She is married and lives with her husband. They have two children, one of whom lives at home (age 23) and one who has recently moved out.

She and her husband run their own business. She left the business to do a massage course but has since returned. She works three days a week doing the accounts.

She has always been very healthy and has no history of disease.

She has never taken medication, except for the hormone pill on which she was for a short while.

She has itchy skin and this has become worse over the past few months. She has had this condition for the past 2-3 years. She has been to an allopathic doctor who prescribed anti-histamines, however, she has not taken them as she feels it would not solve the cause.

She also has problems with her knees and this has been for the past 4-5 years.

She is unable to get to sleep easily - usually takes 30 mins to get to sleep and gets agitated (tosses and turns).

She wakes up multiple times at night (1am, 2am, 3am, 4am). This has been a long term problem - she used to wake up to drink water but now wakes up because her skin is itchy. She goes back to bed and tosses/turns until she falls asleep - only to wake up a short time later.

She went through menopause around the age of 48 (6 or so years ago). It was a quick transition without too much fuss - her period stopped for a while then came back and then went for good. She didn’t feel very different afterwards.

She gets up for morning prayers between 4 and 5. Usually she doesn’t get much sleep so she lies in bed until 4:30am because she’s tired.

Her husband’s alarm goes off at 6 and the radio is on until she finally gets up at 7/7:15am.

She has morning evacuations, rarely goes again during the day. If she has to go again at work she will hold it in (as she doesn’t like going to the toilet at work).

She is not troubled if a meal is missed, feels low energy if she skips a meal but does okay without it (she does get hungry though).

She has a BALANCED/LOW agni.

At 7:15 she gets out of bed and showers. Afterwards she has breakfast that consists of shreddies/muesli and milk (semi-skimmed)

After she gets into the office, she will have a snack (fruit/banana). Lunch at 12:30 is a sandwich (brown bread, tuna, cheese / chicken, humus). Occasionally she may have mung beans, bombay mix, etc.

In the afternoon, around 4pm, she will have a dry biscuit with tea or fruit

Dinner consists of curries, veg soup (warm, cooked food). She usually has tea or warm milk before bed.

Skin: Good hydration for her age.

Temp: Cool with cold fingers (she always feels cold) warm forearm.

Nails: Very healthy, but shows poor circulation. Her nails also show malabsorption which has been around for some time.

Pulse: Showing typical signs of Vata in the digestive tract and outer pathways. The imbalance is deep and becoming (or is) chronic.

Tongue: No toxins, tongue clear and pink (not bright pink but healthy).

Prakriti: VATA and KAPHA

There are several indications that she has Vata in her natal constitution. Most notably that her passage through menopause was early (aged 48) and it was a quick process. The ease of the transition through menopause along with the strong constitution, forebearance and body type, shows Kapha.

Vikriti: VATA

The source of her problems began with the onset of her menopause - the transition from the Pitta to Vata stage of life.

In her case, Vata is showing up in several forms: insomnia, painful joints, poor circulation, etc. The itchy skin is a sign that Kapha has been pushed into the outer pathway.

After more questioning she realised that her sleep problems (waking several times during the night) began around the same time as her menopause. Her sleep problems have been constant for the past six years.

As she has moved towards and into the Vata stage of life, Vata dosha became aggravated and has been causing the problems with inability to sleep (especially during the Vata time of the morning - 2 to 6am). This problem has been chronic enough that Vata has moved into Rasa dhatu and is implicating Kapha (itching).

Her condition is described as Rasa Gata Vata (Vata dosha in Rasa dhatu).

She follows a very healthy diet for both her prakriti and virkiti, however, improving her agni and warming/oleating her skin will benefit her greatly.

I prescribed a mix herbs that pacify Vata and work on the digestion. These herbs are taken before meals in warm water and draw the excess Vata back into the inner pathway for elimination.

I showed her how to make a ginger tea that is drunk throughout the day to further assist in removing the excess Vata

She was shown a self-abhyanga and performed this massage with warm oil, using it liberally on the affected areas. This practice will serve to return Vata to it’s home, creating balance.

Once her agni had improved, I prescribed Ashwagandha to regenerate her tissues and further balance Vata.