Clinical Cases

A Case of Difficult Concentration

Written by Paresh Vasani

A case of difficult concentration and lack of confidence in a young man.

Young man, age 23 years. First visit on April, 2004

(This is in the patient’s language, how he expressed himself. He is speaking in the vernacular.)

Patient: My main problem is that first, I am not able to concentrate properly. Second I am having allergies and I have breathing problems also. I am not able to breathe comfortably. Once I breathe the second time I won’t be able to breathe properly continuously. These are the main problems. Initially I had a problem while urinating, which used to pain a lot. Now don’t have that problem.

While lifting some weight some blood used to get clotted here and my hand will start paining, like pulling some weight. If I do exercise continuously, after some time my muscles won’t allow, my muscles won’t work with me. I won’t be able to do it again. These are some of the problems.

My comments

My muscle won’t work with me – this could show the affection of function of a part, role of a part.

Patient continues

Up to my 10th standard I was not having any problems. The problem started when I was in my 12th standard. It started like what you call this Hu Hu. I was having it about one complete day. My Mom was doing some medicines which she knows, so that will go. But it was not going. Then I visited a doctor and he told me that phlegm has increased in my body and now it is coming and I have to take medicine for about a month. He gave an injection and it went away. But the very next day my body was full of patches. Initially my mom thought it was like some insect bite or something and we will do our traditional things and it will go. For 12 days my mom was doing the same thing and it did not go and we went to doctor again. He said it was allergy and he would give one injection and it would go. One injection was ok. I was all right on that day, but next day it started again. Once I take medicine it will go, and next day it will come back again and that was happening for 1-2 months.

I started taking medicines like allegra, altiba, those were powerful doses. I never felt any side effects and started feeling dizziness. My legs become very black. I was taking those medicines for one and a half years and after that, I went to an Ayurvedic doctor who gave me medicine and I was feeling better, and those black things on my legs went away. I was feeling quite okay, but my problems were not getting solved. Again I took medicine from them. Initially they used to give me powerless medicines and my disease used to get cured from that medicine. After that sometimes it will not get cured from that medicine and at that power. That was happening for two and a half years. My friend told me about this clinic. My friend is working in a company. My friend was having some problem like in complete silence, he was having some strange noises in this ears. Even I am having this problem, like in complete silence I can hear some sound. He suggested that clinic. She asked me about everything. She gave me medicine which I was taking from her for one year. The only advantage is, I am still alive.

In 2001 Dec the problem became very severe. There was severe pain, some sort of irritation, some sort of burning and I felt I am not capable of anything. I am a waste in this world. I was about to commit suicide, and at that time I went there and she gave me medicine and I felt better.

My comments

This is a very important sentence of the case

    • What is the opposite of this sentence – I am ok – I could live only if I am capable
    • So it is the issue of capable and not capable
    • How much is the depth and desperation of this issue of capability (this sensation) – this is the miasm. Miasm is the depth, the degree of desperation, the intensity of the Sensation.
    • This sentence shows he is very desperate – if not capable – suicide – soft hint to Syphilitic miasm
    • So in this sentence we get the combination of Sensation and the miasm. If not capable, then will commit suicide. In every case, you must see the sensation and miasm together in the same sentence.
    • Again – it is too early, so we must confirm it through out the case. If we are right, it will come up again and again in the case.


Patient continues

Before that. If I start studying I felt that I won’t be able to do this lesson. I would just feel sleepy and would go to sleep. I was sleeping morning noon and night. After sleep I would feel refreshed for a while, 5-10 min and then I would feel I am not capable of anything. Not about to do anything. It is in my mind, I won’t be able to do anything. I would commit suicide. Those things did not appear after taking medicine and I could concentrate at least a little bit. I was able to complete some lessons after taking medicine, but still I was not able to concentrate completely..even if I complete a portion. After 1-2 weeks if I revise once which I finished, I feel I am doing it again. I am doing completely new. That sort of thing.

D) Out of all these problem, which problem bothers you the most right now?

P) I m not able to concentrate. Currently we are having our own printing press. I want to look after that printing press since my dad was not well. So I failed last year. I’m trying to finish this year but I m not confident that I will finish it this year. Initially we were having the printing press during my 10th. My dad was not feeling well when I was in 10th. When I was about to give the10th, he was very sick. He thought, he was not going to live long, so he wanted to do a business which I and my mom would take care of after he passes away. My dad used to deal in garments and the whole burden was on my head. My dad was on complete bed rest. I was the one to take care of everything….whether everyone has come on the job. Whether everyone is coming on time.

My comments

This shows his perception of the situation –

It was like a burden – Delusion state – how he perceives that everything had to be done by him.

Patient continues

He always shouted at me, if I was not able to give delivery on time. I just keep on thinking, what I am going to do, he is going to scold me. It started like that. My heart starts paining when think about it. Oh my god! He is going to scold me. He is going to scold me if I don’t give delivery on time.

During my 12th, my dad got well and I was concentrating on my studies and I finished my 12th and then during my 2nd year my dad shifted to printing presses, as we suffered a tremendous loss in the garment industry. 15 lakhs went away. Even printing went in the same way. We were putting in new machines and no one had complete knowledge about the machine in my house. Whoever comes to the job, I used to be there and I learned every technique about the machines. I used to stay with the operators. After he was away, I used to stay at the machine and normally everything went on time. If for one day I was not able to give delivery on time, he will shout at me “Oh what are you doing? I was not expecting this from you, that you will not give delivery on time… that’s why I am giving you jobs, otherwise I would have given it outside. There are many others who can do the job for me” They would just shout at me. I would start fearing. I don’t have any other option for income.

My comments

You again see the desperation -” if the customer is upset – I have no other source of income” – hopeless – hint of the Syphilitc miasm.

Patient continues

It was that increased. These are the things which I think started this. That’s it. I want to finish my BSC. When I was in the 10th, within one month I could study to score passing marks, but now I am not able to do anything. I was able to finish almost half the papers. Now If I sit for revising something, it is completely new. I don’t know what the problem is.

D) When you say I was not capable to do anything, what do you mean by that?

P) I was not able to study. Even if my mom and dad said do this job or do that I will feel that I will not be able to do. I was having fear in my chest. My heart is paining. I don’t know how to explain that. It is like fear. Like someone shouts at you. Someone has given a job to you to finish in a particular time and you are not able to do it in that time. That’s how you feel. Those sort of feelings I had in my mind. I was having it in excess.

D) Describe that which you are showing?

[Moving hand near the chest]

P) I used to have the pain.

My comments

Anything intense which comes along the way – has to be examined – e.g the Gesture here – so we must examine that and see if it fits the same thought. If it goes to something else, then our thinking could be wrong. This kind of openness or flexibility is a must, otherwise we will fail.

I examined the gesture, here but I didn’t get anything special.

Patient continues

D) Okay, just talk about “not capable of doing”. What does “not capable” mean?

P) I will not be able to do it

D) Your mother and father gave you some work and you were just not capable of doing your job?

P) My dad tells me this especially during garment work. In printing I don’t have to do much work. Everything the machine doesm but in the garment line I feel too slow. Everything has to be done manually. I feel too slow. My dad does work very fast, but I feel very slow doing that work. My dad will be scolding me, “If you work like this you won’t be able to do anything in your life”. Even in the printing press I am quite slow. But it is fully operated by machines and I didn’t experience much problem. In studies also I will just look at chapter, I will feel I will not be able to do this. I will read the chapter once but I feel it is too big; I will not be able to do that. In our studies we have the topic “relativity”. It is a damn easy chapter actually, but it looks big and I feel, “Oh my god! , this is too big, I will not be able to do this topic and will leave it.” I just won’t do that. I have not done anything and feel, “Oh my god!, I will not be able to do anything”. I am not able to describe completely what I am not capable of doing.

My comments

Again it shows

    • Issue of capable – not capable – structure as sensation
    • Desperation – it is too big – I will not be able to do it


Again, we see the same issue of capability , lacking that capability is coming throughout the case in different aspects, work, studies etc – so we know we are on right track.

So the kingdom is becoming clear –

Lack of capability, lack of structure – Mineral kingdom – so this is Sensation A – Kingdom

Now we will have to understand what is the sub-kingdom and the source – that is, which row of periodic table and which column.

Patient continues

D) You are doing very well and describing very well. You are on the right track. Just talk about the feeling “I cannot do it”. I am not capable”. Just describe this.. “not capable of doing”.

P) I do everything quite slowly. My mom and dad say don’t do it slowly, do it faster. I am doing the job but still they are blaming me. I have to do the work also and I have to hear everything from my mom and dad. I used to work a lot from 1-2 am. The parties used to shout at me. I am working also and hear shouting from others. I am working till 2 o’ clock and sleeping till 9:30 am. My mom used to shout at me, why don’t you take bath till 9 o clock. After that the water will go. I am working till 2 o’ clock and you are not letting me sleep for another one or 2 hrs. Those were things which made me feel bad.

Initially I was having cold problems also. Continuously I was having this problem. When my hair gets a little wet, I get cold. That problem has stopped.

D) What is the meaning of “incapable”? If you are incapable of doing something, how will you describe that?

P) I won’t be able to do any job given at that time.

D) You are describing very well. Just say more

P) They are giving me a particular job. Even if I am not interested in that job, I will feel like I should do that job, but I am not able to do it. I don’t know why I am not able to do that job. People say that you are not interested in that job, so you are not able to do it. Bu I am not able to do that job. I am not trained and don’t have any experience in doing that job,so I can’t do it. I feel it is my fault. It is because of me, I am not doing that job. I should have knowledge and experience to do that job… that’s why I am not able to do that job. It is not because of anything else.

D) Okay, you were talking about “burden”, and you said when your father was sick, it was a burden. So just describe what a burden is.

P) I had to look after everything. There was a lot of work and I had to look after everything. If someone has not come to work, I had to be find an alternative. I had to search for other people who can stitch this one, bring them here. I would go for delivery and they would say “This is not right, that is not right, the length is short by ½”or 1”. Though it is not my fault they would scold me. There was a lot of work and the whole burden was on my head and everything had to be looked over by me.

My comments

“I had to look after everything -the whole burden was on me. I had to take charge of things around me.” – this gives a hint towards the row – he was responsible for that.

Patient continues

D) What is a “burden”?

P) The whole thing was on my head. The whole company was on my head. Though I have relatives, what they will do? He will just take the job, whatever he has to do. He would just stay there. I had to do everything. If someone has not come, I used to go and search for them. If helpers have not come, I had to do the job of helpers. If the delivery people have not come, then I used to do the delivery. People who stitch buttons, they have not come, I have to do that….. These were the burdens.

My comments

So we understand it more and more

Patient continues

D) Forget your work for a moment. Forget yourself for a moment. Just describe the “BURDEN”

P) Giving someone an excess amount of work which he can’t do.

D) Just describe this.. “he is given an excess amount of work which he can’t do”

P) To a normal person, which he can’t do.

D) Just describe this.

P) Like an uneducated guy, he knows nothing and you are making him study. He knows nothing, no A B C D, and you are making him study 10th std. At that time it is burden on his head. He does not know anything and you are making him study 10th std. He will definitely not be able to do it, but still you are making him do it. So it’s a burden.

My comments

This is the combination of an image – delusion and sensation and the miasm

What he describes

    • Image of a boy who doesn’t know A B C D and making him appear for class 10
    • Feels can’t do it – structure sensation
    • It is like a burden
    • See the depth – you don’t know Abcd and how huge is the task – almost impossible – hopeless – syphilitic


Most cases you will see combination of Delusion sensation and energy at a junction – that combination is most vital.

Patient continues

D) You are doing very well. Just describe the person, the experience of the person who doesn’t know A B C D and you tell him to study 10th. Just describe the experience of that person

P) He may not be interested. He may be having interest, but he should have that capacity to study. But since he doesn’t have that capacity, he will definitely try. He is having interest, he will definitely try to study, but since he doesn’t have the capacity, what he will do? He will try and try, and at last ,good for nothing. Though he might have learnt something it’s of no use. It is very difficult for that person. He may say he wants to study, but you just force him to study. I don’t think he will be able to do that.

D) What would that person experience? What would he feel?

P) Initially he would feel nice, since he has not been to school before and he is getting to study 10th std. He will feel very nice initially. Oh my god! I am studying and after that, once he starts studying and experiences problems in studies, he definitely would feel bad. Oh my god, why did I come for studies?

D) What would be his experience when the portion is too big and std 10th? How would he feel ? How would he experience it?

P) He will try to finish the portion and take the exams. That’s the least he can do. He can’t leave his studies because someone is forcing him to study and finish the 10th. He can’t leave that and he won’t be able to do that.

D) When you say “incapacity” and “incapable“, what comes to your mind? Just describe “incapacity” and “incapable”.

P) A lame person running a race with someone whose legs and hands are OK, like an athletes. He is not capable of running a race. This is incapable. He is not capable of running but you are making him to go for the race.

My comments

Another example

What he describes

    • Image of a lame person
    • Feels he can’t do it – structure sensation
    • See the depth – how huge is the task – almost impossible – hopeless – syphilitic


Patient continues

D) Describe the “lame person” What would he experience?

P) Same thing. He will feel a little bit initially because someone is forcing him from behind… you have to go for that race. Initially he will feel this disability, but when he goes for the race, at that time he feels “What a big mistake I have done by listening to someone, I have come to the race, which I shouldn’t have?”

The analysis is already described.

Which Kingdom does he belong to?

No sensitivity. No local sensation and its opposite. What was there with pain (heaviness) didn’t go further.

No issue of survival – Victim/ aggressor. Though he uses some words like forced etc., but you don’t see the energy of a victim in it.

Mineral kingdom

    • I am lacking something.
    • Lacking capacity to do something.
    • Development of confidence, capacity to do something.
    • Affection of function of the structure (muscle refuses to work)


Once you know the kingdom, the next step is, which row of the periodic table?

    • Is he lacking existence (Row 1)
    • Lacking maternal support (Row 2)
    • Lacking identity, choice, care (Row 3)
    • Lacking security (Row 4)
    • Lacking ability to go in to something new and create (Row 5)
    • Lacking capacity to take responsibility of self and surrounding (Row 6)


What kind of Burden is he describing?

    • There was a lot of work and the whole burden was on my head and everything had to be looked over by me.
    • Uneducated boy studying for Class 10.
    • Lame person running race.


All these examples definitely point to Row 6 of the periodic table, where the main issue is to take responsibility, to take charge of the surrounding and the self.

Which column of the periodic table?

Lacking capacity denotes the left side of the periodic table. Let us differentiate the three columns of the Periodic table.

Column 1 of Periodic table

    • The structure has not started to form.
    • Completely dependent on somebody and feels their structure as his own.
    • Incapability to do things. Lack of confidence.
    • Cannot do things alone or on their own.
    • Always needing somebody next to him/her.
    • Intense childlike dependence.


Column 2 of Periodic table

    • Beginning to feel the presence of structure.
    • But it is a provisional structure, like a tent, which serves the purpose only as long as conditions are optimal.
    • If things are a little out of the way, then immediately one seeks for a permanent structure.


Column 3

    • Wants his own structure
    • But doubts his capacity.
    • Uncertain regarding the type of structure.
    • Column in the case
    • He will feel very nice initially. Oh my god! I am studying and after that once he starts studying and experiences his problems in studies, he definitely would feel bad.
    • I will try to finish the portion and give the exams, that’s the least I can do.


Here in the case we see some efforts, some trying, but when difficulties are there, he cannot do it. This points towards Column 2.

The remedy I thought for him was Baryta carb.

If we look at the case from the repertory point of view, the few rubrics that describe his condition well are

    • Delusion, walks on his knees.
    • Delusion, legs are cut off
    • Confidence want of self
    • Confidence want of self – inadequate, feels
    • Confidence want of self – feels himself failure.


You will see many rubrics coming up in the case like confidence want of self etc.

From the Materia medica point of view, we know Baryta as a strong syphilitic remedy that comes to our mind for inferiority complex and feeling incapable.

Miasm / Desperation

He clearly belongs to the syphilitic miasm based on the following points:

    • Person who doesn’t know A, B, C,D told to study class 10 (almost impossible task)
    • Lame person running race against normal people.
    • If I don’t do work properly – I will lose work and no other source of income.
    • I am a waste, I want to commit suicide.


What is Row 6 of the periodic table?

I am safe, my food etc is taken care of, I am protected, I am creative but now I have to take responsibility and leadership. Now I need power. Issues of independence, dependence, handicapped, foundation etc.

Understanding of Baryta

“I have to stand on my own feet but my legs are cut, I am dependent and I need support”.

Beginning to take responsibility for oneself, but is still very much dependent on others.

In face of slightest problem, one feels like a handicapped person putting his burden on somebody else.

I can take responsibility but only with support.

Imbecile, retarded / precocious, intelligent.

Follow ups of last few years from 2004 onwards

A tremendous change happened with his level of confidence and in his perception of life and himself. He could take part in public speaking or dance shows. His insecurity with respect to customers changed a lot. He could handle them much better. He took a job, changed his job further and took up good responsibility for the department. His physical complaints too disappeared quickly. He was given a few doses of 1m and 10 m potencies over a period of the last 4 years.

This case illustrates how, from different approaches, we can come to the same remedy. Whether you approach through the repertory or materia medica or the Sensation method, all will point to the same remedy. These are just different tools and each case will need different tools to reach the core.

About the author

Paresh Vasani

Dr. Paresh has a successful practice in Mumbai, started 17 years ago. He has developed a reputation for his immense patience and calmness. Treating scores of patients in India and abroad has given him some fine insights into the science and art of Homoeopathy. He is well known for supervising case-taking, in this way helping other homeopaths achieve depth of understanding. He is also the main force behind developing the Homoeopathic software, VitalQuest, which is based on Dr. Rajan Sankaran’s Sensation Method.


  • Nice presentation of sensation method case. But, we can choose Baryt.carb from the rubric Lack of self confidence.

  • i would like to have complete information about the periodical table and where to resource it from.
    Contact details of Dr Paresh Vasani

  • I had taken a case of a 63yr old patient having complaint of insomnia since 20 years. He is alcoholic. By deeper casetaking i came to the point that in his life he wanted support in each and every aspect, felt alone without support, as if dead, nothing , no existence , destroyed. He is very careful that he will be not destroyed.. I read this article that make me clear about column and row of the case of this article. So sir, if you can guide me in this case, thank you.

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