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Thematic Approach of Clinic Case-- Andréa Costa Pinto IkegamiTranslated by Maria Gabriela Ruscica |
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The author presents a clinical case that serves to illustrate the application of non- traditional techniques for approaching cases. This method of Alfonso Masi Elizalde, represents a wider scope of possible strategies in order to individualize not merely each and every patient, but homeopathic practice itself. KeywordsIndividualization – Clinical strategies – Masi Elizalde Patient Male, 76 years, assisted in clinic, teacher at Paulista School of Homeopathy. Separated, two children, retired professor. Consultation held on 18 August 2002, with complaint of “buzz in left ear” for two months. He does not refer to any other complaint or pathological history. He makes an effort to maintain his health and follows a macrobiotic diet. His aspect is more youthful than expected for his age.
Clinical Diagnosis 1. Buzz (Observation: normal audiometry and impedanciometry) Miasmatic Diagnosis Egotrophy (Classification of Masi Elizalde) Symptoms and Themes • Buzz in left ear, like a cicada. Worsening from 5 to 6 AM, when just waking up . Improvement reading a special book of spiritual self-help. On exceptional occasions, improvement after rain and after "taking a drink" like whisky and “caipirinhas”. • Calcification: "I attribute to calcification", "My conclusion is that aging is degenerating everything, calcification"; "I took magnesium because I have it has the capacity to remove calcium in excess". • Knowledge: "I found the buzz was reduced temporarily reading a book of 'Rational Culture'. I gained this knowledge twenty years ago. It is a book written by an alien. When people read this book, they go to another energy field", "I am from 'Rational Culture', we have a self-knowledge and eliminate psychological causes". "Perfect gut, I compared my gut with the pineal gland; I did a study and my times are all correct"; ."I used my knowledge to write a book on this subject"; "I want to bring this knowledge to the greatest number of people, through a radio program, to disseminate it" [He is author of several books about coming to 'Rational Culture' after reading a work assigned to an alien]. • Dissemination of knowledge: "I want to bring this knowledge to the largest number of people, through a radio program, to disseminate it". He is author of several books, at each visit he brings many materials, and asks to give classes on the subject in school. • Preoccupation with health: "We are all subject to pollution from pesticides; I do exams every year to see if I have some virus hidden" [extreme concern with food, corporal functions, realization of researches on health issues, etc.]. • Universal Love: "Today I think family is a falsehood. Love, fraternity, peace is universal. I become particular love in universal". Physical Examination Not significant. Approach of CaseThe patient’s story emphasizes the following aspects: “excess of calcium”; fear of contagion; anxiety about health, desiring to read medical books, needing to know everything. This group of themes and symptoms immediately brought to mind Calcarea carbonica. A second group of themes and symptoms was composed of knowledge; light; universal love/brotherhood, suggested Phosphorus. Masi Elizalde explains that the dynamic nature of Calcarea phosphorica is a conviction that one is the carrier of good news and has the duty to communicate it to others. The Calc Phos theme seemed to apply in this case, to the extent that the patient reported being the carrier of a knowledge that should save the world. Also, his mission was to disseminate it to the public as widely as possible, for which purpose he had even rejected his family. The conviction of possessing knowledge and having to disseminate it was a constant in his life, manifested before his philosophical-religious conversion ( through teaching and literary activity.) He was prescribed Calcarea phosphorica CH200 in a single dose. Evolution The effect of the prescribed dose was an immediate improvement of his chief complaint, the buzz, demonstrated by a decrease in intensity/ frequency of this symptom and its having no more interference in his daily life. Similarly, a deeper improvement was perceived in his emotional relations. He perceived that love was not only universal, but also involved the love of family. He resumed his relationship with his wife and children. Just one dose of Calc Phos was prescribed in May 2004. The patient continues with good progress until today. Discussion The approach used in this case seems to contradict all standards of good homeopathic practice, both Hahnemannian and Kentian. However, homeopathy is by definition, the medicine of the individual, and demands the most absolute individualization of each case (Hahnemann, 1995: # 82). The individual circumstances of this case - obsessive presence of repeated elements – guides us to choose an approach that prioritizes, precisely, the special elements in this case.. A standard repertorial analysis did not confirm the remedies suggested by the textual analysis (Calcarea carbonica, Phosphorus and Calcarea phosphorica). In fact, the chosen remedy appeared in the 94th position in the repertorization.
The prescription of Calcarea phosphorica was suggested by applying the methodology of Masi Elizalde. It is useful to highlight that the remedy not only led to improvement of the chief complaint, but managed a deeper change in the existential dynamic of the patient. It allowed him to objectify the content of "Noumenon" from Elizalde’s terminology, that is, seeing the world no longer distorted by a "psoric spot" in his imagination. Professor Elizalde insisted that all theoretical elaborations about "medicals theses" should pass the test of experience. That is, the prescription of a remedy based on understanding of its deep matter, must induce movement of significant improvement in all transcendental areas - physical, psychological and existential. From that point of view, this case serves to confirm the thesis of the prescription and to remind us that intellectually elaborated ideas must always go through the sieve of real application. ConclusionsThe proposed example suggests that there are strategies for working cases that are appropriate to the particular characteristics of each case. Standard methodology for the analysis of cases, at present, is the result of a long process of construction, begun in the Hahnemann’s time. However, inclusion of new kinds of understanding, such as linguistics, and new instruments of technological application, such as programs and digital libraries, allow us an unprecedented flexibility in choice of strategies. References HAHNEMANN, S. Organon da Arte de Curar. 6ª ed. Trad. de E.M. Villela e I. C. Soares. Ribeirão Preto: Museu de Homeopatia Abrahão Brickmann, 1995. MASI ELIZALDE, A. [Palestras na Associação Paulista de Homeopatia, 1982 -2000]. Gravação em fita cassete, Biblioteca da APH/EPH. ROSENBAUM, P. Medicina do Sujeito. Rio de Janeiro: Luz Menescal, 2004. ---------------------------------------- Andréa Costa Pinto Ikegami
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