Prescribing Opium in Cirrhosis Liver

Name of Patient: Inderjit Singh Sidhu, 32 yrs male

Complaints: Insomnia since last 3-4 months, loss of sight some time, involuntary movements of head and legs, urinary output increased (taking allopathic diuretic med), severe constipation since so many months- enema has to be done almost daily to pass stool. Ascitis. Pain in legs & back, unable to sit, can not turn side without help. Feverish, chilly feeling, thirsty, can't tolerate hunger. Very irritable. Burning soles & palms

All the complaints are since so many years but more since 25 th Jan 2010.

Got admitted in PGI Chd in ICU, being diagnosed as CKD, cirrhosis liver, Ascitis, encephalopathy, hepatosplenomegly.

Cause---Alcoholism

H/O Hospital admission in Nov last year. Blood transfusion had to be done since Hb- was 4gm%

Past H/O Surgical removal of piles 1 ½ yrs back. Left arm amputated in accident 10yrs back

Personal H/O-Pt is non-vegetarian, alcoholic, nonsmoker, taking hot tea 4-5 cups daily

Thirst- increased.

Appetite- increased.

Thermals- Can tolerate heat and cold.

Desire- Sweets++, fruits, fried food, milk, chicken, eggs.

Aversion- nil.

Stool-Constipation ,

Urine- increased frequency & quantity.

Sleep-Insomnia since so many months.

Speech-Normal,

Open air desire.

Nature of Pt. - Irritable, shares his views with wife, Can't wait in line, goes out of way, can't tolerate tight cloths, anticipation, fastidious, wants new things always but don't throw old ones. No desire traveling, avoids staying at night at anybody's house. Likes nature, animals, and parrots. Angry on domestic matters, releases sometimes but calms after few minutes. Never fights if any body blames, not revengeful forgives easily. Does not bother if anybody is fighting in neighborhood. No effect on mind if there is death of any closed person. Fear of heights, closed places. Weeping tendency now less previously increased > consolation. Wants support, takes time to decide. Sympathetic, tries to do good for others. Likes sad songs. No leadership.

OPIUM 200 one dose was given on 7-2-10 on following selected criteria

Miasm- Syphilitic

Rubrics- Indifferance to all (Even towards his disease), painlessness of painful parts

Dipsomania, Contented

Followups-On 13-2-10 Generals improved. Slept after so many months. Pyrexia, Temp 102. SL given

20-2-10 passed stool without any aid. Sleep normal. Urine output normal without any diuretics.

27 Feb to 13 March-Al-round betterment. Passes stool 3 times daily.