Minutus

Hi,
I am having trouble with a couple of rubrics.

CAN'T FIND RUBRIC
I know there is a rubric for the person who must have exactly so many hours of sleep. This client needs exactly 8 hours of sleep. If she gets 7.75 hours of sleep, she feels lousy.

Also, her face turns bright red when she is stressed. They say she has rosacea which is a dilation of the surface skin blood vessels, not acne. Radar has says it is acne. (FACE - ERUPTIONS - acne - rosacea). This is a rubric with 72 remedies in it so it is too large to use as anything but an elimination rubric (ie the remedy I am considering should be included in this rubric.) During the day her face will change from bright red to normal skin color. The color is more intense on her cheeks but the whole face seems red.

The scar tissue from the surgery to one wound looks dark almost black (caucasian skin) and it is proud tissue. GENERALS - WOUNDS - granulations, proud flesh. I found Keiloids too, but do not see the discoloration.
SKIN - DISCOLORATION - brown - elevated comes up with causticum and I think it would be as in a burn scar. SKIN - CICATRICES - nodules
SKIN - DISCOLORATION - brown - elevated
GENERALS - WOUNDS - granulations, proud flesh
SKIN - KELOID
SKIN - ULCERS - proud flesh
Is this the best I can do? Eventually use Thiosium. She has been like this since childhood, but I would think alcoholism would aggravate it.
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This might actually be an interesting one for Gunpowder (Kali Nit)
given it was used in wartime wounds, deep abcesses from wounds.
And the explosive quality of the nitricums may apply to rosacea
flares which can come on instantly.

Consider Aconite (adrenal panic that may precede a rosacea flush)
also shock from old surgery never nealed, or Sanguinaria.

Carol Willis
http://groups.yahoo.com/group/willis_protocols
Article archive in Files, blog, Links, not a discussion group.
"Kathryn Ellen Madono" wrote:
many hours of sleep. This client needs exactly 8 hours of sleep.
If she gets 7.75 hours of sleep, she feels lousy.
she has rosacea which is a dilation of the surface skin blood
vessels, not acne. Radar has says it is acne. (FACE - ERUPTIONS -
acne - rosacea). This is a rubric with 72 remedies in it so it is
too large to use as anything but an elimination rubric (ie the
remedy I am considering should be included in this rubric.) During
the day her face will change from bright red to normal skin color.
The color is more intense on her cheeks but the whole face seems red.
black (caucasian skin) and it is proud tissue. GENERALS - WOUNDS -
granulations, proud flesh. I found Keiloids too, but do not see the
discoloration.
and I think it would be as in a burn scar. SKIN - CICATRICES -
nodules
like this since childhood, but I would think alcoholism would
aggravate it.

Thank-you Carol

Hi, Ellen.

One possible rubric:

GENERALITIES - MODALITIES - SLEEP - loss of, from

The keloids, in the broadest terms, would be covered in this rubric:
SKIN - PHENOMENA - CICATRICES

If you combine these rubrics with the acne rosacea one it dramatically pares
down the remedy list.

The redness of her face with stress would be a symptom well worth defining
and then using, it seems to me -- more useful than the acne rosacea rubric.
What does "stress" constitute in this case? What kinds of situations make
her face red? I bet this can be one useful key to the case.

You mention Causticum. This is certainly a possible remedy for this
configuration of symptoms, depending on a lot of other things, of course.
One might also think of Ars or Sulph, depending on the cause of the redness.

Rosemary

Hi Rosemary,
Weakness from loss of sleep under generalities is a good suggestion. Thank-you. Nat-m is in there.

The usual nat-m headache is a "thousand little hammers" but px has throbbing all around the upper part of the head. Nat-m has that too. When stressed, this px withdraws and broods. She was also a very good girl as a child and complains about her mother's negative remarks. Able to quote many of them. I think you are right about the red face. Not acne. Nat-m has that too. Cicatrices do not fit the case.

Thank-you
Ellen Madono
REST OF THE CASE
I think in connection with the rosacea, she gets sudden violent headaches that wake her at night. Behind her eyes and in her head she has pounding as if she had a cap around her head or her head were tightly wrapped. This sounds like the belladonna headache where the blood is congested. Worse looking down (bell) Better lying in a dark room closing her eyes (Bell) Nausea but can't vomit. Jarring hurts (Also Nat-m???).

Growing up often she often felt sick because of the above sleep problem and the concomittant headache. All through her childhood she would occasionally refuse to do chores or complain. For this she was put down by her exhausted single mother. "You're lazy, You'll never amount to anything" her mother told her. Although her mother had been badly mistreated by her alcoholic father before he dissappeared, her mother firmly believed that women should depend on men or they would suffer. As it turned out px was a lesbian and her mother could never accept this either. So the core feeling of the case is abandoned and forsaken chiefly by her mother and older sister but then as an adult alcoholic she abandoned herself. She responds to the least hint of rejection by withdrawing. Even as a very small child, she was left alone a lot while her mother worked as a butcher. She is very affectionate and does not like to be left alone. She is so concerned about her dog that he is written into her will with 5,000 dollars for his care should she die before he does.

Px has beaten up her body doing very hard labor (factory iron worker etc) and has submitted to many surgeries for the muscular breakdown. Nodules develop on the ends of the bones (Knees, shoulders). I saw a keloid by accident, but did not ask about other scars because px is not very forthcoming about her various sufferings. She feels the rosacea makes her ugly. She has built 3 houses by herself and is determined to do better than her mom. While I am thinking the case, I gave her arnica for the physical wounds and in a month the headache has not come and she is lifting weights to reduce her weight. So she is very happy with her response (does not attribute it to the arnica). Patient on Amytriptoline with side affects of weight gain and fatigue but fearful of depression so not willing to come off it soon.

DIFFERENTIAL
SEPIA: She has the irregular periods of sepia that she hates (lesbian). No pain or other problems except early menopause may be occuring. Appreciates her emotionally warm partner, not married to her work.
BELL: Gave her bell in case she had one of those headaches. Bell is more confident and more intellectual?? Px has a good visual memory and has trouble in school because she is physically restless. Px too concrete about life to be bothered by hallucination or the imagination of Bell.
SULPHUR: Hot body. There is an alcoholic laborer type of sulphur with many of her sleep problems and her physical state. But sulphur covers everything usually anyway, so I'm wary.
NAT-M: Withdrawn trying to please impossible standards of mother. Brooding. Nat-mur's little hammer headache may be like her throbbing. Itching with sticky lachrymation in eyes and photophobia. Itching sinus drainage. Maybe the rosasea is just "redness of the cheeks."

Rx
Since she is no longer working as a laborer, the physicals of the case which are quite important to her are probably less central than the depression brought on by poor sleep. If she does not get the physical exertion, she feels sad. Nat-mur then may be central using Sulphur to occasionally push it and spin off the toxins of the medication and to push the many physicals. Note both Sulphur and nat-m are hot bodies. Carc, med, thuja 200c might be used miasmatically, but those sx would have to further develop. One difficulty in the case is she has been taught not to complain so she does not want to tell you about her suffering (Nat-m). On first meeting she seems upfront, but it is really hard to pull out the depth of the suffering.

Other remedies to consider are calc-flour for bone spurs. Thios for scar tissue. Might also consider Nat-sulph if the headaches come back. Probably use 6c for these physicals.
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Have you considered the Ranunculus family, especially Ran B. Best
wishes, Joy

http://www.homeopathicmateriamedica.com
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Dear Ellen, on further reflection I would also add Carcinosin to your
list of rx to consider as it addresses the keloids, alcoholism, lack of
nurture, exacting sleep requirements borders on fastidiousness or a
compulsive need to have exactly 8 hours, heat and discolouration within
the face, ecchymosis (h/o alcohol abuse could cause this).

I was also wondering about all the surgery she has had - is this
possibly a bit extreme, is this a munchausen situation a kind of self
harm that might be linked with the alcoholism?

Just a few thoughts, best wishes, Joy

http://www.homeopathicmateriamedica.com
http://www.homeopathicmateriamedica.blogspot.com
http://homepage.mac.com/joylucas/
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