LIC. JOSÉ EDUARDO CALZADA ROVIROSA,
CONCEPTO UNIDADES VSMGZ
Case No. 1
Mr. S.A., age 35 years> consulted on August 30,1974.
He had been married 7 years and had two children aged 5 and 2. His was a sedentary occupation with long work-ing hours.
Complaints — His only complaint was headaches from which he had suffered for few years. Some years ago when he go up in the morning if there was sudden exposure to light, then felt heavy in the head through the day and pain by evening. Later he felt that exposure to cold, as an air-conditioned room would give him headache. In March 1973 started getting unbearable headaches and he noticed that there was periodicity. He would get the headache every 14 days on alternate weekends. He felt pain in one eyeball, mostly right, and then as if a rope was pulling it backwards into the head.
Later it would "explode" into the whole head. San-guinaria canadensis 30 would relieve it and he kept fairly
well for a year. But a month ago he had two severe at-tacks. Pain would be very bad and throbbing in charac-ter^ Mostly no nausea or vomiting. 10 years ago he had an accident in which there had been blood from the nose.
Mentioned that he had flickering in the eye in 1971-72.
Mouth — Very foul in the morning. That time saliva thick liquid, ropy, yellowish. Doesn't want to speak till he rinses well. Earlier drooling of saliva in sleep.
Appetite — Can overeat. Does not know when to stop, or even when stomach is full yet can eat. This is only at dinner. Mostly vegetarian. Very rarely meat.
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Salt + sweets +. B.O.R.
Sleep — Good. Dreams related to work.
Vaccination — Three times in last 10 years. Pre-viously less often. For yellow fever also.
Stands both seasons well, but prefers hot water bath even in the hot summer of Delhi, especially morning bath.
Cool. Calm temperament. Not a worrier. Mentioned that he had a peculiar habit that in writing may start by firsts writing the second or even third letter so also in dates he will first put the year and then the prefix of the month and then before that the date.
Premature ejaculation.
P.I. — Nil of note except an accident in October, 1965 as mentioned above.
1974
August 30: Natrum muriaticum 6x, 30, 200/1 powder of each through the evening and bed-time of the same
day. * * *
1975
June 12: He reports again after a gap of 10 months
"Very grateful. No headaches. Not even heaviness of head, let alone migraines." The reason for the second visit was that for the previous week slight heaviness in temples which could be due to extra tension of work that had to be finished by a deadline. Continues to take extra salt and sugar also on high side. Feels better massaging neck muscles. Heavy feeling by sleeping under a fan.
Aversion to drafts. No H/O wetting or cold or cough recently.
Repeated the prescription of August 30, 1974 that is Natrum muriaticum.
* * *
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He did not report again but on January 17, 1982, after seven years, met me in the queue at the security check at the airport and said, "Haven't you recognised me. You cured me of my migraines which have never recurred since and I am so immensely obliged to you."
Case No. 2 (Migraine)
Mrs. K.R. telephones in September 1989 from Turkey seeking help for a lump in the breast and tells me that I have her previous history.
/ She had consulted on February 11, 1980. Age 28 years, been married 5 years, one child three years by Caesarean section. Prior to that she had had two miscar-riages. Her main complaint was Migraine headaches for the previous one and half years. No relation to menses.
During attacks must have no noise and no light. Is rather tense as her son, the only child, is weak and according to her has poor appetite.
Vaccinated for Smallpox in childhood and revac-cinated a few times but not after she left school. Chilly patient +. Previous winter had frequent colds and sinusitis.
Mostly a blocked nose and not so much discharge.
Has a Meibomian cyst for three years. Face is greasy otherwise skin dry; gets cuts on soles of feet in winter.
Secondary sterility.
P.I. Much Acne before marriage. Now occasional. At age 16 had a lump in breast. Removed by operation.
1980
February 11: Sepia 200/3 powders at half hourly in-terval.
February 27: Headache from ?loss of sleep for two days as child is ill. This was not like the severe migraine variety. Cocculus indicus. 30/6 powders every 4 hours.
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March 26: Headache for last three days.
Sepia 200/3 powders at 14 minutes interval.
June 14: No Migraine. Meibomian cyst gone.
Feet dry for previous three years, cracks at heels
< winter, then there is pain and bleeding from the cracks/fissures. Nails of big toes getting thick and brittle.
Petroleum 200/3 powders on the same day.
1989
September 15: Seen from time to time for some other odd complaints till 1984 when she went abroad and then contacted in 1989 as mentioned at the begin-ning for altogether different complaints. On enquiry I learnt that there had been no recurrence of Migraine or the cyst in the eye after the treatment she had had in 1980.
Comments: It is to be noted that Sepia which does not appear in the Rubric Tumors on lids or the sub-rubric meibomian glands on p.268 but was prescribed on general considerations and it cured this also.
Case No. 3 (Migraine)
Mrs. P.P., age 34 years consulted on December 23, 1989. She had come from Calcutta and the subsequent reporting which was mostly by telephone was irregular.
She had been married for 13 years; had 2 children aged 12 and 10 and no abortions.
She said she had been diagnosed as a case of 'migraine' for the previous 4 years. The pain used to be in vertex and left paraorbital region. Would have vomits with the pain. It occurred u i an average once a month but not related to M.P. Also not related to exposure to
ST.IX or cold air or eating. Over-exertion and mental ten-sion could result in attack. For this a year earlier she had
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been prescribed Tegretol (Mazetol) which she used for 3 months. With this she felt drowsy, so discontinued.
Bouts of sneezings in the morning "on putting foot on ground in morning or putting hands in cold water".
Occasional breathing problem "once a year and very mild".
(H/O Bronchial Asthma in childhood). Itching under eyes and sides of nose in the upper part, between the eyes for previous few months. For some time low B.P. — usual reading is 90/50.
Appetite: Good. Non-vegetarian. Likes sour.
B.O.R. "However, 'heating things' (like garlic, dry fruits, mutton (not fish)-black pepper in excess, garam masala (spices)) result in piles with hard stool and bleeding." Also has a general allergy to garlic — by eating or cutting garlic gets itchiness in fingers and cuts or fissures.
Sleep: Poor. Frequently uses Calmpose, otherwise lies awake till 2 a.m.
Dreams: Clairvoyant. Of the dead — close relations,
"because I was much attached". Occasionally of being afraid of water. As a child dreams of falling.
Vaccination for Small Pox a few times in childhood.
Neither markedly hot nor chilly.
Anger — at times. "Have been tense since the time of marriage, there being a joint family with business and other disputes. Now separating. For 6-7 years forgotten to smile or laugh because of the tense atmosphere". Sen-sitive. Sympathetic. Cries for any emotional scene. No fears. Not keen on company.
M.P.: Regular and normal, no pain. No leucorrhoea.
P.I.: Very bad eczema at age 7-8 years, mostly on head with discharge. Now itching legs from use of nylon and on the area of watch strap in summer. Serious
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pneumonia at age 8 years, after that asthma for 3-4 years. Measles at age 31 and Chicken Pox at age 32 years.
F.H.: Mother died at the age of 54 years. Had hyper-tension and C.H.F. Father has some heart complaint.
Has no brothers or sisters.
O.E.: Lean. 109 lbs. Height 5'4". B.P. 120/82. Slight bleeding from gums. In rest of the physical examination N.A.D.
1989
December 23: Phosphorus 200/3 powders during eve-ning and bedtime on first day. Made a note in the mar-gin Natrum muriaticum for future consideration.
1990
March 16: Sneezing has been less. Still gets headaches. Itching below eyes. Insomnia on some days when tense.
Phosphorus 200/3 powders at 15 minutes interval.
June 6: "Strong aggravation after medicine" -Migraine attack for which used 'strong' allopathic medicines. Later had eczema hands. She has a tendency to get this when she uses detergents for washing. So nor-mally uses gloves. At present has eczema on the hands.
Pain in right knee. Father feels that she is by nature a tense person.
Natrum muriaticum 6x,30,200/1 powder of each in morning, evening and bedtime of the same day in that order.
August 31: During the previous 3 months had headache twice and according to her father it was due to unusual tension.
Natrum muriaticum 200/3 powders at 15 minutes in-terval.
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Letter dated December 26: Headache on October 6, when she was on fast (Karvachauth). Skin of upper eyelid dry — like dandruff.
1991
January 2: Natrum muriaticum 200/3 powders at 15 minutes interval.
February 12: "Much better in this period, please repeat". Saccharum lactis.
She had progressive improvement and needed a repeat of the medicine three times during a year when-ever three was a tendency to recur. The last occasion when it was given was February 10, 1992.
* * *
1993
January 9: Telephoned after a long gap. Was very happy as she was now completely free of headache. The only complaint was sneezings immediately on rising.
Nux vomica 200/3 powders at bedtime on 3 consec-tive nights.
Case No. 4 (Headaches)
Mrs. B.S. age 34 years. Came from Varanasi and con-sulted on July 5,1990. She had been married for 15 years and had 3 children, aged 13, 7 and 5, all by caesarean section. No abortions.
She complained of headache for the previous 10 years. Initially, it was occasional, that is once in 2-6 months, progressively, it became more frequent from February, 1990. With headache nausea and at times vomiting. From May 21st, the headache had been a daily feature. It starts in one temple then extends to the other side and then involves the whole head upto occiput.
There is no regular alternation of sides and it does not
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start more frequently on left or right. There is no visual disturbance. In the previous two weeks she never felt totally normal. There is always some heaviness of the head but the pain is not so intense. During this period whenever pain increases, then there is some difficulty in breathing.
She had anxiety problem for the previous two and a half years. Her father-in-law died in December, '87 and mother-in-law died around beginning of 1989. She gets anxiety, restlessness and has tears. This may be due to some tension or even without any cause. Had some depression tendency even before father-in-law died.
Cannot think of any factors that provoke or bring on the headache.
Another symptom she complained of was acidity for more than 8 years. Initially there had been burning and later pain in epigastrium. Endoscopy, Barium Meal, X-Ray examination, etc. were all normal. These symptoms had been relieved for the previous one year.
She had been fond of sour things and chillies but given up after she developed acidity. Thirstless. Dreams:
pleasant. Meeting people. Hot patient.
B.P. ? Labile. At present low 105/90. At one time when she was worried it was 160/100.
Anger + +; worrier, likes company.
M.P. Regular for the last 3 months. Before that it had always been irregular. Mild pain in abdomen before menses.
P.I. Tonsillectomy. Some abdominal tumour removed at the time of first C.S. 3C.S.
Family history: Grandfather Asthma, Father Diabetes. No T.B.
O.E. Obese. 5'2", 151 lbs. 108/76. Halitosis, bleeding gums. Using glasses.
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1990
July 5: Prescribed Pulsatilla 10m/3 powders at 15 minutes interval.
July 13: M.B.; had some trouble on July 9 — after shopping. Subsequent reports were by letter or by telephone from Varanasi and she showed a consistent improvement. So continued on sac lac.
August 24: She had had no headache or depression in spite of viral fever for a few days in interim period.
September 22: Generally better but reported headache four times in the period August 17 to Septem-ber 18 — thrice with tension and once by exertion. Hus-band has been ill in the last month and has been tense.
Amenorrhoea for two months. L.M.P. July 23. Decided to watch. So continued Saccharum lactis.
October 16: No complaints but in previous two days short fits of depression. Gets dull and feels like crying and no appetite but there was no headache.
November 3: No headache. At times a sense of ex-treme weakness which may last only some 15 minutes or may go on even upto 2 days. It is felt that it is mostly related to over-exertion.
December 15: Had headache for 3-4 hours on 7th.
No special reason.
December 24: Came personally. No headache after the 7th. Depression persists-comes on suddenly. There is anxiety and choking feeling. It lasts 20-25 minutes. Can occur any time. In that state crying and desire to hold somebody tightly. Hair falling. Dandruff.
Repeated her prescription — Pulsatilla 10M/3 powders at 15 minutes interval.
December 28: On 26th night anxiety + +, flight perspiration, suffocation feeling after watching a movie on video. This was at 10.20 p.m. Got o.k. by 12.30 a.m.
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No ascribable reason. She was taking Saccharum lactis in pills now added a Saccharum lactis powder also at bed
time.
1991
January 4: "Been well after starting the powder".
June 14: No headaches. Depression on some days.
Gets anxious, then feels weepy, followed by weakness and dullness. The cause may be very minor. During the previous 3 months been much better and had mild depression only on 3 days.
August 19: Headache much much better, practically nil. Now the problem is of depression off and on and suddenly gets serious and leaves company or starts crying. Gives no reason nor any can be deduced from circumstances. Pulsatilla 10M/3 powders at 15 minutes interval.
September 24: Headache twice in this period. Lasts 60-90 minutes. Gets phases of irritability and depression.
This may or may not be accompanied by headache. With depression much crying and followed by great weakness.
Acidity symptoms again, relieved by vomiting Pulsatilla 10M/3 powders at 15 minutes interval.
November 25: There was a wedding in the family.
She had over-exerted doing all the shopping. The day following the wedding very severe headache. Repeated Pulsatilla 10M/3 powders at 15 minutes interval.
December 12: Better in headache and depression.
1992
February 21: "Keep well when using medicine other-wise very occasional and mild headache". And of course what she was using was Saccharum lactis.
May 18: Came to see personally "I feel quite well in every way. In the month of March, there was
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able strain because of the examination of children, but no trouble. I feel confident that now I will remain well even without medicine as I have already been without it for the previous 6 weeks".
Discussion:
It was a very interesting case fairly typical of the stress headache variety in a somewhat neurotic in-dividual. It will be noticed that only one remedy, that is, Pulsatilla was needed all along in the same potency. It is also to be emphasised that altogether she needed it five times during the entire period of little less than 2 years while she was under treatment. The repetition was only when there was a recurrence of symptoms.