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Case Study

Dependent Yet Irritable
Dr Shrilekha Hada

A 24 yr old single female, came in April 94, with chief complaints of Allergies (allergic rhinitis and urticaria) and pre-menstrual syndrome. Her speech was very rapid and excitable with repetitive hand gestures showing restlessness. She had red vesicular eruptions on her upper limbs with intense itching and aggravation from sour. 4 to5 days before her menstrual cycle, she suffers from mood swings-irritability to depression. She becomes quarrelsome and snaps at anyone who dares to talk to her. This change in her makes her feel crazy as it is very unlike her usual self. Her routine gets disturbed and she is unable to concentrate on work. 

Physical Generals
Appetite: desire for sour and spicy food: aversion to milk, sweets and bland food
Thermal: chilly, aggravated in cold wet weather.
Sleep: is disturbed in anticipation if she has to wake up early the next morning. She dreams of her dead cousin very often and also about people close to her dying which makes her feel very uneasy.
F/H: Fa- Astma; Mo-allergic rhinitis. 

Personality : She says that she is very conscious of the image she projects to other. She dresses to impress people, avoids arguments and gives in easily to keep everyone happy. She is hasty and impatient and cannot remain idle. Always keeps herself busy. She is very anxious about her health and wants immediate relief. Anticipatory anxiety for appointments and large gatherings. She is extremely punctual and organized in her work.
Keeping in mind the Tubercular miasm, the thermal modality, anticipatory anxiety, image consciousness and fastidiousness, I prescribed Silicea 1M. In spite of repeating the remedy over a period of two months, there was only mild improvement. I was not satisfied. 

After probing further into her life, I found that her family (namely her parents) and friends held a central position in her life. She felt dependent on family and friends for survival. She went out of her way to help them. She worried that something bad would happen to people she loved, leaving her alone and without support. She was very conscientious about her duties and could always be relied upon.
She reported two new symptoms - hairfall with itching in scalp and inability to fall asleep until 1 - 1.30am. 

The most striking feature about her is the role of her family and friends whom she supports as well as is dependent upon. She complies eagerly if asked for any kind of help which in turn assures her of security from them. Her need for relationships and her dependence on them not only on 1:1 basis but with a group of people, led me to think of Kali. A Kali personality needs security from a group/family. The Kali sat that comes closest to the patient is Kali-ars is on the basis of the following

·         Very anxious and excitable. Kali-ars is one of the most anxious remedies of the HMM.

·         Anxiety about health and despair of recovery.

·         Highly organized and fastidious.

·         Conscientious and dutiful.

·         Quarrelsome with family (during PMS)

·         Restlessness with excitable speech.

·         Fear of death with dreams of the dead.

·         Hurry, impatient.


At the physical lever, Kali-ars is useful in pruritie skin conditions, is very chilly aggravated in wet weather, aggravated 1-3 am, desires sour. All of this is covered by the patient. 

Follow up :
Kali-ars 1M 1 dose gave relief upto 50%. She was able to work during the days of PMS. Between' 95-'96, 5 doses were given and the last dose was given in March'97 for recurrence of PMS, after which she has not complained.