Clinical Cases

Clinical Cases

The eminent Eugenia Candegabe presents 6 cases to demonstrate important principles of casetaking.

Translated by Katja Schuett and Alan Schmukler

Case no.1

F.L., 55 years, widower, merchant by profession. He came to consult me because of his aphonia from which he suffered for ten years, and which was caused by recurrent polyps on both sides of the vocal cords. He also came to see me because he was about to get another surgical intervention.

The study of mental and general symptoms only revealed a few characteristics. He is an active man, impatient, picky at work, and he is called, “the easily angered man”. He was not too preoccupied after a major economic breakdown two years ago. He is cheerful, prefers company, and likes good food with a preference for seasoned food and seafood. Profuse perspiration from exertion on the head and chest when it’s hot. Puts on weight easily. Makes a self-assured impression and that he knows what he is doing. Weariness in legs. When walking around the block the walk becomes a torture with burning pain and stiffness.

As this symptomatology only gives us a vague diagnostic presumption we cautiously consider the prevailing local symptoms. He complains about aphonia in the morning, painless, and has difficulties using his voice which converts into a whispering, caused by the pathological anatomy of polyps. All his life he has had a very deep voice, which called the attention of bystanders.

REPERTORIZATION

Symptom

Page

Voice, hoarseness, morning

759

Voice, painless

760

Voice, low

761

Voice, whispering

762

Polyps, larynx

755

Heaviness, lower limbs, while walking

1016

Perspiration, during slight exertion

1297

Obesity

1376

The only remedy that covers all rubrics is Calcium Carbonicum which had a surprising effect in 200C. It did not only cure his aphonia and polyps but also changed the tone of his voice in such a way that he was the subject of cheerful comments from his relatives and friends.

This seems to contradict the law as the symptom’s order of hierarchical disappearance is from local to general. However, this can be explained considering the information given in §153 Organon: The patient’s “most striking, uncommon and peculiar symptoms” are just those which correspond to the alternation of his voice. And why? Because this is a defective disease in which the capacity of the vital force to express it’s disturbance with symptoms is blocked – Psora – and where the secretive Sycosis manifests with its hydrogenoid tendency – obesity – and the exonerative, proliferative tendency – polyps.

Beyond the repertorization which is a useful guide for prescribing purposes, we can see that the chosen remedy fits the experimental idea of our patient perfectly: he is “fat, tired, perspiring, and self-assured”.

Case no.2

Patricia K., 3 years old. She was brought to the consultation with the following symptoms: Flat wart on the palm of the right hand, three millimeters in diameter, since forty days. Frequent colds, which occur one after the other, and with nasal obstruction at night. Loud and sibilant cough, worse on lying down. Chilly. Very offensive perspiration of feet. Anorexia; only wants to eat salty food, cheese, ham, small aperitifs, salt, dips. She has a cheerful character, wakes up happily, and is intelligent. But she gets easily annoyed, gets angry and cries if she does not get immediate attention. She often screams: “Why should I wait!” But the most striking symptom is her fear of physicians since she has been operated on due to appendicitis at the age of 19 months, and which is why each of my gestures during the consultation is watched with suspicion. On the other hand she fears darkness and windup toys. Her general appearance is that of a thin and fair-haired child, who stays near her mother with a certain level of timidity and evident suspicion.

As this case can mislead us, we first define the principal symptom. There has been nothing abnormal with her operation, neither before nor after, that justifies her pronounced fear of physicians, which each of her relatives has noticed. Obviously this is the fear of evil which appeared after this first surgical experience, which is remarkable considering her age and the care given by his family afterwards to prevent the development of this apprehension. Therefore, the first characteristic symptom for repertorization is the fear of evil.

REPERTORIZATION

Fear of evil

Desires of salt things

Dictatorial

Cold in general, agg.

Perspiration foot, offensive

Warts, hands

Page

44

486

36

1348

1183

1223

Causticum

2

2

1

2

0

3

Calc carb

3

2

0

3

2

3

Cocc

2

2

0

2

0

0

Nat mur

2

3

0

2

1

2

Nit ac

1

2

0

3

3

3

Phos

2

3

0

3

2

1

Sulf

1

2

0

2

2

3

When considering that Causticum is the only remedy that covers the mental symptoms in their totality we should choose this remedy due to the greater hierarchical value of mentals, even if the total sum of grades for this remedy is lower than for others, as this mental attitude of being fearful of what others could do to them, mixed with timidity and tyranny, is only typical for Causticum.

At first sight, would we not have chosen Lycopodium for a fearful and timid child who is dictatorial, and being guided by intuitively knowing that it is a thin, bossy and intelligent child? The total healing of this child by means of a single dose of Causticum 200, which changed her character in such a way that she lost her fear, increased her weight, does not feel that cold anymore, and which let the wart disappear, confirms the choice of the remedy, and our disregarding the remedy which appeared to be the right one “prima facie” for an authoritarian child with offensive perspiration of feet.

Case no.3

Warts on hands and fingers do not only belong to Causticum, also not in cases with few symptoms like the previous case. Let’s study the following case:

Emma R., 40 years, single. She came to consult me because of a wart on the right forefinger which had the size of a chickpea, and which was suppurating after it had been tried to be “cured” by means of cauterization with silver nitrate. She feels very hot, and has a phobia of enclosed places. She talks vehemently with a certain tone of superiority, and reveals being affected by seeing others suffering and that she loves children. Unfortunately, she does not have children due to her failing relationships.

The following symptoms indicate Lycopodium as the only remedy which cured the patient. The wart slowly disappeared within two months.

Haughty

p.51

Sympathetic

p.86

Fear,narrow places

p.46

Warm agg.

p.1412

Warts, fingers

p.1224

The purpose of describing this case is to show that the three characteristic, mental symptoms were obtained by letting the patient talk freely and at length without that further “a posteriori” questions, which contributed more information. In a certain way this was a defective disease with only one general symptom of warmth, and the local symptom of the wart. However, even if the wart has been the reason to consult me, the mental symptoms are of primary importance and evident as soon as we would think of them.

Case no.4

Here I present a case full of symptoms which appeared clear and perfect to me so that they should not be missing in the remedy and therefore be repertorized, and because I have learned during the course of years that one of the greatest difficulties in proper homeopathic case taking is to interpret correctlywhat each symptom wants to express.

Elvira G., married, 6 children, consulted me in March 1965 because her husband has grown apart from her after her last birth in 1960. “I suffered a lot and could not overcome it. I felt tired with the constant desire to weep which was only ameliorated by the company of my children which seemed beautiful to me.” She suffered from dyspepsia which was worse from fat and butter. Her body hurt all over, she suffered from occipital headache and a cold sensation in the back, like frozen iron. Fresh air ameliorates. Scanty menses. Offensive perspiration of feet. She reports that she had been a timid child, docile, and subject to a rigidly structured home. She confessed to have married because he might have been the only man to look at her.

Her history reveals the classical tonsil surgery, and that her liver has been affected – fever, headache, vomiting -, apart from an eczema behind the ears in early childhood and allergic rhinitis in adolescence. But what afflicts her the most is her despondency, sadness and weeping. She expresses her mild and resigned lamentations without any apparent rebelliousness.

Since December 1964 she suffers from severe weakness in the waist and back which is worse when standing, and whose pain extends from the nape on one side and the toes on the other side, with the sensation of a weight and stitches. She feels worse at mid-morning, and from cold. Heat makes her depressed, and her menstruation became scanty. She feels lonely, terribly depressed, and permanently betrayed. Everything makes her feeling sad and terrible, like pleasant memories from other times. She has lost her memory and feels unable and insecure to resolve, doubting everything with desperation, and trying to find someone to consult for banal solutions. She tends to isolate herself so that her family does not take notice of what is happening with her. How she needs the support of someone who understands her, which is what she is missing so much! And this is truly what makes her ill, as she told me about her martial situation and that her husband is an irresponsible man who does neither have moral competence nor gives material support to his home.

With this clear case history and synthesizing the picture we find a poor woman in need of support, who lacks confidence in herself (Confidence, want of self, p.13), and who has a strong feeling of loneliness and abandonment (Forsaken, p.49), after the experience of severe grief (Grief, ailments from, p.51). She doubts everything and is meticulous (Conscientiousness about trifles, p.16), feels worse when standing (Standing, aggr., p.1403) and in the morning (Morning, aggr., p.1341), as well as from fatty food (Food, fat, aggr., p.1363), and from cold and heat (Heat and cold, aggr., p. 1349). She suffers from offensive perspiration of feet (Perspiration foot, offensive, p.1183). Presenting this symptom picture I happily prescribe Pulsatilla 200 and later 10M.

May, 1965. The state of mind, digestion, and menstruation ameliorated; there appeared a crusty, marginal skin eruption on the scalp which makes us content. The pain in the legs increased and there appeared an edema in both ankles. We decided to wait because the law of cure is obviously followed with symptoms developing from center to circumference. Placebo.

June, 1965. She feels very cold, the pains further increased in intensity. Walking is difficult and the picture of rheumatoid arthritis seems to emerge. She has the sensation of stiffness; prefers to be alone and to go unnoticed. The children bother her and complain that she is an embittered person. She sleeps with her teeth clinched, is indifferent, and does not enjoy talking or anything else. She weeps when talking and complains that her husband “tries everything to harm her”. She talks about the past and of not having siblings, and that she was unfriendly with her father although he is a very loving man. She missed him badly when he died. Today she became more human and understands people better. Feeling desperate and mortified she feels like a prisoner in her house.

Obviously, the disease got worse as the local aggravation was not accompanied by a real mental amelioration but only an alleviation due to the catharsis experienced from talking with the physician. Now, three more symptoms are revealed: “consequences of mortification” (Mortification, ailments from, p. 68), “constantly talks about past, disagreeable matters” (Dwells on past disagreeable occurrences, p.39), and “aversion to company” (Company, aversion to, p.12). Integrating these into the previous symptom picture I rectify the prescription and administer Natrium muriaticum, concluding that the rigidity is the expression of contained anger. Nat-m 1M.

September, 1965. Slight amelioration. Walking is a little better as well as the state of mind. Digestive disturbances returned. The conflictual “stress” continues and she emphasizes the lack of security due to the total loss of memory. She always feels criticized, observed, and watched. She finds the topic of money sickening. Suppresses the anger about her husband. Natrium muriaticum10M.

December, 1965. She is more decisive and aggressive. But the pains persist, she walks with difficulty, and the eczema on the scalp got progressively worse until covering the whole cranium. The nail of the right big toe is ingrown and suppurates since a month, and there appeared some pustular eruptions. Each wound becomes infected. Then I remembered her meticulousness and poor self esteem when marrying, and considering the “folie du doute” and offensive perspiration of feet the picture of Silicea emerges, although not much convincing, but which seems to be justified by the appearance of the last symptoms without there being an amelioration of the previous symptom picture. Silicea 1M.

March, 1966. No amelioration. She was worried about the result and revolted against me for not being able to cure such a suffering patient, and that she understood well my honest desire to help her. After repeating once more, and without expressing hope, the sad story about her bad state, I ask her: Amid all this, how do you feel ? “Doctor, I feel sad, very sad. Everything afflicts me, but the pain has made a better human of me because I understand all the suffering people. I suffer with them and want to help them. Each day my memory gets worse and amid all my sadness I think that something happens to me or that something will happen to my children. “These poor little fellows! Hopefully, they will be more happy in life than me. I even became fearful. Do you know that I fear to loose a molar, to feel pain, and to have an accident?” She spoke softly and without resentment, expressing her grief which developed from the failure of her life. Her arthritis was worse, especially in the ankles, which prevented her from walking. The rigidity seems to be the somatic manifestation of her moral suffering in life.

Finally, the case clearly offered distinct features. I realized that her feeling of abandonment was a common symptom as she was really abandoned. Each other woman had also suffered great pain from such an injustice. The act of Mortification does not necessarily implicate the etiological condition of being mortified. The determinant features of the personality which developed in this debilitated and defeated woman due to the difficulties of her life, were ailments from grief, sympathy for her fellows, the fear that something will happen to her or her relatives, the sensitivity to cold and heat, intolerance of fatty food and stiffness of ankles which prevented her from walking. These symptoms correspond to the following repertory rubrics:

KENT’S REPERTORY

Grief, ailments from, p.51

Sympathetic, p. 86

Fear, happen something will, p.45

Cold, heat and cold, aggr., p. 1349

Food, fat, aggr., p. 1363

Stiffness, ankle, p. 1195

Causticum

2

3

3

2

2

3

6/15

Lycopodium

1

1

1

2

0

2

5/7

Natrium mur

2

3

2

1

1

1

6/10

Pulsatilla

1

2

0

1

3

0

4/7

In this case the extreme irascibility with anger and bad humor of Nat mur was missing as well as the suppressed impetuous aggressivity caused by the frustrations of life which are the foundation for resentments. It is Causticum’s sadness with its anxious fear and desire for affection and protection, which is projected due to one’s identification with the excessive grief suffered by others. Here it’s worth remembering Kent’s words: “Great stiffness of the joints, and while this is going on, the patient is growing weaker, is running into a state of melancholy, of hopelessness, anxiety and fear. Constantly present in his mind is the hopelessness and a feeling that something is hanging over him, that something is going to happen. These are general features of Causticum. They all go to make up one picture, they are inseparable.”

Since then she took two doses of Causticum 200. The amelioration was spectacular, beginning with her state of mind and attitude towards life. There appeared conjunctival irritations with pain and suppuration which were left without intervention. Walking was much better, she was more optimistic, the eczema ameliorated as well as the offensive foot perspiration, a symptom which is not covered by Causticum. This proves that the simillimum which covers “the minimal syndrome of maximal value” restores health in its totality, by following the law of cure, although it does not have some lesser important symptoms in its pathogenesis.

Case no.5

Pedro S., 51 years, toolmaker, married, two children. He consulted me because of his nervousness, and his fear of diseases. He feels intensely depressed when a known person dies, and he often looks for his pulse because he suffers from palpitations when being nervous. He is easily angered and likes to be quiet and undisturbed when working, which is where he feels most secure. He says his is under constant tension, which was brought about by severe quarrels within the family, which he has had since being very young. He does not want to make any further comments, only that this has made him “to believe in nothing and nobody”. Since being a child he has had almost no friends, he feels mortified by the situation of his country, and by peoples’ attitude or anything that he considers to be unfair.

Despite this he considers himself to be a very good comrade of his children and relatives. He feels uneasy about their diseases and fears something might happen to them if someone is late. His tension causes him to startle from the least noise and causes anxious palpitations. He feels disturbed by heat which puts him in a bad humor. Since being very young he easily loses weight despite eating well. He hates being enclosed, and always wants to have the house ventilated. He is a tall and robust patient, who gives the impression of not wanting to waste words. His wife says that “he has a very straight character and does not tolerate half-measures”. The remaining interview does not elicit any further information but there are sufficient hints to make an exact diagnosis. Analyzing the reason for his nervous state, we consider that he has told us about the great difficulties with the family in the past which have caused so much damage that he does not believe in anything or anybody. This caused him to form a resentful attitude towards the world, based on his biological predisposed psyche, and not to have any friends since being a child. He was not able to handle the anxieties which the frustrations of his life caused, which lead to the exaltation of his aggressiveness and to feeling tense, accompanied by being easily startled and palpitations. And on the other side, their repression causes the feeling of guilt which forms the foundation for his fear of others. As the repertorization should only consider the authentic symptoms to avoid prejudices the following symptoms are considered:

Fear of impending disease, p.44

Fear, happen something will, p.45

Mortification, ailments after, p.68

Starting, noise from, p. 83

Palpitation, heart, anxiety, p.874

Warm, aggr., p. 1412

Nat mur

2

2

3

0

3

1

5/11

Ph-ac

2

2

3

0

3

1

5/11

Phos

3

3

0

0

3

1

4/11

Lyc

0

1

3

2

2

2

5/10

The chosen remedy was Natrium muriaticum which proved to be correct as it initiated the cure in this patient of his feelings of resentment. A single dose of Nat-m 1M was left to act for a year after which the patient’s attitude towards life had substantially changed. Consequently, his fears disappeared and he changed into a calm person, without having problems. The full comprehension of the human personality based on pathobiography demands the highestconscientiousness in the medical art to determine the correct valuation of symptoms. A patient who says he is a very good comrade of his children and is excessively concerned about the fate of his relatives lets us first think of the remedy picture of Natrium muriaticum.

Case no.6

Lorenzo C., 53 years, single, working in the rural area. He came to consult me on 9/14/1965 because he suffered from nausea since three years. His vision is clouded, there is gagging, retching, and vomiting. He sways when walking and has to hold onto the wall because he has the feeling he is drifting to the right side during a crisis. He has been in the Argerich Hospital, in the department of neurology and the department of ENT where Meniere’s disease was diagnosed after a comprehensive examination. The prognosis was that “he either could be cured in months or years or never be cured”, of which the last assertion seemed to be the right one up to this date.

Rectal fistula. No special antecedents. General symptoms: rather cold. Always profuse perspiration of head. Constant sensation of heaviness, mediofrontal, like a wedge, which impedes clear thinking. Physical aspect: he is a tall and robust man, bloated face, stooped posture.

He is surprised because no other physician has asked him these type of questions, and what happened in his life when he became ill. He said that he felt excessively shocked when his mother suffered from severe arteriosclerosis. When he went to the hospital to visit her, he felt that the view of the patients, gurneys, appliances, and operating rooms did not augur well: He even cried when meeting the physician and before an unimportant consultation. For the same reason he avoids seeing movies or reading stories which are about accidents, crimes, or which contain violent acts. All his gestures are slow and deliberate, which he tells is his usual way of behaving. It is almost funny to observe, as if in a room of the Neuropsychiatry of the distinguished Hospital of Buenos Aires, facing a case labeled Meniere’s disease “sine materia”, without the physicians having the idea about a possible connection between the disease and a determinant psychic causa. It is evident that our patient, who has an extreme fear of diseases and is on the verge of crying when entering the consultation room because of some unimportant pain, has suffered a tremendous stress when visiting his mother in the hospital and experienced her death as if it were his own death.

REPERTORIZATION

Fear, disease, of impending, p.44

Slowness, p.81

Horrible things, sad stories, affect her profoundly, p.52

Vertigo, falling to right, p. 99

Perspiration, scalp, p.221

Calc carb

2

2

3

2

3

5/12

Phos

3

3

0

0

3

3/9

Sep

2

2

0

0

2

3/6

Thuj

1

1

0

0

1

3/3

Calcarea carbonica clearly emerges from repertorization, which cured the patient’s impressionability, vertigo, and the rectal fistula, after three doses of Cal-c 1M and one dose of Calcarea carbonica 10M during a year of treatment.

@This article was first published in „HOMEOPATIA“, Revista de la Asociacion Medica Homeopatica Argentina, (Junio-Julio-Agosto, 1966) and is republished with friendly permission of Dr.Eugenio Candegabe.

About the author

Eugenio Candegabe

Eugenio Candegabe

Dr. Eugenio Federico Candegabe is Argentina"™s foremost exponent of Kentian Homeopathy. He was born on 28 July 1924, and qualified in medicine at the University of Buenos Aires in 1949. In 1954 he went on to study under Dr. Tomas Pablo Paschero, with whom he subsequently worked closely. He is a founding member of the Escuela Meodica Homeopática Argentina "Dr. Tomas Pablo Paschero" (E.M.H.A.), where he has been nominated for Professor Emeritus.

6 Comments

  • I am very satisfied to this type of case history which you are uploading time to time thank you and hope this type of clinical cases we will get in near future thank you again .

  • really speaking, only by perusing such classic articles we can whet our brain to do more and more service to the sick as well as our great homoeopathy. thanks a lot for your efforts.

  • highly educative.causticum and phosphorus both want cold drinks both kind hearted.dr kn kasad eminent homeopath words are that phos full blown picture is agonizing chilly and burning active euthanasia.causticum is disturbed by poor plight of others and phos extrovert is sympathy beggar.books say causticum is for paralysed tissues in parts esp face bladder area whereas phos is multiorgan weakness created by fatty degeneration.saying that there is thin difference between friend and foe clinical operational use of causticum and phos is a puzzle.kindly make it convenient to throw deeper light as these two remedies are well known to pray before dharamraj delete ones name from the list and let enjoy world for some moretime.with regards.

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