Would really appreciate some help on this case of a 38 year old lady hospitalised for bi-lateral swelling in the feet which spread up to the knees together with abdominal pain and swelling. Scans showed no sign of DVT or pelvic mass. She was given an injection in the abdomen (doesn't know what) and discharged with diuretics. These disagreed and were discontinued by her GP. Abdominal symptoms went but oedema in legs remained with pain in knees.

Pt is afraid of water and drowning. She is warm and needs a fan on at night, thirsty for water, < left-side, sour foods aggravate, aggressive before menses, sleepless after waking and jealous of those asleep around her, scared of animals especially snakes, suspicious after an incident last year she wouldn't initially discuss.

After a Px of Lachesis 30 split dose swelling in right leg was gone and reduced by 50% in left leg, urination increased, ROS of long-standing throat condition on left side only. Patient had been using Vicks for knee pain and cortisone cream on left leg which was now very itchy. She was now colder by day.

I continued with Lachesis in LMs. Throat cleared up and period reduced from 10 days of intermittent bleeding to 7 days of constant flow with no aggression. Improvement in leg Ss continued at a slower rate and then stopped and swelling started to increase. Rash on left leg was worse and bleeding, right foot became itchy too > cool applications, pain in left knee severe.

Since then the patient has revealed the incident last year was the discovery that her husband was phoning an old girlfriend. She has lost all trust in him and wanted to leave. She feels violent towards the woman and would like to beat her up. She thinks about what has happened constantly.

I have tried Apis, Sulphur and most recently higher potencies of Lachesis to no avail. After the Sulphur the knee pain spread back to the right knee.

I feel confused that the Lachesis has helped menstrual and throat Ss but not done more for the oedema. I am now considering Vipera as the leg is < hanging down, but would be grateful for people's thoughts on this one.

Many thanks

Esme

Vipera is a good idea. You sound like a very good homeopath!

Snoopy

Don't know about that Snoopy - you begin to doubt your own name after a while!

Thanks for your reply.

Esme

You may also want to consider Hyos as complementary in its link in Jealousy and ailments from being betrayed.

Crotalus casv. may complete the work Lachesis starts, if you wish to keep to the snake remedies.

What symptoms remain?

__________________
David Kempson.<br />Dip.Homoeopathic Medicine.<br />Lecturer Australian College of Natural Therapies (Brisbane Campus)<br />Member AHA, AROH, HMA<br />Member Australian Homoeopathic Association. Member#0442.

Crotalus casv is a very interesting thought. I do have a feeling this needs a snake Rx.

Pt has just returned from new hospital appt. She has been told the leg is severely infected, given 15 days of antibiotics and told not to use any remedies till the 15 days are up on the basis that the Rxs caused the itching which led to the scratching and subsequent infection.

The leg is extremely painful - she can't identify the sensation. &lt; touch and hanging down but no longer &gt; being elevated. She can't walk on it. She is sleepy in the day and very fed up.

At this point I don't know whether she will come back - it seems doubtful.

Thanks guys.

Esme

sounds like calc carb.

Could you say more about that Anna?

Thanks

Esme

yes, i just took a look at boger's boenninghausen p 876 lower extremities agg, hanging down - calc carb is the only remedy.
so then i took a look at boenninghausen's characteristics materia medica for lower extremeties and there you have:
'heaviness of the legs...swelling of knees with stitches...tension in legs, especially from the knees to toes...inflammatory swelling and ulcers on lower leg...'

it also covers the abdominal swelling, although that is not current.

high thirst, weariness and want of strength are calc symptoms, and althouth calc can be hot or cold, it seems like the lach brought out the chilly character of calc clearly.

i would only take the jealousy into account if it showed a clear and direct relation to the presenting symptoms eg. started at the same time, shows aggravation in relation to jealous-making events. similarly all the other concomitants are only of certain use in treating this condition if they are clearly related to it.

to me it looks like lach did some good work for starters as a partial similimum but then, as soon as you get a certain reaction, even to an LM potency, it should be stopped. since it wasn't stopped a proving of lachesis commenced. there was recently a topic on this bb about the dosing protocols for LMs which you might find interesting - i think it was one of Karin's topics.

don't be down, we all have a lot to learn.

Hi Anna

Thanks very much for your thoughts. Calc has repped out quite highly throughout the case along with Puls which has agg.leg hanging down too. Interestingly her sister has done well on Calc.

The incident with her husband and ensuing jealousy etc. immediately preceded the onset of oedema so it seemed important to use. Although Calc can feature these emotions, my sense is that it does so with less intensity than she is diplaying. Also she lacks the general fearfullness of Calc, doesn't sweat and the itching was &gt; cold applications

She began to aggravate at the point of finishing LM1 and as she was about to start LM2. When she called me 2 days later I asked her to stop taking the LM2. However I have seen people aggravate at the end of LM1 before because the Vital Force has finished with that potency and wants something stronger. So it was hard to know whether she needed more or less. Usually I will wait and use their energy levels as an indicator. But in this case pain and urgency precluded that.