Date: 09 Jan 2016, Mrs. PPK, age-53yrs, education- matriculation, married since 33yrs.
Chief complaints: stitching pain in head with sensation as if head would burst. Aggravated since 5 days and not ameliorated through allopathic medication. She has left sided pain which is ameliorated by bandaging head and a keeping scarf over sore eyes.
She ‘s been suffering from headache for 33yrs. It started after marriage but symptoms were not as severe as the last 1 ½ years. It is now continuous daily. In the past there was generalized pain in head with severe aches in posterior side of neck and back muscles, with stiffness which was aggravated in morning on waking and was ameliorated by pressure and massage and with activity.
She had intense palpitation when headache was anticipated with copious perspiration even in cold weather. During headache her appetite becomes ravenous and she eats voraciously every half an hour, which lasts for 4- 5 days. After that she feels vertigo as if turning in a circle which is aggravated by lying on bed and turning and ameliorated by lying on her side.
She attended many funerals in these 1 ½ years, sometimes every 15 days. It is common to take a bath after a funeral and the patient’s headache started every time she attended a funeral and after washing her hair. Her sleeps was disturbed and she cannot sleep until 2:30 am. I inquired about any special dreams. She told me that she is religious and inclines toward religion related dreams. Sometimes she can foretell incidents that will happen in the next two days, especially about death.
She dreams about accidents or other incidents. For example, in dreams she sees rituals which are performed after death. Initially she did not understand the meaning of such dreams and asked to her father in law, who said it may be someone is dying, and truly this incident happened in 2-3 days. I thought maybe it was coincidence and questioned her about how she came to know who is dying. She said that she doesn’t know but if it is not clear in dreams, then it must be that she feels intense desire to meet this person who will die. She doesn’t understand why she wants to meet this person to whom she is not acquaintance. Due to such thoughts she becomes restless for a day or two. The person she dreams of dies in one or two days. This was verified by her family. This caused her great suffering so she cannot be at peace.
Associated complaints: She had urogenital complaints since 15- 20 years. This problem was severe and she cannot control urine and it passes involuntary in profuse quantities with burning sensation. Along with urinary infection she had leucorrhoea with pain in lumbar region with general body ache. Leucorrhoea is so profuse and causes itching in genitalia with foul odor.
Life space investigation: She was born into a rich family who were strict with their daughters. Her father was alcoholic and had extramarital relations and she observed his harsh nature of father towards her mother. Her father was murdered when she was in 5th std. Afterwards her mother took care of the family including two sisters and one brother.
Her father in law was of orthodox nature. He put restrictions on who enters when unknown people visit the home. She feels the father in law was of a suspicious nature. She was not allowed outside alone and nor to laugh loudly. She felt a lot of stress at that time. She feels it is better to die, than to live such life. Her husband was understanding and supportive. They left the family and live independently. She feels guilty about her husband as she separated him from his parents.
She delivered four daughters normally without complication, but three abortions in which two were spontaneous at 3rd month. The third abortion was a male baby at 7th month. One male baby died soon after difficult labor of breech presentation. This was a very sad state of mind for the patient, that none of her male babies survived, even after great care. At the seventh month abortion she did gender detection through sonography and after that bleeding started. The baby was decomposed which poisoned the patient and she took a month to recover.
She attended funeral of her sister’s son and her problems worsened after that. This young man had been was very dear to her. He repeatedly asked the patient to adopt but her husband was against it. He was admitted in hospital and she could help him by spending some money but she was not an earning member of the family.
Menstrual history: no menses since one year. Earlier she had headaches 2-3 days before menses. Her breast becomes sensitive and engorges with hardness 8-10 days before menses. Menses was regular with 3 days duration.
Family history: GM- Vitiligo, GF- Asthma, mother- corneal opacity, daughter- migraine and corneal opacity, Vitiligo.
Patient also has corneal opacity since childhood as her mother and daughter had same problem. Vision of both eyes are dim. She cannot read newspapers or cards.
Investigation: 11/09/2014: CT BRAIN, USG ABDOMEN and ECG scan done which is normal. 30/05/2013: urine culture- no growth, 31/05/2013: Urine Routine- Pus cell-plenty, cast-pus cell, amorphous, albumin-+++, 21/06/2013: urine Routine- hazy, alb-traces, pus cell-14-16, RBC-2-4,
She is a chilly patient.
Treatment taken: Allopathic medicine caused a hypersensitivity reaction, including angioneurotic edema and urticarial eruptions since 3-4 years, hence she avoids it mostly. She consulted a neurologist and took treatment one year. The headaches improved but she had severe aggravation of urinary problems
In childhood, despite of all material wealth she was dissatisfied. Extramarital affair of alcoholic father, harsh behavior of father towards her mother and later her father was murdered. After marriage her husband was a source of love and affection but the father in law put restriction on her against her wish for freedom. This was reflected in her headaches. In such environment she conceives a baby.
She doesn’t feel any emotional disturbance during and after delivering a female baby but an emotional surge occurs after abortion and stillbirth of the male baby. She had had a strong desire for a son. This is confirmed by her thought of adopting the sister’s son, even though he was alcoholic.
Now consider if a person has not proper understanding and her desire is swaying like uncontrolled wind that causes destruction wherever it went. In this patient her main functional organ which can satisfy her desire is urogenital tract. The major impact of destruction urogenital with repeated infections, uncontrolled burning urination and profuse leucorrhoea. Sensitiveness of breasts and headache before menses was an indication that her physical system was sick. Whenever abortion or death occurs it creates a lot of suffering for her.
Now let us study how desire for son creates fear, which helps patient to familiarize herself with the death process. The death process does not make much impact on an individual unless it is very important for them. This was also true about our patient but her desire for a son made the difference here. This makes her apprehensive and cautious and especially to the prior condition of death so that she can prevent abortion. Her consciousness threshold was increased for the death process. This takes the form of predicting death through clairvoyance.
Now her desire becomes a continuous stream of consciousness concomitant with clairvoyance, excessive sweating, and ravenous hunger resulting in neurological problem like migraine headache.
ESSENTIAL EVOLUTIONARY TOTALITY
Let us study the whole evolutionary totality. Mother, patient and daughter have corneal opacity which indicates Syphilitic predisposition which is irreversible pathology inherent in the gene structure. Another predisposition is Sycotic indicated by asthma and vitiligo. Her reaction to father’s history and FIL’s restriction indicates her passive aggression of repulsive behavior and suppressed anger. This also indicates her sensitivity to dominance. The continuous source of activity was her desire for a son which is Psoric. This desire went into her subconscious as dreams of dying persons and clairvoyance. The result of this process is migraine headache, urinary tract infections and pelvic inflammatory diseases. Syphilitic genetic predisposition and irrational psoric desire combine to create repeated abortions. Hypersensitivity reactions to drugs are due to Sycotic predisposition in family. Sensitiveness of breast before menses is also a characteristic expression in this case.
REMEDIES FOR DIFFERENTIATION:
Calcarea carb, Carcinosin, Staphisagria
In my academic dissertation I have included 3 cases of Carcinosin. Repression is another coping strategy I observed in my study. Dominance from people are mostly intolerable to them and such people take a more compassionate approach to such situation. Sadness and anger are mostly repressed. Carcinosin is not proved like other polychrest remedies, hence clinical data are mostly relied on.
Calcarea carb is another remedy similar in aspect but it is more at the tissue level as per neurological head complaints and physical generals such as menses and perspiration.
The Staphisagria totality does not cover her coping strategy and sensitiveness.
REMEDY SELECTION AND FOLLOW UP:
I prescribe Carcinocin 200 single dose at bed time with placebo for 7 days. She does not experience headache and leucorrhoea in first 2 days but it again starts but with low intensity. In next follow up for 7 days I prescribe Carcinocin 200 for 3 days at bed time – 3 doses in a week. She does not experience headache except when she travels. No leucorrhoea while taking 3 doses but traces afterwards. No palpitation, voracious hunger and sweating during headache. She visited me for follow up on 4th February 2016. She said that 5 days before she experienced headache when she was in temple MATH. In the same afternoon she got news of the death of a relative. In the evening the headache was severe with traces of leucorrhoea; at night she took one allopathic tablets. In the morning headache was relieved. She attended a funeral but had no headache since.
Now she is much relaxed as no such anticipation about occurring death in relatives and no inclination towards dreams. On 13 February she got acute complaints of vertigo, pain in neck with increased thirst which was relieved by Bryonia 200 QDS for 2 days. Afterwards she was on Carcinocin 200, 3 doses for the week and afterwards no complaints of headache even though she attended a funeral and got her head wet. No urogenital problems and no clairvoyance about death. Last month she complained of dental sensitivity that she had many years ago. She also spoke of bleeding gums, I prescribed Mercurius sol 200 one dose every night which relieved her sensitivity but aggravated an ear problem which she hadn’t reported previously. An old purulent discharge of chronic suppurative otitis media came back and this time I prescribed Chamomilla 200 QDS for 2 days followed by Mercurius for the old syphilitic miasm in background. Now she is overall better and enjoying health.