23 year-old, Hindu Female – 8th of August 1988.
1) (a) Presenting complaints started in February 1988. Recurrent vomiting followed by sweat. Sweat also on little exertion. (b) Loss of sleep. (c) Slurring of speech aggravated in the morning & night, ameliorated after warm drinks. (d) Dimness of the vision aggravated from excitement and better by rest. (e) Vertigo with dizziness especially while walking. (f) Loss of appetite. (g) Dull, heavy headache.
2) (i) Aggravated in the morning and at night (especially the vomiting & vertigo). (ii) Aggravation from motion, exertion, better by rest. (iii) Better in open air. (iv) Worse from warmth in general. (v)Headache ameliorated by pressure. (vi) Would be better by sleep. (vii) Better by consolation.
3) (i) Dull & heavy ache. (ii) Giddiness. (iii) Occasional aphthous ulcers. (iv) Occasional dry cough with pain on right side of the chest. (v) Occasional palpitation especially after emotion. (vi) Gas and distension in the upper abdomen. (vii) Appetite extremely poor, although slight hunger felt between 9 a.m. to 10 a.m. (viii) Sweat ++, especially in the back parts. (ix) No odour. (x) Sweat on exertion. (xi) Vomiting followed by sweat. (x) Urine:- Regular. (xi) Stool: White mucus, no ineffectual urging. Neither diarrhoeic nor constipated. Mucus: present: +. (xii) Coldness of the extremities especially after the vomiting. (xiii) Sexual desire ++. History of sexual abuse (? masturbation) during youth, before marriage. (xiv) Menses: (a) Started at 14 years of age, occasional pain. (b) Menstruation is scanty. (c) Occasional flow with scanty periods. (d) White discharge after periods. (xv) Mind was first clear – there was gradual stupefaction. (xvi)) Gloomy ++. (xvii) Absent minded +. (xviii) Forgetful ++. (xvix) Wants to be alone. (xx) Fear of death (occasional). (xxi) Memory:- Weak. (xxii) Weepy +. (xxiii) Sympathetic +. (xxiv) Slow & dull. (xxv) Fear of darkness, incurable disease. (xxvi) H/O recurrent vomiting at 7 years of age. (xxvii) Also H/O school-going diarrhoea treated allopathically. (xxviii) H/O measles in childhood. (xxix) Cannot correlate. (xxx) Chilly patient. Sensitive cold and damp. (xxxi) Likes to take bath regularly. Does not catch cold easily.
4) Desires: (i) Sweet + (ii) Sour + (iii) Pungent and hot + (iv) Salt + (v) Salty + (vi) Bitter: No. (vii) Bread + (viii) Milk: No. (ix) Potato + (x) Vegetables & spinach + (xi) Onion: No. (xii) Fruits + (xiii) Fish ++ (xiv) Meat/Chicken + (xv) Egg (boiled/fried) + (xii) Rich, spicy & fat food + (xvii) Warm food: No. (xviii) Cold food ++ (xix) Warm drinks: No. (xx) Cold drinks + (xxi) Ice cream+.
5) (i) Thirstless. (ii) Loss of sleep maybe from worry. (iii) Married for four years. (iv) Rheumatism with mother; (v) Asthma with father. (vi) Treated by one of Calcutta’s leading Homoeopaths with Causticum without effect.
INVESTIGATIONS CARRIED OUT BEFORE / AFTER DR. BANERJEA’S TREATMENT:
20/7/1988: E.E.G.: Mildly abnormal E.E.G. indicating interseizure pattern of left temporal region.
20/7/1988: C.T. Scan of Brain : C.T. study reveals an irregularly enhanced cystic midline S.O.L. (space occupying lesion) in the posterior fossa. Findings are suggestive of Haemangioblastoma. Cystic astrocytoma cannot be ruled out on these findings.
6/11/1989: C.T. Scan of Brain : Normal Scan.
CASE ANALYSIS, MIASMATIC DIAGNOSIS AND FINAL PRESCRIPTION
Provisional diagnosis: Brain Tumour (Haemangioblastoma or Cystic Astrocytoma).
Miasmatic diagnosis: Psora-Sycotic.
Constitutional remedy: Gelsemium.
Satellite medicines: Causticum.
MIASMATIC INTERPRETATION AND DISCUSSION:
1) General nature of the Sycotic Miasm : Sycosis produces incoordination everywhere; over-production, growth infiltration in the forms of warts, condylomata, tumours & fibrous tissues, etc.
2) Organs/tissues are affected by this stigmata (Sycosis): Entodermal tissues, soft tissues etc. (– whereas Psora affects Ectodermal tissues, Syphilis affects mesodermal tissues).
3) Psychic manifestations of Sycotic Stigmata in relation to the case in concern: Sycosis, the incoordinating miasm, manifests incoordination in the psychic sphere also. As if the association of the fibres of the cerebrum and the linking fibres of the autonomic nervous system with central nervous system have become out of gear. This incoordination is manifested in the field of memory by forgetfulness of what she has just thought, said and done.
4) General Manifestations of Sycotic Stigmata : All “hypers” are Sycotic ( whereas “hypos” are generally Psoric and “dyses” are generally Syphilitic). Hyperplasia of the tissues of the case in concern is Sycotic.
1) PSORIC: Wants to lie down day and night which ameliorates her trouble is a characteristic.
2) PSORIC: Vertigo aggravated from movement and ameliorated by rest, lying down is Psoric. (Comp: SYCOTIC: Headache aggravated by lying down, ameliorated by movements, (SYPHIL: Headache aggravated by lying down, during sleep).
3) SYCOTIC: Absentmindedness.
4) PSORIC: Weepy and depression. Various fears, like in this case fear of darkness, fear of incurable diseases.
5) PSORIC: Anamnesis from P/H: H/O School going diarrhoea.
6) PSORA-SYCOTIC: CRAVINGS: Sweet (+) is Psoric, pungent & hot is Psoric, aversion to milk is Psoric; whereas desires salt & salty food is Sycotic, desires cold food can be Sycotic. ( Desire for cold food can be Syphilitic too, but the other symptoms of Syphilitic Miasm do not corroborate the case in concern and moreover patient has a strong desire for animal food like fish ++, meat & chicken +, egg + but in Syphilitic Miasm there is a general aversion to animal foods.)
7) SYCOTIC: Anamnesis from F/H.
8 ) Psora-Sycotic: Paresis and functional paralysis is more Psora-Sycotic: functional incoordination.
9) SYCOTIC TAINT OF GELS: Dr. Clarke refers a case of Hydrosalpingitis of gonorrhoeal origin cured by Gels 1M.
POINTS IN FAVOUR OF GELSEMIUM:
1) Slurring of speech, which was > by warm drinks (patient as a whole was not fond of warm drinks, but she found sipping warm water relieved (particular modality of the complaint: Dr. Clarke refers stimulants ameliorate).
2) Dim vision < from excitement (in Gels, we have general < from emotion & excitement).
3) Vertigo > in open air (Boericke).
4) Dull headache > by pressure and compression.
5) Complete relaxation and prostration of the whole muscular system lack of muscular coordination (Clarke).
6) Coldness of extremities (Kent).
7) Insomnia from worry (Clarke).
8) Dr. Harvey Farrington refers weakness & languor are the earliest symptoms to appear. Patient feels tired and weary and wants to lie down. Dr. Farrington clearly emphasized that the excessive weakness is the prodromal state of practically all the complaints where Gelsemium is indicated. Dr. Clarke refers that the lassitude is expressed by the patient ( not expressed, Murex Acid).
9) Desire to be let alone.
11) Mind was first clear – gradual or insidious stupefaction.
12) Listless attitude. Wants to lie down and rest (Clarke).
13) Apathy regarding illness.
14) Anamnesis of the P/H of school going diarrhoea.
15) Dr. Clarke refers to functional paralysis (paresis) of all descriptions.
16) Appearance: Heavy, dull appearance of the face (expression of the countenance) (Clarke). Apathy regarding her illness; “discernings are lethargic” (Ref. Boericke).
17) The miasmatic breakdown of Gelsemium is Psora +, Sycosis ++, Syphilis +, Tubercular+.
NOTES ON GELSEMIUM :-
1) When there are present many groups of symptoms of various ailments and if, according to the indications, Gelsemium is being prescribed at the outset, it can really abort the entire disease (ref. Ghatak).
2) Due to the absence of a deep-acting antipsoric base, Gelsemium cannot prevent the frequent relapse of the complaints due to Psoric stigmata. Dr. Nilmoni Ghatak refers that one might think that when Gelsemium has the capability to cure many deep-seated diseases, like paralysis, then how can it be possible that the medicine does not possess deep-seated anti-Psoric stigmata, but it may be noted that when the exciting cause excites the latent/dormant Psora to explode and thereby there occurs the manifestation of paralytic symptoms, Gelsemium has the inability to prevent the said explosion of latent Psora and thereby annihilating the problem permanently like, Sulphur, Causticum, etc. Do, which also correspond miasmatically to the case. But Gelsemium has the capability of aborting the ailment when indicated by its totality especially at the outset.
FINAL PRESCRIPTION AND REMEDY REACTION:
I started this case with Gelsemium 200C; this potency was chosen because of the pathology of the case and the vitality of the patient, despite it being a neurological case. The case was much improved with Gelsemium 1M in just under 9 months of treatment. Within 15 months from the beginning of treatment a normal CT scan of the brain was received.
Date Report after Treatment Last medicine
8/8/88 Gelsemium 200C: 2 doses.
25/8/88 No change Sac lac.
24/9/88 No change. Standstill, but no Gelsemium 200C: 2 doses.
12/10/88 Standstill. Not worsening. Sac lac.
16/11/88 Standstill. So go to higher Gelsemium 1M: 2 doses.
13/12/88 Improved. Vomiting is less Sac lac.
Vertigo & weakness are better.
15/2/89 Every way better. Patient has Sac lac.
conceived. LMP 18/12/88.
27/3/89 Every way better. Pregnancy is Sac lac.
progressing nicely and
26/4/89 More or less cured; no major Sac lac.
presenting complaint, weakness,
occasional headache, etc.
Patient is reluctant to continue
any further treatment
as she has to travel about 120km
to come to the city.
Authenticity of cure :