This is a case of a 24 year old female patient, software engineer by profession. This case has been solved by Sankaran’s Sensation method.
Observation: She is slender, thin and tall. She has a dark complexion.
Short forms used in the case: Hg stands for hand gesture, Q stand for questions asked by doctor. ANS stands for answers given by the patient
Q: Tell me about all your complaints in details
ANS: I get severe pain in my lower back; low backache gives me stiffness in back due to which I can’t squat, and it gives pain in legs also. I cannot sit erect.
(She is already diagnosed to have the congenital disorder Spina bifida which keeps giving her severe low backache.)
I get white discharge before and after menses, there is pain in lower abdomen during white discharge, it is pulling kind of pain, I get profuse bleeding on first day of chums. I also get pain in both breasts < while travelling in a train
Q: Describe the pulling sensation that you get during the white discharge?
Ans: The pain is as if someone is pulling from inside, as if intestines are stretched, like when muscles contract due to strain. It is as if you pull the rope, as if in the same way muscles are stretched and pulled from inside.
Q: Tell me more about the pulling and stretching sensation.
ANS: The pain is unbearable, I have to give up all the work and sit down doing nothing which is especially troublesome in office as I have to meet up with my daily work commitments.
(The important thing here is that when she was asked to describe the pulling sensation more, she spontaneously said that due to this pain her efficiency at work is lowered. She has to sit and do nothing. So when you are asking her to describe a sensation she is telling you that due to this pain, her daily function is getting affected; instead of describing the sensation in the chief complaint she is telling you the effect of the chief complaint on her.)
(Here I first tried to probe two sensations i.e. stiffness and pulling, which didn’t really sustain for long and the patient was not able to describe both these sensations further. Also there were no hg (hand gestures) accompanying these sensations, so I considered at that point in time that there is no energy in these sensations and these two sensations are local rather than being general or global. Had the patient been describing the same sensations in both the complaints (low backache and white discharge), it would have been more important and then it might have been the sensation deciding the remedy.)
(One more important thing is that in cases of arthritis or backache, a sensation of stiffness is often described, as it is a common sensation of these pathologies.)
I have tendency to get hypotension at times.
I get headache while working on computer.
Q: Describe the headache. What kind of pain you do you get there?
ANS: Pain is as if someone is hitting the head, it causes dizziness. If I work on computer without spectacles head would start aching and it is more in the occiput.
Q: Describe the sensation you get in the head when you say someone is hitting the head.
ANS: It is as if someone is hitting my head with hammer. < Loud noise, >Sleeping
Q: Describe this more as if someone is hitting the head with a hammer.
ANS: Head is shaking from inside, as if skull is steady and rest of the brain is shaking inside. Also there is numbness and heaviness.
Q: Tell me more about someone is hitting in your head with a hammer.
ANS: As if someone is hitting you with stones. But this headache would stop on its own after I get a nice sleep.
(In spite of probing the sensation “as if someone is hitting with stone”, she couldn’t describe it any further)
(So far we get three sensations in the case viz stiffness, pulling, something is hitting my head. 3 diverse sensations none of which held for long even after probing for them for enough time. So after exploring chief complaint let’s explore the other areas in this case. Let’s try and see if we get a clue to her simillimum in her mental state)
Q: Tell me everything about your nature, as in things which affect you or about your likings and disliking, about your stresses?
ANS: I get angry easily, I think a lot on trifling things, I weep easily, small things touch me easily if someone says something bad to me.
I don’t like it when things don’t go according to me, when someone behaves against my mind. If he or she is doing wrong according to me, he has to convince me that his point is valid; he has to convince me about his points. If I am convinced then only I will agree. [Here she narrates two small incidences where she had argument with her land lady and her friends, she says “my friend was saying repeatedly that he is right but I was convinced only when he explained it to me”]
If things are not happening according to me, or if someone does things which I don’t agree upon I get angry. I expect that person should go according to my mind
(To find a remedy for the case, the first thing is to decide whether the patient’s energy matches with the mineral, animal or plant kingdom. Here so far we don’t get any features matching with animal kingdom. We got three sensations but none of them held for long and when probed for these sensations instead of describing them further, she is saying her efficiency at work is reduced due these problems, so this is a case of mineral kingdom. In the mineral kingdom what is bothering them is, what is their capacity and ability and here she is telling you that due to these complaints her capacity at work is reduced. So this patient belongs to the mineral kingdom. Now as we proceed further in this case we get a first clue for the third row. She says, “he has to convince me about his points” as if she is saying “I have my own points and you have your points”, as if she is saying that “I have my own choice and you have your own choice”, but you will have to convince me about your points i.e. your choice. As we all know, the third row issues are Love, Care and Identity and it is not that in all cases we will get to hear these exact words from patients. Here when she is saying my points she is expressing that my identity is developed, so I have my own choice, my own opinion and my own points. Third row patients often use words like my choice, my views, my opinion. It is their identity which they are expressing through their choice, opinion and their views. In the third row, the issue is an IDENTITY… I have a separate existence now but who am I? The sense of identity is not developed on the left hand side and as we move further from Silicea onwards, it is well developed. As a sense of identity is developed at Silicea onwards, they will start asserting their identity, like what we get to see in this case when she says..”I have my own points” she is trying to assert her identity. )
Q: Tell me about your stresses?
Currently I have a job related stress. I am looking for a new job; my current job is paying me very less. It is not a secure job, my needs are not fulfilled properly . Now I don’t want to demand anything to parents, you can’t be dependent on your parents for lifelong. Now I want to be independent. Self-independence is very important; I don’t want to be dependent on family anymore.
Q: What do you mean by a secure job?
ANS: Secure means money related, I want to earn more and don’t want to be dependent on anybody. If you are earning well you can fulfil your basic needs. I want to buy a home in Mumbai on my own.
Q: What do you mean by secure?
ANS: Secure means safe, if you earn lots of money you can save it in banks so it will be of help in future for yourself and your family.
(Here we get a clue for the 4th row. Issues with the 4th row are security and task; they seek to have security in terms of money, job, health and relationship. So if you earn lots of money and save it you are secure, if you have your own house you are secure. Also 4th row patients are very conscientious about their work, whether it’s a job of an employee or whether it’s household work of a house maker lady, they are very dutiful towards their work and getting their routine work done properly is very important to them, as it’s a task assigned to them. So what bothers her is due to her physical complaints, her office work is getting affected at times. This is again confirmation of the fourth row}
Q: What do you mean by self-independence?
ANS: You shouldn’t be dependent on anybody for anything. I don’t want to take anybody’s support.
Q: What do you mean by support?
ANS: Support means help e.g. a small creep that grows on a support of stick. (Delusional level, 4th level)
Q: What is bothering you most right now?
ANS: I am in a relationship with a guy. We look forward to marry each other and I have told about it to my parents, but he has yet not told about our relationship to his family. I keep nagging him as to when is he going to disclose about our relationship to his family. Then we have a quarrel. (Situational level), then I start weeping. He is very committed and caring towards me. Suppose I am not keeping well he will take me to doc, get me the medicines. But he doesn’t talk much and doesn’t share. He is possessive about me and he has put restrictions on me as to what kind of dresses I should wear etc.
(Till here she is describing a situation, which is a at a delusional level and we do not prescribe on delusional level but on the sensation level, so let’s find out what is her perception in this situation)
Q: So what is bothering you most in this relationship?
ANS: He won’t agree to do things according to me (Again, here what is bothering her is that he is not doing things according to her, i.e. he is not going by her choice.)
(As it is a relationship that is bothering her right now, this is a case of salt, one element is from 3rd row and the other element is from the 4th row. She is talking about support, and when she says “ I don’t want to be dependent on anybody”, subconsciously she has a sensation of being dependent. A sensation of being dependent is prominently found in 1st and 2nd column, and her dependence is for security for money and job. So one of the components of salt is from either 1st or second column of fourth row. So it is either Kali or Calcium. She says “I have a job but my job is not secure.” So indirectly she is telling you she has a structure but it is not strong enough to survive in a crisis. If there happens to be a crisis in the future she will have to seek support from her parents. Also, features which we get to see in Kali, like desire for company or absolute dependence on family are absent here, so it is not Kali but it is a second column and so one of the components of the salt is calcium. Also she says, “Secure means money related”, so her dependence is mainly for financial things, which again suggests Calcarea as it is the element from the 4th row whose dependence is for financial support. Now let’s explore further which is the other component of salt which is from the third row.)
Q: Tell me about your childhood?
ANS: I wanted all the attention from mother. I won’t allow her to pamper my sisters, used to get angry in childhood also.
Q: Tell me about the dreams you get?
I used to get one dream repeatedly in childhood. I am on something like a small piece of a land or small rock along with mom and suddenly rock starts breaking and mother goes away from me; I used to wake up horrified after this dream. (Delusional level)
Q: What do you feel in this dream?
ANS: I used to wake up horrified after this dream.
Q: What was the feeling that used to make you feel horrified?
ANS: Mother on whom you depend for love and care, she is going away from me and separating from me.
(This dream of hers coincides with two prominent rubrics of Phosphorus. The first part of the dream that she is on small piece of a land or a rock, coincides with the rubric, Delusion, Iceland, is on a distant and the second part of the dream is that the rock is breaking and she is separating from her mother, which coincides with the rubric, Estranged from her family. This is also in the third row as their issue is identity, on extreme left, in Natrum, identity is not yet developed and the feeling is, I am you, I don’t have my own identity. Natrum doesn’t have its own choice and they go by the choice of the person on whom they entirely depend. Magnesium onwards the identity starts developing, but in magnesium the feeling is, I have my own will and my own choice, but if I express it, I will be forsaken, so I have to go by the choice of the person on whom I depend upon for love, care and nourishment. In Alumina there is confusion of identity, so the feeling is “Am I what I want to be, or am I what they want me to be; so should I go by my own choice or their choice” From Silicea onward identity is clearly developed. They are very clear about who they are and what they want; there is clarity in their thought process as to what are their choices, opinions and viewpoints. In Silicea the feeling is, I am this and others should also perceive me in this particular way only, so in Silicea identity is fixed. From Silicea onward comes Phosphorus, where again identity is clearly developed; they are very clear about their choice, their views and opinions. So when she says “he has to convince me that his point is valid, he has to convince me about his points.”, she is saying that, I am not you; I have my own choice and my own point of view, so you will have to convince me about your points. Even though Phosphorus has a clear sense of identity for care and love, they are still dependent on others, which if they don’t get from their family, they feel estranged from their family and they become indifferent toward their family and try to get this missing love and care from outsiders by being very sympathetic and friendly with others. Then they expect others to return this love and affection. As they are still dependent on others for care and love, the feeling of separation from the mother horrifies them. When the rock is breaking and she is separating from her mother, the feeling is: The person who is supposed to take care of me is going away from me, so the other component of the salt which is the remedy of this case is Phosphorus.)
So the remedy for this case is CALCAREA PHOS
The miasm of this case is tubercular, as suggested by her lean thin appearance and also the feeling of restriction that she is getting in this relationship.
(COMPARISON WITH 2ND ROW: As there is a dream of separation from the mother, in second row which has the theme of foetal life and birth process, being part within and then separating, for a moment while taking the case, even I thought that it could be a second row remedy, but it is not the feeling of a foetus who was part of mother so far and is now going to separate from her, but rather it is feeling of separation from a person on whom you depend upon for love and care. Also as she is asserting her identity through her points, it is third row rather than 2nd row}
Fear: of ghosts, of dogs.
Sweating: scanty, only in arm pits.
Aversion: curd, milk, buttermilk, butter
Craving: sweets, non-veg
Treatment: Calc phos 200, single dose, stat
1st follow up (21/02 /2012): White discharge is much less, backache and white discharge better by 30 to 40 %. Frequency of backache is also less. Pain in lower abdomen that I used to get during white discharge is also much less.
Treatment: Treatment: Calc phos 1M, single dose, stat
(Even though she was better by 30 to 40 %, I decided to give her a higher potency as the case is basically at the delusional level, as she has given us strong delusions through her dream of separating from mother as the rock breaks. The potency which was given earlier was 200, so it would act at a superficial level i.e. at level of facts and feelings i.e. signs and symptoms which are already better by 30 to 40 %)
2nd follow up(23/03/ 2012): In between, backache had stopped completely, but since 7 to 8 days it has been surfacing again. There is no white discharge anymore. Right now what is bothering her more is physical stress; She can keep mental stress aside.
(So Calc Phos 1M has very well taken care of her mental stress and her mental stress is less now.)
Treatment: She is better at the mental level, so I preferred to give her Calc phos 200 which will now act at the fact level, i.e. at level of signs and symptoms.
3rd follow up21/04/2012: Backache and white discharge are 90 % better
Treatment: Sac lac
4th follow up (2/11/2012): There was a discontinuation of treatment for 7 months as she got herself shifted to a new place and after this she turns up with her face full of pigmentation and pimples. She had been to the skin specialist already and he has prescribed for her some topical steroid application along with internal medicines, which didn’t help her, so she came back to me for treatment. I prescribe Calc Phos 1M without much improvement in her complaints.
In between she called me in the afternoon as she started getting white discharge and severe pain in her lower abdomen. I guided her to prepare a water dose of Calc Phos 200 which I had left with her in case it was needed. I guided her to take a spoonful of that every two hours and to inform me about the improvement by tomorrow. She called me up and told me that the white discharge and pain stopped completely by that night.
5th follow up(4/12/2012): In spite of giving her the same medicine which had been a lot of help to her earlier, her complaints were not getting better and also she was getting scanty menses, plus she’s a thin girl putting on weight. All these things made me suspect that she might have PCOD (Polycystic Ovarian Disease). I got her USG abdomen and pelvis done and she was diagnosed to have been suffering from PCOD. I prescribed Calc Phos LM 1.
Follow up on phone after prescribing Calc Phos LM 1.
Q: Hi, How are you doing?
ANS: Hello doc I am fine. My pimples are settled down now, my face is looking better, only pimple marks are remaining now.
She tells me that white discharge and low backache are better by 60 % and menstrual flow was good this time.
(Here again we get to learn about the third row. When asked about her health she first says that her pimples have settled down now and that her face is looking better now; so for the third row how they appear to others is very important )
Follow up on 11/ 12/ 2012 (She comes down to the clinic as her water dose is finished off):
Observation: I could see that the pigmentation on her face is much better, pimples are much less and there is a remarkable difference in her face.
Q: Tell me all changes that you felt after I started with the new potency. How much better do you feel overall?
ANS: Overall better by 60 to 70 %
White discharge better by 70 %
Headache better by 80 %
Mental stress better by 60 to 70 %
Even my colleagues in office have noticed the change in my face; they are telling me not to stop the treatment.
Flow during menses was proper. It was neither too much nor too little. She had pain in lower tummy during menses, which got better as I repeated the water dose;
Frequency of mouth ulcers has gone down drastically. Earlier she used to get them at least twice every month, but this month there are no ulcers.