This is a case of vitiligo in a 45 year old male who came to me in August 2016. The patient presented with hypo-pigmented patches since 8 months.
Location – Head (right parietal area) and right lower part of the face.
Sensation – occasional itching
APPEARANCE OF THE PATIENT
*Dark complexioned, lax muscles, pot bellied
*Dark circles around the eyes
*Numerous moles and skin tags all over the body
*Very unkempt and haggard look
*Yellow discolouration of sclera
*Frontal baldness
OCCUPATION
He is a street vendor by profession. Has a sedentary job. Barely earns enough to support his family.
PHYSICAL GENERALS
Appetite- increased markedly; hungry soon after eating.
Desires- salty, spicy; chicken, fish, rice Thirst- 2-3 lit/ day; prefers room temperature water as he has teeth sensitivity.
Sweat – forehead, palms, soles, legs
Stool – D1N0; at times constipated; offensive
Urine – D4-5N0-1 ; offensive and dark coloured
Sleep – 5-6 hours; refreshing; on sides mostly or on back. Hypnic jerk during sleep
Dreams- of running, of falling, of people attacking him, of elephants.
Thermal reaction – averse to extremes of temperature. Gets shudders while he bathes with cold water. Likes fanning all through the year
Tongue – fissured
MENTAL GENERALS
*Gets offended easily
*Lacks confidence
*Finicky about cleanliness.
*Sexual desire increased
*Feels insulted when people contradict him.
*Worried about his disease.
*Dull intellect of late.
*Indolent, averse to any kind of work.
ON OBSERVATION
*Involuntary sighing while narrating his symptoms.
ANAMNESIS
The yellow discolouration of his eyes made me enquire about any history of alcohol intake. The patient remarked that he was a chronic alcoholic and he had a hereditary tendency to alcoholism. Prior to the development of this complaint, his daughter was married. He had to leave his house at that time for some reason which he did not disclose to me. However, when I asked about the effect of the whole scenario on him, he said that he felt angry and insulted. He said that he suffered from insomnia for almost a month and his intake of alcohol was increased during that period so that he was able to sleep.
In this case, as he was a street vendor (a general thought that struck my mind , knowing their habits and the easy access to such affairs), I asked him about any history of intimate contact outside, to which he agreed and exclaimed that this ailment started a month after that contact. He said that he felt really guilty after it.
PRESCRIPTION AND FOLLOW UP
The patient was prescribed SYPHILINUM in L.M. potency up to L.M.4 based on the history of outside contact, hereditary tendency to alcoholism and a craving for alcohol, fissured tongue, offensiveness, frontal baldness , and an obsessive desire for cleanliness. There was formation of islands between the lesions but the progress stopped after L.M. 4 (even after changes in frequency, strokes and cups and waiting for a considerable time period).
The case was taken again on account of the stasis that had come in the progress. It was discovered that the patient had recently visited his village, where he had to move around with a cloth covering his face, so that nobody notices his complaint as it was considered a sign of some sin in his village. He left his family and came back to Delhi as he had to face humiliation on a daily basis. He said that he felt terribly insulted and as he could not speak it out, he preferred to come back to Delhi.
On this basis I prescribed Staphysagria in L.M potency with great results.
Patient is still under treatment and his spots have become much darker. There is a general feeling of well being, and moreover he has a more elated expression on his face. This case has been followed for six months now.
REFERENCES
GUIDING SYMPTOMS OF MATERIA MEDICA – C.HERING
Indifference, low-spirited, dulness of mind; after onanism.
Sad distressing thoughts about one’s illness.
Aversion to mental or physical labor ; inability to think.
Hypochondriasis ; apathy ; weak memory ; caused by unmerited insults, sexual excesses, or by persistently dwelling on sexual subjects.
Great indignation about things done by others or by himself ; grieves about consequences.
Ailments from indignation and vexation, or reserved displeasure ; sleeplessness.
Continual concern about the future.
…was insulted, being too dignified to fight, subdued his wrath and went home sick, trembling and exhausted.
