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| Hpathy Ezine - September, 2006 | ||||
Violent Man with Chronic Pancreatitis- Dr. Praful M Barvalia |
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| Preliminary information Name : MR. M.R. Age : 43 years Wife’s Age : 37 years Religion : Muslim — Non-Vegetarian Occupation : Beer Bar at Central Mumbai. Admitted at: Mumbadevi Homoeopathic Hospital attached to Smt. CMP Homoeopathic Medical College, Vile Parle, Mumbai. I.P.D. Reg. No. 1032 Class - Male / General ward Date of admission : 23/03/1994 Date of discharge : 26/04/1994
Recurrent bouts of Jaundice since 1984. He has had a total of 7 episodes over the last 10 years one every 5 to 6 months. The jaundice was often accompanied by fever, acute abdominal pains and dyspepsia as described below: The case was diagnosed as Chronic Pancreatitis. He had severe attacks of excruciating pain in the abdomen radiating to the infrascapular region. The pain was > flexing the limbs on the abdomen. He had nausea which was > warmth, but with no vomiting. He had frequent belching with heaviness in the abdomen. Also, the flatus was impeded, could not come out. During this time he would develop fever with chills that would last the whole night with a concomitant splinter like pain in the eyes. The twisting, griping pain in the abdomen would radiate to back. The patient described this pain as, "agonizing and makes me restless. I am like a fish tossed out of the pond”. Concomitantly he would have itching all over the body, a lot of weakness and his sclera was yellowish.
Diabetes Mellitus under poor control. Blood sugar levels were erratic with irregular intake of Insulin. This was diagnosed when he had the first attack of jaundice with pancreatitis.
Life Space appreciation
Mr. M. is from Zamindar [Landlord] family from Bihar. His father was an excise inspector and was a respectable land lord of the village. He was considered a man of principle, who would not tolerate wrongdoing. He punished villagers and had them beaten if they did anything wrong. His mother was calm & quiet. He was proud of his village being in the neighborhood of an ex- Prime Minister Chandrashekhar’s village, Baliya. He boasted of having taken a photograph with Rajiv Gandhi. He studied up to Class 6 and used to enjoy hobbies like wrestling, playing and hunting in the forest. Initially they were quite rich. But all the problems in his family started after his grandmother’s death. His father left his job and instead they all started living on the money earned by selling off their land. Around this time he came to Bombay with his uncle. He stayed at Dongri and established a beer bar. Gradually he flourished in his business but developed an addiction to beer, charas, ganja etc. He used to have lot of sexual thoughts and developed “bad-habits” like masturbation. He complained of spermatorrhoea (prostatorhea). Once he got married he settled in Mumbai, and brought the rest of the family to Mumbai. He is extremely contemptuous about relatives. He makes statements like, “My grandmother was 100% mad, my wife has only 50% brain, my brother is 50% mad”. After coming to Mumbai, he came in contact with one of the top dons of the underworld and sincerely worked under him. He became this don’s right hand within no time. Robbery, extortion of money and participation in riots were his regular activities. Gambling and prostitution were inevitable accompaniments. He expected his wife to eat heavy food, and then would want her to go jogging with which she would not comply. Also she could not conceive and that enraged him. Since he had oligospermia, he had no offspring. His infertility affected him in that he constantly worried, “My dynasty will be destroyed”. He believes he does not have any defect and even mentioned confidently that “I’m quite powerful”. He refused to take any treatment for this while his wife took treatment from different doctors, but all in vain. He mentioned that wife was not interested in going out and wanted to remain home. “I wanted to leave her and marry somebody else, so that my dynasty continues, but now at this age what will she do? This is my confusion and dilemma”. He is extremely impulsive and violent. He had few arguments with one of his customers, which resulted in a severe altercation and fight. He was so enraged that he impulsively pushed an iron rod into the customer's abdomen. He was arrested but somehow he got away. He is quite censorious about his parents and relatives but needs them badly and cannot stay without them. He always grumbled that though he helped the relatives, they never reciprocated. He wanted to build a bungalow for his parents so he sold his house at Virar for 4 lacs. He then purchased one bungalow for his parents at the out-skirt of his village in a remote place and spent 2 lacs in renovation and construction. His parents found it extremely difficult to stay at such a secluded spot and he had to sell the place incurring loss of Rs. 2 lacs. He says, “I’ll do whatever comes at the spur of the moment and then repent”. Yet he is quite sensitive. He is moved by seeing poor, hungry people
and tries to help them by providing money & food. He has great
respect for food. If he happens to see piece of roti (bread) on
the road, he will pick it up and keep it aside so that no one would
walk over it. In his youth, his father would warn him about his
misdeeds and he would react. Now nobody tells him anything. He is
also extremely obsessed with his health. Often he would plead, “Please
doctor you cure me, and for my whole life I will sing your song”.
He presented several hand written papers to the doctor demonstrating
monotonous repetition of complaints and anxiety about health. He
repeatedly mentioned about his weak will and sought reassurance
for his recovery with no disability. At the end he wrote “Doctor
you are great, forgive me for my mistakes”. In spite of being
a Muslim by religion on every page of the written history he put
the symbol of
Pulse : 71/min B.P.: 130/80 mm Hg Abdomen : fullness present. Tongue : creamish coating Past History: Underwent a Cholycystectomy (gall bladder removal) in 1981-82.
Current Medications: Insulin 16 units (Highly purified - Redexon Belcomlex). Case Analysis
The following traits can be determined from the life space above and will allow us to understand the totality.
Anacardium is indicated because of cruel behaviour, violence and impulsive attitude. A vicious anacardium can be malicious and scheming. Hering describes this as : “estrangement from society and individuals. He is very indifferent and unfeeling.” But our patient demonstrates an emotional need for relationship. Mercurius and Lachesis enter the fray with ego and violence. Intense need for relationship, complaining attitude and anxiety about health helped decide on KALI-IOD. The following references gives us the depth to image the mental picture of Kali Iod that he presented: Hering:
Phatak
Robert: Differential Material Medica:
Investigations done: 1) During admission 23/03/94
30/03/94
05/04/94
09/04/94
18/4/94
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(AUM).
During the follow up he was extremely expressive and wanted to remain
in close contact. He would often invite various interns and junior
doctors to his restaurant and bar, which they would never accept.
