot. Unable to keep her foot on
ground. Worse by lying on bed, evening and night. Feels better by application of ice,
cold fomentation. She is diabetic and has complaints of hypertension and is on
medication for that. On the basis of examination and clinical history, the patient was
diagnosed with sprain. On the basis of totality of symptoms, Arnica 30, 3 Doses was
prescribed for a day with SL 3 doses. As per patient there was no change in
symptoms observed. Same prescription was repeated next day follow-up but no
relief when came for next day follow-up. Potency of medicine is increased Arnica
200, 1 dose with SL was given. Patient didn’t get relief and did not improve.

Case No. 18

A 35 yr. old male patient came with a complaint of eruptions on back, very painful
since 2 days. Pus filled, burning and stinging pain. Very much tender, doesn’t allow
to touch it. Worse by touch and better by warmth. On the basis of examination and
clinical history, the patient was diagnosed with boils. On the basis of totality of
symptoms, Hepar sulph 30, 3 Doses was prescribed for a day with SL 3 doses. As
per patient there was increase in pain after 1 st dose but it got decreased in
sometime. Next day Hepar sulph 30 was repeated along with SL in similar way for 2

Page | 52
days which resulted in discharge of pus, relief in pain. Further repetition of SL was
done on next follow-up. He got improved 4 days.

Case No. 19

A 12 yr. old male child patient came with a complaint of loose stool with blood since
1 day. Severe colic in abdomen with frequent urge for stool. Stools are bloody and
slimy with some fibrinous flakes. Severe burning in anus. Tenesmus of rectum.
Shivering due to frequent stools. Unable to walk on his own due to weakness. He
had eaten street food after which these complaints started. On the basis of
examination and clinical history, the patient was diagnosed with dysentery. He was
admitted in hospital. On the basis of totality of symptoms, Cantharis 30, 1 Dose was
prescribed and was under observation. Slight increase in tenesmus 1hr after first
dose was observed. So SL was given till he felt slight better. Further, when he was
feeling slight better aprox. 1 hr after SL, Cantharis 30, 3 doses and SL, 3 doses was
prescribed in alternate for 1 day. Next day after follow-up seeing patient’s condition
Cantharis 200, 1 dose and with 3 doses of SL was prescribed. SL was repeated on
further follow up. He got improved in 3-4 days.

Case No. 20

A mother came with his 6 months old male child. Child was suffering with fever
1000F since one day. He was crying, shrieking, irritable and excited. Doesn’t know
what he wanted. As per mother his teeth has started to appear since few days.
Oversensitive to pain and doesn’t sleeps. He wants to be held and carried, always
moving. Worse at night and better by carrying. On the basis of examination and
clinical history, the patient was diagnosed as of having fever due to dentition. On the
basis of totality of symptoms, Chamomila 30, 3 Doses was prescribed for a day with
SL, 2 doses in alternate with that. As per patient’s mother there was slight increase
in temperature and irritability approx. 1 hr after taking first dose but started feeling
better after sometime and temperature also started to decrease. Next day
Chamomila 30 was repeated along with SL in similar way for 1 day. Further
repetition of SL was done on subsequent follow-ups with complete relief in 4-5
days.

Case No. 21
Page | 53
A 32 yr. old male patient who is a teacher came with complaint of sour eructation
with burning since last night after eating Chinese food. Bloating of abdomen, fullness
feeling even after eating little. Burning eructation which causes burning in
oesophagus for long duration. Worse at night. On the basis of examination and
clinical history, the patient was diagnosed as of having acidity. On the basis of
totality of symptoms, Lycopodium 30, 3 Doses was prescribed for a day with SL 3
doses. As per patient there was slight increase in burning and eructation approx. 1
hr after taking first dose but started feeling better later. Next day follow-up
Lycopodium 30 was repeated along with SL in similar way for 2 days. Patient was
feeling better and got improved in 4 days.

Case No. 22

A 6 yr. old male child patient came along with his parents with a complaint of pain
and swelling on left eye upper eyelid since 2 days. Pain in the eye with redness and
slight burning sensation especially morning and evening. Dryness in the eye.
Watering from the eye after waking. On the basis of examination and clinical history,
the patient was diagnosed with Stye. On the basis of totality of symptoms, Pulsatilla
30, 3 Doses was prescribed for a day with SL 3 doses in alternate. As per patient’s
mother there was slight increase redness and pain approx. half an hr. after taking
first dose so was advised SL, he started feeling better after sometime. Next day
Pulsatilla 30, 2 dose was repeated along with SL in similar way for 2 days. Further
repetition of SL was done on subsequent follow-ups with complete relief in 3-4
days.

Case No. 23

A 5 yr. old female child patient came with her parents. She had complaints of itching
and crawling sensation in anal region since 1 day. Severe abdominal pain, cramping
type around the umbilicus region. Nauseating feeling during pain sometimes. Slight
convulsions along with paleness of the face due to worms. On the basis of
examination and clinical history, the patient was diagnosed with worm infestation. On
the basis of totality of symptoms, Spigelia 30, 3 Dose was prescribed for a day with

Page | 54
SL 3 dose. As per patient’s mother there was slight increase in pain and irritability
after taking first dose but felt better later. Next day, Spigelia 30, 3 dose was repeated
along with SL in similar way for 1 day. She got improved in 3 days.

Case No. 24

A 8 yr. old female patient came with complaint of severe toothache since one day.
Unbearable pain. Swelling of cheeks with redness of face. Drinking cold water
makes her feel better while having tea or any warm drinks increases the pain. On the
basis of examination and clinical history, the patient was diagnosed toothache. On
the basis of totality of symptoms, Chamomila 30, 3 Doses was prescribed for a day
with SL 2 doses. As per patient there was increase in pain but decreases later after
sometime. Next day Chamomila 30 was repeated along with SL in similar way for 2
days. Further repetition of SL was done. She got improved in 4-5 days.

Case No. 25

A 10 yr. old male child came with a complaint of difficulty in deglutition since 1-2
days. Complaint started after drinking cold water and cold air exposure. There is
dryness of throat with difficulty in deglutition especially solid food. Pain in throat
aggravate at night, cold water, cold air. Feels better by warm things. Burning type of
pain in throat and hoarseness of voice. On the basis of examination and clinical
history, the patient was diagnosed with acute tonsillitis. He took some medication but
no relief. On the basis of totality of symptoms, Belladona 30, 3 Doses was prescribed
for a day with SL, 2 doses in alternate with that. As per patient there was slight
increase in redness and pain of throat after taking first dose but felt better later. Next
day Belladona 30 was repeated along with SL in similar way for 1 day. Further as
effective recovery was not being observed potency was increased. Belladona 200, 1
dose with SL 2 doses was prescribed for 1 day with repetition of SL in next follow-up.
He improved in 4-5 days.

Case No. 26

A 16 yr. old female patient came with a complaint of cold with thick yellowish
discharge from nose since 2 days. Slight cough with whitish yellowish expectoration
and headache mainly in vertex. Worse in warm room and better in open air. On the

Page | 55
basis of examination and clinical history, the patient was diagnosed with coryza. On
the basis of totality of symptoms, Pulsatilla 30, 3 Doses was prescribed for a day
with SL 3 doses. As per patient there was slight increase in cough approx. 1hr. after
taking first dose which remained like that. Next day after proper follow-up potency
was increased and Pulsatilla 200, 1 dose was prescribed along with SL 2 doses for 1
day. Patient did not improve.

Case No. 27

A 17 yr. old female patient came with a complaint of menstrual pain since morning.
Fluctuating type of pain coming and going. The menstrual flow is bright red, profuse.
Pain and cramping are worse in morning, from jarring, touch, and walking or
bending. Better by steady pressure standing and sitting erect. On the basis of
examination and clinical history, the patient was diagnosed with dysmenorrhoea. On
the basis of totality of symptoms, Belladona 30, 3 Doses was prescribed for a day
with SL 2 doses. As per patient there was increase in pain approx. 1 hr after taking
first dose but she started feeling better after sometime. Next day Belladona 30 was
repeated along with SL in similar way for 1 day. She got better in 2 days.

Case No. 28

A 35 yr. old male patient came with a complaint of fever 101 0F with lots of shivering
and weakness. Sleepiness, weakness, trembling along with chills. Feels dizziness,
lack of energy, heavy and droopy eyelids. Bodyache. Headache worse by least
movement, noise. On the basis of examination and clinical history, the patient was
diagnosed as of having pyrexia. He was admitted in hospital. He took some
allopathic medication but no relief. On the basis of totality of symptoms, Gelsemium
30, 2 Dose was prescribed for 1 hourly. There was slight increase in shivering and
temperature for some time approx. 25-30 mins after taking second dose. SL was
given, and was left to wait and watch till he started feeling slight better. Further a
higher potency was given for better result. Gelsemium 200, 1 dose along with SL
was prescribed for 1 day. Patient was feeling better and got improved in 3 days.

Case No. 29

Page | 56
A 17 yr. old female patient came with a complaint of Loose stools with mucus and
pain since yesterday. The stools are jelly-like mucus, brownish and covered with
blood and accompanied by griping pain in the epigastric region. The rectum feels
sore after passing stools. Patient feels very weakness and dizziness. Fainted once.
Feels better when lying on her abdomen and worse when standing and walking. On
the basis of examination and clinical history, the patient was diagnosed dysentery.
On the basis of totality of symptoms, Aloe Socotrina 30, 1 Dose was given but there
was slight increase in pain after sometime. SL was given after 45 mins, she started
feeling slight better after sometime. Further repetition was done after 1 hr, Aloe
Socotrina 30, 3 doses along with SL was prescribed for 1 day. Next day a higher
potency was given for better result after follow-up. Aloe Socotrina 200, 1 dose along
with SL was prescribed for 1 day. Further repetition of SL was. She got improved in
3-4 days completely.

Case No. 30

A 4 yr. old male child came along with his parents. He had a complaint of difficulty in
swallowing and speaking since 1 day. Tonsils inflamed and enlarged. Throat
appears whitish on inspection. Pain in throat. Worse by eating deep fried food. On
the basis of examination and clinical history, the patient was diagnosed with acute
tonsillitis. On the basis of totality of symptoms, Kali Mur 30, 3 Doses was prescribed
for a day with SL, 2 doses in alternate with that. As per patient there was increase in
pain after taking first dose but felt better later. Next day Kali Mur 30 was repeated
along with SL in similar way for 1 day. After follow-up on next day a higher potency
was given for better result. Kali Mur 200, 1 dose and SL was prescribed for 1 day.
He got improved in 4 days.

Page | 57
 CONCLUSION

CONCLUSION

In present study on the subject allotted that is “Study Of Kent’s Twelve Observation
With Special Emphasis On Significance Of Kent’s 3rd Observation In Acute Cases”
the results worked out has shown a positive indication towards Kent’s Observation,
its significance, how having keen and thorough knowledge about 12 observation
helps in day-today practice. Thorough study was done from the renowned books,
journals and web browsers to achieve the aim and objective of the research work.

The cases are collected from homeopathic medical college and hospital. The cases
were taken in detailed as given in case taking proforma. Medicine was prescribed
based on totality of symptoms.

In this study, we have provided the data of 30 patients where 27 patients have been
proved, 2 patients have not improved and 1 has discontinued the treatment. Hence,
the success rate is 90.0%.

Page | 58
In this occasion, we have provided the data of 30 patients where male: female ratio
was 16:14. Patients came for 0-10 years, 11-20 years, 21-30 years, 31-40 years,
4150 years were 10, 08, 05, 05, 02 respectively. As per as miasms are concerned
Psora covered 25 cases 83.33 % followed by Psoro-Sycosis which covered 05 cases
16.67 %.

From interpretation of statistical data derived from total 30 cases selected by random
sampling method we can conclude that Kent’s 3 rd observation is very much
significant in acute cases, being the most assuring remedy reaction leading to
recovery when prescribed on homoeopathic principles. Kent’s 12 observation is very
important, inerasable and unavoidable part of Homoeopathy.

Page | 59
 SUMMARY

SUMMARY

Kent’s observation is a very important, inerasable and unavoidable part of

Homoeopathy.

Kent’s observation helps students and new budding homoeopaths by

simplifying their queries and guiding them towards right way of clinical
practice.

Third observation is considered to be most assuring because of its prognosis and

remedy reaction.

In acute cases it helps us to determine whether we are proceeding towards

the right direction i.e. route of recovery or not else it may leads to worse or
may be fatal condition sometimes.

In the treatment, Homoeopathic remedies selected on totality of symptoms are

found effective for the presenting phase.

Kent’s observation includes almost complete homoeopathic knowledge i.e.

knowledge of susceptibility, posology, knowledge of drug, its preparation,
drug proving and second prescription etc.

Page | 60
It is also seen that homoeopathic medicines have brought about an
improvement in the general well-being of the patient and their immunity has
improved.

BIBLIOGRAPHY

Page | 61
 BIBLIOGRAPHY

1) Dr. Samuel Hahnemann-translated by William Boriecke-Organon of Medicine-

Sixth Edition-published in 1921-pg. no 92-305

2) Stuart Close-The Genius of Homoeopathy-Lecture and Essay on Homoeopathic

Philosophy-reprint edition Dec 2011-published by Indian Books & Periodicals
Publishers-pg. no 15, 74, & 75.

3) M.L.Dhawale-Principles and Practice of Homoeopathy-4 th edition, revised and

enlarged edition 2014-published by Institute of Clinical Research-pg. no 341-354

4) James Tyler Kent-Lectures on Homoeopathic Philosophy-edition

2002-published by B. Jain Publishers(P)LTD.-pg.no 224-234

5) https://www.homoeobook.com>pdf-19-4-2018

6) Herbert A. Roberts-The Principles and Art of Cure by Homoeopathy edition

2002published by B. Jain Publishers(P)LTD.-pg. no 124-134

7) https://mykent.weebly.com/index.html

8) Homeopathic-articles/homeopathic-philosophy/kent-observationsin-homeopathy

http://www.homeorizon.com

9) Samuel Hahnemann-The Chronic Disease Vol. 1-reprint edition 2000-published

by B. Jain Publishers-pg. no 119-135

10) What is homoeopathic aggravation-Homeopathy Plus

https://homeopathyplus.com

11) Aggravation in homoeopathy-Katja Schuett-June 2013

https://hpathy.com

12) R. E. Dudgeon-Lectures on the Theory and Practice of Homoeopathy reprint

edition 1990-published by B. Jain Publishers-pg. no 118

13) George Vithoulkas-The Science of Homoeopathy-reprint edition 1993-published

by B. Jain Publishers-pg. no 227-229

Page | 62
14) Richard Hughes-The Principles and Practice of Homoeopathy-reprint edition
1999-published by B. Jain Publishers-pg. no 152

15) B. K. Sarkar-Hahnemann’s Organon of Medicine-sixteenth edition published by

Birla Publication Pvt. Ltd.-pg. no 405

16) J. T. Kent- Kent’s New Remedies Clinical Cases Lesser Writings Aphorisms And
Percepts-reprint edition 1998-published by B. Jain Publishers-pg. no 415

17) Farok J. Master-Clinical Organon of Medicine-publication 2010-published by B.

Jain Publisher-pg. no 257

18) Second Prescription | National Health Portal of India

https://www.nhp.gov.in/second-prescription_mtl 19) Principles of Prescribing |

National Health Portal of India https://www.nhp.gov.in/Principles-of-

Prescribing_mtl

20) K. Park-Principles of Epidemiology and Epidemiologic Methods-Parks

Textbook Of Preventive Social Medicine-19th edition-published in 2007-pg.no 67

21) Dr. J. V. Dixit-Principles And Practice Of Biostatics-second edition published

in 2003.

Page | 63
 APPENDIX

APPENDIX GLOSSARY /
DEFINATIONS

• Sick- It is a man that is sick and to be restored to health, not his body, not
the issue.

• Aggravation- An aggravation is something that makes a situation or

condition worse.

• Homoeopathic aggravation- An aggravation is the temporary

appearance of new symptoms, or a temporary intensification of exciting
symptoms, following a dose of a homoeopathic remedy.

• Acute Cases- A disease or disorder that lasts a short time, comes on

rapidly, and is accompanied by distinct symptoms.

Page | 64
 • Potency- potency is the dose of a drug required to produce a specific
effect of given intensity as compared to a standard reference.

• Miasms- Miasm refers to the dynamic disease - producing power which

stains and pollutes the human organism with unhealthy tendencies and
thus becomes the producer of different types of diseases.

• Individualization- A process of differentiating of one from others of same

class or group by some unique features.

• Palliation- Relief of symptoms and suffering caused by life-threatening

diseases and helps a patient feel more comfortable and improves the
quality of life, but does not cure the disease.

CASE RECORDING FORMAT

CASE NO.

OPD No. D.O.E. :

Name : Age :

Sex : Religion :

Occupation : Marital Status:

Chief Complaints :

History of Chief Complaints :

Past History :

Family History :

Drug History :

Page | 65
History of Allergy:

Personal History

- Living environment: -

- Drinking water: -

- Socio-Economic: -

Gynecological History:

Menarche:

LMP:

Interval/ Time :

Duration :

Quantity :

Character:

HOMOEOPATHIC GENERALITIES :

Diet :-

Appetite :-

Desire :-

Aversion :-

Thirst :-

Sweat :-

Urine :-

Stool :-

Sleep :-

Dreams :-

Thermal Reaction :

Page | 66
Physical Makeup:

Mental :

GENERAL EXAMINATION :

Gait :-

Decubitus :- Built

:-

Nutrition :-

Weight :-

Clinical Examination:

Pallor :- Clubbing :-

Temp :- Icterus :-
Oedema :- Cyanosis :-

Pulse :- RR :-

B.P. :- Tongue :-

Local Examination :

Systemic Examination :

R.S.: - CVS:

GIT: -

CNS: -

Differential Diagnosis: - Provisional

Diagnosis : -

Totality Of Symptoms: -

Page | 67
Miasmatic Diagnosis : -

PRESCRPITION :

Rx –

Advice :

Follow up :

Result: -
DATA COLLECTION FORMAT

The data for study will be collected by taking cases of patients according to
comprehensive case taking Proforma of our college.

Page | 68
 QUESTIONNAIRE

Registration No :

(Optional)

Date :

Name :

Age :

Sex :

Occupation :

Religion :

Marital Status :

Annual Income :

Address :

Page | 69
Addiction :-
Sr. No. Choose Appropriate Option Duration
1 Smoking Y/N
2 Tobacco Y/N
3 Alcohol Y/N
4 Tea/Coffee Y/N

Family History of Chronic Disease: - Y/N :-

Sr. No. Mother Side Father Side

1
2
3

Page | 70
 SCALES

Outcome Assessment-

Outcome will be assessed as to how many patients have been recovered or

improved or not improved, and dropped out after they have been treated
homoeopathic treatment.

Page | 71
SPECIAL METHODS
Not Applicable

REAGENTS
Not Applicable

Page | 72
 CONSENT FORM

FOR PARTICIPATION IN CLINICAL STUDY

Study Title: “STUDY OF KENT’S TWELVE OBSERVATION WITH SPECIAL

EMPHASIS ON SIGNIFICANCE OF KENT’S 3RD OBSERVATION IN ACUTE
CASES”.

Subject’s Initials: ______________ Age: _____ Sex: _____

Date of birth: _________________

1. I confirm that I have read and understood the information sheet for the above
study. I have had the opportunity to ask questions and all my questions and doubts
have been answered to my complete satisfaction.

2. I understand that my participation in the study is voluntary and that I am free

to withdraw at any time, without giving reasons, without my relationship with the
attending physicians being compromised or my legal rights being affected.

3. I understand that my identity will not be revealed in any information released

to third parties or published, unless as required under the law. I agree not to restrict
the use of any data or results that arise from the study.

4. I agree not to withhold any information about my health from the investigator
and will convey the same truthfully.

Page | 73
5. I agree to my taking part in the above study and to comply with the
instructions given during the study and to cooperate with the study team.

6. I give my consent to my undergoing a complete physical examination as

specified in the study protocol and explained to me.

Signature / thumb impression of the subject:

Name and address:

Signature of witness:

Name and address:

Investigator’s name and Signature:

Place: ---------------------

Date:

Page | 74
 INFORMED CONSENT FORM

I ___________________ (Name of patient) exercising my free power of

choice, hereby give my consent to be included as a subject in the clinical trial:-I have
read and understood the Patient’s Information Sheet. I have received a copy of
signed and dated informed consent form and ‘Patient’s Information Sheet’ I have
been explained about my _____________________ (Name of Disease) and the
objectives of this trial. I have also been informed about alternative treatments
available and possible risks and benefits. I agree to participate and co-operate fully.

I have been told that this drug is expected to act as ______________________

(curative/palliative etc.) drug. I agree to undergo clinical examination and my blood
and urine samples will be drawn for laboratory investigations during the course of
this study.

I agree that my medical records may be disclosed to the appropriate authorities

keeping my name and address confidential.

I am aware of my right to opt out of the trial at any time during the course of trial
without having to give the reason for doing so.

I voluntarily consent to participate in this study.

Signature Of patient: Signature of Researcher

Student:

Page | 75
Name of Patient: Name:

Date: Designation:

Place: Reg. No.:

PATIENT INFORMATION SHEET & WRITTEN CONSENT FORM

Name of Post Graduate Homoeopathic Medical College & Hospital with
address Title of study:-

I Mr/Mrs/Ms/ ___________________________________________ the undersigned

hereby consent to the Homeopathic treatment under the direct supervision of Dr.
___________________________ and by in my vernacular language.

I also consent to the administration Homeopathic medicines.

I have been told about additional investigation which may become necessary during
my treatment. I agree to the use of photography for the purpose of diagnosis and
treatment.

I hereby certify that I have read and fully understood and above authorization for
Homeopathic treatment the reason why the above named treatment is considered
necessary, it advantages and possible alternative modes of treatment and my
responsibilities towards the same which have been explained to me in this language.
I also certify that I understand that no guarantee or assurance has been given about
the results that may be obtained.

DATE: …………….. SIGNATURE………………….:

Page | 76
 सहमतीपत्र

•रूग्ण पत्रक क्र :

•रुग्णणांचे नाव :
•पत्ता :
•वय:
•ल िंग :
•सिंशोधकाचे नाव :
•पत्ता :
१) मी, खा ी सही करणार ,................................या सिंशोधन व उपचारािंसाठी.....................यािंच्या देखरेखखा ी भाग
घण्े यास माझी अनुमती दशशववतो .
२) उपचारािंसाठी आवश्यक होवमओपॅविक औषधािंच्या सेवनासाठी मी अनुमती देत आहे.
३) म ा माझ्यावर के े जाणारे उपचार व सिंशोधन सिंदभाशत सपिं ूणश मावहती दण्े यात आ ी असून ती म ा
समज ी आहे.
४) म ा या सिंशधनादरम्यान कराव्या ागणायाया अवशकयाया चाचण्या्दल मावहती दण्े यात आ ी आहे.
५)मी रूग्णमवहती पवत्रका सिंपणू श वाच े असून म ा त े समज े आहे.
६) या उपचााादरम्यान रोगवनदान व उपचारासाठी जर छायावचत्रण करावे ाग े तर याया ा माझी अनुमती आहे. ७)
मझ्यारोगा्दल ची व उपचारािंची मावहती सिंशधनासाठी वापरण्या््त माझी समती आह े आवण असे करताना माझी ओळख
दद ी जाणार नाही ह े मी गृहीत धरतो.
८) मी ह े प्रमाणीत करतो की उपचार व यायाचे वनष्कषश/ पररणाम या सिंदभाशत म ा कु ठ ीही ग्वाही देण्यात आ े
ी नाही.
९) वरी सवश मावहती म ा माझ्या भाषेत योग्य प्रकारे समजावण्यात आ ी असून म ा ते नीट समज ी आहे.
--------------------------------------------------- रुग्णािंचे
नाव
स्वणक्षरी /डाव्या अगिं ठ्याचा ठसा ददनाकिं
------------------------------------------------------
सणक्षीदणरााािंचे नाव स्वणक्षरी ददनाकिं
------------------------------------------------------
सिंशोधकािंचे नाव स्वणक्षरी
ददनाकिं

CASE RECORD

CASE 1

OPD No.: 8784 D.O.E.: 2/01/2019

Name : ABC Age : 29 Yrs.

Page | 77
Sex : Female Religion : Hindu

Occupation : Private Job Marital Status: Married

Chief Complaints : High fever with bodyache since 1 day

History of Chief Complaints : High fever with bodyache since 1 day. Feeling chills
and cold. Profuse perspiration with odour. Severe headache. Worst by least motion
and evening. Better by lying still.

Past History : NAD

Family History :

Father: - Diabetes

Mother: - Joints Pain, Hypertensive

Drug History : Took allopathic medicine but no relief.

History of Allergy: NAD

Personal History

- Living environment: - Hygienic.

- Drinking water: - Tap water.

- Socio-Economic: - Medium

HOMOEOPATHIC GENERALITIES :

Diet :- Mixed

Appetite :- Normal

Desire :- Spicy and hot food

Aversion :- cold food and drinks

Page | 78
 Thirst :- Thirsty, large quantities of cold water.

Sweat :- Profuse with odour

Urine :- Normal

Stool :- Satisfactory

Sleep :- Disturbed

Dreams :- Unremembered

Thermal Reaction : Hot Patient

Mental : Irritable and wants to be quiet and left alone

GENERAL EXAMINATION :

Gait :- Normal

Decubitus :- Changeable

Built :- Average

Nutrition :- Good

Weight :- 54 kg

Clinical Examination:

Pallor :- Ab Clubbing :- Ab

Temp :- 102oF Icterus :- Ab

Oedema :- Ab Cyanosis :- Ab

Pulse :- 96 B/Min RR :- 20/Min

B.P. :- 120/80 mm Hg

Systemic Examination :

Page | 79
 R.S.: - NAD

CVS: - NAD

GIT: - NAD

CNS: - NAD

Differential Diagnosis: - Viral fever, Typhoid, Malaria

Provisional Diagnosis : - Viral fever

Totality Of Symptoms: -

Irritable

Wants to be quiet and left alone

High fever with bodyache

Feeling chills and cold.

Profuse perspiration with odour.

Severe headache.

Worst by least motion and evening.

Better by lying still.

Thirst increased, large quantity of cold water

Hot patient

Miasmatic Diagnosis : - Psora

PRESCRPITION :

Rx –

At 3 p.m.- Bryonia 30 / 1 Dose

Page | 80
Follow up :

4 pm Increase in temperature and chills SL / 1 dose

slightly

5 pm Temperature decreases to 101.8 0F, Bry 30 / 3 times / 1 hourly

chilliness reduced
SL / 2 dose / 1 hourly

3/01/2019 Temperature decrease to 1000F, no Bry 30 / BD / 1 Day

chills, bodyache and headache better
SL / TDS /1 Day

4/01/2019 Temperature normal, slight bodyache SL / BD /1 Day

5/01/2019 Recovered , no new complaints SL / BD / 1 Day

Result: - Patient is improved.

CASE 6

OPD No. 8916 D.O.E. : 30/01/2019

Name : RST Age : 10 Yrs.

Sex : Female Religion : Hindu

Occupation : Student Marital Status: Unmarried

Page | 81
Chief Complaints : Earache with thick discharge since 2 days.

History of Chief Complaints : Pulsating pain in left ear with thick, profuse
yellowish-green offensive discharge since 2 days. Patient complaints of difficulty in
hearing due to stuffiness. The left ear lobe is hot, red and swollen. Pain is worse at
night and feels better when moves slowly across room.

Past History : NAD

Family History : NAD

Drug History : NAD

History of Allergy: NAD

Personal History

Milestone: - On Time

Living environment: - Unhygienic.

Drinking water: - Tap water.

Socio-Economic: - Medium

History of immunization - Done

HOMOEOPATHIC GENERALITIES :

Diet :- Vegetarian

Appetite :- Normal

Desire :- Sweet, Cold Food

Aversion :- Warm Food

Thirst :- Thirstless

Sweat :- Normal

Page | 82
 Urine :- Normal

Stool :- Normal

Sleep :- Disturbed

Dreams :- Unremembered

Thermal Reaction : Chilly Patient

Mental : Mild, gentle, weeps easily, company desire and likes consolation.

GENERAL EXAMINATION :

Gait :- Normal

Decubitus :- Changeable

Built :- Average

Nutrition :- Good

Weight :- 30 kg

Clinical Examination:

Pallor :- Ab Clubbing :- Ab

Temp :- 98.9oF Icterus :- Ab

Oedema :- Ab Cyanosis :- Ab

Pulse :- 86 B/Min RR :- 20/Min

Local Examination: -

On inspection-: Redness of ear lobe with thick yellowish-green discharge

Systemic Examination :

Page | 83
 R.S.: - NAD

CVS: - NAD

GIT: - NAD

CNS: - NAD

Differential Diagnosis: - Acute otitis media, Ear boil, otitis externa

Provisional Diagnosis : - Acute otitis media

Totality Of Symptoms: -

Patient is mild, gentle.

Company desire and want of consolation

Weeps easily on trifles

Earache with redness

Profuse yellowish-green thick discharge

Discharge is offensive

Chilly patient

Miasmatic Diagnosis : - Psoro-sycotic

PRESCRPITION :

Rx –

Pulsatilla 30 / TDS /1 Day

SL / TDS / 1 Day

Advice: Avoid entering of water inside ear.

Follow up :

Page | 84
 31/01/2019 Puls 30/ BD/1 DAY
Increase in earache after 1st dose but
decreases around 1 hr later as per
patient. Decrease in redness and pain. SL / BD/ 1 DAY

1/02/2019 Relief in pain, redness and decrease in SL / TDS / 1 DAY

discharge

2/02/2019 Relief in complaints. No new SL /BD/ 1 DAY

complaints

Result: - Patient is improved.

CASE 13

OPD No. 9047 D.O.E. : 1/03/2019

Name : XYZ Age : 40 Yrs.

Sex : Male Religion : Hindu

Occupation : Business Marital Status: Married

Chief Complaints : Loose watery stools since last night.

History of Chief Complaints : Loose watery stools since last night. Loose stool,
offensive odor, excessive nausea, vomiting, stomach pain, and a sour/bitter taste in

Page | 85
the mouth. Extreme weakness and fatigue due to dehydration. It started after eating
stall food. Worse after eating, midnight and better by heat especially stomach pain.
Past History : Hypertension

Family History :

Father: - Cardiac issues, hypertensive, diabetes

Mother: - hypertension, died of cancer

Drug History : NAD

History of Allergy: NAD

Personal History

- Addiction: - Alcohol once or twice in a month

- Living environment: - Hygienic.

- Drinking water: - Tap water.

- Socio-Economic: - Medium

HOMOEOPATHIC GENERALITIES :

Diet :- Mixed

Appetite :- Normal

Desire :- Spicy and hot food

Aversion :- cold food and drinks

Thirst :- Thirstless

Sweat :- Profuse

Urine :- Normal

Stool :- Loose stool

Page | 86
 Sleep :- Disturbed

Dreams :- Unremembered

Thermal Reaction : Chilly Patient

Mental : restlessness, agony

GENERAL EXAMINATION :

Gait :- Normal

Decubitus :- Changeable

Built :- Average

Nutrition :- Good

Weight :- 85 kg

Clinical Examination:

Pallor :- Ab Clubbing :- Ab

Temp :- 98oF Icterus :- Ab

Oedema :- Ab Cyanosis :- Ab

Pulse :- 90 B/Min RR :- 20/Min

B.P. :- 140/90 mm Hg

Local Examination :

Inspection :- Dry skin due to dehydration

Palpation :- Tenderness in abdominal area with hardness

Systemic Examination :

R.S.: - NAD

Page | 87
 CVS: - NAD

GIT: - NAD

CNS: - NAD

Differential Diagnosis: - Diarrhoea, Dysentry

Provisional Diagnosis : - Diarrhoea

Totality Of Symptoms: -

Patient is restless both physically and mentally

Loose stool with offensive odor

Nausea and vomiting

Stomach pain

Extreme weakness and fatigue

Worse after eating, midnight

Better by heat

Chilly patient

Miasmatic Diagnosis : - Psora

PRESCRPITION :

Rx –

Arsenic album 30 / TDS /1 Day

SL / TDS / 1 DAY

Advice: Drink plenty of water to keep hydrated.

Eat moong daal khichdi.

Page | 88
Follow up :

2/03/2019 Increase in pain and restlessness with Ars alb 30 / TDS /2 DAYS
decrease in frequency of stool later
SL / BD / 2 DAYS

4/03/2019 Recovered , no new complaints SL / BD / 1 DAY

Result: - Patient is improved.

CASE 18

OPD No. 9972 D.O.E. : 5/08/2019

Name : LMN Age : 35 Yrs.

Sex : Male Religion : Muslim

Occupation : Business Marital Status: Married

Chief Complaints : Eruptions on back, very painful since 2 days.

History of Chief Complaints : Eruptions on back, very painful since 2 days. Pus

filled, burning and stinging pain. Very much tender, doesn’t allow to touch it. Worse

by touch and better by warmth. Past History : Typhoid 6 yrs. ago

Family History :

Page | 89
 Father :- Hypertension, Cardiac issues

Mother :- Diabetes, Hypothyroid

Drug History : NAD

History of Allergy: NAD

Personal History

- Living environment: - Unhygienic.

- Drinking water: - Tap water.

- Socio-Economic: - Medium

HOMOEOPATHIC GENERALITIES :

Diet :- Mixed

Appetite :- Normal

Desire :- Spicy and sour food

Aversion :- Deep fried

Thirst :- Thirsty

Sweat :- Normal

Urine :- Normal

Stool :- Satisfactory

Sleep :- Disturbed due to pain

Dreams :- Unremembered

Thermal Reaction : Chilly Patient

Page | 90
Physical Makeup: Skin unhealthy, wheatish colouration

Mental : Peevish, anxious, dull, low

GENERAL EXAMINATION :

Gait :- Normal

Decubitus :- On abdomen due to boil

Built :- Average

Nutrition :- Good

Weight :- 78 Kg

Clinical Examination:

Pallor :- Ab Clubbing :- Ab

Temp :- 98oF Icterus :- Ab

Oedema :- Ab Cyanosis :- Ab

Pulse :- 86 B/Min RR :- 20/Min

B.P. :- 120/80 mm Hg Tongue :- Yellowish-white

Local Examination :

On Inspection :- Pus filled boil on back with slight redness.

Systemic Examination :

R.S.: - NAD

CVS: - NAD

GIT: - NAD

CNS: - NAD

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Differential Diagnosis: - Boils, Acne, Insect bite

Provisional Diagnosis : - Boils

Totality Of Symptoms: -

Peevish and low spirited

Pus filled boils on back

Burning and stinging pain

Tenderness

Worse by touch

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 Better by warmth Miasmatic

Diagnosis : - Psora-sycotic

PRESCRPITION :

Rx –

Heper Sulph 30 / TDS /1 Day

SL / TDS / 1 Days Follow

up :

6/08/2019 Slight increase in pain for an hour but Hep sulph30 / TDS /2 Days
it got decrease later.
SL / BD / 2 Days

8/08/2019 Discharge of pus, relief in pain SL / BD / 1 Day

9/08/2019 No more boils. Relief in all complaints SL/ BD / 1 Day

Result: - Patient is improved.

CASE 25

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OPD No. 11679 D.O.E. : 2/10/2019

Name : PQR Age : 10 Yrs.

Sex : Male Religion : Hindu

Occupation : Student

Chief Complaints : Difficulty in deglutition since 1-2 days.

History of Chief Complaints : Difficulty in deglutition since1-2 days. Complaint

started after drinking cold water and cold air exposure. There is dryness of throat
with difficulty in deglutition especially solid food. Pain in throat aggravate at night,
cold water, cold air. Feels better by warm things. Burning type of pain in throat and
hoarseness of voice. Past History : NAD

Family History : NAD

Drug History : Took allopathic medicines but no relief.

History of Allergy: NAD

Personal History

- Living environment: - Hygienic.

- Drinking water: - Tap water.

- Socio-Economic: - Medium

HOMOEOPATHIC GENERALITIES :

Diet :- Mixed

Appetite :- Decreased

Desire :- Spicy

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 Aversion :- Sweet

Thirst :- Thirstless

Sweat :- Scanty

Urine :- Normal

Stool :- Satisfactory

Sleep :- Disturbed

Dreams :- Unremembered

Thermal Reaction : Chilly Patient

Mental : Anxiety and irritability due to complaints

GENERAL EXAMINATION :

Gait :- Normal

Decubitus :- On back

Built :- Average

Nutrition :- Moderate

Weight :- 32 kg

Clinical Examination:

Pallor :- Ab Clubbing :- Ab

Temp :- 99.4oF Icterus :- Ab

Oedema :- Ab Cyanosis :- Ab

Pulse :- 80 B/Min RR :- 16/Min

Local Examination :

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 Inspection

Nose-: Congestion in both nostrils.

Throat-: Congested, tonsils enlarged

Systemic Examination :

R.S.: - NAD

CVS: - NAD

GIT: - NAD

CNS: - NAD

Differential Diagnosis: - Acute tonsillitis, Pharyngitis, Bronchitis

Provisional Diagnosis : - Acute tonsillitis

Totality Of Symptoms: -

Anxious, irritable

Difficulty in deglutition especially for solid food

Dryness of throat with hoarseness of voice

Pain in throat worse at night, cold water, cold air

Feels better by warm things

Chilly patient

Miasmatic Diagnosis : - Psora

PRESCRPITION :

Rx –

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Belladona 30 / TDS /1 Day

SL / BD / 1 Day

Advice: Drink lukewarm water and avoid cold food n drinks.

Follow up :

3/10/2019 Slight increase in redness and pain Bell 30 / BD / 1 Day

of throat for some time
afternoon and night

SL / BD / 1 Day morning
and evening

4/10/2019 Difficulty in deglutition is improved, Bell 200 / OD / 1 Day

redness, pain and dryness of throat
SL / BD / 1 Day
reduced. Hoarseness also better.
Afebrile

5/10/2019 Relief in pain, redness and dryness of SL/ BD / 2 Days

throat. No difficulty in deglutition.
Slight hoarseness

7/10/2019 No new complaints. Relief in previous SL / BD / 1 Day

all complaints

Result: - Patient is improved.

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MASTER CHART

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SR. NO. DATE OPD NO. NAME AGE SEX PROVISIONAL REMEDY RESULT
(YRS) DIAGNOSIS

1 2/01/2019 8784 ABC 29 F Fever Bryonia Improved

2 9/01/2019 8816 PQR 26 M Fever Arsenic Album Improved

3 14/01/2019 8831 XYZ 25 M Dyspepsia Nux Vomica Improved

4 21/01/2019 8862 UVW 3 M Boil Belladona Improved

5 28/01/2019 8902 ABC 25 F Injury Hypericum Dropped Out

6 30/01/2019 8916 RST 10 F Acute Otitis Media Pulsatilla Improved

7 1/02/2019 8925 LMN 6 M Fever Aconite Improved

8 4/02/2019 8931 PQR 19 F Dysmenorrhoea Mag Phos Improved

9 12/02/2019 8964 ABC 18 F Acute Tonsilitis Hepar Sulph Improved

10 16/02/2019 8989 LMN 34 M Toothache Plantago M Improved

11 25/02/2019 9016 PQR 15 M Pyrexia Nux Vomica Improved

12 26/02/2019 9020 STM 30 F Conjunctivitis Pulsatilla Improved

13 1/03/2019 9047 XYZ 40 M Diarrhoea Arsenic Album Improved

14 7/03/2019 9084 UVW 2 M Worm Infestation Cina Improved

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15 15/03/2019 9136 XYZ 20 F Acute Gastritis Carbo Veg Improved

16 27/03/2019 9195 ABC 45 F Fever Belladona Improved

17 29/03/2019 9208 RST 50 F Sprain Arnica Not Improved

18 5/08/2019 9972 LMN 35 M Boil Hepar Sulph Improved

19 10/08/2019 10008 PQR 12 M Dysentery Cantharis Improved

20 4/09/2019 10173 IJK 6 MO M Fever Chamomila Improved

21 11/09/2019 10367 ABC 32 M Acidity Lycopodium Improved

22 18/09/2019 10452 UVW 6 M Stye Pulsatilla Improved

23 25/09/2019 11007 XYZ 5 F Worm Infestation Spigelia Improved

24 30/09/2019 11664 EFG 8 F Toothache Chamomila Improved

25 2/10/2019 11679 PQR 10 M Acute Tonsilitis Belladona Improved

26 4/10/2019 11708 LMN 16 F Coryza Pulsatilla Not Improved

27 7/10/2019 11736 XYZ 17 F Dysmenorrhoea Belladona Improved

28 9/10/2019 11745 PQR 35 M Fever Gelsemium Improved

29 14/10/2019 11815 LMN 17 F Dysentery Aloe Socotrina Improved

30 16/10/2019 11841 XYZ 4 M Acute Tonsilitis Kali Mur Improved

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