A young girl of 24 yrs wanted a remedy desperately. She thought she would go bald as her hair was falling badly and had thinned out alarmingly over the last 6 months. This was September 2003.
She also had acne especially on her forehead during menses. Her menstrual cycles were regular. The other chronic problem was recurrent colds – sneezing, coryza – yellowish green discharge, worse especially in the morning, though in general she always felt better lying in bed. She was generally chilly, preferred warm drinks and was aggravated by cold things. These symptoms always started 2 days before menses.
Concomitant to this, she always felt tired once this cold started and was very irritable during that time. I also confirmed that whenever she had any physical symptom, even motion sickness, the first thing she would do to feel better was to lie in bed for a few hours – and she would recover nearly 50% after that. So this was an important general modality which had to be covered by the remedy.
Her past history included Jaundice 12 years back, Sinusitis (recurrent) 10 years back, and a chronic skin condition in childhood which caused mosquito bites to become easily suppurated and left large dark scars on healing. Her dreams were of friends and family.
I generally move to investigate the mental state only once the patient has given me all the details of their physical modalities and I have confirmed the most characteristic ones. This is because the average Indian finds it difficult to talk about their state of mind. They do not believe it is really relevant, and even if they were willing to cooperate, most people are hardly even aware of their feelings and thoughts, enough to give them any significance. Often one then needs to ask open-ended questions to draw out information that may be helpful. Since this girl was a relative, I did not need other relevant information about family relationships, etc.
What she told me spontaneously was that she was very forgetful. And that she suffered from “anxiety attacks” very often, especially in the last 5-6 years.
I asked what this feeling was exactly:
“I panic that something bad is going to happen – like an inner dread. I can’t define any particular circumstance or situation that frightens me though. But I don’t think this is important for my hair fall“.
I had to ask her to tell me a little more about her nature and things that would trouble her easily:
After a lot of thought, she said that what would upset her badly was if she had a fight with a close friend or with her mother.
What was her response to this situation?
“I would feel better if I sat close to my mother or close friend. Or otherwise I would just go lie down for a while till I felt better.
I get easily irritated at small things very often. And I feel very jealous when my parents show more interest in other people, especially when I’m not feeling well. I feel they do not give me what I want because they don’t care for me enough. Instead they are more concerned about everyone else. When they do this I feel sad and I am very irritable with them.”
She is the only child after 8 miscarriages, and is a most wanted child! Her parents also play a responsible role in the extended large family of siblings who live close to each other.
By this time, I had repertorized the following rubrics as there was not much more to go on and she really felt she has told me everything there was to know!
NOSE; DISCHARGE; yellowish green (K333, G281)
NOSE; DISCHARGE; General; morning <(K329, G277)
GENERALITIES; LYING; amel.; bed, in (K1372, SII-357, G1132)
GENERALITIES; MENSES; agg.; before (K1373, SII-366, G1133)
MIND; IRRITABILITY; trifles, from (SI-672) (Anger; tendency; tendency; trifles, from)
3 remedies were evident: Pulsatilla and Manganum covered all rubrics. Silica seemed a distinct possibility. In many instances these three remedies need to be differentiated with each other to decide which the similimum is for the patient.
I looked up Phatak for Manganum, and sure enough here is what it said in the mental state:
Constant moaning or groaning. Weak and nervous. Anxiety and fear. Involuntary laughing and weeping. Anxiety and fear when moving in the room better lying down. Anxiety as if something bad is going to happen. Sad, weeping, silent. All the mental conditions are better lying down. Does not enjoy joyous music, but immediately affected by the saddest.
Then starts, what I call, the fun part of case taking: Confirming the remedy!
I asked her about her response to music.
She said she hated listening to sad music. Also when she was angry with someone, she would recall everything that person did to her ever since she knew them and that would fuel her anger because she still felt bitter about those episodes. She tried very hard not to think of these things and was remorseful that she was like this!
Then I asked her to tell me about her studies and her career to see what I could find there. She is an architect by profession and has just begun her career assisting a senior architect.
She said that a college education does not equip one to deal with the real world. So she has always felt the need to be constantly learning in order to deal with situations that she faced. She would rather ask and learn, even though anyone would ridicule her for seeming naÃ¯ve. She would not mind the criticism as it helped her learn to cope in the world better.
From childhood, she always liked learning NEW things. Nothing could restrict her from studying something if she felt convinced of what she wanted to do. She never felt fearful when she began on new projects of learning.
Her response to the remedy was dramatic. She was surprised, because she has taken homeopathy right from childhood but had never felt so good before! I had her take only 2 split doses of 30C 2 days before her menses, when she felt her cold symptoms start. She did this for 3 consecutive months. The cold resolved easily in a few hours. The hair quality began to improve and the hair fall stopped. Also she did not have “anxiety episodes” anymore. Within 6 months, she’s got back her lovely hair again. Of course I also advised her how to look after it.
After 5 months on treatment, she wrote me a frantic mail that she was desperately in need of some medicine again – her acne was not there, but instead there were small pus boils on her face and on her back and they were painful. Please advise her on what to take soon, otherwise she would have to start antibiotics to get well. She has already begun to apply a pimple cream on her face. Obviously this was her old childhood symptom of (suppressed) suppurated mosquito bites coming up again and all it needed was time to heal and resolve. I asked her not to do anything about it and just wait for a month.
The boils cleared up in 2 weeks and she had been relatively well till I heard from her a couple of months back. She said the cold had recurred before her last period. “Please suggest a homeopathic medicine, but please don’t give me something that will make the boils come up again. I’m going for a cousin’s wedding in London as bridesmaid. I don’t want to walk down the aisle behind her with boils on my face!” She had 2 split doses of Manganum 30C again and has been fine since then.
Here in this case, the entry point in perceiving the remedy was through the characteristic general modalities, concomitants and characteristic particulars. In cases where there is not very much to go on with the mental characteristics it is important that case taking and case analysis fit in with the type of case that presents itself. Knowing various facets of a remedy and understanding the mental state, always gives one greater confirmation that one has chosen a SIMILIMUM which is constitutional. Hence I find it unnecessary to be picky about how one perceives the similimum.
Jan Scholten describes Manganum in the 7th Stage of the Periodic table as an element of the Iron Series. This stage always seeks to learn extra skills and enjoys learning these new skills and new ways of thinking. In order to refine their knowledge they like to have feedback and hence do not mind criticism if they can learn from it. They always feel they will be capable of doing their task if they are properly trained. So once they have acquired the skill they do not lack confidence. This clearly differentiates the remedy from Silica and even Pulsatilla where this is not even an issue.
I now knew that there was only a small chance of her needing any other remedy than Manganum. It seemed to be her constitutional remedy and it would be a question of time before she was completely cured.