A Long-Term Case Study of Phosphorus
Reprinted with permission from the journal Spectrum.
The rows of the periodic table mimic the development of a person, beginning at birth and ending in old age and death. If we perceive that a patient belongs to the Mineral Kingdom, we must find the stage of development that he is stuck in, and then pinpoint the row.
In the Third Row, the main issue is the development of one’s identity and the expressions of it as image, choice and ego. The central question in this row is “I am separate, but who am I?”
The third row represents the progressive development from dependence to independence in the areas of care, nourishment, and choice. If your inner song comes from the third row of the periodic table, you exist as an entity on your own, but you are apt to be unsure of your identity.
The elements of this row are Sodium, Magnesium, Aluminium, Silica, Phosphorous, Sulphur, Chloride and Argon.
From Sodium to Aluminium there is an absence of individual identity. Sodium feels that he has an independent existence, but he does not have a distinct identity or capacity to find one. There is no sense of identity and there is confusion about him. Magnesium is starting to build his own ideas but he is afraid of expressing them. He is scared of being forsaken if he expresses himself, so he adopts the identity that others want. Aluminium is confused about his identity; he is not certain whether he has an independent personality or if he is what others want. Silica is sure about his identity and he has a well-defined image of his own. Phosphorous has an identity apart from what was given. Sulphur is proud of his identity and he knows that he is better than others. Chloride has an identity that is the opposite of what was given. Argon has his own identity and he is happy with that.
Individuals in this row have developed the structure of existence and are separate, and now it is the stage where the child (or an individual stuck at this stage of development) starts discovering and asserting his own individuality and identity.
It is the stage of development in a child of approximate age 3-6 years where he begins to develop and assert his choices, to develop and demand the ability to do things for himself and to become conscious of himself and of other peoples’ impressions about him.
It is also the stage where the child needs warmth, nourishment, care and emotional support. It is also when children start developing fears of natural, unknown and unfamiliar things and start realizing the difference between the known (familiar) and the unknown (unfamiliar) and between right and wrong. There are also issues related to growth and development.
In my practice I frequently encounter cases that require row 3 remedies, which have led me to believe that the issues of this row are of great significance for adults as well. It is an important issue in man to develop his individuality, have an identity, choice and ego.
One has to keep in mind that this row is not indicated only for children’s cases. Any individual, irrespective of age, stuck in this stage of development will need a remedy from this row and they will show all the features mentioned here.
Developing Their Identity
This is the stage where the child has developed its physical existence and established separation from the parent figure, so now they are ready to develop and express their individual will (or choice). In order to exercise his will he is also developing the ability to be independent. In
the beginning of the row (left hand side) this issue is undeveloped but as the row advances, the development happens.
For example, “Which clothes should I wear for the party?” So far the parent decided for them but now they have their own choice and they want to act accordingly. We see children at this stage where they start knowing what they want and becoming clear about their preferences and choices. For example, they know what color or style of dress they want, or what game they would like to buy or what they want to eat when they go to a restaurant. They start becoming very clear about this and also start expressing it.
Along with the development of identity comes the feeling, ‘This is mine and not yours. This is mine and that is yours.’ So the child starts recognizing what belongs to them and what doesn’t belong to them.
In Sulphur, these feelings are well-established and expressed as selfishness or self-centeredness. It’s a more advanced development of a sense of self. On the other hand, Natrum, as the first of the series, will totally give up everything for the other person. Depending on which column the person falls in, they may either give up (identity), or become confused, or insist on their choice, or try to get their way with the parents in letting them decide or they outgrow this stage and it is not an issue anymore (like in noble/rare gases).
Developing A Sense Of Right And Wrong
They want to be the one to decide for themselves what is right and what is wrong, rather than being told by their parents. At best they are willing to listen to the parent given the pros and cons of a situation, but they still want to be the ones to decide. This can lead to conflict with the parental figure and the child may be called stubborn or contrary or rebellious. This sense of right and wrong will later on in life develop into the feeling of conscience.
Comparison With Row 4
In Row 4 this feeling about doing anything right or wrong has more to do with issues of legality, social acceptability and crime: “If you do something wrong then you can be caught, punished and put behind bars.” It is more about cheating somebody or being dishonest in a criminal sense. Right and wrong in row 3 is about deciding for oneself what right and wrong is, rather than accepting the definition of the other. This is a part of developing ones’ identity and individuality.
Doing Things For Themselves
At this stage children start developing the ability to take care of themselves and their basic needs and start developing the ability to make decisions for themselves. For example, they want to comb their hair or tie their shoe laces or pack their bags. They want to take care of their own basic needs by themselves.
When a person needs a particular remedy from this row, like Magnesium carbonica or Magnesium sulphurica they will say in the chief complaint, for example with rheumatoid arthritis, “You know doctor, the problem is that I am not even able to comb my own hair. I need someone to do it for me.”
Here the pathology rather than the delusion or the sensation, will predominate. Whereas in the fourth row the concern would be, “I am not able to work or earn money, or do my task or duty.” In the fifth row they would say something along the lines of, “I am not able to pursue my skill or talent”.
So you have to see where the pathology is affecting the person, at what row. For example in the third row they say, “My legs are so badly affected that I cannot even feed myself and my husband has to feed me.”
Developing The Ability To Express
Along with the development of identity and choice children also develop the ability to express themselves. In the initial stages, since they are not even sure what they feel or what they want, they find it difficult to communicate. Later in the row their ability to communicate develops. In patients it can be seen as difficulty in expressing themselves and difficulty in communication or being communicative. It can also be seen as desire for communication and disappointment when such communication is missing.
The important issues of Row 3 can be summarized as follows:
- Developing an identity
- Developing a sense of right and wrong
- Doing things for themselves
- Developing the ability to express
- Care and nourishment
- Becoming self conscious
- Conscious about appearance
- Wanting to be different
- Lost and direction
- Attachment to specific things
- Growth and development
- Fear of natural things, unknown, unfamiliar, left alone in dark unknown place, etc.
- Issue of complete and implicit trust, understanding, familiarity, comfort, communication, and confidence
*Note: The name of the patient has been changed for privacy reasons and content of the case has been edited for clarity, brevity and publishing purposes
Swati* came to me on February 23, 2004. The main complaint was her irregular menstrual cycle, which first began at the age of 30. At the time of our consultation, she was 32-years-old and also had associated complaints such as hair loss, pain in the breasts and mood swings before menses. Her menses came every 20-21 days and also was very heavy in the first two days and then stopped or was very light for the last two days. Another major issue that was troubling her was weakness and tiredness.
She described her weakness as a drained feeling. She could do many things in the past, but now, she not able to do them. She says that her stamina and strength have decreased a lot. She is unable to play with her young daughter and does not feel like doing anything on most days, just lying down and relaxing.
She is a computer engineer, doing 3D simulations for her husband who is an architect. She used to be able to work for 10 hours, and now she can only work for 6. Swati explained that she already took a one-year break to look after her daughter, although she had work commitments. She explained that in her job, one must be upgraded in the new software that comes out every few months. She has to continually upgrade and because it has to be done fast, and she is feeling exhausted.
Presently, she is feeling that she is not giving enough time to her daughter or to her career, causing a feeling that she is lacking somewhere. For some reason, she doesn’t have any more energy, mentally or physically. She describes it as a feeling of being bogged down, which to her means mentally tied down, caught up in the situation, where she is deadlocked where there is no middle path. She feels that she must choose either her home or her career.
When asked about this, she described an image of being on a deserted island, where there is no way out and no help is available. She was all on her own. At the same time, the island was beautiful and she could do whatever she wanted there if she was alone. She had to get away from there but she did not want to. She had to go from one point to another, and there was a wide gap in between. She described, “It is like the gap in between what you want to be and what you don’t want to be. It is an empty space that you are not able to fill. It is like being on the island and doing what you want to versus being another place and doing what others want you to. It is too wide a gap to bridge”. When asked about the feeling, she explained it was one of helplessness.
When asked about her dreams, she told us that there was a situation where her husband’s grandmother was sick and on her deathbed. All she wanted was for her son to come to her before she could die. Swati described that because of this situation she would dream of it. She often dreams of a grandmother meeting her grandson, who was waiting for him to come before she passed on. When he meets the grandmother, she is very happy and passes peacefully. When Swati has this dream, she feels the deep pain and suffering of the grandmother.
When we inquired about her interests and hobbies she explained that she loved traveling, music, cooking, painting and sports. She also used to play a lot of outdoor games like throwball and volleyball. These things make her feel alive, she gets more oxygen going in and feels lighter and active. Her heart is pumping and the energy is exhausted but you still feel alive physically and mentally. She loves travelling and seeing different places and things, she likes to see different people’s differences.
When we asked Swati about her relationship, she explained that she had an arranged marriage and her husband was a person who would get along with everyone and not have any difference of opinion. She felt this was not right of him to do, but he would think one way and she would think another way. Swati explained that he was even dominated by his mother and this was not right either. She feels that you cannot force another person to do something that he does not want to do. She believes everyone needs that space. How much can she bend or blend in?
In her own childhood, Swati was brought up very independently. She explained that she made her own decisions. In her situation currently, Swati’s mother-in-law tells her what to do and always tells her what she is doing is wrong, and to do it like her. This makes Swati very upset because her husband does not support her, she wants to do things her way and not like her mother-in-law. In the first two years of marriage it was very difficult because she had to cope with this alone, and she became indifferent towards her family. She had no help and had to bring up her daughter on her own. Her own family was so far away and she had no relatives close by. She did not have any support emotionally or anyone to talk to.
We asked her to tell about this and she explained that when someone is alone, they have to solve or handle problems all by themselves. Generally, Swati feels comfortable this this, but sometimes she cannot find a solution or reason out. Otherwise, she is quite comfortable alone.
Swati explains that she has not many friends because she is new to this place, but she is also not open about herself. She had many friends in her old city because she was a good listener. Everyone would come to her with their sob stories and ask her what they should do. She wasn’t open about herself but she helped them instead.
She craves watermelon and any juices, like sweet lime juice. She is not particular and likes to try everything. She is very fond of chocolates and ice creams, but is overall health conscious and eats salads and sprouts. She likes the cold weather.
We asked again about her weakness and Swati explained that it is quite prominent. The doctors have given her iron preparations but it is not a permanent solution. She wants to find a permanent solution instead of being in the middle.
In this case, the first thing that we have at our fingertips to examine is the Level of Experience of our patient.
Each of us can experience reality on one of seven levels:
Level 1: Name – 6C
Level 2: Fact – 30C
Level 3: Emotions/Feeling – 200C
Level 4: Delusions/Imaginations – 1M
Level 5: Sensation/Experience – 10M
Level 6: Energy – 50M
Level 7: Witnessing – CM
The pattern of that experience actually defines who the individual is at the deepest level. Finding the level of experience is critical because it indicates the potency that one needs.
Firstly and very interestingly, our patient did not get her menses until age 30 and therefore we can conclude that she had a delay in normal development. She also experiences weakness, both physically and mentally.
With this information only, we can ascertain that the level of the patient is part of the psycho-neuro-endocrine-immune system Axis (PNEI). The mind, the nerves and the hormones and the immune system all function in association with each other. This level corresponds with the level of Delusions/Imaginations (Level 4). It therefore becomes important to study Swati’s mind, her nervous sensitivity, her hormonal functioning and finally, all the characteristic symptoms.
Swati gives emotional symptoms as well as Sensation symptoms. Yet, she lives mostly on the level of delusion. Her whole situation is living out her delusion, or one can say, living her sensation on the delusion level, therefore we gave her 1M potency.
In order to understand the patient further, we can use the Sensation Approach and decide which Kingdom she falls in. Is her experience a competition-survival issue, a sensitivity issue, or a structure issue?
In our patient, we can see that the mental and physical symptom is weakness. In the past, she could do more work and her stamina would be high. Now, she is unable to do what she used to do and her stamina is decreasing. This indicates a loss of function and strength, pointing towards the Mineral Kingdom.
The patient also experiences a lacking, where she feels she is forced to choose between her career and her daughter. Swati feels that there is no middle path or help from anyone, and she is on her own. Here, the issues are of choice and identity, representing the Third Row in the Periodic Table of Elements. For Swati, the question that seems to arise is, “how much should I bend or blend in?”. There are also elements of, “I need the space” and “I need the choice”.
Swati described her beautiful delusion of being on a deserted island, all alone, where she can do whatever she wants. When alone, she is unsupported but can do whatever she wants. She has the space and choice. She described a wide gap between being on the island and doing what you want to, versus being another place, doing what others want you to and you do not have any choice. Here, we again see the elements of choice and needing space coming up.
Here, we can understand what column and remedy the patient fits into. Phosphorus has a clear identity, he knows who he is and what he wants. Yet he is not independent enough to assert and insist on his choice.
Also, in the situation with her husband, mother-in-law and current family life, there is an element of independence, doing what is right or wrong, support and of choice. In Swati’s case, the issues here are of choice and of support. The development of the individual’s identity comes through choice and the development of independence is in terms of taking care of oneself is also an issue.
We can also see the Phos element when Swati spoke about her friends. The Phosphorus individual must be sensitive to the feelings of others to win their affection. The effort of Phosphorus therefore is in the direction of caring for others, being sympathetic to them. These patients feel anxiety of other people, like Swati did in the dream of her grandmother.
Like our patient, Phosphorus individuals want an identity apart from what they have been given, their key words are: “I am not you”.
We see many key rubrics of Phos that match our patient:
- CONFUSION OF MIND: identity, as to his: duality, sensation of
- HELPLESSNESS, weakness, weariness, with
- DELUSIONS, IMAGINATIONS: ISLAND, IS ON A DISTANT, ENJOYING THE TRANQUILLITY
- INDIFFERENCE, apathy: family, to his
- WEAKNESS; menses, during
- WEAKNESS; women, in
- MENSES, delayed in girls, first menses
- MENSES, irregular
- FOOD and drinks, juicy things, desires
- FOOD and drinks, ice cream, desires
One can recognize the tubercular miasm in Phosphorus; high energy with emaciation and weakness. Here, the patient has to adapt and do things continually and fast (upgrading her work) because the circumstances change, she feels there is no way out and deadlocked resulting in weakness and exhaustion, mentally and physically. She also enjoys being active, travelling and seeing different places, people and having new experiences. She has to adapt quickly to change in circumstances concerning one’s choice and identity or else one’s identity will be finished.
We gave Swati a single dose of Phosphorus 1M.
Phosphorus From The Materia Medica
- Great weakness and prostration: with nervous debility and trembling; of whole body; weakness and weariness from loss of vital fluids
- A weak, empty, all – gone sensation in head, chest, stomach and entire abdomen.
- Apathetic; unwilling to talk; answers slowly; moves sluggishly
- Longs for: cold food and drink; juicy, refreshing things; ice – cream amel. gastric pains.
- Great debility of the nervous system.
- In the late stage of brain or nervous troubles, calling for this remedy, we find the patient losing all ambition to do anything; either mental or physical labor is shunned. There is great indifference. He cannot think with his usual clearness; cannot apply himself to study or mental operations, ideas come slowly or not at all.
- Bleed easily
Swati has been following up with us since 2004. The last follow-up we conducted was by telephone in January 2017. In summary, there has been a vast improvement in all of her reported symptoms over the past 12-13 years.
After one year of treatment all of her main complaints (tiredness, weakness, irregular menses, hairfall) were 40% better. Her menses was on a 30-day cycle, and the weakness had reduced but not gone. She still felt like something was stopping her from doing what she wanted to do, she felt stuck, like she was alone, a sense of emptiness came up again. In the second year of treatment, her symptoms continued to improve. She now was giving herself space to do what she wanted to do and started painting and writing when she was alone. She felt that this could finally bridge the gap, which gave her strength and made her feel free. She felt a oneness with herself and she felt as if she could enjoy and be happy with herself.
For the first couple of years, she was given a dose of Phosphorus 1M monthly. After two years of great progress and results, she was advised to stop the medicine and return after 6 months.
She would follow-up once or twice a year for the next four years, always with similar reports: her symptoms are better. But the best thing that occurred over these years was her mood swings had reduced and she was getting along with her mother-in-law. She handled situations much better and feels more relaxed. At these follow-ups we would either prescribe Phos 1M or placebo.
In 2010, she came to us with a return of her old symptoms. Her breast pain and heaviness had increased, her hair loss was an issue, and she was feeling weakness and constipation. We prescribed for her Phos 200 and with this she improved in a few months. At the end of 2010, we advised her again to stop the medicine for 3-6 months as she was almost fully better.
She followed-up again with us in 2013 and reported she was getting migraines. We re-dosed the remedy in 200 potency, and this symptom also continued to improve slowly and gradually over 6 months.
In 2014, she presented with some acidity issues and a return of her menses ever 3 weeks. We prescribed Phos 1M and this symptom also resolved over time.
In 2015, she came to see us because she had a fever and cough. However, she reported a cheerful mood and a good status for in her original complaints (the irregular menses cycle weakness).
We called her again recently to get an update and she reports that all is well and she will be returning for a visit later in the year.
About the Author
Dr Rajan Sankaran is an internationally renowned as a clear thinker and is known for his path breaking concepts. He has been awarded a Fellowship of the Society of Homeopaths (U.K.). He has authored numerous books including: The Synergy in Homoeopathy, The Spirit of Homoeopathy, The Substance of Homoeopathy, The Soul of Remedies, and many others. He has also created a Homeopathic case taking and analysis software called Vital Quest.
‘the other song’ is a medical education centre, a meeting point for different schools of thought, which puts good health and well being at the core of an academic culture dedicated to complete patient care and learning through in-depth live case-taking experience by a team of 35 doctors headed by Dr Rajan Sankaran.