Alopecia Universalis
NATIONAL JOURNAL OF HOMOEOPATHY 2004 Jan / Feb VOL VI NO 1.
Dr Bandish Ambani
'Medo

A girl aged 12 yr came to me with the c/o of loss of hair first on the scalp, then eyebrows and lastly from eye lashes. She had another complaint of bedwetting. Allopathic treatment had been taken including steroid injections to the scalp, but to no avail. Since she was very young, her parents were very worried.

PHYSICAL GENERALS:
APPETITE: Voracious, can eat even after a full meal.
THIRST: Unquenchable.
STOOL: Normal.
URINE: Bedwetting, daily 2/3 times in a night.
PERSPIRATION: Profuse.
CRAVINGS: Cold drinks, ice-cream, chocolates, rice, chinese food. in general fond of all kinds of food.
AVERSION: Sweets.
THERMALS: Hot.
SLEEP: Sleeps on the sides, talks in her sleep.
DREAMS: of God.

PHYSICAL CONSTITUTION:She was obese since birth.

LIFE SITUATION: She was a school going girl, average in studies. Not at all interested in studies. She had poor memory, was forgetful, made mistakes while writing and had poor self confidence. She was also poor in mathematics. She was a very pampered and protected girl by all her family members especially the grand parents. She was a lazy and indolent girl.

MENTALS: A very obstinate and stubborn girl. She would have to get whatever she wanted at that instant only. The parents gave an example: the girl came to my clinic for treatment, if first they took her to a Chinese restaurant and fed her. She would weep easily at small matters-liked to be consoled and wanted sympathy from others. She was very sensitive and there was tremendous attachment to all her family members. Though, 12, she behaved like a younger child; childish, liked to play only with younger children so that she could boss them. Nervous before examinations and stage fear. Though, she liked dancing, she would not go and perform on the stage. She liked music very much.
Very fearful from childhood- fear of dark,wanted lights on at night; would never stay alone; fear of dogs and watching horror shows on television, yet watched them in daytime with subsequent nightmares at night. Very loquacious, yet during the interview, I observed that she was quite abrupt and at times rude. Rude even with grand parents.
Very careful of her things and liked everything in order.
A very religious girl, she would pray and go to temples regularly. Does not like tight and rough clothing. During the history taking it was observed that she did not like it when mother narrated her negative points and immediately contradicted. Very fidgety, constantly moving her hands or legs and at times making faces.
The following symptoms were taken for repertorization:

·         Fear dark, alone, animals, and dogs.

·         Weeping at trifles

·         Weeping children in

·         Rudeness

·         Forgetfulness

·         Confusion of mind

·         Memory weakness

·         Timidity

·         Dancing

·         Obstinate

The remedy given wasStramonium 1M 1dose. She started improving; hair started growing on the scalp, but no growth on the eyebrows and eyelashes. So is this follow up good or bad? Most people will answer this as good follow-up as the hair has started to grow from above downwards that is according to the Hering’s law. The Hering’s law of direction of cure states that the cure should take place

·         From above downwards

·         Inside out

·         Centre to periphery

·         From important organs to lesser important organs and

·         In the reverse order of the appearance of symptoms.

Hering’s law has multiple corollaries. We do not know which corollary is to be given more importance. In some cases, a cure takes place from above downwards and in others from inside out, which is the right direction and what is more important? Which organ is more important and which is less is decided by embryology: the order in which the organs have developed, its function and origin from the particular germinal layer. Hence, the correct direction of the Hering’s law of cure is:

·         From important organs to lesser important organs

·         Inside out

·         Centre to periphery and

·         In reverse order of appearance of symptoms.

To this Dr Vijayakar has made the following additions:

·         From more dangerous Miasm to less dangerous Miasm

·         From important organs to lesser important organs

·         From above downwards

·         Inside out

·         Centre to periphery and

·         In reverse order of appearance of symptoms.

So in this case, the follow-up is not right, even though the direction of cure is from above downwards. The function of the eyelashes is protection of the eyeballs, it prevents the dust particles from entering. The eyebrows are there to prevent the sweat from going into the eyes. The hair on the scalp is only cosmetic and hence less important than the eye brows and eye lashes.

Other Examples of the Right Direction of Cure: In Asthma, breathlessness should improve and then cough should start or increase, followed by throat irritation, followed by sneezing, finally, ending in skin irritation. Not every lesion on the skin is a good sign, for eg Skin flaking and peeling in psoriasis after gastritis or bronchitis is a bad sign as the flaking of the skin is due to the excessive irritation of dermis, which arises from the 3^rd layer, the connective tissues and the gastritis and bronchitis means involvement of the lining of the gastro-intestinal and the respiratory tract respectively. Also, development of hypo-pigmented patches of Vitiligo on skin after joint pains or asthma is not at all a good sign.
Thus, the prescription here was partially similar. The mistake was that the symptoms taken for prescription were all mentals and only represent the emotions and not the basic characteristics of the patient. Physicals were not considered-the thermals, cravings and aversions, etc. And miasm was not considered for the prescription.
If prescriptions are not holistic, then at best we can only arrive at the partial similimum instead of the correct genetic constitutional similimum. I reanalyzed the case.

On Re-Analysis
She was becoming backward in her studies. Before the remedy,she was failing in 2 subjects but now she started failing in 5 subjects; marks scored were less than what she was scoring before the treatment. I had to increase the potency as well as repeat the remedy more often to continue the same progress as before. Also, she was more lethargic and dull. Her bedwetting also was recurring on and off.

After the right similimum, within 15 days the eyelashes started growing. Her Alopecia totally improved in about 3 month’s time. Her bedwetting stopped completely. She improved in her studies and started passing in all her subjects. She became less lazy and indolent. She also became less rude and her speech was less abrupt.
The following symptoms were taken for Repertorisation. This time, the physicals and the other basic characteristics of the patient were also taken into consideration.

Mentals

·         Fear, dark, alone and dogs.

·         Weeping in children.

·         Weeping trifles at.

·         Anticipation.

·         Anxiety-anticipating an engagement.

·         Confusion of mind.

·         Forgetfulness.

·         Weakness memory of.

·         Rudeness

·         Abrupt

·         Timidity

PHYSICALS

·         Physical constitution-Obese

·         Thermals-Hot patient

·         Cravings-Ice cream

·         Aversion-Sweets

The remedy given was Medorrhinum 1M 1 dose
The mistake that was made was that a chilly remedy was given to a hot patient and above all the miasm was not matching.
The following is the comparison table of the remedies Stramoniumand Medorrhinum

Stramonium Fear dark, alone, animals and dogs. Weeping at trifles Weeping children in Rudeness Forgetfulness Confusion of mind Memory weakness Timidity Dancing Obstinate Chilly patient Craving-Sour, Chocolate Aversion-Water Chilly patient Speed-Fast Miasm-Psoric and Syphilitic

Medorrhinum Fear, dark, alone, dogs. Weeping at trifles  Weeping children in  RudenessForgetfulness.  Confusion of mind  Weakness memory of.  Timidity  Anticipation, Anxiety-anticipating an engagement.  Abrupt Obstinate  Obesity Hot patient Cravings Ice cream Aversion sweets  Hot patient Aversion sweets  Speed-Slow  Miasm-King of Sycotic miasm

The overall picture of Medorrhinum is as follows:

MENTALS

1. Anxiety, anticipating an engagement.
2. Anticipation, ailments from anticipation.
3. Anticipation for matters before they occur and generally correctly.
4. Clairvoyant, presentiment of death.
5. Anxiety of conscience, as if guilty of crime.
6. Anxiety, time is set if a.
7. Weeping, children in.
8. Weeping, easily.
9. Fear dark, animals, dogs.
10. Abrupt.
11. Rudeness.
12. Fear, misfortune, of.
13. Fear, death, of.
14. Hurry.
15. Time passes too slowly, appears longer.
16. Egotism, self esteem.
17. Washing always her hands.
18. Sensitive, reprimands, to.
19. Delusion, that someone is behind him
20. Memory, weakness, loss of.
21. Confusion of mind.
22. Forgetfulness.
23. Timidity.
24. Jealousy.
25. Kill desire to.
26. Love animals for.
27. Cruelty to animals.
28. Dreams, of ghosts (Kent); dead people.
29. Dreams, she is drinking (Boericke).
30. Responsibility, averse to.

PHYSICALS
CONSTITUTION: Dwarfish, stunted.
GENERALS:
1 Appetite-Ravenous hunger even after eating (Kent).
2 Thirst-Unquenchable.
3 Cravings-ale, fruits green, oranges, potatoes, sweets, sweet and sour, sweet and salty, combination of sour, sweet and salty, ice, ice cream.
4 AVERSION-Sweets
5 PERSPIRATION-Yellowish staining sweat
6 SLEEP-on abdomen or knee elbow
7 MENSES-Profuse, offensive stains difficult to wash off (Mag-mur).
8 THERMALS Hot-uncovers body or feet.
9 MODALITIES > sea shore, < cold, damp weather, < daytime, sunrise to sunset > night
10 Restlessness, especially of the legs (Zinc.).
11 Soles-Burning, wants them uncovered and fanned (Sulph).

CONCLUSION
The prescription always has to be holistic considering both,the physicals and mentals. If that is the case then the results are very fast, permanent and according to the right Hering’s law.
Hering’s has to be properly interpreted and the importance of the corollaries has to be decided, according to embryology and the development of the human being.
Strong physical generals like the thermals and the thirst cannot be ignored and a hot patient cannot be given chilly remedy and vice versa. This also applies to the speed of the remedy where a fast remedy cannot be given to a slow patient and vice-versa. The most important point being that the remedy that is selected should cover the miasm of the patient and the disease. If the remedy does not cover, the miasm then the disease tends to recur and permanent cure is not achieved. The remedy, that is given as the constitutional should cover the miasm and then only the remedy will be the correct constitutional and will act curatively.