INTERESTING CASE. NEED YOUR HELP. . A lady aged 40 yrs came to my opd with complaining of severe continuous itching all over the body since 3 months. took all the best allopathic treatment but fails to relieve. . Housewife. AMBITHERMAL. Red Rashes all over body( like urticaria ) converted in to white scales(like dandruff) after itching . . Recurrent Stomatitisis since 5 yrs. amelioration by cold drinks. Regularly taking antidepressants since 4 yrs. . previously treated as anaemic. (7%HB ) now HB %is 11 .. other investigations are WNL. APPETITE -DECREASED. hunger intolerable. feels weak when too much hungry. THIRST. -FOR SMALL QUANTITIES OF WATER AT SHORT INTERVAL. ++ Desire -ice-cream even in winter and all the season. Aversion - eggs and meat. even smell of it intolerable. . perspiration -waking after from bed at neck, chest and back. sleep - can't sleep without taking pills (AD) . Dreams of someone choking her neck. suffocating feeling .wakes up immediately. Menses; -. irregular, late upto 4 days delayed. during first day severe bodyache without a abdominal pain. wants all the time in bed. rest. weakness. after first day no any complaints on 2 , 3 and 4th day. discharge normal. . leucorrhoea before 8 days of menses. scanty. excoriating. . having three children. by normal delivery. . Mother - died due to LEPROSY Father - DM. . At her birth she is weighing down. . MENTALS :-. *ANGRY, EASILY. SUICIDAL TENDENCY AFTER ANGER. ATTEMPT ONE TIME. TAKEN 17 PILLS OF CLONAZEPAM. ADMITTED TO ICU 4 DAYS. *Noise any type of makes her irritable. specially of kitchen pots. *Doesn't keep secret for long time. *fear of snakes. . so the tell me diagnosis and plan of management.

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Dear Akshay, Thank you for sharing! In this case if we see medically then this is a case of massive depressive disorder. In massive depression the patients are usually suicidal and even can attempt it. No fear of death. In addition the increase in hunger can also be seen in depression along with low energy. If we look at the family history her father is diabetic. Hence, I would like to do few blood investigations like BS, and vitamin B12, vitamin D, iron or PBF and TSH However, in homeopathy I have seen the following symptoms are really important:- The most import symptom is coming through her dream which can be repertorize as her a) Delusion choking someone her throat b) The other SRP which if important is drinks little and often which you knew already ARS ALB. 3) excoriating discharge ARS ALB c) hunger increased a sign of depression ARS ALB d) reveals secret easily e) fear of snakes which is common in India may not be a good symptom f) Massive depression ARS ALB g) skin itching ARS ALB h) she is very sensitive to noises may be due to depression or due to allopathic medicine but we can repertorize this symptom too. I haven't repertorize but I will tomorrow. HOPE THIS HELPS!

The other complementary remedy of ars alb which is Lachesis can be a choice of remedy.
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Agree with @Dr. Surbala Badgaiyan ma'am, But Along with Pitta, Kapha is also Involved as Itching is caused by Kapha Only.... And Vitiation of Mansika Dosha is also there.... So, we need to work on Tridosha and Mansika Dosha.... We also need to advise for Daiva Vyapashrayai Chikitsa/Bhootaghna Chikitsa.... @Dr. Akshay Ingole sir You can add Brahmi Vati and Jatamamsi Churna along with your homeopathic management, It will help you alot in balancing Mansika Dosha....

Thanks sir
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Agree with Surbala mam. Want to add few Chandraprabha vati 2 tds Suvarna sootshekhar ras 1 bd Jatamasi +Ashwagandha +shatavari +mouktik praval +bramhi + shankhapushpi 1/2 tsf each bd with goghrut . Saraswatarishta 3tsf tds with lukewarm water after food.

Chandrakala ras can also be added
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@Dr. Akshay Ingole -i think it's urticaria.scaly lesion after itching is due to dry skin because u told her nutritional status is not good

Thanks mam
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@Dr. Akshay Ingole Sir! More clear images are required to make perfect diagnosis. But, it seems to be a case of PLAQUE PSORIASIS with PERSISTENT DEPRESSIVE DISORDER Doctor! You have mentioned that she has become addict of Antidepressants. Please note that long term use of antidepressants may cause increase/decrease of appetite, INSOMNIA as well as SUICIDAL TENDENCY and PSYCHOSIS. So, it is possible that she is also suffering from side effects of antidepressants. Though your case taking favours ARSENIC ALBUM, I advise you to give one dose of NUX VOM to get clear picture of original diseased patient.

Yes sir. Agree completely. But it more likely looks urticaria rather than psoriasis. . The rash sign is positive when touched that red area it becomes pale yellow. And off suddenly when fingers goes away. I gave her Nux v 1m single dose. Let's see what happens. .
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Urticaria n scale lesions due to poor metabolism poor balance diet Vit B deficiency also Tb.Mosiba 1tds Tb.Greosovin-OD 250 mg 1bd Cap.Rablet-L 1bd Tb.purugo-25/Atarex 25 SR HS L/A.....liquid paraffin +lemon +arq shahtara (5:1.5:2) apply all over the body at bed time Calamine lotion in morning after the first application of coconut oil Arq shahtara +arq mundi +arq ushba +arq murakkab musaffi each of 25 ml with sharbat aamla +sharbat faulad + sharbat ushba khaas each 15 ml. BD Itrifal ustukhuddus 1tsf bd For 2 month Insha allah jald hi kamyabi milegi

Thanks sir
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It's chronic urticaria or may be psoriasis It may be that the immune system attacks healthy tissues,triggering the release of inflammatory chemicals in the skin. Check the cells count Liver function Look for the possibility of bone marrow disorders or liver disease.

Thanks sir
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@Dr.Akshaya Ingoleji , According to Ayurveda's it's pitta& cophaj mixed /dwandaj mungdal khichari with cow gee is the best pitta& cophaj , Kamdudha Ra's motiyut 1 tds, Sutsekhar Ra's 2 tds, Khadirarist, Chandnasaw 30 ml bd, Cap.Finbid1 bd, Brahmani bati 2 bd, Sarswata rist, Kumari aswa no.3, 30 ml with warm water bd.Apply Mahamarchyadi tail.

Thanks sir
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A Case of depression probably suppressed intermittent. Nux vomica 30 One Dose dry Followed 6 wks after sepia 200 One Dose dry on tongue.

She was treated for depression where as she is a case of bi Polar disorder. She needs tab quitipin 25 and adjust after ecg till optimum single dose at bed time in sustain release form. Please discuss with attending psychaetrist.
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@Dr. Akshay Ingole sir,,what u have told about pt and pt disease it's a case of pittaj vyadhi,all symptoms are of pitta impurity with increased level,so, along with your homeopathic treatment advice her to take ghee 5-6 tsp daily,..ghee in both nostril at bed time 2-2 drops,,,,also rubbing of ghee or tail in leg palm ,it will help her for good sleep...

Thanks mam
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