Case 2: The Tall Sophisticated One
NATIONAL JOURNAL OF HOMOEOPATHY 2005
Dr Bhavini Shah
'Puls / Lach / Tub-b

Mrs RT 41 yr, looking not a day over 32, came to our clinic by prior appointment on 24th Oct 2005.. She was tall and statuesque and her hair was her crowning glory. We did delay in taking her in, but with great charm, she accepted the apology. However we could sense her autocratic layer. She owns a spa, has 2 sons and resides at the posh Pali Hill of Mumbai. Within 5 min in the clinic, she had my staff eating out of her hand, by receiving free tips on their beauty problems, without even being asked.

Chief Complaint
Hair fall - approx 500 / day. Beauty is her business, so she had tried all treatment before coming to me. You can imagine how anxious she must have been!!.

Since childhood, frequent sneezing  throat pain  green expectoration à dry cough  Day 3: swelling of face  fever  pricking sensation in the throat, has to clear throat all the time. < AM, < swallowing, > warm. Associated with headache at the vertex, drowsiness and dry feeling in the throat.

Other Complaints

1.     Develops hives over the skin if there is lots of physical exertion. The hives become red3 and itching³. > hot³, < mosquito bite.

2.     Leucoderma  small patch over ankle. P/h big patch since 1975 treated homeopathically and now only a small patch left.

3.     On 30/11 she developed backache as he started walking as an exercise. Pain³ > lying on sides, > warm, < lying on back, < walking.
Diagnosis: 1. Alopaecia 2. Urticaria.

Patient As A Person
Height: 5'7'. Fair, Slim, elegant, looked younger than her age. Not wearing any jewelry.
Tongue: dry coated
Teeth: cavities ++, root canal done
Perspiration: Dimished3, Armpits +.
Digestion: Acidity 1/wk. Flatulence +.
Appetite: Normal
Thirst: 2-3 glasses/day
Craving: dry fruits3, chillies4, pickles3, sweets3.
Habits: Alcohol - red wine or cognac 2/months. Cigarette smoking - quit since 4 years, after smoking for 5-6 years.
Stool: 1/d. satisfactory.
Urine: increased infrequency. 8-10/d, 1-2/n. sometimes she has to pass 3 times in 10 min.

Menstrual Function
Last MP: Aug 205.Menopause+. C/O Hot flushes --. Felt low  Small popular eruptions.

Sexual Function: when asked she equanimously said Extremely........ (and didn't know what was coming- but the Non-verbals showed as if Good)......low. Once in 2 months. Said I think my husband is going through male menopause. He has less desire.

Obstetric History: G6P2A4L2. 2 sons.
4 abortions induced after the youngest son.
Delivery: normal.
No significant problems during pregnancy or after delivery.
Sleep: very less. Awake till 2 am. Restless in sleep. Light sleeper. Disturbed by husband snoring. Unrefreshing when gets up from the sleep since 2 months.
Dreams: in childhood there was a recurrent dream that she is climbing some steps endlessly. Thermal: Sun causes heavy headedness.
Enjoys winter, loves monsoon.
Fan: S++, W+. covering S-, W+.
Bathing: cold water in summer, luke warm in water.
CH4

Life Situation And Mental State
3/9/1964 - 2nd of 3 sisters. Born and brought up in Mumbai. Average student. Took part in sports. Exercise, cycling, swimming.
In her words "But I had inferior feeling in school. I couldn't be like others. Never spoke much with others. Not concentrating on studies, I was mischievous so teachers were rude to me.
Also mother used to shout at me regarding my studies. So I felt that I am not loved.

1979: my father expired due to alcoholic liver disease. When he died I felt he was very selfish since he could have avoided the situation to arise but didn't.- he just left us! Now I think that am I wrong and may be others are right. Because ultimately it all boils down to Karma. I am little low in self esteem.
After studying till Xth, did few jobs as sales girl in designer studio.
Assistant designer in foreign based boutique, then as a manager in another boutique.
I got a job in airline just because of my personality though I didn't have the qualification.
God was kind to me and I am grateful to Him.
Knew a boy since school.

1987: got married to him. Mother-in-law very dominating. Stayed with her for 2 years. Then separated. Mother-in-law now stays with one of the Sis-in-law. Though patient is in good terms with sis-in-law.
I am now a very strong personality. I don't allow anyone to tell me anything and get away. I am not diplomatic. Diplomacy is Hypocrisy. I am very blunt. If I don't like something, I tell them, and if like it, I admit it.

1997: Started the Spa
Now I am very happy. I have done well in all the roles. I have worked to the bone. . I am not a kitty person and I don't play cards. I have been a very good mother, friend, wife, I have adjusted to all different environments.
I was very fastidious. I maintained sanity. But my children don't follow that and now my energy levels can't meet the requirements. So my husband gets angry. At the end of the day I become like dead meat. My chest hurts at the end of the day."

Emotional State
Irritable³, very bad temper. If my temper goes, my tongue goes. I am very blunt.
Brooding³.
Forgives but never forgets.
Fear heights³. Claustrophobia > open air.
Otherwise bold. Would never give up.
Hyperactive³.
Perfectionist³. Motivation, will, drive++.
Spiritual and adventurous.
Loaner, > alone or one or 2 closed friends.
Talks excessive³. All her sentences ends in "Darling", "God bless you".
Hurried³ nature.

Rubrics For Repertorisation (Robin Murphy Repertory)

1.     RM 1078 Masculine woman

2.     RM 1042 Extrovert

3.     RM 1042 Extravagance

4.     RM 1018 Courageous

5.     RM 1043 Fastidious

6.     RM 1034 Domineering

7.     RM 0996 Anger violent

8.     RM 1110 Talk excessive

9.     RM 1008 Brooding

10.  RM 1109 Sympathetic

11.  RM 1047 Fear height

12.  RM 1044 Fear closed places. Claustrophobia

13.  RM 0260 Dry cough < am

14.  RM 1309 Skin discoloration white spots

15.  RM 0546 Craving spicy

16.  RM 0545 Craving Sweets

17.  RM 0544 Craving Pickles

18.  RM 0536 Craving Chocolate

19.  RM 0361 Hot patient

Remedies On Repertorisation
Sulp 25/15, Nat-m 22/13, Phos, 23/12, Puls 22/11, Nux-v 17/11, Lyc 20/11, Calc 18/11,Lach 16/8, Sep 18/10

Plan
Acute: Puls for cough
Arn for backache due to overexertion
Constitutional: Lach
Intercurrent: Tub-b

Discussion: From every angle whichever approach you use, you would come to Lachesis.

1.     It is an out and out animal remedy. 1-upmanship. Words like- worked to the bone; at the end of the day feel like crushed meat etc.

2.     A picture-perfect Lach: Dominating, Vivacious. Outgoing, dressed in latest fashion.

Hypocritical. Vide interview-
First interview- life is very good, everyone is perfect - children and husband.. Second interview: she has no energy to do all work. Husband wants home perfect and shouts as he enters. No respect for her- she too is working and if no servant she has to do all the work- washing vessels (implying that it is below her and yet she has to do it). Children do not help. Messy home. She has spoilt them.
No sex. How can you when he criticizes so much? You want to hit back!! (So she deprives him of sex, not realizing she is depriving herself too. Rather she could use these tender moments to win husband onto her side. But she is too aggressive for that)

Treatment And Follow Up