The case is in the patient’s own verbatim. My thought process and explanations are in bold in brackets. His peculiar words are in italics.
Tell me about your complaints?
It starts with cough and cold. Then I realise that I cannot breathe completely, the air doesn’t go in completely at one go. I need to inhale 1-2 times to feel relaxed. It happens especially during eating. It is aggravated when I am lying down but I feel better if the head is raised during sleeping. I am also better on hill stations where the climate is cleaner.
Tell me more about not being able to breathe completely?
The breath stops, does not go in completely. I cannot eat and feel suffocated. When I breathe deeply only then feel do I feel calm and satisfied. I breathe with my mouth. I have to straighten my spine. I breathe in 2-3 times or I feel suffocated. The air stops somewhere in the middle. It doesn’t go in completely. I am very uneasy. I know that if I try it will happen. Whatever the oxygen requirement is needed is not going inside.
I play football a lot but I never had trouble during that.
(Here he spontaneously connects to a situation and it is peculiar; that he is better during physical play in spite of asthma so I enter the case here).
Tell me about playing football?I love football because there is lot of activity. Cricket is dull and lazy. In football you run up and down. I also like dancing where the body is active. I am hyperactive. But whenever I drink water during hyperactivity it has to cause cough. However I love playing football even if I get wet in the rain and play. I like running and have been following it since childhood. The body gets fit I guess. It gets loose of its stiffness.
What do you mean when you say loose?
My parts relax and the stiffness is gone. My hands, feet, neck are all relaxed. The stiffness after sitting in one place all day long during work is relaxed and normal. Even during dance there are body movements and the parts get loose. It is like greasing a rusted part. (This is peculiar comparison – as if rusty and needs greasing so we are one layer deeper and I need to go further into this more). I want to add one more thing that I also get fever during asthma and my eyes burn and breath is hot.
Explain this greasing of rusty parts?
Making them flexible, thighs, knees, and ankles. Get flexibility in my walk. My joints move normally and start relaxing. So I generally play the entire weekends on Saturdays and Sundays. By the end of Thursday I start getting fixtures in my body especially in my neck, shoulders and spine and I play the weekends to get back to normal. This happens week after week.
Even during work I get lot of stiffness and strain in my body and I change my sitting position a lot. I develop muscle pains and am very uncomfortable. I support my back or change positions. My muscles get all contracted (Hand gesture of pressing his fist). It is pressed and better by changing sitting position.
(So there is a sensation common to both work and play – of stiffness, strain, contraction, fixture and he is better by activity during football, dancing, changing positions and loosening up)
I cannot tolerate oranges, watermelons or rice. I always drink luke warm water and even bathe with warm water. My asthma is aggravated by cream, menthos (mint flavour), bananas, and cardamon as well as aerated cold drinks. I have forgotten the taste of ice cream, which I stopped since childhood. I have had asthma since the age of 7 to 8 years.(He comes back to asthma so I probe here deeper to get the sensation during asthma. The deepest sensation in the chief complaint has to connect to the whole case. )
Tell me more about the asthma attack?
I cannot breathe in completely. It happens especially when I am eating. I breathe in 2-3 breaths to feel completely relaxed and then can I eat or otherwise I stop eating and am busy with breathing and getting the air in. I feel very uneasy. I straighten my back and get each breath deeper and deeper and after a few breaths I know it is going to happen so there is not much fear. May be the cough is jammed inside and so air cannot pass.
What is jammed?
It doesn’t pass through. So I make efforts so that it can loosen the cough. It is blocked and nothing can pass through.
(He gets a similar sensation during asthma i.e. of being jammed, blocked and making effort to loosen up. The opposite of jam is loose. I try and elicit the sensations in other areas to see if there is a connection through the whole case.)
What upsets you the most?When I want to do something and it doesn’t happen it upsets me. In my job I am a top performer but if someone goes above me then I have to perform much better next time. I feel I have not given 100%. I am not happy with my position; I want to reach managerial level. Once my colleague was promoted and I felt very bad. I want to go higher and this temporary job doesn’t give me any satisfaction.
What gives you satisfaction?
Playing football, chilling out the body and when mind is free of tension at work.
What is freedom from tensions like?
No tensions of job, family, being late. You are in your world.
What gives you tensions?
If I am stuck in a traffic jam! I get angry very fast. You can’t move (Hand gesture similar as before). I get irritated or if someone stops me e.g. that day the policeman stopped my auto rickshaw. I don’t like someone ordering or bossing over me. I also get tensed if someone asks me to move in a small gap or place. I will never enter such a place. I will get stuck. I will not be able to come out.
The other day I was seeing the video of Vaishnodevi temple. (It is a holy pilgrimage place in North India in the Himalayas.). There was this small gap on the way up. I saw people crawling and I said I could never go in. I will never be able to come out. I will get stuck, my body will get stuck and I will never be able to move in that small place. I could see people moving but I had the instant reaction that I cannot go. I can stand in crowded trains but seeing that Vaishnodevi video I don’t know what happened.
(Again the same sensation of being stuck and not able to move)
Also fixed timings are a no no, same with someone ordering me.
Any dreams?
I had repeated scary ghost dreams as a child. A ghost is taking me away and I am sweating in my palms. He has caught both my hands and is dragging me away. I am trying my level best to get myself freed and get rid of him. I am a kid and helpless. No one is there is rescue me as he has killed my parents. I will be killed if I don’t free myself.
Tell me about the fever during the attack?
During fever my eyes start burning, breathe is hot, the whole body is painful especially head, hands, shoulders and back. Cough is always there (3). Body pain is too much. There is ache in all my muscles.
Case AnalysisI analysed the case using Kentian analysis and repertorized the rubrics from the Complete repertory –
- Mind – Activity desire for.
- Generalities – activity desires physical
- Generalities – agility
- Generalities – Change of position desires.
- Generalities – sensation of tension, tightness, contraction, strictures.
- Respiration deep desire to breathe frequent and long.
- Respiration lying while aggravates.
- Respiration difficult sitting bent forward aggravates
- Respiration difficult sitting upright ameliorates.
- Back pain sitting while long after
- Back pain motion on amel
- Cough chill/fever during.
- Fever pain with.
The remedy coming up was Rhus Tox.
Understanding the case in the light of newer concepts of sensations by Rajan Sankaran using plant family, miasm and hand gestures.
The common sensation throughout the case is – Caught, stiff, tight, tension, stuck, pressing. [1; 78]
Active reaction – Activity, movement, loosen up, relax, escape ie stuck and want to move constantly. [1; 78]
Miasm – According to Sankaran’s concept of miasms – They provide the reaction, the pace and the depth to which someone experiences the sensation. In our case – He needs to make a critical effort to come out of the stuck situation eg take in breath during the asthma attack itself or he could die. In the dream the sensation and miasm again come up strongly – The dream is of getting caught and trying level best to free himself. So the sensation is similar of being caught and wanting to free but the miasm is clear here of being a helpless kid and making critical efforts to get away from the situation – typhoid miasm)
In Sankaran’s Insight into plants vol –1
Family Anacardiaceae
Miasm Typhoid
Caught, stuck and held in a situation and have to come out of it immediately or it can be dangerous –[1; 79]
Rx Rhus tox 1M 1 dose on 11th July 2005.Follow up
He came back on 14th August. He had a very mild attack of asthma that month and it was without any fever for the first time. Cough still persisted but without yellow expectoration. Stiffness same. He was given one dose of RhusTox 1M to be taken only during any attack.
He reported back on 12th September. He says the stiffness in his entire body has gone completely. He no longer gets the stiffness on Thursdays. Body is calmer. He is feeling positive mentally and sleep is much better. He had no episode of asthma that month. I told him to experiment with substances that aggravate him and report back. He was scared of trying any thing, especially ice cream which he had not had since childhood, but I encouraged him to report back in case. He still has the previous powder with him.
He kept in touch on phone when I moved to Sydney. He was much better even after trying every aggravating substance. His family was very surprised. He could eat ice cream after years without an asthmatic attack. He says he feels much more confident in himself. He gets no body pains even after playing. He says that the body strain is gone like magic.
He continues to remain in touch through emails and keeps well.
ConclusionIt was a case in which I learnt a lot personally, I learnt about seeing a well-known remedy in the light of the newer concepts of sensations and delusions. It is amazing that no matter what way you look at a case the simillimum is crystal clear. I just hope to keep this openness in all my cases and I am sure homoeopathy will continue to surprise me. I guess we all agree that every case just convinces us how much more there is yet to learn and know.
References- Sankaran Rajan (2002). Insight into Plants. Homoeopathic Research and charities, Mumbai.India
- Zandvoort Roger Van (2008) Complete repertory v2008 from the software HomeoQuest (c) Shilpa Bhouraskar.
No comments:
Post a Comment