Vitiligo case, part2

[Jan Klüssendorf]

Dear all,

Thanks for your responses and suggestions so far.
Some of you have asked me some additional questions and I will try to answer
them below.
There was also a suggestion to rate the symptoms in order to see which are
strong and which are rather secondary.
So I will retake the original text, add a symptom rate (1 for weak, 4 for
strong) and add as well the answers to your questions, as far as I have
them.
Thank you in advance for your help.
20 yr girl
Family history: one grand mother diabetic, mother inclined towards a form of
hysterical reaction under stress, no other diseases known.
Is a student to become a teacher, is relatively bright (2) especially for
facts (showbiz etc..), good memory (2)
Looks well groomed. Slender but not slim. Clean skin. Dark hair and eyes.
Dimples in her cheek when she laughs.
(4) Since about 10 years white pigment spots (vitiligo) in the face. Got up
one day with it. No cause known.
The spots are on her nose and on her left eyelid + partly on her eyebrow +
eyelashes. In the white spots there are some little freckles.
White spots have grown over the years but stabilized since some years. No
known relationship with vaccinations (neither with other symptoms below)
(Over her body she has some *very* tiny little white spots as well.)

(2) Other complain is constipation (is only able to have movements twice a
week). She has almost no urging. Stool is dry. Not much flatus.
Advised her in a previous contact to replace breakfast by fresh ripe fruit
(which btw (3) she hates in the morning, not in the rest of the day), but
which already worked out wonderful: now, when she keeps her diet, she has
movements almost every day). Additional information (thank Joy for asking):
there is indeed a relationship with the pill: she realizes now, when I asked
here about it, that the constipation 'started' when starting with the pill.
Additional info: in the week (1 of the 4) when she doesn't have to take the
pill the constipation is much better.

(1) Suspicious to new people, reserved, out of a fear to be deceived.
(3) She is a good-humoured, optimistic person, certainly not haughty, with a
good sense of self confidence.
(2) Healthy ambitious (to become a good teacher). (1) Normally sympathetic.
(2) Hates people who dawdle or arriving late to an appointment. So there is
a kind of impatience but not very obvious I would say.
(3) Is rather meticulous re her school or work, but her room is a mess.
(3) Is afraid of all rodents, (2) to be alone in the house (at night), to
(3) get a serious disease (cancer), of (1) death.
Likes company (3) but likes "sometimes", to be alone for a while (1) as
well.
No (apparent) jealousy, No striking and recurring dreams.
(4) Sleep position: always on her belly. Sleep is OK and deep (3)
No problems in relation to thunderstorms.

(2) She gets now and then a headache (forehead, pulsating like the
heartbeat) caused by (3) being a while in the sun or in (2) closed (class)
rooms.
(2) Likes fresh air, but doesn't sleep with open windows in winter.
(2) Is not very chilly, rather warm-blooded, but not striking. (2) But feels
uncomfortable in warm heated rooms.
(2) Prefers summer, dry and warm.
(1) Perspire relatively easy, on her back. (not very marked however).
(2) When she has a fever, temperature keeps low.
(2) Gets easily a bladder and (once) a kidney infection (used antibiotics
for that).

(2) Is very thirsty (water) in de morning when getting up, in the afternoon
and at evening. Likes to drink rather big quantities at once.
(3) But hates cold drinks and cold food.

Doesn't likes: (3) butter, (2) broccoli, (2) cauliflower, (1) sauerkraut,
(2) beans,
Likes: (3) meat, (3) fat, (3) salt, (2) soft things (pasta etc..) on which
she doesn't have to chew much.

Menstruation: nothing special. Is on the anti-conception pill.
During consultation she's quit calm& open, but, shy, reserved and uneasy
(1) to talk about her constipation, menstruation etc....
But, since she is a close friend of my son, that's maybe more for an
explanation for this uneasiness. That's why I rated this symptom with a (1).

Jan Klüssendorf
Airstop Taxistop Café Parti
tel: +32 (9) 242 32 21 fax: +32 (9) 242 32 29
www.airstop.com www.taxistop.org www.cafeparti.be

[Joy Lucas]

Dear Jan,

Thanks for the extra notes.

I am still feeling that there is something missing from the case, it seems
(she seems?) quite closed. In a way it suggests the Natrums - closed,
reserved, fearful, suspicious, impatient, thirsty, likes air, h/a from sun.
and on another level I keep thinking of Medorrhinum - hurried, suspicious,
fears rats and mice, the dark, sleeps on belly, blotches on face, affinity
with bladder and kidneys, warm. But all this still doesn't feel right
somehow. I know your choice of Arsenicum reps. out but I can't say I see
this remedy here.

Some thoughts:-

It is interesting that she has a grandmother who has diabetes as there is a
connection with this and vitiligo. There is also a connection with thyroid
problems, and addisons disease which involves the adrenal glands, which
could be a link to her recurrent bladder/kidney infections. Has she had any
tests regarding these conditions - they are often routine when people
present with vitiligo as they can be precursers to these conditions. And re:
her bladder infections it might be worth taking some notes on how they
present.

I would still like to know what was going on in her life when this so
suddenly appeared.

Did you delve into her fear of being deceived and thus her suspicion of new
people - why has she developed this fear?

How does she express herself in certain situations e.g. confrontations, how
does she relate to her mother (whom you describe as having a tendency
towards being hysterical under stress) - how does she deal with this?

What is she sensitive to, what makes her cry, makes her angry. How much is
she suppressing her emotions.

What were the bowels like before the pill?

Because I feel that there has to be a connection between her bladder/kidney
infections and the vitiligo I keep thinking about the Berberis group of
remedies. With affinities to these organs there is also circumscribed
pigmentation disorders of the skin, white blotches and pimples on the face.
Generally very thirsty due to a dry mouth. The headaches are >> fresh air.
Emotionally they are usually melancholic with feelings of dejection. There
are big fears in the dark and are easily frightened about anything. Overall
I would say they are quite closed, they don't open up very well during
consultation. You have the added problem in as much as she is a friend of
your son and she might be a bit embarrassed.

I hope this helps and doesn't hinder - perhaps you might want to share a bit
more information.

With best wishes, Joy.

[Jan Klüssendorf]

Dear Joy,

I was rereading this mail of you.
And just this morning I tried (my first !!) to detect the underlying chronic
disease in this case and it now looks clear to me that the most prominent cd
in this case must be Sycosis: sleeping on her belly, low fever reaction,
liking meet and fat, infection of bladder and kidneys, the vitiligo itself
(?).....and I also discovered just the other day that she has on the back of
her both hands (more the left hand) what the doctors called a innocent cyst.
So your intuit of Medorrhinum was probably a good one.

Jan