Female – age 54
Presented – 14. 08. 2012
Main Complaint – Facial neuralgic pain
Occupation – Company director
This tall, slim, attractive, well dressed woman presented with facial neuralgia, accompanied with a severe red rash around the left side of her chin extending to the left side of her face and neck. Her G.P. had diagnosed Herpes Zoster (Shingles) and had prescribed a course of antibiotics, which had no effect.
Her medical history revealed that she had chicken pox and measles as a child and asthma up to her mid teens (treated with steroids). Both parents were deceased; her father died of a heart attack at the age of 62, her Mother died in a car accident at the age of 64. She was an only child and feels that she had a good childhood but admits to being a ‘bossy’ child who did not like school or university, often rebelling against authority. “Even now I could not stand to work for anyone else. I need to be my own boss. I don’t take kindly to being told what to do”.
I asked her to tell me about the pain and when it first started. She explained that the pain occurred quite suddenly about two months ago when her partner touched her chin. “It was like an electric shock”. The rash followed about two days later.
What makes the pain better/worse?
The pain is worse when she touches her face or eats something. Cold water helps but the pain returns soon after. She also says the pain is worse when she is stressed and first thing in the morning when she wakes.
I asked her to tell me about the stresses that affect her.
The stress she feels now is mainly with her husband and also at work. She believes her husband is having an affair and that her business partner is stealing money from the company.
I questioned further and she revealed that the pain started after she accused her husband. She was out of control, screaming and hitting him and he tried to calm her down, touched her chin and the pain started immediately. “He didn’t hit me, he only touched my chin”. She says she is calmer now but still mistrusts him, often checking his mobile phone messages. She is also convinced that her business partner is stealing company funds. “I have nothing to go on but I don’t trust her at all. I will catch her one day”.
Apart from the facial pain, how does all this stress affect you?
She explained that it made her angry and aggressive. “I will get them back for this, I will have my revenge”.
I asked if she had any other current health problems.
Her other problems are flushes of heat, mainly in her face at various times during the day. She has icy cold hands and feet which she puts down to poor circulation. Her sleep is not good, often waking unrefreshed. She says she feels weak in the morning and needs time to ‘come round’ before tackling the business of the day. She feels better as the day progresses and can be quite busy and energetic. She usually goes to bed around midnight and when in bed can sometimes feel a tightening in her chest around the heart region.
And in the past?
Her Menses have been absent for around twelve months but she used to have very painful periods when she was unable bear any tight clothing around the abdomen. She also suffered from P.M.S., experiencing left sided headaches as well as becoming depressed and irritable before her period. She tends to over indulge with alcohol, especially white wine, and loves to eat pasta dishes She comes across as a very intense woman who hardly stopped talking throughout the consultation.
Using Dr Herscu’s system of analysis by cycles and segments I put the following rubrics into five segments that exemplified this patient. (To understand more about this system of analysis please read the other articles or visit www.nesh.com)
Skin. eruptions. herpes zoster
Skin. eruptions. herpetic. red
Mind. Hatred. revengeful. hatred and.
Generals. heat. flushes of. daytime
Face. heat. flushes
Generals. weakness. morning. waking on
Mind. jealousy.quarrelling. reproaches and scolding with
Mind. jealousy. strikes his wife. driving to
5. Constriction/Closing off
Chest. constriction. heart
Extremeties. Coldness. icy cold
Upon repertorization five remedies were present in all five segments.
Arsenicum, Causticum, Lachesis, Lycopodium and Rhus tox
I discounted Arsenicum, Causticum and Lycopodium as they did not fit the overall picture of the patient. Rhus tox is of course one of our biggest ‘Shingles’ remedies but again the remedy picture did not fit this patient. Lachesis however contains many of the keynote symptoms of the patient, in particular the loquacity, left sided symptoms, sleeping into an aggravation, the flushes of heat, the suspicious/jealous/revengeful nature, the history of painful periods, the intolerance of tight clothing and of course the intensity showed by the patient.
Lachesis 200c, one dose
Follow up after one month:
The patient reported that after an initial slight aggravation the facial pain and rash was 90% better and improving daily. She only occasionally felt the constriction in her chest. The flushes of heat had disappeared and she felt much better and calmer than before. She felt foolish for doubting her husband and their relationship was improving. She was still mistrustful of her partner at work and was conducting an investigation.
Watch and wait, the patient is improving on all levels.
Follow up after three months:
All facial pain, rash and constriction in chest have now gone. Her sleep has improved whereby she now feels quite refreshed upon waking. She feels more settled in her life and her relationship with her husband is good. Her partner at work was indeed stealing money and this situation is now resolved. She has no new symptoms to report.
Close case and advise patient to come for a checkup in six months.