PATIENT, a 27 year old female made an appointment with my clinic and traveled with her family to visit my office on October 14, 2013. The entire family was from a strict Christian movement and the female is not allowed to travel alone. PATIENT was thin (like a straw) and pale in appearance. PATIENT also appeared to be shy and reserved, and had her hands in front of her on her lap and had shown little emotions – neither happy nor sad. Instead of going over her problems, I felt it might be better if I could make PATIENT feel more comfortable being with me, so that she would be able to open up and give me feedback on her illness. So I started by asking her how many hours it took her to get to the city, if she had a comfortable night’s rest and asked how the weather was in her hometown. PATIENT described problem as unbearable and severe cramps in the lower abdomen. Pain was constant and she has had on-going moderate pain for approximately 15 years, however at least 2 days in every month the pain would be very severely discomforting. She said that almost every month, she would have to go to the hospital for intravenous pain medication. PATIENT said that the pain would be so excruciating that her mother would attend to her at her bedside, and she would be overcome with crying because she felt so bad. When the pain was severe, she would experience light headedness and headaches, feel nausea but would not vomit. I thought this pain was related to her stomach and digestion. However she said that her digestion was ok, she was able to eat normal food, she had a healthy appetite, all tests she had relating to her digestive system were ok. It was very puzzling that the symptoms did not match what I was diagnosing. She said that due to these persistent and crippling stomach pains, at the age of 14 she had exploratory surgery and her appendix was removed. Since that time, there was no change in the occurrence and severity of the pain. I reviewed her family history, and it was noted on her summary sheet that her father and mother both had hypertension and cholesterol problems. There was no history of cancer in her family, and she does not recall her mother telling her that she had the same type of pains with her monthly cycle. At the age of 16 she had surgery to clean her womb, she had temporary relief but the pain was never gone. PATIENT described the pain as remaining all the time, and she said it has now become a part of her life as she has visited many doctors over the years, and has had procedures done which has not eliminated the pain. She said that she came to try homeopathy as the regular physician was going to perform another surgery on her which she did not feel she would be relieved of her pain. PATIENT exhibited the following physical signs and symptoms:Normal blood pressureNormal CholesterolNo endometriosisAcute and Chronic painPrimary dysmenorrheaScanty mensesExcruciating pain prior to/and during menses
Primary Dysmenorrhea, no other related uterine problems
Excruciating pain lasting 2-3 days per month at onset of menstruation
Chronic pain, condition lasts for duration of lifetime
Symptomatic low self esteem
The remedies considered based on this repertorization was Pulsatilla and Sepia as described in the repertory from Kent’s Rubic, Boericke’s Materia Medica and Homeopathic Guide by Tandon.
The remedy that I chose to prescribe was Pulsatilla based on the overall physical, mental and emotional state of the PATIENT. Dr. William Boericke describes Pulsatilla as predominantly a female remedy. Pulsatilla is an excellent remedy in cases of premenstrual syndrome where suppressed or scanty, lack of menstrual flow is accompanied by acute pain. The menses start, stop, start and flow, stop again. Thus Pulsatilla is effective in cases of abnormally delayed menstruation in females of a mild, gentle temperament. Also headache accompanied by menstruation is relieved by Pulsatilla. The headache is usually throbbing and congestive.
I informed PATIENT that I would prescribe Pulsatilla 200 three times a day for 4 weeks. I advised PATIENT that homeopathic remedies have no side effects and they do not clash with any other –pathy. The following information was discussed with the PATIENT: Pulsatilla 200 is being selected because it covers the primary symptoms she described which was painful and scanty menstruation combined with headaches and nausea. Pulsatilla also matched her mental and emotional state – she was weepy and wanted consolation, she rather enjoyed the comforts of a homely surrounding and enjoyed comraderie of the colony. In chronic cases, medicines with potencies of 200 or more are effective. These potencies go very deep into the system and effect remarkable cures, so that was the reason for choosing the 200 potency. I asked PATIENT if she consented to continuing with treatment and she said yes. Consent noted in PATIENT’s log.
I advised PATIENT that her mouth should be clean, and with no smell from coffee, pickles, onion, toothpaste, because if the remedy should interact with the smell, the medicinal effect dies. It would be better if she can ingest the remedy on her tongue because the medicine goes direct from the taste buds into the blood stream. PATIENT was also advised that the pills can be taken out of the phial onto a stainless steel spoon or it can be shaken from the phial directly on to the tip of the tongue. She should avoid touching the medicine with her hands. PATIENT said she understood the process, and I administered the first dose while PATIENT was in my office. She was sent home with at least a 4 week supply. As far as storage of the medicine at home, she was advised to store the medicine in a cool, dry and dust-free place, away from heat and direct sunglight and also away from any substances that have strong odors.
PATIENT was advised to call in after she had her first menses since taking the remedy, and if at all possible to come in for a follow up visit.
PATIENT returned home up north, and called within 1 week from visit. She stated that she had started her menstruation, and the flow was normal, she had not experienced the severe and debilitating cramping as before. Her symptoms were less severe and were tolerable. PATIENT was advised to continue the medicine and when she was feeling much better, that she could cut back the medicine to 2x per day. Additional medicine was prepared and given to another member of the colony when they came to town.
After 3 months on January 22, 2014, PATIENT called once again to report that she has not experienced any nausea or cramps with her monthly menses. She feels very positive that her life is now normal and she is pain free. PATIENT did not return for a follow-up visit.
In the following year, I have come to know that PATIENT is now seeing a boy and will soon be married. PATIENT has also gained some weight and appears to have a very positive disposition.