Passive Case Witnessing Problem

It’s a case of a 6 year old girl who consulted me on 18/12/08.

The very first peculiar thing we observe about the child is …she enters the consulting room holding mothers hand tightly.

M: She has made a drawing for you.

(Child’s sibling is also our patient. Every time when this child used to accompany her sister, she would draw and now also she has got the following drawings. This itself shows us the child’s intense connection with her subconscious through this form of art.)

M: She does not have any health problem as such but I wanted to start treatment for her overall development.

PASSIVE CASE WITNESSING PROCESS

D:        Tell me what’s happening to you..? Can I send your mother out?

P: No.

OBSERVATION: Clings tightly to her mother.

D:        Okay, tell me what’s your name?

P: OBSERVATION: Sitting in mothers lap with her hands around mother’s neck. N……P……

D:        Tell me more about you?

P: PAUSE

OBSERVATION: Smiles and clings more to the mother.

D:        Tell me what are your interest and hobbies? What you like to do?

P: I like to swim, like to draw, I like running…playing.

D:        Wow! What else?

P: I like to play on the computer, like to watch TV.

OBSERVATION: Now she removes her hand from the mother’s neck and sits leaning on the table, yet she is in her mothers lap.

D:        What else you like to do?

P: Like to go to school.

D:        Very nice, very nice you are talking?

M: You sit on the chair and talk to the doctor.

P: OBSERVATION; child sits on a chair next to the mother but still holding her arm.

As the mother starts to leave the room, the child jumps off the chair, starts crying and goes and hugs the mother, and goes out with her.)

(The mother comes in with her after some time but now the child sits on the chair and mother on the sofa behind her.)

D:        OK, so tell me what else you like to do?

P: I’ll like to play – go on a slide. Like to read books.

D:        Very nice. You are speaking so well. What else you like to do?

P: Like to dance… then I like to play, then I do homework.

OBSERVATION: Looks behind towards the  mother.

ACTIVE CASE WITNESSING PROCESS

D:        And what are you scared of?

P: Scared of lions, tigers…

D:        What else?

P: Bhoot.

The mother had some work and she had to go out of the room. Immediately the child said no.

D:        You are speaking so well. Just talk with me and your mother will come in 2 minutes.

P: No…no…(OBSERVATION: She gets up and clings to mother and starts crying)

D:        OK you don’t talk, but can you draw till your mom comes back?

(She sits on the chair and starts drawing.)

(Since she was not ready to communicate even after so much of encouragement and the fact that at the beginning she had brought drawings, we ask her to draw.)

OBSERVATION: She covers the paper with the hand and also draws at one lower section of the page.)

D:        Wow! What is this?

P: This is my sister & me, & this is my father and my brother.

D:        And what is this?

P: A heart.

ACTIVE – ACTIVE CASE WITNESSING PROCESS…

D:        What is this heart doing here?

P: I love heart so I drew it.

D:        Earlier also you drew hearts. What about this heart you love?

P: I love heart like that only.

D:        Heart with arrows what does this mean?

P: Looking into the drawing. (PAUSE)

D:        What are you all doing?

P: We all are looking at the heart and thinking what is it.

D:        What does the heart mean?

P: I don’t know.

D:        You like drawing heart huh. When do you draw it?

P: In school. In my drawing class. I draw heart and stars and one day I drew heart and star in the Christmas tree.

D:        In this drawing who is having the flower? (We spotted a flower in the drawing she had made.)

P: My sister- she is just holding it.

D:        She is going to give it to someone or what?

P: Me.

D:        And heart will go to whom.

P: To my brother and father.

D:        Why?

P: Like that only.

D:        Like that only. OK… Would you like to draw something more for me?

D:        Wow! What is this?

P: A drawing.

D:        Of what?

P: Drawing of a garden. This is me and my brother.

D:        What are you both doing here?

P: We have come here to play.

D:        What are you playing?

P: Running and catching.

D:        What is this?

P: Flowers.

D:        Which flower are they?

P: This is flower, this rose and…this …this is pink flower.

D:        Draw one more thing for me?

P: OBSERVATION:  She draws human figures and then joins all of them together.

D:        Wow! What is this? I don’t know what it is.

P: My family.

D:        What’s your family doing here?

P: Ring-a-ring-a-roses.

D:        Ring-a-ring-a-roses. What’s that?

P: I don’t know.

D:        Whom you like the most in your family?

P: My mom.

D:        What about mom you like the most.

P: (PAUSE)

D:        You like or your sister likes?

P: I like more.

D:        What else?

P: (PAUSE)

ACTIVE – ACTIVE IN DIFFERENT AREA – FEAR

D:        What are you scared the most.

P: Lion and tiger.

D:        What about them scares you the most?

P: Because lion crawls and eat us.

D:        What else do they do.

P: Smiles.

D:        You said previously that you are also scared of ghost. What about them scares you?

P: (PAUSE) … I saw the movie called Road side Romeo. (This is a bollywood movie)

(Here when we ask her about fears, she herself goes to the area of movies, so we become active- active to explore this area.)

ACTIVE – ACTIVE IN DIFFERENT AREA -MOVIES

D:        What is there in that movie?

P: There’s a dog, many dogs but 1 dog’s name is Romeo.

D:        Go on?

P: There is a girl called Leila and she loved…. and that dog he loved Leila..

D:        I don’t know what they do? Love means what?

P: I don’t know.

D:        What about the movie do you like the most?

P: I like Leila.

D:        What about Leila you like?

P: (PAUSE)

OBSERVATION: leans on the table and hides mouth behind both palms.

D:        Which other movies you like?

P: Romeo & Jaane tu… (It’s a Bollywood romantic movie.)

D:        And what is there in that movie Jaane tu…?

P: I forget.

D:        Anything else about you.

P: Nods no.

D:        So you like all movies with love/

P: Nods Yes.

D:        What about it you like?

P: I don’t know… because nice things happen.

D:        What?

P: Like they don’t shout, they don’t hit and all.

D:        Anything else.

P: No.

Child goes out and comes back with another drawing along with the mother.

MOTHER’S OBSERVATION OF THE CHILD

She is very affectionate child.  She will go and give big hugs even to strangers. She is very fond of her younger brother and she will make him understand things by saying you can win this or that and she lets him win. Actually she is friendly with anybody and everybody.

END OF THE CASE

—————————————————

UNDERSTANDING OF THE CASE

OU OF PLACE/ OUT OF ORDER

Passive case witnessing process

Verbally the child didn’t speak anything peculiar but our observations regarding the child were very peculiar…

• Her clinging.
• Sitting in the mother’s lap.
• Holding mother tightly.
• Holding her hand while talking.
• Hugging the mother.

Active case witnessing process

• Clings to mother as she tries to go out of the room.
• Covering the paper with hand while drawing.
• A heart.

Active-Active case witnessing process

• I love heart .
• I drew heart and star in the Christmas tree.
• Drawing of a garden
• Flowers.
• Draws human figures and then joins all of them together.
• Too much family attachment.
• Ring-a-ring-a-roses.
• That dog he loved Laila Leila
• Like they don’t shout, they don’t hit and all.

WHAT IS THE FOCUS/CENTRE/ESSENCE OF THE CASE

• Love, attachment and togetherness.
• Love for heart.

This is very evident from her body language and all her drawings. Also this further gets confirmed from the mother’s observation of the child.

WHICH KINGDOM?

• Pure sensitivity seen.
• Drawings of garden, flowers.

This clearly points to the PLANT KINGDOM.

WHICH FAMILY?

This tremendous attachment to the mother, togetherness of the family, hugging and clinginess, love for hearts is very suggestive of the MALVALES family.

WHICH MIASM?

We observed that whenever she draws she covers the paper with her hand. This gives a hint of the SYCOTIC MIASM.

WHICH REMEDY?

The remedy from the Malvales family with Sycotic miasm running in the centre is TILIA EUROPA. BUT in the case we observed that along with the general theme of the Malvales family, the child’s focus was “Heart”. So when a further inquisitive search was made keeping focus on the “Heart” interestingly we found out a remedy TILIA CORDATA which also belongs to the same family where the leaves of the tree are heart shaped.
Thus the remedy given was TILIA CORDATA.

WHICH POTENCY?

At the end of Passive case witnessing process, verbally the child seemed to be at the ‘Name and Fact’ level but the peculiar body language which we didn’t understand initially and which got connected later on with the whole phenomenon, represented the child’s complete altered energy pattern. Thus the child (non-verbally) vibrated at the Delusion level. Therefore the potency given was 1M, single dose.

A follow up drawing

END OF THE CASE

Seborrheic Dermatitis



Hpathy Ezine, July, 2011 | Print This Post |

Seborrheic dermatitis is a common chronic dermatitis that is characterized by erythema and greasy looking scales in areas rich in sebaceous glands.Seborrheic dermatitis produces pruritis, burning, flaking, and redness of the affected skin.Although these are many treatments for seborrheic dermatitis, recurrences are very common, with the disease typically relapsing for years.

Seborrheic dermatitis is a common chronic dermatitis that is characterized by erythema and greasy looking scales in areas rich in sebaceous glands, such as the hairline (scalp), nasolabial fold, and midline, chest areas. Dandruff may be an early precursor or this condition. The prevalence of dandruff is higher in person infected with human immunodeficiency virus (HIV) and those with Parkinson’s disease. At all ages, seborrheic dermatitis is more common in males than females.

Although the cause of seborrheic dermatitis is unclear, it is thought that the normal yeast flora (Pityrosporum orbiculare or Malassezia furfur) play some role in inducing inflammation of the skin, which leads to increased epidermal proliferation and desquamation. The name is misleading, and patients affected with seborrheic dermatitis do not have more seborrhea than the normal population. On the face, it can involve only the eyebrows, glabella, and nasolabilal folds, or it can cause a mild blepharitis with red eyelid margins.

Pathogenesis: Two main factors are presence of generous amount of epidermal lipids and colonization, at least transiently by Malassezia species (lipophilic, usually nonpathogenic yeasts). Immune response also plays a role; tends to be far more severe in HIV/AIDS. In our view seborrheic dermatitis overlaps with psoriasis and may well be a minimal form of this disorder.

Etiology of Seborrheic Dermatitis

Seborrheic dermatitis has several potential etiologies. One theory of seborrheic dermatitis causation is related to the propensity of the condition to localize where sebaceous glands are found. In this theory the condition is caused by excessive sebum production, which allows yeasts and bacteria to produce free acids from the sebum. The free fatty acids, in turn, irritate the skin.

As in dandruff, M. furfur has been implicated in the etiology of seborrheic dermatitis. The severity of the seborrheic dermatitis appears to decrease when the count of organism on the scalp decrease, although the inflammatory reaction can be present with a normal number of fungi. Further, in one study M. furfur was isolated from lesional skin in significantly higher rates than from non-lesional skin.

Manifestations of Seborrheic Dermatitis

Seborrheic dermatitis produces pruritis, burning, flaking, and redness of the affected skin. Seborrheic dermatitis scales are yellow red and greasy in appearance, unlike the dry scale of dandruff. Borders are indistinct, characterized by underlying skin inflammation, as implied by the name.

While dandruff is confined to the scalp, seborrheic dermatitis affects other areas of the body in addition to the scalp in a classical symmetric pattern. The highest risk locations have either high concentrations of sebaceous glands or high likelihood of colonization by yeasts and bacteria such as areas covered by hair or in skin folds.

Common sites for seborrheic dermatitis include facial hair bearing areas and the central face (e.g., hairline, forehead, face, eyebrow, eyelashes, eyelids, beard, and mustache), the external ear canal, behind the ears, in the nasal folds, and occasionally non-facial areas such as the scalp, presternal chest, and inframammary areas, axillae, between the shoulder blades, umbilicus inguinal folds, gluteal cleft, Perianal area, and in the pubic area and groin.

Histological features

Seborrheic dermatitis cannot be reliably or consistently distinguished from other forms or eczematous dermatitis based on assessment of histo-pathologic features alone. However, classic examples of seborrheic dermatitis exhibit spongiosis localized to the ostia or upper infundibula or hair follicles. Neutrophilic crust is commonly present. Pityrosporum (Malassezia) yeast spores may be present in the stratum corneum.

Prognosis of seborrheic dermatitis

Although these are many treatments for seborrheic dermatitis, recurrences are very common, with the disease typically relapsing for years. Although the prognostic studies identified were not long term ones, preventives regimens have been developed and can help reduce the severity of the disease. These include improvement in lifestyle, intake of supplements, and sun exposure.

Differential diagnosis of seborrheic dermatitis

  • Psoriasis
  • Rosacea
  • Malar rash of lupus
  • Tinea faciei
  • On body: Pitryasis rosea, tinea versicolor
  • In intertriginous areas:

Erythrasma, inverse psoriasis, Candidiasis

  • In infants: atopic dermatitis, irritant diaper dermatitis, Candidiasis, omen syndrome.

Diagnosis of seborrheic dermatitis

A diagnosis of seborrheic dermatitis is usually made on clinical grounds. Histopathological findings of seborrheic dermatitis are non-specific, thus making tissue biopsies unhelpful except in cases where the intent is to exclude psoriasis. There are no laboratory markers to support this diagnosis.

Clinical Course and Complications of seborrheic dermatitis

Infantile seborrheic dermatitis often resolves spontaneously by 6 to 12 months of age. The vast majority of infantile SD responds well to topical therapy. There is no long term squeal of the condition.

Scalp involvement in infants does not adversely affect hair growth. There is no evidence currently to suggest a link between infantile SD and later development of atopic dermatitis or psoriasis.

Treatment of seborrheic dermatitis

Topical therapy is sufficient for most cases of infantile seborrheic dermatitis. Treatment consist of bathing with a mild agent such as mold tar shampoo, mineral oil, or oatmeal baths, to remove the scales followed by application of a topical corticosteroid to affected areas. “At a Glance” Treatment

Topical therapy:

  • Bathing with mild agents such as mold tar shampoo, mineral oil, or oatmeal baths to remove the scales.
  • Follow bathing with application of topical corticosteroids can be applied to affected areas three times a day.
  • An antifungal cream is not required, but may be added if desired.

Homeopathic treatment of Seborrheic dermatitis – Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat seborrheic dermatitis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to cure seborrheic dermatitis that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of seborrheic dermatitis:

Ashish Sharma

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