Varicose Veins
1. PRELIMINARY DATA
- No.: 219/2026
- Patient's Name: DEF
- Address: Flat 503, Ruby Residency, Pune.
- Occupation: Saleswoman (prolonged standing in shop, heavy lifting)
- Religion: Hindu
- Date: 01/06/2026
- Age: 49 Years
- Sex: Female
- Education: 12th Pass
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Lower Limbs (calves, ankles, thighs) | Dilated, tortuous veins, aching/heaviness in legs, swelling ankles, burning/itching over veins | < Prolonged standing/sitting, < Hot weather, < Before menses, > Elevation of legs, > Cold applications, > Walking gently, since 12 years (progressive, visible varicosities, occasional ulcers) | Restless legs at night, cramps, fatigue, irritability |
| General | Heaviness in legs | < After meals | Anxiety about ulcers/bleeding |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Multiple pregnancies with leg swelling; suppressed skin eczema with ointments; recurrent ankle sprains; frequent standing job since 20s; overweight gain after menopause.
- Family History: Mother has varicose veins & ulcers. Sister has deep vein thrombosis history. Father has hypertension.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: Cold drinks (+++), Salty food (+)
- Aversions: Fatty food
- Thirst: Increased, for cold water
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Profuse on legs, offensive
- Sleep: Disturbed by restless legs/cramps
- Thermal State: Hot patient (prefers cool, uncovers legs)
B. Reactions - Physical Factors
- Weather: Aggravation in hot humid weather
- Position: Better elevation of legs
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, restless, worried
- Anxiety: About leg appearance, family burden
- Fear: Fear of ulcers/bleeding, fear immobility
- Dreams: Falling, legs failing, arguments
- Other: Suppressed frustration, feels unattractive
6. PHYSICAL GENERAL EXAMINATION
- Wt: 78 kg | Ht: 160 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 82 bpm | B.P.: 134/84 mmHg
- Face: Tired
- Tongue: Clean
- Nails: Normal
- Skin: Dilated veins visible on calves/thighs, ankle oedema, pigmentation
7. SYSTEMIC EXAMINATION
- Vascular: Prominent varicose veins, Trendelenburg positive, ankle oedema, stasis dermatitis
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about appearance/health, fear immobility (Grade 3)
- Physical General: Hot patient, thirst cold large quantities, profuse offensive sweat, leg heaviness (Grade 3)
- Particular: Chronic varicose veins with aching/burning, swelling, < standing/hot, > elevation/cold (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic venous disorder with strong Mental Generals (irritability, fears) and Physical Generals (thermal, thirst, sweat) dominating; Kent suits extremities rubrics for varicose veins.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and restlessness
- Anxiety about appearance
- Fear immobility
- Thirst cold large quantities
- Hot patient
- Profuse offensive perspiration
- Varicose veins aching/burning
- Swelling ankles
- < Standing, hot weather
-
Elevation, cold applications
- Family venous issues
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Irritability | Mind; IRRITABILITY | 57 |
| 2 | Anxiety health | Mind; ANXIETY; health, about | 6 |
| 3 | Thirst large quantities cold | Stomach; THIRST; large quantities, for; cold | 529 |
| 4 | Extremities veins varicose | Extremities; VEINS; varicose | 1223 |
| 5 | Extremities pain burning legs | Extremities; PAIN; burning; legs | 1011 |
| 6 | Perspiration offensive | Perspiration; ODOR; offensive | 1298 |
| 7 | Heat sensation | Generalities; HEAT; sensation of | 1366 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Pulsatilla | 7/7 | 21 |
| 2 | Hamamelis | 6/7 | 18 |
| 3 | Fluoricum Acidum | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Aching, irritability, hot | Dilated veins, oedema | Family venous problems | Destructive fear immobility |
Dominant Miasm: Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Varicose Veins (chronic, symptomatic)
- Differentiation of Remedies: Compared Pulsatilla with Hamamelis. Hamamelis has more venous congestion/bleeding, chilly; Pulsatilla matches hot, changeable symptoms, thirst cold, desire cold drinks, irritability/weepiness, > open air/cold, varicose veins with heaviness. Fluoricum more for destructive changes.
- Selection of Remedy (Materia Medica): Pulsatilla matches chronic varicose veins with heaviness/aching < standing/hot, > elevation/cold, hot patient, thirst cold large quantities, irritability/anxiety (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic venous sycotic case, sensitive constitution)
- Actual Prescription:
- Pulsatilla 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 15/07/2026 | Heaviness reduced 60%, swelling milder, no cramps, veins less prominent | Placebo | Leg elevation daily, compression stockings, avoid prolonged standing |
| 15/11/2026 | Symptoms minimal, no oedema, veins stable, energy better | Placebo | Regular walking, weight management, report progression |