A case with serious internal bleeding

- Sadhna thakkar's case
 Internal hemorrhage, cirrhosis of the liver, alcoholism
 Crotalus horridus
 Case

 Have you had days when one patient after the other walks into the clinic and says he/she is not better? Well I have. At these times what has helped me renew my commitment to my practice is to go through all my old journals from the early part of my practice. I am so glad that I developed a habit of writing down all my homeopathic experiences from early on. I would like to share a case that I like very much because it has renewed my commitment to homeopathy time and again.
 This was a case I had when I was doing my residency in the homeopathic hospital. We had a new admission on a Sunday of a man in his 20's. He was transferred from the allopathic hospital where they had given up all hopes of saving him. This man was almost in a hepatic coma. He had cirrhosis of liver and his liver enzymes were at dangerous levels. He was vomiting and passing stools that were coffee brown in color-indicating that he was bleeding internally. His vital signs were quite grave and he was in a collapsed state. His eyes were half shut and on examination, his nails and sclera were golden yellow. He was almost delirious and couldn't answer any questions, yet he would be mumbling and crying periodically-saying "I want to die, I want to die". His color was very dark, almost ashy, and he had petechial hemorrhaging on his body. There were bruises which had turned into blackish discolorations on his buttocks and back from sleeping in the position for too long. He had a very offensive breath.
 The history I got from his family was that he has been an alcoholic since a very young age. This was his third time where he had almost died. He wouldn't listen to anyone. Even though he was out of the hospital after being treated for cirrhosis of liver just a few months ago, he didn't take the advice of his doctors to discontinue alcohol. Family members said he is a very stubborn man and a very angry man. He wouldn't listen to anyone or any advice. The moment someone mentioned his alcoholism he would go into a rage and become violent. He lived alone which is unusual for a man in his 20's in Bombay. He had no friends and he didn't get along with anyone in the family. They said he was a loner.
 I was quite new at that time in my practice. My supervising physician could not be reached as it was a Sunday. Being a resident medical doctor, it was my responsibility to take action. I decided to look up all of the objective signs in this case and see what came through the repertorisation. At the time we still used Kent's Repertory. I took the following rubrics:
 Generalities; COLLAPSE
 Mind; MANIA-A-POTU
 Generalities; HAEMORRHAGE
 Generalities; HAEMORRHAGE; orifices of the body, from
 Stomach; VOMITING; blood
 Stomach; Vomiting; coffee-brown, dark
 Mouth; ODOR; putrid
 Mouth; ODOR; offensive
 Stomach; desires; alcohol
 Skin; DISCOLORATION; blackish
 Eye; YELLOWNESS
 Stomach; DESIRES; alcoholic drinks
 Mind; DEATH; desires
 Mind; DEATH; thoughts of
 I went through all the Materia Medica and looked at the remedies like Ars., Carb-v, Crot-h, Elaps, Lach., Phos., Secale-cor. All of the remedies for the collapsed state with internal bleeding. I decided to give him Crot-h based on the aversion to members of family and the description of Crot-h in Allen's Keynotes.
 "Diseases caused by a previous low state of the system; chronic alcoholism; exhausted vital force; genuine collapse...Hemorrhagic diathesis; blood flows from eyes, ears, nose, and every orifice of the body; bloody sweat. Yellow color of conjunctiva; Prostration of vital force; pulse scarcely felt; blood-poisoning; dark, green vomiting; black or coffee grounds, or yellow fever...Diarrhea; stools black, thin, like coffee grounds, offensive, from noxious effluvia or septic matters in food or drinks.
 Since I was a resident in the hospital, it was safe for me to give one dose and wait for the changes. After half an hour, he asked for water. He had vomited coffee-brown liquid again but his color looked a little better. At that time I repeated another dose of Crot-h 30C. In the next hour, his color kept getting better, and his vital signs improved. No vomiting and no stool. He was given one more dose of Croth 30C during the night. In the morning, to my surprise, he was sitting up in the bed and talking to his mother and sister who stayed overnight with him in the hospital. He asked for breakfast and he seemed quite conscious. His vital signs were almost normal and his color was back to normal. He was discharged from the hospital in 3 days and within a week his liver enzymes came back to normal range. His case was followed on an out-patient basis for the next year. Crot-h was given 3 times in 200C and then 1M during that period. In the meantime, he turned his life around, he came to live with the family, found a job and started working. The last I had heard before leaving the hospital was that he was engaged to be married soon.
 This was my first experience with Crot-h and a remarkable one I think. It is unfortunate that we rarely get to treat these kinds of cases in the U.S.  because such cases can bring back the respect and acceptance homeopathy lost in the early part of the century in this country.
 -Sadhna Thakkar, CCH, BHMS
 Sadhna Thakkar, CCH, BHMS is a founder and director of National Institute of Classical Homeopathy and Homeopathy Health Care. She brought her extensive clinical experience from Bombay to the U.S.  several years ago. She has been teaching seminars in Classical Homeopathy to professionals in the US and Canada since past three years. Her private practice is in Santa Monica and Thousand Oaks in Southern California.