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Case Study

Sterility Case
Dr Sudhir Joshi
'Nat-m / Calc-flour

Mrs D, Hindu Anavil Brahmin 39 yrs, B Com, Housewife Married since 1997, lives in Navsari
Spouse: Mr S: 39 yrs; a Bakery Manager
Father: 69 yrs has a Factory at Baroda
Mother died
Brothers 41 yrs and 32 yrs. Sister 42 yrs All married
Case defined on 8/2/02

1. Female Genital System
Primary Sterility
2. GIT Burning < Fasting3
4 yrs Sour vomit < 2 p m
3. GIT Gases < sleep loss
Constipation > Digene
4. Head Pain < Fasting3
Rt.temple Throbbing3 < Afternoon> vomit after 8 yrs Vertigo
> Tab.Senec
> Ayurved tab
< Before menses3

Patient as a Person
Stocky, Greasy complexion.
Thermal state: Chilly.
Perspiration: Profuse especially in Summer.
Appetite: good.
Cravings: Spicy, Salty, Coffee, Masala milk.
Aversion: Plain milk3.

Menstrual Function:
FMP:15 yrs LMP:23/01/02 Regular Scanty.
Before menses - Rt. Temporal headache3.Breasts tender.Lower abdominal pains.Nausea, Acidity.Irritability, No desire to talk.Uneasiness.
Leucorrhoea <sex after Smell offensive+ With itching .Associated with Backpain,lower limbs pains.
Sexual Function: can not enjoy if tired Semen dribbles out soon after.

Family History
Mother died of Blood cancer.
Sister: Bilious headaches.
Brother: Gall stones and Oligospermia.

Ovulation usually on 18th or 19th day
10/1/00 USG: Pelvic Endometriosis.
24/3/00 Post coital test Cervix 10 to 15 actively motile sperms. Vagina: no sperms seen.

Age 39 yrs Salary Rs 4000 per month.
Caste: Anavil Brahmin.
Brothers: Two elders.

1. Male Sexual system Primary sterility
2. GIT Burning < Fried food
10 yrs vomit sour < outside food
< loss of sleep
3. Head Pain < sun

Patient as a person
Perspiration: profuse all over Sour.
Appetite: Always hungry.
Cravings: Spicy, Sour, Pickle, Papad Manikchand (12 to 15 yrs)
Aversion: Sweet.
Sexual function:
Desire Good.
Frequency 3 to 4 time per week.
Premature ejaculations almost in a minute
Pt feels that semen is thin
Wife will not cooperate if tense
Thermal state: Ambithermal.

Past history: Appendicectomy at 17
Family history: Fa died IHD and HT (2001)
Mo died CRF and DM (1998)
Investigations: Semen Analysis (summary )
Sperm concentration 15 to 62 mill /ml (funny to have range as value).
Normal forms 40to 70%
Abnormal forms 30 to 60%
Rapid linear progress 10 to 20 %
Slow linear progress 15 to 20%
Pus cells 2 to 15 / h.p.f

Life story
The wife comes from a upper middle class business family. Her father shifted to Baroda for better prospects. It was a close knit family. Life was smooth and devoid of any stresses at Baroda. Due to Mangal in the Kundali. (Hindus believe in horoscope matching. She had a small stigma called Mangal, which makes it difficult to get married, unless the boy also has same star.) Her marriage got delayed.
After marriage she came to a small village. Husband has two married elder brothers, Father and Mother. Eldest brother had transferable Govt. job so he never stayed at the village. He was a sort of independent unit who visits native place on occasions.
Soon after the marriage MIL had severe complications due to DM and needed frequent hospitalizations due to Renal failure. MIL died in 1998.
Pt’s second SIL was slow in all the household work. Pt. shared all the duties because she never liked to sit idle. She described her SIL as emotional with lot of attachments.

In 1999, the couple shifted to Navsari for two purposes. One, husband found a better job. Previous job was at diamond factory at Surat. Husband never liked that job due to poor pay scale. At Navsari he got the job as a manager of a bakery.
The second purpose was education of two nieces. Higher education was not available at the village.
Here Pt took the charge of the situation. Pt thought that it is her duty to teach them all the lessons of life. Pt. feared that if they will not score good grades she would be blamed. If they are well groomed it will look nice. So she started disciplining them in her own way, she would loose her cool easily if there was resistance, would shout loudly. Girls also had a habit of arguing, and that too in the native language and tone, which is quite rude. Thus these arguments became endless.
Pt felt that they watch TV all day and don’t do their work. She wanted them to study in TIME, do there own work independently and keep there things IN ORDER. At times Pt used to grumble long and irritably and had no idea what she spoke.
Pt admitted that girls felt guilty about it. The girls used to cook and do all the work in her absence.
Husband never took Pt’s side. He explained that the girls will not get spoilt if play for a while or watch a TV show. Husband told her that the aim of your life is nothing, but to find the faults in the girls and advice them unnecessarily. He advised her to take the things lightly and let them be. But she would always end the argument by saying ‘ I strongly feel that it is my responsibility to see that the girls don’t get spoiled’.
The elder niece (16 yrs) would argue "Why are you forcing us to do things which you have not done?’ With bitterness Pt replied ‘Times have changed , it is for your good’.
The atmosphere at home was always negatively charged.
Sexual pleasure also suffered because of vexed state of Pt and intense desire of husband to have a child. Pt told that for him sex is to produce child. Once I conceive it will be all over.
Above all this, Husband is finding this job very boring, with restricted financial opportunities. He has many plans and ambition with desire to earn lot of money. He could not go to college because....

The couple had come with a lot of hope. They had tried all the best Gynecologists in this area. This is the LAST try.
When we studied this case we could list complaints of Premature Ejaculation and Infected Semen in the Husband. With the wife: Delayed Ovulation, Adenomyosis Uteri and Dribbling of semen soon after. Above all, the level of active and hidden conflicts in the family at interpersonal and intrapersonal level.
While taking the case we could understand the chronic state of Vexation, Irritable mood and Guilt filled up the Mental state. Pt.felt herself extremely responsible towards nieces. She never got whatever she has desired. This increased her irritability further. She always projected it while relating with the husband. It has blocked all possibility of communications outside. She started doubting capabilities of husband. The couple never shared true HUSBAND-WIFE relationship.
During the discussion we focused on the effect of Negative emotions on the Endocrine system. We then very firmly put few questions eg ‘ What you have received after all thus intense efforts?’ What went wrong and Why?’ ‘Why no one is happy after all ?’ ‘Who is the true Mother?’
She told that she was playing a role of Foster Mother.
We told her no. You are Inspector and unless this Inspector is replaced by a true Mother you will not become a real Mother.
She was silent for few long minutes.
Then we added that if you can CONCEIVE this concept at your heart you may CONCEIVE actually.
She received it well in a positive manner and went out after a promise that she will CHANGE.
Husband was called to teach Sqeeze Method Exercise for Premature ejaculation. We also discussed few financial opportunities in the town. He shared his plans very freely. He was also advised to stop Manikchand (unche log nichi pasand) on insistence from Pt.

The Result
After all the data it was possible to Strcturalise and repertorise.
Mrs D’s totality.
Ailments from Anger Vexation.
Relaxation-vagina sphincter of (semen dribbling out).
Perspiration profuse.
Irritability Before Menses.
Agg Before Menses.
Headache accompanied by vomit
Cr: Salty Spicy. Av: Milk.
Remedy: Nat-mur

Mr S Totality:
Avarice Obesity
Sexual desire increased
Ejaculation, quick too
Perspiration: General all over
Fasting Agg. Always hungry
Cr. Sour Spicy Ambithermal

Remedy: Calc-flour.
We started the treatment with Nat-mur 200 3P weekly for the Pt. And Calc-flour 30 daily for the Husband from 8/2/02. There was overall improvement at all the levels soon after the few doses. The LMP was 19/3/02. Pregnancy test was Positive on 30/4/02.The entire pregnancy period was uneventful except Hyperacidity and minor complaints. At full term she delivered a very healthy baby boy. This action was Homoeopathy at its best, with proper counseling to the couple.