A case of Atopic Dermatitis in an infant treated with Alumina
Dr. Aradhana Chitra, BHMS, CCAH
Edited by- Dr. Alifiya Dedanwala, Publications Team
An eighteen month old child came to me with severe itching over the entire body since birth. It was more in the folds of the skin (flexural crease areas) especially the elbows, behind the knees, around the neck, and ankles. There was itching throughout the day but it worsened at night; during dry weather; in winters; sand, oil and cream application.
Itching would lead to redness of the skin followed by bleeding and oozing of liquid. Due to the itching, his skin texture had become hard very rough, over the years, like elephants skin and blackish in colour, especially around ankles and neck.
When scratched, black powder would fall out and the skin would peel out sometimes.
On observation, his skin was red, rough, dry, thick and hardened.
Observation regarding the child. He was in mother’s lap, very restless,rubbing his body with whatever object came in his hand.
On inquiry about the nature of the child. He was an active child, liked going out, reserved, not very social, did not go to strangers easily. He was clinging to mother and needed mother all the time when sick. He wanted things especially whatever the elder sister had. He would throws tantrums when not given. Tried to mimic the sister in everything she did. He was afraid of strange sounds and sudden noise. His reaction was to cling to the mother with fear. He had cravings for sweets, chocolates.
Sometimes he would pick at walls and lick the mud.
Mother’s pregnancy history
On observation – mother was very hurried and hasty in speech. During her second trimester, there was a situation where she got to know that her husband had to travel abroad during her delivery time for a site visit. This made her very tensed and anxious. The reason for her anxiety was that she was unable to decide where to get her delivery done; in the place she stayed ie. Bangalore or in her native town.
This was so because her daughter was studying in Bangalore and if she travelled to her native, then daughter would have to miss an entire term. But if she stayed back in Bangalore , then there would be nobody to take care of her.
In Bangalore, there would be no one to take her to the hospital if a sudden need arose before or during the delivery. If something happened to her new born, who would take her to the hospital? These thoughts were on her mind the entire second and third trimester.
Dr: What was the feeling in this situation?
Pt :- I was totally confused. I didn’t know what to do. I could not reach to a decision. I had constant thoughts of “what should I do”?With that thought I would start shivering and sweating. My hands would sweat a lot. I would not be able to do household work properly. I would keep calling my husband and parents and ask their suggestions and opinion. I used to come to a decision but then would not feel confident about it.
Fear was what if I made a mistake and my decision goes wrong?
Everyone would suggest me to take my own decision. But then that would bring me more distress. I was in constant state of confusion.
I was not at all confident and if others gave their opinion, I would confuse them too by giving pros and cons .
(This was a very prominent state during her entire 2ndand 3rdtrimester and she was in a constant state ofindecisiveness and confusion)
Nature of the mother
She would get nervous and worried easily. Eg – if she had to travel alone in car or by bus, she would not know the bus numbers or bus stops. She would be afraid of getting lost. She didn’t know the local language so was afraid whether the bus conductor will understand her language and if she got off at the wrong stop, she won’t be able to decide the next step for her.
She also had a fear that, if she asks a silly question to the conductor, how he would perceive her. What would he think about her? So she always preferred being with her husband, as all decisions would not fall upon her and she could be carefree.
She said, “My husband is a very confident person. I know whatever he decides will be the right thing.”
She also does not like to go to PTM (parents teachers meeting) of her daughter. She is worried about the questions asked by the teacher? And whether she will be able to answer them correctly. This confuses her. So she prepares the questions and answers before hand, before going to the PTM in order to be sure of the questions she would be asked and the answers she gives to the teachers.
During fear and confusion, her speech becomes a little hurried, and voice starts shivering. This concerns her of her impression before the teachers. The fact that she does not even know how to speak properly. “What teachers would think about me? That I don’t know what and how to speak and how do I even take care of my child?”
“I don’t want my image to be bad in front of them.”
Childhood Nature :-
She was not a confident person right from her childhood. She could not decide even if she had to buy a dress for herself; needed others help and assurance. Even if she knew the right answer, yet wanted others opinion and confirmation of being right, as she would get very confused.
She said – “I think I have no self confidence. I have an inferiority complex. I get very tensed in crowds. I can’t speak to strangers. I am not free when speaking to strangers. I feel what they would be thinking about me. How I am speaking or what I am speaking or How I am dressed? Whether they will like it or not?”
(She is conscious about what people will think about her.)
Analysis of the Case:
The main aspect of the case is Confusion, ‘confusion of identity’, that forms the crux of the case.
- Unsure, to make a choice between right and wrong
Lack of confidence
- Especially in making a choice, decision
Dependence on others
- For opinions, suggestions
Need for Support
- For making a choice for herself
- Needs Assurance
“ knows what she wants but NOT SURE”
- Other Aspects
- Image conscious
- What others will think about me
- Shyness, Embarrassment
Need for Care and love
- Parents ,relatives , family
- Husband- to take her to hosp
- Need for love so can’t hurt anybody
Also if we take the rubrics of the case :-
Symptom Totality – Mental and physicals
- mind; CONFUSION of mind; identity, as to his (129)
- mind; IRRESOLUTION, indecision (260)
- mind; CONFIDENCE; want of self (269)
- mind; TIMIDITY (234)
- skin; ITCHING; intolerable (45)
- skin; ITCHING; desquamation, with (10)
- skin; ERUPTIONS; eczema; moist (86)
- skin; ERUPTIONS; bleeding (82)
- skin; HARD; thickening (40)
Remedy given was Alumina 1M followed by Alumina 0/7 LM daily dose.
- Boericke’s Materia Medica
- Generalities: It affects the CEREBRO SPINAL AXIS causing Disturbance in co-ordination, and paretic effects
- It causes Dryness of skin and mucous membranes; eyes, throat, rectum etc., or irritability and relaxation. Mucus discharges profuse. Discharges are thin, acrid and scanty. Tendency to induration.
- Mind: low spirited, fears loss of reason. Confused as to his personal identity. Hasty, hurried. Variable mood.
- Skin: Intolerable itching, when getting warm in bed. Dry, rough, cracked skin. Itching, burning, over seat of pain. Must scratch, until it bleed Eczema. The slightest injuries of the skin smart and become inflamed. Skin symptoms, < winter, full and new moon.
- Hering’s Condensed Materia Medica:
- Consciousness of his personal identity confused.
- Frans Vermulens Materia Medica:
- Confusion of mind, as to his Identity
- Internal hastiness, hence makes mistakes in speaking
- Intolerable itching of skin in bed, without eruptions
- Zandvoortmillenium repertory
- Delusions, consciousness, belongs to another.
- Delusions, body, body parts: head: belongs to another.
- Delusion; errors of personal identity
- Delusions, sees anything, as if another person had seen it, or as if he could transfer himself into another and only then could see’
- Delusions, hearing, of: his own voice seems changed.
Understanding from the System Point of View:
In this case, there is no issue of Survival, Hierarchy, Competitiveness/ Jealousy/ One-upmanship, Victim –Aggressor feelings, Someone doing something to me– Bossing me or Dominating me or Exploiting me etc. Hence, Animal Kingdom is ruled out. Neither there is Issue of Sensitivity as seen in Plant Kingdom where one can expresses sensitivity and reactivity.
But there is definitely an Issue of Structure.
- Am I complete or Incomplete?
- Developed or undeveloped?
- DoI lack something or will lose something
In this patient, we see
- Lack of confidence
- Need for support
- Dependence on the others
- Parents/ husband/ relatives
- So the remedy belongs to Mineral kingdom.
In Mineral kingdom , Row 3 has issues of
- Love, Care and Nourishment: growth and Identity and the expressions of it like image, choice and ego.
- I am lacking an identity, my own individuality
‘I am separate, but who am I?
It’s a stage where the child needs to develop his IDENTITY and Individuality. He needs to know who he is so that he can make a choice for himself, decide what is wrong or right and at the same time assert his choice.
The patient is stuck up in this stage of development.
- The question here is :-
Can I make a choice ??
Do I have a Identity ?
I am separate but “who am I”?
- MAIN ISSUE for our patient is MAKING a CHOICE and asserting her choice.
- A person who is trying to identify her individualism.
- Patient behaves like a child who is dependant, needs support especially when it comes to making a choice as she does not know what she wants.
This belongs to Row 3, Column 3
One Knows what he wants but lots of doubt and Confusion. Uncertainty regarding who one is and what one wants. It feels being suppressed and controlled by others’ decisions.
One has to mould oneself according to what they want.
- Capacity to decide and do things for himself, taking care of himself is slightly developed but there is
- The issue is of identity and he is confused about it.
Follow up after 2 months:-
Dr:- tell me what is the difference you find in him from the time we have started the medication?
Pt:-Earlier skin was very hard and very rough and tough around ankles, neck … now its soft and thin.
Dr:-Hard means what used to happen?
Pt :- it was like elephants skin hard , black colour ..if we scratch then black powder would come out , skin would come out if we scratch.
Dr:-When was it?
Pt:- since 2 months it has become very soft. Now there is no problemon his neck .
Dr:-What used to happen in the hard skin?
Pt:-He would have itching , if he scratched the skin, it would come out and become reddish around the neck. As of now it’s not there. Earlier on folds there was a reddish colour.If there is itching then it would become red. But now it’s got healed and its black in colour. Redness has reduced.
Dr:-How is the child’s general condition before starting my treatment and now
Pt:- Earlier his itching was on the whole body, now its reduced only to folds and only on some days he has itching. Only if we don’t apply oil then that day he has itching and that too only in folds. Otherwise he had itching on the entire body.
Dr:-you used oil earlier as well?
Dr:-Then that time ?
Pt:- that time his skin was very rough ,we used to apply oil but still skin was very rough but now that has reduced and so has the itching.
Remedy Given: Alumina 0/7 daily dose
Follow up after 6 months:-
Dr:-What is the difference in his whole state before and now?
Pt:-His dryness has reduced. Itching has also reduced.He is much better. Skin has become very soft, just like normal.
Dr:-How is he as a child now ?
Pt:- Before he would take the cream and give it to us to apply but now he does not want the cream itself. He no longer tells us. We apply only after having a bath and at bedtime. Otherwise he would take the cream and ask us to apply but now it’s not that way.
Dr:-In what way this has made a difference to you?
Pt:-I am very happy actually as earlier he was not getting good sleep but now he is sleeping comfortably . He does not have itching, otherwise he would scratch on head, neck during sleep also and whole body at night. But now he does not have it at bed time. He is getting a good sleep now. That is the main difference as he used to wake up at night and scratch his whole body. As he is sleeping well, I am getting a good sleep too.
Dr. Aradhana Chitra
BHMS, CCAH, Practicing Homeopath
& Head Bangalore Satellite Center the other song Academy
Dr. Aradhana Chitra has been an active homeopathic practitioner and has also been involved in education for over 20 yrs. As a practitioner, she consults at RxDx Teleradiology, a multi-specialty center in Bangalore, a charity clinic for the under privileged, as well as the nationwide clinic, a multi-center medical network across India. Dr. Chitra heads the Bangalore satellite center of “The Other Song” academy, a world renowned homeopathic research and education institution. She has successfully conducted advanced courses like CCAH, FCAH and Masters Program, held every year at the Bangalore satellite centre. She has also mentored doctors of “Dr. Batra’s Clinic”, by imparting specialist training and guiding them in solving difficult and complicated cases. She has treated vast number of cases related to autoimmune diseases like Psoriasis, Vitiligo, Rheumatoid Arthritis, SLE, allergies, Asthmas, bronchitis, eczema, migraines, osteoarthritis, psychological problems, OCD’s, Ulcerative colitis and others.