Clinical Cases

I Feel High and Dry

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A case, describing in detail, the method of case analysis and the selection of the remedy.

Name : Mr. H. R. V. Age : 39 years. A primary school teacher.

Chief Complaints

Location

O. D. P.

Sensation & PathologyModalities

A. F., < & >

Concomitants
Respiratory system since 6 years

Lasts for 3/4 days Origin – sudden

R.nostril—L..nostril

Sneezing

Coryza:  watery, thin.

Then

Cough; followed by scanty expectoration,

whitish, sticky,

difficult to get

detached.

Then

breathlessness

Sensation of

obstruction

< Change of        weather2

<  Night

<  Midnight

after3

<  2 a.m.- 4

a.m.3

<  Dust3

<  Cereals2

< Talking

from2

Lachrymation

Sleep disturbance

Mouth breathing

Bodyache

Wants to take rest.

Dullness++

Thirst increased,

large quantity at long  intervals

Humming like noise in ears.

Heaviness of head

Hoarseness of voice

Soreness in throat

Palpitation

Mind : since 1½ yearsDepressionA.F. heart

attack 5 years back

<  any mental or physical complaints

Patient as a person

Appearance: Obesity, tilting to. Short. Hair: Baldness+

Perspiration: Scanty

Physical examination: BP- 140/90 mm Hg. Pulse- 78/min.

CVS-nil ECG- Old infarct.

Desires: Meat3, Sweets2, Milk2, Warm Food4, Salty things3

Eliminations: H/O constipation with unsatisfying, hard stools

Urine: Burning since three months, < after micturition.

Sleep  –

Duration – 10 p.m. – 6 a.m. Unrefreshing.

Sleeps on left side. Awakes around 2 a.m.

Dreams –

Fearful, daily routine. I am wandering anywhere in jungle. I am running and someone is behind me. About tigers and I am alone in a jungle. Lonely feeling and I have fear of being lonely.

I have these dreams since 1989 almost daily.

Life – space

I feel nervous, I don’t want to work, I prefer to take rest or to sleep. Usually when I am nervous, I watch T.V. especially cricket matches and news channel. But in the last 8-10 months, I don’t have interest even in those things. 7-8 months ago my wife moved to her mother’s house to give birth and for getting help with the newborn. She was complaining of weakness and was insisting to go to her parents. So I gave her permission to do so. I stayed at my home alone with my daughter.

I miss my wife a lot. I feel nervous, I feel alone and sad. In the last few days I am not able even to read because I have no interest in that. Since the last 10 months, I have no interest in my work too.

(Body language: Downcast eyes. Slumped and slouched body posture. Sighing.)

One day I felt formication in my legs. While I was standing I felt giddiness – that was at 2:30 a.m. I went to consult a specialist; he took me to an emergency room. I was diagnosed for heart attack at that time.

My wife and I quarrel about a lot of things. We don’t have sexual relations. She doesn’t like it. I feel very bad about that. I have a lot of sexual desire but my wife never responds. It is like this since the beginning of relations (marriage). Previously we used to have contact after 2-3 months. Now there are no contacts at all. This is the only reason of my sadness and also of my illness.

My wife never takes care of my family and me. She always wants to go to her mother’s house. If I resist, she creates a quarrel. She insults me. She is very straight forward.

I had no other choice except adjustment. (Holding the head in hands in exasperation. Closing the eyes. Clearing throat often.)

Whenever my wife refuses me I become restless. I am unable to sleep even when I feel the need to sleep. I have spent n number of sleepless nights. I become angry but keep quiet. I am never angry on students. Sometimes I have high sexual desire but I have to suppress it because when she refuses me, I feel insulted. I don’t talk about this with anybody.

Now our quarrels are reduced because I am taking the submissive role. When my voice increases during quarrel, she becomes angrier. She is haughty, irritable and after this we do not talk for 10-15 days. That’s why most of the time I am taking the submissive role. I adjust a lot. I hate her mother and father because they never think of me; they never send her home early when she is there. That’s why I have a strong hostile feeling against my in-laws. (Growling voice tones. The exaggerated use of pointers).

During university studies in the boy’s hostel, I used to feel alone and I always used to become homesick.

I have three brothers & one sister. In my family my father was the sole earning member. It was not sufficient for us and many of my demands were not fulfilled like good clothes etc. Hence I used to feel inferior compared to others. When I got a job these feelings were reduced. Now I feel lonely and very sad. Whenever I feel alone I read spiritual books or listen to some CDs of spiritual masters. I like them. I am quite emotional, especially about my family members. With my children, I don’t have any problem. They are very close to my parents also. My wife and my parents are not on good terms. She doesn’t talk properly to them. They are not talking with each other since 13 years. So my parents do not want to visit us. I feel very bad that I can’t give them back what they did for me.

I don’t have a lot of friends. I like solitude, but I feel alone. I can mix easily in group. But if I am alone, I feel sad. Since my illness I have become more anxious. I failed once in a college and became very sad and nervous. I started feeling aloofness since then. Again I failed in diploma Engineering course. So I left it and went to learn teaching course. After completion I got a job immediately. But these failures still torment me.

In college I had lot of friends. After failure I started avoiding them because now they have good jobs and they are rich. I feel left behind, I feel inferior.

I want everything perfect. Sometimes this is the reason of quarrel between me and my wife. I am fastidious; I want all neat and tidy. If things are not at the right place, I become irritable.

Everybody knows that I am a good teacher, I am never angry at students. I used to be angry in the past. I feel disturbed, when any work has not been done on time. I am anxious about students and completion of their syllabus. I am impatient, I do things in a hurried way like my work, walking, eating, etc. I am hurried since childhood.

In a nut-shell

  • Aloneness feeling, but desires to be alone
  • Inferiority complex
  • Anxiety, health about
  • Neglected, rejected feeling
  • Anger, suppressed
  • Sex desire, suppressed
  • Fastidious
  • Hurried
  • Submissive
  • Sensitive, criticism to
  • High sexual desire
  • Hatred feeling towards wife and her parents
  • Sadness

Reactions: Physical Factors

Weather – < damp wet weather = bodyache, laziness

Air – cold air < coryza. Fanning < bodyache.

Bath – warm water throughout year.

Covering – winter – 1blanket + 1light sheet

Uncovering in summer

History (Personal, Past & Family)

P/H-1986 – Typhoid

1997 Myocardial infarction

F/H- Mother – Rheumatism

Father – Hypertension

Dispositions

  • Alone feeling
  • Suppressed sexual desire
  • Anger in
  • Insulted feeling if sexual desire is not satisfied
  • Introvert
  • Unsatisfied demands in the childhood
  • Feeling of low self esteem
  • Caring about children
  • Rejected feeling
  • Alone feeling but desires solitude
  • Hurried in acts
  • Fastidious
  • Hatred feeling towards wife and her parents
  • High sexual desire
  • Anxiety health about

EVOLUTION AS A PERSON



Miasm

Dominant Miasm is sycosis as the patient is suffering with chronic coryza with nasal obstruction, and h/o constipation. The past history of myocardial infarction was a syphilitic activity of episodic type. Patient recovered from it and is now in the sycotic miasmatic influence.

Analysis of data

Here we find a sensitive person who is feeling a lot of lowness since childhood. Poverty during childhood appears to be a factor in the personality development. He used to compare himself with the rich people and used to identify himself as the inferior one. The seeds of depression and loneliness have been sowed during this tender age.

After marriage there is a gap between his expectations as a human being and dispositions of his wife. The wife is unable to fulfill his needs and she has not the stuff of caring for this individual. It seems she has attachment towards the parents and she is still even after many years of marriage in the same parental nest. She has not become an integral part of husband’s house. Moreover, she has no interest in sex. Wife appears more like a Sepia lady, dry and drab.

There is suppression of emotions in the case and this relates more to sexual type. The temperament is melancholic and the patient takes all this as a rejected feeling coupled with depression. The energy level is poor and he doesn’t find interest in day to day activities.

In addition to suppression the patient has anxiety as a disposition. There is insecurity and it is related to whether wife will return back from her parental home. The chronic unfavorable atmosphere finally took its toll to allow the patient to develop a myocardial infarction.

This case is a vivid example of symbolic language of heart as an organ related to love as an emotion.

Rubrics

Forsaken

Mind, reserved

Mind, anxiety, health about

Mind, company, aversion to

Male, sexual desire suppressed, ailments from

Coryza, < night

Desires-meat

Desires-warm food

Desires -salty food

Repertorization

Aur 10/4, calc 16/8, phos 18/8, ph-ac 12/6, puls 16/5, nat-m 13/6, nit-ac 13/6, arg-n 11/5, ars 14/5, carb-v 11/6, sil 8/6, nux-v 9/5, staph 14/6, con 10/4, lyc 16/6, mag-c 8/4, nat-c 12/5, plat 11/4, aur-m-n 15/6, cycl 10/5, germ 10/4

Remedy Selection

Aurum, Phos-ac., Staph. and Con. come close for differentiation. Aur. goes for self-aggrandizement and renders two responses – the depressive melancholy culminating into suicidal disposition and the violent anger. Although the patient has melancholy, it has not evolved into the Aur. state. Further, Aur. is not yielding in disposition. In view of myocardial infarction in the past and chronic depressive state, Aur. has to be kept as a standby in this case. Phos-ac. ranks high owing to indifference, sexual desire increased and ailments from suppressed sexual desire. Our patient also says, “in the last few days I am not able even to read because I have no interest in that. Since the last 10 months, I have no interest in my work too.” But note that he says about having no interest in a depressed emotional tone, but he is doing his job with interest. The drive has not been hampered to the extent of the state of Phos-ac. “Wants nothing and cares for nothing” is the evolution in Phos-ac. over the years of torture. Further Phos-ac. has no yielding disposition. Staph. gets projected due to humiliated feeling and chronic anger. The identification of love with sex is a strong feature of Staph. But there are two types of Staph. states – the sweet Staph. that looks like Puls. and the wild Staph. that resembles Acid-nit. Staph. can’t remain in mild and yielding state for long and becomes wild. There is want of self-control and violent outbursts of passion. This patient has coverage of ‘ailments from’ of Staph., but the behavioral response over the long period with wife, essentially, of sheepishness, is not the cup of tea of Staph.

The chief issue is the sexual sphere. The whole case revolves around sex and patient’s identification of pleasure is sex. But behind sex, there is a strong need of intimacy and behind it is a strong feeling of being rejected. This issue combined with the following data shifts the case towards Conium.

  • High sexual desire.
  • Ailments from suppressed sexual desire.
  • Rejected feeling.
  • Suppressed anger.
  • Sheepishness.
  • Anxiety as a disposition.
  • Hurried.
  • Ego-atrophic response.
  • A strong action on the heart.

(From “A Select Materia Medica” by P. Ishwardas Tarkas and Ajit Kulkarni).

Conium was also confirmed through body language. The patient presented himself constantly in fugitive mode, in the initial interview and in the subsequent follow-up interviews too. This was surely a sign of sheepishness which was the main feature of this case and of the Conium state.

(The fugitive mode reflects the disinterest, apathy, rejection or depression. Many melancholic, depressed and anxious patients manifest the gestures of fugitive mode. The fugitive mode is a good parameter of assessing low energy level of the patient).

Cues of the fugitive mode

  • Glancing often at watch or other objects
  • Sighing
  • Yawning
  • Fiddling with pen, eyeglasses, paper etc.
  • Doodling
  • Shifting weight
  • Rolling the eyes
  • Stretching
  • Picking at fingernails or imaginary lint
  • Pointing the body away from the other person
  • Low tone of voice
  • Relaxed, slumped or slackened body
  • Downcast eyes
  • Inattention to hygiene and dress
  • Becoming silent
  • Coughing nervously
  • Clearing the throat
  • Wringing the hands

(From Ajit Kulkarni’s book on “Body Language and homoeopathy”)

Posology

This is a psycho-somatic case. The dominant miasm is sycotic. But we must focus in this case on maintaining cause. This is related to his sexual sphere. Further, there are ample qualified mental symptoms in this case.

Although the patient showed myocardial infarction in the past we must remember that this is a past injury incidence in his life and no more has the system shown any syphilitic pathologies after the incidence. Hence it is not necessary to select a potency of low type.

Hence, Conium has been selected as a constitutional remedy to be given as a single dose in 1M potency.

Follow-up

The patient was followed up for over two years.

He was prescribed 3 doses of Conium 1M over a period of two years as and when necessary.

He showed improvement at all levels. All his physical complaints were reduced a lot. Previously he used to get up at night due to respiratory complaints and there were sleep disturbances as well. They improved after the remedy. The recurrent cough spasms (were they due to attention seeking?) reduced gradually. There was appreciable change in his slouching body posture. His low tone voice was changed and we were able to see that he now talks in a more decisive way.

His sensitivity towards his wife was reduced gradually. In the subsequent follow-ups, he told me that he doesn’t bother much about his wife’s behavior. “I have my own life and I must find my own way of joy.”

About the author

Ajit Kulkarni

Ajit Kulkarni

Dr. Ajit Kulkarni M.D. (Hom.) is a veteran homoeopath, an academician and a famed international teacher, known for his innovative ideas. Dr. Kulkarni has presented 70 international seminars around the world and more than 100 seminars in India. He is Director of the Homeopathic Research Institute, Pune, India. He is a prolific writer on homeopathy and his works include co-authoring Absolute Homeopathic Materia Medica, and authoring “Law of Similars in Medical Science”, “Homeopathic Posology”
“Kali Family and Its Relations”, Body Language and Homeopathy”, as well as 22 books in the Russian language. He received the Award of Excellence in Homoeopathy (2011), from the Post-Graduate Association of India, the ‘Homoeo-Ratna’ award (2014) from ‘Homoeo-Friends’, India, and the “Life Achievement Award”, (2018), from the Sontara Bhansali Charitable trust and Indian Homeopahic Forum.” Dr. Kulkarni has represented homeopathy on Bulgarian TV and gave an address at Kachare Classic, Erandwane, near New Karnataka High school, Pune. Visit him at his website: Website: www.ajitkulkarni.com E-mail ID: [email protected]

6 Comments

  • Congrats Dr. Kulkarni for this interesting article. Although it is lengthy yet its contents are highly expressive for the doctors and students to learn the technique to write histories and reach the similimum. The decision of high potency is also appreciable.
    Dr. Shiv Dua

  • Dear Sir,

    Whenever, wherever, I read article by Dr. Kulkarni, I am so passionate that do not rest till its completion. A great humanitarian, cosmopolitan, classical homeopath he is ! He has deep rooted and vast knowledge & experience of homoeopathy. I really bow down my head before his teachings and learning . We are fortunate to have such kind of classical doctor.

    with regards,

    S.N.Ojha

  • detail case taking approach is needed to bring the essential constitution of the patients is reflected in your case analysis.

  • Reading Dr. Kulkarni’s cases, the way he glides analysing the patients situation homeopathicaly and humanly is very instructive.

    It is a brilliant Conium case.

    Read also the Coffea case and the MM of Tarkas which Dr. Kulkarni put together. It is a one of a kind Materia Medica.

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