Introduction:

   Dr. A.P. Sivakumaran, is a young homoeopath, dedicated and renders service to homoeopathy. He holds clinical meets and medical camps. He had authoured a book in tamil and his papers had been published in journals. Here he presents a case of Sepia.

A 32 years old female presented the following symptoms
· Severe back pain with milky leucorrhea, burning micturition since three months.
· Pain in left mammary gland with heaviness, ameliorated by squeezing out the discharge. Pain in nape of the neck, left-sided.
· Pain in the left iliac fossa, amelioration 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 caesarean section.

Physical Generals:
Appetite : More ,Irregular intake of food.
Thirst : More
Sweat : Profuse but does not feel better by sweat.
Stool : Constipation++, dry hard stool and wetness in anus after lower segmental caesarean section. Indigestion+.
Urine : Burning during urination, occasional involuntary passage of urine while coughing and straining.
Menses : Scanty, 2/50 days cycle, want of more flow.
Sleep : Disturbed

Mental Generals:
Her wed lock is love marriage against the will of her parents, gradually 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. Aversion to coition because of dyspareunia.
Physical Examination:
Short, fair complexion, obese+, not anaemic.
Weight – 61 kg
Pulse - 95/min.}

Systemic Examination:
CVS : NAD
RS : NAD
She was advised to take ultrasound abdomen and pelvis.
Refer plate I & plate I I

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 succession for 15 days. She was 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 impressed that
Normal sized anteverted uterus.
No uterine fibroids or free fluids in the pelvis.
Both ovaries are normal in size. No adnexal mass lesion.
Refer plate III & IV

Discussion:
Sepia sucuss is the similimum for this particular case, prescribed based on totality of symptoms, especially for her indifference which restored the sick to health . Lachesis and Sepia scored equal marks with repertorisation however Sepia succus was the similimum on the basis of totality of symptom.s