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Case Study

I can have Ice-cream Again!
Dr Bhavini Shah

Mrs RM, 49 yrs came to me on 29/4/02 for multiple apthae since May 1997- came on suddenly and very painful- could not eat or talk. Attacks every month lasting 7 days

2. Skin rashes - burning, red, macular, voice hoarseness, swelling of tongue, edema face. A/F milk³ and milk products (paneer, butter milk, ice cream etc). > cold > cold season-USA. < hot³.
She lost wt 4 kgs in 1 week, with the first attack.

3. She also was under regular medication for Hypertension, hyperthyroidism

Gas lower abdomen with sensation 'if only she would burp'.

Personal History
Appetite: Decreased since 1 month.v
Thirst: 8-10 glasses/ day
Craving: Ice cream³, but Agg³
Stool: Normal
Urine: 6-7/D, 2-3/N. Constant urge to pass urine
Caries in the teeth ++.v Perspiration: ++v M/H: Menopause since Dec 01.
O/H: G2A0P2L2. She has 2 daughters
Thermal: Likes winter. Does not want fan or AC, does not cover herself, cold to tepid water for bath. C2H3.
Sleep: Disturbed due to thoughts and chief complaint.

Life Situation and Mental State
In childhood PGM used to say don't say anything since your tongue is black and it may come true. She was also very close to FA, H and MIL.

Pt was only daughter amongst 9 uncle and the only Si among 9 Br. So very loved and Pampered. Wanted to study much. She played sports - Hockey And being amongst 9 brothers, was quite a tomboy. She never had the need for going outside the family, so did not a single friend in childhood. Father achieved much after her birth - owned 2 buildings etc. Father had been told that till you have your daughter, you will have everything!!! At 19 yrs ie in 1972, when she got married, father lost everything; uncles developed insecurity, did not want to be with a sinking ship and so fully separated. Fa got a double shock.

July 1997 Fa died of 1st heart attack. Uncles took away all the property. Brother sold house, went to Nasik to settle. God was kind: they faced their, increased liabilities boldly .Cried while narrating the history. It was as if it had happened yesterday.

1991: MIL very ill. On respirator.
1992: She prayed to God to either take her or make her well. She died next day. Missed her3 sorely, she also felt a sense of guilt,.

Patient says she can talk to God. When she prays, her prayers are always answered.. But she never asks for material things.

Husband is a very practical man, caring but never expresses emotions. He wants his own space. Whenever pt ill, she wants some one near, and feels neglected. Children are grown up and don't have time. Husband says worry is her passion! This upsets her.

Irritable³ http://www.njhonline.com/images/rtarrow.gif weepy³, anger suppressed, brooding. Hurt very easily. Forgives but cannot forget. Loner http://www.njhonline.com/images/rtarrow.gif does not like many friends, close only to H and MIL. Sympathetic. Fear of water³. Perfectionist³. Does not socialize since does not like gossiping. Talks excessive, continuously.


  1. 1056 A/F Grief
  2. 563 Nervous constitution
  3. 1019 Crying Amel
  4. 1008 Brooding
  5. 1109 Sympathetic
  6. 1090 Religious
  7. 1057 Guilty
  8. 990 Abandoned feeling
  9. 543 Milk <
  10. 1494 Drug abuse of
  11. 637 Thyroid gland affection
  12. 1296 Left frozen shoulder
  13. 148 Urine frequent urge

Nat-m 21/10, Lach 20/10, Puls 21/9, Ign 17/8







Lach 200 1st dose


Tongue swelling > 60%. Skin rash > 60 %



Was > till 2 months



Since 13/7/02 1 Apthae painful without any milk. Tongue swelling+. Hoarseness L3

Lach 200 2nd dose


Apthae ++. Sudden rapid growth. Pain3 red3.

Bell 1 M 1 dose


1 painful. Other small apthae.

Syph 1M 1 dose to taken on 22/7


Apthae > 21/7. Throat since 27/7. Gas+. Cannot burp. Wants cold drinks.

Arg-n 200 1 dose


Loose motion. 7/day watery, painless.

Nux-v 200 2 p, mix in water 1TSF after every loose stool


Loose motions not better

Croton-tig 200


>. No loose motion since first dose

Lach 200 3rd dose


Urticaria since 2 days < day. > Night (18/9 Br hospitalized for cirrhosis) so AF stress.

Lach 200 4th dose


Ate ice cream. Skin burning < scalp, neck, legs. Itching3 < evening and night

Lach 200 5th dose


Could eat paneer. No < on skin. Throat hoarse, cough < lying down. Ulcer painful. Uneasy in throat

Lach 200 6th dose


Went to USA. I gave her 2 doses of Lach to be taken once in 15 days. Could eat everything over there- all ice-creams, milk. Whole family celebrated.