A Case of Seronegative Arthritis: Opium

Italics are used to highlight the pertinent phrases.

The case was translated to English from the local language the patient used.

(In brackets and green are my lines of thought.)

Date of first consultation: 20^th August’ 2004

39 years old male came to me with the complaint of joint pains and associative swellings of finger joints. He was diagnosed as a case of Seronegative arthritis involving his big as well as small joints asymmetrically.

D: Tell me about your problems?

P: Pains (shows right hand, fingers with swelling ++) and there is swelling as well. Pain in finger increases a lot at night and it goes on increasing as the night progresses. Also there is pain in elbow joint (points out) and right side of hip joint.

(Observation: Stammering speech +++)

With pain I use Reli spray (Ayurvedic pain relief Spray), which relieves the pain. It’s only on one side of my body. (On right side). It comes once in a week. I get premonition about the pain, I get the feel that it will come tonight and then it has to come; It always happens that way.

Highest pain that I get is at around 12 to 1 am so I use Reli spray in advance (hip joint with reli spray) so as to relive it in advance. This pain (hip joint rt.) increases if I put my weight on right side. I have to support myself on opposite side (left) to get up from seating position.

It increases if I eat sour. Specifically I have noticed it increases when I have unripe mangoes.

D: More about this pain?

P: It increases on pressure. Pain is as if. …It’s as if a boil inside, a boil – how would you feel? – That kind. Then you can’t bend your limb from hip joint. It remains straight only.

D: More about pain?

P: It’s a highest level of pain. I think that what will happen in future? Today, I can tolerate this pain but it is going to increase in future. When it happens, I just look at that; I see it’s happening; I feel if I’ll tell my wife she’ll get worried. I know it is going to worsen, so I just keep quiet. Today I have the capacity if someone cuts me with a blade, I’ll not even say “ oooh…” (Weeps).

(We have this case where the chief complaint is asymmetrically involved joint pains with stiffness and swelling (typical of Seronegative Arthritis), aggravating more at bedtime. He gives various modalities that aggravate or ameliorate his pain. The pain is intolerable, but he keeps quiet, silently tolerates it. Interestingly, he uses various images to describe the pain as well as how he copes up- for instance “pain is as if boil inside”, or “he will not go 'oooh' even if being cut with a blade”.

This gives us a faint idea about his level of experience and the way he copes up. Lets go further without disturbing the flow of the patient to understand his experience better.)

D: Tell me more?

P: That night pain in right hip was so severe; I could not even bend my leg from its position. I had to keep that straight as slightest movement caused more pain. I started weeping with the pain, it was that severe.

D: More about pain?

P: It was as if someone has beaten there, pain was so much as if hit by a blunt object. You cannot touch there.

(Though he is giving various images like pain as if beaten, as if hit by blunt instrument, etc, we have to go further to understand whether these images are the final experience or there is more to it.

It is very important to understand that a patient whose level of experience is images (delusion) will give many images. And also that the images are not the final destination, as we need to understand the final experience of these images in order to reach the core. Not doing so may make a physician tumble down and go wrong with the prescription. The chances of the images being the final source or not, are equal. So, it's extremely important to trace them further. And that’s what I did)

D: Tell me more?

P: I tolerate, I don’t cry. I feel it’s going to stay; you have to tolerate, what else?

(It is very essential to understand the psyche of the patient at this point- though his disease is arthritic joints, his attitude towards it is equally diseased; “I feel it’s going to stay; you have to tolerate”!!! – This expresses his hopelessness about the problem; When we treat the patient it is a must to impart positivism towards this attitude besides imparting result at physical levels, to avail the complete beauty of healing experience for him. We shall monitor this during his follow ups)

D: What more?

P: I have this stammering problem. It happens when I meet a new person, strange person. I have no problems with this in my day-to-day life. It’s there since childhood.

Joint pain started when I was sixteen. It started on the tips of the finger. Slightest touch used to aggravate; fingers used to turn red.

D: More?

P: Pain as if hit by a blunt instrument. Pain increases on keeping the part hanging. Pain as if heaviness < hanging the hand; > jerking the hand; as if blood got clotted inside which gets better on jerking the hand. As if got caught, I can’t bend the part. Severe pain that gets aggravated on slightest touch and bending. With pain joint gets stiff, you can’t bend your fingers from the joint. In hip, pain is as if something is lying there in the joint and I am not able to remove it.

It is out of my control to remove it. First time I cried with that pain, it was so severe; during that pain episode, I was sleeping and I was in a dream. In that dream, I was in a boat in a flooded ocean, and I saw many people drowning and being pulled inside by the force of water. I saw myself trying to save people. I got on right side of my boat and saved some one, than I went on left side and help someone with my hand and saved him. I saw myself saving them from either of my sides and I went on doing that and with every movement my pain increased.

D: Meaning?

P: Meaning when I was sitting still no problem, but with so much of pain, people are asking for help, they want me to save them, help them. Someone is calling me from this side (shows right side) and then some other calling me from left side. It was like intolerable.

(Interesting; Pains are intolerable and so is the situation!)

D: What was the most important part in the dream according to you?

P: There was so much pain and I was moving my leg from here and there.

D: More?

P: I don’t remember but my entire concentration was on pain. With so much of pain, I was slowly moving my limb from right position to left with lots of difficulty. At that time, I was explaining myself that this pain is there, and it is going to be there forever, (again the hopelessness!!!) so forget about the pain and concentrate on saving lives of people. The pain was as if something got broken inside. As if frozen from inside. There was this flood happening in water, I could not move my limb but I was doing it forcefully. My limb was not giving me support to move, but people were dying, they were getting drowned in that flood. There was pain, but most important at that time was to save people.

(When we ask about which part of the dream was most important, he points towards the severe, intolerable pain. Also, he tells the severity of the situation he was in, which again in his perception was very intense and intolerable. So much so that he had to forget about the pain, forcefully move his painful limbs and save dying people. A very demanding situation where one needs a super human effort to tackle the situation! And he seemed to do that successfully. Again we witness his hopelessness about his pain. He gives a few more images to describe his pain like as if broken, frozen, etc. Let’s trace them further to understand the final experience.)

D: More about that pain?

P: limit less pain, out of tolerance, beyond my limit to tolerate, I cried with pain. In dream also, pain was out of my limit to tolerate, but the situation around was so much out of control. There was this flood happening so I started working for it.

(And we again come down to “intolerable aspect of pain” and his sensitivity towards that; Though he uses various images to describe his pain, ultimately it all boils down to them being intolerable, out of his limit, severe pains; it's so severe that he is almost in tears with the pains. One more interesting thing we understand is that he silently tolerates such intolerable pains. Even the situation of the dream is out of his limit to control, but yet he tried controlling it by saving people’s lives to control his intolerant pains.

Two things we understand distinctly so far; one is his sensitivity towards severe intolerable pain as well as the situation and his coping up for the same by controlling them which, in his perception are beyond his limit to control. This type of coping up suggests the Cancer miasm. In Cancer misam, the situation is beyond control, beyond his/her limits to handle, very very demanding, where one requires a super-human power to deal with it- that’s exactly what we understand from patient’s description of his dream. The second thing that we understand here is that the patient is using lots of example, images to describe his coping up, his pains etc; also it is a very common for him to use his subconscious dreams to describe how it is to cope up with his pain, how intense and demanding is the situation in his perception. This indicates the level at which the patient is comfortably vibrating and living his experiences, whether pain or dream or otherwise [we’ll see this once we move ahead]. This level is that of Imagination, Delusion. His level of experience is Delusion.

Now we need to trace other uncompensated areas of his life and explore them in order to understand his experience of them. If we get similar experiences to that we have gathered so far (usually this is what happens if we have explored the correct track), that will be confirmatory. Sometimes, it does happen that exploring another area brings forth a completely different scene- it means either we left the earlier experience half explored or we took a wrong path may be out of our prejudice. In such a case, we need to understand the newly explored scene until the entire vital core gets clearly understood and then we need to get back to the experience that we have gathered earlier to understand the missing link.)

D: More about you in general?

P: Since childhood, I do skipping, 400 at a stretch. So that I stay fit, my goal is to stay fit.

D: What bothers you the most otherwise?

P: In the hands pains are okay, I can tolerate but hip joint pains are out of my limit. (Miasm)

D: So how does it bother you?

(This question helps to understand the experience of the problem at the general level, meaning how it feels to him (and not to his part-a local part). If the experience of a local part (in this case joint pains) is the same as that of his experience in general; and also if he describes the same experience at other subconscious / uncompensated areas, then that becomes a vital/core experience of the patient. That’s the central disturbance of the case)

P: so if it increases in future, it’s going to be more painful so I keep myself mentally prepared since it has happened. Once I try to prepare myself mentally that it’s going to happen like this in future also, so be ready! I prepare, accept “it’s going to happen.”

D: How is the feeling?

P: Now, nothing as I am prepared for that. I have told myself that it is going to get worsen.

D: How does it feel to have this pain?

P: It’s out of my tolerance limit. It pains so bad. If it increases I won’t be able to walk- I’ll be bed ridden.

D: How would that feel?

P: Depressed.

D: More about it?

P: Out of my limit pain, I’ll cry with pain- so severe. It will be out of my control.

(Again we get the same experience! The effect of this pain leads to his imagination of it getting worsened and then it will be intolerable and out of his control! So I decided to explore one more area of his life completely disconnected from the pain issue and understand his experience and coping up there.)

D: Any incidents of life which had a deep impact upon you?

P: Yes and even today if I remember that incident, I get tears in my eyes.

Once, my elder daughter, who had lots of pressure of studies, was found laying unconscious on her bed , not moving, her eyes wide open, and limbs straight (Tears in his eyes).

It happened right in front of my eyes; I felt “What if some thing goes wrong with her”? That scene was worst scene (Bhayankar he said in local language.) for me; it still brings tears to my eyes. I still cry if I remember that (Weeps).

I was shocked “what is happening to her” “your own child is in trouble, she is suffering and you can’t do any thing about it, so much helpless you are”. I was shocked, it was out of my imagination, that entire scene was shocking, I couldn’t tolerate that.

D: More about shocking?

P: It was completely unexpected, coming to you suddenly and again so painful. The one whom I love so much, so dearly, if anything go wrong to her, if she is in pain, she is suffering, that’s shocking for me.

One other such incident, when I was walking with my mother, holding her hand, she missed a step and fell down, I was shocked! “I am there with her and still she fell down” I felt “oh my god!”

D: When you say shocking, what do you mean?

P: I blame myself that I am helpless, in that situation, I could not do anything.

(In such incidences, we can witness his sensitivity towards intolerable pain and suffering of his daughter and his mother. He felt shocked- shocked to see them suffering and feeling helpless to control the situation. Again the same issue, sensitivity and experience.)

D: More about your nature?

P: I can weep very easily- I get sentimental over various things, specifically the one that involves my family.

D: What else?

P: Nothing.

D: Other dreams?

P: -

D: Any other incidence which had a deep impact upon you?

P: Once I got badly hurt on my scalp- that was very painful, once I got hurt and my skin was torn open, entire flesh came out but I didn’t cry. I cry when the pain gets out my tolerance limit. There was intolerable pain, a lot of suffering but still I could tolerate. I did not feel helpless.

(We understand that all his issues, be it his pains with joint, or the effect of this pain upon him, his dream, his daughter’s suffering or that of his mother’ and his injury leads to one and the same issue, same experience and coping up- and that’s his sensitivity towards intolerable, severe pains and suffering and his ability or inability to keep that under control.)

D: This stammering?

P: It is there since childhood. I used to feel very bad “What’s wrong with me, there is something wrong with me, compared to others.” So previously I avoided talking to people (facing them, talking on phone, I did not used to leave my house.) But after marriage I became confident. Previously I felt people will laugh at me but after marriage I felt I will overcome this- I’ll talk; so I started talking in public, participating in group of people- for business, friend circle, I talk even if I stammer- so now I do not feel bad, no inner fears, now.

(We realize he worked and succeed in controlling his fear to participate in public out of his stammering problem.)

D: Your interest and hobbies?

P: I like out door games like cricket, as a child played various out door games. I like watching fighting, action movies. I watch sports and movies on television. I like to take active participation in games, sports, you should play with all your heart, 100%- it’s fun, you feel happy when you win. You feel proud for your self; it’s full of fun and excitement. Tremendous happiness. You just dance with that.

D: How do you like music?

P: I love music, I love to listen to melodious songs. Many times I just switch off all the lights when I go to bed with the music on, old melodious music, silent, complete silence, especially sad songs, not fun kinds. I feel peaceful… completely peaceful experience. Silence, dark, sad songs, a wonderful combination. It feels fresh, haven, I forget everything then, ‘even if I am in pain’ I feel totally calm, at peace. I forget all my pains.

D: What is the exactly opposite feeling of that “peace, calm”?

P: I never confront anybody – “I just leave it thinking let him be like that.” I feel bad from inside when anybody hurts me or fools me, but I just leave the matter.

D: How particular are you with keeping things in order?

P: Very much. I do not like things lying here and there. I want them in place. So I always shout at my daughter if she does not take care of placing things in order.

Advice : CBC, ESR, S. URIC ACID, RA HLA-B27)

Understanding of the case:

On one side we get sensitivity towards intense, intolerable, severe pain and suffering and on other side there is peace, calm, complete silence, no pains. The issue here is that of a sensitivity towards one sensation- the sensation of intolerable pain. We do not find an issue of structure, maintenance, lack etc., like that of a mineral kingdom, nor is there the issue of victim /aggressor etc. like that of an Animal kingdom. This is purely an issue of plant kingdom. He being a sensitive person so much so that tears comes easy to him again confirms the Plant kingdom in the case.

His sensitivity towards Intolerable pain indicates Papavaraceae family.

When we study remedies of Papaveraceae (as Dr.Rajan Sankaran explains), we get following symptoms:
Painlessness of complaints usually painful (Complete)
Ailments from shock (Knerr)
Ailments from; fright, fear; accident, from sight of an (1) (Complete)
Delusion; hurt him, people want to, execute him (1) (Knerr)

We can see that the fright (and the pain) is intense resulting in convulsion, numbness, sleepiness and anesthesia, and also that the person cannot allow their pain (and emotion) to touch him, hence painlessness is one of the main symptoms of Opium and other members of the Papaveraceae family too.

Thus on one side we get intense pain at physical as well as mental level (shock, fear, fright, accident, injury, murder, violence, stabbing) along with sleepiness, coma, catalepsy, anesthesia, numbness as passive reaction to pain. This is the vital sensitivity of Papavaraceae, intense hell like pain, turmoil like state. Another side of intense pain is a state of no-pain, calmness, tranquility; a state that one experiences in meditation

(The one that our patient described experiencing when he listens to music in a dark room and he also mentioned- with this calm feeling, he forgets his pains).

Miasm: Cancer.

So, Papavaraceae at the cross point of cancer miasm and the remedy we have is Opium. The central issue of Opium is to control Pain and suffering or failing to do the same; quite in tune with that of our patient.

As we know, painlessness is one of the main symptoms of Opium, where patient does not allow the pain to touch him as he is so much sensitive towards the pain sensation. That is the reason for meditation being a big theme in Opium, again, 'Tranquility' is a symptom of Opium (Chel, Codeinum, Fumaria, Morph are the other drugs from same family sharing this state).

Characteristic Rubrics of the case covered by opium:

Mind; DREAMS; journey; water, by; anxious (1) *

(Opium is the only drug mentioned for this symptom. In combination with the symptom mentioned below, it more or less expresses the patient’s experience in his dream of water )

Mind; DELUSIONS, imaginations; casualties, sees (7) *

(Again there are only 7 remedies out of which Opium is one)

Other rubrics are-

Mind; AFFECTIONATE

Mind; ANXIETY; future, about

Mind; ANXIETY; pains, from

Mind; AILMENTS from; excitement; emotional, mental symptoms from

Mind; AILMENTS from; fright or fear; accident, from sight of an

Mind; AILMENTS from; grief, sorrow, care

Mind; AILMENTS from; injuries, accidents

Mind; DELUSIONS, imaginations; enlarged; he is

Mind; DREAMS; unsuccessful efforts to; do various things

Mind; SENSITIVE, oversensitive; general; pain, to

Mind; TIMIDITY

Mind; TRANQUILLITY, serenity, calmness; general

Mind; WEEPING, tearful mood; general; pains; with

Mind; WEEPING, tearful mood; general; easily

Generalities; SIDE; right

Generalities; MIDNIGHT; agg.; about

Generalities; INJURIES, blows, falls and bruises; general

Generalities; PAIN; general; joints

Generalities; PAIN; sore, bruised

Generalities; PAIN; tearing; internal

Generalities; SHOCKS; general; injury, from

Extremity Pain; RHEUMATIC

Extremities; STIFFNESS; general;

Extremities; BOENNINGHAUSEN; lower limbs; agg.; touch

Extremities; SEPARATED sensation; body, from, lower limbs; severed from his body, legs

(As patient narrated- he wants to cut his painful leg from his body and keep aside)

Remedy given: Opium 1M, one dose.

(Potency was selected 1M since his level of experience is relatively high, at Delusion level)

Follow ups: 20/09/04

D: How are you?

P: Fine (Smile on face). I feel my pains, complains will go away. It will get cured. I got pain episode twice but with much less severity.

D: So over all how do you feel?

P: I feel fresh. I do not get tired even with a lot of physical work, otherwise I used to feel tired, but now I feel fresh even in the last evening when I came home from my work.

D: How about your dreams?

P: No dreams. I feel out of depressions, hopelessness, I feel tension free, previously mood used to be sad without any reason. But now it’s not there.

Plan: Placebo

Follow Up: 01/11/04

D: How are you?

P: Very good. All these days no episode of pains. Energy level is also very well. Since last few days minimum pains in my fingers, very light pains (Shows terminal inter phalanges joints) But I can move my fingers without pain and no swelling as well.

Plan : Placebo.

Follow up: 22/11/04

D: How are you?

P:After 2^nd day of last treatment, my mood changed, I was very short tempered, I used to get angry on small, small stuffs which is very unlike me as I do not confront anybody.

Now since last 2 days I am better.

Over all I am fine.

(A very good sign, before he used to control his emotions, now they are coming out)

D: So how are you since the time we have started with treatment?

P: No problem at all. No joint pains. A week later of last previous dose

(placebo) I saw a dream,

Dream: I was going out with 4-5 friends. They were ahead of me. I think we were swimming and it was all water around. I thought how is it possible to swim and go ahead but I heard some voice coming and telling me “you go ahead, you can do that.” So I started going and I reached the shore.

D: What was your feeling?

P: One needs to decide to go ahead. I feel there is a lot of change in my attitude. I don’t care about people what they think of me, which I always did. I always have compromised myself with everything, with my wishes, but now I feel what I want. I will speak and I will get that done. I will have the control of my life in my hands now; I will decide what I want and what I do not.

D: How do you like this change?

P: I like it very much. My confidence has increased.

D: Dreams?

P: More hopeful dreams, but I do not remember well.

(Observation: Stammering in his speech has reduced a lot.)

(A very good change we can see in him. Previously he never confronted anybody even if that hurt him, he would control all his emotions, and would keep them inside. But now, he retaliates back- “short tempered” -- a homeopathic aggravation happening at emotional level which is a good sign as there will not be any suppression – “compromise” in his words. Now he doesn’t care about what others think about him, ”something that previously held him back and his reactions are also much more balanced as he does what he feels is right. This is the positive shift in his attitude, his perception of life and along with that his c/c is much better. Also, we can appreciate the shift in his hopelessness- now he feels his joint pains will go away and he also feels one must decide to move ahead in life.)

Plan: placebo.

Follow up: 31/12/04

Continuous dry cough, pain in throat < deglutition < lt. Side

< Laughing

After initial 2 days of last treatment, loose stool lasted for 2 days then fine.

Plan: Opium 1m one dose.

Follow up: 10/01/05

Had kept a fast for two days where he did not eat/drink for 2 entire days while he was out for a pilgrimage). After opening the fast, he develops stomach upset, pain in epigastrium <touch <eating anything. No coughing No left pains. But restlessness at night because of these pains in stomach, vomited twice.

Dream: He saw himself on pilgrimage. Constant feeling was that he has to finish it and he is trying very hard to finish. He felt that he is very anxious and he is trying very hard to reach to the final point on pilgrimage but it’s not just getting over. He just sees himself trying too hard to finish a ‘never ending’ pilgrimage. This made him restlessness and he was very restless in his sleep during this dream.

Acidity ++

Feels lethargic.

Plan: Opium 1M

(Same state is aggravated after the fast that he kept. He again felt the task is too difficult (out of his reach), he is trying hard to get over that, so repeated the same drug.)

Follow up: 20/01/05

Gastric pain- dyspepsia >, now no pains, no vomiting.

Still appetite is not normal as before.

Still feels weak on exertion.

(He narrates his feeling during those dreams more clearly this time.)

After coming home from pilgrimage- I used to dream one dream, where constantly same feeling kept on repeating which made me anxious.

(The feeling was as if he has to finish his pilgrimage, time is less and task of finishing is very big. He is trying hard for that with inner feelings of how will he finish that and felt anxious. This dream kept on coming for 3-4 days and hence sleep was disturbed, unrefreshing. Now after the last medicine, much better, no such dreams.)

Plan : Placebo.

Follow up: 14/02/05

- > all

- No stomach upsets.

- No joint pains.

- Appetite good, as before.

- No weakness.

- Mood wise, very okay.

Plan : Placebo.

Follow up: 18/03/05

Medicines not taken since one week as got over. Got severe pains in right elbow joint- Maximum highest pains three days ago in night time.

Also pains in right side small joints of finger.

Now, at present no pains that severe pain lasted for one night. Now very little pain on movement of right elbow joint. Otherwise- everything is all right.

No Dreams.

Sleep: Good.

Plan : Placebo

Follow up: 15/04/05

No pain in joints at all.

D: Overall how are you?

P: Very good, Normal.

I feel everything is normal with me. So I have become irregular with my regular homeopathic dosage as no joint pains now. Life is also going very well.

No dreams now, sleep is good. Fresh in the morning.

D: How is your over all energy level?

P: Fine with my physical work and exertion – no tiredness in the evening.

Previously there were many tensions about life, financially, familial, health wise, but now positive thinking. “If it's there, it's going to be there, why to get bothered about by thinking it again and again.” Now I feel I need to go ahead in my business, in my life. Previously worried about others but now I think let them think what they want but I have to go ahead, why to worry about them.

(Last follow up on 22/11/04- Approximately 4-5 months back, he said the same thing “why bother” but now with that, there is a desire to go ahead, do more in business- that’s one more addition which indicates his way towards health.)

D: How is your mood now generally?

P: Cheerful, fresh.

D: How do you deal with day to day stress of your life?

P: Previously if anybody passed some comment I used to feel excited, angry and thoughts would start like “I’ll do this to him/ I’ll do that to him” which would go on and on. But now, I think let them talk what they want and then I feel I need to do this so I’ll do it, let them think whatever they want.

Previously towards life also, my attitude was somewhat sad, but now it’s not there. I feel total attitude change, more positive toward life.

D: How is your sensitivity towards health of family members, your kids?

P: Changed. I used to get irritated on my daughter, if she had not kept her things well on its place, now I think let me see how to deal with her. I don’t get irritated, in fact I do a lot of masti (fun) and we have a lot of fun with them.

D: How is that feeling of “beyond my capacity but I have to do it?”

P: now I feel whatever work I take, I feel it’s going to happen well, I feel sure about that. No doubts now in the mind like whether I’ll be able to do it or not.

D: Previously you got such dreams of “out of your reach” how about that feeling?

P: Now no such dreams. Everything is the same, house, family, money, and business. But previously it used to give me tension so I used to get excited over little stuff, I used get angry, feel like crying etc. But now I don’t feel it that ways. Now, total attitude has changed.

D: When you say tension “what you mean?”

P:Tension meaning I used to think about future and used to get tensed like what will happen, how it will happen, how I’ll I handle, am I capable to handle etc…

Now I feel much more confidant.

D: How is your speech? I see much difference than what it used to be in front of me. How you feel?

P: I feel there is some change, stammering has reduced a bit but since I stopped getting bothered about that I have not paid much attention to that, but now I will. I’ll let you know the next time.

Plan : Placebo.

(Patient was asked to stop the medication and see me if required. I saw him after a year, and asked him to report so as to understand his walk on the path of healing when he's off all the medications.)

Follow up: 3/12/05

(More than a year after his first homoeopathic consultation with me)

Feeling fresh. No much joint problems now. Lots of change in confidence as well. Acidity is much better. Previously I didn’t have confidence. I used to think that in future my problem will also progress. So because of that I would always be under tension. Now I don’t have that thought in my mind. Now I feel tension free.

Previously, because my mind would be pre-occupied by such worrying thoughts I couldn’t give my 100% attention to business and family. I feel I have come out of this. I feel happy as if I have won a lottery (smiles).

Energy wise I am fresh. The enthusiasm was not there previously. I was sad. My attention was somewhere else. Now I feel that I must do something. Now I want to do something.

D: How do you feel because of such change?

P: How should I explain my happiness? I feel at peace. I can feel peace in my mind. It is like kind of change in my thinking that whenever any problem will come I will face it. I can face it. Recently, one of my friends got a problem at his family, I went there and explained and controlled the situation and the problem was solved. That time his uncle praised me for such tactfully speaking and controlling the situation. Before I used to think that because of my stammering speech I’ll have a lot of problem. But when the same speech was being praised, I felt proud of myself.

D: More about that peace, mental peace. How is that peace?

P: If there is a music playing somewhere, I would dance; it happened a few days back; there was a music going on in our neighborhood, I started dancing care-freely. When you are happy you don’t feel other’s presence like what they will think of me. Just enjoy. My daughter, my wife everyone was looking at me and I was dancing. I was enjoying. Let it be. Just enjoying. You can’t describe peace. You tend to remain happy. If I feel like dancing, I dance. That’s peace.

D: So all this change has come in you and you have started living in the present?

P: If I want to laugh, I laugh. If I feel like crying while watching a television serial, than why should I hesitate? I cry. Why should I bother about my wife and daughter as what they will feel….? If I feel like crying, then I should cry. That’s the change.

My mind remains at peace, healthy, even the wrong behavior of opposite person doesn’t spoil my thoughts like before. Previously, I wanted to break things. Wrong thoughts would come. But now it doesn’t happen.

D: How about your stammering?

P: There is a change. First there was fear. From where it has changed, how it has changed that I don’t know but there is a definite change.

D: What dreams do you get?

P: I haven’t had any dreams which I could remember. I can’t remember.

My sleep has been good.

D: Your Joint problems now?

P: Much better. Previously, before the homoeopathic treatment, it used to come at least twice a month for past 15 -16 years. [Gesture shows the finger joints- proximal inter-phalangeal joints] all middle joints used to pain and also my knee and hip specifically right side. Now, after the course of homoeopathic treatment, in past one year, no problems at all; once I had minimal bearable pain in finger joint that subsided on its own within a day without any medicinal help. Only, y’day, again it started paining in this finger joint, but now it’s good. It was there only for a night, now I don’t have it.

D: Overall?

P: I am very good. Much better.

Previously, I lived only for my work and home. My brother is very active socially. Be it religious work or social work. I never took part but now I take. Now I feel that I can do it. I should do it. I do feel at times that I am late. I would have involved right from beginning. Maybe it’s because of a lack of confidence that I haven’t participated. Though I am late but still there is much to enjoy. I should enjoy. I should do something for someone. I should participate. If I live only for myself then it’s of no use. Everyone does that. My thinking has changed. First I use to feel good only at my house but now I want to help others. I not only want to live for my family but also for others. This is one more change I have noticed.

I feel as if I had everything inside but now I am making use of it. And I am very happy about this change and realization.

Final Comments:

He continued feeling better, occasionally he did have joint pains (involving small finger joint) but with much less intensity and severity which went away in a day or two without requiring any medical interventions. His stammering is still present but much less in intensity. He also has become much more social, helping with a lot of religious activities happening in his area- something that he always wanted to do but could not out of his attitude- he said- this shift in his attitude besides positive shifts in his chief complaint has changed his life and his outlook towards life. Now he perceives and reacts according to the demands of the situation without getting paralyzed by negative attitudes that he previously harbored. This shift has opened a completely new avenue of his own personality which he never realized he possessed- and being aware about this side of his and acting and reacting accordingly has surged his life with a feeling of true joy and satisfaction, a feeling which keeps nurturing his life force to be more aware of his potential and function accordingly. He kept succeeding in his business as well. He still is a very sensitive person, but his sensitivity doesn’t curb his potential now or color his perception in negative ways as it did previously.

Your balanced sensitivity makes you a better human as it allows you to sense, feel and react to other’s problems – a true humanity without unnecessarily paralyzing your potential. And this is what he feels is a change in him and for this he expressed his gratitude towards homoeopathy and left with a smile.

Unfortunately, I have not presented any of his investigation reports with this case because they were lost in a mishap at his home. (Honestly, I do not recollect how I missed reporting investigation findings on his case paper- may be hush hush of patients in charitable trust where he came would have been the reason!)

All these years, this was the fact that kept me from presenting this case with such a wonderful result by homoeopathy in Seronegative arthritis. But recent encounters with the same patient reporting no signs of paralyzing pains in all these years off medications, helped me to overcome my restraint and come out with this case with the feeling that the detailed follow ups which has stood the test of time may help to overcome the misfortune of absence of supportive investigation reports. So, I humbly present this case with report of his investigation report that has lain somewhere in my memory.

What I could recollect is his ESR came to normal, which was very high after the first report before starting homoeopathic medication, and him being Seronegative, his RA always came negative and I do not remember the status of HLA-B27 prior and after homoeopathic medication. His x-ray lumbar region did not show any sign of Ankylosing spondylitis).