Mr. I. C., a 60 years old male patient was brought to us for the treatment of Bronchial Asthma by his daughter who was a final year student of our college at that time.
The chief complaints were breathlessness and cough, which had been gradually increasing in intensity over the past 40 years. Now he suffered from it every day.
The patient believes that his respiratory symptoms began after his tonsils were removed when he was 15 years old. He had an uncontrollable hemorrhage after the surgery and was advised to have ices and chilled drinks for several days. According to him, the symptoms of colds and sneezes began soon after and later developed into breathlessness.
He sneezes everyday in the morning and has a runny nose- the discharge being whitish and sticky. Cough and breathlessness are also a daily feature. The cough is accompanied by an easy expectoration, which is whitish and sticky but soon turns yellow.
His complaints are worse from emotional stress, from cold damp air/weather, cold drinks/food, oily food and sour food (except lemons). He is better in the open air, sitting up erect with head bent backwards and from expectoration.
During the attack, he sweats profusely, all over the body, esp. on the arms, chest and back. Occasionally, he vomits with the cough and breathlessness.
For the past 7-8 years, he has also had pains in spots in the kidney region on both sides. He also has pains in the bones and joints of the lower limbs. What is peculiar is that the pain is worse after urination and after inhalers. It is relieved by hard pressure and lying on the side.
He avoids urinating because of the severe pain that he gets after urination.
He has a food appetite with a craving for milk and milk products, sweets, fish and meat.
Thirst is normal and his bowel movements are regular.
Sweat is profuse, esp. on the back, arms and chest. It is non-offensive.
His sleep has reduced for the past 5-6 years due to business worries. He does not have any peculiar or recurrent dreams.
He cannot tolerate the heat but his respiratory symptoms are < cold.
He has a large family of 10 children. At present he lives with his wife and 2 unmarried sons and 2 unmarried daughters. 1 son died when he was very young. All the other children are married and have their own families. This patient had a timber business that closed down a couple of months before he visited me. He had made a name for himself as an honest businessman.
He has had a lot of mental stress throughout his life. But, he has been selfless and sympathetic. He considers it his duty to help everyone and tries to do his best even at this age and with this illness. He is a workaholic and always wants to remain busy. He can never be found resting at home. On holidays, he would be tinkering with things at home and would constantly be doing something.
He is impatient and wants things to be done instantaneously. He is an honest man and would not like to earn money with dishonest means.
He gets angry if things go wrong. Will initially explain things to the person concerned, but if they recur, he neglects that person. At the same time he is forgiving. If the other person apologizes, he forgives him, even if he has caused a lot of hurt and harm.
He is very sensitive and weeps easily- in front of others.
At present he is under a lot of stress because he was cheated in business. His partner embezzled the funds after the business was sold off. He feels cheated and deceived.
He has had a lot of grief in life. His son died suddenly after he developed a high fever. One daughter has cerebral palsy and requires special care.
He has a history of tonsillectomy, urinary calculi, benign enlargement of prostate.
Family history:
- Mother- Diabets mellitus, Ischemic heart disease
- Brother- Chronic Renal Failure
- Brother- Ischemic heart disease
- Sister- Brain tumor
- Sister- Osteosarcoma (was amputated)
- Son- Died after high fever
- Daughter- Cerebral palsy