Understanding the theme for constitutional prescribing – A case of vitiligo A 10-year-old, prepubertal girl came to our clinic with her mother 6 months ago with CO appearance of a hyperpigmented patch, about 2.5 cm in diameter on the left side of her chin, increasing rapidly since 2 weeks. No h/o any skin ailment in the pastThe patient had a history of repeated cold and cough with episodes of wheezing better by asthalin inhaler. The skin patch was shown to a dermatologist, diagnosed as vitiligo 3 months ago. Advised Deplin cream and Decdan B with no significant change. There is no itching, no redness, no roughness of the skin. Discoloration changes from brown to pink to white.The patient stays with her mother in Mumbai. Her parents separated when she was 8 years old. There were constant fights between parents. Father was very aggressive and abusive. She subsequently moved to her grandparent’s residence with her mother and got very attached to her grandmother, who looked after her. Mother is a control freak and wants everything in order. Mother had conceived the patient after 2 elective abortions, as she did not want to have a child, due to differences with the father. However, the parents made up and decided to have a child through IUI.The patient was very sensitive to parents’ quarrels as she loved both of them dearly. Continuous conflict at home had affected the child as the parents used the word ‘separation ‘. quite often. She is now very afraid of being left alone. A sensitive, mature, and conscientious child became introverted, nervous with low confidence. She is afraid of staying alone and wants somebody in the room. She desires eggs and has one every day. Based on this, please see the following rubrics:white spots, vitiligowhite discoloration skindesires eggsfear separation ofInsecurityabandoned, forsaken feeling abuse, ailments fromconfidence want of
Calcarea carbonicum matches this symptom picture almost in its entirety. The feeling of insecurity, loss of confidence, and sense of isolation following parents’ separation along with the marked desire for eggs makes Calcarea carb a perfect prescription. Was administered in ascending potencies of 30 c, 200c, and 1M with the very rapid results. *
For constitutional prescribing it is very important to take the case in detail and choose the rubrics according to the theme of the case. It is essential to catch the thread that runs through the case, else we will miss the wood for the trees!