Clinical Cases

Case of a Two Year Old Girl with Eczema

Dr. Vishpala Parthasarathy presents a case of a two year old girl with eczema. She uses comparative material medica to decide on the simillimum.

INTRODUCTION: Living Repertory is the best way to really identify the remedy. You find more rubrics until you hit the jackpot. Living Repertory means working the repertory while taking the case, as opposed to Dead Repertorization, working out the case after the patient leaves, when we cannot get the finer differentiations.

Baby I. K. 2yrs 2m, came for eczema on 20/08/15: (Reg. S/40/15)

Chief Complaint

  • SKIN- Itching3+ with redness and burning in the popliteal fossa since July15. More on Rt. side. Also there is redness on the face near the angles of the eye. A/F- joining school since July 15 < AM3+, < Luke warm water, < scratching, < sweat? Diagnosed as ECZEMA by 2 skin specialists, though it looked more like Atopic Dermatitis to me. However Homoeopathy does not focus on diagnosis, so either diagnosis was okay for me. I could and would heal both.

Past History

NAD

Family History

PGM- Dry skin, Rec UTI, Hypothyroid, anxiety state.. Mo and Fa: colds recurrent.

Patient As A Person

  • weight: 12kg
  • PERSPIRATION: Profuse3+ on the back and forehead. Pt. is in the AC almost all day.
  • appetite: Reduced due to the complaints.
  • craving: Sweets3+ Fish, meat, Curd, Chicken, Salty3+, Fruits, Lady finger. She has a peculiar craving for Dalchini (an Indian spice) and eats a lot of it.
  • aversion: None
  • thirst: A lot i .e. 3+.
  • teeth: N
  • EAR/HEARING: N
  • Stool: 1/d, Normal.
  • DIGESTION:
  • Urine: Always Nappy pad in the night, which often produces rash. Adv. not to use.
  • thermal: Hot. AC needs. Sweats a lot. Hardly wants covers.
  • NAILS: Normal
  • oedema : Absent
  • skin: Eczema, dryness and redness
  • hair: NS
  • sleep: Sound.
  • dreams: NS. Child is 2 y old only
  • MIND: Anger- throws things, weepy+, clinging Mo (now reduced), Wants Mo to drop her to school, jealous of sibling but also very attached to her. Looks after the sibling and plays with her and treats her like a new doll.
  • But when mother gives too much attention to sister, pt. gets angry. Throws tantrums while changing clothes. is a very affectionate3+ and friendly and gives advice to all. Everyone calls her the grandmother of the house!  She is very alert; we noticed that during the case-taking too. She would correct the PGM when she did not agree with something told to us.
  • Fear- horses, strangers, loud noises, dogs. Otherwise pt. is active, playful, needs someone around mostly but can also play by herself. In outside world she is timid and not so aggressive. She likes order and keeps her toys in place, when told by mother.

Life Space

2008- Parents got married.  Mo couldn’t conceive in spite of reports of both the parents being normal. So pt. is an IUI baby.

25/04/15- Born at Mumbai with help of vacuum delivery.

Pt. currently living with her parents, one younger sister and grand-parents.

Pt. very affectionate towards the family but used to cling a lot to mother. She must constantly smell the mother’s hair while going to sleep. Now after the birth of her sibling, the parents have divided the responsibility. Pt. sleeps with the father in another room so that she is less disturbed, gets proper attention and does not feel mother is doing so much for the sister in the night.  She is a very happy, friendly and joyful child. Hardly ever cries. Quite precocious and speaks very clearly and maturely for her age.

We will do the working as I did it in the clinic, as what I call the LIVING REPERTORY.

  1. When she walked in, the first word which comes to mind is a pretty, cute child. But she took 5 mins to get used to us. Then she was very comfortable and laid on the examination couch. To me she looked like a Calcarea phos. But I was jumping the gun.

Timid when she entered and then sharp was my observation.

Repertorial Totality

  • Anger children in
  • Anger throws things
  • Timidity
  • Fear noises from
  • Precocity
  • Weeping easily
  • Mischievous
  • Affectionate
  • Clinging mother to
  • Desires fish
  • Desire Chicken
  • Desires sweets
  • Desires ice-cream
  • Perspiration profuse
  • Itching- knees hollow of
  • Redness- knees hollow of
  • Pain burning knees hollow of

Understanding and Analysis

REMEDIES AFTER REPERTORIAL FILTER- Tub, Phos, Carc, Pul, Lyc, Sulp, calc.  But I am jumping the gun (this is phrase which means I am telling the last part of the story first).

I want to properly give a demo and explain to you the concept of LIVING REPERTORY i.e. how our thinking goes as we are proceeding with the case

First we want to take what was observed the when patient first comes in.

  • Atopic.
  • mind; TIMIDITY (234)
  • mind; AFFECTIONATE (78)
  • mind; INQUISITIVE; observing others (11)
  • mirilli’s themes; KNOWLEDGE (308)
  • mind; QUICK to act (56)
  • mind; CONCENTRATION; active (116)
  • mind; ATTACHED, very; mother, to (44)

April 2016 Vishpala Parthasarathy

Calc and Phos both are quite high in the repertory working.

  1. When we added all other  mind symptoms viz. the fears, Stram was leading

April 2016 Vishpala Parthasarathy..

  1. When I put in all the cravings then the calc really receded and the phos was strong.

,

Mind; FEAR; animals, of (121)

Mind; FEAR; strangers, of (29)

Mind; FEAR; noise, from (66)

Mind; FEAR; dogs, of (39)

Skin; DRYNESS (352)

Skin; REDNESS (828)

Mind; PRECOCITY (61)

Generalities; FOOD and drinks; sweets; desires (249)

Generalities; FOOD and drinks; salt or salty food; desires (131)

Generalities; FOOD and drinks; vegetables; desires (96)

Generalities; FOOD and drinks; spices, condiments, piquant, highly seasoned food; desires (116)

  1. Finally to differentiate: I used some finer points

We found the patient had a very strong sense of smell, loved dalchini– a strong spice which is not a common craving found in children or even adults for that matter.

In the mind symptoms, the peculiar thing was she is she was very affected by scolding, too sensitive to it – this is not marked in Calc. Pt was also very alert and on the move always, fears thunder and dark too and is precocious.  I zeroed in on Phos only.

INDICATED REMEDY

Phos: i.e. only Phos the element and not a salt like Calcarea phos. 

Why not Calcarea phos?

Explanation

This child was such a dadima ‘(grandmother). She said her grandmother brought her. She loves and looks after everyone and she is so bright and observant and affectionate. Precocious too.  But what differentiated it from Calc: very active, always on the move. Very bright. And very angry when she does not get her way. Calc likes to listen and obey as she does not want to lose her mother’s affection, so she will try to please. She is tall and lean and very good looking. Her cravings too are more Phos, especially when we see added spice, fish, chicken in the  repertory, not calc or calc-phos.  So the balance titled in favor of Phos. This is how you need to differentiate and be sure.

Potency

Child had no dreams. So it was more emotions and skin so pt is at level 3 and the 200 potency was selected.

April 2016 Vishpala Parthasarathy.,

Mind; FEAR; dogs, of (39)

Skin; DRYNESS (352)

Skin; REDNESS (828)

Mind; PRECOCITY (61)

Generalities; FOOD and drinks; sweets; desires (249)

Generalities; FOOD and drinks; salt or salty food; desires (131)

Generalities; FOOD and drinks; vegetables; desires (96)

Generalities; FOOD and drinks; spices, condiments, piquant, highly seasoned food; desires (116)

Generalities; FOOD and drinks; fish; desires (60)

Generalities; FOOD and drinks; chicken; desires (18)

Extremities; ITCHING; knees; hollow of (37)

Extremities; PAIN; knees; hollow of (177)

Mind; SCORN; ailments from, agg. (32)

Nose; ODORS; strong, agg. (9)

Follow-Up

Date   Follow-up Rx
20/08/15 Precocious, very alert, acute sense of smell, attractive, < scolded=cries, < thunder storm, fear dark

No dreams and child so only 200

Phos 200 2p, 1p=2
024/08/15 Skin Popliteal fossa Left >, is at L8, (is 20% better. But thigh got a new spot. Stopped diaper in the night and immediately pt. started to try to control urine3+. (Which means that we only do not allow the child to evolve and grow because of the adult lazyhood). SL
31/08/15 Rash L7, itching < evening, clinging >. Mind better. So wait. SL
3/09/15 Overall >, no more jealousy, but rash SQ (not better so go to higher potency 1st day– Phos 200,1p, 1p=2

2nd day- Phos 1M, 1p. 1p=2

07/09/15 Left knee >3+, L0, Rt. Itching L5 but redness <.

Wait

SL
10/09/15 >2+, Redness > 60%, itching <, Crankiness>.

Overall- 50%>

Given the Bach flower to help soothe the skin and break the link. (needs repetition)

Phos 0/7, in a 4oz bottle. Take 1 tsf OD

Crab apple + Walnut    4pills/ TDS

28/09/15 Day-19 < ,Anger increased, makes Mo angry, throws tantrums, Rash >

 

SL
1/10/15 >3+, Parents went out alone and pt. for the 1st time in her life, stayed with MGM and was joyful SL
12/10/15 Rash- Popliteal- Dryness1+, i.e. at L1 level.  itching 1-2/d < sweat, no redness

Face- L0, 1/1-2wk.

Smells Mo hair(a habit)- SQ

PGM- pt. is much happier, independent, talks more and playful

 

SL
26/10/15 >3+, Redness L0/for last 15d, Itching L0, dryness L1.

Crankiness >3+. L0

SL

April 2016 Vishpala Parthasarathy,..  April 2016 Vishpala Parthasarathy,,

April 2016 Vishpala Parthasarathy,,

After two weeks

April 2016 Vishpala Parthasarathy.,.

Jan’16

April 2016 Vishpala Parthasarathy''

Conclusion

Patient was completely relieved in 2 months. And even her dalchini craving has gone down; so also her sensitiveness to many things.

As patient is completely alright, they find no time to come! The mother has not come at all, even to hear the case, as she has the other small infant. First the mother telephoned and asked, “Can you help with the itching?” I told her I have to see the child. So as mother was busy with the 2nd little baby, the grandmother who is our regular patient brought in the child.

The history is taken any way we can get it. As long as it is complete, we can prescribe.

Long live Homoeopathy!

About the author

Vishpala Parthasarathy

Dr. Vishpala Parthasarathy, MD (Hom), F.C.A.H.(MUHS) is a consulting Homoeopath, DBM (Wellinkar) PgG Dip.counselling and Editor, National Journal of Homoeopathy. She is also Hon. Physician, Dr M L Dhawale Memorial Hospital Plgr and Consultant, the other song. She was Facilitator during Sarla Sonawala Memorial Seminar on Depr, Feb 20-21, 2016.

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