Date: 02-08-2019
A girl of 19 presented with complaint of severe dysmenorrhoea. She had visited gynaecologists in her city since menarche. She was carrying a bag of pain killers and oral contraceptive pills which always helped her temporarily.
Chief Complaint:
Pain in hypogastrium during menses since puberty.
Pain is spasmodic, cramping in nature.
Pain is so severe she has to lie down.
Mild relief by warm application.
Associated symptoms:
Severe nausea during menses.
Diarrhoea with abdominal pain whenever she eats pulses (edible seeds of plants in the legume family.
Gastric disturbance on and off.
Vomiting while travelling since her childhood even after taking antiemetics.
Menstrual History:
Menstrual cycle of 22-25 days. Recent menses date: 02-08-2019
Discharge: Profuse, reddish, clotted, smells offensive.
Duration: 7-8 days.
Sometimes metrorrhagia at 13th – 15th day with profuse bleeding like menses.
Physical General:
Built: lean, tall, with curly hair
Appetite: Good. Decreases during menses.
Desire: Spicy food, fermented food.
Stool and Urine: Normal
Sleep: Good. 6-7 hours
Mental Generals:
Ambitious: She is very ambitious. She has always been a topper since her kindergarten academically, as well as in other activities. For this she wakes up early morning and never sleeps until she finishes a whole day syllabus.
Fixed Ideas. She can’t change her mind. It’s hard to convince her of things outside her experience.
Easily affected by emotional scenes in movies. Cries easily.
Loquacious
Fastidious: She is very particular about her homework. In her writing we can’t find any mistake or correction on the whole page. If she makes any mistake she will rewrite.
Censorious: She is critical of how people dress, what books her friends read, how food is prepared etc.
Fear: Of falling – She never goes near the terrace parapet for fear of falling.
Repertorization:
Analysis:
Dysmenorrhoea with nausea, desires spicy food, concomitant symptoms of motion sickness, recurrent gastric troubles, ambitious, fixed ideas, emotionally sensitive nature, loquacious, fastidious. The reportorial totality led me to prescribe Nux vomica.
Prescription:
| Date | Complaint and Follow Up | Prescription |
| 02-08-2019 | Complaint described as above | Nux Vomica 200 3 dose
Daily once for 3 days |
| 05-08-2019 | Abdominal Pain same on 1st day.
Pain severity started decreasing from 2nd day. Discharge same as before – profuse. |
Placebo thrice a day for 15days. |
| 25-08-2019 | 1st day of menses:
Abdominal pain, lumbar pain, mild nausea, profuse menses, has to lie >applying hot water bag 4th day: Pain relieved completely. Nausea absent. |
Nux Vomica 1m 2 doses
in morning for 2 days. Placebo thrice a day for 1month. Advised hot water bag application |
| 19-09-2019 | 1st day of menses:
Abdominal pain slight, nausea severe, slight backache, can do her routine work. Menses flow slow. 3rd day: No pain at all. Nausea vanished. Feels fresh. Discharge- Less clots comparatively. Quantity less. |
Nux Vomica 1m 1 dose
Placebo thrice a day for 1 month |
| 14-10-2019 | 2nd day of menses.
Abdominal Pain bearable. Nausea absent. |
Placebo thrice a day for 1month |
| 14-11-2019 | 6th day of menses.
Daily medicine helped her. No need to take any doses. Can do routine work since 1st day of menses. She said that last week she travelled by car for 200 km without nausea. |
Placebo thrice a day for 1month
Nux Vomica 1m 2 dose SOS. Advised to stop medicine. |
She is in touch with me till today as her brother and grandma are also under my treatment. She used 1 SOS dose after 6 months of stopping treatment. She is absolutely normal now during her menses. Still ambitious, fastidious and enjoys her routine.
