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Case Study

The Fastidious Mother
Dr Vibha Shah

Introduction: This case had 2 unusual aspects of this case.

  1. Primarily the child (patient's son) was brought to me for treatment. During history-taking, it became obvious, that the mother's nature was responsible for child's anxiety state and anorexia with nausea and vomiting. This then made it mandatory for the mother to be treated. So I had to manoeuver her to opt for Homoeopathy, ostensibly for her headaches. Fortunately, she also developed an acute throat pain for which she asked for medicine. I seized this opportunity to take her case. This in ordinary parlance would be called patient- grabbing!!
  2. Then through her headaches, she had to be treated for her obsession with cleanliness. So this cannot be called a pure OCD case, like the other one I got in Feb this year, where the patient, a MBBS student, came directly for her OCD. That case is still under treatment and cannot be presented yet.

Case Mrs SR, 31 yr, started treatment on 26-3-96 with an acute throat pain since 4 days, pricking and poking on swallowing - whether saliva or pickles; > warm drink. She felt terribly weak and chilly with tongue dry and pain in ears and legs.

Other Complaints

  1. Headache since 1992, now continuous and constant with DNS and Nausea. Pain AF computers < reading, TV, sun, heat, afternoon, > sleep. The accompanying nausea was worse in closed room and better open air. Pain traveled from temples to the top of the head to the neck.
  2. Abdomen: girdle like pain since 23-11-96 AF Caesarean, worse standing and over exertion.
    USG - Normal and Nil - Gynaec. According to Gynecologist it could be a B-coli infection.
  3. A patch on the Rt side of her neck with itching > heat.

Patient As A Person: 
Tall well-built woman, 5'6" and 75kg.
Hair: wavy and thick, which was falling after coming to Bombay.
Skin: had a tendency to ecchymosis and there were bags under her eyes.
Teeth: healthy with no cavities.
Perspiration: normal
Appetite: good, with occasional gas.
Cravings: chocolates3, pickles2, sweets, sour2.
Aversions: None major.
Stools: normal- twice a day.
Sleep: normal
Thermals: Hot pt.
MP = 4-5/30, normal with heavy bleeding. PMS for 2 days - felt lethargic and moody with leg ache and body ache; second day - pain in the abdomen.
Pregnancy in 1996, uneventful except very weepy and depressed during pregnancy.

Life Story:
Born in 1965. Middle of 3 girls. Father was in the army, disciplined but very caring. Mother, very hardworking, a very good housekeeper and did all her work in spite of army staff. Just for background, the patient's mother was one of 6 daughters; her father had been murdered, and so was married at 14y. So she was very self-reliant and hard working. She taught all house work to her daughters.

1985. Did BA in computers. Took up a job.
1991 Married. Arranged marriage. Husband was an only son, in a well-educated, Joint-family. Family chosen as educated and MIL working - a principal in college. It was expected that such a family would be more broad minded, but these expectations were belied. She was very conservative and interfering. She would go to any length to show the patient in a poor light. Pt would cook the meals and then before the men came home, she would have a bath and get ready.

And that time MIL would go into the kitchen, and it would appear as if not DIL, but she was doing everything! Husband constantly gave her sermons of how to behave. Pt being very sensitive got into a very tense state. She got pregnant soon after: her Pregnancy was awful. She was unhappy, sad would weep constantly. Dreams, which scared her - of death and disease. Her BP went up in pregnancy, with severe morning sickness for 3 mths and oedema feet.

Delivery: 1994 Large baby- 4kg and born with cleft palate. That became a major issue. No one in our family has a history of this problem, so how come this child got a cleft-palate. Tremendous guilt in patient, though no history even in their family. This was in 1994. 2 more yrs were passed with strain.

1996: Husband transferred to Bombay, so situation was better, but the tremendous anxiety was transferred to the son- his feeds and cleanliness.

1998: Father died after being ill with Cancer for 6 mths. Pt went to Delhi. MIL came to her house and warned her not to stay more than the customary 13 days!

In 1999: Her 3 rd sister got married and mother managed everything on her own- single-handedly conducted the wedding! Pt could help a little.
1999 end. Husband given a 3-yr posting in Germany from Siemens. Even at that time, the in-laws tried to break them. Told patient she could stay in Delhi and he would go to settle the son in Germany. She absolutely put her foot down and went with him.

irritable3 weepy3 when sad. Suppressed, mortification, guilt2, brooding2self-pity with depression in evening3
Likes people, very critical, lonely, with anxiety and worry and depression in pm Sleepless when H traveling, from being alo e and anxiety.
Fastidious3 critical3 if her plans altered. Irresolute and pessimist.

Pt has done BA in computers and was working before marriage. Not allowed later. Speech soft spoken but told the story in detail omitting no detail, which put her in good light. 2nd interview with husband: in which he told how difficult life as due to her over fastidious nature. "No one can come to our house, because they dirty the bathroom and she is upset. If we are all going out with our friends after that, she will insist on cleaning the bathroom before leaving. So all have to wait for her. While waiting, those friends feel so guilty that they never come again!! About laying the table: This is my job, but it is not as easy as you may think it is.

I have to wash the plates again (they were already washed after lunch) with aqua guard water, wipe them so that no drop of water fall on the floor and then lay the table in perfect position with knife, cutlery etc. Child also is so tense while eating, in case he drops something on the floor; she will rush to clean up immediately. If he vomits, which he does often out of fear and spasm, and then she rushes to clean up immediately." Now we could understand the chain of events, which led the child to develop anorexia and nausea and stop eating. Though small, he can subconsciously feel it is better not to eat, than be scolded for messing. This non-eating does not solve anything. This perfect mother, if she has a child who does not eat, then perfection is marred. This again makes her very tense. So the whole thing has becomes a vicious cycle.

Planning And Programming: 
Acute: Puls - for pain in abdomen- Bell /SOS Constitutional: Kali-carb selected for Anxiety3, Panic3, Guilty feeling; attachment to self and son; hair fall & sinus and sleeplessness and Fastidiousness.







For Anxiety, resentment at being stuck at home with son- Bondage and panic-attacks.

A opening prescription to alleviate the anxiety.

Ignatia 1M- 1 dose


Throat+; Headache+ < sun; Anxiety 3Eye > cold washing


Arg-nit 200-7P HS


Headache-0; throat SQ After 8 Pm


Puls 30 4P HS
Ferr-ph 6x 2/7


Thirst++ Chilly =0
Eyes burning+ Redness> cold;
Discharge: white green


Puls 30 1P = 3 doses/ per day. Not between 4-8pm.


>3: Throat=0 Eye complaints=0. No PMS

MP=6-3Acute over. Now constitutional remedy.

Kali-carb 200-1
Next wk Tub-b 1M-1


>3 head= 0 neck ache < exertion.

> but AF still < so constitutional .

Kali-c 200-2nd.


Eyes Burning3 > cold. Very, very fastidious.

First tackle acute and rpt C for Mind

Puls 30 -3P HS- every night. Kali-carb 200 -3rd dose after acute better.


Complaints >3 except hazy vision + puffiness of eyes


Puls 200 -3P HS


Headache in forehead and nape; eyes watering; thirst++heaviness in head > pressure


Bry 30 3P 1P=3


Upset as her husband was not talking to her and felt that her life has been ruined. Throat< Can swallow but voice stifled: pain in left ear with salivation and duskiness.

Tremendous dep + throat+ obsession= syphilitic miasm.

Merc-i-f 30 1P =2 doses per day.


Nausea3; craving cold water; sweats and cramps and fever


Phos 30 4P

6-9-96 onwards

She continued consulting us for her acute complaints and the appropriate medicines were given which alleviated the complaints.



After that each throat episode responded to MIF followed by the constitutional and Tub. Once Syphillinum was given.In 1 yr, her finikiness was much better

MIF 200

10th April 97

She lost her father of Lymphoid Leukemia. Spent much time in Delhi. Came back to Mumbai with new resolution of making up with husband. She told him let us start afresh. He said "on my rules" She agreed.


Says has been well from last 6mths. Looks more relaxed. Son also talking much more and looks relaxed. Since 1d feverish, dull with throbbing headache

Bryo 200 1P=3


Much > slight headache c nausea

Kali-c 200-1 dose

End 1999

Husband transferred or taken new job in Munich, Germany. Pt happy to go there. She squashed the move by FIL to go instead to help him settle. She could ct to see her son settle in Delhi. No further reports except through her friend, who says they are well.

Conclusion: In this case it was really a pleasure to see the son, our first pt, flower after the pressure of the mother and his anxiety state reduced. A child, who the first time he came, sat for an hour without moving, his stare fixed on some point in the distance, now is bubbly and very vocal, though he still misses his father when he is out of town, and cries but no longer gets fever like he used to on the earlier days.( For those of you who have been following the NJH activities, this case was discussed in the Behavioural Disorders seminar of Jan 1999).

The mother too, ie our patient, used to be like a tightly coiled wire, waiting to snap at the first person that came along. Here a normal homemaking trait, which would be much appreciated, became abnormal and pathological, due to the stress produced after marriage and of the child with a defect. A perfect house, where nothing, at any time would be out of place, compensated for whatever imperfections showed up to the world in these two circumstances. But this perfect house may be admired but certainly not loved, because it did not become a home filled with comfort, love and care. It took a great deal of counseling and the appropriate Homoeopathic remedy to achieve this.