Asthma :: A Case of Asthma – Staphysagria

A girl of 26 years first consulted us on 4/5/2000. She was of short height, dark complexion & had thick, black & curly hair.

Presenting complaints:
– Breathlessness and wheezing off and on since 1991.
Sweating of the palms & soles all the year round.
Headache in the occipital region, eyebrows & the maxillary region.
Rashes when wearing woolens, sweaters.
– Teeth are sensitive to cold water, cold drinks, and cold food items.

History:
Cold and cough since childhood, persistent and perennial.
It starts with sneezing, much watering. After this discharge thickens & cough starts. The discharge is dirty green, nose remains blocked &there is no sense of smell or taste and cannot expectorate the phlegm.
< Change of temperature, morning when puts her foot on ground, cold things, winters, when touched or hit on the nose.– Breathlessness and wheezing off & on since 1991.
In the beginning coughing would lead to breathlessness. Since last year any increase in/ fresh attack of coryza leads to breathlessness. During the attack, cough is non productive.
Cough < lying down, night but increases towards dawn, 4:30 a.m.
During the attack sensation as if “a band around the chest in mid sternal region” and sensation as if “lungs were constricted”.
She has not slept since last 15 days as due to breathlessness. She spends the whole night sitting.
Breathlessness < leaning backwards or lying down; > sitting bent forwards.

Sweating of the palms & soles all the year round.

Headache in the occipital region, eyebrows & the maxillary region.
Headache < during coryza; > putting a cap on, tying the head tightly.

Rashes when wearing woolens, sweaters.

– Teeth are sensitive to cold water, cold drinks, and cold food items.

Treatment taken:
She has taken lot of allopathic & homoeopathic treatment since childhood.

Past illnesses:
– Jaundice before the age of 5 years.
– Mumps at the age of 9-10 years.
– Chicken pox at the age 7-8 years, with very few eruptions.
– Depression in class 12th. Took allopathic treatment.
– Ringworm on left hand 3-4 years back, applied ointment over it.

Family illnesses:
– Father suffered with some skin disease. In childhood he suffered with recurrent cold & cough and again he is having the same the problem now.
– Two paternal uncles are suffering with D.M.
– Mother use to work in T.B. hospital. She is suffering with hypertension, gall stones & has undergone hysterectomy for ovarian cyst.
– Maternal uncle had congenital heart disease.

Personal history:
Unmarried, working as a secretary in The Nigeria High Commission, non- vegetarian, no addictions.
Menses:
Menarche: 12- 13 years.
Cycle: 3-4/ 27-33 days.
Before menses: pain in the lower abdomen, back & thighs, which is very severe in nature. She has to take a pain killer.
During menses: pain continues on the first day & after that no pains.

Generals:
Appetite: cannot wait for food, non-vegetarian.
Thirst: changeable or less.
Desires: sour+++; chicken+++; mutton++; sweets++; warm food++; coffee++.
Aversion: milk
Bowels: once a day, irregular habits.
Urine: normal
Sleep: normal, on abdomen.
Perspiration: offensive
Thermal reaction: chilly, even during the month of May she uses quilt occasionally.
Is sensitive to cigarette fumes and strong perfumes/ odors.

Life and circumstances:
The parents of the patient got married at an older age (when in their mid or late thirties) and she is eldest of their three daughters. Since childhood she has had a very strong love & affection for the animals so she wanted to become a veterinary doctor. After 12th examinations her mother emotionally blackmailed her into joining B.Sc. saying that they are now too old & will be retiring soon & so she must soon finish up her studies and take up some job as she has 2 younger sisters also. She completed her graduation and side-by-side did her secretarial and personnel management courses and now works as a secretary-a job or designation she doesn’t like at all.
When she passed her Xth class examinations her friends changed school or went to different sections. As she does not mix easily she started keeping quiet and started having negative feelings – no one loves her, won’t be able to clear her exams etc. Thereafter in class 12th she had depression.
While she was in class 8th her mother’s brother (who was just 7-8 years elder to her) proposed to her. She refused and thereafter stopped talking to him. She didn’t like it and told her mother who asked her to forget it.

Mentals:
Very sensitive and nervous in nature. She is so nervous that she even loses weight before examination. She feels things and then keeps them inside. Does not open up or mix up easily with others. Likes to stay alone. If hurt, cries when alone. She is affected by music; sad music makes her sad and vice-versa. Loves animals, collects all stray dogs and treats the sick or the injured ones. Likes reading fiction works like Danielle Stele, Mills & Boons, and Sidney Sheldon etc. ‘Creeps’ from lizards. She feels INSULTED about the fact that she is doing the job of a secretary when all her other friends are professionals. Always remembers that her mother did not let her do what she wanted. Now advises all her friends and even her younger sisters to choose whatever line they want to go into. Whenever she gets angry she can’t express her anger properly – starts trembling and goes away. If in front of her someone misbehaves with someone else then she feels angry & sometimes even interferes in his or her matter.

On examination:
Tongue-Dry, whitish coated, red tipped.
Auscultation- Prolonged expiration; mild end inspiratory rhonchi in L.U.Z.

Analysis:
The most striking features in the case were – anger suppressed inside, her inability to express anger and her strong feelings of insult due to the circumstances in her life. In fact when she said that she starts trembling in anger & yet is unable to express it, it was the clue to the remedy, which would help in unlocking the case. We also found that the patient was very sensitive (both mentally and physically) & her teeth were very sensitive to cold. The case beautifully appeared to be of Staphysagria but we decided to check whether the drug also covered the main trouble of asthma – due to which she had spent last 15 nights sitting. In Kent’s repertory we find this remedy under both the rubrics:
– Respiration- difficult; anger, after
– Respiration- lying; impossible.
Reading the drug in Allen’s Keynotes confirms the choice of the remedy. Here we would also like to give the credit to our Guru Prof. L. M. Khan who introduced us to this remedy and showed how deeply it acts.

Prescription:
4/5/2000
Rx
Staphysagria L.M.1 T.D.S.
50 Millesimal potency was chosen due to the condition of the patient (she was having breathlessness at that time and was already much drugged).

Follow up:
12/5/2000
Looking better.
Could sleep at night after starting the medicine.
First 2 days no problem; thereafter feverish feeling and had coryza. Took no other medicine and became all right in 2-3 days.
Yesterday again had breathing trouble but milder than before; also had headache and cramps; phlegm is of white color with yellowish stains.
Day before yesterday she had a fight with sister, which became a bit too serious; couldn’t take out anger; went and cried in the bathroom. (Interpretation- probably this lead to the attack of breathlessness)
Auscultation- Prolonged expiration; mild end inspiratory rhonchi in L.U.Z.

Rx
Staphysagria L.M. 1 T.D.S.
Arsenicum album 30 4 powders SOS (dissolve in 1/2 cup water; 1tsp every 10 minutes at the time of attack)

19/5/2000
Slight running nose and sneezing in between, though better than before.
Cough present since yesterday; slight phlegm is coming out.
No attack before yesterday- had to use 1 dose of Arsenicum album in water; took 3-4 doses & then fell asleep.
Appetite: Normal; Bowels: regular; Sleep: Normal.
Auscultation- Prolonged expiration; No added sounds.
Rx
Staphysagria L.M. 1 T.D.S.
Placebo 2 pills x T.D.S.

26/5/2000
Had running nose &sneezing off & on, but it didn’t bother much.
No breathlessness at all in between.
Cough present with phlegm- very less, whitish, sticky, ball like.
Appetite: Normal; Bowels: regular; Sleep: Normal.
Auscultation- Prolonged expiration; No added sounds.
Rx
Staphysagria L.M. 1 T.D.S.
Placebo 2 pills x T.D.S.

2/6/2000
No complaint of breathlessness in between.
Slight running nose and sneezing- maximum 5-6 times in morning, more when it suddenly rains.
Has been having ice creams almost daily- but no trouble.
Slight phlegm comes out.
Slight occipital headache today.
Auscultation- Prolonged expiration; No added sounds.
Rx
Staphysagria L.M. 1 T.D.S.
Placebo 2 pills x T.D.S.

She has now improved considerably and only after the sudden changes in weather does she need few doses of Staphysagria LM1 otherwise she is fine. She can even withstand dust more comfortably as she says that she even does dusting herself now. The case is still under observation.

Dr. Gyandas G. Wadhwani and Dr. (Mrs.) Parul G. Wadhwani


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