Don’t Be Led Astray by Assumptions – A Case of Constipation

Homeopathic case-taking and remedy-correspondence has always been compared with solving a ‘jig-saw’ puzzle. Often you find yourself in the jargon of pieces scattered together, with no clue around, but suddenly we find a piece that binds all unresolved sections and the picture evolves in front of us within a few seconds. It is not unnatural for a homeopathic physician to get addicted to this process, especially after experiencing this kind of ‘kick’. Most of the times, we find these resolving pieces by revisiting the data or from the follow-up discussion; but they can also be obtained from the family members’ assessment and inputs. This case demonstrates exactly the same…

A 23 yr old girl was referred to me by her aunt who is one my ‘patient families’. The girl was suffering with severe constipation since last 2 years. During the history-taking, the girl said that the complaints started after she lost her father. He was suffering from adenocarcinoma of the lungs that got detected in an advanced state, thus leaving no chance to save his life. His untimely death was naturally a shock for this young girl, and since then she started getting bouts of depression and later started suffering from constipation.

Constipation: soft stools yet expelled with lot of difficulty; with ineffectual urging

Hunger: normal but with easy satiety due to fullness of abdomen

Anxiety: health about, especially felt within abdomen – << constipated while, >> passing stools

Sadness: sudden bouts of sadness – << evening; << cloudy weather

= = =

The case primarily presented with the constipation resulting from grief and sadness after a shocking demise of the father. I referred to the repertory for a few rubrics (just to confirm the remedy in mind):

… and prescribed IGNATIA

02 Aug 12: First prescription = Ignatia 200 [1] + placebo x 2 wks

18 Aug 12: Status quo = Ignatia 1M [1] + placebo x 2 wks

03 Sep 12: Status quo = Placebo x 2 wks

It was this time, when the patient who had referred her came for her follow-up. She asked me about the progress of the girl. When I said, “there is a definite psychosomatic process behind her constipation, which is evident from the temporal correlation’ she said, ‘yes, quite likely! Can responsibility make you constipated?’

She told me that almost the entire family was disturbed due to the sudden demise of her father. For most it was the biggest shock, but not for our patient. She recovered quite well and did all the rituals in calm and composed manner. When I again asked for specifics related to the dates/onset of symptoms, she said the ailments didn’t start immediately after the demise, but almost 6-8 months later. It was the time when all familial and financial responsibilities fell upon her. There were many problems with the health-insurance and she had a tough time to settle all those scores. Even today she is the only source of income and feels that as a big load on her mind.

It was the time to get help from my dearest repertory by Dr Phatak…

The rubric ‘responsibility unusual agg’ was mentioned by DR Sankaran in his article on Phatak’s repertory. Her narration reminded me of that rubric.

17 Sep 12: Based on the etiological factor of ‘unusual responsibility’ I prescribed AURUM MET 200 [1 dose] + placebo x 2 wks

2 October: Anxiety 60-70% and Constipation 80% ameliorated = placebo

= = =

Once again a case that made me aware of my prejudices. I would need to work hard to make this a rare event.