October 2010|Vol 7|Issue 10

October 2010 | Volume 7 | Issue 9

 

Case
 
A case of Sepia
 


 


Dr.Sivakumaran, BHMS
37, SBOA Colony Extension
Behind Hotel Gowri Krishna By-Pass Road
Madurai - 625010



        A female aged 32 years presented the following complaints
    · Severe back pain with milky leucorrhea, burning micturition since 3 months.
    · Pain in the left iliac fossa, > by pressure, complaints of dyspareunia with dryness of vagina.
    · Occipital headache with left-sided nasal obstruction. Heaviness of head aggravated by change of climate and dampness.
    · Constipation ++ dry, hard and difficult in evacuation.
    · Pain in both heels < dampness.
    · Bitter taste in mouth.

    Past history:
    Recurrent tendency to catch cold.

    Family history:
    Father diabetic, hypertensive, also a heart patient.

    Personal history:
    Occasional non-vegetarian. She got married at the age of 21 years. Has two children.
    I child – Full term normal delivery. II child – Lower segmental caesarian section.

    Mental Generals:
    She did love marriage against the opinion of her parents, now severe indifference with loved ones, with her husband and also with her children. Irritable+ desire to be alone, but fear of being alone. Sadness++. Weeping while narrating complaints.

    Physical Generals:
    · Irregular intake of food. Want of appetite.
    · Thirst+
    · Sweat++ but does not feel better by sweat.
    · Stool-constipation++, dry hard stool
    · Urine-burning during urination, occasional involuntary passage of urine while coughing and straining.
    · Menses-Scanty, 2/50 days cycle, want of more flow.
    · Sleeplessness++

    Physical Examination:
    Short, fair complexion, obese+, not anemic.
    Weight – 61 kg
    Pulse - 95/min.
    Investigation
    USG of pelvis (Refer Plate - I)
    Intramural myoma in size 1.0 x 0.9 cm in anterior fundal region.
    Bilateral tiny intrarenal calculi.
    Bulky anteverted uterus with tiny intramural myoma.
    Minimal free fluid is seen in pouch of Douglas.
    Few cervical cysts are seen in both lips of cervix.
    Bilateral large ovaries with multiple small surface follicles suggestive of polycystic ovaries.


    First Prescription 12.06.08
    Sepia succus 0/3 1 Dose added in 120 ml aqueous solution, 5 drops every day morning with 100 ml of plain water in empty stomach, each time after 10 succussions for 15 days. She was strictly advised to take vegetarian diet, to avoid coffee, tea, milk products. She was also advised to stop medicine if she feels better.

    Follow Up 1 28.06.08
    Complaints reduced very well. Left side nose obstruction+. Pain in neck+. No burning micturition. Pain in left breast, left iliac region reduced a lot.
    Rx
    Placebo for 15 days.

    Follow Up 2 14.07.08
    Cold+. Cough+. Acute coryza, Generals Normal.
    Rx
    Placebo for one month.

    Follow Up 3 18.08.08
    No Complaints. Generals Normal
    Rx
    Placebo for one month.

    Follow Up 4 03.09.08
    No Complaints. Generals Normal
    Rx
    Placebo for one month.

    Follow Up 5 19.09.08
    Patient is advised to take ultrasound abdomen. And it stated as
    Normal sized anteverted uterus.
    No uterine fibroids or free fluids in the pelvis.
    Both ovaries are normal in size. No adnexal mass lesion.
    (Refer the plate II)

    Discussion:
    After Repertorial analysis, Lachesis and Sepia scored equal marks. Sepia succus was the similimum to this particular case, as her indifference differentiated the nearby remedy