I'm bored and ignored: a case of Cubeba officinalis

A 14 year old girl came to my clinic with the presenting complaint of psoriasis, especially on her face and extremities, since one year. The eruption was worse in winter and better in summer. Itching was worse at night and after bathing, and she was bleeding after scratching.

She says the following about herself:

“I want to do something as soon as I think of it. Why should I have to follows the opinion of others? I dislike to be criticized.

“I want to go outside, to see all the places I have previously not seen, but I am not able to go outside now. I want to eat all the food I like but I am not able to eat a variety of foods and I am not able to wear proper clothes. Now, I am constantly looking at the same place in my house, I have been jailed in my room. I dislike being there in my house. If I could go outside, I would play, enjoy good food, and nice scenery. I want to go to the temple garden, which would be pleasant for me.

“I dislike being alone. I am not able to do my work alone, I need my parents help to do my daily routine activities. In my home, nobody speaks to me, the time passes slowly; I dislike being there in the same place for a long time. I want to go to the Velankanni temple (one of the religious site on the Bay of Bengal Coast). My friends have gone to this temple and told me of the enjoyment of that place. If I go to different places, my mind would become relaxed. Due to my complaints, I want to be in my room and I dislike to speak.

“I am afraid that my complaints will affect my brain, heart, or my lungs; when I eat, the scaly lesions might fall into my food and affect my major organs. It might affect my brain, which will lead to madness like my father, who is suffering from psychiatric illness.

“I am afraid that if this condition persists for a long time, I may end up becoming an outcast. I want to weep alone. The pain of my lesions makes me want to die – it is throbbing and dragging. I fear death due to my complaints.

“I am constantly worried about what others think of me and what they say about me.

At school, all the students and teachers neglect me; they don’t want to come near me or to touch me. It makes me angry when people look at me closely and ask me why I have this disease, what happened? I think that everyone is watching me; they are embarrassed about me, even if their looks are sympathetic. Now, I don’t go to school and I don’t want to go outside. Nobody talks to me, even at home. I don’t like to speak to strangers, either, because of what people say about me. I get palpitations when I speak to strangers.

I think that I have a contagious disease that will spread to everyone, so I don’t like to go to public places.

“If this complaint persists, I won’t be able to go out of my home.  I don’t like to be in jail; I may become mad if this condition persists. I want to die.

“It makes me angry when people boss me around.  Why do I have to follow these people’s advice?  I feel low, these people are high, they are in good in health, that’s the only reason they can command me around like that.

“My father has the same problem of psoriasis with insanity, so people say that my complaints originated from him, and that he is mad. I feel very angry when others comment about my father. I don’t like this complaint about me being spread, so I am conscious about my activities. If my father was healthy, he might be affectionate towards me, and give me things to play with.

“My mother used to weep and scold me a lot for my complaints; she would say “why were you born? Go away and die!” I got lot of reproaches. I think that I have done something wrong. I often want to die when my mother scolds me. I feel like I am disturbing her. My mother doesn’t buy toys for me, only for my sister. If I did not have this complaint, she might care for me a lot, like my younger sister. My mother often prepares food which I dislike and I never want to eat, and she buys things that I dislike. I get angry and ask her why she prepares such food.

“In my family, one relative beats my mother. I am afraid of what will happen to my mother. My brother was stabbed by some rowdies and I fainted when I saw the blood. After that, I don’t want to see blood because that frightens me lot. I have a fear of accidents, of blood, of injuries, and of quarreling.

“I want to watch cartoon programs on TV and to laugh at the jokes. I want to play tennis and cricket – both are exiting and stimulating games and they bring liveliness. I am not able to do my own work.”

Mother’s point of view: “She always fights with her sister. She is obstinate, and she doesn’t yield, she does what she wants to do. She is easily angered; she doesn’t want to do her daily routine work without the help of others. She is egotistic, and has no affection towards her sister.”

Observations

Generals:
Sweating on upper lip and neck

Climate: eruption  < winter

Winter desire

Summer aversion

(Sweating, heat, aversion)

Fan at maximum in all climates

Covering: great aversion in all climates

Bathing: normal water in all seasons

Appetite: good

Thirst: 2-3 litres /day

Motion: not satisfied, alternating day, difficulty to pass stool

Pain during stool, bleeding occasionally.

Urine: normal

Menses: 10 days lasting from last 4 months, regular

Dream: “A lot of snakes are surrounding us, nobody is there except me and my mother. This is a critical situation. Nobody is there to secure them and we are calling for help. I think that we are going to die. Then, the snake went away and we escaped from that situation. God has saved us.”

Food and drinks: desire curd rice, pepper pongal; pepper gives the taste to pongal

Drawing:

I asked her to draw some pictures and to talk spontaneously about them.

1. Apple, grape, mango: “I desire to eat apples because of the sweet taste. I want to eat grapes and mango; they have a sour taste, these fruits are very tasty fruit compared to other fruits.”

2. Flowers – roses, jasmine: “Both look very beautiful, we can decorate beautifully. I want to be alone, because if I am alone nobody can say anything about my complaints. If we are in nature, that is a relaxed environment.”

3. Mountain, sun, river, man going in a boat: “This is a natural, calm environment, cold climate, a very entertaining place; I want to be in this place that I have never seen before. This place gives joy me and pleasure.”

AM: Please close your eyes and tell me whatever spontaneously comes to you now.

P: “Calm places. There is nobody who commented on me before. It’s a pleasurable place, it gives me joy.”

4. Nature, house with garden, trees, birds, sun rise, sun set, fish, hen, zoo: “I love nature, I like to see the sun rising and setting, it looks beautiful. Fish, hen, both look beautiful, these animals are my pets. They never disturb me or bite me. No disturbances, no noise, nobody there. Pleasant sound. Chilly looking place. I like to be there, we can play well, and pets give affection. This gives me pleasure. Gardens and zoo are the places which look very beautiful and I like to see these animals, it creates a good mood where we can play.”

Analysis

1. She wants amusement and entertainment.

2. She wants tasty food.

3. She wants exiting and stimulating games. She wants liveliness.

4. She wants pleasure and cheerfulness.

5. She feels that time pass slowly (boredom).

6. She wants pleasurable places with beautiful scenery: temple, garden, zoo, mountain, sun, river, man going in a boat, nature, house with garden, trees, birds, sunrise and sunset, fish.

Plant kingdom

Sensitivity and reactivity.

On the one side, her sensitivity lies in her painful situation that causes boredom and a lack of excitement, and on the other side, she wants amusement and enjoyment. The basic main sensation fits the Piperaceae family

Miasm: Leprosy

Despair

Forsaken feeling

Outcast

Disgusting, dirty, embarrassed situation so she avoids the sight of people

From Rajan Sankaran’s schema:

The Piperaceae family and the Leprosy miasm gives: Cubeba officinalis

Confirmation: desire for pepper pongal, coinciding with pepper family.

Rubrics

MIND - AMUSEMENT - desire for; Piper methysticum (Piperaceae family)

GENERALS - FOOD and DRINKS - delicacies – desire; Cubeba officinalis

GENERALS - FOOD and DRINKS - fruit - desire – sour; Cubeba officinalis

Prescription:  Cubeba officinalis 200C, 1dose

Follow-ups

Two months later: one week after the medicine, she had fever and cough lasting for two days. Sleep is good, itching is better, and the head scales have completely disappeared.

Overall, 50% of the eruption disappeared. No difficulty or bleeding when passing motion. Intensity of desperation is less compared to before. Ten days ago, she went to the Velankanni temple with her friends and enjoyed herself. Her boring and painful situation has now changed, and she goes out to enjoy herself.

Six months later: eruption is almost gone; no itching, no scarring. Sleep is good, no dreams. Stools are regular, without straining. Mentally, she feels good; she started going to school again and became very interested in her studies. She was mingling easily with the other children. The neglected feeling is almost gone. She is very happy with her recovery.

Prescription: Sac lac

Eleven months later: no recurrence of the eruption, generally she feels well. She visited various amusing places and she enjoyed herself.

Prescription: Sac lac

Fifteen months later: tiny eruption on the knee and finger, with mild itching lasting one month. She comes back five months later, due to the fear that the eruption would recur.

Prescription: Cubeba officinalis 200C, one dose

A month later: eruption has totally disappeared, no itching. Sac lac prescribed.

Two months later: no recurrence, she is healthy physically and mentally, and studies well. The desire for enjoyment and amusement is less in comparison to before.

Photos: Arul Manickam