Cases presented in clinic are evaluated for clinical diagnosis utilizing conventional medical procedures. Once completed, a full homoeopathic diagnosis is made based on the individual presentation of expressed symptoms for evaluation based on Hahnemann’s directives, utilizing the P & W Boenninghausen repertory* as the guide to the remedies for evaluation.
Patient: R.G. male, age 58, presented via telephone consultation, with constant pain resulting from a high impact injury due to failure of two parachutes to deploy during a training exercise with the American Army in 1976. Compression injuries from a 160 mph fall resulted in a 7 inch shortening of the spine and lower limbs.
Since then, the patient had received no operative procedures related to the injuries , but had been given regular doses of a variety of pain medications.
The patient complained of constant pain. After walking 100 yards, he had to sit down with legs crossed and bend forward to ameliorate the pain. When reclining, the patient had to elevate feet, and then had to change position to one side or another, but not on the back. Sleep was not plentiful, disrupted by the pain.
There was a constant cramp present in the legs and back. Spasms. Both calves would be hard and tensive, then relax to soft muscle and then cramp again. Standing was worse for the patient, and changing position offered temporary relief. When in pain, touch aggravated the patient.
The patient complained of headaches, pain at the base of the skull extending up and over to the forehead, like the head was going to explode. There was a nerve pain into the eyes and cheeks which came on after a pain blocking injection in the face.
Patient complained of lack of focus of vision in the morning which rectified itself usually after rising, and was aggravated by reading. Patient also complained of high pitched tinnitus. The patient reacted badly to cold in any circumstance.
This is a very difficult condition to treat. There is a compression of the spine along with nerve damage and resulting continued pain, for 30 some years. The allopathic prognosis, as already defined by the treatment given, was pain management only.
Following the directives of aphorism § 6 Fifth Edition
The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.
I looked hard at the situation and started with the causation – impact injury. I then looked at the resultant conditions that have arisen from the injury. I paid special attention to the modifiers of his circumstances both good and bad.
I came to the following homoeopathic diagnosis:
Injuries to bones due to fall. Standing aggravated. Cold air aggravated. Changing position ameliorated pains. The patient had developed unceasing cramps since the injury. The patient developed tinnitus. The patient developed unclear vision.
I repertorised just these symptoms as being representative of the change of state since the injury.
As I perused the list of remedies, I saw that my initial mental choices of Phos and Silica were showing, but lacked a crucial modifier, that change of position ameliorated. In reading Acid phosphoricum, I was amazed to see the description of the provers experience mirrored in this patients own words.
I mailed the patient Acid phosphoricum Q 0/1 with instructions to take a dose daily. In the follow up 4 weeks later, the patient said he had been able to sleep right through the night without waking. Within a week the pain had diminished to almost 10% of the previous level. He noted that the cramps were beginning to abate for longer periods.
I kept the patient on Acid phosphoricum 0/1 daily for 9 weeks. Then I received a message that for the previous 4 days all the pain had returned. I asked the patient to stop the medicine and wait. In a few days the pain subsided. In evaluating the situation, I nearly sent the Q 0/2 potency to replace the 0/1, and proceed up the scale, yet in discussion with a colleague, we reasoned that the body was perhaps producing new neural pathways to replace the damaged ones, and perhaps the pain was a natural consequence of this repair action. I elected to continue with the 0/1 he had in his possession. Immediately the patient experienced an increase in wellbeing and continued to improve. A few weeks later, he informed me that the pain had returned a little, and that even after stopping and starting as instructed, it was not improving.
I mailed out the 0/2 potency and upon starting it, pain relief was instantaneous and the cramps disappeared altogether.
In the 10 months or so of treatment, we are now at 0/4. The patient has continued pain relief, no cramps, the tinnitus has gone and his vision has cleared up. He was able to chop wood during the summer for his fuel requirements, without too many problems, and has been able to walk further than before. I requested the patient measure his height on a monthly basis and he has grown ¾ of an inch.
Prognosis. I did not expect too much in a situation like this. However once again, the power of the medicines has impressed me with their ability to influence the human economy. We just need to follow the absolutes of the presenting case and evaluate them very carefully, and select the remedy with even more care. I see no need to change the remedy as long as the symptoms are representative of the disease expression and will continue as required until each potency has exhausted its action.
*Polony & Weaver OpenRep SYNOPSIS program : http://www.homeopathyonline.org/