The Tormented Wife
NATIONAL JOURNAL OF HOMOEOPATHY 1997 Mar / Apr VOL VI NO 2.
Dr Varsha Shah
'Mag-m

Female - aged 61 yrs, married for 35 yrs 

Chief Complaints
1] Pain in the knee joints, swelling ++ since last 10-12 yrs
Pain < on standing, < eating, < worries, < working in water, > tensions, > Hot fomentation > Rest
2] Oozing of blood from nipple, for which frozen section biopsy was done.
Histopathology Report - non-malignant Papillomatous growth.
3] Pain in calf muscles with sever cramps. Cannot stand. Nodular swelling in varicose veins.
4] Sudden giddiness and black-outs, often falls down even in bathroom. At times has hurt herself. Soon after marriage after 1 yr, she delivered her first son. Increased work pressure at home. Mother-in-law and sister-in-law used to torture her. She was not allowed to sleep with her husband. After sometime she was not allowed to breast feed her son because work would suffer. 

Physical Generals
Hot CH4
Feels excessively hot and wants full fan. Does not like to cover. Bath, tepid water excessive perspiration;
APPETITE - average; DESIRES- spicy, salt++; STOOL - tendency for constipation. URINE - occasional burning.
P/N/O MENSES: excess, clots ++ used to stain linen. 

Mind : In childhood she used to feel that her elder brother was given more importance. Elder brother used to dominate her. She could not speak about her desires to her parents. She used to take utmost care of her younger siblings. Mother used to beat all her children. After marriage she was dominated by MIL and SIL. Previously, she could not speak a word, now after so many years of suffering, speaks back, but then repents. Now at times becomes excessively irritable, at times stubborn.

Investigations : Hb -11.5 gms
RA Test negative
ESR - 25 mm of Hg
EEG -Shows epileptic pattern
Blood sugar - normal
ECG - shows a minor degree of Ischemic changes. 

Examination
BP: 130/90
O/E swelling of both knee joints, tenderness++, Varicose veins++. Multiple brown warts on abdomen.

Family History : Husband: 62 yrs. Son 1: 33 yrs. Son 2: 28 yrs
Mother: expired old age, rheumatoid arthritis with contractures. TB
Father: expired at age 54, sudden Myocardial Infarction
Brother1: 64 years alive chronic amoebiasis
Brother2: 55 years alive, suffers from diabetes and bronchial asthma
Brother3: 52 years alive, no major illness
Sister: 53 Rheumatoid Arthritis 

Past History : Child hood: had recurrent cold and cough, measles, chickenpox and also boils and eczematous skin eruptions++

Understanding Of The Case
Hot patient
FUNDAMENTAL MIASMS - Tubercular
DOMINANT MIASMS - Sycotic
1] Suppressions: emotions, sexual desires
2] Rejection or neglected feeling in childhood
3] Sensitivity++
4] Somatisation: spasms, pains, epileptic seizures
Considering the evolutionary aspects, life situation, physical generals, and degenerative changes at the level of knee joints and mental conditions, the remedy selected was....Mag-mur 200 To start with it was given daily at bedtime.
Slowly her anti-epileptic drug was reduced, she was on Epilex 1 tab TDS.

1] Acute totality. For joints pain in knee joints, Crepitus+ < movement, > rest, > warm application associated with cramps in calf muscles.
Mag-phos 200 every 4 hrly was given.
2] For acute severe bronchitis cough, cold with lower respiratory tract.
O/E: chest congestion++, Hot++, Ronchi++, Crepts lower base. Patient unable to cough easily. Antim tart 200 4 hrly.
Patient's treatment was continued for 4-5 months regularly.
Mag-mur 200 in infrequent doses, potency raised gradually to 10M 1 HS
Intercurrent antisycotic given was Med 1M [but after Med 1M [1], she had skin eruptions. Placebo given and observed, but the irritation continued.
Skin burning++, itching severe++ > cold, few doses of Calc sulph 30 4 hrly for 2 days helped her.
At times pains and cramps in varicose veins were very severe, unable to stand. Considering acute severity Vipera 200 was given, very few doses. After the treatment, there was no oozing of blood from the breast. Normal mammography report, with overall general improvement. The anti-epileptic drugs were reduced. She is still under observation. It was not easy to change patient's situation. This was the optimum cure achieved within the situation.

Case 2: Unwanted Child
Baby P, aged 8 yrs. Birth weight 7 ½ lbs.
Chief Complaints
1. Breathing through mouth since age of 6 months
2. Recurrent URTI

Starts with irritation in nose, itching, sneezing, nose block, < by ice creams, < by chocolates, < change of climate, < swimming, < getting wet in the rain, < cloudy weather.
Followed by red inflammed tonsils with difficulty in swallowing. Lt side more swollen. 
'High fever with difficulty in breathing starts at night, as soon as the child goes to sleep. < 11-12 midnight, with dry irritating cough.
On examination rhonchi++ which remains for 1-2 hours during the day but clears as soon as child moves around.

Family History
Mother aged 32 yrs a housewife is very strict and has an obsession for feeding the child forcibly. At times shouts and beats also. During questioning it was revealed that she conceived soon after 1 month of marriage, but both the parents did not want the child. The mother was ready for an abortion, but she was dissuaded by her sister who is also a Homoeopathic physician, that being a first pregnancy, MTP, was not advisable. Mother does not want a second child at all. 

Past History : Severe suppurated tonsils 2-3 attacks.
Father: 37 years. MCom LLB Diabetes, since 6 yrs
Grandfather: Died at the age of 74 years of IHD was a patient of Cardiac Asthma.
Grandmother: Alive 68 yrs no major illness.
Fathers sister: 45 yrs Mitral stenosis and was operated for it.
Fathers brother: 1 brother 47 epilepsy
2nd brother: 43 normal
3rd brother: 41 normal

Hot
Appetite : Average
Desires : Jaggery and salt+ but cannot eat spicy food.
Aversion : Milk
Stool : Sever constipation ++ no urge, at times fissure in anus redness++
Thermal : Bath-tepid
Cover thin cover likes fan, but direct fan or draft aggravates the cough.
C2H3 sleeps with mouth open
Dreams : Frightening ++ of TV serials. Wakes up during sleep. Grinding teeth at night. 
Dribbling of saliva at night.

Similimum
The dominant miasm is tubercular++. Based on the symptomatology the constitutional similimum is clear ie. Magnesium-mur.

Treatment : For the acute episodes the following remedies were also prescribed.
1. Tonsils Lt sided swelling ++ glands ++
Merc iod Rub 200 hourly
2. Lower resp tract: Antim-tart 200 and Mag- phos 30 was prescribed 2 hourly. Constitutional remedy and potency was raised to 1 M in frequent doses. Tub- bov 1 M was also prescribed as an intercurrent.