PRESENTATION BY: DR. BIPIN JETHANIReader, Department of Organon of Medicine,

Nehru Homoeopathic Medical College & Hospital, New Delhi.

drbipin.jethani@gmail.com#9810146343, 9868396623

E-JOURNAL OF DEPT. OF AYUSH

‘HOMOEOPATHIC PULSE’

UPDATE ON REPERTORY

Repertorial understanding of

mercurius solubilis hahnemanni:

MY EXPERIENCE IN a CASE OF alopecia

areata

INTRODUCTION: ALOPECIA AREATA

Alopecia areata is a recurrent non-scarring type of hair loss that can affect any hair-bearing area and can manifest in many different patterns. Although it is a benign condition and most patients are asymptomatic, it can cause emotional and psychosocial distress.

AUTOIMMUNE ETIO-PATHOGENESIS OF ALOPECIA

AREATA• Alopecia areata is considered an

autoimmune disease, in which the immune system, mistakenly attacks the hair follicles and this can lead to hair loss on the scalp and elsewhere.

• In most cases, hair falls out in small, round patches about the size of a quarter. In many cases, the disease does not extend beyond a few bare patches. However, in some people, hair loss is more extensive.

A CASE OF ALOPECIA AREATA:CASE STUDY

16 year old female presented with c/o patch of alopecia areata on scalp. Her other complaints were painful delayed menses since menarche.

Recurrent tendency to pain in throat followed by rattling cough from least exposure to cold air.

KNOWN CASE OF ALOPECIA AREATA

It began as a small patch of alopecia on scalp, approximately 1 year back and had spread to become of big patch of alopecia.

Occasional c/o itching.

EVOLUTIONARY HISTORYINTRA-UTERINE LIFE

h/o Hyperemesis till 7th month <: night.

Had fever/ malaise off and on but mother did not

take any medication

SIGNIFICANT LANDMARKS

Patient had severe itching in scalp since 2 yrs age. Applied medicated shampoos.

Tendency to cough with each phase of dentition.

Tendency to pain throat from least exposure to cold air – recurrent antibiotic intake. Now pain in throat is followed by rattling cough.

MENSTRUAL HISTORY

Menarche = 11 yrs

(EARLY MENARCHE)

Even thelarche occurred at age of 8 years.

• Tendency to delayed cycle (40-45 days) with severe pain before and during flow.

• Flow dark with occasional clots

FAMILIAL BACKGROUNDPaternal GrandMother – HTN, NIDDM, CAD

Paternal Grandfather – Parkinsonism

Maternal Grandmother – Generalised Anxiety Disorder

Maternal Grandfather – Asthma, Psoriasis

Mother – S.L.E.

Father – Recurrent cough in change of weather

LIFE SPACE• Was the only daughter and had a

happy childhood.• Intelligent child with sharp memory.• Had been Active restless child.• Has always behaved maturely and

with responsibility for her age. • Her mother says that ‘she used to

behave as an adult’ since very young age’.

PHYSICAL GENERALS CHILLY patient Thirst normal, likes cold water

but avoids Diet: Non-Vegetarian Desire: sweets(+); chocolates Sleep: sound Perspiration: increased, offensive. Tongue: small fissures seen in the

center

CASE ANALYSIS:progression of pathology to deeper level

• The progression of the case from complaint of simple itching to the stage of autoimmunity in form of Alopecia aerata on scalp shows that the patient’s pathology had moved from superficial pathology to deep seated pathology.

• Similarly the complain of pain in throat had over the period of time progressed to c/o cough ------ this signifies downward movement of pathology to more vital organ.

CHARACTERISTIC SYMPTOM(§ 153)

PRECOCITY

• PRECOCIOUS THELARCHE & MENARCHE

• PRECOCIOUS BEHAVIOUR(she used to talk as an

adult since very young age)

OTHER SIGNIFICANT SYMPTOMS

• CHILLY PATIENT

• PERSPIRATION INCREASED, OFFENSIVE

• DENTITIONAL COUGH

REPERTORIAL STUDY OF SYMPTOMS

KENT’S REPERTORY

MIND SECTION

In the rubric ‘PRECOCITY’; the

only remedy mentioned is

MERC.

Boger-Boenninghausen’s Characteristics & Repertory

Under the chapter on AGGRAVATION AND AMELIORATION IN GENERAL, we find:

• Dentition, during (in children) agg. : ACO., am-c., ars., bell., BOR., bry., CALC-C., calc-p., CHAM., Cic., cina., Cof.., colch., Cup., Hep., Hyo., Ign., Ip., KRE., mag-c., Merc., Merc-c., nit-ac., Nux-m., nux-v., op., POD., pul., rhe., Rhus-t., Sec-c., sil., stan., stra., sul., zin.

basis of PRESCRIPTION:repertorial study

The repertorial analysis in the form of Kent’s General rubric of PRECOCITY and Boger-Boenninghausen’s aggravation in General during dentition led to the remedy Merc. sol.

The other significant aspects of the case (Chilly patient and profuse, offensive sweating) confirmed the selection of similimum – Mercurius solubilis Hahnemanni.

Prescription

The patient was prescribed Merc. sol. 30/ unit dose followed by placebo

FOLLOW-UP

AT THE TIME OF PRESENTATION FOLLOW-UP AFTER 4 MONTHS

FOLLOW UP

AT THE TIME OF PRESENTATION FOLLOW UP AFTER 6 MONTHS

FOLLOW UPBesides the improvement in patch

of alopecia; the following significant points were also noted during follow up:

The patient’s sensitivity to cold air has markedly decreased.

The menses have also become regular with occasional c/o dysmenorrhoea.

CASE DISCUSSION & conclusion

The diligent use of Repertories often help in better understanding of the characteristics of our homoeopathic medicines. The repertories also give us the vital clues for the selection of similimum as can be deciphered from the foregoing case study.