Dr.
Winston Vargheese
Introduction
Dr.Winston
Vargheese, lecture, physician, and Research scholar is known to
every body. His in depth study, innovative application makes every
body surprise. He had written many articles in Souvenir, Magazines
and Journal. And also presented many scientific papers in seminars.
His rational approach to his patients and clinical evidence based
documents are added advantage for our fraternity..
A female patient aged 51 years from a Village
Malavilai, adjustant to Kulasekharam, presented the complaints
of itching of the skin with blackish discoloration in small
patches and thickening of the skin especially over the hands
and leg. The complaints started since ten months. Itching is
better by warm application and after scratching there used to
be burning sensation. Patient had similar complaints 7 years
back for which she has taken allopathic medicines and was feeling
better with that. The complaints have reappeared once again
three years before and she consulted a dermatologist who has
diagnosed the case as Lichen Planus and then she was treated
with steroids. She was also having headache since two years,
which used to trouble her whenever she goes out in sun, when
she travels by bus and when she is hungry.
Past History
In her childhood she used to have recurrent attacks of running
nose and cold. These complaints have vanished completely after
she developed the skin complaints.
Family History
Nothing was enquired about Menstrual History
She had menopause without deterioration of any complaints, two
years back.
Personal History
- She desires fish
- Does not prefer to be covered usually,
but if too cold then uses a very thin covering. Wants to take
cold water bath and prefers to emain in open air.
Life space investigation
Patient is the only child of the family from a
lower middle class family. She has two daughters and two sons.
Sons are doing their degree. The daughters are elder ones. Husband
is a party worker involved with labour union and he spends most
of the time for party work and even money he spends on party work.
The daughters are to be married; patient feels that father is
not very much bothered about it. She worries a lot about the irresponsibility
of her husband and gets angry over the issue, yet does not express
about. While narrating these there was tears on patients eyes
and she was very quick to wipe it out so that the physician does
not notice that.
Physical Examination
Pulse 74/min, BP110/70mm Hg
Thickened lichenified patches all over the body
Analysis and evaluation
This is a case of Lichen Plannus and where the
immunity plays a very major role. The immunity itself is maintained
by the Psycho –Neuro - Endocrine mechanism. So in understanding
the patient the importance has to be given for the mind. The prolonged
worry and the suppression of anger is to be given more importance
and so the mental generals need much importance in the construction
of totality. More over there are no characteristic modalities
available, so the prescription should be based on Mental Generals
and Physical Generals.
Totality
The remedies which came up predominantly
for this totality are Natrum. Mur and Pulsatilla.
Reportorial Totality
1. Kent: Mind. Grief Ailment
from
2. Kent: Mind. Weeping, tearful mood
3. Kent: Mind. Ailments from anger after silent grief
5. Kent: Stomach: Desires fish
6. Kent: Head. Headache in general sun from exposure
7. Kent: Head. Headache in general
fasting from
8. Kent: Skin. Discolouration blackish
Prescription
10-8-2002 First Prescription
Rx
Natrum. Mur 0/6
3 Doses on alternate days at night
Not much change
But generally feels better
Rx
Natrum. Mur 0/6 7 Doses daily night
The remedy was continued till 31-8-2004 then there was marked
improvement in the lesions and yet there was itching persisting.
Later on the potency was raised to Natrum Mur 0/12 and was repeated
frequently. Now the patient is completely free of the Skin lesions
and no more itching. Patient also got Rhus tox and Pulsatilla
in between when she developed fever and acute coryza as acute
remedies.
Discussion
Since the disease is an autoimmune disease which is usually a
functional change and not much of structural damage is not there
a higher potency could have been used. But as auto immune disease
where a flare up and aggravation could be expected the safer potency
Millesimal was used so that a frequent repetition was done. During
the course of treatment the old symptoms of cold reappeared. But
those symptoms were so much troubling the patient that she even
developed fever, which required an acute remedy intervention.
Limitation
The other physical generals such as Perspiration, Appetite, and
thirst were not enquired. The family history and miasmatic background
is not understood.
Conclusion
When there is physical disease and mental state or symptoms are
available prime importance has to be given. In autoimmune disease
where one expects flare up the medicine in Millesimal potency
can be used without any aggravation and with positive results.
Lichen planus is a disease, which allopathic system considers
as an incurable disease and there could be remissions. It requires
a prolonged medication especially with steroids. But with homoeopathic
treatment the improvement is very fast and there are no remissions
till now.
