Graphitis, Carbo veg. Boron, Post mature elderly Multigravida

This case is from the labor room where many times we do not get the time to repertorize the case and the prescription is based on the clinical experience of past cases. Nearly all the patients that I treat during labor are from a remote village area that does not come for regular antenatal check-up's every month. It is difficult to get their mental picture as most of them are in labor.

Case
A post mature elderly multigravida was admitted to the labor ward in the morning.
It was expected that she would deliver by afternoon, but there was no progress.


Observation
She was obese and appears to be in strong labor.
Perspiration on her face and though the labor pains were not so strong she seemed exhausted.
On examination the cervix was almost fully dilated, but the head was high and not descending due to the insufficient contractions.
On further enquiry she had bearing down pain in her uterus, but they were weak and insufficient.
She has red patches on her arms.
On further enquiry she said she has suffered from such problems in the past, and was treated allopathically.


Understanding
An obese elderly multigravida with low reactivity and sluggishness.
Unhealthy skin.
Exhausted.


Prescription
Graphites 1m, 1 dose dissolved in water and 1 spoonful every 15 to 20 minutes.
After a few doses the pains became more intense and regular.
Within the next hour and a half she delivered a healthy baby boy.


This is a case where I was called upon when the routine allopathic medication had not had much benefit.
The lack of contractions, obesity, repeated skin problems, plus the perspiration on the face and exhaustion because of the pain led me to think of Graphites. Carbo-Vegetabilis and Graphites as I understand and have seen in cases so far are good remedies for actual contractures. I use them when there are deficient contractions
Boron generally, for me, is more indicated in cases where there is strong labor pain, but the baby does not descend or come down with the contractions. Hering mentions under Graphites that it is indicated in cases where labor pains are weak or entirely ceased.
Under Carbo-Veg, he mentions it is indicated in patients who have weak labor pains as a result of severe illness or due to loss of vital fluids.
I find Carbo-Vegetabilis more useful in cases where the labor pains stop or become weak after sudden gushing of the amniotic fluid.
I have also used it with success in cases where the pains have stopped or diminished after the patient gives the history that the pains are less after the rupture of bag of waters.