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

Review on ECG Diagnosis and Cardiac Treatment



Hpathy Ezine, February, 2011 | Print This Post |

The author provides detailed information about the role of ECG in cardiac diagnosis and gives a summary of some relevant homeopathic remedies.

Cardiology deals with the heart, aorta, peripheral vessels and blood. Ventricle is the main chamber, atrium is the antechamber. Left atrial wall thickness is 3mm, right atrium is 4mm, RV is 5mm, and LV is 15mm.

Properties of cardiac muscles: Automacity, rhythmicity, conductivity, excitability, refractioneries, tonicity, all or none law, contractility, aberrant conduction.

Coronary artery and its branches

Left CA supplies to left and right ventricles but Right CA supplies mostly to left ventricle posterior surface. Length of coronary trunk is 4 cm and diameter of coronary artery is about 1cm. Length of a capillary is about 1cm, one capillary supplies for each muscle fiber. Capillary pressure at artery end is 32mm and 20 mm at venal end. (Total lengths of blood vessels are about 1,00,000 km)

Stroke Volume x Rate = Output. Coronary circulation takes about 5%-20% of cardiac output i.e., 200ml-800ml. Output x Mean Pressure= Work. Peripheral vasoconstriction causes sufficient rise in SBP which promotes optimum blood supply to coronary as well as to central organs.

Cardiac pains

Etiology: paroxysmal atrial tachycardia-overwork, coronary insufficiency-osseous obstruction, polyp thrombosis, spasm, ischemic anoxia, aortic aneurysms, low output by LVH, failure (peripheral capillary dilatation with low volume, parasympathetic irritation, MS, AS, LVH, etc. All poisons, CO2, H+, urea, excess of bitter, cold, etc.

Coronary ischemia

Etiology: atheroma, spasm, coronary osteal plaque obstruction, low flow due to failure, low stroke volume <40ml/beat, low minute volume, reactive venous stasis-thrombosis, LVH, less size of cardiac cavity, low output with low rate (parasympathetic, sympatholytics, hypothyroid, anemia), AS, MS, verrucous endocarditis (infection, rheumatism, failure, peripheral capillary dilatation). Coronary artery stasis and clot formation may be developed secondary to the damage of coronary vein & capillaries.

Ventricular Hypertrophy

Common causes are aortic hypertension and myocardial ischemia. Ischemia later may result in VH, work failure, finally local injury itself or infarction. The extra systole waves are developed from injured or infracted fibrosis scar. Atrial fibrosis and resultant dilatation increase the atrial rate, pain, ADH secretion, Na+ retention, venous stasis. It later causes PAT, clot formation, polyp and finally results in embolic phenomena in lungs or brain. Aortic low BP stimulates the VMC at medulla and causes sinus tachycardia, sympathetic peripheral constriction, para sympatholytic splanchnic vasoconstriction and thus increases blood pressure reflexively. Vagal excitation may manifest as aphonia, bronchospasm, low pulse or low BP also.

Efferent sympathetic (cervical) to medulla may cause (parasympathetically) bradycardia. Parasympathetic from front of neck to medulla may cause sympathetic tachycardia. Fibrosis develops early on hypertrophied fiber.

Injury

Myocardial injury occurs spreading from pericardium or endocardium. It may be due to toxins, neoplasm, urea infiltrations, fatty degeneration deposit on muscles, ischemic anoxia. It occurs at epicardial or subendocardial or transmural portion itself. Injury signs are ST elevation for superficial injury or ST depression for deep injury.

Myocardial infarction

It is the most common cause of sudden death in many countries; about 30%. Coronary arterial diseases constitute only 35% of all myocardial diseases. Infarction is more often seen in people with high-stress jobs and less in people who have a relaxed work environment, are vegetarians or live in a cooperative culture.

Premonitory subjective symptoms for infarction are usually absent in many patients. (Latent signs are seen as horizontal line at the mount of Venus in the palm, and deep crater on heart line).

Differential diagnosis

Gall bladder disorder, esophageal spasm, parasympathetic irritation (aphonia and bronchospasm, peptic ulcer), pleurisy, osteochondritis, cervical radiculopathy, etc.

Etiology

Heredity, Asians (small sized vessels, thin and inflammatory pericardium) Hereditary-aortic aneurism, syphilis, congenital heart diseases, High Mg (hard water -sea coast), excess of salt, high cholesterol, hypothyroidism-lipid pericardial effusion, hyperthyroid, overwork, hypercalcaemia (prawn, sea fish, shell fish), high BP, smoking, ambition, overwork with rapid rate, lead contamination-petrol & paints, old hemoglobin particle, O2 lack, CO2 excess, lack of water intake, lack of rest, excess of heat, stress, anger, lack of smile, fear, depression, negative personality.

Summary of ECG

The Electrocardiogram is a graphic representation of the electrical potential produced in association with the heart beat.

Scope of ECG

To estimate fitness of sportsman, drivers, sailors, and pilots; to detect hypertrophy, injury, hormonal & electrolyte imbalance, arrhythmia- atrial fibrillation, AV block; LBBB, wall disorder, position of heart, drug effects, progress of treatment, old infarction, etc.

BASIC PRINCIPLE

Potentials are due to exchange of K+ outside and Na+ into the cell.

The electromotive force is transmitted to 7 different directions in each beat. 80% of electric potential is lost during transition. Positive waves occur when current flows toward exploring electrode and negative waves occur when current of electricity flows away from the electrode as result of excitation. Activation time is short on strong stimulation and in thin fiber.

ECG WAVES

ECG can be divided into atrial P and ventricular q R S T U waves units. P-R, qRS, Q-T interval; Segment are PR, ST, TP segments.

P wave is a compound atrial wave. P wave duration / P-R interval if > 1.6 (giant P) indicates atrial hypertrophy. Atrial activation time > 0.02 seconds indicates right atrial enlargement > 0 .03 seconds indicates left atrial enlargement, P-R interval is increased in long refractive period of ventricle or AV block by vagus irritation.

LEAD

Lead axis is the imaginary line between two points of opposite poles. ECG leads are standard lead, unipolar limb lead, and unipolar chest lead.

Heart has three portions – anterior surface, posterior surface, and cavity. Representation of right & left ventricles may vary in LII, avL, avF with changes in position.

The LIII R represents the Lt ventricle in vertical position and the Lt ventricle in horizontal position.

Summary of ECG diagnosis

1. HEART RATE:

Normal heart rate is 60 -100/ minute. Atrial rate = 60 / P-P interval, i.e., 300 / number of 0.2 seconds (large box) or 1500 / number of 0.04 seconds (small box) in between P-P interval. Ventricular rate = 60 / R-R interval i.e., 300 / number of 0.2 seconds (large box) or 1500 / number of 0.04 seconds (small box) in between R-R interval. (Speed of machine is 1500 cm/minute.)

P.B. Kader

Dr. P.B. Kader D.H.M.S, Dc.M.N - born 17.4.1959, studied homeopathy and received his degree from Dr. Padiyar Memorial Medical College, Chottanikara , in 1981. He has published four medical books- three in Malayalam: *Arinjirekenta Rogangal (essays about 28 diseases for public awareness) *E.C.G. Apagradhanum (interpretation of E.C.G. waves) * Premaham -A complete book about diabetes written for lay people *The keynotes to the Holistic Therapeutics. (English-208 pages) Dr. Kader has also published more than 40 articles in various journals and Malayalam magazines and has conducted over 50 medical camps. He is currently available for consultations at the Homoeopathic Research Centre in Kerala, India.

Comments

  1. Janaki Subramaniam

    February 17, 2011

    Very good & informative article. It would have been better if ECG samples had also been given alongside.
    Dr. Janaki

  2. DR.MUBARAK

    February 18, 2011

    good effort.

  3. S.N.Ojha

    February 18, 2011

    Dear Sir,

    This article by Dr. Kader is very impressive , elaborated detail on ECG. It could have been more attractive and impressive if some of the scanned copy of ECG were attached.

    Has Dr. Kader written a book in English on interpretation of E.C.G. waves? If yes , how can one obtain. it. Please email to me.

    with regards,

    S.N.Ojha

  4. Dr.K.K.Nassir

    February 19, 2011

    Very nice work & useful & informative ,Congratulations………….

  5. H.Dr Muhammad Ayub Khan

    February 20, 2011

    Dear Sir,
    With great respect to your dignity. I have learnt much from your article. It is a best way to show the work for the followers, Sir.

    • DR..P.B.KADER

      March 4, 2011

      thank you.

  6. Dr Mehra

    February 20, 2011

    Very useful and informative article. It would have been much better if details of the ECG graph with their interpretations and some case reports, were added. Also throw some light on Homeopathic potencies which are to be employed in such cases. Generally we are advised to give mother tinctures (cactus etc.) in cardiac troubles. In your opinion what do you suggest. You have not discussed anything about the systolic hypertension due to aging. Is it be ignored, or you can suggest some medicines?

    • DR..P.B.KADER

      March 4, 2011

      thanks for your information.

      sympathatolytic like Nux omica Veratrun viride,Secale cor,Rauwolfia are

      some drugs for systolic hypertension.Zingiber,Boerhavia difusa also

      effective.

  7. george

    February 24, 2011

    Sir,
    I want to contact Dr.Kader.
    So please let me know where the Homoeopathic Research Centre in Kerala, India is situated.
    My mail id is gorgvc@gmail.com
    .Thanking you
    george

  8. DR C S GUPTA

    February 25, 2011

    DEAR DR KADER,

    YOUR ARTICLE ON HEART DISEASES ARE V V EXHAUSTIVE AND GIVE FULL DETAILS OF HOMEO REMEDIES IN VARIOUS CONDITIONS AND I THINK THERE IS NO NEED TO CONSULT ANY OTHER REPERTORY.
    THANKS
    DR SHEKHAR

  9. Adv.K.N.Prathapan

    March 3, 2011

    You have done a great work. It seems that you really have profound knowledge on ECG. Even though it is little difficult to understand for an ordinary person,it is an asset to cardiologists as well as all the doctors.

    • DR..P.B.KADER

      March 4, 2011

      you are very welcome..

  10. sanker

    March 6, 2011

    Sir,
    I want to contact Dr.Kader.
    So please let me know where the Homoeopathic Research Centre in Kerala, India is situated.
    My mail id is utterker@gmail.com
    .Thanking you

    • Dr.P.B.Kader

      March 6, 2011

      Thanks,
      Homoeopathic research centre is situiated at kochangadi,west cochin,kerela,india.

  11. S.JOHNSAMUEL

    August 25, 2012

    I learn more about heart troubles &remdies INDETAIL.THANK YOU

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