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Case Study

How a Rubric Reveals its Essence
Dr M O Mini

Mrs. NM 26, a mother of a 1-year-old son, came to me on 7th sept 1996, with the complaint of Dysfunctional Uterine Bleeding since 8 months.

She was tall, thin, smartly dressed, soft-spoken but blunt. She sat demurely while giving a detailed history. Beginning her cycle in Feb, she had excessive bleeding - pale blood, anemia, weakness, emotional upset and anxiety. After 2 months she was advised by her Gynecologist take hormonal tablets and go for D&C. After D & C, her bleeding stopped for one week and then restarted. Disgusted, she stopped all her medications for one week and then came for Homoeopathy. USG - NAD. Her other problems were numbness, tingling of soles and fingers, painful legs and constipation.

Life Story - She has pleasant memories of growing up and recalls a loving home and childhood. Both her parents were domineering and 'ruled with love'. Occasionally had fights with her sister but was very close to her. Even to this day she cannot tolerate being separated from parents for a long period.

She was married at the age of 20. Her husband is domineering and dictatorial. He never took responsibility for his part of the partnership. She describes her marriage of 6 years as being a 'one-sided marriage.' She always had a healthy sex drive. Her desire for love and affection always had gone abegging. Her husband used to maintain his ego, independence and separateness. This lack of intimacy has been difficult for her. She always desired a strong shoulder, which she does not get from him. The dream she had about marriage was destroyed by his loveless and isolating behaviour. She felt lonely and insecure with him. The only prize she got from the one sided marriage was her son and she dreads a second pregnancy for this reason.

Food - Desires salt, fish, milk, chocolate, garlic, ice-cream
Aversion meat, sour, spicy.
Hunger: increased
Thirst: High for cold water
Stool constipated
Urine NAD. Perspiration increased.
Surgery: MTP& D&C
Menses: regular up to Jan 1996 when she had menses; no pain no other complaint
Sleep: disturbed.
Fears: bridges, cancer, elevators, robbers, etc.

Discussion: Nat-mur was just jumping out from the pages. She is quiet, with dream sympathetic, craving love and affection; she prefers to be alone but becomes attached. Soft spoken, loving, like's consolation. The self-containment of her emotions and the inner loneliness all speaks quietly of Nat-Mur. Additionally she is extremely sensitive to the feelings of others. The concern for her husband's fragility after family stresses and other financial problems exemplifies this strongly. In addition to these mental and emotional symptoms, her physical and general symptoms also support Nat-mur. She has had headaches, short sightedness, chronic constipation, she loves fish, salt, garlic extreme thirst, disturbed sleep etc.

I started with Nat- mur 200 then 1M with reasonable intervals. The patient used to call me on telephone daily. There was no response even after waiting for a considerable period of time. She was much anxious about her condition. Every day she enquired about the serious conditions associated with uterine bleeding, the possibility of D&C, USG, and Biopsy etc. everytime I reassured her with soft words and she was profusely thankful to me.

One evening she told me about her superior officer. A 37 years old married man having a child. With a smile she added "I feel safe, I feel free, I feel happy with him. Leaning from the chair and holding my hands warmly she whispered "he loves me too much, that he never compelled me to sleep with him" [Recall she has had no boyfriends before or after marriage. I enjoyed just seeing her so happy]

Suddenly the question arose whether this was really a case of Nat- mur? Yes I have ignored the sexual interest and the out-spoken behaviour of this lady and put my prejudice on many points in favour of Nat- mur. She has always had a healthy sex drive throughout her entire marriage. She even complained that with her husband that her craze for love had gone abegging which had been hard for her self-esteem. Once she pointed out that she waits to hear the sweet romantic words from his lips, which she always used to whisper in his ears in bed. But her husband opens his lips only to order her. These words clear out the patients desire for sex at emotional level.

Typically Nat- mur lady has decreased sex desire and often has aversion to coition. It is common to have vaginal dryness and dysparunia. 
Another very important aspect of her nature that I find different from Nat- mur is her very closeness with her senior officer which is very uncomfortable for a Nat- mur patient as she fears that it may rupture the wall around her sensitive and vulnerable emotions.

Also her open nature: she spoke so freely with happiness, even though she has a child and a domineering husband and is a member of an orthodox family. She knows that her husband can easily walk out on her and she is afraid of her family's disapproval very much. She is less aware and easily forgetful nature of patient. That changed the essence of the patient. The little ability of the patient to protect herself from the emotional vulnerability, the easy and outgoing nature of Phosphorus.

For the 2nd prescription I considered her enjoyment in sex, desire for sex and expression of love at the emotional level. The easily spaced out nature, the beautiful phrases of her love, the easily forgetting nature, over sensitiveness to others feelings and her self-containment of emotions are other pointers. The strong anxiety about her health, possibility of serious condition associated with her illness, her vulnerability to suggestions, are also relevant.

Important Physical symptoms of Phos:

·         Tendency to hemorrhage

·         Thirst for cold drinks

·         Desires ice-creams, salt, fish, sweets, chocolates

·         Disturbed sleep, fear of cancer

She was given Phos 200 and 1M with reasonable intervals.

Follow-Up: Bleeding stopped immediately after the 1M dose. She woke up with ease, got peaceful sleep, she reported being mentally stronger; she reads, writes a lot, has been laughing a lot more. She says she feels so much better. Her overall energy has markedly increased.

Follow-Up After 6 months:
Menstrual cycle returned to normalcy. Her bowel symptoms cleared. Pain in legs, numbness also cleared.
After 18 months- 7th March98
Her menstrual cycle is normal. No particular complaints. Her energies still fantastic. She is involved in a lot of activities. She has made many friends. Now she has started writing her first book.