Excerpted from Similia to Synergy
This case highlights the need for focused, detailed inquiry. I have studied with many masters of homœopathy. Each one had a different style of practice, a different philosophy, different tools that he used. Some consulted only Materia Medica and some the Repertory. Some focused strictly on the proving symptoms. One thing they all had in common was a depth of inquiry into the patient’s experience, to look for what was peculiar and characteristic in that individual. They looked for what was strange that perhaps they had never seen before. These masters shared a tireless curiosity and dedication to find those characteristic symptoms through the art of detailed inquiry and case-taking.
[Case 1] A Case of Myoclonal Jerk – Nitric Acid
Very early in practice, one of my patients was diagnosed with myoclonal jerks. When he held a tea cup, his hand would jerk and the tea would spill everywhere. Sometimes the cup would fly from his hand and smash on the floor. I treated him with many remedies to no avail. One day I said to myself, let me really understand what is going on with this man.
“Tell me – when do these jerks happen? Do they happen all day long?”
He answered quickly, “No, no. It doesn’t happen the whole day. It seldom happens.” I became more curious and asked, “So when do you notice it? Is it in the morning, afternoon, evening, night?”
“It is usually in the morning.”
“In the morning? When in the morning; every morning?”
“No, no. Not every morning, but especially those mornings when I have to get up early.”
“What do you mean, ‘when you get up early’?”
He thought for a moment. “Suppose my usual waking time is 6:30 and, if for some reason, I have to go to the airport early to pick up somebody and I get up at 4:00 or something. Then that’s when my hand would jerk.”
I could have considered the modality: ‘Jerking from loss of sleep’, or ‘Aggravation from loss of sleep’, but I wanted to continue. I asked, “Tell me – you get jerks when you get up early in the morning. How long do these jerks last?”
“They only last for two to three hours in the early part of the morning. Otherwise, for the rest of the day, I don’t have any jerks.”
“So, you get up at 4:00, and you pick up somebody at the airport. Then your jerks last for one to two hours after that. In that one to two hours, how is your state? How are you?”
He answered, “At that time, I am drowsy, until my time to wake up.”
“Okay. So here you are not fully asleep and not fully awake. In that intervening period, that’s when you get the jerks?”
He said excitedly, “That’s it exactly. This is the same thing that happens at night when I have to pick up somebody from the airport. My usual sleeping time is from 10:30 – 11:00. But if I have to go at 12 midnight to the airport and I feel drowsy, then in that state, the jerks come.”
If we open Phatak’s Repertory to the section ‘Sleep’, there is an interesting rubric
‘Sleep, half asleep, when agg’. It is given ‘half sleep evening aggravates, afternoon aggravates, before, during, falling to aggravates’, and after that, ‘sleep, half asleep aggravates’. There are four remedies: Camphor, Nitric acid, Sabadilla, and Valeriana. I considered these four remedies and the patient’s other symptoms; I decided to give Nitric acid. After this remedy, no more jerks and no more broken cups. This kind of investigation, into the peculiar, is something I learned while watching many master homœopaths.
In this case, the jerks will not give us the remedy because they are common to many remedies. What gives us the remedy is that his nerves are extremely sensitive when he is in a half-asleep state. This man is particularly sensitive to the period of being half asleep and half awake – which is Nitric acid.
During a case, if there isn’t anything other than one peculiar sensation or modality, then that’s the main symptom of the case. This symptom needs to be explored. One needs to understand that such a peculiar symptom gives a solidity to the case. The remedy that covers the peculiar symptom is generally the remedy for the patient.
[Case 2] A Case of Vitiligo – Calcarea Carb
A 10-year-old boy was brought to the clinic with several patches of vitiligo all over his body. While taking the case, his mother narrated a very interesting story told to her by her daughter, who vividly described the situation at her brother’s school.
“We were in the biology class and we dissected a frog but unfortunately the frog had not received enough chloroform or anaesthesia. With its abdomen open and bowels out, it just jumped out of the tray and it was flopping on the floor.”
The boy was extremely affected by this event, becoming so scared and upset that he couldn’t speak or eat for several days. This event deeply affected him. The other peculiar symptom was that, upon careful examination, the white spots –the vitiligo/leucoderma – were bordered by a dark line.
In Kent’s Repertory we find the rubric ‘Mind: horrible things, sad stories affect her profoundly’, or, ‘Mind: fear which is excited, after hearing of cruelties’. The other rubric consulted was ‘Skin: discoloration; white, dark borders, spots, with’. With these rubrics, the remedy Calcarea carb came through clearly.
This is the kind of work we used to do. We would simply investigate the cases, find the most peculiar symptom, whether it was in the mind or body, and come to the remedy.
[Case 3] Is Indira Gandhi Good or Bad – Calcarea Sulphurica
Another child with vitiligo was referred to Dr. Jayesh Shah, a very good friend of mine with whom I have worked for many years. When the parents were asked to describe their daughter’s nature, they spontanteously spoke about how intensely offended she became when someone disagreed with her opinion. A story to illustrate came to their mind. In those days, Indira Gandhi was the Prime Minister of India. There was an argument: was she a good or bad Prime Minister? This girl was very supportive of Indira Gandhi and felt she was an excellent Prime Minister. A classmate said that she didn’t agree with her sentiments and that, in fact, Indira Gandhi was a dictator and had destroyed the country. The patient became so angry by this opposing opinion that she immediately developed an aversion to this classmate. She would say, “I don’t even want to look at her face. How dare she speak like this? Why does no one appreciate my opinion or what I say? Why does everyone think that my opinion is wrong?”
At this point we can go into any number of theories. We could conclude that this patient is egoistical, haughty, indignant, or can’t tolerate contradiction. We could jump from this story into the system, miasm, or kingdom. But, at the time, we didn’t have any one of these concepts. I think life was quite a bit simpler. Jayesh simply went to Kent’s Repertory, looked into the Mind section, and found two rubrics: ‘Mind: hatred; persons of, who do not agree with him’, and, ‘Mind, lamenting, bemoaning, wailing, appreciated, because he is not’. The remedy found in both rubrics is Calcarea sulphurica.
The child did beautifully on Calcarea sulph. These exact symptoms are found in the proving of Calcarea sulph: ‘Hatred; persons of, agree with him, who do not’, and ‘Lamenting, bemoaning, wailing, appreciated, because he is not’.
Proving symptoms are the most reliable. With direct symptoms from the provers, we don’t need to look elsewhere. There are no preconceived notions of remedy pictures, just the symptoms of the patient.
What can we understand from these cases? Before we go on to complicated theories, systems, concepts, themes, miasms, sub-kingdoms, sensations, and other ideas, we must be grounded and solidly based in the fundamentals of homœopathy; the understanding of holism and individualism; the significance of the peculiar symptom and of generalization; the importance of the concomitant symptoms and the search for the peculiar; locating the symptom in the Repertory; seeing the exact expression of that peculiarity in the Materia Medica; generalizing that peculiarity, sensation, or modality and seeing it as the main expression in the case; taking this understanding to our Repertory search. These ideas make for a solid, grounded foundation. A strong base is built on which modern research and new ideas can develop. If we lose these fundamental ideas, the building is shaky and insecure. These underlying concepts are of essential importance.
[Case 4] The Case of My Grandmother – Alumina
My grandmother was losing weight with a very distressing symptom. Whenever she would eat and swallow, the food would get stuck somewhere in her esophagus and she would vomit. She was dwindling away, becoming weak and exhausted. This happened with certain foods more than others. Eating potatoes was particularly bad. Even a small mouthful would get stuck and she would vomit immediately. She was losing weight and had almost completely given up hope. This was early in my studies and I knew very little homœopathy. Luckily, I was an eager Repertory student and started to search for her symptom.