Clinical Cases

A Case of Chronic Urticaria

Pooja Gori
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Dr. Pooja D. Gori treats a case of chronic urticaria in a boy of 14.

This is a case of a boy of 14 who arrived with the complaint of rashes on upper limbs and chest and almost all over body with bad itching and heat sensation throughout. He said:  “ It came to me on 17th of December 2016 with rashes and I have applied many anti fungal ointments but no relief but and the condition rather worsened.

ODP:

This urticaria started at age of approx 8-9 years.

He was given many allopathic drugs and ointments for the same.

Earlier the attack of itching with urticaria used to come once in 15-20 days and intensity of rash and itching was not this bad. Now it is present almost every day and does not feel better unless take he takes Allegra or other anti-histaminics.

C/O:

1- Red raised rashes all over body,

Severe itching – will scratch till it becomes raw or bleeds.  But that scratching will not give any relief and will keep itching the whole night.

< night

<bed in

<warmth of bed or covering agg++

>Applying cold water or draft of cold air.

>Uncovering.

Hypopigmented patches after scratching and bleeding spots.

Mainly on arms and forearms.

Prone to mosquito bites.

2- Tendency to catch cold since childhood

< cold drinks or cold food

< change of weather

< any coloured food

Past history : Recurrent tonsillitis.

Physical general:

Appetite: Good and likes every kind of food.  Cannot tolerate hunger, will get irritable and would want his food at once.

Thirst: Good. 1.5 litres a day.

Cravings: Ice creams, potato, bread, tomatoes (favourite food is sandwich) and loves all kind of food. Can eat any tasty dish.

Aversion: MILK +2

Aggravation: Cold food/cold drinks+2

Urination: no complaints.

Stools: no complaints.

Sleep : Good , refreshing, lazy to wake up in the morning. Sleeps on abdomen.

Thermals: Hot patient, can’t tolerate heat and sun.

Mind:  Very intelligent boy, loves reading and is very good in school work.

Very lazy (said by mother.)  Will sit on couch and watch television all the time if allowed.

Anticipation before exams but always prepared.

Does not like to mix with new people, little shy initially; later is comfortable with them.

Likes to read a lot.

Gets angry very easily from small small things, especially when things do not happen as he wishes. He’ll make all those childish tantrums then.

DIAGNOSIS: Urticaria

MIASM: Psora as fundamental and dominant miasm.

TOTALITY OF SYMPTOMS:

  1. Intelligent
  2. Reading desires
  3. Timidity when appearing in public
  4. Sleep position on abdomen
  5. Dryness of skin
  6. Itching, especially at night
  7. Suppressed eruptions
  8. Chronic urticaria
  9. Bleeding after scratching
  10. Itching on becoming warm
  11. Allergic constitution
  12. Cold taking a tendency
  13. Covers – agg.
  14. Bread – desire
  15. Drink, cold water – agg.
  16. Cold food – agg.
  17. Milk – aversion
  18. Potatoes – desire
  19. Tomatoes – desire
  20. Hot patient
  21. Hunger agg.
  22. Change of weather agg.

Now, the biggest question arises, do we give acute or constitutional remedy?

Whenever in doubt, I always refer to Dr. Hahnemann and source books and other masters. Their experience teaches a lot to us. Thus, to be more sure of my constitutional remedy, I considered only characteristic particulars for the prescriptive totality, using the most peculiar, queer, rare and strange symptoms of the case as ELIMINATING RUBRICS.

The remedy is clearing indicated and it covers the totality of the patient.

Whether to give Urtica urens or Mezereum or Antimonium crudum or Apis in this acute exacerbation of itching or to go with polychrest as a constitutional?

Differentiation of constitutional medicine:

Since it is a chronic case, a chronic anti-psoric remedy is the most appropriately desired one. Physical characteristics have a high symptom similarity with Lycopodium, most importantly – chronic urticaria, and urticaria < warmth of bed (Thus taken as eliminating rubrics)

Lycopodium clavatum– Skin – Rawness in folds; intertrigo- persistent. Urticaria, chronic, agg. warmth. Eczema associated with urinary, gastric and hepatic disorders.  ( Dr. Farokh Master)

Chronic urticaria – Lycopodium clavatum – Lycopodium has an unhealthy skin which is dry, hot skin which burns and itches when warm. It is more suited to the chronic type of urticaria, which are characterised by severe itching and burning, worse by warm application and worse by exercise. Urticaria in patients with liver, gastric and renal disorders. Urticaria in patients with scrofulous and uric acid diathesis. (Diseases of the skin – Dr. Farokh Master)

Lycopodium clavatum – Skin – Urticaria; chronic agg. warmth.

(Materia Medica of Homoeopathic Medicines – S. R. Phatak)

Lycopodium clavatum – Clinical – Urticaria from a very warm bed or room.

(Homoeopathic materia medica of graphic drug pictures and clinical comments – Pulford A.)

Lycopodium clavatum – Skin – Urticaria, chronic cases. Ulcers: tearing, shooting, itching at night, burning when touched; fistulous, with hard, red, shining everted edges and inflammatory swelling of affected parts; bleeding easily; phagedenic; swollen; superficial; edges high or callous; black gangrenous; of offensive smell; thin ichor; flat with a bluish white base.

(Concordant Materia medica – VERMEULEN F.)

When using the BOERICKE REPERTORY, FOR THE CONFIRMATION OF CHARACTERISTIC PHYSICAL PARTICULARS, we get –

REMEDY given: Lycopodium

(Reasons mentioned above)

POSOLOGY & REPETITION: 30 5 cup method twice a day for 15 days.

  1. Chronic disease with acute exacerbation
  2. Constant suppression of disease with local application.

FOLLOW UPS:

After 15 days, the child was 40-50% ameliorated.

Treatment given – Lyco 30 5 cup method twice a day for next 15 days.

Next follow up –

The patient is 60-70 % ameliorated.

The patient received the same medicines in same potency and same repetition for next one month, after which his amelioration came to a standstill.

That time the patient was given Lycopodium 200 in 5 cup method once daily, after which he is almost 80-90% ameliorated.

The patient is now given infrequent repetitions of Lycopodium 200 in 5 cup method and is doing very well with it.

LEARNING FROM THE CASE –

The constitution to be treated is not only the mind but also the pathology with its peculiar, characteristics.  Using the reference of Source books and referring to masters is what takes us to the right path and simillimum.

The right application of knowledge is what gives consistent results, thus, a simple case with application of simple knowledge, but with the RIGHT APPLICATION and APPROPRIATE USE of the source books and knowledge of materia medica can repeat the results in all cases.

About the author

Pooja Gori

Pooja Gori

Dr. Pooja D. Gori, B.H.M.S, C.G.O, C.C.H (Mumbai) has been an assistant to Dr. Farokh Master for one and a half years. She works at Homoeopathic Charitable Clinic, A/4 –Mumbai and Ghoghari Samaj Trust, Mumbai.

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5 Comments

  • Your article on urticaria is praiseworthy. May I know your email address for a clarification on urticaria. Thanks for your valuable article.

  • Urticaria is a manifestation of Psora &Syphilis combined, Lyco. works for all the three miasms,so it was fine. High potency is certainly needed for chronic cases if the mental General & physical General are present, with a long duration.Kents repertory is always prefered for chronic cases. Thanks

  • Nice case.
    ? Cure was rapid.
    One thing I need to understand from the learned author of this case is: Why the medicine repeated so often when it was realized that the patient improved 50 – 60 %, 70 – 80%? I there any advise by any masters except the so called modern masters?
    What’s 5 cup method?