Abstract – Skin that is unusually red. All inflammatory skin disorders are accompanied with erythema; however, the phrase “the erythemas” is typically used to refer to a collection of conditions that are red but do not have main scaling. A distinct elevation of skin that can change colour is called a papule. It’s possible to feel rather than sight those that emerge from the subcutis. Skin elevation, small and solid, less than 0.5 cm in diameter. A noticeable buildup of pus in a blister is called a pustule. Folliculitis and bacterial infections frequently cause pustules, which can also develop in some inflammatory conditions like pustular psoriasis. A 28 year old female patient came to the OPD (out-patient-department) for the complaint of eruptions on nose without any itching since 3 years treated with a single dose of Lachesis.
Keywords – Erythema, Papules, Pustules, Single dose, Lachesis.
Introduction –
Erythema – Skin that is unusually red.[1] All inflammatory skin disorders are accompanied with erythema; however, the phrase “the erythemas” is typically used to refer to a collection of conditions that are red but do not have main scaling. These regions are observed in certain viral and bacterial diseases, including measles and toxic shock syndrome. Another frequent factor is drug use. The rash is frequently referred to as a “toxic” or “reactive” erythema if the reason is not immediately apparent. When urticated erythema becomes palpable, it is linked to oedema.[2]
Papules – A distinct elevation of skin that can change colour is called a papule. It’s possible to feel rather than sight those that emerge from the subcutis.[3] Skin elevation, small and solid, less than 0.5 cm in diameter.[4]
Pustules – A noticeable buildup of pus in a blister is called a pustule.[5] Folliculitis and bacterial infections frequently cause pustules, which can also develop in some inflammatory conditions like pustular psoriasis.[6]
Lachesis – The Surukuku Snake of South America. Ophidia. Hering made the first dilution and trituration of the snake toxin, Trigonocephalus Lachesis, in alcohol on July 28, 1828. The first instances were published by the Archives in 1835. In 1837, this remedy was included in our Materia Medica.[7]
There are numerous mental states. An unwarranted feeling of jealousy, suspicion, and envy. Often, this drug has helped girls who were simply suspicious of their female companions get over their misgivings. She never witnesses a whispered discussion, but to her detriment, others are talking about her. It is full with religious madness. Lachesis is very talkative and gregarious. The victim feels compelled to talk constantly. It occurs at a different level when the patient feels under pressure to do tasks quickly and anticipates that everyone else will do the same. The loquacity that results from this anxiousness is unfathomable until you hear it for yourself. Loquacity, jump from one word to another story. Young women and girls who have experienced disappointment, who have been staying awake at night due to a disruption in their affections, or who have been grieving, disappointed, or experiencing broken hopes. Extended sadness, mental depression, hysterical symptoms, crying, mental prostration, and despair, together with heart ache, a feeling of weakness or absence, and trouble breathing. She contemplates suicide and eventually returns to an apathetic condition, which is characterized by a dislike of everything, including employment and even thought.
The medicine is in the miasmatic range between syphilis and sycosis. It is competitive, aggressive, seductive, and sexual, like animal remedies, and it has the clairvoyance, dishonesty, and toxic nature of snake medicines. Her ability to outsmart her opponent through crafty, manipulative discourse is crucial to her life. She has the ability to be witty, sardonic, loud, animated, expressive, and enthusiastic, and her loquacity enables her to capture and maintain the attention of the audience. When the listener has left her company, she injects the venom that acts on him at the appropriate moment without his knowledge. She continuously gauges the listener’s level of interest. She has clairvoyant and prophetic discussions. When her greatest efforts to compete fail, she may become pious and spiritual, think that death is near, and choose to concentrate on spiritual issues. Then she starts to meditate. [8]
Case History – A 28 year old female patient came to the OPD (out-patient-department) for the complaint of eruptions on nose without any itching since 3 years.
Sometimes blood and pustular discharges occur from nose.
Modalities – < before menses, > after menses.
History of patient illness –
The patient said that 3 years back she travelled in a bus and at that time she was suffering from motion sickness. During that travelling she had nausea but can’t vomit out. After that she develop eruptions on nose.
Treatment history – The patient adopted allopathic treatment. he felt better after the treatment but after sometimes her complaint appeared again.
Past History –
In 2010 patient had dermatitis, adopted allopathic treatment.
In 2021 patient had history of recurrent UTI.
Family History – father has urticaria, mother suffer from osteoarthritis
Physical General –
Thirst – thirsty.
Thermals – affected by extremes of temperature.
Appetite – good.
Sleep – easily disturbed by slightest noise, alert.
Dreams – death.
Desire – spicy food, sweet.
Aversion – oily food.
Stool – constipated, offensive.
Urine – recurrent UTI.
Perspiration – scanty.
Mental general – I observed, a kind of superiority in patient thoughts. She thinks that the person who got the achievements of something was not deserving. She thinks that she is more deserving and intelligent than that person. A kind of bitterness and jealousy I observed. She is very abrupt. Occupied with her religion. About her complaint she thinks that 3 years back she travelled in a bus after that she developed eruptions on her nose. Other than this she is very intelligent and competitive from childhood, and wants appreciation. Answers abruptly and very harshly.
General Examination –
Blood pressure – 120/80 mmHg.
Pulse rate – 80 bpm.
Respiratory rate – 16/min.
Tongue – slight trembling and dry.
Face – redness and popular and pustular eruptions on nose.
Analysis and Evaluation of symptoms –
Table no.1 showing the analysis and evaluation of symptoms of the patient according to Dr. J.T. Kent
| Mental general | Physical general | Particular |
| Superiority complex Appreciation desire
Jealous Religious Abrupt and harsh |
Thirsty
Thermals – affected by extremes of temperature Appetite – good Sleep – alert Dreams – death Desire – spicy, sweet Aversion – oily food Stool – constipated, offensive Perspiration – scanty |
Redness with eruptions on nose with discharge of blood and pustules |
Totality of symptoms –
Superiority complex
Appreciation desire
Jealous
Religious
Abrupt and harsh
Thirsty
Thermals – affected by extremes of temperature
Appetite – good
Sleep – alert
Dreams – death
Desire – spicy, sweet
Aversion – oily food
Stool – constipated, offensive
Perspiration – scanty
Redness with eruptions on nose with discharge of blood and pustules
Miasmatic diagnosis – Psorosyphilitic
Table no.2 showing the Miasmatic Diagnosis as per the symptoms present
| PSORA | SYPHILIS |
| Redness
Eruptions |
Blood and pustular discharge |
Selection of Repertory – synthesis repertory by Dr. Frederik Schroyens.
Software used – Synthesis App 1.3 [v. 135]
Repertorial Totality –
Figure no.1 Repertorial analysis showing the comparison of remedies based on the totality of symptoms. The chart illustrates the scoring of various remedies such as Lachesis, sulphur, platina, kola, causticum.
Repertorial analysis –
Lachesis 14/7, Sulphur 9/6, Platina 8/6, Kola 5/8, Causticum 8/4.
Selection of remedy with justification – The Homoeopathic medicine selected on the basis of totality of symptoms. Lachesis 200 single dose was selected and prescribed as per the totality of symptoms and reperterization. Final selection of the medicine is based on Homoeopathic Materia Medica.
Prescription – first visit was on date – 24/11/23, Lachesis 200 single dose was prescribed followed by placebo BD for 15 days.
Follow-up –
| DATE | SYMPTOMS | PRESCRIPTION |
| 18/12/23 | 50% of eruptions are disappeared in the first follow-up.
Generals are better. |
Placebo BD for 15 days |
| 25/1/24 | Patient is better than before no need to repetition of medicine. | Placebo BD for 15 days |
| 20/2/24 | Eruptions disappeared about 80%. stool was slightly constipated I advised her to take fibrous food and plenty of water.
Sleep is better. |
Placebo BD for 15 days |
| 23/3/24 | Patient is better than before. | Placebo BD for 15 days |
Table no.3 showing the improvement after prescribing homoeopathic medicine
| BEFORE | AFTER | |
Figure no.2 showing the improvement in the complaint before and after prescribing homoeopathic medicine
Discussion – This is the case of erythematous papules and pustules treated by single dose of Lachesis 200, followed by placebo for 15 days. A proper case taking was done and the medicine was prescribed on the basis of covering totality of symptoms. In this case the repetition of the medicine was not done because only in one dose patient showed very marked improvement. This means our homoeopathic medicine is more powerful than the natural disease.
- 26. A weaker dynamic affection is permanently extinguished in the living organism by a stronger one, if the latter (whilst differing in kind) is very similar to the former in its manifestations’.[9]
Conclusion – This is a classical case of simple, single and minute dose. This case shows the effectiveness of Homoeopathy in skin diseases, where other Pathy’s has no permanent cure but in Homoeopathy we can cure and heal the person.
References –
[1] Hutchinson’s clinical methods an integrated approach to clinical practice 24th edition edited by Michael Glynn,William M. Drack
[2] [4] Clinical Dermatology RICHARD WELLER, HAMISH HUNTER AND MARGARET MANN FIFTH EDITION WILEY Blackwell
[3] [5] Davidson’s principles & practice of medicine 21st edition edited by Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston
[6] https://www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/description-of-skin-lesions#Lesion-Type-(Primary-Morphology)_v958357[6]
[7] http://homeoint.org/books3/kentmm/lach.htm Lachesis – LECTURES ON HOMOEOPATHIC MATERIA MEDICA by JAMES TYLER KENT, A.M., M.D.
[8] https://homeoguide.org/wp-content/uploads/2020/06/The-Soul-of-Remedies-Rajan-Sanakaran.pdf
[9] Organon of Medicine Word Index Included Fifth & Sixth Edition Combined Samuel Hahnemann Translated by R.E. Dudgeon, MD William Boericke, MD B. JAIN PUBLISHERS (P) LTD.
[11] synthesis repertory by Dr. Frederik Schroyens.
[12] Synthesis App 1.3 [v. 135]
About the Author:
Dr. Laxmi verma, Post graduate trainee, Department of Homoeopathic Materia Medica, Government Homoeopathic Medical College and Hospital, Ayush Parisar, Near Kaliyasot Dam, Bhopal, Madhya Pradesh, India
Dr. Shobhana Shukla, HOD & Professor, Department of Homoeopathic Materia Medica, Government Homoeopathic Medical College and Hospital, Ayush Parisar, Near Kaliyasot Dam, Bhopal, Madhya Pradesh, India and former Joint Director, AYUSH Bhopal.
Dr. Sindhu Suryawanshi, Professor & Guide, Department of Homoeopathic Materia Medica, Government Homoeopathic Medical College and Hospital, Ayush Parisar, Near Kaliyasot Dam, Bhopal, Madhya Pradesh, India
