Minutus

I had this young woman in today and her presenting complaints preceded any grief issues. I see this woman as as quite grounded and knows where she is going . Her problems to me are physical and I would be appreciative at anyone's ideas for a remedy as I haven't prescribed yet. The problem is I can't find a Rx which has got both her problems in it which I am happy with. I am thinking of Aurum - I have looked at Aurum Mur.but am not happy with this.

Rochelle

16th February 2004

Background- This 27 yr old woman presents as a 5ft 8 tall woman who is very slim and weighs between 9½ and 10 stone. She arrived wearing gym clothes for her Pilates lesson although her usual clothes would be a pair of designer jeans and boots she said. Her hair is long curly and dyed bright red. Her eyebrows are dark and her skin is freckly. She lives with her partner of 10 years and has no children. She spoke quietly but confidently. She has tried seeing a herbalist and a Chinese herbalist with no improvements.
Presenting Complaints - acne and severe period pain on the first day only which often leads to her being bed ridden and vomiting.
Acne- started at age about 15. It is on her cheeks and venturing down her neck. Her forehead chin and nose are clear. The active acne presents as infected pustules and on her cheeks and neck where it is not active there is a great deal of deep red scarring. It is worse before menses and around mid cycle it starts going down. They pustules are not painful. It has been relieved in the past by being on Dianette (a mixture of co cyprindiol and ethinylestradiol) at age 18 for 2 years and from Roaccutane (last lot was 3 years ago) which she has had 2 treatment courses of.
Around the time the acne started her dad's business went bust and there was lots of worry and a big life style change. "It was an insecure time. We had horses at the time. Everything I loved was going to stop. We just kept going. Dad didn't cope as he buried his head in the sand. Mum was keeping a roof over our heads. Me and my sister were strong to keep it all going. (tears). I've never been an aah poor me type and I just got on with it. No one knew what was going on. I wasn't sure how it would pull back together. We used to go to horse shows and travel the country but it had to stop. The pleasure in life had to stop. You wanted back that level of security of dad working. I worried about other people. I thought that if they're OK I will be alright."
"I'm not sure if I want children or not. I am not using any contraception at the moment. There is lots going on in my life so I'm too selfish. I feel my life is very full and I am happy about that."
Menses - "the pain started over 5 years ago - after I stopped the pill. The pain is before the period starts - the same day it starts. I get severe cramp, like I would imagine labour pains to be. They are at the bottom of my abdomen. As soon as the period comes on it starts to go. Sometimes it is like a shooting, stabbing pain. I am very heavy the first 3 to 4 days. I don't se tampons as I would have to change it after 20 mins. With the pain I can vomit. I have to lie still and am better if I can sleep it off so I go to bed." No clots. She gets swelling in her breasts before a period and can be irritable and sensitive but I asked about this.
She is a singer of pop songs and works 3 or 4 nights a week. She also does recording sessions as a backing singer.
"I eat healthily and don't go out drinking."
Food - likes stir fries and although she calls herself a vegetarian se feels that she needs fish. She prefers savoury although she says she likes sweet as well. Favourite fruits are melon pineapple and kiwi. She doesn't eat meat.
Drink- mostly water
"I am ambitious, confident and a health freak as I read a lot of health books. Yes I like money."
"My mother died 4 years ago aged 46 from an asthma attack. I grieved OK. You have to learn to live with it. I can cope with it better now (eyes watered). I don't dwell by throw myself into my work."
"I am very intuitive. I don't suffer fools. I know what I want. I am very persistent and can suss people out within 10 mins. of meeting them and decided if someone is feeding me a load of rubbish. I trust my own instincts. I am not easily swayed by others. I am more a leader." She sees herself above others.
Anger - "It's more a frustration. It is only 18 months ago that I left home and moved in with my boyfriend. I was frustrated and angry wit my dad as he wouldn't get his act together and he would do things differently than me which would wind me up. He's go round the houses whereas I'm a decisive person. I'll do something straight away and I'll change it if it is not correct" She reckoned she wasn't impulsive. "If I am angry I will get on the treadmill at the gym or go for a walk to clear my head. I would walk in the country. Or I might put my anger in a lyric for a song to sing." She writes lyrics from music she hears. She plays a keyboard.
Upset - "I am upset about mum still." If upset she would prefer to be on her own but it is OK if her partner cuddles her.
"I am independent. I liked being at home as I had the freedom to do as I liked."
"I am not a morning person".
She admits that she probably prefers her own company.
Fears - an insecurity of what is coming next but it is not a fear for the future. "I don't do change very easily. I like to know where I am and so be organised. I want to be 2 steps ahead. I am impatient as I want to be there and I try to hurry things along."
She is tidy.
Very cold hands and feet always although her body is warm.
"Sometimes I have got to be careful what I say in the male orientated world of entertainment."
Environment - prefers the warmth and the sun.
Father - good relationship.
Has had cold sores in the past.
She has hair around her nipples and shaves hair on her stomach below her belly button.
Family Medical History

Mother asthma d. age 46 (on mother's side allergies to animals and eczema.)

Aunt - asthmatic - severe when younger but fine now

Grandmother d. heart attack asthmatic

Grandfather - d 79 Cancer
www.rochellemarsden.co.uk

[Non-text portions of this message have been removed]

Sounds to have a hormonal influence - what about a dose of Folliculinum
which often looks like lachesis. Or maybe have a look at Cyclamen.

Why Aurum? This is usually amenorrhea.

Best, Joy

www.homeopathicmateriamedica.com
on 2/17/04 5:51 PM, rochelle at rochelle@ntlworld.com wrote:

Dear Joy,

Thank you for your reply.

The only reason why I was looking at Aurum is because it has the acne on the face and pain labour like before menses, ailments in puberty (which was when the acne started) ambitious (which she kept saying she was). However it is not in the dysmenorrhoea rubrics. I did think of Cyclamen but haven't looked into it yet. Definitely not Lachesis as she has no throat issues as I checked on that.
Using Jeremy Sherr technique of just repping a couple of rubrics even if they are large I put in Acne -face and Menses painful at the beginning. I got 6 Rx in this order- Syph,(6) Calc (4) Crot h(4)Calc p(2) Foll (2) Quercus (2) and Sel (2) of which only Foll is at all interesting to me really!!
I would be interested to know if in this case others also think that the 2 main symptoms really must be in the Rx as I do.I often just look at M and E but in this case I really don't these are terribly important.

Regards

Rochelle

Rochelle

Well, the acne started round the time dad's business went awry and the
patient said it was a time of great worry - she also kept saying she is
ambitious, which can be a result of financial or other stability worries -
one is driven to succeed so one does not become "bust" and a failure...

I have a feeling M&Es are still relevant here. There is also an element of
"pride of appearance" (designer jeans, shaving of bodily hair) which do not
happily co-exist with unsightly facial acne... Aurum has worries about
success and how one "appears" to the world. Also it is a syphilitic remedy
- and acne is a destructive, scarring ailment.

A penny's worth of musings...

Best
Eleana

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She sounded to me as though Lachesis would be something worth researching for her. I didn't think that someone had to exhibit ALL the major affinities and problems of a remedy for it to work for them. Was I wrong? I.e., the lack of problems in her throat would not necessarily, of itself, eliminate Lachesis if the whole case actually resonated strongly with the remedy.

The hormonal component, the fact that her pain was better when the menstrual flow started, the fact that she's "not a morning person," the acne (though as you've undoubtedly already found out, acne on the cheeks is famously absent from the Repertory), her career choice, her usual way of dressing and presenting herself, her chilly extremities, > sun and warmth, her rather vivacious emotional responses -- these made me think of an animal remedy, and made me think seriously of Lach or another snake.

Joy's suggestion of Foll as a remedy that resembles Lach is a good one.

Rosemary

Dear All,

I really think I am going for Foll on this one - probably a 200C. Have been looking at all my notes on it today. Cyclamen didn't suit at all. I did question her re Lachesis and really there is nothing there. Couldn't find enough on Pit g to decide on that and I also looked in detail at Aurum N M. I liked the Nux analysis but although there is ambition there is no aggression in this woman.
We have acne which has been cured by the pill in the past, the period pains came on after being on the pill > for the flow, heavy bleeding. The hair in unusual places is hormonal. The distress at the life style changes at 15 could be part of the picture and I think this could be part of the Foll picture as well not her present picture but then. She said that she made sure that others (her mum and dad) were alright and then she would be OK. I think intuition is also part of the Foll picture. There is Reynard's in Foll which may explain her poor circulation in the extremities. Well it looks as if i have talked myself into Foll!!!



Thanks to all who have helped me clear my mind including Andy for his usual great rubrics sent privately.

Regards
Rochelle
www.rochellemarsden.co.uk

Thanks Patricia. I am interested to know where you got this core issue from
as I can't find it in anything I have read. I can't honestly say it suits my
patient who appears very confident and knows where she is going. It's just
that there is a fear of what is coming next but not of the future. She likes
to know where she is and where she is going if that makes sense.

Regards
Rochelle
www.rochellemarsden.co.uk

Eversince I started learning homeopathy, I was
'taught' that when treating woman, their menstrual
symptom must be included. Dr Benedict D' Castro, in
Logic of repertories, stated this explicitly and I was
much the wiser after reading it.

This folliculinum decision, I mean: Does it include
the menstrual sx ? If just acne , there may be many.
IMHO the abdomen+cramp+shooting with that PQRS of
vomitting with particular reference to menses and a
lesser one of eruption is what can decide this case:-)
Experienced ones can have different views on this. No
mental sx of marked value is in this case. Even
causation 'puberty from' is not clear or muddled by
further suppressions.

I will be very thankful to you if you post us the
follow up.
With warm regards
Venkat

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Yes Folliculinum does have Pain at beginning of menses, swelling of breasts before menses and heavy periods. I will send a follow up in about a month but re the menses it usually takes 3 months for a homeopathic Rx to make a difference. I have given her some herbal Crampbark to take for the pain next month. Interestingly she has tried the special magnet for menses pain and it hasn't worked. Apparently it does work for most people. She has had scans and nothing has been found that could explain the pain.

Regards
Rochelle
www.rochellemarsden.co.uk

Hi again Rochelle

It's "early days" with the Lacs yet and more and more "observations" will be
making it into the literature over the next few years.
This observation is from my clinical experience but triggered initially by a
pespective put by Sankaran at a paper he gave at the ICCH Conf in Tromso in
2000 and one can see it in his proving if you go through it carefully .
He added some good info to be added to the initial proving of Houghton and
Halahan.

He introduced the idea that the core issue is about getting this balance
right and I have worked with it to good effect over the past 4 years.
I don't know if you can still get a copy of the Proceedings from that
conference; might be worth your while to track it down as Alize Timmerman
also gave an excellent paper on Lac-h which touched on this idea as well.

The Links book on MM of Milk has something in it by me which expounds on
this idea; with cases.

It's not a fear of the future but a problem with reaching out and grabbing
it by the throat as the individual is "torn" between meeting his/her own
neeeds vs meeting those of others and tends to put the others first.

It is the Christian way; part of our conditioning & why we, in Western
cultures, tend to abgnegate our needs in favour of another's. We "turn the
other cheek" and value Humility over Egotism..
Sankaran at Tromso very nicely suggested that it is why we tend to sign our
names using only the initial and add emphasis to the surname which
represents the group identity. How many lists of names have we ever seen
with both a given name and a surname? Not many! Sankaran took this idea
further by pointing out that in Eastern cultures (especially communist
regimes) the tendency has been to give all of the power to the state; to
wear grey; to lose one's individuality.
Sankaran urges that we need a balance and Lac-h can bring that about.

So, the Lac-h "issue" is about getting in touch with the divinity within and
not looking outside for it.
We are creative beings who have the power to shape our own destinies. That
is why Foll is comp to Lac-h; it's a creativity issue in that instance.

Because of this tendency not to promote the individual consciousness, if any
of my patients are Lac-h I look at the way they sign their name and often
suggest a change in signature.

hope that helps.

best wishes
Patricia