Armeen Jasavala and Alifiya Dedanwala
This is a case of a fifteen-year-old girl with a keloid on the left arm.
P: I have a keloid on my arm. It pains a lot. It hurts me when I am studying and even when I go out. It appeared after a BCG injection [vaccination against tuberculosis] was given at birth. It was very small when I was five, but now it has increased and itches a lot.
D: Tell more.
P: It hurts me. It pains very badly. It is like a strike on the arm. Sometimes, I can’t raise my arm. It strikes me here. It hurts me. If anyone touches it, then it pains a lot and then it pains the whole day. It pains more in winter. It hurts a lot and in between, it strikes.
What important symptoms did we get so far?
She feels that the pain is as if she is struck on the arm. It pains even on touch and it pains a lot.
D: Describe this a little more.
P: It is like a pin. As if a safety pin has pricked and I feel like pressing it tight with my hand. But it goes on hurting. Pinning, pinning, pinning. That’s the way it hurts me. It also happens when I am sitting idle. It pains when I am studying. Then I can’t study. I just hold the arm with my hand till the pain is better. When the pain goes, I start studying again. Then after some time, it hurts again. When I am sitting, I am always conscious that this arm should not be touched. It pains horribly and I feel as if I am going to faint. It pains as if I have hit a cupboard door. I try to press very hard so that it stops. But it continues. I feel like crying. It hurts very badly like some sharp object is beating on my body. Like somebody coming and beating me again and again. Then, the pain radiates down the arm. It’s like hitting me, ‘Thaak! thaak!’ One second it hits me, and after two seconds again it hits me. It hits at regular intervals. After five seconds, it becomes continuous.
What do we understand about her from the history we have got so far?
The pain is poking like a pin. She presses the part tightly. It is as if beaten, or as if you have struck somewhere. It is intermittent when it starts. The pain radiates down. It pains horribly—this indicates the intensity of the pain. She feels she will faint with pain and finally, she cries with pain.
D: Tell more.
P: It is a very tough pain. I get angry, tensed up, worried. That anger is expressed on my sister. I beat her in anger. I feel as if somebody has held me very tightly and I am getting hurt. I can’t stop it. I try to pinch my hand to divert my attention. It pains for two to three days. It is unbearable pinning. The striking is so bad, so unbearable, that I feel frustrated. I feel almost unconscious for a moment till the pain lowers down. At that time, I can’t talk to anybody. The pain is so much that I am unable to sleep.
What is important here?
The patient feels the pain as if somebody has held her very tightly and she attempts to divert her attention. She gets angry during the pain and feels almost unconscious because of the pain. For her, the striking feeling is so bad and unbearable. She cannot talk to anybody and cannot sleep because of the pain.
D: Tell me more.
P: The arm muscle contracts and I feel as if it is held tightly and stamped. It hurts badly as if hit with a baton. The pain increases and increases, and it lowers my strength. Then, you feel tired. It is as if somebody else is striking you, as if something is hitting me and not stopping. That person is hurting me. I am trying to stop it. It is going above my limitation. I just can’t bear it. I am tired of trying to stop it.
What more do we get from her here?
The pain for her is as if it is held tightly and stamped. It is as if one is ‘hit’. It lowers her strength and she feels tired with it. Her perception is that it is going above her limitation.
P: I feel like weeping. I don’t want to answer when people ask me about it. I feel downcast. Why me? I feel shattered when they ask me. I get angry, irritated, furious. I bang my hand in anger.
Here we see some important emotions being expressed:
‘Weeping, downcast, shattered, furious, bang my hand in anger’. She feels she is hit and then hits her hand in anger. In addition to this, she has a feeling of ‘Why me?’. All of these descriptions are associated with emotions. From this explanation, we can conclude that the disease experience is intense at both the physical and emotional level.
D: What dreams do you get?
P: I am travelling in a car and the car is on a bridge. The bridge breaks and I am in the water. I try to save myself but the speed of the water is so much that I can’t do it. I am drowning, asking for help but no one is around. I am trying to come out of the water. I go completely blank at that moment.
In the situation in the dream, what is her individual quality?
Her individual experience in this situation is that she is trying to come out and at that moment she goes blank.
D: Any fears?
P: When I hear of tsunamis and all, I feel as if I am struck. What will I do if a tsunami comes?
From here we can see that we get the same sensation that ran through and through the case, and this was the sensation of ‘being struck’.
End of case.
Follow-up after two months:
After the remedy, the pain and tenderness in the keloid stopped immediately. In two months, the size of the keloid reduced by five millimeters. The blackish discoloration around the keloid also disappeared. She stopped getting angry and beating her sister and could concentrate on her studies. The patient’s father had taken a photograph of the keloid on the day her history was taken in our clinic. He made a power point slide comparing this photograph with a new photograph two months after the remedy was given.
Photograph of power point slide:
In the follow up taken nine months later we observed that the keloid had flattened and it had became soft. The pain never came up again.
What is her sensation?
The sensation in this case is: hit, struck and hurt. There is also an element of being very sensitive to touch, as it will cause pain. The same sensation is observed in all areas. This indicates a plant remedy.
What is the passive reaction?
The passive reaction in this case is: fainting, unconscious, and blank.
What is the active reaction?
The active reaction in this case is: anger and hitting. The plant family that covers this sensation, passive reaction and active reaction is the Compositae family.
The next point to be understood in this case is the miasm. What is the miasm in this case?
Some of my colleagues who watched the video of this case said that it was a malarial miasm because of the intermittent nature of the pain and the persecuted [‘why me’] feeling [somebody beating me again and again]. However, the features of the cancer miasm came up strongly. The patient perceives the pain as ‘too much’. It is beyond her limitation and she tries hard to stop it.
Do we give a remedy covering the malarial miasm or the cancer miasm?
A single dose of Bellis perenis 200C was given, which is a remedy belonging to the cancer miasm. What clinched the final diagnosis of the remedy was the following rubric:
- Cicatrices, keloid (Complete repertory)
Bellis perenis is one of the remedies listed under this rubric. The following symptoms of this patient are mentioned in Murphy’s Materia Medica and are covered by Bellis perenis:
- Pressure ameliorates
- Squeezing pain [sensation of being pressed tightly and stamped]
- Feeling tired with the pain
- Injury to nerves with intense soreness [radiating pain, touch aggravates]
- Tumors from injury
The presence of Bellis perenis in the rubric ‘Cicatrices, keloid’ means that this remedy has the power to produce and cure keloids. Producing this type of pathology is a unique characteristic of Bellis perenis.
Every remedy has its own special seat of action and the power to produce a specific disease process. The sphere of action and the type of action is always a characteristic symptom of the remedy.
In this case, the sphere of action is the scar tissue. The type of action is the tumor of the scar tissue (keloid) and the pain produced is a neuralgic type of pain. Bellis per belongs to the Compositae family whose main sensation is ‘injury’, both at the physical and mental level. The main feeling is that of being injured, hurt, there is fear of being approached, touched. The main ailments are from being injured, shocked, burnt, and the reaction is that of being violent, cruel and insulting.
|Sensation||Active reaction||Passive reaction||Compensation|