Rajesh Rajendran created the doc: "Doc No 0088 - a good case to

learn"
Name - Miss MA
Age - 26 years.
Sex- Female
Marital status - Unmarried
Diagnosis - Charcot-Marie-Tooth disease

PRESENTING COMPLAINTS

1. a) Large Non healing Ulcer upon the Right Gluteal Sulcus to

towards the medial side (Inter gluteal cleft) since 6 months b)
a non healing Ulcer upon the right foot below the toe ( hallux
amputated for the same reason Please find the pics for
appropriate understanding) since six months
2. Foot drop. High arched feet, weak lower limbs,
3. Pain in the Extremities.
4. Should take support to walk.

H/o presenting complaints.

she had slight deformity of limbs and an altered gait in childhood.

But not so worrying and they being from low socio economic
background didnt worry to look over. In 2003 the girl returned for
the funeral of her Paternal uncle and suddenly started headache
followed by pain in throat, nausea and vomiting. She used to have all
this continually and finally would get admitted in the hospital and
get discharged. It continued till 2008. Until she took homeopathic

treatment from a nearby homeopath. Mean while her legs started to

loose the strength, in her legs, unable to walk, she dropped out from
the school. At the age of 15. Latter on the complaints of vomiting
subsided and no episodes till now. Except one last month but lasted
only for a day without any medications.

I would just post the conversation here with out nay

interpretation. She was lively smiling through out the conversation,
accompanied by her father and mother. She was talkative, she was
asking doctor what is this disease about, nobody ever told anything
an all these years. They used to give medicines and send me off,
advised me physiotherapy. But not of much help. When will I
recover, I have come with lots of hope, all I want is this ulcers to
heal and atleast walk on my own with some aid. I want to study
further and atleast complete my graduation.

I ask my brothers that I will study from home and give the exams,
they say just keep quiet and be at home, we cant come all the way
for you. Now I feel scared to talk to them for the fear that they will
just ignore my words and say shut up. Not just about studies but
anything. My mother and father take care of me. I read the news
papers, books , television and play with my brothers kids they are
loving ones.

She was going on talking, mean while the mother said; she will be so
jovial and lively all the day talking. But in the night she weep alone
in the bed. The girl added I weep in pain more than physical, its in
me. I dont know what would be my future. I just at least want to be
free from this ulcers and gain little strength. So that I can study and
earn a degree, support myself.There was an eagerness in the eyes,
but very active, no pauses while talking, spontaneous. She ended
saying that I feel that I walk for sure.

on enquiry her parents revealed that she is irritable, and gets angered,
she will throw the thing at them when angered. If she wants
something to happen, it should or else she will get angry. She fears
darkness, and goat especially. And always want someone beside.

other findings,

Ambithermal,
Desires spicy things,
Aversion to sour things,
Appetite normal
Thirst- Increased during night
Bowels -regular
Urination increase frequency in the night.
Sleeplessness.

Its a diagnosed case of Charcot Marie Tooth Disease.

Please read the links in the comments, to have an idea about the
signs and symptoms, etio-pathogenesis and prognosis. It should not
be the basis of prescription but to guide it.

It whats needs to be cured is clear. In the case itself as expressed by

the Girl in her own words. Although supportive physical therapy is
need.

today i had a case of a girl age - 5 yrs , c/o breathlessness, cough and
cold recurrently since 2 years <cold food < weather change , starts typicaly
with cold then running nose --then cough -- then breathlessness. had been
to many eminant pediatricians in mumbai ... all have diagnosed allergic
asthama .... but no one could help her.during the attack of breathlessnessshe sleeps quitely and does ...

today i had a case of a girl age - 5 yrs , c/o breathlessness, cough and
cold recurrently since 2 years <cold food < weather change , starts typicaly
with cold then running nose --then cough -- then breathlessness. had been
to many eminant pediatricians in mumbai ... all have diagnosed allergic
asthama .... but no one could help her.during the attack of breathlessnessshe sleeps quitely and does ...

SENILE DEMENTIA
This case developed in a man 78 years of age, a man of exceptionally
fine intellect, but always rather eccentric, a man of very positive
convictions, so positive that it was as difficult to change his opinions as
to change the contour of the rock of Gibraltar.
In conversation with him some months previously I had noticed the
expression of some peculiar religious beliefs. These increased until
they became an obsession, to which he gave utterance early and late.
Finally an acute mania developed. He imagined people were talking to
him, heard imaginary voices and believed that people were plotting
evil against him. He imagined that he was Adam, or God or Moses,
generally some religious character. His nights were sleepless, with very

great restlessness, and he was constantly talking. He had the Lachesis

symptom of great loquacity, but there was little sense or connection in
what he did say. Appetite poor but elimination, both intestinal and
urinary, was good. The heart was weak, showed all sorts of murmurs,
intermitted every fourth or fifth beat. There was decided mitral
regurgitation. The pulse was very weak; Various remedies were given
with little or no effect. A specialist gave the opinion that it was
softening of the brain and that he would not live long. Finally an
intense muscular and mental restlessness developed. He would sit in a
chair perfectly erect with his hands, feet and every part of his body in
motion; not the irregular, unrhythmic motions of chorea, but voluntary
motions, although he could not control his movements except for the
minute. He kept his feet in constant motion, tapping the floor
continuously. He also kept his hands moving constantly and every half
minute he looked to one side under his chair, as if seeking something.
At the same time he made a clucking noise with his tongue against the
hard palate as if clucking to a horse. Such constant movement would
have eventually exhausted him. Tarantula met his symptoms and in
thirty minutes, according to the testimony of his children, there was a
notable improvement. He got some sleep for the first night in a week.
From that time on there was an improvement until he was in fairly
good health. There is no question but that Tarantula saved his life and
also restored his reason. I purposely gave both the Tarantula hispania
and the Tarantula cubensis at different times but could see no
difference in the effect.