A 30 year old female, housewife, married for11 years came to our clinic on 26/02/18. Chief complaint: profuse bleeding since her last menses. LMP – 17/01/18 remained for 15 days as heavy flow. It started again on 11/02/18 and she took medicine from a quack with no relief. Time passed and after fruitless efforts to stop the intra-vaginal bleeding, someone suggested going for USG. On the 25th they got a USG done and it was found that she had a 7 cm large bilocular right ovarian cyst. The same day she was rushed to an allopathic doctor and was told she had to undergo surgery as the cyst was large and bleeding profusely. Due to lack of money she didn’t get the procedure.
On 26th of February she consulted us with the complaints described above. Since menarche she had severe dysmenorrhea and menses were 4-5 days.
She has one daughter 10 years old
One miscarriage at 3 months two years after her first child.
Difficulty in conceiving second baby
Cholecystectomy done at age 15
Married at 16 years of age and it was a love marriage
H/O Pyorrhea
5-6 months ago, she had itching and burning in va-gina and took allopathic medicines.
Leucorrhoea the last 2-3 months- thick white / yellowish and scanty discharge
Physical Generals:
Hot / Thirsty
Appetite good but often desires indigestible things
Likes spicy foods
Difficulty in tolerating hunger or keeping a fast
Perspiration profuse and it stains the cloth yellow
Sleep normal, sleeps on side
Not very fearful but does get anxious sometimes
Vertigo travelling in car/auto/bus – no nausea and vomiting
Senses normal
Mental Generals:
She comes from a conservative family and has an older brother and two younger sisters.
She has had a feeling of not been loved and believed her siblings were given more love and respect. Initially she felt bad but later became indifferent and then developed jealousy.
Not interested in studies but would still do the work. Studied up to class 10.
She took a stand and convinced everyone in in her family that she should marry for love.
Her personality traits she described as easily irritated and angered, easily offended. Helpful towards others. Anxious about little things and unreasonable behavior from others. Sometimes very contrary.
Her financial condition is not good but she is managing with a minimum of resources and working as a cook.
Analysis:
In the 5th Organon Hahnemann said it was necessary to understand the exciting causes of acute diseases and chronic illnesses which are often due to the miasms. In order to remove all the symptoms of a chronic disease it is necessary to remove its cause. If only one aspect or another of the underlying disease state is treated the illness will either be suppressed or palliated. This patient’s case is chronic and has sycosis as the fundamental pathology considering tissue changes and her disposition. The pelvic inflammation she suffered 5-6 months ago was suppressed, especially the discharge. We know that after such an attempt to suppress, the destructive progress of the disease becomes more rapid and often leads to malignancies.
Since childhood she had developed disliking for her siblings in the form of jealosy and contrary behaviour which resulted in quarrelsomeness.
Miasmatically in this case we need to treat:
The sensitivity of the patient should be addressed along with the cause and changes in her pathology. The changes in the ovary in the form of a cyst are at the level of the endocrine system, 5th Layer as per Dr. Vijayakars theory of suppression. Miasmatically this disease has already bloomed and as of now there is no use hunting for the cause as per foot note 120.
.Sycosis is nothing but developed Psora as stated in app 81, so we need to take care of Psora basically i.e basic disposition and sensitivities.
The remedy required for this constitution should be: hot /thirsty, jealous and with contrary behavior. I deduced that the patient is jealous after coming to know that she hates her siblings if they get more love or respect. She is easily offended if if things are not done according to her wishes. (sensitivity + jealousy)
Rubrics Selected:
Offended Easily, Jealousy in Children – In general she is a sensitive child since the beginning who developed jealousy toward siblings later on.
Calcarea Sulph is selected (a) as there is strong tendency of jealosy which took the form of sibling rivalry.
(b) She took stand for her point of view in having a love marriage and convinced every one, ie a courageous personality.
(c) Tendency to characteristic yellow discharges
(d) Hot/Thirsty
We have taken one innate character and one physical tendency and differentiated on the basis of generals. In those cases where structural changes have taken place, less and less physiology is involved. In sycotic cases where there are growths or looseness etc., the emotions and mentals are less important. We have to consider tissues and the cells and innate characteristics of constitution.
Note : If at places physiology is involved, we have to take into consideration the exiting cause App 5.
Rx _ Cal Sulph -200 (1) on 26/02/18
First Follow up: 16/02/18
Two days after the first dose, bleeding started decreasing and on the fourth day bleeding stopped completely,
Indigestion for a few days
Rx _ Sac Lac two weeks
Second FU: 01/03/18
Indigestion>>
Aphthae mouth inside lower lip for a few days
General Condition better
Rx _ Sac Lac four weeks
Third FU: 30/03/18
Aphthae mouth >>>
One eruption in urethra with itching for five days
Hand dorsum eruption itching
Tongue clean
Menses on 12th April, flow for 2 days, dark red clotted blood
Dysmenorrhoea >
Pain epigastric region
No need to worry about these eruptions coming temporarily for short duration, as it is exteriorization of illness. Most importantly, this time menses remained for two days only and her general condition was better.
Rx _ Sac Lac four weeks
Fourth FU: 01/05/18
Menses on 14th May – duration four days, no clotting.
Dysmenorrhoea >>>
G C >>>
Fifth FU : 04/06/18
Ultrasonography absolutely normal
Uterus slightly bulky and antiverted
B / L Ovaries normal in size and shape.
No cyst seen.
Rx _ Sac Lac four weeks
Sixth FU : 20/07/18
General improvement >>>
Rx Sac Lac four weeks.
