Hi,
My wife has this problem since the last three months:

When she lies down in the night, the bleeding starts somewhere in the head and trickles into her nose and into the lungs/stomach. Then there is suffocation or has to gasp for breath.

If she sits down it is better but still the blood escapes into the lungs and stomach.

Bryonia 30 helps in stopping the bleeding within few minutes of taking it. Can I go for a higher dose. Other symptoms that have been observed....she gets dizzy on standing for long time. Walking helps. Brain goes dead and blank...probably a symptom of being anaemic.

No particular day or repetition observed....

I am guessing it should be during the regular Periods time.

Thanks,
Sridhar

Hi Sridhar,

Is the bleeding coming from her nasal passages, I assume? (If it's anything else, I'd think you need to know what!!) If this is a problem that keeps recurring, it sounds like you have a palliative remedy, but need to treat deeper to stop the problem at its root. Has she been treated "constitutionally", on basis of her total picture aside from the bleeding?

Shannon

some strong Lach modalities (keynotes) to this case, would you care to share it in further detail?

merrilee

The following are my general observations:

Mind: Forgetful. Have to remind her to do things. Does not like to talk over phone.
Very pleasant if she happens to talk to someone on phone but hates to initiate the talk or make the phone call.
Cannot sleep in moving vehicle. Scared of sudden dips in the road especially while driving.
Gets dizzy all of sudden on standing for long time and falls over. Usually sees black spots in front of eyes before falling. Recovers after 15 minutes of lying down in the same position.

Ear, Throat :
Cannot bear cold weather. Gets ear infections, sore throat often if it is cold outside.

Likes/Dislikes:
Does not like salads or raw food. Does not like smell of milk...she usually adds chocolate powder. Cannot take milk directly.
Loves pizza.

Female:
Periods absent eversince the insertion of Mirena. Irregular bleeding happens and stops after two days.
Pain during coition. Likes to have candies and chocolates during periods...but does not have.

Nose:
Internal Nose bleeding and usually happens during the time of periods (no periods though...but during that time if it would happen though) and on lying down. Sitting position is the best. Sometimes the bleeding lasts for an hour and all of it goes into the stomach. Loss of blood makes her dizzy.

Sleep: Likes to sleep with legs folded or likes if someone puts something heavy on her legs during sleep (usually my legs).

Thanks,
Sridhar

Quote:

Nose:........

Hi
your prescription of Bryonia may be fine - it is included in the following rubric which is relevant I would like to think on this a little more and get back

Best

Robyn

NOSE - EPISTAXIS - menses - instead of
apis both-ax. Bry. carb-an. cham. dulc. erig. eupi. ferr. graph. Ham. Lach. lyc. nat-s. phos. Puls. senec. sep. sil.

NOSE - EPISTAXIS - menses - suppressed menses; from acon. bell. both-ax. BRY. Cact. calc. carl. Con. Croc. dulc. Gels. ham. hyos. kali-i. LACH. nit-ac. ol-j. Phos. PULS. Rhus-t. Sabin. senec. Sep.
--

please tell us more about the physical makeup of this woman,also the likes/dislikes,fears, so we can get a picture of her constitutional.

To the other homeopaths; sounds like cal carb const, but too early to tell yet...
Gina Tyler

Quote:

Originally Posted by Sridhar Kotti My wife has this problem since the last three months

Hi Sridhar,
I took a look at the addl sx you gave in the second email. I did an analysis before I read that email which I include here.

But clarification needed from that email:
========
From that email: what does this mean

Quote:

Periods absent eversince the

Is Mirena a tampon, IUD, etc... (sorry if not up on this term).

Also,

Quote:

Cannot sleep in moving vehicle. Scared of sudden dips in the

Does she "startle" easily? (lends weight to Phos which has vertigo and black spots, or Ferrum phos (confirmed anemia or ferrum characteristics plus phos)

Most importantly (was this the "Mirena" insertion?)--what happened 3 mos
ago...?
========

ANALYSIS PREVIOUSLY DONE:
What happened in her life just before 3 months ago when this began? Did something suppress the menses--emotional, meteorological, trauma exertion, etc. What are some other characteristics she has aside from this syndrome...

====
hot/cold person--ok she is cold
occupation
demeanor--forgetful, seems high strung
vitality
is she in fact clinically anemic
does the hemorrhage fully REPLACE the menses--I gather it does..
what is her age? Has climacteric begun?

Bry was good prescrip on the vertigo and the vicarious menses. But it could be a simile. I would want more info to confirm an rx. I hope the info here can help you do this, or post further info based on the below, and that might allow confirmation.

Quote:

Originally Posted by Sridhar Kotti When she lies down in the night, the bleeding starts somewhere in the head and trickles into her nose and into the lungs/stomach. Then there is suffocation or has to gasp for breath.

Hemorrhage, passive, night or epistaxis night, or (possibly if yet fully confirmed) menses vicarious, night. The suffocation probably not peculiar in such a situation, despite being a Lach or snake keynote..

Quote:

Originally Posted by Sridhar Kotti If she sits down it is better but still the blood escapes into the lungs and stomach.

So at least once started, it does not depend wholly on the condition of lying.

Quote:

Originally Posted by Sridhar Kotti Bryonia 30 helps in stopping the bleeding within few minutes of taking it.

Bryonia appropriate for vicarious menses aspect, worse lying on one particular (liver side). Usually the epistaxis is in AM on waking, however. If you used vertigo better walking, then Bry fits there also. If Bry really is not just a rough simile--then depending on what happened 3 months before (emotional trauma?) perhaps nat-m is something that should be looked at as it is the chronic of Bry, but this is just a general thing not to miss in case it applies. The case will likely ride on details you have not yet revealed, esp. what happened 3 mos ago, and her other char.

Quote:

Originally Posted by Sridhar Kotti Can I go for a higher dose. Other symptoms that have been observed....she gets dizzy on standing for long time. Walking helps. Brain goes dead and blank...probably a symptom of being anaemic.

dizzy (vertigo will have to do) on long standing better walking.

Quote:

Originally Posted by Sridhar Kotti No particular day or repetition observed.... I am guessing it should be during the regular Periods time.

In order to confirm vicarious menses, the hemorrhages will need to be confirmed as replacing the menses. Any menses at all?

REPERTORIZATION:
Menses [sen] vicarious or epistaxis [3] menses (78) : acet-ac., acon., agar., alum., am-c., ambr., ars., bapt., bar-c., bell., both-a., bov., brom., Bry., cact., calc., carb-an., carbn-o., chin., cimic., coll., con., corn., croc., crot-h., cupr., cycl., dig., dulc., erig., eupi., ferr., ferr-acet., gels., ger., glon., graph., Ham., hydr., hyos., ip., kali-c., kali-hp., kali-i., lach., lith-c., mag-c., meli., meli-a., mill., nat-c., nat-m., nat-s., nit-ac., nux-m., nux-v., ol-j., phos., podo., puls., rhus-t., sabad., sabin., sang., sec., senec., sep., sil., sulph., thea., thlaspi, thuj., tril., ust., verat., vib., xan., zinc.

Hemorrhage [sen] night (45) : acet-ac., acon., alet., am-acet., arn., ars., bad., bapt., bell., Bov., calc., calen., canth., chin., coch., dig., dros., ferr., ferr-f., ferr-p., gall-ac., graph., ham., iod., ip., kali-c., lach., lyc., mag-m., meli., merc-c., nit-ac., ph-ac., phos., puls., rhus-a., rhus-t., sabin., sec., semp., stict., sulph., thuj., tub., ust.

Epistaxis [sen] sleep (31) : am-c., arn., bell., bov., bry., conv., cor-r., Crot-c., gels., graph., ham., hir., lach., Mand., Merc., merc-c., nat-m., nat-s., nit-ac., nux-v., phos., pitu-a., puls., pyrog., rhus-t., stry., sulph., tab., tarent., thlaspi, Verat.

=============
If we cross these three:
Elimination: bell., Bov., graph., Ham., lach., nit-ac., phos., puls., rhus-t., sulph.
=============

if then further cross:
Vertigo [sen] walking [sen] amel/better: abrom-aug.188, acon.5, am-c.5, am-m.102, anac.5, apis36, apisin., arn.36, aur.8, bell.5, berb.2191, bran., bry.5, cact.91, calc.5, calc-p.37, calc-s.91, camph.54, cann-i.118, carb-ac.8, carb-v.8, caust.54, chin.8, coca36, con.8, crot-h.8, cycl.8, cyn-d.192, dros.8, eup-pur., euph.8, eupi.188, ferr.8, fumar-ac.232, grat.54, iod.8, kali-bi.5, kali-c.1, kurch.97, lach., lil-t., lyc.36, lycps.54, mag-c.36, mag-m.5, mag-p.223, med.8, mill.36, mur-ac.8, nat-c., nat-m.8, nux-v.85, oena., par.5, ph-ac.8, phel.8, phos.5, pic-ac.8, plat.36, plb.54, ptel.54, 2puls.8, ran-g.85, rhod.5, rhus-t.8, sabad.5, sep.8, sil.5, spig.8, spira.36, stann.8, 3Staph.5, sul-ac., sulph.5, tab.36, tell.8, ter.36, zinc.5

Elimination: bell., lach., phos., puls., rhus-t., sulph.

===========
But at this point, we get only the most well characterized rx.

Referenceworks Looks:
=======
1. Dizzy/vertigo [sen] standing [rem] ((epistaxis [sen]menses/bleeding)/(menses [sen] vicarious)) [rem] hemorrhage/epistaxis [sen] night/sleep [sen] lying:
bov., lach., lyc. phos. rhus-t. 3Sulph.

=====
2. Menses [sen] vicarious [sen] night:
ham., ust., 3Zinc.

=====
3. Hemorrhage/epistaxis [sen] posterior [sen] nares [rem] night:
ail., bar-c., crot-h., elaps, ferr-p., 2ger., 2helia.

Some candidates:
-Puls--a main rx for vicarious menses, dizzy on standing, better walking. Menses too scanty or suppressed
-crot-h-- Vicarious menstruation; in debilitated constitutions (Dig., Phos.).
-Bovista--epistaxis night
-ferrum phos- (hemorrhage in an anemic person)
-phos Vicarious menstruation; in debilitated constitutions (Dig., Phos.).
-rhus-t (modality-driven---vertigo better walking); epistaxis menses suppressed
-digital-Vicarious menstruation; in debilitated constitutions (Dig., Phos.).
-lach--epistaxis at climacteric
--nit-ac tendency to vicarious menses
--bell--in a calc constitution
--graph--in corpulent woman with skin eruptions
-elaps--(Roberts) XX. CLINICAL FIELDS.
Nervous disorders. Affections of glands and skin or axilla.
Nasopharyngeal catarrhs with green crusts. Haemorrhages: epistaxis.
Hemiplegia. Amaurosis. Pneumonia. Phthisis. Affections of ear, nose, throat.
Sexual and menstrual symptoms.
-Ham--if some mechanical injury (esp to ovary) happened 3 mos ago
-Ustilago- Nose. Bright epistaxis, amel. pressure. menses vicarious night.
-Zinc--epistaxis night, menses suppressed
-sulph-- Epistaxis, aggravation night or lying on right side.

other hemorrhagic rx
--melilotus--epistaxis improves a congestive head condition
--millefolium--Affects the CAPILLARIES of LUNGS; nose, and uterus. Bruised
soreness; congestions; profuse, painless, bright red, fluid haemorrhages; epistaxis, haemoptysis, oozing of blood from the edges of closed wounds, from overexertion, etc.--may be traumatic cause

unlikely--
--geranium--acute epistaxis-- given in thirty-drop doses of the tincture every three hours.
--helianthus--if malarial miasm case

A few selected
======
bovista
Medical Advance
Epistaxis:Bovista-- At night; during stool; from bending forward or any bodily exertion.
[Aconite: congestive, arterial bleeding;
Belladonna: congestive;
Bryonia: in AM after rising; vicarious:
Crocus; black, viscid blood with cold sweat on forehead;
Mercurius: blood coagulates in the nose and hangs down in strings;
Nitric acid: frequently specific in epistaxis;
Pulsatilla: vicarious menstruation;
Trillium: passive hemorrhage].

====
Ham
Nosebleed: flow passive, long - lasting, blood non - coagulable (Crot.); profuse amel. headache (Mel.); idiopathic, traumatic, vicarious, of childhood.
Hemorrhage: profuse, dark, grumous, from ulceration of bowels (Crot.); uterine, active or passive; after a fall or rough riding; vicarious menstruation; no mental anxiety.

====
Puls
Vertigo: excessive, like intoxication, as if one had turned in a circle a long time, with nausea, on looking upward, as if he would fall, or as if he were dancing, thought he was unable to stand or grasp an object, with heat, nausea and loss of sight, in evening, with inclination to vomit, when stooping, when rising from a seat, after eating, when lifting up eyes, as from heaviness in head, especially while sitting, in morning on rising from be, has to lie down again, worse sitting or lying, better by walking and in open air, caused by indigestion, in consequence of scanty menses.

========
crot-h-- (nice coverage of both crot-h and lach)
Crotalus horridus
Keynotes and materia medica
Sudden onset: especially of septic states; with rapid progression of the disease leading to prostration and nervousness
Sepsis: septic conditions, blood poisoning with hemorrhages; in any acute illness i.e. typhoid, diphtheria, puerperal fever, dysentery (from bad water or food Ars., Pyr.,), malignant scarlet fever smallpox cholera, yellow fever, tubular nephritis, acute alcoholism (with the delirium tremens), hydrophobia, epilepsy etc. It is a specific for black-water fever (S.H.). Or from insect stings/bites, burns, abscesses (with sepsis).
Hemorrhage: bleeding from all orifices in the body (eyes, ears, nose, stomach, mucous membranes everywhere, bowels, uterus). Even the sweat is bloody (axillae/anywhere). The blood oozes out and is black, fluid and thin and keeps on flowing. Or it is partly clotted.
Jaundice: due to haemolytic anemia (rather than hepatic). The skin is mottled - blue intermingled with yellow.
Prostration: general collapse with weak pulse; a rapidly increasing unconsciousness; slides down in the bed.
Nervousness: there is a tremulous weakness; the tongue quivers on protruding it; twitching and trembling of muscles (chorea-like); convulsions (in septic states).
Besotted: in appearance, like one intoxicated; bloated; blue, mottled (blue and yellow) or pale.
Pains: come on suddenly, last some time and disappear suddenly.
Malignancy: with hemorrhage; cancer of stomach, of tongue, of uterus; with ulceration, and jaundice.
Oedema: of parts affected with sepsis; of tongue (tongue can be dry/cracked with a central brown streak).
Offensiveness: of breath (which smells mouldy); of urine; of all discharges
Ulceration: anywhere (mouth/stomach etc.); in mouth, bleeding - after Merc-s in those with increased salivation (Kent).
Neuralgia: after sepsis (or malaria).
Bilious: sick headache with vomiting of bile; nausea, vomiting, distention ++.
Menopause: with hot flushes and heavy sweating; with hemorrhage from uterus (esp. with cancer of uterus) and jaundice.
Mentals:
Melancholy; thoughts dwell on death in a disinterested way.
Weeps easily: while reading.
Anxious.
Irritable: from trifles (Nux-v.)
Aversion to certain family members: in delirium, sepsis or dementia
Terrible dreams: of death, murder, dead bodies

Differential Diagnosis with Lachesis
The snakes have many similarities, all affect the cerebrospinal nerve centres and the blood (causing decomposition/ a breaking down).
Crotalus and Lachesis have the following similar symptoms:
* An aggravation on waking (after sleep) - Lachesis more so.
* Intolerance for tight clothing (especially around the neck) - Lachesis more so.
* Both are hemorrhagic remedies: Crotalus is more so.
* Both have blueness of the parts: Lachesis is more so.
* Both have yellowness and jaundice, Crotalus is more so.
* Both are loquacious, Crotalus mumbles and stumbles and can talk to him/herself in a low, passive way.
Lachesis talks fast, is more lucid and finishes other peoples sentences and stories (Crotalus can do this too), tells stories and is more wild and excited.
* Both talk of death, only Lachesis is more scared, Crotalus more apathetic.
* Both have a sense of constriction, of tightness around the throat with difficulty swallowing. Crotalus has difficulty swallowing solids, Lachesis has more difficulty with fluids than solids (and more difficulty still with empty swallowing than with fluids).
* They can both have one-sided symptoms. Crotalus is more right-sided; Lachesis is more left-sided.
* Crotalus has a cold, dry skin (especially cold extremities); Lachesis has a cold, clammy skin.
* Crotalus is worse for cold air (respiratory symptoms); Lachesis is worse for heat.
* Both have trembling of the tongue when protruding it; Lachesis more so.

Comparative Materia Medica
Hemorrhage (snake) remedies:
* Crot-h. - dark, fluid blood (partly coagulates)
* Elaps - dark, fluid blood (no clotting)
* Lach. - blood with charred straw sediment; hemorrhage amel.
* Naja - blood coagulates into long strings, least hemorrhagic of all snakes.
* Tarentula - axillary abscesses and septic insect bites
* Sepsin - septic dysentery (see Clarke)
* Pyrogen - restlessness, high temperature with low pulse (or v.v. - not as often).
* Anthrac - anthrax; boils, carbuncles with burning pains.
* Crotalus cascavella has the same sensitiveness and intolerance to tight clothing (as Crotalus horridus and Lachesis) and some liver symptoms, some yellowness and some bleeding, but these symptoms are not as marked. Crotalus cascavella affects the tissues less and the mentals more.
Heart symptoms are not as marked with Crotalus horridus - as with the other snake remedies (Naja, Lach., Elaps). Boils, abscesses, carbuncles, whitlows etc. - oozing thick black blood that does not coagulate (Arsenicum, Lachesis, Secale.). Puerperal fever with continued oozing of black offensive blood that does not coagulate
(Sec.). Prostration with sepsis (Bapt., Ars., Sec., other snakes and sometimes Arn., Phos., Pyr.,-Kent). Sepsis (Lach., Crot-h., Tarent-c., Anthrac., Pyr., Sepsin.-Tyler). Also consider: Secale, Kreosotum, Terebinthina.

The Chronic Picture (Crot-h)
Makes lots of mistakes in writing and calculating (in broken down constitutions).
Irritable. Excitable (can get to fever pitch over certain things).
Suspicious of friends (can't be rational).
Change of weather to warm aggravates.
Periodicity (yearly or every 3 months).
Craving for stimulants, especially alcohol.
Delirium tremens in "old inebriates" who look besotted, with a purple face and a craving for alcohol, especially wine.
"It is remarkable how much alcohol can be swallowed by persons bitten by serpents, without the usual psychological manifestations." - Farrington.
Great difficulty sleeping. Terrible dreams, of murder, death, dead people, dead bodies (they can even smell the dead bodies). Wake in fright and become increasingly tired.
===================

Ferrum Phos (Farrington)
FERRUM PHOSPHORICUM
3. GENERAL CHARACTERISTICS
Anemic subjects, liable to local congestions. Hilarity; indifference; hopelessness; physical and mental depression; difficult concentration; impairment of memory. CONGESTION, passive, inflammation; FEVER; thirst.
Weakness: prostration.
Sensation: heat; burning.
Pains; pressive, pulsating, shooting, stitching.
Dryness of mucous membranes. Hemorrhage. Discharges: bloody. Anemia.
Varices: phlebitis. Dropsy.
Ailments from getting chilled; from injuries; from loss of vital fluids.
>>>>>>>>>>Worse: NIGHT; morning; cold; touch; jar; motion;
>>>>>>>>>>>>>>>while standing.
Better: cold applications; warmth; gentle motion; while lying down.
12. The Ferrum phos. patient has a marked tendency toward hemorrhage.
>>>>>>>>>Passive arterial bleeding from the nose, throat, gums, larynx, lungs, or stomach. Hemoptysis, whether due to tuberculosis or to an injury, will be quickly checked by Ferrum phos. if the other guiding features are present. The flow is less profuse than when Aconite or Belladonna is indicated. In exceptional cases of otitis media, with agonizing pains, Ferrum phos. may obviate the necessity of paracentesis. The cavity of the middle ear may be filled to bursting with blood and, perhaps muco - pus. Swelling and congestion in the Eustachian tube recede and with drainage once more established, the pent up fluid finds a natural exit. Ferrum phos. is frequently of benefit when epistaxis accompanies an acute coryza or a sinus, also when epistaxis occurs in the morning after rising, on blowing the nose, from coughing or sneezing; or when nose - bleed relieves a congestive, frontal headache. Again in gastritis with vomiting of blood or food mixed with blood; and bleeding from the rectum, with or without the presence of hemorrhoids. In pneumonia, bronchitis or phthisis florida, the sputa are almost always more or less blood streaked. The menses are bright red, copious and premature; leucorrhea bloody. The Ferrum phos. hemorrhage is peculiar in that blood coagulates with surprising rapidity into gelatinous mass.
13. The Ferrum phos. patient, usually anemic, cannot withstand the loss of blood or other vital fluids. We have adynamia, headache and even dropsy as the after effects of hemorrhage.
14. The tendency to relaxation in the Ferrum phos. subject is seen in both veins and arteries, differing from Aconite and Belladonna. It has cured naevi in children, unaided by external treatment and varicose veins, especially in young people. In the early stages of phlebitis, it is promptly efficacious when there are fever, local heat and tenderness and the general Ferrum phos. constitution.

dear sridhar,

let me know more about your wife's thirst and details about food cravings and aversions. how about sweets ? fatty food ?

well, I do need more info but I am already thinking about pulsatilla. I do have bry. and lach. in mind but I feel more inclined about puls.

andy has asked for more info. send all the details.

if you wish, you may send the full case, will all details (in one private email) to me. I will look at it and suggest the remedy.

dr manish agarwala

Yahoo! India Matrimony: Find your life partneronline.

Hi All,

Was there any mention that a clinical diagnosis had been done? (I may have missed it)

If not that should be our first advice - to protect the patient and to protect the reputation of homeopaths.

IMO

Regards

Luise

Hi Luise,

I did not see any dx mentioned either. I assume she would return to the gynecologist who inserted the IUD since that is the morbific trigger here.

The sx of vicarious menstruation apparently began after insertion of an IUD of a hormone releasing type 3 mos ago (see below). The rx could conceivably be either Bovista or Hamamaelis (vicarious night bleeding (from menstrual suppression) of traumatic origin); but with the hormones as maintaining cause, hom. treatment problematic.

Best,
A

=======
Mirena is an IUD (intra-uterine device) which also releases a low dose of the hormone levonorgestrel (a progestogen hormone)

A significant advantage of Mirena is that it usually reduces blood loss during menstruation by up to 75 percent

It can also be used to control very heavy periods (menorrhagia), provided there is no underlying serious cause. Used in this way it may be a useful alternative to hysterectomy for certain women.

Mirena is nearly 100 percent effective at preventing pregnancy

It should be inserted within 7 days of the first day of a period. Screening for sexually transmitted diseases should be done prior to insertion

The IUD should be changed after 5 years

Menstrual problems (usually spotting) are the most commonly reported side effect particularly in the early months

What is it?

Mirena is a new development in the contraceptive market. It is an IUS intrauterine system) which slowly releases a progestogen hormone levonorgestrel). This is one of the main normal female hormones produced by the ovaries and also present in the combined contraceptive pill and in the mini-pill (progestogen only pill). It is also present in some forms of hormone replacement.

Mirena is a small T-shaped device which contains a total of 52 mg levonorgestrel with a release rate of 15 Ug per 24 hours.

The low-dose hormone works as a contraceptive by its effects on the lining of the uterus and also making the cervical mucous more hostile. Ovulation may be inhibited in some women, but this is not the main mechanism of action.

The ovaries continue to function normally (producing the female hormone estradiol, even when periods become absent (as happens in approximately 20% of users).

There is a failure rate of 0.16 per 100 women years of use. This is similar to tubal ligation or vasectomy.

The ectopic pregnancy rate is also low at 0.05 per 100 women years (compared to 1.2 to 1.6 for women using no contraception).

Unlike other IUDs, the Mirena decreases the amount of blood lost during menstruation. Conventional IUDs can increase period flow by about 50 percent, whereas Mirena decreases blood loss by 75 percent.

It may be used as a treatment in women with very heavy periods, provided underlying pathology has been excluded first. It may decrease blood loss by up to 88% in this situation and can be a useful alternative to hysterectomy in certain situations.

Periods become lighter and more infrequent six months after insertion and studies have found it decreases blood loss by up to 97 percent after one year. Mirena also helps to ease painful periods (dysmenorrhoea).

Mirena cannot be used as a form of emergency contraception like copper IUDs can.

Studies show Mirena does not interfere with future fertility. Around 80 percent of the women who wanted to become pregnant conceived within 12 months after the IUD was removed.