The Constitutional Approach in Management of Acute Disease

This article is the second part of “An Approach in the Management of Acute Diseases” and I suggest you read my first article in conjunction with this one. In the last article we discussed the patterns in acute disease and I gave case examples of two of the four patterns which demonstrated how I approached this. In this article we discuss the remaining two patterns in the same way. In first article we discussed how to recognise the acute pattern and how, if the constitutional state is exaggerated, the person needs a constitutional medicine in acute disease. The question is how do we recognise that person’s constitution if it is disturbed by an acute attack or influence? The answer is, if the person is displaying these symptoms or criteria this would point to constitutional involvement in the acute:

–      a) a similar dream or the same dream he has had in the past during the period of acute attack

–      b) a past fear is exaggerated during the acute.

–      c) past or similar emotions come out very strongly during the acute influence.

–      d) similar thoughts or dreams or delusions frequently in different situations of

different acutes.

–      e) attitude or behaviour or personality is exaggerated during an acute attack.

−      f) There have been the same signs and symptoms during each acute attack in

the past

One precaution we need to take is, if we haven’t asked for a past history or directly asked the person to co-relate similar things in the past, we need to allow the person to co-relate present issues with the past incidences automatically, without our insistence or guidance.

Now, let’s try to understand these patterns of acute by two case examples…

Case-1

A 12 year old girl from abroad complained of not having any interest to do anything and constant coughing for the last two-three months. We usually talk or chat with her mother online.

These are the important points she wrote in her case record form:

−       I’m constantly bored and the only time I don’t feel that way is when I go for a walk or when I train. (She likes physical exercise so much.)

−       My hands and my feet are sweating constantly

−       My eyes often hurt from sitting at the computer or looking at the mobile-phone for a long time.

−       I have joint pain, back pain and neck pain

−       I have blepharitis (Homeopathy for Blepharitis) and short-sightedness. My doctor does not recommend wearing glasses for now.

−       I cannot stand the smell of Pelargonium roseum (A kind of plant from geraniales family)

−       I like being with my friends

−       I like walking for hours with many people

−       I like rock music

−       I love dancing Latino American dances

−       I’m afraid of dogs but only when they start barking at me or chasing me.

−       I’m afraid of spiders

−       I had a dream that I was in a forest with two of my girlfriends and there was a man with an axe who was chopping wood. He saw us and started chasing us in order to kill us but we managed to escape.

−       I dreamt that I was by the window at home and I saw the blocks burning and the fire was coming towards us and then I told my father to get ready so that we can run away. But he was very slow and in the end we went out in the corridor and the neighbour told us we could not get away because the lower levels were burning…and then I woke up.

−       When a schoolmate tore the diary and then the teacher blamed me. (Note from the mother: This happened a few weeks ago and since then the child is constantly coughing.)

−       When I had a quarrel with my best friend I felt really bad. I thought I didn’t have any friends. She meant everything to me…but that was before. Now it’s not like that and I have a lot more friends and she also found new friends.

−       I like sweets (chocolate, biscuits) I don’t like hypocrites.

−       I like people who are free to do anything they want without complying with others.

−       I love dancing

−       I don’t like babies. I’m annoyed when they whine. They always want something and they cry.

−       There was a girl named Kalina at school who told others some bad and untrue things about me so that they could hate me. She humiliated me all the time and she always did so that I was the one to be scolded.

−       I love to be with my friends. They mean everything to me and I value them a lot.

−       When I grow up I don’t want to work in office or something like that. I want to have a rock band with my friends. We’ll go on tours around the world.

−       When I grow up I want to be free, not to be obliged to get up early every day in order to go to work and sit in a closed office. I want to see the world, to see how other people have fun. I want to do what I love most –to play guitar /something that I haven’t learned yet/. I want my work to be my hobby.

Some important points I confirm in the live online talk…

D: Tell me everything about your interests?

(She doesn’t wish to talk with me, her replies are short and she isn’t interested in our conversation. That’s why I begin with what she likes a lot.)

P: I like rock music and I wish to be a rock star when I would become older.

D: Now, forget yourself and talk about being a rock star?

P: Rock stars are people who live life according to their wishes; they are totally free and do what whatever they want. They never bother for anything. Their life is full of fun and happiness and they never get bored with their work. They travel a lot and live a glamorous life. They never think how others think about them. They are completely different guys, and never want for anything. They never get tired from traveling and playing music, they can even play music constantly night after night.

D: They never get tired?

P: Yes, they hardly get tired from traveling or playing music day after day. Their capacity is extraordinary and they like this kind of life so never get bored from it. Even though it’s hard physical exertion they become happy and full with fun when they are playing music. They forget the entire world when they play music and just play music like a mad man.

(This is very interesting…Rock stars have extraordinary physical capacity and they hardly get bored or tired from constant physical exertion and in her notes from case record form she mentions that she only feels better when she walks long distances and she never gets bored when she walks. So this is the pattern that runs in the centre of the case.)

D: Okay I understand. Now talk about what happens when you smell Pelargonium roseum plant? (It’s peculiar her sensitivity, so I want to know more about it.)

P: We were in my granny’s house in a village where accidentally I smelt this plant and I don’t know that it causes any reaction to anybody. It looks like a beautiful flower so I smelt it and it made me mad. After half an hour I was under total influence of that smell and I start behaving as if I had taken a drug or drunk alcohol. It was terrific experience as if I’m in different world and everything looks beautiful and wonderful and I’m not walking on the ground but I’m stepping in the air and just jumping from here to there. It was a terrific experience.

D: Just tell me more about that experience?

P: It’s as if I was under the influence of something and behaving differently and smiling without cause or talking and talking constantly or just becoming restless and doing the same thing constantly. The effect went away slowly.

(Note from the mother: she doesn’t have any interest in anything, not in study, school, home, with her parents, with her sister and even in eating. She makes a bad face about being asked to do small things and complains that she gets bored from this. Her behavior is disrespectful to everyone even her teachers and at school she is a headache for the teachers.)

Analysis:

The most interesting point in the case is her typical sensitivity to that plant. This was the first time I had heard about this plant so I looked it up in Google and I find that a number of people do have a sensitivity to this plant but nobody gets this euphoric effect. So the drug like effect it has on our patient is very specific to our patient only. When she explained the experience of the Rock star she also described this drug like effect so it became clear for me that she needed a drug remedy. Another interesting thing is the polarity of boring and fun that runs prominently in the whole case. Boring and tiredness and the opposite of extreme power to do any-kind of constant physical exertion without getting tired or bored. So we want a family which has this polarity. The Geraniales family has this polarity in its general themes and the plant she was sensitive to belongs to geraniales. Coca is a drug remedy from geraniales so I read about coca in the materia medica and prescribed Coca 200c.

Follow up after one month:

After this she changed a little bit and she an had interest in staying at home and her cough became wet, but it didn’t reduce.

Follow up after two months:

Her coughing stops and she has more interest in life and becomes more normal but according to her mother she is still lazy and takes a long time to finish her routine work.

Totally she needed 3 doses of coca 200c in 5 months.

One morning her mother sends me a message that her daughter has fever and flu and she needed my help. (mother is a homeopath)

Acute case taking:

Like last time she didn’t want to talk with me. Her laziness had increased and she didn’t even want to get out of bed. She stayed lying in bed and answered all questions through her mother, not with me.

−       I want to sleep all day and don’t wish to do anything. I can’t see properly in the light and need to close my eyes in lights. I can’t bear noise, so sleep in my room silently. I have pain in both sides of neck, so I’m not able to move my head.

−       My voice is little bit heavy and hoarse and my throat is pinkish but there is no pain in my throat.

−       I can’t drink water because it tastesbitter; I can eat anything but liquids taste bitter.

−       I don’t want to move anywhere even in bed I sleep silently.

−       This has all happened since the weather changed from very hot to cold suddenly.

Notes from mother:

−       She doesn’t get out of bed at all, day or night and doesn’t want to wash. She is so dull that she hardly sits up, even though she is awake. Before the fever she was dull and weak but now it is much worse. Generally she refuses to do any kind of work even school work.

−       She answers very slowly and thinks a lot in between during answering.

−       Her temperature is not as high nearly 37° C

−       She wants somebody with her constantly to talk to her or help her in doing small things. She doesn’t wish to be alone since she has this problem at night.

−       I ask for her dreams or unusual thoughts but she had nothing to say.

−       She complains that since this problem she can’t see properly. (Before the acute she had the same problem and she wrote this in her record form.)

−       She can eat normally but drinks little and says drinks taste bitter.

−       She generally prefers to eat vegetables but now she likes them even more.

−       I went with her for a little walk and during the walk she described these feelings…“my legs are too long and I’m making long-long steps during walking”

Whenever we see that a person has same kind of experience in the past as he or she had during the acute then it is confirmation that he needs a constitutional medicine. We can confirm it in different ways:

1. If he has the same recurrent dream during the acute as before.
2. If he has the same strong fears during the acute which he normally has
3. He has the same emotions which he normally has, i.e. not only during the acute.
4. He has the same thoughts or dreams or delusions frequently in different situations of different acutes.
5. His general attitude or behavior is exaggerated during acute attack.

Analysis:

In this case we see that her original state is exaggerated during the acute. She becomes more dull and more sleepy and has much less interest in anything. We weren’t able to find any deeper information at the mental and holistic levels but we have some peculiar symptoms at the physical and general levels and some symptoms at the mental level, so here the acute influence is not so strong, so it is not able to produce deeper turmoil and that’s why she requires lower potency. I select the following rubrics and prescribe Kreosotum 30c potency one dose and advise mother to report to me first and then repeat a second dose tomorrow.

 Follow up next day:

During my chat with her mother she was playing outside and there was nothing else to say to me. It was the biggest surprise for me and her mother because one single dose of the medicine cured her completely. I advised the mother to wait and watch and if anything comes back then write to me and we will give her a second dose.

Follow up after month: 

She is eager to talk with me and this is a great surprise for both me and her mother. Her Mother says she wishes to thank you and she has been waiting for her appointment. During our live talk she is completely changed. Her pattern of talking her behaviour and her attitude towards me is totally changed. Her Mother mentioned that her teachers could not believe that she is the same girl. She has improved in her school work and is taking part in extra activities at school. It was a miraculous effect from a single dose of 30c.

Follow up after three months:

She didn’t require a dose after first dose of 30c and she is still improving. Her mother says she has asked for extra math classes in a different city from us. This was a big surprise for me, because before she didn’t want to study anything and now she has an interest in extra classes.

In total she required one dose of 30c and one dose of 200c during a 6 month period. She is still improving day by day and everybody says to her mother that she is much more grown up.

Note: Her some chronic issues are better with Coca but after Kreosotum her entire personality changed.

Case-2

A 10 year old boy had complained of bronchial asthma.

D: Tell me everything about Meet?

M (Mother): He frequently has a cold and shortness of breath. Till the age of 7 he was never ill but suddenly he had one spell of a cough and cold which carried on for one month and the doctor diagnosed it as bronchitis.

D: Tell me about any changes in Meet after the bronchitis?

M: Before he was a good boy, but because of the constant coughing now, he irritates a lot in small things. Now, he gets tired and has no interest in anything. Because he is tired He is not ready to go to school in the morning.

(The boy’s nature changed after bronchitis and now he has recurrent attacks of cold and cough. This means he had the same spell of illness with same signs and symptoms. This indicates his constitution is sensitive / susceptible to bronchitis and he requires a constitutional medicine.)

P (Patient): When I don’t go to school? (He interrupts our talk and jumps in between our interactions.)

M: Oh, that was not my meaning, you are not ready with your books and bag and all during the school time. This is the way he gets angry. Always disagrees and misunderstands my conversation and always answers this way as if everybody else is wrong and he is the only correct person. Sometime he is startled in sleep. When he was child he used to wet the bed.

P: Now, I don’t wet the bed!

M: (Smile) Yes, now he becomes older and doesn’t wet the bed. He is always the first person to get a cold and cough in our family, even a slight change in environment or change in the food. He had that long spell of illness and finally the doctors put him on an inhaler and he slowly improved. One thing I note doctor, he is a very lazy boy and gets tired now and then, but whenever he has a cold or coryza then he becomes alright and takes part actively in all work and activities at school as well as at home.

D: What is it, just explain again?

M: Basically he is lazy and always says “no” to extra than his routine, but whenever he has an illness he demands to go outside and do some extra activity like visit super market or visit zoo. In short his energy gets increased during his illness and become more active. Then there is not even a problem to get him prepared to go school and get up in the morning.

(We obtain a lot of beautiful information from his mother. Nnow we confirm this information with the patient and try to understand more changes and everything as completely as we can.)

D: Okay, I understand. Now I wish to talk with Meet alone, so will you please sit outside?

M: No, problem.

D: Meet, will you explain as much as you can about you and your problem?

P: I do not like anybody who tells me something again and again or anybody who tries to irritate me. I cannot tolerate it when my mom says no to me whenever I wish to do something or go somewhere. She always tries to find fault in me that I don’t like. I am never wrong! Sometimes my sister or my mom may be wrong, but they never agree with me. Anybody who tries to contradict me I don’t like that at all, even at school. Because after that I get angry, with my teachers as well. I answer anybody back.

D: What do you feel at that time?

P: I feel so angry. Why don’t they understand me. I answer back to anybody except my school principal and my father. When they contradict me I feel as if they try to obstruct me. (HG) I don’t sustain any kind of resistance; I wish to go my way. Whenever anybody tries to hinder me (HG) I can’t tolerate that. Suppose I wish to go to my friend’s home, why does my sister have to tell my mom?! She always tries to restrict me whenever I want to go outside. She is always an obstacle in my way.

(He sees contradiction in the form of obstacle! This is totally illogical because nobody till today describes contradiction as obstacle, so we need to explore it more.)

D: Okay, now forget your sister and all; we are not talking about them. Just tell me what you feel when you have obstacles?

P: I feel as if she is disturbing me. She is putting stones in my way, always! (He gets angry) I don’t like anybody’s disturbances. Anybody try to keep me stuck in one thing i don’t like. I wish to follow my own way of working. Sometimes I wish that I have an easy and smooth life without that disturbances and obstacles! It’s only possible when my sister gets married and that’s a long way off because she is only 15 years old. (Smile)

D: Okay, now forget about your sister; just tell me what is an obstacle in general?

P: Obstacle means…there is good road and suddenly you have big stone right in the middle. Suppose you are driving a car and suddenly a dog or cow comes in your way, which makes you irritated. You are going smoothly with ease and suddenly something that tries to hinder your way is an obstacle.

(Obstacles means “something makes you stuck , disturbs you, hinders you and you lose your own easy way”.)

D: Okay, now tell me about your dreams?

P: I rarely have dreams. Doctor, are you confident that you can treat me ? Because I’m sure my disease is incurable or will never get cured completely and that’s the reason I become sad and I’m not interested in doing anything.

Analysis:

He is sensitive to contradiction but when we examine at a deeper level it turns into sensitive to disturbances and obstacles and the opposite is the smooth easy way. This is the sensation of ‘Cruciferae family’. Now I looked into some characteristic symptoms of his basic nature/personality and I found this symptom very peculiar…his weakness and dullness or tiredness goes away when he become ill. Generally people become weak and dull during cold and coryza, but in contrast he becomes active.

The second thing is his entire being gets disturbed because of his illness and everything is exaggerated, so it indicates involvement of the whole state and we can see the disturbance is at the deeper level because we are clear for the systematic method (kingdom, family and miasm) understanding also. So, he requires his constitutional medicine in a high potency.

I select the following rubrics and prescribe Sinapis Nigra 1m for one day.

 

Conclusion:

In total he required 5 doses of Sinapis Nigra 1m in one and half years. His recurrent attacks of cold and cough have totally stopped and in his nature he has become more calm and mild and never tries to answer back snappishly.

This is the beginning of our journey together and let’s be ready to have fun all the time in each issue of our beloved e-portal of Hpathy and Homeopathy 4 everyone.