PATHOLOGICAL
CASE
VARICOSE ULCER
Dr.
Prasad S. Shetye and Dr. Falguni K. Khariwala
“Before
I built a wall I’d ask to know
What I was walling in or walling out.”
– Robert
Frost, ‘Mending Wall’
A
52 years
old female came to see us on 7th March 1998. She
was suffering from varicose ulcer on right leg just
above the ankle. It was a non-healing ulcer after an injury. It
appeared for the first time in October 1990. When it got
infected she applied soframycin and had a severe allergic reaction
from it.
OBSERVATIONS: She came in smiling. She is obese wearing dull-purple colored saree. Her daughter who accompanied her filled the personal details form.
As she entered in and settled down she complained
of the room being very cold.
The varicose ulcer was extremely painful and she had to take painkillers.
The
pain was
<
by first motion.
< by change of position.
< immediately after standing.
<
when goes to rest – first few minutes it pains and then it
subsides.
Due
to severe burning pain in the ulcer she was unable to sleep
peacefully. So unbearable was
her pain that she would sleep with ‘painkiller’ tablets on the side
table.
OBSERVATION: She
was frowning.
She
developed varicose veins during second pregnancy. They
were much more prominent on right-leg than on left.
During this pregnancy she had chicken pox leading to viral flu.
She became anaemic and took iron injections.
She went through lot of tensions.
As she didn’t have anyone else to look after her during
pregnancy, she was scared – “What if no one comes for help? … What
if child is not normal?” It was during this stressful period that she
developed varicose veins.
Past
History: Bleeding piles. At the age of 39 years she
underwent hysterectomy as she was continuously bleeding for
2 months. After that she
developed cervical spondilitis and would get numbness of fingers. Due to this she would drop things.
If
she overworked with right hand, she would suffer from pain on right side
of the body.
Due
to continuous suffering from painful varicose ulcer, she would shift her
body weight on left lower limb due to which her
left knee also started paining.
Occasionally she suffered from urticaria.
By
nature she is worrying type. She worries about finances as
according to her, her husband lends money and doesn’t get it back. He
is 12 years elder to her and is doing service. She does not get along well
with her husband at all. She feels he is not bothered about her or
children. (She has one son who is a surgeon and one daughter.)
OBSERVATION: In her way of narration there was absolutely no
respect for her husband.
There
is so much of pent up feeling within her.
She is extremely unhappy with her marriage and husband. She felt
her in-laws were also not nice with her and had “omitted” her
completely! She feels it very
strongly … she says, “After marriage all my happiness has gone away.
All my sisters are so well settled and happy…
only I am like this!!” i.e. only she is not financially well off
as compare to her other sisters.
According to her, her husband is very adamant. He will not change. He doesn’t tell her anything about money or his savings.
Her
son is a surgeon. He got married in July 1997 and since then there are fights
and lot of stresses. He
separated immediately after marriage and didn’t give them his address.
Now whenever he comes home she fights with him.
She feels – “You should do ‘TIT FOR TAT’!!” She feels
very upset with her son, as he doesn’t give any financial aid.
This
whole episode of son’s marriage and his decision to stay separately has
made her feel insulted and mortified.
She
says she can’t cheat anyone, “I will feel guilty.”
Appetite is good. She
is a pure vegetarian. Being a South Indian she drinks coffee regularly.
She
can’t bear extremes of temperature but prefers hot weather.
FMP when in 9th std.
It was regular.
On
Examination –
Ribbed nails.
As
it was very evident that the patient had no harmonious feeling towards her
husband and was full of complaints and criticism about him, we wanted to
listen to her husband’s side also.
After
insisting that we must speak to him, he came and saw us on 11th
April 1998.
Husband’s
interview:
(on 11- 4 - 98).
According
to him, she is a very adamant lady. She is very quarrelsome
and selfish. He said, “It is so much into her nature to fight that she
creates situation for quarreling! She fights with everyone. No neighbors
are left with whom she has not fought.
She always criticizes and gossips about others.
By nature she is jealous … she curses others.”
OBSERVATION:
He was overtly stressed and disturbed as he was describing his wife’s
nature.
Between
the two of them there had been lot of fights right from the beginning …
the main reason would always be money as she always compared their
financial status with her other sisters’.
According
to him basically she is a “frustrated woman” as she feels her husband
is doing nothing compare to her sisters’ husbands … they have so many
things e.g. car, T.V. of a reputed brand and other material things. She
always blames him for everything. He had given up any hope of she ever
changing.
OUR
PERCEPTION:
This
was a very challenging case, more so because when she informed her surgeon
that she was going for homoeopathic treatment he ridiculed her by saying
what the small pills were going to do when nothing had happened under
allopathic treatment for the last eight years! According to him surgery
was the only answer for this problem of hers.
Also
her suffering was immense and she needed help at the earliest.
As
a person she was …
·
Quarrelsome
·
Jealous
·
Selfish
·
Censorious
There
was A/F mortification.
Pathology is a meaningful provider and thus it
has meaningful significance. On the physical level she was
suffering from varicose ulcer. That’s the pathology. Also
she was having varicose veins. She had severe menorrhagia
and bleeding piles. Thus it was the heart and the circulatory
system through which the disease was manifesting itself.
So in the remedy that we selected we desired to have the
circulatory system as the genesis of its pathological manifestation.
That was the kind of lineage we were looking for while
selecting a suitable remedy for her.
What
else can we consider as her symptoms?
·
Speech
hasty
·
Extremities,
varices lower limbs.
·
Extremities,
varices, leg, ulceration.
Her
pain was burning in character.
From
this understanding of hers we prescribed her the remedy Lachesis.
In
Lachesis the chief lineage of action
is on the heart and circulation. It has hemorrhagic
tendency and we know how this patient had menorrhagia continuously for 2
months. Also, she had bleeding piles. Ultimately, as her state remained
untreated, the disease progressed and produced varicose veins leading to
varicose ulcer … and that is the kind of similarity and lineage we were
looking for.
In
Lachesis, there is sensitivity of nerves causing excessive painfulness …
she had severe burning pain in the ulcer.
Thus
the patient’s state beautifully finds its similarity in Lachesis.
If
one refers to Dr. Herring’s Guiding Symptoms, he mentions …
‘After
a fall, ulcer on right leg with varicose swelling’ i.e. after an injury
as is in her case.
She
was prescribed Lachesis 200 (minimum dose) in June 1998.
She started feeling better. Her ulcer started healing and shrunk in size (see photograph below). In May 2000 her past problem of bleeding hemorrhoids recurred which also disappeared in about a week’s time (recurrence of earlier symptoms according to Dr. Herring’s law of direction of cure). She started getting better in all her complaints. The medicine was repeated infrequently as and when required in deviated doses.
By Nov. 2000 i.e. after 2 1/2 years of treatment her ulcer healed completely. (See photograph below.) In her words (summarized from her last video follow- up) … “I am absolutely allright now. I used to get such severe pain … it would pull like a shock up to my head. It was really very terrible!! Now I sleep very well. There is no pain and as the ulcer has completely healed there is no more that offensive smell. Previously I would literally limp while walking but now even my neighbors notice that my walk is perfectly normal. Now I can even go out and I am really very happy!”
Conclusion:
When you heal
a life, a cured disease comes as a part and parcel of that healing.
We don’t have to be judgmental about our patients as they act in
accordance to the state that they have inherited or imbibed. It is not in
‘confronting’ but in ‘c a r e fronting’ the patient that we
will be true healers. For then our patients will open up those
compartments that they have kept locked in their attics. We have found
that unconditional love always opens people to express their innermost
feelings and through their expressions we reach to the state in which each
is stuck.
“It is
this intangible thing, love, love in many forms, which enters into every
therapeutic relationship. It is an element of which the physician may be
the carrier, the vessel. And it is an element which binds and heals, which
comforts and restores, which works what we have to call – for now –
miracles”.
… Karl Menninger,
Vital Balance.
Our mental attitudes affect first our susceptibility
to disease and then our ability to overcome it. A correctly
chosen homoeopathic remedy affects both stopping the walling in
and walling out and allows our patients to enjoy harmony and
‘wellness’.
You treat a patient – you win or you lose
– but when you treat an individual you win no matter what the
outcome. Many call these results miraculous but for us these are the
outcome of following the principles as laid down in the ‘Organon’
and the guidelines as regards this are written by Dr. Hahnemann as early
as § 3. Apart from choosing the correct remedy ‘…choice of
the remedy, the medicine indicated…’ to overcome the disease
dynamis, it is also equally important that we prescribe the right quantity
and repeat the appropriate dose (deviated doses) ‘… quantity of a
required (proper dose) and the proper period of repeating the dose …’
(§ 3).
To summarise, it will be better to quote Dr.
Kent as he says it better than we could have ever put it in words and
also it will be considered imprudent of us if we were to say the same.
“Correspondences are only the outgrowth of
observations. They are not available to the physician except by the law
‘Similia Similibus Curanture’. Think of these things; meditate and
profit by it; use it. Few know the truth; the world is ignorant. The less
a man knows the less responsibility he has. When you perceive the truth, a
study accompanies it. You are a million times more responsible. When you
come within range of eternal truth, law, and order you take a tremendous
responsibility upon yourself. What we hear at conventions is usually
opinions of men; what we hear now is not opinion. You can see from your
own knowledge that this must be true. I have no opinion and I avoid
offering any until I perceive the stamp of eternal truth.”
…
Kent